Tag: pubmed

Port J Card Thorac Vasc Surg. 2022 Jan 4;28(4):31-36. doi: 10.48729/pjctvs.221.

ABSTRACT

OBJECTIVES: Identify risk factors for major perioperative complications (MPC) after anatomical lung resection for NonSmall-Cell Lung Cancer (NSCLC) and establish a scoring system.

METHODS: Single center retrospective study of all consecutive patients diagnosed with NSCLC submitted to anatomical lung resection from 2015 to 2019 (N=564).

EXCLUSION CRITERIA: previous lung surgery, concomitant non-lung cancer related procedures, urgency surgery.

STUDY POPULATION: 520 patients.

PRIMARY END-POINT: MPC defined as a composite endpoint including at least one of the in-hospital complications. Univariable and Multivariable analyses were developed to identify predictors of perioperative complications and create a risk score. Discrimination was assessed using the C-statistic. Calibration was evaluated by Hosmer and Lemeshow test and internal validation was obtained by means of bootstrap replication.

RESULTS: Mean age of 65 years and 327 (62.9%) were males. Mean hospital stay of 9 days after surgery. Overall MPC rate was 23.3%. Male gender, hypertension, FEV1<75%, thoracotomy, bilobectomy/pneumectomy and additional resection were independent predictors of MPC. A risk score based on the odds ratios was developed – Major Perioperative Complications of Lung Resection (MPCLR) scoring system – and ranged between 0 and 14 points. It was divided in 5 groups: 1-2 points (positive preditive value 15%); 3-4 (PPV 25%); 5-7 (PPV 35%); 8-9 (PPV 60%); >10 points (PPV 88%). The score showed rea- sonable discrimination (C-statistic=0.70), good calibration (P=.643) and it was internally validated (C-statistic=0,70 BCa95% CI,0.65-0.79).

CONCLUSIONS: This study proposes a simple and daily-life risk score system that was able to predict the incidence of perioperative complications.

PMID:35334178 | DOI:10.48729/pjctvs.221

Spec Care Dentist. 2022 Mar 25. doi: 10.1111/scd.12714. Online ahead of print.

ABSTRACT

AIMS: A Virtual Dental Home (VDH) is an alternative care model using teledentistry technology to provide care in community settings for special care populations. The Dental Hygiene Department at Idaho State University developed a VDH educational program to deliver preventive and therapeutic care at an assisted-living (AL) facility for memory care residents. The purpose of the educational program was to design and implement a VDH model for AL residents, and subsequently to evaluate the effectiveness of the educational program through students’ knowledge, clinical confidence, and perspectives.

METHODS AND RESULTS: Senior dental hygiene students (n = 32) completed didactic, laboratory, and clinical experiences on implementing an VDH. Using a pretest/posttest design, data were collected using a self-generated questionnaire; validity and reliability of the questionnaire were established prior to administration. Likert data were analyzed (n = 22, 69%) using the Wilcoxon Signed Rank test and Bonferroni correction. The change in scores of all three variables was statistically significant. The educational program was effective for increasing knowledge, clinical confidence, and perspectives of the dental hygiene students.

CONCLUSION: Educational programs that include didactic, laboratory, and clinical experiences prepare graduates for using alternative care models, thereby, enhancing the potential to improve access to care for vulnerable populations in community settings.

PMID:35334117 | DOI:10.1111/scd.12714

Int Endod J. 2022 Mar 25. doi: 10.1111/iej.13736. Online ahead of print.

ABSTRACT

BACKGROUND: A comprehensive effort to evaluate outcomes of primary root canal treatment (RCT) between 1966 and 2002 was published by Ng et al. (2007, 2008). Changes in endodontic materials and treatment methods warrants an updated analysis of outcomes.

OBJECTIVES: This study aimed to 1) quantify the success rates of primary RCT published between 2003 and 2020; and 2) investigate the influence of some characteristics known/ suspected to be associated with treatment outcomes.

METHODS: An electronic search was performed in the following databases (01-01-2003 to 12-31-2020): Pubmed, Embase, CINHAL, Cochrane and Web of Science. Included study designs were longitudinal clinical studies (randomized control trials, cohort studies, retrospective observational studies). Studies with at least twelve-months of post-operative review and success rates based on clinical and radiographic criteria were analyzed. The terms ‘strict’ (complete resolution of periapical lesion) or ‘loose’ (reduction in size of existing periapical lesion) were used to describe the outcome criteria. Weighted, pooled success rates were calculated. Random effects meta-regression models were used to investigate potential sources of statistical heterogeneity. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate for quality assessment of the included studies.

RESULTS: Forty-two studies were included in the review. Meta-analyses showed that the weighted pooled success rates were estimated to be 92.6% (95% CI: 90.5-94.8%) under ‘loose criteria’ and 82.0% (95% CI: 79.3-84.8%) under ‘strict’ criteria. The most significant areas of study heterogeneity were year of publication and qualification of operator. The majority (64.29%) of studies were considered to be of low quality of evidence.

DISCUSSION: Biological factors continue to have the most significant impact on RCT outcomes. The technological method of instrumentation had no significant effect. The quality of evidence, was based primarily on study design and only randomized control trials were considered to be “high” quality of evidence.

CONCLUSIONS: The reported success rates show improvement over time. Weighted success rates for studies with a minimum of four-year follow-up had better outcomes, compared to those with less than four years, when ‘strict criteria’ were used.

PMID:35334111 | DOI:10.1111/iej.13736

Cancer Causes Control. 2022 Mar 25. doi: 10.1007/s10552-022-01573-y. Online ahead of print.

ABSTRACT

PURPOSE: Underserved Black and Hispanic/Latinx women show low rates of follow-up care after an abnormal Pap test, despite the fact that cervical cancer is one of the few preventable cancers if detected early. However, extant literature falls short on efficacious interventions to increase follow-up for this population. A concurrent mixed methods study was completed to evaluate the acceptability of a text message-based intervention and identify perceived barriers and facilitators to follow-up after an abnormal Pap test among underserved predominantly Black and Hispanic/Latinx women.

METHODS: Patients who completed follow-up for an abnormal Pap test were recruited to complete a cross-sectional survey, qualitative interview assessing barriers and facilitators to follow-up, and text message content evaluation (N = 28). Descriptive statistics were performed to describe background variables and to evaluate the acceptability of text messages. A directed content analysis was completed for the qualitative interviews.

RESULTS: Participants expressed interest in a text message-based intervention to increase abnormal Pap test follow-up. In the qualitative interviews, low knowledge about cervical risk and negative affect toward colposcopy/test results were identified as barriers to follow-up. Facilitators of follow-up included feeling relieved after the colposcopy and adequate social support. Participants rated the text messages as understandable, personally relevant, and culturally appropriate.

CONCLUSION: The findings suggest that underserved Black and Hispanic/Latinx women experience cognitive and emotional barriers that undermine their ability to obtain follow-up care and a text message-based intervention may help women overcome these barriers. Future research should develop and evaluate text message-based interventions to enhance follow-up after an abnormal Pap test.

PMID:35334016 | DOI:10.1007/s10552-022-01573-y

J Neurovirol. 2022 Mar 25. doi: 10.1007/s13365-022-01064-5. Online ahead of print.

ABSTRACT

The objective of this study is to investigate the risk factors of oral or facial herpes simplex virus (HSV-1) infection after primary trigeminal neuralgia (PTN). The clinical data of 33 PTN patients admitted by the same surgeon in the neurosurgery were retrospectively analyzed. Among the 33 patients, 26 patients underwent microvascular decompression (MVD), 6 patients who have not been found the clear offending vessels during the operation underwent partial sensory rhizotomy (PSR), and only one underwent adhesive band separation. Thirteen patients with postoperative oral and facial HSV-1 infection were selected as the herpes group, and the remaining 20 patients without postoperative oral and facial HSV-1 infection were selected as the non-herpes group. The differences between the two groups were compared by statistical analysis of factors such as gender, age, operation mode, operation time, and serum HSV-1 antibody titer value before surgery. Compared with the non-herpes group, there were no statistically significant differences in sex ratio (P = 0.930), age composition (P = 0.261), or disease profile (P = 0.226). Twenty-six patients underwent MVD operation, eight of whom were infected, and the difference between the two groups was statistically significant (P = 0.029). The operation time of the herpes group was 10-30 min, which was significantly longer than that of the non-herpes group. The difference in operation time between the two groups was statistically significant (P = 0.023). Serum HSV-1-IgM was negative (< 0.9 COI) in all patients before surgery, but the positive rate of HSV-1-IgG (≥ 1.1 COI) was 97%, and the titer was greater than four times in 97% (32/33) of patients. The titer of IgG antibody in the herpes group was significantly lower than that in the non-herpes group, and the difference between the two groups was statistically significant (P = 0.017). The serum HSV-1-IgG in most of the PTN patients was positive. Latent HSV-1 in the trigeminal ganglion may be reactivate after PTN surgery to produce ipsilateral oral and facial herpes infection. The infection of HSV-1 reactivation after PTN surgery was positively correlated with the operation time but negatively correlated with the titer of HSV-1-IgG antibody before PTN surgery. The incidence of HSV-1 infection after PTN operation is related to different surgical procedures.

PMID:35334082 | DOI:10.1007/s13365-022-01064-5

Biomech Model Mechanobiol. 2022 Mar 25. doi: 10.1007/s10237-022-01564-7. Online ahead of print.

ABSTRACT

On the basis of a tensor representation of protein shape, obtained by an affine decomposition of residue velocity, we show how to identify actions at continuum scale for both single proteins and their complexes in terms of power equivalence. The approach constructs and justifies a continuum modeling of protein complexes, which avoids a direct, atomistic-based, simulation of the whole complex, rather it focuses (in a statistical sense) on a single protein and its interactions with the neighbors. In the resulting setting we also prove the existence of equilibrium configurations (native states) under large strains.

PMID:35334002 | DOI:10.1007/s10237-022-01564-7

Eur Arch Otorhinolaryngol. 2022 Mar 25. doi: 10.1007/s00405-022-07325-7. Online ahead of print.

ABSTRACT

PURPOSE: The preoperative diagnosis of noninvasive fungal rhinosinusitis (NIFRS) is inaccurate, and biomarkers to assist the diagnosis are urgently needed. We aimed to evaluate the relationship between albumin levels and NIFRS to assist in early diagnosis.

METHODS: Patients with NIFRS and chronic sinusitis were enrolled in this study. Appropriate statistical methods were used to determine whether there was a statistical difference between the groups. Subgroup analysis was performed to investigate the relationship between albumin levels and NIFRS, and a generalised additive model (GAM) was used to perform nonlinear relationships.

RESULTS: A total of 620 patients were included, including 240 patients with NIFRS. A close relationship was found between albumin levels and NIFRS (P < 0.0001), and the low albumin group was associated with a higher incidence of NIFRS, which was reduced by 60 and 70% in the middle and high albumin groups, respectively. The subgroup analysis also demonstrated an association between albumin levels and NIFRS, except in patients with an alcohol history (P = 0.0665). Interestingly, a nonlinear relationship is observed according to the adjusted GAM. The inflection point was set at 37.0 g/L. A negative correlation was observed among patients with albumin > 37.0 g/L. When the albumin count was <37.0 g/L, the Y value obviously increased and was saturated at 70%, with no further significant increase.

CONCLUSION: Albumin levels were significantly negatively correlated with the incidence of NIFRS, and the incidence increased markedly among patients with albumin < 37.0 g/L.

PMID:35333963 | DOI:10.1007/s00405-022-07325-7

Langenbecks Arch Surg. 2022 Mar 25. doi: 10.1007/s00423-022-02498-5. Online ahead of print.

ABSTRACT

PURPOSE: Presentation of results of non-stenting treatment versus endoscopic stenting placement in gastric staple leaks after laparoscopic sleeve gastrectomy (LSG).

METHODS: Between January 2007 and August 2020, 1371 eligible patients underwent LSG. After gastric leak detection, patients were classified into treatment groups A (endoscopic stent placement) and B (non-stenting management). Overall hospital stay, the time to complete gastric leak resolution and the incidence of further operative management constituted the main outcome measures. Statistical analysis included descriptive statistics and linear regression tests as needed.

RESULTS: A total of 27 patients (19 F/8 M, median age: 44.8 years (range: 36-58) with median preoperative BMI: 43.5 kg/m² (range: 37.0-48.7)) presented with gastric staple line leak (1.9%) – mean detection day 5.8 postop (range: 1-12). Eight patients enrolled in group A and 19 patients in group B. The mean hospital stay for group A was 41.2 days (range: 24-60) versus 15 days (range: 12-18) for group B (p < 0.001). Complete leakage resolution was observed at mean 42.4 days (range 25-60) for group A and 34.5 days (range: 28-40) for group B patients, (p = 0.025). Only 2 group A patients accomplished complete leak resolution without additional intervention. Five group A patients (62.5%) versus 4 group B patients (21.1%) needed operative intervention during the treatment course (p = 0.037).

CONCLUSIONS: Conservative, non-stenting treatment of staple line leaks after LSG is feasible and is associated with superior results in terms of hospital say and leak resolution in comparison to endoscopic stenting.

PMID:35333965 | DOI:10.1007/s00423-022-02498-5

Eur Arch Otorhinolaryngol. 2022 Mar 25. doi: 10.1007/s00405-022-07349-z. Online ahead of print.

ABSTRACT

BACKGROUND: Surgical site infection (SSI) in open surgical tracheostomy (ST) occurs in up to 33% of the cases. SSI can be reduced by a postoperative antibiotic prophylaxis (POAP). The effect of Clindamycin on SSIs in head and neck surgery (HNS) is discussed controversially in the literature.

METHODS: An 8 year single-center retrospective comparative analysis of 441 STs (Visor-ST and Bjoerk-flap technique) performed within major HNS was evaluated due to the event of a SSI within 7 days and analyzed descriptively. Logistic regression model evaluated the impact of POAP with Clindamycin on SSIs.

RESULTS: The use of Clindamycin showed twice the rate of ST-SSI as all patients that did not receive Clindamycin, treated with other perioperative antibiotics. (Fisher’s p = 0.008) The logistic regression model could not prove a statistically significant impact. (OR = 2.91, p = 0.04).

CONCLUSION: We recommend that Clindamycin should be reconsidered as a POAP regimen in ST. Further studies should evaluate alternatives for Penicillin-allergic patients.

LEVEL OF EVIDENCE III: Comparative retrospective monocentric study.

PMID:35333962 | DOI:10.1007/s00405-022-07349-z

Eur Spine J. 2022 Mar 25. doi: 10.1007/s00586-022-07184-0. Online ahead of print.

ABSTRACT

PURPOSE: In this prospective observational cohort study, the development of lumbar intervertebral discs (LIVD) on magnetic resonance imaging (MRI) was investigated from childhood to adulthood with emphasis on the possible association of disc degeneration (DD) to low back pain (LBP).

METHODS: In 2021, 89 subjects who were enrolled in 1994 in a longitudinal study with lumbar spine MRI at ages 8, 11 and 18 were invited to participate in a long-term follow-up comprising a clinical examination, selected patient-reported outcome measures and a lumbar spine MRI. We assessed all MRIs (three lowest LIVDs) with the Pfirrmann summary score, and the ratio of signal intensity of nucleus pulposus to signal intensity of cerebrospinal fluid (SINDL). We further analyzed whether disc changes at any age were associated with self-reported LBP at age 34.

RESULTS: Of the 48 subjects in the follow-up, 35 reported LBP at age 34. The Pfirrmann summary score significantly increased with age (p < 0.001). Subjects reporting LBP at age 34 demonstrated statistically significantly higher summary scores at age 18 and 34 compared to asymptomatic subjects (p = 0.004 at age 18, and p = 0.039 at age 34). SINDL significantly decreased with age (p < 0.001 for all levels separately), but no significant differences between subjects with or without LBP at age 34 were noticed.

CONCLUSION: Subjects with LBP at age 34 had more widespread or severe DD already at age 18 compared to those without LBP.

PMID:35333957 | DOI:10.1007/s00586-022-07184-0