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Publication
Journal: British Journal of Dermatology
April/3/2021
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Journal: Heart Failure Reviews
April/3/2021
Abstract
Many studies have reported various minimally invasive techniques for continuous-flow left ventricular assist device implantation. There is no consensus on whether minimally invasive techniques can bring more benefits for patients compared with the conventional technique, due to the limited number of patients and diverse results in current studies. Our meta-analysis mainly discussed the comparison of minimally invasive and conventional techniques. We searched controlled trials from PubMed, Cochrane Library, and Embase databases until Dec 11, 2020. Perioperative and postoperative outcomes were analyzed among 10 included studies. The protocol has been registered with PROSPERO (CRD42020221532). There were no statistical differences in the 30-day mortality (OR 0.57; 95% CI 0.29 to 1.14), 6-month mortality (OR 0.66; 95% CI 0.41 to 1.05), neurological dysfunction (OR 1.10; 95% CI 0.69 to 1.76), major infection (OR 0.68; 95% CI 0.36 to 1.28), and pump thrombus (OR 1.49; 95% CI 0.63 to 3.52) among the cohorts. Minimally invasive techniques were associated with lower incidences of major bleeding (OR 0.39; 95% CI 0.22 to 0.68), severe right heart failure (OR 0.43; 95% CI 0.23 to 0.81), and less blood-product utilization (SMD -0.44). Sensitivity analysis suggested that minimally invasive techniques were associated with a lower incidence of respiratory failure (OR 0.50; 95% CI 0.26 to 0.96) and shorter mechanical ventilation time (SMD -0.53). Subgroup analysis demonstrated that patients, implanted with a centrifugal pump by minimally invasive techniques, were associated with a shorter length of intensive care unit (ICU) stay (SMD -0.27) and hospital stay (SMD -0.42), and less blood-product utilization (SMD -0.26). In conclusion, minimally invasive techniques can reduce the risks of major bleeding, severe right heart failure, and blood-product utilization, as well as have positive impacts on reducing mechanical ventilation time and the risk of respiratory failure. Minimally invasive centrifugal pump implantation can reduce the length of ICU and hospital stay.
Keywords: Continuous-flow left ventricular assist device; Heart failure; Minimally invasive techniques; The conventional technique.
Publication
Journal: Clinical Child and Family Psychology Review
April/3/2021
Abstract
Theoretical conceptualizations of "aggressive-victims" portray them as more emotionally dysregulated and socially inept than adolescents who are either aggressive or victimized. The purpose of this systematic review is to synthesize the literature comparing the psychosocial adjustment of aggressor/victim subgroups (i.e., aggressive-victims, predominant-aggressors, predominant-victims, and youth with limited involvement) and determine whether empirical findings are consistent with theory, particularly regarding whether aggressive-victims possess unique and shared characteristics relative to those with other patterns of involvement in aggression. This review focuses on studies with early adolescent samples given the heightened vulnerability for aggression and victimization and the need for more effective interventions during this developmental period. A systematic search of three databases (PubMed, PsycINFO, Academic Search Complete) identified 25 studies, which varied in their sample characteristics, approach to defining subgroups, and findings regarding the unique and shared characteristics of aggressive-victims. I propose several guidelines for future research in this area and highlight several gaps in our existing knowledge. Implications for theory and prevention efforts are discussed.
Keywords: Adolescents; Aggression; Aggressive-victims; Peer victimization; Psychosocial adjustment; Systematic review.
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Journal: Eating and Weight Disorders
April/3/2021
Abstract
Purpose: Obstructive Sleep Apnea (OSA) is associated with the presence and severity of Non-Alcoholic Fatty Liver Disease (NAFLD). We aimed to investigate the relationship between the severity of OSA and NAFLD and to recognize a polysomnographic parameter correlated with progression of fibrosis, determined by a non-invasive score of liver fibrosis, FIBrosis-4 index (FIB-4), in patients affected by severe obesity and OSA.
Methods: We enrolled 334 patients (Body Mass Index, BMI 44.78 ± 8.99 kg/m2), divided into classes according to severity of OSA evaluated with Apnea Hypopnea Index (AHI): OSAS 0 or absent (17%), mild OSA (26%), moderate OSA (20%), severe OSAS (37%). We studied anthropometric, polysomnographic, biochemical data and FIB-4. A multiple regression model was computed to identify a polysomnographic independent predictor of FIB-4 among those parameters previously simple correlated with FIB-4.
Results: The severity of OSA was associated with a decrease in High-Density Lipoprotein-cholesterol (HDL) and an increase in BMI, triglycerides, Homeostasis model assessment insulin-resistance index (HOMA), transaminases and FIB-4. FIB-4 correlated with sex, age, BMI, AHI, mean percentage oxyhaemoglobin (meanSaO2%), number of desaturations, platelets, transaminases, HDL, triglycerides and HOMA. The only variables independently related to FIB-4 were sex, BMI, triglycerides and meanSpO2 (r = 0.47, AdjRsqr = 0.197).
Conclusion: MeanSpO2% represented an independent determinant for the worsening of FIB-4 in patients with severe obesity and OSA. Hence, it could hypothesize a clinical role of meanSaO2% in recognizing patients with obesity and OSA and higher risk of developing advanced fibrosis and, thus, to undergo further investigation.
Level iii: Evidence obtained from well-designed cohort analytic studies.
Keywords: FIB-4; Fibrosis; Non-Alcoholic Fatty Liver Disease; Obesity; Obstructive Sleep Apnea Syndrome.
Publication
Journal: Allergy: European Journal of Allergy and Clinical Immunology
April/3/2021
Abstract
Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID-19 vaccines are expected to have similar positive impacts on health across the globe. While serious allergic reactions to vaccines are rare, their underlying mechanisms and implications for clinical management should be considered to provide individuals with the safest care possible. In this review, we provide an overview of different types of allergic adverse reactions that can potentially occur aftervaccination and individual vaccine components capable of causing the allergic adverse reactions. We present the incidence of allergic adverse reactions during clinical studies and through post-authorization and post-marketing surveillance and provide plausible causes of these reactions based on potential allergenic components present in several common vaccines. Additionally, we review implications for individual diagnosis and management and vaccine manufacturing overall. Finally, we suggest areas for future research.
Keywords: COVID-19; SARS-CoV-2; allergy; anaphylaxis; vaccine.
Publication
Journal: New Phytologist
April/3/2021
Abstract
Endodormancy and the related chilling requirement synchronize the seasonal development of the trees from the boreal and temperate regions with the climatic conditions prevailing at their native growing sites. The endodormancy phenomenon has been known at the whole-plant level for a hundred years, and in the last couple of decades, insights into the physiological and molecular basis of endodormancy and its release have also been obtained. Intriguingly, recent studies have shown experimentally that subtropical trees also show endodormancy and a chilling requirement. Motivated by the climatic differences between the subtropical and the more northern zones, we address here the similarities and differences in endodormancy between trees growing in the subtropical zone and those growing in the more northern zones.
Keywords: chilling requirement; climatic adaptation; plasmodesmata; process-based modelling; subtropical trees.
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Journal: Journal of Oral Pathology and Medicine
April/3/2021
Abstract
Objective: The steady and continued increase of the Journal of Oral Pathology & Medicine's (JOPM) popularity, prompted a bibliometric analysis of the journal. The purpose was to assess the significance and effect of the published research articles in the Journal from 1972 - 2020, aiding the identification of landmark articles. We performed a bibliometric analysis using the top 100 cited papers in the Journal of Oral Pathology & Medicine.
Materials and methods: An extensive review of the Web of Science was undertaken. Standard information such as author details, affiliated institutions, publication year, and the country of origin was recorded.
Results: The top 100 cited articles in JOPM were assessed. The maximum and minimum number of citations in the top 100 articles was 1,459 and 95 respectively. A total of 16,790 citations were recorded for these 100 aricles. Authors were affiliated to 28 different countries, 17 research articles from the UK and 12 from the USA. Other countries furnished seven or fewer articles.
Conclusion: This bibliometric analysis provides a synopsis of research published in the journal over a 48 year period. Recent interest in the journal shows a healthy increase in submissions and profile.
Keywords: Oral pathology; bibliometrics; citation; impact factor; periodontal research; web of science.
Publication
Journal: ChemMedChem
April/3/2021
Abstract
CoVID-19 is a multi-symptomatic disease which has made a global impact due to its ability to spread rapidly, and its relatively high mortality rate. Beyond the heroic efforts to develop vaccines, which we will not discuss, the response of scientists and clinicians to this complex problem has reflected the need to detect CoVID-19 rapidly, to diagnose patients likely to show adverse symptoms, and to treat severe and critical CoVID-19. Here we aim to encapsulate these varied and sometimes conflicting approaches and the resulting data in terms of chemistry and biology. In the process we highlight emerging concepts, and potential future applications that may arise out of this immense effort.
Keywords: Chemical BiologyTherapeuticsDiganosticsDrugs mode of actionCoronaviruses.
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Journal: Journal of Cardiovascular Electrophysiology
April/3/2021
Publication
Journal: Oncologist
April/3/2021
Publication
Journal: Journal of Cancer Research and Clinical Oncology
April/3/2021
Abstract
Purpose: Human tau is a highly dynamic, multifunctional protein expressed in different isoforms and conformers, known to modulate microtubule turnover. Tau oligomers are considered pathologic forms of the protein able to initiate specific protein accumulation diseases, called tauopathies. In our study, we investigated the potential association between autophagy and tau oligomers accumulation and its role in the response of prostate cancer cells to docetaxel.
Methods: We evaluated in vitro the expression of tau oligomers in prostate cancer cell lines, PC3 and DU145, in presence of autophagy inhibitors and investigated the role of tau oligomers accumulation in resistance to docetaxel treatment.
Results: Tau protein was basally expressed in prostate cancer lines as several monomeric and oligomeric forms. The pharmacologic inhibition of autophagy induced in cancer cells the accumulation of tau protein, with a prevalent expression of oligomeric forms. Immunofluorescence analysis of untreated cells revealed that tau was visible mainly in dividing cells where it was localized on the mitotic spindle. Inhibition of autophagy determined an evident upregulation of tau signal in dividing cells and the presence of aberrant monoastral mitotic spindles. The accumulation of tau oligomers was associated with DNA DSB and increased cytotoxic effect by docetaxel.
Conclusions: Our data indicate that autophagy could exert a promoting role in cancer growth and during chemotherapy facilitating degradation of tau protein and thus blocking the antimitotic effect of accumulated tau oligomers. Thus, therapeutic strategies aimed at stimulating tau oligomers formation, such as autophagy inhibition, could be an effective adjuvant in cancer therapy.
Keywords: Autophagy; Cancer Therapy; Docetaxel; Mitosis; Prostate Cancer; Tau oligomer.
Publication
Journal: Internal and Emergency Medicine
April/3/2021
Abstract
Individuals belonging to ethnic minority groups are more susceptible to depression and comorbid hypertension than European host populations. Yet, data on how depression is related to hypertension in ethnic groups in Europe are lacking. Therefore, we studied the association between significant depressed mood (SDM) and hypertension prevalence, awareness, treatment, and control among ethnic groups. Data from the HELIUS study included 22,165 adults (aged 18-70) from six ethnic backgrounds in the Netherlands. Logistic regression analysis was used to explore the association between SDM and hypertension prevalence, awareness, treatment, and control with adjustment for age, sex, and for sensitivity analysis purposes also for anti-depressants. After adjustment for age and sex, Dutch with SDM had an increased odds of hypertension (OR 95% CI 1.67; 1.08-2.59). Among Turkish, SDM was associated with higher odds of hypertension awareness (2.09; 1.41-3.09), treatment (1.92; 1.27-2.90) and control (1.72; 1.04-2.83). Among Moroccans, SMD was associated with an increased odds of hypertension awareness (1.91; 1.14-3.21) but decreased odds of hypertension control (0.42; 0.20-0.89). Additional adjustment for anti-depressant medications did not change the results. There were no associations between SDM and hypertension, awareness, treatment and control in South-Asian Surinamese, African Surinamese and Ghanaian participants. The results underline significant differences in the association between SDM and hypertension awareness, treatment and control between ethnic groups. Our findings emphasize the necessity to further study ethnicity-related factors that may influence the association between SDM and hypertension to promote hypertension control especially, among Moroccans with SDM.
Keywords: Depression; Ethnic groups; HELIUS study; Hypertension; Significant depressed mood; The Netherlands.
Publication
Journal: Probiotics and Antimicrobial Proteins
April/3/2021
Abstract
Within the food-producing sectors, aquaculture is the one that has developed the greatest growth in recent decades, currently representing almost 50% of the world's edible fish. The diseases can affect the final production in intensive aquaculture; in seabass, aquaculture vibriosis is one of the most important diseases producing huge economical losses in this industry. The usual methodology to solve the problems associated with the bacterial pathology has been the use of antibiotics, with known environmental consequences. This is why probiotic bacteria are proposed as an alternative fight against pathogenic bacteria. The aim of this study was to analyse a strain of Bacillus velezensis D-18 isolated from a wastewater sample collected from a fish farm, for use as probiotics in aquaculture. The strain was evaluated in vitro through various mechanisms of selection, obtaining as results for growth inhibition by co-culture a reduction of 30%; B. velezensis D-18 was able to survive at 1.5-h exposure to 10% seabass bile, and at pH 4, its survival is 5% and reducing by 60% the adhesion capacity of V. anguillarum 507 to the mucus of seabass and in vivo by performing a challenge. Therefore, in conclusion, we consider B. velezensis D-18 isolate from wastewater samples collected from the farms as a good candidate probiotic in the prevention of the infection by Vibrio anguillarum 507 in European seabass after in vitro and biosafety assays.
Keywords: Bacillus velezensis D-18; Probiotic; Seabass; Survival; Vibriosis.
Publication
Journal: Acta Obstetricia et Gynecologica Scandinavica
April/3/2021
Abstract
Introduction: It has been suggested that women with obesity have increased risk of developing placenta accreta spectrum (PAS). It is unclear if this is independent of the increased risk of cesarean delivery seen with obesity itself. The aim of this study was to explore the association between maternal obesity and PAS, particularly severe PAS (percreta).
Material and methods: This is a cohort study based on cases recorded in the International Society for Placenta Accreta Spectrum (IS-PAS) database between April 2008 and May 2019. Multivariable logistic regression was used to explore the effect of maternal obesity on severity of PAS; this model was adjusted for other known risk factors including previous cesarean deliveries, maternal age, and placenta previa. The estimated rate of obesity in a hypothetical cohort with similar characteristics (previous cesarean delivery and same parity) was calculated and compared with the observed rate of obesity in the women of the PAS cohort (one sample test of proportions).
Results: Of the 386 included women with PAS, 227 (58.8%) had severe disease (percreta). In univariable analysis, maternal obesity initially appeared to be associated with increased odds of developing the most severe type of PAS, percreta (odds ratio [OR] 1.87; 95% CI 1.14-3.09); however, this association was lost after adjustment for other risk factors including previous cesarean delivery (OR 1.44; 95% CI 0.85-2.44). There was no difference in the observed rate of obesity and the rate estimated based on the risk of cesarean delivery from obesity alone (31.3% vs 36.8%, respectively; P = .07).
Conclusions: Obesity does not seem to be an independent risk factor for PAS or severity for PAS. These findings are relevant for clinicians to provide accurate counseling to women with obesity regarding increased risks related to pregnancy.
Keywords: abnormally invasive placenta; body mass index; obesity; placenta accreta spectrum; pregnancy.
Publication
Journal: Tropical Animal Health and Production
April/3/2021
Abstract
The aim of study was to compare the influence of chitosan sources (commercial chitosan vs chitosan extract) on rumen fermentation, methane (CH4) emission, and milk production in tropical lactating dairy cows. Six lactating Holstein-Friesian crossbreeds (410 ± 5 kg, 120 ± 21 day-in-milk) were arranged in a 3 × 3 replicated Latin square design. In addition to control, a 2% chitosan extract supplement and a 2% commercial chitosan supplement of dry matter intake were the treatments. The results denoted that no significant differences on daily dry matter, nutrients, or estimated energy intake were noted when cows received different sources of chitosan. Nutrient digestibility was not influenced differently by extraction-based or commercial chitosan supplements. The pH, temperature, ammonia nitrogen, blood urea, and microbial count were similar among treatments. The different sources of chitosan supplements did not change the totals of volatile fatty acids, acetate, and butyrate; in contrast, different chitosan sources influenced (P<0.05) propionate content. The ruminal acetate to propionate ratio was markedly (P<0.05) reduced with chitosan supplement, but no change appeared between sources of chitosan. At 4 h after feeding, the methane estimation significantly decreased with the addition of chitosan supplementation (P<0.05) compared to the control group. The purine derivatives and microbial protein synthesis were not altered by the treatments. No significant differences existed on milk yield, milk composition, or milk urea nitrogen when cows received different sources of chitosan (P>0.05). In summary, supplementing extracted chitosan showed more potential than did the commercial chitosan for enhancing economic efficiency and recycling shrimp residues, therefore, reducing environmental waste.
Keywords: Chitosan; Microbial synthesis; Milk composition; Purine derivatives; Volatile fatty acids.
Publication
Journal: Pain Practice
April/3/2021
Abstract
Purpose: The purpose of the study was to investigate factors associated with early discontinuation of low-dose ketamine infusions due to adverse drug events (ADEs).
Methods: A retrospective, matched case-control study of surgical patients who received low-dose ketamine infusions for postoperative pain over 6 years was conducted. Forty-seven study patients, who required early discontinuation of their infusion due to ADEs, were included and matched 1:1 with 47 controls, who did not experience ADEs, for a total of 94 patients. The two groups were compared based on surgery type, ASA classification, administration of specific perioperative anxiolytic, anesthetic, and analgesic medications, and use of regional anesthesia.
Results: Of the study patients, 44.7% underwent spine procedures (vs 34% of controls), 27.6% underwent abdominal procedures (vs 8.5% of controls), 19.2% underwent orthopedic procedures (vs 46.8% of controls), and 8.5% underwent thoracic procedures (vs 6.4% of controls). There were no statistically significant differences in ASA classification, preoperative gabapentinoid and antidepressant use, average ketamine infusion dose, or postoperative use of peripheral nerve catheters, NSAIDs, acetaminophen, muscle relaxants and non-benzodiazepine sleep aides. Study patients had higher rates of intraoperative volatile anesthetic use (78.7% vs 57.7%, p=0.03) and more postoperative opioid PCA use (53.2% vs 29.8%, p=0.02) than controls. Control patients had higher rates of preoperative opioid use (76.7% vs 53.2%, p=0.02) and premedication with midazolam (89.4% vs 70.2%, p=0.02) than study patients.
Conclusion: Patients who required discontinuation of their low-dose ketamine infusion due to ADEs were more likely to be opioid naïve, received less preoperative benzodiazepines, and had greater postoperative opioid PCA requirements. Control patients, on the other hand, had higher rates of preoperative opioid use and experienced fewer ADEs despite greater total ketamine doses.
Keywords: acute pain; adverse drug-event; ketamine; postoperative pain.
Publication
Journal: Oral Diseases
April/3/2021
Abstract
Objectives: Signals from inflamed tooth pulp activate thalamic neurons to evoke central sensitization. We aimed to gain insights into the mechanisms mediating the early phase of pulpal inflammation-induced thalamic neural and glial activation.
Materials and methods: Pulpal inflammation was induced via the application of mustard oil (MO) to the upper first molar of Wistar rats with or without local anesthesia (LA). After 0.5, 1, 2, and 24 hours, contralateral thalami were subjected to microarrays, a real-time polymerase chain reaction and immunohistochemistry to identify differentially expressed genes and assess potassium voltage-gated channel subfamily A member 1 (Kv1.1)-expressing axons and glial fibrillary acidic protein (GFAP)-expressing astrocytes.
Results: The Kv1.1 gene (Kcna1) was down-regulated and the density of Kv1.1-expressing axons decreased in non-anesthetized rats, but not in anesthetized rats 1 hour after the MO treatment. The density of GFAP-expressing astrocytes increased in both groups until 24 hours after the MO treatment, with a greater increase being observed in the MO+saline group than in the MO+LA group.
Conclusions: MO induced the transient down-regulation of Kcna1, transiently reduced the density of Kv1.1-expressing axons, and increased astrocytes in thalami within 1 hour of pulpal application. These results suggest central sensitization represented by neuronal hyperexcitability and astrocyte activation.
Keywords: central sensitization; potassium voltage-gated channel subfamily A member 1; pulp inflammation; thalamus.
Publication
Journal: Journal of Personality
April/3/2021
Abstract
Introduction: Extraversion and conscientiousness are well-studied personality traits associated with reward processing and goal prioritization, respectively, and bear on individual differences in financial risk-taking. Using unique large datasets, we investigated the link between these traits and male online gamblers' actual betting participation and intensity.
Methods: We combined datasets containing online horse betting data (during 2015-2016) from the Finnish monopoly betting company; administrative registry data from Statistics Finland; and personality trait measures from the Finnish Defence Forces corresponding to extraversion and conscientiousness as defined in the five-factor model. We modelled associations between these traits and betting participation (n=471,968) and intensity (n=11,217) among male horse bettors (age=36-53).
Results: Controlling for demographics and IQ, individuals scoring high on conscientiousness (or extraversion) were less (or more) likely to bet, and less (or more) intensive bettors - even when personality was measured 16-34 years before betting occurred. One SD personality score increase represented an annual decrease (conscientiousness) or increase (extraversion) of €570-754 in spending.
Conclusion: Extraversion and conscientiousness are implicated in real-life financial behavior with tangible consequences for individuals. These effects are stronger than for many known demographic variables used in gambling studies, and persist up to 34 years after personality has been measured.
Keywords: betting intensity; horse race betting; male; online gambling; personality.
Publication
Journal: Medical Journal of Australia
April/3/2021
Abstract
Keywords: COVID-19; Child health; Infectious diseases; Parenting; Respiratory tract infections.
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Journal: Journal of Endocrinological Investigation
April/3/2021
Abstract
Purpose: Symptoms of hypogonadism are often reported by subjects with normal serum testosterone (T) levels. We aimed to assess the association between clinical symptoms in andrological outpatients and sex steroids levels.
Methods: This is a retrospective cross-sectional cohort study in an Academic clinic and research unit. International Index of Erectile Function (IIEF, EF domain) and Aging Males Symptoms scale (AMS) questionnaires were completed by 635 and 574 men, respectively (mean age: 47.3 ± 13.9 and 47.4 ± 13.8 years, p = 0.829), free of interfering medications with complaints possibly related to hypogonadism.
Results: Serum total/free T as well as dihydro-T (DHT) was associated with IIEF-EF and AMS scores in the overall population using univariate analyses. Multivariate approaches revealed DHT concentrations in subjects with normal T levels (n = 416, Total T > 12 nmol/L) to be significant predictors of AMS scores. A 0.1 nmol/l serum DHT increase within the eugonadal range was associated with a 4.67% decrease in odds of having worse symptoms (p = 0.011). In men with biochemical hypogonadism (Total T < 12 nmol/L), total and free T rather than DHT were associated with AMS results. This association was not found for IIEF-EF scores. Indirect effects of age and BMI were seen for relations with hormone concentrations but not questionnaire scores.
Conclusion: DHT can be associated with symptoms of hypogonadism in biochemically eugonadal men. Serum DHT measurement might be helpful once the diagnosis of hypogonadism has been ruled out but should not be routinely included in the primary diagnostic process.
Keywords: Aging Males Symptoms scale; Dihydrotestosterone; Erectile dysfunction; International Index of Erectile Function; Male hypogonadism; Testosterone.
Publication
Journal: Acta Neurochirurgica
April/3/2021
Abstract
Background: Hemangioblastomas (HGBs) are highly vascular benign tumors, commonly located in the posterior fossa, and 80% of them are sporadic. Patients usually present with features of raised intracranial pressure and cerebellar symptoms. HGB can be classified as either mostly cystic or solids. Although the solid component is highly vascularized, aneurysm or hemorrhagic presentation is rarely described, having catastrophic results.
Methods: We identified 32 consecutive patients with posterior fossa HBG who underwent surgery from 2008 through 2020 at our medical center. Tumors were classified as predominantly cystic or solid according to radiological features. Resection was defined as gross total (GTR) or subtotal (STR).
Results: During the study period, 32 posterior fossa HGBs were resected. There were 26 cerebellar lesions and 4 medullar lesions, and in 2 patients, both structures were affected. Predominant cystic tumors were seen in 15 patients and solids in 17. Preoperative digital subtraction angiography (DSA) was performed in 8 patients with solid tumors, and 4 showed tumor-related aneurysms. Embolization of the tumors was performed in 6 patients, including the four tumor-related aneurysms. GTR was achieved in 29 tumors (91%), and subtotal resection in 3 (9%). Three patients had postoperative lower cranial nerve palsy. Functional status was stable in 5 patients (16%), improved in 24 (75%), and 3 patients (9%) deteriorated. One patient died 2 months after the surgery. Two tumors recurred and underwent a second surgery achieving GTR. The mean follow-up was 42.7 months (SD ± 51.0 months).
Conclusions: Predominant cystic HGB is usually easily treated as the surgery is straightforward. Those with a solid predominance present a more complex challenge sharing features similar to arteriovenous malformations. Given the important vascular association of solid predominance HGB with these added risk factors, the preoperative assessment should include DSA, as in arteriovenous malformations, and endovascular intervention should be considered before surgery.
Keywords: Aneurysm; Embolization; Hemangioblastoma; Subarachnoid hemorrhage; Von Hippel Lindau disease.
Publication
Journal: Aging clinical and experimental research
April/3/2021
Abstract
Background/objective: Partnerships between healthcare providers and researchers may accelerate the translation of interventions into widespread practice by testing them under real-world conditions, but depend on provider's willingness to engage with researchers and ability to fully implement an intervention.
Aim: To understand nursing home leader's motivations for participating in a research study and perceptions of the process and value.
Methods: After a feasibility study of tuned lighting in a nursing home, we conducted semi-structured telephone interviews with six facility leaders. Interviews were audio-recorded, transcribed, and independently coded by four investigators.
Results: Three themes emerged: (1) The importance of the nursing home's culture and context: the facility had stable leadership, clear processes for prioritizing and implementing new initiatives, and an established interest in the study's topic. (2) The importance of leader's belief in the value of the intervention: leaders perceived research generally and the intervention specifically as positively impacting their facility and residents. (3) The importance of ongoing collaboration and flexibility throughout the study period: leaders served as champions to catalyze the project and overcome implementation barriers.
Conclusion: Nursing home leader's perspectives about their participation in a feasibility study underscore the importance of establishing strong researcher-provider partnerships, understanding the environment in which the intervention will be implemented, and employing pragmatic methods that allow for flexibility in response to real-world implementation barriers. We recommend eliciting qualitative information to understand the environment in which an intervention will be implemented and to engage opinion leaders who can inform the protocol and champion its success.
Keywords: Embedded research; Nursing home; Pragmatic research; Qualitative; Stakeholder engagement.
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Journal: Acta Reumatol Port
April/3/2021
Abstract
Objective: To investigate the relationship between body mass index (BMI) and disease activity in patients with Juvenile Idiopathic Arthritis (JIA).
Methods: Patients with JIA, aged ≤18 years, registered at the Rheumatic Diseases Portuguese Register (Reuma.pt) in Portugal and Brazil were included. Age- and sex-specific BMI percentiles were calculated based on WHO growth standard charts and categorized into underweight (P <3), normal weight (3≤P≤85), overweight (85 <P ≤97) and obesity (P >97). Disease activity was assessed by Juvenile Arthritis Disease Activity Score (JADAS-27). Uni- and multivariate analyses were performed.
Results: A total of 275 patients were included. The prevalence of underweight, normal weight, overweight and obesity was 6.9%, 67.3%, 15.3% and 10.5%, respectively. Underweight patients had significantly higher number of active joints (p <0.001), patient's/parent's global assessment of disease activity (PGA) (p=0.020), physician's global assessment of disease activity (PhGA) (p <0.001), erythrocyte sedimentation rate (ESR) (p=0.032) and overall higher JADAS-27 (p <0.001), compared to patients with normal weight, overweight and obesity. In the multivariate regression, underweight persisted significantly associated with higher disease activity, compared to normal weight (B=-9.430, p <0.001), overweight (B=-9.295, p=0.001) and obesity (B=-9.120, p=0.001), when adjusted for age, gender, country, ethnicity, JIA category and therapies used. The diagnosis of RF- (B=3.653, p=0.006) or RF+ polyarticular JIA (B=5.287, p=0.024), the absence of DMARD therapy (B=5.542, p <0.001) and the use of oral GC (B=4.984, p=0.002) were also associated with higher JADAS-27.
Conclusion: We found an independent association between underweight and higher disease activity in patients with JIA. Further studies are needed to understand the underlying mechanisms of this association.
Publication
Journal: International Journal of Clinical Practice
April/3/2021
Abstract
Purpose: Urinary incontinence (UI) after radical prostatectomy (RP) is an early side effect after catheter removal. This systematic review and meta-analysis was conducted to compare different forms of non-invasive treatments for post-RP UI and to analyze whether the addition of biofeedback (BF) and/or pelvic floor muscle electric stimulation (PFES) to PF muscle exercise (PFME) alone can improve results in terms of continence recovery rate.
Materials and methods: A literature search was performed following the PRISMA guidelines. We performed a cumulative meta-analysis to explore the trend in the effect sizes across subgroups during a 12-mo follow-up.
Results: 26 articles were selected. At baseline after RP and catheter removal, mean pad weight varied extremely. At 1- and 3-mo intervals, mean difference in pad weight recovery from baseline was significantly higher using guided programs (BF, PFES or both) than using PFME alone (3-mo: PFME 111.09 g (95%CI 77.59-144.59), BF 213.81 g (95%CI -80.51-508-13), PFES 306.88 g (95%CI 158.11-455.66), BF+PFES 266.31 g (95%CI 22.69-302.93); p<0.01), while at 6- and 12-mo differences were similar (p>0.04). At 1- and 3-mo intervals, event rate (ER) of continence recovery was significantly higher using guided programs than using PFME alone (3-mo: PFME 0.40 (95%CI 0.30-0.49), BF 0.49 (95%CI 0.31-0.67), PFES 0.57 (95%CI 0.46-0.69), BF+PFES 0.75 (95%CI 0.60-0.91); p<0.01), while at 6- and 12-mo ERs were similar.
Conclusions: Regarding non-invasive treatment of UI secondary to RP, the addition of guided programs using BF or/and PFES demonstrated to improve continence recovery rate, particularly in the first 3-mo interval, when compared to the use of PFME alone.
Keywords: biofeedback; electric stimulation; pad test; pelvic floor muscle exercises; radical prostatectomy; urinary incontinence.
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