JAMA. 2022 Nov 1;328(17):1768-1770. doi: 10.1001/jama.2022.18865.
NO ABSTRACT
PMID:36318139 | DOI:10.1001/jama.2022.18865
Tag: pubmed
JAMA. 2022 Nov 1;328(17):1747-1765. doi: 10.1001/jama.2022.18324.
ABSTRACT
IMPORTANCE: It is uncertain whether hormone therapy should be used for the primary prevention of chronic conditions such as heart disease, osteoporosis, or some types of cancers.
OBJECTIVE: To update evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions.
DATA SOURCES: PubMed/MEDLINE, Cochrane Library, EMBASE, and trial registries from January 1, 2016, through October 12, 2021; surveillance through July 2022.
STUDY SELECTION: English-language randomized clinical trials and prospective cohort studies of fair or good quality.
DATA EXTRACTION AND SYNTHESIS: Dual review of abstracts, full-text articles, and study quality; meta-analyses when at least 3 similar studies were available.
MAIN OUTCOMES AND MEASURES: Morbidity and mortality related to chronic conditions; health-related quality of life.
RESULTS: Twenty trials (N = 39 145) and 3 cohort studies (N = 1 155 410) were included. Participants using estrogen only compared with placebo had significantly lower risks for diabetes over 7.1 years (1050 vs 903 cases; 134 fewer [95% CI, 18-237]) and fractures over 7.2 years (1024 vs 1413 cases; 388 fewer [95% CI, 277-489]) per 10 000 persons. Risks per 10 000 persons were statistically significantly increased for gallbladder disease over 7.1 years (1113 vs 737 cases; 377 more [95% CI, 234-540]), stroke over 7.2 years (318 vs 239 cases; 79 more [95% CI, 15-159]), venous thromboembolism over 7.2 years (258 vs 181 cases; 77 more [95% CI, 19-153]), and urinary incontinence over 1 year (2331 vs 1446 cases; 885 more [95% CI, 659-1135]). Participants using estrogen plus progestin compared with placebo experienced significantly lower risks, per 10 000 persons, for colorectal cancer over 5.6 years (59 vs 93 cases; 34 fewer [95% CI, 9-51]), diabetes over 5.6 years (403 vs 482 cases; 78 fewer [95% CI, 15-133]), and fractures over 5 years (864 vs 1094 cases; 230 fewer [95% CI, 66-372]). Risks, per 10 000 persons, were significantly increased for invasive breast cancer (242 vs 191 cases; 51 more [95% CI, 6-106]), gallbladder disease (723 vs 463 cases; 260 more [95% CI, 169-364]), stroke (187 vs 135 cases; 52 more [95% CI, 12-104]), and venous thromboembolism (246 vs 126 cases; 120 more [95% CI, 68-185]) over 5.6 years; probable dementia (179 vs 91 cases; 88 more [95% CI, 15-212]) over 4.0 years; and urinary incontinence (1707 vs 1145 cases; 562 more [95% CI, 412-726]) over 1 year.
CONCLUSIONS AND RELEVANCE: Use of hormone therapy in postmenopausal persons for the primary prevention of chronic conditions was associated with some benefits but also with an increased risk of harms.
PMID:36318128 | DOI:10.1001/jama.2022.18324
Biol Open. 2022 Oct 31:bio.059229. doi: 10.1242/bio.059229. Online ahead of print.
ABSTRACT
Plasticity in hatching time allows embryos to maximize fitness by balancing benefits and costs of remaining bound within the chorion against the benefits and costs of emerging as a free-swimming larva. In our first experiment, we exposed zebrafish (Danio rerio) embryos to either chemical cues from crushed embryos (simulating egg predation) or to blank water control. Embryos exposed to alarm cues hatched sooner with shorter body lengths and underdeveloped fins relative to larvae from the water treatment. Burst swimming speed was significantly slower for larvae that hatched from the alarm cue treatment. In a second 2 x 2 experiment, we exposed zebrafish embryos to either chemical alarm cues from conspecific embryos, mechanical disturbance (magnetic stir bar) to simulate a predator probing the substrate for developing embryos, both chemical and mechanical indicators of risk, or neither (control). We found similar effects in terms of earlier time to hatch at an earlier stage of development and poorer swimming performance of hatchling larvae. In the second experiment these effects occurred in response to mechanical disturbance with or without the presence of chemical alarm cues. Alarm cues alone produced no effects in the second experiment. Taken together, these data indicate that zebrafish embryos demonstrate a facultative tradeoff between risk of predation acting on two stages of their life history.
PMID:36318109 | DOI:10.1242/bio.059229
Radiology. 2022 Nov 1:212922. doi: 10.1148/radiol.212922. Online ahead of print.
ABSTRACT
Background Deep learning (DL)-based MRI reconstructions can reduce examination times for turbo spin-echo (TSE) acquisitions. Studies that prospectively employ DL-based reconstructions of rapidly acquired, undersampled spine MRI are needed. Purpose To investigate the diagnostic interchangeability of an unrolled DL-reconstructed TSE (hereafter, TSEDL) T1- and T2-weighted acquisition method with standard TSE and to test their impact on acquisition time, image quality, and diagnostic confidence. Materials and Methods This prospective single-center study included participants with various spinal abnormalities who gave written consent from November 2020 to July 2021. Each participant underwent two MRI examinations: standard fully sampled T1- and T2-weighted TSE acquisitions (reference standard) and prospectively undersampled TSEDL acquisitions with threefold and fourfold acceleration. Image evaluation was performed by five readers. Interchangeability analysis and an image quality-based analysis were used to compare the TSE and TSEDL images. Acquisition time and diagnostic confidence were also compared. Interchangeability was tested using the individual equivalence index regarding various degenerative and nondegenerative entities, which were analyzed on each vertebra and defined as discordant clinical judgments of less than 5%. Interreader and intrareader agreement and concordance (κ and Kendall τ and W statistics) were computed and Wilcoxon and McNemar tests were used. Results Overall, 50 participants were evaluated (mean age, 46 years ± 18 [SD]; 26 men). The TSEDL method enabled up to a 70% reduction in total acquisition time (100 seconds for TSEDL vs 328 seconds for TSE, P < .001). All individual equivalence indexes were less than 4%. TSEDL acquisition was rated as having superior image noise by all readers (P < .001). No evidence of a difference was found between standard TSE and TSEDL regarding frequency of major findings, overall image quality, or diagnostic confidence. Conclusion The deep learning (DL)-reconstructed turbo spin-echo (TSE) method was found to be interchangeable with standard TSE for detecting various abnormalities of the spine at MRI. DL-reconstructed TSE acquisition provided excellent image quality, with a 70% reduction in examination time. German Clinical Trials Register no. DRKS00023278 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Hallinan in this issue.
PMID:36318032 | DOI:10.1148/radiol.212922
Acta Med Acad. 2022 Aug;51(2):85-91. doi: 10.5644/ama2006-124.376.
ABSTRACT
OBJECTIVES: Superficial benign parotid tumors are a common neoplasm of the salivary glands. Different surgical procedures have been applied for partial superficial parotidectomy (PSP) and extracapsular dissection (ECD), which are the two predominant surgical techniques. Our study aimed to evaluate PSP versus ECD for benign parotid tumors, in relation to post-operative complications and recurrence rates.
MATERIALS AND METHODS: 266 patients who underwent parotidectomies of benign superficial parotid tumors were evaluated retrospectively. The first group (PSP group) was composed of 143 patients who underwent PSP, and the second group (ECD group) was composed of 123 patients who underwent ECD.
RESULTS: In the ECD group the rate of patients presenting with total postoperative permanent facial nerve paralysis, House-Brackmann grade III, was 0.8%, whereas in the PSP group it was 1.4%. Frey’s syndrome was only reported in the PSP group. Salivary fistula occurred in both groups at similar rates. Sensation dysfunction due to greater auricular nerve division occurred in 72% patients in the PSP group and 10.6% in the ECD group. No statistical difference regarding recurrence rates was found between the two groups.
CONCLUSIONS: Both ECD and PSP procedures are safe surgical options for superficial parotidectomy in the treatment of benign tumors, with similar recurrence rates and post-surgical complications, apart from sensation abnormalities due to more extensive auricular nerve division.
PMID:36318000 | DOI:10.5644/ama2006-124.376
Br J Math Stat Psychol. 2022 Nov 1. doi: 10.1111/bmsp.12290. Online ahead of print.
ABSTRACT
Response process data collected from human-computer interactive items contain detailed information about respondents’ behavioural patterns and cognitive processes. Such data are valuable sources for analysing respondents’ problem-solving strategies. However, the irregular data format and the complex structure make standard statistical tools difficult to apply. This article develops a computationally efficient method for exploratory analysis of such process data. The new approach segments a lengthy individual process into a sequence of short subprocesses to achieve complexity reduction, easy clustering and meaningful interpretation. Each subprocess is considered a subtask. The segmentation is based on sequential action predictability using a parsimonious predictive model combined with the Shannon entropy. Simulation studies are conducted to assess the performance of the new method. We use a case study of PIAAC 2012 to demonstrate how exploratory analysis for process data can be carried out with the new approach.
PMID:36317951 | DOI:10.1111/bmsp.12290
Turk J Pharm Sci. 2022 Oct 31;19(5):583-588. doi: 10.4274/tjps.galenos.2021.09216.
ABSTRACT
OBJECTIVES: Gomphandra tetrandra (Wall.) Sleumer (leaves) belonging to the family Stemonuraceae was investigated for preliminary phytochemical screening and evaluating their pharmacological activities in various pharmacological models.
MATERIALS AND METHODS: The crude methanolic extract was screened with different chemical reagents for the qualitative detection of different phytochemical groups. The peripheral analgesic function was determined using the acetic acid-induced writhing procedure and sedative-hypnotic behaviors were assessed using hole-board, open field, and hole-cross tests using different doses of the extract (200 mg/kg and 400 mg/kg body weight).
RESULTS: Phytochemical screening revealed that methanolic extract of G. tetranda leaves contains steroids, gums, mucilages, phytosterols, carbohydrates, and flavonoids. The crude methanolic extract at 200 mg/kg and 400 mg/kg doses showed statistically significant activity in acetic acid-induced writhing inhibition test with 60% (p<0.01) and 76.47% (p<0.01) inhibition, respectively, compared to control. The extract also had dose-dependent substantial (p<0.01) sedative-hypnotic activities compared with diazepam in the hole-board, open field, and hole-cross tests.
CONCLUSION: It may be assumed that the methanolic leaf extract of G. tetrandra possesses a strong possibility of having analgesic and sedative-hypnotic activity due to the presence of bioactive compounds in its leaves. Moreover, observed results have opened a new era of in-depth research to discover the possible mechanism of analgesic and sedative-hypnotic activity.
PMID:36317941 | DOI:10.4274/tjps.galenos.2021.09216
Heart Surg Forum. 2022 Sep 12;25(5):E638-E644. doi: 10.1532/hsf.4815.
ABSTRACT
BACKGROUND: Ventricular septal defect (VSD) and atrial septal defect (ASD) are congenital heart diseases. The techniques of transthoracic closure (TC) and percutaneous closure (PC) for the treatment of VSD and ASD have continuously improved and matured. This study aimed to retrospectively analyze the therapeutic effects of TC and PC on VSD and ASD patients.
METHODS: We retrospectively reviewed 928 patients (552 VSD and 376 ASD) who had undergone TC or PC guided by transesophageal ultrasound at the Department of Cardiac Macrovascular Surgery of the First Affiliated Hospital of Nanchang University between August 2010 and August 2020. We collected and evaluated the clinical data of the patients, including age, gender, weight, inlet and outlet diameters of defect, and the operation results of TC and PC. Descriptive statistics were used to analyze means and standard deviations (SD), and the Chi-square test was used to evaluate the difference between groups.
RESULTS: Among the 928 patients who were treated with the closure operation, there were no casualties, with 907 patients (97.7%) showing successful closure. Among the 552 VSD patients who were treated with TC, 540 showed successful close, while 12 cases required extracorporeal circulation after the failure of TC. Among the 376 patients with ASD, 256 patients were treated with TC, of which 251 were successful, and five were failures, including three shedding cases. In addition, among the 120 patients who were treated with PC, 116 were successful, and four were failures, including two shedding cases. Postoperative follow up for patients with successful closure operations demonstrated that the complications of aortic and tricuspid regurgitation, hydro-pericardium, III° atrioventricular block, shedding of closure umbrella, hemolysis, and thrombosis had not occurred.
CONCLUSION: Closure operation of VSD and ASD by esophageal ultrasound has the advantages of lower trauma and blood loss, shorter hospital stay, simple operation, fewer postoperative complications, and significant therapeutic efficacy.
PMID:36317916 | DOI:10.1532/hsf.4815
Heart Surg Forum. 2022 Sep 28;25(5):E709-E714. doi: 10.1532/hsf.4825.
ABSTRACT
OBJECTIVE: This study aimed to evaluate the efficacy and safety of high-frequency oscillation ventilation combined with volume guarantee (HFOV-VG) in preterm infants with acute hypoxemic respiratory failure (AHRF) after patent ductus arteriosus ligation.
METHODS: We retrospectively analyzed the clinical data of 41 preterm infants, who were ventilated for AHRF after patent ductus arteriosus ligation between January 2020 and January 2022. HFOV alone was used in 20 of the 41 infants, whereas HFOV-VG was used in the other 21 infants.
RESULTS: There was no statistically significant difference in the demographic information and baseline characteristics of preterm infants included in the study. The average frequency tidal volume (VThf) of the HFOV-VG group was lower than that of the HFOV group (2.6 ± 0.6 mL versus 1.9 ± 0.3 mL, P < .001). In addition, the incidence of hypocapnia and hypercapnia in infants supported with HFOV-VG was significantly lower (15 versus 8, P < .001; 12 versus 5, P < .001). Furthermore, the duration of invasive ventilation in the HFOV-VG group also was lower than in the HFOV group (3.7 ± 1.2 days versus 2.1 ± 1.0 days, P < .01).
CONCLUSION: Compared with HFOV alone, HFOV-VG decreases VThf levels and reduces the incidence of hypercapnia and hypocapnia in preterm infants with acute hypoxic respiratory failure after patent ductus arteriosus ligation.
PMID:36317914 | DOI:10.1532/hsf.4825
Turk J Pharm Sci. 2022 Oct 31;19(5):543-551. doi: 10.4274/tjps.galenos.2021.96603.
ABSTRACT
OBJECTIVES: Drug information systems are commonly used by professionals to assist in the identification of drug interactions and to ensure the safe use of medications. Real-world evidence about the comparison of different drug interaction sources is scarce. We aimed to compare two drug interaction databases to identify interactions in a population-based survey.
MATERIALS AND METHODS: This is a cross-sectional study based on a previous survey performed in the city of Manaus, Brazil, in 2019. We included adults aged 18 years and over, who used two or more medicines 15 days before the interview. To assess potential drug interactions, we searched Micromedex and UpToDate databases. The primary outcome was the prevalence of potential drug interactions in each database. Weighted Kappa statistics were calculated to assess agreement on the presence of drug interaction, documentation and severity.
RESULTS: A total of 752 participants were included in the study. The prevalence of drug interactions was 43.8% [95% confidence interval (CI): 40.2, 47.3%] in UpToDate and 30.2% (95% CI: 26.9, 33.5%), in Micromedex. The agreement related to drug interactions between the two databases was fair (Kappa: 0.631). For severity (Kappa: 0.398) and documentation (Kappa: 0.311), the agreement was poor.
CONCLUSION: Agreement among compared databases was sub-optimal. Better quality and transparency of evidence available in drug interaction sources are needed to support informed healthcare professionals’ decision.
PMID:36317874 | DOI:10.4274/tjps.galenos.2021.96603