Tag: pubmed

Diagn Interv Radiol. 2023 Jun 5. doi: 10.4274/dir.2023.232129. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the efficacy of interventional radiological (IR) procedures in iatrogenic urinary tract injury and investigate the factors affecting the outcome.

METHODS: Fifty-eight patients (21 male) with a mean age of 50.3 ± 15.8 years referred for iatrogenic urinary tract injury were enrolled in this study. Technical success was defined as (i) successful placement of a nephrostomy catheter within the renal pelvis and/or (ii) successful antegrade ureteral stent placement (double J stent) between the renal pelvis and bladder lumen. Complete resolution was defined as maintained ureteral patency without an external drain and ureteral stent. The factors that may affect complete resolution [ureteral avulsion, ureterovaginal fistula (UVF), history of malignancy/radiotherapy, and time to IR management] were also investigated. The receiver operating characteristic analysis was performed to estimate the cut-off time point for the IR management timing affecting complete resolution.

RESULTS: The technical success rate for nephrostomy and ureteral stent placement was 100% (n = 58/58) and 78% (n = 28/36), respectively. In 14 patients, non-dilated pelvicalyceal systems were evident. In 18 patients, no further intervention after percutaneous nephrostomy was performed due to (i) poor performance status (n = 6) and (ii) reconstruction surgery upon clinicians’ and/or patients’ request (n = 12). Reconstruction surgery was required in 11 of the remaining 40 patients due to failure of percutaneous treatment (n = 11/40, 27.5%). In six of the patients, ureteral stents could not be removed due to the development of benign ureteral strictures (n = 6/40, 15%). Our complete resolution rate was 57.5% (n = 23/40). Age, gender, type of surgery (endoscopic or open), side and location of the injury did not statistically affect the complete resolution rate. The presence of ureteral avulsion, history of malignancy and radiotherapy individually or in combination significantly affected the complete resolution rate negatively. The presence of UVF also had a negative effect on the complete resolution rate; however, it did not reach statistical significance. Delayed intervention was also a significant factor related to lower complete resolution. The optimal cut-off point of the time interval for favorable clinical outcome was found to be 0-19^th day following the surgery.

CONCLUSION: IR procedures are safe and effective in the management of iatrogenic urinary tract injuries. Antegrade ureteral stenting should be performed as soon as possible to establish ureteral integrity without the development of stricture.

PMID:37272307 | DOI:10.4274/dir.2023.232129

Nucl Med Commun. 2023 Jun 5. doi: 10.1097/MNM.0000000000001717. Online ahead of print.

ABSTRACT

BACKGROUND: Although it causes low-dose radiation exposure, dimercaptosuccinic acid (DMSA) renal cortical scintigraphy is the gold standard examination method in the noninvasive diagnosis of renal scar tissue (RST). Shear wave elastography (SWE) has recently come to the fore as a technique for measuring kidney stiffness in the examination of RST. The present study aims to compare DMSA and SWE tests to evaluate whether SWE can be used instead of DMSA as a test that does not cause radiation exposure in pediatric patients.

METHODS: In this prospective study, sonographic elastography was performed on pediatric patients with DMSA images. In the SWE examination, measurements were made from each kidney’s upper, middle and lower parts. DMSA and elastography data were compared for the diagnosis of RST.

RESULTS: A total of 64 patients were included in the present study. There were 68.8% female (n = 44) and 31.2% (n = 20) male patients. There were 45 pediatric patients [Female 30 (66.7%), male 15 (33.3%)] in group 1 (pathological group) and 19 pediatric patients [Female 14 (73.7%), male 5 (26.3%)] in the control group. When DMSA data and SWE values were compared, it was found that elastography did not show a statistically significant performance in predicting renal scarring.

CONCLUSION: In the existing literature, various studies reported different values for the diagnosis of renal stiffness using SWE. Similar to some previous studies, the present study observed no significant correlations between DMSA and SWE. Thus, DMSA preserves its major role and effectiveness as an important predictor of RST in pediatric patients.

PMID:37272283 | DOI:10.1097/MNM.0000000000001717

Nucl Med Commun. 2023 Jun 5. doi: 10.1097/MNM.0000000000001712. Online ahead of print.

ABSTRACT

INTRODUCTION: A DnCNN for image denoising trained with natural images is available in MATLAB. For Tc-99m DMSA images, any loss of clinical details during the denoising process will have serious consequences since denoised image is to be used for diagnosis. The objective of the study was to find whether this pre-trained DnCNN can be used for denoising Tc-99m DMSA images and compare its performance with block matching 3D (BM3D) filter.

MATERIALS AND METHODS: Two hundred forty-two Tc-99m DMSA images were denoised using BM3D filter (at sigma = 5, 10, 15, 20, and 25) and DnCNN. The original and denoised images were reviewed by two nuclear medicine physicians and also assessed objectively using the image quality metrics: SSIM, FSIM, MultiSSIM, PIQE, Blur, GCF, and Brightness. Wilcoxon signed-rank test was applied to find the statistically significant difference between the value of image quality metrics of the denoised images and the corresponding original images.

RESULTS: Nuclear medicine physicians observed no loss of clinical information in DnCNN denoised image and superior image quality compared to its original and BM3D denoised images. Edges/boundaries of the scar were found to be well preserved, and doubtful scar became obvious in the denoised image. Objective assessment also showed that the quality of DnCNN denoised images was significantly better than that of original images at P-value <0.0001.

CONCLUSION: The pre-trained DnCNN available with MATLAB Deep Learning Toolbox can be used for denoising Tc-99m DMSA images, and the performance of DnCNN was found to be superior in comparison with BM3D filter.

PMID:37272279 | DOI:10.1097/MNM.0000000000001712

Acta Paediatr. 2023 Jun 4. doi: 10.1111/apa.16866. Online ahead of print.

ABSTRACT

AIM: To explore the perspectives of adults born prematurely on guidelines for management at extreme premature birth, and personalisation at the limit of viability.

METHODS: We conducted four two-hour online focus group interviews in the Netherlands.

RESULTS: Twenty-three participants born prematurely were included in this study, ranging in age from nineteen to fifty-six years, and representing a variety of health outcomes. Participants shared their perspectives on different types of guidelines for managing extremely premature birth. They agreed that a guideline was necessary to prevent arbitrary treatment decisions and to avoid physician bias. All participants favoured a guideline that is based upon multiple prognostic factors beyond gestational age. They emphasized the importance of discretion, regardless of the type of guideline used. Discussions centred mainly on the heterogeneity of value judgments about outcomes after extreme premature birth. Further, participants defined personalisation as ‘not just looking at numbers and statistics’. They associated personalisation mainly with information provision and decision-making. Participants stressed the importance of involving families in decision-making and taking their care needs seriously.

CONCLUSION: Adults born prematurely prefer a periviability guideline that considers multiple prognostic factors and allows for discretion.

PMID:37272253 | DOI:10.1111/apa.16866

Scand J Med Sci Sports. 2023 Jun 4. doi: 10.1111/sms.14424. Online ahead of print.

ABSTRACT

Spatiotemporal metrics such as step frequency have been associated with running injuries in some studies. Wearables can measure these metrics and provide real-time feedback in-field, but are often not validated. This study assessed the validity of commercially available wireless instrumented insoles (ARION) for quantifying spatiotemporal metrics during level running at different speeds (2.78-5.0 m s^-1 ,) and slopes (3° and 6° up/downhill) to an instrumented treadmill. Mean raw, percentage and absolute percentage error, and limits of agreement (LoA) were calculated. Agreement was statistically quantified using four thresholds: excellent, <5%; good, <10%; acceptable, <15%; and poor, >15% error. Excellent agreement (<5% error) was achieved for stride time across all conditions, and for step frequency across all but one condition with good agreement. Contact time and swing time generally showed at least good agreement. The mean difference across all conditions was -0.95% for contact time, 0.11% for stride time, 0.6% for swing time, -0.11% for step frequency, and -0.09% when averaged across all outcomes and conditions. The accuracy at an individual level was generally good to excellent, being <10% for all but two conditions, with these conditions being <15%. Additional experiments among four runners showed that step length could also be measured with an accuracy of 1.76% across different speeds with an updated version of the insoles. These findings suggests that the ARION wearable may not only be useful for large-scale in-field studies investigating group differences, but also to quantify spatiotemporal metrics with generally good to excellent accuracy for individual runners.

PMID:37272215 | DOI:10.1111/sms.14424

J Clin Nurs. 2023 Jun 4. doi: 10.1111/jocn.16776. Online ahead of print.

ABSTRACT

AIMS: To identify the barriers and enablers perceived by hospital-based clinicians to providing evidence-based continence care to inpatients.

DESIGN: This was a cross-sectional study of inpatient clinicians using a questionnaire.

METHODS: Acute care and rehabilitation clinicians from 15 wards that admit patients after stroke at 12 hospitals (NSW = 11, Queensland =1, metropolitan = 4, regional = 8) were invited to complete an online questionnaire. The 58 questions (answered on a 5-point Likert scale) were aligned to 13 of the 14 domains of the Theoretical Domains Framework. Results were dichotomized into ‘strongly agree/agree’ and ‘unsure/disagree/strongly disagree’ and proportions were calculated. Data collection occurred between January 2019 and March 2019.

RESULTS: The questionnaire was completed by 291 participants with 88% being nurses. Barriers were found in nine domains including knowledge; skills; memory attention and decision making; emotion; environmental context and resources; behavioural regulation; social professional role; intensions, social influences; and beliefs about capabilities. Enablers were found in seven domains including goals; social influences; knowledge; skills; social, professional role and identity; reinforcement and beliefs about consequences.

CONCLUSION: This multi-site, multi-professional study that included predominantly nurses highlights the barriers and enablers to inpatient continence care. Future implementation studies in inpatient continence management should address these identified barriers and enablers to improve effectiveness of implementation of evidence-based care.

IMPLICATIONS FOR THE PROFESSION: This study highlights that although there are many barriers to ward nurses providing evidence-based continence care, there are also several enablers. Both should be addressed to improve practice.

REPORTING METHOD: We adhered to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) (Supplementary File 1).

RELEVANCE TO CLINICAL PRACTICE: Establishing barriers to practice gives a broader understanding of why practice does not occur and establishes areas where researchers and clinicians need to address in order to change behaviour.

PMID:37272209 | DOI:10.1111/jocn.16776

Int J Gynaecol Obstet. 2023 Jun 4. doi: 10.1002/ijgo.14897. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the differences in both maternal and neonatal outcomes between flexible and non-flexible sacrum positions at birth.

METHODS: A descriptive, cross-sectional, retrospective study was carried out on a sample of low-risk pregnant women. Univariate and multivariate logistic regressions and multivariate linear regressions were conducted to estimate the association between our discrete or continuous variables of interest. Maternal outcomes were perineal tear, maternal blood loss, second stage length; neonatal outcomes were Apgar scores and neonatal asphyxia. Results were adjusted for maternal age, neonatal birth weight, and epidural analgesia.

RESULTS: We considered for final analysis 2198 women. In primiparous women, women giving birth in the all-fours position were significantly more likely to have an intact perineum (P = 0.011) and a shorter length of the second stage of labor (P = 0.022). Maternal age (P = 0.005) and neonatal weight (P = 0.013) significantly increased perineal tearing; maternal age (P = 0.004) and neonatal birth weight (P < 0.001) were significantly associated with a higher amount of blood loss. Maternal age (P = 0.002) and neonatal weight (P < 0.001) significantly increased the length of the second stage of labor. For multiparous women, the side-lying position was significantly correlated with an intact perineum (P = 0.031); maternal age and intact perineum were statistically inversely associated. Epidural analgesia significantly increased the length of the second stage of labor in both nulliparous (P < 0.001) and pluriparous women (P < 0.001). No significant differences were found in neonatal outcomes.

CONCLUSION: Women with a low-risk labor should be free to choose their birth position as flexible sacrum positions are shown to increase maternal well-being and do not affect neonatal health.

PMID:37272201 | DOI:10.1002/ijgo.14897

Clin Anat. 2023 Jun 4. doi: 10.1002/ca.24061. Online ahead of print.

ABSTRACT

Our study aimed to evaluate the hip joints of healthy children aged 2-13 years morphometrically through radiographic images. Demographic characteristics of 300 healthy children in our study include an average age of 6.4 years old based on the 2-to-13-year-old bracket and sex classified to 133 girls and 167 boys. A total of 600 normal hips from these children were digitally measured based on Acetabular Index, ACM angle, MZ distance, Sharp angle, CE angle, Femoral Head Coverage Ratio, Cranial, and medial joint space (MJS). *p < 0.05; **p < 0.01 indicated a statistically significant difference. It was found that Acetabular Index, ACM angle, MZ distance, Sharp angle, Cranial, and MJSs decreased with age; Acetabular Depth value and CE angle increased with age; the CE angle differed between the sides (right-left) in the young teens period and in boys; and the cranial joint space (CJS) differed between the sides in girls. In addition, girls had higher values than boys in terms of Acetabular Index, ACM angle, Sharp angle, MZ distance, and Femoral Head Coverage Ratio; CE angle and MJS were higher in girls; and Acetabular Depth Value and CJS did not differ significantly between sexes. Obtaining the normal values will guide in the diagnosis and treatment of many clinical conditions including DDH and Legg-Calve-Perthes disease. It can also be used to compare the hips between healthy children and those diagnosed with Cerebral Palsy.

PMID:37272199 | DOI:10.1002/ca.24061

J Sci Food Agric. 2023 Jun 4. doi: 10.1002/jsfa.12762. Online ahead of print.

ABSTRACT

BACKGROUND: Climate changes associated to global warming are increasingly affecting the quality of cultivated crops. Cultivation at different altitudes and similar latitudes may offer an extraordinarily useful opportunity to trigger changes in climate variables and to further investigate their effect on crop quality. This study evaluated the effect of climatic indices, calculated using temperature, rainfall precipitation and solar radiation data, on commercial parameters and volatile organic compounds (VOCs) profile of wheat at harvest.

RESULTS: Three common and durum wheat varieties, including two heritage wheat, were sown in experimental fields sited at three altitudes for three consecutive years and analysed for their yield, grading parameters and VOCs profiles. The datasets were processed by partial least square regression (PLS-R) and the results indicate that summer days (SU25) and diurnal temperature range (ΔT) are the climatic indices mainly responsible for VOCs profile changes in both common and durum wheat. Accumulated growth degree days (GDD), consecutive dry days (CDD) and accumulated solar radiation (ASR) induced species-specific responses. Terpenes represented the chemical class of VOCs most affected by stresses followed by ketones, and alcohols, which were affected by CDD, GDD and ASR.

CONSLUSION: This study showed a selective response of wheat to abiotic stresses associated with climate variables in terms of VOCs synthesis. The findings reported may be of relevance in several fields, from plant ecology to agronomy and food quality with final implication in local economy strategies. This article is protected by copyright. All rights reserved.

PMID:37272187 | DOI:10.1002/jsfa.12762

Zhongguo Dang Dai Er Ke Za Zhi. 2023 May 15;25(5):508-515. doi: 10.7499/j.issn.1008-8830.2301015.

ABSTRACT

OBJECTIVES: To investigate the distribution characteristics and correlation of intestinal and pharyngeal microbiota in early neonates.

METHODS: Full-term healthy neonates who were born in Shanghai Pudong New Area Maternal and Child Health Hospital from September 2021 to January 2022 and were given mixed feeding were enrolled. The 16S rRNA sequencing technique was used to analyze the stool and pharyngeal swab samples collected on the day of birth and days 5-7 after birth, and the composition and function of intestinal and pharyngeal microbiota were analyzed and compared.

RESULTS: The diversity analysis showed that the diversity of pharyngeal microbiota was higher than that of intestinal microbiota in early neonates, but the difference was not statistically significant (P>0.05). On the day of birth, the relative abundance of Proteobacteria in the intestine was significantly higher than that in the pharynx (P<0.05). On days 5-7 after birth, the relative abundance of Actinobacteria and Proteobacteria in the intestine was significantly higher than that in the pharynx (P<0.05), and the relative abundance of Firmicutes in the intestine was significantly lower than that in the pharynx (P<0.05). At the genus level, there was no significant difference in the composition of dominant bacteria between the intestine and the pharynx on the day of birth (P>0.05), while on days 5-7 after birth, there were significant differences in the symbiotic bacteria of Streptococcus, Staphylococcus, Rothia, Bifidobacterium, and Escherichia–Shigella between the intestine and the pharynx (P<0.05). The analysis based on the database of Clusters of Orthologous Groups of proteins showed that pharyngeal microbiota was more concentrated on chromatin structure and dynamics and cytoskeleton, while intestinal microbiota was more abundant in RNA processing and modification, energy production and conversion, amino acid transport and metabolism, carbohydrate transport and metabolism, coenzyme transport and metabolism, and others (P<0.05). The Kyoto Encyclopedia of Genes and Genomes analysis showed that compared with pharyngeal microbiota, intestinal microbiota was more predictive of cell motility, cellular processes and signal transduction, endocrine system, excretory system, immune system, metabolic diseases, nervous system, and transcription parameters (P<0.05).

CONCLUSIONS: The composition and diversity of intestinal and pharyngeal microbiota of neonates are not significantly different at birth. The microbiota of these two ecological niches begin to differentiate and gradually exhibit distinct functions over time.

PMID:37272178 | DOI:10.7499/j.issn.1008-8830.2301015