Nevin Manimala

J Shoulder Elbow Surg. 2022 Apr 1:S1058-2746(22)00335-4. doi: 10.1016/j.jse.2022.02.029. Online ahead of print.

ABSTRACT

INTRODUCTION: The Grammont-style reverse shoulder arthroplasty (RSA) relies on medialization and distalization of the shoulder center of rotation. Lateralized designs have recently gained popularity. The amount of lateralization, however, remains a controversial topic. The purpose of this study was to correlate the change in humeral offset (HO) with outcomes and complications following RSA. We hypothesized that a lateralized HO following RSA would be associated with improved range of motion (ROM), better patient reported outcomes (PROs), and less complications.

MATERIALS AND METHODS: A consecutive series of 104 patients (109 shoulders) was retrospectively evaluated. All patients underwent primary RSA by two Shoulder and Elbow fellowship-trained orthopedic surgeons at two different centers. Inclusion criteria was a primary RSA with at least 1-year follow-up. All patients had the HO measured on a preoperative and a postoperative Grashey radiograph and the change in HO was calculated (ΔHO = _PostHO – _PreHO). A negative value was defined as a medialized HO and a positive value as a lateralized HO. ROM and primary outcomes, including forward elevation (FE), external rotation (ER), Internal Rotation (IR), Subjective Shoulder Value (SSV), and American Shoulder and Elbow Surgeons (ASES) score were collected. Complications and revisions were also reported.

RESULTS: The mean age was 72 years with a mean follow-up of 22.3 months. The average FE (92° vs 148°), ER (34° vs 44°), SSV (35% vs 87%), and ASES score (37.2 vs 81.2) increased significantly (all, P < .01) compared to preoperative values. The HO was medialized postoperatively in 63 shoulders and lateralized in 46 shoulders. No statistically significant differences in the mean values for postoperative FE (147° vs 146°, P=0.892), ER (43° vs 45°, P=0.582), IR (L3 vs L3, P=0.852), SSV (88% vs 85%, P=0.476) and ASES score (81.3 vs 81.1, P=0.961) were found between the groups. However, there was significantly more improvement in ER in the lateralized HO cohort than the medialized cohort (16º vs 7º, P = 0.033). Six shoulders, 5 medialized and 1 lateralized HO, demonstrated scapular notching and remained asymptomatic. Five shoulders, 4 medialized and 1 lateralized HO, experienced at least one instability incident, and 2 shoulders with medialized HO had an acromion/scapular spine fracture. Overall, 2 shoulders with medialized HO underwent revision surgery due to instability.

CONCLUSIONS: While RSA provides significant improvement in ROM and PROs regardless of postoperative HO, restoring baseline HO or lateralization beyond baseline may be favorable for improving ER and decreasing complications following RSA.

PMID:35378314 | DOI:10.1016/j.jse.2022.02.029

Fish Shellfish Immunol. 2022 Apr 1:S1050-4648(22)00175-9. doi: 10.1016/j.fsi.2022.03.049. Online ahead of print.

ABSTRACT

The impact of dietary supplementation with silk fibroin (SF) microparticles on the wound healing process in gilthead seabream (Sparus aurata) skin was studied. A control diet was enriched with different SF levels: 0 (control), 50 (SF50 diet), and 100 (SF100 diet) mg Kg-1 to form three experimental diets and was fed to seabream for 30 days. Experimental wounds were performed and after 7 days post-wounding (dpw) skin mucus immunity, macroscopic wound closure, and skin regeneration were studied at a microscopic and genetic level. Results indicated that fish fed SF100 did not suffer the decreases in protease and IgM levels observed in the skin mucus of wounded fish fed with the control diet. Macroscopic findings illustrated that dietary SF100 significantly improved the wound closure ratio compared to those reared in the control group. At a microscopic level, changes in the shape of keratocyte cells were evident in the wounded fish. In addition, the intercellular spaces present between epidermal cells and their proliferation in the epidermis, as well as the presence of blood vessels in the dermis were significantly statistically higher in the skin of fish fed the SF100 diet and sampled at 7 dpw compared to those observed in the skin of fish fed the control or SF50 diets. Moreover, regarding the RNA: DNA ratio, statistically significant increases and decreases were observed in fish fed the control and SF100 diet, respectively, in non-wounded and wounded fish. Interestingly, dietary SF100 supplementation improved skin cell proliferation, enhanced the inflammatory phase, and increased the expression of important genes involved in tissue repair and extracellular matrix formation. In conclusion, the SF100 diet can be considered as an appropriate feed additive to improve wound healing in gilthead seabream.

PMID:35378308 | DOI:10.1016/j.fsi.2022.03.049

Endocr Pract. 2022 Apr 1:S1530-891X(22)00107-0. doi: 10.1016/j.eprac.2022.03.019. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite increased demand and worsening burnout among US endocrinologists, there is a paucity of data on job satisfaction and associated factors. This study examines factors associated with job satisfaction among a nationally representative sample of US endocrinologists.

METHOD: We conducted a cross-sectional survey of 1700 US adult endocrinologists on Facebook group “Endocrinologists.” The survey was conducted over four weeks using an anonymous online questionnaire. The 45-question survey assessed job and salary satisfaction scores on a 5-point Likert scale along with multiple job-related variables. Univariate and multivariate analyses were conducted to identify factors affecting job satisfaction.

RESULTS: Out of 1700, 654 adult endocrinologists (504 females and 139 males) completed the survey. Mean job satisfaction score was 3.72± 0.86, with 67.5% having high job satisfaction. Comparatively, 339 (52.1%) had high salary satisfaction. There was a statistically significant relationship between job and salary satisfaction score (p<0.01). Factors significantly associated with job satisfaction score (p<0.05) included: practice region, gender, number of medical assistants per endocrinologist, self-performance of thyroid ultrasound, and number of patients in the hospital per week. Multivariate analysis showed full time employment, along with high salary satisfaction, seeing less new patients per day, performing thyroid ultrasounds along with fewer patients in the hospital to be associated with highest job satisfaction.

CONCLUSIONS: This study found about a third of endocrinologists to have lower job satisfaction and identified multiple modifiable factors associated with endocrinologists’ job satisfaction. Interventions focused on these potentially modifiable factors may improve job satisfaction among US endocrinologists.

PMID:35378303 | DOI:10.1016/j.eprac.2022.03.019

Pharmacol Res. 2022 Apr 1:106204. doi: 10.1016/j.phrs.2022.106204. Online ahead of print.

ABSTRACT

BACKGROUND: Anxiety disorder is a common psychiatric illness. Medicinal herbs have become a field of interest in the treatment of anxiety. This study aimed to evaluate and compare the efficacy and acceptability of all possible medicinal herbs for the treatment of anxiety.

METHODS: A Bayesian network meta-analysis was conducted for adults with diagnosed or subthreshold anxiety in randomized controlled trials identified in PubMed, EMBASE, the Cochrane Library, and Web of Science, searched between Jan 1, 1987, and Dec 31, 2021. The outcomes included efficacy (measured by endpoint Hamilton Anxiety Scale [HAMA] Scores) and acceptability (discontinuation by ineffectiveness, worsening of the symptoms, or adverse events).

RESULTS: A total of 29 trials were reviewed, comparing 12 medicinal herbs. Silexan (mean difference [MD]: -3.84, 95% credible interval [CrI]: -6.31 to -1.34) displayed a significant effect on anxiety, and possibly benefitted the treatment of depression (standard mean difference [SMD]: -0.37, 95% confidence interval [CI]: -0.53 to -0.20) and insomnia (SMD: -0.48, 95% CI: -0.76 to -0.21). Kava was found to be an effective anxiolytic (MD: -2.46, 95% CrI: -4.47 to -0.32) but possibly ineffective in patients with generalized anxiety disorder (MD: -0.17, 95% CrI: -2.55 to -1.97). Ginkgo biloba (MD: -4.63, 95% CrI: -9.01 to -0.23) and Withania somnifera (MD: -4.90, 95% CrI: -9.70 to -0.17) were efficacious, as measured by HAMA scores but the trials were limited by their small sample sizes. Galphimia glauca (MD: -1.23, 95% CrI: -4.68 to 2.23) and Manasamitravn Vataka (MD: -1.35, 95% CrI: -7.39 to 4.68) exhibited the same anxiolytic effect as standard treatments, but both were absent from trials that were rated low risk, highlighting that confidence in their ability to provide an anxiolytic effect requires additional study. Conversely, although Passionflower (MD: -4.20, 95% CrI: -8.82 to 0.16) and Saffron (MD: -2.71, 95% CrI: -6.06 to 0.57) did not reduce HAMA scores significantly in the summary network, both were worthy of further study because of support from separate networks. There was insufficient evidence to confirm the effectiveness of Valerian (MD: 0.95, 95% CrI: -6.57 to 8.42) in standard-controlled estimation or the ineffectiveness of Chamomile (MD: 0.54, 95% CrI: -5.13 to 6.25) compared with a placebo for anxiety. Gamisoyo-san (MD: -0.98, 95% CrI: -6.48 to 4.54) and L-theanine (MD: -0.49, 95% CrI: -6.54 to 5.57) did not outperform a placebo for the treatment of anxiety in terms of statistical certainty. All medicinal herbs were well-tolerated and exhibited a good safety profile compared with control groups. When all herbs were compared, there was no statistical evidence to suggest any comparison significantly reduced HAMA scores except Ginkgo biloba vs Kava (MD: -4.41, 95% CrI: -8.32 to -0.35), although Ginkgo biloba was ranked as worst due to its poor tolerability.

CONCLUSION: Medicinal herbs may be promising for the treatment of anxiety. However, these results should be considered preliminary because of the unconvincing sample sizes, together with the potential effectiveness of placebos.

PMID:35378276 | DOI:10.1016/j.phrs.2022.106204

Ann Anat. 2022 Apr 1:151941. doi: 10.1016/j.aanat.2022.151941. Online ahead of print.

ABSTRACT

PURPOSE: Atherosclerotic plaques in the brain-supplying arteries are slowly-developing alterations of vascular structures that can lead to neurological impairment due to stenosis and insufficient oxygenation of eloquent brain areas. The aim of this study is to provide detailed demographic information related to the incidence of atherosclerotic plaques in the cerebral arteries.

MATERIAL AND METHODS: Forty-eight circles of Willis (21 men, 21 women, mean age: 70.26, six samples unknown) were macroscopically analyzed for length, diameter, and presence of atherosclerotic plaques. Statistical analysis was used to identify potential differences in the locations and frequencies of atherosclerotic plaques in relation to age and sex.

RESULTS: The study sample revealed 261 atherosclerotic plaques. The key findings were significant correlations between plaque development and age and between plaque location and age; however, there was no significant sex difference.

CONCLUSION: The upper and lower branches of the middle cerebral artery (MCA) were novel locations predisposing to plaque development. A cut-off value at 60 years revealed a significant difference in plaque development and distribution. There were no significant sex differences in the occurrence of atherosclerotic plaques.

PMID:35378255 | DOI:10.1016/j.aanat.2022.151941

J Environ Pathol Toxicol Oncol. 2022;41(1):45-53. doi: 10.1615/JEnvironPatholToxicolOncol.2021039719.

ABSTRACT

Malignant peripheral nerve sheath tumors (MPNSTs), glioblastomas (GBMs), and malignant melanomas (MMs) are neural crest-originating aggressive tumors with a poor prognosis. Signal transducer and transcription activator 3 (STAT3) plays a role in many biological processes, including cell life and proliferation, the acute phase response, chronic inflammation, autoimmunity, metabolism, and cancer progression, It is also known to be a prooncogenic transcription factor. Vascular endothelial growth factor (VEGF) is one of the most potent proangiogenic stimuli ever identified. It mediates tumor neovascularization, and is associated with angiogenesis and lymphangiogenesis. The prostate-specific membrane antigen (PSMA) folate hydrolase I, despite its name, has been found in tissues other than the prostate. It is overexpressed in prostate cancer cells and several other cancers, and has the potential to be a target for radioligand therapy. We investigated the value of STAT3, VEGF and PSMA immunohistochemical expression patterns and their effects on survival in MPNSTs, GBMs, and MMs. Their expression patterns were evaluated in 25 MPNSTs, 27 GBMs, and 25 MM cases. All GBM cases stained positively for STAT3 and VEGF. In the other groups, the staining patterns were heterogeneous. None of the cases showed positive staining with PSMA. There was no statistically significant difference in survival between cases with differing VEGF and STAT3 staining patterns in the MPSNT and MM groups, but there was an increase in mortality as the VEGF score increased in the GBM group. The suppression of VEGF and STAT3 may be a promising avenue for treatment of MPNSTs, GBMs, and MMs, although further research is needed.

PMID:35378003 | DOI:10.1615/JEnvironPatholToxicolOncol.2021039719

J Long Term Eff Med Implants. 2022;32(1):85-91. doi: 10.1615/JLongTermEffMedImplants.2021039490.

ABSTRACT

Peri-implant mucositis is a reversible inflammatory process of the soft tissue surrounding a dental implant. If left untreated, peri-implant mucositis can evolve into peri-implantitis, which leads to the loss of the supporting bone around the implant. The treatment of peri-implantitis is of special importance, since peri-implantitis can be very expensive and troublesome for both the patient and the dentist and a lack of complete resolution can lead to a low probability of implant success. This study aims to evaluate the effects of probiotic tablets on the condition of patients with peri-implant mucositis after scaling. In this double-blind randomized intervention trial, packages containing 14 probiotic capsules or a single-dose placebo were provided to 25 volunteer patients after scaling among those called to a private clinic in Mashhad. During the research process, we used the probing depth (PD) index and the bleeding on probing (BOP) index to diagnose peri-implant mucositis before and after the 28-day period. According to the study findings, on the day of scaling and 4 weeks after scaling and mouthwash use, there was a statistically significant difference in BOP index values between the probiotic group and the placebo group (P < 0.001). There was no difference in PD index values between these two groups. In conclusion, probiotic treatment can be used in interventions, prevention, and dentists’ recommendations to alleviate or eradicate peri-implant mucositis.

PMID:35377998 | DOI:10.1615/JLongTermEffMedImplants.2021039490

J Long Term Eff Med Implants. 2022;32(1):77-84. doi: 10.1615/JLongTermEffMedImplants.2021039830.

ABSTRACT

OBJECTIVE: Guided bone regeneration (GBR) is considered as a prerequisite in some cases of implant dentistry. For this purpose, bone materials are commonly used. Calcium compounds and Ca-P based materials like hydroxyapatite (HA, Ca10 (PO4)6(OH)2), due to their similarity with the human bone, can be used as graft materials for bone regeneration. This study aimed to evaluate biocompatibility of antler xenograft and compare the osteoconduction effects of antler xenograft with Cerabone in regeneration of calvarium bony defects of rabbits.

METHODS AND MATERIALS: Five defects with a diameter of 6 mm and a depth of 3 mm were prepared in the calvarium of four rabbits. Thereafter, two defects were randomly grafted with antler xenograft, two defects were filled with Cerabone, and one defect remained as the untreated group. Histological evaluations, including measuring percentage of new regenerated bone and the amounts of osteoblast, osteoclast, and osteocyte cells, were also performed. To do statistical analyses, paired t-test, chi-square, and Fisher tests were applied.

RESULTS: The percentage of new bone formation was significantly higher in antler xenograft (73.33%) and in Cerabone (48.91%) compared to the untreated group (18.91%). The amounts of osteocytes and osteoblasts were obtained as 3.52 ± 0.17 and 2.41 ± 0.24 in the Antler xenograft and as 2.57 ± 0.29 and 2.31 ± 0.32 in the Cerabone group, respectively. Bone marrow formation were significantly higher in antler xenograft (6.66 ± 5.34) and Cerabone (1.99 ± 3.17) compared to the untreated group.

CONCLUSION: According to this pilot study, results of using antler xenograft as an osteoconductive materials in regeneration of rabbit calvarial defects are comparable with Cerabone. Although more clinical studies are needed.

PMID:35377997 | DOI:10.1615/JLongTermEffMedImplants.2021039830

J Long Term Eff Med Implants. 2022;32(1):65-71. doi: 10.1615/JLongTermEffMedImplants.2021039884.

ABSTRACT

The aim of this retrospective study was to evaluate the long-term predictability of treatment using implants with hydrophobic and hydrophilic surfaces, according to clinical parameters and survival rates. Records from all patients who received dental implants between January 2013 and December 2014 at ILAPEO College were fully evaluated by two graduate dentists. Records with incomplete or unclear data were excluded from the study. The variables evaluated were demographic data, design of implants and prosthetic components, type of loading, data related to the patients’ general health, and survival of implants and prostheses. The final retrospective sample comprised 776 patients with 2707 implants, with up to 5 years of follow-up. Survival rates of implants and prostheses were 97.93% and 98.77%, respectively. Implants with hydrophobic (97.87%) and hydrophilic (98.34%) surfaces exhibited similar survival rates. Considering the different types of loading, there was no statistically significant difference between loading protocols regarding implant survival rates. Unsuitable healing capacity, uncooperative and not motivated patient, loss of prosthesis, and peri-implant bone loss were confirmed statistically to be factors that may contribute to implant loss, according to hazard ratio and odds ratio. The present study showed similar and high overall survival rates for implant with both types of surfaces, in the long term. The surface treatment, implant model and loading protocol had no significant influence on implant loss. Therefore, the evaluated implant systems were able to offer a high predictability for both hydrophobic and hydrophilic implants.

PMID:35377995 | DOI:10.1615/JLongTermEffMedImplants.2021039884

J Long Term Eff Med Implants. 2022;32(1):25-32. doi: 10.1615/JLongTermEffMedImplants.2021038617.

ABSTRACT

Implant therapy is a treatment option to ensure prosthesis survival rate and it is also done as a fixed dental prosthesis for replacing single and multiunit gaps. Posterior maxilla often has insufficient bone quality and quantity; for this reason it makes implant placement challenging in the site. Posterior edentulous maxilla presents special challenges to implant surgeons that are unique to this region compared to other regions of the maxilla. Thus, the aim of this study is to determine the common implant dimensions used in posterior maxilla. Completed case sheets were collected from a private dental hospital software system. Case sheets were taken from June 2019 to March 2020. Data was retrieved and evaluated by two reviewers. The parameters taken were patients, age groups, gender, teeth indicated for implants (maxillary premolars and molars), implant height, and implant width. Two-hundred fifty-four implants have been placed on the posterior maxilla of which 139 were premolars and 115 were molars. There was no statistical significance between the implants placed in both males and females (p value: 0.274). Between the age groups, the highest number of implants was seen in 41-60 years (n = 146) followed by 17-40 years (n = 78) and finally > 61 years (n = 30). The p value was 0.000, which was statistically significant. Various implant sizes for posterior maxilla have been introduced due to its challenging site. Thus in our study, we can see there is a difference in sizes for premolars and molars. Implant dimensions with increased height are used in the premolars compared to the molars. Implant dimensions with increased width are used in the molars compared to the premolars. In general, implant width and implant height can range from 3.6 to 4.5 mm and implant height ranging from 9.50 to 12.00 mm.

PMID:35377991 | DOI:10.1615/JLongTermEffMedImplants.2021038617