Tag: pubmed

Zhongguo Gu Shang. 2022 Mar 25;35(3):214-9. doi: 10.12200/j.issn.1003-0034.2022.03.004.

ABSTRACT

OBJECTIVE: To explore the MRI findings of os acromiale and to analyze the relationship between os acromiale and the supraspinatus and infraspinatus injury.

METHODS: From January 2010 to August 2020, 21 patients with os acromiale (os arcomiale group) were compared with 21 subjects with no evidence of os acromiale (no os arcomiale group). There were 14 males and 7 females in the os arcomiate group, aged from 29 to 77 years old, mean aged (55.5±11.5) years old. While in the control group, there were 10 males and 11 females in no os arcomiale group, aged from 31 to 70 years old, mean aged (51.1±10.0) years old. The os acromiales were classified as edematous os acromiale or non-edematous os acromiale based on whether the presence of marrow edema, and as displaced os acromiale or non-displaced os acromiale based on whether the presence of displacement of the os acromiale. The MRI features of os acromiale were analyzed. Statistical analyses were performed to identify the differences between the os arcomiale group and no os arcomiale group regarding rotator cuff tear, supraspinatus and infraspinatus injury. Differences in the supraspinatus and infraspinatus tear between the edematous and non-edematous os acromiale group, the displaced and non-displaced os acromiale group, the displaced os acromiale and no os arcomiale group were also assessed.

RESULTS: On MRI, all the 21 os acromiales appeared as a triangular or irregular bone fragment of the distal acromion, and forms a pseudo-acromioclavicular joint with the acromion. Eleven cases were edematous os acromiale, 11 cases were displaced os acromiale. In the os arcomiale group, 17 had supraspinatus tear, 1 had supraspinatus tendinitis, 11 had infraspinatus tear, and 4 had infraspinatus tendinitis. In the no os arcomiale group, 11 had supraspinatus tear, 2 had supraspinatus tendinitis, 5 had infraspinatus tear, and 1 had infraspinatus tendinitis. No statistically significant difference between the os arcomiale group and no os arcomiale group regarding the rotator cuff tear, supraspinatus and infraspinatus injury (P>0.05). In the 11 cases of edematous os arcomiale, 10 had supraspinatus tear and 7 had infraspinatus tear. In the 10 cases of non-edematous os acromiale, 7 had supraspinatus tear and 4 had infraspinatus tear. No statistically significant difference was noted between the edematous os acromiale and non-edematous os acromiale in terms of supraspinatus and infraspinatus tear (P>0.05). In the 11 cases of displaced os acromiale, 11 had supraspinatus tear and 9 had infraspinatus tear. In the 10 cases of non-displaced os acromiale, 6 had supraspinatus tear and 2 had infraspinatus tear. In the no os arcomiale group, 11 had supraspinatus tear and 5 had infraspinatus tear. There was a statistically significant increases in the prevalence of supraspinatus and infraspinatus tear in the displaced os acromiale group compared with non-displaced os acromiale group, the displaced os acromiale group and no os arcomiale group(P<0.05).

CONCLUSION: Shoulder MRI can very well depict os acromiale and can reveal associated abnormalities such as adjacent bone marrow edema, displaced deformity, and rotator cuff tear, and it can be used to assess the stability of the os acromiale. The presence of os acromiale may not increase the risk of supraspinatus and infraspinatus tear significantly. However, the presence of displaced os acromiale is at greater risk of supraspinatus and infraspinatus tear.

PMID:35322609 | DOI:10.12200/j.issn.1003-0034.2022.03.004

Zhongguo Gu Shang. 2022 Mar 25;35(3):209-13. doi: 10.12200/j.issn.1003-0034.2022.03.003.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and prognosis of double button plate combined with strengthened anchor technique and clavicular hook plate internal fixation for complete acromioclavicular joint dislocation.

METHODS: From July 2017 to September 2020, a total of 42 patients with acromioclavicular joint dislocation treated by surgery were choosen as study objects and divided into observation group (21 cases) and control group (21 cases). In the observation group, there were 14 males and 7 females, aged 21 to 63 years old, with an average of (45.05±8.70) years old. In the control group, there were 16 males and 5 females, aged 25 to 68 years old, with an average of(45.00±9.44) years old. The patients in the observation group were treated with double button plate combined with strengthened anchor technique, whereas those in the control group received clavicular hook plate internal fixation. The two groups were compared in terms of operating time, intraoperative blood loss, postoperative hospital stay, shoulder pain(visual analogue scale, VAS) score, shoulder function Constant-Murley score and postoperative complications.

RESULTS: There was no significant difference between the two groups in intraoperative blood loss or postoperative hospital stay(P>0.05). The operating time of double button plate combined with strengthened anchor technique group (65.24±5.36) min was significantly longer than that of the clavicular hook plate group (48.81±4.72) min, and the difference was statistically significant (P<0.05). There was no significant difference in shoulder function or pain degree between the two groups before operation (P>0.05). After 1 month, 3 months and 6 months, the Constant-Murley score of the observation group was 73.29±2.15, 85.43±1.47, 93.86±1.24 separately, which were significantly higher than those of the control group;and the VAS score was 2.76±0.62, 1.71±0.64, 0.57±0.51 separately, which were significantly lower than those of the control group (P<0.05). One instance of shoulder discomfort was found in the observation group, while 5 cases of shoulder pain, 2 cases of restricted shoulder mobility, and 1 case of subacromial bone absorption were found in the control group. In both group, there was no loss of reduction.

CONCLUSION: In the treatment of complete acromioclavicular joint dislocation double button plate combined with strengthened anchor technique achieves favorable clinical result. Internal fixation does not need to be removed. The recovery of shoulder joint function and pain relief are superior than clavicular hook plate internal fixation, which is more worthy of clinical promotion.

PMID:35322608 | DOI:10.12200/j.issn.1003-0034.2022.03.003

ESC Heart Fail. 2022 Mar 23. doi: 10.1002/ehf2.13910. Online ahead of print.

ABSTRACT

AIM: The optimal strategy for diabetes control in patients with heart failure (HF) following myocardial infarction (MI) remains unknown. Metformin, a guideline-recommended therapy for patients with chronic HF and type 2 diabetes mellitus (T2DM), is associated with reduced mortality and HF hospitalizations. However, worse outcomes have been reported when used at the time of MI. We compared outcomes of patients with T2DM and HF of ischaemic aetiology according to antidiabetic treatment.

METHODS AND RESULTS: This study used linked data from primary care, hospital admissions, and death registries for 4.7 million inhabitants in England, as part of the CALIBER resource. The primary endpoint was a composite of cardiovascular mortality and HF hospitalization. The secondary endpoints were the individual components of the primary endpoint and all-cause mortality. To evaluate the effect of temporal changes in diabetes treatment, antidiabetic medication was included as time-dependent covariates in survival analyses. The study included 1172 patients with T2DM and prior MI and incident HF between 3 January 1998 and 26 February 2010. Five hundred and ninety-six patients had the primary outcome over median follow-up of 2.53 (IQR: 0.98-4.92) years. Adjusted analyses showed a reduced hazard of the composite endpoint for exposure to all antidiabetic medication with hazard ratios (HRs) of 0.50 [95% confidence interval (CI): 0.42-0.59], 0.66 (95% CI: 0.55-0.80), and 0.53 (95% CI: 0.43-0.65), respectively. A similar effect was seen for all-cause mortality [HRs of 0.43 (95% CI: 0.35-0.52), 0.57 (95% CI: 0.46-0.70), and 0.34 (95% CI: 0.27-0.43), respectively].

CONCLUSIONS: When considering changes in antidiabetic treatment over time, all drug classes were associated with reduced risk of cardiovascular mortality and HF hospitalization.

PMID:35322592 | DOI:10.1002/ehf2.13910

Early Interv Psychiatry. 2022 Mar 23. doi: 10.1111/eip.13282. Online ahead of print.

ABSTRACT

AIM: Community participation in occupational, social, recreational, and other domains is critically important during young adulthood. Coordinated Specialty Care (CSC) programs provide developmentally tailored care to young adults experiencing early psychosis within the United States, but little is known about the breadth of efforts to promote community participation. This study aimed to develop and evaluate indicators of these efforts based on the perspectives of a national multi-stakeholder group.

METHODS: Seventeen stakeholders (i.e., young adults with early psychosis, family members, experts by profession) participated in a modified e-Delphi study, conducted in two rounds. The purpose of round one was to generate a comprehensive list of community participation-promoting indicators. During round two, stakeholders rated the importance and feasibility of the implementation of each indicator. Descriptive statistics and percentage of agreement regarding round two ratings were assessed.

RESULTS: During round one, 186 indicators of activities and/or practices designed to promote community participation were identified; this list was reduced to 44 by eliminating redundancies or indicators not related to community participation. In round two, we found broad agreement regarding the importance, but significant variation in perceived feasibility of indicators. The highest-rated indicators in both categories pertained to staff knowledge (regarding barriers and supports to participation and the importance of participation to health) and strategies for addressing participation barriers.

CONCLUSIONS: This study is expected to facilitate the identification and development of promising CSC activities and practices designed to promote community participation among young adults while potentially also enhancing engagement in services and improving clinical outcomes.

PMID:35322565 | DOI:10.1111/eip.13282

J Med Imaging Radiat Oncol. 2022 Mar 24. doi: 10.1111/1754-9485.13404. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study was to assess whether simethicone reduces the rectal volume (RV) and gas volume (GV), to increase treatment accuracy and to decrease toxicity of prostate radiation therapy.

METHODS: 30 patients were randomised to simethicone or no intervention. Cone-beam computed tomography (CBCT) scans were performed on Days 1-3 and weekly until completion of radiation. RV and GV were measured using volume delineation. Toxicity data were collected.

RESULTS: 264 CBCTs were analysed. RV and GV were not significantly different in the simethicone group compared with the control group at each time point (P >0.05) after adjusting for Week 0 values as a covariate. The simethicone group showed an average reduction in RV and GV of 10% and 21%, respectively, compared with the control group (P >0.05). Standard deviations were calculated over 10 time points, which were grouped to represent the first 2-3 weeks of radiation therapy versus subsequent weeks. These were not significantly different between the simethicone and control group. However, there was a statistically significant decrease in the variability of RV at time points 6-10 compared with time points 1-5 within the simethicone group (P = 0.012), but no significant difference was found between these grouped time points in the control group (P = 0.581). The toxicity questionnaires showed no significant difference between the groups.

CONCLUSIONS: Simethicone did not decrease the RV or GV overall. However, simethicone appeared to significantly decrease the RV variability from Week three onwards. This suggests that taking simethicone two to three weeks before starting radiation therapy may reduce RV variability, although a larger study is needed to confirm this.

PMID:35322563 | DOI:10.1111/1754-9485.13404

Eur Eat Disord Rev. 2022 Mar 23. doi: 10.1002/erv.2895. Online ahead of print.

ABSTRACT

BACKGROUND: Up to 20% of the cases of anorexia nervosa (AN) are chronic and treatment-resistant. Recently, the efficacy of deep brain stimulation (DBS) for severe cases of AN has been explored, with studies showing an improvement in body mass index and other psychiatric outcomes. While the effects of DBS on cognitive domains have been studied in patients with other neurological and psychiatric conditions so far, no evidence has been gathered in AN.

METHODS: Eight patients with severe, chronic, treatment-resistant AN received DBS either to the nucleus accumbens (NAcc) or subcallosal cingulate (SCC; four subjects on each target). A comprehensive battery of neuropsychological and clinical outcomes was used before and 6-month after surgery.

FINDINGS: Although Body Mass Index (BMI) did not normalise, statistically significant improvements in BMI, quality of life, and performance on cognitive flexibility were observed after 6 months of DBS. Changes in BMI were related to a decrease in depressive symptoms and an improvement in memory functioning.

INTERPRETATION: These findings, although preliminary, support the use of DBS in AN, pointing to its safety, even for cognitive functioning; improvements of cognitive flexibility are reported. DBS seems to exert changes on cognition and mood that accompany BMI increments. Further studies are needed better to determine the impact of DBS on cognitive functions.

PMID:35322504 | DOI:10.1002/erv.2895

Bipolar Disord. 2022 Mar 23. doi: 10.1111/bdi.13208. Online ahead of print.

ABSTRACT

OBJECTIVES: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD.

METHODS: Thirteen cohorts from 7 countries included n=5,882 individuals with BD across multiple sites. The statistical approach consisted of a systematic uniform application of analyses across sites. Each site performed a logistic regression analysis with empirically derived “higher versus lower function” as the dependent variable and selected clinical and demographic variables as predictors.

RESULTS: We found high rates of functional impairment, ranging from 41-75%. Lower community functioning was associated with depressive symptoms in 10 of 12 of the cohorts that included this variable in the analysis. Lower levels of education, a greater number of prior mood episodes, presence of a comorbid substance use disorder, and a greater total number of psychotropic medications were also associated with low functioning.

CONCLUSIONS: The bipolar clinical research community is poised to work together to characterize the multi-dimensional contributors to impairment and address the barriers that impede patients’ complete recovery. We must also identify the core features which enable many to thrive and live successfully with BD. A large-scale, worldwide, prospective longitudinal study focused squarely on BD and its heterogeneous presentations will serve as a platform for discovery and promote major advances toward optimizing outcomes for every individual with this illness.

PMID:35322518 | DOI:10.1111/bdi.13208

J Obstet Gynaecol Res. 2022 Mar 23. doi: 10.1111/jog.15232. Online ahead of print.

ABSTRACT

OBJECTIVE: Ovarian torsion is a common cause of local ischemic damage, reduced follicular activity and infertility. This study aimed to investigate how well platelet-rich plasma (PRP) protects against experimental ischemic (I) and ischemia-reperfusion (I/R) injury in rat ovaries and its effect on in vitro fertilization (IVF) outcomes.

METHOD: Fifty-six adult female Sprague-Dawley albino rats were randomly assigned to six groups of eight animals each: Sham, Ischemia, I/R, Sham + PRP, I + PRP, and I/R + PRP. The remaining eight animals were used to prepare the PRP. The ischemia groups were subjected to bilateral adnexal torsion for 3 h, while the I/R and I/R + PRP groups received subsequent detorsion for 3 h. Intraperitoneal (i.p.) PRP was administered 30 min prior to ischemia (I + PRP) or reperfusion (I/R + PRP). The ovaries were stimulated through an intraperitoneal injection of 150-300 internal units of IU/kg PMSG. After ovulation induction, oocytes were taken from the ovaries, and IVF was performed.

RESULTS: The number of MII oocytes reached the highest number with 4.63 ± 0.74 in the S group and had the lowest number with 0.50 ± 0.53 in the I/R group. There were statistically significant differences for the number of embryos obtained on the second day between the I and I + PRP groups and the I/R and I/R + PRP groups (p = 0.000). In comparing anti-Müllerian hormone 1 (AMH1) and AMH2 values within the group, the highest decrease was observed in the I and I/R groups.

CONCLUSION: PRP is effective in minimizing ovarian damage and preserving ovarian reserves following ovarian torsion.

PMID:35322499 | DOI:10.1111/jog.15232

Korean J Fam Med. 2022 Mar;43(2):125-131. doi: 10.4082/kjfm.21.0086. Epub 2022 Mar 17.

ABSTRACT

BACKGROUND: Many studies have assessed the risk factors for adverse drug reactions (ADRs) in elderly patients. However, most of these studies have focused on risk factors for ADRs, not serious ADRs (s-ADRs). s-ADRs are commonly found in hospitalized patients. s-ADRs warrant imminent but thorough investigations, given their critical impact on patient health. Therefore, this retrospective study aimed to assess the associated risk factors for s-ADRs in elderly hospitalized patients.

METHODS: In-patients aged >65 years having ADRs during hospitalization at a university hospital in Korea between 2010 and 2012 were included. Medical professionals spontaneously reported ADRs using an electronic submission system at the study hospital. Further, all descriptions of ADRs were characterized and categorized through the screening of electronic medical records. We compared the characteristics of patients having s-ADRs with those of patients not having s-ADRs.

RESULTS: There were 353 cases of ADRs, 67 of which were s-ADRs. Patients taking more than eight concomitant drugs showed the highest odds ratio (OR, 11.99; 95% confidence interval [CI], 3.42-42.03). The ratio of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) was also significantly related to s-ADRs (OR, 2.78; 95% CI, 1.33-5.81). The use of antibiotics (OR, 2.39; 95% CI, 1.13-5.02) and antineoplastics (OR, 4.17; 95% CI, 1.09-15.94) were significant risk factors.

CONCLUSION: Our findings highlight the importance of polypharmacy. Liver function tests (AST/ALT ratio) must be monitored carefully within high-risk groups for ADRs.

PMID:35320898 | DOI:10.4082/kjfm.21.0086

Klin Monbl Augenheilkd. 2022 Mar 23. doi: 10.1055/a-1738-9941. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the macular and optic disc vascular changes in vitamin B12 deficiency anemia.

METHODS: A total of 24 patients with vitamin B12 deficiency anemia and 24 healthy controls were involved in this study. All participants were evaluated for central macular thickness (CMT), peripapillary retina nerve fiber layer (RNFL) thickness, foveal avascular zone (FAZ) area, macular vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP), choriocapillaris flow area, and optic disc radial peripapillary capillary (RPC) VD using optic coherence tomography (OCT) and optic coherence tomography angiography (OCTA). Metabolic parameters were also noted.

RESULTS: Temporal RNFL thickness significantly decreased in the B12 deficiency anemia group (p = 0.04). Choriocapillaris flow area (p = 0.045) and macular vessel density in both SCP (p = 0.022) and DCP (p = 0.018) markedly declined in the study group. Optic disc RPC VD in the B12 deficiency anemia group was lower in all regions compared to that of the control group, but the difference was not statistically significant (p > 0.05). There were significant positive correlations between choriocapillaris flow area, macular VD, vitamin B12, and hemoglobin.

CONCLUSION: Retinal vascular alterations were observed in B12 deficiency anemia, and OCTA may be beneficial in the diagnosis and follow-up of ocular complications in these cases.

PMID:35320869 | DOI:10.1055/a-1738-9941