Tag: pubmed

Medicine (Baltimore). 2022 Sep 30;101(39):e30231. doi: 10.1097/MD.0000000000030231.

ABSTRACT

Physical factors such as frequency of low back pain, sensory abnormalities in the lower extremities, smoking history before surgery, and preoperative mental health status as predictors of operative outcomes have been growing as areas of interest in the field of degenerative lumbar spinal stenosis (DLSS). This study aimed to investigate the correlation between the preoperative Short Form-36 Mental Component Score (SF-36 MCS) and long-term prognosis after decompression surgery for DLSS. In total, 198 patients were enrolled in this study. The Oswestry Disability Index (ODI) and Rolland Morris Disability Questionnaire (RMDQ) were used to evaluate spinal functional outcomes. The SF-36 questionnaire was used and analyzed by classifying it into physical component score (PCS) and mental component score (MCS). The SF-36 MCS was divided into role limitations caused by emotional problems, social functioning, vitality, and emotional well-being. In the correlation between preoperative MCS and ODI improvement, the r value was -0.595 (P < .05) at 12 months postoperatively. ODI improvement at 12 months after decompression surgery showed a statistically significant and strong negative correlation with preoperative MCS. In the correlation between preoperative MCS and RMDQ improvement, the r value was -0.544 (P < .05) at 12 months postoperatively. Therefore, RMDQ improvement 12 months after decompression surgery showed a strong negative correlation with preoperative MCS. Regarding the correlation between preoperative MCS and SF-36 PCS improvement, the r values were 0.321 (P < .05) at 6 months postoperatively and 0.343 (P < .05) at 12 months postoperatively. Therefore, SF-36 PCS improvement at 6 and 12 months after decompression surgery showed a strong positive correlation with preoperative SF-36 MCS scores. Preoperative SF-36 MCS is a factor that can predict the prognosis of patients who underwent decompression surgery for lumbar spinal stenosis for at least 1 year postoperatively.

PMID:36181126 | DOI:10.1097/MD.0000000000030231

Medicine (Baltimore). 2022 Sep 30;101(39):e30878. doi: 10.1097/MD.0000000000030878.

ABSTRACT

To explore the prognostic significance and underlying mechanism of TYRO protein tyrosine kinase-binding protein (TYROBP) in osteosarcoma. Firstly, the expression of TYROBP was analyzed using the t test. The Kaplan-Meier plotter analysis and a receiver operating characteristic curve were performed to evaluate the influence of TYROBP on overall survival (OS). Further, Cox regression analysis was conducted to predict the independent prognostic factors for OS of osteosarcoma patients, and a nomogram was constructed. Then, the relationship between TYROBP and clinicopathological characteristics was determined using statistical methods. Enrichment analyses were conducted to evaluate the biological functions of TYROBP. Finally, the ESTIMATE algorithm was used to assess the association of TYROBP with immune cell infiltration. TYROBP was significantly increased in osteosarcoma (all P < .001). However, the high expression of TYROBP was related to better OS in osteosarcoma patients. Cox regression analysis showed that TYROBP was an independent prognostic factor for predicting OS (P = .005), especially in patients of the male sex, age <18 years, metastasis, and tumor site leg/foot (all P < .05). Besides, TYROBP mRNA expression was significantly associated with the tumor site (P < .01) but had no remarkable relationship with age, gender, and metastasis status (all P > .05). Functional annotation and gene set enrichment analysis (GSEA) revealed that TYROBP was mainly involved in immune-related pathways. Importantly, TYROBP positively correlated with immune scores (P < .001, R = .87). TYROBP served as an independent prognostic biomarker for OS in osteosarcoma. High TYROBP expression might prolong the survival of osteosarcoma patients mainly through promoting antitumor immunity.

PMID:36181123 | DOI:10.1097/MD.0000000000030878

Medicine (Baltimore). 2022 Sep 30;101(39):e30772. doi: 10.1097/MD.0000000000030772.

ABSTRACT

INTRODUCTION: Cholecystectomy is the intervention of choice for treating acute cholecystitis; when conservative management does not work, it operates on the patient outside the critical condition. It can be performed together with or after endoscopic papillotomy through endoscopic retrograde cholangiopancreatography (ERCP) when it is concurrent with a situation of cholechodocolithiasis or when there is compression and consequent increase in pressure in the bile duct caused by a calculus jammed in the vesicular infundibulum (Mirizzi’s syndrome), with or without jaundice, fever, and pain in the right hypochondrium (Charcot’s Triad), which can progress to sepsis of biliary origin. This review aims to assess whether the timing of cholecystectomy (before or after ERCP) interferes with the postoperative period and clinical outcome in patients with acute cholecystitis.

METHODS AND ANALYSIS: By searching the MEDLINE/PubMed, Embase, Web of Science, ScienceDirect, ClinicalTrials.gov, CINAHAL, Latin American and Caribbean Literature in Health Sciences, Scopus and Cochrane Central databases, Controlled Trials Registry Randomized clinical trials will be searched to analyze whether ERCP performed before or after open or laparoscopic cholecystectomy (LC) in patients with acute cholecystitis is beneficial or not, through the analysis of postoperative complications. No language or publication period restrictions will be imposed. The primary outcome will be postoperative complications (postoperative morbidity and mortality). Four independent reviewers will select the studies and extract data from the original publications, with a fifth reviewer in case of disagreement regarding the inclusion or not of particular research in the present review. The risk of bias will be assessed using The Risk of Bias 2 (RoB 2.0) tool, and the certainty of evidence will be evaluated using the grading of recommendations assessment, development, and evaluation. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will calculate the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogeneous.

ETHICS AND DISCLOSURE: Since the present study will review secondary data, previously published and scientifically validated, it will not be necessary to obtain ethical approval. The results of this systematic review will be published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER: International Prospective Registry of Systematic Reviews (PROSPERO) CRD42021290726.

PMID:36181122 | DOI:10.1097/MD.0000000000030772

Medicine (Baltimore). 2022 Sep 30;101(39):e30849. doi: 10.1097/MD.0000000000030849.

ABSTRACT

Neurofilament light chains (NfLs) are promising biomarkers of neuroaxonal damage in stroke patients. We investigated the correlations between NfL levels and infarct volume, initial stroke severity, and functional outcomes at discharge in patients with acute ischemic stroke. We prospectively included 15 patients with first-ever acute ischemic stroke and 8 age- and sex-matched healthy controls without other neurological disorders. Serum NfL levels were measured using the single-molecule array (Simoa) technique twice within 24 hours of admission (NfL1D) and on the seventh hospital day (NfL7D) in patients with stroke and once in healthy controls. We assessed the infarct volume on diffusion-weighted magnetic resonance imaging using the free software ITK-SNAP. Serum NfL1D levels in stroke patients were significantly higher (28.4 pg/mL; interquartile range [IQR], 43.0) than in healthy controls (14.5 pg/mL; IQR, 3.2; P = .005). Temporal pattern analyses demonstrated that NfL7D levels were increased (114.0 pg/mL; IQR, 109.6) compared to NfL1D levels in all stroke patients (P = .001). There was a strong correlation between NfL7D levels and infarct volume (R = 0.67, P = .007). The difference between NfL1D and NfL7D (NfLdiff levels) was strongly correlated with the infarct volume (R = 0.63; P = .013). However, there was no statistically significant correlation between NfL levels and the initial stroke severity or functional outcomes at discharge. NfL levels in the subacute stage of stroke and the NfL difference between admission and 7th day of hospital were correlated with infarct volume in patients with acute ischemic stroke.

PMID:36181119 | DOI:10.1097/MD.0000000000030849

Medicine (Baltimore). 2022 Sep 30;101(39):e30705. doi: 10.1097/MD.0000000000030705.

ABSTRACT

BACKGROUND: Alzheimer disease (AD) is a common cause of dementia, and there are still a lack of treatment options to reverse or prevent disease progression. Existing evidence shows that acupuncture has advantages in the treatment of AD, but whether the efficacy of acupuncture belongs to the placebo effect remains controversial, and there is no strict placebo-controlled clinical study to evaluate the efficacy and safety of acupuncture combined with Western medicine in the treatment of AD.

METHODS: This is a prospective randomized, a single-blind, sham-acupuncture controlled trial to study the clinical efficacy of acupuncture combined with Western medicine in the treatment of mild to moderate AD. Participants will be randomly divided into treatment and control groups. The treatment group using acupuncture combined with donepezil hydrochloride orally, and the control group using sham acupuncture combined with donepezil hydrochloride orally, followed up for 24 weeks after 24 weeks of continuous treatment. Outcome measures included: AD assessment scale-cognitive subscale, mini-mental state examination, activities of daily living, neuropsychiatric inventory questionnaire, serum superoxide dismutase, and homocysteine levels. Finally, SPASS 21.0 software was used for statistical analysis of the data.

DISCUSSION: This study will evaluate the efficacy of acupuncture combined with Western medicine in improving cognitive function and activities of daily living in AD patients. The results of this study will verify whether the efficacy of acupuncture in the treatment of AD belongs to the placebo effect, which will also provide a reference for the clinical use of acupuncture combined with Western medicine in the treatment of AD.

TRIAL REGISTRATION: The TCTR identification number is TCTR20220817004.

PMID:36181104 | DOI:10.1097/MD.0000000000030705

Medicine (Baltimore). 2022 Sep 30;101(39):e30697. doi: 10.1097/MD.0000000000030697.

ABSTRACT

Type II diabetes mellitus (DM2) is a worldwide disease with an important economic and health impact. Currently, depression, anxiety and stress are common disorders among diabetic populations but their respective prevalence may well be underestimated. So far, Latin American countries have only reported limited information about the impact of mental diseases on DM2 outpatients. The objective of this study was to evaluate the prevalence and risk factors related to depression, anxiety, and stress among ambulatory DM2 populations from two third-level hospitals in Quito, Ecuador. A cross-sectional study based on a random sample was carried out in two hospitals. Patients were evaluated by the 21-item Depression, Anxiety and Stress Scale (DASS-21). In addition, a validated survey was used to grade socioeconomic, demographic, clinical, and comorbidity variables. Descriptive statistics and multiple logistic regression were used to analyze the data. Statistical analysis was performed by SPSS (version 22.0). STROBE guidelines were used for reporting this trial. A total of 208 adult patients with DM2 were included (women 58%; men 42%). The prevalence of depression, anxiety and stress was 31.7% (95% CI, 25.5-38.5%), 33.7% (95% CI, 27.3-40.5%), and 25.0% (95% CI, 19.3-31.5%), respectively. Male gender was associated with a decreased risk for depression (OR 0.39 [95% CI, 0.18-0.81]; P = .01), anxiety (OR 0.31 [95% CI, 0.16-0.65]; P = .002), and stress (OR 0.35 [95% CI, 0.15-0.77]; P = .009). A higher level of education was associated with low risk for depression (OR 0.23 [95% CI, 0.11-0.46]; P < .001), anxiety (OR 0.47 [95% CI, 0.25-0.90]; P = .02), and stress (OR 0.24 [95% CI, 0.12-0.49]; P = .001). In contrast, patients with DM2 complications were more likely to have depression (OR 2.96 [95% CI, 1.32-6.63]; P = .008) and anxiety (OR 2.56 [95% CI, 1.20-5.48]; P = .01). Finally, an income higher than the basic salary reduced the risk of depression alone (OR 0.39 [95% CI, 0.16-0.91]; P = .03). In conclusion, a high prevalence rate of depression, anxiety, and stress was found in the DM2 outpatient population. Thus, more tailored care surveillance for DM2 patients is needed considering the bio-psycho-social environment to provide an integral health management.

PMID:36181107 | DOI:10.1097/MD.0000000000030697

Medicine (Baltimore). 2022 Sep 30;101(39):e30566. doi: 10.1097/MD.0000000000030566.

ABSTRACT

Pancreatic cancer is one of the most lethal malignancies with a rise in mortality rates. FOLFIRINOX and nab-paclitaxel plus gemcitabine demonstrated a survival benefit compared to gemcitabine alone. Both protocols are now considered the standard of first-line treatment with no significant difference between them, primarily based on observational studies. Although new therapeutic options have emerged recently, the prognosis remains poor. We conducted a retrospective single-center study on 139 patients treated for metastatic pancreatic adenocarcinoma (mPDAC) with gemcitabine monotherapy (Gem) or nab-paclitaxel + gemcitabine (Nab-P/Gem) in the first line. The aim of our study was to evaluate the effectiveness in terms of overall survival (OS) and progression-free survival (PFS) as well as the influence of patient and disease characteristics on outcomes. Nab-P/Gem resulted in OS of 13.87 months compared to 8.5 months in patients receiving Gem. The same trend was achieved in PFS, 5.37 versus 2.80 months, respectively, but without reaching statistical significance. Furthermore, the 6-month survival in the Nab-P/Gem group was also higher, 78.1% versus 47.8%. In terms of survival, the group of elderly patients, patients of poorer performance, with higher metastatic burden and liver involvement, benefited the most from combination therapy. In our analysis ECOG performance status (p.s.), previous primary tumor surgery, and liver involvement were found to be independent prognostic factors. The addition of nab-paclitaxel to gemcitabine resulted in a significant improvement in the OS of patients with mPDAC. Subgroup analysis demonstrated that patients with some unfavorable prognostic factors benefited the most.

PMID:36181099 | DOI:10.1097/MD.0000000000030566

Vasc Endovascular Surg. 2022 Sep 30:15385744221131424. doi: 10.1177/15385744221131424. Online ahead of print.

ABSTRACT

OBJECTIVES: To study the role of combined CTPA and indirect CT venogram to diagnose venous thromboembolism (VTE) in patients with COVID-19 pneumonia and to compare the clinical characteristics, laboratory parameters, CT findings and clinical outcomes between the VTE positive and negative groups.

METHODS: In this retrospective study, 131 patients with COVID-19 pneumonia who underwent CTPA and venogram between August 2020 and January 2021 were included. Relevant demographical, clinical and laboratory data and CT images were collected. Two thoracic radiologists independently reviewed the CTPA and venogram images.

RESULTS: VTE was identified in 29 patients (22% of the study population). CT venogram identified DVT in 9 patients. No statistical difference was observed between the two groups with respect to age, gender, BMI and presence of comorbidities. There was a significant difference in the hospital stay duration, which is increased in the VTE positive group. The number of patients who were dependent on oxygen and mortality were also high in the positive group. There was statistically significant difference in the mean D-dimer value and the mean Neutrophil/lymphocyte ratio, which were higher in the VTE positive group.

CONCLUSION: Combined CTPA and venogram can be used as a one-stop investigation for diagnosing PE and DVT of lower limbs in patients with COVID-19 pneumonia. CTPA with venogram should be performed in patients with D-dimer value in the range of 1000 – 1200 μg/L and above to rule out VTE as the hospital stay duration and final outcomes vary between the positive and negative groups.

PMID:36179371 | DOI:10.1177/15385744221131424

J Phys Chem B. 2022 Sep 30. doi: 10.1021/acs.jpcb.2c05125. Online ahead of print.

ABSTRACT

Following the compressibility route in statistical mechanics, the local isothermal modulus is derived for nanoconfined fluids. Based on this inhomogeneous modulus, an acoustic-propagation model (APM) is first proposed for averaged isothermal modulus in the pore. By utilizing the density profiles obtained from classical density functional theory, the inhomogeneous modulus of supercritical methane in the graphite slit pore is calculated. It is found that the profile of the modulus in the pore is out of phase with that of density. Further, employing the proposed APM method, the averaged isothermal modulus is calculated, and the effects of pressure, pore size, and temperature on the averaged modulus are investigated. It is found that (i) averaged modulus obtained from APM method still satisfies the Tait-Murnaghan (TM) equation, (ii) the averaged modulus is proportional to the reciprocal pore width for wider pores, while it oscillates with the reciprocal pore width for narrower pores, and (iii) the reciprocal modulus is proportional to temperature, while the linearization coefficient is insensitive to the pore size. These findings bear important implications for understanding the elasticity in fluid-saturated nanoporous media and may shed light on the capture or storage of special gases in the fields of geochemistry and geophysics.

PMID:36179366 | DOI:10.1021/acs.jpcb.2c05125

Prim Care Companion CNS Disord. 2022 Sep 27;24(5):21m03189. doi: 10.4088/PCC.21m03189.

ABSTRACT

Objective: To investigate sex differences in psychiatric comorbidities in adolescents with autism spectrum disorder (ASD).

Methods: The US National Inpatient Sample dataset (January 2016 to December 2018) was used for this retrospective study. The patient population was selected by performing a query on all adolescent patients (aged 12-17 years) having ASD with the ICD-10-CM code starting with F84. All missing sex data were excluded. Additional data on mood disorders, anxiety disorders, personality disorders, adjustment disorders, psychotic disorders, attention-deficit/hyperactivity disorder (ADHD)/conduct disorders, sleep-wake disorders, and substance use disorders were collected. Data on psychiatric comorbidities were collected using the ICD-10-CM code provided in the Clinical Classifications Software of the dataset.

Results: Mood disorders (37.4% vs 44.1%, P < .001) and anxiety disorders (29.4% vs 37.0%, P < .001) were more prevalent in females compared to males. The prevalence of ADHD and other conduct disorders was significantly higher in males than females (47.7% vs 36.7%, P < .001). Substance use disorders were slightly higher among males compared to females (3.7% vs 3.0%, P = .04).

Conclusion: The study findings revealed statistically significant disparities in psychiatric comorbidities among adolescent male and female patients with ASD. These findings could serve as a pilot for larger-scale research with this patient population in the future.

PMID:36179362 | DOI:10.4088/PCC.21m03189