Medicina
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Randomized Controlled Trial
Diagnosis of Pain Deception Using Minnesota Multiphasic Personality Inventory-2 Based on XGBoost Machine Learning Algorithm: A Single-Blinded Randomized Controlled Trial.
Background and Objectives: Assessing pain deception is challenging due to its subjective nature. The main goal of this study was to evaluate the diagnostic value of pain deception using machine learning (ML) analysis with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales, considering accuracy, precision, recall, and f1-score as diagnostic parameters. Materials and Methods: This study was a single-blinded, randomized controlled trial. ⋯ In the logistic regression analysis, pain and MMPI-2 did not show diagnostic value. However, in the ML analysis, values of the selected MMPI-2 (sMMPI-2) scales related to pain deception showed an accuracy of 0.724, a precision of 0.692, a recall of 0.692, and an f1-score of 0.692. Conclusions: Using MMPI-2 test results, ML can diagnose pain deception better than the conventional logistic regression analysis method by considering different scales and patterns together.
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Randomized Controlled Trial
Bilateral Rectus Sheath Block with Continuous Bupivacaine Infusions After Elective Open Gastrectomy: A Randomized Controlled Trial.
Background and Objectives: Multimodal analgesia has been shown to be effective in facilitating early postoperative gastrointestinal function and rehabilitation in patients undergoing open gastrectomy. We conducted a clinical trial to investigate the effectiveness of bilateral rectus sheath block (RSB) with continuous bupivacaine infusion in comparison with placebo following elective open gastrectomy. Materials and Methods: Patients indicated for elective open gastrectomy were screened, enrolled, and randomised between October 2021 and September 2023. ⋯ Clinically, Group A patients had a significantly shorter time to first gas (p = 0.001), a shorter time to first bowel movement (p < 0.001), a shorter time to first out-of-bed activity (p < 0.001), and a shorter overall hospitalisation duration (p < 0.001) compared to Group B patients. Conclusions: Bilateral RSB with continuous bupivacaine infusion is effective in managing pain and can reduce the use of opioid analgesics in the postoperative period. Furthermore, it promotes early recovery, and a shorter hospital stay.
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Comparative Study
Comparative Retreatment Efficacy of Two Multi-File Systems with Different Access Cavity Designs: A Micro-Computed Tomography Study.
Background and Objectives: The access cavity design and instrumentation system could affect the remaining root canal obturation materials in root canal retreatment. This study aimed to evaluate the efficiency of two different multi-file systems in removing obturation materials with two different access cavities utilizing micro-CT scanning. Materials and Methods: Conservative access cavity (CAC) preparation was performed for 80 mandibular premolars. ⋯ However, group 3 (TAC and PTN) showed the highest percentage of remaining obturation materials at 29.53%, contrasting with group 6 (CAC and PTR + PTUL). Conclusions: Neither retreatment procedure succeeded in completely removing filling materials. Nevertheless, the impact of access cavity design, different multi-file systems, and their interaction on the remaining root canal obturation materials was deemed insignificant.
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Background and Objectives: Musculoskeletal disorders affect a large portion of the population worldwide. The Musculoskeletal Health Questionnaire (MSK-HQ) is a helpful tool for assessing the health state of patients with these disorders. The primary goal of this study is to evaluate the psychometric properties of the MSK-HQ-IT in a population of kitesurfers. ⋯ The study highlights distinct injury patterns between professionals and non-professionals, with professionals being more prone to upper limb injuries and non-professionals showing a higher prevalence of lumbar and thoracic spine issues. These findings emphasize the need for targeted injury prevention strategies. Further research should focus on expanding the sample size and investigating long-term impacts of repetitive high-impact landings on musculoskeletal health in kitesurfers.
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Background and Objectives: The objective of this study was to assess the efficient use of advanced energy devices by examining the impact of their usage frequency on surgical outcomes of total laparoscopic hysterectomies. Materials and Methods: A retrospective study was conducted between 2020 and 2023 by a single surgeon. The patients' medical records and surgical videos were reviewed. ⋯ Additionally, the application of hemostatic agents, the need for intraoperative or postoperative transfusions, and the use of intravenous hemostatic agents postoperatively showed no notable variation. Complication rates, including rates of hematoma, urinary tract injury, gastrointestinal injury, and infections necessitating reoperation, were also comparable. Conclusions: The findings suggest that the prudent and strategic use of advanced energy devices, rather than their frequent application, may improve surgical efficiency without increasing the risk of complications.