Nevin Manimala

Lasers Med Sci. 2021 May 14. doi: 10.1007/s10103-021-03329-7. Online ahead of print.

ABSTRACT

The purpose of this study was to assess skin elasticity, the reduction in the number and the depth of wrinkles and changes in the other skin defects (bags under the eyes, dark circles under the eyes, skin hyperpigmentation in the ageing eye area following the use of non-ablative fractional laser, bipolar radiofrequency and intense pulsed light). Moreover, the study was also comparison which device brought better results than the others. This study included 71 patients (66 women, 5 men), aged 33-63 years (the average age was 45.81 years) with skin phototypes II and III. Twenty-four patients received five treatment sessions with a 1410-nm non-ablative fractional laser in 2-week intervals, 23 patients received five treatment sessions with a bipolar radiofrequency in 1-week intervals and 24 patients received five treatment sessions with an intense pulsed light in 2-week intervals. The treatment was applied on the skin in the eye area. The Cutometer (Courage + Khazaka electronic) reference test was used as an objective method for the assessment of skin elasticity. A questionnaire was used to compare baseline state with changes that occurred after the series of treatment sessions. The results of cutometric measurements of R2, R6 and R7 parameters and the results of questionnaires indicated that non-ablative fractional laser therapy, bipolar radiofrequency and intense pulsed light improved skin elasticity. Of the three treatments, the most significant percentage improvement in the R6 parameter was demonstrated by non-ablative fractional laser therapy which gave better final results than the other methods (p < 0.0001). No other statistically significant relationships were found between RF and IPL. In the (subjective) opinion of study participants (questionnaire), all used methods resulted in the reduction of the amount and the depth of wrinkles. However, they did not observe significant impact of individual treatment method on the signs of skin ageing, including discolorations within eye area, bags (fatty hernia), dark circles (vascular/pigmentary) and oedema (predisposition to water retention). Non-ablative fractional laser therapy, bipolar radiofrequency and intense pulsed light improved skin elasticity and the reduction of wrinkles. The most significant improvement of elasticity was demonstrated by laser therapy. It seems necessary to expand the group with the effect of individual treatments against bags and dark circles under the eyes.

PMID:33988812 | DOI:10.1007/s10103-021-03329-7

Ir J Med Sci. 2021 May 14. doi: 10.1007/s11845-021-02635-x. Online ahead of print.

ABSTRACT

BACKGROUND: An increasing prevalence of overweight and obesity in children has been reported globally. Most studies examining the trajectory of BMI in children over time have tended to focus on children with typical development. Our group previously reported static prevalence rates in children with cerebral palsy. However, concern remains within our multi-disciplinary team that progression into higher BMI categories is apparent as children with cerebral palsy age.

AIMS: To examine the progression of BMI status as children with cerebral palsy age and determine the severity of obesity.

METHODS: A retrospective analysis was conducted of the National Movement Laboratory database yielding 574 participants that met inclusion criteria. BMI was calculated retrospectively, and age adjusted BMI centiles were used for analysis. A chi-square test for homogeneity was used to compare differences in proportions. Differences in age, weight and height between assessments were assessed using a Wilcoxon signed rank test. Statistical significance was set at p < 0.05.

RESULTS: No statistically significant differences were present in proportions for any BMI classifications between first and repeat assessments. Small increases were evident in both the obesity (7.8 to 11.5%) and overweight (10.8 to 12.4%) categories. Eighty percent of children remained in a normal BMI category between assessments while 56% remained either overweight or moved into a category of obesity.

CONCLUSION: The majority of children with cerebral palsy who presented with a normal BMI at first assessment maintained this BMI classification at follow-up. The results of this study highlight the importance of maintaining a healthy BMI status.

PMID:33988804 | DOI:10.1007/s11845-021-02635-x

Neurol Sci. 2021 May 14. doi: 10.1007/s10072-021-05303-1. Online ahead of print.

ABSTRACT

Neurodegenerative disorders like Alzheimer’s, Parkinson’s, and associated dementia typically originate with altered protein folding and aggregation of their β structures in the neurons. This self-aggregation leads to glial activation in the brain, causing neuroinflammation and leads to neuronal death. According to statistics provided by WHO, there are around 50 million people with dementia worldwide and every year, 10 million more cases are projected to increase. Also, around 5-8 percentage of people who are aged above 60 globally has dementia or associated disorders. Over 82 million in 2030 and 152 in 2050 are expected to have dementia. Most of these patients fall into low-middle-income countries which makes it even more essential to find an affordable and effective treatment method. Polyphenols of different origin are studied for their potential role as anti-neuro-inflammatory molecules. This review would summarize recent advances in three widely researched dietary polyphenols projected as potential therapeutic agents for disorders like Alzheimer’s, Parkinson’s, etc. They are Resveratrol, Catechins, and Tannins. The review would discuss the recent advances and challenges in using these polyphenols using specific examples as potential therapeutic agents against neuroinflammation associated disorders. An abstract of neuroinflammation-associated events and the effects by selected polyphenols.

PMID:33988799 | DOI:10.1007/s10072-021-05303-1

Int Urogynecol J. 2021 May 14. doi: 10.1007/s00192-021-04829-4. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: This was a planned secondary analysis of a systematic review that described sexual function outcomes following pelvic organ prolapse (POP) surgery. We aimed to describe the relationship of pre- and postoperative vaginal anatomic measures with sexual function outcomes. Data Sources included the Medline, Embase, and clinicaltrials.gov databases from inception to April 2018.

METHODS: The original systematic review included prospective, comparative studies that reported sexual function outcomes before and following POP surgery. Studies were extracted for population characteristics, sexual function outcomes, and vaginal anatomy, including total vaginal length (TVL) and genital hiatus. By meta-regression, we analyzed associations across studies between vaginal anatomic measurements and sexual function using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12) and dyspareunia outcomes.

RESULTS: We screened 3124 abstracts and identified 74 papers representing 67 original studies. Among these, 14 studies reported TVL and PISQ-12 outcomes. Nine studies reported TVL and dyspareunia outcomes, eight studies reported GH and PISQ-12 outcomes, and seven studies reported GH and dyspareunia outcomes. We found no associations between anatomic measures and PISQ-12 or dyspareunia, although, we found a statistically significant association found between preoperative TVL and change in PISQ-12.

CONCLUSION: Across studies, the evidence does not support an association between vaginal anatomy and either validated, condition-specific sexual function questionnaires or dyspareunia. However, no study has directly analyzed these associations in the setting of pelvic floor reconstructive surgery.

PMID:33988785 | DOI:10.1007/s00192-021-04829-4

AIDS Behav. 2021 May 14. doi: 10.1007/s10461-021-03301-0. Online ahead of print.

ABSTRACT

The SAVA syndemic is frequently used to describe the co-occurrence of HIV, gender-based violence (GBV), and substance use. In this study we determine the extent to which the typologies of the SAVA syndemic can be described and utilized for intervention strategies among youth living in the slums of Kampala, Uganda. We analyzed the “Kampala Youth Survey 2014,” a cross-sectional survey conducted in the spring of 2014, consisting of a convenience sample (N = 1134) of urban youth (12-18 years of age). Descriptive statistics were computed for hypothesized risk factors and demographic variables among the 8 typologies of GBV, HIV, and alcohol use. Multinomial logistic regression was conducted to determine statistically significant correlates with each typology. The overall prevalence of GBV was 31.7%, whereas the overall prevalence of alcohol use in the past 12 months was 31.2%. HIV-Positive youth comprised 10.5% of the total sample. Females comprised the majority of the typology with no SAVA components compared to males (55% vs. 45%, respectively), as well as the SAVA syndemic typology (GBV + HIV + ALC +) (58% vs. 42%, respectively). Engaging in commercial sex work (36%), witnessing parental abuse (61%), and depression/suicidality (81%) were all highly prevalent among youth in the SAVA syndemic typology (GBV, HIV, and alcohol use). Sex work and observing parental abuse were associated with the SAVA syndemic typology in the multivariable model. In our study, alcohol rarely coexisted without GBV among the typologies. Therefore, prevention efforts including structural interventions may be particularly warranted in vulnerable populations to address alcohol use, which may directly or indirectly impact GBV and HIV.

PMID:33988783 | DOI:10.1007/s10461-021-03301-0

J Community Health. 2021 May 14. doi: 10.1007/s10900-021-00994-1. Online ahead of print.

ABSTRACT

The COVID-19 pandemic brought forward the challenge of dispersing accurate medical information to the public rapidly. Credible and non-credible sources may impact public reactions to the virus. The purpose of this study is to assess those reactions of women located in or near Kansas. A survey was conducted in July 2020 with questions on knowledge of COVID-19, attitudes and behaviors towards COVID-19, and primary sources of information. 305 survey respondents met criteria for further analysis, and descriptive statistical analyses were applied. Participants were generally knowledgeable of the pandemic, with a mean knowledge score of 11.40 out of 13 (SD 1.3). The attitude statement with the highest rate of agreement was that “social distancing is an effective way of controlling COVID-19 spread” (n = 265, 86.9%) and that with the highest rate of disagreement was, “I am not worried about my friends’ and family members health” (n = 253, 83.0%). The most-implemented behaviors as indicated by participants were avoiding contact with sick individuals and washing hands with soap and water often (n = 294, 96.4%), and the least implemented was avoiding meat consumption (n = 257, 84.3%). Finally, most participants indicated that health officials were their primary source of information (n = 215, 70.5%). Participants of this survey had fairly good knowledge of the virus. Attitudes of participants as a whole may be described as cautious without being overly fearful. Reported behaviors also align well with current public health recommendations. These responses may be reflective of where participants are receiving their information, which, for the majority, is from public health officials.

PMID:33988776 | DOI:10.1007/s10900-021-00994-1

Environ Monit Assess. 2021 May 14;193(6):339. doi: 10.1007/s10661-021-09114-x.

ABSTRACT

About one-half of the homes on First Nations (FN) reserves in Manitoba, Canada, receive piped water from a water treatment plant (WTP). Many other homes (31%) are equipped with cisterns that are filled by a water truck, and our objective was to determine how the use of cisterns affects drinking water safety relative to drinking water piped directly to homes from the WTP. The study included belowground concrete cisterns, belowground fiberglass cisterns, and aboveground polyethylene cisterns stored in insulated shelters, and all the data collection methods showed that the tap water in homes with cisterns were relatively more contaminated with coliform bacteria than the tap water in piped homes. The frequency and severity of Escherichia coli and total coliform contamination were numerically greater in drinking water samples from belowground concrete and fiberglass cisterns than in piped water samples in each community, and the contamination of belowground cisterns by coliform bacteria was greatest in late spring. As well, data obtained under the Access to Information Act showed no statistical differences in the percent of satisfactory samples (no detects) between 2014 and 2018, suggesting no clear indication of improved water quality in any of the Tribal Councils in which these three and other communities are a member off. Our results point to the need for additional treatment of drinking water in homes supplied by belowground concrete or fiberglass cisterns and replacement of belowground cisterns with aboveground cisterns or piped water to reduce the risk of water-borne illnesses.

PMID:33988761 | DOI:10.1007/s10661-021-09114-x

Environ Monit Assess. 2021 May 14;193(Suppl 1):272. doi: 10.1007/s10661-020-08811-3.

ABSTRACT

Regime shifts of major salinity constituents (Ca, Mg, Na, K, SO₄, Cl, HCO₃, and NO₃) in the lower Salinas River, an agricultural ecosystem, can have major impacts on ecosystem services central to continued agricultural production in the region. Regime shifts are large, persistent, and often abrupt changes in the structure and dynamics of social-ecological systems that occur when there is a reorganization of the dominant feedbacks in the system. Monitoring information on changes in the system state, controlling variables, and feedbacks is a crucial contributor to applying sustainability and ecosystem resilience at an operational level. To better understand the factors driving salinization of the lower Salinas River on the central coast of California, we examined a 27-year record of concentrations of major salinity constituents in the river. Although limited in providing an understanding of solute flux behavior during storm events, long-term “grab sampling” datasets with accompanying stream discharges can be used to estimate the actual history of concentrations and fluxes. We developed new concentration-discharge relationships to evaluate the dynamics of chemical weathering, hydrological processes, and agricultural practices in the watershed. Examinations of long-term records of surface water and groundwater salinity are required to provide both understanding and perspective towards managing salinity in arid and semi-arid regions while also enabling determination of the influence of external climatic variability and internal drivers in the system. We found that rock weathering is the main source of Ca, Mg, Na, HCO₃, and SO₄ in the river that further enables ion exchange between Ca, Mg, and Na. River concentrations of K, NO₃, and Cl were associated with human activities while agricultural practices were the major source of K and NO₃. A more direct anthropogenic positive trend in NO₃ that has persisted since the mid-1990s is associated with the lag or memory effects of field cropping and use of flood irrigation. Event to inter-year scale patterns in the lower Salinas River salinity are further controlled by antecedent hydrologic conditions. This study underscores the importance of obtaining long-term monitoring records towards understanding watershed changes-of-state and time constants on the range of driving processes.

PMID:33988750 | DOI:10.1007/s10661-020-08811-3

Emerg Radiol. 2021 May 14. doi: 10.1007/s10140-021-01940-3. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: The supradental space is a small, predominantly fat-filled recess superior to the atlanto-axial joint and inferior to the basion of the clivus that contains a small venous plexus. The posterior boundary of the supradental space is formed by the tectorial membrane, a stabilizing ligament of the craniocervical junction. The purpose of our study was to examine the imaging appearance of the supradental space in patients with tectorial membrane injury.

MATERIALS AND METHODS: Adult patients with tectorial membrane injury were identified utilizing keyword searches of radiology reports using Nuance mPower software. Age-matched positive and negative control groups were obtained. Two CAQ-certified neuroradiologists evaluated the cervical CT exams of these patients for supradental fat pad effacement from hematoma formation. The integrity of the osteoligamentous structures of the craniocervical junction was recorded on CT and MRI exams along with demographic information, clinical history, surgical management, and global outcome. Statistical analysis was performed.

RESULTS: Sixteen adults were diagnosed with tectorial membrane injury on cervical MRI. All patients with a visible supradental space demonstrated fat pad effacement and Hounsfield units consistent with hematoma formation. The positive and negative control groups demonstrated supradental fat pad effacement in 2/16 and 1/16 patients, respectively. A p-value of < 0.001 was obtained.

CONCLUSION: The “supradental space sign,” defined as hematoma formation in the supradental space with effacement of the supradental fat pad is associated with tectorial membrane injury in adult trauma patients with sensitivity of 93.75% (95% confidence interval 69.77 to 99.84%) and specificity of 90.62% (95% confidence interval 74.98 to 98.02%).

PMID:33988749 | DOI:10.1007/s10140-021-01940-3

JAMA Netw Open. 2021 May 3;4(5):e219627. doi: 10.1001/jamanetworkopen.2021.9627.

ABSTRACT

IMPORTANCE: Flotation restricted environmental stimulation therapy (REST) is an emerging therapeutic intervention that, to our knowledge, has never been directly compared with an indistinguishable placebo in patients with chronic pain.

OBJECTIVE: To determine whether 5 flotation-REST sessions alleviate chronic pain.

DESIGN, SETTING, AND PARTICIPANTS: This single-blind, randomized clinical trial compared flotation-REST as an intervention for the treatment of chronic pain with indistinguishable placebo and wait-list control conditions at Hannover Medical School, Hannover, Germany. Men and women aged 18 to 75 years who had been diagnosed with chronic pain disorder with psychological and somatic factors (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification, code F45.41) by physicians at the study center were randomly assigned to 1 of the 3 groups. Data were collected from June 26, 2018, to June 18, 2020.

INTERVENTIONS: Patients in the intervention and placebo groups underwent 5 treatment sessions lasting 60 to 90 minutes, each session separated by 4 days. The placebo treatment was delivered in the same floating tank but controlled for effortless floating and environmental stimulus restriction. Patients in the wait-list control group did not receive any additional treatment but were asked to continue any ongoing treatments at the time of enrollment.

MAIN OUTCOMES AND MEASURES: The primary outcome was a change in pain intensity 1 week after the last treatment session. The assessment was repeated at 12 and 24 weeks. Secondary outcomes included pain-related disability, pain area, pain widespreadness (number of body regions affected by pain), anxiety, depression, and quality of life, as well as several other short-term outcomes.

RESULTS: A total of 99 patients (mean [SD] age, 51.7 [12.3] years; 80 women [81%]) were included in the study. No differences were found among the groups in the primary outcomes (mean [SD] change in maximum pain: -7.6 [19.7] for the intervention group, -5.8 [12.7] for the placebo group, and 0.4 [14.0] for the wait-list control group; mean [SD] change in mean pain: -2.1 [19.4] for the intervention group,-4.2 [16.2] for the placebo group, and 2.0 [12.6] for the wait-list control group). Long-term secondary outcomes did not show significant differences. In the short term, patients in the intervention group showed significant improvements in pain intensity (-17.0 [17.1]; P < .001), relaxation (23.9 [22.6]; P < .001), anxiety (-10.1 [8.4]; P < .001), pain area (-3.6% [7.4%]; P < .001), and widespreadness (-2.0 [3.0]; P < .001), and similar changes where observed in the placebo group.

CONCLUSIONS AND RELEVANCE: Patients with chronic pain experienced no long-term benefits from the 5 flotation-REST interventions. Clinically relevant short-term changes in pain in the placebo group suggest that improvements may not be caused by environmental stimulus restriction or effortless floating as previously thought.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03584750.

PMID:33988708 | DOI:10.1001/jamanetworkopen.2021.9627