Nevin Manimala

World J Mens Health. 2021 Feb 24. doi: 10.5534/wjmh.200155. Online ahead of print.

ABSTRACT

PURPOSE: Male infertility is a worldwide problem with limitations in the treatment. Phosphodiesterase-5 inhibitors (PDE5is) is the first choice for the treatment of erectile dysfunction, more and more studies show that it has a certain effect on male infertility in recent years. But there was currently no high quality of systematic review to evaluate the effects of PDE5is on semen quality.

MATERIALS AND METHODS: We retrieved the electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, etc. Related randomized controlled trials (RCTs) were collected and selected up to May 20, 2020. We have searched literature with terms “male infertility”, “phosphodiesterase-5 inhibitors”, “PDE5i”, “Tadalafil”, “Sildenafil”, “Vardenafil”, “Udenafil”, “Avanafil”, “semen”, and “sperm”. Mean value and its standard deviation were used to perform quantitative analysis. All statistical analyses were conducted by RevMan 5.3 and Stata software.

RESULTS: There were a total of 1,121 participants in the nine included studies. There was a statistically significant improvement treated with PDE5is compared with sham therapy, which including sperm concentration (mean difference [MD]=1.96, 95% confidence interval [CI]=1.70-2.21, p<0.001; MD=3.22, 95% CI=1.96-4.48, p<0.001), straight progressive motility (%) Grade A (MD=3.71, 95% CI=2.21-5.20, p<0.001), sperm motility (MD=8.09, 95% CI=7.83-8.36, p<0.001), morphologically normal spermatozoa (%) (MD=0.67, 95% CI=0.20-1.15, p=0.005; MD=1.27, 95% CI=0.02-2.52, p=0.05), sperm abnormalities (%) (MD=-0.64, 95% CI=-0.81–0.47, p<0.001), and progressive motile sperm (MD=5.34, 95% CI=3.87-6.81, p<0.001).

CONCLUSIONS: In this meta-analysis of nine RCTs, treatment with PDE5is could improve some indicators of male sperm.

PMID:33663030 | DOI:10.5534/wjmh.200155

Psychogeriatrics. 2021 Mar 4. doi: 10.1111/psyg.12673. Online ahead of print.

ABSTRACT

BACKGROUND: The changes that occur during the ageing process affect the mental health of individuals and their adaptation to old age. In this study, it was aimed to evaluate the effect of progressive muscle relaxation (PMR) exercises on the depression level of elderly women and their adaptation to old age.

METHODS: A randomised controlled trial design was used. The sample consisted of 49 elderly women (21 intervention and 28 controls) from a family health centre of a city in Turkey. The research data were collected using the introductory information form, Mini-Mental State Examination, Barthel index, Geriatric Depression-15 Scale, and Assessment Scale of Adaptation Difficulty for the Elderly. Two home visits were made to women in the first and eighth week of the application. PMR was applied by women in the intervention group in 28 min sessions three times a week for 8 weeks. During the 8 weeks the women were called by the researcher once a week and PMR was reminded.

RESULTS: As a result of the PMR exercises performed for 8 weeks, it was determined that there was a statistically significant difference in the mean Geriatric Depression-15 Scale and Assessment Scale of Adaptation Difficulty for the Elderly scores of the women in the intervention group compared to the control group (P < 0.05).

CONCLUSION: In this study, it was found that PMR exercises reduce the depression level of elderly women and increase their adaptation to old age.

PMID:33663021 | DOI:10.1111/psyg.12673

Eur J Pediatr Surg. 2021 Mar 4. doi: 10.1055/s-0041-1723994. Online ahead of print.

ABSTRACT

INTRODUCTION: The majority of pediatric surgeons and hepatologists recommend the centralization of biliary atresia (BA) treatment within experienced liver units. We aimed to investigate whether voluntary self-restriction and acceptance of the need for this change in practice changed the BA referral policy in Germany during the last decade.

MATERIALS AND METHODS: In cooperation with pediatric surgeons, gastroenterologists or hepatologists, and pediatric liver transplant units, the 2-year follow-up data of infants with BA born in Germany between 2010 and 2014 were collected using www.bard-online.com or pseudonymized data transfer. Results were compared with our previous analysis of the outcome data of infants with BA born between 2001 and 2005 in Germany.

RESULT: Overall, 173 infants with BA were identified, of whom 160 underwent Kasai portoenterostomy (KPE; 92.5%) and 13 (7.5%) underwent primary liver transplantation at 21 German centers. At 2-year follow-up, overall survival was 87.7% (vs. 81.9% in 2001-2005 [p = 0.19]), survival with native liver post-KPE was 29.2% (vs. 22.8% in 2001-2005 [p = 0.24]), and jaundice-free survival with native liver post-KPE was 24.0% (vs. 20.1% in 2001-2005 [p = 0.5]). Compared with the 2001-2005 analysis, all criteria showed improvement but the differences are statistically not significant.

CONCLUSION: Our observation shows that KPE management requires improvement in Germany. Centralization of BA patients to German reference liver units is not yet mandatory. However, European and national efforts with regard to the centralization of rare diseases support our common endeavor in this direction.

PMID:33663007 | DOI:10.1055/s-0041-1723994

Eur J Pediatr Surg. 2021 Mar 4. doi: 10.1055/s-0041-1723993. Online ahead of print.

ABSTRACT

INTRODUCTION: Placental insufficiency is one of the reasons for the reduction of hormone production. Thus, if one of the suspected causes of hypospadias is placental insufficiency, then the neurodevelopmental status of boys with hypospadias may be impaired. The aim of this study was to evaluate the neurodevelopmental status of boys with hypospadias and guide the parents of those who need support to related departments for early intervention.

MATERIALS AND METHODS: Boys were divided into two groups, those with hypospadias (group H) and healthy children undergoing traditional circumcision (group C). The parents of the boys completed the Ages and Stages Questionnaire (ASQ) and ASQ-Social Emotional (SE), both of which are screening instruments for the early identification of developmental and social-emotional problems, respectively.

RESULTS: Seventy-eight boys had hypospadias and 59 were admitted for traditional circumcision. The group H had statistically significant more impaired scores than group C in communication, gross motor, and personal-social skill sections. The multivariate logistic regression analysis revealed that hypospadias was the independent predictive factor for communication and personal-social skills.

CONCLUSION: Hypospadias and neurologic impairment may share common etiologic factors. Accordingly, physicians should keep in mind that if a boy presents with hypospadias, the possibility of having neurologic impairment is higher than normal population and early intervention has crucial importance. Every boy with hypospadias should be evaluated for neurodevelopmental status.

PMID:33663006 | DOI:10.1055/s-0041-1723993

Homeopathy. 2021 Mar 4. doi: 10.1055/s-0040-1721062. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the increasing demand for complementary and integrative medicine, only a few studies have evaluated the effect of these types of treatments on the quality of life (QoL) of patients with chronic diseases. The objective of this study was to evaluate the QoL of women treated with homeopathy within the Public Health System of Belo Horizonte, Brazil.

METHODS: This is a prospective randomized controlled pragmatic trial. The patients were divided into two independent groups, one group underwent homeopathic treatment in the first 6-month period and the other did not receive any homeopathic treatment. In both randomized groups, patients maintained their conventional medical treatment when necessary. The World Health Organization Quality of Life abbreviated questionnaire (WHOQOL-BREF) was used for QoL analysis prior to treatment and 6 months later.

RESULTS: Randomization afforded similar baseline results in three domains of QoL analysis for both groups. After 6 months’ treatment, there was a statistically significant difference between groups in the physical domain of WHOQOL-BREF: the average score improved to 63.6 ± (SD) 15.8 in the homeopathy group, compared with 53.1 ± (SD) 16.7 in the control group.

CONCLUSIONS: Homeopathic treatment showed a positive impact at 6 months on the QoL of women with chronic diseases. Further studies should be performed to determine the long-term effects of homeopathic treatment on QoL and its determinant factors.

PMID:33662995 | DOI:10.1055/s-0040-1721062

Homeopathy. 2021 Mar 4. doi: 10.1055/s-0040-1722234. Online ahead of print.

ABSTRACT

BACKGROUND: Artesunate (ATS) is a semi-synthetic compound derived from artemisinin, which is widely accepted in the treatment of malaria. However, there is evidence that ATS, under certain in vitro conditions, induces several impairments to normal cell functions. Canova (CA) is a Brazilian homeopathic formulation indicated for patients with depressed immune system. CA shows both in vitro and in vivo protective effects against mutagenic/carcinogenic compounds. Therefore, we aimed to assess in vitro the cytoprotective effects of CA against the cytotoxicity of ATS in Vero cells.

METHODS: Viability of Vero cells exposed to ATS was assessed by MTT assay, whereas the anti-cytotoxic effect of CA was evaluated by apoptosis and necrosis quantification with fluorescent dyes.

RESULTS: After 24 hours of ATS treatment, a reduction in cell viability was observed at 32 and 64 µg/mL, the latter being statistically significant (p < 0.05) in relation to the negative control. The concentration of 64 µg/mL was chosen for the subsequent experiments. ATS significantly induced both apoptosis and necrosis in Vero cells in relation to controls (p < 0.01). We also observed a statistically significant decrease in the number of apoptotic cells observed in the CA 16% + ATS co-treatment compared with ATS treatment (p < 0.01). Treatment with CA alone also had no influence on either type of cell death.

CONCLUSION: Our results demonstrated that ATS is cytotoxic in the assessed conditions. However, such cytotoxicity was attenuated when the cells were treated simultaneously with ATS and CA.

PMID:33662994 | DOI:10.1055/s-0040-1722234

Home Healthc Now. 2021 Mar-Apr 01;39(2):91-98. doi: 10.1097/NHH.0000000000000948.

ABSTRACT

Home visiting programs provide families with an array of services that contribute to decreased infant and maternal morbidity and mortality. However, little is known as to how mothers perceive participation in home visiting programs, and questions remain regarding what improvements can be made to better serve these families. The purpose of this program evaluation was to assess mothers’ perceived benefits and barriers to participation in established home visiting and outreach programs at Child Developmental Resources (CDR) in Williamsburg, Virginia. The program evaluation was a descriptive project consisting of 30-minute telephone interviews. Participants included 23 English-speaking mothers enrolled in CDR programs. Maternal demographics and perception of benefits/barriers were measured. Descriptive statistics were performed to describe sample demographics and outcome variables. Overall, most mothers perceived CDR programs as beneficial and were very satisfied with the services; however, a few changes could be made to improve programs and combat barriers to participation. Potential alternatives to supplement programs were suggested including the use of mobile technology in the participant’s home.

PMID:33662967 | DOI:10.1097/NHH.0000000000000948

Obes Facts. 2021 Mar 4:1-13. doi: 10.1159/000513042. Online ahead of print.

ABSTRACT

There is substantial evidence documenting the effects of behavioural interventions on weight loss (WL). However, behavioural approaches to initial WL are followed by some degree of longer-term weight regain, and large trials focusing on evidence-based approaches to weight loss maintenance (WLM) have generally only demonstrated small beneficial effects. The current state-of-the-art in behavioural interventions for WL and WLM raises questions of (i) how we define the relationship between WL and WLM, (ii) how energy balance (EB) systems respond to WL and influence behaviours that primarily drive weight regain, (iii) how intervention content, mode of delivery and intensity should be targeted to keep weight off, (iv) which mechanisms of action in complex interventions may prevent weight regain and (v) how to design studies and interventions to maximise effective longer-term weight management. In considering these issues a writing team within the NoHoW Consortium was convened to elaborate a position statement, and behaviour change and obesity experts were invited to discuss these positions and to refine them. At present the evidence suggests that developing the skills to self-manage EB behaviours leads to more effective WLM. However, the effects of behaviour change interventions for WL and WLM are still relatively modest and our understanding of the factors that disrupt and undermine self-management of eating and physical activity is limited. These factors include physiological resistance to weight loss, gradual compensatory changes in eating and physical activity and reactive processes related to stress, emotions, rewards and desires that meet psychological needs. Better matching of evidence-based intervention content to quantitatively tracked EB behaviours and the specific needs of individuals may improve outcomes. Improving objective longitudinal tracking of energy intake and energy expenditure over time would provide a quantitative framework in which to understand the dynamics of behaviour change, mechanisms of action of behaviour change interventions and user engagement with intervention components to potentially improve weight management intervention design and evaluation.

PMID:33662958 | DOI:10.1159/000513042

J Sport Rehabil. 2021 Mar 3:1-4. doi: 10.1123/jsr.2020-0275. Online ahead of print.

ABSTRACT

CONTEXT: Total Motion Release® (TMR®) is a novel treatment paradigm used to restore asymmetries in the body (eg, pain, tightness, limited range of motion). Six primary movements, known as the Fab 6, are performed by the patient and scored using a 0 to 100 scale. Clinicians currently utilize the TMR® scale to modify treatment, assess patient progress, and measure treatment effectiveness; however, the reliability of the TMR® scale has not been determined. It is imperative to assess scale reliability and establish minimal detectable change (MDC) values to guide clinical practice.

OBJECTIVE: To assess the reliability of the TMR® scale and establish MDC values for each motion in healthy individuals in a group setting.

DESIGN: Retrospective analysis of group TMR® assessments.

SETTING: University classroom.

PARTICIPANTS: A convenience sample of 61 students (23 males and 38 females; 25.48 [5.73] y), with (n = 31) and without (n = 30) previous exposure to TMR®.

INTERVENTION: The TMR® Fab 6 movements were tested at 2 time points, 2 hours apart. A clinician with previous training in TMR® led participant groups through both sessions while participants recorded individual motion scores using the 0 to 100 TMR® scale. Test-retest reliability was calculated using an intraclass correlation coefficient (2,1) for inexperienced, experienced, and combined student groups. Standard error of measurement and MDC values were also assessed for each intraclass correlation coefficient.

OUTCOME MEASURE: Self-reported scores on the TMR® scale.

RESULTS: Test-retest reliability ranged from 0.57 to 0.95 across the Fab 6 movements, standard error of measurement values ranged from 4.85 to 11.77, and MDC values ranged from 13.45 to 32.62.

CONCLUSION: The results indicate moderate to excellent reliability across the Fab 6 movements and a range of MDC values. Although this study is the first step in assessing the reliability of the TMR® scale for clinical practice, caution is warranted until further research is completed to establish reliability and MDC values of the TMR® scale in various settings to better guide patient care.

PMID:33662931 | DOI:10.1123/jsr.2020-0275

Forensic Sci Int. 2021 Feb 20;321:110739. doi: 10.1016/j.forsciint.2021.110739. Online ahead of print.

ABSTRACT

Sex estimation is a crucial component of the biological profile. Stull et al. (2017) have proposed a promising juvenile sex estimation method using long bone measurements taken from a South African sample, providing relatively high classification accuracies and made easy to use via the KidStats web-based app. In this study, we test the models developed by Stull et al. (2017) on an external historic population from Lisbon, Portugal, in order to determine whether the models can be reliably applied to archeological and forensic populations outside of the original population sample. The study sample consisted of 102 individuals (45 females and 57 males) aged under 13 years at death from the Lisbon identified skeletal collection. Measurements from these individuals were used to test the flexible discriminant analysis (FDA) models given by Stull et al. (2017). Allocation accuracies were calculated for boys and girls and children over and under 2 years separately and combined. Our findings show that the models developed by Stull et al. (2017) yield poor accuracy when applied to our external population and thus can potentially be misapplied on archeological skeletal remains or forensic remains of unknown origin. A number of statistical issues may explain why models fail to be transportable or even generalizable, namely multicollinearity, model overfitting and overly optimist bootstrapped cross-validation rates. It is also likely that population differences in size and sexual size dimorphism also affected the applicability of the models. We emphasize the importance of externally validating prediction models, particularly if they are intended to be applied across populations. Our study addresses Stull and co-worker’s request for further validation of the method on populations outside of South Africa, as the models cannot be confidently applied in the field until it has been externally validated.

PMID:33662898 | DOI:10.1016/j.forsciint.2021.110739