Tag: pubmed

Chirurgia (Bucur). 2021 Oct;116(5):591-598. doi: 10.21614/chirurgia.116.5.591.

ABSTRACT

Introduction: A patent digestive anastomosis is not only the result of the surgery team experience, but also dependent on the patient̢??s factors. Accepting the possible dramatic effects of an anastomotic leak, identification of risk factors remains a priority in case management. Material and methods: Multifactorial assessment scores permit risk quantification, increase grade of suspicion and early management implementation. The correlation between diverse potential risk factors and anastomotic leak (AL) was studied. The identified risk factors were included in a predictive score system. FISTULA SCORE represents a feasible instrument based on 12 clinical, paraclinical and therapeutic variables, with good statistical significance (Se = 79.5%, Sp = 90.2%). Results: Anastomotic leaks (AL) were observed in 39 cases (7.68%) out of 508 patients analysed, appearing in days 2 Р10 after surgery, with a mean value of 6 days. FISTULA SCORE was based on attributed risks found in our study group for each factor and has the purpose to identify patients at risk for AL and, in some cases, to change the therapeutic or surgical strategy. In AL patients group, the mean score was 5.06 1.95 points, and in AL-free patients group Р1.57 1.61 points. Conclusions: The risk for AL must be appreciated and quantified with a multivariable scoring system. FISTULA SCORE can identify, with a good statistical significance, patient at risk for AL, changing the management of case, reducing length of stay, costs, morbidities, mortality and psychological effects on patient and medical stuff.

PMID:34749855 | DOI:10.21614/chirurgia.116.5.591

J Am Assoc Lab Anim Sci. 2021 Nov 8. doi: 10.30802/AALAS-JAALAS-21-000038. Online ahead of print.

ABSTRACT

Rectal prolapse (RP) is a common clinical condition in mice, that does not have a recognized or documented standard ofcare. At our institution, an average of 240 mice develop RP each year. Our practice has been to recommend euthanasia uponidentifying a RP based on its appearance as a painful or distressful condition. This study aimed to assess treatment options that would maintain the RP mucosa and allow mice to reach their study endpoint, and to evaluate the perception of this condition as a painful or distressful event. This study used 120 mice with spontaneous RP, concurrently assigned to ongoing research protocols. Mice were randomly assigned to 1 of 3 treatment groups: petroleum jelly, lidocaine jelly, or no treatment. Fecal samples were collected for pathogen testing, and all mice received an initial base score, followed by weekly blind scores. Upon euthanasia, RP tissue was collected for histopathology. Of the 120 mice identified with RP, 47 mice were breeders; 28% successfully produced 22 additional litters after developing RP. Seventy-three were nonbreeders, with 92% reaching their research study endpoint. No statistically significant differences were detected between the 3 treatment groups based on gross mucosal health, pain and distress, or histopathology. In this study, none of the mice in any group were euthanized based on the RP endpoint scoring criteria. These findings demonstrate that treatment is unnecessary for RP, and mice with RP did not show signs of pain or distress. In adherence to the 3Rs, this study supports animal number reduction and clinical refinement, allowing mice with RPs to reach their intended research study endpoints or produce additional litters.

PMID:34749842 | DOI:10.30802/AALAS-JAALAS-21-000038

Res Involv Engagem. 2021 Nov 8;7(1):80. doi: 10.1186/s40900-021-00321-x.

ABSTRACT

BACKGROUND: Due to demographic changes and a strained public sector operating in many countries globally, informal care is increasing. Currently, at least 1.3 million adults in Sweden regularly provide help, support and/or care to a family member/significant other. With no sign of an imminent decrease in their caring activities, it is important that informal carers are considered as a key stakeholder group within research that affects them, e.g., the co-design of carer and/or dyadic support interventions. The objective of this descriptive, quantitative study was to investigate informal carers’ perceived motivations and obstacles to become involved in research.

METHODS: A cross-sectional survey design was adopted, using first-wave data from a panel study. The data, collected in Sweden between September 2019 and March 2020, included survey responses from 147 informal carers who were either aged 60+ years themselves or were caring for someone who was aged 60+ years.

RESULTS: Our main results showed that informal carers are, in general, interested in research. Slightly fewer were interested in becoming actively involved themselves, but older age was the only characteristic significantly associated with less interest of being actively involved. Two latent motivational dimensions emerged from the factor analysis: ‘family motivation’ and ‘the greater good motivation’. These, according to our results, almost equally valued dimensions, described the differing reasons for informal carers to become involved in research. The most common perceived obstacle was lack of time and it was reported by more women than men.

CONCLUSION: Our study contributes with new knowledge of informal carers’ perceived motivations and obstacles regarding carer involvement in research. Paying attention to the differing motivational dimensions held by informal carers could help researchers create conditions for more inclusive and systematic participation of informal carers within research. Thereby, increasing the opportunities for research that is deemed to be of higher societal impact. IRRID (International Registered Report Identifier): RR2-10.2196/17759.

PMID:34749834 | DOI:10.1186/s40900-021-00321-x

Diabetes Metab Res Rev. 2021 Nov 8:e3511. doi: 10.1002/dmrr.3511. Online ahead of print.

ABSTRACT

PURPOSE: Subclinical systemic inflammation may lead to development of type 2 diabetes, but there has been no investigation into its relationship with early progression of glycemic deterioration and insulin resistance, especially in younger population. In this study we assess longitudinal associations of pro- and anti-inflammatory markers with markers that assess glycemia and insulin resistance.

METHODS: This study includes 6537 initially nondiabetic children (mean age at baseline = 6.2 years) with repeated measurements from the IDEFICS/I.Family cohort study (mean follow-up = 5.3 years) from eight European countries. Markers of inflammation were used as independent variables and markers of glycemia/insulin resistance as dependent variables. Associations were examined using two-level growth model. Models were adjusted for sex, age, major lifestyle, metabolic risk factors, early life markers, and other inflammatory markers in final model.

RESULTS: Children with 6 years of follow-up showed that a one-unit increasea in z-score of leptin level was associated with 0.38 (95% CI = 0.32 to 0.44) unit increase in HOMA-IR z-scores. Leptin continued to be associated with HOMA-IR even when analysis was limited to children with no overall obesity, no abdominal obesity, and low to normal triglyceride levels. An inverse association was observed between IL-15 and HOMA-IR (β = -0.11, 95% CI = -0.15 to -0.07).

MAIN CONCLUSIONS: IL-15 should be evaluated further in the prevention or treatment of prediabetes whereas leptin may prove to be useful in early detection of prediabetes via their association with marker of insulin resistance in European children. This article is protected by copyright. All rights reserved.

PMID:34748681 | DOI:10.1002/dmrr.3511

J Oral Pathol Med. 2021 Nov 8. doi: 10.1111/jop.13257. Online ahead of print.

ABSTRACT

BACKGROUND: Oral lichen planus (OLP) is considered an oral potentially malignant disorder. While OLP has been associated with the development of oral squamous cell carcinoma (OSCC), little is known about the role of topical corticosteroids therapy (TCT) in the promotion of carcinogenesis. The study aims to determine if TCT influences the time of malignant transformation of OLP to OSCC. The study also investigates this correlation in the presence or absence of Candida overgrowth, and in the context of conventional OSCC risk factors such as smoking, alcohol use, and male gender.

METHODS: A retrospective analysis of electronic health records at a tertiary care academic medical center was performed. Patients with OLP and OSCC were considered for inclusion. The diagnosis of OLP required both clinical and histological documentation.

RESULTS: Eighty-two patients met inclusion criteria, consisting of 48 women (58.25%) and 34 men (41.5%) and the mean patient age was 65.9 years (SD=13.25). Forty-five patients (54.9%) received TCT for OLP before they developed OSCC. The time between the OLP and OSCC diagnoses increased by four years in patients who received topical steroid therapy for OLP (P<.001) and decreased by three years (P= .010) in those with Candida overgrowth. Gender, smoking, and alcohol use did not have a statistically significant influence on the time between OLP and OSCC.

CONCLUSION: The management of OLP using TCT potentially delayed cancer development in our study. Conversely, it appears that Candida may play a role in the field cancerization of OLP patients.

PMID:34748663 | DOI:10.1111/jop.13257

Eur J Pain. 2021 Nov 8. doi: 10.1002/ejp.1882. Online ahead of print.

ABSTRACT

BACKGROUND: Visual and acoustic virtual reality (VR) has been increasingly explored as a non-pharmacological tool for pain relief in clinical settings.

OBJECTIVE: We aimed to evaluate the effectiveness of VR as a distraction technique in the management of acute pain during operative hysteroscopy in the outpatient setting.

METHODS: A prospective, open-label, randomized control trial in a tertiary university-affiliated medical center between April to August 2020. Overall, 82 women were randomly allocated to undergo operative hysteroscopy either with the use of VR (n = 44, study group) or with standard treatment (control group, n = 38). VR was applied throughout the procedure and no anesthesia was given. The primary outcome measures included self-reported intraoperative pain. Other objectives included vital parameters as pulse rate (PR) and respiratory rate (RR) before and during the first 3 minutes of the procedure. Pain and anxiety outcomes were measured as numeric rating scores.

RESULTS: The baseline parameters were similar between groups. The mean duration for the procedure was 8.1 ±3.2 vs. 7.3± 6.0 minutes for the study and the control groups (p = 0.23). There were no statistically significant differences between the reported pain scores during the procedure [median (interquartile range) 5.0 (3.0-7.2) vs 5.0 (3.0-8.0), respectively; P = .67]. While neither intraoperative heart rate nor respiratory rate differed between groups [14.0 (13.0-16.0) vs 14.0 (11.0-16.5); P = .77)], the increase of heart rate was found greater in the VR group [+7.0 (8.5) vs. +1.0 (12.2); P = .01].

CONCLUSION: VR was not effective in reducing pain during an outpatient operative hysteroscopy.

PMID:34748679 | DOI:10.1002/ejp.1882

Med Phys. 2021 Nov 8. doi: 10.1002/mp.15327. Online ahead of print.

ABSTRACT

PURPOSE: Cardiovascular magnetic resonance (CMR) is a vital diagnostic tool in the management of cardiovascular diseases. The advent of advanced CMR technologies combined with artificial intelligence (AI) has the potential to simplify imaging, reduce image acquisition time without compromising image quality, and improve magnetic field uniformity. Here we aim to implement two AI-based deep learning techniques for automatic slice alignment and cardiac shimming and evaluate their performance in clinical cardiac MRI.

METHODS: Two deep neural networks were developed, trained and validated on pre-acquired cardiac MRI datasets (>500 subjects) to achieve automatic slice planning and shimming (implemented in the scanner) for CMR. To examine the performance of our automated cardiac planning (EasyScan) and AI-based shim (AI shim), two prospective studies were performed subsequently. For the EasyScan validation, 10 healthy subjects underwent two identical CMR protocols: with manual cardiac planning and with AI-based EasyScan to assess protocol scan time difference and accuracy of cardiac plane prescriptions on a 1.5T clinical MRI scanner. For the AI shim validation, a total of 20 subjects were recruited: 10 healthy and 10 cardio-oncology patients with referrals for a CMR examination. Cine images were obtained with standard cardiac volume shim and with AI shim to assess signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), overall image quality (sharpness and MR image degradation), ejection fraction (EF) and absolute wall thickening. A hybrid statistical method using of non-parametric (Wilcoxon) and parametric (t-test) assessments was employed for statistical analyses.

RESULTS: CMR protocol with AI-based plane prescriptions, EasyScan, minimized operator dependence and reduced overall scanning time by over 2 minutes (∼ 13 % faster, P < 0.001) compared to the protocol with manual cardiac planning. EasyScan plane prescriptions also demonstrated more accurate (less plane angulation errors from planes manually prescribed by a certified cardiac MRI technologist) cardiac planes than previously reported strategies. Additionally, AI shim resulted in improved B0 field homogeneity. Cine images obtained with AI shim revealed a significantly higher SNR (12.49 %; P = 0.002) than those obtained with volume shim (volume shim: 32.90 ± 7.42 vs. AI shim: 37.01 ± 8.87) for the left ventricle (LV) myocardium. LV myocardium CNR was 12.48 % higher for cine imaging with AI shim (149.02 ± 39.15) than volume shim (132.49 ± 33.94). Images obtained with AI shim resulted in sharper images than those obtained with volume shim (P = 0.012). The LVEF and absolute wall thickening also showed that differences exist between the two shimming methods. The LVEF by AI shim was shown to be slightly larger than LVEF by volume shim in two groups: 2.87 % higher with AI shim for the healthy group, and 1.70 % higher with AI shim for the patient group. The LV absolute wall thickening (in mm) also showed that differences exist between shimming methods for each group with larger changes observed in the patient group (healthy: 3.31 %, P = 0.234, and patient group: 7.29 %, P = 0.059).

CONCLUSIONS: CMR exams using EasyScan for cardiac planning demonstrated accelerated cardiac exam compared to the CMR protocol with manual cardiac planning. Improved and more uniform B0 magnetic field homogeneity also achieved using AI shim technique compared to volume shimming. This article is protected by copyright. All rights reserved.

PMID:34748660 | DOI:10.1002/mp.15327

J Prosthodont. 2021 Nov 8. doi: 10.1111/jopr.13447. Online ahead of print.

ABSTRACT

PURPOSE: This is a clinical study to compare complete digital workflows generated using intraoral scanning and the split-file technique with a conventional workflow for cement-retained implant-supported restorations.

MATERIALS AND METHODS: Forty patients requiring posterior single-unit implant restorations were included. Twenty patients were randomly assigned to the complete digital workflow group, involving intraoral scanning and manufacture of cement-retained crowns using the split-file technique (test group). The remaining 20 patients were assigned to the hybrid workflow group (control group), involving conventional impressions and CAD/CAM-fabricated crowns based on stone casts. Scanning of the crowns was performed before and after clinical adjustment using an intraoral scanner (TRIOS Color; 3Shape). Two 3D digital models were trimmed and superimposed to evaluate changes in dimensions using Geomagic Control 2014 software. Chair-side and laboratory times for the entire workflow were recorded. Independent-sample t tests were used for the statistical analysis.

RESULTS: All crowns were inserted without re-fabrication. The average maximum occlusal adjustment of the crowns, measured as maximum deviation of occlusal area in superimposed pre and post scans, was -212.7 ±150.5 and -330.7 ±192.5 μm in the test and control groups, respectively (p = 0.037).The average area of occlusal adjustment, measured as area of deviation larger than 100 μm, was 8.4 ±8.1 and 17.1 ±12.3 mm² in the test and control groups, respectively (p = 0.012). The mesial and distal contact adjustment amounts, maximum deviations of proximal area, were -33.0 ±96.2 and -48.6 ±70.5 μm in the test group, and -3.7 ±66.7 μm and -11.4 ±106.7 μm in the control group, respectively. The mean chair-side time was 20.20 ± 3.00 and 26.65 ± 4.53 min in the test and control groups, respectively (p < 0.001). The mean laboratory time was 43.70 ± 5.56 and 84.55 ± 5.81 min in the test and control groups, respectively (p < 0.001).

CONCLUSIONS: Single-unit cement-retained crowns with complete digital workflows required fewer crown adjustments and had shorter clinical and laboratory times compared to conventional impressions and hybrid workflows. Digital impressions and the split-file technique provided customized abutments and cement-retained crowns, thus broadening the indications for digital workflows for implants. This article is protected by copyright. All rights reserved.

PMID:34748653 | DOI:10.1111/jopr.13447

Photodermatol Photoimmunol Photomed. 2021 Nov 8. doi: 10.1111/phpp.12751. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: The aim was to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical instrumentation (MI) in reducing Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) counts from C-shaped root-canals.

METHODS: Teeth with C-shaped canals as identified on cone beam computed tomographic images were included. Following incubation with E. faecalis and C. albicans, samples were divided into 4 groups as follows: Group-1: MI with adjunct aPDT; Group-2: aPDT alone; Group-3: MI alone; and Group-4: no treatment. The pulp chambers of these teeth were exposed and coronal pulp was mechanically derided using sterile endodontic excavators. Using flexible files, all canals were debrided up to size #30 K-files with intermittent irrigation with 2.5% sodium hypochlorite irrigation. In groups 1 and 3, methylene-blue was injected in all canals and aPDT was performed using a 600 nm diode laser. Sample-size estimation was done on data from a pilot investigation and group-comparisons were done using one way analysis of variance and Bonferroni post-hoc adjustment tests. P<0.05 was considered statistically significant.

RESULTS: Sixty periodontally hopeless mandibular second molars with C-shaped canals were included. There was a statistically significant reduction CFU/ml of E. faecalis (P<0.001) and C. albicans (P<0.001). at post-operative microbial assessments in Group-1. There was no difference CFU/ml of E. faecalis and C. albicans at post-operative microbial assessments in groups 2, 3 and 4.

CONCLUSION: MI with adjunct aPDT is more effective in reducing count of E. faecalis and C. albicans from C-shaped root canals.

PMID:34748657 | DOI:10.1111/phpp.12751

J Periodontal Res. 2021 Nov 8. doi: 10.1111/jre.12943. Online ahead of print.

ABSTRACT

OBJECTIVE: The current study aimed to evaluate the effect of electronic cigarette (EC) aerosol, Cannabis, and conventional cigarettes smoke on gingival fibroblast/gingival mesenchymal stem cells’ (GF/G-MSCs) of never smokers.

MATERIAL AND METHODS: Human GF/G-MSCs (n = 32) were isolated and characterized using light microscopy, flow cytometry, and multilineage differentiation ability. Following the application of aerosol/smoke extracts, GF/G-MSCs were evaluated for cellular proliferation; colony-forming units (CFU-F) ability; cellular viability (using the MTT assay); mitochondrial depolarization using JC-1 dye; and genes’ expression of ATM, p21, Oct4, and Nanog.

RESULTS: Colony-forming units and viability (OD 450 nm) were significantly reduced upon exposure to Cannabis (mean ± SD; 5.5 ± 1.5; p < .00001, 0.47 ± 0.21; p < .05) and cigarettes smoke (2.3 ± 1.2 p < .00001, 0.59 ± 0.13, p < .05), while EC aerosol showed no significant reduction (10.8 ± 2.5; p = .05, 1.27 ± 0.47; p > .05) compared to the control group (14.3 ± 3, 1.33 ± 0.12). Significantly upregulated expression of ATM, Oct4, and Nanog (gene copies/GADPH) was noticed with Cannabis (1.5 ± 0.42, 0.82 ± 0.44, and 1.54 ± 0.52, respectively) and cigarettes smoke (1.52 ± 0.75, 0.7 ± 0.14, and 1.48 ± 0.79, respectively; p < .05), whereas EC aerosol caused no statistically significant upregulation of these genes compared to the control group (0.63 ± 0.1, 0.31 ± 0.12, and 0.64 ± 0.46, respectively; p > .05). The p21 gene was not significantly downregulated in EC aerosol (1.22 ± 0.46), Cannabis (0.71 ± 0.24), and cigarettes smokes (0.83 ± 0.54) compared to the control group (p = .053, analysis of variance).

CONCLUSION: Cannabis and cigarettes smoke induce DNA damage and cellular dedifferentiation and negatively affect the cellular proliferation and viability of GF/G-MSCs of never smokers, whereas EC aerosol showed a significantly lower impact on these properties.

PMID:34748642 | DOI:10.1111/jre.12943