Nevin Manimala

Ultrasonography. 2023 Jun 30. doi: 10.14366/usg.23084. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to evaluate pain and image quality associated with the use of two different ultrasound transducers.

METHODS: Fifty healthy male participants aged 30 years or older were prospectively enrolled. All ultrasound procedures were performed using a V8 machine (Samsung Medison, Seoul, Korea) equipped with EA2-11 (conventional) and miniER7 (small-caliber) transrectal transducers, operated by a single genitourinary radiologist. To minimize bias, one group of volunteers underwent ultrasonography with the conventional transducer first, followed by the small transducer. For the remaining participants, the examinations were performed in the opposite order. Ultrasonography, including the measurement of total prostate and transitional zone volumes, was conducted in accordance with standard practice. After testing with both probes, participants were asked to rate their pain on a 10-point numerical rating scale (NRS). A radiologist then evaluated the quality of the images acquired with each probe using a 5-point numeric scale and compared the prostate volume measurements obtained by each method.

RESULTS: The mean NRS scores associated with the conventional and small transducers were 4.7±1.8 and 2.7±1.2, respectively (P<0.05). The mean ultrasound image qualities from the two transducers were statistically similar (4.78 and 4.74, P>0.05). The whole prostate gland volume as measured with the conventional transducer (mean±standard deviation, 24.2±9.1 mL) was greater than the measurement (22.1±8.7 mL) obtained with the small-caliber transducer (P<0.05). However, only two of the 50 whole gland volume measurements differed by more than two standard deviations.

CONCLUSION: The use of a small transrectal probe significantly reduced pain without compromising image quality.

PMID:37586719 | DOI:10.14366/usg.23084

Clin Respir J. 2023 Aug 16. doi: 10.1111/crj.13687. Online ahead of print.

ABSTRACT

BACKGROUND: To help elderly patients with severe or very severe chronic obstructive pulmonary disease (COPD) with pulmonary rehabilitation, we have developed Zheng’s supine rehabilitation exercise (ZSRE). Currently, none of the terminal or critically ill patients with severe exercise limitation can complete the 6-min walking distance (6MWD) and cardiopulmonary exercise testing (CPET).

METHODS: In this study, we discuss the definition of the standardized 3-min simulated pedal motion (3MSPM) test and its operational specifications. Also, we evaluate the minimal clinically important difference (MCID) value of the 3MSPM.

RESULTS: The results showed that the mMRC score of COPD patients with acute exacerbation of dyspnea was progressively reduced from the second day of respiratory rehabilitation, and the difference between the first and seventh days was statistically significant (p < 0.000, χ² = 176.664). 6MWD increased progressively, and the difference between 6MWD on day 1-7 was statistically significant (p = 0.024, F = 2.443). The difference between 3MSPM on day 1-7 was also statistically significant (p < 0.000, F = 4.481). Further analysis showed that 6MWD was negatively correlated with mMRC (p < 0.000, OR = -0.524). 3MSPM was positively correlated with 6MWD (p < 0.000, OR = 0.640) but negatively correlated with mMRC (p < 0.000, OR = -0.413). There is a linear regression relationship between 6MWD and 3MSPM, that is, 6MWD = 14.151 + 0.301 * 3MSPM, adjusted R² = 0.401.

CONCLUSION: Based on the regression equation, 3MSPM can predict 6MWD, and it can be used as a simple exercise endurance method to evaluate patients with safety hazards in underground activities or who cannot complete the 6MWD test. The minimum clinically important difference value is increased by 23.

PMID:37586707 | DOI:10.1111/crj.13687

J Am Vet Med Assoc. 2023 Aug 16:1-7. doi: 10.2460/javma.23.05.0239. Online ahead of print.

ABSTRACT

OBJECTIVE: To report the short-term and long-term outcomes of dogs that underwent the modified closed and traditional closed anal sacculectomy procedures for the treatment of anal sac neoplasia.

ANIMALS: 90 client-owned dogs.

METHODS: The medical records of 2 tertiary referral hospitals were reviewed to identify dogs that underwent anal sacculectomy for treatment of anal sac neoplasia between January 2016 and December 2020. Data collected included signalment and preoperative diagnostic findings. The occurrence of intraoperative and postoperative complications, short-term outcomes, and long-term outcomes were also collected. Descriptive statistics were calculated to summarize dog signalment information, and recurrence, metastasis, and survival proportions were compared between techniques using Fisher exact tests.

RESULTS: 35 and 55 dogs, respectively, underwent the modified or traditional closed anal sacculectomy procedure. Minor postoperative complications that resolved with minimal intervention occurred in 5 of 35 (14.3%) modified approach dogs and 12 of 55 (21.8%) traditional approach dogs. Tumor recurrence was confirmed in 8 of 35 (22.9%) modified and 8 of 55 (26.4%) traditional approach dogs and was suspected in 3 of 35 (8.6%) and 6 of 55 (13.2%; P = .68), respectively. Confirmed metastatic disease was identified in 8 of 35 (22.9%) and 14 of 53 (26.4%) modified and traditional approach dogs, respectively, and was suspected in 4 of 35 (11.4%) and 7 of 53 (13.2%). Sixty-three (70%) dogs survived to study conclusion.

CLINICAL RELEVANCE: No benefits in complication rate or local recurrence were identified in dogs following the modified approach as opposed to the traditional closed anal sacculectomy technique.

PMID:37586695 | DOI:10.2460/javma.23.05.0239

Am J Vet Res. 2023 Aug 21:1-11. doi: 10.2460/ajvr.23.03.0052. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate behaviors associated with inflammatory pain induced by carrageenan injection in the cockatiel and determine interobserver agreement.

ANIMALS: 16 adult cockatiels.

METHODS: Cockatiels were randomly assigned as either treatment (carrageenan injection) or control (sham injection) group. The treatment group received a subcutaneous injection of 0.05 mL of a 1% lambda carrageenan solution into the left footpad. Following treatment or control procedures, all cockatiels were video recorded individually for 9.5 hours. Ten minutes of video at each of 11 time points postinjection and/or handling were evaluated by 3 different observers. Twenty-five behaviors within 6 categories (resting, locomotion, maintenance, intake, interaction with environment, and limb and body posture) were assessed, in addition to crest position and mentation. Differences in individual behaviors tallies were assessed using serial Wilcoxon sum rank tests. Interobserver agreement was assessed using an intraclass correlation coefficient for a 2-way design for consistency among multiple observers.

RESULTS: Treatment cockatiels exhibited significantly increased focal preening (q = .023) and increased burst preening (q = .036), while control cockatiels spent significantly more time in an upright stance (q = .036). Although the remainder of behaviors observed were not statistically significant between groups, additional variables of interest seen more frequently in treatment cockatiels included non-weight-bearing stance, holding of the body low, and being nonvigilant. The level of agreement between observers was variable based on the specific behaviors; nevertheless, the dynamic behaviors were substantial to strong.

CLINICAL RELEVANCE: Carrageenan-induced inflammation-associated behaviors may be valuable in developing a pain scale and evaluating mild inflammatory pain in small psittacine species.

PMID:37586693 | DOI:10.2460/ajvr.23.03.0052

J Speech Lang Hear Res. 2023 Aug 16:1-21. doi: 10.1044/2023_JSLHR-23-00091. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to examine the growth of previously established clinical markers of developmental language disorder (DLD) in Spanish-speaking bilingual children with and without DLD.

METHOD: Forty-three bilingual children with DLD and 57 typically developing children were tested 3 times over a 2-year period. Their average age at Time 1 was 5;10 (years;months). All children completed an elicitation task examining the production of articles, clitics, verbs, and the subjunctive mood in Spanish at each time point, in addition to other behavioral testing in Spanish and English. We used growth curve analysis to examine change patterns of the morphosyntactic structures over time.

RESULTS: At the onset of the study, children without DLD produced higher accuracy rates than children with DLD across all morphosyntactic structures. In addition, there was a positive effect of time on all structures. Furthermore, the interaction between time and DLD was statistically significant for clitic pronouns.

CONCLUSION: In agreement with previous literature on language growth in monolingual children with DLD, bilingual children with DLD showed language growth that was parallel to that of bilingual children without DLD but with significantly lower levels of attainment.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23810820.

PMID:37586692 | DOI:10.1044/2023_JSLHR-23-00091

Environ Pollut. 2023 Aug 14:122382. doi: 10.1016/j.envpol.2023.122382. Online ahead of print.

ABSTRACT

Assessing natural background levels (NBLs) in groundwater is a global concern. Knowledge on groundwater NBLs in urbanized areas is challenging due to the impact of complex human activities. Preselection related methods are common ones for assessing groundwater NBLs. The present study used three preselection related methods to assess groundwater heavy metals (lead, zinc, barium) NBLs in four groundwater units of the Pearl River Delta (PRD) where urbanization continues, and to identify the best one for assessing groundwater NBLs in urbanized areas. Here, methods include a preselection method (method-P), a preselection dominated method (method-PD), and a statistic dominated method (method-SD). Results showed that the method-PD was better than other two methods for assessing groundwater NBLs of heavy metals in the PRD. This is supported by the evidence that differences among heavy metals concentrations in various land-use types in residual datasets formed by the method-PD were insignificant. NBLs of lead in groundwater units I to IV assessed by the method-PD were 2.8 μg/L, 5.9 μg/L, 5.8 μg/L, and 2.6 μg/L, respectively. NBLs of zinc in groundwater units I to IV assessed by the method-PD were 30 μg/L, 180 μg/L, 160 μg/L, and 100 μg/L, respectively. NBLs of barium in groundwater units I to IV assessed by the method-PD were 120 μg/L, 120 μg/L, 90 μg/L, and 50 μg/L, respectively. Compared to the method-PD, the method-SD often underestimates groundwater NBLs of heavy metals because of using the experiential evaluation for residual datasets. The method-P also has an inaccurate evaluation of groundwater NBLs of heavy metals in comparison with the method-PD, owing to both of using the experiential evaluation and the absence of a function for outliers test. The method-P combining with an outliers test would be better than itself for assessing groundwater NBLs. Therefore, the method-PD is the first choice to be recommended for assessing groundwater NBLs in urbanized areas such the PRD. However, this method should not be taken into account for assessing groundwater NBLs in areas where groundwater Cl/Br mass ratios are invalid. Instead, the method-SD and the method-P combining with one outliers test may be choices, because no constraint for these two methods.

PMID:37586681 | DOI:10.1016/j.envpol.2023.122382

Clin Immunol. 2023 Aug 14:109740. doi: 10.1016/j.clim.2023.109740. Online ahead of print.

ABSTRACT

Anti-fibroblast antibodies (AFA) have been reported in systemic sclerosis (SSc) and are known to promote fibroblast activation. Aim of this study was to characterize the fine specificity of AFA and to analyze any correlations with clinical parameters associated to fibrosis. To this end, AFA were affinity-purified from a patient with diffuse cutaneous SSc (dcSSc) and interstitial lung disease (ILD). Panning of a phage display peptide library with purified AFA identified the motif <KxywxQ>. The peptide p121, bearing the AFA-specific motif, was used in ELISA to screen sera from 186 SSc patients and 81 healthy donors. Anti-p121 Ab serum levels were statistically higher in SSc than in healthy groups, and directly associated with dcSSc, reduced FVC (FVC < 70), and ILD. Given these clinical correlates, this study lays the groundwork for the identification of the antigen recognized by anti-p121 Ab, which might represent a novel therapeutic target for ILD.

PMID:37586673 | DOI:10.1016/j.clim.2023.109740

J Ren Nutr. 2023 Aug 14:S1051-2276(23)00114-0. doi: 10.1053/j.jrn.2023.07.004. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the effect of an adaptive nutritional and educational intervention for patients on hemodialysis in a routine care setting, using real-world data from electronic health records.

METHODS: Decentralized clinical trial of seven hemodialysis facilities recruited patients who have been on hemodialysis for over 3 months (N=153) for an 8-week adaptive intervention protocol. Patients were divided into four groups: (1) control (2) education intervention (3) meal intervention (4) education and meal interventions. Educational contents were digitally delivered via mobile phones and pre-made meals tailored on laboratory findings were home-delivered. Changes in serum electrolytes and malnutrition inflammation score (MIS) were analyzed.

RESULTS: Meal intervention statistically significantly stabilized serum phosphorus level (β = -0.81 mg/dL, 95% Confidence Interval (C.I.)=[-1.40, -0.22]) at week 8, with increased likelihood of being within target serum value range (Odds ratio = 1.21, 95% C.I.=[1.04, 1.40]). Meal group showed better nutritional status (MIS=3.65) than the education group (MIS=5.10) at week 8 (adjusted p<0.05). No significant changes were observed in serum potassium level, depression, and self-efficacy.

CONCLUSION: It was demonstrated that an adaptive meal intervention in a real-world care setting may benefit serum phosphorus control and nutritional status of patients on hemodialysis, without negative effect on depression levels or self-efficacy. More work is need to develop an effective educational intervention.

PMID:37586668 | DOI:10.1053/j.jrn.2023.07.004

Arthroscopy. 2023 Aug 14:S0749-8063(23)00651-5. doi: 10.1016/j.arthro.2023.07.054. Online ahead of print.

ABSTRACT

PURPOSE: To verify whether the distance from the hinge point to the tibial cortex affects the occurrence time and characteristics of the Lateral hinge fracture(LHF) in medial open wedge high tibial osteotomy(MOWHTO).

METHODS: We retrospectively reviewed 171 knees in 171 patients (121 women, 50 men; mean age, 53.9 years; range, 36-67 years) who had undergone MOWHTOwith locking plate fixation between January 2011 and December 2020. Osteotomy hinge point and LHFs were identified on intraoperative fluoroscopy and immediate postoperative radiographs. LHF type was classified as suggested by Takeuchi et al. Acute fracture was defined as a fracture that occurred during surgery, and delayed fracture was defined as a fracture observed after 1 month postoperatively. The nearest distances from osteotomy hinge point to lateral, distal, and proximal cortex were measured on postoperative radiographs. We compared the distance between the different types, and between acute and delayed LHFs.

RESULTS: There were 55 LHFs (32%) [type I, 40 knees; type II, 14 knees; type III, 1 knee] that occurred acutely in 41 knees and were found as delayed fractures in 14 knees. The patient demographics were not significantly different between non-LHFs and each type of LHFs. Proximal and distal distances were not statistically different among fracture types and between occurrence times. However, lateral distances were significantly shorter in type I LHFs (6.2±1.8 mm) and longer in type II LHFs (9.3±2.3 mm) than in non-LHFs (7.1±2.7 mm) (p=0.020 and 0.004, respectively). The lateral cortical distances were also different between acute LHFs (6.4±1.9 mm) and delayed LHF (9.0±2.7 mm) (p<0.001). In the case of fracture type, the frequency of of type I decreases with increase in the lateral distance, whereas that of type II increases with increase in the lateral cortical distance. In acute fracture, type I was dominant (85.4%), whereas in delayed fracture, type II was dominant (57.2%).

CONCLUSION: The lateral cortical distance from the hinge point was significantly associated with LHF occurrence. Shorter distance increased the risk for acute type I LHF, whereas longer distance increased the risk for delayed type II LHFs.

LEVEL OF EVIDENCE: Level III, retrospective comparative prognostic trial.

PMID:37586667 | DOI:10.1016/j.arthro.2023.07.054

Travel Med Infect Dis. 2023 Aug 14:102629. doi: 10.1016/j.tmaid.2023.102629. Online ahead of print.

ABSTRACT

INTRODUCTION: Human migration is an activity that affects society in economic and political aspects and as a social determinant because of its differential impact on individual’s health.

OBJECTIVE: To describe the situation of health and infectious diseases of vertical transmission risk in migrant pregnant women from an area of the Colombian Caribbean from 2019 to 2021.

METHODS: A descriptive cross-sectional study was carried out on pregnant irregular migrants in the Riohacha and Santa Marta municipalities in Colombia. Hemogram, uranalysis, toxoplasma, FTA-ABS, VDRL, rubella, hepatitis B, HIV (TORCHs), vaginal swab, basal glycemia, and transaminases, among other paraclinical tests, were done on pregnant women. Data was arranged, tabulated, and analyzed in SPSS v.23.0. A descriptive statistical analysis with measures of central tendency and dispersion for quantitative variables, and proportions analysis was done for qualitative variables.

RESULTS: A total of 555 clinical records were analyzed. Of the infectious agents with a risk of vertical transmission, syphilis was the most frequent with 3.6%. Regarding toxoplasmosis, 2.5% were IgM-positive. 4.2% of the pregnant women had IgG antibodies against Rubella and 2 women showed antibodies against HIV.

CONCLUSIONS: Our results reflect the need for the implementation of educational, prevention, and detection health programs with the aim to decrease the number of prenatal infections in the pregnant migrant population for preventing fatal complications both in mothers and newborns.

PMID:37586652 | DOI:10.1016/j.tmaid.2023.102629