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Nevin Manimala Statistics

A Retrospective Study on the Effects of Kinesiology Taping on Edema of the Lower Limb in 14 Patients Following Intramedullary Nailing for Femoral Shaft Fracture

Med Sci Monit. 2022 Apr 3;28:e936619. doi: 10.12659/MSM.936619.

ABSTRACT

BACKGROUND Kinesiology tape indications of use include pain mitigation, neurosensory input, and promotion of circulation. Current evidence suggests that residual functional limitations following intramedullary nailing of the femoral shaft may be due to soft tissue injury and compromise. This retrospective study from a single center aimed to compare the effects of kinesiology taping on edema of the lower limb in 14 patients following intramedullary nailing for femoral shaft fracture. MATERIAL AND METHODS The randomized control trial design consisting of 2 groups totaling 14 patients. The intervention group (n=7) received standard therapy and kinesiology tape decompression/fan application. The control group (n=7) received standard therapy with no kinesiology tape. Outcome measures included limb girth tape measurements, Visual Analog Scale (VAS) for pain, involved knee ROM goniometry, and Timed Up and Go (TUG). RESULTS Results of this study showed there was a decrease in limb volume in the control group and an increase in limb volume in the intervention group. Both groups had improvements in TUG scores. The only statistically significant finding was among the control group, which had a decrease of 1.6 in mean VAS score before and after IM nailing (P=0.010). CONCLUSIONS In this study from a single center, kinesiology tape in patients with intramedullary nailing for femoral shaft fracture did not significantly reduce the volume of the lower limb, reduce pain, or improve postoperative mobility. The only significant improvement from the use of kinesiology tape was improved active knee extension due to improvement in quadriceps force.

PMID:35368016 | DOI:10.12659/MSM.936619

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Impact of the coronavirus pandemic on maxillofacial trauma: A retrospective study in southern Spain

Med Oral Patol Oral Cir Bucal. 2022 Apr 3:25063. doi: 10.4317/medoral.25063. Online ahead of print.

ABSTRACT

BACKGROUND: The coronavirus pandemic has impacted health systems worldwide, with Spain being one of the most affected countries. However, little is known about the extent to which the effects of staying home, social distancing, and quarantine measures have influenced the epidemiology of patients with maxillofacial trauma. The aim of this study was to analyze the impact of the coronavirus pandemic on the incidence, demographic patterns, and characteristics of maxillofacial fractures in the largest hospital in southern Spain.

MATERIAL AND METHODS: Data from patients who underwent surgery for maxillofacial fractures during the first year of the pandemic between 16 March 2020 and 14 March 2021 (pandemic group) were retrospectively compared with a control group during the equivalent period of the previous year (pre-pandemic group). The incidence was compared by weeks and by lockdown periods of the population. Demographic information, aetioloy, fracture characteristics, treatment performed, and days of preoperative stay were evaluated. Descriptive and bivariate statistics were calculated (p<0.05).

RESULTS: During the first year of the pandemic, there was a 35.2% reduction in maxillofacial fractures (n=59) compared to the pre-pandemic year (n=91, p=0.040). A significant drop was detected during the total home lockdown period of the population (p=0.028). In the pandemic group, there was a reduction in fractures due to interpersonal aggressions, an increase in panfacial fractures, a significant increase in other non-facial injuries associated with polytrauma (p=0.037), a higher number of open reduction procedures with internal fixation, and a significantly longer mean preoperative stay (p=0.016).

CONCLUSIONS: The first pandemic year was associated with a decline in the frequency of maxillofacial trauma and a change in the pattern and characteristics of fractures. Inter-annual epidemiological knowledge of maxillofacial fractures may be useful for more efficient planning of resource allocation and surgical practice strategy during future coronavirus outbreaks and population lockdowns.

PMID:35368010 | DOI:10.4317/medoral.25063

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Clinical manifestations of head and neck cancer in pediatric patients, an analysis of 253 cases in a single Brazilian center

Med Oral Patol Oral Cir Bucal. 2022 Apr 3:25255. doi: 10.4317/medoral.25255. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric head and neck cancer (PHNC) is rare and its nonspecific clinical manifestations may often lead to delayed diagnosis. We aimed to describe the signs, symptoms, and clinicopathological characteristics of PHNC.

MATERIAL AND METHODS: Medical records were retrospectively reviewed for all PHNC cases diagnosed from 1986 to 2016 affecting patients aged 19-years and younger from a tertiary referral center in Brazil. Demographic variables, anatomical site of primary tumors, histopathological diagnoses, signs and symptoms, and patterns of misdiagnosis were collected and interpreted by statistical and descriptive analysis.

RESULTS: A total of 253 PHNC cases were included. The mean age was 9.3 years and male patients were more frequently affected (60.9%). Burkitt lymphoma (23.7%), nasopharyngeal carcinoma (15.8%), and rhabdomyosarcoma (15.4%) were the most common cancer types. The nasopharynx (28.9%), cervical/lymph node region (25.3%), and craniofacial bones (8.3%) were the predominant anatomical sites. Tumor/swelling (68.4%), was the clinical finding often presented. The univariable analysis showed association between tumor histology and clinical variables such as sex (p=0.022), age (p<0.0001), anatomical location (p<0.0001) tumor/swelling (p=0.034), pain (p=0.031), systemic/general manifestations (p=0.004), nasal/breathing alterations (p=0.012), orbital/ocular alterations (p<0.0001). Misdiagnosis such as tonsillitis, otitis, and abscess were frequent.

CONCLUSIONS: Although the clinical findings of PHNC are often unspecific, this study provided signs and symptoms with significant correlations between tumor histology. The suspicion of malignancy should be considered when the main signs and symptoms reported here appear and persist, in order to conduct a timely diagnosis.

PMID:35368009 | DOI:10.4317/medoral.25255

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Alcohol use and alcohol use disorder differ in their genetic relationships with PTSD: A genomic structural equation modelling approach

Drug Alcohol Depend. 2022 Mar 28;234:109430. doi: 10.1016/j.drugalcdep.2022.109430. Online ahead of print.

ABSTRACT

PURPOSE: Posttraumatic Stress Disorder (PTSD) is associated with increased alcohol use and alcohol use disorder (AUD), which are all moderately heritable. Studies suggest the genetic association between PTSD and alcohol use differs from that of PTSD and AUD, but further analysis is needed.

BASIC PROCEDURES: We used genomic Structural Equation Modeling (genomicSEM) to analyze summary statistics from large-scale genome-wide association studies (GWAS) of European Ancestry participants to investigate the genetic relationships between PTSD (both diagnosis and re-experiencing symptom severity) and a range of alcohol use and AUD phenotypes.

MAIN FINDINGS: When we differentiated genetic factors for alcohol use and AUD we observed improved model fit relative to models with all alcohol-related indicators loading onto a single factor. The genetic correlations (rG) of PTSD were quite discrepant for the alcohol use and AUD factors. This was true when modeled as a three-correlated-factor model (PTSD-AUD rG:.36, p < .001; PTSD-alcohol use rG: -0.17, p < .001) and as a Bifactor model, in which the common and unique portions of alcohol phenotypes were pulled out into an AUD-specific factor (rG with PTSD:.40, p < .001), AU-specific factor (rG with PTSD: -0.57, p < .001), and a common alcohol factor (rG with PTSD:.16, NS).

PRINCIPAL CONCLUSIONS: These results indicate the genetic architecture of alcohol use and AUD are differentially associated with PTSD. When the portions of variance unique to alcohol use and AUD are extracted, their genetic associations with PTSD vary substantially, suggesting different genetic architectures of alcohol phenotypes in people with PTSD.

PMID:35367939 | DOI:10.1016/j.drugalcdep.2022.109430

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Nevin Manimala Statistics

Exploring Network Properties Across Preclinical Stages of Alzheimer’s Disease Using a Visual Short-Term Memory and Attention Task with High-Density Electroencephalography: A Brain-Connectome Neurophysiological Study

J Alzheimers Dis. 2022 Apr 1. doi: 10.3233/JAD-215421. Online ahead of print.

ABSTRACT

BACKGROUND: Visual short-term memory (VSTMT) and visual attention (VAT) exhibit decline in the Alzheimer’s disease (AD) continuum; however, network disruption in preclinical stages is scarcely explored.

OBJECTIVE: To advance our knowledge about brain networks in AD and discover connectivity alterations during VSTMT and VAT.

METHODS: Twelve participants with AD, 23 with mild cognitive impairment (MCI), 17 with subjective cognitive decline (SCD), and 21 healthy controls (HC) were examined using a neuropsychological battery at baseline and follow-up (three years). At baseline, the subjects were examined using high density electroencephalography while performing a VSTMT and VAT. For exploring network organization, we constructed weighted undirected networks and examined clustering coefficient, strength, and betweenness centrality from occipito-parietal regions.

RESULTS: One-way ANOVA and pair-wise t-test comparisons showed statistically significant differences in HC compared to SCD (t (36) = 2.43, p = 0.026), MCI (t (42) = 2.34, p = 0.024), and AD group (t (31) = 3.58, p = 0.001) in Clustering Coefficient. Also with regards to Strength, higher values for HC compared to SCD (t (36) = 2.45, p = 0.019), MCI (t (42) = 2.41, p = 0.020), and AD group (t (31) = 3.58, p = 0.001) were found. Follow-up neuropsychological assessment revealed converge of 65% of the SCD group to MCI. Moreover, SCD who were converted to MCI showed significant lower values in all network metrics compared to the SCD that remained stable.

CONCLUSION: The present findings reveal that SCD exhibits network disorganization during visual encoding and retrieval with intermediate values between MCI and HC.

PMID:35367964 | DOI:10.3233/JAD-215421

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Association between greenspace and lung function in Italian children-adolescents

Int J Hyg Environ Health. 2022 Mar 31;242:113947. doi: 10.1016/j.ijheh.2022.113947. Online ahead of print.

ABSTRACT

BACKGROUND: Few studies have examined the impact of urban greenspace exposure on lung function in children-adolescents, and the available evidence is still inconsistent. The aim of the current study was to verify the hypothesis that the effects of greenspace exposure vary with differing levels of lung function of children-adolescents.

METHODS: Between November 2005 and May 2006, 2150 children-adolescents (age-range: 10-15 years) living in the city of Palermo were enrolled in a cross-sectional survey. Parents were interviewed through a modified version of the Italian Studies on Respiratory Disorders in Children and the Environment (SIDRIA) questionnaire. All children-adolescents performed spirometry and were tested for allergic sensitization. Exposures to greenspace and grey space at the home addresses were measured using the CORINE land-cover classes. Parametric quantile regression models were applied for assessing the association between greenspace exposure and spirometry parameters, accounting for possible confounders and effect modifiers. A p-value lower than 0.05 was considered statistically significant.

RESULTS: From the 1st to the 21st percentile, children-adolescents living within greenspace had higher FEV1 than those living within grey space. In particular, the estimated effects were: 1st (β = 0.238 L, p = 0.01), 5th (β = 0.140 L, p = 0.01), 10th (β = 0.097 L, p = 0.015), and 15th (β = 0.073 L, p = 0.025). Similarly, from the 1st to the 29th percentile, children-adolescents living within greenspace had higher FVC than those living within grey space. In particular, the estimated effects were: 1st (β = 0.367 L, p = 0.0003), 5th (β = 0.215 L, p = 0.0003), 10th (β = 0.150 L, p = 0.0004), and 15th (β = 0.112 L, p = 0.001). No significant associations were found for FEV1/FVC, FEF25-75 and FEF25-75/FVC.

CONCLUSION: Quantile regression techniques may provide new insights into the evaluation of the association between greenspace exposure and lung function in children-adolescents, showing substantially heterogeneous effects from lower to higher quantiles of spirometry parameters. These results may help implementing policies for planning sustainable housing and surrounding greenspaces.

PMID:35367927 | DOI:10.1016/j.ijheh.2022.113947

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Nevin Manimala Statistics

Prevalence of psychological comorbidities in bone infection

J Psychosom Res. 2022 Mar 31;157:110806. doi: 10.1016/j.jpsychores.2022.110806. Online ahead of print.

ABSTRACT

OBJECTIVE: Bone infections represent a major complication in orthopedic and trauma surgery. Concomitant psychological disorders can significantly influence treatment outcomes. However, these are often overlooked. Therefore, we aimed to determine the nationwide epidemiology of fracture-related infection (FRI) and osteomyelitis in combination with psychological comorbidities.

METHODS: A dataset provided by the Federal Statistical Office (Destatis) consisting of annual, Germany-wide ICD-10 diagnosis codes from 2009 to 2019 was analysed. Incidences of the codes “T84.6, infection and inflammatory reaction due to internal fixation device” and “M86.-, osteomyelitis” were quantified. Proportions of secondary diagnoses of the chapter F of the ICD-10 were determined.

RESULTS: Incidences were 19.1/100,000 inhabitants for osteomyelitis and 10.5/100,000 inhabitants for FRI. Patients with psychological comorbidities constituted 14.6% of osteomyelitis cases and 26.5% of FRI cases, respectively. Between 2009 through 2019, the proportion of patients with a concomitant “F” diagnoses of the ICD-10 increased by 27.3% for osteomyelitis and by 24.1% for FRI. Most prevalent secondary diagnoses were organic, including symptomatic, mental disorders (F0), affective disorder (F3) and mental and behavioral disorders due to psychoactive substance use (F1), whereby the latter decreased over the years.

CONCLUSION: The implementation of prevention strategies, interdisciplinary approaches and psychological support in orthopaedics and trauma surgery is warranted.

PMID:35367917 | DOI:10.1016/j.jpsychores.2022.110806

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Cancer Related Mortality in Port Harcourt, Southern Nigeria

West Afr J Med. 2022 Mar 30;39(3):237-240.

ABSTRACT

BACKGROUND: Globally, cancer is a leading cause of death and source of resistance to increasing life expectancy. In 2019, the World Health Organisation estimated cancer as the first or second leading cause of death before the age of 70 in 112 countries and third or fourth in 23 other countries. Despite the fact that cancer has been recognized as a public health problem, there is paucity of data on cancer mortality in Nigeria. The aim of this study is to determine the pattern of cancer mortality at the University of Port Harcourt Teaching Hospital.

MATERIALS AND METHODS: This is a 5 year retrospective study of all cancer related deaths at the University of Port Harcourt Teaching Hospital from 1st January, 2014 to 31st December, 2018. Relevant data were extracted and analyzed using Statistical Package for Social Sciences version 24.

RESULTS: There were 4449 deaths during the period under review, of which 293 were cancer related deaths, giving a mortality rate of 6.59%. There were 114 males and 179 females giving a male to female ratio of 1:1.6. Cancer of the breast was the most common cause of cancer death and accounted for 61 (20.8%) deaths within the study period.

CONCLUSION: Cancer is a major cause of mortality in Nigeria. Cancer of the breast is the leading cause of cancer mortality in females and overall while cancer of the prostate remains the commonest in men.

PMID:35366667

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A Comparison of Two Regimens for Post-Caesarean Section Analgesia in a Tertiary Health Centre in Northern Nigeria

West Afr J Med. 2022 Mar 30;39(3):217-222.

ABSTRACT

BACKGROUND: Post-caesarean section pain is a problem i n our environment. Though many modalities for pain management exist, there is the need to investigate safer and affordable regimens that will provide adequate analgesia with minimal side effects and with ease of administration. Alternating doses of intramuscular acetaminophen and intramuscular pentazocine was studied as an alternative to provide safe and effective post-caesarean section analgesia. Its effectiveness and side effect profile in our environment have not been previously investigated.

AIMS AND OBJECTIVES: The study aimed to compare the analgesic and side effect profile of intramuscular pentazocine with another regimen involving alternating doses of pentazocine and acetaminophen within the first 48hours after surgery.

DESIGN OF THE STUDY: This was a prospective, comparative and randomized study among 142 women who voluntarily consented to the study and had elective caesarean section from May 2014 to May 2015 at the Ahmadu Bello University Teaching Hospital, Zaria. Setting: The Study was conducted at the obstetrics and gynecology department of the teaching hospital of Ahmadu Bello University, Zaria.

MATERIALS AND METHODS: Consecutive eligible pregnant women who were slated for elective caesarean section were recruited at the antenatal clinic unit of the department and randomized using the WINPEPI software by Abramson to either receive intramuscular pentazocine or alternating doses of pentazocine and acetaminophen over the first 48hours after surgery. The pain scores, side effect profile and the time taken for the return of bowel sounds were compared among the two groups using relevant statistical methods with IBM SPSS version 20 with Z tests and chi-square to test for strength of relationships of variables. The level of significance was 0.05.

RESULTS: The average age of the participants was 29.82years with standard deviation 6.138; 64.8% were Hausa-Fulani, 71.83% were Muslims, 45.07% were unemployed, 97.89% were married, 42.2% were multiparous, 59.86% booked in our centre and 59.2% were having their first caesarean section. Seventy-six participants received combination of injection pentazocine/acetaminophen while 66 received pentazocine injection alone. The drop-out rate was 8.5%. There was no statistically significant difference in the pain scores both on the visual analogue scale and the verbal rating scale in the first 48hours in both groups, no difference in the need for rescue analgesics (p=0.709), time taken for the return of bowel sounds (P=0.391), incidence of side effects (p=0.394) and participants’ level of satisfaction (p=0.255).

CONCLUSION: Both regimens were comparable in analgesic efficacy, incidence of side effects and satisfaction levels.

PMID:35366664

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The haemodynamic effects of umbilical cord milking in term infants: a randomised controlled trial

Singapore Med J. 2022 Apr 3. doi: 10.11622/smedj.2022041. Online ahead of print.

ABSTRACT

INTRODUCTION: Umbilical cord milking (UCM) is a method which allows for postnatal placental transfusion. Several benefits of this method have been demonstrated in studies. However, our knowledge about the haemodynamic effects of this method is limited among term infants. The aim of this study was to evaluate the haemodynamic effects of UCM in term infants.

METHODS: In this prospective randomised controlled study, 149 healthy term infants with a birth week of 37 weeks or more were randomised to either the UCM or immediate cord clamping (ICC) groups. Blinded echocardiographic evaluations were performed in all the neonates in the first 2 to 6 hours.

RESULTS: Superior vena cava (SVC) flow measurements were higher in the UCM group compared to the ICC group (132.47 ± 37.0 mL/kg/min vs. 126.62 ± 34.3 mL/kg/min), but this difference was not statistically significant. Left atrial diameter (12.23 ± 1.99 mm vs. 11.43 ± 1.78 mm) and left atrium-to-aorta diastolic diameter ratio (1.62 ± 0.24 vs. 1.51 ± 0.22) were significantly higher in the UCM group. There were no significant differences in other echocardiographic parameters between the UCM and ICC groups.

PMID:35366660 | DOI:10.11622/smedj.2022041