Nevin Manimala

Med Sci Sports Exerc. 2021 Aug 1;53(8):1615-1623. doi: 10.1249/MSS.0000000000002621.

ABSTRACT

PURPOSE: This study aimed to investigate the tracking and changes of steps per day in adults and their determinants over 13 yr.

METHODS: A total of 2195 subjects (1236 women) 30-45 yr of age were randomly recruited from the ongoing Cardiovascular Risk in Young Finns Study in 2007 and were followed up in 2020. Steps per day, including both total and aerobic steps per day, were monitored for seven consecutive days with a pedometer in 2007-2008 and 2011-2012 and with an accelerometer in 2018-2020. Tracking was analyzed using Spearman’s correlation. Stability and changes of steps per day over time in both low-active and high-active groups (based on median values) were described by percentage agreements, kappa statistics, and logistic regression. Associations of sex, age, and body mass index with the initial number and changes in steps per day were analyzed using linear growth curve modeling.

RESULTS: Tracking correlations of total steps per day at 4-, 9-, and 13-yr intervals were 0.45-0.66, 0.33-0.70, and 0.29-0.60, while corresponding correlations for aerobic steps per day were 0.28-0.55, 0.23-0.52, and 0.08-0.55, respectively. Percentage agreements were higher than 54%, and kappa statistics ranged from slight to fair over time. Compared with the low-active group, the high-active group at baseline had a higher probability of being active later in adulthood. Female sex and higher age were associated directly with the initial number of steps per day and inversely with changes in the number of steps per day. Body mass index was inversely associated with the initial number of steps per day and changes in the number of total steps per day.

CONCLUSION: The 13-yr tracking of steps per day in adulthood was found to be low to moderately high. Daily ambulatory activity is essential to maintaining an active lifestyle throughout adulthood. Changes in the amount of adult steps per day vary by sex, age, and BMI.

PMID:34261992 | DOI:10.1249/MSS.0000000000002621

J Chin Med Assoc. 2021 Jul 13. doi: 10.1097/JCMA.0000000000000583. Online ahead of print.

ABSTRACT

BACKGROUND: Guyon’s canal syndrome is nerve compressive pathology which can lead to sensory and/or motor function deficits. This problem is usually difficult to distinguish from cubital tunnel syndrome and relatively less common than cubital tunnel syndrome. This study evaluated the functional results and patient-reported outcomes following decompression of the ulnar nerve in Guyon’s canal.

METHODS: Patients who were diagnosed with Guyon’s canal syndrome confirmed by electrodiagnostic studies and underwent nerve decompression surgery were included in this study. The functional improvement by examining the Froment’s sign, Wartenberg’s sign, static two-point discrimination, and Semmes Weinstein monofilament examination as physical examination scores was evaluated. The Visual Analog Scale (VAS) of satisfaction and the disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were used for the postoperative patient-reported outcome evaluation.

RESULTS: From 2003 to 2019, 38 cases had been enrolled with a mean age of 53 years, ranging from 19 to 85 years. There were seven patients with comorbidity of diabetes mellitus and 28 patients who received additional neurolysis combined with the Guyon’s release procedure. There were 19 patients with a good response to surgery and ten patients with a poor surgical outcome due to persistent paresthesia or weakness. After statistical analysis, it was revealed that several influential factors could have been related to a compromised functional outcome, including a symptom duration of more than three months, combination with additional neurolysis of ipsilateral extremity, and/or comorbidity with diabetes mellitus.

CONCLUSION: It was concluded that promising functional outcomes after surgical release of ulnar neuropathy in Guyon’s canal could be achieved if the patients did not need additional neurolysis or the symptom duration was within three months.

PMID:34261979 | DOI:10.1097/JCMA.0000000000000583

Pain. 2021 Jul 14. doi: 10.1097/j.pain.0000000000002406. Online ahead of print.

ABSTRACT

Purpose of this study was to examine the discriminative properties of the three-item PEG questionnaire for grading impact of non-dental orofacial pain.286 consecutive patients with orofacial pain of non-dental origin filled out the PEG questionnaire and Graded Chronic Pain Scale (GCPS, version 2). Correlation between the PEG and GCPS scores, internal consistency of the PEG, and differences between groups were examined statistically (level of significance: p≤0.05).The mean(±SD) age of the 213 patients (158 female) who were included in the analysis was 43.1(±16.7) years. Of the sample, 48.8%(n=104) had some degree of orofacial pain-related disability (mean overall characteristic pain intensity: 51.2±23.2, average overall PEG score: 4.3±2.7, average PHQ-9 score: 8.2±6.5). No significant differences were found between the sexes for any score. Number of disability points (GCPS) and overall PEG score showed a strong and positive correlation (Spearman’s ρ=0.77, p<0.001). The internal consistency of the PEG questionnaire was high (Cronbach’s α=0.86).Assuming three different levels of orofacial pain-related disability (mild, moderate, and severe), we obtained overall accuracy of 69.01%, with high specificity for mild and severe cases. The three PEG groups (mild/moderate/severe) differed from each other significantly regarding their clinical grading according to the GCPS (Kruskal-Wallis, p<0.001).Analysis of the receiver operating characteristic curve showed that a single cut-off value of 3.8 points in the PEG score yields adequate validity (sensitivity=0.91; specificity=0.78). The proposed two cut-off points (upper=7, lower=4) yield low sensitivity for the upper threshold.The three-item PEG questionnaire is suitable for grading impact of non-dental orofacial pain.

PMID:34261977 | DOI:10.1097/j.pain.0000000000002406

J Craniofac Surg. 2021 Jul 14. doi: 10.1097/SCS.0000000000007992. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the age-related changes in the viscoelastic properties and tone of the superior orbicularis oris muscle by a portablehand-held myotonometer.

METHODS: A total of 128 individuals (65 female, 63 male) who met the inclusion criteria were evaluated. Individuals were divided into 2 groups as under 40 years old (Group 1), and above (Group 2). The viscoelastic properties and muscle tone of orbicularis oris muscle were evaluated bilaterally in supine position with the Myoton PRO (Myoton AS, Estonia) device from the skin overlying the orbicularis oris. The reference point is accepted as the right and left paramedial philtrum dimple. The statistical analysis was performed.

RESULTS: There was no statistically significant difference in the elasticity values of the right and left orbicularis oris muscles of the Group 1 and Group 2 individuals. There was a difference between the groups when the tone and stiffness values of both groups were compared. It was determined that individuals over the age of 40 had higher muscle tone and stiffness. All mechanical properties of the superior orbicularis oris muscle between the male and female individuals in Group 1 were different. The values are higher in the female gender. The elasticity values in both genders in Group 2 were similar. Tone and stiffness parameters were different between genders.

CONCLUSIONS: Myoton PRO can be recommended as an alternative device in the quantitative evaluations of post-operative follow-ups, and pre/post rehabilitation in terms of viscoelastic parameters of the muscle.

PMID:34261972 | DOI:10.1097/SCS.0000000000007992

J Craniofac Surg. 2021 Jul 14. doi: 10.1097/SCS.0000000000007966. Online ahead of print.

ABSTRACT

AIMS: The authors sought to assess the changes in eyelid position after silicone tube insertion and removal in endoscopic dacryocystorhinostomy.

METHODS: The authors retrospectively reviewed 60 eyes of 48 consecutive patients who underwent endoscopic dacryocystorhinostomy operation at Korea University Guro Hospital, Seoul, Republic of Korea, between April 2019 and November 2019. All cases were evaluated to discern eyelid positioning, focusing on the marginal reflex distance 1, medial palpebral fissure, central palpebral fissure (PF-2), lateral palpebral fissure (PF-3), and medial canthal angle (MCA) before surgery and at 1 week and 1, 2, 3, and 4 months postoperatively.

RESULTS: Twelve patients (25%) were operated on bilaterally and 36 patients (75%) were operated on unilaterally. The average patient age was 56.5 years and 9 men (18.8%) and 39 women (81.3%) were included in this study. At 2 months postoperatively, all values of interest (marginal reflex distance 1 , medial palpebral fissure, PF-2, PF-3, and MCA) had decreased significantly (P < 0.05, Friedman test), but the changes in PF-3 immediately after surgery were not significant (P = 0.062, Wilcoxon rank-sum test). From 2 to 3 months after surgery, all 5 indicators of interest increased significantly. After silicone tube removal, whereas there was no statistically significant difference in medial palpebral fissure, PF-3, and marginal reflex distance 1 values; the changes in PF-2 and MCA values as compared with before surgery was 0.47 mm (P = 0.02, Wilcoxon test) and 3.25° (P = 0.000, Wilcoxon test), respectively, which was significantly different. However, with these small gaps, it will be difficult to notice the changes in PF-2 and MCA values during clinical examination.

CONCLUSION: Insertion of a silicone tube during endoscopic dacryocystorhinostomy leads to temporary deformation of the lid position. However, after silicone tube removal, all eyelids recovered to their original shape.

PMID:34261970 | DOI:10.1097/SCS.0000000000007966

J Hypertens. 2021 Jul 12. doi: 10.1097/HJH.0000000000002945. Online ahead of print.

ABSTRACT

OBJECTIVE: As a risk indicator of hypertension, arterial stiffness is difficult to measure. Thus, we aimed to evaluate the association between estimated pulse wave velocity (ePWV) as a convenient indicator and the incidence of hypertension.

METHODS: The Kailuan cohort was selected for statistical analysis and 54 849 individuals were included in the final cohort. Multiple linear regression was used to analyse the correlation between ePWV and mean SBP (SBP_m) measured at five time points over a 10-year period and between ePWV and mean DBP (DBP_m) measured at five time points over a 10-year period. Logistic regression was used to analyse the effect of estimated arterial stiffness on hypertension.

RESULTS: The mean age of individuals was 48.44 ± 9.32 years, and 41 419 individuals (75.51%) were male. A multiple linear regression analysis showed that ePWV was positively correlated with both SBP_m and DBP_m. For every 1 cm/s increase in ePWV, SBP_m and DBP_m increased by 5.60 and 2.12 mmHg, respectively. A logistic regression analysis showed that in the total cohort, the incidence of hypertension in populations with moderate, moderate-high and high ePWV values was 3.03, 5.44 and 7.87-times higher, respectively, compared with individuals with low ePWV values. ePWV had a higher predictive value in female and middle age population compared with male and the eldly population grouped by sex and age respectively.

CONCLUSION: ePWV positively correlates with both SBP_m and DBP_m, and an increase in ePWV is associated with an increase in the incidence of hypertension.

PMID:34261958 | DOI:10.1097/HJH.0000000000002945

J Hypertens. 2021 Jul 13. doi: 10.1097/HJH.0000000000002941. Online ahead of print.

ABSTRACT

OBJECTIVE: An association between periodontitis and arterial hypertension has been suggested recently. This study aimed at investigating the hypothesis that periodontal health is linked to incident arterial hypertension.

METHODS: We analyzed data from the French population-based e-cohort NutriNet-Santé, selecting participants who had completed two oral health questionnaires in 2011-2012. Pregnant women, participants with diabetes, cancer, arterial hypertension and cardiovascular diseases at inclusion were excluded. Incident cases of arterial hypertension were self-reported and/or based on the use of antihypertensive therapy. Periodontal health was evaluated by estimating the modified and validated PEriodontal Screening Score (mPESS), with mPESS at least 5 corresponding to a high probability of severe periodontitis. Descriptive statistics and Cox proportional hazards regression models, taking into account sociodemographic and lifestyle confounders, were used.

RESULTS: The study population consisted of 32 285 participants (mean age: 45.79 ± 13.87 years); 78.5% were women. Two thousand one hundred and sixteen incident cases of arterial hypertension were identified during a median follow-up of 8 years (April 2012–December 2019). In the fully adjusted model, an mPESS at least 5 [hazard ratio: 1.84; 95% confidence interval (CI): 1.66-2.03] and the presence of nonreplaced missing teeth (hazard ratio: 1.13; 95% CI: 1.03-1.23) were significantly associated with a greater risk of incident arterial hypertension, whereas a regular annual visit to the dentist was associated with a lower risk (hazard ratio: 0.88; 95% CI: 0.80-0.97).

CONCLUSION: Self-reported assessed periodontitis was associated with incident arterial hypertension over an 8-year period. The present results highlight the importance of considering periodontal health when assessing an individual’s risk of arterial hypertension.

TRIAL REGISTRATION: # NCT03335644.

PMID:34261955 | DOI:10.1097/HJH.0000000000002941

Pediatr Crit Care Med. 2021 Jul 14. doi: 10.1097/PCC.0000000000002808. Online ahead of print.

ABSTRACT

OBJECTIVES: To derive and internally validate a bronchiolitis-specific illness severity score (the Critical Bronchiolitis Score) that out-performs mortality-based illness severity scores (e.g., Pediatric Risk of Mortality) in measuring expected duration of respiratory support and PICU length of stay for critically ill children with bronchiolitis.

DESIGN: Retrospective database study using the Virtual Pediatric Systems (VPS, LLC; Los Angeles, CA) database.

SETTING: One-hundred twenty-eight North-American PICUs.

PATIENTS: Fourteen-thousand four-hundred seven children less than 2 years old admitted to a contributing PICU with primary diagnosis of bronchiolitis and use of ICU-level respiratory support (defined as high-flow nasal cannula, noninvasive ventilation, invasive mechanical ventilation, or negative pressure ventilation) at 12 hours after PICU admission.

INTERVENTIONS: Patient-level variables available at 12 hours from PICU admission, duration of ICU-level respiratory support, and PICU length of stay data were extracted for analysis. After randomly dividing the cohort into derivation and validation groups, patient-level variables that were significantly associated with the study outcomes were selected in a stepwise backward fashion for inclusion in the final score. Score performance in the validation cohort was assessed using root mean squared error and mean absolute error, and performance was compared with that of existing PICU illness severity scores.

MEASUREMENTS AND MAIN RESULTS: Twelve commonly available patient-level variables were included in the Critical Bronchiolitis Score. Outcomes calculated with the score were similar to actual outcomes in the validation cohort. The Critical Bronchiolitis Score demonstrated a statistically significantly stronger association with duration of ICU-level respiratory support and PICU length of stay than mortality-based scores as measured by root mean squared error and mean absolute error.

CONCLUSIONS: The Critical Bronchiolitis Score performed better than PICU mortality-based scores in measuring expected duration of ICU-level respiratory support and ICU length of stay. This score may have utility to enrich interventional trials and adjust for illness severity in observational studies in this very common PICU condition.

PMID:34261942 | DOI:10.1097/PCC.0000000000002808

Adv Skin Wound Care. 2021 Jul 13. doi: 10.1097/01.ASW.0000765916.20726.41. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the frequency of hand dermatitis among nurses during the COVID-19 pandemic and factors affecting this.

METHODS: The research sample consisted of 175 nurses working in state hospitals. Research data were collected via Google Survey between October and September 2020. The data were collected using a Sociodemographic Data Collection Form, and a self-assessment form was used to determine dermatological symptoms.

RESULTS: The frequency of hand dermatitis among nurses was 70.9%. A statistically significant difference was found between sex, allergy history, and increased frequency of handwashing and the frequency of hand dermatitis. No significant difference in terms of the frequency of hand dermatitis was found between the nurses who provided care to COVID-19 positive patients and the nurses who did not provide care to COVID-19 positive patients. However, the frequency of washing hands and using hand disinfectants and hand creams was found to have increased significantly during the COVID-19 pandemic compared to the pre-pandemic period.

CONCLUSIONS: The frequency of hand dermatitis increased among nurses during the pandemic. The increased frequency of handwashing during the pandemic poses a risk of hand dermatitis symptoms among nurses. The increased frequency of handwashing during the pandemic should not discourage nurses from appropriate hand hygiene practices.

PMID:34261909 | DOI:10.1097/01.ASW.0000765916.20726.41

Am J Phys Med Rehabil. 2021 Jul 13. doi: 10.1097/PHM.0000000000001845. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the therapeutic effects of transcranial direct current stimulation (tDCS) on swallowing function in post-stroke patients.

DESIGN: We searched for potentially eligible randomized controlled trials from electronic databases, including the PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Chinese Science and Technology Periodical (VIP) databases, from their inception to January 15, 2021. All statistical analyses were performed using RevMan 5.4, and the standardized mean difference with 95% confidence intervals was estimated for the swallowing function outcomes and to understand the mean effect size.

RESULTS: Ten studies involving 343 participants were included in this meta-analysis. The overall analyses demonstrated a significant effect size for swallowing function. Subgroup analyses suggested that both acute and chronic stroke patients showed significant effects on swallowing function after tDCS. Furthermore, compared with sham stimulation, tDCS anodal to the affected, unaffected, and bilateral hemispheres can produce a significant effect size for swallowing function in stroke patients.

CONCLUSIONS: This meta-analysis showed that tDCS is likely to be effective for the recovery of dysphagia in post-stroke patients, in the acute or chronic phase, and that the effect of anodal tDCS to unaffected hemispheres is larger.

PMID:34261896 | DOI:10.1097/PHM.0000000000001845