Tag: nevin manimala

J Plast Reconstr Aesthet Surg. 2023 Jun 8;84:241-249. doi: 10.1016/j.bjps.2023.06.001. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare the condylar head displacement (CHD) after bilateral sagittal split ramus osteotomy (BSSO) between different degrees of mandibular advancement in skeletal class II patients and to evaluate whether the temporomandibular joint (TMJ) function would be affected.

PATIENTS AND METHODS: Fifty-nine patients (118 condyles) were included in this retrospective study and were divided into three groups based on the distance of mandibular advancement. The CHD in three directions, x (sagittal direction), y (coronal direction), and z (axial direction), was measured before operation (T0), immediately after operation (T1), and at least 6 months after operation (T2), and the TMJ function of patients was followed up and scored using the Helkimo index system. All the abovementioned data were statistically analyzed, and p < 0.05 was considered the statistical difference standard.

RESULT: During the BSSO surgery, the condyle was predominantly displaced in a lateral, posterior, and superior direction whenever in T1 and T2, even though the degree of CHD was different. Regarding the amount of CHD, the large advancement group was higher than the other two groups in T1 and T2 (p＜0.01). The Helkimo index scores of the three groups were evaluated, and there was no significant statistical difference between the Ai and Di index of the three groups.

CONCLUSION: In our center, CHD occurred in lateral, posterior, and superior directions following mandibular advancement in skeletal class II patients, with a positive correlation between the CHD and the mandibular advancement; however, the TMJ function of the three groups did not show significant differences.

PMID:37352620 | DOI:10.1016/j.bjps.2023.06.001

Accid Anal Prev. 2023 Jun 21;190:107147. doi: 10.1016/j.aap.2023.107147. Online ahead of print.

ABSTRACT

RESEARCH QUESTION/OBJECTIVE: In the US, child fatalities in hot cars [i.e., pediatric vehicular heatstroke (PVH)] occur on average once every 10 days. Despite national campaigns and recurring media attention, there has been little change in the rate of PVH deaths annually. The objective of this study was to characterize caregivers’ beliefs, behaviors, and attitudes related to PVH risk factors and potential mitigating technologies.

METHODS/DATA SOURCES: We conducted a national survey of US caregivers to: (1) determine caregivers’ perceptions of PVH risk for children in their care, as well as their thoughts about adopting risk mitigating technologies, (2) characterize scenarios in which caregivers intentionally leave children unattended in vehicles, and (3) assess caregiver awareness of national PVH campaigns. We used a variety of question formats (select all that apply, multiple choice, free response). Data were analyzed data using descriptive statistics and caregiver responses related to PVH event behaviors were compared across selected demographic characteristics using chi-square tests.

RESULTS: Exactly 1,500 caregivers completed the survey; 60% were female and 60% were non-Hispanic White. Most, or 88%, of our respondents reported they do not leave their child(ren) alone in vehicles for any amount of time. However, there were differences in who engages in this behavior by caregivers’ gender, education, income, and number of children. Few, or 12%, believed they were at any risk for having a child overheat in a vehicle, and most caregivers described negative and/or judgmental views of those who were at-risk. Nearly all participants indicated it was important that caregivers receive education about PVH (95%), and the majority, or 90%, responded they would be willing to adopt risk mitigating technology themselves, many believing they and others would be perceived as better caregivers if they did so.

SIGNIFICANCE OF RESULTS: This is the first nationally representative study to the authors’ knowledge that characterizes caregivers’ attitudes, behaviors, and perceived risk of PVH, along with their willingness to adopt mitigating technologies. Our dissonant finding that caregivers view those who may be at risk for PVH negatively while simultaneously viewing those who adopt risk mitigating strategies positively provides stakeholders with unique insight for future efforts. Specifically, messaging utilizing themes of positive caregiving might be more effective at increasing caregivers’ adoption than threat-based campaigns focused on communicating risk. Additionally, our findings of demographic differences in behaviors related to PVH are a helpful first step to inform the development of tailored interventions (e.g., public messaging) and potential risk mitigating technologies that may be more likely to be widely adopted.

PMID:37352613 | DOI:10.1016/j.aap.2023.107147

Blood. 2023 Jun 23:blood.2022017643. doi: 10.1182/blood.2022017643. Online ahead of print.

ABSTRACT

T-cell large granular lymphocytic leukemia (T-LGLL) is a clonal proliferation of cytotoxic T-lymphocytes that can result in severe neutropenia, anemia, and bone marrow failure. Strong evidence from patients and mouse models demonstrate the critical role of interleukin-15 in T-LGLL pathogenesis. BNZ-1 is a pegylated peptide that selectively inhibits the binding of IL-15 and other gc cytokines to their cellular receptor complex, that has demonstrated efficacy in ex vivo T-LGLL cells and transgenic mice in pre-clinical studies. We conducted a phase I/II trial of BNZ-1 in patients with T-LGLL who had hematocytopenias (anemia or neutropenia) that required therapy. Clinical responses were assessed using hematologic parameters (improvement in hematocytopenias) based off response criteria from the ECOG 5998 T-LGLL trial. BNZ-1 demonstrated clinical partial responses in 20% of patients with T-LGLL with minimal toxicity and the maximum tolerated dose (MTD) was not reached. Further, T-LGLL leukemic cells showed significantly increased apoptosis in response to BNZ-1 treatment as early as day two, including in clinically non-responding patients, with changes that remained statistically different from baseline throughout treatment (p<0.005). We report first-in-human proof that T-LGLL leukemic cells are dependent on IL-15 and that intervention with IL-15 inhibition with BNZ-1 in T-LGLL patients shows therapeutic effects, which carries important implications for the understanding of the pathogenesis of this disease. Clinical Trial # NCT03239392.

PMID:37352612 | DOI:10.1182/blood.2022017643

Biochem Biophys Res Commun. 2023 Jun 14;672:137-144. doi: 10.1016/j.bbrc.2023.06.012. Online ahead of print.

ABSTRACT

The functional connectivity patterns of the brain during resting state are closely related to an individual’s cognition, emotion, behavior, and social interactions, making it an important research method to measure personality traits in an unbiased way, replacing traditional paper-and-pencil tests. However, due to the dynamic nature of the brain, whether the changes in functional connectivity caused by age can stably map onto personality traits has not been previously investigated. This study focuses on whether network features that are significantly related to personality traits can effectively distinguish subjects with different personality traits, and whether these network features vary across different periods of adulthood. The study included 343 healthy adult participants, divided into early adulthood and middle adulthood groups according to the age threshold of 35. Resting-state functional magnetic resonance imaging (fMRI) and the Big Five personality questionnaire were collected. we investigated the relationship between personality traits and intrinsic whole-brain functional connectome. We then used support vector machine (SVM) to evaluate the performance of personality network features in distinguishing subjects with high and low scores in the early-adulthood sample, and cross-validated in the mid-adulthood sample. Additionally, edge-based analysis (NBS) was used to explore the stability of personality networks across the two age samples. Our results show that the network features corresponding to openness personality trait are stable and can effectively differentiate subjects with different scores in both age samples. Furthermore, this study found that these network features vary to some extent across different periods of adulthood. These findings provide new evidence and insights into the application of resting-state functional connectivity patterns in measuring personality traits and help us better understand the dynamic characteristics of the human brain.

PMID:37352602 | DOI:10.1016/j.bbrc.2023.06.012

Int J Pediatr Otorhinolaryngol. 2023 Jun 15;171:111636. doi: 10.1016/j.ijporl.2023.111636. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare surgical outcomes for children with peritonsillar abscess (PTA) who are taken to the operating room (OR) for incision and drainage (I&D) or quinsy tonsillectomy.

METHODS: This is a multicenter retrospective study of pediatric patients who underwent I&D of a PTA between 2012 and 2017 included in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Patient demographics, comorbidities, and 30-day postoperative events (reoperation, readmission, and complications) were assessed.

RESULTS: 777 patients were identified (mean age of 10.7 years, 54% female). 656 (84%) were admitted through the emergency department, and 395 (51%) met criteria for systemic inflammatory response syndrome or sepsis. Fifty-two (6.7%) had a quinsy tonsillectomy done at the time of incision and drainage. For quinsy tonsillectomy versus I&D alone, there was no statistically significant difference in length of stay (LOS) (1.9 v. 1.7 days, p = .523), readmission (17 v. 0, p = .265) or return to the OR (18 v. 1, p = .810). Patients younger than 5 years had a longer LOS (p < .001) while females (p = .003) and patients between 12 and 17 years of age (p = 0.021) were more likely to be readmitted. Of 725 patients treated with I&D alone, 10 (1.4%) patients required a repeat I&D and 6 (0.83%) went on to have an interval quinsy tonsillectomy.

CONCLUSIONS: Outcomes of I&D and quinsy tonsillectomy for pediatric PTA in the operating room are the same. If tonsillectomy is indicated in the case of recurrent tonsillitis or PTA, a quinsy tonsillectomy is a good option.

PMID:37352593 | DOI:10.1016/j.ijporl.2023.111636

Int J Pediatr Otorhinolaryngol. 2023 Jun 17;171:111632. doi: 10.1016/j.ijporl.2023.111632. Online ahead of print.

ABSTRACT

OBJECTIVES: Supraglottoplasty (SGP) for severe laryngomalacia (LM) in children with medical comorbidities has been associated with high risk of surgical failure and increased need of postoperative pediatric intensive care unit (PICU) intervention, but evidence for this is ambiguous. The objective was to evaluate surgical outcome and risk of need for PICU-intervention following SGP for severe LM in comorbid patients.

METHODS: Retrospective observational study of 116 patients treated with SGP for severe LM between 2000 and 2021 at a tertial referral pediatric airway surgery center Karolinska University Hospital. Medical records were reviewed and patient data regarding surgical timing, type of SGP procedure, PICU-intervention, complications, and outcomes were recorded. Patients were defined as non-comorbid vs high-risk comorbid (HRC) based on a coexisting comorbidity for risk of surgical failure and postoperative PICU-intervention. Surgical failure was defined as need of revision surgery, tracheostomy or assisted ventilation (continuous positive airway pressure and bilevel positive airway pressure). PICU intervention was defined as need of postoperative assisted ventilation or intubation. Statistical comparisons were performed with outcome of SGP on children with LM and no comorbidities.

RESULTS: 41/116 patients included had a HRC associated with an increased risk of PICU-intervention and surgical failure. 75/116 patients were defined as non-comorbid. The overall surgical success in the study population was 89.7% (104/116), 94.7% in the non HRC group vs 80.5% in the HRC-group. 5/41 HRC patients and 1/75 non-comorbid patients needed SGP revision in which 5/6 was successful. There was no significantly increased need for postoperative PICU intervention in HRC patients.

CONCLUSION: SGP for severe LM patients with high-risk comorbidities performed in a tertiary setting had an overall good result and low risk of PICU-intervention. Revision SGP was more common in HRC patients but had a good outcome. Multidisciplinary experience in perioperative care of comorbid patients may be of key importance for outcome and children with high-risk comorbidities should thus not be withheld the possible benefit of SGP without assessment at a tertiary pediatric airway center.

PMID:37352590 | DOI:10.1016/j.ijporl.2023.111632

Am J Emerg Med. 2023 Jun 7;71:74-80. doi: 10.1016/j.ajem.2023.06.002. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency department (ED) visits can be divided into urgent and non-urgent. A delay in seeking medical help, especially in urgent cases, can lead to fatal consequences, along with a higher rate of complications and morbidity. Coronavirus disease 2019 (COVID-19) pandemic spread led to restrictions and eventually quarantines. We investigated the impact of the COVID-19 spread and quarantine on ED visits rates comparing to parallel periods in preceding years (2013-2019). In addition, we compared this decrease to holidays and weekends, times in which a decrease in ED visits is seen.

METHODS: This was a descriptive retrospective study. Causes of ED referrals were divided into urgent and non-urgent, then into different subcategories including infectious, cardiac, etc. RESULTS: For the spring COVID-192020 quarantine period, a 56.3% decrease of mean ED visits per day was seen, as compared to preceding years (55.7% and 98.9% respectively). This decrease was also statistically evident when comparing the urgent and non-urgent causes separately and for all sub-categories. This pattern of decrease also showed statistical evidence of fewer ED visits during holidays for most comparisons, in which lower ED visit rates are expected. Significantly lower rates of ED visits were demonstrated during the COVID-19 quarantine period, as compared to preceding years and main holidays and weekends, a decrease that was also demonstrated for urgent life-threatening causes.

CONCLUSION: Our findings can be used to inform a wide range of stakeholders, including regional planners, historians, sociologists, and international healthcare organizations. Healthcare providers should understand the reasons for this ED visit decline pattern, attempt to address patients’ concerns, and increase awareness regarding alarming symptoms in urgent medical situations.

PMID:37352578 | DOI:10.1016/j.ajem.2023.06.002

Melanoma Res. 2023 Jun 21. doi: 10.1097/CMR.0000000000000906. Online ahead of print.

ABSTRACT

CDKN2A pathogenic variants are well known to be associated with cutaneous melanoma and noncutaneous tumors (NCTs). Herein, we investigated the temporal correlation between the first cutaneous melanoma and NCT both in CDKN2A mutation carriers (MUT) and in wild-type melanoma patients, a poorly explored issue to date. Two hundred forty-five cutaneous melanoma patients were genotyped for the CDKN2A gene and divided into 51 MUT and 189 wild-type; the remaining five variant carriers were excluded from the analyses. MUT developed a significantly higher number of cutaneous melanoma than wild-type, while 13.7% in both genotyped groups received a diagnosis of at least one malignant NCT, without statistically significant differences. The onset of the first cutaneous melanoma preceded that of the first malignant or benign NCT in both MUT and wild-type patients by an average of 4.5 and 3.02 years, respectively. Considering only malignant tumors, the diagnosis of melanoma preceded that of the first NCT on an average of 8 and 4.34 years, in MUT and wild-type patients respectively. We emphasize the relevance to adopt a global vision for the primary and secondary surveillance of patients affected by cutaneous melanoma, not only limited to high-risk for multiple primary skin cancers but also to NCT that may develop several years after the diagnosis of the first cutaneous melanoma.

PMID:37352544 | DOI:10.1097/CMR.0000000000000906

P R Health Sci J. 2023 Jun;42(2):158-163.

ABSTRACT

OBJECTIVE: To assess the contraceptive methods used by sexually active Hispanic women living in Puerto Rico.

METHODS: From October 2016 through February 2018, 518 patients completed a self-administered questionnaire. The inclusion criteria were being over the age of 21 and having visited San Juan City Hospital or University District Hospital. The results were analyzed using descriptive statistics and a 2-sample t test, where P < .05 was considered significant.

RESULTS: A total of 518 participants completed the questionnaire. Of the 518, 413 (81.0%) reported having used at least 1 form of contraception; 252 (49.4%) used OCPs, 305 (60.8%) used male condoms, 92 (33.8%) used the rhythm method, 83 (30.6%) undergone female sterilization, 98 (19.9%) used the withdrawal method, 92 (18.9%%) used an implant, 67 (13.5%) received progesterone injections, 41 (8.3%) used female condoms, 13 (4.9%) had partners who undergone male sterilization, 20 (4.1%) used the transdermal patch, 16 (3.2%) used a vaginal ring, and 26 (5.3%) used an intrauterine device.

CONCLUSION: Of the 518 women, 24.2% used LARC, representing an increase in the usage by this population; this increase is likely linked to LARC’s being easily accessible and free of charge. Public health interventions should be developed to increase knowledge about sexual health, educate about the effectiveness of different contraceptive methods and the prevention of sexually transmitted diseases, and reduce both the barriers to acquiring contraception and, thereby, the number of unintended pregnancies in this population.

PMID:37352539

P R Health Sci J. 2023 Jun;42(2):127-131.

ABSTRACT

OBJECTIVE: The visit-to-visit variability (VVV) of blood pressure (BP) has been recognized as a risk factor for cardiovascular events and chronic kidney disease (CKD). The objective of this study is to valuate the association between the VVV of BP and changes in estimated glomerular filtration rate (eGFR) in elderly CKD patients at different stages of renal function.

MATERIALS AND METHODS: For 60 months, we analyzed the medical records of 105 patients with and without diabetes and hypertension. Systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) were examined. A multivariable linear regression model was used to analyze the correlation between eGFR and the VVV of BP.

RESULTS: No differences were demonstrated between the groups in the clinical characteristics. Mean SBP and DBP were not significant between the groups, and we observed no decrease in renal function. A significant negative correlation between PP and eGFR was observed in the total CKD population with a P of .010 (95% CI: -0.20, -0.03) and a correlation coefficient of -0.11.

CONCLUSION: Our study shows no statistical significances in terms of the VVVs of BP in any of the geriatric groups, with no significant decreases in renal function. However, we observed a significant negative correlation between PP and eGFR. We demonstrated that if a VVV of BP does not occur, there is no decrease in eGFR.

PMID:37352534