Category: Nevin Manimala

J Sleep Res. 2022 Feb 27:e13573. doi: 10.1111/jsr.13573. Online ahead of print.

ABSTRACT

Evidence on the relationship between periodic limb movements during sleep (PLMS) and cerebral small vessel disease is lacking. This study aimed to assess the association between the PLMS index and the neuroimaging features of cerebral small vessel disease on magnetic resonance imaging. Consecutive patients diagnosed with cerebral small vessel disease were enrolled. Data on the clinical characteristics, polysomnography, and brain magnetic resonance imaging were collected. The Accubrain software was used to calculate automatically the volume of white matter hyperintensities, the number of lacunar infarctions, and cerebral microbleeds. The severity of white matter hyperintensities, enlarged basal ganglia perivascular spaces, and the total cerebral small vessel disease scores were also rated visually using semiquantitative scales. The severity of PLMS was measured using the PLMS index, and the patients were divided into two groups using an established cut-off value of ≥15 per hour. Logistic regression was used to examine the association between PLMS and the neuroimaging features of cerebral small vessel disease. In total, 37 patients were included in the final analyses. The mean age was 66.49 ± 11.31 years, and 73.0% were males. The mean PLMS index was 19.30 ± 10.18. In univariate analyses, it was found that patients with cerebral small vessel disease with a PLMS index ≥15 had increased enlarged basal ganglia perivascular spaces (OR 6.136, 95%CI 1.101-34.214) and increased total cerebral small vessel disease scores (OR 6.0, 95%CI 1.253-28.742). Only the association between the PLMS index and the total cerebral small vessel disease burden score remained statistically significant after adjusting for age, sex, and the presence of moderate to severe obstructive sleep apnea syndrome. In conclusion, an elevated PLMS index is likely to be associated with a greater cerebral small vessel disease burden. PLMS might be a novel potential marker of cerebral small vessel disease.

PMID:35224805 | DOI:10.1111/jsr.13573

Clin Oral Implants Res. 2022 Feb 27. doi: 10.1111/clr.13912. Online ahead of print.

ABSTRACT

AIM: To compare the effectiveness of two xenografts for maxillary sinus floor augmentation in terms of clinical, radiographical, histological and molecular outcomes.

MATERIALS AND METHODS: A split-mouth randomized clinical trial was conducted at the University of Granada. Ten consecutive patients in need of bilateral two staged maxillary sinus floor augmentation were included. Each patient received both biomaterials (porcine bone mineral and anorganic bovine bone), which were randomly assigned for bilateral sinus augmentation. The maxillary autogenous bone scraped from the sinus access window was mixed with each xenograft at a 20:80 ratio. After a healing period of 6 months, bone biopsies were collected with a trephine during the implant placement in the regenerated area. Histological, histomorphometrical, immunohistochemical and molecular outcomes were analyzed. Clinical and radiographical data throughout the treatment phases were also evaluated.

RESULTS: The resulting anatomical features were similar between both groups. After six months of graft consolidation, the graft resorption rates were similar between both biomaterials. The histological, histomorphometrical and immunohistochemical results showed no statistical differences between groups.

CONCLUSION: Anorganic bovine bone and porcine bone mineral combined with maxillary autogenous cortical bone show similar biological and radiological features in terms of biomaterial resorption, osteoconduction and osteogenesis when used for maxillary sinus floor augmentation.

PMID:35224778 | DOI:10.1111/clr.13912

Echocardiography. 2022 Feb 27. doi: 10.1111/echo.15328. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the association between the grade of diastolic dysfunction (DD) and the occurrence of early allograft dysfunction (EAD) in liver transplant patients following the new 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) guidelines.

METHODS: From January 2015 to December 2019, we retrospectively analyzed 83 patients who underwent orthotopic liver transplantation (OLTx) and their susceptibility to develop EAD according to the grade of preoperative DD. EAD was defined according to the criteria proposed by Olfhoff et al.; DD was defined with four parameters: E/A, e/e’, Left Atrium volume, and Tricuspid Regurgitation velocity.

RESULTS: According to the ASE/EACVI guidelines grade II DD was detected in 20 patients (24.1%) undergoing OLTx. A statistically significant association was found between grade II DD and the occurrence of EAD (p-value < 0.003). The Kaplan-Meier analysis failed to find any significant difference between the survival probability, nevertheless at the end of a 90-day follow-up period, mortality showed a different trend in classes with more severe diastolic dysfunction.

CONCLUSION: According to the ASE/EACVI guidelines from 2016, patients with grade II DD seem to have a higher propensity to develop early allograft dysfunction EAD after OLTx. Our study advises a need for an urgent prospective multicenter study to elucidate the long-term outcomes of liver transplants patients with diastolic dysfunction.

PMID:35224775 | DOI:10.1111/echo.15328

Med J Aust. 2022 Feb 28. doi: 10.5694/mja2.51436. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine associations between area-level socio-economic factors and the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Victoria during 2020.

DESIGN, SETTING: Population-level ecological study of the incidence of SARS-CoV-2 infections in Victoria, by postcode, 1 March – 13 August 2020.

MAIN OUTCOME MEASURES: Relationships between the incidence of SARS-CoV-2 infections by postcode (Department of Health and Human Services data published on The Age website), and demographic, education level, ethnic background, economic and employment-related factors, housing-related factors, and social disadvantage (Australian Bureau of Statistics data for 2014-19), expressed as incidence rate ratios (IRRs).

RESULTS: During the study period, 15 482 SARS-CoV-2 infections with associated postcodes were recorded in Victoria. Incidence was higher for metropolitan than regional postcodes (418.3 v 62 infections per 100 000 population; IRR, 6.2; 95% CI, 4.6-8.2). In regional postcodes, incidence rose with mean household size (per person: IRR, 7.30; 95% CI, 4.37-12.2), unemployment proportion (per percentage point: IRR, 1.50; 95% CI, 1.33-1.69), and proportions for whom rent (IRR, 1.15; 95% CI, 1.07-1.22) or mortgage repayments (IRR, 1.22; 95% CI, 1.15-1.28) exceeded 30% of household income. In metropolitan areas, incidence increased with unemployment proportion (IRR, 1.14; 95% CI, 1.05-1.23) and proportion without paid leave (IRR, 1.22; 95% CI, 1.02-1.45). Incidence also increased with proportion speaking languages other than English at home (regional: IRR, 1.08; 95% CI, 1.06-1.11; metropolitan: IRR, 1.01; 95% CI, 1.002-1.02) and with Indigenous Australian proportion (metropolitan only: IRR, 1.91; 95% CI, 1.10-2.73).

CONCLUSIONS: Socio-economic factors may have contributed to the non-homogeneous incidence of SARS-CoV-2 infections across Victoria during 2020.

PMID:35224751 | DOI:10.5694/mja2.51436

Clin Oral Implants Res. 2022 Feb 28. doi: 10.1111/clr.13913. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare screw-retained and cemented all-ceramic implant-supported single crowns regarding biological and technical outcomes over a 5-year observation period.

MATERIALS AND METHODS: in 44 patients, 44 two-piece dental implants were placed in single tooth gaps in the esthetic zone. Patients randomly received a screw-retained (SR) or cemented (CR) all-ceramic single crown and were then re-examined annually up to 5 years. Outcome measures included: clinical, biological, technical and radiographic parameters. Data were statistically analyzed with Wilcoxon-Mann-Whitney, Wilcoxon and Fisher exact tests.

RESULTS: During the observation period, three patients (6.8%) were loss to follow-up. Eight restorations (18.2%, CI (8.2%, 32.7%)) were lost due to technical (6 patients, 13.6% (CI (5.2%, 27.4%)), 2 CR and 4 SR group, intergroup p=0.673; implants still present) or biological complications (2 patients, 4.5% (CI (0.6%, 16.5%)), only CR group, intergroup p=0.201, both implants lost). This resulted in a survival rate of 81.2% (CI (65.9%, 90.1%)) on the restorative level (18 SR; 15 CR, 3 lost to follow-up). At the 5-year follow-up, the median marginal bone levels were located slightly apical relative to the implant shoulder with 0.4 mm (0.5; 0.3) (SR) and 0.4 mm (0.8; 0.3) (CR) (intergroup p=0.582). Cemented restorations demonstrated a significantly higher biological complication rate (36.8%, SR 0.0%; intergroup p=0.0022), as well as a significantly higher overall complication rate (68.4%, SR 22.7%, intergroup p=0.0049). All other outcomes did not differ significantly between the two groups (p > 0.05).

CONCLUSIONS: All-ceramic single-tooth restorations on two-piece dental implants resulted in a relatively low survival rate. Cemented restorations were associated with a higher biological and overall complication rate than screw-retained restorations.

PMID:35224774 | DOI:10.1111/clr.13913

Cochrane Database Syst Rev. 2022 Feb 28;2:CD003233. doi: 10.1002/14651858.CD003233.pub3.

ABSTRACT

BACKGROUND: Focal segmental glomerulosclerosis (FSGS) can be separated into primary, genetic or secondary causes. Primary disease results in nephrotic syndrome while genetic and secondary forms may be associated with asymptomatic proteinuria or with nephrotic syndrome. Overall only about 20% of patients with FSGS experience a partial or complete remission of nephrotic syndrome with treatment. FSGS progresses to kidney failure in about half of the cases. This is an update of a review first published in 2008.

OBJECTIVES: To assess the benefits and harms of immunosuppressive and non-immunosuppressive treatment regimens in adults with FSGS.

SEARCH METHODS: We searched the Cochrane Kidney and Transplant Register of Studies to 21 June 2021 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov.

SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs of any intervention for FSGS in adults were included. Studies comparing different types, routes, frequencies, and duration of immunosuppressive agents and non-immunosuppressive agents were assessed.

DATA COLLECTION AND ANALYSIS: At least two authors independently assessed study quality and extracted data. Statistical analyses were performed using the random-effects model and results were expressed as a risk ratio (RR) for dichotomous outcomes, or mean difference (MD) for continuous data with 95% confidence intervals (CI). Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

MAIN RESULTS: Fifteen studies (560 participants) were included. No studies specifically evaluating corticosteroids compared with placebo or supportive therapy were identified. Studies evaluated participants with steroid-resistant FSGS. Five studies (240 participants) compared cyclosporin with or without prednisone with different comparators (no specific treatment, prednisone, methylprednisolone, mycophenolate mofetil (MMF), dexamethasone). Three small studies compared monoclonal antibodies (adalimumab, fresolimumab) with other agents or placebo. Six single small studies compared rituximab with tacrolimus, cyclosporin plus valsartan with cyclosporin alone, MMF with prednisone, chlorambucil plus methylprednisolone and prednisone with no specific treatment, different regimens of dexamethasone and CCX140-B (an antagonist of the chemokine receptor CCR2) with placebo. The final study (109 participants) compared sparsentan, a dual inhibitor of endothelin Type A receptor and of the angiotensin II Type 1 receptor, with irbesartan. In the risk of bias assessment, seven and five studies were at low risk of bias for sequence generation and allocation concealment, respectively. Four studies were at low risk of performance bias and 14 studies were at low risk of detection bias. Thirteen, six and five studies were at low risk of attrition bias, reporting bias and other bias, respectively. Of five studies evaluating cyclosporin, four could be included in our meta-analyses (231 participants). Cyclosporin with or without prednisone compared with different comparators may increase the likelihood of complete remission (RR 2.31, 95% CI 1.13 to 4.73; I² = 1%; low certainty evidence) and of complete or partial remission (RR 1.64, 95% CI 1.10 to 2.44; I² = 19%) but not of partial remission (RR 1.36, 95% CI 0.78 to 2.39, I² = 22%). In Individual studies, cyclosporin with prednisone versus prednisone may increase the likelihood of partial (49 participants: RR 7.96, 95% CI 1.09 to 58.15) or complete or partial remission (49 participants: RR 8.85, 95% CI 1.22 to 63.92) but not of complete remission. The remaining individual comparisons may make little or no difference to the likelihood of complete remission, partial remission or complete or partial remission compared with no treatment, methylprednisolone, MMF, or dexamethasone. Individual study data and combined data showed that cyclosporin may make little or no difference to the outcomes of chronic kidney disease or kidney failure. It is uncertain whether cyclosporin compared with these comparators in individual or combined analyses makes any difference to the outcomes of hypertension or infection. MMF compared with prednisone may make little or no difference to the likelihood of complete remission (33 participants: RR 1.05, 95% CI 0.58 to 1.88; low certainty evidence), partial remission, complete or partial remission, glomerular filtration rate, or infection. It is uncertain whether other interventions make any difference to outcomes as the certainty of the evidence is very low. It is uncertain whether sparsentan reduces proteinuria to a greater extent than irbesartan.

AUTHORS’ CONCLUSIONS: No RCTs, which evaluated corticosteroids, were identified although the KDIGO guidelines recommend corticosteroids as the first treatment for adults with FSGS. The studies identified included participants with steroid-resistant FSGS. Treatment with cyclosporin for at least six months was more likely to achieve complete remission of proteinuria compared with other treatments but there was considerable imprecision due to few studies and small participant numbers. In future studies of existing or new interventions, the investigators must clearly define the populations included in the study to provide appropriate recommendations for patients with primary, genetic or secondary FSGS.

PMID:35224732 | DOI:10.1002/14651858.CD003233.pub3

Stat Med. 2022 Feb 27. doi: 10.1002/sim.9357. Online ahead of print.

ABSTRACT

False negative rates of severe acute respiratory coronavirus 2 diagnostic tests, together with selection bias due to prioritized testing can result in inaccurate modeling of COVID-19 transmission dynamics based on reported “case” counts. We propose an extension of the widely used Susceptible-Exposed-Infected-Removed (SEIR) model that accounts for misclassification error and selection bias, and derive an analytic expression for the basic reproduction number R0 as a function of false negative rates of the diagnostic tests and selection probabilities for getting tested. Analyzing data from the first two waves of the pandemic in India, we show that correcting for misclassification and selection leads to more accurate prediction in a test sample. We provide estimates of undetected infections and deaths between April 1, 2020 and August 31, 2021. At the end of the first wave in India, the estimated under-reporting factor for cases was at 11.1 (95% CI: 10.7,11.5) and for deaths at 3.58 (95% CI: 3.5,3.66) as of February 1, 2021, while they change to 19.2 (95% CI: 17.9, 19.9) and 4.55 (95% CI: 4.32, 4.68) as of July 1, 2021. Equivalently, 9.0% (95% CI: 8.7%, 9.3%) and 5.2% (95% CI: 5.0%, 5.6%) of total estimated infections were reported on these two dates, while 27.9% (95% CI: 27.3%, 28.6%) and 22% (95% CI: 21.4%, 23.1%) of estimated total deaths were reported. Extensive simulation studies demonstrate the effect of misclassification and selection on estimation of R0 and prediction of future infections. A R-package SEIRfansy is developed for broader dissemination.

PMID:35224743 | DOI:10.1002/sim.9357

Aust Dent J. 2022 Feb 28. doi: 10.1111/adj.12908. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the effect of three different surface treatments on the microhardness and color change of artificial enamel lesions.

MATERIALS AND METHODS: One hundred bovine teeth were randomly assigned into four groups. Artificial enamel lesions were created using demineralizing solution for all groups except the sound enamel group. Different surface treatments were then performed G1: resin-infiltrant; G2: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); G3: artificial saliva; G4: Sound Enamel. Each group was subdivided into three subgroups, where each subgroup was subjected to a different testing method. Subgroup 1: surface microhardness; subgroup 2: cross-sectional microhardness; subgroup 3: color measurement. Statistical analysis was performed by ANOVA, followed by Tukey’s post-hoc test.

RESULTS: Sound enamel group recorded the highest surface and cross-sectional microhardness results. No significant difference was found between the resin-infiltrant group and CPP-ACP regarding surface and cross-sectional microhardness at different lesion depths. Resin-infiltrant group showed the least color change (∆E) results compared to the other groups.

CONCLUSION: Resin-infiltrant can effectively enhance surface microhardness and enamel resistance to demineralization, additionally, reduce the staining susceptibility of white spot lesions (WSLs) after treatment. CPP-ACP application for four weeks seems to improve surface microhardness; however, has a limited effect in resisting staining of WSLs after treatment. © 2022 Australian Dental Association.

PMID:35224731 | DOI:10.1111/adj.12908

Eur J Clin Invest. 2022 Feb 27:e13762. doi: 10.1111/eci.13762. Online ahead of print.

ABSTRACT

BACKGROUND: Randomized controlled trials (RCT) in mental disorders research commonly use active control groups including psychotherapeutic shams or inactive medication. This meta-analysis assessed whether placebo conditions (active controls) had an effect compared to no treatment or usual care (passive controls).

METHODS: PubMed, Scopus, PsycINFO, PsycARTICLES, Ovid, the Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to April 2021 and reference lists of relevant articles. Three-arm RCTs, including active and passive control groups, were selected. Where individual standardized mean difference (SMD) was calculable, random effects meta-analyses were performed to estimate an overall effect size with 95% confidence intervals (CI) comparing active vs passive controls. Heterogeneity was assessed using I² statistic and meta-regression. Funnel asymmetry was evaluated using Egger’s test (Prospero registration: CRD42021242940).

RESULTS: 24 articles with 25 relevant RCTs were included in the review, of which 11 studies were of high risk of bias. There was an improvement in outcomes favouring the placebo conditions, compared to passive controls, overall (25 studies, SMD 0.24, 95% CI 0.06-0.42, I² = 43%) and in subgroups with anxiety (SMD 0.45, 95% CI 0.07-0.84, I² = 59%) or depression (SMD 0.22, 95% CI 0.04-0.39, I² = 0%). Meta-regression did not show a significant explanation for heterogeneity. Egger’s test showed no asymmetry (p = .200).

CONCLUSIONS: A small placebo effect was observed in mental disorders research overall, and in patients with anxiety or depression. These findings should be interpreted with caution in the light of heterogeneity and risk of bias.

PMID:35224726 | DOI:10.1111/eci.13762

Trop Anim Health Prod. 2022 Feb 27;54(2):117. doi: 10.1007/s11250-022-03110-0.

ABSTRACT

The aim of this study was to find the direct economic losses due to the three viral causes of the avian respiratory syndrome, including Newcastle disease (ND), H9N2 influenza, and infectious bronchitis (IB) in stamped-out broiler farms during 2016-2017 across the country. This study was carried out on the information on cross-sectional monitoring in the years 2016-2017. The statistical society of the study was all the active broiler farms of the country stamped out due to respiratory syndrome. This study used compensation insurance data, and other sources. One-way ANOVA or Kruskal-Wallis tests were used to analyze normally and non-normally distributed data. In total, during the study period, 132 broiler farms and 1,723,131 fowls were stamped out. According to the results of the present investigation, the sum of costs and losses due to respiratory complex was 9.47 $US Million, 2016-2017 (5.72 from $US Million chicken meat losses and 3.75 $US Million was the total cost). ND was the main cause of economic losses and costs with 3.86 $US equal to 40.8% of the total. Cost of feeding was the highest followed by veterinary services and medicines, vaccination, and 1-day-old chicks costs with 2.27, 1.11, 0.33, and 0.036 $US Million, 2016-2017. In conclusion, we need to improve the preventive measures against respiratory viruses, especially NDV. Additionally, as the cost of feeding was the largest, it is important to shorten the time interval between disease occurrence and stamping out to reduce the cost.

PMID:35224709 | DOI:10.1007/s11250-022-03110-0