Nevin Manimala

J Knee Surg. 2021 Jun 29. doi: 10.1055/s-0041-1731352. Online ahead of print.

ABSTRACT

In the absence of effective long-term repair of meniscal injuries, damage to the knee may lead to the development of osteoarthritis. Recent reports have recommended meniscal repair to be undertaken in all cases of meniscal tears. However, the most common complication encountered during repair of the medial meniscus is iatrogenic cartilage and meniscal injury due to its unclear visualization. The aim of this study is to evaluate the long-term clinical and radiological results of the pie-crust (PC) technique performed during the repair of medial meniscal tears. This retrospective study included 86 patients who underwent arthroscopic medial meniscus repair. PC technique was performed if the medial joint width was less than 5 mm. The patient population was divided into two groups as who underwent meniscus repair with PC technique (PC + repair group) or not (repair group). All patients were evaluated clinically (Kujala score, International Knee Documentation Committee (IKDC) subjective score, Lysholm score, and Tegner activity score) and radiologically (medial joint width and valgus laxity angle). When the medial joint width measurements before the PC technique and at the postoperative first and sixth months were compared, it was found to be statistically significant (p < 0.05). However, there was no significant difference between the preoperative and 12-month postoperative joint width measurements (p > 0.05). At the 12-month follow-up, no statistically significant difference was determined for the valgus laxity angle in the PC group compared with preoperative values (p > 0.05). The follow-up Kujala score, IKDC subjective score, Lysholm score, and Tegner activity score were similar between the groups. The clinical scores in both groups were determined to have statistically significant increase at 12-month postoperatively compared with the preoperative values (p < 0.05). The results of this study showed that performing the PC technique prior to medial meniscal tear repair increase the medial joint visualization safely and effectively without permanent valgus laxity.

PMID:34187063 | DOI:10.1055/s-0041-1731352

Laryngorhinootologie. 2021 Jun 29. doi: 10.1055/a-1528-7584. Online ahead of print.

ABSTRACT

OBJECTIVE: Dysphagia constitutes a frequent post-operative functional impairment in head-and-neck cancer patients. This impairment can result in aspiration/penetration and limitations of oral intake. Therefore, often it requires a therapeutic intervention. In this study, prevalence of post-operative dysphagia and its associations with the tumour stage, localisation, patients’ age, and biological sex were analysed for the inpatient treatment setting.

MATERIAL AND METHODS: A total of 201 adult head-and-neck cancer patients (mean age 63 years) were analysed prospectively by FEES in two university hospitals in regard to their penetration/aspiration, limitations of oral intake, and need for therapeutic interventions directly after the operative tumour treatment. Additionally, the influence of the same patients’ characteristics on these three parameters were analysed by means of univariate and multivariate statistical methods.

RESULTS: Out of 201 patients, 66.7 % needed a therapeutic intervention because of their dysphagia, 57.2 % needed a nasogastral or PEG tube due to limitations of oral intake, 45.3 % had an aspiration. In the latter subgroup, 38.5 % had a silent aspiration. Higher tumour stage, patients’ higher age and male sex were shown to be significant influence factors for dysphagia, tumour localisation showed only a marginally significant result.

CONCLUSIONS: The study demonstrated a clinical importance and relevance of the consequent and systematic treatment of post-operative dysphagia in head-and-neck cancer patients in the acute care units as a constituent of a modern oncological therapy.

PMID:34187052 | DOI:10.1055/a-1528-7584

Zootaxa. 2021 May 26;4975(3):544560. doi: 10.11646/zootaxa.4975.3.5.

ABSTRACT

Brachytrupes megacephalus (Lefebvre, 1827) is of significant biogeographic importance. It occurs in Sicily and on some of the circum-Sicilian and Pelagian islands, as well as in the Maltese Islands, Sardinia and the Maghreb (notably but not exclusively, in Algeria and Tunisia, where it maintains populations in both coastal and desert regions). Within European territory, it occurs solely in Italy and Malta, where it is protected under the EU Habitats Directive and the Bern Convention. In northern Africa, the species is regarded as a polyphagous pest, particularly in Saharan locations. The present work is based on field observations, mostly from the Maltese Islands, that span more than three decades; it provides insights on spatial distribution, population trends and behaviour. In examining the relationship between the species’ frequency during its mating season and weather conditions, results suggest a weak yet statistically significant correlation between mating strategies and ambient meteorological conditions. Moreover, patch occupancy in spring and autumn varied considerably within a specified area of study, primarily due to competitive mating strategies employed in spring, with an occupancy ratio of approximately 1:6. To-date, the species is known from 13 locations, one in Gozo and 12 in Malta, of which some constitute the Ahrax promontory metapopulation. Connectivity between the Ahrax subpopulation cluster is discussed in the light of habitat and topographical characteristics. Contrasting findings on variances in behaviour between Maltese populations and other populations in Sicily and the Maghreb are discussed. Discernible behavioural disparities include the length of excavated tunnels during spring and summer/autumn seasons in the different geographical locations, attraction to artificial sources of light, and the degree of damage to crops across geographic regions.

PMID:34187031 | DOI:10.11646/zootaxa.4975.3.5

Zootaxa. 2021 Jun 3;4981(1):89106. doi: 10.11646/zootaxa.4981.1.4.

ABSTRACT

In this study we redescribe the taxonomy of some holothuriid species collected from different localities of the Algerian coastal waters. Morphological (anatomical and endoskeletal) and previous molecular studies show the presence of two distinct morphotypes of Holothuria (Holothuria) tubulosa “A” “B”. Morphotype “A” corresponds to the classical Holothuria (Holothuria) tubulosa Gmelin 1791, described by Koehler (1921) and hereafter referred to as H. (H.) tubulosa (s.s.), while morphotype “B”, we believe, represents a new species, herein named H. (Holothuria) algeriensis n. sp. with characteristics significantly different from those of Holothuria (H.) tubulosa (s.s.). Both morphology and statistical analysis (Linear Discriminant Analysis) confirm significant differences between these two morphotypes. To visualize these differences, measurements made on ossicles of Holothuria (H.) tubulosa (s.s.) and Holothuria (H.) algeriensis n. sp. were compared with other species present in our collections, including the north-eastern Atlantic and Mediterranean Holothuria (Roweothuria) arguinensis Koehler Vaney, 1906, recently recorded from Algerian waters, the Mediterranean Holothuria (Roweothuria) poli Delle Chiaje, 1824 and Holothuria (Holothuria) stellati Delle Chiaje, 1824. We conclude that the two morphotypes of H. (H.) tubulosa are significantly different to warrant the recognition of a new species, H. (H.) algeriensis n. sp. and the linear discriminant analysis (LDA) of the five species demonstrate this.

PMID:34186955 | DOI:10.11646/zootaxa.4981.1.4

Zootaxa. 2021 Jun 18;4990(1):1-22. doi: 10.11646/zootaxa.4990.1.1.

ABSTRACT

All the Turkish populations studied, both those previously assigned to D. dryada (Subaşı and Yoldere villages, near Hopa) and those attributed to D. clarkorum (the largest sample studied so far, 177 specimens in total), are indistinguishable from each other and therefore must all be ascribed to the natural variability of a monotypic D. clarkorum. The Georgian specimens from the Type Locality of D. dryada (Charnaly river gorge, Chevachauri district) are clearly different, so that taxon cannot be considered a simple synonym for D. clarkorum, but as a valid taxon, although its proper status (more probably as a subspecies of D. clarkorum), is yet to be clarified. It is a highly threatened population, so studies should be done in vivo or with as low intrusiveness as possible. Darevskia dryada is clearly larger (SVL) than any D. clarkorum studied, with strongly longer heads and pilei in adult males (and hence more teeth in dentary bone), and higher dorsalia counts. There also seem to be (but need to be studied in a larger sample) more longitudinal rows of temporal scales between tympanic and parietal plates, a tendency to have more supralabial scales; comparatively smaller values for longitudinal rows of scales on the ventral surface of the thigh between the femoral pores and the outer row of enlarged scales, and higher collaria, and circumanalia scales. Other differences in femoralia and gularia are also reflected in Darevsky Tuniyev’s (1997) tables and should also be investigated with more Georgian specimens. Two supposed discriminant characters, the frontonasal index and the presence of developed masseteric, are not valid. The frontonasal index does not discriminate both taxa; D dryada specimens fall inside the variation of D. clarkorum for this character. Also the presence of a developed masseteric plate is supposed to be rare if at all in D. clarkorum but always present in D. dryada; however, it appears in nearly 75% of D. clarkorum studied and in all D. dyada, so is also no longer valid for taxa discrimination. Although very similar, D. clarkorum and D. dryada are morphologically different, and genetic studies (as the unpublished results mentioned by Fu, 1999) do not make the provenance of the specimens clear, and hence the correct identification of the supposed specimens of D. dryada used. There are no geographical clines in D. clarkorum. However, as stated by Schmidtler et al. (2002), there is an inverse relationship between altitude and dorsalia values in D. clarkorum. Both the general differentiation between populations and the scalation (dorsalia) appear statistically correlated with the altitude and also with latitude (being both factors not strictly the same). The correlation seems to be stronger with morphology in general (multiple scalation characters and head biometry) than only with dorsalia. In the case of the general differentiation among samples, it is also significantly correlated with temperatures during the activity period (April-September) and with precipitation during incubation (July-August). As these climatic parameters of temperature and precipitation are not directly correlated with the dorsalia variation, the relation with altitude (and perhaps latitude) must be linked to some other climatic parameter not studied here, perhaps solar radiation or evapotranspiration.

PMID:34186776 | DOI:10.11646/zootaxa.4990.1.1

Zootaxa. 2021 May 21;4974(3):585595. doi: 10.11646/zootaxa.4974.3.7.

ABSTRACT

The freshwater leech family Salifidae Johansson has a Paleotropical range, with a hotspot of species richness in the Oriental Region, and a few species endemic to Africa, Madagascar, and Reunion. Barbronia gwalagwalensis Westergren Siddall, 2004 was thought to be a characteristic example of the latter group being a lineage endemic to South Africa. However, we found that this species also occurs in Asia (Myanmar and Korea). Our time-calibrated phylogeny based on the mitochondrial cytochrome c oxidase subunit I (COI) gene reveals that the split between the African and Asian populations of this species occurred in the mid-Pleistocene, approximately 1.3 Ma ago (95% HPD 0.7-2.1 Ma). The statistical biogeographic modeling indicates that a B. gwalagwalensis population in South Africa most likely originated due a long-distance dispersal event with a subsequent vicariance (probability = 88.9%). A Late Quaternary range extension towards South Africa is known to occur in some other freshwater taxa (e.g. the freshwater mussel Unio caffer Krauss species group), which agrees with our hypothesis on the ancient origin of the South African B. gwalagwalensis population. Conversely, we can assume that the African population of this species was recently introduced from Asia. If so, the high levels of genetic divergence between African and Asian populations could be a part of a more general phylogeographic pattern historically originated within the Asian subcontinent due to the isolation by orographic or marine barriers. These two alternative hypotheses need further research efforts, i.e. sampling and sequencing of other Barbronia taxa, the ranges of which are situated between South Africa and Southeast Asia, as well as of topotypes of B. weberi (Blanchard, 1897) from Indonesia. Finally, our results highlight that the salifid genus Barbronia Johansson originated in the Oriental Region and that these leeches share both recently and historically high potential for long-distance dispersal events.

PMID:34186580 | DOI:10.11646/zootaxa.4974.3.7

Trans R Soc Trop Med Hyg. 2021 Jun 29:trab094. doi: 10.1093/trstmh/trab094. Online ahead of print.

ABSTRACT

BACKGROUND: Serological evaluation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an alternative that allows us to determine the prevalence and dynamics of this infection in populations. The goal of this study was to determine the clinical and sociodemographic dynamics of SARS-CoV-2 infection in a region of the Colombian Caribbean.

METHODS: Between July and November 2020, a cross-sectional observational study was carried out in Córdoba, located in northeast Colombia in the Caribbean area. Eight municipalities with the largest populations were chosen and 2564 blood samples were taken. A commercial enzyme-linked immunosorbent assay was used with the recombinant protein antigen N of SARS-CoV-2. The people included in the study were asked for sociodemographic and clinical data, which were analysed by statistical methods.

RESULTS: A seroprevalence of 40.8% was obtained for SARS-CoV-2 in the Córdoba region. In the bivariate analysis, no differences were observed in seropositivity against SARS-CoV-2 for gender or age range (p>0.05). Higher seropositivity was found in low socio-economic status and symptomatic patients (p<0.0001). A total of 30.7% of the asymptomatic patients were seropositive for SARS-CoV-2, which could be linked to the spread of this infection. In the multivariate analysis, seroconversion was related to poverty and clinical manifestations such as anosmia and ageusia (p<0.05).

CONCLUSIONS: The high seropositivity in Córdoba is due to widespread SARS-CoV-2 in this population. The relationship between seropositivity and socio-economic status suggests a higher exposure risk to the virus caused by informal economic activities in low-income groups. Clinical manifestations such as anosmia and ageusia could be clinical predictors of infection by the new emergent coronavirus.

PMID:34185868 | DOI:10.1093/trstmh/trab094

Anesth Prog. 2021 Jun 1;68(2):69-75. doi: 10.2344/anpr-68-01-10.

ABSTRACT

The inferior alveolar nerve block (IANB) does not always result in successful pulpal anesthesia. Nitrous oxide may increase the success of the IANB. The purpose of this investigation was to study the effect of nitrous oxide/oxygen (N2O/O2) on IANB injection pain and mandibular pulpal anesthesia in asymptomatic subjects. One hundred five asymptomatic subjects received an IANB after the administration of N2O/O2 or room air/oxygen (air/O2) at 2 separate appointments. After the IANB, subjects rated their level of pain for each phase of the injection (needle insertion, needle placement, and solution deposition) using a Heft Parker visual analog scale. Pulpal anesthesia was evaluated with an electric pulp tester for 60 minutes. The mean pain rating for all 3 injection phases showed a statistically significant reduction in pain when N2O/O2 was used compared with Air/O2 (P < .05). Odds ratios demonstrated a statistically significant increase in IANB success for the N2O/O2 group compared with the air/O2 group. N2O/O2 administration statistically decreased pain for all 3 injection phases of the IANB. In addition, nitrous oxide statistically increased the likelihood of pulpal anesthesia for posterior mandibular teeth. However, the incidence of pulpal anesthesia was not 100%.

PMID:34185865 | DOI:10.2344/anpr-68-01-10

Int Health. 2021 Jun 29:ihab040. doi: 10.1093/inthealth/ihab040. Online ahead of print.

ABSTRACT

BACKGROUND: Underweight is one of the largest contributors to child morbidity and mortality and is considered to be the largest contributor to the global burden of diseases in low-and middle-income countries. In Mauritania, where one-fifth of children are underweight, there is a dearth of evidence on socio-economic, sex and geographic disparities in childhood underweight. As a result, this study aimed at investigating the socio-economic, sex and geographic disparities in childhood underweight in Mauritania.

METHODS: Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Mauritania Multiple Indicator Cluster Surveys (MICSs) conducted between 2007 and 2015 were analysed. Childhood underweight was disaggregated by five equity stratifiers: education, wealth, residence, region and sex. In addition, absolute and relative inequality measures, namely difference (D), population attributable risk (PAR), ratio (R) and population attributable fraction (PAF) were calculated to understand inequalities from wider perspectives. Corresponding 95% confidence intervals (CIs) were computed to measure statistical significance.

RESULTS: Substantial absolute and relative socio-economic, sex and geographic disparities in underweight were observed from 2007 to 2015. Children from the poorest households (PAR=-12.66 [95% CI -14.15 to -11.16]), those whose mothers were uneducated (PAF=-9.11 [95% CI -13.41 to -4.81]), those whose mothers were rural residents (R=1.52 [95% CI 1.37 to 1.68]), residents of HodhCharghy (PAF=-66.51 [95% CI -79.25 to -53.76]) and males (D=4.30 [95% CI 2.09 to 6.52]) experienced a higher burden of underweight. Education-related disparities decreased from 2007 to 2015. The urban-rural gap in underweight similarly decreased over time with the different measures showing slightly different reductions. Wealth-driven disparities decreased marginally from 2011 to 2015. The sex-based and regional disparities increased, at least on average, over the 8-y intersurvey period.

CONCLUSIONS: The burden of underweight was significantly higher among children from disadvantaged subpopulations, those with uneducated and poorest/poor mothers, those living in rural areas and those living in HodhCharghy. Special nutrition intervention and efforts focused on these deprived subpopulations are required to reduce childhood morbidity and mortality associated with underweight and help achieve the Sustainable Development Goals.

PMID:34185850 | DOI:10.1093/inthealth/ihab040

Int Health. 2021 Jun 29:ihab039. doi: 10.1093/inthealth/ihab039. Online ahead of print.

ABSTRACT

BACKGROUND: This study was carried out to enable an assessment of geospatial distribution and access to healthcare facilities under the National Health Insurance Scheme (NHIS) of Nigeria. The findings will be useful for efficient planning and equitable distribution of healthcare resources.

METHODS: Data, including the distribution of selected health facilities, were collected in Ibadan, Nigeria. The location of all facilities was recorded using Global Positioning System and was subsequently mapped using ArcGIS software to produce spider-web diagrams displaying the spatial distribution of all health facilities.

RESULTS: The result of clustering analysis of health facilities shows that there is a statistically significant hotspot of health facility at 99% confidence located around the urban areas of Ibadan. The significant hotspot result is dominated by a feature with a high value and is surrounded by other features also with high values. Away from the urban built-up area of Ibadan, health facility clustering is not statistically significant. There was also a high level (94%) of bypassing of NHIS-accredited facilities among the enrollees.

CONCLUSIONS: Lopsided distribution of health facilities in the study area should be corrected as this may result in inequity of access to available health services.

PMID:34185841 | DOI:10.1093/inthealth/ihab039