Nevin Manimala

J Magn Reson Imaging. 2021 Jul 22. doi: 10.1002/jmri.27851. Online ahead of print.

ABSTRACT

BACKGROUND: The striatum has been reported to be implicated in various neurological diseases, including lifelong premature ejaculation (LPE). Altered striatum-related functional connectivity was investigated in LPE patients in previous studies; however, structural abnormalities in the striatum have been less studied in LPE.

PURPOSE: To identify the gray matter volume (GMV) and structural covariance patterns of the striatum between LPE patients and healthy controls (HCs).

STUDY TYPE: Prospective.

SUBJECTS: Forty-three LPE patients and 31 male HCs.

FIELD STRENGTH/SEQUENCE: 3.0 T magnetic resonance imaging (MRI) scanner; T1-weighted imaging using a spoiled gradient recalled echo sequence.

ASSESSMENT: Preprocessing of structural MRI data and the striatum-seeded GMV computation were conducted using SPM12.

STATISTICAL TESTS: Two sample t-test was used to compare differences in GMV of the striatum between patients and HCs. Regions showing altered between-group GMV were considered as seeds for structural covariance analysis in two groups. Additionally, correlations between GMV findings and clinical features were assessed with age and total intracranial volume (TIV) as covariates and with age, TIV, anxiety, and depression scores as covariates in the patient group, P < 0.05 was considered statistically significant.

RESULTS: Compared to HCs, LPE patients had significantly decreased GMV in four regions located in the bilateral caudate and putamen. Distinct striatum-based structural covariance patterns in the two groups were mainly related to the thalamus, amygdala, insula, anterior cingulate cortex, middle cingulate cortex, medial prefrontal cortex, primary motor cortex, and precuneus/cuneus. LPE patients showed that GMV in the bilateral caudate negatively correlated with the premature ejaculation diagnostic tool (PEDT) scores (r = -0.369, r = -0.377, respectively).

DATA CONCLUSION: Our findings indicated that LPE patients had altered GMV and structural covariance patterns in the striatum compared to HCs. The correlations between abnormal GMV and PEDT were also shown in the present findings. These findings may contribute to enhancing the understanding of the pathophysiology of LPE.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 3.

PMID:34291847 | DOI:10.1002/jmri.27851

J Surg Oncol. 2021 Jul 22. doi: 10.1002/jso.26616. Online ahead of print.

ABSTRACT

BACKGROUND: The coronavirus (COVID-19) pandemic led to disruptions in operative and hospital capabilities as the country triaged resources and canceled elective procedures. This study details the operative experience of a safety-net hospital for cancer-related operations during a 3-month period at the height of the pandemic.

METHODS: Patients operated on for or diagnosed with malignancies of the abdomen, breast, skin, or soft-tissue (September 3, 2020-September 6, 2020) were identified from operative/clinic schedules. Sociodemographics, tumor and treatment characteristics, and COVID-19 information was identified through retrospective chart review of a prospectively maintained database. Descriptive statistics were calculated.

RESULTS: Fifty patients evaluated within this window underwent oncologic surgery. Median age was 61 (interquartile range: 53-68), 56% were female, 86% were White, and 66% were Hispanic. The majority (28%) were for colon cancer. Only two patients tested positive for COVID-19 preoperatively or within 30 days of their operation. There were no mortalities during the 1-year study period.

CONCLUSION: During the COVID-19 pandemic, many hospitals and operative centers limited interventions to preserve resources, but oncologic procedures continued at many large-volume academic cancer centers. This study underscores the importance of continuing to offer surgery during the pandemic for surgical oncology cases at safety-net hospitals to minimize delays in time-sensitive oncologic treatment.

PMID:34291824 | DOI:10.1002/jso.26616

Aesthet Surg J. 2021 Jul 22:sjab290. doi: 10.1093/asj/sjab290. Online ahead of print.

ABSTRACT

BACKGROUND: Post-mastectomy pocket irrigation solution choice is debated and primarily surgeon dependent. We compare triple antibiotic solution (TAS) to 0.05% chlorhexidine gluconate (CHG).

OBJECTIVES: The purpose of this study was to determine surgical site infection (SSI) rates after using TAS vs CHG for breast pocket irrigation in immediate tissue expander breast reconstruction.

METHODS: A prospective, blinded, randomized controlled trial was performed in patients (18-81 years old) undergoing bilateral mastectomy with tissue expander (TE) reconstruction. In each patient, one mastectomy pocket was randomized to TAS and the other to CHG. Both the TE and the pocket were irrigated in the respective solution. The primary outcome was the incidence of surgical site infections (SSI). Secondary outcomes were rates of mastectomy flap necrosis, hematoma, and seroma.

RESULTS: Eighty-eight patients undergoing bilateral immediate breast reconstruction were enrolled. Demographic and operative characteristics were equivalent as each patient served as their own control. Between the TAS and CHG groups, there was no difference in the incidence of SSI (5 [4.5%] vs 7 [8.0%], p = 0.35), including minor infections (2 [2.3%] vs 1 [1.1%], p = 0.56), major infections (2 [2.3%] vs 6 [6.8%], p = 0.15), and those resulting in explantation (2 [2.3%] vs 5 [4.5%], p = 0.25). There was also no difference in necrosis, hematoma, or seroma formation. No patients who developed SSI had radiation.

CONCLUSIONS: This study does not demonstrate a statistically significant difference in SSI between TAS and CHG irrigation, though TAS approached statistical significance for lower rates of infectious complications.

PMID:34291796 | DOI:10.1093/asj/sjab290

Twin Res Hum Genet. 2021 Jul 22:1-3. doi: 10.1017/thg.2021.26. Online ahead of print.

ABSTRACT

The Hardy-Weinberg law of population genetics is usually associated with the notion of random mating of parents. A numerical example for a triallelic autosomal locus shows that an uncountable set of mating combinations can maintain Hardy-Weinberg proportions. Therefore, one cannot infer random mating in a population from the observation of Hardy-Weinberg equilibrium. The mating system which ensures that the genotypic distribution of offspring is the same as that of the parents is specified.

PMID:34291729 | DOI:10.1017/thg.2021.26

Climacteric. 2021 Jul 22:1-9. doi: 10.1080/13697137.2021.1941850. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study was to evaluate the clinical response and collagen remodeling in the vaginal wall after three sessions of carbon dioxide (CO₂) laser application.

METHODS: Fourteen postmenopausal women with vulvovaginal atrophy, aged 45-65 years and sexually active, were evaluated with clinical questionnaires, gynecological examinations and histological techniques before and after 20 weeks of treatment (ClinicalTrials.gov NCT03939078). Treatment consisted of 3-monthly sessions of the CO₂ laser. Clinical questionnaires included the Vaginal Health Index, the Female Sexual Function Index and the International Consultation on Incontinence Questionnaires Short Form. Biopsies were taken from the lateral vaginal wall at week 0 (left wall) and week 20 (right wall). Tissue samples were stained with hematoxylin and eosin, Periodic Acid-Schiff, Picrosirius Red Stain and Orcein dyes. Immunohistochemical study was used to quantify collagens I and III in the samples.

RESULTS: The mean age was 54.4 ± 4.5 years, and the average time of amenorrhea was 7.6 ± 5.1 years. The Female Sexual Function Index and the Vaginal Health Index Score values increased while the International Consultation on Incontinence Questionnaire Short Form score decreased after the programmed treatment. There was no significant change in vaginal pH. Histological studies showed increases in the total and superficial epithelial cell layers, and type III collagen fibers (from 10.86 ± 7.66 to 16.87 ± 3.96, p < 0.05), and immunohistochemical studies confirmed the significant increase in collagen III.

CONCLUSION: Histological findings revealed epithelial atrophy reversal and collagen remodeling of the vaginal wall. Immunohistochemical analysis showed an increase in collagen type III fibers.

PMID:34291703 | DOI:10.1080/13697137.2021.1941850

Behav Modif. 2021 Jul 22:1454455211033515. doi: 10.1177/01454455211033515. Online ahead of print.

ABSTRACT

To our knowledge, no studies on health conditions in U.S. military firefighters exist. Data and demographics from the Defense Medical Epidemiology Database were analyzed on several shared medical issues among military personnel and civilian firefighters. Descriptive statistics and Chi-Square goodness of fit tests were conducted to support study aims. Between 2001 and 2015, substantial incidence rate increases (per 10,000) of tinnitus, PTSD, insomnia, and OSA (2005-2015) were observed. Modest to large increases in depressive disorders, adjustment reaction, generalized anxiety disorder, and panic disorder were observed. Decreasing rates were observed for alcohol dependence, hypertension, and tobacco use disorder. While efforts have examined the impact of sustained operations on military members, first responder military subgroups like firefighters are deficient. Cognitive Behavior Therapy interventions are efficacious for preventing and reducing behavioral health problems; therefore, tailoring them specifically for U.S. military firefighters could significantly improve quality of life and long-term health.

PMID:34291696 | DOI:10.1177/01454455211033515

Aging Ment Health. 2021 Jul 22:1-12. doi: 10.1080/13607863.2021.1950615. Online ahead of print.

ABSTRACT

Objectives Fear of falling is common among older adults and can increase fall-risk through premature activity restriction. Exergames, an emerging tool in fall prevention, combine exercise with interactive and adaptive game elements. This review examines the extent to which exergame interventions reduce fear of falling among community-dwelling older adults. Method: Guided by the PRISMA methodology, we reviewed peer-reviewed studies that were published in English between 2006 and 2019 and employed a comparative design to test the effect of exergames on fear of falling in community-dwelling older adults. Two reviewers screened the literature and extracted data on the exergame platform, participants, study design, and results. A modified PEDro scale was used to assess study quality. Disagreements were resolved through discussion with the third reviewer. Results: Our literature search resulted in 23 eligible studies on exergame interventions where fear of falling was the primary or secondary outcome. Most interventions (35%) occurred within hospitals and were delivered via a Wii-based system (61%). Fear of falling was most commonly measured using the Falls Efficacy Scale, the Activities-specific Balance Scale and their modified versions. A total of 15 of the 23 studies reported statistically significant changes in fear of falling. Quality assessment showed 10 studies to be rated as ‘good.’ Conclusion: This review showed that exergame may have a positive effect in reducing fear of falling in community-dwelling older adults. The finding provides a direction for clinical practice in the research area of intervention on fear of falling in older adults.

PMID:34291684 | DOI:10.1080/13607863.2021.1950615

J Biomed Opt. 2021 Jul;26(7). doi: 10.1117/1.JBO.26.7.077001.

ABSTRACT

SIGNIFICANCE: Measurements of auditory ossicles displacement are commonly carried out by means of laser-Doppler vibrometry (LDV), which is considered to be a gold standard. The limitation of the LDV method, especially for in vivo measurements, is the necessity to expose an object in a straight line to a laser beam operating from a distance. An alternative to this approach is the use of a handheld laser-fiber vibrometry probe (HLFVP) with a curved tip.

AIM: We evaluate the feasibility of an HLFVP with a curved tip for measuring sound-induced displacement of the auditory ossicles.

APPROACH: A handheld vibrometer probe guiding the laser beam with a fiber-optic cable was used for displacement measurements of the incus body and the posterior crus of the stapes. Tonal stimuli at frequencies of 0.5, 1, 2, and 4 kHz were presented by means of an insert earphone positioned in the outer ear canal. The probe was fixed at the measurement site using a tripod or hand-held by one of the two surgeons.

RESULTS: The measurements were carried out on six fresh temporal bones. Multivariate analysis of variance showed statistically significant differences for stimulus frequency (F3,143 = 29.37, p < 0.001, and η2 = 0.35), bone (F5,143 = 4.61, p = 0.001, and η2 = 0.01), and measurement site (F1,143 = 4.74, p = 0.03, and η2 = 0.02) in the absence of statistically significant differences for the probe fixation method (F2,143 = 0.15, p = 0.862, and η2 = 0.001). Standard deviations of the means were 6.9, 2.6, 1.9, and 0.6 nm / Pa for frequency, bone, site, and fixation, respectively. Ear transfer functions were found to be consistent with literature data.

CONCLUSIONS: The feasibility of applying HLFVP to measure the displacement of auditory ossicles has been confirmed. HLFVP offers the possibility of carrying out measurements at various angles; however, this needs to be standardized taking into account anatomical limitations and surgical convenience.

PMID:34291616 | DOI:10.1117/1.JBO.26.7.077001

Nurs Open. 2021 Jul 22. doi: 10.1002/nop2.988. Online ahead of print.

ABSTRACT

OBJECTIVES: Less than 5% of all harmful medicine-related incidents (MIs) or adverse drug reactions received by the Spanish Pharmacovigilance system are notified by Registered Nurses (RNs). The main objective of this study was to determine the impact of a multifaceted institutional intervention (MII) in patient safety on the reporting competence of medication incidents of hospital RNs.

DESIGN: One-group pre-test-posttest design.

SETTING: Tertiary, public, teaching hospital in Spain.

PARTICIPANTS: A total of 139 RNs responded to pre- and postintervention questionnaires constituting the paired sample subjected to analysis.

INTERVENTION: A MII, consisting of educational activities and materials, change in MI reporting form from paper to electronic and appointment of reporting support services, was designed and directed to all hospital RNs and midwifes.

MAIN OUTCOME MEASURES: Overall MIs reporting competence (OC) and its dimensions (attitudes, knowledge and skills) were measured through a synthetic variable (total OC value range: 34-170 points) by means of an electronic questionnaire.

RESULTS: A statistically significant 7.96-point increase in OC from baseline to the final measurement was obtained (CI: 5.05-10.85). There was an increase of 7.38 points in the skills dimension (CI: 5.06-9.68). After the MII, 73.4% nurses improved their OC and 33.8% reported at least one no-harm MI postintervention compared to 4.4% pre-intervention (p < .001). A one-point increase in OC improved the probability of becoming reporter by 2.9% and a one-point increase in skills by 6.4%.

CONCLUSION: MIs reporting competence among RNs increased after a multifaceted institutional intervention, due to an improvement in the skills dimension. The MII was also effective in raising both, the rate of RNs who become reporters and the number of no-harm MIs reported.

PMID:34291607 | DOI:10.1002/nop2.988

Brain Behav. 2021 Jul 21. doi: 10.1002/brb3.2252. Online ahead of print.

ABSTRACT

BACKGROUND: Orthostatic hypotension (OH) is a common nonmotor symptom in patients with Parkinson’s disease (PD), with an incidence ranging from 14% to 54%.

AIMS: This study explored changes in cognition and transcranial sonography (TCS) findings in patients with PD and OH.

METHODS: We enrolled PD patients who visited the outpatient or inpatient department from 2017 to 2020. Blood pressure was measured in different positions, and demographic data were collected. Motor and nonmotor symptoms were evaluated using standard scales. A subset of 107 patients underwent TCS.

RESULTS: We enrolled 66 PD-OH patients and 92 PD-no orthostatic hypotension (NOH) patients. There were no significant differences in gender, age, disease duration, or Hoehn and Yahr stage between groups. Binary logistic regression revealed age as an independent risk factor for OH in PD patients. There were statistically significant group differences in visuospatial and executive function and Unified Parkinson’s Disease Rating Scale (UPDRS) I and II scores (p < .05). Among PD-OH patients, there was a statistically significant difference in UPDRS II and III scores between patients with or without clinical symptoms (p < .05). The substantia nigra (SN) area was significantly larger in PD-NOH patients (0.45 ± 0.18 cm² ) than PD-OH patients (0.34 ± 0.16 cm² ) (p < .05).

CONCLUSIONS: PD-OH patients had poorer visuospatial and executive function and lower UPDRS I and II scores compared with PD-NOH patients. Within the PD-OH group, there was no significant difference in cognition between patients with or without clinical symptoms. The difference in the SN area may indicate different subtypes of PD or a tendency to develop parkinsonism syndrome.

PMID:34291604 | DOI:10.1002/brb3.2252