Tag: nevin manimala

J Cataract Refract Surg. 2022 Mar 24. doi: 10.1097/j.jcrs.0000000000000946. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to assess the efficiency of an index derived from multiple logistic regression analysis (MLRA) to measure differences in corneal tomography findings between subclinical keratoconus (SKC) in one eye, corneal ectasia, and healthy corneas.

SETTING: Two private Brazilian ophthalmological centers.

DESIGN: Multicenter, case-control study.

METHODS: This study included 187 eyes with very asymmetric ectasia and normal corneal topography and tomography (VAE-NTT) in the VAE-NTT group (G), 2,296 eyes with healthy corneas in the control group (CG), and 410 eyes with ectasia in the ectasia group. An index, termed as Boosted Ectasia Susceptibility Tomography Index (BESTi), was derived using MLRA to identify a cutoff point to distinguish patients in the three groups. The groups were divided into two subgroups with equal number of patients: validation set and external validation (EV) set.

RESULTS: BESTi had an area under the curve (AUC) of 0.91 with 86.02% sensitivity (Se) and 83.97% specificity (Sp) between CG and VAE-NTT G in the EV set, which were significantly greater than those of the Belin-Ambrósio Deviation Index (BAD-D; AUC: 0.81; Se: 66.67%; Sp: 82.67%; P < .0001) and Pentacam Random Forest Index (PRFI; AUC: 0.87; Se: 78.49%; Sp: 79.88%; P = .021).

CONCLUSIONS: BESTi facilitated early detection of ectasia in SKC. BESTi demonstrated higher Se and Sp than PRFI and BAD-D for detecting SKC.

PMID:35333829 | DOI:10.1097/j.jcrs.0000000000000946

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13566-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic ankle instability (CAI), which is characterized by deficient postural control, is associated with functional limitations and diminished self-reported quality of life. Recent studies have suggested that balance training can improve postural control, but high-quality evidence-based research to confirm the effect of balance training on dynamic postural stability in CAI patients is lacking.The purpose of this study was to synthesize current evidence regarding the effect of balance training on dynamic postural stability in Chronic ankle instability (CAI) patients.

EVIDENCE ACQUISITION: PubMed, Embase, Web of Science and Cochrane Library databases were searched for clinical trials that evaluated the effect of balance training on posture and balance in CAI patients from their inception to 15 July 2021. All statistical analyses were performed in RevMan 5.4. The risk of bias was assessed by the Cochrane Collaboration’s risk of bias tool, and studies that reported statistically comparable outcomes were analysed in meta-analyses using random effects models. Heterogeneity was assessed using the I2 statistic index.

EVIDENCE SYNTHESIS: A total of 12 RCTs included in this meta-analysis and revealed that balance training was effective for improving the dynamic posture stability of CAI patients (SMD=0:90; 95%CI: 0.54 to 1.26; P<0:00001, I2 = 71%; Star Excursion Balance Test). Subgroup analysis (balance training vs. other training) revealed a small negative effect size, but this was not statistically significant (SMD=-0.12, 95% CI=-0.53 to 0.29, P=0.56, I² = 9%). Another subgroup analysis (balance training vs. no training) revealed that balance training was more likely to have greater improvement on the dynamic posture stability of CAI patients (SMD=0.94, 95% CI: 0.71 to 1.17; P<0.00001, I² = 0%).

CONCLUSIONS: Balance training yielded a statistically significant and clinically meaningful improvement in dynamic postural stability in CAI patients. Limited evidence indicates that balance training was more effective than other training methods.

PMID:35333029 | DOI:10.23736/S0022-4707.22.13566-8

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13655-8. Online ahead of print.

ABSTRACT

BACKGROUND: female soccer players are often diagnosed with medial shin pain, which includes tibial stress fracture, medial tibial stress syndrome, and chronic exertional compartment syndrome. As the possibility of varied sites of pain affecting sports activities has not been fully researched, an urgent discussion and evidence is required. This study investigates the prevalence and effect of sites of pain on the sports activities of female soccer players with medial shin pain.

METHODS: a questionnaire survey was conducted for 196 female soccer players with medial shin pain to assess symptom duration, the effect of practice and performance, and sites of pain. The players were classified into three conditions (tibial stress fracture, medial tibial stress syndrome, or medial shin pain with neurological symptoms) and compared based on sites of pain.

RESULTS: we observed that medial tibial stress syndrome had a lower impact on performance compared to that of tibial stress fracture and medial shin pain with neurological symptoms. While participants with tibial stress fracture had to suspend practice sessions more frequently, the difference in symptom duration between the classified groups was not statistically significant. The effect of sites of pain on sports activities was not significantly different in participants with medial tibial stress syndrome.

CONCLUSIONS: medial shin pain should be evaluated carefully to differentiate between medial tibial stress syndrome and medial shin pain with neurological symptoms. Restriction of sports activities may help improve the patient’s condition early, regardless of the presentation.

PMID:35333031 | DOI:10.23736/S0022-4707.22.13655-8

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13498-5. Online ahead of print.

ABSTRACT

BACKGROUND: Our previous study has developed FIVE, futsal neuromuscular warm-up program to improve physical performance components and prevent the incidence of futsal injury. Experimental research was needed to verify the effect of FIVE program on physical performance components affecting injury, such as lower limb muscle strength. This study aimed to investigate the effect of FIVE program on the lower limb muscle strength among young futsal players.

METHODS: Ninety-five young male futsal players were recruited using purposive random sampling from futsal clubs in Indonesia. The players were randomized into 2 groups; 42 players were in the experimental (EXP) group, and 53 players were in the control (CON) group. The EXP group performed FIVE exercises in addition to their regular futsal training, and the CON group performed their regular futsal training only. Both groups performed the intervention 3 times per week within 6 weeks. All players completed pre-and post-intervention lower limb muscle strength tests comprising the isometric leg strength, isometric hip abduction strength, and isometric hip adduction. The strength test was conducted using dynamometer. Changes in performance (pre- vs. post-intervention) of each group were analyzed using paired T-test and Wilcoxon test. The pre- and post-strength test changes (Δ post-pre) between EXP and CON group was compared using independent T-test and Mann Whitney test. Statistical significance was set to p < 0.05. Thirty-one players dropped out in this study.

RESULTS: This study showed all measurements on lower limb muscle strength improved significantly in the EXP group (p < 0.05) while hip abduction and hip adduction strength were significantly decreased in the CON group. Improvement of isometric hip abduction and adduction strength in the EXP group was significantly different from the CON group (p = 0.00 and p = 0.00, respectively).

CONCLUSIONS: Results suggest that FIVE could be an alternative warm-up program to improve lower limb muscle strength among young futsal players.

PMID:35333027 | DOI:10.23736/S0022-4707.22.13498-5

Musculoskeletal Care. 2022 Mar 25. doi: 10.1002/msc.1635. Online ahead of print.

ABSTRACT

BACKGROUND: Pain, as a psychological experience, is caused by complex interactions among sensory-discriminative, motivational-affective, and cognitive-evaluative dimensions. The psychosocial approach is one of the important approaches in managing musculoskeletal pain in patients. Therefore, this study aimed to determine and compare the effects of psychosocial skills training on pain intensity in patients with acute and chronic musculoskeletal pain.

METHODS: In this quasi-experimental study, 64 patients with acute and chronic musculoskeletal pain were selected using convenience sampling and were divided into a control and an intervention group. Both groups received psychosocial training in pain management in groups of 8-10 people over six 1-h sessions. The data were collected at baseline, after the intervention, and 3 months later using a numerical rating scale (NRS). Then, the data were entered into the SPSS 22 software and were analysed using descriptive and inferential statistics.

RESULTS: In this study, the mean age of the participants was 50.10 ± 10.63 years and 60.9% of them were female. Based on the results, time had a significant effect on pain intensity (p < 0.001), but the effect of group on pain intensity was not statistically significant (p = 0.07). The group × time effect on pain intensity was also statistically significant (p < 0.001).

CONCLUSION: Psychosocial training had a positive impact on the reduction of pain among the patients with acute and chronic musculoskeletal pain. Additionally, the training was more effective in patients with acute pain due to early training. These findings can help healthcare providers in the field of musculoskeletal pain management, especially in patients with acute pain.

PMID:35332994 | DOI:10.1002/msc.1635

Health Info Libr J. 2022 Mar 25. doi: 10.1111/hir.12427. Online ahead of print.

ABSTRACT

BACKGROUND: A validated generic impact questionnaire can demonstrate how individual and groups of health libraries contribute to continuing education and patient care outcomes.

OBJECTIVES: To validate an existing generic questionnaire for Knowledge for Healthcare, England by examining: (1) internal reliability; (2) content validity; and (3) suggest revisions.

METHODS: Methods used included Cronbach’s alpha test, simple data mining of patterns among a data set of 187 questionnaire responses and checking respondents’ interpretation of questions.

RESULTS: Cronbach’s alpha was 0.776 (acceptable internal reliability). The patterns of responses indicated that respondents’ interpretations of the questions were highly plausible, and consistent. The meaning of ‘research’ varied among different occupational groups, but overall, respondents could identify relevant personal and service impacts. However, users were confused about the terms that libraries use to describe some services.

DISCUSSION: The analysis indicated that the questionnaire worked well for the two types of personal services (literature/evidence searches and training/e-learning) frequently cited on the responses. Further research may be required for library assessment of the impact of other services such as digital resource services.

CONCLUSIONS: The generic questionnaire is a reliable way of assessing the impact of health library and knowledge services, both individually and collectively.

PMID:35332978 | DOI:10.1111/hir.12427

J Esthet Restor Dent. 2022 Mar 25. doi: 10.1111/jerd.12908. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate, in vitro, the influence of at-home bleaching with 16% carbamide peroxide (CP) gels containing different thickeners on the color, gloss, roughness, and microhardness of a composite resin with bisphenol A (BPA) and without bisphenol A (BPA-free).

MATERIAL AND METHODS: Cylindrical samples (7 × 2 mm) of a composite resin with BPA (Filtek Z350 XT®; 3M/ESPE) and composite resin BPA-free (Vittra APS®; FGM) were subdivided into six subgroups (n = 12), according to the bleaching gel used: no bleaching (control), commercial gel with 16% CP and carbopol, experimental gel with 16% CP and carbopol, experimental gel with 16% CP and natrosol, experimental gel with carbopol and experimental gel with natrosol. At the end of the experimental phase, the specimens were analyzed for color (ΔE*_ab and ΔE₀₀ ), surface roughness (Ra), gloss (GU), and surface microhardness (SMH). The data for all analyzes were submitted to Levene’s test, Shapiro-Wilk’s test and ANOVA.

RESULTS: For ΔE*_ab and ΔE₀₀ no statistically significant differences were found between all groups evaluated. Bleaching with experimental 16% CP gel with carbopol resulted in the lowest GU values for both composite resins evaluated. 16% CP experimental gel with natrosol resulted in higher Ra for the BPA composite resin and the bleaching with natrosol resulted in higher Ra for BPA-free. About 16% CP experimental gel with carbopol and 16% CP experimental gel with natrosol resulted in the lowest final SMH for composite resin with BPA. For the BPA-free composite resin, no differences were found between the groups in SMH for the same resin, however they presented the lowest values compared with all others groups.

CONCLUSION: The effects on physical properties are dependent on the composition of the composite resin and the thickener/bleaching gel used. The BPA-free composite resin showed less changes after exposure to bleaching agent, although its initial physical properties were worse compared to a bleached BPA.

CLINICAL RELEVANCE: The hydrogen peroxide and thickener of the at-home bleaching gel does impact the properties of composites with BPA or BPA-free such as gloss, roughness and surface microhardness, extremely important factors for maintaining an aesthetically and physically satisfactory restoration. BPA-free composite resins have inferior properties after at-home bleaching with different thickeners.

PMID:35332985 | DOI:10.1111/jerd.12908

Health Soc Care Community. 2022 Mar 25. doi: 10.1111/hsc.13765. Online ahead of print.

ABSTRACT

To a great extent, older people in Sweden, often with extensive care needs, are cared for in their own home. Support is often needed from both family and professional caregivers. This study aimed to describe and analyse different aspects of health, functioning and social networks, and how they relate to formal and informal care in the home among older adults. Analyses were performed utilising data from the OCTO-2 study, with a sample of 317 people living in Jönköping County, aged 75, 80, 85 or 90 years, living in their own homes. Data were collected with in-person-testing. Based on receipt of care, the participants were divided into three groups: no care, informal care only, and formal care with or without informal care. Descriptive statistics and multinomial regression analysis were performed to explore the associations between received care and different aspects of health (such as multimorbidity, polypharmacy), social networks (such as loneliness, number of confidants) and functioning (such as managing daily life). The findings demonstrate that the majority of the participants received no care at home (61%). Multimorbidity and polypharmacy were more common among those receiving some kind of care in comparison to those who received no care; moreover, those receiving some kind of care also had difficulties managing daily life and less satisfaction with their social networks. The multinomial logistic regression analyses demonstrated that age, functioning in daily life, perceived general health and satisfaction with the number of confidants were related to receipt of care, but the associations among these factors differed depending on the type of care that was received. The results show the importance of a holistic perspective that includes the older person’s experiences when planning home care. The results also highlight the importance of considering social perspectives and relationships in home care rather than focusing only on health factors.

PMID:35332977 | DOI:10.1111/hsc.13765

J Magn Reson Imaging. 2022 Mar 25. doi: 10.1002/jmri.28158. Online ahead of print.

ABSTRACT

BACKGROUND: The feasibility and reproducibility of multifrequency MR elastography (MRE) for diagnosing pancreatic ductal adenocarcinoma (PDAC) have not been reported.

PURPOSE: To determine the feasibility and reproducibility of multifrequency MRE for assessing pancreatic stiffness in healthy and diseased pancreases.

STUDY TYPE: Prospective.

SUBJECTS: A total of 40 healthy volunteers and 10 patients with PDAC were prospectively recruited between March 2018 and October 2021.

FIELD STRENGTH/SEQUENCE: A 3.0-T pancreatic MRE at frequencies in the order of 30, 40, 60, 80, and 100 Hz.

ASSESSMENT: Body mass index (BMI) and wave distance of the healthy pancreas and PDAC were measured. Image quality was assessed using the image quality score (IQS: 1-4, ≥3 were considered diagnostic quality). Three readers independently performed the pancreatic stiffness and IQS assessments to evaluate reproducibility.

STATISTICAL TESTS: Logistic regression analyses were performed to determine variables that influenced IQS. Statistical significance was set at P <0.05. Levels of inter- and intrarater agreement were assessed using intraclass correlation coefficients (ICC) and Cohen’s kappa coefficient (κ). Good reproducibility was set at ICC and κ ≥ 0.8.

RESULTS: In logistic regression analysis, a diagnostic IQS in healthy volunteers was independently associated with a lower BMI (odds ratio [OR] = 0.89 kg/m^-2 ), shorter wave distance (OR = 0.70 cm^-1 ), and lower frequency (30 and 40 Hz: OR = 170.01 and 96.02). In PDAC, frequency was the only independent factor for diagnostic IQS (30-60 Hz: OR = 46.18, 46.18, and 17.20, respectively) with 100 Hz as a reference. In healthy volunteers, good reproducibility was observed at 30 and 40 Hz. In PDAC, good reproducibility was observed at 30-60 Hz.

DATA CONCLUSION: MRE at 30 and 40 Hz provides diagnostic wave images and reliable measurements of pancreatic stiffness in healthy volunteers. MRE at 30-60 Hz is acceptable for PDACs (IQS ≥ 3, ICC and κ ≥ 0.80).

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.

PMID:35332973 | DOI:10.1002/jmri.28158

Int J Eat Disord. 2022 Mar 25. doi: 10.1002/eat.23698. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the impact of our new rapid refeeding protocol on patients with anorexia nervosa (AN) in our Eating Disorders Program. We hypothesize that the new protocol would lead to a more rapid weight gain and a shorter length of stay, with no effect on medical complications or program completion.

METHOD: This cohort design included consecutive inpatients and day hospital patients admitted to the program with a BMI <18 kg/m² and a diagnosis of AN between 2007 and 2020; N = 326 patients. Main outcomes measured were rate of weight gain and length of stay. Safety indicators included electrolyte disturbances and supplementation required, complications including refeeding syndrome and completion of the program. A p value <.05 was considered statistically significant.

RESULTS: Total length of stay was 21 days shorter for patients on the rapid refeeding protocol compared to the traditional refeeding protocol. Patients on the new protocol gained 0.21 more kg/week compared to patients on the old protocol. There was no difference in completion rates between programs. Electrolyte imbalances were mild to moderate and easily treated with oral electrolyte supplementation. There were no deaths or cases of refeeding syndrome with either protocol.

DISCUSSION: This is the first Canadian study to assess the effectiveness and safety of rapid refeeding in an adult population. Rapid refeeding protocols can be safely administered and are cost effective. Shorter hospital admissions are desirable to minimize possible regression and dependency on inpatient services and positively impacts patients’ quality of life.

PUBLIC SIGNIFICANCE: This study advances the idea that rapid refeeding in patients with anorexia nervosa can be administered safely and effectively with close medical monitoring. In addition, rapid refeeding leads to shorter hospital stays, with a cost-savings to the health system. Shorter admissions are desirable to minimize possible regression and dependency on inpatient services and also positively impacts patients’ quality of life.

PMID:35332954 | DOI:10.1002/eat.23698