Tag: pubmed

J Magn Reson Imaging. 2022 Mar 14. doi: 10.1002/jmri.28154. Online ahead of print.

ABSTRACT

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is increasingly common worldwide and can lead to the development of cirrhosis, liver failure and cancer. Virtual magnetic resonance elastography (VMRE), which is based on a shifted apparent diffusion coefficient (sADC), is a potential noninvasive method to assess liver fibrosis without the specialized hardware and expertise required to implement traditional MR elastography (MRE). Although hepatic steatosis is known to confound ADC measurements, previous studies using VMRE have not corrected for hepatic fat fraction.

PURPOSE: To compare VMRE, corrected for the confounding effects of unsuppressed fat signal, to MRE and biopsy in subjects with suspected NAFLD.

STUDY TYPE: Prospective, cross-sectional.

POPULATION: A total of 49 adult subjects with suspected NAFLD (18 male; median age 55 years, range 33-74 years) who underwent liver biopsy.

FIELD STRENGTH/SEQUENCE: 3T, diffusion-weighted spin echo planar, chemical-shift encoded (IDEAL IQ) and MRE sequences.

ASSESSMENT: Two observers drew regions of interest on sADC, proton density fat fraction and MRE-derived stiffness maps. Fat-corrected sADC values were used to calculate the diffusion-based shear modulus according to the VMRE method. Predicted fibrosis stage for MRE and VMRE was determined using previously published cut-off values.

STATISTICAL TESTS: The relationship between VMRE and MRE was assessed with least-squares linear regression (coefficient of determination, R² ). Agreement between MRE and VMRE-predicted fibrosis stage was evaluated with a kappa coefficient and accuracy compared using McNemar’s test. A one-way ANOVA determined if the fat-corrected sADC (VMRE) and MRE differed by fibrosis stage. A P value < 0.05 was considered statistically significant.

RESULTS: Least squares regression of VMRE vs. MRE revealed R² = 0.046 and a slope that was not significantly different from zero (P = 0.14). There was no agreement between MRE and VMRE-predicted fibrosis stage (kappa = -0.01). The proportion of correctly predicted fibrosis stage was significantly higher for MRE compared to VMRE. MRE was significantly associated with fibrosis stage, but fat-corrected sADC was not (P = 0.24).

DATA CONCLUSION: Fat-corrected VMRE was not associated with fibrosis stage in NAFLD. Further investigation is required if VMRE is to be considered in subjects with NAFLD.

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.

PMID:35285996 | DOI:10.1002/jmri.28154

Dermatol Ther. 2022 Mar 14:e15440. doi: 10.1111/dth.15440. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment of recalcitrant plantar warts represent a highly challenging issue for both patients and physicians. Candida antigen and purified protein derivative (PPD) have shown promising efficacy in the treatment of warts, however no previous studies have compared both antigens for recalcitrant plantar warts.

AIM: To assess the efficacy and safety of intralesional Candida antigen versus intralesional PPD in the management of recalcitrant plantar warts.

PATIENTS AND METHODS: The study included 120 adult patients with multiple recalcitrant plantar warts. They were randomly assigned to one of three groups; Candida antigen, PPD, or normal saline. Injections into the largest wart were repeated every two weeks until clearance or for a maximum of 5 sessions.

RESULTS: Complete wart clearance was reported in 33 patients (82.5%) of the Candida antigen group, in 22 patients (55.6%) of the PPD group, and in one patient (5%) of the control saline group. A statistically significant difference was found between the studied groups in favor of Candida antigen. Adverse effects were mild and insignificant in the 3 groups.

CONCLUSIONS: Intralesional antigen immunotherapy by Candida antigen or PPD is a promising, safe, and cost-effective therapeutic option for multiple recalcitrant plantar warts, with statistically significant superiority of Candida antigen. This article is protected by copyright. All rights reserved.

PMID:35285995 | DOI:10.1111/dth.15440

Aust Dent J. 2022 Mar 14. doi: 10.1111/adj.12910. Online ahead of print.

ABSTRACT

BACKGROUND: Canalis sinuosus (CS) and its relationship with adjacent teeth is relevant for surgery in the anterior maxilla. Therefore, the aim of this study was to report the prevalence, characteristics, and variations of CS.

METHODS: Cone beam computed tomography (CBCT) scans of the anterior maxilla of 201 patients were reviewed. CS and the adjacent teeth were analysed by age, sex, and scan resolution, using analysis of variance, chi-squared and Fisher’s exact tests. The widest and narrowest diameters of CS, and distance to tooth apex (DTA), were compared by quadrant, closest tooth, and location, and the associations were examined statistically with P < 0.05.

RESULTS: In the 201 scans, 412 CS were identified in 198 patients associated with 395 different teeth. Mean widest diameter was 1.08 ± 0.39 mm (range: 0.42-2.60 mm), while the narrowest diameter was 0.71 ± 0.26 mm (range: 0.25-1.59 mm), and mean DTA of 2.16 ±1.25 mm (range: 0-6.22 mm). CS detection was significantly lower with CBCT taken at resolution size of 0.250 voxels (P = 0.02).

CONCLUSIONS: CS was very common in the anterior maxilla. Clinicians would be well advised to identify this anatomical structure using CBCT before undertaking any surgery in the anterior maxilla. © 2022 Australian Dental Association.

PMID:35285958 | DOI:10.1111/adj.12910

Cancer. 2022 Mar 14. doi: 10.1002/cncr.34173. Online ahead of print.

ABSTRACT

BACKGROUND: African ancestry (AA) and obesity are associated with worse survival in early-stage breast cancer. Obesity disproportionately affects women of AA; however, the intersection between ancestry and obesity on breast cancer outcomes remains unclear.

METHODS: A total of 2854 patients in the adjuvant trial E5103 were analyzed. Genetic ancestry was determined using principal components from a genome-wide array. The impact of continuous or binary body mass index (BMI) on disease-free survival (DFS) and overall survival (OS) was evaluated by multivariable Cox proportional hazards models in AA patients and European ancestry (EA) patients.

RESULTS: There were 2471 EA patients and 383 AA patients. Higher BMI was significantly associated with worse DFS and OS only in AA patients (DFS hazard ratio [HR], 1.25; 95% CI, 1.07-1.46; OS HR, 1.38; 95% CI, 1.10-1.73), not in EA patients (DFS HR, 0.97; 95% CI, 0.90-1.05; OS HR, 1.03; 95% CI, 0.93-1.14). Severe obesity (BMI ≥40) was significantly associated with worse survival in AA patients (DFS HR, 2.04; 95% CI, 1.21-3.43; OS HR, 2.21; 95% CI, 1.03-4.75) but had no impact on that of EA patients. In the estrogen receptor-positive (ER+) and triple-negative breast cancer subgroups, BMI was significantly associated with worse outcomes only in those AA patients with ER+ disease. Within the AA group, BMI remained associated with worse survival regardless of the AA proportion.

CONCLUSIONS: Higher BMI was statistically significantly associated with worse breast cancer outcomes in AA but not EA patients. This association was most significant for severe obesity and those with ER+ disease. These observations help define optimal populations for weight change interventions designed to affect disparities and survival in early-stage breast cancer.

LAY SUMMARY: African ancestry and obesity are both risk factors for worse survival after early-stage breast cancer. Women of African descent are also disproportionately affected by obesity; however, it is unclear what impact body weight has on racial disparities in breast cancer. Data from a large phase 3 clinical trial in high-risk, early-stage breast cancer were used to determine how body weight affects survival outcomes in European versus African Americans. Study results demonstrate that a higher body mass index is associated with increased risk of breast cancer recurrence and worse survival in women of African ancestry but not in women of European ancestry.

PMID:35285940 | DOI:10.1002/cncr.34173

Perspect Psychiatr Care. 2022 Mar 14. doi: 10.1111/ppc.13062. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study is to determine the relationship between nurses’ job satisfaction levels and quality of life.

DESIGN AND METHODS: This cross-sectional study was conducted on 225 nurses working in a university hospital in Turkey. Nurse Information Form, Minnesota Satisfaction Questionnaire (MSQ), and The World Health Organization Quality of Life Instrument-WHOQOL-BREF (TR) were used to collect the data.

FINDINGS: It was determined that while the MSQ mean score of the nurses was low, their WHOQOL-BREF mean score was moderate. A positive statistically significant and linear correlation was determined between job satisfaction and quality of life (p < 0.01). While the nurses’ MSQ score increased, their WHOQOL-BREF score also increased.

PRACTICE IMPLICATIONS: As job satisfaction of nurses increases, both their quality of life and quality of nursing care will be enhanced.

PMID:35285955 | DOI:10.1111/ppc.13062

JAMA Netw Open. 2022 Mar 1;5(3):e222101. doi: 10.1001/jamanetworkopen.2022.2101.

ABSTRACT

IMPORTANCE: Understanding mental health and substance use treatment seeking and suicidality among suicide decedents is important to determine prevention efforts.

OBJECTIVE: To evaluate differences in treatment seeking and suicidality between suicide decedents who died by firearms and those who died by other methods.

DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional data were collected on 234 652 suicide decedents from 2003 to 2018. Participant information was reported by their state of residence to the National Violent Death Reporting System. Statistical analysis was performed from July 1, 2021, to January 21, 2022.

MAIN OUTCOMES AND MEASURES: Main outcomes were treatment for mental health and substance use at time of death, previous treatment for mental health and substance use, history of suicidal ideation or plans, history of suicide attempts, and disclosure of suicidal ideation or plans.

RESULTS: A total of 234 652 participants (182 520 male [77.8%]; 205 966 White [87.8%]; mean [SD] age, 46.3 [18.2] years [range, 3-112 years]) were included in this study. Compared with suicide decedents who died by another method (n = 117 526 [50.1%]), those who died by firearm (n = 117 126 [49.9%]) were more likely to have disclosed thoughts or plans of suicide within the month prior to death (odds ratio [OR], 1.16 [95% CI, 1.13-1.18]) and were less likely to have previously attempted suicide (OR, 0.44 [95% CI, 0.43-0.46]). Compared with those who died by poisoning, those who used a firearm were more likely to have had a history of suicidal thoughts or plans (OR, 1.19 [95% CI, 1.15-1.23]) and to have disclosed their thoughts or plans of suicide within the month prior to death (OR, 1.06 [95% CI, 1.03-1.10]). Compared with those who died by hanging, those who used a firearm were more likely to have disclosed their thoughts or plans of suicide to another person within the month prior to their death (OR, 1.14 [95% CI, 1.11-1.17]).

CONCLUSIONS AND RELEVANCE: These findings provide information that suggests who is at risk to die by firearm suicide. Community-based interventions in suicide prevention could help reduce access to firearms during a time of crisis. The finding that firearm suicide decedents were more likely to disclose their suicidal thoughts or plans provides an important avenue for prevention.

PMID:35285919 | DOI:10.1001/jamanetworkopen.2022.2101

JAMA Netw Open. 2022 Mar 1;5(3):e222117. doi: 10.1001/jamanetworkopen.2022.2117.

ABSTRACT

IMPORTANCE: Penicillin allergy labels influence clinical decision-making, yet most children who are labeled do not have type 1 hypersensitivity allergic reactions and instead have a history of predictable adverse reactions or unspecified illness symptoms while receiving penicillin for viral infections. Studies describing penicillin allergy labeling in the pediatric outpatient setting are lacking.

OBJECTIVE: To describe the epidemiology and factors associated with penicillin allergy labels across 2 large US pediatric primary care networks.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, longitudinal birth cohort study was conducted in 90 primary care pediatric practices serving a diverse population of children across Houston, Texas, Austin, Texas, Philadelphia, Pennsylvania, and parts of New Jersey. Participants were children born between January 2010 and June 2020 who had a health care visit in the first 14 days of life and at least 2 additional visits in the first year of life at one of 90 primary care pediatric practices. Censoring criteria were additionally applied to exclude data from children no longer seeking health care in the 90 clinics over time. Statistical analysis was performed from February to May 2021.

EXPOSURES: Basic patient demographics, health care utilization, penicillin exposure, and primary clinic location.

MAIN OUTCOMES AND MEASURES: Addition of penicillin allergy label in the electronic medical record.

RESULTS: Among 334 465 children in the birth cohort, 164 173 (49.1%) were female; 72 831 (21.8%) were Hispanic, 59 598 (17.8%) were non-Hispanic Black, and 148 534 (44.4%) were non-Hispanic White; the median (IQR) age at censoring was 3.8 (1.7-6.6) years; 18 015 (5.4%) were labeled as penicillin allergic, but the prevalence of penicillin allergy labeling ranged from 0.9% to 10.2% across practices. Children were labeled at a median (IQR) age of 1.3 (0.9-2.3) years. Non-Hispanic White children were more likely to be labeled compared with non-Hispanic Black children after controlling for potential confounders (adjusted odds ratio, 1.7 [95% CI, 1.6-1.8]). There were 6797 allergic children (37.7%) labeled after receiving 1 penicillin prescription and 1423 (7.9%) labeled after receiving 0 penicillin prescriptions.

CONCLUSIONS AND RELEVANCE: In this cohort study of more than 330 000 children, penicillin allergy labeling was common and varied widely across practices. Children were labeled early in life, and almost half were labeled after receiving 1 or 0 penicillin prescriptions. These findings raise questions regarding the validity of penicillin allergy labels. Future work exploring the fidelity of and outcomes associated with penicillin allergy-labeling in children is warranted.

PMID:35285918 | DOI:10.1001/jamanetworkopen.2022.2117

Lab Med. 2022 Mar 14:lmac014. doi: 10.1093/labmed/lmac014. Online ahead of print.

ABSTRACT

OBJECTIVE: The T-cell receptor β constant region 1 (TRBC1) antibody can identify T-cell clonality and distinguish pathological from normal T cells. This study aims to establish optimal cutpoints for establishing monotypia and validate the diagnostic abilities of the TRBC1 antibody when used as a reflex test in conjunction with an existing T-cell antibody panel.

MATERIALS AND METHODS: We used 46 normal peripheral blood specimens and examined 8 patients with reactive lymphoproliferations to determine the normal biological range of TRBC1 on CD4+ and CD8+ T cells. We also evaluated 43 patient specimens that were submitted for investigation of a lymphoproliferative disorder for CD2/CD3/CD4/CD5/CD7/CD8/CD16/CD26/CD45/CD56/TCR αβ/TCR γδ, along with TRBC1 expression. The results were compared to TCR gene rearrangement patterns using polymerase chain reaction (PCR) analysis.

RESULTS: Statistical analysis established differing cutoff points for establishing monotypia dependent on restricted TRBC1 or TRBC2 usage. Direct comparison with molecular analysis indicated that no specimen identified with the restricted expression of TRBC1 was reported as polyclonal by PCR with a concordance rate of 97% between a clonal PCR result and monotypic TRBC1 expression.

CONCLUSION: Incorporation of the TRBC1 antibody using statistically derived cutoff points in a reflex setting for the evaluation of a suspected T-cell neoplasm improves the identification of clonal T-cell populations by flow cytometry and correlates well with molecular methods.

PMID:35285909 | DOI:10.1093/labmed/lmac014

Int J Qual Health Care. 2022 Mar 14:mzac012. doi: 10.1093/intqhc/mzac012. Online ahead of print.

ABSTRACT

BACKGROUND: Doctors and nurses are frequently exposed to needlestick and sharps injuries (NSIs) because of their work. It is estimated that NSIs are more common than the reported rates to Infection Control Committee. The purpose of this study was to determine the incidence and reporting rates of NSIs in our hospital.

METHODS: After their consent forms were obtained for the questionnaire, 670 doctors and nurses were interviewed face-to-face by the Infection Control Committee nurse. The questionnaire consisted of 22 questions, and the answers were recorded. The questions were on demographic data and injuries. The data of NSIs, whose active surveillance was made in our hospital since 2005 and in the last 1 year were also analyzed retrospectively.

RESULTS: A total of 119 (17%) out of 670 people who participated in the study had at least one NSIs; 43 (36%) of the 119 people were doctors, and 76 (63.9%) were nurses. The most common injuries among doctors were found in assistant doctors (60%). No statistically significant differences were detected between the doctors and nurses in terms of injury status (p=0.398). The most common injuries were found in surgical clinics, and a significant difference was detected here when compared to other clinics. The data that 20 (17%) of the 118 people who were injured by the NSIs reported the injury were obtained from the Infection Control Committee database.

CONCLUSION: It is seen that injuries are high in surgical clinics and assistant doctors who have high work stress and workload. There were more injuries with sharp objects than the expected rates in our hospital although the reports were made very rarely. First of all, we should determine strategies, especially education, to reduce injuries, and then remove the obstacles to unreported injuries. Activities of clinics with high reporting rates needs to be search and adapt them to our clinic.

PMID:35285914 | DOI:10.1093/intqhc/mzac012

Eur J Orthod. 2022 Mar 14:cjac006. doi: 10.1093/ejo/cjac006. Online ahead of print.

ABSTRACT

AIM: To assess whether the efficacy of external tooth bleaching differs between untreated and orthodontically treated teeth.

MATERIALS AND METHOD: Three groups of subjects were formed; group Debonded included 24 consecutive orthodontically treated patients evaluated immediately after removal of fixed appliances. The Retention group included 24 consecutive orthodontically treated patients in the phase of retention. The Untreated group consisted of 24 arbitrarily selected undergraduate dental students without history of fixed-appliances orthodontic therapy. Each of the above three groups was further randomized into two subgroups, Bleaching and Placebo. Each subgroup received either a 38% hydrogen peroxide bleaching treatment or a placebo agent, respectively. Tooth colour changes were assessed at seven timepoints: 1 day before intervention; on the day of intervention before and after treatment; and at 7, 14, 21, and 90 days for parameters L*, a*, b*, and ΔΕ in all upper incisors and canines with the use of a reflectance spectrophotometer. Intra-rater agreement was estimated with the Intra-class Correlation Coefficient and method’s error was calculated using the Repeatability Coefficient. Regarding tooth colour changes, an analysis of variance was used to assess differences between groups.

RESULTS: Bleaching was associated with an increase of the L* value and decrease of b* and a* values in both orthodontically treated and untreated teeth. Parameters ΔE, L*, and b* exhibited statistically significant differences between the Bleaching-Untreated and Bleaching-Retention subgroups. In the Bleaching subgroups, statistically significant differences were found between different teeth for all parameters.

CONCLUSIONS: Previous exposure to fixed orthodontic appliance influenced the efficacy of external tooth bleaching. The effect of bleaching was higher after orthodontic treatment and with longer period in retention. Canines changed in colour more than incisors, and the effect was reduced over time.

PMID:35285904 | DOI:10.1093/ejo/cjac006