Tag: pubmed

Neurosurg Rev. 2023 Jun 26;46(1):150. doi: 10.1007/s10143-023-02050-z.

ABSTRACT

To analyze the perioperative course and clinical outcome of patients with large (lPA) and giant (gPA) pituitary adenoma who underwent endoscopic endonasal transsphenoidal surgery (EETS) using either two-dimensional (2D-E) or three-dimensional (3D-E) endoscopic systems. Single-center retrospective study of consecutive patients with lPA and gPA who underwent EETS between November 2008 and January 2023. LPA were defined as ≥ 3 cm and < 4 cm in diameter in at least one dimension and a volume of ≥ 10ccm; gPA were defined as larger than 4 cm in diameter and with a greater volume than 10ccm. Patient data (age, sex, endocrinological and ophthalmological status) and tumor data (histology, tumor volume, size, shape, cavernous sinus invasion according to the Knosp classification) were analyzed. 62 patients underwent EETS. 43 patients were treated for lPA (69.4%) and 19 patients for gPA (30.6%). 46 patients (74.2%) underwent surgical resection using 3D-E and 16 patients 2D endoscopy (25.8%). Statistical results are referred to the comparison between 3D-E and 2D-E. Patients’ age ranged from 23-88 years (median 57), 16 patients were female (25.8%), 46 male (74.2%). Complete tumor resection was possible in 43.5% (27/62), partial resection in 56.5% (35/62). Resection rates did not differ between 3D-E (27 patients [43.5%]) and 2D-E (7 patients [43.8%], (p = 0.985). Visual acuity improved in 30 of 46 patients with preoperative deficit (65.2%). In the 3D-E group 21 of 32 patients (65.7%) improved, compared to 9 of 14 patients in the 2D-E group (64.3%). Improvement of visual field was achieved in 31 of 50 patients (62.0%; 22 of 37 patients in the 3D-E group [59.4%] and 9 of 13 patients in the 2D-E group [69.2%]). CSF leak was the most frequent complication and occurred in 9 patients (14.5%, [8 patients 17.4% 3D-E]) without statistical significance. Other surgical complications like postoperative bleeding, infection (meningitis) and deterioration of visual acuity and field were detected without statistical difference. New pituitary anterior lobe dysfunction was observed in 30 of 62 patients (48.4%, 8 patients [50.0%] in the 2D-E group and 22 patients [47.8%] in the 3D-E group). A transient deficit of posterior lobe was detected in 22.6% (14/62). No patient died within 30 days of surgery. Although 3D-E may improve surgical dexterity, in this series of lPA and gPA it was not associated with higher resection rates compared to 2D-E. However, 3D-E visualization during resection of large and giant PA is safe and feasible and patient’s clinical outcome is not different compared to 2D-E.

PMID:37358696 | DOI:10.1007/s10143-023-02050-z

Neurol Sci. 2023 Jun 26. doi: 10.1007/s10072-023-06909-3. Online ahead of print.

ABSTRACT

BACKGROUND: Pregnancy has been observed to reduce the frequency of relapses in Multiple Sclerosis (MS) patients, but the relapse risk tends to increase during the early post-partum period. Increased pre- and post-partum disease activity may predict a poor long-term prognosis. This study aimed to evaluate the correlation between magnetic resonance imaging (MRI) activity during the year before pregnancy and long-term clinically meaningful worsening in Expanded Disability Status Scale (EDSS).

METHODS: This observational, retrospective, case-control study included 141 pregnancies in 99 females with MS. Statistical analyses were used to evaluate the correlation between MRI activity during the year pre-pregnancy and post-partum clinical worsening during a 5-year follow-up. Clustered logistic regression was used to investigate the predictors of 5-year clinically meaningful worsening in EDSS (lt-EDSS).

RESULTS: We found a significant correlation between an active MRI pre-pregnancy and lt-EDSS (p = 0.0006). EDSS pre-pregnancy and lt-EDSS were also significantly correlated (p = 0.043). Using a multivariate model, we predicted which females would not experience long-term clinical deterioration by a stable MRI pre-pregnancy (92.7% specificity; p = 0.004).

CONCLUSIONS: An active MRI pre-conception is a strong predictor of lt-EDSS and a higher annual relapse rate during the follow-up period, regardless of whether the female had clinical evidence of disease activity prior to conception and delivery. Optimizing disease control and achieving imaging stability prior to conception may reduce the risk of long-term clinical deterioration.

PMID:37358691 | DOI:10.1007/s10072-023-06909-3

Clin Oral Investig. 2023 Jun 26. doi: 10.1007/s00784-023-05117-9. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the skeletal and dentoalveolar dimensions of subjects with the unilateral maxillary-impacted canine and compare it with the non-impacted side using cone beam computed tomography (CBCT).

METHODS: A split-mouth study that included 26 CBCTs (52 sides) with unilateral impacted canine was designed. The parameters analyzed were alveolar height; bucco palatal width at 2 mm, 6 mm, and 10 mm from alveolar crest; premolar width; lateral angulation of incisors; root length of lateral incisors; and crown-root angulation of lateral incisors. Obtained data were statistically analyzed by unpaired independent t-test.

RESULTS: The bucco palatal width at 2 mm and the premolar width from mid-palatal raphe were 1.22 mm and 1.71 mm less on the impacted side, respectively; the central and lateral incisor angulations were less by 3.69 degrees and 3.40 degrees, respectively, on the impacted side; the lateral incisor root length was 2.8 mm shorter on the impacted side; the crown-root angulation for lateral incisor was 2.4 degrees more on the impacted side.

CONCLUSION: The following conclusions can be drawn: (1) The premolar width is less on the impacted side. (2) The incisors are more distally angulated on the impacted side. (3) The crown-root angulation of the lateral incisor is mesially directed on the impacted side.

CLINICAL RELEVANCE: Asymmetric arch expansions should be undertaken in severe transverse asymmetries. In the beginning stages of treatment, the arch alignment, excluding incisors, must be undertaken to safeguard the roots of incisors.

PMID:37358689 | DOI:10.1007/s00784-023-05117-9

Clin Oral Investig. 2023 Jun 26. doi: 10.1007/s00784-023-05120-0. Online ahead of print.

ABSTRACT

OBJECTIVE: This study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders.

METHODS: A total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography.

RESULTS: The glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle width and length showed no significance between the two groups, while condyle height was smaller in temporomandibular disorders patients. Anterior and medial joint spaces increased while the superior and posterior joint spaces reduced in temporomandibular disorders patients.

CONCLUSION: There were significant differences between the patients with and without temporomandibular joint disorders in terms of mandibular fossa positions and height as well as condylar positions and inclinations in horizontal and vertical planes together with reduced condylar height and reduced posterior and superior joint spaces in the temporomandibular disorders patients.

CLINICAL RELEVANCE: The temporomandibular disorder is a multifactorial disorder in which one of these factors is the dimensional and positional characteristics of the temporomandibular joints; including or excluding this factor requires a comprehensive three-dimensional investigation of patients with TMD compared to the normal group under the condition that the facial pattern is average as a confounding factor.

PMID:37358688 | DOI:10.1007/s00784-023-05120-0

Lasers Med Sci. 2023 Jun 26;38(1):148. doi: 10.1007/s10103-023-03816-z.

ABSTRACT

In this study, it was aimed to evaluate the smear and debris removal efficiency of laser and ultrasonic irrigation activation methods in traditional and conservative endodontic access cavity preparations. 60 freshly extracted human mandibular molar teeth were randomly divided into 2 groups according to the access cavity preparation (n = 30): Traditional endodontic access cavities (TEC) and Conservative endodontic access cavity (CEC). After the access cavity preparation, the mesiobuccal root canals were prepared to 35/0.4 with the VDW Rotate file system. Teeth with completed root canal preparation were randomly divided into 3 subgroups according to the final irrigation activation protocol (n = 30): Conventional needle irrigation, passive ultrasonic activation and laser activation. The crowns of the teeth were removed and the mesiobuccal roots were divided longitudinally into two halves, mesial and distal. Samples were scanned with scanning electron microscopy. Photomicrographs in the coronal, middle, and apical thirds of each specimen were taken at a magnification of 200 for debris and 1000 for evaluation of the smear layer. Data were analysed using the three-way Robust Anova test and Bonferroni test.The effect of access cavity design on remaining smear (p = 0.057) and debris (p = 0.5) was not statistically significant. The effect of the interaction of access cavity and irrigation activation on the remaining smear and debris was not statistically significant (p = 0.556, p = 0.333). Significantly fewer smears were detected in the laser activation group than in the ultrasonic activation and control groups. Conservative access cavities did not differ from conventional access cavities in terms of debris and smear.

PMID:37358660 | DOI:10.1007/s10103-023-03816-z

Graefes Arch Clin Exp Ophthalmol. 2023 Jun 26. doi: 10.1007/s00417-023-06151-9. Online ahead of print.

ABSTRACT

BACKGROUND: Omnigen is a vacuum-dehydrated amniotic membrane transplant. It can be delivered to the eye pre-mounted on a special bandage contact lens (Omnilenz) that enables its application without the need for sutures or glue; the aim of this study is to evaluate the short-term clinical outcomes of Omnilenz-Omnigen complex in eyes with acute chemical injury (CEI).

METHODS: A prospective interventional study included patients with different grades of acute CEI attending the casualty between July 2021 and November 2022. All patients received first aid measures followed by the application of Omnilenz-Omnigen within the first 2 days. Patients were followed up for at least 1 month. Primary outcomes include epithelial defect and limbal ischemia. Secondary outcomes include best-corrected visual acuity (BCVA) and tolerability.

RESULTS: The study included 23 eyes of 21 patients with acute CEI mostly due to alcohol (34.8%). After the 1^st application, the size of the epithelial defect showed a statistically significant reduction (p = 0.016) with improvement in BCVA (p < 0.001). Restoration of the limbal vascularity was obtained in 56.5% of the eyes. Repeated application of Omnilenz was required in 5 eyes (21.7%). The size of the epithelial defect was reduced after the second application (p = 0.504) with improved BCVA (p = 0.185). After 1^st month, complete epithelial healing was achieved in all the eyes. Mild limbal ischemia persists in 3 (13%) of the eyes. Final BCVA showed statistically significant improvement (p < 0.001). None of the patients develops any serious complications.

CONCLUSION: Omnilenz proved to be easy to apply and well tolerated by patients, with promising clinical outcomes.

PMID:37358651 | DOI:10.1007/s00417-023-06151-9

Int J Cancer. 2023 Jun 26. doi: 10.1002/ijc.34574. Online ahead of print.

ABSTRACT

An association between polycystic ovary syndrome (PCOS) and epithelial ovarian tumors is biologically plausible as conditions inherent to PCOS such as excessive androgenic hormones, reproductive factors and obesity are also risk factors for these hormone-sensitive tumors. However, previous studies have showed conflicting results and have various methodological limitations. This population-based cohort study investigates the association between PCOS and epithelial ovarian tumors and includes all women born in Denmark between January 1, 1940 and December 31, 1993 (n = 1 719 304). PCOS diagnoses, ovarian cancer and borderline ovarian tumor diagnoses, covariates, migration and vital status were obtained from the Danish national registers. Adjusted cox proportional hazard regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for epithelial ovarian cancer and for borderline ovarian tumors overall as well as for histological subtypes separately. During median 26 years of follow-up we identified 6490 women with ovarian cancer and 2990 women with borderline ovarian tumors. Overall, we observed no marked associations between a diagnosis of PCOS and overall epithelial ovarian cancer or overall epithelial borderline ovarian tumors, irrespective of time since diagnosis. However, we found an increased risk of ovarian cancer among postmenopausal women with PCOS (HR 2.28 95% CI 1.02-5.09) and an increased risk of serous borderline ovarian tumors (HR 2.34 95% CI 1.21-4.53) in women with PCOS compared with women without PCOS. Importantly, low statistical precision is a crucial limitation of our study and in previous studies and larger studies with longer follow-up are therefore warranted.

PMID:37357906 | DOI:10.1002/ijc.34574

Turk Psikiyatri Derg. 2023 Summer;34(2):8-88. doi: 10.5080/u26398.

ABSTRACT

Metacognitive beliefs operate through cognitive attentional syndrome, where attention concentrated on negative automatic thoughts results in rumination. This perseverative thinking style manifesting in the form of rumination and worry intensifies depression. This study aims to assess the effect of cognitive behaviour therapy (CBT) on metacognitive beliefs, symptom severity, quality of life, and functionality. A pre-post study design comparing CBT-alone and CBT-with-medication was employed using purposive sampling to recruit 40 participants diagnosed with depressive disorders. All the participants received 10 sessions of CBT. Pre and post assessment measures were Beck Depression Inventory-II, Metacognitive Questionnaire-30, World Health Organization Quality of Life- Brief, and Global Assessment of Functioning. Paired t-test analysis revealed significant difference on outcome measures in both groups. Between-subject analysis revealed that the CBT-alone group was not significantly different in terms of improvement than CBT-withmedication group even when confounding variables were statistically controlled by way of testing analysis of covariance and propensity score match (nearest neighbour match). Keywords: Cognitive behaviour therapy, metacognition, depressive disorders, metacognitive beliefs, depression, quality of life.

PMID:37357894 | DOI:10.5080/u26398

Psychol Med. 2023 Jun 26:1-13. doi: 10.1017/S0033291723001563. Online ahead of print.

ABSTRACT

BACKGROUND: In late 2019, a new virus began spreading in Wuhan, China. By the end of 2021, more than 260 million people worldwide had been infected and 5.2 million people had died because of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Various countermeasures have been implemented to contain the infections, depending on the country, infection prevalence, and political and infrastructural resources. The pandemic and the containment measures have induced diverse psychological burdens. Using internet queries as a proxy, this study examines the psychological consequences on a European level of SARS-CoV-2 containment measures.

METHODS: Using informetric analyses, this study reviews within 32 European countries a total of 28 search parameters derived from the International Statistical Classification of Diseases and Related Health Problems (ICD-10) as aspects of affective disorder.

RESULTS: Our results show that there are several psychological aspects which are significantly emphasized during the pandemic and its containment measures: ‘anxiety’, ‘dejection’, ‘weariness’, ‘listlessness’, ‘loss of appetite’, ‘loss of libido’, ‘panic attack’, and ‘worthlessness’. These terms are significantly more frequently part of a search query during the pandemic than before the outbreak. Furthermore, our results revealed that search parameters such as ‘psychologist’, ‘psychotherapist’, ‘psychotherapy’ have increased highly significantly (p < 0.01) since the pandemic.

CONCLUSIONS: The psychological distress caused by the pandemic correlates significantly with the frequency of people searching for psychological and psychotherapeutic support on the Internet.

PMID:37357891 | DOI:10.1017/S0033291723001563

Pain Pract. 2023 Jun 26. doi: 10.1111/papr.13262. Online ahead of print.

ABSTRACT

INTRODUCTION: Limb amputation can cause residual limb pain (RLP) and/or phantom limb pain (PLP). Although targeted muscle reinnervation (TMR) was initially introduced to facilitate the control of prosthetic limbs, it has been noted that these patients experience less pain and improved prosthetic functional outcomes. As a result, the use of TMR in managing neuroma-related RLP is increasing. The aim of this review is to assess the quality and strength of the evidence supporting the effectiveness of TMR in managing amputation-related pain.

METHODS: Five different databases, including MEDLINE (PubMed), Scopus, Web of Science, Cochrane Library, and Embase, were searched from inception to March 2022. The protocol for this systematic review has been registered in the PROSPERO database (CRD42020218242). To be included, studies needed to compare pre- and postoperative pain outcomes or different techniques for adult patients who underwent TMR following amputation. Eligible studies also needed to use patient-reported outcome measures (PROMS) and be clinical trials or observational studies published in English. Excluded studies were case reports, case series, reviews, proof of concept studies, and conference proceedings. A meta-analysis was performed on studies that had similar intervention and control groups to examine treatment effects using a random-effects model. Studies were weighted using the inverse variance method, and a statistically significant p-value was considered to be less than or equal to 0.05.

RESULTS: This review included five studies for qualitative analysis and four studies for quantitative analysis. Reviewed studies enrolled a total of 127 patients. The TMR group was compared with standard treatment at 12 months follow-up. The TMR group showed significantly better PLP as assessed by the numerical rating score RLP, and PLP assessed using Patient-Reported Outcomes Measurement Information System (PROMIS) also showed significantly lower pain intensity in the TMR group.

CONCLUSION: There is limited evidence of good quality favoring TMR in reducing postamputation PLP and RLP pain compared with standard care. Randomized clinical trials are encouraged to compare the efficacy of different surgical techniques.

PMID:37357830 | DOI:10.1111/papr.13262