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Orthopaedic Journal of Sports Medicine May 2024Greater trochanteric pain syndrome (GTPS) is characterized by gluteal enthesopathy involving the peritrochanteric space and associated with chronic pain and functional...
BACKGROUND
Greater trochanteric pain syndrome (GTPS) is characterized by gluteal enthesopathy involving the peritrochanteric space and associated with chronic pain and functional impairment. A corticosteroid injection in the trochanteric bursa is the usual palliative treatment for pain. However, it is important to investigate treatment options that will relieve pain in the peritrochanteric space.
PURPOSE
To compare the clinical efficacy of subfascial platelet-rich plasma (PRP) injection and enthesis needling for GTPS.
STUDY DESIGN
Randomized controlled trial; Level of evidence, 1.
METHODS
A total of 92 patients (90% women; mean age, 55 years old; mean body mass index, 25.3 kg/m) were randomly divided into a subfascial PRP injection group and an enthesis needling group. Descriptive data and radiographic measurements of the pelvis-including leg-length difference, pelvic width difference, and pelvic trochanteric index-were recorded. The primary outcome measures were the Hip Outcome Score (HOS) activities of daily living (HOS-ADL) and sports-specific (HOS-SS) subscales and the visual analog scale for pain at 3, 6, and 12 months posttreatment. In addition, we evaluated the presence or absence of ultrasound characteristics (fascia nodules, trochanteric bursa distension, and calcium deposits) over time in response to treatment.
RESULTS
Baseline demographic and radiological characteristics were similar between the groups. The PRP group saw significantly greater improvement from baseline to 12 months posttreatment on the HOS-SS subscore compared with the needling group (32.09 [95% CI, 28.99-40.20] vs 20.52 [95% CI, 11.99-29.05]; = .048). At 3 months, 60% of patients in the PRP group versus 33.3% in the needling group had a reduction in pain compared with a baseline of >20% ( = .040). After subfascial PRP injection, fewer patients had a fascia nodule over the trochanter and/or bursa distension ( = .006 and = .004, respectively). The pelvic trochanteric index was predictive of HOS-ADL and HOS-SS outcomes ( = .011 and = .022, respectively). The interaction between treatment modality and fascia nodule influenced HOS-ADL and HOS-SS outcomes ( = .021 and = .023) as well as the interactions of treatment modality, fascia nodules, and calcifications ( = .027).
CONCLUSION
Both subfascial PRP injection and enthesis needling resulted in clinical improvements, but the improvement in the HOS-SS was greater in the PRP group.
REGISTRATION
NCT04231357 (ClinicalTrials.gov identifier).
PubMed: 38751852
DOI: 10.1177/23259671241249123 -
Translational Breast Cancer Research :... 2024While the axillary nodal basin is the most common lymphatic drainage pathway of the breast, the internal mammary (IM) lymph node chain plays a significant role in breast... (Review)
Review
BACKGROUND AND OBJECTIVE
While the axillary nodal basin is the most common lymphatic drainage pathway of the breast, the internal mammary (IM) lymph node chain plays a significant role in breast cancer staging and treatment. It has been identified as sentinel nodal drainage in approximately 13-37% of patients. Despite this, the data is still limited with regard to diagnosis and management when there is suspicion or confirmation of IM lymph node (IMLN) involvement by metastatic breast cancer. The objective of this publication is to provide a comprehensive assessment of the current body of literature surrounding the diagnosis, management and prognostic value of IMLNs in breast cancer treatment.
METHODS
Review of the literature published regarding IMLN diagnosis, significance, and management was completed in PubMed. Additional focus was placed on reviewing articles published within the past 10 years as foundation for an update regarding the current practice and future directions in this space.
KEY CONTENT AND FINDINGS
Improved imaging techniques, with positron emission tomography-computed tomography and magnetic resonance imaging, have led to increase in the identification of IM lymphadenopathy, yielding surgical staging of the IM nodes nearly obsolete. While IM nodal metastases may play a role in overall survival (OS), it has not been demonstrated to be an independent risk factor for increased locoregional recurrence. IM nodal irradiation (IMNI) therapy has been a mainstay in the treatment of IM disease in the context of breast cancer. IMNI has demonstrated improvement in OS and risk of distant recurrence. Wide variations in radiation practices for patients with IM lymphadenopathy exist internationally, highlighting the lack of clear data driven consensus guidelines.
CONCLUSIONS
Herein, we provide an updated assessment of the current diagnosis, clinical significance, and management of IM lymphadenopathy for breast cancer patients.
PubMed: 38751672
DOI: 10.21037/tbcr-24-2 -
JPMA. the Journal of the Pakistan... Apr 2024The nasopharynx is a rare anatomical location where a foreign body may become lodged after being ingested or inhaled. We are presenting a rare case of nasopharyngeal...
The nasopharynx is a rare anatomical location where a foreign body may become lodged after being ingested or inhaled. We are presenting a rare case of nasopharyngeal foreign body impaction in a two-and-a-half-year-old child that had been missed for almost a year. The child presented with a history of right-sided foul-smelling nasal discharge, snoring and mouth breathing. An X-Ray soft tissue lateral view of the post-nasal space showed an irregular partially radiopaque nasopharyngeal foreign body. The removal of the foreign body was performed under general anaesthesia successfully. Foreign body impaction in the nasopharynx can easily be missed and it is important to keep this region in mind when dealing with missing inhaled or ingested foreign bodies.
Topics: Humans; Foreign Bodies; Nasopharynx; Child, Preschool; Male; Radiography
PubMed: 38751281
DOI: 10.47391/JPMA.9051 -
Research Square Apr 2024Natural killer (NK) cells are important effectors of the innate immune system. Unlike T cells, NK cells do not require antigen-priming, making them an important...
Natural killer (NK) cells are important effectors of the innate immune system. Unlike T cells, NK cells do not require antigen-priming, making them an important first-line of defense against malignant cells. Because of the potential for increased cancer risk as a result of astronaut exposure to space radiation, we performed studies to determine whether conditions of microgravity present during spaceflight affects the body's natural defenses against leukemogenesis. Human NK cells were cultured for 48 hours under normal gravity and simulated microgravity (sµG), and cytotoxicity against K-562 (CML) and MOLT-4 (T-ALL) cell lines was measured using standard methodology or under continuous conditions of sµG. Even this brief exposure to sµG markedly reduced NK cytotoxicity against both leukemic cells using standard assay procedures, and these deleterious effects were even more pronounced in continuous sµG. RNA-seq performed on NK cells from two healthy donors provided insight into the mechanism(s) by which sµG reduced cytotoxicity. Given our prior report that human HSC exposed to simulated space radiation gave rise to T-ALL , the reduced cytotoxicity against MOLT-4 is striking and raises the possibility that µG may add to astronaut risk of leukemogenesis during prolonged missions beyond LEO.
PubMed: 38746365
DOI: 10.21203/rs.3.rs-3972868/v1 -
ArXiv Apr 2024Magnetic resonance imaging (MRI) has revolutionized medical imaging, providing a non-invasive and highly detailed look into the human body. However, the long acquisition...
Magnetic resonance imaging (MRI) has revolutionized medical imaging, providing a non-invasive and highly detailed look into the human body. However, the long acquisition times of MRI present challenges, causing patient discomfort, motion artifacts, and limiting real-time applications. To address these challenges, researchers are exploring various techniques to reduce acquisition time and improve the overall efficiency of MRI. One such technique is compressed sensing (CS), which reduces data acquisition by leveraging image sparsity in transformed spaces. In recent years, deep learning (DL) has been integrated with CS-MRI, leading to a new framework that has seen remarkable growth. DL-based CS-MRI approaches are proving to be highly effective in accelerating MR imaging without compromising image quality. This review comprehensively examines DL-based CS-MRI techniques, focusing on their role in increasing MR imaging speed. We provide a detailed analysis of each category of DL-based CS-MRI including end-to-end, unroll optimization, self-supervised, and federated learning. Our systematic review highlights significant contributions and underscores the exciting potential of DL in CS-MRI. Additionally, our systematic review efficiently summarizes key results and trends in DL-based CS-MRI including quantitative metrics, the dataset used, acceleration factors, and the progress of and research interest in DL techniques over time. Finally, we discuss potential future directions and the importance of DL-based CS-MRI in the advancement of medical imaging. To facilitate further research in this area, we provide a GitHub repository that includes up-to-date DL-based CS-MRI publications and publicly available datasets - https://github.com/mosaf/Awesome-DL-based-CS-MRI.
PubMed: 38745700
DOI: No ID Found -
Scientific Reports May 2024In order to solve the difficult portability problem of traditional non-invasive sleeping posture recognition algorithms arising from the production cost and...
In order to solve the difficult portability problem of traditional non-invasive sleeping posture recognition algorithms arising from the production cost and computational cost, this paper proposes a sleeping posture recognition model focusing on human body structural feature extraction and integration of feature space and algorithms based on a specific air-spring mattress structure, called SPR-DE (SPR-DE is the Sleep Posture Recognition-Data Ensemble acronym form). The model combines SMR (SMR stands for Principle of Spearman Maximal Relevance) with horizontal and vertical division based on the barometric pressure signals in the human body's backbone region to reconstruct the raw pressure data into strongly correlated non-image features of the sleep postures in different parts and directions and construct the feature set. Finally, the recognit-ion of the two sleep postures is accomplished using the AdaBoost-SVM integrated classifier. SPR-DE is compared with the base and integrated classifiers to verify its performance. The experimental results show that the amount of significant features helps the algorithm to classify different sleeping patterns more accurately, and the f1 score of the SPR-DE model determined by the comparison experiments is 0.998, and the accuracy can reach 99.9%. Compared with other models, the accuracy is improved by 2.9% ~ 7.7%, and the f1-score is improved by 0.029 ~ 0.076. Therefore, it is concluded that the SMR feature extraction strategy in the SPR-DE model and the AdaBoost-SVM can achieve high accuracy and strong robustness in the task of sleep posture recognition in a small area, low-density air-pressure mattress, taking into account the comfort of the mattress structural design and the sleep posture recognition, integrated with the mattress adaptive adjustment system.
Topics: Humans; Posture; Sleep; Beds; Algorithms; Pressure; Male; Adult
PubMed: 38744916
DOI: 10.1038/s41598-024-61267-0 -
Gut Microbes 2024The role of gut microbiome in health, a century-old concept, has been on the center stage of medical research recently. While different body sites, disease conditions,... (Review)
Review
The role of gut microbiome in health, a century-old concept, has been on the center stage of medical research recently. While different body sites, disease conditions, and populations have been targeted, neonatal and early infancy appear to be the most suitable period for such interventions. It is intriguing to note that, unlike traditional use in diarrhea and maintenance of gastrointestinal health, microbiome-mediating therapies have now addressed the most serious medical conditions in young infants such as necrotizing enterocolitis and neonatal sepsis. Unfortunately, almost all new endeavors in this space have been carried out in the Western world leaving behind millions of neonates that can benefit from such manipulations while serving as a large resource for further learning. In this review, an attempt has been made to quantify the global burden of neonatal morbidity and mortality, examples presented on interventions that have failed as a result of drawing from studies conducted in the West, and a case made for manipulating the neonatal gut microbiome to address the biggest killers in early life. A brief comparative analysis has been made to demonstrate the differences in the gut microbiota of North and South and a large clinical trial of synbiotics conducted by our group in a South Asian setting has been presented. Although challenging, the value of conducting such global health research is introduced with an intent to invite medical scientists to engage in well-planned, scientifically robust research endeavors. This can bring about innovation while saving and serving the most vulnerable citizens now and protecting them from the negative health consequences in the later part of their lives, ultimately shaping a resilient and equitable world as pledged by 193 United Nations member countries in 2015.
Topics: Humans; Gastrointestinal Microbiome; Infant, Newborn; Global Health; Enterocolitis, Necrotizing; Infant; Synbiotics; Neonatal Sepsis
PubMed: 38743045
DOI: 10.1080/19490976.2024.2352175 -
Veterinary Medicine and Science May 2024A 15-month-old, grey, Thoroughbred filly presented for investigation of a 6-week history of corneal oedema and blepharospasm on the right eye (OD). The filly was...
A 15-month-old, grey, Thoroughbred filly presented for investigation of a 6-week history of corneal oedema and blepharospasm on the right eye (OD). The filly was otherwise healthy. Following ophthalmic examination, glaucoma on the OD was diagnosed. A space occupying mass within the anterior chamber was documented on transpalpebral ultrasonographic examination. This mass obliterated most of the anterior intraocular structures on the peripheral nasal side (corneal endothelium and drainage angle), leading to secondary glaucoma. After systemic and topical treatment addressing secondary glaucoma, the corneal oedema reduced. The mass was visualised as an irregularly rounded brown structure associated with the iris on the peripheral nasal side of the anterior chamber. Given the filly's signalment, location and appearance of the mass, a tentative diagnosis of intraocular melanoma was made and enucleation was performed. Histopathological evaluation of the globe revealed solid sheets of heavily pigmented melanocytic cells, disrupting the normal ciliary body architecture and extending into the iris and subretinal. The cells were pleomorphic, polyhedral to round with occasional spindle-shaped cells, and contained moderate to large amounts of granular black-brown pigment (melanin). The iridal component expanded into the anterior chamber, with cells directly opposed to Descemet's membrane, with loss of the endothelium and expanding and occluding the filtration angle in this area. The lesion infiltrated locally into the edge of the sclera, but did not extend through the sclera, though occasional perivascular clusters of melanophages were observed within the scleral stroma adjacent to the optic nerve. Diagnosis of a uveal melanocytic neoplasm was confirmed, with characteristics similar to only one reported case . This is a unique case of a rapidly growing, invasive, uveal melanoma in a young horse. Intraocular melanoma should be considered as a differential diagnoses for glaucoma in grey horses, regardless of the age and absence of melanocytic skin lesions.
Topics: Animals; Horses; Horse Diseases; Glaucoma; Melanoma; Female; Eye Neoplasms
PubMed: 38739097
DOI: 10.1002/vms3.1471 -
Sensors (Basel, Switzerland) Apr 2024This paper presents findings from a spaceborne Earth observation experiment utilizing a novel, ultra-compact hyperspectral imaging camera aboard a 3U CubeSat. Leveraging...
This paper presents findings from a spaceborne Earth observation experiment utilizing a novel, ultra-compact hyperspectral imaging camera aboard a 3U CubeSat. Leveraging the Offner optical scheme, the camera's hyperspectrometer captures hyperspectral images of terrestrial regions with a 200 m spatial resolution and 12 nanometer spectral resolution across a 400 to 1000 nanometer wavelength range, covering 150 channels in the visible and near-infrared spectrums. The hyperspectrometer is specifically designed for deployment on a 3U CubeSat nanosatellite platform, featuring a robust all-metal cylindrical body of the hyperspectrometer, and a coaxial arrangement of the optical elements ensures optimal compactness and vibration stability. The performance of the imaging hyperspectrometer was rigorously evaluated through numerical simulations prior to construction. Analysis of hyperspectral data acquired over a year-long orbital operation demonstrates the 3U CubeSat's ability to produce various vegetation indices, including the normalized difference vegetation index (NDVI). A comparative study with the European Space Agency's Sentinel-2 L2A data shows a strong agreement at critical points, confirming the 3U CubeSat's suitability for hyperspectral imaging in the visible and near-infrared spectrums. Notably, the ISOI 3U CubeSat can generate unique index images beyond the reach of Sentinel-2 L2A, underscoring its potential for advancing remote sensing applications.
PubMed: 38732991
DOI: 10.3390/s24092885 -
Diagnostics (Basel, Switzerland) Apr 2024The paper presents a system for analyzing cardiac activity with the possibility of continuous and remote monitoring. The created sensor mobile device monitors heart...
The paper presents a system for analyzing cardiac activity with the possibility of continuous and remote monitoring. The created sensor mobile device monitors heart activity by means of the convenient and imperceptible registration of cardiac signals. At the same time, the behavior of the human body is also monitored through the accelerometer and gyroscope built into the device, thanks to which it is possible to signal in the event of loss of consciousness or fall (in patients with syncope). Conducting real-time cardio monitoring and the analysis of recordings using various mathematical methods (linear, non-linear, and graphical) enables the research, accurate diagnosis, timely assistance, and correct treatment of cardiovascular diseases. The paper examines the recordings of patients diagnosed with arrhythmia and syncope recorded by electrocardiography (ECG) sensors in real conditions. The obtained results are subjected to statistical analysis to determine the accuracy and significance of the obtained results. The studies show significant deviations in the patients with arrhythmia and syncope regarding the obtained values of the studied parameters of heart rate variability (HRV) from the accepted normal values (for example, the root mean square of successive differences between normal heartbeats (RMSSD) in healthy individuals is 24.02 ms, while, in patients with arrhythmia (6.09 ms) and syncope (5.21 ms), it is much lower). The obtained quantitative and graphic results identify some possible abnormalities and demonstrate disorders regarding the activity of the autonomic nervous system, which is directly related to the work of the heart.
PubMed: 38732339
DOI: 10.3390/diagnostics14090926