Tag: pubmed

J Low Genit Tract Dis. 2021 Oct 1;25(4):291-295. doi: 10.1097/LGT.0000000000000627.

ABSTRACT

OBJECTIVES: The purpose of this cross-sectional study was to prepare a reliable and easy-to-use architectural classification for vulvar lichen sclerosus (VLS) aimed at defining the morphological patterns of this condition.

MATERIALS AND METHODS: An expert panel composed by 7 physicians with expertise in clinical care of vulvar conditions outlined the architectural criteria for the definition of VLS severity (phimosis of the clitoris, involvement of the interlabial sulci, narrowing of the vulvar introitus), identifying 5 grades to build up a classification. Thirteen physicians with 2-30 years expertise in vulvar diseases (nonexpert group) were asked to evaluate 3-5 pictures from 137 patients. Each physician individually assigned a grade to each case, according to the previously mentioned criteria. Interrater reliability was analyzed by means of intraclass correlation coefficient (ICC). The reliability concerning the 2 classifications of each rater was analyzed by means of κ statistic. Intraobserver and interobserver reliability in vivo was analyzed by means of κ index.

RESULTS: This study provides a new classification of VLS, based on defined anatomical criteria and graded into mutually exclusive progressive classes.The ICC analysis showed a substantial interrater reliability of the classification, ICC = 0.89 (0.87-0.91), both in the expert panel and in the nonexpert group (ICC = 0.92 and 0.87, respectively). An “almost perfect” intraobserver and interobserver reliability was achieved among physicians in vivo (κ = 0.93).

CONCLUSIONS: Our classification showed a high reliability. It is easy to use, and it can be applied in clinical practice and eventually, in the evaluation of regenerative and cosmetic surgery.

PMID:34542084 | DOI:10.1097/LGT.0000000000000627

J Back Musculoskelet Rehabil. 2021 Sep 17. doi: 10.3233/BMR-210019. Online ahead of print.

ABSTRACT

BACKGROUND: Given the characteristics of the superficial trunk muscles that cross the chest and pelvis, their excessive contraction might limit chest mobility.

OBJECTIVE: To examine the immediate effects of two types of trunk muscle exercises on chest mobility and trunk muscle activities.

METHODS: Fourteen healthy men (age: 21.1 ± 1.0 years, height: 172.7 ± 5.6 cm, weight: 61.0 ± 7.1 kg, body mass index: 20.4 ± 1.7 kg/m2; mean ± SD) randomly performed trunk side flexion and draw-in exercises using a cross-over design. The chest kinematic data and trunk muscle activities were measured before and after each intervention during the following tasks: maximum inspiration/expiration and maximum pelvic anterior/posterior tilt while standing. Two-way repeated measures analysis of variance was used for statistical analysis (P< 0.05).

RESULTS: After the side flexion, upper and lower chest mobility significantly decreased, and superficial trunk muscle activity significantly increased during the maximum pelvic anterior tilt (P< 0.05). Additionally, after the draw-in, upper chest mobility significantly increased during the maximum pelvic anterior tilt (P< 0.05).

CONCLUSIONS: Increased activity of the superficial abdominal muscles might limit chest mobility during maximum pelvic anterior tilt. Conversely, the facilitation of deep trunk muscles might increase upper chest mobility during the maximum pelvic anterior tilt.

PMID:34542061 | DOI:10.3233/BMR-210019

J Alzheimers Dis. 2021 Sep 16. doi: 10.3233/JAD-210319. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to high mortality rates in nursing homes (NHs) in Europe. For adequate risk management and good prognostications, it is essential to identify mortality risk factors.

OBJECTIVE: This study aimed to determine whether previously identified risk factors for 30-day mortality in Dutch NH residents with COVID-19 are unique to COVID-19.

METHODS: In this cohort study, we included 1,294 NH residents with COVID-19 (cases) and 17,999 NH residents without COVID-19 (controls, from the pre-COVID-19 period). We used descriptive statistics and Cox proportional hazard models to compare mortality rates in residents with and without COVID-19, categorized by risk factors.

RESULTS: Cases had a more than 18 times higher hazard of death within 30 days compared to controls (HR 18, 95%CI: 16-20). For residents with COVID-19, being male, having dementia, and having Parkinson’s disease (PD) were all associated with a higher 30-day mortality (HR 1.8 versus 1.3 versus 1.7). Being male was also associated with a higher mortality (HR 1.7) in the control group, whereas having dementia and PD were not. COVID-19 symptomatology was very similar for residents with and without dementia or PD, except for delirium and malaise which was more frequent in residents with dementia.

CONCLUSION: Dementia and PD were significant additional risk factors for mortality in Dutch NH residents with COVID-19, whereas male gender was not unique to residents with COVID-19. The frailty of PD and dementia in NH residents with COVID-19 are relevant to consider in prognostication, communication, and care planning with residents and their families.

PMID:34542068 | DOI:10.3233/JAD-210319

NeuroRehabilitation. 2021 Sep 13. doi: 10.3233/NRE-210144. Online ahead of print.

ABSTRACT

BACKGROUND: The risk of falling for individuals with stroke is about twice that of healthy older adults. Lack of appropriate initiative to address the fear-related maladaptive behaviour can manifest itself in the form of loss of physical functions resulting in disability and handicap.

OBJECTIVE: To examine the effectiveness of the structured balance awareness program (SBAP) in improving the perceived balance confidence, and thereby modifying the fear-related maladaptive behaviour in post-stroke survivors.

METHODS: A randomized experimental control design was used on a sample of 97 post-stroke survivors aged between 55 to 75 years. The patients received either the SBAP or health awareness program (HAP) for eight weeks and were compared on Activities-specific Balance Confidence (ABC) Scale, Berg Balance Scale (BBS) and Falls Efficacy Scale International (FESI).

RESULTS: A paired t-test demonstrated statistically significant improvement among all the variables in the SBAP group. An independent t-test exhibited a statistically significant improvement on ABC (t = 2.57, p = 0.012 *), BBS (t = 3.32, p = 0.001 *) and FESI (t = 3.38, p = 0.001 *) in the SBAP group.

CONCLUSION: The study showed that the SBAP was effective in minimizing the fear-related maladaptive behaviour in post-stroke survivors.

PMID:34542039 | DOI:10.3233/NRE-210144

J Back Musculoskelet Rehabil. 2021 Sep 17. doi: 10.3233/BMR-210018. Online ahead of print.

ABSTRACT

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs.

OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH.

METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05.

RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05).

CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.

PMID:34542060 | DOI:10.3233/BMR-210018

Twin Res Hum Genet. 2021 Sep 20:1-6. doi: 10.1017/thg.2021.33. Online ahead of print.

ABSTRACT

The aim of the present study was to compare the rate of preterm birth (PTB) and growth from birth to 18 years between twins conceived by in vitro fertilization (IVF) and twins conceived by spontaneous conception (SC) in mainland China. The retrospective cohort study included 1164 twins resulting from IVF and 25,654 twins conceived spontaneously, of which 494 from IVF and 6338 from SC were opposite-sex twins. PTB and low birth weight (LBW), and growth, including length/height and weight, were compared between the two groups at five stages: infancy (0 year), toddler period (1-2 years), preschool (3-5 years), primary or elementary school (6-11 years), and adolescence (10-18 years). Few statistically significant differences were found for LBW and growth between the two groups after adjusting for PTB and other confounders. Twins born by IVF faced an increased risk of PTB compared with those born by SC (adjusted odds ratio [aOR] 8.21, 95% confidence interval [CI] [3.19, 21.13], p < .001 in all twins and aOR 10.12, 95% CI [2.32, 44.04], p = .002 in opposite-sex twins). Twins born by IVF experienced a similar growth at five stages (0-18 years old) when compared with those born by SC. PTB risk, however, is significantly higher for twins conceived by IVF than those conceived by SC.

PMID:34542028 | DOI:10.1017/thg.2021.33

J Parkinsons Dis. 2021 Sep 15. doi: 10.3233/JPD-212742. Online ahead of print.

ABSTRACT

BACKGROUND: Palliative care for persons with Parkinson’s disease (PD) is developing. However, little is known about the experiences of patients with PD in the palliative phase and of their family caregivers.

OBJECTIVE: To explore needs of patients with PD in the palliative phase and of their family caregivers.

METHODS: A mixed methods case study design. Health care professionals included patients for whom the answer on the question “Would you be surprised if this patient died in the next 12 months?” was negative. At baseline, and after six and twelve months, we conducted semi-structured interviews with patients and caregivers. Participants completed questionnaires on quality of life, disease burden, caregiver burden, grief, and positive aspects of caregiving. We analyzed quantitative data using descriptive statistics, while we used thematic analysis for qualitative data.

RESULTS: Ten patients and eight family caregivers participated, of whom five patients died during the study period. While the quantitative data reflected a moderate disease burden, the qualitative findings indicated a higher disease burden. Longitudinal results showed small differences and changes in time. Patients reported a diverse range of symptoms, such as fatigue, immobility, cognitive changes, and hallucinations, which had a tremendous impact on their lives. Nevertheless, they rated their overall quality of life as moderate to positive. Family caregivers gradually learned to cope with difficult situations such delirium, fluctuations in functioning and hallucinations. They had great expertise in caring for the person with PD but did not automatically share this with health care professionals. Patients sensed a lack of time to discuss their complex needs with clinicians. Furthermore, palliative care was rarely discussed, and none of these patients had been referred to specialist palliative care services.

CONCLUSION: Patients with PD experienced many difficulties in daily living. Patients seems to adapt to living with PD as they rated their quality of life as moderate to positive. Family caregivers became experts in the care for their loved one, but often learned on their own. An early implementation of the palliative care approach can be beneficial in addressing the needs of patients with PD and their family caregivers.

PMID:34542031 | DOI:10.3233/JPD-212742

Int J Hyperthermia. 2021;38(1):1384-1393. doi: 10.1080/02656736.2021.1976850.

ABSTRACT

PURPOSE: The aim of this study was to assess the feasibility of T2 relaxation time in predicting the immediate technical outcome i.e., nonperfused volume ratio (NPVr) of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) treatment of symptomatic uterine fibroids and to compare it with existing T2-weighted imaging methods (Funaki classification and scaled signal intensity, SSI).

MATERIALS AND METHODS: 30 patients with 32 uterine fibroids underwent an MRI study including a quantitative T2 relaxation time measurement prior to MRgHIFU treatment. T2 relaxation times were measured with a multi-echo fast imaging-based technique with 16 echoes. The correlation between pretreatment values of the uterine fibroids and treatment outcomes, that is nonperfused volume ratios (NPVr), was assessed with nonparametric statistical measures. T2 relaxation time-based method was compared to existing T2-weighted imaging-based methods using receiver-operating-characteristics (ROC) curve analysis and Chi-square test.

RESULTS: Nonparametric measures of association revealed a statistically significant negative correlation between T2 relaxation time values and NPVr. The T2 relaxation time classification (T2 I, T2 II, and T2 III) resulted in the whole model p-value of 0.0019, whereas the Funaki classification resulted in a p-value of 0.56. The T2 relaxation time classification (T2 I and T2 II) achieved a whole model of a p-value of 0.0024, whereas the SSI classification had a p-value of 0.0749.

CONCLUSIONS: A longer T2 relaxation time of the fibroid prior to treatment correlated with a lower NPVr. Based on our results, the T2 relaxation time classifications seem to outperform the Funaki classification and the SSI method.

PMID:34542013 | DOI:10.1080/02656736.2021.1976850

Eur J Sport Sci. 2021 Sep 19:1-9. doi: 10.1080/17461391.2021.1974100. Online ahead of print.

ABSTRACT

Bio-banding has been introduced to reduce the impact of inter-individual differences due to biological maturation among youth athletes. Existing studies in youth soccer have generally examined the pilot-testing application of bio-banding. This is the first study that investigated whether bio-banded (BB) versus chronological age (CA) competition affects reliable physiological and technical-tactical in-game key performance indicators (KPIs) using a randomized cross-over repeated measures design. Sixty-five youth elite soccer players from the under-13 (U₁₃) and under-14 (U₁₄) age category and with maturity offsets (MO) between -2.5 and 0.5 years, competed in both a BB and CA game. For statistical analysis, players were divided into four sub-groups according to CA and MO: U₁₃MO_low (CA ≤ 12.7, MO ≤ -1.4), U₁₃MO_high (CA ≤ 12.7, MO > -1.4), U₁₄MO_low (CA > 12.7, MO ≤ -1.4), U₁₄MO_high (CA > 12.7, MO > -1.4). The two-factor mixed ANOVA revealed significant (p < .05) interactions between competition format and sub-group for the KPIs high accelerations (ηp2 = .176), conquered balls (ηp2 = .227) and attack balls (ηp2 = .146). Especially, U₁₃MO_high (i.e. early maturing players) faced a higher physiological challenge by having more high accelerations (|d| = 0.6) in BB games. Notably, U₁₄MO_low (i.e. late maturing players) had more opportunities to show their technical-tactical abilities during BB games with more conquered balls (|d| = 1.1) and attack balls (|d| = 1.6). Affected KPIs indicate new challenges and learning opportunities during BB competition depending on a player’s individual maturity status. Bio-banding can beneficially be applied to enhance the talent development of youth elite soccer players.

PMID:34542017 | DOI:10.1080/17461391.2021.1974100

Waste Manag Res. 2021 Sep 18:734242X211046853. doi: 10.1177/0734242X211046853. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has created unprecedented difficulties for health care institutions, which are required to manage not only the flow of patients with COVID-19, but also the management of medical and pharmaceutical waste (MPW). At the level of Morocco, the waste produced by hospitals has risen sharply in the regions most affected by the virus, such as the Rabat-Sale-Kenitra region (15.05% of recorded cases). The objective of this study is to perform a descriptive statistical analysis and to evaluate the generation rates of MPW generated during the treatment of the coronavirus pandemic, with reference to a large health care hospital in the region, in order to enable decision-makers to adopt responses in terms of regular and continuous management of MPW. The Moulay Abdellah hospital in Sale has a bedding capacity allocated to the COVID-19 patient of 110 beds with a Average Occupation Rate (AOR) of 100% and an average production of 13tons per month. The study showed that the average rate of MPW generated is 4 kg per bed per day, which is twice as high as the average generation rate during normal operation in 2019. As well, frequency analysis of the data revealed that MPW generation follows a log normal distribution with a correlation coefficient of 0.9. The distribution is skewed to the right and flatter than the normal distribution curve as judged by the skewness coefficient which is 0.87 and kurtosis coefficient which has a value of 1.286, indicating a deviation from normality.

PMID:34541985 | DOI:10.1177/0734242X211046853