Tag: pubmed

Clin Oral Investig. 2022 Mar 29. doi: 10.1007/s00784-022-04439-4. Online ahead of print.

ABSTRACT

OBJECTIVES: Periodontitis is a local inflammatory disease of high prevalence worldwide. Increasing evidence has shown its association with cardiovascular diseases. While high-density lipoprotein is an important protective factor in preventing cardiovascular diseases, this study aims to examine whether high-density lipoprotein cholesterol (HDL-C) level is associated with different status of periodontitis.

MATERIALS AND METHODS: A total of 874 Chinese retirees (≥ 60 years of age) with different statuses of periodontitis were enrolled. Periodontal clinical data were collected to define periodontal disease severity (no, mild-moderate, severe). Peripheral blood was collected for serum lipid profile analysis. Linear and logistic regression analysis with adjustment for potential confounders (gender, age, BMI, alcohol intake, exercise frequency, smoking habits) were used to determine the association of periodontitis with HDL-C.

RESULTS: After adjustments for confounders, linear regression analyses revealed a significant relationship between the decreased HDL-C and periodontitis severity (p < 0.05). Although the multivariable-adjusted ORs of decreased HDL-C were not statistically significant, logistic regression analyses showed Chinese elderly with severe periodontitis had higher odds of exhibiting clinically abnormal HDL-C levels than those without periodontitis.

CONCLUSIONS: The elderly population with periodontitis showed HDL-C levels significantly lower than those without periodontitis. The severity of periodontitis was positively correlated with serum HDL-C levels.

CLINICAL RELEVANCE: Periodontitis reduces HDL-C level in the elderly population, indicating that oral health should be paid attention to in the prevention and treatment of dyslipidemia.

PMID:35348881 | DOI:10.1007/s00784-022-04439-4

Arch Orthop Trauma Surg. 2022 Mar 29. doi: 10.1007/s00402-022-04426-0. Online ahead of print.

ABSTRACT

INTRODUCTION: While higher institutional case volume is associated with better postoperative outcomes in various types of surgery, institutional case volume has been rarely included in risk prediction models for surgical patients. This study aimed to develop and validate the predictive models incorporating institutional case volume for predicting in-hospital mortality and 1-year mortality after hip fracture surgery in the elderly.

MATERIALS AND METHODS: Data for all patients (≥ 60 years) who underwent surgery for femur neck fracture, pertrochanteric fracture, or subtrochanteric fracture between January 2008 and December 2016 were extracted from the Korean National Health Insurance Service database. Patients were randomly assigned into the derivation cohort or the validation cohort in a 1:1 ratio. Risk prediction models for in-hospital mortality and 1-year mortality were developed in the derivation cohort using the logistic regression model. Covariates included age, sex, type of fracture, type of anaesthesia, transfusion, and comorbidities such as hypertension, diabetes, coronary artery disease, chronic kidney disease, cerebrovascular disease, and dementia. Two separate models, one with and the other without institutional case volume as a covariate, were constructed, evaluated, and compared using the likelihood ratio test. Based on the models, scoring systems for predicting in-hospital mortality and 1-year mortality were developed.

RESULTS: Analysis of 196,842 patients showed 3.6% in-hospital mortality (7084/196,842) and 15.42% 1-year mortality (30,345/196,842). The model for predicting in-hospital mortality incorporating the institutional case volume demonstrated better discrimination (c-statistics 0.692) compared to the model without the institutional case volume (c-statistics 0.688; likelihood ratio test p value < 0.001). The performance of the model for predicting 1-year mortality was also better when incorporating institutional case volume (c-statistics 0.675 vs. 0.674; likelihood ratio test p value < 0.001).

CONCLUSIONS: The new institutional case volume incorporated scoring system may help to predict in-hospital mortality and 1-year mortality after hip fracture surgery in the elderly population.

PMID:35348872 | DOI:10.1007/s00402-022-04426-0

Surg Endosc. 2022 Mar 29. doi: 10.1007/s00464-022-09192-z. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic-assisted thermal ablation has been used successfully to treat early hepatocellular carcinoma (HCC) tumors, defined as < 3 cm in diameter. This approach allows for ablation of tumors located in areas of the liver that are otherwise inaccessible for a percutaneous approach. Thermal ablation of exophytic tumors remains controversial due to a reported increased risk of tumor seeding of the abdominal cavity and incomplete ablation.

METHODS: This cohort study consisted of 663 HCC tumors treated with thermal ablation at a single, quaternary academic medical center between 2/2001 and 1/2021. Post treatment, patients were followed at a defined interval schedule beginning at one month post treatment, then every 3 months for 2 years, every 6 months in year 3, followed by yearly studies. Patients’ medical records were reviewed for three years post ablation for evidence of complete ablation and intra-abdominal dissemination of disease.

RESULTS: 326 patient records met the inclusion criteria. Comparing the exophytic and non-exophytic groups, there were statistically significant differences in etiology of liver disease (p = 0.048) and TNM stage (p = 0.03), as well as a higher rate of incomplete ablation in the non-exophytic group (10.2% vs 3.3%; p = 0.045). Otherwise, there were no statistically significant differences in baseline characteristics, tumor characteristics, or use of thermal ablation technology. Rates of intra-abdominal dissemination of HCC were low in both groups: 1.1% (n = 1) in the exophytic group and 1.7% (n = 4) in the non-exophytic group. There was no significant difference in intra-abdominal dissemination of HCC between the groups (p > 0.99, RR = 0.66; 95% CI 0.07-5.79). Additionally, no differences were seen in dissemination between microwave ablation and radiofrequency ablation (p > 0.99).

CONCLUSION: This study demonstrates that laparoscopic-assisted thermal ablation of small, exophytic tumors is safe and does not increase the risk for disseminated intra-abdominal HCC disease.

PMID:35348874 | DOI:10.1007/s00464-022-09192-z

Eur Radiol. 2022 Mar 29. doi: 10.1007/s00330-022-08576-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the diagnostic performance of the coronavirus disease 2019 (COVID-19) Reporting and Data System (CO-RADS) for detecting COVID-19.

METHODS: We searched PubMed, EMBASE, MEDLINE, Web of Science, Cochrane Library, and Scopus database until September 21, 2021. Statistical analysis included data pooling, forest plot construction, heterogeneity testing, meta-regression, and subgroup analyses.

RESULTS: We included 24 studies with 8382 patients. The pooled sensitivity and specificity and the area under the curve (AUC) of CO-RADS ≥ 3 for detecting COVID-19 were 0.89 (95% confidence interval (CI) 0.85-0.93), 0.68 (95% CI 0.60-0.75), and 0.87 (95% CI 0.84-0.90), respectively. The pooled sensitivity and specificity and AUC of CO-RADS ≥ 4 were 0.83 (95% CI 0.79-0.87), 0.84 (95% CI 0.78-0.88), and 0.90 (95% CI 0.87-0.92), respectively. Cochran’s Q test (p < 0.01) and Higgins I² heterogeneity index revealed considerable heterogeneity. Studies with both symptomatic and asymptomatic patients had higher specificity than those with only symptomatic patients using CO-RADS ≥ 3 and CO-RADS ≥ 4. Using CO-RADS ≥ 4, studies with participants aged < 60 years had higher sensitivity (0.88 vs. 0.80, p = 0.02) and lower specificity (0.77 vs. 0.87, p = 0.01) than studies with participants aged > 60 years.

CONCLUSIONS: CO-RADS has favorable performance in detecting COVID-19. CO-RADS ≥ 3/4 might be applied as cutoff values given their high sensitivity and specificity. However, there is a need for more well-designed studies on CO-RADS.

KEY POINTS: • CO-RADS shows a favorable performance in detecting COVID-19. • CO-RADS ≥ 3 had a high sensitivity 0.89 (95% CI 0.85-0.93), and it may prove advantageous in screening the potentially infected people to prevent the spread of COVID-19. • CO-RADS ≥ 4 had high specificity 0.84 (95% CI 0.78-0.88) and may be more suitable for definite diagnosis of COVID-19.

PMID:35348865 | DOI:10.1007/s00330-022-08576-y

Eur Radiol. 2022 Mar 29. doi: 10.1007/s00330-022-08692-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop a deep learning algorithm to automatically evaluate and diagnose scoliosis on full spinal X-ray images.

METHODS: This retrospective study collected full spinal X-ray images (anteroposterior) from four hospital databases from January 1, 2018, to March 31, 2021. The data were divided into training and validation sets. Full spinal X-ray images for external validation were independently collected at one hospital from April 1, 2021, to June 30, 2021. Model effectiveness was validated with a public dataset. Statistical software R was used to analyze the accuracy and sensitivity of the model curvature and anatomical balance parameters and assess interrater consistency.

RESULTS: This study included 788 and 185 training and test datasets, respectively. The accuracy and recall of the algorithm model for the Cobb angle, apical vertebrae (AV), upper vertebrae, and lower vertebrae were 89.36%, 85.71%, 77.2%, and 80.24% and 97.35%, 93.38%, 84.11%, and 87.42%, respectively. The symmetric mean absolute percentage error at the Cobb angle was 5.99%, and the automatic measurement time was 1.7 s. The mean absolute error values of the Cobb angle and the distances between the center sacral vertical line and AV and C7 plumb line were 1.07° and 1.12 and 1.38 mm, respectively. Statistical analysis confirmed that the Cobb angle results were in good agreement with the gold standard (interclass coefficients of 0.996, 0.978, and 0.825; p < 0.001).

CONCLUSION: Our deep learning algorithm model had high sensitivity and accuracy for scoliosis, which could help radiologists improve their diagnostic efficiency.

KEY POINTS: • Our deep learning algorithm model had high sensitivity and accuracy for scoliosis, which could help radiologists improve their diagnostic efficiency. • Multi-center validation data were used in this study to guarantee the reliability of the research. • Algorithmic model measures 200 times faster than radiologists.

PMID:35348867 | DOI:10.1007/s00330-022-08692-9

Graefes Arch Clin Exp Ophthalmol. 2022 Mar 29. doi: 10.1007/s00417-022-05597-7. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the role of cardiac autonomic neuropathy (CAN), vascular condition, and sensory function in diabetic retinopathy (DR) progression.

METHODS: This 3-year cohort study conducted in a community hospital included 4850 patients over 20 with type 2 diabetes mellitus. Participants were assessed in 2017 at baseline and were followed up in 2020. Patients were divided into two groups based on whether they had DR progression or not and were compared using the chi-square test or two-sample t-test. Beta coefficient and odds ratio (OR) with 95% confidence intervals were calculated using binary logistic regression. The receiver operating characteristic (ROC) curve of various independent variables for DR progression was provided with C-statistics.

RESULTS: Abnormal hemoglobin A1c (HbA1c) level/variation, estimated glomerular filtration rate, urine albumin-to-creatinine ratio, R-R interval variation, standard deviation of the average NN intervals, autonomic nervous system function, power of high-frequency (HF) bands, balance, cardio-ankle vascular index (CAVI), and warm stimulation (WS) were associated with DR progression. Average HbA1c, HF, and proliferative diabetic retinopathy were independent factors for patients developing DR progression. The top three areas under the curve of ROCs were HF + baseline DR grading, WS + baseline DR grading, and CAVI + baseline DR grading. These variable combinations were the most reliable predictors of DR progression.

CONCLUSION: CAN, abnormal vascular condition, and sensory function are associated with DR progression. The combination of HF, WS, and CAVI with baseline DR grading provides the most accurate predictive model for DR progression. Early detection of these factors is important to prevent DR progression.

PMID:35348845 | DOI:10.1007/s00417-022-05597-7

Pediatr Radiol. 2022 Mar 29. doi: 10.1007/s00247-022-05333-7. Online ahead of print.

ABSTRACT

BACKGROUND: The value of ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) in the diagnostic assessment of pediatric fever of unknown origin is not known, and evidence from adults is not applicable.

OBJECTIVE: To quantify the contribution of ¹⁸F-FDG PET to pediatric fever of unknown origin, considering its diagnostic limitations.

MATERIALS AND METHODS: We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials up to Feb. 18, 2021. We included studies on patients with pediatric fever of unknown origin presenting sufficient data to calculate the likelihood of achieving definite diagnosis (based on pathology or clinical follow-up) between those with abnormal PET findings versus those with normal PET findings. We assessed the risk of bias using a modified Newcastle-Ottawa quality assessment scale and quantified the value of PET by pooling the likelihood of achieving definite diagnosis using a random-effects model.

RESULTS: We included 6 studies and found that pediatric patients with abnormal PET findings were about 17 times more likely to achieve definite diagnoses than those with normal PET findings (odds ratio [OR]: 16.75, 95% confidence interval [CI] 8.0-35, P < 0.00001). Sensitivity analyses using a fixed-effect model (OR 16.91, 95% CI 8.1-35, P < 0.0001) or removing one study at a time (OR 12-20, 95% CI lower bound 3.8-8.6, 95% CI upper bound 33-45, P < 0.0001) did not significantly alter the results. Sample size (interaction P = 0.75), imaging modality (interaction P = 0.29), length of follow-up (interaction P = 0.37), fever of unknown origin subclasses (interaction P = 0.89) and geographical areas (interaction P = 0.74) of studies showed no statistically significant influence on the results.

CONCLUSION: ¹⁸F-FDG PET is a promising approach in the diagnostic work-up of pediatric fever of unknown origin. Further studies are warranted to support routine use in clinical care.

PMID:35348809 | DOI:10.1007/s00247-022-05333-7

Int Orthop. 2022 Mar 29. doi: 10.1007/s00264-022-05388-z. Online ahead of print.

ABSTRACT

PURPOSE: In clinical practice, many patients complained that their knees became larger after total knee arthroplasty (TKA), yet no studies have described this phenomenon. We named this as “patient-perceived enlargement of knee” (PPEK). This study aimed to investigate the prevalence of PPEK after TKA; assess the association between PPEK and demographics, surgical options, or component size; assess the influence of PPEK on patient satisfaction and functional outcomes; and determine whether there was radiological difference between patients with or without PPEK.

METHODS: We reviewed patients that underwent unilateral primary TKA between May 2018 and April 2019. We investigated the prevalence of PPEK and acquired functional scores and satisfaction. Patients were divided into two groups according to whether they complained of PPEK. In radiological evaluation, we measured anterior and posterior condyle offset (ACO and PCO) of the femur, tibial coverage lines, tibial overhanging lines, and femoral overhanging lines.

RESULTS: A total of 389 patients were enrolled and 101 patients felt their knee became “larger” after TKA. Patients with PPEK had significantly shorter height and lower weight, yet component size distribution showed no statistical difference. Patients with PPEK had significantly lower functional scores and satisfaction. Patients with PPEK had significantly larger ACO, shorter postoperative PCO, more ACO increase, and less anterior underhang of the tibia.

CONCLUSION: PPEK is common in TKA patients, especially in individuals with smaller height and weight. PPEK is associated with poor satisfaction and lower functional scores. In radiology, post-operative ACO, PCO, and anterior underhang of the tibial component were correlated with PPEK.

PMID:35348833 | DOI:10.1007/s00264-022-05388-z

J Trop Pediatr. 2022 Mar 28:fmac026. doi: 10.1093/tropej/fmac026. Online ahead of print.

ABSTRACT

BACKGROUND: The first case of COVID-19 in Cameroon was recorded in March 2020. In response to the pandemic, Cameroon like most countries instituted a number of control measures to curb the spread of the pandemic across the country. These COVID-19 control measures added to the fear of this disease within the population may have led to other detrimental health effects like; the pattern of hospitalizations and hospital outcome.

METHODS: We did a cross-sectional study with data from in-patient admission records of children admitted at the pediatric ward of the Regional Hospital Bamenda over a 24 months period, (1st of March 2019 to the 28th of February 2021). The pre-pandemic period in Cameroon (that is the first 12 months, from March 2019-February 2020) and the pandemic period (that is the last 12 months, from March 2020-February 2021) were compared.

RESULTS: A total of 2,282 hospitalization records were included in the study. Most of the hospitalized children were males (57.23%). There was a 19.03% decline in pediatric hospitalizations during the first twelve months of the pandemic, which was statistically significant (P = 0.00024). The causes of hospitalizations and mortality remained similar over both periods, with severe malaria the leading cause of admissions. Hospital deaths before and during the pandemic were 1.6% and 1.9% respectively.

CONCLUSION: There was a statistically significant decline in pediatric hospitalizations during the first twelve months of the pandemic, as compared to the same period before the pandemic. Hospital mortality, and causes of hospitalizations remained similar over both periods.

LAY SUMMARY: The COVID-19 pandemic is a public health emergency and challenge to the health systems of most countries worldwide. The initial response of the Cameroon government to the COVID-19 pandemic was to put a number of measures in place to stop the spread of the virus across the country. These measures, though beneficial in the fight against COVID-19 could have led to other detrimental health effects on the population, through a change in the pattern of hospitalizations and hospital outcome, and all these made worse by the fear of COVID within the population.We carried out a descriptive and retrospective cross sectional study using hospitalization and mortality data from the pediatric ward of the Regional Hospital Bamenda, in Cameroon. We compared the data for the last twelve months before the pandemic (March 2019-February 2020) to that of the first twelve months during the pandemic in Cameroon (March 2020-February 2021).The comparison of the two periods showed that there was a statistically significant decline in pediatric hospitalizations during the first twelve months of the pandemic, by 19.03% (P = 0.00024). The hospital mortality rates before and during the pandemic were 1.6% and 1.9% respectively and the causes of these hospitalizations and mortality remained similar over both periods.

PMID:35348796 | DOI:10.1093/tropej/fmac026

Nicotine Tob Res. 2022 Mar 26;24(5):768-777. doi: 10.1093/ntr/ntab206.

ABSTRACT

INTRODUCTION: The Population Assessment of Tobacco and Health (PATH) Study is a longitudinal cohort study on tobacco use behavior, attitudes and beliefs, and tobacco-related health outcomes, including biomarkers of tobacco exposure in the U.S. population. In this report we provide a summary of urinary nicotine metabolite measurements among adult users and non-users of tobacco from Wave 1 (2013-2014) of the PATH Study.

METHODS: Total nicotine and its metabolites including cotinine, trans-3′-hydroxycotinine (HCTT), and other minor metabolites were measured in more than 11 500 adult participants by liquid chromatography tandem mass spectrometry methods. Weighted geometric means (GM) and least square means from statistical modeling were calculated for non-users and users of various tobacco products.

RESULTS: Among daily users, the highest GM concentrations of nicotine, cotinine and HCTT were found in exclusive smokeless tobacco users, and the lowest in exclusive e-cigarette users. Exclusive combustible product users had intermediate concentrations, similar to those found in users of multiple products (polyusers). Concentrations increased with age within the categories of tobacco users, and differences associated with gender, race/ethnicity and educational attainment were also noted among user categories. Recent (past 12 months) former users had GM cotinine concentrations that were more than threefold greater than never users.

CONCLUSIONS: These urinary nicotine metabolite data provide quantification of nicotine exposure representative of the entire US adult population during 2013-2014 and may serve as a reference for similar analyses in future measurements within this study.

IMPLICATIONS: Nicotine and its metabolites in urine provide perhaps the most fundamental biomarkers of recent nicotine exposure. This report, based on Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, provides the first nationally representative data describing urinary nicotine biomarker concentrations in both non-users, and users of a variety of tobacco products including combustible, e-cigarette and smokeless products. These data provide a urinary biomarker concentration snapshot in time for the entire US population during 2013-2014, and will provide a basis for comparison with future results from continuing, periodic evaluations in the PATH Study.

PMID:35348786 | DOI:10.1093/ntr/ntab206