Pub Date : 2024-09-09DOI: 10.3390/medicina60091475
Jung-Soo Pyo, Kyeung-Whan Min, Ji-Eun Choi, Dong-Wook Kang
Background and Objectives: This study aimed to elucidate the diagnostic role of α-Methylacyl-CoA racemase (AMACR) immunohistochemistry in gastric dysplasia and adenocarcinoma. Materials and Methods: Immunohistochemistry for AMACR was performed on 39 gastric dysplasia and 40 gastric adenocarcinoma cases. The expression patterns of AMACR were investigated and divided into luminal and cytoplasmic expression patterns in the gastric lesions. In addition, correlations between AMACR expression and patient age, sex, and tumor size were evaluated. Results: AMACR was expressed in 26 of 39 cases of gastric dysplasia (66.7%) and 17 of 40 cases of gastric adenocarcinomas (42.5%). The AMACR expression rates in high- and low-grade dysplasia were 80.0% and 52.6%, respectively. A detailed analysis of the expression patterns revealed that the luminal expression pattern was significantly higher in low-grade dysplasia than in high-grade dysplasia and gastric adenocarcinoma (p < 0.001). The cytoplasmic expression pattern, without luminal expression, was predominant in high-grade dysplasia and gastric adenocarcinoma. In addition, the rates of loss of expression in the overall area were 15.1 ± 23.9%, 49.0 ± 29.9%, and 59.0 ± 32.2% in low-grade dysplasia, high-grade dysplasia, and gastric adenocarcinoma, respectively. The negative rate of low-grade dysplasia was significantly lower than that of high-grade dysplasia and gastric adenocarcinoma (p < 0.001 and p < 0.001, respectively). Conclusions: AMACR is a useful diagnostic marker for differentiating low-grade dysplasia from high-grade dysplasia and gastric adenocarcinoma. Luminal or cytoplasmic expression patterns and the extent of loss of expression are important for differentiation.
{"title":"Diagnostic Roles of α-Methylacyl-CoA Racemase (AMACR) Immunohistochemistry in Gastric Dysplasia and Adenocarcinoma","authors":"Jung-Soo Pyo, Kyeung-Whan Min, Ji-Eun Choi, Dong-Wook Kang","doi":"10.3390/medicina60091475","DOIUrl":"https://doi.org/10.3390/medicina60091475","url":null,"abstract":"Background and Objectives: This study aimed to elucidate the diagnostic role of α-Methylacyl-CoA racemase (AMACR) immunohistochemistry in gastric dysplasia and adenocarcinoma. Materials and Methods: Immunohistochemistry for AMACR was performed on 39 gastric dysplasia and 40 gastric adenocarcinoma cases. The expression patterns of AMACR were investigated and divided into luminal and cytoplasmic expression patterns in the gastric lesions. In addition, correlations between AMACR expression and patient age, sex, and tumor size were evaluated. Results: AMACR was expressed in 26 of 39 cases of gastric dysplasia (66.7%) and 17 of 40 cases of gastric adenocarcinomas (42.5%). The AMACR expression rates in high- and low-grade dysplasia were 80.0% and 52.6%, respectively. A detailed analysis of the expression patterns revealed that the luminal expression pattern was significantly higher in low-grade dysplasia than in high-grade dysplasia and gastric adenocarcinoma (p < 0.001). The cytoplasmic expression pattern, without luminal expression, was predominant in high-grade dysplasia and gastric adenocarcinoma. In addition, the rates of loss of expression in the overall area were 15.1 ± 23.9%, 49.0 ± 29.9%, and 59.0 ± 32.2% in low-grade dysplasia, high-grade dysplasia, and gastric adenocarcinoma, respectively. The negative rate of low-grade dysplasia was significantly lower than that of high-grade dysplasia and gastric adenocarcinoma (p < 0.001 and p < 0.001, respectively). Conclusions: AMACR is a useful diagnostic marker for differentiating low-grade dysplasia from high-grade dysplasia and gastric adenocarcinoma. Luminal or cytoplasmic expression patterns and the extent of loss of expression are important for differentiation.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.3390/medicina60091473
Basant E. Katamesh, Pragyat Futela, Ann Vincent, Bright Thilagar, Mary Whipple, Abdul Rhman Hassan, Mohamed Abuelazm, Sanjeev Nanda, Christopher Anstine, Abhinav Singla
Background and Objectives: Proteomics encompasses the exploration of protein composition, regulation, function, and pathways. Its influence spans diverse clinical fields and holds promise in addressing various women’s health conditions, including cancers, osteoporosis, and cardiovascular disorders. However, no comprehensive summary of proteomics and menopausal health exists. Our objective was to summarize proteomic profiles associated with diseases and disorders in peri- and postmenopausal women. Materials and Methods: We conducted a comprehensive search of databases including PubMed, Google Scholar, the Cochrane database, Elsevier, and ScienceDirect until 2022. A total of 253 studies were identified, and 41 studies met the inclusion criteria to identify data of interest. These included the study design, disease, and proteomics/proteins of significance, as described by the authors. Results: The 41 studies covered diverse areas, including bone disorders (10 studies), cardiovascular diseases (5 studies), oncological malignancies (10 studies), and various conditions, such as obesity, nonalcoholic liver disease, the effects of hormone replacement therapy, and neurological diseases (16 studies). The results of our study indicate that proteomic profiles correlate with heart disease in peri- and postmenopausal women, with distinct sex differences. Furthermore, proteomic profiles significantly differ between women with and without osteoporosis. Additionally, patients with breast, ovarian, and endometrial cancer exhibit notable variations in proteomic profiles compared to those without these conditions. Conclusions: Proteomics has the potential to enhance risk assessment and disease monitoring in peri- and postmenopausal women. By analyzing unique protein profiles, clinicians can identify individuals with heightened susceptibility to specific diseases or those already affected by established conditions. This review suggests that there is sufficient preliminary data related to proteomics in peri- and postmenopausal women for early identification of cardiovascular disease, osteoporosis, and cancers, disease monitoring, and tailoring individualized therapies. Rigorous validation studies involving large populations are essential before drawing definitive conclusions regarding the clinical applicability of proteomic findings.
{"title":"Navigating the Proteomic Landscape of Menopause: A Review","authors":"Basant E. Katamesh, Pragyat Futela, Ann Vincent, Bright Thilagar, Mary Whipple, Abdul Rhman Hassan, Mohamed Abuelazm, Sanjeev Nanda, Christopher Anstine, Abhinav Singla","doi":"10.3390/medicina60091473","DOIUrl":"https://doi.org/10.3390/medicina60091473","url":null,"abstract":"Background and Objectives: Proteomics encompasses the exploration of protein composition, regulation, function, and pathways. Its influence spans diverse clinical fields and holds promise in addressing various women’s health conditions, including cancers, osteoporosis, and cardiovascular disorders. However, no comprehensive summary of proteomics and menopausal health exists. Our objective was to summarize proteomic profiles associated with diseases and disorders in peri- and postmenopausal women. Materials and Methods: We conducted a comprehensive search of databases including PubMed, Google Scholar, the Cochrane database, Elsevier, and ScienceDirect until 2022. A total of 253 studies were identified, and 41 studies met the inclusion criteria to identify data of interest. These included the study design, disease, and proteomics/proteins of significance, as described by the authors. Results: The 41 studies covered diverse areas, including bone disorders (10 studies), cardiovascular diseases (5 studies), oncological malignancies (10 studies), and various conditions, such as obesity, nonalcoholic liver disease, the effects of hormone replacement therapy, and neurological diseases (16 studies). The results of our study indicate that proteomic profiles correlate with heart disease in peri- and postmenopausal women, with distinct sex differences. Furthermore, proteomic profiles significantly differ between women with and without osteoporosis. Additionally, patients with breast, ovarian, and endometrial cancer exhibit notable variations in proteomic profiles compared to those without these conditions. Conclusions: Proteomics has the potential to enhance risk assessment and disease monitoring in peri- and postmenopausal women. By analyzing unique protein profiles, clinicians can identify individuals with heightened susceptibility to specific diseases or those already affected by established conditions. This review suggests that there is sufficient preliminary data related to proteomics in peri- and postmenopausal women for early identification of cardiovascular disease, osteoporosis, and cancers, disease monitoring, and tailoring individualized therapies. Rigorous validation studies involving large populations are essential before drawing definitive conclusions regarding the clinical applicability of proteomic findings.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-08DOI: 10.3390/medicina60091469
Teodora Surdea-Blaga, Stefan-Lucian Popa, Cristina Maria Sabo, Radu Alexandru Fărcaş, Liliana David, Abdulrahman Ismaiel, Dan Lucian Dumitrascu, Simona Grad, Daniel Corneliu Leucuta
Background and Objectives: The threshold for ineffective esophageal motility (IEM) diagnosis was changed in Chicago v4.0. Our aim was to determine IEM prevalence using the new criteria and the differences between patients with definite IEM versus “inconclusive diagnosis”. Materials and Methods: We retrospectively selected IEM and fragmented peristalsis (FP) patients from the high-resolution esophageal manometries (HREMs) database. Clinical, demographic data and manometric parameters were recorded. Results: Of 348 HREMs analyzed using Chicago v3.0, 12.3% of patients had IEM and 0.86% had FP. Using Chicago v4.0, 8.9% of patients had IEM (IEM-4 group). We compared them with the remaining 16 with an inconclusive diagnosis of IEM (borderline group). Dysphagia (77% vs. 44%, Z-test = 2.3, p = 0.02) and weight loss were more commonly observed in IEM-4 compared to the borderline group. The reflux symptoms were more prevalent in the borderline group (87.5% vs. 70.9%, p = 0.2). Type 2 or 3 esophagogastric junction morphology was more prevalent in the borderline group (81.2%) vs. 64.5% in IEM-4 (p = 0.23). Distal contractile integral (DCI) was lower in IEM-4 vs. the borderline group, and resting lower esophageal sphincter (LES) pressure and mean integrated relaxation pressure (IRP) were similar. The number of ineffective swallows and failed swallows was higher in IEM-4 compared to the borderline group. Conclusions: Using Chicago v4.0, less than 10% of patients had a definite diagnosis of IEM. The dominant symptom was dysphagia. Only DCI and the number of failed and inefficient swallows were different between definite IEM patients and borderline cases.
{"title":"Comparative Prevalence of Ineffective Esophageal Motility: Impact of Chicago v4.0 vs. v3.0 Criteria","authors":"Teodora Surdea-Blaga, Stefan-Lucian Popa, Cristina Maria Sabo, Radu Alexandru Fărcaş, Liliana David, Abdulrahman Ismaiel, Dan Lucian Dumitrascu, Simona Grad, Daniel Corneliu Leucuta","doi":"10.3390/medicina60091469","DOIUrl":"https://doi.org/10.3390/medicina60091469","url":null,"abstract":"Background and Objectives: The threshold for ineffective esophageal motility (IEM) diagnosis was changed in Chicago v4.0. Our aim was to determine IEM prevalence using the new criteria and the differences between patients with definite IEM versus “inconclusive diagnosis”. Materials and Methods: We retrospectively selected IEM and fragmented peristalsis (FP) patients from the high-resolution esophageal manometries (HREMs) database. Clinical, demographic data and manometric parameters were recorded. Results: Of 348 HREMs analyzed using Chicago v3.0, 12.3% of patients had IEM and 0.86% had FP. Using Chicago v4.0, 8.9% of patients had IEM (IEM-4 group). We compared them with the remaining 16 with an inconclusive diagnosis of IEM (borderline group). Dysphagia (77% vs. 44%, Z-test = 2.3, p = 0.02) and weight loss were more commonly observed in IEM-4 compared to the borderline group. The reflux symptoms were more prevalent in the borderline group (87.5% vs. 70.9%, p = 0.2). Type 2 or 3 esophagogastric junction morphology was more prevalent in the borderline group (81.2%) vs. 64.5% in IEM-4 (p = 0.23). Distal contractile integral (DCI) was lower in IEM-4 vs. the borderline group, and resting lower esophageal sphincter (LES) pressure and mean integrated relaxation pressure (IRP) were similar. The number of ineffective swallows and failed swallows was higher in IEM-4 compared to the borderline group. Conclusions: Using Chicago v4.0, less than 10% of patients had a definite diagnosis of IEM. The dominant symptom was dysphagia. Only DCI and the number of failed and inefficient swallows were different between definite IEM patients and borderline cases.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-08DOI: 10.3390/medicina60091468
Szymon Jozef Pietrzyk, Emilia Kielczynska, Martyna Kowalczyk, Mateusz Mazurek, Zygmunt Antoni Domagala
Since December 2019, COVID-19 has rapidly spread worldwide, prompting the World Health Organization (WHO) to declare it a pandemic and advocate for the widespread use of face masks to mitigate transmission. In this review, we delve into the potential impact of prolonged face mask use on temporomandibular joint (TMJ) health, an area that has garnered limited attention amidst COVID-19 research. Research has revealed that improper mask fit and constant readjustment can lead to TMJ abnormalities. Similarly, there is a demonstrated correlation between continuous mask usage and an increased incidence of headaches, temporomandibular pain, and diminished quality of life. Many studies have highlighted discomfort in the preauricular area, headaches, TMJ noises, headache, jaw pain, and muscle fatigue, as well as dermatological disorders, which have been attributed to prolonged mask wear and its impact on TMJ health. Our study catalyzes future research endeavors, urging a deeper exploration of the implications of long-term mask wear, not only in the context of the COVID-19 pandemic but also among occupational groups regularly exposed to extended mask use. By unraveling the complexities of TMJ health in the face of evolving preventive measures, we aim to enhance our understanding of this issue and safeguard the well-being of mask-wearers worldwide.
{"title":"Potential Impacts of Prolonged Face Mask Use on Temporomandibular Joint Health as Neglected Lifestyle Repercussions of COVID-19 Pandemic—A Narrative Review","authors":"Szymon Jozef Pietrzyk, Emilia Kielczynska, Martyna Kowalczyk, Mateusz Mazurek, Zygmunt Antoni Domagala","doi":"10.3390/medicina60091468","DOIUrl":"https://doi.org/10.3390/medicina60091468","url":null,"abstract":"Since December 2019, COVID-19 has rapidly spread worldwide, prompting the World Health Organization (WHO) to declare it a pandemic and advocate for the widespread use of face masks to mitigate transmission. In this review, we delve into the potential impact of prolonged face mask use on temporomandibular joint (TMJ) health, an area that has garnered limited attention amidst COVID-19 research. Research has revealed that improper mask fit and constant readjustment can lead to TMJ abnormalities. Similarly, there is a demonstrated correlation between continuous mask usage and an increased incidence of headaches, temporomandibular pain, and diminished quality of life. Many studies have highlighted discomfort in the preauricular area, headaches, TMJ noises, headache, jaw pain, and muscle fatigue, as well as dermatological disorders, which have been attributed to prolonged mask wear and its impact on TMJ health. Our study catalyzes future research endeavors, urging a deeper exploration of the implications of long-term mask wear, not only in the context of the COVID-19 pandemic but also among occupational groups regularly exposed to extended mask use. By unraveling the complexities of TMJ health in the face of evolving preventive measures, we aim to enhance our understanding of this issue and safeguard the well-being of mask-wearers worldwide.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.3390/medicina60091467
Amjad Hajaj Alharbi, Mohamed K. Seyam, Ahmad Alanazi, Ahmed Almansour, Shahnaz Hasan
Background and Objectives: Anterior knee pain (AKP) refers to chronic prepatellar pain and is one of the most common knee complaints in physically active women. This condition can significantly affect daily activities and overall quality of life. This study aims to assess the impact of pain, risk factors, and functional ability on different levels of physical activity (comparing low versus moderate activity) in women with AKP. Materials and Methods: This cross-sectional study involved fifty-six women diagnosed with AKP (aged 20–45 years) who were equally allocated into low and moderate physical activity groups. Their AKP and functional ability were assessed using the visual analog scale (VAS) and double squats and step-down tests, respectively. Possible risk factors were assessed using the Q-angle, modified Thomas test, sit and reach test, and patellar glide test. A person’s correlation coefficient and independent t-tests were used to determine the relationship and the differences between these variables while keeping the confidence interval level at 95%. Result: Women with moderate activity levels showed significantly higher scores on the VAS than those with low activity levels (p = 0.040). However, both groups had no significant difference in their functional ability or potential risk factors (p > 0.05). Additionally, their functional ability (double squat) showed a positive association with hamstring flexibility (Pearson correlation coefficient [r]:0.3; p = 0.006). Conclusions: Women with AKP who were engaged in moderate physical activity experienced higher levels of pain compared to those with low activity levels. These findings underscore the urgent need for further investigation into different levels of physical activity to develop appropriate prevention and treatment strategies for women with AKP.
{"title":"Influence of Pain, Risk Factors, and Functional Ability on Physical Activity Levels in Women with Anterior Knee Pain: A Cross-Sectional Study","authors":"Amjad Hajaj Alharbi, Mohamed K. Seyam, Ahmad Alanazi, Ahmed Almansour, Shahnaz Hasan","doi":"10.3390/medicina60091467","DOIUrl":"https://doi.org/10.3390/medicina60091467","url":null,"abstract":"Background and Objectives: Anterior knee pain (AKP) refers to chronic prepatellar pain and is one of the most common knee complaints in physically active women. This condition can significantly affect daily activities and overall quality of life. This study aims to assess the impact of pain, risk factors, and functional ability on different levels of physical activity (comparing low versus moderate activity) in women with AKP. Materials and Methods: This cross-sectional study involved fifty-six women diagnosed with AKP (aged 20–45 years) who were equally allocated into low and moderate physical activity groups. Their AKP and functional ability were assessed using the visual analog scale (VAS) and double squats and step-down tests, respectively. Possible risk factors were assessed using the Q-angle, modified Thomas test, sit and reach test, and patellar glide test. A person’s correlation coefficient and independent t-tests were used to determine the relationship and the differences between these variables while keeping the confidence interval level at 95%. Result: Women with moderate activity levels showed significantly higher scores on the VAS than those with low activity levels (p = 0.040). However, both groups had no significant difference in their functional ability or potential risk factors (p > 0.05). Additionally, their functional ability (double squat) showed a positive association with hamstring flexibility (Pearson correlation coefficient [r]:0.3; p = 0.006). Conclusions: Women with AKP who were engaged in moderate physical activity experienced higher levels of pain compared to those with low activity levels. These findings underscore the urgent need for further investigation into different levels of physical activity to develop appropriate prevention and treatment strategies for women with AKP.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.3390/medicina60091464
Maria Goldberg, Valeri Heinrich, Ghaith Altawalbeh, Chiara Negwer, Arthur Wagner, Jens Gempt, Bernhard Meyer, Amir Kaywan Aftahy
Background and Objectives: The impact of surgery for recurrent brain metastases in elderly patients has been the object of debate due to limited information in the literature. We analyzed clinical outcome and survival of elderly patients with recurrent brain metastases in order to assess potentially beneficial role of surgery. Materials and methods: In total, 219 patients with recurrent brain metastases between 2007 and 2022 were identified, of which 95 underwent re-resection; 83 patients aged 65 and older were analyzed. A survival analysis was performed, and clinical outcomes were evaluated. Results: The median survival time after surgery for recurrent brain metastases was 6 months (95CI 4–10) in older patients and 8 (95CI 7–9) in younger patients (p = 0.619). Out of all the older patients, 33 who underwent surgical resection showed prolonged survival compared with patients who did not receive surgical resection (median: 14, 95CI 8–19 vs. 4, 95CI 4–7, p = 0.011). All patients had preoperative Karnofsky performance scores of >70, which did not deteriorate after surgery (87.02 ± 5.76 vs. 85 ± 6.85; p = 0.055). In the univariate analysis, complete cytoreduction was a favorable prognostic factor. The tumor volume, the number of metastases, extracranial disease progression, adjuvant radiation, and systemic therapy did not affect survival in this cohort. Conclusions: Patients aged 65 and older benefit from neurosurgical resections of recurrent brain metastases. Survival did not differ from that in younger patients, which can be explained by a better preoperative functional status. Moreover, independent of the extent of resection, older patients who underwent surgery showed better survival than patients who did not receive surgical treatment. Complete cytoreduction was a favorable prognostic marker.
{"title":"The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population","authors":"Maria Goldberg, Valeri Heinrich, Ghaith Altawalbeh, Chiara Negwer, Arthur Wagner, Jens Gempt, Bernhard Meyer, Amir Kaywan Aftahy","doi":"10.3390/medicina60091464","DOIUrl":"https://doi.org/10.3390/medicina60091464","url":null,"abstract":"Background and Objectives: The impact of surgery for recurrent brain metastases in elderly patients has been the object of debate due to limited information in the literature. We analyzed clinical outcome and survival of elderly patients with recurrent brain metastases in order to assess potentially beneficial role of surgery. Materials and methods: In total, 219 patients with recurrent brain metastases between 2007 and 2022 were identified, of which 95 underwent re-resection; 83 patients aged 65 and older were analyzed. A survival analysis was performed, and clinical outcomes were evaluated. Results: The median survival time after surgery for recurrent brain metastases was 6 months (95CI 4–10) in older patients and 8 (95CI 7–9) in younger patients (p = 0.619). Out of all the older patients, 33 who underwent surgical resection showed prolonged survival compared with patients who did not receive surgical resection (median: 14, 95CI 8–19 vs. 4, 95CI 4–7, p = 0.011). All patients had preoperative Karnofsky performance scores of >70, which did not deteriorate after surgery (87.02 ± 5.76 vs. 85 ± 6.85; p = 0.055). In the univariate analysis, complete cytoreduction was a favorable prognostic factor. The tumor volume, the number of metastases, extracranial disease progression, adjuvant radiation, and systemic therapy did not affect survival in this cohort. Conclusions: Patients aged 65 and older benefit from neurosurgical resections of recurrent brain metastases. Survival did not differ from that in younger patients, which can be explained by a better preoperative functional status. Moreover, independent of the extent of resection, older patients who underwent surgery showed better survival than patients who did not receive surgical treatment. Complete cytoreduction was a favorable prognostic marker.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.3390/medicina60091462
Daniela Neves-Leal, Antonia M. Caleya, Andrea Martin-Vacas, Nuria E. Gallardo-López, Carlos Gallego
Background and Objectives: The aim was to compare the activity of the masseter muscles in children with different types of breathing. Materials and Methods: A cross-sectional study was conducted including patients aged 6–12 years with mixed dentition, who came for oral care at the Master’s Degree in Pediatric Dentistry program at the Complutense University of Madrid (UCM), according to inclusion and exclusion criteria. The sample was divided into three groups: nasal breathers without dental alterations (control group), oral breathers with dental malocclusion, and oral breathers with previous orthodontic treatment. An electromyography was performed, and statistic methods were conducted with a 95% confidence to contrast hypothesis. Results: A total of 122 children were analyzed and distributed into three groups. The electrical muscle activity of masseters was significantly different between the study groups (p < 0.001 for all comparisons). Pairwise comparisons revealed a significantly higher electrical muscle activity in the control group (nasal breathers) during chewing compared to both groups of oral breathers (p < 0.001 for both comparisons). Orthodontic treatment decreased electrical muscle activity during isometric contraction in oral breathers compared to nasal breathers (p < 0.001), but did not significantly affect electrical muscle activity during chewing. Higher decompensation values were obtained in oral breathers without previous orthodontic treatment compared the other study groups (p < 0.001 for both comparisons), although electrical muscle activity values were similar in both groups of oral breathers (p > 0.05 for both comparisons). Conclusions: Differences in electrical muscle activity between nasal and oral breathers can be confirmed. Oral breathers with and without orthodontic treatment showed lower electrical muscle activity of masseters during chewing than nasal breathers, while at isometric contraction, only oral breathers with previous orthodontic treatment showed lower electrical activity. Higher decompensation values were found in oral breathers without previous orthodontic treatment, in comparison to the control group and oral breathers with previous orthodontic treatment.
背景和目的:目的是比较不同呼吸方式儿童的颌下肌活动情况。材料与方法:根据纳入和排除标准,对马德里康普斯顿大学(UCM)儿童牙科硕士课程中前来接受口腔护理的 6-12 岁混合牙患者进行了横断面研究。样本被分为三组:无牙齿改变的鼻呼吸者(对照组)、牙齿畸形的口呼吸者和曾接受过正畸治疗的口呼吸者。研究人员进行了肌电图检查,并采用置信度为 95% 的统计方法来对比假设。结果:共对 122 名儿童进行了分析,并将其分为三组。研究组之间的颌间肌肌电活动有显著差异(所有比较中的 P < 0.001)。配对比较显示,与两组口腔呼吸者相比,对照组(鼻腔呼吸者)咀嚼时的肌肉电活动明显较高(两组比较的结果均为 p <0.001)。与鼻腔呼吸者相比,正畸治疗降低了口腔呼吸者等长收缩时的肌肉电活动(p < 0.001),但对咀嚼时的肌肉电活动没有显著影响。与其他研究组相比,未接受过正畸治疗的口腔呼吸者的失代偿值更高(两组比较,P < 0.001),尽管两组口腔呼吸者的肌肉电活动值相似(两组比较,P > 0.05)。结论鼻腔呼吸者和口腔呼吸者的肌电活动差异可以得到证实。与鼻腔呼吸者相比,接受过或未接受过正畸治疗的口腔呼吸者在咀嚼时的肌肉电活动较低,而在等长收缩时,只有接受过正畸治疗的口腔呼吸者的肌肉电活动较低。与对照组和曾接受过正畸治疗的口腔呼吸者相比,未接受过正畸治疗的口腔呼吸者的失代偿值更高。
{"title":"The Influence of the Type of Breathing on the Masticatory Muscle Patterns in Children","authors":"Daniela Neves-Leal, Antonia M. Caleya, Andrea Martin-Vacas, Nuria E. Gallardo-López, Carlos Gallego","doi":"10.3390/medicina60091462","DOIUrl":"https://doi.org/10.3390/medicina60091462","url":null,"abstract":"Background and Objectives: The aim was to compare the activity of the masseter muscles in children with different types of breathing. Materials and Methods: A cross-sectional study was conducted including patients aged 6–12 years with mixed dentition, who came for oral care at the Master’s Degree in Pediatric Dentistry program at the Complutense University of Madrid (UCM), according to inclusion and exclusion criteria. The sample was divided into three groups: nasal breathers without dental alterations (control group), oral breathers with dental malocclusion, and oral breathers with previous orthodontic treatment. An electromyography was performed, and statistic methods were conducted with a 95% confidence to contrast hypothesis. Results: A total of 122 children were analyzed and distributed into three groups. The electrical muscle activity of masseters was significantly different between the study groups (p < 0.001 for all comparisons). Pairwise comparisons revealed a significantly higher electrical muscle activity in the control group (nasal breathers) during chewing compared to both groups of oral breathers (p < 0.001 for both comparisons). Orthodontic treatment decreased electrical muscle activity during isometric contraction in oral breathers compared to nasal breathers (p < 0.001), but did not significantly affect electrical muscle activity during chewing. Higher decompensation values were obtained in oral breathers without previous orthodontic treatment compared the other study groups (p < 0.001 for both comparisons), although electrical muscle activity values were similar in both groups of oral breathers (p > 0.05 for both comparisons). Conclusions: Differences in electrical muscle activity between nasal and oral breathers can be confirmed. Oral breathers with and without orthodontic treatment showed lower electrical muscle activity of masseters during chewing than nasal breathers, while at isometric contraction, only oral breathers with previous orthodontic treatment showed lower electrical activity. Higher decompensation values were found in oral breathers without previous orthodontic treatment, in comparison to the control group and oral breathers with previous orthodontic treatment.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.3390/medicina60091459
Lenka Stepankova, Kamila Zvolska, Alexandra Pankova, Jakub Rafl, Gleb Donin, Ales Tichopad, Eva Kralikova
Background and Objectives: There is little information on changes in the process and outcomes of intensive tobacco dependence treatment during the COVID-19 pandemic. The following characteristics were evaluated: interest in treatment, the number of face-to-face or telephone follow-ups, the duration of pharmacotherapy use, and the success rate. The aim of our study was to compare the number of patients who entered tobacco dependence treatment programmes and evaluate the one-year success rate in patients three years before and three years after the COVID-19 pandemic. Materials and Methods: A single-site retrospective cohort study using data from patients treated at the Centre for Tobacco Dependence in Prague, Czech Republic, between 2017 and 2022 (n = 2039) was performed. The one-year abstinence rate was validated by measuring carbon monoxide in exhaled air (6 ppm cut-off). Patients were divided into two groups: the group for which treatment was initiated in 2017–2019 (i.e., before the COVID-19 pandemic, BC; n= 1221) and the group for which treatment was initiated in 2020–2022 (i.e., during the COVID-19 pandemic, DC; n = 818). Results: No significant differences in the success rate of tobacco dependence treatment were found between the two groups (BC group, 40.5% (494/1221) vs. DC group, 42.2% (345/818)) (χ2 (1, N = 2.039) = 0.6, p = 0.440). Furthermore, differences were not found in sex, education level, age at first cigarette, the duration of pharmacotherapy use, or the number of in-person visits. In contrast, there was an increase in the number of telephone contacts between the groups (18.7% (SD = 17.5%) vs. 32.9% (SD = 18.2%), p < 0.001). Conclusions: The number of patients who started treatment during the COVID-19 pandemic decreased by one-third compared to that during the 3-year period before the pandemic. The overall treatment success rate did not change significantly even with the increase in the number of telephone visits with the therapist.
{"title":"Changes in the Success and Characteristics of Tobacco Dependence Treatment before and during the COVID-19 Pandemic: Clinical Sample Comparisons","authors":"Lenka Stepankova, Kamila Zvolska, Alexandra Pankova, Jakub Rafl, Gleb Donin, Ales Tichopad, Eva Kralikova","doi":"10.3390/medicina60091459","DOIUrl":"https://doi.org/10.3390/medicina60091459","url":null,"abstract":"Background and Objectives: There is little information on changes in the process and outcomes of intensive tobacco dependence treatment during the COVID-19 pandemic. The following characteristics were evaluated: interest in treatment, the number of face-to-face or telephone follow-ups, the duration of pharmacotherapy use, and the success rate. The aim of our study was to compare the number of patients who entered tobacco dependence treatment programmes and evaluate the one-year success rate in patients three years before and three years after the COVID-19 pandemic. Materials and Methods: A single-site retrospective cohort study using data from patients treated at the Centre for Tobacco Dependence in Prague, Czech Republic, between 2017 and 2022 (n = 2039) was performed. The one-year abstinence rate was validated by measuring carbon monoxide in exhaled air (6 ppm cut-off). Patients were divided into two groups: the group for which treatment was initiated in 2017–2019 (i.e., before the COVID-19 pandemic, BC; n= 1221) and the group for which treatment was initiated in 2020–2022 (i.e., during the COVID-19 pandemic, DC; n = 818). Results: No significant differences in the success rate of tobacco dependence treatment were found between the two groups (BC group, 40.5% (494/1221) vs. DC group, 42.2% (345/818)) (χ2 (1, N = 2.039) = 0.6, p = 0.440). Furthermore, differences were not found in sex, education level, age at first cigarette, the duration of pharmacotherapy use, or the number of in-person visits. In contrast, there was an increase in the number of telephone contacts between the groups (18.7% (SD = 17.5%) vs. 32.9% (SD = 18.2%), p < 0.001). Conclusions: The number of patients who started treatment during the COVID-19 pandemic decreased by one-third compared to that during the 3-year period before the pandemic. The overall treatment success rate did not change significantly even with the increase in the number of telephone visits with the therapist.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objectives: This study uses finite element analysis to evaluate the impact of abutment angulation, types, and framework materials on the stress distribution and fatigue performance of dental implant systems. Materials and Methods: Three-dimensional models of maxillary three-unit fixed implant-supported prostheses were analyzed. Abutments with different angles and types were used. Two different framework materials were used. Conducted on implants, a force of 150 N was applied obliquely, directed from the palatal to the buccal aspect, at a specific angle of 30 degrees. The distribution of stress and fatigue performance were then assessed, considering the types of restoration frameworks used and the angles of the abutments in three distinct locations. The simulation aspect of the research was carried out utilizing Abaqus Software (ABAQUS 2020, Dassault Systems Simulation Corp., Johnston, RT, USA). Results: In all models, fatigue strengths in the premolar region were higher than in the molar region. Maximum stress levels were seen in models with angled implants. In almost all models with the zirconia framework, fatigue performance was slightly lower. Conclusions: According to the findings of this study, it was concluded that the use of metal-framework multi-unit restorations with minimum angulation has significant positive effects on the biomechanics and long-term success of implant treatments.
{"title":"Influence of Framework Material and Abutment Configuration on Fatigue Performance in Dental Implant Systems: A Finite Element Analysis","authors":"Meryem Erdoğdu, Mehmet Gökberkkaan Demirel, Reza Mohammadi, Neslihan Güntekin, Masoud Ghanbarzadeh Chaleshtori","doi":"10.3390/medicina60091463","DOIUrl":"https://doi.org/10.3390/medicina60091463","url":null,"abstract":"Background and Objectives: This study uses finite element analysis to evaluate the impact of abutment angulation, types, and framework materials on the stress distribution and fatigue performance of dental implant systems. Materials and Methods: Three-dimensional models of maxillary three-unit fixed implant-supported prostheses were analyzed. Abutments with different angles and types were used. Two different framework materials were used. Conducted on implants, a force of 150 N was applied obliquely, directed from the palatal to the buccal aspect, at a specific angle of 30 degrees. The distribution of stress and fatigue performance were then assessed, considering the types of restoration frameworks used and the angles of the abutments in three distinct locations. The simulation aspect of the research was carried out utilizing Abaqus Software (ABAQUS 2020, Dassault Systems Simulation Corp., Johnston, RT, USA). Results: In all models, fatigue strengths in the premolar region were higher than in the molar region. Maximum stress levels were seen in models with angled implants. In almost all models with the zirconia framework, fatigue performance was slightly lower. Conclusions: According to the findings of this study, it was concluded that the use of metal-framework multi-unit restorations with minimum angulation has significant positive effects on the biomechanics and long-term success of implant treatments.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Superficial venous thrombosis (SVT) is a fairly common disorder, characterized by the formation of thrombi inside superficial veins, with or without an associated inflammatory reaction. Its evolution is frequently self-limited. However, serious complications may change this clinical course with extension to deep vein thrombosis (DVT) and pulmonary embolism (PE). SVT shares similar risk factors with DVT and is frequently associated with the presence of varicose veins. However, the occurrence of non-varicose veins could conceal risk factors such as malignancies, thrombophilia, or Buerger’s disease. While the clinical diagnosis is generally straightforward, additional diagnostic evaluations are often necessary. Duplex ultrasound (DUS) is an invaluable tool that provides the location of SVT, the proximity to the sapheno–femoral junction, and the clot length, all of which influence the decision for optimal management. The treatment of SVT should be symptomatic, pathogenic (limiting the extension of thrombosis), and prognostic (to prevent complications). There are several guidelines that provide recommendations, and despite the need for more consensus and for further studies, the treatment of SVT should be mainly medical, including anticoagulation in specific clinical situations and symptom relief, with invasive treatment in a minority of cases. Initiation, intensity, and length of anticoagulant treatment should be based on the eventual risk of progression to DVT or PE, which can be high, intermediate, or low, based on the location of SVT and the clot length. Our review summarizes the evaluation and proper management of SVT and highlights the importance of a shared decision within the heart team regarding this condition in order to prevent further complications.
{"title":"Current Diagnostic and Therapeutic Challenges in Superficial Venous Thrombosis","authors":"Ana-Maria Balahura, Adrian-Gabriel Florescu, Teodora-Maria Barboi, Emma Weiss, Daniela Miricescu, Ciprian Jurcuț, Mariana Jinga, Silviu Stanciu","doi":"10.3390/medicina60091466","DOIUrl":"https://doi.org/10.3390/medicina60091466","url":null,"abstract":"Superficial venous thrombosis (SVT) is a fairly common disorder, characterized by the formation of thrombi inside superficial veins, with or without an associated inflammatory reaction. Its evolution is frequently self-limited. However, serious complications may change this clinical course with extension to deep vein thrombosis (DVT) and pulmonary embolism (PE). SVT shares similar risk factors with DVT and is frequently associated with the presence of varicose veins. However, the occurrence of non-varicose veins could conceal risk factors such as malignancies, thrombophilia, or Buerger’s disease. While the clinical diagnosis is generally straightforward, additional diagnostic evaluations are often necessary. Duplex ultrasound (DUS) is an invaluable tool that provides the location of SVT, the proximity to the sapheno–femoral junction, and the clot length, all of which influence the decision for optimal management. The treatment of SVT should be symptomatic, pathogenic (limiting the extension of thrombosis), and prognostic (to prevent complications). There are several guidelines that provide recommendations, and despite the need for more consensus and for further studies, the treatment of SVT should be mainly medical, including anticoagulation in specific clinical situations and symptom relief, with invasive treatment in a minority of cases. Initiation, intensity, and length of anticoagulant treatment should be based on the eventual risk of progression to DVT or PE, which can be high, intermediate, or low, based on the location of SVT and the clot length. Our review summarizes the evaluation and proper management of SVT and highlights the importance of a shared decision within the heart team regarding this condition in order to prevent further complications.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142190372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}