Medicine最新文献

{"title":"A nomogram for predicting coronary artery lesions in patients with Kawasaki disease.","authors":"Wenjie Xuan, Yinping Yao, Yayun Wang, Xiaohong Chen, Huanying Yao","doi":"10.1097/MD.0000000000040428","DOIUrl":"10.1097/MD.0000000000040428","url":null,"abstract":"<p><p>As an acute systemic vasculitis, Kawasaki disease (KD) could develop coronary artery lesions (CAL) sometimes. However, its etiology was still unidentified. This study was to construct a predictive model based on clinical features and laboratory parameters, and then perform a rapid risk assessment of CAL. We collected clinical and laboratory data retrospectively for all patients with KD who were hospitalized at our hospital from January 2016 to June 2023. All the patients were divided into CAL and non-CAL groups and then randomly assigned to a training set and a verification set. The independent risk variables of CAL were identified by univariate analysis and multivariate logistic regression analysis of the training set. These components were then utilized to build a predictive nomogram. Calibration curve and receiver operating characteristic curve were used to evaluate the performance of the model. The predictive nomogram was further validated in the verification set. In the training set, 49 KD patients (19.9%) showed CAL. Compared with the non-CAL group, the proportion of fever days ≥ 10, C-reactive protein and total bilirubin were significantly higher in the CAL group, whereas age was younger, hemoglobin and albumin were lower. Younger age, fever days ≥ 10, higher C-reactive protein, lower hemoglobin and albumin were identified as independent risk factors for CAL in KD patients. The nomogram constructed using these factors showed satisfactory calibration degree and discriminatory power (the area under the curve, 0.764). In the verification set, the area under the curve was 0.798. Younger age, fever days ≥ 10, lower hemoglobin and albumin levels, higher C-reactive protein levels were independent risk factors for CAL in KD patients. The predictive nomogram constructed utilizing 5 relevant risk factors could be conveniently used to facilitate the individualized prediction of CAL in KD patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of dexmedetomidine combined with propofol-etomidate mixture in radical gastrectomy under general anesthesia.","authors":"Ji Liu, Jinqiu Yang, Xiyang Yang, Guangfen Yin, Tao Li, Ruoyu Li, Ai Wang","doi":"10.1097/MD.0000000000039669","DOIUrl":"10.1097/MD.0000000000039669","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is the third most common malignant tumor with the second highest mortality rate in the world, and radical gastrectomy is the main treatment method, but the operation needs a long period of time to carry out and has strong surgical trauma stimulation, which is likely to cause sympathetic nerve excitement and stress reaction in the body. Therefore, the selection of appropriate anesthetic medication regimen and anesthesia method has an important impact on the intraoperative management and postoperative recovery of patients. This study aims to compare the clinical effects of dexmedetomidine alone in combination with propofol, etomidate and propofol-etomidate mixture in the treatment of radical gastrectomy for gastric cancer.</p><p><strong>Methods: </strong>A total of 90 patients undergoing elective radical gastrectomy were randomly divided into the propofol group (group P), the etomidate group (group E), and the etomidate-propofol mixture group (group PE). Anesthesia induction was performed under the monitoring of bispectral index anesthesia depth. The same pumping drugs were used in 3 groups: 0.1 to 0.3 μg/kg·min remifentanil, 0.5 μg/kg·h dexmedetomidine, and 5 to 10 μg/kg·min rocuronium. The primary outcome indicator was the hemodynamic conditions. The secondary outcome indicators included awakening time and time to accurately answer questions after operation, the prevalence of postoperative respiratory depression and adverse events, the incidence of postoperative cognitive dysfunction, and preoperative and postoperative Montreal Cognitive Assessment and Mini-Mental State Examination scores.</p><p><strong>Results: </strong>Among the 3 groups of patients, the use rate of vasoactive drugs in group P was higher (P < .05); the systolic blood pressure, diastolic blood pressure, and heart rate of group P at T1 to T4 were significantly lower than those of groups E and PE (P < .05); the systolic blood pressure, diastolic blood pressure, and heart rate of group E in T2, T4, and T6 were significantly higher than those of groups P and PE (P < .05). The wake-up time after operation and the time to accurately answer the questions were longer in group E than in groups P and PE (P < .05). The incidence of postoperative respiratory depression in group P was higher than that in groups E and PE (P < .05). The Montreal Cognitive Assessment score of group P was lower than that of groups E and PE 7 days after operation (P < .05).</p><p><strong>Conclusion: </strong>Dexmedetomidine combined with propofol-etomidate mixture is a better anesthesia drug combination.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast tumor with giant borderline phyllodes: Case report and literature review.","authors":"Gongyin Zhang, Jinsheng Zeng, Changwang Li, Changlong Wei","doi":"10.1097/MD.0000000000037260","DOIUrl":"10.1097/MD.0000000000037260","url":null,"abstract":"<p><strong>Rationale: </strong>Giant phyllodes tumors are rare fibroepithelial neoplasms, accounting for less than 1% of all primary breast tumors. Their main features are a single-round mass, progressive enlargement, and a high rate of local recurrence. A phyllodes tumor measuring more than 10 cm in diameter is usually defined as a \"giant\" tumor. Surgery remains the primary treatment option, although the efficacy of adjuvant radiotherapy needs to be confirmed by further studies.</p><p><strong>Patient concerns: </strong>We report a rare case involving a 38-year-old woman who presented, in May 2022, with a large, borderline lobulated tumor in her left breast, measuring 35 cm × 30 cm. She needed to physically support the mass when performing any activity, and even slight physical activity elevated her heart rate to 130 beats/min. In addition, the patient was unable to lie flat and could only sleep on her left side.</p><p><strong>Diagnoses: </strong>Breast B-ultrasound examination and chest computed tomography scans showed the possibility of inflammatory changes. Ultrasound-guided pathologic examination of the mass could not determine the type of mass. Immunofluorescence and bacterial culture of the aspirated fluid were also negative, ruling out the possibility of infection. A mastectomy was then performed to clarify the diagnosis.</p><p><strong>Interventions: </strong>The tumor was completely removed, and the patient did not receive any adjuvant therapy after surgery.</p><p><strong>Outcomes: </strong>The patient recovered smoothly. Unfortunately, she experienced a recurrence of the left breast mass six months later, which progressed to malignancy.</p><p><strong>Lessons: </strong>The most effective treatment for phyllodes tumors of breast is wide local excision with clean margins greater than 1 cm. Simple mastectomy is recommended for borderline or malignant cases, especially when it is difficult to achieve reliable negative margins. Although adjuvant radiotherapy and chemotherapy after surgery are not generally recommended as first-line treatments, it raises the question of whether the recurrence could have been delayed if the patient had received postoperative radiation therapy.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between anemia and sensorineural hearing loss: A review.","authors":"Liting Ye, Dong Lai, Junhu Tai","doi":"10.1097/MD.0000000000040326","DOIUrl":"10.1097/MD.0000000000040326","url":null,"abstract":"<p><p>Anemia affects a third of the world's population and contributes to increased morbidity and mortality, decreased work productivity, and impaired neurological development. In recent years, many studies have found a possible association between anemia and sensorineural hearing loss (SNHL), especially in various types of nutritional deficiency and hemoglobin disorders anemia. Anemia may affect hearing through various mechanisms, including affecting microcirculation in the ear, causing tissue hypoxia in the ear, and through inflammatory and oxidative stress pathways. This review aims to comprehensively analyze the association between various types of anemia and SNHL, including possible biological mechanisms, clinical features, and treatment strategies, and clarify the importance of anemia treatment and management in preventing SNHL.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Day napping and metabolic-associated fatty liver disease: A systematic review and meta-analysis of observational studies.","authors":"Linxiao Gao, Jianping Gong, Guochao Zhong, Yajun Qin","doi":"10.1097/MD.0000000000040362","DOIUrl":"10.1097/MD.0000000000040362","url":null,"abstract":"<p><strong>Background: </strong>Napping inevitably affects human health, and the association between napping and metabolism-related diseases is being more seriously considered. However, the conclusions of studies on the relationship between napping and fatty liver disease (NAFLD)/metabolic-associated fatty liver disease (MAFLD) remain controversial.</p><p><strong>Methods: </strong>We performed a systematical search to identify eligible studies up to July 31, 2024. The fixed effects model was used to calculate the pooled odds ratio (OR). Subgroup were performed. Sensitivity analyses and meta-regression analysis were carried to explore the heterogeneity. Publication bias was assessed by funnel plot and Egger's test.</p><p><strong>Results: </strong>48,248 participants from 13 studies were included in this meta-analysis. The pooled analysis found napping to have an association between the incidence of NAFLD/MAFLD (OR, 1.13; 95% confidence interval (CI), 1.08-1.19; P < .001). The robustness of this study was confirmed using a sensitivity analysis. No apparent heterogeneity or publication bias was observed. Further meta-analysis revealed that short nap duration did not greatly affect the incidence of the disease (OR, 1.01; 95% CI, 0.91-1.12; P = .80). However, long nap duration was significantly linked to high risk of the disease (OR, 1.21; 95% CI, 1.02-1.44; P = .03).</p><p><strong>Conclusion: </strong>Patients with NAFLD/MAFLD may had higher prevalence of napping habit. Future research is warranted to conduct a dose-response analysis, measure the effects of confounding factors, and explore the causal relationships between NAFLD/MAFLD. The research protocol was registered and approved in PROSPERO (registration no: CRD42023439507).</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided popliteal sciatic nerve block for surgical anesthesia in wound care patients with ongoing anticoagulant/antiaggregant therapy: A single-center, prospective study.","authors":"Ali Eman, Onur Balaban, Özge Pekşen, Alper Erkin","doi":"10.1097/MD.0000000000040311","DOIUrl":"10.1097/MD.0000000000040311","url":null,"abstract":"<p><p>Ultrasound-guided peripheral nerve blocks may be a good alternative in patients under antithrombotic drugs. We evaluated the efficacy of ultrasound-guided popliteal sciatic nerve block in patients undergoing lower extremity wound debridement of whom antithrombotic drugs could not be stopped. We focused on hemorrhagic complications related to sciatic nerve block. Wound care patients followed by Cardiovascular Surgery Department scheduled for lower extremity wound surgery were included in this prospective observational study. Data was collected between March 2021 and September 2022. All patient were under antithrombotic therapy and discontinuation of anticoagulant drugs were not possible. Single-insertion and multiple-injection sciatic nerve block at popliteal region was applied to all patients under ultrasound guidance. Primary outcome was the rate of hemorrhage. Secondary outcomes were block onset times, block success and postoperative analgesia times. Data of 105 patients was evaluated, 87 were male and 18 were female. Mean patient age was 61.92 ± 10.06, mean patient body mass index was 25.68 ± 6.33. All patients were under 1 or more antithrombotic drugs. Only one minor hematoma was detected by postoperative ultrasonography control in 1 patient. Hemorrhage complication rate was 1 of 105 (% 0.95, 95% CI, 0.00024-0.051). Overall block success rate was 99.05%. Mean block onset time was 16.27 ± 5.69 minutes. Mean postoperative analgesia time was 19.5 ± 11.22 hours. Sciatic nerve block under ultrasound guidance using in-plane technique was safe and provided sufficient surgical anesthesia and postoperative analgesia for lower extremity wound debridement surgery in patients on antithrombotic drugs.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of cognitive training on cognitive function in patients after cardiac surgery: A systematic review and meta-analysis of randomized controlled trials.","authors":"Rongxiang Zhang, Chenyang Zhu, Shiqi Chen, Feng Tian, Pingping Huang, Yuan Chen","doi":"10.1097/MD.0000000000040324","DOIUrl":"10.1097/MD.0000000000040324","url":null,"abstract":"<p><strong>Background: </strong>Postoperative cognitive deficits frequently occur in patients undergoing cardiac surgery, leaving them with reduced cognitive function. Cognitive training has been shown to improve cognitive function, however, the role in patients after cardiac surgery is unclear. In this study, we aimed to evaluate the effectiveness and safety of cognitive training in patients undergoing cardiac surgery.</p><p><strong>Method: </strong>A systematic search of PubMed, Embase, Cochrane Library, CINAHL, Ovid Medline, Web of Science, CNKI, and Wanfang was conducted until March 2024. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Data were meta-analyzed using RevMan 5.4 software. Potential bias and reliability of evidence were fairly assessed by using the Cochrane risk of bias method and the GRADE evidence grading method.</p><p><strong>Results: </strong>A total of 16 studies involving 1335 cardiac surgery patients were included in this study. Compared with the control group, the cognitive training group had a significantly lower incidence of postoperative cognitive dysfunction (RR 0.35, 95% CI 0.18-0.65, P = .001), significantly improved cognitive function (MD 2.54, 95% CI 1.27-3.81, P < .001), and a significantly higher quality of life-mental component (MD 5.22, 95% CI 2.32-8.13, P < .001), anxiety (MD -6.05, 95% CI -10.96 to -1.15, P = .02) and depression (MD -3.97, 95% CI -7.15 to -0.80, P = .01) were significantly improved between groups. However, the differences were not statistically significant for postoperative delirium (RR 1, 95% CI 0.38-2.65, P = 1.00) and postoperative hospitalization (MD -0.95, 95% CI -2.90 to 1.00, P = .34).</p><p><strong>Conclusions: </strong>The present study, based on a low to moderate quality of evidence, suggests that cognitive training improves cognitive functioning, reduces the incidence of postoperative cognitive dysfunction, and has a positive impact on anxiety and depression in patients undergoing cardiac surgery. However, current evidence does not allow for the determination of effects on quality of life, postoperative delirium, and postoperative length of stay.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leiomyoma of the prostate: A case report and literature review.","authors":"Zejun Liu, Ji Lu, Kai Yu, Tengteng Jian, Rui Hu, Min Liu","doi":"10.1097/MD.0000000000040340","DOIUrl":"10.1097/MD.0000000000040340","url":null,"abstract":"<p><strong>Rationale: </strong>Prostate leiomyoma is a rare condition globally, often challenging to diagnose preoperatively, with most cases being definitively identified through postoperative pathology. This benign tumor generally has a good prognosis and is primarily treated with transurethral resection of the prostate in clinical settings. However, there are no established guidelines or therapeutic protocols for managing this disease.</p><p><strong>Patient concerns: </strong>The patient was admitted to our hospital's Department of Urology with complaints of hematuria, urinary frequency, and urgency for 1 month. Pelvic computed tomography revealed an irregular, mass-like high-density shadow posterior to the bladder, indistinctly separated from the prostate. The patient had been diagnosed with renal insufficiency during a physical examination 4 years prior but had not received standardized treatment. Six years ago, the patient underwent electrocision of the prostate at our hospital, and postoperative pathology indicated prostate leiomyoma.</p><p><strong>Diagnoses: </strong>Postoperative pathology confirmed a diagnosis of prostate leiomyoma.</p><p><strong>Interventions: </strong>The patient presented with an enlarged prostate and preoperative hematuria. Holmium laser enucleation of the prostate (HoLEP) was performed. The Foley catheter was removed on the second postoperative day, and the patient was discharged 3 days after surgery.</p><p><strong>Outcomes: </strong>Following discharge, the patient was instructed to undergo reexaminations every 6 months. Current follow-up indicates the patient is in good health, with no recurrence of the mass observed.</p><p><strong>Lessons: </strong>Prostate leiomyoma is an extremely rare condition, and the current primary approach for managing prostate smooth muscle tumors involves active patient monitoring, regular evaluations, and timely surgical intervention if clinical symptoms emerge. In this study, we present a new case report of prostatic smooth muscle tumor and review the existing literature to explore treatment options for prostate leiomyoma within this field.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of cardiac deterioration in acute heart failure patients: Evaluation of the efficacy of single laboratory indicator models versus comprehensive models.","authors":"Xiaoyu Yang, Liang Wen, Min Sun, Junlu Yang, Bin Zhang","doi":"10.1097/MD.0000000000040266","DOIUrl":"10.1097/MD.0000000000040266","url":null,"abstract":"<p><p>This study aims to compare the efficacy of single-indicator models versus comprehensive models in predicting cardiac deterioration events in patients with acute heart failure (AHF), providing a more precise predictive tool for clinical practice. This retrospective cohort study included 484 patients with AHF treated at our hospital between June 2018 and January 2023. Patients were categorized into a deterioration group and a non-deterioration group based on the occurrence of cardiac deterioration events within 1 year, defined as cardiogenic shock, cardiac arrest, or the need for mechanical circulatory support. We collected clinical data, laboratory markers, and imaging indicators for analysis. Both single-indicator models and comprehensive models (clinical data + indicators) were constructed and evaluated using the area under the receiver operating characteristic (ROC) curve (AUC) to assess their predictive performance. Among the 484 AHF patients, 121 were in the deterioration group and 363 were in the non-deterioration group. Among the single indicators, WBC had the highest AUC of 0.683. The indicator model (WBC, NOMO, Cr, BUN, Troponin, NT-proBNP, D-Dimer, LVEF, and RVFAC) achieved an AUC of 0.886 in the training set and 0.876 in the validation set. The comprehensive model (age, time from onset to admission, heart failure type, WBC, NOMO, Cr, BUN, troponin, NT-proBNP, LA, D-dimer, fibrinogen, and RVFAC) had an AUC of 0.940 in the training set and 0.925 in the validation set. In the training set, the comprehensive model had a significantly higher AUC than the indicator model (P < .05), while no significant difference was observed between the 2 in the validation set (P > .05). Furthermore, decision curve analysis (DCA) and calibration curve analysis indicated that the comprehensive model provided greater clinical benefits and better predictive accuracy in clinical applications. The comprehensive model demonstrates superior predictive capability for cardiac deterioration events in AHF patients, significantly outperforming both single-indicator and indicator models. This suggests that a comprehensive assessment can more accurately identify high-risk patients, offering a more reliable basis for clinical decision-making.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying thermoplastic mask quality for precision radiotherapy in head and neck cancer: A 3D stress test and 6D-axis error analysis.","authors":"Weirchiang You, Chienchih Chen, Hsiushan Chu, Yuchen Yau, Tingyang Liu, Peishuan Lai, Yungcheng Chen, Niwei Chen, Chefu Tsai, Heyuan Hsieh","doi":"10.1097/MD.0000000000040365","DOIUrl":"10.1097/MD.0000000000040365","url":null,"abstract":"<p><p>Patients with head and neck cancers often require radiotherapy, where immobilization devices like thermoplastic masks ensure precise radiation delivery by minimizing movement. However, the quality of these masks lacks standard reference data. This study aimed to establish institutional acceptance criteria for thermoplastic mask quality and quantify their effectiveness using a 3 dimensional stress test and verified the setup errors using daily megavoltage computed tomography (MVCT). Between April and June 2022, 30 patients underwent radiotherapy with thermoplastic masks. Four key facial points (forehead, bilateral cheekbones, and chin) were tested for supporting force. Mean forces ranged from 3.97 N to 8.8 N. MVCT was used to assess 6 dimensional-axis errors, with mean translational errors (x, y, z) of 0.32 mm, -1.09 mm, and 2.24 mm, respectively, and rotational errors (yaw, pitch, roll) of -0.12°, 0.22°, and 0.35°, respectively. The results demonstrated that the thermoplastic masks provided precise immobilization, minimizing setup errors in 6 dimensions. Our findings offer a quantifiable method to ensure high-quality immobilization during radiotherapy for patients with head and neck cancers.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}