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Andreassen M, Borgestig M, Hemmingsson H. The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults. Ann Med 2024; 56:2318397. [PMID: 38442288 PMCID: PMC10916903 DOI: 10.1080/07853890.2024.2318397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE This study investigates the psychosocial impact of eye-gaze assistive technology (EGAT) in both children and adults with long-term experience using eye-gaze assistive technology in everyday life, as well as the psychosocial impact as related to duration of use. METHODS In this descriptive comparative study, 34 adult and 27 child EGAT users participated in a structured individual interview using the Psychosocial Impact of Assistive Devices Scale (PIADS). RESULTS The participants' age ranged from 5-74 years, 50% were female and 52% had been diagnosed with cerebral palsy. The EGAT had a positive psychosocial impact on competence, adaptability, and self-esteem among adult and child users. Competence was the only subscale with a higher value for adults (p = 0.038), compared to children. The items with the highest impact for the psychosocial aspects were quality of life, ability to participate, and self-esteem. The adults had longer duration of use than children, but for high-, medium-, and low-duration users, the device showed a positive psychosocial impact. CONCLUSIONS Participants considered EGAT to have high positive impacts for participation and quality of life. The study adds new knowledge in that high positive psychosocial impact may be found even among low-duration users of EGAT, which is important to consider for service providers.
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Affiliation(s)
- Maria Andreassen
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Maria Borgestig
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden
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Khan MS, Islam KN, Rana S, Sarkar NK. Knowledge, attitude, and practice of blood donation: A cross-sectional survey in Khulna city, Bangladesh. Public Health Pract (Oxf) 2024; 7:100488. [PMID: 38449770 PMCID: PMC10915592 DOI: 10.1016/j.puhip.2024.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
Background There is evidence that the worldwide need for safe blood is not being met, particularly in poor nations like Bangladesh, where there is a scarcity of voluntary blood donors. This research intends to evaluate the public's knowledge, attitude, and practice of voluntary blood donation and the socio-demographic factors associated with blood donation in Khulna city, Bangladesh. Materials and methods 720 interviews were taken using a structural questionnaire with Khulna city residents implementing the convenience sampling technique. After pre-processing and removing missing values, 697 records were left for further analysis. To investigate the association of sociodemographic factors such as age, gender, education, occupation, marital status, permanent address, and smoking status with knowledge, attitude, and practice of blood donation, the binary logistic regression model was used. Results According to this research, 478 (68.58%), 654 (93.83%), and 451 (64.71%) respondents were knowledgeable, had a favorable attitude, and practiced VBD, respectively. The study level higher secondary (AOR = 2.2; CI: 1.16-4.18), honors or degree (AOR = 2.37; CI: 1.3-4.3), and masters or above (AOR = 3.27; CI: 1.69-6.35) were associated with the knowledge. The favorable attitude was connected with being male (AOR = 2.24; CI: 1.23-4.06), learning about VBD through online social media (AOR = 2.61; CI: 1.13-6.05), and having knowledge of VBD (AOR = 3.05; CI: 1.82-5.12). Age between 26 and 35 years (AOR = 2.83; CI: 1.43-5.57) and older than 45 years (AOR = 3.74; CI: 1.34-10.4), being a man (AOR = 3.6; CI: 2.25-5.78), being a smoker (AOR = 1.87; CI: 1.17-2.98), knowing about VBD (AOR = 2.31; CI: 1.55-3.42), and having a positive attitude (AOR = 3.78; CI: 2.11-6.77) were significant factors for practicing blood donation. Conclusion This research demonstrates poor blood donation practices and limited knowledge of blood donation among Khulna city residents. The awareness of the residents should be prolonged for voluntary blood donation by the health bureau, the government, and non-governmental organizations.
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Affiliation(s)
- Md. Salauddin Khan
- Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh
| | - Khondokar Naymul Islam
- Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh
| | - Sohel Rana
- Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh
| | - Nilay Kumar Sarkar
- Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh
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Lunga H, O'Connor M, Rocher AGL, Marais LC. Outcomes of surgically managed adult traumatic brachial plexus injuries in an upper-middle-income country. J Orthop 2024; 51:66-72. [PMID: 38313427 PMCID: PMC10831236 DOI: 10.1016/j.jor.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 02/06/2024] Open
Abstract
Background Traumatic brachial plexus injuries (TBPIs) are debilitating and complex to treat. The last five decades have seen advances in surgical management, and consequently improved functional outcomes in patients with these injuries. There is limited data available describing the outcomes of surgically managed TBPIs within the South African context. This study aimed to identify the common causes of injury, injury characteristics, and functional outcomes of surgically managed patients with TBPIs. Methods We conducted a retrospective chart review of all adult patients that underwent surgery for TBPIs over a period of ten years at a specialised hand unit in South Africa. The minimum follow-up period was one year. Patient demographic details, injury characteristics and functional outcomes were collected. Statistical analysis was performed to determine factors associated with functional outcomes. A good functional outcome for recovery was defined as a Medical Research Council (MRC) grade of three or more for the affected elements of the plexus at the most recent follow-up. Results Forty-seven patients of median age 32 years were included in the final analysis. Most patients were male (87.2 %). The majority of patients were injured in motor vehicle accidents (MVAs) or from penetrating stab wounds (48.9 % and 38.3 % respectively). The median pre-operative MRC grade of the affected elements of the brachial plexus was 0.0, and post-operatively was 2.0. Fourteen patients (14 of 47, 29.8 %) had a good outcome and 33 had a poor outcome (33 of 47, 70.2 %). There was no difference in outcome comparing penetrating injury mechanisms to closed traction or blunt injuries, (p = 0.386, OR 1.75, 95 % CI 0.49-6.20). All patients with pan-plexal injuries had a poor outcome (15 of 33, 46 %). All patients who received intercostal (6 of 33, 18 %) or phrenic nerve transfers (3 of 33, 9 %) had a poor outcome. Conclusion Adult traumatic BPIs in this South African sample typically presented more than two months after injury and were comprised of a high proportion of penetrating injuries. Just under a third of surgically managed patients had a good outcome. Pan plexal injuries have uniformly poor outcomes. We recommend early referral for all TBPIs to a unit that manages BPI to improve outcomes.
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Affiliation(s)
- Henry Lunga
- Department of Orthopaedic Surgery, Inkosi Albert Luthuli Central Hospital, 800 Vusi Mzimela Road, Umkumbaan, Durban, 4091, South Africa
- Department of Orthopaedic Surgery, University of KwaZulu-Natal, Nelson R. Mandela School of Clinical Medicine, 719 Umbilo Road, Umbilo, Berea, Durban, 4001, South Africa
| | - Megan O'Connor
- Department of Orthopaedic Surgery, Inkosi Albert Luthuli Central Hospital, 800 Vusi Mzimela Road, Umkumbaan, Durban, 4091, South Africa
- Department of Orthopaedic Surgery, University of KwaZulu-Natal, Nelson R. Mandela School of Clinical Medicine, 719 Umbilo Road, Umbilo, Berea, Durban, 4001, South Africa
| | - Antoine GL. Rocher
- Department of Orthopaedic Surgery, Inkosi Albert Luthuli Central Hospital, 800 Vusi Mzimela Road, Umkumbaan, Durban, 4091, South Africa
- Department of Orthopaedic Surgery, University of KwaZulu-Natal, Nelson R. Mandela School of Clinical Medicine, 719 Umbilo Road, Umbilo, Berea, Durban, 4001, South Africa
| | - Leonard C. Marais
- Department of Orthopaedic Surgery, University of KwaZulu-Natal, Nelson R. Mandela School of Clinical Medicine, 719 Umbilo Road, Umbilo, Berea, Durban, 4001, South Africa
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Lin YJ, Lai MC, Yang LK, Gau SSF. Sex-differential patterns of neuropsychological functioning in adults with attention-deficit/hyperactivity disorder. Compr Psychiatry 2024; 131:152464. [PMID: 38394925 DOI: 10.1016/j.comppsych.2024.152464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The sex-differential prevalence of attention-deficit/hyperactivity disorder (ADHD) varies across the lifespan, but little is known about sex differences in executive functions in adults with ADHD. METHODS We assessed 261 adults, aged 18-40 years, diagnosed with ADHD (170 males [assigned at birth], aged 25.81 ± 5.49; 91 females, aged 27.76 ± 5.42) and 308 neurotypical adults (176 males, aged 24.62 ± 5.14; 132 female, aged 25.37 ± 5.42) via psychiatric interviews to confirm ADHD and other psychiatric diagnoses. They were assessed by the Cambridge Neuropsychological Testing Automated Battery (CANTAB) on Reaction Time (arousal/processing speed), Rapid Visual Information Processing (sustained attention), Spatial Span (spatial memory), Spatial Working Memory, Intradimentional/Extradimensional Shift (set-shifting), and Stocking of Cambridge (spatial planning). The primary analyses were adjusted for age, full-scale IQ, and co-occurring psychiatric conditions. RESULTS Adults with ADHD had various co-occurring psychiatric conditions without sex differences in ADHD-neurotypical differences. Both adult males and females with ADHD performed poorer in all CANTAB tasks than same-sex neurotypical adults. Significant sex-moderating effects were observed in neuropsychological performance, including greater ADHD-neurotypical differences in arousal for females than males and in location memory for spatial tasks in males than females. CONCLUSION There were no sex-moderating effects in the presence of co-occurring psychiatric conditions in adult ADHD. However, there were sex-moderating effects on how ADHD related to neuropsychological functioning in adulthood. ADHD was associated with more challenges in arousal/processing speed in females and more challenges in strategy use or inhibition in spatial memory in males.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Psychiatry and Child Development Center, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Meng-Chuan Lai
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Li-Kuang Yang
- Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, and Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Sim Y, Choi SH, Lee N, Park YW, Ahn SS, Chang JH, Kim SH, Lee SK. Clinical, qualitative imaging biomarkers, and tumor oxygenation imaging biomarkers for differentiation of midline-located IDH wild-type glioblastomas and H3 K27-altered diffuse midline gliomas in adults. Eur J Radiol 2024; 173:111384. [PMID: 38422610 DOI: 10.1016/j.ejrad.2024.111384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/09/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE To compare the clinical, qualitative and quantitative imaging phenotypes, including tumor oxygenation characteristics of midline-located IDH-wildtype glioblastomas (GBMs) and H3 K27-altered diffuse midline gliomas (DMGs) in adults. METHODS Preoperative MRI data of 55 adult patients with midline-located IDH-wildtype GBM or H3 K27-altered DMG (32 IDH-wildtype GBM and 23 H3 K27-altered DMG patients) were included. Qualitative imaging assessment was performed. Quantitative imaging assessment including the tumor volume, normalized cerebral blood volume, capillary transit time heterogeneity (CTH), oxygen extraction fraction (OEF), relative cerebral metabolic rate of oxygen values, and mean ADC value were performed from the tumor mask via automatic segmentation. Univariable and multivariable logistic analyses were performed. RESULTS On multivariable analysis, age (odds ratio [OR] = 0.92, P = 0.015), thalamus or medulla location (OR = 10.48, P = 0.013), presence of necrosis (OR = 0.15, P = 0.038), and OEF (OR = 0.01, P = 0.042) were independent predictors to differentiate H3 K27-altered DMG from midline-located IDH-wildtype GBM. The area under the curve, accuracy, sensitivity, and specificity of the multivariable model were 0.88 (95 % confidence interval: 0.77-0.95), 81.8 %, 82.6 %, and 81.3 %, respectively. CONCLUSIONS Along with younger age, tumor location, less frequent necrosis, and lower OEF may be useful imaging biomarkers to differentiate H3 K27-altered DMG from midline-located IDH-wildtype GBM. Tumor oxygenation imaging biomarkers may reflect the less hypoxic nature of H3 K27-altered DMG than IDH-wildtype GBM and may contribute to differentiation.
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Affiliation(s)
- Yongsik Sim
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Seo Hee Choi
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Narae Lee
- Department of Nuclear Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
| | - Yae Won Park
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Maharani K, Dian S, Ganiem AR, Imran D, Estiasari R, Ardiansyah E, Andini PW, Kristina F, Pangeran D, Chaidir L, Alisjahbana B, Rukmana A, Kusumaningrum A, Adawiyah R, Subekti D, Yunihastuti E, Yunus RE, Waslia L, van Ingen J, van Laarhoven A, Hamers RL, van Crevel R. Clinical presentation, management, and outcome of suspected central nervous system infections in Indonesia: a prospective cohort study. Infection 2024; 52:583-595. [PMID: 38315377 PMCID: PMC10954958 DOI: 10.1007/s15010-023-02170-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/27/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Little is known about the etiology, clinical presentation, management, and outcome of central nervous system (CNS) infections in Indonesia, a country with a high burden of infectious diseases and a rising prevalence of HIV. METHODS We included adult patients with suspected CNS infections at two referral hospitals in a prospective cohort between April 2019 and December 2021. Clinical, laboratory, and radiological assessments were standardized. We recorded initial and final diagnoses, treatments, and outcomes during 6 months of follow-up. RESULTS Of 1051 patients screened, 793 were diagnosed with a CNS infection. Patients (median age 33 years, 62% male, 38% HIV-infected) presented a median of 14 days (IQR 7-30) after symptom onset, often with altered consciousness (63%), motor deficits (73%), and seizures (21%). Among HIV-uninfected patients, CNS tuberculosis (TB) was most common (60%), while viral (8%) and bacterial (4%) disease were uncommon. Among HIV-infected patients, cerebral toxoplasmosis (41%) was most common, followed by CNS TB (19%), neurosyphilis (15%), and cryptococcal meningitis (10%). A microbiologically confirmed diagnosis was achieved in 25% of cases, and initial diagnoses were revised in 46% of cases. In-hospital mortality was 30%, and at six months, 45% of patients had died, and 12% suffered from severe disability. Six-month mortality was associated with older age, HIV, and severe clinical, radiological and CSF markers at presentation. CONCLUSION CNS infections in Indonesia are characterized by late presentation, severe disease, frequent HIV coinfection, low microbiological confirmation and high mortality. These findings highlight the need for earlier disease recognition, faster and more accurate diagnosis, and optimized treatment, coupled with wider efforts to improve the uptake of HIV services.
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Affiliation(s)
- Kartika Maharani
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Sofiati Dian
- Department of Neurology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia.
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
| | - Ahmad Rizal Ganiem
- Department of Neurology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Darma Imran
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Riwanti Estiasari
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Edwin Ardiansyah
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Putri Widya Andini
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fransisca Kristina
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - David Pangeran
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Lidya Chaidir
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Bachti Alisjahbana
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Andriansjah Rukmana
- Department of Microbiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Ardiana Kusumaningrum
- Department of Microbiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Robiatul Adawiyah
- Department of Parasitology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Decy Subekti
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Evy Yunihastuti
- Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Reyhan Eddy Yunus
- Department of Radiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Lia Waslia
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Jakko van Ingen
- Department of Microbiology, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Arjan van Laarhoven
- Department of Internal Medicine, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Raph L Hamers
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Center for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Reinout van Crevel
- Department of Internal Medicine, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, The Netherlands
- Center for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Benevides TW, Datta B, Jaremski J, McKee M. Prevalence of intellectual disability among adults born in the 1980s and 1990s in the United States. J Intellect Disabil Res 2024; 68:377-384. [PMID: 38234197 DOI: 10.1111/jir.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Prevalence of intellectual disability (ID) is currently estimated through parent report on surveys of children. It is difficult to estimate the number of adults living with ID in the United States because no comprehensive survey or surveillance allows for identification. The purpose of this study was to estimate the prevalence and number of adults with ID born between 1980 and 1999 using multiple years of the National Health Interview Survey (NHIS) and Census data. METHODS We concatenated the NHIS from 1997-2016 that evaluated parental response about whether a child aged 3-17 years had an ID. Using weighted survey analyses, we estimated the prevalence of ID among individuals across four birth cohorts-(1) 1980-1984, (2) 1985-1989, (3) 1990-1994, and (4) 1995-1999. The number of adults with ID was then extrapolated by applying these prevalence rates to Census population estimates (as of 1 July 2021) of respective birth cohorts. RESULTS Weighted prevalence of ID varied by birth cohort, sex, race and ethnicity, and US Census Bureau regions. The overall prevalence rate was 1.066 [95% confidence interval (CI): 0.831-1.302] for adults born between 1980 and 1984, 0.772 (CI: 0.654-0.891) for adults born between 1985 and 1989, 0.774 (0.675-0.874) for adults born between 1990 and 1994, and 1.069 (CI: 0.898-1.240) for adults born between 1995 and 1999. Overall, we estimate that 818 564 adults with ID who were approximately 21-41 years were living in the United States as of 2021. CONCLUSIONS This study provides researchers examining adult health outcomes with an estimated denominator of young and middle-aged adults living with ID in the United States. Policymakers can use this information to support justification for resource and service needs, and clinicians may benefit from understanding that ID is a lifelong developmental condition often with additional physical, emotional and developmental needs requiring tailored care.
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Affiliation(s)
- T W Benevides
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - B Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - J Jaremski
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - M McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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Tagawa H, Fushimi Y, Funaki T, Nakajima S, Sakata A, Okuchi S, Hinoda T, Grinstead J, Ahn S, Hidaka Y, Yoshida K, Miyamoto S, Nakamoto Y. Vessel wall MRI in moyamoya disease: arterial wall enhancement varies depending on age, arteries, and disease progression. Eur Radiol 2024; 34:2183-2194. [PMID: 37798407 DOI: 10.1007/s00330-023-10251-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/19/2023] [Accepted: 08/08/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE To investigate the relationship of followings for patients with moyamoya disease (MMD): arterial wall enhancement on vessel wall MRI (VW-MRI), cross-sectional area (CSA), time-of-flight MR angiography (MRA), age, locations from intracranial internal carotid artery (ICA) to proximal middle cerebral artery (MCA), disease progression, and transient ischemic attack (TIA). METHODS Patients who underwent VW-MRI between October 2018 and December 2020 were enrolled in this retrospective study. We measured arterial wall enhancement (enhancement ratio, ER) and CSA at five sections of ICA and MCA. Also, we scored MRA findings. Multiple linear regression (MLR) analysis was performed to explore the associations between ER, age, MRA score, CSA, history of TIA, and surgical revascularization. RESULTS We investigated 102 sides of 51 patients with MMD (35 women, 16 men, mean age 31 years ± 18 [standard deviation]). ER for MRA score 2 (signal discontinuity) was higher than ER for other scores in sections D (end of ICA) and E (proximal MCA) on MLR analysis. ER in section E was significantly higher in patients for MRA score 2 with TIA history than without. ER significantly increased as CSA increased in section E, which suggests ER becomes less in decreased CSA due to negative remodeling. CONCLUSION Arterial wall enhancement in MMD varies by age, location, and disease progression. Arterial wall enhancement may be stronger in the progressive stage of MMD. Arterial wall enhancement increases with history of TIA at proximal MCA, which may indicate the progression of the disease. CLINICAL RELEVANCE STATEMENT Arterial wall enhancement in moyamoya disease varies by age, location of arteries, and disease progression, and arterial wall enhancement may be used as an imaging biomarker of moyamoya disease. KEY POINTS It has not been clarified what arterial wall enhancement in moyamoya disease represents. Arterial wall enhancement in moyamoya disease varies by age, location of arteries, and disease progression. Arterial wall enhancement in moyamoya disease increases as the disease progresses.
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Affiliation(s)
- Hiroshi Tagawa
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Takeshi Funaki
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Sachi Okuchi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | | | - Sinyeob Ahn
- Siemens Healthineers, San Francisco, CA, USA
| | - Yu Hidaka
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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9
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Tavakol S, Zieles K, Peters M, Omini M, Chen S, Jea A. The impact of social determinants of health on early outcomes after adult Chiari surgery. GeroScience 2024; 46:1451-1459. [PMID: 37996723 PMCID: PMC10828512 DOI: 10.1007/s11357-023-01021-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/19/2023] [Indexed: 11/25/2023] Open
Abstract
We sought to identify social determinants of health (SDoH) for adult patients undergoing Chiari decompression surgery and to analyze their association with postoperative outcomes, including length of stay (LOS), return to the system within 30 days, and the Chicago Chiari Outcomes Score (CCOS). This is a retrospective study of adult patients who underwent Chiari decompression surgery between June 2021 and January 2023. Data was gathered through electronic medical record review and telephone surveys. Descriptive statistics were used to evaluate demographics of all patients meeting inclusion criteria. Fisher's exact tests and logistic regression were used for data analysis. A total of 37 patients underwent Chiari decompression (23 CCOS/SDoH survey respondents): 48% bony decompression only, 30% bony decompression plus intradural exploration, and 22% occipitocervical fusion. Seven patients (30%) had a LOS > 2 days, 1 patient (4%) required inpatient rehabilitation postoperatively, 4 patients (17%) returned to the system within 30 days, 10 patients (43%) had an extremely favorable CCOS (15-16), and 11 patients (48%) reported interaction with a Chiari support group. Mean follow-up was 9.5 months. Patients with occipitocervical fusion were more likely to have a LOS > 2 days (p = 0.03), patients who exercised ≥ 3 days per week were more likely to have a favorable CCOS (p = 0.04), and patients who participated in a Chiari support group were less likely to have a favorable CCOS (p = 0.03). Chiari decompression plus occipitocervical fusion may be associated with increased LOS. While more frequent exercise may be associated with better post-surgical outcomes, participation in a Chiari support group may be correlated with worse outcomes.
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Affiliation(s)
- Sherwin Tavakol
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Kristin Zieles
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Mikayla Peters
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Michael Omini
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Andrew Jea
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Shiha MG, Nandi N, Raju SA, Wild G, Cross SS, Singh P, Elli L, Makharia GK, Sanders DS, Penny HA. Accuracy of the No-Biopsy Approach for the Diagnosis of Celiac Disease in Adults: A Systematic Review and Meta-Analysis. Gastroenterology 2024; 166:620-630. [PMID: 38176661 DOI: 10.1053/j.gastro.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/26/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND & AIMS Current international guidelines recommend duodenal biopsies to confirm the diagnosis of celiac disease in adult patients. However, growing evidence suggests that immunoglobulin A (IgA) anti-tissue transglutaminase (tTg) antibody levels ≥10 times the upper limit of normal (ULN) can accurately predict celiac disease, eliminating the need for biopsy. We performed a systematic review and meta-analysis to evaluate the accuracy of the no-biopsy approach to confirm the diagnosis of celiac disease in adults. METHODS We systematically searched MEDLINE, EMBASE, Cochrane Library, and Web of Science from January 1998 to October 2023 for studies reporting the sensitivity and specificity of IgA-tTG ≥10×ULN against duodenal biopsies (Marsh grade ≥2) in adults with suspected celiac disease. We used a bivariate random effects model to calculate the summary estimates of sensitivity, specificity, and positive and negative likelihood ratios. The positive and negative likelihood ratios were used to calculate the positive predictive value of the no-biopsy approach across different pretest probabilities of celiac disease. The methodological quality of the included studies was evaluated using the QUADAS-2 tool. This study was registered with PROSPERO, number CRD42023398812. RESULTS A total of 18 studies comprising 12,103 participants from 15 countries were included. The pooled prevalence of biopsy-proven celiac disease in the included studies was 62% (95% confidence interval [CI], 40%-83%). The proportion of patients with IgA-tTG ≥10×ULN was 32% (95% CI, 24%-40%). The summary sensitivity of IgA-tTG ≥10×ULN was 51% (95% CI, 42%-60%), and the summary specificity was 100% (95% CI, 98%-100%). The area under the summary receiver operating characteristic curve was 0.83 (95% CI, 0.77 - 0.89). The positive predictive value of the no-biopsy approach to identify patients with celiac disease was 65%, 88%, 95%, and 99% if celiac disease prevalence was 1%, 4%, 10%, and 40%, respectively. Between-study heterogeneity was moderate (I2 =30.3%), and additional sensitivity analyses did not significantly alter our findings. Only 1 study had a low risk of bias across all domains. CONCLUSION The results of this meta-analysis suggest that selected adult patients with IgA-tTG ≥10×ULN and a moderate to high pretest probability of celiac disease could be diagnosed without undergoing invasive endoscopy and duodenal biopsy.
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Affiliation(s)
- Mohamed G Shiha
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, United Kingdom; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
| | - Nicoletta Nandi
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, United Kingdom; Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Suneil A Raju
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, United Kingdom; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom
| | - Graeme Wild
- Department of Immunology, Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - Simon S Cross
- Department of Histopathology, Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - Prashant Singh
- Division of Gastroenterology, Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Luca Elli
- Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Govind K Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - David S Sanders
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, United Kingdom; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom
| | - Hugo A Penny
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, United Kingdom; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom
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Kelly C, Anderson S, Looney A, Shannon N, Senaratne R, O'Connor E, Breen K, Lennon G, McGuire B, Murphy M, Moran D, Galvin D. Nephrectomy for xanthogranulomatous pyelonephritis-a not-so-simple solution. Ir J Med Sci 2024; 193:1055-1060. [PMID: 37610600 PMCID: PMC10961261 DOI: 10.1007/s11845-023-03496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Xanthogranulomatous pyelonephritis (XGP) is a rare chronic inflammatory condition of the kidney, associated with high patient morbidity, often requiring targeted antibiotic therapy and surgical removal of the affected kidney. AIM We report the outcomes of patients undergoing nephrectomy for XGP in our institution over a 12-year period. METHODS Following ethical approval, a retrospective review of histological samples of renal tissue demonstrating features of XGP from June 2010 to 2022 was conducted. Laboratory, imaging, and clinical data of included participants were collected. RESULTS Eleven patients were included (8 women, 3 men), mean age of 58.1 (35-81). Recurrent urinary tract infection was the most common clinical presentation (55%, n = 6). Other presentations included flank pain (36%, n = 4), collection/ abscess (45%, n = 5), and nephro-cutaneous fistulae (9%, n = 1). The majority of patients had bacteriuria (91%, n = 10), and Escherichia coli was the most common bacteria isolated (55%, n = 6). Antibiotic resistance was seen in 60% of positive urine samples (n = 6). An open nephrectomy was performed in all but one case (91%, n = 10). A postoperative complication occurred in 73% (n = 8), with 50% (n = 4) of complications Clavien Dindo grade 3 or higher, including one patient mortality. CONCLUSIONS XGP is a difficult and complex condition to treat. All patients in this series presented with infection or associated sequelae thereof. Complex XGP cases therefore often require open nephrectomy and have high rates of postoperative complications. Careful consideration of antibiotic and operative intervention is therefore essential to ensure the best outcome for these patients.
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Affiliation(s)
- Caroline Kelly
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland.
| | - Steven Anderson
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Aisling Looney
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Naomi Shannon
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Radha Senaratne
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Eabhann O'Connor
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Kieran Breen
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Gerald Lennon
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Barry McGuire
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Michael Murphy
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Diarmaid Moran
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - David Galvin
- Urology Department, St. Vincent's University Hospital, Dublin, Ireland
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12
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Liu X, Han T, Wang Y, Liu H, Sun Q, Xue C, Deng J, Li S, Zhou J. Whole-tumor histogram analysis of postcontrast T1-weighted and apparent diffusion coefficient in predicting the grade and proliferative activity of adult intracranial ependymomas. Neuroradiology 2024; 66:531-541. [PMID: 38400953 DOI: 10.1007/s00234-024-03319-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE To investigate the value of histogram analysis of postcontrast T1-weighted (T1C) and apparent diffusion coefficient (ADC) images in predicting the grade and proliferative activity of adult intracranial ependymomas. METHODS Forty-seven adult intracranial ependymomas were enrolled and underwent histogram parameters extraction (including minimum, maximum, mean, 1st percentile (Perc.01), Perc.05, Perc.10, Perc.25, Perc.50, Perc.75, Perc.90, Perc.95, Perc.99, standard deviation (SD), variance, coefficient of variation (CV), skewness, kurtosis, and entropy of T1C and ADC) using FireVoxel software. Differences in histogram parameters between grade 2 and grade 3 adult intracranial ependymomas were compared. Receiver operating characteristic curves and logistic regression analyses were conducted to evaluate the diagnostic performance. Spearman's correlation analysis was used to evaluate the relationship between histogram parameters and Ki-67 proliferation index. RESULTS Grade 3 intracranial ependymomas group showed significantly higher Perc.95, Perc.99, SD, variance, CV, and entropy of T1C; lower minimum, mean, Perc.01, Perc.05, Perc.10, Perc.25, Perc.50 of ADC; and higher CV and entropy of ADC than grade 2 intracranial ependymomas group (all p < 0.05). Entropy (T1C) and Perc.10 (ADC) had a higher diagnostic performance with AUCs of 0.805 and 0.827 among the histogram parameters of T1C and ADC, respectively. The diagnostic performance was improved by combining entropy (T1C) and Perc.10 (ADC), with an AUC of 0.857. Significant correlations were observed between significant histogram parameters of T1C (r = 0.296-0.417, p = 0.001-0.044) and ADC (r = -0.428-0.395, p = 0.003-0.038). CONCLUSION Whole-tumor histogram analysis of T1C and ADC may be a promising approach for predicting the grade and proliferative activity of adult intracranial ependymomas.
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Affiliation(s)
- Xianwang Liu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Tao Han
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Yuzhu Wang
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
| | - Hong Liu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Qiu Sun
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Caiqiang Xue
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Juan Deng
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Shenglin Li
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Junlin Zhou
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, People's Republic of China.
- Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China.
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China.
- Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China.
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13
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Khoeri MM, Maladan Y, Salsabila K, Alimsardjono L, Vermasari N, Puspitasari I, Yunita R, Tafroji W, Sarassari R, Sari RF, Balqis SA, Wahid GA, Purwanto DS, Harimurti K, Soebandrio A, Safari D. Whole genome sequencing data of Streptococcus pneumoniae isolated from Indonesian population. Data Brief 2024; 53:110251. [PMID: 38533114 PMCID: PMC10964051 DOI: 10.1016/j.dib.2024.110251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/21/2023] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
Streptococcus pneumoniae is the leading cause of bacterial pneumonia, bacteremia, and meningitis. Indonesia introduced the pneumococcal conjugate vaccine (PCV) nationwide in 2022. In this study, we present whole genome sequence (WGS) data of 94 S. pneumoniae isolates that were obtained from hospitalized patients, healthy children, and adult groups from different regions prior to PCV program in Indonesia. DNA sequences of S. pneumoniae were obtained using the TruSeq Nano DNA kit (Illumina NovaSeq6000 Platform). The genome data of S. pneumoniae features a 1,969,562 bp to 2,741,371 bp circular chromosome with 39-40% G+C content. The genome includes 1935-3319 coding sequences (CDS), 2 to 5 rRNA genes, 43 to 49 tRNA genes, and 56 to 71 ncRNA. These data will be useful for analyzing the serotype, sequence type, virulence genes, antimicrobial resistance genes, and the impact of pneumococcal vaccination in Indonesia. The FASTQ raw files of these sequences are available under BioProject accession number PRJNA995903 and Sequence Read Archive accession numbers SRR25316461-SRR25316554.
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Affiliation(s)
- Miftahuddin Majid Khoeri
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
- Doctoral program in Biomedical, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Yustinus Maladan
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Korrie Salsabila
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | | | | | | | - Rina Yunita
- Haji Adam Malik Hospital, Medan, North Sumatera, Indonesia
- Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Wisnu Tafroji
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Rosantia Sarassari
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Ratna Fathma Sari
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Sarah Azhari Balqis
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Ghina Athyah Wahid
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Diana Shinta Purwanto
- Department of Biochemistry, Faculty of Medicine, Sam Ratulangi University, Manado, North Sulawesi, Indonesia
| | - Kuntjoro Harimurti
- Departement of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Amin Soebandrio
- Departement of Clinical Microbiology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Dodi Safari
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
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14
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Bouman EJ, Mackenbach JD, Twisk JWR, Raimondo L, Beulens JWJ, Elders PJM, Rutters F. Is the association between social jetlag and BMI mediated by lifestyle? A cross-sectional survey study in the Dutch general population. Prev Med 2024; 181:107908. [PMID: 38382765 DOI: 10.1016/j.ypmed.2024.107908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Social jetlag is a discordance between the social and biological rhythm and is associated with higher HbA1c, higher BMI, and higher odds of obesity. The pathways that could explain these associations are still debated. This study aims to assess the mediating role of several lifestyle factors in the cross-sectional association between social jetlag and BMI. METHODS We used cross-sectional data from 1784 adults from urban areas in the Netherlands, collected in 2019. Social jetlag (difference in midpoint of sleep between week and weekend nights) was categorized as low(<1 h), moderate(1-2h), and high(>2 h). BMI(kg/m2) was calculated from self-reported height and weight. The association between social jetlag and BMI was assessed using linear regression, adjusted for sex, age, education, and sleep duration and stratified for the effect modifier stress (high vs. low). Mediation analysis was performed for self-reported smoking, physical activity, alcohol consumption, and adherence to a healthy diet. RESULTS High social jetlag was associated with higher BMI (0.69 kg/m2,95%CI 0.05;1.33). This association was stronger in people with high stress (0.93 kg/m2,95%CI 0.09;1.76). Social jetlag was also associated with higher odds of smoking, lower physical activity, higher alcohol consumption, and lower healthy diet adherence. In people with high stress, these factors mediated 10-15% of the association between social jetlag and BMI. CONCLUSIONS Social jetlag is associated with higher BMI and this association is stronger in people with high stress. In people with high stress, healthy diet adherence mediated 12% of this association. Other pathways involved in this association should be further investigated.
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Affiliation(s)
- Emma J Bouman
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands.
| | - Joreintje D Mackenbach
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands
| | - Jos W R Twisk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands
| | - Laura Raimondo
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands
| | - Joline W J Beulens
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands
| | - Petra J M Elders
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, General Practice, Meibergdreef 9, Amsterdam, Netherlands
| | - Femke Rutters
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands
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15
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Kaewlai R, Wongveerasin P, Lekanamongkol W, Wongsaengchan D, Teerasamit W, Tongsai S, Khamman P, Chatkaewpaisal A, Noppakunsomboon N, Apisarnthanarak P. CT of appendicoliths in adult appendicitis: clinical significance and characteristics of overlooked cases. Eur Radiol 2024; 34:2534-2545. [PMID: 37837538 PMCID: PMC10957675 DOI: 10.1007/s00330-023-10273-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES Accurate computed tomography (CT) identification of appendicoliths in adults with acute appendicitis is crucial as it may preclude nonoperative management due to high risk of failure and complications. This investigation aimed to identify the significance of appendicoliths in acute appendicitis and to evaluate the performance of portovenous-phase (PVP) CT and the consequences of overlooked appendicoliths. METHODS CT examinations of 324 consecutive patients (mean age 51.9 years, 112 men) with pathologically confirmed acute appendicitis were retrospectively included. Two radiologists independently reviewed the images, and disagreement was resolved by a consensus. RESULTS Appendicoliths were identified in 134/324 patients, of which 75 had complicated appendicitis. Among 190 patients without appendicoliths, 52 had complicated appendicitis. An appendicolith was independently associated with complicated appendicitis (adjusted odds ratio 2.289; 95% CI: 1.343-3.902; p = 0.002). The larger minimum diameter was significantly associated with complication. The 4.5-/6.0-mm cutoffs for minimum and maximum diameters of appendicoliths demonstrated 82.7%/85.3% sensitivity and 35.6%/33.9% specificity in predicting complications. The PVP alone had 82.1-88.1% sensitivity, respectively per patient and per appendicolith, and a 100% specificity in the detection of appendicoliths, as compared with combined noncontrast and PVP. PVP overlooked 28/237 appendicoliths (11.8%) corresponding to 24/134 patients (17.9%). Of the 24 patients with overlooked appendicoliths, 16 had complicated appendicitis but 14 were correctly categorized by findings other than appendicoliths. In total, 2/127 patients (1.6%) with complicated appendicitis were misdiagnosed as having uncomplicated appendicitis. CONCLUSIONS Appendicoliths in acute appendicitis were strongly associated with complications. While PVP overlooked some appendicoliths, only 1.6% of complicated appendicitis were misclassified when considering other CT findings. CLINICAL RELEVANCE STATEMENT This study found a strong association between appendicoliths and complications. Its presence may preclude conservative management. Although portovenous-phase CT overlooked some appendicoliths, the combination with other CT findings allowed correct classification in a vast majority of cases. KEY POINTS • Accurate identification of appendicoliths is crucial for nonoperative management decisions in adult acute appendicitis. • Appendicoliths are strongly associated with complications in adult acute appendicitis. • Portovenous-phase CT overlooked some appendicoliths, but only a small percentage of patients with complicated appendicitis were misclassified when considering other CT findings.
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Affiliation(s)
- Rathachai Kaewlai
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand.
| | - Pootipong Wongveerasin
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Warunyou Lekanamongkol
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Dhanawin Wongsaengchan
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Wanwarang Teerasamit
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Sasima Tongsai
- Department of Research, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Pramuk Khamman
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Anchisa Chatkaewpaisal
- Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Napakadol Noppakunsomboon
- Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
| | - Piyaporn Apisarnthanarak
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd, Bangkok Noi, Bangkok, 10700, Thailand
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Hong S, Son JW, Yoon Y. Clinical Midterm Results of Surgical Aortic Valve Replacement with Sutureless Valves. J Chest Surg 2024:jcs.23.142. [PMID: 38528758 DOI: 10.5090/jcs.23.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/20/2023] [Accepted: 01/18/2024] [Indexed: 03/27/2024] Open
Abstract
Background Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis. Methods Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020. In total, 113 patients were included (mean age, 75.3±8.4 years; 57.5% women; median Society of Thoracic Surgeons score, 9.7%; mean follow-up period, 51.19±20.6 months). Of these patients, 41 were octogenarians (36.2%) and 3 were nonagenarians (2.6%). Transthoracic echocardiography was employed to assess changes in ejection fraction (EF), left ventricular mass index (LVMI), and mean pressure gradient (MPG). Results The in-hospital mortality rate was 2.6%, and 13 patients developed new-onset atrial fibrillation. A permanent pacemaker was implanted in 3 patients (2.6%). The median intensive care unit stay was 1 day (interquartile range [IQR], 1-2 days), and the median hospital stay was 12 days (IQR, 9.5-15 days). The overall survival rate at 5 years was 95.9%. LVMI and MPG were reduced postoperatively, while EF increased over the follow-up period. No structural valve deterioration was observed, and no meaningful paravalvular leakage developed during follow-up. Conclusion The use of a sutureless valve in the aortic position is safe and feasible, even for high-risk elderly patients requiring surgical AVR. LVMI and MPG decreased postoperatively, while EF increased over the follow-up period.
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Affiliation(s)
- Soonchang Hong
- Department of Cardiothoracic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung-Woo Son
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yungjin Yoon
- Department of Cardiothoracic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
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Hashiguchi K, Mine S, Shiota J, Akashi T, Tabuchi M, Kitayama M, Matsushima K, Akazawa Y, Yamaguchi N, Nakao K. Colonic intussusception after endoscopic mucosal resection successfully managed by endoscopic procedure. Clin J Gastroenterol 2024:10.1007/s12328-024-01953-8. [PMID: 38504057 DOI: 10.1007/s12328-024-01953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/10/2024] [Indexed: 03/21/2024]
Abstract
Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.
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Affiliation(s)
- Keiichi Hashiguchi
- Department of Endoscopy, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan.
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Shoichiro Mine
- Department of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Junya Shiota
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taro Akashi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Maiko Tabuchi
- Department of Histology and Biomedical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Moto Kitayama
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kayoko Matsushima
- Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuko Akazawa
- Department of Histology and Biomedical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoyuki Yamaguchi
- Department of Endoscopy, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Miché M, Strippoli MPF, Preisig M, Lieb R. Evaluating the clinical utility of an easily applicable prediction model of suicide attempts, newly developed and validated with a general community sample of adults. BMC Psychiatry 2024; 24:217. [PMID: 38509477 PMCID: PMC10953234 DOI: 10.1186/s12888-024-05647-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND A suicide attempt (SA) is a clinically serious action. Researchers have argued that reducing long-term SA risk may be possible, provided that at-risk individuals are identified and receive adequate treatment. Algorithms may accurately identify at-risk individuals. However, the clinical utility of algorithmically estimated long-term SA risk has never been the predominant focus of any study. METHODS The data of this report stem from CoLaus|PsyCoLaus, a prospective longitudinal study of general community adults from Lausanne, Switzerland. Participants (N = 4,097; Mage = 54 years, range: 36-86; 54% female) were assessed up to four times, starting in 2003, approximately every 4-5 years. Long-term individual SA risk was prospectively predicted, using logistic regression. This algorithm's clinical utility was assessed by net benefit (NB). Clinical utility expresses a tool's benefit after having taken this tool's potential harm into account. Net benefit is obtained, first, by weighing the false positives, e.g., 400 individuals, at the risk threshold, e.g., 1%, using its odds (odds of 1% yields 1/(100-1) = 1/99), then by subtracting the result (400*1/99 = 4.04) from the true positives, e.g., 5 individuals (5-4.04), and by dividing the result (0.96) by the sample size, e.g., 800 (0.96/800). All results are based on 100 internal cross-validations. The predictors used in this study were: lifetime SA, any lifetime mental disorder, sex, and age. RESULTS SA at any of the three follow-up study assessments was reported by 1.2%. For a range of seven a priori selected threshold probabilities, ranging between 0.5% and 2%, logistic regression showed highest overall NB in 97.4% of all 700 internal cross-validations (100 for each selected threshold probability). CONCLUSION Despite the strong class imbalance of the outcome (98.8% no, 1.2% yes) and only four predictors, clinical utility was observed. That is, using the logistic regression model for clinical decision making provided the most true positives, without an increase of false positives, compared to all competing decision strategies. Clinical utility is one among several important prerequisites of implementing an algorithm in routine practice, and may possibly guide a clinicians' treatment decision making to reduce long-term individual SA risk. The novel metric NB may become a standard performance measure, because the a priori invested clinical considerations enable clinicians to interpret the results directly.
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Affiliation(s)
- Marcel Miché
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60-62, 4055, Basel, Switzerland.
| | - Marie-Pierre F Strippoli
- Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Roselind Lieb
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60-62, 4055, Basel, Switzerland
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Johnston AW, Hensel DJ, Roth JD, Wiener JS, Misseri R, Szymanski KM. Prevalence of sexual abuse and intimate partner violence in adults with spina bifida. Disabil Health J 2024:101617. [PMID: 38531731 DOI: 10.1016/j.dhjo.2024.101617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND People with disabilities and chronic medical conditions are known to be at higher risk of sexual abuse (SA) and intimate partner violence (IPV). People with spina bifida (SB) are vulnerable, but little is known about the prevalence of abuse in this population. OBJECTIVE To evaluate the prevalence and risk factors of SA and IPV in adults with SB. METHODS An anonymous international cross-sectional online survey of adults with SB asked about history of SA ("sexual contact that you did not want") and IPV ("hit, slapped, kicked, punched or hurt physically by a partner"). RESULTS Median age of the 405 participants (61% female) was 35 years. Most self-identified as heterosexual (85%) and were in a romantic relationship (66%). A total of 19% reported a history of SA (78% no SA, 3% preferred not to answer). SA was more frequently reported by women compared to men (27% vs. 5%, p < 0.001) and non-heterosexual adults compared to heterosexuals (41% vs. 15%, p < 0.001). Twelve percent reported a history of IPV (86% no IPV, 2% preferred not to answer). IPV was more frequently reported by women compared to men (14% vs. 9%, p = 0.02), non-heterosexuals compared to heterosexuals (26% vs. 10%, p = 0.002), and adults with a history of sexual activity versus those without (14% vs. 2%, p = 0.01). CONCLUSION People with SB are subjected to SA and IPV. Women and non-heterosexuals are at higher risk of both.
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Affiliation(s)
- Ashley W Johnston
- Division of Pediatric Urology, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA
| | - Devon J Hensel
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Joshua D Roth
- Division of Pediatric Urology, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA
| | - John S Wiener
- Division of Pediatric Urology, Duke University Medical Center, Durham, NC, USA
| | - Rosalia Misseri
- Division of Pediatric Urology, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA
| | - Konrad M Szymanski
- Division of Pediatric Urology, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA.
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Pan MR, Dong M, Zhang SY, Liu L, Li HM, Wang YF, Qian QJ. One-year follow-up of the effectiveness and mediators of cognitive behavioural therapy among adults with attention-deficit/hyperactivity disorder: secondary outcomes of a randomised controlled trial. BMC Psychiatry 2024; 24:207. [PMID: 38491411 PMCID: PMC10943890 DOI: 10.1186/s12888-024-05673-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The long-term effectiveness of cognitive behavioural therapy (CBT) in medicated attention-deficit/hyperactivity disorder (ADHD) adults with residual symptoms needs to be verified across multiple dimensions, especially with respect to maladaptive cognitions and psychological quality of life (QoL). An exploration of the mechanisms underlying the additive benefits of CBT on QoL in clinical samples may be helpful for a better understanding of the CBT conceptual model and how CBT works in medicated ADHD. METHODS We conducted a secondary analysis of a randomised controlled trial including 98 medicated ADHD adults with residual symptoms who were randomly allocated to the CBT combined with medication (CBT + M) group or the medication (M)-only group. Outcomes included ADHD-core symptoms (ADHD Rating Scale), depression symptoms (Self-rating Depression Scale), maladaptive cognitions (Automatic Thoughts Questionnaire and Dysfunctional Attitude Scale), and psychological QoL (World Health Organization Quality of Life-Brief Version-psychological domain). Mixed linear models (MLMs) were used to analyse the long-term effectiveness at one-year follow-up, and structural equation modeling (SEM) was performed to explore the potential mechanisms of CBT on psychological QoL. RESULTS ADHD patients in the CBT + M group outperformed the M-only group in reduction of ADHD core symptoms (d = 0.491), depression symptoms (d = 0.570), a trend of reduction of maladaptive cognitions (d = 0.387 and 0.395, respectively), and improvement of psychological QoL (d = - 0.433). The changes in above dimensions correlated with each other (r = 0.201 ~ 0.636). The influence of CBT on QoL was mediated through the following four pathways: 1) changes in ADHD core symptoms; 2) changes in depressive symptoms; 3) changes in depressive symptoms and then maladaptive cognitions; and 4) changes firstly in depressive symptoms, maladaptive cognitions, and then ADHD core symptoms. CONCLUSIONS The long-term effectiveness of CBT in medicated ADHD adults with residual symptoms was further confirmed. The CBT conceptual model was verified in clinical samples, which would be helpful for a deeper understanding of how CBT works for a better psychological QoL outcome. TRIAL REGISTRATION ChiCTR1900021705 (2019-03-05).
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Affiliation(s)
- Mei-Rong Pan
- Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Min Dong
- Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Shi-Yu Zhang
- Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Lu Liu
- Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Hai-Mei Li
- Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yu-Feng Wang
- Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Qiu-Jin Qian
- Peking University Sixth Hospital/ Institute of Mental Health, Beijing, 100191, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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Chan CYW, Tan YWE, Chandren JR, Chandirasegaran S, Chung WH, Chiu CK, Kwan MK. Prediction of Postoperative Curve Correction based on the Supine Radiographs for Adult Idiopathic Scoliosis (AdIS) patients. Spine J 2024:S1529-9430(24)00111-6. [PMID: 38499066 DOI: 10.1016/j.spinee.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/22/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND CONTEXT Preoperative supine radiographs are mandatory in the new AdIS classification. Supine radiographs are easily reproducible and highly predictive of side bending radiographs. However, few studies evaluated the use of supine radiographs in predicting postoperative curve correction after PSF in AdIS. PURPOSE To investigate the use of supine and side bending (SB) radiographs in predicting postoperative curve correction in Adult Idiopathic Scoliosis (AdIS) patients who underwent Posterior Spinal Fusion (PSF). STUDY DESIGN Retrospective study PATIENT SAMPLE: 93 AdIS patients who underwent PSF between 2022 and 2023 were included. OUTCOME MEASURES Demographic data were age, gender, height, weight, BMI, Risser grade, Lenke curve types and Cobb angles. Main outcome measures are pre-operative and immediate post-operative Cobb angle (proximal thoracic (PT), main thoracic (MT) and thoracolumbar/lumbar (TL/L) curves), Supine Cobb angle and Flexibility rate (PT, MT and TL/L), and Correction Rate (PT, MT and TL/L) METHODS: Correlation study was performed between supine Cobb angle vs. post-operative Cobb angle for PT, MT and TL/L curves. A predictive formula was derived from the correlation plots. RESULTS A total of 93 subjects were included in our study with a median age of 24.7 years and comprised of 80 females (86.0%). Preoperative Supine Cobb angle (r=0.835, r=0.881, r=0.767, p<0.001) and preoperative SB Cobb angle (r=0.815, r=0.872, r=0.801, p<0.001) showed similar strong positive correlation with postoperative PT, MT and TL/L Cobb angle, but preoperative Supine Cobb angle had slightly stronger correlation in PT and MT, whereas preoperative SB Cobb angle had stronger correlation in TL/L curve. Using the derived predictive formulae, there was a significant, strong, positive correlation between the predicted value and actual value of postoperative standing Cobb angle, (r=0.852, P<0.001), with 71.0% of the patients had predicted postoperative Cobb angle from the supine radiographs within 5 degrees of the actual value. CONCLUSION Both supine radiographs and side bending radiographs had strong predictability of the postoperative Cobb angle for PT, MT and TL/L curves. In 71.0% of patients, the actual postoperative Cobb angle was within 5 degrees of the predicted postoperative Cobb angle using the predictive formulae.
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Affiliation(s)
- Chris Yin Wei Chan
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti of Malaya, Kuala Lumpur.
| | - Yee Wern Evonne Tan
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti of Malaya, Kuala Lumpur
| | | | | | - Weng Hong Chung
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti of Malaya, Kuala Lumpur
| | - Chee Kidd Chiu
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti of Malaya, Kuala Lumpur
| | - Mun Keong Kwan
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti of Malaya, Kuala Lumpur
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Leng X, Yang H, Zhao L, Feng J, Jin K, Liao L, Zhang F. Dengue encephalopathy in an adult due to dengue virus type 1 infection. BMC Infect Dis 2024; 24:319. [PMID: 38491361 PMCID: PMC10943806 DOI: 10.1186/s12879-024-09198-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/06/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Dengue is an important public health problem, which caused by the dengue virus (DENV), a single-stranded RNA virus consisted of four serotypes. Central nervus system (CNS) impairment in dengue usually results from DENV-2 or DENV-3 infection, which lead to life-threatening outcomes. Furthermore, neurological complications due to DENV-1 was rare especially in adult patients. CASE PRESENTATION A 44-year-old man without comorbidities had lethargy after hyperpyrexia and a positive DENV NS1 antigen was detected for confirming the diagnosis of dengue on day 8 of onset. Then logagnosia, decreased muscle strength, delirium and irritability were occurred even radiographic examination were normal. He was treated with low-dose hormone, sedatives and gamma goblin with a short duration of 6 days. The cerebrospinal fluid (CSF) tests were persistent normal. However, presence of DENV-1 RNA was confirmed both in CSF and serum. Furthermore, the complete sequence of the DENV isolated from the patient's serum was performed (GenBank No.: MW261838). The cytokines as IL-6, IL-10 and sVCAM-1 were increased in critical phase of disease. Finally, the patient was discharged on day 24 of onset without any neurological sequelae. CONCLUSION Encephalopathy caused by a direct CNS invasion due to DENV-1 during viremia was described in an adult patient. Treatment with low-dose hormone and gamma goblin was helpful for admission.
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Affiliation(s)
- Xingyu Leng
- Guangzhou Medical Research Institute of Infectious Diseases, Department of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China
| | - Huiqin Yang
- Guangzhou Medical Research Institute of Infectious Diseases, Department of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China
| | - Lingzhai Zhao
- Guangzhou Medical Research Institute of Infectious Diseases, Department of Clinical Laboratory, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P. R. China
| | - Jiamin Feng
- Guangzhou Medical Research Institute of Infectious Diseases, Institution of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China
| | - Kanghong Jin
- Guangzhou Medical Research Institute of Infectious Diseases, Department of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China
| | - Lu Liao
- Guangzhou Medical Research Institute of Infectious Diseases, Department of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China
| | - Fuchun Zhang
- Guangzhou Medical Research Institute of Infectious Diseases, Department of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China.
- Guangzhou Medical Research Institute of Infectious Diseases, Institution of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China.
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Zhao D, Zhou F, Liu W, Huang Z, Xu X, Zheng B, Liu C, Bai C, Liu J, Sun Y, Wang W, Xiao S. Adult head and neck rhabdomyosarcoma: radiotherapy- based treatment, outcomes, and predictors of survival. BMC Cancer 2024; 24:340. [PMID: 38486204 PMCID: PMC10938762 DOI: 10.1186/s12885-024-12079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Adult head and neck rhabdomyosarcoma (HNRMS) is an exceptionally rare malignancy, and there is a paucity of data and research dedicated to understanding its characteristics and management in adult populations. This study aimed to assess the outcomes and identify survival predictors in adult HNRMS. METHODS We retrospectively evaluated 42 adult patients (> 16 years) with HNRMS who received radiotherapy (RT)-based treatment at our institute between 2008 and 2022. We analysed the clinical characteristics and prognosis of these patients, including the locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS), using the Kaplan-Meier method. The chi-square and Fisher's exact tests were used to analyse differences between groups for dichotomous and categorical variables, respectively. Survival rates were calculated using the Kaplan-Meier method. Prognostic variables were assessed through univariate Cox analyses. RESULTS The median patient age was 28 years (range, 16-82 years). Alveolar RMS was the most common histological type, observed in 21 patients (50.0%), followed by embryonal in 16 patients (38.1%). The anatomic sites of origin were orbital in one (2.4%), parameningeal in 26 (61.9%), and non-orbital/non-parameningeal in 15 (35.7%) patients. Nineteen patients (45.2%) had regional lymph node metastasis, and five patients (11.9%) presented with distant metastatic disease. Distant metastasis (n = 17) was the primary cause of treatment failure. At a median follow-up of 47.0 months, the 5-year LRFS, PFS, and OS rates were 69.0%, 39.7%, and 41.0%, respectively. Univariate analysis revealed that tumour size, lymph node involvement, and the local treatment pattern (surgery and RT vs. RT alone) were significant predictors of survival. CONCLUSIONS The main failure pattern in patients with HNRMS receiving RT-based treatment was distant metastasis. Tumour size > 5 cm and lymph node involvement were predictors of worse LRFS. Multimodality local treatment, combining surgery and RT, is effective and provides survival benefits.
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Affiliation(s)
- Dan Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Fang Zhou
- Department of Radiotherapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, P.R. China
| | - Weixin Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Zhou Huang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Xiaolong Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Baomin Zheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Changqing Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Chujie Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Bone and Soft Tissue Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Jiayong Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Bone and Soft Tissue Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Yan Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Weihu Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China.
| | - Shaowen Xiao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China.
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Fujiwara Y, Kitagami H, Kikkawa T, Sakashita K, Kusumi T, Nishida Y. Esophageal cancer in an adult with congenital esophageal stenosis: a case report. Surg Case Rep 2024; 10:58. [PMID: 38467897 PMCID: PMC10928053 DOI: 10.1186/s40792-024-01858-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Congenital esophageal stenosis (CES) is a rare condition. We encountered a case of esophageal cancer that developed in an adult with persistent CES. Although many studies have investigated the therapeutic outcomes and performed surveillance for symptoms after treatment for CES, few have performed long-term surveillance or reported on the development of esophageal cancer. We report this case because it is extremely rare and has important implications. CASE PRESENTATION A 45-year-old woman with worsening dysphagia was transferred to our hospital. The patient was diagnosed with CES at 5 years of age and underwent surgery at another hospital. The patient underwent esophageal dilatation for stenosis at 36 years of age. Esophagoscopy performed at our hospital revealed a circumferential ulcerated lesion and stenosis 15-29 cm from the incisors. Histological examination of the biopsy specimen revealed squamous cell carcinoma. Computed tomography (CT) revealed abnormal circumferential wall thickening in parts of the cervical and almost the entire thoracic esophagus. 18F-fluorodeoxyglucose-positron emission tomography-CT revealed increased uptake in the cervical and upper esophagus. No uptake was observed in the muscular layers of the middle or lower esophagus. Based on these findings, the patient was diagnosed with clinical stage IVB cervical and upper esophageal cancer (T3N1M1 [supraclavicular lymph nodes]). The patient underwent a total esophagectomy after neoadjuvant chemotherapy. The esophagus was markedly thickened and tightly adhered to the adjacent organs. Severe fibrosis was observed around the trachea. Marked thickening of the muscular layer was observed throughout the esophagus; histopathological examination revealed that this thickening was due to increased smooth muscle mass. No cartilage, bronchial epithelium, or glands were observed. The carcinoma extended from the cervical to the middle esophagus, oral to the stenotic region. Finally, we diagnosed the patient with esophageal cancer developing on CES of the fibromuscular thickening type. CONCLUSIONS Chronic mechanical and chemical irritations are believed to cause cancer of the upper esophagus oral to a persistent CES, suggesting the need for long-term surveillance that focuses on residual stenosis and cancer development in patients with CES.
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Affiliation(s)
- Yushi Fujiwara
- Department of Gastroenterological Surgery, Keiyukai Sapporo Hospital, Minami1-1, Hondori 9-Chome, Shiroishi-Ku, Sapporo, 003-0026, Japan.
| | - Hidehiko Kitagami
- Department of Gastroenterological Surgery, Keiyukai Sapporo Hospital, Minami1-1, Hondori 9-Chome, Shiroishi-Ku, Sapporo, 003-0026, Japan
| | - Tomohiro Kikkawa
- Department of Gastroenterological Surgery, Keiyukai Sapporo Hospital, Minami1-1, Hondori 9-Chome, Shiroishi-Ku, Sapporo, 003-0026, Japan
| | - Keita Sakashita
- Department of Gastroenterological Surgery, Keiyukai Sapporo Hospital, Minami1-1, Hondori 9-Chome, Shiroishi-Ku, Sapporo, 003-0026, Japan
| | - Takaya Kusumi
- Department of Gastroenterological Surgery, Keiyukai Sapporo Hospital, Minami1-1, Hondori 9-Chome, Shiroishi-Ku, Sapporo, 003-0026, Japan
| | - Yasunori Nishida
- Department of Gastroenterological Surgery, Keiyukai Sapporo Hospital, Minami1-1, Hondori 9-Chome, Shiroishi-Ku, Sapporo, 003-0026, Japan
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Shi S, Zhao Q, Wu G, Yan H, Yu B, Zheng Q, Li Y, Zheng L, Yuan Y, Zhong J, Xu J, Wu Y, Xu J, Chen L, Li S, Jiang J, Wang J, Fan J, Chen M, Tang B, Li W, Wu Q, Shi B, Zhou S, Zhao X, Yin Y, Zhang Z, Zhong G, Han X, Liu F, Wu M, Gao L, Yang B, Tang Y, Huang H, Huang C. Variation and disparity in awareness of atrial fibrillation in China: A national cross-sectional study. Int J Cardiol 2024:131957. [PMID: 38471651 DOI: 10.1016/j.ijcard.2024.131957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/18/2024] [Accepted: 03/08/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND The latest information regarding the awareness of atrial fibrillation (AF) remains limited in China. OBJECTIVES The present study aimed to understand the variation and disparity in awareness of AF in China. METHODS The cross-sectional study used data from the 2020 nationwide epidemiology survey on AF among adults aged 18 years or older in mainland China to assess the prevalence of AF awareness. The awareness of AF diagnostic methods and outcomes was also assessed using an interviewer-administered questionnaire. RESULTS Of the 114,039 adults responding to the survey, 1463 (age-standardized prevalence, 55.3% (95% confidence interval [CI], 47.7-62.9%) and 10,202 (8.2%, 95%CI 5.4-10.9%) were aware of AF in participants with and without AF, respectively. Of these, 36.4% (95%CI 30.0-42.9%) and 6.3% (95%CI 3.6-9.1%) considered electrocardiogram as a method of diagnosing AF, and 30.0% (95% CI 3.2-8.2%) and 5.2% (95%CI 2.7-7.6%) considered stroke as an outcome of AF. The proportion of participants who being aware of AF varied significantly across sociodemographic and cardiovascular disease subgroups, and was almost consistently lower in rural areas than those in urban areas. Overall, lack of AF awareness was associated with rural areas, geographical region, lower education levels, and without history and had no risk factors of cardiovascular disease. CONCLUSIONS Nearly half of adults with AF, and >90% non-AF population are unaware of AF in China, with significant variation and disparity. Focused public health initiatives are needed to improve awareness and knowledge of AF among high-risk populations.
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Affiliation(s)
- Shaobo Shi
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Qingyan Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Gang Wu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan 430060, China
| | - Bin Yu
- School of Public Health, Wuhan University, Wuhan 430060, China
| | - Qiangsun Zheng
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Yigang Li
- Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Liangrong Zheng
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Yiqiang Yuan
- Henan Provincial Chest Hospital, Zhengzhou 450008, China
| | - Jingquan Zhong
- Qilu Hospital of Shandong University, Jinan 250063, China
| | - Jian Xu
- Anhui Provincial Hospital, Hefei 230001, China
| | - Yanqing Wu
- The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Jing Xu
- Tianjin Chest Hospital, Tianjin 300222, China
| | - Lin Chen
- Fujian Provincial Hospital, Fuzhou 350013, China
| | - Shufeng Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Jian Jiang
- West China Hospital of Sichuan University, Chengdu 610044, China
| | - Jingfeng Wang
- Sun Yat-sen Memorial Hospital, Guangzhou 510120, China
| | - Jie Fan
- The First People's Hospital of Yunnan Province, Kunming 650034, China
| | | | - Baopeng Tang
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China
| | - Wei Li
- The Affiliated Hospital of Guizhou Medical University, Guizhou 550004, China
| | - Qiang Wu
- Guizhou Provincial People's Hospital, Guizhou 550002, China
| | - Bei Shi
- Affiliated Hospital of Zunyi Medical University, Zunyi 563099, China
| | - Shenghua Zhou
- The Second Xiangya Hospital of Central South University, Changsha 430062, China
| | - Xingsheng Zhao
- Inner Mongolia Autonomous Region People's Hospital, Huhehot 010020, China
| | - Yuehui Yin
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Zheng Zhang
- The First Hospital of Lanzhou University, Lanzhou 730013, China
| | - Guoqiang Zhong
- The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Xuebin Han
- Shanxi Cardiovascular Hospital, Taiyuan 030024, China
| | - Fan Liu
- The Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - Ming Wu
- Hainan General Hospital, Haikou 570311, China
| | - Lianjun Gao
- The First Affiliated Hospital of Dalian Medical University, Dalian 116051, China
| | - Bo Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Yanhong Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China.
| | - He Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China.
| | - Congxin Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China.
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Wang J, Tian L, Liu B. Plastic bronchitis secondary to thoracotomy in an adult: A case report. Respir Med Case Rep 2024; 48:102002. [PMID: 38510662 PMCID: PMC10950725 DOI: 10.1016/j.rmcr.2024.102002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/29/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024] Open
Abstract
This study presents a rare case of plastic bronchitis (PB) in a 57-year-old adult post-lung lobectomy, a condition predominantly found in post-Fontan children. The patient exhibited progressive dyspnea and complete atelectasis on the surgical side, revealing a gray rubbery bronchial cast obstructing the right main bronchus. Treatment involved repeated bronchoscopies, glucocorticoids, acetylcysteine, physiotherapy, and a low-fat diet, leading to gradual improvement. No similar cases have been reported, highlighting PB's diagnostic challenge. This underscores the need to consider rare conditions like PB in post-lobectomy complications. Timely examinations and bronchoscopies are essential for accurate diagnosis, ensuring prompt treatment and improving patient outcomes.
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Affiliation(s)
- Jia Wang
- Department of Pain Management, West China Hospital, Sichuan University, Chengdu, China
| | - Long Tian
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
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Tekle A, Tsegaye A, Ketema T. Adherence to Anti-Retroviral Therapy (ART) and Its Determinants Among People Living with HIV/AIDS at Bonga, Kaffa, South-West Ethiopia. Patient Prefer Adherence 2024; 18:543-554. [PMID: 38476589 PMCID: PMC10929121 DOI: 10.2147/ppa.s445164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Background The scaling-up of antiretroviral therapy (ART) is the greatest accomplishment to reduce the burden of acquired immunodeficiency syndromes (AIDS) to date. However, it requires optimal adherence to be effective. Thus, this study was designed to assess the level of adherence of people living with HIV (PLWH) to ART and its determinants in one of the hardest-hit areas with HIV in Ethiopia. Methods A health facility-based cross-sectional study design was conducted among adult PLWH, age >18 years, and receiving ART in southwest Ethiopia. Data was collected by face-to-face interviews following the Self-Rating Scale Item for drug adherence and from participants' medical cards. The effects of variables related to socio-demographic and socio-economic factors, disease and medication, health facilities, and patients' behavior on ART adherence were analyzed using a binary logistic regression model. The data was analyzed using R software. Results Self-reported good adherence to ART recorded in this study was 73.1% (n =301/412). The risk of poor adherence was significantly higher among those who were divorced, merchants, used ART for longer durationsand were found in stage IV WHO pathogenesis. Contrarily, those who had a positive perception of the effectiveness of ART had significantly better adherence to ART. Longer duration on ART and frequency of pills taken, ≥3 pills per day, were significantly associated with a low CD4+ cell count (<500 cells/mm3). For each unit increase in medication frequency per day, the likelihood of having a high viral load of >1000 copies/mL was 5.35 times higher. Conclusion The ART adherence documented in this study was graded as moderately low. Some variables, such as clinical, medical, and behavioral, were found to affect the adherence of people living with HIV to ART. Hence, care providers should be aware of such variables in the process of treatment, follow-up, and monitoring of people living with HIV in the study area.
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Affiliation(s)
- Asrat Tekle
- Jimma University, College of Natural Sciences, Department of Biology, Jimma, Ethiopia
| | - Arega Tsegaye
- Jimma University, College of Natural Sciences, Department of Biology, Jimma, Ethiopia
| | - Tsige Ketema
- Jimma University, College of Natural Sciences, Department of Biology, Jimma, Ethiopia
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28
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Liu X, Zhang Q, Chen H, Hao Y, Zhang J, Zha S, Zhou B, Yi Y, Xiao R, Hu K. Comparison of the clinical characteristics in parents and their children in a series of family clustered Mycoplasma pneumoniae infections. BMC Pulm Med 2024; 24:107. [PMID: 38439032 PMCID: PMC10910824 DOI: 10.1186/s12890-024-02922-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/22/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae infections have increased in China recently, causing some evidence of familial clustering. The purpose of this study was to compare the clinical features of parents and children in cases of familial clustering of Mycoplasma pneumoniae infection. METHODS A retrospective analysis was performed on the cases of familial clustering of Mycoplasma pneumoniae infection, and the clinical characteristics of parents and children were compared. RESULTS We identified 63 families, of these, 57 (65.5%) adults and 65 (94.2%) children required hospitalization. Fifty-seven adults (mean age 35.1 ± 4.6 years, 80.7% female) and 55 children (mean age 6.3 ± 3.9 years, 54.5% female) were included in the analysis. The incidence of mycoplasma infection in adults had increased gradually over the past year, while the rate in children had spiked sharply since June 2023. The clinical symptoms were similar in the two groups, mainly fever and cough. The peak temperature of children was higher than that of adults (39.1 ± 0.7℃ vs 38.6 ± 0.7℃, p = 0.004). Elevated lactate dehydrogenase was more common in children than in adults (77.8% vs 11.3%, p < 0.001). Bronchial pneumonia and bilateral involvement were more common in children, while adults usually had unilateral involvement. Three (60%) adults and 21 (52.5%) children were macrolide-resistant Mycoplasma pneumoniae infected. Children were more likely to be co-infected (65.5% vs 22.8%, p < .001). Macrolides were used in most children and quinolones were used in most adults. Ten (18.2%) children were diagnosed with severe Mycoplasma pneumoniae pneumonia, whereas all adults had mild disease. Children had a significantly longer fever duration than adults ((5.6 ± 2.2) days vs (4.1 ± 2.2) days, p = 0.002). No patient required mechanical ventilation or died. CONCLUSIONS Mycoplasma pneumoniae infection shows a familial clustering epidemic trend at the turn of summer and autumn, with different clinical characteristics between parents and children.
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Affiliation(s)
- Xu Liu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qingfeng Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hao Chen
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yueying Hao
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingyi Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Shiqian Zha
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Beini Zhou
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yaohua Yi
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China
- Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Rui Xiao
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China
- Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Taylor SC, Gehringer BN, Dow HC, Langer A, Rawot E, Smernoff Z, Steeman S, Almasy L, Rader DJ, Bučan M, Brodkin ES. Contrasting Views of Autism Spectrum Traits in Adults, Especially in Self-Reports vs. Informant-Reports for Women High in Autism Spectrum Traits. J Autism Dev Disord 2024; 54:1088-1100. [PMID: 36484966 PMCID: PMC9734875 DOI: 10.1007/s10803-022-05822-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 12/13/2022]
Abstract
There is uncertainty among researchers and clinicians about how to best measure autism spectrum dimensional traits in adults. In a sample of adults with high levels of autism spectrum traits and without intellectual disability (probands, n = 103) and their family members (n = 96), we sought to compare self vs. informant reports of autism spectrum-related traits and possible effects of sex on discrepancies. Using correlational analysis, we found poor agreement between self- and informant-report measures for probands, yet moderate agreement for family members. We found reporting discrepancy was greatest for female probands, often self-reporting more autism-related behaviors. Our findings suggest that autism spectrum traits are often underrecognized by informants, making self-report data important to collect in clinical and research settings.
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Affiliation(s)
- Sara C Taylor
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
- Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brielle N Gehringer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Holly C Dow
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Allison Langer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Eric Rawot
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Zoe Smernoff
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Samantha Steeman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Daniel J Rader
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Maja Bučan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Edward S Brodkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA.
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Fukuda Y, Horita N, Aga M, Kashizaki F, Hara Y, Obase Y, Niimi A, Kaneko T, Mukae H, Sagara H. Efficacy and safety of macrolide therapy for adult asthma: A systematic review and meta-analysis. Respir Investig 2024; 62:206-215. [PMID: 38211545 DOI: 10.1016/j.resinv.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/29/2023] [Accepted: 12/25/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The evidence for macrolide therapy in adult asthma is not properly established and remains controversial. We conducted a systematic review and meta-analysis to examine the efficacy and safety of macrolide therapy for adult asthma. METHODS We searched randomized controlled trials from MEDLINE via the PubMed, CENTRAL, and Ichushi Web databases. The primary outcome was asthma exacerbation. The secondary outcomes were serious adverse events (including mortality), asthma-related quality of life (symptom scales, Asthma Control Questionnaire, and Asthma Quality of Life Questionnaire), rescue medication (puffs/day), respiratory function (morning peak expiratory flow, evening peak flow, and forced expiratory volume in 1 s), bronchial hyperresponsiveness, and minimum oral corticosteroid dose. Of the 805 studies, we selected seven studies for the meta-analysis, which was conducted using a random-effects model. SYSTEMATIC REVIEW REGISTRATION University Hospital Medical Information Network Clinical Trials Registry (UMIN000050824). RESULTS No significant difference between macrolide and placebo for asthma exacerbations was observed (risk ratio 0.71, 95 % confidence interval [CI] 0.46-1.09; p = 0.12). Macrolide therapy for adult asthma showed a significant improvement in rescue medication with short-acting beta-agonists (mean difference -0.41, 95 % CI -0.78 to -0.04; p = 0.03). Macrolide therapy did not show more serious adverse events (odd ratio 0.61, 95 % CI 0.34-1.10; p = 0.10) than those with placebo. The other secondary outcomes were not significantly different between the macrolide and placebo groups. CONCLUSIONS Macrolide therapy for adult asthma may be more effective than placebo and could be a treatment option.
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Affiliation(s)
- Yosuke Fukuda
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan; Department of Medicine, Division of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan.
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Kanagawa, Japan
| | - Masaharu Aga
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Fumihiro Kashizaki
- Department of Respiratory Medicine, Yokohama Minami Kyosai Hospital, Kanagawa, Japan
| | - Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akio Niimi
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hironori Sagara
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan
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de Araújo PSP, Pinto PHV, da Silva RHA. Age estimation in adults by canine teeth: a systematic review of the Cameriere method with meta-analysis on the reliability of the pulp/tooth area ratio. Int J Legal Med 2024; 138:451-465. [PMID: 37861739 DOI: 10.1007/s00414-023-03110-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
The age estimation of an adult using methods accessible to the forensic routine is a goal pursued by forensic experts. Cameriere, Ferrante and Cingolani (2004) proposed the use of the pulp/tooth area ratio of canine teeth as a promising variable, but its reliability has shown conflicting results in the scientific literature. This article aimed to carry out a systematic review with meta-analysis to verify whether the pulp/tooth area ratio of canine teeth includes a variable that can be used alone to estimate dental age in adults. A systematic search was carried out in six databases using keywords related to the theme in Portuguese, English, and Spanish. The study selection process followed pre-established eligibility criteria. Assessments were carried out regarding risk of bias and publication bias of selected studies, and meta-analysis was carried out considering Pearson's correlation coefficient between pulp/tooth area ratio and chronological age as effect measure. Most selected studies showed low risk of bias; no publication bias was found when all studies were considered, and potential publication bias was found when outliers were removed. Despite the high heterogeneity among studies and the need for more research, it could be observed that the pulp/tooth area ratio has strong negative correlation with chronological age, and the pulp/tooth area ratio could be derived from both periapical radiographs and orthopantomographs. Therefore, it is suggested that there is scientific evidence that the pulp/tooth area ratio obtained from canine teeth is reliable for dental age estimation in adults.
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Affiliation(s)
- Priscila Santiago Paiva de Araújo
- Department of Stomatology, Public Health and Forensic Odontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Paulo Henrique Viana Pinto
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo Henrique Alves da Silva
- Department of Stomatology, Public Health and Forensic Odontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Jeffus SK, Sturgis CD, McHugh KE, Verret M, Ooms K, Vestal S, Doxtader EE, Shah AA. The spectrum of malignant diagnoses in cerebrospinal fluid cytology from an adult population: a multi-institutional retrospective review. J Am Soc Cytopathol 2024; 13:141-148. [PMID: 38135580 DOI: 10.1016/j.jasc.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/24/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Limited updated literature exists about the prevalence and spectrum of malignancies involving cerebrospinal fluid (CSF). In this multi-institutional study, we review our experience with focus on first time malignancy diagnosis in CSF samples of adults. MATERIALS AND METHODS Institutional databases at 4 academic centers were queried retrospectively for CSFs over a 10-year period. The following data elements were collected: total # of CSFs, total # of CSFs with a malignant diagnosis; for each patient with a first time CSF diagnosis of malignancy: age, gender, diagnosis, prior history of malignancy, and ancillary studies. RESULTS Twenty-four thousand one hundred forty-two CSFs were collected with a positive for malignancy rate of 2.3% (n = 551). Out of 347 (1.4%) adults with a first-time diagnosis of CSF malignancy 182 (52%) were female (age range: 19-89/mean: 57) and 165 (48%) were male (age range: 20-95/mean: 60). Hematolymphoid malignancies (48%, n = 168) were overall the most common neoplasm. In women, metastatic carcinomas (63%, n = 114) were the leading malignancy, of which the majority were breast primaries. In men, lymphomas/leukemias (64%, n = 106) were the leading malignancy, of which the majority were B-cell lymphomas. Ancillary studies aided the final diagnosis in 110 (32%) cases. For 286 (82%) cases, a prior history of malignancy was available to correlate CSF findings. CONCLUSIONS A malignancy diagnosis in the CSF of adults is rare. The most common malignancies in females and males are metastatic breast carcinoma and hematolymphoid malignancies, respectively. Metastatic neoplasms account for the majority, with primary central nervous system neoplasms being quite uncommon. History of malignancy and ancillary tests can be helpful.
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Affiliation(s)
- Susanne K Jeffus
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| | - Charles D Sturgis
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota
| | - Kelsey E McHugh
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, Arizona
| | - Meredith Verret
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kaitlyn Ooms
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
| | - Sarah Vestal
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Akeesha A Shah
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
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Park S, Tang A, Barclay R, Bayley M, Eng JJ, Mackay-Lyons M, Pollock C, Pooyania S, Teasell R, Yao J, Sakakibara BM. Investigating the Telerehabilitation With Aims to Improve Lower Extremity Recovery Poststroke Program: A Feasibility Study. Phys Ther 2024; 104:pzad165. [PMID: 38051660 DOI: 10.1093/ptj/pzad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 06/19/2023] [Accepted: 09/15/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the feasibility of a progressive virtual exercise and self-management intervention, the TeleRehabilitation with Aims to Improve Lower extremity recovery poststroke program (TRAIL), in individuals with stroke. METHODS A single group pre-post study design was used. Thirty-two participants were recruited who were aged 19 years or older, had a stroke within 18 months of the beginning of the study, had hemiparesis of the lower extremity, and were able to tolerate 50 minutes of activity. Participants completed TRAIL, a synchronous exercise and self-management program delivered via videoconferencing. Participants received 8 telerehabilitation sessions over 4 weeks that were 60 to 90 minutes, with a trained physical therapist in a ≤2 to 1 participant-to-therapist ratio. Feasibility indicators in the areas of process (recruitment and retention rates, perceived satisfaction), resources (treatment fidelity and adherence, participant and assessor burden, therapist burden), management (equipment, processing time), and scientific indicators (safety, treatment response, treatment effect) were collected throughout the study using a priori criteria for success. The treatment effect was examined on the Timed "Up & Go" test, the virtual Fugl-Meyer Lower Extremity Assessment, the 30-Second Sit-to-Stand Test, the Functional Reach, the Tandem Stand, the Activities-Specific Balance Confidence Scale, the Stroke Impact Scale, and the Goal Attainment Scale. RESULTS Forty-seven individuals were screened, of which 32 (78% male; median age of 64.5 years) were included for the study from 5 sites across Canada. Nine feasibility indicators met our study-specific threshold criteria for success: retention rate (0 dropouts), perceived satisfaction, treatment fidelity, adherence, therapist burden, equipment, and safety. In terms of treatment response and effect, improvements were observed in Timed "Up & Go" test (Cohen d = 0.57); Fugl-Meyer Lower Extremity Assessment (d = 0.76); 30-Second Sit-to-Stand Test (d = 0.89); and Goal Attainment Scale (d = 0.95). CONCLUSION The delivery of TRAIL, a lower extremity stroke rehabilitation program using videoconferencing technology, is feasible and appears to have positive influences on mobility, lower extremity impairment, strength, and goal attainment. IMPACT Community-based telerehabilitation programs, such as TRAIL, could extend the continuum of care during the transition back to community postdischarge or during global disruptions, such as Coronavirus Disease 2019 (COVID-19). Delivery of synchronous lower extremity rehabilitation via videoconferencing to community-dwelling stroke survivors is feasible.
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Affiliation(s)
- Sarah Park
- Graduate Program in Rehabilitation Sciences at UBC, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Chronic Disease Prevention & Management, Faculty of Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Ada Tang
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Janice J Eng
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | | | - Courtney Pollock
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Sepideh Pooyania
- Section of Physical Medicine and Rehabilitation, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robert Teasell
- Parkwood Institute, St Joseph's Health Care, London, Ontario, Canada
| | - Jennifer Yao
- GF Strong Rehabilitation Centre, Vancouver Coastal Health Authority. Vancouver, British Columbia, Canada
| | - Brodie M Sakakibara
- Graduate Program in Rehabilitation Sciences at UBC, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Chronic Disease Prevention & Management, Faculty of Medicine, University of British Columbia, Kelowna, British Columbia, Canada
- Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Newberry-Dupé J, Chu W, Craig S, Borschmann R, O'Reilly G, Yates P, Melvin G, King K, Hiscock H. Adult Mental Health Presentations to Emergency Departments in Victoria, Australia between January 2018 and October 2020: Changes Associated with COVID-19 Pandemic Public Health Restrictions. Psychiatr Q 2024; 95:33-52. [PMID: 37938493 PMCID: PMC10901934 DOI: 10.1007/s11126-023-10057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
The COVID-19 pandemic and associated public health measures altered patterns of help-seeking for mental health, with increases in emergency department utilisation reported. We examined the association between COVID-19 restrictions and adult emergency department (ED) mental health presentations in Victoria, Australia, through secondary analysis of data from 39 public EDs across the state. Participants were all patients (18+ years) presenting between 1 January 2018 and 31 October 2020 with mental health or intentional self-harm. The main outcome was number of presentations for each mental health condition, by patient age, socioeconomic status (SES), location, and ED triage category. We used a Poisson regression model to compare predicted monthly ED presentations based on trends from 2018, 2019 and 2020 (up to 31 March), with observed presentations during the initial months of the COVID-19 pandemic (1 April to 31 October 2020). There was an average of 4,967 adult mental health presentations per month pre-COVID-19 (1 January-31 March 2020) and 5,054 per month during the COVID-19 period (1 April-31 October 2020). Compared to predicted incidence, eating disorder presentations increased 24.0% in the COVID-19 period, primarily among higher SES females aged 18-24 years. Developmental/behavioural disorder presentations decreased by 19.7% for all age groups. Pandemic restrictions were associated with overall increases in monthly adult ED presentations for mental health, with some disorders increasing and others decreasing. Accessibility of acute mental health services needs to be addressed to meet changing demand and ensure services are responsive to changes in presentations resulting from future public health challenges.
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Affiliation(s)
- Jackson Newberry-Dupé
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia.
| | - Wanyu Chu
- Centre for Health Services, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Simon Craig
- Paediatric Emergency Department, Monash Medical Centre, Emergency Service, Monash Health, Clayton, VIC, Australia
- Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Emergency Research Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Rohan Borschmann
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
| | - Gerard O'Reilly
- Emergency and Trauma Centre, The Alfred, Melbourne, Australia
- National Trauma Research Institute, The Alfred, Melbourne, Australia
- School of Public Health and Preventive Medicine, Alfred Campus, Monash University, Melbourne, Australia
| | - Paul Yates
- Department of Geriatric Medicine, Continuing Care Clinical Service Unit, Austin Health, Heidelberg, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Glenn Melvin
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Kylie King
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Harriet Hiscock
- Centre for Health Services, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Tullberg M, Toma AK, Yamada S, Laurell K, Miyajima M, Watkins LD, Wikkelsø C. Classification of Chronic Hydrocephalus in Adults: A Systematic Review and Analysis. World Neurosurg 2024; 183:113-122. [PMID: 38143036 DOI: 10.1016/j.wneu.2023.12.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Chronic hydrocephalus in adults (CHiA) includes all nonacute forms of hydrocephalus occurring in adulthood. It covers a spectrum of disorders. Some of these have relatively agreed on definitions, while others are less well characterized. The existing medical classification systems lack adequate structure and are neither clinically oriented nor easy to use, which severely hampers research and clinical care efforts. METHODS A systematic literature review and data analysis were performed, focusing on the terms "adult hydrocephalus" and "classification," using the PubMed, Scopus, and Cochrane Library databases. Data on terminology, definitions, patient demographics, symptom duration, and clinical presentations were extracted, analyzed, and compiled. A Delphi process was followed to define CHiA disorders. RESULTS A total of 33 studies collectively used 48 terms to define various CHiA disorders. Different terms were used to describe similar conditions. CHiA disorders were found to be clustered into 7 distinctive clinical entities based on the clinical characteristics. CONCLUSIONS An evidence-based new clinical classification for CHiA is suggested. Our review identified gaps in knowledge and areas for further research.
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Affiliation(s)
- Mats Tullberg
- Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Ahmed K Toma
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Shigeki Yamada
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Katarina Laurell
- Department of Biomedical and Clinical Sciences, Neurobiology, Linköping University, Linköping, Sweden
| | - Masakazu Miyajima
- Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Centre, Tokyo, Japan
| | - Laurence D Watkins
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Carsten Wikkelsø
- Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Braga J, Grine FE. New craniodental fossils of Paranthropus robustus from Kromdraai, South Africa (2014-2017 excavations). J Hum Evol 2024; 188:103481. [PMID: 38382132 DOI: 10.1016/j.jhevol.2023.103481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 02/23/2024]
Abstract
Since the initial discovery of Paranthropus robustus at the site of Kromdraai in 1938, the hypodigm of this species has been expanded by subsequent work at the localities of Swartkrans and Drimolen, with a few fossils also known from Cooper's D, Gondolin and Sterkfontein Member 5. Beginning in 2014, systematic excavations at Kromdraai uncovered a large and previously unknown fossiliferous area, shedding light on Units O and P in the earliest part of the site's stratigraphic sequence. The aim of this paper is to provide detailed descriptions and illustrations of 30 P. robustus craniodental specimens recovered between 2014 and 2017 within the Unit P deposits at Kromdraai. This new sample predates all prior conspecific specimens found at this site (including the holotype of P. robustus from Kromdraai, TM 1517). Its basic dental morphology dimensions and cranial features are compared in a preliminary analysis with other P. robustus samples. The P. robustus sample from Kromdraai Unit P documents previously unknown portions of the P. robustus juvenile cranium. The new dental and cranial remains aid in the exploration of potential morphological distinctions between site-specific P. robustus samples and are compared favorably in size and morphology with the small P. robustus specimens from Drimolen (e.g., DNH 7). These findings do not support the hypothesis that the specimens from Drimolen belong to a different taxonomic group. Instead, they reinforce the presence of a significant degree of sexual dimorphism within P. robustus. The Kromdraai Unit P specimens also contribute to the biodemographic profile of P. robustus. The notable prevalence of infants (i.e., juvenile individuals before the emergence of their first permanent molars) mirrors the natural mortality profiles observed in wild chimpanzees. This suggests a closer resemblance in the processes of accumulation in Kromdraai Unit P and Drimolen than at Swartkrans.
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Affiliation(s)
- José Braga
- Centre for Anthropobiology & Genomics of Toulouse, CNRS UMR 5288, Université de Toulouse, Université Paul Sabatier, 37 allées Jules Guesde, Toulouse, France; Evolutionary Studies Institute, University of the Witwatersrand, Johannesburg, South Africa.
| | - Frederick E Grine
- Department of Anthropology, Stony Brook University, Stony Brook, NY 11794, USA; Department of Anatomical Sciences, Stony Brook University, Stony Brook, NY 11794, USA
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Atri S, Debiche A, Sebai A, Eya A, Haddad A, Kacem M. A case report of intestinal acute intussusception secondary to a lipoma: Imagery has a great value. Int J Surg Case Rep 2024; 116:109395. [PMID: 38432164 PMCID: PMC10943927 DOI: 10.1016/j.ijscr.2024.109395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Acute intestinal intussusception (AII) in adults, unlike in children, is a rare manifestation that is frequently secondary to malignant or benign tumors and intestinal intussusception on a lipoma is more exceptional. CASE PRESENTATION We present a rare case of AII caused by a lipoma in a previously healthy 44-year-old man. He experienced severe right lower quadrant pain and constipation. An abdominal CT scan revealed ileocecal intussusception, displaying the classic "sandwich" and "cocarde" images. Additionally, a Caecal lipoma was identified. The patient underwent midline laparotomy, revealing significant small bowel distention upstream of the ileocolic intussusception. Subsequently, a right hemicolectomy with ileocolostomy was performed. Pathological examination confirmed colonic ischemic necrosis attributed to AII originating from a submucosal caecal lipoma. CLINICAL DISCUSSION AII is a rare cause of abdominal pain and accounts for 1 to 5 % of adult intestinal obstructions. In adults, an organic cause is found in 70 to 90 % of cases, often secondary to an endoluminal lesion of malignant nature. Pure colonic intussusception on a lipoma is exceptional. CT scan, can show characteristic images and confirms the fatty nature of the lipoma. Surgical intervention is necessary as treatment for intussusception and anatomopathological examination is required for diagnostic confirmation. CONCLUSION Intestinal intussusception caused by an intestinal lipoma is rare. Imaging, mainly ultrasound and CT scan, plays a crucial role in providing a positive and etiological diagnosis of the condition by showing characteristic images. Treatment is always surgical, and there is no place for reduction under radiological control.
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Affiliation(s)
- Souhaib Atri
- Hopital la Rabta, Tunis, Tunisia; University of Tunis El Manar Faculty of Medicine of Tunis
| | - Ahmed Debiche
- Hopital la Rabta, Tunis, Tunisia; University of Tunis El Manar Faculty of Medicine of Tunis.
| | - Amine Sebai
- Hopital la Rabta, Tunis, Tunisia; University of Tunis El Manar Faculty of Medicine of Tunis
| | - Azouz Eya
- Hopital la Rabta, Tunis, Tunisia; University of Tunis El Manar Faculty of Medicine of Tunis
| | - Anis Haddad
- Hopital la Rabta, Tunis, Tunisia; University of Tunis El Manar Faculty of Medicine of Tunis
| | - Montassar Kacem
- Hopital la Rabta, Tunis, Tunisia; University of Tunis El Manar Faculty of Medicine of Tunis
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Olatunji BO, Kim J. Examining reciprocal relations between disgust proneness and OCD symptoms: A four-wave longitudinal study. J Behav Ther Exp Psychiatry 2024; 82:101907. [PMID: 37690887 DOI: 10.1016/j.jbtep.2023.101907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 06/26/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Although disgust proneness has been implicated in the development of obsessive-compulsive disorder (OCD), available studies have largely employed cross-sectional designs and the prospective and potentially reciprocal association between disgust proneness and OCD symptoms remains unclear. The present study employs cross lagged panel analysis to examine the prospective and reciprocal association between disgust proneness and OCD symptoms. METHOD A community sample of adults (N = 307) completed symptom measures of disgust proneness and OCD symptoms at four time points with 1 month intervals. RESULTS The results showed that the cross-lagged paths from disgust proneness to OCD symptoms were significant (average β = 0.07, p's < 0.001) when controlling for depression. However, the paths from total OCD symptoms to disgust proneness were not significant. In contrast, the cross-lagged paths from disgust proneness to washing OCD symptoms were not significant. However, the paths from washing OCD symptoms to disgust proneness were significant (average β = 0.05, p's < 0.01) when controlling for depression. LIMITATIONS The study is limited is limited by exclusive reliance on self-report in a nonclinical sample. CONCLUSIONS The findings offer preliminary evidence suggesting that disgust proneness may be a cause and consequence of OCD depending on the nature of the symptoms. Thus, the longitudinal relation between disgust proneness and OCD may be transactional where one influences the effect of the other.
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Affiliation(s)
| | - Jingu Kim
- Busan National University of Education, South Korea; Radboud University, the Netherlands.
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Morimoto N, Urayama KY, Tanaka A, Ai M. Relationship between dietary fiber to carbohydrate ratio and mortality risk in US adults: NHANES 2007-2018. Nutr Metab Cardiovasc Dis 2024; 34:661-671. [PMID: 38161116 DOI: 10.1016/j.numecd.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/04/2023] [Accepted: 11/06/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIMS The evidence is inconsistent regarding associations between relative proportions of macronutrient intake and disease risk, potentially due to limitations in accounting for differential effects of simple sugars and dietary fiber, grouped as "carbohydrates." We examined the association between the ratio of dietary fiber to carbohydrate intake (FC-R) measure, the relative proportion of macronutrients, and mortality risk in a nationally representative sample of U.S. adults. METHODS AND RESULTS We performed a retrospective cohort study, using data from the National Health and Nutrition Examination Survey in 2007-2018 and linked mortality data among 15,789 adults aged ≥40 years. We categorized participants into three groups by tertile cutpoints of FC-R, and by percent calories from carbohydrate (<45 %, 45-65 %, and >65 %). Cox proportional hazards regression was performed to estimate hazard ratios (HR) for all-cause mortality with 95 % confidence intervals (95 % CI), adjusting for demographic, health history, and lifestyle factors. During a median follow-up of 6.5 years, 2044 deaths were observed. Compared to the low FC-R group, higher FC-R groups showed a reduction in mortality risk after adjusting for potential confounders (high vs low: HR = 0.71, 95 % CI = 0.62-0.83). The association persisted in those consuming 45-65 % and >65 % of calories from carbohydrate, while the association was attenuated in those with <45 % of calories from carbohydrate. Percent calories from carbohydrate showed no association with mortality risk. CONCLUSION Higher FC-R was associated with lower all-cause mortality risk in adults with moderate to high levels of percent calories from carbohydrate. Mechanisms of the association warrant further investigation.
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Affiliation(s)
- Nobuhisa Morimoto
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
| | - Kevin Y Urayama
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan; Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Tanaka
- Nutrition Clinic, Kagawa Nutrition University, Tokyo, Japan
| | - Masumi Ai
- Department of Insured Medical Care Management, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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O'Regan PW, Dewhurst C, O'Mahony AT, O'Regan C, O'Leary V, O'Connor G, Ryan D, Maher MM, Young R. Split-bolus single-phase versus single-bolus split-phase CT acquisition protocols for staging in patients with testicular cancer: A retrospective study. Radiography (Lond) 2024; 30:628-633. [PMID: 38330895 DOI: 10.1016/j.radi.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/17/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Computed tomography (CT) imaging has become indispensable in the management of medical oncology patients. Risks associated with high cumulative effective dose (CED) are relevant in testicular cancer patients. Split-bolus protocols, whereby the contrast medium injection is divided into two, followed by combining the required phase images in a single scan acquisition has been shown to provide images of comparable image quality and less radiation dose compared to single-bolus split-phase CT for various indications. We retrospectively evaluated the performance of split-bolus and single-bolus protocols in patients having follow-up CT imaging for testicular cancer surveillance. METHODS 45 patients with testicular cancer undergoing surveillance CT imaging of the thorax, abdomen, and pelvis who underwent split-bolus and single-bolus protocols were included. Quantitative image quality analysis was conducted by placing region of interests in pre-defined anatomical sub-structures within the abdominal cavity. The signal-to-noise ratio (SNR) and radiation dose in the form of dose length product (DLP) and effective dose (ED) were recorded. RESULTS The DLP and ED for the single-bolus, split-phase acquisition was 506 ± 89 mGy cm and 7.59 ± 1.3 mSv, respectively. For the split-bolus, single-phase acquisition, 397 ± 94 mGy∗cm and 5.95 ± 1.4 mSv, respectively (p < 0.000). This represented a 21.5 % reduction in radiation dose exposure. The SNR for liver, muscle and fat for the single-bolus were 7.4, 4.7 and 8, respectively, compared to 5.5, 3.8 and 7.4 in the split-bolus protocol (p < 0.001). CONCLUSION In a testicular cancer patient cohort undergoing surveillance CT imaging, utilization of a split-bolus single-phase acquisition CT protocol enabled a significant reduction in radiation dose whilst maintaining subjective diagnostic acceptability. IMPLICATIONS FOR PRACTICE Use of split-bolus, single-phase acquisition has the potential to reduce CED in surveillance of testicular cancer patients.
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Affiliation(s)
- P W O'Regan
- Department of Radiology, School of Medicine, University College Cork, Ireland.
| | - C Dewhurst
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - A T O'Mahony
- Department of Radiology, Cork University Hospital/Mercy University Hospital, Cork, Ireland.
| | - C O'Regan
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - V O'Leary
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - G O'Connor
- Department of Radiology, Mercy University Hospital, Cork, Ireland.
| | - D Ryan
- Department of Radiology, School of Medicine, University College Cork, Ireland.
| | - M M Maher
- Department of Radiology, School of Medicine, University College Cork, Ireland.
| | - R Young
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College, Cork, Ireland.
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Licchetta L, Bruschi G, Stipa C, Belotti LMB, Ferri L, Mostacci B, Vignatelli L, Minardi R, Di Vito L, Muccioli L, Boni A, Tinuper P, Bisulli F. Tuberous sclerosis complex in adulthood: focus on epilepsy prognosis. Epilepsy Behav 2024; 153:109688. [PMID: 38428171 DOI: 10.1016/j.yebeh.2024.109688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/18/2024] [Accepted: 02/05/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Typically diagnosed in early childhood or adolescence, TSC is a chronic, multisystemic disorder with age-dependent manifestations posing a challenge for transition and for specific surveillance throughout the lifetime. Data on the clinical features and severity of TSC in adults and on the prognosis of epilepsy are scarce. We analyzed the clinical and genetic features of a cohort of adult patients with TSC, to identify the prognostic predictors of seizure remission after a long follow-up. METHOD We conducted a retrospective analysis of patients diagnosed with TSC according to the updated international diagnostic criteria. Pearson's chi-square or Fisher's exact test and Mann Whitney U test were used to compare variables among the Remission (R) and Non-Remission (NR) group. Univariate and multivariate logistic regression analyses were performed. RESULTS We selected 43 patients with TSC and neurological involvement in terms of epilepsy and/or brain lesions, attending the Epilepsy Center of our Institute: of them, 16 (37.2%) were transitioning from the pediatric care and 6 (13.9%) were referred by other specialists. Multiorgan involvement includes cutaneous (86.0%), nephrological (70.7%), hepatic (40.0%), ocular (34.3%), pneumological (28.6%) and cardiac (26.3%) manifestations. Thirty-nine patients (90.7 %) had epilepsy. The mean age at seizure onset was 4 ± 7.3 years: most patients (29, 76.3 %) presented with focal seizures or spasms by age 3 years; only 2 (5.3 %) had seizure onset in adulthood. Twenty-seven patients (69.2 %) experienced multiple seizure types overtime, 23 (59.0 %) had intellectual disability (ID). At last assessment, 14 (35.9 %) were seizure free (R group) and 25 (64.1 %) had drug-resistant seizures (NR group). At logistic regression univariate analysis, ID (OR 7.9, 95 % CI 1.8--34.7), multiple seizure types lifelong (OR 13.2, 95 % CI 2.6- 67.2), spasms/tonic seizures at presentation (OR 6.5, 95 % CI 1.2--35.2), a higher seizure frequency at onset (OR 5.4, 95 % CI 1.2--24.3), abnormal neurological examination (OR 9.8, 95 % CI 1.1--90.6) and pathogenic variants in TSC2 (OR 5.4, 95 % CI 1.2--24.5) were significantly associated with non-remission. In the multivariate analysis, both ID and multiple seizure types lifelong were confirmed as independent predictors of poor seizure outcome. CONCLUSIONS In our cohort of adult patients with TSC, epilepsy remains one of the main neurological challenges with only 5.3% of cases manifesting in adulthood. Approximately 64% of these patients failed to achieve seizure remission. ID and multiple seizure types were the main predictors of poor outcome. Nephrological manifestations require continuous specific follow-up in adults.
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Affiliation(s)
- Laura Licchetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
| | - Giulia Bruschi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy; Unit of Neurology and Unit of Clinical Neurophysiology, Department of Neuroscience, University of Padua, Padua, Italy
| | - Carlotta Stipa
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
| | - Laura Maria Beatrice Belotti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
| | - Lorenzo Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna Italy.
| | - Barbara Mostacci
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
| | - Luca Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
| | - Raffaella Minardi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
| | - Lidia Di Vito
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
| | - Lorenzo Muccioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna Italy
| | - Antonella Boni
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria Dell'età Pediatrica, via Altura 3, Bologna 40138, Italy
| | - Paolo Tinuper
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna Italy
| | - Francesca Bisulli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna Italy
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Than V, Doroud N, O'Brien L. Mental health service utilization and help seeking behaviours of adult Cambodians living in Western countries: A systematic scoping review. Int J Soc Psychiatry 2024:207640241230848. [PMID: 38420918 DOI: 10.1177/00207640241230848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Health disparity and under-utilization of health services is prevalent among Asian refugees and migrants in Western countries and can profoundly impact health outcomes. Cambodians who survived extreme physical and emotional trauma during the genocides enacted by the Khmer Rouge regime in the 1970's are particularly vulnerable to poor mental health outcomes decades later. Understanding the experiences of help-seeking and service use by displaced Cambodians in Western countries may help to design more effective and culturally safe healthcare services. AIMS To identify characteristics or factors associated with help seeking behaviours and service utilization of displaced Cambodians with mental health issues living in Western countries. METHODS This review followed the Arksey & O'Malley methodological framework for scoping reviews. Articles for review were identified through searches of nine electronic databases and manual searches. Relevant articles were selected, and data was extracted and synthesized into key themes. RESULTS This review included 15 articles. Most of the studies were conducted in the USA (n = 13) with one each conducted in Canada and New Zealand. Seven studies used qualitative interviews, five used a cross-sectional survey approach, two used a mixed-methods approach and one was a narrative review and case series. Key findings highlighted the impact of Cambodian cultural beliefs about mental health (guilt, shame and help-seeking stigma) on service utilization and the disconnect between Western models of service provision and preferred Cambodian ways of receiving support. CONCLUSION Mental health services in Western countries are likely to be under-utilized by Cambodians due to a mismatch between health beliefs and Western models of care. Further investigation of the association between health beliefs and barriers to service utilization among adult Cambodian refugees is warranted.
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Affiliation(s)
- Vannaral Than
- Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nastaran Doroud
- Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Lisa O'Brien
- Swinburne University of Technology, Hawthorn, VIC, Australia
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Norouziasl R, Zeraattalab-Motlagh S, Jayedi A, Shab-Bidar S. Efficacy and safety of n-3 fatty acids supplementation on depression: a systematic review and dose-response meta-analysis of randomised controlled trials. Br J Nutr 2024; 131:658-671. [PMID: 37726108 DOI: 10.1017/s0007114523002052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
We aimed to investigate the effectiveness of n-3 fatty acids supplementation on the risk of developing depression, depressive symptoms and remission of depression. We searched PubMed, Scopus and Web of Science from inception to December 2022 to find randomised trials of n-3 fatty acids supplementation in adults. We conducted random-effects meta-analyses to estimate standardised mean differences (SMD) and 95 % CI for continuous outcomes and risk difference and 95 % CI for binary outcomes. A total of sixty-seven trials were included. Each 1 g/d n-3 fatty acids supplementation significantly improved depressive symptoms in adults with and without depression (moderate-certainty evidence), with a larger improvement in patients with existing depression. Dose-response analyses indicated a U-shaped effect in patients with existing depression, with the greatest improvement at 1·5 g/d. The analysis showed that n-3 fatty acid supplementation significantly increased depression remission by 19 more per 100 in patients with depression (low-certainty evidence). Supplementation with n-3 fatty acids did not reduce the risk of developing depression among the general population, but it did improve the severity of depression among patients with existing depression.
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Affiliation(s)
- Reyhane Norouziasl
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Ribas Ball M, de Miguel Negro M, Galán Menéndez P, Dos Subirà L, Castro Alba MA, Martí Aguasca G. Anesthetic management of pulmonary artery banding in adult patient with single ventricle and uncorrected transposition of the great arteries. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00052-0. [PMID: 38428677 DOI: 10.1016/j.redare.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Pulmonary artery banding (PAB) is a procedure mainly performed during the neonatal period as an initial stage to definitive palliative reconstruction, a scenario in which the criteria for banding adjustment are well defined. However, the indication for BAP in the adult is extraordinarily rare, even more in patients with single ventricle and unrepaired transposition of the great arteries (TGA), and there are no established criteria for banding adjustment. Due to the small number of these procedures, there is limited experience in their anesthetic management and complications. We describe a case of a 29-year-old patient diagnosed with a cyanotic congenital heart disease of double-inlet left ventricle with TGA and unrepaired mitral stenosis, who underwent to a hybrid procedure of PAB and enlargement of the communication between the two atria.
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Affiliation(s)
- M Ribas Ball
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M de Miguel Negro
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - P Galán Menéndez
- Servicio de Anestesiología y Reanimación, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Dos Subirà
- Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M A Castro Alba
- Servicio de Cirugía Cardiovascular, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Martí Aguasca
- Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Wang M, Deng Y, Liu Y, Suo T, Guo B, Eickhoff SB, Xu J, Rao H. The common and distinct brain basis associated with adult and adolescent risk-taking behavior: Evidence from the neuroimaging meta-analysis. Neurosci Biobehav Rev 2024:105607. [PMID: 38428473 DOI: 10.1016/j.neubiorev.2024.105607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
Risk-taking is a common, complex, and multidimensional behavior construct that has significant implications for human health and well-being. Previous research has identified the neural mechanisms underlying risk-taking behavior in both adolescents and adults, yet the differences between adolescents' and adults' risk-taking in the brain remain elusive. This study firstly employs a comprehensive meta-analysis approach that includes 73 adult and 20 adolescent whole-brain experiments, incorporating observations from 1986 adults and 789 adolescents obtained from online databases, including Web of Science, PubMed, ScienceDirect, Google Scholar, EBSCO PsycINFO, Scopus, Medline and PsycARTICLES. It then combines functional decoding methods to identify common and distinct brain regions and corresponding psychological processes associated with risk-taking behavior in these two cohorts. The results indicated that the neural bases underlying risk-taking behavior in both age groups are situated within the cognitive control, reward, and sensory networks. Subsequent contrast analysis revealed that adolescents and adults risk-taking engaged frontal pole within the fronto-parietal control network (FPN), but the former recruited more ventrolateral area and the latter recruited more dorsolateral area. Moreover, adolescents' risk-taking evoked brain area activity within the ventral attention network (VAN) and the default mode network (DMN) compared with adults, consistent with the functional decoding analyses. These findings provide new insights into the similarities and disparities of risk-taking neural substrates underlying different age cohorts, supporting future neuroimaging research on the dynamic changes of risk-taking.
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Affiliation(s)
- Mengmeng Wang
- Center for Magnetic Resonance Imaging Research & Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai, China; Business School, NingboTech University, Ningbo, China
| | - Yao Deng
- Center for Magnetic Resonance Imaging Research & Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai, China; Beijing Normal University, China
| | - Yingying Liu
- Center for Magnetic Resonance Imaging Research & Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai, China
| | | | - Bowen Guo
- Center for Magnetic Resonance Imaging Research & Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai, China
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Jing Xu
- Center for Magnetic Resonance Imaging Research & Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai, China.
| | - Hengyi Rao
- Center for Magnetic Resonance Imaging Research & Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai, China; Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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Verma R, Verma J, Gupta N. Multilocular cystic nephroma in an adult: a diagnostic quandary. CEN Case Rep 2024:10.1007/s13730-024-00852-8. [PMID: 38416370 DOI: 10.1007/s13730-024-00852-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
Multilocular cystic nephroma (MLCN) is an unusual, benign slow-growing renal cystic neoplasm which mimics other cystic renal lesions and has such clinical, radiological, and morphological features that causes diagnostic dilemma. MLCN lies in the spectrum of mixed epithelial and stromal tumor (MEST) family of kidney. According to World Health Organization (WHO 2016 classification), MEST encompasses spectrum of tumors ranging from predominantly cystic tumors, adult cystic nephroma (ACN) to tumors that are variably solid (MEST), thus creating diagnostic dilemma. Moreover, it has several benign and malignant differentials due to its several overlapping histomorphological features which when not cautiously dealt with may result in misdiagnosing it as malignant lesion. We hereby present a case of a woman in late twenties who presented with left flank swelling and pain since 6 months which was misdiagnosed as renal cell carcinoma on radiology which turned out to be ACN on histology and further verified on immunohistochemistry.
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Affiliation(s)
- Ritu Verma
- Department of Pathology, SGPGIMS, C-Block, Lucknow, UP, India
| | - Jyoti Verma
- Department of Pathology, SGPGIMS, C-Block, Lucknow, UP, India.
- Department of Pathology, AIIMS, Mangalagiri, AP, India.
| | - Neelima Gupta
- Department of Pathology, SGPGIMS, C-Block, Lucknow, UP, India
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Freeman NLB, Muthukkumar R, Weinstock RS, Wickerhauser MV, Kahkoska AR. Use of machine learning to identify characteristics associated with severe hypoglycemia in older adults with type 1 diabetes: a post-hoc analysis of a case-control study. BMJ Open Diabetes Res Care 2024; 12:e003748. [PMID: 38413176 PMCID: PMC10900355 DOI: 10.1136/bmjdrc-2023-003748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Severe hypoglycemia (SH) in older adults (OAs) with type 1 diabetes is associated with profound morbidity and mortality, yet its etiology can be complex and multifactorial. Enhanced tools to identify OAs who are at high risk for SH are needed. This study used machine learning to identify characteristics that distinguish those with and without recent SH, selecting from a range of demographic and clinical, behavioral and lifestyle, and neurocognitive characteristics, along with continuous glucose monitoring (CGM) measures. RESEARCH DESIGN AND METHODS Data from a case-control study involving OAs recruited from the T1D Exchange Clinical Network were analyzed. The random forest machine learning algorithm was used to elucidate the characteristics associated with case versus control status and their relative importance. Models with successively rich characteristic sets were examined to systematically incorporate each domain of possible risk characteristics. RESULTS Data from 191 OAs with type 1 diabetes (47.1% female, 92.1% non-Hispanic white) were analyzed. Across models, hypoglycemia unawareness was the top characteristic associated with SH history. For the model with the richest input data, the most important characteristics, in descending order, were hypoglycemia unawareness, hypoglycemia fear, coefficient of variation from CGM, % time blood glucose below 70 mg/dL, and trail making test B score. CONCLUSIONS Machine learning may augment risk stratification for OAs by identifying key characteristics associated with SH. Prospective studies are needed to identify the predictive performance of these risk characteristics.
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Affiliation(s)
- Nikki L B Freeman
- Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Rashmi Muthukkumar
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ruth S Weinstock
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
| | - M Victor Wickerhauser
- Department of Mathematics, Washington University in St Louis, St Louis, Missouri, USA
| | - Anna R Kahkoska
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Sasaki S, Shimizu S, Nakaya I, Miyaoka Y, Koizumi M, Nishiwaki H, Sofue T, Ishimoto T, Kurita N, Wada T. Preference for anti-phospholipase A2 receptor antibody assay in patients with suspected membranous nephropathy: a survey study on medical practice after publication of Japanese Guidelines for Nephrotic Syndrome 2020. Clin Exp Nephrol 2024:10.1007/s10157-024-02462-1. [PMID: 38402500 DOI: 10.1007/s10157-024-02462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND International practice guidelines advocate for the use of anti-phospholipase A2 receptor (PLA2R) antibody testing to diagnose primary membranous nephropathy (pMN). This study aimed to clarify the current status of anti-PLA2R antibody testing in the diagnosis of pMN in Japan and to scrutinize the factors associated with the implementation of this antibody test. METHODS Utilizing a web-based questionnaire for nephrologists, responses were collected from 306 facilities and 427 nephrologists between November 2021 and December 2021. Preference for anti-PLA2R antibody testing was also investigated. Factors related to the experience of quantifying anti-PLA2R antibodies were estimated by generalized estimating equations using a robust analysis of variance with clusters of facilities of affiliation. RESULTS Of the 427 respondents, 140 (32.8%) had previous measurement experience at their current workplace and 165 (38.6%) had previous measurement experience overall. In pMN-suspected cases without contraindications to renal biopsy, 147 (34.4%) of the respondents opted to request anti-PLA2R antibody testing. The respondents' experience with anti-PLA2R antibody quantification at their current place of work was generally higher in university hospitals and increased with the annual number of kidney biopsies and the number of years since graduation. CONCLUSION The results of this study suggest that a significant proportion of nephrologists in Japan have no experience in performing anti-PLA2R antibody assays, and that the assays may be hampered by the limited capabilities of the current workplace and the financial burden on facilities and patients.
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Affiliation(s)
- Sho Sasaki
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
| | - Sayaka Shimizu
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
- Patient Driven Academic League (PeDAL), Tokyo, Japan.
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan.
| | - Izaya Nakaya
- Department of Nephrology and Rheumatology, Iwate Prefectural Central Hospital, Iwate, Japan
| | | | - Masahiro Koizumi
- Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroki Nishiwaki
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan
- Showa University Research Administration Center (SURAC), Showa University, Tokyo, Japan
| | - Tadashi Sofue
- Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan
| | - Takuji Ishimoto
- Department of Nephrology and Rheumatology, Aichi Medical University, Aichi, Japan
| | - Noriaki Kurita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan
| | - Takehiko Wada
- Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Kanagawa, Japan
- Department of Nephrology, Toranomon Hospital, Tokyo, Japan
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Brandolino A, deRoon-Cassini TA, Biesboer EA, Tomas CW, Woolfolk M, Wakinekona NA, Subramanian M, Cheruvalath H, Schroeder ME, Trevino CM. Improved follow-up care for gun violence survivors in the Trauma Quality of Life Clinic. Trauma Surg Acute Care Open 2024; 9:e001199. [PMID: 38390473 PMCID: PMC10882323 DOI: 10.1136/tsaco-2023-001199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/17/2023] [Indexed: 02/24/2024] Open
Abstract
Background Outpatient follow-up represents a crucial opportunity to re-engage with gun violence survivors (GVS) and to facilitate positive health outcomes. Current outpatient models for firearm-related injuries and trauma care are inconsistent and unstandardized across trauma centers. This project describes the patient population served by the multidisciplinary Trauma Quality of Life (TQoL) Clinic for GVS. Also of primary interest was the outpatient follow-up services used by patients prior to their clinic appointment. Subsequent referrals placed during Clinic, as well as rate of attendance, was a secondary aim. Methods This was a descriptive retrospective analysis of a quality improvement project of the TQoL Clinic. Data were extracted from the electronic medical record and were supplemented with information from the trauma registry and the hospital-based violence intervention program database. Descriptive statistics characterized the patient population served. A Χ2 analysis was used to compare no-show rates for the TQoL Clinic against two historical cohorts of trauma clinic attendees. Results Most attendees were young (M=32.0, SD=1.8, range=15-88 years), Black (80.1%), and male (82.0%). Of the 306 total TQoL Clinic attendees, 82.3% attended their initial scheduled appointment. Most non-attendee patients rescheduled their appointments (92.1%), and 89.5% attended the rescheduled appointment. TQoL Clinic demonstrated a significantly lower no-show rate than the traditional trauma clinic model, including after the implementation of the hospital's inpatient violence intervention program (χ2(2)=75.52, p<0.001). Conclusion The TQoL Clinic has demonstrated improved outpatient follow-up to address the comprehensive needs of GVS. Trauma centers with high gunshot wound volume should consider the implementation of the multidisciplinary TQoL Clinic model to increase access to care and to continue partnership with violence intervention programs to address health outcomes in those most at risk of future morbidity and mortality. Level of evidence Therapeutic/care management, level III.
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Affiliation(s)
- Amber Brandolino
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Terri A deRoon-Cassini
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Elise A Biesboer
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Carissa W Tomas
- Comprehensive Injury Center, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Monet Woolfolk
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nalani A Wakinekona
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Maya Subramanian
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Heloise Cheruvalath
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mary E Schroeder
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Colleen M Trevino
- Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Dias C, Rodrigues IT, Gonçalves H, Duarte I. Communication strategies for adults in palliative care: the speech-language therapists' perspective. BMC Palliat Care 2024; 23:49. [PMID: 38383383 PMCID: PMC10880300 DOI: 10.1186/s12904-024-01382-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Communication disorders are a challenge that many patients in palliative care (PC) may encounter. This intervention area is emerging for the speech-language therapist (SLT), the professional who works in preventing, assessing, diagnosing, and treating human communication disorders. This study aims to identify and classify the communication strategies considered most important by SLTs for use in PC and evaluate whether there are any differences in perception regarding the importance of strategies between SLTs with and without PC experience. METHODS This cross-sectional quantitative study was conducted using a survey, which employed a well-structured, self-completion questionnaire previously validated by a panel of experts with over six years of PC experience. RESULTS The strategies rated as most important within each group were the following: (i) adjust the patient's position and minimise environmental noise; (ii) establish eye contact and adjust the pace of speech; (iii) adjust the language level and raise one topic at a time; (iv) use images of the patient's interests and their personal objects; (v) use orality and multimodal form; (vi) use simplified language and structured pauses; and (vii) use tables with images and books with pictures. CONCLUSIONS Verbal and non-verbal strategies were rated as highly important. There was no evidence of differences in perception in terms of importance between the SLTs with or without experience in PC, but more studies are needed to support this aspect. The patient's communication ability is one of the cornerstones of PC quality. Through their actions, speech-language professionals could empower the patient with strategies so that they can autonomously and self-determinedly express their experiences and most significant needs.
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Affiliation(s)
- Cátia Dias
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Inês Tello Rodrigues
- Centre for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, Leiria, Portugal
- Alcoitão School of Health Sciences (ESSAlcoitão), Alcabideche, Portugal
| | - Hernâni Gonçalves
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ivone Duarte
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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