Tag: pubmed

J Coll Physicians Surg Pak. 2023 Oct;33(10):1141-1147. doi: 10.29271/jcpsp.2023.10.1141.

ABSTRACT

OBJECTIVE: To make a comparative evaluation of induction chemotherapy (ICT) or adjuvant chemotherapy (ACT) added to standard concurrent chemoradiotherapy in patients diagnosed with locally advanced nasopharyngeal cancer (LANPC) (Stage 3-4a patients, except T3N0).

STUDY DESIGN: Observational study. Place and Duration of the Study: Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey, from April 2009 to June 2021.

METHODOLOGY: Clinicopathological features of adult patients diagnosed with LANPC were recorded from the hospital’s patient registry database. Patients without the medical records were excluded. An assessment of the effectiveness of induction or ACT added to standard definitive chemoradiotherapy (CRT) was performed, and the application cycles were evaluated.

RESULTS: Seventy-four patients (71.6% male, mean age 50.8±11.7) with LANPC were included in the study. There is no statistical difference in progression-free survival (PFS) between patients who applied ICT (before CRT) and ACT (after CRT) (p = 0.61). Female patients and patients aged ≤50 years had better PFS as independent factors (HR=3.82, 95% CI 1.14-12.74, p = 0.029; HR: 1.06 95% CI 1.02-1.10, p = 0.002, respectively). Also, patients aged 50 years and younger and female patients had a statistically longer overall survival (OS) (p = 0.045, and p = 0.012, respectively). While there was statistically no significant difference in PFS according to the number of cycles for EBER-positive patients received adjuvant Cisplatin-5FU (CF); 3 cycles compared to 2 showed a statistically higher OS (p = 0.06, and p = 0.022, respectively). Conclusion: LANPC patients were found to have a positive survival if they were young and females. There was a positive impact on survival of intensified adjuvant CF in EBER-positive nonkeratinising, undifferentiated LANPC patients.

KEY WORDS: Locally advanced nasopharyngeal cancer, EBER, Induction chemotherapy, Adjuvant chemotherapy.

PMID:37804020 | DOI:10.29271/jcpsp.2023.10.1141

J Coll Physicians Surg Pak. 2023 Oct;33(10):1136-1140. doi: 10.29271/jcpsp.2023.10.1136.

ABSTRACT

OBJECTIVE: To determine the performance of lactate clearance to predict prognosis in patients with upper gastrointestinal bleeding (UGIB).

STUDY DESIGN: Observational study. Place and Duration of the Study: Department of Emergency Medicine, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey, from January 2018 to 2022.

METHODOLOGY: This study was conducted with 141 patients with UGIB. Lactate clearance was calculated based on the lactate levels at the time of admission and 6th hour. The primary outcome was survival. The secondary outcomes were the need for intensive care unit, endoscopic intervention, blood transfusion, and length of hospital stay.

RESULTS: The median age of the patients was 71 years and 65.2% were males. In the non-survivor group; systolic blood pressure, diastolic blood pressure, base deficit, delta lactate, and lactate clearance were significantly lower; however, heart rate, baseline lactate and final lactate were significantly higher. The median lactate clearance of survivors and non-survivors were 23.61 and -0.51, respectively (p = 0.002). A unit decrease in lactate clearance increased mortality 1.011-fold. The performance of lactate clearance in predicting mortality was followed as; sensitivity 76.4, specificity 51.4 (AUC = 0.673, p = 0.002), and the cut-off value was 21.51. Lactate clearance was not statistically significant in determining the need for intensive care (p = 0.110), endoscopic intervention (p = 0.152) and blood transfusion (p = 0.266) in UGIB.

CONCLUSION: Lactate clearance was an independent predictor of in-hospital mortality in UGIB. It is thought that the study will guide clinicians in the differentiation of critically-ill patients and an effective treatment planning.

KEY WORDS: Upper gastrointestinal haemorrhage, Lactate, Lactate clearance, Mortality, endoscopy, Blood transfusion, Intensive care.

PMID:37804019 | DOI:10.29271/jcpsp.2023.10.1136

J Coll Physicians Surg Pak. 2023 Oct;33(10):1130-1135. doi: 10.29271/jcpsp.2023.10.1130.

ABSTRACT

OBJECTIVE: To determine the clinical efficacy of ultrasonic irrigation combined with epoxy resin-based sealer in single visit root canal treatment of chronic pulpitis.

STUDY DESIGN: Randomised controlled trial. Place and Duration of the Study: Department of Stomatology, Hefei BOE Hospital, Hefei, China, from March 2019 to December 2021.

METHODOLOGY: Ninety patients with chronic pulpitis, comprising 104 affected teeth, were enrolled. Using a random number table, they were divided into Group A (n = 30, 35 teeth), Group B (n = 30, 35 teeth), and the control group (n = 30, 34 teeth). All underwent single visit root canal treatment. Group A received ultrasonic irrigation followed by sealing with epoxy resin-based paste; Group B had conventional syringe irrigation followed by the same sealing; the control group had syringe irrigation and closure with zinc oxide-eugenol paste. Pain during treatment, posttreatment clinical outcomes, and differences in inflammatory markers (IL-4, IL-6, hs-CRP), and quality of life (QOL) scores pre- and posttreatment over two months were observed.

RESULTS: After the treatment, improvement rates for Groups A, B, and the control group were 91.4%, 65.7%, and 61.7%, respectively. Pain occurrence rates were 6.7%, 30.0%, and 36.7%, respectively. Group A outperformed both Group B and the control group in improvement and pain incidence with statistical significance (p<0.016). Posttreatment, Group A had lower IL-4, IL-6, hs-CRP levels than Groups B and the control group (p<0.05), and had higher scores for sleep, mood, and appetite (p<0.05).

CONCLUSION: Ultrasonic irrigation combined with epoxy resin-based paste yields better results for chronic pulpitis treatment, reducing postoperative pain, mitigating inflammation levels, and enhancing quality of life.

KEY WORDS: Chronic pulpitis, Ultrasonic irrigation, Epoxy resin paste, Root canal treatment, Therapeutic effect.

PMID:37804018 | DOI:10.29271/jcpsp.2023.10.1130

J Coll Physicians Surg Pak. 2023 Oct;33(10):1124-1129. doi: 10.29271/jcpsp.2023.10.1124.

ABSTRACT

OBJECTIVE: To find the frequency of hearing loss in newly diagnosed patients with fibromyalgia (FM), and the factors affecting it.

STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation and Department of Otorhinolaryngology Head and Neck Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Turkey, from March 2021 to November 2022.

METHODOLOGY: Patients with FM and gender/age matched controls were compared with pure-tone audiometric (PTA), and transient evoked otoacoustic emissions (TEOE) tests after standardised otorhinolaryngologic assessment The subjects were questioned for NSAID uptake and scored with ASAS-NSAID score.

RESULTS: There were 33 patients with FM and 32 healthy volunteers. Subjective tinnitus, dizziness, and hearing loss rate in the FM group were 12%, 18%, and 15%, respectively. PTA air and bone conduction studies yielded significant differences between the control and FM group (p<0.05). The statistical difference was pronounced in higher frequencies. TEOE tests showed the FM group had significantly lower scores when compared to the control group at 3000 Hz and 4000 Hz (p<0.05). The median ASAS-NSAID scores were 0 for the control group and 7.78 for the FM group (p <0.001).

CONCLUSION: Patients with FM had high rate of audiometric hearing loss of the sensorineural type. The abnormalities were more prominent in the high frequencies but also present in the low frequencies.

KEY WORDS: Fibromyalgia syndrome, Hearing loss, Audiometry, Ototoxicity, Central sensitisation.

PMID:37804017 | DOI:10.29271/jcpsp.2023.10.1124

J Coll Physicians Surg Pak. 2023 Oct;33(10):1100-1105. doi: 10.29271/jcpsp.2023.10.1100.

ABSTRACT

OBJECTIVE: To investigate the predictive value of the carotid plaque contrast-enhanced ultrasound (CEUS) score and blood homocysteine (HCY) in senile metabolic syndrome (MetS) complicated by cerebral infarction.

STUDY DESIGN: Observational study. Place and Duration of the Study: Department of Ultrasound Imaging, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, China, from July 2020 to December 2021.

METHODOLOGY: A total of 118 senile MetS patients complicated by cerebral infarction were selected as Group A, and 103 senile MetS patients without cerebral infarction were selected as Group B. Both groups were compared in terms of cardiovascular risk factors and ultrasonic examination of carotid plaques. The independent risk factors for cerebral infarction among senile MetS patients were analysed using logistic regression. An ROC curve was used to assess the predictive value of statistically significant risk factors in senile MetS complicated by cerebral infarction.

RESULTS: Significant differences were observed in smoking, abdominal circumference, blood pressure, HCY, fasting blood glucose, high-density and low-density lipoprotein cholesterol, triacylglycerol, carotid plaque thickness, CEUS score, lumen stenosis, and ulcer plaque between the two groups. Logistic regression analysis showed that the plaque CEUS score and HCY were independent risk factors for senile MetS complicated by cerebral infarction. The areas under the ROC curve for the CEUS score and HCY were 0.795 and 0.812, respectively, and was 0.858 for the combined diagnosis of both. When the CEUS score was ≥2 and HCY was ≥16.45 mmol/l, the sensitivity and specificity of predicted senile MetS complicated by cerebral infarction were 83.1% and 74.8%, respectively.

CONCLUSION: The carotid plaque CEUS score and blood HCY exhibit a substantial predictive capacity for cerebral infarction in elderly MetS patients. The combined diagnostic efficacy of the two is superior.

KEY WORDS: Contrast-enhanced ultrasound, Homocysteine, Elderly, Metabolic syndrome, Cerebral infarction, Carotid plaque.

PMID:37804013 | DOI:10.29271/jcpsp.2023.10.1100

J Coll Physicians Surg Pak. 2023 Oct;33(10):1093-1099. doi: 10.29271/jcpsp.2023.10.1093.

ABSTRACT

OBJECTIVE: To analyse potential molecular mechanisms and identify potential therapeutic regimens and drugs to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Crohn’s disease (CD) through bioinformatics and systems biology.

STUDY DESIGN: Bioinformatics Study. Place and Duration of the Study: Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China, from May to December 2022.

METHODOLOGY: The common differentially expressed genes (DEGs) between CD and SARS-CoV-2 infection were identified using two RNA-seq datasets (GSE147507, GSE153974) extracted from Gene Expression Omnibus (GEO). Subsequently, functional enrichment, pathway analysis, and candidate drug analysis were performed using these DEGs.

RESULTS: In total, 44 DEGs were identified as common between CD and SARS-CoV-2 infection. A protein-protein interaction (PPI) network was constructed, hub genes were identified, and critical modules were determined by means of bioinformatics and combinatorial statistical approaches. Functional and pathway analyses conducted under ontological conditions showed a common association between CD and infection with SARS-CoV-2. The common DEGs were then used to identify coregulatory networks of interactions between transcriptional factors and genes, between proteins and medicines, and between DEGs and miRNAs.

CONCLUSION: Top 10 hub genes including IL6, CXCL1, CSF2, CXCL2, CXCL5, MMP3, PTGS2, CXCL3, SELE, and LCN2 were identified, which may function as potential candidate targets for SARS-CoV-2 infection. Additionally, the identification of certain promising treatment drugs for patients with SARS-CoV-2 infection and CD was also made.

KEY WORDS: SARS-CoV-2, COVID-19, Drug molecule, Hub gene, Protein-protein interaction (PPI), Gene ontology, Crohn’s disease, Differentially expressed genes.

PMID:37804012 | DOI:10.29271/jcpsp.2023.10.1093

J Coll Physicians Surg Pak. 2023 Oct;33(10):1087-1092. doi: 10.29271/jcpsp.2023.10.1087.

ABSTRACT

OBJECTIVE: To determine the accuracy of diagnosis of pulmonary nodules using artificial intelligence method.

STUDY DESIGN: Observational study. Place and Duration of the Study: Department of Thoracic Surgery, Jinan Central Hospital, Jinan, China, from January 2020 to May 2021.

METHODOLOGY: An analysis of clinical characteristics exhibited by 32 patients initially diagnosed with malignant tumours through imaging (LDCT) and artificial intelligence (AI), was reclassified as having benign lesions following surgical intervention. Quantitative parameters were assessed, including CT mean value, kurtosis, skewness, solid ratio, and the ratio of length to short diameter, within a cohort of 32 benign patients juxtaposed with 58 patients diagnosed with lung cancer during the same time frame. The AI-derived parameters were subjected to Mann-Whitney U non-parametric test.

RESULTS: A total of 32 benign pulmonary lesions were evaluated that were initially misdiagnosed as malignant prior to surgery. These lesions displayed an average length of (18.56 ± 12.16) mm, with the majority characterised as solid (68.8%). Notably, a substantial proportion of these lesions exhibited imaging features akin to malignant growths. The AI-derived quantitative parameters of the 32 benign cases and the 58 malignant cases revealed statistical significance in average CT value and solid ratio. However, statistical significance was not established for kurtosis, skewness, or the ratio of length to short diameter. The area under the Receiver Operating Characteristic (ROC) curve for average CT value and solid ratio stood at 0.71 and 0.705, respectively.

CONCLUSION: Among the cases initially misdiagnosed as malignant yet subsequently identified as benign, a notable number of these instances were solid nodules, often resembling malignant lesions in imaging characteristics. There was moderate discriminatory capacity for average CT value and solid ratio, rendering them valuable tools for distinguishing between benign and malignant lesions within this particular cohort. This underscores their high diagnostic significance.

KEY WORDS: Artificial intelligence, Benign lesions of lung, Lung cancer, Quantitative parameters, Postoperative.

PMID:37804011 | DOI:10.29271/jcpsp.2023.10.1087

Ann Clin Transl Neurol. 2023 Oct 7. doi: 10.1002/acn3.51914. Online ahead of print.

ABSTRACT

OBJECTIVE: We explored various prognostic factors of motor outcomes in corticosteroid-naive boys with Duchenne Muscular Dystrophy (DMD).

METHODS: The associations between parent-reported neurodevelopmental concerns (speech delay, speech and language difficulties (SLD), and learning difficulties), DMD mutation location, and motor outcomes (6-minute walk distance (6MWD), North Star Ambulatory Assessment (NSAA) total score, 10-meter walk/run velocity, and rise from floor velocity) were studied in 196 corticosteroid-naive boys from ages 4 to less than 8 years.

RESULTS: Participants with SLD walked 25.8 fewer meters in 6 minutes than those without SLD (p = 0.005) but did not demonstrate statistical differences in NSAA total score, 10-meter walk/run velocity, and rise from floor velocity. Participants with distal DMD mutations with learning difficulties walked 51.8 fewer meters in 6 minutes than those without learning difficulties (p = 0.0007). Participants with distal DMD mutations were slower on 10-meter walk/run velocity, and rise from floor velocity (p = 0.02) than those with proximal DMD mutations. Participants with distal DMD mutations, who reported speech delay or learning difficulties, were slower on rise from floor velocity (p = 0.04, p = 0.01) than those with proximal DMD mutations. The mean NSAA total score was lower in participants with learning difficulties than in those without (p = 0.004).

INTERPRETATION: Corticosteroid-naive boys with DMD with distal DMD mutations may perform worse on some timed function tests, and that those with learning difficulties may perform worse on the NSAA. Pending confirmatory studies, our data underscore the importance of considering co-existing neurodevelopmental symptoms on motor outcome measures.

PMID:37804000 | DOI:10.1002/acn3.51914

Shanghai Kou Qiang Yi Xue. 2023 Jun;32(3):328-331.

ABSTRACT

PURPOSE: To analyze the reasons for cancellation of oral and maxillofacial day surgery on the same day, and to propose countermeasures, so as to provide reference for improving the work efficiency and medical quality of day surgery ward.

METHODS: The number of oral and maxillofacial day surgery cancellation cases in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from June 1, 2021, to December 31, 2021 was calculated and then the relevant causes were analyzed.

RESULTS: During the statistical period, a total of 3134 patients underwent oral and maxillofacial day surgery. Among them, 72 (2.30%) cases were canceled of day surgery on the same day. Cancellation of oral and maxillofacial day surgery was as followed: patient-related factors(31, 43.05%), disease-related factors (28, 38.89%), epidemic of Covid 19-related(10, 13.89%), and hospital-related factors(3, 4.17%). The top three departments of oral and maxillofacial day surgery cancellation were Department of Preventive Dentistry(7, 7.37%), Department of Oral Surgery(22, 6.56%) and Department of Oral and Craniomaxillofacial Surgery(18,2.77%).

CONCLUSIONS: The cancellation rate of oral and maxillofacial day surgery can be reduced by strengthening screening in anesthesia assessment at outpatient clinic, strengthening doctor-patient communication, strengthening health education and epidemic prevention and control in day outpatient management center.

PMID:37803993

Shanghai Kou Qiang Yi Xue. 2023 Jun;32(3):323-327.

ABSTRACT

PURPOSE: To investigate the difference in the retention effect of 3D printing resin splint and Hawley retainer combined with lingual retention wire in periodontal disease patients after orthodontic treatment.

METHODS: Forty patients who finished orthodontic treatment for periodontal disease from January 2021 to February 2022 were selected and divided into experimental group and control group according to the random number table method, with 20 patients in each group. Patients in the experimental group used 3D printing resin splint for retention, while patients in the control group used Hawley retainer combined with a lingual retention wire for retention. The chair-side operation time of the retainers was recorded for both groups. The maxillary and mandibular cuspid width, molar width, overjet, overbite and irregularity index were measured at 1 month and 6 months after orthodontic treatment in both groups. Statistical analysis was performed with SPSS 12.0 software package.

RESULTS: The mean time for chair-side manipulation of experimental group and control group was 8.23, 11.17 min, respectively. The difference between the two groups was statistically significant (P＜0.05) when comparing the width of the maxillary and mandibular cusps, the width of the molars, overjet, overbite and the irregularity index after 1 month and 6 months of wear of the retainers, which were significantly greater in the experimental group than in the control group at 6 months(P＜0.05).

CONCLUSIONS: 3D printing resin splint, with short chair-side manipulation time, was more effective than Hawley retainer combined with a lingual retention wire, and the efficacy of both groups was otherwise generally consistent.

PMID:37803992