Nevin Manimala

Front Vet Sci. 2024 Dec 18;11:1506106. doi: 10.3389/fvets.2024.1506106. eCollection 2024.

ABSTRACT

BACKGROUND: Canine gastroenteritis (CGE) is a common cause for seeking veterinary care in companion animal medicine and an area where antibiotics have been reported to be widely used. Therefore, creating relevant benchmarks for antibiotic use in CGE is important when implementing and analyzing antibiotic stewardship interventions. The aim of this paper was to describe the level and temporal trend of systemic antibiotic use for CGE in Sweden between 2020 and 2023.

MATERIALS AND METHODS: This was an observational multicenter cohort study. Retrospective data from 93,641 CGE consultations was extracted from the electronic health record and analyzed. All CGE consultations were included irrespective of age, breed, severity of disease and level of care. To evaluate the data, 100 medical records of CGE consultations were also manually reviewed using a predefined study protocol.

RESULTS: The overall level of systemic antibiotic use in Swedish dogs diagnosed with gastroenteritis was 5.7% during the study period, with aminopenicillins being the most abundantly used antibiotics (60.2%). The yearly level of antibiotic use in CGE declined from 8.1% in 2020 to 3.9% in 2023, with a statistically significant annual percentage change (APC) of -21.3% (95% CI, -22.8 to -19.7). Concurrently, the annual all-cause mortality decreased for all CGE consultations. Higher levels of antibiotic use were seen in hospitalized CGE (21.7% compared to 2.1% for non-hospitalized CGE, OR 13.1, 95% CI: 12.3-14.0, p < 0.001) and hemorrhagic diarrhetic CGE (21.0% compared to 5.5% for non-hemorrhagic diarrhetic CGE, OR 4.6, 95% CI: 4.2-4.9, p < 0.001).

CONCLUSION: This study revealed a low level and a significantly declining trend of antibiotic use in canine gastroenteritis in Sweden, implicating a high level of awareness and compliance to antibiotic guidelines among Swedish veterinarians. During the same period, the all-cause mortality rates decreased significantly for all CGE consultations, implicating that this level of antibiotic use do not compromise patient safety. Benefiting from automatic surveillance, we hereby provide important benchmarks which should encourage more prudent use of antibiotics in CGE internationally.

PMID:39744720 | PMC:PMC11688813 | DOI:10.3389/fvets.2024.1506106

Front Physiol. 2024 Dec 18;15:1498590. doi: 10.3389/fphys.2024.1498590. eCollection 2024.

ABSTRACT

OBJECTIVE: The primary aim of this study was to compare the immediate effect of contrast compression therapy with the use of Game Ready (GRT) on hyperaemic reactions in the upper limb on the application and contralateral sides, specifically in the context of mixed martial arts (MMA) athletes.

DESIGN: In this experimental, single-blind, randomized crossover study, we recruited 30 male volunteers training in MMA (mean age: 28.33 ± 3.79 years, BMI: 25.25 ± 3.06, training experience: 9.93 ± 3.83). They were randomly assigned to the experimental (n = 15) or control (sham) group (n = 15). The experimental group underwent a 10-minute Game Ready Therapy (GRT) session, while the control group GRS underwent a sham therapy session. After a 2-week break, a cross-over change of therapy in the groups was performed, ensuring a comprehensive evaluation of the contrast compression therapy’s perfusion effects in 30 participants. Main outcome measures: Hyperemic reaction was measured: rest flow (RF – [non-referent unit]); therapeutic flow (TF- [min]), i.e., the average flow recorded during GR or sham therapy: time of recovery (TR – [min]), i.e., the time for perfusion to return to the resting value after the intervention. Measurements were performed on the ipsilateral and contralateral sides.

RESULTS: The mean perfusion during therapy was significantly higher in GRT compared to GRS (24.70 ± 1.45 vs. 12.60 ± 1.37; p < 0.001; ES = 5.7 [large]; △ = 12.10 > MDC). The time from cessation of contrast therapy to the return of blood flow to resting values showed significantly higher values in GRT compared to GRS (3.07 ± 0.45 vs. 16.80 ± 0.91; p < 0.001; ES = 16.27 [large]). No statistically significant difference was noted between the mean resting perfusion value (RF) and the mean perfusion value during therapy (TF) in the contralateral limb (7.74 ± 0.89 vs. 7.66 ± 0.89; p = 0.284; ES = 0.20 [negligible]; △ = 0.09 < MDC.

CONCLUSION: This study suggests that compression contrast therapy on the ipsilateral side positively affects the intensification of the hyperaemic reaction. However, no statistically significant hyperaemic responses were observed on the contralateral side.

PMID:39744701 | PMC:PMC11688390 | DOI:10.3389/fphys.2024.1498590

Infect Dis Clin Microbiol. 2024 Dec 19;6(4):282-290. doi: 10.36519/idcm.2024.370. eCollection 2024 Dec.

ABSTRACT

OBJECTIVE: The impact of cytomegalovirus (CMV) on inflammatory bowel disease (IBD) flares remains a matter of debate. This study aimed to evaluate patients with CMV infection who presented with IBD exacerbation in terms of diagnosis and treatment and investigate the importance of CMV DNA levels in colitis development.

MATERIALS AND METHODS: Patients who were followed up with IBD and examined with clinical suspicion of CMV colitis at a university hospital between January 2016 and December 2021 were retrospectively scanned. This study included all patients who underwent colonoscopic biopsy with a preliminary diagnosis of CMV colitis and compared those with colitis detected histopathologically with those without colitis.

RESULTS: Thirty-nine patients with IBD were included in the study. No statistically significant difference was observed regarding the two groups’ demographic data, clinical findings, and outcomes. The median serum CMV DNA level in patients with CMV colitis was 104 copies/mL, which was lower than in patients without colitis (1216 copies/mL) (p=0.008). Among patients with CMV colitis, CMV DNA levels were negative or low in 16 (61.5%).

CONCLUSION: In patients with IBD, CMV colitis may not always be accompanied by CMV viremia. Therefore, negative or low serum CMV DNA levels are not sufficient to exclude CMV colitis. In case of high clinical suspicion, further examinations should be planned.

PMID:39744664 | PMC:PMC11687240 | DOI:10.36519/idcm.2024.370

Infect Dis Clin Microbiol. 2024 Dec 19;6(4):268-275. doi: 10.36519/idcm.2024.380. eCollection 2024 Dec.

ABSTRACT

OBJECTIVE: Clostridioides difficile is one of the leading causes of antibiotic-associated diarrhea. Recurrent C. difficile infection (rCDI) is significant because of prolonged hospital stays, morbidity, and additional costs. Our study aimed to examine the characteristics of C. difficile infections and investigate factors associated with recurrence.

MATERIALS AND METHODS: Adult patients with signs of acute gastroenteritis and gastrointestinal polymerase chain reaction (GI PCR) panel tests performed on stool material, and C. difficile was detected as the causative agent were included in the study. rCDI was defined as the recurrence of symptoms and re-detection of C. difficile in the GI PCR panel within eight weeks after the onset of the initial episode in patients whose symptoms improved with appropriate antimicrobial treatment. Variables in patients with and without recurrence were compared, and risk factors for recurrence were investigated.

RESULTS: A total of 59 patients with C. difficile infection (CDI) were diagnosed. The median age of patients was 75, and 57.6% were male. Forty-nine patients (83.1%) were diagnosed with the infection while hospitalized. The most commonly used treatment was metronidazole. rCDI was identified in eight patients. The presence of malignancy, hematological malignancy, development of CDI episode in the intensive care unit, and continuation of antibiotic treatment for non-C. difficile etiology after CDI diagnosis were statistically more common in the recurrence group (p<0.05). Mortality during hospitalization occurred in a total of 11 patients (18.6%).

CONCLUSION: CDI is important because of its frequent occurrence and potential for fatal outcomes. It is crucial to identify patients at risk for recurrence. In our study, the development of CDI attacks in the intensive care unit, malignancy, and continuation of antibiotic treatment for non-CDI infection after CDI diagnosis were found to be associated with recurrence. Evaluating these parameters in patient follow-up will contribute to prognostic assessment.

PMID:39744662 | PMC:PMC11687231 | DOI:10.36519/idcm.2024.380

Infect Dis Clin Microbiol. 2024 Dec 19;6(4):258-267. doi: 10.36519/idcm.2024.367. eCollection 2024 Dec.

ABSTRACT

OBJECTIVE: Cytokines and chemokines are clinically relevant for severity prediction and treatment of COVID-19 caused by SARS-CoV-2. We aimed to demonstrate the potential cytokines for severity prediction in the five days after symptom onset and describe the importance of serum cytokine levels for patients with different disease severity.

MATERIALS AND METHODS: Hospitalized COVID-19 patients and healthy control participants were recruited, and serial sera were collected from COVID-19 patients. Thirteen cytokines, including interleukin (IL) 1β, interferon (IFN) α2, IFN- γ, tumor necrosis factor (TNF) α, monocyte chemoattractant protein (MCP-1/CCL2), IL-6, IL-8 (CXCL8), IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33, were studied by bead-based multiplex assay by flow cytometry. Data regarding routine laboratory test results (leucocyte count, neutrophil count, lymphocyte count, platelet count, hemoglobin, liver transaminases, C-reactive protein [CRP], procalcitonin, and creatinine) were collected.

RESULTS: We demonstrated that COVID-19 patients had elevated serum levels of IFN-α2, TNF-α, MCP-1/CCL2, IL-6, IL-8, IL-18, IL-33 compared to healthy participants. Elevated levels of CRP and decreased lymphocyte count were observed in the critical disease group. Longitudinal analysis revealed a statistically significant increase in IL-6, IL-18, and MCP-1 serum levels of critical patients compared to healthy controls.

CONCLUSION: MCP-1, IL-6, and IL-18 were found to be the best predictors of critical COVID-19 disease, and MCP-1 has the highest level of predictive performance.

PMID:39744658 | PMC:PMC11687237 | DOI:10.36519/idcm.2024.367

Curr J Neurol. 2024 Apr 3;23(2):89-95. doi: 10.18502/cjn.v23i2.16837.

ABSTRACT

Background: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder that is diagnosed using clinical signs and symptoms and confirmed via nerve conduction studies (NCSs). While NCS is a semi-invasive procedure, magnetic resonance imaging (MRI) is a non-invasive diagnostic tool that detects macroscopic nerve abnormalities and evaluates a patient’s surgical or medication treatment options. This study assessed magnetic resonance neurography (MRN)’s diagnostic and grading value by comparing it to electrodiagnostic studies in patients with CTS and healthy individuals. Methods: This was a cross-sectional study on 27 wrists with CTS and 27 healthy wrists. After history taking and physical examination, we employed an NCS to confirm and determine the severity of CTS, then MRN and diffusion tensor imaging (DTI) were used to calculate apparent diffusion coefficient (ADC), fractional anisotropy (FA), and cross-sectional area (CSA). Results: 18 patients with CTS (27 median nerves) and 15 healthy controls (27 median nerves) were evaluated. The mean FA in the CTS group was significantly lower (0.38 ± 0.05 vs. 0.45 ± 0.06, P < 0.001). The mean CSA and ADC were higher in patients with CTS but not statistically significant. FA’s diagnostic cut-off was 0.42, with a sensitivity of 70.4% and a specificity of 63%. Conclusion: MRN with DTI can be an effective and non-invasive diagnostic technique for the detection of CTS. The FA measure demonstrated adequate sensitivity and specificity for differentiating patients with CTS from healthy individuals.

PMID:39744656 | PMC:PMC11685557 | DOI:10.18502/cjn.v23i2.16837

Curr J Neurol. 2024 Apr 3;23(2):124-130. doi: 10.18502/cjn.v23i2.16841.

ABSTRACT

Background: Stress has been known as a risk factor for the onset and modification of autoimmune disorders such as myasthenia gravis (MG). However, the patients can control their stress and improve their quality of life (QOL) using some factors such as psychological and social support. Psychological capital and social support play a key role in decreasing stress and improving QOL in the patients with MG. Therefore, the present study aimed to assess the mediator role of the psychological capital and social support in perceived stress and QOL of the patients with MG. Methods: In the present cross-sectional study, 203 patients with MG, including 138 women and 65 men, were selected from Iran Myasthenia Gravis Association and Shariati Hospital, Tehran City, Iran, using available sampling. The selected patients completed the Myasthenia Gravis Quality of Life questionnaire (MG-QOL), Luthans Psychological Capital Questionnaire (PCQ), Multidimensional Scale of Perceived Social Support (MSPSS), and Cohen Perceived Stress Scale (PSS-14). To assess the mediator role of the psychological capital and the perceived social support in the relationship with the perceived stress and QOL of the patients with MG, structural equation modeling (SEM) was used. Results: There was a significant negative relationship between the perceived stress and the variables of psychological capital (including hope, resilience, optimism, and self-efficacy), perceived social support dimensions (including support from important people, support from family, and support from friends), and QOL dimensions (including social activity and mental health) (P < 0.01). The results also showed that the perceived social support dimensions (including support from important people, support from family, and support from friends) and the variables of psychological capital (including hope, resilience, optimism, and self-efficacy) had a significant positive relationship with the QOL in patients with MG (P < 0.01). The indirect effect of perceived stress on the QOL through social support and psychological capital was 0.16 and 0.15, respectively, which was statistically significant (P < 0.05). Conclusion: The present study results show that a part of the shared variance between the conceptual circles of the perceived stress and QOL in patients with MG results from variability in the psychological capital and social support.

PMID:39744654 | PMC:PMC11685554 | DOI:10.18502/cjn.v23i2.16841

Obes Surg. 2025 Jan 2. doi: 10.1007/s11695-024-07652-0. Online ahead of print.

ABSTRACT

Metabolic and bariatric surgery (MBS) has been associated with weight reduction and obesity complications improvement. However, there is no clear evidence of the extent and consistency of the effects of this procedure on rheumatic diseases. This study aims to conduct a meta-analysis to address the impact of MBS on rheumatic diseases. We searched PubMed, Cochrane, and Embase for studies reporting the prevalence of rheumatic diseases, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the medication use after MBS. We conducted a random-effects meta-analysis using odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI). P-values < 0.05 were considered statistically significant. We included 28 studies comprising 43,421 patients, with 13,347 patients with rheumatic diseases. The prevalence of osteoarthritis (OA), rheumatoid arthritis, and psoriatic arthritis was significantly reduced after MBS (OR 0.20; 95% CI 0.12 to 0.33; P = 0.01). The WOMAC index for patients with OA had a statistically significant overall reduction after MBS at 6 months (MD – 20.60 points; 95% CI – 28.73 to – 12.47; P < 0.01) and at 12 months (MD – 15.88 points; 95% CI – 19.09 to – 12.66; P < 0.01). Medication use significantly decreased after MBS, both at the follow-up beyond 2 years (OR 0.49; 95% CI 0.35 to 0.69; P < 0.01) and up to 2 years (OR 0.32; 95% CI 0.15 to 0.69; P < 0.01). In this meta-analysis, we found a significant decrease in the prevalence of rheumatic diseases, improvements in the WOMAC index, and reduced medication use among patients undergoing MBS.

PMID:39743656 | DOI:10.1007/s11695-024-07652-0

Odontology. 2025 Jan 2. doi: 10.1007/s10266-024-01047-4. Online ahead of print.

ABSTRACT

This in vitro research assessed the influence of the instrument kinematics (rotary and reciprocating) and the apical preparation limit on the root canal disinfection and apical bacterial extrusion. After 21 days of Enterococcus faecalis biofilm formation in 72 mesial root canals of mandibular molars, the root canals were distributed into 2 groups (n = 36) according to the systems used for preparation: ProDesign S and Reciproc. The groups were redistributed according to the limit of apical preparation (n = 11): (a) 1 mm up to the apical foramen (TL-1); (b) at the apical foramen (TL = 0); (c) 1 mm beyond the apical foramen (TL + 1). After preparation, the remaining biofilm adhered to the dentin walls at the apical third was removed by sonication. The aliquots of bacterial suspension released, and the irrigating solution leaked through the apical foramen during preparation were plated for colony-forming units (CFUs) counting. Data were statistically assessed by the Kruskal-Wallis and Dunn tests (α = 5%). Both systems promoted decontamination of the apical third, regardless the limit of apical preparation (p > 0.05). A larger quantity of bacteria was extruded from the root canals prepared 1 mm beyond the apical foramen, regardless the instrumentation kinematics (p < 0.05). The apical third of the root canal was efficiently decontaminated after preparation, regardless the instrumentation kinematics and the apical limit. However, a larger quantity of bacterial extrusion was observed when preparation was performed beyond the anatomical root canal limits.

PMID:39743655 | DOI:10.1007/s10266-024-01047-4

Clin Oral Investig. 2025 Jan 2;29(1):39. doi: 10.1007/s00784-024-06124-0.

ABSTRACT

OBJECTIVES: The study aimed to assess the percent correct shade identification of four intraoral scanners (IOS) and a spectrophotometer, focusing on how reliably each device selects the correct tooth shade compared to a visual observer’s selection. The research question addresses how much clinicians can trust the device-selected shade without visual verification.

MATERIALS AND METHODS: Sixteen participants with natural, unrestored teeth were included. The teeth evaluated were tooth 21 (left maxillary central incisor), tooth 23 (left maxillary canine), and tooth 26 (first left maxillary molar). Tooth color was measured using four IOS devices and the Vita Easyshade V in three regions: incisal, middle, and cervical. The nearest 3D Master shade selected by each device was compared to the visual observer’s selection. The percent exact match, acceptable match (> 1.2, ≤ 2.7 ∆E_ab), and mismatch type A (< 2.7, ≤ 5.4 ∆E_ab) were calculated. Statistical analysis was performed using a chi-square test with a 95% confidence level.

RESULTS: The overall clinical pass rate was highest for Carestream (78.2%), followed by Easyshade (63.5%), Primescan (51.2%), Trios (39.5%), and Medit (31.3%). Carestream also recorded the highest rate of mismatch type A (47.7%). Significant differences between devices were observed for all categories (p < 0.05).

CONCLUSIONS: Carestream demonstrated the highest overall clinical pass rate, while Medit exhibited the lowest. The study highlights the variability between devices in shade matching performance.

CLINICAL RELEVANCE: This study highlights the importance of considering device performance when relying on IOS or spectrophotometers for shade selection without visual assessment, as the reliability can vary significantly across devices.

PMID:39743647 | DOI:10.1007/s00784-024-06124-0