Category: Nevin Manimala

Orthop J Sports Med. 2024 Nov 19;12(11):23259671241289096. doi: 10.1177/23259671241289096. eCollection 2024 Nov.

ABSTRACT

BACKGROUND: A retear after anterior cruciate ligament (ACL) reconstruction remains a common and devastating complication. Knee bone morphology is associated with the risk of ACL injuries, ACL retears, and osteoarthritis, and a combination of tools that derive bone shape from clinical imaging, such as magnetic resonance imaging (MRI) and statistical shape modeling, could identify patients at risk of developing these joint conditions.

PURPOSE: To identify bone shape features before primary ACL reconstruction in patients with an eventual retear compared to those with a known intact ACL graft.

STUDY DESIGN: Case-control study; Level of evidence, 3.

METHODS: Bone was automatically segmented on 2-dimensional proton density-weighted MRI of the knee in patients at the time of the initial ACL injury using deep convolutional neural networks. Patients with a subsequent retear after reconstruction within 3 years (22 femurs, 19 tibias) were compared with those with an intact ACL graft at 3 years (20 femurs, 22 tibias) using statistical shape modeling to identify preoperative bone shape features predictive of a retear after ACL reconstruction.

RESULTS: Statistical shape modeling revealed 2 specific bone shape features (modes) in the femur and 1 mode in the tibia that demonstrated significant differences at the time of the initial injury in patients with subsequent retears. In the femur, a narrower intercondylar notch width, a widened medial condylar width, an increased femoral condylar offset ratio, increased surface area along the lateral femoral condyle relative to the medial condyle, and a more prominent trochlear sulcus at the time of the initial injury were associated with retears after ACL reconstruction. In the tibia, a diminished ACL facet prominence, a squared lateral and medial tibial plateaus, and a broader and flattened tibial spine at the time of the initial injury were associated with retears after ACL reconstruction.

CONCLUSION: Using the automatic bone segmentation pipeline on preoperative MRI, the authors identified bone shape features associated with a retear after ACL reconstruction. The use of this pipeline enables large-scale studies of bone shape on MRI and could predict patients at risk of ACL retears to alter treatment decisions.

PMID:39569414 | PMC:PMC11577471 | DOI:10.1177/23259671241289096

Orthop J Sports Med. 2024 Nov 20;12(11):23259671241292641. doi: 10.1177/23259671241292641. eCollection 2024 Nov.

ABSTRACT

BACKGROUND: Patellofemoral osteochondral fractures (OCFs) have the potential to hinder patients’ function and quality of life. Several fragment fixation techniques have been described, with both metallic screw and bioabsorbable fixation showing favorable functional outcomes. Despite the promising results associated with both fixation methods, no study has directly compared their functional outcomes.

PURPOSE: To compare the functional and radiographic outcomes between bioabsorbable and metallic screw patellofemoral OCF fixation in an adolescent cohort.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: A retrospective review was conducted identifying surgically treated pediatric patients (<18 years of age) with OCFs of the patellofemoral joint. Inclusion criteria were treatment with metallic screw or bioabsorbable fixation (bioabsorbable compression screw, suture bridge, or chondral darts), with preoperative radiographs and operative notes available for review. Patient information, injury characteristics, treatments, and outcomes were collected with a specific focus on return-to-activity time and postoperative complications. Univariate analyses were conducted to compare radiographic and functional outcomes between groups.

RESULTS: According to the study criteria, 37 knees in 37 patients (84% male), with a mean age of 14.2 ± 1.8 years, were identified. A total of 24 patients were injured during sports participation, with basketball and football being the most common sports. OCF fixation cohorts consisted of 12 patients treated with metallic screw fixation and 25 with bioabsorbable fixation. No statistically significant differences were appreciated when comparing median time to full activity between the fixation groups (P = .427). However, time to full activity was unequally distributed, with 66.7% of the metallic screw fixation group returning to activity later than the total cohort’s median, compared with 42.9% of the bioabsorbable fixation group (P = .04). Two-thirds (8/12) of patients treated with metallic screws required return to the operating room for hardware removal compared with no patient treated with bioabsorbable fixation (P < .001). Two complications occurred with no significant differences appreciated between groups (P = .202). However, both postoperative complications were recorded in the metallic screw fixation group: 1 patient with osteochondral malunion and another with arthrofibrosis.

CONCLUSION: This study demonstrated that pediatric patellofemoral OCFs had good outcomes with high healing and low complication rates regardless of fixation type. Because of the high rate of secondary hardware removal procedures, metallic screw constructs delayed the return to sports and activity time. Patients treated with bioabsorbable fixation did not require a secondary operation for hardware removal and thus were more likely to recover sooner. Future studies are necessary to assess the potential outcome differences between different types of bioabsorbable fixation methods. Based on these findings, surgeons can consider bioabsorbable fixation as an option for the management of OCF lesions.

PMID:39569413 | PMC:PMC11577468 | DOI:10.1177/23259671241292641

Epilepsy Behav Rep. 2024 Oct 29;28:100724. doi: 10.1016/j.ebr.2024.100724. eCollection 2024.

ABSTRACT

Benefits of exercise on general health and wellbeing are undeniable. The International League Against Epilepsy has provided some guidance into exercise and sports for epilepsy. However, people with epilepsy are typically misinformed and restricted by fear and lack of evidence about exercise benefits in epilepsy. Our study seeks to investigate engagement in exercise in epilepsy at our center and identify potential barriers to physical activity. We conducted an anonymous survey at the Epilepsy Clinic using a clinically validated measure of exercise (IPAQ) at various levels: vigorous, moderate, and walking, and a questionnaire of 21 potential reasons for inactivity. Data were collected in REDCap. Statistical analysis was performed on SAS. We collected responses from 72 epilepsy participants between January and April 2024. Participants with controlled seizures were more likely to engage in moderate exercise compared to respondents with uncontrolled seizures. The top two general perceived barriers were having no one to exercise with and not liking exercise. Epilepsy-specific barriers were higher in respondents with uncontrolled seizures compared to those with controlled seizures, with the top two reasons being fear of “exercise-induced” seizures and lack of guidance on appropriate exercises. Our findings showed that there were more participants with controlled seizures who perform moderate exercise compared to those with uncontrolled seizures. Future studies are needed to evaluate whether exercise can have an impact on improving seizure control. Our study also highlights opportunities to educate health care providers, patients, and community members about exercise to facilitate engagement in exercise and improve epilepsy outcomes.

PMID:39569405 | PMC:PMC11576386 | DOI:10.1016/j.ebr.2024.100724

Neurol Clin Pract. 2025 Feb;15(1):e200400. doi: 10.1212/CPJ.0000000000200400. Epub 2024 Nov 15.

ABSTRACT

BACKGROUND AND OBJECTIVES: Recent studies have suggested that antibiotics could be a contributing factor to Parkinson disease (PD), but validation in other population cohorts, such as Asians, is needed. This study examined the association between exposure to antibiotics and PD risk in the Korean population.

METHODS: Using the National Health Insurance Service (NHIS) database, this population-level cohort research study from Korea included 298,379 people aged 40 years and older who underwent a national health examination in 2004-2005. Cumulative antibiotic exposure days were investigated over 4 years (2002-2005), and new cases of PD were followed for 14 years (2006-2019). Various covariates, such as infectious diseases, were considered in the analysis. Multivariable Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) and CIs for the PD risk from antibiotic exposure.

RESULTS: PD risk was statistically significantly higher in those exposed to antibiotics for ≥121 days than in those not exposed to antibiotics (aHR, 1.29; 95% CI 1.07-1.55). In addition, compared with those exposed to antibiotics for 1-14 days, those exposed to antibiotics for ≥121 days had a higher risk of PD (aHR, 1.37; 95% CI 1.17-1.61). The results of sensitivity analyses that applied washout periods or extended antibiotic exposure periods were consistent with those of the main analyses.

DISCUSSION: Extended usage of antibiotics was linked to a higher incidence of PD, even after controlling for several risk variables. Further research is needed to warrant the causation and mechanisms of antibiotic exposure and PD.

PMID:39569393 | PMC:PMC11575412 | DOI:10.1212/CPJ.0000000000200400

J Oral Maxillofac Res. 2024 Sep 30;15(3):e4. doi: 10.5037/jomr.2024.15304. eCollection 2024 Jul-Sep.

ABSTRACT

OBJECTIVES: This cross-sectional study aimed to measure the distance between the buccal and lingual cortical bones and its relation with the mandibular canal roof of third molars classified as III-C position according to Winter, Pell and Gregory classifications in cone-beam computed tomography.

MATERIAL AND METHODS: A total of 140 lower third molars were classified according to Winter, Pell and Gregory. The distance between the buccal external cortex and the lingual external cortex was measured at 25%, 50% and 75% of the distance to the roof of the mandibular canal in parasagittal sections of teeth classified in horizontal III-C position. The presence or absence of lesions associated with the elements in this position was observed. Descriptive statistical analysis was performed and the intra-examiner agreement was calculated using the Bland-Altman and t-test methods (0.88 and 0.91, respectively). The significance level used was 5% (P ≤ 0.05).

RESULTS: Seventy patients (29.4 [SD 8.8] years, 54% women and 46% men) were included. Fourteen (10%) third molars were classified in horizontal III-C position. The average measurements taken were 1.78, 1.1 and 1.53 mm for the distances between the buccal external cortex and lingual external cortex, at 25%, 50% and 75% of the distance to the roof of the mandibular canal, respectively. No pathological conditions associated with the included elements were observed.

CONCLUSIONS: Analysis of cone-beam computed tomography parasagittal sections of third molars classified in horizontal III-C position, revealed proximity of impacted teeth to the mandibular canal roof, mainly in the midline between the buccal and lingual external cortices.

PMID:39569361 | PMC:PMC11574970 | DOI:10.5037/jomr.2024.15304

J Oral Maxillofac Res. 2024 Sep 30;15(3):e5. doi: 10.5037/jomr.2024.15305. eCollection 2024 Jul-Sep.

ABSTRACT

OBJECTIVES: The aim of this case-control study was to examine upper airway by acoustic reflection in class II children with large horizontal maxillary overjet compared to children with neutral occlusion.

MATERIAL AND METHODS: The study group included children of 9 to 14 years with class II and large horizontal maxillary overjet (≥ 6 mm) compared to children with neutral occlusion (controls). Acoustic pharyngometry and rhinometry were performed in natural head position. Differences between groups were tested by chi-square test, general linear model (adjusted for age, gender and body mass index [BMI]), and Mann-Whitney test.

RESULTS: The study and control group consisted of 37 (boys: 19, girls: 18) and 32 (boys: 16, girls: 16) participants, respectively. No significant differences in age, gender, and BMI were found between the groups. For the acoustic rhinometry measurements significantly increased resistance (P = 0.04), reduced volume (P = 0.03) and distance to minimal cross-section area (MCA) (P = 0.035) were found in the study group, but only for the right nostril. However, significantly reduced MCA for both nostrils was found in the study group (P = 0.025 to 0.04). No significant differences in acoustic pharyngometry measurements were found.

CONCLUSIONS: Nasal airway dimensions were significantly reduced, and nasal resistance was significantly increased in the study group compared to controls. Thus, class II and large overjet with indication for growth adaptive treatment may be a risk factor for sleep-disordered breathing. In the future, orthodontic paediatric patients may benefit from non-invasive risk assessment of narrow upper airway using acoustic reflection.

PMID:39569360 | PMC:PMC11574966 | DOI:10.5037/jomr.2024.15305

J Oral Maxillofac Res. 2024 Sep 30;15(3):e1. doi: 10.5037/jomr.2024.15301. eCollection 2024 Jul-Sep.

ABSTRACT

OBJECTIVES: Recently surface modification techniques have been introduced to dental implants to improve osseointegration, bone formation at the implant surface, and to reduce the occurrence of mucositis and peri-implantitis. The aim of this systematic literature review was to investigate the dependence of the risk of inflammation of the tissues surrounding the implant on different implant alloys and surface coating materials.

MATERIAL AND METHODS: The search for the systematic review of the scientific literature was performed between November 28, 2023, and February 5, 2024. Articles were retrieved using the PRISMA screening system from MEDLINE (PubMed), EMBASE (ScienceDirect), Cochrane Central Register of Controlled Trials (the Cochrane Library), Springer Link, and Google Scholar databases. The literature review included publications in English, randomized controlled clinical trials assessing bleeding on probing, pocket depth, and marginal bone level around the implant.

RESULTS: A total of 41 full-text articles were selected after removing duplicates, of which 5 were included in this systematic literature review. The data from the studies were structured and presented in summary tables. Statistically significant differences in marginal bone level loss were observed using fluoride and sandblasting with large grit and acid-etching methods for implant surface modification. However, the effects of other surface coating materials and different implant alloys on bone loss, bleeding on probing, and pocket depth were not found to be significant.

CONCLUSIONS: Despite the limitations of this literature review, it can be concluded that implant alloys and surface coating materials are potential risk factors for the development of inflammation in the tissues surrounding the implant.

PMID:39569359 | PMC:PMC11574969 | DOI:10.5037/jomr.2024.15301

Parasit Vectors. 2024 Nov 20;17(1):480. doi: 10.1186/s13071-024-06561-6.

ABSTRACT

BACKGROUND: One bioassay for detecting acaricide resistance in livestock ticks is the adult immersion test (AIT), wherein engorged ticks are briefly immersed into a solution of a particular acaricidal compound and examined for mortality, their egg-laying capacity and offspring hatchability in vitro. Usually, the recommended label dose or an established discriminating dose of an acaricide is used to determine high mortality (≥ 95%) of susceptible tick strains. Such a test intends to detect the presence of resistance in a tick population. However, the adult immersion test does not directly translate the bioassay results to the predicted efficacy in the field. In this paper, we used the AIT as an initial screening bioassay supplemented with the resistance intensity test (RIT), a novel larval-based bioassay, wherein the resistance level can be determined and translated to the expected field efficacy. This was done by adopting World Health Organisation (WHO) guidelines for resistance detection in mosquitoes, which combines a 1 × recommended dose with 5 × and 10 × concentrated doses to reveal low, moderate and high resistance intensity, respectively.

METHODS: Engorged Rhipicephalus microplus ticks were collected from cattle at six different ranches across Rio Grande do Sul, Brazil, as part of the state’s acaricide resistance surveillance program. Groups of adult ticks from each field collection were subjected to the AIT from each field sample. Additionally, engorged female ticks from each ranch were allowed to lay eggs, and their larval progeny aged 14 to 28 days were then used in the RIT. Deltamethrin and a combination of cypermethrin, chlorpyrifos and piperonyl butoxide were used in both tests, and the results were statistically analysed.

RESULTS: The in vitro efficacy of deltamethrin against adult ticks in the AIT ranged between 8.74% and 25.38%. The corresponding RIT results on their larval progeny indicated a high resistance level. In the immersion test, the in vitro efficacy of the combination of cypermethrin, chlorpyrifos, and piperonyl butoxide against adult ticks ranged between 49.31% and 100%. The corresponding RIT results on their larval progeny indicated a similar response ranging from fully susceptible to low or moderate resistance. The Pearson correlation coefficient (r = 0.883) showed a high correlation between tick mortality at the 1 × recommended concentrations of acaricides in both tests.

CONCLUSIONS: The resistance intensity test is a valuable addition to the range of bioassays currently available for detecting acaricide resistance by determining the level of acaricide resistance. This is relevant to whether or not to continue using a particular acaricidal class for controlling cattle ticks.

PMID:39568084 | DOI:10.1186/s13071-024-06561-6

Nutr Metab (Lond). 2024 Nov 20;21(1):96. doi: 10.1186/s12986-024-00864-2.

ABSTRACT

BACKGROUND: Numerous studies indicate that visceral adipose tissue (VAT) significantly contribute to metabolic syndrome (MetS) development. This study aims to assess the distinguishing value of novel obesity markers, specifically lipid accumulation products (LAP) and cardiometabolic index (CMI), in relation to MetS. Considering the gender disparity in MetS prevalence, it is essential to explore whether LAP and CMI exhibit differential distinguishing capabilities by gender.

METHOD: The investigation included a total of 11,687 qualified individuals who participated in the NHANES survey spanning a 14-year period from 2005 to 2018. Biochemical analysis of blood and body measurements were utilized to determine LAP and CMI values for each participant. Inclusion of gender as a variable was a key factor in the examination of all data. Restricted cube plots (RCS) were utilized to analyze the strength of the relationship between LAP, CMI, and MetS. The study delved into potential connections between LAP and CMI with MetS, all-cause and cardiovascular mortality using various statistical models such as multivariate logistic regression and Cox regression.

RESULTS: The findings revealed a significant nonlinear association between CMI, LAP, and MetS (P-non-linear < 0.001), irrespective of gender, with all models exhibiting a J-shaped trend. The multivariable logistic regression analysis considered both LAP and CMI as continuous variables or tertiles, revealing significant associations with MetS in male, female, and general populations (All the P < 0.001). Although males displayed a higher risk of MetS, no gender differences were observed in the area under the curve (AUC) values of LAP and CMI for distinguishing (P > 0.005) MetS. Impressively, LAP and CMI were identified as the primary predictors of MetS in both genders from AUC (P < 0.005). More specifically, the cutoff points for distinguishing MetS in females were LAP = 49.87 or CMI = 0.56, while for males, they were LAP = 52.76 or CMI = 0.70. Additionally, the Cox regression analysis revealed that LAP and CMI were correlated with all-cause mortality in both general population and females (P < 0.005), but not in males.

CONCLUSION: In comparison to other measures of obesity, LAP and CMI demonstrated superior diagnostic accuracy for MetS in both males and females. Additionally, LAP and CMI were found to be predictive of all-cause mortality in both general population and females. These markers are cost-effective, easily accessible, and widely applicable for the early identification and screening of MetS in clinical settings.

PMID:39568067 | DOI:10.1186/s12986-024-00864-2

J Orthop Surg Res. 2024 Nov 20;19(1):776. doi: 10.1186/s13018-024-05278-7.

ABSTRACT

OBJECTIVE: This study aims to assess the significance of monitoring temperature change trends at various wound sites in the healing process of diabetic foot ulcers after microcirculation reconstruction surgery.

METHODS: A retrospective analysis was conducted on individuals with diabetic foot ulcers who had been admitted to the Department of Orthopedics at the Second Hospital of Shanxi Medical University between July 2020 and February 2022. Temperature changes were regularly monitored at the center of the wound and the distal tibia of the ipsilateral lower leg to assess microcirculatory blood perfusion. Wound, ischemia, and foot infection (WIFi) grading was performed at admission and the final follow-up was to determine the value of temperature monitoring at various sites. Additionally, the formation of collateral microarterial vessels was monitored to determine their consistency with the observed trends in temperature differences. Follow-up assessments included the recurrence of ulcers, development of ulcers at different locations, re-amputation of the toe or limb, and diabetes-related mortality.

RESULTS: A total of 29 patients were included in the follow-up, with an average age of 57.14 ± 14.75 years and a follow-up period of 9.79 ± 4.13 months. Following microcirculation reconstruction surgery, as the microvascular network formed, the temperature difference between the center of the wound and the distal tibia on the same side gradually decreased, with no statistical difference observed at 4 weeks postoperatively. At both admission and the final follow-up, there was a significant reduction in the wound (W) and ischemia (I) grades within the WIFi classification. The temperature at the wound center showed progressive improvement as collateral microarterial vessels developed. During the follow-up period, there were 2 cases of ulcer recurrence, 1 case of an ulcer appearing at a different location, no cases of re-amputation of the toe or limb, and 2 diabetes-related fatalities.

CONCLUSION: Skin temperature monitoring offers a direct and reliable indication of microcirculatory blood perfusion. Its simplicity and cost-effectiveness make it a valuable tool for widespread use in evaluating wound healing following microcirculation reconstruction surgery.

PMID:39568046 | DOI:10.1186/s13018-024-05278-7