Nevin Manimala

Ir J Med Sci. 2022 Sep 27. doi: 10.1007/s11845-022-03168-7. Online ahead of print.

ABSTRACT

BACKGROUND: Platelet-rich plasma(PRP) and prolotherapy(PRL) are regenerative treatment approaches in the knee osteoarthritis (KOA).

AIM: To see how efficient PRP and PRL are in treating KOA.

METHODS: A total of 108 patients with a diagnosis of KOA who received either PRL, PRP, or exercise therapy and whose 3-month follow-up data were available were included in this retrospective study (PRL n = 35 or PRP n = 35, exercise n = 38). Visual Analogue Scale(VAS) and The Western Ontario McMaster University Osteoarthritis Index(WOMAC) were used as outcome measures at baseline, 1 month, and 3 months.

RESULTS: There were no statistically significant differences between the three groups in terms of demographic parameters, baseline assessments of pain intensity, or WOMAC scores. At the first and third months, all groups showed a substantial improvement in the VAS activity, resting and WOMAC values as compared to before treatment(p < 0.05). When the groups were compared, the VAS activity, resting, and WOMAC values in PRP and PRL improved significantly in the first and third months compared to the exercise group. At one month, there was a statistically significant improvement in VAS activity and WOMAC pain and total scores compared to PRP and PRL, but this improvement was not significant at 3 months.

CONCLUSION: Pain and disability were significantly improved with PRL and PRP compared with exercise therapy. Although PRP is more effective than PRL in the first month after treatment, PRL may be preferred due to its low cost, long-term efficacy, and low complication rates due to the periarticular application.

PMID:36166187 | DOI:10.1007/s11845-022-03168-7

Hormones (Athens). 2022 Sep 27. doi: 10.1007/s42000-022-00398-3. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study is to explore the association between adiposity indices and blood lipid indices and prediabetes. We compare the predictive value of new adiposity indices and traditional adiposity indices and blood lipid indices in the diagnosis of prediabetes.

METHODS: This is a prospective cohort study of 7953 participants. The follow-up time was 3 years. The eight adiposity indices included the following: body mass index (BMI), waist circumference (WC), body roundness index (BRI), A Body Shape Index (ABSI), visceral adiposity index (VAI), lipid accumulation product (LAP), fatty liver index (FLI), and triglyceride-to-glucose fasting index (TyG), as well as four blood lipid indices as follows: total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C).The association between adiposity indices and blood lipid indices for diagnosis of prediabetes was estimated using a logistic regression model to obtain the odds ratio (OR) and its 95% confidence interval (CI). We calculated the area under the curve (AUC) of receiver operating characteristic (ROC) curve analysis to measure the predictive value of adiposity indices and blood lipid indicators for the diagnosis of prediabetes in the general population stratified by gender.

RESULTS: The median age of the participants was 56 years old, men accounting for 35.3% of the final group. After adjusting for confounding factors, association of BMI, BRI, VAI, LAP, TyG, TC, TG, and LDL-C with prediabetes status was assessed at both baseline and follow-up. TyG (AUC, overall: 0.677 (95% CI, 0.665, 0.689), male: 0.645 (95% CI, 0.624-0.667), and female: 0.693 (95% CI, 0.678-0.708)) have better diagnostic value for prediabetes than VAI, LAP, FLI, TC, TG, HDL-C, and LDL-C. The predictive value of the combination of TyG, BRI, VAI, and TG significantly improves the power of any single index in the diagnosis of prediabetes. The AUC and corresponding 95% CI of TyG, BRI, VAI, and TG and the combination of these four indicators to diagnose prediabetes were 0.677 (0.665, 0.689), 0.630 (0.617, 0.643), 0.618 (0.606, 0.631), 0.622 (0.609, 0.635), and 0.728 (0.716, 0.739), respectively.

CONCLUSIONS: Among the eight adiposity indices and four blood lipid indices evaluated in the study, TyG had the highest diagnostic value for prediabetes in isolated indexes, and the combination of TyG, BRI, VAI, and TG significantly improved the diagnostic value for prediabetes of any single indicator.

PMID:36166170 | DOI:10.1007/s42000-022-00398-3

Community Ment Health J. 2022 Sep 27. doi: 10.1007/s10597-022-01025-6. Online ahead of print.

ABSTRACT

The COVID-19 pandemic and associated sequelae have disproportionately exacerbated refugee mental health due to health disparities, poverty, and unique risk factors. In response to the pandemic, most mental health providers have shifted to virtual platforms. Given the high need for services in this population, it is essential to understand the effectiveness and potential barriers to serving refugees via telehealth. This study is one of the first to examine the extent that socio-cultural and structural barriers impact telemental health services received by resettled refugees during the COVID-19 pandemic. This study also addresses the potential benefits of telemental health service delivery to refugees. We surveyed 85 providers serving refugee and non-refugee clients in the United States. Statistical analyses revealed that more significant socio-cultural and structural barriers, including access to technology, linguistic challenges, and privacy limitations, exist for refugees compared to non-refugee clients. Potential benefits of telemental health for refugees during the pandemic included fewer cancellations, fewer transportation concerns, and better access to childcare. These results highlight the need to address the disparity in telemental health service delivery to refugees to limit inequities for this population.

PMID:36166148 | DOI:10.1007/s10597-022-01025-6

Acta Neurol Belg. 2022 Sep 27. doi: 10.1007/s13760-022-02085-x. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Aneurysmal subarachnoid hemorrhages (aSAH) have high mortality and morbidity. However, the impact on Quality of Life (QoL) of patients remains poorly documented, and data on primary caregiver burden is even scarcer.

METHODS: This is a single center, cross-sectional study performed at the Antwerp University Hospital, Belgium. We included aSAH patients during follow-up at the outpatient clinic and assessed the QoL, by using the Stroke Specific Quality of Life scale (SSQoL). Caregiver burden was evaluated by the Caregiver Strain Index (CSI). The aSAH severity and functional outcome (at 90 days) were assessed, respectively, by mFisher score and modified Ranking Scale (mRS). Statistical analysis was performed using SPSS version 27.

RESULTS: In total, 22 aSAH patients were included, on average 15.5 (range 4-45) months after the aSAH. The SSQoL score was 3.7 ± 0.7, with a mean psychosocial domain score of 3.2 ± 0.8 and physical domain of 4.2 ± 0.8. Psychosocial factors, especially decreased energy levels and cognitive impairment, had a negative impact on the QoL (p = 0.02 en p = 0.05). No association was found between QoL and mFisher, nor between QoL and mRS. Fifteen primary caregivers completed the CSI. Only 3 (20%) of them reported a high care burden (CSI > 6), although changes in daily life and personal plans were reported, respectively, by 73% (n = 11) and 67% (n = 10) of caregivers. We only found a correlation between the mFisher score and CSI (p = 0.01).

CONCLUSION: Our results emphasize that there is an important psychosocial impact on the QoL of patients after aSAH, and their primary caregivers. More research is warranted.

PMID:36166138 | DOI:10.1007/s13760-022-02085-x

Environ Sci Pollut Res Int. 2022 Sep 27. doi: 10.1007/s11356-022-23187-2. Online ahead of print.

ABSTRACT

The environmental pollution caused by climate change and global warming pose significant risks to health. This raises the question how environmental disturbances can affect health expenditures. Based on this, this study examines the asymmetric effect of environmental quality on health expenditures in Türkiye using the non-linear ARDL (NARDL) model for the 1975-2019 period. In addition to environmental quality, natural resources, economic growth, and trade openness variables are also included in the health expenditure model. The findings support the existence of an asymmetric cointegration relationship between the series. The findings also indicate that positive environmental pollution shocks affect health expenditures positively in the long run, while negative environmental pollution shocks do not have a statistically significant effect on health expenditures. Positive and negative natural resource shocks affect health expenditures negatively in the long run. Despite the effect of positive economic growth shocks on health expenditures is positive but statistically insignificant, the effect of negative economic growth shocks is positive and significant. Besides, positive trade openness shocks have a negative effect on health expenditures and negative trade openness shocks have a positive effect. The findings prove that the steps to be taken to protect the environment in the current period will increase the effectiveness of health expenditures in the future. This situation has a guiding feature for policy-makers in terms of policy decisions.

PMID:36166119 | DOI:10.1007/s11356-022-23187-2

Int J Clin Oncol. 2022 Sep 27. doi: 10.1007/s10147-022-02237-2. Online ahead of print.

NO ABSTRACT

PMID:36166110 | DOI:10.1007/s10147-022-02237-2

Eur J Pediatr. 2022 Sep 27. doi: 10.1007/s00431-022-04629-y. Online ahead of print.

ABSTRACT

Extremely preterm birth is associated with a high risk of chronic pulmonary insufficiency of prematurity (CPIP). Lung ultrasound score (LUS) proved capable to characterise CPIP progression beyond the acute setting, but still, post-discharge data remain lacking. We hypothesised a priori that LUS in both BPD and no-BPD infants declines with postnatal age from birth through early infancy. This observational retrospective cohort study included preterm infants < 32 gestational weeks, who underwent the follow-up for CPIP. LUS was assessed from birth to 8 months postnatal age, over antero-lateral (LUS) and posterior (pLUS) pulmonary areas, placing the transducer longitudinally over the midclavicular and midaxillary lines and medial to the scapular line respectively. Extended LUS (eLUS) including LUS and pLUS was calculated. The primary outcome was LUS time course. Secondary outcomes included the correlation between LUS and pLUS. Sixty-two infants were included: 22 (35.5%) in the BPD group and 40 (64.5%) in the no-BPD group. BPD group infants were smaller (weight 841 g (± 228) vs 1226 (± 328), p < 0.001) and younger (26.8 weeks (± 2.0) vs 28.9 (± 1.9), p < 0.001). LUS declined over time in the entire population (ß = – 1.75, p < 0.001) and in both no-BPD and BPD groups (ß = – 1.64, p < 0.001 and ß = – 1.93, p < 0.001, respectively). eLUS declined correspondingly (p < 0.001). LUS and likewise eLUS were significantly different between BPD and no-BPD groups over time (p < 0.001). Conclusion: LUS trajectory progressively decreased from birth to early infancy. BPD cohort tracked higher, implying a worse respiratory status. pLUS had a similar timepoint course, adding no further information to LUS. To the best of our knowledge, this is the first study that describes preterm LUS time course after discharge. LUS may help track the CPIP progression. What is Known: • Extremely preterm birth is associated with high risk of chronic pulmonary insufficiency of prematurity (CPIP). • Several studies investigated the ability of lung ultrasound score (LUS) to characterize CPIP progression beyond the acute setting, still post-discharge data remain lacking. What is New: • LUS trajectory progressively decreases from birth to early infancy; BPD cohort tracks higher, implying a worse respiratory status. pLUS has similar timepoint course, adding no further information to LUS. • The use of LUS may contribute to better characterising and monitoring CPIP in BPD and no-BPD infants.

PMID:36166097 | DOI:10.1007/s00431-022-04629-y

Clin Exp Med. 2022 Sep 27. doi: 10.1007/s10238-022-00890-5. Online ahead of print.

ABSTRACT

Bibliometric analysis is helpful to determine the most influential studies in a specific field. A large number of publications in anaphylaxis have been published. However, no bibliometric analysis of anaphylaxis was conducted based on our known. The aim of this study is to identify the top 100 most cited articles in anaphylaxis and analyze their bibliometric characteristics. We searched in the Web of Science core database on November 20, 2021. Articles were listed in descending order by their total citations. Hence the top 100 most cited articles in anaphylaxis were identified and analyzed. Bibliometric indicators included: year of publication, total number of citations and average citations per year (ACY), journal of publication and impact factor (IF), countries, institutes, and authors, which were analyzed by Biblioshiny. Co-occurrence was used to visualize the classification and hotspots. The top 100 most cited articles were published between 1991 and 2017. The largest number of articles was published in a single interval in 2006-2008. Total citations of the 100 articles were between 155 and 1241 and were positively correlated with the number of articles published in each 3-year interval. The top100 articles were published in 34 different journals. The Journal of Allergy and Clinical Immunology published the most (n = 41). The corresponding authors of the top100 articles were from 13 different countries, mostly in North America and Europe. Statistical analysis revealed a positive correlation between total number of citations and ACY (r = 0.670, p < 0.01) and between total number of citations and IF (r = 0.219, p < 0.05), whereas a negative correlation between ACY and length of time since publication (r = – 0.697, p < 0.01). The research focuses were classified into three clusters: (1) the epidemiology and management. (2) the risk factor and treatment. (3) the assessment and diagnosis. COVID-19 vaccines, drug allergy and management were the recent major topics. This bibliometric analysis reveals the progress and hotspots of research in anaphylaxis, which may lay a foundation for further research.

PMID:36166096 | DOI:10.1007/s10238-022-00890-5

Knee Surg Sports Traumatol Arthrosc. 2022 Sep 27. doi: 10.1007/s00167-022-07158-1. Online ahead of print.

ABSTRACT

PURPOSE: Computer-assisted surgery (CAS) total knee arthroplasty (TKA) remains a controversial area of surgical practice. The aim of this study is to report the ten-year revision rates and patient-reported outcome measures (PROMS) of a single-blinded, prospective, randomised controlled trial comparing electromagnetically (EM) navigated and conventional TKA.

METHODS: 199 patients were randomised to receive either EM navigated or conventional TKA where the aim of implantation was neutral mechanical alignment in all cases. Ten-year revision rates were collated and compared between the two intervention groups. Longitudinal PROMS data was collected prospectively at various time points up to 10 years post-operatively.

RESULTS: Over the ten-year period, there were 23 deaths (22.8%) in the EM navigation cohort and 30 deaths (30.6%) in the conventional cohort. At 10 years post-operatively, there was no statistically significant difference in all cause revision between the EM navigation and conventional cohort (4.0 vs 6.1%, p = 0.429). When analysing causes of revision that might be influenced by utilising EM navigation, there was no statistically significant difference in revisions (3.0% EM navigated vs 4.1% conventional group, p = 0.591). Patients that received navigated TKAs had improved Oxford Knee Society, American Knee Society Score and range of motion at 3 months following surgery compared to conventional TKA (p = 0.002, p = 0.032, and p = 0.05, respectively). However, from 1 to 10 years post-operatively, both interventions had equivalent outcomes.

CONCLUSION: There is no difference in revision rates or clinical outcomes comparing EM navigated versus conventional TKA at ten-year follow-up. The expected mortality rate makes it unlikely that a difference in revision rates will reach statistical significance in the future. In the setting of an experienced knee arthroplasty surgeon, it is difficult to justify the additional costs of CAS in TKA surgery.

LEVEL OF EVIDENCE: I.

PMID:36166095 | DOI:10.1007/s00167-022-07158-1

Eur J Orthop Surg Traumatol. 2022 Sep 27. doi: 10.1007/s00590-022-03369-x. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare the postoperative alignment of the lower limbs using fixed angle versus variable valgus angle distal femur resection in uncomplicated total knee replacement (TKR) and to determine the mean valgus correction angle (VCA) in the study population.

METHODS: This was a prospective comparative study conducted between July 2018 and December 2019 in patients with osteoarthritic knees who underwent primary TKR. Forty-nine patients with 54 knees completed the study. They were randomized into fixed valgus angle (group A) and variable valgus angle (group B) groups. Twenty-four patients with 26 knees were in group A who had distal femur resection with 5-degree valgus correction, while 25 patients with 28 knees were in group B who had distal femur resection with individualized valgus correction angle calculated from hip-knee-ankle scanogram.

RESULTS: The demographic data were comparable in the two groups. There was no statistically significant difference between the groups in the mean preoperative mechanical femorotibial angle (MFTA). The fixed angle group had a mean postoperative MFTA of 2.0 ± 2.8°, while variable angle group had a mean of 1.6 ± 2.4°. However, the difference between the groups did not reach statistical significance (p = 0.60). The mean VCA in the study population was 5.8 ± 1.2° (Range 4-9°).

CONCLUSION: Our study has shown that the use of variable valgus angle for distal femur resection in uncomplicated TKR did not significantly improve the accuracy of restoring the postoperative coronal alignment within 0 ± 3°.

PMID:36166094 | DOI:10.1007/s00590-022-03369-x