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Otology & Neurotology : Official... Mar 2021Recent publications reported that patients with rheumatoid arthritis (RA) experience an increased risk of suffering sudden sensorineural hearing loss (SSNHL), however,...
OBJECTIVES
Recent publications reported that patients with rheumatoid arthritis (RA) experience an increased risk of suffering sudden sensorineural hearing loss (SSNHL), however, these cases are poorly understood. This study aims to explore the clinical presentations and hearing recovery of SSNHL patients with RA.
STUDY DESIGN
Retrospective study.
SETTING
Tertiary medical center.
PATIENTS
Forty-seven SSNHL patients with RA (RA group) and 431 SSNHL patients without RA (non-RA group) were recruited between April 2015 and June 2019.
INTERVENTIONS
In the non-RA group, all patients were administrated with oral steroids. In the RA group, 21 patients were treated with oral steroid (OS group) and 26 patients were administrated with intratympanic steroids plus oral steroids (IS+OS group).
MAIN OUTCOME MEASURES
We explored the clinical features and hearing recovery of SSNHL patients with RA in comparison with patients without RA, we also evaluated the therapeutic effect of combined steroids in SSNHL patients with RA.
RESULTS
RA group had higher initial hearing loss level (mean 68.5 dB), final hearing threshold (mean 52.3 dB), the rates of profound hearing loss (48.9%), and no recovery (48.9%) than non-RA group (mean 55.1 dB, mean 34.8 dB, 32.9 and 27.6%, all p < 0.05), however, had lower hearing gains (mean 16.1 dB) and the rate of partial recovery (12.8%) than non-RA group (mean 20.3 dB and 28.8%, all p < 0.05). Furthermore, IS+OS group had higher hearing gains (mean 21.1 dB) and lower rate of no recovery (30.8%) than in the OS group (mean 10.0 dB and 71.4%, all p < 0.05).
CONCLUSIONS
SSNHL patients with RA experienced severe hearing loss and had poor hearing prognosis. IS+OS provide better hearing recovery than OS for this population.
Topics: Arthritis, Rheumatoid; Glucocorticoids; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Prognosis; Retrospective Studies; Treatment Outcome
PubMed: 33021510
DOI: 10.1097/MAO.0000000000002962 -
Bulletin of the National Research Centre 2023The stay-at-home conditions due to the COVID-19 pandemic significantly alter the Malaysian lifestyle, and all Malaysians faced difficulties adopting the new lifestyle. A...
BACKGROUND
The stay-at-home conditions due to the COVID-19 pandemic significantly alter the Malaysian lifestyle, and all Malaysians faced difficulties adopting the new lifestyle. A hypothetico-deductive technique has been conducted in this study, to find out what kind of changes the COVID-19 has brought about in the behavior of Malaysians and how they are coping with the changing lifestyles. According to G* Power 3.1 sample size determination in Malaysia, the entire sample of 112 was sufficient to provide the value for the medium effect size for the computation of the F-tests and the findings were reliable (The Cronbach's alpha values were all above 0.70.). To calculate the mean of the lifestyle during COVID-19, the mean scores range between 1.00 and 5.00 marks indicating much reduced to much increased.
RESULTS
It seemed that the jobs traveling (mean 1.80) and outdoor sports time (mean = 1.94) were somewhat reduced. In contrast, indoor sports activities (mean = 3.01), online games (mean = 2.76), physical exercises (mean = 2.63), and the number of staycations (mean = 2.46) during the pandemic stayed the same. However, religious activities (mean = 3.73), body mass index (mean = 3.54), online shopping (mean = 3.90), sleeping time (mean = 3.43), amount of anxiety (mean = 3.38), amount of caffeine (mean = 3.15), medical consumption (mean = 3.10), watching movies (mean = 3.26), and watching drama series (mean = 3.37) during COVID-19 were somewhat increased. In addition, respondents' time spent on social media (mean = 4.27) and online meetings (mean = 4.37) during COVID-19 were much increased. We found no significant differences in the means of the dependent variables (lifestyle of COVID-19) among all demographic characteristics except age and employment status.
CONCLUSIONS
New behavioral changes bring new challenges. Malaysians should need to adopt some precautions to minimize the negative effect of new behavioral changes in post-COVID-19 life. The results will help policymakers to make the right decisions about improving the quality of life after COVID-19.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s42269-023-00979-1.
PubMed: 36624728
DOI: 10.1186/s42269-023-00979-1 -
Micron (Oxford, England : 1993) Nov 2022In this work, we have explored the factors which govern mean free path values obtained from off-axis electron holography measurements. Firstly, we explore the topic from...
In this work, we have explored the factors which govern mean free path values obtained from off-axis electron holography measurements. Firstly, we explore the topic from a theoretical perspective, and show that the mean amplitude reconstructed from off-axis holograms is due to the coherent portion of the direct, central object-transmitted beam only - it is not affected by the presence or absence of other scattered beams. Secondly, we present a detailed experimental study which compares mean free path values obtained from hologram sideband, centreband, EELS, and TEM measurements as a function of optical collection angle and energy-loss-filtering. These results confirm that the coherent portion of the direct beam defines the mean amplitude, and additionally show that the coherent portion corresponds to the conventional energy-filtered signal (with threshold 5 eV in this work). Finally, we present summary measurements from a selection of different materials, and compare the results against a simple electron scattering model. This study reinforces the claim that the mean amplitude is defined by the energy-filtered direct beam, and confirms that the contributions of elastic and inelastic scattering to the total mean free path are broadly in line with theoretical expectations for these different materials. These results in aggregate indicate that neither experimental collection angles nor enhanced sensitivity to low-loss phonon scattering affect the mean amplitude signal arising from off-axis holography reconstructions, nor the associated mean free path values which are derived from this mean amplitude.
PubMed: 36155105
DOI: 10.1016/j.micron.2022.103346 -
JNCI Cancer Spectrum Mar 2023Knowledge of treatment assignment may affect patient-reported outcomes (PROs), which is of concern in oncology, where open-label trials are common. This study measured...
BACKGROUND
Knowledge of treatment assignment may affect patient-reported outcomes (PROs), which is of concern in oncology, where open-label trials are common. This study measured the magnitude of open-label bias by comparing PROs for similar patient groups in oncology trials with different degrees of concealment.
METHODS
Individual patient data from ipilimumab arms of 2 melanoma and docetaxel arms of 2 non-small cell lung cancer (NSCLC) trials were adjusted for differences using propensity score weighting. Patients were aware of treatment assignment in CA184-022 and CheckMate 057 (open-label) but not in MDX010-20 and VITAL (blinded). Overall survival (OS) and mean changes from baseline to week 12 in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (melanoma) and Lung Cancer Symptom Scale (NSCLC) scores were compared between open-label and blinded groups.
RESULTS
After adjustment, baseline characteristics were balanced between blinded (melanoma, n = 125; NSCLC, n = 424) and open-label (melanoma, n = 69; NSCLC, n = 205) groups. Study discontinuation and PRO completion rates at week 12 and OS were similar. There was no clear direction in differences in change scores between groups. In the melanoma trials, role functioning (mean = -5.2, 95% confidence interval [CI] = -15.4 to 5.0), global health status (mean = -1.3, 95% CI = -8.7 to 6.1), and pain (mean = 6.2 , 95% CI = -1.8 to 14.2) favored the blinded, whereas emotional functioning (mean = 2.2, 95% CI = -5.8 to 10.2) and diarrhea (mean = -8.3, 95% CI = -17.3 to 0.7) favored the open-label group. In the NSCLC trials, changes in dyspnea (mean = 5.4, 95% CI = -0.7 to 11.5) favored the blinded and changes in appetite (mean = -1.2, 95% CI = -8.1 to 5.7) favored the open-label group. None were clinically or statistically significant.
CONCLUSIONS
This study adds to the growing evidence demonstrating that concerns regarding open-label bias should not prohibit the interpretation of large and meaningful treatment effects on PROs.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Melanoma; Patient Reported Outcome Measures; Quality of Life; Clinical Trials as Topic
PubMed: 36661326
DOI: 10.1093/jncics/pkad002 -
BMJ Open Ophthalmology 2020To validate the extrapolated norms or e-norms methodology in establishing a reference range for the biometric data used for intraocular lens power calculation.
OBJECTIVE
To validate the extrapolated norms or e-norms methodology in establishing a reference range for the biometric data used for intraocular lens power calculation.
METHODS AND ANALYSIS
All measurements were performed with an optical low-coherence reflectometer. A novel technique, the e-norms methodology, was used to determine the normative values of measurements.
RESULTS
Eyes (n=500) were measured to evaluate the axial length (AL), K readings (Ks), anterior chamber depth (ACD) and lens thickness (LT). Using the e-norms methodology, the normal AL ranged from 22.50 to 24.50 mm (mean=23.50 mm), with medium-long eyes between 24.51 and 24.99 mm and the long eyes measuring 25.00 mm and longer; the medium-short eyes ranged from 22.01 and 22.49 mm, with the short eyes measuring 22.00 mm and shorter. Normal values ranged from 2.50 to 3.50 mm for ACD (mean=3.00 mm), from 4.40 to 5.44 mm for LT (mean=4.92 mm), and from 42.50 to 44.82 dioptres for Ks (mean=43.66 dioptres).
CONCLUSION
Measurements of the biometric mean values compared favourably with published data. The e-norms methodology assisted in establishing a biometric reference range. Furthermore, it allowed us to cluster patients into groups based on AL differences.
PubMed: 33024826
DOI: 10.1136/bmjophth-2020-000500 -
Journal of Glaucoma Jul 2023The aim of our study was to evaluate the subclinical changes in the macula, retinal nerve fiber layer (RNFL), and choroidal thickness after coronavirus disease 2019...
PRCIS
The aim of our study was to evaluate the subclinical changes in the macula, retinal nerve fiber layer (RNFL), and choroidal thickness after coronavirus disease 2019 (COVID-19) infection using spectral domain optical coherence tomography.
METHODS
Our study was prospectively designed and involved 170 eyes of 85 patients. Patients with polymerase chain reaction (PCR)-positive COVID-19 infection were examined in the ophthalmology clinic before and after infection were included. All included patients had mild COVID-19 with no hospitalization and no need for intubation. Control ophthalmic examination was repeated at least 6 months after PCR positivity. Macular and choroidal thickness and RNFL parameters were compared before and at least 6 months after PCR-positive COVID-19 infection using optical coherence tomography.
RESULTS
When the mean macular thickness data were evaluated, a significant decrease was detected in the inner (mean difference, -3.37 µm; 95% CI: -6.09 to -0.65, P = 0.021) and outer (mean difference, -6.56 µm; 95% CI: -9.26 to -3.86, P < 0.001) temporal segments and the inner (mean difference, -3.39 µm; 95% CI: -5.46 to -1.32, P = 0.002) and outer (mean difference, -2.01 µm; 95% CI, -3.70 to -0.31, P = 0.018) su p erior segments in the post-COVID-19 measurements compared with pre-COVID-19 measurements. Similarly, on RNFL evaluation, some thinning was evident in the temporal superior (mean = 1.14 µm, P = 0.004) and temporal inferior (mean = 1.30 µm, P = 0.032) regions. All choroidal regions, including central, nasal 500 µm and 1500 µm and temporal 500 µm and 1500 µm, exhibited significant thinning ( P < 0.001).
CONCLUSION
At least 6 months after mild COVID-19 infection, significant thinning was seen in the temporal and superior quadrants of the macula, the temporal superior and temporal inferior regions of the RNFL, and all measured areas of choroidal regions.
Topics: Humans; Optic Disk; Retinal Ganglion Cells; Tomography, Optical Coherence; Nerve Fibers; COVID-19; Intraocular Pressure
PubMed: 36897648
DOI: 10.1097/IJG.0000000000002204 -
Journal of Morphology Mar 2020Mandibular mobility accompanying gape change in Northern and Antarctic minke whales was investigated by manipulating jaws of carcasses, recording jaw movements via...
Mandibular mobility accompanying gape change in Northern and Antarctic minke whales was investigated by manipulating jaws of carcasses, recording jaw movements via digital instruments (inclinometers, accelerometers, and goniometers), and examining osteological and soft tissue movements via computed tomography (CT)-scans. We investigated longitudinal (α) rotation of the mandible and mediolateral displacement at the symphysis (Ω ) and temporomandibular joint (Ω ) as the mouth opened (Δ). Results indicated three phases of jaw opening. In the first phase, as gape increased from zero to 8°, there was slight (<1°) α and Ω rotation. As gape increased between 20 and 30°, the mandibles rotated slightly laterally (Mean 3°), the posterior condyles were slightly medially displaced (Mean 4°), and the anterior ends at the symphysis were laterally displaced (Mean 3°). In the third phase of jaw opening, from 30° to full (≥90°) gape, these motions reversed: mandibles rotated medially (Mean 29°), condyles were laterally displaced (Mean 14°), and symphyseal ends were medially displaced (Mean 1°). Movements were observed during jaw manipulation and analyzed with CT-images that confirmed quantitative inclinometer/accelerometer data, including the unstable intermediate (Phase 2) position. Together these shifting movements maintain a constant distance for adductor muscles stretched between the skull's temporal fossa and mandible's coronoid process. Mandibular rotation enlarges the buccal cavity's volume as much as 36%, likely to improve prey capture in rorqual lunge feeding; it may strengthen and stabilize jaw opening or closure, perhaps via a simple locking or unlocking mechanism. Rotated lips may brace baleen racks during filtration. Mandibular movements may serve a proprioceptive mechanosensory function, perhaps via the symphyseal organ, to guide prey engulfment and water expulsion for filtration.
Topics: Animals; Feeding Behavior; Female; Humans; Jaw; Male; Minke Whale; Movement; Range of Motion, Articular; Rotation; Temporomandibular Joint; Tomography, X-Ray Computed
PubMed: 32003486
DOI: 10.1002/jmor.21107 -
Acta Ortopedica Mexicana 2021The aim of the study was to evaluate the outcomes and complications in patients with myelomeningocele who have undergone spinal fusion for neuromuscular scoliosis.
OBJECTIVE
The aim of the study was to evaluate the outcomes and complications in patients with myelomeningocele who have undergone spinal fusion for neuromuscular scoliosis.
MATERIAL AND METHODS
Retrospective study of 40 consecutive patients with myelomeningocele with neuromuscular scoliosis who underwent spinal arthrodesis, treated at our center between July 1991 and July 2028.
RESULTS
Mean follow up was 10 years. There were 19 male and 21 females. The average age at operation was 13 years. The mean preoperative scoliosis curve was 90o. At last follow up, the mean scoliosis curve was 43o. Mean correction of 52%. The average of pelvic obliquity was 19o. At last follow up de obliquity was 9o. Mean correction of 53%. The mean preoperative coronal balance was 28.4 mm. At the last follow up it was 17 mm. Mean correction of 40%. The mean preoperative kyphosis was 50o. At the last follow up it was 41o. Mean correction of 18%. The mean preoperative sagittal balance was 63.3 mm. At the last follow up it was 38.3 mm. Mean correction of 40%. There were 13 complications (32.5%), with infection being the most frequently observed complication.
CONCLUSIONS
The goals of the spinal surgery in patients with MMC are to obtain a stable, balanced and painless spinal fusion. Although the surgical treatment of these patients remains difficult, it is associated with high complication rate.
Topics: Female; Humans; Male; Meningomyelocele; Neuromuscular Diseases; Retrospective Studies; Scoliosis; Spinal Fusion; Treatment Outcome
PubMed: 35451247
DOI: No ID Found -
Pathology, Research and Practice Aug 2020Endometrial ablation for abnormal uterine bleeding is used as a less invasive alternative to hysterectomy, however, in cases of treatment failure hysterectomy may be...
BACKGROUND
Endometrial ablation for abnormal uterine bleeding is used as a less invasive alternative to hysterectomy, however, in cases of treatment failure hysterectomy may be finally performed. The histologic changes in these post-treatment uteri are not well-described.
OBJECTIVE
To describe the histological findings in post-endometrial ablation uteri.
STUDY DESIGN
During a ten-year period, 321 patients were treated with endometrial ablation. Twenty-five patients (7.8%), 10 treated with NovaSure® and 15 treated with ThermaChoice® endometrial ablation were finally subjected to hysterectomy mostly due to persistent uterine bleeding. Histologic features of these hysterectomies are described.
RESULTS
The patients' age ranged from 33 to 73 years (mean 44.5) and 34-53 (mean 42) for the NovaSure® and ThermaChoice® group, respectively. The time from endometrial ablation to hysterectomy was 2-24 months (mean 8.8) and 2-60 months (mean 23.2) for the two groups, respectively (p = 0.01). Hysterectomies performed later (mean 22 months) showed no fibrosis (p = 0.04) compared with those performed earlier (mean 5 months). Endometrial lining was found more frequently in hysterectomies performed later (mean 13 months) than those performed earlier (mean 2 months, p = 0.0004). Abundant necrotic tissue of myometrial origin was found in 28% of the cases, but it was not associated with the time of hysterectomy (p = 0.2). A zonation effect and vascular changes also seen. Granulomatous reaction was not found. Ten patients (40%) harbored adenomyosis and another three (12%) extensive leiomyomas/diffuse leiomyomatosis.
CONCLUSION
Necrosis, fibrosis and vascular changes are found during the first year of post-thermal uterine effect. Hysterectomies performed later show less prominent changes and almost normal endometrial lining. Adenomyosis is found in an important part of post-endometrial ablation hysterectomies.
Topics: Adult; Aged; Endometrial Ablation Techniques; Female; Humans; Hysterectomy; Middle Aged; Radiofrequency Ablation; Retrospective Studies; Treatment Failure; Uterine Hemorrhage; Uterus
PubMed: 32475645
DOI: 10.1016/j.prp.2020.152992 -
Journal of Patient Safety Dec 2021The primary aim was to measure resident safety culture in six nursing homes in northern Belgium (Flanders). In addition, differences in safety culture perceptions...
OBJECTIVES
The primary aim was to measure resident safety culture in six nursing homes in northern Belgium (Flanders). In addition, differences in safety culture perceptions between professions were also examined. Finally, results of the present study were compared with the Nursing Home Comparative Database from the Agency for Healthcare Research and Quality (USA).
METHODS
A cross-sectional study was conducted by administering the Nursing Home Survey on Patient Safety Culture in six nursing homes in Belgium (Flanders). Each nursing home has 92 to 170 licensed nursing home beds. Data collection occurred between December 2016 and January 2017.
RESULTS
Highest mean scores were found for "feedback and communication about incidents" (mean [SD] = 4.20 [0.58]), "overall perceptions of resident safety" (mean [SD] = 4.07 [0.52]), and "supervisor expectations and actions promoting resident safety" (mean [SD] = 4.04 [0.70]). The lowest mean score was found for "staffing" (mean [SD] = 2.99 [0.61]). In addition, managers/supervisors scored significantly higher on all resident safety dimensions, with the exception of the dimensions "teamwork" and "supervisor expectations and actions promoting resident safety." Finally, the present study scored higher on the dimensions "teamwork," "nonpunitive response to mistakes," "handoffs," "feedback and communication about incidents," and "communication openness" than the benchmarking data from the Nursing Home Comparative Database.
CONCLUSIONS
More work is necessary to improve the safety of resident care in nursing homes, especially regarding staffing issues and turnover rates. The present research findings serve to shine a light on an often-overlooked patient population and emphasize the need to develop improvement strategies for preventing resident safety incidents in nursing homes.
Topics: Belgium; Cross-Sectional Studies; Humans; Nursing Homes; Patient Safety; Safety Management; Surveys and Questionnaires
PubMed: 29596134
DOI: 10.1097/PTS.0000000000000476