bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Ramadan Participation with Psychological Parameters: A Cross-Sectional Study during the COVID-19 Pandemic in Iran
Authors: Akbari Hesam , Yoosefi Mohammad , Pourabbas Maryam , Weiss Katja , Knechtle Beat , Vancini Rodrigo , Trakada Georgia , Ben Saad Helmi , Lavie Carl , Ghram Amine
Published: April 2022

COVID-19 restrictions are associated with poor physical-activity (PA). Less is known about the relationship between the combination of these restrictions with Ramadan intermittent fasting (RIF), PA, mental health, and sleep-quality. The present study aimed to evaluate whether COVID-19 restrictions and RIF during the fourth wave of the COVID-19 pandemic in Iran are associated with poor PA, anxiety, well-being, and sleep-quality outcomes. A total of 510 individuals participated in an online questionnaire that was disseminated to adults (≥18 years) residing in Iran from 13 May 2021 to 16 May 2021 (~3 days), just after the end of Ramadan 2021. PA behavior (Godin-Shephard Leisure-Time Exercise Questionnaire), anxiety (General Anxiety Disorder-7), well-being (Mental Health Continuum-Short Form), and sleep-quality (Pittsburgh Sleep Quality Index). Of 510 individuals included in the study (331 female (64.9%); mean ± SD, 31 ± 12 years), 172 (33.7%) reported less PA during the Ramadan 2021. PA was associated with better well-being and sleep-quality outcomes. Regardless of PA, participants who fasted for all of Ramadan had less anxiety and better well-being outcomes than those who fasted part of Ramadan or did not fast at all. However, the fasting part of Ramadan decreased the sleep-quality of active participants. The Ramadan 2021 was associated with poor PA, well-being, and sleep-quality of Iranians. However, PA was associated with better well-being and sleep-quality outcomes, and those who fasted all Ramadan had better anxiety and well-being outcomes. Therefore, PA during Ramadan might be an essential and scalable mental health resilience builder during COVID-19 restrictions which should be encouraged.
In Vivo Confocal Microscopy in Different Types of Dry Eye and Meibomian Gland Dysfunction
Authors: Sim Ralene , Yong Kenneth , Liu Yu-Chi , Tong Louis
Published: April 2022

In vivo confocal microscopy (IVCM) imaging is increasingly popular in ocular surface disease diagnosis and management. We conducted a systematic review to update the use of IVCM in the diagnosis and treatment of dry eye and meibomian gland dysfunction (MGD). A literature review was conducted on IVCM studies in MGD, dry eye disease, systemic disease causing dry eye, dry eye in glaucoma patients, contact lens-associated ocular conditions, graft-versus-host disease, and Sjogren’s syndrome-related dry eye. The articles were identified through PubMed and a total number of 63 eligible publications were analyzed in detail. All primary research studies on confocal microscopy on dry eye and related conditions from 2017 onwards were included. The reports were reviewed for their contribution to the existing literature as well as potential biases and drawbacks. Despite limitations such as small field of view, lack of population-based norms, and lack of standardization of image acquisition, interpretation, and quantification, IVCM is useful as a complementary technique for clinical diagnosis in various ocular surface disorders related to dry eye. With advances in hardware and software in the near future, it has the potential for further practical impact.
Trends of Dietary Intakes and Metabolic Diseases in Japanese Adults: Assessment of National Health Promotion Policy and National Health and Nutrition Survey 1995–2019
Authors: Fauzi Muhammad , Kartiko-Sari Indri , Poudyal Hemant
Published: April 2022

Health Japan 21 is Japan’s premier health promotion policy encompassing preventive community health measures for lifestyle-related diseases. In this repeated cross-sectional survey, we report 24-year trends of type 2 diabetes mellitus (T2DM), obesity, hypertension, and their association with dietary intakes to evaluate Health Japan 21’s impact and identify gaps for future policy implementation. We analyzed data from 217,519 and 232,821 adults participating in the physical examination and dietary intake assessment, respectively, of the National Health and Nutrition Survey 1995–2019. Average HbA1c and BMI have significantly increased along with the prevalence of T2DM and overweight/obesity among males. Despite a significant decrease in daily salt intake, the decline in the combined prevalence of Grades 1–3 hypertension was non-significant. Seafood and meat intakes showed strong opposing trends during the study period, indicating a dietary shift in the Japanese population. Neither salt nor vegetable/fruit intake reached the target set by Health Japan 21. Metabolic disease trend differences between males and females highlight the need for a gender-specific health promotion policy. Future Health Japan 21 implementation must also consider locally emerging dietary trends.
Incidence and Outcome of Patients with Cardiogenic Shock and Detection of Herpes Simplex Virus in the Lower Respiratory Tract
Authors: Scherer Clemens , Lüsebrink Enzo , Binzenhöfer Leonhard , Stocker Thomas J. , Kupka Danny , Chung Hieu Phan , Stambollxhiu Era , Alemic Ahmed , Kellnar Antonia , Deseive Simon , Stark Konstantin , Petzold Tobias , Hagl Christian , Hausleiter Jörg , Massberg Steffen , Orban Martin
Published: April 2022

(1) Herpes simplex virus (HSV) reactivation in critically ill patients can cause infection in the lower respiratory tract, prolonging mechanical ventilation. However, the association of HSV reactivation with cardiogenic shock (CS) is unclear. As CS is often accompanied by pulmonary congestion and reduced immune system activity, the aim of our study was to determine the incidence and outcome of HSV reactivation in these patients. (2) In this retrospective, single-center study, bronchial lavage (BL) was performed on 181 out of 837 CS patients with mechanical ventilation. (3) In 44 of those patients, HSV was detected with a median time interval of 11 days since intubation. The occurrence of HSV was associated with an increase in C-reactive protein and the fraction of inspired oxygen at the time of HSV detection. Arterial hypertension, bilirubin on ICU admission, the duration of mechanical ventilation and out-of-hospital cardiac arrest were associated with HSV reactivation. (4) HSV reactivation could be detected in 24.3% of patients with CS on whom BL was performed, and its occurrence should be considered in patients with prolonged mechanical ventilation. Due to the limited current evidence, the initiation of treatment for these patients remains an individual choice. Dedicated randomized studies are necessary to investigate the efficacy of antiviral therapy.
Handheld Fundus Camera for Diabetic Retinopathy Screening: A Comparison Study with Table-Top Fundus Camera in Real-Life Setting
Authors: Midena Edoardo , Zennaro Luca , Lapo Cristian , Torresin Tommaso , Midena Giulia , Pilotto Elisabetta , Frizziero Luisa
Published: April 2022

The aim of the study was to validate the performance of the Optomed Aurora® handheld fundus camera in diabetic retinopathy (DR) screening. Patients who were affected by diabetes mellitus and referred to the local DR screening service underwent fundus photography using a standard table-top fundus camera and the Optomed Aurora® handheld fundus camera. All photos were taken by a single, previously unexperienced operator. Among 423 enrolled eyes, we found a prevalence of 3.55% and 3.31% referable cases with the Aurora® and with the standard table-top fundus camera, respectively. The Aurora® obtained a sensitivity of 96.9% and a specificity of 94.8% in recognizing the presence of any degree of DR, a sensitivity of 100% and a specificity of 99.8% for any degree of diabetic maculopathy (DM) and a sensitivity of 100% and specificity of 99.8% for referable cases. The overall concordance coefficient k (95% CI) was 0.889 (0.828–0.949) and 0.831 (0.658–1.004) with linear weighting for DR and DM, respectively. The presence of hypertensive retinopathy (HR) was recognized by the Aurora® with a sensitivity and specificity of 100%. The Optomed Aurora® handheld fundus camera proved to be effective in recognizing referable cases in a real-life DR screening setting. It showed comparable results to a standard table-top fundus camera in DR, DM and HR detection and grading. The Aurora® can be integrated into telemedicine solutions and artificial intelligence services which, in addition to its portability and ease of use, make it particularly suitable for DR screening.
Non-Achievement of Alanine Aminotransferase Normalization Associated with the Risk of Hepatocellular Carcinoma during Nucleos(t)ide Analogue Therapies: A Multicenter Retrospective Study
Authors: Inoue Jun , Kobayashi Tomoo , Akahane Takehiro , Kimura Osamu , Sato Kosuke , Ninomiya Masashi , Iwata Tomoaki , Takai Satoshi , Kisara Norihiro , Sato Toshihiro , Nagasaki Futoshi , Miura Masahito , Nakamura Takuya , Umetsu Teruyuki , Sano Akitoshi , Tsuruoka Mio , Onuki Masazumi , Niitsuma Hirofumi , Masamune Atsushi ,   THERME Study Group
Published: April 2022

Patients with a chronic hepatitis B virus (HBV) infection who are treated with nucleos(t)ide analogues (NAs) are still at risk for hepatocellular carcinoma (HCC), and it has been clinically questioned whether patients with a high risk of HCC can be identified efficiently. We aimed to clarify the risk factors associated with the development of HCC during NA therapies. A total of 611 chronically HBV-infected patients without a history of HCC, who were treated with NAs for more than 6 months (median 72 months), from 2000 to 2021, were included from 16 hospitals in the Tohoku district in Japan. Incidences of HCC occurrence were analyzed with clinical factors, including on-treatment responses. Alanine aminotransferase (ALT) normalization, based on the criteria of three guidelines, was analyzed with other parameters, including the age–male–ALBI–platelets (aMAP) risk score. During the observation period, 48 patients developed HCC, and the cumulative HCC incidence was 10.6% at 10 years. Non-achievement of ALT normalization at 1 year of therapy was mostly associated with HCC development when ALT ≤ 30 U/L was used as the cut-off (cumulative incidence, 19.9% vs. 5.3% at 10 years, p < 0.001). The effectiveness of the aMAP risk score at the start of treatment was validated in this cohort. A combination of an aMAP risk score ≥ 50 and non-achievement of ALT normalization could stratify the risk of HCC significantly, and notably, there was no HCC development in 103 patients without these 2 factors. In conclusion, non-achievement of ALT normalization (≤30 U/L) at 1 year might be useful in predicting HCC during NA therapies and, in combination with the aMAP risk score, could stratify the risk more precisely.
Multiple Primary Melanomas: Retrospective Review in a Tertiary Care Hospital
Authors: Palacios-Diaz Rodolfo David , de Unamuno-Bustos Blanca , Abril-Pérez Carlos , Pozuelo-Ruiz Mónica , Sánchez-Arraez Javier , Torres-Navarro Ignacio , Botella-Estrada Rafael
Published: April 2022

Multiple primary melanomas (MPM) refer to the occurrence of more than one synchronous or metachronous melanoma in the same individual. The aim of this study was to identify the frequency of MPM and describe the clinical and histopathologic characteristics of patients with MPM. An observational single-center retrospective study was designed based on a cohort of melanoma patients followed in a tertiary care hospital. Fifty-eight (8.9%) patients developed MPM. Most patients were men (65.5%) and the median age at the time of diagnosis of the first melanoma was 71 years old. The median time of diagnosis of the second melanoma from the first melanoma was 10.9 months, and 77.6% of second melanomas were diagnosed within the first 5 years. In total, 29 (50%) and 28 (48.3%) first and second melanomas were located in the trunk, respectively. Concordance of anatomic site between primary and subsequent melanoma was found in 46.6% of the patients. Proportion of in situ melanomas was increasingly higher in subsequent melanomas (from 36.21% of first melanomas to 100% of fifth melanomas). An increasing rate of melanomas with histological regression was observed within subsequent melanomas (from 60.3% of first melanomas to 80% of third melanomas). Our results support the importance of careful long-term follow-up with total body examination in melanoma patients.
Influence of Baseline CT Body Composition Parameters on Survival in Patients with Pancreatic Adenocarcinoma
Authors: Beetz Nick Lasse , Geisel Dominik , Maier Christoph , Auer Timo Alexander , Shnayien Seyd , Malinka Thomas , Neumann Christopher Claudius Maximilian , Pelzer Uwe , Fehrenbach Uli
Published: April 2022

Pancreatic cancer is the seventh leading cause of cancer death in both sexes. The aim of this study is to analyze baseline CT body composition using artificial intelligence to identify possible imaging predictors of survival. We retrospectively included 103 patients. First, the presence of surgical treatment and cut-off values for sarcopenia and obesity served as independent variates. Second, the presence of surgery, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle index (SMI) served as independent variates. Cox regression analysis was performed for 1-year, 2-year, and 3-year survival. Possible differences between patients undergoing surgical versus nonsurgical treatment were analyzed. Presence of surgery significantly predicted 1-year, 2-year, and 3-year survival (p = 0.01, <0.001, and <0.001, respectively). Across the follow-up periods of 1-year, 2-year, and 3-year survival, the presence of sarcopenia became an equally important predictor of survival (p = 0.25, 0.07, and <0.001, respectively). Additionally, increased VAT predicted 2-year and 3-year survival (p = 0.02 and 0.04, respectively). The impact of sarcopenia on 3-year survival was higher in the surgical treatment group (p = 0.02 and odds ratio = 2.57) compared with the nonsurgical treatment group (p = 0.04 and odds ratio = 1.92). Fittingly, a lower SMI significantly affected 3-year survival only in patients who underwent surgery (p = 0.02). Especially if surgery is performed, AI-derived sarcopenia and reduced muscle mass are unfavorable imaging predictors.
Intravenous Ferric Carboxymaltose Improves Response to Postoperative Anemia Following Total Knee Arthroplasty: A Prospective Randomized Controlled Trial in Asian Cohort
Authors: Choi Keun Young , Koh In Jun , Kim Man Soo , Kim Chulkyu , In Yong
Published: April 2022

Background: Ferric carboxymaltose (FCM) is an intravenous (IV) high-dose iron that is effective in the treatment of iron deficiency anemia. This study was performed to determine whether postoperative FCM infusion is effective at improving hemoglobin (Hb) responders, Hb and iron profiles, and the patient’s quality of life (QOL). Methods: A total of 110 patients with postoperative anemia, defined by a Hb < 10 g/dL within 3 days of unilateral primary TKA, between June 2018 and February 2020 were randomized into either the FCM or Control group. On postoperative day 3, the FCM group (55 patients) received IV FCM while the Control group (55 patients) did not. The Hb responders (Hb increase ≥ 2 g/dL compared to baseline), Hb level, iron profiles (ferritin, total iron-binding capacity (TIBC), transferrin saturation (TSAT)), and EQ-5D scores were compared at weeks 2, 4, and 8. Results: The FCM group demonstrated a significantly greater number of Hb responders (p < 0.001) and a higher Hb level (p = 0.008) at 2 weeks postoperative than did the Control group. The FCM group recovered its preoperative Hb level between 4 and 8 weeks. In contrast, the Control group did not recover its preoperative level until 8 weeks. The FCM infusion group also had higher serum ferritin, iron and TSAT, and lower TIBC levels than those of the Control group between 2 and 8 weeks (all p < 0.001). However, there was no significant difference in the postoperative transfusion rate (p = 0.741) or EQ-5D score between the two groups (all p > 0.05). Discussion: In postoperative anemia following TKA, IV FCM increases the Hb response and improves Hb and iron metabolism variables, however, it does not affect the transfusion rate or QOL.
Survival According to Therapy Regimen for Small Intestinal Neuroendocrine Tumors
Authors: Koch Christine , Bambey Cornelia , Filmann Natalie , Stanke Marc , Waidmann Oliver , Husmann Gabriele , Bojunga Joerg
Published: April 2022

Introduction: Scarce data exist for therapy regimens other than somatostatin analogues (SSA) and peptide receptor radiotherapy (PRRT) for siNET. We analyzed real world data for differences in survival according to therapy. Patients and methods: Analysis of 145 patients, diagnosed between 1993 and 2018 at a single institution, divided in treatment groups. Group (gr.) 0: no treatment (n = 10), gr 1: TACE and/or PRRT (n = 26), gr. 2: SSA (n = 32), gr. 3: SSA/PRRT (n = 8), gr. 4: chemotherapy (n = 8), gr. 5: not metastasized (at diagnosis), surgery only (n = 53), gr. 6 = metastasized (at diagnosis), surgery only (n = 10). Results: 45.5% female, median age 60 years (range, 27–84). A total of 125/145 patients with a resection of the primary tumor. For all patients, 1-year OS (%) was 93.8 (95%-CI: 90–98), 3-year OS = 84.3 (CI: 78–90) and 5-year OS = 77.5 (CI: 70–85). For analysis of survival according to therapy, only stage IV patients (baseline) that received treatment were included. Compared with reference gr. 2 (SSA only), HR for OS was 1.49 (p = 0.47) for gr. 1, 0.72 (p = 0.69) for gr. 3, 2.34 (p = 0.19) for gr. 4. The 5 y OS rate of patients whose primary tumor was resected (n = 125) was 73.1%, and without PTR was 33.3% (HR: 4.31; p = 0.003). Individual patients are represented in swimmer plots. Conclusions: For stage IV patients in this analysis (limited by low patient numbers in co. 3/4), multimodal treatment did not significantly improve survival over SSA treatment alone. A resection of primary tumor significantly improves survival.
Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer Based on Functional Assessment and NIRS Analysis
Authors: Durán-Gómez Noelia , López-Jurado Casimiro Fermín , Nadal-Delgado Marta , Pérez-Civantos Demetrio , Guerrero-Martín Jorge , Cáceres Macarena C.
Published: April 2022

Background: Chemotherapy-related cognitive impairment (CRCI), or “chemobrain,” isdefined as a phenomenon of cognitive deficits in cancer patients after chemotherapy and is characterized by deficits in areas of cognition, including memory, attention, speed of processing, and executive function, which seriously affect quality of life. The purpose of this study is to investigate the impact of CRCI in breast cancer (BC) patients in chemotherapy treatment (CT+) or not (CT−) and to analyze their relationship with detectable objective changes in cerebral activity during the execution of a phonological and semantic verbal fluency task (PVF and SVF). Methods: An observational, cross-sectional study was carried out at Badajoz University Hospital (Spain). A total of 180 women with BC were included. We used Cognitive Scale (FACT-Cog) for neuropsychological subjective assessment, obtaining scores of perceived cognitive impairment (PCI), and near-infrared spectroscopy system (NIRS) for neuropsychological objective assessment during a verbal fluency task (PVF and SVF), determining alterations in the prefrontal cortex (PFC) assessed as changes in regional saturation index (rSO2). Results: A total of 41.7% percent of the patients in the sample had PCI. CT+ was significantly associated with a worse impact in PCI (X¯ = 50.60 ± 15.64 vs. X¯ = 55.01 ± 12.10; p = 0.005). Average rSO2 decreased significantly in CT+ (X¯ = 63.30 ± 8.02 vs. X¯ = 67.98 ± 7.80; p < 0.001), and BC patients showed a significant decrease in PVF and SVF on average (X¯ = 41.99 ± 9.52 vs. X¯ = 47.03 ± 9.31, and X¯ = 33.43 ± 11.0 vs. X¯ = 36.14 ± 10.68, respectively; p < 0.001). Conclusions: Our findings suggest that cognitive impairments in the domain of executive functioning exist among patients with BC who received CT. The results corroborate the hypothesis that CT is an important factor in cognitive impairment in patients with BC, which has been demonstrated by both subjective (PCI) and objective (PVF, SVF, and rSO2) neuropsychological measures. The combination of doxorubicin, cyclophosphamide, and docetaxel induce cognitive impairment.
The Current Role of Peptide Receptor Radionuclide Therapy in Meningiomas
Authors: Fodi Christina-Katharina , Schittenhelm Jens , Honegger Jürgen , Castaneda-Vega Salvador Guillermo , Behling Felix
Published: April 2022

Meningiomas are the most common primary intracranial tumors. The majority of patients can be cured by surgery, or tumor growth can be stabilized by radiation. However, the management of recurrent and more aggressive tumors remains difficult because no established alternative treatment options exist. Therefore, innovative therapeutic approaches are needed. Studies have shown that meningiomas express somatostatin receptors. It is well known from treating neuroendocrine tumors that peptide radioreceptor therapy that targets somatostatin receptors can be effective. As yet, this therapy has been used for treating meningiomas only within individual curative trials. However, small case series and studies have demonstrated stabilization of the disease. Therefore, we see potential for optimizing this therapeutic option through the development of new substances and specific adaptations to the different meningioma subtypes. The current review provides an overview of this topic.
There Is a Differential Pattern in the Fatty Acid Profile in Children with CD Compared to Children with UC
Authors: Kikut Justyna , Drozd Arleta , Mokrzycka Małgorzata , Grzybowska-Chlebowczyk Urszula , Ziętek Maciej , Szczuko Małgorzata
Published: April 2022

Background: Crohn’s disease (CD) and Ulcerative Colitis (UC) are classified as inflammatory bowel diseases (IBD). Currently, an increasing number of studies indicate that the metabolic consequences of IBD may include abnormalities in the fatty acid profile. The aim of this study was to compare fatty acid concentrations in IBD in order to identify differences between CD and UC and differences between the phases of both diseases. Methods: Sixty-three adolescent patients with CD (n = 33) and UC (n = 30) aged 13.66 ± 2.67 and 14.15 ± 3.31, respectively, were enrolled in the study. Analysis was performed by gas chromatography. Results: A statistically significant higher concentration of vaccenic acid was observed in the total UC group relative to total CD. In remission CD relative to active CD, a significantly higher concentration of palmitic acid was shown. Whereas in active CD, significantly higher levels of linoleic acid were observed relative to remission. The UC group had significantly higher lauric acid and gamma-linoleic acid levels in active disease relative to remission. Conclusions: The identified differences between FA levels in UC and CD could potentially be involved in the course of both diseases.
Medical, Endoscopic and Surgical Management of Stricturing Crohn’s Disease: Current Clinical Practice
Authors: Fousekis Fotios , Mitselos Ioannis , Tepelenis Kostas , Pappas-Gogos George , Katsanos Konstantinos , Lianos Georgios , Frattini Francesco , Vlachos Konstantinos , Christodoulou Dimitrios
Published: April 2022

The development of fibrostenotic intestinal disease occurs in approximately one-third of patients with Crohn’s disease and is associated with increased morbidity. Despite introducing new biologic agents, stricturing Crohn’s disease remains a significant clinical challenge. Medical treatment is considered the first-line treatment for inflammatory strictures, and anti-TNF agents appear to provide the most considerable benefit among the available medical treatments. However, medical therapy is ineffective on strictures with a mainly fibrotic component, and a high proportion of patients under anti-TNF will require surgery. In fibrotic strictures or cases refractory to medical treatment, an endoscopic or surgical approach should be considered depending on the location, length, and severity of the stricture. Both endoscopic balloon dilatation and endoscopic stricturoplasty are minimally invasive and safe, associated with a small risk of complications. On the other hand, the surgical approach is indicated in patients not suitable for endoscopic therapy. This review aimed to present and analyze the currently available medical, endoscopic, and surgical management of stricturing Crohn’s disease.
Perineural Invasion in Pancreatic Ductal Adenocarcinoma (PDAC): A Saboteur of Curative Intended Therapies?
Authors: Felsenstein Matthäus , Lindhammer Flora , Feist Mathilde , Hillebrandt Karl Herbert , Timmermann Lea , Benzing Christian , Globke Brigitta , Zocholl Dario , Hu Mengwen , Fehrenbach Uli , Sinn Bruno Valentin , Pelzer Uwe , Sauer Igor Maximillian , Pratschke Johann , Malinka Thomas
Published: April 2022

(1) Background: Perineural invasion (PNI) is a common characteristic of pancreatic ductal adenocarcinoma (PDAC) and is present in most resection margins. We hypothesized that curative pancreatic tumor resection with long-term survival could only be achieved in PNI-negative patients. (2) Material and Methods: A retrospective investigation of PDAC patients who underwent curative-intended surgery during the period 2008 to 2019 was performed at our institution. (3) Results: We identified 571 of 660 (86.5%) resected patients with well-annotated reports and complete datasets. Of those, 531 patients (93%) exhibited tumors with perineural invasion (Pn1), while 40 (7%) were negative for PNI (Pn0). The majority of patients in the Pn1 group presented advanced tumor stage and positive lymph node infiltration. Patients in the Pn0 group showed an improved disease-free and long-term survival compared to the Pn1 group (p < 0.001). Subgroup analysis of all R0-resected patients indicated improved long-term survival and disease-free survival of R0 Pn0 patients when compared to R0 Pn1 patients (p < 0.001). (4) Conclusion: Our study confirmed that Pn0 improves the long-term survival of PDAC-resected cancer patients. Furthermore, PNI significantly challenges the long-term survival of formally curative (R0) resected patients. We provide new insights into the dynamics of PNI in pancreatic cancer patients which are needed to define subgroups of patients for risk stratification and multimodal treatment strategies.
Alterations in Fixation Indices in Primary Open-Angle Glaucoma by Microperimetry
Authors: Zabel Katarzyna , Zabel Przemyslaw , Suwala Karolina , Gorczyca Aleksandra , Jaworski Damian , Kaluzna Martyna , Gebska-Toloczko Martyna , Wnuk Kacper , Buszko Katarzyna , Kaluzny Jakub J.
Published: April 2022

The aim of this study was to determine whether primary open-angle glaucoma (POAG) is associated with changes in fixation stability parameters assessed by microperimetry (MP) and whether the severity of glaucoma is related to a deterioration in these indicators. This study analyzed fixation stability using MP macular analyzer integrity assessment (MAIA) in patients with mild and moderate/severe POAG and healthy controls. The resulting fixation indices were correlated with parameters used to assess retinal function with MP and standard automated perimetry (SAP) and retinal structure with optical coherence tomography (OCT) and OCT angiography (OCTA). We enrolled 54 eyes in the POAG groups (32 eyes with mild POAG and 22 eyes with moderate/severe POAG) and 24 eyes in the healthy group. It was shown that fixation stability in POAG eyes deteriorated with increasing disease severity, and significant differences in bivariate contour ellipse area (BCEA) including 95% of fixation points were observed among groups (p = 0.042). Quantitative analysis of structural and functional retinal parameters also showed significant deterioration with the progression of glaucoma (p < 0.001). Correlations among fixation parameters and abnormalities in the retinal structure and function were confirmed. We concluded that POAG is associated with disturbances in the fixation pattern, which worsen as the disease progresses and can be effectively assessed by performing a MP test.
The Multidimensional Prognostic Index Predicts Mortality in Older Outpatients with Cognitive Decline
Authors: Overbeek Femke C. M. S. , Goudzwaard Jeannette A. , van Hemmen Judy , van Bruchem-Visser Rozemarijn L. , Papma Janne M. , Polinder-Bos Harmke A. , Mattace-Raso Francesco U. S.
Published: April 2022

Since the heterogeneity of the growing group of older outpatients with cognitive decline, it is challenging to evaluate survival rates in clinical shared decision making. The primary outcome was to determine whether the Multidimensional Prognostic Index (MPI) predicts mortality, whilst assessing the MPI distribution was considered secondary. This retrospective chart review included 311 outpatients aged ≥65 years and diagnosed with dementia or mild cognitive impairment (MCI). The MPI includes several domains of the comprehensive geriatric assessment (CGA). All characteristics and data to calculate the risk score and mortality data were extracted from administrative information in the database of the Alzheimer’s Center and medical records. The study population (mean age 76.8 years, men = 51.4%) was divided as follows: 34.1% belonged to MPI category 1, 52.1% to MPI category 2 and 13.8% to MPI category 3. Patients with dementia have a higher mean MPI risk score than patients with MCI (0.47 vs. 0.32; p < 0.001). The HRs and corresponding 95% CIs for mortality in patients in MPI categories 2 and 3 were 1.67 (0.81–3.45) and 3.80 (1.56–9.24) compared with MPI category 1, respectively. This study shows that the MPI predicts mortality in outpatients with cognitive decline.
Dry Needling in Physical Therapy Treatment of Chronic Neck Pain: Systematic Review
Authors: Rodríguez-Huguet Manuel , Vinolo-Gil Maria Jesus , Góngora-Rodríguez Jorge
Published: April 2022

Chronic Neck Pain (CNP) is one of the main causes of disability worldwide, and it is necessary to promote new strategies of therapeutic approach in the treatment of chronic pain. Dry needling (DN) is defined as an invasive physiotherapy technique used in the treatment of neuromusculoskeletal disorders. The purpose of this review was to assess the effectiveness of invasive techniques in treatment of CNP. The search focused on randomized clinical trials, and according to the selection criteria, eight studies were obtained. In conclusion, DN can be an effective treatment option for CNP, positive outcomes were achieved in the short-term and in the follow-up performed between three and six months, and this technique may offer better outcomes than a placebo intervention based on the application of simulated DN.
Ovocystatin Induced Changes in Expression of Alzheimer’s Disease Relevant Proteins in APP/PS1 Transgenic Mice
Authors: Stanczykiewicz Bartlomiej , Gburek Jakub , Rutkowska Maria , Lemieszewska Marta , Gołąb Krzysztof , Juszczyńska Katarzyna , Piotrowska Aleksandra , Trziszka Tadeusz , Dzięgiel Piotr , Podhorska-Okołów Marzenna , Zabłocka Agnieszka , Rymaszewska Joanna
Published: April 2022

Background: Ovocystatin is marked by structural and biological similarities to human cystatin C, which plays an important role in the course of neurodegenerative diseases. Recently, it has been shown that ovocystatin might prevent aging-related cognitive impairment in rats and reduce memory decline in an APP/PS1 mice model. Thus, this study aimed to assess the effect of ovocystatin on histopathological changes in APP/PS1 mice. Materials and methods: Ovocystatin was administered intraperitoneally for four weeks (40 μg/mouse) to 35-weeks-old transgenic (AD, n = 14) and wild type (NCAR, n = 15) mice (stock B6C3-Tg(APPswe, PSEN1dE9)85Dbo/Mmjax). A histopathological evaluation comprised antibodies directed against β-amyloid (1:400, SIG-39320-1000, Covance) and Tau (1:4000, AHB0042, Invitrogen). Three regions of the hippocampus— the dentate gyrus (DG) and the cornu ammonis (CA1 and CA3)—were analyzed by immunohistochemistry in each animal. All differences are expressed as percentage relative to the control group. Results: The main results showed that the percentage of immunoreactive area of β-amyloid, tau protein deposits in APP/PS1+ovCYS was decreased in DG, CA1, and CA3 regions compared with the APP/PS1 control, respectively (p < 0.05). Conclusions: Ovocystatin caused significant changes in the expression pattern of all investigated proteins in hippocampal tissues both in APP/PS1 and NCAR mice.
Cerebral Hypoperfusion Intensity Ratio Is Linked to Progressive Early Edema Formation
Authors: van Horn Noel , Broocks Gabriel , Kabiri Reza , Kraemer Michel C. , Christensen Soren , Mlynash Michael , Meyer Lukas , Lansberg Maarten G. , Albers Gregory W. , Sporns Peter , Guenego Adrien , Fiehler Jens , Wintermark Max , Heit Jeremy J. , Faizy Tobias D.
Published: April 2022

The hypoperfusion intensity ratio (HIR) is associated with collateral status and reflects the impaired microperfusion of brain tissue in patients with acute ischemic stroke and large vessel occlusion (AIS-LVO). As a deterioration in cerebral blood flow is associated with brain edema, we aimed to investigate whether HIR is correlated with the early edema progression rate (EPR) determined by the ischemic net water uptake (NWU) in a multicenter retrospective analysis of AIS-LVO patients anticipated for thrombectomy treatment. HIR was automatically calculated as the ratio of time-to-maximum (TMax) > 10 s/(TMax) > 6 s. HIRs < 0.4 were regarded as favorable (HIR+) and ≥0.4 as unfavorable (HIR−). Quantitative ischemic lesion NWU was delineated on baseline NCCT images and EPR was calculated as the ratio of NWU/time from symptom onset to imaging. Multivariable regression analysis was used to assess the association of HIR with EPR. This study included 731 patients. HIR+ patients exhibited a reduced median NWU upon admission CT (4% (IQR: 2.1–7.6) versus 8.2% (6–10.4); p < 0.001) and less median EPR (0.016%/h (IQR: 0.007–0.04) versus 0.044%/h (IQR: 0.021–0.089; p < 0.001) compared to HIR− patients. Multivariable regression showed that HIR+ (β: 0.53, SE: 0.02; p = 0.003) and presentation of the National Institutes of Health Stroke Scale (β: 0.2, SE: 0.0006; p = 0.001) were independently associated with EPR. In conclusion, favorable HIR was associated with lower early edema progression and decreased ischemic edema formation on baseline NCCT.
Surreptitious Adversarial Examples through Functioning QR Code
Authors: Chindaudom Aran , Siritanawan Prarinya , Sumongkayothin Karin , Kotani Kazunori
Published: April 2022

The continuous advances in the technology of Convolutional Neural Network (CNN) and Deep Learning have been applied to facilitate various tasks of human life. However, security risks of the users’ information and privacy have been increasing rapidly due to the models’ vulnerabilities. We have developed a novel method of adversarial attack that can conceal its intent from human intuition through the use of a modified QR code. The modified QR code can be consistently scanned with a reader while retaining adversarial efficacy against image classification models. The QR adversarial patch was created and embedded into an input image to generate adversarial examples, which were trained against CNN image classification models. Experiments were performed to investigate the trade-off in different patch shapes and find the patch’s optimal balance of scannability and adversarial efficacy. Furthermore, we have investigated whether particular classes of images are more resistant or vulnerable to the adversarial QR attack, and we also investigated the generality of the adversarial attack across different image classification models.
Elaboração e avaliação de material psicoeducativo para famílias de crianças com diabetes tipo 1
Authors: Brito Ariane de , Remor Eduardo
Published: April 2022

Descrever o processo de elaboração e avaliação de materiais psicoeducativos para famílias de crianças com diabetes mellitus tipo 1 (DM1). O estudo foi desenvolvido em cinco fases consecutivas: construção dos materiais psicoeducativos (três histórias) baseados em evidências, avaliação dos materiais por juízes especialistas (Parte 1), ilustração e diagramação dos materiais, avaliação dos materiais por juízes especialistas (Parte 2), e avaliação pelo público-alvo. O processo de avaliação foi realizado por um total de seis juízes e 22 cuidadores de crianças com DM1. Na Parte 1, três juízes apresentaram percentual de concordância de 61,1% e melhorias no conteúdo das histórias foram realizadas. Já na Parte 2, outros três juízes concordaram em 73,6% quanto às ilustrações e legibilidade. Os cuidadores também avaliaram positivamente os materiais, por exemplo, quanto aos aspectos: clareza, foco dos objetivos e layout. Materiais psicoeducativos para famílias de crianças com DM1, baseados em evidências, foram elaborados e avaliados, preenchendo uma lacuna observada no contexto brasileiro. Os materiais podem ser utilizados como auxílio em intervenções familiares no contexto do DM1 que visam promover educação sobre saúde mental para pais/cuidadores durante o cuidado da criança com DM1.
Methods of assessment of muscle weakness acquired in ICU: a narrative description / Métodos de avaliação da fraqueza muscular adquirida na ICU: uma descrição narrativa
Authors: Sumar Alice Henrique dos Santos , Dos Santos Bianca Kons , De Sousa Tatiane Regina , Sarmento Tuane
Published: April 2022

Introduction: With scientific and technological advances, the survival of critically ill patients has increased over the years. However, some patients require prolonged invasive mechanical ventilation (IMV), which can increase the length of stay in the intensive care unit (ICU) and lead to ICU-acquired muscle weakness (ICUAW). There are several tools to diagnose ICUAW, however, most of them depend on patient collaboration, and often, due to sedation, this becomes unfeasible. Objective: To describe the ICUAW assessment instruments in critically ill patients. Methodology: A bibliographic search was carried out in PubMed, MedLine (International Literature and Health), LILACS (Latin America and the Caribbean in Health Sciences) and Cochrane databases between 1995 and December 2019 using the keywords: muscle weakness, muscle strength and intensive care unit. Conclusion: The assessment of muscle weakness is of great importance to verify the health status of critically ill patients admitted to the ICU and to guide them towards the most appropriate treatment plan. Thus, it is essential for the physical therapist to know the various instruments for assessing muscle weakness acquired in the ICU.
Staphylococcus warneri: brief literature review / Staphylococcus warneri: breve revisão da literatura
Authors: Karam Bruna Ribeiro Sued , Ribeiro Paula Marcele Afonso Pereira
Published: April 2022

Coagulase-negative Staphylococcus warneri is an opportunistic pathogen that is capable of causing several infections, especially in patients with indwelling medical devices. Antimicrobial resistance is a global challenge for the treatment of infections caused by staphylococci. The most important virulence factor of CoNS is the biofilm-producing ability. This brief literature review discusses aspects of the antimicrobial resistance and virulence factors of the Staphylococcus warneri. Literature about the Staphylococcus warneri listed in PubMed between 2011 and 2021 was reviewed. Staphylococcus warneri is a part of the normal flora of the skin, especially the nares, head, legs, and arms. The importance of S. warneri as a modern-day pathogen is growing, as it has established itself as a successful nosocomial pathogen. S. warneri isolates from these infections are generally resistant to beta-lactam antimicrobial agents. The virulence of S. warneri have been suggested to be multifactorial, including adhesins, enzymes, extracellular toxins, capsule, iron uptake systems, virulence regulators and to adhere to produce biofilm, invade and destroy epithelial cells. The pathogenetic mechanisms of infections their mechanisms of bacterial persistence and evasion of the host’s immune system have not yet been clearly elucidated. Only with deeper studies, which will allow a more comprehensive understanding of its physiological characteristics, will it be possible to design effective strategies against S. warneri.
Thermography in dentistry: a bibliometric review / Termografia em odontologia: uma revisão bibliométrica
Authors: Noronha Jéssica Hálice , Haddad Denise Sabbagh , Arita Emiko Saito , Neves Eduardo Borba
Published: April 2022

Infrared thermography is an imaging exam present in the scope of diagnosis, evolutionary monitoring, and prognosis in the health area. Over the years, thermography has been studied in medicine, and it is a technique recently used in Dentistry. In this sense, the objective of this work was to carry out a literature review with a bibliometric approach to the use of thermal images for the diagnosis/monitoring of dental treatments. Studies that relate thermography to dental specialties were analyzed, considering the use of thermography as a diagnostic aid and monitoring of dental treatments in its wide range of activities. Searches were performed in the following databases: PubMed, Web of Science, Embase, Scopus, Scielo, from 1985 to 2020, with a search phrase including thermography and Dentistry specialties. The results show the trends in publications relating thermographic images to dental specialties by year of publication, journals, country, type of study, manufacturer of cameras used, resolution, and ambient temperature, totaling 119 publications in 83 journals. Temporomandibular Dysfunction and Orofacial Pain was the specialty with the highest concentration of publications relating thermography to Dentistry (27 articles). Endodontics was the second specialty (23 articles), Restorative Dentistry was the third specialty (18 articles) followed by Surgery (17 articles). It can be concluded that thermography is indicated as an auxiliary diagnostic method in Dentistry specialties. The main indications for thermography in Dentistry are in the context of diagnosis of Orofacial Pain (dysfunctions temporomandibular disorders of the muscular and articular types, noninflammatory odontalgias and neuropathies), Endodontics (inflammatory odontalgias), Implantology (osseointegration), and follow-up evolution of the postoperative surgeries.
The importance of Cone-Beam computed tomography in diagnosis of associated mandibular osteonecrosis: case report / A importância da TCFC no diagnóstico e prognóstico da osteonecrose mandibular associada aos bisfosfonatos: relato de caso clínico
Authors: Machado Emanuelle Farias , Aguiar Ellen Nunes Santos , Santana Fellipe Reale , Gomes Raul de Souza , Pinto Samya Leal Peixoto , Santana Joelson Ferreira , Freitas Maria da Conceição Andrade de , Andrade Rita de Cássia Dias Viana , Fraga Taís de Lima e , Ismerim Adna Barros
Published: April 2022

The Cone-Beam Computed Tomography (CBCT) is very useful in diagnosis and treatment planning, as well as in the prognosis of osteonecrosis of the jaws. This study reports a clinical case of Bisphosphonate-Associated Mandibular Osteonecrosis from the perspective of CBCT. The patient, female, 83 years old, presented painful symptoms in the posterior region of the right mandible and reported Bisphosphonate medication for more than five years to treat osteoporosis and osteopenia. Based on clinical and CBCT imaging characteristics, the patient was diagnosed with Bisphosphonate-Associated Mandibular Osteonecrosis. Initially, the treatment consisted of oral antibiotic therapy, pain control, hyperbaric oxygenation and oral hygiene (mouthwashes). After 11 months of clinical therapy, CBCT revealed bone reconstruction of the buccal cortex, but also a hypodense imaging in the lingual cortex compatible with bone lysis and bone sequestration. The patient was referred for bone debridement and sequestrectomy. The histopathological diagnosis consisted of osteonecrosis with secondary acute osteomyelitis. After 60 days of the surgical procedure and hyperbaric sessions/systemic antibiotic therapy, an oral healthy mucosa in the region of the right mandibular body was evidenced in the intraoral examination. Cortical bone regeneration was observed on CBCT. Concluded that the use of CBCT, in this case report, makes it possible to estimate the extent of the lesion and the post-treatment outcome, assessing bone density, the presence of bone sequestration and the involvement of the involved areas. In fact, early diagnosis is essential for the success of the therapeutic approach.
Pneumomediastino espontâneo em paciente com COVID-19: um relato de caso / Spontaneous pneumomediastinum in a patient with COVID-19: a case report
Authors: Herênio Yuree Milhomem Bandeira , Arguello Anna Carolina da Costa , Carvalho Camila de Quevedo , Barbosa Fernando Grubert Peixoto , Conceição Daiana Lopez , Carreiro Ana Caroline Blanco , Nunes Thiago Franchi , Santos Rômulo Florêncio Tristão
Published: April 2022

O pneumomediastino é um acúmulo de ar incomum e potencialmente fatal dentro do mediastino, tradicionalmente associado a barotrauma, lesão no esôfago, traqueia, pulmão ou espaço pleural e infecções, sendo incomum na pneumonia viral, porém tem sido relatado em alguns casos com a síndrome da pneumonia por COVID-19. Neste relato, apresentamos um caso de pneumomediastino espontâneo em um paciente diagnosticado com pneumonia pela COVID-19.
Q Fever: characteristics and reports of an important neglected zoonosis in Brazil / Febre Q: características e relatos de uma importante zoonose negligenciada no Brasil
Authors: Meurer Igor Rosa , Silva Marcio Roberto , Vanelli Chislene Pereira , Guimarães Ricardo José de Paula Souza e , Corrêa José Otávio do Amaral
Published: April 2022

The Q fever is a zoonotic disease neglected in many countries all over the world. This zoonosis is caused by the bacteria Coxiella burnetii, a pathogen that presents stability and environmental resistance with high capacity to cause human infection, which could be fatal. This literature review study aims to describe the general aspects of Q fever, presenting the main cases occurred in Brazil and discussing ways to avoid this zoonosis negligence and underreporting in Brazil. The Q fever is still a disease unknown by the larger part of healthcare professionals in Brazil. In addition, the disease in humans presents a clinical picture similar to that of other acute feverish diseases. Therefore, cases of Q fever cannot be diagnosed and their treatment can be erroneous, which can increase the chances of chronic Q fever occurrence. The inclusion of Q fever as a disease of mandatory notification in humans and the utilization of the "One Health" approach are essential for the confrontation of the disease. Moreover, measures for the control, investigation, and prevention of Q fever will contribute to avoid the occurrence of outbreaks and possible worsening resulting from this zoonosis.
On the Chemistry of Hammarsten Test for Indican in Urine
Authors: Sánchez-Viesca Francisco , Gómez Reina
Published: April 2022

Physiological indican, indoxyl sulphate, is an analyte since higher levels of this compound indicate stomach dysfunction and intestinal dysbiosis. The Hammarsten test for indican in urine is interesting from the Biochemistry point of view as for Organic Chemistry since the chemistry involved in this test has not been described. The test employs a solution of calcium chlorohypochlorite added to acidulated urine with fuming hydrochloric acid, in the presence of chloroform. The latter turns blue due to indigo formation. The colour can be pale, bright, or dark, in accordance with indican concentration. This swift indigo-synthesis in acidic medium, via chlorinated intermediates, differs notably from the oxygenation process in alkaline medium that takes place during the obtention of indigo from vegetable source. We provide the route from physiological indican to indigo blue and to indigo red (indirubin), giving the electron flow, step by step, in this reaction series.