Significant Statistical Difference Research Articles

Feasibility study of a novel digital template-guided flapless extraction for maxillary palatal impacted teeth.

With the increasing maturity of 3D printing technology, the application of digital guide template in the extraction of impacted teeth has become more sophisticated. However, for maxillary palatal deeply impacted teeth, there still exist significant clinical challenges. This experiment introduces a novel digital guide template and innovatively employs a flapless technique to explore a minimally invasive approach for the extraction of palatal deeply impacted teeth. This experiment included 40 patients diagnosed with palatal completely impacted teeth, randomly divided into an experimental group and a control group. The experimental group used the new digital guide template for flapless extraction, while the control group employed the traditional freehand flap technique. The experimental group can significantly reduce the localization time of palatally impacted teeth (P < 0.001), with total surgery times of 18.15 ± 4.88min and 22.00 ± 7.71min for the experimental and control groups, respectively (P = 0.067). Although there were no significant statistical differences between the two groups in terms of intraoperative bleeding, adjacent tooth damage, infection, or damage to nearby important anatomical structures, the experimental group showed significant improvements in postoperative pain (P < 0.05), swelling (P < 0.001), and patient satisfaction (P < 0.001) compared to the control group. Compared to traditional freehand flap surgery, flapless extraction of palatally impacted teeth guided by digital templates significantly reduces the localization time of impacted teeth and demonstrates notable advantages in some postoperative complications. Future studies with larger sample sizes are needed to substantiate the feasibility of this technique.

Do lead (Pb) content of lipsticks expose a health risk to children? A risk assessment study.

Lead (Pb) content in lipsticks and potential life-long exposure of which might cause severe effects in consumers are an important concern for public. Thus, studies emphasize that lead exposure has no safe levels. From 10 different brands, in total, 25 solid, gloss and creamy lipsticks are deployed from Turkish markets that are also categorized in two different price ranges. In order to evaluate the blood Pb levels in children, the United States Environmental Protection Agency's 'Exposure Uptake Biokinetic Model' is utilized. To assess the health risk of chronic usage both for children and adults, oral daily systemic exposure levels are calculated with the worst-case scenario and are compared with Maximum Allowable Dose Level for lipsticks. For lifetime risk assessment, exposure is assumed to start by age 7, and four different exposure scenarios have been deployed. The mean lead content of lipsticks shows significant statistical differences between the high- and low-priced lipstick groups. Daily level and total risk for lifetime Pb exposure from deployed lipsticks are below the acceptable risk levels but long-worn usage of products with routine monitoring of metal content is crucial for sensitive and unintended exposure groups.

The use of intramedullary reduction techniques in the treatment of irreducible intertrochanteric femoral fractures with negative medial cortical support

ObjectiveTo explore the clinical efficacy of intramedullary reduction techniques for irreducible intertrochanteric femoral fractures with negative medial cortical support.MethodsA retrospective analysis was conducted on 69 patients with irreducible intertrochanteric femoral fractures with negative medial cortical support treated in the Department of Orthopedics at Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University) from July 2019 to December 2021. Patients were divided into Group A and Group B. Group A (experimental group) consisted of 36 cases with an average age of 76.2 ± 5.9 years, while Group B (control group) comprised 33 cases with an average age of 76.6 ± 6.3 years. Group A received treatment using intramedullary reduction techniques, while Group B received treatment using traditional extramedullary reduction techniques. Both groups achieved anatomic reduction of the medial cortex or slight positive support. Surgical duration, intraoperative fracture reduction time, intraoperative bleeding, intraoperative fluoroscopy time, fracture reduction quality, fracture healing, postoperative neck-shaft angle loss, femoral neck shortening, and hip joint functional recovery score (FRS) were compared between the two groups.ResultsAll patients were followed up for an average of 13.8 months. Group A showed superior outcomes compared to Group B in surgical duration, intraoperative fracture reduction time, intraoperative bleeding, intraoperative fluoroscopy time, fracture reduction quality, fracture healing, postoperative neck-shaft angle loss, and femoral neck shortening (P &amp;lt; 0.05). Hip joint function assessed by functional recovery score was better in Group A than Group B at 1 and 3 months postoperatively (P &amp;lt; 0.05), with no significant statistical difference at other time points (P &amp;gt; 0.05).ConclusionFor irreducible intertrochanteric femoral fractures with negative medial cortical support, intramedullary reduction techniques used during surgery demonstrated simplicity, significant reduction in surgical duration, decreased intraoperative bleeding, fewer amounts of intraoperative fluoroscopy, improved fracture reduction quality, and reduced surgical complexity. Further clinical research and application are warranted.

Anorectal function and symptoms 6 months after robot-assisted laparoscopic radical prostatectomy: a single-center study.

Robot-assisted laparoscopic radical prostatectomy (RALP) is a common procedure for the treatment of localised prostate cancer. Anorectal symptoms such as fecal incontinence (FI), rectal urgency or disturbed defecation have been reported after the operation. Anorectal function is dependent on the integrity of anal and pelvic nerves and muscles, rectal sensory function as well as rectal reservoir function. The aim of this study was to investigate the potential influence of RALP on anorectal physiological function and bowel symptoms. In this pilot study, 29 patients with localised prostate cancer scheduled for RALP were included. Anorectal physiology was used to measure rectal sensitivity and reservoir function as well as anal sphincter pressures. Bowel symptoms were measured by a bowel function questionnaire and a 2-week bowel function diary. Measurements were done before the operation and repeated at 6 months after the operation. The study observed a significant postoperative increase in rectal sensory threshold for rectal balloon distention, from 20 to 40 mmHg, P < 0.001. This change is indicative of a decrease in rectal sensation after RALP. There were no other statistical significant differences in any of the physiological tests performed. Importantly, there was no change in any of the bowel symptoms after surgery. This study showed that RALP may lead to impaired rectal sensory function. This finding did not, however, seem to have any influence on the patients´ postoperative clinical bowel function.

Serum Plasminogen Activator Inhibitor-1, α 1-Acid Glycoprotein, C-Reactive Protein, and Platelet Factor 4 Levels—Promising Molecules That Can Complete the “Puzzle” of the Biochemical Milieu in Severe Burns: Preliminary Results of a Cohort Prospective Study

Background: Burns represent a serious health problem, associated with multiple-organ failure, prolonged hospitalization, septic complications, and increased rate of mortality. The main aim of our study was to evaluate the levels of various circulating molecules in children with severe burns (more than 25% TBSA), in three different moments: 48 h, day 10, and day 21 post-burn. Materials and Methods: This study included 32 children with burns produced by flame, hot liquid, and electric arc and 21 controls. Serum plasminogen activator inhibitor-1 (PAI-1), α 1-acid glycoprotein (AGP), C-reactive protein (CRP), and platelet factor 4 (PF4) were detected using the Multiplex technique. Several parameters, such as fibrinogen, leucocyte count, thrombocyte count, triiodothyronine, thyroxine, and thyroid-stimulating hormone were also determined for each patient during hospitalization. Results: Significant statistical differences were obtained for CRP, AGP, and PF4 compared to the control group, in different moments of measurements. Negative correlations between CRP, AGP, and PF4 serum levels and burned body surface, and also the hospitalization period, were observed. Discussions: CRP levels increased in the first 10 days after burn trauma and then decreased after day 21. Serum PAI-1 levels were higher immediately after the burn and started decreasing only after day 10 post-burn. AGP had elevated levels 48 h after the burn, then decreased at 7–10 days afterwards, and once again increased levels after 21 days. PF4 serum levels increased after day 10 since the burning event. Conclusions: Serum CRP, AGP, PAI-1, and PF4 seem to be promising molecules in monitoring patients with a burn within the first 21 days.

Serum Levels of Zinc, Albumin, Interleukin-6 and CRP in Patients with Unipolar and Bipolar Depression: Cross Sectional Study

Unipolar (UD) and bipolar depression (BDD) show a high degree of similarity in clinical presentations, which complicates the differential diagnosis of these disorders. The aim of this study was to investigate the serum levels of interleukin 6 (IL-6), C-reactive protein (CRP), albumin (Alb), and zinc (Zn) in patients with UD, BDD, and healthy controls (HC). A total of 211 samples were collected: 131 patient samples (65 UD and 68 BDD) and 80 HC. The Montgomery–Asberg Depression Rating Scale (MADRS), along with the Hamilton Depression Rating Scale (HAMD-17), were administered to patient groups to evaluate symptoms. A cross-sectional study was performed to analyse the serum levels of IL-6, CRP, albumin, and zinc. The concentration of CRP was determined using the immunoturbidimetry method, zinc using the colorimetric method, and albumin using the colorimetric method with bromocresol green on the Alinity c device. IL-6 cytokine concentration in serum samples was ascertained using a commercial enzyme immunoassay, ELISA. We found no significant differences in serum concentrations of zinc, albumin, CRP, and IL-6 between the groups of patients with unipolar and bipolar depression. There was a significant statistical difference (p &lt; 0.001) between serum levels of all investigated parameters in both groups of depressed patients in comparison with HC. Furthermore, correlations with specific items on HAMD-17; (namely, hypochondrias, work and activities, somatic symptoms-general, and weight loss) and on MADRS (concentration difficulties, lassitude) were observed in both patient groups. These findings confirm the presence of low-grade inflammation in depression, thus adding better insight into the inflammation hypothesis directed to explain the aetiology of depressive disorders. Our results do not indicate potential biomarkers for distinguishing between unipolar and bipolar depression.

Vitamin D levels and its influencing factors in pregnant women in mainland China: A systematic review and meta-analysis.

Maternal vitamin D deficiency is a prevalent public health issue worldwide. While isolated reports from certain cities in China have highlighted the existence of maternal vitamin D deficiency, no nationwide investigation has been conducted on this topic. Therefore, we conducted a meta-analysis and systematic review to examine the prevalence and associated influencing factors of maternal vitamin D deficiency in mainland China. This study aims to provide a theoretical foundation for future prevention and supplementation strategies for maternal vitamin D. We retrieved relevant Chinese and English literature on the status of maternal vitamin D deficiency in mainland China from databases such as CNKI, Wanfang Data, VIP, CBM, Web of Science, Google Scholar, and PubMed. The literature search and database construction were conducted until September 8, 2023. Data were extracted and synthesized following PRISMA guidelines.After literature screening and quality assessment, we performed meta-analysis, sensitivity analysis, and identified publication bias using RevMan 5.3 software. A total of 26 articles were reviewed, involving 128,820 pregnant women. Among them, 108,768 had vitamin D insufficiency or deficiency, resulting in a prevalence of 84% (95% CI: 81%~88%). Subgroup analysis revealed the highest prevalence of vitamin D deficiency or insufficiency among pregnant women in mainland China to be in the northwest region (94%, 95% CI: 94%~95%). Furthermore, the highest prevalence was observed during the winter and spring seasons (80%, 95% CI: 77%~83%) and in the early stages of pregnancy (93%, 95% CI: 90%~95%). Significant statistical differences (P<0.05) were found among these three subgroups. No publication bias was detected, and sensitivity analysis indicated the stability of the meta-analysis outcome. This study provides evidence of the prevalence of vitamin D deficiency or insufficiency among pregnant women in mainland China. To improve the overall health and well-being of the population, relevant health authorities should develop policies aimed at alleviating this phenomenon.

Comparison of Lateral and Central Achilles Tendon-Splitting Approaches in the Treatment of Haglund Deformity.

This study aimed to compare the complications and outcomes of lateral and central Achilles tendon-splitting approaches for the treatment of Haglund syndrome. Patients who underwent surgery for Haglund syndrome between June 2012 and June 2022 were included in the study. Patients undergoing lateral approach surgery were included in group 1, whereas patients undergoing central Achilles tendon-splitting approach surgery were included in group 2. Surgical outcomes of the patients were evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle hindfoot scale, visual analog pain scale (VAS), and Victorian Institute of Sport Assessment-Achilles (VISAA) scores. In addition, preoperative and final follow-up scores were compared. The study included 66 patients: 32 (14 females, 18 males) underwent surgery using the lateral approach in group 1, whereas in group 2, 34 patients (18 females, 16 males) underwent surgery using the central Achilles tendon-splitting approach. There was a significant statistical difference in the AOFAS, VISAA, and VAS scores between preoperative and final follow-up for both group 1 and group 2 (P < .001, P < .001, P < .001, P < .001, respectively). Group 1 had a small (0.76) relative increase in VAS score compared with group 2 (P = .033). There was no significant difference between the complication rates of group 1 and group 2. In our study, we found the lateral approach and central Achilles tendon-splitting approaches to be safe and effective in the surgical treatment of Haglund syndrome without clinically meaningful differences in outcomes or complication rates. Level III, retrospective cohort study.

Surgical treatment of multiple magnet ingestion by children: A single-center experience from China.

The incidence of magnet ingestion in children has escalated concurrent with the rise in popularity of magnetic playthings, bearing the capacity to induce substantial morbidity. The objective of this study was to encapsulate our accumulated expertise in handling pediatric cases featuring multiple magnetic foreign bodies within the gastrointestinal tract sometimes necessitating surgical intervention, as well as to formulate a clinical management algorithm. This was a retrospective review of patients with multiple magnetic foreign bodies in the digestive tract, admitted to Shenzhen Children's Hospital, between January 2018 and December 2022. A total of 100 cases were included in this study, including 66 males and 34 females. The main clinical manifestation ns were abdominal pain and vomiting. All patients had abdominal x-ray, all of which indicated foreign bodies in the digestive tract. 33 patients had to undergo a surgical intervention. Among these cases, the gastrointestinal complications occurred in 31 patients, including gastric rupture (n = 9), intestinal obstruction (n = 11) and intestinal perforation (n = 30). Postoperative intestinal obstruction occurred in 6 children. There was no statistical significant difference in age and gender between the Surgical group and Non-surgical group, but the Surgical group had a higher number of magnets ([7.5(2-44) vs 4(2-20)], p = 0.009), a longer interval between time of misingestion to clinical visit ([48(7.2-480) vs 5(2-336)]hours, p < 0.001), and a longer length of hospital stay ([10(6-19) vs 2(1-8)]days, p < 0.001). Multiple magnet ingestion in children can lead to serious complications and carry severe risks. Timely diagnosis and effective treatment are crucial for managing such patients.

Chlorophyll a fluorescence and phytochemical response in blackberry species (Rubus sp) cultivated in the high tropics

BACKGROUND: The evaluation of chlorophyll fluorescence activity is a useful tool for rapid and effective assessments of the effect of abiotic factors on the physiology of different crops. In Rubus, this type of measurements describes tolerance to high temperatures, sensitivity to heat and morphological alterations in flowering and chlorophyll content, as a result of plant stress. OBJECTIVE: The present research estimated chlorophyll fluorescence and the presence of some phenolic compounds in the leaves of three cultivars of blackberry (Rubus sp.) established in the central region of Colombia, under conditions of open air between 2400 and 2800 masl. MATERIAL AND METHODS: This was done through the measurement of chlorophyll a (Junior-PAM II modulated fluorometer), the quantification of phenolic compounds (Folin Ciocalteu), the determination of antioxidant capacity (DPPH and ABTS) and the study of phenolic profiles (UHPLC) in leaves of three blackberry cultivars. RESULTS: Cultivars R. alutaceus (0.66), R. glaucus (0.73) and R. alpinus (0.76), presented values lower than the optimum (0.83), for the parameter F v /F m . In addition, the direct relationships between the parameters that define the behavior of PSII and the accumulation of different polyphenols were described. Reference was also made to the content of phenolic compounds (ranging from 125 to 150 mg GA g–1 dw), which did not show significant statistical differences. The heat map and principal component analysis show the close relationship between the parameters that characterize the functioning of PSII and the accumulation of phenolic compounds, as a mechanism of adaptation to the adverse conditions of the blackberry cultivars studied. CONCLUSIONS: The results reveal that the leaves of the Rubus studied could be a source of functional ingredients for use in the cosmetic, nutraceutical and food industries and epigallocatechin was attributed the greatest responsibility for the antioxidant capacity.

Antimicrobial Properties of Aloe vera Ethanol Extract as a Denture Disinfectant: An In Vitro Study.

Introduction The aim of this study was to evaluate the activity of an ethanolic extract of Aloe vera on Candida albicans and Staphylococcus aureus. Materials and methods A total of 42 heat-cured acrylic resin specimens were made and divided into three groups according to the disinfection method: (1) Corega disinfectant tablets; (2) ethanol extract of Aloe vera; and (3) distilled water (as a control group). Fresh Aloe vera whole leaves were washed with distilled water, chopped into small pieces, air-dried, and ground into powder. The powder was extracted with 95% ethanol. The acrylic specimens were contaminated with C. albicans and S. aureus, and then the specimens were immersed in study solutions for three minutes. The viable colonies were counted using the colony-forming units (CFU) method. Results The results showed a decrease in the number of C. albicans CFU for denture tablets and Aloe vera ethanoic extract groups compared to the negative control group. There were no significant statistical differences between the denture tablet group and the Aloe vera ethanolic extract group (P < 0.05). Aloe vera ethanolic extract groups significantly decreased the number of S. aureus CFU compared to the negative control group and less compared to the denture tablet, where significant statistical differences were found between the tablet group and the Aloe vera ethanolic extract group. Conclusions Within the limitations of this study, it was concluded that Aloe vera extract was effective against C. albicans and S. aureus when acrylic resin specimens were immersed for three minutes.

Clinico-pathological study of esophageal mucoepidermoid carcinoma: a 10-year survival from a single center

BackgroundMucoepidermoid Carcinoma of the Esophagus (MECE) is a relatively rare tumor type, with most of the current data derived from case reports or small sample studies. This retrospective study reports on the 10-year survival data and detailed clinicopathological characteristics of 48 patients with esophageal MEC.MethodsData were collected from 48 patients who underwent curative surgery for esophageal MEC at the Fourth Hospital of Hebei Medical University between January 1, 2004, and December 31, 2020. These were compared with contemporaneous cases of Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC). Using the Kaplan-Meier method and multivariate Cox regression analysis, we investigated the clinicopathological factors affecting the survival of patients with MEC.ResultsThe incidence of MECE was predominantly higher in males, with a male-to-female ratio of approximately 7:1. The mid-thoracic segment emerged as the most common site of occurrence. A mere 6.3% of cases were correctly diagnosed preoperatively. The lymph node metastasis rate stood at 35.4%. The overall 1-year, 3-year, 5-year, and 10-year survival rates for all patients were 85.4%, 52.1%, 37.0%, and 31.0%, respectively. Post 1:1 propensity score matching, no significant statistical difference was observed in the Overall Survival (OS) between MEC patients and those with Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC) (P = 0.119, P = 0.669). Univariate analysis indicated that T staging and N staging were the primary factors influencing the prognosis of esophageal MEC.ConclusionsMECE occurs more frequently in males than females, with the mid-thoracic segment being the most common site of occurrence. The rate of accurate preoperative endoscopic diagnosis is low. The characteristic of having a short lesion length yet exhibiting significant extramural invasion may be a crucial clinicopathological feature of MECE. The OS of patients with MEC does not appear to significantly differ from those with esophageal squamous carcinoma and adenocarcinoma.

ROLE OF DYNAMIZATION IN INTRAMEDULLARY NAILING OF TIBIA

Objectives: This study aims to know the functional outcomes of intramedullary nailing (IMN) osteosynthesis in long bone shaft fractures among adult patients with stable internal fixation and union. Additionally, it seeks to assess the specific and general complications experienced by both groups. Methods: The study was conducted at the Department of Orthopedics, Government Medical College, and Rajindra Hospital in Patiala, spanning from March 2021 to December 2022. It was a prospective, manipulative, controlled study involving a total of 40 cases of tibia diaphyseal fractures that were presented to the orthopedics department. Fractures were classified according to the AO fracture classification. Results: The average time for union in the dynamic group was 15.60 weeks (with a standard deviation of 1.27). A significant statistical difference was observed, favoring the dynamization nailing group (p&lt;0.01), indicating a strong trend toward faster union. Out of the 40 patients, 16 (40%) experienced at least one complication. In conclusion, dynamic IMN osteosynthesis permits micromotion between fracture fragments, directly stimulating bone formation and the development of callus. Conclusion: For closed or open tibial diaphyseal fractures with minimal comminution (types A and B based on the AO classification) up to Gustilo 3A, dynamic IMN assembly is considered a safe and effective treatment option.

Effects of Laghoo Shankaprakshalana (yogic colon cleansing) on anthropometric measurements in obese individuals.

Obesity is considered as one of the major public health burden and it is predictor of cardiovascular risk factor. Yoga is a mind-body medicine helps to promote health. This study was aimed to explore whether Laghoo Shankaprashalana (LS) reduce the body weight in obese individuals. This was a single group pre-post study. A total of 40 subjects (9 Male, 31 Female) aged between 18 and 40 years were recruited. This study was conducted in government yoga and naturopathy medical college, Chennai. Subjects were practiced weekly once LS for eight weeks (eight sessions). Subjects were assessed pre and post on body weight, body mass index, waist circumference, hip circumference, waist hip ratio, pulse rate and blood pressure. Variables were analyzed using Paired sample t test except waist hip ratio, which were analyzed using Wilcoxon's signed ranks test. There was significant reduction in the body weight (p<0.001, 5.81 %), Body Mass Index (p<0.001, 5.88 %), Waist Circumference (p<0.001, 7.20 %), Hip Circumference (p<0.001, 5.04 %), and Waist Hip Circumference (p<0.001, 3.19 %) after LS. However, there was no statistical significance difference in pulse rate, blood pressure. Eight sessions of Laghoo Shankaprakshalana helps to reduces body weight, body mass index, waist circumference, hip circumference and waist hip ratio. Reduction in the waist circumference might helps to reduce the cardiovascular risk. LS may be one of the cost effective intervention that can be incorporated in the weight loss regimen.

Analysis of the virulence and genetic differences of carbapenem-resistant Acinetobacter baumannii epidemic clones

Objective: To evaluate the virulence levels of carbapenem-resistant Acinetobacter baumannii ST191, ST195, and ST208, and to analyze the differences in virulence factors among these epidemic clones. Methods: The study involved the genomic sequencing of 233 Acinetobacter baumannii strains that were isolated from the Fifth Medical Center of the Chinese People's Liberation Army General Hospital (North Hospital) between 2011 and 2019. The genomic data was cross-referenced with the Virulence Factor Database (VFDB) to examine the presence of virulence genes in the strains. Furthermore, a Galleria mellonella infection survival model was used to evaluate the virulence levels of the strains, and the association between virulence levels and virulence genes was analyzed. Results: The study included 38 strains of the ST191 clone, 104 strains of the ST195 clone, and 91 strains of the ST208 clone. In the Galleria mellonella infection survival experiment, the average mortality rate for ST191 was 23.0%, with 3 (7.9%) highly virulent strains. For ST195, the average mortality rate was 53.0%, with 34 (32.7%) highly virulent strains. For ST208, the average mortality rate was 47.0%, with 20 (21.9%) highly virulent strains. There was a significant statistical difference in mortality rates between ST191 and ST195 (χ2=13.9, P<0.001) as well as between ST191 and ST208 (χ2=15.2, P<0.001). A comparison of the strains with the VFDB revealed significant differences in the virulence genes carried by the clones. Specifically, the type Ⅵ secretion system-related genes (clpV/tssH, hcp/tssD, tagX, tssA, tssB, tssC, tssE, tssF, tssG, tssK, ssL, tssM) and the sugar transferase gene ACICU_RS00475 were found to be universally absent in ST191 strains (0%) while being prevalent in ST195 (100.0%) and ST208 (>82.0%) strains. Statistical analysis revealed an association between the mortality rate of the clones and the presence of virulence genes(clpV/tssH P<0.001, hcp/tssD P=0.001, tagX P<0.001, tssA P<0.001, tssB P=0.001, tssC P=0.001, tssE P=0.001, tssF P=0.001, tssG P<0.001, tssK P<0.001, tssL P<0.001, tssM P=0.001, ACICU_RS00475 P=0.001). Conclusion: Among the carbapenem-resistant epidemic clones of Acinetobacter baumannii, the ST191 clone shows lower mortality rates in Galleria mellonella, possibly because of the lack of type Ⅵ secretion system and sugar transferase genes.

Effectiveness of gonadotropin-releasing hormone agonists for ovarian function suppression in premenopausal patients with hormone receptor-positive breast cancer: a retrospective single-center real-world study.

This study evaluated the effectiveness of ovarian function suppression (OFS) of various gonadotropin-releasing hormone agonists (GnRHa) combined with aromatase inhibitors (AI) in premenopausal patients with hormone receptor-positive (HR-positive) breast cancer. Potential risk factors associated with insufficient OFS were analyzed. Premenopausal HR-positive breast cancer patients who had received AI with GnRHa were studied retrospectively. Patients were divided into different groups according to monthly or trimonthly GnRHa schedules they received, and the effectiveness of OFS was compared between groups. Insufficient OFS was defined as at least one instance of estradiol ≥ 30pg/ml. Patient data was gathered from medical records for this comparison. Of the 264 patients enrolled in this study, 117 were administered 3.6mg of goserelin monthly (goserelin 1M group), 63 received 3.75mg of leuprorelin monthly (leuprorelin 1M group) and 84 were given 11.25mg of leuprorelin every three months (leuprorelin 3M group). Overall, 7.20% experienced insufficient OFS. The incidence rates in the three GnRHa depot groups were 7.69%, 6.35%, and 7.14%, respectively, without a significant statistical difference (P = 0.900). Notably, younger patients exhibited a higher likelihood of insufficient OFS [OR = 0.900, 95%CI (0.824-0.982), P = 0.018]. Insufficient OFS remains a concern during GnRHa and AI treatment. The effectiveness of the three GnRHa depots commonly used in China seems comparable. Younger patients face a heightened risk of insufficient OFS.

The impact of different corticosteroids in hospitalised patients with severe COVID-19 pneumonia: a retrospective observational study

Background: The COVID-19 pandemic created havoc on health care systems and economies worldwide. Corticosteroids have been shown to be effective in the management of COVID-19. Methods: A retrospective observational study was conducted on 311 patients meeting the inclusion criteria at the Augustus Long Hospital, Trinidad and Tobago between July-December 2021. Data was classified into three treatment groups: low dose dexamethasone, high dose dexamethasone and methylprednisolone pulse therapy. The primary outcomes were the 28-day mortality and need for invasive mechanical ventilation and the secondary outcome was the length of hospital stay. The patient cohort was also classified into simple oxygen and high flow oxygen groups and a subgroup analysis was also performed. Results: There were no significant statistical differences between age, gender, vaccination status and co-morbidities between the treatment groups. However, there were significant differences in the ethnic ratios amongst the high dose dexamethasone and methylprednisolone treatment groups (East Indians to Africans; 61.7%vs. 37%; 72.9% vs.25.4% respectively; p=0.02). In patients receiving simple oxygen on admission, those who were treated with low dose dexamethasone when compared to high dose dexamethasone and methylprednisolone, had the lowest 28-day mortality (15.3% vs. 40.9% vs. 40% respectively; p&lt; 0.001), lowest need for IMV (0.7% vs. 9.1% vs. 40% respectively; p&lt; 0.001) and the shortest length of hospital stay (median [IQR] days; 7[12-5], 11[22-7], 16[27-14] respectively; p&lt; 0.001). In patients receiving high flow oxygen, those treated with methylprednisolone had the lowest 28-day mortality (45.8%), when compared to the high dose dexamethasone (59.5%) and low dose dexamethasone (81%) groups; however, these results were not statistically significant (p = 0.053). Conclusion: In our study, patients receiving simple oxygen had better clinical outcomes when treated with low dose dexamethasone compared to higher dose corticosteroids. Methylprednisolone pulse therapy may be beneficial in patients requiring high flow oxygen; but further studies are needed.

Comparison of the efficacy and complications of tolterodine and α-adrenergic receptor blockers in improving ureteral stent-related symptoms: A systematic review and meta-analysis.

We conducted a systematic evaluation of the therapeutic efficacy and complications of tolterodine and α-adrenergic receptor blockers in alleviating ureteral stent-related symptoms. Until August 2023, we conducted a comprehensive literature search on PubMed, Embase, Web of Science, and Cochrane Library to identify randomized controlled trials evaluating the efficacy and complications of tolterodine and α-adrenergic receptor blockers in treating ureteral stent-related symptoms. Two reviewers independently screened studies and extracted data. The scores from various domains of the Ureteral Stent Symptom Questionnaire (USSQ) were summarized and compared, and statistical analysis was performed using RevMan 5.4.0 software. A total of 8 studies met the inclusion criteria for our analysis. These studies were conducted at different centers. All studies were randomized controlled trials, involving a total of 487 patients, with 244 patients receiving α-adrenergic receptor blockers and 243 patients receiving tolterodine. The results showed that tolterodine demonstrated significantly better improvement in body pain (MD, 1.56; 95% CI [0.46, 2.66]; p = 0.005) (MD, 0.46; 95% CI [0.12, 0.80]; p = 0.008) (MD, 3.21; 95% CI [1.89, 4.52]; p = 0.00001) among patients after ureteral stent placement compared to α-adrenergic receptor blockers at different time points. Additionally, at 4 weeks, tolterodine showed superior improvement in general health (MD, 0.15; 95% CI [0.03, 0.27]; p = 0.01) and urinary symptoms (MD, 1.62; 95% CI [0.59, 2.66]; p = 0.002) compared to α-adrenergic receptor blockers, while at 6 weeks, tolterodine showed better improvement in work performance (MD, -1.60; 95% CI [-2.73, -0.48]; p = 0.005) compared to α-adrenergic receptor blockers. Additionally, the incidence of dry mouth (RR, 4.21; 95% CI [1.38, 12.87]; p = 0.01) is higher with the use of tolterodine compared to α-adrenergic receptor blockers. However, there were no significant statistical differences between the two drugs in other outcomes. This meta-analysis suggests that tolterodine is superior to α-adrenergic receptor blockers in improving physical pain symptoms after ureteral stent placement, while α-adrenergic receptor blockers are more effective than tolterodine in enhancing work performance. Additionally, the incidence of dry mouth is higher with the use of tolterodine compared to α-adrenergic receptor blockers. However, higher-quality randomized controlled trials are needed to further investigate this issue.

Decoding medical jargon: The use of AI language models (ChatGPT-4, BARD, microsoft copilot) in radiology reports

ObjectiveEvaluate Artificial Intelligence (AI) language models (ChatGPT-4, BARD, Microsoft Copilot) in simplifying radiology reports, assessing readability, understandability, actionability, and urgency classification. MethodsThis study evaluated the effectiveness of these AI models in translating radiology reports into patient-friendly language and providing understandable and actionable suggestions and urgency classifications. Thirty radiology reports were processed using AI tools, and their outputs were assessed for readability (Flesch Reading Ease, Flesch-Kincaid Grade Level), understandability (PEMAT), and the accuracy of urgency classification. ANOVA and Chi-Square tests were performed to compare the models' performances. ResultsAll three AI models successfully transformed medical jargon into more accessible language, with BARD showing superior readability scores. In terms of understandability, all models achieved scores above 70%, with ChatGPT-4 and BARD leading (p < 0.001, both). However, the AI models varied in accuracy of urgency recommendations, with no significant statistical difference (p = 0.284). ConclusionAI language models have proven effective in simplifying radiology reports, thereby potentially improving patient comprehension and engagement in their health decisions. However, their accuracy in assessing the urgency of medical conditions based on radiology reports suggests a need for further refinement. Practice implicationsIncorporating AI in radiology communication can empower patients, but further development is crucial for comprehensive and actionable patient support.

New Biomarker Candidates of Sepsis: Diagnostic and Prognostic Value of Presepsin, Angiopoietin 1 and 2

Objective: Sepsis is an uncontrolled inflamatory response that occurs in the body towards infection. It’s an important clinical picture that is seen in high morbidity and mortality so early diagnose and treatment areimportant. For that reason, for the septic cases to get early diagnosis and to predict the prognosis, new biomarkers are needed nowadays. Presepsin, angiopoietin 1 and angiopoietin II are biomarkers that are not usedroutinely yet, in our study, according to the new description given in Sepsis 3 meeting, in cases that are diagnosed with sepsis, we aimed at comparing diagnostic and prognostic values of these biomarkers. Methods: In our study, there were two groups. Patient group consisting of 48 cases with 33 men and 15 women and control group consisting of 42 cases with 23 men and 19 women. Control group is selected within patient relatives with similarities of age and sex. Demographic datas, accompanying diseases, APACHE II, SAPS and SOFA scores counted in the first 24 hours, leukocyte count, eritrocyte sedimentation rate, C-reactive protein, procalcitonin value, culture sampling results (blood, urine, sputum, endotracheal aspirate) that are measured in their stays, 7th and 28th day mortality counts after their ICU stays are written down. Presepsin, angiopoietin I and angiopoietin II are detected by sandwich ELISA method. Results: According to demographic features there isn’t any significant statistical difference between the patient group and the control group (p&gt;0.005). In patient group Presepsin, angiopoietin I and angiopoietin II values were statistically high significantly compared to the control group (p&lt;0.001). After the evaluation, serumpresepsin value noticed that has a diagnostic value in the diagnosis of sepsis (EAA: 0.74, 95%GA: 0.64–0.85, p&lt;0.001). The suggested border value for this value is predicted as 0.47, 73%sensitivity and 62% specificity are determined. Serum angiopoietin I value noticed that has a diagnostic value in the diagnosis of sepsis (EAA: 0.80, 95%GA: 0.71–0.89, p&lt;0.001). The suggested border value for this value is predicted as 178.24, 69% sensitivity and 69% specificity are determined. Serum angiopoietin II value noticed that has a diagnostic value in the diagnosis of sepsis (EAA: 0.89, 95% GA: 0.82–0.95, p&lt;0.001). The suggested border value for this value is predicted as 77.56, 84% sensitivity and 83% specificity are determined. Conclusions: In our study, presepsin, angiopoietin I and angiopoietin II values are determined as statistically high according to healthy control group and are found successful with high sensitivity and specificity in diagnosing. Presepsin, angiopoietin I and angiopoietin II values in septic patients are found successful with high sensitivity and specificity at 7th and 28th days mortality prediction.