Tag: pubmed

Orthod Craniofac Res. 2022 Mar 29. doi: 10.1111/ocr.12575. Online ahead of print.

ABSTRACT

OBJECTIVE: Certain malocclusions or unilateral tooth loss can lead to asymmetric functional load of the two mandibular sides during mastication and induce skeletal asymmetries to the condylar process of growing individuals. However, in adults, asymmetric function may have a different impact. The aim of the present study was to investigate three-dimensionally the effects of unilateral masticatory function on the condylar process morphology in growing and adult rats and the adaptive processes to differential condylar loading.

MATERIALS AND METHODS: Fifty-six growing and adult Wistar rats aged 4 and 26 weeks respectively were obtained. The maxillary right molars of the experimental animals were extracted and all animals were followed for 12 weeks. Three-dimensional images were obtained by an in-vivo microcomputed tomography (micro-CT) examination. The following measurements were studied: condylar process height, condylar base width, and condylar cross-sectional surface.

RESULTS: While no differences were found with regards to condylar process height and base width, the cross-section of the condyle on the extraction side did not increase during growth in the young rats. No such differences were found in adults. Young rats had statistically significantly shorter condylar height, base width and cross-sectional surface than the adult rats and showed significant growth of these structures during the experimental period.

CONCLUSION: Condylar height and base width growth are not hindered by reduced occlusal function, contrary to the average cross-sectional surface, which implies that the condyle form of growing individuals becomes thinner while maintaining its length, in the absence of occlusal stimuli. The condyle of adult rats with extractions is less affected by occlusion changes.

PMID:35347850 | DOI:10.1111/ocr.12575

J Cosmet Dermatol. 2022 Mar 29. doi: 10.1111/jocd.14941. Online ahead of print.

ABSTRACT

BACKGROUND: Cleft lip and/or palate (CL/P) are congenital cleft facial deformities that are abnormal developments caused by errors in the fusion process of the embryo’s face. Surgery is an important treatment, but postoperative scars will still cause psychological shadows to patients. This study aimed to systematically evaluate the efficacy of Botulinum toxin type A (BTXA) in preventing and treating postoperative CL/P scars and improving scar quality.

METHODS: A systematic review was performed by searching PubMed, EMBASE, the Cochrane Library and Web of Science for relevant trials. All relevant trials were performed before June 30, 2021. The data were entered into Revman 5.3 software, and a meta-analysis was conducted by using the random-effects model or fixed-effects model.

RESULTS: Four randomized controlled trials involving 161 cases were included. Through quantitative analysis, BTXA showed significant differences in preventing and treating postoperative CL/P scars in terms of scar width (MD: -0.20; [95% CI, -0.30, -0.10], p<0.0001) and the Visual Analog Scale (VAS) (MD: 1.30; [95% CI, 1.06, 1.55], p<0.0001), although no significant difference was noted on the Vancouver Scar Scale (VSS) (MD: -0.75; [95% CI, -1.68, 0.19], p=0.12) between the two groups.

CONCLUSION: In preventing and treating postoperative CL/P scar hypertrophy, we found that BTXA injection can show better results. There was no statistically significant difference between the results after omitting Navarro’s study or Chang’s study because of the time of injection-before/during surgery or adult CL/P scars.

PMID:35347825 | DOI:10.1111/jocd.14941

Vet Radiol Ultrasound. 2022 Mar 29. doi: 10.1111/vru.13086. Online ahead of print.

ABSTRACT

The prognosis for canine sinonasal tumors remains rather poor despite definitive-intent radiotherapy (RT). Theoretical calculations predicted improved outcomes with simultaneously integrated boost (SIB) protocols. With the hypothesis of clinically detectable differences in outcome between groups, our retrospective study evaluated prognostic variables and outcome in dogs treated with regular versus SIB RT. Dogs with sinonasal tumors treated with either a regular (10 × 4.2 Gy) or new SIB protocol (10 × 4.83 Gy to macroscopic tumor) were included. Information regarding signalment, tumor stage, type, clinical signs, radiation toxicity, response, and outcome was collected. Forty-nine dogs were included: 27 treated regularly and 22 treated with SIB RT. A total of 69.4% showed epistaxis, 6.1% showed epileptic seizures, 46.9% showed stage IV tumors, and 6.1% showed lymph node metastases. Early toxicity was mostly mild. Late grade 1 skin toxicity (alopecia/leucotrichia) was seen in 72.1% of dogs, and a possible grade 3 ocular toxicity (blindness) was seen in one dog. Complete/partial resolution of clinical signs was seen in 95.9% of patients as best clinical response and partial remission was seen as best imaging response in 34.7%. The median progression-free survival (PFS) was 274 days (95% CI: 117-383) for regular and 300 days (95% CI: 143-451) for SIB RT, which was not significantly different (P = 0.42). Similarly, the median overall survival (OS) was 348 days (95% CI: 121-500) for regular and 381 days (95% CI: 295-634) for the SIB RT (P = 0.18). Stratified by protocol, the hazard ratio of stage IV versus stage I-III tumors was 2.29 (95% CI: 1.156-4.551, P = 0.02) for OS but not PFS. All dogs showed acceptable toxicity. In contrast to theoretical predictions, however, we could not show a statistically significant better outcome with the new protocol.

PMID:35347801 | DOI:10.1111/vru.13086

Indoor Air. 2022 Mar;32(3):e13013. doi: 10.1111/ina.13013.

ABSTRACT

The association between particulate matter and children’s increased blood pressure is inconsistent, and few studies have evaluated indoor exposure, accounting for time-activity. The present study aimed to examine the association between personal short-term exposure to PM_2.5 and blood pressure in children. We conducted a panel study with up to three physical examinations during different seasons of 2018 (spring, summer, and fall) among 52 children. The indoor PM_2.5 concentration was continuously measured at home and classroom of each child using indoor air quality monitors. The outdoor PM_2.5 concentration was measured from the nearest monitoring station. We constructed a mixed effect model to analyze the association of short-term indoor and outdoor PM_2.5 exposure accounting for time-activity of each participant with blood pressure. The average PM_2.5 concentration was 34.3 ± 9.2 μg/m³ and it was highest in the spring. The concentration measured at homes was generally higher than that measured at outdoor monitoring station. A 10-μg/m³ increment of the up to previous 3-day mean (lag0-3) PM_2.5 concentration was associated with 2.7 mmHg (95%CI = 0.8, 4.0) and 2.1 mmHg (95%CI = 0.3, 4.0) increases in systolic and diastolic blood pressure, respectively. In a panel study comprehensively evaluating both indoor and outdoor exposures, which enabled more accurate exposure assessment, we observed a statistically significant association between blood pressure and PM_2.5 exposure in children.

PMID:35347791 | DOI:10.1111/ina.13013

Indoor Air. 2022 Mar;32(3):e13018. doi: 10.1111/ina.13018.

ABSTRACT

The adaptive thermal heat balance (ATHB) framework introduced a method to account for the three adaptive principals, namely physiological, behavioral, and psychological adaptation, individually within existing heat balance models. This work presents a more detailed theoretical framework together with a theory-driven empirical determination toward a new formulation of the ATHB_PMV . The empirical development followed a rigor statistical process known from machine learning approaches including training, validation, and test phase and makes use of a subset (N = 57 084 records) of the ASHRAE Global Thermal Comfort Database. Results show an increased predictive performance among a wide range of outdoor climates, building types, and cooling strategies of the buildings. Furthermore, individual findings question the common believe that psychological adaptation is highest in naturally ventilated buildings. The framework offers further opportunities to include a variety of context-related variables as well as personal characteristics into thermal prediction models, while keeping mathematical equations limited and enabling further advancements related to the understanding of influences on thermal perception.

PMID:35347785 | DOI:10.1111/ina.13018

Int J Health Plann Manage. 2022 Mar 28. doi: 10.1002/hpm.3454. Online ahead of print.

ABSTRACT

Norwegian health authorities emphasise that all citizens should have equal access to healthcare and implement cancer patient pathways (CPPs) to ensure medical care for all patients within the same time frame and to avoid unwanted variation. Statistics regarding prostate cancer indicate longer wait times for patients from a local hospital compared to patients from a university hospital. This study describes which health system-related factors influence variations in wait times. Eighteen healthcare workers participated in qualitative individual interviews conducted using a semi-structured interview guide. Transcripts were analysed by systematic text condensation, which is a cross-case method for the thematic analysis of qualitative data. The analysis unveiled four categories describing possible health system-related factors causing variation in times spent on diagnostics for patients in the local hospital and in university hospital, respectively: (a) capacity and competence, (b) logistics and efficiency, (c) need for highly specialised investigations, and (d) need for extra consultations. Centralisation of surgical treatment necessitated the transfer of patients, with extra steps indicated in the CPP for patients transferring from the local hospital to the university hospital for surgery. The local hospital seemed to lack capacity more frequently than the university hospital. Possible factors explaining variations in wait time between the two hospitals concern both internal conditions at the hospitals in organising CPPs and the implications of transferring patients between hospitals. Differences in hospitals’ capacity can cause variations in wait time. The extra steps involved in transferring patients between hospitals can lead to additional time spent in CPP.

PMID:35347768 | DOI:10.1002/hpm.3454

Birth. 2022 Mar 28. doi: 10.1111/birt.12636. Online ahead of print.

ABSTRACT

BACKGROUND: Bangladesh has experienced an alarming increase in birth through cesarean over the last decade. In this article, we examine rural Bangladeshi women’s reporting of why they underwent cesarean, who proposed the cesarean, and when in the process, the decision for a surgical birth was made.

METHODS: We conducted a cross-sectional household survey of 2299 women in Kushtia district. Of these, 1233 who gave birth through cesarean completed a supplemental questionnaire. Descriptive statistics were used to report cesarean rates, which were disaggregated by sociodemographic characteristics and by antenatal care contacts with health services. We analyzed women’s reported reasons for having a cesarean, when the decision was taken, and who proposed the intervention.

FINDINGS: Over half (54%) of women gave birth through cesarean. The proportion of cesareans was significantly higher among women with higher educational attainment, higher socioeconomic status, and increased antenatal care during pregnancy, particularly if this care was sought in private facilities (P < .05). Women reported that health service providers primarily proposed the cesarean (73%), followed by family members (21%) and finally, the birthing person themselves (6%). With respect to the reasons for cesarean, 34% of women reported nonmedical reasons (convenience and avoidance of labor pain), and 44% mentioned only medical reasons. Over half of the women reported that the decision to undergo a cesarean was made on the day of birth.

CONCLUSIONS: Women in rural Bangladesh often report avoidable reasons for cesarean. Better regulation of cesarean services in both public and private health services, as well as improved counseling of women with respect to cesarean indications and their consequences, is recommended.

PMID:35347769 | DOI:10.1111/birt.12636

J Small Anim Pract. 2022 Mar 28. doi: 10.1111/jsap.13491. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate and compare the accuracy of two veterinary portable blood glucose metres (AccuTell; AccubioTech; and AlphaTrak2; Abbott Laboratories).

MATERIALS AND METHODS: One hundred twenty venous blood samples were obtained for immediate whole blood glucose concentration measurement using two portable blood glucose metres designed for use in dogs. Plasma glucose concentration was measured by a laboratory analyser using a hexokinase reaction method. Packed cell volume was measured for each sample. Linear regression analysis was performed and Bland-Altman plots constructed with International Standards Organisation 15197:2013 standards applied to assess relationship and agreement between results of portable blood glucose metres and laboratory analyser methods, respectively. Clarke’s error grid analysis was used to assess clinical accuracy and usefulness.

RESULTS: The AccuTell and the AlphaTrak2 had mean differences of -0.69 ± 0.70 mmol/L (bias ±sd) and -1.09 ± 1.22 mmol/L (bias ± sd) with the reference analyser, respectively. Eighty-eight of 120 (73.3%) samples for the AccuTell, and 73 of 120 (60.8%) samples for the AlphaTrak2 were plotted in the zone of the error grid analysis that indicated less clinical risk of misdiagnosis of glucose status. Neither device fulfilled the International Standards Organisation 15197:2013 standards for system accuracy. A statistically significant effect of packed cell volume was identified on the difference between blood glucose concentration obtained by the AlphaTrak2 and the hexokinase reaction method, but not for the AccuTell.

CLINICAL SIGNIFICANCE: Both devices do not meet International Standards Organisation 15197:2013 standards. Users should expect 95% of the samples measured with the AccuTell to be between -0.7 and +2.1 mmol/L higher than actual values, and 95% of the samples measured with the AlphaTrak2 to be between -1.3 and +3.5 mmol/L higher than actual values.

PMID:35347740 | DOI:10.1111/jsap.13491

HIV Med. 2022 Mar 28. doi: 10.1111/hiv.13307. Online ahead of print.

ABSTRACT

INTRODUCTION: This short report describes the results of a survey that was developed by Public Health England (PHE), the British HIV Association (BHIVA) and the Children’s HIV Association (CHIVA) and circulated to all UK national health service HIV providers in the UK following the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus disease 2019 [COVID-19]) pandemic to assess the impact of the pandemic on HIV clinics.

METHODS: The survey was created by BHIVA/CHIVA and PHE and was piloted prior to circulation to all HIV clinics within the UK on 3 July 2020. The survey questions were designed to assess the impact of the first wave of COVID-19 on HIV clinics and lead/senior HIV clinicians. Clinicians’ responses were collected between 3 July 2020 and 17 September 2020. The survey responses were collated, and non-statistical analysis was performed.

RESULTS: The results of the survey confirmed that services had undergone substantial changes, including a shift from face-to-face consults to predominantly virtual consultations. Some clinicians’ responses suggested that the first wave had many negative effects on people living with HIV, including their ability to access mental health services.

CONCLUSION: The first wave of COVID-19 caused significant changes to HIV services within the UK. There was a shift toward the use of technology in healthcare, and results from subsequent clinician surveys carried out since the first wave of COVID-19 will reflect the ongoing transformation of care towards a more virtual service.

PMID:35345056 | DOI:10.1111/hiv.13307

Sportverletz Sportschaden. 2022 Mar 28. doi: 10.1055/a-1688-3720. Online ahead of print.

ABSTRACT

BACKGROUND: Evaluation of different factors in patient quality of life after minimally invasive stabilization of intra-articular calcaneal fractures, including the return-to-sports rate.

PATIENTS AND METHODS: Patients with minimally invasive stabilization of intra-articular calcaneal fractures were collected from the database of a Level I trauma center and evaluated in a retrospective and explorative way. The clinical and radiological examination have been done immediately after the operation, after 2 and 6 weeks postoperative and after a minimum follow-up of 2 years. Clinical and radiological examination was performed by applying the American Orthopedic Foot and Ankle Society hindfoot scale score (AOFAS), 36-item Short Form Health Survey (SF-36), the Tegner Activity Scale, the Foot and Ankle Outcome Score (FAOS) and with a questionnaire about pre- and postoperative engagement in sport and recreational activities.

RESULTS: Fourty-nine patients with an isolated uni-lateral fracture of the calcaneus who fulfilled all inclusion criteria were assessed. Fourty-two of them were male and 24 were under the age of 50 years. No statistically significant differences were noted between Sanders I/II and Sanders III/IV in terms of SF-36, AOFAS, FAOS or Tegner-scale. A less satisfying result was noticed in Sanders III/IV patients. General health, pain in FAOS, physical functioning and pain in SF-36 were strongly dependent on Tegner score values. Twenty-nine percent of our study population changed sport activities after injury, whereas 22 percent stopped all kinds of sports. Consequently, our overall return-to-sport rate was 78 percent.

CONCLUSION: Clinical results including different scores and quality of life parameters in our study population were satisfying. About 80 percent of patients could return to sports, but there are still many patients that were not able to perform sports and physical activities on the same level as before.

PMID:35345053 | DOI:10.1055/a-1688-3720