Medicine
-
The increase in life expectancy along with technological advances has translated into a higher number of pituitary adenomas (PA) diagnosed from the age of 65. In the elderly, symptoms related to comorbidities might overlap with endocrine dysfunction, in addition to increasing anesthetic and surgical risks. This study aimed to compare baseline clinical and tumor features between patients with PA from different age groups: younger adults (YA), 18 to 64 years, and older adults (OA), ≥65 years. ⋯ The rate of TSS-related complications was similar between the groups for major, minor and endocrine/electrolyte complications. OA-PA clinically differ from the younger: tend to present more frequently with chronic comorbidities and less frequently with hormone-secreting effects, are more often NF and larger in size without a significant increase in invasiveness. The TSS results were reassuring, proving to be equally safe for the elderly.
-
Observational Study
Retrospective observational study of the effects of residual neuromuscular blockade and sugammadex on motor-evoked potential monitoring during spine surgery in Japan.
Given neuromuscular blockade (NMB) can affect the amplitude and detection success rate of motor-evoked potentials (MEP), sugammadex may be administered intraoperatively. We evaluated the factors affecting the degree of residual NMB (i.e., the train-of-four [TOF] ratio) and the relationship between TOF ratio and MEP detection success rate in Japanese patients undergoing spine surgery. This single-center retrospective observational study included adults who underwent spine surgery under propofol/remifentanil anesthesia, received rocuronium for intubation, and underwent myogenic MEP monitoring after transcranial stimulation. ⋯ The time from intubation to the start of MEP monitoring after NMB recovery was significantly shorter in patients administered sugammadex versus patients without sugammadex (P < .0001). The MEP detection success rate was higher in patients with a TOF ratio of ≥0.75. Sugammadex shortened the time from intubation to the start of MEP monitoring after NMB recovery.
-
Clinical investigation of obesity-related risk factors aids in the early detection, prevention, and management of obesity. We aimed to examine the association between obesity and serum uric acid (sUA). A cross-sectional study was conducted including 18473 subjects from the National Health and Nutrition Examination Survey (NHANES). ⋯ Subgroup analyses were stratified by race/ethnicity, results indicated the positive association of sUA with BMI in males remained in all races including Mexican American (β = 1.203, 95% CI: 0.965-1.442, P < .0001), other Hispanic (β = 1.126, 95% CI: 0.858-1.395, P < .0001), non-Hispanic White (β = 1.493, 95% CI: 1.343-1.642, P < .0001), non-Hispanic Black (β = 1.331, 95% CI: 1.122-1.540, P < .0001), and other races (β = 1.329, 95% CI: 1.115-1.544, P < .0001). And the positive association of sUA with BMI in females also remained in all races including Mexican American (β = 1.806, 95% CI: 1.520-2.092, P < .0001), other Hispanic (β = 2.033, 95% CI: 1.687-2.379, P < .0001), non-Hispanic White (β = 1.847, 95% CI: 1.657-2.037, P < .0001), non-Hispanic Black (β = 2.141, 95% CI: 1.874-2.408, P < .0001), and other races (β = 1.348, 95% CI: 1.081-1.615, P < .0001). The current cross-sectional study with 18473 US participants found that an elevated sUA was positively correlated with a higher BMI in males, females, and all kinds of races.
-
To investigate the associations of job-related psychological flexibility, coping style and personality types with and their interactions in depression in Chinese physicians. A cross-sectional survey of 444 physicians was conducted by using the convenience sampling method in the municipal hospitals in Zhengzhou, Henan province. Center for Epidemiological Studies Depression, Work-related Acceptance and Action Questionnaire, the Simplified Coping Style Questionnaire and Eysenck Personality Questionnaire-Revision Short Scale of China were administered to each participant. ⋯ Multivariate regression models showed that a significant interaction existed between coping style, work-related psychological flexibility and Extroversion (β = -0.103, P < .05), independently explaining 0.7% variance of depression, and that a significant interaction existed between coping style, work-related psychological flexibility and neuroticism (β = 0.116, P < .05), independently explaining 1.0% variance of depression. Interactions existed between personality types, coping style and work-related psychological flexibility in depression tendency in Chinese healthcare workers, with neuroticism (extrovert unstable) being a risk factor and extroversion (extrovert stable) being a protective factor. Precision prevention strategies could be made based on personality types to reduce depression in health workers.
-
The cage nonunion may cause serious consequences, including recurrent pain, radiculopathy, and kyphotic deformity. The risk factors for nonunion following anterior cervical discectomy and fusion (ACDF) are controversial. The aim of the study is to investigate the risk factors for nonunion in cervical spondylotic cases after ACDF. ⋯ The calibration curves showed that the predicted outcome fitted well to the observed outcome in the training cohort (P = .102,) and validation cohort (P = .125). The decision curves showed the nomogram had more benefits than the All or None scheme if the threshold probability is >10% and <100% in training cohort and validation cohort. We found that age, smoking, angle of C2 to C7, number of operated levels, and serum vitamin D were all significant predictors of nonunion.