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Acta Clinica Croatica Aug 2023The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the...
The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the ankle after surgery treatment and the obtained values of manual muscle test (MMT) and range of motion (ROM) after rehabilitation, compared with the obtained values of FADI index and on that basis evaluate its possibility in assessing the functionality of the respondents after surgery for bimalleolar or trimalleolar fracture of the ankle. The sample included 60 subjects over the age of 18 who underwent surgery for osteosynthesis due to bimalleolar or trimalleolar fracture of the ankle. All subjects were treated with kinesitherapy as part of the postoperative rehabilitation program. The research was conducted from 2013 to 2018 at the Department of Orthopedics of Dr. Safet MujiÊ Cantonal Hospital in Mostar and Mostar University Clinical Hospital. A statistically significant correlation was found between FADI index values group and average percentage recovery MMT (p<0.05), as well as a statistically significant correlation between FADI score values group and mean percentage ROM value (p<0.05). A statistically significant association was found between mean percentage recovery ROM and MMT (p<0.05). The conducted research confirmed the working hypothesis of the conducted study. The effects of kinesitherapy after ankle surgery can be evaluated using the FADI index, as well as by manual muscle test and ROM measurement.
Topics: Humans; Adult; Middle Aged; Ankle Fractures; Ankle Injuries; Lower Extremity; Ankle Joint; Fracture Fixation, Internal; Treatment Outcome; Retrospective Studies
PubMed: 38549599
DOI: 10.20471/acc.2023.62.02.03 -
Medicine Oct 2023The aim of this study is to investigate the differences on admission troponin values among gender in hospital outcomes and in the 2-year follow-up period in coronavirus...
The aim of this study is to investigate the differences on admission troponin values among gender in hospital outcomes and in the 2-year follow-up period in coronavirus disease (COVID-19) patients. Data of 826 patients with moderate-to-severe COVID-19 disease were analyzed retrospectively. All patients had nasal and oropharyngeal swab samples taken according to Ministry of Health guidelines on admission. Patients were divided into female (n = 438) and male (n = 388) groups and were follow-up for 2 years. Clinical events such as need for intensive care unit, respiratory failure, need for inotropic initiation, acute renal failure, cardiac injury, and in-hospital mortality were also recorded. The cumulative endpoints were determined as all-cause mortality, re-hospitalization, and stroke during the 2-year follow-up period. Also, factors affecting the cumulative endpoints were investigated. In clinical events and cumulative endpoints, the differences of troponin values between the gender were investigated and the factors causing cardiac injury were determined separately in men and women. Mean age (59.43 ± 19.15 vs 58.14 ± 16.66) and comorbidities were significantly higher in the female group. There were no differences between genders in terms of clinical events except respiratory failure, which was more frequent in the male group (P = .016). In-hospital survivor rate in the female group was 16 ± 2.5 days (95% confidence interval: 11.08-20.91), in the male group was 14 ± 0.92 days (95% confidence interval: 12.18-15.81) P = .008, while there were no differences between groups among in-hospital morality rates (P = .208). During the 2-year follow-up period cumulative endpoints were more in the male group (P < .05). Troponin value in female ≥ 93 pg/mL, in male ≥ 28 pg/mL was related with cardiac injury. All clinical events occur at lower troponin values in the male group. In both groups, independent risk factors for in-hospital mortality were troponin and the existence of fragmented QRS; for cumulative endpoints were respiratory failure, cardiac injury, and age. We observed that in COVID-19 disease, troponin value differs by gender. A lesser increase in troponin levels in men was indicative of cardiac injury. Even slight increases in troponin levels in men should alert clinicians for cardiac injury and other clinical events.
Topics: Humans; Female; Male; Troponin; COVID-19; Retrospective Studies; SARS-CoV-2; Respiratory Insufficiency
PubMed: 37904399
DOI: 10.1097/MD.0000000000035553 -
Journal of Orofacial Orthopedics =... Oct 2023This in vitro study was conducted to compare the discoloration of a flowable self-adhesive composite, a highly filled composite adhesive, and a liquid polish applied...
PURPOSE
This in vitro study was conducted to compare the discoloration of a flowable self-adhesive composite, a highly filled composite adhesive, and a liquid polish applied highly filled composite adhesive for bonded lingual retainers.
METHODS
Thirty composite discs were fabricated and divided into three groups: group 1, flowable self-adhesive (GC Ortho Connect™ Flow [GCO], GC Orthodontics, Tokyo, Japan); group 2, highly filled composite adhesive (Transbond™ LR [TLR], 3M Unitek, Monrovia, CA, USA); and group 3, highly filled composite adhesive with liquid polish (TLR and BisCover LV™ [TLRB], BISCO Inc, Schaumburg, IL, USA). L*a*b* values were measured by spectrophotometer prior to (T0) and following (T1) immersion in coffee. T1 - T0 differences were calculated as ∆L*, ∆a*, ∆b*, and ∆E*ab values. The Shapiro-Wilk test was performed to determine whether the data were normally distributed. The values that did not fit the normal distribution were evaluated with the Kruskal-Wallis one-way analysis of variance (ANOVA), and Dunn's test was used for multiple comparisons. The level of significance was p < 0.05.
RESULTS
The difference between the TLR and TLRB groups was statistically significant for ∆E*ab (P = 0.007). ∆E*ab value of TLR group was greater than ∆E*ab value of TLRB group. The differences between the GCO and TLR groups (p = 0.001) and the TLR and TLRB groups (p = 0.010) were statistically significant for ∆a*. ∆a* values of GCO and TLRB groups were greater than ∆a* value of TLR group. The difference between the TLR and TLRB groups was statistically significant (p = 0.003) for ∆b*. ∆b* value of TLR group was greater than ∆b* value of TLRB group.
CONCLUSIONS
Using a Transbond LR polished with BisCover LV or only GC Ortho Connect Flow for lingual retainer bonding reduces coffee-induced discoloration.
Topics: Resin Cements; Dental Cements; Dental Bonding; Coffee; Composite Resins; Materials Testing
PubMed: 36867217
DOI: 10.1007/s00056-023-00453-7 -
Cureus Dec 2023Introduction We introduced a novel numerical index known as posterior protrusion measures (PPM), derived from lateral plain radiograph images, which effectively serves...
Introduction We introduced a novel numerical index known as posterior protrusion measures (PPM), derived from lateral plain radiograph images, which effectively serves to distinguish stable from unstable pertrochanteric fractures. The present study aims to scrutinize PPM values among two classified fracture patterns, stable and unstable, within the three-dimensional (3D) CT classification system, establishing a numeric threshold for PPM to differentiate between these groups; explore the potential relationship between the PPM index and unclassified categories; investigate how groups divided by the PPM threshold value can predict fracture stability based on 3D CT. Materials and methods In this study, three observers were tasked with measuring PPM on a single occasion. The chi-square test assessed the association between each demographic parameter on a categorical scale and stable/unstable groups. Continuous variables were also subject to examination. Receiver operating characteristic (ROC) analysis was employed to determine optimal cut-off points of PPM for predicting the presence of stable versus unstable groups. Additionally, the chi-square test examined the linear relation between separated groups based on the defined threshold PPM value and the stable/unstable groups. Results A total of 106 pertrochanteric fractures were identified using CT scan images and plain radiographs in the 3D CT classification system, revealing the stable group of 35 patients and the unstable group of 71 patients. The PPM values for stable/unstable fractures were, on average (± standard deviation), 0.34±0.25/0.50±0.29 for observer 1, 0.31±0.23/0.57±0.31 for observer 2, and 0.41±0.29/0.57±0.26 for observer 3, respectively (p<0.01). We established 0.3 as the cut-off value for PPM. The average PPM value among three observers represented each patient to assess fracture stability. The group with PPM <0.3 included 27 patients (16 stable and 11 unstable), and the group with PPM ≥0.3 group comprised 79 patients (19 stable and 60 unstable; p<0.005). Conclusion The present study revealed a significant difference in PPM values among stable and unstable 3D CT classification groups. Additionally, a threshold PPM value of 0.3 suggests a pivotal point for differentiating fracture stability. This innovative methodology makes a substantial contribution to clinical endeavors, potentially circumventing the necessity for 3D CT scanning.
PubMed: 38292954
DOI: 10.7759/cureus.51363 -
Cardiovascular Intervention and... Apr 2024Patients with severe aortic stenosis often experience pulmonary congestion due to incremental afterload. The trajectory of pulmonary fluid volume during transcatheter...
Patients with severe aortic stenosis often experience pulmonary congestion due to incremental afterload. The trajectory of pulmonary fluid volume during transcatheter aortic valve replacement (TAVR) remains uncertain. Remote dielectric sensing (ReDS) is a recently introduced device for non-invasive quantification of lung fluid volume without expert techniques. We evaluated the trajectory of ReDS values during TAVR and its prognostic implications. Patients with severe aortic stenosis who underwent ReDS measurements upon admission and at the index discharge after TAVR between 2021 and 2022 were eligible. They were followed up until August 2023. The primary focus was on the trajectory of ReDS values during TAVR, with secondary consideration given to its impact on the composite of death or all-cause readmission after TAVR. A total of 57 patients were included. Median age was 84 years and 24 were male. ReDS value remained unchanged after TAVR, changing from 27% (IQR 24%, 29%) to 26% (IQR 24%, 30%) (p = 0.65). ReDS value did not decrease in 23 (40%) patients. The presence of coronary artery disease and atrial fibrillation were associated with no decrease in ReDS value. This lack of decrease in ReDS value was linked to death or all-cause readmission after TAVR, with an age-adjusted hazard ratio of 3.40 (95% confidence interval 1.01-11.4, p = 0.048). The degree of lung fluid amount did not decrease in 40% of TAVR candidates during the procedure. The lack of decrease in lung fluid amount was associated with mortality and morbidity after TAVR. The next concern is to establish therapeutic strategy for patients with residual pulmonary congestion after TAVR.
Topics: Humans; Male; Aged, 80 and over; Female; Transcatheter Aortic Valve Replacement; Aortic Valve Stenosis; Treatment Outcome; Risk Factors; Lung; Aortic Valve; Severity of Illness Index
PubMed: 38038803
DOI: 10.1007/s12928-023-00971-6 -
Academic Radiology Sep 2023We aimed to assess the value of dual-energy computed tomography angiography (DE-CTA) derived parameters as a quantitative biomarker of thrombus composition in acute...
OBJECTIVES
We aimed to assess the value of dual-energy computed tomography angiography (DE-CTA) derived parameters as a quantitative biomarker of thrombus composition in acute ischemic stroke (AIS).
METHODS
AIS patients who underwent DE-CTA before thrombectomy between August 2016 and September 2022 were included in this study. We assessed the relative proportion of red blood cells (RBCs) and the fibrin/platelet ratio (F/P) of the retrieved clots and categorized the clots as RBC-dominant (RBCs > F/P) or F/P-dominant (F/P > RBCs). The thrombus based parameters were measured on polyenergetic images (PEI), virtual monoenergetic (VM), virtual non-contrast (VNC), iodine concentration (IC), and effective atomic number (Z) images respectively, and the slope of the spectral Hounsfield unit curve (λHU) was calculated. These parameters were compared in the DE-CTA images of RBC- and F/P-dominant thrombi. The diagnostic performance of the parameters was analyzed using the ROC curve. Correlations between thrombus composition and DE-CTA-derived parameters were assessed.
RESULTS
The retrieved clots in 54 of 88 patients (61.36%) were RBC-dominant. The RBC-dominant thrombi showed significantly higher VNC values and lower IC, λHU, and Z values than the F/P-dominant thrombi (p < 0.05). The CT density measured on IC images showed the largest AUC value (AUC, 0.94; sensitivity, 77.78%; specificity, 100.00%). The Spearman rank-order correlation coefficient values showed that CT density measured on IC images of the thrombus showed the strongest association with the proportion of RBCs (r = -0.64, p < 0.001) and F/P (r = 0.65, p < 0.001).
CONCLUSIONS
DE-CTA-derived parameters, especially the CT density measured on IC images, could be associated with thrombus composition and allow for personalized thrombectomy strategies.
Topics: Humans; Computed Tomography Angiography; Ischemic Stroke; Thrombectomy; Thrombosis
PubMed: 36587997
DOI: 10.1016/j.acra.2022.12.023 -
Quantitative Imaging in Medicine and... Sep 2023In our previous study, we developed a combined diagnostic model based on time-intensity curve (TIC) types and radiomics signature on contrast-enhanced magnetic resonance...
Role of combined clinical-radiomics model based on contrast-enhanced MRI in predicting the malignancy of breast non-mass enhancements without an additional diffusion-weighted imaging sequence.
BACKGROUND
In our previous study, we developed a combined diagnostic model based on time-intensity curve (TIC) types and radiomics signature on contrast-enhanced magnetic resonance imaging (CE-MRI) for non-mass enhancement (NME). The model had a high diagnostic ability for differentiation without the additional diffusion-weighted imaging (DWI) sequence. In this study, we aimed to compare the diagnostic performance of the combined clinical-radiomics model based on CE-MRI and DWI in discriminating Breast Imaging-Reporting and Data System (BI-RADS) 4 NME breast lesions, ductal carcinoma in situ (DCIS), and invasive carcinoma.
METHODS
This retrospective study enrolled 364 NME lesions (343 patients). Of these, 183 malignant and 84 benign breast lesions classified as BI-RADS 4 NMEs by the initial diagnosis were reclassified based on the combined clinical-radiomics model and DWI, respectively. The nomogram score (NS) values for malignancy risk derived from the combined clinical-radiomics model and the minimal apparent diffusion coefficient (ADC) values from DWI were calculated and compared. The percentage of false positives were estimated in comparison with the original classification. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic value of the NS and minimal ADC values in distinguishing benign and malignant lesions, DCIS, and invasive breast carcinoma. An ablation experiment was used to test the value of the additional DWI sequence.
RESULTS
The diagnostic value of the NS values [area under curve (AUC) =0.843; 95% CI: 0.789-0.896] for discriminating the 267 NME breast lesions categorized as BI-RADS 4 was significantly higher than the minimal ADC values (AUC =0.662; 95% CI: 0.590-0.735). The NS values showed higher sensitivity, specificity, and accuracy compared with the minimal ADC values (sensitivity: 80.3% 65.6%; specificity: 79.8% 65.5%; accuracy: 80.1% 65.5%). The NS values and minimal ADC values did not achieve high diagnostic accuracy in discriminating between DCIS and invasive cancer. However, the diagnostic performance of the combined NS-ADC model (AUC =0.731; 95% CI: 0.655-0.806) was higher than that of the NS values alone (P=0.008) and comparable to that of the minimal ADC values (P=0.440).
CONCLUSIONS
The combined clinical-radiomics model based on CE-MRI could improve the diagnostic performance in discriminating the BI-RADS 4 NME lesions without an additional DWI sequence. However, DWI may improve the diagnostic performance in discriminating DCIS from invasive cancer.
PubMed: 37711822
DOI: 10.21037/qims-22-1199 -
Oncology Letters Oct 2023The prognosis of a gastric cancer (GC) diagnosis is poor due to the current lack of effective early diagnostic methods. Extracellular vesicle (EV) biomarkers have...
The prognosis of a gastric cancer (GC) diagnosis is poor due to the current lack of effective early diagnostic methods. Extracellular vesicle (EV) biomarkers have previously demonstrated strong diagnostic efficiency for certain types of cancer, including pancreatic and lung cancer. The present review aimed to summarize the diagnostic value of circulating EV biomarkers for early stage GC. The PubMed, Medline and Web of Science databases were searched from May 1983 to September 18, 2022. All studies that reported the diagnostic performance of EV biomarkers for GC were included for analysis. Overall, 27 studies were selected containing 2,831 patients with GC and 2,117 controls. A total of 58 EV RNAs were reported in 26 studies, including 39 microRNAs (miRNAs), 10 long non-coding RNAs (lncRNAs), five circular RNAs, three PIWI-interacting RNAs and one mRNA, in addition to one protein in the remaining study. Meta-analysis of the aforementioned studies demonstrated that the pooled sensitivity, specificity and AUC value of the total RNAs were 84, 67% and 0.822, respectively. The diagnostic values of miRNAs were consistent with the total RNA, as the pooled sensitivity, specificity and AUC value were 84, 67% and 0.808, respectively. The pooled sensitivity, specificity and AUC values of lncRNAs were 89, 69% and 0.872, respectively, markedly higher compared with that of miRNAs. A total of five studies reported the diagnostic performance of EV RNA panels for early stage GC and reported powerful diagnostic values with a pooled sensitivity, specificity and AUC value of 80, 77% and 0.879, respectively. Circulating EV RNAs could have the potential to be used in the future as effective, noninvasive biomarkers for early GC diagnosis. Further research in this field is necessary to translate these findings into clinical practice.
PubMed: 37664665
DOI: 10.3892/ol.2023.14009 -
Health Science Reports Sep 2023Ectopic pregnancy (EP) is a potentially life-threatening emergency. We investigate the predictive value of serum βHCG level and it's changes from the baseline to the...
BACKGROUND AND AIMS
Ectopic pregnancy (EP) is a potentially life-threatening emergency. We investigate the predictive value of serum βHCG level and it's changes from the baseline to the 4th and 7th days after single dose (SD) methotrexate (MTX) treatment in successful treatment of tubal EP. It is important for early diagnosis of EP.
METHODS
In this cross-sectional study, 690 women with tubal EP and under treatment with SD MTX were evaluated. Successful and failed groups were analyzed on the baseline, 4th and 7th days of MTX treatment. Data were analyzed using SPSS22 software. All values of less than 0/05 were considered satistically significant.
RESULTS
SD MTX treatment was successful in 584 (84.7%) patients. The mean baseline ßHCG value was 882.35 ± 430.76 in the successful group and 1083.99 ± 1080.25 in the failed group. There was a 19.53% decrease in ßHCG values between the baseline and 4th days in the successful group and a 12.94% increase in the failed group ( < 0.001). On days baseline, 4 and 7; receiver operating characteristic curve analysis's value was 504.5, 429, 279 for cut off; 58%, 73%, 81% for sensitivity and 51%, 52%, 55% for specificity, respectively.
CONCLUSION
A decrease in the ßHCG value and/or a cut-off decrease of 59.9% on the baseline, 4th day and 81.6% between the baseline and 7th days, can predict the successful treatment of tubal EP with SD MTX.
PubMed: 37680207
DOI: 10.1002/hsr2.1442 -
Environmental Science and Pollution... Jul 2023In this paper, the thermo-hydraulic performance of a solar air heater (SAH) duct roughened with discrete D-shaped ribs is numerically investigated using ANSYS Fluent...
In this paper, the thermo-hydraulic performance of a solar air heater (SAH) duct roughened with discrete D-shaped ribs is numerically investigated using ANSYS Fluent 2020 R. The numerical investigation is carried out at rib radius to transverse pitch ratio (r/P) from 0.1 to 0.35 and longitudinal pitch to rib radius ratio (P /r) from 4 to 10 under various operating conditions with Reynolds number (Re) varied from 10,200 to 20,200. The numerical results are validated with previous experimental results for the Nusselt number (Nu) values, and good agreement is found with mean absolute percentage error (MAPE) of 3.6%. Based on the results of the numerical investigation, it was found that the value of Nu and the friction factor (f) decreases with the increase of the value of P/r, while the ratio r/P is kept constant. From the overall analysis, it is concluded that the optimum results are obtained for r/P of 0.25 and P/r = 4, and the maximum thermo-hydraulic performance parameter is 1.12. Further correlations are developed for the value of Nu and f for the whole range of r/P as 0.10-0.35 and P/r as 4-10. According to the developed correlations, the values of Nu are within ± 2% of the results of CFD, while the values of f are within ± 2.7% of the results of CFD.
PubMed: 37407860
DOI: 10.1007/s11356-023-28247-9