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Neurology. Clinical Practice Jun 2023To evaluate the diagnostic accuracy of the ambulatory EEG (aEEG) at detecting interictal epileptiform discharges (IEDs)/seizures compared with routine EEG (rEEG) and...
BACKGROUND AND OBJECTIVE
To evaluate the diagnostic accuracy of the ambulatory EEG (aEEG) at detecting interictal epileptiform discharges (IEDs)/seizures compared with routine EEG (rEEG) and repetitive/second rEEG in patients with a first single unprovoked seizure (FSUS). We also evaluated the association between IED/seizures on aEEG and seizure recurrence within 1 year of follow-up.
METHODS
We prospectively evaluated 100 consecutive patients with FSUS at the provincial Single Seizure Clinic. They underwent 3 sequential EEG modalities: first rEEG, second rEEG, and aEEG. Clinical epilepsy diagnosis was ascertained based on the 2014 International League Against Epilepsy definition by a neurologist/epileptologist at the clinic. An EEG-certified epileptologist/neurologist interpreted all 3 EEGs. All patients were followed up for 52 weeks until they had either second unprovoked seizure or maintained single seizure status. Accuracy measures (sensitivity, specificity, negative and positive predictive values, and likelihood ratios), receiver operating characteristic (ROC) analysis, and area under the curve (AUC) were used to evaluate the diagnostic accuracy of each EEG modality. Life tables and the Cox proportional hazard model were used to estimate the probability and association of seizure recurrence.
RESULTS
Ambulatory EEG captured IED/seizures with a sensitivity of 72%, compared with 11% for the first rEEG and 22% for the second rEEG. The diagnostic performance of the aEEG was statistically better (AUC: 0.85) compared with the first rEEG (AUC: 0.56) and second rEEG (AUC: 0.60). There were no statistically significant differences between the 3 EEG modalities regarding specificity and positive predictive value. Finally, IED/seizure on the aEEG was associated with more than 3 times the hazard of seizure recurrence.
DISCUSSION
The overall diagnostic accuracy of aEEG at capturing IED/seizures in people presenting with FSUS was higher than the first and second rEEGs. We also found that IED/seizures on the aEEG were associated with an increased risk of seizure recurrence.
CLASSIFICATION OF EVIDENCE
This study provides Class I evidence supporting that, in adults with First Single Unprovoked Seizure (FSUS), 24-h ambulatory EEG has increased sensitivity when compared with routine and repeated EEG.
PubMed: 37197370
DOI: 10.1212/CPJ.0000000000200160 -
Quantitative Imaging in Medicine and... May 2023This systematic review and meta-analysis evaluated the diagnostic performance of biparametric magnetic resonance imaging (bpMRI) for the detection of intermediate- and...
BACKGROUND
This systematic review and meta-analysis evaluated the diagnostic performance of biparametric magnetic resonance imaging (bpMRI) for the detection of intermediate- and high-risk prostate cancer (IHPC).
METHODS
Two medical databases (PubMed and Web of Science) were systematically reviewed by 2 independent researchers. Studies published before March 15, 2022, that used bpMRI (i.e., T2-weighted images combined with diffusion-weighted imaging) to detect prostate cancer (PCa) were included. The results of prostatectomy or prostate biopsy were the reference standards for the studies. The Quality Assessment of Diagnosis Accuracy Studies 2 tool was used to assess the quality of the included studies. Data on true- and false-positive and -negative results were extracted to complete 2×2 contingency tables, and the sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each study. Summary receiver operating characteristic (SROC) plots were constructed using these results.
RESULTS
In all, 16 studies (6,174 patients) that used Prostate Imaging Reporting and Data System version 2 or other scoring systems, such as Likert, SPL and Questionnaire were included. Sensitivity, specificity, positive and negative likelihood ratios, and the diagnosis odds ratio of bpMRI in the detection of IHPC were 0.91 (95% CI: 0.87-0.93), 0.67 (95% CI: 0.58-0.76), 2.8 (95% CI: 2.2-3.6), 0.14 (95% CI: 0.11-0.18), and 20 (95% CI: 15-27), respectively, with an area under the SROC curve of 0.90 (95% CI: 0.87-0.92). There was considerable heterogeneity between the studies.
CONCLUSIONS
bpMRI exhibited a high negative predictive value and accuracy in the diagnosis of IHPC, and may be valuable for detecting PCa with poor prognosis. However, the bpMRI protocol needs to be standardized further to improve its wider applicability.
PubMed: 37179947
DOI: 10.21037/qims-22-1024 -
European Review For Medical and... Apr 2023There have been insufficient reports to date regarding the treatment of cervical spinal tuberculosis, and the optimal surgical approaches to treating this condition have... (Review)
Review
Application of combined anterior and posterior approaches for the treatment of cervical tuberculosis with anterior cervical abscess formation and kyphosis using a Jackson operating table: a case report and literature review.
BACKGROUND
There have been insufficient reports to date regarding the treatment of cervical spinal tuberculosis, and the optimal surgical approaches to treating this condition have yet to be established.
CASE REPORT
This report describes the treatment of a case of tuberculosis associated with a large abscess and pronounced kyphosis through the use of a combined anterior and posterior approach with the aid of the Jackson operating table. This patient did not exhibit any sensorimotor abnormalities of the upper extremities, lower extremities, or trunk, and presented with symmetrical bilateral hyperreflexia of the knee tendons, while being negative for Hoffmann's sign and Babinski's sign. Laboratory test results revealed an erythrocyte sedimentation rate (ESR) of 42.0 mm/h and a C-reactive protein (CRP) of 47.09 mg/L. Acid-fast staining was negative, and spine magnetic resonance imaging revealed the destruction of the C3-C4 vertebral body and a posterior convex deformity of the cervical spine. The patient reported a visual analog pain score (VAS) of 6, and exhibited an Oswestry disability index (ODI) score of 65. Jackson table-assisted anterior and posterior cervical resection decompression was performed to treat this patient, and at 3 months post-surgery the patient's VAS and ODI scores were respectively reduced to 2 and 17. Computed tomography analyses of the cervical spine at this follow-up time point revealed good structural fusion of the autologous iliac bone graft with internal fixation and improvement of the originally observed cervical kyphosis.
CONCLUSIONS
This case suggests that Jackson table-assisted anterior-posterior lesion removal and bone graft fusion can safely and effectively treat cervical tuberculosis with a large anterior cervical abscess combined with cervical kyphosis, providing a foundation for future efforts to treat spinal tuberculosis.
Topics: Humans; Tuberculosis, Spinal; Abscess; Operating Tables; Treatment Outcome; Spinal Fusion; Kyphosis; Cervical Vertebrae; Retrospective Studies; Thoracic Vertebrae; Debridement
PubMed: 37140294
DOI: 10.26355/eurrev_202304_32115 -
Data in Brief Jun 2023The data presented in this article are related to the research paper entitled "" (Remote Sensing of Environment, Volume 284, January 2023, 113336,...
Dataset of night-time emissions of the Earth in the near UV range (290-430 nm), with 6.3 km resolution in the latitude range -51.6
The data presented in this article are related to the research paper entitled "" (Remote Sensing of Environment, Volume 284, January 2023, 113336, https://doi.org/10.1016/j.rse.2022.113336). The data have been acquired with the Mini-EUSO detector, an UV telescope operating in the range 290-430 nm and located inside the International Space Station. The detector was launched in August 2019, and it has started operations from the nadir-facing UV-transparent window in the Russian Zvezda module in October 2019. The data presented here refer to 32 sessions acquired between 2019-11-19 and 2021-05-06. The instrument consists of a Fresnel-lens optical system and a focal surface composed of 36 multi-anode photomultiplier tubes, each with 64 channels, for a total of 2304 channels with single photon counting sensitivity. The telescope, with a square field-of-view of 44°, has a spatial resolution on the Earth surface of 6.3 km and saves triggered transient phenomena with a temporal resolution of 2.5 µs and 320 µs. The telescope also operates in continuous acquisition at a 40.96 ms scale. In this article, large-area night-time UV maps obtained processing the 40.96 ms data, taking averages over regions of some specific geographical areas (e.g., Europe, North America) and over the entire globe, are presented. Data are binned into 0.1 × 0.1 or 0.05 × 0.05 cells (depending on the scale of the map) over the Earth's surface. Raw data are made available in the form of tables (latitude, longitude, counts) and .kmz files (containing the .png images). These are - to the best of our knowledge - the highest sensitivity data in this wavelength range and can be of use to various disciplines.
PubMed: 37095754
DOI: 10.1016/j.dib.2023.109105 -
BMC Musculoskeletal Disorders Feb 2023Muscle-sparing techniques, more consistent acetabular component positioning with fluoroscopy guidance, development in implants and instrumentation, expedited...
BACKGROUND
Muscle-sparing techniques, more consistent acetabular component positioning with fluoroscopy guidance, development in implants and instrumentation, expedited rehabilitation, and patients' expectations have led to increased utilization of various direct anterior and anterolateral approaches to the hip joint.
METHODS AND SURGICAL TECHNIQUE
In this technical note, we demonstrate for the first time a hybrid modification of traditional Smith-Peterson and Watson-Jones approaches to the hip joint on a standard operating room (OR) table.
CONCLUSIONS
As demonstrated in this article, a precise knowledge of anatomy and clear goals in the surgical approach can minimize complications and facilitate visualization and instrumentation placement in the "direct anterior approach" to the hip joint.
Topics: Humans; Hip Joint; Acetabulum; Fluoroscopy; Muscles; Operating Tables
PubMed: 36855127
DOI: 10.1186/s12891-023-06254-8 -
BMC Surgery Feb 2023Our study aimed to identify preoperative predictors for perioperative allogenic blood transfusion (ABT) in patients undergoing major lung cancer resections in order to...
Preoperative risk factors predict perioperative allogenic blood transfusion in patients undergoing primary lung cancer resections: a retrospective cohort study from a high-volume thoracic surgery center.
BACKGROUND
Our study aimed to identify preoperative predictors for perioperative allogenic blood transfusion (ABT) in patients undergoing major lung cancer resections in order to improve the perioperative management of patients at risk for ABT.
METHODS
Patients admitted between 2014 and 2016 in a high-volume thoracic surgery clinic were retrospectively evaluated in a cohort study based on a control group without ABT and the ABT group requiring packed red blood cell units within 15 days postoperatively until discharge. The association of ABT with clinically established parameters (sex, preoperative anemia, liver and coagulation function, blood groups, multilobar resections) was analyzed by contingency tables, receiver operating characteristics (ROC) and logistic regression analysis, taking into account potential covariates.
RESULTS
60 out of 529 patients (11.3%) required ABT. N1 and non-T1 tumors, thoracotomy approach, multilobar resections, thoracic wall resections and Rhesus negativity were more frequent in the ABT group. In multivariable analyses, female sex, preoperative anemia, multilobar resections, as well as serum alanine-aminotransferase levels, thrombocyte counts and Rhesus negativity were identified as independent predictors of ABT, being associated with OR (95% Confidence interval, p-value) of 2.44 (1.23-4.88, p = 0.0112), 18.16 (8.73-37.78, p < 0.0001), 5.79 (2.50-13.38, p < 0.0001), 3.98 (1.73-9.16, p = 0.0012), 2.04 (1.04-4.02, p = 0.0390) and 2.84 (1.23-6.59, p = 0.0150), respectively.
CONCLUSIONS
In patients undergoing major lung cancer resections, multiple independent risk factors for perioperative ABT apart from preoperative anemia and multilobar resections were identified. Assessment of these predictors might help to identify high risk patients preoperatively and to improve the strategies that reduce perioperative ABT.
Topics: Female; Humans; Thoracic Surgery; Retrospective Studies; Cohort Studies; Blood Transfusion; Lung Neoplasms
PubMed: 36849951
DOI: 10.1186/s12893-023-01924-9 -
International Journal of Environmental... Feb 2023As a means of enhancing food security, efficient agricultural processing and the maintenance of a smooth supply chain are essential for ensuring food quality and...
As a means of enhancing food security, efficient agricultural processing and the maintenance of a smooth supply chain are essential for ensuring food quality and reducing food wastage. Agricultural enterprises play a crucial role in the processing and transportation of food from farms to dinner tables. Operating income growth plays the vital role of ensuring that agricultural enterprises function in a stable manner while also indicating the quantity and quality of market food supply. Therefore, the objective of this study is to explore the impact of digital inclusive finance on food security by analyzing the effect of digital inclusive finance on the operating income of agricultural enterprises in China. By applying pooled OLS analysis to Chinese agricultural enterprises that are listed in the National Equities Exchange and Quotations, this study finds that digital inclusive finance can help improve agricultural operating income. The results reveal that digital inclusive finance can facilitate the promotion of agricultural operating income by increasing the supply of financing, accelerating inventory liquidity, and supporting investment in research and development. In addition, this study concludes that digital inclusive finance is more effective for increasing agricultural operating income as a result of its wider coverage and deeper utilization. Furthermore, the development of traditional finance is still necessary for the digitization of digital inclusive finance to be effective.
Topics: Agriculture; Farms; China; Meals; Food Security; Economic Development
PubMed: 36833648
DOI: 10.3390/ijerph20042956 -
Revista de Salud Publica (Bogota,... Sep 2019Estimate the coverage of screening mammograms in Colombia during 2014, as well as the performance in hours of equipment by the team and the number of teams required, to...
OBJECTIVE
Estimate the coverage of screening mammograms in Colombia during 2014, as well as the performance in hours of equipment by the team and the number of teams required, to reach the goal of 70% coverage of screening mammography before the year 2021.
MATERIALS AND METHODS
A descriptive census study was carried out to characterize existing mammography equipment in the country. To this end, information was required from the Special Registry of Health Providers (REPS) and the operating licenses of mammography equipment processed before the territorial entities; the information was processed, validated and analyzed through frequency distribution tables in the Microsoft Office Excel® program.
RESULTS
The estimation of screening mammography coverage for the country based on the census of mammographers is 27.6%; To reach the screening goal of screening mammography of 70% at the country level, a mammograph requires weekly 38.2 hours for screening, use 56.3% of total time for screening mammograms and acquire approximately 69 additional equipment to those screened in 2014. There are marked differences in these data at the department and regional level.
CONCLUSION
At the country level, the estimation of screening mammography coverage is not good, it is necessary to improve the performance of mammography equipment, as well as acquire additional equipment for some regions; accompanied by effective programmatic strategies in early detection of breast cancer.
Topics: Humans; Female; Mammography; Breast Neoplasms; Colombia; Mass Screening; Early Detection of Cancer
PubMed: 36753200
DOI: 10.15446/rsap.V21n5.81275 -
Asian Journal of Urology Jan 2023There are many models to predict extracapsular extension (ECE) in patients with prostate cancer. We aimed to externally validate several models in a Japanese cohort.
OBJECTIVE
There are many models to predict extracapsular extension (ECE) in patients with prostate cancer. We aimed to externally validate several models in a Japanese cohort.
METHODS
We included patients treated with robotic-assisted radical prostatectomy for prostate cancer. The risk of ECE was calculated for each patient in several models (prostate side-specific and non-side-specific). Model performance was assessed by calculating the receiver operating curve and the area under the curve (AUC), calibration plots, and decision curve analyses.
RESULTS
We identified ECE in 117 (32.9%) of the 356 prostate lobes included. Patients with ECE had a statistically significant higher prostate-specific antigen level, percentage of positive digital rectal examination, percentage of hypoechoic nodes, percentage of magnetic resonance imaging nodes or ECE suggestion, percentage of biopsy positive cores, International Society of Urological Pathology grade group, and percentage of core involvement. Among the side-specific models, the Soeterik, Patel, Sayyid, Martini, and Steuber models presented AUC of 0.81, 0.78, 0.77, 0.75, and 0.73, respectively. Among the non-side-specific models, the memorial Sloan Kettering Cancer Center web calculator, the Roach formula, the Partin tables of 2016, 2013, and 2007 presented AUC of 0.74, 0.72, 0.64, 0.61, and 0.60, respectively. However, the 95% confidence interval for most of these models overlapped. The side-specific models presented adequate calibration. In the decision curve analyses, most models showed net benefit, but it overlapped among them.
CONCLUSION
Models predicting ECE were externally validated in Japanese men. The side-specific models predicted better than the non-side-specific models. The Soeterik and Patel models were the most accurate performing models.
PubMed: 36721693
DOI: 10.1016/j.ajur.2022.02.008 -
Frontiers in Public Health 2022Elements associated with an increased risk factor for the contagion of COVID-19 in shelters include the turnover and overcrowding of people, time spent in communal...
The epidemiological follow-up process for suspected and confirmed cases of COVID-19 in migrant shelters on the northern border of Mexico from July to December 2020: Between contagion underestimation and containment.
BACKGROUND
Elements associated with an increased risk factor for the contagion of COVID-19 in shelters include the turnover and overcrowding of people, time spent in communal areas, daily supply needs, water availability, and sanitation levels. The "Report on the Effects of the COVID-19 Pandemic on Migrants and Refugees," shows that factors such as the shortage of food, supplies, water, sanitizing materials, spaces for healthy distancing, financial resources for rent and essential services, and the lack of medical or psychological care complicated providing care for migrants and applicants seeking international protection.
OBJECTIVE
We describe shelter operations regarding the detection and follow-up of suspected and confirmed COVID-19 cases showing mild symptoms among the migrant population housed in the border cities under study.
METHODS
We conducted semi-structured, in-depth interviews with study subjects (people in charge, managers, coordinators, shelter directors) from 22 migrant shelters, and 30 with key informants. We studied the cities of Tijuana (Baja California), Nogales (Sonora), Ciudad Juárez (Chihuahua), Piedras Negras (Coahuila), and Heroica Matamoros (Tamaulipas). The research was based on a qualitative methodological design with an ethnographic approach. The information collected was transcribed and systematized into two tables or analytical templates, one for interviews with study subjects, and another for interviews with key actors.
FINDINGS
Overall, seventy-eight registered shelters provided accommodation services for migrants in the five cities the study focused on: thirty-seven in Tijuana, five in Nogales, twenty-two in Ciudad Juárez, eight in Piedras Negras, and five plus a camp (six in total) in Matamoros. The major concentration of shelters was in Tijuana (47.4%) and Ciudad Juárez (28.2%). At the beginning of the pandemic, only a few shelter facilities met quarantine and isolation guidelines, such as having separate bathrooms and sufficient space to isolate the "asymptomatic" and "confirmed" from close "contacts". The lack of isolation space and the inability to support the monitoring of patients with COVID-19 posed a challenge for those housed in shelters, forcing many shelters to close or continue operating behind closed doors to avoid becoming a source of infection during the pandemic.
DISCUSSION AND OUTLOOK
Contrary to speculation, during the onset of the pandemic northern border migrant shelters did not become sources of COVID-19 infection. According to the data analyzed from 78 shelters only seven had confirmed cases, and the classification of "outbreak" was applied only in two facilities. Contagion control or containment was successful as the result of following a preventive containment logic, including the isolation of all suspected but unconfirmed cases, without a clear understanding of the human and financial resources required to maintain isolation areas. However, shelters in the study implemented protocols for epidemiological surveillance, control, and prevention with elements that interfered with monitoring spaces, and processes that caused oversights that resulted in underestimating the number of cases.
LIMITATIONS
Due to travel restrictions imposed to prevent and contain coronavirus infections it was impossible to stay on-site in the cities studied, except for Tijuana, or carry-out recordings of migrants' views in shelters.
Topics: Humans; COVID-19; Mexico; Transients and Migrants; Pandemics; Follow-Up Studies; Piedra
PubMed: 36711368
DOI: 10.3389/fpubh.2022.980808