Tag: nevin manimala

Cir Cir. 2023;91(5):641-647. doi: 10.24875/CIRU.23000311.

ABSTRACT

OBJECTIVE: In this randomized and prospective research, we aimed to relieve surgical and muscle-related pain early after lumbar disc operations with caudal preemptive analgesia.

MATERIALS AND METHODS: A total of 120 patients with single-level lumbar disc herniation were included in this study. The caudal epidural injection was performed for all patients 20 min before surgery. The patients were divided into three groups. Non-steroidal anti-inflammatory drugs or tramadol use were recorded. Pre-operative and post-operative pain was interpreted through a visual analog scale.

RESULTS: There was a difference between the groups in all post-operative measurements (p < 0.05), between Group 1 and Group 3, and between Group 2 and Group 3. A statistical significance has been achieved between the groups at the 1^st h, 2^nd h, 4^th h, and 24^th h (p < 0.05). The difference between the pain intensities of the patients at the 24^th h and the 1^st week was statistically significant in Groups 1 and 2 (p < 0.05). Evaluation of the effects of medical treatments reduced the severity of back pain and foot pain.

CONCLUSION: The preemptive bupivacaine or in combination with methylprednisolone caudal injection is an effective and safe method to reduce post-operative pain and ameliorate functional capacity for the treatment of lumbar disc herniation.

PMID:37844891 | DOI:10.24875/CIRU.23000311

Cir Cir. 2023;91(5):627-632. doi: 10.24875/CIRU.22000578.

ABSTRACT

OBJECTIVE: Acidosis is the most dangerous complication in subarachnoid hemorrhage (SAH). This study aimed to investigate the effect of acidic cerebrospinal fluid on central canal structures after SAH.

MATERIALS AND METHODS: Twenty-eight hybrid rabbits were studied. Blood and cerebrospinal fluid pH values were recorded before/during/after the experimental procedures. The structures related to the central canals at the level of C5 of the cervical spinal cord were then examined histopathologically. The relationship between pH values of ependymal cells and degenerated epithelial cell densities was statistically analyzed.

RESULTS: Mean blood pH values and degenerated ependymal cell density (n/mm²) were as follows: 7.351 ± 0.033/23 ± 7 in control, 7.322 ± 0.059/78 ± 13 in SHAM, and 7.261 ± 0.048/254 ± 62 in study animals. Gross examinations revealed swelling, edema, pia-arachnoid adhesions, ventral canal dilatation, arachnoiditis, central canal hemorrhage, occlusions, and dilatation in the spinal cord.

CONCLUSION: Cerebrospinal fluid acidosis-induced central channel pathologies should be considered an important complication of SAH following SAH.

PMID:37844888 | DOI:10.24875/CIRU.22000578

Cir Cir. 2023;91(5):658-663. doi: 10.24875/CIRU.22000419.

ABSTRACT

BACKGROUND: Open abdomen is an alternative for the management of trauma patient, and negative pressure therapy of the wound using VAC^® device is a genuine sort of treatment. Although the device poses technical advantages, risks are present and a critical complication is the enteroatmospheric fistula formation (EAF).

OBJECTIVE: To analize the role of negative pressure therapy length and VAC^® device number of changes on the EAF formation in trauma patients udergoing open abdomen.

METHOD: Cut-off points were calculated using receiver operational characteristics curve. Values were compared with Student’s t or Mann-Withney U tests, considering statistically significant p < 0.05.

RESULTS: EAF were present in 39 cases (5.9%). A significant difference in the presence of EAF was present in patients with negative pressure therapy of the wound length ≥ 11.2 days (46.9 vs. 1.3%; relative risk [RR]: 3.67; 95% confidence interval [95% IC]: 2.4-6.68; p = 0.017) and when ≥ 2.6 VAC^® device changes were performed (34.6 vs. 0.5%; RR: 6.92; 95% IC: 1.1-4.3; p < 0.001).

CONCLUSIONS: At our institution, the practice of >3 VAC^® device changes and length of therapy > 11 days should be carefully considered leading to reduce the risk of EAF formation.

PMID:37844886 | DOI:10.24875/CIRU.22000419

Cir Cir. 2023;91(5):596-600. doi: 10.24875/CIRU.22000203.

ABSTRACT

OBJECTIVE: To compare the protective effect of nitroglycerin ointment 2% and Dimethylsulfoxide (DMSO) in dorsal flaps of the rat.

METHODS: A blind, experimental study was conducted in 24 male Wistar rats, with a mean weight of 320 (286-376) grams. Group 1: Control. Petrolatum jelly (Vaseline), n = 8, Group 2: Nitroglycerin (NTG) ointment 2% (Nitro-Bid, Altana Co.) n = 8, and Group 3: DMSO gel 90% (Neogen corp. Lexington KY, 40611), n = 8.

RESULTS: A total of 24 rats were operated on in the 6-month period of this study. Using a non-parametric Mann-Whitney U-test analysis, a statistically significant p was obtained between the control group and 2% NTG ointment, both in the area of necrosis and in the healthy area (p = 0.026). In contrast, the comparison between DMSO [CH3) 2SO] and the control group (p = 0.180) and between both study groups, with a p = 0.18, was not significant.

CONCLUSIONS: Our study concluded that there is a protective effect of 2% NTG ointment for flap survival in relation to the control group (petrolatum). DMSO administered topically did not show a protective effect, compared to the control group.

PMID:37844881 | DOI:10.24875/CIRU.22000203

Am J Clin Nutr. 2023 Oct 13:S0002-9165(23)66178-7. doi: 10.1016/j.ajcnut.2023.10.004. Online ahead of print.

NO ABSTRACT

PMID:37844874 | DOI:10.1016/j.ajcnut.2023.10.004

SLAS Technol. 2023 Oct 14:S2472-6303(23)00060-2. doi: 10.1016/j.slast.2023.10.002. Online ahead of print.

ABSTRACT

Rapid and accurate measurements of immune protein markers are essential for diagnosis and treatment in all clinical settings. The recent pandemic has revealed a stark need for developing new tools and assays that could be rapidly used in diverse settings and provide useful information to clinicians. Here, we describe the development and test application of a novel one-step CRP/IP-10 duplex assay for the LightDeck platform capable of delivering reproducible and accurate measurements in under eight minutes. We used the optimized assay to measure CRP and IP-10 levels in human blood and serum samples from healthy, SARS-CoV-2 (COVID-19) positive, and influenza-like illness (ILI) presenting patients. Our results agreed with previously published analyte levels and enabled us to make statistically significant comparisons relevant to multiple clinical parameters. Our duplex assay is a simple and powerful tool for aiding prognostic decision-making in diverse settings.

PMID:37844868 | DOI:10.1016/j.slast.2023.10.002

J Shoulder Elbow Surg. 2023 Oct 14:S1058-2746(23)00734-6. doi: 10.1016/j.jse.2023.09.009. Online ahead of print.

ABSTRACT

BACKGROUND: Giant cell tumors of bone (GCTB) are rare aggressive tumors and proximal humerus is a relatively rare location for GCTB as well, limited evidence exists on which surgical approaches and reconstruction techniques are optimal. Here, using the largest case series to date, we evaluated the recurrence rate of proximal humerus GCTBs and the functional outcomes of different resection and reconstruction options in this multicenter study.

METHODS: All 51 patients received initial surgical treatment for proximal humerus GCTBs from January 2007 to December 2020, with a minimum two-year follow-up. Local recurrence and functional outcomes were statistically analyzed in relation to demographic, clinical, and primary surgical variables. Functional outcomes were patient-reported and assessed by the Musculoskeletal Tumor Society (MSTS) score and the Disabilities of the Arm, Shoulder and Hand (QuickDASH) instrument.

RESULTS: Mean follow-up was 81.5 months (range, 30-191 months), and overall recurrence rate was 17.6% (9/51). The majority of the recurrence (N=7) occurred in the first two years of follow-up. The intralesional curettage group (N=23) had a statistically significant difference in recurrence rate compared to en-bloc resection (N=28) (34.8% vs. 3.6%, p=0.007). Among patients receiving en-bloc resection, 16 shoulders were reconstructed with hemiarthroplasty, 8 with reverse total shoulder arthroplasty (rTSA) with allograft-prosthetic composite (APC) reconstruction, and 4 with arthrodesis. Based on intention-to-treat analysis, the mean functional MSTS scores of the curettage groups, rTSA with APC, hemiarthroplasty, or arthrodesis was 26.0±3.1 vs. 26.0±1.7 vs. 20.3±2.8 vs. 22.5±1.3 (p<0.001 [curettage vs. hemiarthroplasty, p<0.001; rTSA with APC vs. hemiarthroplasty, p=0.004]), respectively, while for QuickDASH, it was 14.0±11.0 vs. 11.6±4.5 vs. 33.1±11.8 vs. 21.6±4.7 (p<0.001 [curettage vs. hemiarthroplasty, p<0.001; rTSA with APC vs. hemiarthroplasty, p=0.003]), respectively.

CONCLUSIONS: Based on our data, en-bloc resection followed by reverse shoulder arthroplasty showed a lower recurrence rate, and no significant difference in functional outcome scores for proximal humerus GCTBs compared with intralesional curettage. Therefore, we believe that rTSA with APC may be reasonable for initial treatment of proximal humerus GCTBs.

PMID:37844829 | DOI:10.1016/j.jse.2023.09.009

J Affect Disord. 2023 Oct 14:S0165-0327(23)01259-4. doi: 10.1016/j.jad.2023.10.077. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study was to validate the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) Cross-Cutting Symptom Measure (CCSM) as a screening tool for a wide variety of disorders within busy community outpatient mental health settings.

METHOD: Participants (N = 851) were referred for coordinated specialty care services (mean age = 20.26 years (SD = 2.97); 82.5 % Caucasian, 7.5 % African American, 0.7 % Native American, 0.7 % Pacific Islander, 0.8 % Asian, 7.8 % Multiracial; 15.1 % Latinx; 53.1 % female, 45.5 % male, 1.4 % other gender).

RESULTS: At optimal cut-score, specificity ranged from 57 to 77 % for depression, anxiety, substance use and psychosis domains; sensitivity ranged from 63 to 72 %. Scores for depression, anxiety, substance use and psychosis domains differed significantly by groups with and without diagnoses. Correlations among domains were larger where expected (r = 0.52, depression-suicidal ideation), and relatively smaller where expected (r = 0.28, suicidal ideation-inattention). Depression, anxiety, substance use and psychosis domains evidenced incremental validity for their respective diagnoses (change in explained variance, 3-15 %). Psychometric features of CCSM were broadly supported.

LIMITATIONS: Criterion measures did not have inter-rater reliabilities as this is generally prohibitive in clinic settings.

CONCLUSION: The CCSM could provide a first step in screening for multiple disorders; however, it cannot replace structured interviews for making diagnoses related to these conditions.

PMID:37844781 | DOI:10.1016/j.jad.2023.10.077

J Affect Disord. 2023 Oct 14:S0165-0327(23)01247-8. doi: 10.1016/j.jad.2023.10.066. Online ahead of print.

ABSTRACT

BACKGROUND: Few studies have focused on the associations of adolescent substance use and depressive symptoms with adult major depressive disorder (MDD).

METHODS: Data from 168,859 adults, among which, 15,959 had experienced MDD in the past year, as indicated by a major depressive episode (MDE) marked by MDD symptoms, were from the 2016-2019 National Surveys on Drug Use and Health. Weighted multivariable logistic regression (MLR) analyses were used to determine the associations.

RESULTS: The overall MDD prevalence was 7.2 %, whereas the prevalence for adults without early onset depressive symptoms prior to age 18 was 4.6 %. Variable cluster analysis revealed that adolescent use of alcohol, cigarettes, marijuana, cocaine, hallucinogen use, and inhalants prior to age 18 were in one cluster. MLR analyses showed that the presence of depressive symptoms prior to age 18 was the major risk factor for MDD, while adolescent use of alcohol, marijuana, and inhalants prior to age 18 were associated with increased odds of MDD (p < 0.05) both in the whole data and the subset of adults without depressive symptoms prior to age 18. Adolescent use of cocaine prior to age 18 were associated with MDD only in the whole data, whereas adolescent smokeless tobacco use was associated with MDD only in those without depressive symptoms prior to age 18.

CONCLUSIONS: These findings highlight the comorbid early substance use and depressive symptoms during adolescence with adult MDD. Intervention strategies should simultaneously address early-onset substance use and depressive symptoms prior to age 18.

PMID:37844780 | DOI:10.1016/j.jad.2023.10.066

Ageing Res Rev. 2023 Oct 14:102089. doi: 10.1016/j.arr.2023.102089. Online ahead of print.

ABSTRACT

Parkinson’s disease (PD) is a neurodegenerative disorder, characterized by motor and non-motor symptoms, that still lacks of a disease-modifying treatment. Consistent evidence proved the benefits of physical therapy on motor and non-motor symptoms in PD patients, leading the scientific community to propose physical activity as disease-modifying therapy for PD and suggesting the involvement of neurotrophic factors (NFs) as key mediators of neuroplasticity. However, the lack of standardized exercise training and methodological flaws of clinical trials have limited the evidence demonstrating the exercise-induced changes in serum and plasma neurotrophic factors concentration. A systematic search, covering 20 years of research in this field and including randomized and non-randomized controlled trials (RCTs and non-RCTs), which reported changes in serum and plasma NFs after a specific intervention, were reviewed. Pooled effect sizes (p-ESs) and 95% confidence intervals (95%CIs) were calculated using a random effects model with R software. A total of 18 articles, of which exercise programs of interventions were codified in terms of type, intensity and duration adopting a standardisation methodology, were included in the systematic review. Six papers, describing the effect of different training programs on BDNF and IGF-1 levels, were included and independently analysed in two meta-analyses. Quantitative analysis for BDNF indicated a statistically significant improvement in serum concentration of PD patients (MD: 5.99ng/mL; 95%IC: 0.15 -11.83; I²= 77%) performing physical activity compared with control conditions in RCTs. Preliminary evidence supported the hypothesis that a moderate intensity aerobic exercise (MIAE) would be necessary to induce the changes in NFs. However, sensitivity analysis of meta-analysis and the few studies included in subgroup analysis did not support these results. Alongside, meta-analysis followed by sensitivity analysis revealed a potential change in serum IGF-1 (MD: 33.47ng/mL; 95%IC: 8.09-58.85) in PD patients performing physical activity with respect controls in RCT studies. Considering the limited evidence to support or refute the increase in NFs levels in PD patients performing physical activity, there is a need to develop a rigorous controlled randomized trial, with standardization for loading intensity of physical activity, greater sample size, and a correct stratification of PD patients to establish a well-defined correlation between physical activity and NFs levels.

PMID:37844764 | DOI:10.1016/j.arr.2023.102089