Nevin Manimala

J Voice. 2021 Oct 13:S0892-1997(21)00334-9. doi: 10.1016/j.jvoice.2021.09.039. Online ahead of print.

ABSTRACT

INTRODUCTION: Dysphonia and laryngeal problems are some of the manifestations of the COVID-19 pandemic due to respiratory disease as a primary effect of COVID-19. The aim of the present study was to investigate voice quality and vocal tract discomfort symptoms in patients with COVID-19.

MATERIALS AND METHODS: Forty-four COVID-19 patients with a mean age of 49.61 ± 16.48 years and 44 healthy subjects with a mean age of 48.52 ± 13.8 years participated in the study. The voice quality of the participants was evaluated using auditory-perceptual evaluation with the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale. The vocal tract discomfort symptoms of the participants were assessed using the Persian version of the VTD scale.

RESULTS: Patients with COVID-19 had higher scores in all items of the GRBAS, including grade, roughness, breathiness, asthenia, and strain, than healthy subjects, and these differences were statistically significant (P < 0.05). Among the GRBAS parameters, grade had the highest effect size and asthenia had the lowest effect size in both speech tasks. The COVID-19 patients had a greater frequency of vocal tract discomfort symptoms than healthy subjects in all items of the VTDp scale and these differences were statistically significant (P < 0.05) in the following items: burning, tight, dry, pain, sore, irritable, and lump in the throat. The most and the least effect size in frequency of the vocal tract discomfort symptoms were related to dry (d = 1.502) and tickling (d = 0.157), respectively. Also, COVID-19 patients had more significant severity in all items of the VTDp scale except tight and tickling. The most and the least effect size in severity of the vocal tract discomfort symptoms was related to dry (d = 1.416) and tickling (d = 0.152), respectively.

CONCLUSION: The present study suggests that COVID-19 patients have more deviations in voice quality than healthy subjects. Moreover, mild vocal tract discomfort is prevalent in patients with COVID-19, and patients have more frequent and severe physical discomforts of the vocal tract than healthy subjects.

PMID:34776316 | DOI:10.1016/j.jvoice.2021.09.039

Surgery. 2021 Nov 11:S0039-6060(21)00959-4. doi: 10.1016/j.surg.2021.10.001. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic cholecystectomy operative difficulty is highly variable and influences outcomes. This systematic review analyzes the performance and clinical value of statistical models to preoperatively predict laparoscopic cholecystectomy operative difficulty.

METHODS: PRISMA guidelines were followed. PubMed, Embase, and the Cochrane Library were searched until June 2020. Primary studies developing or validating preoperative models predicting laparoscopic cholecystectomy operative difficulty in cohorts of >100 patients were included. Studies not reporting performance metrics or enough information for clinical implementation were excluded. Data were extracted according to CHARMS, and study quality was assessed using the PROBAST tool.

RESULTS: In total, 2,654 articles were identified, and 22 met eligibility criteria. Eighteen were model development, whereas 4 were validation studies. Eighteen studies were at high risk of bias. However, 11 studies showed low concern for applicability. Identified models predict 9 definitions of laparoscopic cholecystectomy operative difficulty, the most common being conversion to open surgery and operating time. The most validated models predict an intraoperative difficulty scale and procedures >90 minutes with an area under the curve of >0.70 and >0.76, respectively. Commonly used predictors include demographic variables such as age and gender (9/18 models) and ultrasound findings such as gallbladder wall thickness (11/18). Clinical implementation was never studied.

CONCLUSION: There is a longstanding interest in estimating laparoscopic cholecystectomy operative difficulty. Models to preoperatively predict laparoscopic cholecystectomy operative difficulty have generally good performance and seem applicable. However, an unambiguous definition of operative difficulty, validations, and clinical studies are needed to implement patients’ stratification in laparoscopic cholecystectomy.

PMID:34776259 | DOI:10.1016/j.surg.2021.10.001

Eval Program Plann. 2021 Oct 27:102023. doi: 10.1016/j.evalprogplan.2021.102023. Online ahead of print.

ABSTRACT

This study aims to examine the changes in efficiency and efficiency levels of the maternal and child health hospitals in Turkey from 2014 to 2017, by applying two-stage data envelopment analysis (DEA). At the first stage of the study, the efficiency of the hospitals was evaluated with input-oriented CCR (Charnes, Cooper, Rhodes) and Malmquist Productivity Index (MPI). At the second stage, panel Tobit regression analysis was utilized to find out the factors that affect the efficiency scores specified at the first stage. According to the results of the first stage, the mean efficiency values calculated for 2014, 2015, 2016, and 2017 were 0.83, 0.90, 0.86, and 0.80, respectively. At the second stage, it was revealed that the variables of not being in a metropolis and having 200 beds at least had statistically a significant effect on the efficiency score (p < 0.05) whereas being a training and research hospital was ineffective (p > 0.05). The number of the studies which assess the efficiency of maternal and child health hospitals in Turkey was quite limited. Moreover, such studies do not contain second-stage analyses. Lastly, it is thought that those results will provide health policy-makers substantial and evidence-based information in the allocation of the resources for the related services.

PMID:34776257 | DOI:10.1016/j.evalprogplan.2021.102023

Therapie. 2021 Oct 24:S0040-5957(21)00211-0. doi: 10.1016/j.therap.2021.10.006. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: A notable proportion of COVID-19 patients need statins for their co-existing conditions. Statins possess several anti-inflammatory properties. We have attempted to describe potential association of exposure to statins and severity of COVID symtpoms in a historical study in hospitalized COVID-19 patients.

METHODS: This single-center, historical cohort study was performed in Baharloo hospital as a referral hospital for COVID-19 patients in Tehran. Patients were divided into two groups; 163 statins users and 547 non-users. Mortality rate, intensive care unit (ICU) admission and length of hospitalization were compared between studied groups. In addition, during the investigation, pre-existing conditions were evaluated for groups. If a significant difference was observed between groups, the feature was considered in the adjustment of the odds ratio.

RESULTS: At the beginning, statistical analysis study showed that statins users had significantly (p<0.0001) higher mortality rate, ICU admission and length of hospitalization. But after implementation of variables such as age, sex, diabetes, hypertension status, stroke, dyslipidemia, cardiovascular diseases, chronic kidney disease (CKD), corticosteroids, renin-angiotensin-aldosterone axis inhibitors and proton pump inhibitors (PPIs) for adjustment of the odds ratio, a considerable alteration appeared in the studied values. Following adjustment of odds ratio it was shown that statins did not change mortality (95% CI, OR 0.71 (0.41-1.22), p=0.22), ICU admission (95% CI, OR 1.05 (0.66-1.66), p=0.835) and length of hospitalization (95% CI, OR 1.30 (0.78-2.17), p=0.311). In addition, we found that statins could not decrease inflammatory markers in COVID-19 infected patients.

CONCLUSION: The use of statins did not seem to change outcomes in COVID19.

PMID:34776254 | DOI:10.1016/j.therap.2021.10.006

J Thorac Cardiovasc Surg. 2021 Oct 23:S0022-5223(21)01491-4. doi: 10.1016/j.jtcvs.2021.09.060. Online ahead of print.

ABSTRACT

OBJECTIVE: The study objective was to determine the impact of reoperative aortic root replacement on short-term outcomes and survival.

METHODS: This was a retrospective study of aortic root operations from 2010 to 2018. All patients with a complete aortic root replacement were included, and patients undergoing valve-sparing root replacements were excluded. Patients were dichotomized by first-time sternotomy versus redo sternotomy, which was defined as having had a prior sternotomy for whatever reason. Within the redo sternotomy group, reoperative aortic root replacements were identified, being defined as a complete aortic root replacement in patients with a prior aortic root replacement; 1:1 nearest neighbor propensity matching was used to compare outcomes across groups. Kaplan-Meier survival estimates were generated and compared using log-rank statistics.

RESULTS: A total of 893 patients undergoing complete ARR were identified, of whom 595 (67%) underwent first-time sternotomy and 298 (33%) underwent redo sternotomy. After matching, postoperative outcomes were similar for the first-time and redo sternotomy groups, including operative mortality. Redo sternotomy was not associated with reduced survival after aortic root replacement compared with first-time sternotomy (P = .084), with 5-year survival of 73.7% for first-time sternotomy and 72.9% for redo sternotomy. In the redo sternotomy group (n = 298), 69 (23%) were reoperative aortic root replacements and 229 (77%) were first-time aortic root replacements. After matching, postoperative outcomes were similar for the first-time and reoperative aortic root replacement groups, including operative mortality. Reoperative aortic root replacement was not associated with reduced survival, compared with first-time aortic root replacement (P = .870), with 5-year survival of 67.9% for first-time aortic root replacement and 72.1% for reoperative aortic root replacement.

CONCLUSIONS: Reoperative aortic root replacement can be performed safely and provides similar survival to first-time aortic root replacement.

PMID:34776246 | DOI:10.1016/j.jtcvs.2021.09.060

Gynecol Oncol. 2021 Nov 11:S0090-8258(21)01552-3. doi: 10.1016/j.ygyno.2021.10.088. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the association between hysterectomy and ovarian cancer, and to understand how hormone therapy (HT) use and endometriosis affect this association.

METHODS: We conducted a pooled analysis of self-reported data from 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC). Women with (n = 5350) and without ovarian cancer (n = 7544) who never used HT or exclusively used either estrogen-only therapy (ET) or estrogen+progestin therapy (EPT) were included. Risk of invasive epithelial ovarian cancer adjusted for duration of ET and EPT use and stratified on history of endometriosis was determined using odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Overall and among women without endometriosis, there was a positive association between ovarian cancer risk and hysterectomy (OR = 1.19, 95% CI 1.09-1.31 and OR = 1.20, 95% CI 1.09-1.32, respectively), but no association upon adjusting for duration of ET and EPT use (OR = 1.04, 95% CI 0.94-1.16 and OR = 1.06, 95% CI 0.95-1.18, respectively). Among women with a history of endometriosis, there was a slight inverse association between hysterectomy and ovarian cancer risk (OR = 0.93, 95% CI 0.69-1.26), but this association became stronger and statistically significant after adjusting for duration of ET and EPT use (OR = 0.69, 95% CI 0.48-0.99).

CONCLUSIONS: The hysterectomy-ovarian cancer association is complex and cannot be understood without considering duration of ET and EPT use and history of endometriosis. Failure to take these exposures into account in prior studies casts doubt on their conclusions. Overall, hysterectomy is not risk-reducing for ovarian cancer, however the inverse association among women with endometriosis warrants further investigation.

PMID:34776242 | DOI:10.1016/j.ygyno.2021.10.088

J Bodyw Mov Ther. 2021 Oct;28:62-67. doi: 10.1016/j.jbmt.2021.07.026. Epub 2021 Aug 8.

ABSTRACT

OBJECTIVE: To examine the effects of dynamic tape on balance control in subjects with chronic ankle instability (CAI).

METHODS: This two group experimental pre- and post-treatment design included 18 individuals with CAI and 18 controls. The single-limb stance test with eyes open and closed, standing on a force plate (Accusway Plus; AMTI) for 30 s, was conducted before, 10 min (T1) and 24 h (T24) after a dynamic tape application over the gastrocnemius muscle. Outcome measurements were: mean sway velocity, sway area (circular area), and standard deviation of the body center of pressure path length in both mediolateral and anteroposterior directions. Individuals with poor (unable to perform a single leg test for at least 30 s, eyes closed) vs. good postural stability, were also compared.

RESULTS: In both groups, a repeated analysis of variance demonstrated a significant time main effect on sway velocity (F = 14.95; p < 0.001) and path length (F = 14.95; p < 0.001) during eyes closed. Post-hoc analysis revealed a significant decrease in T1 values compared to baseline. When comparing individuals with poor vs good stability amongst the CAI group, a statistically significant interaction was observed between group, time on sway velocity and path length (F = 3.92; p < 0.05) during eyes closed. In the poor postural group, most T1 values were significantly lower than baseline.

CONCLUSIONS: Dynamic tape when applied to posterior calf muscles, enhanced balance control with no difference between CAI individuals and controls. The contribution of the tape was greater in those with poor postural stability.

PMID:34776201 | DOI:10.1016/j.jbmt.2021.07.026

J Bodyw Mov Ther. 2021 Oct;28:6-12. doi: 10.1016/j.jbmt.2021.07.014. Epub 2021 Aug 12.

ABSTRACT

INTRODUCTION: Sport participation is an important for deaf children as participants experience physical, psychological and social benefits; however, the beneficial effect of core stability training on core muscle endurance is unclear. The present study aimed to examine the effects of an 8-week core stability exercise training program on endurance of trunk muscles in deaf children.

METHODS: Twenty male deaf students (age, 16.5 ± 0.65 y; body mass, 62.08 ± 5.39 kg; BMI, 22.33 ± 2.24 kg/m²) volunteered to participate in this study and were randomly assigned to experimental (EXP, n = 10) and control (CON, n = 10) groups. The subjects in the EXP group performed 3 times a week for 8 weeks period of core stability training program and tested trunk muscle endurance including prone bridge, supine bridge and flexor endurance tests at pre and post 8 weeks intervention.

RESULTS: The CON group did not show any significant change after training period (p > 0.05). The EXP group showed significantly changes in core stability muscle endurance tests following the 8-week core stability training program (p < 0.05). In addition, the EXP group indicated statistically significant changes than the CON group in truck muscle endurance (p < 0.05).

CONCLUSIONS: The results indicated that core stability training program improved trunk muscle endurance. Therefore, this training approach can be recommended in deaf rehabilitation programs to improve trunk muscle endurance.

PMID:34776200 | DOI:10.1016/j.jbmt.2021.07.014

J Bodyw Mov Ther. 2021 Oct;28:563-569. doi: 10.1016/j.jbmt.2021.09.001. Epub 2021 Sep 23.

ABSTRACT

BACKGROUND: Rhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD.

MATERIALS AND METHODS: This was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package.

RESULTS: A statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85-1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49).

CONCLUSION: In this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.

PMID:34776197 | DOI:10.1016/j.jbmt.2021.09.001

J Bodyw Mov Ther. 2021 Oct;28:530-534. doi: 10.1016/j.jbmt.2021.09.003. Epub 2021 Sep 25.

ABSTRACT

BACKGROUND: Smartphones are thought to have many negative effects on interpersonal relationships, physical-mental health, and general functionality as well as bring many conveniences to our daily lives. This study aimed to determine the effect of smartphone addiction on physical activity level in sports science undergraduates. Secondly, comparing the physical activity level in students by gender was aimed.

METHOD: A total of 300 (134 female, 166 male) healthy university students were included in this study. The mean age of the subjects was 21.36 ± 2.33 years. The universe of the study consisted of volunteer students (Coaching Education, Physical Education and Sports Teaching, Sports Management, Recreation Departments) at the Faculty of Sport Sciences. Participants’ demographic information was obtained and their physical activity levels were questioned with International Physical Activity Questionnaires (IPAQ) and smartphone addictions with the Smartphone Addiction Scale- Short Version (SAS-SV). The significance level was accepted as p < .05 in statistical evaluations.

RESULTS: According to IPAQ scores, physical activity levels of the participants were as follows; 65.3% were adequate, 32.7% low and 2% inactive. One-hundred and twenty-six participants (42%) were smartphone addicts according to the SAS-SV results. When the departments were examined within themselves, it was found that IPAQ and SAS-SV scores were negatively correlated for Physical Education and Sports Teaching (r = – 0.262; p = .021) and Sports management (r = – 0.295; p = .01).

PMID:34776190 | DOI:10.1016/j.jbmt.2021.09.003