Tag: nevin manimala

Ann Anat. 2023 Jun 9:152117. doi: 10.1016/j.aanat.2023.152117. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence regarding the etiology or effective treatments for chronic orofacial pain, the majority diagnosed as temporomandibular disorder (TMD), is limited.

PURPOSE: To investigate whether occlusal equilibration therapy (ET) and decreasing the (higher) angle of the lateral guidance on the nonworking-side leads to a reduction in chronic TMDs intensity.

METHODS: We conducted a randomized, explanatory, single blind with blinded assessment, placebo-controlled trial with strong protection against bias involving patients with chronic TMDs. Patients were randomly assigned to receive equilibration therapy or sham therapy. ET in this study consisted in minimal invasive occlusal remodeling to obtain balanced occlusion with reduction of the steeper angle of lateral mandibular movement with respect to the Frankfort plane. The primary outcome was the change in pain intensity score (on a 0 – 10 point scale, with 0 indicating no pain and 10 the worst possible pain) at month 6. Secondary outcomes include maximum unassisted mouth opening and psychological distress.

RESULTS: A total of 77 participants underwent randomization, 39 of whom received ET and 38 sham therapy. The trial was stopped early for efficacy, according to preestablished rules when 67 participants (n=34, n=33, respectively) had completed the analysis. At month 6, the mean unadjusted pain intensity score was 2.1 in the ET and 3.6 in the sham therapy group (adjusted mean difference, -1.54; 95% confidence interval [CI] -.5 to -2.6; P=0.004; ANCOVA model). The mean increase in maximum unassisted mouth opening (main secondary outcome) was significantly higher in the real therapy group (adjusted mean difference 3.1mm, 95% CI 0.5 to 5.7, p=0.02).

CONCLUSION: ET significantly reduced the intensity of facial pain associated with chronic TMDs and increased maximum unassisted mouth opening, as compared with sham therapy, over the course of 6 months. There were no serious adverse events. (Funded by the Instituto de Salud Carlos III from the Ministry of Science and Innovation of the Government of Spain and European Regional Development Fund, Grant nº PI11/02507; “una manera de hacer Europa”.

DATA AVAILABILITY: Data citation 1. Urbano Santana, José López-Cedrún, Urbano Santana-Mora, Maria Jesús Mora, Fernanda Lorenzo-Franco, Nicolás Carral-Roura, et al. Composite pictures from the two study groups of the MAP Trial. Figshare 2020. https://doi.org/10.6084/m9.figshare.13107953.v1 Data citation 2. Urbano Santana-Penin et al. Dryad Digital Repository 2022. MAP Trial raw data. https://doi.org/10.5061/dryad.zkh189370.

PMID:37302432 | DOI:10.1016/j.aanat.2023.152117

Mar Pollut Bull. 2023 Jun 9;193:115152. doi: 10.1016/j.marpolbul.2023.115152. Online ahead of print.

NO ABSTRACT

PMID:37302205 | DOI:10.1016/j.marpolbul.2023.115152

J Anxiety Disord. 2023 Jun 1;97:102732. doi: 10.1016/j.janxdis.2023.102732. Online ahead of print.

ABSTRACT

Sleep disturbance is highly debilitating, and an abundance of research suggests that repetitive negative thinking (i.e., rumination, worry) may contribute to the development and maintenance of maladaptive sleep patterns, such as insomnia symptoms. Although repetitive negative thinking is often conceptualized as a ‘trait’ risk factor for anxiety-related disorders, it is unclear if it consists of time-varying (TV) or state-like features versus time-invariant (TI) or trait-like characteristics. Furthermore, it is unclear if it is the TV or TI components of repetitive negative thinking that contribute to insomnia symptoms that is commonly observed in anxiety-related disorders. In a 6-wave, 5-month longitudinal study, community participants (N = 1219) completed measures of rumination, worry, transdiagnostic repetitive negative thinking, and insomnia symptoms. A latent variable (trait-state-occasion) model was applied to the measures of repetitive negative thinking. The results showed that although estimates of TI factor variance and TV factor variance were both significant for latent repetitive negative thinking, worry, and rumination, the proportion of TI factor variance (0.82-0.89) was greater than the amount of TV factor variance (0.11-0.19). Although TV factor stability was statistically significant for latent repetitive negative thinking, rumination, and worry, the magnitude of the coefficients was small. Furthermore, regression weights for the latent repetitive negative thinking, rumination, and worry TI factor were significant and larger than those for the TV factor in predicting insomnia symptoms at each of the six time points. These findings suggest that repetitive negative thinking is largely TI, and it is this TI component that contributes to insomnia symptoms. Implications for conceptualizations of repetitive negative thinking as a predisposing and perpetuating factor in insomnia for anxiety and related disorders are discussed.

PMID:37302163 | DOI:10.1016/j.janxdis.2023.102732

Respir Med Res. 2023 Mar 24;84:101013. doi: 10.1016/j.resmer.2023.101013. Online ahead of print.

ABSTRACT

BACKGROUND: GAP (gender-age-physiology) and TORVAN are multi-parametric prognostication scores for idiopathic pulmonary fibrosis (IPF). We compared their prognostic value in patients treated with nintedanib or pirfenidone and explored their effect on patient survival in relation to disease staging.

STUDY DESIGN AND PATIENTS: Retrospective evaluation of 235 naïve IPF patients (M = 179; mean age 69.8 yrs±7.1; 102 treated with nintedanib and 133 with pirfenidone), referred to two Italian academic centers between February 2012 and December 2019.

RESULTS: During a median follow-up of 4.2 years, the incidence rate of death was 14.5 per 100 person-years (95% CI: 12 to 17.4), with no differences between nintedanib and pirfenidone (log-rank p = 0.771). According to time-ROC analysis, GAP and TORVAN showed a similar discrimination performance at 1, 2, and 5 years. Survival of GAP-2/GAP-3 IPF patients treated with nintedanib was worse than that of patients in GAP-1 (HR 4.8, 95% CI: 2.2 to 10.5 and HR 9.4, 95% CI: 3.8 to 23.2). TORVAN I patients treated with nintedanib exhibited better survival than those in stages III (HR 3.1, 95% CI: 1.4 to 6.6) and IV (HR 10.5, 95% CI: 3.5 to 31.6). A significant treatment x stage interaction was observed for both disease staging indexes (p = 0.042 for treatment by GAP interaction and p = 0.046 for treatment by TORVAN interaction). A better survival was associated with nintedanib in patients with mild disease (GAP-1 or TORVAN I stage) and with pirfenidone in GAP-3 or TORVAN IV cases, although these findings did not always reach statistical significance.

CONCLUSIONS: GAP and TORVAN similarly perform in IPF patients on anti-fibrotic therapy. However, the survival of patients treated with nintedanib and pirfenidone appears to be differently affected by disease staging.

PMID:37302161 | DOI:10.1016/j.resmer.2023.101013

Sci Prog. 2023 Apr-Jun;106(2):368504231179062. doi: 10.1177/00368504231179062.

ABSTRACT

Whether true inter-individual response differences (IIRD) occur as a result of resistance training on body weight and body composition in older adults with overweight and obesity is not known. To address this gap, data from a previous meta-analysis representing 587 men and women (333 resistance training, 254 control) ≥ 60 years of age nested in 15 randomized controlled trials of resistance training ≥ 8 weeks were included. Resistance training and control group change outcome standard deviations treated as point estimates for body weight and body composition (percent body fat, fat mass, body mass index in kg^.m², and lean body mass) were used to calculate true IIRD from each study. True IIRD as well as traditional pairwise comparisons were pooled using the inverse-variance (IVhet) model. Both 95% confidence intervals (CI) and prediction intervals (PI) were calculated. While statistically significant improvements were found for body weight and all body composition outcomes (p < 0.05 for all), no statistically significant IIRD was observed for any of the outcomes (p > 0.05 for all) and all 95% PIs overlapped. Conclusions: While resistance training is associated with improvements in body weight and body composition in older adults, the lack of true IIRD suggests that factors other than training response variation (random variation, physiological responses associated with behavioral changes that are not the result of resistance training) are responsible for the observed variation in body weight and body composition.

PMID:37302150 | DOI:10.1177/00368504231179062

Int Nurs Rev. 2023 Jun 11. doi: 10.1111/inr.12856. Online ahead of print.

ABSTRACT

AIM: This study examined the level of proactive work behavior and predictability of education level, work engagement, transformational leadership of nurse managers, and organizational support on proactive work behaviors among nurses.

BACKGROUND: Nurses face many challenges to provide quality nursing care as numbers of patients increase in particular as a result of COVID-19 and human resource shortages worldwide, this includes Myanmar. Proactive work behavior is a critical factor in providing quality nursing care.

METHODS: We collected data from 183 registered nurses in four university-affiliated general hospitals in Myanmar by using stratified random sampling. Instruments included the Utrecht Work Engagement Scale, the Global Transformational Leadership Scale, the Survey of Perceived Organizational Support, and the Proactive Work Behavior Scale. Descriptive statistics and multiple regression were used to analyze data. Findings are reported according to the STROBE checklist.

RESULTS: The overall level of proactive work behavior was perceived as moderate. Transformational leadership and work engagement were significant predictors of proactive work behaviors of nurses, explaining 33.0% of the total variance.

CONCLUSION: Findings provide that both transformational leadership and work engagement are significant predictors of proactive work behaviors which are important for improving the quality of patient care and organizational outcomes.

IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse administrators and hospital directors should encourage nurses to voice ideas for improving the standard of work, provide opportunities for generating ideas, support resources for taking charge and preventing problems whilst also supporting the promotion of nurse managers’ transformational leadership and nurses’ work engagement.

PMID:37302103 | DOI:10.1111/inr.12856

Asian Pac J Allergy Immunol. 2023 Jun 11. doi: 10.12932/AP-090223-1541. Online ahead of print.

ABSTRACT

BACKGROUND: Preclinical studies demonstrated anti-inflammatory effects of Zingiber montanum (J.König) Link ex Dietr.(Phlai). However, its clinical effect on allergic rhinitis (AR) is not evident.

OBJECTIVE: We sought to assess the efficacy and safety of Phlai for treating AR.

METHODS: A phase 3, randomized, double-blind, placebo-controlled study was conducted. Patients with AR were randomized into three groups and received Phlai 100 mg or Phlai 200 mg or placebo once a day for four weeks. The primary outcome was a change in the reflective total five symptom score (rT5SS). The secondary outcomes were the change in the instantaneous total five symptom score (iT5SS), the reflective individual symptom scores (rhinorrhea, nasal congestion, sneezing, itchy nose, itchy eyes), Rhinoconjunctivitis Quality of Life-36 Questionnaire (RCQ-36) score, peak nasal inspiratory flow (PNIF), and adverse events.

RESULTS: Two hundred and sixty-two patients were enrolled. Compared with placebo, Phlai 100 mg improved rT5SS [adjusted mean difference (aMD) -0.62; 95%CI -1.22, -0.03; p = 0.039], rhinorrhea (aMD -0.19; 95%CI -0.37, 0.002; p = 0.048), itchy nose (aMD -0.24; 95%CI -0.43, -0.05; p = 0.011), and itchy eyes (aMD -0.19; 95%CI -0.36, -0.02; p = 0.033) at week 4. Nasal obstruction, sneezing, iT5SS, overall RCQ-36 score, PNIF did not reach statistical significance. Phlai 200 mg did not bring additional benefits compared to 100 mg. Adverse events were similar among groups.

CONCLUSIONS: Phlai was safe. At four weeks, there were small improvements in rT5SS, together with the individual symptoms of rhinorrhea, itchy nose, and itchy eyes.

PMID:37302097 | DOI:10.12932/AP-090223-1541

Undersea Hyperb Med. 2023 Second Quarter;50(2):95-104.

ABSTRACT

INTRODUCTION: In this study, we aimed to examine dental barotrauma and temporomandibular joint (TMJ) complaints in a large group of divers.

METHODS: This survey study included scuba divers older than 18. The questionnaire contained 25 questions about the demographic characteristics of divers, dental health behaviors, and diving-related dental, sinus and/or temporomandibular joint pain.

RESULTS: The study group consisted of 287 instructors, recreational and commercial divers (mean age 38.96 years) (79.1% males). A total of 46% of divers reported a frequency of tooth brushing less than twice a day; 28% never receive a routine dental examination; 22.6% experienced dental pain after and/or during diving, mostly in the upper posterior teeth (40%); 17% required dental treatment; 77% of these cases are restoration fracture. TMJ symptoms after diving were statistically significantly higher in women (p=0.04). Jaw and masticatory muscle pain in the morning (p≺0.001) limitation of mouth opening (p=0.04) and joint sounds in daily life (p≺0.001) were recorded as exacerbated after diving; the results were found to be statistically significant.

CONCLUSION: In our study, the localization of barodontalgia was consistent with the distribution of caries and restored tooth areas in the literature. Dive-related TMJ pain was also more common in those with pre-dive problems such as bruxism and joint noise. Our results are important to remind us of the necessity of preventive dentistry practices and early diagnosis of problems in divers. Divers should take personal precautions, such as brushing their teeth twice a day and avoiding the need for urgent treatment. The use of a personalized mouthpiece is also recommended for divers to prevent dive-related temporomandibular joint diseases.

PMID:37302074

Technol Health Care. 2023 Jun 8. doi: 10.3233/THC-230218. Online ahead of print.

ABSTRACT

BACKGROUND: Although the success rate of resuscitation in preterm infants is increasing, the long length of hospital stay in preterm infants and the need for more invasive operations, coupled with the widespread use of empirical antibiotics, have increased the prevalence of fungal infections in preterm infants in neonatal intensive care units (NICUs) year on year.

OBJECTIVE: The present study aims to explore the risk factors of invasive fungal infections (IFI) in preterm infants and to identify some prevention strategies.

METHODS: A total of 202 preterm infants with a gestational age of 26 weeks to 36+6 weeks and a birth weight of less than 2,000 g, admitted to our neonatal unit during the 5-year period from January 2014 to December 2018, were selected for the study. Among these preterm infants, six cases that developed fungal infections during hospitalization were enrolled as the study group, and the remaining 196 infants who did not develop fungal infections during hospitalization were the control group. The gestational age, length of hospital stay, duration of antibiotic therapy, duration of invasive mechanical ventilation, indwelling duration of the central venous catheter, and duration of intravenous nutrition of the two groups were compared and analyzed.

RESULTS: There were statistically significant differences between the two groups in the gestational age, length of hospital stay, and duration of antibiotic therapy.

CONCLUSION: A small gestational age, a lengthy hospital stay, and long-term use of broad-spectrum antibiotics are the high-risk factors for fungal infections in preterm infants. Medical and nursing measures to address the high-risk factors might reduce the incidence of fungal infections and improve the prognosis in preterm infants.

PMID:37302058 | DOI:10.3233/THC-230218

J Pediatr Rehabil Med. 2023;16(2):241-273. doi: 10.3233/PRM-230019.

ABSTRACT

Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards. Although extensively acknowledged and explored in the methodological literature, most clinicians seem unaware of these issues and may automatically accept evidence syntheses (and clinical practice guidelines based on their conclusions) as trustworthy.A plethora of methods and tools are recommended for the development and evaluation of evidence syntheses. It is important to understand what these are intended to do (and cannot do) and how they can be utilized. Our objective is to distill this sprawling information into a format that is understandable and readily accessible to authors, peer reviewers, and editors. In doing so, we aim to promote appreciation and understanding of the demanding science of evidence synthesis among stakeholders. We focus on well-documented deficiencies in key components of evidence syntheses to elucidate the rationale for current standards. The constructs underlying the tools developed to assess reporting, risk of bias, and methodological quality of evidence syntheses are distinguished from those involved in determining overall certainty of a body of evidence. Another important distinction is made between those tools used by authors to develop their syntheses as opposed to those used to ultimately judge their work.Exemplar methods and research practices are described, complemented by novel pragmatic strategies to improve evidence syntheses. The latter include preferred terminology and a scheme to characterize types of research evidence. We organize best practice resources in a Concise Guide that can be widely adopted and adapted for routine implementation by authors and journals. Appropriate, informed use of these is encouraged, but we caution against their superficial application and emphasize their endorsement does not substitute for in-depth methodological training. By highlighting best practices with their rationale, we hope this guidance will inspire further evolution of methods and tools that can advance the field.

PMID:37302044 | DOI:10.3233/PRM-230019