Category: Nevin Manimala

Clin Rheumatol. 2023 Aug 4. doi: 10.1007/s10067-023-06723-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effectiveness of prolotherapy with dextrose concentrations of 5%, 10%, and 20% in patients diagnosed with knee osteoarthritis.

METHODS: This study was planned as a prospective, randomized controlled interventional trial. Prolotherapy at 5% dextrose concentration in group 1, 10% in group 2, and 20% in group 3 was applied to the knee intra-articularly and periarticularly at 0, 3, and 6 weeks, and a home exercise program was given. Group 4 received a home exercise program. All groups received hotpack therapy at weeks 0, 3, and 6. Outcome measures included the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee range of motion, timed up and go test, and Short Form-36.

RESULTS: A total of 128 patients were divided into 4 groups. At the 6th and 12th weeks, VAS scores were significantly lower in groups 2 and 3 than in group 4 (p < 0.05). At the 12th week, the WOMAC pain score was significantly lower in group 3 than in group 4, and WOMAC physical function and WOMAC total scores were significantly lower in groups 1, 2, and 3 than in group 4 (p < 0.05). Week 6 active and passive knee flexion and week 12 passive knee flexion were significantly higher in group 3 than in group 4 (p < 0.05).

CONCLUSIONS: Although no significant difference was observed among the dextrose prolotherapy groups, higher dextrose concentrations demonstrated a greater improvement compared to the control group. Therefore, the use of 20% dextrose is recommended due to its significant superiority. Long-term follow-up and placebo-controlled studies are needed.

TRIAL REGISTRATION: ClinicalTrial.gov Identifier: NCT05537077, registration date: 09.03.2022, retrospectively registered. Key Points • The utilization of dextrose prolotherapy has gained popularity in the management of osteoarthritis, aiming to harness its regenerative and proliferative properties. However, the comparative efficacy of various concentrations of dextrose prolotherapy in treating knee osteoarthritis remains unexplored in the literature. This study aimed to address this gap by comparing different concentrations of dextrose prolotherapy in the treatment of knee osteoarthritis. The findings revealed no statistically significant difference among the various concentrations of dextrose prolotherapy for knee osteoarthritis treatment.

PMID:37540383 | DOI:10.1007/s10067-023-06723-4

Lasers Med Sci. 2023 Aug 4;38(1):175. doi: 10.1007/s10103-023-03833-y.

ABSTRACT

Endovenous laser ablation (EVLA) is a common minimally invasive technique used to treat varicose veins. The most commonly used laser wavelengths for EVLA/EVLT of varicose veins are 810 nm and 1470 nm. The laser pulse frequency is typically set to continuous wave (CW) mode, with a pulse duration of a few milliseconds (ms) delivered in a radial mode. The energy delivered per pulse is typically set between 40 and 120 Joules, with a power setting of 10 to 30 watts and an intensity setting of 40 to 120 J/cm². The controversy exists regarding the benefits of performing saphenofemoral junction (SFJ) ligation prior to EVLA to decrease the recurrence rate of varicose veins. This meta-analysis aims to investigate the effectiveness of combining EVLA with high ligation versus using EVLA alone in treating lower extremity varicose veins. We conducted a systematic search of four databases from their inception until July 1, 2022, for randomized controlled trials and prospective controlled trials evaluating the advantages and disadvantages of EVLA with or without high ligation for the treatment of lower extremity varicose veins. In analyzing binary data, rate difference (RD) is used, while odds ratio (OR) is used for evaluating the confidence interval (CI) of binary data. A P value of less than 0.05 is deemed statistically significant. Heterogeneity is assessed using the chi-square test. If the I² statistic, which reflects statistical heterogeneity, is greater than 50%, a random-effects model should be used. In the absence of significant statistical heterogeneity, a fixed-effects model should be used if I² is less than 50%. We used the Cochrane risk-of-bias tool to assess the quality of the studies and Review Manager 5.4 for the primary and secondary outcome analysis. The meta-analysis was conducted in accordance with the Cochrane Handbook. There were no significant differences in the rate of major complications (RR = 1.63; 95% CI, 0.40-6.69; P = 0.50) or in the frequency of minor complications (RR = 1.07, 95% CI, 0.87-1.31; P = 0.52) between the EVLA with high ligation (EVLA/HL) group and the EVLA group. However, the rate of vein occlusion was significantly lower in the EVLA group than in the EVLA/HL group (RR = 1.06; 95% CI, 1.03-1.09; P = 0.0004). Our meta-analysis indicates that combining EVLA with high ligation provides stable long-term clinical efficacy in treating varicose veins of the lower extremities, although it increases the invasiveness of the surgery. The use of EVLA alone may be less effective in preventing vein occlusion.

PMID:37540336 | DOI:10.1007/s10103-023-03833-y

Ir J Med Sci. 2023 Aug 4. doi: 10.1007/s11845-023-03469-5. Online ahead of print.

ABSTRACT

BACKGROUND: Micro-RNA (miRs) targeting kinases and phosphatases regulate the hyper-phosphorylation of tau protein, which is a characteristic feature of Chronic Traumatic Encephalopathy (CTE).

PRIMARY OBJECTIVE: Identification of lead dysregulated miR expressed in CTE, and other similar tauopathies.

METHODS: A search strategy was devised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to mine into multiple indexing databases such as Web of Science, Google Scholar, and PubMed spanning from 2005 to June 2022. Seven articles were screened out of 34,221 publications based on inclusion criteria and were categorized into two groups i.e., (1) CTE and its risk factors and (2) Age-related neurodegenerative disorders.

RESULTS: Statistical analysis [RevMan 5.4.1] results showed that the overall risk ratio (RR) of the first group is significant (RR = 0.62, 95% CI = [0.38, 1.00], z = 1.95, p = 0.05) whereas, the second group favours the control population (RR = 1.64, 95% CI = [0.85, 3.16], z = 1.14, p = 0.14).

CONCLUSION: We observed that among all other dysregulated miRs, miR-181c-5p is significantly overexpressed in Alzhimers disease (AD) and CTE. Further, we found that miR-210-3p is also upregulated notably in all groups. In sum, we conclude that these miRs can be considered as potential target and biomarker in the diagnosis and treatment of various tauopathies.

PMID:37540332 | DOI:10.1007/s11845-023-03469-5

Anthropol Anz. 2023 Aug 4. doi: 10.1127/anthranz/2023/1676. Online ahead of print.

ABSTRACT

Porotic hyperostosis and cribra orbitalia are pathological changes occurring on the human skull. These changes were observed and evaluated on skeletal remains from Dětkovice – Za zahradama and Vídeňská Street in Brno; both sites are dated back to the 10^th to 12^th centuries AD. A total of 605 subjects were assessed for age, sex, and the above-stated pathologies using standard methods. The influence of age and sex on the occurrence of these pathologies was examined statistically. Results indicated that at the site of Dětkovice – Za zahradama, porotic hyperostosis, and cribra orbitalia do not depend on sex or age. However, at Vídeňská Street in Brno, these pathologies do not depend on sex, but they depend on age so a higher incidence of pathologies in juveniles is observed. Differences between both sites could be caused by different numbers of evaluated individuals or different state of preservation of skeletal remains. The aetiology of the origin of these pathologies could not be determined by the methodology used here, but with the prevailing lower age of pathological subjects, a lack of nutrition with consequent absence of iron and developing anaemia might be the cause. Based on our statistical data, we can observe that the pathologies we studied occur more frequently in children older than newborns and younger infants. This may indicate that these studied pathologies arise only during the lifetime of the individual and do not have a prenatal occurrence.

PMID:37539649 | DOI:10.1127/anthranz/2023/1676

J Clin Sleep Med. 2023 Aug 4. doi: 10.5664/jcsm.10756. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Chronic disruptions to sleep in childhood are associated with increased prevalence of psychiatric disease later in development. When sleep disruptions remit before adolescence, the increased prevalence of psychiatric disease is no longer observed, highlighting the importance of early detection and intervention. Clinicians typically rely on caregiver report for diagnosis and management of childhood sleep challenges. We examined if findings on polysomnogram (PSG) can offer similar insight into childhood sleep difficulties and the risk of subsequent psychiatric illness.

METHODS: A cohort was identified of 348 children ages 5 years 11 months and younger with sleep difficulties rising to the level of formal clinical workup. A retrospective review of caregiver reported sleep concerns, polysomnogram (PSG) results, and subsequent psychiatric illness was completed. PSG findings were compared to presence of psychiatric illness later in life as well as caregivers’ reported concerns. Chi-square and Fisher’s exact tests were completed to evaluate correlations and Cohen’s kappa was used to evaluate agreement.

RESULTS: With only a few exceptions, comparisons between clinician findings on PSG and subsequent psychiatric diagnoses were statistically nonsignificant. Similarly, the relationship between caregivers’ subjective complaints about sleep and clinician findings on PSG demonstrated only slight to fair agreement, suggesting reported concerns were not predictive of PSG results.

CONCLUSIONS: Parental reports of subjective sleep concerns are indicative of different sleep pathologies compared to sleep pathologies detected on PSG. The addition of PSG to caregiver reported data appears to have limited clinical utility in understanding sleep concerns associated with the risk of subsequent psychiatric illness in young children.

PMID:37539644 | DOI:10.5664/jcsm.10756

Acta Biomed. 2023 Aug 3;94(4):e2023107. doi: 10.23750/abm.v94i4.14184.

ABSTRACT

BACKGROUND AND AIM: The study aimed to evaluate the epidemiological trend of hand, foot and mouth disease (HFMD) in Italy using data on Internet search volume.

METHODS: A cross-sectional study design was used. Data on Internet searches were obtained from Google Trends (GT) and Wikipedia. We used the following Italian search term: “Malattia mano-piede-bocca” (Hand-foot-mouth disease, in English). A monthly time-frame was extracted, partly overlapping, from July 2015 to December 2022. GT and Wikipedia were overlapped to perform a linear regression and correlation analyses. Statistical analyses were performed using the Spearman’s rank correlation coefficient (rho). A linear regression analysis was performed considering Wikipedia and GT.

RESULTS: Search peaks for both Wikipedia and GT occurred in the months November-December during the autumn-winter season and in June during the spring-summer season, except for the period from June 2020 to June 2021, probably due to the restrictions of the COVID19 pandemic. A temporal correlation was observed between GT and Wikipedia search trends.

CONCLUSIONS: This is the first study in Italy that attempts to clarify the epidemiology of HFMD. Google search and Wikipedia can be valuable for public health surveillance; however, to date, digital epidemiology cannot replace the traditional surveillance system.

PMID:37539609 | DOI:10.23750/abm.v94i4.14184

Acta Biomed. 2023 Aug 3;94(4):e2023167. doi: 10.23750/abm.v94i4.14229.

ABSTRACT

BACKGROUND AND AIM: To investigate the association between CYP17A1 (rs74357) polymorphism and the risk of Polycystic Ovary Syndrome (PCOS).

METHODS: Literature on the association of CYP17rs74357 gene polymorphism and susceptibility to PCOS was retrieved by searching databases such as PubMed, Science Direct, Google Scholar and Embase from. The association measure was analyzed using an Odds Ratio (OR) and 95% Confidence Interval (CI). All the statistical analyses were executed using CMA 3.0 Software.

RESULTS: In the present meta-analysis,24 studies including 3462 PCOS and 2898 controls were analyzed. The overall results validated that the 17 CYP17 T/C (rs74357) gene polymorphism was significantly associated with PCOS risk in 5 genetic models: recessive model (fixed and random effect), dominant model (random effect), CC vs. TT (fixed effect), CT vs. TT (fixed effect), and allele contrast (random effect). Stratified analyses by ethnicity/country also detected significant association between Asian and Caucasian under the recessive, dominant, CC vs. TT, CC vs. CT, and the allele contrast models.

CONCLUSIONS: In the present study, CYP17 T/C (rs74357) gene polymorphism increase the susceptibility of PCOS, and the recessive C allele, can be proposed as a predictive factor for the risk of PCOS or an important pathway in PCOS associated metabolic and hormonal dysregulation especially insulin resistance.However, larger sample size andmultiracial studies are needed in the future to confirm the findings.

PMID:37539608 | DOI:10.23750/abm.v94i4.14229

Acta Biomed. 2023 Aug 3;94(4):e2023206. doi: 10.23750/abm.v94i4.14719.

ABSTRACT

BACKGROUND AND AIM OF THE WORK: Work-family and family-work conflict can be defined as the degree to which participation in one role, in this case as a worker, interferes with the ability to cope with the responsibilities of another role, namely that of a member of a household. The aim of the study is to investigate the presence of indicators of work- family and/or family-work conflict in a cohort of Italian nurses and possible correlations with social and work variables.

RESEARCH DESIGN AND METHODS: An observational, quantitative, multicenter survey was conducted for the study through the computerized administration of a validated questionnaire (Work-Family and Family-Work Conflict, CLF), with the implementation of sociographic variables. The cooperation of 15 Orders of Nursing Professions throughout the country was sought for sample collection. Data collection was bimonthly.

RESULTS: Among the participating nurses, there is a statistically significant predominance of conflict in the family-work direction. In particular, the phenomenon seems to be related to age and the presence of children and/or elderly at home to care for. Some work variables seem to positively affect the prevention of potential work-life conflict, such as rostering and work articulation.

CONCLUSIONS: These findings place emphasis on the need for healthcare organizations to address the work-family balance of their employees.

PMID:37539595 | DOI:10.23750/abm.v94i4.14719

Chaos. 2023 Aug 1;33(8):083109. doi: 10.1063/5.0156492.

ABSTRACT

The occurrence mechanisms of extreme events under random disturbances are relatively complex and not yet clear. In this paper, we take a class of generalized Duffing-type systems as an example to reveal three mechanisms for the occurrence of extreme events. First, it is intuitive that a very large excitation can generate extreme events, such as the Lévy noise. In such a case, extreme excitation works, while it does not require much about the systems. Second, when a system has a bifurcation structure, if the difference of the branches at the bifurcation point is large, a randomly varying bifurcation parameter can lead to extreme events. Finally, when a system has rare attractors, a random impulse excitation, such as Poisson white noise, is able to cause the system to escape from one general attractor into rare attractors. Such a kind of special regime switching behavior can lead to extreme events. These results reveal the possible mechanisms of extreme events in a class of nonlinear Duffing-type systems and provide guidance for further prediction and avoidance of extreme events.

PMID:37539590 | DOI:10.1063/5.0156492

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 May 28;48(5):691-697. doi: 10.11817/j.issn.1672-7347.2023.220481.

ABSTRACT

OBJECTIVES: Clinically, it has been found that some patients with epilepsy are accompanied by cerebellar atrophy that is inconsistent with symptoms, but the pattern of cerebellar atrophy after epilepsy and the role of cerebellar atrophy in the mechanism of epilepsy have not been elucidated. This study aims to explore the specific pattern of cerebellar atrophy after epilepsy via analyzing magnetic resonance images in patients with postepileptic cerebellar atrophy.

METHODS: A total of 41 patients with epilepsy, who received the treatment in Xiangya Hospital of Central South University from January 2017 to January 2022 and underwent cranial MRI examination, were selected as the case group. The results of cranial MRI examination of all patients showed cerebellar atrophy. In the same period, 41 cases of physical examination were selected as the control group. General clinical data and cranial MRI results of the 2 groups were collected. The maximum area and signal of dentate nucleus, the maximum width of the brachium pontis, the maximum anterior-posterior diameter of the pontine, and the maximum transverse area of the fourth ventricle were compared between the 2 groups. The indexes with difference were further subjected to logistic regression analysis to clarify the characteristic imaging changes in patients with cerebellar atrophy after epilepsy.

RESULTS: Compared with the control group, the maximum width of the brachium pontis and the maximum anterior-posterior diameter of the pontine were decreased significantly, the maximum transverse area of the fourth ventricle was increased significantly in the case group (all P<0.05). The difference in distribution of the low, equal, and high signal in dentate nucleus between the 2 groups was statistically significant (χ²=43.114, P<0.001), and the difference in the maximum area of dentate nucleus between the 2 groups was not significant (P>0.05). The maximum width of the brachium pontis [odds ratio (OR)=3.327, 95% CI 1.454 to 7.615, P=0.004] and the maximum transverse area of the fourth ventricle (OR=0.987, 95% CI 0.979 to 0.995, P=0.002) were independent factors that distinguished cerebellar atrophy after epilepsy from the normal control, while the anterior-posterior diameter of pontine (OR=1.456, 95% CI 0.906 to 2.339, P>0.05) was not an independent factor that distinguished them.

CONCLUSIONS: In MRI imaging, cerebellar atrophy after epilepsy is manifested as significant atrophy of the brachium pontis, significant enlargement of the fourth ventricle, and increased dentate nucleus signaling while insignificant dentate nucleus atrophy. This particular pattern may be associated with seizures and exacerbated pathological processes.

PMID:37539571 | DOI:10.11817/j.issn.1672-7347.2023.220481