Tag: pubmed

J Ultrasound Med. 2023 Jan 2. doi: 10.1002/jum.16171. Online ahead of print.

ABSTRACT

OBJECTIVES: By analyzing the differences of contrast-enhanced ultrasound (CEUS) features between low- and high-grade of WHO/ISUP grading, to explore the diagnostic value of CEUS in evaluating the prognosis of renal cell carcinoma (RCC).

METHODS: The qualitative and quantitative features of CEUS in 69 patients with RCC confirmed by surgical pathology in the Lanzhou University Second Hospital from March to October 2021 were retrospectively analyzed. Patients were categorized into two groups: low-grade group (n = 22) and high-grade group (n = 47), with surgical pathology as reference standard. The diagnostic performance of statistically significant CEUS features was evaluated by receiver operating characteristic (ROC) curves.

RESULTS: There were statistically significant differences in enhancement degree (P = .032) and quantitative features such as slope_lesion (P = .034), the differences between lesion and cortex in arrive time (∆AT = AT_lesion – AT_cortex , P = .013), peak intensity(∆PI = [PI_lesion – PI_cortex ]/PI_cortex , P = .003), area under the curve (∆Area = Area_lesion – Area_cortex , P = .008) in two groups, and the sensitivity was 70.2% and specificity was 71.4% of ∆PI, which has a high diagnostic performance in the differentiation of low-grade group from high-grade group (P = .005).

CONCLUSIONS: CEUS features such as ∆PI, may help differentiate low-grade RCC from high-grade RCC. CEUS has a promising application prospect in preoperative evaluation of the prognosis of RCC.

PMID:36591798 | DOI:10.1002/jum.16171

Wiad Lek. 2022;75(11 pt 2):2867-2871. doi: 10.36740/WLek202211225.

ABSTRACT

OBJECTIVE: The aim: To highlight legal measures of counteraction to genitals mutilating surgeries (female circumcision) and the perspectives for their possible improvement.

PATIENTS AND METHODS: Materials and methods: International regulatory legal acts, acts of “soft” law, statistical data, research results are the materials of the research. Comparative, comparative and legal, system analysis, formal and logical, other methods were applied during the research.

CONCLUSION: Conclusions: It has been proved that although there are four different types of female circumcision, any such surgery performed without medical grounds is female genitals mutilating surgery. The authors have offered to enshrine a direct ban on performing genitals mutilating surgeries (female circumcision) in the norms of national legislation with appropriate measures of legal liability for those involved.

PMID:36591782 | DOI:10.36740/WLek202211225

Wiad Lek. 2022;75(11 pt 2):2835-2838. doi: 10.36740/WLek202211219.

ABSTRACT

OBJECTIVE: The aim of the work is to identify the peculiarities of medical and social justification of the financial and economic condition of «Horodenka non-commercial center of primary medical care» before and after introduction of a hospital district. To achieve the goal, the following are defined task: to conduct an analysis of the main indicators of «Horodenka non-commercial center of primary medical care»; to determine the problems of inefficient work of the «Horodenka non-commercial center of primary medical care».

PATIENTS AND METHODS: Materials and methods: When conducting research, they were used general scientific and special methods of research, in particular the system approach and system analysis – to carry out a comprehensive study of the identified objects and systems in their external and internal relationships, as well as determination of approaches to identifying and analyzing problems and developing ways to solve them solution; process approach – for the study of various types of activities in the existing management system of the health care facility before and after implementation of the hospital district; medical and statistical – for statistical processing of received data; analytical methods.

RESULTS: Results: The efficiency of health care facilities and the quality of the provided medical services are considered as the main target functions of the health care system. In many countries, programs for ensuring the quality of medical care have been implemented and are operating. The activities of Ukrainian medical institutions and the health care system as a whole are often harshly criticized by patients and the public for the low quality of providing medical services. The quality of medical services, medical care and medical infrastructure definitely depends on the principles of building the Ukrainian medical system and the development of the national economy. Because without a financial basis, it is very difficult to build an effective health care system and ensure proper medical care and the work of all medical institutions.

CONCLUSION: Conclusions: Thus, after the introduction of the hospital district in the «Horodenka non-commercial center of primary medical care», it is proposed to carry out a number of measures to increase the effectiveness of the implementation of financial management. In order to increase the efficiency of management, including financial resources, it is important to improve personnel management. The main emphasis in the management is the formation of the personnel potential of the «Horodenka non-commercial center of primary medical care» the involvement of qualified specialists in the field of medicine, the motivation of various directions for the support and improvement of the qualifications of management personnel. It is also important to use the system of financial planning of a budget institution, to ensure expenses for its life activities. In particular, the main direction of cost control is targeted use of funds, strict control over this use, formation of an effective internal audit system of a medical institution.

PMID:36591776 | DOI:10.36740/WLek202211219

Wiad Lek. 2022;75(11 pt 2):2765-2770. doi: 10.36740/WLek202211209.

ABSTRACT

OBJECTIVE: The aim: To investigate the pharmacists level of readiness to provide assistance to pharmacy visitors on COVID-19 and ways to expand their social role in society during the pandemic.

PATIENTS AND METHODS: Materials and methods: Based on the analysis of the statistical data, sociological research and mathematical analysis, as well as generalization of the obtained results have been used in the work. The objects of the study were pharmaceutical workers of pharmacies. The survey was conducted in August 2021 via online survey of the target audience in professional groups.

RESULTS: Results: The results of the survey of pharmaceutical workers indicate a high level of need (63.9% of respondents) for the continuous acquisition of relevant information on COVID-19. According to the results of the study, the growth of the social role of pharmacy specialists in combating coronavirus infection has been proved, which was supported by 86.2% of respondents in their daily activities. The possibility of introduction of 6 new functions to Ukrainian pharmacies has been considered.

CONCLUSION: Conclusions: The practical significance of the obtained results is that together they create a scientific and methodological basis for improving the process of pharmaceutical workers participation in combating coronavirus infection.

PMID:36591766 | DOI:10.36740/WLek202211209

World J Surg Oncol. 2023 Jan 2;21(1):1. doi: 10.1186/s12957-022-02879-6.

ABSTRACT

BACKGROUND: Self-expanding metal stents (SEMS) served as a bridge to surgery (BTS). However, this method may be associated with worse long-term prognosis and relapse of CRC patients. Therefore, we attempted to clarify this in the angle of circulating tumor cells (CTCs).

METHODS: A multicenter study was performed from March 2018 to January 2021. Thirty-two colorectal cancer patients with obstruction were selected, of which 21 patients were performed SEMS as a BTS while 11 patients were performed emergency surgery. Bloods samples were collected in two groups of patients for further detecting CTCs. In the SEMS group, the samples were collected before and after stent insert and after radical surgery performed. In the ES group, the samples were collected before stent insert and after emergency surgery performed.

RESULTS: The number of CTCs did not show statistically significant differences before and after stent placement (34.90 vs 38.33, p=0.90), neither between the SEMS group and ES group in initial CTC levels (34.90 vs 58.09, p=0.394). No significant differences (38.33 vs 58.09, p=0.632) were observed after stent insert in the SMES group and the initial CTC levels in the ES group. Moreover, no major differences (24.17 vs 42.27, p=0.225) were observed after radical operation performed in both groups.

CONCLUSION: The treatment of SEMS does not cause an increase in the number of CTC after stent insertion. Furthermore, there are may be other factors besides CTC to cause these poorer oncologic outcomes after SEMS placement.

PMID:36588150 | DOI:10.1186/s12957-022-02879-6

Ir J Med Sci. 2023 Jan 2. doi: 10.1007/s11845-022-03249-7. Online ahead of print.

ABSTRACT

BACKGROUND: In 2018, there were more than 12,000 self-harm presentations to emergency departments (EDs) in Ireland with 50% occurring between 7p.m. and 3a.m. There is evidence that the assessment quality and follow-up is variable across clinicians. To address this, The National Clinical Programme for the Management of Self-Harm in the ED (NCPSH 2016) was developed to set clear standards.

AIM: Our aim was to compare diagnosis and management of patients presenting to Beaumont Hospital (BH) ED, across a 3-year period, by the on-site Liaison Psychiatry Service, during normal working hours, to the off-site on call service outside of normal working hours (OOH).

METHODS: This is a retrospective audit of BH ED patients referred for psychiatric assessment between 2018 and 2020, using patient electronic records for data collection, and Pearson’s chi square testing for group differences. Post hoc analysis was performed using adjusted residuals and Bonferroni correction.

RESULTS: Of 3659 psychiatric referrals to Beaumont ED from 2018 to 2020, alcohol-related disorders were the most common diagnosis and were diagnosed more frequently during normal working hours (n = 592, 16.2%; 22.9% normal hours vs 8.5% OOH, p < 0.001), while personality disorder was diagnosed more frequently out of hours. (n = 432, 11.8%; 9.6% normal hours vs 14.4% out of hours, p < 0.001). There was a statistically significant difference in referral to voluntary services out of hours (7.2% normal hours vs 0.3% OOH).

CONCLUSION: In contrast to previous findings, our study found higher rates of alcohol-related disorders diagnosed during normal hours vs OOH. Furthermore, voluntary and addiction services were under-utilised OOH and this presents an important teaching opportunity.

PMID:36588147 | DOI:10.1007/s11845-022-03249-7

Neuropsychol Rev. 2023 Jan 2. doi: 10.1007/s11065-022-09572-1. Online ahead of print.

ABSTRACT

The aim of this meta-analysis is twofold: (a) to assess cognitive impairments in isolated rapid eye movement (REM) sleep behavior disorder (iRBD) patients compared to healthy controls (HC); (b) to quantitatively estimate the risk of developing a neurodegenerative disease in iRBD patients according to baseline cognitive assessment. To address the first aim, cross-sectional studies including polysomnography-confirmed iRBD patients, HC, and reporting neuropsychological testing were included. To address the second aim, longitudinal studies including polysomnography-confirmed iRBD patients, reporting baseline neuropsychological testing for converted and still isolated patients separately were included. The literature search was conducted based on PRISMA guidelines and the protocol was registered at PROSPERO (CRD42021253427). Cross-sectional and longitudinal studies were searched from PubMed, Web of Science, Scopus, and Embase databases. Publication bias and statistical heterogeneity were assessed respectively by funnel plot asymmetry and using I². Finally, a random-effect model was performed to pool the included studies. 75 cross-sectional (2,398 HC and 2,460 iRBD patients) and 11 longitudinal (495 iRBD patients) studies were selected. Cross-sectional studies showed that iRBD patients performed significantly worse in cognitive screening scores (random-effects (RE) model = -0.69), memory (RE model = -0.64), and executive function (RE model = -0.50) domains compared to HC. The survival analyses conducted for longitudinal studies revealed that lower executive function and language performance, as well as the presence of mild cognitive impairment (MCI), at baseline were associated with an increased risk of conversion at follow-up. Our study underlines the importance of a comprehensive neuropsychological assessment in the context of iRBD.

PMID:36588140 | DOI:10.1007/s11065-022-09572-1

Environ Sci Pollut Res Int. 2023 Jan 1. doi: 10.1007/s11356-022-24323-8. Online ahead of print.

ABSTRACT

Since the energy expenditure of households is an essential component of the total demand for energy, making the energy consumption in dwellings sustainable is vital to manage financial, environmental, and political risks related to energy import and consumption because controlled and sustainable energy expenditure, as one of the most prominent issues in today’s world, depends on a consensus of common sense regarding all the parties in the sector including households. This matter has rendered an investigation into the factors affecting the energy expenditure of households valuable and constituted the motivation of this study. The aim of the study is to determine the factors that affect the entire energy expenditure of households in Turkey, including heating, electricity, kitchen needs, and fuel needs for transportation, and to determine the quantities of these effects. In this regard, household budget research surveys conducted by the Turkish Statistical Institute were used in the study. The study concluded that socioeconomic indicators, particularly the age, marital status, educational background, and income of household responsible people and the technical characteristics of houses, have an effect on the energy expenditure of households. The results of the study provide valuable information to policy makers and decision makers in order to minimize the risks originating from energy import and expenditure by revealing the factors affecting the energy expenditure of households in Turkey.

PMID:36588133 | DOI:10.1007/s11356-022-24323-8

Ophthalmol Ther. 2023 Jan 2. doi: 10.1007/s40123-022-00640-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Photobiomodulation (PBM) represents a potential treatment for non-exudative age-related macular degeneration (AMD). PBM uses wavelengths of light to target components of the mitochondrial respiratory chain to improve cellular bioenergetic outputs. The aim of this study was to further investigate the effects of PBM on clinical, quality of life (QoL) and anatomical outcomes in subjects with intermediate stage non-exudative AMD.

METHODS: The multicenter LIGHTSITE II study was a randomized clinical trial evaluating safety and efficacy of PBM in intermediate non-exudative AMD. The LumiThera Valeda® Light Delivery System delivered multiwavelength PBM (590, 660 and 850 nm) or sham treatment 3 × per week over 3-4 weeks (9 treatments per series) with repeated treatments at baseline (BL), 4 and 8 months. Subjects were enrolled with 20/32 to 20/100 best-corrected visual acuity (BCVA) and no central geographic atrophy (GA) within the central fovea (500 μm).

RESULTS: LIGHTSITE II enrolled 44 non-exudative AMD subjects (53 eyes). PBM-treated eyes showed statistically significant improvement in BCVA at 9 months (n = 32 eyes, p = 0.02) with a 4-letter gain in the PBM-treated group versus a 0.5-letter gain in the sham-treated group (ns, p < 0.1) for patients that received all 27 PBM treatments (n = 29 eyes). Approximately 35.3% of PBM-treated eyes showed ≥ 5-letter improvement at 9 months. Macular drusen volume was not increased over time in the PBM-treated group but did show increases in the sham-treated group. While PBM and sham groups both showed GA lesion growth in the trial period, there was 20% less growth in the PBM group over 10 months, suggesting potential disease-modifying effects. No safety concerns or signs of phototoxicity were observed.

CONCLUSION: These results confirm previous clinical testing of multiwavelength PBM and support treatment with Valeda as a novel therapy with a unique mechanism of action as a potential treatment for non-exudative AMD.

TRIAL REGISTRATION: Clinicaltrial.Gov Registration Identifier: NCT03878420.

PMID:36588113 | DOI:10.1007/s40123-022-00640-6

Clin Transl Med. 2023 Jan;13(1):e1152. doi: 10.1002/ctm2.1152.

ABSTRACT

BACKGROUND: Gut-brain axis is widely implicated in the pathophysiology of Parkinson’s disease (PD). We take an integrated approach to considering the gut as a target for disease-modifying intervention, using continuous measurements of disease facets irrespective of diagnostic divide.

METHODS: We characterised 77 participants with diagnosed-PD, 113 without, by dietary/exogenous substance intake, faecal metabolome, intestinal inflammation, serum cytokines/chemokines, clinical phenotype including colonic transit time. Complete-linkage hierarchical cluster analysis of metabolites discriminant for PD-status was performed.

RESULTS: Longer colonic transit was linked to deficits in faecal short-chain-fatty acids outside PD, to a ‘tryptophan-containing metabolite cluster’ overall. Phenotypic cluster analysis aggregated colonic transit with brady/hypokinesia, tremor, sleep disorder and dysosmia, each individually associated with tryptophan-cluster deficit. Overall, a faster pulse was associated with deficits in a metabolite cluster including benzoic acid and an imidazole-ring compound (anti-fungals) and vitamin B3 (anti-inflammatory) and with higher serum CCL20 (chemotactic for lymphocytes/dendritic cells towards mucosal epithelium). The faster pulse in PD was irrespective of postural hypotension. The benzoic acid-cluster deficit was linked to (well-recognised) lower caffeine and alcohol intakes, tryptophan-cluster deficit to higher maltose intake. Free-sugar intake was increased in PD, maltose intake being 63% higher (p = .001). Faecal calprotectin was 44% (95% CI 5%, 98%) greater in PD [p = .001, adjusted for proton-pump inhibitors (p = .001)], with 16% of PD-probands exceeding a cut-point for clinically significant inflammation compatible with inflammatory bowel disease. Higher maltose intake was associated with exceeding this calprotectin cut-point.

CONCLUSIONS: Emerging picture is of (i) clinical phenotype being described by deficits in microbial metabolites essential to gut health; (ii) intestinal inflammation; (iii) a systemic inflammatory response syndrome.

PMID:36588088 | DOI:10.1002/ctm2.1152