Tag: pubmed

Neurol Sci. 2022 Mar 24. doi: 10.1007/s10072-022-06024-9. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the association between stroke and the risk for mortality among coronavirus disease 2019 (COVID-19) patients.

METHODS: We performed systematic searches through electronic databases including PubMed, Embase, Scopus, and Web of Science to identify potential articles reporting adjusted effect estimates on the association of stroke with COVID-19-related mortality. To estimate pooled effects, the random-effects model was applied. Subgroup analyses and meta-regression were performed to explore the possible sources of heterogeneity. The stability of the results was assessed by sensitivity analysis. Publication bias was evaluated by Begg’s test and Egger’s test.

RESULTS: This meta-analysis included 47 studies involving 7,267,055 patients. The stroke was associated with higher COVID-19 mortality (pooled effect = 1.30, 95% confidence interval (CI): 1.16-1.44; I² = 89%, P < 0.01; random-effects model). Subgroup analyses yielded consistent results among area, age, proportion of males, setting, cases, effect type, and proportion of severe COVID-19 cases. Statistical heterogeneity might result from the different effect type according to the meta-regression (P = 0.0105). Sensitivity analysis suggested that our results were stable and robust. Both Begg’s test and Egger’s test indicated that potential publication bias did not exist.

CONCLUSION: Stroke was independently associated with a significantly increased risk for mortality in COVID-19 patients.

PMID:35325320 | DOI:10.1007/s10072-022-06024-9

Graefes Arch Clin Exp Ophthalmol. 2022 Mar 24. doi: 10.1007/s00417-022-05624-7. Online ahead of print.

ABSTRACT

PURPOSE: Diabetic retinopathy (DR) is a microvascular inflammatory and neurodegenerative disease. The purpose of this study was to analyze the relationship between DR severity and the levels of potential biomarkers in the serum and/or vitreous.

METHODS: A prospective, consecutive, controlled, observational study was performed between June 2018 and January 2020. Blood and vitreous samples were collected on the day of vitrectomy in patients without diabetes and in patients with diabetes with epiretinal membrane, macular edema, and indication for vitrectomy.

RESULTS: Transthyretin (TTR) was the only blood biomarker with levels statistically higher in patients with diabetes (p = 0.037). However, no correlation with DR severity was observed. Erythropoietin (EPO) was the only blood biomarker whose levels were associated with DR severity (p = 0.036). In vitreous samples, levels of EPO (p = 0.011), interleukin (IL)-6 (p < 0.001), IL-8 (p < 0.001), IL-17 (p = 0.022), monokine induced by interferon-γ (MIG) (p < 0.001), and interferon gamma-induced protein 10 (IP-10) (p = 0.005) were significantly higher in patients with diabetes. Additionally, in vitreous, IL-6, IL-8, MIG, and IPL-10 levels were also higher in more severe DR cases (p < 0.05).

CONCLUSIONS: Among the studied biomarkers, vitreous IL-6, IL-8, MIG, and IP-10 were the ones whose levels had the strongest coherent relationship with DR severity prediction and, thus, have the best potential post-vitrectomy prognostic value.

PMID:35325286 | DOI:10.1007/s00417-022-05624-7

Skeletal Radiol. 2022 Mar 24. doi: 10.1007/s00256-022-04024-6. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to determine the anatomical risk factors that may play a role in the etiology of medial-sided osteochondral lesions of the talus (OLT) using morphological parameters in magnetic resonance imaging (MRI).

SUBJECTS AND METHODS: One hundred twenty-four patients with medial-sided OLT and age- and sex-matched 124 controls were included in this retrospective study. Two examiners conducted independent OLT classification and measurements of five MRI parameters: tibial axis-medial malleolus angle (TMM), the anterior opening angle of the talus (AOT), talus position (TalPos), the ratio of the distal tibial articular surface to the length of the trochlea tali arc (TAS/TAL), depth of the incisura fibularis (IncDep). Statistical analysis included intraclass correlation coefficients, independent t-tests, receiver-operating characteristic (ROC) analysis, area under the curve (AUC) calculation, and logistic regression analysis. A p-value < 0.05 was considered statistically significant.

RESULTS: TTM, AOT, TalPos, and TAL values were significantly higher and the TAS/TAL ratio was significantly lower in the case group than in the control group (p < 0.001). Cut-off and AUC values for TMM were 15.15° (AUC 0.763), AOT 13.05° (AUC 0.826), TalPos 0.75 mm (AUC 0.887), TAL 35.45 mm (AUC 0.642), and TAS/TAL ratio 0.82 (AUC 0.784), p < 0.001. Multivariate logistic regression analysis results were odds ratio (OR) = 6.1 for TMM ≥ 15.15°, OR = 8.9 for AOT ≥ 13.05°, OR = 36.1 for TalPos ≥ 0.75 mm, and OR = 6.7 for TAS/TAL ratio ≤ 0.82.

CONCLUSION: Ankle morphology might have an influence on OLT development. The talus position (TalPos) and anterior opening angle of the talus (AOT) seemed to be the strongest predisposing factors.

PMID:35325267 | DOI:10.1007/s00256-022-04024-6

Int J Colorectal Dis. 2022 Mar 24. doi: 10.1007/s00384-022-04103-z. Online ahead of print.

ABSTRACT

PURPOSE: Management of rectal cancer with a complete clinical response (cCR) to neoadjuvant chemoradiotherapy (NACRT) is controversial. Some advocate “watch and wait” programmes and organ-preserving surgery. Central to these strategies is the ability to accurately preoperatively distinguish cCR from residual disease (RD). We sought to identify if post-NACRT (preoperative) inflammatory markers act as an adjunct to MRI and endoscopy findings for distinguishing cCR from RD in rectal cancer.

METHODS: Patients from three specialist rectal cancer centres were screened for inclusion (2010-2015). For inclusion, patients were required to have completed NACRT, had a post-NACRT MRI (to assess mrTRG) and proceeded to total mesorectal excision (TME). Endoluminal response was assessed on endoscopy at 6-8 weeks post-NACRT. Pathological response to therapy was calculated using a three-point tumour regression grade system (TRG1-3). Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), serum albumin (SAL), CEA and CA19-9 levels post-NACRT (preoperatively) were recorded. Variables were compared between those who had RD on post-operative pathology and those with ypCR. Statistical analysis was performed using SPSS (version 21).

RESULTS: Six hundred forty-six patients were screened, of which 422 were suitable for inclusion. A cCR rate of 25.5% (n = 123) was observed. Sixty patients who achieved cCR were excluded from final analysis as they underwent organ-preserving surgery (local excision) leaving 63 ypCR patients compared to 359 with RD. On multivariate analysis, combining cCR on MRI and endoscopy with NLR < 5 demonstrated the greatest odds of ypCR on final histological assessment [OR 6.503 (1.594-11.652]) p < 0.001]. This method had the best diagnostic accuracy (AUC = 0.962 95% CI 0.936-0.987), compared to MRI (AUC = 0.711 95% CI 0.650-0.773) or endoscopy (AUC = 0.857 95% CI 0.811-0.902) alone or used together (AUC = 0.926 95% CI 0.892-0.961).

CONCLUSION: Combining post-NACRT inflammatory markers with restaging MRI and endoscopy findings adds another avenue to aid distinguishing RD from cCR in rectal cancer.

PMID:35325271 | DOI:10.1007/s00384-022-04103-z

Knee Surg Sports Traumatol Arthrosc. 2022 Mar 24. doi: 10.1007/s00167-022-06942-3. Online ahead of print.

ABSTRACT

PURPOSE: This systematic review and meta-analysis analyzed the influence of pre-operative intra-articular injections (IAI) on periprosthetic joint infection (PJI) rates after primary total knee arthroplasty (TKA).

METHODS: Studies published between January 1st, 2000 and May 1st, 2021 evaluating PJI rates among TKA patients with and without IAI were identified from PubMed, Cochrane Library, MEDLINE, EBSCO Host, and Google Scholar. The pooled effect of IAI on PJI risk was calculated utilizing Mantel-Haenszel (M-H) models. Sub-analysis comparisons were conducted based on the interval from IAI to TKA: 0-3 months; > 3-6 months; > 6-12 months. The Methodological Index for Non-Randomized Studies (MINORS) and the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool were utilized to evaluate the quality of each included study.

RESULTS: The present analysis included 12 studies reporting on 349,605 TKAs (IAI: n = 115,122; No IAI: n = 234,483). Patients receiving an IAI at any point prior to TKA (2850/115,122; 2.48%) had statistically significant increased risk of infection compared to patients not receiving IAIs (4479/234,483; 1.91%; OR: 1.14, 95% CI: 1.08-1.20; p < 0.0001). However, this finding was not demonstrated across sensitivity analyses. Receiving injections within 3 months prior to TKA was associated with increased infection risk (OR: 1.23, 95% CI: 1.14-1.31; p < 0.0001). There were no differences in infection rates when injections were given between > 3 and 6 months (OR: 0.82, 95% CI: 0.47-1.43; p = 0.49) and > 6-12 months prior to TKA (OR: 1.26, 95% CI: 0.89-1.78; p = 0.18).

CONCLUSIONS: Based on the current literature, the findings of this analysis suggest that patients receiving IAI should wait at least 3 months before undergoing TKA to mitigate infection risk. Orthopaedic surgeons and patients can utilize this information when undergoing shared decision-making regarding osteoarthritis management options and timing.

LEVEL OF EVIDENCE: Level III.

PMID:35325263 | DOI:10.1007/s00167-022-06942-3

Radiat Prot Dosimetry. 2022 Mar 22:ncac033. doi: 10.1093/rpd/ncac033. Online ahead of print.

ABSTRACT

OBJECTIVES: The study aims to assess the change of peripheral blood cell numbers following protracted low-dose radiation exposure among medical radiation workers.

METHODS: A cohort of 375 Chinese medical workers were followed for 5 years (2015-19) and recorded the changes in blood cells and cumulative doses. T-test, least significant difference-T test, variance analysis and correlation analysis were utilized in this study.

RESULTS: Compared with the control group, the white blood cells, hemoglobin counts and the ratio of eosinophils in the study group showed a downward trend. The differences in blood cells between groups were mainly found in the number of red blood cells. In a short cumulative time, such as 1 or 3 years, a correlation between the cumulative dose and the quantity of blood cells was detected, but not at 5 years.

CONCLUSIONS: There is no significant difference in the blood cell counts between different types of work, and the long-term cumulative dose has not been statistically correlated with the number of blood cells. So that the number of peripheral blood cells can no longer be used as a good indicator of radiation damage.

PMID:35325251 | DOI:10.1093/rpd/ncac033

Int J Comput Dent. 2022 Mar 24;25(1):37-45.

ABSTRACT

AIM: To evaluate the survival of implant-retained restorations fabricated on CAD/CAM-derived zirconia abutments luted to a titanium base.

MATERIALS AND METHODS: 153 patients who received a total of 310 dental implants (Camlog Promote plus or Xive S) and all-ceramic restorations on yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) abutments luted to a titanium base during the last 10 years were included. Patients were examined for technical complications during routine visits. Crestal bone level changes were randomly analyzed based on periapical radiographs of 75 implants.

RESULTS: Among the included 153 patients, 17 ceramic chippings (5.5%), 6 abutment loosenings (1.9%), and 2 abutment fractures (0.6%) were identified. The mean follow-up time was 4.7 years (standard deviation [SD]: 1.94), with a follow-up period of up to 10 years (maximum). Kaplan-Meier estimation resulted in a survival rate without complications of 91.6% for the restoration and 97.4% for the abutment. There was no statistically significant difference between the two implant systems, either between implant location or regarding the complication rate of the type of restoration. For the 75 implants included in the radiographic analysis, the mean bone level change was 0.384 mm (SD: 0.242, 95% CI: 0.315 to 0.452) for the Camlog implant system and 0.585 mm (SD: 0.366, 95% CI: 0.434 to 0.736) for the Xive system (P = 0.007).

CONCLUSION: The results of the present retrospective study demonstrate acceptable clinical outcomes for zirconia abutments luted to a titanium base in combination with all-ceramic restorations. The assessed abutment design does not appear to have a negative impact on peri-implant hard tissue.

PMID:35322651

Int J Comput Dent. 2022 Mar 24;25(1):27-36.

ABSTRACT

AIM: To compare the clinical outcomes of conventional and digital implant impressions in all-on-4 mandibular implant prostheses.

MATERIALS AND METHODS: Fifty-six participants were randomly stratified into two control groups (Axial Conventional Impression Group [ACIG] and Tilted Conventional Impression Group [TCIG]), and two test groups (Axial Digital Impression Group [ADIG] and Tilted Digital Impression Group [TDIG]). Conventional pick-up and digital impressions were made for each group, respectively. Participants in ACIG and ADIG received four axial implants, and those in TCIG and TDIG received two anterior axial and two distal tilted implants. All participants received all-on-4 mandibular prostheses and maxillary complete dentures. Implant survival, prosthetic complications, and marginal bone loss were recorded at 6, 12, and 24 months. Data were statistically described in terms of mean ± standard deviation.

RESULTS: After 24 months, the implant survival rate was 100%. A significant difference in bone loss was shown between ACIG and ADIG at 6, 12, and 24 months, with P = 0.647, 0.821, and 0.505, respectively. An insignificant difference in bone loss was shown between TCIG and TDIG at 6 ,12, and 24 months, with P = 0.671, 0.935, and 0.687, respectively. No significant difference was shown in prosthodontic complications between all groups throughout the follow-up period.

CONCLUSIONS: The digital impressions showed clinically better implant survival, stable peri-implant marginal bone level, and reasonable prosthodontic complications. The present study represents a steppingstone and proof of concept that supports the routine clinical use of digital impressions, especially in a post-COVID-19 world.

PMID:35322650

Int J Comput Dent. 2022 Mar 24;25(1):17-25.

ABSTRACT

AIM: To determine the effect of intraoral conditions on the accuracy of digital full-arch scans.

MATERIALS AND METHODS: A reference bar was used for the in vivo and in vitro parts of the present study. For the in vitro part (PAT-vitro), the bar was fixed to connect the maxillary second molars on the patient’s resin model. The same reference bar was fixed in a similar position intraorally for the in vivo testing (PAT-vivo). Model and patient were digitized using an intraoral scanner (Cerec Primescan AC, N = 40, n [PAT-vitro] = 20, n [PAT-vivo] = 20). Datasets were exported and metrically analyzed (Geomagic Control 2015) to determine the 3D linear and angular distortions in all three coordinate axes of the datasets with reference to the bar. Normality of the data distribution was tested using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Homogeneity of the variances was tested using the Levené test. Statistically significant differences for all measured parameters in view of trueness were determined using the two-sample t test, and in view of precision using the two-sample Kolmogorov-Smirnov test.

RESULTS: The PAT-vivo group showed significantly higher trueness for most of the measured linear and angular distortion parameters than the PAT-vitro group. Regarding precision, the PAT-vitro group showed significantly better values for most of the measured linear and angular distortion parameters than the PAT-vivo group.

CONCLUSIONS: Within the limitations of the present study, Cerec Primescan AC leads to comparable accuracy parameters when applied in vivo and in vitro. The reproducibility (precision) was higher when scans were performed in vitro. Due to the high trueness, the system seems to be a valid tool to obtain digital full-arch datasets in vivo with comparable accuracy to in vitro tests. coronalaxial.

PMID:35322649

J Tradit Chin Med. 2022 Feb;42(1):132-139. doi: 10.19852/j.cnki.jtcm.20210425.003.

ABSTRACT

OBJECTIVE: To treat patients with psoriasis vulgaris using Traditional Chinese Medicine (TCM), one must stratify patients into subtypes (known as TCM syndromes or Zheng) and apply appropriate TCM treatments to different subtypes. However, no unified symptom-based classification scheme of subtypes (Zheng) exists for psoriasis vulgaris. The present paper aims to classify patients with psoriasis vulgaris into different subtypes via the analysis of clinical TCM symptom and sign data.

METHODS: A cross-sectional survey was carried out in Beijing from 2005-2008, collecting clinical TCM symptom and sign data from 2764 patients with psoriasis vulgaris. Roughly 108 symptoms and signs were initially analyzed using latent tree analysis, with a selection of the resulting latent variables then used as features to cluster patients into subtypes.

RESULTS: The initial latent tree analysis yielded a model with 43 latent variables. The second phase of the analysis divided patients into three subtype groups with clear TCM Zheng connotations: ‘blood deficiency and wind dryness’; ‘blood heat’; and ‘blood stasis’.

CONCLUSIONS: Via two-phase analysis of clinic symptom and sign data, three different Zheng subtypes were identified for psoriasis vulgaris. Statistical characteristics of the three subtypes are presented. This constitutes an evidence-based solution to the syndromedifferentiation problem that exists with psoriasis vulgaris.

PMID:35322643 | DOI:10.19852/j.cnki.jtcm.20210425.003