Tag: pubmed

Int Ophthalmol. 2022 Oct 5. doi: 10.1007/s10792-022-02532-x. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to investigate preoperative blood-ocular barrier disruption via laser flare photometry (LFP) in patients diagnosed with rhegmatogenous retinal detachment (RRD), and to analyse possible associations with symptom duration and anatomical parameters.

METHODS: We retrospectively analysed consecutive patients presenting with RRD at a single centre between January 2016 and March 2020. LFP was performed in both eyes after pupillary dilatation prior to RRD surgery. Symptom duration, extent of retinal detachment, and lens status were assessed. For statistical analysis, we carried out the unequal variances t test and Welch’s analysis of variance (ANOVA).

RESULTS: We included 373 eyes of 373 patients (mean age 63.96 years ± 10.29; female:male ratio 1:1.8). LFP values quantified in photon count per millisecond (pc/ms) increased with longer symptom duration when comparing patients with a symptom duration of 0-3 days (n = 158; 9.25 ± 6.21 pc/ms) and ≥ 4 days (n = 215; 11.97 ± 11.58 pc/ms; p = 0.004). LFP values also rose with the number of retinal quadrants affected by RRD (1 quadrant, 6.82 ± 4.08 pc/ms; 2 quadrants, 10.08 ± 7.28 pc/ms; 3 quadrants, 12.79 ± 7.9 pc/ms; 4 quadrants, 31.57 ± 21.27 pc/ms; p < 0.001), macula off status (macula on, 8.89 ± 6.75 pc/ms; macula off, 12.65 ± 11.66 pc/ms; p < 0.001), and pseudophakic lens status (pseudophakia, 12.86 ± 9.52 pc/ms; phakia: 9.31 ± 9.67 pc/ms; p < 0.001).

CONCLUSION: In RRD patients, blood-ocular barrier disruption quantified by LFP is associated with the duration of symptoms and the disease’s anatomical extent. These results warrant further investigation of the potential clinical use of LFP in RRD.

PMID:36197523 | DOI:10.1007/s10792-022-02532-x

Surg Endosc. 2022 Oct 5. doi: 10.1007/s00464-022-09675-z. Online ahead of print.

ABSTRACT

BACKGROUND: One-stage revision Roux-en-Y gastric bypass (RRYGB) after Laparoscopic adjustable gastric banding (LAGB) is widely adopted, but its safety is still debated.

OBJECTIVE: This study aimed to compare outcomes between primary Roux-en-Y gastric bypass (PRYGB and RRYGB after LAGB.

METHOD: A retrospective record-based cohort study of patients who underwent PRYGB and RRYGB for failed LAGB and completed at least 2 years of follow-up from 2008 to 2019. Propensity score matching (PSM) analysis was conducted to obtain a balanced sample of patients with RRYGB and PRYGB interventions by adjusting for baseline covariates including age and sex.

RESULTS: Patients with PRYGB (n = 558) and RRYGB (n = 156) were included. PSM identified 98 patients for RRYGB and 98 patients for PRYGB. Both cohorts exhibited significant reductions in BMI compared to baseline values (p < 0.001), but reductions were significantly higher in PRYGB compared to those in RRGYB at 6 months (- 10.55 ± 8.54 vs. – 8.38 ± 5.07; p = 0.032), 1-year (- 21.50 ± 8.19 vs. 16.14 ± 6.93; p < 0.001), and 2 years (- 24.02 ± 7.85 vs. – 18.93 ± 6.80; p < 0.001), respectively. A significant improvement in food tolerance from the 1st to the 2nd year was seen after RYGB (p < 0.001). The rates of early and late complications were similar in both cohorts (p = 0.537, p = 1.00). Overall re-intervention rates were 5.1 and 3.1% for RRYGB and PRYGB p = 0.721). Both cohorts exhibited significant improvement in comorbidities after 2 years (p < 0.001).

CONCLUSIONS: One-stage RRYGB for failed LAGB is safe and effective with comparable rates of complications, re-interventions, and resolution of associated comorbid conditions compared to PRYGB.

PMID:36197519 | DOI:10.1007/s00464-022-09675-z

Eur Spine J. 2022 Oct 5. doi: 10.1007/s00586-022-07408-3. Online ahead of print.

ABSTRACT

PURPOSE: There is currently no consensus on the management of high-grade spondylolisthesis (HGS) in paediatric populations. The objective of this analysis is to compare the outcomes of reduction followed by fusion (RFF) or in situ fusion (ISF) in paediatric patients.

METHODS: Using major databases, a systematic literature search was performed. Primary studies comparing ISF with RFF in paediatric and adolescent patients were identified. Study data including patient-reported outcomes, complications, and spinopelvic parameters were collected and analysed.

RESULTS: Seven studies were included, comprising 97 ISF and 131 RFF. Average patient age was 14.4 ± 2.1 years and follow up was 8.2 ± 5.1 years. Patients undergoing RFF compared to patients undergoing ISF alone were less likely to develop pseudarthrosis (RR 0.51, 95% CI, [0.26, 0.99], p = 0.05). On average, RFF led to 11.97º more reduction in slip angle and 34.8% more reduction in sagittal translation (p < 0.00001) compared to ISF. There was no significant difference between patient satisfaction and pain at follow up. Neurologic complications and reoperation rates were not significantly different.

CONCLUSIONS: Both RFF and ISF are effective techniques for managing HGS. Performing a reduction followed by fusion reduces the likelihood of pseudarthrosis in paediatric patients. The difference between risk of neurologic complications, need for reoperation, patient satisfaction, and pain outcomes did not reach statistical significance. Correlation with patient-reported outcomes still needs to be further explored. LEVEL 3 EVIDENCE: Meta-analysis of Level 3 studies.

PMID:36197510 | DOI:10.1007/s00586-022-07408-3

World J Urol. 2022 Oct 5. doi: 10.1007/s00345-022-04168-z. Online ahead of print.

ABSTRACT

BACKGROUND: The European Association of Urology provides Clinical Practice Guideline on upper tract urothelial carcinoma (UTUC). Due to the rarity of UTUC, guidelines are necessary to help guide decision-making based on the highest quality of care evidence available.

OBJECTIVES: To evaluate guideline adherence in the management of UTUC by assessing recommendations on diagnostics needed for risk classification and subsequent treatment selection; to assess predictors for the latter.

PARTICIPANTS: Data from the Clinical Research Office of the Endo Urology Society UTUC-registry were included for analysis.

STATISTICAL ANALYSIS: Overall compliance were evaluated by cross-tables, differences in risk groups characteristics and treatment selection were assessed by Chi-square tests, predictors for treatment selection by logistic regression analysis.

RESULTS: Data from 2380 patients were included. Imaging by CT-scan had highest adherence (85%) but was low for other diagnostics (17.7-49.7%). Multivariable regression analysis showed higher odds of receiving radical nephroureterectomy in patients with large tumours (OR 5.45, 95% CI 3.77-7.87, p < 0.001), signs of invasion (OR 3.07,CI 2.11-4.46, p < 0.001), high tumour grade (OR 2.05, CI 1.38-3.05, p < 0.001) and multifocality (OR 1.76,CI 1.05-2.97, p =0.032).

CONCLUSIONS: CT-imaging is the most used and most impactful decision tool for risk-stratification and treatment selection in UTUC. Due to the low compliance in most of the diagnostic recommendations, proper risk stratification is not possible in a significant group of patients raising the question whether current stratification is deemed applicable in daily practice. Established prognostic factors on survival guides decision-making regarding radical versus kidney-sparing surgery. Tumour size was the most influencing factor on treatment decision.

CLINICAL TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (ClinicalTrials.gov NCT02281188; https://clinicaltrials.gov/ct2/show/NCT02281188 ).

PMID:36197507 | DOI:10.1007/s00345-022-04168-z

Hum Brain Mapp. 2022 Oct 5. doi: 10.1002/hbm.26081. Online ahead of print.

ABSTRACT

A multiband (MB) echo-planar imaging (EPI) sequence is compared to a multiband multiecho (MBME) EPI protocol to investigate differences in sensitivity for task functional magnetic resonance imaging (fMRI) at 3 T. Multiecho sampling improves sensitivity in areas where single-echo-EPI suffers from dropouts. However, It requires in-plane acceleration to reduce the echo train length, limiting the slice acceleration factor and the temporal and spatial resolution Data were acquired for both protocols in two sessions 24 h apart using an adapted color-word interference Stroop task. Besides protocol comparison statistically, we performed test-retest reliability across sessions for different protocols and denoising methods. We evaluated the sensitivity of two different echo-combination strategies for MBME-EPI. We examined the performance of three different data denoising approaches: “Standard,” “AROMA,” and “FIX” for MB and MBME, and assessed whether a specific method is preferable. We consider using an appropriate autoregressive model order within the general linear model framework to correct TR differences between the protocols. The comparison between protocols and denoising methods showed at group level significantly higher mean z-scores and the number of active voxels for MBME in the motor, subcortical and medial frontal cortices. When comparing different echo combinations, our results suggest that a contrast-to-noise ratio weighted echo combination improves sensitivity in MBME compared to simple echo-summation. This study indicates that MBME can be a preferred protocol in task fMRI at spatial resolution (≥2 mm), primarily in medial prefrontal and subcortical areas.

PMID:36196782 | DOI:10.1002/hbm.26081

Korean J Radiol. 2022 Sep 30. doi: 10.3348/kjr.2022.0388. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether Sonazoid-enhanced ultrasound (SZUS) was noninferior to SonoVue-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) using the same diagnostic criteria.

MATERIALS AND METHODS: This prospective, single-center, noninferiority study (NCT04847726) enrolled 105 at-risk participants (71 male; mean age ± standard deviation, 63 ± 11 years; range, 26-86 years) with treatment-naïve solid hepatic nodules (≥ 1 cm). All participants underwent same-day SZUS (experimental method) and SVUS (control method) for one representative nodule per participant. Images were interpreted by three readers (the operator and two independent readers). All malignancies were diagnosed histopathologically, while the benignity of other lesions was confirmed by follow-up stability or pathology. The primary endpoint was per-lesion diagnostic accuracy for HCC pooled across three readers using the conventional contrast-enhanced ultrasound diagnostic criteria, including arterial phase hyperenhancement followed by mild (assessed within 2 minutes after contrast injection) and late (≥ 60 seconds with a delay of 5 minutes) washout. The noninferiority delta was -10%p. Furthermore, different time delays were compared as washout criteria in SZUS, including delays of 2, 5, and > 10 minutes.

RESULTS: A total of 105 lesions (HCCs [n = 61], non-HCC malignancies [n = 19], and benign [n = 25]) were evaluated. Using the 5-minutes washout criterion, per-lesion accuracy of SZUS pooled across the three readers (72.4%; 95% confidence interval [CI], 64.1%-79.3%) was noninferior to that of SVUS (71.4%; 95% CI, 63.1%-78.6%), meeting the statistical criterion for non-inferiority (difference of 0.95%p; 95% CI, -3.8%p-5.7%p). The arterial phase hyperenhancement combined with the 5-minutes washout criterion showed the same sensitivity as that of the > 10-minutes criterion (59.0% vs. 59.0%, p = 0.989), and the specificities were not significantly different (90.9% vs. 86.4%, p = 0.072).

CONCLUSION: SZUS was noninferior to SVUS for diagnosing HCC in at-risk patients using the same diagnostic criteria. No significant improvement in HCC diagnosis was observed by extending the washout time delay from 5 to 10 minutes.

PMID:36196767 | DOI:10.3348/kjr.2022.0388

Acta Ophthalmol. 2022 Oct;100 Suppl 270:3-37. doi: 10.1111/aos.15248.

ABSTRACT

Ocular adnexal lymphoma is a relatively rare disease but is one of the most common malignancies in the ocular adnexa, and its incidence is steadily increasing. Ocular adnexal lymphoma consists mainly of four histopathological subtypes of non-Hodgkin B-cell lymphoma: extranodal marginal zone lymphoma (EMZL), follicular lymphoma (FL), mantle cell lymphoma (MCL) and large B-cell lymphoma (LBCL). The clinical characteristics associated with each of the subtypes are not well known due to the sparsity of cases. Furthermore, a number of molecular and phenotypic features have been identified as recurrent and prognosticating in LBCL but are not yet well documented for the ocular adnexal region: concurrent MYC and BCL2 and/or BCL6 rearrangements, MYC/BCL2 double-expressor phenotype (in diffuse large B-cell lymphomas), and MYD88 and CD79B mutations. Therefore, the present PhD study aimed to investigate the clinical features of (1) conjunctival lymphoma by subtype and (2) ocular adnexal MCL in an international multicentre cohort of 307 patients and (3) the clinical and genetic features of ocular adnexal LBCL in 34 Danish patients. This was performed by collecting clinical data on the patients and tissue samples of the LBCLs. The tissue samples were analysed immunohistochemically for phenotype, by allele-specific PCR and Sanger sequencing for the presence of the mutations, and by fluorescence in situ hybridisation for the rearrangements. Statistical analyses were performed to detect correlations with clinical features and survival. The analyses revealed that conjunctival EMZL and FL typically presented in individuals in their 60s as localised unilateral tumour masses and had favourable prognoses (5-year disease-specific survival: 82%-97%). LBCL and MCL were found in all the ocular adnexal structures, with the orbit being the most common location (82% and 58%, respectively). These lymphomas typically presented in patients in their 70s, with MCL having a male predominance. MCLs commonly presented with bilateral lesions and systemic involvement, while LBCLs were unilateral localised tumours. Both subtypes had poor prognoses, with 49%-62% of patients having succumbed to the disease within 5 years. Ocular adnexal LBCLs had presence of concurrent MYC and BCL2 and/or BCL6 rearrangements in 16% of cases, MYC/BCL2 double-expressor phenotype in 44% of diffuse large B-cell lymphomas, and MYD88 ± CD79B mutations in 29% of cases. MYC/BCL2 double-expressor phenotype and MYD88 mutations were associated with adverse prognoses. All in all, the results indicate that the histopathological subtype of ocular adnexal lymphoma is a major outcome predictor. Furthermore, the results underline the importance of analysing the expression of MYC and BCL2 by immunohistochemistry in diffuse large B-cell lymphoma patients and advocate for incorporating the analysis of MYD88 mutations in the routine diagnostic workup of ocular adnexal LBCL. SUMMARY IN DANISH: Lymfomer i øjenregionen (orbita, conjunctiva, øjenlåg, tårekirtel og tåresaek) er relativt sjaeldne tumorer, men er blandt de hyppigste cancerformer i denne region og forekomsten er hastigt stigende. Lymfomer i øjenregionen består hovedsageligt af 4 undertyper af non-Hodgkin B-celle lymfom: ekstranodalt marginal zone lymfom, follikulaert lymfom, storcellet B-celle lymfom og mantle celle lymfom. Grundet sygdommens sjaeldenhed er kliniske karakteristika ved de forskellige lymfomundertyper kun sparsomt undersøgt. Endvidere er der blevet identificeret en raekke prognostisk vigtige molekylaere og faenotypiske kendetegn ved storcellede B-celle lymfomer, som endnu ikke er velundersøgt i øjenregionen. Det drejer sig om samtidig rearrangement i MYC og BCL2 og/eller BCL6, samtidig overekspression af MYC og BCL2 samt MYD88 og CD79B mutationer. Dette ph.d.-studie havde derfor til formål at undersøge de kliniske kendetegn ved (1) mantle celle lymfomer i øjenregionen og (2) de forskellige undertyper af conjunktivale lymfomer i en international kohorte med 307 patienter samt (4) de kliniske, molekylaere og faenotypiske kendetegn ved storcellet B-celle lymfom i 34 danske patienter. Vaevsmaterialet med storcellede B-celle lymfomer blev undersøgt ved hjaelp af immunhistokemi for faenotypen, ved hjaelp af allel-specifik PCR og Sanger sekventering for mutationerne og ved hjaelp af fluorescens in situ-hybridisering for rearrangementerne. Der blev udført statistiske analyser med henblik på at finde eventuelle sammenhaenge med kliniske karakteristika og overlevelse. Analyserne viste, at conjunctivalt ekstranodalt marginal zone lymfom og follikulaert lymfom typisk forekom blandt patienter i 60erne som ensidige tumorer uden spredning og var forbundet med en god prognose (5-års sygdomsspecifik overlevelse på 82-97%). Storcellet B-celle lymfom og mantle celle lymfom blev fundet i samtlige strukturer i øjenregionen med orbita som den hyppigste lokalisation (hhv. 82% og 58%). Disse lymfomundertyper forekom primaert hos patienter i 70erne med overvaegt af maend blandt mantle celle lymfomerne. Mantle celle lymfomerne praesenterede sig typisk som dobbeltsidige laesioner i øjenregionen med systemisk involvering, mens storcellede B-celle lymfomer var ensidige tumorer uden spredning. Begge undertyper havde en dårlig prognose, hvor cirka halvdelen af patienterne døde af sygdommen indenfor 5 år. Genetisk var storcellede B-celle lymfomer i øjenregionen karakteriseret ved betydelig praevalens af MYD88 mutationer (29%), som var forbundet med en dårlig prognose. Rearrangementer i MYC og BCL2 og/eller BCL6 forekom i 16% af tilfaeldene. Derudover havde 44% af diffuse storcellede B-celle lymfomer samtidig overekspression af MYC og BCL2, som var associeret med en dårlig prognose for patienterne. Alt i alt viser resultaterne, at den histologiske undertype er en vigtig prognostisk faktor for lymfomer i øjenregionen. Derudover fremhaever resultaterne vigtigheden af undersøgelsen af MYC/BCL2 faenotypen og implementeringen af MYD88 mutationsundersøgelsen i rutinediagnostikken af storcellede B-celle lymfomer i øjenregionen.

PMID:36196757 | DOI:10.1111/aos.15248

Neuro Oncol. 2022 Oct 5;24(Supplement_5):v1-v95. doi: 10.1093/neuonc/noac202.

ABSTRACT

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and the National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.71 per 100,000 population (malignant AAAIR=7.02 and non-malignant AAAIR=17.69). This overall rate was higher in females compared to males (27.62 versus 21.60 per 100,000) and non-Hispanic persons compared to Hispanic persons (25.09 versus 22.95 per 100,000). The most commonly occurring malignant brain and other CNS histopathology was glioblastoma (14.2% of all tumors and 50.1% of all malignant tumors), and the most common non-malignant histopathology was meningioma (39.7% of all tumors and 55.4% of all non-malignant tumors). Glioblastoma was more common in males, and meningiomas were more common in females. In children and adolescents (ages 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.20 per 100,000 population. An estimated 93,470 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US population in 2022 (26,670 malignant and 66,806 non-malignant). There were 84,264 deaths attributed to malignant brain and other CNS tumors between 2015 and 2019. This represents an average annual mortality rate of 4.41 per 100,000 population and an average of 16,853 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 35.7%, while for non-malignant brain and other CNS tumors the five-year relative survival rate was 91.8%.

PMID:36196752 | DOI:10.1093/neuonc/noac202

Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6845-6855. doi: 10.26355/eurrev_202209_29788.

ABSTRACT

OBJECTIVE: This study was conducted to examine whether lopinavir/ritonavir (Lop/r), an HIV protease inhibitor, can improve disc physiology and slow down intervertebral disc (IVD) degeneration through in vitro experimental methods, as well as whether it can suppress inflammation with interleukin-1 beta (IL-1β) and sex-determining region Y (SRY) protein-related high-mobility group box genes-9 (SOX9) through hypoxia-inducible factor 1-alpha (HIF-1α) and the nuclear factor kappa B (NF-κB) signaling pathway. The aim was to investigate whether Lop/r application is toxic to IVD cells and the microenvironment simultaneously.

PATIENTS AND METHODS: Human primary cell cultures were prepared using herniated IVD tissues obtained from patients with lumbar disc hernia who were unresponsive to conservative and medical treatment, and thereby, were operated on. The untreated culture samples served as control group, and the samples treated with Lop/r served as study group. Microscopic evaluations were performed simultaneously using fluorescent and supravital dyes in all groups. In addition to cell viability, toxicity, and proliferation analysis through a commercial kit, IL-1β, SOX9, HIF-1α, and NF-κB protein expressions were evaluated using Western blotting. In the statistical comparison of the obtained data, an alpha value less than 0.05 was considered significant.

RESULTS: Cell proliferation decreased in the Lop/r group, but no cell death was observed (p < 0.05). Moreover, at the end of 72 hours after Lop/r application, IL-1β and NF-kB protein expressions decreased by 40% and 52%, respectively, while HIF-1α and SOX9 protein expressions increased by 4% and 59%, respectively (p< 0.05).

CONCLUSIONS: Although these data were obtained from an in vitro experimental study, it is believed that these findings could make significant contributions to the pharmaco-regenerative treatment modalities of IVD degeneration. Lop/r suppresses the IL-1β and NF-κB and induces SOX9 and HIF-1α, since these signaling pathways may be related to human IVD degeneration.

PMID:36196733 | DOI:10.26355/eurrev_202209_29788

Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6821-6826. doi: 10.26355/eurrev_202209_29784.

ABSTRACT

OBJECTIVE: This research was conducted to determine the relationship between social appearance anxiety and happiness in overweight young girls.

SUBJECTS AND METHODS: This is a correlational descriptive study and the study sample included 343 overweight young female students from a university in eastern Turkey. A Personal Information Form, the Oxford Happiness Questionnaire-Short Form (OHQ-SF), and the Social Appearance Anxiety Scale (SAAS) were used for data collection. Descriptive statistics (percentage, mean, standard deviation), independent-samples t-test, analysis of variance, and correlation and regression analyses were used in data analysis.

RESULTS: The mean age of the participants was 21.55 ± 3.03 years. About a third of the participants (30.6%) was composed by year 3 university students, 60.6% had an income level equal to their expenditure level, and 50.7% was residing in the city center. The OHQ-SF mean total score of the participants was 17.03 ± 5.86, and the SAAS mean total score was 43.36 ± 17.07. There was a moderate negative correlation between the mean scores of the OHQ-SF and the SAAS (r: -.547, p<0.001). Social appearance anxiety explained 30% of happiness in young girls participating in the study (β: -.547, p<0.001).

CONCLUSIONS: Happiness in young girls was effective on social appearance anxiety. Health professionals may also evaluate the level of happiness in the care and counseling services they provide to young girls during extraordinary circumstances such as the COVID-19 pandemic.

PMID:36196730 | DOI:10.26355/eurrev_202209_29784