Tag: nevin manimala

J Knee Surg. 2022 Mar 3. doi: 10.1055/s-0042-1743230. Online ahead of print.

ABSTRACT

Total knee arthroplasty (TKA) in cases of complex deformity (e.g., ligamentous laxity, posttraumatic arthritis) may require prostheses with inherent varus-valgus stability greater than that of traditional posterior stabilized or cruciate-retaining implants. Here, we investigate the clinical and radiographic outcomes of TKA using a midlevel constraint (MLC) prosthesis. A retrospective review of 53 patients (62 knees) who underwent primary TKA with an MLC implant was performed. Short tibial stem extensions were utilized in 49 knees, and 13 knees received no stem extension. Mean follow-up time was 31.6 months (standard deviation [SD] = 10.0, range = 24-53). Preoperative and postoperative range of motion (ROM) were assessed. Plain radiographs were reviewed for alignment, radiolucent lines, component loosening, and osteolysis. Patients who developed postoperative arthrofibrosis underwent manipulation under anesthesia (MUA). Failure was defined as instability, component loosening, or need for revision surgery. Mean ROM significantly improved from 114.1 degrees (SD = 19.7 degrees) preoperatively to 123.5 degrees (SD = 12.2 degrees) at final follow-up (t = -3.43, p = 0.001). Thirty-seven knees initially presented with varus deformity (mean = 7.5 degrees, SD = 4.8 degrees), whereas 23 had valgus deformity (mean = 10.6 degrees, SD = 6.5 degrees), and 2 knees had neutral alignment. Following surgery, mean alignment was 4.3 degrees valgus (SD = 1.7 degrees, range = 0-8 degrees), representing a statistically significant improvement (t = 5.29, p < 0.001). Six patients (9.7%) developed arthrofibrosis requiring MUA, which was irrespective of baseline ROM (p = 0.92) and consistent with 12% incidence reported in the literature. There were no significant differences in postoperative ROM (t = 0.38, p = 0.71), alignment (t = -0.22, p = 0.83), or incidence of arthrofibrosis (χ² = 0.07, p = 0.79) between short-stemmed and nonstemmed implants. There was no radiographic evidence of radiolucent lines, component loosening, or osteolysis in any patients. No patients required revision surgery. Use of an MLC prosthesis with primary femoral component in TKA resulted in satisfactory clinical and radiographic results with no evidence of component loosening, osteolysis, instability, or need for revision at minimum 2-year follow-up.

PMID:35240717 | DOI:10.1055/s-0042-1743230

Am J Perinatol. 2022 Mar 3. doi: 10.1055/a-1787-6785. Online ahead of print.

ABSTRACT

OBJECTIVE: Approximately 2% of women who undergo CVS will subsequently undergo amniocentesis due to placental mosaicism or sampling/laboratory issues. Our objective was to compare obstetric outcomes in women who underwent both procedures with those who had CVS alone.

STUDY DESIGN: Retrospective case-control study of patients with singleton pregnancies undergoing invasive testing from 2010-2020. All women who underwent CVS followed by amniocentesis were compared to a control group who underwent CVS alone matched (2:1) for age and year of pregnancy. Women with pregnancy loss at <16 weeks were excluded from the control group. Pregnancies terminated for genetic abnormalities were excluded. Obstetric outcomes were compared between cases and controls. Student t test and Fisher’s exact test were used for statistical comparison.

RESULTS: During the study period 2539 women underwent CVS, and 66 (2.6%) subsequently underwent amniocentesis. The 66 cases were compared to 132 age-matched controls who underwent CVS alone. Mean maternal age was 36.8 ± 3.4-yrs, and 43% of women were nulliparous. Amniocentesis was performed due to sampling or laboratory issues in 33% of cases, placental mosaicism in 44%, and further diagnostic testing in 23%. There were no pregnancy losses or stillbirths in either group. Those who had two invasive procedures delivered at similar gestational ages and birthweights, and did not have higher rates of adverse outcomes compared to those who underwent CVS alone.

CONCLUSION: Patients considering CVS who are concerned about the possibility that a second invasive procedure could be required should be reassured that this does not appear to be associated with higher rates of adverse outcomes. Due to study size, we cannot exclude the possibility of small differences in uncommon outcomes, such as pregnancy loss or stillbirth.

PMID:35240697 | DOI:10.1055/a-1787-6785

Am J Perinatol. 2022 Mar 3. doi: 10.1055/a-1786-8688. Online ahead of print.

ABSTRACT

BACKGROUND: Safety and efficacy data on controlled hypothermia (CH) for neonates with moderate to severe hypoxic ischemic encephalopathy has been extrapolated to a subgroup of these patients who also require extracorporeal membrane oxygenation for refractory persistent pulmonary hypertension of the newborn (PPHN). However, safety data on the concomitant use of CH and ECMO are lacking.

METHODS: Single-center retrospective study of neonates ≥35 weeks’ gestation with refractory PPHN who required ECMO between 01/2010-12/2020. Study groups were divided into those receiving CH/ECMO versus ECMO only. Baseline characteristics, short-term outcomes, and brain magnetic resonance imaging (MRI) data were compared.

RESULTS: A total of 36 neonates who received ECMO for refractory PPHN were included. Of these, 44.4% (n=16) received CH/ECMO and 55.6% (n=20) ECMO only. Bleeding complications were more common in CH/ECMO group 50% (n=8) vs ECMO only 15% (n=3, p=0.023). T1 brain magnetic resonance imaging severity scores was higher in CH/ECMO group vs ECMO only group, however there were not statistically different in T2 and DWI scores. Functional status and survival to discharge were comparable between groups.

CONCLUSION: In our cohort, neonates who received CH/ECMO had higher bleeding complications than ECMO only group with comparable functional status and survival at discharge.

PMID:35240700 | DOI:10.1055/a-1786-8688

Audiol Neurootol. 2022 Mar 3:1-15. doi: 10.1159/000521963. Online ahead of print.

ABSTRACT

BACKGROUND: Audiovestibular symptoms during the acute stage have been reported in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while very few studies investigated the long-term audiovestibular manifestations of SARS-CoV-2.

OBJECTIVE: The objective of this study was to examine the occurrence of short- and long-term audiovestibular symptoms associated with SARS-CoV-2 infection.

METHOD: In this cross-sectional study, a questionnaire was distributed to severe hospitalized cases and nonhospitalized patients with mild disease, all with confirmed SARS-CoV-2 test results. Participants were inquired to report audiovestibular symptoms during the acute phase and at 6-month follow-up after contracting SARS-CoV-2.

RESULTS: A total of 301 participants completed the questionnaire. Auditory symptoms were reported by 21.9% and 1.99% of patients during the acute phase and 6 months post SARS-CoV-2 infection, respectively. During the acute phase of SARS-CoV-2 infection, aural fullness represents the most common symptoms (18.94%) followed by tinnitus (9.97%) and hearing loss (6.31%). Vestibular symptoms were reported by 34% during the acute phase; most commonly was dizziness (29.9%) followed by vertigo (24.25%) and unsteadiness (8.31%). Long-term and persistent vestibular problems were reported by 3.99% patients. There were no statistically significant differences in self-reported audiovestibular symptoms between patients with severe SARS-CoV-2 disease compared to those with mild disease.

CONCLUSION: The current study showed that audiovestibular symptoms are common among SARS-CoV-2 infected patients during the acute phase of the disease. However, these symptoms are mostly temporary and showed complete spontaneous recovery during the first 2 weeks postinfection.

PMID:35240596 | DOI:10.1159/000521963

J Craniofac Surg. 2022 Feb 28. doi: 10.1097/SCS.0000000000008579. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the frequency of signs and symptoms of temporomandibular disorders (TMD), surgical complications, and patient’s self-reported mental health problems during orthognathic treatment.

MATERIAL AND METHODS: The clinical records of 145 patients treated with orthognathic treatment were retrospectively studied. Variables regarding occlusal parameters, treatment duration, TMD symptoms, complications, and self-reported mental health status at time points of T0 (beginning of the treatment), T1 (before surgery), and T2 (final examination) were evaluated. The variables were statistically compared with significance level of P < 0.05.

RESULTS: A total of 51% (n = 74) of the patients had TMD symptoms at 1 or several time points, women having significantly more TMD signs and symptoms (P = 0.002). Temporomandibular disorder signs and symptoms decreased significantly after orthognathic treatment (P=0.001). At least 1 self-reported mental health-related factor during 1 or several time points (T0-T2) was recorded in 17.2% (n = 25) of the patients. There was no significant difference in frequency of self-reported mental health problems in patients with TMD signs and symptoms compared with patients without TMD signs and symptoms (P > 0.05). The frequency of postoperative complications was 39.3%, being significantly higher after Bilateral Sagittal Split Osteothomy (BSSO, 48.7%). There was no difference in treatment duration of patients with self-reported mental health problems compared with patients without (P > 0.05).

CONCLUSIONS: In this study population, TMD signs and symptoms seem to be typical both in patients with or without self-reported mental health problems. Women had significantly more TMD symptoms. Orthognathic surgery treatment seems to have a positive effect on TMD signs and symptoms.

PMID:35240673 | DOI:10.1097/SCS.0000000000008579

Int J Med Inform. 2022 Feb 26;161:104732. doi: 10.1016/j.ijmedinf.2022.104732. Online ahead of print.

ABSTRACT

BACKGROUND: Regenerative endodontic procedures (REPs) are one of the most important developments in dental practice, and in the era of Covid 19 pandemic, audio-visual contents of YouTube™ could be an information source for dental students, practitioners and patients. The aim of this study was to evaluate the quality, content and the demographics of YouTube™ videos about REPs.

METHODS: A search on YouTube™ was performed for REPs using “endodontic regeneration”, “pulp regeneration”, “regenerative endodontics”, “regenerative endodontic procedures”, “revascularization” and “revitalization” keywords. Totally 531 videos were found and 60 videos met the inclusion criteria. Following the assessment of the demographic features of the videos and the viewing rate of the videos were calculated. The content of the videos was evaluated based on the selected headings. The quality of the videos was assessed using the video information, quality index (VIQI), Global Quality Score (GQS) and DISCERN. The statistical analysis was performed using Spearman Correlation and linear regression analysis.

RESULTS: Majority of the videos about REPs were created by dental professionals (91.7%). The most commonly covered topic was “clinical application” (76.7%). Total content score showed a positive correlation with total VIQI (r = 0.795; p < 0.001) and GQS (r = 0.952; p < 0.001). There were significant relationships between total content score, duration, GQS, total VIQI score and DISCERN.

CONCLUSION: The findings revealed that YouTube™ videos about REPs provide predominantly clinical information about patient chairside practice of REPs and they could be considered as a supplementary information source for dental students and practitioners.

PMID:35240558 | DOI:10.1016/j.ijmedinf.2022.104732

Pathol Res Pract. 2022 Feb 26;232:153830. doi: 10.1016/j.prp.2022.153830. Online ahead of print.

ABSTRACT

PURPOSE: The gastrointestinal tract is home to a wide variety of neoplasms. Gastrointestinal adenocarcinomas display distinct prognostic patterns. With the advent of next generation sequencing, attempts are being made to delineate distinct molecular characteristics of these adenocarcinomas from adjoining anatomical sites.

METHODS: Thirty-seven cases of upper gastrointestinal adenocarcinomas including those of the esophagus, gastroesophageal junction, stomach, small intestine and gallbladder were retrieved. Next generation sequencing data consisting of base substitutions, copy number variations, indels and rearrangements, in 324 genes, were analyzed for recurrent genetic abnormalities. Statistical analysis was performed using IBM SPSS25 and SAS software.

RESULTS: Genetic alterations were found in 181 genes. APC mutations were found in 50% of the esophageal adenocarcinomas, 5% of the gastric adenocarcinomas and 33.3% of the small intestinal adenocarcinomas (p = 0.04). PIK3 gene family mutations were found in 10% of the gastric adenocarcinomas, 66% of the gall bladder adenocarcinomas and 66% of the small intestinal adenocarcinomas (p = 0.002). The mutations were found exclusively in the PIK3 class 1 family. TP53 mutations were more common in tumors with intact DNA mismatch repair protein expression as assessed by immunohistochemistry (p = 0.042).

CONCLUSION: In this study, APC gene mutations were found to be more frequent in esophageal and small intestinal adenocarcinomas than previously reported. PIK3 class 1 gene family mutations were found to be more frequent in gallbladder and small intestinal adenocarcinomas. An inverse relationship was found between TP53 mutations and loss of DNA mismatch repair protein expression.

PMID:35240548 | DOI:10.1016/j.prp.2022.153830

Gait Posture. 2022 Feb 23;94:39-44. doi: 10.1016/j.gaitpost.2022.02.023. Online ahead of print.

ABSTRACT

BACKGROUND: The stochastic resonance (SR) phenomenon has been used to improve postural control through the application of imperceptible noise to the somatosensory system. White noise signals have been applied in numerous SR studies on postural control. However, because the SR effect depends on the noise structure, the stimulation effects of signals with different structures, such as pink noise and chaotic signals, on postural control, must be determined to achieve better clinical applications of SR technology.

RESEARCH QUESTION: During quiet standing, how is postural control affected by subthreshold electrical stimulation to the knee joints when signals with different structures (white noise, pink noise, and chaotic signals) are used?

METHODS: Sixteen healthy young adults stood quietly for 40 s with their eyes closed. To evaluate postural sway, we calculated the mean velocity, root mean square (CoP_RMS), and range (CoP_Range) values for the center of pressure (CoP) in the anteroposterior direction. The standing task was conducted under subthreshold electrical stimulation with white noise, pink noise, and chaotic signals based on the Lorenz system, in addition to the no-stimulation condition. The four stimulation conditions were randomized within each set and repeated seven times.

RESULTS: Significant effects of stimulation were observed in the CoP_RMS and CoP_Range values. The CoP_RMS value under the pink noise signal was significantly lower than that under the no-stimulation condition. The CoP_Range value also tended to decrease under the pink noise signal compared with the no-stimulation condition; however, the differences were not statistically significant. No significant changes were found with the white noise and chaotic signals compared with the no-stimulation condition.

SIGNIFICANCE: We demonstrated that the pink noise signal was more effective in reducing postural sway than the white noise and chaotic signals based on the Lorenz system during quiet standing.

PMID:35240552 | DOI:10.1016/j.gaitpost.2022.02.023

Leg Med (Tokyo). 2022 Feb 25;56:102050. doi: 10.1016/j.legalmed.2022.102050. Online ahead of print.

ABSTRACT

This study evaluated the genetic variation of 17 autosomal short tandem repeat (STR) loci included in the PowerPlex® 18D Kit. Samples of 562 unrelated healthy Lahu individuals living in Yunnan Province in southwestern China were investigated. The data were analyzed to provide information on allele frequencies and other statistical parameters relevant to the forensic population. Of the 17 loci, 16 reached the Hardy-Weinberg equilibrium after Bonferroni correction. A total of 176 alleles were identified in 17 STR loci, and allele frequencies ranged from 0.000890 to 0.578292. The combined discrimination power (CPD) and probability of excluding paternity (CPE) of the 17 STR loci were 0.999999999999999999489 and 0.999998301753122. The genetic relationships among 28 populations were also estimated.

PMID:35240543 | DOI:10.1016/j.legalmed.2022.102050

J Vet Cardiol. 2022 Feb 2;41:44-56. doi: 10.1016/j.jvc.2022.01.005. Online ahead of print.

ABSTRACT

INTRODUCTION/OBJECTIVES: Minimal information exists regarding epicardial pacemaker (EP) implantation in pet ferrets (Mustela putorius furo). The objectives were to describe the indications, surgical technique, and outcome of EP implantation in ferrets for the treatment of advanced atrioventricular block (AVB).

ANIMALS, MATERIALS, AND METHODS: Eight client-owned ferrets presenting to five veterinary referral centers. Signalment, physical exam findings, diagnostic tests, anesthesia protocols, surgical implantation techniques, postoperative treatment plans, and EP interrogations were reviewed. Intra- and postoperative, minor and major, and EP-related complications were established. Descriptive statistics were performed to report complication rates. Survival analyses were performed.

RESULTS: All ferrets had advanced AVB: 3/8 had high-grade second-degree and 5/8 had third-degree. The primary clinical signs were collapse and weakness. Seven EP were implanted via a transdiaphragmatic approach and one via a left intercostal thoracotomy. Intraoperative complications occurred in 2/8 ferrets, both major. One ferret with severe comorbidities died during general anesthesia. Postoperative pacemaker-related complications were minor: inappropriate sinus beat sensing in 2/8 and occasional muscle fasciculations in 1/8. Two ferrets were alive at the time of manuscript submission, at 10 and 21 months postoperatively. The overall median survival time was 24 months.

CONCLUSIONS: Implantation of EP was performed successfully in most ferrets for treatment of advanced AVB and was well tolerated. Ferrets with advanced AVB may experience resolution of clinical signs associated with their cardiac disease following EP implantation. Additional studies are warranted to investigate the effects of epicardial pacing on survival times in this species.

PMID:35240454 | DOI:10.1016/j.jvc.2022.01.005