Tag: pubmed

Acta Cytol. 2021 Jun 30:1-6. doi: 10.1159/000517005. Online ahead of print.

ABSTRACT

INTRODUCTION: Core-needle biopsy (CNB) is a minimally invasive procedure used in preoperative diagnosis of breast lumps. It has been seen that in few years, the CNB seems to be replacing the fine-needle aspiration cytology (FNAC), although no study had yet conclusively proved a superiority of one over the other.

AIMS AND OBJECTIVES: The aim of this study was to study the cytohistological spectrum of palpable breast lesions and to evaluate the diagnostic accuracy of FNAC versus CNB for breast lesions.

MATERIALS AND METHODS: The study was a cross-sectional study conducted in the Department of Pathology and Surgery, over a period of 1 year in 152 patients. All the patients were subjected to FNAC and CNB. Cytosmears were stained with May-Grunwald Giemsa and hematoxylin and eosin was done on CNB and excision biopsy (EB) specimens. Sensitivity and specificity were calculated in percentage with 95% confidence interval with reference to CNB/surgical specimens. Kappa statistics were used to compare the level of agreement between FNAC versus CNB and CNB versus surgical specimens.

RESULTS: A total of 152 patients were taken for FNAC and CNB. EB was performed in only 104 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNAC verses CNB in correlation with subsequent histopathology were found to be (93.40 vs. 94.06%), (97.50 vs. 100.00%), (99.00 vs. 100.00%), (84.78 vs. 33.33%), and (94.52 vs. 94.23%), respectively.

CONCLUSION: CNB has overcome the pitfall of FNAC but CNB cannot replace FNAC but both procedures are complementary to each other.

PMID:34192704 | DOI:10.1159/000517005

Cardiology. 2021 Jun 30:1-8. doi: 10.1159/000512430. Online ahead of print.

ABSTRACT

INTRODUCTION: The value of color Doppler ultrasonography (CDUS) with the supraclavicular approach for preoperative evaluation of the native left internal mammary artery (LIMA) as well as for the postoperative detection of LIMA graft patency was recently suggested. However, the parameters such as the flow volume and pulsatile index (PI) have not been studied in detail.

OBJECTIVES: The objectives of this study were to analyze the LIMA data in the perioperative period and explore the relationships between the intraoperative graft flow with transit-time flow measurement (TTFM) and the postoperatively measured parameters with CDUS.

METHODS: Fifty-eight patients with significant stenosis (≥70%) or occlusions in left anterior descending artery (LAD) who were referred for isolated coronary artery bypass grafting (CABG) were enrolled in this study and examined by CDUS prior to CABG from April to July 2016. The perioperative measurements of proximal LIMA by CDUS were compared. In addition, the correlation between the intraoperative graft flow, such as the mean graft flow (MGF) and PI, and the immediate postoperative measurements of CDUS in LIMA bypassed grafts was statistically analyzed.

RESULTS: Six patients were excluded due to screening failure, or insufficient visualization of CDUS images for analysis. Fifty-two patients with in situ LIMA-LAD graft, with or without additional arterial grafts or saphenous vein grafts, were included in the final analysis. The postoperative diameters of proximal LIMA were not significantly different from preoperative diameters (2.21 ± 0.18 vs. 2.27 ± 0.22 mm, p = 0.070). The flow volume on the early postoperative CDUS significantly increased (39.77 ± 21.59 vs. 25.96 ± 13.17 mL/min, p < 0.001) and the PI significantly decreased (1.43 ± 0.46 vs. 4.20 ± 1.49, p < 0.001) versus those of preoperative measurements. The MGF had a moderate correlation with the flow volume on the early postoperative CDUS (r = 0.414, p = 0.002), and the PI by TTFM had a weak correlation with that by CDUS (r = 0.353, p = 0.010) as well.

CONCLUSIONS: The MGF and PI by TTFM in CABG were associated with in situ LIMA graft parameters measured by CDUS studies. CDUS is a useful functional noninvasive tool for the preoperative screening and postoperative follow-up of patients with in situ LIMA bypass.

PMID:34192706 | DOI:10.1159/000512430

Urol Int. 2021 Jun 30:1-5. doi: 10.1159/000516682. Online ahead of print.

ABSTRACT

BACKGROUND: Many surgical techniques, as well as dressing models, were identified in the treatment of hypospadias. There are many publications in the literature that are the result of the effort to find the ideal dressing after hypospadias surgery. The dressing has some benefits; however, it has some adverse effects. The present study aimed to discuss outcomes of the patients who have been operated through the tubularized incised plate urethroplasty (TIPU) method and followed with and without dressing postoperatively.

METHODS: Patients operated on through the TIPU method between March 2015 and August 2019 were reviewed retrospectively. The patients were divided into two groups, dressing and undressing. Preoperative hypospadias severity was evaluated according to the Glans-Urethral Meatus-Shaft (GMS) scoring method. The care results of the patients were recorded. Postoperative outcomes were compared according to the Hypospadias Objective Scoring Evaluation (HOSE) scale, and statistical analyses were conducted. The results of both groups were compared statistically.

RESULTS: One hundred and nineteen patients were divided into two groups: dressing (n = 56) and nondressing (n = 63). The patients’ average age was 3.54 ± 2.97 years in group 1 and 3.50 ± 3.01 years in group 2 (p = 0.940). There was not any statistically significant difference between the two groups for demographic data. Minimal bleeding had stopped in three patients in the nondressing group spontaneously before discharging. No severe edema or hematoma, which might have concerned the parents, appeared. Two (3.5%) and 3 (4.7%) patients underwent a maximum of three urethral dilation sessions in dressing and nondressing groups, respectively (p = 0.556). We found no significant difference between groups in the comparison of preoperative GMS and postoperative HOSE scoring.

DISCUSSION: The most important limitation of the study is that it is retrospective. Pre- and postoperative scoring systems are objective. The data obtained in the literature show that surgeons prefer to apply dressings commonly after the TIPU technique. Advantages and disadvantages of dressing are mentioned in the literature. Even if the paradigm is dressing in hypospadias surgery, according to the results of our study, dressing may not affect the functional and cosmetic results of TIPU repair.

CONCLUSION: Postoperative functional and cosmetic results of TIPU in hypospadias appear to be independent of dressing. However, the results must be supported by further research.

PMID:34192707 | DOI:10.1159/000516682

Complement Med Res. 2021 Jun 30:1-7. doi: 10.1159/000510901. Online ahead of print.

ABSTRACT

BACKGROUND: Incomplete abortion is a common complication of pregnancy. Sesamum indicum L. is a widely used emmenagogue herb.

OBJECTIVES: We designed a clinical trial to evaluate the efficacy of sesame for the removal of retained products of conception (RPOC).

METHODS: In this randomized, open-label, and controlled trial, 45 patients received sesame powder as an intervention group and 45 patients received expectant management as a control group for 5 days. The primary outcome measure was complete resolution of RPOC assessed by sonography. Secondary outcome measures were severity of patients’ vaginal bleeding and pain.

RESULTS: 84.1% had complete resolution of RPOC in the sesame group, while 26.2% had complete resolution of RPOC in the control group, which was statistically significant (p < 0.001). Moreover, patients in the sesame group showed a significantly more decreasing trend in pain and vaginal bleeding compared to the control group (p < 0.001).

CONCLUSION: Sesame had a significant effect on the removal of RPOC and the reduction of pain and vaginal bleeding.

PMID:34192691 | DOI:10.1159/000510901

Gynecol Obstet Invest. 2021 Jun 30:1-8. doi: 10.1159/000515531. Online ahead of print.

ABSTRACT

PURPOSE: The study was aimed to systematically assess the effect and safety of remifentanil patient-controlled analgesia (rPCA) versus epidural analgesia (EA) during labor.

METHODS: Eligible trials were retrieved from PubMed, EMBASE, ScienceDirect, and Cochrane Library before April 2020. The primary outcomes were patient satisfaction with pain relief and average visual analog scale (VAS) pain scores during labor; the secondary outcomes were rate of spontaneous delivery, oxygen desaturation, maternal hyperthermia, and neonatal Apgar scores <7 at 1 and 5 min.

RESULTS: Eleven studies involving 3,039 parturients were included. We found that parturients receiving rPCA were similarly satisfied with pain relief compared to those receiving EA (standardized mean difference: -0.19; 95% confidence interval [CI]: -0.57, 0.18), though had significantly higher VAS pain scores during labor (weighted mean difference: 1.41; 95% CI: 0.32, 2.50). The rate of spontaneous delivery was comparable. rPCA increased the risk of maternal oxygen desaturation (risk ratio [RR]:3.23, 95% CI: 1.98, 5.30). There was no statistical significance regarding hyperthermia (RR: 0.49, 95% CI: 0.24, 1.01). No significant difference was found for neonatal Apgar scores <7 at 1 and 5 min.

CONCLUSION: rPCA could be an optional alternative for pain relief to EA without worsening maternal satisfaction with pain relief, delivery modes, or neonatal morbidity. However, rPCA was associated with higher pain intensity during labor and higher incidence of maternal oxygen desaturation. The routine use of rPCA in labor must be armed with close respiratory monitoring. Continued well-designed studies are required to provide more robust evidence.

PMID:34192701 | DOI:10.1159/000515531

J Vet Cardiol. 2021 Jun 5;36:105-114. doi: 10.1016/j.jvc.2021.05.010. Online ahead of print.

ABSTRACT

INTRODUCTION: Combining an antiplatelet drug, clopidogrel, with the direct oral Factor Xa inhibitor, apixaban, could provide an effective antithrombotic strategy in dogs. Thus, a limited 3 + 3 phase I dose-escalation clinical trial in healthy dogs was conducted to evaluate bleeding (primary end-point) and pharmacodynamic (PD)/pharmacokinetic (PK) parameters (secondary end-point).

ANIMALS: Eleven beagle dogs, median body weight 10.2 kg (9.7-10.9 kg), were enrolled.

METHODS: Four doses of apixaban (three dogs/dose) administered for eight days. Clopidogrel dose was fixed at 18.75 mg per os (PO) q 24 h with escalation of apixaban dose at 5 mg PO q 12 h, 5 mg PO q 8 h, 10 mg PO q 12 h, and 10 mg PO q 8 h. Laboratory testing included fecal occult blood, coagulation parameters, Factor X activity, apixaban concentration, platelet aggregometry, and thromboelastography on days 1, 3, and 8.

RESULTS: Evidence of bleeding was not observed at any dosage. Dose-dependent changes in PD/PK parameters between baseline and 3 h post-medication were observed including a prolongation of prothrombin time, a prolongation of activated partial thromboplastin time, a decrease of Factor X activity level, and increased apixaban concentration.

CONCLUSIONS: The combination of apixaban at a dosage range of approximately 0.5 mg/kg PO q 12 h to 1 mg/kg PO q 8 h and clopidogrel at approximately 1.8 mg/kg PO q 24 h did not cause bleeding over a one-week period in healthy dogs. Clinically relevant changes in PD/PK data occur at all dosage levels. This study provides a starting point for longer-term clinical trials to determine safety and efficacy.

PMID:34192609 | DOI:10.1016/j.jvc.2021.05.010

J Affect Disord. 2021 Jun 12;293:159-167. doi: 10.1016/j.jad.2021.05.018. Online ahead of print.

ABSTRACT

BACKGROUND: Postpartum depression (PPD) is a serious postpartum mental health problem worldwide. To date, minimal is known about the alteration of topographical organization in the brain structural covariance network of patients with PPD. This study investigates the brain structural covariance networks of patients with PPD by using graph theoretical analysis.

METHODS: High-resolution 3D T1 structural images were acquired from 21 drug-naive patients with PPD and 18 healthy postpartum women. Cortical thickness was extracted from 64 brain regions to construct the whole-brain structural covariance networks by calculating the Pearson correlation coefficients, and their topological properties (e.g., small-worldness, efficiency, and nodal centrality) were analyzed by using graph theory. Nonparametric permutation tests were further used for group comparisons of topological metrics. A node was set as a hub if its betweenness centrality (BC) was at least two standard deviations higher than the mean nodal centrality. Network-based statistic (NBS) was used to determine the connected subnetwork.

RESULTS: The PPD and control groups showed small-worldness of group networks, but the small-world network was more evidently in the PPD group. Moreover, the PPD group showed increased network local efficiency and almost similar network global efficiency. However, the difference of the network metrics was not significant across the range of network densities. The hub nodes of the patients with PPD were right inferior parietal lobule (BC = 13.69) and right supramarginal gyrus (BC = 13.15), whereas those for the HCs were left cuneus (BC = 14.96), right caudal anterior-cingulate cortex (BC = 15.51), and right precuneus gyrus (BC = 15.74). NBS demonstrated two disrupted subnetworks that are present in PPD: the first subnetwork with decreased internodal connections is mainly involved in the cognitive-control network and visual network, and the second subnetwork with increased internodal connections is mainly involved in the default mode network, cognitive-control network and visual network.

CONCLUSIONS: This study demonstrates the alteration of topographical organization in the brain structural covariance network of patients with PPD, providing in sight on the notion that PPD could be characterized as a systems-level disorder.

PMID:34192630 | DOI:10.1016/j.jad.2021.05.018

J Phys Condens Matter. 2021 Jun 30. doi: 10.1088/1361-648X/ac101c. Online ahead of print.

ABSTRACT

An inelastic x-ray scattering experiment has been performed on molten NaCl over wide wave vector and energy transfer ranges. Data of high statistical quality are analyzed using a memory function approach within a generalized Langevin equation. The approach with two relaxation times for the memory function provides a very good data description over the whole wave vector range beyond the hydrodynamic regime. A slow thermal and a fast structural relaxation process in the memory function completely define the density fluctuations in molten NaCl and evidences the thermal-viscoelastic model as the minimal description for collective particle dynamics in molten alkali halides. The obtained excitation frequencies demonstrate a large positive dispersion effect, which can be related to the viscoelastic reaction of the molten salt. A transition from the viscoelastic to a hydrodynamic response of the molten salt at small wave vectors is observed. In the hydrodynamic regime the resulting thermal diffusivity agrees well with values obtained through light scattering. The modeling indicates some deficiencies at small wave vectors and large energy transfers and the spectra of the current correlation function evidences additional intensity at high frequency. The frequency of these additional modes approach a non-zero value at zero wave vector and indicates a non-acoustic character of these excitations. The frequency center of this additional inelastic intensity coincides with optic-type modes in molten NaCl predicted by simulations.

PMID:34192684 | DOI:10.1088/1361-648X/ac101c

Microb Pathog. 2021 Jun 27:105072. doi: 10.1016/j.micpath.2021.105072. Online ahead of print.

ABSTRACT

Toxoplasma gondii (T. gondii) is an intracellular parasitic protozoan infecting homoeothermic animals and about a third of the world’s population. Inflammasomes are intracellular multi-protein complex, which are activated by many factors. Inflammasomes are activated during toxoplasmosis; however, there are a lot of obscure aspects. THP-1 monocyte cells were converted to M0 macrophages by PMA and treated by 100 μg/mL soluble total Ag (STAg) derived from T. gondii strain RH for two time points 3 h and 24 h. After total RNA extraction and cDNA synthesis, the expression pattern of NLRP1, NLRP3, NLRC4, AIM2, IL1β, and IL18 was evaluated by relative real-time PCR. In addition, the cytokine release of IL1β and TNFα were evaluated in supernatant of each well. The results showed statistically significant time-dependent overexpression of inflammasomes. NLRP1 and NLRP3 showed the higher and lower expression, respectively, during 3 h and 24 h after exposure. Both IL1β and IL18 downregulated 3 h after exposure. IL18 presented statistically significant upregulation after 24 h, but IL1β showed statistically significant downregulation after 24 h. The release of IL1β increased after 3 h, but it slightly decreased during 24 h after exposure. The concentration of TNFα showed an insignificant decrease compared to control, while it increased during 24 h after exposure. Taken together, this study suggested that T. gondii STAg induces NLRP1 more than NLRP3, NLRC4, and AIM2. Our findings also proposed that T. gondii STAg downregulates the gene expression of IL1β, but increases the release of this cytokine. It seems that Toxoplasma STAg probably increase the release of IL1β via activating NLRPs and AIM2 to cleave pro-caspase 1 to caspase 1 that leads to conversion of pro IL1β to mature IL1β.

PMID:34192597 | DOI:10.1016/j.micpath.2021.105072

Anat Rec (Hoboken). 2021 Jun 30. doi: 10.1002/ar.24700. Online ahead of print.

ABSTRACT

The aim of the study was to explore the effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients. All patients were divided into Group A and Group B based on different interventions (Group A: acupuncture + conventional rehabilitation, Group B: conventional rehabilitation alone). Acupuncture was conducted once a day, five times a week for 8 weeks, and rehabilitation (including physical therapy and occupational therapy) was conducted for 2 hr per session, once a day, five times a week for 8 weeks. Mini-mental State Examination (MMSE) and Fugl-Meyer Assessment (FMA) were used to assess the motor and cognitive functions at baseline and the end of 8 weeks. After the intervention, FMA and MMSE scores were improved significantly in the two groups (p <.05), compared with the scores prior to intervention. After 8 weeks of intervention, a statistically significant difference in the FMA and MMSE scores was observed between the Group A and the Group B. The results suggested that the combined intervention is more effective than the conventional rehabilitation alone in improving cognitive and motor functions in poststroke patients.

PMID:34192418 | DOI:10.1002/ar.24700