Nevin Manimala

Int J Paediatr Dent. 2021 May 22. doi: 10.1111/ipd.12800. Online ahead of print.

ABSTRACT

BACKGROUND: Although single-file rotary systems are accepted in the field of paediatric dentistry in terms of providing time advantage, research works continue due to the variable anatomical structure of the root canal.

AIM: This study aimed to evaluate rotary systems in different kinematics in terms of microcracks and the shaping of the danger zone in primary molars by micro-CT.

DESIGN: The mesial canals of primary molars (n = 30) were used. Root canals in each group (n = 10) were prepared with single-file rotary systems (One Shape®, OS; XP-endo® Shaper, XP-ES; WaveOne Gold, WOG). The images were evaluated for dentin thickness in the danger zone and microcrack formation.

RESULTS: WOG caused the highest dentin reduction in the danger zone area. OS led to significantly less dentin reduction than XP-ES and WOG (P < .05). The XP-ES showed the highest number of microcracks (P < .05). No statistically significant difference was found between WOG and OS (P > .05). In all systems, more microcracks were observed in the middle third than coronal and apical.

CONCLUSION: Within the limitations of this study, the rotary systems were superior to reciprocating in terms of shaping ability in the danger zone. It is thought that further studies with different systems should be designed considering the anatomical variations and chemical composition of primary teeth.

PMID:34022087 | DOI:10.1111/ipd.12800

Clin Exp Dermatol. 2021 May 22. doi: 10.1111/ced.14753. Online ahead of print.

ABSTRACT

BACKGROUND: Linear lesions are fairly common in our day to day practice. However, the appearances can be deceptive which puts dermatologists in a diagnostic dilemma.

AIMS: To study the various clinical presentations, demographic profile of patients and clinico-pathological correlations of dermatoses presenting with a linear distribution.

METHODS: We conducted an institution based cross-sectional, descriptive study on 281 consecutive patients with linear lesions, attending the Dermatology clinic. MedCalc version 11.6 software was used for statistical analysis.

RESULTS: Patients were divided into eight groups : lesions along Blaschko’s lines(n=136), along blood vessels(n=3), along lymphatics(n=3), koebner’s phenomenon(n=24), autoinoculation(n=24), external factors(n=45), infestations(n=2) and others(n=44). Mean age at presentation was 24.50±18.82 years. Male:female ratio was 1.32:1. Commonest complaints were itching/burning in 56.94% patients. Commonest site was upper limb (44.48%); followed by lower limb(30.60%), trunk and abdomen(22.42%), head and neck(19.20%) and genitalia(0.35%). Apart from the common cases, we came across a wide gamut of rare conditions (angiokeratoma circumscriptum neviforme, porokeratotic eccrine ostial and dermal duct nevus, blaschko-linear syringocystadenoma papilliferum, progressive cribriform and zosteriform hyperpigmentation, unilateral nevoid acanthosis nigricans, fixed drug eruption, discoid lupus erythematosus etc.) CONCLUSION: Linear lesions act as diagnostic clues in many dermatological conditions. Therefore, the importance of meticulous examination in clinical dermatology cannot be overemphasized.

PMID:34022084 | DOI:10.1111/ced.14753

J Nurs Manag. 2021 May 22. doi: 10.1111/jonm.13379. Online ahead of print.

ABSTRACT

AIM: To identify the factors affecting nurses’ turnover intention.

BACKGROUND: The shortage of nurses has been a great challenge worldwide and nurses’ turnover may exacerbate the situation.

METHODS: A cross-sectional study was conducted among nurses in six secondary hospitals in China. A model was constructed and structured questionnaires were adopted to measure model variables. Structural equation modeling was used to verify the model.

RESULTS: Totally, 594 valid questionnaires were collected. The final model showed an acceptable fit, 35.0% of the total variation was explained. Nine of the ten pathways were statistically significant. The model verified the contribution of professional value, nursing practice, job stress, and social support to turnover intention and their effects were mediated by job satisfaction and organizational commitment. As hypothesized, there existed a significant effect between job satisfaction and organizational commitment. Unexpectedly, job stress had a greater direct effect on turnover intention than job satisfaction and organizational commitment.

CONCLUSIONS: The structural model provided a feasible model that could explain nurses’ turnover intention in China.

IMPLICATIONS FOR NURSING MANAGEMENT: To prevent the turnover of nurses, administrators and managers should advisably prioritize the effect of job stress, especially in hospitals with similar medical context.

PMID:34022081 | DOI:10.1111/jonm.13379

Child Care Health Dev. 2021 May 22. doi: 10.1111/cch.12886. Online ahead of print.

ABSTRACT

BACKGROUND: Advancing physical therapy interventions for children and young people is a high research priority. This includes research to describe and specify the control condition, typically “current care”, for effectiveness trials. This paper aims to identify physical therapy outcomes commonly targeted, and intervention techniques and approaches commonly used, by physiotherapists working with children (aged 2-19 years) with mobility limitations in the United Kingdom.

METHODS: A cross-sectional survey. Participants were recruited through the interactive Chartered Society of Physiotherapy members-only online discussion forum, the Association of Paediatric Chartered Physiotherapists, direct emails and snowball sampling within the authors’ professional networks, and Twitter. Data were collected using a structured online questionnaire and analysed using descriptive statistics.

RESULTS: We received 146 responses, 95/146 (65.1%) of which were fully complete. Therapists reported targeting 367 unique outcome constructs of which 193 (52.6%) mapped onto activities and participation (e.g. moving around using equipment, maintaining body position, walking), 158 (43.1%) on body functions (e.g. muscle strength, joint mobility, gait functions), 11 (3.0%) on body structure (e.g. muscle length), and 3 (0.8%) on environmental factors (e.g. access home environment, access school environment, family confidence). The most commonly used interventions related to postural management (115/133 of respondents, 86.4%) and exercise therapy (116/137, 84.67%), and included techniques such as ‘use equipment’ (118/137, 86.1%), ‘instruct how to do something’ (117/137, 85.4%), ‘practice’ (105/137, 76.6%), and ‘stretch’ (99/137, 72.3%).

CONCLUSIONS: In designing trials, current care can be described as a combination of biomechanical and physiological techniques and approaches targeted at body functions and through that to activity and participation. While some environmental behaviour change techniques and strategies were reported, the explicit use of these in current care appears limited.

PMID:34022063 | DOI:10.1111/cch.12886

Pain Med. 2021 May 22:pnab176. doi: 10.1093/pm/pnab176. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the effectiveness and safety of epidural analgesia in the presurgical period on hip fracture patients undergoing surgical repair.

DESIGN: Systematic review.

METHODS: The study protocol was registered with the PROSPERO systematic reviews register: CRD42019140396. Electronic databases were searched for randomized controlled trials comparing preoperative epidural analgesia to other forms of pain management in hip fracture patients. The primary outcomes included perioperative cardiac events and mortality. Pain, non-cardiac complications, and adverse effects were also examined as secondary outcomes. Heterogeneity of the included studies was assessed using the I2 statistic and a random-effects meta-analysis was conducted once sufficient homogeneity was demonstrated.

RESULTS: Four studies met the inclusion criteria, which included a total of 221 patients. Preoperative epidural analgesia resulted in fewer cardiac events, which was a reported outcome in two included studies (RR 0.30; 95% CI 0.14-0.63; I2 = 0%). Preoperative epidural analgesia was also associated with decreased perioperative mortality in a meta-analysis of two studies (RR 0.13; 95% CI 0.02-0.98; I2 = 0%). Pain was not pooled due to variability in assessment methods, but preoperative epidural analgesia was associated with reduced pain in all four studies.

CONCLUSIONS: Preoperative epidural analgesia for hip fracture may reduce perioperative cardiac events and mortality, but the number of included studies in this systematic review was low. More research should be done to determine the benefit of early epidural analgesia for hip fractured patients.

PMID:34022058 | DOI:10.1093/pm/pnab176

Rheumatology (Oxford). 2021 May 22:keab456. doi: 10.1093/rheumatology/keab456. Online ahead of print.

ABSTRACT

OBJECTIVES: Knee joint distraction (KJD) has shown long-term clinical improvement and short-term cartilage restoration in young osteoarthritis (OA) patients. The current objective was to evaluate MRI cartilage thickness up to ten years after KJD treatment, using a three-dimensional surface-based approach.

METHODS: Twenty end-stage knee OA patients were treated with KJD. 1.5 T MRI scans were performed before and at one, two, five, seven, and ten years after treatment. Tibia and femur cartilage segmentation and registration to a canonical surface were performed semi-automatically. Statistical parametric mapping (SPM) with linear mixed models was used to analyse whole-joint changes. The influence of baseline patient characteristics was analysed with SPM using linear regression. Relevant weight-bearing parts of the femur were selected to obtain the average cartilage thickness in the femur and tibia of the most (MAC) and least affected compartment (LAC). These compartmental changes over time were analysed using repeated measures ANOVA; missing data was imputed. In all cases, p< 0.05 was considered statistically significant.

RESULTS: One- and two-years post-treatment, cartilage in the MAC weight-bearing region was significantly thicker than pre-treatment, gradually thinning after five years, but still increased at ten years post-treatment. Long-term results showed areas in the LAC were significantly thicker than pre-treatment. Male sex and more severe OA at baseline somewhat predicted short-term benefit (p> 0.05). Compartmental analyses showed significant short- and long-term thickness increase in the tibia and femur MAC (all p< 0.05).

CONCLUSIONS: KJD results in significant short- and long-term cartilage regeneration, up to ten years post-treatment.

PMID:34022055 | DOI:10.1093/rheumatology/keab456

Chest. 2021 Apr;159(4):1677-1678. doi: 10.1016/j.chest.2020.11.029. Epub 2021 Apr 6.

NO ABSTRACT

PMID:34021997 | DOI:10.1016/j.chest.2020.11.029

PM R. 2021 May 22. doi: 10.1002/pmrj.12645. Online ahead of print.

ABSTRACT

BACKGROUND: Rehabilitation outcomes of COVID-19 patients are unknown.

OBJECTIVE: The purpose of this study is to describe COVID-19 patients undergoing inpatient rehabilitation and their rehabilitation outcomes.

METHODS: Retrospective observational cohort study of all inpatients from a rehabilitation hospital between March 1 and September 30, 2020. Inclusion criteria are: ≥18 years of age and admission and discharge within the study time frame. The initial search yielded 920 patients; 896 met the inclusion criteria. Data was derived from the eRehabData database. Subjects were stratified by COVID-19 status and rehabilitation impairment. Data included age, gender, body mass index (BMI), length of stay (LOS), discharge location, and functional ability measures for self-care and mobility (FA-SC, FA-Mob). Descriptive statistics included age, BMI, gender, LOS, and discharge location. One-sample t-tests were used to assess the difference of age, BMI, LOS, FA-SC, FA-Mob, and FA efficiency between COVID-19+ and COVID-19- patients.

RESULTS: COVID-19+ patients were younger (59·4 years vs 62·9 years; t(894)= -2·05, p=0·04) with a higher mean BMI (32 vs 28; t(894)= 3·51, p<0·01) than COVID-19- patients. COVID-19+ patients had equivalent or superior improvements in FA-SC and FA-Mob, functional change efficiency, and LOS than COVID-19- patients. Comparing Medically Complex patients, those with COVID-19 had greater FA-SC and FA-Mob efficiencies than COVID-19- patients. COVID-19+ patients had similar rates of return to the community.

CONCLUSIONS: Patients with COVID-19 who meet the admission criteria for inpatient rehabilitation can benefit from inpatient rehabilitation similarly to their non-COVID-19 counterparts with similar rehabilitation-specific diagnoses. This article is protected by copyright. All rights reserved.

PMID:34021974 | DOI:10.1002/pmrj.12645

J Cosmet Dermatol. 2021 May 22. doi: 10.1111/jocd.14246. Online ahead of print.

ABSTRACT

BACKGROUND: Sensitive skin is subjective cutaneous hyperreactivity to environmental factors. Demodicosis is a skin disorder caused by Demodex.There may be a link between demodicosis and sensitive skin.

AIM: This study aimed to examine facial Demodex density and other factors associated with sensitive skin in patients.

METHODS AND METHODS: A total of 349 randomly selected patients who presented to the dermatology department. The research data were collected using a questionnaire form that included the participants’ sociodemographic and lifestyle characteristics, a sensitive skin questionnaire, the Dermatology Life Quality Index (DLQI), and European Health Interview Survey (EHIS). Patients underwent standardized superficial skin surface biopsy of 4 areas of the face. D. folliculorum count greater than 5 mites/cm² was considered positive.

RESULTS: In relation to Demodex, there was an increase in skin sensitivity with higher Demodex density (p =0,04). There was a statistically significant, weak positive correlation between skin sensitivity and DLQI score (r=0.33, p=0.00) and there was also a significant but very weak negative correlation between skin sensitivity and EUROHIS (r=-0.164, p=0.002). Skin sensitivity was more common in patients with a concomitant dermatological disease (p=0.01) and increased with more frequent cosmetic use (p=0.00).

CONCLUSION: Alongside other risk factors, for the patients presenting with complaints of sensitive skin, investigating Demodex population density may help alleviate sensitive skin symptoms with appropriate therapies and preventive measures.

PMID:34021963 | DOI:10.1111/jocd.14246

J Cosmet Dermatol. 2021 May 22. doi: 10.1111/jocd.14247. Online ahead of print.

ABSTRACT

BACKGROUND: The temporal lifting technique can provide lateral facial lifting when administering hyaluronic acid (HA) based soft tissue fillers into the subdermal plane of the temple. However, the central facial oval is not influenced by this technique.

OBJECTIVES: To identify the safety and aesthetic effectiveness of additional midfacial injection points (in addition to the temporal lifting technique) that can volumize the medial midface, lift the lateral face, increase jawline contouring when included into a full-face injection algorithm.

METHODS: The patient records of nine consecutive patients (all females) with a mean age of 35.0 (8.4) years and a mean body mass index of 21.7 (2.4) kg/m² were retrospectively analyzed after a full-face injection algorithm was performed using HA based fillers. The additional injection points target the supraperiosteal plane of the medial zygomatic arch, the lateral infraorbital region and the pyriform fossa using both needles and cannula.

RESULTS: No adverse events were observed during the 6-months retrospective observational period. The volume of the medial midface increased, the volume of the lateral midface decreased, and the contour of the jawline improved; all effects reached a highly statistically significant level with p < 0.001.

CONCLUSION: Despite each in dividual injection is currently performed on a daily clinical basis the evaluated injection algorithm following the temporal lifting technique shows some evidence that it is safe and aesthetically effective. Future studies will need confirm the results presented herein in a larger sample and with objective outcome measures to guide safe and effective aesthetic outcomes.

PMID:34021958 | DOI:10.1111/jocd.14247