Tag: pubmed

Front Oncol. 2022 Oct 18;12:998159. doi: 10.3389/fonc.2022.998159. eCollection 2022.

ABSTRACT

BACKGROUND: Indocyanine green (ICG) imaging-guided lymphadenectomy has been introduced in gastric cancer (GC) surgery and its clinical value remains controversial. The aim of this study is to evaluate the efficacy of ICG fluorescence imaging-guided lymphadenectomy in radical gastrectomy for GC.

METHODS: Studies comparing lymphadenectomy in radical gastrectomy between use and non-use of ICG fluorescence imaging up to July 2022 were systematically searched from PubMed, Web of Science, Embase and Cochrane Library. A pooled analysis was performed for the available data regarding the baseline features, the number of retrieved lymph nodes (LNs), the number of metastatic LNs and surgical outcomes as well as oncological outcomes. RevMan 5.3 software was used to perform the statistical analysis. Quality evaluation and publication bias were also conducted.

RESULTS: 17 studies with a total of 2274 patients (1186 in the ICG group and 1088 in the control group) undergoing radical gastrectomy and lymphadenectomy were included. In the pooled analysis, the baseline features were basically comparable. However, the number of retrieved LNs in the ICG group was significantly more than that in the control group (MD = 7.41, 95% CI = 5.44 to 9.37, P < 0.00001). No significant difference was found between the ICG and control groups in terms of metastatic LNs (MD = -0.05, 95% CI = -0.25 to 0.16, P = 0.65). In addition, the use of ICG could reduce intraoperative blood loss (MD = -17.96, 95% CI = -27.89 to -8.04, P = 0.0004) without increasing operative time (P = 0.14) and overall complications (P = 0.10). In terms of oncological outcomes, the use of ICG could reduce the overall recurrence rate (OR = 0.50; 95% CI 0.28-0.89; P = 0.02) but could not increase the 2-year overall survival rate (OR = 1.25; 95% CI 0.72-2.18; P = 0.43).

CONCLUSIONS: ICG imaging-guided lymphadenectomy is valuable for complete LNs dissection in radical gastrectomy for GC. However, more high-quality randomized controlled trials are needed to confirm this benefit.

PMID:36330471 | PMC:PMC9623049 | DOI:10.3389/fonc.2022.998159

Kidney Res Clin Pract. 2022 Sep 14. doi: 10.23876/j.krcp.21.254. Online ahead of print.

ABSTRACT

BACKGROUND: The diagnosis of peritonitis among peritoneal dialysis (PD) patients is based on clinical presentation, dialysis effluent white blood cell (WBC) count, and dialysis effluent culture. Peritoneal fluid WBC count is very important in the initial diagnosis of peritonitis. The purpose of this work was to determine the optimal number of peritoneal WBCs with different clinical presentations at admission to define PD-related peritonitis.

METHODS: Medical records of chronic PD patients who underwent work-up for suspected peritonitis between 2008 and 2019 were reviewed retrospectively. Results of all peritoneal WBC count tests during this period were collected. Clinical manifestations and follow-up analysis of each peritoneal WBC count were performed.

RESULTS: The peritoneal WBC count cutoff of 100/μL recommended by International Society for Peritoneal Dialysis provided specificity of only 35%. Increasing peritoneal WBC count cutoff to 150, 200, and 250/μL provided sensitivity around 98% and gradually increasing specificity. The chi-square automatic interaction detector model of statistical analysis determined that peritoneal WBC count below 230/μL combined with absence of inflammatory markers (fever, increased C-reactive protein) ruled out peritonitis with 99.8% sensitivity. Peritoneal fluid WBC count cutoff of 230/μL provided specificity of 89% and good positive and negative likelihood scores of 8.3 and 0.03, respectively. Peritoneal fluid polymorphonuclear count has lower discriminating ability for peritonitis compared to peritoneal fluid WBC count.

CONCLUSION: Increasing peritoneal fluid WBC count cutoff to 230/μL in suspected PD-related peritonitis could improve specificity without compromising the sensitivity of the test.

PMID:36328997 | DOI:10.23876/j.krcp.21.254

Kidney Res Clin Pract. 2022 Sep 13. doi: 10.23876/j.krcp.22.039. Online ahead of print.

ABSTRACT

BACKGROUND: Many countries have their own hemodialysis (HD) quality assurance programs and star rating systems for HD facilities. However, the effects of HD quality assurance programs on patient mortality are not well understood. Therefore, in the present study, the effects of the Korean HD facility star rating on patient mortality in maintenance HD patients were evaluated.

METHODS: This longitudinal, observational cohort study included 35,271 patients receiving HD treatment from 741 facilities. The fivestar ratings of HD facilities were determined based on HD quality assessment data from 2015, which includes 12 quality measures in structural, procedural, and outcome domains. The patients were grouped into high (three to five stars) and low (one or two stars) groups based on HD facility star rating. Cox proportional hazards model was used to evaluate the effects of star rating on patient mortality during the mean follow-up duration of 3 years.

RESULTS: The patient ratio between high and low HD facility star rating groups was 82.0% vs. 18.0%. The patients in the low star rating group showed lower single-pool Kt/V and higher calcium and phosphorus levels compared with subjects in the high star rating group. After adjusting for sociodemographic and clinical parameters, the HD facility star rating independently increased the mortality risk (hazard ratio, 1.11; 95% confidence interval, 1.04-1.18; p = 0.002).

CONCLUSION: The HD facilities with low star rating showed higher patient mortality.

PMID:36328993 | DOI:10.23876/j.krcp.22.039

Kidney Res Clin Pract. 2022 Sep 8. doi: 10.23876/j.krcp.21.294. Online ahead of print.

ABSTRACT

BACKGROUND: Several studies have reported that depression is prevalent in patients with diabetes or chronic kidney disease. However, the relationship between weight changes and the risk of depression has not been elucidated in patients with diabetic kidney disease (DKD).

METHODS: From the Korean National Health Insurance Service database, we selected 67,866 patients with DKD and body weight data from two consecutive health examinations with a 2-year interval between 2009 and 2012. Weight change over 2 years was categorized into five groups: ≥-10%, <-10% to ≥-5%, <-5% to <5%, ≥5% to <10%, and ≥10%. The occurrence of depression was monitored via the codes of International Statistical Classification of Diseases, 10th revision through the end of 2018.

RESULTS: During the 5.24-year follow-up, 17,023 patients with DKD developed depression. Weight change and the risk of depression had a U-shaped relationship: patients with ≥-10% weight change (hazard ratio [HR], 1.12) and those with ≥10% weight change (HR, 1.11) showed higher HRs for depression than those with <-5% to <5% weight change, even after adjusting for several confounding factors. In the subgroup analyses, the risk of depression tended to increase as weight gain or weight loss increased in all subgroups.

CONCLUSION: Both weight loss and weight gain increased the risk of depression in patients with DKD.

PMID:36328992 | DOI:10.23876/j.krcp.21.294

Kidney Res Clin Pract. 2022 Oct 25. doi: 10.23876/j.krcp.22.059. Online ahead of print.

ABSTRACT

BACKGROUND: T50 is a novel serum-based marker that assesses the propensity for calcification in serum. A shorter T50 indicates a greater propensity to calcify and has been associated with cardiovascular disease and mortality among patients with chronic kidney disease. The factors associated with T50 and the correlation between T50 and bone mineral density (BMD) are unknown in hemodialysis (HD) patients.

METHODS: This cross-sectional study included 184 patients undergoing HD. Individuals were grouped into tertiles of T50 to compare the demographic and disease indicators of the tertiles. Linear regression was used to evaluate the association between T50 and hip and spinal BMD in a multivariate model.

RESULTS: Mineral and inflammatory parameters, including serum phosphate (r = -0.156, p = 0.04), albumin (r = 0.289, p < 0.001), and high-sensitivity C-reactive protein (r = -0.224, p = 0.003) levels, were associated with T50. We found a weak association between T50 and BMD in the total hip area in the unadjusted model (β = 0.030, p = 0.04) but did not find a statistically significant association with the total hip (β = 0.017, p = 0.12), femoral neck (β = -0.001, p = 0.96), or spinal BMD (β = 0.019, p = 0.33) in multivariable-adjusted models.

CONCLUSION: T50 was moderately associated with mineral and inflammatory parameters but did not conclusively establish an association with BMD in HD patients. Broad-scale future studies should determine whether T50 can provide insights into BMD beyond traditional risk factors in this population.

PMID:36328988 | DOI:10.23876/j.krcp.22.059

Epidemiol Infect. 2022 Nov 4:1-23. doi: 10.1017/S0950268822001698. Online ahead of print.

NO ABSTRACT

PMID:36328978 | DOI:10.1017/S0950268822001698

Rural Remote Health. 2022 Nov;22(4):6957. doi: 10.22605/RRH6957. Epub 2022 Nov 3.

ABSTRACT

INTRODUCTION: Social support has been found in many contexts, and in urban Ecuador, to be protective of health, particularly in the context of disaster. Fewer studies have explored the presence and impact of social support in rural Ecuador. This study engages a rural community in Ecuador to examine the general levels of social support, differences in social support based on different demographic groupings and relationships among social support and health outcomes and protective health behaviors.

METHODS: A cross-sectional design was used to survey 416 people in a rural Ecuadorian community that had recently experienced an earthquake. Spanish-language versions of the Multidimensional Scale of Perceived Social Support and the Interpersonal Support Evaluation List-12 were applied, as well as questions about demographics and risk reduction behaviors. Body mass index, blood pressure, and cholesterol and blood sugar levels were assessed. Analysis of variance assessed differences in social support among demographic groupings, risk reduction behaviors, and health outcomes.

RESULTS: Levels of social support were moderate. Few statistically significant (ie p<0.05) differences in amount of social support received or in sources of social support were found. Men, people 80 years or older, divorced or widowed people, and people living in peripheral areas received less social support than women, people of all other ages, married/cohabitating people, and people living within the village, respectively. Effect sizes of these differences were small. No relationship between social support and health outcomes were found, and few were found for risk reduction factors.

CONCLUSION: These findings indicate that social support may function differently in rural Ecuador than in urban contexts. Those promoting social support in rural communities may wish to focus on community-level, not individual-level, interventions. Limitations of applying an assessment of social support from urban Ecuadorian contexts to rural Ecuadorian contexts are discussed.

PMID:36328965 | DOI:10.22605/RRH6957

Phys Sportsmed. 2022 Nov 3. doi: 10.1080/00913847.2022.2143247. Online ahead of print.

ABSTRACT

OBJECTIVES: To present one of the first descriptive case series of pediatric and adolescent lower extremity stress injuries, their management and outcomes in athletes and non-athletes.

METHODS: : IRB-approved retrospective study included patients under 18 years at a tertiary children’s hospital who were diagnosed with a lower extremity stress fracture/reaction. Demographic data, mechanism of injury, physical exam, radiographic findings, treatment, & outcomes were collected. Descriptive statistical analysis was conducted.

RESULTS: 97 patients with stress injuries on clinical exam and on radiographs or MRI were included. Average age when diagnosed was 11.7 years (range 1.1-18 years) and the most common injuries were to the tibia (n=33, 28.4%) and the least common involved were the cuneiforms (n=4, 3.4%). Patients under the age of 14 were more likely to experience cuboid and calcaneal stress injuries (mean age 5.5 and 8.3 years respectively). 19 patients (19.6%) had high-risk stress fractures, with the average age of 14.9 years versus 11.6 for those with low risk (p-value=0.01) and return to activity time being 15 weeks compared to 10.5 (p-value=0.027). The most common forms of treatment were controlled ankle motion (CAM) walker boots (58.6%) and physical therapy (PT) (38.1%). Mean Lower Extremity Function Score of the patient population was 73.8, indicating no clinically important difference from full functionality.

CONCLUSION: Lower extremity stress injuries in this cohort were most seen in the tibia, although patients younger than 14 had a high number of cuboid and calcaneal stress injuries. Those with high-risk stress fractures were older and took longer to recover when compared to low-risk injuries. Treatment is commonly conservative, with CAM boots and PT being the most frequently utilized interventions and serving as a successful approach to treatment, with patients returning to activity at an average of 11.4 weeks, which is comparable to similar studies.

PMID:36328959 | DOI:10.1080/00913847.2022.2143247

Int J Immunogenet. 2022 Nov 3. doi: 10.1111/iji.12606. Online ahead of print.

ABSTRACT

Endometriosis is an inflammatory disease characterized by the presence of ectopic endometrial tissue, immune cell dysfunction and abnormal cytokine secretion. In addition to immunological factors, genetic variations that influence endometriosis severity and cytokine expression levels play important roles in the pathogenesis of this disease. Interleukin-12 (IL-12), specifically its p40 subunit encoded by IL-12B gene and the interleukin-12 receptor β1 (IL-12Rβ2) chain of its receptor, as well as interleukin-27 (IL-27) are important in the establishment of endometriosis. So, in this study, we measured IL-12 and IL-27 serum levels and investigated the possible links between IL-12B rs3212227, IL-12Rβ2 rs3790565 and IL-27 rs153109 polymorphisms and the risk of developing endometriosis in a group of Iranian women. In this case-control study, 162 endometriosis patients and 151 healthy women were included and tested for the aforementioned polymorphisms using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The enzyme-linked immunosorbent assay (ELISA) method was also used to measure IL-12 and IL-27 serum levels. Although there was no statistically significant association between the genotypes and alleles of the studied polymorphisms and the development of endometriosis in general, the AA genotype of IL-12B rs3212227 showed a significant association with uterine endometriosis when compared to AC+CC genotypes (p = .04, CI = 0.270-0.988, OR = 0.517). Indeed, the AA genotype of the IL-12B rs3212227 single nucleotide polymorphism (SNP) may be linked with a lower risk of developing uterine endometriosis. There was no significant difference in IL-27 levels between the two studied groups (p = .49), and IL-12 levels were undetectable in both groups. In conclusion, the AA genotype of IL-12B rs3212227 might be associated with a decreased risk of uterine involvement in endometriosis patients.

PMID:36328955 | DOI:10.1111/iji.12606

J Plast Reconstr Aesthet Surg. 2022 Oct 15:S1748-6815(22)00569-1. doi: 10.1016/j.bjps.2022.10.019. Online ahead of print.

ABSTRACT

Anecdotally, female plastic surgeons are disproportionately underrepresented as speakers, moderators, and panelists at national and regional plastic surgery meetings. No studies have attempted to quantify female representation at Plastic Surgery The Meeting (PSTM). The objective of our study is to examine trends in female participation at PSTM. Names of participating plastic surgeons and their conference positions were obtained from PSTM meeting programs between 2015-2020. Conference positions included instructor, lead, lecturer, moderator, panelist, or other. Presentations were grouped as the following: conference/symposium; general session; instructional course; and lab. An automated gender assignment tool (gender-api.com) was used to determine the gender of participants. Descriptive statistics and trend analyses using Cochran-Armitage trend tests were performed. Between 2015-2020, 3,382 individuals (602 females, 17.8%) presented at PSTM in one of the instructional or moderating roles. Female presenters at PSTM increased from 60 (12.4%) in 2015, to 155 (26.5%) by 2020. The results for the proportion of females presenting in the general session and the instructional courses were statistically significant (p < .0001; p =.029), demonstrating a positive linear trend in the female proportions over the years. From 2015 to 2020, the proportions of females holding positions as moderators, panelists, and “other” increased significantly (p = .011; p = .011; p < .0001). Although female participation at PSTM has shown substantial growth over the last five years, there still exists a considerable gender imbalance. Notably, females were less likely to hold prominent positions, such as instructors, leads, or lecturers.

PMID:36328946 | DOI:10.1016/j.bjps.2022.10.019