Tag: pubmed

Eur Arch Otorhinolaryngol. 2022 Oct 14. doi: 10.1007/s00405-022-07671-6. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of surgical procedures (transoral laser microsurgery (TLM) and open partial laryngectomy (OPL)) on the prognosis of patients with early laryngeal cancer.

METHODS: A total of 760 patients diagnosed with early laryngeal cancer (T1-2N0M0) and treated with TLM (n = 416) or OPL (n = 344) between 2004 and 2015 were abstracted from the SEER database. Propensity score matching (PSM) and stabilized inverse probability of treatment weighting (SIPTW) were performed to obtain comparable cohorts. The survival rates were estimated by the Kaplan-Meier method, and compared using the log-rank test. Univariate and multivariate Cox regression analyses with a false discovery rate (FDR) correction were applied to contrast the association between two surgical approaches and overall survival (OS) and disease-specific survival (DSS).

RESULTS: The 5-year OS for the TLM group was 79.5% versus 77.7% for the OPL group (P = 0.619). Similar results were revealed for the comparison of 5-year DSS rates (91.1% versus 91.5%, P = 0.891). After PSM and SIPTW balance the confounding factors, no significant difference was observed in the OS and DSS of patients treated with TLM compared to patients treated with OPL. The consistent results were still yielded (all P > 0.05), when stratified by gender, age, year of diagnosis, residence, household income, tumor site, T stage, differentiation, and adjuvant therapy.

CONCLUSION: This study provides strong evidence that there is no significant difference in the prognosis of early laryngeal carcinoma between the treatment of TLM and OPL, which may be helpful to guide the clinical decision-making of these patients.

PMID:36239784 | DOI:10.1007/s00405-022-07671-6

Childs Nerv Syst. 2022 Oct 14. doi: 10.1007/s00381-022-05669-3. Online ahead of print.

ABSTRACT

PURPOSE: Abusive head trauma (AHT) is a major cause of morbidity and mortality in children. Studies on pediatric head injury observe that AHT patients often have a higher incidence of malignant cerebral oedema and, overall, worse prognosis. There are limited studies with a focus on the outcome of decompressive surgery in children with AHT. This is a study undertaken to review our institutional experience on the role of decompressive surgery in AHT patients and objectively assess its outcomes, in corroboration with current literature.

METHODS: This is an ethics-approved, retrospective study. Inclusion criteria consist of all children with a diagnosis of AHT managed by the Neurosurgical Service, KK Women’s and Children’s Hospital. Demographical and clinical variables are incorporated in the statistical analyses.

RESULTS: From 2011 to 2021, a total of 7 patients required decompressive surgery for AHT. Mean age of the cohort was 17.1 months (with the majority of patients being male (n = 5, 71.4%). During the follow-up period, there was 1 mortality (14.3%), 3 patients developed cerebral palsy (42.9%), and 3 patients had post-traumatic epilepsy (42.9%). With regards to functional outcome, 4 patients (57.1%) had a favorable KOSCHI score at 6 months follow-up.

CONCLUSION: Decompressive surgery in children with AHT presents with its own unique challenges. We therein present our neurosurgical experience in decompressive surgery for this extremely vulnerable group of patients. Given the potential role of decompressive surgery in AHT, the development of an objective marker to select such patients who may benefit most from intervention should be the way forward.

PMID:36239781 | DOI:10.1007/s00381-022-05669-3

Nurs Educ Perspect. 2022 Oct 12. doi: 10.1097/01.NEP.0000000000001061. Online ahead of print.

ABSTRACT

This project aimed to explore the cultural competence of third-year undergraduate nursing students. A retrospective, quantitative, quasi-experimental design was used to collect data from 15 undergraduate students who took part in a three-week travel abroad community clinical to Thailand during 2019. Students engaged in reflective journaling. Data were collected before and after travel using the 20-item Cultural Intelligence Scale. Post mean scores were higher than presurveys, indicating that students improved on cultural competency overall. All subcategories showed a positive difference, and the results were overall statistically significant.

PMID:36239770 | DOI:10.1097/01.NEP.0000000000001061

J Natl Cancer Inst. 2022 Oct 14:djac157. doi: 10.1093/jnci/djac157. Online ahead of print.

ABSTRACT

BACKGROUND: There is increasing interest in better understanding the biology and clinical presentation of invasive lobular cancer (ILC), which is the most common special histological subtype of breast cancer. Limited large contemporary data sets are available allowing comparison of clinicopathologic features between ILC and invasive ductal cancer (IDC).

METHODS: The Great Lakes Breast Cancer Consortium was formed to compare clinical behavior of ILC (n = 3617) and IDC (n = 30 045) from 33 662 patients treated between 1990 and 2017 at 3 large clinical centers. We used Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity score matching to evaluate treatment differences and outcomes. All statistical testing used 2-sided P values.

RESULTS: Compared with IDC, patients with ILC were more frequently diagnosed at later stages and with more lymph node involvement (corrected P < .001). Estrogen receptor-positive ILCs were of lower grade (grade 1 and 2: 90% in ILC vs 72% in IDC) but larger in size (T3 and 4: 14.3% in ILC vs 3.4% in IDC) (corrected P < .001), and since 1990, the mean ILC size detected at diagnosis increased yearly. Patients with estrogen receptor (ER)-positive ILC underwent statistically significantly more mastectomies compared with ER-positive IDC (57% vs 46%). Using Kaplan-Meier analysis, patients with ER-positive ILC had statistically significantly worse disease-free survival and overall survival than ER-positive IDC although 6 times more IDCs were classified as high risk by OncotypeDx Breast Recurrence Score assay.

CONCLUSIONS: This large, retrospective, collaborative analysis with 3 clinical centers identified meaningful differences in clinicopathological features between ILC and IDC, providing further evidence that these are 2 different entities requiring different clinical management.

PMID:36239760 | DOI:10.1093/jnci/djac157

HNO. 2022 Oct 14. doi: 10.1007/s00106-022-01228-z. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the variety of existing methods for olfactory rehabilitation after total laryngectomy, olfactory disability remains one of the main factors limiting quality of life for laryngectomees.

OBJECTIVE: Considering the need for a socially acceptable rehabilitation method that is suitable for everyday use, this study sought to elucidate whether retronasal olfaction during phonation through a tracheoesophageal voice prosthesis is possible.

MATERIALS AND METHODS: The odor identification of 22 laryngectomees was assessed using the Sniffin’ Sticks test battery (12 odors), while performing an established method of olfactory rehabilitation-“polite yawning”-or while transnasal expiration or phonation through the tracheoesophageal fistula (TF). To facilitate the latter, a novel Expiratory Nasal Airflow M‑Maneuver (ENAMM) was developed.

RESULTS: All 21 non-anosmic laryngectomees included in the study were able to identify odors retronasally. While only 6 of 22 patients (27.3%) could perform the nasal expiration through the TF, all patients could easily perform phonation using ENAMM after proper instruction. The odor identification scores with the ENAMM technique did not statistically differ from ones with “polite yawning” (5.4 ± 3.1 vs. 6.4 ± 3.2, p = 0.279). The ENAMM was easy to learn and showed a tendency of increasing olfactory scores over time, possibly due to a learning effect.

CONCLUSIONS: Study results show that retronasal olfaction using a voice prosthesis after total laryngectomy is possible and suggest the potential of ENAMM as a method of olfactory rehabilitation for laryngectomy patients.

PMID:36239758 | DOI:10.1007/s00106-022-01228-z

Eur Arch Paediatr Dent. 2022 Oct 14. doi: 10.1007/s40368-022-00761-3. Online ahead of print.

ABSTRACT

PURPOSE: Estimate the incidence of teething symptoms and investigate risk factors at three centers in different regions of Brazil.

METHODS: A prospective cohort study enrolled children at birth in the cities of Manaus (northern region), Porto Alegre (southern region) and Salvador (northeast region). Sociodemographic and anthropometric variables were collected at baseline and 6 months. At 12 months, data were collected on the child’s health through structured interviews and dental examinations, including the primary outcome: occurrence of signs and symptoms of tooth eruption reported by parents. Statistical analysis involved Poisson regression with robust variance, with calculation of relative risks (RR).

RESULTS: The incidence of teething symptoms was 82.4% (238/289). The multivariate analysis revealed a higher occurrence of the outcome in the city of Salvador (RR = 1.39; 95% CI 1.23-1.58), when mother’s education was more than 11 years (RR = 1.31; 95% CI 1.04-1.65), when a larger number of individuals resided in the home (RR = 1.15; 95% CI 1.02-1.29), when a smoker resided in the home (RR = 1.16; 95% CI 1.03-1.31) and when the child presented flu or cold in the first year of life (RR = 1.23; 95% CI 1.09-1.38). The most reported symptoms were fever (50.5%), irritability (42.6%), itching (40.8%) and diarrhea (35.3%). Most parents (82%) took some action to alleviate symptoms, including unprescribed systemic medication, such as analgesic, anti-inflammatory and anti-diarrheic agents.

CONCLUSION: Reports of teething symptoms were associated with the city investigated, socioeconomic factors of the families and characteristics of the child’s health. A high rate of administering unprescribed medication was also found.

PMID:36239737 | DOI:10.1007/s40368-022-00761-3

Curr Med Imaging. 2022 Oct 14. doi: 10.2174/1573405619666221014113907. Online ahead of print.

ABSTRACT

BACKGROUND: The techniques differed in many of the literature on the detection of Acute Lymphocytic Leukemia from the blood smear pictures, as the cases of infection in the world and the Kingdom of Saudi Arabia were increasing and the causes of this disease were not known, especially for children, which is a serious and fatal disease.

OBJECTIVE: Through this work we seek to contribute to discover the blood cells affected by Acute Lymphocytic Leukem and to find an effective and fast method and to have the correct diagnosis as the time factor is important in the diagnosis and the initiation of treatment. which is based on one of the deep learning techniques that specialize in very deep networks, the use of one of the CNNs is VGG16.

METHODS: Detection scheme is implemented by pre-processing, feature extraction, model building, fine tuning method, classification are executed. By using VGG16 pre-trained, and using SVM and MLP classification algorithms in Machine Learning.

RESULTS: Our results are evaluated based on criteria such as Accuracy, Precision, Recall, and F1-Score. The accuracy results for SVM classifier MLP of 77% accuracy at 0.001 learning rate and the accuracy for SVM classifier 75% at 0.005 learning rate. Whereas, the best accuracy result for VGG16 model was 92.27% at 0.003 learning rate. The best validation accuracy result was 85.62% at 0.001 learning rate.

PMID:36239727 | DOI:10.2174/1573405619666221014113907

Int J Gynaecol Obstet. 2022 Oct 14. doi: 10.1002/ijgo.14510. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the incidence, indications, and maternal outcomes of emergency peripartum hysterectomy at a tertiary setting in Ethiopia MATERIAL AND METHODS: A four-years retrospective review of emergency peripartum hysterectomy cases was conducted at St.Paul’s Hospital Millennium Medical College(Ethiopia), from January 2016 to December 2019. Data were collected by reviewing maternal charts of EPH cases using a structured data extraction format. StataCorp. 2015. Stata Statistical Software: release 14. College station, TX” StataCorp. LP. was used for data analysis. Frequency and percentages are used to present the significance of results.

RESULTS: Among 39,629 deliveries during the study period, there were 105 emergency peripartum hysterectomies, making the incidence rate 2.6 per 1000 deliveries. The common indications for emergency peripartum hysterectomy were uterine rupture- 63/105 (60%), intractable uterine atony -23/105(21.9%) and placenta accrete spectrum -14/105(14.7%). The most common complications were anemia 85/105(80.9%), puerperal fever 13/105 (12.4%), acute kidney injury 10/105(9.5%), and relaparotomy 7/105 (6.7%) CONCLUSION: The incidence of peripartum hysterectomy observed in our institution is high. Appropriate patient selection for vaginal delivery and strict labor follow-up with early intervention for labor abnormalities should be the guiding principles of optimal obstetric care to alleviate the burden of uterine rupture.

PMID:36239219 | DOI:10.1002/ijgo.14510

Eur Heart J. 2022 Aug 4:ehac364. doi: 10.1093/eurheartj/ehac364. Online ahead of print.

ABSTRACT

AIMS: This study aimed to examine the association of premature menopause and age at menopause with the risk of heart failure (HF) and atrial fibrillation (AF).

METHODS AND RESULTS: A total of 1 401 175 postmenopausal women, who had undergone health examination provided by the Korean National Health Insurance Service, were included, and their reproductive histories were collected. Multivariable Cox proportional hazard models were performed to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident HF and AF, according to the history of premature menopause and age at menopause. At a mean follow-up of 9.1 years, there were 42 699 (3.0%) and 44 834 (3.2%) new cases of HF and AF, respectively. Women with history of premature menopause had an increased risk of HF (HR: 1.33, 95% CI: 1.26-1.40) and AF (HR: 1.09, 95% CI: 1.02-1.16), compared to women without the history. Compared with women aged ≥50 years at menopause, those aged 45-49, 40-44, and <40 years at menopause showed a significantly increased trend in HRs for the incident risk of both HF and AF (P for trend <0.001). The robustness of the results of a series of sensitivity analyses further strengthens the main findings.

CONCLUSION: Our findings suggest that postmenopausal women with a history of premature menopause or early menopausal age may have an increased risk of HF and AF. These reproductive factors need to be considered for preventing the future risk of HF and AF.

PMID:36239217 | DOI:10.1093/eurheartj/ehac364

Eur J Prev Cardiol. 2022 Oct 14:zwac234. doi: 10.1093/eurjpc/zwac234. Online ahead of print.

ABSTRACT

AIMS: To explore sex-specific time trends in atrial fibrillation (AF) incidence and to estimate the impact of changes in risk factor levels using individual participant-level data from the population-based Tromsø Study 1994-2016.

METHODS AND RESULTS: A total of 14 818 women and 13 225 men aged 25 years or older without AF were enrolled in the Tromsø Study between 1994 and 2008 and followed up for incident AF throughout 2016. Poisson regression was used for statistical analyses. During follow-up, age-adjusted AF incidence rates in women decreased from 1.19 to 0.71 per 1000 person-years. In men, AF incidence increased from 1.18 to 2.82 per 1000 person-years in 2004, and then declined to 1.94 per 1000 person-years in 2016. Changes in systolic (SBP) and diastolic blood pressure (DBP), body mass index (BMI), physical activity, smoking and alcohol consumption together accounted for 10.9% (95% confidence interval [CI]: -2.4; 28.6) of the AF incidence decline in women and for 44.7% (95% CI: 19.2; 100.0) of the AF incidence increase in men. Reduction in SBP and DBP had the largest contribution to the decrease in AF incidence in women. Increase in BMI had the largest contribution to the increase in AF incidence in men.

CONCLUSION: In the population-based Tromsø Study 1994-2016, AF incidence decreased in women and increased following a reverse U-shape in men. Individual changes in SBP and DBP in women and individual changes in BMI in men were the most important risk factors contributing to the AF incidence trends.

PMID:36239184 | DOI:10.1093/eurjpc/zwac234