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Clinical Oral Investigations Jul 2024Studies exploring variations in peripheral muscle oxygenation and pressure pain thresholds (PPT) of masticatory muscles in individuals with Temporomandibular Disorders...
OBJECTIVES
Studies exploring variations in peripheral muscle oxygenation and pressure pain thresholds (PPT) of masticatory muscles in individuals with Temporomandibular Disorders (TMDs) are limited. The purpose of this study was to compare variations in peripheral oxygenation of the masseter muscle; PPT of the masseter and temporal muscles and correlate peripheral muscle oxygenation and PPT of the masseter muscle in individuals with different types of TMDs.
MATERIALS AND METHODS
Cross-sectional study involving 116 participants classified into three groups: muscle group (MG, n = 32), joint group (JG, n = 30) and muscle-joint group (MJG, n = 54). Individuals aged 26.97 ± 6.93, 68.97% female, 31,03% males were included. All participants were evaluated using the Diagnostic Criteria for Temporomandibular Disorders, Near-infrared spectroscopy (NIRS) for peripheral muscle oxygenation and pressure algometer for PPT.
RESULTS
There was no difference in masseter muscle oxygenation among groups. In the masseter muscle, a weakly positive correlation was observed between PPT and variation in tissue saturation index in the MG (rho = 0.365) and JG (rho = 0.317). In addition, the MJG expressed lower PPT (p = 0.004) than JG, demonstrating that MJG had more pain in this muscle.
CONCLUSIONS
MJG have lower PPT in the masseter muscle. Although the PPT is dependent on the type of TMDs, the correlation between PPT and oxygenation is weak. All TMDs groups evaluated (MG, JG, MJG) showed hemodynamic similarities of the masseter muscle.
CLINICAL RELEVANCE
Understanding pain thresholds and the hemodynamic behavior of the masticatory muscles contributes to a more assertive physiotherapeutic assessment in TMDs, serving as a basis for careful and individualized interventions.
Topics: Humans; Male; Temporomandibular Joint Disorders; Female; Cross-Sectional Studies; Adult; Pain Threshold; Pain Measurement; Masseter Muscle; Spectroscopy, Near-Infrared; Facial Pain; Oxygen; Temporal Muscle
PubMed: 38954100
DOI: 10.1007/s00784-024-05806-z -
Techniques in Coloproctology Jul 2024Colorectal anastomotic leakage causes severe consequences for patients and healthcare system as it will lead to increased consumption of hospital resources and costs.... (Observational Study)
Observational Study Comparative Study
BACKGROUND
Colorectal anastomotic leakage causes severe consequences for patients and healthcare system as it will lead to increased consumption of hospital resources and costs. Technological improvements in anastomotic devices could reduce the incidence of leakage and its economic impact. The aim of the present study was to assess if the use of a new powered circular stapler is cost-effective.
METHOD
This observational study included patients undergoing left-sided circular stapled colorectal anastomosis between January 2018 and December 2021. Propensity score matching was carried out to create two comparable groups depending on whether the anastomosis was performed using a manual or powered circular device. The rate of anastomotic leakage, its severity, the consumption of hospital resources, and its cost were the main outcome measures. A cost-effectiveness analysis comparing the powered circular stapler versus manual circular staplers was performed.
RESULTS
A total of 330 patients were included in the study, 165 in each group. Anastomotic leakage rates were significantly different (p = 0.012): 22 patients (13.3%) in the manual group versus 8 patients (4.8%) in the powered group. The effectiveness of the powered stapler and manual stapler was 98.27% and 93.69%, respectively. The average cost per patient in the powered group was €6238.38, compared with €9700.12 in the manual group. The incremental cost-effectiveness ratio was - €74,915.28 per patient without anastomotic complications.
CONCLUSION
The incremental cost of powered circular stapler compared with manual devices was offset by the savings from lowered incidence and cost of management of anastomotic leaks.
Topics: Humans; Anastomotic Leak; Cost-Benefit Analysis; Female; Surgical Staplers; Male; Anastomosis, Surgical; Middle Aged; Aged; Incidence; Surgical Stapling; Colon; Rectum; Propensity Score; Adult; Cost-Effectiveness Analysis
PubMed: 38954099
DOI: 10.1007/s10151-024-02936-0 -
Supportive Care in Cancer : Official... Jul 2024Financial toxicity is used to describe the financial hardship experienced by cancer patients. Financial toxicity may cause negative consequences to patients, whereas... (Observational Study)
Observational Study
PURPOSE
Financial toxicity is used to describe the financial hardship experienced by cancer patients. Financial toxicity may cause negative consequences to patients, whereas little is known in Chinese context. This study aimed to explore the level of financial toxicity, coping strategies, and quality of life among Chinese patients with hematologic malignancies.
PATIENTS AND METHODS
We conducted a prospective, observational study among 274 Chinese patients with hematologic malignancies from November 2021 to August 2022 in Sun Yat-sen University Cancer Center. Clinical data were extracted from electronic clinical records. Data on financial toxicity, coping strategies, and quality of life were collected using PRO measures. Chi-square or independent t test and multivariate logistic regression were performed to explore the associated factors of financial toxicity and quality of life, respectively. Effects of financial toxicity on coping strategies were examined using Chi-square.
RESULTS
The mean age of the participants was 50.2 (± 14.6) years. Male participants accounted for 57.3%. About half of the participants reported high financial toxicity. An average median of ¥200,000 on total medical expenditures since the diagnosis was reported. The average median monthly out-of-pocket health expenditure relating to cancer treatment was ¥20,000 (range ¥632-¥172,500) after reimbursement. Reduce daily living expenses (64.9%), borrowing money (55.7%), and choosing cheaper regimens (19.6%) were the commonly used strategies to cope with financial burden. Financial toxicity was negatively associated with quality of life (β = 0.071, P = 0.001).
CONCLUSIONS
Financial toxicity was not uncommon in patients with hematological malignancies. Reducing daily living expenses, abandoning treatment sessions, and borrowing money were the strategies commonly adopted by participants to defray cancer costs. Additionally, participants with high level of financial toxicity tended to have worse quality of life. Therefore, actions from healthcare providers, policy-makers, and other stakeholders should be taken to help cancer patients mitigate their financial toxicity.
Topics: Humans; Quality of Life; Male; Hematologic Neoplasms; Female; Cross-Sectional Studies; Middle Aged; Adaptation, Psychological; Prospective Studies; Adult; China; Health Expenditures; Aged; Cost of Illness; Financial Stress; Coping Skills
PubMed: 38954081
DOI: 10.1007/s00520-024-08693-y -
Pediatric Surgery International Jul 2024Duplication enucleation (DE) has been described as an alternative to intestinal resection with primary anastomosis (IRA) for intestinal duplications, but no comparative... (Comparative Study)
Comparative Study
PURPOSE
Duplication enucleation (DE) has been described as an alternative to intestinal resection with primary anastomosis (IRA) for intestinal duplications, but no comparative study exists. The aim of this study was to compare both surgical procedures for intestinal duplication.
METHODS
A retrospective study was performed, including all children treated for intestinal duplication (2005-2023). Patients that underwent DE were compared to those that underwent IRA. Statistical significance was determined using p < 0.05. Ethical approval was obtained.
RESULTS
A total of 51 patients (median age: 5 months) were treated for intestinal duplication, including 27 patients (53%) that underwent DE and 24 IRA (47%). A cystic image was detected prenatally in 19 patients (70%) with DE and 11 patients (46%) with IRA (p = 0.09). Enucleation was performed using laparoscopy in 7 patients (14%). Patients that underwent DE had shorter time to first feed (1 vs 3 days, p = 0.0001) and length of stay (4 vs 6 days, p < 0.0004) compared to IRA. A muscular layer was identified in 68% of intestinal resection specimens.
CONCLUSION
Compared to intestinal resection with anastomosis, duplication enucleation is associated with decreased postoperative length of stay and delay to first feeds without increasing post-operative complications. Regarding histological analysis, enucleation seems feasible in most cases.
Topics: Humans; Retrospective Studies; Anastomosis, Surgical; Female; Male; Infant; Intestines; Laparoscopy; Child, Preschool; Treatment Outcome; Length of Stay; Infant, Newborn; Digestive System Surgical Procedures; Child
PubMed: 38954073
DOI: 10.1007/s00383-024-05749-2 -
Medical Microbiology and Immunology Jul 2024Streptococcus pneumoniae infection is a major public health concern with high morbidity and mortality rates. This study aimed to evaluate the serotype distribution,...
Serotype distribution, antibiotic resistance, multilocus sequence typing, and virulence factors of invasive and non-invasive Streptococcus pneumoniae in Northeast China from 2000 to 2021.
Streptococcus pneumoniae infection is a major public health concern with high morbidity and mortality rates. This study aimed to evaluate the serotype distribution, antimicrobial resistance changes, clonal composition, and virulence factors of S. pneumoniae isolates causing pneumococcal disease in northeast China from 2000 to 2021. A total of 1,454 S. pneumoniae isolates were included, with 568 invasive strains and 886 non-invasive strains. The patients from whom the S. pneumoniae were isolated ranged in age from 26 days to 95 years, with those ≤ 5 years old comprising the largest group (67.19%). 19 F, 19 A, 23 F, 14, and 6B were the most common serotypes, of which 19 A and 19 F were the main serotypes of invasive and non-invasive S. pneumoniae, respectively. CC271 was the most common multilocus sequence type. Serotype 14 had the lowest expression of cbpA, rrgA, and psrP genes, but expression levels of 19 A and 19 F genes were similar. All isolates were sensitive to ertapenem, moxifloxacin, linezolid, and vancomycin but highly resistant to macrolides, tetracyclines, and cotrimoxazole. Simultaneous resistance to erythromycin, clindamycin, tetracyclines, and trimethoprim/sulfamethoxazole was common pattern among multidrug-resistant isolates. Non-invasive S. pneumoniae had higher resistance to β-lactam antibiotics than invasive strains. 19 A and 19 F were the main strains of penicillin-resistant S. pneumoniae. The resistance rate of β-lactam antibiotics decreased from 2017 to 2021 compared to previous periods. Including PCV13 in the national immunization program can reduce the morbidity and mortality rates of pneumococcal disease effectively.
Topics: Streptococcus pneumoniae; Humans; Multilocus Sequence Typing; China; Virulence Factors; Pneumococcal Infections; Serogroup; Child, Preschool; Infant; Middle Aged; Adolescent; Anti-Bacterial Agents; Adult; Child; Aged; Young Adult; Aged, 80 and over; Infant, Newborn; Microbial Sensitivity Tests; Female; Male; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial
PubMed: 38954065
DOI: 10.1007/s00430-024-00797-w -
Supportive Care in Cancer : Official... Jul 2024
Topics: Humans; Neoplasms; Adult; Mass Screening; Adolescent; Young Adult; Needs Assessment; Medical Oncology; Health Services Needs and Demand
PubMed: 38954063
DOI: 10.1007/s00520-024-08668-z -
Acta Neurochirurgica Jul 2024External ventricular drain (EVD) is one of the most frequent procedures in neurosurgery and around 15 to 30% of these patients require a permanent cerebrospinal fluid...
PURPOSE
External ventricular drain (EVD) is one of the most frequent procedures in neurosurgery and around 15 to 30% of these patients require a permanent cerebrospinal fluid (CSF) diversion. The optimal EVD weaning strategy is still unclear. Whether gradual weaning compared to rapid closure, reduces the rate of permanent CSF diversion remains controversial. The aim of this trial is to compare the rates of permanent CSF diversion between gradual weaning and rapid closure of an EVD.
METHODS
This was a single-center, retrospective cohort study including patients between 2010 to 2020. Patients were divided into a weaning (WG) and non-weaning (NWG) group. The primary outcome was permanent CSF diversion rates, secondary outcomes included hospitalization time, EVD-related morbidity, and clinical outcome.
RESULTS
Out of 412 patients, 123 (29.9%) patients were excluded due to early death or palliative treatment. We registered 178 (61.6%) patients in the WG and 111 (38.4%) in the NWG. Baseline characteristics were comparable between groups. The VPS rate was comparable in both groups (NWG 37.8%; WG 39.9%, p = 0.728). EVD related infection (13.5% vs 1.8%, p < 0.001), as well as non-EVD related infection rates (2.8% vs 0%, p < 0.001), were significantly higher in the WG. Hospitalization time was significantly shorter in the NWG (WG 24.93 ± 9.50 days; NWG 23.66 ± 14.51 days, p = 0.039).
CONCLUSION
Gradual EVD weaning does not seem to reduce the need for permanent CSF diversion, while infection rates and hospitalization time were significantly higher/longer. Therefore, direct closure should be considered in the clinical setting.
Topics: Humans; Male; Female; Retrospective Studies; Middle Aged; Adult; Drainage; Aged; Ventriculostomy; Hydrocephalus; Treatment Outcome
PubMed: 38954061
DOI: 10.1007/s00701-024-06166-z -
International Ophthalmology Jul 2024Investigate the most appropriate mathematical formula to objectively express upper eyelid contour symmetry.
PURPOSE
Investigate the most appropriate mathematical formula to objectively express upper eyelid contour symmetry.
METHODS
62 eyes of 31 patients were included in the study. The upper eyelid contour symmetry of the patients was classified subjectively (independent of MRD1) as poor, acceptable, and good by three oculoplastic specialists (senior, expert, and junior surgeon). Bézier curves of the upper lid contour were drawn with ImageJ software (NIH, Bethesda, MA, USA). Using the algorithms created by Author SKC in Spyder (Python 3.7.9.), the symmetry of the Bézier curves of the left eyelids were obtained according to the y-axis, and the mid-pupils of both eyes were superimposed. The lower curve moved vertically to the equal height of the other curve to equalize MRD1's. R (Coefficient of determination), RMSE (Root-mean-square error), MSE (Mean squared error), POC (Percentage of co-efficiency), and MAE (Mean absolute error) were calculated. We evaluated the correlation between these objective formulas and the subjective grading of three surgeons using Spearman's rho (ρ).
RESULTS
The correlation coefficient of RMSE and MSE were the same for all surgeons grading. There was a strong correlation between the senior surgeon's subjective scoring (N; poor = 8, acceptable = 16, good = 8) and R, RMSE, POC, MAE (ρ = 0.643, p < 0.001, ρ = -0.607, p < 0.001, ρ = 0.562, p < 0.001, ρ = -0.517, p < 0.001, respectively). We found a strong relationship between the expert surgeon's subjective scoring (N; poor = 9, acceptable = 13, good:10) and R (ρ = 0.611, p < 0.001), RMSE (ρ = -0.549, p < 0.001), POC (ρ = 0.511, p < 0.001), and MAE (ρ = -0.450, p < 0.05). We found a strong correlation between junior surgeon's subjective scoring (N; poor = 6, acceptable = 18, good = 8) and R, RMSE, and POC (ρ: -0.517, p < 0.001; ρ: -0.470, p < 0.001; ρ: 0.521, p < 0.001; respectively) and moderate correlation between MAE (ρ:-0.394, p < 0.05). The highest correlation is observed with R.
CONCLUSIONS
RMSE, MSE, POC, MAE, and especially R, may quantitatively express upper eyelid contour symmetry, comparable with the oculoplastic surgeon. The highest correlation was observed between the senior surgeon and R, and decreases with the experience of the surgeon.
Topics: Humans; Eyelids; Female; Male; Middle Aged; Algorithms; Aged; Adult; Blepharoplasty
PubMed: 38954051
DOI: 10.1007/s10792-024-03157-y -
Journal of Psycholinguistic Research Jul 2024In the realm of language education, the influence of learners' personality traits on their educational outcomes within novel instructional frameworks has gained...
In the realm of language education, the influence of learners' personality traits on their educational outcomes within novel instructional frameworks has gained prominence, prompting an exploration into the effects of ambiguity tolerance on grammar acquisition among English as a Foreign Language (EFL) students. This study investigates the impact of learners' personality traits on their learning outcomes in innovative instructional models, such as flipped and blended classes. A sample of 120 EFL students was divided into four comparative groups and two control groups based on their proficiency and ambiguity tolerance (AT) scores. The study utilized a Learning Management System (LMS) to deliver instruction to the different groups. The blended group received a combination of online and face-to-face instruction, while the flipped group received online instruction using the flipped approach. The control group received only face-to-face instruction. After a semester of instruction, a posttest on grammar learning was administered. The findings showed that the blended group performed better than the flipped and face-to-face groups in terms of grammar learning. The study also found no significant differences in grammar learning between high AT and low AT participants in the flipped and blended classes. However, high AT students in the face-to-face class demonstrated higher levels of success in grammar learning compared to low AT students.
Topics: Humans; Female; Male; Learning; Multilingualism; Young Adult; Students; Adult; Language; Personality
PubMed: 38954044
DOI: 10.1007/s10936-024-10096-3 -
Cancer Immunology, Immunotherapy : CII Jul 2024Vulvar squamous cell carcinoma (VSCC) arises after an HPV infection or the mutation of p53 or other driver genes and is treated by mutilating surgery and/or (chemo)...
BACKGROUND
Vulvar squamous cell carcinoma (VSCC) arises after an HPV infection or the mutation of p53 or other driver genes and is treated by mutilating surgery and/or (chemo) radiation, with limited success and high morbidity. In-depth information on the immunological make up of VSCC is pivotal to assess whether immunotherapy may form an alternative treatment.
METHODS
A total of 104 patient samples, comprising healthy vulva (n = 27) and VSCC (n = 77), were analyzed. Multispectral immunofluorescence (15 markers) was used to study both the myeloid and lymphoid immune cell composition, and this was linked to differences in transcriptomics (NanoString nCounter, 1258 genes) and in survival (Kaplan-Meier analyses).
RESULTS
Healthy vulva and VSCC are both well infiltrated but with different subpopulations of lymphoid and myeloid cells. In contrast to the lymphoid cell infiltrate, the density and composition of the myeloid cell infiltrate strongly differed per VSCC molecular subtype. A relative strong infiltration with epithelial monocytes (HLADRCD11cCD14CD68CD163CD33) was prognostic for improved survival, independent of T cell infiltration, disease stage or molecular subtype. A strong infiltration with T cells and/or monocytes was associated with drastic superior survival: 5-year survival > 90% when either one is high, versus 40% when both are low (p < 0.001).
CONCLUSION
A hot myeloid and/or lymphoid infiltrate predicts excellent survival in VSCC. Based on the response of similarly high-infiltrated other tumor types, we have started to explore the potential of neoadjuvant checkpoint blockade in VSCC.
Topics: Humans; Female; Vulvar Neoplasms; Prognosis; Carcinoma, Squamous Cell; Biomarkers, Tumor; Monocytes; Middle Aged; Aged; Lymphocytes, Tumor-Infiltrating; Adult; Aged, 80 and over
PubMed: 38954042
DOI: 10.1007/s00262-024-03755-w