Tag: pubmed

J Prev Alzheimers Dis. 2022;9(4):589-600. doi: 10.14283/jpad.2022.70.

ABSTRACT

BACKGROUND: The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are low costing and noninvasive neuropsychological tests in screening Mild Cognitive Impairment (MCI) due to Alzheimer’s disease (AD). There is no consensus on which test performs better in detecting MCI due to AD based on the different imperfect reference standards. Therefore, we conducted a meta-analysis to assess the diagnostic performance of MMSE and MoCA for screening MCI due to AD in the absence of a gold standard.

METHODS: Six electronic databases were searched for relevant studies until April, 2022. A hierarchical Bayesian latent class model was used to estimate the pooled sensitivity and specificity of MoCA and MMSE in the absence of a gold standard.

RESULTS: 90 eligible studies covering 21273 individuals for MMSE, 26631 individuals for MoCA were included in this meta-analysis. The pooled sensitivity was 0.71(95%CI: 0.67-0.74) for MMSE and 0.85(95%CI: 0.83-0.88) for MoCA, while the pooled specificity was 0.71(95%CI: 0.68-0.74) for MMSE and 0.79(95%CI: 0.76-0.81) for MoCA. MoCA was useful to “rule in” and “rule out” the diagnosis of MCI due to AD with higher positive likelihood ratio (4.07; 95%CI: 3.60-4.62) and lower negative likelihood ratio (0.18; 95%CI: 0.16-0.22). Moreover, the diagnostic odds ratio of MoCA was 22.08(95%CI: 17.24-28.29), which showed significantly favorable diagnostic performance.

CONCLUSIONS: It suggests that MoCA has greater diagnostic performance than MMSE for differentiating MCI due to AD when the gold standard is absent. However, these results should be taken with caution given the heterogeneity observed.

PMID:36281663 | DOI:10.14283/jpad.2022.70

Prostate. 2022 Oct 25. doi: 10.1002/pros.24446. Online ahead of print.

ABSTRACT

BACKGROUND: Prostate biopsy is still unavoidable in patients with a rising prostate-specific antigen even though multiparametric magnetic resonance imaging (MRI) is widely used. ¹⁸ F-DCFPyL positron emission tomography (PET)/MRI was proved to be promising both in sensitivity and specificity. But its guiding fusion biopsy and the advantages in the diagnosis of prostate disease is seldom reported. This study aimed to verify the feasibility and advantage of ¹⁸ F-DCFPyL PET/MRI-guided fusion targeted biopsy (TB) over whole-mount histopathology (WMH) for prostate cancer diagnosis.

METHODS: A prospective study of 94 biopsy-naïve patients were conducted using ¹⁸ F-DCFPyL PET/MRI scans and scored on a scale of 1-4. Systematic biopsy was performed for all patients. Patients with suspicious lesions also underwent PET/MRI/transrectal ultrasound-guided fusion biopsy. Patients with pathologically confirmed cancer underwent surgery and WMH sections. Systematic biopsy was compared with TB for the detection of index tumors (ITs). Significant cancer was defined as Grade group (GG) 2 or higher no matter the length of the cancer core.

RESULTS: ¹⁸ F-DCFPyL PET/MRI detected 30/94 (32%) patients with a score of 4, all of whom were verified to have prostate cancer. While it detected 10 patients with a score of 1 (10.6%), they were shown to have no cancer. The sensitivity and specificity of ¹⁸ F-DCFPyL PET/MRI were 94.4% and 75%, respectively, if images with a score of 3 are defined as positive. Systematic biopsy detected 18% (203/1128) samples as prostate cancer; conversely, TB detected 113 samples out of 259 scores (43.6%). A statistically significant difference was seen between the PCa detection rates by TB and SB (p < 0.001). All targeted lesions were pathologically proven to be the IT on WMH.

CONCLUSIONS: In biopsy-naïve patients, the ultrasound fusion biopsy targeted by ¹⁸ F-DCFPyL PET/MRI is an identical pathway for the detection of prostate cancer.

PMID:36281654 | DOI:10.1002/pros.24446

Orthop Surg. 2022 Oct 25. doi: 10.1111/os.13549. Online ahead of print.

ABSTRACT

OBJECTIVE: Surgeon handedness has been widely discussed in operative surgery, and could cause clinical discrepancy. However, few studies have reported the effect of handedness on unicompartmental knee arthroplasty (UKA). Based on our clinical observation and case analysis, we aimed to find out the effects of surgeon handedness on UKA.

METHODS: We retrospectively studied 94 UKA procedures performed by one right-handed surgeon from January 2017 to December 2018 at a single medical center. The cases were divided into two groups by operation side (49 L-UKAs and 45 R-UKAs). Preoperative demographic data were collected. Imaging parameters (femorotibial and hip-knee-ankle angles and tibial-plateau retroversion) and joint function scores (Knee Society Score [KSS] and Oxford Knee Score [OKS]) were recorded. Patients were followed up regularly and Forgotten Joint Score (FJS) was calculated at the last follow-up. All data were compared between the two groups with independent-samples t-test, and paired t-test was used for intragroup comparisons.

RESULTS: The average follow-up was 26.7 ± 3.2 months. The average patient age was 63.5 ± 9.0 years and the average body mass index was 26.89 ± 3.43 kg/m² . There was no significant group difference in any preoperative characteristic. Both the KSS and OKS improved significantly after surgery (p < 0.05). No significant group difference was found between the KSS or OKS at any follow-up visit. The varus or valgus of tibial component was 3.57 ± 1.42° on the left side and 3.19 ± 1.56° on the right side (p = 0.45). The varus or valgus of femoral component was 7.81 ± 2.43° in patients undergoing L-UKA and 7.05 ± 2.90° in those undergoing R-UKA (p = 0.04). No statistical differences were found in outliers of component orientation on both sides. The femorotibial and hip-knee-ankle angles improved significantly in both groups, and there was no significant group difference in either lower limb alignment or tibial-plateau retroversion. The complication rate was 8.16% (4/49) in the L-UKA group and 6.67% (3/45) in the R-UKA group. There was no correlation between prosthesis orientation and early joint function score.

CONCLUSIONS: Surgeon handedness may cause a worse prosthetic orientation on femoral side during surgeon’s non-dominant UKA, and surgeons should be cautious of bone resection and prosthesis implantation. However, radiographic difference did not bring variations on short-term clinical outcomes or lower limb alignment.

PMID:36281639 | DOI:10.1111/os.13549

J Esthet Restor Dent. 2022 Oct 25. doi: 10.1111/jerd.12978. Online ahead of print.

ABSTRACT

OBJECTIVE: The cement bonding strategy and the polymerization mode can influence the prognosis of indirect restorations. The microtensile bond strength (μTBS) and dentin endogenous enzymatic activity of a dual-cure resin cement (PV5) used in combination with two dentin surface conditioners (accelerator-enhancer primer, TP or universal adhesive, UA) were evaluated.

MATERIALS AND METHODS: PV5 was used to lute composite overlays after dentin treatment with TP or UA. The resin cement was self-cured, SC (1 h at 37 °C) or dual-cured, DC (20 s light-cure followed by 15 min self-cure at 37°C). The μTBS test, fractographic analysis, and the in situ zymography evaluations were performed after 24 h (T₀ ) or 1 yr (T₁₂ ) of artificial storage. Data were statistically analyzed (α = 0.05).

RESULTS: TP/DC obtained the highest adhesive strengths (45 ± 9 and 36.6 ± 8), while UA/SC (17 ± 8 and 11 ± 4) the lowest, both at T₀ and T₁₂ , respectively. DC resulted in superior bonding values than the SC, independent of the dentin surface treatment (p < 0.05). The type of adhesive, curing mode and aging influenced the gelatinolytic activity (p < 0.05).

CONCLUSIONS: The dual-cure resin cement used in combination with its accelerator-enhancer primer showed superior bonding performances with respect to universal adhesive. Dual-curing the resin cement was determinant to enhance bonding capability over time, independent of the adhesive strategy.

CLINICAL RELEVANCE: Clinicians must be aware to faithfully follow manufacturer’s recommendation regarding the adhesive strategy suggested with the resin cement used.

PMID:36281586 | DOI:10.1111/jerd.12978

Korean J Gastroenterol. 2022 Oct 25;80(4):177-185. doi: 10.4166/kjg.2022.077.

ABSTRACT

BACKGROUND/AIMS: Endoscopic stenting is an evolving treatment for symptomatic Crohn’s strictures. Several case series and small studies have reported its efficacy. Future studies can be designed based on a systematic review of the evaluation of efficacy. Hence, this meta-analysis was conducted to assess the critical role of stents in the management of intestinal strictures associated with Crohn’s disease (CD).

METHODS: A literature search of various databases from 2000 to February 2022 was conducted for studies evaluating the outcome of stents in patients with CD-related stricture. The outcomes assessed included technical and clinical success, adverse events, symptom recurrence, and the need for a surgical resection. Pooled event rates across studies were expressed with summative statistics.

RESULTS: Ten studies with 170 patients were included in the present analysis. The pooled event rates for technical success, clinical success, stent migration, and post-procedural pain were 98.2% (95% CI, 95.8-100), 71.3% (95% CI, 57.4-85.1), 32% (95% CI, 0.0-65.3) and 20.2% (95% CI, 4.1-36.2), respectively. The cumulative recurrence rate and need for surgery were 40.1% (95% CI, 20.3-59.9) and 8.6% (95% CI, 1.7-15.5), respectively. Subgroup analysis showed that partially-covered (PC) self-expanding metallic stent (SEMS) was significantly better than fully-covered SEMS with a lower stent migration rate and symptom recurrence rate.

CONCLUSIONS: Overall efficacy of stents in the management of CD-related stricture remains moderate with a low complication rate. Among the stents, PC-SEMS may be associated with a more favorable outcome. Future studies will be needed to determine the long-term benefits of endoscopic stenting.

PMID:36281550 | DOI:10.4166/kjg.2022.077

Korean J Intern Med. 2022 Oct 25. doi: 10.3904/kjim.2022.050. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: To identify changes in symptoms and pulmonary sequelae in patients with coronavirus disease 2019 (COVID-19).

METHODS: Patients with COVID-19 hospitalized at seven university hospitals in Korea between February 2020 and February 2021 were enrolled, provided they had ≥ 1 outpatient follow-up visit. Between January 11 and March 9, 2021 (study period), residual symptom investigations, chest computed tomography (CT) scans, pulmonary function tests (PFT), and neutralizing antibody tests (NAb) were performed at the outpatient visit (cross-sectional design). Additionally, data from patients who already had follow-up outpatient visits before the study period were collected retrospectively.

RESULTS: Investigation of residual symptoms, chest CT scans, PFT, and NAb were performed in 84, 35, 31, and 27 patients, respectively. After 6 months, chest discomfort and dyspnea persisted in 26.7% (4/15) and 33.3% (5/15) patients, respectively, and 40.0% (6/15) and 26.7% (4/15) patients experienced financial loss and emotional distress, respectively. When the ratio of later CT score to previous ones was calculated for each patient between three different time intervals (1-14, 15-60, and 61-365 days), the median values were 0.65 (the second interval to the first), 0.39 (the third to the second), and 0.20 (the third to the first), indicating that CT score decreases with time. In the high-severity group, the ratio was lower than in the low-severity group.

CONCLUSIONS: In COVID-19 survivors, chest CT score recovers over time, but recovery is slower in severely ill patients. Subjects complained of various ongoing symptoms and socioeconomic problems for several months after recovery.

PMID:36281537 | DOI:10.3904/kjim.2022.050

Ann Lab Med. 2023 Mar 1;43(2):174-179. doi: 10.3343/alm.2023.43.2.174.

ABSTRACT

BACKGROUND: Development of an accessible method to routinely evaluate the clonality of strains is needed in microbiology laboratories. We compared the discriminatory power of the Fourier-transform infrared (FTIR) spectroscopy-based IR Biotyper (Bruker Daltonics GmbH, Bremen, Germany) to matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), using whole-genome sequencing (WGS) as the reference method.

METHODS: Eighty-three extended-spectrum β-lactamase-producing Escherichia coli isolates were tested using WGS, MALDI-TOF MS, and IR Biotyper. Simpson’s diversity index (SDI), a statistical analysis for testing the homogeneity of a dendrogram, and the adjusted Rand index (aRI) were used to compare the discriminatory ability between typing tests.

RESULTS: The SDI (95% confidence interval) was 0.969 (0.952-0.985) for WGS, 0.865 (0.807-0.924) for MALDI-TOF MS, and 0.974 (0.965-0.983) for IR Biotyper. Compared with WGS, IR Biotyper showed compatible diversity, whereas MALDI-TOF MS did not. The concordance and aRI improved from 66.3% to 84.3% and from 0.173 to 0.538, respectively, for IR Biotyper versus MALDI-TOF MS with WGS as the reference method. IR Biotyper showed substantially improved performance in strain typing compared with MALDI-TOF MS.

CONCLUSIONS: IR Biotyper is useful for diversity analysis with improved discriminatory power over MALDI-TOF MS in comparison with WGS as a reference method. IR Biotyper is an accessible method to evaluate the clonality of strains and could be applied in epidemiological analysis during an outbreak of a health care facility, as well as for research on the transmission of resistant bacteria in community settings.

PMID:36281511 | DOI:10.3343/alm.2023.43.2.174

Phys Sportsmed. 2022 Oct 24:1-8. doi: 10.1080/00913847.2022.2136984. Online ahead of print.

ABSTRACT

OBJECTIVE: Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years.

METHODS: During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used.

RESULTS: The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%).

CONCLUSION: In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.

PMID:36281474 | DOI:10.1080/00913847.2022.2136984

Biomed Res Int. 2022 Oct 15;2022:2545830. doi: 10.1155/2022/2545830. eCollection 2022.

ABSTRACT

The global malaria morbidity and mortality witnessed an increase from 2019 to 2020 partly due to disruptions in control programs’ activities imposed by the COVID-19 pandemic. Therefore, there is still a significant burden of malaria in Cameroon which needs attention from all fronts to attain elimination goals. It is normally expected that a typical forest ecology that has undergone urbanization and subjected to high rates of ecological instabilities should also have a shift from characteristic perennial malaria transmission and a shift in the type of malaria endemicity plaguing such distorted forest ecology. In this observational comparative study, we randomly enrolled participants from rural and urban settings of a forest zone during a low malaria transmission period, which coincided with the onset of COVID-19 pandemic. An optimized structured questionnaire was employed, to collect socio-demographic data and associated risk factors. The CareStart™ Malaria HRP2 antigen test was performed on participants from both settings to determine the prevalence of community asymptomatic malaria. Of 307 participants, 188 (61.0%) were from the rural, while 119 (38.8%) from the urban community. The overall prevalence of asymptomatic malaria (27.0%) detected Plasmodium falciparum antigen in 83 participants. The urban community’s prevalence was 4.2% (5 positives) while the rural community’s was 41.5% (78 positives). In simple logistic regression models, rural forest community and farm around the house were statistically significant predictors of testing positive (coefficient 2.8, 95% CI 1.8-3.7, p value<0.001) and (coefficient 3.1, 95% CI 1.1-5.1, p value =0.003), respectively. In the multivariate model, the strongest predictor of testing positive was living in a rural community, with p < 0.001 and odds ratio of 10.9 (95% CI, 3.8-31.8). These results indicate that during a low transmission period, the prevalence of asymptomatic malaria differs between depleted urban and rural forested settings, suggesting a need for strategic target intervention for the control of asymptomatic malaria.

PMID:36281461 | PMC:PMC9587908 | DOI:10.1155/2022/2545830

Biomed Res Int. 2022 Oct 15;2022:6565620. doi: 10.1155/2022/6565620. eCollection 2022.

ABSTRACT

OBJECTIVE: Primary bladder tumors have a high degree of malignancy. To investigate the expression of human papillomavirus type 16 (HPV-16) in primary bladder tumors and the loss of cell differentiation and to explore the significance of HPV-16 detection, it is expected to be a disease. Treatment provides a theoretical basis.

METHODS: Fifty-seven patients with primary bladder tumors admitted to our hospital from January 2019 to January 2022 were selected as the research subjects, and they were divided into HPV-related groups according to the human papillomavirus (HPV) infection status (n = 28) and HPV unrelated group (n = 29). The general data of patients were collected, the expression of HPV-16 in bladder tissue samples was detected, and the correlation between pathological parameters and HPV-16 expression was analyzed.

RESULTS: Among HPV subtypes, HPV 16 subtype accounted for the highest proportion, followed by HPV-18 and HPV-6 subtypes; there was no significant difference in tumor stage (stage 1, stage a, stage 2a) between the HPV-related group and the HPV-unrelated group (stage 1, stage a, and stage 2a). P > 0.05); there was no significant difference in postoperative pathological expression (high expression and low expression) of patients (P > 0.05); there was no statistical difference in age and gender between HPV-related and HPV-unrelated groups (P > 0.05), HPV-related group and HPV-unrelated group compared daily regular drinking and smoking status, the difference was statistically significant (P < 0.05); HPV-16 expression was not correlated with tumor differentiation degree and age of patients (P > 0.05); the area under the curve (AUC) of HPV-16 for judging primary bladder tumor expression and cellular molecular deletion was 0.891, with a sensitivity of 83.94% and a specificity of 88.57%.

CONCLUSION: HPV-16 is an upper, expressed in primary bladder tumors and will participate in the differentiation and loss of cells, which can provide effective guidance and basis for the diagnosis of primary bladder tumors, which is an important factor for judging the pathological stage and prognosis of patients and can provide a theoretical reference for the formulation of therapeutic measures.

PMID:36281460 | PMC:PMC9587909 | DOI:10.1155/2022/6565620