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Radiography (London, England : 1995) Jun 2024Diuresis renography is a nuclear medicine examination that can distinguish between obstructive and non-obstructive uropathy. Renography has been investigated before, but...
INTRODUCTION
Diuresis renography is a nuclear medicine examination that can distinguish between obstructive and non-obstructive uropathy. Renography has been investigated before, but not from a patient perspective. The aim of this study was to gain knowledge and understanding of patient experiences with the diuresis renography process.
METHODS
The study had a qualitative descriptive design; data was collected through semi-structured interviews with 17 adult patients that had recently undergone diuresis renography. The transcripts were analysed using inductive qualitative content analysis to identify their manifest and latent content.
RESULTS
One main theme was identified: 'Not smooth all the way through, but still in good hands'. The participants understood the necessity of the performed renography and endured the examination despite its worrying elements. They were bothered by diuretic effects, worried about radioactivity and felt isolated during the imaging. The technologists' caring and informative approach eased their experience. The main theme was identified from three subthemes: 'I experienced inconvenience', 'I was worried' and 'I felt safe'.
CONCLUSION
The participants experienced worry throughout the renography process but were still satisfied with the examination, mostly because of the technologists being involved. Communication and interaction between patient and technologist are important for creating a good experience. Improved knowledge of patient experiences during renographies could be used to develop patient information and increase technologists' awareness of factors patients may experience as troubling.
IMPLICATIONS FOR PRACTICE
This study describes issues that contribute to both negative and positive experiences. Improved professional awareness and knowledge about these issues can contribute to the development of patient information and professional encounters, and may improve patients' compliance and overall experience.
PubMed: 38944581
DOI: 10.1016/j.radi.2024.06.009 -
HPB : the Official Journal of the... Jun 2024Laparoscopic liver resection (LLR) has been associated with improved patient recovery as well as reduced postoperative adhesions compared to open LR (OLR) and could...
BACKGROUND
Laparoscopic liver resection (LLR) has been associated with improved patient recovery as well as reduced postoperative adhesions compared to open LR (OLR) and could therefore facilitate redo liver surgery. LLR prior to liver transplantation (LT) is increasingly performed, LT being saved for HCC recurrence. LT is still performed by open surgery due to vascular reconstructions and underlying liver chronic disease. We evaluated the impact of laparoscopic approach for LR prior to LT in terms of intraoperative transfusions, adhesions severity and outcome.
METHODS
Data from all patients who underwent a LT after LR in two French high-volume tertiary centers were retrospectively reviewed. The impact of LLR on per operative and postoperative outcome was assessed using logistic regression.
RESULTS
170 patients were included, 43 patients in the LLR group and 127 in the OLR group. Preoperative characteristics were comparable between both groups, except LLR group included more patients with "very early-stage" BCLC tumors than OLR group (51% vs. 33%, p = 0.02) and less anatomical resections (54% vs. 75%, p = 0.015). During LT, the transfusion rate was significantly higher in the OLR group (71.4% vs 44.2%, p = 0.002) as well as the proportion of type III adhesions according to OLSG classification (p < 0.001). Multivariate analysis found LLR to be an independent protective factor for adhesions and transfusion (p = 0.001 and p = 0.03 respectively).
CONCLUSION
Laparoscopic liver resection was associated with reduced postoperative adhesions and transfusion requirements during subsequent liver transplantation.
PubMed: 38944570
DOI: 10.1016/j.hpb.2024.06.001 -
International Journal of Biological... Jun 2024This study investigates the potential applications of incorporating 2D bacterial cellulose microfibers (BCM) biochar into chitosan/polyethyleneimine beads as a...
This study investigates the potential applications of incorporating 2D bacterial cellulose microfibers (BCM) biochar into chitosan/polyethyleneimine beads as a semi-natural sorbent for the efficient removal of tetracycline (TET) and metronidazole (MET) antibiotics. Batch adsorption experiments and characterization techniques evaluate removal performance and synthesized adsorbent properties. The adsorbent eliminated 99.13 % and 90 % of TET and MET at a 10 mg.L concentration with optimal pH values of 8 and 6, respectively, for 90 min. Under optimum conditions and a 400 mg.L concentration, MET and TET have possessed the maximum adsorption capacities of 691.325 and 960.778 mg.g, respectively. According to the isothermal analysis, the adsorption of TET fundamentally follows the Temkin (R = 0.997), Redlich-Peterson (R = 0.996), and Langmuir (R = 0.996) models. In contrast, the MET adsorption can be described by the Langmuir (R = 0.997), and Toth (R = 0.991) models. The pseudo-second-order (R = 0.998, 0.992) and Avrami (R = 0.999, 0.999) kinetic models were well-fitted with the kinetic results for MET and TET respectively. Diffusion models recommend that pore, liquid-film, and intraparticle diffusion govern the rate of the adsorption process. The developed semi-natural sorbent demonstrated exceptional adsorption capacity over eleven cycles due to its porous bead structure, making it a potential candidate for wastewater remediation.
PubMed: 38944566
DOI: 10.1016/j.ijbiomac.2024.132953 -
Dental Materials : Official Publication... Jun 2024To assess the influence of calcination process on the properties of minimally processed recycled 3Y-TZP, and to compare it with its commercial counterpart.
OBJECTIVE
To assess the influence of calcination process on the properties of minimally processed recycled 3Y-TZP, and to compare it with its commercial counterpart.
METHODS
Non-milled 3Y-TZP waste was collected, fragmented and ball-milled to a granulometric < 5 µm. Half of the recycled powder was calcined at 900 °C. Recycled 3Y-TZP disks were uniaxially pressed and sintered to create two recycled groups: 1) Calcined and 2) Non-calcined to be compared with a commercial CAD/CAM milled 3Y-TZP. The microstructure of experimental groups was assessed through density (n = 6), scanning electron microscopy (n = 3) and energy-dispersive X-ray spectroscopy (n = 3); and the crystalline content was evaluated through X-ray diffraction (XRD) (n = 3). Optical and mechanical properties were investigated through reflectance tests (n = 10), and Vickers hardness, fracture toughness (n = 5), and biaxial flexural strength tests (n = 16), respectively. Fractographic analysis was performed to identify fracture origin and crack propagation. Statistical analyses were performed through ANOVA followed by Tukey´s test, and by Weibull statistics.
RESULTS
Particle size distribution of recycled powder revealed an average diameter of ∼1.60 µm. The relative density of all experimental groups was > 98.15 % and XRD analysis exhibited a predominance of tetragonal-phase in both recycled groups, which were similar to the crystallographic pattern of the control group. Cross-section micrographs presented flaws on the non-calcined group, and a more homogeneous microstructure for the calcined and commercial groups. Commercial samples showed lower contrast-ratio and higher translucency-parameter than the recycled groups, where non-calcined presented higher translucency-parameter and lower contrast-ratio than its calcined counterpart. The commercial group presented higher fracture toughness and characteristic strength than the recycled groups. Moreover, the calcined group exhibited higher hardness, characteristic strength, and probability of survival at higher loads than the non-calcined group. Fractographic analysis depicted the presence of microstructural flaws in the non-calcined group, which may have acted as stress-raisers and led to failures at lower flexural strengths values.
SIGNIFICANCE
The calcination process improved the microstructure, optical, and mechanical properties of the recycled 3Y-TZP.
PubMed: 38944559
DOI: 10.1016/j.dental.2024.06.026 -
The International Journal on Drug Policy Jun 2024A market for cannabis with low levels (LT) of Tetrahydrocannabinol (THC) has recently emerged in Europe alongside an ongoing trend of domestic cannabis cultivation with...
BACKGROUND
A market for cannabis with low levels (LT) of Tetrahydrocannabinol (THC) has recently emerged in Europe alongside an ongoing trend of domestic cannabis cultivation with high-THC content (HT). This phenomenon may have diversified the growers' profile. This study investigates LT growers' (LTG) characteristics (demographics, consumption patterns, growing experience) and growing motivations with a subsequent comparison with HT growers (HTG).
METHODS
Data from 11,479 small-scale growers was collected through an online survey (ICCQ 2) conducted by the Global Cannabis Cultivation Research Consortium (GCCRC) from 2020 to 2021. This exploratory study analyses a subsample of the 1618 respondents residing in Italy and Switzerland. A quantitative approach was used, performing comparative bivariate and multivariate analyses between participants who have only grown HT plants in the previous year (HTG; n = 1303) and those who have either grown LT only or alongside HT (LTG; n = 315).
RESULTS
LTGs differ significantly from HTGs. LTGs are older than HTGs. Growing medical cannabis for oneself and others is more likely among them than HTGs. Compared to HTGs, LTGs have lesser odds to grow for recreational use and to have problematic cannabis use. Growing for legality, pleasure and accessing milder cannabis is more likely for LTGs than HTGs. HTGs have greater experience than HTGs, growing for longer, more extensively and better meeting their consumption needs. There is a wider production of by-products, such as oils and extracts, among LTGs than HTGs. Having been in contact with the police for growing is also more likely among them than HTGs.
CONCLUSION
LTGs reported significantly more growing experience when compared to HTGs and should be considered a distinct group of growers. The results suggest that the emergence of the legal LT market has more likely drawn previous HTGs into growing LT, mainly medically, rather than attracting new individuals toward cannabis cultivation.
PubMed: 38944558
DOI: 10.1016/j.drugpo.2024.104505 -
Seminars in Nuclear Medicine Jun 2024Recent advancements in PET technology have culminated in the development of total-body PET (TB-PET) systems, which overcome many limitations of traditional scanners.... (Review)
Review
Recent advancements in PET technology have culminated in the development of total-body PET (TB-PET) systems, which overcome many limitations of traditional scanners. These TB-PET scanners, while still becoming widely available, represent the forefront of clinical imaging across numerous medical institutions worldwide. Early clinical applications have demonstrated their enhanced image quality, precise lesion quantification, and overall superior performance relative to conventional scanners. The capabilities of TB-PET technology, including extended scan range, ultrahigh sensitivity, exceptional temporal resolution, and dynamic imaging, offer significant potential to tackle unresolved clinical challenges in medical imaging. In this discussion, we aim to explore the emerging applications, opportunities, and future perspectives of TB-PET/CT in musculoskeletal disorders (MSDs). Clinical applications for both oncologic and non-oncologic musculoskeletal diseases are discussed, including inflammatory arthritis, infections, osteoarthritis, osteoporosis, and skeletal muscle disorders. From the ability to visualize small musculoskeletal structures and the entire axial and appendicular skeleton, TB-PET shows significant potential in the diagnosis and management of MSD conditions as it becomes more widely available.
PubMed: 38944556
DOI: 10.1053/j.semnuclmed.2024.05.009 -
Journal of Cardiothoracic and Vascular... Apr 2024Carotid artery stenting (CAS) may be performed by transfemoral or transcervical (TCAR) approaches and with a variety of anesthetic techniques. No current literature...
OBJECTIVES
Carotid artery stenting (CAS) may be performed by transfemoral or transcervical (TCAR) approaches and with a variety of anesthetic techniques. No current literature clearly supports one anesthetic method over another. We therefore sought to evaluate the outcomes of CAS procedures based on anesthetic approach.
DESIGN
Retrospective cohort study.
SETTING
American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2018.
PARTICIPANTS
All individuals undergoing CAS during the study period.
INTERVENTIONS
Anesthetic type (locoregional versus general [GA]).
MEASUREMENTS AND MAIN RESULTS
Locoregional anesthesia for CAS was used for 754 (65.5%) patients, with the remainder under GA. Demographic variables were comparable, as were the incidence of symptomatic presentation, high-risk anatomy or physiology, severity of the stenosis, and presence/severity of contralateral carotid disease. There was no difference in composite outcome (stroke, myocardial infarction [MI], and death) (7.0% v 6.1%, p = 0.53). The GA group had lower odds ratio of MI (0.12, p = 0.0362) but higher odds ratio of death (3.33, p = 0.008) and postoperative pneumonia (3.87, p = 0.0083), although on multivariable analysis the risk of death appeared confounded by respiratory variables. Multivariable and propensity score-weighted analyses did not identify a significant association of GA with the composite outcome.
CONCLUSIONS
In patients undergoing CAS in the National Surgical Quality Improvement Program, GA was not associated with the composite outcome but was associated with increased rates of postoperative pneumonia and decreased rates of MI. Further investigation should attempt to better clarify these relationships.
PubMed: 38944543
DOI: 10.1053/j.jvca.2024.04.023 -
Clinical Radiology May 2024Radiomics involves the extraction of quantitative data from medical images to facilitate the diagnosis, prognosis, and staging of tumors. This study provides a...
Systematic review and meta-analysis of the prognostic value of F-Fluorodeoxyglucose (F-FDG) positron emission tomography (PET) and/or computed tomography (CT)-based radiomics in head and neck cancer.
AIM
Radiomics involves the extraction of quantitative data from medical images to facilitate the diagnosis, prognosis, and staging of tumors. This study provides a comprehensive overview of the efficacy of radiomics in prognostic applications for head and neck cancer (HNC) in recent years. It undertakes a systematic review of prognostic models specific to HNC and conducts a meta-analysis to evaluate their predictive performance.
MATERIALS AND METHODS
This study adhered rigorously to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for literature searches. The literature databases, including PubMed, Embase, Cochrane, and Scopus were systematically searched individually. The methodological quality of the incorporated studies underwent assessment utilizing the radiomics quality score (RQS) tool. A random-effects meta-analysis employing the Harrell concordance index (C-index) was conducted to evaluate the performance of all radiomics models.
RESULTS
Among the 388 studies retrieved, 24 studies encompassing a total of 6,978 cases were incorporated into the systematic review. Furthermore, eight studies, focusing on overall survival as an endpoint, were included in the meta-analysis. The meta-analysis revealed that the estimated random effect of the C-index for all studies utilizing radiomics alone was 0.77 (0.71-0.82), with a substantial degree of heterogeneity indicated by an I of 80.17%.
CONCLUSIONS
Based on this review, prognostic modeling utilizing radiomics has demonstrated enhanced efficacy for head and neck cancers; however, there remains room for improvement in this approach. In the future, advancements are warranted in the integration of clinical parameters and multimodal features, balancing multicenter data, as well as in feature screening and model construction within this field.
PubMed: 38944542
DOI: 10.1016/j.crad.2024.05.016 -
Soins. Psychiatrie 2024Despite well-established recommendations and psycho-education programmes, the health of family carers is most often impaired, which means that the support they provide...
Despite well-established recommendations and psycho-education programmes, the health of family carers is most often impaired, which means that the support they provide is seen only in terms of burden. A phenomenological approach based on strength-based care shows that they develop skills and strategies for the well-being of their loved one, and are nurtured by a sense of hope that enables them to acquire experiential knowledge.
Topics: Humans; Caregivers; Social Support; Adaptation, Psychological; Cost of Illness; Caregiver Burden; Female; France; Male
PubMed: 38944535
DOI: 10.1016/j.spsy.2024.05.008 -
The Surgical Clinics of North America Aug 2024Primary hyperparathyroidism can be sporadic or part of a genetic syndrome, such as MEN1 or HPT-JT. Diagnosis of hereditary HPT requires a thorough history and physical.... (Review)
Review
Primary hyperparathyroidism can be sporadic or part of a genetic syndrome, such as MEN1 or HPT-JT. Diagnosis of hereditary HPT requires a thorough history and physical. Parathyroidectomy is curative with greater than 95% success. However, some patients have persistent or recurrent disease requiring reoperation. Reoperative parathyroidectomy is technically challenging, and localizing the pathologic gland can difficult. Patients needing reoperation should undergo evaluation by a high-volume surgeon. Care should be taken to obtain all of the preoperative workup and operative note from the initial surgery. Radioguided parathyroidectomy can be safely and effectively performed in patients with hereditary HPT or undergoing reoperative surgery.
Topics: Humans; Hyperparathyroidism, Primary; Parathyroidectomy; Recurrence; Reoperation; Parathyroid Neoplasms
PubMed: 38944501
DOI: 10.1016/j.suc.2024.02.010