Tag: pubmed

BMC Anesthesiol. 2023 Oct 20;23(1):348. doi: 10.1186/s12871-023-02310-x.

ABSTRACT

BACKGROUND: A simulated education, prior to surgery about postoperative nasal stuffiness and ease of breathing through the mouth may help patients tolerate discomfort after nasal surgery. This study aimed to investigate the effect of preoperative simulated education on immediate postoperative opioid requirements in patients undergoing elective nasal surgery.

METHODS: This randomized controlled trial of 110 patients undergoing nasal surgery randomly allocated patients into either a control (group C) or an education group (group E). One day before surgery, patients in group E were intensively trained to breathe through the mouth by using a nasal clip, with informative explanations about inevitable nasal obstruction and discomfort following surgery. Patients in group C were provided with routine preoperative information. Total intravenous anesthesia (TIVA) with propofol and remifentanil was used for anesthesia. No further opioid was used for analgesia intraoperatively. The primary outcome was index opioid (fentanyl) requirements at the post-anesthesia recovery unit (PACU). Secondary outcomes were emergence agitation, pain scores at the PACU, and postoperative recovery using the Quality of Recovery-15 (QoR15-K).

RESULTS: The rate of opioid use in the PACU was 51.0% in the group E and 39.6% in the group C (p = 0.242). Additional request for analgesics other than index opioid was not different between the groups. Emergence agitation, postoperative pain severity, and QoR15-K scores were comparable between the groups.

CONCLUSION: Preoperative education with simulated mouth breathing in patients undergoing nasal surgery did not reduce opioid requirements.

TRIAL REGISTRATION: KCT0006264; 16/09/2021; Clinical Research Information Services ( https://cris.nih.go.kr ).

PMID:37864142 | DOI:10.1186/s12871-023-02310-x

Cardiol Ther. 2023 Oct 20. doi: 10.1007/s40119-023-00336-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Although ablation of typical atrial flutter (AFL) can be easily achieved with radiofrequency energy (RF), no studies compare the effectiveness of different ablation catheters. Our study aimed to compare the efficacy of various types of ablation catheters in treating typical AFL.

METHODS: We analyzed patients with AFL who underwent RF ablation by a single operator at our institution. Successful ablation was evidenced by a bidirectional conduction block (trans-isthmus conduction time ≥ 130 ms or double potentials ≥ 90 ms). Logistic regression was used to compare success rate and linear regression to compare lesion time.

RESULTS: Out of 222 patients, only six did not meet the success criteria (2.7%). The catheters used were non-irrigated, large-tip, internally irrigated (Chili II Boston Scientific), and externally irrigated (non-force-sensing) catheters (Cool Path, Abbott). An externally irrigated force-sensing catheter (TactiCath, Abbott) was used with > 10 gm of force and (LPLD) setting (30 W- 45 °C- 60 s), and high-power short-duration (HPSD) setting (50 W- 43 °C – 12 s). No complications were encountered. The catheter type had no statistically significant association with ablation success. With the use of externally irrigated catheter with contract force-sensing and HPSD settings, statistically significantly shortening of lesion time was achieved 758.3 s, [CI – 1128.29, – 388.35 s] followed by LPLD by 419.0 s [CI – 808.49, – 29.47 s].

CONCLUSIONS: The typical atrial flutter radiofrequency ablation procedure had a high success rate, which was not influenced by the type of ablation catheter. Contact force ablation catheter and HPSD are associated with shorter total lesion time.

PMID:37864121 | DOI:10.1007/s40119-023-00336-3

Cardiovasc Interv Ther. 2023 Oct 20. doi: 10.1007/s12928-023-00965-4. Online ahead of print.

ABSTRACT

Histopathological examination has revealed that stents on severely calcified plaques were associated with delayed vascular healing. Although atherectomy devices can increase the number of malapposed struts, tissue responses to implanted drug eluting stents in atherectomy patients remain largely unknown. This retrospective observational study included 30 patients who underwent atherectomy and everolimus-eluting stent (EES) deployment for severely calcified coronary lesions (biodegradable polymer EES (BP-EES), n = 15; durable polymer EES (DP-EES), n = 15). Optical coherence tomography was carried out at baseline and follow-up, and struts with acute stent malapposition (ASM) were categorized as struts on modified calcium (mod-Ca), non-modified calcium (non-mod-Ca), or non-calcium (non-Ca). Adequate vascular healing, defined as ASM resolution with neointimal coverage, was compared between the BP-EES and DP-EES groups. Multivariate linear regression analysis using a generalized estimated equation revealed that BP-EES use was associated with significantly better adequate vascular healing compared with DP-EES (odds ratio [OR]: 3.691, 95% confidence interval [CI] 1.175-11.592, P = 0.025). adequate vascular healing was associated with the underlying plaque morphology (mod-Ca vs non-mod-Ca: OR 2.833, 95% CI 1.491-5.384, P = 0.001; non-Ca vs non-mod-Ca: OR 1.248, 95% CI 0.440-3.543, P = 0.677). This study demonstrates that drug-eluting stent selection and calcium modification are possible factors affecting vascular healing of malapposed struts in severely calcified lesions.

PMID:37864118 | DOI:10.1007/s12928-023-00965-4

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023 Oct 20. doi: 10.1007/s00103-023-03788-z. Online ahead of print.

ABSTRACT

BACKGROUND: More than 60 years after the enactment of the first Licensing Regulations for Dentists (ZÄPrO), a new Licensing Regulations for Dentists, the ZApprO, was implemented in 2020. The aims of this study were to evaluate and compare the “Course in Technical Propaedeutics” (TPK) with the course “Dental Propaedeutics with a Focus on Dental Technology” (ZPDT), which are based on different legal foundations.

METHODS: The following parameters were compared after completion of the courses: (1) theoretical and practical knowledge, (2) regular department-internal learner evaluation, and (3) special evaluation of learning conditions by the learners and (4) by the instructors. The theoretical and practical exams and the questionnaires were analyzed in terms of their test-statistical characteristics (difficulty, discrimination index, internal consistency). Group comparisons between TPK and ZPDT were conducted using t‑tests for independent groups.

RESULTS: Significant differences were only detected in the students’ evaluation of their learning conditions, with theoretical and practical knowledge transfer being rated lower in the TPK than in the ZPDT.

DISCUSSION: The comparable results of the knowledge assessments and the regular learner evaluation, triangulated with the comprehensive learner and instructor evaluation, allowed a broad assessment of both courses. The significant differences identified provide opportunities for optimization of the newly implemented ZPDT course.

PMID:37864053 | DOI:10.1007/s00103-023-03788-z

Sci Rep. 2023 Oct 20;13(1):17933. doi: 10.1038/s41598-023-43860-x.

ABSTRACT

According to WHO statistics, breast cancer (BC) disease represents about 2.3 million diagnosed and 685,000 deaths globally. Regarding histological classification of BC, the Estrogen (ER) and Progesterone (PR) receptors negative-expression cancer, named Triple-Negative BC (TNBC), represents the most aggressive type of this disease, making it a challenge for drug discovery. In this context, our research group, applying a well-established Virtual Screening (VS) protocol, in addition to docking and molecular dynamics simulations studies, yielded two ligands identified as 6 and 37 which were chemically synthesized and evaluated on MCF-7 and MDA-MB-231 cancer cell lines. Strikingly, 37 assayed on MDA-MB-231 (a TNBC cell model) depicted an outstanding value of 18.66 μM much lower than 65.67 μM yielded by Gossypol Bcl-2 inhibitor whose main disadvantage is to produce multiple toxic effects. Highlighted above, enforce the premise of the computational tools to find new therapeutic options against the most aggressive forms of breast cancer, as the results herein showed.

PMID:37863936 | DOI:10.1038/s41598-023-43860-x

Nat Commun. 2023 Oct 20;14(1):6667. doi: 10.1038/s41467-023-42367-3.

ABSTRACT

Traditional total mesorectal excision (TME) for rectal cancer requires partial resection of Denonvilliers’ fascia (DVF), which leads to injury of pelvic autonomic nerve and postoperative urogenital dysfunction. It is still unclear whether entire preservation of DVF has better urogenital function and comparable oncological outcomes. We conducted a randomized clinical trial to investigate the superiority of DVF preservation over resection (NCT02435758). A total of 262 eligible male patients were randomized to Laparoscopic TME with DVF preservation (L-DVF-P group) or resection procedures (L-DVF-R group), 242 of which completed the study, including 122 cases of L-DVF-P and 120 cases of L-DVF-R. The initial analysis of the primary outcomes of urogenital function has previously been reported. Here, the updated analysis and secondary outcomes including 3-year survival (OS), 3-year disease-free survival (DFS), and recurrence rate between the two groups are reported for the modified intention-to-treat analysis, revealing no significant difference. In conclusion, L-DVF-P reveals better postoperative urogenital function and comparable oncological outcomes for male rectal cancer patients.

PMID:37863878 | DOI:10.1038/s41467-023-42367-3

Environ Sci Pollut Res Int. 2023 Oct 21. doi: 10.1007/s11356-023-30077-8. Online ahead of print.

ABSTRACT

Safe drinking water sources are crucial for human health. Consequently, water quality management, including continuous monitoring of water quality and algae at sources, is critical to ensure the availability of safe water for local residents. This study aimed to construct statistical prediction models considering probability distributions relevant to cyanophyte cell counts and compare their prediction performance. In this study, water quality parameters at Juam Lake and Tamjin Lake, representative water sources in the Yeongsan and Seomjin rivers, South Korea, were investigated. We used a water quality monitoring network, algae alert system, and hydraulic and hydrological data measured every 7 days from January 2017 to December 2022 from the Water Environment Information System of the National Institute of Environmental Research. Using data for 2017-2021 as a training set and data for 2022 as a test set, the performances of seven models were compared for predicting cyanophyte cell counts. Environmental factors associated with algae in water sources were observed based on the monitoring data, and a prediction model appropriate for the cyanophyte distribution was generated, which also included the risk of toxicity. The extreme gradient boosting with the random forest model had the best predictive performance for cyanophyte cell counts. The study results are expected to facilitate water quality management in various water systems, including water sources.

PMID:37863853 | DOI:10.1007/s11356-023-30077-8

J Pediatr Nurs. 2023 Oct 18:S0882-5963(23)00286-5. doi: 10.1016/j.pedn.2023.10.009. Online ahead of print.

ABSTRACT

AIM: This study was performed with the aim of investigating the correlation and the effective factors between internet addiction, obesity risk and sleep disorders in children.

MATERIAL AND METHOD: The sample for this descriptive and relational search type study comprised the parents of 458 children aged 7-10 years attending a primary school in Turkey. Data were collected the Parent and Child Descriptive Information Form, Family Child Internet Addiction Scale (FCIAS), Family Nutrition and Physical Activity Tool (FNPAT) and Sleep Disturbance Scale for Children (SDSC).

RESULTS: There was a statistically significant, positive and weak correlation between the Body Mass Index (BMI) and FCIAS scores of children (p < 0.001). There was a statistically significant, negative and very weak correlation between FNPAT total score with FCIAS total score (p = 0.007). There was a statistically significant, positive and moderate correlation between SDSC total score and FCIAS total score (p < 0.001). According to regression analysis, FCIAS was a determinant at significant levels for FNPAT and SDSC (p < 0.05).

CONCLUSION: There was a relationship between internet addiction and obesity and sleep quality. As a result of the study, the increase in internet use was determined to negatively impact physical activity and health nutrition behavior, and to increase sleep disturbance.

IMPLICATIONS FOR PRACTICE: Pediatric nurses are recommended to give counseling to children and families about preventing obesity and the risk of sleep disorders by identifying children at risk in terms of internet addiction in the early period.

PMID:37863788 | DOI:10.1016/j.pedn.2023.10.009

Int Immunopharmacol. 2023 Oct 18;124(Pt B):111060. doi: 10.1016/j.intimp.2023.111060. Online ahead of print.

ABSTRACT

Tuberculosis poses a significant threat to human health due to the lack of an effective vaccine. Although promising progress has been made in the development of tuberculosis vaccines, new vaccines that broaden the antigenic repertoire need to be developed to eradicate this illness. In this study, we used Mycobacterium tuberculosis ferritin BfrB and heat-shock protein GrpE to construct a novel multi-antigenic fusion protein, BfrB-GrpE (BG). BG protein was stably overexpressed in the soluble form in Escherichia coli at a high yield and purified via sequential salt fractionation and hydrophobic chromatography. Purified BG was emulsified in an adjuvant containing N, N’-dimethyl-N, N’-dioctadecylammonium bromide, polyinosinic-polycytidylic acid, and cholesterol (DPC) to construct the BG/DPC vaccine, which stimulated strong cellular and humoral immune responses in mice. Moreover, combination of BG with our previously developed vaccine, Mtb10.4-HspX (MH), containing antigens from both the proliferating and dormant stages, significantly reduced the bacterial counts in the lungs and spleens of M. tuberculosis-infected mice. Importantly, mice that received BG + MH/DPC after M. tuberculosis H37Rv infection survived slightly better (100% survival) than those that received the BCG vaccine (80% survival), although the difference was not statistically significant. Our findings can aid in the selection of antigens and optimization of vaccination regimens to improve the efficacy of tuberculosis vaccines.

PMID:37862738 | DOI:10.1016/j.intimp.2023.111060

J Neurosurg Spine. 2023 Oct 20:1-8. doi: 10.3171/2023.8.SPINE23450. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to compare and contrast lumbar bone quality and osteoporosis/osteopenia screening results via dual-energy x-ray absorptiometry (DEXA), CT, and MRI.

METHODS: A consecutive series of 426 candidates screened for lumbar disc replacement over a 5-year period beginning in 2018 was reviewed. Patients with a preoperative lumbar spine DEXA scan and a CT and/or MRI scan were included. The primary outcome measures included the bone mineral density (BMD) and osteoporosis or osteopenia classification from DEXA scans, Hounsfield units (HUs) for CT, and vertebral bone quality (VBQ) assessment for MRI. Patients were included if they had a DEXA scan within 1 year of an MRI or CT scan. DEXA BMD scores from composite or level-by-level reports were recorded. Asynchronous MRI and CT measurements were conducted using PACS. Interrater and intrarater reliability scores were generated for both CT and MRI measurements and ranged from 1.000 for MRI L1-4 scans to 0.683 for MRI VBQ.

RESULTS: All 3 types of scans were statistically significantly correlated with one another; however, CT was more strongly correlated with the lumbar DEXA value (r = 0.439, p < 0.001). The correlation between MRI VBQ and DEXA was -0.103, (p < 0.045). The CT level-by-level measurements correlate with the corresponding level-by-level DEXA BMD values (correlation ranging from 0.531 to 0.289, p < 0.001 to p = 0.007). CT HU values were more strongly related to osteoporosis/osteopenia classification based on DEXA T-scores than were MRI VBQ values. Receiver operating characteristic analyses found that the area under the curve was 0.817 for CT and 0.539 for MRI.

CONCLUSIONS: These results demonstrate that CT HUs more closely correlate to DEXA scores than MRI VBQ in this population of patients undergoing surgery for symptomatic disc degeneration. Thus, CT may be an alternative to DEXA for assessing VBQ in this population.

PMID:37862719 | DOI:10.3171/2023.8.SPINE23450