Category: Nevin Manimala

Bratisl Lek Listy. 2024;125(12):844-850. doi: 10.4149/BLL_2024_129.

ABSTRACT

BACKGROUND: Fractures of thoracolumbar spine in the field of ankylosing diseases such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) can by surgically treated with miniinvasive posterior transpedicular fixation. The exact length of implant is the subject of several studies. In our study, we retrospectively evaluated the treatment of B3 fractures of the ankylosed thoracolumbar spine with use a shorter versus longer implant, always with 8 screws.

METHODS: A total of 46 patients were included in the study (36 men and 10 women). Sixteen patients had AS and 30 patients had DISH. Patients treated between 2018 and 2022 with minimally invasive dorsal transpedicular fixation using 8 transpedicular screws were included in this study. We compared two groups where the first consisted of patients operated on with fixation of a maximum of 4 segments and the second group of patients consisted of patients in whom longer stabilization was used, at least 5 to 8 segments, with skipping of some vertebra between screws. We compared the effect of fixation length on reduction and retention before surgery, after surgery, and after 6 and 12 months. We evaluated the effect of reduction and retention on the basis of differences in the measurement of the Cobb angle and the angle, which we called “vege”, which was formed by dislocation of the fracture. Furthermore, we monitored demographic data, the length of surgery, the number of complications, the number of concomitant injuries, the presence of a neurological deficit, and the result was assessed by the AO Spine PROST questionnaire.

RESULTS: In the entire group of 46 patients, the difference in the “vege” angle was significant (p<0.001). When comparing the reduction between the groups with short and longer fixation, the difference was not significant (p=0.829). The difference of the Cobb angle before and after the surgery in the comparison between the two groups did not show a statistically significant difference (p=0.434). Measurements of the Cobb angle bisegmentally after 6 and 12 months showed a progressive change in terms of kyphotization, which was smaller in the group with longer fixation, this difference was not statistically significant (p=0.709). Complete reduction was achieved in the group with short fixation vs 75% vs 63.3% with longer fixation (p-0.739). At the check-up after 6 months, all incomplete intraoperative reductions were spontaneously reduced.

CONCLUSIONS: Based on this study, we could conclude that both used constructions are comparable in terms of treatment results. It can be observed that longer fixation is more resistant to kyphotization at 6 and 12 months, but we would need a larger group of patients to confirm this hypothesis. In all incomplete reduced fractures through the surgery, complete reduction after verticalization occurred within 6 months in both groups. The angle of reduction was greater in the group with longer fixation, but the difference was not significant (Tab. 6, Fig. 8, Ref. 31).

PMID:39629657 | DOI:10.4149/BLL_2024_129

J Endovasc Ther. 2024 Dec 4:15266028241292468. doi: 10.1177/15266028241292468. Online ahead of print.

ABSTRACT

PURPOSE: To date, no direct comparison has been made between the patency rates of drug-eluting stents (DESs) and interwoven stents (IWSs) in addressing hemodialysis access dysfunction. This study aims to directly compare the primary patency rates of DES and IWS in clinically significant vein-graft anastomotic stenosis of arteriovenous grafts (AVGs).

MATERIAL AND METHODS: Between January 2015 and October 2022, we enrolled all hemodialysis patients with clinically significant vein-graft anastomotic stenosis of AVGs who presented at our institution. Patient demographics, AVG details, lesion characteristics, and primary patency data for each stent group were systemically recorded. Following this, a Kaplan-Meier analysis of the primary stent patency was performed, with statistical significance set at p<0.05.

RESULTS: A total of 51 patients (19 men and 32 women; mean age=64 years; range=49-79 years) were enrolled. Among them, 16 were treated with DES and 35 were treated with IWS. Notably, the most common stent placement location in each group was the vein-graft anastomosis of the brachioaxillary grafts, and the primary patency rate was monitored over a follow-up period of 24 months. At 6, 12, and 24 months, the primary patency rates for DES vs IWS were 100% vs 62.7%, 91.7% vs 38.8%, and 62.9% vs 21.4%, respectively (p<0.001).

CONCLUSION: Our findings suggest that DES may be a more effective treatment choice for clinically significant vein-graft anastomotic stenosis in AVGs for hemodialysis access than nondrug-coated IWS.

CLINICAL IMPACT: Drug-eluting stents (DES) have been widely recognized for their efficacy in reducing reintervention rates in coronary and femoropopliteal pathologies. However, their application in managing failing hemodialysis access remains inadequately explored. This study highlights the promising potential of DES in addressing clinically significant vein-graft anastomotic stenosis in hemodialysis arteriovenous grafts (AVG). DES may represent a viable alternative for mitigating substantial immediate recoil stenosis following balloon angioplasty and for preventing early restenosis at the vein-graft anastomosis of AVG, offering a novel therapeutic avenue for future clinical practice.

PMID:39629634 | DOI:10.1177/15266028241292468

BJPsych Open. 2024 Dec 4;10(6):e217. doi: 10.1192/bjo.2024.817.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has disproportionately affected women’s mental health. However, most evidence has focused on mental illbeing outcomes, and there is little evidence on the mechanisms underlying this unequal impact.

AIMS: To investigate gender differences in the long-term trajectories of life satisfaction, how these were affected during the pandemic and the role of time-use differences in explaining gender inequalities.

METHOD: We used data from 6766 (56.2% women) members of the 1970 British Cohort Study (BCS70). Life satisfaction was prospectively assessed between the ages of 26 (1996) and 51 (2021) years, using a single question with responses ranging from 0 (lowest) to 10 (highest). We analysed life satisfaction trajectories with piecewise latent growth curve models, and investigated whether gender differences in the change in the life satisfaction trajectories with the pandemic were explained by self-reported time spent doing different paid and unpaid activities.

RESULTS: Women had consistently higher life satisfaction than men before the pandemic (Δ_{intercept,unadjusted} = 0.213, 95% CI 0.087-0.340; P = 0.001) and experienced a more accelerated decline with the pandemic onset (Δ_{quad2,unadjusted} = -0.018, 95% CI -0.026 to -0.011; P < 0.001). Time-use differences did not account for the more accelerated decrease in women’s life satisfaction levels with the pandemic (Δ_{quad2,adjusted} = -0.016, 95% CI -0.031 to -0.001; P = 0.035).

CONCLUSIONS: Our study shows pronounced gender inequalities in the impact of the pandemic on the long-term life satisfaction trajectories of adults in their 50s, with women losing their pre-pandemic advantage over men. Self-reported time-use differences did not account for these inequalities. More research is needed to tackle gender inequalities in population mental health.

PMID:39629603 | DOI:10.1192/bjo.2024.817

Circ Cardiovasc Imaging. 2024 Dec 4:e017425. doi: 10.1161/CIRCIMAGING.124.017425. Online ahead of print.

ABSTRACT

BACKGROUND: In aortic stenosis, the myocardium responds with left ventricular hypertrophy, which is characterized by increased left ventricular mass due to cellular hypertrophy and extracellular matrix expansion. Following aortic valve replacement (AVR), left ventricular hypertrophy regression occurs, but early cellular and extracellular dynamics are unknown.

METHODS: Patients with severe symptomatic aortic stenosis undergoing surgical or transcatheter AVR were prospectively recruited. Pre- and early post-AVR cardiac magnetic resonance imaging assessed left ventricular remodeling, global longitudinal strain, and T1 mapping to determine extracellular volume fraction and volume of cellular and extracellular compartments.

RESULTS: In all, 39 patients (aged 71.4±9.8 years, male 79%, aortic valve peak velocity 4.4±0.5 m/s) underwent cardiac magnetic resonance before and at median 7.7 weeks post-AVR. Left ventricular mass index reduced significantly by 15.4% (P<0.001*), primarily driven by cellular compartment regression (18.7%, P<0.001*), with a smaller reduction in the extracellular compartment (7.2%, P<0.001*). This unbalanced regression led to an apparent increase in extracellular volume fraction (27.4±3.1% to 30.2±2.8%; P<0.001*). Although there was no significant change in global longitudinal strain post-AVR, an increase in extracellular volume fraction was associated with worsening of global longitudinal strain (Pearson r=0.41, P=0.01). Mode of intervention (transcatheter versus surgical) did not influence the above myocardial parameters post-AVR (all P>0.05). The asterisk in P values indicates a statistical significance of <0.05.

CONCLUSIONS: Within 8 weeks of AVR for aortic stenosis, substantial left ventricular hypertrophy regression occurs involving both cellular and extracellular compartments, demonstrating the early myocardial adaptability to afterload relief. Cellular compartment regression is greater than extracellular regression, leading to an apparent increase in extracellular volume fraction. Mode of intervention did not affect degree of reverse remodeling, indicating that both are effective at resulting beneficial changes post-AVR.

REGISTRATION: URL: https://www.isrctn.com; Unique identifier: NCT04627987.

PMID:39629586 | DOI:10.1161/CIRCIMAGING.124.017425

Curr Rheumatol Rev. 2024 Dec 3. doi: 10.2174/0115733971314061241126044624. Online ahead of print.

ABSTRACT

INTRODUCTION: Investigating CD68+ positive cells in the synovial tissue is crucial for understanding the pathogenesis of psoriatic arthritis (PsA) and developing targeted treatment strategies. The role of CD68+ positive cells in the synovial tissue of patients with PsA for joint destruction has not been fully studied.

OBJECTIVE: The objective of the study was to examine the presence of CD68+ cells in the synovial tissue of patients with PsA, particularly those with high inflammatory activity.

METHODS: Synovial tissue samples were collected during knee joint replacement surgeries from patients with PsA (16 patients) and gonarthrosis (25 patients). Immunohistochemical methods were employed to detect CD68+ cell expression in the tissue samples. The results were analyzed by histologists, and the staining intensity and percentage of positively stained cells were evaluated. The data were then divided into three groups for statistical analysis: negative, weakly positive, and strongly positive histological samples. Routine indices for disease activity, VAS, DAPSA, PASDAI, and mCPDAI were used to assess PsA activity in all patients and to assess correlations with CD68+ positive cells in the synovial tissue. Statistical analysis was performed using SPSS version 26.0 (SPSS Inc., Chicago, IL, USA).

RESULTS: The expression of CD68+ positive cells was significantly higher in patients with PsA compared to those with activated gonarthrosis (p < 0.001). The indices for disease activity, VAS, DAPSA, PASDAI, mCPDAI, and mCPDAI showed a significant positive relationship with the expression of CD68 + cells on synovial tissue in patients with PsA (p < 0.01) Conclusion: The findings of the study confirm the increased numbers of CD68+ cells in PsA vs. gonathrosis synovium. This suggests the need to explore therapeutic approaches aimed at suppressing or blocking CD68+ cells to potentially mitigate joint damage.

PMID:39629578 | DOI:10.2174/0115733971314061241126044624

Curr Med Imaging. 2024;20(1):e15734056299979. doi: 10.2174/0115734056299979240927101222.

ABSTRACT

BACKGROUND: Bruxism may cause increased alveolar bone thickness and density and irregular enlargement of the periodontal space.

AIM: This study aimed to evaluate the mandibular bone quality using radio-morphometric indices and Fractal Dimension (FD) analysis in orthopantomography (OPG).

MATERIAL AND METHODS: OPGs of 100 patients, 50 bruxers and 50 non-bruxers, were included in this study. Values, such as mental index (MI), panoramic mandibular index (PMI), gonial index (GI), antegonial notch depth (AND), mandibular cortical index (MCI), and antegonial index (AI), were calculated in OPG. Eight bilateral areas of interest (ROI) were selected on ort for FD analysis: ROI 1, mandibular condyle; ROI 2, mandibular ramus; ROI 3, mandibular angulus; and ROI 4, mandibular mental area.

RESULTS: MI, PMI, and AND values were higher in bruxers than in the control group (p&#60;0.05). MCI and AI values calculated on both sides were not statistically significantly related in bruxism and control group individuals (p>0.05). As a result of the calculations, the FD values of the left condyle (p=0.02) and left angulus (p=0.03) areas showed a statistically significant difference between individuals with and without bruxer. No statistically significant difference was found in the FD measurements calculated from the ramus and mental areas on the right and left sides (p>0.05). The relationship between FD values and gender in these areas was examined, and no statistically significant difference was found (p&#60;0.05).

CONCLUSION: In dentistry, bruxism can be diagnosed and treated by measuring MI, PMI, and AND values. No difference was found in mandibular cortical bone thickness in bruxers and non-bruxers, according to AI and MCI. The mean GI measured on the right side differed between groups. FD values of the mandibular trabecular bone were affected by bruxism in the right condyle and right angulus areas.

PMID:39629572 | DOI:10.2174/0115734056299979240927101222

J Phys Ther Educ. 2024 Dec 4. doi: 10.1097/JTE.0000000000000381. Online ahead of print.

ABSTRACT

INTRODUCTION: Generative artificial intelligence (AI) is rapidly gaining popularity across health care, education, and society. The purpose of this study was to assess perceptions and use of generative AI in academic physical therapy (PT).

REVIEW OF LITERATURE: Generative AI became one of the fastest-growing technologies ever after the public release of ChatGPT in November 2022. Early data indicate that attitudes toward generative AI in higher education are mixed and rapidly evolving, with significant ethical concerns around use and potential misuse. There are no published studies investigating perceptions and use of generative AI in PT education.

SUBJECTS: A total of 175 surveys were completed and analyzed. Respondents included PT educators, administrators, and students.

METHODS: An anonymous, online survey on use and perception of AI was distributed through email and social media. Descriptive statistics and cross-tabulations were performed to analyze respondent characteristics and responses to survey questions.

RESULTS: Most respondents (61.1%) reported they did not use generative AI during the 2022-2023 academic year, whereas 35.4% were generative AI users. More than 40% of respondents were optimistic or very optimistic toward generative AI. Users of AI were more likely to report an optimistic or very optimistic disposition toward AI compared with nonusers. AI users were more likely to agree or completely agree that generative AI has more benefits than drawbacks compared with nonusers.

DISCUSSION AND CONCLUSION: Results of this survey suggest that, despite the rapid uptake of generative AI in society, many PT educators and students harbor reservations and uncertainties toward its use. Artificial intelligence users were less likely to hold negative perceptions toward it and were more likely to find it useful. Understanding use and perceptions of generative AI in PT education may inform strategies to promote innovation, policy-making, and ethical integration of this new and rapidly evolving technology.

PMID:39629551 | DOI:10.1097/JTE.0000000000000381

Cancer Sci. 2024 Dec 4. doi: 10.1111/cas.16422. Online ahead of print.

ABSTRACT

Pancreatic cancer is among the deadliest cancers, with a grim prognosis despite advances in treatment. We conducted a population-based case-control study from Taiwan, linking Health and Welfare Data Science Center data to the Taiwan Cancer Registry, which offers a promising strategy for its treatment through drug repurposing. The study aims to identify the association of anti-parkinsonian drugs with pancreatic cancer risk across different age groups. The analysis encompassed 18,921 pancreatic cancer cases and 75,684 matched controls, employing conditional logistic regression to assess the impact of anti-parkinsonian drugs on the risk of pancreatic cancer. Key findings revealed a statistically significant association of the administration with specific anti-parkinsonian medications, including anticholinergic agents, tertiary amines, dopa derivatives, and dopamine receptor agonists, with a reduction in pancreatic cancer risk. These associations were represented as adjusted odds ratios (aORs), ranging from 0.620 (95% CI 0.470-0.810) to 0.764 (95% CI 0.655-0.891). Further, age-stratified analysis revealed variations in efficacy across different age groups. Anticholinergic agents and tertiary amines exhibited greater effectiveness in the 40-64-year age group (aOR, 0.653; 95% CI, 0.489-0.872), whereas dopa derivatives and dopamine receptor agonists were particularly efficacious in the cohort aged ≥65 years (aOR, 0.728; 95% CI, 0.624-0.850 and aOR, 0.665; 95% CI, 0.494-0.894, respectively). Notably, specific drugs such as trihexyphenidyl, levodopa/dopa decarboxylase inhibitor (DDCI), and pramipexole demonstrated a significant decrease in cancer risk, especially in the elderly population. These preliminary findings can contribute to the possible therapeutic role of anti-parkinsonian drugs in the treatment of pancreatic cancer.

PMID:39629516 | DOI:10.1111/cas.16422

J Family Med Prim Care. 2024 Oct;13(10):4173-4180. doi: 10.4103/jfmpc.jfmpc_888_23. Epub 2024 Oct 18.

ABSTRACT

BACKGROUND: Due to affluent lifestyles, primary care physicians are concerned about metabolic syndrome (MetS). Inflammation and insulin resistance are caused by extra adipose tissue. Our study seeks to evaluate, taking into account numerous variables, the relationship between high-sensitivity C-reactive protein (hsCRP) levels and MetS in adults aged 50+ in Northern Kashmir, India.

MATERIALS AND METHODS: In Northern Kashmir, India, a hospital-based cross-sectional study looked into the relationship between hsCRP and MetS in people over 50. The recruitment process included people looking for basic healthcare services. Utilising modified NCEP-ATP III criteria, MetS was established. The association between MetS and hsCRP levels was evaluated statistically while taking into account various variables.

RESULTS: The waist circumference, body mass index, systolic and diastolic blood pressure, as well as the prevalence of hypertension, diabetes mellitus (DM), and dyslipidemia were all greater in those with MetS. While demonstrating decreased levels of high-density lipoprotein cholesterol (HDL-C), they also showed higher levels of high-sensitive C-reactive protein (hsCRP) and fasting plasma glucose. A study of correlations revealed a substantial inverse relationship between hsCRP and HDL-C. Elevated hsCRP levels were found to be substantially linked with MetS by the use of logistic regression, along with obesity, uric acid levels, hypertension, DM, and dyslipidemia. These results underline how crucial it is to keep an eye on these variables in order to recognize and treat MetS as soon as possible.

CONCLUSION: Among this investigation, we found strong evidence that high- hsCRP, an independent risk factor for MetS, was present among middle-aged and elderly residents of the northern Kashmir region of India.

PMID:39629444 | PMC:PMC11610817 | DOI:10.4103/jfmpc.jfmpc_888_23

J Family Med Prim Care. 2024 Oct;13(10):4276-4283. doi: 10.4103/jfmpc.jfmpc_183_24. Epub 2024 Oct 18.

ABSTRACT

CONTEXT: Each year, about 21 million girls aged 15-19 in developing regions experience pregnancy, posing significant challenges for their health, well-being, and economic stability due to its vast impact.

AIM: To identify the risk factors contributing to teenage pregnancy as compared to Pregnancy in pregnant women in the rural area of the Khordha district with the assessment of their knowledge and, health-seeking behaviour (Contraception and STDs) among teenage and adult pregnant women in the study area.

SETTINGS AND DESIGN: Hospital-based case-control study conducted at Bhubaneswar’s Community Health Centre.

MATERIAL AND METHODS: The study, conducted from April to July 2022, recruited 138 participants using consecutive sampling and interviewed them using a pretested semi-structured questionnaire.

STATISTICAL ANALYSIS: Chi-square and logistic regression assessed association and strength.

RESULTS: Factors contributing to teenage pregnancy include education below high school (AOR = 2.46; 95%CI 0.89-6.79), SC and ST caste (AOR = 2.34; 95%CI 0.94-5.82), having more than three siblings (AOR = 4.45; 95%CI 1.53-12.96), and lack of communication about sexual issues (AOR = 2.84; 95%CI 1.25-6.39). Awareness of contraceptive methods was 34.8% among cases and 56.5% among controls (p = 0.02). Regarding STD awareness and symptoms, 15.2% of cases and 42.4% of controls were knowledgeable and experienced symptoms (p < 0.01).

CONCLUSIONS: This study suggests that factors such as lower education, minority caste, having more than three siblings, and lack of communication about sexual issues contribute to early pregnancy. These findings could enhance existing ARSH platforms by integrating regular engagement and sensitization efforts.

PMID:39629440 | PMC:PMC11610855 | DOI:10.4103/jfmpc.jfmpc_183_24