Tag: pubmed

Radiol Med. 2022 Jul 18. doi: 10.1007/s11547-022-01524-2. Online ahead of print.

ABSTRACT

BACKGROUND: There is an unmet need for new biomarkers able to predict both the outcomes of up-front therapy and the compliance of elderly patients diagnosed with glioblastoma. For this purpose, temporal muscle thickness is a promising tool to be investigated.

METHODS: Data from 52 glioblastoma patients older than 65 years, treated with post-operative radio or radio-chemotherapy and referred to Pisa University Hospital, were retrieved. The thickness of temporal muscle (TMT) was divided into quartiles and correlated with overall survival (Our primary endpoint). Survival curves were calculated using Kaplan-Meier method, and log-rank test was used to evaluate the differences between curves.

RESULTS: Patients in the lower quartile of TMT, with TMT thinner than 7 mm, have survived longer; both univariate and multivariate analyses showed a statistically significant correlation between TMT and overall survival (P = 0.012 and P = 0.003, respectively).

CONCLUSION: Future prospective and more extensive studies focused on elderly glioblastoma patients are needed to confirm the role of TMT as prognostic value on OS and to help explaining this association.

PMID:35849309 | DOI:10.1007/s11547-022-01524-2

Ann Surg Oncol. 2022 Jul 18. doi: 10.1245/s10434-022-12245-1. Online ahead of print.

NO ABSTRACT

PMID:35849286 | DOI:10.1245/s10434-022-12245-1

Indian J Pediatr. 2022 Jul 18. doi: 10.1007/s12098-022-04289-8. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether magnesium sulfate and therapeutic hypothermia in combination decreases mortality and/or major neurodevelopmental disability at 1 y of age among term neonates with hypoxic-ischemic encephalopathy.

METHODS: A total of 134 term neonates were randomized to receive intravenous magnesium sulfate at a dose of 250 mg/kg (at 8 mg/kg/min) once daily for 3 d starting within 6 h after birth along with therapeutic hypothermia in the intervention group and therapeutic hypothermia alone in the comparator group. The primary outcome was the composite outcome of mortality and/or major neurodevelopmental disability (Developmental Assessment Scale for Indian Infants score < 70) at 1 y of age.

RESULTS: A total of 115 infants were included in the primary analysis. The composite primary outcome occurred in 14 (24%) infants in the intervention group and 19 (33%) infants in the comparator group, and the difference was not statistically significant (p = 0.30; relative risk 0.72; 95% confidence interval 0.40-1.30). The secondary outcomes including neonatal mortality, major neurodevelopmental disability at 1 y of age, neurological status at discharge, level of oxidative stress markers, and adverse effects including hypotension and respiratory depression requiring support were also comparable between the groups.

CONCLUSIONS: The combination of magnesium sulfate and therapeutic hypothermia did not improve the composite outcome of neonatal mortality and/or major neurodevelopmental disability at 1 y of age.

TRAIL REGISTRATION: Clinical Trials Registry of India (CTRI/2018/06/014594), prospectively registered.

PMID:35849276 | DOI:10.1007/s12098-022-04289-8

Neurochem Res. 2022 Jul 18. doi: 10.1007/s11064-022-03679-w. Online ahead of print.

ABSTRACT

Glioblastoma (GBM) is one of the most common malignancies among primary brain tumors in adults, featuring a poor prognosis and a high recurrence rate. Eukaryotic elongation factor 2 kinase (eEF2K) is a calcium/calmodulin-dependent protein kinase that is involved in promoting tumor cell proliferation, migration, invasion, and survival. However, its expression level in GBM, its prognostic impact and correlation with immune infiltration are not yet known. In this study, we used The Cancer Genome Atlas (TCGA) database to explore the potential molecular mechanisms of eEF2K in GBM development and clinical prognosis in terms of gene expression, survival status, immune infiltration, and associated cellular pathways. We found that eEF2K expression levels were elevated in GBM, but eEF2K was not associated with the prognosis of GBM patients; eEF2K expression in GBM was associated with multiple immune cell infiltrations. These results show a statistical correlation between eEF2K expression and the development of GBM and immune cell infiltration, which helps us to understand the roles of eEF2K in GBM from different perspectives.

PMID:35849271 | DOI:10.1007/s11064-022-03679-w

Insights Imaging. 2022 Jul 18;13(1):120. doi: 10.1186/s13244-022-01258-9.

ABSTRACT

BACKGROUND: Online summative assessment has emerged during the COVID-19 pandemic as an alternative to traditional examinations, bringing opportunities and challenges. The study aims to evaluate the feasibility and effectiveness of online structured oral examination (SOE) in radiology clerkships. The study identifies measures taken to successfully implement online SOE and minimize chances of cheating. It also discusses the challenges encountered and how they were addressed.

METHODS: SOE percent scores of fourth-year medical students from two institutions were correlated with students’ grade point average (GPA). The scores were compared among different institutions, students’ genders, students’ batches, examination versions, and examiners with different experience levels. Students’ perceived satisfaction and concerns were captured using anonymous self-administered questionnaire. Technical problems and success rate of SOE implementation were recorded. Results were analyzed using descriptive and inferential statistics.

RESULTS: A total of 79 students participated in the study, out of which 81.0% (n = 64) responded to the survey. SOE scores showed poor positive correlation with the students’ GPAs (r = 0.22, and p = .09). Scores showed no significant difference between the two institutions or genders. Scores were also not significantly different between students who were examined by junior or senior examiners. All but one version of examination showed no significant difference in students’ scores. No significant difference was observed in students’ scores between each two subsequent batches who were exposed to the same examination version.

CONCLUSION: Online summative SOE is a feasible alternative whenever face-to-face SOE could not be implemented provided that appropriate measures are taken to ensure its successful execution.

PMID:35849259 | DOI:10.1186/s13244-022-01258-9

Eur Arch Otorhinolaryngol. 2022 Jul 18. doi: 10.1007/s00405-022-07544-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To comprehensively analyse the disease presentation and mortality of COVID-associated rhino-orbito-cerebral mucormycosis.

METHODS: A retrospective analysis of the demographics, clinical and radiographic findings was performed. A binary logistic regression analysis was performed to examine the survival of patients with mucormycosis from hypothesised predictors.

RESULTS: A total of 202 patients were included in this study. Statistical significance was demonstrated in the predilection to the male gender, recent history of SARS-COV-2, history of use of corticosteroid and hyperglycemia in this cohort of CAM. The mortality rate was 18.31%. Advanced age, raised HbA1c and intra-orbital extension were found to be predictors adversely affecting survival.

CONCLUSION: Early diagnosis, aggressive surgical therapy, early and appropriate medical therapy can help improve outcomes.

LEVEL OF EVIDENCE: Level 4.

PMID:35849188 | DOI:10.1007/s00405-022-07544-y

Environ Sci Pollut Res Int. 2022 Jul 18. doi: 10.1007/s11356-022-22041-9. Online ahead of print.

ABSTRACT

Controlling green credit risk is conducive to increasing the confidence of financial institutions, improving the enthusiasm of enterprises for green innovation, and promoting the sustainable development of green credit and the high-quality development of green economy. This paper puts government intervention, green technology innovation, and regulatory action into the same theoretical framework and puts forward the green credit risk transmission mechanisms which involve the transmission relationship and transmission path on the basis of the influencing factors. Then, this research uses stationary time series data (from the “China Statistical Yearbook,” the “Statistical Yearbook” of various provinces, the annual reports of listed companies, etc.) to analyze the current situation of green credit risk in different regions. From the systematic perspective, this study verifies the transmission path of green credit risk and tests the rationality and effectiveness of the green credit risk transmission mechanisms. The research shows that the management of green credit risk requires the active actions of government departments, financial institutions, green enterprises, and regulatory departments.

PMID:35849231 | DOI:10.1007/s11356-022-22041-9

Eur Radiol. 2022 Jul 18. doi: 10.1007/s00330-022-08985-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the performance of Liver Imaging Reporting and Data System category 5 (LR-5) for diagnosing HCC between CT and MRI using comparative studies.

METHODS: The MEDLINE and EMBASE databases were searched from inception to April 21, 2021, to identify studies that directly compare the diagnostic performance of LR-5 for HCC between CT and MRI. A bivariate random-effects model was fitted to calculate the pooled per-observation sensitivity and specificity of LR-5 of each modality, and compare the pooled estimates of paired data. Subgroup analysis was performed according to the MRI contrast agent.

RESULTS: Seven studies with 1145 observations (725 HCCs) were included in the final analysis. The pooled per-observation sensitivity of LR-5 for diagnosing HCC was higher using MRI (61%; 95% confidence interval [CI], 43-76%; I² = 95%) than CT (48%; 95% CI, 31-65%; I² = 97%) (p < 0.001). The pooled per-observation specificities of LR-5 did not show statistically significant difference between CT (96%; 95% CI, 92-98%; I² = 0%) and MRI (93%; 95% CI, 88-96%; I² = 16%) (p = 0.054). In the subgroup analysis, extracellular contrast agent-enhanced MRI showed significantly higher pooled per-observation sensitivity than gadoxetic acid-enhanced MRI for diagnosing HCC (73% [95% CI, 55-85%] vs. 55% [95% CI, 39-70%]; p = 0.007), without a significant difference in specificity (93% [95% CI, 80-98%] vs. 94% [95% CI, 87-97%]; p = 0.884).

CONCLUSIONS: The LR-5 of MRI showed significantly higher pooled per-observation sensitivity than CT for diagnosing HCC. The pooled per-observation specificities of LR-5 were comparable between the two modalities.

KEY POINTS: • The pooled sensitivity of LR-5 using MRI was higher than that using CT (61% versus 48%), but the pooled specificities of LR-5 were not significantly different between CT and MRI (96% versus 93%). • Subgroup analysis according to the MRI contrast media showed a significantly higher pooled per-observation sensitivity using ECA-enhanced MRI than with EOB-enhanced MRI (73% versus 55%), and comparable specificities (93% versus 94%). • Although LI-RADS provides a common diagnostic algorithm for CT or MRI, the per-observation performance of LR-5 can be affected by the imaging modality as well as the MRI contrast agent.

PMID:35849177 | DOI:10.1007/s00330-022-08985-z

Eur Radiol. 2022 Jul 18. doi: 10.1007/s00330-022-09013-w. Online ahead of print.

ABSTRACT

OBJECTIVES: Predictors of malignant middle cerebral artery infarction (mMCAi) in patients after intravenous thrombolysis were well documented, but the risk factors of mMCAi after endovascular thrombectomy (EVT) were not fully explored. Therefore, the present study aimed to investigate the predictors of mMCAi after EVT in stroke patients.

METHODS: This was a secondary analysis of the DIRECT-MT trial. Patients who underwent EVT for the occlusions of MCA and/or intracranial internal carotid artery were analyzed. Primary outcome was the occurrence of mMCAi after EVT. Demographic, clinical, imaging, and treatment data were recorded, and multivariate logistic regression analysis was used to identify independent predictors. All of the candidate predictors were included, and forward elimination was applied to establish the most effective predictive model. Predictive ability and calibration of the model were assessed using the area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow test, respectively.

RESULTS: Of 559 enrolled patients, 74 (13.2%) patients developed mMCAi. Predictors of mMCAi included unsuccessful reperfusion, higher serum glucose, lower Alberta Stroke Project Early Computed Tomography Change Score (ASPECTS), higher clot burden score (CBS), lower collateral score, and higher pass number of thrombectomy device. AUC of predictive model integrating all independent variables was 0.836. The Hosmer-Lemeshow test showed appropriate calibration (p = 0.859).

CONCLUSIONS: Reperfusion, serum glucose, ASPECTS, CBS, collateral, and pass number of thrombectomy device were associated with the occurrence of mMCAi in stroke patients after EVT, while alteplase treatment was not. Our findings might facilitate the early identification and management of stroke patients at a high risk of mMCAi.

KEY POINTS: • A total of 13.2% of stroke patients with large vessel occlusion of anterior circulation developed mMCAi after EVT. • The occurrence of mMCAi had a definite negative impact on the outcome for stroke patients. • Reperfusion, serum glucose, ASPECTS, CBS, collateral score, and the pass number of thrombectomy device were associated with the occurrence of mMCAi after EVT in stroke patients.

PMID:35849176 | DOI:10.1007/s00330-022-09013-w

World J Surg. 2022 Jul 18. doi: 10.1007/s00268-022-06659-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Isolated hip fractures (IHF) are common injuries in the elderly. Controversy exists about which hospital service is best suited to manage these patients. We hypothesize that baseline patient severity of illness (SOI) score drives patient outcomes, not the hospital service managing these patients.

METHODS: Retrospective review of all IHF patients from 2014 to 2018 at our Level 1 trauma center. Basic demographics were obtained. Patients were divided into service line they were admitted; surgical vs non-surgical. Primary outcomes included hospital length of stay (HLOS), time to OR, time to VTE prophylaxis, complication rate (defined by the Trauma Quality Improvement Program), 30-day mortality, and readmissions. SOI score (which is DRG-based) was controlled to see if any differences in primary outcomes occurred between cohorts. Chi-square was used for categorical variables and regression analysis for continuous variables. Significance was p < 0.05.

RESULTS: A total of 366 total patients were analyzed with the same ISS. A total of 102 were admitted to a surgical service and 264 to a non-surgical service. Average overall age was 80 year, 66.9% were female, and 86% were Caucasian. There was no statistical difference between outcomes when comparing admitting services. Controlling for SOI score, there was no difference between admitting service for outcomes as well. SOI score was a significant predictor for increased HLOS and complication occurrence (p < 0.001) via regression analysis, with a 6.06-fold increase in complication rate from mild to moderate SOI score (p = 0.001).

CONCLUSION: There is no difference in outcomes based on admitting service and process measures. However, the SOI score is perhaps a better predictor of outcomes for isolated hip fracture patients.

PMID:35849173 | DOI:10.1007/s00268-022-06659-x