Category: Nevin Manimala

J Exp Orthop. 2022 Jun 8;9(1):53. doi: 10.1186/s40634-022-00495-7.

ABSTRACT

PURPOSE: To evaluate the clinical outcomes, MRI imaging and histological characteristics of biopsy samples of the tendon from patients in whom rotator cuff repair was previously performed with a bioinductive type I bovine collagen implants.

METHODS: Prospective study of 30 patients with partial or complete rotator cuff tears who underwent arthroscopic repair and augmentation with a resorbable type I bovine collagen implant. Preoperatively and at 6 and 12 months after surgery, the VAS, ASES and Constant-Murley scores were evaluated and an MRI study was performed. At 6 months, biopsies of the resulting tissue were obtained and examined histologically.

RESULTS: Patients experienced statistically significant and sustained improvement from baseline for all scores and the mean tendon thickness increased by 1.84 mm. Magnetic resonance imaging evidence of complete healing was found in 27 patients and a considerable reduction in defect size, greater than 50%, was shown in 3. In all samples obtained, the new tissue generated had the histological appearance of a tendon, and was indistinguishable from the native tendon. There was no evidence of any remaining collagen implant.

CONCLUSIONS: Biopsies of tissue formed from bioinductive type I bovine collagen implants showed, six months after surgery, the generation of a neotendon indistinguishable from the native one. Histology and MRI imaging, revealed complete integration of the implant and absence of inflammatory or foreign body reactions. The clinical parameters, thickness and MRI signal of the tendon improved significantly at 6 months, regardless of the type and size of the tear, and remained unchanged until 12 months.

LEVEL OF EVIDENCE: Level IV, case series.

PMID:35674990 | DOI:10.1186/s40634-022-00495-7

Rheumatol Ther. 2022 Jun 8. doi: 10.1007/s40744-022-00460-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Sustained improvement of high degree in clinical outcomes have been demonstrated in phase 3 trials with secukinumab in both psoriatic arthritis (PsA) and ankylosing spondylitis (AS). The objective of the SERENA study was to evaluate the effectiveness, retention rates, and safety of secukinumab in patients with PsA and AS.

METHODS: SERENA is an ongoing, longitudinal, real-world observational study involving patients with moderate-to-severe psoriasis, PsA, or AS. Patients had received at least 16 weeks of secukinumab treatment before recruitment to the study. Retention rate was defined as percentage of patients who continued secukinumab treatment over the course of study. Effectiveness of secukinumab in AS and PsA cohorts was assessed using descriptive statistics.

RESULTS: The current interim analysis included 1004 patients with PsA or AS. Overall secukinumab retention rates at 2 years after enrolment were 74.9 and 78.9% in patients with PsA and AS, respectively. At baseline and at 2 years, swollen joint count [3.3 (5.8) vs. 2.9 (5.8)], tender joint count [6.3 (9.4) vs. 5.6 (7.2)] in patients with PsA and BASDAI scores [3.2 (2.3) vs. 2.9 (2.3)] in patients with AS, suggest sustained effectiveness for patients remaining on secukinumab for at least 2 years after enrolment. A total of 73 patients had treatment interruption; 78% of these patients reinitiated secukinumab without a loading dose. No new or unexpected safety signals were reported.

CONCLUSIONS: After more than 2 years since initiation, secukinumab demonstrated high retention rates and favorable safety profile as well as sustained effectiveness in patients who continued secukinumab treatment.

PMID:35674938 | DOI:10.1007/s40744-022-00460-x

Anal Sci. 2022 Jun 8. doi: 10.1007/s44211-022-00137-z. Online ahead of print.

ABSTRACT

An ultra-high performance liquid chromatography system coupled with the Q-Exactive mass spectrometry (UHPLC-QE-MS) approach combined with multivariate statistical analysis was used to investigate the metabolic profiles of the fruits of Lycium barbarum in different geographical origins in China. Several classes of compounds such as sugars, amino acids, organic acids, fatty acids, polyphenols and alkaloid were identified in hydroalcoholic extracts, and ten differential metabolites including amino acids, organic acids and vitamins were identified by multivariate statistical method. It was discussed that the differences between organic acids and amino acids in the samples may be caused by environmental factors such as ultraviolet radiation, soil and altitude. A total of 119 metabolic pathways were involved in the differential metabolites and 17 of them were retained for enrichment analysis. It was found that alanine, aspartate and glutamate metabolism, arginine biosynthesis, glutathione metabolism, glyoxylate and dicarboxylate metabolism, purine metabolism, histidine metabolism and aminoacyl-tRNA biosynthesis were the most important pathways. These findings play an important role in the origin tracing of the Lycium barbarum fruit.

PMID:35674936 | DOI:10.1007/s44211-022-00137-z

J Man Manip Ther. 2022 Jun 8:1-10. doi: 10.1080/10669817.2022.2082637. Online ahead of print.

ABSTRACT

PURPOSES: To compare the effectiveness of instrument-assisted soft tissue mobilization (IASTM) and pressure algometry with sham ultrasound (control group) on the clinical measures of headache, pressure pain threshold (PPT) of upper trapezius and suboccipital muscles and cervical alignment in patients with tension type headache (TTH).

METHODS: Seventy-two patients with TTH of both genders were randomly allocated to 3 experimental groups: a) the IASTM group (n=24), b) pressure algometry group (n=24), and c) sham ultrasound control group (n=24). Headache frequency and disability, pressure pain threshold of upper trapezius and suboccipital muscles, cervical lordosis angle (CA) and anterior head translation (AHT) were measured four weeks before and after intervention. Moreover, headache frequency was followed up for two more weeks after intervention.

RESULTS: Statistically significant improvements (P <0.05; effect size ranges 1.1-1.9) were observed in all outcome measures following IASTM compared to the other two intervention methods. In the IASTM group, the headache frequency decreased from 15 to 2 days/month. Also, headache disability decreased from 19 to 10. Further, CA increased from 17.5° to 31.4° and AHT decreased from 24.1 to 15.5 mm. The pressure algometry group showed significantly lower headache frequency at the follow-up (P < 0.01) than the sham ultrasound control group. However, Similar findings in the other evaluated outcomes were found between the pressure algometry and sham ultrasound control groups (P ˃ 0.05).

CONCLUSION: The results of the present study indicate the effectiveness of IASTM in improving headache symptoms and cervical alignment in patients with TTH.

PMID:35674120 | DOI:10.1080/10669817.2022.2082637

J Vasc Access. 2022 Jun 8:11297298221075166. doi: 10.1177/11297298221075166. Online ahead of print.

ABSTRACT

OBJECTIVE: To establish a multidisciplinary management model based on Delphi method to guide nursing practice and reduce the incidence of CVAD-associated Skin Impairment (CASI) in tumor patients.

METHODS: On the basis of literature review and focus group interview, the initial item pool of CASI management model for cancer patients was determined. The Delphi method was used to conduct two rounds of letter consultation with 36 authoritative and representative experts to determine the content and weight of indicators of CASI multidisciplinary management model for cancer patients.

RESULTS: Most of the research group were experts with bachelor degree or above. More than 90% of experts have worked for more than 10 years; Areas of expertise include oncology care, venous therapy, wound stomatology, and dermatology. The recovery rate of the two rounds of expert correspondence questionnaire was 100%. The authority coefficient of experts was 0.898, indicating a good degree of authority. Kendall’s harmony coefficients were 0.193 and 0.250, with statistically significant differences (p < 0.001). After two rounds of expert letter consultation, a multidisciplinary management model of CASI for cancer patients was initially formed, which included 15 first-level prevention indexes and 38 second-level prevention indexes of CASI for cancer patients. There were 9 first-level indexes and 16 second-level indexes of CASI treatment in tumor patients.

CONCLUSION: Cancer patients based on Delphi method to construct CASI multidisciplinary management model has high reliability and scientificity, multidisciplinary management model in the management of patients with tumor CASI exploration will provide new methods for central venous catheter nursing and the new way of thinking, will also be intravenous fluids will provide a scientific basis for professional development and quality improvement and practical experience.

PMID:35674111 | DOI:10.1177/11297298221075166

Psychol Med. 2022 Jun 8:1-13. doi: 10.1017/S0033291722001349. Online ahead of print.

ABSTRACT

BACKGROUND: Despite a large descriptive literature linking creativity and risk for psychiatric illness, the magnitude and specificity of this relationship remain controversial.

METHODS: We examined, in 1 137 354 native Swedes with one of 59 3-digit official and objective occupational codes in managerial and educated classes, their familial genetic risk score (FGRS) for ten major disorders, calculated from 1^st through 5^th degree relatives. Mean FGRS across disorders were calculated, in 3- and 4-digit occupational groups, and then controlled for those whose disorder onset preceded occupational choice. Using sequential analyses, p values were evaluated using Bonferroni correction.

RESULTS: 3-digit professions considered to reflect creativity (e.g. ‘artists’ and ‘authors’) were among those with statistically significant elevations of FGRS. Among more specific 4-digit codes, visual artists, actors, and authors stood out with elevated genetic risks, highest for major depression (MD), anxiety disorders (AD) and OCD, more modest for bipolar disorders (BD) and schizophrenia and, for authors, for drug and alcohol use disorders. However, equal or greater elevations in FGRS across disorders were seen for religious (e.g. ministers), helping (e.g. psychologists, social workers), and teaching/academic occupations (e.g. professors). The potential pathway from FGRS → Disorder → Occupation accounts for a modest proportion of the signal, largely for MD and AD risk.

CONCLUSIONS: While traditional creative occupations were associated with elevated genetic risk for a range of psychiatric disorders, this association was not unique, as similar, or greater elevations were seen for religious, helping and teaching professions and was stronger for internalizing than psychotic disorders.

PMID:35674100 | DOI:10.1017/S0033291722001349

Pharmacogenomics. 2022 Jun 8. doi: 10.2217/pgs-2022-0037. Online ahead of print.

ABSTRACT

Antidepressant medications are frequently used as the first line of treatment for depression. However, their effectiveness is highly variable and influenced by genetic factors. Recently, pharmacogenetic studies, including candidate-gene, genome-wide association studies or polygenic risk scores, have attempted to uncover the genetic architecture of antidepressant response. Genetic variants in at least 27 genes are linked to antidepressant treatment response in both coding and non-coding genomic regions, but evidence is largely inconclusive due to the high polygenicity of the trait and limited cohort sizes in published studies. Future studies should increase the number and diversity of participants to yield sufficient statistical power to characterize the genetic underpinnings and biological mechanisms of treatment response, improve results generalizability and reduce racial health-related inequities.

PMID:35673953 | DOI:10.2217/pgs-2022-0037

Curr Opin Neurol. 2022 Jun 1;35(3):271-277. doi: 10.1097/WCO.0000000000001057.

ABSTRACT

PURPOSE OF REVIEW: Although substantial progress has been made in understanding the natural history of multiple sclerosis (MS) and the development of new therapies, many questions concerning disease behavior and therapeutics remain to be answered. Data generated from real-world observational studies, based on large MS registries and databases and analyzed with advanced statistical methods, are offering the scientific community answers to some of these questions that are otherwise difficult or impossible to address. This review focuses on observational studies published in the last 2 years designed to compare the effectiveness of escalation vs. induction treatment strategies, to assess the effectiveness of treatment in pediatric-onset and late-onset MS, and to identify the clinical phenotype of secondary progressive (SP)MS.

RECENT FINDINGS: The main findings originating from real-world studies suggest that MS patients who will qualify for high-efficacy disease-modifying therapies (DMTs) should be offered these as early as possible to prevent irreversible accumulation of neurological disability. Especially pediatric patients derive substantial benefits from early treatment. In patients with late-onset MS, sustained exposure to DMTs may result in more favorable outcomes. Data-driven definitions are more accurate in defining transition to SPMS than diagnosis based solely on neurologists’ judgment.

SUMMARY: Patients, physicians, industry, and policy-makers have all benefited from real-world evidence based on registry data, in answering questions of diagnostics, choice of treatment, and timing of treatment decisions.

PMID:35674068 | DOI:10.1097/WCO.0000000000001057

Vasa. 2022 Jun 8. doi: 10.1024/0301-1526/a001012. Online ahead of print.

ABSTRACT

Background: Peripheral artery disease (PAD) affects more than 202 million people worldwide. Several studies have shown that patients with PAD are often undertreated, and that statin utilization is suboptimal. European and American guidelines highlight statins as the first-line lipid-lowering therapy to treat patients with PAD. Our objective with this meta-analysis was to further explore the impact of statins on lower extremities PAD endpoints and examine whether statin dose (high vs. low intensity) impacts outcomes. Patients and methods: We performed a systematic review and meta-analysis according to the PRISMA guidelines. Any study that presented a comparison of use of statins vs. no statins for PAD patients or studies comparing high vs. low intensity statins were considered to be potentially eligible. We excluded studies with only critical limb threatening ischemia (CLTI) patients. The Medline (PubMed) database was searched up to January 31, 2021. A random effects meta-analysis was performed. Results: In total, 39 studies and 275,670 patients were included in this meta-analysis. In total, 136,025 (49.34%) patients were on statins vs. 139,645 (50.66%) who were not on statins. Statin use was associated with a reduction in all cause-mortality by 42% (HR: 0.58, 95% CI: 0.49-0.67, p<0.01) and cardiovascular death by 43% (HR: 0.57, 95% CI: 0.40-0.74, p<0.01). Statin use was associated with an increase in amputation-free survival by 56% (HR: 0.44, 95% CI: 0.30-0.58, p<0.01). The risk of amputation and loss of patency were reduced by 35% (HR: 0.65, 95% CI: 0.41-0.89, p<0.01) and 46% (HR: 0.54, 95% CI: 0.34-0.74, p<0.01), respectively. Statin use was also associated with a reduction in the risk of major adverse cardiovascular events (MACE) by 35% (HR: 0.65, 95% CI: 0.51-0.80, p<0.01) and myocardial infarction rates by 41% (HR: 0.59, 95% CI: 0.33-0.86, p<0.01). Among patients treated with statins, the high-intensity treatment group was associated with a reduction in all cause-mortality by 36% (HR: 0.64, 95% CI: 0.54-0.74, p<0.01) compared to patients treated with low intensity statins. Conclusions: Statin treatment among patients with PAD was associated with a statistically significant reduction in all-cause mortality, cardiovascular mortality, MACE, risk for amputation, or loss of patency. Higher statin dose seems to be associated with improved outcomes.

PMID:35673949 | DOI:10.1024/0301-1526/a001012

Eur J Phys Rehabil Med. 2022 Jun 8. doi: 10.23736/S1973-9087.22.07361-0. Online ahead of print.

ABSTRACT

BACKGROUND: One of the most overspread postural abnormalities is forward head posture (FHP) and it is described as head projection anteriorly in relation to the trunk which appears mainly in sagittal plane. Scapular stabilization exercise (SSE) is capable of restoring each of thoracic cage and head neutral optimum position by neck and shoulder muscles interactions and through controlling scapular position and movement.

AIM: This study was conducted to investigate the impact of adding scapular stabilization (SSE) to postural correctional exercises (PCE) on symptomatic forward head posture.

DESIGN: The pre-post single-masking (assessor) randomized experimental trial.

SETTING: Participants with postural dysfunction in form of forward head posture admitted to outer clinic of the Faculty of Physical Therapy.

POPULATION: Sixty participants (20 to 35 years) with symptomatic FHP and recruited from outer clinic at faculty of physical therapy.

METHODS: participants were allocated randomly by opaque sealed envelope to two groups who are referred from an orthopedist: Group “A” received Scapular stabilization exercises and postural correction exercises, whereas Group “B” received only postural correctional exercises; treatments were performed three times / week for 10 weeks. The craniovertebral angle, pressure pain threshold, cervical flexor and extensor muscles endurance, Arabic neck disability index, upper trapezius and sternocleidomastoid muscle root mean square during rest and activity were used to evaluate the patients’ pre-treatment and post-treatment.

RESULTS: within group analysis for sixty participants reported statistical significant difference between baseline and post-treatment as p-value <0.05 with more refinement in stabilization exercise group.

CONCLUSIONS: Adding Scapular Stabilization exercises to postural correctional exercises is more effective method than postural correctional exercises seldom for the management of forward head posture patients.

CLINICAL REHABILITATION IMPACT: Both scapular stabilization and postural correction exercise increase craniovertebral angle and pressure pain threshold and decrease muscle activity and disability. Scapular stabilization alone increase craniovertebral angle and pressure pain threshold and decrease muscle activity and disability more than postural correction exercise. In addition of statistical significant difference in all variables but there were clinical change in disability only.

PMID:35673945 | DOI:10.23736/S1973-9087.22.07361-0