P–328 Dienogest significantly decreases the size of the cyst and alters Anti-Müllerian Hormone concentration in patients with endometrioma

Abstract Study question Does utilization of dienogest make any impact on the size of cyst and Anti-Müllerian Hormone (AMH) concentration in patients with endometrioma throughout 12-months? Summary answer Although dienogest makes a gradual reduction in the size of endometrioma cyst throughout 12-months, a significant drop in AMH serum concentration was also noticed. What is known already According to recent studies, pre-operative serum AMH levels might be illusively increased with parallel to the size of endometrioma which will be a misleading factor while deciding to operate the patient via cystectomy. Although dienogest is one of the medical options that might be commenced in patients with endometrioma cyst, there is limited data about its effect on the size of the endometrioma and hence serum AMH concentration throughout 12 months of follow up. Study design, size, duration The current observational cohort study was conducted among patients with endometrioma those treated with dienogest from January 2017 to January 2020. The primary outcome was alteration in diameter of endometrioma cyst at 6th and 12th months of treatment. Secondary outcome was alteration in serum AMH concentration in the same period. Of 104 patients treated with dienogest, 44 patients were excluded due to being treated with any type of surgical intervention during follow up period. Participants/materials, setting, methods A total of 60 patients were recruited for the final analysis. Of them, primary symptom was dysmenorrhea, chronic pelvic pain and menstrual irregularity in 16 (26.7%), 25 (41.7%) and 8 (13.3%) patients, respectively. Eighteen patients (30%) were asymptomatic. As 21 patients had bi-lateral endometrioma, size of the leading cyst was considered to be analyzed for the primary outcome measure. Paired-t test was used for comparison of numerical values and p ≤ 0.05 was taken as statistical significance. Main results and the role of chance The mean age was 31.5±8.0 years. In the time point when dienogest was started, the mean size of the endometrioma was 46.3±17.4 mm. The mean serum AMH concentration was 3.6±2.4 ng/ml. After 6 months of treatment, the mean size of the endometrioma decreased to 38.6±14.0 mm which corresponds to a mean difference of 7.8 mm (95% CI: 3.0 to 12.6; p: 0.003). The respective figure for AMH was 3.3±2.7 ng/ml which corresponds to a mean difference of 0.3 ng/ml (95% CI: –0.2 to 0.8; p: 0.23) at 6 months. After 12 months of treatment, the mean size of the endometrioma was 37.5±15.7 mm which corresponds to a mean difference of 8.9 mm (95% CI: 2.9 to 14.9; p: 0.005) at the end of 12 months. The respective figure for AMH was 2.7±1.9 ng/ml which corresponds to a mean difference of 0.9 ng/ml (95% CI: 0.1 to 1.7; p: 0.045) at the end of 12 months. The mean diameter of endometrioma and AMH concentration did not differ throughout the time period between 6th and 12th months of the treatment. Limitations, reasons for caution Although herein we present the largest data that depicts the alteration of endometrioma cyst and AMH concentration with the application of dienogest, the lack of control group is a limitation that avoids to perform any comparison. Wider implications of the findings: A shrinkage after commencement of treatment suggest that dienogest might present improvement in patients with endometrioma with respect to radiological findings, but further studies are required whether a decline in AMH concentration after 12 months refers to a genuine decrease in ovarian reserve or resolution of misleading high pre-treatment levels. Trial registration number not available

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Comparative study of intracranial access in thrombectomy using next generation 0.088 inch guide catheter technology

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-017341 ◽

2021 ◽

pp. neurintsurg-2021-017341

Author(s):

Devin V Bageac ◽

Blake S Gershon ◽

Jan Vargas ◽

Maxim Mokin ◽

Zeguang Ren ◽

...

Keyword(s):

Primary Outcome ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Control Group ◽

Anterior Circulation ◽

Guide Catheter ◽

Catheter Failure ◽

Catheter Technology ◽

Intracranial Vasculature

BackgroundMost conventional 0.088 inch guide catheters cannot safely navigate intracranial vasculature. The objective of this study is to evaluate the safety of stroke thrombectomy using a novel 0.088 inch guide catheter designed for intracranial navigation.MethodsThis is a multicenter retrospective study, which included patients over 18 years old who underwent thrombectomy for anterior circulation large vessel occlusions. Technical outcomes for patients treated using the TracStar Large Distal Platform (TracStar LDP) or earlier generation TRX LDP were compared with a matched cohort of patients treated with other commonly used guide catheters. The primary outcome measure was device-related complications. Secondary outcome measures included guide catheter failure and time between groin puncture and clot engagement.ResultsEach study arm included 45 patients. The TracStar group was non-inferior to the control group with regard to device-related complications (6.8% vs 8.9%), and the average time to clot engagement was 8.89 min shorter (14.29 vs 23.18 min; p=0.0017). There were no statistically significant differences with regard to other technical outcomes, including time to recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2B). The TracStar was successfully advanced into the intracranial internal carotid artery in 33 cases (73.33%); in three cases (6.67%), it was swapped for an alternate catheter. Successful reperfusion (mTICI 2B-3) was achieved in 95.56% of cases. Ninety-day follow-up data were available for 86.67% of patients, among whom 46.15% had an modified Rankin Score of 0–2%, and 10.26% were deceased.ConclusionsTracstar LDP is safe for use during stroke thrombectomy and was associated with decreased time to clot engagement. Intracranial access was regularly achieved.

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A Randomised Controlled Trail of Plasma Exchange in Rapidly Progressive Renal Failure of Myeloma.

Blood ◽

10.1182/blood.v104.11.4899.4899 ◽

2004 ◽

Vol 104 (11) ◽

pp. 4899-4899

Author(s):

William F. Clark ◽

A. Keith Stewart ◽

Gail A. Rock ◽

Marion Sternbach ◽

David M. Sutton ◽

...

Keyword(s):

Serum Creatinine ◽

Sample Size ◽

Plasma Exchange ◽

Kidney Failure ◽

Statistical Significance ◽

Control Group ◽

Significant Difference ◽

The Mean ◽

Baseline Characteristics

Abstract In myeloma, plasma exchange (PE) has been suggested to prevent rapidly progressive kidney failure by reducing exposure to nephrotoxic light chains. We carried out a randomized controlled multi-centre trial comparing PE or no PE in 104 patients of whom 101 met the inclusion, exclusion criteria and 4 were lost to follow-up. We compared baseline characteristics as well as renal outcomes and performed a futility analysis to determine the sample size necessary for potential statistical significance for the changes noted. Thirty-nine patients were randomized to the control group and 58 to the PE group with a 6-month follow-up. The baseline characteristics of these 2 groups were similar including serum creatinine, dialysis dependence, age, gender, serum calcium, serum albumin, 24 -hour urine for protein levels and Durie-Salmon myeloma staging. Thirteen (33.3%) of the control group and 19 (33.3%) of the PE group died within 6 months of follow up. Ten patients (31%) in the control and 10 patients (21%) in the PE arm were dialysis dependent at 6 months. Seven patients (47%) came off dialysis in the control and 13 patients (59%) in the PE arm with the mean number of dialysis days from 0–6 months being 45.7±67.6 in the control versus 29.2±56.1 in the PE arm at 6 months. The mean serum creatinine in the control group was 314.6±256.1 μmol/L versus 215.4±215.3 μmol/L in the PE group and the composite end point of death, dialysis or serum creatinine >254 μmol/L occurred in 12 (30.8%) in the control and 11 (19.3%) in the PE arm. The futility analysis to indicate the per group sample size necessary to achieve statistical significance at 6 months for the difference we observed was infinite for cumulative mortality, 805 for dialysis dependence, 2418 for coming off dialysis, 321 for number of dialysis days, 132 for creatinine difference of 100 μmol/L and for the composite outcome of death, dialysis or creatinine>354 μmol/L, 737. We did not observe a statistically significant difference in mortality or renal morbidity for PE versus no PE in patients with myeloma and rapidly progressive kidney failure.

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Effect of Xiaoyutang Combined with Intraperitoneal Heat Perfusion Chemotherapy on Immune Function, Circulating mir, Prognosis, and Survival of Postoperative Patients with Colorectal Cancer

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/1619809 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Lingxia Li ◽

Yunjiu Wang ◽

Xiaowan Huang ◽

Jian Sun ◽

Jue Zhang

Keyword(s):

Colorectal Cancer ◽

Immune Function ◽

Statistical Significance ◽

Control Group ◽

Study Group ◽

Intergroup Interactions ◽

Random Number Table ◽

The Mean ◽

Lost To Follow Up

Objective. To explore the effects of Xiaoyutang combined with intraperitoneal heat perfusion chemotherapy on immune function, circulating Mir, and prognosis and survival of postoperative patients with colorectal cancer. Methods. A total of 96 patients with colorectal cancer who were treated in our hospital from May 2018 to August 2019 and followed up to August 2021 were selected as the study subjects. The patients were randomly divided into a control group and study group by a 1 : 1 random number table method, 48 cases in each group. Patients in the control group were given intraperitoneal thermal perfusion chemotherapy after surgery, and patients in the research group were treated with Xiaoyutang on this basis. The treatment cycle was 21 days, and all patients were treated for 3 consecutive cycles. The therapeutic efficacy, immune function (CD3+, CD4+, and CD4+/CD8+), circulating mir (mir-29a, mir-145, and mir-92a), prognosis, and survival of the two groups were compared. Results. After 3 cycles of treatment, ORR and DCR in the study group were higher than those in the control group (60.42% vs. 37.50%) and 85.42% vs. 66.67%, respectively, with statistical significance ( P < 0.05 ). There were statistically significant differences in CD3+, CD4+, CD4+/CD8+, mir-29a, mir-145, and mir-92a time points and intergroup and intergroup interactions between the two groups ( P < 0.05 ); the levels of CD3+, CD4+, and CD4+/CD8+ in the study group were higher than those in the control group after 1, 2, and 3 cycles of treatment ( P < 0.05 ); the expressions of mir-29a, mir-145, and mir-92a were significantly lower than those in the control group ( P < 0.05 ). By the end of follow-up, 3 cases were lost to follow-up in the study group and 5 cases in the control group. The recurrence rate and mortality of the study group were lower than those of the control group at 1- and 2-year follow-up ( P > 0.05 ), and the mean survival time of patients in the study group was higher than that in the control group; the differences were statistically significant ( χ 2 = 5.151 , P = 0.023 ). Conclusion. Xiaoyutang combined with peritoneal heat perfusion chemotherapy has a good postoperative effect on patients with colorectal cancer, which can effectively improve the immune function and circulating Mir of patients with colorectal cancer, reduce tumor recurrence, and improve the prognosis of patients.

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Redefining the Neck: A Retrospective Review Utilizing Hyoid Suspension

The American Journal of Cosmetic Surgery ◽

10.1177/0748806818791940 ◽

2018 ◽

Vol 35 (4) ◽

pp. 198-204

Author(s):

Sami A. Nizam ◽

Rhys Branman

Keyword(s):

Standard Deviation ◽

Statistical Significance ◽

Biomechanical Testing ◽

Retrospective Chart Review ◽

Mean Difference ◽

Control Group ◽

P Value ◽

Hyoid Suspension ◽

The Mean ◽

Experimental Group

Neck contouring is one of the most frequent reasons patients seek cervicofacial rhytidectomy. But what makes for aesthetically pleasing youthful neck? Ellenbogen and Karlin described 5 criteria in their 1980 landmark publication, including having a cervicomental angle between 105° and 120° and a visible subhyoid depression. Recent advances in neck anatomy have revealed the existence of ligamentous like structures attaching the skin and platysma to the hyoid. These have been termed the hyoplatysmal ligament (HPL) and cervicomental suspensory angle ligament by different authors. This study was undertaken to determine whether surgically reestablishing the above structures utilizing a hyoid suspension technique resulted in statistically significant changes in cervicomental contour. A retrospective chart review was performed from January 2014 to present. After December 2016, the second author began utilizing a hyoid suspension technique where the inter- and subplatysmal fat was resected and the HPL was reestablished surgically (hyoid suspension). Cases before this date served as controls if a similar neck manipulation was performed without reestablishing the HPL. In total, 104 charts were queried, of which, 21 charts fit inclusion criteria to serve as controls and 20 as the experimental group. Before and after profile pictures were then compared for differences in cervicomental angle utilizing commercially available imaging software (Canfield Mirror, Parsippany, New Jersey). An unpaired Student t test was then performed to determine whether this 2 groups differed significantly utilizing a P value of .05 to denote statistical significance. The mean difference between pre- and postoperative cervicomental angle for the control group was 17.38° with a standard deviation of 8.05°. The mean difference between pre and postoperative cervicomental angle for the experimental group was 28.75° with a standard deviation of 15.52°. The resulting 11.37° difference in cervicomental angle between the 2 groups was found to be statistically significant with a P value of .0051. Our cosmetic surgical and anatomical knowledge continues to progress. Brant first described a ligamentous structure that attaches the platysma to the hyoid. Through biomechanical testing, he noted this ligament to be one of the weakest in the face and neck. Thereafter, in 2016 Yousif et al and Le Lourn separately described similar procedures to attach the platysma to the hyoid, in effect reestablishing this ligament. Utilizing one simple surgical maneuver, the hyoid suspension reestablishes the HPL. This surgically creates an acute cervicomental angle, resulting in less platysmal displacement postoperatively, with virtually no addition to surgical time or morbidity.

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Interspinous ligamentoplasty in the treatment of degenerative spondylolisthesis: midterm clinical results

Journal of Neurosurgery Spine ◽

10.3171/2010.3.spine0957 ◽

2010 ◽

Vol 13 (1) ◽

pp. 27-35 ◽

Cited By ~ 9

Author(s):

Soon-Woo Hong ◽

Ho-Yeon Lee ◽

Kyeong Hwan Kim ◽

Sang-Ho Lee

Keyword(s):

Statistical Significance ◽

Translational Motion ◽

Degenerative Spondylolisthesis ◽

Angular Motion ◽

Disc Height ◽

Control Group ◽

Adjacent Segment ◽

Foraminal Stenosis ◽

The Mean

Object Pseudarthrosis and adjacent-segment degeneration remain problems after fusion surgery. To overcome these complications, many dynamic stabilization methods have been developed. This study was conducted to elucidate the midterm results on the effectiveness of interspinous ligamentoplasty (ILP) to treat degenerative spondylolisthesis. Methods Thirty-two consecutive surgeries involving decompression and ILP were performed by 2 surgeons at the authors' institution during 2001 and 2002. Nine patients were excluded from the study because of inadequate follow-up or radiological data, leaving a study population of 23 patients with a mean duration of follow-up of 64.6 months (range 60–77). All the patients had symptomatic spinal stenosis and Grade 1 spondylolisthesis at L4–5 level without foraminal stenosis and deformity. Clinical outcomes were evaluated by visual analog scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Radiological measurements included segmental lordosis, total lumbar lordosis, posterior disc height, anterior slippage, angular motion, translational motion, and facet degeneration grade. Eighteen patients who had undergone bilateral laminotomy alone were included as a Control Group. Results Twenty-two of the 23 patients who underwent ILP returned to their active daily lives. Symptomatic instability was less common in the ILP Group than in the Control Group (4.3% vs 27.8%). The mean postoperative VAS leg scores, VAS back scores, and ODI scores at final follow-up were significantly improved in both groups, in comparison to preoperative scores; however, the mean difference in ODI scores was significantly greater in the ILP group (29.3% vs 16.6%, p = 0.049). In radiological analysis, segmental and total lordoses were significantly increased in the ILP Group. In both groups slippage increased, disc height decreased, and angular motion was maintained, but translational motion decreased with statistical significance in the ILP Group, whereas it increased in the Control Group. Radiological instability was observed in 3 patients in the ILP Group, and 9 in the Control Group (significant between-groups difference, p = 0.016). Conclusions Interspinous ligamentoplasty is a good option treating patients with Grade 1 degenerative spondylolisthesis requiring surgery. It is less invasive and effectively stabilizes the unstable spine with a relatively small incidence of postoperative instability. Interspinous ligamentoplasty provides satisfactory clinical and radiological results at midterm follow-up.

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A Wearable Technology Delivering a Web-Based Diabetes Prevention Program to People at High Risk of Type 2 Diabetes: Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/15448 ◽

2020 ◽

Vol 8 (7) ◽

pp. e15448

Author(s):

Emily Staite ◽

Adam Bayley ◽

Ebaa Al-Ozairi ◽

Kurtis Stewart ◽

David Hopkins ◽

...

Keyword(s):

Physical Activity ◽

Controlled Trial ◽

Intervention Group ◽

Diabetes Prevention Program ◽

Mean Difference ◽

Control Group ◽

Web Based ◽

The Mean

Background Intensive lifestyle interventions are effective in reducing the risk of type 2 diabetes, but the implementation of learnings from landmark studies is expensive and time consuming. The availability of digital lifestyle interventions is increasing, but evidence of their effectiveness is limited. Objective This randomized controlled trial (RCT) aimed to test the feasibility of a web-based diabetes prevention program (DPP) with step-dependent feedback messages versus a standard web-based DPP in people with prediabetes. Methods We employed a two-arm, parallel, single-blind RCT for people at high risk of developing diabetes. Patients with a hemoglobin A1c (HbA1c) level of 39-47 mmol/mol were recruited from 21 general practices in London. The intervention integrated a smartphone app delivering a web-based DPP course with SMS texts incorporating motivational interviewing techniques and step-dependent feedback messages delivered via a wearable device over 12 months. The control group received the wearable technology and access to the web-based DDP but not the SMS texts. As this was a feasibility study, the primary aim was to estimate potential sample size at different stages of the study, including the size of the target study population and the proportion of participants who consented, were randomized, and completed follow-up. We also measured the main outcomes for a full-scale RCT, namely, change in weight and physical activity at 6- and 12-month follow-ups, and secondary outcomes, including changes in the HbA1c level, blood pressure, waist circumference, waist-to-hip ratio, and lipid levels. Results We enrolled 200 participants: 98 were randomized to the intervention and 102 were randomized to the control group. The follow-up rate was higher in the control group (87/102, 85.3%) than in the intervention group (69/98, 70%) at 12 months. There was no treatment effect on weight at 6 months (mean difference 0.15; 95% CI −0.93 to 1.23) or 12 months (mean difference 0.07 kg; 95% CI −1.29 to 1.44) or for physical activity levels at 6 months (mean difference −382.90 steps; 95% CI −860.65 to 94.85) or 12 months (mean difference 92.64 steps; 95% CI −380.92 to 566.20). We did not observe a treatment effect on the secondary outcomes measured at the 6-month or 12-month follow-up. For the intervention group, the mean weight was 92.33 (SD 15.67) kg at baseline, 91.34 (SD 16.04) kg at 6 months, and 89.41 (SD 14.93) kg at 12 months. For the control group, the mean weight was 92.59 (SD 17.43) kg at baseline, 91.71 (SD 16.48) kg at 6 months, and 91.10 (SD 15.82) kg at 12 months. In the intervention group, the mean physical activity was 7308.40 (SD 4911.93) steps at baseline, 5008.76 (SD 2733.22) steps at 6 months, and 4814.66 (SD 3419.65) steps at 12 months. In the control group, the mean physical activity was 7599.28 (SD 3881.04) steps at baseline, 6148.83 (SD 3433.77) steps at 6 months, and 5006.30 (SD 3681.1) steps at 12 months. Conclusions This study demonstrates that it is feasible to successfully recruit and retain patients in an RCT of a web-based DPP. Trial Registration ClinicalTrials.gov NCT02919397; http://clinicaltrials.gov/ct2/show/NCT02919397

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Impact of a “Pharmacist First” innovative workflow plan in patients with hypertension and/or diabetes

Canadian Pharmacists Journal / Revue des Pharmaciens du Canada ◽

10.1177/17151635211016498 ◽

2021 ◽

pp. 171516352110164

Author(s):

Randy So ◽

Yazid Al Hamarneh ◽

Carlene Oleksyn ◽

Mary Purschke ◽

Ross Tsuyuki

Keyword(s):

Blood Pressure ◽

Laboratory Tests ◽

Primary Outcome ◽

Control Group ◽

Workflow Model ◽

Patients With Diabetes ◽

The Mean ◽

The Impact

Usual community pharmacy workflow, whereby patients might see a pharmacist at the end of the dispensing process, is not conducive to proactive patient-centred care. The objective of this study was to evaluate the impact of the “Pharmacist First” (P1st) workflow model on blood pressure and glycemic control in patients with hypertension and/or diabetes. This retrospective review was set in 2 community pharmacies that use the P1st model in the Greater Edmonton Region. The population entailed patients with hypertension and/or type 1 or 2 diabetes who received care via the P1st workflow model. The P1st workflow model places the patient in immediate contact with the pharmacist. The pharmacist first assesses prescription appropriateness, reviews relevant laboratory tests, discusses chronic disease control and addresses any questions or concerns the patient has before passing the prescription to be filled by a technician. This allows issues or concerns to be identified and addressed up front, rather than waiting until the prescription is filled and the patient is ready to leave the pharmacy. The primary outcome assessed in this study was change in blood pressure and/or A1C from baseline to the last follow-up visit. We reviewed 215 patient records. The mean age was 69.4 years (standard deviation 12.5), 51.2% of patients were male, 57.7% had hypertension, 5.6% had diabetes, and 36.7% had both. Median follow-up time was 4.2 months (interquartile range 2.5 -9.3). In 203 patients with hypertension, systolic blood pressure was reduced from 139.83 mmHg to 131.26 mmHg ( p < 0.001) and diastolic blood pressure from 80.26 mmHg to 76.86 mmHg ( p < 0.001). In 87 patients with diabetes, A1C changed from 7.4% to 7.2% ( p = ns). The P1st workflow model demonstrated significant improvements in blood pressure. Further investigation is needed to evaluate the effectiveness of this model with a control group, longer follow-up and evaluation of the patient experience.

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A Wearable Technology Delivering a Web-Based Diabetes Prevention Program to People at High Risk of Type 2 Diabetes: Randomized Controlled Trial (Preprint)

10.2196/preprints.15448 ◽

2019 ◽

Author(s):

Emily Staite ◽

Adam Bayley ◽

Ebaa Al-Ozairi ◽

Kurtis Stewart ◽

David Hopkins ◽

...

Keyword(s):

Physical Activity ◽

Controlled Trial ◽

Intervention Group ◽

Diabetes Prevention Program ◽

Mean Difference ◽

Control Group ◽

Web Based ◽

The Mean

BACKGROUND Intensive lifestyle interventions are effective in reducing the risk of type 2 diabetes, but the implementation of learnings from landmark studies is expensive and time consuming. The availability of digital lifestyle interventions is increasing, but evidence of their effectiveness is limited. OBJECTIVE This randomized controlled trial (RCT) aimed to test the feasibility of a web-based diabetes prevention program (DPP) with step-dependent feedback messages versus a standard web-based DPP in people with prediabetes. METHODS We employed a two-arm, parallel, single-blind RCT for people at high risk of developing diabetes. Patients with a hemoglobin A1c (HbA1c) level of 39-47 mmol/mol were recruited from 21 general practices in London. The intervention integrated a smartphone app delivering a web-based DPP course with SMS texts incorporating motivational interviewing techniques and step-dependent feedback messages delivered via a wearable device over 12 months. The control group received the wearable technology and access to the web-based DDP but not the SMS texts. As this was a feasibility study, the primary aim was to estimate potential sample size at different stages of the study, including the size of the target study population and the proportion of participants who consented, were randomized, and completed follow-up. We also measured the main outcomes for a full-scale RCT, namely, change in weight and physical activity at 6- and 12-month follow-ups, and secondary outcomes, including changes in the HbA1c level, blood pressure, waist circumference, waist-to-hip ratio, and lipid levels. RESULTS We enrolled 200 participants: 98 were randomized to the intervention and 102 were randomized to the control group. The follow-up rate was higher in the control group (87/102, 85.3%) than in the intervention group (69/98, 70%) at 12 months. There was no treatment effect on weight at 6 months (mean difference 0.15; 95% CI −0.93 to 1.23) or 12 months (mean difference 0.07 kg; 95% CI −1.29 to 1.44) or for physical activity levels at 6 months (mean difference −382.90 steps; 95% CI −860.65 to 94.85) or 12 months (mean difference 92.64 steps; 95% CI −380.92 to 566.20). We did not observe a treatment effect on the secondary outcomes measured at the 6-month or 12-month follow-up. For the intervention group, the mean weight was 92.33 (SD 15.67) kg at baseline, 91.34 (SD 16.04) kg at 6 months, and 89.41 (SD 14.93) kg at 12 months. For the control group, the mean weight was 92.59 (SD 17.43) kg at baseline, 91.71 (SD 16.48) kg at 6 months, and 91.10 (SD 15.82) kg at 12 months. In the intervention group, the mean physical activity was 7308.40 (SD 4911.93) steps at baseline, 5008.76 (SD 2733.22) steps at 6 months, and 4814.66 (SD 3419.65) steps at 12 months. In the control group, the mean physical activity was 7599.28 (SD 3881.04) steps at baseline, 6148.83 (SD 3433.77) steps at 6 months, and 5006.30 (SD 3681.1) steps at 12 months. CONCLUSIONS This study demonstrates that it is feasible to successfully recruit and retain patients in an RCT of a web-based DPP. CLINICALTRIAL ClinicalTrials.gov NCT02919397; http://clinicaltrials.gov/ct2/show/NCT02919397

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Evaluation of Oxidative Stress Biomarkers in Patients with Henoch-Schönlein Purpura

Folia Medica ◽

10.3897/folmed.63.e59406 ◽

2021 ◽

Vol 63 (6) ◽

pp. 928-931

Author(s):

Kadir Soylemez ◽

Fatih Temiz ◽

Tahir Dalkiran ◽

Yasar Kandur ◽

Ergul Belge Kurutas ◽

...

Keyword(s):

Oxidative Stress ◽

Patient Group ◽

Statistical Significance ◽

Control Group ◽

Healthy Children ◽

Oxidative Stress Biomarkers ◽

Systemic Involvement ◽

The Mean

Introduction: Henoch-Schönlein Purpura (HSP) is a systemic vasculitic syndrome characterized by non-thrombocytopenic purpura, arthritis/arthralgia, abdominal pain, and glomerulonephritis. The pathogenesis of HSP has not been clearly identified. Oxidative damage has a role in the pathogenesis of most cases. Aim: This study aimed to evaluate changes of oxidative stress by studying parameters like superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) in an attempt to identify the role of oxidative stress in HSP from another perspective. Materials and methods: This study enrolled 23 pediatric patients (ten girls and thirteen boys) diagnosed with HSP who were under follow-up at Sutcu Imam University School of Medicine Department of Pediatrics between 2014 and 2016 and twenty healthy children as the control group. The parents of all subjects gave informed consent to participate in the study. In the HSP group, the beginning season of the illness and the systemic involvement during follow-up were determined. Blood specimens were obtained at presentation before any treatment was started. SOD, CAT activities, and MDA values in erythrocyte and plasma samples were compared between the patient group and the healthy children. Results: Twenty-three patients with HSP (13 males, 10 females) and 20 healthy children participated in this study. The mean age of the HSP cases was 8.21±3.78 years (range 2-16 years) and of the controls was 8.6±4.2 (range 3-14 years). The mean MDA value was 2.95±0.71 nmol/ml in the patient group and 2.67±0.66 nmol/ml in the control group (p=0.787). The mean level of the CAT enzyme was 1.32±0.35 U/g Hb in the patient group and 7.8±1.74 U/g Hb in the control group (p=0.001). The mean levels of the SOD enzyme were 3.06±0.85 U/g Hb in the patient group and 0.97±0.36 U/g Hb in the control group (p=0.001). Conclusions: Although high MDA levels support the role of lipid peroxidation in the pathogenesis of HSP, statistical significance was not reached owing to a limited number of our patients. The reduced CAT enzyme activity is consistent with the findings of previous reports. This finding supports the notion that oxidative stress can play a role in the pathogenesis of HSP. Keypoints: Our findings support the notion that oxidative stress can play a role in the pathogenesis of HSP.

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The benefit of radiosurgery for ARUBA-eligible arteriovenous malformations: a practical analysis over an appropriate follow-up period

Journal of Neurosurgery ◽

10.3171/2017.1.jns162962 ◽

2018 ◽

Vol 128 (6) ◽

pp. 1850-1854 ◽

Cited By ~ 11

Author(s):

Daniel A. Tonetti ◽

Bradley A. Gross ◽

Kyle M. Atcheson ◽

Brian T. Jankowitz ◽

Hideyuki Kano ◽

...

Keyword(s):

Death Rate ◽

Arteriovenous Malformations ◽

Primary Outcome ◽

Latency Period ◽

Secondary Outcome ◽

Seizure Disorders ◽

Institutional Experience ◽

The Mean ◽

Stroke Death

OBJECTIVEThe authors of this study found that, given the latency period required for arteriovenous malformation (AVM) obliteration after stereotactic radiosurgery (SRS), a study with limited follow-up cannot assess the benefit of SRS for unruptured AVMs.METHODSThe authors reviewed their institutional experience with “ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)–eligible” AVMs treated with SRS between 1987 and 2016, with the primary outcome defined as stroke (ischemic or hemorrhagic) or death (AVM related or AVM unrelated). Patients with at least 3 years of follow-up in addition to those who experienced stroke or died during the latency period were included. Secondary outcome measures included obliteration rates, patients with new seizure disorders, and those with new focal deficits without stroke.RESULTSOf 233 patients included in this study, 32 had a stroke or died after SRS over the mean 8.4-year follow-up (14%). Utilizing the 10% stroke or death rate at a mean 2.8-year follow-up for untreated AVMs in ARUBA, the rate in the authors’ study is significantly lower than that anticipated at the 8.4-year follow-up for an untreated cohort (14% vs 30%, p = 0.0003). Notwithstanding obliteration, in this study, annualized rates of hemorrhage and stroke or death after 3 years following SRS were 0.4% and 0.8%, respectively. The overall obliteration rate was 72%; new seizure disorders, temporary new focal deficits without stroke, and permanent new focal deficits without stroke occurred in 2% of patients each.CONCLUSIONSAfter a sensible follow-up period exceeding the latency period, there is a lower rate of stroke/death for patients with treated, unruptured AVMs with SRS than for patients with untreated AVMs.

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