Tag: pubmed

Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jun 21:S2212-4403(21)00478-8. doi: 10.1016/j.oooo.2021.06.009. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the frequency of monocyte chemoattractant protein (MCP)-1 CCR2 gene polymorphisms in Turkish patients with oral lichen planus (OLP).

STUDY DESIGN: A cohort of 50 patients with OLP and 142 control participants without OLP were recruited to investigate the frequency of MCP-1 and CCR2 gene polymorphisms. Chi-square and Fisher’s exact tests were used. Student t test and analysis of variance were used to compare demographic data between groups.

RESULTS: The MCP AA genotype was less common in the patient group (52%) than in the control group (66.2%; odds ratio [OR] = 0.553; 95% confidence interval [CI], 0.287-1.065; P = .075). The MCP G allele was higher in the patient group (48%) than in the control group (33.8%; OR = 1.808; 95% CI, 0.939-3.479; P = .075). The frequency of the MCP GG genotype was observed to be higher in the patient group (4%) than in the controls (0.7%; OR: 5.875, 95% CI:0.521-66,24; p = 0.106). The CCR2 64I64I genotype was more common in the patient group (6%) than in the control group (2.8%). All results were not statistically significant.

CONCLUSION: We suggest that the G allele of MCP-1 and 64I64I genotype of CCR2 polymorphisms do not pose an increased risk for Turkish patients with OLP to develop oral squamous cell carcinoma.

PMID:34511342 | DOI:10.1016/j.oooo.2021.06.009

Neurologia. 2021 Aug 2:S0213-4853(21)00123-7. doi: 10.1016/j.nrl.2021.07.002. Online ahead of print.

ABSTRACT

PURPOSE: Covid-19 has affected all people, especially those with chronic diseases, including Parkinson’s Disease (PD). Covid-19 may affect both motor and neuropsychiatric symptoms of PD patients. We intend to evaluate different aspects of Covid-19 impact on PD patients.

METHODS: 647 PD patients were evaluated in terms of PD-related and Covid-19-related clinical presentations in addition to past medical history during the pandemic through an online questioner. They were compared with an age-matched control group consist of 673 individuals and a sample of the normal population consist of 1215 individuals.

RESULTS: The prevalence of Covid-19 in PD patients was 11.28%. The mortality was 1.23% among PD patients. The prevalence of Covid-19 in PD patients who undergone Deep Brain Stimulation (DBS) was 18.18%. No significant association was found between the duration of disease and the prevalence of Covid-19. A statistically significant higher prevalence of Covid-19 in PD patients who had direct contact with SARS-CoV-19 infected individuals was found. No statistically significant association has been found between the worsening of motor symptoms and Covid-19. PD patients and the normal population may differ in the prevalence of some psychological disorders, including anxiety and sleeping disorders, and Covid-19 may affect the psychological status.

CONCLUSION: PD patients possibly follow tighter preventive protocols, which lead to lower prevalence and severity of Covid-19 and its consequences in these patients. Although it seems Covid-19 does not affect motor and psychological aspects of PD as much as it was expected, more accurate evaluations are suggested in order to clarify such effects.

PMID:34511276 | DOI:10.1016/j.nrl.2021.07.002

Foot Ankle Surg. 2021 Sep 9:S1268-7731(21)00182-X. doi: 10.1016/j.fas.2021.09.001. Online ahead of print.

ABSTRACT

BACKGROUND: Inherent characteristics of extensile lateral approach (ELA) for fixation of displaced intraarticular calcaneal fractures together with delayed or probably insufficient physical therapy programs may lead to weakness of the muscle groups crossing the ankle joint. Peroneal tendons might be involved more than others because of possible postoperative adhesions. The aim of this study was to evaluate the isokinetic strength of the muscle groups crossing the ankle joint and also to assess balance and functional ability in this group of patients.

METHODS: Based on a pilot study, 23 patients undergone open reduction and internal fixation (ORIF) via ELA and 22 healthy subjects as the control group participated in this observational cross-sectional study. Patients more than 20 years of age with at least 12 months passed their unilateral closed intraarticular calcaneal fracture fixation without any postoperative complications like infection or wound dehiscence were included. Patients with history of concomitant lower extremity injury, spine trauma or surgery, cases underwent removal of calcaneal plates, and cases with neuromuscular or vestibular dysfunction were excluded. The outcome was assessed by isokinetic parameters such as peak torque, peak torque normalized to body weight, mean power and total work modified star excursion balance test, triple hop for distance test, and evertor-to-invertor (E/I) strength ratio. Isokinetic tests were performed at 60 and 120°/s.

RESULTS: Greater strength was observed in all muscles in the control group at 60°/s (p < 0.05). Evertors and invertors were weaker in the operated group at 120°/s in comparison to the dorsiflexors and plantarflexors. Modified star excursion (p: 0.003) and triple hop tests (p: 0.001) were lower in the operated group. E/I ratio was not statistically significant between the two groups at 60°/s (p: 0.44) and 120°/s (p: 0.62).

CONCLUSIONS: Strength deficit in all muscle groups crossing the ankle joint, and not evertors in isolation, in addition to balance and functional impairments would be seen one year following ORIF of calcaneal fracture via ELA. A long-term rehabilitation program emphasizing different kinds of contraction at low and high speeds and balance training in these patients is highly recommended.

PMID:34511327 | DOI:10.1016/j.fas.2021.09.001

Br J Anaesth. 2021 Sep 9:S0007-0912(21)00518-3. doi: 10.1016/j.bja.2021.08.011. Online ahead of print.

ABSTRACT

BACKGROUND: Disparities in neuraxial analgesia use for childbirth by maternal origin have been reported in high-resource countries. We explored the association between maternal immigrant status (characterised separately by geographic continental origin and Human Development Index [HDI] of maternal country of birth) and neuraxial analgesia use. We hypothesised that immigrant women from low-resource countries may have more limited access to neuraxial analgesia than native French women.

METHODS: The study population, extracted from the 2016 National Perinatal Survey, a cross-sectional study of a representative sample of births in France, included only women who initially wished to deliver with neuraxial analgesia. We used multivariable multilevel logistic regression to explore the association between immigrant status and both use of neuraxial analgesia and its timely administration.

RESULTS: Among the 6070 women included, 88.1% gave birth with neuraxial analgesia and 15.8% were immigrants. There was no difference in neuraxial analgesia use between native French women and either immigrant women by geographic continental region of origin, or immigrants from countries with low HDI. However, immigrants from countries with very high HDI were more likely to give birth with neuraxial analgesia (adjusted odds ratio [aOR]=2.6; 95% confidence interval (CI), 1.2-5.8; P=0.018) and its timeliness <60 min after admission (aOR=1.8; 95% CI, 1.2-2.7; P=0.005) compared with native French women.

CONCLUSIONS: In France, immigrant women from low-resource countries have similar access to labour neuraxial analgesia to native French women. Our results suggest differential neuraxial analgesia use in favour of immigrant women from very high HDI countries compared with native women.

PMID:34511258 | DOI:10.1016/j.bja.2021.08.011

Neurologia. 2021 Sep 9:S0213-4853(21)00116-X. doi: 10.1016/j.nrl.2021.05.016. Online ahead of print.

ABSTRACT

INTRODUCTION: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications.

OBJECTIVE: The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain.

METHODS: We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 11 Spanish centres.

RESULTS: We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3-6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score ≤ 2), with papilloedema (P=.03), focal deficits (P=.001), and encephalopathy (P <.001) showing a statistically significant association with poor prognosis (mRS> 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%.

CONCLUSION: The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity.

PMID:34511275 | DOI:10.1016/j.nrl.2021.05.016

Am J Surg. 2021 Sep 4:S0002-9610(21)00521-3. doi: 10.1016/j.amjsurg.2021.08.038. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical evaluation of medical student performance has been criticized as variable and subjective. The aim of this study was to assess the correlation of a summative surgical OSCE exam to clinical faculty evaluations as well as surgery shelf exam score and final grades.

METHODS: The performance of 392 students who completed the surgical clerkship between 2017 and 2019 was assessed via Pearson Coefficients comparing OSCE grades, clinical evaluations of Medical Knowledge and Patient Care, Communication and Professionalism, the National Board of Medical Examiners (NBME) shelf surgical subject exam, and final clerkship grade.

RESULTS: Results demonstrate a statistically significant positive relationship between the OSCE, Shelf score and grade, final clerkship grade, and all clinical evaluations except Communication skills. The greatest correlation occurred between OSCE and shelf scores and grades. Although significant, the degree of correlation with clinical observation was significantly less.

CONCLUSION: This study demonstrates that a surgical OSCE has a small positive correlation with clinical knowledge as measured by the NBME shelf exam. There is also an equal correlation with medical knowledge standards, with the OSCE better predicting NBME shelf outcome. This lower correlation to clinical assessment suggests that either the clinical grades contain elements not detected on an OSCE exam but could also support the hypothesis that variability in clinical grades do contain a significant degree of subjectivity.

PMID:34511199 | DOI:10.1016/j.amjsurg.2021.08.038

Rehabilitacion (Madr). 2021 Sep 9:S0048-7120(21)00073-6. doi: 10.1016/j.rh.2021.07.001. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The aim of this study is to present a new virtual reality (VR) low cost application based on Leap Motion Controller (LMC) device for upper extremity motor rehabilitation after neurological pathology and to demonstrate its clinical feasibility by carrying out a pilot experience.

MATERIAL AND METHODS: The LMC allows the interaction with virtual applications by capturing the patient’s hand movements. A pilot study was carried out with 4 patients with upper limb impairment reflected with Upper Extremity Motor Score (UEMS) greater than 10. They were assessed using the Box and Block (BBT) and the writing task within the Jebsen-Taylor Hand Function (JTHF) before and after the intervention.

RESULTS: All patients completed the 9-session, 30-min protocol divided into 3 sessions per week. They went from an average result of 38 (SD 20) blocks in BBT before the intervention to 44 (SD 21.72) after it. They went from 28.25 s (SD 8.61) to 26.75 s (SD 21.72) in the JTHF. Statistically significant differences were no found. The device usability was assessed by the QUEST scale, being the security, effectiveness and ease to use the aspects that patients considered to be a priority. CONCLUSIóN: A new VR development based on the LMC device is presented and the clinical feasibility of its application in neurological patients with upper limb involvement has been proven. A clinical study with a large sample size is needed to assess its potential clinical effectiveness as a treatment element.

PMID:34511255 | DOI:10.1016/j.rh.2021.07.001

Surg Oncol Clin N Am. 2021 Oct;30(4):693-708. doi: 10.1016/j.soc.2021.06.008.

ABSTRACT

For several decades, cytotoxic chemotherapy was the mainstay of treatment for pancreatic ductal adenocarcinoma (PDAC). Advances in molecular profiling have identified predictive genomic alterations in PDAC-the germline and somatic genome are now routinely interrogated in patients with PDAC because of their therapeutic relevance. The composite role of the epithelial cell compartment and the tumor microenvironment in defining PDAC biology needs further elucidation to deconvolute the spatiotemporal heterogeneity appreciated in this disease. Novel clinical trial approaches leveraging signal seeking, adaptive statistical designs, and master protocols using several candidate drugs that target relevant therapeutic targets are are essential to unlocking the potential of precision medicine in PDAC.

PMID:34511190 | DOI:10.1016/j.soc.2021.06.008

Br J Nutr. 2021 Sep 13:1-16. doi: 10.1017/S0007114521003664. Online ahead of print.

ABSTRACT

Tea contains polyphenols such as flavonoids, anthocyanidins, flavanols and phenolic acids which in laboratory studies have reported to promote antioxidant enzyme formation, reduces excess inflammation, slow cancer cell proliferation and promote apoptosis. Evidence from epidemiological studies, on the effect of tea consumption on CaP incidence has been conflicting. We analysed data from 25 097 men within the intervention arm of the 155000 participant Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial screening trial. Histologically confirmed cases of prostate cancer were reported in 3,088 men (12.3%) during the median 11.5 year follow up. Tea consumption was assessed with a food frequency questionnaire. Baseline characteristics were compared between groups using Chi-square and Kruskal-Wallis tests. Cox regression models were used to assess associations between tea intake and CaP incidence. There was no statistical difference between the risk of CaP between men who never drank tea to those who drank tea at any quantity. Amongst tea drinkers, those in the highest third of consumption group had a small but significantly lower risk compared to those in the lowest third (11.2% v 13.2% HR 1.16; 95% CI 1.05-1.29, p=0.004). This pattern persisted with adjustments for demographics and lifestyle. In conclusion, among tea drinkers, there was a small positive association between drinking tea and a reduced risk of prostate cancer. It does not support starting to drink tea, if men previously did not, to reduce the risk. Further research is needed to establish whether tea is justified for future prospective nutritional intervention studies investigating CaP prevention.

PMID:34511161 | DOI:10.1017/S0007114521003664

Psychol Med. 2021 Sep 13:1. doi: 10.1017/S0033291721003858. Online ahead of print.

NO ABSTRACT

PMID:34511157 | DOI:10.1017/S0033291721003858