Nevin Manimala

Clin Child Psychol Psychiatry. 2021 Dec 29:13591045211055822. doi: 10.1177/13591045211055822. Online ahead of print.

ABSTRACT

The current study aims to clarify the longitudinal relations among parent emotion regulation (ER), child ER, and children’s oppositional defiant disorder (ODD) symptoms. In the current study, parents of 275 children (195 boys, 70.1%) with ODD symptoms (M_age = 9.32 years, SD = 1.64) reported their ER using the Difficulties in Emotion Regulation Scale, child ERs using the Emotion Regulation Checklist, and children’s ODD symptoms using the eight symptoms indicated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) at three time points (T1, T2, and T3) within 2 years. Results indicated the longitudinal relationships between parent ER and children’s ODD symptoms were directly influenced by each other. Children’s ODD symptoms had important effects on both child ER and parent ER. Findings suggested that to reduce children’s ODD symptoms, it is necessary not only to improve child ER but also to improve parent ER.

PMID:34965152 | DOI:10.1177/13591045211055822

Vestn Oftalmol. 2021;137(6):55-60. doi: 10.17116/oftalma202113706155.

ABSTRACT

PURPOSE: To assess the effects of phacoemulsification cataract surgery (PCS) and its pharmacological support on the prevalence of dry eye (DE) type ocular surface changes.

MATERIAL AND METHODS: The study included 550 patients with age-related (369 patients) or complicated (181 patients) cataracts (247 men, 303 women; mean age 71.6±7.3 years) who were assessed using the Ocular Surface Disease Index (OSDI), tear break-up test (TBUT), Shirmer-1 test, lipid interference test, OCT meniscometry, examined for xerosis indicators and «lid vipers» symptom in order to detect DE before PCS, as well as on days 1, 7, 30 after PCS. Meibomian gland dysfunction (MGD) was determined by the Norn compression test, which was performed before PCS. The significance of differences was assessed using Pearson χ² test.

RESULTS: Before PCS the prevalence of DE was 51.1%, asymptomatic subclinical DE – 28.9%. MGD was detected in 79.4% of DE patients and in 50.3% subclinical DE patients. After PCS, an increase in DE prevalence was noted (due to increase in the prevalence of mild DE): on the 1^st day – up to 58% (χ²=5.295; p=0.022; p<0.05), on the 7^th day after surgery – up to 63.1% (χ²=16.165; p=0.001; p<0.01), on the 30^th day – up to 55.6% (χ²=2.283; p=0.131; p>0.05).

CONCLUSION: The study revealed a trend towards an increase in DE prevalence after PCS (due to an increase in the proportion of hypersecretory mild DE), which was statistically significant on days 1 and 7 after the operation and statistically insignificant by the 30^th day after surgery. Apparently, it could be associated with aggravation of “background” asymptomatic ocular surface changes. From our point of view, the high prevalence of DE and subclinical DE in cataract patients before PCS makes it advisable to carry out preoperative preparation aimed at normalizing the condition of ocular surface. At the same time, the high prevalence of MGD in DE and subclinical DE patients determines one of the directions of preoperative treatment – eyelids hygiene.

PMID:34965068 | DOI:10.17116/oftalma202113706155

Acta Gastroenterol Belg. 2021 Oct-Dec;84(4):601-605. doi: 10.51821/84.4.011.

ABSTRACT

BACKGROUND AND AIMS: Gastric bypass surgery effectively treats obesity; however, its association with belching, which occurs in other bariatric surgeries, remains unclear. Hence, we aimed to evaluate belching occurrence after gastric bypass surgery.

METHODS: We enrolled 12 healthy volunteers and 17 patients (12 and 5 underwent Roux-en-Y gastric bypass and mini-gastric bypass surgeries 24 (18-54) months prior, respectively). Gastrointestinal symptoms were assessed. Gastroscopy was performed, followed by the 24-hour pH-impedance analysis.

RESULTS: Age and sex were not statistically different between the two groups (P > 0.05). Patients had a significantly higher mean DeMeester score than the healthy controls (9.11 ± 19.40 vs. 6.04 ± 5.60, P = 0.048), but the pathologic acid reflux (DeMeester score > 14) rate was similar in both groups (11.8% vs. 8.3%). Regarding the impedance, symptom-association probability was positive in 11.8% of patients. The patients also had higher alkaline reflux rates (6% vs. 0%); additionally, 50% of them experienced belching based on the questionnaire, and 25% had esophagitis based on gastroscopy. Furthermore, patients had a significantly higher number of gas reflux (123.24 ± 80 vs. 37.2 ± 21.5, P = 0.001) and supragastric/ gastric belches (182 ± 64/228 ± 66.69 vs. 25.08 ± 15.20/12.17 ± 17.65, P = 0.001). Supragastric belching was more frequent than gastric belching in the controls, whereas gastric belching was more frequent in the patients.

CONCLUSION: Belching increases after gastric bypass surgery in a long-term period. Gastric belching was more frequent than supragastric belching in these patients.

PMID:34965042 | DOI:10.51821/84.4.011

Acta Gastroenterol Belg. 2021 Oct-Dec;84(4):563-569. doi: 10.51821/84.4.006.

ABSTRACT

BACKGROUND AND STUDY AIM: In European Society of Gastrointestinal Endoscopy guidelines, biliary cannulation of naive papillae is defined as difficult in the presence of more than 5 papilla contacts, more than 5min cannulation time or more than one unintended pancreatic duct cannulation or opacification. It is not known whether cholecystectomy is a cause of difficult biliary cannulation. This study aimed to investigate whether cholecystectomy (CCY) is a cause of difficult biliary cannulation in patients who have undergone Endoscopic Retrograde Cholangiopancreatography (ERCP) for choledocholithiasis.

PATIENTS AND METHODS: Adult patients with naive papillae and those who underwent ERCP for common bile duct stones and/or sludge were included in this retrospective study. Patient demographics, clinical presentation (acute cholangitis, biliary pancreatitis or biliary colic), periprocedural data including laboratory and radiological findings and ERCP results were compared between no-CCY and post-CCY groups.

RESULTS: 438 patients were included in the present study and 347 of these patients were in the no-CCY group and 91 patients were in post-CCY group. A statistically significant difference was found in the number of patients with difficult cannulation in the post-CCY group (n=30, 33.0%) patients compared to the no- CCY group (n=67, 19.3%) (p=0.011). According the multivariate analyses results, presence of history of cholecystectomy was found an independent risk factor of difficult cannulation (Odds ratio: 2.014; 95 % Cl 1.205-3.366; p=0.008).

CONCLUSIONS: The results showed that biliary cannulation was significantly more difficult in patients with cholecystectomy who underwent ERCP for common bile duct stones.

PMID:34965037 | DOI:10.51821/84.4.006

Swiss Med Wkly. 2021 Dec 20;151:w30054. doi: 10.4414/smw.2021.w30054. eCollection 2021 Dec 20.

ABSTRACT

AIMS OF THE STUDY: In Switzerland, there has been a boom in the market for cannabidiol (CBD) products in recent years. However, little is known on the prevalence, modes of administration and motives for use of CBD products. The aim of the present study was to fill this gap using recent (2019) data from the Cohort Study on Substance Use Risk Factors (C-SURF).

METHODS: Between April and December 2019, an unselected sample of 5233 Swiss young men from the French- and German-speaking regions (mean age 28.2 years, standard deviation 1.3) completed a self-report questionnaire covering measures of use of CBD products, modes of administration and motives to use of CBD, tetrahydrocannabinol (THC) and cigarettes. Descriptive statistics were used to estimate prevalence of self-reported use, modes of administration and motives to use CBD, whereas logistic regression models were used to test the associations of linguistic region, THC and tobacco use with use of CBD.

RESULTS: Lifetime and 12-month prevalence of self-reported use of CBD were 32.4% and 18.5%, respectively. Among past 12-month CBD users, 79.4% used CBD once a month or less often, whereas 20.6% used it more than once a month. The most often reported modes of administration of CBD were in association with tobacco: flowers mixed with tobacco (67.5%), and CBD cigarettes with tobacco (37.1%), while 18.6% used flowers without tobacco. The three most reported reasons for using CBD were: out of curiosity (74.0%), to feel the effects of THC (38.1%) and for well-being and health (37.5%). In multivariable models, CBD use was associated with use of THC (odds ratio [OR] 9.85, 95% confidence interval [CI] 8.28-11.73), cigarettes (OR 2.74, 95% CI 2.28-3.29) or e-cigarettes (OR 1.5795% CI 1.27-1.95), as well as for the linguistic region (French-speaking vs German-speaking region OR 1.3895% CI 1.15-1.65).

CONCLUSIONS: Self-reported use of CBD is common among young Swiss men: about one third used CBD in their life and about one in five in the previous 12 months. However, the vast majority of CBD users used it infrequently and out of curiosity. CBD use was particularly prevalent among users of THC and cigarette smokers. CBD was most often used in combination with tobacco, thus exposing users to risks associated with smoking tobacco products.

PMID:34964581 | DOI:10.4414/smw.2021.w30054

Monaldi Arch Chest Dis. 2021 Dec 28. doi: 10.4081/monaldi.2021.2024. Online ahead of print.

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is usually associated with a variety of extra-pulmonary manifestations. Metabolic syndrome (MetS) is one such entity that has been scarcely studied in Indian patients. Availability of a good screening marker may help in timely detection of this co morbidity in COPD patients. We conducted a cross sectional study to evaluate the prevalence of MetS among COPD patients and to evaluate the role of Interleukin-6 and insulin resistance (as measured by HOMA-IR) as screening markers for MetS in COPD. A total of 100 stable COPD patients were evaluated for MetS using US National Cholesterol Education Program Adult Treatment Panel III (2005) guidelines. Interleukin-6 and HOMA-IR (for insulin resistance) were measured and compared between COPD patients with and without MetS. ROC analysis was done to find the best cut-off value and sensitivity and specificity of both the molecules in detecting MetS. In the results, the mean age of the study cohort was 59.9+8.7yrs (males=93). Forty five COPD patients (45%) fulfilled the criteria for MetS. Patients with MetS were comparatively younger (57.9+9.5 v/s 61.6+7.8 years; p=0.037) but had longer duration of preceding COPD (9.9+2.8 v/s 6.0+2.2 years; p<0.001) as compared to those without MetS. Both IL-6 and HOMA index were statistically higher (p<0.05) in COPD-MetS patients as compared to the other group. At cutoff value of 36.3 pg/ml for IL-6 and 1.61 for HOMA index, IL-6 and HOMA-IR had sensitivity 91.1% and 82.2% respectively in detecting MetS among COPD patients. To conclude, metabolic syndrome is a common comorbidity seen in COPD patients. Interleukin-6 has a better sensitivity than HOMA-IR in screening MetS among COPD patients.

PMID:34964574 | DOI:10.4081/monaldi.2021.2024

Monaldi Arch Chest Dis. 2021 Dec 28. doi: 10.4081/monaldi.2021.1984. Online ahead of print.

ABSTRACT

Dyspnea is a common symptom in Systemic Sclerosis (SSc) that considerably decreases patients’ quality of life (QoL). Pulmonary Rehabilitation (PR) mitigates dyspnea impact on daily activities. The aim of this study is to evaluate the effect on respiratory disability of home-based PR in SSc patients with dyspnea. In this observational prospective monocentric study, we screened all dyspneic SSc consecutive patients attending the Rheumatological day hospital in the University hospital of Parma from January 2019 and June 2019. The aim of our study was to understand if a PR unsupervised home-based program could improve respiratory disability in this specific population. Dyspnea was evaluated with the self-administered questionnaires modified Medical Research Council (mMRC) and Saint George’s Respiratory Questionnaire (SGRQ).Patients also filled in Short Form 36 (SF36) and the Modified-Health Assessment Questionnaire for SSc (HAQ-MOD). Health Professionals assessed and trained the patients and collected data before PR and at the end of the program. PR consisted in 5 weekly unsupervised sessions for 8 weeks. Wilcoxon test for paired data evaluated the changes after PR. p<0.05 was considered statistically significant. 46 SSc patients were included (43 female). Only 31 (29 female) performed PR as planned (Adherent Group-AG) while the others gave up within the first week (Non-Adherent Group-NAG). All SGRQ domains (Symptoms: from 30 to 18; p=0.0055; Activity: from 47 to 35, p=0.23; Impact from 29 to 25, p=0.044) and SGRQ total score (from 35 to 29; p=0.022) improved in AG. SGRQ scores did not change in NAG as well as SF36 and HAQ-MOD in both groups. The home-based PR program dramatically decreased the effect, frequency and severity of respiratory symptoms. Conversely, it slightly changed the activities causing breathlessness and dyspnea-related social functioning disturbances. PR appears to be a useful tool in treatment strategies aiming to achieve a QoL improvement in SSc patients.

PMID:34964573 | DOI:10.4081/monaldi.2021.1984

Microsc Res Tech. 2021 Dec 29. doi: 10.1002/jemt.24040. Online ahead of print.

ABSTRACT

Aim of this study was to determine the fracture strength and modes of endocrown and overlay restorations with/without fiber reinforcement on endodontically treated teeth. Sixty-five molar teeth were used: Group IN (intact teeth), Group E (endocrown), Group ER (endocrown + ribbond), Group O (overlay), Group OR (overlay + ribbond; n = 13). Ribbond (Seattle, WA) was inserted at the base of pulp chamber in Group ER and OR. All restorations were designed and produced by using computer-aided design and computer-aided manufacturing (Sirona Dental Systems, Bensheim, Germany) and Cerasmart (GC Corp. Kasugai, Aichi, Japan). All teeth were subjected to thermomechanical aging and fractured in a universal test device. Fractured surfaces were analyzed with a stereomicroscope (SMZ1000, Nikon, Japan). Data were analyzed with Welch’s analysis of variance and Games-Howell test (p < .001). Group E showed significantly lower fracture strength values than other groups(p < .05). No statistically significant differences were found among the other groups(p > .05). Most of the unfavorable fractures were seen in Groups E and O. Overlay restorations showed higher fracture strength values than endocrown restorations. Although fiber insertion did not improve the fracture strength of the indirect restorations, it reduced the frequency of irreparable fracture mode. Overlay restorations and fiber application are more advantageous in preserving the durability of the endodontically treated teeth.

PMID:34964540 | DOI:10.1002/jemt.24040

Hemodial Int. 2021 Dec 29. doi: 10.1111/hdi.12987. Online ahead of print.

ABSTRACT

INTRODUCTION: Severe infection is a major problem in hemodialysis patients. Multiplex proteomics might reveal novel insights into disease mechanisms increasing the risk of infection and might also be used as a risk prediction tool. The aims of this study were (1) to evaluate associations between 92 proteins assessed by a proximity extension assay and the development of severe infection in patients on hemodialysis and (2) to develop a risk prediction model for severe infection using prespecified clinical variables and proteomics.

METHODS: Prospective, observational multicenter cohort study with 5-year follow-up. Patients receiving in-center hemodialysis in five facilities in Denmark were included. The primary composite endpoint was death caused by infection, bacteremia, and infections requiring hospitalization of at least 2 days or prolonging a hospital stay.

FINDINGS: Of 331 patients included 210 patients reached the primary endpoint during follow-up. In adjusted Cox regression analyses, 14 plasma proteins were associated with severe infection. Correcting for multiple testing revealed only cathepsin-L1 and interleukin-6 significantly associated with the primary outcome. Cathepsin-L1-hazard ratio: 1.64 (95% confidence interval [CI] 1.24-2.17) and interleukin-6-hazard ratio: 1.16 (95% CI 1.05-1.29). Apparent C-statistics of the risk prediction model using clinical variables was 0.605, addition of cathepsin-L1 and interleukin-6 to the model improved discrimination slightly: C = 0.625.

DISCUSSION: Proteomic profiling identified cathepsin-L1 and interleukin-6 as markers for infectious risk in hemodialysis patients. Further studies are needed to replicate the results and to examine possible causality. The developed risk prediction models need considerable improvement before implementation in clinical practice is meaningful.

PMID:34964538 | DOI:10.1111/hdi.12987

Eur J Pain. 2021 Dec 29. doi: 10.1002/ejp.1903. Online ahead of print.

ABSTRACT

BACKGROUND: Knee pain is the major complaint in individuals with knee osteoarthritis (OA), and the effects of transcutaneous electrical nerve stimulation (TENS) on knee pain are controversial. The present study applied TENS along with functional tests to investigate its effect on pain level in individuals with mild to moderate knee OA.

METHODS: Twenty volunteers with knee OA classification of graded 2-3 performed four functional tests (stair climb test – SCT, timed up and go test – TUG, 6-minute walk test – 6MWT, knee extensor strength test – KES, and 2-step test from the locomotive syndrome risk test – LSR_2ST) while wearing either an active or inactive TENS. Knee pain level before and after each test was self-accessed by the visual analog scale (VAS). The effect of TENS (active vs. inactive) on pain level was submitted to statistical analyses.

RESULTS: Knee pain during SCT, TUG, and LSR_2ST tests was significantly lower when subjects used the active TENS, compared to using the inactive unit. The effect of the active TENS on pain level was also more significant in subjects with no anxiety or depression.

CONCLUSIONS: The results provided evidence of immediate pain relief in individuals with mild to moderate knee OA when TENS is applied along with functional activities, that usually induced pain in people with knee OA.

PMID:34964537 | DOI:10.1002/ejp.1903