Tag: nevin manimala

J Clin Ultrasound. 2021 Sep 7. doi: 10.1002/jcu.23062. Online ahead of print.

ABSTRACT

PURPOSE: Despite continued efforts, a majority of patients with valvular heart disease (VHD) remain undiagnosed and untreated. This study aimed to assess the adoptability and accuracy of point-of-care handheld echocardiographic assessments (POCE) in the primary care setting.

METHODS: Eleven previously untrained primary care providers were trained to use the Vscan Extend (GE, WI) POCE to assess VHD, left ventricular function (LVEF), and major extra-cardiac findings. Their assessments were compared to those of three blinded expert readers. A total of 175 patients underwent POCE assessments which were evaluated using Kappa statistics (κ) together with their estimated standard error, p value, and 95% CI bounds.

RESULTS: Each patient had a mean of 3.3 ± 1.1 (±SD) assessments performed. Identical or nearly identical agreement between previously untrained primary providers and expert readers was evident for the diagnosis of tricuspid regurgitation, mitral regurgitation, pericardial effusion, and volume status. These agreements were strongest in apical long axis (κ = 1, p < 0.001) and parasternal long and short axis views (κ > =0.82 p < 0.001), though agreement remained robust in apical 4-chamber views (κ ≥ 0.76). The agreements in LVEF assessment were identical in the apical long axis view (κ = 1, p < 0.001) and robust in the remaining 3 views (κ > =0.66, p < 0.001). The assessments of aortic stenosis (parasternal/long, κ = 0.42, and parasternal/short, κ = 0.47, both p < 0.001) were weak in their agreement.

CONCLUSION: Compared to expert echocardiography readers, the untrained providers’ use of POCE for VHD shows high user adoptability and diagnostic accuracies in the primary care setting.

PMID:34818437 | DOI:10.1002/jcu.23062

Acta Cir Bras. 2021 Oct 25;36(9):e360902. doi: 10.1590/ACB360902. eCollection 2021.

ABSTRACT

PURPOSE: To investigate experimentally the effects of Tropifexor, a farnesoid X receptor agonist, on liver injury in rats with obstructive jaundice.

METHODS: Forty healthy Wistar albino female rats were divided randomly in selected groups. These groups were the sham group, control group, vehicle solution group, Ursodeoxycholic acid group and Tropifexor group. Experimental obstructive jaundice was created in all groups, except the sham one. In the blood samples obtained, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total bilirubin and direct bilirubin levels were established and recorded. Additionally, liver malondialdehyde, myeloperoxidase and catalase enzyme activity in the tissue samples were studied. Histopathological analysis was also performed.

RESULTS: No statistical difference was found between the control group and the Tropifexor group when AST, ALT and ALP values were compared. However, it was found that the Tropifexor group had statistically significant decreases in the values of GGT, total bilirubin and direct bilirubin (p < 0.05). Additionally, Tropifexor decreased the median values of malondialdehyde and myeloperoxidase, but this difference was not statistically significant compared to the control group. Finally, the Tropifexor group was statistically significant in recurring histopathological liver damage indicators (p < 0.05).

CONCLUSIONS: Tropifexor reduced liver damage due to obstructive jaundice.

PMID:34818403 | DOI:10.1590/ACB360902

Int J Periodontics Restorative Dent. 2021 Nov-Dec;41(6):e243-e253. doi: 10.11607/prd.4707.

ABSTRACT

This study evaluated long-term clinical and patient satisfaction outcomes following a modified lip repositioning technique that utilized periosteal sutures in a twin population. Twin sisters diagnosed with maxillary lip hypermobility were randomly assigned to either the control group (original LipStaT technique) or test group (addition of periosteal sutures). The participants (n = 12; 6 per group) were evaluated at intervals for up to 3 years postoperative. Clinical measurements, digital images, and patient satisfaction surveys were collected. Descriptive statistics were used to assess outcome variables: average lip width at rest (ALW), vertical lip translation (VLT), and average gingival display (AGD). Student t test, one-way analysis of variance, and Spearman rank correlation tests were used to compare mean values of variables at five time points for both groups. The level of significance was α = .05. In the control group, mean VLT and AGD values showed statistically significant decreases from baseline (14.8 mm and 7.0 mm, respectively) to 2 years (5.7 mm and 2.4 mm, respectively), but a slight increase was seen at 3 years (7.5 mm and 5.0 mm, respectively; P < .0001). In the test group, mean VLT and AGD values showed statistically significant decreases from baseline (14.8 mm and 6.9 mm, respectively) to 3 years (5.5 mm and 3.5 mm, respectively; P < .0001). A higher participant satisfaction score at 3-year follow-up was observed in the test group. The modified lip repositioning technique in a population of twins resulted in more stable outcomes that lasted up to 3 years postoperatively.

PMID:34818391 | DOI:10.11607/prd.4707

Int J Periodontics Restorative Dent. 2021 Nov-Dec;41(6):895-900. doi: 10.11607/prd.5039.

ABSTRACT

This study aimed to determine the impact of implant placement depth (bone-level [BL] and subcrestal [SC]) on soft-tissue inflammatory parameters bleeding on probing (BOP), probing depth (PD), and crestal bone resorption (CBR) in moderate cigarette-smokers and nonsmokers at 5 years postplacement. Patient details were recorded, including sex, age, smoking history, duration of implants in function, implant arch location, and daily toothbrushing and flossing habits. Peri-implant BOP, PD, and CBR were measured in all groups, and group comparisons were done; a probability score < .05 was selected as a value for statistical significance. Fifty-three patients (27 smokers, 26 nonsmokers) had BL implants, and 55 patients (28 smokers, 27 nonsmokers) had SC implants. Among all patients, PD was higher in smokers than nonsmokers (P < .05). The peri-implant sites that demonstrated BOP were higher (P < .05) in nonsmokers than smokers. Among smokers, the CBR was higher in those with BL implants than those with SC implants (P < .05). Among nonsmokers, there was a difference in BOP, PD, and CBR at the 5-year follow-up. At 5 years, SC implants demonstrated less CBR than BL implants. Peri-implant PD is higher in smokers than nonsmokers, irrespective of the implant placement depth.

PMID:34818397 | DOI:10.11607/prd.5039

Int J Periodontics Restorative Dent. 2021 Nov-Dec;41(6):e233-e242. doi: 10.11607/prd.4819.

ABSTRACT

This retrospective study compares clinical and radiographic results of implants with and without a laser-microtextured collar placed in patients with a past history of periodontitis after 10 years of follow-up. A total of 57 implants (29 implants with laser-microtextured collar, 28 implants with a smooth collar) were placed in 35 patients. After 10 years of follow up, the survival rates (SRs) were 87.9% and 84.8% for implants with and without a laser-microtextured collar, respectively. No statistically significant differences (P > .05) were found between groups in terms of full-mouth plaque and bleeding scores. However, a statistically significant difference (P < .05) was recorded in terms of probing depth (PD) and marginal bone loss (mBL). Within the limitations of this study, implants with a laser-microtextured collar and implants with a smooth collar placed in patients with a past history of periodontitis yielded no statistically significant differences in SRs after 10 years of follow-up. However, implants with a laser-microtextured collar showed lower PD and mBL compared to implants with a smooth collar.

PMID:34818389 | DOI:10.11607/prd.4819

Addiction. 2021 Nov 24. doi: 10.1111/add.15755. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Many nations have provisions for involuntary treatment of alcohol dependence where the person is at serious risk of harm to themselves. To date, there has been little thorough evaluation of its effectiveness. This study aimed to determine if there were differences between involuntary and voluntary treatment for alcohol dependence on subsequent emergency and hospital care.

DESIGN: A retrospective cohort design using linked routinely collected administrative data on health care utilisation.

SETTING: Hospital and community-based alcohol treatment, New South Wales, Australia.

PARTICIPANTS: 231 patients who were involuntarily treated for alcohol dependence, and 231 matched controls who received treatment as usual within the period May 2012 to April 2018.

INTERVENTION AND COMPARATOR: Involuntary treatment comprised a 28-day mandated hospital admission which included supervised withdrawal, comprehensive assessment, rehabilitation and support followed by voluntary aftercare support for up to 6 months. Treatment as usual comprised three not mutually exclusive forms of intensive voluntary alcohol treatment: withdrawal management, rehabilitation, and pharmacotherapies for alcohol dependence.

MEASUREMENTS: Outcome measures: changes in the number of emergency department (ED) visits and number of unplanned hospital admissions 12 months before and 12 months after completion of index treatment.

FINDINGS: Both groups showed a reduction in ED visits (Incidence Rate Ratio (IRR)=0.56, 95% Credible Intervals (CrI) 0.39-0.78) and unplanned hospital admissions (IRR=0.49, 95% CrI 0.37-0.65). There was no statistically significant difference between the two groups (IRR=0.77, 95% CrI: 0.58 – 1.03 for ED visits and IRR= 0.79, 95% CrI: 0.62-1.01 for hospital admissions). The Bayes factors were 0.925 and 0.936 for ED visits and unplanned hospital admissions, respectively, interpreted as weak evidence in support of the null hypothesis of no difference between the interventions.

CONCLUSIONS: Involuntary treatment of alcohol dependence was associated with reduced health service utilisation in the year following treatment, and the outcomes did not differ from those of a matched control group.

PMID:34817096 | DOI:10.1111/add.15755

Laryngoscope. 2021 Nov 24. doi: 10.1002/lary.29958. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: Evaluation of the clinical outcomes after 6 months of treatment with a novel adjustable implant, the APrevent® Vocal-Implant-System (VOIS), in conjunction with medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis.

STUDY DESIGN: Prospective case series study at single tertiary referral center.

METHODS: Preoperative and 1 week, 7 weeks, and 6 months postoperative glottal efficiency (maximum phonation time [MPT]), voice quality (including GRBAS-scores and acoustic parameters) and self-perceived voice-related handicap (voice handicap index [VHI-30]) were measured and analyzed, whereas type of vocal fold closure was evaluated and determined by flexible videolaryngoscopy based on Södersten and Lindestad classification (Wilcoxon signed-rank test).

RESULTS: Thirteen patients underwent MT with VOIS under local anesthesia. Six months after surgery, the VHI-30 and MPT had improved from a preoperative mean of 75.0 ± 22.9 and 2.7 ± 2.1 s to a postoperative mean of 20.6 ± 19.7 and 6.3 ± 4.0 s, respectively. The mean GRBAS score improved from preoperative scores of G_preop = 2.7, R_preop = 2.6, B_preop = 2.6, A_preop = 2.2, and S_preop = 2.0 to G_postop = 0.3, R_postop = 0.3, B_postop = 0.2, A_postop = 0.2, and S_postop = 0.3 at 6 months postoperatively. Improved glottal closure was achieved in all patients (n = 13). Five patients received postoperative adjustment for the optimization of voice quality and glottal closure. No intra- or postoperative complications were observed. Significant improvements in acoustic parameters, including percentage jitter, percentage shimmer, and signal-to-noise ratio, were also observed after MT. All results were statistically significant (P < .05, Cohen’s d > .8).

CONCLUSIONS: APrevent® VOIS-Implantation is a safe procedure with good voice outcomes. Postoperative adjustments can be performed smoothly to optimize voice quality and glottal closure.

LEVEL OF EVIDENCE: III Laryngoscope, 2021.

PMID:34817072 | DOI:10.1002/lary.29958

Clin Endocrinol (Oxf). 2021 Nov 24. doi: 10.1111/cen.14641. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this cross-sectional study was to comprehensively assess bone health in women with prior gestational diabetes mellitus, including bone microarchitecture (TBS), bone mineral density (BMD, DXA) and bone turnover (osteocalcin).

DESIGN, PATIENTS AND MEASUREMENTS: Study participants underwent a detailed anthropometric, biochemical and hormone assessment, including insulin and osteocalcin measurement. BMD was measured at lumbar spine, femur neck and total hip using DXA and TBS derived from lumbar spine DXA images using TBS iNsight software.

RESULTS: A total of 240 women (mean age: 33.3 ± 5.0 years; median postpartum duration: 34 [interquartile range 13.0-54.5] months were evaluated. At the current visit, 115 (47.9%) and 36 (15%) women had prediabetes and diabetes, respectively. Women with dysglycemia (diabetes/prediabetes) had a higher BMD at all three sites, compared to those with normoglycemia; however, the difference was not statistically significant. Women with dysglycemia had a significantly lower TBS (1.32 ± 0.09 vs. 1.35 ± 0.09; p = .038). In the fully adjusted model, the odds ratio for association between diabetes and low TBS was 2.92 (95% confidence interval: 1.20, 7.08; p = .018). Women with dysglycemia had significantly lower serum osteocalcin levels (18.6 ± 8.5 ng/ml vs. 21.5 ± 9.7 ng/ml; p = .018). HOMA-IR (r = -.285, p < .001) was negatively correlated, while Matsuda index (r = .274, p < .001) and disposition index (r = .159, p = .016) were positively correlated with serum osteocalcin levels.

CONCLUSIONS: Bone health is affected early in the natural history of diabetes and is associated with an overall low bone turnover state.

PMID:34817083 | DOI:10.1111/cen.14641

Int Endod J. 2021 Nov 24. doi: 10.1111/iej.13668. Online ahead of print.

ABSTRACT

AIM: To identify the top 100 most-cited case reports and case series published in Endodontic journals and to analyse their bibliometric characteristics.

METHODOLOGY: The Clarivate Analytics’ Web of Science (WoS), Scopus, and PubMed databases were used to identify the top 100 most-cited case reports and case series in Endodontic journals. Complete bibliographic records of the selected case reports and case series were exported in plain text or BibTeX format and imported into the R environment for statistical computing and graphics. The following parameters were then analysed: names and affiliations of the authors, title, year of publication, journal of publication, first author, corresponding author, literature cited within reports, language, citation counts, impact factor of the journal, keywords, Keywords Plus, and research topic.

RESULTS: In total, 88 case reports and 12 case series published in English between 1977 and 2016 were identified as the most-cited reports in the field of Endodontics. The terms ‘case report(s)’ or ‘case series’ were not included in the title of 57 articles. The number of authors per report ranged from one to seven, with the average number of co-authors per report being 3.14. The most cited author was M Trope (University of Pennsylvania, USA). The University of Washington and Private Practice, Cetraro, Italy were the most productive institutions. The country whose case reports received the largest total number of citations was the USA. The largest number of the most-cited reports appeared in 2002, 2004, and 2007 (n=7, respectively). According to the WoS database, the total number of citations ranged from 42 to 453, with the average number of citations per report being 79.97. The majority of the top 100 most-cited articles were published in the Journal of Endodontics and the International Endodontic Journal. The most frequently used author keywords were revascularization and mineral trioxide aggregate. The majority of the case reports and case series dealt with topics related to pulp regeneration.

CONCLUSION: This bibliometric study provides a comprehensive overview on the progress, trends and current directions in clinical practice within the field of Endodontics.

PMID:34817068 | DOI:10.1111/iej.13668

Arq Neuropsiquiatr. 2021 Nov;79(11):982-988. doi: 10.1590/0004-282X-ANP-2021-0023.

ABSTRACT

BACKGROUND: Headache is a very common complaint and it is increasingly prevalent among university students. Tinnitus consists of subjectively perceived sounds that occur in the absence of an external auditory signal. Presence of headache and tinnitus in association has implications for therapy and prognosis, because this describes the temporality of the symptoms. Recognition of the epidemiological profile of symptomatic students might contribute to interventions.

OBJECTIVE: To investigate the prevalence of the association between headache and tinnitus, and to describe the epidemiological profile of the study population and the chronological order of appearance of these symptoms.

METHODS: Cross-sectional, observational and analytical study on a sample representative of an academic center. Data referring to the epidemiological and clinical profile of headache and tinnitus among medical students were collected through an online questionnaire built using the Google Forms tool.

RESULTS: Out of the 234 participants, 26.1% reported having tinnitus and headache (p < 0.001). The participants with headache were more likely to be women (p = 0.045), white (p = 0.009) and 21-25 years old (p = 0.356). Among right-sided, left-sided and non-unilateral headaches, tinnitus was present predominantly in the non-unilateral type, but without statistical significance. Regarding timing, 18.0% of the students said that tinnitus started before headache, 57.4% said that headache started before tinnitus and 24.6% said that they started simultaneously.

CONCLUSIONS: An important association between headache and tinnitus regarding lateralization and temporality was demonstrated. Thus, these data match the presumption that headache and tinnitus have a physiopathological connection.

PMID:34816995 | DOI:10.1590/0004-282X-ANP-2021-0023