Tag: pubmed

Jpn J Clin Oncol. 2022 Feb 12:hyac011. doi: 10.1093/jjco/hyac011. Online ahead of print.

ABSTRACT

Older patients tend to have comorbidities and physiological decline, which require adaptation in terms of standard treatment. Therefore, the care of older patients poses a unique challenge for healthcare providers. Their standard care is relatively less established than for younger patients because older patients are often excluded from clinical trials, resulting in limited representation. This review, using various data sources, such as cancer registries and national statistics, aims to describe the nationwide status of older patients in Japan and the care provided to them. Incidence statistics have revealed that each age group’s most common types of cancers are different. Relevant data have also shown that older patients are more likely to be left without treatment compared with their younger counterparts, although the extent of such differences tends to depend on the cancer type. A survey of the general population has shown that older patients are more likely to be treated for common diseases; however, they are found to have undetected diseases when screened for the common diseases. Individuals’ life expectancies may vary depending on their physical conditions. The social lives of older persons, which often revolve around their jobs and family structures, vary widely. Thus, clinicians and caregivers should consider the background information of older patients in order to accommodate their special needs.

PMID:35149875 | DOI:10.1093/jjco/hyac011

Arch Orthop Trauma Surg. 2022 Feb 11. doi: 10.1007/s00402-022-04372-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Classifying complex acetabular defects in revision total hip arthroplasty (THA) by means of conventional radiographs comes with significant limitations. Statistical shape modelling allows the virtual reconstruction of the native pelvic morphology, hereby enabling an analytic acetabular defect assessment. Our objective was to evaluate the effect of advanced imaging augmented with analytic representations of the defect on (1) intra- and inter-rater reliability, and (2) up- or downscaling of classification scores when evaluating acetabular defects in patients undergoing revision THA.

MATERIALS AND METHODS: The acetabular defects of 50 patients undergoing revision THA were evaluated by three independent, fellowship-trained orthopaedic surgeons. Defects were classified according to the acetabular defect classification (ADC) using four different imaging-based representations, namely, standard radiographs, CT imaging, a virtual three-dimensional (3D) model and a quantitative analytic representation of the defect based on a statistical shape model reconstruction. Intra- and inter-rater reliabilities were quantified using Fleiss’ and Cohen’s kappa scores, respectively. Up- and downscaling of classification scores were compared for each of the imaging-based representations and differences were tested.

RESULTS: Overall inter-rater agreement across all imaging-based representations for the classification was fair (κ 0.29 95% CI 0.28-0.30). Inter-rater agreement was lowest for radiographs (κ 0.21 95% CI 0.19-0.22) and increased for other representations with agreement being highest when using analytic defect models (κ 0.46 95% CI 0.43-0.48). Overall intra-rater agreement was moderate (κ 0.51 95% CI 0.42-0.60). Intra-rater agreement was lowest for radiographs (κ 0.40 95% CI 0.23-0.57), and highest for ratings including analytic defect models (κ 0.64:95% CI 0.46-0.82). Virtual 3D models with quantitative analytic defect representations upscaled acetabular defect scores in comparison to standard radiographs.

CONCLUSIONS: Using 3D CT imaging with statistical shape models doubles the intra- and inter-rater reliability and results in upscaling of acetabular defect classification when compared to standard radiographs. This method of evaluating defects will aid in planning surgical reconstruction and stimulate the development of new classification systems based on advanced imaging techniques.

PMID:35149888 | DOI:10.1007/s00402-022-04372-x

Cereb Cortex. 2022 Feb 12:bhac021. doi: 10.1093/cercor/bhac021. Online ahead of print.

ABSTRACT

Semantic processing is the ability to discern and maintain conceptual relationships among words and objects. While the neural circuits serving semantic representation and controlled retrieval are well established, the neuronal dynamics underlying these processes are poorly understood. Herein, we examined 25 healthy young adults who completed a semantic relation word-matching task during magnetoencephalography (MEG). MEG data were examined in the time-frequency domain and significant oscillatory responses were imaged using a beamformer. Whole-brain statistical analyses were conducted to compare semantic-related to length-related neural oscillatory responses. Time series were extracted to visualize the dynamics and were linked to task performance using structural equation modeling. The results indicated that participants had significantly longer reaction times in semantic compared to length trials. Robust MEG responses in the theta (3-6 Hz), alpha (10-16 Hz), and gamma (64-76 Hz and 64-94 Hz) bands were observed in parieto-occipital and frontal cortices. Whole-brain analyses revealed stronger alpha oscillations in a left-lateralized network during semantically related relative to length trials. Importantly, stronger alpha oscillations in the left superior temporal gyrus during semantic trials predicted faster responses. These data reinforce existing literature and add novel temporal evidence supporting the executive role of the semantic control network in behavior.

PMID:35149873 | DOI:10.1093/cercor/bhac021

Clin Oral Implants Res. 2022 Feb 11. doi: 10.1111/clr.13904. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this in vitro study was to determine accuracy defined by trueness and precision of computer-assisted implant surgery comparing two guided surgery kits designed for either closed sleeves or open sleeves with a lateral window.

MATERIAL AND METHODS: Each n=20 implants were placed fully guided (sleeve-bone distance of 2 or 4mm) in identical replicas using a surgical guide with both closed sleeve or an open sleeve, partially guided, or free hand. The achieved implant position was digitized and compared with the planned position. Trueness and precision were determined. The angular deviation was defined as the primary outcome parameter. The means, standard deviation, and 95%-confidence intervals were analyzed statistically with 1-way ANOVA and the Scheffé procedure.

RESULTS: The accuracy of guided implant placement using closed and open sleeves was comparable when the sleeve-bone distance was 2 mm. Accuracy decreased when the sleeve-bone distance increased in both fully guided groups, more so in the open than in the closed sleeve group. The least accurate method was the free hand group. Partially guided implant surgery was more accurate than free hand placement, but less accurate than the fully guided groups with 2 mm sleeve-bone distance.

CONCLUSIONS: The closer the sleeve to the bone, the more accurate and precise is computer-assisted implant surgery using a closed system and a system using open sleeves. Partially guided implant surgery using only the static guide for the pilot drill is less accurate than both fully guided approaches, but more accurate than free hand surgery.

PMID:35148444 | DOI:10.1111/clr.13904

Radiol Oncol. 2022 Feb 11;56(1):37-45. doi: 10.2478/raon-2022-0005.

ABSTRACT

BACKGROUND: We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method.

PATIENTS AND METHODS: Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon’s and Karlsson’s) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%).

RESULTS: Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI. The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant (p < 0.001). Gordon’s method calculating MI reached a positive predictive value (PPV) of 83%, negative predictive value (NPV) of 83%, 77% sensitivity, 88% specificity, and 83% overall accuracy. Karlsson’s method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy. Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy.

CONCLUSIONS: We found that objective TVUS assessment of myometrial invasion was performed with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer.

PMID:35148470 | DOI:10.2478/raon-2022-0005

Nutr Clin Pract. 2022 Feb 11. doi: 10.1002/ncp.10832. Online ahead of print.

ABSTRACT

The administration of intravenous vitamin C (IV-VC) in treating patients with coronavirus disease 2019 (COVID-19) is still highly controversial. There have been no previous studies on the effect of IV-VC on the severity and mortality of COVID-19. Hence, we conducted a systematic review and meta-analysis to compare the disease severity and mortality in patients with COVID-19 who promptly received IV-VC treatment vs those who did not. We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, MEDLINE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, up to June 23, 2021. We identified a total of seven related articles, which were included in this study. This meta-analysis showed that IV-VC treatment did not affect disease severity compared with placebo treatment or usual care (odds ratio [OR], 0.70; 95% CI, 0.45 to 1.07; P = 0.10). In addition, no statistically significant difference in mortality was observed between patients who received IV-VC treatment and those who did not (OR, 0.64; 95% CI, 0.41 to 1.00; P = 0.05). Moreover, the adjusted meta-analysis revealed that the use of IV-VC did not influence disease severity (OR, 0.67; 95% CI, 0.34 to 1.31; P = 0.242) or mortality (OR, 1.02; 95% CI, 0.75 to 1.40; P = 0.877) in comparison with a control group. The results of this meta-analysis demonstrated that short-term IV-VC treatment did not reduce the risk of severity and mortality in patients with COVID-19.

PMID:35148440 | DOI:10.1002/ncp.10832

Rev Neurol. 2022 Feb 16;74(4):125-134. doi: 10.33588/rn.7404.2021196.

ABSTRACT

INTRODUCTION: Deep brain stimulation (DBS) of the subthalamic nucleus is currently an evidence-based therapeutic option for motor symptoms in patients with Parkinson’s disease (PD), although other non-motor symptoms can be affected by stimulation.

AIM: Our objective is to evaluate the global changes in the connectivity of the large-scale structural network in PD patients that have obtained a benefit from subthalamic DBS.

SUBJECTS AND METHODS: Retrospective study of 31 subjects: 7 PD patients with subthalamic DBS (group A), 12 age and gender-matched non-operated PD (B) and 12 healthy controls (C). All subjects had undergone a 1.5 T brain MRI with DTI. DICOM images were processed with the FSL5.0 software and TBSS tool.

RESULTS: The study group comprised 23 men and 8 women. No statistically significant differences in age, gender, scores on the HandY scale and mean follow-up between group A and B were found, and in age and gender between groups A and C. Statistical analysis revealed differences in the fractional anisotropy of the different groups in certain areas: bilateral corticospinal tract, anterior thalamic radiations, bilateral fronto-occipital fascicle, both superior longitudinal fascicles, and left inferior longitudinal fascicle.

CONCLUSIONS: In our series, PD patients treated with bilateral subthalamic DBS showed a significantly higher fractional anisotropy in widespread areas of the cerebral white matter; suggesting that neuromodulation produces connectivity changes in different neural networks.

PMID:35148421 | DOI:10.33588/rn.7404.2021196

J Oral Rehabil. 2022 Feb 11. doi: 10.1111/joor.13311. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a specially designed mobile application developed to provide patients with a sense of anxiety control during the various stages of endodontic treatment. The patients’ anxiety was assessed by measuring their salivary cortisol levels.

METHODS: A total of 46 patients requiring endodontic treatment were recruited. The patients were randomly assigned to two groups. The experimental group used the special communication application, while the control group did not. Salivary samples were collected from all patients preoperatively, postanesthesia, and postoperatively. The samples were analyzed with an enzyme-linked immunosorbent assay to measure the cortisol levels.

RESULTS: A significant difference in cortisol levels was observed between the experimental and the control group (Mann-Whitney U test, P < .05). This difference was significant in the experimental group in each step (P < .01). No difference was found in the control group steps (P > .05).

CONCLUSIONS: Perceived control of anxiety using the specially designed software was effective in reducing salivary cortisol levels.

PMID:35148428 | DOI:10.1111/joor.13311

Pain Med. 2022 Feb 11:pnac021. doi: 10.1093/pm/pnac021. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence indicates that combining behavioral treatments with pharmacological treatments for migraine prevention improves efficacy, however little is known about the outcomes of combining neuromodulation and behavioral interventions for acute treatment of migraine. Remote Electrical Neuromodulation (REN) is an FDA-cleared non-pharmacological migraine treatment. The current study evaluated the clinical benefits of augmenting REN treatment with a specially tailored behavioral therapy comprised of Guided Intervention of Education and Relaxation (GIER), for the acute treatment of migraine.

METHODS: In this two-arm observational study, real-world data were collected from patients across the United States who were using the REN device. Eighty-five migraine patients aged ≥18, who treated their attacks with REN in parallel with the GIER intervention were individually matched on age and sex with 85 patients who used REN alone. The groups were compared on the proportion of migraine attacks in which they achieved pain relief, pain freedom, improvement of function, and return to normal function, at 2 hours post-treatment.

FINDINGS: Data from 170 users were analyzed (85 per group). Compared to the REN-only group, the REN+GIER group displayed statistically significant higher proportion of patients achieving consistent pain relief (p = 0.008), consistent improvement in function (p = 0.014), and consistent return to normal function (p = 0.005); all at 2 hours post treatment.

CONCLUSIONS: The results suggest that combining the GIER behavioral intervention with REN treatment can improve the therapeutic efficacy beyond that of REN alone, in terms of both pain level and improvement of disability.

PMID:35148414 | DOI:10.1093/pm/pnac021

Eur J Orthod. 2022 Feb 11:cjac001. doi: 10.1093/ejo/cjac001. Online ahead of print.

ABSTRACT

AIM: To assess the extent of publication bias assessment in systematic reviews (SRs) across the orthodontic literature over the last 12 years and to identify the appropriateness of assessment and association with publication characteristics, including year of publication, journal, searching practices within unpublished literature or attempts to contact primary study authors and others.

MATERIALS AND METHODS: We searched six journals and the Cochrane Database of Systematic Reviews for relevant articles, since January 2010, until November 2021. We recorded practices interrelated with publication bias assessment, at the SR and meta-analysis level. These pertained to reporting strategies for searching within unpublished literature, attempts to communicate with authors of primary studies and formal assessment of publication bias either graphically or statistically. Potential associations between publication bias assessment practices with variables such as journal, year, methodologist involvement, and others were sought at the meta-analysis level.

RESULTS: A sum of 289 SRs were ultimately included, with 139 of those incorporating at least one available mathematical synthesis. Efforts to search within unpublished literature were reported in 191 out of 289 Reviews (66.1%), while efforts to communicate with primary study authors were recorded for 150 of 289 of those (51.9%). An appropriate strategy plan to address issues of publication bias, conditional on the number of studies available and the methodology plan reported, was followed in 78 of the 139 meta-analyses (56.1%). Formal publication bias assessment was actually reported in 35 of 139 meta-analyses (25.2%), while only half of those (19/35; 54.3%) followed an appropriately established methodology. Ten of the latter 19 studies detected the presence of publication bias (52.6%). Predictor variables of appropriate publication bias assessment did not reveal any significant effects.

CONCLUSIONS: Appropriate methodology and rigorous practices for appraisal of publication bias are underreported in SRs within the orthodontic literature since 2010 and up-to-date, while other established methodologies including search strategies for unpublished data or communication with authors appear currently suboptimal.

PMID:35148373 | DOI:10.1093/ejo/cjac001