Tag: pubmed

J Magn Reson Imaging. 2022 Mar 23. doi: 10.1002/jmri.28168. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship of tissue chemistry to breast density and cancer risk has not been documented despite breast density being a known risk factor.

PURPOSE: To investigate whether distinct chemical profiles associated with breast density and cancer risk are identified in healthy breast tissue using in vivo two-dimensional correlated spectroscopy (2D COSY).

STUDY TYPE: Prospective.

POPULATION: One-hundred-seven participants including 55 at low risk and 52 at high risk of developing breast cancer.

FIELD STRENGTH/SEQUENCE: 3 T/ axial/ T1, T2, 2D COSY.

ASSESSMENT: Two radiologists defined breast density on T2. Interobserver variability assessed. Peak volumes normalized to methylene at (1.30, 1.30) ppm as internal shift reference.

STATISTICAL TESTS: Chi-squared/Mann-Whitney/Kappa statistics/Kruskal Wallis/pairwise analyses. Significance level 0.05.

RESULTS: Ten percentage were fatty breasts, 39% scattered fibroglandular, 35% heterogeneously dense, and 16% extremely dense. Interobserver variability was excellent (kappa = 0.817). Sixty percentage (64/107) were premenopausal. Four distinct tissue chemistry categories were identified: low-density (LD)/premenopausal, high-density (HD)/premenopausal, LD/postmenopausal, and HD/postmenopausal. Compared to LD, HD breast chemistry showed significant increases of cholesterol (235%) and lipid unsaturation (33%). In the low-risk category, postmenopausal women with dense breasts recorded the largest significant changes including cholesterol methyl 540%, lipid unsaturation 207%, glutamine/glutamate 900%, and choline/phosphocholine 800%. In the high-risk cohort, premenopausal women with HD recorded a more active chemical profile with significant increases in choline/phosphocholine 1100%, taurine/glucose 550% and cholesterol sterol 250%.

DATA CONCLUSION: Four distinct chemical profiles were identified in healthy breast tissue based on breast density and menopausal status in participants at low and high risk. Gradual increase in neutral lipid content and metabolites was noted in both risk groups across categories in different order. In low risk, the HD postmenopausal category exhibited the highest metabolic activity, while women at high risk exhibited the highest lipid content and metabolic activity in the HD premenopausal category.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 3.

PMID:35319148 | DOI:10.1002/jmri.28168

Head Neck. 2022 Mar 23. doi: 10.1002/hed.27038. Online ahead of print.

ABSTRACT

BACKGROUND: To assess the efficacy and safety of preoperative embolization (PE) in patients with carotid body tumor (CBTs).

METHODS: In a single-center retrospective cohort study, 127 patients underwent surgical resection of CBTs from January 2003 to December 2019. One-to-one propensity score matching was conducted between patients with or without PE.

RESULTS: Thirty-two (25.2%) patients received PE. After propensity score matching, no statistically significant differences were found in the baseline characteristics of 28 patients in each group. Compared with NPE group, operative time and estimated blood loss (EBL) were significantly reduced in the PE group. The incidence of stroke, perioperative complications, intraoperative blood transfusion, vascular reconstruction, hospital stay, tumor recurrence, and all-cause mortality were not different between the PE and NPE group.

CONCLUSIONS: Preoperative embolization was efficient and safe with a reduction of intraoperative blood loss and operative time during CBT resection.

PMID:35319144 | DOI:10.1002/hed.27038

J Magn Reson Imaging. 2022 Mar 23. doi: 10.1002/jmri.28172. Online ahead of print.

ABSTRACT

BACKGROUND: Advanced diffusion-based MRI biomarkers may provide insight into microstructural and perfusion changes associated with neurodegeneration and cognitive decline.

PURPOSE: To assess longitudinal microstructural and perfusion changes using apparent diffusion coefficient (ADC) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in cognitively impaired (CI) and healthy control (HC) groups.

STUDY TYPE: Prospective/longitudinal.

POPULATION: Twelve CI patients (75% female) and 13 HC subjects (69% female).

FIELD STRENGTH/SEQUENCE: 3 T; Spin-Echo-IVIM-DWI.

ASSESSMENT: Two MRI scans were performed with a 12-month interval. ADC and IVIM-DWI metrics (diffusion coefficient [D] and perfusion fraction [f]) were generated from monoexponential and biexponential fits, respectively. Additionally, voxel-based correlations were evaluated between change in Montreal Cognitive Assessment (ΔMoCA) and baseline imaging parameters.

STATISTICAL TESTS: Analysis of covariance with sex and age as covariates was performed for main effects of group and time (false discovery rate [FDR] corrected) with post hoc comparisons using Bonferroni correction. Partial-η² and Hedges’ g were used for effect-size analysis. Spearman’s correlations (FDR corrected) were used for the relationship between ΔMoCA score and imaging. P < 0.05 was considered statistically significant.

RESULTS: Significant differences were found for the main effects of group (HC vs. CI) and time. For group effects, higher ADC, IVIM-D, and IVIM-f were observed in the CI group compared to HC (ADC: 1.23 ± 0.08^. 10^-3 vs. 1.09 ± 0.07^. 10^-3 mm² /sec; IVIM-D: 0.82 ± 0.01^. 10^-3 vs. 0.73 ± 0.01^. 10^-3 mm² /sec; and IVIM-f: 0.317 ± 0.008 vs. 0.253 ± 0.009). Significantly higher ADC, IVIM-D, and IVIM-f values were observed in the CI group after 12 months (ADC: 1.45 ± 0.05^. 10^-3 vs. 1.50 ± 0.07^. 10^-3 mm² /sec; IVIM-D: 0.87 ± 0.01^. 10^-3 vs. 0.94 ± 0.02^. 10^-3 mm² /sec; and IVIM-f: 0.303 ± 0.007 vs. 0.332 ± 0.008), but not in the HC group at large effect size. ADC, IVIM-D, and IVIM-f negatively correlated with ΔMoCA score (ρ = -0.49, -0.51, and -0.50, respectively).

DATA CONCLUSION: These findings demonstrate that longitudinal differences between CI and HC cohorts can be measured using IVIM-based metrics.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.

PMID:35319142 | DOI:10.1002/jmri.28172

J Surg Oncol. 2022 Mar 23. doi: 10.1002/jso.26863. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Fluorescence from adrenal tumors can be detected with near-infrared imaging after injection with indocyanine green. However, it is unknown if adrenal tumors exhibit autofluorescence. The aim of this study was to determine whether adrenal tumors emit near-infrared autofluorescence (NIRAF).

METHODS: This was a prospective study of patients who underwent minimally invasive adrenalectomy at a tertiary center. Intraoperative images were analyzed to detect NIRAF with a 750 nm camera. Descriptive and comparative statistical analyses were performed.

RESULTS: Twenty-five adrenalectomies were examined. Only 11 tumors (44%), that originated from the cortex exhibited autofluorescence. A contrast distinction between the tumor and retroperitoneum was observed in 23 patients, whereas a contrast distinction between the tumor and normal adrenocortical tissue was seen in 12 patients. The overall fluorescence intensity of adrenal tumors was found to be variable and ranging between 0.3 and 5.6 times that of the background tissue. Pheochromocytoma, malignancy and adrenal cyst did not demonstrate NIRAF.

CONCLUSION: This is the first study to show that adrenocortical tissue can demonstrate NIRAF. The pattern of fluorescence was similar to that observed after indocyanine green injection in our historical experience. NIRAF has a potential to be used as an intraoperative optical adjunct during adrenalectomy.

PMID:35319103 | DOI:10.1002/jso.26863

Laryngoscope. 2022 Mar 23. doi: 10.1002/lary.30102. Online ahead of print.

ABSTRACT

OBJECTIVES: Assess current frenotomy practice patterns of pediatric otolaryngologists via a cross-sectional survey.

STUDY DESIGN: Survey study.

METHODS: A 31-question electronic survey assessing frenotomy practice patterns was distributed to all American Society of Pediatric Otolaryngology (ASPO) members. Descriptive statistics were used to summarize responses and demographics of respondents.

RESULTS: Of all ASPO members, 41% (240/588) completed the survey. Most respondents, 185 (77%), reported increased frenotomy referrals over the last 5 years and 144 (60%) described the current number of referrals as “too many.” The two primary lingual frenotomy indications identified in infants were: breastfeeding/nipple pain (92%) and inability to latch (83%). For older children, speech difficulty (87%) was the primary indication. Maxillary frenotomy indications in infants varied amongst respondents. For analgesia during in-office frenotomy procedures, respondents used glucose/sucrose drops (48%), topical lidocaine (29%), or no pain control measure (27%). For post-procedure care, respondents recommended continuing lactation support (45%), massaging/stretching the wound (38%), or none (40%). Most respondents, 143 (60%), reported having seen a complication from frenotomy, and the most reported frenotomy complications were frenulum re-attachment and excessive bleeding.

CONCLUSIONS: In the last 5 years, otolaryngologists have seen an increase in referrals for frenotomy. Pediatric otolaryngologists have varying practice patterns with regards to ankyloglossia diagnosis and treatment. The reported indications for frenotomy varied amongst pediatric otolaryngologists especially with respect to maxillary frenotomy. Practice patterns also varied with respect to procedural pain control and frenotomy aftercare recommendations. More frenotomy research is needed to establish a standard of care for patients with ankyloglossia.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2022.

PMID:35319112 | DOI:10.1002/lary.30102

Aust Occup Ther J. 2022 Mar 23. doi: 10.1111/1440-1630.12799. Online ahead of print.

ABSTRACT

INTRODUCTION: Occupational therapists are key members of the multidisciplinary team and regularly work with people of higher weight across age groups and practice settings. There is limited existing research regarding the occupational therapy role with this client group. The aim of this study was to explore occupational therapy practice and barriers to service provision for Australian occupational therapists working with clients of higher weight.

METHODS: A cross-sectional study design using a self-administered online survey was distributed to members of the national occupational therapy professional association. The survey was designed to identify common assessments and interventions used with clients of higher weight and explore occupational therapists’ perspectives on their knowledge and confidence and the barriers to service delivery. Descriptive statistics were used to summarise rating scales, and open-ended responses were analysed using thematic analysis.

RESULTS: Eighty Australian occupational therapists working in a range of settings and with varied experience levels participated in the study. Participants described the most common areas of occupational therapy assessment and intervention when working with clients of higher weight to be self-care, equipment prescription, home modifications and pressure care. Respondents were least confident in interventions related to psychosocial, leisure and employment interventions. Barriers to service delivery included accessibility and cost of equipment, lack of training and weight stigma.

CONCLUSION: Occupational therapy practice promotes and enables participation in everyday occupations with people of higher weight. This study highlights not only the occupational therapy skills and unique approach to the person, their environment and occupations but also the challenges faced by occupational therapists when working with people of higher weight. Occupational therapists could consider utilising the weight-inclusive paradigm to broaden their contribution from self-care to other important aspects of participation and well-being.

PMID:35319102 | DOI:10.1111/1440-1630.12799

Stat Med. 2022 Mar 23. doi: 10.1002/sim.9374. Online ahead of print.

ABSTRACT

In randomized clinical trials, incorporating baseline covariates can improve the power in hypothesis testing for treatment effects. For survival endpoints, the Cox proportional hazards model with baseline covariates as explanatory variables can improve the standard logrank test in power. Although this has long been recognized, this adjustment is not commonly used as the primary analysis and instead the logrank test followed by the estimation of the hazard ratio between treatment groups is often used. By projecting the score function for the Cox proportional hazards model onto a space of covariates, the logrank test can be more powerful. We derive a power formula for this augmented logrank test under the same setting as the widely used power formula for the logrank test and propose a simple strategy for sizing randomized clinical trials utilizing historical data of the control treatment. Through numerical studies, the proposed procedure was found to have the potential to reduce the sample size substantially as compared to the standard logrank test. A concern to utilize historical data is that those might not reflect well the data structure of the study to design and then the sample size calculated might not be accurate. Since our power formula is applicable to datasets pooled across the treatment arms, the validity of the power calculation at the design stage can be checked in blind reviews.

PMID:35319100 | DOI:10.1002/sim.9374

Food Funct. 2022 Mar 23. doi: 10.1039/d2fo00051b. Online ahead of print.

ABSTRACT

Insights into food matrix factors impacting bioavailability of bioactive carotenoids and chlorophylls from fruits and vegetable ingredients are essential to understanding their ability to promote health. The stability and bioaccessibility of carotenoids and chlorophylls were assessed from dehydrated, spray-dried, freeze-dried and fresh spinach ingredient forms using in vitro models simulating upper gastrointestinal (GI) digestion and lower GI anaerobic fecal fermentation. Intestinal transport of bioaccessible bioactives from both upper and lower GI compartments was assessed using the Caco-2 human intestinal cell model. Differences in carotenoid and chlorophyll contents were observed between ingredient forms and these influenced bioaccessibility. Lower carotenoid and chlorophyll contents in spray dried spinach resulted in the lowest total bioaccessible content among all spinach treatments (5.8 ± 0.2 μmoles per g DW carotenoid and chlorophyll). The total bioaccessible content was statistically similar between freeze-dried (12.5 ± 0.6 μmoles per g DW), dehydrated (12.5 ± 3.2 μmoles per g DW), and fresh spinach (14.2 ± 1.2 μmoles per g DW). Post anaerobic fermentation, cellular accumulation of carotenoids was higher (17.57-19.52 vs. 5.11-8.56%), while that of chlorophylls was lower (3.05-5.27 vs. 5.25-6.44%), compared to those observed following upper GI digestion. Collectively, these data suggest that spinach forms created by various drying technologies deliver similar levels of bioaccessible spinach bioactives and that the lower GI tract may serve as a site for significant absorption fostered by interactions with gut microbial communities that liberate additional bioactives from the spinach matrix.

PMID:35319058 | DOI:10.1039/d2fo00051b

Eur Radiol. 2022 Mar 22. doi: 10.1007/s00330-022-08694-7. Online ahead of print.

ABSTRACT

OBJECTIVES: Describe the cumulative incidence (CUIN) of peritoneal carcinomatosis (PC) and survival in patients presenting with advanced rectal cancer at staging pelvic MRI.

METHODS: From 2013 to 2018, clinicopathologic records of patients with pretreatment rectal MRI clinical (c)T3c, cT3d, cT4a, and cT4b primary rectal adenocarcinoma were retrospectively reviewed by two radiologists. Standard MRI descriptors and pathologic stages were recorded. Recurrence-free (RFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Development of PC was explored using competing risk analysis. Differences in survival were compared using the log-rank test. Gray’s test was used to test for differences in CUIN of PC.

RESULTS: Three hundred forty-three patients (147 women; median age, 56 years) had MRI stages cT3cd, n = 170; cT4a, n = 40; and cT4b, n = 133. Median follow-up among survivors was 27 months (0.36-70 months). For M1 patients, OS differed only by cT stage (2-year OS: cT3 88.1%, cT4a 79.1%, cT4b 64.7%, p = 0.045). For M0 patients, OS and RFS differed only by pathological (p)T stage. We observed a statistically significant difference in the cumulative incidence of PC by cT stage (2-year CUIN: cT3 3.2%, cT4a 8.5%, cT4b 1.6%, p = 0.01), but not by pT stage. Seventy-nine patients (23%) presented with metastatic disease (M1), eight with PC (2.3%). Overall, eight patients presented with PC (cT4a: n = 4, other stages: n = 4) and 22 developed PC (cT4a: n = 5, other stages: n = 17).

CONCLUSIONS: PC is uncommon in rectal cancer. MRI-based T stage exhibited an overall association with the cumulative incidence of PC, and descriptively, cT4a stage appears to have the highest CUIN.

KEY POINTS: • In a retrospective study of 343 patients with rectal cancer undergoing baseline MRI and clinical follow-up, we found that peritoneal carcinomatosis was rare. • We observed a significant overall association between PC at presentation and cT stage that appeared to be driven by the higher proportion of cT4a patients presenting with PC. • Among patients that did not present with PC, we observed a significant overall association between time to PC and cT stage that may be driven by the higher cumulative incidence of PC in cT4a patients.

PMID:35319077 | DOI:10.1007/s00330-022-08694-7

J Strength Cond Res. 2022 Apr 1;36(4):941-947. doi: 10.1519/JSC.0000000000004230.

ABSTRACT

Huang, Z-H, Ma, CZ-H, Wang, L-K, Wang, X-Y, Fu, S-N, and Zheng, Y-P. Real-time visual biofeedback via wearable ultrasound imaging can enhance the muscle contraction training outcome of young adults. J Strength Cond Res 36(4): 941-947, 2022-Real-time ultrasound imaging (RUSI) can serve as visual biofeedback to train deep muscle contraction in clinical rehabilitative settings. However, its effectiveness in resistance training in sports/fitness fields remains unexplored. This article introduced a newly developed wearable RUSI system that provided visual biofeedback of muscle thickening and movement and reported its effectiveness in improving the training outcomes of muscle thickness change (%) during dynamic contraction. Twenty-five healthy young men participated and performed pec fly exercise both with and without RUSI biofeedback. Statistical analysis was conducted to examine the reliability of the measurements and the immediate effects of (a) RUSI biofeedback of muscle contraction and (b) training intensity (50 vs. 80% of 1-repetition maximum [1RM]) on the pectoralis major (PMaj) thickness change measured by ultrasound images. In addition to significantly high inter-contraction reliability (ICC3,1 > 0.97), we observed significantly increased PMaj thickness change for both training intensities upon receiving biofeedback in subjects, compared with without biofeedback (p < 0.001). We also observed significantly larger PMaj thickness change at 80% of 1RM compared with 50% of 1RM (p = 0.023). The provision of visual biofeedback using RUSI significantly enlarged the magnitude of PMaj thickness change during pec fly exercises, potentially indicating that RUSI biofeedback could improve the ability of targeted muscle contraction of PMaj in healthy young adults. To our knowledge, this study has pioneered in applying RUSI as a form of biofeedback during weight training and observed positive effectiveness. Future iterations of the technique will benefit more subject groups, such as athletes and patients with neuromuscular disorders.

PMID:35319000 | DOI:10.1519/JSC.0000000000004230