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Timofeeva, N. Yu, N. V. Bubnova, G. Yu Struchko, I. S. Stomenskaya, and O. Yu Kostrova. "Problems of metastasis (literature review)." MD-Onco 1, no. 1 (December 7, 2021): 93–99. http://dx.doi.org/10.17650/2782-3202-2021-1-1-93-99.
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Despite significant successes in the development of medical sciences, the study of oncopathology issues still occupies a leading place due to the identification of a large number of advanced cases of the disease. Firstly, this may be due to the rapid growth of a malignant tumor, for example, against the background of immunodeficiency. Secondly, with late treatment of patients, when they already have distant metastases. The success of treatment of any oncological process primarily depends on the timing of the diagnosis: the earlier the tumor is diagnosed, the greater the chance of a positive outcome and an increase in the life expectancy of the cancer patient. The most formidable complication of oncopathology and the main cause of death from it is metastasis, which often reduces to zero all the effects of therapy. Metastasis remains a mystery today. So, despite the large number of various theories, the question of the spread of the tumor throughout the body has not yet been resolved. There is no definite answer to the question: do metastases metastasize? The mechanisms of the influence of hormones on the processes of metastasis have not been fully studied. Difficulties in diagnosis are associated with the lack of clinical manifestations before the appearance of metastases, the inability to track and compare changes in tissues and organs in vivo, the non-specificity of the results of available research methods, and the lack of control of the spread of metastases throughout the body. Experimental studies on laboratory animals can provide answers to these and many other questions. In a review of the literature, a study of the main issues of metastasis is conducted.
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Abraham, Reem Rachel, Faith Alele, Ullas Kamath, Annamma Kurien, Kiranmai S. Rai, Indira Bairy, Mohandas K. G. Rao, et al. "Assessment for learning: a needs analysis study using formative assessment to evaluate the need for curriculum reform in basic sciences." Advances in Physiology Education 42, no. 3 (September 1, 2018): 482–86. http://dx.doi.org/10.1152/advan.00093.2018.
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A needs analysis study for curriculum reform in basic sciences was conducted at Melaka Manipal Medical College, India, by means of a formative assessment method, namely Basic Science Retention Examination (BSRE). Students participated in a BSRE, which comprised recall and clinical multiple-choice questions in six discipline areas. They also rated the clinical relevance of each question and provided responses to three open-text questions about the exam. Pass rates were determined; clinical relevance ratings and performance scores were compared between recall type and clinical questions to test students’ level of clinical application of basic science knowledge. Text comments were thematically analyzed to identify recurring themes. Only one-third of students passed the BSRE (32.2%). Students performed better in recall questions compared with clinical questions in anatomy (51.0 vs. 40.2%), pathology (45.1 vs. 38.1%), pharmacology (41.8 vs. 31.7%), and biochemistry (43.5 vs. 26.9%). In physiology, students performed better in clinical questions compared with the recall type (56.2 vs. 45.8%). Students’ response to BSRE was positive. The findings imply that transfer of basic science knowledge was poor, and that assessment methods should emphasize clinical application of basic science knowledge.
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Wang, Xiaona, Jun Chen, Hui Xiong, and Xuhui Yu. "Genotype-phenotype associations in familial exudative vitreoretinopathy: A systematic review and meta-analysis on more than 3200 individuals." PLOS ONE 17, no. 7 (July 13, 2022): e0271326. http://dx.doi.org/10.1371/journal.pone.0271326.
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Objective To systematically review the relationship between genotypes and clinical phenotypes of Familial exudative vitreoretinopathy (FEVR) to support risk estimation and therapeutic decisions. Design Systematic review with meta-analysis. Data sources The data of our study were collected from PubMed, Embase, Web of Science, Cochrane, CBM, China National Knowledge Infrastructure (CNKI), WAN FANG and VIP databases since inception to August 2021. Results A total of 3257 patients from 32 studies were included according to the inclusion and exclusion criteria. Among all the cases, the mutation frequencies of LRP5, FZD4, NDP, TSPAN12, ZNF408 and KIF11 were 13.6%, 11.5%, 4.6%, 6.7%, 1.6%, and 5.7%, respectively. We found that the patients with NDP and FZD4 suffer more severe symptoms, among which 86.4% patients of NDP and 78.6% patients of FZD4 were in the advanced stage of FEVR. Retinal detachment is the most frequent symptom with patients of LRP5 and NDP mutations, accounting for 51.9% and 64.5%, respectively. For the patients with the mutation of TSPAN12, retinal fold is the most common clinical manifestation, and suffer the mildest clinical phenotypes compared with the other three genes. Conclusion The results of the meta-analysis indicate that different types of genetic mutations occur at different frequencies. In addition, the clinical manifestations of FEVR are related to the type of gene mutation. Therefore, targeted treatment strategies and follow-up recommendations should be adopted for different pathogenic genes of FEVR.
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Mehrnoush, Vahid, Shahrzad Keramati, Asmaa Ismail, Waleed Shabana, Ahmed Zakaria, Hazem Elmansy, Walid Shahrour, Owen Prowse, and Ahmed Kotb. "Adverse pathological outcomes of patients with de novo muscle invasive bladder cancer in Northern Ontario." Archivio Italiano di Urologia e Andrologia 94, no. 1 (March 29, 2022): 41–45. http://dx.doi.org/10.4081/aiua.2022.1.41.
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Objective: This study aimed to investigate the clinical and pathological characteristics of patients with de novo muscle-invasive bladder cancer (MIBC) who underwent radical cystectomy in Northern Ontario. Methods: This is a retrospective cross-sectional study of patients with de novo T2 MIBC who underwent radical cystectomy over a 2-year-period in Thunder Bay Regional Health Sciences Centre. Clinical and pathological characteristics of Trans Urethral Resection of Bladder Tumors and cystectomy specimens were analyzed. Results: Of the 59 patients aged 67 ± 8.8 years, predominated by males (80%), 27.1% were younger than age 60. After surgery, upstaging was noted in 59.3% (T3 in 27.1% and T4 in 32.2%) while node positive was noted in 36% of patients. Prostate adenocarcinoma was incidentally discovered in 20 (34%) of patients with 50% considered significant (Gleason score ≥ 7). Downstaging was found in those who had neoadjuvant chemotherapy (p = 0.001). Conclusions: The high prevalence of younger ages (less than 60), a high rate of upstaging, the presence of high-grade incidental prostate cancer, and lymph node positives in T2 de novo MIBC in Northern Ontario, warrants further investigation of potential causes and risk factors at individual, public, and population health levels in the region.
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Dey, Joydeep, and Sunil Karforma. "Unsynchronized Ann & Genetics Guided Telecardiology Security Reinforcement in the Light of Covid-19." Journal of Mathematical Sciences & Computational Mathematics 3, no. 2 (January 3, 2022): 142–55. http://dx.doi.org/10.15864/jmscm.3201.
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In this COVID-19 crucial stage, cryptographic developments help to convey secret information inside the digital telemedicine frameworks. The novel corona virus had broken all configurations of our life. In the clinical medical sciences, patients are encouraged to select the remote based telemedicine services. Cardiac patients are especially defenseless to this COVID-19. Patients having Chronic Obstructive Pulmonary Diseases (COPDs) as co-morbidity are enthusiastically prescribed to remain protected at their remote isolations. Through such telecardiology, they might impart their basic data with various cardiovascular experts. This will diminish their odds of getting COVID-19 positive because of no actual developments outside homes. Patients experiencing such significant COPDs are to be analyzed and treated appropriately via cardiologists. Contemporary imperfections on patients' private data are an open challenge in such telecardiology. Electronic cardiac data are very much vulnerable in nature. Along these lines, it is exceptionally critical to force a high level security strategy in such COVID-19 telecardiology. In this paper, we have generated session key based on unsynchronized artificial neural networks and genetic algorithm. Two unsynchronized ANNs were considered to have two intermediate keys. These keys were genetically crossover to form the session key. Furthermore, that session key would e used in the secret share generation process. Entropy values observed with respect to the secret share were nearly closed to eight. Histogram, floating frequency, and autocorrelation, etc were generated by the proposed technique with well-distributed in shapes. The functional time in the form of encryption and decryption were evaluated in this paper for different secret shares. Patients' medical data are very much under severe risk of intrusion. Lastly, secret shares were transmitted through RSA. This framework acts against various security conducts in correspondence network particularly where online clinical exchanges have overflowed colossally in this COVID-19 period.
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Siddiqui, Ruqaiyyah, Mehwish Sagheer, and Naveed Ahmed Khan. "Prevalence of Acanthamoeba and superbugs in a clinical setting: coincidence or hyperparasitism?" Parasitology Research 112, no. 3 (November 24, 2012): 1349–51. http://dx.doi.org/10.1007/s00436-012-3202-5.
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Pallari, Elena, Tayana Soukup, Andri Kyriacou, and Grant Lewison. "Assessing the European impact of alcohol misuse and illicit drug dependence research: clinical practice guidelines and evidence-base policy." Evidence Based Mental Health 23, no. 2 (March 30, 2020): 67–76. http://dx.doi.org/10.1136/ebmental-2019-300124.
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BackgroundDespite alcohol and illicit drug dependence being one of the most common diagnoses in Europe, there is heterogeneity of research evidence used in policy and practice.ObjectiveWe sought to (1) evaluate European research outputs on alcohol misuse and drug addiction in 2002–2018 in the Web of Science, (2) compare these with their burden of disease and (3) determine their impact in several ways.MethodsA bibliometric research was undertaken including an assessment of the citation counts, the influence of research on members of national health advisory committees, and their contribution to the evidence base of clinical practice guidelines (CPGs).FindingsThere were 3201 analysed references cited in 28 CPGs across 11 European Countries on alcohol misuse and illicit drug abuse. Research conducted in the USA dominated both sets of CPGs, while many European countries were overcited relative to their research presence. The illicit drug research appeared to be adequate relative to the evidence of harm in Europe. However, alcohol misuse research appeared grossly inadequate to the harm it causes by a factor of 20.ConclusionsThe volume of research on illicit drug addiction is commensurate to the European burden, whereas alcohol misuse is far below what is needed to curb a significant source of harm.Clinical implicationsThe research asymmetries call for attention to the causes of the problem. Development of research-based solutions to a serious social harm is needed, including minimum pricing and collaborative work to harmonise efforts on disease management and treatment practices across European countries.
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Bateman, D. "Mosby's color atlas and text of Neurology, 2nd edition.: Edited by G D Perkin (Pp 324, pound28.95). Published by Elsevier Science, London, 2002. ISBN 0 7234 3208 2." Journal of Neurology, Neurosurgery & Psychiatry 73, no. 5 (November 1, 2002): 606—b—606. http://dx.doi.org/10.1136/jnnp.73.5.606-b.
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Pradhan, Shanti, Sanjib Mani Regmi, and Nabina Shrestha. "Inducible Clindamycin Resistant Staphylococcus aureus among Patients Attending Tertiary Care Centre: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 59, no. 243 (November 15, 2021): 1111–15. http://dx.doi.org/10.31729/jnma.6882.
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Introduction: Staphylococcus aureus, a superbug, resistant to multiple antibiotics led to growing interest in the usage of macrolide-lincosamide-streptogramin B antibiotics, which are now rapidly developing resistance. This study aims to find the prevalence of inducible clindamycin-resistant Staphylococcus aureus among obtained clinical samples from in-patient and out-patient departments of a tertiary care center. Methods: This is a descriptive cross-sectional study done in clinical samples from the in-patient and out-patient departments of a tertiary care center from September 2020-May 2021. Ethical clearance was taken from the Institutional Review Committee (Ref: 068/2077/2078). Staphylococcus aureus were isolated and antibiotic susceptibility tests were performed by disc diffusion method. Inducible clindamycin and methicillin resistance Staphylococcus aureus were detected using D-test and cefoxitin disc according to Clinical and Laboratory Standards Institute guidelines. Convenient sampling was done and the data was analyzed using Statistical Package for Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among a total of 141 Staphylococcus aureus isolated, the prevalence of inducible clindamycin resistant phenotype was 41 (29.1%) (21.6-36.59 at 95% Confidence Interval). Whereas, 30 (21.3%) were constitutive clindamycin resistant. The inducible 28 (47.5%) and 19 (32.2%) constitutive clindamycin resistance was higher among methicillin-resistant Staphylococcus aureus. Conclusions: The frequency of inducible clindamycin resistance among methicillin resistant Staphylococcus aureus was high, which alarms the use of macrolide-lincosamide-streptogramin B antibiotics in Staphylococcus aureus infections. Hence, D-test should be performed to detect inducible clindamycin resistance in routine testing to prevent treatment failure.
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Sassine, S., S. Fadela Zekhnine, M. Qaddouri, L. Djani, C. Cambron-Asselin, M. Savoie-Robichaud, Y. Lin, et al. "A188 FACTORS ASSOCIATED WITH CLINICAL REMISSION IN PEDIATRIC LUMINAL CROHN’S DISEASE: A RETROSPECTIVE COHORT STUDY." Journal of the Canadian Association of Gastroenterology 5, Supplement_1 (February 21, 2022): 71–72. http://dx.doi.org/10.1093/jcag/gwab049.187.
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Abstract Background The natural evolution of Crohn’s disease is incompletely understood in the pediatric population. Data on factors influencing time-to-remission are very limited in the literature. Aims The aim of this retrospective cohort study was to describe the time to clinical remission in children with Crohn’s disease as well as changes over the past decade and to identify factors associated with time to clinical remission. Methods Patients under 18 years old diagnosed between 2009 and 2019 were included. All data were collected from the patients’ medical records and the CHU Sainte-Justine inflammatory bowel disease registry. Survival analyses and linear regression models were used to assess the impact of clinical, laboratory, endoscopic, histological and therapeutic factors on time to clinical remission. Results 654 patients were included in the study. There was no change in the time to clinical remission over the past decade. Female sex in adolescents (ajusted bêta regression coefficient (aβ)= 31.8 days, p= 0.02), upper digestive tract involvement (aβ= 46.4 days, p= 0.04), perianal disease (aβ= 32.2 days, p= 0.04), presence of active inflammation on biopsies (aβ= 46.7 days, p= 0.01) and oral 5-ASA exposure (aβ=56.6 days, p= 0.002) were all associated with longer time to clinical remission. However, antibiotic exposure (aβ= -29.3 days, p=0.04), increased eosinophils on biopsies (aβ= -29.6 days, p=0.008) and combination of exclusive enteral nutrition and TNF- alpha inhibitors as induction therapy (aβ= -36.8, p=0.04) were associated with shorter time to clinical remission. Conclusions Time to clinical remission did not improve during the decade and was associated with baseline clinical and histological data and treatment strategies. Combination of enteral nutrition and TNF-alpha inhibitors was associated with faster clinical remission. Kaplan-Meier curve representing the time to clinical remission of patients according to the first induction treatment administered. Funding Agencies NoneFonds Recherche Santé Québec / Fondation du CHU Sainte-Justine
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Negesso, Abebe Edao, Gizachew Kedida Rikitu, Gelila Biresaw Sime, Endale H. Gebregzabher, Saba Gebremichael Tekele, and Abay Sisay Misganaw. "Preceptors training need assessment for medical laboratory professional clinical education programs in Ethiopia." PLOS ONE 17, no. 10 (October 6, 2022): e0275533. http://dx.doi.org/10.1371/journal.pone.0275533.
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Background Health Workforce Improvement Program and professional associations recognized the need for a formalized method of providing academic education that would improve how preceptors teach and assess student. Thus, this study aimed to assess training needs of preceptors for Medical Laboratory Science clinical practicum education programs in Ethiopia. Methods A cross-sectional survey design was implemented in targeted health facility throughout the country to assess academic educational needs of preceptors for Medical Laboratory clinical practicum education programs. The study participants were conveniently selected practicing health professionals who formally or informally nominated as a clinical trainer or acts as clinical trainer giving practical training to the student in the targeted practice setting. An adapted structured questionnaire modified to local context was used to conduct the survey and the perceived competency assessment used five scale of measurement (Not capable, Beginner, Advanced beginner, Competent, Proficient). The frequency was presented using tables and figures. Results A total of 304 laboratory professionals participated in this study. More than half (52.6%) of the study participants were in the age group of 21 to 30 years and 264/304 (86.8%) were male. The majority (43.0%) of study participants had 6 to 10 years of experience and 212 (68.8%) did not receive clinical teaching skills training in the past two years. Regarding applying different hands-on teaching methods, the majority 38/304(12.5%) were not capable for role play and community based training, 49/304(16.1%) reported being Beginners, 85/304 (28%) said that they are advanced beginners in the competency. In this study, most study participants 98/304(32.2%) and 130/304(42.8%) perceived that they are competent and proficient in applying laboratory practice teaching methods respectively. Conclusion The average cumulative level of competency from level 1 (not capable) to level 3 (advanced beginner), we found: learning in the practical teaching area 45.4%, clinical practicum teaching quality improvement and advocacy 42.9%, student assessment methods 42.7%, communication, collaboration and partnership 40.9%. Overall competence of preceptors (proportion of preceptors reported competent) was 57%. We recommend designing the performance interventions in the form of training by including communication skills for effective preceptor ship, students assessment and feedback, teaching and instruction strategies, planning for clinical practicum learning and principles of learning and teaching in practical areas.
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OTOBO, Daniel D., Jacob O. ADEFILA, Johnson YONNI, Anita A. OMORUYI, Ugochukwu L. EZEJIOFOR, Musa A. NUHU, Hayyatudeen O. TANKO, Laughter AMAMCHUKWU, and Lshola A. MUBARAK. "The breakthroughs and barriers to clinical utilization of in vivo cellular therapies in the management of osteoarthritis in humans: A review." International Journal of Orthopaedics Sciences 8, no. 3 (July 1, 2022): 232–35. http://dx.doi.org/10.22271/ortho.2022.v8.i3d.3204.
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Vo, Ty, and Kristine B. Marcus. "Ranirestat: A Selective Aldose Reductase Inhibitor for Diabetic Sensorimotor Polyneuropathy." Journal of Pharmacy Technology 24, no. 6 (November 2008): 340–44. http://dx.doi.org/10.1177/875512250802400605.
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Objective: To review the pharmacology, pharmacokinetics, clinical efficacy, and safety of ranirestat, an oral aldose reductase inhibitor with a unique chemical structure, as treatment of diabetic sensorimotor polyneuropathy in patients with diabetes mellitus. Data Sources: Primary literature and review articles were identified by searching MEDLINE (1950–June 2008), EMBASE (1991–June 2008), International Pharmaceutical Abstracts (1970–June 2008), and Google Scholar using the key terms ranirestat, AS-3201, SX-3030, aldose reductase inhibitors, diabetes mellitus, and peripheral neuropathy. Additional articles were identified from the bibliographies of the obtained literature. Study Selection and Data Extraction: Reviewed literature was restricted to available English-language articles. Preclinical and clinical trials were reviewed. One Phase 2 clinical trial and its extension study were identified. No data have yet been reported from Phase 3 trials that were conducted between 2004 and 2006. Data Synthesis: Ranirestat is a selective and reversible inhibitor of aldose reductase. Nerve damage is reduced by inhibiting this key enzyme in the polyol pathway, thus preventing the accumulation of sorbitol and fructose. Ranirestat has been compared with placebo in randomized, double-blind, controlled trials. Improvement in nerve function, sensation, and clinical grading scale were noted. Ranirestat was reported to be well tolerated. Conclusions: Ranirestat may offer a clinical advantage over current treatment modalities as the first agent to address one factor in the underlying cause of diabetic sensorimotor polyneuropathy. Further studies should be done on safety, efficacy, tolerability, and quality of life to determine how successful this agent will be in the treatment of diabetic sensorimotor polyneuropathy. ACPE Universal Program Numbers: 407-000-08-056-H01-P (Pharmacists); 407-000-08-056-H01-T (Technicians)
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Maldonado-Lasunción, Inés, Nick O’Neill, Oliver Umland, Joost Verhaagen, and Martin Oudega. "Macrophage-Derived Inflammation Induces a Transcriptome Makeover in Mesenchymal Stromal Cells Enhancing Their Potential for Tissue Repair." International Journal of Molecular Sciences 22, no. 2 (January 14, 2021): 781. http://dx.doi.org/10.3390/ijms22020781.
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Pre-clinical and clinical studies revealed that mesenchymal stromal cell (MSC) transplants elicit tissue repair. Conditioning MSC prior to transplantation may boost their ability to support repair. We investigated macrophage-derived inflammation as a means to condition MSC by comprehensively analyzing their transcriptome and secretome. Conditioning MSC with macrophage-derived inflammation resulted in 3208 differentially expressed genes, which were annotated with significantly enriched GO terms for 1085 biological processes, 85 cellular components, and 79 molecular functions. Inflammation-mediated conditioning increased the secretion of growth factors that are key for tissue repair, including vascular endothelial growth factor, hepatocyte growth factor, nerve growth factor and glial-derived neurotrophic factor. Furthermore, we found that inflammation-mediated conditioning induces transcriptomic changes that challenge the viability and mobility of MSC. Our data support the notion that macrophage-derived inflammation stimulates MSC to augment their paracrine repair-supporting activity. The results suggest that inflammatory pre-conditioning enhances the therapeutic potential of MSC transplants.
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Akbarzadeh, Marzieh, Tahereh Naderi, Mohammad H. Dabbaghmaneh, and Hamidreza Tabatabaee. "Comparison of Levels of Androgenic Hormones in various Phenotypes of Polycystic Ovarian Syndrome in High School Girls aging 14 to 18 Years." Journal of South Asian Federation of Obstetrics and Gynaecology 8, no. 1 (2016): 33–39. http://dx.doi.org/10.5005/jp-journals-10006-1382.
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ABSTRACT Introduction Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. Polycystic ovarian syndrome is mainly diagnosed based on oligomenorrhea or amenorrhea accompanied by clinical or laboratory evidence of hyperandrogenemia. This study aimed to compare the levels of androgenic hormones in various phenotypes of PCOS in high school girls aged 14 to 18 years in 2009. Materials and methods This cross-sectional study was conducted on 3200 girl students aged 14 to 18 years. The research community included high school girls in different educational districts of Shiraz. After obtaining written informed consents, demographic questionnaire was completed and clinical signs of increased androgens (acne, hirsutism and alopecia) were recorded. In addition, ultrasound for cyst was performed for the students with menstrual disorders. Results The mean age of the study population was 16.17 ± 1.25 years. Hyperandrogenism and polycystic ovaries phenotype compared to other phenotypes were more prevalent (45 patients, 30.8%) in the study population. In addition, the mean testosterone, free testosterone (FT), and dehydroepiandrosterone sulfate (DHEAS) levels were higher in the patients with polycystic ovaries and hyperandrogenism. However, the results of independent t-test revealed no significant difference between the patients with polycystic ovaries and hyperandrogenism and noninfected participants regarding the mean hormone levels (p > 0.05). Yet, the correlation was significant in the other three phenotypes (p < 0.05). Moreover, 144 cases (4.6%) suffered from oligomenorrhea, 29.5% of whom presented PCOS symptoms in the ultrasound. Conclusion Androgenic hormone levels were higher in the PCOS phenotypes with menstrual disorders, particularly oligomenorrhea. Therefore, compared to other symptoms of hyperandrogenism and ultrasound, menstrual disorders were more important in PCOS. How to cite this article Akbarzadeh M, Naderi T, Dabbaghmaneh MH, Tabatabaee H. Comparison of Levels of Androgenic Hormones in various Phenotypes of Polycystic Ovarian Syndrome in High School Girls aging 14 to 18 Years. J South Asian Feder Obst Gynae 2016;8(1):33-39. The research is the result of the thesis proposal by Mrs Tahrei Naderi, No. 3958, is financially supported by the Research Vice-chancellor of Shiraz University of Medical Sciences.
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Jahan, Asmay, Nazmun Nahar, Afroza Akhter, Mukta Sarker, and Fahmida Rahman. "Haematological Profile of Preterm Neonates:An Experience of A Specialized Tertiary Hospital in Dhaka, Bangladesh." International Journal of Human and Health Sciences (IJHHS) 6, no. 3 (June 13, 2022): 275. http://dx.doi.org/10.31344/ijhhs.v6i3.458.
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Background: A complete blood count(CBC) elements that are abnormally high or low can influence our clinical decisions. However, the reference ranges for the various CBC elements in neonates change considerably in respect to gestational age.Objective: To observe and correlate gestational agerelated changes in the haematological profileof the preterm neonates.Methods: This cross-sectional, prospective study was conducted between July 2007 and January 2008 in collaboration between Department of Paediatrics and Department of Obstetrics & Gynaecology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital, Dhaka, Bangladesh. A total of 49 preterm newborns of different gestational age (28 males and 21 females) included in this study.They were divided into three groups based on their gestational age: group I (30 weeks; n=11), group II (31-33 weeks; n=17) and group III (34-36 weeks; n=21). Within 48 hours of delivery, 1 ml venous blood was collected from each neonate and was sent to the Department of Clinical Pathology of the same hospital. Complete blood count (CBC) was done by using Abbott’s Cell-Dyn 3200 Automated Hematology Analyzer.Results: Significant differences were observed in total count of RBC, WBC, and platelet among those three groups. However, differential count of WBC, heamoglobin level, and haematocrit value among those three groups showed no significant differences (P>0.05). Gestational age showed a positive correlation with total count of RBC (r=0.216; P<0.05). Gestational age had also a positive correlation with neutrophil (r=0.448; P<0.001). Besides, gestational age was negatively correlated with lymphocyte (r=-0.389; P<0.001) However, gestational age did not bear any correlation with total count of WBC, monocyte, and eosinophil. Finally, gestational age was found to bear a positive correlation with heamoglobin level (r=0.412; P<0.001) and haematocrit value (r=0.382; P<0.001).Conclusion: Our data suggest that differences exist in different haematological parameters among preterm neonates of different gestational age.International Journal of Human and Health Sciences Vol. 06 No. 03 July’22 Page: 275-279
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Cornely, Oliver, Thibaut Leguay, Johan Maertens, Carlo Castagnola, Achilles Anagnostopoulos, Bernadino Allione, Claus Peter Heussel, et al. "A Double-Blind, Multicentre, Randomised, Placebo-Controlled Study to Assess the Efficacy, Safety and Tolerability of Prophylactic Liposomal Amphotericin B (AmBisome®) for the Prevention of Invasive Fungal Infections in Subjects Receiving Remission-Induction Chemotherapy for Acute Lymphoblastic Leukaemia (AmBiGuard trial)." Blood 124, no. 21 (December 6, 2014): 3646. http://dx.doi.org/10.1182/blood.v124.21.3646.3646.
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Abstract Background: Adult patients undergoing remission-induction (RI) chemotherapy for newly diagnosed acute lymphoblastic leukaemia (ALL) are at high risk of invasive fungal disease (IFD), particularly invasive aspergillosis. The prevalence of IFD in this population has not been widely studied. There is currently no approved standard for antifungal prophylaxis and it is recommended by the European Working Group for Adult ALL that azole antifungal agents be avoided because of drug interactions with vincristine, a standard component of induction chemotherapy regimens. Methods: This was a double-blind, multicentre, placebo-controlled study in patients aged ≥18 years receiving RI chemotherapy for newly diagnosed ALL. Study subjects received either liposomal amphotericin B (L-AMB) 5mg/kg or placebo by IV infusion twice weekly in a 2:1 random allocation. The primary endpoint of the study was the proportion of subjects with proven or probable invasive fungal infection (IFI) assigned in a blinded review by an independent data review board (IDRB) using EORTC/MSG (European Organization for Research and Treatment of Cancer/Mycoses Study Group) definitions (1). Subjects were closely monitored for signs and symptoms of IFI, including biweekly galactomannan and β-D-glucan assessments. Clinical, laboratory or radiographic findings suggestive of IFI prompted further investigation according to a specified protocol. Subjects with defined clinical and mycological criteria or a halo sign on chest CT had prophylaxis interrupted and pre-emptive antifungal therapy initiated while further diagnostic procedures were undertaken. Prophylaxis was stopped when subjects met protocol-specified criteria for proven or probable IFI and appropriate antifungal therapy started. Secondary objectives included safety and tolerability of prophylactic L-AMB and the impact of IFI prevention on the efficacy of RI chemotherapy. Results: A total of 355 subjects from 83 centres in 13 countries in Europe (including Turkey and Israel) and South America were randomised and received at least 1 dose of either L-AMB (n=237) or placebo (n=118). Sixteen subjects were excluded from the efficacy analysis, 1 due to misdiagnosis (AML) and 15 due to protocol-prohibited antifungal treatment. 7.9% (18/228) subjects in the L-AMB group and 11.7% (13/111) subjects in the placebo group were considered by the IDRB to have experienced a proven or probable IFI (p=0.24, RR 0.33 [CI -0.32 to 0.66]). Of these, 1 case (0.4%) in the L-AMB group and 3 cases (2.7%) in the placebo group were considered proven. In subjects who were neutropenic (absolute neutrophil count <0.5x109/L) ≥10 days, the incidence was 6.9% (12/174) in the L-AMB group versus 13.1% (11/84) in the placebo group (p=0.10). Overall mortality was similar: 7.2% (17/237) in the L-AMB group vs 6.8% (8/118) in the placebo group (p=1.00) as was the incidence of serious adverse events (SAEs; 33.3% (79/237) vs 32.2% (38/118), [p=0.90]). SAEs of any grade related to the study drug were reported for 8.4% subjects (20/237) in the L-AMB group compared with 1.7% subjects (2/118) (p=0.02) in the placebo group. The most common (>5%) study drug-related adverse events (AEs) were hypokalaemia (10.5% [25/237] vs 3.4% [4/118] p=0.02) and increased creatinine (6.3% [15/237] vs. 0% [p=0.003]). Complete remission at the end of RI chemotherapy was achieved by 72.6% (172/237) subjects in the L-AMB group versus 78.8% (93/118) subjects in the placebo group (p=0.24). Conclusions: In this study, the largest of its kind to date, the rate of IFI among adult patients undergoing RI chemotherapy for newly diagnosed ALL was 11.7% in the placebo group. Study subjects who received L-AMB at 5mg/kg twice weekly for prophylaxis showed a reduction in IFIs relative to placebo (RR 0.33 [CI -0.32 to 0.66]), although this did not reach statistical significance (p=0.24). L-AMB prophylaxis was generally well tolerated. The incidence of IFI in patients with ALL receiving RI therapy indicates that antifungal prophylaxis is merited in this patient population. Further analysis is needed to determine which patients might benefit the most. clinicaltrials.gov number: NCT01259713 (1) De Pauw et al 2008 Clin Infect Dis 46: 1813–1821 Disclosures Cornely: Gilead Sciences: Consultancy, Research Funding, Speakers Bureau. Off Label Use: Liposomal Amphotericin B (AmBisome®) is a broad spectrum antifungal agent indicated for the treatment of severe systemic and/or deep mycoses, empiric treatment of presumed fungal infections in febrile neutropenic patients and treatment of visceral leishmaniasis. In this study the efficacy, safety and tolerability of prophylactic liposomal amphotericin B (AmBisome®) was explored for the prevention of invasive fungal infections in subjects receiving remission-induction chemotherapy for Acute Lymphoblastic Leukaemia (the AmBiGuard trial).. Leguay:Gilead Sciences: Research Funding. Maertens:Gilead Sciences: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Castagnola:Gilead Sciences: Research Funding. Anagnostopoulos:Gilead Sciences: Research Funding. Allione:Gilead Sciences: Research Funding. Heussel:Gilead Sciences: Consultancy, Speakers Bureau. Donnelly:Astellas, Gilead, Merck, Pfizer: Consultancy, Honoraria, Research Funding. Agrawal:Gilead, Pfizer, Astellas, MSD, Bio-Rad: Honoraria, Research Funding. Garner:Gilead Sciences: Employment, Equity Ownership. Simcock:Gilead Sciences: Employment, Equity Ownership. Hawkins:Gilead Sciences: Employment, Equity Ownership. Goekbuget:Gilead Sciences: Consultancy, Honoraria.
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Nikbakht, Hossein-Ali, Layla Shojaie, Nasim Niknejad, Soheil Hassanipour, Hassan Soleimanpour, Sohrab Heidari, Sima Afrashteh, Ehsan Sarbazi, and Saber Ghaffari-Fam. "Mortality Rate of Acute Stroke in Iran: A Systematic Review and Meta-Analysis." Caspian Journal of Neurological Sciences 8, no. 4 (October 1, 2022): 252–67. http://dx.doi.org/10.32598/cjns.4.31.338.1.
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Background: There is limited data about the short-term stroke mortality rates for patients in treatment settings. Objectives: This study aimed to estimate the short-term stroke (in hospital, one month, one year) mortality rates in Iran through a systematic review and meta-analysis. Materials & Methods: We searched electronic databases, including three national (IranDoc, Megiran, SID) and four international (Scopus, PubMed, Web of Science, Google Scholar), from January 1990 to March 2020. We considered all observational studies on stroke mortality, such as cohort and crosssectional studies. Furthermore, the sub-group analyses were performed based on each province and metaregression analysis based on the study’s year and patients’ mean age. Results: Among 143 studies, 28 were eligible (11 cohort and 17 cross-sectional studies). Based on the random model, the mortality rates for in-hospital, 1-month, and 1-year mortality were reported as 18.71% (95% CI: 15.09%-22.34%), 23.43% (95% CI: 20.08%-26.78%), and 34.44% (95% CI: 32.02%- 36.85%), respectively. The results also revealed that mortality rates were neither related to the year studies conducted nor to the patient’s age. Conclusion: Approximately one-fifth of stroke patients in Iran die in the hospital after admission. The mortality rate increased in the one-month and one-year period, and about one-third of the patients died in the first year. Therefore, it is cardinal to focus on programs and solutions in which we can ameliorate mortality in the short-term period after stroke by performing primary specific treatments on patients.
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Ratnanather, J. Tilak, Rohit Bhattacharya, Margo B. Heston, Joanne Song, Lindsey R. Fernandez, Hong Seo Lim, Seung-Wook Lee, et al. "An mHealth App (Speech Banana) for Auditory Training: App Design and Development Study." JMIR mHealth and uHealth 9, no. 3 (March 15, 2021): e20890. http://dx.doi.org/10.2196/20890.
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Background With the growing adult population using electronic hearing devices such as cochlear implants or hearing aids, there is an increasing worldwide need for auditory training (AT) to promote optimal device use. However, financial resources and scheduling conflicts make clinical AT infeasible. Objective To address this gap between need and accessibility, we primarily aimed to develop a mobile health (mHealth) app called Speech Banana for AT. The app would be substantially more affordable and portable than clinical AT; would deliver a validated training model that is reflective of modern techniques; and would track users’ progress in speech comprehension, providing greater continuity between periodic in-person visits. To improve international availability, our secondary aim was to implement the English language training model into Korean as a proof of concept for worldwide usability. Methods A problem- and objective-centered Design Science Research Methodology approach was adopted to develop the Speech Banana app. A review of previous literature and computer-based learning programs outlined current AT gaps, whereas interviews with speech pathologists and users clarified the features that were addressed in the app. Past and present users were invited to evaluate the app via community forums and the System Usability Scale. Results Speech Banana has been implemented in English and Korean languages for iPad and web use. The app comprises 38 lessons, which include analytic exercises pairing visual and auditory stimuli, and synthetic quizzes presenting auditory stimuli only. During quizzes, users type the sentence heard, and the app provides visual feedback on performance. Users may select a male or female speaker and the volume of background noise, allowing for training with a range of frequencies and signal-to-noise ratios. There were more than 3200 downloads of the English iPad app and almost 100 downloads of the Korean app; more than 100 users registered for the web apps. The English app received a System Usability Scale rating of “good” from 6 users, and the Korean app received a rating of “OK” from 16 users. Conclusions Speech Banana offers AT accessibility with a validated curriculum, allowing users to develop speech comprehension skills with the aid of a mobile device. This mHealth app holds potential as a supplement to clinical AT, particularly in this era of global telemedicine.
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Apostu, Dragos, Doina Piciu, Daniel Oltean-Dan, Dan Cosma, Ondine Lucaciu, Catalin Popa, Alexandru Mester, and Horea Benea. "How to Prevent Aseptic Loosening in Cementless Arthroplasty: A Review." Applied Sciences 12, no. 3 (February 1, 2022): 1571. http://dx.doi.org/10.3390/app12031571.
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Aseptic loosening is the main late postoperative complication of cementless total hip arthroplasties (THAs), leading to pain and functional impairment. This article aims to update the orthopedic surgeon on the various methods by which the aseptic loosening rate can be reduced. We performed a systematic review by searching the PubMed database for hip aseptic loosening. We included meta-analysis, randomized controlled trials, reviews, and systematic reviews in the last 10 years, which provided information on techniques that can prevent aseptic loosening in total hip arthroplasty. From a total of 3205 articles identified, 69 articles (2%) met the inclusion criteria, leading to a total of 36 recommendations. A lot of research has been conducted in terms of septic loosening in the last decade. Currently, we have various techniques by which we can reduce the rate of aseptic loosening. Nevertheless, further randomized clinical trials are needed to expand the recommendations for aseptic loosening prevention.
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Buendía, Jefferson Antonio, Esteban Halac, Andrea Bosaleh, María T. Garcia de Davila, Oscar Imvertasa, and Guillermo Bramuglia. "Frequency of CYP3A5 Genetic Polymorphisms and Tacrolimus Pharmacokinetics in Pediatric Liver Transplantation." Pharmaceutics 12, no. 9 (September 22, 2020): 898. http://dx.doi.org/10.3390/pharmaceutics12090898.
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The evidence available in the pediatric population is limited for making clinical decisions regarding the optimization of tacrolimus (TAC) in pharmacotherapy. The objective of this study was to estimate the frequency of CYP3A5 genetic polymorphisms and their relationship with tacrolimus requirements in the pediatric population. This was a longitudinal cohort study with a two-year follow-up of 77 patients under 18 years old who underwent a liver transplant during the period 2009–2012 at the J.P. Garrahan Pediatric Hospital. Tacrolimus levels from day five up to two years after the transplant were obtained from hospital records of routine therapeutic drug monitoring. The genotyping of CYP3A5 (CYP3A5*1/*3 or *3/*3) was performed in liver biopsies from both the donor and the recipient. The frequency of CYP3A5*1 expression for recipients was 37.1% and 32.2% for donors. Patients who received an expresser organ showed lower Co/dose, especially following 90 days after the surgery. The role of each polymorphism is different according to the number of days after the transplant, and it must be taken into account to optimize the benefits of TAC therapy during the post-transplant induction and maintenance phases.
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N. G., Chandan, Shashikumar N. S., and Nagabushan H. "Pharmaceutical drug promotion: perception and attitude of medical interns towards drug company interactions in a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 6, no. 6 (May 23, 2017): 1456. http://dx.doi.org/10.18203/2319-2003.ijbcp20172241.
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Background: Interactions of pharmaceutical industry with the physicians which are usually mediated through pharmaceutical representatives have a significant impact on physician decision-making. This interaction can start as early as medical school during their training and this is said to influence their prescribing behavior when they become physicians. Aims and objectives of the study was to evaluate the attitude of interns towards pharmaceutical companies interactions including accepting gifts, ethical issues and influence on clinical decisions and also to study perception of medical interns towards the accuracy of information provided by the medical representatives.Methods: This was a cross sectional questionnaire based study that was conducted among the medical interns of the teaching hospital attached to Mandya Institute of Medical Sciences, Mandya. The study was carried out between July and August 2016. A preformed structured questionnaire was distributed to the interns consenting to participate in the study. Completed questionnaires were collected, compiled and data was analyzed.Results: A total of 93 questionnaires were distributed and 90 interns responded (response rate 96.7%). About 44.4% respondents felt that accepting gifts from Drug Company would influence their own decision making. Only 26.6% of them were of the opinion that it is ethical to accept pharmaceutical company gifts. Majority of them felt that Medical Representatives exaggerate the benefits of medicines and downplay the risks and contraindications of medicine. About 32.2% of them were of the opinion that they would prefer to prescribe the drug from the companies offering them with gifts over those without. Majority of the respondents felt that the doctors should be offered with gifts by drug companies whenever their drugs are prescribed.Conclusions: Attitude of Medical Interns towards Drug Company interactions as observed suggests for training the budding doctors on appropriate drug company interactions to prevent the risks associated with promotional efforts of pharmaceutical companies.
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Gomes, Cícera Maria, Karen de Morais-Zani, Stephen Lu, Diego de Souza Buarque, Glória Regina Cardoso Braz, Kathleen Fernandes Grego, Aparecida Sadae Tanaka, and Anita Mitico Tanaka-Azevedo. "Differential transcript profile of inhibitors with potential anti-venom role in the liver of juvenile and adultBothrops jararacasnake." PeerJ 5 (April 27, 2017): e3203. http://dx.doi.org/10.7717/peerj.3203.
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BackgroundSnakes belonging to theBothropsgenus are vastly distributed in Central and South America and are responsible for most cases of reported snake bites in Latin America. The clinical manifestations of the envenomation caused by this genus are due to three major activities—proteolytic, hemorrhagic and coagulant—mediated by metalloproteinases, serine proteinases, phospholipases A2and other toxic compounds present in snake venom. Interestingly, it was observed that snakes are resistant to the toxic effects of its own and other snake’s venoms. This natural immunity may occur due the absence of toxin target or the presence of molecules in the snake plasma able to neutralize such toxins.MethodsIn order to identify anti-venom molecules, we construct a cDNA library from the liver ofB. jararacasnakes. Moreover, we analyzed the expression profile of four molecules—the already known anti-hemorrhagic factor Bj46a, one gamma-phospholipase A2inhibitor, one inter-alpha inhibitor and one C1 plasma protease inhibitor—in the liver of juvenile and adult snakes by qPCR.ResultsThe results revealed a 30-fold increase of gamma-phospholipase A2inhibitor and a minor increase of the inter-alpha inhibitor (5-fold) and of the C1 inhibitor (3-fold) in adults. However, the Bj46a factor seems to be equally transcribed in adults and juveniles.DiscussionThe results suggest the up-regulation of different inhibitors observed in the adult snakes might be a physiological adaptation to the recurrent contact with their own and even other snake’s venoms throughout its lifespan. This is the first comparative analysis of ontogenetic variation of expression profiles of plasmatic proteins with potential anti-venom activities of the venomous snakeB. jararaca. Furthermore, the present data contributes to the understanding of the natural resistance described in these snakes.
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Alimena, Stephanie, James Webber, Laura Wollborn, Marta Williams, Chad B. Sussman, Joyce Y. Wang, Julia Spiegel, and Kevin M. Elias. "Abstract PR001: Assessing differences in miRNA profiles by race and ethnicity: Implications for creating an equitable ovarian cancer early detection test." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): PR001. http://dx.doi.org/10.1158/1538-7755.disp22-pr001.
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Abstract Introduction: Assessing serum micro RNA (miRNA) profiles is an emerging technique for earlier detection of ovarian cancer. A panel of miRNAs for ovarian cancer prediction has been proposed, but it is unknown whether race and ethnicity may influence their expression. The goal of this study was to determine how race affects expression of miRNAs associated with ovarian cancer risk to ensure creation of an equitable test. Methods: Serum samples from 1586 women from the Mass General Brigham BioBank were analyzed for the presence of 179 different miRNAs. The Abcam Fireplex® assay was used to assess miRNA expression determined by flow cytometry, measured in mean fluorescence units (MFI) and log2 normalized prior to analysis. Demographic characteristics and medical histories were abstracted from linked electronic medical records. Patients with missing race/ethnicity were excluded. Differences in miRNA profiles by race/ethnicity (white, non-Hispanic vs non-white) were assessed using dimension reduction. The miRNA expression data was mapped to two-dimensions using constrained least-squares, then the reduced dimension data was used to train a simple neural network to predict race/ethnicity. In addition, pairwise t-test analyses were performed to analyze racial/ethnic differences among eight miRNAs previously reported to be informative for prediction of ovarian cancer. Results: The racial/ethnic composition of the study population was similar to the state population (76.9% white, 13.4% Hispanic, 5.2% black, 2.6% Asian, 1.9% Other). Non-white patients were on average younger (41.9 years ± 13.2 vs 51.3 years ± 15.1, p<0.01) and had fewer comorbid conditions compared to white patients (3.5 comorbidities ± 2.7 vs 4.6 comorbidities ± 2.8, p<0.01). The dimension reduction and classification analysis showed a significant effect of race on miRNA profiles, with miRNAs able to predict race at an AUC of 0.71 (95% CI 0.68-0.74) after 10-fold cross validation. The AUC remained consistent when stratified for age, menopausal status, and comorbidities. Among eight miRNAs highly predictive of ovarian cancer, seven significantly varied by race (hsa-mir-150-5p, hsa-mir-200c-3p, hsa-mir-23b-3p, has-mir-29a-3p, hsa-mir-320c, hsa-mir-320d, and hsa-mir-32-5p, p<0.01). Hsa-mir-200c-3p was the most significantly different by race (7.19 mean log2 MFI among non-white vs 6.94 mean log2 MFI among white patients, p<0.01). Upon analyzing each racial subtype and variation in hsa-mir-200c-3p, black and Hispanic patients had relatively similar mean values which were significantly different from values observed among white patients. Conclusions: miRNA expression is significantly influenced by race and ethnicity, with differences remaining largely consistent even after controlling for confounders. Understanding baseline differences in biomarker test characteristics prior to clinical implementation of novel diagnostic tools is essential to ensuring instruments perform comparably across diverse populations. Citation Format: Stephanie Alimena, James Webber, Laura Wollborn, Marta Williams, Chad B. Sussman, Joyce Y. Wang, Julia Spiegel, Kevin M. Elias. Assessing differences in miRNA profiles by race and ethnicity: Implications for creating an equitable ovarian cancer early detection test [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PR001.
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Tomaszewski, Krzysztof A., Brandon M. Henry, Jens Vikse, Joyeeta Roy, Przemysław A. Pękala, Maren Svensen, Daniel L. Guay, Karolina Saganiak, and Jerzy A. Walocha. "The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system." PeerJ 4 (February 29, 2016): e1726. http://dx.doi.org/10.7717/peerj.1726.
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Background and Objectives.The medial circumflex femoral artery (MCFA) is a common branch of the deep femoral artery (DFA) responsible for supplying the femoral head and the greater trochanteric fossa. The prevalence rates of MCFA origin, its branching patterns and its distance to the mid-inguinal point (MIP) vary significantly throughout the literature. The aim of this study was to determine the true prevalence of these characteristics and to study their associated anatomical and clinical relevance.Methods.A search of the major electronic databases Pubmed, EMBASE, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, and CNKI was performed to identify all articles reporting data on the origin of the MCFA, its branching patterns and its distance to the MIP. No data or language restriction was set. Additionally, an extensive search of the references of all relevant articles was performed. All data on origin, branching and distance to MIP was extracted and pooled into a meta-analysis using MetaXL v2.0.Results.A total of 38 (36 cadaveric and 2 imaging) studies (n= 4,351 lower limbs) were included into the meta-analysis. The pooled prevalence of the MCFA originating from the DFA was 64.6% (95% CI [58.0–71.5]), while the pooled prevalence of the MCFA originating from the CFA was 32.2% (95% CI [25.9–39.1]). The CFA-derived MCFA was found to originate as a single branch in 81.1% (95% CI [70.1–91.7]) of cases with a mean pooled distance of 50.14 mm (95% CI [42.50–57.78]) from the MIP.Conclusion.The MCFA’s variability must be taken into account by surgeons, especially during orthopedic interventions in the region of the hip to prevent iatrogenic injury to the circulation of the femoral head. Based on our analysis, we present a new proposed classification system for origin of the MCFA.
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Das, Sukriti, Md Mamunur Rashid, Md Hasanuzzaman, Asit Chandra Sarker, Ayub Ansari, Dipankar Ghosh, and Sharif Bhuiyan. "Surgical Outcome of EDH in Children: Our Observation in DMCH." Bangladesh Journal of Medical Science 21, no. 4 (September 11, 2022): 865–74. http://dx.doi.org/10.3329/bjms.v21i4.60288.
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Background:Epidural hematoma (EDH) is accumulation of blood between the inner table of the skull and thedural membrane due to trauma and predominantly consists of venous blood in case ofchildren.Children with extradural hematoma (EDH) present differently than adults and outcome would also be different. Methods and Materials: This is a prospective interventional study done in the Department of Neurosurgery, Dhaka Medical College and Hospital (DMCH) in between period of January 2016 to December 2019. Children of both sex below 12 years of age with EDH were included after fulfilling inclusion and exclusion criteria. Follow up period was 1 month after surgery. Results: Among 90 patients, 73.3% were male and 26.7% were female. Age 5 - 12 years is most commonly affected among all age groups, attributing to 58.9%, fall from height was the most common cause (58.9%) followed by road traffic accident (32.2%), fall of heavy object over head (7.8%) etc. The most common symptom was vomiting which was present in 85.6% of patients followed by altered consciousness in 72.2%, headache in 60% and scalp swelling in 25.6% of patients. The follow-up of our patients was 1 month after surgery. Most of our patients made good recovery. Among them 73 patients (81.1%) were neurologically intact (GOS 5), 10 (11.1%) patients had some deficit but could do their daily activity independently (GOS 4), 03 patients (3.3%) was dependant on other for daily activity with cognitive deficit (GOS 3) and 4 patients (4.4%) died. Conclusion:EDH in children can be managed by surgery with good outcomes. Even in the presence of poor initial clinical and radiologic conditions, timely intervention can lead to a good recovery. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 865-874
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Antelo, Oscar Mario, Armando Yukio Saga, Ariel Adriano Reyes, Thiago Martins Meira, Sergio Aparecido Ignácio, and Orlando Motohiro Tanaka. "Simulation of the clinical procedure by digital intraoral palpation of the greatest prominence of the Infrazygomatic crest for mini-implants insertion." Research, Society and Development 11, no. 5 (April 15, 2022): e54211528496. http://dx.doi.org/10.33448/rsd-v11i5.28496.
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The objective of this cross-sectional retrospective study was to simulate using cone-beam computed tomography (CBCT) in adults, the clinical procedure performed by intraoral digital palpation of the greatest prominence (GP) of the Infrazygomatic crest (IZC) for mini-implants (MIs) insertion. CBCT images of 34 adults (14 men, 20 women), aged 18.0 to 57.7 years (mean, 32.2 years) were selected. On 3D reconstruction, the GP of the IZC region was determined using the anatomical morphology, and its anteroposterior position on the selected axial slice was evaluated relative to the dental reference located between the maxillary first and second molars (U6–U7). On the selected coronal slice, two reference lines were established to evaluate the insertion angle and insertion depth (IZC thickness) for MIs. The same procedure was performed on slices with intervals of 1 mm mesially as well as distally up to reach 4 mm. The right and left sides were measured. In relation to U6-U7, the GP of the IZC was 0.19 mm (±1.79) mesial on the right side and 0.29 mm (±1.65) mesial on the left side. The greatest bone thickness of the IZC was 4.95 mm (±2.39) on the right side, 3.81 mm distal from U6-U7, and 4.79 mm (±2.13) on the left side, 3.71 mm distal from U6-U7. The GP-IZC determined visually on the 3D reconstruction, did not present the greatest bone thickness. The bone tended to gradually become thicker distal to the GP-IZC and the dental reference U6-U7.
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Egorov, V. V., A. V. Postupaev, and N. V. Postupaeva. "Efficiency of micropulse cyclophotocoagulation in treatment of refractory glaucoma." Modern technologies in ophtalmology, no. 2 (April 13, 2022): 88–94. http://dx.doi.org/10.25276/2312-4911-2022-2-88-94.
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Purpose. To evaluate the clinical efficacy of micropulse cyclophotocoagulation (mCPC) in the treatment of patients with grade III refractory glaucoma. Material and methods. A clinical analysis of the state of 30 eyes with grade III refractory glaucoma after mCPC was performed. Forms of glaucoma: multiple operated primary open-angle glaucoma – 22 eyes, neovascular glaucoma – 7 eyes, uveal glaucoma with neovascularization – 1 eye. The level of intraocular pressure (IOP) before surgery was 27–41 mm Hg, averaging 32.2 ± 3.8 mm Hg. The average number of antihypertensive drops before surgery was 2.6 ± 0.3 drugs. The observation period was 6 months. Results. All surgeries went without complications. The average level of IOP on the 1st postoperative day was 22.7 ± 2.1 mm Hg, in 93 % of cases IOP decreased to 18–24 mm Hg. After 1 week, the average level of IOP was 21.8 ± 1.7 mm Hg: in 93 % of cases it was 18–23 mm Hg, in 7 % the level of IOP remained elevated to 25–27 mm Hg. Art. By the 1st month after mCPC, the average IOP level decreased to 20.3 ± 2.2 mm Hg, after 3 months it was 20.8 ± 2.2 mm Hg. After 6 months, the level of IOP corresponded to 18–26 mm Hg. Art., averaging 21.6 ± 1.9 mm Hg. The number of antihypertensive drugs was reduced to an average of 1.7 ± 0.2. Conclusion. mCPC has been shown to be effective in normalizing IOP levels in the majority of patients with grade III refractory glaucoma (87 %) at 6 month follow-up. Keywords: refractory glaucoma, micropulse cyclophotocoagulation, intraocular pressure.
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Ghosh, Tandra, Jesmine Banu, Shaheen Ara Anwary, Abhijit Roy, Mostafa M. Al Tarique, Nurjahan Begum, and Nastaran Lasker. "Intrauterine instillation of granulocyte colony stimulating factor for infertile women with thin endometrium in intrauterine insemination cycle: a non-randomized clinical trial." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 12 (November 25, 2022): 3242. http://dx.doi.org/10.18203/2320-1770.ijrcog20223114.
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Background: Endometrial thickness is one of the major factors for a receptive endometrium and successful implantation. Thin endometrium, generally measuring <7 mm are thought to be less able to support implantation and pregnancy. Several adjuvants have been investigated for their efficacy on thin endometrium in assisted reproductive technology. Granulocyte colony stimulating factor (G-CSF) is a glycoprotein that promotes endometrial stromal cell decidualization via cyclic adenosine monophosphate mediator and induces endometrial proliferation and differentiation. This study was done to evaluate the effect of G-CSF in improving endometrial thickness and pregnancy rate in infertile patients undergoing stimulated IUI (intrauterine instillation) having thin endometrium.Methods: This was a non-randomized clinical trial done among 40 infertile patients with thin endometrium (<7 mm) on the day of ovulation trigger in stimulated IUI patients. Study subjects were non randomly allocated into 2 groups. In group A 20 patients received intrauterine instillation of G-CSF (300 mcg/0.5 ml) via intrauterine catheter on triggering day and in group B another 20 patients received intrauterine instillation of 0.5 ml normal saline in the same procedure. After 48 hours endometrial thickness was measured in both groups. IUI was done on the same day. Pregnancy was detected by serum beta hCG level after 14 days of IUI.Results: In both groups most of the respondents were aged between 30-34 years, 14 (70%) in group A and 11 (55%) in group B. The mean±SD of age 32.4±3.1 in group A, 32.2±3.4 in group B and P value was 0.9. In group A the minimum endometrial thickness on day of ovulation trigger was 4.4 mm and after 48 hours of treatment with G-CSF, it was found 6.3 mm. The maximum endometrial thickness recorded in group A was 6.9 mm and it also increased to 8.7 mm after G-CSF treatment and followed by in group B min thickness 4.8 mm increase to 5.2 mm and max thickness 6.8 mm increased to 8.7 mm. The mean±SD of ET (mm) on the day of ovarian trigger was 5.8±0.8 which increased to 7.4±0.8 in group A and followed by 5.9±0.6 to 7.1±0.9 in group B. ET mean change (mean±SD) for group A was 1.6±0.7 which was greater than the group B 1.3±0.8. Pregnancy rate was 2 (10%) in group A and 1(5%) in group B.Conclusions: Mean increase in endometrial thickness and pregnancy rate was higher in G-CSF group than normal saline group, but the difference was not statistically significant.
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Takagi, Kimiaki, Hiroshi Takahashi, Tomomi Miura, Kasumi Yamagiwa, Kota Kawase, Yuka Muramatsu-Maekawa, Takuya Koie, and Masashi Mizuno. "Prognostic Value of the Controlling Nutritional Status (CONUT) Score in Patients at Dialysis Initiation." Nutrients 14, no. 11 (May 31, 2022): 2317. http://dx.doi.org/10.3390/nu14112317.
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Protein-energy wasting (PEW) is common in patients with chronic kidney disease (CKD), and affects their prognosis. The Controlling Nutritional Status (CONUT) score is a nutritional screening tool calculated using only blood test data. This study aimed to investigate the prognostic value of CONUT score in patients just initiating dialysis. A total of 311 CKD patients who stably initiated dialysis were enrolled. Only 27 (8.7%) patients were classified as having normal nutritional status. The CONUT score was also independently correlated with elevated C-reactive protein levels (β = 0.485, p < 0.0001). During the median follow-up of 37 months, 100 patients (32.2%) died. The CONUT score was an independent predictor of all-cause mortality (adjusted hazard ratio 1.13, 95% confidence interval 1.04–1.22, p < 0.0024). As model discrimination, the addition of the CONUT score to a prediction model based on established risk factors significantly improved net reclassification improvement (0.285, p = 0.028) and integrated discrimination improvement (0.025, p = 0.023). The CONUT score might be a simplified surrogate marker of the PEW with clinical utility and could predict all-cause mortality, in addition to improving the predictability in CKD patients just initiating dialysis. The CONUT score also could predict infectious-disease mortality.
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Sancho, Juan-Manuel, Olga García, Pablo Mozas, Santiago Mercadal, Eva Donato, Ana Muntañola Prat, Javier Lopez Jimenez, et al. "Idelalisib for Relapsed/Refractory Follicular Lymphoma: Retrospective Study from Spanish Lymphoma Group Geltamo (GELT-IDE-2018-02)." Blood 134, Supplement_1 (November 13, 2019): 5249. http://dx.doi.org/10.1182/blood-2019-125921.
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Background and objective. Idelalisib is an oral inhibitor of the p110δ isoform of PI3K (phosphoinositide 3-kinase) approved in Europe and USA as monotherapy in relapsed/refractory follicular lymphoma (FL) after 2 previous lines of therapy based on a phase 2 study (Gopal et al, N Eng J Med 2014). However, there are scarce data on the use of idelalisib in clinical practice (Eyre et al, Br J Haematol 2017). The objective of this study was to analyze the efficacy and toxicity of idelalisib in relapsed/refractory FL patients in clinical practice in Spanish hospitals of GELTAMO group (GELT-IDE-2018-02 Study). Patients and Methods. Retrospective study of relapsed/refractory FL patients treated with idelalisib as salvage therapy in clinical practice. Demographic and clinical and biological variables were analyzed at FL diagnosis and at the time of idelalisib therapy, as well as its efficacy and toxicity. Results. A total of 43 patients from 20 hospitals were included. At time of idelalisib therapy, median age was 63 years (range 44-83), number of previous lines of therapy was 3 (2-7), 42% (n=18) were refractory to last previous treatment and 42% (n=18) had received an autologous stem cell transplantation (SCT); 56% (n=24) had progressed in the first 24 months after FL diagnosis (POD24). Median duration of treatment with idelalisib at time of analysis was 8.1 months (1.1-37.4) and 28/43 patients (65%) discontinued therapy, 13 due to progression, 12 due to adverse events (AE) and 3 due to physician's decision. Overall response rate (ORR) was 73% (32% CR) and median PFS 14.6 months (95% CI 0-32.2), with a trend to be higher in non-POD24 group (median PFS of 9.4 months [95% CI 1.7-16.9] in POD24 vs. 27 months [95% CI NA] in non-PO24 patients, p=0.082); median duration of response to idelalisib was 25.1 months (95% CI 13.1-37.6). Median overall survival (OS) was not reached at the time of analysis, with a 2-year OS of 74% (95% CI 58%-90%) (Figure). In 4 patients, an allogeneic SCT was performed after idelalisib. A total of 86% (n=37) of patients showed any AE, being in 56% (n=24) of grade ≥3 AE. Toxicities of grade ≥3 more frequent were: neutropenia (23% of patients), diarrhea (23%), infections (23%: pneumonia in 4 patients, CMV infection in 2, febrile neutropenia in 1 and other infections in 3 [1 of them died due to Aspergillus infection]), and increased transaminases (9%). Conclusions. In this series of patients with relapsed/refractory FL, several previous lines of therapies and factors associated with poor prognosis, the treatment with idelalisib was associated with efficacy and toxicity similar to published studies. These results support the use of idelalisib as an option for FL patients with multiple or poor risk relapses. Financial support: Gilead Figure. Progression-free survival (PFS) and overall survival (OS) for patients with follicular lymphoma treated with idelalisib. Figure Disclosures Sancho: SERVIER: Honoraria; SANOFI: Honoraria; Novartis: Consultancy, Honoraria; CELGENE: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; JANSSEN: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; ROCHE: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; GILEAD: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; CELLTRION: Consultancy; Kern-Pharma: Honoraria; Sandoz: Consultancy. Lopez Jimenez:GILEAD SCIENCES: Honoraria, Other: Education funding. Ramirez Payer:GILEAD SCIENCES: Research Funding. Cordoba:Janssen: Consultancy, Honoraria, Speakers Bureau; Servier: Consultancy, Honoraria, Speakers Bureau; Kyowa-Kirin: Consultancy, Honoraria, Speakers Bureau; Gilead: Consultancy, Research Funding, Speakers Bureau; Roche: Honoraria, Speakers Bureau; FUNDACION JIMENEZ DIAZ UNIVERSITY HOSPITAL: Employment; Celgene: Consultancy, Honoraria, Speakers Bureau; Pfizer: Consultancy. Martín:Kiowa Kirin: Consultancy; Gilead: Consultancy, Honoraria; Celgene: Consultancy, Honoraria, Other: Travel Expenses, Research Funding; iQone: Consultancy; Teva: Research Funding; Janssen: Honoraria, Other: Travel Expenses, Research Funding; Roche: Consultancy, Honoraria, Other: Travel Expenses; Servier: Honoraria, Other: Travel Expenses. Armando:Roche: Consultancy, Research Funding; Janssen: Research Funding; Gilead: Consultancy, Research Funding; Celgene: Consultancy, Research Funding.
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Pasricha, Sant-Rayn S., Zoe McQuilten, Mark Westerman, Anthony Keller, Elizabeta Nemeth, Tomas Ganz, and Erica M. Wood. "Is Serum Hepcidin a Useful Diagnostic Test for Iron Deficiency?" Blood 116, no. 21 (November 19, 2010): 2056. http://dx.doi.org/10.1182/blood.v116.21.2056.2056.
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Abstract Abstract 2056 Introduction: Iron deficiency remains the commonest blood disorder worldwide. Hepcidin is a key regulator of iron homeostasis. In iron depletion, decreased hepcidin facilitates increased iron absorption and recycling. Hepcidin is detectable in whole blood, serum & urine, and although assays have been developed, the utility and clinically appropriate cutoffs for diagnosis of iron deficiency remain to be established. Blood donors are at particular risk of iron deficiency, yet early diagnosis remains challenging in this setting; thus donors are an ideal population in which to evaluate a new diagnostic test of iron deficiency. We evaluated hepcidin as a diagnostic test of iron deficiency in female blood donors. Methods: Subjects: Premenopausal, non-anemic females accepted for whole blood donation by the Australian Red Cross Blood Service, not taking iron supplements and with no history of hemochromatosis. Iron status assessment: Serum ferritin (chemiluminescence), soluble transferrin receptor (sTfR) (immunoturbidometry) and serum hepcidin (competitive ELISA). Analysis: Diagnostic utility of hepcidin, compared with ‘gold standards’ ferritin, sTfR and sTfR/log(ferritin) index, was evaluated by Area under Receiver Operating Characteristic curves (AUCROC). Potential hepcidin cutoffs were identified, and their sensitivities and specificities evaluated. Results: We recruited 261 donors: 22.6% had ferritin<15ng/mL, 10.3% had sTfR>4.4mg/mL, and 20.3% had sTfR/log(ferritin) index>3.2. The 95% range of hepcidin values was <5.4-175.0ng/mL (overall); 9.3–203.0ng/mL (if ferritin≥15ng/mL); and 8.1–198.5ng/mL (if sTfR/log(ferritin)index≤3.2). By linear regression, log(hepcidin) was associated with log(ferritin) (coefficient +1.08, P<0.001); log(sTfR) (coefficient -2.02, P<-0.001) and log(sTfR/ferritin index) (coefficient -1.58, P<0.001). The AUCROC for hepcidin, compared with sTfR/log(ferritin) index>3.2 was 0.89, compared with ferritin<15ng/mL was 0.87 and compared with sTfR>4.4mg/mL was 0.81. An undetectable hepcidin (<5.4ng/mL) had sensitivity and specificity of 32.2% and 99.9% respectively for identification of sTfR/log(ferritin) index>3.2; hepcidin<8.1ng/mL had sensitivity and specificity of 41.5% and 97.5% respectively, and hepcidin<20ng/mL had sensitivity and specificity 74.6% and 83.2% respectively. Conclusions: Hepcidin shows promise as a diagnostic test for iron deficiency. Further work is needed to select suitable cutoffs for this assay, however a cutoff of <8.1ng/mL seems to accurately identify normal subjects, whilst <20ng/mL offers a balance between appropriate identification of cases and normal subjects. Hepcidin may become a valuable clinical index of iron status. Rapid diagnosis of iron deficiency with point of care whole blood or urine hepcidin assays may be achievable and useful in various settings, including blood donation. Prevention of donor iron deficiency is a high priority for the Australian Red Cross Blood Service and is being addressed through a comprehensive strategy. Disclosures: Westerman: Intrinsic Life Sciences: Employment, Membership on an entity's Board of Directors or advisory committees. Nemeth:Intrinsic Life Sciences: Employment, Membership on an entity's Board of Directors or advisory committees. Ganz:Intrinsic Life Sciences: Employment, Membership on an entity's Board of Directors or advisory committees.
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Pichardo, Margaret, Catherine A. Ochieng, Yaideliz M. Romero-Ramos, and Ana I. Velazquez. "Abstract B092: Examining knowledge and willingness to participate in randomized clinical trials among patients with and without cancer." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): B092. http://dx.doi.org/10.1158/1538-7755.disp22-b092.
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Abstract Background Randomized clinical trials (CT) are often the major and only source of life saving treatment for patients with cancer. Knowledge and perceptions regarding CTs may be important determinants to patient’s decision to enroll in a CT. We examined predictors of knowledge and willingness to participate in a CT and compared these outcomes among patients with and without a history of cancer. Methods We used questionnaire data from 3,865 adults, ages 18 and older, who participated in the Health Information National Trends Survey (HINTS) 5 cycle 4. Predictors examined included sociodemographic characteristics (self-identified gender and race and ethnicity, age, education, and income), smoking status, and history of cancer. Overall knowledge and CT participation outcomes included self-reported level of knowledge (a lot vs. a little or don’t know), prior invitation to participate in CT (yes/no), and participation in CT (yes/no). We also explored sources of information, knowledge of clinicaltrials.gov, and reasons and motivators to consider participation. Among cancer survivors, we also examined prior participation in CT for cancer (yes/no) and prior discission of a CT as treatment option (yes/no). Weighted bivariate tests were calculated using chi-square tests. Result Overall, 50% of the population was female, had a mean age of 48.5 years, 50.2% identified as female, 38.1% had some college education, and 58.7% self-identified as non-Hispanic White. A total of 9.1% had a history of cancer. Majority of participants reported low levels of knowledge about CT (89.2% vs. 9.2% lot of knowledge) with similar self-reported knowledge between patients with and without cancer. Majority of participants had never heard of clinicaltrials.gov (90.5% vs. 6.7% had heard), never been invited to participate in a CT (87% vs. 8.9% had been invited), and if invited, 52% did not participate in a CT (vs. 45% reported participating). Among patients with cancer, 85% of adults had discussed a CT as a treatment option, but only 4.8% had participated in a CT. Majority of participants agreed “a lot or somewhat” that they would participate in CT because they were helping others (65.7% vs 31.1%), were encouraged by their doctor (64.7% vs. 31.8%) or family and friends (57.3% vs. 38.9%), desired to get better (84.8% vs. 11.2%), desire to try to kind of care (63.9% vs. 32.2%), and standard of care was not covered by insurance (65.4% vs. 30.5%). In bivariate analysis, variable associations between sociodemographic predictors and CT outcomes were found. Conclusion We found low levels of CT knowledge and access, despite high reported strong motivations to participate in a CT. By identifying factors that could be strongly linked to motivators of CT participation we could develop future interventions that guide cancer CT recruitment strategies. Citation Format: Margaret Pichardo, Catherine A. Ochieng, Yaideliz M. Romero-Ramos, Ana I. Velazquez. Examining knowledge and willingness to participate in randomized clinical trials among patients with and without cancer [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B092.
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DUBOSSARSKAYA, Yu A., Z. M. DUBOSSARSKAYA, and L. P. GREK. "POSSIBILITIES OF THERAPY OF PAIN SYNDROME IN ENDOMETRIOSIS." Scientific digest of association of obstetricians and gynecologists of Ukraine, no. 1(47) (September 8, 2021): 23–29. http://dx.doi.org/10.35278/2664-0767.1(47).2021.242670.
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Therapeutic tactics of endometriosis are aimed primarily at overcoming the pain syndrome, the absence of recurrence of the underlying disease, maintaining fertility and improving the psycho-emotional state of women. The objective to develop, pathogenetically substantiate treatment and rehabilitation measures taking into account pathogenetic preconditions in women with endometriosis in combination with pain. Materials and methods 85 patients with genital endometriosis with severe pelvic pain (VAS 7-10 points) (n = 44) - group I and moderate (VAS 4-6 points) (n = 41) - group II. The mean age of women in clinical trials I and II of the study was 37.71 ± 0.93 and 41.05 ± 1.08 (M ± m) years, respectively. The choice of treatment tactics was determined on the basis of immunohistochemical markers: estrogen receptors (ER), progesterone (PGR), proliferation index (Ki-67), vasculoendothelial growth factor (VEGF), cyclooxygenase-2 (COX-2) in eutopic acid., psychoemotional characteristics and intensity of pelvic pain. Rеsultes of treatment in the examined patients a significant (p <0.05) reduction of pelvic pain was determined, both in the short and long term. After 6 months, the level of personal anxiety decreased - by - 38.62%, after 12 months. – at - 48.15% (p <0.05). The rate of decrease in the level of depressive disorders on the Hamilton scale of all studied women was: - 32.2% after 6 months and -42.15% after 12 months (p <0.05). Conclusion our approach to treating endometriosis helped to overcome pain in 83.53% of women, improve psycho-emotional and general condition, normalize sleep - was determined in 88.3% of women, reduce reactive anxiety and depressive disorders in 84.7% of patients, indicates the effectiveness proposed therapy.
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Pachade, Samiksha, Prasanna Porwal, Dhanshree Thulkar, Manesh Kokare, Girish Deshmukh, Vivek Sahasrabuddhe, Luca Giancardo, Gwenolé Quellec, and Fabrice Mériaudeau. "Retinal Fundus Multi-Disease Image Dataset (RFMiD): A Dataset for Multi-Disease Detection Research." Data 6, no. 2 (February 3, 2021): 14. http://dx.doi.org/10.3390/data6020014.
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The world faces difficulties in terms of eye care, including treatment, quality of prevention, vision rehabilitation services, and scarcity of trained eye care experts. Early detection and diagnosis of ocular pathologies would enable forestall of visual impairment. One challenge that limits the adoption of computer-aided diagnosis tool by ophthalmologists is the number of sight-threatening rare pathologies, such as central retinal artery occlusion or anterior ischemic optic neuropathy, and others are usually ignored. In the past two decades, many publicly available datasets of color fundus images have been collected with a primary focus on diabetic retinopathy, glaucoma, age-related macular degeneration and few other frequent pathologies. To enable development of methods for automatic ocular disease classification of frequent diseases along with the rare pathologies, we have created a new Retinal Fundus Multi-disease Image Dataset (RFMiD). It consists of 3200 fundus images captured using three different fundus cameras with 46 conditions annotated through adjudicated consensus of two senior retinal experts. To the best of our knowledge, our dataset, RFMiD, is the only publicly available dataset that constitutes such a wide variety of diseases that appear in routine clinical settings. This dataset will enable the development of generalizable models for retinal screening.
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Perry, Laura M., Leah E. Walsh, Ronald Horswell, Lucio Miele, San Chu, Brian Melancon, John Lefante, Christopher M. Blais, and Michael Hoerger. "Racial disparities in end-of-life care among Louisiana cancer decedents in a population-based study from 2011-2017." Journal of Clinical Oncology 37, no. 31_suppl (November 1, 2019): 46. http://dx.doi.org/10.1200/jco.2019.37.31_suppl.46.
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46 Background: Cancer patients’ comfort near the end of life is often undermined by unnecessary aggressive treatments. Furthermore, Black adults receive more aggressive end of life care compared to White adults. We hypothesized that these inequalities would be especially pronounced in Louisiana given regional trends of high cancer mortality coupled with inaccessibility to high quality cancer care. Methods: This was a retrospective analysis of end-of-life care using a Patient-Centered Outcomes Research Institute (PCORI)-funded PCORnet database in the Deep South, called Research Action for Health Network (REACHnet). Of 3,089,092 individuals included, 1,290 met eligibility criteria for the present study: 1) died in Louisiana with a metastatic cancer diagnosis between January 1, 2011 and December 31, 2017, 2) had at least one outpatient clinic visit within six months of death, and 3) self-identified as White or Black. In collaboration with the Louisiana Clinical and Translational Science (LA CaTS) Center, we extracted data on five validated indicators of aggressive care in the final 30 days of life: chemotherapy use, inpatient hospitalizations, ED admissions, ICU admissions, and mechanical ventilation. Hypotheses were analyzed using binary logistic regression to examine whether patient race (White vs. Black) was associated with receipt of each indicator of aggressive end-of-life care, while controlling for sex, age, number of comorbidities, and cancer type. Results: Patients were either White ( n = 875, 67.8%) or Black ( n = 415, 32.2%) adults, and the majority were ≥60 years old (72.4%). Most patients (85.0%) received at least one indicator of aggressive care in the last 30 days of life ( M = 1.91, SD = 1.23), most commonly inpatient hospitalizations (77.0%). Black individuals were more likely than White individuals to be hospitalized ( OR = 1.66, 95% CI: 1.21 to 2.27, p= .002) or admitted to the ED ( OR= 1.57, 95% CI: 1.16 to 2.13, p= .004) during their last month of life, but race was not associated with other indicators. Conclusions: Findings have implications for informing healthcare decision making near the end of life for patients, families, and clinicians in the Deep South.
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Zheng, Xiaohui, Hongyu Wu, Zhe Shen, Caihong Wang, and Yunfei Ma. "COOH-Terminated Silicon Quantum Dots as a Highly Efficient Drug Nanocarrier for Targeted Tumor Cell Imaging." Journal of Biomedical Nanotechnology 17, no. 9 (September 1, 2021): 1830–39. http://dx.doi.org/10.1166/jbn.2021.3151.
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Fluorescent silicon quantum dots (SiQDs) characterized by exceptional photostability and colloidal robustness as well as beneficial biocompatibility are fast becoming new pharmaceutical nanocarriers. With a view to efficiently loading cisplatin (CDDP) onto SiQDs, carboxylate group (COOH) terminated SiQDs were imperative because of chelate formation with CDDP. In this work, we employed a facial microwave irradiation route for rapidly synthesizing high-quality COOH-SiQDs through the use of 3-aminopropyl trimethoxy silane (APTMS) molecules to fulfil the role of silicon precursor and maleic acid (MA) as the agent for facilitating reduction. The SiQDs showed blue fluorescence with an associated photoluminescence quantum yield (PLQY) of 40.2%, the size of which was small at 3.2 ±0.6 nm, and long-lasting stability (an extensive range in pH (4-12) and concentrations of electrolytes reaching 3 Molarity of a solution of sodium chloride). As nanocarriers, carboxylic acids chelation generated a high loading of CDDP onto SiQDs (drug loading capacity, DLC up to 32.2% at pH = 9) and a drug release of CDDP up to 57.6% at pH = 5. Furthermore, the MTT assays demonstrated the non or low cytotoxicity of SiQDs and the role of the controlled release of SiQD-CDDP Finally, the prepared SiQD-CDDP were used for cell imaging, and further targeted labeling of some tumors after folic acid (FA) conjugation. These characteristics allow for the deployment of SiQDs as a highly efficient nanocarrier that facilitate the delivery of clinical drugs for the future.
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Zaidi, S., A. Amara Korba, A. Bessas, A. Bouzenad, N. K. Hamnoune, Dj Hezil, and I. Bitam. "Serological study of leptospirosis in cats from Algeria." African Journal of Clinical and Experimental Microbiology 23, no. 4 (October 25, 2022): 416–25. http://dx.doi.org/10.4314/ajcem.v23i4.10.
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Background: By the nature of their environment and behavior, stray cats are at risk of exposure to leptospirosis. Leptospirosis is an emerging zoonotic disease with worldwide distribution. The prevalence of leptospirosis in the feline species in Algeria is unknown. The main objectives of this study are to determine the seroprevalence and identify the most common Leptospira serovars in stray cats in the Algiers region.Methodology: Serum samples from 144 randomly selected healthy stray cats from 57 municipalities of the Algiers region were analyzed by the microscopic agglutination test (MAT). The MAT was performed to determine the antibody titers against nine Leptospira serovars (Canicola, Copenhageni, Icterohaemorrhagiae, Autumnalis, Grippotyphosa, Bratislava, Pomona, Pyrogenes, Patoc). The age of each cat was estimated based on dentition and physical appearance, and information on cat sex, breed and clinical status were collected. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 17.0Results: Leptospira antibodies were detected in 8 of 144 healthy stray cats, giving a seroprevalence rate of 5.6% [95% confidence interval (CI)=1.814-9.297]. The antibody titers ranged from 1:100 to 1:3200. Serovars Pyrogenes (1:100) and Patoc (1:100) were the most prevalent serovars detected in 2.8% (4/144) of the cats, followed by serovars Icterohaemorrhagiae (1:100) and Bratislava (1:100) detected in 2.1% (3/144) of the cats. The seroprevalence of 7.8% (7/90) in the male cats was higher than 1.9% (1/54) in the female cats but this did not reach a significant difference (OR=4.47, 95% CI=0.5344-37.387, p=0.2586). All the positive cats were over one year of age.Conclusion: This study showed that stray cats in Algiers are exposed to leptospirosis. In addition, the serovars detected are very common serovars in dogs and humans. The control of leptospirosis is largely dependent on general hygiene measures and the control of animal reservoirs. Additional investigations are necessary to clarify the epidemiology of the disease in the different regions of Algeria.
Contexte: De par la nature de leur environnement et de leur comportement, les chats errants sont à un risque d'exposition à la leptospirose. La leptospirose est une maladie zoonotique émergente de distribution mondiale. La prévalence de la leptospirose chez l’espèce féline en Algérie est inconnue. Les principaux objectifs de cette étude sont de déterminer la séroprévalence et d'identifier les sérovars de Leptospira les plus fréquents chez leschats errants de la région d'Alger.Méthodologie: Des échantillons de sérum de 144 chats errants sanitaires sélectionnés au hasard dans 57 communes de la région d'Alger ont été analysés par le test d'agglutination microscopique (MAT). Le MAT a été réalisé pour déterminer les titres d'anticorps contre neuf sérotypes de Leptospira (Canicola, Copenhageni, Icterohaemorrhagiae, Autumnalis, Grippotyphosa, Bratislava, Pomona, Pyrogenes, Patoc). L'âge de chaque chat a été estimé sur la base de la dentition et de l'apparence physique, et des informations sur le sexe, la race et l'état clinique du chat ont été collectées. Les données ont été analysées à l'aide du package statistique pour les sciences sociales (SPSS) version 17.0Résultats: Des anticorps contre Leptospira ont été détectés chez 8 des 144 chats errants sanitaires, donnant un taux de séroprévalence de 5,6% [intervalle de confiance (IC) à 95%=1,814-9,297]. Les titres d'anticorps variaient de 1:100 à 1:3200. Les sérovars Pyrogenes (1:100) et Patoc (1:100) étaient les sérovars les plus prévalents détectés chez 2,8 % (4/144) des chats, suivis des sérovars Icterohaemorrhagiae (1:100) et Bratislava (1:100) détectés chez 2,1% (3/144) des chats. La séroprévalence de 7,8 % (7/90) chez les chats mâles était supérieure à 1,9 % (1/54) chez les chattes, mais cela n'a pas atteint une différence significative (OR=4,47, IC 95%=0,5344-37,387, p=0,2586). Tous les chats positifs avaient plus d'un an.Conclusion: Cette étude a montré que les chats errants d'Alger sont exposés à la leptospirose. De plus, les sérovars détectés sont des sérovars très répandus chez le chien ou chez l'homme. Le contrôle de la leptospirose est largement tributaire des mesures d'hygiène générales et de la lutte contre les réservoirs animaux. Des investigations complémentaires sont nécessaires pour préciser l'épidémiologie de la maladie dans les différentesrégions de l'Algérie.
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KIEU, Violet, Alex POLYAKOV, Genia ROZEN, Daniel LANTSBERG, Kate STERN, and Wan Tinn TEH. "A Cross-Sectional Analysis of Live Birth Rates in Day 5 Fresh Versus Vitrified Single Blastocyst Transfer Cycles." Fertility & Reproduction 04, no. 03n04 (September 2022): 138. http://dx.doi.org/10.1142/s2661318222740504.
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Background: The use of frozen embryo transfers (FETs) in assisted reproduction has increased worldwide. Proponents of FETs suggest that controlled ovarian hyperstimulation (COH) in a fresh transfer impairs endometrial-embryo synchronicity, however there has been conflicting evidence on live birth rate (LBR) and clinical pregnancy rate (CPR) outcomes. Aim: To compare LBRs and CPRs between single autologous day 5 fresh versus vitrified blastocyst transfer cycles, in order to investigate the impact of COH on embryo-endometrium asynchrony. Method: A large cross-sectional analysis of 6,002 embryo transfers (ETs), comprising of 3774 fresh and 2228 FET cycles from 2016-2019. Inclusion criteria: first two stimulation cycles, single ET, and no pre-implantation genetic testing for aneuploidy (PGT-A). Multivariate analysis performed, also sub-group analysis for high-responders (>20 oocytes collected). Results: Univariate analysis showed no absolute difference in LBR (28.3% vs 27.4%, p=0.43) and CPR (32.2% vs 30.9%, p=0.30), however multivariate analysis demonstrated significantly lower LBR (OR 0.864, p<0.05, 95% CI 0.749-0.997) and CPR (OR 0.852, p<0.05, 95% CI 0.742-0.979) in FET compared to fresh ETs. Younger patient age, previous IVF pregnancy, advanced blastocyst expansion, higher trophectoderm quality and lower cumulative number of ETs all improved the odds of both LBR and CPR (p<0.001). Conventional IVF, rather than ICSI, improved CPR (p<0.05) but not LBR (p=0.138). BMI affected neither LBR (p=0.492) nor CPR (p=0.359). In sub-group multivariate analysis of high-responders, no significant difference in LBR (p=0.439) or CPR (p=0.450) noted. Conclusion: This study demonstrates a relative higher LBR and CPR for fresh ETs compared to FETs, in multivariate analysis. Having a FET decreased the odds of LBR by nearly 14% compared to fresh ET, when adjusted for confounders. Our results suggest that universal freeze-all strategy, without appropriate indication, may lead to suboptimal outcomes. In high-responders, freeze-all cycles may be beneficial, as adjusted outcomes appear to be similar.
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Palaia, Gaspare, Maurizio Bossù, Nicola Pranno, Massimo Ralli, Alice Bruscolini, Mauro Capocci, Gianfranco Gaimari, et al. "Oral Pathologies in Migrants: The Experience of the “PROTECT” Project in 3023 Patients." Applied Sciences 12, no. 24 (December 9, 2022): 12621. http://dx.doi.org/10.3390/app122412621.
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Introduction: The number of people with migrant status living in Europe is proliferating. Most of the refugees in Italy come from war zones, and many of them denounce having been victims of persecutory acts in their country of origin. Highly cultured migrant populations have shown better results and oral health behaviour than those who were poorly cultured. The PROTECT project aimed to build a network for the early management of head and neck pathologies among refugees and migrants, promoting the dissemination of correct information about the prevention and treatment of these pathologies. Materials and methods: A national cross-sectional study among the refugees and migrant population in the Lazio region, Italy, from February 2018 to September 2021 was performed. The oral health of 3023 participants was investigated within a network of 56 reception centres and cultural associations. Data collected via an oral health survey questionnaire gathered information on participants’ demographic factors, migration status and dental behaviours and clinical examinations of the participants with the help of mouth mirrors, periodontal probes and artificial light. Results: The mean age was 31.6 ± 13.1, and among all the subjects, 2058 were male (68.1%) and 965 were women (41.9%). Most participants were born in Nigeria, followed by Bangladesh, Pakistan, Somalia, Mali and Senegal. The overall oral pain prevalence was 48.2%. The prevalence of patients claiming poor oral hygiene was 32.4%; 36.2% of the subjects consumed high amounts of sugar; and 26.7% saw their dentist for a check-up in the last year. At the clinical examination, 68.9% of patients had caries experience (considering decay of deciduous teeth, and caries of permanent teeth and teeth with fillings), with 32.2% showing pulpal involvement. Low levels of oral hygiene were also found at the clinical examination, with 46.5% of patients presenting plaque and calculus. The trend of the DMFT index was found to be 5.41. Good periodontal health (CPI = 0) was present in approximately 33.5% of patients. The CPI = 1 index reported bleeding from gingivitis in 37% of patients; tartar was found in 27% of patients (CPI = 2). The percentage of patients with CPI = 3 was 3.6%. Just over half (52.2%) of the migrants examined had malocclusion, and only 0.7% had a malocclusion in treatment. Conclusions: The goal to be achieved is to develop education and prevention programs for head–neck diseases, and perhaps even more. The first step towards this goal can be removing the obstacles migrants encounter in accessing health care.
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Bang, Oh Young, Young Keun On, Myung-Yong Lee, Sung-Won Jang, Seongwook Han, Sola Han, Mi-Mi Won, et al. "The risk of stroke/systemic embolism and major bleeding in Asian patients with non-valvular atrial fibrillation treated with non-vitamin K oral anticoagulants compared to warfarin: Results from a real-world data analysis." PLOS ONE 15, no. 11 (November 30, 2020): e0242922. http://dx.doi.org/10.1371/journal.pone.0242922.
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Background Although randomized trials provide a high level of evidence regarding the efficacy of non-vitamin K oral anticoagulants (NOACs), the results of such trials may differ from those observed in day-to-day clinical practice. Aims To compare the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) between NOAC and warfarin in clinical practice. Methods Patients with non-valvular atrial fibrillation (NVAF) who started warfarin/NOACs between January 2015 and November 2016 were retrospectively identified from Korea’s nationwide health insurance claims database. Using inpatient diagnosis and imaging records, the Cox models with inverse probability of treatment weighting using propensity scores were used to estimate hazard ratios (HRs) for NOACs relative to warfarin. Results Of the 48,389 patients, 10,548, 11,414, 17,779 and 8,648 were administered apixaban, dabigatran, rivaroxaban and warfarin, respectively. Many patients had suffered prior strokes (36.7%, 37.7%, 31.4%, and 32.2% in apixaban, dabigatran, rivaroxaban, and warfarin group, respectively), exhibited high CHA2DS2-VASc (4.8, 4.6, 4.6, and 4.1 in apixaban, dabigatran, rivaroxaban, and warfarin group, respectively) and HAS-BLED (3.7, 3.6, 3.6, and 3.3 in apixaban, dabigatran, rivaroxaban, and warfarin group, respectively) scores, had received antiplatelet therapy (75.4%, 75.7%, 76.8%, and 70.1% in apixaban, dabigatran, rivaroxaban, and warfarin group, respectively), or were administered reduced doses of NOACs (49.8%, 52.9%, and 42.8% in apixaban, dabigatran, and rivaroxaban group, respectively). Apixaban, dabigatran and rivaroxaban showed a significantly lower S/SE risk [HR, 95% confidence intervals (CI): 0.62, 0.54–0.71; 0.60, 0.53–0.69; and 0.71, 0.56–0.88, respectively] than warfarin. Apixaban and dabigatran (HR, 95% CI: 0.58, 0.51–0.66 and 0.75, 0.60–0.95, respectively), but not rivaroxaban (HR, 95% CI: 0.84, 0.69–1.04), showed a significantly lower MB risk than warfarin. Conclusions Among Asian patients who were associated with higher bleeding risk, low adherence, and receiving reduced NOAC dose than that provided in randomised controlled trials, all NOACs were associated with a significantly lower S/SE risk and apixaban and dabigatran with a significantly lower MB risk than warfarin.
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Santos, Leandro Porto dos, Diego Ribeiro de Souza, Renata Gorjao, Adriana Cristina Levada-Pires, Elaine Hatanaka, Maria Fernanda Cury-Boaventura, Douglas Vicente Russo Junior, et al. "Association between the number of steps performed during work and metabolic syndrome indicators in São Paulo city military police officers: The health promotion of Military Police (HPMP) study." Research, Society and Development 11, no. 2 (January 20, 2022): e13511225376. http://dx.doi.org/10.33448/rsd-v11i2.25376.
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We evaluated the working number steps (STEPS) of 25 military police officers (MPOs: day shift n = 14 and night shift n = 11) from the Military Police of São Paulo State (PMESP) while patrolling São Paulo city center and its association with metabolic syndrome (MetS) indicators. The participants' body composition and anthropometric parameters: body mass index (BMI), fat-free mass (FFM), skeletal muscle mass (SMM) and clinical and laboratory data: systolic (SBP) and diastolic (DBP) blood pressure, and fasting plasma levels of glucose, glycated hemoglobin A1c (HbA1c), insulin, HDL-cholesterol, triacylglycerol (TG), and C-reactive protein (CRP) were also measured. According to the number of steps taken during the daily 12 h working period, the MPOs were divided into three groups: 600-2,000, 2,001-8,000, and >8,000 steps. On average, each participant took 5169 ± 614 steps per 12 h shift. While MPOs from the night shift walked 25% more than the day shift (6188±1069 vs. 4367±664), this difference was not statistically significant. Notably, the BMI, FFM (13.4%), SMM (14.5%), plasma HDL-cholesterol levels (32.2%), and DBP (19.1%) were significantly higher in group 1 compared to the other two groups. Furthermore, reduced physical activity, age, BMI, and tenure at PMESP were associated with increased MetS indicators. Overall, MPOs performing less than 2,000 steps per shift presented marked changes in body composition and plasma measurements and a higher MetS prevalence (64%) than those who were more physically active.
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Hilal, Talal, William B. Hillegass, Miguel Gonzalez-Velez, Jose F. Leis, and Allison C. Rosenthal. "Adverse Events in Clinical Trials of Ibrutinib and Acalabrutinib for B-Cell Lymphoproliferative Disorders: A Systematic Review and Network Meta-Analysis." Blood 136, Supplement 1 (November 5, 2020): 23. http://dx.doi.org/10.1182/blood-2020-137062.
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Introduction: Bruton tyrosine kinase (BTK) inhibitors are a class of drugs that inhibit B-cell receptor (BCR) and are increasingly used in B-cell lymphoproliferative neoplasms, including chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), and Waldenstrom's macroglobulinemia. Ibrutinib, a first-generation BTK inhibitor has been associated with increased risk of cardiovascular adverse events (AEs), including atrial fibrillation (AF), hypertension (HTN) and bleeding. These unique AEs are thought to be due to off-target effects. Acalabrutinib, a second-generation BTK inhibitor is characterized by less off-target effects, and is thought to be associated with a decreased risk of cardiovascular and other AEs. However, a head to head comparison of ibrutinib and acalabrutinib has not been conducted. Herein, we conducted a systematic review and network meta-analysis of AEs from prospective clinical trials of ibrutinib and acalabrutinib in B-cell lymphoproliferative disorders to compare their safety profile. Methods: We searched PubMed, Embase, Scopus, and Web of Science from database inception through November 15th 2019. Only full-text articles were included. Other inclusion criteria included prospective trials (single arm or randomized) with ibrutinib, ibrutinib plus anti-CD20 antibody, or acalabrutinib as investigational agents. Trials investigating BTK inhibitor plus chemotherapy were excluded. When updated results of prospective trials were available, data were extracted from the most recent publication with the longest follow-up. Reports of 17 AEs of interest, including number of events (any grade and grade 3 or higher) were documented. Rate of discontinuation was investigated. Results: Twenty-seven prospective clinical trials, 12 multicenter single-arm, 9 multicenter randomized, 5 single center single-arm, and 1 single center randomized, were included. Data from 29 study arms including 3207 patients were analyzed in 3 groups - ibrutinib, ibrutinib plus anti-CD20 antibody, and acalabrutinib with augmented Bayesian network meta-analysis and meta-regression implemented in R including packages gemtc and rjags. The most common any grade AEs (>20%) with ibrutinib were diarrhea (46%, 95% CI 36-55%), myalgias/arthralgias (37%, 95%CI 28-46%), fatigue (33%, 95% CI 24-42%), cough (26%, 95% 17-36%), anemia (23%, 95% 15-30%), thrombocytopenia (22%, 95% 15-30%), and pyrexia (21%, 95% 13-30%). The most common any grade AEs with acalabrutinib were headache (37%, 95%CI 26-48%), diarrhea (30%, 95% 20-41%), peripheral edema (21%, 95% 15-28%), fatigue (20%, 95% 11-29%), and myalgias/arthralgias (16%, 95% 8-24%). The most common any grade cardiovascular AEs with ibrutinib were bleeding/bruising (32%, 95% 23-41%), HTN (23%, 95% 15-32%), AF (9%, 95% 3-15%). The most common any grade cardiovascular AEs with acalabrutinib were bleeding/bruising (41%, 95% CI 30-52%), and HTN (6%, 95% 1-11%). The rate of AEs with ibrutinib compared to ibrutinib plus anti-CD20 antibody were similar so the data was pooled. Of all AEs of interest, there was a significant difference in any grade AEs favoring ibrutinib for headache (12% vs. 37%), and infections (35% vs 57%). There was a significant difference in any grade AEs favoring acalabrutinib for myalgias/arthralgias (16% vs. 37%), anemia (6% vs. 23%), thrombocytopenia (5% vs. 22%), and HTN (6% vs. 23%). After adjusting for median follow-up and age, there was no significant difference in rates of bleeding/bruising and any grade infections between ibrutinib and acalabrutinib. However, there was a significant difference favoring acalabrutinib for any grade HTN (OR 0.26, 95% CI 0.17-0.40) p<0.0001, grade 3 HTN (OR 0.15, 95% 0.08-0.27) p<0.0001, any grade AF (OR 0.35, 95% 0.18-0.66), p=0.0012, grade 3 AF (OR 0.04, 95% 0.01-0.25) p=0.0009, and grade 3 infections (OR 0.62, 95% 0.46-0.85),p=0.003. Conclusions: Acalabrutinib appears to have an overall improved safety profile compared to ibrutinib. This is particularly true for anemia, thrombocytopenia, and cardiovascular AEs, including AF and HTN. Figure 1 Disclosures No relevant conflicts of interest to declare.
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Sd, Inbaraj, and Muniappan M. "EFFECT OF TRIGONELLA FOENUM GRAECUM ON ΑLPHA-GLUCOSIDASE AND DIPEPTIDYL PEPTIDASE-IV INHIBITORY ACTIVITY - AN IN VITRO STUDY." Asian Journal of Pharmaceutical and Clinical Research 11, no. 10 (October 7, 2018): 513. http://dx.doi.org/10.22159/ajpcr.2018.v11i10.28766.
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Objective: The objective of this study is to find the effect of seed extract of Trigonella foenum graecum on the inhibition of α-glucosidase and dipeptidyl peptidase-4 (DPP-4) enzyme activity by in vitro method.Methods: Methanolic seed extract of T. foenum graecum seed was prepared and supplied by Sami Labs, Bengaluru, on request. For alpha-glucosidase inhibition assay, the following concentrations (0, 20, 40, 60, 80, and 100 μg/ml) of extracts and for DPP-4 inhibition assay (0, 5, 10, 20, 40, 80, 160, and 320d μg/ml) concentrations were used. The absorbance was measured at 540 and 405 nm using multiplate reader, and the percentage of α-glucosidase and DPP-4 enzyme inhibitory activity of extract fractions was calculated. Acarbose for alpha-glucosidase inhibition and vildagliptin for DDP-4 inhibition were used as standard drugs. The IC50 value for alpha-glucosidase inhibition and DPP-4 inhibition was determined.Results: The maximum alpha-glucosidase inhibitory activity of T. foenum graecum extract at 100 μg/ml was 68% (p<0.05) with IC50 value of 57.25 when compared to the acarbose (STD) of 94% with IC50 values of 42.78. The maximum percentage of DPP-4 inhibition of T. foenum graecum extract at 320 μg/ml is 77.84% (p<0.01) with IC50 value of 52.26 when compared to the vildagliptin (STD) it is 80.15% with IC50 value of 22.98.Conclusion: The results of the in vitro studies show that T. foenum graecum seed extract has significant alpha-glucosidase and DPP-4 inhibition. Further in vivo and clinical studies are necessary to establish the antihyperglycemic and antidiabetic potential of T. foenum graecum seed extract for the treatment of Type 2 diabetes mellitus.
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Schaadt, Gesa, Rachel G. Zsido, Arno Villringer, Hellmuth Obrig, Claudia Männel, and Julia Sacher. "Association of Postpartum Maternal Mood With Infant Speech Perception at 2 and 6.5 Months of Age." JAMA Network Open 5, no. 9 (September 21, 2022): e2232672. http://dx.doi.org/10.1001/jamanetworkopen.2022.32672.
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ImportanceLanguage development builds on speech perception, with early disruptions increasing the risk for later language difficulties. Although a major postpartum depressive episode is associated with language development, this association has not been investigated among infants of mothers experiencing a depressed mood at subclinical levels after birth, even though such a mood is frequently present in the first weeks after birth. Understanding whether subclinical depressed maternal mood after birth is associated with early language development is important given opportunities of coping strategies for subclinical depressed mood.ObjectiveTo examine whether depressed maternal mood at subclinical levels 2 months after birth is associated with infant speech perception trajectories from ages 2 to 6.5 months.Design, Setting, and ParticipantsIn this longitudinal cohort study conducted between January 1, 2018, and October 31, 2019, 46 healthy, monolingual German mother-infant dyads were tested. The sample was recruited from the infants database of the Max Planck Institute for Human Cognitive and Brain Sciences. Initial statistical analysis was performed between January 1 and March 31, 2021; the moderation analysis (results reported herein) was conducted between July 1 and July 31, 2022.ExposuresMothers reported postpartum mood via the German version of the Edinburgh Postnatal Depression Scale (higher scores indicated higher levels of depressed mood, with a cutoff of 13 points indicating a high probability of clinical depression) when their infants were 2 months old.Main Outcomes and MeasuresElectrophysiological correlates of infant speech perception (mismatch response to speech stimuli) were tested when the infants were aged 2 months (initial assessment) and 6.5 months (follow-up).ResultsA total of 46 mothers (mean [SD] age, 32.1 [3.8] years) and their 2-month-old children (mean [SD] age, 9.6 [1.2] weeks; 23 girls and 23 boys) participated at the initial assessment, and 36 mothers (mean [SD] age, 32.2 [4.1] years) and their then 6.5-month-old children (mean [SD] age, 28.4 [1.5 weeks; 18 girls and 18 boys) participated at follow-up. Moderation analyses revealed that more depressed maternal subclinical postpartum mood (mean [SD] Edinburgh Postnatal Depression Scale score, 4.8 [3.6]) was associated with weaker longitudinal changes of infants’ electrophysiological brain responses to syllable pitch speech information from ages 2 to 6.5 months (coefficient: 0.68; 95% CI, 0.03-1.33; P = .04).Conclusions and RelevanceThe results of this cohort study suggest that infant speech perception trajectories are correlated with subclinical depressed mood in postpartum mothers. This finding lays the groundwork for future research on early support for caregivers experiencing depressed mood to have a positive association with children’s language development.
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Chow, Daniel S., Justin Glavis-Bloom, Jennifer E. Soun, Brent Weinberg, Theresa Berens Loveless, Xiaohui Xie, Simukayi Mutasa, et al. "Development and external validation of a prognostic tool for COVID-19 critical disease." PLOS ONE 15, no. 12 (December 9, 2020): e0242953. http://dx.doi.org/10.1371/journal.pone.0242953.
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Background The rapid spread of coronavirus disease 2019 (COVID-19) revealed significant constraints in critical care capacity. In anticipation of subsequent waves, reliable prediction of disease severity is essential for critical care capacity management and may enable earlier targeted interventions to improve patient outcomes. The purpose of this study is to develop and externally validate a prognostic model/clinical tool for predicting COVID-19 critical disease at presentation to medical care. Methods This is a retrospective study of a prognostic model for the prediction of COVID-19 critical disease where critical disease was defined as ICU admission, ventilation, and/or death. The derivation cohort was used to develop a multivariable logistic regression model. Covariates included patient comorbidities, presenting vital signs, and laboratory values. Model performance was assessed on the validation cohort by concordance statistics. The model was developed with consecutive patients with COVID-19 who presented to University of California Irvine Medical Center in Orange County, California. External validation was performed with a random sample of patients with COVID-19 at Emory Healthcare in Atlanta, Georgia. Results Of a total 3208 patients tested in the derivation cohort, 9% (299/3028) were positive for COVID-19. Clinical data including past medical history and presenting laboratory values were available for 29% (87/299) of patients (median age, 48 years [range, 21–88 years]; 64% [36/55] male). The most common comorbidities included obesity (37%, 31/87), hypertension (37%, 32/87), and diabetes (24%, 24/87). Critical disease was present in 24% (21/87). After backward stepwise selection, the following factors were associated with greatest increased risk of critical disease: number of comorbidities, body mass index, respiratory rate, white blood cell count, % lymphocytes, serum creatinine, lactate dehydrogenase, high sensitivity troponin I, ferritin, procalcitonin, and C-reactive protein. Of a total of 40 patients in the validation cohort (median age, 60 years [range, 27–88 years]; 55% [22/40] male), critical disease was present in 65% (26/40). Model discrimination in the validation cohort was high (concordance statistic: 0.94, 95% confidence interval 0.87–1.01). A web-based tool was developed to enable clinicians to input patient data and view likelihood of critical disease. Conclusions and relevance We present a model which accurately predicted COVID-19 critical disease risk using comorbidities and presenting vital signs and laboratory values, on derivation and validation cohorts from two different institutions. If further validated on additional cohorts of patients, this model/clinical tool may provide useful prognostication of critical care needs.
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Rikken, Quinten, Emma Wijnhoud, Jari Dahmen, Inger Sierevelt, Sjoerd A. Stufkens, and Gino Kerkhoffs. "Incidence of (Osteo)Chondral Lesions Concomitant to Chronic Lateral Ankle Instability: Systematic Review and Meta-Analysis." Foot & Ankle Orthopaedics 7, no. 1 (January 2022): 2473011421S0041. http://dx.doi.org/10.1177/2473011421s00415.
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Category: Ankle Introduction/Purpose: To determine the incidence of (osteo)chondral lesions ((O)CLs) in patients with chronic lateral ankle instability (CLAI). Methods: A literature search was conducted in PubMed (MEDLINE), EMBASE (Ovid), and the Cochrane Library databases for articles published from January 2000 until December 2020. Two authors independently screened the search results and conducted the quality assessment using the MINORS criteria. Clinical studies that reported findings on (O)CLs of the ankle as per preoperative or intraoperative diagnostic measures in patients with CLAI (> 6 months of symptoms) were included. Chondral and osteochondral lesions were analyzed altogether for the primary outcome, namely, the incidence of (O)CLs in ankles with CLAI. Additionally, a subgroup analysis for the incidence of (O)CLs located on the talus. Secondary outcomes included the study-, patient, and lesion characteristics. Lesions characteristics included lesion localization and chondral- or osteochondral involvement. A random-effects model with 95% confidence intervals (95% CI) was used to analyze the primary outcome and subgroup analysis. Secondary outcomes were pooled using a simplified pooling method. Results: 12 studies with a total of 2145 patients with 2170 ankles with CLAI were included. The overall pooled incidence of (O)CLs in ankles with CLAI was 32.2% (95% CI 22.7 - 41.7). The pooled incidence of talar (O)CLs was 26.5% (95% CI 19.0 - 34.0). Overall the most common location of OCLs in patients with CLAI is the talus with 85%, of which 68% of (O)CLs are located on the medial talus and 32% are located laterally. 43% of lesions were chondral lesions and 57% of lesions were osteochondral in nature. Conclusion: (O)CLs were found in up to 32% of ankles with CLAI. Furthermore, most lesions are located on the medial talar dome. These findings will aid physicians in the early recognition and treatment of ankle (O)CLs in the context of CLAI.
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Chetoui, Mohamed, Moulay A. Akhloufi, Bardia Yousefi, and El Mostafa Bouattane. "Explainable COVID-19 Detection on Chest X-rays Using an End-to-End Deep Convolutional Neural Network Architecture." Big Data and Cognitive Computing 5, no. 4 (December 7, 2021): 73. http://dx.doi.org/10.3390/bdcc5040073.
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The coronavirus pandemic is spreading around the world. Medical imaging modalities such as radiography play an important role in the fight against COVID-19. Deep learning (DL) techniques have been able to improve medical imaging tools and help radiologists to make clinical decisions for the diagnosis, monitoring and prognosis of different diseases. Computer-Aided Diagnostic (CAD) systems can improve work efficiency by precisely delineating infections in chest X-ray (CXR) images, thus facilitating subsequent quantification. CAD can also help automate the scanning process and reshape the workflow with minimal patient contact, providing the best protection for imaging technicians. The objective of this study is to develop a deep learning algorithm to detect COVID-19, pneumonia and normal cases on CXR images. We propose two classifications problems, (i) a binary classification to classify COVID-19 and normal cases and (ii) a multiclass classification for COVID-19, pneumonia and normal. Nine datasets and more than 3200 COVID-19 CXR images are used to assess the efficiency of the proposed technique. The model is trained on a subset of the National Institute of Health (NIH) dataset using swish activation, thus improving the training accuracy to detect COVID-19 and other pneumonia. The models are tested on eight merged datasets and on individual test sets in order to confirm the degree of generalization of the proposed algorithms. An explainability algorithm is also developed to visually show the location of the lung-infected areas detected by the model. Moreover, we provide a detailed analysis of the misclassified images. The obtained results achieve high performances with an Area Under Curve (AUC) of 0.97 for multi-class classification (COVID-19 vs. other pneumonia vs. normal) and 0.98 for the binary model (COVID-19 vs. normal). The average sensitivity and specificity are 0.97 and 0.98, respectively. The sensitivity of the COVID-19 class achieves 0.99. The results outperformed the comparable state-of-the-art models for the detection of COVID-19 on CXR images. The explainability model shows that our model is able to efficiently identify the signs of COVID-19.
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Niederwanger, Christian, Tobias Hell, Sophie Hofer, Christina Salvador, Miriam Michel, Bettina Schenk, Benedikt Treml, and Mirjam Bachler. "Antithrombin deficiency is associated with mortality and impaired organ function in septic pediatric patients: a retrospective study." PeerJ 6 (September 5, 2018): e5538. http://dx.doi.org/10.7717/peerj.5538.
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BackgroundSepsis remains a major problem in intensive care medicine. It is often accompanied by coagulopathies, leading to thrombotic occlusion of small vessels with subsequent organ damage and even fatal multi-organ failure. Prediction of the clinical course and outcome—especially in the heterogeneous group of pediatric patients—is difficult. Antithrombin, as an endogenous anticoagulant enzyme with anti-inflammatory properties, plays a central role in controling coagulation and infections. We investigated the relationship between antithrombin levels and organ failure as well as mortality in pediatric patients with sepsis.MethodsData from 164 patients under the age of 18, diagnosed with sepsis, were retrospectively reviewed. Antithrombin levels were recorded three days before to three days after peak C-reactive protein to correlate antithrombin levels with inflammatory activity. Using the concept of developmental haemostasis, patients were divided into groups <1 yr and ≥1 yr of age.ResultsIn both age groups, survivors had significantly higher levels of antithrombin than did deceased patients. An optimal threshold level for antithrombin was calculated by ROC analysis for survival: 41.5% (<1 yr) and 67.5% (≥1 yr). The mortality rate above this level was 3.3% (<1 yr) and 9.5% (≥1 yr), and below this level 41.7% (<1 yr) and 32.2% (≥1 yr); OR 18.8 (1.74 to 1005.02),p = 0.0047, and OR 4.46 (1.54 to 14.89),p = 0.003. In children <1 yr with antithrombin levels <41.5% the rate of respiratory failure (66.7%) was significantly higher than in patients with antithrombin levels above this threshold level (23.3%), OR 6.23 (1.23 to 37.81),p = 0.0132. In children ≥1 yr, both liver failure (20.3% vs 1.6%, OR 15.55 (2.16 to 685.01),p = 0.0008) and a dysfunctional intestinal tract (16.9% vs 4.8%, OR 4.04 (0.97 to 24.08),p = 0.0395) occurred more frequently above the antithrombin threshold level of 67.5%.ConclusionIn pediatric septic patients, significantly increased mortality and levels of organ failure were found below an age-dependent antithrombin threshold level. Antithrombin could be useful as a prognostic marker for survival and occurrence of organ failure in pediatric sepsis.
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Jamil, Faiza, Madeeha Shafqat, Sharoon Samuel, Zunairah Shah, Ceren Durer, Seren Durer, Maryam Sadiq, et al. "Efficacy and Toxicity Profile of Elotuzumab for Multiple Myeloma: A Systematic Review and Meta-Analysis." Blood 132, Supplement 1 (November 29, 2018): 5640. http://dx.doi.org/10.1182/blood-2018-99-117209.
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Abstract Background: Elotuzumab (elo) is a humanized monoclonal antibody, which has been approved by the FDA for use in combination with lenalidomide (lena) and dexamethasone (dexa) in patients (pts) with relapsed and refractory multiple myeloma (RRMM). Elotuzumab is effective as a single agent, as well as in combination for multiple myeloma treatments, supporting the use of elo in pts with RRMM and newly diagnosed multiple myeloma (NDMM) pts. Method: After review of literature using database searches was done on 6/27/18 (Pubmed, Embase, Cochrane Library, Web of Science and Clinical Trials.gov), 9 prospective and 1 retrospective study with 1128 enrolled pts met the inclusion criteria to date in RRMM and 2 clinical trials including 123 pts in NDMM (Table 1). CMA software v.3 was used for meta-analysis. A random-effect model was applied. Result: Regimens used in RRMM: Based on pooled analysis (95% CI), an overall response rate (ORR) of 66% (54-76.2) was calculated in 685 evaluable pts treated with elo based regimens in RRMM (Figure 1). Most common grade (G) ≥ 3 hematological adverse events (HAE) and non-hematological adverse events (NHAE) based on regimen were calculated using pooled analysis in RRMM pts (Table 2). Anemia was noted in 12.1% ( 7.7-18.6) in 559 pts, while neutropenia in 14.5% (7.5-26.4) out of 591 pts and thrombocytopenia (tcp) in 11.9% (7.9-17.4) in 198 evaluable pts. Diarrhea 5.5% (3.6-8.3), pyrexia 2.4% (1.5-4), peripheral neuropathy (PN) 8.4% (3.8-17.8) were measured in 626, 668 and 143 pts respectively. Elotuzumab as monotherapy: 1 study (n=34) evaluated the efficacy of elo as single agent in RRMM. The median age, time from diagnosis and number of prior therapies were 64.5 years (y) (46-87), 4.4 y (0.9-12.8) and 4.5 y (2-10) respectively. It produced an ORR of 1.4% (0.1-19.1 95% CI) in 34 evaluable pts. Adverse events recorded were pyrexia and fatigue in 17.6% and 8.8% pts respectively. Elotuzumab in two drug regimen: In RRMM, 2 clinical trials (n=49) evaluated the efficacy (95% CI) of elo, ORR of 25% (4.1-72.3) was calculated. The best PFS (progression free survival) produced was in combination of elo 20 mg with bortezumib (bort) 1.3mg/m2 of 9.46 months as compared to 1.8 months when elo10mg/kg + dexamethasone (dexa) 28mg was used. In our analysis for safety, common G≥ 3 HAE calculated were, thrombocytopenia 8.7% (3.3-21.1) n=49, neutropenia 10.7 % (3.5-28.4) n=28 pts and anemia 7.1% (1.8-24.5) n=28 pts. NHAE included diarrhea 1.7% (0.1-22.3), PN 10.7% (3.5-28.4), pyrexia 1.7% (0.1-22.3) in 28 evaluable pts each. Elotuzumab in three drug regimen: In RRMM, 10 clinical trials including 602 pts evaluated the efficacy of elo as a part of triple drug regimen, producing an ORR of 72.2% (54-76.2). The best results were produced with the combination of elo 10-20mg/kg + lenalidomide (lena) 25mg + dexa 40mg producing a PFS of 32.2 mo and 28.62 mo in its phase I and II cohorts respectively. Based on pooled analysis (95% CI) common HAE calculated were neutropenia 17.5% (7.6-35.4) in n=563, thrombocytopenia 12.7% (8.2-19.4) in n=149 and anemia 13% (8-20.5) in n=531 pts. Common G ≥ 3 NHAE estimated were diarrhea 5.7% (3.7-8.6), PN 6.6% (2-19.2), pyrexia 2.5% (1.5-4.1) in 598, 115 and 640 pts respectively. Elotuzumab based regimen in NDMM: A currently ongoing clinical trial NCT02272803 has produced promising results in NDMM pts. As a part of three drug regimen with dose of elo 10mg/kg-20mg/kg, lena 25mg, dexa 20mg in 40 pts produced an ORR of 87.5% (73.2-95.8) versus control group of lena 25mg plus dexa 40mg in 42 pts with an ORR of 73.8% (58-86.1). The PFS rate recorded at 1 year was 93% (79-98%) and 91% (73-97%) respectively. The HAE G ≥ 3 included, neutropenia 18% and leukopenia 15%. In another study with 41 pts, elo was used in combination with lena, bort and dexa producing an ORR of 100% and greater than grade 3 adverse events including Tcp 15%, PN 2%. Conclusion: Results produced in our study suggest that elotuzumab is highly effective when used in pts with RRMM and NDMM. Combination regimens for elo produces an ORR ranging from 79-83% with elo + lena+ dexa, proving that the best results were produced by three drug regimens. Large prospective studies are required to evaluate efficacy and safety of elotuzumab in combination therapies. Disclosures No relevant conflicts of interest to declare.