Category: Nevin Manimala

Bone Jt Open. 2022 May;3(5):404-414. doi: 10.1302/2633-1462.35.BJO-2021-0185.R1.

ABSTRACT

AIMS: Perthes’ disease is an uncommon hip disorder with limited data on the long-term outcomes in adulthood. We partnered with community-based foundations and utilized web-based survey methodology to develop the Adult Perthes Survey, which includes demographics, childhood and adult Perthes’ disease history, the University of California Los Angeles (UCLA) Activity Scale item, Short Form-36, the Hip disability and Osteoarthritis Outcome Score, and a body pain diagram. Here we investigate the following questions: 1) what is the feasibility of obtaining > 1,000 survey responses from adults who had Perthes’ disease using a web-based platform?; and 2) what are the baseline characteristics and demographic composition of our sample?

METHODS: The survey link was available publicly for 15 months and advertised among support groups. Of 1,505 participants who attempted the Adult Perthes survey, 1,182 completed it with a median timeframe of 11 minutes (IQR 8.633 to 14.72). Participants who dropped out were similar to those who completed the survey on several fixed variables. Participants represented 45 countries including the USA (n = 570; 48%), UK (n = 295; 25%), Australia (n = 133; 11%), and Canada (n = 46; 4%). Of the 1,182 respondents, 58% were female and the mean age was 39 years (SD 12.6).

RESULTS: Ages at onset of Perthes’ disease were < six years (n = 512; 43%), six to seven years (n = 321; 27%), eight to 11 years (n = 261; 22%), and > 11 years (n = 76; 6%), similar to the known age distribution of Perthes’ disease. During childhood, 40% (n = 476) of respondents had at least one surgery. Bracing, weightbearing restriction, and absence of any treatment varied significantly between USA and non-USA respondents (p < 0.001, p = 0.002, and p < 0.001, respectively). As adults, 22% (n = 261) had at least one total hip arthroplasty, and 30% (n = 347) had any type of surgery; both more commonly reported among women (p = 0.002).

CONCLUSION: While there are limitations due to self-sampling, our study shows the feasibility of obtaining a large set of patient-reported data from adults who had childhood Perthes’ from multiple countries. Cite this article: Bone Jt Open 2022;3(5):404-414.

PMID:35535518 | DOI:10.1302/2633-1462.35.BJO-2021-0185.R1

J Eur Acad Dermatol Venereol. 2022 May 10. doi: 10.1111/jdv.18203. Online ahead of print.

ABSTRACT

BACKGROUND: Reactive granulomatous dermatitis (RGD) is an umbrella term used to describe interstitial granulomatous dermatitis (IGD), palisaded neutrophilic and granulomatous dermatitis (PNGD), and interstitial granulomatous drug eruption (IGDR).

OBJECTIVE: To describe systemic associations of RGD, explore possible associations between histopathologic findings and systemic RGD associations, and determine clinical relevance of RGD subtypes.

METHODS: We retrospectively studied clinical and histopathologic characteristics of patients with RGD from 1990 through 2020.

RESULTS: Of 65 patients with RGD (41 women, 24 men; median age at diagnosis, 62 years), 37 had IGD, 26 had PNGD, and 2 had IGDR. Fifty patients (76.9%) had an associated systemic condition; rheumatologic conditions were identified for 34 (52.3%) patients. The associated systemic condition occurred before RGD in approximately 75% of patients. Statistical analyses did not show significant associations between specific subtypes of RGD and systemic diseases or treatment response, and specific histopathologic findings were not predictive of an associated systemic disease.

CONCLUSIONS: Although most patients with RGD had an associated systemic condition, subtypes of RGD did not correlate with systemic associations, lending support to the use of the umbrella term RGD.

PMID:35535506 | DOI:10.1111/jdv.18203

Bone Jt Open. 2022 May;3(5):398-403. doi: 10.1302/2633-1462.35.BJO-2022-0033.

ABSTRACT

AIMS: This study aims to estimate economic outcomes associated with 30-day deep surgical site infection (SSI) from closed surgical wounds in patients with lower limb fractures following major trauma.

METHODS: Data from the Wound Healing in Surgery for Trauma (WHiST) trial, which collected outcomes from 1,547 adult participants using self-completed questionnaires over a six-month period following major trauma, was used as the basis of this empirical investigation. Associations between deep SSI and NHS and personal social services (PSS) costs (£, 2017 to 2018 prices), and between deep SSI and quality-adjusted life years (QALYs), were estimated using descriptive and multivariable analyses. Sensitivity analyses assessed the impact of uncertainty surrounding components of the economic analyses.

RESULTS: Compared to participants without deep SSI, those with deep SSI had higher mean adjusted total NHS and PSS costs (adjusted mean difference £1,577 (95% confidence interval (CI) -951 to 4,105); p = 0.222), and lower mean adjusted QALYs (adjusted mean difference -0.015 (95% CI -0.032 to 0.002); p = 0.092) over six months post-injury, but this difference was not statistically significant. The results were robust to the sensitivity analyses performed.

CONCLUSION: This study found worse economic outcomes during the first six months post-injury in participants who experience deep SSI following orthopaedic surgery for major trauma to the lower limb. However, the increase in cost associated with deep SSI was less than previously reported in the orthopaedic trauma literature. Cite this article: Bone Jt Open 2022;3(5):398-403.

PMID:35535505 | DOI:10.1302/2633-1462.35.BJO-2022-0033

Am J Hosp Palliat Care. 2022 May 10:10499091221100809. doi: 10.1177/10499091221100809. Online ahead of print.

ABSTRACT

BACKGROUND: Recurrent or refractory cancer often results in substantial and extensive physical, emotional, psychosocial, and spiritual burdens for children and their families. However, the therapeutic benefits of legacy interventions in children with recurrent or refractory cancer have been examined only recently, with limited attention to specific effects on children’s coping abilities.

OBJECTIVE: The purpose of this study was to determine the effects of a digital storytelling-legacy intervention on the adaptive coping of children with recurrent or refractory cancer.

METHODS: This study used a 2-arm randomized, waitlist-controlled trial design. A total of 150 children with recurrent or refractory cancer and their parents were recruited via Facebook advertisements.

RESULTS: The analysis sample included 92 dyads (35-intervention group, 57-control group). The legacy intervention showed small and statistically nonsignificant effects on primary-control and disengagement coping strategies among children with recurrent or refractory cancer.

CONCLUSIONS: Legacy interventions using readily accessible digital storytelling have the potential to enhance the adaptive coping skills among children with recurrent or refractory cancer. Further research should determine how to enhance interventions tailored to this population to optimize the benefits.

PMID:35535490 | DOI:10.1177/10499091221100809

Circ Res. 2022 May 9:101161CIRCRESAHA121318391. doi: 10.1161/CIRCRESAHA.121.318391. Online ahead of print.

NO ABSTRACT

PMID:35534922 | DOI:10.1161/CIRCRESAHA.121.318391

J Dent Educ. 2022 May 9. doi: 10.1002/jdd.12946. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVE: Admission to dental school is based on various factors including academic achievements in undergraduate coursework and the Dental Admission Test (DAT) scores. Students’ success in an operative course requires fundamental knowledge, hand skills, spatial awareness, and self-assessment ability. The goal of this study is to evaluate how admissions factors, such as Grade Point Average (GPA) and DAT, including the Perceptual Ability Test (PAT), relate to students’ academic and preclinical performance and self-assessment skills in preclinical operative dentistry.

METHODS: A total of 239 students were included from seven class years (2016-2022). Third-year dental students participated in a preclinical operative dentistry course. At the end of the course, they took the final multiple-choice exam and performed four competency examination procedures: Class II amalgam preparation and restoration and Class III resin-composite preparation and restoration. Calibrated faculty graded students’ work independently and students also self-assessed their performance using the same rubrics as faculty. Linear regressions were performed to estimate the association between the admission factors with the mean faculty scores (measuring preclinical performance), student-faculty (S-F) gap scores (evaluating self-assessment skills), and their final didactic exam scores.

RESULTS: Overall, students’ self-assessment was higher compared to faculty score. Linear regression analysis demonstrated positive correlations between the PAT and students’ preclinical performance as well as between the DAT and their didactic exam scores. In general, S-F gap score decreased as PAT score increased, and it was statistically significant lower for the Class III preparation, indicating a better self-assessment skill. No correlations were observed between student performance and GPA scores.

CONCLUSION: The findings from the association between student performance and admission factors may play an important role in the dental school admissions process and assist students who may benefit from early faculty intervention and support.

PMID:35534921 | DOI:10.1002/jdd.12946

BMC Oral Health. 2022 May 9;22(1):170. doi: 10.1186/s12903-022-02175-5.

ABSTRACT

BACKGROUND: Helicobacter pylori infection is one of the most common infectious diseases in humans. Dental plaque is considered as a reservoir of this bacterium, which could play an important role in the development of gastrointestinal problems. Our aim was to investigate the prevalence of H. pylori and its virulence factors in dental plaques in children with and without dental caries.

METHODS: Among children aged 6 to 12 years, a total of 72 children were enrolled in the study, including 36 cases with total DMFT/dmft > 3 (case group) and 36 participants with total DMFT/dmft < 1 (control group). After removing supra-gingival plaques from the lower first permanent molar teeth, the samples were examined using PCR method for the presence of H. pylori and some of its virulence factors. Statistical analysis was performed using chi-square, Fisher’ exact test, t-tests, and logistic regression.

RESULTS: Of 72 participants, 40 cases were male, and 32 cases were female. The minimum and maximum values of total DMFT/dmft indices were zero and ten, respectively, and the mean ± SD value of total DMFT/dmft was 2.78 ± 3.22. Except for vegetable consumption (p = 0.045), there was no significant difference between the two groups regarding gastrointestinal disorders, feeding methods in infancy (p = 0.058), frequency of daily brushing (p = 0.808), frequency of dental visits (p = 0.101), and history of dental scaling (p = 0.246) and professional topical fluoride therapy (p = 0.5). Out of 72 samples, 15 cases were positive for H. pylori DNA (20.8%), and there was no significant association between the presence of this bacterium in dental plaque and dental caries (p = 0.281). The frequency of virulence factors detected in 15 H. pylori cases was as follows: cagA in six cases (40.0%), vacAm1 in three cases (20.0%), and vacAs1 in one case (6.7%). There was no significant difference between the groups regarding the prevalence of virulence factors.

CONCLUSION: Our results indicate the presence of H. pylori along with some virulence factors in dental plaques as a reservoir of this bacterium in children in Iran. Although there was no significant association between this bacterium and the incidence of dental caries, dental health in children needs to be seriously taken into consideration.

PMID:35534888 | DOI:10.1186/s12903-022-02175-5

J Perinat Med. 2022 May 10. doi: 10.1515/jpm-2021-0522. Online ahead of print.

ABSTRACT

OBJECTIVES: Normal thyroid activity has an essential role in fetal development, its deficiency may hamper fetal neurodevelopment and neonatal growth. The quantitation of thyroid hormones although useful, still exposes differences on cut off levels to diagnose thyroid deficit accurately that can elicit under or over diagnosis of thyroid dysfuntion.

METHODS: A total of 839 pregnant patients were studied for thyroidal clinical assessment through quantitation of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) circulating levels. Patients evaluated for prenatal and neonatal outcomes. Thyroid function deficiencies were determined with the American Thyroid Association (ATA) 2011 and 2017 values. Statistical analysis searched for associations between variables, odds ratios (OR) and correlations were calculated to evaluate the reliability of the cutoff values recommended by the ATA.

RESULTS: Mean age of our cases was 27.5 + 5.83 years at diagnosis, mean gestational age at first consultation was 23.8 + 10.5 weeks. Mean TSH levels detected were: 2.5 + 1.89 mIU/L, total T3: 3.55 + 4.1 ng/dL, FT4: 3.14 + 4.4 ng/dL. The ATA 2011 values yielded 332 hypothyroidism cases vs. 507 euthyroid patients, a total incidence of 39.6% vs. the ATA 2017 values, diagnosing 100 hypothyroidism cases and 739 euthyroid patients, total incidence of 11.9%. Association with complications were not significant.

CONCLUSIONS: Using ATA 2017 values showed a decreased population with gestational hypothyroidism, hence preventing overdiagnosis and over-treatment. No significant complications were associated, requiring the determination of new regional values. Education and sensibilization of our population is needed to comply with early prenatal consultation and thyroid function testing.

PMID:35534885 | DOI:10.1515/jpm-2021-0522

Parasit Vectors. 2022 May 10;15(1):107. doi: 10.1186/s13071-022-05230-w.

ABSTRACT

BACKGROUND: Feline leishmaniosis caused by Leishmania infantum is often associated with feline immunodeficiency virus (FIV) infection; however, the role and clinical significance of this coinfection remain unknown. This study aimed to assess whether FIV is associated with L. infantum infection in cats from canine leishmaniosis endemic areas and to report the clinical signs and hematological alterations associated with coinfection.

METHODS: A retrospective matched case-control study (ratio 1:2) was conducted. Data of clinical examination and complete blood count (CBC) were selected from a cohort of 705 cats examined for epidemiological studies on feline leishmaniosis conducted between 2012 and 2019. Ninety-one FIV seropositive cases and 182 FIV seronegative control cats were selected. Matching was done according to age, sex, lifestyle and geographic provenience of case cats. Rapid ELISA devices were mainly used to detect anti-FIV antibodies. Anti-Leishmania IgG antibodies were detected by indirect-immunofluorescence test (IFAT). Leishmania DNA was searched in blood, oral and conjunctival swabs by quantitative real-time PCR.

RESULTS: Feline immunodeficiency virus seropositive cats had no hematological abnormalities suggestive of an advanced stage of FIV infection and were statistically more frequently IFAT positive, and their risk of being L. infantum antibody positive was 2.8 greater than in the FIV seronegatives. The association of FIV seropositivity with L. infantum antibody positivity was confirmed in the univariable model of logistic regression. A multivariate model found FIV infection and L. infantum PCR positivity as predictors of a positive L. infantum IFAT result. Male outdoor cats from rural or suburban areas were at risk for FIV and L. infantum antibody positivity. Clinical signs more frequently associated with the coinfection were oral lesions, pale mucous membranes and low body condition score (BCS).

CONCLUSIONS: This study documents that FIV seropositive cats with no hematological abnormalities suggestive of an advanced stage of FIV infection are more prone to be L. infantum seroreactive by IFAT in endemic areas. Therefore, FIV seropositive cats should be tested for L. infantum antibodies and treated for preventing sand fly bites. Pale mucous membranes, low BCS and oral lesions but no CBC abnormalities were significantly associated with the coinfection.

PMID:35534884 | DOI:10.1186/s13071-022-05230-w

Environ Health. 2022 May 9;21(1):50. doi: 10.1186/s12940-022-00861-z.

NO ABSTRACT

PMID:35534876 | DOI:10.1186/s12940-022-00861-z