Nevin Manimala

BMC Public Health. 2023 Aug 25;23(1):1627. doi: 10.1186/s12889-023-16528-4.

ABSTRACT

BACKGROUND: Current global trend of insufficient physical activity (PA) among children and adolescents highlights the necessity of finding effective ways to promote PA in childhood. Self-determination theory (SDT) has demonstrated efficacy as a conceptual framework for developing interventions aimed at promoting diverse health behaviours. Parents have potential to influence children’s health behaviours to a great extent, which could be enhanced from an online, self-paced training to gain knowledge on how to support children’s intrinsic motivation towards particular health behaviour. In this pilot study, we developed and tested an online SDT-informed need-supportive training for parents, enabling them to interact with their children in a way to support their intrinsic motivation towards leisure-time physical activity.

METHODS: Sixty eight students (M_age = 12.5 ± 0.72) and one parent for each child were randomly assigned to the 6-week intervention condition or control condition. Students completed psychological measures (i.e., perceptions of parents’ need-supportive behaviours, basic psychological need satisfaction and frustration, autonomous and controlled forms of motivation, as well as social cognition beliefs towards leisure-time PA) and self-reported PA pre-intervention, post-intervention, and one-month after the intervention. Repeated measures ANOVAs were conducted to test the effects of the intervention condition and time.

RESULTS: While a statistically significant intervention effect on children’s leisure-time PA was not found, students in the intervention group reported higher, albeit marginal, perceptions of intrinsic motivation (F(2, 84) = 3.095, p = 0.050) and lower perceptions of introjected regulation (F(2, 88) = 3.107, p = 0.050) and autonomy frustration (F(2, 84) = 2.987, p = 0.056) at follow-up. Contrary to expectations, children in the control group demonstrated higher perceptions of intention (F(2, 84) = 4.838, p = 0.010) and effort (F(2, 80) = 3.473, p = 0.036) towards leisure-time physical activity at follow-up. No significant changes were found in perceptions of need-supportive behaviour from parents, attitude, and perceived behavioural control.

CONCLUSIONS: Our pilot study highlights the importance of parental training and the potential for SDT-informed interventions to support children’s intrinsic motivation towards physical activity. Further research is needed to test the intervention in other domains and combine interventions in several domains to have the highest impact.

TRIAL REGISTRATION: This pilot study is part of preparation for the main study, prospectively registered in ISRCTN registry as ISRCTN78373974 (15.12.2022). The current stage of the main study is ‘recruiting’.

PMID:37626288 | DOI:10.1186/s12889-023-16528-4

BMC Prim Care. 2023 Aug 25;24(1):164. doi: 10.1186/s12875-023-02120-7.

ABSTRACT

BACKGROUND: Arterial hypertension is a high prevalence disease that increase healthcare costs and affects physical activity level. This study aimed to analyse the interrelationship between arterial hypertension, health service costs, therapeutic treatment, and physical activity in patients with cardiovascular diseases.

METHOD: Cross-sectional study that evaluated 306 patients from a hospital in Presidente Prudente-Brazil. Based on their medical diagnosis, they were classified into multiple groups to access primary care and hospital-related costs variations. Then, using data from medical records and face to face interviews, they were examined on their treatment adherence and physical activity practice. Healthcare costs were accessed using medical records. Finally, the generalised linear model was used to analyse the interrelationship between treatment adherence, physical activity, health care costs and arterial hypertension. The data were analysed with Stata/MP4 16, and a p-value of less than 5% was used to determine statistical significance.

RESULTS: The group that adhered to the arterial hypertension treatments but were physically inactive presented higher costs with consultation (US$=24.1, 95%CI = 1.90;46,3)​​ medication (US$=56.60, 95%CI = 1.65; 111.5) and total primary health care costs (US$=71.60, 95%CI = 19.2; 123.9) even after adjusting for confounding variables, meanwhile those participants that adhered to the treatments and were physical active did not present difference in healthcare cost when compared to normotensive and physical active participants.

CONCLUSION: To be adherent to hypertension treatment were related to higher health care costs meanwhile been physical activity were related to lower health care costs and the combination of both showed that be adherent and physical activity represent the same cost with health than those normotensive and active emphasizing the importance of adherence and physical activity in the hypertensive treatment.

PMID:37626283 | DOI:10.1186/s12875-023-02120-7

Clin Oral Investig. 2023 Aug 26. doi: 10.1007/s00784-023-05219-4. Online ahead of print.

ABSTRACT

PURPOSE: To compare the failure rates and the prevalence of technical complications between full-coverage tooth-supported monolithic zirconia (MZ) and porcelain-veneered zirconia (PVZ) fixed dental prosthesis, based on a systematic literature review.

METHODS: An electronic search was performed in three databases, supplemented by hand searching. Several statistical methods were used.

RESULTS: Seventy-four publications reported 6370 restorations (4264 PVZ; 2106 MZ; 8200 abutment teeth; 3549 patients), followed up until 152 months. A total of 216 prostheses failed, and survival was statistically significant different between groups. PVZ had higher occurrence of complications than MZ; the difference was especially greater for either minor or major chipping. The difference in prevalence of either minor or major chipping was statistically significant for PVZ prostheses between cementation with glass ionomer and adhesive resin cement (higher), adhesive resin and resin-modified glass ionomer cement (RMGIC, higher), and between RMGIC (higher) and glass ionomer cement. For MZ the difference was significant only for minor chipping between RMGIC (higher) and adhesive resin cement. Abutment teeth to PVZ prostheses more often lost vitality. Decementation was not observed with RMGIC. Air abrasion did not seem to clinically decrease the decementation risk. The 5-year difference in the occurrence of minor or major chipping between MZ and PVZ prostheses was statistically significant, but nor for catastrophic fracture.

CONCLUSION: Tooth-supported PVZ prostheses present higher failure and complication rates than MZ prosthesis. The difference in complications is striking when it comes to chipping.

CLINICAL RELEVANCE: Awareness of the outcome differences between different types of zirconia prostheses is important for clinical practice.

PMID:37626273 | DOI:10.1007/s00784-023-05219-4

Bone Marrow Transplant. 2023 Aug 25. doi: 10.1038/s41409-023-02039-8. Online ahead of print.

ABSTRACT

Hematopoietic cell transplant (HCT) recipients are at risk for thromboembolic and bleeding complications. There is limited evidence regarding the optimal approach to managing venous thromboembolism (VTE) prophylaxis in hospitalized patients undergoing HCT. In this retrospective cohort study, we evaluated the incidence of bleeding and VTE events in hospitalized HCT patients who received VTE prophylaxis per our institution’s VTE Prophylaxis Protocol (VPP), with either enoxaparin 40 mg subcutaneously daily or heparin 5 000 units subcutaneously twice daily, compared to historical controls who did not receive VTE prophylaxis. The primary outcome was a composite of major bleeding events, clinically relevant non-major bleeding (CRNMB), and minor bleeding. The secondary outcome was a composite of VTE events. A total of 614 patients were evaluated, including 278 prior to and 336 after implementation of VPP. VTE prophylaxis resulted in no difference in bleeding events (15.1% in the pre-VPP group vs. 14.6% in the post-VPP group, p = 0.86) or composite of major and CRNMB events (0.72% vs. 0.30%, p = 0.59). There was a trend toward lower incidence of VTE events in the post-VPP group which did not reach statistical significance (8.6% vs. 6.0%, p = 0.20). We conclude that VTE prophylaxis does not pose additional bleeding risk in HCT patients.

PMID:37626267 | DOI:10.1038/s41409-023-02039-8

Obes Surg. 2023 Aug 26. doi: 10.1007/s11695-023-06789-8. Online ahead of print.

ABSTRACT

PURPOSE: For children and adolescents with severe obesity, metabolic and bariatric surgery including laparoscopic sleeve gastrectomy (LSG) is increasingly used to facilitate weight loss and reduce associated medical problems. Outcomes of LSG are understudied among patients under age 15 years. We sought to examine surgical complications and weight loss outcomes among children and adolescents who underwent LSG.

MATERIALS AND METHODS: This is a single-center retrospective cohort analysis at a high-volume metropolitan children’s hospital in the northeast USA between 2011 and 2021. Weight loss was assessed at routine follow-up appointments for up to 36 months postoperatively.

RESULTS: There were 12 patients under 13 years of age (< 13), 45 from 13 up to 15 years of age (13-14), and 57 patients aged 15 years or over (≥ 15). Among all patients, 70% were female, 41% were Hispanic, and 18% were non-Hispanic Black. There were no operative mortalities. Two patients had surgical complications requiring reoperation. Follow-up beyond 6 months occurred for 62% of patients. Weight loss was evident for each group at all time points, and there was no statistically significant difference among groups at any time point. BMI Z-score reduction at 6 months was 1.53 for the < 13 group, 0.89 for the 13-14 group, and 0.86 for the ≥ 15 group and at 36 months was 1.79, 1.50, and 1.16, respectively.

CONCLUSION: These results support that LSG is a safe and effective method of achieving weight loss for young adolescents with severe obesity. Strategies to promote postoperative follow-up are needed.

PMID:37626262 | DOI:10.1007/s11695-023-06789-8

Heart Vessels. 2023 Aug 26. doi: 10.1007/s00380-023-02301-5. Online ahead of print.

ABSTRACT

Recently, instantaneous wave-free ratio (iFR) has emerged as an alternative to the fractional flow reserve (FFR) for intracoronary physiological assessment. Although all diastolic resting indices are reportedly identical to the iFR, limited data exist on diastolic pressure ratio (dPR) measured using a microcatheter (dPR_micro). This study aimed to evaluate the diagnostic accuracy of dPR_micro compared to FFR measured using a microcatheter (FFR_micro) in real-world practice for intracoronary physiological assessment. This was a single-center, retrospective, observational study. We identified 103 consecutive suspected angina pectoris patients (107 lesions) who underwent dPR_micro and FFR_micro measurement using the Navvus® catheter at Takasaki Heart Hospital from March 2019 to June 2019. A total of 103 lesions in 103 patients were finally included in the study. The mean FFR_micro and dPR_micro values were 0.80 and 0.88, respectively. With an FFR_micro ≤ 0.80, the dPR_micro showed a diagnostic accuracy of 79.6%, sensitivity of 74.6%, specificity of 87.5%, positive predictive value of 90.4%, and negative predictive value of 68.6%. The area under the receiver operating characteristic (ROC) curve was 0.894 (95% confidence interval, 0.833-0.956), and the optimal cut-off value for dPR_micro derived from the ROC analysis was 0.90. dPR_micro and FFR_micro values were discordant in 21/103 cases (20.4%). As a multivariable logistic regression analysis was performed, the male sex (vs. female) had a statistically significant association with a dPR_micro-FFR_micro discordance (OR 4.91; 95% CI, 1.04-23.0; P = 0.044). No other factors were found to be significantly associated with the discordance. In conclusion, dPR_micro measured using a microcatheter had good diagnostic accuracy and correlation with FFR_micro, hence, it can be useful for making revascularization decisions. However, re-studies in larger populations will be needed to better understand the properties of diastolic resting index measured using a microcatheter in clinical settings.

PMID:37626238 | DOI:10.1007/s00380-023-02301-5

Surg Endosc. 2023 Aug 25. doi: 10.1007/s00464-023-10347-9. Online ahead of print.

ABSTRACT

BACKGROUND: Cap-assisted endoscopic mucosal resection (EMR-c) has emerged as a potential alternative to standard piecemeal wide-field EMR (WF-EMR) for the resection of laterally spreading tumors (LSTs). However, clear indications for this technique are still lacking. Our objective was to investigate the performance of salvage EMR-c after WF-EMR failure in the resection of large colorectal LSTs.

METHODS: The data of consecutive patients undergoing WF-EMR for large colorectal LSTs (2015-2021) were analyzed in this single-center, retrospective, observational study. In the event of a WF-EMR failure, the procedure was switched to EMR-c in the same session. The efficacy of the two techniques was evaluated in terms of complete endoscopic resection, R0 resection, and recurrence rate. Safety was also assessed.

RESULTS: Overall, the data from 81 WF-EMRs were collected. Eighteen cases of WF-EMR failure were switched to EMR-c in the same session and complete endoscopic resection was achieved in 17/18 patients (94.4%). No statistically significant difference was observed between WF-EMR and salvage EMR-c in terms of macroscopic radicality (P = 0.40) and R0 resection (P = 0.12). However, recurrence was more common with EMR-c (44.4% vs. 23.5%; P = 0.05), as were adverse events, particularly intraprocedural bleeding (27.8% vs. 7.9%; P = 0.04).

CONCLUSION: EMR-c is an effective salvage technique for challenging colorectal LSTs following WF-EMR failure. Due to the elevated risk of adverse events associated with this procedure, careful patient selection, endoscopic expertise, and close follow-up are strongly recommended.

PMID:37626237 | DOI:10.1007/s00464-023-10347-9

Pediatr Neurol. 2023 Aug 3;148:1-7. doi: 10.1016/j.pediatrneurol.2023.07.023. Online ahead of print.

ABSTRACT

BACKGROUND: One of the most severe perinatal lesions of the central nervous system is intraventricular hemorrhage, which often, especially in prematurely born babies with low gestational age and body weight, is complicated by posthemorrhagic hydrocephalus, which requires good early diagnosis and timely treatment. The purpose of the article is to improve the methods of diagnosis and treatment of posthemorrhagic hydrocephalus in young children.

METHODS: The study was conducted between 2009 and 2018 in the neurosurgical department of the City Children’s Hospital No. 2 in Astana. Three groups of patients from birth to age six months were studied. During the investigation the following research methods were used: clinical and anamnestic, laboratory, instrumental, and methods of mathematical statistics. Statistical analysis was performed using the program Statistica for Windows 13.0 (StatSoft Inc. No. JPZ804I382130ARCN10-J). Patients of the main and control groups underwent various surgical interventions to relieve posthemorrhagic occlusive hydrocephalus.

RESULTS: It was found that the maximum number of complications develop in newborns with low gestational age and low body weight. Repeated lumbar or ventricular punctures in patients with posthemorrhagic hydrocephalus followed by external drainage are characterized by the greatest number of complications, among which infection and catheter occlusion prevail.

CONCLUSIONS: It has been established that the proposed algorithm for the diagnosis and treatment of patients with posthemorrhagic hydrocephalus can significantly reduce the number of complications, shorten the duration of hospital stay, reduce the percentage of long-term complications, and improve the quality of life.

PMID:37625173 | DOI:10.1016/j.pediatrneurol.2023.07.023

J Orthop Sports Phys Ther. 2023 Sep;0(9):1-3. doi: 10.2519/jospt.2023.12209.

ABSTRACT

SYNOPSIS: The Journal of Orthopaedic & Sports Physical Therapy was first published in the summer of 1979 by the Orthopaedic and Sports Sections of the American Physical Therapy Association. The journal’s mission was to publish scientifically rigorous content and promote its application to movement-related health. In 1979, we were focused solely on 1 journal, and the publishing organization shared the journal’s name. In the decades since, our organization has grown such that it now publishes 3 peer-reviewed journals and provides plenty of additional resources to help the musculoskeletal rehabilitation community translate quality research to quality practice. We are pleased to reintroduce ourselves as Movement Science Media. We aspire to deliver your one-stop shop for trustworthy content-helping you stay informed about the latest in musculoskeletal rehabilitation. J Orthop Sports Phys Ther 2023;53(9):1-3. doi:10.2519/jospt.2023.12209.

PMID:37625167 | DOI:10.2519/jospt.2023.12209

Trans R Soc Trop Med Hyg. 2023 Aug 25:trad058. doi: 10.1093/trstmh/trad058. Online ahead of print.

ABSTRACT

BACKGROUND: The study aimed to identify predictors of severe dengue during the 2017 epidemic and to develop and validate a simple predictive score for severity.

METHODS: A retrospective analytical study was conducted using clinical and laboratory data from adult dengue patients with a confirmed microbiological diagnosis. The study included patients who presented to a tertiary care centre in Kerala, India, during the febrile phase (≤4 d) between June 2017 and February 2019. Using appropriate statistical tests, we derived predictors of severe disease and computed a risk score model.

RESULTS: Of the 153 patients (mean age 50±17 y; 64% males), 31 (20%) had severe dengue and 4 (3%) died. Petechial lesions, hypoalbuminemia (<3.5 g/dl), elevated alanine aminotransferase (>40 IU/l) and urea >40 IU/l were significant predictors. Our scoring system (cut-off: 2) showed excellent performance, with an area under the receiver operating characteristics curve of 0.9741, sensitivity of 100%, specificity of 96% and accuracy of 98%. The risk score was secondarily validated on 48 patients hospitalized from March 2019 to June 2019.

CONCLUSION: Our scoring system is easy to implement and will help primary healthcare practitioners in promptly identifying severe dengue cases upon hospital presentation.

PMID:37625166 | DOI:10.1093/trstmh/trad058