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1.
Annu Rev Genomics Hum Genet ; 24: 347-368, 2023 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-37253596

RESUMO

Continued advances in precision medicine rely on the widespread sharing of data that relate human genetic variation to disease. However, data sharing is severely limited by legal, regulatory, and ethical restrictions that safeguard patient privacy. Federated analysis addresses this problem by transferring the code to the data-providing the technical and legal capability to analyze the data within their secure home environment rather than transferring the data to another institution for analysis. This allows researchers to gain new insights from data that cannot be moved, while respecting patient privacy and the data stewards' legal obligations. Because federated analysis is a technical solution to the legal challenges inherent in data sharing, the technology and policy implications must be evaluated together. Here, we summarize the technical approaches to federated analysis and provide a legal analysis of their policy implications.


Assuntos
Fenbendazol , Privacidade , Humanos , Instalações de Saúde , Disseminação de Informação , Políticas
2.
Gynecol Oncol ; 187: 37-45, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-38713997

RESUMO

OBJECTIVE: To assess the prognostic performance of the 2023 International Federation of Gynecology and Obstetrics (FIGO) endometrial cancer staging schema. METHODS: This retrospective cohort study queried the Commission-on-Cancer's National Cancer Database. Study population was 129,146 patients with stage I-IV endometrial cancer per the 2009 FIGO staging schema. Stage-shifting and overall survival (OS) were assessed according to the 2023 FIGO staging schema. RESULTS: Upstage (IA → II, 21.4 %; IB → II, 53.0 %) and downstage (IIIA→IA3, 22.2 %) occurred in both early and advanced diseases. Inter-stage prognostic performance improved in the 2023 schema with widened 5-year OS rate difference between the earliest and highest stages (68.2 % to 76.9 %). Stage IA1-IIB and IIC had distinct 5-year OS rate differences (85.8-96.1 % vs 75.4 %). The 5-year OS rate of the 2009 stage IIIA disease was 63.9 %; this was greater segregated in the 2023 schema: 88.0 %, 62.4 %, and 55.7 % for IIIA→IA3, IIIA1, and IIIA2, respectively (inter-substage rate-difference, 32.3 %). This 5-year OS rate of stage IA3 disease was comparable to the 2023 stage IB-IIB diseases (88.0 % vs 85.8-89.5 %). In the 2023 stage IIIC schema (micrometastasis rates: 29.6 % in IIIC1 and 15.6 % in IIIC2), micrometastasis and macrometastasis had the distinct 3-year OS rates in both pelvic (IIIC1-i vs IIIC1-ii, 84.9 % vs 71.1 %; rate-difference 13.8 %) and para-aortic (IIIC2-i vs IIIC2-ii, 82.9 % vs 65.2 %; rate-difference 17.7 %) nodal metastasis cases. The 5-year OS rate of the 2009 stage IVB disease was 23.4 %; this was segregated to 25.4 % for stage IVB and 19.2 % for stage IVC in the 2023 staging schema (rate-difference, 6.2 %). CONCLUSION: The 2023 FIGO endometrial cancer staging schema is a major revision from the 2009 FIGO schema. Almost doubled enriched sub-stages based on detailed anatomical metastatic site and incorporation of histological information enable more robust prognostication.


Assuntos
Neoplasias do Endométrio , Estadiamento de Neoplasias , Humanos , Feminino , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/mortalidade , Estudos Retrospectivos , Pessoa de Meia-Idade , Prognóstico , Idoso , Estudos de Coortes , Adulto , Idoso de 80 Anos ou mais
3.
Eur J Neurol ; 31(11): e16236, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38379392

RESUMO

This paper retraces the early history of the European Journal of Neurology (EJN), as it is about to enter its 30th year. It describes how our discipline organized itself during the latter part of the 20th century in Europe. In some ways, the creation and the evolution of the journal parallel the process of unification of Europe in its current form in the late 1980s and early 1990s. It started as a new journal with no impact factor and no indexation. It grew progressively thanks to the support of the European Federation of Neurological Societies (EFNS) and from the European scientific community The progressive merging of EFNS with the European Society of Neurology and the creation of the European Academy of Neurology were essential for reaching the current prominence of EJN within neurological publishing and for making it the widely heard official voice of European neurology.


Assuntos
Neurologia , Publicações Periódicas como Assunto , Neurologia/história , Europa (Continente) , Publicações Periódicas como Assunto/história , História do Século XX , Humanos , Sociedades Médicas/história , História do Século XXI
4.
Eur J Neurol ; 31(11): e16347, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38863385

RESUMO

BACKGROUND AND PURPOSE: To acknowledge the occasion of the 10th anniversary of the formation of the European Academy of Neurology (EAN), the World Federation of Neurology was invited to contribute its perspective on the formation of the EAN and its activities over the past decade. METHODS: This article is based on the experiences of the author in several functions with the European Union of Medical Specialists, the European Federation of Neurology and the European Neurological Society and with the World Federation of Neurology as a trustee since 2009. This article is supported by the author's own archive as well as by several publications. RESULTS: The formation of the EAN was influenced by the activities of the two main predecessor societies, the European Neurological Society and European Federation of Neurology, which left an imprint on the structure of the EAN. The newly formed EAN underwent rigorous structural and organizational changes and has been acting as a successful and independent regional society, expanding increasingly in worldwide activities. CONCLUSION: The EAN, with its 47 member countries, strong democratic leadership and structure, is an excellent example of a regional society with expanding global influence that uses its advocacy skills to influence and improve the structure of neurology in Europe.


Assuntos
Neurologia , Sociedades Médicas , Humanos , Europa (Continente) , Neurologia/história , Neurologia/organização & administração , Sociedades Médicas/história , Sociedades Médicas/organização & administração , História do Século XXI
5.
AIDS Behav ; 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39222183

RESUMO

We examined changes in HIV testing and medical care among men who have sex with men (MSM) in Russia. Data come from the 2010 and 2017 waves of the European MSM Internet Survey. From 2010 to 2017 there was an increase in the proportion who had ever received an HIV test (+ 11.2%), had tested for HIV in the last year (+ 2.1%), had ever taken antiretroviral therapy (ART) (+ 31.9), were currently taking ART (+ 31.5%), and had an undetectable viral load (+ 19.4%). These results are encouraging, yet they also reveal that substantial proportions of MSM experience considerable unmet prevention and treatment needs.


RESUMEN: Examinamos los cambios en las pruebas de detección de VIH y la atención médica entre hombres que tienen sexo con hombres (HSH) en Rusia. Los datos provienen de las olas de 2010 y 2017 de la Encuesta Europea de Internet para HSH. De 2010 a 2017 hubo un aumento en la proporción de quienes alguna vez se habían hecho una prueba de VIH (+ 11.2%), se habían hecho una prueba de VIH en el último año (+ 2.1%), alguna vez habían tomado terapia antirretroviral (TAR) (+ 31.9%), estaban tomando TAR actualmente (+ 31.5%) y tenían una carga viral indetectable (+ 19.4%). Estos resultados son alentadores, pero también revelan que una proporción sustancial de HSH experimenta considerables necesidades de prevención y tratamiento no satisfechas.

6.
Clin Chem Lab Med ; 62(12): 2435-2443, 2024 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-39238208

RESUMO

OBJECTIVES: This study aimed to assess the validity of external quality assessment (EQA) laboratory results across various cultural and environmental contexts and to identify potential improvement areas. METHODS: The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on Global Laboratory Quality (TF-GLQ) conducted a 2-year study (2022 and 2023) in which EQA materials, related software and online training was provided by a commercial vendor to 100 laboratories in ten IFCC member society countries. The results were analysed on a monthly basis by the TF-GLQ, to show the number of submissions per country, tests per lab, acceptability rates, random failures and to get a measure of which analytes performed poorly. RESULTS: The EQA material was dispatched on a quarterly basis. Some countries had problems with customs releasing the material in a timely manner, resulting in laboratories not receiving them on time leading to no submission. We report here the results for the second year of the survey. The number of examinations varied between laboratories, ranging from seven to 84 analytes. Of the ten countries surveyed, six averaged greater than 90 % acceptable results over the whole 12-months cycle, one had unacceptable results for two of the nine months they returned results and the other four were considered to not perform to an acceptable standard. CONCLUSIONS: All 100 participating laboratories indicated satisfaction with the EQA survey and related services, including on-site training, and report handling. However, specimen receiving issues, suggest benefits in dispatching materials for a full 12-month cycle. Significant discrepancies in EQA performance indicate that four countries require long-term assistance, training and guidance. To ensure reliable patient results, promoting EQA in certain countries is essential to achieve the required level of quality.


Assuntos
Laboratórios Clínicos , Humanos , Laboratórios Clínicos/normas , Garantia da Qualidade dos Cuidados de Saúde/normas , Controle de Qualidade , Laboratórios/normas
7.
J Clin Periodontol ; 51(2): 145-157, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38084804

RESUMO

AIM: The epidemiological relationship between periodontitis and caries remains controversial, and evidence synthesis is currently lacking. Therefore, this systematic review was designed to answer the following PECO question: 'In human adults (P), do subjects suffering from periodontitis (E) have higher presence/number of untreated carious lesions and caries experience (O) than subjects not suffering from periodontitis (C)?'. MATERIALS AND METHODS: Observational studies that met specific inclusion criteria established to answer to the PECO question were included. Two review authors independently searched for eligible studies, screened the titles and abstracts, carried out the full text analysis, extracted the data and performed the risk of bias assessment. In case of disagreement, a third review author took the final decision during ad hoc consensus meetings. Data synthesis was carried out through random-effects meta-analyses. RESULTS: A total of 18 studies on 21 cohorts, involving 135,018 participants, were included. Meta-analyses showed a significant association between periodontitis and the presence of at least one tooth with either untreated carious lesions (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.32-2.01; p <.00; I2 = 83.0%) or caries experience (decayed and filled teeth ≥ 1) (OR = 1.27; 95% CI: 1.01-1.59; p = .038; I2 = 90.0%). Moreover, subjects with periodontitis exhibited a higher number of surfaces (difference in means [MD] = 0.86; 95% CI: 0.46-1.27; p <.001; I2 = 0.0%) and teeth (MD = 0.35; 95% CI: 0.28-0.42; p <.001; I2 = 69.6%) with untreated carious lesions, as well as a higher number of teeth with caries experience (standardized difference in means [SMD] = 1.46; 95% CI: 0.15-2.78; p = .029; I2 = 98.9%) compared with those without periodontitis. Sensitivity analyses focusing on severe periodontitis as exposure mostly showed consistent results. Estimates for caries experience were only slightly attenuated in adjusted models compared with crude models. Subgroup analyses by caries location also indicated that periodontitis was associated only with root caries, while it was not with caries affecting the anatomical crown. CONCLUSIONS: Periodontitis was found to be associated with the presence and number of treated/untreated root carious lesions. Therefore, caries-specific preventive measures (e.g., fluorides) should be considered for individuals with periodontitis.


Assuntos
Cárie Dentária , Periodontite , Cárie Radicular , Adulto , Humanos , Cárie Dentária/complicações , Cárie Dentária/epidemiologia , Periodontite/complicações , Periodontite/epidemiologia , Fluoretos , Assistência Odontológica
8.
Neurosurg Rev ; 47(1): 829, 2024 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-39472325

RESUMO

This study aimed to evaluate age as a prognostic factor and develop a comprehensive prognostic model for patients undergoing clipping surgery for World Federation of Neurosurgical Societies (WFNS) grade I/II aneurysmal subarachnoid haemorrhage (SAH). We retrospectively investigated 188 patients with WFNS grade I/II SAH who underwent microsurgical clipping at our institute between December 2010 and January 2020. The data of 176 patients (75 with grade I and 101 with grade II) were analysed. Data on patient demographics, aneurysm characteristics, SAH factors, surgical details, and clinical outcomes were collected. Prognostic factors were assessed using bivariate and multivariable logistic regression analyses, and recursive partitioning analysis. Favourable outcomes (mRS 0-2) were observed in 76% of patients. Age, a significant negative prognostic factor in multivariable analysis (odds ratio 0.55, 95% confidence interval 0.40-0.76, p < 0.001), was cutoff at 70 years by the receiver operating characteristic curve. Patients aged ≤ 70 years had significantly better outcomes than those aged > 70 years (84% vs. 46%, respectively; p < 0.001). Epileptic seizures were significantly associated with poor outcomes in older adults (p < 0.001). A prognostic model (favourable, intermediate, and poor) based on age and postoperative adverse events showed significantly different outcomes between age groups (p < 0.001). Age was a stronger prognostic factor than WFNS grading for patients with grade I/II SAH undergoing microsurgical clipping. For patients aged ≤ 70 years, precise microsurgeries with fewer complications were associated with favourable outcomes beyond WFNS grade. For older patients, postoperative intensive seizure management may prevent poor outcomes.


Assuntos
Procedimentos Neurocirúrgicos , Hemorragia Subaracnóidea , Humanos , Hemorragia Subaracnóidea/cirurgia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Prognóstico , Resultado do Tratamento , Fatores Etários , Procedimentos Neurocirúrgicos/métodos , Estudos Retrospectivos , Adulto , Idoso de 80 Anos ou mais , Microcirurgia/métodos
9.
J Obstet Gynaecol Res ; 50 Suppl 1: 42-48, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39473042

RESUMO

Cervical cancer poses a significant health burden, particularly in low- and middle-income countries, where access to screening and treatment remains limited. Asia Oceania Federation of Obstetrics and Gynecology (AOFOG)'s response, guided by the World Health Organization's global strategy, emphasizes three key targets: achieving high HPV vaccination coverage among girls, ensuring widespread screening with high-performance tests, and guaranteeing timely treatment for precancerous and cancerous lesions. AOFOG supports member countries through initiatives such as educational campaigns, guidelines development, and collaboration with local and international partners. Variations in screening methods across AOFOG member countries reflect diverse socioeconomic contexts and healthcare infrastructures, ranging from HPV testing in countries like Australia and Malaysia to cytology and visual inspection methods in others. Innovations such as HPV self-testing and AI-enhanced screening are emerging to improve accessibility and accuracy, addressing barriers like stigma and resource scarcity. Despite challenges, AOFOG remains committed to reducing cervical cancer incidence and mortality through coordinated regional efforts, aiming for equitable access to preventive measures and treatment across the diverse landscape of the Asia-Pacific region.


Assuntos
Detecção Precoce de Câncer , Ginecologia , Neoplasias do Colo do Útero , Humanos , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/diagnóstico , Feminino , Ásia/epidemiologia , Ginecologia/normas , Obstetrícia/normas , Vacinas contra Papillomavirus/administração & dosagem , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/diagnóstico , Oceania , Sociedades Médicas
10.
Health Res Policy Syst ; 22(1): 33, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38443935

RESUMO

OBJECTIVE: This work compares the marketing authorization, labels and dosage forms of medicines in the WHO Model List of Essential Medicines for Children (EMLc) in China, the Russian Federation and Brazil to urge policymakers to pay more attention to paediatric medication. METHODS: Medicines were selected from the 8th EMLc. By searching relevant databases, which include different types of medical information in China, the Russian Federation and Brazil, the marketing authorization, labels and dosage forms of paediatric medicines in the three countries were evaluated. RESULTS: A total of 485 drug products containing 312 active pharmaceutical ingredients listed in the WHO EMLc were evaluated. Among them, 344 products were approved for use in China, 286 in the Russian Federation and 264 in Brazil. Out of the 344 approved medicines, 317 (92.15%) were authorized for paediatric use in China, 224 (78.32%) in the Russian Federation and 218 (82.58%) in Brazil. In terms of guidance information labelling on drug labels, 75.08%, 83.04% and 88.07% of paediatric drugs approved in China, the Russian Federation and Brazil, respectively, clearly indicated the usage and dosage for paediatric use. Additionally, injections and tablets were the most prevalent dosage forms in these three countries. CONCLUSION: There is still scope for enhancing the marketing authorization and development of dosage forms for paediatric medicines in the three countries. Furthermore, additional measures are being implemented to enhance the information provided on drug labels for children, particularly in China.


Assuntos
Marketing , Humanos , Criança , Brasil , China , Federação Russa , Organização Mundial da Saúde
11.
Euro Surveill ; 29(9)2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38426241

RESUMO

We report on an ongoing measles outbreak in the Federation of Bosnia and Herzegovina with 141 cases notified between week 52 2023 and week 6 2024. Among those with known vaccination status, 97% were unvaccinated and the most affected group is children under the age of 5 years (n = 87) who were not vaccinated during the pandemic years. Sixty-eight cases were hospitalised, the most common complications were measles-related pneumonia and diarrhoea. The sequenced measles viruses from four cases belonged to genotype D8.


Assuntos
Exantema , Sarampo , Criança , Humanos , Pré-Escolar , Vacinação , Bósnia e Herzegóvina/epidemiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vírus do Sarampo/genética , Surtos de Doenças/prevenção & controle
12.
Arch Gynecol Obstet ; 310(5): 2603-2615, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38886217

RESUMO

PURPOSE: The significant global burden of endometrial cancer (EC) and the challenges associated with predicting EC recurrence indicate the need for a dynamic prediction model. This study aimed to propose nomograms based on clinicopathological variables to predict recurrence-free survival (RFS) and overall survival (OS) after surgical resection for EC. METHODS: This single-institution retrospective cohort study included patients who underwent surgical resection for EC. Web-based nomograms were developed to predict RFS and OS following resection for EC, and their discriminative and calibration abilities were assessed. RESULTS: This study included 289 patients (median age, 56 years). At a median follow-up of 51.1 (range, 4.1-128.3) months, 13.5% (39/289) of patients showed relapse or died, and 10.7% (31/289) had non-endometrioid tumors (median size: 2.8 cm). Positive peritoneal cytology result (hazard ratio [HR], 35.06; 95% confidence interval [CI], 1.12-1095.64; P = 0.0428), age-adjusted Charlson comorbidity index (AACCI) (HR, 52.08; 95% CI, 12.35-219.61; P < 0.001), and FIGO (Federation of Gynecology and Obstetrics) stage IV (HR, 138.33; 95% CI, 17.38-1101.05; P < 0.001) were predictors of RFS. Similarly, depth of myometrial invasion ≥ 1/2 (HR, 1; 95% CI, 0.46-2.19; P = 0.995), AACCI (HR, 93.63; 95% CI, 14.87-589.44; P < 0.001), and FIGO stage IV (HR, 608.26; 95% CI, 73.41-5039.66; P < 0.001) were predictors of OS. The nomograms showed good predictive capability, positive discriminative ability, and calibration (RFS: 0.895 and OS: 0.891). CONCLUSION: The nomograms performed well in internal validation when patients were stratified into prognostic groups, offering a personalized approach for risk stratification and treatment decision-making.


Assuntos
Neoplasias do Endométrio , Recidiva Local de Neoplasia , Nomogramas , Humanos , Feminino , Neoplasias do Endométrio/cirurgia , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Adulto , Intervalo Livre de Doença , Estudos de Coortes , Estadiamento de Neoplasias , Idoso de 80 Anos ou mais
13.
Sensors (Basel) ; 24(13)2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-39001153

RESUMO

Smoke is an obvious sign of pre-fire. However, due to its variable morphology, the existing schemes are difficult to extract precise smoke characteristics, which seriously affects the practical applications. Therefore, we propose a lightweight cross-layer smoke-aware network (CLSANet) of only 2.38 M. To enhance the information exchange and ensure accurate feature extraction, three cross-layer connection strategies with bias are applied to the CLSANet. First, a spatial perception module (SPM) is designed to transfer spatial information from the shallow layer to the high layer, so that the valuable texture details can be complemented in the deeper levels. Furthermore, we propose a texture federation module (TFM) in the final encoding phase based on fully connected attention (FCA) and spatial texture attention (STA). Both FCA and STA structures implement cross-layer connections to further repair the missing spatial information of smoke. Finally, a feature self-collaboration head (FSCHead) is devised. The localization and classification tasks are decoupled and explicitly deployed on different layers. As a result, CLSANet effectively removes redundancy and preserves meaningful smoke features in a concise way. It obtains the precision of 94.4% and 73.3% on USTC-RF and XJTU-RS databases, respectively. Extensive experiments are conducted and the results demonstrate that CLSANet has a competitive performance.

14.
J Esthet Restor Dent ; 36(8): 1138-1152, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38475965

RESUMO

OBJECTIVE: This randomized, double-blind clinical investigation assessed the performance of two high-viscosity glass-ionomer systems and a bulk-fill composite in different cavity types. MATERIALS AND METHODS: In 146 participants, 360 (class I, II, and V) cavities were restored using three different materials (Equia Forte HT, Chemfill Rock, and SonicFill 2) with equal allocation. Using modified World Dental Federation criteria, restorations were assessed after 1 week, 6 months, and 18 months by an experienced examiner. Statistical analysis was conducted using Fisher's exact and Wilcoxon signed rank tests (α = 0.05). RESULTS: After 18 months, 267 restorations were assessed in 116 participants. After 18 months, 5 Equia Forte HT restorations failed due to debonding and fracture. Only one loss was observed in the Chemfill Rock restorations. Equia Forte HT exhibited significantly lower retention than SonicFill 2 after 18 months (p = 0.019), irrespective of cavity type. At 1 week, 3 Class I restorations with SF showed postoperative sensitivity. The type of cavity did not affect the performance of the restorative materials used (p > 0.05). CONCLUSION: Equia Forte HT and Chemfill Rock presented similar clinical performance regardless of color match. Equia Forte HT showed a lower performance compared to SonicFill 2. CLINICAL SIGNIFICANCE: Glass-hybrid materials presented a lower performance in terms of color match or retention when compared to a sculptable bulk-fill composite resin.


Assuntos
Resinas Compostas , Humanos , Resinas Compostas/química , Método Duplo-Cego , Viscosidade , Feminino , Pessoa de Meia-Idade , Adulto , Masculino , Restauração Dentária Permanente/métodos , Cimentos de Ionômeros de Vidro/química , Preparo da Cavidade Dentária
15.
J Esthet Restor Dent ; 2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39051792

RESUMO

OBJECTIVE: To assess the clinical performance of two composite materials with two universal adhesives and a two-step self-etch adhesive on class II restorations for 18 months. MATERIALS AND METHODS: Two hundred and fifty-two class II cavities were bonded with G-Premio Bond, Single Bond Universal, and Clearfil SE Bond 2. A nanohybrid composite (Filtek Z550 Universal) or a microhybrid composite (G-aenial Posterior) was used to fill the bonded cavities. World Dental Federation criteria were used to evaluate the restorations at 1 week, 6, and 18 months. Statistical analysis was performed using Friedman and Fisher's exact tests (α = 0.05). RESULTS: Retention loss and fracture were not observed in any restorations during the 18 months. The adhesives used showed no significant differences for all criteria examined (p > 0.05) regardless of composite material. After an 18-month follow-up, seven G-aenial Posterior and three Filtek Z550 Universal restorations presented slight marginal discrepancies, with no significant differences (p = 0.246). At 1 week, Filtek Z550 Universal (9.5%) led to significantly higher postoperative sensitivity compared with G-aenial Posterior (0.8%) (p = 0.001). CONCLUSIONS: Universal adhesives showed similar clinical performance to Clearfil SE Bond 2. The restorations with Filtek Z550 Universal had a relatively higher risk of postoperative sensitivity. CLINICAL SIGNIFICANCE: Universal adhesives were clinically successful for 18 months. At 1 week, the type of composite material used significantly affected the occurrence of postoperative sensitivity.

16.
Australas Psychiatry ; : 10398562241285377, 2024 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-39322617

RESUMO

OBJECTIVE: To introduce the World Federation for Mental Health (WFMH) viewpoint on the Pacific Island countries' mental health capacity building. CONCLUSION: Multi-agency collaboration guided by a nuanced understanding of the local context can enable a public health model of mental health service delivery in the Pacific Island countries.

17.
Medicina (Kaunas) ; 60(3)2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38541238

RESUMO

Background and Objectives: Endometrial carcinoma is one of the most common gynecological cancers, and benign lesions such as endometrial hyperplasia, polyps, adenomyosis and leiomyomas should be included in the differential diagnosis. Magnetic resonance imaging has an important role in evaluating endometrial cancer and assessing the depth of myometrial invasion, and it closely correlates with the prognosis of the patient. The purpose of this study is to evaluate the MRI semiology of the endometrial carcinomas that mimic benign lesions, the main factors that may affect the correct diagnosis and the feasibility of magnetic resonance imaging to evaluate the depth of the myometrial invasion of endometrial cancer. Materials and Methods: This is a retrospective analysis of 45 patients that underwent MRI examinations and the lesions were pathologically diagnosed as endometrial carcinoma after surgical resection. This study evaluated the staging accuracy of T2-weighted imaging, diffusion-weighted imaging (DWI), ADC mapping and T1-weighted imaging with fat saturation before and after gadolinium injection. Results: In 36 of the 45 cases, the MRI of the lesion showed the characteristics of endometrial cancer and the diagnosis was certain. Nine lesions (20%) were described as unequivocal and had unspecific MR appearance. In eight of the nine cases (89%), the histopathologic report revealed the presence of leiomyomas and two of these cases (22%) were also associated with adenomyosis. The cause of underestimation in these patients was coexisting lesions exhibiting heterogenous intensity and contrast enhancement, which made it difficult to detect the margins of the lesions. The depth of the myometrial invasion was underestimated in nine cases and overestimated in three cases. The staging accuracy with MRI was 74%. There was a significant correlation between MR imaging and histopathologic finding in the assessment of myometrial invasion (p < 0.001). Cervical extension was noted in eight cases (18%), but was missed on MR imaging in two patients and overstaged in none. Six of them were associated with myometrial invasion in more than 50% of the thickness. There was a significant correlation between MR imaging and histopathologic finding in the assessment of cervical extension (p < 0.001). Conclusions: Our data confirm the high accuracy of MRI in the diagnosis and local staging of endometrial carcinoma. The information provided by MRI has an important role in planning the treatment and the prognosis of the patients.


Assuntos
Adenocarcinoma , Adenomiose , Neoplasias do Endométrio , Leiomioma , Neoplasias Uterinas , Feminino , Humanos , Adenomiose/complicações , Adenomiose/patologia , Estudos Retrospectivos , Invasividade Neoplásica/patologia , Imageamento por Ressonância Magnética/métodos , Neoplasias Uterinas/complicações , Neoplasias do Endométrio/patologia , Estadiamento de Neoplasias , Leiomioma/complicações , Adenocarcinoma/patologia , Sensibilidade e Especificidade
18.
Ter Arkh ; 96(8): 751-756, 2024 Sep 14.
Artigo em Russo | MEDLINE | ID: mdl-39404719

RESUMO

AIM: To systematize data on the prevalence of gastroesophageal reflux disease (GERD) in the adult population of Russia. MATERIALS AND METHODS: The search for studies was conducted in the electronic databases MEDLINE/PubMed, EMBASE, and RSCI (Russian Science Citation Index) from January 2000 to December 2022. The review included relevant publications in peer-reviewed periodicals in English or Russian, publications with data from cross-sectional epidemiological studies assessing the prevalence of GERD in the Russian population, studies on adult patients with GERD, and publications with detailed descriptive statistics that allow using the data in the meta-analysis. RESULTS: The final analysis included 6 studies involving 34,192 subjects. The overall prevalence of GERD (prevalence of heartburn ± regurgitation once a week or more frequently) in the analyzed studies was 25.605% (95% confidence interval [CI] 17.913-34.147). The analysis used a random effect model, as there was significant heterogeneity between the results in both groups (I2=99.63%; p<0.0001). The overall mean age of GERD patients in the study population was 48.14 (95% CI 32.25-4.03) years. The prevalence of GERD in the male population was 23.653% (95% CI 13.351-35.832) and 25.457% (95% CI 17.094-34.849) in females. CONCLUSION: This meta-analysis demonstrated that GERD is a common esophageal disease in the Russian population, affecting approximately one in four country residents.


Assuntos
Refluxo Gastroesofágico , Humanos , Refluxo Gastroesofágico/epidemiologia , Federação Russa/epidemiologia , Prevalência
19.
Sud Med Ekspert ; 67(5): 62-66, 2024.
Artigo em Russo | MEDLINE | ID: mdl-39440567

RESUMO

Legislation and industry-specific regulatory documents of Russia, some historical aspects and current problems of staffing in forensic medical organizations were analyzed to improve legal and regulatory framework for skilled personnel training in the sphere of forensic medical examination. Changes in the qualification requirements to medical and pharmaceutical workers with higher education in specialty are proposed, namely to remove restrictions on the possibility of postgraduate training in forensic medical examination specialty for those who have received higher medical education (specialist's degree program) in «medical and preventative care¼ specialty, considering the interdisciplinary relationship between forensic medical activity and preventive medicine, common approaches to the specialist's degree programs formation and general medical thinking development in students. This will help to achieve the target of the President and the Government of the Russian Federation on provision of health care with qualified personnel and increase of staffing of specialists in forensic medical organizations.


Assuntos
Medicina Legal , Federação Russa , Medicina Legal/legislação & jurisprudência , Medicina Legal/métodos , Medicina Legal/educação , Humanos , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/legislação & jurisprudência
20.
Crit Rev Clin Lab Sci ; : 1-15, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37909425

RESUMO

Serum protein electrophoresis (SPEP) is a valuable laboratory test that separates proteins from the blood based on their electrical charge and size. The test can detect and analyze various protein abnormalities, and the interpretation of graphic SPEP features plays a crucial role in the diagnosis and monitoring of conditions, such as myeloma. Furthermore, the advancement of artificial intelligence (AI) technology presents an opportunity to enhance the organization and optimization of analytical procedures by streamlining the process and reducing the potential for human error in SPEP analysis, thereby making the process more efficient and reliable. For instance, AI can assist in the identification of protein peaks, the calculation of their relative proportions, and the detection of abnormalities or inconsistencies. This review explores the characteristics and limitations of AI in SPEP, and the role of standardization in improving its clinical utility. It also offers guidance on the rational ordering and interpreting of SPEP results in conjunction with AI. Such integration can effectively reduce the time and resources required for manual analysis while improving the accuracy and consistency of the results.

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