Tag: nevin manimala

Am J Sports Med. 2021 Mar 5:363546521996701. doi: 10.1177/0363546521996701. Online ahead of print.

ABSTRACT

BACKGROUND: Recurrent shoulder instability is a prevalent condition, with glenoid bone loss as a common cause. Arthroscopic repair using distal tibial allografts provides long-lasting treatment by restoring glenoid surface area and presumably avoids risks of sensitization against donor human leukocyte antigen (HLA). Two case studies have challenged this assumption, suggesting that small bone allografts are able to induce host adaptive immune responses to donor HLA. The incidence of small bone allograft HLA sensitization and its effects on resorption and patient outcomes are unclear.

PURPOSE/HYPOTHESIS: The purpose was to assess the rate of sensitization against donor HLA after distal tibial allograft procedures for shoulder instability due to glenoid bone loss and to find whether HLA sensitization negatively affects patient-reported and radiographic outcomes. We hypothesized that sensitized patients would have worse radiographic and self-reported outcomes compared with nonsensitized patients.

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

METHODS: A total of 71 patients with a mean age of 28.85 years (range, 13.58-61.31 years) were enrolled, with 58 patients submitting sufficient pre- and postoperative blood samples for HLA antibody testing. In patients who developed HLA antibodies postoperatively, donor HLA typing was used to confirm donor-specific sensitization. Pre- and postoperative computerized tomography scans (0.9 ± 0.8 years follow-up) were used to grade resorption based on the modified Zhu resorption grade classification (ie, grade 0 = no resorption; grade 1 = less than 25% resorption; grade 2 = between 25% and 50% resorption; and grade 3 = larger than 50% resorption). The Western Ontario Shoulder Instability Index outcome scores were obtained preoperatively and at regular postoperative appointments. Resorption and outcome data were compared between sensitized and nonsensitized patients using the Fisher exact test, independent 2-tailed Student t tests, and the Wilcoxon rank-sum test to determine the effect of HLA sensitization on radiographic and patient-reported outcomes.

RESULTS: A total of 7 (12.1%) patients with sufficient HLA samples were sensitized against donor HLA postoperatively. Sensitized patients did not have significantly higher rates of resorption (21.9% vs 14.3%, 21.9% vs 28.6%, 43.8% vs 28.6%, and 12.5% vs 28.6% for respective resorption grades 0-3; P = .67; α = .05). Self-reported outcomes were not statistically significant between sensitized and nonsensitized patients (24.9 ± 27.61 vs 40.16 ± 18.99; P = .37; α = .05) and did not differ significantly based on resorption grade (47.4 ± 0.0 vs 55.2 ± 18.8, 30.4 ± 15.8 vs 39.9 ± 20.9, 41.2 ± 0.0 vs 39.1 ± 13.1, and -24.9 ± 0 vs 24.4 ± 19.6 for resorption grades 0-3; P > .05; α = .05).

CONCLUSION: Sensitization against donor HLA after small bone graft allografting was not previously considered but has been brought to light as a possibility. Aside from potential complications for future organ transplants, HLA sensitization does not introduce a risk for adverse outcomes or higher grades of resorption compared with nonsensitized patients after small bone allografting for shoulder instability.

PMID:33667132 | DOI:10.1177/0363546521996701

Rev Med Inst Mex Seguro Soc. 2021 Feb 2;59(1):7-16. doi: 10.24875/RMIMSS.M21000047.

ABSTRACT

Introduction: Food choices and nutritional requirements of women, which vary throughout their life cycle, are unknown for Argentinian women. Objective: To identify Argentinian women’s dietary patterns and their relation to socioeconomic and health characteristics, during puerperium. Method: The food intake of 249 puerperal women was assessed for a cross-sectional study. Dietary patterns were determined by factor analysis, whose adherence was associated with different variables through Spearman’s correlation and multivariate analyses. Results: Three patterns were revealed: macronutritional (MP), phytochemical (PP) and energetic (EP). Physical activity and family history of cardiometabolic diseases were positively associated to MP adherence (odds ratio [OR] = 2.69 and 2.68, respectively). Women without formal employment adhered less to PP (OR = 0.49). Low educational level increased adherence to EP (OR = 2.20). Body mass index correlated inversely to PP (rho = -0.16). Correspondence analysis revealed that high adherence to MP and PP were associated with formal employment, high educational level, adequate physical activity, normal body mass index and a diverse diet. Conclusion: Food choices were conditioned by family disease, physical activity, employment, and educational level. We identified three dietary patterns in postpartum women, which constitute an original contribution to future nutritional approaches.

PMID:33667039 | DOI:10.24875/RMIMSS.M21000047

Rev Med Inst Mex Seguro Soc. 2021 Feb 2;59(1):34-47. doi: 10.24875/RMIMSS.M21000050.

ABSTRACT

Background: Adolescents (ages 10-19) represent approximately 16% of the population in Mexico. This article identifies their main morbidity and mortality conditions, as well as current strategies and interventions to reduce preventable causes. Objective: Identify the main causes of morbidity, mortality, and disease burden in adolescents from 10 to 19 years of age, and current interventions to reduce mortality and improve adolescent health in the Mexican and international context. Method: A descriptive-exploratory statistical analysis of primary sources was performed to identify the main causes of adolescent morbidity and mortality in Mexico. Through a structured literature search, current policies, and interventions to improve adolescent health were identified. Results: Accidents are the second leading cause of death in adolescents aged 10 to 14 years and in the group of 15 to 19 years. Intentional injuries have increased in recent years, occupying the third cause of death in adolescents between 10 and 14 years old and the first cause of death among youngsters between 15 and 19 years old. Conclusions: The current health system urgently needs restructuring and reengineering, in which adolescent health and wellbeing intervention needs are considered.

PMID:33667042 | DOI:10.24875/RMIMSS.M21000050

J Med Internet Res. 2021 Mar 5;23(3):e26646. doi: 10.2196/26646.

ABSTRACT

BACKGROUND: The increasing development of artificial intelligence (AI) systems in medicine driven by researchers and entrepreneurs goes along with enormous expectations for medical care advancement. AI might change the clinical practice of physicians from almost all medical disciplines and in most areas of health care. While expectations for AI in medicine are high, practical implementations of AI for clinical practice are still scarce in Germany. Moreover, physicians’ requirements and expectations of AI in medicine and their opinion on the usage of anonymized patient data for clinical and biomedical research have not been investigated widely in German university hospitals.

OBJECTIVE: This study aimed to evaluate physicians’ requirements and expectations of AI in medicine and their opinion on the secondary usage of patient data for (bio)medical research (eg, for the development of machine learning algorithms) in university hospitals in Germany.

METHODS: A web-based survey was conducted addressing physicians of all medical disciplines in 8 German university hospitals. Answers were given using Likert scales and general demographic responses. Physicians were asked to participate locally via email in the respective hospitals.

RESULTS: The online survey was completed by 303 physicians (female: 121/303, 39.9%; male: 173/303, 57.1%; no response: 9/303, 3.0%) from a wide range of medical disciplines and work experience levels. Most respondents either had a positive (130/303, 42.9%) or a very positive attitude (82/303, 27.1%) towards AI in medicine. There was a significant association between the personal rating of AI in medicine and the self-reported technical affinity level (H₄=48.3, P<.001). A vast majority of physicians expected the future of medicine to be a mix of human and artificial intelligence (273/303, 90.1%) but also requested a scientific evaluation before the routine implementation of AI-based systems (276/303, 91.1%). Physicians were most optimistic that AI applications would identify drug interactions (280/303, 92.4%) to improve patient care substantially but were quite reserved regarding AI-supported diagnosis of psychiatric diseases (62/303, 20.5%). Of the respondents, 82.5% (250/303) agreed that there should be open access to anonymized patient databases for medical and biomedical research.

CONCLUSIONS: Physicians in stationary patient care in German university hospitals show a generally positive attitude towards using most AI applications in medicine. Along with this optimism comes several expectations and hopes that AI will assist physicians in clinical decision making. Especially in fields of medicine where huge amounts of data are processed (eg, imaging procedures in radiology and pathology) or data are collected continuously (eg, cardiology and intensive care medicine), physicians’ expectations of AI to substantially improve future patient care are high. In the study, the greatest potential was seen in the application of AI for the identification of drug interactions, assumedly due to the rising complexity of drug administration to polymorbid, polypharmacy patients. However, for the practical usage of AI in health care, regulatory and organizational challenges still have to be mastered.

PMID:33666563 | DOI:10.2196/26646

J Strength Cond Res. 2021 Feb 1;35(Suppl 1):S95-S101. doi: 10.1519/JSC.0000000000003574.

ABSTRACT

Kasovic, J, Martin, B, Carzoli, JP, Zourdos, MC, and Fahs, CA. Agreement between the Iron Path app and a linear position transducer for measuring average concentric velocity and range of motion of barbell exercises. J Strength Cond Res 35(2S): S95-S101, 2021-The purpose of this study was to compare average concentric velocity (ACV) and range of motion (ROM) values measured by the Iron Path (IP) app to the previously validated Open Barbell System (OBS) linear position transducer during the front and back squat and conventional and sumo deadlift. Twenty-seven men and women (21 ± 3 years old; 76.7 ± 14.5 kg; 1.72 ± 0.09 m) with squat and deadlift training experience completed a modified one repetition maximum protocol on 4 separate occasions in a randomized order. The IP app and OBS device recorded ACV and ROM during each protocol. The level of statistical significant was set at p ≤ 0.05. Bland-Altman plots showed fairly large limits of agreement for both ACV and ROM. Furthermore, 95% confidence intervals for the intraclass correlation coefficients indicated the agreement in ACV between the devices for each of the 4 lifts to range from 0.648-0.876 to 0.849-0.930 and for agreement in ROM between devices to range from -0.053-0.480 to 0.545-0.770. Compared with the OBS, the IP app recorded significantly (p < 0.05) lower ACV values for the front squat and back squat and greater ROM values for the sumo deadlift. We suggest the IP app should not be used in place of a validated linear position transducer for measuring ACV or ROM for barbell lifts.

PMID:33666594 | DOI:10.1519/JSC.0000000000003574

Phys Chem Chem Phys. 2021 Mar 5. doi: 10.1039/d1cp00326g. Online ahead of print.

ABSTRACT

The two species considered here, O2 (oxygen molecule) and Ar (argon-atom), are both abundant components of Earth’s atmosphere and hence familiar collision partners in this medium. O2 is quite reactive and extensively involved in atmospheric chemistry, including Chapman’s cycle of the formation and destruction of ozone; while Ar, like N2, typically plays the nevertheless crucial role of inert collider. Inert species can provide stabilization to metastable encounter-complexes through the energy transfer associated with inelastic collisions. The interplay of collision frequency and energy transfer efficiency, with state lifetimes and species concentrations, contributes to the rich and varied chemistry and dynamics found in diverse environments ranging from planetary atmospheres to the interstellar and circumstellar media. The nature and density of bound and resonance states, coupled electronic states, symmetry, and nuclear spin-statistics can all play a role. Here, we systematically investigate some of those factors by looking at the O2-Ar system, comparing rigorous quantum-scattering calculations for the 16O16O-40Ar, 18O16O-40Ar, and 18O18O-40Ar isotope combinations. A new accurate potential energy surface was constructed for this purpose holding the O2 bond distance at its vibrationally averaged distance.

PMID:33666616 | DOI:10.1039/d1cp00326g

J Palliat Med. 2021 Mar 5. doi: 10.1089/jpm.2020.0358. Online ahead of print.

ABSTRACT

Background: Health professionals who care for patients and their families at the end of life (EOL) may experience gratitude, and enhanced spirituality and meaning in life, yet they are also at increased risk of psychological distress, compassion fatigue, and occupational burnout given the stressors they encounter in their work. Objectives: This research evaluated the feasibility and acceptability of a novel six-week mindfulness-based compassion training intervention, which was tailored to health professionals involved in EOL care (“MBCT4HP”), and explored its impact on levels of psychological distress, compassion fatigue, compassion satisfaction, occupational burnout, self-compassion, and mindfulness. Design: We adopted an observational, repeated measures pilot study. Setting/Subjects: Thirty-one health professionals participated. The intervention comprised six, weekly sessions (totaling seven hours) designed to foster compassion for self and others, including formal and informal compassion and mindfulness practices, daily home practice, and a reflective experiential pedagogy. Measurements: Validated outcome measures for anxiety, depression, and stress; compassion satisfaction, compassion fatigue (burnout, secondary traumatic stress); occupational burnout (emotional exhaustion, personal accomplishment, and depersonalization), self-compassion, and mindfulness were administered at baseline, end of intervention, and eight weeks postintervention. The feasibility and acceptability of the intervention was assessed using attendance records, home practice logs, and self-report satisfaction items. Descriptive statistics and Generalized Linear Mixed Models were used to analyze the data. Results: Participants reported that the sessions were useful, relevant, easy to understand, and that they gave them sufficient knowledge to implement the strategies learned. Levels of anxiety, compassion fatigue (burnout only), and emotional exhaustion decreased over time with some decay in effects at follow up, and levels of compassion satisfaction and self-compassion increased with time. Conclusions: The intervention was feasible and acceptable to health professionals involved in EOL care and had a positive impact on levels of anxiety, compassion fatigue (burnout), emotional exhaustion, compassion satisfaction, and self-compassion.

PMID:33666500 | DOI:10.1089/jpm.2020.0358

J Laparoendosc Adv Surg Tech A. 2021 Mar 5. doi: 10.1089/lap.2021.0016. Online ahead of print.

ABSTRACT

Purpose: To compare and analyze the incidence of postoperative reflux esophagitis (RE) in patients with early- and intermediate-stage proximal gastric cancer after proximal gastrectomy plus esophagus-remnant stomach anterior wall anastomosis with proper spacing between the reserved anastomotic stoma and the stump of the remnant stomach versus total gastrectomy plus Roux-en-Y anastomosis and to analyze the advantages and disadvantages of these anastomosis approaches. Methods: Hospitalization data of 23 patients with early- and intermediate-stage proximal gastric cancer were retrospectively analyzed. They were divided into an observation group who underwent proximal gastrectomy plus esophagus-remnant stomach anterior wall anastomosis with proper spacing between the reserved anastomotic stoma and the stump of the remnant stomach and a control group who underwent total gastrectomy plus Roux-en-Y anastomosis. Quality observation indicators were compared between the two groups. Results: There was no statistically significant difference between the groups in the number of lymph nodes cleared or the recurrence rate at 12 months postoperatively. The incidence of postoperative RE was significantly lower in the observation group (25%) than in the control group (80%). The operation time, postoperative length of hospital stay, appetite change, body mass index, and hemoglobin level at 6 months postoperatively were significantly better in the observation group than in the control group (P < .05). Conclusion: Proximal gastrectomy plus esophagus-remnant stomach anterior wall anastomosis with proper spacing between the reserved anastomotic stoma and the stump of the remnant stomach can be used as a preferred surgical procedure for early- and mid-stage proximal gastric cancer.

PMID:33666512 | DOI:10.1089/lap.2021.0016

Expert Rev Med Devices. 2021 Mar 5. doi: 10.1080/17434440.2021.1899805. Online ahead of print.

ABSTRACT

INTRODUCTION: Energy-based devices are widely used in thyroid surgery in order to achieve optimal hemostasis, while their role in the incidence of hypocalcemia and hypoparathyroidism comprises a topic evaluated in numerous studies.

AREAS COVERED: The aim of this systematic review is to investigate the potential benefit of Ultrasonic Shears and Electrothermal Bipolar (Radiofrequency) System in thyroid surgery regarding the incidence of post-operative hypocalcemia and hypoparathyroidism. A systematic review of the literature in PubMed/Medline and Scopus databases was conducted. 49 studies met the inclusion criteria and were analyzed. A statistically decreased rate of transient hypocalcemia and hypoparathyroidism were reported in 15 studies and 4 studies respectively, when using energy-based devices. However, 18 and 13 surveys examined transient hypocalcemia and hypoparathyroidism respectively and demonstrated no statistical difference between energy-based devices and conventional hemostasis. No difference was observed between the groups concerning permanent hypocalcemia. Out of 13 studies, only 2 showed a significant reduction in the occurrence of permanent hypoparathyroidism in the energy-based device group.

EXPERT OPINION: Energy-based devices reduced the rate of transient hypocalcemia and hypoparathyroidism after thyroid surgeries in 42.8% and 23.5% of the included studies respectively. Further studies are needed to evaluate their impact on permanent post-operative hypocalcemia and hypoparathyroidism.

PMID:33666537 | DOI:10.1080/17434440.2021.1899805

SICOT J. 2021;7:7. doi: 10.1051/sicotj/2021002. Epub 2021 Mar 5.

ABSTRACT

BACKGROUND: Identifying the risk factors for the neurological deficit in spine tuberculosis would help surgeons in deciding on early surgery, thus reducing the morbidity related to neurological deficit. The main objective of our study was to predict the risk of neurological deficit in patients with spinal tuberculosis (TB).

METHODS: The demographic, clinical, radiological (X-ray and MRI) data of 105 patients with active spine TB were retrospectively analyzed. Patients were divided into two groups – with a neurological deficit (n = 52) as Group A and those without deficit (n = 53) as Group B. Univariate and multivariate logistic regression analysis was used to predict the risk factors for the neurological deficit.

RESULTS: The mean age of the patients was 38.1 years. The most common location of disease was dorsal region (35.2%). Paradiscal (77%) was the most common type of involvement. A statistically significant difference (p < 0.05) was noted in the location of disease, presence of cord compression, kyphosis, cord oedema, loss of CSF anterior to the cord, and degree of canal compromise or canal encroachment between two groups. Multivariate analysis revealed kyphosis > 30° (OR – 3.92, CI – 1.21-12.7, p – 0.023), canal encroachment > 50% (OR – 7.34, CI – 2.32-23.17, p – 0.001), and cord oedema (OR – 11.93, CI – 1.24-114.05, p – 0.03) as independent risk factors for predicting the risk of neurological deficit.

CONCLUSION: Kyphosis > 30°, cord oedema, and canal encroachment (>50%) significantly predicted neurological deficit in patients with spine TB. Early surgery should be considered with all these risk factors to prevent a neurological deficit.

PMID:33666548 | DOI:10.1051/sicotj/2021002