Tag: pubmed

Transfusion. 2022 Sep 2. doi: 10.1111/trf.17081. Online ahead of print.

ABSTRACT

BACKGROUND: Bacterial contamination in platelets remain a major public health concern, which prompted the US Food and Drug Administration guidance for bacterial contamination mitigation. Pathogen reduction technology (PRT) is one mitigation strategy that has shown success in Europe over the last decade. Therefore, our center sought to transition from a dual system of bacterial culturing (BacT) and PRT to full PRT.

METHODS: A 1 month pilot study was conducted to simulate 100% PRT conditions. Our center also collected baseline data on key platelet production metrics in the 4 months prior to 100% PRT and compared it to the 4 months post-implementation.

RESULTS: The pilot study showed no statistical differences in split rate, proportion of low-yield products, or proportion of single, double, and triple collections. The only observed difference was an 11 min increase in the average duration of double collections. Our baseline versus post-implementation monitoring showed no difference in split rate, discard rate, percentage of low-yield units, and average yield of low yield units. Statistical differences were detected in the proportion of single, double, and triple collections, as well as the average yield of full dose products. Roughly 20% of our inventory consisted of low-yield products.

DISCUSSION: With suitable mitigation strategies, transitioning to a full PRT inventory may result in higher net margins while not adversely affecting overall platelet production. A pilot study is a good way to project potential effects of switching from a dual BacT and PRT inventory to full PRT, and can be adopted by other centers aiming to make the transition.

PMID:36052676 | DOI:10.1111/trf.17081

J Esthet Restor Dent. 2022 Sep 2. doi: 10.1111/jerd.12959. Online ahead of print.

ABSTRACT

BACKGROUND: The prosthetic screw fixes the prostheses to the implants. Upon osteointegration, the untightening of the prosthetic screw is the most common problem in oral rehabilitation with implants.

OBJECTIVE: To study the deformation of the implant retaining hexagonal screw head.

METHODS: This investigation used two methods for evaluating the screw head’s area of deformation (mm² ): a stereoscopic microscopy and micro computed tomography (microCT). For stereoscopic microscopy, 16 titanium alloy (T) and 16 titanium gold-plated alloy (G) screws of the Zimmer Biomet™ brand were used, divided into eight groups: group 0 (control group), groups T1 and G1 (screws tightened 10 times to 20 Ncm), the groups T2 and G2 (screws tightened 20 times to 20 Ncm) and the groups T3 and G3 (screws tightened 10 times to 30 Ncm). In the study with microCT, one screw was randomly chosen from each of the groups described above to perform the scanning by microCT.

RESULTS: When comparing the type of screw material using stereoscopic microscopy, no statistically significant differences were found (p > 0.05). Contrarily, different number of successive grips and different torque value showed statistically significant differences in the head section of the retaining screws (p < 0.05). The observation by microCT showed the torque applied is crucial to the head deformation in titanium screws. In gold-plated screws the successive tightening appears to be pivotal.

CONCLUSION: Titanium and gold screws tend to behave similarly. By increasing the tightening cycles and the torque values of protocols greater levels of deformations can be expected. In general, microCT data showed better results for gold-plated titanium alloy.

CLINICAL SIGNIFICANCE: To control severe screw head deformation and the impossibility of untightening the implant’s restoration, clinicians should avoid extreme torque values and prevent surpassing 10 tightening cycles.

PMID:36052667 | DOI:10.1111/jerd.12959

Biomark Med. 2022 Sep 2. doi: 10.2217/bmm-2022-0265. Online ahead of print.

ABSTRACT

Aim: The study investigated heparin-binding protein (HBP) levels in patients with severe COVID-19 pneumonia and their relation to prognosis. Methods: A total of 134 patients with serious COVID-19 pneumonia were prospectively analyzed. HBP levels were statistically compared between both the patient and healthy control groups and within the patient group itself. Results: HBP was defined to be significantly higher in the patient group compared with the control group. There was a statistically significant distinction between the patients who survived and those who died with regard to HBP levels. When the cutoff value of HBP was >13.47, sensitivity (89.8%), specificity (74.1%) had area under the curve values of 0.806 (p < 0.001). Conclusion: HBP level may be used for prognosis prediction of patients with COVID-19.

PMID:36052658 | DOI:10.2217/bmm-2022-0265

Gut Liver. 2022 Sep 2. doi: 10.5009/gnl220060. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: The discrepancies between the diagnosis of preoperative endoscopic forceps biopsy (EFB) and endoscopic submucosal dissection (ESD) in patients with early gastric neoplasm (EGN) exist objectively. Among them, pathological upgrading directly influences the accuracy and appropriateness of clinical decisions. The aims of this study were to investigate the risk factors for the discrepancies, with a particular focus on pathological upgrading and to establish a prediction model for estimating the risk of pathological upgrading after EFB.

METHODS: We retrospectively collected the records of 978 patients who underwent ESD from December 1, 2017 to July 31, 2021 and who had a final histopathology determination of EGN. A nomogram to predict the risk of pathological upgrading was constructed after analyzing subgroup differences among the 901 lesions enrolled.

RESULTS: The ratio of pathological upgrading was 510 of 953 (53.5%). Clinical, laboratorial and endoscopic characteristics were analyzed using univariable and binary multivariable logistic regression analyses. A nomogram was constructed by including age, history of chronic atrophic gastritis, symptoms of digestive system, blood high density lipoprotein concentration, macroscopic type, pathological diagnosis of EFB, uneven surface, remarkable redness, and lesion size. The C-statistics were 0.804 (95% confidence interval, 0.774 to 0.834) and 0.748 (95% confidence interval, 0.664 to 0.832) in the training and validation set, respectively. We also built an online webserver based on the proposed nomogram for convenient clinical use.

CONCLUSIONS: The clinical value of identifying the preoperative diagnosis of EGN lesions is limited when using EFB separately. We have developed a nomogram that can predict the probability of pathological upgrading with good calibration and discrimination value.

PMID:36052614 | DOI:10.5009/gnl220060

Gut Liver. 2022 Sep 2. doi: 10.5009/gnl210404. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy.

METHODS: Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated.

RESULTS: A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively).

CONCLUSIONS: In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.

PMID:36052612 | DOI:10.5009/gnl210404

Turk J Orthod. 2022 Sep 2. doi: 10.5152/TurkJOrthod.2022.21072. Online ahead of print.

ABSTRACT

OBJECTIVE: To comparatively evaluate the perception of patients’ soft tissue profiles treated with Herbst and Twin Block appliances and correlate the perception with cephalometric parameters.

METHODS: The record of 30 patients (15 Herbst and 15 Twin Block) treated for a period of 6 months (±1.1 months) was included in the study. A total of 60 resulting profile silhouettes (from pre- and post-functional profile photographs) were evaluated by 30 examiners and were divided into 3 groups: orthodontists, general dentists, and laypersons. The profiles were arranged in a randomized order, and the examiners rated the profiles using a visual analog scale. Paired t-test and independent t-test were performed to find a significant difference within and between the appliances, respectively. A treatment outcome correlation was done using Pearson’s correlation test between the visual analog scale scores and cephalometric parameters.

RESULTS: Within the appliances, the orthodontist perceived a difference with only the Twin Block appliance (P = .02). The general dentists perceived a significant difference with both Herbst (P = .02) and Twin Block (P = .001) appliances, whereas the laypersons did not perceive any profile improvement on treatment with functional appliances. However, between the appliances, no statistically significant profile difference was seen with all 3 groups of examiners. The ANB angle had a significant negative correlation (P = .007) to the visual analog scale scores given by the orthodontists for the Herbst appliance.

CONCLUSION: No perceptible difference was found in the profile enhancement between Herbst and Twin Block appliances with all 3 groups of examiners. The ANB angle contributed to the difference in profile perception between the appliances for the orthodontists.

PMID:36052579 | DOI:10.5152/TurkJOrthod.2022.21072

Psychol Med. 2022 Sep 2:1-10. doi: 10.1017/S003329172200188X. Online ahead of print.

ABSTRACT

BACKGROUND: Major depressive disorder (MDD) has been associated with alterations in brain white matter (WM) microstructure. However, diffusion tensor imaging studies in biological relatives have presented contradicting results on WM alterations and their potential as biomarkers for vulnerability or resilience. To shed more light on associations between WM microstructure and resilience to familial risk, analyses including both healthy and depressed relatives of MDD patients are needed.

METHODS: In a 2 (MDD v. healthy controls, HC) × 2 (familial risk yes v. no) design, we investigated fractional anisotropy (FA) via tract-based spatial statistics in a large well-characterised adult sample (N = 528), with additional controls for childhood maltreatment, a potentially confounding proxy for environmental risk.

RESULTS: Analyses revealed a significant main effect of diagnosis on FA in the forceps minor and the left superior longitudinal fasciculus (p_tfce-FWE = 0.009). Furthermore, a significant interaction of diagnosis with familial risk emerged (p_tfce-FWE = 0.036) Post-hoc pairwise comparisons showed significantly higher FA, mainly in the forceps minor and right inferior fronto-occipital fasciculus, in HC with as compared to HC without familial risk (p_tfce-FWE < 0.001), whereas familial risk played no role in MDD patients (p_tfce-FWE = 0.797). Adding childhood maltreatment as a covariate, the interaction effect remained stable.

CONCLUSIONS: We found widespread increased FA in HC with familial risk for MDD as compared to a HC low-risk sample. The significant effect of risk on FA was present only in HC, but not in the MDD sample. These alterations might reflect compensatory neural mechanisms in healthy adults at risk for MDD potentially associated with resilience.

PMID:36052484 | DOI:10.1017/S003329172200188X

Cancer Med. 2022 Sep 2. doi: 10.1002/cam4.5185. Online ahead of print.

ABSTRACT

BACKGROUND: Blood neutrophil to lymphocyte ratio (NLR) or lymphocyte count may be important markers for immune function. Previous work has shown higher NLR was associated with higher risk of hepatitis B-related hepatocellular carcinoma (HCC). However, studies in non-alcoholic fatty liver disease (NAFLD) patients are lacking.

METHODS: Utilizing the University of Pittsburgh Medical Center (UPMC) electronic health records, we created a retrospective cohort of 27,834 patients diagnosed with NAFLD from 2004 to 2018 with complete NLR data. After an average 5.5 years of follow-up, 203 patients developed HCC. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of HCC incidence associated with different levels of NLR and lymphocyte count.

RESULTS: Compared with the lowest tertile of NLR (<1.97), the highest tertile of NLR (≥3.09) was statistically significantly associated with a 43% higher risk of HCC incidence (HR = 1.43, 95% CI: 1.01-2.03, p_trend = 0.031) after adjustment for age, sex, race, body mass index, smoking status, history of type 2 diabetes, hyperlipidemia, hypertension, and fibrosis-4 score category. Conversely the highest tertile of lymphocyte count (≥2.15 K/ul) was significantly associated with a 36% lower risk of HCC (HR = 0.64, 95% CI: 0.43-0.94, p_trend = 0.028) compared to the lowest tertile (<1.55 K/ul). There was no association between neutrophil count and HCC risk.

CONCLUSIONS: Higher NLR and lower lymphocyte count are associated with significantly higher risk of HCC among NAFLD patients. These findings warrant further investigation of immune response and surveillance in association with HCC development in NAFLD patients.

PMID:36052483 | DOI:10.1002/cam4.5185

Contemp Nurse. 2022 Sep 2:1-22. doi: 10.1080/10376178.2022.2107038. Online ahead of print.

ABSTRACT

AIM: To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).

METHODS: We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).

RESULTS: At 90-days, 47.9% (n = 69) had a good prognosis (mRS ≤ 2) including 22.2%(n = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (n =70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (p = 0.02), nasogastric tube (p＜0.001), indwelling urinary catheter (p＜0.001), central venous catheter (p = 0.03), health knowledge needs of pressure injury prevention (p = 0.03), National Institute of Health Stroke Scale (NIHSS) score (p＜0.001) and Activities of Daily Living (ADL) score (p＜0.001) at the time of discharge from hospital. The average hospitalisation time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalisation was $Y$21291.93 (SD 9165.01).

CONCLUSION: Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.

IMPACT STATEMENT: We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.

PMID:36052463 | DOI:10.1080/10376178.2022.2107038

Ann Ital Chir. 2022;92:369-373.

ABSTRACT

AIM: This single-tertiary non-Covid center retrospective study analyses the impact on Covid-19 pandemic on the presentation and the treatment in patients operated for acute appendicitis.

METHODS: Total number of 152 patients operated for acute appendicitis in two separate periods (April – August 2019, and April – August 2020), were subjected to retrospective analysis. Patients were divided in two groups: pre-pandemic Group A and pandemic Group B.

RESULTS: Eighty one patient was operated in the pandemic period and the rest 71 one year ago in the same period. Preoperative C-reactive protein levels presented statistically higher in the pandemic group (p = 0.0455). Time from admission to surgery was shorter in the pandemic group (7.5 ± 4.6 vs 5.8 ± 4.9; p = 0.0155). Overall operative time and the laparoscopic operative time were statistically longer in the pandemic group (68.8 vs. 76.8 minutes; p = 0.039 and 60.04 vs 74.0 minutes; p = 0.0141, respectively). Complicated appendicitis rates were similar, although periappendicular abscess was more common in the pandemic group, but without statistical significance. Length of stay was shorter in the pandemic group (p = 0.53).

CONCLUSION: Our data showed that during the Covid-pandemic, acute appendicitis surgery is safe and feasible with results equal to the prepandemic period.

KEY WORDS: Appendicitis, Appendectomy, Covid.

PMID:36052461