Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 287
Filtrar
1.
Cureus ; 16(4): e58222, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38745809

RESUMEN

INTRODUCTION:  Pain after breast cancer surgery is one of the main reasons for postoperative morbidity and pulmonary complications leading to increased hospital stay. Therefore, effective management of postoperative pain becomes necessary to alleviate patients' suffering and allow early mobilization and hospital discharge. Traditionally, opioids have been used to manage perioperative pain but they are associated with side effects. So, an opioid-sparing multimodal analgesia approach is used nowadays. Ultrasound-guided pectoral type-II (PEC II) block is increasingly being used to address acute postoperative pain after breast cancer surgery. However, to date, not many studies have been done regarding prolonging the duration of analgesia of PEC II blocks for postoperative pain relief in patients undergoing modified radical mastectomy (MRM). So, we undertook this study to compare the analgesic efficacy of PEC II block using dexamethasone as an adjuvant to ropivacaine versus plain ropivacaine in patients undergoing MRM. METHODS:  After obtaining approval from the institute ethics committee and written informed consent from the patients, this prospective, double-blind, parallel group, randomized controlled study was carried out at All India Institute of Medical Sciences (AIIMS) Raipur, from March 2021 to March 2022. Sixty-four female patients, aged 18 years and above, belonging to the American Society of Anesthesiologists, physical status I, II, and III, undergoing unilateral, elective MRM under general anesthesia, were randomly allocated to two groups A and B, with 32 patients in each to receive 30 mL of 0.25% ropivacaine plus 2 mL (8 mg) of dexamethasone and 30 mL of 0.25% ropivacaine plus 2 mL of normal saline, respectively. The primary outcome measure was total opioid consumption till 12 hours postoperatively. Secondary outcome measures were the difference in pain scores based on the numeric rating scale till 12 hours postoperatively, post-operative sedation scores, the incidence of postoperative nausea vomiting (PONV), and other adverse events (if any). RESULTS: The mean (SD) of morphine (mg) consumed intraoperatively was 5.50 (1.05) and 5.95 (0.86) with P = 0.033 and that consumed postoperatively was 1.00 (0.00) and 1.69 (0.93) with P <0.001 in group A and B respectively, with morphine consumption being higher in the group. The difference in the NRS score for pain at rest was statistically significant at 2 h (P=0.030), 4 h (P=0.004), 6 h (P=0.002), and, 12 h (P=0.039) time points with the score being higher in group B. The groups were comparable in terms of postoperative sedation score (P > 0.05) and incidence of postoperative nausea and vomiting. None of the patients in group A and 6.2% of the patients in group B had nausea (P = 0.492). None of the patients in either of the groups had vomiting. No other complication occurred during the entire study in either of the groups. CONCLUSION: In comparison to plain ropivacaine, the addition of dexamethasone as an adjuvant to ropivacaine for PEC II block in patients undergoing MRM significantly reduced perioperative opioid consumption and postoperative NRS scores. No significant change was noted in terms of postoperative sedation score, incidence of PONV, and other side effects between the groups. Therefore, we conclude that the analgesic efficacy of US-guided PEC II block using dexamethasone, as an adjuvant to ropivacaine is superior to that of plain ropivacaine in patients undergoing MRM.

2.
MethodsX ; 12: 102727, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38746478

RESUMEN

A compact 1 × 4 antipodal Vivaldi antenna (AVA) array designed for 5 G applications is introduced in this study. An elliptical-shaped parasitic patch and corrugation are strategically employed to enhance gain and bandwidth, making it well-suited for 5 G applications. The resulting AVA array with corrugation and parasitic patch (AVA-PC) is designed and simulated on ANSYS HFSS, demonstrating a stable gain ranging from 10 dBi to 11.7 dBi over the frequency range of 23.45 GHz to 28.74 GHz. The antenna, with 25.8 mm x 22.4 mm x 0.5 mm dimensions, is implemented on Roger's RT/Duroid substrate 5880. •Design uses an antipodal Vivaldi antenna to build a 1 × 4 AVA.•The array employs corrugations and an elliptical patch as a performance enhancement technique.•Simulated results confirm the designed antenna's practical utility for 5 G applications in a band of 23.45 GHz to 28.74 GHz.

3.
J Assoc Physicians India ; 72(1): 18-21, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38736069

RESUMEN

INTRODUCTION: The world has changed tremendously for patients suffering from diabetes mellitus with the development of cutting-edge technologies like continuous glucose monitoring and flash glucose monitoring systems. Now, the details of constant fluctuations of glucose in their blood can be monitored not only by medical professionals but also by patients, and this is called glycemic variability (GV). Traditional metrics of glycemic control measurement, such as glycated hemoglobin (HbA1c), fail to reflect various short-term glycemic changes like postprandial hyperglycemia and hypoglycemic episodes, paving the way to the occurrence of various diabetic complications even in asymptomatic, well-controlled diabetic patients. This need for advanced management of diabetes and effective monitoring of these swings in blood glucose can be met by using a continuous glucose monitoring system (CGMS). AIM AND OBJECTIVE: To evaluate the extent of GV in well-controlled type 2 diabetes mellitus (T2DM) patients using a flash CGMS and to assess the correlation between GV and HbA1c. MATERIALS AND METHODS: A hospital-based prospective observational study was carried out from May 2020 to Oct 2021 at the Department of Medicine, SMS Hospital, Jaipur, Rajasthan (India), after approval from the Ethics Committee of the institution. A total of 30 patients with well-controlled T2DM (HbA1c was ≥6.5, but ≤7.5) were included in the study using simple random techniques after written informed consent from patients. Patients were studied for glycemic excursions over a period of 7 days by using FreeStyle® Libre Pro™, which is a flash glucose monitoring system. The CGM sensor was attached to the left upper arm of the patient on day 0 and removed on day 7. The data recorded in the sensor was then retrieved using pre-installed computer software and analyzed using standard CGM metrics like standard deviation (SD), percentage coefficient of variation (%CV), time above range (TAR), time below range (TBR), and time in range (TIR), out of which %CV was used to quantify GV. %CV has been used to cluster patients into four cohorts from best to worst, namely: best/low CV ≤ 10%, intermediate CV from 10 to 20%, high CV from 20 to 30%, and very high CV of >30%. Scatterplots are used to establish correlations between various parameters. RESULT: Data from a total of 30 patients were analyzed using CGMS and thus used for calculating standard CGM metrics; glucose readings every 15 minutes were recorded consecutively for 7-day periods, making it a total of 672 readings for each patient. Interpreting the CGM data of all 30 patients, the following results were found: the mean blood glucose of all cases is 134.925 ± 22.323 mg/dL, the mean SD of blood glucose of all cases is 35.348 ± 9.388 mg/dL, the mean of %CV of all cases is 26.376 ± 6.193%. CGM parameters of time are used in the form of percentages, and the following results were found: the mean of TAR, TBR, and TIR is 14.425 ± 13.211, 5.771 ± 6.808, and 82.594 ± 12.888%, respectively. Clustering the patients into cohorts, the proportion of patients exhibiting best/low %CV (10%) is 0, intermediate %CV (10-20%) is 16.67% (five out of 30 patients), high %CV (20-30%) is 50% (15 out of 30 patients) and very high %CV (>30%) is 33.33% (10 out of 30 patients). Also, there is no significant correlation found between HbA1c and %CV (ρ = 0.076, p-value = 0.690); a significant negative correlation was found between %CV and TIR (ρ = -0.604, p < 0.001S); a positive correlation of %CV with TAR and TBR is significant (ρ = 0.816, p-value of <0.001). CONCLUSION: Using a flash CGMS device and considering %CV as the parameter and primary measure of GV, the study demonstrated the overall instability of a person's glycemic control, making note of unrecognized events of hypoglycemia and hyperglycemia in asymptomatic well-controlled T2DM patients, revealing the overall volatile glycemic control. The most important finding of this study is that even those diabetics who are considered well-controlled experience a great degree of GV as assessed by CGM-derived metrics. This study also demonstrated that there is no significant correlation between HbA1c and GV, suggesting that patients may not have optimal control of their diabetes despite having "normal HbA1c" values; hence, GV can be considered an HbA1c-independent danger factor, having more harmful effects than sustained hyperglycemia in the growth of diabetic complications. So, by using CGM-derived metrics, the measurement of GV has the potential to complement HbA1c data. In this manner, a more comprehensive assessment of glycemic excursions can be provided for better treatment decisions, thereby facilitating optimal glycemic control, which is essential for reducing overall complications and promoting good quality of life.


Asunto(s)
Automonitorización de la Glucosa Sanguínea , Glucemia , Diabetes Mellitus Tipo 2 , Hemoglobina Glucada , Humanos , Diabetes Mellitus Tipo 2/sangre , Automonitorización de la Glucosa Sanguínea/métodos , Automonitorización de la Glucosa Sanguínea/instrumentación , Glucemia/análisis , Hemoglobina Glucada/análisis , Femenino , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Control Glucémico/métodos , Adulto , Anciano , Monitoreo Continuo de Glucosa
4.
World J Surg ; 48(6): 1433-1439, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38658165

RESUMEN

BACKGROUND: Excess and prolonged axillary drainage is a frequent nuisance following axillary lymph node dissection (ALND) in breast cancer patients. No consensus exists about the best method to prevent this consistently and reliably. Tranexamic acid (TA) has been found to reduce the amount and duration of drainage, but the reduction is not optimal. We hypothesized that systemic administration of TA along with the topical application of hemocoagulase (H) to the axillary dissection bed may decrease the cumulative axillary drain output and shorten the requirement of drainage after ALND as compared to placebo. PATIENT AND METHODS: Seventy women undergoing ALND for breast carcinoma were randomized into two groups, the intervention (TA + H) group and the control (C) group. The cumulative drain output (primary objective), duration of drainage, incidence of seroma formation after drain removal, number of seroma aspirations required, volume of seroma aspirated, and incidence of surgical site infection (SSI) were compared. RESULTS: The mean cumulative output in the TA + H group was significantly lower than the C group (290 ± 200 mL vs. 552 ± 369 mL, p < 0.001). Axillary drains were removed significantly earlier in the TA + H group (6.6 ± 2.2 vs. 11.7 ± 6.0 days, p < 0.001), but the incidence of seroma formation (p = 0.34), number of aspirations required (p = 0.33), volume of seroma aspirated (p = 0.47), and the incidence of SSI (p = 0.07) were similar. CONCLUSIONS: Perioperative systemic administration of tranexamic acid along with topical application of H to the axillary dissection bed is effective in reducing cumulative axillary drain output after ALND. This strategy may also facilitate earlier removal of suction drains.


Asunto(s)
Administración Tópica , Antifibrinolíticos , Axila , Neoplasias de la Mama , Drenaje , Escisión del Ganglio Linfático , Ácido Tranexámico , Humanos , Femenino , Ácido Tranexámico/administración & dosificación , Ácido Tranexámico/uso terapéutico , Neoplasias de la Mama/cirugía , Persona de Mediana Edad , Método Doble Ciego , Antifibrinolíticos/administración & dosificación , Antifibrinolíticos/uso terapéutico , Drenaje/métodos , Adulto , Batroxobina/administración & dosificación , Batroxobina/uso terapéutico , Seroma/prevención & control , Seroma/etiología , Anciano , Resultado del Tratamiento , Atención Perioperativa/métodos , Hemostáticos/administración & dosificación , Hemostáticos/uso terapéutico
5.
Artículo en Inglés | MEDLINE | ID: mdl-38668856

RESUMEN

BACKGROUND: Evaluation of axillary lymph nodes status in cN0 axilla is performed by sentinel lymph node biopsy (SLNB) utilizing a combination of radioactive isotope and blue dye or alternative to isotope like Indocyanine green (ICG). Both are very resource-intensive; which has prompted development of low-cost technique of Fluorescein Sodium (FS)-guided SLNB. This systematic review and meta-analysis evaluate the diagnostic performance of FS-guided SLNB in early breast cancer. OBJECTIVES: The objective was to evaluate the diagnostic performance of FS for sentinel lymph node biopsy. METHODS: Eligibility criteria: Studies where SLNB was performed using FS. INFORMATION SOURCES: PubMed, EMBASE, Cochrane library and online clinical trial registers. Risk of bias: Articles were assessed for risk of bias using the QUADAS-2 tool. SYNTHESIS OF RESULTS: The main summary measures were pooled Sentinel Lymph Node Identification Rate (SLN-IR) and pooled False Negative Rate (FNR) using random-effects model. RESULTS: A total of 45 articles were retrieved by the initial systematic search. 7 out of the 45 studies comprising a total of 332 patients were included in the meta-analysis. The pooled SLN-IR was 93.2% (95% confidence interval [CI], 0.87-0.97; 87% to 97%). Five validation studies were included for pooling the false negative rate and included a total of 211 patients. The pooled FNR was 5.6% (95% confidence interval [CI], 2.9-9.07). CONCLUSION: Fluorescein-guided SLNB is a viable option for detection of lymph node metastases in clinically node negative patients with early breast cancer. It achieves a high pooled Sentinel Lymph Node Identification Rate (SLN-IR) of 93% with a false negative rate of 5.6% for the detection of axillary lymph node metastasis.

6.
Artículo en Inglés | MEDLINE | ID: mdl-38566498

RESUMEN

Abnormal cardiac functionality produces irregular heart rhythms which are commonly known as arrhythmias. In some conditions, arrhythmias are treated as very dangerous which may lead to sudden cardiac arrest. The incidence and prevalence of cardiac anomalies seeks early detection of arrhythmias using automated classification techniques. In the past, numerous automated arrhythmia detection techniques have been developed that are based on electrocardiogram (ECG) signal analysis. Focusing on the prospective research in this field, this article reports a comprehensive review of existing techniques that are obtained using search engines such as IEEE explore, Google scholar and science direct. Based on the review, the existing techniques are broadly categorized into two types: machine-learning and deep-learning-based techniques. In this study, it is noticed that the performance of the machine-learning-based arrhythmia detection techniques depend on pre-processing of ECG signal, R-peaks detection, features extraction and classification tools while the deep-learning-based techniques do not require the features extraction step. Generally, the existing techniques utilize Massachusetts Institute of Technology-Beth Israel Hospital arrhythmia database to evaluate the classification performance. The classification performance of automated techniques also depends on ECG data used for training and testing of the classifier. It is expected that the performance should be evaluated using a variety of ECG signals including the cases of inter-patient and intra-patient paradigm. The existing techniques also require to deal with the class-imbalance problem. In addition to this, a specific partition-ratio between training and testing datasets should be maintained for fair comparison of performance of different techniques.

7.
Int J Gen Med ; 17: 1101-1116, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38529100

RESUMEN

Background: The lack of focus on the health status of shrimp cultivators by previous studies while the production of shrimp has been rising over the years after the introduction of the blue revolution in India. The present study estimated the burden of diseases among shrimp cultivators in India. Methods: Primary data were collected by using simple random sampling. The sample size was 357. The classification of diseases were made by using the international classification of diseases, tenth revision (ICD-10), version 2019. Disability-adjusted life years (DALY) were used to measure the health status of shrimp cultivators. DALY is the summation of the burden of disease from mortality and morbidity. Sensitive and uncertainty analysis was used by changing the value of the parameter and method, respectively. Results: The burden of disease among shrimp cultivators in 2020 ranges from 101.03 DALY based on equal age weightage, without discount rate, and potential life expectancy (DALY0,0,PLE) to 84.02 DALY based on unequal age weightage, discount rate, and standardized life expectancy (DALY1,0.03,SLE). The burden of disease per 100,000 shrimp cultivators was 28,477.74 DALY and 23,600.84 DALY when calculated by using DALY0,0,PLE and DALY1,0.03,SLE method, respectively. The higher burden of diseases from non-communicable diseases was followed by injury and communicable diseases for both methods. The disease burden from mortality was more than two-thirds of the total burden of disease and the rest from morbidity. The burden of disease among shrimp cultivators was sensitive to parameter changes because it changes between 92.10 DALY and 63.03 DALY with the change in the parameter. Uncertainty in the burden of disease among them was due to method variation, which ranges from 120.03 DALY to 74.06 DALY. Conclusion: The higher burden of non-communicable diseases, and the lower burden of communicable, and injuries per 100,000 shrimp cultivators compared to the national level in India.

8.
MethodsX ; 12: 102619, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38445176

RESUMEN

An analog comb filter is implemented by linking multiple VDCC-based notch filters in a cascading fashion (N in total), eliminating N different pole frequencies. This study focuses on suppressing a fundamental frequency of power-line interference of 50 Hz and its consecutive three odd harmonics at 150 Hz, 250 Hz, and 350 Hz. One significant advantage of this comb filter is the independent control over filters' parameters like quality factor and pole frequency. Additionally, these filters can be electronically tuned by adjusting the transconductance gain of VDCC. The suggested notch filter configuration involves 2 capacitors, 2 resistors, and 1 VDCC element. Extensive simulations were conducted using PSPICE simulator software to validate the effectiveness of these filters. The basic building block, VDCC, is designed and implemented in the simulation using integrated circuits MAX435 and AD844.•Design uses a VDCC-based high Q notch filter as the active building block.•The filter employs fewer active and passive components.•Simulated results using commercially available ICs, MAX435 and AD844, confirm the filter's practical utility.

10.
J Clin Microbiol ; 62(3): e0104823, 2024 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-38329335

RESUMEN

Human granulocytic anaplasmosis (HGA) is an emerging, rickettsial tick-borne disease caused by Anaplasma phagocytophilum. Sero-epidemiological data demonstrate that this pathogen has a worldwide distribution. The diagnosis of HGA requires a high index of clinical suspicion, even in endemic areas. In recent years, HGA has increasingly been reported from Asia and described in China, Japan, and Korea. We serologically and molecularly screened 467 patients with clinical suspicion of Anaplasmosis. The present study describes the epidemiology, clinical, and laboratory details of 6 confirmed and 43 probable cases of human granulocytic anaplasmosis. One of the HGA patients developed secondary invasive opportunistic Aspergillus fumigatus and Acinetobacter baumanii infection during the illness, which resulted in a fatal infection. The HGA patients without severe complications had excellent treatment responses to doxycycline. The emergence of this newly recognized tick-borne zoonotic HGA in North India is a significant concern for public health and is likely underdiagnosed, underreported, and untreated. Hence, it is also essential to establish a well-coordinated system for actively conducting tick surveillance, especially in the forested areas of the country.IMPORTANCEThe results of the present study show the clinical and laboratory evidence of autochthonous cases of Anaplasma phagocytophilum in North India. The results suggest the possibility of underdiagnosis of HGA in this geographical area. One of the HGA patients developed secondary invasive opportunistic Aspergillus fumigatus and Acinetobacter baumanii infection during the illness, which resulted in a fatal infection.


Asunto(s)
Anaplasma phagocytophilum , Anaplasmosis , Enfermedades por Picaduras de Garrapatas , Animales , Humanos , Anaplasmosis/diagnóstico , Anaplasmosis/tratamiento farmacológico , Anaplasmosis/epidemiología , Doxiciclina/uso terapéutico , China/epidemiología , India
11.
IEEE Trans Biomed Eng ; PP2024 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-38294922

RESUMEN

Recent studies have shown that virtual gamified therapy can be a potential adjunct to conventional orthopedic rehabilitation. However, the off-the-shelf gaming consoles used for virtual rehabilitation pose several practical challenges in deploying them in clinical settings. In this paper, we present the design of a portable glove-based virtual hand rehabilitation system (RehabRelive Glove) that can be used at both clinics and homes for physiotherapy. We also evaluate the system's efficacy on patients with post-traumatic hand injuries. Thirty patients were randomly categorized into groups A (virtual rehabilitation) and B (conventional physiotherapy). Both groups received fifteen 25-minute sessions of respective therapy over three weeks. The wrist and finger joints' range of motion (ROM) and grip strength were measured every seven sessions to compare the efficacy. Group A showed about 1.5 times greater improvement in flexion/extension ROM of the wrist compared to Group B. While both groups improved finger ROM and grip strength with time, no significant difference was observed between the groups. The results suggest that the proposed virtual rehabilitation system effectively enables patients with hand injuries to recover ROM faster.

13.
Trop Med Health ; 52(1): 10, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38225634

RESUMEN

Measles poses a significant global health threat, exacerbated by the COVID-19 pandemic. Despite the efficacy of two vaccine doses, under-5 mortality rates persist, with over 61 million delayed measles vaccinations worldwide. Nepal, striving to eliminate measles by 2023, faces a resurgence, attributing 1013 cases to inadequate vaccination and healthcare accessibility issues. Compounded by disruptions from the COVID-19 pandemic, the outbreak highlights the urgent need for vaccination promotion, improved healthcare access, and misinformation mitigation. This situation underscores the critical role of global collaboration and healthcare infrastructure investment to safeguard children's lives in Nepal and similar vulnerable regions.

15.
Plant Physiol ; 194(3): 1336-1357, 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-37930810

RESUMEN

Plants must rapidly and dynamically adapt to changes in their environment. Upon sensing environmental signals, plants convert them into cellular signals, which elicit physiological or developmental changes that allow them to respond to various abiotic and biotic cues. Because plants can be simultaneously exposed to multiple environmental cues, signal integration between plant cells, tissues, and organs is necessary to induce specific responses. Recently, CLAVATA3/EMBRYO SURROUNDING REGION-related (CLE) peptides and their cognate CLAVATA-type receptors received increased attention for their roles in plant-environment interactions. CLE peptides are mobile signaling molecules, many of which are induced by a variety of biotic and abiotic stimuli. Secreted CLE peptides are perceived by receptor complexes on the surface of their target cells, which often include the leucine-rich repeat receptor-like kinase CLAVATA1. Receptor activation then results in cell-type and/or environment-specific responses. This review summarizes our current understanding of the diverse roles of environment-regulated CLE peptides in modulating plant responses to environmental cues. We highlight how CLE signals regulate plant physiology by fine-tuning plant-microbe interactions, nutrient homeostasis, and carbon allocation. Finally, we describe the role of CLAVATA receptors in the perception of environment-induced CLE signals and discuss how diverse CLE-CLAVATA signaling modules may integrate environmental signals with plant physiology and development.


Asunto(s)
Interacción Gen-Ambiente , Transducción de Señal , Transporte Biológico , Carbono , Péptidos
16.
Chemistry ; 30(13): e202303287, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-37997510

RESUMEN

An efficient and short synthesis of fused dihydroisoquinolines, diaryl substituted pyridine derivatives in good to high yields has been established by using an environmentally safe, solvent-metal-oxidant-free tandem approach. In this article, we discuss how the electrocyclic reaction is more pronounced in the solid phase in the presence of urea, whereas the typical aza-Michael addition is more prominent in presence of arylamine in the solution phase for 3-(2-formylcycloalkenyl)acrylic ester derivative substrates. The wide range of substrates and urea-promoted neat synthesis made our approach more significant in medical and also analytical science. Moreover, an isoquinoline alkaloid decumbenine B analogue has been synthesized by using our newly developed neat methodology. We have also investigated the photophysical properties of the synthesized fused dihydroisoquinoline derivatives. One of the synthesized molecules was used as a sensor for the selective detection of toxic picric acid. Therefore, the effective neat synthesis and molecular sensing applications of these compounds made our approach more exciting in the field of heterocyclic chemistry.

17.
Breast Dis ; 42(1): 395-399, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38108339

RESUMEN

Lymphedema (LE) in a breast cancer patient usually results from axillary lymph node dissection, sentinel lymph node biopsy, and/or axillary radiotherapy. Although lymphatic obstruction and consequent LE can occur due to axillary lymph node involvement, such presentation in breast cancer patients has rarely been reported. This report describes the case of a 50-year-old lady with right breast carcinoma who presented with right upper limb lymphedema. Surprisingly, she did not have any bulky axillary lymphadenopathy that could have accounted for lymphedema of the upper limb, but a suspicious breast mass was present on clinical examination. Diagnosis of breast cancer on clinical examination can be challenging in such patients due to breast edema and careful imaging of the breast and axilla with appropriate imaging tools (mammogram, ultrasound, MRI, PET mammography) should be resorted to before excluding malignancy. Lymphoscintigraphy confirmed the findings of lymphedema in the right upper limb and revealed uptake in the epitrochlear lymph nodes of the contralateral limb suggesting that she might had pre-existing widespread "subclinical lymphedema" which presented as "clinical lymphedema" in right upper limb after axillary lymph node/lymphatic involvement by right breast carcinoma.


Asunto(s)
Neoplasias de la Mama , Carcinoma , Linfedema , Femenino , Humanos , Persona de Mediana Edad , Neoplasias de la Mama/complicaciones , Extremidad Superior , Linfedema/diagnóstico por imagen , Linfedema/etiología , Mama , Axila
18.
J Indian Prosthodont Soc ; 23(3): 244-252, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37929363

RESUMEN

Aims: The study aimed to evaluate biological, mechanical, and patient reported parameters associated with ASC abutments and MU abutments for the fabrication of screw retained implant crowns in the anterior esthetic zone. Setting and Design: For the study, 20 patients were selected and implants were placed within the constraints of prosthetic envelope. Later, the screw retained crown was fabricated. Materials and Methods: Biological parameters (including implant survival rate, marginal bone levels using cone beam computed tomography, and soft tissue assessment using periodontal indices) were measured at the time of crown placement and 1 year follow up. Mechanical parameter (screw loosening) was calculated using removal torque loss (RTL) values obtained at the time of crown placement and 1 year follow up. Patient reported parameters were evaluated using a questionnaire at 1 year follow up. Statistical Analysis Used: All data were tabulated, statistically analyzed, and compared using SPSS version 23 IBM Corporation, Armonk, NY, USA. Results: Implant survival was found 100% in both the groups. The marginal bone level reduced considerably in both the groups from baseline to 1 year follow up. The MU abutment group had slightly less marginal bone loss than the ASC abutment group. Additionally, there was no statistically significant difference between the two groups' periodontal indices at baseline and 1-year follow-up values. At baseline, the RTL value was substantially lower (P <0.003) in the ASC abutment group than in the MU abutment group, however at the 1-year follow-up, there was no statistically significant difference in RTL or screw loosening between the two groups. Patient-reported data showed no statistically significant difference. Conclusion: Within the constraints of this study, it was suggested that both ASC and MU abutments provide equally promising results in terms of biological, mechanical, and patient-reported parameters in the anterior esthetic region for single screw-retained crowns.


Asunto(s)
Implantes Dentales , Humanos , Pilares Dentales , Prótesis Dental de Soporte Implantado , Estética Dental , Tornillos Óseos , Medición de Resultados Informados por el Paciente
19.
J Mol Model ; 29(11): 355, 2023 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-37910226

RESUMEN

CONTEXT: This article presents a theoretical study of three insensitive high explosives based on the FOX-7 moiety. A few heterocyclic five- and six-member nitrogen-rich compounds have been created in an effort to better serve as a potential insensitive high explosive. It has been addressed how these molecules should be optimised in terms of stability, sensitivity, detonation properties, IR frequency computations, formal charge calculations, and more. Comprehensive research has been done on these compounds' molecular density and energy of activation associated with the conversion from nitro (C-NO2) to nitrito (C-ONO) during the initial phase of their decomposition. The bond dissociation energy along with BSSE correction for the most reactive C-NO2 bond is examined. The two designed molecules have intra-molecular hydrogen-bonding while other does not have any intra-molecular hydrogen-bonding. The newly designed compounds exhibit higher detonation values compared to TNT, which suggests that they ought to be prepared in a laboratory by skilled experimenters. METHODS: The stability of the C-NO2 link and the covalent character of the bonds have both been calculated using the atoms in molecule (AIM) method. The electronic structure calculations have been recovered at DFT method with aug-cc-pVDZ basis set using the Gaussian-16 quantum chemistry programme.

20.
Indian J Surg Oncol ; 14(3): 561-563, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37900655

RESUMEN

Soft tissue metastasis from carcinoma breast is rare, and still rarer is metastasis to skeletal muscles. So far, soft tissue metastasis from breast carcinoma has been reported only in a small number of case series and case reports. To the best of our knowledge, no case of breast cancer metastasizing to the lower limb muscles has been reported. It is important to differentiate soft tissue metastasis from primary soft tissue malignancy, as the management and prognosis of these differ markedly. Here, we present a case of breast cancer metastasizing to the soft tissue at multiple sites including the right thigh muscles.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...