Tag: pubmed

Zhonghua Nan Ke Xue. 2022 Dec;28(12):1089-1095.

ABSTRACT

OBJECTIVE: To investigate the value of combined detection of tPSA, fPSA and peripheral blood neutrophil count (Neut#) in the diagnosis of PCa.

METHODS: This study included 238 cases of PCa, 328 cases of BPH and 303 normal men as healthy controls present at our hospital for medical or physical examination from August 2018 to December 2021. We detected the levels of serum tPSA and fPSA and Neut# of the subjects, and assessed the value of the combined detection in the diagnosis of PCa using logistic regression analysis, ROC curves, Pearman correlation analysis and nonparametric test.

RESULTS: There were significant differences in the tPSA and fPSA levels and Neut# between any two of the PCa, BPH and healthy control groups (P < 0.05). The index N of the combined detection of tPSA, fPSA and Neut# showed an evidently higher diagnostic value than that of any single-item detection. The Gleason scores of the subjects were correlated positively with the tPSA and fPSA levels and index N, with the correlation coefficients of 0.184, 0.245 and 0.166 respectively, P < 0.05), and negatively with the Neut#, with the correlation coefficient of －0.168, P < 0.05). Statistically significant differences were observed in the tPSA and fPSA levels, Neut# and index N in those with different Gleason scores (P < 0.05).

CONCLUSION: The combined detection of tPSA, fPSA and Neut# improves the diagnosis of PCa and can be applied clinically as an auxiliary diagnostic method.

PMID:37846628

Zhonghua Nan Ke Xue. 2022 Dec;28(12):1080-1088.

ABSTRACT

OBJECTIVE: To analyze the clinicopathological and imaging features of primary squamous cell carcinoma of the prostate (PSCC) and provide some new ideas for exploring suitable diagnostic and treatment strategies for the disease.

METHODS: We retrieved and analyzed the studies published at home and abroad between 1976 and 2022 and reviewed the clinical data of our Department of Medical Oncology on 70 cases of PSCC, as well as the survival statistics of another 58 cases.

RESULTS: Clinically, PSCC was characterized by normal PSA and increased squamous cell carcinoma antigen. Overall survival of the patients was evidently correlated to the PSCC stage, chemotherapy and radiotherapy, significantly longer in those treated by chemotherapy with platinum than in those without platinum (P = 0.001). Univariate analysis suggested that the overall survival of the patients was significantly correlated with chemotherapy.

CONCLUSION: PSCC has a poor prognosis. A deep insight into the clinical characteristics of PSCC is important for timely detection and suitable treatment of the malignancy.

PMID:37846627

J Ultrasound Med. 2023 Oct 17. doi: 10.1002/jum.16352. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the biomechanical properties of porcine oral tissues with in vivo ultrasonography and to compare the difference between oral alveolar mucosa and gingival tissue concerning compressional and tensile mechanical strain.

MATERIALS AND METHODS: Sinclair minipigs (6 females and 4 males, 6 to 18 months of age) were anesthetized for ultrasonography. In vivo high-frequency tissue harmonic ultrasound (12/24 MHz) cine-loops were obtained while inducing mechanical tissue stress (0 to 1 N). Post-processing strain analysis was performed in a cardiac speckle tracking software (EchoInsight®). Region of interest (ROI) was placed for gingival and alveolar mucosa tissues for longitudinal (compressional) and tensile strain analyses. A calibrated gel pad was employed to determine the absolute force (pressure) for the measured tissue strain response function. The resulting elasticity data was statistically analyzed using custom Matlab scripts.

RESULTS: In total, 38 sonography cine-loops around the third premolars were included in the investigation. The longitudinal strain of alveolar mucosa ${\epsilon }_{\mathrm{AM}}^L$ was found to be significantly (P < .05) larger than that of gingiva ${\epsilon }_G^L$ . Across the measured force range, ${\epsilon }_{\mathrm{AM}}^L$ ~ 1.7 × ${\epsilon }_G^L$ . Significant differences between alveolar mucosa and gingiva tissues were found for all forces. The tensile strain of the alveolar mucosa ${\epsilon }_{\mathrm{AM}}^T$ was found to be ~2 × ${\epsilon }_G^T$ (on the epithelial surface of the gingiva). Both were statistically significantly different for forces exceeding ~0.08 N. At depth, that is, 500 and 1000 μm below the epithelial surface, the gingiva was found to have less ability to stretch contrary to the alveolar mucosa. Gingival tissue at 500 μm depth has significantly less tensile strain than at its surface and more than at 1000 μm depth. In contrast, the tensile strain of alveolar mucosa is largely independent of depth.

CONCLUSION: Ultrasonography can reveal significant differences in oral alveolar mucosal and gingival elastic properties, such as compressional and tensile strain. Under minute forces equivalent to 10 to 40 g, these differences can be observed. As dental ultrasound is a chairside, and noninvasive modality, obtaining real-time images might soon find clinical utility as a new diagnostic tool for the objective and quantitative assessment of periodontal and peri-implant soft tissues in clinical and research realms. As ultrasound is a safe modality with no known bioeffects, longitudinal monitoring of areas of concern would be particularly attractive.

PMID:37846622 | DOI:10.1002/jum.16352

J Gerontol B Psychol Sci Soc Sci. 2023 Oct 17:gbad154. doi: 10.1093/geronb/gbad154. Online ahead of print.

ABSTRACT

OBJECTIVES: The experience of being sandwiched between support obligations towards both aging parents and adult offspring is likely to become more common and more relevant. We aim at assessing the effect of demographic and social sandwiching on the psychological health and subjective well-being of individuals experiencing these transitions, and to what extent, these effects vary across welfare regimes.

METHODS: Data are from 63,585 individuals aged 50-75 participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). We estimate within- and between-individual effects using hybrid regression models to predict depressive symptoms (EURO-D) and subjective well-being (CASP).

RESULTS: Among demographically sandwiched women, transitioning into social sandwiching and into supporting only parents were associated with a moderate but statistically significant increase in EURO-D and decline in CASP scores. The same association is not observed for male respondents. The pattern of variation among women living in countries characterized by different welfare regimes suggests that social sandwiching is less detrimental in the Nordic regimes than in other welfare contexts.

DISCUSSION: Results from the between-individuals part of the model indicate that there is a selection into social sandwiching of more healthy individuals into support roles. However, the within-individuals part of the model indicates that the transition into social sandwiching has a detrimental effect on women’s (but not men’s) psychological health and well-being. The explanations for this gendered effect of social sandwiching may be found in the “invisible” support provided by women and the gendered division of specific care tasks.

PMID:37846581 | DOI:10.1093/geronb/gbad154

JBI Evid Implement. 2023 Oct 17. doi: 10.1097/XEB.0000000000000385. Online ahead of print.

ABSTRACT

INTRODUCTION: Ward rounds are crucial inpatient activities during which patients’ conditions are discussed. Team-based models such as nurse-led ward rounds (NLWRs) have been conceptualized and trialled, with positive results.

METHODS: An evidence-based quality improvement pilot project to introduce NLWRs was implemented at a cardiovascular medical-surgical unit in a Singapore tertiary hospital. The JBI Evidence Implementation Framework was used to guide the project. The evidence-based NLWR format incorporated stakeholder feedback on NLWR frequency, preparation, coordination, and content. Baseline and 6-month post-implementation audits were carried out.

RESULTS: The 4 audit criteria improved from baseline, reaching 100% compliance for criteria 1, 2, and 3 associated with interprofessional communication and collaboration. An improvement from baseline (30% to 46.7%) was also observed for criterion 4 on patient involvement during medical ward rounds. Moreover, there were improvements in clinical outcome data such as patient hospitalization length, “best medical therapy” rates, and inpatient complications. A statistically significant improvement in nurses’ confidence to lead discussions during medical rounds was also observed (p = 0.026).

CONCLUSIONS: This project promoted greater compliance with NLWR criteria through audit and feedback cycles and the contextualization of implementation strategies. A well-supported program that prepares nurses for interprofessional communication also improves nurses’ confidence in team communication, bolstering their ability to provide high-quality patient care.

PMID:37846554 | DOI:10.1097/XEB.0000000000000385

Turk Neurosurg. 2023 Aug 18. doi: 10.5137/1019-5149.JTN.43674-23.1. Online ahead of print.

ABSTRACT

AIM: The pterional approach is a common procedure in neurosurgery but it has a broad degree of complications including temporal hollowing. The most of the patients who had temporal hollowing after pterional craniotomy have phychological, physical and social problems in rest of their lives. The purpose of this study is to investigate effect of osteoplastic pterional craniotomy on temporal hollowing and its sequelas.

MATERIAL AND METHODS: 97 patients who had pterional craniotomy for aneurysm surgery were analysed retrospectively. 63 of them were conventional pterional approach and 34 of them were osteoplastic pterional approach. Temporal muscle volume was calculated on postoperative 6th month CT bilaterally and differences between conventional pterional and osteoplastic approach were compared.

RESULTS: 97 patients, 45 of whom were female and 52 of whom were male, were included in the study. The mean age of these patients was 50.37 years. Of the patients in the conventional group, 31 were female and 32 were male. Of the patients in the osteoplastic group, 14 were female and 20 were male. The left and right temporal muscle volume difference is not statistically meaningful in osteoplastic approach group while the temporal muscle volume is slightly decreased in conventional pterional approach group when compared the non-operated side.

CONCLUSION: This study shows the osteoplastic pterional approach is superior to conventional pterional approach to keep muscle volume and function. Patients who underwent osteoplastic craniotomy demonstrated higher levels of satisfaction with their facial appearance compared to those who underwent craniotomy using the conventional pterional approach.

PMID:37846540 | DOI:10.5137/1019-5149.JTN.43674-23.1

Turk Neurosurg. 2023 Apr 12. doi: 10.5137/1019-5149.JTN.43003-22.3. Online ahead of print.

ABSTRACT

AIM: Carotid stenosis (CS) is one of the modifiable risk factors for stroke. We aimed to compare the postprocedural cerebral diffusion-weighted imaging (DWI) findings in cases of CS-related carotid plaques in terms of plaque morphology, degree of stenosis, and the use of a distal protection filter. We also used DWI to assess the asymptomatic cerebral embolism rates during carotid artery stending (CAS) operations performed for noncalcified versus calcified carotid plaques.

MATERIAL AND METHODS: Our study included 99 patients admitted to the Ankara City Hospital Stroke Center in 2022. All of our patients have been evaluated and scheduled for CAS as a result of a decision made by the council. Cases of stenosis of 50% in symptomatic patients and 70% in asymptomatic patients were included. The patients were grouped according to their Doppler ultrasonography results. All of the patients underwent DWI within the first 24 hours after the procedure, and then two groups of patients were compared.

RESULTS: A statistically significant difference was found between the distributions of the presence of silent micro-infarcts on DWI in terms of plaque characteristics (p 0.001). In the patients with normal DWI findings, the percentage of calcified plaques was 38.7%, while the percentages of hypoechoic plaques, plaques with low echogenicity, and ulcerated plaques were 91.3%, 85.7%, and 78.8%, respectively. The rates of calcified plaques and ulcerated plaques differed in the group of patients with silent micro-infarcts. The rate of silent micro-infarcts was 61.3% in the patients with calcified plaques, 8.7% in those with hypoechoic plaques, 14.3% in those with low-echogenicity plaques, and 21.2% in those with ulcerated plaques.

CONCLUSION: The study found that carotid stents implanted in calcified and ulcerated plaques had a higher correlation with the presence of periprocedural asymptomatic ipsilateral DWI findings than those implanted in hypoechoic plaques and low-echogenicity plaques.

PMID:37846536 | DOI:10.5137/1019-5149.JTN.43003-22.3

Turk Neurosurg. 2023 Feb 14. doi: 10.5137/1019-5149.JTN.43115-22.1. Online ahead of print.

ABSTRACT

AIM: Anterior cervical discectomy and fusion (ACDF) is a common spine procedure for cervical spinal cord decompression and treatment. In recent years, the incidence of obesity and public health awareness of the deleterious effects of obesity on surgical outcomes has increased. This study investigates the impact of obesity on ACDF postoperative morbidity and mortality.

MATERIAL AND METHODS: The American College of Surgeons’ National Surgical Quality Improvement Project (NSQIP) files from 2006 to 2019 were queried for all patients who underwent an ACDF. Fisher exact tests were used in analyzing univariate differences in preoperative comorbidities and postoperative morbidity and mortality between patients with and without obesity (BMI ≥ 30 kg/m2). Results with a p value 0.05 were considered statistically significant. Multivariable logistic regression models were used in determining the independent impact of obesity on ACDF postoperative morbidity and mortality. A p value 0.017 was required for multivariate statistical significance.

RESULTS: There were 96,882 patients who underwent an ACDF from 2006 to 2019 found. 53.77% had non-obese BMI. Patients had statistically significant differences in most perioperative comorbidities and postoperative outcomes on univariate analysis. On multivariate analysis, patients with obesity has decreased adjusted odds of wound infections (aOR = 0.7208, CI 0.574-0.9075, p = 0.0053), pulmonary events (aOR = 0.7939, CI 0.6903-0.9129, p = 0.0012), sepsis (aOR = 0.5670, CI 0.4359-0.7374, p = 2.32E-05), transfusion requirements (aOR = 0.5396, CI 0.4498-0.6473, p = 3.04E-11), return to operating room (aOR = 0.7537, CI 0.6727-0.8447, p = 1.17E-06), and length of stay 10 days (aOR = 0.7061, CI 0.6438-0.7744, p = 1.49E-13).

CONCLUSION: Obesity is a protective factor toward ACDF postoperative complications. Obesity as a marker of patient selection criteria for ACDF procedures should not be used by spine surgeons.

PMID:37846533 | DOI:10.5137/1019-5149.JTN.43115-22.1

Hum Reprod. 2023 Oct 16:dead210. doi: 10.1093/humrep/dead210. Online ahead of print.

ABSTRACT

STUDY QUESTION: Can emergency vitrification protect embryos and oocytes during natural disasters or other events that prevent normal practice to achieve satisfactory embryonic development and clinical outcomes at a later time?

SUMMARY ANSWER: Emergency vitrification of oocytes and Day 0-Day 5 (D0-D5) embryos during disasters is a safe and effective protective measure.

WHAT IS KNOWN ALREADY: When some destructive events such as floods, earthquakes, tsunamis, and other accidents occur, emergency vitrification in embryo laboratories to protect human embryos, oocytes, and sperm is one of the important measures of an IVF emergency plan. However, there are few detailed reports on emergency vitrification in a state of disaster, especially about oocytes and D0 zygotes. Therefore, the effectiveness and safety of emergency vitrification of oocytes and D0-D5 embryos in disaster states are still unclear.

STUDY DESIGN, SIZE, DURATION: A retrospective study was made in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2018 to November 2022. The record rainstorms in Zhengzhou, China, caused severe flooding, traffic disruptions, and power outages. From 17:30, 20 July 2021 to 17:30, 21 July 2021, 1246 oocytes and D0-D5 embryos of 155 patients were vitrified whilst the laboratory had only an emergency power supply.

PARTICIPANTS/MATERIALS, SETTING, METHODS: As of 21 December 2021, 1149 emergency vitrified oocytes and D0-D5 embryos of 124 patients underwent frozen-thawed embryo transfer (FET). They were divided into the following four groups according to the days of embryo culture in vitro: oocyte group, Day 0-Day 1 (D0-D1) group, Day 2-Day 3 (D2-D3) group, and Day 4-Day 5 (D4-D5) group. Control groups for each were selected from fresh cycle patients who underwent IVF/ICSI from January 2018 to October 2021. Control and emergency vitrification patients were matched on criteria that included age, fertilization method, days of embryonic development, and number and grade of transferred embryos. A total of 493 control patients were randomly selected from the eligible patients and matched with the emergency vitrification groups in a ratio of 4:1. The results of assisted reproduction and follow-up of pregnancy were analyzed. The embryonic development, clinical outcomes, and birth outcomes in each group were statistically analyzed.

MAIN RESULTS AND THE ROLE OF CHANCE: A significant difference was observed in fertilization rate (81% versus 72%, P = 0.022) between the oocyte group and the control group. Significant differences were also observed in the monozygotic twin pregnancy rate (10% versus 0%, P = 0.038) and ectopic pregnancy rate (5% versus 0%, P = 0.039) between the D0-D1 group and the control group. No significant differences (P > 0.05) were observed between vitrified oocytes/D0-D1 embryos/D2-D3 embryos and the control group on the number of high-quality embryos (3.17 ± 3.00 versus 3.84 ± 3.01, P = 0.346; 5.04 ± 3.66 versus 4.56 ± 2.87, P = 0.346; 4.85 ± 5.36 versus 5.04 ± 4.64, P = 0.839), the number of usable blastocysts (1.22 ± 1.78 versus 1.21 ± 2.03, P = 0.981; 2.16 ± 2.26 versus 1.55 ± 2.08, P = 0.090; 2.82 ± 3.23 versus 2.58 ± 3.32, P = 0.706), clinical pregnancy rate (56% versus 57%, P = 0.915; 55% versus 55%, P = 1.000; 40% versus 50%, P = 0.488), miscarriage rate (30% versus 15%, P = 0.496; 5% versus 11%, P = 0.678; 17% versus 20%, P = 1.000), and live birth rate (39% versus 49%, P = 0.460; 53% versus 50%, P = 0.772; 33% versus 40%, P = 0.635). No significant differences (P > 0.05) were observed between the D4-D5 group and the control group on clinical pregnancy rate (40% versus 55%, P = 0.645), miscarriage rate (0% versus 18%, P = 1.000), and live birth rate (40% versus 45%, P = 1.000).

LIMITATIONS, REASONS FOR CAUTION: The retrospective study design is a limitation. The timing and extent of natural disasters are unpredictable, so the sample size of vitrified oocytes, zygotes, and embryos is beyond experimental control.

WIDER IMPLICATIONS OF THE FINDINGS: This study is the first study analyzing embryonic development, clinical outcomes, and birth outcomes of large samples of oocytes, D0 zygotes, and D1-D5 embryos after emergency vitrification under the disaster conditions. The results show that emergency vitrification is a safe and effective protective measure applicable to oocytes and D0-D5 embryos. The embryology laboratories need to be equipped with an emergency uninterrupted power supply capable of delivering for 6-8 h at full load.

STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the National Natural Science Foundation of China (grant 81871206). The authors declare that they have no conflicts of interest. All authors have completed the ICMJE Disclosure form.

TRIAL REGISTRATION NUMBER: N/A.

PMID:37846525 | DOI:10.1093/humrep/dead210

Nicotine Tob Res. 2023 Oct 17:ntad202. doi: 10.1093/ntr/ntad202. Online ahead of print.

ABSTRACT

INTRODUCTION: Secondhand smoke (SHS) exposure during pregnancy is linked to adverse birth outcomes, such as low birth weight and preterm birth. While questionnaires are commonly used to assess SHS exposure, their ability to capture true exposure can vary, making it difficult for researchers to harmonize SHS measures. This study aimed to compare self-reported SHS exposure with measurements of airborne SHS in personal samples of pregnant women.

METHODS: SHS was measured on 48-hour integrated personal PM2.5 Teflon filters collected from 204 pregnant women, and self-reported SHS exposure measures were obtained via questionnaires. Descriptive statistics were calculated for airborne SHS measures, and analysis of variance tests assessed group differences in airborne SHS concentrations by self-reported SHS exposure.

RESULTS: Participants were 81% Hispanic, with a mean (SD) age of 28.2 (6.0) years. Geometric mean (SD) personal airborne SHS concentrations were 0.14 (9.41) µg/m3. Participants reporting lower education have significantly higher airborne SHS exposure (p=0.015). Mean airborne SHS concentrations were greater in those reporting longer duration with windows open in the home. There was no association between airborne SHS and self-reported SHS exposure; however, asking about the number of smokers nearby in the 48-hour monitoring period was most correlated with measured airborne SHS (Two+ smokers: 0.30µg/m3 vs. One: 0.12µg/m3 and Zero: 0.15µg/m3; p=0.230).

CONCLUSIONS: Self-reported SHS exposure was not associated with measured airborne SHS in personal PM2.5 samples. This suggests exposure misclassification using SHS questionnaires and the need for harmonized and validated questions to characterize this exposure in health studies.

IMPLICATIONS: This study adds to the growing body of evidence that measurement error is a major concern in pregnancy research, particularly in studies that rely on self-report questionnaires to measure secondhand smoke (SHS) exposure. The study introduces an alternative method of SHS exposure assessment using objective optical measurements, which can help improve the accuracy of exposure assessment. The findings emphasize the importance of using harmonized and validated SHS questionnaires in pregnancy health research to avoid biased effect estimates. This study can inform future research, practice, and policy development to reduce SHS exposure and its adverse health effects.

PMID:37846518 | DOI:10.1093/ntr/ntad202