Tag: pubmed

Med J Aust. 2021 Apr 26. doi: 10.5694/mja2.51043. Online ahead of print.

ABSTRACT

OBJECTIVES: To estimate initial levels of symptoms of depression and anxiety, and their changes during the early months of the COVID-19 pandemic in Australia; to identify trajectories of symptoms of depression and anxiety; to identify factors associated with these trajectories.

DESIGN, SETTING, PARTICIPANTS: Longitudinal cohort study; seven fortnightly online surveys of a representative sample of 1296 Australian adults from the beginning of COVID-19-related restrictions in late March 2020 to mid-June 2020.

MAIN OUTCOME MEASURES: Symptoms of depression and anxiety, measured with the Patient Health Questionnaire (PHQ-9) depression and Generalised Anxiety Disorder (GAD-7) scales; trajectories of symptom change.

RESULTS: Younger age, being female, greater COVID-19-related work and social impairment, COVID-19-related financial distress, having a neurological or mental illness diagnosis, and recent adversity were each significantly associated with higher baseline depression and anxiety scores. Growth mixture models identified three latent trajectories for depression symptoms (low throughout the study, 81% of participants; moderate throughout the study, 10%; initially severe then declining, 9%) and four for anxiety symptoms (low throughout the study, 77%; initially moderate then increasing, 10%; initially moderate then declining, 5%; initially mild then increasing before again declining, 8%). Factors statistically associated with not having a low symptom trajectory included mental disorder diagnoses, COVID-19-related financial distress and social and work impairment, and bushfire exposure.

CONCLUSION: Our longitudinal data enabled identification of distinct symptom trajectories during the first three months of the COVID-19 pandemic in Australia. Early intervention to ensure that vulnerable people are clinically and socially supported during a pandemic should be a priority.

PMID:33899939 | DOI:10.5694/mja2.51043

JPEN J Parenter Enteral Nutr. 2021 Apr 26. doi: 10.1002/jpen.2125. Online ahead of print.

ABSTRACT

BACKGROUND: Uncertainty remains about the best route and timing of medical nutrition therapy in the acute phase of critical illness. Early combined enteral (EN) and parenteral nutrition (PN) may represent an attractive option to achieve recommended energy and protein goals in select patient groups. This meta-analysis aims to update and summarize the current evidence.

METHODS: This systematic review and meta-analysis includes randomized controlled trials (RCTs) targeting the effect of EN alone vs. a combination of EN with PN in the acute phase of adult critically ill patients. Assessed outcomes include mortality, ICU and hospital-length of stay (LOS), ventilation days, infectious complications, and physical recovery, as well as quality of life outcomes.

RESULTS: 12 RCTs with 5543 patients were included. Treatment with a combination of EN with PN led to increased delivery of macronutrients. No statistically significant effect of a combination of EN with PN vs. EN alone on any of the parameters were observed: mortality (Risk Ratio 1.0, 95% confidence intervals [CI], 0.79 to 1.28 p = 0.99), hospital LOS (mean difference -1.44, CI -5.59 to 2.71, p = 0.50), ICU LOS and ventilation days. Trends toward improved physical outcomes were observed in two of four trials.

CONCLUSION: A combination of EN with PN improved nutrition intake in the acute phase of critically ill adults and was not inferior regarding the patient´s outcomes. Large, adequately designed trials in select patient groups are needed to answer the question if this nutritional strategy has a clinically relevant treatment effect. This article is protected by copyright. All rights reserved.

PMID:33899951 | DOI:10.1002/jpen.2125

Clin Exp Immunol. 2021 Apr 26. doi: 10.1111/cei.13608. Online ahead of print.

ABSTRACT

Renal cell carcinoma (RCC) comprises of clear cell (ccRCC) and non-clear cell (nccRCC) tumors. Despite definitive surgical resection in localized disease, recurrence often occurs. A commercial method based on a multiplex PCR assay exclusively targets rearranged T-cell receptor (TCR) genes to generate high-throughput sequencing-based data, thus allowing to characterize the immune repertoire within tumors. Here we performed a retrospective analysis on archived tumor samples from patients with recurring vs non-recurring T3 ccRCC and on samples from early nccRCC vs ccRCC. Following genomic DNA extraction and multiplex PCR, the fraction of T cells within tumors, the number of unique receptors (‘richness’) and their relative abundances (‘clonality’) were calculated. Statistical significance and correlations were calculated using Student’s T test and Spearman rho, respectively. Average fraction and clonality of T cells in tumors from non-recurring patients was 2.5-fold and 4.3-fold higher than in recurring patients (p=0.025 and p=0.043, respectively). A significant positive correlation was found between T cell fraction and clonality (Spearman rho=0.78, p=0.008). The average fraction of T cells in ccRCC tumors was 2.8-fold higher than in nccRCC tumors (p=0.015). Clonality and estimated richness were similar between ccRCC and nccRCC tumors. In summary, Recurrence of ccRCC is associated with a lower fraction and clonality of T cells within tumors. nccRCC tumors are more ‘deserted’ than ccRCC, but similar in their ability to generate a clonal T cell repertoire. Our work suggests associations between the characteristics of T cell infiltrate, histology and tumor recurrence.

PMID:33899933 | DOI:10.1111/cei.13608

Eur J Prev Cardiol. 2021 Feb 5:zwab010. doi: 10.1093/eurjpc/zwab010. Online ahead of print.

NO ABSTRACT

PMID:33899916 | DOI:10.1093/eurjpc/zwab010

Int J Mol Med. 2020 Nov 30. doi: 10.3892/ijmm.2020.4803. Online ahead of print.

ABSTRACT

Following the publication of the above article, an interested reader drew to the authors’ attention that the data shown in Fig. 2D representing the P53 and Bax data were strikingly similar. After having re‑examined their raw data, the authors have realized that this error arose inadvertently; the data shown for Bax in the original figure were selected incorrectly. In the article, the expression levels of the apoptosis‑regulatory factors P53 and Bax were investigated by western blot analysis and reverse transcription‑quantitative PCR analysis. The authors were also able to confirm that this error regarding the image placement did not influence the statistical analysis shown for the effect of PIAS1 gene silencing on pancreatic acinar cell apoptosis. The corrected version of Fig. 2, containing the correct data for Bax protein expression in Fig. 2D, is shown below. The authors are grateful to the Editor of International Journal of Molecular Medicine for granting them the opportunity to publish this Corrigendum, and stress that this error did not significantly influence either the results or the conclusions of the paper. Furthermore, the authors apologize to the readership for any inconvenience caused. [the original article was published in International Journal of Molecular Medicine 26: 919-926, 2010; DOI: 10.3892/ijmm_00000507].

PMID:33899923 | DOI:10.3892/ijmm.2020.4803

Zhongguo Gu Shang. 2021 Apr 25;34(4):337-40. doi: 10.12200/j.issn.1003-0034.2021.04.008.

ABSTRACT

OBJECTIVE: To explore the clinical effect of modified interlaminar approach for the treatment of single-segment lumbar spinal stenosis.

METHODS: From February 2015 to August 2017, 80 patients with single-segment lumbar spinal stenosis planned to undergo endoscopic surgery were selected, including 38 males and 42 females;aged 33 to 69 (47.6±9.5) years old. Using random number table method, the patients were divided into study group and traditional group, 40 cases in each group, and underwent surgical treatment through modified translaminar approach and traditional approach respectively. The operation time, intraoperative blood loss, and hospital stay were recorded;visual analogue scale (VAS) and Oswestry Disability Index (ODI) before and after operation were compared between two groups;spinal canal arca, spinal canal diameter, disc yellow space and surgical complications were observed.

RESULTS: All 80 patients were followed up for at least 3 months. Two patients had incision infection, both of them were in traditional group;there was no significant difference in operation time between two groups(P>0.05). Intraoperative blood loss and hospital stay in study group were lower than those in traditional group(P<0.05). At 1 week and 3 months after operation, VAS and ODI of all patients were significantly lower than before operation (P<0.05), but the difference between two groups was not statistically significant (P>0.05). At 3 months after surgery, measured values of spinal canal area and spinal canal diameter were larger in study group than in traditional group (P<0.05). The operative complication rate of the study group was 5.00% compared with 12.50% of the traditional group, and the difference was not statistically significant (P>0.05).

CONCLUSION: Compared with the traditional approach, the modified interlaminar approach has advantages of less trauma, faster recovery and better postoperative spinal space recovery in the treatment of single-segment lumbar spinal stenosis.

PMID:33896132 | DOI:10.12200/j.issn.1003-0034.2021.04.008

Zhongguo Gu Shang. 2021 Apr 25;34(4):341-6. doi: 10.12200/j.issn.1003-0034.2021.04.009.

ABSTRACT

OBJECTIVE: To investigate the efficacy and safety of ultrasound-guided selective nerve branch blockage in the treatment of lumbar spinal nerve posterior branch syndrome.

METHODS: A total of 40 patients with lumbar spinal nerve posterior branch syndrome treated by Pain Clinic from May 2017 to December 2018 were selected. According to the method used in locating site for nerve blockage, the patients were divided into ultrasound-guided group and anatomical positioning group, with 20 cases in each group. In anatomical positioning group, there were 7 males and 13 females, aged (63.42±7.71) years old, weighted (63.65±10.72) kg, numerical rating scale (NRS) was (6.61±1.52) scores, course of disease was (16.55±4.68) months. Pain sites:4 cases at L_2,3, 8 cases at L_3,4, 11 cases at L_4,5, and 11 cases at L₅S₁. In ultrasound-guided group, there were 10 males and 10 females, aged (59.58±10.21) years old, weighted (60.61±13.81) kg, NRS was(6.84±2.43) scores, and course of disease was(13.70±5.98) months. Pain sites:6 cases at L_2,3, 6 cases at L_3,4, 9 cases at L_4,5, and 13 cases at L₅S₁. Ultrasound-guided group used ultrasound-guided selective posteromedial branch and posterolateral branch nerve blockage, and the anatomical positioning group used anatomical localization method to block the posteromedial branch and posterolateral branch of lumbar spinal nerve. Each nerve branch was injected 3 ml of 0.125% ropivacaine. The number of treatment required and prone position time of each treatment were recorded, and the NRS scores of patients at the time points of immediately after the end of the treatment, the first week, the second week, the first month and the third month were evaluated. And adverse events such as local anesthetic allergy and poisoning, local puncture infection, total spinal anesthesia, dizziness, drowsiness, nausea, vomiting and other adverse reactions were observed.

RESULTS: There were no statistically significant differences in gender, age, weight, NRS, course of disease and pain segment distribution between two groups (P>0.05). The number of treatment required in anatomical positioning group was significantly higher than that in ultrasound-guided group (P<0.000 1). During each treatment, the time in the prone position of the patients in anatomical positioning group was significantly lower than that in ultrasound guided group (P< 0.000 1). NRS scores immediately after the end of treatment, 1 week, 2 weeks, 1 month and 3 months, anatomical positioning group were 2.98 ±0.25, 3.04 ±0.38, 3.37 ±0.47, 3.42 ±0.85, 3.50 ±0.43, respectively, 2.94 ±0.31, 3.00 ±0.29, 3.21 ±0.68, 3.16 ± 0.94, 3.17±0.53 in ultrasound-guided group, and there was significant difference at 1 month and 3 months between two groups(P< 0.05). There were no adverse events such as local anesthetic allergy and poisoning, local puncture infection, and total spinal anesthesia, and no adverse reactions such as lethargy, nausea, and vomiting occurred in two groups. There were 6 cases of dizziness in anatomical positioning group and 12 cases in ultrasound guided group. The difference between two groups was statistically significant(P<0.05).

CONCLUSION: Comparedwith anatomicalpositioning, ultrasound-guided selective nerve branch block for the treatment of posterior branch of the lumbar spinal cord syndrome can reduce the number of treatments and maintain a longer therapeutic effect, but it is also necessary to pay attention to the time of each treatment to avoid dizziness and other adverse reactions.

PMID:33896133 | DOI:10.12200/j.issn.1003-0034.2021.04.009

Zhongguo Gu Shang. 2021 Apr 25;34(4):315-20. doi: 10.12200/j.issn.1003-0034.2021.04.004.

ABSTRACT

OBJECTIVE: To explore the dynamic changes of lumbosacral sagittal parameters after real-time three-dimensional navigation assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and traditional open TLIF for treatment of lumbar degenerative disease.

METHODS: The clinical data of 61 patients with lumbar degenerative disease underwent single-segment surgery from September 2017 to September 2019 were retrospectively analyzed. Among them, 31 cases underwent MIS-TLIF with 3D navigation techniques (MIS-TLIF group) and another 30 cases underwent conventional open TLIF (traditional open TLIF group). The basic information, operative time and intraoperative blood loss were collected. The sagittal radiologic parameters were measured before surgery and 3 months after surgery, including lumbar lordosis (LL), segmental lordosis (SL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), anterior disc height (ADH), posterior disc height(PDH).And the average disc height(DH) and pelvic incidence to lumbar lordosis mismatch (PI-LL) were calculated.

RESULTS: Operative time and intraoperative blood loss in MIS-TLIF group were significantly less than in traditional open TLIF group(P<0.05). In MIS-TLIF group, LL, SL, PI-LL, and DH were significantly improved at 3 months after surgery (P<0.05), while PI, PT, and SS were not statistically different from those before surgery (P>0.05). LL, PI-LL, and DH of patients in the traditional open TLIF group were significantly improved at 3 months after surgery (P<0.05), while the PI, PT, SS, and SL were not statistically different from those before surgery (P>0.05). LL change showed a significant correlation with SL change (r= 0.433, P<0.001). Change in SL closely correlated to change in ADH (r=0.621, P<0.05) and PDH(r=0.527, P<0.05).

CONCLUSION: Real-time navigation-assisted MIS-TLIF and traditional open TLIF can recover DH in a short term for lumbar degenerative diseases, improve LL and PI-LL, and make the arrangement of the sagittal plane of the lumbosacral region more coordinated after surgery. But only the navigation assisted MIS -TLIF can significantly improve SL. Compared with traditional open TLIF, real-time navigation assisted MIS-TLIF in the treatment of degenerative lumbar diseases has the advantages of short operation time and less intraoperative bleeding.

PMID:33896128 | DOI:10.12200/j.issn.1003-0034.2021.04.004

Zhongguo Gu Shang. 2021 Apr 25;34(4):327-32. doi: 10.12200/j.issn.1003-0034.2021.04.006.

ABSTRACT

OBJECTIVE: To compare the efficacy of microscope assisted anterior cervical discectomy and fusion with conventional surgical approach in the treatment of single-segment cervical spondylotic myelopathy.

METHODS: The clinical data of 89 patients with single-segment cervical spondylotic myelopathy treated from March 2015 to March 2019 were retrospectively analyzed. There were 55 males and 34 females, with an average of (52.00±11.36) years old. Among the patients, 34 cases were treated with conventional anterior cervical discectomy with fusion (conventional group), including C_3,4 in 3 cases, C_4,5 in 10 cases, C_5,6 in 15 cases, C_6,7 in 6 cases; 55 cases were treated with microscopeassisted anterior cervical discectomy with fusion (microscope group), including C_3,4 in 5 cases, C_4,5 in 23 cases, C_5,6 in 20 cases, C_6,7 in 7 cases. Operative time, intraoperative blood loss, hospital stay and complications were compared between two groups. Clinical efficacy was assessed by visual analogue scale(VAS), Japanese Orthopaedics Association (JOA) scores, Oswestry Disability Index(ODI) during follow-up period (postoperative 1 week, 3 months and 12 months).

RESULTS: Intraoperative blood loss and hospital stay in microscope group were less than those in conventional group (P<0.05), and operative time of conventional group was shorter than that of microscope group (P<0.05). Postoperative JOA, VAS and ODI were significantly improved in each groups (P<0.05). VAS scores of microscope group were better than that of conventional group at 1 week and 3 months after operation(P<0.05), but there was no statistically significant difference between two groups at 12 months after operation (P>0.05). JOA scores of microscope group at each postoperative follow-up were better than that of conventional group (P<0.05). ODI scores of microscope group at 3, 12 months after operation were better than that of conventional group (P<0.05).

CONCLUSION: Both methods can achieve satisfactory effect in treating single-segment cervical spondylotic myelopathy. However, microscope-assisted anterior cervical discectomy and fusion has advantages of clear vision, less bleeding and fewer intraoperative complications.

PMID:33896130 | DOI:10.12200/j.issn.1003-0034.2021.04.006

Zhongguo Gu Shang. 2021 Apr 25;34(4):333-6. doi: 10.12200/j.issn.1003-0034.2021.04.007.

ABSTRACT

OBJECTIVE: To explore the relationship between lumbar degenerative spondylolisthesis and T2WI high signal in the interspinous ligament in MRI in order to improve the understanding of the signal changes of the interspinous ligament.

METHODS: The clinical data of 43 patients with clinically diagnosed lumbar degenerative spondylolisthesis were collected from March 2018 to March 2020, there were 19 males and 24 females, aged 50 to 92 years with an average of 69 years old. Using picture archiving and communication systems (PACS) to access images and record the distribution and incidence of T2WI high signal in the interspinous ligament between the slipped and non-slipped segments. Using Spearman correlation analysis to explore the relationshipbetween the T2WI high signal of the interspinous ligament and the degree of lumbar spondylolisthesis.

RESULTS: Except for 8 ligaments that were not included in the statistical results due to poor image quality, 43 patients with a total of 207 lumbar vertebrae and interspinous ligaments were included in the study. According to the Meyerding classification method, 43 patients had a total of 48 segments with spondylolisthesis, 41 segments in grade Ⅰ and 7 segments in grade Ⅱ. There were 30 cases of MRI T2WI high signal in the interspinous ligament corresponding to spondylolisthesis segment, including 3 cases on L_2,3 segment, 3 cases on L_3,4 segment, 20 cases on L_4,5 segment, and 4 cases on L₅S₁ segment. And there were 53 cases of MRI T2WI hyperintensity in 159 non slipped interspinous ligaments, of which 6 cases were at L_1,2, 6 were at L_2,3, 13 were on L_3,4, 7 were on L_4,5, and 21 were on L₅S₁. Compared with the non slipped segment, the incidence of high signal on the T2WI of the interspinous ligament was 62.5% and 33.3%, respectively, and the difference was statistically significant (χ²= 13.06, P<0.05). Spearman correlation analysis showed that the presence of T2WI hyperintensity of interspinous ligament was positively correlated with the degree of lumbar spondylolisthesis (r=0.264, P<0.05).

CONCLUSION: In patients with degenerative lumbar spondylolisthesis, the MRI T2WI hyperintensity is more common in the interspinous ligament. The occurrence of T2WI high signal is positively correlated with the degree of spondylolisthesis, which should be payed enough attention in imaging diagnosis.

PMID:33896131 | DOI:10.12200/j.issn.1003-0034.2021.04.007