Tag: pubmed

Surg Laparosc Endosc Percutan Tech. 2022 Oct 24. doi: 10.1097/SLE.0000000000001115. Online ahead of print.

ABSTRACT

OBJECTIVE: The umbilicus is the only anatomic entrance and incision site for trans-umbilical laparoendoscopic single-site surgery (TU-LESS). Data on incisional surgical site infections (ISSI) and incision healing in TU-LESS are lacking. Therefore, we aimed to observe umbilical incision healing and possible hernia after TU-LESS and explore the efficacy of preoperative umbilicus preparation on ISSI.

SUBJECTS AND METHODS: Consecutive patients aged 18 to 65 years, who were scheduled to undergo TU-LESS at a teaching hospital between March 2020 and November 2021, were enrolled in this prospective study. All patients were randomized to the study group with preoperative umbilicus preparation 30 minutes before patients were sent to the operating room and to the control group without preparation. The umbilical dimple was disinfected twice using povidone-iodine in both groups before the skin incision. The primary outcome was ISSI within 30 days of surgery. Umbilical hernia at 3 months after surgery and perioperative data such as operation time, complications, and incision healing were recorded and compared.

RESULTS: A total of 400 patients were recruited for this study. TU-LESS was performed in all patients without major complications. ISSI occurred in 5 patients in the study group (2.5%) and 3 patients in the control group (1.5%), with no significant differences between both groups (P=0.479). No umbilical hernia occurred in any patient during the 3 months follow-up. Six patients in the study group (3.1%) and 1 in the control group (0.5%) experienced excessive scarring, a relatively high incidence in the study group, though the difference was not statistically significant (P=0.067).

CONCLUSIONS: TU-LESS-related umbilical hernias are rare with existing suturing methods. Umbilicus preparation before TU-LESS could not decrease ISSI; however, it increased the nursing workload, which should be avoided.

PMID:36314980 | DOI:10.1097/SLE.0000000000001115

Turk Arch Pediatr. 2022 Nov;57(6):644-650. doi: 10.5152/TurkArchPediatr.2022.22124.

ABSTRACT

OBJECTIVE: Bartter syndrome and Gitelman syndrome are rare inherited tubulopathies characterized by hypokalemic, hypochloremic metabolic alkalosis. This study aimed to clarify the frequency of the phenotypic and genotypic subgroups, clinical features, long-term management, and prognosis of children diagnosed with Bartter syndrome and Gitelman syndrome in this study.

MATERIALS AND METHODS: Twenty-seven patients with Bartter syndrome and 6 patients with Gitelman syndrome, who were followed up between 2004 and 2020 in a single center, were included in the study.

RESULTS: The median age of diagnosis was 4 months in patients with Bartter syndrome and 174 months in patients with Gitelman syndrome. At the last follow-up, a total of 12 Bartter syndrome patients had chronic kidney disease with a mean 7.79 ± 4.73 years of age; 5 (18.5%) of these patients had chronic kidney disease stage 2, 5 (18.5%) had chronic kidney disease stage 3, and 2 (7.4%) had chronic kidney disease stage 5. Of the 5 patients with Bartter syndrome with chronic kidney disease stage 2, 2 had CLCNKB and 1 had SLC12A1 gene mutation. Also, CLCNKB mutation was detected in 2 of 5 patients with Bartter syndrome with chronic kidney disease stage 3. Finally, 2 patients with Bartter syndrome with chronic kidney disease stage 5 had BSND mutation in one and CLCNKB mutation in the other. Estimated glomerular filtration rates of all patients with Gitelman syndrome were normal at the last follow-up. There was no statistically significant association of development of chronic kidney disease with genetic mutation, nephrocalcinosis, prematurity, and hypokalemia.

CONCLUSION: Patients with Bartter syndrome and Gitelman syndrome may have a different clinical course due to the underlying genetic mutation. Bartter syndrome and Gitelman syndrome require lifelong treatment, and regular follow-up is important to prevent advanced-stage chronic kidney disease.

PMID:36314956 | DOI:10.5152/TurkArchPediatr.2022.22124

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7550-7555. doi: 10.26355/eurrev_202210_30026.

ABSTRACT

OBJECTIVE: This study investigated the prevalence of dental caries in first permanent molars among children aged 7-14 years in Saudi Arabia.

PATIENTS AND METHODS: This retrospective cross-sectional study included 6,089 panoramic radiographs of boys and girls aged 7-14 years who visited Riyadh Elm University Dental Hospital in Riyadh. All the panoramic radiographs were examined by five calibrated examiners for caries, filling, missing, and pulp therapy in the first permanent molars (FPMs). The Chi-square test was applied at a p<0.05.

RESULTS: A total of 24,356 FPMs were evaluated from the panoramic radiograph, 69.5% of FPMs were sound, 22.5% were carious, and 7.3% were treated. The prevalence of decayed FPMs was 30.5%. A statistically significant difference in the status of FPM was observed across genders. Caries in the mandibular FPM was significantly higher than those in the maxillary FPM at p<0.05.

CONCLUSIONS: The prevalence of caries in the FPM was relatively high, and females had more decay than males. Additionally, the mandibular FPMs showed higher levels of caries than the upper FPMs.

PMID:36314345 | DOI:10.26355/eurrev_202210_30026

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7695-7704. doi: 10.26355/eurrev_202210_30046.

ABSTRACT

OBJECTIVE: The majority of children experience a mild course of acute Coronavirus Disease 2019 (COVID-19). Only few studies have looked at long-term recovery from COVID-19 infection in children. The purpose of this study was to identify the predictors of long-COVID by performing a thorough analysis of the clinical, laboratory, and demographic characteristics of children with COVID-19.

PATIENTS AND METHODS: Between August and October 2021, data were obtained retrospectively from the medical records of 251 children diagnosed with COVID-19 at a tertiary single-center hospital. The prognostic effects of admission-related factors were compared between patients who experienced long-lasting symptoms and those who did not.

RESULTS: Long-COVID symptoms were noted in 12.4% of patients. Joint pain (7.6%), lumbago (4.8%), and headache (3.2%) were the most common symptoms. The mean onset of long-COVID symptoms was 1.35±0.49 months. The onset of long-COVID symptoms was 4 weeks after initial diagnosis in 64.5% of patients and 4-8 weeks later in 35.5% of the patients. The mean duration of long-COVID symptoms was 5.32±2.51 months. Children with long-COVID had higher leukocytes, neutrophils, monocytes, basophils, platelets, and D-dimer when compared with patients without long-COVID (p < 0.001). Leukocytes, neutrophils, monocytes, platelets, and D-dimer had the highest AUC in the ROC analysis (0.694, 0.658, 0.681, 0.667, and 0.612, respectively) and were statistically significant.

CONCLUSIONS: Despite the majority of children with COVID-19 having mild or asymptomatic acute disease, the majority of long-COVID symptoms were associated with functional impairment between 1 and 9 months after the start of the infection. Increased leukocytes, monocytes, neutrophils, platelets, and D-dimer appear to be the most powerful laboratory predictors for long-COVID and monitoring these predictors may assist clinicians to identify and follow-up patients with higher risk for long-COVID.

PMID:36314341 | DOI:10.26355/eurrev_202210_30046

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7667-7678. doi: 10.26355/eurrev_202210_30043.

ABSTRACT

OBJECTIVE: Activation of the PI3K/AKT/mTOR pathway in patients with HER2-positive breast cancer is associated with acquired resistance to trastuzumab. This randomized controlled trial (RCTs) meta-analysis was designed to evaluate the clinical efficacy and safety of PI3K/Akt/mTOR inhibitors in combination with trastuzumab in HER2-positive breast cancer.

MATERIALS AND METHODS: We searched on Web of Knowledge, PubMed, Embase, Cochrane, CNKI, and ClinicalTrials.Gov for RCTs comparing PI3K/Akt/mTOR inhibitors plus trastuzumab vs. standard trastuzumab treatments. Pooled estimates of progression-free survival (PFS), pathologic complete response (pCR), and incidence of adverse events were determined.

RESULTS: 5 studies out of 610 were found to be eligible and were included in our analysis (n=1,548 participants). PI3K/Akt/mTOR inhibitors combination with trastuzumab treatments resulted in a statistically significant increase in PFS compared with conventional trastuzumab therapy (HR 0.82; 95% CI: 0.76-0.90; p<0.00001). The new combination treatment was more effective on hormone receptor-negative patients (HR 0.73; 95% CI: 0.58-0.93; p=0.010). In addition, the combination of PI3K/Akt/mTOR inhibitors with trastuzumab slightly increased the risk of some adverse events, such as neutropenia, leukopenia, fatigue, and anemia.

CONCLUSIONS: The combination treatments of PI3K/Akt/mTOR inhibitors and trastuzumab for PI3K/Akt/mTOR inhibitors combined with trastuzumab treatments for patients with HER2-positive breast cancer can improve median progression-free survival while increasing the incidence of adverse events. It is still controversial based on the current evidence. Due to the limited number and quality of included studies, more high-quality studies are needed for further analysis.

PMID:36314338 | DOI:10.26355/eurrev_202210_30043

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7594-7599. doi: 10.26355/eurrev_202210_30034.

ABSTRACT

OBJECTIVE: The aim of the study was to investigate the existence of neuroendocrine cells and to compare the density of those in normal ovarian tissue, endometriotic and non-endometriotic benign ovarian cysts.

PATIENTS AND METHODS: Twenty patients with the diagnosis of endometrioma and 30 control subjects consisting of ovarian serous cystadenoma (n=10), ovarian mucinous cystadenoma (n=10) and normal ovarian tissue (n=10) were included. The tissues were prepared and assessed according to staining density by using the H-score method.

RESULTS: Tissues with mucinous cystadenoma were significantly more stained with PAS and VanGieson, when compared to women with endometrioma. Macrophage deposition was higher in cyst samples with endometrioma and in normal ovarian tissue when compared to serous cystadenoma and mucinous cystadenoma. Normal ovarian tissue was significantly more stained with PGP9.5, NSE and SYN when compared to endometrioma and non-endometriotic benign ovarian cyst. PGP9.5 staining was higher in normal ovarian tissue when compared with endometriotic lesions (p<.001). Endometrioma samples were significantly more stained with p53 when compared to non-endometriotic cysts and normal ovarian tissue. c-Kit staining was mild and not statistically significant among all groups.

CONCLUSIONS: During endometrioma transformation, expression intensity of neuroendocrine markers decreases compared to normal ovarian tissue and other benign ovarian cysts.

PMID:36314331 | DOI:10.26355/eurrev_202210_30034

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7541-7549. doi: 10.26355/eurrev_202210_30025.

ABSTRACT

OBJECTIVE: The aim of the current study was to describe the alternation pattern of cerebral and ocular blood flow velocities (BFVs) in symptomatic patients with unilateral carotid stenosis after carotid endarterectomy.

PATIENTS AND METHODS: 20 symptomatic patients underwent carotid endarterectomy for ≥ 50% unilateral carotid stenosis. Cerebral and ocular hemodynamics were evaluated by Transcranial Doppler (TCD) and Color Doppler imaging (CDI), respectively, first preoperatively, then during the following several days after carotid endarterectomy before discharge, and finally two to sixteen months later.

RESULTS: Statistically significant improvements in the BFVs were recorded in the ipsilateral anterior cerebral artery (ACA), middle cerebral artery (MCV) and short posterior ciliary artery (SPCA) during the following several days after carotid endarterectomy. Preoperative retrograde flows of the ipsilateral ophthalmic artery (OA) in two patients returned to anterograde direction immediately following carotid endarterectomy. At the follow-up of two to sixteen months, the BFVs of the ipsilateral ACA, MCA and SPCA tended to decline and were no longer statistically significant from the preoperative values.

CONCLUSIONS: Carotid endarterectomy significantly increased the flow velocities of ipsilateral cerebral anterior circulation and OA branching artery in patients with unilateral carotid stenosis early after surgery. At the long-term follow-up, the flow velocities in the ipsilateral hemisphere had the tendency to reduce and approach the preoperative level.

PMID:36314325 | DOI:10.26355/eurrev_202210_30025

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7514-7521. doi: 10.26355/eurrev_202210_30022.

ABSTRACT

OBJECTIVE: Acute pancreatitis (AP) is one of the diseases that surgical clinics deal with the most. While mortality rates are approximately 1% in all cases, this rate may increase to 15% in pancreatic necrosis cases. Therefore, early diagnosis and treatment are very important in necrotizing pancreatitis. Our aim in this study is to present the guiding effectiveness of procalcitonin and immature granulocyte ratios (IG%) in planning the early diagnosis and treatment of acute necrotizing pancreatitis.

PATIENTS AND METHODS: 582 patients hospitalized in our clinic with the diagnosis of acute pancreatitis were included in this study. All patients were divided into two groups as acute edematous pancreatitis (AEP) and acute necrotizing pancreatitis (ANP) according to tomography results. White blood cell (WBC) count, procalcitonin, IG%, C-reactive protein (CRP), amylase and lipase, albumin, CRP/albumin levels were recorded. The differences between the two groups were analyzed statistically.

RESULTS: According to the results of contrast-enhanced abdominal tomography (CECT), 525 patients were diagnosed with AEP and 57 with ANP. WBC, CRP, procalcitonin, IG and CRP/albumin were found to be significantly higher in ANP patients when compared to AEP (p<0.0001). According to the ROC analysis result, procalcitonin (AUROC: 0.999), IG% (AUROC: 0.995), WBC count (AUROC: 0.841), CRP (AUROC: 0.947), albumin (AUROC: 0.862), and CRP/albumin (AUROC: 0.946) ratio were markers that could be used for early prediction of ANP.

CONCLUSIONS: Early diagnosis of ANP can reduce morbidity and mortality. Procalcitonin and IG% levels can be easily accessible and effective markers in the early diagnosis of ANP and in the planning of treatment.

PMID:36314322 | DOI:10.26355/eurrev_202210_30022

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7454-7460. doi: 10.26355/eurrev_202210_30014.

ABSTRACT

OBJECTIVE: This study used the Sniffin’ Sticks test battery to evaluate olfactory function in employees of a bakery exposed to flour dust.

SUBJECTS AND METHODS: The study enrolled 43 individuals with exposure (i.e., to flour) plus 41 healthy volunteers as controls. Olfactory function was assessed in these subjects through the use of the Sniffin’ Sticks test battery. The overall score was calculated by adding up the scores for each of the 12 separate odors. A score of 6 or less was deemed anosmia, from 7 to 10 hyposmia, and a score of 11 or 12 was taken to indicate no impairment of olfaction.

RESULTS: There was a statistically significant difference between the scores obtained in the exposure group (10.09±2.29) and the control group (10.73±2.07), the exposure group having a lower score (p<0.05). Within the exposure group, men and women did not score differently (p>0.05). Furthermore, in this group, the overall score did not correlate significantly with age, sex, length of employment, or use of tobacco or alcohol use (p>0.05). Using the scheme employed in this study, 9.3% of the exposed workers were anosmic, compared to 9.8% in the controls, whereas 34.9% of baker workers were hyposmic, compared to just 14.6% of the controls. Thus, our study shows that impairment of the ability to smell was present in 44.2% of individuals exposed occupationally to flour dust.

CONCLUSIONS: This study reveals that being exposed to flour dust reduces the ability to smell normally. In order to minimize the impact of being exposed, workplaces should ensure adequate ventilation and provide workers with protective facemasks.

PMID:36314315 | DOI:10.26355/eurrev_202210_30014

Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7344-7348. doi: 10.26355/eurrev_202210_30003.

ABSTRACT

OBJECTIVE: An interaction between hereditary and environmental variables is thought to be the cause of keratoconus, a progressive ectatic corneal condition. The identification of risk factors is necessary since they are currently the subject of intense debate and are crucial to the management and prevention of the disease. The objective of this study is to gain a better understanding of the risk factors associated with the onset and progression of keratoconus. It would be valuable for both eye care professionals and patients in Saudi Arabia.

PATIENTS AND METHODS: Patients seeking eye care at Qassim University eye clinic were included in this study. Participants were divided into: cases (with keratoconus) and control (without keratoconus but with other ocular problems). Keratoconus diagnoses of the participants were made by the attending optometrists or ophthalmologists. Multivariate logistic analyses were performed to identify the risk factors for keratoconus. Moreover, by performing logistic regression and CART analysis, supervised learning algorithms were developed to predict the likelihood of keratoconus based on the risk factors.

RESULTS: There were 75 keratoconus patients and 75 control. The CART model to predict the chances of keratoconus occurrence has an accuracy of 73%. Our prediction model can be a baseline model for future risk factor analysis studies that will be done in the Middle Eastern region. The models can be better trained by refining the risk factor quality and also by increasing the keratoconus population in the study. Including clinical parameters in the prediction models would result in complex as well as models with better prediction accuracy.

CONCLUSIONS: Clinical ocular parameters including the corneal topographic variables have to be obtained to better correlate the risk factors with specific changes or the subtypes of the keratoconus. Complex diseases like keratoconus require machine learning models apart from statistical analysis for association and causation. Machine learning models would not only predict the disease but also provide insight into how the risk factors interact with each other.

PMID:36314304 | DOI:10.26355/eurrev_202210_30003