Category: Nevin Manimala

J Cosmet Dermatol. 2021 Oct 3. doi: 10.1111/jocd.14510. Online ahead of print.

ABSTRACT

BACKGROUND: Radiofrequency is a commonly used method to non-invasively tighten the skin that can be safely applied to any skin type.

AIMS: The aim of our study was to evaluate the safety and efficacy of the focused radiofrequency and ultrasound hybrid device for face and neck rejuvenation, in terms of improvement of facial wrinkles and jaw sagging.

METHODS: A total of 158 patients had undergone four weekly sessions of focused radiofrequency and ultrasound to face and neck area. Photodocumentation was obtained before first visit and two weeks after last visit. An independent, blinded dermatologist evaluated the severity of wrinkles and sagging of seven different anatomical regions on a validated scale of 0-4 (0: no lines/sagging, 1: mild, 2: moderate, 3: severe, 4: very severe) before and after the procedure. Patients rated their satisfaction with the result of the treatment on a scale of 1-5 (1: dissatisfied, 2: poorly satisfied 3: satisfied, 4: very satisfied, 5: perfectly satisfied).

RESULTS: For seven anatomical regions, statistically significant reduction was observed in mean wrinkle/sagging scores (p = < 0.001). Patients were satisfied with the effects of the procedure, with a mean satisfaction score of 4.61 ± 0.55.

CONCLUSIONS: Our findings demonstrate that combined focused radiofrequency and ultrasound is an effective and safe method for the rejuvenation of different sub-areas of the face and neck with high patient satisfaction scores.

PMID:34601819 | DOI:10.1111/jocd.14510

Trop Med Int Health. 2021 Oct 3. doi: 10.1111/tmi.13684. Online ahead of print.

ABSTRACT

BACKGROUND: To estimate the prevalence of macrosomia and contributing factors among pregnant women with diabetes in Ethiopia.

METHODS: The Cochrane, PubMed, Google Scholar, SCOPUS, Web of Science electronic databases and gray literature found in online university repositories were searched for primary studies reporting the prevalence of macrosomia (birth weight ≥4 kg, irrespective of gestational age) and/or at least one determinant factor using WHO diabetes diagnosis criteria were involved. Variations across the studies were checked using the I² statistic; funnel plot and Egger’s test were used to assess publication bias. A weighted inverse random effect model was used to estimate the overall prevalence of macrosomia.

RESULTS: The overall prevalence of macrosomic newborns among pregnant women with diabetes [15.1% (95% CI; 9.0%, 21.2%)] was higher than the prevalence among non-diabetic mothers (3.9%). Maternal blood glucose level >100 mg/dl [AOR=10.5: 95% CI; 5.9, 15.1] and >120 mg/dl [AOR=8.8: 95% CI; 4.5, 13.0], lack of Antenatal Care (ANC) visit [AOR=10.8: 95% CI; 6.0, 15.0], previous adverse birth outcomes and advanced maternal age [AOR=3.5: 95% CI; 1.0, 5.9] were significantly associated with the prevalence of macrosomia at 95 % CI.

CONCLUSION: The pooled prevalence of macrosomia among pregnant women with diabetes was higher than the prevalence among non-diabetic pregnant women (3.9%). Advanced maternal age, previous adverse birth outcomes, lack of ANC and uncontrolled maternal plasma glucose level were independent predictors of macrosomia.

PMID:34601758 | DOI:10.1111/tmi.13684

J Obstet Gynaecol Res. 2021 Oct 3. doi: 10.1111/jog.15032. Online ahead of print.

ABSTRACT

AIM: We aimed to evaluate the addition of fetal thigh circumference (TC) to other ultrasound parameters to predict fetal weight compared to two standard formulae (Hadlock’s and Vintzileos methods).

METHODS: We conducted this prospective study on pregnant women between November 2018 and September 2019. The actual fetal weight was estimated within 48 h of delivery; then, it was compared to the estimated fetal weight by ultrasound. We used the Statistical Package for the Social Sciences (SPSS) software version 20.0 to perform the statistical analysis.

RESULTS: A total of 123 pregnant women, with a mean age of 26.68 (5.24) years and a mean gestational age of 38.78 (0.85) weeks, were included in our study. We detected a significant positive correlation between different ultrasound parameters and actual weight (all p ≤ 0.001). The highest correlation was observed between TC and actual fetal weight (r = 0.685). Regarding both formulae, the correlation coefficient was higher in the Vintzileos formula than the Handlock formula (0.976 vs. 0.823). Our linear regression analysis showed that fetal TC could be an indicator for estimating fetal weight (p < 0.001). There was a statistically significant difference between the actual weight and the weight estimated by the Hadlock formula (p < 0.001). We detected no statistically significant difference between the estimated TC by ultrasound and the actual TC (p = 0.0602).

CONCLUSION: Fetal TC can help accurately measure fetal birth weight when incorporated with other fetal parameters. The inclusion of fetal TC assessment in routine ultrasound examination is suggested to improve the birth estimates.

PMID:34601765 | DOI:10.1111/jog.15032

Headache. 2021 Oct 3. doi: 10.1111/head.14225. Online ahead of print.

ABSTRACT

OBJECTIVE: This internet survey aimed to analyze the activity of midolordecabeza.org, a specialized website for headache stakeholders.

BACKGROUND: eHealth tools, such as websites, can be educational for stakeholders of a specific disease, such as patients. This is particularly helpful in chronic disorders such as migraine. eHealth also enhances patient-centered outcome research. The website midolordecabeza.org has the stated aim of organizing key information on headache making it accessible and useful for all stakeholders, and, eventually promoting patient participation.

METHODS: We analyzed Google Analytics (GA) data to study the web’s activity, traffic source, geographical distribution of access, registered-user behavior, electronic device performance, and temporary references with greater web activity.

RESULTS: From January 2015 until December 2020, the website registered 1,121,585 visitors, 1,775,953 sessions, and a total of 3,833,144 views with an average time per session of nearly 2 min. Higher data traffic has been registered in Spanish-speaking countries such as Spain (33.3%; 591,256/1,775,953), where Spain’s regions with higher views were statistically significantly correlated with the nationwide migraine prevalence (ρ = 0.505; p = 0.039). In regard to social behavior, returning users were statistically significantly associated with being a woman (84.0%; 5696/6781), and they predominantly acceded from organic searches (50.6%; 3434/6781). When answering available open surveys, 72.5% (1827/2520) described their migraine as a disabling disease with high impact on their daily tasks and 64.4% (14,016/21,764) were unaware of what their headache diagnosis is.

CONCLUSIONS: Spanish-speaking patients with migraine around the world increasingly visited the headache-specialized website midolordecabeza.org using different electronic devices, showing great interest in their disease. This website allowed them to get updated information on their disease, share clinical data with physicians, and finally express their concerns.

PMID:34601726 | DOI:10.1111/head.14225

Int Endod J. 2021 Oct 3. doi: 10.1111/iej.13642. Online ahead of print.

ABSTRACT

AIM: To evaluate the influence of traditional and conservative access cavity preparations on the remaining dentine thickness in the coronal third of mesial canals of extracted mandibular molars prepared with reciprocating instruments, using micro-computed tomography as the analytical tool.

METHODOLOGY: Seventy extracted mandibular molars were scanned at a pixel size of 19 μm. From this initial sample, twenty teeth were selected, pair-matched, and distributed into 2 groups (n=10) according to the access cavity preparation: traditional (TradAC) or conservative (ConsAC). The root canals were sequentially enlarged with Reciproc Blue R25 (size 25, 0.08v taper) and R40 (size 40, 0.06v taper) instruments. A new scan was performed and the postoperative stacks were co-registered with their respective preoperative datasets. A colour-coded cross-sections of the roots were created and used to identify and measure the smallest dentine thickness related to both MB and ML canals at 1.0-mm intervals from the furcation level up to 5 mm in the apical direction, in both mesial and distal aspects of the roots, before and after preparation. The statistical analyses were performed with paired-samples t-test, independent-samples Student T, and Chi-Square test with a significance level of 5%.

RESULTS: In all levels of both groups, dentine thickness before preparation was greater than after preparation (p < 0.05). No difference in the percentage of dentine reduction were observed between TradAC and ConsAC groups (p > 0.05), but a significantly greater reduction was observed to the distal aspect of the roots (p < 0.05). After root canal preparation, dentine thickness thinner than 0.5 mm was observed mostly at the distal aspect of the root (10% to 15%) of the MB and ML canals, with no influence of the access cavity type on its incidence to either mesial (X² =1.66; p=0.2) or distal (X² =0.40; p=0.5) directions. In the TradAC group, dentine thickness in most slices was greater than 1.0 mm after preparation (n=124) while, in the ConsAC, it ranged from 0.5 to 1.0 mm (n=136).

CONCLUSION: Traditional or conservative access cavity preparation in extracted mandibular molars did not influence the remaining dentine thickness in the coronal third of mesial canals enlarged with thermomechanically-treated nickel-titanium reciprocating instruments.

PMID:34601728 | DOI:10.1111/iej.13642

J Gastrointest Cancer. 2021 Oct 3. doi: 10.1007/s12029-021-00723-w. Online ahead of print.

ABSTRACT

PURPOSE: Mortality from pancreatic cancer has risen fast in the past two decades in East Africa, including Kenya. However, there was a paucity of conclusive data about the survival of pancreatic cancer patients in the study setting. Hence, this study aimed to assess the survival outcomes of pancreatic cancer patients at Kenyatta National Hospital.

METHODS: A hospital-based retrospective cohort analysis was used to evaluate the survival outcomes among pancreatic cancer patients treated in the study setting from 1 January 2015 to 31 December 2019. A total of 64 eligible pancreatic cancer patients were included in the study. In the pre-designed data abstraction tool, the data were collected by reviewing the medical records of the patients. The data were analyzed using the Statistical Package for the Social Sciences version 22 software. The mean survival time was estimated using Kaplan-Meier survival analysis. Cox regression analysis was employed to estimate the predictors of mortality among pancreatic cancer patients.

RESULTS: The mean age of the study participants was 60.38 ± 12.61 years. Most of the patients had adenocarcinoma (96.9%) and were diagnosed at an advanced stage of the disease. The overall mean and median survival estimate for pancreatic cancer was 48.7 ± 9.7 and 39.0 ± 23.9 months, respectively. The present study showed that the overall survival rate of pancreatic cancer patients was 79.7%.

CONCLUSION: The mortality rate of pancreatic cancer in the present study was 20%. The overall mean survival estimate for pancreatic cancer was 48.7 ± 9.7 months, and the majority had disease progression in the last follow-up period.

PMID:34601708 | DOI:10.1007/s12029-021-00723-w

Int Urol Nephrol. 2021 Oct 3. doi: 10.1007/s11255-021-02999-0. Online ahead of print.

ABSTRACT

PURPOSE: It is a prospective randomized controlled trial comparing the efficacy of percutaneous tibial nerve stimulation versus sham for a shortened 6-week protocol of treatment in management of refractory OAB in non-neurogenic adult patients.

METHODS: A total of 50 adults with refractory non-neurogenic overactive bladder symptoms were randomized 1:1 to 6 weeks of treatment with weekly percutaneous tibial nerve stimulation or sham therapy. Overactive bladder symptom score as well as 3-day voiding diaries were completed at baseline and at 7th week, 3rd and 6th month.

RESULTS: The 7th week, 3rd and 6th month symptom score assessment for overall bladder symptoms demonstrated that percutaneous tibial nerve stimulation patients achieved statistically significant improvement in bladder symptoms with 52% reporting moderately improved responses compared to non-response of sham patients from baseline (P = 0.001). Voiding diary parameters after 6 weeks of therapy showed that PTNS patients had statistically significant improvements in frequency, voided volume and urgency urinary incontinence episodes compared to sham. No serious device-related adverse events or malfunctions were reported.

CONCLUSION: A shortened 6-week treatment protocol with PTNS appears to be successful and more effective than sham in the treatment of refractory OAB. PTNS therapy is safe and effective in treating OAB symptoms with 52% success rate following a shortened 6-week protocol. The duration of treatment with PTNS can be halved compared to the conventional 12 weeks, which would make it more acceptable and cost effective for patients.

PMID:34601705 | DOI:10.1007/s11255-021-02999-0

Ir J Med Sci. 2021 Oct 3. doi: 10.1007/s11845-021-02788-9. Online ahead of print.

ABSTRACT

BACKGROUND: International evidence indicates that about 10% of people with alcohol dependence will seek and commence treatment each year. Based upon Irish estimates of prevalence of dependence, a target of 690.0 treated cases per 100,000 population per annum is expected.

AIMS: This study analyses routine national surveillance data on alcohol treatment to measure how treatment need is being met.

METHODS: National treatment surveillance data on problem alcohol use collected by the National Drug Treatment Reporting System (NDTRS) were analysed. The study included cases resident in Ireland, aged 18-64 years entering treatment for alcohol use disorder (AUD) between 2015 and 2019 (n = 44,079). Treatment rates were calculated per 100,000 of the population. Descriptive and exploratory statistics were used to describe characteristics of cases treated.

RESULTS: National rate of treated AUD was 270 cases per 100,000 annually, with a rate of treated alcohol dependence of 165/100,000. There was a fivefold difference between the lowest and highest rates (119 cases per 100,000 in Meath versus 633 in Waterford). Drinking patterns indicate high levels of alcohol consumption and prolonged use prior to treatment. The use of other drugs alongside alcohol was common.

CONCLUSIONS: Despite high rates of alcohol consumption and dependence, the rate of treatment entry nationally is sub-optimal, although there are wide geographic variations. There is a need to better understand the reasons for low treatment entry rates in Ireland for people with alcohol dependence. Monitoring and surveillance play a key role in measuring the successful efforts to reduce the harm of alcohol.

PMID:34601707 | DOI:10.1007/s11845-021-02788-9

Environ Sci Pollut Res Int. 2021 Oct 3. doi: 10.1007/s11356-021-16562-y. Online ahead of print.

ABSTRACT

The circular economy (CE) is a proposal for a new, more sustainable, and durable economy model. As a consequence, this pro-environmental economic model induces visible changes in the labor market which are Green Jobs (GJs). This paper is focused on the creation of Green Jobs in the CE. The GJs are most visible in the environmental goods and services sector (EGSS). This study aims to investigate EGSS among 28 European Union countries in the years 2009-2019. The adopted method was literature research complemented by the statistical analysis of secondary data from Eurostat in the linear regression method. Then, some Sustainable Development Goals (SDGs) and their measure were used as main indicators reflecting changes in the labor market. Results are presented as a model indicating which of the SDGs can support CE and enhance a number of the Green Jobs. Presented results contribute to the science because combine factors influencing GJs creation in EGSS, in a CE perspective. This study underlines a lack of uniform methods for measuring and forecasting the effects of Green Jobs creation and indicates future research directions.

PMID:34601690 | DOI:10.1007/s11356-021-16562-y

Neurol Sci. 2021 Oct 2. doi: 10.1007/s10072-021-05636-x. Online ahead of print.

ABSTRACT

BACKGROUND: Up to 50% of motor neuron disease (MND) patients show neuropsychological deficits which negatively affect prognosis and care. However, disability-related logistical issues and uneven geographical coverage of healthcare services may prevent MND patients from accessing neuropsychological evaluations. This study thus aimed to standardize for the Italian population the ALS Cognitive Behavioral Screen-Phone Version (ALS-CBS™-PhV), an MND-specific, telephone-based screening for frontotemporal dysfunction.

METHODS: The cognitive section of the ALS-CBS™-PhV, the Italian telephone-based Mini-Mental State Examination (Itel-MMSE), and the Telephone Interview for Cognitive Status (TICS) was administered to 359 healthy individuals (143 males, 216 females; age, 52.7 ± 15.8; education, 13.1 ± 4.4). Norms were derived through equivalent scores. Validity, factorial structure, reliability, diagnostic accuracy, and item difficulty and discrimination were examined. Statistical equivalence between the telephone-based and in-person versions was tested.

RESULTS: ALS-CBS™-PhV measures were predicted by age and education. The ALS-CBS™-PhV reflected a mono-component structure, converged with Itel-MMSE and TICS scores (r_s = .23-.51) and was equivalent to its in-person format (t = .37; p = .72). Good internal (Cronbach’s α = .61), test-retest (ICC = .69), and inter-rater (ICC = .96) reliability was detected. High accuracy was found when tested against both the Itel-MMSE and the TICS (AUC = .82-89). Backward digit span items were the most discriminative.

DISCUSSION: The ALS-CBS™-PhV is a statistically solid screening test for frontotemporal disorders featuring MND. Its standardization allows for (1) improvements in tele-healthcare for MND patients, (2) epidemiological applications, and (3) effective assessments in decentralized clinical trials. The ALS-CBS™-PhV can be also suitable for assessing bedridden and visually impaired patients with motor disorders.

PMID:34601697 | DOI:10.1007/s10072-021-05636-x