Category: Nevin Manimala

Pathophysiology. 2021 Dec 20;28(4):544-550. doi: 10.3390/pathophysiology28040035.

ABSTRACT

Sarcoidosis (SC) is a granulomatous disease of an unknown origin. The most common SC-related neurological complication is a small fiber neuropathy (SFN) that is often considered to be the result of chronic inflammation and remains significantly understudied. This study aimed to identify the clinical and histological correlates of small fiber neuropathy in sarcoidosis patients. The study was performed in 2018-2019 yy and included 50 patients with pulmonary sarcoidosis (n = 25) and healthy subjects (n = 25). For the clinical verification of the SFN, the “Small Fiber Neuropathy Screening List” (SFN-SL) was used. A punch biopsy of the skin was performed followed by enzyme immunoassay analysis with PGP 9.5 antibodies. Up to 60% of the sarcoidosis patients reported the presence of at least one complaint, and it was possible that these complaints were associated with SFN. The most frequent complaints included dysfunctions of the cardiovascular and musculoskeletal systems and the gastrointestinal tract. A negative, statistically significant correlation between the intraepidermal nerve fiber density (IEND) and SFN-SL score was revealed. In patients with pulmonary sarcoidosis, small fiber neuropathy might develop as a result of systemic immune-mediated inflammation. The most common symptoms of this complication were dysautonomia and mild sensory dysfunction.

PMID:35366250 | DOI:10.3390/pathophysiology28040035

Environ Sci Pollut Res Int. 2022 Apr 2. doi: 10.1007/s11356-022-19975-5. Online ahead of print.

ABSTRACT

For nations already facing pollution issues, fossil fuel energy consumption is deteriorating living standards. Though prevailing infrastructure makes fossil fuel energy use feasible for production, it still pollutes our environment. This study in the domain of environment and development assesses the impact of fossil fuel energy consumption on the infant mortality rate in 15 Asian economies during 1996 and 2019. The living standards are assessed using infant mortality rate, while non-linear fossil fuel energy consumption is used with gross capital formation, employment, and preprimary education as independent variables. The feasible generalized least square method evaluates the effects. The study concludes that fossil fuel energy consumption follows a U-shaped relationship explaining infant mortality. The results point out that over-consumption of fossil fuel energy is deteriorating the living standards considering low air quality levels in Asian economies.

PMID:35366207 | DOI:10.1007/s11356-022-19975-5

Breast Cancer Res Treat. 2022 Apr 2. doi: 10.1007/s10549-022-06571-x. Online ahead of print.

ABSTRACT

PURPOSE: This case-control study assesses the independent roles of reproductive history, postmenopausal hormonal therapy (HT), socioeconomic status (SES), and occupational physical activity on the risk of breast cancer (BC).

METHODS: Odds ratios (OR) were estimated from conditional logistic multivariate regression model in a data set of 19,253 Finnish women diagnosed with BC between 1994 and 2013 and 96,265 age-matched population controls.

RESULTS: Both pre- and postmenopausal white-collar workers had significantly increased risk of ductal and lobular BC as compared to manual workers. Moderate occupational physical activity reduced risk of lobular BC by 14%. There was a transient increase in the risk of BC observed after each birth followed by a protective effect starting some years after the delivery. As the number of children increased, the short-term excess risk was lower and protective effect was observed earlier. Continuous estrogen-progestin therapy (EPT) significantly increased the risk of both ductal and lobular BC and the magnitude of risk was directly proportional to duration of use (OR for 5+ years of use 2.26, 95% confidence interval 2.12-2.42). Monthly EPT for 5+ years increased the risk (OR 1.32, 95% CI 1.20-1.45). Users of estradiol plus levonorgestrel intrauterine system devices showed ORs of 1.56 (95% CI 1.45-1.69) and 2.18 (95% CI 1.81-2.64) for ductal and lobular BC, respectively.

CONCLUSION: This study concludes that pregnancy has a dual effect on BC risk, with a transient increase in risk followed by a long-term protective effect. The SES and HT have a large effect on BC risk while occupational physical activity has only a small independent effect.

PMID:35366162 | DOI:10.1007/s10549-022-06571-x

Int Urol Nephrol. 2022 Apr 2. doi: 10.1007/s11255-022-03188-3. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed at comparing the prevalence of cognitive frailty and explore the differences in the influencing factors between elderly and middle-young patients receiving maintenance hemodialysis (MHD).

METHODS: In this cross-sectional study, the frailty phenotype, mini-mental state examination, and clinical dementia rating were used to assess the current status of cognitive frailty in 852 patients receiving MHD from four hospitals in Lianyungang City and Xuzhou City, Jiangsu Province, China; the influencing factors were then analyzed for statistical significance.

RESULTS: Of the total 852 patients receiving MHD, 340 were classified into an elderly group (≥ 60 years) and 512 into a middle-young group (< 60 years). The prevalence of cognitive frailty was 35.9% and 8.8%, respectively. The results of multivariate logistic regression analysis showed that the independent factors of cognitive frailty were age (P < 0.001), education level (P = 0.010), nutritional status (P = 0.001), serum albumin level (P = 0.010), calf circumference (P = 0.024), and social support level (P < 0.001) in the elderly group and comorbidity status (P = 0.037), education level (P < 0.001), nutritional status (P = 0.008), serum creatinine level (P = 0.001), waist circumference (P < 0.001), and depression (P = 0.006) in the middle-young group.

CONCLUSION: The prevalence of cognitive frailty was significantly higher in the elderly group than in the middle-young group, and the influencing factors differed between the two populations.

PMID:35366144 | DOI:10.1007/s11255-022-03188-3

J Psycholinguist Res. 2022 Apr 2. doi: 10.1007/s10936-022-09863-x. Online ahead of print.

ABSTRACT

In recent years large datasets of lexical processing times have been released for several languages, including English, French, Spanish, and Dutch. Such datasets have enabled us to study, compare, and model the global effects of many psycholinguistic measures such as word frequency, orthographic neighborhood (ON) size, and word length. We have compiled and publicly released a frequency and ON dictionary of 64,546 words and 1800 plausible NWs from a language that has been relatively little studied by psycholinguists: Persian. We have also collected visual lexical decision reaction times for 1800 Persian words and nonwords. Persian offers an interesting psycholinguistic environment for several reasons, including that it has few long words and has resultantly dense orthographic neighborhoods. These characteristics provide us with an opportunity to contrast how these factors affect lexical access by comparing them to several other languages. The results suggest that sensitivity to word length and orthographic neighbourhood may reflect the statistical structure of a particular language, rather than being a universal element of lexical processing. The dictionary and LDRT data are available from https://osf.io/tb4m6/ .

PMID:35366147 | DOI:10.1007/s10936-022-09863-x

Int Ophthalmol. 2022 Apr 2. doi: 10.1007/s10792-022-02273-x. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the results of surgical management of glaucoma following different keratoplasty techniques.

METHODS: Medical records of 628 cases who underwent keratoplasty were reviewed. One hundred and eighty-eight patients (29.9%) who developed post-keratoplasty glaucoma were evaluated. Patients who could not be controlled with maximal medical treatment and underwent glaucoma surgery were included in this study. Trabeculectomy, Ahmed glaucoma valve (AGV) implantation or diode laser cyclophotocoagulation (DLC) were applied.

RESULTS: Glaucoma surgery was performed in 55 (29.3%) patients who had uncontrolled post-keratoplasty glaucoma. In penetrating keratoplasty group (n = 42), DLC was applied to 30 (71.4%) eyes, AGV to 11 (26.2%) eyes, and trabeculectomy in 1 (2.4%) eye. In Descemet’s membrane endothelial keratoplasty group (n = 8), DLC was applied to 4 (50%) eyes, trabeculectomy for 3 (37.5%) eyes and AGV for 1 (12.5%) eye. In deep anterior lamellar keratoplasty group (n = 5), DLC was applied to 2 (40%) eyes, trabeculectomy to 2 (40%) eyes and AGV to 1 (20%) eye. While a statistically significant decrease was found in intraocular pressure (IOP) and anti-glaucomatous medication after surgery (p < 0.05 for each), no significant difference was found in best corrected visual acuity (BCVA). During follow-up, DLC was applied as re-glaucoma surgery in 19 (34.5%) cases. A significant reduction in IOP together with number of anti-glaucomatous medications was found with re-operation; however, a significant decrease in BCVA was noted (p < 0.05 for each).

CONCLUSION: Glaucoma surgeries after keratoplasty are effective in decreasing IOP and the number of anti-glaucomatous medication. While BCVA doesn’t change after the first glaucoma surgery, after re-operation significant decrease may occur.

PMID:35366139 | DOI:10.1007/s10792-022-02273-x

Eur Radiol. 2022 Apr 2. doi: 10.1007/s00330-022-08766-8. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of the study was to evaluate the effect of an interactive training program on the learning curve of radiology residents for bladder MRI interpretation using the VI-RADS score.

METHODS: Three radiology residents with minimal experience in bladder MRI served as readers. They blindly evaluated 200 studies divided into 4 subsets of 50 cases over a 3-month period. After 2 months, the first subset was reassessed, resulting in a total of 250 evaluations. An interactive training program was provided and included educational lessons and case-based practice. The learning curve was constructed by plotting mean agreement as the ratio of correct evaluations per batch. Inter-reader agreement and diagnostic performance analysis were performed with kappa statistics and ROC analysis.

RESULTS: As for the VI-RADS scoring agreement, the kappa differences between pre-training and post-training evaluation of the same group of cases were 0.555 to 0.852 for reader 1, 0.522 to 0.695 for reader 2, and 0.481 to 0.794 for reader 3. Using VI-RADS ≥ 3 as cut-off for muscle invasion, sensitivity ranged from 84 to 89% and specificity from 91 to 94%, while the AUCs from 0.89 (95% CI:0.84, 0.94) to 0.90 (95% CI:0.86, 0.95). Mean evaluation time decreased from 5.21 ± 1.12 to 3.52 ± 0.69 min in subsets 1 and 5. Mean grade of confidence improved from 3.31 ± 0.93 to 4.21 ± 0.69, in subsets 1 and 5.

CONCLUSION: An interactive dedicated education program on bladder MRI and the VI-RADS score led to a significant increase in readers’ diagnostic performance over time, with a general improvement observed after 100-150 cases.

KEY POINTS: • After the first educational lesson and 100 cases were interpreted, the concordance on VI-RADS scoring between the residents and the experienced radiologist was significantly higher. • An increase in the grade of confidence was experienced after 100 cases. • We found a decrease in the evaluation time after 150 cases.

PMID:35366122 | DOI:10.1007/s00330-022-08766-8

Skeletal Radiol. 2022 Apr 2. doi: 10.1007/s00256-022-04035-3. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: While ultrasound-guided percutaneous irrigation for painful calcific tendinopathy (US-PICT) is the treatment of choice for the rotator cuff, there is a lack of knowledge regarding the treatment of this condition with atypical location. The purpose of our study is to assess if US-PICT can be applied safely and successfully in atypical sites, outside of the rotator cuff.

MATERIALS AND METHODS: We retrospectively reviewed the US-PICT performed outside the rotator cuff, in the last 5 years in a single institution. A total of 16 patients have been included in this study. We collected the values of the numerical rating scale (NRS) for pain pre- and post-procedure (7 days and 3-month follow-up). Moreover, we assessed the imaging studies available pre- and post-procedure (ultrasound and plain radiography) to assess complications.

RESULTS: In all the 16 patients (10F, 6 M; mean age 50.2; range 24-65-year-old), no complications have been observed during and after the procedures. The mean pain NRS before treatment was 8.7 (range 10-6) and dropped to 1.1 (6-0) after 1 week as well after 3 months 1.1 (6-0). The NRS pain reduction from baseline resulted to be statistically significant after 7 days and 3 months (p < 0.001).

CONCLUSION: Our results suggest the safety and efficacy of this procedure, underlining the great potential of US-PICT applied even in different atypical locations.

PMID:35366095 | DOI:10.1007/s00256-022-04035-3

Community Ment Health J. 2022 Apr 2. doi: 10.1007/s10597-022-00963-5. Online ahead of print.

ABSTRACT

Crisis Resolution and Home Treatment Teams (CRHTTs) provide 24-hour, seven day per week support for people in crisis. The COVID-19 pandemic has placed significant demand on urgent care and increased the need for brief interventions in CRHTT settings with flexible methods of delivery. This evaluation aimed to examine client satisfaction with the ‘Crisis Toolbox’ (CTB), a brief, skills-based intervention delivered in one CRHTT during COVID-19. All participants who received the CTB completed a satisfaction questionnaire. Descriptive statistics were calculated to quantify acceptability and qualitative themes were generated using thematic analysis. Fifty-eight people participated, all of whom reported high levels of satisfaction with the CTB. Four qualitative themes also emerged relating to ‘Active ingredients of the CTB’, ‘The therapeutic relationship’, ‘Service-user preferences’ and ‘Expectations and continuity of care’. The CTB appears to be a valued intervention. Further research is now needed to assess its clinical impact and effect on operational indicators.

PMID:35366118 | DOI:10.1007/s10597-022-00963-5

Knee Surg Sports Traumatol Arthrosc. 2022 Apr 2. doi: 10.1007/s00167-022-06958-9. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate whether an arthroscopic transosseous technique (ATO) with cortical implants is effective for rotator cuff tear (RCT) repair in patients with cysts of the greater tuberosity (GTC).

METHODS: Patients treated with the ATO technique between January 2013 and October 2017 were evaluated. Inclusion criteria were patients treated for both cyst-related and non-cyst-related RCTs and patients with a moderate-sized tear (1-3 cm) according to the DeOrio and Cofield classification. A total of 39 patients were separated into two groups: Group 1 (n = 16) patients with cyst-associated RCT, and Group 2 (n = 23) patients with no cyst. Implant pull-out and migration were evaluated radiologically on standard antero-posterior shoulder radiographs and rotator cuff re-tear was assessed on magnetic resonance images at the final follow-up examination. Group 1 patients were separated into two subgroups according to cyst size (cyst < 5 mm and cyst ≥ 5 mm) and subgroup analysis was performed. Clinical assessment was performed using a visual analog scale, the Constant score and Oxford shoulder score.

RESULTS: The mean follow-up time was 33.7 ± 11.7 months. The mean cyst size was 5.4 ± 1.5 mm. There was no significant difference in re-tear rates between the cystic and non-cystic groups. The mean implant migration distance was 3.0 ± 2.2 mm in patients with a RCT -related cyst and 0.7 ± 0.8 mm in those without a cyst. A statistically significant difference was found between the groups (p = 0.002). There was no statistically significant difference between the groups in respect of clinical scores. No implant failure was observed.

CONCLUSION: The ATO method performed with a cortical implant in RCTs resulted in satisfactory recovery and clinical outcomes in the short to medium term with low failure rates. While no implant failures were observed, implant migration was associated with cyst presence. Therefore, judicious use is advocated in the choice of transosseous fixation for cyst-related RCTs and patients should be informed of the possibility of implant migration.

LEVEL OF EVIDENCE: III.

PMID:35366077 | DOI:10.1007/s00167-022-06958-9