Nevin Manimala

Foot Ankle Int. 2021 May 22:10711007211004191. doi: 10.1177/10711007211004191. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic ankle instability is a common condition that can be treated with lateral ankle ligament repair. These procedures have a reported success rate greater than 85% in the literature, but little has been reported about the differences in postoperative outcomes between males and females. The purpose of this study was to evaluate sex-specific outcomes following lateral ankle ligament repair.

METHODS: In this systematic review and meta-analysis, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to search for articles on electronic databases and included studies in which study participants underwent primary lateral ligament repair and sex-specific outcomes were evaluated. Functional postoperative outcomes for males and females were recorded and statistically analyzed.

RESULTS: Out of 2768 studies, 7 (0.25%) met inclusion criteria and were analyzed in this review. These studies included 618 patients (402 males [65%] and 216 females [35%]) who underwent primary lateral ligament repair for ankle instability. Karlsson score (P = .1582) and American Orthopaedic Foot & Ankle Society (AOFAS) score (P = .1586) analyses found no statistically significant difference between males and females. Postoperative success rate-defined as a “good” or “excellent” Karlsson score (>81)-was not found to be significantly different between males and females (P = .9374).

CONCLUSION: There was no difference in postoperative mean Karlsson scores, AOFAS scores, or success rates between males and females who underwent primary lateral ankle ligament repair.

LEVEL OF EVIDENCE: Level IV, therapeutic.

PMID:34024152 | DOI:10.1177/10711007211004191

Eur J Ophthalmol. 2021 May 22:11206721211019580. doi: 10.1177/11206721211019580. Online ahead of print.

ABSTRACT

PURPOSE: To assess the variability of silicone oil (SO) particles released across syringes from the same lot and the role of different needle gauges.

MATERIALS AND METHODS: Four syringe models and six needle models were assessed for SO release. About 50 microliters of a buffer solution were loaded into the syringe, needle or syringe/needle setup. The data were analyzed by imaging flow cytometry with fluorescently labeling for SO.

RESULTS: All syringe models had a high coefficient of variation in SO release across syringes from the same lot. The amount of SO was significantly greater in the syringe when the needle was attached. SO particles with the BD 30G needle attached to the syringe were statistically greater than the 27G counterpart (p = 0.005). None of the other comparisons was statistically different. Finally, the number of SO particles was higher in the syringe/needle setup than in needles only (p = 0.0024).

CONCLUSION: We found a high variability in SO content across syringes from the same lot. Additionally, there was no clear association between needle gauge and the number of SO particles, as well as their coefficient of variation. Finally, the needles accounted for a small number of SO particles in comparison to the combined syringe-needle setup.

PMID:34024140 | DOI:10.1177/11206721211019580

Foot Ankle Int. 2021 May 24:10711007211007843. doi: 10.1177/10711007211007843. Online ahead of print.

ABSTRACT

BACKGROUND: Hallux rigidus is a common and painful degenerative condition of the great toe limiting a patient’s physical function and quality of life. The purpose of this study was to investigate pre- and postoperative physical function (PF) and pain interference (PI) levels of patients undergoing synthetic cartilage implant hemiarthroplasty (SCI) vs arthrodesis (AD) for treatment of hallux rigidus using the Patient-Reported Outcomes Measurement Information System (PROMIS).

METHODS: PROMIS PF and PI t scores were analyzed for patients who underwent either SCI or AD. Postoperative final PROMIS t scores were obtained via phone survey. Linear mixed model analysis was used to assess differences in PF and PI at each follow-up point. Final follow-up scores were analyzed using independent sample t tests.

RESULTS: Total 181 (59 SCI, 122 AD) operatively managed patients were included for analysis of PROMIS scores. Final phone survey was performed at a minimum of 14 (mean 33, range, 14-59) months postoperatively, with 101 patients (40 SCI, 61 AD) successfully contacted. The mean final follow-up was significantly different for SCI and AD: 27 vs 38 months, respectively (P < .01). The mean age of the SCI cohort was lower than the AD cohort (57.5 vs 61.5 years old, P = .01). Average PF t scores were higher in the SCI cohort at baseline (47.1 and 43.9, respectively, P = .01) and at final follow-up (51.4 vs 45.9, respectively, P < .01). A main effect of superior improvement in PF was noted in the SCI group (+4.3) vs the AD group (+2) across time intervals (P < .01). PI t scores were similar between the 2 procedures across time points.

CONCLUSION: The SCI cohort reported slightly superior PF t scores preoperatively and at most follow-up time points compared with the arthrodesis group. No differences were found for PI or complication rates between the 2 treatment groups during this study time frame.

LEVEL OF EVIDENCE: Level III.

PMID:34024138 | DOI:10.1177/10711007211007843

Clin Nurs Res. 2021 May 22:10547738211018316. doi: 10.1177/10547738211018316. Online ahead of print.

ABSTRACT

Women giving birth in in-patient maternity units are required to complete certain education. The aim of this study was to investigate the effects of prompting on post-partum women’s education engagement (time from assignment to completion) while testing the feasibility of staff nurses assisting in research. A quasi-experimental design was used with 141 women allocated by admission date to one of three groups (usual care and two intervention) between September 2014 and December 2015. Intervention group I women were quickest to engage in their education and had the shortest length of stay. Significance was found for academic attainment (df = 1, F = 6.218, p = .014), partial eta squared = 0.053 and R² = 0.124. Women who had attended college engaged more quickly in all groups than those who had not. This statistically significant finding indicates how nurses can identify patients needing more assistance. Nurses reported no adverse effects on care.

PMID:34024137 | DOI:10.1177/10547738211018316

Clin Exp Reprod Med. 2021 May 18. doi: 10.5653/cerm.2020.04091. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to compare the pregnancy outcomes of in vitro fertilization with embryo transfer between embryos cultured in a time-lapse monitoring system (TLS) and those cultured in a conventional incubator (CI).

METHODS: The medical records of 250 fertilized embryos from 141 patients undergoing infertility treatment with assisted reproductive technology at a tertiary hospital from June 2018 to May 2020 were reviewed. The study population was divided into TLS and CI groups at a 1 to 1 ratio (125 embryos per group). The primary outcome was the live birth rate.

RESULTS: The TLS group had a significantly higher clinical pregnancy rate (46.4% vs. 27.2%, p=0.002), implantation rate (27.1% vs. 12.0%, p=0.004), and live birth rate (32.0% vs. 18.4%, p=0.013) than the CI group. Furthermore, subgroup analyses of the clinical pregnancy rate and live birth rate in the different age groups favored the TLS group. However, this difference only reached statistical significance in the live birth rate in women aged over 40 years and the clinical pregnancy rate in women aged 35-40 years (p=0.048 and p=0.031, respectively). The miscarriage rate, cleavage rate, and blastocyst rate were comparable.

CONCLUSION: TLS application improved the live birth rate, implantation rate, and clinical pregnancy rate, particularly in the advanced age group in this study, while the other reproductive outcomes were comparable. Large randomized controlled trials are needed to further explore the ramifications of these findings, especially in different age groups.

PMID:34024081 | DOI:10.5653/cerm.2020.04091

Isr Med Assoc J. 2021 May;23(5):286-290.

ABSTRACT

BACKGROUND: Consent rates for organ donation remain one of the most important factors determining the number of organs available for transplantation. Trauma casualties constitute a substantial part of the deceased organ donor pool and have unique characteristics that distinguish them from the general donor population. However, this group has not been extensively studied.

OBJECTIVES: To identify donor factors associated with positive familial consent for solid organ donation among trauma casualties.

METHODS: This retrospective study included all trauma casualties who were admitted to the Rabin Medical Center, Beilinson hospital, during the period from January 2008 to December 2017, who were potential organ donors. Data collected included demographic features, the nature of the injury, surgical interventions, and which organs were donated. Data was collected from the Rabin Medical Center Trauma Registry.

RESULTS: During the study period 24,504 trauma patients were admitted and 556 died over their hospital course. Of these 76 were potential donors, of whom 32 became actual donors and donated their organs. Two factors showed a statistically significant correlation to donation, namely female gender (P = 0.018) and Jewish religion of the deceased (P = 0.032).

CONCLUSIONS: Only a small group of in hospital trauma deaths were potential solid organ donors (13.7%) and less than half of these became actual donors. Consent rates were higher when the deceased was female or Jewish.

PMID:34024044

Neurol Ther. 2021 May 22. doi: 10.1007/s40120-021-00258-z. Online ahead of print.

ABSTRACT

INTRODUCTION: Hereditary transthyretin amyloidosis (ATTRv amyloidosis) is a clinically heterogeneous disease caused by mutations in the transthyretin (TTR) gene. The most common mutation, Val30Met, can manifest as an early- or late-onset disease.

METHODS: The Transthyretin Amyloidosis Outcomes Survey (THAOS) is an ongoing, global, longitudinal, observational survey of patients with transthyretin amyloidosis, including both inherited and wild-type disease and asymptomatic patients with TTR mutations. This is a descriptive analysis of symptomatic patients with ATTRv Val30Met amyloidosis with late- (age at least 50 years) vs. early-onset (age less than 50 years) disease in THAOS (data cutoff August 1, 2019).

RESULTS: Of 1389 patients with ATTRv Val30Met amyloidosis, 491 (35.3%) had late-onset disease. Compared with early-onset, patients with late-onset were more likely to be male (66.2% vs. 53.6%) and have a longer mean (standard deviation [SD]) time from onset to diagnosis (3.8 [3.4] vs. 2.7 [4.1] years). Late-onset disease was associated with more severe neurological impairment at enrollment (median [10th, 90th percentile] derived Neuropathy Impairment Score in the Lower Limbs, 25.0 [4.0, 69.3] vs. 8.0 [0, 54.8]; Neurologic Composite Score, 42.0 [2.0, 155.0] vs. 21.0 [0, 102.0]). Cardiac findings were more prominent in late-onset disease. An overall interpretation of electrocardiogram as abnormal was reported in 72.1% of late-onset patients (vs. 44.3% early-onset). A left-ventricular septal thickness of at least 12 mm was reported in 69.7% of late-onset patients (vs. 14.6% early-onset). All differences were statistically significant (p < 0.001).

CONCLUSION: In THAOS, late-onset ATTRv Val30Met amyloidosis is common, presenting with more severe neurologic and cardiac findings at enrollment. Heterogeneity of disease may make it more difficult to diagnose. Increased recognition of late-onset ATTRv Val30Met amyloidosis could lead to more timely diagnosis and improve patient outcomes.

TRIAL REGISTRATION: ClinicalTrials.gov NCT00628745.

PMID:34024024 | DOI:10.1007/s40120-021-00258-z

Int Urol Nephrol. 2021 May 22. doi: 10.1007/s11255-021-02892-w. Online ahead of print.

ABSTRACT

PURPOSE: To review the literature regarding any clinically significant association between prostate size and the incidence of prostate cancer (PCa). No previous review or meta-analysis has reported this clinical question.

METHODS: A thorough literature review was performed using PubMed and applying the ‘PRISMA’ guidelines. Inclusion and exclusion criteria were defined.

RESULTS: A total of 30 articles met the search criteria. Of these 30 articles, 27 reported an inverse correlation between prostate volume (PV) and incidence of biopsy-proven PCa. The remaining three articles provided no clear statistically significant results, and there was no study showing a direct or positive correlation between PV and the incidence of PCa.

CONCLUSION: This review and meta-analysis is the first report summarizing the literature on the clinical question of whether prostate size affects the incidence of PCa. Ninety percent of studies (27/30) show significant evidence supporting the hypothesis that prostate size may be protective of PCa. This review and the outlined discussion should encourage other clinical investigators to explore the relationship between PV and the incidence and aggressiveness of PCa. If future studies should confirm the hypothesis of the dynamic interactions between the different prostatic zones in a growing prostate, it will have relevant clinical implications on the management of BPH and PCa.

PMID:34024008 | DOI:10.1007/s11255-021-02892-w

Environ Sci Pollut Res Int. 2021 May 22. doi: 10.1007/s11356-021-14479-0. Online ahead of print.

ABSTRACT

The investigation of sediment transport in tropical rivers is essential for planning effective integrated river basin management to predict the changes in rivers. The characteristics of rivers and sediment in the tropical region are different compared to those of the rivers in Europe and the USA, where the median sediment size tends to be much more refined. The origins of the rivers are mainly tropical forests. Due to the complexity of determining sediment transport, many sediment transport equations were recommended in the literature. However, the accuracy of the prediction results remains low, particularly for the tropical rivers. The majority of the existing equations were developed using multiple non-linear regression (MNLR). Machine learning has recently been the method of choice to increase model prediction accuracy in complex hydrological problems. Compared to the conventional MNLR method, machine learning algorithms have advanced and can produce a useful prediction model. In this research, three machine learning models, namely evolutionary polynomial regression (EPR), multi-gene genetic programming (MGGP) and M5 tree model (M5P), were implemented to model sediment transport for rivers in Malaysia. The formulated variables for the prediction model were originated from the revised equations reported in the relevant literature for Malaysian rivers. Among the three machine learning models, in terms of different statistical measurement criteria, EPR gives the best prediction model, followed by MGGP and M5P. Machine learning is excellent at improving the prediction distribution of high data values but lacks accuracy compared to observations of lower data values. These results indicate that further study needs to be done to improve the machine learning model’s accuracy to predict sediment transport.

PMID:34023993 | DOI:10.1007/s11356-021-14479-0

Eur Spine J. 2021 May 23. doi: 10.1007/s00586-021-06868-3. Online ahead of print.

ABSTRACT

PURPOSE: The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD).

METHODS: Biopsies of the annulus fibrosus (AF) and the nucleus pulposes (NP) from patients with DDD undergoing 1-2 level fusion surgery at L4/L5 or L5/S1 were obtained from total of 34 patients [9 M, 25 F] with average age of 53 [32-63]. The mRNA expression of TNF-α, IL-1β, and IL-6 in the AF and NP was analyzed using quantitative real-time polymerase chain reaction (RT-qPCR), and the expression level of these markers was correlated to the visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores (0-100) for pain and disability.

RESULTS: We report a statistically significant positive correlation between pain intensity (VAS score) and the expression of TNF-α in both the AF (r = 0.54, p = 0.001) and NP (r = 0.40, p = 0.02), similarly with IL-1β in AF (r = 0.37, p = 0.02) and IL-6 in NP (r = 0.40, p = 0.02). In addition, we found significant positive correlation observed between disability score (ODI) and expression of IL-6 in both AF (r = 0.36, p = 0.03) and NP (r = 0.41, p = 0.01).

CONCLUSION: We conclude that the intensity of LBP and disability is associated with the level of inflammation in the disc.

PMID:34023967 | DOI:10.1007/s00586-021-06868-3