Tag: pubmed

Environ Sci Technol. 2022 May 25. doi: 10.1021/acs.est.2c01072. Online ahead of print.

ABSTRACT

Implementation of regulatory standards has reduced exhaust emissions of particulate matter from road traffic substantially in the developed world. However, nonexhaust particle emissions arising from the wear of brakes, tires, and the road surface, together with the resuspension of road dust, are unregulated and exceed exhaust emissions in many jurisdictions. While knowledge of the sources of nonexhaust particles is fairly good, source-specific measurements of airborne concentrations are few, and studies of the toxicology and epidemiology do not give a clear picture of the health risk posed. This paper reviews the current state of knowledge, with a strong focus on health-related research, highlighting areas where further research is an essential prerequisite for developing focused policy responses to nonexhaust particles.

PMID:35612468 | DOI:10.1021/acs.est.2c01072

Acta Otorhinolaryngol Ital. 2022 Apr;42(2):140-149. doi: 10.14639/0392-100X-N2055.

ABSTRACT

BACKGROUND: This study aimed to evaluate the performance of the 2017 8^th TNM edition and the latest update in 2020 compared to the 7^th in a large cohort of patients affected by oral tongue squamous cell carcinoma (OTSCC), considering all stages.

MATERIALS AND METHODS: The cohort involved 300 patients affected by OTSCC treated with surgery. All cases were classified according to the 7^th, 8^th (2017), and the latest updated TNM edition (October 2020),. Patients were grouped based on the shift in tumour (T) category, lymph nodal (N) category and final pathological stage. Overall survival (OS) and disease-free survival (DFS) were calculated with the Kaplan-Meier method. Univariate and multivariate analyses were carried out.

RESULTS: According to the 7^th edition, multivariate analysis OS revealed that stage IV patients had an almost 4-fold risk of death compared to stage I (HR = 3.81 95% CI: 2.32-6.25; p < 0.001). Regarding DFS, stage IV patients had a 2-fold greater risk of relapses, or second primary, than patients in stage I (HR = 2.51 95% CI: 1.68-3.74; p < 0.001). According to 2017 8^th edition for OS, stage IV patients presented a 5-fold higher risk of death compared to patients in stage I (HR = 5.18 95% CI: 2.96-9.08; p < 0.001) and almost 4-old greater risk of relapses or second primary compared to patients in stage I considering DFS (HR = 3.61 95% CI: 2.28-5.71; p < 0.001). Regarding the recent edition of 8^th TNM (2020), stage IV patients had an almost 5-fold greater risk of death compared to patients in stage I considering OS (HR = 4.84 95% CI: 2.74-8.55; p < 0.001), while for DFS they had 3-fold greater risk of relapse or second primary compared to patients in stage I (HR = 3.13 95% CI: 1.99-4.91; p < 0.001).

CONCLUSIONS: This study confirmed that the recent update of the 8th edition of the TNM (2020) improves stratification and identification of advanced tumours, reducing the number of T3 compared to the 2017 edition and increasing the number of patients with pT4. This improvement made by the updated edition may reduce the risk of skipping adjuvant therapy.

PMID:35612505 | DOI:10.14639/0392-100X-N2055

Int J Periodontics Restorative Dent. 2022 May 24. doi: 10.11607/prd.6002. Online ahead of print.

ABSTRACT

This study evaluated the efficacy of trapezoidal coronally advanced flap (tCAF), envelope coronally advanced flap (eCAF), and coronally advanced tunnel flap (TUN) in treating gingival recession (GR) through a network meta-analysis. Eligible articles from the PubMed, Embase, and Cochrane Library databases published up to September 2020 were selected to identify randomized controlled trials (RCTs) on tCAF, eCAF, and TUN treatments. Sample size, treatment time, and outcome measures including complete root coverage (CRC), root coverage esthetic score (RES), and other data were extracted from the article, and integrated analysis was conducted. In total, 10 RCTs met the inclusion criteria, involving 310 patients. Direct meta-analysis showed no significant differences in CRC among the three surgical methods; A significant difference was seen for RES, with TUN worse than tCAF (weighted mean difference: -0.73; 95% CI: -1.44, -0.02; P = .045). The network meta-analysis showed no statistical significance in the cross-comparison of tCAF, eCAF, and TUN. However, eCAF had the most significant effect on improving CRC (SUCRA = 69.2) and RES (SUCRA = 85.0). eCAF has the best prognosis in the treatment of GR, followed by tCAF and TUN. This may influence the surgeon’s treatment choice, as eCAF may be more effective in root coverage procedures.

PMID:35612437 | DOI:10.11607/prd.6002

Surg Infect (Larchmt). 2022 May 24. doi: 10.1089/sur.2022.072. Online ahead of print.

ABSTRACT

Background: Splenic abscess (SA) is a rare, life-threatening illness that is generally treated with splenectomy. However, this is associated with high mortality and morbidity. Recently, percutaneous drainage (PD) has emerged as an alternative therapy in select patients. In this study, we compare mortality and complications in patients with SA treated with splenectomy versus PD. Patients and Methods: A systematic literature search of 13 databases and online search engines was conducted from 2019 to 2020. A bivariate generalized linear mixed model (BGLMM) was used to conduct a separate meta-analysis for both mortality and complications. We used the risk of bias in non-randomized studies of interventions (ROBINS-I) tool to evaluate risk of bias in non-randomized studies, and the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach for assessing quality of evidence and strength of recommendations. Results were presented according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: The review included 46 retrospective studies from 21 countries. For mortality rate, 27 studies compared splenectomy and PD whereas 10 used PD only and nine used splenectomy only. Data for major complications were available in 18 two-arm studies, seven single-arm studies with PD, and seven single-arm studies with splenectomy. Of a total of 589 patients, 288 were treated with splenectomy and 301 underwent PD. Mortality rate was 12% (95% confidence interval [CI], 8%-17%) in patients undergoing splenectomy compared with 8% (95% CI, 4%-13%) with PD. Complication rates were 26% (95% CI, 16%-37%) in the splenectomy group compared with 10% (95% CI, 4%-17%) in the PD group. Conclusions: Percutaneous drainage s associated with a trend toward lower complications and mortality rates compared with splenectomy in the treatment of SA, however, these findings were not statistically significant. Because of the heterogeneity of the data, further prospective studies are needed to draw definitive conclusions.

PMID:35612434 | DOI:10.1089/sur.2022.072

Health Secur. 2022 May 24. doi: 10.1089/hs.2021.0214. Online ahead of print.

ABSTRACT

A disaster overwhelms the normal operating capacity of a health service. Minimal research exists regarding Australian hospitals’ capacity to respond to chemical, biological, radiological, or nuclear (CBRN) disasters. This article, and the research supporting it, begins to fill that research gap. We conducted a descriptive quantitative study with 5 tertiary hospitals and 1 rural hospital in Queensland, Australia. The study population was the hospitals’ clinical leaders for disaster preparedness. The 25-item survey consisted of questions relating to each hospital’s current response capacity, physical surge capacity, and human surge capacity in response to a CBRN disaster. Data were analyzed using descriptive statistics. The survey data indicated that over the previous 12 months, each site reached operational capacity on average 66 times and that capacity to respond and create additional emergency, intensive care, or surgical beds varied greatly across the sites. In the previous 12 months, only 2 sites reported undertaking specific hospital-wide training to manage a CBRN disaster, and 3 sites reported having suitable personal protective equipment required for hazardous materials. There was a noted shortfall in all the hospitals’ capacity to respond to a radiological disaster in particular. Queensland hospitals are crucial to CBRN disaster response, and they have areas for improvement in their response and capacity to surge when compared with international preparedness benchmarks. CBRN-focused education and training must be prioritized using evidence-based training approaches to better prepare hospitals to respond following a disaster event.

PMID:35612425 | DOI:10.1089/hs.2021.0214

Clin Ter. 2022 May 25;173(3):249-256. doi: 10.7417/CT.2022.2428.

ABSTRACT

CONTEXT: In Europe, during an era of globalization in which traveling and studying abroad is becoming easier and more affordable, an open question remains on whether different European medical schools educate students with a dissimilar level of preparedness and/or satisfaction.

OBJECTIVE: To develop and validate the EUropean Students’ Preparedness and Satisfaction Questionnaire (EUSPSQ), a standardized European tool to assess preparedness and satisfaction in medical education.

MATERIALS AND METHODS: 30 participants belonging to the 5th and 6th year of two different European medical schools (Sapienza University of Rome and Universidad Complutense de Madrid) participated in the validation of the study. A standard validation protocol that included item development, test-retesting, and a series of statistical validation analyses, was used. Feasibility, test-retest reliability, inter-item reliability were assessed quantitatively. Face validity was evaluated qualitatively by an expert professor in the field.

RESULTS: Test-retest and inter-item reliability were considered satisfactory for all the parts of the questionnaire. Part III and IV presented lower Cohen’s kappa values, probably as a consequence of their inherent subjectivity. When one item in Part III was removed, the Cronbach’s alpha values of both initial and 48h answers consider-ably increased (-0.355 to 0.713 and -0.202 to 0.808 respectively). We therefore decided to eliminate the question from the EUSPSQ. Internal and external validity were considered appropriate. The questionnaire was also feasible and viable to complete.

DISCUSSION: Preliminary findings indicate that the EUSPSQ can be a valid, viable and reliable questionnaire to measure preparedness and satisfaction of 5th and 6th year medical students across different European Universities.

PMID:35612340 | DOI:10.7417/CT.2022.2428

Clin Ter. 2022 May 25;173(3):274-279. doi: 10.7417/CT.2022.2431.

ABSTRACT

PURPOSE: To evaluate safety and efficacy of customized central corneal regularization (CCR), together with simultaneous accelerated corneal collagen cross-linking (A-CXL) – CCR-CXL protocol, to treat keratoconus-related corneal ectasia.

DESIGN: Retrospective, comparative observational case series.

METHODS: Patients that had undergone combined CCR-CXL protocol. Main inclusion criteria were keratoconus visual acuity deterioration and contact lens intolerance. All patients underwent complete ophthalmological evaluation, corrected distance visual acuity (CDVA) and Scheimpflug-corneal tomography. Central corneal regularization was performed by ablation using flying spot laser. Subsequently, the stroma was saturated with 0.17% riboflavin-5-phosphate added every 2 minutes, followed by A-CXL 9 mW/cm2 for 10 minutes. CDVA, medium keratometry value (Kmed), and total corneal morphological irregularity index (CMI) of patients were analyzed before surgery and after 1, 3 and 12 months. A P value of .05 or less was considered statistically significant.

RESULTS: 46 eyes of 39 keratoconus patients were treated. At 1 month, the mean CDVA (LogMar) increased from 0.19 ± 0.02 to 0.12 ± 0.02 (P < .05), and the difference remained stable at month 12. Kmax decrease was statistically significant from 57.02 ± 5.65 to 50.21 ± 4.48 (P < .05). CMI decreased significantly from 47.8 ± 2.84 to 30.1 ± 2.4 (P < .01).

CONCLUSIONS: CCR-CXL protocol is safe and effective in arresting keratectasia progression and increasing corneal optic regularity in keratoconus. These findings showed a significant improvement in CDVA, keratometry values and corneal optical aberrations after being treated with the CCR-CXL protocol.

PMID:35612343 | DOI:10.7417/CT.2022.2431

Endocr Metab Immune Disord Drug Targets. 2022 May 24. doi: 10.2174/1871530322666220524104929. Online ahead of print.

ABSTRACT

BACKGROUND: Hypovitaminosis D and low testosterone levels are common in men with T2DM, and vitamin D has been proposed to regulate pituitary-testicular function.

OBJECTIVE: We investigated the association between testosterone levels and the circulating vitamin D among type 2 diabetic males.

METHODOLOGY: We recruited 95 type 2 diabetic males in this cross-sectional study, and investigated the circulating form of vitamin D which is 25-hydroxyvitamin D (25(OH) D). 25(OH) D level <30 ng/mL was used to define vitamin D insufficiency and 25(OH) D level <20 ng/ml defined deficiency. Testosterone deficiency was defined as a total testosterone level less than300 ng/dl.

RESULT: Testosterone deficiency prevalence in type 2 diabetic males was 46.3%. Testosterone deficient diabetics had significantly lower 25(OH) D levels than patients with normal testosterone. We observed a higher prevalence of vitamin D deficiency in testosterone deficient diabetics compared with testosterone sufficient patients. Furthermore, significantly lower total testosterone but not LH levels were observed in diabetic males with vitamin D deficiency in comparison to non-deficient patients. We observed that 25(OH) D significantly predicted total testosterone levels in diabetic males evaluated by linear regression analysis. However this association was no longer statistically significant after exclusion of macro-albuminuric patients. Moreover, Vitamin D deficiency was a significant risk factor for testosterone deficiency in logistic regression analysis.

CONCLUSION: Testosterone deficient diabetic males had significantly lower 25(OH)D levels and a higher prevalence of vitamin D deficiency in comparison with normal testosterone diabetic males. Likewise, vitamin D deficient patients had lower testosterone levels. Overall, 25(OH) D significantly predicted total testosterone levels. The vitamin D deficiency was thus a significant risk factor for testosterone deficiency in diabetic males.

PMID:35611781 | DOI:10.2174/1871530322666220524104929

Clin Exp Hypertens. 2022 May 25:1-9. doi: 10.1080/10641963.2022.2079666. Online ahead of print.

ABSTRACT

OBJECTIVE: Excessive salt intake is currently the foremost universal risk factor for controllable chronic disease. This study evaluated the short-term effects of a modest salt intake reduction combined with the Chinese Modified Dietary Approaches to Stop Hypertension (CM-DASH) diet on sodium and potassium intake, mean arterial pressure (MAP), and pulse pressure (PP) in hypertensive patients with type II diabetes.

METHODS: Sixty-one participants were randomized to the intervention group (52% low-sodium salt and DASH) and control group (normal salt and DASH). An 8-week dietary intervention was applied. Daily salt intake, blood pressure (BP), and drug use were recorded every week. Twenty-four-hour urine, casual urine, and blood samples were measured at baseline, the 4th week, and the end of the intervention.

RESULTS: Fifty-nine patients (25 men) completed the entire study. Sodium intake decreased by 1259.66 (792.76, 1726.56)/705.80 (149.21, 1262.39) mg/day after 4 weeks (intervention: P < .001; control: P = .015). Potassium intake increased by 641.14 (73.31, 1208.96)/43.43 (-259.66, 346.53) mg/day (intervention: P = .028); MAP decreased by 9.06 (6.69, 11.43)/7.16 (4.03, 10.28) mmHg (both: P < .001); PP decreased by 7.97 (3.05, 12.88)/5.74 (2.55,8.94) mmHg (intervention: P = .002; control: P = .001) after 8 weeks. However, the difference between the two groups was not statistically significant.

CONCLUSION: Modest salt reduction and the CM-DASH diet for hypertensive patients with type II diabetes can achieve short-term salt reduction effects. The effect on changing salt-eating habits needs to be investigated with an extended follow-up.

PMID:35611762 | DOI:10.1080/10641963.2022.2079666

Orthop Surg. 2022 May 25. doi: 10.1111/os.13311. Online ahead of print.

ABSTRACT

As more high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are performed, orthopaedic surgeons realize that more HTO and UKA failures will require revision to total knee arthroplasty (TKA) in the future. To systematically evaluate the clinical outcomes of TKA after HTO and TKA after UKA, the Embase, PubMed, Ovid, Web of Science, and Cochrane Library databases were searched for studies investigating revision TKA after HTO and UKA published up to June 2021. RevMan version 5.3 was used to perform the meta-analysis. The revision TKA after HTO and revision TKA after UKA groups were compared in terms of operative time, range of motion (ROM), knee score, postoperative complications, postoperative infection, revision, and revision implants used. Nine studies were ultimately included in the meta-analysis. Results revealed that the knee score for the revision TKA after HTO group was better than that of the revision TKA after UKA group (MD 4.50 [95% CI 0.80-8.20]; p = 0.02). The revision TKA after HTO group had a lower revision rate (OR 0.65 [95% CI 0.55-0.78]; p < 0.00001) and fewer revision implants used (OR 0.11 [95% CI 0.05-0.23]; p < 0.00001). There were no statistical differences in operation time (MD -2.00 [95% CI -11.22 to 7.21]; p = 0.67), ROM (MD -0.04 [95% CI -3.69-3.61]; p = 0.98), postoperative complications (OR 1.41 [95% CI 0.77-2.60]; p = 0.27), or postoperative infections (OR 0.89 [95% CI 0.61-1.29]; p = 0.53). To conclude, the revision rate of revision TKA after UKA was greater, and more revision implants were required. It is important for orthopaedic surgeons to preserve bone during primary UKA.

PMID:35611758 | DOI:10.1111/os.13311