Dawsonclark4753

We investigated the accuracy of digital breast tomosynthesis compared to full-field digital mammography for evaluating tumor-free resection margins in the intraoperative specimen during breast-conserving surgery, reducing re-excision rates.

In total, 170 patients, with proven breast cancer and eligible for breast-conserving surgery, were enrolled. Intraoperative specimens underwent digital mammography and digital breast tomosynthesis. Two breast radiologists, with ten years of experience in breast imaging, in batch mode, evaluated tumor-free resection margins and the distance between the margins and lesion. Histopathological findings were considered the standard of reference.

We used the correlation analysis to evaluate the agreement between measures oftumor-free resection margins obtained with digital mammography and the true value (histopathological findings), and between digital breast tomosynthesis and histopathological findings. The size evaluation determined by digital breast tomosynthesis was more accurately correlated with that found by pathology; the calculated Pearson's correlation coefficient of digital breast tomosynthesis and digital mammography to the pathologically determined tumor-free resection margins were 0.92 and 0.79 in CC view and 0.92 and 0.72 in LL view, respectively. Compared with the pathologically determined tumor-free resection margins, the size determined by both imaging modalities was, on average, overestimated. Bland-Altman analysis showed an excellent inter readers agreement.

Digital breast tomosynthesis is more accurate in assessment of margin status than digital mammography; it could be a more accurate technique than full-field digital mammography for the intraoperative delineating of tumor resection margins.

Digital breast tomosynthesis is more accurate in assessment of margin status than digital mammography; it could be a more accurate technique than full-field digital mammography for the intraoperative delineating of tumor resection margins.

Parkinson's disease (PD) and restless legs syndrome/Willis-Ekbom disease (RLS/WED) are both common movement disorders. Based on their clinical overlap, association studies of PD and RLS/WED have been conducted for many years.

To investigate whether or not the genetic risk factor of PD was also associated with RLS/WED.

We included 102 idiopathic RLS/WED patients and 189 matched controls from southeast China. The clinical data included the International Restless Legs Syndrome Study Group Rating Scale, the subtypes of RLS/WED symptoms (painful or other discomfort), the comorbidities, the pregnancy history of female patients, the Hamilton Depression Scale (HAMD), and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Risk gene analysis between RLS/WED and control groups including 21 SNPs (single nucleotide polymorphisms) was conducted. Genotyping was done by Sanger sequencing.

We found that rs4273468 polymorphism of BST1 gene increased the risk of idiopathic RLS/WED patients in southeastern Chinese population (P = <0.001, OR = 2.85, p = 0.019 after Bonferroni correction). Moreover, the haplotype of G-G (rs4698412-rs4273468) was significantly associated with Chinese RLS/WED patients (p = <0.001).

BST1 may contribute to the development of RLS/WED. Further studies on larger cohorts are needed to confirm these findings.

BST1 may contribute to the development of RLS/WED. Further studies on larger cohorts are needed to confirm these findings.

Risk of nutritional disorders (NDs) in bariatric surgical patients has led to guideline recommendations for pre- and post-operative nutrient deficiency screening. The aim of this study was to identify baseline factors associated with incident NDs and, in addition, to explore possible differences in health care spending and use between patients with and without incident NDs following bariatric surgery.

Using data linked with a state-wide bariatric surgical registry and a state-wide claims database, subjects who underwent bariatric surgery between July 1, 2013, and December 31, 2015, were identified. Incident NDs and health care cost and use outcomes following 1 year from surgery were extracted from the claims data. Logistic regression was used to identify baseline factors associated with incident NDs. Zero-inflated negative binomial regression and generalized linear regression were used to estimate health care cost and use outcomes.

A total of 3535 patients who underwent bariatric surgery were identified. Of these patients, those without continuous health insurance enrollment (n=1880), having prevalent (pre-surgery) NDs (n=461), and missing baseline BMI (n=41) were excluded. Of patients analyzed (n=1153), about 30% had incident NDs, with a mean (SD) age and BMI at surgery of 46 (12) years and 48 (9.2) kg/m

, respectively. Patients with one incident ND had higher total health care spending (coefficient=$41118, p-value<0.01) and ED visits (IRR=1.86, p-value<0.01).

Those without pre-operative NDs may have a higher chance of having NDs post-operatively. Taking multivitamins and continues monitoring are necessary to prevent any negative outcomes related to post-operative NDs.

Those without pre-operative NDs may have a higher chance of having NDs post-operatively. Taking multivitamins and continues monitoring are necessary to prevent any negative outcomes related to post-operative NDs.

Drug-related problems (DRPs) prevent patients from fully benefiting from drug treatment. Unrelieved pain in patients with cancer is still widespread. Pharmacists can play a role in closely monitoring cancer patients, pain control maintenance, and patient consultation.

To evaluate the clinical effects and changes in drug costs of pharmacists' interventions on patients with DRPs related to cancer pain.

An academic teaching hospital in Shanghai, China.

Patients with cancer pain admitted to Shanghai Tongren Hospital from October 2018 to February 2019 were randomized into the intervention and control groups. The Pharmaceutical Care Network Europe classification V8.02 was used to categorize DRPs treated with analgesics. Patients' pain relief, the occurrence of adverse drug reactions, and drug cost-saving through the resolution of DRPs were evaluated.

Problems and causes of drug-related problems, interventions proposed, and outcome of pharmacy recommendations.

A total of 172 patients were enrolled and randomized into the intervention group (n = 86) and the control group (n = 86). The pharmacist detected 66 DRPs in 48 patients (55.8%) of the intervention group, an average of 0.8 DRPs per patient. A total of 149 interventions were proposed by the pharmacist. Compared to the control group, the drug intervention produced more pain relief on the third day of analgesic treatment. In the intervention group, a total of 33 DRP interventions resulted in cost changes, saving a drug cost of $489.90, averaging $11.94 per intervention.

Our study suggests that pharmacy service in patients with cancer pain can resolve drug-related problems and reduce drug costs.

Our study suggests that pharmacy service in patients with cancer pain can resolve drug-related problems and reduce drug costs.

To investigate keratoplasty outcomes in a university-based hospital.

Medical records of all patients undergoing keratoplasty at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between January 1, 2006, and December 31, 2015, with a minimum follow-up period of three months were reviewed retrospectively. Indications, surgical procedures, complications and outcomes of all surgeries were collected and analyzed.

Graft survival and visual acuity.

Data were available for 488 grafts in the study period, including 313 optical penetrating keratoplasty (PKP), 42 therapeutic/tectonic PKPs, 72 deep anterior lamellar keratoplasty, 58 Descemet's stripping automated endothelial keratoplasty and 3 Descemet's membrane endothelial keratoplasty. A total of 389 (79.7%) grafts survived, whereas 99 (20.3%) grafts failed. The projected 1-year, 3-year and 5-year cumulative survival rates for the entire study group were 85.8%, 74.9% and 71.1%, respectively. Corneal ectasia was the commonest surgical indication accounting for 48% of the cases. The best long-term survival rates were observed in the stromal dystrophy and corneal ectasia groups. selleck inhibitor The worst survival rates were noticed in the congenital corneal opacities group. Vision improved in in 57.5% of grafted eyes, remained the same in 39.8% and deteriorated in 2.7%. Postoperative complications occurred in 36% of the grafts with rejection being the most common, and its mere occurrence increased the risk of graft failure by 20-fold.

The outcome of grafting in a university-based hospital can be excellent in low-risk grafts and fair to low in high-risk grafts. Our results are relatively comparable to nationally and internationally reported outcomes.

The outcome of grafting in a university-based hospital can be excellent in low-risk grafts and fair to low in high-risk grafts. Our results are relatively comparable to nationally and internationally reported outcomes.

To review recent progress, challenges, and future perspectives of stromal keratophakia for the treatment of advanced keratoconus.

We systematically reviewed the literature in the PubMed database, last update June 30, 2020. No language restriction was applied. The authors checked the reference lists of the retrieved articles to identify any additional study of interest.

Several techniques have been proposed for the treatment of keratoconus in order to avoid or delay keratoplasty. This was primarily due to the lack of accessibility to donor corneas in many countries. The ease and predictability of the more advanced femtosecond lasers used to correct ametropias by stromal lenticule extraction lead to hypothesize that generated refractive lenticules could be implanted into corneal stromal layers to restore volume and alter the refractive properties of the cornea in patients with corneal ectasias. At the same time, new techniques for preservation, customization, and cellular therapy of the corneal stromal harized.

To analyze the factors influencing visual field recovery in patients with pituitary adenoma following surgical treatment.

We retrospectively reviewed 144 eyes of 72 patients with pituitary adenoma who had been followed up for more than 6 months following surgery between January 2016 and December 2019. Pre and postoperative visual acuity, visual field test and retinal nerve fiber layer (RNFL) thickness were investigated. We defined recovery of visual field defects as being an improvement in mean deviation (MD) of 2dB or more.

The average age of the 72 patients (144 eyes) was 51.94 ± 14.69years, making for 37 patients in the recovery group and 35 patients in the non-recovery group. Preoperative MD, pattern standard deviation (PSD), and visual field indexes (VFI) were negatively correlated to postoperative MD, PSD and VFI changes and positively correlated to postoperative MD, PSD, and VFI values. Using multiple regression analysis, a shorter duration of symptoms (Odds ratio [OR], 0.990; p = 0.033), higher preoperative MD values (OR, 0.871; p = 0.025), and thicker temporal RNFL (OR, 1.068; p = 0.048) were associated with a visual field recovery following surgery.

The prognosis for visual field recovery is favorable for patients who have a short period from symptom onset to surgery, a higher MD value of preoperative VF, and a thicker peripapillary temporal RNFL thickness. Therefore, the preoperative MD, temporal RNFL thickness, and the symptom period can be predictive variables affecting postoperative visual field recovery.

The prognosis for visual field recovery is favorable for patients who have a short period from symptom onset to surgery, a higher MD value of preoperative VF, and a thicker peripapillary temporal RNFL thickness. Therefore, the preoperative MD, temporal RNFL thickness, and the symptom period can be predictive variables affecting postoperative visual field recovery.