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1.
PLoS One ; 19(6): e0304843, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38838047

RESUMO

Imaging modalities for percutaneous coronary intervention (PCI), such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT), have increased in the current PCI era. However, their clinical benefits in acute myocardial infarction (AMI) have not been fully elucidated. This study investigated the long-term outcomes of image-guided PCI in patients with AMI using data from the Korean Acute Myocardial Infarction Registry. A total of 9,271 patients with AMI, who underwent PCI with second-generation drug-eluting stents between November 2011 and December 2015, were retrospectively examined, and target lesion failure (TLF) at 3 years (defined as the composite of cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization) was evaluated. From the registry, 2,134 patients (23.0%) underwent image-guided PCI (IVUS-guided: n = 1,919 [20.6%]; OCT-guided: n = 215 patients [2.3%]). Based on propensity score matching, image-guided PCI was associated with a significant reduction in TLF (hazard ratio: 0.76; 95% confidence interval: 0.59-0.98, p = 0.035). In addition, the TLF incidence in the OCT-guided PCI group was comparable to that in the IVUS-guided PCI group (5.3% vs 4.7%, p = 0.903). Image-guided PCI, including IVUS and OCT, is associated with favorable clinical outcomes in patients with AMI at 3 years post-intervention. Additionally, OCT-guided PCI is not inferior to IVUS-guided PCI in patients with AMI.


Assuntos
Infarto do Miocárdio , Intervenção Coronária Percutânea , Sistema de Registros , Tomografia de Coerência Óptica , Humanos , Intervenção Coronária Percutânea/métodos , Masculino , Feminino , República da Coreia/epidemiologia , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/terapia , Infarto do Miocárdio/cirurgia , Pessoa de Meia-Idade , Idoso , Resultado do Tratamento , Tomografia de Coerência Óptica/métodos , Estudos Retrospectivos , Ultrassonografia de Intervenção/métodos , Stents Farmacológicos , Cirurgia Assistida por Computador/métodos
3.
Chemosphere ; 355: 141859, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38561161

RESUMO

To promptly and simply create highly crystalline S/C co-doped TiO2 (SC-TiO2) photocatalysts at room temperature and atmospheric pressure, we suggest a novel plasma-assisted sol-gel synthesis method. This method is a simultaneous synthetic process, in which an underwater plasma undergoes continuous reactions to generate high-energy atomic and molecular species that enable TiO2 to achieve crystallinity, a large surface area, and a heterogeneous structure within a few minutes. In particular, it was demonstrated that the heterogeneously structured TiO2 was formed by doping that sulfur and carbon replace O or Ti atoms in the TiO2 lattice depending on the composition of the synthesis solution during underwater plasma treatment. The resultant SC-TiO2 photocatalysts had narrowed bandgap energies and extended optical absorption scope into the visible range by inducing the intermediate states within bandgap due to generation of oxygen vacancies on the surface of TiO2 through synthesis, crystallization, and doping. Correspondingly, SC-TiO2 showed a significant degradation efficiency ([k] = 6.91 h-1) of tetracycline (TC, antibiotics) under solar light irradiation, up to approximately 4 times higher compared to commercial TiO2 ([k] = 1.68 h-1), resulting in great water purification. Therefore, we anticipate that this underwater discharge plasma system will prove to be an advantageous technique for producing heterostructural TiO2 photocatalysts with superior photocatalytic efficiency for environmental applications.


Assuntos
Carbono , Luz , Carbono/química , Antibacterianos , Tetraciclina , Enxofre , Titânio/química , Catálise
4.
Injury ; 55(2): 111285, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38134489

RESUMO

INTRODUCTION: Inability to drive a motor vehicle due to lower extremity injury is a major inconvenience. Timing of safe return to driving has not been much studied. Objective measurements such as time to brake (TTB) have been proposed; however, utility and concordance of functional outcome measurements have not been previously evaluated. The purpose of this project is to measure these parameters and to assess for associations with ability to safely return to driving, improving the ability of clinicians to assess for measurements of driving readiness without specifically measuring TTB. METHODS: A prospective, cohort study of 232 patients with complex lower extremity injuries to the pelvis, acetabulum, hip, femur, knee, tibia, ankle, and foot was performed. Time to brake (TTB) was measured once weightbearing was allowed. Function was assessed by the Musculoskeletal Function Assessment (MFA) questionnaire, and pain, mobility, and physical functions, via patient reported outcome measurement information system (PROMIS) surveys. RESULTS: Patients with longer TTB had significantly elevated MFA scores indicating increased musculoskeletal dysfunction post-injury. As the MFA score increased by 1 point, TTB increased by 0.013 s (p<0.001). PROMIS metrics were also significantly associated with patients experiencing more pain and worse mobility as TTB increased. DISCUSSION: Many patients continue to exhibit musculoskeletal dysfunction several months post-treatment for complex lower extremity injuries. Patients with better PROMIS metrics and MFA scores, and shorter TTB are more appropriate to return to driving. Surgeons may be better informed about safe driving ability by considering these measurements. LEVEL OF EVIDENCE: II.


Assuntos
Traumatismos da Perna , Humanos , Estudos Prospectivos , Estudos de Coortes , Extremidade Inferior/lesões , Dor , Medidas de Resultados Relatados pelo Paciente
5.
Medicine (Baltimore) ; 102(41): e35548, 2023 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-37832124

RESUMO

The effects of cholesterol variability on cataracts, dementia, and osteoporosis remain controversial. Using a common data model, we investigated the effects of variations in cholesterol levels on the development of cataracts, dementia, and osteoporosis. Patients who received statin therapy between 2011 and 2020 and those with 3 or more tests for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were included. The patients were divided into those with a coefficient of variation (CV) of TC higher than the mean (high-CV group) and those with a lower CV of TC (low-CV group). Moreover, 1:1 propensity score matching was conducted based on demographic variables. Cataract, dementia, or osteoporosis was defined as having a diagnostic, drug, or surgical code based on the cohort definition. Of the 12,882 patients, cataracts, dementia, and osteoporosis were developed in 525 (4.1%), 198 (1.5%), and 438 (3.4%) patients, respectively. The stratified Cox proportional hazards model showed that the incidences of cataracts and osteoporosis were 1.38 and 1.45 times greater in the high-CV group than in the low-CV group, respectively. Our study revealed that TC variability is associated with developing cataracts and osteoporosis.


Assuntos
Doenças Cardiovasculares , Catarata , Demência , Osteoporose , Humanos , Doenças Cardiovasculares/epidemiologia , Incidência , Colesterol , HDL-Colesterol , Demência/epidemiologia , Catarata/epidemiologia , Osteoporose/epidemiologia , Triglicerídeos
6.
Sci Rep ; 13(1): 16069, 2023 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-37752202

RESUMO

Nonalcoholic fatty liver disease (NAFLD) can lead to a prothrombotic state, which significantly burdens public healthcare systems. This study investigated the relationship between NAFLD and the incidence of venous thromboembolism (VTE) in Korea using National Health Insurance Service-National Sample Cohort 2.0 data. A population-based retrospective cohort analysis was conducted on 472,212 healthy individuals who underwent national health check-ups in Korea from 2009 to 2014. NAFLD was defined using the fatty liver index (FLI). Multivariate Cox proportional hazards regression models were used to analyze the association between FLI and VTE. Individuals were categorized into four quartiles according to FLI values (first quartile [Q1], 0-5.7; second quartile [Q2], 5.8-15.3; third quartile [Q3], 15.4-37.2; and fourth quartile [Q4], > 37.2). The incidence of VTE tended to increase with increasing FLI values (Q1, 598 [0.5%]; Q2, 1,033 [0.9%]; Q3, 1,443 [1.2%]; and Q4, 1,425 [1.2%]). In the age- and sex-adjusted multivariate model, the hazard ratio (HR) (95% confidence interval [CI]) was 1.47 (1.33‒1.62) for Q4 compared with Q1. After adjusting for clinical variables with P < 0.1 in the univariate analyses, the HR (95% CI) was 1.45 (1.30‒1.62) for Q4 compared with Q1. FLI was related to VTE risk, as confirmed after adjusting for other risk factors.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Tromboembolia Venosa , Trombose Venosa , Adulto , Humanos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Tromboembolia Venosa/epidemiologia , Estudos Retrospectivos , República da Coreia/epidemiologia
7.
J Clin Hypertens (Greenwich) ; 25(9): 828-844, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37584254

RESUMO

The authors performed this study to investigate the efficacy and safety of a rosuvastatin (RSV)/amlodipine (AML) polypill compared with those of atorvastatin (ATV)/AML polypill. We included 259 patients from 21 institutions in Korea. Patients were randomly assigned to 1 of 3 treatment groups: RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, or ATV 20 mg /AML 5 mg. The primary endpoint was the efficacy of the RSV 10.20 mg/AML 5 mg via percentage changes in LDL-C after 8 weeks of treatment, compared with the ATV 20 mg /AML 5 mg. There was a significant difference in the mean percentage change of LDL-C at 8 weeks between the RSV 10 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (full analysis set [FAS]: -7.08%, 95% CI: -11.79 to -2.38, p = .0034, per-protocol analysis set [PPS]: -6.97%, 95% CI: -11.76 to -2.19, p = .0046). Also, there was a significant difference in the mean percentage change of LDL-C at 8 weeks between the RSV 20 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (FAS: -10.13%, 95% CI: -15.41 to -4.84, p = .0002, PPS: -10.96%, 95% CI: -15.98 to -5.93, p < .0001). There was no significant difference in the adverse events rates between RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, and ATV 20 mg/AML 5 mg. In conclusion, while maintaining safety, RSV 10 mg/AML 5 mg and the RSV 20 mg/AML 5 mg more effectively reduced LDL-C compared with the ATV 20 mg /AML 5 mg (Clinical trial: NCT03951207).


Assuntos
Dislipidemias , Hipertensão , Leucemia Mieloide Aguda , Humanos , Rosuvastatina Cálcica/efeitos adversos , Atorvastatina/efeitos adversos , Anlodipino/efeitos adversos , Hipertensão/tratamento farmacológico , Hipertensão/induzido quimicamente , LDL-Colesterol , Dislipidemias/tratamento farmacológico , Leucemia Mieloide Aguda/induzido quimicamente , Método Duplo-Cego , Resultado do Tratamento
8.
J Lipid Atheroscler ; 12(2): 152-163, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37265852

RESUMO

Objective: Lipoprotein(a) (Lp[a]) and the atherogenic index of plasma (AIP) have been reported as predictive markers of coronary artery calcium (CAC). However, previous studies demonstrated that the cardiovascular risk associations with Lp(a) are attenuated in patients with low-density lipoprotein cholesterol (LDL-C) levels ≤135 mg/dL. However, few articles have identified the risk factors of CAC in patients without high LDL-C. Therefore, we performed this study to investigate the association of Lp(a) and AIP with CAC in patients with LDL-C levels ≤135 mg/dL. Methods: This study included 625 lipid-lowering agent naive patients with LDL-C levels ≤135 mg/dL who underwent coronary computed tomographic angiography. We performed multivariate logistic regression analysis to evaluate the risk factors for a coronary artery calcium score (CACS) >0, CACS ≥400, and CAC ≥90th percentile. Results: The mean age of the patients was 55.0±7.9 years and their mean LDL-C level was 94.7 ±23.3 mg/dL. Multivariate regression analysis showed that age, male sex, diabetes, hypertension, Lp(a), and AIP were independent predictors of CAS>0. Age, male sex, and diabetes were independent predictors of CACS≥400. Diabetes, hypertension, and AIP were independent predictors of CAC ≥90th percentile (all p<0.05). Unlike Lp(a), higher AIP tertiles were associated with significantly higher CAC percentiles and greater proportions of patients with CACS ≥400 and CAC ≥90th percentile. Conclusion: In patients without high LDL-C, AIP could be a more reliable predictor of CAC than Lp(a).

9.
Artigo em Inglês | MEDLINE | ID: mdl-37026753

RESUMO

INTRODUCTION: No guidelines exist for recommending return to driving. This study will examine time to brake (TTB) after lower extremity injuries versus in uninjured people. The potential effect of various types of lower extremity injuries on TTB will be measured. METHODS: Patients with injuries to the pelvis, hip, femur, knee, tibia, ankle, and foot underwent testing using a driving simulator to assess TTB. Comparison was with a control group of uninjured people. RESULTS: Two-hundred thirty-two patients with lower extremity injuries participated. The majority were in the tibia and ankle regions (47%). Mean TTB for control subjects was 0.74 seconds, compared with 0.83 for injured patients, noting a 0.09-second difference (P = 0.017). Left-sided injuries averaged TTB of 0.80 seconds, right-sided injuries averaged TTB of 0.86 seconds, and bilateral injuries averaged TTB of 0.83 seconds, all prolonged versus control subjects. The longest TTB was exhibited after ankle and foot injuries (0.89 seconds) while the shortest was after tibial shaft fractures (0.76 seconds). DISCUSSION: Any lower extremity injury caused a prolonged TTB compared with control patients. Left, right, and bilateral injuries all had longer TTB. Ankle and foot injuries experienced the longest TTB. Additional investigation is warranted to develop safe guidelines for return to driving.


Assuntos
Condução de Veículo , Traumatismos do Pé , Traumatismos da Perna , Fraturas da Tíbia , Humanos , Extremidade Inferior/lesões , Tornozelo , Fraturas da Tíbia/diagnóstico por imagem
10.
Medicine (Baltimore) ; 101(22): e29151, 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35665724

RESUMO

BACKGROUND: Neck pain and functional impairment are common complications of traffic accidents (TAs); however, the effects of manual therapy on these symptoms have rarely been studied in the literature. Thus, this randomized controlled trial aims to assess the effectiveness and safety of non-resistance manual therapy (NRT)-a treatment combining mobilization and pressure release techniques-on acute neck pain caused by TA. METHOD: This study will use a two-armed, parallel, assessor-blinded randomized controlled trial design and will be conducted in the Daejeon Jaseng Hospital of Korean Medicine in South Korea. One hundred twenty patients will be recruited and randomized into an integrative Korean medicine treatment (IMKT) + NRT group and IMKT group in a 1:1 ratio. The primary outcome is a change in the numeric rating scale for neck pain immediately after treatment on hospital day 5 compared to those at baseline. The secondary outcomes are numeric rating scale for radiating arm pain, visual analogue scale for neck pain and radiating arm pain, cervical active range of motion, neck disability index, Patient Global Impression of Change, Short Form-12 Health Survey, and Posttraumatic Stress Disorder Checklist for DSM-5. DISCUSSION: The findings of this study on the effectiveness and safety of NRT will be helpful for patients with TA-induced neck pain in clinical practice and will provide evidence for developing relevant healthcare-related policies. TRIAL REGISTRATION: This protocol has been registered at Clinicaltrials.gov (NCT04660175).


Assuntos
Terapia por Acupuntura , Dor Aguda , Manipulações Musculoesqueléticas , Acidentes de Trânsito , Terapia por Acupuntura/métodos , Dor Aguda/etiologia , Humanos , Pacientes Internados , Manipulações Musculoesqueléticas/métodos , Cervicalgia/diagnóstico , Cervicalgia/etiologia , Cervicalgia/terapia , Resultado do Tratamento
11.
Acta Orthop Traumatol Turc ; 56(3): 232-235, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35703514

RESUMO

Compared to other lateral soft tissue release methods during hallux valgus surgery, the medial transarticular approach has the advantages of being reproducible, safe, and simple. However, a few reports have described the disadvantages of medial transarticular lateral soft tissue release, including only inadequate lateral soft tissue release. Herein, we report a case of intermetatarsal neuroma in the first web space after hallux valgus correction using distal chevron metatarsal osteotomy and medial transarticular lateral soft tissue release. This case report aimed to highlight the possibility of nerve damage due to medial transarticular lateral soft tissue release during hallux valgus correction surgery.


Assuntos
Joanete , Hallux Valgus , Ossos do Metatarso , Neuroma , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Humanos , Ossos do Metatarso/cirurgia , Neuroma/etiologia , Neuroma/cirurgia , Osteotomia/efeitos adversos , Osteotomia/métodos , Radiografia , Resultado do Tratamento
12.
Biomed Res Int ; 2021: 3501770, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34840970

RESUMO

The hypothalamus plays a central role in the integrated regulation of feeding and energy homeostasis. The hypothalamic arcuate nucleus (ARC) contains a population of neurons that express orexigenic and anorexigenic factors and is thought to control feeding behavior via several neuronal circuits. In this study, a comparative proteomic analysis of low-fat control diet- (LFD-) and high-fat diet- (HFD-) induced hypothalamic ARC was performed to identify differentially expressed proteins (DEPs) related to changes in body weight. In the ARC in the hypothalamus, 6621 proteins (FDR < 0.01) were detected, and 178 proteins were categorized as DEPs (89 upregulated and 89 downregulated in the HFD group). Among the Gene Ontology molecular function terms associated with the DEPs, protein binding was the most significant. Fibroblast growth factor receptor substrate 2 (Frs2) and SHC adaptor protein 3 (Shc3) were related to protein binding and involved in the neurotrophin signaling pathway according to Kyoto Encyclopedia of Genes and Genomes analysis. Furthermore, high-precision quantitative proteomic analysis revealed that the protein profile of the ARC in mice with HFD-induced obesity differed from that in LFD mice, thereby offering insight into the molecular basis of feeding regulation and suggesting Frs2 and Shc3 as novel treatment targets for central anorexigenic signal induction.


Assuntos
Núcleo Arqueado do Hipotálamo/metabolismo , Obesidade/metabolismo , Proteoma/metabolismo , Animais , Peso Corporal , Dieta com Restrição de Gorduras , Dieta Hiperlipídica/efeitos adversos , Modelos Animais de Doenças , Regulação para Baixo , Comportamento Alimentar , Ontologia Genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fatores de Crescimento Neural/genética , Fatores de Crescimento Neural/metabolismo , Proteínas do Tecido Nervoso/genética , Proteínas do Tecido Nervoso/metabolismo , Obesidade/etiologia , Obesidade/genética , Ligação Proteica , Proteoma/genética , Proteômica , Transdução de Sinais , Regulação para Cima
13.
Clin Shoulder Elb ; 24(3): 125-134, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34488292

RESUMO

BACKGROUND: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. METHODS: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. RESULTS: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. CONCLUSIONS: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

14.
Nat Commun ; 12(1): 4334, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34267194

RESUMO

Structural and morphological control of crystalline nanoparticles is crucial in the field of heterogeneous catalysis and the development of "reaction specific" catalysts. To achieve this, colloidal chemistry methods are combined with ab initio calculations in order to define the reaction parameters, which drive chemical reactions to the desired crystal nucleation and growth path. Key in this procedure is the experimental verification of the predicted crystal facets and their corresponding electronic structure, which in case of nanostructured materials becomes extremely difficult. Here, by employing 31P solid-state nuclear magnetic resonance aided by advanced density functional theory calculations to obtain and assign the Knight shifts, we succeed in determining the crystal and electronic structure of the terminating surfaces of ultrafine Ni2P nanoparticles at atomic scale resolution. Our work highlights the potential of ssNMR nanocrystallography as a unique tool in the emerging field of facet-engineered nanocatalysts.

15.
SICOT J ; 7: 29, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33929313

RESUMO

OBJECTIVE: The purpose of this study was to characterize and compare risk behaviors between motorcyclists and motor vehicle drivers who were involved in accidents and required hospitalization. The study focused on patients who were recently involved in motorcycle collisions (MCCs) and motor vehicle collisions (MVCs). METHODS: We identified 63 patients involved in MCCs and 39 patients involved in MVCs who were admitted to our level-1 trauma center from April 2014 to September 2015. These 102 patients completed a questionnaire designed to evaluate risky driving behaviors. Pearson's chi-squared tests and unpaired two-tailed t-tests were used to evaluate categorical and normally distributed continuous variables, respectively. Multivariable linear regression was used to analyze predictors of risk behavior. Significance was set at p < 0.05. RESULTS: When compared to patients involved in an MCC, patients involved in MVCs were more likely to be female (p = 0.007), drive more frequently (p < 0.001), and never perceive the risk of an accident (p = 0.036). MVC patients were more likely to have admitted to substance use on the day of the accident (p = 0.030), historically drive under the influence of drugs (p = 0.031), drive while tired (p < 0.001), drive while text messaging (p < 0.001), and speed while overtaking vehicles (p = 0.011). Overall, MVC patients engaged in more risk behaviors (3.3 ± 1.3 vs. 2.0 ± 1.5; p < 0.001) and were more likely to engage in multiple risk behaviors (p < 0.001). MVCs were associated with increased risk behavior, even after controlling for protective behaviors, driving history, and demographics (p = 0.045). CONCLUSIONS: Within our cohort of trauma patients at our institution, motor vehicle drivers were more likely than motorcyclists to engage in any one risk behavior and engage in a higher number of risk behaviors. In addition, motor vehicle drivers perceived their risk of a potential accident as lower than riding a motorcycle. Education initiatives should focus on motor vehicle driver safety interventions that reduce risk behaviors.

16.
Clin Orthop Relat Res ; 479(3): 506-517, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32401002

RESUMO

BACKGROUND: Most cancer centers prefer preoperative radiation therapy (preRT) over postoperative therapy to treat soft-tissue sarcoma (STS) to limit long-term fibrosis, joint stiffness, and edema. Surgery is often delayed after preRT to allow for tissue recovery and to reduce wound complications. However, the association between the time interval between preRT and surgery and survival is unknown. QUESTIONS/PURPOSES: (1) What factors are associated with the preRT-surgery interval in patients with STS? (2) Is the preRT-surgery interval associated with overall survival? METHODS: The National Cancer Database, a nationwide registry that includes 70% of all new cancers in the United States with 90% follow-up, was reviewed to identify 6378 patients who underwent preRT and surgical resection for a localized extremity or pelvic STS from 2004 to 2014. Patients were excluded if they had lymphatic or metastatic disease at diagnosis (23%; n = 1438), underwent neoadjuvant chemotherapy (24%; 1531), were missing vital status (8%; 487), had chemosensitive histologies (9%; 603), underwent radiation other than external beam (1%; 92), were missing preRT-surgery interval (1%; 45), or had a preRT-surgery interval greater than 120 days (< 1%; 6). A total of 2176 patients were included for analysis, with a mean preRT-surgery interval of 35 ± 16 days. A multiple linear regression model was generated to assess demographic, clinicopathologic, and treatment characteristics associated with the preRT-surgery interval. A Kaplan-Meier survival analysis was then conducted, stratified by the preRT-surgery interval, to assess survival over 10 years. Finally, a multivariate Cox regression analysis model was constructed to further evaluate the association between the preRT-surgery interval and overall survival, adjusted for demographic, clinicopathologic, and treatment characteristics. RESULTS: A longer preRT-surgery interval was associated with higher age (ß = 0.002 per year [95% CI 0.0 to 0.004]; p = 0.026), tumor location in the pelvis (compared with the lower extremity; ß = 0.15 [95% CI 0.082 to 0.22]; p < 0.001), and malignant peripheral nerve sheath tumor subtype (compared with undifferentiated pleomorphic sarcoma; ß = 0.17 [95% CI 0.044 to 0.29]; p = 0.008). A shorter preRT-surgery interval was associated with higher facility volume (ß = -0.002 per case [95% CI -0.003 to -0.002]; p = 0.026) and higher tumor stage (compared with Stage I; ß = -0.066 [95% CI -0.13 to -0.006]; p = 0.03 for Stage II; ß = -0.12 [95% CI -0.17 to -0.065]; p < 0.001 for Stage III). The 5-year overall survival rates were similar across all preRT-surgery interval groups: less than 3 weeks (66% [95% CI 60 to 72]), 3 to 4 weeks (65% [95% CI 60 to 71]), 4 to 5 weeks (65% [95% CI 60 to 71]), 5 to 6 weeks (66% [95% CI 60 to 72]), 6 to 7 weeks (63% [95% CI 54 to 72]), 7 to 9 weeks (66% [95% CI 58 to 74]), and more than 9 weeks (59% [95% CI 48 to 69]). Over 10 years, no difference in overall survival was observed when stratified by the preRT-surgery interval (p = 0.74). After controlling for potentially confounding variables, including age, sex, Charlson/Deyo comorbidity score, histology, tumor size, stage and surgery type, the preRT-surgery interval was not associated with survival (hazard ratio = 1 per day [95% CI 1 to 1]; p = 0.88). CONCLUSION: With the numbers available, this study demonstrates that a delay in surgery up to 120 days after radiation is not associated with poorer survival. Therefore, clinicians may be able to delay surgery to minimize the risks of wound complications and modifiable comorbidities without affecting overall survival.Level of Evidence Level III, therapeutic study.


Assuntos
Procedimentos Ortopédicos/mortalidade , Radioterapia Adjuvante/mortalidade , Sarcoma/mortalidade , Neoplasias de Tecidos Moles/mortalidade , Fatores de Tempo , Adolescente , Adulto , Bases de Dados Factuais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Modelos de Riscos Proporcionais , Radioterapia Adjuvante/métodos , Sistema de Registros , Estudos Retrospectivos , Sarcoma/terapia , Neoplasias de Tecidos Moles/terapia , Taxa de Sobrevida , Resultado do Tratamento , Estados Unidos/epidemiologia , Adulto Jovem
17.
J Colloid Interface Sci ; 588: 646-656, 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33267951

RESUMO

HYPOTHESIS: Here, FePd magnetic nanoparticles (MNPs) are developed as artificial enzymes with high biocompatibility and reusability. EXPERIMENT: The nanoparticles (NPs) are synthesized in an aqueous solvent by one-pot synthesis utilizing glutathione (GSH) and cysteine (Cys) as surfactants. FINDINGS: The prepared hydrophilic FePd NPs are redispersible in water. Further, they exhibit catalytic activity for the degradation of rhodamine B (RhB), as well as for the inhibition of reactive oxygen species (ROS) production induced by H2O2, which are two- and seven-fold enhancements of their catalytic performances, respectively, compared with that of horseradish peroxidase. The computational simulation and electrochemical analysis indicate that the enhancement of the catalytic effect is due to the protection of the MNP surface by GSH and Cys. In vitro experiments reveal that FePd MNPs behave like a peroxidase and decrease the ROS in mammalian cells. The cytotoxicity assessment of FePd MNPs via exposures to different cell lines for over seven days indicates that they can maintain the cell viability of >90% for up to 20 µgmL-1 concentration. FePd MNPs with high saturation magnetization and biocompatibility can be utilized as recyclable peroxidase-mimicking nanozymes and biosensors in a variety of catalytic and biological applications.


Assuntos
Nanopartículas de Magnetita , Paládio , Espécies Reativas de Oxigênio , Rodaminas , Animais , Peróxido de Hidrogênio , Ferro , Rodaminas/química
18.
Clin Shoulder Elb ; 23(4): 201-204, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33330259

RESUMO

Calcific tendinitis of the shoulder joint, also known as chemical furuncle of the shoulder, causes intense shoulder pain and usually occurs within 1-2 cm from the insertion of the rotator cuff. We experienced a rare case of calcific tendinitis in the posterosuperior labrum of the shoulder joint in a 39-year-old male patient who presented with severe pain and weakness in the right shoulder. Radiographs and magnetic resonance imaging (MRI) findings showed calcific tendinitis in the posterosuperior labrum of the shoulder joint. A 1-week attempt at conservative treatment failed, so the calcified deposit in the posterosuperior labrum was arthroscopically removed. The patient's symptoms were completely relieved, and satisfactory clinical outcomes were achieved. Postoperative follow-up X-ray and MRI showed no recurrence of calcific tendinitis.

19.
HSS J ; 16(Suppl 2): 230-237, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33380952

RESUMO

BACKGROUND: Symptomatic post-operative lumbar epidural hematoma (PLEH) is a complication of lumbar spine surgery that can cause permanent neurologic consequences through compression of the cauda equina and nerve roots. QUESTIONS/PURPOSES: We sought to investigate the incidence, timing, and risk factors for symptomatic epidural hematomas following posterior lumbar decompression, as well as to identify additional post-operative complications associated with symptomatic lumbar epidural hematomas. METHODS: Elective lumbar spine procedures were identified in the National Surgical Quality Improvement Program (NSQIP) database between 2012 and 2016. Analyzed predictors of reoperation or readmission within 30 days for symptomatic PLEH included demographics, comorbidities, pre-operative laboratory values, peri-operative characteristics, and post-operative complications. RESULTS: There were 75,878 cases included in the analysis. The incidence rate of symptomatic PLEH was 0.27% (n = 206), 54.4% (n = 112) of which occurred within 5 days of the procedure. Increased age, obesity (body mass index of 35 or higher), peri-operative transfusion, multilevel surgery (two or more levels), dural tear repair, and microscope use were independently associated with PLEH. Post-operative complications associated with PLEH included surgical site infection and urinary tract infection. CONCLUSIONS: Readmission or reoperation for symptomatic PLEH following elective lumbar spine surgery is rare and can occur many days or weeks after a procedure. There are modifiable risk factors for PLEH and associated additional post-operative complications that physicians should be suspicious of following posterior lumbar decompression.

20.
PLoS One ; 15(12): e0242912, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33259513

RESUMO

The purpose of this study was to establish a Korean version of the Central Sensitization Inventory (CSI-K) for Korean-speaking patients facing total knee arthroplasty (TKA) for knee osteoarthritis (OA) and to investigate the psychometric characteristics of the CSI-K. We recruited a total of 269 patients with knee OA who were scheduled to undergo TKA for the study. CSI-K and pain-related outcomes, including the pain visual analog scale (VAS) and the Western Ontario and McMaster Universities OA Index (WOMAC) pain sub-scores, were measured. Since central sensitization (CS) is closely related to the quality of life (QOL) and limited functionality as well as pain, the patient's function was measured using the WOMAC function sub-scores, and QOL was measured using the EuroQol five-dimension test (EQ-5D). Reliability and validity were evaluated. Exploratory factor analysis (EFA) was conducted to begin the data reduction to validate the existing questionnaire translation. The internal consistency was excellent, with a Cronbach's alpha of 0.941. The test-retest reliability was acceptable-to-excellent with an ICC of 0.888. As expected, the CSI scores correlated strongly with the WOMAC pain scores (r = 0.524, p < 0.001) and moderately with the pain VAS (r = 0.496, p < 0.001), the WOMAC function (r = 0.408, p < 0.001), and the EQ-5D scores (r = 0.437, p < 0.001). EFA resulted in a six-factor model. The findings demonstrate that the CSI was successfully trans-culturally adapted into a simplified Korean version (CSI-K) that was reliable and valid for Korean-speaking patients who awaiting TKA for knee OA.


Assuntos
Adaptação Psicológica , Artroplastia do Joelho/psicologia , Sensibilização do Sistema Nervoso Central , Comparação Transcultural , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/psicologia , Idoso , Intervalos de Confiança , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , República da Coreia
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