Tag: pubmed

Int J Cardiovasc Imaging. 2022 Feb 22. doi: 10.1007/s10554-021-02516-5. Online ahead of print.

ABSTRACT

Cardiac magnetic resonance (CMR) is the gold standard for evaluating myocardial fibrosis. Few studies have explored the association between ventricular arrhythmias (VAs) and fibrosis in apparently normal hearts. We aimed to investigate the association between the occurrence and morphology of VAs and left ventricular late gadolinium enhancement (LV-LGE) in patients without known structural heart diseases. This study enrolled 78 patients with apparently normal hearts who underwent 24-h ambulatory Holter electrocardiogram (ECG) and CMR examinations simultaneously. The presence and extent of LGE was determined using CMR imaging and compared based on occurrence and morphology of VAs. The clinical characteristics were also recorded and calculated. LV-LGE was observed in 19 (37.3%) and 4 (14.8%) patients with and without VAs, respectively (P = 0.039). It was more frequently observed in patients with polymorphic VAs (P = 0.024). The polymorphic VAs had a higher tendency of LGE extent than monomorphic VAs, while the difference did not reach statistical significance (P = 0.055). In multivariable analyses, the presence of polymorphic VAs [hazard ratio (HR) 11.19, 95% CI 1.64-76.53, P = 0.014] and hypertension (HR 4.64, 95% CI 1.08-19.99, P = 0.039) were associated with greater prevalence of LV-LGE. In patients without structural heart diseases, besides hypertension, multiple VA morphologies on Holter ambulatory ECG measurements is another important marker of increased incidence of myocardial fibrosis.

PMID:35192083 | DOI:10.1007/s10554-021-02516-5

Support Care Cancer. 2022 Feb 22. doi: 10.1007/s00520-022-06882-1. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to explore the association between mindfulness and social engagement among Chinese breast cancer survivors (BCSs) and the mediator role of stigma in the relation of mindfulness and social engagement.

METHODS: This cross-sectional study was conducted among 937 BCSs from March to April 2021 in Shanghai, China. Data were collected using the Mindful Attention Awareness Scale, the Stigma Scale for Chronic Illness 8-item version, and the index of social engagement. Descriptive statistics, independent-sample t-test, one-way ANOVA, and regression analyses were used to explore the role of stigma in the association of mindfulness and social engagement among Chinese BCSs.

RESULTS: Social engagement levels differed significantly by participant’s BMI, education level, employment status, personal monthly income, monthly per capita household income. Mindfulness was positively correlated with social engagement, and stigma was negatively correlated with mindfulness and social engagement among Chinese BCSs. Stigma plays a complete mediating role in the relationship between mindfulness and social engagement in BCSs.

CONCLUSION: In the practice of individual mindfulness intervention on social engagement of BCSs, health care providers should identify and eliminate the constraints, which restrain the reduction of stigma level while individual mindfulness is being enhanced.

PMID:35192056 | DOI:10.1007/s00520-022-06882-1

Arch Gynecol Obstet. 2022 Feb 21. doi: 10.1007/s00404-022-06430-6. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: There is a complex relationship between obesity and pelvic organ prolapse. The objective of our study was to evaluate whether body mass index (BMI) changes the relationship between signs and symptoms of prolapse.

METHODS: This was a retrospective observational study based on datasets of women seen in a tertiary urogynecological center with symptoms of pelvic floor and lower urinary tract dysfunction between April 2012 and October 2015. Patients underwent a structured interview, clinical examination (based on the POP-Q) and 4D transperineal ultrasound (TPUS). Offline assessment of sonographic organ descent was undertaken later, blinded to all patient data.

RESULTS: Weight and BMI affect the relationship between symptoms and signs of prolapse. This effect is statistically highly significant. The more obese a patient is, the less likely she is to notice a given degree of objective prolapse, regardless of whether it is diagnosed clinically or on imaging.

CONCLUSIONS: In this retrospective study, we found a highly significant effect of weight and BMI on prolapse perception in the sense that obesity seems to mask prolapse while a low BMI increases the likelihood of a given degree of prolapse being noticed by the patient.

PMID:35192039 | DOI:10.1007/s00404-022-06430-6

Abdom Radiol (NY). 2022 Feb 22. doi: 10.1007/s00261-022-03450-3. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the diagnostic performance and inter-observer variability of differentiating T1 and T2 gallbladder (GB) cancers using multi-detector row CT (MDCT).

METHODS: This retrospective study included 151 patients with surgically confirmed T1 (n = 49)- or T2 (n = 102)-stage GB cancer who underwent contrast-enhanced MDCT from 2016 to 2020. Five radiologists (two experienced and three less experienced) evaluated the T-stage with a confidence level calculated using a six-point scale. GB cancers were morphologically classified into three types: polypoid, polypoid with wall thickening, and wall thickening. The diagnostic performance of T-staging was assessed using receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated based on a binary scale (T1 = positive). Inter-observer agreement was assessed using Fleiss κ statistics.

RESULTS: The area under the receiver operating characteristic (ROC) curve of each reviewer for T-staging ranged from 0.69 to 0.80 (median 0.77). The overall accuracy of the five radiologists was 78% (95% confidence interval [CI] 71-84%). Sensitivity was higher and specificity was lower in experienced radiologists than in less experienced radiologists (P < 0.001). The overall inter-observer agreement was fair (κ = 0.36; 95% CI 0.31, 0.41). The overall accuracy for T-stage was 63% (95% CI 48-76), 78% (95% CI 63-88), and 87% (95% CI 77-93) for polypoid, polypoid with wall thickening, and wall thickening type, respectively.

CONCLUSION: The accuracy of MDCT for differentiating T1 and T2 GB cancer is limited, and there is considerable inter-observer variability.

PMID:35192044 | DOI:10.1007/s00261-022-03450-3

Environ Manage. 2022 Feb 22. doi: 10.1007/s00267-022-01610-1. Online ahead of print.

ABSTRACT

The Covid-19 pandemic has caused the alteration of many aspects of the solid waste management chain, such as variations in the waste composition, generation and disposal. Various studies have examined these changes with analysis of integrated waste management strategies; qualitative studies on perceived variations and statistical evaluations based on waste collected or disposed in landfills. Despite this information there is a need for updated data on waste generation and composition, especially in developing countries. The objective of this article is to develop a data sampling and analytical approach for the collection of data on household waste generation and composition during the pandemic; and, in addition, estimate the daily generation of masks in the study area. The proposed methodology is based on the principles of citizen science and utilizes virtual tools to contact participants, and for the training and collection of information. The study participants collected the information, installed segregation bins in their homes and trained their relatives in waste segregation. The article presents the results of the application of the methodology in an urban district of Lima (Peru) in August 2020. The results suggest an apparent decrease in household waste per capita and a slight increase in plastics composition in the study area. It is estimated that each participant generates 0.124 masks per day and 0.085 pairs of gloves per day. The method developed and results presented can be used as a tool for public awareness and training on household waste characterization and segregation. Furthermore it can provide the necessary evidence to inform policy directives in response household waste issues and Covid-19 restrictions.

PMID:35192024 | DOI:10.1007/s00267-022-01610-1

Pediatr Cardiol. 2022 Feb 22. doi: 10.1007/s00246-022-02835-x. Online ahead of print.

ABSTRACT

Pediatric single ventricle patients have seen dramatic improvements in overall outcomes over the past several decades. This is attributed to the development of home monitoring programs for interstage patients. In today’s current COVID-19 pandemic, the use of telemedicine has allowed providers to care for these patients and support their families effectively while minimizing the risk of COVID-19 exposure. Our single-center study reviewed the charts of nine patients followed by our single ventricle team through the COVID-19 pandemic. Patients discharged from the hospital and enrolled in our digital home monitoring program were included. Records were retrospectively reviewed for total number of outpatient visits, adverse events, unplanned hospital readmissions, and unplanned procedures. These results were then compared to outcomes from 2018 to 2019. In-person visits averaged every 6 weeks compared to every 2-3-week pre-pandemic. Zero adverse events reported with the use of telemedicine compared to one adverse event pre-pandemic. There was a 50% decrease in unplanned readmissions and 60% decrease in unplanned procedures during our study period. One patient was diagnosed with acute COVID-19 infection and managed conservatively via telemedicine with full recovery. To our knowledge, this is the only case-control study reporting the use of telemedicine during the COVID-19 pandemic in the interstage population. Although not statistically significant, we report a decrease in total adverse events, unplanned procedures, and unplanned admissions. Telemedicine visits allowed for identification of issues requiring hospital readmission as well as conservative management of one patient with COVID-19.

PMID:35192020 | DOI:10.1007/s00246-022-02835-x

Eur Radiol. 2022 Feb 22. doi: 10.1007/s00330-022-08606-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the effects of O⁶-methylguanine DNA methyltransferase (MGMT) promoter methylation status of gliomas on O-(2-¹⁸F-fluoroethyl)-L-tyrosine ([¹⁸F]FET) uptake and cerebral blood flow (CBF) of arterial spin labeling (ASL), evaluated by hybrid PET/MR. Stereotactic biopsy was used to validate the findings.

METHODS: A set of whole tumor and reference volumes of interest (VOIs) based on PET/FLAIR imaging were delineated and transferred to the corresponding [¹⁸F]FET PET and CBF maps in 57 patients with newly diagnosed gliomas. The mean and max tumor-to-brain ratio (TBR) and normalized CBF (nCBF) were calculated. The predictive efficacy of [¹⁸F]FET PET and CBF in determining MGMT promoter methylation status of glioma were evaluated by whole tumor analysis and stereotactic biopsy. The correlation between PET/MR parameters and MGMT promoter methylation were analyzed using histological specimens acquired from multiple stereotactic biopsies.

RESULTS: Based on the analysis of whole tumor volume and biopsy site, TBRmean, TBRmax, nCBFmean, and nCBFmax showed no statistically significant differences between gliomas with and without MGMT promoter methylation (all p > 0.05). Furthermore, stereotactic biopsy demonstrated that TBRmean, TBRmax, nCBFmean, and nCBFmax showed no correlation with MGMT promoter methylation (r = -0.117, p = 0.579; r = -0.161, p = 0.443; r = -0.271, p = 0.191; r = -0.300, p = 0.145; respectively).

CONCLUSIONS: MGMT promoter methylation status shows no effect on [¹⁸F]FET uptake and CBF of ASL in gliomas. Stereotactic biopsy validates it and further reveals there is no correlation of [¹⁸F]FET PET uptake and CBF with the percentages of MGMT promoter methylation.

KEY POINTS: • Based on whole tumor VOI assessment, MGMT promoter methylation status shows no effect on [¹⁸F]FET uptake and CBF of ASL in gliomas. • For WHO grade IV glioblastomas, [¹⁸F]FET PET and ASL parameters based on hybrid PET/MR fail to predict the MGMT promoter methylation status. • Stereotactic image-based histology reveals that there is no correlation of [¹⁸F]FET PET uptake and CBF with the status and percentages of MGMT promoter methylation in gliomas.

PMID:35192012 | DOI:10.1007/s00330-022-08606-9

World J Surg. 2022 Feb 22. doi: 10.1007/s00268-022-06484-2. Online ahead of print.

ABSTRACT

BACKGROUND: Three percent hypertonic saline (3% HTS) acts like an osmotic buffer and draws fluid from the extracellular space into the intravascular compartment. Primary objective was to evaluate whether use of 3% HTS resulted in a difference in intraoperative maintenance fluid requirement versus 0.9% saline (NS). Secondary objectives were to evaluate differences in 24 h fluid requirements and safety of 3% HTS.

METHODS: Adult patients of either sex, 18-65 years, undergoing elective major open abdominal surgeries were randomized to receive infusions of 3% HTS or NS at 1 ml/kg/hr through large bore peripheral i.v cannulas, or central venous catheters after anesthesia induction. Intraoperative maintenance fluids were administered to maintain mean arterial pressure (≥70 mmHg), urine output (≥0.5 ml/kg/hr) and central venous pressure of 8-10 cm H₂O.

RESULTS: Ninety-three patients completed the study (46 in 3% HTS and 47 in NS group). No difference was seen in the volume of intraoperative maintenance fluids (3% HTS vs NS; 2243.9 ± 896.7 ml vs 2093.6 ± 868.7 ml; P = 0.34). Similarly, the 24 h postoperative fluid requirement was not different (3% HTS vs NS; 2006.6 ± 398.6 ml vs 2018.3 ± 389.3 ml; P = 0.94). Patients in 3% HTS group had statistically but not clinically significant higher serum sodium values at postoperative 12th and 24 h. No complication like thrombophlebitis or tissue ischemia was reported due to administration of 3% HTS through peripheral lines.

CONCLUSION: Administration of 3% HTS did not reduce intraoperative maintenance fluid requirements in patients undergoing major open abdominal surgeries.

TRIAL REGISTRATION: CTRI/2019/09/021032.

PMID:35192016 | DOI:10.1007/s00268-022-06484-2

Theor Appl Genet. 2022 Feb 22. doi: 10.1007/s00122-022-04041-y. Online ahead of print.

ABSTRACT

We propose using probability concepts from Bayesian models to leverage a more informed decision-making process toward cultivar recommendation in multi-environment trials. Statistical models that capture the phenotypic plasticity of a genotype across environments are crucial in plant breeding programs to potentially identify parents, generate offspring, and obtain highly productive genotypes for target environments. In this study, our aim is to leverage concepts of Bayesian models and probability methods of stability analysis to untangle genotype-by-environment interaction (GEI). The proposed method employs the posterior distribution obtained with the No-U-Turn sampler algorithm to get Hamiltonian Monte Carlo estimates of adaptation and stability probabilities. We applied the proposed models in two empirical tropical datasets. Our findings provide a basis to enhance our ability to consider the uncertainty of cultivar recommendation for global or specific adaptation. We further demonstrate that probability methods of stability analysis in a Bayesian framework are a powerful tool for unraveling GEI given a defined intensity of selection that results in a more informed decision-making process toward cultivar recommendation in multi-environment trials.

PMID:35192008 | DOI:10.1007/s00122-022-04041-y

Eur J Clin Pharmacol. 2022 Feb 22. doi: 10.1007/s00228-022-03298-y. Online ahead of print.

ABSTRACT

PURPOSE: Given the biological differences between females and males, sex-specific evaluations should be carried out to obtain better cancer prevention, diagnosis, and treatment strategies. To this purpose, our aim was to evaluate sex differences for toxicity in a cohort of colorectal cancer (CRC) patients undergoing chemotherapy.

METHODS: We performed a retrospective study in 329 CRC patients. Differences between males and females were tested performing the Mann-Whitney U test or the Fisher exact test. Multivariate logistic regression models were computed to evaluate the association between sex and risk of chemotherapy agent-related toxicity.

RESULTS: According association sex toxicity, significant differences were observed in the median number of episodes of nausea (p = 0.044), vomit (p = 0.007), heartburn (p = 0.022), thrombocytopenia (p = 0.005), mucositis (p = 0.024). Moreover, statistically significant differences between males and females were observed in the distribution of the highest toxicity grades of nausea (p = 0.024), heartburn (p = 0.016), and thrombocytopenia (p = 0.034). Females have an increased risk of vomit (p = 0.002), alopecia (p = 0.035), heartburn (p = 0.005), mucositis (p = 0.003), and lower risk for thrombocytopenia (p = 0.005).

CONCLUSION: According to the association of sex chemotherapy agent-related toxicities, females resulted on average at a significant increased risk of more common adverse events (constipation, dysgeusia, alopecia, heartburn, vomit, asthenia, nausea, pain events, and mucositis). Sex-tailored CRC chemotherapy treatment is necessary to obtain efficacy avoiding toxicity, based on patients’ biological and genetic characteristics, a vision that would change CRC setting, a stable disease but still orphan of a real tailored approach.

PMID:35192004 | DOI:10.1007/s00228-022-03298-y