Category: Nevin Manimala

Rev Assoc Med Bras (1992). 2022 Nov 21;68(10):1481-1485. doi: 10.1590/1806-9282.20221177. eCollection 2022.

ABSTRACT

OBJECTIVE: Mini-percutaneous nephrolithotomy is a recent advancement in the field of kidney stone treatment; however, its role has not been completely established. We aimed to compare the outcomes of initial Mini-percutaneous nephrolithotomy and flexible ureteroscopy.

METHODS: A retrospective review of consecutive mini-percutaneous procedures was performed. Inclusion criteria were as follows: all percutaneous nephrolithotomy procedures performed with an access sheath up to 24Fr, kidney stone burdens up to 1550 mm3; and the presence of postoperative computed tomography (for control). The data collected for Mini-percutaneous nephrolithotomy procedures were paired 1:2 with patients treated with flexible ureteroscopy for stones between 100 and 1550 mm3, and with postoperative computed tomography for control. A 14Fr Mini-percutaneous nephrolithotomy set was used. The stone-free rate was defined as the absence of fragments on the control computed tomography, whereas success was limited to 2-mm residual fragments. Statistical analysis was performed using SPSS version 19.

RESULTS: A total of 63 patients met the inclusion criteria (42 with flexible ureteroscopy and 21 with mini-percutaneous nephrolithotomy). Demographic data were comparable. The stone-free rate and success were similar between the groups (76.2 vs. 66.7%, p=0.42 and 90.5 vs. 85.7%, p=0.57). The complication rate was also similar (26.1 vs. 9.6%, p=0.188), but Mini-percutaneous nephrolithotomy had longer hospitalization and fluoroscopy time (p=0.001 in both).

CONCLUSIONS: Our initial study of Mini-percutaneous nephrolithotomy showed that it is a promising procedure, with outcomes similar to flexible ureteroscopy, but with higher inpatient numbers and fluoroscopy times. A larger study population size and better equipment may improve the outcomes of mini-percutaneous nephrolithotomy.

PMID:36417657 | DOI:10.1590/1806-9282.20221177

Rev Assoc Med Bras (1992). 2022 Nov 21;68(10):1476-1480. doi: 10.1590/1806-9282.20220880. eCollection 2022.

ABSTRACT

OBJECTIVE: This study aimed to investigate the effect of mutations by comparing wild-type SARS-CoV-2 and Omicron regarding clinical features in patients with COVID-19. It also aimed to assess whether SARS-CoV-2 cycle threshold value could predict COVID-19 severity.

METHODS: A total of 960 wild-type and 411 Omicron variant patients with positive results in SARS-CoV-2 real-time reverse transcriptase polymerase chain reaction test from oropharyngeal and/or nasopharyngeal samples during their hospital admissions were included in this retrospective study. The reference symptoms of the patients were obtained from the hospital database. The correlation between chest computed tomography findings and the “cycle threshold” of patients with wild-type SARS-CoV-2 was assessed.

RESULTS: Cough, fever, shortness of breath, loss of taste and smell, and diarrhea were found to be statistically significantly higher (p=0.001; 0.001; 0.001; 0.001; and 0.006; respectively) in the wild-type cohort, while in the Omicron cohort, sore throat and headache were found to be statistically significantly higher (p=0.001 and 0.003, respectively). An inverse relationship was found between chest computed tomography findings and viral load.

CONCLUSION: This study revealed that the Omicron variant tended to infect predominantly the upper respiratory tract and showed decreased lung infectivity, and the disease progressed with a milder clinical course. Therefore, the study showed that the tropism of the virus was changed and the viral phenotype was affected. It was also found that SARS-CoV-2 viral load did not predict COVID-19 severity in patients with wild-type SARS-CoV-2.

PMID:36417656 | DOI:10.1590/1806-9282.20220880

Rev Assoc Med Bras (1992). 2022 Nov 21;68(10):1452-1457. doi: 10.1590/1806-9282.20220668. eCollection 2022.

ABSTRACT

OBJECTIVE: This study aimed to demonstrate the effectiveness of kinesio taping in nonspecific neck pain and to assess whether ultrasonographic parameters of the upper trapezius muscle can be used in the follow-up of kinesio taping treatment.

METHODS: This was a single-blind, prospective, randomized controlled trial study involving 60 participants with nonspecific neck pain. The participants were randomly assigned into two groups. Kinesio taping group (n=29) received a 4-week neck exercise program, with kinesio taping applied twice a week for a total of four times, and the exercise group (n=28) received a 4-week neck exercise program. Participants were evaluated according to pain intensity (Visual Analog Scale), cervical range of motion, and disability (Neck Disability Index). Also, trigger point diameter and upper trapezius muscle thickness were evaluated with ultrasonography. Before and after the therapy, as well as the first month, all measures were taken by an investigator other than the practitioner of the treatment program.

RESULTS: The results showed that the Visual Analog Scale and Neck Disability Index scores in the kinesio taping group were statistically significantly improved when compared to the exercise group (p<0.05). In addition, the thickness of the upper trapezius muscle and the diameter of the trapezius muscle trigger point were statistically significantly improved in the kinesio taping group compared to the exercise group (p<0.05). In the kinesio taping group, there was no statistical significance in cervical range of motion as compared to the exercise group.

CONCLUSION: The combination of kinesio taping and exercise therapy was effective in reducing nonspecific neck pain and neck disability. Also, this study showed that ultrasonographic evaluation of the trapezius muscle could be used in the follow-up of kinesio taping therapy.

PMID:36417652 | DOI:10.1590/1806-9282.20220668

Rev Assoc Med Bras (1992). 2022 Nov 21;68(10):1447-1451. doi: 10.1590/1806-9282.20220657. eCollection 2022.

ABSTRACT

OBJECTIVES: The transition from face-to-face to remote teaching is yet to be fully understood. In clinical training, traditional teaching must prevail because it is essential for the acquisition of skills and professionalism. However, the responses of each school to the pandemic and the decision on when to resume clerkship rotations were mixed. In this study, we aimed to analyze whether the time to resume clerkship rotations was associated with the performance of the students by using a multi-institutional Progress Test.

METHODS: This is a cross-sectional study conducted at nine different Brazilian medical schools that administer the same annual Progress Test for all students. We included information from 1,470 clerkship medical students and analyzed the time of clinical training interruption as the independent variable and the student’s scores as the dependent variable.

RESULTS: The comparisons of the students’ scores between the schools showed that there are differences; however, they cannot be attributed to the time the clerkship rotations were paused. The correlation between the schools’ average scores and the time to resume clerkship rotations was not significant for the fifth year (r= -0.298, p=0.436) and for the sixth year (r= -0.440, p=0.240). By using a cubic regression model, the time to resume clerkship rotations could explain 3.4% of the 5-year students’ scores (p<0.001) and 0.9% of the 6-year students, without statistical difference (p=0.085).

CONCLUSIONS: The differences between the students’ scores cannot be attributed to the time when the schools paused the clerkship rotations.

PMID:36417651 | DOI:10.1590/1806-9282.20220657

Rev Assoc Med Bras (1992). 2022 Nov 21;68(10):1428-1433. doi: 10.1590/1806-9282.20220514. eCollection 2022.

ABSTRACT

OBJECTIVE: In the current literature, there are few studies investigating the relationship between premature coronary atherosclerosis and nonalcoholic fatty liver disease. We aimed to evaluate the relationship between nonalcoholic fatty liver disease and premature coronary atherosclerosis.

METHODS: In this cross-sectional study, female patients aged <55 years and male patients aged <50 years were enrolled. Both male and female patients underwent coronary angiography and abdomen ultrasonography between 2014 and 2019. A stepwise binary logistic regression analysis was carried out to evaluate the independent variables related to premature coronary atherosclerosis and nonalcoholic fatty liver disease. A p-value<0.05 was considered statistically significant.

RESULTS: nonalcoholic fatty liver disease was present in 44% of patients (n=377). Notably, 62% of the patients were female and the mean age was 44.5 (39-49) years. In a multivariate analysis, nonalcoholic fatty liver disease was shown to be an independent risk factor of premature coronary atherosclerosis (OR 1.438; 95%CI, 1.050-1.969; p=0.024).

CONCLUSIONS: The presence of nonalcoholic fatty liver disease is an important independent risk factor for the development of premature coronary atherosclerosis.

PMID:36417648 | DOI:10.1590/1806-9282.20220514

Rev Assoc Med Bras (1992). 2022 Nov 21;68(10):1423-1427. doi: 10.1590/1806-9282.20220445. eCollection 2022.

ABSTRACT

OBJECTIVE: This study aimed to investigate the relationship between the presence of hip osteoarthritis and the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, monocyte-lymphocyte ratio, and neutrophil-monocyte ratio.

METHODS: Participants with hip osteoarthritis and healthy controls aged 45-75 years were recruited in the study. The participants with hip osteoarthritis were divided into two groups: mild/moderate hip osteoarthritis and severe hip osteoarthritis. Complete blood parameters of the participants were recorded, and neutrophil-lymphocyte ratio, neutrophil-monocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio were calculated. Pain severity was evaluated using a visual analog scale.

RESULTS: A total of 76 participants with hip osteoarthritis and 59 healthy controls were included in the study. The mean age of the participants was 57.6±6.11 years. Mean neutrophil-lymphocyte ratio and neutrophil-monocyte ratio values were statistically significantly different between the hip osteoarthritis group and healthy control group (p<0.05). Platelet-lymphocyte ratio, monocyte-lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein values were not significantly different between the groups. Also, there was no difference between all inflammatory parameters and hip osteoarthritis severity (p>0.05).

CONCLUSIONS: Neutrophil-lymphocyte ratio and neutrophil-monocyte ratio values were higher in patients with hip osteoarthritis than in healthy controls. Mean platelet-lymphocyte ratio, monocyte-lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein values did not change according to the presence of hip osteoarthritis. Not all hematological indices give valuable information regarding the severity of hip osteoarthritis.

PMID:36417647 | DOI:10.1590/1806-9282.20220445

Braz J Biol. 2022 Nov 21;82:e266637. doi: 10.1590/1519-6984.266637. eCollection 2022.

ABSTRACT

Here, we investigated the relationship between Plant communities and the environment from the moist temperate vegetation of Lakoo mountainous forest District Swat. We sampled data from 162 sampling units (Quadrates) using 1x1m2 for herbs 5x5m2 and shrubs, while 10 x10m2 for trees, systematically considering six elevation gradients between the altitudinal from 1970m to 3095m. We performed statistical analysis like Canonical correspondence analysis (CCA) and TWINSPAN (two-way indicator species analysis) for ecological assessment and clustering of plant communities. To check upon the correlation of species (CR) with topographic and edaphic variables we used statistical software PC-ORD version 7. We recognized 264 species plants belonging to thirty families. We recorded key sampling measurements of density, frequency, and cover for all these species which are vital for community description. The results showed Shannon-Winner,s, and Simpson diversity values as 19.18 and 3.17 respectively. The importance value indexes (IVI) were used to identify the leading and rare species of plant in each community or cluster group. In total we recognized eleven different communities as: Berberis- Abies- Bergeni, Picea – Indigofera- Poa,Abies- Parrotiopsis- Poa, Quercus- Viburnum- Poa, Picea- Salix- Primula, Abies- Viburnum- Poa, Viburnum- Taxus- Poa, Pinus- Viburnum- Lithospermum, Abies-Berberis- carex, Pinus- Viburnum- Poa and Parrotiopsis- Picea- Poa through hierarchical cluster analysis (TWINSPAN). CCA analysis revealed that of all studied edaphic and topographic variables altitude, silt, calcium carbonate, and organic matter were the strongest factors determining plant community diversity and composition in each microclimate of the eleven communities. Visually the vegetation of the forest was dominated by small-sized trees followed by shrubs, and regenerates indicating the stage of secondary regeneration. We found severe human interference in disturbing the existing biodiversity, which requires immediate conservation to ensure sustainable management and utilization of natural resources of the Lalkoo moist temperate forest.

PMID:36417625 | DOI:10.1590/1519-6984.266637

An Acad Bras Cienc. 2022 Nov 21;94(suppl 3):e20200568. doi: 10.1590/0001-3765202220200568. eCollection 2022.

ABSTRACT

This paper provides general expressions for Bartlett and Bartlett-type correction factors for the likelihood ratio and gradient statistics to test the dispersion parameter vector in heteroscedastic symmetric nonlinear models. This class of regression models is potentially useful to model data containing outlying observations. Furthermore, we develop Monte Carlo simulations to compare size and power of the proposed corrected tests to the original likelihood ratio, score, gradient tests, corrected score test, and bootstrap tests. Our simulation results favor the score and gradient corrected tests as well as the bootstrap tests. We also present an empirical application.

PMID:36417597 | DOI:10.1590/0001-3765202220200568

Neural Comput. 2022 Nov 18:1-22. doi: 10.1162/neco_a_01555. Online ahead of print.

ABSTRACT

We propose a nonlinear probabilistic generative model of Koopman mode decomposition based on an unsupervised gaussian process. Existing data-driven methods for Koopman mode decomposition have focused on estimating the quantities specified by Koopman mode decomposition: eigenvalues, eigenfunctions, and modes. Our model enables the simultaneous estimation of these quantities and latent variables governed by an unknown dynamical system. Furthermore, we introduce an efficient strategy to estimate the parameters of our model by low-rank approximations of covariance matrices. Applying the proposed model to both synthetic data and a real-world epidemiological data set, we show that various analyses are available using the estimated parameters.

PMID:36417591 | DOI:10.1162/neco_a_01555

J Am Acad Orthop Surg. 2022 Nov 16. doi: 10.5435/JAAOS-D-22-00164. Online ahead of print.

ABSTRACT

INTRODUCTION: Orthopaedic surgery residency applicants submit more applications than ever before. While this issue is multifactorial, increased information and transparency regarding residency programs are important. This study aimed to evaluate the completeness and variability of the information that is currently available regarding orthopaedic residency programs on two publicly available databases, the Fellowship and Residency Electronic Interactive Database (FREIDA) and the newly created Orthopaedic Residency Information Network (ORIN).

METHODS: Orthopaedic surgery residency programs were identified and evaluated using FREIDA and ORIN on September 11, 2021. Information on the FRIEDA and ORIN databases were evaluated in the following categories: program overview, the residency application, and education information. Univariate statistical analysis was performed on the data.

RESULTS: Of the 194 programs that participated in the FREIDA database, over 48% failed to include basic program information including resident demographics and key application information including USMLE Step requirements. Of the 141 programs that participated in the ORIN database, most the programs did not report USMLE Step median and cutoff scores and clerkship grades. Depending on the database and type of information, factors including the program’s National Institutes of Health funding, reputation, size, and type were associated with the availability of information.

CONCLUSION: This study showed that while most orthopaedic surgery residency programs participate in FREIDA and ORIN, the information included was highly variable and incomplete for nearly all programs. Improving the completeness of information in these databases has the potential to allow students to make more informed application decisions.

PMID:36417565 | DOI:10.5435/JAAOS-D-22-00164