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Polónia J, Marques Pereira R. Guidelines-based therapeutic strategies for controlling hypertension in non-controlled hypertensive patients followed by family physicians in primary health care in Portugal: the GPHT-PT study. Blood Press 2024; 33:2345887. [PMID: 38680045 DOI: 10.1080/08037051.2024.2345887] [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: 02/08/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE In a prospective open study, with intervention, conducted in Primary Health Care Units by General Practitioners (GPs) in Portugal, the effectiveness of a single pill of candesartan/amlodipine (ARB/amlodipine), as the only anti-hypertension (anti-HTN) medication, in adult patients with uncontrolled HTN (BP > 140/or > 90 mm Hg), either previously being treated with anti-HTN monotherapies (Group I), or combinations with hydrochlorothiazide (HCTZ) (Group II), or not receiving medication at all (Group III), was evaluated across 12-weeks after implementation of the new therapeutic measure. MATERIALS AND METHODS A total of 118 GPs recruited patients with uncontrolled HTN who met inclusion/exclusion criteria. Participants were assigned, according to severity, one of 3 (morning) fixed combination candesartan/amlodipine dosage (8/5 or 16/5 or 16/10 mg/day) and longitudinally evaluated in 3 visits (v0, v6 and v12 weeks). Office blood pressure was measured in each visit, and control of HTN was defined per guidelines (BP< 140/90 mmHg). RESULTS Of the 1234 patients approached, 752 (age 61 ± 10 years, 52% women) participated in the study and were assigned to groups according to previous treatment conditions. The 3 groups exhibited a statistically significant increased control of blood pressure after receiving the fixed combination candesartan/amlodipine dosage. The overall proportion of controlled HTN participants increased from 0,8% at v0 to 82% at v12. The mean arterial blood pressure values decreased from SBP= 159.0 (± 13.0) and DBP= 91.1 (± 9.6) at baseline to SBP= 132,1 (± 11.3) and DBP= 77,5 (± 8.8) at 12 weeks (p < 0.01). Results remained consistent when controlling for age and sex. CONCLUSION In patients with uncontrolled HTN, therapeutic measures in accordance with guidelines, with a fixed combination candesartan/amlodipine, allowed to overall achieve HTN control at 12 weeks in 82% of previously uncontrolled HTN patients, reinforcing the advantages of these strategies in primary clinical practice.
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Affiliation(s)
- Jorge Polónia
- RISE & Department of Medicine, Faculty of Medicine of Porto, Porto, Portugal
- Blood Pressure Unit & CV Risk, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Raul Marques Pereira
- School of Medicine, University of Minho, Braga, Portugal
- Association P5 Digital Medical Center (ACMP5), School of Medicine, University of Minho, Braga, Portugal
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Ito M, Sasaki A, Haga M, Iwatani A, Nishimura E, Arai H, Nagano N, Suga S, Araki S, Konishi A, Onouchi Y, Namba F. Association of hyaluronan and proteoglycan link protein 1 gene with the need of home oxygen therapy in premature Japanese infants with bronchopulmonary dysplasia. J Matern Fetal Neonatal Med 2024; 37:2332914. [PMID: 38522947 DOI: 10.1080/14767058.2024.2332914] [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: 12/28/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD) has a lasting effect on the respiratory function of infants, imposing chronic health burdens. BPD is influenced by various prenatal, postnatal, and genetic factors. This study explored the connection between BPD and home oxygen therapy (HOT), and then we examined the association between HOT and a specific single-nucleotide polymorphism (SNP) in the hyaluronan and proteoglycan link protein 1 (HAPLN1) gene among premature Japanese infants. MATERIALS AND METHODS Prenatal and postnatal data from 212 premature infants were collected and analyzed by four SNPs (rs975563, rs10942332, rs179851, and rs4703570) around HAPLN1 using the TaqMan polymerase chain reaction method. The clinical characteristics and genotype frequencies of HAPLN1 were assessed and compared between HOT and non-HOT groups. RESULTS Individuals with AA/AC genotypes in the rs4703570 SNP exhibited significantly higher HOT rates at discharge than those with CC homozygotes (odds ratio, 1.20, 95% confidence interval, 1.07-1.35, p = .038). A logistic regression analysis determined that CC homozygotes in the rs4703570 SNP did not show a statistically significant independent association with HOT at discharge. CONCLUSIONS Although our study did not reveal a correlation between HAPLN1 and the onset of BPD, we observed that individuals with CC homozygosity at the rs4703570 SNP exhibit a reduced risk of HOT.
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Affiliation(s)
- Masato Ito
- Department of Pediatrics, Akita University Graduate School of Medicine, Akita, Japan
| | - Ayumi Sasaki
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Mitsuhiro Haga
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Ayaka Iwatani
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Eri Nishimura
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Hirokazu Arai
- Department of Neonatology, Akita Red Cross Hospital, Akita, Japan
| | - Nobuhiko Nagano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Japan
| | - Shutaro Suga
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shunsuke Araki
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Asami Konishi
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
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Dariva M, Guedes M, Rigodon V, Kotanko P, Larkin JW, Ferlin B, Pecoits-Filho R, Barretti P, de Moraes TP. Transition between peritoneal dialysis modalities: Impact on blood pressure levels and drug prescription in a national multicentric cohort. Perit Dial Int 2024:8968608241240566. [PMID: 38596899 DOI: 10.1177/08968608241240566] [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] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Hypertension is a leading cause of kidney failure, affects most dialysis patients and associates with adverse outcomes. Hypertension can be difficult to control with dialysis modalities having differential effects on sodium and water removal. There are two main types of peritoneal dialysis (PD), automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD). It is unknown whether one is superior to the other in controlling blood pressure (BP). Therefore, the aim of our study was to analyse the impact of switching between these two PD modalities on BP levels in a nationally representative cohort. METHODS This was a cohort study of patients on PD from 122 dialysis centres in Brazil (BRAZPD II study). Clinical and laboratory data were collected monthly throughout the study duration. We selected all patients who remained on PD at least 6 months and 3 months on each modality at minimum. We compared the changes in mean systolic/diastolic blood pressures (SBP/DBP) before and after modality transition using a multilevel mixed-model where patients were at first level and their clinics at the second level. RESULTS We analysed data of 848 patients (814 starting on CAPD and 34 starting on APD). The SBP decreased by 4 (SD 22) mmHg when transitioning from CAPD to APD (p < 0.001) and increased by 4 (SD 21) mmHg when transitioning from APD to CAPD (p = 0.38); consistent findings were seen for DBP. There was no significant change in the number of antihypertensive drugs prescribed before and after transition. CONCLUSIONS Transition between PD modalities seems to directly impact on BP levels. Further studies are needed to confirm if switching to APD could be an effective treatment for uncontrolled hypertension among CAPD patients.
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Affiliation(s)
- Marcus Dariva
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| | - Murilo Guedes
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| | - Vladimir Rigodon
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
- Global Medical Office, Fresenius Medical Care, Waltham, MA, USA
| | - Peter Kotanko
- Renal Research Institute, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John W Larkin
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
- Global Medical Office, Fresenius Medical Care, Waltham, MA, USA
| | - Bruno Ferlin
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| | - Roberto Pecoits-Filho
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
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Fan L, Li W, Du R, Hu Y, Li W, Zhu W, Zhang L, Su Y. Apnea Testing Practice to Increase Baseline PaCO 2 and Frequency of Blood Gas Analyses. J Cardiothorac Vasc Anesth 2024; 38:1006-1010. [PMID: 38246819 DOI: 10.1053/j.jvca.2023.12.028] [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: 11/09/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE To study the influence of the initial partial pressure of carbon dioxide (PaCO2) and frequency of blood gas analyses on the positivity rate and safety of apnea testing (AT). DESIGN A prospective multicenter cohort study. SETTING Seven teaching hospitals. PARTICIPANTS A total of 55 patients who underwent AT. INTERVENTIONS Patients were divided into 2 groups according to their initial PaCO2-the experimental group (≥40 mmHg, 27 patients) and the control group (<40 mmHg, 28 patients). Blood gas analysis was performed at 3, 5, and 8 minutes, and vital signs were taken. AT results and complications were compared between the groups. RESULTS The initial PaCO2 of the experimental group was 42.8 ± 2.2 mmHg v 36.4 ± 2.9 mmHg in the controls. The AT positivity rate was 100%. The experimental group needed less time to reach the target PaCO2 than the control group (4.07 ± 1.27 minutes v 5.68 ± 2.06 minutes; p = 0.001). Twenty-six patients (96.3%) in the experimental group reached the target PaCO2 in 5 minutes v 17 in the control group (60.7%) (p = 0.001). Seven patients (12.7%) were unable to complete 8-minute disconnection due to hypotension. The experimental group had a slightly lower incidence of hypotension than the control group, but there was no statistical difference (7.4% v 17.9%, p = 0.245). CONCLUSION Increasing the baseline PaCO2 and doing more blood gas analyses can significantly shorten the time needed for AT and improve the AT positivity rate.
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Affiliation(s)
- Linlin Fan
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Wei Li
- Department of Neurology, Army Medical Center of PLA, Chongqing, China
| | - Ran Du
- Neurological Intensive Care Unit, First Affiliated Hospital of Anhui Medical University, Zhengzhou, China
| | - Yajuan Hu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wenchen Li
- First Hospital of Jilin University, Changchun, China
| | - Wenhao Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Zhang
- First People's Hospital of Yunnan Province, Kunming, Yunnan Province, China
| | - Yingying Su
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China.
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Nightscales R, Chen Z, Barnard S, Auvrez C, Tao G, Sivathamboo S, Bennett C, Rychkova M, D'Souza W, Berkovic SF, Nicolo J, O'Brien TJ, Perucca P, Scheffer IE, Kwan P. Applying the ILAE diagnostic criteria for Lennox-Gastaut syndrome in the real-world setting: A multicenter retrospective cohort study. Epilepsia Open 2024; 9:602-612. [PMID: 38135919 PMCID: PMC10984283 DOI: 10.1002/epi4.12894] [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: 07/11/2023] [Revised: 12/02/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE Lennox-Gastaut syndrome (LGS) is an archetypal developmental and epileptic encephalopathy, for which novel treatments are emerging. Diagnostic criteria for LGS have recently been defined by the International League Against Epilepsy (ILAE). We aimed to apply these criteria in a real-world setting. METHODS We applied ILAE diagnostic criteria to a cohort of patients diagnosed with LGS by epileptologists following inpatient video-EEG monitoring (VEM) at tertiary comprehensive epilepsy centers between 1995 and 2015. We also assessed mortality in this cohort. RESULTS Sixty patients diagnosed with LGS and had complete records available for review were identified. Among them, 29 (48%) patients met ILAE diagnostic criteria for LGS (ILAE-DC group). Thirty-one did not meet criteria (non-ILAE-DC) due to the absence of documented tonic seizures (n = 7), EEG features (n = 12), or both tonic seizures and EEG features (n = 10), intellectual disability (n = 1), or drug resistance (n = 1). The ILAE-DC group had a shorter duration of epilepsy at VEM than the non-ILAE-DC group (median = 12.0 years vs. 23.7 years, respectively; p = 0.015). The proportions of patients with multiple seizure types (100% vs. 96.7%), ≤2.5 Hz slow spike-and-wave EEG activity (100% vs. 90%), seizure-related injuries (27.6% vs. 25.8%), and mortality (standardized mortality ratio 4.60 vs. 5.12) were similar between the groups. SIGNIFICANCE Up to 52% of patients diagnosed with LGS following VEM may not meet recently accepted ILAE criteria for LGS diagnosis. This may reflect both the limitations of retrospective medical record review and a historical tendency of applying the LGS diagnosis to a broad spectrum of severe, early-onset drug-resistant epilepsies with drop attacks. The ILAE criteria allow the delineation of LGS based on distinct electroclinical features, potentiating accurate diagnosis, prognostication, and management formulation. Nonetheless, mortality outcomes between those who did and did not meet ILAE diagnostic criteria for LGS were similarly poor, and both groups suffered high rates of seizure-related injury. PLAIN LANGUAGE SUMMARY More than half of patients diagnosed with Lennox-Gastaut Syndrome (LGS) at three Australian epilepsy monitoring units between 1995 and 2015 did not meet the recently devised International League Against Epilepsy (ILAE) diagnostic criteria for LGS. Mortality was equally high in those who did and did not meet the ILAE diagnostic criteria, and seizure-related injury was common. The ILAE diagnostic criteria will guide accurate diagnosis, management, prognostication, and research in patients with LGS, however may be limited in their practical application to patients with a longer duration of epilepsy, or to those for whom detailed assessment is difficult.
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Affiliation(s)
- Russell Nightscales
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
| | - Zhibin Chen
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Clinical Epidemiology, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Department of Medicine (The Royal Melbourne Hospital)The University of MelbourneMelbourneVictoriaAustralia
| | - Sarah Barnard
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
| | - Clarissa Auvrez
- NorthWestern Mental HealthMelbourne HealthMelbourneVictoriaAustralia
| | - Gerard Tao
- Department of Medicine (The Royal Melbourne Hospital)The University of MelbourneMelbourneVictoriaAustralia
| | - Shobi Sivathamboo
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
- Department of Medicine (The Royal Melbourne Hospital)The University of MelbourneMelbourneVictoriaAustralia
- Department of NeurologyThe Royal Melbourne HospitalMelbourneVictoriaAustralia
| | - Caitlin Bennett
- Epilepsy Research Centre, Department of Medicine (Austin Health)The University of MelbourneHeidelbergVictoriaAustralia
| | - Maria Rychkova
- Department of Medicine (The Royal Melbourne Hospital)The University of MelbourneMelbourneVictoriaAustralia
| | - Wendyl D'Souza
- Department of Medicine, St. Vincent's HospitalThe University of MelbourneFitzroyVictoriaAustralia
| | - Samuel F. Berkovic
- Epilepsy Research Centre, Department of Medicine (Austin Health)The University of MelbourneHeidelbergVictoriaAustralia
- Bladin‐Berkovic Comprehensive Epilepsy Program, Department of NeurologyAustin HealthHeidelbergVictoriaAustralia
| | - John‐Paul Nicolo
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
- Department of NeurologyThe Royal Melbourne HospitalMelbourneVictoriaAustralia
| | - Terence J. O'Brien
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
- Department of Medicine (The Royal Melbourne Hospital)The University of MelbourneMelbourneVictoriaAustralia
- Department of NeurologyThe Royal Melbourne HospitalMelbourneVictoriaAustralia
| | - Piero Perucca
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
- Department of NeurologyThe Royal Melbourne HospitalMelbourneVictoriaAustralia
- Epilepsy Research Centre, Department of Medicine (Austin Health)The University of MelbourneHeidelbergVictoriaAustralia
- Bladin‐Berkovic Comprehensive Epilepsy Program, Department of NeurologyAustin HealthHeidelbergVictoriaAustralia
| | - Ingrid E. Scheffer
- Epilepsy Research Centre, Department of Medicine (Austin Health)The University of MelbourneHeidelbergVictoriaAustralia
- Bladin‐Berkovic Comprehensive Epilepsy Program, Department of NeurologyAustin HealthHeidelbergVictoriaAustralia
- Department of Paediatrics, The University of Melbourne, Royal Children's HospitalFlorey and Murdoch Children's Research InstitutesMelbourneVictoriaAustralia
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
- Department of Medicine (The Royal Melbourne Hospital)The University of MelbourneMelbourneVictoriaAustralia
- Department of NeurologyThe Royal Melbourne HospitalMelbourneVictoriaAustralia
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Hoffmann MA, von Eyben FE. To see clear is not enough; it is the action that counts. Transl Androl Urol 2024; 13:454-457. [PMID: 38590956 PMCID: PMC10999022 DOI: 10.21037/tau-23-582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/08/2024] [Indexed: 04/10/2024] Open
Affiliation(s)
- Manuela Andrea Hoffmann
- Department of Nuclear Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Institute for Preventive Medicine of the German Armed Forces, Andernach, Germany
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Wang C, Xu H, Liu G, Liu J, Yu H, Chen B, Zheng G, Shu M, Du L, Xu Z, Huang L, Li H, Shu S, Chen Y. A multicenter clinical epidemiology of pediatric pneumococcal meningitis in China: results from the Chinese Pediatric Bacterial Meningitis Surveillance (CPBMS) 2019-2020. Front Cell Infect Microbiol 2024; 14:1353433. [PMID: 38558854 PMCID: PMC10978625 DOI: 10.3389/fcimb.2024.1353433] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/05/2024] [Indexed: 04/04/2024] Open
Abstract
Objective To analyze the clinical epidemiological characteristics including clinical features, disease prognosis of pneumococcal meningitis (PM), and drug sensitivity of S. pneumoniae isolates in Chinese children. Methods A retrospective analysis was performed on the clinical, laboratory microbiological data of 160 hospitalized children less than 15 years of age with PM from January 2019 to December 2020 in 33 tertiary hospitals in China. Results A total of 160 PM patients were diagnosed, including 103 males and 57 females The onset age was 15 days to 15 years old, and the median age was 1 year and 3 months. There were 137 cases (85.6%) in the 3 months to <5 years age group, especially in the 3 months to <3 years age group (109 cases, 68.2%); S. pneumoniae was isolated from cerebrospinal fluid (CSF) culture in 95(35.6%), and 57(35.6%) in blood culture. The positive rates of S. pneumoniae detection by CSF metagenomic next-generation sequencing (mNGS)and antigen detection method were 40.2% (35/87) and 26.9% (21/78). Fifty-five cases (34.4%) had one or more predisposing factors of bacterial meningitis; and 113 cases (70.6%) had one or more extracranial infection diseases Fever (147, 91.9%) was the most common clinical symptom, followed by vomiting (61, 38.1%) and altered mental status (47,29.4%). Among 160 children with PM, the main intracranial imaging complications were subdural effusion and (or) empyema in 43 cases (26.9%), hydrocephalus in 24 cases (15.0%), cerebral abscess in 23 cases (14.4%), intracranial hemorrhage in 8 cases (5.0%), and other cerebrovascular diseases in 13 cases (8.1%) including encephalomalacia, cerebral infarction, and encephalatrophy. Subdural effusion and (or) empyema and hydrocephalus mainly occurred in children < 1 years old (90.7% (39/43) and 83.3% (20/24), respectively). 17 cases with PM (39.5%) had more than one intracranial imaging abnormality. S. pneumoniae isolates were completely sensitive to vancomycin (100.0%, 75/75), linezolid (100.0%,56/56), ertapenem (6/6); highly sensitive to levofloxacin (81.5%, 22/27), moxifloxacin (14/17), rifampicin (96.2%, 25/26), and chloramphenicol (91.3%, 21/23); moderately sensitive to cefotaxime (56.1%, 23/41), meropenem (51.1%, 23/45) and ceftriaxone (63.5, 33/52); less sensitive to penicillin (19.6%, 27/138) and clindamycin (1/19); completely resistant to erythromycin (100.0%, 31/31). The cure and improvement rate were 22.5% (36/160)and 66.3% (106/160), respectively. 18 cases (11.3%) had an adverse outcome, including 6 cases withdrawing treatment therapy, 5 cases unhealed, 5 cases died, and 2 recurrences. S. pneumoniae was completely susceptible to vancomycin (100.0%, 75/75), linezolid (100.0%, 56/56), and ertapenem (6/6); susceptible to cefotaxime, meropenem, and ceftriaxone in the order of 56.1% (23/41), 51.1% (23/45), and 63.5 (33/52); completely resistant to erythromycin (100.0%, 31/31). Conclusion Pediatric PM is more common in children aged 3 months to < 3 years old. Intracranial complications mostly occur in children < 1 year of age with fever being the most common clinical manifestations and subdural effusion and (or) empyema and hydrocephalus being the most common complications, respectively. CSF non-culture methods can facilitate improving the detection rate of pathogenic bacteria. More than 10% of PM children had adverse outcomes. S. pneumoniae strains are susceptible to vancomycin, linezolid, ertapenem, levofloxacin, moxifloxacin, rifampicin, and chloramphenicol.
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Affiliation(s)
- Caiyun Wang
- Department of Infectious Disease, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, Zhejiang, China
| | - Hongmei Xu
- Department of Infectious Disease, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Gang Liu
- Department of Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
- Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Liu
- Department of Infectious Disease, Hunan Children’s Hospital, Changsha, Hunan, China
| | - Hui Yu
- Department of Infectious Disease, The Children’s Hospital of Fudan University, Shanghai, China
| | - Biquan Chen
- Department of Infection, Anhui Province Children’s Hospital, Hefei, Anhui, China
| | - Guo Zheng
- Department of Neurology, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Min Shu
- Department of Pediatrics, West China Second University Hospital, Sichuan University/West China Women’s and Children’s Hospital, Chengdu, Sichuang, China
| | - Lijun Du
- Department of Neurology, Children’s Hospital of Shanxi, Taiyuan, Shanxi, China
| | - Zhiwei Xu
- Pediatric Inpatient Ward, The 2nd Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lisu Huang
- Department of Infectious Disease, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, Zhejiang, China
- Department of Infectious Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haibo Li
- Outpatient Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Sainan Shu
- Department of Pediatric Infection and Gastroenterology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yinghu Chen
- Department of Infectious Disease, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, Zhejiang, China
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Takahashi H, Takegami Y, Tokutake K, Takahashi Y, Kato M, Mabuchi M, Imagama S. Does Preoperative Manual Reduction (Omoto Technique) Affect Surgical Outcomes for Calcaneal Fractures? A Multicenter (TRON Group) Retrospective Study. J Foot Ankle Surg 2024:S1067-2516(24)00048-6. [PMID: 38438100 DOI: 10.1053/j.jfas.2024.02.003] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/28/2023] [Accepted: 02/17/2024] [Indexed: 03/06/2024]
Abstract
The Omoto technique is a well-known method that is commonly used for non-invasive manual repair of calcaneal fractures. However, there have been no detailed studies on its clinical outcomes in preoperative closed reduction for surgical cases. This multicenter retrospective study aimed to compare the clinical and radiographic outcomes of calcaneal fractures treated with and without the preoperative Omoto technique, assessing its effectiveness. We extracted 335 patients with calcaneal fracture who underwent surgery between 2015 and 2020 from our multicenter database, named TRON. We evaluated the clinical outcomes using the American Orthopedic Foot and Ankle Society (AOFAS) score, the Böhler angle (BA) for radiographic analysis, and noted any complications. We divided the patients into those managed with the Omoto technique (group O) and those managed without the Omoto technique (group N). Patients were matched by age, sex, and fracture type, resulting in 43 patients per group. The use of the Omoto technique at the time of injury significantly improved the Böhler angle (BA). Furthermore, there were no significant differences in AOFAS, postoperative complications, or BA values at the final follow-up. In conclusion, our study demonstrates that the Omoto technique, when used preoperatively for calcaneal fractures, does not negatively impact the outcomes of subsequent surgical treatments. For patients who prefer to avoid surgery, the Omoto technique can be an effective initial intervention. Additionally, our findings suggest that the Omoto technique may facilitate less invasive surgical options in certain cases.
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Affiliation(s)
- Hidetane Takahashi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiko Takegami
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Katsuhiro Tokutake
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Takahashi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mihoko Kato
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Marie Mabuchi
- Department of Orhopaedic Surgery, Japan Community Health care Organization Chukyo Hospital Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Lerner Y, Peled T, Yehushua M, Rotem R, Weiss A, Sela HY, Grisaru-Granovsky S, Rottenstreich M. Labor Induction in Women with Isolated Polyhydramnios at Term: A Multicenter Retrospective Cohort Analysis. J Clin Med 2024; 13:1416. [PMID: 38592253 PMCID: PMC10932132 DOI: 10.3390/jcm13051416] [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: 02/07/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 04/10/2024] Open
Abstract
Background: With the increasing popularity of elective induction after 39 + 0 weeks, the question of whether induction of labor (IOL) is safe in women with isolated polyhydramnios has become more relevant. We aimed to evaluate the pregnancy outcomes associated with IOL among women with and without isolated polyhydramnios. Methods: This was a multicenter retrospective cohort that included women who underwent induction of labor at term. The study compared women who underwent IOL due to isolated polyhydramnios to low-risk women who underwent elective IOL due to gestational age only. The main outcome measure was a composite adverse maternal outcome, while the secondary outcomes included maternal and neonatal adverse pregnancy outcomes. Results: During the study period, 1004 women underwent IOL at term and met inclusion and exclusion criteria; 162 had isolated polyhydramnios, and 842 had a normal amount of amniotic fluid. Women who had isolated polyhydramnios had higher rates of the composite adverse maternal outcome (28.7% vs. 20.4%, p = 0.02), prolonged hospital stay, perineal tear grade 3/4, postpartum hemorrhage, and neonatal hypoglycemia. Multivariate analyses revealed that among women with IOL, polyhydramnios was significantly associated with adverse composite maternal outcome [aOR 1.98 (1.27-3.10), p < 0.01]. Conclusions: IOL in women with isolated polyhydramnios at term was associated with worse perinatal outcomes compared to low-risk women who underwent elective IOL. Our findings suggest that the management of women with polyhydramnios cannot be extrapolated from studies of low-risk populations and that clinical decision-making should take into account the individual patient's risk factors and preferences.
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Affiliation(s)
- Yael Lerner
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
| | - Tzuria Peled
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
| | - Morag Yehushua
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
| | - Reut Rotem
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
| | - Ari Weiss
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
| | - Hen Y. Sela
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
| | - Sorina Grisaru-Granovsky
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
| | - Misgav Rottenstreich
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Affiliated with the Hebrew University School of Medicine, Jerusalem 91031, Israel
- Department of Nursing, Jerusalem College of Technology, Jerusalem 9548301, Israel
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10
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Barros FC, Gunier RB, Rego A, Sentilhes L, Rauch S, Gandino S, Teji JS, Thornton JG, Kachikis AB, Nieto R, Craik R, Cavoretto PI, Winsey A, Roggero P, Rodriguez GB, Savasi V, Kalafat E, Giuliani F, Fabre M, Benski AC, Coronado-Zarco IA, Livio S, Ostrovska A, Maiz N, Castedo Camacho FR, Peterson A, Deruelle P, Giudice C, Casale RA, Salomon LJ, Soto Conti CP, Prefumo F, Mohamed Elbayoumy EZ, Vale M, Hernández V, Chandler K, Risso M, Marler E, Cáceres DM, Crespo GA, Ernawati E, Lipschuetz M, Ariff S, Takahashi K, Vecchiarelli C, Hubka T, Ikenoue S, Tavchioska G, Bako B, Ayede AI, Eskenazi B, Bhutta ZA, Kennedy SH, Papageorghiou AT, Villar J. Maternal vaccination against COVID-19 and neonatal outcomes during Omicron: INTERCOVID-2022 study. Am J Obstet Gynecol 2024:S0002-9378(24)00078-4. [PMID: 38367758 DOI: 10.1016/j.ajog.2024.02.008] [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: 11/22/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND In early 2023, when Omicron was the variant of concern, we showed that vaccinating pregnant women decreased the risk for severe COVID-19-related complications and maternal morbidity and mortality. OBJECTIVE This study aimed to analyze the impact of COVID-19 during pregnancy on newborns and the effects of maternal COVID-19 vaccination on neonatal outcomes when Omicron was the variant of concern. STUDY DESIGN INTERCOVID-2022 was a large, prospective, observational study, conducted in 40 hospitals across 18 countries, from November 27, 2021 (the day after the World Health Organization declared Omicron the variant of concern) to June 30, 2022, to assess the effect of COVID-19 in pregnancy on maternal and neonatal outcomes and to assess vaccine effectiveness. Women diagnosed with laboratory-confirmed COVID-19 during pregnancy were compared with 2 nondiagnosed, unmatched women recruited concomitantly and consecutively during pregnancy or at delivery. Mother-newborn dyads were followed until hospital discharge. The primary outcomes were a neonatal positive test for COVID-19, severe neonatal morbidity index, severe perinatal morbidity and mortality index, preterm birth, neonatal death, referral to neonatal intensive care unit, and diseases during the neonatal period. Vaccine effectiveness was estimated with adjustment for maternal risk profile. RESULTS We enrolled 4707 neonates born to 1577 (33.5%) mothers diagnosed with COVID-19 and 3130 (66.5%) nondiagnosed mothers. Among the diagnosed mothers, 642 (40.7%) were not vaccinated, 147 (9.3%) were partially vaccinated, 551 (34.9%) were completely vaccinated, and 237 (15.0%) also had a booster vaccine. Neonates of booster-vaccinated mothers had less than half (relative risk, 0.46; 95% confidence interval, 0.23-0.91) the risk of being diagnosed with COVID-19 when compared with those of unvaccinated mothers; they also had the lowest rates of preterm birth, medically indicated preterm birth, respiratory distress syndrome, and number of days in the neonatal intensive care unit. Newborns of unvaccinated mothers had double the risk for neonatal death (relative risk, 2.06; 95% confidence interval, 1.06-4.00) when compared with those of nondiagnosed mothers. Vaccination was not associated with any congenital malformations. Although all vaccines provided protection against neonatal test positivity, newborns of booster-vaccinated mothers had the highest vaccine effectiveness (64%; 95% confidence interval, 10%-86%). Vaccine effectiveness was not as high for messenger RNA vaccines only. Vaccine effectiveness against moderate or severe neonatal outcomes was much lower, namely 13% in the booster-vaccinated group (all vaccines) and 25% and 28% in the completely and booster-vaccinated groups, respectively (messenger RNA vaccines only). Vaccines were fairly effective in protecting neonates when given to pregnant women ≤100 days (14 weeks) before birth; thereafter, the risk increased and was much higher after 200 days (29 weeks). Finally, none of the neonatal practices studied, including skin-to-skin contact and direct breastfeeding, increased the risk for infecting newborns. CONCLUSION When Omicron was the variant of concern, newborns of unvaccinated mothers had an increased risk for neonatal death. Neonates of vaccinated mothers had a decreased risk for preterm birth and adverse neonatal outcomes. Because the protective effect of COVID-19 vaccination decreases with time, to ensure that newborns are maximally protected against COVID-19, mothers should receive a vaccine or booster dose no more than 14 weeks before the expected date of delivery.
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Affiliation(s)
- Fernando C Barros
- Post Graduate Program in Health in the Life Cycle, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Robert B Gunier
- School of Public Health, University of California, Berkeley, CA
| | - Albertina Rego
- Departamento de Pediatria, Faculdade Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Stephen Rauch
- School of Public Health, University of California, Berkeley, CA
| | - Serena Gandino
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Jagjit S Teji
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Jim G Thornton
- University of Nottingham Medical School, Nottingham, United Kingdom
| | - Alisa B Kachikis
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
| | - Ricardo Nieto
- Division Neonatología, Hospital Materno Infantil Ramón Sarda, Buenos Aires, Argentina
| | - Rachel Craik
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Paolo I Cavoretto
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital and University, Milan, Italy
| | - Adele Winsey
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Paola Roggero
- Department of Woman, Child and Neonate, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gabriel B Rodriguez
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Valeria Savasi
- Unit of Obstetrics and Gynecology, L- Sacco Hospital ASST Fatebenefratelli Sacco, Milan, Italy; Department of Biological and Clinical Sciences, University of Milan, Milan, Italy
| | - Erkan Kalafat
- Department of Obstetrics and Gynecology, Koc University Hospital, Istanbul, Turkey
| | - Francesca Giuliani
- Neonatal Special Care Unit, Regina Margherita Children's Hospital, Turin, Italy
| | - Marta Fabre
- Instituto de Investigación Sanitario de Aragón (IIS Aragon), Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | | | - Stefania Livio
- Hospital Buzzi, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Adela Ostrovska
- Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Nerea Maiz
- Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron, Barcelona Hospital Campus, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | | | - Philippe Deruelle
- Department of Obstetrics and Gynecology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Carolina Giudice
- Servicio de Neonatologia, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - Roberto A Casale
- Maternal and Child Department, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | | | | | - Federico Prefumo
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Marynéa Vale
- Hospital Universitário da Universidade Federal do Maranhão, São Luís, Brazil
| | | | | | - Milagros Risso
- Servicio de Neonatología del Departamento Materno Infantil, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Emily Marler
- St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | | | - Ernawati Ernawati
- Medical Faculty Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Michal Lipschuetz
- Obstetrics and Gynecology Division, Hadassah Medical Center Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shabina Ariff
- Department of Paediatrics & Child Health, The Aga Khan University Hospital, Karachi, Pakistan
| | - Ken Takahashi
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Teresa Hubka
- AMITA Health Resurrection Medical Center, Chicago, IL
| | - Satoru Ikenoue
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | | | - Babagana Bako
- Department of Obstetrics and Gynaecology, College of Medical Sciences, Gombe State University, Gombe, Nigeria
| | | | - Brenda Eskenazi
- School of Public Health, University of California, Berkeley, CA
| | - Zulfiqar A Bhutta
- Center for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Stephen H Kennedy
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Aris T Papageorghiou
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom; St George's University Hospitals NHS Foundation Trust, London, United Kingdom.
| | - Jose Villar
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
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11
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Inoue T, Endo T, Muto J, Umebayashi D, Mitsuhara T, Shigekawa S, Kanematsu R, Iwasaki M, Takami T, Hida K, Mizuno M. Shorter survival time of adolescents and young adult patients than older adults with spinal cord glioblastoma: a multicenter study. J Neurosurg Spine 2024; 40:196-205. [PMID: 37976504 DOI: 10.3171/2023.9.spine23642] [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: 06/10/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Cancers in adolescents and young adults (AYAs) (age 15-39 years) often present with unique characteristics and poor outcomes. To date, spinal cord glioblastoma, a rare tumor, remains poorly understood across all age groups, including AYAs. This comparative study aimed to investigate the clinical characteristics and outcomes of spinal cord glioblastoma in AYAs and older adults (age 40-74 years), given the limited availability of studies focusing on AYAs. METHODS Data from the Neurospinal Society of Japan's retrospective intramedullary tumor registry (2009-2020) were analyzed. Patients were dichotomized on the basis of age into AYAs and older adults. Univariate and multivariate Cox proportional hazards regression models were utilized to explore risk factors for overall survival (OS). RESULTS A total of 32 patients were included in the study, with a median (range) age of 43 (15-74) years. Of these, 14 (43.8%) were AYAs and 18 (56.2%) were older adults. The median OS was 11.0 months in AYAs and 32.0 months in older adults, and the 1-year OS rates were 42.9% and 66.7%, respectively, with AYAs having a significantly worse prognosis (p = 0.017). AYAs had worse preoperative Karnofsky Performance Status (KPS) than older patients (p = 0.037). Furthermore, AYAs had larger intramedullary tumors on admission (p = 0.027) and a significantly higher frequency of intracranial dissemination during the clinical course (p = 0.048). However, there were no significant differences in the degrees of surgical removal or postoperative radiochemotherapy between groups. The Cox proportional hazards regression model showed that AYAs (HR 3.53, 95% CI 1.17-10.64), intracranial dissemination (HR 4.30, 95% CI 1.29-14.36), and no radiation therapy (HR 57.34, 95% CI 6.73-488.39) were risk factors for mortality for patients of all ages. Worse preoperative KPS did not predict mortality in AYAs but did in older adults. The high incidence of intracranial dissemination may play an important role in the poor prognosis of AYAs, but further studies are needed. CONCLUSIONS The clinical characteristics of AYAs with spinal cord glioblastoma differ from those of older adults. The prognosis of AYAs was clearly worse than that of older adults. The devastating clinical course of spinal glioblastoma in AYAs was in line with those of other cancers in this age group.
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Affiliation(s)
- Tomoo Inoue
- 1Department of Neurosurgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Toshiki Endo
- 2Department of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Jun Muto
- 3Department of Neurosurgery, Fujita Health University, Nagoya, Aichi, Japan
| | - Daisuke Umebayashi
- 4Department of Neurosurgery, Kyoto Prefectural Hospital of Medicine, Kyoto, Kyoto, Japan
| | - Takafumi Mitsuhara
- 5Department of Neurosurgery, Hiroshima University Graduate School of Medicine, Hiroshima, Hiroshima, Japan
| | - Seiji Shigekawa
- 6Department of Neurosurgery, Ehime University, Ehime, Ehime, Japan
| | - Ryo Kanematsu
- 7Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka, Japan
| | - Motoyuki Iwasaki
- 8Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Toshihiro Takami
- 9Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Osaka, Japan
| | - Kazutoshi Hida
- 10Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Hokkaido, Japan; and
| | - Masaki Mizuno
- 11Department of Minimum Invasive Neurospinal Surgery, Mie University, Mie, Mie, Japan
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12
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Iwai T, Imagumbai T, Hiraoka S, Kishi T, Okabayashi S, Ashida R, Mitsuyoshi T, Matsuo Y, Ishigaki T, Mizowaki T, Kokubo M. Clinical outcomes of scalp or face angiosarcoma treatment with intensity-modulated radiotherapy: a multicenter study. J Radiat Res 2024; 65:78-86. [PMID: 37996084 PMCID: PMC10803163 DOI: 10.1093/jrr/rrad089] [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: 07/04/2023] [Revised: 09/04/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023]
Abstract
Combined modality therapy, including radiotherapy (RT), is a common treatment for scalp or face angiosarcoma. Although intensity-modulated radiotherapy (IMRT) can deliver homogeneous doses to the scalp or face, clinical data are limited. This multicenter study aimed to evaluate scalp or face angiosarcoma treated with definitive or post-operative IMRT. We retrospectively analyzed data from patients who received IMRT for scalp or face angiosarcoma at three institutions between January 2015 and March 2020. Local control (LC) rate, overall survival (OS), progression-free survival (PFS), recurrence patterns and toxicity were evaluated. Fifteen patients underwent IMRT during the study period. Definitive RT was performed on 10 patients and post-operative RT was performed on 5 patients. The 1-year LC rate was 85.7% (95% confidence interval [CI], 53.9-96.2%). The 1-year OS and PFS rates were 66.7% (95% CI, 37.5-84.6%) and 53.3% (95% CI, 26.3%-74.4%), respectively. Univariate analysis revealed that a clinical target volume over 500 cm3 was associated with poor LC. Distant metastasis was the most common recurrence pattern. All patients experienced Grade 2 or 3 radiation dermatitis, and five patients experienced grade ≥ 3 skin ulceration. One patient who underwent maintenance therapy with pazopanib developed Grade 5 skin ulceration. Fisher's exact test showed that post-operative RT was significantly associated with an increased risk of skin ulceration of grade ≥ 3. These results demonstrate that IMRT is a feasible and effective treatment for scalp or face angiosarcoma, although skin ulceration of grade ≥ 3 is a common adverse event in patients who receive post-operative RT.
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Affiliation(s)
- Takahiro Iwai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Toshiyuki Imagumbai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Shinya Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Takahiro Kishi
- Department of Radiation Oncology, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, 543-8555, Osaka, Japan
| | - Shun Okabayashi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Ryo Ashida
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Takamasa Mitsuyoshi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, 377-2, Ohno-Higashi, Osaka-Sayama, 589-8511, Osaka, Japan
| | - Takashi Ishigaki
- Department of Radiation Oncology, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, 543-8555, Osaka, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
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Martínez-López J, de la Cruz J, Gil-Manso R, Yuste VJ, Aspa-Cilleruelo JM, Escobar CE, López-Jiménez J, Duarte R, Yerovi CJ, Hernández-Rivas JÁ, Herráez R, Quiroz-Cervantes K, Bustelos-Rodriguez R, Benavente C, Martínez Barranco P, Bastos Oteiro M, Alegre A, Pérez-Oteyza J, Ruiz E, Marcheco-Pupo EA, Cedillo Á, de Soto Álvarez T, García Ramirez P, Alonso Trillo R, Herrera P, Bengochea Casado ML, Arroyo Barea A, Martin De Bustamante JM, Ortiz J, Calbacho Robles M, García-Suárez J. COVID-19 Outcomes in Patients with Hematologic Malignancies in the Era of COVID-19 Vaccination and the Omicron Variant. Cancers (Basel) 2024; 16:379. [PMID: 38254867 PMCID: PMC10814951 DOI: 10.3390/cancers16020379] [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: 11/13/2023] [Revised: 01/02/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
A greater understanding of clinical trends in COVID-19 outcomes among patients with hematologic malignancies (HM) over the course of the pandemic, particularly the Omicron era, is needed. This ongoing, observational, and registry-based study with prospective data collection evaluated COVID-19 clinical severity and mortality in 1818 adult HM patients diagnosed with COVID-19 between 27 February 2020 and 1 October 2022, at 31 centers in the Madrid region of Spain. Of these, 1281 (70.5%) and 537 (29.5%) were reported in the pre-Omicron and Omicron periods, respectively. Overall, patients aged ≥70 years (odds ratio 2.16, 95% CI 1.64-2.87), with >1 comorbidity (2.44, 1.85-3.21), or with an underlying HM of chronic lymphocytic leukemia (1.64, 1.19-2.27), had greater odds of severe/critical COVID-19; odds were lower during the Omicron BA.1/BA.2 (0.28, 0.2-0.37) or BA.4/BA.5 (0.13, 0.08-0.19) periods and among patients vaccinated with one or two (0.51, 0.34-0.75) or three or four (0.22, 0.16-0.29) doses. The hospitalization rate (75.3% [963/1279], 35.7% [191/535]), rate of intensive care admission (30.0% [289/963], 14.7% [28/191]), and mortality rate overall (31.9% [409/1281], 9.9% [53/536]) and in hospitalized patients (41.3% [398/963], 22.0% [42/191]) decreased from the pre-Omicron to Omicron period. Age ≥70 years was the only factor associated with higher mortality risk in both the pre-Omicron (hazard ratio 2.57, 95% CI 2.03-3.25) and Omicron (3.19, 95% CI 1.59-6.42) periods. Receipt of prior stem cell transplantation, COVID-19 vaccination(s), and treatment with nirmatrelvir/ritonavir or remdesivir were associated with greater survival rates. In conclusion, COVID-19 mortality in HM patients has decreased considerably in the Omicron period; however, mortality in hospitalized HM patients remains high. Specific studies should be undertaken to test new treatments and preventive interventions in HM patients.
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Affiliation(s)
- Joaquín Martínez-López
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | - Javier de la Cruz
- imas12 Research Institute, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Rodrigo Gil-Manso
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | | | | | | | - Javier López-Jiménez
- Hematology Department, Hospital Universitario Ramón Y Cajal, 28034 Madrid, Spain
| | - Rafael Duarte
- Hematology Department, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain
| | | | | | - Regina Herráez
- Hematology Department, Hospital Universitario Infanta Sofía, 28702 Madrid, Spain
| | | | | | - Celina Benavente
- Hematology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | | | - Mariana Bastos Oteiro
- Hematology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28009 Madrid, Spain
| | - Adrián Alegre
- Hematology Department, Hospital Universitario de La Princesa, IIS-HUP, 28006 Madrid, Spain
| | - Jaime Pérez-Oteyza
- Hematology Department, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain
| | - Elena Ruiz
- Hematology Department, Hospital Universitario del Tajo, 28300 Madrid, Spain
| | | | - Ángel Cedillo
- Asociación Madrileña de Hematología y Hemoterapia (AMHH), 28010 Madrid, Spain
| | | | | | | | - Pilar Herrera
- Hematology Department, Hospital Universitario Ramón Y Cajal, 28034 Madrid, Spain
| | | | - Andrés Arroyo Barea
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | | | - Javier Ortiz
- Hematology Department, Hospital Universitario de La Princesa, IIS-HUP, 28006 Madrid, Spain
| | - María Calbacho Robles
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | - Julio García-Suárez
- Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, 28805 Madrid, Spain
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Wang X, Ye Z, Li S, Yan Z, Cheng J, Ning G, Hou Z. A multicenter study of cervical cancer using quantitative diffusion-weighted imaging. Acta Radiol 2024:2841851231222360. [PMID: 38196316 DOI: 10.1177/02841851231222360] [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] [Indexed: 01/11/2024]
Abstract
BACKGROUND Parameters from diffusion-weighted imaging (DWI) have been increasingly used as imaging biomarkers for the diagnosis and monitoring of treatment responses in cancer. The consistency of DWI measurements across different centers remains uncertain, which limits the widespread use of quantitative DWI in clinical settings. PURPOSE To investigate the consistency of quantitative metrics derived from DWI between different scanners in a multicenter clinical setting. MATERIAL AND METHODS A total of 193 patients with cervical cancer from four scanners (MRI1, MRI2, MRI3, and MRI4) at three centers were included in this retrospective study. DWI data were processed using the mono-exponential and intravoxel incoherent motion (IVIM) model, yielding the following parameters: apparent diffusion coefficient (ADC); true diffusion coefficient (D); pseudo-diffusion coefficient (D*); perfusion fraction (f); and the product of f and D* (fD*). Various parameters of cervical cancer obtained from different scanners were compared. RESULTS The parameters D and ADC derived from MRI1 and MRI2 were significantly different from those derived from MRI3 or MRI4 (P <0.01 for all comparisons). However, there was no significant difference in cervical cancer perfusion parameters (D* and fD*) between the different scanners (P >0.05). The P values of comparisons of all DWI parameters (D, D*, fD*, and ADC) between MRI3 and MRI4 (same vendor in different centers) for cervical cancer were all >0.05, except for f (P = 0.05). CONCLUSION Scanners of the same model by the same vendor can yield close measurements of the ADC and IVIM parameters. The perfusion parameters showed higher consistency among the different scanners.
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Affiliation(s)
- Xue Wang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Zhijun Ye
- Department of Radiology, The Second Affiliated Hospital of Sichuan University, Chengdu, PR China
| | - Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Gang Ning
- Department of Radiology, The Second Affiliated Hospital of Sichuan University, Chengdu, PR China
| | - Zujun Hou
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, PR China
- Chinese Academy of Sciences, Suzhou Institute of Biomedical Engineering and Technology, Suzhou, PR China
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Zhang W, Zhang D, Liu S, Wang H, Liu X, Dai C, Fang Y, Fan Y, Wei Z, Feng M, Wang R. Predicting delayed remission in Cushing's disease using radiomics models: a multi-center study. Front Oncol 2024; 13:1218897. [PMID: 38264759 PMCID: PMC10803608 DOI: 10.3389/fonc.2023.1218897] [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: 05/08/2023] [Accepted: 11/28/2023] [Indexed: 01/25/2024] Open
Abstract
Purpose No multi-center radiomics models have been built to predict delayed remission (DR) after transsphenoidal surgery (TSS) in Cushing's disease (CD). The present study aims to build clinical and radiomics models based on data from three centers to predict DR after TSS in CD. Methods A total of 122 CD patients from Peking Union Medical College Hospital, Xuanwu Hospital, and Fuzhou General Hospital were enrolled between January 2000 and January 2019. The T1-weighted gadolinium-enhanced MRI images and clinical data were used as inputs to build clinical and radiomics models. The regions of interest (ROI) of MRI images were automatically defined by a deep learning algorithm developed by our team. The area under the curve (AUC) of receiver operating characteristic (ROC) curves was used to evaluate the performance of the models. In total, 10 machine learning algorithms were used to construct models. Results The overall DR rate is 44.3% (54/122). According to multivariate Logistic regression analysis, patients with higher BMI and lower postoperative cortisol levels are more likely to achieve a higher rate of delayed remission. Among the 10 models, XGBoost achieved the best performance among all models in both clinical and radiomics models with AUC values of 0.767 and 0.819 respectively. The results from SHAP value and LIME algorithms revealed that postoperative cortisol level (PoC) and BMI were the most important features associated with DR. Conclusion Radiomics models can be built as an effective noninvasive method to predict DR and might be useful in assisting neurosurgeons in making therapeutic plans after TSS for CD patients. These results are preliminary and further validation in a larger patient sample is needed.
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Affiliation(s)
- Wentai Zhang
- Department of Thoracic Surgery, Peking University First Hospital, Beijing, China
- Department of Neurosurgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Dewei Zhang
- Department of Neurosurgery, Jing'an District Center Hospital of Shanghai, Fudan University, Shanghai, China
| | - Shaocheng Liu
- Intensive Care Unit, Beijing Mentougou District Hospital, Beijing, China
| | - He Wang
- Department of Neurosurgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Xiaohai Liu
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Congxin Dai
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yi Fang
- Department of Neurosurgery, The Fuzhou General Hospital, Fuzhou, China
| | - Yanghua Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhenqing Wei
- Department of Neurosurgery, The First Hospital Affiliated to Dalian Medical University, Dalian, China
| | - Ming Feng
- Department of Neurosurgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Renzhi Wang
- Department of Neurosurgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
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Li X, Peng C, Liu Y, Hu Y, Yang L, Yu Y, Zeng H, Huang W, Li Q, Tao N, Cao L, Zhou J. Modified American College of Radiology Thyroid Imaging Reporting and Data System and Modified Artificial Intelligence Thyroid Imaging Reporting and Data System for Thyroid Nodules: A Multicenter Retrospective Study. Thyroid 2024; 34:88-100. [PMID: 37950720 DOI: 10.1089/thy.2023.0429] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2023]
Abstract
Background: Risk stratification systems for thyroid nodules are limited by low specificity. The fine-needle aspiration (FNA) biopsy size thresholds and stratification criteria are based on evidence from the literature and expert consensus. Our aims were to investigate the optimal FNA biopsy size thresholds in the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and artificial intelligence (AI) TI-RADS and to revise the stratification criteria in AI TI-RADS. Methods: A total of 2596 thyroid nodules (in 2511 patients) on ultrasound examination with definite pathological diagnoses were retrospectively identified from January 2017 to September 2021 in 6 participating Chinese hospitals. The modified criteria for ACR TI-RADS were as follows: (1) no FNA for TR3; (2) FNA threshold for TR4 increased to 2.5 cm. The modified criteria for AI TI-RADS were as follows: (1) 6-point nodules upgraded to TR5; (2) no FNA for TR3; (3) FNA threshold for TR4 increased to 2.5 cm. The diagnostic performance and the unnecessary FNA rate (UFR) of modified versions were compared with the original ACR TI-RADS. Results: Compared with the original ACR TI-RADS, the modified ACR (mACR) TI-RADS yielded higher specificity (73% vs. 46%), accuracy (74% vs. 51%), area under the receiver operating characteristic curve (AUC; 0.80 vs. 0.70), and lower UFR (25% vs. 48%; all p < 0.001), although the sensitivity was slightly decreased (87% vs. 93%, p = 0.057). Compared with the original ACR TI-RADS, the modified AI (mAI) TI-RADS yielded higher specificity (73% vs. 46%), accuracy (75% vs. 51%), AUC (0.81 vs. 0.70), and lower UFR (24% vs. 48%; all p < 0.001), although the sensitivity tended to be slightly decreased (89% vs. 93%, p = 0.13). There was no significant difference between the mACR TI-RADS and mAI TI-RADS in the diagnostic performance and UFR (all p > 0.05). Conclusions: The revised FNA thresholds and the stratification criteria of the mACR TI-RADS and mAI TI-RADS may be associated with improvements in specificity and accuracy, without significantly sacrificing sensitivity for malignancy detection.
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Affiliation(s)
- Xiaoxian Li
- Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
| | - Chuan Peng
- Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
| | - Ying Liu
- Department of Ultrasound, Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Yixin Hu
- Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
| | - Liang Yang
- Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
| | - Yiwen Yu
- Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
| | - Hongyan Zeng
- Department of Ultrasound, Huadu District People's Hospital, Guangzhou, China
| | - Weijun Huang
- Department of Ultrasound, Foshan First Municipal People's Hospital (The Affiliated Foshan Hospital of Sun Yat-sen University), Foshan, Guangdong Province, China
| | - Qian Li
- Department of Ultrasound, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China
| | - Nansheng Tao
- Department of Ultrasound, The Fifth People's Hospital of Nanhai, Foshan, Guangdong Province, China
| | - Longhui Cao
- Department of Anesthesiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
| | - Jianhua Zhou
- Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
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Plevová I, Kachlová M, Jarošová D, Zeleníková R, Mynaříková E. Satisfaction with nursing care of hospitalized patients: A descriptive, cross-sectional, multicenter study. Med Pr 2023; 74:461-468. [PMID: 38160419 DOI: 10.13075/mp.5893.01364] [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: 01/03/2024] Open
Abstract
BACKGROUND In the assessment of healthcare processes focusing on the quality of care provided, patient satisfaction is an important indicator that healthcare providers may use for future setting of healthcare and preventing adverse events. The study aimed to determine satisfaction with nursing care among hospital inpatients. MATERIAL AND METHODS The sample comprised 14 023 patients staying in medical and surgical wards of 14 acute care hospitals in the Czech Republic in 2019-2020. Data were collected using the Patient Satisfaction Scale, a standardized tool containing 11 items in 3 subscales. Data analysis included descriptive statistics and correlation analysis (Spearman's rank correlation coefficient). RESULTS Overall, patients reported high satisfaction with nursing care (M = 3.57). Patients were most satisfied with how their technical/rational needs were met (M = 3.57); the least satisfaction was identified in the domain of information needs (M = 3.53). Patients who perceived their health as good (47%) or very good (18%) showed high satisfaction scores (M = 3.77 and M = 3.73, respectively). High scores were also achieved for patients with secondary (M = 3.58) and tertiary (M = 3.59) education, those whose admission was planned (M = 3.59) and those staying in large hospitals (M = 3.60). There were no differences in satisfaction with regard to gender (p = 0.755) and the COVID-19 pandemic (p = 0.190). CONCLUSIONS Patients' satisfaction with care provided is a highly significant parameter of healthcare quality. It is influenced by a number of aspects which, if adequately defined, may aid in improving the quality of care. Med Pr Work Health Saf. 2023;74(6):461-8.
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Affiliation(s)
- Ilona Plevová
- University of Ostrava, Ostrava, Czech Republic (Faculty of Medicine, Department of Nursing and Midwifery)
| | - Miroslava Kachlová
- University of Ostrava, Ostrava, Czech Republic (Faculty of Medicine, Department of Nursing and Midwifery)
| | - Darja Jarošová
- University of Ostrava, Ostrava, Czech Republic (Faculty of Medicine, Department of Nursing and Midwifery)
| | - Renata Zeleníková
- University of Ostrava, Ostrava, Czech Republic (Faculty of Medicine, Department of Nursing and Midwifery)
| | - Eva Mynaříková
- University Hospital in Ostrava, Ostrava, Czech Republic (Department of Nursing Care)
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Rutili V, Souki BQ, Nieri M, Carlos ALFM, Pavoni C, Cozza P, McNamara JA, Giuntini V, Franchi L. Long-term effects produced by early treatment of Class III malocclusion with rapid maxillary expansion and facemask followed by fixed appliances: A multicentre retro-prospective controlled study. Orthod Craniofac Res 2023. [PMID: 38146808 DOI: 10.1111/ocr.12748] [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: 10/16/2023] [Revised: 11/11/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To assess the short- and long-term dentoskeletal effects of early Class III treatment with rapid maxillary expansion and facemask (RME/FM) followed by fixed appliances. MATERIALS AND METHODS A total of 44 patients (27 females, 17 males) treated consecutively with RME/FM were included from the archives of 3 centres. Three lateral cephalograms were available: T0 (before the start of RME/FM therapy, mean age 8.1 ± 1.8 years), T1 (immediately after RME/FM, mean age 9.8 ± 1.6 years), and T2 (long-term observation, mean age 19.5 ± 1.6 years). A control group of 17 untreated Class III subjects (12 females and 5 males) also was selected. Between-group statistical comparisons were performed with ANCOVA. RESULTS No statistically significant differences for any of the cephalometric variables were found at T0. In the short term, the treated group showed significant improvements in ANB (+2.9°), Wits appraisal (+2.7 mm), SNA (+1.8°) and SNB (-1.1°). A significant closure of CoGoMe angle (-1.3°) associated with smaller increments along Co-Gn (-2.4 mm) also was found together with a significant increase in intermaxillary divergence (+1.3°). In the long-term, significant improvements in ANB (+2.6°), Wits appraisal (+2.7 mm) and SNB (-1.7°) were recorded together with a significant closure of the CoGoMe angle (-2.9°). No significant long-term changes in vertical skeletal relationships were found. CONCLUSIONS RME/FM therapy was effective in improving Class III dentoskeletal relationships in the short term. These changes remained stable in the long-term due mainly to favourable mandibular changes.
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Affiliation(s)
- Valentina Rutili
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | | | - Chiara Pavoni
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - Paola Cozza
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, Michigan, USA
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
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Xin L, Wu Q, Zhan C, Qin H, Xiang H, Gao M, Duan X, Liu Y, Ye J. A multicenter study of the clinicopathological characteristics and a risk prediction model of early-stage breast cancer with hormone receptor-positive/human epidermal growth factor receptor 2-low expression. Chin Med J (Engl) 2023; 136:2967-2973. [PMID: 37822006 PMCID: PMC10752477 DOI: 10.1097/cm9.0000000000002831] [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: 01/26/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND In light of the significant clinical benefits of antibody-drug conjugates in clinical trials, the human epidermal growth factor receptor 2 (HER2)-low category in breast cancers has gained increasing attention. Therefore, we studied the clinicopathological characteristics of Chinese patients with hormone receptor (HR)-positive/HER2-low early-stage breast cancer and developed a recurrence risk prediction model. METHODS Female patients with HR-positive/HER2-low early-stage breast cancer treated in 29 hospitals of the Chinese Society of Breast Surgery (CSBrS) from Jan 2015 to Dec 2016 were enrolled. Their clinicopathological data and prognostic information were collected, and machine learning methods were used to analyze the prognostic factors. RESULTS In total, 25,096 patients were diagnosed with breast cancer in 29 hospitals of CSBrS from Jan 2015 to Dec 2016, and clinicopathological data for 6486 patients with HER2-low early-stage breast cancer were collected. Among them, 5629 patients (86.79%) were HR-positive. The median follow-up time was 57 months (4, 76 months); the 5-year disease-free survival (DFS) rate was 92.7%, and the 5-year overall survival (OS) rate was 97.7%. In total, 412 cases (7.31%) of metastasis were observed, and 124 (2.20%) patients died. Multivariate Cox regression analysis revealed that T stage, N stage, lymphovascular thrombosis, Ki-67 index, and prognostic stage were associated with recurrence and metastasis ( P <0.05). A recurrence risk prediction model was established using the random forest method and exhibited a sensitivity of 81.1%, specificity of 71.7%, positive predictive value of 74.1%, and negative predictive value of 79.2%. CONCLUSION Most of patients with HER2-low early-stage breast cancer were HR-positive, and patients had favorable outcome; tumor N stage, lymphovascular thrombosis, Ki-67 index, and tumor prognostic stage were prognostic factors. The HR-positive/HER2-low early-stage breast cancer recurrence prediction model established based on the random forest method has a good reference value for predicting 5-year recurrence events. REGISTRITATION ChiCTR.org.cn, ChiCTR2100046766.
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Affiliation(s)
- Ling Xin
- Department of Breast and Thyroid, Peking University First Hospital, Beijing 100034, China
| | - Qian Wu
- Department of Breast and Thyroid, Peking University First Hospital, Beijing 100034, China
| | - Chongming Zhan
- Jun Yi Tai He Medical Technology Co. Ltd., Beijing 100024, China
| | - Hongyan Qin
- Jun Yi Tai He Medical Technology Co. Ltd., Beijing 100024, China
| | - Hongyu Xiang
- Department of Breast and Thyroid, Peking University First Hospital, Beijing 100034, China
| | - Min Gao
- Department of Breast and Thyroid, Peking University First Hospital, Beijing 100034, China
| | - Xuening Duan
- Department of Breast and Thyroid, Peking University First Hospital, Beijing 100034, China
| | - Yinhua Liu
- Department of Breast and Thyroid, Peking University First Hospital, Beijing 100034, China
| | - Jingming Ye
- Department of Breast and Thyroid, Peking University First Hospital, Beijing 100034, China
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Liu S, Yang G, Zeng G, Zhou X, Chen R, Chen B, Chen J, Wen X, Zhang X, Ren H, Zu R, Wang D, Leng P, Luo H. Factors influencing platelet isolation: a prospective multicenter study from Western China. Platelets 2023; 34:2194445. [PMID: 37041749 DOI: 10.1080/09537104.2023.2194445] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Tumor-educated platelets (TEPs) have been widely reported to have promising application potential; nonetheless, platelet isolation from peripheral blood is an important but neglected step in TEPs research for platelet-based liquid biopsy. In this article, we discussed some common influence factors for platelet isolation. To investigate the factors involved in platelet isolation, a prospective multicenter study was conducted on healthy Han Chinese adults (18 to 79 years of age). A total of 208 individuals were included in the final statistical analysis out of the 226 healthy volunteers who were prospectively enrolled from four hospitals. The primary study metric was the platelet recovery rate (PRR). The similar pattern was observed in the four hospitals, The PRR at room temperature (23°C±2°C) was slightly higher than the PRR at cold temperature (4°C±2°C). Moreover, the PRR gradually decreased as the storage time increased. The PRR for samples within 2 hours of storage is significantly higher than for samples beyond 2 hours (p < .05). Additionally, PRR was also affected by the equipment used in different centers. This study confirmed several factors that influence platelet isolation. In our study, we indicated that platelet isolation should be performed within two hours of peripheral blood draw and held at room temperature until isolation, and that centrifuge models should be fixed during the extraction process, which will further improve the research progress of platelet-based liquid biopsy in cancer.
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Affiliation(s)
- Shan Liu
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affliliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Guishu Yang
- Department of Clinical Laboratory, Guangyuan Central Hospital, Guangyuan, China
| | - Guangqun Zeng
- Department of Clinical Laboratory, People's Hospital of Pengzhou city, Pengzhou, Sichuan, china
| | - Xihao Zhou
- Department of Clinical Laboratory, People's Hospital of Fushun city, Fushun, Sichuan, china
| | - Rong Chen
- Department of Clinical Laboratory, the first people's Hospital of Shuangliu, Shuangliu, Sichuan, China
| | - Bin Chen
- Department of Clinical Laboratory, Biomedical Informatics Society of Chengdu, Chengdu, Sichuan, China
| | - Jin Chen
- Department of Clinical Laboratory, the first people's Hospital of Guangyuan, Guangyuan, Sichuan, China
| | - Xiaoxia Wen
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xingmei Zhang
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hanxiao Ren
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ruiling Zu
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affliliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Dongsheng Wang
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affliliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Leng
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Huaichao Luo
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affliliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
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Zhang S, He Y, Wu W, Tan H, Xie S, Liu M, Chen W, Sun D. Comparison of the performance of two automatic cell morphology analyzers for peripheral-blood leukocyte morphology analysis: Mindray MC-100i and Sysmex DI-60. Int J Lab Hematol 2023; 45:860-868. [PMID: 37575073 DOI: 10.1111/ijlh.14145] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/07/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION To compare the morphological classification ability of peripheral-blood leukocytes of the automatic cell morphology analyzers MC-100i and DI-60. METHODS (1) MC-100i and DI-60 were used to analyze leukocytes in 432 venous blood samples collected from three tertiary hospitals across China. The preclassification results were compared with the results reported by senior morphological experts (postclassification results) to evaluate the accuracy, sensitivity, specificity, and consistency of leukocyte preclassification for both instruments. (2) In 200 of the 432 blood samples, morphological experts conducted manual microscopic examination for various types of leukocytes. The correlation between the MC-100i and DI-60 leukocyte postclassification results and the expert microscopist results were analyzed. RESULTS (1) MC-100i preclassified leukocytes and nucleated red blood cells (RBCs). Compared with the postclassification results, the total leukocyte preclassification accuracy of MC-100i was 97.16%, while that of DI-60 was 87.24%. The sensitivity of MC-100i to abnormal cells (including blasts, promyelocytes, neutrophilic myelocytes, neutrophilic metamyelocytes, reactive lymphocytes, abnormal promyelocytes, plasma cells, abnormal lymphocytes and nucleated RBCs) was 90.24%, which was significantly higher than the 50.72% sensitivity of DI-60. (2) Comparing the postclassification results with manual microscopy, except for reactive lymphocytes and basophils, the MC-100i and DI-60 results had good correlations with various leukocyte types and nucleated RBCs (r > 0.85), and MC-100i was better than DI-60 in the recognition of basophils. CONCLUSION Both MC-100i and DI-60 have good detection ability for five normal types of leukocytes in peripheral blood. MC-100i has significantly better detection sensitivity for abnormal cells in peripheral blood than DI-60.
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Affiliation(s)
- Shihong Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yongjian He
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenjing Wu
- Department of Laboratory Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hongxia Tan
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shuhua Xie
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Min Liu
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei Chen
- Department of Laboratory Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dehua Sun
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Terai T, Kawai M, Kitahata Y, Satoi S, Hashimoto D, Nagai M, Nishiwada S, Yamamoto T, Yamaue H, Sho M. Central pancreatectomy might be an acceptable surgical procedure for clinical T1 pancreatic body ductal adenocarcinoma: A multicenter retrospective analysis. J Hepatobiliary Pancreat Sci 2023; 30:1334-1342. [PMID: 37792641 DOI: 10.1002/jhbp.1355] [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] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Central pancreatectomy (CP) is accepted as a function-preserving procedure for benign tumors. However, the indication of CP for pancreatic cancers is limited. This multicenter study aimed to clarify the indications of CP for clinical T1 pancreatic body cancer. METHODS This multicenter study analyzed patients who underwent CP or distal pancreatectomy (DP) for clinical T1 pancreatic body cancer between 2013 and 2020 at three high-volume centers. RESULTS A total of 50 patients were enrolled: nine patients, who underwent CP, were classified into the CP group, while 38 patients, who underwent DP, served as controls. Three patients converted CP to DP during operation were excluded. Five patients in the CP group and 15 patients in the control group underwent preoperative treatment. The 5-year survival rate was 100% in the CP group, and 42% (p = .040) in the control group. Recurrence was found in three patients in the CP group. Importantly, insulin was not required after surgery in patients in the CP group. CONCLUSION The clinical outcomes of CP were comparable to or even better than that of conventional pancreatectomy. Our collaborative study suggests that CP may be an acceptable therapeutic option for selected patients with clinical T1 pancreatic body cancer.
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Affiliation(s)
- Taichi Terai
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Manabu Kawai
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yuji Kitahata
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Sohei Satoi
- Department of Surgery, Kansai Medical University, Hirakata City, Osaka, Japan
- Division of Surgical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Daisuke Hashimoto
- Department of Surgery, Kansai Medical University, Hirakata City, Osaka, Japan
| | - Minako Nagai
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Satoshi Nishiwada
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Tomohisa Yamamoto
- Department of Surgery, Kansai Medical University, Hirakata City, Osaka, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
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李 亦, 张 晓, 曹 力, 孙 永, 叶 晔, 谢 杰, 胡 懿, 李 忠, 唐 本. [A multicenter randomized controlled trial of domestic robot-assisted and conventional total knee arthroplasty]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2023; 37:1326-1334. [PMID: 37987040 PMCID: PMC10662400 DOI: 10.7507/1002-1892.202307078] [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] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023]
Abstract
Objective To investigate the accuracy, safety, and short-term effectiveness of a domestic robot-assisted system in total knee arthroplasty (TKA) by a multicenter randomized controlled trial. Methods Between December 2021 and February 2023, 138 patients with knee osteoarthritis who received TKA in 5 clinical centers were prospectively collected, and 134 patients met the inclusion criteria were randomly assigned to either a trial group ( n=68) or a control group ( n=66). Seven patients had lost follow-up and missing data, so they were excluded and the remaining 127 patients were included for analysis, including 66 patients in the trial group and 61 patients in the control group. There was no significant difference ( P>0.05) in gender, age, body mass index, side, duration of osteoarthritis, Kellgren-Lawrence grading, preoperative Knee Society Score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between the two groups. The trial group completed the TKA by domestic robot-assisted osteotomy according to the preoperative CT-based surgical planning. The control group was performed by traditional osteotomy plate combined with soft tissue release. Total operation time, osteotomy time of femoral/tibial side, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. The radiographs were taken at 5 and 90 days after operation, and hip-knee-ankle angle (HKA), lateral distal angle of femur (LDFA), and posterior tibial slope (PTS) were measured. The difference between the measured values of the above indexes at two time points after operation and the preoperative planning target values was calculated, and the absolute value (absolute error) was taken for comparison between the two groups. The postoperative recovery of lower limb alignment was judged and the accuracy was calculated. KSS score and WOMAC score were used to evaluate the knee joint function of patients before operation and at 90 days after operation. The improvement rates of KSS score and WOMAC score were calculated. The function, stability, and convenience of the robot-assisted system were evaluated by the surgeons. Results The total operation time and femoral osteotomy time of the trial group were significantly longer than those of the control group ( P<0.05). There was no significant difference in the tibial osteotomy time and the amount of intraoperative blood loss between the two groups ( P>0.05). The incisions of both groups healed by first intention after operation, and there was no infection around the prosthesis. Nine patients in the trial group and 8 in the control group developed lower extremity vascular thrombosis, all of which were calf intermuscular venous thrombosis, and there was no significant difference in the incidence of complications ( P>0.05). All patients were followed up 90 days. There was no significant difference in KSS score and WOMAC score between the two groups at 90 days after operation ( P>0.05). There was significant difference in the improvement rate of KSS score between the two groups ( P<0.05), while there was no significant difference in the improvement rate of WOMAC score between the two groups ( P>0.05). Radiological results showed that the absolute errors of HKA and LDFA in the trial group were significantly smaller than those in the control group at 5 and 90 days after operation ( P<0.05), and the recovery accuracy of lower limb alignment was significantly higher than that in control group ( P<0.05). The absolute error of PTS in the trial group was significantly smaller than that in the control group at 5 days after operation ( P<0.05), but there was no significant difference at 90 days between the two groups ( P>0.05). The functional satisfaction rate of the robot-assisted system was 98.5% (65/66), and the satisfaction rates of stability and convenience were 100% (66/66). Conclusion Domestic robot-assisted TKA is a safe and effective surgical treatment for knee osteoarthritis, which can achieve favorable lower limb alignment reconstruction, precise implant of prosthesis, and satisfactory functional recovery.
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Affiliation(s)
- 亦丞 李
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 晓岗 张
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 力 曹
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 永强 孙
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 晔 叶
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 杰 谢
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 懿郃 胡
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 忠 李
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
| | - 本森 唐
- 新疆医科大学第一附属医院骨科(乌鲁木齐 830054)Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China
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Lee T, Cho Y, Cha KS, Jung J, Cho J, Kim H, Kim D, Hong J, Lee D, Keum M, Kushida CA, Yoon IY, Kim JW. Accuracy of 11 Wearable, Nearable, and Airable Consumer Sleep Trackers: Prospective Multicenter Validation Study. JMIR Mhealth Uhealth 2023; 11:e50983. [PMID: 37917155 PMCID: PMC10654909 DOI: 10.2196/50983] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/08/2023] [Accepted: 09/20/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Consumer sleep trackers (CSTs) have gained significant popularity because they enable individuals to conveniently monitor and analyze their sleep. However, limited studies have comprehensively validated the performance of widely used CSTs. Our study therefore investigated popular CSTs based on various biosignals and algorithms by assessing the agreement with polysomnography. OBJECTIVE This study aimed to validate the accuracy of various types of CSTs through a comparison with in-lab polysomnography. Additionally, by including widely used CSTs and conducting a multicenter study with a large sample size, this study seeks to provide comprehensive insights into the performance and applicability of these CSTs for sleep monitoring in a hospital environment. METHODS The study analyzed 11 commercially available CSTs, including 5 wearables (Google Pixel Watch, Galaxy Watch 5, Fitbit Sense 2, Apple Watch 8, and Oura Ring 3), 3 nearables (Withings Sleep Tracking Mat, Google Nest Hub 2, and Amazon Halo Rise), and 3 airables (SleepRoutine, SleepScore, and Pillow). The 11 CSTs were divided into 2 groups, ensuring maximum inclusion while avoiding interference between the CSTs within each group. Each group (comprising 8 CSTs) was also compared via polysomnography. RESULTS The study enrolled 75 participants from a tertiary hospital and a primary sleep-specialized clinic in Korea. Across the 2 centers, we collected a total of 3890 hours of sleep sessions based on 11 CSTs, along with 543 hours of polysomnography recordings. Each CST sleep recording covered an average of 353 hours. We analyzed a total of 349,114 epochs from the 11 CSTs compared with polysomnography, where epoch-by-epoch agreement in sleep stage classification showed substantial performance variation. More specifically, the highest macro F1 score was 0.69, while the lowest macro F1 score was 0.26. Various sleep trackers exhibited diverse performances across sleep stages, with SleepRoutine excelling in the wake and rapid eye movement stages, and wearables like Google Pixel Watch and Fitbit Sense 2 showing superiority in the deep stage. There was a distinct trend in sleep measure estimation according to the type of device. Wearables showed high proportional bias in sleep efficiency, while nearables exhibited high proportional bias in sleep latency. Subgroup analyses of sleep trackers revealed variations in macro F1 scores based on factors, such as BMI, sleep efficiency, and apnea-hypopnea index, while the differences between male and female subgroups were minimal. CONCLUSIONS Our study showed that among the 11 CSTs examined, specific CSTs showed substantial agreement with polysomnography, indicating their potential application in sleep monitoring, while other CSTs were partially consistent with polysomnography. This study offers insights into the strengths of CSTs within the 3 different classes for individuals interested in wellness who wish to understand and proactively manage their own sleep.
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Affiliation(s)
| | - Younghoon Cho
- Asleep Co., Ltd., Seoul, Republic of Korea
- Clionic Lifecare Clinic, Seoul, Republic of Korea
| | | | | | - Jungim Cho
- Asleep Co., Ltd., Seoul, Republic of Korea
| | | | - Daewoo Kim
- Asleep Co., Ltd., Seoul, Republic of Korea
| | | | | | - Moonsik Keum
- Clionic Lifecare Clinic, Seoul, Republic of Korea
| | - Clete A Kushida
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Redwood City, CA, United States
| | - In-Young Yoon
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jeong-Whun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
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Hosomi Y, Ushigome E, Kitagawa N, Kitagawa N, Tanaka T, Hasegawa G, Ohnishi M, Tsunoda S, Ushigome H, Nakamura N, Asano M, Hamaguchi M, Yamazaki M, Fukui M. Predictive power of isolated high home systolic blood pressure for cardiovascular outcomes in individuals with type 2 diabetes mellitus: KAMOGAWA-HBP study. Diab Vasc Dis Res 2023; 20:14791641231221264. [PMID: 38063417 PMCID: PMC10710111 DOI: 10.1177/14791641231221264] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
AIMS/INTRODUCTION Isolated high home systolic blood pressure (IHHSBP) is a risk for cardiovascular disease (CVD). However, no study has shown an association between IHHSBP and CVD in diabetes. We examined the association between IHHSBP and CVD in type 2 diabetes. MATERIALS AND METHODS This retrospective cohort study included 1082 individuals with type 2 diabetes, aged 20 to 90 years, without a history of macrovascular complications. Home blood pressure (HBP) was measured three times every morning and evening for 14 days. Cox proportional hazards models were used to examine the relationship between IHHSBP and CVD incidence. RESULTS With the normal HBP group as the reference, the adjusted hazard ratio (HR) (95% confidence interval [CI]) for CVD was 1.58 (1.02-2.43) in the IHHSBP group. Correcting for antihypertensive medication use did not change HR. Based on sex, the adjusted HR (95% CI) for CVD was 1.25 (0.74-2.13) in males and 2.28 (1.01-5.15) in females. CONCLUSIONS In individuals with type 2 diabetes, those with IHHSBP had a higher HR for cardiovascular disease than those with normal HBP. But, Isolated high home diastolic blood pressure and high HBP were not. The association between IHHSBP and CVD was stronger in females than in males.
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Affiliation(s)
- Yukako Hosomi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Nobuko Kitagawa
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Toru Tanaka
- Department of Endocrinology and Metabolism, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Goji Hasegawa
- Department of Endocrinology and Metabolism, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Masayoshi Ohnishi
- Department of Endocrinology and Metabolism, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - Sei Tsunoda
- Department of Cardiology, Nishijin Hospital, Kyoto, Japan
| | - Hidetaka Ushigome
- Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Naoto Nakamura
- Department of Endocrinology and Metabolism, Saiseikai Kyoto Hospital, Kyoto, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Valero-Martínez C, Urgelles JF, Sallés M, Joven-Ibáñez BE, de Juanes A, Ramírez J, Juanola X, Almodóvar R, Laiz A, Moreno M, Pujol M, Beltrán E, Pinto-Tasende JA, Crespí L, Sala-Icardo L, Castañeda S, García-Vicuña R. Dual targeted therapy in patients with psoriatic arthritis and spondyloarthritis: a real-world multicenter experience from Spain. Front Immunol 2023; 14:1283251. [PMID: 37936691 PMCID: PMC10627177 DOI: 10.3389/fimmu.2023.1283251] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023] Open
Abstract
Dual targeted therapy (DTT) has emerged as a promising approach in patients with refractory spondyloarthritis (SpA) or psoriatic arthritis (PsA) and extra-musculoskeletal manifestations of both diseases, but its effectiveness/safety ratio still remains unclear. This is a retrospective, real-world multicenter study in refractory SpA and PsA patients with simultaneous use of two biological or synthetic targeted agents. Effectiveness was assessed using Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) and Disease Activity in Psoriatic Arthritis (DAPSA) Score. We identified 39 different DTT combinations in 36 patients (22 SpA; 14 PsA), 25 of them with concomitant inflammatory bowel disease. The most commonly used combinations were TNF inhibitor plus antagonist of the IL12/23 pathway, followed by TNF inhibitor plus IL-17 antagonist. During a median exposure of 14.86 months (IQR 8-20.2), DTT retention rate was 69.4% (n=25/36; 19 SpA, 6 PsA). Major clinical improvement (change in ASDAS-CRP > 2 or improvement > 85% in DAPSA) was achieved in 69.4% of patients (n=25/36 therapeutical combinations; 17/21 SpA, 8/15 PsA), with a 58.3% (n=21/36 combinations; 15/20 SpA, 6/13 PsA) low-activity/remission rate. Of the patients who were receiving glucocorticoids, 55% managed to withdraw them during follow-up. Interestingly, only four serious adverse events in three patients were observed, leading to DTT discontinuation.
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Affiliation(s)
| | | | - Meritxell Sallés
- Rheumatology Unit, Althaia Xarxa Assistencial Universitària, Manresa, Spain
| | | | | | - Julio Ramírez
- Rheumatology Unit, Hospital Clinic, Barcelona, Spain
| | - Xavier Juanola
- Rheumatology Unit, Hospital U. Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Raquel Almodóvar
- Rheumatology Unit, Hospital U. Fundación Alcorcón, Madrid, Spain
| | - Ana Laiz
- Rheumatology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mireia Moreno
- Rheumatology Unit, Hospital U. Parc Taulí, I3PT (UAB), Sabadell, Spain
| | - Manel Pujol
- Rheumatology Unit, Hospital U, Mútua Terrassa, Barcelona, Spain
| | - Emma Beltrán
- Rheumatology Unit, Hospital del Mar, Barcelona, Spain
| | | | - Laura Crespí
- Rheumatology Unit, Hospital de Manacor, Manacor, Spain
| | | | - Santos Castañeda
- Rheumatology Unit, Hospital U. de La Princesa, IIS-Princesa, Madrid, Spain
- Cátedra Universidad Autónoma de Madrid UAM-Roche, enfermedad pulmonar intersticial difusa (EPID)-Future, Department of Medicine, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Rosario García-Vicuña
- Rheumatology Unit, Hospital U. de La Princesa, IIS-Princesa, Madrid, Spain
- Department of Medicine, Universidad Autónoma de Madrid (UAM), Madrid, Spain
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Choi M, Wang SE, Park JS, Kim HS, Choi SH, Lee JH, Chong JU, Nagakawa Y, Wada K, Nakamura Y, Sunagawa H, Dasari BVM, Peng CM, Seng LL, Wolters H, Gurbadam U, Park BUK, Winslow E, Fishbein T, Hawksworth J, Radkani P, Kang CM. Impact of adjuvant therapy in patients with invasive intraductal papillary mucinous neoplasms of the pancreas: an international multicenter cohort study. Int J Surg 2023; 109:2906-2913. [PMID: 37300881 PMCID: PMC10583921 DOI: 10.1097/js9.0000000000000537] [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: 03/06/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adjuvant therapy prolongs survival in patients with pancreatic ductal adenocarcinoma. However, no clear guidelines are available regarding the oncologic effects of adjuvant therapy (AT) in resected invasive intraductal papillary mucinous neoplasms (IPMN). The aim was to investigate the potential role of AT in patients with resected invasive IPMN. MATERIALS AND METHODS From 2001 to 2020, 332 patients with invasive pancreatic IPMN were retrospectively reviewed in 15 centres in eight countries. Propensity score-matched and stage-matched survival analyses were conducted. RESULTS A total of 289 patients were enroled in the study after exclusion (neoadjuvant therapy, unresectable disease, uncertain AT status, and stage IV). A total of 170 patients were enroled in a 1:1 propensity score-matched analysis according to the covariates. In the overall cohort, disease-free survival was significantly better in the surgery alone group than in the AT group ( P =0.003), but overall survival (OS) was not ( P =0.579). There were no significant differences in OS in the stage-matched analysis between the surgery alone and AT groups (stage I, P =0.402; stage II, P =0.179). AT did not show a survival benefit in the subgroup analysis according to nodal metastasis (N0, P =0.481; N+, P =0.705). In multivariate analysis, node metastasis (hazard ratio, 4.083; 95% CI, 2.408-6.772, P <0.001), and cancer antigen 19-9 greater than or equal to 100 (hazard ratio, 2.058; 95% CI, 1.247-3.395, P =0.005) were identified as adverse prognostic factors in resected invasive IPMN. CONCLUSION The current AT strategy may not be recommended to be performed with resected invasive IPMN in stage I and II groups, unlike pancreatic ductal adenocarcinoma. Further investigations of the potential role of AT in invasive IPMN are recommended.
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Affiliation(s)
- Munseok Choi
- Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea
| | - Shin-E Wang
- Department of Surgery, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan
| | | | | | - Sung Hoon Choi
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongam-si, Korea
| | - Jin Ho Lee
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jae Uk Chong
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Keita Wada
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshiharu Nakamura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
| | - Hiroki Sunagawa
- Department of Gastrointestinal Surgery, Nakagami Hospital, Okinawa, Japan
| | - Bobby VM Dasari
- Department of HPB and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, UK
| | - Cheng-Ming Peng
- Department of General Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Lee Lip Seng
- Hepatopancreatobiliary Unit, Department of General Surgery, Changi General Hospital, Singapore
| | - Heiner Wolters
- Department of Visceral and General Surgery, St. Josefs-Hospital, Dortmund, Germany
| | - Unenbat Gurbadam
- Department of Surgery, National Cancer Center Hospital, Ulan Bator, Mongolia
| | - Byoung UK Park
- Department of Pathology, The University of California, San Francisco, CA
| | - Emily Winslow
- Department of Pathology, The University of California, San Francisco, CA
- MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Thomas Fishbein
- MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Jason Hawksworth
- MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Pejman Radkani
- MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Chang Moo Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Fotouhi AR, Patel KB, Skolnick GB, Merrill CM, Hofmann KM, Mantilla-Rivas E, Collett BR, Allhusen VD, Naidoo SD, Rogers GF, Keating RF, Smyth MD, Magge SN. School-age anthropometric and patient-reported outcomes after open or endoscopic repair of sagittal craniosynostosis. J Neurosurg Pediatr 2023; 32:455-463. [PMID: 37486865 DOI: 10.3171/2023.5.peds2382] [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: 02/20/2023] [Accepted: 05/30/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE Several studies have compared perioperative parameters and early postoperative morphology between endoscope-assisted strip craniectomy with orthotic therapy (endoscopic repair) and cranial vault remodeling (open repair). To extend these results, the authors evaluated school-age anthropometric outcomes after these techniques across three institutions. METHODS School-aged children (age range 4-18 years) with previously corrected isolated sagittal craniosynostosis were enrolled. Upon inclusion, 3D photographs and patient-reported outcomes were obtained, and the cephalic index and head circumference z-scores were calculated. Analyses of covariance models controlling for baseline differences and a priori covariates were performed. RESULTS Eighty-one participants (median [range] age 7 [4-15] years) were included. The mean (95% CI) school-age cephalic index was significantly higher in the endoscopic cohort, though within the normal range for both groups (endoscopic 78% [77%-79%] vs open 76% [74%-77%], p = 0.027). The mean change in the cephalic index from preoperation to school age was significantly greater in the endoscopic group (9% [7%-11%] vs open 3% [1%-5%], p < 0.001). Compared to preoperative measurements, mean school-age head circumference z-scores decreased significantly more in the open cohort (-1.6 [-2.2 to -1.0] vs endoscopic -0.3 [-0.8 to -0.2], p = 0.002). Patient-reported levels of stigma were within the normal limits for both groups. CONCLUSIONS Endoscopic and open repair techniques effectively normalize school-age anthropometric outcomes. However, endoscopic repair produces a clinically meaningful and significantly greater improvement in the school-age cephalic index, with maintenance of head growth. These findings demonstrate the importance of early referral by pediatricians and inform treatment decisions.
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Affiliation(s)
- Annahita R Fotouhi
- 1Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Kamlesh B Patel
- 1Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Gary B Skolnick
- 1Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Corinne M Merrill
- 1Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri
| | | | | | - Brent R Collett
- 3Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | | | - Sybill D Naidoo
- 1Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Gary F Rogers
- 5Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC
| | - Robert F Keating
- 2Division of Neurosurgery, Children's National Hospital, Washington, DC
| | - Matthew D Smyth
- 6Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
| | - Suresh N Magge
- 2Division of Neurosurgery, Children's National Hospital, Washington, DC
- 7Division of Neurosurgery, CHOC Neuroscience Institute, Children's Hospital of Orange County, Orange, California; and
- 8Department of Neurosurgery, University of California, Irvine, California
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Aires J, Ilhan ZE, Nicolas L, Ferraris L, Delannoy J, Bredel M, Chauvire-Drouard A, Barbut F, Rozé JC, Lepage P, Butel MJ. Occurrence of Neonatal Necrotizing Enterocolitis in Premature Neonates and Gut Microbiota: A Case-Control Prospective Multicenter Study. Microorganisms 2023; 11:2457. [PMID: 37894115 PMCID: PMC10609581 DOI: 10.3390/microorganisms11102457] [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: 09/13/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Necrotizing enterocolitis (NEC) is still one of the leading causes of neonatal death. The present study reports the data from a French case-control prospective multicenter study. METHODS A total of 146 preterm neonates (PNs) with or without NEC were included. Bacterial 16S rRNA gene sequencing was performed on stool samples (n = 103). Specific culture media were used to isolate Escherichia coli, Clostridium butyricum, and Clostridium neonatale, and strains were phenotypically characterized. RESULTS The gut microbiota of PNs was dominated by Firmicutes and Proteobacteria, and five enterotypes were identified. The microbiota composition was similar between NEC cases and PN controls. However, differences were observed in the relative abundance of Lactobacillus genus, which was significantly lower in the NEC group, whereas that of the Clostridium cluster III was significantly higher (p < 0.05). Within enterotypes, several phylotypes were significantly more abundant in NEC cases (p < 0.05). Regarding perinatal factors, a statistical association was found between the gut microbiota and cesarean delivery and antifungal therapy. In NEC cases and PN controls, the carriage rates and virulence genes of uropathogenic E. coli were equivalent based on culture. No correlation was found between E. coli, C. butyricum, and C. neonatale carriages, beta-lactam resistance, and antibiotic treatment. CONCLUSIONS At disease onset, our data support a microbiota dysbiosis between NEC and control infants at the genus level. In addition, it provides valuable information on bacterial antimicrobial susceptibility.
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Affiliation(s)
- Julio Aires
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Zehra Esra Ilhan
- Micalis Institute, INRA, AgroParisTech, University Paris-Saclay, 91190 Paris, France; (Z.E.I.); (M.B.)
| | - Lancelot Nicolas
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Laurent Ferraris
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Johanne Delannoy
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Maxime Bredel
- Micalis Institute, INRA, AgroParisTech, University Paris-Saclay, 91190 Paris, France; (Z.E.I.); (M.B.)
| | - Anne Chauvire-Drouard
- Centre d’Investigation Clinique CIC 1413, INSERM, CHU de Nantes, 44093 Nantes, France;
| | - Frédéric Barbut
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Jean-Christophe Rozé
- Department of Neonatal Medicine, University Hospital of Nantes, 44093 Nantes, France;
| | - Patricia Lepage
- Micalis Institute, INRA, AgroParisTech, University Paris-Saclay, 91190 Paris, France; (Z.E.I.); (M.B.)
| | - Marie-José Butel
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
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30
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Tawiah R, Bondell H. Multilevel joint frailty model for hierarchically clustered binary and survival data. Stat Med 2023; 42:3745-3763. [PMID: 37593802 DOI: 10.1002/sim.9829] [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: 11/23/2022] [Revised: 03/22/2023] [Accepted: 05/29/2023] [Indexed: 08/19/2023]
Abstract
Hierarchical data arise when observations are clustered into groups. Multilevel models are practically useful in these settings, but these models are elusive in the context of hierarchical data with mixed multivariate outcomes. In this article, we consider binary and survival outcomes and assume the hierarchical structure is induced by clustering of both outcomes within patients and clustering of patients within hospitals which frequently occur in multicenter studies. We introduce a multilevel joint frailty model that analyzes the outcomes simultaneously to jointly estimate their regression parameters and explicitly model within-patient correlation between the outcomes and within-hospital correlation separately for each outcome. Estimation is facilitated by a computationally efficient residual maximum likelihood method that further predicts cluster-specific frailties for both outcomes and circumvents the formidable challenges induced by multidimensional integration that complicates the underlying likelihood. The performance of the model and estimation procedure is investigated via extensive simulation studies. The practical utility of the model is illustrated through simultaneous modeling of disease-free survival and binary endpoint of platelet recovery in a multicenter allogeneic bone marrow transplantation dataset that motivates this study.
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Affiliation(s)
- Richard Tawiah
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Victoria, Australia
| | - Howard Bondell
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Victoria, Australia
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Shibuya K, Hasegawa H, Suzuki T, Takahashi H, Nishiyama K, Oishi M, Fujii Y. Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study. Neurol Med Chir (Tokyo) 2023; 63:393-399. [PMID: 37380448 PMCID: PMC10556208 DOI: 10.2176/jns-nmc.2023-0039] [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: 03/02/2023] [Accepted: 04/19/2023] [Indexed: 06/30/2023] Open
Abstract
In Japan, which has a super-aging society, there are increasing opportunities to perform mechanical thrombectomy for the elderly; however, there is no recorded evidence of thrombectomy for the elderly. This study examined the usefulness of thrombectomy in the elderly. We retrospectively analyzed patient data using a multicenter acute ischemic stroke registry (NGT-FAST). We examined outcomes in patients 75 years and older who underwent thrombectomies between January 1, 2021, and December 31, 2021. The patients were divided into two groups: the 75-84-year-old group and the 85+-year-old group. There was no difference in the pretreatment National Institutes of Health Stroke Scale score or Alberta Stroke Program Early Computed Tomography Score between the two groups, but the 85+-year-old group had a significantly lower rate of pre-stroke modified Rankin Scale (mRS) score of 0-2. There were no differences in time from onset to treatment or effective recanalization rate, but complications tended to be more common in the 85+-year-old group. The number of patients with a good outcome at discharge (an mRS score of 0-3) was significantly lower in the 85+-year-old group than in the 75-84-year-old group. In addition, 90.9% of patients in the 85+-year-old group with a pre-stroke mRS score of 3 deteriorated after treatment. The pre-stroke mRS score is very important in determining the indication for thrombectomy in the elderly because their preoperative condition is more likely to influence the outcome than that of younger patients.
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Affiliation(s)
- Kohei Shibuya
- Department of Neurosurgery, Brain Research Institute, Niigata University
| | - Hitoshi Hasegawa
- Department of Neurosurgery, Brain Research Institute, Niigata University
| | - Tomoaki Suzuki
- Department of Neurosurgery, Brain Research Institute, Niigata University
| | - Haruhiko Takahashi
- Department of Neurosurgery, Brain Research Institute, Niigata University
| | - Kei Nishiyama
- Department of Emergency Medicine, Niigata University
| | - Makoto Oishi
- Department of Neurosurgery, Brain Research Institute, Niigata University
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University
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Wang L, Xu T, Wang Q, Ni H, Yu X, Song C, Li Y, Li F, Meng T, Sheng H, Cai X, Dai T, Xiao L, Zeng Q, Guo P, Wei J, Zhang X. Exposure to Fine Particulate Matter Constituents and Human Semen Quality Decline: A Multicenter Study. Environ Sci Technol 2023; 57:13025-13035. [PMID: 37608438 PMCID: PMC10483896 DOI: 10.1021/acs.est.3c03928] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/24/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/24/2023]
Abstract
Exposure to fine particulate matter (PM < 2.5 μm in diameter [PM2.5]) may accelerate human sperm quality decline, although research on this association is limited. Our objective was to investigate the relationship between exposure to the chemical constituents of PM2.5 air pollution and decreased sperm quality and to further explore the exposure-response relationship. We conducted a multicenter population-based cohort study including 78,952 semen samples from 33,234 donors at 6 provincial human sperm banks (covering central, northern, southern, eastern, and southwestern parts of China) between 2014 and 2020. Daily exposure to PM2.5 chemical composition was estimated using a deep learning model integrating a density ground-based measure network at a 1 km resolution. Linear mixed models with subject- and center-specific intercepts were used to quantify the harmful impacts of PM2.5 constituents on semen quality and explore their exposure-response relationships. Per interquartile range (IQR) increase in PM2.5 exposure levels during spermatogenesis was significantly associated with decreased sperm concentration, progressive motility, and total motility. For PM2.5 constituents, per IQR increment in Cl- (β: -0.02, 95% CI: [-0.03, -0.00]) and NO3- (β: -0.05, 95% CI: [-0.08, -0.02]) exposure was negatively associated with sperm count, while NH4+ (β: -0.03, 95% CI: [-0.06, -0.00]) was significantly linked to decreased progressive motility. These results suggest that exposure to PM2.5 chemical constituents may adversely affect human sperm quality, highlighting the urgent need to reduce PM2.5 exposure.
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Affiliation(s)
- Lingxi Wang
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Ting Xu
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Qiling Wang
- National
Health Commission Key Laboratory of Male Reproduction and Genetics, Guangzhou 510600, China
- Department
of Andrology, Guangdong Provincial Reproductive
Science Institute (Guangdong Provincial Fertility Hospital), Guangzhou 510600, China
| | - Haobo Ni
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Xiaolin Yu
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Chunying Song
- Human
Sperm Bank, The Shanxi Bethune Hospital,
Shanxi Academy of Medical Sciences, Taiyuan 030032, China
| | - Yushan Li
- Human
Sperm Bank, The Third Affiliated Hospital
of Zhengzhou University, Zhengzhou 450052, China
| | - Fuping Li
- Human
Sperm
Bank, the Key Laboratory of Birth Defects and Related Diseases of
Women and Children of Ministry of Education, West China Second University Hospital of Sichuan University, Chengdu 610041, China
| | - Tianqing Meng
- Reproductive
Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Human
Sperm Bank, Reproductive Medicine Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Huiqiang Sheng
- Human
Sperm Bank, The Zhejiang Provincial Maternal
and Child and Reproductive Health Care Center, Hangzhou 310008, China
| | - Xiaoyan Cai
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Tingting Dai
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Lina Xiao
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Qinghui Zeng
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Pi Guo
- Department
of Preventive Medicine, Shantou University
Medical College, Shantou 515041, China
| | - Jing Wei
- Department
of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary
Center, University of Maryland, College Park, Maryland 20740, United States
| | - Xinzong Zhang
- National
Health Commission Key Laboratory of Male Reproduction and Genetics, Guangzhou 510600, China
- Department
of Andrology, Guangdong Provincial Reproductive
Science Institute (Guangdong Provincial Fertility Hospital), Guangzhou 510600, China
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Wang H, Xu B, Bao Y, Yang Y, Qian L, Zhang H, Zhu C, Yin Y, Jiang M, Dai J, Xu Y, Zhu X, Zhu X, Shen K. Etiology and clinical features of children with bronchiectasis in China: A 10-year multicenter retrospective study. Clin Respir J 2023; 17:841-850. [PMID: 37259267 PMCID: PMC10500320 DOI: 10.1111/crj.13630] [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: 01/12/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The current study aims to investigate the etiology spectrum and the clinical characteristics of bronchiectasis in Chinese children. METHODS The study is designed as a multicenter retrospective study. 193 cases were enrolled in 13 centers in China between 2008 and 2017. The inclusive cases must meet the clinical as well as the HRCT criteria. Only if both two radiologists confirmed the diagnosis, the case could be enrolled. The cases that could not provide clinical and imageology data were excluded. The data were entered into the specialized system and then analyzed. RESULTS One hundred sixty-nine cases (87%) were found to have the underlying etiology. Post-infective (46%), primary immunodeficiency (14%), and PCD (13%) were the common causes. All cases came from 28 provinces in Mainland China. The median age of symptom onset was 5.8 (2.0, 8.9) years. The median age of diagnosis was 8.4 (4.5, 11.6) years. The main symptoms were cough, sputum expectoration, and fever during the exacerbation. Nineteen percent of patients suffered from limited exercise tolerance. Clubbing was found in 17% of cases. Nearly 30% of patients presented growth limitations. On the HRCT findings, 126 cases had diffused bronchiectasis, and bilateral involvement was found in 94 cases. The lower lobes and right middle lobes were most commonly involved. Approximately 30% of cultures of sputum and bronchoalveolar lavage were positive. CONCLUSION A majority of cases could be found the underlying etiology. Post-infective, primary immunodeficiency, and PCD were the most common causes. Some clinical figures might indicate a specific etiology.
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Affiliation(s)
- Hao Wang
- Beijing Children's HospitalCapital Medical UniversityBeijingChina
- National Clinical Research Center for Respiratory DiseasesBeijingChina
| | - Bao‐ping Xu
- Beijing Children's HospitalCapital Medical UniversityBeijingChina
- National Clinical Research Center for Respiratory DiseasesBeijingChina
| | - Yan‐min Bao
- Shenzhen Children's HospitalShenzhenGuangzhouChina
| | - Yungang Yang
- The first affiliated hospital of Xiamen UniversityXiamenFujianChina
| | - Li‐ling Qian
- Children's Hospital of Fudan UniversityShanghaiChina
| | - Hai‐lin Zhang
- The 2nd Affiliated Hospital and Yuying Children's Hospital of WMUWenzhouZhejiangChina
| | - Chun‐mei Zhu
- Capital Institute of PediatricsChildren's HospitalBeijingChina
| | - Yong Yin
- Shanghai Children's Medical CenterShanghaiChina
| | - Min Jiang
- The First Affiliated Hospital of Guangxi Medical UniversityNanningGuangxiChina
| | - Ji‐hong Dai
- Children's Hospital of Chongqing Medical UniversityChongqingChina
| | | | - Xiao‐hua Zhu
- Jiangxi Provincial Children's HospitalNanchangJiangxiChina
| | - Xiao‐ping Zhu
- The Affiliated Hospital of Guizhou Medical UniversityGuiyangGuizhouChina
| | - Kun‐ling Shen
- Beijing Children's HospitalCapital Medical UniversityBeijingChina
- National Clinical Research Center for Respiratory DiseasesBeijingChina
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Shen L, Du L, Hu Y, Chen X, Hou Z, Yan Z, Wang X. MRI-based radiomics model for distinguishing Stage I endometrial carcinoma from endometrial polyp: a multicenter study. Acta Radiol 2023; 64:2651-2658. [PMID: 37291882 DOI: 10.1177/02841851231175249] [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: 06/10/2023]
Abstract
BACKGROUND Patients with early endometrial carcinoma (EC) have a good prognosis, but it is difficult to distinguish from endometrial polyps (EPs). PURPOSE To develop and assess magnetic resonance imaging (MRI)-based radiomics models for discriminating Stage I EC from EP in a multicenter setting. MATERIAL AND METHODS Patients with Stage I EC (n = 202) and EP (n = 99) who underwent preoperative MRI scans were collected in three centers (seven devices). The images from devices 1-3 were utilized for training and validation, and the images from devices 4-7 were utilized for testing, leading to three models. They were evaluated by the area under the receiver operating characteristic curve (AUC) and metrics including accuracy, sensitivity, and specificity. Two radiologists evaluated the endometrial lesions and compared them with the three models. RESULTS The AUCs of device 1, 2_ada, device 1, 3_ada, and device 2, 3_ada for discriminating Stage I EC from EP were 0.951, 0.912, and 0.896 for the training set, 0.755, 0.928, and 1.000 for the validation set, and 0.883, 0.956, and 0.878 for the external validation set, respectively. The specificity of the three models was higher, but the accuracy and sensitivity were lower than those of radiologists. CONCLUSION Our MRI-based models showed good potential in differentiating Stage I EC from EP and had been validated in multiple centers. Their specificity was higher than that of radiologists and may be used for computer-aided diagnosis in the future to assist clinical diagnosis.
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Affiliation(s)
- Liting Shen
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Lixin Du
- Department of Medical Imaging, Shenzhen Longhua District Central Hospital, Shenzhen, PR China
| | - Yumin Hu
- Department of Radiology, Lishui Central Hospital, Zhejiang, PR China
| | - Xiaojun Chen
- Department of Radiology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, PR China
| | - Zujun Hou
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, PR China
| | - Zhihan Yan
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Xue Wang
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
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Lu C, Yang F, Liu H, Dou L, Wang Y, Li H, Duan X, Wu L, Wang Y, Zhang X, Xu J, Su J, Xu D, Zhao J, Wu Q, Li M, Leng X, Zeng X. Chinese Registry of Psoriatic Arthritis (CREPAR): I. Clinical characteristics of Chinese patients with psoriatic arthritis. Int J Rheum Dis 2023; 26:1737-1744. [PMID: 37424174 DOI: 10.1111/1756-185x.14805] [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: 06/16/2022] [Revised: 10/17/2022] [Accepted: 06/17/2023] [Indexed: 07/11/2023]
Abstract
AIM To describe the clinical characteristics of Chinese patients with psoriatic arthritis (PsA) using the data recorded in the Chinese Registry of Psoriatic Arthritis (CREPAR). METHODS This is a cross-sectional study based on the CREPAR registry, which is a prospective registry founded in December 2018. Data regarding clinical characteristics and treatment of patients were collected during every visit. Data recorded at enrollment were extracted, analyzed, and compared with data in other registries or cohorts. RESULTS A total of 1074 patients were registered from December 2018 to June 2021. Of these, 929 (86.5%) patients had a history of peripheral arthritis, and 844 patients (78.6%) had peripheral arthritis at enrollment, of which polyarthritis is the most common subtype. Axial involvement was present in 39.9% of patients, and 50 (4.7%) patients had axial involvement only. More than half of the patients (55.4%) had at least two musculoskeletal presentations at enrollment. The prevalence of low disease activity and remission according to DAPSA were 26.4% and 6.8%, respectively. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biological DMARDs were used in 64.9% and 29.1% of patients, respectively. Among patients with different musculoskeletal presentations, patients with dactylitis had the highest proportion of nonsteroidal anti-inflammatory and csDMARD use. The proportion of patients receiving bDMARDs was highest in axial PsA. CONCLUSION The CREPAR registry has provided information on Chinese patients with PsA. Compared with data in other registries or cohorts, the disease activity of patients in CREPAR was higher, and the proportion of bDMARD use was lower.
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Affiliation(s)
- Chaofan Lu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Fan Yang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Huilan Liu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Lei Dou
- Department of Rheumatology and Immunology, The Second People's Hospital of Wuhu, Wuhu, China
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hongbin Li
- The Division of Rheumatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Xinwang Duan
- Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lijun Wu
- Department of Rheumatology and Immunology, The People's Hospital of the Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yongfu Wang
- Department of Rheumatology, First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Xiuying Zhang
- Department of Rheumatology, ZiBo Central Hospital, Zibo, China
| | - Jian Xu
- Department of Rheumatology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jinmei Su
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Qingjun Wu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaomei Leng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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Liu F, Li Q, Xiang Z, Li X, Li F, Huang Y, Zeng Y, Lin H, Fang X, Yang Q. CT radiomics model for predicting the Ki-67 proliferation index of pure-solid non-small cell lung cancer: a multicenter study. Front Oncol 2023; 13:1175010. [PMID: 37706180 PMCID: PMC10497212 DOI: 10.3389/fonc.2023.1175010] [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: 02/27/2023] [Accepted: 08/07/2023] [Indexed: 09/15/2023] Open
Abstract
Purpose This study aimed to explore the efficacy of the computed tomography (CT) radiomics model for predicting the Ki-67 proliferation index (PI) of pure-solid non-small cell lung cancer (NSCLC). Materials and methods This retrospective study included pure-solid NSCLC patients from five centers. The radiomics features were extracted from thin-slice, non-enhanced CT images of the chest. The minimum redundancy maximum relevance (mRMR) and least absolute shrinkage and selection operator (LASSO) were used to reduce and select radiomics features. Logistic regression analysis was employed to build predictive models to determine Ki-67-high and Ki-67-low expression levels. Three prediction models were established: the clinical model, the radiomics model, and the nomogram model combining the radiomics signature and clinical features. The prediction efficiency of different models was evaluated using the area under the curve (AUC). Results A total of 211 NSCLC patients with pure-solid nodules or masses were included in the study (N=117 for the training cohort, N=49 for the internal validation cohort, and N=45 for the external validation cohort). The AUC values for the clinical models in the training, internal validation, and external validation cohorts were 0.73 (95% CI: 0.64-0.82), 0.75 (95% CI:0.62-0.89), and 0.72 (95% CI: 0.57-0.86), respectively. The radiomics models showed good predictive ability in diagnosing Ki-67 expression levels in the training cohort (AUC, 0.81 [95% CI: 0.73-0.89]), internal validation cohort (AUC, 0.81 [95% CI: 0.69-0.93]) and external validation cohort (AUC, 0.78 [95% CI: 0.64-0.91]). Compared to the clinical and radiomics models, the nomogram combining both radiomics signatures and clinical features had relatively better diagnostic performance in all three cohorts, with the AUC of 0.83 (95% CI: 0.76-0.90), 0.83 (95% CI: 0.71-0.94), and 0.81 (95% CI: 0.68-0.93), respectively. Conclusion The nomogram combining the radiomics signature and clinical features may be a potential non-invasive method for predicting Ki-67 expression levels in patients with pure-solid NSCLC.
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Affiliation(s)
- Fen Liu
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Qingcheng Li
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Zhiqiang Xiang
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Xiaofang Li
- Department of Radiology, The Affiliated Huaihua Hospital, Hengyang Medical School, University of South China, Huaihua, China
| | - Fangting Li
- Department of Radiology, People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Yingqiong Huang
- Department of Radiology, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Ye Zeng
- Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Huashan Lin
- Department of Pharmaceutical Diagnosis, GE Healthcare, Changsha, China
| | - Xiangjun Fang
- Department of Radiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Qinglai Yang
- Center for Molecular Imaging Probe, Hunan Province Key Laboratory of Tumor Cellular and Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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Wu P, Jiang Y, Xing H, Song W, Cui X, Wu XL, Xu G. Multimodality deep learning radiomics nomogram for preoperative prediction of malignancy of breast cancer: a multicenter study. Phys Med Biol 2023; 68:175023. [PMID: 37524093 DOI: 10.1088/1361-6560/acec2d] [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: 04/18/2023] [Accepted: 07/31/2023] [Indexed: 08/02/2023]
Abstract
Background. Breast cancer is the most prevalent cancer diagnosed in women worldwide. Accurately and efficiently stratifying the risk is an essential step in achieving precision medicine prior to treatment. This study aimed to construct and validate a nomogram based on radiomics and deep learning for preoperative prediction of the malignancy of breast cancer (MBC).Methods. The clinical and ultrasound imaging data, including brightness mode (B-mode) and color Doppler flow imaging, of 611 breast cancer patients from multiple hospitals in China were retrospectively analyzed. Patients were divided into one primary cohort (PC), one validation cohort (VC) and two test cohorts (TC1 and TC2). A multimodality deep learning radiomics nomogram (DLRN) was constructed for predicting the MBC. The performance of the proposed DLRN was comprehensively assessed and compared with three unimodal models via the calibration curve, the area under the curve (AUC) of receiver operating characteristics and the decision curve analysis.Results. The DLRN discriminated well between the MBC in all cohorts [overall AUC (95% confidence interval): 0.983 (0.973-0.993), 0.972 (0.952-0.993), 0.897 (0.823-0.971), and 0.993 (0.977-1.000) on the PC, VC, test cohorts1 (TC1) and test cohorts2 TC2 respectively]. In addition, the DLRN performed significantly better than three unimodal models and had good clinical utility.Conclusion. The DLRN demonstrates good discriminatory ability in the preoperative prediction of MBC, can better reveal the potential associations between clinical characteristics, ultrasound imaging features and disease pathology, and can facilitate the development of computer-aided diagnosis systems for breast cancer patients. Our code is available publicly in the repository athttps://github.com/wupeiyan/MDLRN.
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Affiliation(s)
- Peiyan Wu
- School of Computer Science and Engineering, Hubei Key Laboratory of Intelligent Robot, Wuhan Institute of Technology, Wuhan, People's Republic of China
| | - Yan Jiang
- School of Computer Science and Engineering, Hubei Key Laboratory of Intelligent Robot, Wuhan Institute of Technology, Wuhan, People's Republic of China
| | - Hanshuo Xing
- School of Computer Science and Engineering, Hubei Key Laboratory of Intelligent Robot, Wuhan Institute of Technology, Wuhan, People's Republic of China
| | - Wenbo Song
- School of Computer Science and Engineering, Hubei Key Laboratory of Intelligent Robot, Wuhan Institute of Technology, Wuhan, People's Republic of China
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xing Long Wu
- School of Computer Science and Engineering, Hubei Key Laboratory of Intelligent Robot, Wuhan Institute of Technology, Wuhan, People's Republic of China
| | - Guoping Xu
- School of Computer Science and Engineering, Hubei Key Laboratory of Intelligent Robot, Wuhan Institute of Technology, Wuhan, People's Republic of China
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Abstract
AIM To compare the long-term results of eversion (ECEA) and conventional carotid endarterectomy (CCEA). METHODS We designed a retrospective, multicenter study which included 25,106 patients who underwent ECEA (n = 18,362) or CCEA (n = 6744). The duration of follow-up was 124.7 ± 53.8 months. RESULTS In the postoperative period, none of the interventions showed clear benefits reducing the frequency of complications: fatal outcome (ECEA: 0.19%, n = 36; CCEA: 0.17%, n = 12; OR = 1.1, 95% CI = 0.57-2.11, p = 0.89), myocardial infarction (ECEA: 0.15%, n = 28; CCEA: 0.13%, n = 9; p = 0.87; OR = 1.14; 95% CI = 0.53-2.42); acute cerebrovascular accident (CVA) (Group I: 0.33%, n = 62; Group II: 0.4%, n = 27; p = 0.53; OR = 0.84; 95% CI = 0, 53-1.32); bleeding with acute haematoma appearance in the area of intervention (Group I: 0.39%, n = 73; Group II: 0.41%, n = 28; p = 0.93; OR = 0.95; 95% CI = 0, 61-1.48); internal carotid artery (ICA) thrombosis (Group I: 0.05%, n = 11; Group II: 0.07%, n = 5; OR = 0.80, 95% CI = 0.28-2.32, p = 0.90). During the long-term follow-up, ECEA was associated with lower frequency of fatal outcome (ECEA: 2.7%, n = 492; CCEA: 9.1%, n = 616; OR = 0.27; 95% CI = 0.24-0.3, p < 0.0001), cerebrovascular death (ECEA: 1.0%, n = 180; CCEA: 5.5%, n = 371; OR = 0.17, 95% CI = 0.14-0.21, p < 0.0001), non-fatal ischaemic stroke (ECEA: 0.62%, n = 114; CCEA: 7.0%, n = 472; OR = 0.08; 95% CI = 0.06-0.1, p < 0.0001); repeated revascularization because of >60% restenosis (ECEA: 1.6%, n = 296; CCEA: 12.6%, n = 851; OR = 0.11, 95% CI = 0.09-0.12, p < 0.0001), and combined endpoint (ECEA: 2.2%, n = 397; CCEA: 13.2%, n = 888; OR = 0.14; 95% CI = 0.12-1.16, p < 0.0001). CONCLUSION ECEA is beneficial over CCEA in a long term.
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Affiliation(s)
- Yuri V Belov
- Petrovsky National Research Centre of Surgery, Moscow, Russia
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Doi Y, Nagata Y, Matsumoto Y, Numata K, Sasaki R, Yamada T, Igaki H, Imagumbai T, Katoh N, Yoshitake T, Shimizuguchi T, Fujioka D, Inoue M, Koide Y, Kimura T, Ito Y. Multicenter retrospective study of stereotactic body radiotherapy for patients with previously untreated initial small hepatocellular carcinoma. Hepatol Res 2023; 53:749-760. [PMID: 37036153 DOI: 10.1111/hepr.13908] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/19/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
AIM We aimed to verify the therapeutic efficacy and safety of stereotactic body radiotherapy (SBRT) for previously untreated initial small hepatocellular carcinoma (HCC) in a multicenter, retrospective study. METHODS Patients who underwent SBRT for HCC at the Japanese Society of Clinical Oncology (JCOG) member hospitals in Japan between July 2013 and December 2017 and met the following eligibility criteria were included: (1) initial HCC; (2) ≤3 nodules, ≤5 cm in diameter; (3) Child-Pugh score of A or B; and (4) unsuitability for or refusal of standard treatment. We analyzed the overall survival, recurrence-free survival, and cumulative incidence of local recurrence rate, and adverse events directly related to SBRT. RESULTS Seventy-three patients with 79 lesions from 14 hospitals were analyzed. The median age was 77 years (range: 50-89 years), and the median tumor size was 23 mm (range: 6-50 mm). The median radiation dose was 40 Gy (range: 35-60 Gy) in five fractions (range: 4-8). The median follow-up period was 45 months (range: 0-103 months). The 3-year overall survival, recurrence-free survival, and cumulative incidence of local recurrence rates were 69.9% (95% CI: 58.7%-81%), 57.9% (95% CI: 45.2%-70.5%), and 20.0% (95% CI: 11.2%-30.5%), respectively. Four cases (5.5%) of adverse events of grade 3 or higher were reported: three cases of grade 3 and one case of grade 4 (duodenal ulcer). No grade 5 toxicities were observed. CONCLUSION SBRT is a promising treatment modality, particularly for small HCCs, as they are not suitable for standard treatment.
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Affiliation(s)
- Yoshiko Doi
- Hiroshima High-Precision Radiotherapy Cancer Center, Hiroshima, Japan
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasushi Nagata
- Hiroshima High-Precision Radiotherapy Cancer Center, Hiroshima, Japan
- Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuo Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Kazushi Numata
- Department of Gastroenterology, Yokohama City University Medical Center, Yokohama, Japan
| | - Ryu Sasaki
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Yamada
- Department of Radiation Oncology, Yamanashi University Hospital, Yamanashi, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital Japan, Tokyo, Japan
| | - Toshiyuki Imagumbai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Norio Katoh
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Tadamasa Yoshitake
- Department of Radiation Oncology, Kyusyu University Hospital, Fukuoka, Japan
| | - Takuya Shimizuguchi
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Den Fujioka
- Department of Radiation Oncology, Tsukuba University Hospital, Ibaraki, Japan
| | - Minoru Inoue
- Department of Radiation Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Yutaro Koide
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tomoki Kimura
- Department of Radiation Oncology, Kochi University Hospital, Kochi, Japan
| | - Yoshinori Ito
- Department of Radiation Oncology, Showa University School of Medicine, Tokyo, Japan
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Zarbo C, Zamparini M, Nielssen O, Casiraghi L, Rocchetti M, Starace F, de Girolamo G. Comparing Adherence to the Experience Sampling Method Among Patients With Schizophrenia Spectrum Disorder and Unaffected Individuals: Observational Study From the Multicentric DiAPAson Project. J Med Internet Res 2023; 25:e42093. [PMID: 37463030 PMCID: PMC10394602 DOI: 10.2196/42093] [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: 08/22/2022] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The Experience Sampling Method (ESM) is a valid method of remotely recording activities and mood, but the predictors of adherence to ESM in patients with Schizophrenia Spectrum Disorder (SSD) are not known. Studies on adherence are significant as they highlight the strengths and weaknesses of ESM-based study designs and allow the development of recommendations and practical guidelines for implementing future studies or treatment plans. OBJECTIVE The aim of this study was to compare the adherence to ESM in patients with SSD and unaffected control individuals, investigate their patterns, and report the predictors of adherence. METHODS In total, 131 patients with SSD (74 in residential facilities and 57 outpatients) and 115 unaffected control individuals were recruited at 10 different centers in Italy as part of the DiAPAson project. Demographic information, symptom severity, disability level, and level of function were recorded for the clinical sample. Participants were evaluated for daily time use and mood through a smartphone-based ESM 8 times a day for 7 consecutive days. Adherence was measured by the response rate to ESM notifications. Results were analyzed using the chi-square test, ANOVA, Kruskal-Wallis test, and Friedman test, and a logistic regression model. RESULTS The overall adherence rate in this study was 50% for residents, 59% for outpatients, and 78% for unaffected control individuals. Indeed, patients with SSD had a lower rate of adherence to ESM than the unaffected control group (P≤.001), independent of time slot, day of monitoring, or day of the week. No differences in adherence rates between weekdays and weekends were found among the 3 groups. The adherence rate was the lowest in the late evening time slot (8 PM to 12 AM) and days 6-7 of the study for both patients with SSD and unaffected control individuals. The adherence rate among patients with SSD was not predicted by sociodemographic characteristics, cognitive function, or other clinical features. A higher adherence rate (ie, ≥70%) among patients with SSD was predicted by higher collaboration skills (odds ratio [OR] 2.952; P=.046) and self-esteem (OR 3.394; P=.03), and lower positive symptom severity (OR 0.835; P=.04). CONCLUSIONS Adherence to ESM prompts for both patients with SSD and unaffected control individuals decreased during late evening and after 6 days of monitoring. Higher self-esteem and collaboration skills predicted higher adherence to ESM among patients with SSD, while higher positive symptom scores predicted lower adherence rates. This study provides important information to guide protocols for future studies using ESM. Future clinical or research studies should set ESM monitoring to waking hours, limit the number of days of monitoring, select patients with more collaborative skills and avoid those with marked positive symptoms, provide intensive training sessions, and improve participants' self-confidence with technologies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-020-02588-y.
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Affiliation(s)
- Cristina Zarbo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Manuel Zamparini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Olav Nielssen
- MindSpot Clinic, Macquarie University, Sydney, Australia
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Letizia Casiraghi
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy
| | - Matteo Rocchetti
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy
| | - Fabrizio Starace
- Department of Mental Health and Dependence, AUSL of Modena, Modena, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Min JY, Kim JY, Sung CM, Kim ST, Cho HJ, Mun SJ, Cho SW, Hong SD, Ryu G, Cho KR, Kim YH, Park SK, Kim DK, Lee DH, Heo SJ, Lee KI, Kim SJ, Lee S, Mo JH, Shin SH, Kim DW. Inflammatory Endotypes of Chronic Rhinosinusitis in the Korean Population: Distinct Expression of Type 3 Inflammation. Allergy Asthma Immunol Res 2023; 15:437-450. [PMID: 37075796 PMCID: PMC10359642 DOI: 10.4168/aair.2023.15.4.437] [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] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/28/2022] [Accepted: 12/13/2022] [Indexed: 07/21/2023]
Abstract
PURPOSE Cluster analyses on inflammatory markers of chronic rhinosinusitis (CRS) in Asians from multicenter data are lacking. This multicenter study aimed to identify the endotypes of CRS in Koreans and to evaluate the relationship between the endotypes and clinical parameters. METHODS Nasal tissues were obtained from patients with CRS and controls who underwent surgery. The endotypes of CRS were investigated by measuring interleukin (IL)-5, interferon (IFN)-γ, IL-17A, IL-22, IL-1β, IL-6, IL-8, matrix metalloproteinase-9, eotaxin-3, eosinophil cationic protein, myeloperoxidase (MPO), human neutrophil elastase (HNE), periostin, transforming growth factor-β1, total immunoglobulin E (IgE), and staphylococcal enterotoxin (SE)-specific IgE. We performed hierarchical cluster analysis and evaluated the phenotype, comorbidities, and Lund-Mackay computed tomography (LM CT) score in each cluster. RESULTS Five clusters and 3 endotypes were extracted from 244 CRS patients: cluster 1 had no upregulated mediators compared to the other clusters (mild mixed inflammatory CRS); clusters 2, 3, and 4 had higher concentrations of neutrophil-associated mediators including HNE, IL-8, IL-17A, and MPO (T3 CRS); and cluster 5 had higher levels of eosinophil-associated mediators (T2 CRS). SE-specific IgE was undetectable in T3 CRS and had low detectable levels (6.2%) even in T2 CRS. The CRS with nasal polyps (CRSwNP) phenotype and LM CT scores showed no significant differences between T2 and T3 CRS, while the incidence of comorbid asthma was higher in T2 CRS than T3 CRS. In T3 clusters, higher levels of neutrophilic markers were associated with disease severity and CRSwNP phenotype. CONCLUSIONS In Koreans, there is a distinct T3 CRS endotype showing a high proportion of CRSwNP and severe disease extent, along with T2 CRS.
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Affiliation(s)
- Jin-Young Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jin Youp Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Chung Man Sung
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hospital and Chonnam National University Medical School, Gwangju, Korea
| | - Seon Tae Kim
- Department of Otolaryngology-Head and Neck Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Hyun-Jin Cho
- Department of Otorhinolaryngology, Gyeongsang National University Hospital and Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sue Jean Mun
- Department of Otorhinolaryngology, Pusan National University Yangsan Hospital, Busan, Korea
| | - Sung-Woo Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sang Duk Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gwanghui Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyoung Rai Cho
- Departments of Otorhinolaryngology-Head and Neck Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | | | - Soo Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Hwasun Hospital, Chonnam, Korea
| | - Sung Jae Heo
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ki-Il Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Su Jin Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, Korea
| | - Sangjun Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ji-Hun Mo
- Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea
| | - Seung-Heon Shin
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Daegu Catholic University, Daegu, Korea.
| | - Dae Woo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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Edberg AK, Trogu G, Manattini A, Renn-Żurek A, Modrzejewska DM, Woźnicka EB, Popovici S, Pintilie L, Beck I, Virbalienė A, Šiurienė A. Existential Loneliness Among Older People from the Perspective of Health Care Professionals: A European Multicenter Study. Psychol Res Behav Manag 2023; 16:2241-2252. [PMID: 37359147 PMCID: PMC10290471 DOI: 10.2147/prbm.s408547] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/28/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Health care professionals (HCPs) encounter different forms of loneliness in their work. It is essential that they have the courage, skills, and tools to deal with loneliness, in particular with existential loneliness (EL) which relates to meaning in life and the fundamentals of living and dying. Aim The aim of this study was to investigate HCPs' views on loneliness among older people and their understanding, perception, and professional experience of EL in older people. Materials and Methods In all, 139 HCPs from five European countries participated in audio-recorded focus group and individual interviews. The transcribed materials were locally analyzed using a predefined template. The participating countries' results were then translated, merged, and inductively analyzed using conventional content analysis. Results Participants described different forms of loneliness - a negative form that is unwanted and causes suffering, and a positive form where solitude is desired and sought. The results showed that the HCPs' knowledge and understanding of EL varied. The HCPs mainly related EL to different types of loss, eg loss of autonomy, independence, hope, and faith, and to concern alienation, guilt, regret and remorse, and concerns about the future. Discussion and Conclusions The HCPs expressed a need to improve their sensitivity and self-confidence to engage in existential conversations. They also stated the need to increase their knowledge and understanding of aging, death, and dying. Based on these results, a training program aimed to increase knowledge and understanding of older people's situation has been developed. The program includes practical training in conversations about emotional and existential aspects, based on recurrent reflections on the topics presented. The program is available at: www.aloneproject.eu.
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Affiliation(s)
| | - Giusy Trogu
- Anziani e non solo Societá Cooperativa Sociale, Carpi, Italy
| | | | | | | | | | | | - Liliana Pintilie
- Executive Office of the Order of General Nurses, Midwives and Nurses in Romania, Iasi, Romania
| | - Ingela Beck
- Kristianstad University, Kristianstad, Sweden
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Zhang H, Zuo L, Li J, Geng Z, Ge S, Song X, Wang Y, Zhang X, Wang L, Zhao T, Deng M, Chai D, Wang Q, Yang Z, Liu Q, Qiu Q, He X, Yang Y, Ge Y, Wu R, Zheng L, Li J, Chen R, Sun J, Hu J. Construction of a fecal immune-related protein-based biomarker panel for colorectal cancer diagnosis: a multicenter study. Front Immunol 2023; 14:1126217. [PMID: 37313408 PMCID: PMC10258350 DOI: 10.3389/fimmu.2023.1126217] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/09/2023] [Indexed: 06/15/2023] Open
Abstract
Purpose To explore fecal immune-related proteins that can be used for colorectal cancer (CRC) diagnosis. Patients and methods Three independent cohorts were used in present study. In the discovery cohort, which included 14 CRC patients and 6 healthy controls (HCs), label-free proteomics was applied to identify immune-related proteins in stool that could be used for CRC diagnosis. Exploring potential links between gut microbes and immune-related proteins by 16S rRNA sequencing. The abundance of fecal immune-associated proteins was verified by ELISA in two independent validation cohorts and a biomarker panel was constructed that could be used for CRC diagnosis. The validation cohort I included 192 CRC patients and 151 HCs from 6 different hospitals. The validation cohort II included 141 CRC patients, 82 colorectal adenoma (CRA) patients, and 87 HCs from another hospital. Finally, the expression of biomarkers in cancer tissues was verified by immunohistochemistry (IHC). Results In the discovery study, 436 plausible fecal proteins were identified. And among 67 differential fecal proteins (|log2 fold change| > 1, P< 0.01) that could be used for CRC diagnosis, 16 immune-related proteins with diagnostic value were identified. The 16S rRNA sequencing results showed a positive correlation between immune-related proteins and the abundance of oncogenic bacteria. In the validation cohort I, a biomarker panel consisting of five fecal immune-related proteins (CAT, LTF, MMP9, RBP4, and SERPINA3) was constructed based on the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression. The biomarker panel was found to be superior to hemoglobin in the diagnosis of CRC in both validation cohort I and validation cohort II. The IHC result showed that protein expression levels of these five immune-related proteins were significantly higher in CRC tissue than in normal colorectal tissue. Conclusion A novel biomarker panel consisting of fecal immune-related proteins can be used for the diagnosis of CRC.
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Affiliation(s)
- Hao Zhang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Lugen Zuo
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Jing Li
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Clinical Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Zhijun Geng
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Central Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Sitang Ge
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xue Song
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Central Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yueyue Wang
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Clinical Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiaofeng Zhang
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Central Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Lian Wang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Tianhao Zhao
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Gastroenterology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Min Deng
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Gastroenterology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Damin Chai
- Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qiusheng Wang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Zi Yang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Quanli Liu
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Quanwei Qiu
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xuxu He
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yiqun Yang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yuanyuan Ge
- Department of Colorectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China
| | - Rong Wu
- Department of General Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Lin Zheng
- Department of Clinical Laboratory, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Jianjun Li
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Runkai Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Jialiang Sun
- Department of General Surgery, Shanghai Fengxian District Central Hospital, Shanghai, China
| | - Jianguo Hu
- Department of Inflammatory Bowel Disease Research Center, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Clinical Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
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Chen D, Cao Y, Tang H, Zang L, Yao N, Zhu Y, Jiang Y, Zhai S, Liu Y, Shi M, Zhao S, Wang W, Wen C, Peng C, Chen H, Deng X, Jiang L, Shen B. Comprehensive machine learning-generated classifier identifies pro-metastatic characteristics and predicts individual treatment in pancreatic cancer: A multicenter cohort study based on super-enhancer profiling. Theranostics 2023; 13:3290-3309. [PMID: 37351165 PMCID: PMC10283048 DOI: 10.7150/thno.84978] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/13/2023] [Indexed: 06/24/2023] Open
Abstract
Rationale: Accumulating evidence illustrated that the reprogramming of the super-enhancers (SEs) landscape could promote the acquisition of metastatic features in pancreatic cancer (PC). Given the anatomy-based TNM staging is limited by the heterogeneous clinical outcomes in treatment, it is of great clinical significance to tailor individual stratification and to develop alternative therapeutic strategies for metastatic PC patients based on SEs. Methods: In our study, ChIP-Seq analysis for H3K27ac was performed in primary pancreatic tumors (PTs) and hepatic metastases (HMs). Bootstrapping and univariate Cox analysis were implemented to screen prognostic HM-acquired, SE-associated genes (HM-SE genes). Then, based on 1705 PC patients from 14 multicenter cohorts, 188 machine-learning (ML) algorithm integrations were utilized to develop a comprehensive super-enhancer-related metastatic (SEMet) classifier. Results: We established a novel SEMet classifier based on 38 prognostic HM-SE genes. Compared to other clinical traits and 33 published signatures, the SEMet classifier possessed robust and powerful performance in predicting prognosis. In addition, patients in the SEMetlow subgroup owned dismal survival rates, more frequent genomic alterations, and more activated cancer immunity cycle as well as better benefits in immunotherapy. Remarkably, there existed a tight correlation between the SEMetlow subgroup and metastatic phenotypes of PC. Among 18 SEMet genes, we demonstrated that E2F7 may promote PC metastasis through the upregulation of TGM2 and DKK1. Finally, after in silico screening of potential compounds targeted SEMet classifier, results revealed that flumethasone could enhance the sensitivity of metastatic PC to routine gemcitabine chemotherapy. Conclusion: Overall, our study provided new insights into personalized treatment approaches in the clinical management of metastatic PC patients.
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Affiliation(s)
- Dongjie Chen
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yizhi Cao
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Haoyu Tang
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Longjun Zang
- Department of General Surgery, Taiyuan Central Hospital, Shanxi, P.R. China
| | - Na Yao
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Youwei Zhu
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yongsheng Jiang
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Shuyu Zhai
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yihao Liu
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Minmin Shi
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Shulin Zhao
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Weishen Wang
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Chenlei Wen
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Chenghong Peng
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Hao Chen
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Xiaxing Deng
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Lingxi Jiang
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Baiyong Shen
- Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Research Institute of Pancreatic Diseases, Shanghai Key Laboratory of Translational Research for Pancreatic Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- State Key Laboratory of Oncogenes and Related Genes, Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
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Harris H, Tao L, Jacobs EB, Bergman Y, Adebayo A, Tekle T, Lewis S, Dahlquist A, Abbey TC, Wenzler E, Humphries R, Simner PJ. Multicenter Evaluation of an MIC-Based Aztreonam and Ceftazidime-Avibactam Broth Disk Elution Test. J Clin Microbiol 2023; 61:e0164722. [PMID: 37070979 PMCID: PMC10204635 DOI: 10.1128/jcm.01647-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/21/2022] [Accepted: 02/22/2023] [Indexed: 04/19/2023] Open
Abstract
Due to limited therapeutic options, there is a clinical need to assess the in vitro activity of the combination of aztreonam (ATM) and ceftazidime-avibactam (CZA) to guide the therapeutic management of multidrug-resistant (MDR) Gram-negative organism infections. We set out to develop a practical MIC-based broth disk elution (BDE) method to determine the in vitro activity of the combination ATM-CZA using readily available supplies and compare it to reference broth microdilution (BMD). For the BDE method, a 30-μg ATM disk, a 30/20-μg CZA disk, both disks in combination, and no disks were added to 4 separate 5-mL cation-adjusted Mueller-Hinton broth (CA-MHB) tubes, using various manufacturers. Three testing sites performed both BDE and reference BMD testing of bacterial isolates in parallel from a single 0.5 McFarland standard inoculum and after overnight incubation, assessed them for growth (not susceptible) or no growth (susceptible) at a final concentration of 6/6/4 μg/mL ATM-CZA. During the first phase, the precision and accuracy of the BDE were analyzed by testing 61 Enterobacterales isolates at all sites. This testing yielded 98.3% precision between sites, with 98.3% categorical agreement and 1.8% major errors (ME). During the second phase, at each site, we evaluated unique, clinical isolates of metallo-β-lactamase (MBL)-producing Enterobacterales (n = 75), carbapenem-resistant Pseudomonas aeruginosa (n = 25), Stenotrophomonas maltophilia (n = 46), and Myroides sp. (n = 1). This testing resulted in 97.9% categorical agreement, with 2.4% ME. Different results were observed for different disk and CA-MHB manufacturers, requiring a supplemental ATM-CZA-not-susceptible quality control organism to ensure the accuracy of results. The BDE is a precise and effective methodology for determining susceptibility to the combination ATM-CZA.
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Affiliation(s)
- Harley Harris
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lili Tao
- Department of Pathology, Microbiology, and Immunology, Division of Laboratory Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Emily B. Jacobs
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yehudit Bergman
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ayomikun Adebayo
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tsigedera Tekle
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shawna Lewis
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ashley Dahlquist
- College of Pharmacy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Taylor C. Abbey
- College of Pharmacy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Eric Wenzler
- College of Pharmacy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Romney Humphries
- Department of Pathology, Microbiology, and Immunology, Division of Laboratory Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Patricia J. Simner
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Yamazaki-Nakashimada MA, Márquez-González H, Miranda-Novales G, Neme Díaz GA, Prado Duran SA, Luévanos Velázquez A, Castilla-Peon MF, González-García N, Sánchez Duran MA, Márquez Aguirre MP, Villasis-Keever MA, Aragón Nogales R, Núñez-Enríquez JC, Martinez Bustamante ME, Aguilar Argüello C, Ramírez de los Santos J, Pérez Barrera A, Palacios Cantú LA, Membrila Mondragón J, Vizcarra Alvarado P, Jiménez Juárez RN, Olivar López V, Velasco-Segura R, López Chávez A. Characteristics and outcomes of multisystem inflammatory syndrome in children: A multicenter, retrospective, observational cohort study in Mexico. Front Pediatr 2023; 11:1167871. [PMID: 37274824 PMCID: PMC10233130 DOI: 10.3389/fped.2023.1167871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/17/2023] [Accepted: 03/27/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Multisystem inflammatory syndrome in children associated with coronavirus disease 2019 (MIS-C), a novel hyperinflammatory condition secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with severe outcomes such as coronary artery aneurysm and death. Methods This multicenter, retrospective, observational cohort study including eight centers in Mexico, aimed to describe the clinical characteristics and outcomes of patients with MIS-C. Patient data were evaluated using latent class analysis (LCA) to categorize patients into three phenotypes: toxic shock syndrome-like (TSSL)-MIS-C, Kawasaki disease-like (KDL)-MIS-C, and nonspecific MIS-C (NS-MIS-C). Risk factors for adverse outcomes were estimated using multilevel mixed-effects logistic regression. Results The study included 239 patients with MIS-C, including 61 (26%), 70 (29%), and 108 (45%) patients in the TSSL-MIS-C, KDL-MIS-C, and NS-MIS-C groups, respectively. Fifty-four percent of the patients were admitted to the intensive care unit, and 42%, 78%, and 41% received intravenous immunoglobulin, systemic glucocorticoids, and anticoagulants, respectively. Coronary artery dilatation and aneurysms were found in 5.7% and 13.2% of the patients in whom coronary artery diameter was measured, respectively. Any cause in-hospital mortality was 5.4%. Hospitalization after ten days of symptoms was associated with coronary artery abnormalities (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2-2.0). Age ≥10 years (OR: 5.6, 95% CI: 1.4-2.04), severe underlying condition (OR: 9.3, 95% CI: 2.8-31.0), platelet count <150,000 /mm3 (OR: 4.2, 95% CI: 1.2-14.7), international normalized ratio >1.2 (OR: 3.8, 95% CI: 1.05-13.9), and serum ferritin concentration >1,500 mg/dl at admission (OR: 52, 95% CI: 5.9-463) were risk factors for death. Discussion Mortality in patients with MIS-C was higher than reported in other series, probably because of a high rate of cases with serious underlying diseases.
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Affiliation(s)
| | | | | | | | | | | | - Maria F. Castilla-Peon
- Hospital Psiquiatrico Infantil Juan N Navarro, Servicios de Atención Psiquiátrica, Mexico City, Mexico
| | - Nadia González-García
- Department of Rheumatology, Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico
| | | | | | | | - Ranferi Aragón Nogales
- XXI Century National Medical Center, Mexican Social Security Institute, Mexico City, Mexico
| | | | | | | | | | | | | | | | | | | | - Víctor Olivar López
- Department of Rheumatology, Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico
| | - Roberto Velasco-Segura
- Instituto de Ciencias Aplicada y Tecnología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Adrián López Chávez
- Department of Rheumatology, Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico
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Nabeya Y. How to interpret the results of clinical studies: "Multicenter cutting-edge study" or "real-world big data study"? Ann Gastroenterol Surg 2023; 7:344-345. [PMID: 37152769 PMCID: PMC10154886 DOI: 10.1002/ags3.12681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023] Open
Affiliation(s)
- Yoshihiro Nabeya
- Division of Esophago‐Gastrointestinal SurgeryChiba Cancer CenterChibaJapan
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Zhang Y, Fang JG, Tu SH, Chen Z, Xie W, Luo AY, Li Y, Ren CC, Mao ZH, Xing H, Wu QF, Li ZY, Zhang JJ, Wang SX. Efficacy and Safety of the Chinese Herbal Compound TJAOA101 in Treating Diminished Ovarian Reserve: A Protocol for Multicenter, Prospective, and Pre-Post Study. Curr Med Sci 2023; 43:284-296. [PMID: 37059935 DOI: 10.1007/s11596-023-2733-6] [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: 12/05/2022] [Accepted: 03/01/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVE Diminished ovarian reserve (DOR) can lead to early menopause, poor fecundity, and an increased risk of disorders such as osteoporosis, cardiovascular disease, and cognitive impairment, seriously affecting the physical and mental health of women. There is still no safe and effective strategy or method to combat DOR. We have developed a novel Chinese herbal formula, Tongji anti-ovarian aging 101 (TJAOA101), to treat DOR. However, its safety and efficacy need to be further validated. METHODS In this prospective and pre-post clinical trial, 100 eligible patients aged 18-45 diagnosed with DOR will be recruited. All participants receive TJAOA101 twice a day for 3 months. Then, comparisons before and after treatment will be analyzed, and the outcomes, including anti-mullerian hormone (AMH) and follicle-stimulating hormone (FSH) levels and the antral follicle count (AFC), the recovery rate of menopause, and the Kupperman index (KMI), will be assessed at baseline, every month during medication (the intervention period), and 1, 3 months after medication (the follow-up period). Assessments for adverse events will be performed during the intervention and follow-up periods. CONCLUSION A multicenter, prospective study will be conducted to further confirm the safety and efficacy of TJAOA101 in treating DOR and to provide new therapeutic strategies for improving the quality of life in DOR patients.
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Affiliation(s)
- Yan Zhang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, 430030, China
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Wuhan, 430030, China
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jian-Guo Fang
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sheng-Hao Tu
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhuo Chen
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Xie
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ai-Yue Luo
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, 430030, China
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Wuhan, 430030, China
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yan Li
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, 430030, China
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Wuhan, 430030, China
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Chen-Chen Ren
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450015, China
| | - Zeng-Hui Mao
- Department of Obstetrics and Gynecology, Changsha Hospital for Maternal and Child Health Care of Hunan Normal University, Changsha, 410007, China
| | - Hui Xing
- Department of Obstetrics and Gynecology, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, 441057, China
| | - Qiong-Fang Wu
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Jiangxi Province, Nanchang, 330006, China
| | - Zhi-Ying Li
- Department of Obstetrics and Gynecology, Renhe Hospital Affiliated to Three Gorges University, Yichang, 443001, China
| | - Jin-Jin Zhang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, 430030, China.
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Wuhan, 430030, China.
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Shi-Xuan Wang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, 430030, China.
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Wuhan, 430030, China.
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Hamaguhi T, Abo M. Recovery of Patients With Upper Limb Paralysis Due to Stroke Who Underwent Intervention Using Low-Frequency Repetitive Transcranial Magnetic Stimulation Combined With Occupational Therapy: A Retrospective Cohort Study. Neuromodulation 2023:S1094-7159(23)00104-6. [PMID: 36932028 DOI: 10.1016/j.neurom.2023.02.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES The combination of repetitive transcranial magnetic stimulation (rTMS) and motor practice is based on the theory of neuromodulation and use-dependent plasticity. Predictive planning of occupational therapy (OT) is important for patients with rTMS conditioning. Recovery characteristics based on the severity of pretreatment upper extremity paralysis can guide the patient's practice plan for using the paretic hand. Therefore, we evaluated the recovery of patients with upper limb paralysis due to stroke who underwent a novel intervention of rTMS combined with OT (NEURO) according to the severity of upper limb paralysis based on the scores of the Fugl-Meyer assessment for upper extremity (FMA-UE) with recovery in proximal upper extremity, wrist, hand, and coordination. MATERIALS AND METHODS In this multicenter retrospective cohort study, the recovery of 1397 patients with upper limb paralysis was analyzed by severity at six hospitals that were accredited by the Japanese Stimulation Therapy Society for treatment. The delta values of the FMA-UE scores before and after NEURO were compared among the groups with severe, moderate, and mild paralysis using the generalized linear model. RESULTS NEURO significantly improved the FMA-UE total score according to the severity of paralysis (severe = 5.3, moderate = 6.0, and mild = 2.9). However, when the FMA-UE subscores were analyzed separately, the results indicated specific improvements in shoulder/elbow, wrist, fingers, and coordination movements, depending on the severity. CONCLUSIONS This study had enough patients who were divided according to severity and stratified by lesion location and handedness parameters. Our results suggest that independently of these factors, the extent of recovery of upper limb motor parts after NEURO varies according to the severity of paralysis.
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50
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Guevara BEK, Tumalad LL, Vista EG, Ngo JL, Alarilla FB, Ceballos RF, Malaluan MJ, Pandita-Reyes BS. Demography, baseline disease characteristics and treatment history of patients with psoriasis in the Philippines: A multicenter, retrospective study. Australas J Dermatol 2023; 64:e178-e182. [PMID: 36912730 DOI: 10.1111/ajd.14021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/13/2023] [Accepted: 02/21/2023] [Indexed: 03/14/2023]
Affiliation(s)
- Bryan Edgar K Guevara
- Department of Dermatology, Southern Philippines Medical Center, Davao City, Philippines.,Brokenshire College of Medicine, Davao City, Philippines
| | | | - Emmerson Gale Vista
- Department of Dermatology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | | | | | - Roel F Ceballos
- Department of Mathematics and Statistics, University of Southeastern Philippines, Davao City, Philippines
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