Tag: nevin manimala

Eur Spine J. 2022 Oct 30. doi: 10.1007/s00586-022-07417-2. Online ahead of print.

ABSTRACT

PURPOSE: Paediatric intervertebral disc calcification (PIDC) is a rare disease, and its aetiology remains unknown. This study aimed to analyse the characteristics and clinical outcomes of patients with PIDC.

METHODS: After applying the exclusion and inclusion criteria, 159 children diagnosed with PIDC were analysed at our hospital between January 2010 and November 2020. Patients’ demographic and clinical data were collected, such as sex, pain, duration time, physical examination, white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and radiography, computed tomography, and magnetic resonance imaging findings. Patients were followed up for at least 6 months, and radiography or symptoms were evaluated. Fisher’s exact test or χ²-test was used for statistical analyses.

RESULTS: One hundred and fifty-nine patients were ultimately followed up with for about 12.5 ± 5.8 months. There were 103 male and 56 female, with an average age of 6.08 ± 2.62 years (2 months to 12 years). A total of 109 patients had only one PIDC, 29 patients had two PIDCs, and 21 patients had multiple PIDCs. Thirty patients were found incidentally and were asymptomatic. A total of 106 patients had neck torticollis. Sixteen patients had IDC herniations, fifteen patients had posterior longitudinal ligament calcification, two patients had anterior longitudinal ligament calcification, and 17 patients had herniation of the vertebral canal. All patients underwent conservative treatment, and none underwent surgery. All patients’ symptoms resolved after either collar fixation or neck traction.

CONCLUSION: PIDC can be treated conservatively, even when accompanied by herniation, longitudinal ligament calcification, or clinical neck symptoms.

LEVEL OF EVIDENCE: IV.

PMID:36309875 | DOI:10.1007/s00586-022-07417-2

Isr Med Assoc J. 2022 Oct;24(10):661-665.

ABSTRACT

BACKGROUND: Gestational hypertensive (GH) disorders remain a major obstetric problem.

OBJECTIVES: To evaluate the incidence of gestational hypertensive disorders among participants undergoing intrauterine insemination (IUI) after exposure to various levels of sperm from sperm donation (SD).

METHODS: A retrospective case-control study was conducted at a single tertiary medical center between 2011 and 2019. Participants conceived via IUI using SD from a single sperm bank and had a successful singleton birth. Group 1 conceived during 1-2 cycles of IUI from the same sperm donor; whereas Group 2 after 3+ cycles.

RESULTS: Overall 171 patients (Group 1 = 81, Group 2 = 90) met inclusion criteria. Participants showed no differences in age, chronic medical conditions, or history of pregnancy complications. The groups differed in gravidity and parity. The factors positively associated with Group 1 included either preeclampsia or GH (11 [13.5%] vs. 1 [1.1%], P = 0.001) and GH alone (8 [9.9%] vs. 1 [1.1%], P = 0.014). Newborns from Group 1 had a statistically significant lower birth weight than those from Group 2 (3003 grams ± 564.21 vs. 3173 grams ± 502.59, P = 0.039). GH was more prevalent in Group 1 (P = 0.008) than a control group of 45,278 participants who conceived spontaneously. No significant differences were observed between Group 2 and the control group.

CONCLUSIONS: The incidence of GH and preeclampsia in participants was higher among those exposed to 1-2 cycles than those exposed to 3+ cycles of IUI.

PMID:36309862

Isr Med Assoc J. 2022 Oct;24(10):654-660.

ABSTRACT

BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare aggressive non-Hodgkin’s lymphoma. There are limited data on the management of PCNSL outside of clinical trials.

OBJECTIVES: To report experience with three main high-dose methotrexate (HDMTX)-based protocols for PCNSL treatment at one medical center.

METHODS: We conducted a retrospective review of the medical records of patients diagnosed with PCNSL who were treated at Soroka Medical Center between 2007 and 2019.

RESULTS: The study included 36 patients, median age 64.9 years; 33 patients received a HDMTX backbone induction therapy, 21 (58.3%) received consolidation treatment in addition. In the entire cohort, 25 patients (75.7%) achieved complete remission (CR, CRu-unconfirmed), with mean progression-free survival (PFS) 32 ± 6.9 months and median overall survival (OS) 59.6 ± 12.4 months. More aggressive regiment such as combination of rituximab, HDMTX, cytarabine and thiotepa had better responses 5 (100%) CR, but also a higher incidence of side effects such as neutropenic fever 5 (100%). In subgroup analysis by age (younger vs. older than 60 years), the PFS was 24.2 vs. 9.3 months, and OS was 64.1 vs. 19.4 months, respectively.

CONCLUSIONS: A difference in CR and PFS favored a more aggressive protocol, but the toxicity of the multiagent combinations was significantly higher. The prognosis in younger was better than in older patients, with higher rates of CR, PFS, and OS, although not statistically significant. Overall treatment outcomes are encouraging; however, there is a real need for an adaptive approach for older patients and balancing among the effectiveness and side effects.

PMID:36309861

Isr Med Assoc J. 2022 Oct;24(10):649-653.

ABSTRACT

BACKGROUND: Contact dermatitis is an inflammatory skin disorder characterized by an erythematous pruritic rash. The disorder can be either irritant or allergic. Allergic contact dermatitis is diagnosed by patch testing along with patient history.

OBJECTIVES: To review the results of patch tests conducted thought 2 years and to present real-life data characterizing clinical features and comparing prevalent local allergens to the ones common worldwide.

METHODS: The retrospective cohort included 517 participants (384 females and 133 males) who underwent patch testing during a 2-year period. For each patient, clinical and demographic data were collected, and statistical analysis was conducted.

RESULTS: We found that 261 patients had a positive test for at least one allergen. More females tested positive than males (52.9% vs. 43.6%). Test indications other than dermatitis were associated with a negative result. Hands, head, and neck were the most prevalent body parts affected. Patients with a background of atopic dermatitis had a higher rate of contact sensitization (69 vs. 43). Patients with a specific suspected offending allergen had significantly higher contact sensitizations. The most common allergen was nickel.

CONCLUSIONS: Patch testing should be conducted in patients with relevant dermatological findings accompanied by taking a thorough medical history. Clinicians should be updated on emerging allergens and exposure trends.

PMID:36309860

Cancer. 2022 Oct 30. doi: 10.1002/cncr.34503. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer remains a leading cause of morbidity and mortality among women in the United States. Previous analyses show that breast cancer incidence increased from 1999 to 2018. The purpose of this article is to examine trends in breast cancer mortality.

METHODS: Analysis of 1999 to 2020 mortality data from the Centers for Disease Control and Prevention, National Center for Health Statistics, among women by race/ethnicity, age, and US Census region.

RESULTS: It was found that overall breast cancer mortality is decreasing but varies by race/ethnicity, age group, and US Census region. The largest decrease in mortality was observed among non-Hispanic White women, women aged 45 to 64 years of age, and women living in the Northeast; whereas the smallest decrease in mortality was observed among non-Hispanic Asian or Pacific Islander women, women aged 65 years or older, and women living in the South.

CONCLUSION: This report provides national estimates of breast cancer mortality from 1999 to 2020 by race/ethnicity, age group, and US Census region. The decline in breast cancer mortality varies by demographic group. Disparities in breast cancer mortality have remained consistent over the past two decades. Using high-quality cancer surveillance data to estimate trends in breast cancer mortality may help health care professionals and public health prevention programs tailor screening and diagnostic interventions to address these disparities.

PMID:36309838 | DOI:10.1002/cncr.34503

Diabetes Metab Res Rev. 2022 Oct 30:e3588. doi: 10.1002/dmrr.3588. Online ahead of print.

ABSTRACT

BACKGROUND: It remained unknown about the status of and trends in racial/ethnic subgroup reporting in the diabetes trials over the past two decades.

OBJECTIVES: In this survey, we aimed to evaluate the current state of and temporal trends in subgroup reporting by race/ethnicity regarding the effects of interventions in diabetes randomized controlled trials (RCTs) from year 2000 to 2020, and to explore the potential trial factors in relation to racial/ethnic subgroup reporting.

METHODS: We searched electronic databases for eligible diabetes RCTs. The outcome was whether the trials had the event of racial/ethnic subgroup reporting regarding the intervention effects on trial primary outcomes. Poisson regression was used to assess the temporal trends in racial/ethnic subgroup reporting, and univariable logistic regression models were employed for evaluating trial factors related to racial/ethnic subgroup reporting.

RESULTS: A total of 405 diabetes RCTs were eligible for inclusion. There were 26 (6.42%) trials with racial/ethnic subgroup reporting. A chronological trend towards increased rates of racial/ethnic subgroup reporting was observed; however the trend was not statistically significant (p = 0.07). Advanced patients’ age (Odds ratio [OR] = 2.92, 95% confidence interval [CI]: 1.24 – 6.88), follow-up duration (OR = 3.53, 95% CI:1.13 – 11.00) and BIPOC (Black, Indigenous, and People of Color) enrollment (OR = 2.39, 95% CI: 1.01 – 5.62) were found to positively relate with racial/ethnic subgroup reporting, while the industrial funding was associated with decreased reporting (OR = 0.43, 95% CI: 0.19 – 0.97). Less than one fourth of the trials with racial/ethnic subgroup reporting predefined the subgroup analysis.

CONCLUSIONS: The majority of diabetes RCTs did not report intervention effects by racial/ethnic subgroup, which was not temporally improved over the past two decades. More efforts and strategies are needed to improve the racial/ethnic subgroup consideration and reporting in diabetes trials. This article is protected by copyright. All rights reserved.

PMID:36309818 | DOI:10.1002/dmrr.3588

Occup Ther Health Care. 2022 Oct 29:1-18. doi: 10.1080/07380577.2022.2138675. Online ahead of print.

ABSTRACT

The purpose of this quasi-experimental pretest-posttest control group study was to examine the effect of group synchronous action observation/mental practice intervention compared to usual rehabilitation care on upper extremity motor recovery after stroke. The intervention group (n = 25) received usual care, consisting of a minimum of 3 hours of rehabilitation services per day, 5 days a week, plus group synchronous action observation/mental practice sessions 3 times per week and the control group (n = 26) received usual care. Outcome measures included the Kinesthetic and Visual Imagery Questionnaire Short Version (KVIQ-10), the Fugl-Meyer Assessment (FMA-UE) of affected upper extremity motor function only and The Box and Block Test (BBT). Although there were no statistically significant differences in upper extremity motor function between the two groups, a subgroup analysis of the intervention group identified statistically significant (FMA-UE: p < .001; BBT: p = .04) and Minimally Important Clinical Differences on upper extremity motor recovery between patients with behaviors demonstrating more versus less commitment to the intervention. Group synchronous action observation/mental practice is a promising intervention for patients demonstrating commitment to actively participating in the intervention to improve outcomes on upper extremity motor recovery after stroke.

PMID:36309807 | DOI:10.1080/07380577.2022.2138675

Pediatr Dent. 2022 Sep 15;44(5):363-367.

ABSTRACT

Purpose: The purpose of this study was to evaluate the surface roughness of three different brands of prefabricated pediatric zirconia crowns (ZRCs) following simulated toothbrushing with a variety of dentifrices. Methods: Ninety-six total maxillary right central incisor prefabricated pediatric ZRCs (n equals 32 ZRCs/brand) were obtained from the manufacturers: Kinder Krowns^®, NuSmile^®, and Sprig^®. ZRCs were equally assigned to dentifrices (n equals eight/dentifrice) with a variety of Relative Dentin Abrasion (RDA) values: Tom’s of Maine Children’s; Crest Kid’s; Prevident 5000; and Crest^® Pro-Health. ZRCs were brushed 10,000 strokes with a V-8 Toothbrushing Machine using the assigned dentifrices. Pre- and post-intervention data for the surface roughness of ZRCs, represented in Ra (average roughness) and Rz (mean roughness depth), were obtained using a stylus profilometer. Data were analyzed independently using two-way repeated measures analysis of variance with the Holm- Sidak method (α equals 0.05). Results: Baseline versus brushed Ra Kinder Krowns^® with Prevident and Sprig^® with Crest Kid’s indicated statistically significant differences. Sprig^® versus NuSmile^® utilizing Crest Kid’s were different in change in roughness. Both baseline and brushed NuSmile^® dentifrice options were different versus all Sprig^® and Kinder^® ZRCs. Conclusions: Despite statistical significance, changes in surface roughness were small in scale. Although this study did not address toothbrushing and different dentifrices may affect the mechanical properties, durability, and/or retention properties of ZRCs, the study’s results provide confidence to clinicians when using prefabricated pediatric ZRCs as a sustainable treatment option along with other restorative options, such as strip crowns and stainless steel crowns.

PMID:36309785

Pediatr Dent. 2022 Sep 15;44(5):340-344.

ABSTRACT

Purpose: The purpose of this retrospective cross-sectional study was to examine protective stabilization (PS) patterns before and after the availability of weighted blankets (WBs) as a behavioral guidance approach during in-office dental moderate sedation. Methods: A retrospective chart review evaluated pediatric patient sedation records after six-pound lead-free WBs were introduced into the dental clinic and compared clinical outcomes to a time before WBs were available. Multivariable logistic regression analyses assessed variables associated with the occurrence of PS use during a sedation visit. Results: PS (PS) usage decreased from 78.7 percent before to 32.8 percent after the availability of WBs during sedation visits (chi-square, P<0.001). Increase in age (adjusted odds ratio [OR] equals 0.69, 95 percent confidence interval [95% CI] equals 0.53 to 0.90, P=0.006) and WB use reduced PS management (adjusted OR equals 0.067, 95% CI equals 0.020 to 0.22, P<0.001). Body mass index, gender, treatment amount, and sedation regimen did not predict the occurrence of PS. The number of completed teeth treated was not found to be statistically different between cases managed with PS versus those managed without restraint. Children managed with PS but without WBs had statistically higher heart rate changes (20.26±23.17) during treatment than children managed without restraint (8.12±15.15). Conclusions: An increase in age and weighted blanket use was associated with a reduction in the occurrence of protective stabilization during moderate sedation dental visits at the university pediatric dental clinic. Clinical practice sedation protocols should consider weighted blanket use as an alternative to PS.

PMID:36309778

Rev Diabet Stud. 2022 Sep 28;18(3):140-145. doi: 10.1900/RDS.2022.18.140.

ABSTRACT

OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is recognized as a common cause of chronic liver disease worldwide. Its association with type 2 diabetes mellitus (T2DM) is known to increase the risk of degenerative complications of diabetes and the likelihood of developing severe hepatic injuries. The objective of this study was to assess the prevalence of NAFLD and to describe the characteristics of its association with T2DM. METHODS: This was a descriptive analytical study, involving patients with T2DM with no history of alcohol consumption, viral hepatitis, hepatotoxic medications, or other chronic liver diseases. The patients underwent an investigation of NAFLD including abdominal ultrasound, non-invasive biomarkers of liver fibrosis, elastography and ultrasound-guided liver biopsy. RESULTS: We collected data from 180 patients with a mean age of 59.3 ± 10.9 years with strong female predominance. The mean duration of diabetes progression was 9.2 ± 7.3 years. Hepatic sonography showed signs of NAFLD in 45.6% of cases. Non-invasive hepatic biomarkers indicated significant fibrosis in 18.3% of cases. Overall, 21% of patients underwent an elastography evaluation, revealing severe fibrosis or cirrhosis in 15.4% of patients. The diagnosis of NASH (Non-alcoholic steatohepatitis) was confirmed histologically in 3 patients. The overall prevalence of NAFLD was 45.6%. Patients with NAFLD had a statistically significant incidence of obesity, metabolic syndrome, hypertension, dyslipidemia, macrovascular complications, and hypertriglyceridemia (p < 0.05). CONCLUSIONS: The combination of NAFLD and T2DM is often found in patients with obesity or metabolic syndrome. The presence of NAFLD can be responsible for increased morbidity and important cardiovascular risks in patients with T2DM.

PMID:36309775 | DOI:10.1900/RDS.2022.18.140