Category: Nevin Manimala

Musculoskeletal Care. 2022 Nov 25. doi: 10.1002/msc.1718. Online ahead of print.

ABSTRACT

INTRODUCTION: The National Institute for Health and Care Excellence (NICE) suggest there is no role for routine radiography in the diagnosis of osteoarthritis (OA). It is not known how consistent this recommendation is across international guidelines, or the impact of UK guidance on domestic OA X-ray request rates.

METHODS: A systematic search identified guideline recommendations on the role of radiography in OA diagnosis. Full texts underwent dual screening and appraisal using the AGREE II tool. A narrative synthesis was performed. Consultation data were extracted from a UK primary care database: the Consultations in Primary Care Archives (CiPCA). The annual proportion of X-ray requests per 100 OA consulters from 2000 to 2012 were calculated. Joinpoint regression analysis examined if there were changes in the trend of X-ray request rates and compared these with the publication dates of UK guidelines.

RESULTS: Eighteen evidence-based OA guidelines were included in the review. Eleven recommended a clinical diagnosis of OA without radiographic confirmation. Seven recommended routine radiography; these guidelines were predominantly for radiologists. A mean of 17.3 X-rays per 100 patients were requested in patients consulting for OA per year between 2000 and 2012. A statistically significant reduction in X-ray request rates was seen in 2003.

CONCLUSION: Recommendations on the role of radiography in OA vary between medical specialty and countries. UK guidelines appear to have had a limited impact on X-ray request rates in OA.

PMID:36426659 | DOI:10.1002/msc.1718

J Clin Nurs. 2022 Nov 25. doi: 10.1111/jocn.16471. Online ahead of print.

ABSTRACT

BACKGROUND: Single studies support the presence of several post-COVID-19 symptoms; however, there is no evidence for the synthesis of symptoms.

OBJECTIVE: We attempt to provide an overview of the persistent symptoms that post-COVID-19 patients encounter, as well as the duration of these symptoms to help them plan their rehabilitation.

DESIGN: Systematic review and meta-analysis.

PARTICIPANTS: A total of 16 studies involving 8756 patients post-COVID-19 were included.

METHODS: The CINAHL, PubMed, EMBASE, Scopus, and Web of Science databases were searched from 2019 to August 2021. Observational studies that reported data on post-COVID-19 symptoms were included. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal for Observational Studies. We included medium- to high-quality studies. We used a random-effects model for the meta-analytical pooled prevalence of each post-COVID-19 symptom, and I² statistics for heterogeneity.

RESULTS: From the 2481 studies identified, 16 met the inclusion criteria. The sample included 7623 hospitalised and 1133 non-hospitalised patients. We found the most prevalent symptoms were fatigue and dyspnea with a pooled prevalence ranging from 42% (27%-58%). Other post-COVID-19 symptoms included sleep disturbance 28% (14%-45%), cough 25% (10%-44%), anosmia/ageusia 24% (7%-47%), fever 21% (4%-47%), myalgia 17% (2%-41%), chest pain 11% (5%-20%), and headache 9% (2%-20%). In addition to physical symptoms, anxiety/depression was also prevalent 27% (8%-53%).

CONCLUSIONS: Fatigue and dyspnea were the most prevalent post-COVID-19 symptoms and experienced up to 12 months.

RELEVANCE TO CLINICAL PRACTICE: Multiple persistent symptoms are still experienced until 12 months of post-Covid 19. This meta-analysis should provide some awareness to nurses to highlights the unmet healthcare needs of post-COVID-19 patients. Long-term monitoring for the evaluation and treatment of symptoms and conditions and rehabilitation programs should be conducted.

PMID:36426658 | DOI:10.1111/jocn.16471

Phys Chem Chem Phys. 2022 Nov 25. doi: 10.1039/d2cp03688f. Online ahead of print.

ABSTRACT

Superparamagnetic nanocrystals of gadolinium orthoferrite (GdFeO₃) with close to isometric morphology were successfully synthesized by heat treatment of gadolinium and iron(III) hydroxides obtained by direct co-precipitation with and without ultrasonic irradiation. The obtained samples were investigated by PXRD, low-temperature nitrogen adsorption-desorption isotherm measurements, HRTEM and VSM. It was established that ultrasonication during co-precipitation led to a decrease in the average size of GdFeO₃ crystallites obtained after heat treatment by approximately 19%, an increase in their BET specific surface area by more than two times, a decrease in the degree of their aggregation by about five times and an improvement in their magnetic properties due to the increase in phase homogeneity. The colloidal solutions of the GdFeO₃ nanoparticles synthesized using ultrasound were investigated by ¹H NMR to measure the T₁ and T₂ relaxation times of water protons at 0.47 T. The resulting relaxivities r₁ and r₂ were approximately recalculated at 1.5, 3 and 4.7 T on the basis of a semi-statistical ad hoc method by analyzing the literature data for a number of structurally similar compounds with reported relaxivity values at different NMR frequencies. According to the experimental and predicted values of the r₂/r₁ ratio, the investigated GdFeO₃ sample may be classified as a T₁-contrast agent for MRI at 0.47 and 1.5 T, as a T₁–T₂ dual-modal contrast agent at 3 T and as a T₂-contrast agent at 4.7 T.

PMID:36426648 | DOI:10.1039/d2cp03688f

J Biopharm Stat. 2022 Nov 25:1-17. doi: 10.1080/10543406.2022.2148163. Online ahead of print.

ABSTRACT

The dynamicity of functional (curve) markers from modern clinical studies offers deeper insights into complex disease physiology. A frequent clinical practice is to examine various ‘pharmacokinetic features’ of functional markers (definite integral, maximum value, time to maximum, etc.) that reflect important physiological underpinnings. For instance, the current diagnostic procedure for kidney obstruction is to examine several pharmacokinetic features of renogram curves characterizing renal function. Motivated by such clinical practices, we develop a statistical framework for evaluating diagnostic accuracy of pharmacokinetic features using area under the receiver operating characteristic curve (AUC). The major challenge is that functional markers are observed at discrete time points with measurement error. To address this challenge, we develop a two-stage non-parametric AUC estimator based on summary functionals providing unified representation of various pharmacokinetic features and study its asymptotic properties. We also propose a sensible adaptation of a semiparametric regression model that can describe heterogeneity of AUC across different subpopulations, while appropriately handling discreteness and noise in observed functional markers. Here, a novel data-driven approach that balances between bias and efficiency of the regression coefficient estimates is introduced. Finally, the framework is applied to rigorously evaluate pharmacokinetic features of renogram curves potentially useful for detecting kidney obstruction.

PMID:36426623 | DOI:10.1080/10543406.2022.2148163

Psychol Med. 2022 Nov 25:1-10. doi: 10.1017/S0033291722003531. Online ahead of print.

ABSTRACT

BACKGROUND: Access to evidence-based psychological treatment is a challenge worldwide. We assessed the effectiveness of a fully automated aviophobia smartphone app treatment delivered in combination with a $5 virtual reality (VR) viewer.

METHODS: In total, 153 participants from the Dutch general population with aviophobia symptoms and smartphone access were randomized in a single-blind randomized controlled trial to either an automated VR cognitive behavior therapy (VR-CBT) app treatment condition (n = 77) or a wait-list control condition (n = 76). The VR-CBT app was delivered over a 6-week period in the participants’ natural environment. Online self-report assessments were completed at baseline, post-treatment, at 3-month and at 12-month follow-up. The primary outcome measure was the Flight Anxiety Situations Questionnaire (FAS). Analyses were based on intent-to-treat.

RESULTS: A significant reduction of aviophobia symptoms at post-test for the VR-CBT app compared with the control condition [p < 0.001; d = 0. 98 (95% CI 0.65-1.32)] was demonstrated. The dropout rate was 21%. Results were maintained at 3-month follow-up [within-group d = 1.14 (95% CI 0.46-1.81)] and at 12-month follow-up [within-group d = 1.12 (95% CI 0.46-1.79)]. Six participants reported adverse effects of cyber sickness symptoms.

CONCLUSIONS: This study is the first to show that fully automated mobile VR-CBT therapy delivered in a natural setting can maintain long-term effectiveness in reducing aviophobia symptoms. In doing so, it offers an accessible and scalable evidence-based treatment solution that can be applied globally at a fraction of the cost of current treatment alternatives.

PMID:36426618 | DOI:10.1017/S0033291722003531

Int J Esthet Dent. 2022 Nov 25;17(4):448-467.

ABSTRACT

OBJECTIVE: The objective of the present study was to assess the progress and efficiency of at-home bleaching protocols with 10% carbamide peroxide using a new methodology based on dental photography.

MATERIALS AND METHODS: A 4-week overnight at-home bleaching protocol using whitening trays and 10% carbamide peroxide was performed on 52 patients. The tooth color was analyzed using standardized photographs taken every week for 4 weeks and at 4 months posttreatment. The values of the color evolution (ΔE00), L*, a*, and b* were also measured and used to assess the evolution of the chroma, luminosity, and hue using the CIEDE2000 formula. The statistical analyses were conducted at a significance level of P < 0.05 by means of a repeated measures analysis of variance (ANOVA).

RESULTS: The tooth color changed the most, and thus the highest ΔE00 was observed, after the first week of treatment. The color continued to change but to a lesser degree during the following weeks. After 4 weeks, the treatment proved to be very effective. Four months after the end of treatment, a color relapse was observed, though it was hardly perceptible to the human eye. The luminosity (L’) changed significantly between the beginning and the end of treatment, affecting the maxilla to a greater extent. The chroma evolution showed a high variance and a low relapse for both jaws. The hue was not affected significantly during the treatment and the stabilization.

CONCLUSIONS: Within the limitations of the present study, the authors were able to assess the progress and efficiency of at-home bleaching with 10% carbamide peroxide in terms of chroma, luminosity, and hue using a new methodology based on dental photography.

CLINICAL SIGNIFICANCE: This new method is effective and enables a reliable analysis of the evolution of a dental bleaching treatment, turning dental photo-graphy into an even more powerful tool for analysis and communication. It can also be used as a proof-of-concept, paving the way for further research on objective monitoring and evaluation of dental treatments using dental photography.

PMID:36426616

Int J Esthet Dent. 2022 Nov 25;17(4):436-447.

ABSTRACT

OBJECTIVE: The present study aimed to evaluate the gender-based association of gingival exhibit with lip dimensions, intercommissural width (ICW), interdental smile line (ISL), and gingival smile line (GSL) in periodontally healthy patients.

MATERIALS AND METHODS: 120 patients aged between 20 and 40 years were divided equally into two groups based on gender. The parameters of lip length (LL) at rest and on smiling, ICW, and the intraoral parameters of gingival exhibit in ISL and GSL were measured on digitized photographs in the maxillary anterior teeth.

RESULTS: The LL positions at rest and on smiling differed significantly: 23.50 ± 3.31 mm and 19.89 ± 1.91 mm, and 16.53 ± 2.94 mm and 13.91 ± 1.93 mm for males and females, respectively. The gingival exhibit of the interdental papillae in ISL was 3.01 ± 1.85 mm for males and 4.26 ± 1.85 mm for females, while the midfacial exhibit in GSL was 0.62 ± 1.01 mm for males and 1.24 ± 1.44 mm for females; both the differences were statistically significant.

CONCLUSION: The gender variability in LL, the interdental papillae exhibit in ISL, and the midfacial exhibit in GSL can provide constructive guidelines that can be implemented in the esthetic zone.

PMID:36426615

J Sch Health. 2022 Nov 25. doi: 10.1111/josh.13288. Online ahead of print.

ABSTRACT

BACKGROUND: Our objective is to describe violence-related injuries to early adolescents that occurred at school, resulting in emergency department (ED) evaluation.

METHODS: This retrospective cohort study at an urban academic pediatric ED in Baltimore, MD, identified patients 10-15 years old who presented with an injury from intentional, interpersonal violence that occurred at school between January 2019-December 2020. Descriptive statistics were used to summarize patient and event characteristics.

RESULTS: Of 819 youth 10-15 years of age evaluated for a violence-related injury, school was the location in 115 cases (14.0%). All events occurred prior to the statewide stay at home order (March 30, 2020). School-injured youth had a mean age of 12.7 ± 1.7 years and were predominantly male (64.3%). Of the 115 cases, 75 (65.2%) involved an altercation with a peer, 26 (22.6%) involved a teacher or school staff, 6 (5.2%) involved a family member, 1 (0.9%) involved police, 6 (5.2%) involved an unknown party, and 1 (0.9%) involved an unrelated but known adult. All injured youth were discharged from the ED.

CONCLUSIONS: School-based violence is a well-recognized cause of traumatic injuries to adolescents and may involve peers, teachers, or school staff.

PMID:36426581 | DOI:10.1111/josh.13288

Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221141254. doi: 10.1177/15330338221141254.

ABSTRACT

Background: This retrospective cohort study was to assess the prognostic value of preoperative albumin-to-alkaline phosphatase ratio (AAPR) on survival outcome for patients with locally advanced oral squamous cell carcinoma (LAOSCC). Methods: A total of 250 patients with LAOSCC receiving upfront radical surgery at a single institute from January 2008 to December 2017 were enrolled. The primary endpoint was the survival predictability of preoperative AAPR on the 5-year overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Cox proportional hazards model was used for survival analysis. The X-tile software was used to estimate the optimal cut-off value of preoperative AAPR on survival prediction. A predictive nomogram incorporating the clinicopathological factors on OS was further generated. Results: The 5-year OS, CSS, and DFS rates were 68.6%, 79.7%, and 61.7%, respectively. The optimal cut-off of preoperative AAPR to predict the 5-year OS was observed to be 0.51. For those with preoperative AAPR≧0.51, the 5-year OS, CSS, and DFS were statistically significantly superior to those with preoperative AAPR<0.51 (OS: 76.1% vs 48.5%, P < .001; CSS: 84.3% vs 66.4%, P = .005; DFS: 68.9% vs 42.6%, P < .001). In Cox model, we observed that preoperative AAPR<0.51 was a significantly negative prognosticator of OS (HR: 2.22, 95% CI: 1.466-3.361, P < .001), CSS (HR: 2.037, 95% CI: 1.16-3.578, P = .013), and DFS (HR: 1.756, 95% CI: 1.075-2.868, P = .025). After adding the variable of preoperative AAPR, the c-index of the predictive nomogram incorporating assorted clinicopathological factors increases from 0.663 to 0.692 for OS. Conclusion: Our results suggest that preoperative AAPR serves as an independent survival predictor for patients with LAOSCC. The nomogram incorporating preoperative AAPR and various clinicopathological features may be a convenient tool to estimate the mortality risk for patients with LAOSCC.

PMID:36426570 | DOI:10.1177/15330338221141254

Andrology. 2022 Nov 25. doi: 10.1111/andr.13352. Online ahead of print.

ABSTRACT

BACKGROUND: Peyronie’s disease (PD) has a huge impact on patients’ physical and psychological wellbeing.

OBJECTIVES: To investigate whether patients’ age has an impact on PD symptomatic burden at first presentation.

MATERIALS & METHODS: Data from 129 consecutive heterosexual patients seeking first medical attention for PD at a single andrological tertiary-referral centre were collected. All patients completed the International Index for Erectile Function (IIEF) and the Peyronie’s Disease Questionnaire (PDQ). Descriptive statistics was used to compare clinical features between younger (≤40years) and older (>40 years) patients. Multivariable linear model assessed the impact of age, the degree of penile curvature, and their impact on PDQ (total scores and its domains), after adjusting for PD duration and IIEF-erectile function domain scores.

RESULTS: Of 129, 24 (18.6%) patients were ≤40 years old. Young patients presented with a less severe curvature than older patients (median (IQR) 20° (15-36) vs. 50° (40-80); p = 0.04). However, younger age was associated with higher Psychological and Physical Symptoms, PDQ-Penile Pain, and PDQ- Symptom bother scores (Coeff -0.11, -0.21, and -0.17, respectively) (all p<0.05). Moreover, the greater the degree of curvature, the higher the PDQ-Psychological and Physical Symptoms and the PDQ-Symptom Bother scores (Coeff. 0.21 and 0.22, respectively; all p<0.05).

CONCLUSION: Around one in five men seeking first medical help for PD is younger than 40 years at presentation in the real-life setting. PD-related distress varies according to patients’ age, with younger men presenting with a greater risk of penile pain and symptom bother despite lower curvature. This article is protected by copyright. All rights reserved.

PMID:36426559 | DOI:10.1111/andr.13352