Nevin Manimala

Asian J Psychiatr. 2022 Mar 14;71:103086. doi: 10.1016/j.ajp.2022.103086. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine whether thyroid function in the normal range is associated with recurrence of depressive or mania in bipolar disorder patients.

METHODS: 104 patients with bipolar disorder in maintenance therapy phase were assigned randomly to mood stabilizer combined with antidepressant group or mood stabilizer group. There were 52 patients in both groups respectively. Clinical symptoms were assessed at baseline, 3rd month, 6th month, 9th month, and 12th month using HAMD-17 and YMRS. Blood samples were analyzed for thyroid function.

RESULTS: There was no statistically significant difference of recurrence rate of depressive episode and mania episode at the end of the 12-months between mood stabilizer combined with antidepressant group and mood stabilizer group. There was significant relation of baseline TT4 (P = 0.020, HR = 0.948), FT3 (P = 0.035, HR = 2.055), and FT4 (P = 0.047, OR=0.769) with the recurrence of depressive episode in mood stabilizer group. The area under curve (AUC) of TT4, FT3, FT4 were 0.685, 0.613, 0.544, respectively. There was significant relation of baseline FT3 (P = 0.044，HR = 4.493) with the recurrence of mania episode for mood stabilizer combined with antidepressants group. The AUC of FT3 was 0.806.

CONCLUSION: Low level of TT4, FT4 and high level of FT3 within normal-range were related with the recurrence of depressive episode in the maintenance treatment with mood stabilizer of bipolar disorder. High level of FT3 within normal-range were related with recurrence of mania when mood stabilizer combined with antidepressants were used in the maintenance treatment of bipolar disorder.

PMID:35316669 | DOI:10.1016/j.ajp.2022.103086

Neuroimage Clin. 2022 Mar 8;34:102985. doi: 10.1016/j.nicl.2022.102985. Online ahead of print.

ABSTRACT

BACKGROUND: The ability to assess brain and cord atrophy simultaneously would improve the efficiency of MRI to track disease evolution.

OBJECTIVE: To test a promising tool to simultaneously map the regional distribution of atrophy in multiple sclerosis (MS) patients across the brain and cord.

METHODS: Voxel-based morphometry combined with a statistical parametric mapping probabilistic brain-spinal cord (SPM-BSC) template was applied to standard T1-weighted magnetic resonance imaging (MRI) scans covering the brain and cervical cord from 37 MS patients and 20 healthy controls (HC). We also measured the cord area at C2-C3 with a semi-automatic segmentation method using (i) the same T1-weighted acquisitions used for the new voxel-based analysis and (ii) dedicated spinal cord phase sensitive inversion recovery (PSIR) acquisitions. Cervical cord findings derived from the three approaches were compared to each other and the goodness to fit to clinical scores was assessed by regression analyses.

RESULTS: The SPM-BSC approach revealed a severity-dependent pattern of atrophy across the cervical cord and thalamus in MS patients when compared to HCs. The magnitude of cord atrophy was confirmed by the semi-automatic extraction approach at C2-C3 using both standard brain T1-weighted and advanced cord dedicated acquisitions. Associations between atrophy of cord and thalamus with disability and cognition were demonstrated.

CONCLUSION: Atrophy in the brain and cervical cord of MS patients can be identified simultaneously and rapidly at the voxel-level. The SPM-BSC approach yields similar results as available standard processing tools with the added advantage of performing the analysis simultaneously and faster.

PMID:35316667 | DOI:10.1016/j.nicl.2022.102985

Nurse Educ Pract. 2022 Mar 14;61:103330. doi: 10.1016/j.nepr.2022.103330. Online ahead of print.

ABSTRACT

AIM: This study aimed to examine if participation in a required clinical course or elective fellowship pertaining to care of people with disabilities (PWD) had an impact on attitudes, knowledge and skills of nursing when compared with those with no clinical exposure to PWD.

BACKGROUND: Worldwide, over 1 billion people live with a disability, 93 million are children and an estimated 1-3% have an intellectual disability; 6.9 billion live with ‘impairment producing health condition’. (WHO, 2011; Maulik et al., 2011; Roscigno, 2013 p.21). Barriers that contribute to health disparities in PWD are numerous; repeated themes of inadequate education of nursing students and faculty, deficient communication skills and negative attitudes are pervasive in the literature (Alshammari et al., 2018; Anyinam et al., 2019; Cervasio et al., 2010; Ilkhani et al., 2015; Lyon & Houser, 2018; Polikandrioti et al., 2020; Temple & Murdoch, 2012; Werner & Grayzman, 2011; WHO, 2011).

STUDY DESIGN: A singular institution descriptive quantitative design using a purposive sample of student volunteers explored differences among pre-licensure senior nursing students which examined perceptions prior to and following a clinical experience specific to the care of PWD.

METHODS: Analyses of the change in scale scores by student type and experience working with PWD were evaluated using one-way ANOVA. Spearman correlations were used to test for an association between the change in scale scores and birth year.

RESULTS: There was no statistical evidence of differences between the elective fellowship (n = 9), clinical (n = 13), or control (n = 24) groups for change in attitudes (p = 0.1383), scenario 1 (p = 0.1996), or knowledge scores (p = 0.2854) (Table 3). Mean pre- and post-test scores for attitudes within the fellowship (69.78, 75.11) and clinical (67.62, 74) group increased more than the control (66.92, 68.29). There was evidence of a difference detected in the attitude questions, scenario 2 scores, with the fellowship and clinical groups showing a larger increase in scores compared with the control group (p < 0.0001) (Table 3). Also, the clinical group experienced a larger increase in skill scores compared with the control group (p = 0.0154).

CONCLUSIONS: Results from pre-post surveys exemplify the need for disability specific undergraduate education. Students will experience confidence and competence in their transition to practice because at anytime, anywhere, they will encounter someone with a disability. Further research is needed to determine the amount and type of education that translates to quality care of PWD.

PMID:35316666 | DOI:10.1016/j.nepr.2022.103330

Am J Dent. 2022 Feb;35(1):30-36.

ABSTRACT

PURPOSE: To evaluate the in vitro marginal integrity of CAD-CAM composite inlays with the proximal box margin relocated with different direct restorative materials before and after thermomechanical aging.

METHODS: Standardized 4 mm-wide Class II cavities were prepared in 40 sound human upper molars. The mesial cervical margin was located in enamel (control) and 1 mm occlusal to the cemento-enamel junction (CEJ), while the distal cervical margin was located in dentin (experimental) and 2 mm apical to the CEJ. In the experimental groups (n=10), the distal margins were relocated up to the CEJ level by using a highly viscous conventional glass ionomer cement (Equia Forte), low-viscosity bulk-fill composite (SureFil SDR Flow), highly viscous nanofilled composite (Filtek Supreme XT), or a highly viscous bulk-fill composite (Filtek Bulk Fill). The inlays were milled from CAD-CAM nanohybrid composite blocks (Brava Block) and luted with dual-cure resin cement (Allcem). The specimens were submitted to thermocycling (5-55°C, 7,800 cycles) and fatigue loading (50 N, 1 Hz, 240,000 cycles). Epoxy resin replicas of the margins were obtained before and after aging and evaluated through scanning electron microscopy. The percentage of continuous margin in relation to individual assessable margin was calculated as the marginal integrity. The data were statistically analyzed using Wilcoxon and Kruskal-Wallis tests (α= .05).

RESULTS: The marginal integrity before and after aging was not significantly different (P> 0.05). Similarly, no significant differences were observed between margins relocated with different restorative materials in comparison to enamel margins (P> 0.05).

CLINICAL SIGNIFICANCE: Cervical margin relocation is a valid protocol to simplify intra-oral scanning and luting of CAD-CAM composite inlays with deep proximal margins. The marginal integrity at deep margins with relocation material was comparable to that of enamel margins.

PMID:35316590

Am J Dent. 2022 Feb;35(1):25-29.

ABSTRACT

PURPOSE: To evaluate the effect of cigarette smoking on the color stability and surface roughness of heat-polymerized poly(methylmethacrylate) (PMMA) and computer-aided design and computer-aided manufacturing (CAD-CAM) PMMA denture base materials.

METHODS: A total of 40 disc-shaped specimens (diameter 15 mm x thickness 2 mm) were divided into two groups according to their processing technique: Group CC, CAD-CAM PMMA; and Group HP, heat-polymerized PMMA. The specimens were exposed to cigarette smoke with 20 cigarettes daily for 5 days. Before the procedure, the color of the denture base was measured using a spectrophotometer in accordance with the Commission Internationale de I’Eclairage (CIE) color system. The surface roughness (Ra) of each sample was measured five times before and after exposure to smoke using a profilometer, and the mean roughness (Ra) values were calculated. The color change and surface roughness were statistically analyzed (P< 0.05).

RESULTS: Greater discoloration was observed in the HP group, whereas the CC group showed clinically acceptable color change. Smoking increased the surface roughness of both denture base materials. However, the HP group had higher mean values than the CC group.

CLINICAL SIGNIFICANCE: Denture base materials are susceptible to changes in color and surface roughness due to oral habits such as cigarette smoking. This in vitro study suggested that smoking can exacerbate the color changes and surface roughness of denture base materials, especially in heat-cured acrylic resins.

PMID:35316589

Am J Dent. 2022 Feb;35(1):12-14.

ABSTRACT

PURPOSE: To evaluate the influence of cannabidiol (CBD) oil on the color stability of resin composites.

METHODS: Three different resin composites were chosen to prepare 90 disk-shaped specimens. The specimens were randomly selected to compose two test groups (classic CBD or chocolate CBD) and one control group (distilled water) for a 14-day test. Two-way ANOVA was used to evaluate the influence of the CBD oil on the color stability of the three resin composites. Tukey post-hoc test (HSD) was used to determine the statistical difference among the groups.

RESULTS: ANOVA indicated statistically significant differences among the storage solutions, resin composite, and their correlations (P< 0.001). HSD indicated significant differences among resin composites after staining. No difference was noticed between the color change of the specimens immersed in classic CBD or chocolate CBD. Color differences of the resin composites were related to the hydrophilic/hydrophobic nature of the resin matrix.

CLINICAL SIGNIFICANCE: CBD oil affected the color stability of all the examined resin composite specimens. Considering the obtained results, appropriate guidance should be provided to patients to prevent potential color alteration owing to the usage of CBD oil.

PMID:35316586

Vet Med Sci. 2022 Mar 22. doi: 10.1002/vms3.787. Online ahead of print.

ABSTRACT

BACKGROUND: Despite their importance to society, dogs are susceptible to various helminths. This study aimed to understand perceptions, attitudes and practices (PAP) regarding canine zoonotic helminthiases (CZH) among dog owners in Rwanda.

METHODS: A cross-sectional study was carried out in Nyagatare district of Rwanda, where 203 dog owners were randomly selected and interviewed. To analyse this study’s data, we used frequency distributions, chi-square test of association and binary logistic regression model.

RESULTS: Overall, 75.9% and 30% of the respondents were aware of canine and human helminthiases, respectively. Around 74.4% knew that dogs source helminthiases from eating raw infected meat. Also, 74.4% knew vomiting, diarrhoea and swelling of the belly as clinical signs of the helminthiases. Around 58.6% washed hands with soap and water after handling a dog. Only 17.2% and 15.5% dewormed the dogs and treated them against ectoparasites using conventional anthelmintics and acaricides manufactured for dogs, respectively. Of all respondents, 33% held genuine perceptions, while 78.3% and 25.1% adopted positive attitudes and appropriate practices about CZH, respectively. The respondents’ educational level and length of dog ownership correlated with their perceptions and practices about CZH, respectively, while sources of information on CZH influenced their PAP of such infections. The adjusted odds ratio (OR) of having genuine perceptions and positive attitudes were more than 82% lower among those who sourced the information from neighbours & colleagues compared to those who gathered it through reading. Again, the length of dog ownership (OR = 0.37, 95% CI: 0.15-0.90) correlated with the respondent’s practices about CZH.

CONCLUSIONS: Only 33% and 25.1% of the respondents held genuine perceptions and adopted positive attitudes regarding CZH, respectively. The findings indicate increased zoonotic helminths in dogs, possible spillover in humans and anthelmintic resistance. Therefore, awareness campaigns are needed to upgrade dog owners’ knowledge of the zoonotic helminthiases in dogs in Nyagatare district.

PMID:35316578 | DOI:10.1002/vms3.787

Clin Implant Dent Relat Res. 2022 Mar 22. doi: 10.1111/cid.13078. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the present systematic review was to evaluate the effect of different lateral bone augmentation (LBA) procedures on the complete correction of a peri-implant bone dehiscence (BD) or fenestration (BF) from implant placement to implant surgical uncovering.

METHODS: Electronic (Medline, Scopus, and Cochrane databases) and hand literature searches were performed for studies including at least one treatment arm where any LBA had been applied to correct a BD/BF at implant placement (T0). Studies where BD/BF was left untreated were also retrieved as negative control. Data from 24 selected articles were used to perform a network meta-analysis. Based on the proportion of nonresolved BD/BF at implant surgical uncovering (T1), a hierarchy of LBA procedures, and was determined. Spontaneous healing (i.e., exposed implant surface covered by a full-thickness flap; SELF) was also included in the hierarchy. Resorbable membrane + bone graft (RM + BG) was used as reference group. An analysis on the effect of nonhuman (NHBS) vs human (HBS) derived bone substitutes was also performed. NHBS was used as the reference group.

RESULTS: No statistically significant differences were found among treatments for the proportion of nonresolved BD/BF. SELF performed substantially worse compared to RM + BG (OR: 5.78 × 10, CI: 4.83 × 10 – 1.3 × 10⁸⁶ ). Treatment based on a combination of a graft material and membrane/periosteum appeared to perform slightly better than treatments using graft material or membrane alone. NHBS appeared to perform better than HBS. SELF had the worst effect among all treatments for both BD/BF height reduction (BDH) and BD/BF width reduction (BDW). Nonresorbable membrane (NRM) and patient’s own periosteum (PERI) + BG showed greater increases in buccal bone thickness than RM + BG.

CONCLUSION: Reconstructive treatment (including use of graft alone, membrane alone, or combinations of grafts and either membrane or patient’s own periosteum) of a BD/BF at implant placement favorably and significantly impacts on the probability to obtain complete correction of the BD/BF at implant uncovering when compared to full-thickness flap repositioning on the BD/BF. When using a bone substitute, a nonhuman derived one may be suggested.

PMID:35316573 | DOI:10.1111/cid.13078

J Neurosci Res. 2022 Mar 22. doi: 10.1002/jnr.25035. Online ahead of print.

ABSTRACT

Herein, we combined neurite orientation dispersion and density imaging (NODDI) and synthetic magnetic resonance imaging (SyMRI) to evaluate the spatial distribution and extent of gray matter (GM) microstructural alterations in patients with relapsing-remitting multiple sclerosis (RRMS) and neuromyelitis optica spectrum disorder (NMOSD). The NODDI (neurite density index [NDI], orientation dispersion index [ODI], and isotropic volume fraction [ISOVF]) and SyMRI (myelin volume fraction [MVF]) measures were compared between age- and sex-matched groups of 30 patients with RRMS (6 males and 24 females; mean age, 51.43 ± 8.02 years), 18 patients with anti-aquaporin-4 antibody-positive NMOSD (2 males and 16 females; mean age, 52.67 ± 16.07 years), and 19 healthy controls (6 males and 13 females; mean age, 51.47 ± 9.25 years) using GM-based spatial statistical analysis. Patients with RRMS showed reduced NDI and MVF and increased ODI and ISOVF, predominantly in the limbic and paralimbic regions, when compared with healthy controls, while only increases in ODI and ISOVF were observed when compared with NMOSD. Compared to NDI and MVF, the changes in ODI and ISOVF were observed more widely, including in the cerebellar cortex. These abnormalities were associated with disease progression and disability. In contrast, patients with NMOSD only showed reduced NDI mainly in the cerebellar, limbic, and paralimbic cortices when compared with healthy controls and patients with RRMS. Taken together, our study supports the notion that GM pathologies in RRMS are distinct from those of NMOSD. However, owing to the limitations of the study, the results should be cautiously interpreted.

PMID:35316545 | DOI:10.1002/jnr.25035

Laryngoscope. 2021 Mar;131(3):509-512. doi: 10.1002/lary.28861. Epub 2020 Jul 6.

ABSTRACT

OBJECTIVES: Adverse events are common occurrences in hospitals that detract from quality of care. There are few data on errors in otolaryngology (ENT) and even fewer data comparing ENT to other services.

METHODS: We retrospectively reviewed adverse event data collected across a regional hospital network from July 2014 to August 2017. We examined categories of adverse events that occurred most commonly in ENT and compared the number of adverse events reported in ENT to those reported across all other departments. Descriptive analysis and the paired t test were used to analyze the data.

RESULTS: Two hundred ninety-one adverse events were reported in ENT departments during the period studied compared to 58,219 events reported across all other specialties. In ENT, the most commonly reported adverse events occurred in the perioperative setting, followed by issues regarding equipment and medical devices and, lastly, airway management. Across all other departments, the most common categories included medication and fluid errors, falls, and safety and security events. ENT departments had significantly higher proportions of perioperative and airway management errors and significantly lower proportions of events related to diagnosis and treatment (P = .004), falls (P < .001), lab results and specimens (P = .001), medication and fluids (P < .001), and safety and security (P < .001).

CONCLUSION: Perioperative and airway management errors occur with a statistically higher frequency in ENT compared to other in-patient and out-patient departments across hospitals. It is important to analyze adverse event reporting in surgical specialties to ensure the development of appropriate quality initiatives.

LEVEL OF EVIDENCE: 4 Laryngoscope, 131:509-512, 2021.

PMID:35316544 | DOI:10.1002/lary.28861