Category: Nevin Manimala

Soc Work Public Health. 2021 Dec 29:1-13. doi: 10.1080/19371918.2021.2018083. Online ahead of print.

ABSTRACT

The Organization for Economic Co-operation and Development (OECD) has developed the Better Life Index (BLI), which is a multidimensional approach to well-being. This study aims to investigate the impact of health and social expenditures as well as the economic freedom index on well-being measured by BLI among 34 OECD countries for 2013-2017 period. We estimated panel models to observe the social and health expenditure effects according to their sources and the overall impact of economic changes among countries. We find that public and private social expenditures have a positive and statistically significant impact on BLI at 1% significance level. Additionally, whereas public health expenditure has a positive and statistically significant impact on BLI at 1% significance level, the effects of private health expenditure are statistically significant at 10% significance level. The economic freedom index has a positive and statistically significant impact on BLI in both models. Both social and health expenditures should take a prominent position in policy debates for a better life.

PMID:34964427 | DOI:10.1080/19371918.2021.2018083

Vestn Otorinolaringol. 2021;86(6):69-73. doi: 10.17116/otorino20218606169.

ABSTRACT

OBJECTIVE: To evaluate the therapeutic and preventive efficacy of the drug with antiviral and immunotropic activity Cytovir-3 in children with COVID-19 on an outpatient basis.

MATERIAL AND METHODS: A retrospective analysis the treatment of 52 pediatric patients aged 1 to 17 years with a confirmed new coronavirus infection SARS-CoV-2 with the drug Cytovir-3 was carried out. 28 people, contacts in the family, received the drug for prophylactic purposes. Clinical observation of patients was carried out with an assessment of the severity and duration of fever, the anosmia, catarrhal symptoms in the nasopharynx and analysis indicator of saturation. In the control group, there were 27 patients of the same age who received the medicine Umifenovir and 25 contact family members who did not receive the medicine for prophylactic purposes.

RESULTS: The use of Cytovir-3 in the COVID-19 treatment in children led to a decrease in intoxication symptoms 3.2-3.4 days after taking the medicine, a significant reduction of anosmia period recovery time, and elimination of the pathogen according to PCR analysis. The patients receiving the drug did not have ENT- complications and did not require hospitalization. Prophylactic administration of the drug in contact family members statistically significantly reduced the likelihood of developing the disease 3.6 times. The clinical efficacy and feasibility of using Cytovir-3 in the treatment and prevention of new coronavirus infection in patients of different ages has been shown.

PMID:34964333 | DOI:10.17116/otorino20218606169

Vestn Otorinolaringol. 2021;86(6):74-81. doi: 10.17116/otorino20218606174.

ABSTRACT

OBJECTIVE: Determine the influence of the anatomical features and sizes of the lateral pocket with a defect on the choice of surgical access and the quality of the performed plastics.

MATERIAL AND METHODS: A retrospective analysis of computed tomograms of 38 patients who underwent surgical treatment at the Burdenko National Medical Research Center for Neurosurgery of the Ministry of Health of Russia about defects of the skull base in the area of the lateral pocket of the sphenoid sinus. The patients were divided into three groups depending on the approach used (the 1st group), the recurrence rate (the 2nd group), and the characteristics of intraoperative visualization of the defect (the 3rd group).

RESULTS: There were no statistically significant differences in anatomical features in patients who underwent trans-pterygoid and transsphenoidal approaches, as well as in patients of the 2nd group. Patients of the 3rd group (with visualization features) showed statistically significant differences between the distance from the defect to the VR line (p=0.007). In patients with good visualization of the defect using direct optics, this distance was shorter than in patients in whom the defect was visualized with an angled endoscope. No other anatomical differences were noted.

CONCLUSIONS: The anatomical features of the lateral pocket structure (type of pneumatization, size and volume) did not affect the choice of access to the defect and the frequency of recurrence. When comparing the approaches, it was noted that the trans-pterygoid access, providing direct visualization of defects, minimizes the risk of recurrence in the postoperative period. An objective anatomical indicator for choosing an access to the defects of the lateral pocket can be the distance from the defect to the VR line: at a distance of more than 0.7 cm, it is advisable to perform a trans-pterygoid approach; at a distance of less than 0.7 cm, it is possible to achieve direct visualization of the defect and perform high-quality plastic surgery with a transsphenoidal access.

PMID:34964334 | DOI:10.17116/otorino20218606174

Vestn Otorinolaringol. 2021;86(6):62-68. doi: 10.17116/otorino20218606162.

ABSTRACT

Parapharyngeal and retropharyngeal abscesses (PPA) in children are a rare pathology, for the diagnosis of which it is necessary to use additional instrumental examination methods. The tactics of treating patients remains a subject of discussion.

OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of PPA in children.

MATERIAL AND METHODS: According to the hospital database, a retrospective analysis of the medical histories of children discharged from the clinic with a diagnosis of “J39.0 Retropharyngeal and parapharyngeal abscess” was carried out in the period from 01.01.14 to 31.12.19. In all cases, the diagnosis was confirmed by computed tomography (CT) data with contrast enhancement. Complaints at the time of treatment, anamnesis and instrumental diagnosis data, clinical features of the course of the disease and the effectiveness of treatment were analyzed.

RESULTS: 121 children were treated for PPA (average age 73±41 months; Me=52.5 months), which is 0.4% of all hospitalized in the otorhinolaryngological department, 0.7% of the number of emergency hospitalizations, 0.8% of the number of hospitalized children with pharyngeal diseases, and 8.3% of the number of patients with pharyngeal abscess. Abscesses were more often localized in the upper pharynx, at the level of the I-II cervical vertebrae (49.6% of all observations); abscesses were found least often in the pharyngeal space (5.8%), there was no statistically significant difference between the right-sided and left-sided location: 47.9% and 46.2%, respectively. Surgical treatment was performed in 98 (81%) patients in the presence of an abscess capsule or an abscess diameter of more than 2 cm according to CT; the remaining 23 (19%) children were treated conservatively. The opening of the abscess was performed endopharyngeal, in the case of a pronounced deep lateral location of the abscess and its proximity to large blood vessels – with access through the tonsillar niche after preliminary tonsillectomy (19.4% of those operated).

CONCLUSION: The final diagnosis of parapharyngeal and retropharyngeal abscess can be established by contrast-enhanced computed tomography. Conservative treatment is indicated for a limited group of patients at the initial stages of the disease, most patients need surgical treatment.

PMID:34964332 | DOI:10.17116/otorino20218606162

Microb Biotechnol. 2021 Dec 28. doi: 10.1111/1751-7915.13988. Online ahead of print.

ABSTRACT

Treatment with rumen fluid improves methane production from non-degradable lignocellulosic biomass during subsequent methane fermentation; however, the kinetics of xylanases during treatment with rumen fluid remain unclear. This study aimed to identify key xylanases contributing to xylan degradation and their individual activities during xylan treatment with bovine rumen microorganisms. Xylan was treated with bovine rumen fluid at 37°C for 48 h under anaerobic conditions. Total solids were degraded into volatile fatty acids and gases during the first 24 h. Zymography showed that xylanases of 24, 34, 85, 180, and 200 kDa were highly active during the first 24 h. Therefore, these xylanases are considered to be crucial for xylan degradation during treatment with rumen fluid. Metagenomic analysis revealed that the rumen microbial community’s structure and metabolic function temporally shifted during xylan biodegradation. Although statistical analyses did not reveal significantly positive correlations between xylanase activities and known xylanolytic bacterial genera, they positively correlated with protozoal (e.g., Entodinium, Diploplastron, and Eudiplodinium) and fungal (e.g., Neocallimastix, Orpinomyces, and Olpidium) genera and unclassified bacteria. Our findings suggest that rumen protozoa, fungi, and unclassified bacteria are associated with key xylanase activities, accelerating xylan biodegradation into volatile fatty acids and gases, during treatment of lignocellulosic biomass with rumen fluid.

PMID:34964273 | DOI:10.1111/1751-7915.13988

Vestn Otorinolaringol. 2021;86(6):41-46. doi: 10.17116/otorino20218606141.

ABSTRACT

Approximately 25% of the world population suffer from halitosis, making it a significant medico-social issue. It is one of the clinical signs of chronic inflammatory diseases of the oropharynx and is commonly caused by the persistence some bacteria in the oral cavity and in the oropharynx. These in turn facilitate formation of volatile sulphur compounds.

OBJECTIVE: To evaluate the effectiveness and safety of the probiotic strain Streptococcus salivarius K12 in the Bactoblis product in exacerbation of chronic inflammatory diseases of the oropharynx.

MATERIAL AND METHODS: 45 patients diagnosed with a diagnosis of exacerbation of chronic pharyngitis were studied, gastroesophageal reflux disease was found in 33 patients. After a microbiological testing, all patients were prescribed probiotic strain Streptococcus salivarius K12 in the amount of 1×10⁹ colony-forming units (CFU) in the form of tablets for resorption as monotherapy for 14 days. The assessment of the therapy was based on physical examination data and on the subjective estimation of the clinical symptoms using a 10-point visual analog scale (VAS) before the start of the treatment and on the 5th and on the 7th day of the therapy.

RESULTS: According to the microbiological analysis was revealed the growth of Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus agalactiae, Streptococcus viridans which was seen within 10³-10⁵ CFU. A significant clinical progress was achieved for all three analyzed signs of diseases (the severity of pain when swallowing, a feeling of perspiration (foreign body) in the pharynx, halitosis), within the statistical significance between the 1st and the 7th day and the 7th and the 14th day of the surveillance. The pain severity was decreased from 5.69±0.39 points to 2.69±0.34 points on the 7th day and to 0.08±0.05 point on the 14th day from the start of the therapy, itchy throat (foreign body sensation) was relived from 6.88±0.23 points to 3.54±0.29 points on the 7th day and to 0.69±0.12 point on the 14th day of the therapy. In addition, there was a decline in the severity of halitosis from 6.16±0.31 points to 2.47±0.44 points on the 7th day and to 0.68±0.29 point on the 14th day of the therapy.

CONCLUSION: Topical application of a drug containing a probiotic Streptococcus salivarius K12, in case of chronic inflammatory diseases of the oropharynx of various etiologies, showed satisfactory effectiveness in the regression of the main symptoms of the exacerbation of the inflammatory process, expressed through pain in the throat when swallowing, halitosis and the foreign body sensation in the oropharynx.

PMID:34964328 | DOI:10.17116/otorino20218606141

Dermatol Ther. 2021 Dec 28:e15294. doi: 10.1111/dth.15294. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment of vitiligo represents a highly therapeutic challenge in spite of the continuous development of new modalities. Combination therapies of vitiligo can help improve treatment response, and reduce recurrence potential.

OBJECTIVE: To compare the efficacy and adverse effects of microneedling combined with 5-fluorouracil, pimecrolimus, and TCA in the treatment of localized, stable vitiligo.

METHODS: The study included 75 patients with non-segmental, stable vitiligo who were randomly assigned to three equal groups: group 1 received a combination of microneedling and 5-FU, group 2 received microneedling and pimecrolimus, and group 3 received microneedling and TCA. The procedure was done every 2 weeks for a maximum of 6 sessions.

RESULTS: Combined microneedling and TCA was associated with the highest degree of repigmentation followed by combined microneedling + 5-fluorouracil, and lastly combined microneedling + pimecrolimus. The difference between the three groups was statistically significant in favor of the combined microneedling and TCA. Pain, erythema, post-inflammatory hyperpigmentation, infection, and scarring were variably reported adverse effects in the 3 groups.

CONCLUSION: Combination therapy seems to be a promising modality for the treatment of vitiligo. Combined microneedling and TCA is superior to combined microneedling with either 5-fluorouracil or pimecrolimus.

PMID:34964230 | DOI:10.1111/dth.15294

Orthod Craniofac Res. 2021 Dec 29. doi: 10.1111/ocr.12562. Online ahead of print.

ABSTRACT

OBJECTIVE: This retrospective study aimed to evaluate inferior scleral exposure changes in Class III patients that underwent orthognathic surgery with Le Fort I osteotomy with and without vertical displacement.

MATERIALS AND METHODS: Preoperative and 6-months postoperative cephalograms and stereophotogrammetric images of 45 subjects (mean age:21.66±2.97 years) that underwent orthognathic surgery for Class III correction were retrieved. Subjects were divided into 3 groups: maxillary advancement-only (AO); maxillary advancement+impaction (AI), maxillary advancement+downfracture (AD). Exclusion criteria were mandibular-only surgery, occlusal canting, facial asymmetry, orbital surgery, and craniofacial syndrome. One investigator measured inferior scleral exposure on both sides using following landmarks: upper eyelid margin (A), inferior limbus (B) and lower eyelid margin (C). Distance between A and C was recorded as overall eye height (E), distance between B and C was recorded as inferior sclera exposure (S). S:E ratio in percentage was calculated to standardize sclera exposure relative to overall eye height. Wilcoxon signed-rank and Kruskal Wallis tests were used for statistical analysis (p<0.05).

RESULTS: Mean value of maxillary movements were: 4.21±1.82mm advancement in AO; 5.08±2.18mm advancement and 2.33±0.99mm impaction in AI; 3.95±1.45mm advancement and 3.1±0.71mm downfracture in AD. Change in reduction of scleral exposure was significant in all groups (p<0.05). AI group bilaterally and AO group right side had highest differences (-4.96±4.86, -6.09±4.21, -4.99±3.23, respectively). There was no significant difference between groups in S:E ratio changes (p>0.05).

CONCLUSION: Intergroup comparisons showed no statistically significant difference, revealing similar reduction in all three groups despite the differences in the vertical movement variable.

PMID:34964257 | DOI:10.1111/ocr.12562

J Cosmet Dermatol. 2021 Dec 28. doi: 10.1111/jocd.14688. Online ahead of print.

ABSTRACT

BACKGROUND: Candida antigen injection is one of the most widely used intralesional immunotherapy in the treatment of warts. It acts through the induction of systemic immune response. The pattern of cytokines production may play an integral role in its mechanism of action.

AIM: To investigate the possible relation between serum levels of IL17 and MIF, and the clinical response to intralesional Candida antigen in multiple common warts.

METHODS: A total of 90 patients with multiple common warts were divided into 2 groups. Sixty patients received intralesional Candida antigen injection into the largest wart, controlled against thirty patients who had intralesional saline, as placebo. The injection was done at a 2-week interval for 5 doses. Blood samples were obtained from both groups, and serum levels of IL17A and MIF were estimated at baseline and 2 weeks after the last session using ELISA kits.

RESULTS: Complete clearance of warts was statistically higher in the Candida antigen group (40% of the patients) compared to the saline group (p < 0.05). The serum levels of IL17 had significantly declined from baseline, while the level of MIF had risen after intralesional Candida antigen injection, but not in the saline group. At a cutoff level of 316 pg/ml, IL17 had a sensitivity of 83.3% to predict therapeutic response.

CONCLUSION: IL17A and MIF may have possible roles in the mechanism of action of Candida antigen in the treatment of common warts. At a certain level, serum IL17A may be a potential predictor of response to treatment.

PMID:34964227 | DOI:10.1111/jocd.14688

Paediatr Anaesth. 2021 Dec 29. doi: 10.1111/pan.14390. Online ahead of print.

ABSTRACT

BACKGROUND: Despite being a standard of care for children undergoing stressful procedures, little data exist on parental perception of pediatric sedation.

AIMS: This study aimed to investigate recovery characteristics and parental satisfaction for pediatric sedations performed with four widely used sedative regimens.

METHODS: A prospective observational study was conducted at the Institute for Maternal and Child Health of Trieste, Italy, enrolling children undergoing procedural sedation with one of the following pharmacological regimens: propofol, propofol + midazolam, ketamine + propofol, and dexmedetomidine + midazolam. A questionnaire was used to assess the occurrence of symptoms upon recovery from sedation and the following day, and the caregivers’ satisfaction for both the recovery pattern and the overall sedation experience, according to a Numerical Rating Scale (0-10). Answers were collected through a telephone survey. The primary outcome was the difference in the quality of the recovery as perceived by caregivers; the secondary and tertiary outcomes were the perceived quality of the overall sedation experience and the frequency of sedation-related adverse events, respectively.

RESULTS: Data from 655 patients, 149 receiving propofol, 245 propofol + midazolam, 134 ketamine + propofol, and 127 dexmedetomidine + midazolam, were analyzed. The level of parents’ satisfaction for both the recovery and the sedation experience was overall high and increased with the patients’ age in all the pharmacological groups (Spearman’s rank correlation, Rho 0.083, p=0.033, and Rho 0.087, p=0.026, respectively), with no statistically significant differences between groups when adjusting for age. The occurrence of irritability, prolonged sleepiness, hyperactivity, unsteadiness, hallucinations, emesis, and respiratory distress at any moment, negatively affected parental satisfaction.

CONCLUSIONS: In this study, caregivers’ satisfaction with pediatric sedation was high, regardless of the regimen used. Lower parental satisfaction was associated with younger age, irritability after sedation, prolonged sleepiness, hyperactivity, unsteadiness, hallucinations, emesis, and respiratory distress.

PMID:34964198 | DOI:10.1111/pan.14390