Tag: nevin manimala

Zhonghua Wei Chang Wai Ke Za Zhi. 2022 Feb 25;25(2):166-172. doi: 10.3760/cma.j.cn441530-20210702-00257.

ABSTRACT

Objective: To compare the clinical efficacy and quality of life between uncut Roux-en-Y and Billroth II with Braun anastomosis in laparoscopic distal gastrectomy for gastric cancer patients. Methods: A retrospective cohort study was performed. Inclusion criteria: (1) 18 to 75 years old; (2) gastric cancer proved by preoperative gastroscopy, CT and pathological results and tumor was suitable for D2 radical distal gastrectomy; (3) postoperative pathological diagnosis stage was T1-4aN0-3M0 (according to the AJCC-7th TNM tumor stage), and the margin was negative; (4) Eastern Cooperative Oncology Group (ECOG) physical status score <2 points, and American Association of Anesthesiologists (ASA) grade 1 to 3; (5) no mental illness; (6) able to answer questionnaires independently; (7) patients agreed to undergo laparoscopic distal gastrectomy and signed an informed consent. Exclusion criteria: (1) patients with severe chronic diseases and American Association of Anesthesiologists (ASA) grade >3; (2) patients with other malignant tumors; (3) patients suffered from serious mental diseases; (4) patients received neoadjuvant chemotherapy or immunotherapy. According to the above criteria, clinical data of 200 patients who underwent laparoscopic distal gastrectomy at the Department of General Surgery of the First Affiliated Hospital of Army Medical University from January 2016 to December 2019 were collected. Of the 200 patients, 108 underwent uncut Roux-en-Y anastomosis and 92 underwent Billroth II with Braun anastomosis. The general data, intraoperative and postoperative conditions, complications, and endoscopic evaluation 1 year after the surgery were compared. Besides, the quality of life of two groups was also compared using the Chinese version of the European Organization For Research and Treatment of Cancer (EORTC) quality of life questionnaire-Core 30 (QLQ-C30) and quality of life questionnaire-stomach 22 (QLQ-STO22). Results: There were no significant differences in baseline data between the two groups (all P>0.05). All the 200 patients successfully underwent laparoscopic distal gastrectomy without intraoperative complications, conversion to open surgery or perioperative death. There were no significant differences between two groups in operative time, intraoperative blood loss, postoperative complications, time to flatus, time to removal of gastric tube, time to liquid diet, time to removal of drainage tube or length of postoperative hospital stay (all P>0.05). Endoscopic evaluation was conducted 1 year after surgery. Compared to Billroth II with Braun group, the uncut Roux-en-Y group had a significantly lower incidences of gastric stasis [19.8% (17/86) vs. 37.0% (27/73), χ(2)=11.199, P=0.024], gastritis [11.6% (10/86) vs. 34.2% (25/73), χ(2)=20.892, P<0.001] and bile reflux [1.2% (1/86) vs. 28.8% (21/73), χ(2)=25.237, P<0.001], and the differences were statistically significant. The EORTC questionnaire was performed 1 year after surgery, there were no significant differences in the scores of QLQ-C30 scale between the two groups (all P>0.05), while the scores of QLQ-STO22 showed that, compared to the Billroth II with Braun group, the uncut Roux-en-Y group had a lower pain score (median: 8.3 vs. 16.7, Z=-2.342, P=0.019) and reflux score (median: 0 vs 5.6, Z=-2.284, P=0.022), and the differences were statistically significant (all P<0.05), indicating milder symptoms. Conclusion: The uncut Roux-en-Y anastomosis is safe and reliable in laparoscopic distal gastrectomy, which can reduce the incidences of gastric stasis, gastritis and bile reflux, and improve the quality of life of patients after surgery.

PMID:35176829 | DOI:10.3760/cma.j.cn441530-20210702-00257

Stat Med. 2022 Feb 17. doi: 10.1002/sim.9332. Online ahead of print.

ABSTRACT

Minimal sufficient balance (MSB) is a recently suggested method for adaptively controlling covariate imbalance in randomized controlled trials in a manner which reduces the impact on randomness of allocation over other approaches by only intervening when the imbalance is sufficiently significant. Despite its improvements, the approach is unable to consider the relative clinical importance or magnitude of imbalance in each covariate weight, and ignores any imbalance which is not statistically significant, even when these imbalances may collectively justify intervention. We propose the common scale MSB (CS-MSB) method which addresses these limitations, and present simulation studies comparing our proposed method to MSB. We demonstrate that CS-MSB requires less intervention than MSB to achieve the same level of covariate balance, and does not adversely impact either statistical power or Type-I error.

PMID:35176811 | DOI:10.1002/sim.9332

J Am Acad Audiol. 2021 Oct;32(9):556-561. doi: 10.1055/s-0041-1732439. Epub 2022 Feb 17.

ABSTRACT

BACKGROUND: There are several types of silicone domes in receiver in the canal hearing aids (RICs), which have different occlusion levels. However, the frequency characteristics of each type of silicone dome are unclear.

PURPOSE: This study aimed to determine the frequency characteristics of three types of silicone domes (open domes, double-type power domes, and tulip domes) in RICs.

RESEARCH DESIGN: This is an interventional study.

STUDY SAMPLE: In total, 11 participants with a normal sense of hearing were prospectively enrolled.

INTERVENTION: Participants were fitted with hearing aids, which were adjusted to similar settings, and only the silicone domes were changed. The acoustic gain of hearing aids was adjusted to 20 dB in the range of 250 Hz to 4 kHz using the 2-cc coupler.

DATA COLLECTION AND ANALYSIS: We measured the real-ear aided gain (REAG) for each type of silicone dome. In each frequency, we statistically compared the REAG of each type of dome. Acoustic gain using the Open Fit coupler of each type of dome was also measured.

RESULTS: The REAG was obtained with no leakage with open domes only at 2 kHz, and with tulip domes and double-type power domes in the range of 1 to 2 kHz. Double-type power domes obtained significantly higher REAG than tulip domes at 250 and 500 Hz. Under the Open Fit coupler, all types obtained higher acoustic gain than the REAG.

CONCLUSION: This study provides the analysis of the frequency characteristics of silicone domes in RICs. The highest degree of occlusion was observed in double-type power domes, followed by tulip domes, and the lowest was observed in open domes.

PMID:35176798 | DOI:10.1055/s-0041-1732439

J Am Acad Audiol. 2021 Oct;32(9):576-587. doi: 10.1055/s-0041-1733970. Epub 2022 Feb 17.

ABSTRACT

BACKGROUND: Numerous cardiometabolic factors may underlie risk of hearing loss. Modifiable risk factors such as non-optimal blood pressure (BP) are of interest.

PURPOSE: To investigate early auditory evoked potentials (AEPs) in persons with nonoptimal BP.

RESEARCH DESIGN: A cross-sectional nonexperimental study was performed.

STUDY SAMPLE: Fifty-two adults (18-55 years) served as subjects. Individuals were classified as having optimal (systolic [S] BP < 120 and diastolic [D] BP < 80 mm Hg, n = 25) or non-optimal BP (SBP ≥=120 or DBP ≥=80 mm Hg or antihypertensive use, n = 27). Thirteen subjects had hypertension (HTN) (SBP ≥130 or DBP ≥80 mm Hg or use of antihypertensives).

DATA COLLECTION AND ANALYSIS: Behavioral thresholds from 0.25 to 16 kHz were collected. Threshold auditory brain stem responses (ABRs) were recorded using rarefaction clicks (17.7/second) from 80 dB nHL to wave V threshold. Electrocochleograms were obtained with 90 dB nHL 7.1/second alternating clicks and assessed for summating and compound action potentials (APs). Outcomes were compared via independent samples t tests. Linear mixed effects models for behavioral thresholds and ABR wave latencies were constructed to account for potential confounders.

RESULTS: Wave I and III latencies were comparable between optimal and non-optimal BP groups. Wave I was prolonged in hypertensive versus optimal BP subjects at stimulus level 70 dB nHL (p = 0.016). ABR wave V latencies were prolonged in non-optimal BP at stimulus level 80 dB nHL (p = 0.048) and in HTN at levels of 80, 50, and 30 dB nHL (all p < 0.050). DBP was significantly correlated with wave V latency (r = 0.295; p = 0.039). No differences in ABR amplitudes were observed between optimal and non-optimal BP subjects. Electrocochleographic study showed statistically comparable action and summating potential amplitudes between optimal and non-optimal BP subjects. AP latencies were also similar between the groups. Analysis using a set baseline amplitude of 0 μV showed that hypertensive subjects had higher summating (p = 0.038) and AP (p = 0.047) amplitudes versus optimal BP subjects; AP latencies were comparable.

CONCLUSION: Elevated BP and more specifically, HTN was associated with subtle AEP abnormalities. This study provides preliminary evidence that nonoptimal BP, and more specifically HTN, may be related to auditory neural dysfunction; larger confirmatory studies are warranted.

PMID:35176801 | DOI:10.1055/s-0041-1733970

Gesundheitswesen. 2022 Feb 17. doi: 10.1055/a-1665-6762. Online ahead of print.

ABSTRACT

BACKGROUND: Information on testing units in health care is scarce, particularly the group of late-presenters among the HIV-first diagnoses is still a challenge in Germany.

AIM: Analysis of the impact of testing units on and reasons for the prevalence of HIV-first diagnoses and late presentation, taking 2014 for illustrative purposes.

MATERIAL AND METHODS: Cross-sectional analysis of all individuals, treated in the Network HIV-Regional who were first diagnosed with HIV in 2014; patient characteristics, demographic and clinical data, including information on HIV testing were collected retrospectively and in a decentralised manner, pseudonymized and statistically evaluated.

RESULTS: A total of 971 individuals with HIV-first diagnosis from 31 specialised care centres throughout Germany (15 hospitals, 16 private practices) represented 27.5% of all National HIV-first diagnoses -registrations from Robert Koch Institute for 2014, with similar results for CD4-cell count and HIV-transmission risk. The most common test site was a hospital (34.8%), followed by the office of a family doctor (19.6%) and medical specialist (16.1%). If the first diagnosis was established in hospital, then the patients were on average older than those tested on an ambulant care basis (42 vs. 37 years, p=0.001); moreover, the HI-viral load was higher (585 vs. 270 thousand copies/mL, p<0.001) and the CD4-cell count lower (265 vs. 414/µL, p<0.001). In 208/971 individuals with first diagnosis, at least one AIDS-defining disease was found, most frequently pneumocystis-pneumonia (43.8%), candidiasis (36.5%) and Kaposi sarcoma (10.6%). A regional comparison revealed that in eastern Germany, for first diagnosed HIV-patients were younger, had a higher HIV-RNA viral load and also more often clinical AIDS.

CONCLUSION: This analysis of HIV-Regional for 2014 enables a deeper insight into HIV first diagnoses, on the eve of the introduction of important prevention tools in Germany, e. g., HIV home testing and pre-exposure prophylaxis. This cross-sectional analysis was representative for Germany and underscores the importance of specialised hospitals, in particular for eastern Germany, and furthermore the involvement of late-presenters into HIV health care.

PMID:35176792 | DOI:10.1055/a-1665-6762

Eur J Dent. 2022 Feb 17. doi: 10.1055/s-0041-1739547. Online ahead of print.

ABSTRACT

OBJECTIVES: Bulk-filled composite resins are popularly used for posterior restorations due to various advantages. Routine oral hygiene measures like toothbrushing and the use of various mouthrinses can influence the mechanical properties of composite resins. Desensitizing mouthrinses are widely used as well, to manage dentinal hypersensitivity. Studies on the influence of desensitizing mouthrinses on bulk-filled composites are limited. Hence, the objective of the present in vitro study was to evaluate the influence of toothbrushing and various desensitizing mouthrinses on the surface roughness and microhardness of Tetric N-Ceram bulk-fill composite resin.

MATERIALS AND METHODS: Fifty Tetric N-Ceram bulk-fill composite resin disks were prepared and were randomly divided into five groups (n = 10). Group 1 (Control): no toothbrushing and no mouthrinse; Group 2: toothbrushing only; Group 3: toothbrushing + HiOra-K mouthrinse; Group 4: toothbrushing + Listerine Sensitive mouthrinse; and Group 5: toothbrushing + Shy-OR mouthrinse. The specimens were brushed with a soft bristle brush using a toothpaste slurry and immersed in respective mouthrinse twice daily for 1 month. The mean surface roughness (average roughness) and microhardness (Vickers Pyramid number) values were determined and the data were tabulated. Data were analyzed using one-way analysis of variance, Post-hoc Tukey test, and Pearson correlation test. A p-value less than 0.05 was considered statistically significant.

RESULTS: Specimens treated with HiOra-K mouthrinse exhibited maximum surface roughness (p < 0.05) and specimens treated with Listerine Sensitive exhibited the least microhardness (p < 0.05). A weak negative correlation was found between surface roughness and microhardness for groups 1, 2, and 5, while a weak positive correlation was found for groups 3 and 4.

CONCLUSIONS: It is suggested that desensitizing mouthrinses containing alcohol or essential oils can lead to increased surface roughness and reduction in microhardness of bulk-fill composites, which could have an undesirable effect on their clinical performance.

PMID:35176786 | DOI:10.1055/s-0041-1739547

Eur J Dent. 2022 Feb 17. doi: 10.1055/s-0041-1740224. Online ahead of print.

ABSTRACT

OBJECTIVES: The objectives of this study were to compare the long-term shear bond strength of conventional adhesive on metal brackets with that of adhesive precoated brackets in vitro and to evaluate the amount of adhesive remnant on the tooth surface after debonding.

MATERIALS AND METHODS: A total of 90 maxillary permanent premolars were randomly divided into two groups. The samples in the first group were bonded with metal brackets using Transbond PLUS Color Change Adhesive (TP), and the samples in the second group were bonded with Flash-Free adhesive precoated brackets (APC FF). The bonding techniques were performed, according to the manufacturer’s instructions. The samples from each group were randomly divided into three subgroups with different thermal cycles (n = 15). The shear bond strength (SBS) and adhesive remnant index (ARI) were measured and calculated.

STATISTICAL ANALYSIS: Two-way ANOVA and Chi-square test were used to analyze the differences in the SBS and ARI between the groups, respectively.

RESULTS: The means of the SBS of the APC FF subgroups were significantly lower than those of the TP subgroups, except in the 10,000 thermocycle subgroups. Chi-square test showed no statistically significant differences between the groups and subgroups. An ARI score of 1 was the predominant score in both groups.

CONCLUSIONS: This study found that the SBS of APC FF gradually increased with time and thermal aging did not affect the failure pattern.

PMID:35176787 | DOI:10.1055/s-0041-1740224

Psychopathology. 2022 Feb 17:1-12. doi: 10.1159/000521915. Online ahead of print.

ABSTRACT

INTRODUCTION: Insight in schizophrenia spectrum disorders (SSD) is associated with outcomes. Although the neurocognitive basis of insight is widely accepted, the specific contribution of decision-making (Jumping to Conclusions [JTC]), Cognitive Insight (CI), and Theory of Mind (ToM) to insight remains unclear.

METHODS: The sample included N = 77 SSD outpatients aged 18-64 years from a randomized controlled trial of metacognitive training. Assessments included JTC-Beads Task, CI-Beck Cognitive Insight Scale, ToM-Hinting Task, and the Emotions Recognition Test Faces.

STATISTICS: hierarchical multivariable linear regression models tested their contribution to total insight (TI) and three insight dimensions – illness recognition (IR), symptom relabelling (SR), and treatment compliance (TC) – measured with the Schedule for the Assessment of Insight – Expanded version, whilst adjusting for potential confounders.

RESULTS: Bivariate analyses showed that CI was associated with TI (R2 change = 0.214; p < 0.001), IR (R2 change = 0.154; p = 0.003), and SR (R2 change = 0.168; p = 0.003), while JTC predicted IR (R2 change = 0.790; p = 0.020). Multivariable regression models showed that CI predicted TI (R2 change = 0.116; p = 0.036) and SR (R2 change = 0.166, p = 0.011), whereas JTC was linked with IR (R2 change = 0.710; p = 0.026). ToM was not linked with any insight score. No cognitive variable was associated with treatment compliance.

DISCUSSION: Results supported the (meta)cognitive model of insight in SSD. JTC and CI emerged as the main (meta)cognitive processes underlying insight. Metacognitive interventions may therefore improve insight in SSD, although these therapies alone may fail to address treatment compliance.

PMID:35176740 | DOI:10.1159/000521915

Rev Bras Ginecol Obstet. 2022 Feb 17. doi: 10.1055/s-0041-1741450. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.

METHODS: Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis on maternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.

RESULTS: Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The following maternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.

CONCLUSION: In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.

PMID:35176779 | DOI:10.1055/s-0041-1741450

Cerebrovasc Dis. 2022 Feb 17:1-4. doi: 10.1159/000521794. Online ahead of print.

ABSTRACT

BACKGROUND: Globally, stroke remains an important cause of death and long-term disability, and the impact of coronavirus disease (COVID-19) on the health system may have impaired stroke care. Previous studies suggest significant reduction in hospital admissions for stroke after COVID-19 onset as patients may hesitate seeking medical help due to fear of exposure.

METHODS: This cross-sectional study included cases of hospital admissions for stroke, identified from the Hospital Information System of the Unified Health System (Sistema Único de Saúde), which contains official and public data in Brazil. Data were collected in duplicate, then categorized according to the International Classification of Diseases, tenth revision (ICD-10), considering codes I60-I69. Linear regression was used to estimate the variation in hospital admissions for stroke in the city of São Paulo (SP) – the largest and most populous city in Brazil and Latin America, between January and June of each analyzed year (2017-2020). The percentage variation between June and January 2020 was also compared. The level of significance was set at 5%, and the statistical program used was Stata, version 14.0.

RESULTS: In the city of SP, during the first wave of COVID-19, from January to June 2020, there were registered decreases in absolute numbers and mean monthly admissions for stroke. Compared to January 2020, data from June 2020 showed 17% reduction in hospitalizations for intracerebral hemorrhage, 32% for cerebral infarction, 26% for stroke unspecified, and 47% for other cerebrovascular diseases.

CONCLUSION: We argue for policies aimed at improving stroke care and developing awareness campaigns regarding the importance of early diagnosis and treatment, as even in less severe presentations, stroke can trigger an increase in mortality, cost, and long-term disability.

PMID:35176738 | DOI:10.1159/000521794