Nevin Manimala

Orthopedics. 2022 Jun 13:1-6. doi: 10.3928/01477447-20220608-01. Online ahead of print.

ABSTRACT

Manipulation under anesthesia (MUA) after total knee arthroplasty (TKA) frequently has been used as a first-line treatment to restore functional range of motion after unsuccessful physical therapy. Although there are studies reporting that MUA assisted in restoring range of motion, there is a paucity of literature on the influence of MUA on the risk of revision TKA. The goal of our study was to determine whether MUA was associated with an increase in the rate of revision TKA within 2 years of MUA. A total of 49,310 patients within a single institution who underwent primary TKA were identified from 1999 to 2019. Data were matched at a 1:3 ratio (TKA with and without MUA, respectively) based on age, sex, and body mass index. A matched comparison cohort was conducted, with the MUA cohort having 575 patients and the no MUA cohort having 1725 patients. A statistically significant increase in the rate of noninfectious etiology revision TKA was found in the MUA cohort (7.3%) compared with the no MUA cohort (4.9%; P=.034). The most common reason for revision TKA after MUA was persistent stiffness, including arthrofibrosis and ankylosis; however, aseptic loosening, ligamentous instability, and periprosthetic fracture were found to be responsible for 21.4% of revision TKA procedures. Although MUA is a commonly performed procedure for treating stiffness after primary TKA, the orthopedic surgeon should counsel patients on the association of increased rate of revision TKA after MUA, most commonly, persistent stiffness. [Orthopedics. 20XX;XX(X):xx-xx.].

PMID:35700432 | DOI:10.3928/01477447-20220608-01

J Pediatr Hematol Oncol. 2022 Jun 15. doi: 10.1097/MPH.0000000000002502. Online ahead of print.

ABSTRACT

The number of studies evaluating teicoplanin lock therapy in coagulase-negative staphylococcus-associated catheter infection in pediatric malignancies is limited. The aim of this study was to evaluate the efficacy of teicoplanin lock therapy in pediatric cancer cases. Twenty-two patients with coagulase-negative staphylococcus-associated totally implantable venous access device infection, who had undergone teicoplanin closure treatment, were included in the study. Demographic data, number of lock treatment days, and treatment success data were obtained from the medical files of the patients. Fourteen of the patients (63.6%) had acute lymphocytic leukemia, 3 (13.6%) had acute myelocytic leukemia, and 5 (22.7%) had solid cancer. The median neutrophil count was 240×103/μL (interquartile range: 0 to 1195×103/μL). Between patients with and without catheter removal, no statistically significant difference was found in terms of baseline C-reactive protein, absolute neutrophil count, and the day of starting systemic teicoplanin treatment (P>0.05). The overall port survival rate of teicoplanin lock therapy was 72.7%. Within an average of 4 days, negative cultures of 16 (72.7%) patients whose catheters had not been removed were obtained. In conclusion, we suggest that teicoplanin lock therapy is an effective and safe treatment for catheter-related infections, caused by methicillin-resistant coagulase-negative staphylococcus.

PMID:35700426 | DOI:10.1097/MPH.0000000000002502

J Pediatr Hematol Oncol. 2022 Jun 7. doi: 10.1097/MPH.0000000000002495. Online ahead of print.

ABSTRACT

BACKGROUND: Germ cell tumors (GCTs) may occur from the neonatal period to late adulthood, characterized by extensive clinical and pathologic heterogeneity. MicroRNAs are a family of small noncoding RNAs that regulate a wide array of biological processes including carcinogenesis. MicroRNAs may be used for many purposes in clinical diagnostics. Numerous studies have proven the diagnostic value of microRNA371-373 and microRNA302/367 expression in malignant GCT. The diagnostic value of microRNA375 is disputable, because while its value is confirmed by some research data, there are still others denying it.

METHODS: The results of our own research on the relative expression of 10 microRNAs, including microRNA375, associated with GCT in the tumor tissues of 84 children and adolescents are presented.

RESULTS: In our research, overexpression of microRNA 371-373, 302/367 detected in the group of malignant GCT subtypes. Statistically significant expression of microRNA375 have been defined not only in the group of malignant GCT subtypes, but also in the group of immature teratomas. Among malignant GCTs, high expression of microRNA375 is specific for yolk sac tumors. In the group of seminomas, embryonic carcinomas, and mature teratomas expression of microRNA375 was observed imperceptible, even so the results were statistically insignificant.

CONCLUSION: Expression of microRNA 371-373, 302/367 is representative of malignant GCT subtypes. Statistically significant and high expression of microRNA375 attributable for yolk sac tumors and immature teratomas.

PMID:35700382 | DOI:10.1097/MPH.0000000000002495

Vopr Kurortol Fizioter Lech Fiz Kult. 2022;99(3):25-31. doi: 10.17116/kurort20229903125.

ABSTRACT

Epilepsy is a chronic disease characterized by recurrent, mostly unprovoked seizures with impaired motor, autonomic, mental or mental functions that occur as a result of excessive neuronal discharges in the gray matter of the cerebral cortex. The problem of the activity of medical rehabilitation for epilepsy in the professional community remains debatable, despite the obviousness of the arguments and judgments presented.

PURPOSE OF THE STUDY: Development of an effective and safe complex for the rehabilitation of young children with epilepsy, accompanied by impaired movement function.

MATERIAL AND METHODS: The study included 123 young children (from 9 to 24 months) with epilepsy accompanied by impaired motor function. By the method of simple randomization, all patients were divided into 4 groups: 3 main groups and a comparison group. All children of the study groups, except for the comparison group, received medical rehabilitation: in the 1st group – classical massage with the exception of the cervical-collar zone; in the 2nd group – kinesitherapy according to the method of V. Voigt; in the 3rd group – a complex effect, including classical massage with the exclusion of the neck-collar zone and kinesitherapy according to the method of V. Voigt. Children of the comparison group received basic therapy. The effectiveness of medical rehabilitation was analyzed using the Gross motor function classification system (GMFCS) and the Griffiths intellectual development scale.

RESULTS: Differences in GMFCS scores before and after medical rehabilitation were statistically significant in group 3. In patients with impaired movement function and suffering from epilepsy, the positive dynamics during complex rehabilitation was more pronounced than when using one isolated technique.

CONCLUSION: Complexity in planning and prescribing a course of rehabilitation determines the greatest efficiency in reducing the deficit of physical activity. With an increase in the index of epileptiform activity according to electroencephalography data without any clinical manifestations, it is not required to cancel rehabilitation measures, it is necessary to strengthen control over the patient.

PMID:35700373 | DOI:10.17116/kurort20229903125

Vopr Kurortol Fizioter Lech Fiz Kult. 2022;99(3):10-15. doi: 10.17116/kurort20229903110.

ABSTRACT

The increase in the number of cerebral strokes is accompanied by the accumulation of patients with hemiparesis. It is especially difficult to restore the function of the upper limb, in particular the hand, which significantly limits the social, domestic and labor adaptation of patients. This makes it relevant to search for new methods for restoring the functions of the hand. Today, mirror therapy is becoming increasingly popular, which, however, does not eliminate myogenic contractures in the joints of a paralyzed limb.

PURPOSE OF THE STUDY: Rationale for the use of mirror therapy in combination with myofascial stretching and postisometric relaxation in patients with hemiparesis.

MATERIAL AND METHODS: 277 patients with hemiparesis were examined, of which 68 patients were included in the main group; 209 – to the comparison group. All patients underwent a course of rehabilitation treatment for 10 days. Patients of the main group additionally received mirror therapy in combination with myofascial stretching and post-isometric relaxation: course – 10 individual sessions, session duration – 30 minutes. Upon admission and before discharge, patients were evaluated for neurological status, severity of spastic and pain syndromes; the strength of the muscles of the paralyzed upper limb according to the Lovett scale; tested self-service skills in accordance with the International Classification of Functioning, Disabilities and Health.

RESULTS: In patients of both groups, the severity of spastic and pain syndromes decreased, muscle strength increased. In the main group, these changes were more pronounced; 35 patients of the main group mastered new types of grip, which statistically significantly improved their social adaptability.

CONCLUSION: Mirror therapy in combination with soft manual therapy techniques is able to restore precise targeted movements in the joints of the hand and fingers, form different grip options, which expands the possibilities of self-care for patients.

PMID:35700371 | DOI:10.17116/kurort20229903110

Proc Natl Acad Sci U S A. 2022 Jun 21;119(25):e2202491119. doi: 10.1073/pnas.2202491119. Epub 2022 Jun 14.

ABSTRACT

Whether the size of the prefrontal cortex (PFC) in humans is disproportionate when compared to other species is a persistent debate in evolutionary neuroscience. This question has left the study of over/under-expansion in other structures relatively unexplored. We therefore sought to address this gap by adapting anatomical areas from the digital atlases of 18 mammalian species, to create a common interspecies classification. Our approach used data-driven analysis based on phylogenetic generalized least squares to evaluate anatomical expansion covering the whole brain. Our main finding suggests a divergence in primate evolution, orienting the stereotypical mammalian cerebral proportion toward a frontal and parietal lobe expansion in catarrhini (primate parvorder comprising old world monkeys, apes, and humans). Cerebral lobe volumes slopes plotted for catarrhini species were ranked as parietal∼frontal > temporal > occipital, contrasting with the ranking of other mammalian species (occipital > temporal > frontal∼parietal). Frontal and parietal slopes were statistically different in catarrhini when compared to other species through bootstrap analysis. Within the catarrhini’s frontal lobe, the prefrontal cortex was the principal driver of frontal expansion. Across all species, expansion of the frontal lobe appeared to be systematically linked to the parietal lobe. Our findings suggest that the human frontal and parietal lobes are not disproportionately enlarged when compared to other catarrhini. Nevertheless, humans remain unique in carrying the most relatively enlarged frontal and parietal lobes in an infraorder exhibiting a disproportionate expansion of these areas.

PMID:35700361 | DOI:10.1073/pnas.2202491119

J Community Psychol. 2022 Jun 14. doi: 10.1002/jcop.22896. Online ahead of print.

ABSTRACT

South Africa alongside other low-middle-income countries have been some of the hardest hit by the substance use scourge. The study sought to identify and measure treatment barriers among young adults (18-29 years) living with substance use disorders, and then examine the role of gender in the perception of treatment barriers, with a view to establish gender-based treatment specialty facilities as a strategy to promote treatment seeking among young South African women. Quantitative method was used for this study, employing simple random sampling. Exploratory factor analysis and independent samples t-tests were used as statistical measures. The identified treatment barriers were found to have a larger effect on females than males. Women were considered less likely to utilise treatment services compared to males. Health promotion practitioners and policymakers can alleviate the situation by establishing gender-based treatment facilities. that respond better to women’s needs.

PMID:35700337 | DOI:10.1002/jcop.22896

Scand J Work Environ Health. 2022 Jun 14:4036. doi: 10.5271/sjweh.4036. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to examine the association between work-unit level leadership quality and individual-level long-term sickness absence (LTSA) in the hospital sector and effect modification by chronic disorders.

METHODS: This longitudinal analysis included 33 025 Danish public hospital employees who were followed-up for one year after baseline in March 2014. Leadership quality was assessed by questionnaire with mean responses aggregated by work-unit and characterized in tertiles. LTSA during follow-up was determined from employer records. Chronic disorders at baseline was assessed from the Danish hospital and prescription registers. We performed multilevel logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusting for potential confounders. We evaluated interaction between chronic illness and low leadership quality on multiplicative and additive scales.

RESULTS: We identified employees as healthy (60.8%) or with somatic (31.6%), mental (3.3%), or both somatic and mental (4.3%) disorders. During follow-up, 6% of employees registered a LTSA. Medium and high leadership quality were associated with lower risk of LTSA with OR of 0.84 (95% CI 0.76-0.94) and 0.73 (95% CI 0.65-0.82) respectively, compared to low leadership quality. Associations were similar for healthy employees and employees with only somatic disorders, whereas no association was observed for employees with mental disorders (in presence or absence of somatic disorders). No statistically significant (α=0.05) interactions between leadership quality and chronic disorders on LTSA were observed.

CONCLUSION: The findings suggest that the quality of leadership in work units is associated with risk of long-term sick leave in the Danish public hospital sector and that strong leadership protects employees against LTSA.

PMID:35700335 | DOI:10.5271/sjweh.4036

Pediatr Diabetes. 2022 Jun 14. doi: 10.1111/pedi.13383. Online ahead of print.

ABSTRACT

BACKGROUND/ OBJECTIVES: Diabetes mellitus is a chronic disease that affects many body systems, including the nervous and auditory systems. It is noted that there is a scarcity of research on the effect of diabetes on cognitive functions in particular and auditory functions in general in children with type 1 diabetes. Therefore, this study was designed to assess cognitive and auditory functions in children with type 1 diabetes mellitus and to correlate the reflection of diabetes control on cognitive functions.

METHODS: This study is a case-control study that included 100 children divided into two groups, the patient group, which includes 50 children with type 1 diabetes, and the control group, which consists of 50 healthy children. Subjects in the current study were submitted to pure tone audiometry, speech recognition threshold test, immittancemetry study, and measurement of cortical auditory evoked and P300 potentials (CAEPs and P300). These audiometric measures were statistically analyzed and correlated with the clinical characteristics of the study group.

RESULTS: The latency of P300 and CAEPs was significantly increased while the amplitude of P300 and CAEPs was significantly decreased in the patient group compared to the control group (p <0.001). P300 and CAEPs latency has a positive correlation with HbA1c levels (r = 0.460). Also, there was significant differences between the two groups regarding the hearing threshold at 8000 Hz, and 28% of patients had bilateral sensorineural hearing loss (SNHL) at 8 kHz.

CONCLUSION: The prolonged P300 and CAEPs latency and decreased amplitude in patients indicate a cognitive decline in individuals with type 1 diabetes compared to healthy individuals. HbA1c levels may increase the risk of cognitive impairment in children. In addition, the risk of bilateral sensorineural hearing loss increased at 8 kHz in children with type 1 diabetes mellitus. This article is protected by copyright. All rights reserved.

PMID:35700327 | DOI:10.1111/pedi.13383

Environ Sci Technol. 2022 Jun 14. doi: 10.1021/acs.est.2c01633. Online ahead of print.

ABSTRACT

Wild birds are known to harbor and discharge antibiotic-resistant bacteria (ARB) and their associated antibiotic resistance genes (ARGs). However, assessments of their contribution to the dissemination of antibiotic resistance in the environment are limited to culture-dependent bacterial snapshots. Here, we present a high-throughput sequencing study that corroborates extensive ARG exchange between wild bird feces and their habitats and implies the need to scrutinize high-mobility birds as potential vectors for global propagation of ARGs. We characterized the resistome (281 ARGs) and microbiome of seven wild bird species and their terrestrial and aquatic habitats. The resistomes of bird feces were influenced by the microbial community structure, mobile genetic elements (MGEs), and residual antibiotics. We designated 33 ARGs found in more than 90% of the bird fecal samples as core ARGs of wild bird feces, among which 16 ARGs were shared as core ARGs in both wild bird feces and their habitats; these genes represent a large proportion of both the bird feces (35.0 ± 15.9%) and the environmental resistome (29.9 ± 21.4%). One of the most detected β-lactam resistance genes (bla_TEM, commonly harbored by multidrug resistant “superbugs”) was used as molecular marker to demonstrate the high interconnectivity of ARGs between the microbiomes of wild birds and their habitats. Overall, this work provides a comprehensive analysis of the wild bird resistome and underscores the importance to consider genetic exchange between animals and the environment in the One Health approach.

PMID:35700319 | DOI:10.1021/acs.est.2c01633