Tag: pubmed

Surg Endosc. 2022 May 16. doi: 10.1007/s00464-022-09320-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Robotic inguinal hernia repair is growing in popularity among general surgeons despite little high-quality evidence supporting short- or long-term advantages over traditional laparoscopic inguinal hernia repair. The original RIVAL trial showed increased operative time, cost, and surgeon frustration for the robotic approach without advantages over laparoscopy. Here we report the 1- and 2-year outcomes of the trial.

METHODS: This is a multi-center, patient-blinded, randomized clinical study conducted at six sites from 2016 to 2019, comparing laparoscopic versus robotic transabdominal preperitoneal (TAPP) inguinal hernia repair with follow-up at 1 and 2 years. Outcomes include pain (visual analog scale), neuropathic pain (Leeds assessment of neuropathic symptoms and signs pain scale), wound morbidity, composite hernia recurrence (patient-reported and clinical exam), health-related quality of life (36-item short-form health survey), and physical activity (physical activity assessment tool).

RESULTS: Early trial participation included 102 patients; 83 (81%) completed 1-year follow-up (45 laparoscopic vs. 38 robotic) and 77 (75%) completed 2-year follow-up (43 laparoscopic vs. 34 robotic). At 1 and 2 years, pain was similar for both groups. No patients in either treatment arm experienced neuropathic pain. Health-related quality of life and physical activity were similar for both groups at 1 and 2 years. No long-term wound morbidity was seen for either repair type. At 2 years, there was no difference in hernia recurrence (1 laparoscopic vs. 1 robotic; P = 1.0).

CONCLUSIONS: Laparoscopic and robotic inguinal hernia repairs have similar long-term outcomes when performed by surgeons with experience in minimally invasive inguinal hernia repairs.

PMID:35578051 | DOI:10.1007/s00464-022-09320-9

J Mol Model. 2022 May 17;28(6):154. doi: 10.1007/s00894-022-05146-3.

ABSTRACT

Cancer affects a major part of the worldwide population, and, to minimize deaths, the diagnosis in the early stages of the disease is fundamental. Thus, to improve diagnosis and treatment new potential spectroscopic probes are crucial. Benzothiazole derivates present antitumor properties and are highly selective and interact strongly with the enzyme phosphoinositide 3-kinase (PI3K), which was associated with cell proliferation and breast cancer cells. In this paper, the rhenium shielding tensors (¹⁸⁷Re(σ)) and hydrogen and carbon chemical shifts (¹H(δ) and ¹³C(δ)) of the Re(CO)₃(NNO) complex conjugated with 2-(4′-aminophenyl)benzothiazole (ReABT) were evaluated. A statistical HCA model was used to analyze the best DFT protocol to compute σ and δ values and to evaluate the relativistic effects, both in the basis set and Hamiltonian as well as the functionals M06L or PBE0. The best protocol was applied to obtain ¹⁸⁷Re(σ) of the ReABT complex in different environments (gas phase, solution, and in the active site of the PI3K enzyme). The results point out that ¹⁸⁷Re(σ) values of the ReABT complex change significantly when the complex is docked in the PI3K enzyme.

PMID:35578053 | DOI:10.1007/s00894-022-05146-3

Surg Endosc. 2022 May 16. doi: 10.1007/s00464-022-09300-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effect of intraoperative lymph node (LN) dissection and postoperative adjuvant chemotherapy on the overall survival (OS) of gastric cancer (GC) patients and their reciprocity.

METHODS: LN noncompliance was defined as the absence of more than one LN station, as described in the protocol for D2 lymphadenectomy in the Japanese Gastric Cancer Association. The definition of adjuvant chemotherapy (AC) noncompliance was that the chemotherapy planned dose does not meet the requirements.

RESULTS: Kaplan-Meier survival curves showed that the OS of patients with major LN noncompliance was significantly lower than that of patients with nonmajor LN noncompliance, and the OS of AC noncompliance patients was significantly lower than that of AC compliance patients. If there was nonmajor LN noncompliance during surgery, the OS of patients with AC compliance was significantly higher than that of patients with AC noncompliance (P = 0.035). In the case of major LN noncompliance during surgery, there was no statistically significant difference in OS between those with AC compliance and those with AC noncompliance (P = 0.682). Multivariate Cox regression analysis including AC noncompliance indicated that major LN noncompliance was an independent prognostic factor for poor OS (P = 0.012), while AC noncompliance was not an independent prognostic factor for OS (P = 0.609).

CONCLUSION: Adequate lymph node dissection and adjuvant chemotherapy are both key steps to improve the awful prognosis of GC patients. Adjuvant chemotherapy may fail to remedy the poor prognosis caused by major LN noncompliance.

PMID:35578049 | DOI:10.1007/s00464-022-09300-z

JBRA Assist Reprod. 2022 May 16. doi: 10.5935/1518-0557.20220008. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the efficacy of two density gradient centrifugation media for retrieving spermatozoa from semen samples by evaluating the total motile sperm count (TMSC) and the percentage recovery.

METHODS: Twenty-two men with different sperm counts participated in the study. The samples were divided into two equal aliquots and processed using the commercial ISolate Sperm Separation Medium (Irvine Scientific, United States) and the GV Gradiente (IngáMed, Brazil). After separation, samples were counted and evaluated for motile sperm recovery.

RESULTS: The mean TMSC in the fresh sample was 19.65±21.08 million/mL. After the ISolate separation the TMSC was 6.71±7.29 million/mL, and for the GV Gradiente it was 6.27±6.82 million/mL. The percentage of motile spermatozoa recovered was 36.47%±21.61 for ISolate and 35.22%±21.24 for the GV Gradiente (p>0.05). The samples from 6 oligospermic patients (27%) were evaluated separately and the TMSC for ISolate was 4.83±2.92 million/mL, and for the GV Gradiente, it was 4.16±3.12 million/mL (p=0.54). When evaluating only normospermic patient samples, the TMSC for ISolate was 9.05±7.29 million/mL, and for the GV Gradiente, it was 8.47±6.79 million/mL (p=0.83).

CONCLUSIONS: There was no statistical difference in retrieving motile sperm using the GV Gradiente and the ISolate Separation Medium.

PMID:35575660 | DOI:10.5935/1518-0557.20220008

J Comput Assist Tomogr. 2022 May-Jun 01;46(3):492-498. doi: 10.1097/RCT.0000000000001285.

ABSTRACT

OBJECTIVE: The aim of the study was to compare a pediatric ultralow-dose pectus excavatum computed tomography (CT) protocol versus standard-dose pediatric thoracic CT in terms of radiation dose, subjective and objective image quality, and its ability to detect incidental nonosseous thoracic pathology compared with imaging and clinical reference.

METHODS: A single institution radiology database identified a total of 104 ultralow-dose pediatric thoracic CT cases with an equal number of age-matched standard-dose chest CT cases also selected for retrospective analysis. Objective image quality (contrast-to-noise and signal-to-noise ratios) and radiation dose were assessed. Qualitative Likert scorings of the bone, lung, and soft tissues were performed by 2 expert radiologists. Electronic health records of the ultralow-dose cohort were reviewed for at least 1 year to evaluate for potentially missed thoracic pathology and symptoms. Variables were compared using parametric and nonparametric tests in R software 4.0.5.

RESULTS: The ultralow-dose protocol group had statistically significant reductions (P < 0.001) in the volume CT dose index (0.31 ± 0.19 vs 2.20 ± 1.64 mGy), effective radiation dose (0.14 ± 0.08 vs 1.07 ± 0.86 mSv), and size-specific dose estimates (0.50 ± 0.30 vs 3.43 ± 2.56 mGy) compared with the standard protocol, yielding an 86.51% and 85.32% reduction, respectively. The signal-to-noise ratio (20.49 ± 6.19 vs 36.48 ± 10.20), contrast-to-noise (21.65 ± 6.57 vs 38.47 ± 10.59), and subjective measures of image quality (lung parenchyma [3.07 ± 0.92 vs 4.42 ± 0.47], bony structures [3.30 ± 0.86 vs 4.52 ± 0.51], and surrounding soft tissues [2.57 ± 0.63 vs 3.89 ± 0.65]) were also significantly lower in the ultralow-dose protocol (P < 0.001). No differences were seen in the number and size of pulmonary nodules between groups. Clinical and imaging follow of all 104 patients undergoing ultralow-dose CT demonstrated no evidence of missed thoracic pathology causing symptoms.

CONCLUSIONS: Ultralow-dose thoracic CT is an acceptable modality for imaging pediatric patients with pectus excavatum and other conditions primarily causing osseous pathology, with effective radiation dose comparable to plain radiographs and a moderate increase in image noise that did not significantly reduce its ability to detect incidental nonosseous thoracic pathology.

PMID:35575655 | DOI:10.1097/RCT.0000000000001285

J Adhes Dent. 2022 May 16;24(1):247-257. doi: 10.3290/j.jad.b3032461.

ABSTRACT

PURPOSE: To investigate marginal integrity of restorations applied with preheated and non-preheated composite, flowable composite, sonically activated composite, and a new thermo-viscous bulk-fill composite using near-infrared technology for preheating, in class V cavities of human molars.

MATERIALS AND METHODS: Standardized cavities were prepared on the buccal surfaces of 60 human mandibular molars and restored with one of the following resin composite materials after application of an etch-and-rinse adhesive (OptiBond FL, Kerr): non-preheated or preheated conventional composite (Filtek Supreme XTE, 3M Oral Care), preheated thermo-viscous composite (VisCalor bulk, Voco), soncially activated composite (SonicFill 3, Kerr), or flowable composite (Filtek Supreme XTE Flowable, 3M Oral Care) applied in bulk or as a lining material using the snow-plow technique. After light curing and polishing, the percentage of continuous margins (PCM) of the restorations in enamel and dentin was assessed using SEM both before and after thermomechanical loading (TML). TML was carried out with 3000 thermal cycles (5°C-50°C) and a simultaneous mechanical stress application with 1.2 million load-cycles (1.7 Hz, 49 N) in a computer-controlled masticator. Non-parametric statistical analysis was performed using Wilcoxon, Kruskal-Wallis, and Mann-Whitney U-tests (α = 0.05).

RESULTS: All groups revealed a significant decline in marginal integrity after TML in both enamel and dentin. Although the flowable group in enamel and the snow-plow group in dentin showed the highest PCM before TML, the differences between the groups were compensated after TML.

CONCLUSION: All of the tested composites and application methods showed similar marginal integrities after thermomechanical loading and can be recommended for clinical implementation.

PMID:35575657 | DOI:10.3290/j.jad.b3032461

J Comput Assist Tomogr. 2022 May-Jun 01;46(3):333-343. doi: 10.1097/RCT.0000000000001291. Epub 2022 Mar 4.

ABSTRACT

BACKGROUND: Routine computed tomography (CT) scans are thought to have poor performance for detection of gastrointestinal (GI) neuroendocrine neoplasms (NENs), which leads to delayed workup. Detection of even 1 bowel tumor can guide diagnostic workup and management. The purposes of this study were to assess the accuracy of multidetector computed tomography (MDCT) and to compare negative versus positive enteric contrast in detecting at least 1 GI tumor per patient with suspected or confirmed diagnosis of a NEN.

METHODS: This retrospective study included 107 patients with intravenous and oral contrast (65 positive, 40 negative, and 2 no oral contrast) abdominopelvic MDCT. Two abdominal radiologists independently analyzed the CTs for detection and localization of bowel NENs. Surgical pathology was considered the reference standard. Analyses included κ and summary statistics, McNemar test, Pearson χ2 test, and Fisher exact test.

RESULTS: Among the 107 CT scans, there were 30 pathology negative studies and 77 studies with positive pathology for GI NEN. Interreader agreement for CT evaluation was substantial (κ = 0.61). At least 1 GI NEN per patient was detected with 51% to 53% sensitivity, 87% to 93% specificity, 91% to 95% positive predictive value (PPV), 42% negative predictive value, and 63% accuracy for each reader, and 57% accuracy when only the concordant (ie, matching) results of the 2 readers were considered. Computed tomography scans with negative enteric contrast had significantly higher sensitivity for concordant results than CTs with positive enteric contrast (58% vs 30%, P = 0.01). Specificity (100% vs 95%, P = 0.5), PPV (100% vs 93%, P = 0.49), negative predictive value (39% vs 39%, P = 0.99), and accuracy (67% vs 51%, P = 0.10) were not significantly different for negative versus positive enteric contrast for the concordant results. There was no significant difference in GI NEN localization between the readers.

CONCLUSIONS: Routine MDCT with either positive or negative enteric contrast can detect at least 1 GI tumor per patient with more than 90% PPV and more than 50% accuracy in patients suspected of GI NEN. Using negative enteric contrast improves sensitivity for GI NEN versus positive enteric contrast. In addition, there is high accuracy in localizing the bowel tumor with positive or negative enteric contrast, which may guide surgery. Radiologists should have heightened awareness that evaluating such scans closely may lead to detection of primary bowel NENs at a higher rate than previously reported.

PMID:35575649 | DOI:10.1097/RCT.0000000000001291

Laryngoscope. 2022 May 16. doi: 10.1002/lary.30216. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the proportion of otolaryngologists with work-related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD.

STUDY DESIGN: Systematic review and meta-analysis.

METHODS: A comprehensive search of the literature identified 1121 articles for initial review of which 19 (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta-analysis. Random effects meta-analyses were used to estimate the proportion of otolaryngologists reporting WRMD.

RESULTS: The overall proportion (95% confidence intervals [CI]) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms. Surgeons performing primarily subspecialty cases had a lower estimated overall prevalence of WRMD versus those performing general ENT cases, however the odds ratio (OR) was not statistically significant (OR [95% confidence interval] 0.53 [0.22, 1.25]). 23%-84% of otolaryngologists underwent medical treatment for WRMD. 5%-23% took time off work and 1%-6% stopped operating completely as a result of WRMD. 23%-62.5% of otolaryngologists believed WRMD negatively impacted their quality of life. Objective measures of ergonomic posture indicate moderate to severe risk of injury during the routine clinic and surgical procedures with none found to be low risk.

CONCLUSIONS: Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. Laryngoscope, 2022.

PMID:35575629 | DOI:10.1002/lary.30216

Am J Clin Nutr. 2022 May 16:nqac147. doi: 10.1093/ajcn/nqac147. Online ahead of print.

ABSTRACT

BACKGROUND: Dietary methyl donors (e.g., choline) support the activity of the phosphatidylethanolamine N-methyltransferase (PEMT) pathway, which generates phosphatidylcholine (PC) molecules enriched in docosahexaenoic acid (DHA) that are exported from the liver and made available to extrahepatic tissues.

OBJECTIVE: This study investigated the effect of prenatal choline supplementation on biomarkers of DHA status among pregnant participants consuming supplemental DHA.

DESIGN: Pregnant participants (N=30) were randomized to supplemental choline intakes of 550 mg/d (500 mg/d d0-choline + 50 mg/d deuterium labeled-choline [d9-choline]; intervention) or 25 mg/d (25 mg/d d9-choline; control) from gestational week (GW) 12-16 until delivery. All participants received a daily 200-mg DHA supplement and consumed self-selected diets. Fasting blood samples were obtained at baseline, GW 20-24, and GW 28-32; maternal/cord blood was obtained at Delivery. Mixed effects linear models were used to assess the impact of prenatal choline supplementation on maternal and newborn DHA status.

RESULTS: Choline supplementation (550 vs 25 mg/d) did not achieve a statistically significant intervention-x-time interaction for RBC PC-DHA (P=0.11); a significant interaction was observed for plasma PC-DHA and RBC total DHA, with choline supplementation yielding higher levels (+32-38% and +8-11%, respectively) at GW28-32 (P<0.05) and Delivery (P<0.005). A main effect of choline supplementation on plasma total DHA was also observed (P=0.018); its interaction with time was not significant (P=0.068). Compared with controls, the intervention group exhibited higher (P=0.007); main effect) plasma enrichment of d3-PC (d3-PC/total PC). Moreover, the ratio of d3-PC:d9-PC was higher (+50-67%, P<0.001) in the choline intervention arm (vs control) at GW 20-24, GW 28-32 and Delivery.

CONCLUSIONS: Prenatal choline supplementation improves hepatic DHA export and biomarkers of DHA status by bolstering methyl group supply for PEMT activity among pregnant participants consuming supplemental DHA Clinical Trial Registry: Synergy BetweenCholine and DHA; NCT03194659 (www.clinicaltrials.gov).

PMID:35575618 | DOI:10.1093/ajcn/nqac147

Radiol Oncol. 2022 May 17;56(2):248-258. doi: 10.2478/raon-2022-0016.

ABSTRACT

INTRODUCTION: Potential changes in patient anatomy during proton radiotherapy may lead to a deviation of the delivered dose. A dose estimate can be computed through a deformable image registration (DIR) driven dose accumulation. The present study evaluates the accumulated dose uncertainties in a patient subject to an inadvertent breathing associated motion.

MATERIALS AND METHODS: A virtual lung tumour was inserted into a pair of single participant landmark annotated computed tomography images depicting opposite breathing phases, with the deep inspiration breath-hold the planning reference and the exhale the off-reference geometry. A novel Monte Carlo N-Particle, Version 6 (MCNP6) dose engine was developed, validated and used in treatment plan optimization. Three DIR methods were compared and used to transfer the exhale simulated dose to the reference geometry. Dose conformity and homogeneity measures from International Committee on Radioactivity Units and Measurements (ICRU) reports 78 and 83 were evaluated on simulated dose distributions registered with different DIR algorithms.

RESULTS: The MCNP6 dose engine handled patient-like geometries in reasonable dose calculation times. All registration methods were able to align image associated landmarks to distances, comparable to voxel sizes. A moderate deterioration of ICRU measures was encountered in comparing doses in on and off-reference anatomy. There were statistically significant DIR driven differences in ICRU measures, particularly a 10% difference in the relative D_98% for planning tumour volume and in the 3 mm/3% gamma passing rate.

CONCLUSIONS: T he dose accumulation over two anatomies resulted in a DIR driven uncertainty, important in reporting the associated ICRU measures for quality assurance.

PMID:35575586 | DOI:10.2478/raon-2022-0016