Tag: pubmed

J Shoulder Elbow Surg. 2023 Sep 1:S1058-2746(23)00639-0. doi: 10.1016/j.jse.2023.07.039. Online ahead of print.

ABSTRACT

BACKGROUND: Anatomic and reverse total shoulder arthroplasty (aTSA, rTSA) are well-established treatments for patients with primary osteoarthritis and an intact cuff. However, it is unclear whether aTSA or rTSA provide superior outcomes in patients with preoperative external rotation (ER) weakness.

METHODS: A retrospective review of a prospectively collected shoulder arthroplasty database was performed between 2007-2020. Patients were excluded for preoperative diagnoses of nerve injury, infection, tumor, or fracture. Analysis included 333 aTSAs and 155 rTSAs performed for primary cuff-intact osteoarthritis with 2-year minimum follow-up. Defining preoperative ER weakness as strength ≤7.2 pounds, 3 cohorts were created and matched: 1) weak aTSAs (n = 74) vs normal aTSAs (n = 74), 2) weak rTSAs (n = 38) vs normal rTSAs (n = 38), and 3) weak rTSAs (n = 60) vs weak aTSAs (n = 60). We compared ROM, outcome scores, strength, complications, and revision rates at latest follow-up.

RESULTS: Despite weak aTSAs having poorer preoperative strength in FE and ER (P<.001), neither of these deficits persisted postoperatively compared to the normal cohort. Likewise, weak rTSAs had poorer preoperative strength in FE and ER, overhead motion, and Constant, SPADI, and UCLA scores (P<.029). However, no statistically significant differences were found between preoperatively weak and normal rTSAs. When comparing weak aTSA versus weak rTSA, no differences were found in preoperative and postoperative outcomes, proportion of patients achieving the MCID and SCB, and complication and rate of revision surgery.

CONCLUSION: In preoperatively weak patients with cuff-intact primary osteoarthritis, aTSA leads to similar postoperative strength, ROM, and outcome scores compared to patients with normal preoperative strength, indicating preoperative weakness does not preclude aTSA use. Furthermore, patients who were preoperatively weak in ER demonstrated improved postoperative rotational motion after undergoing aTSA and rTSA, with both groups achieving the MCID and SCB at similar rates.

PMID:37660887 | DOI:10.1016/j.jse.2023.07.039

J Dent. 2023 Sep 1:104684. doi: 10.1016/j.jdent.2023.104684. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to verify the non-inferiority of Endocem MTA Premixed and Well-Root PT, compared with ProRoot MTA in the pulpotomy of primary molars. In addition, we tried to determine the factors that affect the prognosis of pulpotomy in primary molars.

METHODS: This randomized clinical trial enrolled 158 molars of 52 children; 153 teeth were finally included and divided into three groups: ProRoot MTA (n = 50), Endocem MTA Premixed (n = 53), and Well-Root PT (n = 50). Clinical and radiographic follow-up was performed at 3, 6, and 12 months postoperatively and at the last visit post-treatment. Data were analyzed using the Fisher’s exact test, Cox regression analysis, and the Kaplan-Meier survival curve method.

RESULTS: The success rates in the ProRoot MTA, Endocem MTA Premixed, and Well-Root PT were 92%, 84.9, and 82%, respectively. The cumulative survival rates did not differ significantly among the materials. Among the investigated variables, only ΔF and ΔF max significantly affected the success rates. In the multivariate survival tree model, significant unfavorable survival was observed when the ΔF value was -14.4 or less (hazard ratio, 7.56; P = 0.0295).

CONCLUSIONS: Considering the clinical effectiveness of Endocem MTA Premixed and Well-Root PT and the operational convenience as a premixed type, they can be used as advantageous materials in the pulpotomy of primary molars in pediatric patients. The QLF method is a useful diagnostic method that can establish treatment plans and determine the prognosis of pulpotomy based on the ΔF value in primary molars.

CLINICAL SIGNIFICANCE: Endocem MTA Premixed and Well-Root PT can confer high success rates and are non-inferior to ProRoot MTA in pulpotomy for primary molars. We also showed that QLF technology can be applied to predict the success/failure and prognosis of pulpotomies in primary molars.

PMID:37660882 | DOI:10.1016/j.jdent.2023.104684

Environ Res. 2023 Sep 1:117062. doi: 10.1016/j.envres.2023.117062. Online ahead of print.

ABSTRACT

Psoriasis is one of the most common immune-mediated inflammatory diseases (IMIDs). Living in a rural environment during childhood is associated with a decreased risk of certain IMIDs, like asthma, in adulthood. However, its role in other IMIDs, such as psoriasis is still unclear. To evaluate the relationships between different factors related to the environment during childhood and the risk of psoriasis in adulthood we conducted a study in E3N, a French prospective cohort composed of 98 995 women. During the 1990-2018 follow-up of 72 154 study participants, we identified 1967 incident cases of psoriasis from self-reports in self-administered structured questionnaires. During the 2004-2018 follow-up of 67 917 study participants, 188 moderate-to-severe cases of psoriasis were identified through self-reports and from data from a drug reimbursement database. We fitted Cox proportional hazards regression models with age as the time scale and adjusted for putative confounders (aHRs). We found inverse associations with risk of psoriasis for rural birthplace [aHR: 0.89 (95%CI: 0.79-0.96)] and for having farming parents [aHR: 0.84 (95%CI: 0.72-0.97)]. For moderate-to-severe psoriasis we found a nominally similar inverse association with rural birthplace but not with having farming parents. Our results suggest that an exposure to a rural environment during childhood may be associated with a reduced risk of psoriasis. These findings may help to improve our understanding of the pathogenesis of psoriasis.

PMID:37660877 | DOI:10.1016/j.envres.2023.117062

Sci Total Environ. 2023 Sep 1:166780. doi: 10.1016/j.scitotenv.2023.166780. Online ahead of print.

ABSTRACT

BACKGROUND: Growing studies have focused on the effects of ambient air pollution on thyroid hormones (THs), but the results were controversial. Therefore, a systematic review and meta-analysis was conducted by pooling current evidence on this association.

METHODS: Four databases were searched for studies examining the associations of particulate matter [diameter ≤10 μm (PM₁₀) or ≤2.5 μm (PM_2.5)] and gaseous [sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), carbon monoxide (CO)] pollutants with THs levels. Random effects models were used to pool the changes in THs levels with increasing air pollutant concentrations. Subgroup analyses were constructed by region, design, sample size, pollutant concentrations, evaluated methods, and potential risk exposure windows.

RESULTS: A total of 14 studies covering 357,226 participants were included in this meta-analysis. The pooled results showed significant associations of exposure to PM_2.5, PM₁₀, NO₂, SO₂, and CO with decreases in free thyroxine (FT4) with percent changes (PC) ranging from -0.593 % to -3.925 %. PM_2.5, NO₂, and CO were negatively associated with levels of FT4/FT3 (PC: from -0.604 % to -2.975 %). In addition, results showed significant associations of PM_2.5 with hypothyroxinemia and high thyroid-stimulating hormone (TSH). Subgroup analyses indicated that PM_2.5 and NO₂ were significantly associated with FT4 in studies of Chinese, and similar significant findings were found in studies of PM_2.5 and FT4/FT3 in areas with higher concentrations of air pollutants and larger samples. PM_2.5 exposure in the first trimester was found to be associated with lower FT4 levels in pregnant women.

CONCLUSION: Our findings suggest that exposure to air pollution is associated with changes in THs levels. Enhanced management of highly polluted areas, identification of harmful components and sources of PM, and protection from harmful exposures in early pregnancy may be of great public health importance for the population’s thyroid function.

PMID:37660827 | DOI:10.1016/j.scitotenv.2023.166780

Gynecol Oncol. 2023 Sep 1;177:117-124. doi: 10.1016/j.ygyno.2023.08.013. Online ahead of print.

ABSTRACT

OBJECTIVE: In 2014, the World Health Organization introduced a new histologic classification by dividing primary mucinous ovarian carcinoma (PMOC) into two: expansile (ES) or infiltrative subtypes (IS). This study investigated the clinical implications of these histological subtypes on survival outcomes.

METHODS: Data from 131 patients with PMOC who underwent primary surgery between 2003 and 2021 were analyzed. The patients baseline characteristics, surgical and pathological information were collected. Survival outcomes were calculated, while factors affecting them were also investigated.

RESULTS: During 55.9 months of median follow-up, 27 (20.6%) patients experienced recurrence and 20 (15.3%) died. Among 131 patients, 113 patients were classified into 87 (77%) ES and 26 (23%) IS after a slide review. Advanced stage, lymph node involvement, and residual tumors after surgery were more common in the IS, showing poorer prognosis. In multivariate analyses, advanced stage and residual tumors after surgery were associated with worse survival, while the IS showed no statistical significance. In subgroup analysis for stage I disease, survival did not vary between subtypes. Nevertheless, patients in the IS group who underwent fertility-sparing surgeries demonstrated a 5-year progression-free survival (PFS) rate of 83.3%, significantly lower than patients without fertility preservation, irrespective of histologic subtypes (5-year PFS rate: 97.9%; P = 0.002 for the ES, 5-year PFS rate: 100%; P = 0.001 for the IS).

CONCLUSIONS: The IS of PMOC had poorer survival outcomes and a higher proportion of advanced-stage tumors. Although its independent prognostic significance remains uncertain, adjuvant chemotherapy should be considered for patients with fertility preservation in the IS group.

PMID:37660413 | DOI:10.1016/j.ygyno.2023.08.013

Br J Radiol. 2023 Sep 3:20220598. doi: 10.1259/bjr.20220598. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study is to present the clinical and imaging findings of 16 patients with intraventricular pilocytic astrocytomas.

METHODS: Sixteen patients with histopathological diagnosis of intraventricular pilocytic astrocytoma between February 2016 and January 2022 were evaluated retrospectively. Imaging and clinical findings of the patients, as well as ADC measurements were analyzed.

RESULTS: Of 16 patients, 8 (%50) were male and 8 (%50) were female. The mean age of the patients was 20,8 years (2-44 years range). The most common symptoms in the patients were headache and ataxia. The mean long-axis size of lesions was found to be 48.19 ± 21.59 (range, 15-92 mm). Nine out of 16 lesions (56.2%) were located in the fourth ventricle. The majority of the lesions were iso-hypointense in T1W and hyperintense in T2W images. The mean ADC value of PAs was 1.57 × 10^-3±0.2 mm²/s, while the mean thalamic ADC and white matter ADC values were found to be 0.78 × 10-3±0.04 mm² and s 0.76 × 10-3±0.06 mm² / s, respectively. There was a statistically significant difference between the ADC values obtained from the solid components of the lesions and the thalami/white matter (p < 0.001).

CONCLUSIONS: PAs often originate from midline structures, however, they can also be located intraventricularly. Although intraventricular pilocytic astrocytomas are frequently seen in pediatric population, it should be kept in mind that they can also be seen in adults, albeit rarely.

ADVANCES IN KNOWLEDGE: PA should be considered in the differential diagnosis of intraventricular neoplasms in case of high ADC values.

PMID:37660368 | DOI:10.1259/bjr.20220598

Int J Dent Hyg. 2023 Sep 3. doi: 10.1111/idh.12727. Online ahead of print.

ABSTRACT

OBJECTIVES: Learning styles have been studied in dental and generational research, but research has been limited with Millennial and Generation Z dental hygiene students. The purpose of this quantitative comparative study was to determine if and to what extent there was a difference between Generation Z and Millennial dental hygiene students’ preferred learning styles.

METHODS: First- and second-year dental hygiene students attending three programs located in Southern California were invited to participate in the study. Additional participants were recruited through dental hygiene social media sites. The 44 item Felder-Soloman Index of Learning Styles (ILS) was administered via an online survey platform. Millennial and Generation Z participants were compared on the four dimensions of the ILS: active/reflective, sensing/intuitive, visual/verbal, and sequential/global. The data were analysed using descriptive statistics and the independent samples t-test.

RESULTS: A total of 150 dental hygiene students agreed to participate; Millennials (n = 61), Generation Z (n = 89). There was no significant difference between Millennial and Generation Z students in the active/reflective, sensing/intuitive, or sequential/global dimensions (p > 0.05); both cohorts preferred the active, sensing, and sequential learning styles. There was a statistically significant difference in the visual/verbal dimension with Millennials indicating a significantly greater preference for the visual learning style than Generation Z (p = 0.04).

CONCLUSION: There may be differences between the learning styles of Millennial and Generation Z dental hygiene students. The finding that Generation Z students differ significantly from Millennials on the visual-verbal dimension may indicate a shift toward the verbal dimension learning style that needs further study.

PMID:37660363 | DOI:10.1111/idh.12727

Diabet Med. 2023 Sep 3:e15219. doi: 10.1111/dme.15219. Online ahead of print.

ABSTRACT

AIM: To better understand the prevalence of self-reported psychosocial burdens and the unmet needs identified by people with diabetes in relation to routine diabetes visits.

METHODS: An English language, online survey was distributed via social media, key stakeholder networks, charity and advocacy groups to adults with type 1 diabetes or type 2 diabetes. Survey items were designed by members of the FDA RESCUE Collaborative Community Governing Committee prior to pilot testing with potential participants. Descriptive statistical analyses were conducted; as well as thematic analyses on free text responses using NVivo v14.

RESULTS: 478 participants completed the survey. 373 (78%) had type 1 diabetes, 346 (73%) identified as a woman and 433 (91%) were white. Most participants had experienced self-reported (rather than diagnosed) anxiety and depression (n=323 and n=313 respectively), as well as fear of low blood sugars (n=294), low mood (n=290) and diabetes-related distress (n=257). 68% reported diabetes had negatively affected self-esteem and 62% to feelings of loneliness but 93% reported friends/family/work colleagues were supportive when needed. 272 (57%) reported their diabetes team had never raised the topic of mental health. The overwhelming majority stated the best thing their diabetes team could do to help was to simply ask about mental well-being; listen with empathy and without judgement; and practice skills to understand psychosocial issues in diabetes.

CONCLUSION: Integrating psychosocial discussions and support within routine healthcare visits is crucial to improve outcomes for people with diabetes. Such a biopsychosocial model of healthcare has long been advocated by regulatory bodies.

PMID:37660355 | DOI:10.1111/dme.15219

Orv Hetil. 2023 Sep 3;164(35):1367-1372. doi: 10.1556/650.2023.32854. Print 2023 Sep 3.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic influenced not only the elective, but the acute surgeries also, all around the world. Some authors found more delayed cases and more orchiectomies performed in childhood because of testicular torsions during the pandemic.

OBJECTIVE: To examine the impact of the COVID-19 pandemic on the treatment of childhood testicular torsion and the frequency of semicastration due to torsion at the first author’s institute.

METHODS: A retrospective observational cohort study was performed in a representative Hungarian centre. Boys under 18 years of age operated with testicular torsion were divided into two groups: before COVID-19 (BC; 01/07/2017-31/12/2019) and during COVID-19 (DC; 01/01/2020-30/06/2022) pandemic.

PARAMETERS: elapsed time between the first symptom and arrival at the hospital (<24 h or >24 h), elapsed time to start the surgical procedure since the arrival to the hospital and the rate of semicastration were analysed. For statistical analysis, Mann-Whitney U and chi2 tests were used.

RESULTS: During the study period, altogether, 100 patients (45 BC and 55 DC) were operated on testicular torsion. Statistically significant difference was found between the two timeframes: in the elapsed time from the first symptom and arrival at the hospital (p = 0.048). During the pandemic surgeries started earlier (1.5; 2.5 h) than before the pandemic (1.5; 3.25 h, p = 0.01). No difference was found in the frequency of semicastration between the groups (p = 0.594).

DISCUSSION: Contrary to the literature, during the COVID-19 pandemic, patients with testicular torsion arrived earlier at the hospital, and surgeries were started earlier, than before the pandemic at the investigated institute.

CONCLUSION: The reason behind this accelerated care pathway might be the absence of less severe cases during the COVID-19 period. When people are more prone to stay home, if it does not seem necessary to seek help for any kind of non-urgent medical problem. Orv Hetil. 2023; 164(35): 1367-1372.

PMID:37660346 | DOI:10.1556/650.2023.32854

Biostatistics. 2023 Aug 31:kxad022. doi: 10.1093/biostatistics/kxad022. Online ahead of print.

ABSTRACT

Despite growing interest in estimating individualized treatment rules, little attention has been given the binary outcome setting. Estimation is challenging with nonlinear link functions, especially when variable selection is needed. We use a new computational approach to solve a recently proposed doubly robust regularized estimating equation to accomplish this difficult task in a case study of depression treatment. We demonstrate an application of this new approach in combination with a weighted and penalized estimating equation to this challenging binary outcome setting. We demonstrate the double robustness of the method and its effectiveness for variable selection. The work is motivated by and applied to an analysis of treatment for unipolar depression using a population of patients treated at Kaiser Permanente Washington.

PMID:37660312 | DOI:10.1093/biostatistics/kxad022