Tag: pubmed

J Arthroplasty. 2021 Feb 12:S0883-5403(21)00162-5. doi: 10.1016/j.arth.2021.02.023. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with mood disorders undergoing total joint arthroplasty (TJA) are at increased risk for poor outcomes. This study seeks to examine the effect of anxiety disorders on pain following TJA and evaluate if anxiety disorders are a modifiable risk factor.

METHODS: Between March 2019 and July 2020, 319 TJA patients had preoperative anxiety screening using the Generalized Anxiety Disorder 2-item screening tool (GAD-2) and 6-week postoperative Pain Catastrophizing Scale scores. Patients were organized into 4 cohorts based on preoperative selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) use and GAD-2 scores: Group 1: no SSRI/SNRI use and GAD-2 score <3 (control patients); Group 2: SSRI/SNRI use and GAD-2 score <3 (appropriately treated GAD patients); Group 3: no SSRI/SNRI use and GAD-2 score ≥3 (untreated GAD patients); and Group 4: SSRI/SNRI use and GAD-2 score ≥3 (poorly treated GAD patients). The cohorts underwent multivariate linear regression analysis and equivalence testing.

RESULTS: Patients with preoperative GAD-2 scores ≥3 had worse postoperative pain with significantly higher average 6-week postoperative Pain Catastrophizing Scale score than patients with GAD-2 scores <3 (9.90 vs 5.19, P < .001). Patients with appropriately treated GAD and the control group had statistically equivalent postoperative pain, while patients with poorly treated or untreated GAD had worse postoperative pain.

CONCLUSION: Preoperative GAD is a risk factor for poor postoperative pain control but is a modifiable risk factor when patients are appropriately treated. Screening for preoperative GAD with GAD-2 and referral for treatment may improve patient outcomes and reduce opioid consumption following TJA.

PMID:33648840 | DOI:10.1016/j.arth.2021.02.023

Eur Cytokine Netw. 2020 Dec 1;31(4):129-133. doi: 10.1684/ecn.2020.0457.

ABSTRACT

Tuberculosis (TB) is one of the leading infectious causes of death worldwide and despite the progress recently made in TB control at a global level, the decline in its incidence is still slow. It is therefore crucial to evaluate the performance of new tools for monitoring of TB treatment. The aim of this study was to evaluate the response to tuberculosis treatment using the QuantiFERON-TB Gold Plus (QFT-Plus) kit. Blood samples of 100 patients with active TB were taken before treatment and after three months, if treatment was successful and sputum culture was negative. Whole blood was incubated in the presence or absence of the TB antigens, TB1 and TB2-specific antigens, and the production of IFN-γ was determined using the QuantiFERON-TB Gold Plus (QFT-Plus) test. The data were analyzed using SPSS 16 software and statistical significance was assessed at a two-tailed P value of 0.05. The median values of IFN-γ released following stimulation with TB1 peptides decreased slightly after treatment (2.5 IU/mL (IQR: 0.9-5.3), compared to the baseline (3.4 IU/mL (IQR: 0.5-6.6)). Also, with respect to the TB1 antigen, 38 out of 45 patients were positive for the QFT test before treatment (84.4%) and 37 cases after treatment (82.2%). On the other hand, the median values of IFN-γ determined with the TB2 test declined marginally after treatment (2.7 IU/mL; IQR: 0.95-5.8), as compared to pretreatment (3.0 IU/mL; IQR: 0.7-8.9). Thirty-nine out of 45 patients (86.7%) before initiation of treatment and 37 cases following a 3-month treatment (82.2%) were had positive values. Moreover, the median values of IFN-γ of TB2 minus TB1 before and after treatment were 0.17 (IQR: 0-1.0) and 0.03 (IQR: 0.0.48), respectively; however, these differences were not significant (p value=0.29). Conclusion: The results of this study show no significant differences between the IFN-γ release in TB patients prior to and after treatment. However, more extensive studies are needed in different populations with higher sample sizes to validate these results.

PMID:33648920 | DOI:10.1684/ecn.2020.0457

Eur J Dermatol. 2021 Mar 1. doi: 10.1684/ejd.2021.3967. Online ahead of print.

ABSTRACT

BACKGROUND: Organ transplant recipients (OTR) are at marked increased risk of skin cancer and skin infections compared to the general population.

OBJECTIVES: The purpose of this study was to acquire long-term incidence data on commonly occurring skin diseases in four different transplant groups.

MATERIALS & METHODS: This retrospective single-centre cohort study included 621 OTR. By counting defined malignant, inflammatory, infectious or drug-related skin conditions per patient and visit, incidence rates (IR) for the different groups of OTR were calculated as cases per 1000-patient years and cumulative incidences of non-melanoma skin cancer (NMSC), respectively.

RESULTS: Overall, 2,309 non-malignant skin conditions and 340 NMSC were registered. Skin infections were most common (51.4%), followed by inflammatory skin conditions (35.6%) and sun-induced skin damage (32.9%). Kidney transplant recipients (KTR) had a 4.7-fold (95% CI: 2.7-8.0; p < 0.0001), 2.6-fold (95% CI: 1.2-5.3; p = 0.0098) and 5.4-fold (95% CI: 2.8-10.3; – < 0.0001) higher IR for oral candidiasis, oral aphthosis and herpes simplex virus infections, respectively, compared to the other OTR. Pruritus was most commonly reported in liver transplant recipients (95% CI: 1.3-5.3; p = 0.0047). KTR and lung transplant recipients (LuTR) had a 10.7-fold (95% CI:3.6-43.2; p < 0.0001) higher IR of steroid induced acne. KTR had a 1.6-fold (95% CI: 1.1-2.3; p = 0.0096) higher IR of squamous cell carcinoma compared to the other groups. The incidence of basal cell carcinoma was 2.5-fold higher (95% CI: 1.7-3.6; p < 0.0001) in LuTR, compared to the other OTR.

CONCLUSIONS: This study provides additional organ-specific incidence data on non-malignant skin diseases and skin cancer in OTR.

PMID:33648926 | DOI:10.1684/ejd.2021.3967

J Prosthet Dent. 2021 Feb 26:S0022-3913(21)00043-3. doi: 10.1016/j.prosdent.2021.01.006. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: The lost-wax technique is commonly used for fabricating partial fixed dental prostheses. The casting patterns can be fabricated by using vat photopolymerization (a type of additive manufacturing), but the adaptation of these casting patterns has not been elucidated.

PURPOSE: The purpose of this in vitro study was to evaluate the effect of build orientation on the adaptation of casting patterns fabricated by digital light projection (DLP).

MATERIAL AND METHODS: A 3-unit partial fixed dental prosthesis with mandibular left second premolar and second molar abutment teeth was scanned and virtually designed with a computer-aided design software program. The cement space was designed to be 30 μm. Specimens were fabricated with 3 build orientations: 0 degrees (with the occlusal surface parallel to the platform), 30 degrees, and 45 degrees (by rotating the file along the long axis). The casting patterns were fabricated by using DLP (Cara Print 4.0) with a photopolymerizable monomer (dima Print Cast Q). Photopolymerization, cleaning, and postpolymerization processes were performed according to the manufacturer’s instructions. The adaptation of the specimens was examined by using a silicone replica method. The vertical marginal discrepancy and axial wall, occlusal, and marginal gaps were measured by using a digital measuring microscope. The effect of build orientation at each cross-sectional area was statistically analyzed by using the Kruskal-Wallis test followed by the pairwise Wilcoxon rank sum test with Bonferroni correction (α=.05).

RESULTS: Excess polymerized resin was observed along the intaglio buccal wall at build orientations of 30 degrees and 45 degrees. Vertical marginal discrepancies in the buccolingual section ranged from -50 to 248 μm, while those in the mesiodistal section ranged from -25 to 182 μm. The gaps in the buccolingual section ranged from 0 to 236 μm, while those in the mesiodistal section ranged from 0 to 177 μm. According to the observation of vertical marginal discrepancies and gaps, the 30-degree specimens inclined during insertion, and the 45-degree specimens were not completely seated. However, the marginal gaps of the 0- and 30-degree specimens were within the clinically acceptable limit of 120 μm.

CONCLUSIONS: The limited data indicated that the build orientation influenced the adaptation of casting patterns for 3-unit partial fixed dental prostheses fabricated by using DLP. A build orientation of 0 degrees is recommended for fabricating casting patterns for 3-unit partial fixed dental prostheses because no excess polymerization of the intaglio buccal wall was observed.

PMID:33648796 | DOI:10.1016/j.prosdent.2021.01.006

Auris Nasus Larynx. 2021 Feb 27:S0385-8146(21)00066-3. doi: 10.1016/j.anl.2021.02.008. Online ahead of print.

ABSTRACT

OBJECTIVE: Retrospective videofluoroscopic swallowing study (VFSS) evaluations of pharyngeal swallowing were used to evaluate the types of dysphagia alleviated by the chin-down maneuver.

MATERIALS AND METHODS: The study population consisted of 64 patients who underwent VFSS evaluations during neutral and chin-down maneuvers presenting specifically penetration or aspiration. The assessment of the VFSS movie clips of each maneuver was performed using parameters of the Modified Barium Swallow Impairment Profile (MBSImP) and the presence and degree of airway invasion(PDAI) by three blinded raters in the following five subcategorized groups, 1. patietns presenting penetration or aspiration during swallow 2. after swallow, patients of 3. head and neck, 4. digestive and 5. neuromuscular disorders, respectively. The scores registered for the two maneuvers were statistically compared. Additionally, we examined statistically which factors had the impact on the improvement of the PDAI using fisher’s exact test.

RESULTS: Compared with the neutral position, PDAI, pharyngeal constriction, anterior hyoid movement, pharyngeal constriction, laryngeal elevation, laryngeal closure, upper esophageal sphincter opening, initiation of the pharyngeal swallow, and pharyngeal clearance in pyriform sinus were significantly (p < 0.01-0.05) improved with the chin-down maneuver. In a subcategory comparison with group 1, 3 and 4, the PDAI improved significantly (p < 0.01) with the chin-down maneuver, in which laryngeal elevation and laryngeal closure had statistically the impact (p < 0.01-0.05) on improvement of PDAI.

CONCLUSION: The chin-down maneuver was most effective in improving swallow function when the impairment included penetration and aspiration during swallow caused by inadequate laryngeal elevation and laryngeal closure.

PMID:33648799 | DOI:10.1016/j.anl.2021.02.008

Eur Neuropsychopharmacol. 2021 Feb 26:S0924-977X(21)00135-8. doi: 10.1016/j.euroneuro.2021.02.006. Online ahead of print.

ABSTRACT

Apolipoprotein E (APOE) genotype is the strongest single gene predictor of Alzheimer’s disease (AD) and has been frequently associated with AD-related brain structural alterations before the onset of dementia. While previous research has primarily focused on hippocampal morphometry in relation to APOE, sporadic recent findings have questioned the specificity of the hippocampus and instead suggested more global effects on the brain. With the present study we aimed to investigate associations between homozygous APOE ε4 status and cortical gray matter structure as well as white matter microstructure. In our study, we contrasted n = 31 homozygous APOE ε4 carriers (age=34.47 years, including a subsample of n = 12 subjects with depression) with a demographically matched sample without an ε4 allele (resulting total sample: N = 62). Morphometry analyses included a) Freesurfer based cortical segmentations of thickness and surface area measures and b) tract based spatial statistics of DTI measures. We found pronounced and widespread reductions in cortical surface area of ε4 homozygotes in 57 out of 68 cortical brain regions. In contrast, no differences in cortical thickness were observed. Furthermore, APOE ε4 homozygous carriers showed significantly lower fractional anisotropy in the corpus callosum, the right internal and external capsule, the left corona radiata and the right fornix. The present findings support a global rather than regionally specific effect of homozygous APOE ε4 allele status on cortical surface area and white matter microstructure. Future studies should aim to delineate the clinical implications of these findings.

PMID:33648793 | DOI:10.1016/j.euroneuro.2021.02.006

J Prosthet Dent. 2021 Feb 26:S0022-3913(21)00071-8. doi: 10.1016/j.prosdent.2021.01.024. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: With the aging population, an increasing number of patients will require removable dental prostheses. Despite the recent public efforts to improve oral healthcare, knowledge of hygiene procedures for removable dental prostheses is sparse.

PURPOSE: The purpose of this cross-sectional study was to determine, through questionnaires, the level of awareness and education of home hygiene procedures among elderly Italian individuals wearing removable dental prostheses and to correlate self-reported hygiene habits and prosthesis cleanliness, as determined by a clinical examination.

MATERIAL AND METHODS: A cross-sectional study was performed by questionnaires administered by a dental hygienist to patients attending the dental clinics (prosthodontic and periodontology clinical units) at San Paolo Hospital of Milan from January 2014 to October 2015 and who volunteered to participate. The questionnaire included demographic data and oral hygiene habits. Each participant received an intraoral and prosthesis examination performed by the same dental hygienist. The cleanliness of the removable dental prosthesis was classified according to a 3-point scoring system. Categorical variables were expressed as a percentage of study participants and compared by using the χ² test, while, for the statistical correlations between continuous and categorical variables, the point-biserial correlation calculator was used (α=.05).

RESULTS: Questionnaires were collected from 161 study participants: 92 women (mean ±standard deviation age: 76 ±7.59 years; range: 65-93 years) and 69 men (mean ±standard deviation age: 74 ±6.31 years; range: 65-86 years). A total of 239 prostheses were considered. A significant correlation was found between older participants, older removable dental prostheses, and reduced prosthesis cleanliness, correlating age ranges of participants as well as of removable dental prostheses with the degrees of prosthesis cleanliness (P=.001 and P=.004, respectively). Half the study participants (n=81; 50.3%) reported prosthesis removal during the night, while the others reported sleeping with the prosthesis in place. Some study participants (n=32; 19.9%) reported that they had never received instructions about how to clean the prosthesis. Mechanical brushing with toothbrush and toothpaste was the most common cleaning method (n=47; 29.2%), while the recommended combined cleaning method based on both mechanical brushing and immersion in dental cleanser was applied by 34 (21.1%) study participants. A similar number (n=25; 15.5%) reported at least 1 episode of denture-related stomatitis.

CONCLUSIONS: In the analyzed cohort, patient attitude and habits toward home procedures for denture hygiene resulted in poor prosthesis cleanliness. Most individuals used a toothbrush and toothpaste to clean their device, although combining mechanical and chemical cleaning is typically reported to be the optimal method.

PMID:33648795 | DOI:10.1016/j.prosdent.2021.01.024

Dent Mater. 2021 Feb 26:S0109-5641(21)00069-5. doi: 10.1016/j.dental.2021.02.007. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the influence of the incorporation of chlorhexidine-hexametaphosphate nanoparticles (CHX-HMP NPs) on antibacterial, cytotoxic and physicochemical properties of AH Plus (AH), MTA Fillapex (MTA) and Pulp Canal Sealer (PCS).

METHODS: The NPs were synthesized and characterized by Scanning Electron Microscopy (SEM), Dynamic Light Scattering (DLS), zeta potential, Atomic Force Microscopy (AFM) and Energy-Dispersive X-ray Spectroscopy (EDS). The incorporation was made by weight, 2% and 5% of NPs. The antimicrobial activity, cytotoxicity, flow, radiopacity, setting time, solubility and pH were evaluated. The statistical analysis was performed by two-way analysis of variance test and Tukey post hoc test (P < 0.05).

RESULTS: SEM analysis showed the tendency for CHX-HMP NPs to cluster, the effective mean diameter measured by DLS: 169.39 nm and the zeta potential: -10.18 mV. The NPs were individually measured by AFM: 22.99-52.75 nm. EDS analysis identified the presence of C, N, O, Na, P, Cl. After incorporation: The Direct Contact Test showed an increase in the antimicrobial action of AH, PCS and MTA; the sealers showed a decrease in flow and at 24 h of immersion also an increase in solubility, but did not affect the radiopacity of the samples; AH setting time increased and MTA did not reach setting under any of the conditions tested. All samples showed a decrease in pH value as the immersion time progressed.

SIGNIFICANCE: The incorporation of NPs can improve the antimicrobial performance of endodontic sealers without impairing other biological and physicochemical properties.

PMID:33648745 | DOI:10.1016/j.dental.2021.02.007

Encephale. 2021 Feb 26:S0013-7006(21)00031-2. doi: 10.1016/j.encep.2020.10.006. Online ahead of print.

ABSTRACT

INTRODUCTION: The Receptive Composite Montage (RCM) is a musical induction technique designed to cause a positive state to in-patients diagnosed with depression in a psychiatric institution. This research aims at proving that the RCM brings patients into a relaxation state and a positive mood within 20min.

METHOD: Thirty-seven in-patients with depression took part in this study. The average age of the sample was slightly under 49 years old (48.73±12.41). The relaxing aspect of the RCM was monitored thanks to data given by an oximeter, which measures the heartbeats and the oxygen saturation level in the in-patient’s bloodstream. In order to complete these data, a focal-sampling observation was carried out. Positive mood induction was estimated based on interviews. The data have been processed through analytical statistics.

RESULTS: Heartbeats and oxygen saturation in the bloodstream during the relaxing phase of the montage (P<.001 and z=.018 respectively) tended to increase during the wake-up phase (P<.001) as was anticipated. In-patients who had felt a negative mood before listening to the RCM reported feeling a significant positive mood once they had listened to the RCM (z=.017).

CONCLUSION: The results obtained show that the RCM does induce a relaxation state by decreasing heartbeats and breathing cycles. Moreover, the qualitative data show that when in-patients listen to the RCM, their mood becomes positive through an emotional exercise causing their mood to shift from negative to positive.

PMID:33648753 | DOI:10.1016/j.encep.2020.10.006

Biol Psychiatry. 2021 Jan 9:S0006-3223(21)00033-0. doi: 10.1016/j.biopsych.2020.12.024. Online ahead of print.

ABSTRACT

BACKGROUND: The origin of sex differences in prevalence and presentation of neuropsychiatric and behavioral traits is largely unknown. Given established genetic contributions and correlations, we tested for a sex-differentiated genetic architecture within and between traits.

METHODS: Using European ancestry genome-wide association summary statistics for 20 neuropsychiatric and behavioral traits, we tested for sex differences in single nucleotide polymorphism (SNP)-based heritability and genetic correlation (r_g < 1). For each trait, we computed per-SNP z scores from sex-stratified regression coefficients and identified genes with sex-differentiated effects using a gene-based approach. We calculated correlation coefficients between z scores to test for shared sex-differentiated effects. Finally, we tested for sex differences in across-trait genetic correlations.

RESULTS: We observed no consistent sex differences in SNP-based heritability. Between-sex, within-trait genetic correlations were high, although <1 for educational attainment and risk-taking behavior. We identified 4 genes with significant sex-differentiated effects across 3 traits. Several trait pairs shared sex-differentiated effects. The top genes with sex-differentiated effects were enriched for multiple gene sets, including neuron- and synapse-related sets. Most between-trait genetic correlation estimates were not significantly different between sexes, with exceptions (educational attainment and risk-taking behavior).

CONCLUSIONS: Sex differences in the common autosomal genetic architecture of neuropsychiatric and behavioral phenotypes are small and polygenic and unlikely to fully account for observed sex-differentiated attributes. Larger sample sizes are needed to identify sex-differentiated effects for most traits. For well-powered studies, we identified genes with sex-differentiated effects that were enriched for neuron-related and other biological functions. This work motivates further investigation of genetic and environmental influences on sex differences.

PMID:33648717 | DOI:10.1016/j.biopsych.2020.12.024