Medical sciences (Basel, Switzerland)最新文献

{"title":"The Correlation of Bile Duct Dilatation in Postmortem Computed Tomography of Lethal Intoxication Cases for Different Drug Types-A Retrospective Study.","authors":"Barbara Fliss, Kirththanan Krishnarajah, Lars Ebert, Cora Wunder, Sabine Franckenberg","doi":"10.3390/medsci12040065","DOIUrl":"10.3390/medsci12040065","url":null,"abstract":"<p><strong>Purpose: </strong>To assess (I) whether, in autopsy-proven lethal intoxications with opiates/opioids, a dilatation of the common bile duct (CBD) is still visible in postmortem computed tomography (PMCT) and (II) if a dilatation of the CBD might also be measurable for other substance groups (e.g., stimulants, hypnotics, antipsychotics, etc.).</p><p><strong>Methods: </strong>We retrospectively measured the CBD using PMCT in cases with lethal intoxication (<i>n</i> = 125) and as a control group in cases with a negative toxicological analysis (<i>n</i> = 88). Intoxicating substances were classified into the subgroups (opiates, opioids, stimulants, hypnotics, antipsychotics, gasses, and others). Significance between the study and control groups was tested with the Mann-Whitney U test, and correlations were examined by using crosstables.</p><p><strong>Results: </strong>There was a statistically significant difference between the CBD diameters in the intoxication group overall, when compared to the CBD diameter in the control group (<i>p</i> < 0.001). For both subgroups of \"opiates\" and \"opioids\", there was a strong statistically significant difference between the CBD diameter (being wider) in those groups compared to the control group (both <i>p</i> = 0.001). For the three subgroups \"hypnotics\", \"stimulants\", and \"psychotropic drugs\", there was no statistically significant difference between the CBD diameters in the intoxication subgroups when compared with the control group. The other subgroups were too small for statistical analysis.</p><p><strong>Conclusion: </strong>A dilated common bile duct in postmortem computed tomography might be used as an indication for a lethal opioid or opiate intoxication only in regard to the specific case circumstances or together with other indicative findings in a postmortem investigation.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Adverse Childhood Experiences on Asthma Severity in US Adults.","authors":"Chukwuemeka E Ogbu, Ioannis Stouras, Chisa O Oparanma, Stella C Ogbu, Chinazor Umerah","doi":"10.3390/medsci12040063","DOIUrl":"10.3390/medsci12040063","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/objectives&lt;/b&gt;: The association between adverse childhood experiences (ACEs) and asthma severity among United States (US) adults with asthma has not been well documented. In addition, whether gender differences exist in this association has been underexplored. We aimed to examine the prevalence of asthma severity in the US adult population with asthma and investigate the association between ACEs and asthma severity by using data from non-institutionalized US adults with asthma. &lt;b&gt;Methods&lt;/b&gt;: This cross-sectional study used data from the Adult 2019 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey (ACBS), a survey of US adults aged 18 years or older in 31 US states and Puerto Rico. A total of 22934 adults with asthma participated in 2019 and 2020 ACBS. The 11 BRFSS ACE variables encompassing abuse and household dysfunction were used as ACE measures. ACE measures were summed up as cumulative ACE scores (continuous) and categorized (zero, one ACE, two ACEs, ≥ three ACEs). Asthma severity was categorized as intermittent or persistent. Weighted logistic regression models were used to assess associations of the cumulative ACE score, categorical ACE measures, and the 11 individual ACE responses with asthma severity controlling confounders. Gender differences were explored by stratifying by gender. &lt;b&gt;Results:&lt;/b&gt; The prevalence of persistent asthma among US adults with asthma was 45.3%. The mean cumulative ACE score in adults with intermittent vs. persistent asthma was (2.43 vs. 2.70, &lt;i&gt;p&lt;/i&gt;-value &lt; 0.05). About 22% of adults with asthma had no ACEs, 19% had one ACE, 14% had two ACEs, and 45% had three or more ACEs. A one-unit increase in ACEs score was associated with a 5.4% increase in the odds of persistent asthma (adjusted odds ratio, aOR = 1.054 (95% confidence interval, CI = 1.01-1.10). Experiencing ≥ three ACEs compared to no ACEs was associated with 31% increased odds of persistent asthma (aOR = 1.31, 95% CI = 1.01-1.70). Individual ACE items significantly associated with persistent asthma include parent/adult ever touched you sexually (aOR = 1.33, 95% CI = 1.03-1.74), adult tried to make you touch them (aOR = 1.34, 95% CI = 1.01-1.79), any adult forced you to have sex (aOR = 1.44, 95% CI = 1.04-1.20), parental separation/divorce (aOR = 1.31, 95% CI = 1.05-1.63), and household alcohol abuse (aOR = 1.24, 95% CI = 1.01-1.53). In women, experiencing one ACE and ≥ three ACEs (compared to no ACEs) was associated with 51% and 60% increased odds of persistent asthma, respectively (aOR = 1.51, 95% CI = 1.02-2.23; aOR = 1.60, 95% CI = 1.12-2.27). No significant association was observed between ACEs and asthma severity in men; however, experiencing household physical violence (compared to no household physical violence) was associated with persistent asthma in men (aOR = 1.69, 95% CI = 1.18-2.42). &lt;b&gt;Conclusions&lt;/b&gt;: In this cross-sectional study of US adults with asthma, exposure to ACEs was assoc","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-Blocker Use in Patients Undergoing Non-Cardiac Surgery: A Systematic Review and Meta-Analysis.","authors":"Doménica Herrera Hernández, Bárbara Abreu, Tania Siu Xiao, Andreina Rojas, Kevin López Romero, Valentina Contreras, Sol Villa Nogueyra, Zulma Sosa, Samantha M Alvarez, Camila Sánchez Cruz, Ernesto Calderón Martinez","doi":"10.3390/medsci12040064","DOIUrl":"10.3390/medsci12040064","url":null,"abstract":"<p><strong>Background: </strong>The use of beta-blockers in the perioperative period has been widely investigated due to their potential to reduce the risk of major adverse cardiovascular and cerebrovascular events (MACCE) and mortality; yet their overall impact on various postoperative outcomes remains debated. This study constitutes a systematic review and meta-analysis of the impact of beta-blockers on mortality, MI, stroke, and other adverse effects such as hypotension and bradycardia in patients undergoing non-cardiac surgery.</p><p><strong>Methods: </strong>A comprehensive systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. Searches were performed across PubMed, Cochrane, Web of Science, Scopus, EMBASE, and CINAHL databases; we included randomized controlled trials and cohort and case-control studies published from 1999 to 2024.</p><p><strong>Results: </strong>This meta-analysis included data from 28 studies encompassing 1,342,430 patients. Perioperative beta-blockers were associated with a significant increase in stroke risk (RR 1.42, 95% CI: 1.03 to 1.97, <i>p</i> = 0.03, I² = 62%). However, no statistically significant association was found between beta-blocker use and mortality (RR 0.62, 95% CI: 0.38 to 1.01, <i>p</i> = 0.05, I² = 100%). Subgroup analyses revealed a protective effect on mortality for patients with high risks, such as patients with a history of atrial fibrillation, chronic heart failure, and other arrhythmias. For myocardial infarction (RR 0.82, 95% CI: 0.53 to 1.28, <i>p</i> = 0.36, I² = 86%), a reduction in events was observed in the subgroup of randomized controlled trials. Beta-blockers significantly increased the risk of hypotension (RR 1.46, 95% CI: 1.26 to 1.70, <i>p</i> < 0.01, I² = 25%) and bradycardia (RR 2.26, 95% CI: 1.37 to 3.74, <i>p</i> < 0.01, I² = 64%).</p><p><strong>Conclusions: </strong>Perioperative beta-blockers show increasing rates of stroke events following non-cardiac surgery but do not significantly impact the incidence of MI or mortality. The increased risks of hypotension and bradycardia necessitate careful patient selection and monitoring. Future research should aim to refine patient selection criteria and optimize perioperative management to balance the benefits and risks of beta-blocker use in surgical settings.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Asian Flush and Satisfaction of Sleep via Alcohol Consumption Status in a Sample of Japanese Participants.","authors":"Yuji Shimizu, Tomokatsu Yoshida, Keiko Ito, Kumiko Terada, Nagisa Sasaki, Eiko Honda, Kazushi Motomura","doi":"10.3390/medsci12040062","DOIUrl":"10.3390/medsci12040062","url":null,"abstract":"<p><strong>Background: </strong>The reddening of the face and neck following alcohol consumption is known as Asian flush. Although genetic factors related to Asian flush have been reported to be inversely associated with duration of sleep, no study has reported an association between Asian flush and sleep satisfaction.</p><p><strong>Methods: </strong>A cross-sectional study of 3823 Japanese people, aged 20 to 64 years was conducted. The target population comprised general public resident monitors of Osaka Prefecture who were registered with an internet research company.</p><p><strong>Results: </strong>A significant inverse association was observed between Asian flush and satisfaction of sleep. The potential confounder-adjusted odds ratio (OR) and 95% confidence interval (CI) of satisfied sleep was 0.81 (0.69-0.96). The alcohol consumption status-specific analysis revealed essentially the same associations between consumers and non-consumers of alcohol. The adjusted ORs (95% CIs) were 0.81 (0.65-0.997) for non-consumers and 0.80 (0.61-1.05) for consumers of alcohol.</p><p><strong>Conclusion: </strong>The genetic characteristics of physical reactions to alcohol exposure may influence sleep quality. One's alcohol consumption status may not influence the effects of having a lower tolerance to alcohol on sleep quality.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Matrix of Factor V Leiden (G1691A), Factor II Prothrombin (G2021A), MTHFR C677T and A1298G Polymorphisms in Greek Population: A Preliminary Study.","authors":"Maria Spanoudaki, Aikaterini Itziou, Antonios Cheimaras, Orestis Tsiripidis, Grigoris Risvas, Naysika Tsitlakidou, Vasileios Balis","doi":"10.3390/medsci12040061","DOIUrl":"10.3390/medsci12040061","url":null,"abstract":"<p><strong>Background: </strong>Thrombophilia, characterized by an increased risk of thrombosis, can result from genetic polymorphisms in clotting factors. This study aims to investigate the prevalence of factor V Leiden (G1691A), factor II prothrombin (G20210A), and MTHFR (C677T and A1298C) polymorphisms in a Greek population, evaluating not only their association with thrombophilia, but also broader health implications.</p><p><strong>Methods: </strong>We conducted a cross-sectional study involving one hundred apparently healthy adults from Thessaloniki, Greece. After obtaining informed consent, DNA was isolated and analyzed using real-time PCR to detect the frequencies of the aforementioned polymorphisms.</p><p><strong>Results: </strong>The genetic distribution of the examined polymorphisms aligns closely with that observed in Northern Europe. Factor V Leiden (FVL) and prothrombin G20210A mutations were predominantly wild types, with a small percentage showing heterozygous mutations. The MTHFR C677T and A1298C polymorphisms showed a higher variation in allele frequency. Certain lifestyle factors such as smoking and high body mass index were significantly associated with the occurrence of combined MTHFR genotypes, suggesting an interaction between genetic and environmental risk factors. Family cancer and cardiovascular history was significantly associated with combined FVL and prothrombin G20210A and MTHFR polymorphism heterozygous carriers.</p><p><strong>Conclusions: </strong>Our findings indicate that these genetic polymorphisms are not only pivotal in understanding thrombophilia but also have broader implications for cardiovascular disease and cancer. This study highlights the need for further research into the combined effects of genetic and epigenetic factors on health, which could lead to improved screening and personalized preventive healthcare strategies.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Outcomes of U.S. Patients with CMML: A Two-Decade Analysis from the SEER Database.","authors":"Ayrton Bangolo, Behzad Amoozgar, Abhishek Thapa, Wardah Bajwa, Vignesh K Nagesh, Yaryna Nyzhnyk, Rakshanda Banu, Tirth Bhavsar, Lili Zhang, Olga Velichko, Challa Mani Shankar Reddy, Edwina Essuman, Amal M Ibrahim, Ramkumar Krishnasamy, Achint Jethi, Arun Ram, Abdullah A Haq, Abdulla Ahmad Al Hashm, Parna Pathak, Shafia Naeem, Rachana R Gavva, Prajakta H Ratnaparkhi, Paula Samaha, Cynthia Elizabeth Armendariz Espinoza, Prasansa Dhakal, Frantz Ricot Martine, Mogahid Elkhidir, Jay Mehta, Simcha Weissman","doi":"10.3390/medsci12040060","DOIUrl":"10.3390/medsci12040060","url":null,"abstract":"<p><p><b>Background:</b> Chronic Myelomonocytic Leukemia (CMML) is a rare and aggressive form of leukemia with characteristics of both myeloproliferative neoplasms (MPNs) and myelodysplastic syndromes (MDSs). This study aims to explore the clinical features, survival outcomes, and prognostic factors in CMML patients over the past 20 years using a large sample. <b>Methods:</b> The study data from 4124 patients diagnosed with CMML between 2000 and 2017 were sourced from the SEER database. Demographic and clinical characteristics, along with overall and cancer-specific mortality, were examined. Factors with a <i>p</i>-value < 0.01 in univariate Cox regression were included in the multivariate Cox model to identify independent prognostic factors, with hazard ratios (HRs) greater than one indicating adverse outcomes. <b>Results:</b> The majority of the cohort were male (61.57%), and most diagnoses occurred between ages 60-79 (55.16%), with a small percentage under 40 (1.41%). Non-Hispanic whites represented the largest racial group (79.03%). Multivariate analysis showed higher mortality in males, those aged 80+, residents in metropolitan areas with populations between 250,000 and 1 million, single or widowed individuals, and those who underwent chemotherapy. Conversely, lower mortality was associated with an annual income of $75,000+. <b>Conclusions:</b> CMML remains a rare and highly aggressive hematologic disorder. This U.S.-based retrospective cohort study identified male gender, advanced age, single or widowed status, and chemotherapy as independent poor prognostic factors. While it is expected that older patients and those requiring chemotherapy would have a poorer prognosis, the higher mortality risk in single or widowed patients, as well as males, warrants further investigation. The early involvement of family and community support may help reduce mortality in these groups, suggesting a need for larger prospective studies to explore these associations further.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing NIRS and Pulse Oximetry for Cerebral Oxygen Saturation During Hypoxia Testing.","authors":"Vasilios Alevizakos, Andreas Werner, Lisa-Marie Schiller, Constantin von See, Marcus Schiller","doi":"10.3390/medsci12040059","DOIUrl":"10.3390/medsci12040059","url":null,"abstract":"<p><p><b>Objective:</b> This study evaluates the suitability of cerebral oximetry using near-infrared spectroscopy (NIRS) compared to traditional pulse oximetry (SpO2) for measuring cerebral oxygen saturation during hypoxia testing, aiming to enhance safety during flight operations and training. <b>Material and Methods:</b> The study included 106 participants aged 18-60 years at the Aerospace Medicine Training Center in Königsbrück. Cerebral oxygen saturation (rSO2) and peripheral oxygen saturation (SpO2) were measured using the INVOS™ 5100C cerebral oximeter and Masimo™ MS5 pulse oximeter, respectively. Measurements were taken at baseline, during hypoxia at 25,000 feet, and post recovery. Data analysis included regression analysis, Bland-Altman plots, and concordance correlation coefficients (CCC). Ethical approval was obtained from the Hannover Medical School. Data from 100 participants were analyzed. <b>Results:</b> Baseline SpO2 was 97.5 ± 1.5%, and baseline rSO2 was 77.25 ± 6.4%. During hypoxia, SpO2 dropped significantly, while rSO2 showed higher values. SpO2 recovered faster than rSO2. Deviations in rSO2 between the right and left sides during hypoxia were minimal. Lin's CCC indicated moderate to substantial concordance. NIRS measurements were more stable and less prone to disturbances, with 95 disruptions in pulse oximetry, 25 of which were potentially critical. <b>Conclusions:</b> NIRS is a reliable method for detecting cerebral oxygen saturation, offering significant advantages over traditional pulse oximetry in stability and reliability during hypoxia testing. NIRS is less error-prone, supporting its use for continuous monitoring in aviation settings and enhancing flight safety by providing more accurate hypoxia detection.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of Hereditary Amyloidosis with Rare Variant in Ecuador: Case Reports.","authors":"Diana Elizabeth Luzuriaga Carpio, Borys Roberto Abrigo Maldonado, Humberto Villacorta","doi":"10.3390/medsci12040058","DOIUrl":"https://doi.org/10.3390/medsci12040058","url":null,"abstract":"<p><p>More than approximately 120 transthyretin mutations are known. Their clinical presentation is heterogeneous, as the course of disease onset depends on genetic variation and level of penetrance. They are little known in Ecuador, and some of the reported cases suggest-given analysis of family trees-that they come from a province that is possibly considered endemic. The main objective of this study is to perform a descriptive observational analysis on the presentation of transthyretin amyloidosis in families carrying the p.Ser43Asn gene of the identified index case.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Invasiveness in Lepidic Pattern Adenocarcinoma of Lung: Analysis of Visual Semantic and Radiomic Features.","authors":"Sean F Johnson, Seyed Mohammad Hossein Tabatabaei, Grace Hyun J Kim, Bianca E Villegas, Matthew Brown, Scott Genshaft, Robert D Suh, Igor Barjaktarevic, William Dean Wallace, Fereidoun Abtin","doi":"10.3390/medsci12040057","DOIUrl":"https://doi.org/10.3390/medsci12040057","url":null,"abstract":"<p><strong>Objectives: </strong>To differentiate invasive lepidic predominant adenocarcinoma (iLPA) from adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA) of lung utilizing visual semantic and computer-aided detection (CAD)-based texture features on subjects initially diagnosed as AIS or MIA with CT-guided biopsy.</p><p><strong>Materials and methods: </strong>From 2011 to 2017, all patients with CT-guided biopsy results of AIS or MIA who subsequently underwent resection were identified. CT scan before the biopsy was used to assess visual semantic and CAD texture features, totaling 23 semantic and 95 CAD-based quantitative texture variables. The least absolute shrinkage and selection operator (LASSO) method or forward selection was used to select the most predictive feature and combination of semantic and texture features for detection of invasive lung adenocarcinoma.</p><p><strong>Results: </strong>Among the 33 core needle-biopsied patients with AIS/MIA pathology, 24 (72.7%) had invasive LPA and 9 (27.3%) had AIS/MIA on resection. On CT, visual semantic features included 21 (63.6%) part-solid, 5 (15.2%) pure ground glass, and 7 (21.2%) solid nodules. LASSO selected seven variables for the model, but all were not statistically significant. \"Volume\" was found to be statistically significant when assessing the correlation between independent variables using the backward selection technique. The LASSO selected \"tumor_Perc95\", \"nodule surround\", \"small cyst-like spaces\", and \"volume\" when assessing the correlation between independent variables.</p><p><strong>Conclusions: </strong>Lung biopsy results showing noninvasive LPA underestimate invasiveness. Although statistically non-significant, some semantic features showed potential for predicting invasiveness, with septal stretching absent in all noninvasive cases, and solid consistency present in a significant portion of invasive cases.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Neutropenia on Clinical Outcomes after Lung Transplantation.","authors":"Raquel Sanabrias Fernández de Sevilla, Ana Concepción Sánchez Cerviño, Rosalía Laporta Hernández, Myriam Aguilar Pérez, Christian García Fadul, Sarela García-Masedo Fernández, Amelia Sánchez Guerrero, María Piedad Ussetti Gil","doi":"10.3390/medsci12040056","DOIUrl":"10.3390/medsci12040056","url":null,"abstract":"<p><strong>Background/objectives: </strong>Neutropenia is a frequent complication among solid organ transplant (SOT) recipients receiving immunosuppressive therapy and antimicrobial prophylaxis. However, there are limited studies analysing the frequency and impact of neutropenia in lung transplant recipients (LTRs). Our aim was to analyse the frequency of neutropenia, the need for granulocyte colony-stimulating factor (GCSF) treatment within the first 18 months post-transplant and its association with acute rejection, chronic lung allograft dysfunction (CLAD), overall survival and the development of infections.</p><p><strong>Methods: </strong>This observational and retrospective study recruited 305 patients who underwent lung transplantation between 2009 and 2019, with outpatient quarterly follow-up during the first 18 months post-surgery.</p><p><strong>Results: </strong>During this period, 51.8% of patients experienced at least one episode of neutropenia. Neutropenia was classified as mild in 50.57% of cases, moderate in 36.88% and severe in 12.54%. GCSF treatment was indicated in 23.28% of patients, with a mean dose of 3.53 units. No statistically significant association was observed between neutropenia or its severity and the development of acute rejection, CLAD or overall survival. However, the patients who received GCSF treatment had a higher mortality rate compared to those who did not. Sixteen patients (5.25%) developed infections during neutropenia, with bacterial infections being the most common.</p><p><strong>Conclusions: </strong>Neutropenia is common in the first 18 months after lung transplantation and most episodes are mild. We did not find an association between neutropenia and acute rejection, CLAD, or mortality. However, the use of GCSF were associated with worse post-transplant survival.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}