Nevin Manimala

Spine J. 2022 Apr 8:S1529-9430(22)00147-4. doi: 10.1016/j.spinee.2022.04.001. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Although anterior cervical discectomy and fusion (ACDF) is believed to positively impact a patient’s radicular symptoms as well as axial neck pain, the outcomes of cervical disc replacement (CDR) with regards to neck pain specifically have not been established.

PURPOSE: Primary: to assess clinical improvement following CDR in patients with neck pain greater than arm pain. Secondary: to compare the clinical outcomes between patients undergoing CDR for predominant neck pain (pNP), predominant arm pain (pAP), and equal neck and arm pain (ENAP).

STUDY DESIGN: Retrospective review of prospectively collected data PATIENT SAMPLE: Patients who had undergone one- or two-level CDR for the treatment of degenerative cervical pathology and had a minimum of 6-month follow-up were included and stratified into three cohorts based on their predominant location of pain: pNP, pAP, and ENAP.

OUTCOME MEASURES: Patient-reported outcomes (PROs): Neck Disability Index (NDI), Visual Analog Scale (VAS) neck and arm, Short Form 12-Item Physical Health Score (SF12-PHS), Short Form 12-Item Mental Health Score (SF12-MHS), minimal clinically important difference (MCID).

METHODS: Changes in PROs from preoperative values to early (<6 months) and late (≥6 months) postoperative timepoints were analyzed within each of the three groups. The percentage of patients achieving MCID was also evaluated.

RESULTS: 125 patients (52 pNP, 30 pAP, 43 ENAP) were included. The pNP cohort demonstrated significant improvements in early and late NDI and VAS-Neck, early SF-12 MCS, and late SF-12 PCS. The pAP and ENAP cohorts demonstrated significant improvements in all PROMs, including NDI, VAS-Neck, VAS-Arm, SF-12 PCS, and SF-12 MCS, at both the early and late timepoints. No statistically significant differences were found in the MCID achievement rates for NDI, VAS-Neck, SF-12 PCS, and SF-12 MCS at the late timepoint amongst the three groups.

CONCLUSIONS: CDR leads to comparable improvement in neck pain and disability in patients presenting with neck pain greater than arm pain and meeting specific clinical and radiographic criteria.

PMID:35405338 | DOI:10.1016/j.spinee.2022.04.001

World Neurosurg. 2022 Apr 8:S1878-8750(22)00457-0. doi: 10.1016/j.wneu.2022.04.019. Online ahead of print.

ABSTRACT

INTRODUCTION: The Glasgow Coma Score (GCS) is intended to be an objective, reliable measure of a patient’s mental status. It is included as a metric for trauma registries, having implications for performance metrics and research. Our study compared the GCS recorded in the trauma registry (GCS-1) to that recorded in the neurosurgery consultation (GCS-2).

METHODS: This retrospective review compared GCS-1 to GCS-2. The Trauma Injury Severity Score (TRISS) method was used to calculate probability of survival (POS) for patients using both GCS-1 and GCS-2.

RESULTS: GCS-1 significantly differed from GCS-2 (6.69 vs 7.84, ± 2.553, p<.001). There were 172 (37.55%) patients with a GCS-1 of 3 and 87 (19.00%) with a GCS-2 of 3 (Chi-square p<0.001). The probability of survival (POS) calculated using TRISS methodology with GCS-1 (POS-1) was 74.7% ± 26.6% compared to GCS-2 (POS-2), which was 79.3% ± 24.4%. There was a statistically significant difference in the means of POS-2 and POS-2 (p<0.001). The actual observed survival rate for the cohort was 71.0% (325/458).

CONCLUSION: The immediate GCS recorded on patient arrival after trauma differs significantly from the GCS recorded at later times. This significantly altered the probability of survival as calculated by the TRISS methodology. This could have profound effects on risk-adjusted benchmarking, assessments of quality of care and injury-severity stratification for research. More studies into the optimal timing of GCS recording or changes in GCS ant their impact on survival is warranted.

PMID:35405314 | DOI:10.1016/j.wneu.2022.04.019

Microb Pathog. 2022 Apr 8:105518. doi: 10.1016/j.micpath.2022.105518. Online ahead of print.

ABSTRACT

BACKGROUND: The clinical relevance of Helicobacter heilmannii (H. heilmannii) infection in patients with upper gastrointestinal diseases is not yet fully understood. The main purpose of this study was to evaluate the clinical, endoscopic, histopathological, and therapeutic features of H. heilmannii.

METHODS: To retrieve the relevant studies, we conducted a comprehensive systematic search of global databases such as the ISI Web of Science, PubMed, Scopus, Embase, and Google Scholar. After confirming the studies based on the inclusion criteria statistical analysis was performed using Comprehensive Meta-Analysis software.

RESULTS: In our study, the prevalence of infection with H. heilmannii was measured at 1.9% (95% CI: 0.8-4.2). The prevalence of H. heilmannii in Asian population was higher than Western countries (3.1% vs. 1.2%, respectively). Interestingly, the frequency of coinfection with both H. pylori and H. heilmannii was 15.4% (95% CI: 5.2-37.6). The most common endoscopic findings were chronic gastritis, hyperplasia, and erosion. In addition, our results showed that in people infected with this bacterium, gastric inflammation is typically chronic, focal, and less active than Helicobacter pylori (H. pylori) gastritis. Conventional treatment of H. pylori can lead to the eradication of H. heilmannii.

CONCLUSION: In general, H. heilmannii infection is significantly associated with mild chronic gastritis and can be treated with standard anti-H. pylori treatment.

PMID:35405277 | DOI:10.1016/j.micpath.2022.105518

J Arthroplasty. 2022 Apr 8:S0883-5403(22)00393-X. doi: 10.1016/j.arth.2022.04.002. Online ahead of print.

ABSTRACT

BACKGROUND: Acetabular retroversion may predispose to more severe Femoroacetabular Impingement Syndrome (FAIS) and early labral damage given impaction of the femoral head-neck junction on the retroverted acetabular rim. The cross-over sign (COS), posterior wall sign (PWS), and ischial spine sign (ISS) are markers of acetabular retroversion (AR) on plain radiographs.

METHODS: Patients who underwent primary hip arthroscopy for FAIS from 01/2012 to 12/2018 with a positive PWS were matched 1:1 by age, gender, and BMI to controls with a negative PWS. Pre- and postoperative patient-reported outcomes (PROs; HOS-ADL, HOS-SS, mHHS and iHOT-12) were compared using independent t-tests. Achievement of a Patient Acceptable Symptom State (PASS) or Minimal Clinically Important Difference (MCID) was compared using Fisher’s exact.

RESULTS: 275 patients with a positive PWS and 275 controls were included in the final analysis. Majority of patients (64%) were female, average age, and BMI of 37.6 (SD 8.6) and 25.1 (SD 4.4), respectively. PROs improved significantly for both groups from preoperatively to 2-years postoperatively. There were no statistically significant differences (P≥0.05) in PROs or achievement of MCID or PASS. On subgroup analysis, patients with all three positive signs had significantly lower postoperative PROs, and lower rates of achievement of MCID and PASS.

CONCLUSION: Patients with an isolated PWS achieve similar outcomes following hip arthroscopy at 2-years. However, patients with a concomitant PWS, ISS, and COS demonstrate less favorable outcomes, suggesting the need for increased perioperative counseling and potential evaluation for planned concurrent or serial open procedures such as periacetabular osteotomy.

PMID:35405263 | DOI:10.1016/j.arth.2022.04.002

Sci Total Environ. 2022 Apr 8:155131. doi: 10.1016/j.scitotenv.2022.155131. Online ahead of print.

ABSTRACT

Naturally occurring, geogenic manganese (Mn) and iron (Fe) are frequently found dissolved in groundwater at concentrations that make the water difficult to use (deposits, unpleasant taste) or, in the case of Mn, a potential health hazard. Over 6000 groundwater measurements of Mn and Fe in Southeast Asia and Bangladesh were assembled and statistically examined with other physicochemical parameters. The machine learning methods random forest and generalized boosted regression modeling were used with spatially continuous environmental parameters (climate, geology, soil, topography) to model and map the probability of groundwater Mn > 400 μg/L and Fe > 0.3 mg/L for Southeast Asia and Bangladesh. The modeling indicated that drier climatic conditions are associated with a tendency of elevated Mn concentrations, whereas high Fe concentrations tend to be found in a more humid climate with elevated levels of soil organic carbon. The spatial distribution of Mn > 400 μg/L and Fe > 0.3 mg/L was compared and contrasted with that of the critical geogenic contaminant arsenic (As), confirming that high Fe concentrations are often associated with high As concentrations, whereas areas of high concentrations of Mn and As are frequently found adjacent to each other. The probability maps draw attention to areas prone to elevated, concentrations of geogenic Mn and Fe in groundwater and can help direct efforts to mitigate their negative effects. The greatest Mn hazard is found in densely populated northwest Bangladesh and the Mekong, Red and Ma River Deltas of Cambodia and Vietnam. Widespread elevated Fe concentrations and their associated negative effects on water infrastructure pose challenges to water supply. The Mn and Fe prediction maps demonstrate the value of machine learning for the geospatial prediction modeling and mapping of groundwater contaminants, as well as the potential for further constituents to be targeted by this novel approach.

PMID:35405246 | DOI:10.1016/j.scitotenv.2022.155131

Rom J Intern Med. 2022 Apr 11. doi: 10.2478/rjim-2022-0005. Online ahead of print.

ABSTRACT

Background: Improved prognosis and delay of clinical complications in Diabetes mellitus can be ensured by early screening and regular monitoring after diagnosis. This requires venipuncture at regular intervals of time causing anxiety and discomfort to the patient. Hence, development of a painless, non-invasive procedure is desirable for which saliva is a potential tool. Also, this would provide an easy and cost-effective means for large scale screening and epidemiological intervention. Aim: To measure fasting plasma glucose (FPG) and compare and correlate with salivary glucose levels in normal and diabetic individuals. Also, the correlation between glycated hemoglobin (HbA1c) and salivary glucose is studied in the diabetics and controls. Methods: Blood and salivary glucose was estimated by GOD-POD method and glycated hemoglobin by HPLC. Statistical analysis was done on SPSS 16. Mean, Standard deviation, independent t test, ANOVA (f test), Pearson’s correlation coefficient along with regression analysis was carried out and comparison was done between the control and diabetic groups and the different subgroups within the diabetic group. Results:A significant difference between the salivary glucose levels in subjects indicating that a deranged glycemic status is reflected in saliva. Also, salivary glucose increases in proportion to an increase in the FPG and HbA1C of the diabetics. The regression coefficient was calculated and a formula was derived for prediction of FPG and HbA1c using salivary glucose. Conclusion: Saliva can be used as a screening tool for diabetes. Standardization of the technique and setting up a reference range will also make it useful in diagnosing diabetes mellitus.

PMID:35405049 | DOI:10.2478/rjim-2022-0005

Horm Mol Biol Clin Investig. 2022 Apr 11. doi: 10.1515/hmbci-2021-0074. Online ahead of print.

ABSTRACT

OBJECTIVES: Vitamin D is an important regulator of the immune system, and it has been shown that deficiency of vitamin D is significant environmental factor in some immune-mediated diseases such as Multiple Sclerosis (MS). In this study, we have compared serum 25 hydroxyvitamin (OH) D levels in Relapsing-Remitting Multiple Sclerosis (RRMS), clinically isolated syndrome (CIS), and control groups.

METHODS: Forty patients with CIS and 60 patients who have been diagnosed RRMS between age 18-45, respectively, and followed up at Pamukkale University Faculty of Medicine, Department of Neurology, and 60 healthy individuals have been included in this study. Serum 25(OH) vitamin D, calcium, phosphorus, alkaline phosphatase, parathormone, insulin, and fasting blood glucose levels were studied for all three groups.

RESULTS: A statistically significant difference was determined in the comparison of three groups for mean 25(OH) vitamin D levels. In the intergroup comparison of mean 25(OH) vitamin D; mean 25(OH) vitamin D level was determined to be statistically significantly lower in both RRMS and CIS groups compared to control group (p<0.05).

CONCLUSIONS: Since vitamin D deficiency poses a problem from the early stage of disease spectrum in both CIS patients and MS patients, 25(OH) vitamin D level should be routinely controlled, and replacement should be administered upon any deficiency state.

PMID:35405046 | DOI:10.1515/hmbci-2021-0074

Ecology. 2022 Apr 11:e3718. doi: 10.1002/ecy.3718. Online ahead of print.

ABSTRACT

Monitoring technologies now provide real-time animal location information which opens the possibility of forecasting systems to fuse these data with movement models to predict future trajectories. State space modelling approaches are well established for retrospective location estimation and behavioural inference through state and parameter estimation. Here, we use a state space model within a comprehensive data assimilative framework for probabilistic animal movement forecasting. Real-time location information is combined with stochastic movement model predictions to provide forecasts of future animal locations and trajectories, as well as estimation of key behavioural parameters. Implementation uses ensemble-based sequential Monte Carlo methods (a particle filter). We first apply the framework to an idealized case using a non-dimensional animal movement model based on a continuous-time random walk process. A set of numerical forecasting experiments demonstrate the workflow and key features, such as the online estimation of behavioural parameters using state augmentation, the use of potential functions for habitat preference, as well as the role of observation error and sampling frequency on forecast skill. For a realistic demonstration, we adapt the framework to short-term forecasting of the endangered Southern Resident Killer Whale (SRKW) in the Salish Sea using visual sighting information wherein the potential function reflects historical habitat utilization of SRKW. We successfully estimate whale locations up to 2.5 hours in advance with a moderate prediction error ($< 5$ km), providing reasonable lead-in time to mitigate vessel-whale interactions. It is argued that this forecasting framework can be used to synthesize diverse data types, improve animal movement models and behavioural understanding, and has the potential to become an important new direction for movement ecology.

PMID:35405019 | DOI:10.1002/ecy.3718

Oper Dent. 2022 Apr 11. doi: 10.2341/20-156-L. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of different surface treatments on the shear bond strength (SBS) of lithium silicate (LS) and lithium disilicate (LD) ceramics, after thermocycling.

METHODS AND MATERIALS: For SBS test, 72 ceramic blocks (18×14×2 mm) were made (24 blocks from each ceramic material): VITA Suprinity (LSS), Celtra Duo (LSC), and Lithium disilicate (LD). The blocks were polished with sandpaper of increasing grit (#280, #400, #800, and #1200) and embedded in chemically activated acrylic resin. Afterwards, they were randomly divided into 12 groups (6 blocks per group) according to: “Ceramic” (LD, LSC, and LSS) and “Surface treatment” (HFS: hydrofluoric acid + silane; MEP: Monobond Etch & Prime/Ivoclar). From each treated surface ceramic block, four dual-curing resin cement cylinders (RelyX U200, 3M Oral Care) were prepared using a Tygon tube (Ø=3 mm and h=2 mm) and light cured for 40 seconds (1000 mW/cm2) (N=288/n=24). All specimens were submitted to thermocycling (10,000 cycles, 5°C and 55°C, 30 seconds) and then to SBS test at a crosshead speed of 1 mm/min using a 50-kgf load cell. Forty-five additional blocks were made for roughness and SEM analysis. Failure mode was also performed. The data (MPa) were statistically analyzed by oneway analysis of variance (ANOVA), Tukey test (5%), and Weibull analysis. The Ra was analyzed by Kruskal-Wallis and Dunn Test (5%). The other variables were analyzed qualitatively.

RESULTS: ANOVA revealed that “surface treatment” was significant for all ceramic materials (p<0.05). The LD-HFS (18.66±3.49), LSC-HFS (16.81±2.62), and LSS-HFS (16.33±3.08) groups had significantly higher SBS than the LD-MEP (7.00±4.2), LSC-MEP (14.12±3.51), and LSS-MEP (13.87±2.52) groups. Complete adhesive failures at the cement- dentin interface were more frequent. Weibull modulus was superior for the LD-HFS (6.22), LSC-HFS (8.8), and LSS-HFS (7.4) groups.

CONCLUSION: HF followed by silanization is the most suitable surface treatment for the cementation of LS and LD glass ceramics.

PMID:35405015 | DOI:10.2341/20-156-L

Oper Dent. 2022 Apr 11. doi: 10.2341/20-215-C. Online ahead of print.

ABSTRACT

OBJECTIVES: This double-blind, randomized clinical trial evaluated the influence of dentin moisture on postoperative sensitivity (POS), as well as, on clinical performance in posterior bulk-fill composite restorations, using a universal adhesive, until 12 months after clinical service.

METHODS AND MATERIALS: In accordance with a split-mouth design, 45 patients received posterior restorations, restored with a bulk-fill resin composite (Filtek Bulk Fill, 3M Oral Care) and a universal adhesive used in etch-and-rinse mode (SBU; Single Bond Universal Adhesive), which were applied on dry or moist dentin, with a cavity depth of at least 3 mm. Three operators placed 90 Class I/Class II restorations. Patients were evaluated for spontaneous and stimulated POS in the baseline, and after 48 hours, 7 days, and at 6 and 12 months. In addition, secondary parameters (marginal discoloration, marginal adaptation, fracture, and recurrent caries) were evaluated by World Dental Federation (FDI) criteria after 7 days and at 6 and 12 months. Statistical analyzes were performed using the Chi-square, Fisher exact, Friedman, Kruskall-Wallis, and Mann-Whitney tests (α=0.05).

RESULTS: No significant spontaneous and stimulated POS was observed when SBU was applied in dry and moist dentin (p>0.05). A significant and higher risk of spontaneous POS (20.0%; 95%CI 10.9-33.82 for dry dentin and 22.22%; 95%CI 12.54-36.27 for moist dentin) occurred up to 48 hours after restoration placement for the dry and moist dentin groups (p<0.02). However, the POS intensity was mild up to 48 hours with no significant difference between dry and moist dentin groups (p>0.79). When secondary parameters were evaluated, no significant differences between the groups were observed.

CONCLUSION: Dentin moisture did not influence POS in posterior bulk-fill composite restorations when associated with a universal adhesive applied in etch-and-rinse mode.

PMID:35405005 | DOI:10.2341/20-215-C