Differences In Scale Scores Research Articles

Efficacy of Fecal Microbiota Transplant on Behavioral and Gastrointestinal Symptoms in Pediatric Autism: A Systematic Review.

Background and Aims: There is a high prevalence of gastrointestinal-related (GI) symptoms among children with autism spectrum disorder (ASD), which is associated with the severity of behavioral symptoms. Fecal microbiota transplantation (FMT) is a proposed therapeutic strategy that aims to address the dysregulation of the gut microbiome among children with ASD. Our study performed the first systematic review aimed to evaluate the benefits of FMT on the behavioral and gastrointestinal symptoms of pediatric patients with autism. Methods: A literature search was performed using variations of the keywords "pediatrics" and "fecal microbiota transplantation" in PubMed, EMBASE, CINAHL, Cochrane, and Web of Science from inception to 30 June 2022. Four studies that met the eligibility criteria were included in the systematic review. The efficacy of FMT on behavioral symptoms was measured by the difference in Aberrant Behavior Checklist (ABC) and Child Autism Rating Scale (CARS) scores before and after FMT. Results: We found a statistically significant improvement (p < 0.05) in ABC and CARS scores following FMT, with a statistically significant decrease in scores observed across all studies. In addition, substantial improvements in gastrointestinal symptoms were observed across all studies. Conclusion: Our findings suggest that FMT may offer a promising intervention for treating both behavioral and gastrointestinal symptoms in pediatric patients with autism.

The prediction and treatment of postpartum myofascial pelvic pain.

The clinical manifestations of myofascial pelvic pain (MFPP) are mainly acute or chronic muscle pain at one or more trigger points in the pelvic cavity or pelvic floor. This study aims to explore the predictive value of pelvic floor myoelectric parameters with respect to MFPP and the effect of its clinical treatment. Two hundred and one women followed up in the Wenzhou People's Hospital 6-12 weeks postpartum between July 2020 and July 2021. They were divided into an MFPP group (n= 90) and a non-MFPP group (n= 102), but 9 MFPP patients without a pelvic floor electromyography evaluation were not included. The general demographic data and pelvic floor electromyography evaluation parameters of the two groups were compared; the related factors of postpartum women suffering from MFPP were analyzed, and a nomogram model of the postpartum risk of suffering from MFPP was established. The 99 patients with postpartum MFPP were divided into a treatment group (n= 10) and a control group (n= 89). The difference in visual analog scale scores between the two groups initially and after three months of treatment was compared to evaluate the effective remission rate of postpartum MFPP after treatment. A significant difference was observed in the relaxation time at the rapid contraction stage (z= 4.369, p< 0.05) and the tension contraction stage (z= 135.645, p< 0.01) between the MFPP group and the non-MFPP group. The nomogram model for predicting postpartum MFPP was established with nine variables as potential predictors. The calibration chart and C index of 0.68 (95% CI: 0.65-0.71) proved that the model had a certain degree of discrimination. The clinical decision-making curve showed that the model could increase the net benefit rate of patients. The pain relief rate in the treatment group was significantly higher than that in the control group (p< 0.01). There is a significant correlation between postpartum MFPP and relaxation time at rapid contraction stage and tension contraction stage. The risk prediction nomogram model of postpartum MFPP established with nine potential predictors has a certain prediction capability, and clinical treatment can effectively relieve MFPP in postpartum patients.

Investigating the Impact of Perceived Discrimination on the Integration and Life Satisfaction of New Wave Turkish Immigrants Living in Germany

IntroductionApproximately 21.2 million people with im- migrant backgrounds live in Germany, which constituted 26% of its total population in 2020. Approximately 67% of immigrants are from European countries, including Turkey. Turks account for 13.2% of immigrants and constitute one of the largest immigrant groups (Statistisches Bundesamt, 2020). The integration processes and life satisfaction of new wave Turkish immigrants are differ from the first and second generation Turkish immigrants.ObjectivesThe aim of this study was to investigate the impact of perceived discrimination on their integration process and life satisfaction of new wave Turkish immigrants living in Germany.MethodsThe Community Integration Measure (CIM), Satisfaction with Life Scale (SWLS), The Perceived Discrimination Scale (PDS) were used. Pearson correlation and Regression tests were used in our analyses to observe the differences in scale scores according to the variables. The relationship between the scale scores was analysed with the Pearson correlation test. The effect between the scale scores was analysed with the regression test.ResultsThe findings demonstrated that there was a significant negative relationship between perceived discrimination and social integration (p=0,05) as well as life satisfaction (p=0,05). In addition, there was a significant and positive relationship between social integration and life satisfaction of new wave Turkish immigrant participants.Conclusions The integration process and life satisfaction of new wave Turkish immigrants decreased when they perceive discrimination in their daily lives. However, the level of life satisfaction increased when they integrate into German society without any perceived discrimination.Disclosure of InterestNone Declared

Cerebellar tonsil reduction for surgical treatment of Chiari malformation type I in children.

The goal of this study was to review the efficacy and safety of different surgical techniques used for treatment of Chiari malformation type I (CM-I) in children. The authors retrospectively reviewed 437 consecutive children surgically treated for CM-I. Procedures were classified into four groups: bone decompression (posterior fossa decompression [PFD]) and duraplasty (PFD with duraplasty [PFDD]), PFDD with arachnoid dissection (PFDD+AD), PFDD with tonsil coagulation of at least one cerebellar tonsil (PFDD+TC), and PFDD with subpial tonsil resection of at least one tonsil (PFDD+TR). Efficacy was measured as a greater than 50% reduction in the syrinx by length or anteroposterior width, patient-reported improvement in symptoms, and rate of reoperation. Safety was measured as the rate of postoperative complications. The mean patient age was 8.4 years (range 3 months to 18 years). In total, 221 (50.6%) patients had syringomyelia. The mean follow-up was 31.1 months (range 3-199 months), and there was no statistically significant difference between groups (p = 0.474). Preoperatively, univariate analysis showed that non-Chiari headache, hydrocephalus, tonsil length, and distance from the opisthion to brainstem were associated with the surgical technique used. Multivariate analysis demonstrated that hydrocephalus was independently associated with PFD+AD (p = 0.028), tonsil length was independently associated with PFD+TC (p = 0.001) and PFD+TR (p = 0.044), and non-Chiari headache was inversely associated with PFD+TR (p = 0.001). In the treatment groups postoperatively, symptoms improved in 57/69 (82.6%) PFDD patients, 20/21 (95.2%) PFDD+AD patients, 79/90 (87.8%) PFDD+TC patients, and 231/257 (89.9%) PFDD+TR patients, and differences between groups were not statistically significant. Similarly, there was no statistically significant difference in postoperative Chicago Chiari Outcome Scale scores between groups (p = 0.174). Syringomyelia improved in 79.8% of PFDD+TC/TR patients versus only 58.7% of PFDD+AD patients (p = 0.003). PFDD+TC/TR remained independently associated with improved syrinx outcomes (p = 0.005) after controlling for which surgeon performed the operation. For those patients whose syrinx did not resolve, no statistically significant differences between surgery groups were observed in the length of follow-up or time to reoperation. Overall, there was no statistically significant difference between groups in postoperative complication rates, including aseptic meningitis and CSF- and wound-related issues, or reoperation rates. In this single-center retrospective series, cerebellar tonsil reduction, by either coagulation or subpial resection, resulted in superior reduction of syringomyelia in pediatric CM-I patients, without increased complications.

Bilateral high-frequency noninvasive peroneal nerve stimulation evokes tonic leg muscle activation for sleep-compatible reduction of restless legs syndrome symptoms.

Restless legs syndrome (RLS) is a prevalent sleep disorder with limited treatment options. Bilateral high-frequency noninvasive peroneal nerve stimulation (NPNS) reduces RLS symptoms. Here, we sought to characterize the mechanism of action for NPNS and identify predictors of treatment response. We hypothesized that, similar to voluntary leg movements, NPNS reduces RLS symptoms by activating leg muscles. For 20 adults with moderate-severe RLS, we tested this hypothesis by recording surface electromyography (EMG) from the tibialis anterior leg muscle while administering NPNS at varying amplitudes to determine the minimum NPNS amplitude that evoked EMG activity (motor threshold) and maximal NPNS amplitude that was not distracting (therapeutic intensity level). Afterwards, participants self-administered NPNS (at the therapeutic intensity level) and sham control for 14 days, each in randomized order. Efficacy was defined as International RLS Study Group Rating Scale (IRLS) score difference for NPNS compared with sham. NPNS consistently activated leg muscles; NPNS evoked EMG activity at the therapeutic intensity level for 19 of 20 participants (mean TIL: 26.6 mA, mean MT: 18.3 mA). Evoked EMG activity was tonic (not phasic) and sustained over time. Evoked EMG activity predicted efficacy; participants with lower motor thresholds had greater IRLS improvement (r = .45, P = .046). NPNS treatment did not interfere with self-reported sleep onset (NPNS: 16% of nights; sham: 11%; P = .629) and frequently improved self-reported sleep onset (NPNS: 52% of nights; sham: 15%; P = .002). These results demonstrate that NPNS reduces RLS symptoms by activating afferent pathways, thereby generating tonic and sustained leg muscle activity without interfering with sleep. Registry: ClinicalTrials.gov; Name: Noninvasive Peripheral Nerve Stimulation for Restless Legs Syndrome; URL: https://clinicaltrials.gov/ct2/show/NCT04700683; Identifier: NCT04700683. Charlesworth JD, Adlou B, Singh H, Buchfuhrer MJ. Bilateral high-frequency noninvasive peroneal nerve stimulation evokes tonic leg muscle activation for sleep-compatible reduction of restless legs syndrome symptoms. J Clin Sleep Med. 2023;19(7):1199-1209.

Effectiveness of a cervical cancer prevention program to improve health literacy among Japanese undergraduate females in their 20s: A quasi-experimental study

To improve health literacy (HL) regarding cervical cancer prevention, a health program for females in their 20s was previously developed. The present study aimed to examine the effectiveness of that program. We conducted a quasi-experimental study (with control groups) on female undergraduate students in a private university in Japan. In total, 15 and 60 students were categorized into the experimental and control groups, respectively. Intergroup pair-matching using the identified variables yielded a final assessment population of 28 students (n = 14 in each group). The data analysis consisted of group comparisons of the participants between baseline and final assessment using the Wilcoxon signed-rank sum test and McNemar's test. Experimental group comparisons revealed a significant difference in median HL scale scores (baseline, 57.0; final assessment, 66.0; p =.002), median women's health knowledge test scores (baseline, 14.5; final assessment, 16.0; p =.029), and the percentage of participants who felt confident explaining their own body to a medical practitioner (baseline, Y = 14.3, N = 0.0; final assessment, Y = 100.0, N = 0.0; p<.001); however, no significant difference was found for cervical cancer screening behavior. No changes were seen in any of the variables between baseline and final assessment in the control group. These results indicated that our program was effective for improving HL, confidence in explaining one's own body to a medical practitioner, and women's health knowledge test scores, but not for changing cervical cancer screening behaviors. Further research is needed to determine how to provide more appropriate health programs for females in their 20s.

A randomized trial assessing the impact of educational podcasts on personal control and satisfaction during childbirth

Childbirth education can help pregnant individuals feel in control, relieve anxiety and fear, and decrease pain perception. However, many barriers exist that impede patients from obtaining adequate childbirth education, especially in the era of the COVID-19 pandemic. Advances in technology, such as podcasts, can allow for asynchronous patient education. This study aimed to assess the effect of a labor education podcast on personal perception of control and patient satisfaction during childbirth. This was a randomized controlled trial that included nulliparous, low-risk women with singleton gestations who reached 36 weeks' gestation at 2 academic hospitals in Philadelphia, Pennsylvania. Participants were randomized at 28 weeks and 0 days of gestation to usual education (control) or podcast education (intervention), which included links to 7 labor-related podcast episodes on patient-suggested topics that were available on widely-used podcatchers. Primary outcomes were assessed with a 3-question birth satisfaction survey and the Labour Agentry Scale to evaluate personal perception of control during childbirth. Secondary outcomes included the Edinburgh Postnatal Depression Scale score. Analyses were performed as intention-to-treat. Parametric and nonparametric data were compared using the Student t-test or Wilcoxon rank-sum test, as appropriate. A total of 201 women were randomized, and 153 were included in the final analysis (78 in podcast and 75 in control group). There were no significant differences in maternal demographics. Patients in the podcast group had higher median birth satisfaction scores compared with the control group (20 [18-21] vs 18 [16-21]; P=.002), without a significant difference in median Labour Agentry Scale scores (57 [50-63] vs 54 [47-62]; P=.12). When restricting analysis to patients who underwent induction, Labour Agentry Scale scores were significantly higher in the podcast group (58 [53-64] vs 54 [47-61]; P=.045), representing an increased perception of control. However, birth satisfaction score was not different between the groups (P=.06). The most downloaded podcasts were on induction and labor anesthesia. More than 95% of participants would recommend the podcasts to family and friends. An educational podcast on labor topics was well-received, increased patient satisfaction overall, and increased labor agentry among those who were induced. Podcasts are a promising educational modality to improve patient experience during childbirth, and warrant further exploration.

Brain Tissue Oxygen Levels as a Perspective Therapeutic Target in Traumatic Brain Injury. Retrospective Cohort Study.

Management of traumatic brain injury (TBI) requires a multidisciplinary approach and represents a significant challenge for both neurosurgeons and intensivists. The role of brain tissue oxygenation (PbtO2) monitoring and its impact on posttraumatic outcomes remains a controversial topic. Our study aimed to evaluate the impact of PbtO2 monitoring on mortality, 30 days and 6 months neurological outcomes in patients with severe TBI compared with those resulting from standard intracranial pressure (ICP) monitoring. In this retrospective cohort study, we analysed the outcomes of 77 patients with severe TBI who met the inclusion criteria. These patients were divided into two groups, including 37 patients who were managed with ICP and PbtO2 monitoring protocols and 40 patients who were managed using ICP protocols alone. There were no significant differences in demographic data between the two groups. We found no statistically significant differences in mortality or Glasgow Outcome Scale (GOS) scores one month after TBI. However, our results revealed that GOS scores at 6 months had improved significantly among patients managed with PbtO2; this finding was particularly notable for Glasgow Outcome Scale (GOS) scores of 4-5. Close monitoring and management of reductions in PbtO2, particularly by increasing the fraction of inspired oxygen, was associated with higher partial pressures of oxygen in this group. Monitoring of PbtO2 may facilitate the appropriate evaluation and treatment of low PbtO2 and represents a promising tool for the management of patients with severe TBI. Additional studies will be needed to confirm these findings.

Efficacy and safety of antibiotic therapy for post-Lyme disease? A systematic review and network meta-analysis

BackgroundAt present, the pathogenesis of post-treatment Lyme disease (PTLDS) is not clear, so the treatment scheme of PTLDS, especially antibiotic treatment, is still controversial. This study aims to evaluate the efficacy of antibiotics in the treatment of PTLDS using network meta-analysis (NMA).MethodsFollowing PRISMA guidelines, a systematic literature search was conducted on randomized controlled trials in PubMed, EMBASE, Web of Science and Cochrane Library (the literature was published from database inception through December 16, 2022). Using random effect model and fixed effect model. STATA17.0 software was used to evaluate the quality and heterogeneity of the included research literature.ResultsThe system included 4 randomized controlled trials (485 subjects). The network meta-analysis showed that ceftriaxone had better results than placebo [Mean = 0.87, 95% CI (0.02, 1.71)] and doxycycline [Mean = 1.01, 95% CI (0.03, 1.98)] in FSS scale scores. There was no statistical difference in FSS scale scores of other drugs after treatment. In terms of FSS score results, Ceftriaxone was the best intervention according to the SUCRA value of each treatment (97.7). The analysis of outcome indicators such as Beck Depression Inventory (BDI), Mental-health Scale and Physical-functioning scale showed that there was no statistically significant difference between the antibiotic group and placebo group.ConclusionCeftriaxone treatment may be the best choice for antibiotic treatment of PTLD, which provides useful guidance for antibiotic treatment of PTLD in the future.

Extracorporeal Shock Wave in Combination with Arthroscopy for Calcified Supraspinatus Tendonitis

Objective: Exploring the therapeutic effect of extracorporeal shockwave combined with Arthroscopic Surgery on calcified supraspinatus tendinitis. Materials and Methods: Sixty patients with calcific supraspinatus tendinitis who received treatment in our hospital from June 2022 to June 2023 were randomly divided into two groups. All patients had disease lasting more than 6 months. The control group received extracorporeal shockwave therapy (ESWT), while the observation group, after undergoing arthroscopic debridement of calcific deposits in the joint, began receiving the same ESWT as the control group after 2 weeks. The differences in Visual Analog Scale (VAS) score, University of California at Los Angeles (UCLA) score, and Constant–Murley score between the two groups before and after treatment were recorded and compared. Results: Before treatment, there was no significant difference in VAS score, UCLA score, and Constant–Murley Scale (CMS) score between the two groups of patients (P &gt; 0.05); compared with before treatment, both groups of patients showed a significant decrease in VAS scores after 1 and 2 months of treatment (P &lt; 0.05). After 1 and 2 months of treatment, the VAS scores of the observation group were significantly lower than the ones of the control group (P &lt; 0.05). Compared with before treatment, the UCLA score and CMS score of both groups of patients significantly increased after 1 and 2 months of treatment (P &lt; 0.05). After 1 and 2 months of treatment, the UCLA score and CMS score of the observation group were significantly higher than those of the control group (P &lt; 0.05). Conclusion: The combination of extracorporeal shockwave and arthroscopy has a significant therapeutic effect on calcified supraspinatus tendinitis, helping to improve shoulder joint function and effectively alleviate pain in patients. Keywords: Extracorporeal shockwave, Arthroscopy, Calcifying supraspinatus tendinitis, Shoulder joint function, Pain.

Anamu, moringa, spirulina i hlorela - doprinos kvalitetu života onkoloških pacijenata - rezultati postmarketinške prospektivne studije u Srbiji, 2021 - 2022. godine

Introduction: The quality of life is one of the priority goals in the treatment of oncology patients. In addition to conventional therapies, symptomatic and supportive treatments are valuable for the final treatment outcome. Many such patients resort to alternative methods, such as herbal therapy. Study aim: This prospective study aimed to assess the effect of the plants: anamu, moringa, spirulina, and chlorella, which are routinely used in Cuba, on the quality of life of oncology patients. Materials and methods: Forty-six patients with various stage four malignant tumors were examined. Of the 46 patients, 26 were on chemotherapy, while 18 were on symptomatic and supportive therapy. The patients used extracts of the aforementioned plants orally, for three months. With prior consent and authorization, the standard EORTC QLQ-C30 questionnaire, written in the patients' native language, was used to assess quality of life, before and after three months of use. Results: According to patient ratings, overall assessment of patient general health status and quality of life showed significant improvement after three months of use of the extracts, as compared to the beginning of application. According to the questionnaire, all five parameters improved on the functional scale, (p &lt; 0.001), and the scores on the symptoms scale also improved (fatigue, p = 0.015; pain, p = 0 ,044). Women achieved better physical functionality and significant loss of fatigue and pain, while cognitive functionality improved in men. Emotional functionality improved in the subgroup of patients who were receiving chemotherapy, while in those who had previously received chemotherapy, there were significant differences in the symptoms scale score regarding loss of appetite and constipation - symptoms that resolved after three months of product use, thus equating the subgroups in terms of the reduction of these symptoms. In other functional parameters, statistically significant differences were also obtained for all patients. Conclusion: The improvement in the quality of life and functionality of patients, as well as the reduction in symptoms, whether the patients received chemotherapy or not, was statistically significant.

Efficacy of Low-Dose Versus Traditional Buprenorphine Induction in the Hospital: A Quantitative and Qualitative Study.

Emerging evidence suggests low-dose buprenorphine (LDB) induction can expand opportunities for buprenorphine induction in patients who are taking taking methadone, short-acting opioid agonists, or who have anxiety about opioid withdrawal. How is a rapid LDB protocol using transdermal buprenorphine tolerated in the hospital? A prospective study of 20 patient encounters (n = 20 patients) with traditional buprenorphine induction before implementation of study protocol (control group) and 37 patient encounters (n = 34 patients) with LDB induction protocol (pilot group). Summary statistics were used to describe demographics, clinical opioid withdrawal scale and pain scores within 24 hours preprotocol and within 24 hours postprotocol initiation, hospital length of stay after protocol initiation, receipt of a buprenorphine prescription at discharge, and prescription activity at 30 days. T test and chi-square tests were used to analyze comparisons. A subset of pilot group patients completed a survey about their experience. There were no statistically significant differences in pain and clinical opioid withdrawal scale scores between the pilot and control groups. There were 5 instances of precipitated withdrawal in the pilot group. There was no statistically significant difference in mean discharge time after protocol initiation between the pilot and control groups (P = 0.60). Most patients surveyed described a positive experience with LDB induction. Hospitalization is a critical time to initiate buprenorphine for patients with opioid use disorder. Our data adds to the growing evidence that LDB induction is feasible for patients taking methadone and short-acting opioid agonists, and that a more rapid induction protocol is generally well-tolerated by patients although precipitated withdrawal is a risk. Finally, our rapid induction protocol did not seem to increase hospital length of stay compared with traditional induction.

Evaluation of Adverse Reactions and Effects of Triamcinolone Acetonide Combined with Compound Betamethasone in Keloid

To explore the drug effect and adverse reaction of triamcinolone acetonide combined with compound betamethasone in keloid is the objective of the study. 100 patients were randomly divided into study group and control group (50 patients in each group). The research group received sequential treatment with triamcinolone acetonide injection combined with compound betamethasone injection and the control group received compound betamethasone injection. Both groups had 3 courses of treatment and each course of treatment lasted for 3 w. The Vancouver scar scale score, treatment effect and adverse reactions were compared between the two groups and the recurrence rate was followed up for 1 y after the end of medication. Before treatment, there was no significant difference in Vancouver scar scale scores between the two groups but after medication, the study group was better than that of the control group (p<0.05). The total effective rate of the study group (82 %) was higher than that of the control group (54 %, p<0.05). The total incidence of adverse drug reactions in the study group was 8 % while in the control group it was 6 % and the comparison between the two groups was not statistically significant. The recurrence rates of the study group and the control group were 28 % and 34 % 6 mo after the end of medication and 32 % and 42 % after 12 mo. There was a significant difference between the two groups. The sequential injection of triamcinolone acetonide combined with compound betamethasone is effective in the treatment of keloids, with high safety and low recurrence rate, which is worthy of clinical recommendation.

Determining the Effects of Response Mode and Incentives on Survey Response Rates of School-based Agricultural Education Teachers: An Experimental Study

A decline in response rates was found for agricultural education research studies using survey research methods. The use of incentives and various response modes can affect survey response rates and were the focus of this experiment. The purpose of this study was to determine the effects of survey response mode and incentives on response rates when surveying SBAE teachers. Findings revealed a significant increase in response rates for groups receiving an incentive. No significant differences were found between groups using different survey response modes. When examining summated scale scores for each construct in the questionnaire, participants answering on paper scored more positively in four of the six constructs compared to web responses. Recommendations for practice included using mixed response modes when financially feasible and oversampling to achieve the desired sample size to represent a population. Further research on the effects of communication mode on response rates is needed. An examination of why differences in scale scores occur with different response modes is recommended.

Comparison of Unilateral Biportal Endoscopic Discectomy with Other Surgical Technics: A Systemic Review of Indications and Outcomes of Unilateral Biportal Endoscopic Discectomy from the Current Literature

Unilateral biportal endoscopic (UBE) spine surgery for spinal diseases has been increasing in popularity because of its favorable outcomes. The goal of this systemic review is to analyze the status of outcomes and complications in lumbar disc herniation during UBE discectomy. A comprehensive search of the PubMed, Embase, Web of Science, and OVID databases published until June 30, 2021, was performed. The outcomes of interest were indications, operative time, blood loss, hospital stay, complications, visual analog scale score, and Oswestry Disability Index. Seven studies were included in our research. UBE surgery for lumbar stenosis was excluded. A total of 230 patients with lumbar disc herniation were enrolled in the 7 selected studies. The mean operative time was 74.4 minutes, and the mean length of hospital stay was 4.5 days. Mean incidence of complications reported in the 7 articles was 6.2%. UBE showed shorter hospital stays than did microdiscectomy, no significant differences of Oswestry Disability Index or visual analog scale scores, and good recovery rate among other discectomy techniques (microdiscectomy, full endoscopic transforaminal endoscopic lumbar discectomy, and interlaminar endoscopic lumbar discectomy) at 1 month follow-up. Even with the small number of studies and reports analyzed, biases were the main limitation of this analysis; overall, the clinical outcomes and complication rates associated with UBE discectomy were relatively good. It is clear that UBE discectomy is a good treatment choice for lumbar disc herniation, but to prevent unique UBE surgery complications, a clear understanding of the surgical procedures and careful efforts to overcome the learning curve are necessary.

Preliminary clinical application of multimodal imaging combined with frameless robotic stereotactic biopsy in the diagnosis of primary central nervous system lymphoma

ObjectiveTo evaluate the clinical application of multimodal imaging combined with frameless robotic stereotactic biopsy in the diagnosis of primary central nervous system lymphoma (PCNSL). MethodsWe retrospectively reviewed the clinical data of 8 patients who were considered suspected cases of PCNSL by multimodal imaging techniques. The final pathologic diagnosis were determined by the frameless robotic stereotactic biopsy. The postoperative related complications and pathological results were analyzed. ResultsAll patients underwent biopsies under general anesthesia with an average surgery time of 29.5 ± 4.5 min. The final pathological diagnostic accordant rate with the preoperative ones was 100%, and the pathologic examination of our patients showed features of diffuse large B-cell lymphoma. During the surgery, one patient suffered intratumoral hemorrhage without leading to serious cerebral edema, and conservative treatment was given. There was no death occurring during the study, and there were no significant differences in the Karnofsky Performance Scale Scores of all patients before and after surgery. Finally, they were transferred to the hematology department for standardized chemoradiotherapy according to the pathological results of PCNSL. ConclusionThis study shows that it may play a vital role in the early diagnosis of PCNSL with the technique of multimodal imaging. The technique of frameless robotic stereotactic biopsy for obtaining the pathology outcomes in suspected PCNSL patients has the advantages of safety, efficiency, and minimally invasiveness.

Pain as a risk factor of depression and anxiety symptoms with multiple myeloma during maintenance therapy.

To investigate the prevalence of depression or anxiety in patient with multiple myeloma (MM) in China during maintenance treatment and its associated influencing factors. Patients with MM (n = 160) received maintenance therapy, and control subjects (without MM, n = 160) matched on age, sex, and BMI were recruited. Patients completed questionnaires, including the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Verbal Pain Rating Scale (VPRS). Data on the Clinical characteristics, biochemical indicators of de novo MM were from the database of the Hematology Department of Beijing Chao-yang Hospital. Multiple linear regression model analysis was used to compare the differences in PHQ-9 and GAD-7 scale scores between the control group and the case group after correction for relevant variables. Multiple logistic regression models were subsequently used to analyze the correlation between the presence or absence of anxiety and depression and clinical indicators in the MM groups. Depression symptoms was present in 33.33% and anxiety symptoms in 24.68% of first-episode MM in the maintenance phase of treatment, and depression symptoms in the index-corrected MM group was significantly different from that in the control group (t = 2.54, P < 0.05). Analyses of multiple logistic regressions: biochemical indicators and clinical typing were not significantly associated with anxiety and depression. Compared to the pain rating 1, the risk of depressive mood was greater in the case group with the pain rating 2 (OR = 2.38) and the pain rating ≥ 3 (OR = 4.32). The risk of anxiety was greater in the case group with the pain rating ≥ 3 than the pain rating 1 (OR = 2.89). Despite being in clinical remission, depressive mood problems in patients with MM remain prominent. Clinicians should enhance mood assessment and management in patients with concomitant pain.

MRI Detection of Carotid Intraplaque Hemorrhage and Postintervention Cognition.

Cognitive improvement has been reported after carotid revascularization and attributed to treating stenosis and correcting hypoperfusion. This study investigated the effect of carotid intraplaque hemorrhage on postintervention cognition. In this institutional review board-approved single-center study, consecutive patients scheduled for carotid surgery were recruited for preoperative carotid MR imaging (MPRAGE) and pre- and postintervention cognitive testing using the Repeatable Battery for the Assessment of Neuropsychological Status. Pre- and postintervention scores were compared using t tests and multivariable linear regression. Twenty-three participants were included, with endarterectomy performed in 20 (87%) and angioplasty/stent placement, in 3 (13%). Overall, statistically significant improvements occurred in the pre- versus postintervention mean Total Scale score (92.1 [SD, 15.5] versus 96.1 [SD, 15.8], P = .04), immediate memory index (89.4 [SD, 18.2] versus 97.7 [SD, 14.9], P < .001), and verbal index (96.1 [SD, 14.1] versus 103.0 [SD, 12.0], P = .002). Intraplaque hemorrhage (+) participants (n = 11) had no significant improvement in any category, and the attention index significantly decreased (99.4 [SD, 18.0] versus 93.5 [SD, 19.4], P = .045). Intraplaque hemorrhage (-) participants (n = 12) significantly improved in the Total Scale score (86.4 [SD, 11.8] versus 95.5 [SD, 12.4], P = .004), immediate memory index (82.3 [SD, 14.6] versus 96.2 [SD, 14.1], P = .002), delayed memory index (94.3 [SD, 14.9] versus 102.4 [SD, 8.0], P = .03), and verbal index (94.3 [SD, 13.2] versus 101.5 [SD, 107.4], P = .009). Postintervention minus preintervention scores for intraplaque hemorrhage (+) versus (-) groups showed statistically significant differences in the Total Scale score (-0.4 [SD, 6.8] versus 8.0 [SD, 8.5], P = .02), attention index (-5.9 [SD, 8.5] versus 4.3 [SD, 11.9], P = .03), and immediate memory index (4.2 [SD, 6.7] versus 12.2 [SD, 10.2], P = .04). Cognitive improvement was observed after carotid intervention, and this was attributable to intraplaque hemorrhage (-) plaque. MR imaging detection of intraplaque hemorrhage status may be an important determinant of cognitive change after intervention.

Is unicompartmental knee arthroplasty truly contraindicated in an obese patient? A meta-analysis

BackgroundObesity has long been considered a relative contraindication to unicompartmental knee arthroplasty (UKA). However, with improved implants and techniques, the criteria for UKAs have been challenged. This paper aims to assess the impact of body mass index (BMI) on revision rates and functional outcomes in UKAs. MethodsDatabases of Pubmed, EMBASE, MEDLINE, CINHL and the Cochrane registries were systematically searched following the PROSPERO protocol. Studies comparing implant survival and functional outcome scores between obese and non-obese patients after a UKA were included. ResultsTwenty-five articles reported revision rates or functional outcomes in 42,434 UKA surgeries. There was a trend to higher revision rates in patients with BMI > 30 kg/m2 (odds ratio [OR] 0.91 [0.79–1.05]), BMI >35 kg/m2 (OR 0.70 [0.48, 1.01]) or BMI >40 kg/m2 (OR 0.66 [0.41, 1.07]), although the difference was not significant. There was a significant larger improvement in Oxford Knee Scores in obese patients after a UKA (OR 2.68 [1.79, 3.57], p < 0.00001), but no difference in Knee Society Scores or Visual Analogue Scale scores. ConclusionWith no significant increase in revision rates after a UKA, a significantly greater improvement in Oxford Knee Scores and no differences Knee Society Scores or Visual Analogue Scales, obesity should no longer be viewed as a relative contraindication when performing unicompartmental knee replacements.

The impact of the coronavirus disease 2019 (covid-19) on male sexual health

<h3>Objectives</h3> During the Coronavirus Disease 2019 (COVID-19) pandemic, there was an increase in the amount of men seeking treatment at urology outpatient clinics for sexual complaints. However, it is unknown whether this condition is directly related to COVID-19. The impact of COVID-19 on male sexual health was explored in the present study. <h3>Methods</h3> Individuals in the male sexual health cohort of our clinic were retrospectively examined. Men who applied to our clinic in the last 6 months and had a history of COVID-19 afterward were invited for an assesment at the 3rd month post COVID-19. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), and prolactin (PRL) levels were all measured. Furthermore, the Premature ejaculation diagnostic tool (PEDT), the Chronic prostatitis symptom index (NIH-CPSI), the International Index of erectile function-5 (IIEF-5), the Beck depression inventory (BDI), and the Beck anxiety inventory (BAI) scores were recorded. The pre-covid and post-covid data of the subjects were compared. <h3>Results</h3> The mean age of the participants was 34.8±7.7, the mean body mass index was 26.82±5.3, and the mean modified Charlson comorbidity index was 0.2±0.41. COVID-19 severity was mild in 19/25 (76%) and moderate in 6/25 (24%) of the subjects. LH, FSH, TT, and PRL levels did not differ between precovid and postcovid periods (p>0.05). There was no significant change in PEDT, NIH-CPSI, IIEF-5, or BAI scale scores in the postcovid period (p>0.05), although there was an remarkable decrease in BDI scores as compared to the precovid period (p>0.05). <h3>Conclusions</h3> While there was no difference in sex hormone levels or scale scores used to assess premature ejaculation, erectile dysfunction, chronic prostatitis, or anxiety, we noticed an unanticipated decrease in depression levels in individuals recovering from COVID-19. More precise results on the impact of COVID-19 on male sexual health could be revealed in future cohort studies with higher case numbers. <h3>Conflicts of Interest</h3> The authors declare no conflict of interest.