Tag: pubmed

Eur J Orthod. 2024 Dec 4;47(1):cjae068. doi: 10.1093/ejo/cjae068.

ABSTRACT

OBJECTIVES: The purpose of this retrospective study was to compare the dento-skeletal changes observed in growing Class III patients treated with the Face Mask Protocol (FMP) with and without Bite Block (BB).

MATERIALS: Thirty subjects (12 f, 18 m) who underwent FM/BB therapy were compared to a matched group (FM) of 29 patients (15 f, 14 m) treated without BB. All patients were evaluated before treatment (T0), at the end of active treatment (T1), and at a post-pubertal follow-up observation (T2). A control group (CG) of 20 subjects (10 f, 10 m) with untreated Class III disharmony was used for the comparison of post-pubertal changes. Intergroup statistical comparisons were performed with the independent samples t-test (P < .05).

RESULTS: The comparison between treated samples showed a significant improvement of SN^GoGn (FM/BB vs FM, -2.1°), Overbite (FM/BB vs FM, +1.2 mm), and vertical position of lower molars FM/BB vs FM, -3 mm). When compared with the controls, both treated groups revealed a significant improvement of SNA (FM/BB, +1.8°; FM +2.1°), ANB (FM/BB +1.6°, FM +2.4°), gonial angle (FM/BB -4.9°; FM -4°), incisor inclination (Upper, FM/BB +1.7°, FM +2.3°; Lower, FM/BB -2.5°, FM -2.7°), and Overjet (FM/BB +3.2 mm; FM +4 mm). Improvement of SN^GoGn (-2.1°), Overbite (+1.8 mm), and vertical position of lower molars (-3.8 mm) were observed when FM/BB was compared with CG.

LIMITATIONS: Limitations are related to the difficulty to recruit a larger contemporary long-term control group due to ethical reasons.

CONCLUSION: Both FM protocols induced favorable changes in the treatment of Class III malocclusion with a good post-pubertal stability. The BB allows a more efficient control of the vertical skeletal relationship.

PMID:39704016 | DOI:10.1093/ejo/cjae068

Adv Clin Exp Med. 2024 Dec 20. doi: 10.17219/acem/197425. Online ahead of print.

ABSTRACT

Mental health diagnostics is undergoing a transformation, with a shift away from traditional categorical systems like the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the International Classification of Diseases, 11th Revision (ICD-11), and toward innovative frameworks like the Hierarchical Taxonomy of Psychopathology (HiTOP) and the Research Domain Criteria (RDoC). These emerging models prioritize dimensional and biobehavioral approaches in order to overcome limitations such as oversimplification, comorbidity and heterogeneity. This editorial explores the challenges of implementing these paradigms, such as the need for empirical validation, interdisciplinary collaboration and clinician training. It highlights the importance of advanced tools, biomarkers and technological integration to improve precision in diagnosis and treatment. Future research directions include creating reliable dimensional assessment methods, conducting longitudinal studies and fostering interdisciplinary networks. By bridging traditional and emerging frameworks, the field can progress toward personalized, biologically informed mental health treatment. This transition necessitates collaboration among researchers, clinicians and policymakers to improve diagnostic accuracy and treatment outcomes for those affected by mental health disorders.

PMID:39704003 | DOI:10.17219/acem/197425

J Glob Health. 2024 Dec 20;14:04236. doi: 10.7189/jogh.14.04236.

ABSTRACT

BACKGROUND: Numerous studies have investigated the efficacy of probiotics in treating acute and persistent diarrhoea. However, probiotics have not been established as a recommended management option for diarrhoeal illness by the World Health Organization (WHO). Therefore, we conducted a systematic review of randomised controlled trials to assess the efficacy of probiotics for the management of acute and persistent diarrhoea in children.

METHODS: A systematic search on PubMed, CINAHL, Wiley Cochrane Library, Scopus, Clinicaltrials.gov, and WHO International Clinical Trials Registry Platform (ICTRP) was performed. All studies published in the year 2000 and onwards that assessed the use of probiotics in the management of acute and persistent diarrhoea in children aged 0-10 years were included. The risk of bias was assessed using the Cochrane Risk of Bias II (RoB-2) tool and the quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. This review was commissioned by WHO for revision of their guidelines for childhood diarrhoea management.

RESULTS: The review included 98 studies with a total of 17 236 participants. Studies were categorised based on the WHO definition of diarrhoea or author-specified definition. In studies considering the WHO definition of diarrhoea, the probiotics group was more likely to achieve clinical cure (risk ratio = 1.12 (95% confidence interval (CI) = 1.01, 1.24, studies = 14)) and reduce the duration of diarrhoea (mean difference = -13.27 hours (95% CI = -16.72, -9.83, studies = 33)) than the control group in children with acute diarrhoea. However, the effect size was small, and statistical heterogeneity was very high, leading to low certainty of evidence. In children with persistent diarrhoea, probiotics reduced the duration of diarrhoea by 95 hours (mean difference = -96.45 (95% CI = -110.53, -82.37, studies = 2)), but the certainty of the evidence was very low.

CONCLUSIONS: The results from this systematic review suggest low certainty of evidence for the effect of probiotics on clinical cure and duration of diarrhoea in children. There was significant diversity in the genus, species, dosages, and duration of treatment in the trial and administration. High levels of heterogeneity reduced the certainty of evidence. Large-scale randomised clinical trials are needed to evaluate specific probiotic strains and doses. In addition, cost-effective analysis studies are needed to be explored in future research.

REGISTRATION: The protocol for this review was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023449200).

PMID:39703988 | DOI:10.7189/jogh.14.04236

J Glob Health. 2024 Dec 20;14:05039. doi: 10.7189/jogh.14.05039.

ABSTRACT

BACKGROUND: The resilience of Peru´s health system was weakened by a political crisis that started in 2016 and was further challenged by the coronavirus 2019 (COVID-19) pandemic. We assessed the indirect impact of the pandemic on the utilisation of essential maternal and child health (MCH) services in Peru at national and subnational levels.

METHODS: We assessed the trends in MCH services utilisation and the percentage change from 2018 to 2021, using routine health facility data. We used an interrupted time series analysis to quantify the impact of COVID-19 on the utilisation of health services.

RESULTS: The utilisation of most maternal and child health services dropped dramatically in 2020 after the outbreak. However, we observed a quick recovery in 2021, with service utilisation fairly similar or higher to the pre-pandemic period (2018-2019). The decrease was higher in the utilisation of antenatal care visit one or more (incidence rate ratio (IRR) = 0.79; 95% CI = 0.74-0.83) and antenatal care visits four or more (IRR= 0.76; 95% = 0.74-0.79) in 2020. The IRR showed a drop of 5, 6, 9, and 13% in the utilisation of skilled birth attendances, institutional deliveries, caesarean sections and postnatal care visits within two days of childbirth, respectively in 2020 in comparison to pre-pandemic service utilisation. In 2020 the utilisation decreased in all three natural regions, with the Rainforest being the most affected. In 2021 there was a recovery in all natural regions.

CONCLUSIONS: The pandemic decreased the utilisation of essential maternal and child health services in Peru. This highlights the need to preserve the resilience of a health system both at central and local levels, to face more successfully future pandemics.

PMID:39703982 | DOI:10.7189/jogh.14.05039

Pak J Med Sci. 2024 Dec;40(12PINS Suppl):S25-S31. doi: 10.12669/pjms.40.12(PINS).11111.

ABSTRACT

OBJECTIVES: To determine the effect of Bilateral Subthalamic Nucleus (STN) Deep Brain Stimulation (DBS) on drug reduction for Parkinson’s disease (PD) in a low-middle-income country.

METHODS: This retrospective cohort study included 49 patients following interview based questionnaires who underwent bilateral STN DBS at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan over five years (July 30, 2018 to June 29, 2023). Patients meeting the inclusion and exclusion criteria (49 patients) were selected and the effect of bilateral STN DBS on drug reduction was evaluated.

RESULTS: Following bilateral STN for Parkinsons Disease Levodopa equivalent daily dose (LEDD) and Unified Parkinson’s Disease Rating Scale (UPDRS)-III results were statistically significant, with a P-value of 0.0001. Effect of DBS on UPDRS-IV was 0.2751, which is statistically insignificant. LEDD reduced by 55.03% (P<0.0001), UPRS-III improved by 80.49% (P<0.0001), and UPDRS-IV improved by 1% (P<0.0001). Time spent with dyskinesia reduced by 17.54% (P<0.0001), whereas time spent off period reduced 22.44% (P<0.0001).

CONCLUSION: When the disease is in its early stages and has not yet manifested advanced Parkinsons symptoms, bilateral STN DBS is an effective treatment option. It considerably reduces the need for levodopa and significantly improves the motor symptoms of rigidity, tremors, and bradykinesia.

PMID:39703974 | PMC:PMC11654648 | DOI:10.12669/pjms.40.12(PINS).11111

Pak J Med Sci. 2024 Dec;40(12PINS Suppl):S55-S62. doi: 10.12669/pjms.40.12(PINS).11116.

ABSTRACT

OBJECTIVES: To assess the knowledge, attitude and perception of post-graduate residents of neurosciences towards research ethics (RE) and research ethics committees (RECs).

METHODS: This prospective cross-sectional survey-based study was conducted by the Punjab Institute of Neurosciences, targeting post-graduate neuroscience residents throughout Pakistan during January and February, 2024. An English-language general questionnaire, designed to assess knowledge, attitudes, and perceptions of RE and RECs, was adapted to reflect local conditions. The collected responses were analyzed using the Statistical Package for Social Sciences (SPSS) to determine measures of central tendency, percentages, and frequencies.

RESULTS: Out of 241 residents, 64.3% were males. Sixty-eight percent respondents were from neurosurgery and 32% were from the field of neurology. Approximately 47% responses were from the province of Punjab. More than half (51.5%) of participants acknowledged the existence of a REC within their institution. A similar proportion (52.3%) claimed familiarity with ethical guidelines for research involving human subjects, only a slight majority (48.5%) demonstrated awareness of the specific functions carried out by RECs. Meanwhile, 44.5% expressed concerns that undergoing review by a REC could potentially delay research and pose additional challenges for researchers. Additionally, 27.4% of respondents admitted to considering the fabrication of data or results as acceptable.

CONCLUSION: Our research uncovered a significant correlation between participants’ perceptions of RE and RECs and their comprehension of ethical principles. These findings indicate that medical postgraduates with a deeper understanding or awareness of research ethics principles and RECs tend to hold more robust attitudes toward these aspects.

PMID:39703966 | PMC:PMC11654657 | DOI:10.12669/pjms.40.12(PINS).11116

Patient Prefer Adherence. 2024 Dec 14;18:2545-2557. doi: 10.2147/PPA.S503087. eCollection 2024.

ABSTRACT

BACKGROUND: Understanding medication adherence and its relationship with quality of life (QoL) is essential for improving health outcomes in patients with heart failure (HF).

OBJECTIVE: This study aimed to investigate the predictors of poor quality of life and its relationship with medication adherence among patients with heart failure.

METHODS: A cross-sectional correlational study was performed on 229 patients with HF receiving care at the Cardiac Center of King Salman Specialist Hospital from March to June 2024. Data were collected using a structured questionnaire comprising patient demographics, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to assess QoL, and the General Medication Adherence Scale (GMAS) to measure medication adherence.

RESULTS: The mean medication adherence score among patients with heart HF was 17.53 ± 6.94. The level of adherence was moderate among most patients (47.2%), high (29.7%), and poor (23.1%). Regarding QoL, the mean total score for overall QoL was 42.16 ± 20.53. Specifically, the mean scores were 15.24 ± 8.65 and 10.53 ± 5.82 for the physical and emotional dimensions of QoL, respectively. More than half of the patients experienced poor QoL, while moderate QoL was observed in 31.9% and good QoL in 17% of patients. Furthermore, there were moderate negative correlations between medication adherence and physical QoL (r= -0.51), emotional QoL (r = -0.59), and overall QoL (r = -0.59), all of which were statistically significant (p <0.001).

CONCLUSION: Moderate-to-poor levels of medication adherence and QoL were found among HF patients receiving care in Hail City. Therefore, interventions to improve medication adherence among patients with HF must be prioritized to enhance health outcomes and QoL. It is also crucial to address the factors that negatively influence medication adherence to overcome the barriers that hinder optimal medication adherence.

PMID:39703933 | PMC:PMC11656328 | DOI:10.2147/PPA.S503087

PeerJ. 2024 Dec 16;12:e18652. doi: 10.7717/peerj.18652. eCollection 2024.

ABSTRACT

OBJECTIVE: This systematic review and meta-analysis aims to evaluate the effectiveness and safety of Angio-Seal and StarClose vascular closure devices (VCDs) in achieving hemostasis after interventional surgery.

METHODS: Randomized controlled trials (RCTs) and observational studies comparing Angio-Seal and StarClose were identified through systematic searches. Data on vascular closure success rate, complication rates, hematoma formation, pseudoaneurysm, arterial occlusion, and surgical intervention were extracted and pooled using a random effects model.

RESULTS: Nine studies met the inclusion criteria, total 5,466 patients. The meta-analysis revealed a slight, statistically significant difference in the success rate of vascular closure in favor of Angio-Seal (risk ratio (RR) 1.05, 95% confidence interval (CI) [1.00-1.09], p = 0.03). No significant difference was found in the overall complication rate, hematoma formation, pseudoaneurysm, arterial occlusion, or surgical intervention.

CONCLUSIONS: Angio-Seal demonstrated a slightly higher success rate in vessel closure compared to StarClose. Both devices had a comparable safety profile with no significant differences in major complications.

PMID:39703921 | PMC:PMC11657189 | DOI:10.7717/peerj.18652

PeerJ. 2024 Dec 16;12:e18684. doi: 10.7717/peerj.18684. eCollection 2024.

ABSTRACT

OBJECTIVE: To investigate the current status of knowledge, attitude, and practice (KAP) of healthcare professionals in stroke-related departments of primary-level tertiary hospitals regarding the prevention and treatment of hemiplegic shoulder pain, and to analyze influencing factors. This aims to provide a reference for further training, guidance, and management of hemiplegic shoulder pain.

METHODS: A total of 123 healthcare professionals from stroke-related departments of two tertiary hospitals in a county-level city in Zhejiang province were selected as the research subjects from March 6, 2023, to March 14, 2023. Written informed consent was obtained from all study participants prior to their inclusion in the study. A questionnaire survey was conducted to assess their KAP status on the prevention and treatment of hemiplegic shoulder pain, and statistical analysis was performed using SPSS 23.

RESULTS: The scores for knowledge (29.97 ± 9.94), attitude (27.7 ± 2.81), and behavior (29.86 ± 7.86) among the 123 healthcare professionals indicated that department and position were influencing factors for KAP (P < 0.05).

CONCLUSION: The overall KAP of healthcare professionals in stroke-related departments of primary hospitals regarding the prevention and treatment of hemiplegic shoulder pain needs improvement. Strengthening relevant knowledge and skills training is necessary to reduce the incidence of hemiplegic shoulder pain and improve patients’ quality of life.

PMID:39703917 | PMC:PMC11657197 | DOI:10.7717/peerj.18684

PeerJ. 2024 Dec 16;12:e18679. doi: 10.7717/peerj.18679. eCollection 2024.

ABSTRACT

BACKGROUND: Cerebral palsy (CP) covers a wide range of causes and symptoms. It is characterized by persistent motor and postural dysfunction caused by a non-progressing pathological lesion of the immature brain. Development of fine motor skills, such as the ability to manipulate objects with smaller muscles, is crucial for a child’s development. It is evident that there is a lack of hand grip strength (HGS) and quality of life (QoL) data in children with CP compared to typically developed (TD) children. Understanding the relationship between these factors might help facilitate healthcare provision and provide insight into rehabilitation programs. The aim of this study is to investigate the relationship between HGS and health-related quality of life (HRQoL) in children with CP compared to TD children.

METHODS: An experimental cross-sectional study was conducted and 60 children (30 CP and 30 TD) were chosen; age, gender, height, weight, body mass index, preferred hand, number of siblings, school attendance, and housing type data were collected. HGS was measured using a standard hand dynamometer, and HRQoL was measured using the KIDSCREEN-10 item questionnaire.

RESULTS: There was a statistically significant main effect of gender on the average HGS, F (1, 56) = 24.09, p < 0.001, and the KIDSCREEN-10 sum score, F (1, 56) = 8.66, p < 0.001, and the main effect of group on the KIDSCREEN-10 sum score, F (1, 56) = 17.64, p < 0.001. A significant correlation between HGS and the KIDSCREEN-10 sum score in the CP group (r = 0.35, p = 0.03), and the TD group (r = 0.56, p = 0.001).

CONCLUSION: HGS was lower in children with CP, and girls had significantly lower HGS compared to boys in both groups, CP and TD children. HRQoL was significantly lower in children with CP, with boys reporting higher HRQoL on the KIDSCREEN-10 questionnaire compared to girls. Our data showed that the higher the KIDSCREEN-10 sum score is, the stronger the HGS of children in both groups. The results of this study indicate that hand grip strength may significantly impact the QoL of children with CP. A correlation between HGS and HRQoL points to the importance of improving strength in children with CP through interventions and directed rehabilitation programs.

PMID:39703915 | PMC:PMC11657191 | DOI:10.7717/peerj.18679