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Sheehan FT, Shah P, Boden BP. The Importance of Medial Patellar Shape as a Risk Factor for Recurrent Patellar Dislocation in Adults. Am J Sports Med 2024; 52:1282-1291. [PMID: 38557261 DOI: 10.1177/03635465241233732] [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] [Indexed: 04/04/2024]
Abstract
BACKGROUND Research on the cause of lateral patellar dislocation (LPD) has focused on trochlear morphologic parameters, joint alignment, and patellofemoral soft tissue forces. A paucity of information is available regarding how patellar morphologic parameters influence the risk for LPD. PURPOSE/HYPOTHESIS The purpose was to assess whether patellar morphology is a risk factor for recurrent LPD. It was hypothesized that (1) patients with recurrent LPD would have decreased patellar width and volume and (2) patellar morphologic parameters would accurately discriminate patients with recurrent LPD from controls. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 3. METHODS A total of 21 adults with recurrent LPD (age, 29.7 ± 11.1 years; height, 170.8 ± 9.9 cm; weight, 76.1 ± 17.5 kg; 57% female) were compared with 21 sex- and height-matched controls (age, 27.2 ± 6.7 years; height, 172.0 ± 10.6 cm; weight, 71.1 ± 12.8 kg; 57% female). Three-dimensional axial fat-saturated magnetic resonance imaging scans were used to measure patellar medial, lateral, and total width; patellar volume; patellar medial and lateral facet length; the Wiberg index; and previously validated knee joint alignment and femoral shape measurements (eg, tibial tuberosity to trochlear groove distance, trochlear dysplasia). RESULTS The LPD group demonstrated reduced medial patellar width (Δ = -3.6 mm; P < .001) and medial facet length (Δ = -3.7 mm; P < .001) but no change in lateral width or facet length. This resulted in decreased total patellar width (Δ = -3.2 mm; P = .009), decreased patellar volume (Δ = -0.3 cm3; P = .025), and an increased Wiberg index (Δ = 0.05; P < .001). No significant differences were found for all other patellar shape measures between cohorts. Medial patellar width was the strongest single discriminator (83.3% accuracy) for recurrent LPD. Combining medial patellar width, patellofemoral tilt, and trochlear groove length increased the discrimination to 92.9%. CONCLUSION The medial patellar width was significantly smaller in patients with recurrent LPD and was the single most accurate discriminator for recurrent LPD, even compared with traditional trochlear shape and joint alignment measures (eg, trochlear dysplasia, patella alta). Therefore, medial patellar morphology should be assessed in patients with LPD as a risk factor for recurrence and a potential means to improve treatment.
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Affiliation(s)
- Frances T Sheehan
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, Maryland, USA
| | - Paras Shah
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, Maryland, USA
| | - Barry P Boden
- The Orthopaedic Center, a Division of CAO, Rockville, Maryland, USA
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Lazarczuk SL, Collings TJ, Hams AH, Timmins RG, Opar DA, Edwards S, Shield AJ, Barrett RS, Bourne MN. Biceps femoris long head muscle and aponeurosis geometry in males with and without a history of hamstring strain injury. Scand J Med Sci Sports 2024; 34:e14619. [PMID: 38572910 DOI: 10.1111/sms.14619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/04/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Hamstring strain injuries (HSIs) commonly affect the proximal biceps femoris long head (BFlh) musculotendinous junction. Biomechanical modeling suggests narrow proximal BFlh aponeuroses and large muscle-to-aponeurosis width ratios increase localized tissue strains and presumably risk of HSI. This study aimed to determine if BFlh muscle and proximal aponeurosis geometry differed between limbs with and without a history of HSI. METHODS Twenty-six recreationally active males with (n = 13) and without (n = 13) a history of unilateral HSI in the last 24 months underwent magnetic resonance imaging of both thighs. BFlh muscle and proximal aponeurosis cross-sectional areas, length, volume, and interface area between muscle and aponeurosis were extracted. Previously injured limbs were compared to uninjured contralateral and control limbs for discrete variables and ratios, and along the relative length of tissues using statistical parametric mapping. RESULTS Previously injured limbs displayed significantly smaller muscle-to-aponeurosis volume ratios (p = 0.029, Wilcoxon effect size (ES) = 0.43) and larger proximal BFlh aponeurosis volumes (p = 0.019, ES = 0.46) than control limbs with no history of HSI. No significant differences were found between previously injured and uninjured contralateral limbs for any outcome measure (p = 0.216-1.000, ES = 0.01-0.36). CONCLUSIONS Aponeurosis geometry differed between limbs with and without a history of HSI. The significantly larger BFlh proximal aponeuroses and smaller muscle-to-aponeurosis volume ratios in previously injured limbs could alter the strain experienced in muscle adjacent to the musculotendinous junction during active lengthening. Future research is required to determine if geometric differences influence the risk of re-injury and whether they can be altered via targeted training.
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Affiliation(s)
- Stephanie L Lazarczuk
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Tyler J Collings
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Andrea H Hams
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - David A Opar
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Suzi Edwards
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- School of Environmental and Life Sciences, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Anthony J Shield
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Rod S Barrett
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Matthew N Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Ortug A, Guo Y, Feldman HA, Ou Y, Warren JLA, Dieuveuil H, Baumer NT, Faja SK, Takahashi E. Autism-associated brain differences can be observed in utero using MRI. Cereb Cortex 2024; 34:bhae117. [PMID: 38602735 PMCID: PMC11008691 DOI: 10.1093/cercor/bhae117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 04/12/2024] Open
Abstract
Developmental changes that occur before birth are thought to be associated with the development of autism spectrum disorders. Identifying anatomical predictors of early brain development may contribute to our understanding of the neurobiology of autism spectrum disorders and allow for earlier and more effective identification and treatment of autism spectrum disorders. In this study, we used retrospective clinical brain magnetic resonance imaging data from fetuses who were diagnosed with autism spectrum disorders later in life (prospective autism spectrum disorders) in order to identify the earliest magnetic resonance imaging-based regional volumetric biomarkers. Our results showed that magnetic resonance imaging-based autism spectrum disorder biomarkers can be found as early as in the fetal period and suggested that the increased volume of the insular cortex may be the most promising magnetic resonance imaging-based fetal biomarker for the future emergence of autism spectrum disorders, along with some additional, potentially useful changes in regional volumes and hemispheric asymmetries.
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Affiliation(s)
- Alpen Ortug
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Department of Radiology, Harvard Medical School, Boston, MA 02115, United States
| | - Yurui Guo
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Henry A Feldman
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Yangming Ou
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
- Department of Radiology, Harvard Medical School, Boston, MA 02115, United States
| | - Jose Luis Alatorre Warren
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Department of Radiology, Harvard Medical School, Boston, MA 02115, United States
| | - Harrison Dieuveuil
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Nicole T Baumer
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Susan K Faja
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
- Division of Developmental Medicine, Laboratories of Cognitive Neuroscience, Boston Children's Hospital, Harvard Medical School, Brookline, MA 02115, United States
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Department of Radiology, Harvard Medical School, Boston, MA 02115, United States
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Leo P, Mateo-March M, Giorgi A, Muriel X, Javaloyes A, Barranco-Gil D, Pallarés JG, Lucia A, Mujika I, Valenzuela PL. The Influence of High-Intensity Work on the Record Power Profile of Under-23, Pro Team, and World Tour Cyclists. Int J Sports Physiol Perform 2024:1-5. [PMID: 38531349 DOI: 10.1123/ijspp.2023-0451] [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: 11/07/2023] [Revised: 01/19/2024] [Accepted: 02/12/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Durability (ie, the ability to attenuate the decline in performance after accumulated work) has been identified as a performance determinant in elite cyclists. The aim of the present study was to compare durability in elite cyclists of various performance levels, particularly after high-intensity work, referred to as "high-intensity durability." METHODS Forty-nine (N = 49) male road cyclists were categorized as either under 23 years of age (U23) (N = 11), Pro Team (N = 13), or World Tour (N = 24). The participants' critical power (CP) was assessed during the preseason. Thereafter, the participants' maximum mean power (MMP) values were determined for efforts of different durations (from 5 s to 30 min) after different levels of accumulated work above CP (from 0 to 7.5 kJ·kg-1). RESULTS U23 cyclists showed a significant reduction of all relative MMP values for durations ≥1 minute after ≥5 kJ·kg-1 above CP compared with the "fresh" state (0 kJ·kg-1), whereas in Pro Team and World Tour cyclists, a significant reduction was not observed until 7.5 kJ·kg-1 above CP. In the "fresh" state, both Pro Team and particularly World Tour cyclists attained higher MMP values for efforts ≥10 minutes than U23 riders. However, more differences emerged with greater previous work levels, and indeed after 7.5 kJ·kg-1 above CP World Tour cyclists attained higher MMP values than both U23 and Pro Team cyclists for most efforts (≥30 s). CONCLUSION Pro Team and particularly World Tour cyclists tolerate greater levels of accumulated work at high intensity, which might support the importance of high-intensity durability for performance.
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Affiliation(s)
- Peter Leo
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Manuel Mateo-March
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Department of Sport Sciences, Sports Research Center, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Andrea Giorgi
- Androni Giocattoli-Sidermec Professional Cycling Team, Siena, Italy
- Department of Internal Medicine, Specialist Medicine and Rehabilitation, Azienda USL Toscana-SouthEast, Siena, Italy
| | - Xabier Muriel
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | - Alejandro Javaloyes
- Department of Sport Sciences, Sports Research Center, Universidad Miguel Hernández de Elche, Alicante, Spain
| | | | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Physical Activity and Health Research Group (PAHERG), Research Institute of the Hospital 12 de Octubre, Madrid, Spain
| | - Iñigo Mujika
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Basque Country
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PAHERG), Research Institute of the Hospital 12 de Octubre, Madrid, Spain
- Department of Systems Biology, University of Alcalá, Madrid, Spain
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Pas ML, Boyen F, Castelain D, Chantillon L, Paepe D, Pille F, Pardon B, Bokma J. Bayesian evaluation of sensitivity and specificity of blood culture media and hypoglycemia in sepsis-suspected calves. J Vet Intern Med 2024. [PMID: 38526076 DOI: 10.1111/jvim.17040] [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: 05/03/2023] [Accepted: 02/27/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Sepsis is a life-threatening condition for which critically important antimicrobials are often indicated. The value of blood culture for sepsis is indisputable, but appropriate guidelines on sampling and interpretation are currently lacking in cattle. OBJECTIVE Compare the diagnostic accuracy of 2 blood culture media (pediatric plus [PP] and plus aerobic [PA]) and hypoglycemia for bacteremia detection. Estimate the contamination risk of blood cultures in critically ill calves. ANIMALS One hundred twenty-six critically ill calves, 0 to 114 days. METHODS Retrospective cross-sectional study in which the performance of PP, PA and hypoglycemia to diagnose sepsis was assessed using a Bayesian latent class model. A Cox proportional hazards model was used to compare time to positivity (TTP). Potential contamination was descriptively analyzed. Isolates were considered relevant when they were; member of the Enterobacterales, isolated from both blood cultures vials, or well-known, significant bovine pathogens. RESULTS The sensitivities for PP, PA, and hypoglycemia were higher when excluding assumed contaminants; 68.7% (95% credibility interval = 30.5%-93.7%), 87.5% (47.0%-99.5%), and 61.3% (49.7%-72.4%), respectively. Specificity was estimated at 95.1% (82.2%-99.7%), 94.2% (80.7%-99.7%), and 72.4% (64.6%-79.6%), respectively. Out of 121 interpretable samples, 14.9% grew a presumed contaminant in PA, PP, or both. There was no significant difference in the TTP between PA and PP. CONCLUSIONS AND CLINICAL IMPORTANCE PA and PP appear to outperform hypoglycemia as diagnostic tests for sepsis. PA seems most sensitive, but a larger sample size is required to verify this. Accuracy increased greatly after excluding assumed contaminants. The type of culture did not influence TTP or the contamination rate.
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Affiliation(s)
- Mathilde Laetitia Pas
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Filip Boyen
- Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Donatienne Castelain
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Laurens Chantillon
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Frederik Pille
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Bart Pardon
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Jade Bokma
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Le K, Jin L, Zhong F, Huang X, Zhou L, Zhou J, Xie L. Tumor growth manifested in two-fifths of low-risk papillary thyroid microcarcinoma patients during active surveillance: data from a tertiary center in China. Front Endocrinol (Lausanne) 2024; 15:1359621. [PMID: 38577570 PMCID: PMC10991742 DOI: 10.3389/fendo.2024.1359621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/21/2024] [Indexed: 04/06/2024] Open
Abstract
Purpose To assess tumor growth using tumor doubling rate (TDR) during active surveillance (AS) in China. Methods Between January 2016 and June 2020, a total of 219 patients with low-risk papillary thyroid microcarcinoma (PTMC) (aged 23-75 years) were consecutively enrolled in the AS program. Results Four sections of TDR, >0.5, 0.1~0.5, -0.1~0.1 and <-0.1, corresponded with four categories of tumor volume kinetics: rapid growth, slow growth, stable, and decreased size. We found that 10.5% of PTMCs exhibited rapid growth, 33.33% exhibited slow growth, 26.48% were stable, and 29.68% decreased in size. Tumor growth was associated with two factors: age and volume of PTMC at diagnosis. 85.72% of elderly patients (≥ 61 years old) had tumors that remained stable or even shrank and rapidly growing tumors were not found in them. When the volume was small (≤14.13 mm3), the proportion of rapid growth was high (41.67%), whereas when the volume was large (> 179.5 mm3), the proportion of non-growth was 68.75%. Conclusion TDR may be a better metric for evaluating tumor growth in observational PTMCs. A certain proportion of PTMCs grow during the period of AS and tumor growth was associated with age and volume of PTMC at initial diagnosis. Therefore, how to block tumor growth during the AS period, especially for young patients and patients with early-stage PTMC (size ≤ 5 mm), will be a new challenge.
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Affiliation(s)
- Kehao Le
- Department of Head and Neck Surgery, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lei Jin
- Department of Head and Neck Surgery, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Fangfang Zhong
- Department of Head and Neck Surgery, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaojuan Huang
- Department of Nuclear Medicine, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Liang Zhou
- Department of Head and Neck Surgery, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiamin Zhou
- Department of Technology, Hangzhou KuaikuaiKangfu Technology Co., LTD, Hangzhou, Zhejiang, China
| | - Lei Xie
- Department of Head and Neck Surgery, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Tekin A, Rende B, Efendi H, Bunul SD, Çakır Ö, Çolak T, Balcı S. Volumetric and Asymmetric Index Analysis of Subcortical Structures in Multiple Sclerosis Patients: A Retrospective Study Using volBrain Software. Cureus 2024; 16:e55799. [PMID: 38590495 PMCID: PMC10999780 DOI: 10.7759/cureus.55799] [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] [Accepted: 03/08/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Multiple sclerosis (MS) is a chronic and autoimmune disease that has a significant influence on the central nervous system, such as the brain and spinal cord, affecting millions of individuals globally. Understanding the connection between subcortical brain regions and MS is crucial for effective diagnostic and therapeutic approaches for treating this disabling disease. This study explores the relationship between volume and contours of asymmetry index of subcortical brain regions in individuals with MS using volBrain software (https://www.volbrain.net; developed by José V. Manjón (Valencia Polytechnic University, Valencia, Spain) and Pierrick Coupé (University of Bordeaux, Bordeaux, France)). Methods In our retrospective investigation, we admitted 100 Turkish individuals, comprising 50 patients diagnosed with relapsing-remitting MS (RRMS) (24 (48%) males and 26 (52%) females) and 50 healthy controls (23 (46%) males and 27 (54%) females), registered between October 2017 and February 2022 for five years and underwent assessment in the radiology department at the Teaching and Research Hospital of Kocaeli University; 1,150 Turkish patients were excluded from our study based on our exclusion criteria. We used magnetic resonance imaging with a 3-Tesla (3T) scanner and volBrain software to assess volumes (cm3) and asymmetry indexes due to asymmetry for different levels of atrophy of total intracranial, total brain, gray matter, white matter, and subcortical regions, the most affected regions in MS patients for both patient and control cohorts. Results Statistical analysis revealed a significant difference between patient and control groups (p < 0.001), with patient group mean age at 38.32 years and control group mean age at 32.88 years. Patient group exhibited lower values for total intracranial, total brain, gray matter, white matter, and cerebrospinal fluid volume compared to control group (p < 0.05). The results indicated a statistically significant decrease (p < 0.05) in the values for total intracranial and total brain volume, whereas all other values remained unchanged. We compared volumes of subcortical structures on the right and left sides and found that the putamen, thalamus, and globus pallidus had statistically lower values in the patient group than in the control group (p < 0.001), apart from the lateral ventricle. Furthermore, our retrospective investigation demonstrated a statistically significant difference in the globus pallidus asymmetry index, indicating a preference for the patient group (p < 0.05). A lower asymmetry index value signifies a larger volume for the right side of the subcortical regions of the brain when compared to the left side. Conclusion Brain atrophy, although characterized by irreversible tissue damage, is targeted by therapeutic interventions to prevent progression. It is, therefore, imperative to develop a universally accepted measurement standard for subcortical structures that also considers the inherent variability present within each structure. Our findings serve as an important basis and indicator for the determination of subcortical atrophy and asymmetry in MS, the prognosis of the disease, and the etiology of clinical symptoms. Subsequent research may benefit by adopting the novel approach of considering brain atrophy as an outcome rather than a predictor, thereby facilitating the elucidation of the intricate biological mechanisms that give rise to volume loss.
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Affiliation(s)
- Ayla Tekin
- Anatomy, Kocaeli University, Kocaeli, TUR
| | - Buket Rende
- Anatomy, European Vocational School, Kocaeli Health and Technology University, Kocaeli, TUR
| | | | | | | | - Tuncay Çolak
- Anatomy, Faculty of Medicine, Kocaeli University, Kocaeli, TUR
| | - Sibel Balcı
- Biostatistics and Medical Informatics, Kocaeli University, Kocaeli, TUR
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Riscart-López J, Sánchez-Valdepeñas J, Mora-Vela R, Caro-Ávalos J, Sánchez-González L, Sánchez-Moreno M, León-Prados JA, Pareja-Blanco F. Effects of 4 Different Velocity-Based Resistance-Training Programming Models on Physical Performance. Int J Sports Physiol Perform 2024; 19:271-279. [PMID: 38167650 DOI: 10.1123/ijspp.2023-0313] [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: 08/12/2023] [Revised: 10/22/2023] [Accepted: 11/14/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE To examine the effects of 4 programming models (linear [LP], undulating [UP], reverse [RP], and constant [CP]) on physical performance. METHODS Forty-eight moderately strength-trained men were randomly assigned to LP, UP, RP, and CP groups according to their 1-repetition maximum (1RM) in the full-squat exercise (SQ) and followed an 8-week training intervention using the SQ and monitoring movement velocity for every repetition. All groups trained with similar mean relative intensity (65% 1RM), number of repetitions (240), sets (3), and interset recovery (4 min) throughout the training program. Pretraining and posttraining measurements included, in the SQ, 1RM load, the average velocity attained for all absolute loads common to pretests and posttests (AV), and the average velocity for loads that were moved faster (AV > 1) and slower (AV < 1) than 1 m·s-1 at pretraining tests. Moreover, countermovement jump height and 20-m running sprint time were measured. RESULTS A significant time effect was found for all variables analyzed (P < .05), except for 20-m running sprint time. Significant group × time interactions were observed for 1RM, AV > 1, and AV (P < .05). After training, all groups attained significant strength gains on 1RM, AV, AV > 1, and AV < 1 (P < .001-.01). LP and RP groups improved their countermovement jump height (P < .01), but no significant changes were observed for UP and CP. No significant improvements were achieved in 20-m running sprint time for any groups. CONCLUSIONS These different programming models are all suitable for improving physical performance. LP and RP induce similar or greater gains in physical performance than UP and CP.
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Affiliation(s)
- Javier Riscart-López
- Faculty of Sport Sciences, Universidad Pablo de Olavide, Seville, Spain
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Juan Sánchez-Valdepeñas
- Faculty of Sport Sciences, Universidad Pablo de Olavide, Seville, Spain
- Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
| | - Raúl Mora-Vela
- Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
| | - Javier Caro-Ávalos
- Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
| | - Lidia Sánchez-González
- Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
| | - Miguel Sánchez-Moreno
- Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
- Department of Physical Education and Sports, University of Seville, Seville, Spain
| | - Juan Antonio León-Prados
- Faculty of Sport Sciences, Universidad Pablo de Olavide, Seville, Spain
- Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
| | - Fernando Pareja-Blanco
- Faculty of Sport Sciences, Universidad Pablo de Olavide, Seville, Spain
- Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
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Lau N, Patterson S, Kim S, Kim TY. Emergency Department Volumes After State-Wide Lockdown Orders Across the United States During the COVID-19 Pandemic: COVID-19 lockdown and emergency volume. Disaster Med Public Health Prep 2024; 18:e29. [PMID: 38372077 DOI: 10.1017/dmp.2024.22] [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: 02/20/2024]
Abstract
OBJECTIVE The objective of this study was to describe changes in emergency department volumes after statewide lockdown in a network of hospitals across the United States during the COVID-19 global pandemic. METHODS A retrospective study was performed utilizing data on daily volumes across multiple emergency departments from a centralized data warehouse from a private for-profit hospital system during the COVID-19 pandemic. The mean daily volumes of 148 emergency departments were evaluated across 16 states in relation to each state's governmental statewide lockdown orders. Comparisons of the same period in the prior year were evaluated for percent changes in volumes. We also compared pre-lockdown to post-lockdown volumes. A separate analysis was made for the pediatric ED volumes. RESULTS The 2020 post-lockdown volumes compared to the same 2019 dates revealed a mean percent change of -43.09%. The overall post-lockdown volumes compared to the pre-lockdown volumes had a mean percent change of -45.00%. The pediatric data revealed a greater mean percentage change in volumes of -71.52% (post-lockdown compared to 2019) and -69.03% (post-lockdown compared to pre-lockdown). CONCLUSIONS This study found an overall decrease in volumes among 148 emergency departments across 16 states when compared to the comparable period pre-global pandemic.
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Affiliation(s)
- Nicole Lau
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine
| | - Stephen Patterson
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine
| | - Steven Kim
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine
| | - Tommy Y Kim
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine
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10
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Zhao SL, Xiong JP, Luan JY, Jia ZC, Han JT, Feng QC, Zhuang JM, Li TR, Wang CM, Li X. Intra-Sac Injection of Thrombin During Endovascular Aneurysm Repair to Remedy Type II Endoleak and Promote Sac Shrinkage. Vasc Endovascular Surg 2024; 58:151-157. [PMID: 37607586 DOI: 10.1177/15385744231197457] [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: 08/24/2023]
Abstract
PURPOSE To evaluate the safety and effectiveness of intra-sac thrombin injection to remedy type II endoleaks (T2ELs) during endovascular aneurysm repair (EVAR). MATERIALS AND METHODS 224 cases abdominal aortic aneurysm (AAA) were treated with EVAR. For the 52 cases of intra-operative type II endoleaks and 8 cases of ruptured AAAs, after the grafts were deployed, thrombin was injected into the aneurysm sac through a preset catheter. The occurrence of endoleaks post-EVAR were followed up with by Computed Tomography (CT) angiogram. The diameter and the volume of the aneurysm sac were also measured. Endpoints included incidence of T2ELs, AAA sac shrinkage and re-intervention rate and all-cause mortality. RESULTS The overall technical success rate was 100%. Fifty-two patients were followed up with for 9-56 (median 24) months. No serious complications were observed during follow-up. The incidence of endoleak was 5.8% (3/52) during follow-up. The maximum diameter of the aneurysm decreased from 61.1 ± 14.2 mm to 53.7 ± 10.6 mm, 47.9 ± 8.3 mm and 43.7 ± 7.2 mm (87.9%, 78.4% and 71.5% of pre-EVAR) at the 6-month, 1-year and 2-year follow-up, respectively (P < .05). The volume of the aneurysm sac shrank from 236.2 ± 136.2 cm3 to 202.6 ± 114.1 cm3, 155.6 ± 68.4 cm3 and 129.7 ± 52.4 cm3 (85.8%, 65.9%, and 54.9% of pre-EVAR) at the 6-month, 1-year and 2-year follow-up, respectively (P < .05). The rate of various endoleaks was 5.8% (3/52) and the re-intervention rate was 1.9% (1/52) in this research. CONCLUSIONS Clinical outcomes show that intra-sac injection of thrombin during EVAR is safe and may be effective in remedying small amount and low-velocity endoleaks and promoting shrinkage of the aneurysm sac.
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Affiliation(s)
- Shi Lu Zhao
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Jian Ping Xiong
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Jing Yuan Luan
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Zi Chang Jia
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Jin Tao Han
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Qi Chen Feng
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Jin Man Zhuang
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Tian Run Li
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Chang Ming Wang
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
| | - Xuan Li
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, China
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Udroiu I. A Simplified Method for Calculating Surface Area of Mammalian Erythrocytes. Methods Protoc 2024; 7:11. [PMID: 38392685 PMCID: PMC10891711 DOI: 10.3390/mps7010011] [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: 11/19/2023] [Revised: 01/05/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Knowledge of the geometric quantities of the erythrocyte is useful in several physiological studies, both for zoologists and veterinarians. While the diameter and volume (MCV) are easily obtained from observations of blood smears and complete blood count, respectively, the thickness and surface area are instead much more difficult to measure. The precise description of the erythrocyte geometry is given by the equation of the oval of Cassini, but the formulas deriving from it are very complex, comprising elliptic integrals. In this article, three solids are proposed as models approximating the erythrocyte: sphere, cylinder and a spheroid with concave caps. The volumes and surface areas obtained with these models are compared to those effectively measured. The spheroid with concave caps gives the best approximation and can be used as a simple model to determine the erythrocyte surface area. With this model, a simple method that allows one to estimate the surface area by knowing only the diameter and MCV is proposed.
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Affiliation(s)
- Ion Udroiu
- Dipartimento di Scienze, Università degli Studi "Roma Tre", 00146 Rome, Italy
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12
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Aibar-Duran JA, Salgado-López L, Anka-Tugbiyele MO, Mirapeix RM, Gallardo Alcañiz A, Patino Alvarado JD, Rico Pereira M, Rodríguez Rodríguez R, Munoz-Hernandez F, de Quintana-Schmidt C. Navigated intraoperative ultrasound in neuro-oncology: volumetric accuracy and correlation with high-field MRI. J Neurosurg 2024:1-10. [PMID: 38181499 DOI: 10.3171/2023.10.jns231244] [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: 05/29/2023] [Accepted: 10/16/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVE The use of intraoperative techniques to detect residual tumors has recently become increasingly important. Intraoperative MRI has long been considered the gold standard; however, it is not widely used because of high equipment costs and long acquisition times. Consequently, real-time intraoperative ultrasound (ioUS), which is much less expensive than MRI, has gained popularity. The aim of the present study was to evaluate the capacity of ioUS to accurately determine the primary tumor volume and detect residual tumors. METHODS A prospective study of adult patients who underwent surgery for intra-axial brain tumors between November 2017 and October 2020 was performed. Navigated intraoperative ultrasound (nioUS) of the brain was used to guide tumor resection and to detect the presence of residual disease. Both convex (5-8 MHz) and linear array (6-13 MHz) probes were used. Tumor volume and residual disease were measured with nioUS and compared with MR images. A linear regression model based on a machine learning pipeline and a Bland-Altman analysis were used to assess the accuracy of nioUS versus MRI. RESULTS Eighty patients (35 females and 45 males) were included. The mean age was 58 years (range 25-80 years). A total of 88 lesions were evaluated; there were 64 (73%) gliomas, 19 (21.6%) metastases, and 5 (5.7%) other tumors, mostly located in the frontal (41%) and temporal (27%) lobes. Most of the tumors (75%) were perfectly visible on ioUS (grade 3, Mair grading system), except for those located in the insular lobe (grade 2). The regression model showed a nearly perfect correlation (R2 = 0.97, p < 0.001) between preoperative tumor volumes from both MRI and nioUS. Ultrasonographic visibility significantly influenced this correlation, which was stronger for highly visible (grade 3) tumors (p = 0.01). For residual tumors, the correlation between postoperative MRI and nioUS was weaker (R2 = 0.78, p < 0.001) but statistically significant. The Bland-Altman analysis showed minimal bias between the two techniques for pre- and postoperative scenarios, with statistically significant results for the preoperative concordance. CONCLUSIONS The authors' findings show that most brain tumors are well delineated by nioUS and almost perfectly correlated with MRI-based measurements both pre- and postoperatively. These data support the hypothesis that nioUS is a reliable intraoperative technique that can be used for real-time monitoring of brain tumor resections and to perform volumetric analysis of residual disease.
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Affiliation(s)
- Juan Angel Aibar-Duran
- 1Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- 4Research Institute of Sant Pau (IIB), Barcelona, Spain; and
- 5The Doctorate School, Autonomous University of Barcelona, Spain
| | | | | | - Rosa M Mirapeix
- 5The Doctorate School, Autonomous University of Barcelona, Spain
| | - Alberto Gallardo Alcañiz
- 3Department of Anatomical Pathology, Neuropathology section, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | | | - Marta Rico Pereira
- 1Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | | | - Fernando Munoz-Hernandez
- 1Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- 4Research Institute of Sant Pau (IIB), Barcelona, Spain; and
| | - Cristian de Quintana-Schmidt
- 1Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
- 4Research Institute of Sant Pau (IIB), Barcelona, Spain; and
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Huang CY, Lai CY, Reeves KD, Lam KHS, Li TY, Cheng CI, Wu YT. Volume Effect of Nerve Hydrodissection for Carpal Tunnel Syndrome: A Prospective, Randomized, and Single-Blind Study. J Ultrasound Med 2024; 43:161-169. [PMID: 37873682 DOI: 10.1002/jum.16349] [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: 08/11/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES This study compared ultrasound-guided nerve hydrodissection (HD) outcomes using two commonly used injectate volumes (10 and 5 mL) of normal saline to explore if there is a volume effect of HD for patients with moderate carpal tunnel syndrome (CTS). METHODS Twenty-four participants were randomly assigned to treatment with HD using ultrasound-guidance and either 10 mL or 5 mL of normal saline (HD-10 and HD-5 groups respectively). Our primary outcome measures were the change scores of the two subscales of the Boston Carpal Tunnel Syndrome Questionnaire: The Symptom Severity Scale (SSS) and Functional Status Scale (FSS). We conducted a one-way repeated analysis of variance for 3 time points (4, 12, and 24 weeks) for both SSS and FSS, respectively, for change scores from time 0, and percentage change from time 0. RESULTS All participants (n = 12 per group) completed the study. From 0 to 24 weeks the HD-10 group outperformed the HD-5 group for improvement in SSS (median ± IQR; -0.8 ± 0.4 versus -0.5 ± 0.5; P = .024) and FSS scores (mean ± SD; -0.8 ± 0.2 versus -0.5 ± 0.5; P = .011). The HD-10 group improvement in FSS subtest significantly exceeded the MCID percentage-change-based threshold of 27% (34%; P = .039). CONCLUSIONS Despite the limitations of small study size, a largely inert injectate, and a single injection approach, these findings in favor of the 10 mL group suggest that the volume used for ultrasound-guided HD in moderate CTS matters, and a higher volume is more effective.
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Affiliation(s)
- Chien-Yao Huang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Centers, Taipei, Taiwan
| | - Chia-Ying Lai
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Centers, Taipei, Taiwan
| | | | - King Hei Stanley Lam
- The Hong Kong Institute of Musculoskeletal Medicine, Hong Kong
- Department of Family Medicine, The Chinese University of Hong Kong, Hong Kong
- Department of Family Medicine, The University of Hong Kong, Hong Kong
- Center for Regional Anesthesia and Pain Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tsung-Ying Li
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Centers, Taipei, Taiwan
- Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chin-I Cheng
- Department of Statistics, Actuarial and Data Science, Central Michigan University, Mt. Pleasant, MI, USA
| | - Yung-Tsan Wu
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Centers, Taipei, Taiwan
- Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Research and Development, School of Medicine, National Defense Medical Center, Taipei, Taiwan
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14
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Issa PP, Hossam E, Cheng JH, Magazine BM, Hussein M, Luo X, Abdelhady A, Staav J, LaForteza A, Albuck AL, Shama M, Toraih E, Kandil E. Completion thyroidectomy: A safe option for high- volume surgeons. Head Neck 2024; 46:57-63. [PMID: 37872858 DOI: 10.1002/hed.27551] [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: 06/08/2023] [Revised: 08/10/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The risk of complication in patients undergoing completion thyroidectomy (cT) is mixed. Several studies report increased risk in comparison to total thyroidectomy (TT) and still others reporting a comparatively decreased risk. We compared the rates of complication in patients at our institution undergoing thyroid lobectomy (TL), (TT), and cT by a single high-volume surgeon. METHODS We performed a single-institution retrospective cohort study. Patients undergoing TL, TT, or cT by a high-volume surgeon were included. Rates of complication were collected and compared between the three cohorts. RESULTS A total of 310 patients were included. The overall rate of complication was 4.2%. The complication rates in the TL, TT, and cT cohorts were 1%, 7.1%, and 4.5%, respectively (p = 0.10). Transient hypocalcemia was slightly more common in the TT cohort (6.1%) as opposed to the TL (0%) or cT (0.9%) cohort (p = 0.01). The cohorts also had similar rates of recurrent laryngeal nerve signal loss leading to transient dysphonia (TL: 0% vs. TT: 1% vs. cT: 3.6%, p = 0.10). CONCLUSIONS While rates of complication tended to predictably decrease as approaches became less extensive, there were no significant differences in complication rates among the three surgical approaches when performed by a high-volume surgeon. Considering the low rates of complication overall, patient counseling and preference should be emphasized to provide appropriate and tailored treatment plans.
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Affiliation(s)
- Peter P Issa
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Eslam Hossam
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jack H Cheng
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Brandon M Magazine
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Mohammad Hussein
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Xinyi Luo
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Ali Abdelhady
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jonathan Staav
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Alexandra LaForteza
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Aaron L Albuck
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Mohamed Shama
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Eman Toraih
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Emad Kandil
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
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15
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Hawkins J, Crowley JD, Pelletier MH, Walsh WR. Comparison of three methods for nucleus pulposus volume measurement in rabbit lumbar spines: a preclinical model for measurement of the effectiveness of prophylactic intervertebral disk fenestration in dogs. Am J Vet Res 2024; 85:ajvr.23.07.0165. [PMID: 38029513 DOI: 10.2460/ajvr.23.07.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE Compare 3 methods of nucleus pulposus (NP) volume measurement using the rabbit lumbar spines as a preclinical model to determine the effectiveness of prophylactic intervertebral disk fenestration in dogs. ANIMALS Twelve 9-month-old, skeletally mature female entire New Zealand White rabbits weighing between 3.5 to 4.5 kg. METHODS NP volume measurements of dissected rabbit lumber spines between L1 and L6 were made and compared using gross measurements, reconstructed MRI images, and water volumetry based on Archimedes' principle. Water volumetry was used as the true gold standard volume measurement in this study. RESULTS The true volume (mean ± SD) of the nucleus pulposus NP as measured by water volumetry increased caudally from L1/L2 (16.26 ± 3.32 mm3) to L5/L6 (22.73 ± 6.09 mm3). Volume estimates made by MRI were significantly higher than those made using water volumetry at all sites (L1/L2 [P = .044], L2/L3 [P = .012], L3/L4 [P = .015], L4/L5 [P < .001], and L5/L6 [P < .001]). Gross measurements also significantly overestimated volume when compared to water volumetry at all sites; L1/L2 (P = .021), L2/L3 (P = .025), L3/L4 (P = .001), L4/L5 (P < .001), and L5/L6 (P < .001). MRI and gross volume estimates were significantly different at L4/L5 (P = .035) and L5/L6 (P = .030). CLINICAL RELEVANCE The findings of this preclinical model might be relevant to veterinary surgeons who perform prophylactic fenestration for which there is no reliable method to determine the amount of NP to be removed. Preclinical ex vivo and in vivo fenestration studies with pre- and postoperative NP volume assessment are required.
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Affiliation(s)
- Jason Hawkins
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - James D Crowley
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Small Animal Specialist Hospital, North Ryde, Sydney, Australia
| | - Matthew H Pelletier
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - William R Walsh
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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16
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Abstract
BACKGROUND The purpose of this study was to evaluate the influence of socioeconomic factors on access to congenital hand surgery care, hospital admission charges, and analyze these geographic trends across regions of the country. METHODS Retrospective cohort study was conducted of congenital hand surgery performed in the United States from 2010 through 2020 using the Pediatric Health Information System. Multivariate regression was used to analyze the impact of socioeconomic factors. RESULTS During the study interval, 5531 pediatric patients underwent corrective surgery for congenital hand differences, including syndactyly repair (n = 2439), polydactyly repair (n = 2826), and pollicization (n = 266). Patients underwent surgery at significantly earlier age when treated at above-median case volume hospitals (P < .001). Patients with above-median income (P < .001), non-white race (P < .001), commercial insurance (P < .001), living in an urban community (P < .001), and not living in an underserved area (P < .001) were more likely to be treated at high-volume hospitals. Nearly half of patients chose to seek care at a distant hospital rather than the one locally available (49.5%, n = 1172). Of those choosing a distant hospital, most patients chose a higher-volume facility (80.9%, n = 948 of 1172). On multivariate regression, white patients were significantly more likely to choose a more distant, higher-volume hospital (P < .001). CONCLUSIONS Socioeconomic and geographic factors significantly contribute to disparate access to congenital hand surgery across the country. Patients with higher socioeconomic status are more likely to be treated at high-volume hospitals. Treatment at hospitals with higher case volume is associated with earlier age at surgery and decreased hospital admission charges.
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Biancari F, Mäkikallio T, Loforte A, Kaserer A, Ruggieri VG, Cho SM, Kang JK, Dalén M, Welp H, Jónsson K, Ragnarsson S, Hernández Pérez FJ, Gatti G, Alkhamees K, Fiore A, Lechiancole A, Rosato S, Spadaccio C, Pettinari M, Perrotti A, Sahli SD, L'Acqua C, Arafat AA, Albabtain MA, AlBarak MM, Laimoud M, Djordjevic I, Krasivskyi I, Samalavicius R, Jankuviene A, Alonso-Fernandez-Gatta M, Wilhelm MJ, Juvonen T, Mariscalco G. Inter-institutional analysis of the outcome after postcardiotomy veno-arterial extracorporeal membrane oxygenation. Int J Artif Organs 2024; 47:25-34. [PMID: 38053227 DOI: 10.1177/03913988231214934] [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: 12/07/2023]
Abstract
INTRODUCTION Patients requiring postcardiotomy veno-arterial extracorporeal membrane oxygenation (V-A-ECMO) have a high risk of early mortality. In this analysis, we evaluated whether any interinstitutional difference exists in the results of postcardiotomy V-A-ECMO. METHODS Studies on postcardiotomy V-A-ECMO were identified through a systematic review for individual patient data (IPD) meta-analysis. Analysis of interinstitutional results was performed using direct standardization, estimation of observed/expected in-hospital mortality ratio and propensity score matching. RESULTS Systematic review of the literature yielded 31 studies. Data from 10 studies on 1269 patients treated at 25 hospitals were available for the present analysis. In-hospital mortality was 66.7%. The relative risk of in-hospital mortality was significantly higher in six hospitals. Observed versus expected in-hospital mortality ratio showed that four hospitals were outliers with significantly increased mortality rates, and one hospital had significantly lower in-hospital mortality rate. Participating hospitals were classified as underperforming and overperforming hospitals if their observed/expected in-hospital mortality was higher or lower than 1.0, respectively. Among 395 propensity score matched pairs, the overperforming hospitals had significantly lower in-hospital mortality (60.3% vs 71.4%, p = 0.001) than underperforming hospitals. Low annual volume of postcardiotomy V-A-ECMO tended to be predictive of poor outcome only when adjusted for patients' risk profile. CONCLUSIONS In-hospital mortality after postcardiotomy V-A-ECMO differed significantly between participating hospitals. These findings suggest that in many centers there is room for improvement of the results of postcardiotomy V-A-ECMO.
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Affiliation(s)
- Fausto Biancari
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
- Department of Medicine, South-Karelia Central Hospital, University of Helsinki, Helsinki, Finland
| | - Timo Mäkikallio
- Department of Medicine, South-Karelia Central Hospital, University of Helsinki, Helsinki, Finland
| | - Antonio Loforte
- Department of Cardiothoracic, Transplantation and Vascular Surgery, S. Orsola Hospital, University of Bologna, Bologna, and Department of Surgical Science, University of Turin, Turin, Italy
| | - Alexander Kaserer
- Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland
| | - Vito G Ruggieri
- Division of Cardiothoracic and Vascular Surgery, Robert Debré University Hospital, Reims, France
| | - Sung-Min Cho
- Division of Neurosciences, Critical Care and Cardiac Surgery, Departments of Neurology, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jin Kook Kang
- Division of Neurosciences, Critical Care and Cardiac Surgery, Departments of Neurology, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Magnus Dalén
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Henryk Welp
- Department of Cardiothoracic Surgery, Münster University Hospital, Münster, Germany
| | - Kristján Jónsson
- Department of Cardiac Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | - Giuseppe Gatti
- Division of Cardiac Surgery, Cardio-Thoracic and Vascular Department, University Hospital of Trieste, Trieste, Italy
| | | | - Antonio Fiore
- Department of Cardiac Surgery, Hôpitaux Universitaires Henri Mondor, Creteil, France
| | | | - Stefano Rosato
- Center for Global Health, Italian National Institute, Rome, Italy
| | | | - Matteo Pettinari
- Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Andrea Perrotti
- Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France
| | - Sebastian D Sahli
- Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland
| | - Camilla L'Acqua
- Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino, Milan, Italy
- Anesthesia and Intensive Care Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Amr A Arafat
- Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
- Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt
| | - Monirah A Albabtain
- Cardiology Clinical Pharmacy, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Mohammed M AlBarak
- Intensive Care Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Mohamed Laimoud
- Cardiac Surgical Intensive Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Critical Care Medicine Department, Cairo University, Cairo, Egypt
| | - Ilija Djordjevic
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Ihor Krasivskyi
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Robertas Samalavicius
- II Department of Anesthesia, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Clinic of Emergency Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Agne Jankuviene
- II Department of Anesthesia, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Marta Alonso-Fernandez-Gatta
- Cardiology Department, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain
- CIBER-CV Instituto de Salud Carlos III, Madrid, Spain
| | - Markus J Wilhelm
- Clinic for Cardiac Surgery, University Heart Center, University and University Hospital Zurich, Zurich, Switzerland
| | - Tatu Juvonen
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
- Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland
| | - Giovanni Mariscalco
- Department of Intensive Care Medicine and Cardiac Surgery, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK
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18
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Kouvelos G, Volakakis G, Dakis K, Spanos K, Giannoukas A. The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance. J Clin Med 2023; 13:193. [PMID: 38202200 PMCID: PMC10779888 DOI: 10.3390/jcm13010193] [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: 11/18/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. The aim of the present review is to collect all the available evidence on the role of abdominal aortic aneurysm (AAA) volume in the natural history of AAAs, including small untreated AAAs and AAAs treated by EVAR. The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR. The clinical impact of AAA volume measurements remains unclear. Several studies show that volumetric analysis can assess changes in AAAs and predict successful endoluminal exclusion after EVAR more accurately than diameter. However, most studies lack strict standardized measurement criteria and well-defined outcome definitions. It remains unclear whether volumetry could replace diameter assessment in defining the risk of rupture of AAAs and identifying clinically relevant sac growth.
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Affiliation(s)
- George Kouvelos
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (G.V.); (K.D.); (K.S.); (A.G.)
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19
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Yousif A, DePari M, Vitonis AF, Harris HR, Shafrir AL, Terry KL, Missmer SA, Sasamoto N. Visualized peritoneal fluid variation in adolescents and young adults with endometriosis: is there more to it? Front Reprod Health 2023; 5:1297907. [PMID: 38162009 PMCID: PMC10757835 DOI: 10.3389/frph.2023.1297907] [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: 09/20/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Background Peritoneal fluid is a medium for endometriosis-associated biomarker discovery from which the local peritoneal environment and pathophysiologic pathways are often inferred. Therefore, we evaluated the associations between peritoneal fluid color and volume at time of endometriosis-related laparoscopic surgery with patient characteristics, endometriosis type and lesion location in adolescents and young adults with endometriosis. Methods We conducted a cross-sectional analysis among 545 patients undergoing surgery for endometriosis who enrolled in the Women's Health Study: from Adolescence to Adulthood cohort study. Patient characteristics, surgically visualized endometriosis phenotypes, and gross characteristics of peritoneal fluid were collected in compliance with World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project (EPHect) tools. Chi-square or Fisher's exact tests were applied to test for differences across categories. Results Most of the patients were adolescents or young adults (86% age <25 years) of white race (89%), with only superficial peritoneal lesions and rASRM stage = I/II observed at surgery (both 95%). We observed variation in peritoneal fluid color across different menstrual cycle phases at time of surgery (p = 0.006). Among those who were cycling at time of surgery, endometriosis patients with red peritoneal fluid were most likely to be in the proliferative phase (49%) compared to the secretory phase (27%), while those with yellow or orange peritoneal fluid were most likely to be in the secretory phase (57% and 86% respectively). Yellow color was significantly less common in those taking combined oral contraceptives but much more common with progesterone only formulation exposure (p = 0.002). Peritoneal fluid volume did not differ by cycle phase but was more likely to be low (≤6 ml) for those exposed to hormones at time of surgery (p = 0.01). Those with acyclic pelvic pain were less likely to have red peritoneal fluid (p = 0.001) but had greater volume (p = 0.02) compared to those without. Conclusion Our findings highlight the importance of accounting for menstrual cycle phase and hormonal exposures when designing research using peritoneal fluid samples and inferring from biomarker results intended to advance our understanding of endometriosis and associated symptom pathophysiology.
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Affiliation(s)
- Abdelrahman Yousif
- Department of Obstetrics and Gynecology, Hurley Medical Center, College of Human Medicine, Michigan State University, Flint, MI, United States
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Mary DePari
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- Boston Center for Endometriosis, Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, MA, United States
| | - Allison F. Vitonis
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- Boston Center for Endometriosis, Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, MA, United States
| | - Holly R. Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Amy L. Shafrir
- Boston Center for Endometriosis, Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, MA, United States
- Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College, North Andover, MA, United States
| | - Kathryn L. Terry
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- Boston Center for Endometriosis, Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, MA, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Stacey A. Missmer
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
- Boston Center for Endometriosis, Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, MA, United States
- Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Naoko Sasamoto
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- Boston Center for Endometriosis, Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, MA, United States
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20
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Ando T, Kumamaru H, Kohsaka S, Fukutomi M, Onishi T, Shimamura K, Hayashida K, Tobaru T. Procedural Volume and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement: From a Japanese Nationwide Registry. Am J Cardiol 2023; 209:36-41. [PMID: 37858593 DOI: 10.1016/j.amjcard.2023.09.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Abstract
The impact of procedural volume on transcatheter aortic valve replacement (TAVR) outcomes in Japan remains uncertain. Japan has carefully introduced TAVR after the establishment of techniques in Western countries and therefore may not exhibit volume-outcome relations after TAVR. Data on transfemoral TAVR was collected from the Japan Transcatheter Valve Therapy (J-TVT) registry between 2018 and 2020. Hospitals were categorized into quartiles (lowest, lower, high, and highest) based on annual TAVR volume. The primary analysis compared 30-day mortality among different TAVR volume hospitals. A multivariable adjustment analysis was performed to calculate the adjusted odds ratio (aOR) and 95% confidence intervals (CIs) of 30-day all-cause mortality with highest-volume hospital as the reference. A total of 2,741 transfemoral TAVR cases from 172 hospitals were included in the analysis. Median hospital TAVR volume was 38 (interquartile range 27 to 60) per year. Unadjusted 30-day mortality was 0.46%, 0.69%, 1.17%, and 1.18% from the lowest to the highest quartile of hospitals, respectively. There was no significant difference in 30-day mortality rates for lowest-volume hospitals (aOR 0.51, 95% CI 0.24 to 1.05, p = 0.07), low-volume hospitals (aOR 0.76, 95% CI 0.46 to 1.26, p = 0.29), or high-volume hospitals (aOR 1.11, 95% CI 0.74 to 1.67, p = 0.60). An analysis from the contemporary national registry in Japan did not find an obvious inverse relation between annual hospital volume and 30-day mortality. Our results suggest that TAVR has now reached a level of procedural maturity, with standardized outcomes observed across hospitals regardless of their annual procedural volume.
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Affiliation(s)
- Tomo Ando
- Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan.
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Motoki Fukutomi
- Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan
| | - Takayuki Onishi
- Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan
| | - Kazuo Shimamura
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuya Tobaru
- Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan
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21
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Gregson BA, Metcalfe S, Iqbal A, Rowan E, Prasad M, Bhattathiri P, Gholkar A, Mitchell P, Haley MD, Mendelow AD. Volume reduction with surgery for ICH: when is it effective? Analysis of the CT scans from the STICH II trial. Br J Neurosurg 2023; 37:1635-1642. [PMID: 37161757 DOI: 10.1080/02688697.2023.2207643] [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: 04/01/2022] [Accepted: 04/22/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND The surgical trial of lobar intracerebral haemorrhage (STICH II) was a randomised controlled trial evaluating early surgical removal of a clot. This paper investigates volume change in both arms of the trial with respect to Extended Glasgow Outcome Scale (GOSE) groups. METHODS Patients randomised into STICH II had an initial diagnostic CT and a second CT 5 days after randomisation. Each scan was anonymously assessed by at least two central readers. An analysis of agreement between the two readers was conducted using kappa tests and intraclass correlation. The change in volume in both the early surgery (ES) and the initial conservative treatment (ICT) arms were analysed with respect to the six-month GOSE outcome. RESULTS Of the 597 patients randomised in the trial there were 582 pre-randomisation scans and 566 5-day scans available for analysis of agreement. There was good agreement between the assessors for the radiological inclusion criteria including volume (ICC = 0.87) and this was better than the agreement between the assessor and local investigator (ICC = 0.73). There were 526 patients with two scans available for analysis of change in volume measurement. The median percentage change in volume for the ES group was a reduction of 92.4% (IQR 75.6%, 99.0%) while for the ICT group, in which some cases crossed over to delayed surgery, it was only 5.7% (IQR 16.4% increase, 29.5% reduction). ES patients with almost complete removal (99-100%) had the best outcome with only 30% dead or lower severely disabled. For the ICT group outcome was related to the final volume: the smaller the final volume the better the outcome. CONCLUSIONS This analysis provides evidence for central assessments of scans in exploratory analyses and further information regarding the potential advantage of early and more complete clot removal on outcome in ICH and should inform the planning of future trials.Clinical trials registration: ISRCTN22153967.
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Affiliation(s)
- Barbara A Gregson
- Neurosurgical Trials Group, Newcastle University, Newcastle upon Tyne, UK
| | | | - Ahmed Iqbal
- Neuroradiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Elise Rowan
- Health Research Group, Lincoln University, Lincoln, UK
| | | | | | - Anil Gholkar
- Neuroradiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Patrick Mitchell
- Neurosurgical Trials Group, Newcastle University, Newcastle upon Tyne, UK
| | - Mark D Haley
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - A David Mendelow
- Neurosurgical Trials Group, Newcastle University, Newcastle upon Tyne, UK
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22
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Poyiadji N, Beauchamp N, Myers DT, Krupp S, Griffith B. Diagnostic Imaging Utilization in the Emergency Department: Recent Trends in Volume and Radiology Work Relative Value Units. J Am Coll Radiol 2023; 20:1207-1214. [PMID: 37543154 DOI: 10.1016/j.jacr.2023.06.033] [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: 03/16/2023] [Revised: 05/24/2023] [Accepted: 06/09/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE The aim of this study was to quantify and characterize the recent trend in emergency department (ED) imaging volumes and radiology work relative value units (wRVUs) at level I and level III trauma centers. METHODS Total annual diagnostic radiology imaging volumes and wRVUs were obtained from level I and level III trauma centers from January 2014 to December 2021. Imaging volumes were analyzed by modality type, examination code, and location. Total annual patient ED encounters (EDEs), annual weighted Emergency Severity Index, and patient admissions from the ED were obtained. Data were analyzed using annual imaging volume or wRVUs per EDE, and percentage change was calculated. RESULTS At the level I trauma center, imaging volumes per EDE increased for chest radiography (5.5%), CT (35.5%), and MRI (56.3%) and decreased for ultrasound (-5.9%) from 2014 to 2021. Imaging volumes per EDE increased for ultrasound (10.4%), CT (74.6%), and MRI (2.0%) and decreased for chest radiography (-4.4%) at the level III trauma center over the same 8-year period. Total wRVUs per EDE increased at both the level I (34.9%) and level III (76.6%) trauma centers over the study period. CONCLUSIONS ED imaging utilization increased over the 8-year study period at both level I and level III trauma centers, with an increase in total wRVUs per EDE. There was a disproportionate increased utilization of advanced imaging, such as CT, over time. ED utilization trends suggest that there will be a continued increase in demand for advanced imaging interpretation, including at lower acuity hospitals, so radiology departments should prepare for this increased work demand.
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Affiliation(s)
- Neo Poyiadji
- Department of Radiology, Henry Ford Hospital, Detroit, Michigan. https://twitter.com/NeoPoyiadji
| | | | - Daniel T Myers
- Vice Chair, Department of Radiology, Henry Ford Hospital, Detroit, Michigan
| | - Seth Krupp
- Vice Chair of Operations, Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michgan
| | - Brent Griffith
- Vice Chair, Division Chief of Neuroradiology, Diagnostic Radiology Residency Program Director, Department of Radiology, Henry Ford Hospital, Detroit, Michigan.
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23
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Neve OM, Romeijn SR, Chen Y, Nagtegaal L, Grootjans W, Jansen JC, Staring M, Verbist BM, Hensen EF. Automated 2-Dimensional Measurement of Vestibular Schwannoma: Validity and Accuracy of an Artificial Intelligence Algorithm. Otolaryngol Head Neck Surg 2023; 169:1582-1589. [PMID: 37555251 DOI: 10.1002/ohn.470] [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: 03/20/2023] [Revised: 06/12/2023] [Accepted: 07/11/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE Validation of automated 2-dimensional (2D) diameter measurements of vestibular schwannomas on magnetic resonance imaging (MRI). STUDY DESIGN Retrospective validation study using 2 data sets containing MRIs of vestibular schwannoma patients. SETTING University Hospital in The Netherlands. METHODS Two data sets were used, 1 containing 1 scan per patient (n = 134) and the other containing at least 3 consecutive MRIs of 51 patients, all with contrast-enhanced T1 or high-resolution T2 sequences. 2D measurements of the maximal extrameatal diameters in the axial plane were automatically derived from a 3D-convolutional neural network compared to manual measurements by 2 human observers. Intra- and interobserver variabilities were calculated using the intraclass correlation coefficient (ICC), agreement on tumor progression using Cohen's kappa. RESULTS The human intra- and interobserver variability showed a high correlation (ICC: 0.98-0.99) and limits of agreement of 1.7 to 2.1 mm. Comparing the automated to human measurements resulted in ICC of 0.98 (95% confidence interval [CI]: 0.974; 0.987) and 0.97 (95% CI: 0.968; 0.984), with limits of agreement of 2.2 and 2.1 mm for diameters parallel and perpendicular to the posterior side of the temporal bone, respectively. There was satisfactory agreement on tumor progression between automated measurements and human observers (Cohen's κ = 0.77), better than the agreement between the human observers (Cohen's κ = 0.74). CONCLUSION Automated 2D diameter measurements and growth detection of vestibular schwannomas are at least as accurate as human 2D measurements. In clinical practice, measurements of the maximal extrameatal tumor (2D) diameters of vestibular schwannomas provide important complementary information to total tumor volume (3D) measurements. Combining both in an automated measurement algorithm facilitates clinical adoption.
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Affiliation(s)
- Olaf M Neve
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Stephan R Romeijn
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yunjie Chen
- Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands
| | - Larissa Nagtegaal
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Willem Grootjans
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen C Jansen
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Marius Staring
- Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands
| | - Berit M Verbist
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik F Hensen
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
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Nemes A, Kormányos Á, Ambrus N, Lengyel C. Similarities and Differences between Three-Dimensional Speckle-Tracking Echocardiography-Derived Left and Right Atrial Volumes and Volume-Based Functional Properties in the Same Healthy Adults-A Detailed Analysis from the MAGYAR-Healthy Study. Medicina (Kaunas) 2023; 59:2051. [PMID: 38138154 PMCID: PMC10744728 DOI: 10.3390/medicina59122051] [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] [Received: 09/27/2023] [Revised: 10/23/2023] [Accepted: 11/09/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: It would be important to know what happens to the volume and volume-based functional properties of one atrium if the size of the other atrium is larger or smaller than the average. Therefore, the present study aimed to perform three-dimensional speckle-tracking echocardiography (3DSTE)-derived quantification of left atrial (LA) and right atrial (RA) volumes and volume-based functional properties to examine these associations in healthy adults with mean and lower or higher than mean atrial volumes. Materials and Methods: The present study consisted of 179 healthy volunteers with a mean age of 32.3 ± 12.3 years (92 males). Three-dimensional speckle-tracking echocardiography-derived LA and RA volumes and volume-based functional properties were determined in all cases. Results: When different LA or RA volume groups were evaluated, both LA and RA showed the same pattern of volume changes in all phases of atrial function with higher LA or RA volumes. In case of low and mean LA volumes, RA volumes were higher compared to their LA counterpart. In case of mean and high RA volumes, RA volumes proved to be higher as well. In case of mean LA or RA volumes, differences between LA and RA stroke volumes (SVs) could not be detected, but all atrial emptying fractions (EFs) were lower for RA than for LA. Some differences were detected in counterpart LA/RA total, passive, and active atrial SVs and EFs values in the presence of lower/higher than mean LA/RA volume. Conclusions: In case of mean LA or RA volumes, RA volumes are higher compared to their LA counterpart, LA-SVs and RA-SVs are similar, but atrial EFs are lower for RA than for LA. If lower/higher than mean LA or RA volumes are present, some differences in patterns of changes in counterpart atrial volumes-SVs and EFs-could be detected.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary; (Á.K.); (N.A.); (C.L.)
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25
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Ibrahim K, Bennett IJ. Hippocampal microstructure, but not macrostructure, mediates age differences in episodic memory. Front Aging Neurosci 2023; 15:1285375. [PMID: 38053843 PMCID: PMC10694359 DOI: 10.3389/fnagi.2023.1285375] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
Introduction Separate unimodal magnetic resonance imaging (MRI) literatures have shown that hippocampal gray matter macrostructure (volume) and microstructure (diffusion) decline with age and relate to episodic memory performance, with multimodal MRI studies reporting that episodic memory may be better explained by a combination of these metrics. However, these effects are often assessed independent of age or only within older adults and therefore do not address whether these distinct modalities explain variance in (i.e, mediate) the effect of age on episodic memory. Methods Here, we simultaneously examined the unique and joint contribution of hippocampal volume and diffusion to age-related differences in episodic memory in 83 younger and 61 older adults who underwent a T1- and diffusion-weighted MRI and completed the Rey Auditory Verbal Learning Test. Results As expected, older age was significantly related to smaller volume and higher diffusion (intracellular, dispersion, and free) in bilateral hippocampus and to worse episodic memory performance (immediate and delayed free recall, recognition). Structural equation modelling revealed that the age-memory relationship was significantly mediated by hippocampal diffusion, but not volume. A non-significant influential indirect effect further revealed that the structural metrics did not jointly mediate the age-memory relationship. Discussion Together, these findings indicate that hippocampal microstructure uniquely contributes to age-related differences in episodic memory and suggest that volume and diffusion capture distinct neurobiological properties of hippocampal gray matter.
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Affiliation(s)
| | - Ilana J. Bennett
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
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26
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Kalogerakos PD, Pirentis A, Papaharilaou Y, Skiadas C, Karantanas A, Mojibian H, Marketou M, Kochiadakis G, Elefteriades JA, Lazopoulos G. Significant unfavorable geometrical changes in ascending aorta despite stable diameter at follow-up. Hellenic J Cardiol 2023:S1109-9666(23)00198-7. [PMID: 37931701 DOI: 10.1016/j.hjc.2023.10.007] [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: 05/25/2023] [Revised: 08/25/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The clinical importance of following-up the ascending aortic diameter lies on the fundamental presumption that wall pathology eventually manifests as change in shape. However, the diameter describes the vessel locally, and the 55mm criterion fails to prevent most dissections. We hypothesized that geometric changes across the ascending aorta are not necessarily imprinted on its diameter; i.e. the maximum diameter correlates weakly and insignificantly with elongation, surface stretching, engorgement, and tortuosity. METHODS Two databases were interrogated for patients who had undergone at least 2 ECG-gated CT scans. The absence of motion artifacts permitted the generation of exact copies of the ascending aorta which then underwent three-dimensional analysis producing objective and accurate measurements of the centreline length, surface, volume, and tortuosity. The correlations of these global variables with the diameter were explored. RESULTS Twenty-two patients, 13 male and 9 females, were included. The mean age at the first and last scan was 63.7 and 67.1y, respectively. The mean diameter increase was approximately 1mm/y. There were no dissections, while 7 patients underwent preemptive surgery. The yearly change rate of the global variables, normalized to height if applicable, showed statistically insignificant, weak or negligible correlation with diameter increments at follow-up. Most characteristically, a patient's aorta maintained its diameter, while undergoing 1mm/y elongation, 151mm2/(y∙m) stretching, 2366mm3/(y∙m) engorgement, and 0.02/y tortuosity. CONCLUSIONS Maximum diameter provides a local description for the ascending aorta and cannot fully portray the pathological process across this vessel. Following-up the diameter is not suggestive of length, surface, volume and tortuosity changes.
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Affiliation(s)
- Paris Dimitrios Kalogerakos
- Cardiac Surgery Division, General University Hospital of Heraklion, Crete, Greece; Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.
| | | | | | - Christos Skiadas
- Department of Radiology, General University Hospital of Heraklion, Crete, Greece
| | - Apostolos Karantanas
- Department of Radiology, General University Hospital of Heraklion, Crete, Greece
| | - Hamid Mojibian
- Department of Diagnostic Imaging, Yale University School of Medicine, New Haven, CT, USA; Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - Maria Marketou
- Department of Cardiology, General University Hospital of Heraklion, Crete, Greece
| | - George Kochiadakis
- Department of Cardiology, General University Hospital of Heraklion, Crete, Greece
| | - John Alex Elefteriades
- Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - George Lazopoulos
- Cardiac Surgery Division, General University Hospital of Heraklion, Crete, Greece
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27
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Mufti N, Chappell J, Aertsen M, Ebner M, Fidon L, Deprest J, David AL, Melbourne A. Assessment of longitudinal brain development using super-resolution magnetic resonance imaging following fetal surgery for open spina bifida. Ultrasound Obstet Gynecol 2023; 62:707-720. [PMID: 37161647 PMCID: PMC10947002 DOI: 10.1002/uog.26244] [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: 02/04/2023] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Prenatal surgery is offered for selected fetuses with open spina bifida (OSB) to improve long-term outcome. We studied the effect of fetal OSB surgery on brain development using advanced magnetic resonance imaging (MRI) techniques to quantify the volume, surface area and shape of cerebral structures and to analyze surface curvature by means of parameters that correspond to gyrification. METHODS We compared MRI data from 29 fetuses with OSB before fetal surgery (mean gestational age (GA), 23 + 3 weeks) and at 1 and 6 weeks after surgery, with that of 36 GA-matched control fetuses (GA range, 21 + 2 to 36 + 2 weeks). Automated super-resolution reconstruction provided three-dimensional isotropic volumetric brain images. Unmyelinated white matter, cerebellum and ventricles were segmented automatically and refined manually, after which volume, surface area and shape parameter (volume/surface area) were quantified. Mathematical markers (shape index (SI) and curvedness) were used to measure gyrification. Parameters were assessed according to lesion type (myelomeningocele vs myeloschisis (MS)), postoperative persistence of hindbrain herniation (HH) and the presence of supratentorial anomalies, namely partial agenesis of the corpus callosum (pACC) and heterotopia (HT). RESULTS Growth in ventricular volume per week and change in shape parameter per week were higher at 6 weeks after surgery in fetuses with OSB compared with controls (median, 2500.94 (interquartile range (IQR), 1689.70-3580.80) mm3 /week vs 708.21 (IQR, 474.50-925.00) mm3 /week; P < 0.001 and 0.075 (IQR, 0.047-0.112) mm/week vs 0.022 (IQR, 0.009-0.042) mm/week; P = 0.046, respectively). Ventricular volume growth increased 6 weeks after surgery in cases with pACC (P < 0.001) and those with persistent HH (P = 0.002). During that time period, the change in unmyelinated white-matter shape parameter per week was decreased in OSB fetuses compared with controls (0.056 (IQR, 0.044-0.092) mm/week vs 0.159 (IQR, 0.100-0.247) mm/week; P = 0.002), particularly in cases with persistent HH (P = 0.011), MS (P = 0.015), HT (P = 0.022), HT with corpus callosum anomaly (P = 0.017) and persistent HH with corpus callosum anomaly (P = 0.007). At 6 weeks postoperatively, despite OSB fetuses having a lower rate of change in curvedness compared with controls (0.061 (IQR, 0.040-0.093) mm-1 /week vs 0.094 (IQR, 0.070-0.146) mm-1 /week; P < 0.001), reversing the trend seen at 1 week after surgery (0.144 (IQR, 0.099-0.236) mm-1 /week vs 0.072 (IQR, 0.059-0.081) mm-1 /week; P < 0.001), gyrification, as determined using SI, appeared to be increased in OSB fetuses overall compared with controls. This observation was more prominent in fetuses with pACC and those with severe ventriculomegaly (P-value range, < 0.001 to 0.006). CONCLUSIONS Following fetal OSB repair, volume, shape and curvedness of ventricles and unmyelinated white matter differed significantly compared with those of normal fetuses. Morphological brain changes after fetal surgery were not limited to effects on the circulation of cerebrospinal fluid. These observations may have implications for postnatal neurocognitive outcome. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N. Mufti
- Elizabeth Garrett Anderson Institute for Women's HealthUniversity College LondonLondonUK
- School of Biomedical Engineering and Imaging Sciences (BMEIS)King's College LondonLondonUK
| | - J. Chappell
- School of Biomedical Engineering and Imaging Sciences (BMEIS)King's College LondonLondonUK
| | - M. Aertsen
- Department of RadiologyUniversity Hospitals Katholieke Universiteit (KU) LeuvenLeuvenBelgium
| | - M. Ebner
- School of Biomedical Engineering and Imaging Sciences (BMEIS)King's College LondonLondonUK
| | - L. Fidon
- School of Biomedical Engineering and Imaging Sciences (BMEIS)King's College LondonLondonUK
| | - J. Deprest
- Elizabeth Garrett Anderson Institute for Women's HealthUniversity College LondonLondonUK
- Department of Obstetrics and GynaecologyUniversity Hospitals Katholieke Universiteit (KU) LeuvenLeuvenBelgium
| | - A. L. David
- Elizabeth Garrett Anderson Institute for Women's HealthUniversity College LondonLondonUK
- Department of Obstetrics and GynaecologyUniversity Hospitals Katholieke Universiteit (KU) LeuvenLeuvenBelgium
- National Institute for Health and Care Research University College London Hospitals Biomedical Research CentreLondonUK
| | - A. Melbourne
- School of Biomedical Engineering and Imaging Sciences (BMEIS)King's College LondonLondonUK
- Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
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Gao D, Ou J, Tan BG, Yu ZY, Li KY, Li R, Zhang XM, Chen TW, Zhou HY. A novel quantitative model based on gross tumor volume corresponding to anatomical distribution measured with multidetector computed tomography to determine the resectability of non‑distant metastatic esophageal squamous cell carcinoma. Oncol Lett 2023; 26:485. [PMID: 37818136 PMCID: PMC10561156 DOI: 10.3892/ol.2023.14072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023] Open
Abstract
It is important to accurately determine the resectability of thoracic esophageal squamous cell carcinoma (ESCC) for treatment decision-making. Previous studies have revealed that the CT-derived gross tumor volume (GTV) is associated with the staging of ESCC. The present study aimed to explore whether the anatomical distribution-based GTV of non-distant metastatic thoracic ESCC measured using multidetector computed tomography (MDCT) could quantitatively determine the resectability. For this purpose, 473 consecutive patients with biopsy-confirmed non-distant metastatic thoracic ESCC who underwent contrast-enhanced CT were randomly divided into a training cohort (TC; 376 patients) and validation cohort (VC; 97 patients). GTV was retrospectively measured using MDCT. Univariate and multivariate analyses were performed to identify the determinants of the resectability of ESCC in the TC. Receiver operating characteristic (ROC) analysis was performed to clarify whether anatomical distribution-based GTV could help quantitatively determinate resectability. Unweighted Cohen's Kappa tests in VC were used to assess the performance of the previous models. Univariate analysis demonstrated that sex, anatomic distribution, cT stage, cN stage and GTV were related to the resectability of ESCC in the TC (all P<0.05). Multivariate analysis revealed that GTV [P<0.001; odds ratio (OR) 1.158] and anatomic distribution (P=0.027; OR, 1.924) were independent determinants of resectability. ROC analysis revealed that the GTV cut-offs for the determination of the resectability of the upper, middle and lower thoracic portions were 23.57, 22.89 and 22.58 cm3, respectively, with areas under the ROC curves of >0.9. Unweighted Cohen's Kappa tests revealed an excellent performance of the ROC models in the upper, middle and lower thoracic portions with Cohen k-values of 0.913, 0.879 and 0.871, respectively. On the whole, the present study demonstrated that GTV and the anatomic distribution of non-distant metastatic thoracic ESCC may be independent determinants of resectability, and anatomical distribution-based GTV can effectively be used to quantitatively determine resectability.
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Affiliation(s)
- Dan Gao
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
- Department of Radiology, Qionglai Medical Center Hospital, Chengdu, Sichuan 611530, P.R. China
| | - Jing Ou
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Bang-Guo Tan
- Department of Radiology, Panzhihua Central Hospital, Panzhihua, Sichuan 617067, P.R. China
| | - Zi-Yi Yu
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Ke-Ying Li
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Rui Li
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Xiao-Ming Zhang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Tian-Wu Chen
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
| | - Hai-Ying Zhou
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
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Munhall CC, Shah S, Nguyen SA, Meyer TA, Schlosser RJ, White DR. Otolaryngologic Presentations to Emergency Departments During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2023; 132:1467-1476. [PMID: 37016555 PMCID: PMC10076161 DOI: 10.1177/00034894231165575] [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: 04/06/2023]
Abstract
OBJECTIVES To perform a systematic review of otolaryngologic presentation rates to emergency department settings before and after lockdown due to the COVID-19 pandemic. SOURCES PubMed, Scopus, and CINAHL. METHODS A systematic search was conducted following PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) for studies describing otolaryngologic presentations to emergency department and rapid access clinic settings both in the before-lockdown and after-lockdown periods. The start of after-lockdown period varied based on initiation of lockdown, ranging from March 1st to June 1st of 2020 across general emergency department studies. RESULTS A total of 14 studies were included in this review. About 10 were general emergency departments, 3 were specifically pediatric emergency departments, and 1 study focused on the geriatric population (>65 years). A total of 13 790 patients were included, with 9446 in the before-lockdown period (68.5%) and 4344 in the after-lockdown period (31.5%). Meta-analysis of proportions for otolaryngologic presentations across general emergency departments was performed. Comparison of weighted proportions found significant differences between before-lockdown and after-lockdown presentation rates for infectious etiologies, tonsillitis specifically, foreign bodies, non-infectious airway issues, and epistaxis among these studies. CONCLUSIONS The increased proportions of various non-infectious presentations (eg, epistaxis, foreign bodies, and airway issues) following lockdown might be associated with proportional decreases in infectious pathologies, given decreased social contact to prevent SARS-CoV-2 transmission. Overall, it is important for otolaryngologists to recognize what presentations might more commonly be seen and require evaluation and potential intervention in light of a global pandemic.
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Affiliation(s)
- Christopher C. Munhall
- Department of Otolaryngology – Head and
Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Sunny Shah
- Department of Otolaryngology – Head and
Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Shaun A. Nguyen
- Department of Otolaryngology – Head and
Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Ted A. Meyer
- Department of Otolaryngology – Head and
Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Rodney J. Schlosser
- Department of Otolaryngology – Head and
Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - David R. White
- Department of Otolaryngology – Head and
Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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Sagheer S, Minhas AMK, Zaidi SH, Shah I, Ahuja KR, Ahuja SK, Nazir S, Talha KM, Dani SS, Fudim M, Abramov D, Virani SS, Wasty N. Association of Hospital Procedural Volume With Outcomes of Left Ventricular Assist Device Placement. J Card Fail 2023; 29:1531-1538. [PMID: 37419409 DOI: 10.1016/j.cardfail.2023.06.017] [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: 02/06/2023] [Revised: 05/19/2023] [Accepted: 06/11/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND With the advancement in device technology, the use of durable left ventricular assist devices (LVADs) has increased significantly in recent years. However, there is a dearth of evidence to conclude whether patients who undergo LVAD implantation at high-volume centers have better clinical outcomes than those receiving care at low- or medium-volume centers. METHODS We analyzed the hospitalizations using the Nationwide Readmission Database for the year 2019 for new LVAD implantation. Baseline comorbidities and hospital characteristics were compared among low- (1-5 procedures/year), medium- (6-16 procedures/year) and high-volume (17-72 procedures/year) hospitals. The volume/outcome relationship was analyzed using the annualized hospital volume as a categorical variable (tertiles) as well as a continuous variable. Multilevel mixed-effect logistic regression and negative binomial regression models were used to determine the association of hospital volume and outcomes, with tertile 1 (low-volume hospitals) as the reference category. RESULTS A total of 1533 new LVAD procedures were included in the analysis. The inpatient mortality rate was lower in the high-volume centers compared with the low-volume centers (9.04% vs 18.49%, aOR 0.41, CI0.21-0.80; P = 0.009). There was a trend toward lower mortality rates in medium-volume centers compared with low-volume centers; however, it did not reach statistical significance (13.27% vs 18.49%, aOR 0.57, CI0.27-1.23; P = 0.153). Similar results were seen for major adverse events (composite of stroke/transient ischemic attack and in-hospital mortality). There was no significant difference in bleeding/transfusion, acute kidney injury, vascular complications, pericardial effusion/hemopericardium/tamponade, length of stay, cost, or 30-day readmission rates between medium- and high-volume centers compared to low-volume centers. CONCLUSION Our findings indicate lower inpatient mortality rates in high-volume LVAD implantation centers and a trend toward lower mortality rates in medium-volume LVAD implantation centers compared to lower-volume centers.
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Affiliation(s)
- Shazib Sagheer
- Division of Cardiology, University of New Mexico Health Sciences Center, Albuquerque, NM; Division of Interventional Cardiology, Newark Beth Israel Medical Center, Newark, NJ, USA.
| | | | | | - Ishan Shah
- Division of Cardiology, University of New Mexico Health Sciences Center, Albuquerque, NM; Division of Interventional Cardiology, Newark Beth Israel Medical Center, Newark, NJ, USA
| | - Keerat Rai Ahuja
- Department of Cardiology, Reading Hospital-Tower Health, Reading, PA, USA
| | - Satish Kumar Ahuja
- Department of Internal Medicine, Reading Hospital-Tower Health, Reading, PA, USA
| | - Salik Nazir
- The Aga Khan University, Karachi, Pakistan, and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Khawaja M Talha
- Division of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Sourbha S Dani
- Division of Cardiology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Marat Fudim
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA
| | - Dmitry Abramov
- Department of Medicine, Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Salim S Virani
- The Aga Khan University, Karachi, Pakistan, and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Najam Wasty
- Division of Interventional Cardiology, Newark Beth Israel Medical Center, Newark, NJ, USA
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Nilsen KS, Nordahl SHG, Berge JE, Dhayalan D, Goplen FK. Vestibular Tests Related to Tumor Volume in 137 Patients With Small to Medium-Sized Vestibular Schwannoma. Otolaryngol Head Neck Surg 2023; 169:1268-1275. [PMID: 37337472 DOI: 10.1002/ohn.399] [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: 02/24/2023] [Revised: 05/06/2023] [Accepted: 05/20/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE The video head impulse test (vHIT) and cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP) are new methods for measuring peripheral vestibular function. The objectives of this study were to compare these tests and the traditionally used caloric test in patients with small and medium-sized untreated vestibular schwannoma (VS) and to measure the correlation between the tests' results and tumor volume. STUDY DESIGN National cross-sectional study. SETTING Tertiary university clinic. METHODS Prevalence of abnormal cVEMP, oVEMP, caloric test, and 6-canal vHIT results on the tumor side and the nontumor side were compared and related to tumor volume with regression analyses in 137 consecutive VS patients assigned to a wait-and-scan protocol in the period 2017 to 2019. RESULTS The sensitivity of 6-canal vHIT, caloric test, cVEMP, and oVEMP to detect vestibulopathy in VS patients was 51%, 47%, 39%, and 25%, respectively. Normal tests were found in 21% of the patients. The results of vHIT and caloric test were related to tumor volume, but this was not found for cVEMP and oVEMP. CONCLUSION The caloric test and 6-canal vHIT showed the highest sensitivity in detecting vestibulopathy in untreated VS patients. vHIT, and particularly the posterior canal, was limited with a high prevalence of abnormal results on the nontumor side. A combination of cVEMP and caloric test was favorable in terms of a relatively high sensitivity and low prevalence of abnormal results on the nontumor side. Larger tumors had a higher rate of pathology on caloric testing and vHIT.
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Affiliation(s)
- Kathrin Skorpa Nilsen
- Department of Head and Neck Surgery, Haukeland University Hospital, Norwegian National Advisory Network on Vestibular Disorders, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Norway
| | - Stein Helge Glad Nordahl
- Department of Head and Neck Surgery, Haukeland University Hospital, Norwegian National Advisory Network on Vestibular Disorders, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Norway
| | - Jan Erik Berge
- Department of Head and Neck Surgery, Haukeland University Hospital, Norwegian National Advisory Network on Vestibular Disorders, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Norway
| | - Dhanushan Dhayalan
- Department of Clinical Medicine, University of Bergen, Norway
- Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway
| | - Frederik Kragerud Goplen
- Department of Head and Neck Surgery, Haukeland University Hospital, Norwegian National Advisory Network on Vestibular Disorders, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Norway
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Wang D, Ma Y, Gu B, Li X, Yu Y, Zhang Y, Chen H. Preliminary study of donor volume changes after dual-graft liver transplantation in rats. Front Immunol 2023; 14:1183426. [PMID: 37908343 PMCID: PMC10613707 DOI: 10.3389/fimmu.2023.1183426] [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: 03/10/2023] [Accepted: 09/27/2023] [Indexed: 11/02/2023] Open
Abstract
Dual-graft liver transplantation (DGLT) expands the pool of donors, ensures the safety of the donors, and treats a potential small for size syndrome (SFSS). However, some of the recipient graft showed atrophy. The cause and mechanism of the unbalanced proliferation and atrophy of dual grafts after clinical DGLT have not been clarified. We established and optimized the rat model of DGLT to explore the causes of growth unbalance. Continuously and dynamically observed bilateral graft volume and portal vein blood flow change by magnetic resonance imaging (MRI) and ultrasound (US). We detected liver function indexes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL). Liver samples from receptors were obtained for morphology, and apoptosis was measured by RT-PCR and western blot. Optimization of the model improved the 7-day survival rate from former 58.3% to 87.5%, and the 30-day survival rate was 68.8%. The volume of the right graft gradually increased, and the left graft atrophied during the 30-day observation period. The portal blood flow of the left graft gradually decreased until the 30th day (0.13 ± 0.01 ml/s) compared with the sham group (0.63 ± 0.05 ml/s), and the right graft significantly increased on the 30th day (0.75 ± 0.11ml/s). The liver function initially increased and then recovered. The total volume (12.52 ± 1.60 ml vs 4.47 ± 0.08 ml) and weight (12.09 ± 1 g vs 4.91 ± 0.18 g) of the graft increased significantly compared to pre-transplantation and reached the level of the sham operation group on the 30th day. The volume and weight of the right graft increased more than those of the left graft (P < 0.05). There was more inflammatory cell infiltration in the left graft, and the right graft had obvious proliferation of hepatocytes and mature bile duct cells. Left grafts were more prone to apoptosis than right grafts (P < 0.05). In conclusion, growth of the right graft is superior to the left; after double liver transplantation, perfusion blood flow and apoptosis may be the reason contributing to the volume differences in dual grafts.
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Affiliation(s)
- Dan Wang
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yanling Ma
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Baohong Gu
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Xuemei Li
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yang Yu
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Ying Zhang
- Department of Laboratory Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Hao Chen
- The Department of Tumor Surgery, Second Hospital of Lanzhou University, Lanzhou, China
- The Key Laboratory of The Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
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Altokhis A, Alotaibi A, Morgan P, Tanasescu R, Evangelou N. Predictors of long-term disability in multiple sclerosis patients using routine magnetic resonance imaging data: A 15-year retrospective study. Neuroradiol J 2023; 36:524-532. [PMID: 36745094 PMCID: PMC10569198 DOI: 10.1177/19714009221150853] [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] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Early identification of patients at high risk of progression could help with a personalised treatment strategy. Magnetic resonance imaging (MRI) measures have been proposed to predict long-term disability in multiple sclerosis (MS), but a reliable predictor that can be easily implemented clinically is still needed. AIM Assess MRI measures during the first 5 years of the MS disease course for the ability to predict progression at 10+ years. METHODS Eighty-two MS patients (53 females), with ≥10 years of clinical follow-up and having two MRI scans, were included. Clinical data were obtained at baseline, follow-up and at ≥10 years. White matter lesion (WML) counts and volumes, and four linear brain sizes were measured on T2/FLAIR 'Fluid-Attenuated-Inversion-Recovery' and T1-weighted images. RESULTS Baseline and follow-up inter-caudate diameter (ICD) and third ventricular width (TVW) measures correlated positively with Expanded Disability Status Scale, ≥10 or more of WMLs showed a high sensitivity in predicting progression, at ≥10 years. A steeper rate of lesion volume increase was observed in subjects converting to secondary progressive MS. The sensitivity and specificity of both ICD and TVW, to predict disability at ≥10 years were 60% and 64%, respectively. CONCLUSION Despite advances in brain imaging and computerised volumetric analysis, ICD and TVW remain relevant as they are simple, fast and have the potential in predicting long-term disability. However, in this study, despite the statistical significance of these measures, the clinical utility is still not reliable.
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Affiliation(s)
- Amjad Altokhis
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Clinical Neurology, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
- Department of Radiological Sciences, School of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdulmajeed Alotaibi
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Clinical Neurology, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
- Department of Radiological Sciences, School of Applied Medical Sciences, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Paul Morgan
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
- Medical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Radu Tanasescu
- Clinical Neurology, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Nikos Evangelou
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Clinical Neurology, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
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Williamson A, da Silva A, do Carmo JM, Le Maitre C, Hall JE, Aberdein N. Impact of leptin deficiency on male tibia and vertebral body 3D bone architecture independent of changes in body weight. Physiol Rep 2023; 11:10.14814/phy2.15832. [PMID: 37786973 PMCID: PMC10546263 DOI: 10.14814/phy2.15832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023] Open
Abstract
Leptin an adipokine with potent effects on energy balance and body weight plays an important role in defining bone architecture in growing mammals. However, major changes in body weight can also influence morphology of trabecular and cortical bone. Therefore, we examined the impact of leptin deficiency on tibia and vertebral body 3D bone architecture independent of changes in body weight. Furthermore, advances in computational 3D image analysis suggest that average morphological values may mask regional specific differences in trabecular bone thickness. The study utilized leptin-deficient Ob/Ob mice (n = 8) weight-paired to C57BL/6 (C57) control mice (n = 8) which were split into either lean or obese groups for 24 ± 2 weeks. Whole tibias and L3 vertebrae were fixed before high resolution microcomputed tomography (μCT) scanning was performed. Leptin deficiency independent of body weight reduced tibia cortical bone volume, trabecular bone volume/tissue volume, number, and mineral density. Mean tibia trabecular thickness showed no significant differences between all groups; however, significant changes in trabecular thickness were found when analyzed by region. This study demonstrates that leptin deficiency significantly impacts tibia and vertebral body trabecular and cortical bone 3D architecture independent of changes in body weight.
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Affiliation(s)
- Alexander Williamson
- Biomolecular Science Research Centre, Department of Bioscience and ChemistrySheffield Hallam UniversitySheffieldUK
| | - Alexandre da Silva
- Mississippi Center for Obesity Research, Department of Physiology and BiophysicsUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Jussara M. do Carmo
- Mississippi Center for Obesity Research, Department of Physiology and BiophysicsUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Christine L. Le Maitre
- Biomolecular Science Research Centre, Department of Bioscience and ChemistrySheffield Hallam UniversitySheffieldUK
| | - John E. Hall
- Mississippi Center for Obesity Research, Department of Physiology and BiophysicsUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Nicola Aberdein
- Biomolecular Science Research Centre, Department of Bioscience and ChemistrySheffield Hallam UniversitySheffieldUK
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Sekhon J, Jain R, Bansal K, Luthra N, Singh MR, Kumari B. Efficacy of Different Volumes of 0.2% Ropivacaine in Suprainguinal Fascia Iliaca Compartment Block for Multimodal Analgesia in Lower Limb Surgery. Cureus 2023; 15:e46894. [PMID: 37954742 PMCID: PMC10638675 DOI: 10.7759/cureus.46894] [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] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background Ultrasound-guided (USG) suprainguinal fascia iliaca (SIFI) block is being used widely for post-operative analgesia in patients undergoing hip and femur surgeries. However, the optimal volume of local anesthetic required for SIFI block is not well defined. Thus, we compared different volumes of 0.2% ropivacaine in SIFI for post-operative pain relief in lower limb surgeries. Material and methods A total of 90 patients undergoing hip and femur surgeries were randomly allocated into three groups: A, B, and C, who received USG SIFI block with 20 mL, 30 mL, and 40 mL of 0.2% ropivacaine, respectively. Intravenous tramadol was used as rescue analgesia when the numeric rating scale (NRS) score exceeded 3. Time to first request of rescue analgesic was the primary outcome. NRS scores in the first 24 hours post-operatively, total amount of tramadol consumption in 24 hours, and patient satisfaction with pain management were secondary outcomes. Results The time to first request to rescue analgesic was significantly longer in group B and group C as compared to group A. NRS scores were significantly reduced in group B and group C than group A in the 24-hour post-operative period. Median 24-hour tramadol consumption was significantly less in group C as compared to group A and group B. Patient satisfaction with pain management was better with group B and group C as compared to group A. Conclusion In comparison to 20 mL of 0.2% ropivacaine, 30 mL and 40 mL of 0.2% ropivacaine in SIFI compartment block are more efficacious in reducing post-operative pain after hip and lower limb surgeries.
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Affiliation(s)
- Jessica Sekhon
- Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Richa Jain
- Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Kamya Bansal
- Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Neeru Luthra
- Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Mirley R Singh
- Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Bindu Kumari
- Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, IND
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Nemes A, Kormányos Á, Ruzsa Z, Achim A, Ambrus N, Lengyel C. Left ventricular rotational mechanics and left ventricular volumes: is there a relationship in healthy adults?-three-dimensional speckle-tracking echocardiography-derived insights from the MAGYAR-Healthy Study. Quant Imaging Med Surg 2023; 13:6583-6589. [PMID: 37869328 PMCID: PMC10585552 DOI: 10.21037/qims-23-178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/01/2023] [Indexed: 10/24/2023]
Abstract
Background Left ventricular (LV) rotational mechanics play a crucial role in LV pump function by strengthening and improving its efficacy. Dependence of LV rotational parameters on left atrial volumes has already been demonstrated. The evaluation of the effect of LV rotational mechanics on LV volumes was purposed in a population of healthy subjects by three-dimensional speckle-tracking echocardiography (STE). Methods The study comprised 175 healthy subjects with a mean age of 32.8±12.2 years (79 males). All subjects underwent a complete physical examination, laboratory assessments, standard 12-lead electrocardiography and two-dimensional Doppler and three-dimensional STE, the results of these examinations were within the normal range. Results Increased basal LV rotation was associated with increased LV volume measured in end-systole and impaired LV ejection fraction. Increased apical LV rotation was associated with reduced LV volumes assessed in end-diastole and in end-systole and increased ejection fraction of the LV. Elevated basal LV rotation showed associations with increased LV mass. In case of increasing basal LV rotation, apical LV rotation showed a decreasing tendency and LV twist showed a tendency of increasing. Similarly, lower basal LV rotation and increased LV twist were seen with increasing apical LV rotation. Increasing LV end-diastolic volume was associated with increasing LV volume measured in end-systole and preserved ejection fraction of the LV. Increasing LV end-systolic volume was associated with increasing LV end-diastolic volume and reduction of LV ejection fraction. Increasing LV volumes were associated with increasing LV mass. While increased LV volumes were associated with reduced apical LV rotation and twist, basal LV rotation did not show significant changes. Conclusions LV rotational mechanics are strongly associated with LV volumes in healthy adults suggesting its volume-dependence.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Zoltán Ruzsa
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Alexandru Achim
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
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Huston-Paterson H, Mao Y, Tseng CH, Kim J, Yeh MW, Wu JX. Disparities in Initial Thyroid Cancer Care by Hospital Treatment Volume: Analysis of 52,599 Cases in California. Thyroid 2023; 33:1215-1223. [PMID: 37498775 DOI: 10.1089/thy.2023.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background: Racially minoritized patients with thyroid cancer are less likely to receive high-quality and guideline-concordant care. Inaccessibility of high-volume centers may contribute to inequalities in thyroid cancer outcomes. This study sought to understand the extent to which access to higher volume thyroid cancer centers is associated with patient outcomes. Methods: We queried linked California Cancer Registry and California Office of Statewide Health Planning and Development databases for thyroid cancer patients who received thyroid surgery between 1999 and 2017. Hospitals were stratified by their median annual volume of thyroid cancer operations: ultra-low volume (0-5 cases/year), low-volume (6-25 cases/year), mid-volume (26-50 cases/year), and high-volume (>50 cases/year). We analyzed the rates of complications, rates of reoperation for cancer recurrence, use of radioactive iodine (131I), and mortality by median hospital volume of thyroid surgery. A multivariable regression controlled for high-risk tumor features. Differences in access by center volume were assessed based on patient demographics. Results: We studied 52,599 thyroid cancer patients who underwent thyroidectomy. Patients who underwent thyroidectomy at ultra-low volume centers were more likely to undergo reoperations for recurrent/persistent disease compared with patients at low- (odds ratio [OR] 1.17 [CI 1.02-1.35]), mid- (OR 1.25 [CI 1.06-1.46]), and high-volume centers (OR 1.26 [CI 1.03-1.56]). Patients who received thyroid operations at ultra-low volume centers were also less likely to receive guideline-concordant 131I ablation compared with patients at higher volume centers (OR 0.77 [CI 0.72-0.82]). A pair-wise comparison between all volume categories for all outcomes revealed no statistically significant differences in outcomes between low-, mid-, or high-volume centers. Only ultra-low volume centers had significantly higher rates of adverse outcomes. Ultra-low volume centers were disproportionately accessed by women (p < 0.05), Hispanic, Asian/Pacific Islander, and American Indian people (p < 0.01), those from the lowest three quintiles of socio-economic status (p < 0.01), and the uninsured and those on Medicaid or Medicare (p < 0.01) when compared with higher volume centers. Conclusions: Patients receiving thyroid cancer surgery at centers performing ≤5 such operations per year were more likely to require reoperation for recurrent/persistent disease and less likely to receive appropriate 131I ablation. Ultra-low volume centers served higher proportions of socially and economically marginalized communities.
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Affiliation(s)
- Hattie Huston-Paterson
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Veterans Health Administration, Greater Los Angeles Healthcare System, Los Angeles, California, USA
- National Clinician Scholars Program, University of California Los Angeles, Los Angeles, California, USA
| | - Yifan Mao
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Chi-Hong Tseng
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Jiyoon Kim
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Michael W Yeh
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - James X Wu
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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Liu Y, Zhao X, Song J, Zhao W, Ge Y, Guan J. The Effect of Manual Lymph Drainage and Compression Bandaging for Stage 2 Breast Cancer-Related Lymphedema: A Randomized Controlled Trial. Lymphat Res Biol 2023; 21:479-484. [PMID: 37140566 DOI: 10.1089/lrb.2022.0074] [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: 05/05/2023] Open
Abstract
Aim: To explore the effect of manual lymph drainage (MLD), compression bandaging (CB), or combined decongestive therapy (CDT), including MLD and CB, on stage 2 breast cancer-related lymphedema (BCRL). Methods: Sixty women with stage 2 BCRL were enrolled. They were randomly divided into the MLD group, the CB group or the CDT group. Each group, respectively, received MLD alone, CB alone, or CDT composed of MLD and CB, for 2 weeks. The volume and the local tissue water (LTW) of affected arms were measured before and after treatment. Arm circumferences were measured at 4 cm interval starting from the wrist to the shoulder with a tape measure. LTW was detected using the (tissue dielectric constant, TDC) method and was expressed as TDC value in two sites on the ventral midpoint of upper arm and forearm. Results: The volume of affected arms in each group after 2-weeks' treatment was lower than their baseline and the difference was statistically significant (p < 0.05). But there was no significant difference in volume change among three groups. The TDC value of the upper arm and forearm in the group CB and the group CDT decreased distinctly compared with baseline (p < 0.05). But the TDC value of the upper arm and forearm after MLD did not change (p > 0.05). Compared with the group MLD and the group CDT, the reduction of the TDC value in the group CB was more significant (p < 0.05). Conclusions: MLD or CB alone could effectively reduce the volume of affected arms for patients with stage 2 BCRL, and CB also could reduce the LTW more significantly. CDT did not seem to show an extra advantage. Therefore, CB may be the first choice for stage 2 BCRL. But for patients who are unwilling or intolerant to CB, MLD can be selected.
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Affiliation(s)
- Ying Liu
- Department of Rehabilitation and Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Xiaoyi Zhao
- Department of Rehabilitation and Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Jian Song
- Department of Rehabilitation and Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Wowa Zhao
- Department of Rehabilitation and Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Ying Ge
- Department of Rehabilitation and Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Jinghong Guan
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
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Peyrottes A, Chicaud M, Fourniol C, Doizi S, Timsit MO, Méjean A, Yonneau L, Lebret T, Audenet F, Traxer O, Panthier F. Clinical Reproducibility of the Stone Volume Measurement: A "Kidney Stone Calculator" Study. J Clin Med 2023; 12:6274. [PMID: 37834918 PMCID: PMC10573675 DOI: 10.3390/jcm12196274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND An accurate estimation of the stone burden is the key factor for predicting retrograde intra-renal surgical outcomes. Volumetric calculations better stratify stone burden than linear measurements. We developed a free software to assess the stone volume and estimate the lithotrity duration according to 3D-segmented stone volumes, namely the Kidney Stone Calculator (KSC). The present study aimed to validate the KSC's reproducibility in clinical cases evaluating its inter-observer and intra-observer correlations. METHODS Fifty patients that harbored renal stones were retrospectively selected from a prospective cohort. For each patient, three urologists with different experience levels in stone management made five measurements of the stone volume on non-contrast-enhanced computed tomography (NCCT) images using the KSC. RESULTS the overall inter-observer correlation (Kendall's concordance coefficient) was 0.99 (p < 0.0001). All three paired analyses of the inter-observer reproducibility were superior to 0.8. The intra-observer variation coefficients varied from 4% to 6%, and Kendall's intra-observer concordance coefficient was found to be superior to 0.98 (p < 0.0001) for each participant. Subgroup analyses showed that the segmentation of complex stones seems to be less reproductible. CONCLUSIONS The Kidney Stone Calculator is a reliable tool for the stone burden estimation. Its extension for calculating the lithotrity duration is of major interest and could help the practitioner in surgical planning.
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Affiliation(s)
- Arthur Peyrottes
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Marie Chicaud
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
- Service d’Urologie, CHU de Limoges, 2 Avenue Martin Luther King, 87000 Limoges, France
| | - Cyril Fourniol
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Steeve Doizi
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
| | - Marc-Olivier Timsit
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Arnaud Méjean
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Laurent Yonneau
- Service d’Urologie, Hôpital Foch-Université Paris Saclay-UVSQ, 40 rue Worth, 92150 Suresnes, France; (L.Y.); (T.L.)
| | - Thierry Lebret
- Service d’Urologie, Hôpital Foch-Université Paris Saclay-UVSQ, 40 rue Worth, 92150 Suresnes, France; (L.Y.); (T.L.)
| | - François Audenet
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
| | - Olivier Traxer
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
| | - Frederic Panthier
- GRC n°20, Groupe de Recherche Clinique Sur La Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (A.P.); (M.C.); (S.D.); (O.T.)
- Service D’Urologie, Hôpital Européen Georges Pompidou, AP-HP.Centre, Université Paris-Cité, 20 rue Leblanc, 75015 Paris, France; (C.F.); (M.-O.T.); (A.M.); (F.A.)
- Service D’Urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
- PIMM Laboratory, UMR 8006 CNRS-Arts Et Métiers ParisTech, 151 bd de l’Hôpital, 75013 Paris, France
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Kim DK, Lee KC, Kim JK, Kim T. Assessment of Imaging Factors Associated with Baker's Cyst Rupture on Knee MRI. J Belg Soc Radiol 2023; 107:77. [PMID: 37781476 PMCID: PMC10540859 DOI: 10.5334/jbsr.3258] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/20/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives To identify the factors associated with Baker's cyst rupture on MRI. Material and methods From January 2021 to December 2022, a total of 441 knee MRI examinations in 441 patients (mean age: 47.7 ± 13.8 years) with Baker's cyst were included in this study. Patients were classified into two groups: those with ruptured vs. unruptured Baker's cysts. On knee radiograph, osteoarthritis grade was assessed based on Kellgren-Lawrence grade. On MRI, combined structure injuries, alignment type between semimembranosus tendon and medial head of gastrocnemius tendon, amount of joint effusion, presence of septation, maximal diameters of cyst, and cyst volume were evaluated. Receiver operating characteristic (ROC) analysis was performed to assess the predictive performances of imaging factors for cyst rupture. Results There were 146 patients with Baker's cyst rupture and 295 patients without rupture. Patients with cyst rupture showed significantly longer maximal transverse diameter (25.8 ± 6.8 mm vs. 21.6 ± 5.8 mm, p = 0.035) and larger volume (13.3 ± 6.2 cm3 vs. 9.9 ± 5.1 cm3, p = 0.012) than those without rupture. On ROC analysis, maximal transverse diameter of cyst ≥ 22.2 mm (sensitivity = 64.4%, specificity = 54.9%) and cyst volume ≥ 10.9 cm3 (sensitivity = 71.2%, specificity = 58.3%) were the cutoff values for predicting rupture of cyst, respectively. The cyst volume showed significantly higher area under the curve (AUC) than maximal transverse diameter (0.726 vs. 0.642, p = 0.002). Conclusion Longer transverse diameter and larger volume of Baker's cyst could be predictive imaging parameters for cyst rupture.
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Affiliation(s)
- Dong Kyu Kim
- Department of Radiology, the Armed Forces Capital Hospital, Republic of Korea
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyu-Chong Lee
- Department of Radiology, the Armed Forces Capital Hospital, Republic of Korea
- Department of Radiology, Korea university Anam Hospital, Seoul, Republic of Korea
| | - Jin Kyem Kim
- Department of Radiology, the Armed Forces Capital Hospital, Republic of Korea
| | - Taeho Kim
- Department of Radiology, the Armed Forces Capital Hospital, Republic of Korea
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Ryoo DY, Koehler B, Rath J, Shah ZK, Chen W, Esnakula AK, Hart PA, Krishna SG. A Comparison of Single Dimension and Volume Measurements in the Risk Stratification of Pancreatic Cystic Lesions. J Clin Med 2023; 12:5871. [PMID: 37762812 PMCID: PMC10531933 DOI: 10.3390/jcm12185871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The incidence of pancreatic cystic lesions (PCLs) has been rising due to improvements in imaging. Of these, intraductal papillary mucinous neoplasms (IPMNs) are the most common and are thought to contribute to almost 20% of pancreatic adenocarcinomas. All major society guidelines for the management of IPMNs use size defined by maximum diameter as the primary determinant of whether surveillance or surgical resection is recommended. However, there is no consensus on how these measurements should be obtained or whether a single imaging modality is superior. Furthermore, the largest diameter may fail to capture the complexity of PCLs, as most are not perfectly spherical. This article reviews current PCL measurement techniques in CT, MRI, and EUS and posits volume as a possible alternative to the largest diameter.
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Affiliation(s)
- Da Yeon Ryoo
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (D.Y.R.); (B.K.)
| | - Bryn Koehler
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (D.Y.R.); (B.K.)
| | - Jennifer Rath
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (J.R.); (Z.K.S.)
| | - Zarine K. Shah
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (J.R.); (Z.K.S.)
| | - Wei Chen
- Department of Pathology, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (W.C.); (A.K.E.)
| | - Ashwini K. Esnakula
- Department of Pathology, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; (W.C.); (A.K.E.)
| | - Phil A. Hart
- Division of Gastroenterology, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA;
| | - Somashekar G. Krishna
- Division of Gastroenterology, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA;
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Wen X, Xu L, Chen X, Wu R, Luo J, Wan Y, Mao Z. A quasi-experimental study of the volume-based procurement (VBP) effect on antiviral medications of hepatitis B virus in China. Front Pharmacol 2023; 14:984794. [PMID: 37731741 PMCID: PMC10507907 DOI: 10.3389/fphar.2023.984794] [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: 07/02/2022] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Background: The Pilot Plan of National Centralized Volume-Based Procurement (NCVBP) was adopted to cope with the rapid increase in drug expenditures. This research aimed to quantitatively evaluate the impact of the NCVBP on antiviral medications for the hepatitis B virus. Methods: Data on nucleoside analogs (NAs) medications of hepatitis B virus monthly procurement records in the pilot cities from January 2018 to December 2019 were extracted from the China Drug Supply Information Platform (CDSIP). The impacts of the NCVBP on purchased volumes, expenditures, and pre-defined daily dose costs were evaluated by interrupted time-series (ITS) analysis using Stata 16.0. We constructed two segments with one interruptive point (March 2019). Results: Compared to the same period between pre-and post-intervention, the purchased volume of NAs medications were increased by 92.85%, and selected medications were increased by 119.09%. Analysis of changes in the level of NAs medication followed a decrease in purchased expenditure (coefficient: 5364.88, p < 0.001), meanwhile, the purchased volume was increased with statistical significance (coefficient:605.49, p < 0.001). The Defined Daily Dose cost (DDDc) of NAs medication followed a decrease (coefficient: 8.90, p < 0.001). The NCVBP reform was followed by an increase of 618.41 ten thousand Defined Daily Dose (DDD) (p < 0.001) in purchased volume and a reduction of 5273.84 ten thousand Chinese Yuan (CNY) (p < 0.001) in the purchased expenditure of selected medications in the level. The DDDc of selected medications decreased in the level (coefficient: 9.87, p < 0.001), while the DDDc of alternative medications increased in the slope (coefficient:0.07, p = 0.030). The purchased volume and expenditure of bid-winning products increased by 964.08 ten thousand DDD and 637.36 ten thousand CNY in the level (p < 0.001). An increase of 633.46 ten thousand DDD (p < 0.001) in purchased volume and a reduction of 4285.32 ten thousand CNY (p < 0.001) in the purchased expenditure of generic drugs in the level was observed. Conclusion: The NCVBP reduced the DDDc of NAs medication, improved the utilization of the selected medications, and promoted the usage of generic products.
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Affiliation(s)
- Xiaotong Wen
- Department of Hospital Infection Management, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Luxinyi Xu
- School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Xiaoze Chen
- School of Public Health, Xi’an Jiao Tong Liverpool University, Suzhou, China
| | - Ruonan Wu
- School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Jia Luo
- School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Yuying Wan
- Department of Hospital Infection Management, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zongfu Mao
- School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
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Wójcik M, Dziki D, Matwijczuk A, Gawlik-Dziki U. Walnut Flour as an Ingredient for Producing Low-Carbohydrate Bread: Physicochemical, Sensory, and Spectroscopic Characteristics. Foods 2023; 12:3320. [PMID: 37685252 PMCID: PMC10486641 DOI: 10.3390/foods12173320] [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: 08/09/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Walnut flour (WF) is a nutrient-rich source that can be used as an alternative for individuals on a gluten-free diet. This study aimed to assess the physical, chemical, and sensory changes in low-carbohydrate bread when supplemented with WF. Molecular-level changes were also examined using ATR-FTIR spectra. The bread recipe, containing buckwheat and flaxseed, was enriched with WF at levels ranging from 5% to 20%. The addition of WF resulted in increased loaf volume and decreased baking loss. Enriched bread samples showed higher protein content, while fat and available carbohydrate content decreased. Additionally, WF incorporation led to a decrease in crumb brightness and an increase in redness (from 23.1 to 25.4) and yellowness (from 23.8 to 26.7). WF also increased crumb hardness and chewiness. Moreover, the tested additives primarily influenced the intensity of FTIR spectra, indicating changes in protein, carbohydrate, and fat content, with increased band intensity observed in the protein region. We particularly recommend bread with a WF content of 15%. This type of bread is characterized by high consumer acceptance. Furthermore, compared to bread without the addition of WF, it has a higher content of phenolic compounds, protein, and fat by approximately 40%, 8%, and 4%, respectively. The antioxidant activity of this bread, determined using the ABTS and DPPH methods, is also significantly higher compared to the control bread.
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Affiliation(s)
- Monika Wójcik
- Department of Food Engineering and Machines, University of Life Sciences in Lublin, 28 Głęboka St., 20-612 Lublin, Poland
| | - Dariusz Dziki
- Department of Thermal Technology and Food Process Engineering, University of Life Sciences in Lublin, 31 Głęboka St., 20-612 Lublin, Poland
| | - Arkadiusz Matwijczuk
- Department of Biophysics, Institute of Molecular Biophysics, Faculty of Environmental Biology, University of Life Sciences in Lublin, Akademicka 13, 20-950 Lublin, Poland
| | - Urszula Gawlik-Dziki
- Department of Biochemistry and Food Chemistry, University of Life Sciences in Lublin, 8 Skromna St., 20-704 Lublin, Poland
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Nemes A, Kormányos Á, Rácz G, Ruzsa Z, Achim A, Ambrus N, Lengyel C. Tricuspid annular and right atrial volume changes are associated in healthy adults-insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study. Front Cardiovasc Med 2023; 10:1140599. [PMID: 37731528 PMCID: PMC10507328 DOI: 10.3389/fcvm.2023.1140599] [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: 01/09/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction The tricuspid valve and its annulus (TA) and the right atrium (RA) play a significant role in regulating blood flow in the right heart. However, their effect on each other is not fully understood even in normal circumstances. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is able to simultaneously assess TA and RA at the same time in a non-invasive way. The present study aimed to examine associations between tricuspid annular (TA) dimensions and right atrial (RA) volumes in healthy adults by 3DSTE. Methods The present study comprised 144 healthy subjects (mean age: 34.4 ± 12.6 years, 72 males), who participated in this study on a voluntary basis for screening between 2011 and 2015. In all subjects, electrocardiography, two-dimensional Doppler echocardiography and 3DSTE have been performed. Results With increasing end-systolic maximum RA volume, all end-systolic and end-diastolic TA dimensions showed simultaneous increase, but in various degrees resulting in (non-significant) reduction of TA functional properties. Similarly, with increasing diastolic pre-atrial contraction and minimum RA volumes, TA dimensions increased simultaneously (except end-diastolic TA diameter), but in various degrees resulting in reduced TA fractional shortening and fractional area change. With increasing RA dimensions, end-systolic and end-diastolic TA dimensions showed simultaneous increase, but in different, sometimes not significant degrees. While RA stroke volumes showed increasing pattern with TA dilation, RA emptying fractions have not changed substantially. Conclusions 3DSTE is suitable for non-invasive assessment of TA dimensions and RA volumes at the same time using the same 3D echocardiographic dataset. Significant associations between TA size and RA volumes exist in healthy circumstances. Strong associations in case of dilation of TA in the presence of higher RA volumes could partly explain functional tricuspid regurgitation later developing in subjects in sinus rhythm.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
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Njane SN, Tsuda S, van Marrewijk BM, Polder G, Katayama K, Tsuji H. Effect of varying UAV height on the precise estimation of potato crop growth. Front Plant Sci 2023; 14:1233349. [PMID: 37662173 PMCID: PMC10470036 DOI: 10.3389/fpls.2023.1233349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023]
Abstract
A phenotyping pipeline utilising DeepLab was developed for precisely estimating the height, volume, coverage and vegetation indices of European and Japanese varieties. Using this pipeline, the effect of varying UAV height on the precise estimation of potato crop growth properties was evaluated. A UAV fitted with a multispectral camera was flown at a height of 15 m and 30 m in an experimental field where various varieties of potatoes were grown. The properties of plant height, volume and NDVI were evaluated and compared with the manually obtained parameters. Strong linear correlations with R2 of 0.803 and 0.745 were obtained between the UAV obtained plant heights and manually estimated plant height when the UAV was flown at 15 m and 30 m respectively. Furthermore, high linear correlations with an R2 of 0.839 and 0.754 were obtained between the UAV-estimated volume and manually estimated volume when the UAV was flown at 15 m and 30 m respectively. For the vegetation indices, there were no observable differences in the NDVI values obtained from the UAV flown at the two heights. Furthermore, high linear correlations with R2 of 0.930 and 0.931 were obtained between UAV-estimated and manually measured NDVI at 15 m and 30 m respectively. It was found that UAV flown at the lower height had a higher ground sampling distance thus increased resolution leading to more precise estimation of both the height and volume of crops. For vegetation indices, flying the UAV at a higher height had no effect on the precision of NDVI estimates.
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Affiliation(s)
- Stephen Njehia Njane
- Hokkaido Agricultural Research Center, National Agriculture and Food Research Organization, Memurocho, Kasaigun, Hokkaido, Japan
| | - Shogo Tsuda
- Hokkaido Agricultural Research Center, National Agriculture and Food Research Organization, Memurocho, Kasaigun, Hokkaido, Japan
| | - Bart M. van Marrewijk
- Wageningen Greenhouse Horticulture, Wageningen University and Research, Wageningen, Netherlands
| | - Gerrit Polder
- Wageningen Greenhouse Horticulture, Wageningen University and Research, Wageningen, Netherlands
| | - Kenji Katayama
- Hokkaido Agricultural Research Center, National Agriculture and Food Research Organization, Memurocho, Kasaigun, Hokkaido, Japan
| | - Hiroyuki Tsuji
- Hokkaido Agricultural Research Center, National Agriculture and Food Research Organization, Memurocho, Kasaigun, Hokkaido, Japan
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Kirby RS, Meloni JM, Naik KB, Minnear MD, Pettengill MA. Using Individual Collector Blood Culture Volume Data To Improve Fill Volume. Microbiol Spectr 2023; 11:e0210623. [PMID: 37439689 PMCID: PMC10434280 DOI: 10.1128/spectrum.02106-23] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Affiliation(s)
- Richard S. Kirby
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jenna M. Meloni
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Karishma B. Naik
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Matthew D. Minnear
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Children’s Hospital of Philadelphia, Department of Pathology and Laboratory Medicine, Philadelphia, Pennsylvania, USA
| | - Matthew A. Pettengill
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Bernasconi M, Bilic A, Kauke-Navarro M, Safi AF. Nodal tumor volume as a prognostic factor for oral squamous cell carcinoma-a systematic review. Front Oral Health 2023; 4:1229931. [PMID: 37654649 PMCID: PMC10467257 DOI: 10.3389/froh.2023.1229931] [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: 05/27/2023] [Accepted: 07/13/2023] [Indexed: 09/02/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a complex disease with a high potential for lymph node metastasis and poor survival rates. Accurate nodal staging is crucial for prognostic assessment and treatment planning in OSCC. Recent research has suggested that nodal tumor volume (NTV) may be a more accurate indicator of nodal disease burden than traditional staging methods. However, the prognostic significance of NTV in OSCC remains unclear. This systematic review aims to evaluate the existing evidence on the relationship between NTV and prognosis in OSCC. A comprehensive search of electronic databases was conducted, and studies meeting inclusion criteria were critically appraised and synthesized. Our review identified 23 studies that investigated the prognostic significance of NTV in OSCC. The majority of studies reported that larger NTV was associated with poorer survival outcomes, although the strength of the association varied. The review also identified several areas for future research, including the standardization of NTV measurement and the integration of NTV into the broader landscape of OSCC management. In conclusion, our review suggests that NTV holds promise as a novel prognostic factor in OSCC, but more research is needed to fully elucidate its potential and inform clinical decision-making.
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Affiliation(s)
| | - Ante Bilic
- Faculty of Medicine, University of Berne, Berne, Switzerland
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States
| | - Ali-Farid Safi
- Faculty of Medicine, University of Berne, Berne, Switzerland
- Craniologicum, Center for Craniomaxillofacial Surgery, Berne, Switzerland
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Lu S, Liu H, Sun J, Zhang J, Li L, Tang Q, Liu Y, Deng Y. Evaluation of left atrial and ventricular remodeling in atrial fibrillation subtype by using speckle tracking echocardiography. Front Cardiovasc Med 2023; 10:1208577. [PMID: 37636311 PMCID: PMC10449251 DOI: 10.3389/fcvm.2023.1208577] [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: 04/19/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Background Atrial fibrillation (AF) is associated with cardiac structural and functional remodeling. We investigated the left atrial (LA) and left ventricular (LV) changes in AF subtypes by using two-dimensional echocardiography strain techniques. Methods The study population consisted of 102 subjects with sinus rhythm (control group) and 463 patients with AF, among which 284 patients had paroxysmal AF (PAF) and 179 patients had persistent AF (PerAF). A speckle tracking automatic functional imaging software was used to perform the strain analysis. Results Patients with AF had dilated LA maximum and minimum volume, decreased LA reservoir strain, lower LV ejection fraction (LVEF), and impaired global longitudinal strain (GLS) compared to those of the sinus rhythm control group. In patients with PerAF, the LA maximum and minimum volumes were larger, and the LA reservoir strain [PAF vs. PerAF, 28% (21,33) vs. 19% (14, 28), P < 0.05], LVEF, and absolute GLS value (PAF vs. PerAF, -16.9 ± 3.3 vs. -14.1 ± 3.5%) were lower than those in patients with PAF. Patients with AF regardless of LA enlargement had decreased LA reservoir strain and lower LVEF and absolute GLS value than those in the sinus rhythm control group. Conclusion Compared with those with normal sinus rhythm, patients with AF had dilated LA volume and impaired LA function, which were further worsened in patients with PerAF than those in patients with PAF. LA functional impairment occurred before LA enlargement. Left atrioventricular remodeling happened across different stages of AF development.
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Affiliation(s)
| | | | | | | | | | | | | | - Youbin Deng
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Biegus J, Borlaug BA, Testani JM. Congestion and Decongestion Assessment in Heart Failure: Pressure, Volume, or Both? JACC Heart Fail 2023; 11:1152-1156. [PMID: 37611991 DOI: 10.1016/j.jchf.2023.05.034] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Jan Biegus
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Barry A Borlaug
- The Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeffrey M Testani
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
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Storp JJ, Zimmermann JA, Danzer MF, Alnawaiseh M, Eter N, Al-Nawaiseh S. Characterizing Foveal Hypoplasia Using Optical Coherence Tomography Angiography: Evaluation of Microvascular Abnormalities and Clinical Significance. J Clin Med 2023; 12:4992. [PMID: 37568394 PMCID: PMC10419931 DOI: 10.3390/jcm12154992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to evaluate foveal avascular zone (FAZ) features and macular flow density (FD) in various retinal layers in a cohort of patients with foveal hypoplasia (FH) using optical coherence tomography angiography (OCTA), in order to characterize microvascular abnormalities and explore their potential clinical significance. FAZ parameters and FD, as well as retinal thickness and volume values were analyzed and compared between patients with FH and an age- and gender-matched control cohort. Correlations between disease severity and visual acuity (VA), as well as between disease severity and FAZ features were evaluated. A total of 19 eyes with FH and 19 control eyes were included. The study group showed significantly higher FD values in the foveal sectors of the superficial and deep capillary plexus compared to controls. FAZ area, perimeter, and acircularity index (ACI) were noticeably altered in eyes with FH; however, they did not correlate with disease severity. Visual acuity was negatively correlated with disease severity. The results of this study provide evidence of altered microvasculature architecture specifically in the foveal sectors of patients with FH. The higher FD values in the foveal sectors of FH patients suggest a potential compensatory response of the retinal microvasculature. FAZ parameters and FD values of the foveal sectors could be used as part of an OCTA-based grading system in FH patients.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Julian Alexander Zimmermann
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Moritz Fabian Danzer
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany;
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33604 Bielefeld, Germany;
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Sami Al-Nawaiseh
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
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