bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Indirect Decompression and Fusion More Effective than Direct Decompression and Fusion for Treating Degenerative Lumbar Spinal Stenosis With Instability? A Systematic Review and meta-Analysis
Authors: Gagliardi Martin J. , Guiroy Alfredo J. , Camino-Willhuber Gaston , Joaquim Andrei F. , Carazzo Charles A. , Yasuda Ezequiel , Cabrera Juan P. , Morales Ciancio Alejandro R.
Published: April 2022

Study design: Systematic Review and Meta-analysis.

Objective: Surgical alternatives to treat lumbar spinal stenosis and instability include indirect (ALIF, OLIF, and LLIF) and direct (TLIF or posterior lumbar interbody fusion) decompression and fusion interventions. Although both approaches have proven to be effective in reducing symptoms, it is unknown if there is any difference in effectiveness between them. In this systematic review and meta-analysis, we aimed to evaluate postoperative pain and disability in patients treated whit indirect vs direct decompression and fusion approaches.

Methods: We conducted a systematic review of the literature consulting several databases and identified studies that enrolled patients diagnosed with degenerative lumbar spinal stenosis and instability treated with indirect or direct decompression and fusion techniques. Our primary endpoints were the visual analogue scale, Oswestry Disability Index, and the Japanese Orthopedics Association Back Pain Evaluation Questionnaire 1 year after the procedure. Secondary outcomes included complication rate, blood loss, and surgical time.

Results: Nine retrospective and comparative studies were included enrolling a total of 1004 participants. Both surgical strategies had satisfactory clinical outcomes with no significant difference at 1 year. Although the complication rate was similar for both groups, the profile of the adverse events was different. In addition, patients treated with indirect decompression and fusion had significantly less blood loss and operative times.

Conclusions: Indirect and direct decompression and fusion techniques are similarly effective in treating patients with lumbar spinal stenosis and instability. The ID group had significantly lower intraoperative blood loss and surgical time values.
Midostaurin plus intensive chemotherapy for younger and older patients with AML and FLT3 internal tandem duplications
Authors: Döhner Hartmut , Weber Daniela , Krzykalla Julia , Fiedler Walter , Wulf Gerald , Salih Helmut , Lübbert Michael , Kühn Michael W. M. , Schroeder Thomas , Salwender Hans , Götze Katharina , Westermann Jörg , Fransecky Lars , Mayer Karin , Hertenstein Bernd , Ringhoffer Mark , Tischler Hans-Joachim , Machherndl-Spandl Sigrid , Schrade Anika , Paschka Peter , Gaidzik Verena I. , Theis Frauke , Thol Felicitas , Heuser Michael , Schlenk Richard F. , Bullinger Lars , Saadati Maral , Benner Axel , Larson Richard , Stone Richard , Döhner Konstanze , Ganser Arnold
Published: April 2022

We conducted a single-arm, phase 2 trial (German-Austrian Acute Myeloid Leukemia Study Group [AMLSG] 16-10) to evaluate midostaurin with intensive chemotherapy followed by allogeneic hematopoietic-cell transplantation (HCT) and a 1-year midosta urin maintenance therapy in adult patients with acute myeloid leukemia (AML) and fms-related tyrosine kinase 3 (FLT3) internal tandem duplication (ITD). Patients 18 to 70 years of age with newly diagnosed FLT3-ITD-positive AML were eligible. Primary and key secondary endpoints were event-free survival (EFS) and overall survival (OS). Results were compared with a historical cohort of 415 patients treated on 5 prior AMLSG trials; statistical analysis was performed using a double-robust adjustment with propensity score weighting and covariate adjustment. Results were also compared with patients (18-59 years) treated on the placebo arm of the Cancer and Leukemia Group B (CALGB) 10603/RATIFY trial. The trial accrued 440 patients (18-60 years, n = 312; 61-70 years, n = 128). In multivariate analysis, EFS was significantly in favor of patients treated within the AMLSG 16-10 trial compared with the AMLSG control (hazard ratio [HR], 0.55; P < .001); both in younger (HR, 0.59; P < .001) and older patients (HR, 0.42; P < .001). Multivariate analysis also showed a significant beneficial effect on OS compared with the AMLSG control (HR, 0.57; P < .001) as well as to the CALGB 10603/RATIFY trial (HR, 0.71; P = .005). The treatment effect of midostaurin remained significant in sensitivity analysis including allogeneic HCT as a time-dependent covariate. Addition of midostaurin to chemotherapy was safe in younger and older patients. In comparison with historical controls, the addition of midostaurin to intensive therapy led to a significant improvement in outcome in younger and older patients with AML and FLT3-ITD. This trial is registered at clinicaltrialsregistry.eu as Eudra-CT number 2011-003168-63 and at clinicaltrials.gov as NCT01477606.
The duration of chronic low back pain is associated with acute postoperative pain intensity in lumbar fusion surgery: a prospective observational study
Authors: Qian Mei-ping , Dong Mei-rong , Li Juan , Kang Fang
Published: April 2022

Background

Pre-existing chronic pain has been associated with severe postoperative pain. In this study, we sought to prospectively analyse the association between the duration of chronic low back pain and the intensity of acute postoperative pain after lumbar fusion surgery.

Methods

A total of 330 patients who underwent lumbar fusion surgery were divided into three groups (chronic low back pain less than 1 year, one to 5 years, and more than 5 years) based on the duration of chronic pain. On the first postoperative day, the maximum pain scores of each patient were recorded during the day and at night. Bivariate correlation and logistic regression were performed to identify relationships between acute postoperative pain and related variables (age, sex, smoking history, body mass index, operation history, duration of surgery, level of preoperative pain, aetiology of back pain, Self-rating Anxiety Scale, Self-rating Depression Scale, FRAIL scale, and duration of chronic low back pain). If the postoperative pain score was > 3 when the patient reported was at rest, the patients were treated with postoperative intravenous self-controlled analgesia or rescue analgesics if necessary.

Results

There was an association between severe acute postoperative pain and the duration of chronic low back pain. In terms of VAS day, multivariable logistic regression showed the duration of chronic low back pain was not statistically significant (OR = 2.48, 95% CI: 0.900 to 6.828, p = 0.0789). The result is uncertain because the confidence interval included the null after controlling for SAS, SDS, BMI, and aetiology of back pain. In terms of VAS night, patients with a duration of chronic low back pain of more than 5 years were more likely having moderate to severe acute postoperative pain (VAS > 3) compared to patients with a duration of chronic low back pain less than 1 year (OR = 3.546, 95% CI: 1.405 to 8.95, p = 0.0074). Hospital stay, the pain score on the day of discharge and the pain score after 3 months displayed no significant difference among the three groups (P > 0.05). However, the need for postoperative rescue analgesics was different among the three groups (P < 0.05).

Conclusion

The longer the duration of chronic pain was, the higher the incidence of moderate to severe acute postoperative pain was and the greater the amount of analgesics required after surgery.

Trial registration

This study was registered at the Chinese Clinical Trial Registration Center (http://www.chictr.org.cn/index.aspx, clinical trial number: ChiECRCT20200165, date of registration: July 6, 2020).
The lateral femoral notch sign and coronal lateral collateral ligament sign in magnetic resonance imaging failed to predict dynamic anterior tibial laxity
Authors: Huang Tzu-Ching , Liu Zhao-Wei , Hong Chih-Kai , Wang Chi-Hsiu , Hsu Kai-Lan , Kuan Fa-Chuan , Su Wei-Ren
Published: April 2022

Purpose

To investigate the relationship between the lateral femoral notch sign as well as the coronal lateral collateral ligament (LCL) sign and anterior tibial translation using the GNRB arthrometer in patients with anterior cruciate ligament (ACL) injuries.

Methods

Forty-six patients with ACL injuries were retrospectively included from May 2020 to February 2022; four patients were excluded due to incomplete data. Magnetic resonance imaging (MRI) were reviewed for the lateral femoral notch sign and the coronal LCL sign. The GNRB arthrometer was used to evaluate the dynamic anterior tibial translation of the knee, and the side-to-side differences (SSDs) in tibial translation between the injured knee and healthy knee were calculated at different force levels. Two types of slopes for displacement-force curves were acquired.

Results

Six patients (14.3%) had the positive lateral femoral notch sign (notch depth > 2.0 mm), and 14 patients (33.3%) had the positive coronal LCL sign. The SSD of the anterior tibial translations under different loads as well as the slopes of displacement-force curves were the same in the positive and negative notch sign groups (p all > 0.05) and between the positive and negative coronal LCL sign groups (p all > 0.05). Meanwhile, the measured notch depth and notch length were also not significantly correlated with the anterior tibial translation SSD in the GNRB.

Conclusion

The presence of the lateral femoral notch sign and the coronal LCL sign did not indicate greater dynamic tibial laxity as measured using the GNRB.
Effects of early preventive dental visits and its associations with dental caries experience: a cross-sectional study
Authors: Qu Xing , Houser Shannon H. , Tian Meirong , Zhang Qiong , Pan Jay , Zhang Wei
Published: April 2022

Objectives

Limited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old.

Methods

A cross-sectional survey was conducted in five selected primary health care facilities in Chengdu, China, from May to August 2021. Parent–child dyads during regular systematic medical management were recruited to participate. Children's dental caries were identified through dental examinations and documented as decayed, missing and filled teeth index (dmft) by trained primary care physicians. Dental-related information was collected through a questionnaire. Zero-inflated negative binomial (ZINB) regression was used to test the effect of early PDV on the dmft value, and logistic regression was used to analyse impact factors on the early PDV.

Results

A total of 2028 out of 2377 parent–child dyads were qualified for analysis. Half of the children (50.4%) were male, with a mean age of 4.8 years. Among all the children, 12.1% had their first dental visit for preventive purposes, 34.4% had their first dental visit for symptomatic purposes, and more than half had never visited a dentist. The results showed that a lower dmft value (adjusted OR: 0.69, 95% CI: 0.48–0.84), a higher rate of caries-free (aOR: 6.5, 95% CI: 3.93–10.58), and a lower rate of untreated dental caries (aOR: 0.40, 95% CI: 0.21–0.76) were associated with early PDV utilization. Children who had a higher rate of PDV were positively associated with living in a family with better parental behaviours (aOR: 2.30, 95% CI: 1.71–3.08), better parental oral health perception (aOR: 1.23, 95% CI: 1.06–1.32), fathers who had no untreated caries (aOR: 0.68, 95% CI: 0.47–0.97), families with higher socioeconomic status (aOR: 1.09, 95% CI: 1.04–1.16), and dental health advice received from well-child care physicians (aOR: 1.47, 95% CI: 1.08–2.00).

Conclusions

Early PDV was associated with a lower rate of dental caries prevalence and untreated dental caries among sampled children younger than seven in Western China. Underutilization and social inequities existed in PDV utilization. Public health strategies should be developed to increase preventive dental visits and eliminate social disparities that prevent dental care utilization.
Healthcare provider person-centred practice: relationships between prerequisites, care environment and care processes using structural equation modelling
Authors: Balqis-Ali Nur Zahirah , Saw Pui San , Anis-Syakira Jailani , Fun Weng Hong , Sararaks Sondi , Lee Shaun Wen Huey , Abdullah Mokhtar
Published: April 2022

Background

The translation of person-centred care concepts into practice requires fulfilment of necessary components, including person-centred values and practice held by the employees and having a supportive system. The objectives of this study were multifold: firstly, to evaluate the measurement model, secondly, to examine the roles of prerequisite or attributes of healthcare providers and care environment and how they affect delivery of person-centred processes; and finally, to examine the mediating effect of care environment towards the relationship between prerequisite and care processes.

Methods

A cross sectional study was conducted among healthcare providers working in primary care facilities in a state in Malaysia. The Person-centred Practice Inventory-Staff instrument (PCPI-S) was distributed and completed by respondents. The instrument structure, reliability and validity were assessed through confirmatory factor analysis, while the framework’s unidirectional hypothesis and the mediation path hypothesis were analysed using structural equation modelling.

Results

The overall goodness of fit verifies the original Person-centred Practice Framework, allowing some correlation errors. There were significant relationships between prerequisites of healthcare providers and care environment (β = 0.826, p < 0.001), as well as between care environment and care processes (β = 0.785, p < 0.001). This analysis also proved that care environment plays a partial mediating role in the relationship between prerequisites and care processes.

Conclusions

In order to successfully move towards delivering person-centred practice, it is imperative to equip healthcare providers with person-centred values and beliefs, while at the same time transform current work culture to align with person-centred care. This will allow successful delivery of person-centred processes.

Trial registration

NMRR-18-309-40,447.
Signature transcriptome analysis of stage specific atherosclerotic plaques of patients
Authors: Verma Sonia , Kumar Abhay , Narang Rajiv , Bisoi Akshya K. , Mitra Dipendra K.
Published: April 2022

Background

Inflammation plays an important role in all the stages of atherosclerotic plaque development. The current study aimed at assessing the altered expression of genes functioning in inflammation within the early stage (ES) and advanced stage (AS) atherosclerotic plaques obtained from patients undergoing coronary artery bypass grafting (CABG) surgery and identifying biomarker panel/s that may detect the status of plaque stages using peripheral blood samples.

Methods

A section of ES and AS plaques and normal left internal mammary arteries (LIMA) were obtained from 8 patients undergoing the CABG surgery. Total RNA isolated was analyzed for mRNA and miRNA expression profile by Affymetrix arrays. A significant number of mRNAs was found to be differentially expressed in ES and AS plaque tissues relative to LIMA. The pathway analysis of differentially expressed mRNAs in the two plaque stages was also performed using DAVID Bioinformatics Database.

Results

The mRNAs were found to be involved in critical inflammatory processes such as the toll-like receptor signaling pathway and cytokine-cytokine receptor interaction. Few miRNAs targeting these mRNAs were also altered in the two plaque conditions. QRT-PCR results showed a similar expression pattern of a few of the mRNAs and miRNAs in peripheral blood of the same patients relative to healthy controls.

Conclusion

Changes in mRNA and miRNA expression associated with various inflammatory processes occur in different atherosclerotic stage plaques as well as peripheral blood. Detection of such variations in patients’ blood can be used as a possible prognostic tool to detect and/or predict the risk and stage of atherosclerosis.
Impact of oligomerization on the allergenicity of allergens
Authors: Hasan-Abad Amin Moradi , Mohammadi Mohsen , Mirzaei Hamed , Mehrabi Mohsen , Motedayyen Hossein , Arefnezhad Reza
Published: April 2022

Type I hypersensitivity (allergic reaction) is an unsuitable or overreactive immune response to an allergen due to cross-link immunoglobulin E (IgE) antibodies bound to its high-affinity IgE receptors (FcεRIs) on effector cells. It is needless to say that at least two epitopes on allergens are required to the successful and effective cross-linking. There are some reports pointing to small proteins with only one IgE epitope could cross-link FcεRI-bound IgE through homo-oligomerization which provides two same IgE epitopes. Therefore, oligomerization of allergens plays an indisputable role in the allergenic feature and stability of allergens. In this regard, we review the signaling capacity of the B cell receptor (BCR) complex and cross-linking of FcεRI which results in the synthesis of allergen-specific IgE. This review also discusses the protein-protein interactions involved in the oligomerization of allergens and provide some explanations about the oligomerization of some well-known allergens, such as calcium-binding allergens, Alt a 1, Bet v 1, Der p 1, Per a3, and Fel d 1, along with the effects of their concentrations on dimerization.
The role of SK3 in progesterone-induced inhibition of human fallopian tubal contraction
Authors: Zhang Duo , Zhu Qian , Xia Wei , Zhu Chenfeng , Zhao Xiaoya , Zhang Yiqin , He Chuqing , Ji Sifan , Li Xiaocui , Zhang Jian
Published: April 2022

Background

Normal motor activity of the fallopian tube is critical for human reproduction, and abnormal tubal activity may lead to ectopic pregnancy (EP) or infertility. Progesterone has an inhibitory effect on tubal contraction; however, the underlying mechanisms remain unclear. Small-conductance calcium-activated K+ channel 3 (SK3) is abundantly expressed in platelet-derived growth factor receptor α positive (PDGFRα+) cells and was reported to be important for the relaxation of smooth muscle. The present study aims to explore the expression of SK3 in the human fallopian tube and its role in progesterone-induced inhibition of tubal contraction.

Methods

We collected specimens of fallopian tubes from patients treated by salpingectomy for EP (EP group) and other benign gynecological diseases (Non-EP group). The expression of SK3 was detected by quantitative real-time polymerase chain reaction, western blot, immunocytochemistry, and immunohistochemistry analyses. Isometric tension experiments were performed to investigate the role of SK3 in progesterone-induced inhibition of tubal contraction.

Results

The baseline amplitude and frequency of human fallopian tube contraction were both statistically lower in the EP group compared with the non-EP group. The expression levels of SK3 in different portions of fallopian tubes from the non-EP group were significantly higher than in those from the EP group. Progesterone had an inhibitory effect on tubal contraction, mainly on the amplitude, in both groups, and SK3 as well as other calcium-activated K+ channels may be involved. SK3-expressing PDGFRα (+) cells were detected in the human fallopian tube.

Conclusions

The expression of SK3 is lower in the EP group, and SK3 is involved in the progesterone-induced inhibition of human fallopian tube contraction.
Positive mental health in psychotherapy: a qualitative study from psychotherapists’ perspectives
Authors: Chang Sherilyn , Sambasivam Rajeswari , Seow Esmond , Subramaniam Mythily , Ashok Assudani Hanita , Tan Geoffrey Chern-Yee , Lu Sharon Huixian , Vaingankar Janhavi Ajit
Published: April 2022

Background

There is growing evidence in the literature on the use of positive mental health (PMH) interventions among clinical samples. This qualitative study aims to explore the definitions of PMH from psychotherapists’ perspectives, and to examine views and attitudes related to the construct.

Methods

Focus group discussions were conducted with psychotherapists at a tertiary psychiatric institute. Focus group sessions were transcribed verbatim and transcripts were analyzed using an inductive thematic approach.

Results

Five themes related to psychotherapists’ definition of PMH were identified: (1) acceptance; (2) normal functioning and thriving in life; (3) resilience; (4) positive overall evaluation of life; (5) absence of negative emotions and presence of positive emotion states. Themes related to views and attitudes towards PMH were: (1) novel and valuable for psychotherapy; (2) reservations with terminology; (3) factors influencing PMH.

Conclusion

PMH in psychotherapy is a multidimensional concept that means more than symptom management and distress reduction in clients. There is potential value for its application in psychotherapy practice, though some concerns need to be addressed before it can be well integrated.
Voiding cysto-urethrography of complete urethral duplication in a child, a case report
Authors: Jahanshahi Amirreza , Falaki Reyhane , Falahatian Masih
Published: April 2022

Background

Urethral duplication is a very uncommon congenital anomaly that predominantly affects males. This condition is distinguished by the presence of two urethras, which might be incomplete or complete. The diagnosis of urethral duplication is very important, and missing this diagnosis leads to the delayed surgical correction of patients. Voiding cysto-urethrography is an important diagnostic method to diagnose the urethral duplication that can provide a standard view for surgical operation and determine the type of duplication.

Case presentation

In the present study, we report a 5-year-old boy with complete urethral duplication diagnosed via voiding cysto-urethrography in our medical center. We reviewed the classification of this anomaly, indications of surgery, the importance of voiding cysto-urethrography, and the role of other imaging modalities to diagnose the urethral duplication.

Conclusion

For children with a double urinary stream, a complete genital examination and radiological assessment are required not only to diagnose urethral duplication but also to determine the kind of urethral duplication and rule out related anomalies. These findings guide surgeons in planning the best treatment for the patients to prevent future complications. Voiding cysto-urethrography is one of the most useful and beneficial procedures to diagnose the urethral duplication which can be used as a first imaging modality, especially when there are double functional urethras.
Current Therapy for Metastatic Head and Neck Cancer: Evidence, Opportunities, and Challenges
Authors: Wise-Draper Trisha M. , Bahig Houda , Tonneau Marion , Karivedu Vidhya , Burtness Barbara
Published: April 2022

Management of metastatic head and neck squamous cell carcinoma is evolving as new systemic therapies have led to improvements in survival, and as advances in locoregional therapy and the increased numbers of patients with HPV-associated cancers who develop oligometastases raise the possibility of ablation of limited numbers of metastases. We review the data regarding first-line immunotherapy in PD-L1–expressing metastatic head and neck squamous cell carcinoma, the experience with aggressive local management of oligometastases, and promising novel immunotherapies, targeted therapies, and HPV-specific treatments. For patients with metastatic head and neck squamous cell carcinoma that is PD-L1 expressing, first-line systemic therapy is pembrolizumab or pembrolizumab with chemotherapy. Inclusion of chemotherapy is associated with higher objective response proportion in all biomarker subgroups and may have a greater impact on survival in HPV-associated cancers. For patients with oligometastatic disease, particularly when metastases are metachronous, current evidence supporting the role of local ablation is limited to a small number of retrospective studies. Based on retrospective data, patients with a smaller number of metastases, lung metastases, and/or virally associated head and neck squamous cell carcinoma are most likely to benefit from an aggressive ablative approach. Additionally, we review emerging evidence for targeted therapy in metastatic head and neck squamous cell carcinoma, including with agents that inhibit mutant HRAS or NOTCH1, or overexpressed EGFR. Studies of antiangiogenic agents in combination with immune checkpoint blockade, and combination immunotherapy, are also under study.
Optic Tract as an Upper Limit in Amygdalectomy: Microsurgical Study
Authors: Garcia-Oriola Guillermo , Tomasi Santino Ottavio , Gallardo Federico , Umana Giuseppe Emmanuele , Lawton Michael T. , Winkler Peter A.
Published: April 2022

BACKGROUND:

In surgeries involving resection of the amygdala, despite clear relations established with the medial, lateral, anterior, posterior, and inferior segments, the upper limit remains controversial. The optic tract (OT) has been anatomically considered as a good landmark immediately inferior to the striatopallidal region. This anatomic structure has barely been explored by microsurgical study, generating uncertainty about the exact relationship with the surrounding structures.

OBJECTIVE:

To describe the OT in its entire length through microsurgical study, showing its superior, inferior, medial, and lateral relationships and highlighting its value as a landmark in superior amygdala resection.

METHODS:

Microsurgical anatomic dissection of the OT, from its origin in the chiasm to the lateral geniculate nucleus was performed in 8 alcohol-fixed human hemispheres, showing its different segments and relations. Photographs were taken from different angles to facilitate surgical orientation.

RESULTS:

We performed a dissection of the OT, showing its position relative to caudate and hippocampal formations. We exposed the structures related to the OT superiorly (striatopallidal region and superior caudate fasciculus), inferiorly (head of the hippocampus, amygdala, anterior choroidal artery, perforating artery branch of the anterior choroidal artery, terminal stria, and basal vein), medially (internal capsule and midbrain), and laterally (temporal stem [uncinate and inferior fronto-occipital fascicle], anterior perforated substance, and superior caudate fasciculus).

CONCLUSION:

To date, there is a paucity of articles describing the anatomy of the OT from a neurosurgery perspective. In this study, we describe the microsurgical anatomic path of the OT, as a reliable upper limit landmark for amygdala resection.
Interictal High Gamma Oscillation Regularity as a Marker for Presurgical Epileptogenic Zone Localization
Authors: Sato Yosuke , Tsuji Yoshihito , Yamazaki Madoka , Fujii Yoshihisa , Shirasawa Atsushi , Harada Katsuhiko , Mizutani Tohru
Published: April 2022

BACKGROUND:

To ensure that epilepsy surgery is effective, accurate presurgical localization of the epileptogenic zone is essential. Our previous reports demonstrated that interictal high gamma oscillation (30-70 Hz) regularity (GOR) on intracranial electroencephalograms is related to epileptogenicity.

OBJECTIVE:

To examine whether preoperative GOR analysis with interictal high-density electroencephalography (HD-EEG) improves the accuracy of epileptogenic focus localization and enhances postoperative seizure control.

METHODS:

We calculated GOR from 20 seconds of HD-EEG data for 21 patients with refractory focal epilepsy (4 with nonlesional temporal lobe epilepsy) scheduled for epilepsy surgery. Low-resolution brain electromagnetic tomography was used to analyze the high GOR source. To validate our findings, we made comparisons with other conventional localization methods and postoperative seizure outcomes.

RESULTS:

In all patients, the areas of interictal high GOR were identified and resected. All patients were seizure-free after the operation. The concordance between the results of interictal high GOR on HD-EEG and those of source estimation of interictal discharge was fully overlapping in 10 cases, partially overlapping in 8 cases, and discordant in 3 cases. The concordance between the results of interictal high GOR on HD-EEG and those of interictal 123I-iomazenil single-photon emission computed tomography was fully overlapping in 8 cases, partially overlapping in 11 cases, and discordant in 2 cases. In 4 patients with nonlesional temporal lobe epilepsy, the interictal high GOR on HD-EEG was useful in confirming the epileptogenic zone.

CONCLUSION:

The interictal high GOR on HD-EEG is an excellent marker for presurgical epileptogenic zone localization.
The Effect of Charter School Openings on Traditional Public Schools in Massachusetts and North Carolina
Authors: Mumma Kirsten Slungaard
Published: April 2022

The rapid expansion of charter schools has fueled concerns about their impact on traditional public schools. I estimate the effect of charter openings on traditional public schools in Massachusetts and North Carolina by comparing schools near actual charter sites to those near proposed sites that were never occupied. I find charter openings reduced public school enrollment by around 5 percent and reduced White enrollment in North Carolina. I find no impact on student achievement, and my 95 percent confidence intervals rule out effects larger than ± 0.05 standard deviations. I find no effects on attendance or suspensions. (JEL H75, I21, I28, J15)
Lemierre Syndrome Complicating Deep Neck Infection and Descending Mediastinitis Secondary to Methicillin resistant Staphylococcus aureus (MRSA) Infection
Authors: Al-Hebshi Abdulqader , Alharbi Hind , Karbouji Rayan , Al Qurainees Ghaya , ALkurdi Ahmad
Published: April 2022

Lemierre syndrome (LS) is an oropharyngeal infection, followed by bacteremia, thrombosis of the internal jugular vein and subsequent hematogenic metastasis via septic emboli. We report a case of Lemierre syndrome complicated by descending necrotizing mediastinitis due to a Methicillin-resistant Staphylococcus aureus (MRSA) infection in a 5-month-old Saudi boy.

doi: https://doi.org/10.12669/pjms.38.5.5442

How to cite this:Al-Hebshi A, Alharbi H, Karbouji R, Al-Qurainees G, Alkurdi A. Lemierre Syndrome Complicating Deep Neck Infection and Descending Mediastinitis Secondary to Methicillin resistant Staphylococcus aureus (MRSA) Infection. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5442

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Consequences of emotional intelligence in consumer behavior
Authors: Παναγιωτοπούλου Αλτάνη
Published: April 2022

Σύμφωνα με τη διεθνή βιβλιογραφία, η συναισθηματική νοημοσύνη, η οποία ορίζεται ως η ικανότητα του ατόμου να αντιλαμβάνεται, να διαχειρίζεται και να ενισχύει τα συναισθήματα του τόσο στον εαυτό του όσο και στους άλλους, έχει σημαντικές επιδράσεις σε διάφορες εκφάνσεις της ζωής του (Mayer & Salovey, 1990; Day et al., 2005). Παρά τη σπουδαιότητα της σε τομείς όπως το μάρκετινγκ και τις εμπορικές συναλλαγές, η συναισθηματική νοημοσύνη δεν έχει λάβει την ιδιάζουσα προσοχή σε καίριους τομείς της συμπεριφοράς του καταναλωτή. Σκοπός της παρούσας διδακτορικής διατριβής είναι να συμβάλλει στη σχετική βιβλιογραφία μέσω της διερεύνησης των επιδράσεων της συναισθηματικής νοημοσύνης σε τομείς όπως η αυθόρμητη αγορά και η ηθική κατανάλωση. Τα αποτελέσματα τριών ερευνών αποδεικνύουν ότι η συναισθηματική νοημοσύνη μειώνει την αυθόρμητη κατανάλωση και ενισχύει την ηθική κατανάλωση. Τα συγκεκριμένα ευρήματα έχουν τη δυναμική να επεκτείνουν τη βιβλιογραφία στην συναισθηματική νοημοσύνη και να αναδείξουν το ρόλο της τελευταίας στη διαδικασία λήψης καταναλωτικών αποφάσεων.
Attitudes toward and knowledge of collaboration of dental and medical practice among medical students in Southern India: a cross-sectional questionnaire survey
Authors: Atul Kumar Harshit , Uppoor Ashita , Kadakampally David , Unnikrishnan B , Mithra Prasanna
Published: April 2022

Background:

   Enhancing oral health care services provided through inter-professional collaboration between medical and dental practitioner is important, and even essential. The purpose of this study is to assess the attitude toward and knowledge of medical-dental collaborative practice among medical students attending colleges in Southern India.

Methods:

      A cross sectional questionnaire survey was conducted among medical students and interns of medical colleges in coastal South India with prior information and permission. The questionnaire consisted of 11 questions to assess attitude toward and knowledge of medical-dental collaborative practice. The demographic backgrounds of participants were also recorded. Chi square test was employed for data analysis. The responses obtained were correlated with age, gender and year of study of participants using Pearson’s correlation test

Results:

       A total 250 questionnaires were distributed and 234 responses were appropriately completed. Most of the students agreed that oral health was an integral part of systemic health, however participants disagreed on attending compulsory rotation in dentistry at a statistically significant level (p<0.05), moreover participants did not agree with physicians having an active role in motivating their patients for regular dental check-up. 82% of the medical students believe that dental check-up should be included in health packages under health insurance. A statistically significant (p<0.05) difference was observed among 3rd year & 4th year students and interns and also it was found that female students provided more positive responses towards medical-dental collaboration.

Conclusions:

       Even though medical students showed fairly positive attitudes and knowledge towards dentistry, the analysis within the study groups showed that knowledge and attitudes regarding the collaborative practice worsened over the academic years among the medical students. In order to destigmatize and foster interdisciplinary collaboration which would contribute to higher resource efficiency and the standard of care, continuing education in both the disciplines would be highly beneficial.
Investigating neutrophil cell death in TB pathogenesis
Authors: Fisher Kimone L , Rajkumar-Bhugeloo Kerishka , Moodley Denelle , Mpotje Thabo , Ramsuran Duran , Ndung'u Thumbi , Marakalala Mohlopheni J
Published: April 2022

Background: Neutrophils are one of the major early role players in antimycobacterial immunity. Upon infection, neutrophils can undergo NETosis, a cell death characterized by release of neutrophil extracellular traps (NETs). The role of NETosis in TB progression remains poorly characterized. We aim to characterize mechanisms underlying NETosis during TB pathogenesis by identifying genes that drive the cell death, and to determine their potential as markers of disease progression in high-risk individuals. Finally, we intend to evaluate neutrophil associated genes as targets for host directed therapy to reduce pathological damage caused by NETosis. Methods: Quantitative PCR will be used to quantify expression of specific genes identified in the blood of individuals with active lung disease (n=30), compared to those from healthy (n=30) and latently infected individuals (LTBI) (n=30). In addition, temporal events associated with NETosis will be measured using live microscopy in a neutrophil in vitro model of Mycobacterium tuberculosis (Mtb) infection. Candidate genes found to be associated with NETosis will be targeted with pharmaceutical inhibitors. Conclusion: Genes associated with neutrophil mediated cell death may serve as potential biomarkers of pathological damage and disease progression, as well as targets for host-directed therapy.
Learning from success cases: ecological analysis of pathways to universal access to reproductive health care in low- and middle-income countries.
Authors: Hellwig Franciele , Barros Aluisio JD
Published: April 2022

Background 

Universal access to family planning services is a well-recognized human right and several countries and organizations are committed to this goal. Our objective was to identify countries who improved family planning coverage in the last 40 years and investigate which contexts enabled those advances. 

Methods 

Analyses were based on data from publicly available national health surveys carried out since 1986 in Egypt, Ethiopia, Rwanda, Afghanistan, Brazil, and Ecuador, selected based on previous evidence. We estimated demand for family planning satisfied with modern methods (mDFPS) for each country and explored inequalities in terms of wealth, women’s education, and women’s age. We also explored contextual differences in terms of women’s empowerment, percentage of population living in extreme poverty, and share of each type of contraceptive. To better understand political and sociocultural contexts, country case studies were included, based on literature review. 

Results 

Patterns of mDFPS increase were distinct in the selected countries. Current level of mDFPS coverage ranged between 94% in Brazil and 38% in Afghanistan. All countries experienced important reduction in both gender inequality and extreme poverty. According to the share of each type of contraceptive, most countries presented higher use of short-acting reversible methods. Exceptions were Ecuador, where the most used method is sterilization, and Egypt, which presented higher use of long-acting reversible methods. In the first years analyzed, all countries presented huge gaps in coverage according to wealth, women’s education and women’s age. All countries managed to increase coverage over recent years, especially among women from the more vulnerable groups. 

Conclusions 

Family planning coverage increased along with reductions in poverty and gender inequality, with substantial increases in coverage among the most vulnerable in recent years. Policies involving primary health care services, provision of various methods, and high quality training of health providers are crucial to increase coverage.
What are the active ingredients of ‘arts in health’ activities? Development of the INgredients iN ArTs in hEalth (INNATE) Framework
Authors: Warran Katey , Burton Alexandra , Fancourt Daisy
Published: April 2022

Background: There is a scarcity of research concerning what it is about arts engagement that may activate causal mechanisms leading to effects on health and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be relevant to specific contexts and types of art forms. The aim of this study was to carry out a comprehensive mapping of potential active ingredients, construct a shared language, and propose a framework and toolkit to support the design, implementation, and evaluation of arts in health activities.

Methods: Drawing upon Rapid Appraisal techniques and collaborating with 64 participants working in arts in health, we engaged in a three-phase process: 1) scoping review to inform the development of an initial framework; 2) consultation on the initial framework; and 3) analysis and construction of the INNATE framework.

Results: The study identified 139 potential active ingredients within the overarching categories of  project, people, and  contexts. Project components relate directly to the content of the arts activity itself, intrinsic to what the activity is. The people category denotes how people interact through engagement with the activity and who is involved in this interaction, including activity facilitation. Contexts relates to the activity setting comprising the aggregate of place(s), things, and surroundings. Aligning with complexity science, ingredients may interconnect or feed into one another to prompt mechanisms, and may not be experienced as distinct by participants.

Conclusions: Our mapping exercise is the most extensive to date. In relation to arts in health activities, the INNATE framework can support with: design and implementation, such as co-producing an intervention to meet the needs of a particular population; evaluation, such as facilitating the comparison of different interventions and their efficacy; and replication, scalability, and sustainability through enabling detailed reporting and articulation of what an arts in health activity entails.
Relevance and Practice of Risk Management at Domestic Enterprises
Authors: Teryuhov V.
Published: April 2022

Why does the risk management system at domestic enterprises not work? Why do enterprises treat risk management as an externally imposed requirement in a frivolous and formal way (“for show”)? Th e author tries to answer all these questions in this article.
Nail sparing and sub-nail bed approach for the excision of subungual glomus tumors
Authors: Nam Jae Jun , Kim Yong Been , Kim Jae Joong , Choi In Cheul , Park Jong Woong
Published: April 2022

Purpose: The excision of subungual glomus tumors on the distal phalanx may cause nail deformities. Herein, we report our nail-sparing and sub-nail bed approach for the excision of subungual glomus tumors, which enables subungual glomus tumor excision without removal of the nail plate and further allows access to the tumor mass by dissecting beneath the nail bed and germinal matrix to minimize postoperative pain and nail bed injury. Therefore, the present article describes this operative approach and reports surgical outcomes with respect to patient satisfaction, pain, and the final postoperative nail shape.Methods: Thirty-two cases of clinically diagnosed subungual glomus tumors treated with this approach were retrospectively evaluated. Mean pain scores were measured at 1 week postoperatively and at the last follow-up. Patients were asked for their subjective opinion regarding the final nail shape, and their responses were assessed as “satisfied” or “unsatisfied.” The objective results for the final nail shape were graded as “excellent,” “good,” or “poor” by two orthopedic hand surgeons.Results: The mean postoperative pain score (visual analog scale) at 1 week was 1.8. No patients reported pain at the last follow-up. Subjectively, 96.6% of patients were satisfied with the operation. Objectively, the postoperative nail shape was excellent in 9.3% of cases, good in 87.5%, and poor in 3.1%.Conclusion: This approach provides minimal postoperative pain, high patient satisfaction, and favorable cosmetic outcomes with respect to the nail shape by avoiding removal of the nail plate and incision of the nail bed and germinal matrix.
Gallstone Ileus with Cholecystogastric Fistula in an Older Female
Authors: Taylor Roger , Opara Nnennaya , Simmerman Taylor
Published: April 2022

Cholecystogastric fistulas are a rare but life-threatening complication of cholelithiasis. This medical condition has been explained in detail in several cases in the medical literature. However, there is still conflicting debate on how well to effectively manage patients with such a complex medical condition. We present a 70-year-old Caucasian female with complaints of intermittent dull non-radiating abdominal pain. Her pain started abruptly after breakfast. Patient took some acetaminophen which alleviated her symptom. Several days later, pains return but at this time it was associated with constipation. Patient’s primary care physician (PCP) suspected peptic ulcer disease, which was quickly ruled out following negative result of Helicobacter pylori breath test. The PCP advised patient to visit the emergency department for further investigations to rule out/in possible gallstone ileus causing intestinal obstruction, or Bouveret’s syndrome.
Are Indian Culinary Spices Acting as an Immunomodulatory Factor Against Covid-19?
Authors: Das Sushmita , Handique Pratap Jyoti
Published: April 2022

Coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Coronavirus- 2 (SARS-CoV-2) due to its rapid community transmission and absence of an effective antiviral drug has caused a high morbidity and mortality in human lives world over. According to the WHO Situation Report No. 102 as on January 12, 2022, India recorded 35.87 million confirmed cases of COVID 19 with a death rate of 1.34 %, the total death being 0.48 million, in comparison to the global death rate of 1.78%. The host-pathogen interactions are important to understand an infectious disease and to follow specific treatment for cure and measures for prevention. Various factors involved in disease emergence with interplay between pathogens, hosts and environment changes the disease ecology creating novel transmission patterns and severity. Indian conventional foods and culinary spices contain a number of active principles, including polysaccharides, terpenoids, alkaloids, flavonoids, glycosides, and essential oils, which act as immunomodulators and have tremendous capability to maintain and/or stimulate the immune system primarily through the modulation of nonspecific immune responses. This review highlights the bioactive components of some of the most commonly used Indian culinary spices grounding a new dimension of research on these natural phytoproducts to bring out their functional and medicinal values vis-à-vis improvement of human health. In conclusion, the structure of bioactive molecules present in the Indian dietary spices may pave way for the development of anti-SARS-CoV-2 drugs for the prevention and treatment of COVID-19.
Hypocholesterolemic Effect of Analogue Rice with the Addition of Rice Bran
Authors: Kusnandar Feri , Kharisma Trina , Yuliana Nancy Dewi , Safrida Safrida , Budijanto Slamet
Published: April 2022

The objective of this study was to evaluate the hypocholesterolemic effect of analogue rice added with rice bran from three different rice varieties (white, red and black). The Sprague Dawley rats were fed ad libitum with six different chow formulas, i.e. standard diet equal to AIN-93G (C-), high-cholesterol diet (C+), high cholesterol diet plus analogue rice containing 15% coconut dregs flour (AR1), high cholesterol diet plus 10% rice bran from Ciherang white rice (AR2), Cere red rice (AR3), and Campoireng black rice (AR4). The diet intervention was conducted for 28 days. The total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) of rat plasma as well as total fat of rat liver were analyzed. The results showed that rats fed with AR1, AR2, AR3 and AR4 exhibited significant decreases of TC, LDL-C, AI and liver fat, but increased of HDL-C in comparison to those of a high-cholesterol group (C+). This hypocholesterolemic effect is associated with the significant role of dietary fiber and/or -oryzanol. Among groups with diet containing rice bran, AR2 demonstrated the highest hypocholesterolemic effect followed by AR4 and AR3. The AR1 group also gave a significant hypochlolesterolemic effect (p<0.05) due to the role of the dietary fiber. As a conclusion, this study indicates that analogue rice added with rice bran and/or coconut dregs flour is a potential functional diet that is beneficial to lower the CHD risk.