Mcfarlandcarlson2066
For several years, hyaluronic acid (HyA) and, more recently, polyacrylamide hydrogel (PHyd) have been used to reduce lameness and pain caused by osteoarthritis. However, there is still a lack of scientific evidence of the efficacy of these substances to allow veterinary experts to make decisions about their use in horses. The objective of this study was to evaluate, through a systematic review and network meta-analysis (NMA), the efficacy of HyA, associated or not with other drugs, and PHyd in relieving lameness in horses with osteoarthritis. The searches for primary studies were conducted on four search platforms. The efficacy of HyA and PHyd was estimated through the relative risk difference method. Heterogeneity was observed in the efficacy of HyA, indicating long-term ineffectiveness of this drug when associated or not with anti-inflammatory drugs. In contrast, the results indicate that PHyd is an effective alternative therapy, with a long period of action in reducing lameness in horses with osteoarthritis. This study provides evidence that the application of PHyd and HyA is effective in reducing lameness caused by osteoarthritis in horses at different time periods, where PHyd has a longer time of action.Endometritis is one of the main causes of bovine infertility, which causes serious economic losses to the industry. The endometrium is the first line of defense against invading microbial pathogens in the uterus. Andrographolide is the primary active component of A. paniculate, and has been shown to have anti-inflammatory and antioxidant effects. However, its effects on the LPS-induced signaling pathway in bovine endometrial epithelial cells (bEECs) have not been reported yet. The aim of this study was to investigate the anti-inflammatory effects and mechanism of andrographolide in the LPS-induced inflammatory response of bEECs. We found that andrographolide strongly reduced LPS-induced NO and iNOS expression. The production of cytokines that were upregulated by LPS was significantly suppressed. To investigate the anti-inflammatory mechanism of andrographolide, we examined the activation of Nrf2. The results shown that andrographolide inhibited the expression of Keap1 but increased the expression of Nrf2. The expression levels of target genes of Nrf2 including Ho-1 and Nqo-1 were increased by andrographolide. Taken together, these results suggest that andrographolide may serve as a candidate to protect against the LPS-induced inflammatory response by inducing Nrf2 activation.
To examine differences in lower limb muscle strength between older people with varying degrees of hallux valgus deformity.
Muscle strength was measured at the knee, ankle and foot using hand-held dynamometry and a clinical test of toe strength (the paper grip test) in 157 older people (99 women and 58 men) aged 65 to 91 (mean 74.1, SD 5.9) years. Hallux valgus severity was documented as none, mild, moderate or severe using validated photographs. Differences in muscle strength according to hallux valgus severity were evaluated using analysis of variance, adjusting for age. Paper grip test performance was compared across the hallux valgus severity groups using the chi-square (χ
) statistic.
Knee extension, ankle joint dorsiflexion, ankle joint plantar flexion, ankle joint inversion, ankle joint eversion and lesser toe plantarflexion strength were not significantly different across the four hallux valgus severity groups. However, there was a significant, dose-response reduction in hallux plantarflexion strength with increasing severity of hallux valgus. This persisted after adjustment for age (F
= 5.5, p = 0.001) with a medium effect size (partial η
= 0.10). The number of participants who could successfully complete the paper grip test of the hallux significantly reduced across the four hallux valgus categories (χ
= 18.5, p < 0.001).
There is a specific and progressive reduction in hallux plantarflexion strength with increasing severity of hallux valgus in older people. This finding has potential implications for both the aetiology and treatment of this common and disabling condition.
There is a specific and progressive reduction in hallux plantarflexion strength with increasing severity of hallux valgus in older people. This finding has potential implications for both the aetiology and treatment of this common and disabling condition.
The teaching role of radiology residents has seldom been evaluated, and little is known about how teaching skills of radiology residents evolve throughout their training in the absence of formal teaching guidance. Our objective is to identify residents' characteristics correlating with better teaching and compare teaching characteristics of junior and senior residents.
All seven medical schools in Lebanon were involved in this multi-centric study. A self-assessment questionnaire was sent to sixty-nine radiology residents and filled anonymously. Fifty-seven (83 %) responses were received and represent the study population. Data analysis was based on factors correlating with overall teaching effectiveness. A comparison of senior and junior residents' responses was also performed.
Overall teaching effectiveness correlated with better knowledge, technical skills, clinical judgment, communication skills, identification and correction of learning problems, and importantly providing and receiving feedback. Senior residents rated themselves significantly better than juniors in "knowledge related to radiology" and in "technical skills" but not in "overall teaching effectiveness". Seniors did not agree on the statement "medical students make my clinical responsibilities easier". Although not reaching statistical significance, seniors showed a trend towards improving teaching skills.
Overall teaching effectiveness is correlated with the adoption of proper skills and techniques. Despite the lack of formal teaching guidance, senior radiology residents are improving their techniques as teachers but still face difficulties in several domains.
Overall teaching effectiveness is correlated with the adoption of proper skills and techniques. Despite the lack of formal teaching guidance, senior radiology residents are improving their techniques as teachers but still face difficulties in several domains.
To investigate the predictive value of MRI-based radiomics features for lymph node metastasis (LNM) and vascular endothelial growth factor (VEGF) expression in patients with cervical cancer.
A total of 163 patients with cervical cancer were enrolled in this study. A total of 134 patients were included for LNM differentiation, and 118 were included for VEGF expression discrimination. The patients were randomly assigned to the training group or test group at a ratio of 21. Radiomics features were extracted from T1WI enhanced and T2WI MRI scans of each patient, and tumor stage was also documented according to the International Federation of Gynecology and Obstetrics (FIGO) guidelines. The least absolute shrinkage and selection operator algorithm was used for feature selection. The results of 5-fold cross validation were applied to select the best classification models. The performances of the constructed models were further evaluated with the test group.
Sixteen radiomics features and the FIGO stage were selected to construct the LNM discrimination model. The LNM prediction model achieved the best diagnostic performance, with areas under the receiver operating curve (AUCs) of 0.95 and 0.88 in the training group and test group, respectively. Nine radiomics characteristics were screened to build the VEGF prediction model, with AUCs of 0.82 and 0.70 in the training group and test group, respectively. Decision curve analysis confirmed their clinical usefulness.
The presented radiomics prediction models demonstrated potential to noninvasively differentiate LNM and VEGF expression in cervical cancer.
The presented radiomics prediction models demonstrated potential to noninvasively differentiate LNM and VEGF expression in cervical cancer.
To evaluate whether abdominal atherosclerosis was associated with poorer outcome in a single-centre cohort of patients suffering from nonocclusive mesenteric ischemia (NOMI).
From January 2009 to December 2019, 121 consecutive patients from the critical care unit who underwent laparotomy for suspected NOMI and with available unenhanced and contrast-enhanced CT were included. Clinical and biological data at the time of the CT scan were retrospectively extracted from medical charts and reviewed by a single radiologist. Unenhanced CT acquisitions were used to calculate calcium scores of the abdominal aorta, celiac trunk, superior mesenteric artery (SMA) and common iliac arteries according to the Agatston method. Univariate and multivariate analysis were performed.
Among the 121 patients with NOMI and calcium score calculation, only 4 patients had no aortic calcifications (3 %) and 32 had no superior mesenteric artery calcification (26 %). 35 patients (29 %) died within 24 h after the abdominal CT scan. Univariate analysis showed that a total abdominal calcium score greater than 15 000 (last quartile) was significantly associated with death within 24 h (14 (40 %) vs 17 (20 %) patients, p = 0.035). By multivariate analysis, a total abdominal calcium score greater than 15 000 was an independent risk factor for death (HR = 1.94, 95 %CI [1.02-3.73], p = 0.044). Regarding separate calcium scores, only a SMA calcium score greater than 50 was a risk factor for death (HR 2.46, 95 %CI [1.14-3.93], p = 0.019).
Our results show that abdominal atherosclerosis, especially in the SMA, is associated with poorer outcome in NOMI.
Our results show that abdominal atherosclerosis, especially in the SMA, is associated with poorer outcome in NOMI.
We aimed to interpret MR mammography (MRM) using the Kaiser scores for equivocal or inconclusive lesions on mammography (MG).
Retrospective IRB-approved evaluation of 3623 MG for which MRM was deployed as a problem-solving tool, after inclusion-exclusion criteria were met. Three readers with different levels of experience assigned a final score from 1 to 11 based on the previously established tree classification system. Area under the curve (AUC) derived from receiver operating characteristic (ROC) analysis was used to determine the overall diagnostic performance for all lesions and separately for mass and non-mass enhancement. Sensitivity, specificity, and likelihood ratio values were obtained at different cut-off values of >4, > 5, and > 8 to rule in and rule out malignancy.
Histopathology of 183 mass and 133 non-mass enhancement (NME) lesions show benign etiology in 95 and malignant in 221. The AUC was 0.796 [0.851 for mass and 0.715 for NME]. Applying the Kaiser score upgraded 202 lesions with correct prediction in 77 %, and downgraded 28 lesions with correct prediction in 60.8 %. Using a score <5 instead of <4 to rule out malignancy improved our diagnostic ability to correctly identify 100 % benign lesions. Applying Kaiser score correctly downgraded 60.8 % (17/28) lesions; thus avoiding biopsies in these. click here Using a high cut-off value>8 to rule-in malignancy, we correctly identified 59.7 % of lesions with 80 % specificity and positive likelihood ratio of 3.
The Kaiser score has clinical translation benefits when used as a problem-solving tool for inconclusive MG findings.
The Kaiser score has clinical translation benefits when used as a problem-solving tool for inconclusive MG findings.
