Coronary artery visualization using a 64-row multi-slice computed tomography in unselected patients with definite or suspected coronary artery disease: A comparison with invasive coronary angiography

Background: Multi-slice computed tomography (MSCT) is becoming an increasingly acknowledged means of visualizing coronary arteries. The accuracy of 64-MSCT is still a subject of clinical evaluation. Our study, performed with a 64-slice scanner, was intended to assess the concordance of coronary artery lumen visualization in MSCT and invasive coronary angiography (ICA), both in post-revascularization and previously medically treated patients. Methods: We examined data from 73 patients (31 women, 42 men, mean age 59 years) referred to our hospital in 2006 and 2007 who underwent MSCT and subsequent ICA. Twenty two patients had a history of previous revascularization. Of the remaining 51 patients with intermediate coronary artery disease probability, the indication for 64-MSCT was suspicion of coronary artery disease. MSCT coronary angiography was performed with Aquilion 64 scanner (Toshiba, Japan). We evaluated 15 segments of four native coronary arteries (RCA, LM, LAD and Cx in all patients plus 11 arterial and 22 venous conduits). The cut-off value for significant stenosis was the lumen cross section area reduction exceeding 50%, regardless of segment. Results: Regarding native arteries, MSCT and ICA findings were coherent in 80.8% of all patients, 93.8% of vessels, and 98.4% of segments. MSCT coronary stent patency evaluation was 90.9% correct. The by-pass grafts evaluation was entirely concordant in both methods. The respiratory and heart rate variability artifacts hindered the MSCT analysis in ten patients (13.7%). The artifacts occurrence in misinterpreted studies was nearly two-fold higher than in those that were coherent (21.4% vs. 11.9%). Conclusions: We concluded that a reliable evaluation of the coronaries by means of 64-MSCT is feasible both in patients with suspected coronary artery disease and those with definite coronary artery disease who had previous coronary intervention. Patient selection and co-operation is necessary to avoid respiratory and heart rate variability artifacts that may hinder analysis

Validation of a Brief Pornography Screen Across Multiple Samples

Background and Aims To address current gaps around screening for problematic pornography use (PPU), we initially developed and tested a six-item Brief Pornography Screen (BPS) that asked about PPU in the past six months. Methods and Participants We recruited five independent samples from the U.S. and Poland to evaluate the psychometric properties of the BPS. In Study 1, we evaluated the factor structure, reliability, and elements of validity using a sample of 224 U.S. veterans. One item from the BPS was dropped in Study 1 due to low item endorsement. In Studies 2 and 3, we further investigated the five-item the factor structure of the BPS and evaluated its reliability and validity in two national U.S. representative samples (N = 1,466, N = 1,063, respectively). In Study 4, we confirmed the factor structure and evaluated its validity and reliability using a sample of 703 Polish adults. In Study 5, we calculated the suggested cut-off score for the screen using a sample of 105 male patients seeking treatment for compulsive sexual behavior disorder (CSBD). Results Findings from a principal components analysis and confirmatory factor analysis supported a one-factor solution which yielded high internal consistency (α = 0.89–0.90), and analyses further supported elements of construct, convergent, criterion, and discriminant validity of the newly developed screen. Results from a Receiver Operating Characteristic (ROC) curve suggested a cut-off score of four or higher for detecting possible PPU. Conclusions The BPS appears to be psychometrically sound, short, and easy to use in various settings with high potential for use in populations across international jurisdiction

Ultrasonograficzna ocena wypełnienia żołądka a ryzyko aspiracji treści pokarmowej w okresie okołooperacyjnym

The risk of aspiration of gastric contents in the perioperative period constitutes a serious clinical problem and it is connected with increased mortality. At present, the risk of aspiration is assessed only on the basis of an interview and information obtained from the patient. Such assessment is not always reliable while the concomitance of some additional factors influencing the delay of gastric emptying significantly decreases its sensitivity. Using bedside ultrasound imaging in an assessment of gastric contents is a method which supports an objective, simple and quick assessment of the risk of aspiration, helps one to optimise perioperative anaesthetic management, and should constitute a routine element of the perioperative patient assessment.The risk of aspiration of gastric contents in the perioperative period constitutes a serious clinical problem and it isconnected with increased mortality. At present, the risk of aspiration is assessed only on the basis of an interviewand information obtained from the patient. Such an assessment is not always reliable while the concomitance ofsome additional factors influencing the delay of gastric emptying significantly decreases its sensitivity. Using bedsideultrasound imaging in an assessment of gastric contents is a method which supports an objective, simple andquick assessment of the risk of aspiration, helps one to optimise perioperative anaesthetic management, and shouldconstitute a routine element of the perioperative patient assessment

Predictors of Compulsive Sexual Behavior Among Treatment-Seeking Women.

BACKGROUND: Compulsive Sexual Behavior Disorder is currently included in the forthcoming eleventh revision of the International Classification of Diseases (ICD-11); however, prior studies have been conducted mostly on heterosexual, White/European male samples. AIM: To examine the correlates of compulsive sexual behaviors (CSB) with sociodemographic and sexual history characteristics, as well as predictors of CSB in a sample of treatment-seeking Polish women. METHODS: Six hundred seventy-four (674) Polish women aged 18-66 completed an online-based survey. OUTCOMES: Polish adaptation of the Sexual Addiction Screening Test-Revised (SAST-PL) was used to assess the severity of CSB symptoms. Brief Pornography Screen was used to measure problematic pornography use. The bivariate associations between SAST-PL scores and demographic and sexual history characteristics were also examined. A linear regression analysis was performed to identify variables related to the severity of CSB symptoms. RESULTS: Thirty one percent (31.8%) of women in the studied sample reported treatment seeking for CSB in the past. Problematic pornography use was the strongest predictor of CSB symptoms. Higher severity of CSB symptoms were observed among divorced/separated and single women compared to those who were married or in informal relation. Severity of CSB was positively related to the number of sexual partners during the last year, number of dyadic sexual intercourse during the last 7 days, and negatively associated with age of first sexual intercourse. CLINICAL IMPLICATIONS: Our results suggest that CSB is a significant concern among women and more research is needed to identify protective (eg, relationship status) and risk (eg, problematic pornography use, number of past year sexual partners, frequency of past week masturbation) factors associated with CSB symptom severity among treatment-seeking women. STRENGTHS & LIMITATIONS: Our study is one of very few investigating predictors of CSB among women. Given the lack of precise estimates of the prevalence, as well as lack of psychometrically validated instruments measuring CSB in women, present findings should not be considered indicative of CSB prevalence among Polish women. CONCLUSION: The lack of clinical data on women reporting issues with CSB remains an important target for future clinical research exploration. Kowalewska E, Gola M, Lew-Starowicz M, et al. Predictors of Compulsive Sexual Behavior Among Treatment-Seeking Women. Sex Med 2022;10:100525

Neural Component of the Tumor Microenvironment in Pancreatic Ductal Adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive primary malignancy of the pancreas, with a dismal prognosis and limited treatment options. It possesses a unique tumor microenvironment (TME), generating dense stroma with complex elements cross-talking with each other to promote tumor growth and progression. Diversified neural components makes for not having a full understanding of their influence on its aggressive behavior. The aim of the study was to summarize and integrate the role of nerves in the pancreatic tumor microenvironment. The role of autonomic nerve fibers on PDAC development has been recently studied, which resulted in considering the targeting of sympathetic and parasympathetic pathways as a novel treatment opportunity. Perineural invasion (PNI) is commonly found in PDAC. As the severity of the PNI correlates with a poorer prognosis, new quantification of this phenomenon, distinguishing between perineural and endoneural invasion, could feature in routine pathological examination. The concepts of cancer-related neurogenesis and axonogenesis in PDAC are understudied; so, further research in this field may be warranted. A better understanding of the interdependence between the neural component and cancer cells in the PDAC microenvironment could bring new nerve-oriented treatment options into clinical practice and improve outcomes in patients with pancreatic cancer. In this review, we aim to summarize and integrate the current state of knowledge and future challenges concerning nerve–cancer interactions in PDAC

Ambiguous at the second sight: Mixed facial expressions trigger late electrophysiological responses linked to lower social impressions.

Social interactions require quick perception, interpretation, and categorization of faces, with facial features offering cues to emotions, intentions, and traits. Importantly, reactions to faces depend not only on their features but also on their processing fluency, with disfluent faces suffering social devaluation. The current research used electrophysiological (EEG) and behavioral measures to explore at what processing stage and under what conditions emotional ambiguity is detected in the brain and how it influences trustworthiness judgments. Participants viewed male and female faces ranging from pure anger, through mixed expressions, to pure happiness. They categorized each face along the experimental dimension (happy vs. angry) or a control dimension (gender). In the emotion-categorization condition, mixed (ambiguous) expressions were classified relatively slower, and their trustworthiness was rated relatively lower. EEG analyses revealed that early brain responses are independent of the categorization condition, with pure faces evoking larger P1/N1 responses than mixed expressions. Some late (728- 880 ms) brain responses from central-parietal sites also were independent of the categorization condition and presumably reflect familiarity of the emotion categories, with pure expressions evoking larger central-parietal LPP amplitude than mixed expressions. Interestingly, other late responses were sensitive to both expressive features and categorization task, with ambiguous faces evoking a larger LPP amplitude in frontal-medial sites around 560-660 ms but only in the emotion categorization task. Critically, these late responses from the frontal-medial cluster correlated with the reduction in trustworthiness judgments. Overall, the results suggest that ambiguity detection involves late, top-down processes and that it influences important social impressions

Gray Matter Volume Differences in Impulse Control and Addictive Disorders—An Evidence From a Sample of Heterosexual Males

International audienceBackgrounds: The classification of addictions and impulse control disorders is changing as reflected in the 11th version of International Classification of Disorders (WHO, 2018). However, studies focusing on direct comparison of structural brain differences in behavioral and substance addictions are limited.Aim Here, we contrast gray matter volumes (GMVs) across groups of individuals with compulsive sexual behavior disorder (CSBD), gambling disorder (GD), and alcohol use disorder (AUD) with those with none of these disorders (healthy controls participants; HCs).Methods Voxel-based morphometry was used to study brain structure, and severities of addiction symptoms were assessed with questionnaires. To identify brain regions related to severities of addictions, correlations between questionnaire scores and GMVs were computed.Main Outcome We collected magnetic resonance imaging (GMVs) data from 26 patients with CSBD, 26 patients with GD, 21 patients with AUD, and 25 HC participants (all heterosexual males; age: 24-60; mean = 34.5, standard deviation = 6.48).Results Affected individuals (CSBD, GD, AUD) compared with HC participants showed smaller GMVs in the left frontal pole, specifically in the orbitofrontal cortex. The most pronounced differences were observed in the GD and AUD groups, and the least in the CSBD group. In addition, a negative correlation was found between GMVs and disorder severity in the CSBD group. Higher severity of CSBD symptoms was correlated with decreased GMVs in the right anterior cingulate gyrus.Clinical Implications Our findings suggest similarities between CSBD and addictions.Strenghs and Limitiations This study is the first showing smaller GMVs in 3 clinical groups of CSBD, GD, and AUD. But the study was limited only to heterosexual men. Longitudinal studies should examine the extent to which ventral prefrontal decrements in volume may represent preexisting vulnerability factors or whether they may develop with disorder progression.Conclusions Our research extends prior findings in substance use disorders of lower GMVs in prefrontal cortical volumes among 3 clinical groups of patients with specific impulse control (CSBD) and behavioral (GD) and substance (AUD) addictive disorders. The negative correlation between CSBD symptoms and GMV of right anterior cingulate gyrus suggests a link with clinical symptomatology