Tag: nevin manimala

Br J Neurosurg. 2021 Dec 23:1-8. doi: 10.1080/02688697.2021.2019677. Online ahead of print.

ABSTRACT

PURPOSE: Due to brain shift during bilateral deep brain stimulation (DBS) surgery, placement of the second electrode may be subjected to more error than that of the first electrode. The authors aimed to investigate the accuracy of second electrode placement in this setting.

MATERIALS AND METHODS: Fifty-five patients with Parkinson’s disease who underwent bilateral DBS surgery (110 electrodes) were retrospectively evaluated. The targets were subthalamic nucleus (STN) and globus pallidus interna (GPi) in 40 and 15 cases, respectively. Preoperative planning and postoperative electrode images were co-registered to compare the error margin between the two sides.

RESULTS: There is a statistically significant difference in the directional axis error along the y axis only when comparing each laterality (posterior 0.04 ± 1.21 mm vs anterior 0.41 ± 1.07 mm, p = 0.006). There is no significant difference of other error parameters, final track location, and number of microelectrode recording passes between the two sides. In a subgroup analysis, there is a significant difference in directional axis error along the y axis only in the STN subgroup (posterior 0.40 ± 1.05 mm vs anterior 0.18 ± 1.04 mm, p = 0.003).

CONCLUSION: Although a statistically significant difference in directional axis error along the y axis was found between first and second electrode placements in the STN group but not in the GPi group, its magnitude is well below the clinically significant threshold.

PMID:34939521 | DOI:10.1080/02688697.2021.2019677

Orbit. 2021 Dec 23:1-7. doi: 10.1080/01676830.2021.2002368. Online ahead of print.

ABSTRACT

PURPOSE: To report the microbiologic profile and antibiotic susceptibility trends in orbital cellulitis.

METHODS: Retrospective review of microbiology records of orbital cellulitis between 2005 and 2019. Orbital pus or conjunctival swab underwent culture for bacteria and fungi and antibiotic susceptibility testing for bacterial isolates. The microbiological profile and trends in antibiotic susceptibility were analyzed over the three study periods: 2005-2009, 2010-2014, and 2015-2019.

RESULTS: Of the 203 patient samples, 189 (93%) were orbital pus samples, and 146 (72%) were culture positive. Organisms included bacteria (167/203, 82.3%), fungi (13/203, 6.4%), and mixed infection (25/203, 10.3%). Among bacteria, 79% were gram positive, with Staphylococcus aureus and Streptococcus species being commonest, and 21% were gram negative, with Pseudomonas aeruginosa and Enterobacteriaceae group being the commonest. Aspergillus flavus was the most common fungus isolated. Trend analysis revealed no change in the number of sterile cases and fungal cellulitis. Increase in gram positive bacteria was statistically significant (p = .0002) between 2005-2009 and 2015-2019. The increase in gram negative bacteria was statistically significant (p = .047) between all three time periods. Susceptibility patterns showed increasing trend of resistance to fluoroquinolones, that reached statistical significance for Ciprofloxacin, Moxifloxacin and Gatifloxacin (p < .05). Sterile sample was not found in any of the pediatric (0-16 years) cases (n = 55), compared to 28% in adults.

CONCLUSION: There was a significant rise in gram positive and negative orbital infections over the 15 year period, with increased resistance to fluoroquinolones. Fungal cellulitis and sterile samples showed a steady trend. Orbital aspirate provides accurate detection of the causative organism.

PMID:34939530 | DOI:10.1080/01676830.2021.2002368

J Intensive Care Med. 2021 Dec 23:8850666211067509. doi: 10.1177/08850666211067509. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether surge conditions were associated with increased mortality.

DESIGN: Multicenter cohort study.

SETTING: U.S. ICUs participating in STOP-COVID.

PATIENTS: Consecutive adults with COVID-19 admitted to participating ICUs between March 4 and July 1, 2020.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: The main outcome was 28-day in-hospital mortality. To assess the association between admission to an ICU during a surge period and mortality, we used two different strategies: (1) an inverse probability weighted difference-in-differences model limited to appropriately matched surge and non-surge patients and (2) a meta-regression of 50 multivariable difference-in-differences models (each based on sets of randomly matched surge- and non-surge hospitals). In the first analysis, we considered a single surge period for the cohort (March 23 – May 6). In the second, each surge hospital had its own surge period (which was compared to the same time periods in matched non-surge hospitals).Our cohort consisted of 4342 ICU patients (average age 60.8 [sd 14.8], 63.5% men) in 53 U.S. hospitals. Of these, 13 hospitals encountered surge conditions. In analysis 1, the increase in mortality seen during surge was not statistically significant (odds ratio [95% CI]: 1.30 [0.47-3.58], p = .6). In analysis 2, surge was associated with an increased odds of death (odds ratio 1.39 [95% CI, 1.34-1.43], p < .001).

CONCLUSIONS: Admission to an ICU with COVID-19 in a hospital that is experiencing surge conditions may be associated with an increased odds of death. Given the high incidence of COVID-19, such increases would translate into substantial excess mortality.

PMID:34939474 | DOI:10.1177/08850666211067509

Perfusion. 2021 Dec 23:2676591211063830. doi: 10.1177/02676591211063830. Online ahead of print.

ABSTRACT

PURPOSE: The primary aim of this study was to examine the effects of two oxygenator systems on major adverse events and mortality.

METHODS: A total of 181 consecutive patients undergoing coronary artery bypass grafting in our clinic were retrospectively analyzed. The patients were divided into two groups according to the oxygenator used: Group M, in which a Medtronic Affinity (Medtronic Operational Headquarters, Minneapolis, MN, USA) oxygenator was used, and Group S, in which a Sorin Inspire (Sorin Group Italia, Mirandola, Italy) oxygenator was used.

RESULTS: Group S consisted of 89 patients, whereas Group M included 92 patients. No statistically significant differences were found between the two groups in terms of age (p = .112), weight (p = .465), body surface area (p = .956), or gender (p = .484). There was no statistically significant difference in hemorrhage on the first or second postoperative day (p = .318 and p = .455, respectively). No statistically significant differences were observed in terms of red blood cell (p = .468), fresh frozen plasma (p = .116), or platelet concentrate transfusion (p = .212). Infections, wound complications, and delayed sternal closure were significantly more common in Group M (p = .006, p = .023, and p = .019, respectively). Extracorporeal membrane oxygenators and intra-aortic balloon pumps were required significantly more frequently in Group S (p = .025 and p = .013, respectively). Major adverse events occurred in 16 (18%) patients in Group S and 14 (15.2%) patients in Group M (p = .382). Mortality was observed in six (6.7%) patients in Group S and three (3.3%) patients in Group M (p = .232). No statistically significant difference was found between the two groups in terms of length of hospital stay (p = .451).

CONCLUSION: The clinical outcomes of the two oxygenator systems, including mortality, major adverse events, hemorrhage, erythrocyte and platelet transfusions, and length of hospital stay, were similar.

PMID:34939512 | DOI:10.1177/02676591211063830

Sci Prog. 2021 Oct;104(4):368504211059976. doi: 10.1177/00368504211059976.

ABSTRACT

BACKGROUND: This study aims to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) for the articular-sided partial-thickness rotator cuff tear (PTRCT).

METHODS: Three electronic databases, PubMed/Medline, Embase and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting articular-sided PTRCTs. The pooled statistical indexes included sensitivity, specificity, positive/negative predictive value, diagnostic odds ratio (DOR) and the area under the receiver operating characteristic curve (AUC).

RESULTS: Eleven studies involving 1703 patients and 1704 shoulders were included. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRA to diagnose articular-sided PTRCTs were 0.81 (95% CI, 0.65-0.90), 0.96 (95% CI, 0.91-0.98), 68.14 (95% CI, 33.20-139.84) and 0.96 (95% CI, 0.94-0.97), respectively. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRI were 0.78 (95% CI, 0.65-0.87) and 0.97 (95% CI, 0.84-0.99), 47.82 (95% CI, 8.29-275.89) and 0.89 (95% CI, 0.86-0.92), respectively.

CONCLUSIONS: This meta-analysis reveals that MRA has a better diagnostic value than that of MRI for the diagnosis of articular-sided partial-thickness rotator cuff tears because of an improvement of sensitivity.

PMID:34939473 | DOI:10.1177/00368504211059976

Trends Hear. 2021 Jan-Dec;25:23312165211065608. doi: 10.1177/23312165211065608.

ABSTRACT

Sound textures are a broad class of sounds defined by their homogeneous temporal structure. It has been suggested that sound texture perception is mediated by time-averaged summary statistics measured from early stages of the auditory system. The ability of young normal-hearing (NH) listeners to identify synthetic sound textures increases as the statistics of the synthetic texture approach those of its real-world counterpart. In sound texture discrimination, young NH listeners utilize the fine temporal stimulus information for short-duration stimuli, whereas they switch to a time-averaged statistical representation as the stimulus’ duration increases. The present study investigated how younger and older listeners with a sensorineural hearing impairment perform in the corresponding texture identification and discrimination tasks in which the stimuli were amplified to compensate for the individual listeners’ loss of audibility. In both hearing impaired (HI) listeners and NH controls, sound texture identification performance increased as the number of statistics imposed during the synthesis stage increased, but hearing impairment was accompanied by a significant reduction in overall identification accuracy. Sound texture discrimination performance was measured across listener groups categorized by age and hearing loss. Sound texture discrimination performance was unaffected by hearing loss at all excerpt durations. The older listeners’ sound texture and exemplar discrimination performance decreased for signals of short excerpt duration, with older HI listeners performing better than older NH listeners. The results suggest that the time-averaged statistic representations of sound textures provide listeners with cues which are robust to the effects of age and sensorineural hearing loss.

PMID:34939472 | DOI:10.1177/23312165211065608

J Aging Health. 2021 Dec 23:8982643211059133. doi: 10.1177/08982643211059133. Online ahead of print.

ABSTRACT

OBJECTIVES: This study assessed the relationship between self-reported impairments of vision, hearing, and dual sensory impairment, and change in self-rated health/mortality status over a 5-year period.

METHODS: Data came from the National Health and Aging Trends Study, a nationally representative survey of Medicare beneficiaries ages 65 and older. Analyses consisted of a series of ordinal logistic regressions stratified by sex.

RESULTS: For both women and men, self-reported sensory impairments were not statistical predictors of self-rated health/mortality, when other dimensions of health, such as physical functioning, participation, and activities of daily living functioning were included in models.

DISCUSSION: Understanding how self-reported sensory impairments impact self-rated health could assist in targeting rehabilitation strategies to older adults who experience sensory impairments.

PMID:34939470 | DOI:10.1177/08982643211059133

Eur J Dent. 2021 Dec 22. doi: 10.1055/s-0041-1739441. Online ahead of print.

ABSTRACT

This study sought to systematically review the literature to determine whether clear aligner treatment results in different patient perceptions of treatment process and outcomes compared with conventional fixed appliance treatment. A systematic review was conducted to identify studies that examined differences in patient perceptions between clear aligners and conventional fixed appliance treatment. Studies were identified through searching relevant terms using PubMed and Embase. Following review of identified articles, key information about the studies including study design, setting, comparison groups, sample size/response rate, study location, primary outcomes, and statistical tests used were extracted. A total of 13 articles were identified that met the inclusion criteria for this study. These studies described a variety of outcomes which were divided into two broad categories: treatment process (pain, chewing, speech, daily routine, etc.) and treatment outcomes (satisfaction level, smile outcome perceptions, etc.). There was the strongest evidence that clear aligners had a positive impact with respect to treatment process compared with fixed orthodontic appliances. This study highlights that clear aligners may be effective for improving treatment-process-related outcomes among orthodontic patients. More studies need to be conducted to determine whether clear aligners have a beneficial impact with respect to treatment outcomes.

PMID:34937109 | DOI:10.1055/s-0041-1739441

Eur J Dent. 2021 Dec 22. doi: 10.1055/s-0041-1735910. Online ahead of print.

ABSTRACT

OBJECTIVE: We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone.

MATERIALS AND METHODS: The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total n = 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura.

STATISTICAL ANALYSIS: For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05.

RESULTS: The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (p < 0.05), while for postoperative trismus, there was no statistically significant difference (p > 0.05) between the scores of Group A and Group B.

CONCLUSION: As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.

PMID:34937107 | DOI:10.1055/s-0041-1735910

Eur J Dent. 2021 Dec 22. doi: 10.1055/s-0041-1735934. Online ahead of print.

ABSTRACT

OBJECTIVE: This study evaluated the dynamic cyclic fatigue resistance of the XP-Endo Shaper (XPS), associated with chlorhexidine digluconate (CHX) or sodium hypochlorite (NaOCl) in two different formulations: gel (G) or liquid (L).

MATERIALS AND METHODS: Sixty XPS were used in an artificial stainless-steel canal, and the files were fully immersed in the irrigating solution throughout the experiment until the fracture. The files were divided into six groups (n = 10) based on the irrigation solution used: NaOCl(L), NaOCl(G), CHX(L), CHX(G), natrosol gel (NAT) (control), and lubricating oil (LO) (control). The artificial canal was manufactured 1.5 mm wide, 20 mm long, and, 3.5 mm deep with a straight cervical segment measuring 14.29 mm; an apical segment of 4.71 mm with 3 mm radius; and 90 degrees of curvature apical 1 mm long straight segment. Resistance to cyclic fatigue was determined by recording the number of cycles to fracture (NCF).

RESULTS: The CHX(G), CHX(L), and OIL (LO) groups showed no significant difference between them and presented longer time to fracture (p > 0.05). NaOCl(L) shows the lowest NCF without significant differences between NaOCl(G) and NAT. The NCF of the NaOCl(G) was statistically similar to the CHX(L) and statistically lower than the CHX(G) and OIL groups. NAT did not present a statistical difference of the NaOCl(L), NaOCl(G), and presented a significantly lower NCF than the CHX(G) (p < 0.01).

CONCLUSION: The use of CHX(G) resulted in increased cyclic fatigue resistance of the XPS instruments compared to NaOCl or LO.

PMID:34937108 | DOI:10.1055/s-0041-1735934