Tag: pubmed

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):368-375. doi: 10.13201/j.issn.2096-7993.2025.04.014.

ABSTRACT

Objective:To investigate the incidence of collateral circulation in high-risk patients with sleep apnea and stroke treated by continuous positive airway pressure （CPAP） ventilation and to analyze the influencing factors. Methods:A total of 152 patients diagnosed with obstructive sleep apnea-hypopnea syndrome （OSAHS） combined with acute ischemic stroke （AIS） who were admitted to our hospital from January 2020 to June 2022 were selected for this study. Based on the apnea-hypopnea index （AHI）, the patients were divided into three groups: mild （n=44）, moderate （n=72）, and severe （n=36）. After treatment, the patients were further classified into a group without collateral circulation （n=30） and a group with collateral circulation （n=26）, which included those with moderate collateral circulation （n=69） and good collateral circulation （n=27）. Clinical data across the different groups were compared, and multiple factor analysis was performed to identify factors affecting the occurrence of collateral circulation. Results:The AHI and IL-6 levels in the severe group were significantly higher than those in the mild and moderate groups, while the levels of NO and PO2 were significantly lower in the severe group compared to the mild and moderate groups, with statistically significant differences among the three groups （P<0.05）. After treatment, all groups showed improvement, and the proportion of patients with collateral circulation was 84.09% in the mild group, 81.94% in the moderate group, and 72.22% in the severe group. Significant differences in age, AHI, NIHSS, NO, MoCA, and MMSE scores were observed between the groups with and without collateral circulation （P<0.05）. In the group with collateral circulation, the scores for age, AHI, and NIHSS in the good collateral circulation subgroup were significantly lower than those in the poor collateral circulation and moderate collateral circulation subgroups, while the scores for NO, MoCA, and MMSE were significantly higher in the good collateral circulation subgroup. Multi-factor analysis revealed that age, AHI, and NIHSS were independent risk factors for collateral circulation, whereas NO, MoCA, and MMSE served as protective factors that were negatively correlated with collateral circulation. Classification tree model results indicated that AHI had the greatest influence on the occurrence of collateral circulation among the five influencing factors, demonstrating good predictive capability. Conclusion:Most high-risk patients with sleep apnea and stroke are likely to develop collateral circulation following continuous positive airway pressure ventilation. Factors such as age, AHI, NIHSS, NO, MoCA, and MMSE are important determinants affecting the occurrence of collateral circulation.

PMID:40166881 | DOI:10.13201/j.issn.2096-7993.2025.04.014

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):357-361. doi: 10.13201/j.issn.2096-7993.2025.04.012.

ABSTRACT

Objective:To investigate the effects of the Epley and Semont procedures with varying lateral angles of the head on posterior semicircular canal benign paroxysmal positional vertigo （PC-BPPV）. Methods:A total of 115 patients with unilateral PC-BPPV were randomly divided into five groups: Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group, with 23 patients in each group. Corresponding reduction treatments were performed. Results:The total effective rates for the Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group were 95.7% （22/23）, 4.3% （1/23）, 30.4% （7/23）, 52.2% （12/23）, and 87.0% （20/23） respectively. The inefficiencies were 4.3% （1/23）, 95.7% （22/23）, 69.6% （16/23）, 47.8% （11/23）, and 13.0% （3/23）. Statistically significant differences were observed in the total effective rates among the five groups （χ²=54.11, P<0.01）. The total effective rates in the Semont group, Semont+10° group, and Semont+20° group were significantly different from that of the Epley group （P<0.01）, while no statistically significant difference was found between the Semont+30° group and the Epley group （P= 0.608>0.012 5）. Conclusion:Among the four Semont methods with different lateral lying angles, the total effective rate of reduction treatment increased with the elevation of the lateral lying angle on the affected side. The efficacy of the Semont+30° group in treating PC-BPPV was not significantly different from the Epley group’s reduction effect, which was markedly superior to that of the other four Semont methods at different angles. Therefore, the Semont+30° reduction technique is recommended for the treatment of PC-BPPV.

PMID:40166879 | DOI:10.13201/j.issn.2096-7993.2025.04.012

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):338-343. doi: 10.13201/j.issn.2096-7993.2025.04.009.

ABSTRACT

Objective:To compare the outcomes of simultaneous versus staged nasal bone reduction and septoplasty in the treatment of traumatic nasal bone fractures with associated septal fractures. Methods:Patients with traumatic nasal bone fractures, with or without septal fractures, were recruited from two hospitals and divided into three groups. Group A underwent simultaneous nasal bone reduction and septoplasty, Group B underwent staged nasal bone reduction and septoplasty, and Group C underwent nasal bone reduction only. Nasal appearance scores and nasal congestion Visual Analogue Scale （VAS） scores were measured preoperatively, at 2 weeks postoperatively, and at 3 months postoperatively. For Group B, scores were also recorded at 2 weeks and 3 months after the second-stage surgery. Differences were analyzed using statistical software. Results:Two weeks post-surgery, the nasal appearance scores significantly decreased in all three groups compared to preoperative scores （P< 0.01）, with no statistically significant differences between the groups （P= 0.43, 0.71, 0.58）. In Group A, the VAS score for nasal congestion decreased significantly following simultaneous surgery （P<0.01）. In Group B, there were no significant differences in nasal congestion VAS scores between pre-surgery and post-first-stage, nor between three months post-first-stage and two weeks post-first-stage （P= 0.61, 0.13）. However, the VAS scores significantly decreased after the second-stage surgery compared to pre-surgery, and three months post-second-stage surgery compared to three months post-first-stage surgery （P<0.01）. The VAS scores for nasal congestion at two weeks post-surgery in Group A were lower than those in Group B after the first-stage surgery （P<0.01）. The incidence rates of nasal adhesions post-surgery in Groups A, B, and C were 0%, 6.9%, and 4.3%, respectively. Conclusion:For traumatic nasal bone fractures with associated septal fractures, performing simultaneous nasal bone reduction and septoplasty under general anesthesia using endoscopy is more time-efficient compared to staged surgery, and it results in a lower occurrence rate of post-surgical nasal adhesions.

PMID:40166876 | DOI:10.13201/j.issn.2096-7993.2025.04.009

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):328-332. doi: 10.13201/j.issn.2096-7993.2025.04.007.

ABSTRACT

Objective:To compare the changes in distortion product otoacoustic emission （DPOAE） test results in clinical patients with negative middle ear pressure after equalizing the pressure in the external canal and the middle ear cavity. This study aims to analyze the effect of negative middle ear pressure on otoacoustic emissions and investigate the correlation between the degree of negative middle ear pressure and the changes in amplitude and signal-to-noise ratio of DPOAE. Methods:Twenty-seven clinical patients were included, with 34 ears exhibiting negative middle ear pressure. Acoustic conductance tests, pure tone hearing threshold tests, and DPOAE tests were conducted under ambient pressure and peak pressure after equalizing the middle ear pressure for all tested ears. The amplitude and signal-to-noise ratio of DPOAE before and after compensating for middle ear pressure were recorded and statistically analyzed. Results:At 1.0 k Hz, 1.5 k Hz, and 8.0 k Hz, the DPOAE amplitude under ambient pressure was significantly higher than that under negative pressure （P<0.05）. A significant difference in the DPOAE signal-to-noise ratio was observed at 1.0 k Hz and 8.0 k Hz （P<0.05）. The difference in both amplitude and signal-to-noise ratio between these two test conditions was more pronounced at 1.0 k Hz （P<0.01）. There was no correlation between the negative pressure value from the tympanogram and the change in amplitude, with a weak negative correlation trend observed only at 0.75 k Hz （r=-0.328, P=0.054）. However, a significant negative correlation was found between the negative pressure value from the tympanogram and the change in signal-to-noise ratio at 0.75 k Hz （r=-0.366, P<0.05）. Conclusion:Compensating for middle ear pressure significantly improves the amplitude and signal-to-noise ratio of DPOAE in cases of negative middle ear pressure, particularly in the medium-frequency range. The smaller the degree of negative pressure in the middle ear, the weaker the effect of equalizing middle ear pressure is, especially in the low-frequency range.

PMID:40166874 | DOI:10.13201/j.issn.2096-7993.2025.04.007

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):324-327;332. doi: 10.13201/j.issn.2096-7993.2025.04.006.

ABSTRACT

Objective:To explore the influence of voice training combined with active breathing and circulation techniques on voice recovery following vocal cord polyp surgery. Methods:A total of 110 patients who underwent vocal cord polyp surgery at our hospital from May 2022 to November 2023 were selected and randomly divided into a control group （n=55） and a combination group （n=55） using a random number table method. During the recovery period, both groups received dietary control and aerosol treatment. The control group participated in voice training, while the combination group received active breathing and circulation techniques in addition to voice training for 2 months. Morphological changes, voice acoustic indicators （Shimmer, Jitter, Maximum Phonation Time[MPT]）, and the Voice Handicap Index （VHI） were compared between the two groups, and clinical efficacy was evaluated. Results:The combination group demonstrated higher clinical efficacy after training compared to the control group, with a statistically significant difference （P<0.05）. The proportion of incomplete closure, abnormal mucosal wave, and supraglottic compensation decreased in both groups after training （P<0.05）. However, there was no significant difference in the proportions of incomplete closure and abnormal mucosal wave between the two groups （P>0.05）. Notably, the proportion of patients with supraglottic compensation in the combination group was lower than in the control group （P<0.05）. After training, the Shimmer and Jitter values decreased in both groups, with the combination group exhibiting lower values （P<0.05）. Conversely, the MPT values increased in both groups, again with higher values in the combination group （P<0.05）. Additionally, after training, the functional, physiological, and emotional scores of the VHI decreased in both groups, with the scores in the combination group lower than those in the control group, demonstrating statistical significance （P<0.05）. Conclusion:Voice training combined with active breathing and circulation techniques has a beneficial effect on recovery following vocal cord polyp surgery. This combined approach significantly improves vocal cord morphology and acoustic indices, alleviates voice disorders, and enhances overall voice recovery.

PMID:40166873 | DOI:10.13201/j.issn.2096-7993.2025.04.006

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):319-323. doi: 10.13201/j.issn.2096-7993.2025.04.005.

ABSTRACT

Objective:To evaluate the utility of the Rapid Axial Roll Test （RART）, Supine Roll Test （SRT）, and Lying-Down Test （LDT） in determining the affected semicircular canal in cases of horizontal semicircular canal benign paroxysmal positional vertigo （HSC-BPPV）. Methods:A total of 330 patients diagnosed with HSCBPPV from September 2022 to September 2023 were collected and divided into three groups based on the different positional tests received: ①SRT Group, ②LDT+SRT Group, ③RART+SRT Group. The trial was divided into two stages: LDT/RART for patients in the first stage, and SRT for patients in the second stage. The elicitation rate of nystagmus among the three groups was compared to evaluate the accuracy in determining the affected semicircular canal in HSCBPPV. Results:Nystagmus was elicited in 84.55% （279/330） of the patients by positional tests. The elicitation rate of nystagmus in the RART+SRT/LDT group was 94.55% （104/110）, in the LDT+SRT group it was 84.11% （90/107）, and in the SRT group it was 69.91% （79/113）. The differences among the three groups were statistically significant （χ²= 23.88, P<0.001）. In the ② and ③ groups, there was a statistically significant difference in the elicitation rate of nystagmus between stage Ⅰ （patients with LDT or RART） （χ²=43.842, P<0.001）. SRT was performed in the stage Ⅱ, and there was a statistically significant difference in nystagmus extraction rate between the two groups （χ² =4.690, P=0.030）. The difference in the proportion of agreement between stage Ⅰ（LDT or RART） and stageⅡ （SRT） in determining the affected side of the semicircular canal was also statistically significant （χ² =40.502, P<0.001）. For patients with a consistent diagnosis of the affected semicircular canal, the difference in cure rate was not significant （P=0.149）. The Kappa statistic indicated substantial agreement between RART and SRT in terms of eliciting nystagmus （agreement 96.36%, Kappa = 0.730, P<0.001）. Conclusion:RART and SRT show a high degree of agreement regarding the elicitation rate of nystagmus. RART is simple and safe, and it can effectively induce the characteristic nystagmus of HSC-BPPV, accurately identify the responsible semicircular canal and provide a more optimized examination protocol for clinical practice in HSCBPPV.

PMID:40166872 | DOI:10.13201/j.issn.2096-7993.2025.04.005

Physiother Res Int. 2025 Apr;30(2):e70056. doi: 10.1002/pri.70056.

ABSTRACT

BACKGROUND: A frequent sequela of stroke is upper limb (UL) impairment. Accurate UL function prognosis is crucial for targeted rehabilitation.

OBJECTIVE: To determine the accuracy of physiotherapists’ predictions of UL function and investigate whether prediction accuracy is affected by physiotherapists’ seniority within rehabilitation and/or their level of education. Physiotherapist predictions were compared with a prediction algorithm.

METHODS: Data from 81 patients were included. Two weeks post-stroke, physiotherapists predicted UL function based on clinical reasoning. ARAT scores (poor, limited, good, or excellent) at 3 months post-stroke served to determine prediction accuracy. Prediction accuracy was calculated as correct classification rate (CCR). Logistic regression was used to explore the effect of seniority and education. McNemar’s test was applied to compare physiotherapist predictions to an algorithm applied 2 weeks post-stroke to the same patients.

RESULTS: The overall correct classification rate (CCR) of physiotherapist predictions was 41% (95% CI: 30-51). Predictions were most accurate for the excellent (75%) and poor (71%) categories, but lower for limited (22%) and good (30%). No association was observed between prediction accuracy and physiotherapist seniority or education. There was a tendency, but not a statistically significant superiority, in the prediction accuracy of the algorithm compared to the physiotherapist predictions (Odds ratio 2 [95% CI: 0.96-4.39], McNemar p = 0.0455, exact McNemar p = 0.0652).

TRIAL REGISTRATION: Project number: 628213.

PMID:40166834 | DOI:10.1002/pri.70056

Brain. 2025 Apr 1:awaf111. doi: 10.1093/brain/awaf111. Online ahead of print.

ABSTRACT

RAB3A encodes a small GTP-binding protein that is abundant in brain synaptic vesicles and crucial for the release of neurotransmitters and synaptic plasticity. Here we identified RAB3A as a candidate gene for autosomal dominant cerebellar ataxia by two independent approaches: linkage in a large dominant ataxia family and, in parallel, an untargeted computational genetic association approach, analyzing the 100,000 Genomes Project datasets. To further validate the role of RAB3A in ataxia, we next screened large rare disease databases for rare heterozygous RAB3A variants in probands with ataxia features. In total, we identified 18 individuals from 10 unrelated families all sharing a cerebellar ataxia phenotype. Notably, 9 out of 10 families carried a recurrent variant in RAB3A, p.Arg83Trp, including one de novo occurrence. In addition, our screening revealed three families with a neurodevelopmental phenotype and three unique RAB3A variants, which were either de novo or loss-of-function variants. In line with the different RAB3A variant types, protein domains, and predicted functional consequences, a comprehensive set of complementary methods was used to functionally characterize the identified variants. As expected, GTPase-activating protein (GAP)-dependent GTP hydrolysis was reduced for those two missense variants located in the GAP binding domain of RAB3A (Arg83Trp, Tyr91Cys). In a Drosophila Rab3 loss-of-function model, these two missense variants also failed to rescue a synaptic phenotype. Overexpression of Rab3 variants in Drosophila wildtype background did not cause an obvious phenotype, making a dominant negative effect of these variants unlikely. Lastly, exploring interactors of RAB3A variants by using co-immunoprecipitation and mass spectrometry showed differential changes in variant-specific interactions with known RAB3A key regulatory and effector proteins. In sum, our results establish RAB3A as a neurological disease gene. It represents an autosomal dominant gene for cerebellar ataxia with different variants associated with disease, including the frequent reoccurring variant p.Arg83Trp. Our study sheds light on the variant-specific interactome of RAB3A. Finally, we suggest an association of RAB3A with a neurodevelopmental phenotype, as reported for variants in several RAB3A interaction partners and as seen in Rab3A-deficent mice, although this possible association warrants further investigation by future studies.

PMID:40166812 | DOI:10.1093/brain/awaf111

Parasite Epidemiol Control. 2025 Mar 13;29:e00422. doi: 10.1016/j.parepi.2025.e00422. eCollection 2025 May.

ABSTRACT

BACKGROUND: Malaria and schistosomiasis are two parasite illnesses that share transmission sites in distinct tropical climates. Malaria-schistosomiasis coinfection is widespread in Africa. Also, malaria and Schistosoma mansoni coinfection cause exacerbation of health consequences and co-morbidities. However, there is limited pooled data on the prevalence of malaria and Schistosoma mansoni coinfection in sub-Saharan Africa.

OBJECTIVE: This systemic review and meta-analysis aimed to assess the prevalence of malaria and Schistosoma mansoni coinfection in sub-Saharan Africa.

METHOD: Systematic search on PubMed, Scopus, Google Scholar, and Science Direct was used to identify relevant studies following reviews and meta-analysis guidelines. A total of eighteen relevant articles on the prevalence of malaria and Schistosoma mansoni coinfection were identified for final systematic review and meta-analysis. Extracted data was analyzed using STATA software version 17.0. The absence or presence of publication bias was assessed using Egger’s test. Heterogeneity across studies was checked by I² statistics; if the I² value was ≥50 %, significant heterogeneity was considered and subgroup analysis was done.

RESULTS: A total of 18 studies were included for this systematic review and meta-analysis. From this meta-analysis, the pooled prevalence of malaria and Schistosoma mansoni coinfection was 17.39 % (95 % CI: 5.94-28.84). There was significant heterogeneity in prevalence of coinfection, with I² values greater than or equal to 99.97 % at P = 0.00. The subgroup analysis based on year of publication showed that the pooled prevalence of malaria and Schistosoma mansoni coinfection in studies conducted 2014-2018 was 20.73 % (95 % CI: 0.66-40.80), while it was 14.68 % (95 % CI: 1.02-28.34) in studies conducted 2019-2024. On the other hand, subgroup analysis on diagnostic techniques showed significant differences in the pooled prevalence of malaria and Schistosoma mansoni coinfection.

CONCLUSIONS: This systematic review and meta-analysis showed that malaria and Schistosoma mansoni coinfection are prevalent in sub-Saharan Africa.This highlights the region’s major challenges in controlling malaria and Schistosoma mansoni coinfections.To ensure the efficiency of coinfections control and treatment, regular monitoring, identification, and reduction of the prevalence of malaria and Schistosoma mansoni coinfection must be maintained. Furthermore, cooperative efforts at local, countrywide, and global levels are necessary to address the multifaceted factors causal to malaria-S.mansoni coinfection.

PMID:40166801 | PMC:PMC11957671 | DOI:10.1016/j.parepi.2025.e00422

Cureus. 2025 Mar 1;17(3):e79869. doi: 10.7759/cureus.79869. eCollection 2025 Mar.

ABSTRACT

Lower back pain (LBP) poses a significant challenge for cricketers of all standards, often leading to rehabilitation periods exceeding eight months and potential termination of the playing season. Despite the identification of modifiable risk factors and interventions in previous studies, a comprehensive review of the past decade is absent. With the introduction of shorter formats like Twenty20 (T20) and the rise of franchise cricket, an updated evaluation of risk factors and interventions for preventing and treating LBP in cricketers is needed. This study critically assesses and summarises current understanding in this area, incorporating previous recommendations and considering the evolving cricket landscape. A systematic review was conducted using databases such as SportsDiscus, MEDLINE, CINAHL, ISI Web of Knowledge, and Cochrane Library. Key terms related to LBP in cricketers were utilised. The Down and Black quality assessment tool, in addition to van Tulder’s criteria for levels of evidence, was applied. The quantitative analysis involved meta-analyses conducted using IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York). Sixteen studies, of which 15 were of high quality, investigated risk factors associated with LBP. One low-quality randomised controlled trial examined LBP treatment. The meta-analysis revealed significant associations between LBP and increased workload, decreased bone mineral density, and poor lumbo-pelvic control through increased side flexion during the bowling action. Strong evidence supported the association between the presence of bone marrow oedema (BMO) and LBP. Bone marrow oedema on magnetic resonance imaging (MRI) provides an early indicator before the development of stress fractures, serving as a valid and reliable screening tool. Workload monitoring plays a crucial role in identifying high-risk bowlers. However, further research is needed to establish causal relationships among several other risk factors outlined. Additionally, addressing the scarcity of high-quality interventional studies is of utmost importance.

PMID:40166796 | PMC:PMC11955932 | DOI:10.7759/cureus.79869