Category: Nevin Manimala

Gen Dent. 2023 Jan-Feb;71(1):19-23.

ABSTRACT

Developmental dental anomalies are a common finding in adolescent populations. The objective of this study was to utilize panoramic radiographs to determine the prevalence of dental anomalies and developmental disturbances in a heterogenous adolescent orthodontic patient population seeking care at a North American orthodontic residency program. A total of 1042 panoramic radiographs of 457 male and 585 female orthodontic patients aged 10 to 18 years were evaluated. Developmental and eruption anomalies were recorded and categorized, and chi-square and Fisher exact tests were used for statistical analysis. The evaluation revealed that 40.88% of patients had at least 1 anomalous finding. The most common finding overall was agenesis (12.00%), followed by deviations in eruption path (9.12%), delayed eruption (7.39%), and impaction (7.29%). There was no difference in the prevalence of having any anomalous finding or the prevalence of any specific category of anomalies based on the sex or Angle classification of the patients. Comparison of developmental dental anomalies in 3 age groups (10 to 12, 13 to 15, or 16 to 18 years) revealed no statistically significant difference in the overall prevalence of anomalous findings. Statistically significant differences for some specific categories of anomalies were explainable by correlating dental development with chronologic age, such as a greater frequency of blocked out teeth and eruption path deviation among patients aged 10 to 12 years. Black patients were found to have a significantly greater prevalence of impactions (P = 0.030), and Asian patients had a significantly greater prevalence of anomalies categorized as “other pathology,” which could not be definitively diagnosed by panoramic radiograph alone (P = 0.007).

PMID:36592354

J Behav Addict. 2023 Jan 2. doi: 10.1556/2006.2022.00087. Online ahead of print.

ABSTRACT

RATIONALE: As a result of concerns about predominantly online behavioral addictions, an increasing number of systematic reviews and meta-analyses (SRMA) of treatment interventions for internet use disorders (IUD) are being recorded. This review was designed to (a) systematically identify the evidence base of SRMA and to (b) critically appraise the quality of reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

METHODS: Four databases were searched until August 2022 to systematically identify SRMA. PRISMA indicators were evaluated on a three-level response format to obtain an overall score operationalizing the quality of reporting (score range: 0-84). Additionally, the percentage of adherence to the PRISMA indicators was calculated.

RESULTS: Reporting quality of 23 SRMA, comprising 12 systematic reviews and 11 meta-analyses was evaluated. Quality scores ranged from 25 to 77 (M: 52.91; SD: 17.46). Results of the critical appraisal revealed deviations from the PRISMA indicators, including missing information on (a) registration of a study protocol, (b) statistical synthesis methods (c) evaluation of certainty of evidence, and (d) risk of bias assessment. Eleven (47.83%) of the SRMAs partially adhered, and twelve (52.17%) completely adhered to the PRISMA indicators.

CONCLUSION: This first critical appraisal on the reporting quality of SRMA on treatment interventions for IUD highlights limitations of the evidence base. Inadequate reporting compromises the practical utility and validity of SRMA and may complicate ongoing efforts of consensus on evidence-based interventions for IUD. Future research should focus on sufficient and transparent reporting of the methodological approach.

PMID:36592332 | DOI:10.1556/2006.2022.00087

J Relig Health. 2023 Jan 2. doi: 10.1007/s10943-022-01703-5. Online ahead of print.

ABSTRACT

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person’s degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: this first part discusses positive mental health indicators, while the second discusses negative mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023). A systematic review of PubMed, Science Direct, the Cochrane Library, Google Scholar, the Database of Abstracts of Reviews of Effects, and Google Scholar databases was carried out. In addition to the synthesis of information obtained from the research, a meta-analysis of correlation was also performed to determine the strengths of the relationships between the analysed variables, and selected moderators were assessed using meta-regression. Quality of life, well-being, satisfaction with life, happiness, and post-traumatic growth were the positive mental health indicators considered. Meta-analyses indicated a statistically significant relationship between positive religious coping and flourishing (well-being) with overall correlation values of 0.35 [0.30; 0.40]. Further calculations also indicated a relationship between negative religious coping and flourishing – 0.25 [- 0.34; – 0.15]. Data synthesis shows associations between religious coping and such indicators as satisfaction with life and post-traumatic growth, but these issues require further investigation.

PMID:36592322 | DOI:10.1007/s10943-022-01703-5

High Blood Press Cardiovasc Prev. 2023 Jan 2. doi: 10.1007/s40292-022-00557-y. Online ahead of print.

ABSTRACT

INTRODUCTION: An impact of the sympathetic nervous system in the higher rate of cardiovascular events in the early morning compared to the evening has been claimed. Augmented sympathetic vasoconstriction increases cardiovascular risk by augmenting pulse pressure and cardiac afterload. Type 2 diabetes (T2DM) further increases sympathetic neurovascular transduction and cardiovascular risk.

AIM: We assessed whether peripheral vasoconstriction triggered by a standardized sympathetic stressor is augmented at 6am vs 9pm in adults between 50-80 years with type 2 diabetes (T2DM50-80) vs healthy ones (H50-80).

METHODS: Mean values of sympathetic vasoconstrictor responsiveness (SVR), vascular conductance (VC), brachial artery blood flow, and mean arterial pressure were measured on the contralateral forearm over two 5-minute bouts of rest and handgrip-mediated sympathetic stimulation, respectively.

RESULTS: Although baseline VC values were lower (p < 0.01) in the morning vs evening in both groups, SVR values in response to sympathoexcitation were similar in H50-80 (- 0.43 ± 12.44 vs – 2.57 ± 11.63 %, p = 0.73) and T2DM50-80 (+6.64 ± 10.67 vs +5.21 ± 7.64 %, p = 0.90), but higher (p < 0.01) in T2DM50-80 vs H50-80 at both day hours. Individuals with T2DM reported positive SVR values and VC change-scores, while healthy individuals reported statistically different (p < 0.02) negative SVR values and VC change-scores.

CONCLUSION: Peripheral vasoconstriction triggered by a standardized sympathetic stressor is similar between morning and evening, regardless of T2DM and different baseline VC values. However, peripheral vasoconstriction responsiveness is blunted in individuals with T2DM as handgrip-mediated sympathoexcitation induces vasodilation in the contralateral forearm in adults with T2DM and vasoconstriction in healthy age-matched controls, highlighting a neurovascular response altered by T2DM.

PMID:36592320 | DOI:10.1007/s40292-022-00557-y

J Clin Monit Comput. 2023 Jan 2. doi: 10.1007/s10877-022-00962-7. Online ahead of print.

ABSTRACT

Acute respiratory distress syndrome (ARDS) caused by multilobar pneumonia (MLP) is markedly different from typical ARDS in pathology, imaging characteristics, and lung mechanics. Regional lung assessment is required. We aimed to analyze the relationship between two regional assessment tools, lung ultrasound (LUS) and electrical impedance tomography (EIT) during positive end-expiratory pressure (PEEP) titration, and determine an appropriate PEEP level. We conducted a prospective study of patients with ARDS caused by MLP with PaO₂/FiO₂ < 150 mmHg. All subjects were equipped with two EIT belts connected with a single EIT machine to measure upper and lower hemithorax impedance change alternatingly at each PEEP level. LUS score was simultaneously determined in chest wall regions corresponding to the EIT regions during PEEP titration. We acquired EIT and LUS data in eight regions of interest at seven PEEP levels in 12 subjects. Therefore, 672 pairs of data were obtained for analysis. There were significant relationships between LUS score and tidal impedance variation and pixel compliance (C_pix). The Spearman’s rho between LUS score vs. tidal impedance variation and LUS score vs. the C_pix were – 0.142, P < 0.001, and – 0.195, P < 0.001, respectively. The relationship between the LUS score and C_pix remained the same at every PEEP level but did not reach statistical significance. The individual’s mean expected PEEP by LUS was similar to the EIT [10.33(± 1.67) vs. 10.33(± 1.44) cm H₂O, P = 0.15]. Regarding the MLP, the LUS scores were associated with EIT parameters, and LUS scores might proof helpful for finding individual PEEP settings in MLP.

PMID:36592267 | DOI:10.1007/s10877-022-00962-7

Int J Biometeorol. 2023 Jan 2. doi: 10.1007/s00484-022-02414-y. Online ahead of print.

ABSTRACT

Extreme ambient temperatures are well-known for their adverse impact on public health, in the form of increased mortality and morbidity due to respiratory and cardio-vascular diseases. However, to capture the total impact of weather on cause-specific mortality/morbidity, the synoptic atmospheric conditions over the region under study need to be taken into account. The objective of this work is to identify weather types over Thessaloniki, Greece, statistically associated with mortality from circulatory and respiratory diseases, in an attempt to holistically determine the impact of weather on cause-specific mortality in the region. For this purpose, we employed datasets from the NCEP/NCAR Reanalysis comprising intrinsic daily data, gridded at a resolution of 2.5°×2.5° and covering a 41-year period (1980-2020). The first set used contains data of 500 hPa and 1,000 hPa geopotential heights for the main geographical domain of the Mediterranean region (30°N-45°N, 10°Ε-35°E). The second set comprises meteorological variables (2 m temperature, specific humidity, 2 m zonal and 2 m meridional wind and total cloud cover) for a geographical domain of north Greece (40.95°Ν, 22.50°Ε-26.25°E). We applied a combination of principal components analysis (PCA) as a dimensionality reduction tool and k-means cluster analysis (CA) in order to group days with homogeneous synoptic meteorological parameters. The derived weather types were statistically correlated with respiratory and mortality data for the time-period 1999-2018. It was concluded that the most fatal conditions for public health in Thessaloniki were associated with weather types bringing low/extremely low ambient temperature over north Greece.

PMID:36592210 | DOI:10.1007/s00484-022-02414-y

Eur Spine J. 2023 Jan 2. doi: 10.1007/s00586-022-07505-3. Online ahead of print.

ABSTRACT

BACKGROUND: Spinal chondrosarcomas are rare malignant osseous tumors. The low incidence of spinal chondrosarcomas and the complexity of spine anatomy have led to heterogeneous treatment strategies with varying curative and survival rates. The goal of this study is to investigate prognostic factors for locoregional recurrence-free survival (LRFS) and overall survival (OS) comparing en bloc vs. piecemeal resection for the management of spinal chondrosarcoma.

METHODS: We retrospectively identified patients who underwent curative-intent resection of primary and metastatic spinal chondrosarcoma over a 25-year period. Univariate and multivariate survival analyses were conducted with LRFS as primary endpoint and OS as secondary endpoint. LRFS and OS were modeled using the Kaplan-Meier method and assessed using Cox regression analysis.

RESULTS: For 72 patients who underwent first resection, the median follow-up time was 5.1 years (95% CI 2.2-7.0). Thirty-three patients (45.8%) had en bloc resection, and 39 (54.2%) had piecemeal resection. Of the 68 patients for whom extent of resection was known, 44 patients had gross total resection (GTR) and 24 patients had subtotal resection. In survival analyses, both LRFS and OS showed statistically significant difference based on the extent of resection (p = 0.001; p = 0.04, respectively). However, only LRFS showed statistically significant difference when assessing the type of resection (p = 0.02). In addition, higher tumor grade and more invasive disease were associated with worse LRFS and OS rates.

CONCLUSION: Although in our study en bloc and GTR were associated with improved survival, heterogenous and complex spinal presentations may limit total resection. Therefore, the surgical management should be tailored individually to ensure the best local control and maximum preservation of function.

PMID:36592209 | DOI:10.1007/s00586-022-07505-3

Abdom Radiol (NY). 2023 Jan 2. doi: 10.1007/s00261-022-03793-x. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether microscopic hematuria (MH) patients with a negative initial evaluation have an elevated risk for urinary carcinoma.

METHODS: This is a population-based retrospective study with a matched control identified 8465 adults with an MH ICD code, an initial negative urinary malignancy work-up of cystoscopy and CT urography, and at least 35 months of clinical care. 8465 hematuria naïve controls were age, gender, and smoking status matched. Subsequent coding of non-prostatic urinary cancer, or any following hematuria codes: additional microscopic unspecified or unspecified hematuria, and gross hematuria was obtained. Χ² tests were performed.

RESULTS: There was no statistically significant difference in urinary malignancy rates (p > 0.05). Any urinary cancer: cases 0.74% (63/8465; 95% CI 0.58-0.95%)/controls 0.83% (71/8465; 95% CI 0.66-1.04%%) (p = 0.54); bladder: 0.45%/0.47% (p = 0.82); renal: 0.31%/0.38% (p = 0.43); ureteral: 0.01%/0.02% (p = 0.56). Subsequent gross hematuria in both males and females increased the odds of cancer: males 2.35 (p = 0.001; CI 1.42-3.91); females 4.25 (p < 0.001; CI 1.94-9.34). Males without additional hematuria had decreased odds ratio: 0.32 (p = 0.001; CI 0.16-0.64). Females without additional hematuria 0.58 (p = 0.19; CI 0.26-1.30) and both genders with additional unspecified hematuria/microscopic hematuria males 1.02 (p = 0.97; CI 0.50-2.08) and females 1.00 (p = 0.99; CI 0.38-2.66) did not have increased odds ratios (p > 0.05).

CONCLUSION: MH patients with initial negative evaluation have a subsequent urologic malignancy rate of less than 1% and likely do not need further urinary evaluation unless they develop gross hematuria.

PMID:36592198 | DOI:10.1007/s00261-022-03793-x

Arch Orthop Trauma Surg. 2023 Jan 2. doi: 10.1007/s00402-022-04762-1. Online ahead of print.

ABSTRACT

INTRODUCTION: In view of the vaso-occlusive pathophysiology affecting osseous micro-circulation, sickle cell disease (SCD) is well known to present with diverse skeletal and arthritic manifestations. With prolonged life-expectancy over the past decades, there has been a progressive increase in the proportion of SCD patients requiring joint reconstructions. Owing to the paucity of evidence in the literature, the post-operative complication rates and outcome in these patients following total knee arthroplasty (TKA) are still largely unknown.

METHODS: Based on the National Inpatient Sample (NIS) database (using ICD-10 CMP code), patients who underwent TKA between 2016 and 2019 were identified. The cohort were classified into two groups: A-those with SCD; and B-those without. The data on patients’ demographics, co-morbidities, details regarding hospital stay including expenditure incurred, and complications were analyzed and compared.

RESULTS: Overall, 558,361 patients underwent unilateral, primary TKA; among whom, 493 (0.1%) were known cases of SCD (group A). Group A included a significantly greater proportion of younger (60.14 ± 10.87 vs 66.72 ± 9.50 years; p < 0.001), male (77.3 vs 61.5%; p < 0.001); and African-American (88.2 vs 8.3%B; p < 0.001) patients, in comparison with group B. Group A patients were also at a significantly higher risk for longer duration of peri-operative hospital stay (p < 0.001), greater health-care costs incurred (p < 0.001), and greater need for alternative step-down health-care facilities (p < 0.001) following discharge. Among the SCD patients, 24.7%, 20.9% and 24.9% developed acute chest syndrome, pain crisis and splenic sequestration crisis, respectively during the peri-operative period. Group A patients had a statistically greater incidence of acute renal failure (ARF; p = 0.014), need for blood transfusion (p < 0.001) and deep vein thrombosis (DVT; p = 0.03) during the early admission period.

CONCLUSION: The presence of SCD substantially lengthens the duration of hospital stay and enhances health care-associated expenditure in patients undergoing TKA. SCD patients are at significantly higher risk for systemic complications including acute chest syndrome, pain crisis, splenic sequestration crisis, acute renal failure, higher need for blood transfusions and deep venous thrombosis during the initial peri-operative period following TKA.

PMID:36592196 | DOI:10.1007/s00402-022-04762-1

Eur J Nutr. 2023 Jan 2. doi: 10.1007/s00394-022-03081-w. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to investigate the association between intake of seafood and plant-derived n-3 polyunsaturated fatty acids (PUFA) and development of total atherosclerotic cardiovascular disease (ASCVD) and acute major ischemic events.

METHODS: A total of 53,909 men and women were enrolled between 1993 and 1997 into the Danish Diet, Cancer and Health cohort and followed through nationwide Danish registries for development of total ASCVD defined as a first registration of myocardial infarction, peripheral artery disease, or ischemic stroke due to large artery atherosclerosis or small-vessel occlusion. At recruitment, the intake of the major marine n-3 PUFA, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and the plant-derived n-3 PUFA, alpha-linolenic acid (ALA), was assessed using a validated food frequency questionnaire. Statistical analyses were conducted using sex-stratified multivariable Cox proportional hazard regression models.

RESULTS: During a median of 13.5 years of follow-up, 3958 participants developed ASCVD including 3270 patients with an acute major ischemic event. In multivariable analyses including adjustment for established risk factors, we found no associations for intake of ALA, but indications of inverse associations between intake of EPA, DHA and EPA + DHA and the rate of total ASCVD and acute major ischemic events.

CONCLUSIONS: A high intake of marine n-3 PUFA was associated with a lower risk of total ASCVD and acute major ischemic events, whereas no association could be demonstrated for the plant-derived ALA.

PMID:36592188 | DOI:10.1007/s00394-022-03081-w