Medical Science Monitor最新文献

BACKGROUND Bone marrow edema (BME) basically involves localized hemorrhage and subtle compression fracture within the bone. We compared outcomes of 70 patients with traumatic BME of the talus, treated with a plaster cast, crutches, or walking boot. MATERIAL AND METHODS MRIs diagnosed 70 patients with talus BME who were randomly assigned into 3 groups of different treatments: Group 1 (n=33) patients were treated with plaster cast's Group 2 (n=21) patients used crutches, and Group 3 (n=16) patients used walking boots. The outcome variables were AOFAS and VAS scores. RESULTS No significant difference was demonstrated in the pre-treatment AOFAS scores between the groups (P>0.05). The AOFAS scores differed significantly after treatment, with Group 2 had the greatest increase in scores (P=0.002) and significantly higher AOFAS scores compared to Group 1 (100 [79-100] vs 94 [75-100], P=0.001). No significant difference was found in pre-treatment VAS scores between the groups (P=0.007). The post-treatment VAS scores were significantly reduced, especially for Group 2. Within-group analysis demonstrated a significant decrease of VAS scores for all groups (P<0.001). CONCLUSIONS Use of non-weight-bearing crutches for 3 weeks had better clinical results than use of a plaster cast when treating talus traumatic bone marrow edema. This was reflected in higher AOFAS and VAS, suggesting use of crutches is associated with better pain management and improved function.

BACKGROUND The objective of this study was to compare and evaluate the oncological and functional outcomes of 2 surgical treatments: extended curettage with plate fixation (EC-PF) and extended curettage with intramedullary nail fixation (EC-INF) for primary giant cell tumor (GCT) of the proximal femur. MATERIAL AND METHODS In a retrospective study, we reviewed 19 patients with Campanacci grade II and International Society of Limb Salvage zone H2 GCT of the proximal femur. All patients underwent either EC-PF (n=11) or EC-INF (n=8) surgery. The Mankin scoring system was used to evaluate the surgical effect, and the Musculoskeletal Tumor Society score was used to evaluate the limb salvage function of the patients. The between-group differences were analyzed at the end of follow-up. RESULTS During the follow-up period, there were no cases of recurrence or metastasis in both groups, and the EC-INF group had a higher rate of nononcological complications than the EC-PF group (62.5% vs 9.1%, respectively). Bone graft resorption and atrophy was the most frequent nononcological complication in the EC-INF group. According to the Mankin scoring system, the degree of hip joint function recovery in the EC-PF group was higher than that in the EC-INF group (P<0.05). Meanwhile, the EC-PF group had shorter hospital stays and higher Musculoskeletal Tumor Society scores (P<0.05). CONCLUSIONS Due to the high incidence of nononcological complications associated with intramedullary nailing as a method of internal fixation following extended curettage of the proximal femur GCT, this approach is generally not recommended.

The authors have identified an error in Table 5 concerning the dissection speed. It is currently listed as follows: S-O group 14.5±9.5 and Control group 25.1±18.9. However, this is incorrect. The correct values should be reversed: S-O group 25.1±18.9 and Control group 14.5±9.5.References:Yoichi Nakatsu, Makoto Furihata, Anna Fujiyama, Arisa Yuzawa, Mako Ushio, Shintaro Yano, Hiroki Okawa, Kumiko Noda, Shinjiro Nishi, Shingo Ogiwara, Tsuneo Kitamura, Naoto Sakamoto, Taro Osada: A Retrospective Study of 290 Patients with Resectable Benign and Malignant Gastric Neoplasms to Compare Postoperative Outcomes of Endoscopic Resection with and without the Internal Traction Method Using a Spring-and-Loop with Clip (S-O Clip). Med Sci Monit, 2024; 30: e945341. DOI: 10.12659/MSM.945341.

BACKGROUND There is little information available comparing eco-friendly products versus traditional plastic-based oral care implements. Therefore, this study was conducted to compare the plaque removal efficacy and bacterial contamination of biodegradable miswak (S. persica) toothbrushes with bamboo toothbrushes and conventional toothbrushes. MATERIAL AND METHODS This single-blinded, parallel randomized, observational comparative study comprised 30 participants aged 18-35 years. Participants were randomized into 3 groups of 10 participants each: miswak (S. persica) brush, bamboo brush, and regular toothbrush). Participants were trained on proper brushing technique. Plaque and bleeding scores were measured by Loe and Sillness and Ainamo and Bay indices, respectively, at baseline (T0), at 4 weeks (T1), and 8 weeks (T2). Microbial contamination on the bristles of all 3 brushes was also evaluated. Multigroup comparison was done using one-way ANOVA, whereas inter-group comparisons were made using post hoc Bonferroni correction. RESULTS All 3 groups had lower plaque scores at the end of 8 weeks. A statistically significant reduction in the bleeding index in the miswak group was seen from baseline to week 8, with a 16.68% reduction in bleeding sites. Similar reductions were seen in the bamboo brush (21.04%) and conventional brush (22.7%) groups. Regular toothbrushes had almost 4 times more microbial contamination than bamboo brushes and more than double the level of miswak toothbrushes. Significant difference with ANOVA test was seen among the 3 tooth brushes, with P value 0.001. CONCLUSIONS Miswak natural toothbrushes and bamboo toothbrushes can be as effective as a conventional plastic toothbrush.

BACKGROUND Functional constipation can occur in children and adults and consists of difficult or infrequent bowel movements, painful defecation, or the sensation of incomplete bowel movement, and it can be idiopathic. This study aimed to compare the findings from high-resolution anorectal manometry (HRAM) and the balloon expulsion test (BET) in 360 patients with functional constipation and 73 healthy volunteers. MATERIAL AND METHODS In total, 360 patients with functional constipation and 73 healthy volunteers underwent HRAM and BET in our hospital from January 2017 to December 2023. We collected the general data of all participants and surveyed the defecation symptoms of patients with functional constipation. RESULTS Our study showed no significant correlation between HRAM results and age in healthy volunteers, while men had a higher residual anal pressure (P=0.022), higher anal squeeze pressure (P=0.020), and lower rectoanal pressure gradient than women (P=0.017). Using logistic regression analysis, it was concluded that sex (OR=2.880, 95% CI [1.654,5.015], P=0.000) and sensation of incomplete evacuation (OR=1.892, 95% CI [1.023,3.500], P=0.042) affected the occurrence of dyssynergic defecation. The specificity of BET in diagnosing dyssynergic defecation was 81.89%, while that of HRAM was 52.78%. CONCLUSIONS This observation provides normal values for anorectal pressures by HRAM. HRAM and BET are effective methods for assessing functional constipation. Being male and having sensation of incomplete evacuation are risk factors for dyssynergic defecation. The specificity of BET for diagnosing dyssynergic defecation was higher than that of HRAM.

This review shows how mammary stem cells (MaSCs) influence breast development, breastfeeding, and breast cancer risk. MaSCs, which can differentiate into various cell types, are vital for breast tissue health, but also disease development in breast tissue. Research shows that breastfeeding affects MaSCs, offering protection against breast cancer through various mechanisms. Hormonal changes such as increased prolactin concentration, oxytocin secretion, lower progesterone levels, and reduced exposure to estrogen during lactation promote apoptosis in potential cancer cells, boost immune surveillance, and modulate inflammation. Key findings reveal that pregnancy at an earlier age and extended breastfeeding reduce MaSC numbers, lowering cancer risk. Additionally, breastfeeding induces various epigenetic changes, such as DNA methylation and histone modification, which provide long-term protection against the development of cancer. Components of breast milk, like alpha-lactalbumin and lactoferrin, contribute by promoting cancer cell apoptosis and inhibiting tumor growth. The dual benefits of breastfeeding are reduced breast cancer risk for mothers and immunological advantages for infants. Multicenter epidemiology research has focused particular attention on longer breastfeeding duration associated with a reduced risk of triple-negative breast cancer. This review offers comprehensive evidence that breastfeeding protects against breast cancer through various biological, hormonal, and molecular mechanisms, showing the importance of promoting breastfeeding as a natural cancer prevention method. This article reviews the role of mammary stem cells in breast development, lactation, and breast cancer.

BACKGROUND This study examined the effects of khat extract on the proinflammatory cytokines, liver, and kidneys of rats. Unlike previous research that focused on broad immune markers and general effects, this study investigated specific proinflammatory cytokines (IL-1ß, IL-2, IL-4, IL-6, and TNF-alpha) and considered gender differences in the immune response. Fresh khat plants and nontoxic doses were used to obtain clear observations relevant to human health. MATERIAL AND METHODS Extracts were prepared from young shoots of khat plants and fresh leaves. 150-gram male and female rats were randomly divided into 8 groups (5 rats per group). Six groups received the extract orally for 8 weeks at doses of 100, 300, and 500 mg/kg/day. Blood samples were collected after 56 days and assayed for cytokines using ELISA, while liver enzymes and kidney markers were assayed using kinetics and colorimetric methods. RESULTS Khat extract increased the levels of most cytokines, with higher doses causing greater increase. This effect was consistent across sexes for some cytokines (IL-1ß, IL-2), but not others (IL-4, IL-6, TNF-alpha), where sex played a role at specific doses. Various doses of the extract influenced glucose levels in both male and female rats. In addition, liver enzyme markers showed some variations. CONCLUSIONS This study, with its intriguing findings, illuminates the complex effects of khat on various systems. Variations in AST and ALT levels in the liver support earlier hepatotoxicity research and suggest possible khat-induced damage. This study revealed consistently increased levels of all cytokines as the dose of khat extract increased.

BACKGROUND Tigecycline is a tetracycline antibiotic used to treat gram-positive and gram-negative bacterial infections, and bleeding is a dose-dependent adverse effect. Vitamin K1 is a fat-soluble vitamin used to treat hemorrhagic conditions. This retrospective study from a single center included 920 patients treated with tigecycline for bacterial infections between January 2017 and December 2022 and aimed to evaluate the incidence of coagulopathy and the use of vitamin K1. MATERIAL AND METHODS A total of 220 patients were included and divided into a high-dose group (100 mg, every 12 h) and normal-dose group (50 mg, every 12 h) according to the treatment dose of tigecycline. Clinical characteristics and changes in coagulation indicators during tigecycline treatment were collected. Seventy-two patients were treated with vitamin K1, and the changes in coagulation indicators before and after treatment were compared. ANOVA and t test were used to analyze the effects of different doses of tigecycline on coagulation function and the intervention of vitamin K1. RESULTS Among 920 patients, the incidence of coagulopathy was 23.91%. In both groups, coagulopathy occurred on days 5 to 7 after administration, and the high-dose group had worse coagulation function than the normal-dose group, including activated partial thrombin time, prothrombin time, and fibrinogen (P<0.05). After treatment with vitamin K1, fibrinogen increased and activated partial thrombin time and prothrombin time were shortened in both groups (P<0.05 or P<0.01). CONCLUSIONS Tigecycline caused coagulopathy with dose and time dependence. Vitamin K1 can improve tigecycline-induced coagulopathy.

BACKGROUND Carpal tunnel syndrome (CTS) is a neuropathy caused by the entrapment of the median nerve, which requires effective management strategies. The median nerve is subjected to pressure within the carpal tunnel, resulting in tingling, numbness, and pain in the median side of the hand. We compared the efficacy of splint use with an exercise program vs exercise alone in patients with mild and moderate CTS. MATERIAL AND METHODS Forty-four patients with CTS were enrolled. The patients were randomly divided into 2 groups: splint+exercise and exercise only. A range of assessment tools were used, including ultrasonography, dynamometer, the Leeds Assessment of Neuropathic Symptoms & Signs Pain Score (LANSS), Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score, and 36-Item Short Form Quality of Life Scale (SF-36) score, to provide comprehensive evaluation. RESULTS The 2 groups had comparable outcomes at the end of treatment. There were no statistically significant differences in Q-DASH (P=0.326, Cohen's d=0.067), SF-36 (P=0.329, Cohen's d=0.218), VAS (P=0.521, Cohen's d=-0.299), or LANSS scores (P=0.627, Cohen's d=0.039) between the groups (P>0.05). The results demonstrate that a targeted exercise regimen, when used in isolation, can elicit outcomes that are comparable to those achieved through the integration of splinting techniques. CONCLUSIONS The study findings align with conflicting existing data on the effectiveness of splint immobilization in conjunction with exercises for CTS. The results support the significance of regular exercises, which can be applied in the home-based setting in CTS management, and offer alternative online management strategies.

On October 8 2024, the Royal Swedish Academy of Sciences announced the 2024 Nobel Prize in Physics was awarded to Hopfield and Hinton for their foundation research on machine learning with artificial neural networks, which resulted in the current applications for artificial intelligence (AI). Digital diagnostic histopathology combines image capture with image analysis and uses digital tools to collect, analyze, and share diagnostic information. An increase in chronic diseases, diagnostic departmental workloads, and diagnostic tests to support targeted therapy in cancer patients have driven the use and development of image analysis systems, and several medical device companies have recently developed whole-slide scanning devices. In April 2017, the US Food and Drug Administration (FDA) permitted marketing authorization for the first whole slide imaging (WSI) system. During 2024, large-scale studies from several cancer centers have shown the potential for diagnostic reporting for real-world data and whole-slide modeling to develop validated diagnostic AI algorithms. This editorial discusses why recent advances and applications in AI and digital image analysis may have an important future role in cancer diagnosis and prognosis.