Tag: nevin manimala

Eur J Pain. 2021 Sep 30. doi: 10.1002/ejp.1870. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop a mapping and umbrella review with a meta-meta-analysis (MMA) to critically evaluate the current evidence of motor imagery (MI), action observation and mirror therapy (MT) on pain intensity.

METHODS: The study involved a systematic search of PubMed, PEDro, Scielo, EBSCO and Google Scholar, RESULTS: Ten systematic reviews were included in the qualitative synthesis, 70% of which showed high methodological quality. Three reviews found significant reduction in chronic musculoskeletal pain as the result of applying movement representation methods (MRM) plus usual-care (UC), with a large clinical effect (standardised mean difference [SMD] of -1.47; 95% CI -2.05 to -0.88; heterogeneity Q=1.66; p=0.44; I² =0%). However, two reviews showed no statistically significant reduction in acute and postsurgical pain as a result of applying MI plus UC. Four reviews showed no significant reduction in phantom limb pain (PLP) as a result of applying MT plus UC interventions. In four reviews, the MMA showed significant reduction in complex regional pain syndrome (CRPS) as a result of applying MT plus UC, with a large clinical effect (SMD -1.27; 95% CI -1.87 to -0.67; heterogeneity Q=3.95; p=0.27; I² =24%). In 2 reviews, the MMA showed no significant differences in poststroke pain as a result of applying MT plus UC.

CONCLUSION: Results show that MRM could be effective for chronic musculoskeletal pain, with low to moderate-quality evidence. The results also show a reduction in pain intensity through MT interventions in patients with CRPS, although these results were not found in patients with PLP or poststroke pain.

PMID:34592050 | DOI:10.1002/ejp.1870

Vet Med Sci. 2021 Sep 30. doi: 10.1002/vms3.649. Online ahead of print.

ABSTRACT

BACKGROUND: Septic arthritis (SA) due to Staphylococcus aureus is a major cause of lameness in poultry with improper response to antimicrobial therapy.

OBJECTIVES: The study evaluates the effect of prophylactic administration of vitamin C on SA induced by methicillin resistant S. aureus in chickens.

METHODS: One hundred and twenty chickens were randomly assigned into four groups: I. Negative control (NC), II. Positive control (PC) with SA induced at the age of 35 days by intra articular injection of S. aureus. III. Vehicle control (VC) and IV. Arthritic vitamin C-treated (VitC) group (15 g/100 L of drinking water from day 25 to the end of the experiment). Samplings were performed on day 44 (sampling 1) and day 54 (sampling 2) of age.

RESULTS: Arthritic birds showed an obvious decrease in body weight with severe clinical arthritis and lameness which were not significantly affected by vitamin C administration at both samplings. Moreover, marked increase in serum malondialdehyde (MDA) concentration of the PC group was observed in sampling 1. Administration of vitamin C successfully reduced MDA concentration at both samplings. In sampling 2, birds in the VitC group showed significantly higher total antioxidant capacity (TAC) than NC birds (p < 0.05). Interleukin-6 concentration in synovial fluid of chickens remained statistically similar among groups in both samplings, while histopathological changes were ameliorated in the VitC group in sampling 2.

CONCLUSIONS: Prophylactic administration of vitamin C especially for relatively longer period can ameliorate oxidative stress and histopathological changes due to staphylococcal arthritis in chickens, although it is not associated with a significant effect on clinical manifestations of the disease.

PMID:34592062 | DOI:10.1002/vms3.649

J Magn Reson Imaging. 2021 Sep 30. doi: 10.1002/jmri.27943. Online ahead of print.

ABSTRACT

BACKGROUND: The accuracy of the estimated diffusion tensor elements can be improved by using a well-chosen magnetic resonance imaging (MRI) diffusion gradient encoding scheme (DGES). Conversely, diffusion tensor imaging (DTI) is typically challenged by the subject’s motion during data acquisition and results in corrupted image data.

PURPOSE: To identify a reliable DGES based on the golden ratio (GR) that can generate an arbitrary number of uniformly distributed directions to precisely estimate the DTI parameters of partially acquired datasets owing to subject motion.

STUDY TYPE: Prospective.

POPULATION: Simulations study; three healthy volunteers.

FIELD STRENGTH/SEQUENCE: 3 T/DTI data were obtained using a single-shot echo planar imaging sequence.

STATISTICAL TESTS: A paired sample t-test and the Wilcoxon test were used, P < 0.05 was considered statistically significant.

ASSESSMENT: Two corrupted scenarios A and B were considered and evaluated. For the simulation study, the GR DGES and generated subsets were compared with the Jones and spiral DGESs by electric potential (EP) and condition number (CN). For the human study, the specific subsets A and B selected from scenarios A and B were used for MRI to evaluate fractional anisotropic (FA) map.

RESULTS: For the simulation study, the EPs of the GR (14034.25 ± 12957.24) DGES were significantly lower than the Jones (15112.81 ± 13926.08) and spiral (14297.49 ± 13232.94) DGESs. CN variations of GR (1.633 ± 0.024) DGES were significantly lower than Jones (1.688 ± 0.119) and spiral (4.387 ± 2.915) DGESs. For the human study, GR (0.008 ± 0.020) DGES performed similarly with Jones (0.008 ± 0.022) DGES and was superior to spiral (0.022 ± 0.054) DGES in the FA map error.

DATA CONCLUSION: The GR DGES ensured that directions of the complete sets and subsets were uniform. The GR DGES had lower error propagation sensitivity, which can help image infants or patients who cannot stay still during scanning.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 1.

PMID:34592036 | DOI:10.1002/jmri.27943

Oral Dis. 2021 Sep 30. doi: 10.1111/odi.14037. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study was aimed to comprehensively characterize the epidemiological, clinicopathological characteristics, treatments, and prognosis of intraoral spindle cell carcinoma (SpCC).

MATERIALS AND METHODS: Patients diagnosed with intraoral SpCC at our institution in the past 15 years (2005-2019) were screened from inpatient disease registry. All relevant data concerning patients with intraoral SpCC were retrieved. Previous reports about intraoral SpCC with adequate clinicopathological data in both English and Chinese literature were collected. Eligible cases were further reviewed and pooled for statistical analyses.

RESULTS: Six patients (5 females, 1 male; average age: 59 years) with intraoral SpCC were histopathologically diagnosed and surgically treated at our institution. The literature review identified another 63 published cases from 34 articles. Most cases were presented in the fifth to seventh decade of life with a male preponderance. Gingiva (23/69, 33.3%) was the most common site followed by the tongue (19/69, 27.5%), and buccal mucosa (8/69, 11.6%). Complete surgical ablation remains the primary treatment option. Tumor size, pathological grades, cervical node metastasis, and distant metastasis were significantly associated with reduced survival.

CONCLUSIONS: Intraoral SpCC is an uncommon and aggressive malignancy with dismal prognosis. Much attention and effort are needed to characterize this rare entity and improve its clinical outcomes.

PMID:34592043 | DOI:10.1111/odi.14037

J Magn Reson Imaging. 2021 Sep 30. doi: 10.1002/jmri.27936. Online ahead of print.

ABSTRACT

BACKGROUND: Cognitive decline is a non-hemorrhagic, major complication of intracranial dural arteriovenous fistula (DAVF), thought to be primarily related to venous hypertension. However, imaging features to predict cognitive decline are scanty in the literature.

PURPOSE: To evaluate functional connectivity (FC) changes of resting-state networks (RSNs) in DAVF before and after treatment and its relation to cognitive impairment.

STUDY TYPE: Prospective.

SUBJECTS: DAVF subjects were screened for inclusion. Pre-embolization (N = 33, mean age 45.9 years, 29 males), 1 month post-embolization (N = 20, mean age 42.7 years, 19 males), and healthy controls (HC, N = 33, mean age 45.09 years, 27 males).

FIELD STRENGTH/SEQUENCE: 3.0 T, resting-state functional magnetic resonance imaging (MRI), three-dimensional (3D) T1, T₂ fast spin echo (FSE), diffusion weighted imaging (DWI), susceptibility weighted imaging (SWI), fluid-attenuated inversion recovery, and time of flight.

ASSESSMENT: Data quality assessment was performed. FC analysis was done using group independent component analysis (ICA) and seed to voxel analysis. Neuropsychology (NP) scores of patients were compared with HC and correlated with FC changes.

STATISTICAL TESTS: Voxel-wise parametric T-statistics for F-test was executed in FC analysis (p-FDR corrected <0.05). NP scores between DAVF group and HC group were compared using one-way analysis of variance with post hoc Bonferroni correction (P < 0.05).

RESULTS: Both RSNs analysis methods showed reduced FC at the precuneus-posterior cingulate cortex (PC-PCC) of default mode network (DMN), anterior cingulate cortex (ACC) of the salience network (SN), and possible compensatory increased connectivity at the frontoparietal (FPN) and dorsal attention (DAN) networks. DAVF with low NP scores showed reduced FC at DMN and SN and minimal to absent connectivity at FPN and DAN. At post-embolization 1-month follow-up, improvement in FC at PC-PCC of DMN and ACC of SN were noted.

DATA CONCLUSION: RS-fMRI in DAVF displayed FC changes that may be related to cognitive decline and its subsequent reversibility after treatment. FC changes at DMN, SN, FPN, and DAN were linked to cognitive decline and the corresponding NP scores.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

PMID:34592019 | DOI:10.1002/jmri.27936

Eur J Pain. 2021 Sep 30. doi: 10.1002/ejp.1866. Online ahead of print.

ABSTRACT

BACKGROUND: Internet-delivered cognitive behavioural pain management programs (PMPs) are effective, but less is known about their use outside of research trials. Five years of data from offering the internet-delivered cognitive behavioural PMP in an online therapy clinic was examined to assess effectiveness, acceptability, and predictors of outcomes.

METHODS: Patients (n = 293) were offered a previously validated 8-week internet-delivered cognitive behavioural PMP and administered measures at pre-treatment, post-treatment and 3-months.

RESULTS: There was growth in demand for an internet-delivered cognitive behavioural PMP over time (n = 64 first year to n = 133 fifth year). Moderate-to-large improvements on depression (post-treatment 35% reduction; 3-month 41% reduction) and anxiety (post-treatment 37% reduction; 3-month 41% reduction), and small-to-moderate improvements on disability (post-treatment 19% reduction; 3-month 20% reduction) were found. Lesson completion and satisfaction were high. Lower pain acceptance, lower pain self-efficacy, and higher pain intensity were associated with lower improvements on depression, anxiety and disability.

CONCLUSIONS: This longitudinal observational study provides support for internet-delivered cognitive behavioural PMPs when offered as routine care by an online therapy clinic.

PMID:34592026 | DOI:10.1002/ejp.1866

Aust Dent J. 2021 Sep 30. doi: 10.1111/adj.12878. Online ahead of print.

ABSTRACT

BACKGROUND: In Australia, because of inequity in dental service accessibility and affordability, patients can see general medical practitioners (GPs) for acute dental conditions.

METHODS: This cross-sectional study consisted of surveys distributed to the board registered GPs practising in Australia. The main outcome measures included statistical analysis of GPs managing different dental emergency scenarios and their confidence and expectations in managing dental emergencies.

RESULTS: A total of 425 GPs participated in the study. The sample primarily consisted of GPs practising in metropolitan clinics (n=315). Most participants reported that they would refer to the dentist for mobilised tooth (n=402). There was a negative correlation between GPs with 5-29 years of experience and traumatised tooth management (P<0.05). GPs aged between 40-49 years were more inclined to treat patients with mobilised teeth [Multivariate (MV): 0.42(0.09-0.74)]. However, GPs with 0-5 years of experience were less likely to manage patients with dental abscess [MV: -0.52(-0.80 – – 0.24)].

CONCLUSION: Most GPs refer dental emergencies to dentists. GP management of dental emergencies is predominantly palliative. Therefore, opportunities for collaborative practice models amongst GPs and dentists may be needed to bridge the gap in the regional and remote locations.

PMID:34591999 | DOI:10.1111/adj.12878

Lett Appl Microbiol. 2021 Sep 30. doi: 10.1111/lam.13567. Online ahead of print.

ABSTRACT

Diagnosis of osteoarticular tuberculosis (OATB) exhibits serious challenges owing to paucibacillary nature of specimens and localization of disease at sites that are difficult to access. We recently developed indirect immuno-PCR (I-PCR) and real-time I-PCR (RT-I-PCR) assays for the detection of mycobacterial antigen 85 complex (Ag85) in OATB patients. Detection limits for the purified Ag85 protein were found to be 1 fg ml^-1 and 41 fg ml^-1 by I-PCR and RT-I-PCR, respectively, which were at least 10⁵ -fold lower than respective ELISA. While spiking synovial fluids of non-TB control subjects with the purified Ag85 protein, LODs of 100 fg ml^-1 and 120 fg ml^-1 were obtained by I-PCR and RT-I-PCR, respectively, thus demonstrating the sample matrix effect. Sensitivities of 87.5% and 70.5% were observed in bodily fluids of confirmed (n=8) and clinically suspected (n=51) OATB cases, respectively by I-PCR, with a specificity of 93.9% (n=33). Markedly, the sensitivities obtained by I-PCR/RT-I-PCR were significantly higher (p<0.05-0.01) than ELISA and GeneXpert assay (n=30). However, no substantial difference in sensitivity was observed between the I-PCR and RT-I-PCR assays. After further improving the accuracy of I-PCR, this test may lead to development of an attractive diagnostic kit.

PMID:34592012 | DOI:10.1111/lam.13567

PLoS One. 2021 Sep 30;16(9):e0258070. doi: 10.1371/journal.pone.0258070. eCollection 2021.

ABSTRACT

BACKGROUND: Air pollution is the largest environmental health risk in the United Kingdom, and an issue of concern amongst outdoor workers. Road transport is a major source producing the largest amount of nitrogen dioxide (NO2) and ozone (O3) (as a secondary pollutant). Hundreds of vehicles enter and exit the Tidworth Camp’s main gate daily, potentially producing these pollutants. However, the air pollution exposure experienced by personnel on guard duty is unknown. This study aimed to determine and compare background NO2 and O3 levels experienced by personnel on guard duty.

METHODS: Cross-sectional data was collected using a static sampling technic on randomly selected days of the week. Data analysis was done using IBM-SPSS-26 and a p-value of <0.05 was considered statistically significant.

RESULTS: The background concentration of NO2 and O3 pollutants were within recommended limits. There was no significant difference between mean morning and afternoon exposure levels for both pollutants. However, NO2 and O3 levels were significantly higher during weekdays compared to weekends (M = -0.022, SD = 0.007, t(6) = -8.672, p <0.0001 and M = -0.016, SD = 0.008, t(6) = -5.040, p = 0.002 respectively). Both pollutants showed no significant differences in exposure levels when only weekdays were compared. NO2 levels showed a weak positive correlation during weekdays (r = 0.04) and a strong positive correlation during weekends (r = 0.96). O3 levels had a positive correlation on both weekdays and weekends; however, levels on Monday showed a negative correlation (r = -0.55). Linear regression analysis showed that outside temperature was a significant predictor of O3 levels (p = 0.026).

CONCLUSION: Personnel on guard duty experienced higher pollution levels during weekdays compared to weekends; however, air pollution levels for both pollutants were within recommended limits. Further studies are recommended over hotter months using a personal sampling technic to measure personal air pollution exposure levels in order to minimise any health and safety risks.

PMID:34591936 | DOI:10.1371/journal.pone.0258070

Inflamm Bowel Dis. 2021 Sep 30:izab201. doi: 10.1093/ibd/izab201. Online ahead of print.

ABSTRACT

BACKGROUND: Approximately 33% of Crohn’s disease (CD) patients have associated autoimmune skin disease. The pathophysiology of the latter frequently involves interleukin-12/interleukin-23 signaling pathways that may also impact gut inflammation. Ustekinumab is an anti-IL-12/23 FDA-approved biologic for psoriasis and inflammatory bowel disease. However, its relative efficacy has never been studied in CD with autoimmune skin disease (CD-ASD) vs CD without autoimmune skin disease (CD-none).

METHODS: This is a retrospective, single-center, case-control study comparing markers of disease activity between CD-ASD and CD-none. Biomarkers (fecal calprotectin [FCP], C-reactive protein [CRP]) prior to drug initiation and after at least 5 months of standard IBD dose ustekinumab therapy were extracted from the medical record. In addition, 2 blinded observers performed 5-point Likert scoring before and after endoscopic, pathologic, and imaging reports.

RESULTS: In all, 395 CD patients received ustekinumab therapy (79 CD-ASD, 316 CD-none). Patients were similar in age; gender; ethnicity; CD severity, phenotype, and duration; tobacco, immunomodulator, and steroid use. Ustekinumab had greater efficacy in CD-ASD when evaluated by FCP (P = .0337) and CRP (P = .078). The CD-ASD group also showed better outcomes in Likert scores of endoscopy (P = .016), histopathology (P = .074), and imaging (P = .094). In all Likert parameters, CD-ASD had more patients with complete resolution of moderate/severe disease (P < .05). Additional subanalyses for surgeries, ulcers, abscesses, fistulas, and colitis were conducted, with colitis reaching statistical significance (P = .0011).

CONCLUSIONS: Concurrent autoimmune skin disease in CD is associated with greater ustekinumab effectiveness in controlling intestinal inflammation.

PMID:34591972 | DOI:10.1093/ibd/izab201