18 pages, 624 KiB  
Article
Effectiveness of a Primary Care Multidisciplinary Treatment for Patients with Chronic Pain Compared with Treatment as Usual
by Rinske M. Bults 1,2,*, Johanna M. van Dongen 3, Raymond W. J. G. Ostelo 3,4, Jo Nijs 2,5, Doeke Keizer 6 and C. Paul van Wilgen 2,7
1 Department of Rehabilitation Science, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium
2 Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium
3 Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, 1105 Amsterdam, The Netherlands
4 Department of Epidemiology and Data Science (Amsterdam UMC, Location VUmc), Amsterdam Movement Sciences Research Institute, 1046 Amsterdam, The Netherlands
5 Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1050 Brussels, Belgium
6 General Practice “Het Homeer”, 9281 Harkema, The Netherlands
7 Transcare, Transdisciplinary Pain Management Center, 9711 Groningen, The Netherlands
J. Clin. Med. 2023, 12(3), 885; https://doi.org/10.3390/jcm12030885 - 22 Jan 2023
Cited by 4 | Viewed by 2779
Abstract
To manage chronic pain, multidisciplinary interventions have been increasingly deployed, mostly in secondary or tertiary care settings. Evidence on the effectiveness of multidisciplinary intervention within primary care is scarce. This study examined the effectiveness of a primary care multidisciplinary treatment for chronic pain [...] Read more.
To manage chronic pain, multidisciplinary interventions have been increasingly deployed, mostly in secondary or tertiary care settings. Evidence on the effectiveness of multidisciplinary intervention within primary care is scarce. This study examined the effectiveness of a primary care multidisciplinary treatment for chronic pain compared with treatment as usual (TAU). The intervention consisted of pain neuroscience education and treatment by a GP, psychologist, and physiotherapist. Both groups filled out patient-reported outcome measures at baseline, 6 months, and 12 months. The results indicated there were no statistically significant differences for the primary outcomes of pain intensity, number of pain sites, and health-related quality of life (HR-QoL). There was a statistically significant difference in the secondary outcome perceived health change in favor of the intervention group. None of the other differences were statistically significant. A post-hoc analysis showed that there were statistically significant effects on patients’ illness perceptions in favor of the intervention group. Based on the results, the findings do not support effectiveness of a low intensity outpatient multidisciplinary primary care treatment to treat chronic pain compared with TAU. However, as a result of several study limitations, it is considered unwarranted to conclude that multidisciplinary treatment in primary care is not valuable at all. Full article
(This article belongs to the Section Anesthesiology)
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7 pages, 5079 KiB  
Article
Adaptive Optics of Kyrieleis Plaques in Varicella Zoster Virus-Associated Posterior Uveitis: A Multimodal Imaging Analysis
by Paolo Milella 1,†, Chiara Mapelli 2,*,†, Marco Nassisi 1,2, Gaia Leone 2, Giada Ruggi 3, Antonio Scialdone 3, Giuseppe Casalino 2 and Francesco Viola 1,2
1 Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
2 Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy
3 Ospedale Fatebenefratelli e Oftalmico, ASST Fatebenefratelli Sacco, 20121 Milan, Italy
† These authors contributed equally to this work.
J. Clin. Med. 2023, 12(3), 884; https://doi.org/10.3390/jcm12030884 - 22 Jan 2023
Cited by 4 | Viewed by 1630
Abstract
Kyrieleis plaques (KP) represent a peculiar type of vasculitis affecting retinal arterial branches in a beaded segmental pattern that can be found in several posterior inflammatory ocular conditions. The nature and precise location of KP is unclear. Adaptive Optics (AO) provides an in [...] Read more.
Kyrieleis plaques (KP) represent a peculiar type of vasculitis affecting retinal arterial branches in a beaded segmental pattern that can be found in several posterior inflammatory ocular conditions. The nature and precise location of KP is unclear. Adaptive Optics (AO) provides an in vivo visualization of retinal vasculature on a microscopic level, thus permitting a more detailed characterization of KP as compared to traditional imaging techniques. This study aims to report AO imaging of KP in Varicella Zoster virus (VZV)-associated posterior uveitis and to correlate the findings with traditional imaging techniques. Three patients diagnosed with VZV posterior uveitis underwent adaptive optics (AO) imaging and traditional multimodal imaging techniques, including fundus photography, fluorescein angiography, indocyanine green angiography and optical coherence tomography. In all subjects, AO imaging revealed segmental hyporeflectivity confined to the vessel wall, with no evidence of arterial wall disruption or extravascular involvement. In our series, AO findings support the view that KP are localized within the inner arterial wall, possibly at the endothelial level. Full article
(This article belongs to the Special Issue Retinal Disorders: Clinical Updates and Perspectives)
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14 pages, 541 KiB  
Article
Elective Tracheotomy in Patients Receiving Mandibular Reconstructions: Reduced Postoperative Ventilation Time and Lower Incidence of Hospital-Acquired Pneumonia
by Johannes G. Schuderer 1,*, Leonie Reider 1, Michael Wunschel 1, Gerrit Spanier 1, Steffen Spoerl 1, Maximilian Josef Gottsauner 1, Michael Maurer 1, Johannes K. Meier 1, Peter Kummer 2, Torsten E. Reichert 1 and Tobias Ettl 1
1 Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
2 Section Phoniatrics and Pediatric Audiology, Department of Otolaryngology, University Hospital Regensburg, 93053 Regensburg, Germany
J. Clin. Med. 2023, 12(3), 883; https://doi.org/10.3390/jcm12030883 - 22 Jan 2023
Cited by 5 | Viewed by 1800
Abstract
Elective tracheotomy (ET) secures the airway and prevents adverse airway-related events as unplanned secondary tracheotomy (UT), prolonged ventilation (PPV) or nosocomial infection. The primary objective of this study was to identify factors predisposing for airway complications after reconstructive lower ja surgery. We reviewed [...] Read more.
Elective tracheotomy (ET) secures the airway and prevents adverse airway-related events as unplanned secondary tracheotomy (UT), prolonged ventilation (PPV) or nosocomial infection. The primary objective of this study was to identify factors predisposing for airway complications after reconstructive lower ja surgery. We reviewed records of patients undergoing mandibulectomy and microvascular bone reconstruction (N = 123). Epidemiological factors, modus of tracheotomy regarding ET and UT, postoperative ventilation time and occurrence of hospital-acquired pneumonia HAP were recorded. Predictors for PPV and HAP, ET and UT were identified. A total of 82 (66.7%) patients underwent tracheotomy of which 12 (14.6%) were performed as UT. A total of 52 (42.3%) patients presented PPV, while 19 (15.4%) developed HAP. Increased operation time (OR 1.004, p = 0.005) and a difficult airway (OR 2.869, p = 0.02) were predictors, while ET reduced incidence of PPV (OR 0.054, p = 0.006). A difficult airway (OR 4.711, p = 0.03) and postoperative delirium (OR 6.761, p = 0.01) increased UT performance. HAP increased with anesthesia induction time (OR 1.268, p = 0.001) and length in ICU (OR 1.039, p = 0.009) while decreasing in ET group (HR 0.32, p = 0.02). OR for ET increased with mounting CCI (OR 1.462, p = 0.002) and preoperative radiotherapy (OR 2.8, p = 0.018). ET should be strongly considered in patients with increased CCI, preoperative radiotherapy and prolonged operation time. ET shortened postoperative ventilation time and reduced HAP. Full article
(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)
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9 pages, 568 KiB  
Article
Multidisciplinary Management of Opioid Use–Related Infective Endocarditis: Treatment, QTc Values, and Cardiac Arrests due to Ventricular Fibrillation
by Lynda E. Rosenfeld 1,*, Shashank Jain 2, Andrea Amabile 3, Arnar Geirsson 3, Markus Krane 3,* and Melissa B. Weimer 4
1 Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT 06510, USA
2 Section of Cardiovascular Medicine, Case Western Reserve School of Medicine, Cleveland, OH 44106, USA
3 Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT 06510, USA
4 Division of General Medicine, Program in Addiction Medicine, Yale School of Medicine, New Haven, CT 06510, USA
J. Clin. Med. 2023, 12(3), 882; https://doi.org/10.3390/jcm12030882 - 22 Jan 2023
Cited by 3 | Viewed by 1910
Abstract
(1) Background: The opioid epidemic has led to an increase in cardiac surgery for infective endocarditis (IE-CS) related to injection use of opioids (OUD) and other substances and a call for a coordinated approach to initiate substance use disorder treatment, including medication for [...] Read more.
(1) Background: The opioid epidemic has led to an increase in cardiac surgery for infective endocarditis (IE-CS) related to injection use of opioids (OUD) and other substances and a call for a coordinated approach to initiate substance use disorder treatment, including medication for OUD (MOUD), during IE-CS hospitalizations. We sought to determine the effects of the initiation of a multi-disciplinary endocarditis evaluation team (MEET) on MOUD use, electrocardiographic QTc measurements and cardiac arrests due to ventricular fibrillation (VF) in patients with OUD. (2) Methods and Results: A historical group undergoing IE-CS at Yale-New Haven Hospital prior to MEET initiation, Group I (43 episodes of IE-CS, 38 patients) was compared to 24 patients undergoing IE-CS after MEET involvement (Group II). Compared to Group l, Group II patients were more likely to receive MOUD (41.9 vs. 95.8%, p < 0.0001), predominantly methadone (41.9 vs. 79.2%, p = 0.0035) at discharge. Both groups had similar QTcs: approximately 30% of reviewed electrocardiograms had QTcs ≥ 470 ms and 17%, QTcs ≥ 500 ms. Cardiac arrests due to VF were not uncommon: Group I: 9.3% vs. Group II: 8.3%, p = 0.8914. Half occurred in the 1–2 months after surgery and were contributed to by pacemaker malfunction/ management and half were related to opioid use. (3) Conclusions: MEET was associated with increased MOUD (predominantly methadone) use during IE-CS hospitalizations without an increase in QTc prolongation or cardiac arrest due to VF compared to Group I, but events occurred in both groups. These arrests were associated with pacemaker issues or a return to opioid use. Robust follow-up of IE-CS patients is essential, as is further research to clarify the longer-term effects of MEET on outcomes. Full article
(This article belongs to the Section Cardiovascular Medicine)
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11 pages, 4344 KiB  
Review
Locating the Mandibular Lingula Using Cone-Beam Computed Tomography: A Literature Review
by Chun-Ming Chen 1,2,†, Hui-Na Lee 3,†, Ying-Ting Chen 4 and Kun-Jung Hsu 1,5,*
1 School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
2 Division of Oral and Maxillofacial Surgery, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
3 Division of Conservative Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
4 School of Dentistry, CEU Cardenal Herrera University, 46113 Valencia, Spain
5 Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
† These authors contributed equally to this work.
J. Clin. Med. 2023, 12(3), 881; https://doi.org/10.3390/jcm12030881 - 22 Jan 2023
Cited by 6 | Viewed by 2164
Abstract
This study aimed to review the literature on adult mandibular lingula (ML) locations and related distances determined using cone-beam computed tomography (CBCT). A search was conducted for studies on CBCT using the following databases: PubMed, Web of Science, and Embase. The search results [...] Read more.
This study aimed to review the literature on adult mandibular lingula (ML) locations and related distances determined using cone-beam computed tomography (CBCT). A search was conducted for studies on CBCT using the following databases: PubMed, Web of Science, and Embase. The search results were limited to studies published between 1970 and 2021. The inclusion criteria were the investigation of ML location, CBCT, and participants aged ≥18 years. Eligible studies were examined for the distances from the lingual tip to the anterior ramus border, posterior ramus border, sigmoid notch, inferior ramus border, and occlusal plane. Eight studies on CBCT qualified for inclusion in the study. The mean distances from the ML to the anterior ramus border were 15.57 to 20 mm. In most of these, the ML was located above the occlusal plane. No significant differences were observed in the location and related distances for the ML among patients of different sexes, ethnicities, or skeletal patterns. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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9 pages, 798 KiB  
Review
Artificial Neural Networks in Lung Cancer Research: A Narrative Review
by Elena Prisciandaro 1, Giulia Sedda 1, Andrea Cara 1, Cristina Diotti 1, Lorenzo Spaggiari 1,2 and Luca Bertolaccini 1,*
1 Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
2 Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
J. Clin. Med. 2023, 12(3), 880; https://doi.org/10.3390/jcm12030880 - 22 Jan 2023
Cited by 22 | Viewed by 2692
Abstract
Background: Artificial neural networks are statistical methods that mimic complex neural connections, simulating the learning dynamics of the human brain. They play a fundamental role in clinical decision-making, although their success depends on good integration with clinical protocols. When applied to lung cancer [...] Read more.
Background: Artificial neural networks are statistical methods that mimic complex neural connections, simulating the learning dynamics of the human brain. They play a fundamental role in clinical decision-making, although their success depends on good integration with clinical protocols. When applied to lung cancer research, artificial neural networks do not aim to be biologically realistic, but rather to provide efficient models for nonlinear regression or classification. Methods: We conducted a comprehensive search of EMBASE (via Ovid), MEDLINE (via PubMed), Cochrane CENTRAL, and Google Scholar from April 2018 to December 2022, using a combination of keywords and related terms for “artificial neural network”, “lung cancer”, “non-small cell lung cancer”, “diagnosis”, and “treatment”. Results: Artificial neural networks have shown excellent aptitude in learning the relationships between the input/output mapping from a given dataset, without any prior information or assumptions about the statistical distribution of the data. They can simultaneously process numerous variables, managing complexity; hence, they have found broad application in tasks requiring attention. Conclusions: Lung cancer is the most common and lethal form of tumor, with limited diagnostic and treatment methods. The advances in tailored medicine have led to the development of novel tools for diagnosis and treatment. Artificial neural networks can provide valuable support for both basic research and clinical decision-making. Therefore, tight cooperation among surgeons, oncologists, and biostatisticians appears mandatory. Full article
(This article belongs to the Section Oncology)
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8 pages, 787 KiB  
Article
The Role of Dual-Energy CT for the Assessment of Liver Metastasis Response to Treatment: Above the RECIST 1.1 Criteria
by Alfonso Reginelli 1, Mariateresa Del Canto 1, Alfredo Clemente 1,*, Eduardo Gragnano 1, Fabrizio Cioce 1, Fabrizio Urraro 1, Erika Martinelli 2 and Salvatore Cappabianca 1
1 Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy
2 Medical Oncology, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy
J. Clin. Med. 2023, 12(3), 879; https://doi.org/10.3390/jcm12030879 - 22 Jan 2023
Cited by 7 | Viewed by 2118
Abstract
Imaging assessment of liver lesions is fundamental to predict therapeutic response and improve patient survival rates. Dual-Energy Computed Tomography (DECT) is an increasingly used technique in the oncologic field with many emerging applications. The assessment of iodine concentration within a liver lesion reflects [...] Read more.
Imaging assessment of liver lesions is fundamental to predict therapeutic response and improve patient survival rates. Dual-Energy Computed Tomography (DECT) is an increasingly used technique in the oncologic field with many emerging applications. The assessment of iodine concentration within a liver lesion reflects the biological properties of the tumor and provides additional information to radiologists that is normally invisible to the human eye. The possibility to predict tumor aggressiveness and therapeutic response based on quantitative and reproducible parameters obtainable from DECT images could improve clinical decisions and drive oncologists to choose the best therapy according to metastasis biological features. Moreover, in comparison with standard dimensional criteria, DECT provides further data on the cancer microenvironment, especially for patients treated with antiangiogenic-based drugs, in which tumor shrinkage is a late parameter of response. We investigated the predictive role of DECT in the early assessment of liver metastasis response to treatment in comparison with standard dimensional criteria during antiangiogenetic-based therapy. Full article
(This article belongs to the Special Issue Current Challenges and Opportunities of Hepatobiliary Surgery in 2022 and Beyond)
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12 pages, 1664 KiB  
Article
Assessment of Clinical Indicators Registered on Admission to the Hospital Related to Mortality Risk in Cancer Patients with COVID-19
by Alina Szewczyk-Dąbrowska 1,2,*, Mirosław Banasik 3, Krystyna Dąbrowska 2,4, Krzysztof Kujawa 5, Wojciech Bombala 5, Agata Sebastian 6, Agnieszka Matera-Witkiewicz 7, Magdalena Krupińska 7, Urszula Grata-Borkowska 1, Janusz Sokołowski 8, Katarzyna Kiliś-Pstrusińska 9, Barbara Adamik 10, Adrian Doroszko 11, Krzysztof Kaliszewski 12, Michał Pomorski 13, Marcin Protasiewicz 14,15, Ewa A. Jankowska 14,15,† and Katarzyna Madziarska 3,†
1 Department of Family Medicine, Wroclaw Medical University, Syrokomli Street 1, 51-141 Wroclaw, Poland
2 Regional Specialist Hospital in Wroclaw, Research and Development Center, Kamieńskiego 73a, 51-124 Wroclaw, Poland
3 Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
4 Hirszfeld Institute of Immunology and Experimental Therapy, Weigla 12, 53-114 Wroclaw, Poland
5 Statistical Analysis Centre, Wroclaw Medical University, K. Marcinkowski Street 2-6, 50-368 Wroclaw, Poland
6 Clinical Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
7 Screening of Biological Activity Assays and Collection of Biological Material Laboratory, Wroclaw Medical University, Borowska Street 211a, 50-556 Wroclaw, Poland
8 Clinical Department of Emergency Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
9 Clinical Department of Paediatric Nephrology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
10 Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
11 Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
12 Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
13 Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
14 Institute of Heart Diseases, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
15 Institute of Heart Diseases, University Hospital Wroclaw, Borowska Street 213, 50-556 Wroclaw, Poland
† These authors contributed equally to this work.
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J. Clin. Med. 2023, 12(3), 878; https://doi.org/10.3390/jcm12030878 - 22 Jan 2023
Viewed by 1983
Abstract
Background: Oncology patients are a particularly vulnerable group to the severe course of COVID-19 due to, e.g., the suppression of the immune system. The study aimed to find links between parameters registered on admission to the hospital and the risk of later death [...] Read more.
Background: Oncology patients are a particularly vulnerable group to the severe course of COVID-19 due to, e.g., the suppression of the immune system. The study aimed to find links between parameters registered on admission to the hospital and the risk of later death in cancer patients with COVID-19. Methods: The study included patients with a reported history of malignant tumor (n = 151) and a control group with no history of cancer (n = 151) hospitalized due to COVID-19 between March 2020 and August 2021. The variables registered on admission were divided into categories for which we calculated the multivariate Cox proportional hazards models. Results: Multivariate Cox proportional hazards models were successfully obtained for the following categories: Patient data, Comorbidities, Signs recorded on admission, Medications used before hospitalization and Laboratory results recorded on admission. With the models developed for oncology patients, we identified the following variables that registered on patients’ admission were linked to significantly increased risk of death. They are: male sex, presence of metastases in neoplastic disease, impaired consciousness (somnolence or confusion), wheezes/rhonchi, the levels of white blood cells and neutrophils. Conclusion: Early identification of the indicators of a poorer prognosis may serve clinicians in better tailoring surveillance or treatment among cancer patients with COVID-19. Full article
(This article belongs to the Special Issue Clinical Features and Outcomes of COVID-19 in Older Adults)
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10 pages, 1820 KiB  
Article
Botulinum Neurotoxin Type a Injection Combined with Absorbable Punctal Plug Insertion: An Effective Therapy for Blepharospasm Patients with Dry Eye
by Malachie Ndikumukiza †, Yu-Ting Xiao †, You-Fan Ye, Jia-Song Wang, Xi Peng, Hua-Tao Xie * and Ming-Chang Zhang *
1 Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
† These authors contributed equally to this work.
J. Clin. Med. 2023, 12(3), 877; https://doi.org/10.3390/jcm12030877 - 22 Jan 2023
Cited by 1 | Viewed by 2694
Abstract
Blepharospasm patients often have dry eye manifestations. Botulinum neurotoxin type A (BoNT-A) injection has been the main management for blepharospasm and absorbable punctal plug (APP) insertion is shown to be effective in the treatment of dry eye. However, there have been no studies [...] Read more.
Blepharospasm patients often have dry eye manifestations. Botulinum neurotoxin type A (BoNT-A) injection has been the main management for blepharospasm and absorbable punctal plug (APP) insertion is shown to be effective in the treatment of dry eye. However, there have been no studies investigating the combined treatment of BoNT-A and APP in blepharospasm patients with dry eye. In this retrospective study, 17 blepharospasm patients with dry eye treated by BoNT-A injection and 12 receiving BoNT-A plus APP treatment were enrolled. The efficacy was evaluated according to the Jankovic rating scale, Ocular Surface Disease Index (OSDI), fluorescein staining (FL), fluorescein tear break-up time (FBUT) and Schirmer I test (SIT). Both BoNT-A and BoNT-A+APP treatment effectively reduced the functional impairment of blepharospasm. At baseline, all the patients had high OSDI scores (BoNT-A group: 82.48 ± 7.37, BoNT-A+APP group: 78.82 ± 4.60, p = 0.112), but relatively low degrees of FL (BoNT-A group: 3.18 ± 1.01, BoNT-A+APP group: 3.50 ± 1.24, p = 0.466), FBUT (BoNT-A group: 1.71 ± 0.77, BoNT-A+APP group: 2.17 ± 0.58, p = 0.077) and SIT (BoNT-A group: 2.53 ± 0.99, BoNT-A+APP group: 3.17 ± 1.23, p = 0.153). After treatment, OSDI, FL, FBUT and SIT were all obviously restored in the two groups. When comparing the changing rates, only OSDI (BoNT-A group: −52.23% ± 15.57%, BoNT-A+APP group: −61.84% ± 9.10%, p = 0.047) and FL (BoNT-A group: −22.55% ± 25.98%, BoNT-A+APP group: −41.94% ± 14.46%, p = 0.016) showed significant differences between the two groups. This study suggests that OSDI is not applicable in the diagnosis of dry eye among blepharospasm patients. For blepharospasm patients with severe dry eye symptoms, especially those with fluorescein staining in the cornea, the combined treatment of BoNT-A and APP is more effective than using BoNT-A alone. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Ocular Surface Diseases)
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9 pages, 1029 KiB  
Article
Renoprotective Effect of Taxifolin in Paracetamol-Induced Nephrotoxicity: Emerging Evidence from an Animal Model
by Ismail Topal 1,*, Mustafa Yaşar Özdamar 2, Tulin Catakli 3, İsmail Malkoc 4, Ahmet Hacimuftuoglu 5, Charalampos Mamoulakis 6, Aristidis Tsatsakis 7, Konstantinos Tsarouhas 8,*, Christina Tsitsimpikou 9 and Ali Taghizadehghalehjoughi 10
1 Department of Pediatric Diseases, Medical Faculty, Erzincan University, 24000 Erzincan, Turkey
2 Department of Pediatric Surgery, Faculty of Medicine, Erzincan University, 24000 Erzincan, Turkey
3 Department of Pediatrics, Lokman Hekim Hospital, 06930 Ankara, Turkey
4 Department of Anatomy, Faculty of Medicine, Ataturk University, 25240 Erzurum, Turkey
5 Department of Medical Pharmacology, Medical Faculty, Duzce University, 81620 Duzce, Turkey
6 Department of Urology, University General Hospital of Heraklion, Medical School, University of Crete, 715 00 Heraklion, Greece
7 Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
8 Department of Cardiology, University Hospital of Larissa, Terma Mezourlo, 413 34 Larissa, Greece
9 General Chemical State Laboratory of Greece, 11521 Athens, Greece
10 Department of Pharmacology, Faculty of Medicine, Seyh Edebali University, 11230 Biecik, Turkey
J. Clin. Med. 2023, 12(3), 876; https://doi.org/10.3390/jcm12030876 - 22 Jan 2023
Cited by 10 | Viewed by 2755
Abstract
Background: Taxifolin (TXF) is a flavonoid found abundantly in citrus/onion. Encouraging results on its renoprotective effect have been reported in a limited number of drug-induced nephrotoxicity animal models. The present study aimed to evaluate for the first time the potential renoprotective effects of [...] Read more.
Background: Taxifolin (TXF) is a flavonoid found abundantly in citrus/onion. Encouraging results on its renoprotective effect have been reported in a limited number of drug-induced nephrotoxicity animal models. The present study aimed to evaluate for the first time the potential renoprotective effects of TXF in a paracetamol (PAR)-induced nephrotoxicity rat model. Methods: Rats were divided into three equal groups (n = 6 animals per group). Group 1 (PAR group, PARG) received PAR diluted in normal saline by gavage (1000 mg/kg). Group 2 (TXF group, TXFG) received TXF diluted in normal saline by gavage (50 mg/kg) one hour after PAR administration. Group 3 (control group, CG) received normal saline. Twenty-four hours after PAR administration, all animals were sacrificed using high-dose anesthesia. Blood samples were collected and kidneys were removed. Results: The serum blood urea nitrogen, creatinine levels and serum malondialdehyde levels were significantly increased in the PARG. The serum glutathione peroxidase, glutathione reductase and total glutathione levels were significantly higher in the TXFG. At the same time, the kidneys of the PARG animals demonstrated tubular epithelium swelling, distension and severe vacuolar degeneration. The kidneys of the TXFG animals showed mildly dilated/congested blood vessels. Conclusions: The TXF renoprotective effects are promising in preventing PAR-induced nephrotoxicity, mainly through antioxidant activity, and warrant further testing in future studies. Full article
(This article belongs to the Section Nephrology & Urology)
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13 pages, 4545 KiB  
Article
Treatment of Reticular Oral Lichen Planus with Photodynamic Therapy: A Case Series
by Magdalena Ewa Sulewska 1,*, Jagoda Tomaszuk 1, Eugeniusz Sajewicz 2, Jan Pietruski 3,4, Anna Starzyńska 4 and Małgorzata Pietruska 1,3
1 Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
2 Department of Biocybernetics and Biomedical Engineering, Białystok University of Technology, ul. Wiejska 45c, 15-351 Białystok, Poland
3 Dental Practice, ul. Waszyngtona 1/34, 15-269 Białystok, Poland
4 Department of Oral Surgery, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
J. Clin. Med. 2023, 12(3), 875; https://doi.org/10.3390/jcm12030875 - 22 Jan 2023
Cited by 3 | Viewed by 9045
Abstract
Objectives: The aim of the study was to clinically evaluate the efficacy of photodynamic therapy in treatment of the reticular form of oral lichen planus (OLP). Materials and Methods: Twenty patients aged 40–76, with 40 confirmed OLP lesions in total, underwent photodynamic therapy [...] Read more.
Objectives: The aim of the study was to clinically evaluate the efficacy of photodynamic therapy in treatment of the reticular form of oral lichen planus (OLP). Materials and Methods: Twenty patients aged 40–76, with 40 confirmed OLP lesions in total, underwent photodynamic therapy (PDT) following the authors’ own protocol, which used 5% 5-aminolevulinic acid as a photosensitizer applied two hours prior to illumination with a diode lamp emitting light at 630 nm and 300 mW. The therapy comprised of 10 weekly illumination sessions and was clinically evaluated between its completion and the end of a 12-month follow-up. Results: While the baseline mean size of all 40 lesions was 2.74 ± 3.03 cm2, it was 2.97 ± 3.4 cm2 for the 30 lesions on the buccal mucosa and 2.02 ± 1.32 cm2 for the remaining 10 on the gingiva and tongue. On completion of the therapy, 37 sites improved, including 14 showing complete remission. From that point, the mean size reduction of 56.2% (1.2 ± 1.4 cm2) rose to 67.88% (0.88 ± 1.3 cm2) 12 months later. Conclusions: The results suggest that ALA-mediated photodynamic therapy was effective for the reticular form of OLP and may become an optional or complementary treatment. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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11 pages, 1314 KiB  
Article
Development and Validation of a Nomogram for Predicting Blood Pressure Change Failure in Patients with Pheochromocytoma and Concomitant Hypertension after Adrenalectomy
by Yuntian Ge 1, Yunhong Zhan 1, Chunyu Pan 1, Jia Li 1, Zhenhua Li 1, Song Bai 1,* and Lina Liu 2,*
1 Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, China
2 Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
J. Clin. Med. 2023, 12(3), 874; https://doi.org/10.3390/jcm12030874 - 22 Jan 2023
Cited by 1 | Viewed by 1879
Abstract
(1) Background: Pheochromocytoma is a common cause of secondary hypertension, which is considered curable; nevertheless, some patients still suffer from hypertension after adrenalectomy. Therefore, we developed and validated a nomogram for predicting blood pressure change failure in patients with pheochromocytoma and concomitant hypertension [...] Read more.
(1) Background: Pheochromocytoma is a common cause of secondary hypertension, which is considered curable; nevertheless, some patients still suffer from hypertension after adrenalectomy. Therefore, we developed and validated a nomogram for predicting blood pressure change failure in patients with pheochromocytoma and concomitant hypertension after adrenalectomy. (2) Methods: The development cohort of this study consisted of 259 patients with pheochromocytoma who underwent adrenalectomy at our center between 1 January 2007 and 31 December 2018. Each patient’s clinicopathologic data were recorded. LASSO (the least absolute shrinkage and selection operator) regression was used to reduce and select the features of the data. Furthermore, we used multivariate logistic regression analysis to develop the prediction model. An independent cohort of 110 consecutive patients from 1 January 2019 to 31 December 2021 was used for validation. The performance of this nomogram was assessed with regard to discrimination, calibration, and clinical usefulness. (3) Results: 40.9% and 46.4% of patients experienced blood pressure change failure in the development and validation cohorts of this study, respectively. We found that older patients with a longer duration of hypertension and concomitant cardiovascular events were more likely to suffer from blood pressure change failure. In the validation cohort, the model manifested great discrimination with an AUROC (area under the receiver operating characteristic) of 0.996 (p < 0.001) and good calibration (unreliability test, p = 0.359). Decision curve analysis demonstrated that the model was clinically useful. (4) Conclusions: This study presented a reliable nomogram that facilitated individualized preoperative prediction of blood pressure change failure after adrenalectomy in patients with pheochromocytoma, which may help decision-making in perioperative treatment and follow-up strategies. Full article
(This article belongs to the Topic Diagnosis, Management, and Prognostic Assessment of Chronic Disease)
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19 pages, 1854 KiB  
Article
Stressor-Specific Sex Differences in Amygdala–Frontal Cortex Networks
by Zoé Bürger 1,*, Veronika I. Müller 2,3, Felix Hoffstaedter 2,3, Ute Habel 4,5, Ruben C. Gur 6, Christian Windischberger 7,8, Ewald Moser 7,8, Birgit Derntl 1,9 and Lydia Kogler 1,*
1 Department of Psychiatry and Psychotherapy, Tübingen Centre for Mental Health (TüCMH), Medical Faculty, University of Tübingen, 72076 Tübingen, Germany
2 Institute of Neuroscience and Medicine, INM-7, Research Centre Jülich, 52425 Jülich, Germany
3 Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University, 40225 Düsseldorf, Germany
4 Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074 Aachen, Germany
5 JARA BRAIN Institute I, Translational Brain Medicine, 52428 Jülich, Germany
6 Neuropsychiatry Division, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
7 High-Field MR Center, Medical University of Vienna, 1090 Vienna, Austria
8 Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria
9 LEAD Graduate School and Research Network, University of Tübingen, 72074 Tübingen, Germany
J. Clin. Med. 2023, 12(3), 865; https://doi.org/10.3390/jcm12030865 - 22 Jan 2023
Cited by 14 | Viewed by 2836
Abstract
Females and males differ in stress reactivity, coping, and the prevalence rates of stress-related disorders. According to a neurocognitive framework of stress coping, the functional connectivity between the amygdala and frontal regions (including the dorsolateral prefrontal cortex (dlPFC), ventral anterior cingulate cortex (vACC), [...] Read more.
Females and males differ in stress reactivity, coping, and the prevalence rates of stress-related disorders. According to a neurocognitive framework of stress coping, the functional connectivity between the amygdala and frontal regions (including the dorsolateral prefrontal cortex (dlPFC), ventral anterior cingulate cortex (vACC), and medial prefrontal cortex (mPFC)) plays a key role in how people deal with stress. In the current study, we investigated the effects of sex and stressor type in a within-subject counterbalanced design on the resting-state functional connectivity (rsFC) of the amygdala and these frontal regions in 77 healthy participants (40 females). Both stressor types led to changes in subjective ratings, with decreasing positive affect and increasing negative affect and anger. Females showed higher amygdala–vACC and amygdala–mPFC rsFC for social exclusion than for achievement stress, and compared to males. Whereas a higher amygdala–vACC rsFC indicates the activation of emotion processing and coping, a higher amygdala–mPFC rsFC indicates feelings of reward and social gain, highlighting the positive effects of social affiliation. Thus, for females, feeling socially affiliated might be more fundamental than for males. Our data indicate interactions of sex and stressor in amygdala–frontal coupling, which translationally contributes to a better understanding of the sex differences in prevalence rates and stress coping. Full article
(This article belongs to the Section Mental Health)
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9 pages, 248 KiB  
Article
Factors Associated with Selection of Denture Adhesive Type: A Cross-Sectional Survey
by Kohei Yamaguchi, Yohei Hama *, Hitomi Soeda, Keita Hatano, Mitsuzumi Okada, Ryota Futatsuya and Shunsuke Minakuchi
Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
J. Clin. Med. 2023, 12(3), 873; https://doi.org/10.3390/jcm12030873 - 21 Jan 2023
Cited by 4 | Viewed by 2116
Abstract
The type of denture adhesive, cream or home-liner, chosen by regular denture adhesive users and oral conditions contributing to this selection require elucidation. The factors associated with denture adhesive selection were investigated through a face-to-face survey on oral and denture conditions. Age, sex, [...] Read more.
The type of denture adhesive, cream or home-liner, chosen by regular denture adhesive users and oral conditions contributing to this selection require elucidation. The factors associated with denture adhesive selection were investigated through a face-to-face survey on oral and denture conditions. Age, sex, oral moisture, masticatory performance, retention and stability of the removable denture, ridge shape, mucosal thickness, and duration of denture use were examined in cream and home-liner-type denture adhesive users who did not regularly visit a dentist. Univariate analysis and multivariate analyses were performed. There were 38 and 40 cream-type and home-liner-type adhesive users, respectively. The type of denture adhesive was significantly associated with the oral moisture value, retention, ridge shape, mucosal thickness, and duration of denture use in univariate analyses. The residual ridge conditions with large factor loadings for ridge shape and mucosal thickness and duration of denture use were significantly related to the denture adhesive selection in multivariate logistic analysis. The residual ridge conditions and duration of denture use were significant factors in the selection of cream- and home-liner-type denture adhesives. These results can provide appropriate guidance based on the adhesives patients without dental supervision are more likely to choose. Full article
(This article belongs to the Special Issue New Perspectives in Oral Health for Patients with Special Needs and Compromised Older Adults)
14 pages, 605 KiB  
Article
Patterns of Healthcare Resource Utilisation of Critical Care Survivors between 2006 and 2017 in Wales: A Population-Based Study
by Mohammad Alsallakh 1,*,†, Laura Tan 2,†, Richard Pugh 3, Ashley Akbari 1, Rowena Bailey 1, Rowena Griffiths 1, Ronan A. Lyons 1 and Tamas Szakmany 2,4,*
1 Population Data Science, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea SA2 8PP, UK
2 Department of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Cardiff University, Cardiff CF14 4XN, UK
3 Department of Anaesthetics, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Rhyl LL18 5UJ, UK
4 Critical Care Directorate, Grange University Hospital, Aneurin Bevan University Health Board, Cwmbran NP44 8YN, UK
† These authors contributed equally to this work.
J. Clin. Med. 2023, 12(3), 872; https://doi.org/10.3390/jcm12030872 - 21 Jan 2023
Cited by 4 | Viewed by 2296
Abstract
In this retrospective cohort study, we used the Secure Anonymised Information Linkage (SAIL) Databank to characterise and identify predictors of the one-year post-discharge healthcare resource utilisation (HRU) of adults who were admitted to critical care units in Wales between 1 April 2006 and [...] Read more.
In this retrospective cohort study, we used the Secure Anonymised Information Linkage (SAIL) Databank to characterise and identify predictors of the one-year post-discharge healthcare resource utilisation (HRU) of adults who were admitted to critical care units in Wales between 1 April 2006 and 31 December 2017. We modelled one-year post-critical-care HRU using negative binomial models and used linear models for the difference from one-year pre-critical-care HRU. We estimated the association between critical illness and post-hospitalisation HRU using multilevel negative binomial models among people hospitalised in 2015. We studied 55,151 patients. Post-critical-care HRU was 11–87% greater than pre-critical-care levels, whereas emergency department (ED) attendances decreased by 30%. Age ≥50 years was generally associated with greater post-critical-care HRU; those over 80 had three times longer hospital readmissions than those younger than 50 (incidence rate ratio (IRR): 2.96, 95% CI: 2.84, 3.09). However, ED attendances were higher in those younger than 50. High comorbidity was associated with 22–62% greater post-critical-care HRU than no or low comorbidity. The most socioeconomically deprived quintile was associated with 24% more ED attendances (IRR: 1.24 [1.16, 1.32]) and 13% longer hospital stays (IRR: 1.13 [1.09, 1.17]) than the least deprived quintile. Critical care survivors had greater 1-year post-discharge HRU than non-critical inpatients, including 68% longer hospital stays (IRR: 1.68 [1.63, 1.74]). Critical care survivors, particularly those with older ages, high comorbidity, and socioeconomic deprivation, used significantly more primary and secondary care resources after discharge compared with their baseline and non-critical inpatients. Interventions are needed to ensure that key subgroups are identified and adequately supported. Full article
(This article belongs to the Section Intensive Care)
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