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Nevin Manimala Statistics

Significance of Barrier Membrane on the Reconstructive Therapy of Peri-Implantitis: A Randomized Controlled Trial

J Periodontol. 2022 Nov 18. doi: 10.1002/JPER.22-0511. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the clinical and radiographic significance of using a mixture of mineralized and demineralized allografts in combination (M) or not (NM) with a resorbable cross-linked barrier membrane in the reconstructive therapy of peri-implantitis defects.

METHODS: A two-arm randomized clinical trial was performed in patients diagnosed with peri-implantitis that exhibited contained defects. Clinical parameters were recorded at baseline (T<sub>0</sub> ), 6 months (T<sub>1</sub> ) and 12 months (T<sub>2</sub> ). Radiographic parameters were recorded at T<sub>0</sub> and T<sub>2</sub> . A composite criteria for disease resolution was defined a priori. A generalized linear model (GLM) of repeated measures with generalized estimation equations (GEE) statistical methods were used.

RESULTS: Overall, 33 patients (n<sub>implants</sub> = 48) completed the study. At T<sub>2</sub> , mean disease resolution was 77.1%. The use of a barrier membrane did not enhance the probability of disease resolution at T<sub>2</sub> (OR = 1.55, p = 0.737). Conversely, the odds of disease resolution were statistically associated with modified plaque index (mPI) recorded at T<sub>0</sub> (OR = 0.13, p = 0.006) and keratinized mucosa (KM) width (OR = 2.10, p = 0.035). Moreover, women exhibited greater odds to show disease resolution (OR = 5.56, p = 0.02).

CONCLUSION: Reconstructive therapy by means of a mixture of mineralized and demineralized allografts is effective in clinically resolving peri-implantitis and in gaining radiographic marginal bone level. The addition of a barrier membrane to reconstructive therapy of peri-implantitis does not seem to enhance the outcomes of contained bone defects (NCT05282667). This article is protected by copyright. All rights reserved.

PMID:36399349 | DOI:10.1002/JPER.22-0511

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Analysis of intraoperative laboratory measurements and imaging techniques such as Tc-99 m-MIBI SPECT/CT, 18F-fluorocholine PET/CT and ultrasound in patients operated with prediagnosis of parathyroid adenoma

Ir J Med Sci. 2022 Nov 18. doi: 10.1007/s11845-022-03215-3. Online ahead of print.

ABSTRACT

AIM: The aim of this study is to determine accurately the localization of the adenoma with the imaging methods in the patients, who are planned to be operated on with prediagnosis of parathyroid adenoma.

METHOD: In our study, the files of the patients who were considered to have parathyroid adenoma and underwent operation between 2012 and 2020 with the methods such as Tc99m-MIBI SPECT/CT, 18F-fluorocholine PET/CT, and ultrasound, and biochemical examinations were examined retrospectively.

RESULTS: In this study, 31 (18.2%) male and 139 (81.8%) female adult patients were included. The sensitivities of localization methods were 82.6% for ultrasound and 78.4% for scintigraphy. Adenoma was localised in the right place in 14 of 15 (93.3%) patients with the 18F-fluorocholine PET/CT method. A statistically significant correlation was found between the sensitivity of scintigraphy, the gland weights (p: 0.002), and phosphor values (p: 0.039). A statistically significant improvement was observed in the intact PTH value (p: 0.001) 15 min after the removal of adenoma. A statistically significant improvement was observed in the serum PTH value (p: 0.001), the serum phosphorus value (p: 0.001), and the serum calcium (p: 0.001) in the first 3 months after the operation.

CONCLUSION: Determining localization accurately for the patients enables performing operations with minimally invasive surgery successfully in a shorter time. Also, fewer complications and faster recovery are seen in the patients. It was concluded that studying intraoperative intact PTH and using 18F-fluorocholine PET/CT method for localization give more accurate results for localization and allow having more successful operation outcomes.

PMID:36399322 | DOI:10.1007/s11845-022-03215-3

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Prediction of risk factors for first trimester pregnancy loss in frozen-thawed good-quality embryo transfer cycles using machine learning algorithms

J Assist Reprod Genet. 2022 Nov 18. doi: 10.1007/s10815-022-02645-3. Online ahead of print.

ABSTRACT

PURPOSE: Can the risk factors that cause first trimester pregnancy loss in good-quality frozen-thawed embryo transfer (FET) cycles be predicted using machine learning algorithms?

METHODS: This is a retrospective cohort study conducted at Sisli Memorial Hospital, ART and Reproductive Genetics Center, between January 2011 and May 2021. A total of 3805 good-quality FET cycles were included in the study. First trimester pregnancy loss rates were evaluated according to female age, paternal age, body mass index (BMI), diagnosis of infertility, endometrial preparation protocols (natural/artificial), embryo quality (top/good), presence of polycystic ovarian syndrome (PCOS), history of recurrent pregnancy loss (RPL), recurrent implantation failure (RIF), severe male infertility, adenomyosis and endometriosis.

RESULTS: The first trimester pregnancy loss rate was 18.2% (693/ 3805). The presence of RPL increased first trimester pregnancy loss (OR = 7.729, 95%CI = 5.908-10.142, P = 0.000). BMI, which is > 30, increased first trimester pregnancy loss compared to < 25 (OR = 1.418, 95%CI = 1.025-1.950, P = 0.033). Endometrial preparation with artificial cycle increased first trimester pregnancy loss compared to natural cycle (OR = 2.101, 95%CI = 1.630-2.723, P = 0.000). Female age, which is 35-37, increased first trimester pregnancy loss compared to < 30 (OR = 1.617, 95%CI = 1.120-2.316, P = 0.018), and female age, which is > 37, increased first trimester pregnancy loss compared to < 30 (OR = 2.286, 95%CI = 1.146-4,38, P = 0.016). The presence of PCOS increased first trimester pregnancy loss (OR = 1.693, 95%CI = 1.198-2.390, P = 0.002). The number of previous IVF cycles, which is > 3, increased first trimester pregnancy loss compared to < 3 (OR = 2.182, 95%CI = 1.708-2.790, P = 0.000).

CONCLUSIONS: History of RPL, RIF, advanced female age, presence of PCOS, and high BMI (> 30 kg/m2) were the factors that increased first trimester pregnancy loss.

PMID:36399255 | DOI:10.1007/s10815-022-02645-3

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Evaluation of direct restorations using the revised FDI criteria: results from a reliability study

Clin Oral Investig. 2022 Nov 18. doi: 10.1007/s00784-022-04771-9. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this in vitro reliability study was to determine the intra- and inter-examiner agreement of the revised FDI criteria including the categories “fracture of material and retention” (F1) and “caries at restoration margin” (B1).

MATERIALS AND METHODS: Forty-nine photographs of direct tooth-coloured posterior (n = 25) and anterior (n = 24) restorations with common deficiencies were included. Ten dental experts repeated the assessment in three blinded rounds. Later, the experts re-evaluated together all photographs and agreed on a reference standard. Statistical analysis included the calculation of Cohen’s (Cκ), Fleiss’ (Fκ), and weighted Kappa (wκ), the development of a logistic regression with a backward elimination model and Bland/Altman plots.

RESULTS: Intra- and inter-examiner reliability exhibited mostly moderate to substantial Cκ, Fκ, and wκ values for posterior restorations (e.g. Intra: F1 Cκ = 0.57, wκ = 0.74; B1 Cκ = 0.57, wκ = 0.73/Inter F1 Fκ = 0.32, wκ = 0.53; B1 Fκ = 0.41, wκ = 0.64) and anterior restorations (e.g. Intra F1 Cκ = 0.63, wκ = 0.76; B1 Cκ = 0.48, wκ = 0.68/Inter F1 Fκ = 0.42, wκ = 0.57; B1 Fκ = 0.40, wκ = 0.51). Logistic regression analyses revealed significant differences between the evaluation rounds, examiners, categories, and tooth type. Both the intra- and inter-examiner reliability increased along with the evaluation rounds. The overall agreement was higher for anterior restorations compared to posterior restorations.

CONCLUSIONS: The overall reliability of the revised FDI criteria set was found to be moderate to substantial.

CLINICAL RELEVANCE: If properly trained, the revised FDI criteria set are a valid tool to evaluate direct and indirect restorations in a standardized way. However, training and calibration are needed to ensure reliable application.

PMID:36399211 | DOI:10.1007/s00784-022-04771-9

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Impact of suspected adverse drug reactions on mortality and length of hospital stay in the hospitalised patients: a meta-analysis

Eur J Clin Pharmacol. 2022 Nov 18. doi: 10.1007/s00228-022-03419-7. Online ahead of print.

ABSTRACT

PURPOSE: To estimate the risk of mortality and length of stay in hospitalised patients who have experienced suspected adverse drug reactions (ADRs) as compared to patients who did not experience suspected ADRs.

METHODS: A systematic literature search was conducted on databases for observational and randomised controlled studies conducted in any inpatient setting that reported deaths and/or length of hospital stay in patients who had suspected ADRs and did not have suspected ADRs during hospitalisation. PRISMA guidelines were strictly followed during the review. The methodological quality of included studies was assessed using a tool designed by Smyth et al. for the studies of adverse drug reactions. The meta-analytic summary of all-cause mortality was estimated using odds ratio-OR (95% CI) and length of stay using mean difference-MD (95% CI). Both outcomes were pooled using a random effect model (DerSimonian and Laird method). Subgroup and meta-regression were performed based on study variables: study design, age group, study ward, study region, types of suspected ADRs (ADRAd-suspected ADRs that lead to hospitalisation and ADRIn-suspected ADRs that occur following hospitalisation), study duration, sample size and study period. The statistical analysis was conducted through the ‘Review manager software version 5.4.1 and JASP (Version 0.14.1)’.

RESULTS: After screening 475 relevant articles, 55 studies were included in this meta-analysis. Patients having suspected ADRs had reported significantly higher odds of all-cause mortality [OR: 1.50 (95% CI: 1.21-1.86; I2 = 100%) than those patients who did not have suspected ADRs during hospitalisation. Study wards, types of suspected ADRs and sample size were observed as significant predictors of all-cause mortality (p < 0.05). Patients having suspected ADRs had reported significantly higher mean difference in hospital stay [MD: 3.98 (95% CI: 2.91, 5.05; I2 = 99%) than those patients who did not have suspected ADRs during hospitalisation. Types of suspected ADRs and study periods were observed as significant predictors of length of stay (p < 0.05).

CONCLUSION: Suspected ADRs significantly increase the risk of mortality and length of stay in hospitalised patients.

SYSTEMATIC REVIEW REGISTRATION: CRD42020176320.

PMID:36399205 | DOI:10.1007/s00228-022-03419-7

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The trend of ammonia levels in patients with glufosinate ammonium poisoning with respect to neurotoxicity

Naunyn Schmiedebergs Arch Pharmacol. 2022 Nov 18. doi: 10.1007/s00210-022-02327-y. Online ahead of print.

ABSTRACT

Since glufosinate irreversibly inhibits glutamine synthetase, leading to intracellular accumulation of ammonia, hyperammonemia is considered one of the main mechanisms of glufosinate ammonium toxicity in humans. However, whether hyperammonemia causes neurotoxicity has not yet been studied. Therefore, the purpose of this study was to determine whether the serum ammonia level is elevated before the development of neurotoxicity. In this retrospective observational study, we analyzed data from consecutive patients diagnosed with acute glufosinate ammonium poisoning. The primary outcome was the development of neurotoxicity following the poisoning. Patients who developed neurotoxicity were characterized by higher initial ammonia levels compared to patients without neurotoxicity (121.0 µg/dL [87.0; 141.0] vs 83.0 µg/dL [65.0; 119.0], p < 0.01). However, there was no increase in ammonia levels over time in both the asymptomatic and neurotoxicity groups when serial serum ammonia levels were examined from emergency department admission to hospital discharge. In addition, there was no statistically significant difference between the peak ammonia levels in the asymptomatic group and the peak ammonia levels before symptom onset in the neurotoxicity group (135.0 µg/dL [109.0; 158.0] vs 144.0 µg/dL [120.0; 189.0], p = 0.15). Following the onset of neurotoxicity, the serum ammonia level increased significantly (125.0 [111.0; 151.0] µg/dL to 148.0 [118.0; 183.0] µg/dL, p < 0.01). In conclusion, hyperammonemia cannot be assumed as the cause of neurotoxicity in glufosinate ammonium poisoning and further research is needed to examine the exact mechanism of GA poisoning.

PMID:36399183 | DOI:10.1007/s00210-022-02327-y

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Deep learning-based dynamic PET parametric Ki image generation from lung static PET

Eur Radiol. 2022 Nov 18. doi: 10.1007/s00330-022-09237-w. Online ahead of print.

ABSTRACT

OBJECTIVES: PET/CT is a first-line tool for the diagnosis of lung cancer. The accuracy of quantification may suffer from various factors throughout the acquisition process. The dynamic PET parametric Ki provides better quantification and improve specificity for cancer detection. However, parametric imaging is difficult to implement clinically due to the long acquisition time (~ 1 h). We propose a dynamic parametric imaging method based on conventional static PET using deep learning.

METHODS: Based on the imaging data of 203 participants, an improved cycle generative adversarial network incorporated with squeeze-and-excitation attention block was introduced to learn the potential mapping relationship between static PET and Ki parametric images. The image quality of the synthesized images was qualitatively and quantitatively evaluated by using several physical and clinical metrics. Statistical analysis of correlation and consistency was also performed on the synthetic images.

RESULTS: Compared with those of other networks, the images synthesized by our proposed network exhibited superior performance in both qualitative and quantitative evaluation, statistical analysis, and clinical scoring. Our synthesized Ki images had significant correlation (Pearson correlation coefficient, 0.93), consistency, and excellent quantitative evaluation results with the Ki images obtained in standard dynamic PET practice.

CONCLUSIONS: Our proposed deep learning method can be used to synthesize highly correlated and consistent dynamic parametric images obtained from static lung PET.

KEY POINTS: • Compared with conventional static PET, dynamic PET parametric Ki imaging has been shown to provide better quantification and improved specificity for cancer detection. • The purpose of this work was to develop a dynamic parametric imaging method based on static PET images using deep learning. • Our proposed network can synthesize highly correlated and consistent dynamic parametric images, providing an additional quantitative diagnostic reference for clinicians.

PMID:36399164 | DOI:10.1007/s00330-022-09237-w

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An exploration of flavours in studies of e-cigarettes for smoking cessation: secondary analyses of a systematic review with meta-analyses

Addiction. 2022 Nov 18. doi: 10.1111/add.16091. Online ahead of print.

ABSTRACT

AIMS: To estimate associations between e-cigarette flavour and smoking cessation and study product use at 6 months or longer.

METHODS: Secondary analysis of data from a living systematic review, with meta-analyses and narrative synthesis, incorporating data up to Jan 2022. Included studies provided people who smoked combustible cigarettes with nicotine e-cigarettes for the purpose of smoking cessation, compared with no treatment or other stop smoking interventions. Measurements included smoking cessation and study product use at 6 months or longer reported as risk ratios (RR) with 95% confidence intervals (CI); flavour use at any time points.

RESULTS: We included 16 studies (n=10,336); 14 contributed to subgroup analyses and 10 provided participants with a choice of e-cigarette flavour. We judged nine, five and two studies at high, low, and unclear risk of bias, respectively. Subgroup analyses showed no clear associations between flavour and cessation or product use. In all but one analysis tests for subgroup differences resulted in I2 values between 0% and 35%. In the comparison between nicotine e-cigarettes and nicotine replacement therapy (NRT) (I2 =65.2% for subgroup differences), studies offering tobacco flavour e-cigarettes showed evidence of a greater proportion of participants still using at six-months or longer (RR=3.81; 95% CI=1.45 to 10.05; 3 studies; n=1181; I2 =84%), whereas there was little evidence for greater 6-month use when studies offered a choice of flavours (RR=1.44; 95% CI=0.80 to 2.56; 2 studies; n=454; I2 =82%). However, substantial statistical heterogeneity within subgroups makes interpretation of this result unclear. In the 10 studies where participants had a choice of flavours and this was tracked over time some switching between flavours occurred, but there were no clear patterns in flavour preferences.

CONCLUSIONS: There does not appear to be a clear association between e-cigarette flavours and smoking cessation or longer-term e-cigarette use, possibly due to a paucity of data. There is evidence that people using e-cigarettes to quit smoking switch between e-cigarette flavours.

PMID:36399154 | DOI:10.1111/add.16091

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Stable thyroid function despite regular use of povidone-iodine throat spray for SARS-CoV-2 prophylaxis

Ann Med. 2022 Dec;54(1):3299-3305. doi: 10.1080/07853890.2022.2108132.

ABSTRACT

BACKGROUND: It is unclear whether unintentional ingestion of povidone-iodine following its application to the oropharyngeal space could affect thyroid function.

OBJECTIVE: To examine thyroid function among individuals who regularly apply povidone-iodine throat spray for SARS-CoV-2 prophylaxis.

METHODS: We designed a case-control study to compare thyroid function among participants who received povidone-iodine throat spray three times a day for 42 days (‘cases’) and those who received vitamin C (‘controls’). Thyroid function was assessed by profiling serum TSH, free T3, and free T4; iodine status was estimated using serum thyroglobulin level, while infection status was determined by measuring anti-SARS-CoV-2 antibody against the nucleocapsid antigen. All measurements were performed in pairs, at baseline and 42 days later. Pre-post changes in thyroid function were compared between groups, before and after stratification according to baseline TSH quartiles.

RESULTS: A total of 177 men (117 cases and 60 controls) (mean age, 32.2 years) were included. Despite comparable demographics and clinical profiles, no clinically or statistically significant differences were observed in thyroid indices between ‘cases’ and ‘controls’ before and after stratification according to TSH quartiles. None of the participants developed symptomatic hypo- or hyperthyroidism throughout the study. Post-hoc analysis did not reveal differences in thyroid function according to infection status.

CONCLUSIONS: Data from this study support the overall safety of povidone-iodine use in the oropharyngeal space for SARS-CoV-2 prophylaxis among individuals with normal thyroid function and subclinical thyroid disease.

PMID:36399104 | DOI:10.1080/07853890.2022.2108132

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An in-depth analysis of the sexuality needs of Barcelona’s youth: a holistic view using mixed method

Sex Reprod Health Matters. 2022 Dec;30(1):2135728. doi: 10.1080/26410397.2022.2135728.

ABSTRACT

A positive experience of sexuality during youth is key to good sexual health later in life. Addressing young people’s sexual health needs and sexual and reproductive rights is thus essential. This study aimed to identify unmet sexual health needs among youth in the city of Barcelona (Spain) through mixed methods research. We analysed the narratives of young people (n = 50) aged 14-24 years with different genders, origins, sexualities and socioeconomic backgrounds, collected from January to April 2019. A descriptive statistical analysis was also conducted on the records of visits to sexual health services and reasons for consultation. We found that 21% (n = 32,161) of young people aged 14-24 years had used sexual healthcare services in Barcelona between 2015 and 2017, while the reasons for consultation differed across sex, gender and socioeconomic background. Young people declared that they needed more information to enjoy their sexuality, to know where to go in case of an unexpected situation and to learn how to combat gender-based violence. They stated that the sexuality education they had received was sparse and focused on risks. We found that formal sex education is scarce, with informal sex education thus acquiring a major role. Current services can be improved by expanding coverage, training professionals and reducing acceptability and accessibility barriers. Sexism is ubiquitous in young people’s sexual, dating and personal relationships. We recommend planning sexual health care services and formal sexual education, in which a strong gender strategy is embedded, as part of the same strategy.

PMID:36399103 | DOI:10.1080/26410397.2022.2135728