Archive for month: November, 2024

In a groundbreaking exploration of psychedelic medicine’s potential for treating one of psychiatry’s most challenging conditions, researchers at University of California, San Diego (UCSD) provided an analysis and further details of a trial published in Nature Medicine that had shown how psilocybin therapy affects individuals with anorexia nervosa. In the new peer-reviewed Emerging Topic article in Psychedelics the authors of the original trial offer “a granular view of findings based on qualitative data from semi-structured interviews, extensive feedback and interviews from participants, and [their] subjective interpretations of data patterns.” This new Emerging Topic review reveals both promising outcomes and important limitations that could shape future treatment approaches.

The study, published November 7, 2024, in Psychedelics, offers a unique first-hand perspective on how psilocybin treatment impacts patients with anorexia nervosa, a condition that maintains the highest mortality rate among psychiatric illnesses and has historically resisted conventional treatments.

“Our findings suggest that psilocybin may be helpful in supporting meaningful psychological change in a subset of people with anorexia nervosa,” says Dr. Stephanie Knatz Peck, lead author of the study. “What’s particularly interesting is that 60% of participants reported a reduction in the importance of physical appearance, while 70% noted quality-of-life improvements and shifts in personal identity.”

Key findings from the trial include:

• 90% of participants ranked their psilocybin session among their top five most meaningful life experiences

• Four out of ten participants showed clinically significant reductions in eating disorder psychopathology

• Treatment effects were most pronounced in shape and weight concerns

• Changes in psychological outlook didn’t automatically translate to weight restoration

The research raises intriguing questions about the intersection of psychedelic medicine and eating disorder treatment. Why do some patients respond dramatically while others show minimal improvement? How might genetic variations in serotonin receptors influence treatment outcomes?

“You are able to act in a way that maybe had felt unachievable before if you set the right intention,” reported one participant, while another noted, “Things might not look that different from the outside, but they feel completely different from the inside.”

The study employed a single 25mg dose of psilocybin combined with specialized psychological support before, during, and after administration. While the results show promise, they also highlight the complexity of treating anorexia nervosa, suggesting that psychedelic therapy might work best as part of a comprehensive treatment approach rather than a standalone intervention.

Dr. Walter H. Kaye, senior author and director of the UCSD Eating Disorders Treatment Center, emphasizes the need for larger, well-controlled studies that include brain imaging and genetic analysis to better understand who might benefit most from this novel treatment approach.

The findings open new avenues for research into personalized medicine approaches for eating disorders, while also raising important questions about how to optimize therapeutic protocols for this vulnerable population.

Reference:

Stephanie Knatz Peck, Hannah Fisher, Jessie Kim, Samantha Shao, Julie Trim, and Walter H. Kaye, Psychedelic treatment for anorexia nervosa: A first-hand view of how psilocybin treatment did and did not help, Psychedelics, https://doi.org/10.61373/pp024e.0034.

Induced labor is associated with failure to progress,
prolonged labor, fetal distress, and a rise in cesarean sections when the
cervix is not mature enough to allow for a successful vaginal birth. Bishop scoring
measures the ripening of the cervical papilla. When the bishop score is less
than, cervical ripening treatments are suggested. Bishop’s scoring method for
predicting vaginal delivery in multiparas at term while receiving IOL has been
effective repeatedly. Although recognizing its general simplicity and use, it
may be time to reconsider the Bishop Score assessment’s usefulness in
predicting vaginal delivery in contemporary practice, especially in light of
its expanding usage with nulliparous and preterm patients. Finding biomolecular,
imaging, or other signals that predict the cervix’s preparation for vaginal
delivery after IOL is difficult.

The ultimate goal would be to time IOL surgeries
specifically to get the greatest outcomes for each pregnancy. It is common
knowledge that pregnancies over the due date may result in issues for the
fetus, the newborn, and the mother. Risks rise after 40 weeks of pregnancy and
dramatically after 41 weeks, making this the most frequent reason for inducing
labor in the hopes of a vaginal birth. The cervical ripening and labor
induction procedures ideally call for hospital admission. However, individuals
often choose against medical advice to wait for spontaneous labor pains because
they feel uncomfortable. However, government hospitals are often overrun with
patients in a growing nation like India. It is thus desirable to use any
procedure that is both safe and efficient that might reduce hospital stays and
monetary costs without endangering the health of the pregnant woman or the
fetus. Membrane Sweeping (MS), a straightforward technique that is used all
around the globe to encourage cervical ripening, is quite popular. It’s still
unclear when membrane sweeping should be done to guarantee efficacy

An inexpensive and efficient cervical ripening and medical
induction medication is misoprostol, a PGE1 analog. The aforementioned
components could be taken orally or systemically, which is advantageous in
tropical nations with few resources. Pregnant women’s particular requirements
and worries are the main focus of cervical massage during pregnancy. This
specific massage method is intended to lessen the stresses of bearing the
additional weight, hormonal changes, and postural changes intrinsic to the
prenatal period to improve physical and emotional wellbeing. Cervical massage
develops as a complete method for encouraging relaxation, alleviating pain, and
fostering peace for both the mother and the developing baby by fusing expert
touch with a thorough knowledge of the pregnant body. The efficiency of
cervical ripening may be increased, and labor to begin spontaneously before a
formal induction treatment is required by combining membrane sweeping with
cervical massage. This study compares the efficacy of membrane sweeping with
cervical massage in terms of effectiveness. This study’s secondary goal is to
compare the maternal and newborn morbidity connected to the two methods.

A total of 150 low-risk singleton pregnancies with a
Modified Bishop Score (MBS) of fewer than five at 38 weeks of gestation were
included. The experimental group received membrane sweeping with cervical
massage, and the control group, which just received membrane sweeping, was
randomly allocated to the participants. 48 hours after the intervention,
changes in the MBS were used to gauge cervical favorability. Neonatal
morbidity, membrane rupture, intrapartum and postpartum infections, and other
complications were assessed.

The mean ages and MBS of the primigravidae in the two
research groups at induction were similar. After the intervention, the trial
group’s mean MBS was significantly higher than the control groups. Because of
this, primigravidae observed a substantial change in the MBS after the
operation. The experimental group’s adverse effects and neonatal morbidity were
comparable, except cardiotocographic abnormalities were observed more often in
the control group.

The results of the present investigation revealed that
whereas spontaneous labour did not vary in a quantitatively meaningful way
following the intervention, cervical massage is just as efficient as membrane
sweeping in attaining cervical ripening for labor induction at term in
primigravidae.

Cervical massage combined with membrane sweeping is an
alternative to membrane sweeping that might be a suitable choice for
pre-induction cervical ripening in term mothers. This is particularly true when
the cervical os is closed, and membrane sweeping cannot be performed due to the
lack of access.

In addition, the findings of the present research
demonstrated that cervical massage and membrane sweep would not have a negative
impact on the outcomes for the neonates. This research shows a possible
decrease in the time needed for labor induction in the experimental group. This
discovery is important because it may result in less medical intervention and
more effective labor. Therefore, there was insufficient evidence to conclude
that cervical massage amplifies the adverse outcomes for the mother or the
newborn in the present investigation. As a result, this research demonstrated
that membrane sweeping and cervical massage had similar effects on maternal and
newborn outcomes. Thus, cervical massage is a safe intervention regarding the
danger of infection and prelabor membrane rupture. Although the findings of
this study are encouraging, it is important to acknowledge the need for more
investigation. To completely demonstrate the effectiveness and safety of this
intervention, larger sample sizes, different demographics, and long-term
follow-ups are required. It would also be beneficial to look at any variances
in results depending on unique patient characteristics.

Source: Supriya et al. / Indian Journal of Obstetrics and
Gynecology Research 2024;11(1):47–52;

https://doi.org/10.18231/j.ijogr.2024.009

This work proposes a novel method to evaluate root canal filling (RCF) success using artificial intelligence (AI) and image analysis techniques. 1121 teeth with root canal treatment in 597 periapical radiographs (PARs) were anonymized and manually labeled. First, RCFs were segmented using 5 different state-of-the-art deep learning models based on convolutional neural networks. Their performances were compared based on the intersection over union (IoU), dice score and accuracy. Additionally, fivefold cross validation was applied for the best-performing model and their outputs were later used for further analysis. Secondly, images were processed via a graphical user interface (GUI) that allows dental clinicians to mark the apex of the tooth, which was used to find the distance between the apex of the tooth and the nearest RCF prediction of the deep learning model towards it. The distance can show whether the RCF is normal, short or long. Model performances were evaluated by well-known evaluation metrics for segmentation such as IoU, Dice score and accuracy. CNN-based models can achieve an accuracy of 88%, an IoU of 79% and Dice score of 88% in segmenting root canal fillings. The study demonstrates that AI-based solutions present accurate and reliable performance for root canal filling evaluation.8

Reference:

Çelik, Berrin, et al. “Evaluation of Root Canal Filling Length On Periapical Radiograph Using Artificial Intelligence.” Oral Radiology, 2024.

Keywords:

AI-based, solutions, present, accurately, reliably, evaluate, root, canal, filling, claims research, oral radiology, Çelik,

It would be beneficial for the patient, her family, and the
clinical team to have a reliable prognostic marker of pregnancy outcome at this
early stage. For the patient, ART treatment is often stressful, and waiting for
pregnancy test results can be a time of tension and uncertainty. Information
provided by staff to patients may be inconsistent or nonspecific, causing
further stress and uncertainty.

The objective of this retrospective study study by Gillian
Homan was to assess the predictive value on pregnancy outcome based on serum
hCG and progesterone levels 16 days after ovulation. Other factors, such as
treatment method, ovarian stimulation, luteal support, and age, were also
included in the analysis.

The data were obtained from two integrated Adelaide-based
clinics: the Queen Elizabeth Hospital and Wakefield Clinic. Patient(s): Women
who have achieved a pregnancy through ART treatment. Analysis of data using
logistic regression (STATA v.5.0) to predict a binary outcome: ongoing
pregnancy or miscarriage. Ongoing pregnancy was defined as progression to >20
weeks’ gestation. Miscarriage included spontaneous abortion, biochemical and
ectopic pregnancies, and blighted ovum.

Human chorionic gonadotropin was found to be the main
determinant of ongoing pregnancy. Age and progesterone had minor effects,
whereas stimulation, luteal support, and treatment types were nonpredictive.
Low hCG levels between 25 and 50 IU/L are associated with a low probability of
ongoing pregnancy (<35%), whereas levels of >500 IU/L predict a >95%
chance of ongoing pregnancy.

This study confirms the hypothesis that serum levels of hCG
in samples taken 16 days after ovulation are powerful predictors of good or
poor pregnancy outcome. Because of the large sample size, statistical modeling
could predict with precision, on the basis of the hCG level alone, the
probability of ongoing pregnancy. The strength of the relationship was
sufficient to allow its use at a clinical level for the prediction of pregnancy
outcome to the exclusion of all other markers.

In conclusion, a single serum sample taken and assayed 16
days after ovulation, following ART treatment, is clinically useful in
predicting pregnancy outcome. This is valuable information for both patients
and practitioners, because it does reduce anxiety and provide a basis for early
pregnancy management and monitoring. The findings of this study could be
included in a patient information sheet, because the relationship between the
level of hCG, age, and the predictive value of pregnancy outcome is
comprehensible to patients. This study included all ART treatment cycles;
therefore, this information can be used for all patients in units where a
variety of ART procedures are practiced.

Source: Gillian Homan, B.N., Susan Brown, R.N., John Moran; FERTILITY
AND STERILITY