Study Group Research Articles

Reliability and Validity of the Turkish Version of the Vanderbilt Fatigue Scale for Adults.

Listening-related fatigue (LRF) is a prominent topic of research interest. The purpose of this study is to investigate the reliability and validity of the Turkish version of the 40-item Vanderbilt Fatigue Scale for Adults (TR-VFS-A-40). This study included 317 adults with no hearing loss and 260 adults with hearing loss in the study group, totaling 577 adults aged 18-75 years. While 31 adults in the study group did not use any hearing technology, there were 96 hearing aid users and 123 cochlear implant (CI) users. A subset of 80 CI users completed the TR-VFS-A-40 a second time, 2 weeks later, to assess test-retest reliability. Intraclass correlation coefficients were used to assess test-retest reliability. Cronbach's alpha was used to evaluate internal consistency. To examine construct validity, a confirmatory factor analysis (CFA) was performed. For concurrent validity analysis, the Checklist Individual Strength (CIS) and TR-VFS-A-40 scores were analyzed using the Spearman correlation test. Cronbach's alpha values were excellent for the total scale of .987 and the cognitive, emotional, physical, and social subscales (.953, .954, .955, and .946, respectively). Analyses of concurrent validity revealed strong and significant correlations between CIS and TR-VFS-A-40 scores, indicating a good concurrent validity. The CFA determined that the construct validity of the TR-VFS-A-40 was satisfactory. The TR-VFS-A-40 is a valid and reliable measure of LRF. https://doi.org/10.23641/asha.25457752.

Alteration in the expression of long non-coding RNAs in the circulation of migraineurs.

Current studies have shown emerging roles of lncRNAs in the pathobiology of neuropathic pain and migraine. We have chosen five lncRNAs, namely, PVT1, DSCAM-AS, MEG3, LINC-ROR, and SPRY4-IT1 for assessment of their expression in the circulation of migraineurs. Expressions of PVT1 and MEG3 were higher in total migraineurs and both subgroups compared with controls (P < 0.0001). Meanwhile, expression of both lncRNA was higher in migraineurs with aura versus migraineurs without aura (P value < 0.0001 and = 0.01, respectively). Expression of DSCAM-AS1 was not different between any groups of patients compared with controls. Expression of LINC-ROR was elevated in total patients and patients with aura compared with controls (P value = 0.0002 and < 0.0001, respectively). It was also over-expressed in migraineurs with aura vs. migraineurs without aura (P = 0.01). Finally, expression of SPRY4-IT1 was higher in total patients and patients without aura compared with migraine-free persons (P values < 0.0001). Expressions of five mentioned lncRNAs were correlated in almost all study groups. In patients without aura, correlations were significant only for two pairs (SPRY4-IT1/PVT1 and SPRY4-IT1/DSCAM-AS1). PVT1 and MEG3 had the appropriate AUC, sensitivity and specificity values for separation of total migraineurs and both groups of patients from controls. The highest AUC value was reported for PVT1 in separation of migraineurs with aura from healthy controls (AUC = 0.98). Cumulatively, our study shows evidence for deregulation of lncRNAs in migraineurs.

The Application of Intraoral Scanners in Orthodontic Care for Adolescents with Disabilities

Access to dental services for young disabled patients is challenging and expensive, often necessitating treatment under general anesthesia. Additionally, ensuring accuracy during impression-taking procedures can be very difficult or outright impossible using traditional methods. Newly developed systems for capturing three-dimensional images of the oral cavity can facilitate the treatment of patients with disabilities. The research aimed to assess the timing of intraoral scanning using a scanner in orthodontic treatment, comparing disabled patients undergoing clear aligner therapy with their healthy counterparts. Scanning times were compared in two patient groups. Group I comprised patients with a certificate of disability, while Group II (control) consisted of patients without a certificate of disability. Maxillary and mandibular scans, as well as bite registration, were performed with the intraoral scanner. The mean scanning time in study Group I was 8.59 min, while in control Group II, it was 5.71 min. The results demonstrated statistical significance, reaching a significance level of p &lt; 0.001. The scanning of disabled patients proved to be more challenging and time-consuming compared to patients in the control group. Consequently, doctors must consider the need to allocate more time to a disabled person during a visit. Despite the difficulties, disabled patients accepted this method of bite scanning. There was no need to carry out such a procedure under general anesthesia. This confirms that scanning should be the preferred method in orthodontic treatment for disabled patients.

Early Neurophysiological Abnormalities in Suspected Acute Canine Polyradiculoneuropathy

Acute canine polyradiculoneuritis (ACP) is a common peripheral neuropathy in dogs, and is generally self-limiting and benign. Electrodiagnostic (EDX) tests are typically performed after 7–10 days. Delaying the definitive diagnosis may hamper the treatment of other causes of acute weakness, which may require specific treatments and may carry different prognoses. This retrospective multicenter study aims to assess whether EDX performed within the first 6 days of clinical signs onset can detect alterations indicative of ACP, and aims to characterize the most prevalent alterations. A total of 71 dogs with suspected ACP were retrospectively analyzed and classified into two groups based on EDX timing: early group (EG, 1–6 days after symptom onset) and late group (LG, 7–15 days after symptom onset). In our study, no significant differences were found between the two groups in motor nerve conduction studies (MNCSs) and F-wave analysis, indicating that EDX is able to demonstrate abnormalities even in the first 6 days from onset. Although the LG showed significantly greater degrees of electromyographic (EMG) alterations compared to the EG, frequent muscle alterations were still observed in the EG group. These findings support the use of EDX in patients with suspected ACP within the first 6 days from the clinical onset. Prompt neurophysiological examinations for suspected ACP patients can be performed effectively and can help allow for early diagnosis and facilitate appropriate treatment.

Faster Bone Gap Union in Medial Opening Wedge High Tibial Osteotomy With 3D-Printed Synthetic Bioresorbable Polycaprolactone and Tricalcium Phosphate Osteotomy Gap Fillers Compared to Allogeneic Osteotomy Gap Fillers: A Retrospective Matched-Pair Cohort Study.

The use of synthetic bone substitute material (BSM) as osteotomy gap fillers have been reported to improve outcomes in medial opening wedge high tibial osteotomy (MOWHTO). This study aims to evaluate the early radiological outcomes (bone union) and complication rates of the novel patient-specific 3D-printed honeycomb-structured polycaprolactone and tricalcium phosphate (PCL-TCP) synthetic graft compared to allogeneic bone grafts as an osteotomy gap filler in MOWHTO. A retrospective matched-pair analysis of patients who underwent MOWHTO with either PCL-TCP synthetic graft or allogenic femoral head allograft as osteotomy gap filler was performed. The osteotomy gap was split into equal zones (Zone 1-5), and bone union was evaluated on anteroposterior radiographs based on the van Hemert classification at 1, 3, 6, and 12 months postoperatively. Postoperative complications including infection, lateral hinge fractures, and persistent pain was measured. The study and control group were matched for age, smoking status, diabetes mellitus, and osteotomy gap size. Significantly greater bone union progression was observed in the PCL-TCP group than in the allograft group at 1 month (Zones 1-3), 3 months (Zones 1-4), 6 months (Zones 1-2, 4), and 12 months (Zones 2-3, 5) postoperatively (P < 0.05). No significant difference in complications rates was noted between the two groups at 1 year. Bone union rates observed in patients who underwent MOWHTO with the PCL-TCP synthetic graft osteotomy gap filler were superior to those in the allograft group at 1 year postoperatively, with no significant difference in complication rates (postoperative infection, lateral hinge fractures, and persistent pain).

Endothelin-converting Enzyme-1b Genetic Variants Increase the Risk of Coronary Artery Ectasia.

Coronary artery ectasia (CAE), defined as a 1.5-fold or greater enlargement of a coronary artery segment compared to the adjacent normal coronary artery, is frequently associated with atherosclerotic coronary artery disease (CAD). Membrane-bound endothelin converting enzyme-1 (ECE-1) is involved in the maturation process of the most potent vasoconstrictor ET-1. Polymorphisms in the endothelin (ET) gene family have been shown associated with the development of atherosclerosis. This study aims to investigate the effects of rs213045 and rs2038089 polymorphisms in the ECE-1 gene which have been previously shown to be associated with atherosclerosis and hypertension (HT), in CAE patients. Ninety-six CAE and 175 patients with normal coronary arteries were included in the study. ECE-1b gene variations rs213045 and rs2038089 were determined by real-time PCR. The frequencies of rs213045 C > A (C338A) CC genotype (60.4% vs. 35.4%, p < 0.001) and rs2038089 T > C T allele (64.58% vs. 35.42%, p = 0.017) were higher in the CAE group compared to the control group. The multivariate regression analysis showed that the ECE-1b rs213045 CC genotype (p = 0.001), rs2038089 T allele (p = 0.017), and hypercholesterolemia (HC) (p = 0.001) are risk factors for CAE. Moreover, in nondiabetic individuals of the CAE and control groups, it was observed that the rs213045 CC genotype (p < 0.001), and rs2038089 T allele (p = 0.003) were a risk factor for CAE, but this relationship was not found in the diabetic subgroups of the study groups (p > 0.05). These results show that ECE-1b polymorphisms may be associated with the risk of CAE and this relationship may change according to the presence of type II diabetes.

I s pelvic support osteotomy (PSO) suitable for ordinary high-riding hip dysplasia?

Pelvic support osteotomy (PSO) is regarded to provide pelvic stability and improve abductor function to delay or even avoid total hip arthroplasty (THA) in young patients with high-riding hip dysplasia. However, some of these patients eventually have to undergo THA. Because of the double-angulation deformity of the femur after PSO, subsequent THA is challenging. This study aimed to analyze whether PSO surgery is suitable for high-riding hip dysplasia and summarize orthopaedic strategy during THA for patients with previous PSO. This case-control study included eight cases of THA for high-riding hip dysplasia patients with previous PSO (study group) and 24 cases of high-riding hip dysplasia patients without any hip surgical therapy (control group) by a 1:3 match (from May 2018 to January 2022). We compared demographics and joint function before and after THA between two groups and recorded all patients' preoperative imaging data, surgical procedures, postoperative imaging data, and complications. The surgical techniques for patients with previous PSO were highlighted. There was no statistical difference between the two groups in demographic (p > 0.05). The study group had worse hip Harris score (HHS), range of motion (ROM), visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (p < 0.05) compared with the control group before THA. All patients had concurrent THA and osteotomy at the proximal femur, but the study group experienced longer operation time (p = 0.047) with more blood loss (p = 0.027) and higher complication rate compared with the control group (p = 0.009). At the last follow-up, the study group's HHS, ROM, VAS, and WOMAC were still worse than those in the control group. PSO did not improve the joint function of high-riding hip dysplasia patients but brought challenges to subsequent THA and affected the surgical outcomes. In short, we suggested that PSO is unsuitable for routine high-riding hip dysplasia patients.

Interaction between Neurogenic Pulmonary Edema and Thoracic 3 DRG Degeneration Following Spinal Subarachnoid Hemorrhage: First Experimental Study.

Neurogenic pulmonary edema (NPE) following subarachnoid hemorrhage (SAH) is still one of the most catastrophic complications with high morbidity and mortality rates. Systemic sympathetic hyperactivity has been considered in the pathogenesis, but it has not been clarified. In this study, we investigate the relationship between the degeneration of the T3 dorsal root ganglion (DRG) and the development of NPE following spinal SAH. The study was conducted on 23 rabbits. Five rabbits were used as the control group, 5 as the sham group (n = 5), and 13 as the study group. The correlation between the degenerated neuronal densities of the T3 nerve axons and neurons in the DRG and NPE scores was analyzed statistically. A correlation between the neuronal degeneration of the T3 nerve, its DRG, and high NPE scores was found in the study group and the sham group. Massive NPE was detected in the study group along with neural degeneration of T3 axons and ganglia. The present study indicates that NPE and pulmonary artery vasospasm can be prevented by reducing T3 DRG degeneration.

Ventriculoperitoneal Shunt Surgery in Pediatrics: Does Preoperative Skin Antisepsis with Chlorhexidine/Alcohol Reduce Postoperative Shunt Infection Rate?

In pediatrics, shunt infection is considered the most common complication of ventriculoperitoneal (VP) shunt insertion and the main cause of shunt failure. Careful surgical technique and hygienic skin preparations are highly important for prevention of shunt infections. Our objective was to assess the significance of using preoperative chlorhexidine/alcohol as a skin antiseptic in reducing the infection rate in pediatric VP shunts surgery. We conducted a retrospective, case control study of 80 pediatric patients with active hydrocephalus. The control group (a single step of preoperative skin antisepsis using povidone-iodine and isopropyl alcohol) comprised 40 patients who underwent a shunt surgery between January 2019 and June 2020 and the study group (two steps of preoperative skin antisepsis using 2% chlorhexidine gluconate in 70% isopropyl alcohol as a first step followed by povidone-iodine as a second step) comprised 40 patients who underwent a shunt surgery between July 2020 and January 2022. Shunt infection was encountered in 11 (13.7%) patients. It was significantly higher in preterm babies (p = 0.010), patients with a previous shunt revision (p < 0.001), and those with a previous shunt infection (p < 0.001). The incidence of infection was 22.5% in the control group and 5% in study group, with a statistically significant difference (p = 0.023). Two steps of preoperative skin antisepsis, first using chlorhexidine/alcohol and then povidone-iodine scrub solution, may significantly reduce the infection rate in pediatric VP shunt surgeries.

Birth outcomes associated with a natural delivery approach in a perinatal center: A comparative retrospective study.

At our center, natural home-like delivery settings have been established in or near conventional labor wards, for the care of pregnant women who prefer little or no medical intervention during labor and birth. We compared obstetrical and neonatal outcomes of women in active spontaneous labor, between those who chose to deliver in a natural-delivery setup and those who chose a conventional setting. This retrospective study included low-risk women who delivered at term between March 1, 2020 and December 31, 2022, in a single tertiary university affiliated medical center. Birth outcomes were compared between 124 women who delivered by natural birth (the study group) and 244 who gave birth in a conventional setting (the control group). No cesarean deliveries were performed in the study group, compared to 18 (7.4%) of the control group, p = 0.004. Intrapartum fever, postpartum hemorrhage, and uterotonic administration were similar between the groups. For the study compared to the control group, breastfeeding was more common (71.3% vs. 12.3%, p < 0.001), analgesia administration within 48 h delivery was lower (4.1% vs. 10.7%, p = 0.033), and maternal and neonatal length of hospitalization were shorter. Of the women initially admitted to the natural-delivery room, 14 (11.5%) were transferred to a conventional-delivery room. Birth in a hospital natural-delivery setting was associated with increased likelihood of vaginal birth, increased immediate breastfeeding and breastfeeding at discharge, and lower postpartum pain.

A comparative study on the detection of Mycobacterium leprae DNA in urine samples of leprosy patients using Rlep-PCR with other conventional samples.

Mycobacterium leprae causes leprosy that is highly stigmatized and chronic infectious skin disease. Only some diagnostic tools are being used for the identification M. leprae in clinical samples, such as bacillary detection, and histopathological tests. These methods are invasive and often have low sensitivity. Currently, the PCR technique has been used as an effective tool fordetecting M. leprae DNA across different clinical samples. The current study aims to detect M. leprae DNA in urine samples of untreated and treated leprosy patients using the Rlep gene (129 bp) and compared the detection among Ridley-Jopling Classification. Clinical samples (Blood, Urine, and Slit Skin Smears (SSS)) were collected from leprosy and Non-leprosy patients. DNA extraction was performed using standard laboratory protocol and Conventional PCR was carried out for all samples using Rlep gene target and the amplicons of urine samples were sequenced by Sanger sequencing to confirm the Rlep gene target. The M. leprae DNA was successfully detected in all clinical samples across all types of leprosy among all the study groups using RLEP-PCR. Rlep gene target was able to detect the presence of M. leprae DNA in 79.17% of urine, 58.33% of blood, and 50% of SSS samples of untreated Smear-Negative leprosy patients. The statistical significant difference (p = 0.004) was observed between BI Negative (Slit Skin Smear test) and RLEP PCR positivity in urine samples of untreated leprosy group. The PCR positivity using Rlep gene target (129 bp) was highest in all clinical samples among the study groups, across all types of leprosy. Untreated tuberculoid and PNL leprosy patients showed the highest PCR positivity in urine samples, indicating its potential as a non-invasive diagnostic tool for leprosy and even for contact screening.

A systematic review and meta-analysis of circulating serum and plasma microRNAs in TB diagnosis.

Tuberculosis (TB) ranks as the second leading cause of death globally among all infectious diseases. This problem is likely due to the lack of biomarkers to differentiate the heterogeneous spectrum of infection. Therefore, the first step in solving this problem is to identify biomarkers to distinguish the different disease states of an individual and treat them accordingly. Circulating microRNA (miRNA) biomarkers are promising candidates for various diseases. In fact, we are yet to conceptualize how miRNA expression influences and predicts TB disease outcomes. Thus, this systematic review and meta-analysis aimed to assess the diagnostic efficacy of circulating miRNAs in Latent TB (LTB) and Active Pulmonary TB (PTB). Literature published between 2012 and 2021 was retrieved from PubMed, Web of Science, Cochrane, Scopus, Embase, and Google Scholar. Articles were screened based on inclusion and exclusion criteria, and their quality was assessed using the QUADAS-2 tool. Funnel plots and forest plots were generated to assess the likelihood of study bias and heterogeneity, respectively. After the screening process, seven articles were selected for qualitative analysis. The study groups, which consisted of Healthy Control (HC) vs. TB and LTB vs. TB, exhibited an overall sensitivity of 81.9% (95% CI: 74.2, 87.7) and specificity of 68.3% (95% CI: 57.8, 77.2), respectively. However, our meta-analysis results highlighted two potentially valuable miRNA candidates, miR-197 and miR-144, for discriminating TB from HC. The miRNA signature model (miR197-3p, miR-let-7e-5p, and miR-223-3p) has also been shown to diagnose DR-TB with a sensitivity of 100%, but with a compromised specificity of only 75%. miRNA biomarkers show a promising future for TB diagnostics. Further multicentre studies without biases are required to identify clinically valid biomarkers for different states of the TB disease spectrum. PROSPERO (CRD42022302729).

Dietary intake of polish organic and conventional fruit growers and their life partners – a pilot study

Diet is one of the elements that contribute to health and quality of life. There are significant discrepancies between the diets of people living in different regions, with different beliefs, or with different approaches to sustainability and ecology. There is a lack of research on dietary intake among organic and conventional fruit growers. The aim of our study was to examine the diets of orchardists and their immediate life partners in terms of meeting energy requirements, nutrient intake and fulfillment of dietary recommendations in this group. Fifty-three participants (28 in the organic group and 25 in the conventional group) took part in the study. Dietary data were obtained using the 3-day dietary record. Body mass and height were measured and BMI was calculated. Physical activity was estimated using a questionnaire method. The study group was aged 44 ± 8 years, with a body weight of 84 ± 16 kg and a height of 172 ± 9 cm. The mean BMI was 28 ± 4 kg/m2. Mean energy intake with diet was 2170 ± 606 kcal/day with needs of 3002 (1991–5144) kcal/day. A significant proportion of the study group did not fulfill their calcium and vitamin D requirements. In addition, a significant proportion of the conventional fruit growers did not cover their needs for potassium, magnesium and vitamins: E, C, and folate. Both groups had too high an intake of cholesterol and saturated fatty acids, and too low an intake of polyunsaturated fatty acids. In conclusion, the orchardists' diets mostly provided adequate amounts of nutrients, with inadequate intakes of calcium, vitamin D, cholesterol, and fatty acids. The diets of organic fruit growers were significantly richer in selected nutrients.

The experience with subcutaneous allergen-specific immunotherapy with pollen allergens in patients with atopic dermatitis

BACKGROUND: Atopic dermatitis is a chronic inflammatory skin disease, the key pathogenetic mechanisms of which include activation of T2-immune inflammation, IgE-specific sensitization to various allergens, and disruptions of epidermal barrier functions. Allergen-specific immunotherapy is the only pathogenetic treatment method that can prevent the progression of the disease and the development of the atopic march. Currently, clinical experience has been accumulated in using allergen-specific immunotherapy for atopic dermatitis, yet the existing evidence base does not allow for definitive conclusions regarding the indications for conducting allergen-specific immunotherapy, especially in atopic dermatitis associated with pollen allergy.&#x0D; AIMS: Determination of the clinical significance of sensitization to pollen allergens in atopic dermatitis, determination of indications for allergen-specific immunotherapy with pollen allergens and assessment of the effectiveness and safety of this method in atopic dermatitis patients.&#x0D; MATERIALS AND METHODS: A comparative controlled study to evaluate the effectiveness of subcutaneous allergen-specific immunotherapy with pollen allergens of birch or cereal grasses in 78 adult atopic dermatitis patients was conducted. A single course of subcutaneous allergen-specific immunotherapy with water-salt solutions of tree pollen allergens was administered to 33 patients, and grass pollen allergens were administered to 21 patients with atopic dermatitis. The comparison group ― patients with atopic dermatitis who received standard therapy for the disease without allergen-specific immunotherapy ― 24 patients. The primary endpoints of the study were to evaluate the effectiveness of therapy based on the reduction in the severity of atopic dermatitis symptoms, based on the absolute and relative number of patients who achieved a reduction in SCORAD score by 75% and IGA 1/0.&#x0D; RESULTS: In patients receiving one course of subcutaneous allergen-specific immunotherapy with tree pollen allergens, SCORAD 50 achieved 26, 33, 47% and SCORAD 75 achieved 10, 20 and 33% after 16, 32 and 52 weeks, respectively. In patients who received one course of subcutaneous allergen-specific immunotherapy with grass pollen allergens, SCORAD 50 reached 31, 40, 58% and SCORAD 75 ― 14, 28 and 43% after 16, 32 and 52 weeks, respectively. In the comparison group, the number of such patients was significantly smaller: SCORAD 50 reached 24, 32, 37% and SCORAD 75 ― 13, 22 and 26% after 16, 32 and 52 weeks, respectively. Similar results were obtained when studying the IGA. In all study groups, an improvement in the quality of life of patients was noted, which was reflected in a decrease in the DLQI index by 4 or more points in 12, 25 and 37% of patients receiving one course of subcutaneous allergen-specific immunotherapy with tree pollen allergens, in 14, 28 and 43% in patients after 16, 32 and 52 weeks, respectively. However, the number of such patients in the comparison group was significantly lower: 13, 22 and 26%, respectively.&#x0D; CONCLUSION: Allergen-specific immunotherapy is an effective way to treat atopic dermatitis patients, provided there is proven sensitization to pollen allergens.

Eosinophil-Count-Derived Inflammatory Markers and Psoriasis Severity: Exploring the Link

Psoriasis is an immune-mediated disease, with various triggering factors, genetic predisposition, and an altered immune response concurring in the development of this disease. The eosinophil is a cell with an important role in various kinds of inflammatory processes. Scarce data are available regarding the role of the eosinophil in psoriasis. This study aims to address the overall relationship between eosinophil-count-derived inflammatory markers and psoriasis severity. There were 366 patients fulfilling the inclusion criteria included in this retrospective study and they were divided based on the body surface area (BSA) scale in mild and moderate-to-severe psoriasis. White blood cell (WBC), neutrophil, lymphocyte, monocyte, and eosinophil count, along with eosinophil-to-monocyte ratio (EMR) and eosinophil-to-neutrophil ratio (ENR) differed significantly between the two study groups. Eosinophil count, EMR, and ENR negatively correlated with disease severity. ENR is the most reliable eosinophil-count-derived marker in assessing psoriasis severity with an AUC of 0.627 and a cut-off value of 0.03. Eosinophil-count-derived inflammatory markers’ usefulness in appreciating disease severity was assessed for the first time in the literature in this study and proved to be reliable for the eosinophil count, EMR, and ENR.

Simultaneous Co-surgeon Deep Inferior Epigastric Perforator (DIEP) Flap Breast Reconstructions: Feasibility and Clinical Outcomes.

A co-surgeon model is known to be favorable in microvascular breast reconstruction, but simultaneous co-surgeon deep inferior epigastric perforator (DIEP) flap cases have not been well-studied. The authors hypothesize that performing two simultaneous co-surgeon bilateral DIEP flap reconstructions results in non-inferior clinical outcomes and may improve patient access to care. A single-institution, retrospective cohort study was performed utilizing record review to identify all cases of co-surgeon free-flap breast reconstructions over a 38-month period. Patients who underwent simultaneous bilateral DIEP flap breast reconstructions with the same two co-surgeons were identified. The control group consisted of subjects who underwent non-simultaneous reconstruction by the same co-surgeons within the same, preceding, or following month of those in the study group. Primary outcome variables were 90-day postoperative complications, while secondary outcomes were operating time, ischemia time, and length of stay. Descriptive statistics, univariate and multivariable regression analyses were performed. Overall, 137 subjects were identified and 64 met the inclusion criteria (n=28 study, n=36 control). There were no statistically significant differences between groups in body mass index, radiation, trainee experience, flap perforator number, immediate/delayed reconstruction, or length of stay. There were also no statistically significant differences in complications, including flap loss, anastomosis revision, take-back to the operating room, or re-admission. Operative time was longer in the simultaneous DIEP group (540.5 vs. 443.5 min, p<0.01), but ischemia time was shorter in the simultaneous group (64.0 vs. 80.5min, p<0.01). A simultaneous co-surgeon approach to bilateral DIEP flap reconstruction may improve access to care and does not result in a higher complication rate compared with non-simultaneous bilateral DIEP flaps.

The outcomes of laparoscopic omentum-preserving gastrectomy compared to open surgery with omentectomy in gastric cancer patients: a propensity score matched study of 249 UICC stage 0-IV gastric cancer patients.

We performed a propensity score matched study comparing patients' short- and long-term results after laparoscopic omentum-preserving gastrectomy and open surgery with omentectomy with UICC stages 0-IV. Between 2015 and 2022, 311 patients with gastric cancer underwent surgery at the University Clinical Centre Maribor. Of these, 249 met the inclusion criteria and 198 were included in the study group after PSM. Patients in both groups were well-balanced in demographic and pathological characteristics after PSM. There was no significant difference in the 5-year survival between groups (LAP: 62.2% vs. OPN: 54.4%; p = 0.950). The Cox regression model identified UICC stage and age as significant predictors for survival. In both groups, peritoneal dissemination was the most common site of recurrence. The multivariate analysis identified the UICC stage as a significant predictor for peritoneal recurrence, while omental preservation was not associated with a higher risk of peritoneal dissemination. Omentum preservation was not associated with more intestinal obstruction. Patients in the LAP group had significantly shorter hospital stays (LAP: 9(6) vs. OPN: 10(5); p = 0.009), less postoperative morbidity (LAP: 17% vs. OPN: 23.4%; p = 0.009), and significantly more extracted LNs per operation compared to open surgery (LAP: 31 ± 11 LNs vs. OPN: 25 ± 12 LNs; p = 0.002). Based on our results, we recommend the use of laparoscopic omentum-preserving gastrectomy in patients with early and advanced gastric cancer.

Nosological approaches in studying the incidence rate among dental healthcare workers

AbstractThis paper is aimed at a comprehensive study of the incidence of dentists in the Turkestan region of the Republic of Kazakhstan using the screening study method. The study included 200 dentists from 12 outpatient clinics in Shymkent city, Turkestan region (South Kazakhstan). Data on visits to doctors in the period from 2015 to 2022 were used to investigate the incidence. The average long‐term value of morbidity coefficients among the studied medical workers was 995.9 ± 9.9 cases per 1000 people over 7 years. The analysis of the structure of diseases was carried out based on information obtained from sick leave records of the study group of dentists for the period from 2015 to 2022. The dental profession has its own characteristics; the unfavorable factors identified during the study can be divided into three groups: factors related to the treatment process; factors related to the organization of premises in dental clinics; factors related to insufficient ergonomics of dental equipment and instruments; and the quality of filling and dental materials. Six of the same classes of diseases play a leading role in the structure of diseases identified during medical examinations, but their significance is different: in the first place are diseases associated with increased psychological stress (circulatory disorders, psychoneuroses, diseases of the digestive system), diseases associated with forced working position (musculoskeletal diseases).

Optimized Cytogenetic Risk-Group Stratification of KMT2A-Rearranged Pediatric Acute Myeloid Leukemia.

Comprehensive international consensus on cytogenetic risk-group stratification of KMT2A-rearranged (KMT2A-r) pediatric acute myeloid leukemia (AML) is lacking. This retrospective (2005-2016) International Berlin-Frankfurt-Münster Study Group study on 1,256 children with KMT2A-r AML aimed to validate the prognostic value of established recurring KMT2A fusions and additional cytogenetic aberrations (ACAs), and secondly, to define additional, recurring KMT2A fusions and ACAs, evaluating their prognostic relevance. Compared to our previous study, three additional, recurring KMT2A-r groups were defined: Xq24/KMT2A::SEPT6, 1p32/KMT2A::EPS15, 17q12/t(11;17)(q23;q12). Across 13 KMT2A-r groups, 5-year event-free survival probabilities varied significantly (21.8% to 76.2%; P<0.01). ACAs occurred in 46.8% of 1,200 patients with complete karyotypes, correlating with inferior overall survival (56.8% vs 67.9%; P<0.01). Multivariable analyses confirmed independent associations of 4q21/KMT2A::AFF1, 6q27/KMT2A::AFDN, 10p12/KMT2A::MLLT10, 10p11.2/KMT2A::ABI1, and 19p13.3/KMT2A::MLLT1 with adverse outcomes, but not those of 1q21/KMT2A::MLLT11 and trisomy 19 with favorable and adverse outcomes, respectively. Newly identified ACAs with independent adverse prognoses were monosomy 10, trisomies 1, 6, 16, and X, add(12p), and del(9q). Among patients with 9p22/KMT2A::MLLT3, the independent association of French-American-British-type M5 with favorable outcome was confirmed, and those of trisomy 6 and measurable residual disease at end of induction with adverse outcomes were identified. We provide evidence to incorporate the five adverse-risk KMT2A fusions into the cytogenetic risk-group stratification of KMT2A-r pediatric AML, to revise the favorable-risk classification of 1q21/KMT2A::MLLT11 to intermediate risk, and to refine risk-stratification of 9p22/KMT2A::MLLT3 AML. Future studies should validate the associations between the newly identified ACAs and outcome, and unravel the underlying biological pathogenesis of KMT2A fusions and ACAs.

Impact of pesticide use on farmers health condition: case control design

With global populations growing, it is becoming increasingly impossible to ignore food and energy demands. Livestock and agricultural activities produce a large quantity of food. Though the use of agrochemicals has increased agricultural output, they have also been linked to a number of harmful clear adverse effects on human. chemical Pesticides poisonous compounds that negative effect on consumers. the study conducted a case-control was carried out to investigate variations among intact groups on an independent variable of interest. A random sampling approach was employed for 201 farmers. 098Farmers in the research group were exposed to pesticides, whereas farmers in the control group did not apply pesticides. The data were gathered using a survey (PHQ-15)-based on interviews conducted by the investigator. The current study was carried out in five districts (Al-Mashkhab, Al-Abbasiya, Al-hrea, Al-hera, and Al-qadisya). According to the study findings, total farmers' reactions to general physical condition among study group participants are substantially influenced, however, participant of control group show not effected. The negative health effect for farmers spray and exposed to pesticides shows nausea or vomiting, blurred vision, headache, bronchial sensitivity, skin irritation, and shortness of breath eye irritation. the current survey show the Insecticides are the most often used chemicals. The research indicated that pesticide use and exposure have an influence on human health and have a wide range of adverse health effects. According to the findings of the current study, it is critical to use personal protection equipment (PPE) while spraying. Also, undertake a comprehensive exam on farmers on a regular basis.