Tag: pubmed

J Gen Intern Med. 2022 Jun 15. doi: 10.1007/s11606-022-07558-6. Online ahead of print.

ABSTRACT

BACKGROUND: Women who use drugs (WWUD) have low rates of contraceptive use and high rates of unintended pregnancy. Drug use is common among women in rural U.S. communities, with limited data on how they utilize reproductive, substance use disorder (SUD), and healthcare services.

OBJECTIVE: We determined contraceptive use prevalence among WWUD in rural communities then compared estimates to women from similar rural areas. We investigated characteristics of those using contraceptives, and associations between contraceptive use and SUD treatment, healthcare utilization, and substance use.

DESIGN: Rural Opioids Initiative (ROI) – cross-sectional survey using respondent-driven sampling (RDS) involving eight rural U.S. regions (January 2018-March 2020); National Survey on Family Growth (NSFG) – nationally-representative U.S. household reproductive health survey (2017-2019).

PARTICIPANTS: Women aged 18-49 with prior 30-day non-prescribed opioid and/or non-opioid injection drug use; fecundity determined by self-reported survey responses.

MAIN MEASURES: Unweighted and RDS-weighted prevalence estimates of medical/procedural contraceptive use; chi-squared tests and multi-level linear regressions to test associations.

KEY RESULTS: Of 855 women in the ROI, 36.8% (95% CI 33.7-40.1, unweighted) and 38.6% (95% CI 30.7-47.2, weighted) reported contraceptive use, compared to 66% of rural women in the NSFG sample. Among the ROI women, 27% had received prior 30-day SUD treatment via outpatient counseling or inpatient program and these women had increased odds of contraceptive use (aOR 1.50 [95% CI 1.08-2.06]). There was a positive association between contraception use and recent medications for opioid use disorder (aOR 1.34 [95% CI 0.95-1.88]) and prior 6-month primary care utilization (aOR 1.32 [95% CI 0.96-1.82]) that did not meet the threshold for statistical significance.

CONCLUSION: WWUD in rural areas reported low contraceptive use; those who recently received SUD treatment had greater odds of contraceptive use. Improvements are needed in expanding reproductive and preventive health within SUD treatment and primary care services in rural communities.

PMID:35731368 | DOI:10.1007/s11606-022-07558-6

Clin Oral Investig. 2022 Jun 22. doi: 10.1007/s00784-022-04577-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To provide a higher degree of evidence on the efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults, thereby applying the Dutch Maxillary Expansion Device (D-MED).

MATERIALS AND METHODS: D-MED was developed as an individualized, 3D-designed, and fabricated MARPE appliance supported by 4 palatal miniscrews. Patients from the age of 16 onwards with transverse maxillary deficiency were enrolled consecutively. Pre-expansion and immediate post-expansion CBCTs and intra-oral scans were acquired and measurements of skeletal, alveolar, and dental expansion as well as dental and periodontal side-effects were performed.

RESULTS: Thirty-four patients were enrolled (8 men, 26 women) with mean age 27.0 ± 9.4 years. A success rate of 94.1% was achieved (32/34 patients). The mean expansion duration, or mean observation time, was 31.7 ± 8.0 days. The mean expansion at the maxillary first molars (M1) and first premolars (P1) was 6.56 ± 1.70 mm and 4.19 ± 1.29 mm, respectively. The expansion was 60.4 ± 20.1% skeletal, 8.1 ± 27.6% alveolar, and 31.6 ± 20.1% dental at M1 and 92.2 ± 14.5% skeletal, 0.0 ± 18.6% alveolar, and 7.8 ± 17.7% dental at P1, which was both statistically (p < 0.001) and clinically significant. Buccal dental tipping (3.88 ± 3.92° M1; 2.29 ± 3.89° P1), clinical crown height increase (0.12 ± 0.31 mm M1; 0.04 ± 0.22 mm P1), and buccal bone thinning (- 0.31 ± 0.49 mm M1; – 0.01 ± 0.45 mm P1) were observed, while root resorption could not be evaluated.

CONCLUSIONS: MARPE by application of D-MED manifested its efficacy in a prospective clinical setting, delivering a high amount of skeletal expansion with limited side-effects in late adolescents and adults.

CLINICAL RELEVANCE: Higher quality evidence is supportive of MARPE as a safe and successful non-surgical treatment option for transverse maxillary deficiency.

PMID:35731323 | DOI:10.1007/s00784-022-04577-9

Surg Endosc. 2022 Jun 22. doi: 10.1007/s00464-022-09377-6. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 epidemic imposed significant stressors on individuals and changed how medical care is delivered. The affect that this stress has placed on the field of bariatric surgery and the associated outcomes is not well established.

METHODS: A retrospective review of a prospectively collected database from a single academic institution was conducted. Weight loss and comorbidity outcomes were compared between a cohort of patients operated on during the pandemic and a matched group operated on prior to COVID-19. GAD-7 and PHQ-9 questionnaires were used to assess for anxiety and depression, respectively.

RESULTS: A total of 329 and 155 patients were enrolled in the pre-pandemic and COVID-19 groups respectively. There were no significant differences in pre-operative BMI (p = 0.437) or comorbidities: Type II DM (p = 0.810), hypertension (p = 0.879), sleep apnea (p = 0.502), and hyperlipidemia (p = 0.227). Post-operatively, weight loss was comparable at all time points out to 1 year. Type II DM resolution rates were higher in the control cohort at 6 months (p = 0.007), but not at 12 months (p = 1.000). There was no statistically significant difference in resolution rates between the control group and the COVID-19 group for the other measured comorbidities. There was no difference in objective measures of anxiety and depression when comparing the two groups (both p > 0.05).

CONCLUSIONS: The COVID-19 pandemic has fundamentally changed how society and medical systems function. Focusing on pre-operative dietary training and screening for inadequately managed psychological comorbidities yielded similar weight loss outcomes notwithstanding the significant societal and individual stressors with which patients were faced.

PMID:35731301 | DOI:10.1007/s00464-022-09377-6

Odontology. 2022 Jun 22. doi: 10.1007/s10266-022-00722-8. Online ahead of print.

ABSTRACT

This investigation aimed to synthesize poly(D,L-lactide) (PLA)-based fibrous scaffolds containing natural essential oils (i.e., linalool and citral) and determine their antimicrobial properties and cytocompatibility as a clinically viable cell-friendly disinfection strategy for regenerative endodontics. PLA-based fibrous scaffolds were fabricated via electrospinning with different concentrations of linalool and citral. The micromorphology and average diameter of the fibers was investigated through scanning electron microscopy (SEM). The chemical composition of the scaffolds was inferred by Fourier-transform infrared spectroscopy (FTIR). Antimicrobial efficacy against Enterococcus faecalis and Actinomyces naeslundii was also evaluated by agar diffusion and colony-forming units (CFU) assays. The scaffolds’ cytocompatibility was determined using dental pulp stem cells (DPSCs). Statistical analyses were performed and the significance level was set at α = 5%. Linalool and citral’s incorporation in the PLA fibrous scaffolds was confirmed in the FTIR spectra. SEM images indicate no morphological changes upon inclusion of the essential oils, except the reduced diameter of 40% linalool-laden fibers (p < 0.05). Importantly, significant antimicrobial properties were reported for citral-containing scaffolds for CFU/mL counts (p < 0.05), while only 20% and 40% linalool-laden scaffolds reduced CFU/mL (p < 0.05). Meanwhile, the inhibition halos were verified in a concentration-dependent manner for all monoterpenes-laden scaffolds. Citral- and linalool-laden PLA-based fibrous scaffolds showed acceptable cytocompatibility. The incorporation of natural monoterpenes did not alter the scaffolds’ fibrous morphology, promoted antimicrobial action against endodontic pathogens, and preserved DPSCs viability. Linalool- and citral-laden electrospun scaffolds hold promise as naturally derived antimicrobial therapeutics for applications in regenerative endodontics.

PMID:35731305 | DOI:10.1007/s10266-022-00722-8

Eur Arch Otorhinolaryngol. 2022 Jun 22. doi: 10.1007/s00405-022-07490-9. Online ahead of print.

ABSTRACT

PURPOSE: To compare the efficacy of different reconstructive techniques in preventing pharyngocutaneous fistula (PCF) after salvage total laryngectomy (STL).

METHODS: An arm-based network analysis was conducted using a Bayesian hierarchical model according to the PRISMA-NMA guidelines.

RESULTS: A total of 1694 patients with a median age of 64 years (n = 1569, 95% CI: 62-66 years) were included. If compared to primary pharyngeal closure alone, only a pedicled flap onlay (PFO) showed a statistically significant reduction in PCF rate (OR: 0.35, CI: 0.20-0.61). PFO seemed to perform better than other treatments according to the rank probabilities test (39.9% chance of ranking first).

CONCLUSIONS: A pedicled flap placed with an overlay technique might be preferred over a patch reconstruction to prevent PCF after STL.

PMID:35731297 | DOI:10.1007/s00405-022-07490-9

Eur Arch Otorhinolaryngol. 2022 Jun 22. doi: 10.1007/s00405-022-07507-3. Online ahead of print.

ABSTRACT

PURPOSE: The goal of the present study was to compare the audiologic results, complications, and advantages/disadvantages of endoscopic and microscopic stapedotomy.

METHODS: Patients who experienced stapedotomy surgery in the Ear Nose Throat Clinic (ENT) of XXXX University Faculty of Medicine between September 2011 and January 2018 were included in the study. The data of all patients were analyzed and divided into two groups. Those who underwent endoscopic stapedotomy were included in group I, and patients who underwent microscopic stapedotomy formed group II. Surgical findings, complications, and operation times were compared for the two groups. Air and bone conduction thresholds were evaluated at the frequencies of 500, 1000, 2000, and 4000 Hz pre- and postoperatively at 1, 3, and 6 months, and the mean (± SD) air-bone gap value was recorded.

RESULTS: While the mean pre- and postoperative air-bone gaps were 34.38 ± 7.47 dB (23-53 dB) and 9.69 ± 4.43 dB (0-19 dB), respectively, in group I, 34.32 ± 7.57 dB (23-6 dB) and 9.62 ± 4.25 dB (2-23 dB) were the respective means calculated in group II (p < 0.05). When the mean postoperative air-bone gap was compared, there was no statistically significant difference between the two groups (p = 0.774). The mean operative times for groups I and II were 57.22 ± 4.37 min and 63.70 ± 7.34 min, respectively (p < 0.001). The requirement for chorda tympani nerve manipulation and scutum curettage was significantly less in group I compared to group II (p = 0.003). Postoperative dysgeusia and postoperative pain were found to be higher in group II than group I, but they were not statistically significant (p > 0.05).

CONCLUSION: Endoscopic stapedotomy displayed similar audiological results, shorter operation times, and similar complication rates, as well as being a less invasive surgery, compared to the microscopic approach.

PMID:35731295 | DOI:10.1007/s00405-022-07507-3

Integr Environ Assess Manag. 2022 Jun 22. doi: 10.1002/ieam.4652. Online ahead of print.

ABSTRACT

The watershed management approach is an efficient tool for organizing and implementing natural resource management at the regional and interregional levels. Statistical processing of watershed information contributes to a comprehensive assessment of the environment of the river watersheds at different hierarchical levels. The purpose of this work is to use spatial analysis and data simulation for assessing the state of ecosystems in hydrologically-defined geographic areas like watersheds. The minimal watersheds of the “pilot” territory of four watersheds in Eastern Siberia with an average area of about 1 ha are used as elementary territorial units. For each watershed, spatial analysis tools form a set of attributes of unique natural characteristics, which are obtained using ground and satellite data. Such a set of attributes can be used to assess the state of the territory employing various methods of mathematical modeling and statistical and cluster analysis. Watershed modeling of the territory was carried out based on MERIT Hydro digital elevation model. Based on Terra MODIS satellite information, data on temperature, vegetation indices, and vegetation cover were obtained for each watershed. The NASA GPM reanalysis data were used to generate the data on accumulated precipitation for all elementary watersheds. Analysis of the seasonal dynamics of the surface temperature in the study area was made, and statistical distributions of temperature variations during the year were obtained for each watershed. Effective temperature sum was calculated. Statistical values and average annual characteristics of trends in several vegetation indices were obtained for each watershed. The necessary methods and technologies for generating, storing, and processing data on each watershed have been developed. This article is protected by copyright. All rights reserved. © 2022 SETAC.

PMID:35730526 | DOI:10.1002/ieam.4652

J Orthop Res. 2022 Jun 22. doi: 10.1002/jor.25403. Online ahead of print.

ABSTRACT

The objectives of this study were to estimate pre- and postoperative lower limb kinematics and kinetics and knee intra-articular forces during gait using musculoskeletal modelling in a cohort of patients with knee osteoarthritis (OA) undergoing high tibial osteotomy (HTO), compare these to controls, and determine correlations between changes in these parameters and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores after HTO. Sixteen patients with isolated, symptomatic medial compartment knee OA completed pre- and postoperative gait analysis (mean follow-up time: 8.6 months). Sixteen age- and sex-matched asymptomatic volunteers participated as controls. Musculoskeletal modelling was used to evaluate lower-limb joint moments and knee contact forces during gait. While HTO had limited influence on sagittal plane kinematics and moments, significant changes in the load distribution at the knee after HTO were observed with a lower postoperative compressive load on the medial compartment during midstance and a higher compressive load on the lateral compartment during early and late stance. Moreover, the lateral shear force in midstance was significantly lower after HTO. Changes in the external knee adduction moment (KAM) did not always coincide with reductions in the knee compressive force in the medial compartment. Biomechanical changes did not correlate with improvements in KOOS subscores. Hence, HTO effectively unloaded the medial compartment by redistributing part of the overall compressive force to the lateral compartment during gait with limited influence on gait function. The KAM may not adequately describe compartmental load magnitude or changes induced by interventions at the compartment level. Clinical significance: Current research and clinical trials on interventions aimed at altering ambulatory load largely focus on using the external knee adduction moment as outcome. While this parameter has been suggested as surrogate for the load distribution at the knee, the mechanical implications for joint level loads of such interventions is rarely considered. This study provides important evidence for changes in joint level loads after corrective osteotomy as joint preserving surgery and emphasizes the need for additional biomechanical outcomes of such interventions. This article is protected by copyright. All rights reserved.

PMID:35730475 | DOI:10.1002/jor.25403

Aesthet Surg J. 2022 Jun 22;42(Supplement_1):1-18. doi: 10.1093/asj/sjac116.

NO ABSTRACT

PMID:35730469 | DOI:10.1093/asj/sjac116

Front Biosci (Elite Ed). 2022 Jun 2;14(2):14. doi: 10.31083/j.fbe1402014.

ABSTRACT

BACKGROUND AND AIMS: Considering the advantages of rotary files in instrumenting the root canals of permanent teeth and a lack of adequate data on the use of these systems in primary teeth, the present study aimed to evaluate two rotary files and compare them with hand files in the cleaning efficacy of the root canals of primary molar teeth.

MATERIALS AND METHODS: In the present study, three groups of teeth were prepared with Kedo-S paediatric rotary file system, RaCe (reamer with alternating cutting edges), and hand files (n = 40). The groups were evaluated under a stereomicroscope concerning the cleaning efficacy of the files after cleaning the teeth in the apical, middle, and coronal thirds. The data were analyzed with SPSS 24 (IBM Corporation, USA, 2016) using Fisher’s exact test and chi-squared test; statistical significance was set at p < 0.05.

RESULTS: There were no significant differences in the apical and middle thirds between the different study groups. However, there were significant differences in the coronal third between the hand file and Kedo-S (p = 0.016) and RaCe and Kedo-S (p = 0.001) groups.

CONCLUSIONS: The present study showed that Kedo-S files were more effective than RaCe and hand files in the coronal area than the hand and RaCe files.

PMID:35730455 | DOI:10.31083/j.fbe1402014