Tag: nevin manimala

Am J Sports Med. 2023 Sep 22:3635465231198051. doi: 10.1177/03635465231198051. Online ahead of print.

ABSTRACT

BACKGROUND: During the early evolution of femoroacetabular impingement (FAI) treatment, undercorrection of femoral deformity was a leading cause of hip arthroscopy failures. As the pendulum has swung, overresection of femoral deformity has increased in prevalence as a cause of persistent hip pain after arthroscopy. Computed tomography (CT) scans are increasingly being used in hip arthroscopy for preoperative planning purposes and may allow for improved 3-dimensional (3D) assessment of complex femoral deformities after previous femoroplasty.

PURPOSE: To assess whether CT scans provide additional utility over standard radiographs in understanding proximal femoral morphology in patients being evaluated for revision hip arthroscopy after previous femoroplasty in the setting of FAI.

STUDY DESIGN: Cohort study (Diagnosis); Level of evidence, 3.

METHODS: Preoperative CT scans and standard radiographs were obtained in 80 patients who underwent revision hip arthroscopy for FAI. The anteroposterior and Dunn radiographic views were used to assess patients for residual proximal femoral deformity and were compared with the CT scan views using a commercially available software program. Determinations of underresection were made using alpha angle, while overresection was determined according to a previously described technique. Chi-square tests were performed to determine statistical significance between radiographic and CT classifications of overresection, underresection, and concomitant over- and underresection. A kappa value was calculated to determine the agreement between measurements on the radiographs and CT scans.

RESULTS: There were 30 patients (37.5%) for whom the CT scans revealed information about femoral morphology that was not detected on the radiographs. The kappa value of agreement was 0.28 between CT and radiographic measurements. Underresected cams were detected in 30 patients (37.5%) on CT scans versus 17 patients (21.3%) on radiographs (P = .024). Overresected cams were detected in 31 patients (38.8%) on CT scans versus 14 patients (17.5%) on radiographs (P = .0049). Concomitant areas of under- and overresection were detected in 12 patients (15.0%) on CT scans versus 3 patients (3.8%) on radiographs (P = .027).

CONCLUSION: CT scans with 3D planning software may be more sensitive than traditional radiographic views at detecting aberrant proximal femoral anatomy in the setting of failed FAI surgery. The use of 3D planning software may be considered as an adjunctive tool to better understand complex deformity in the proximal femur for the planning of revision hip arthroscopy.

PMID:37740538 | DOI:10.1177/03635465231198051

Inflamm Bowel Dis. 2023 Sep 22:izad204. doi: 10.1093/ibd/izad204. Online ahead of print.

ABSTRACT

BACKGROUND: Vascular disease and cognitive impairment have been increasingly documented in inflammatory bowel disease (IBD), and both have been individually correlated with changes in brain structure. This study aimed to determine if both macro- and microstructural brain changes are prevalent in IBD and whether alterations in brain structure mediate the relationship between vascular disease and cognitive functioning.

METHODS: Eighty-four IBD participants underwent multimodal magnetic resonance imaging. Volumetric and mean diffusivity measures of the thalamus, hippocampus, normal-appearing white matter, and white matter lesions were converted to age- and sex-adjusted z scores. Vascular comorbidity was assessed using a modified Framingham Risk Score and cognition was assessed using a battery of neuropsychological tests. Test scores were standardized using local regression-based norms. We generated summary statistics for the magnetic resonance imaging metrics and cognitive tests, and these were examined using canonical correlation analysis and linear regression modeling.

RESULTS: Greater vascular comorbidity was negatively correlated with thalamic, normal-appearing white matter, and white matter lesion volumes. Higher Framingham Risk Score were also correlated with lower processing speed, learning and memory, and verbal fluency. Increased vascular comorbidity was predictive of poorer cognitive functioning, and this effect was almost entirely mediated (94.76%) by differences in brain structure.

CONCLUSIONS: Vascular comorbidity is associated with deleterious effects on brain structure and lower cognitive functioning in IBD. These findings suggest that proper identification and treatment of vascular disease is essential to the overall management of IBD, and that certain brain areas may serve as critical targets for predicting the response to therapeutic interventions.

PMID:37740523 | DOI:10.1093/ibd/izad204

J Prim Care Community Health. 2023 Jan-Dec;14:21501319231198942. doi: 10.1177/21501319231198942.

ABSTRACT

AIM: Low- and middle-income countries represent nearly 85% of all cervical cancer cases worldwide; thereby, it is extremely important to identify methods to improve the screening process. Therefore, this study aimed to summarize the primary characteristics of studies on accessibility, coverage, patient preferences, and factors associated with patient satisfaction or acceptance of colposcopy in primary healthcare.

METHODS: A search strategy, based on MeSH, Emtree, and free terms, was run through 5 databases (PubMed, Scopus, Embase, Ovid/Medline, and Web of Science). EndNote 20.1 © and Rayyan QCRI © were used for screening. A preset datasheet was used for data extraction.

RESULTS: The systematic search retrieved 1127 references, and after removing duplicates, screening the titles and abstracts, and reviewing the full text, 7 studies were included. The interrater reliability was 77.73% (kappa statistic = 0.1842). Most studies estimated the proportion of women that sought for colposcopy after a previous screening test for human papilloma virus. One study identifies barriers to colposcopy examination in women at risk of developing cervical cancer. Three studies assessed the decentralization of colposcopy from a tertiary healthcare center to a primary care center. Pap smear was the most common first-line screening test, followed by liquid-based cytology sample and visual inspection with acetic acid.

CONCLUSION: Only a few countries have investigated the use of colposcopy in primary care. Thus, barriers and the care structure for this implementation to be successful in reducing cervical cancer incidence and mortality should be identified.

PMID:37740513 | DOI:10.1177/21501319231198942

Nutr Clin Pract. 2023 Sep 22. doi: 10.1002/ncp.11074. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of a high comorbidity burden in patients who suffered an acute myocardial infarction (AMI) is increasing with the aging population, and the nutrition status also may be a predictor of clinical outcomes for these patients. This study aimed to investigate the relationship between the comorbidity burden and the characteristics of the bioelectrical impedance vector analysis (BIVA) in patients post-AMI.

METHODS: This prospective observational cohort study was conducted with adult patients who were hospitalized with AMI. Pre-existing comorbidities were assessed by the Charlson comorbidity index (CCI) adjusted by age, and anthropometric and BIVA characteristics were evaluated after the hemodynamic stabilization. All patients were followed-up until hospital discharge, and their length of stay was observed.

RESULTS: A total of 184 patients (75% were males; mean age, 60.2 ± 12.3 years) were included. The most common comorbidities were dyslipidemia (73.9%), hypertension (62%), and type 2 diabetes (34.2%). A higher CCI (≥3) was associated with sex (P = 0.008) and age (P < 0.001). Regarding BIVA, statistically significant differences were detected between sex (P < 0.001), age (P < 0.001), and CCI (P = 0.003), with longer vectors in female, older adults, and those with CCI ≥ 3.

CONCLUSION: Finding a relationship between BIVA and CCI suggests the first identified coherent differences, potentially correlated with diseases, representing a first contribution to support this type of assessment. Therefore, with BIVA, healthcare professionals may monitor abnormalities and adopt preventive nutrition care measures on patients post-AMI to improve their clinical status.

PMID:37740504 | DOI:10.1002/ncp.11074

J Prim Care Community Health. 2023 Jan-Dec;14:21501319231199014. doi: 10.1177/21501319231199014.

ABSTRACT

BACKGROUND AND OBJECTIVE: Meta-analysis of randomized controlled trials have demonstrated the efficacy of telemedicine in blood pressure (BP) management when compared to conventional care. We initiated a hypertension telehealth clinic in our urban primary care clinic and through this study aim to evaluate the strengths and limitations of telemedicine in hypertension (HTN) control. The primary outcome of the study is to identify the proportion of patients with improved HTN. Secondary outcomes included identifying: predictors for lower BP, predictors of missing telehealth appointments, and comorbid conditions that are more likely to necessitate use of more than 1 antihypertensive medication.

METHODS AND ANALYSIS: Patients seen in the HTN telehealth clinic from May 1st, 2022 to October 31st, 2022 were identified. A retrospective chart review was done to compare the BP during in-person visit prior to first telehealth visit, telehealth visit home BP readings and last recorded in-office BP on chart at end of study period. Descriptive statistical analysis, Chi Square test, and multivariable logistic regression was used to analyze data.

RESULTS: Of the 234 appointments, 83% were conducted and 154 patients were seen. A remarkable decrease in percentage of patients with BP >140/90 was seen when comparing in-office visit BP to first telehealth visit home BP, 72% versus 45% respectively. No remarkable difference was noted in percentage of patients with BP >140/90 when comparing first telehealth visit home BP to last in-office BP recorded on chart, 45% and 41% respectively. Patients with diabetes had lower odds of missing appointments, adjusted odds ratio (aOR): 0.34 ([0.12-0.91], P = .03). Patients with partners were more likely to have lower BP at the telehealth visit, aOR:3.2 ([1.15-9.86], P = .03) while patients with obstructive sleep apnea (OSA) (aOR 0.27 ([0.08-0.77], P = .02) and CAD, aOR 0.24 ([0.06-0.8], P = .03) were less likely to have lower BP.

CONCLUSION: The study demonstrated telemedicine as a great tool to prevent overtreatment of hypertension as significant difference between in-office BP and home BP during telehealth visits was noted. We did not see a significant change in blood pressure when comparing home BP at first telehealth visit to the last in-person clinic BP at end of study period.

PMID:37740500 | DOI:10.1177/21501319231199014

Int J Phytoremediation. 2023 Sep 22:1-15. doi: 10.1080/15226514.2023.2256412. Online ahead of print.

ABSTRACT

In this study, bamboo waste (BW) was subjected to pyrolysis-assisted ZnCl₂ activation to produce mesoporous activated carbon (BW-AC), which was then evaluated for its ability to remove cationic dyes, specifically methylene blue (MB) and crystal violet (CV), from aqueous environments. The properties of BW-AC were characterized using various techniques, including potentiometric-based point of zero charge (pH_pzc), scanning electron microscopy with energy dispersive X-rays (SEM-EDX), X-ray diffraction (XRD), gas adsorption with Brunauer-Emmett-Teller (BET) analysis, infrared (IR) spectroscopy. To optimize the adsorption characteristics (BW-AC dosage, pH, and contact time) of PBW, a Box-Behnken design (BBD) was employed. The BW-AC dose of 0.05 g, solution pH of 10, and time of 8 min are identified as optimal operational conditions for achieving maximum CV (89.8%) and MB (96.3%) adsorption according to the BBD model. The dye removal kinetics for CV and MB are described by the pseudo-second-order model. The dye adsorption isotherms revealed that adsorption of CV and MB onto BW-AC follow the Freundlich model. The maximum dye adsorption capacities (q_max) of BW-AC for CV (530 mg/g) and MB (520 mg/g) are favorable, along with the thermodynamics of the adsorption process, which is characterized as endothermic and spontaneous. The adsorption mechanism of CV and MB dyes by BW-AC was attributed to multiple contributions: hydrogen bonding, electrostatic forces, π-π attraction, and pore filling. The findings of this study highlight the potential of BW-AC as an effective adsorbent in wastewater treatment applications, contributing to the overall goal of mitigating the environmental impact of cationic dyes and ensuring the quality of water resources.

PMID:37740456 | DOI:10.1080/15226514.2023.2256412

J Genet Couns. 2023 Sep 22. doi: 10.1002/jgc4.1792. Online ahead of print.

ABSTRACT

The COVID-19 outbreak in March 2020 resulted in a shift to telemedicine for cancer genetic counseling (GC). The objective of this study was to determine the effect of telehealth (TH) services on patient acceptance of recommended genetic testing, time to test completion, and follow-up test-disclosure GC appointment, as well as compliance with National Comprehensive Cancer Network (NCCN) recommendations for medical screenings when testing positive for a genetic variant. Data for this retrospective cohort study were collected at a tertiary-care academic health center using the electronic medical record and laboratory portal. Patients with traditional in-person visits (the 2019 control group) and date-matched TH visits (2020) were compared. In total, 206 new GC appointments occurred in the in-person group and 184 new appointments occurred in the TH group. The in-person group was more likely to consent to testing than the TH cohort (92.6% vs. 82.1%, p = 0.003) and had increased rates of sample submission (99.5% vs. 93.75%, p < 0.01), as well as a shorter turn-around time between their initial appointment and laboratory result reporting (34.24 vs. 20.32 days, p < 0.01). There was no increase in time from initial to follow-up GC appointments (67.87 days for control, 62.39 days for THs, p = 0.37). With >2.5 years of follow-up for all study participants, there were no statistically significant differences in pathogenic variant (PV) carrier compliance with screening recommendations. During the COVID-19 pandemic, use of TH allowed patients to access GC with no significant differences in time between initial consultation and follow-up. However, in-person visits were associated with increased patient willingness to consent to and complete genetic testing. This work offers a nuanced look at the success of TH GC during the pandemic and follow-up with screening recommendations, while offering future opportunities to address the acceptance of testing as GC is practiced in a virtual or hybrid model.

PMID:37740447 | DOI:10.1002/jgc4.1792

Med Mycol. 2023 Sep 22:myad092. doi: 10.1093/mmy/myad092. Online ahead of print.

ABSTRACT

The skin fungal infection diagnostic workflow currently includes microscopic and culture-based methods as the gold standard. Recent published data described the possible limitations of these conventional techniques documenting the possibility of reducing response time intervals. The present study reports an evaluation of the DermaGenius® (DG) multiplex kit (PathoNostics) for rapid C. albicans and dermatophytes identification directly from skin samples. The investigations involved ninety specimens which underwent DNA extraction and amplification simultaneously to microscopic and culture methods. According to current guidelines, we defined a dermatophytic skin infection as the simultaneous presence of clinical evidence of skin lesions and positive results for dermatophyte elements from microscopy and/or cultures. The collected data remarked on the advantages of the molecular assay, especially in terms of sensitivity and rapidity. A statistical evaluation analysed a comparison between conventional and innovative diagnostic methods. The sensitivity, specificity, positive and negative predictive values of DG PCR in the cutaneous dermatophytosis were respectively 94.7%, 78.8%, 88.5%, and 89.6%. Based on our experience, the molecular technique could represent a diagnostic confirmation in the case of previous antifungal treatment, little biological material available or urgent clinical conditions.

PMID:37740445 | DOI:10.1093/mmy/myad092

Eur J Cardiovasc Nurs. 2023 Sep 22:zvad097. doi: 10.1093/eurjcn/zvad097. Online ahead of print.

ABSTRACT

AIMS: The aims of this study were to evaluate: (I) the short- and long-term effects of the internet-based cognitive behavior (iCBT) program on symptoms of distress and fear disorder in CVD patients, and (II) the association between changes in depression and changes in symptoms of distress and fear disorder from baseline to 12-months follow-up.

METHODS AND RESULTS: Secondary analysis of data collected in a randomized controlled study evaluating the effects on depression of an iCBT program compared to an online discussion forum (ODF) in CVD patients (n = 144). Data were collected at baseline, at post-intervention (nine weeks), and at 6- and 12-month follow-up.The results showed that symptoms of distress disorder were statistically significantly more reduced in the iCBT group than the ODF group. For symptoms of fear disorder, no differences were found except for avoidance, which showed a statistically significant reduction in the iCBT group. The long-term analysis in the iCBT group showed that CAQ total score and fear decreased from baseline to 6- and 12-months follow-up respectively. Avoidance and attention both decreased statistically significantly from baseline to post-intervention, but not between post-intervention and 12-months follow-up.

CONCLUSION: The results suggest that the iCBT program targeted depression in CVD patients successfully reduced symptoms of distress disorder, and to a lesser extent symptoms of fear disorder. Change in depression was more strongly associated with change in distress than change in fear disorder.

REGISTRATION: clinicaltrials.gov NCT02778074.

PMID:37740442 | DOI:10.1093/eurjcn/zvad097

Am J Hum Biol. 2023 Sep 22:e23995. doi: 10.1002/ajhb.23995. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze changes in height, weight, and body mass index (BMI = kg/m² ) from 1986 to 2022 in 3-11 year old children from Dzeal, a rural Maya community in Yucatan, Mexico.

MATERIALS AND METHODS: From October-2022 to February-2023 (third-wave survey), we obtained anthropometric measurements of children (n = 80) and family socioeconomic data and compared them with data obtained in 1986 (n = 38) and 2000 (n = 76). Comparisons of anthropometric parameters by sex between years of measurement were performed graphically and through one-way ANOVA, splitting children into two age groups: 3-7 and 8-11. Bonferroni adjustments for multiple comparisons were used when ANOVAs were statistically significant (p < .05).

RESULTS: In girls, significant increases in height and weight between surveys were found in 3-7 and 8-11 age groups; in boys, significant increases were only found in the 8-11 age group. Regarding BMI, there were increases in 2022 compared with 1986/2000 in both sexes from 8 years onwards. Differences indicate increases of 3.9 and 4.4 cm per decade in girls aged 3-7 and 8-11, respectively, and increases in weight of 1.1 and 3.3 kg per decade, respectively. Increases in boys 8-11 years were 2.3 cm and 2.4 kg per decade.

CONCLUSION: Significant increases in growth parameters were observed in specific-age children in the community studied in the context of changes in livelihoods and improvements in household material conditions.

PMID:37740441 | DOI:10.1002/ajhb.23995