Tag: pubmed

Dermatol Ther. 2022 Feb 14:e15379. doi: 10.1111/dth.15379. Online ahead of print.

ABSTRACT

CONTEXT: Psoriasis assessment tools in use presently lack reproducibility and are cumbersome to use. An easily reproducible, objective tool with ability to maintain visual records for follow up is hence desirable. We conducted a study with the aim to assess dermoscopic changes in psoriasis while on treatment by recording the number of hemorrhagic dots (Hemorrhagic Dot Score-HDS) in a representative plaque and comparing it to the PASI score.

SETTINGS AND DESIGN: A longitudinal prospective study was conducted between October 2018 to March 2020 in a dermatology centre of a tertiary hospital on cases of chronic plaque psoriasis on treatment over 6 months, assessed at baseline and thereafter monthly for six months.

METHODS: Hundred consenting patients of chronic plaque psoriasis were assessed, clinically, PASI and dermoscopically. HDS and other dermoscopic features were noted at every visit.

STATISTICAL ANALYSIS USED: ANOVA and F test of testing of equality of Variance; effect size in terms of Cohen were used to report the strength of an apparent relationship.

RESULTS AND INTERPRETATION: Percentage improvement in the mean PASI scores and HDS and percentage improvement of mean was found significant in each month on follow up. Systemic therapy as compared to topical therapy showed higher effect size of 6.1 and 1.7 respectively.

CONCLUSION: Hemorrhagic dot score can be used as an objective, definite assessment tool correlating with clinical severity of psoriasis with more accuracy which shows changes early following institution of therapy. This article is protected by copyright. All rights reserved.

PMID:35156286 | DOI:10.1111/dth.15379

Clin Implant Dent Relat Res. 2022 Feb 13. doi: 10.1111/cid.13072. Online ahead of print.

ABSTRACT

BACKGROUND: Nonsurgical treatment of peri-implantitis may help in reducing microbial load and inflammatory parameters. The potential clinical benefits of using different treatment approaches, in the initial nonsurgical treatment phase, particularly the airflow, are still not clear. The aim of this systematic review and meta-analyses was to evaluate the outcomes of nonsurgical treatment of peri-implantitis using airflow method in terms of changes in periodontal parameters, peri-implant marginal bone level, postoperative pain/discomfort, and patient satisfaction.

METHODS: Electronic databases were searched to identify randomized controlled trials (RCTs) that compared airflow with mechanical debridement using ultrasonic/curettes. The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. Data were analyzed using a statistical software program.

RESULTS: A total of 316 studies were identified, of which, five RCTs with 288 dental implants in 174 participants were included. Overall meta-analysis showed more reduction in probing pocket depths at 1-3 months (mean difference [MD] -0.23; 95% confidence interval [CI] -0.50-0.05; p = 0.10) and 6 months (MD -0.04; 95% CI -0.34 to 0.27; p = 0.80) in favor of airflow, but the difference was not statistically significant. The use of airflow was associated with significant reduction in bleeding on probing and increase in peri-implant mucosal recession. The differences in plaque score, peri-implant marginal bone level changes, and patient reported outcomes between airflow and mechanical debridement were not statistically significant.

CONCLUSIONS: The short-term clinical and radiographic outcomes following nonsurgical treatment of peri-implantitis using airflow or mechanical debridement were comparable. The airflow has short-term positive effects on reducing bleeding on probing. Further evidence from RCTs are still required to substantiate the current findings.

PMID:35156296 | DOI:10.1111/cid.13072

Colorectal Dis. 2022 Feb 13. doi: 10.1111/codi.16092. Online ahead of print.

ABSTRACT

AIM: Metabolic syndrome (MetS) is a cluster of factors including obesity, hypertension, diabetes, hypercholesterolemia and hyperlipidaemia. It has been associated with an increased risk of colorectal neoplasia. This systematic review and meta-analysis assessed the association between MetS and: (i) recurrence of adenomas or occurrence of CRC in patients with prior adenomas; (ii) survival in patients with CRC.

METHOD: MEDLINE, Embase, Scopus and Web of Science were searched up to 22/11/2019. Two authors independently conducted title and abstract screening; full text of eligible studies was evaluated. Where ≥3 studies reported effect measures for a specific outcome, meta-analysis using random effects model was conducted. I² was used to assess between-study heterogeneity. Quality appraisal was undertaken with the Newcastle-Ottawa Score.

RESULTS: The search identified 1764 articles, 55 underwent full text screening, resulting in a total of 15 eligible studies. Five studies reported on metachronous neoplasia, with differing outcomes precluded a meta-analysis. No consistent relationship between MetS and metachronous neoplasia was found. Ten studies reported on survival outcomes. MetS was associated with poorer CRC-specific survival (HR=1.8, 95%CI 1.04-3.12, I² =92.7%, n=3). Progression-free survival was also worse but this did not reach statistical significance (HR=1.12, 95%CI 0.89-1.42, I² =85.6%, n=3). There was no association with overall survival (HR=1.04, 95%CI 0.94-1.15, I² =43.7%, n=7). Significant heterogeneity was present but subgroup analysis did not account for this.

CONCLUSION: MetS is associated with poorer CRC-specific survival, but evidence is inconsistent on metachronous neoplasia. Further research is warranted to better understand the impact of MetS on the adenoma-carcinoma pathway.

PMID:35156283 | DOI:10.1111/codi.16092

Addiction. 2022 Feb 13. doi: 10.1111/add.15819. Online ahead of print.

NO ABSTRACT

PMID:35156243 | DOI:10.1111/add.15819

Glob Chang Biol. 2022 Feb 13. doi: 10.1111/gcb.16128. Online ahead of print.

ABSTRACT

Thin, hair-like lichens (Alectoria, Bryoria, Usnea) form conspicuous epiphyte communities across the boreal biome. These poikilohydric organisms provide important ecosystem functions and are useful indicators of global change. We analyse how environmental drivers influence changes in occurrence and length of these lichens on Norway spruce (Picea abies) over 10 years in managed forests in Sweden using data from >6000 trees. Alectoria and Usnea showed strong declines in southern-central regions, whereas Bryoria declined in northern regions. Overall, relative loss rates across the country ranged from 1.7% per year in Alectoria to 0.5% in Bryoria. These losses contrasted with increased length of Bryoria and Usnea in some regions. Occurrence trajectories (extinction, colonization, presence, absence) on remeasured trees correlated best with temperature, rain, nitrogen deposition, and stand age in multinomial logistic regression models. Our analysis strongly suggests that industrial forestry, in combination with nitrogen, is the main driver of lichen declines. Logging of forests with long continuity of tree cover, short rotation cycles, substrate limitation and low light in dense forests are harmful for lichens. Nitrogen deposition has decreased but is apparently still sufficiently high to prevent recovery. Warming correlated with occurrence trajectories of Alectoria and Bryoria, likely by altering hydration regimes and increasing respiration during autumn/winter. The large-scale lichen decline on an important host has cascading effects on biodiversity and function of boreal forest canopies. Forest management must apply a broad spectrum of methods, including uneven-aged continuous cover forestry and retention of large patches, to secure the ecosystem functions of these important canopy components under future climates. Our findings highlight interactions among drivers of lichen decline (forestry, nitrogen, climate), functional traits (dispersal, lichen colour, sensitivity to nitrogen, water storage), and population processes (extinction/colonization).

PMID:35156274 | DOI:10.1111/gcb.16128

Environ Toxicol Chem. 2022 Feb 13. doi: 10.1002/etc.5306. Online ahead of print.

ABSTRACT

Tests for dose-response trend may be used to support conclusions on the toxicity of a substance in a range of doses evaluated in a comparative experiment. Criteria are proposed for evaluating and comparing alternative tests, and applied in a comparison of some tests applicable with continuous responses, namely a multiplicity-adjusted pairwise comparison procedure, a trend test based on a single contrast, and four multiple-contrast trend tests. Methods considered treat dose as ordinal information. A particular focus is comparison of the simple test of a single contrast, with coefficients proportional to dose rank, to multiple-contrast methods available with modern computing. To explore the role of dose-response curve shape, we generate regular dose response shapes (or profiles), defined by mean response for each dose level, using a simple grid-based algorithm. Power for individual profiles may be used to illustrate the effect of curve shape on the power of alternative tests. To facilitate selection of tests we report average power over profiles, averaging at different levels of granularity, first separately for each of several curve shape categories, then over all profiles weighting shape categories equally. Power results for the six tests evaluated provide at least clear distinctions between some procedures that are more-preferred, versus less-preferred. Our analyses expand the comparisons of tests available and contribute methodology for choice of statistical methods for toxicological data analysis. This article is protected by copyright. All rights reserved. © 2022 SETAC.

PMID:35156237 | DOI:10.1002/etc.5306

J Trauma Stress. 2022 Feb 13. doi: 10.1002/jts.22778. Online ahead of print.

ABSTRACT

Verbal learning deficits are common among sexually traumatized women who have not been formally diagnosed with posttraumatic stress disorder (PTSD). Aberrant resting-state functional connectivity (rsFC) of the amygdala and hippocampus are implicated in PTSD and verbal memory impairment. We tested rsFC between bilateral dentate gyrus (DG) and both centromedial (CM) and basolateral (BL) nuclei of the amygdala as statistical mediators for the effect of sexual trauma-related symptom severity on delayed verbal recall performance in 63 older women (age: 60-85 years) undiagnosed with PTSD. Participant data were drawn from the NKI-Rockland Study. Individuals completed a 10-min resting-state scan, Rey Auditory Verbal Learning Test (RAVLT), and the Sexual Abuse Trauma Index (SATI) from the Trauma Symptom Checklist. Z-scores indicating rsFC of DG with BL and CM amygdala seeds were evaluated in two separate mediation models. Higher SATI scores were associated with lower RAVLT after controlling for age, β = -.23, 95% CI [.48, .03], p = .039. This effect was negated upon adding a negative path from SATI to rsFC of left DG and right CM, β = -.29, 95% CI [-.52, -.02], p = .022, and a positive path from that seed pair to RAVLT List A recall, β = .28, 95% CI [.03, 0.48], p = .015. Chi-square fit indices supported partial mediation by this seed pair, p = .762. In the absence of PTSD sexual trauma symptoms partially relate to verbal learning deficits as a function of aberrant rsFC between left hippocampus DG and right amygdala CM nuclei.

PMID:35156236 | DOI:10.1002/jts.22778

Int J Health Plann Manage. 2022 Feb 13. doi: 10.1002/hpm.3432. Online ahead of print.

ABSTRACT

Ethiopia is an underfinanced country when compared to the Sub-Saharan average. Direct payment has a high account in Ethiopia and inhibits access to health services for the poor. We aimed to identify the factors associated with catastrophic health expenditure (CHE) in the South Wollo Zone, Ethiopia. A community-based cross-sectional study was conducted. A two-stage sampling technique was used to get a total of 494 households. The data were entered using Epi data version 4.6 and analysed using STATA version 14.1 software for binary logistic regression analysis. A multivariable logistic regression analysis was done to identify the factors associated with CHE. The total magnitude of CHE was found to be 33.97% at the 10% threshold of total household expenditure and 14.98% at the 40% threshold of non-food expenditure. Insured households (adjusted odds ratio = 0.02, 95% CI: 0.01-0.10) were statistically associated with CHE with total household and non-food measures. Catastrophic health expenditure was found to be decreased among insured households and increased among households had children less than 5 years of age, members with chronic illness, and poor health status. Therefore, encouraging insurance and health promotion activities to improve the health status of the community are important.

PMID:35156225 | DOI:10.1002/hpm.3432

Curr Rev Musculoskelet Med. 2022 Feb 14. doi: 10.1007/s12178-022-09747-6. Online ahead of print.

ABSTRACT

PURPOSE OF THE REVIEW: Consensus on the effects of soft tissue surgical intervention in the management of brachial plexus birth injury (BPBI) sequalae is lacking. The purpose of this review is to examine the available literature on the functional and structural outcomes following soft tissue surgical management of BPBI sequalae.

RECENT FINDINGS: EMBASE, PubMed, and MEDLINE were searched for related literature from the point of database inception until April 2021. Relevant papers were screened by two reviewers independently and in duplicate. A meta-analysis was performed using a random effects model. A total of 25 studies (852 patients) were included in the review, with the number included in each meta-analysis varying based on outcome of interest. There were significant improvements from pre- to post-operative time points for the following measures: Mallet aggregate scores (5.0 points, p<0.0001), active external rotation in adduction (48.9°, p=0.003), passive external rotation in adduction (64.6°, p< 0.00001), active abduction (46.2°, p<0.00001), glenoid version (14.4°, p< 0.00001), and percentage of the humeral head anterior to the scapular line (17.53°, p< 0.00001). Furthermore, data revealed an overall complication rate of 9.3% (79/852 patients) and a major complication rate of 0.47% (4/852 patients). Patients with BPBI sequela experience statistically significant improvements in functional, structural, and range of motion outcomes of the GH joint following soft tissue surgical management. Understanding the ideal indications for each procedure and age of surgical management with future prospective studies will help to optimize surgical management of these patients.

PMID:35156170 | DOI:10.1007/s12178-022-09747-6

J Pharmacokinet Pharmacodyn. 2022 Feb 13. doi: 10.1007/s10928-022-09808-w. Online ahead of print.

ABSTRACT

Nonadherence to medication is a major public health problem. To combat nonadherence, some clinicians have suggested using “forgiving” drugs, which maintain efficacy in spite of delayed or missed doses. What pharmacokinetic (PK) and pharmacodynamic (PD) factors make a drug forgiving? In this paper, we address this question by analyzing a linear PK/PD model for a patient with imperfect adherence. We assume that the drug effect is far from maximal and consider direct effect, effect compartment (biophase), and indirect response PD models. We prove that the average drug effect relative to the clinically desired effect is simply the fraction of prescribed doses actually taken by the patient. Hence, under these assumptions, drug forgiveness cannot be defined in terms of the average effect. We argue that forgiveness should instead be understood in terms of effect fluctuations. We prove that the rates of PK absorption, PK elimination, and PD elimination are exactly equivalent for determining effect fluctuations. We prove all the aforementioned results for any pattern of nonadherence, including late doses, missed doses, drug holidays, extra doses, etc. To obtain quantitative estimates of effect fluctuations, we consider a simple statistical pattern of nonadherence and analytically calculate the coefficient of variation of effect. We further show how effect fluctuations can be reduced by taking an extra “make up” dose following a missed dose if any one of the aforementioned PK/PD rates is sufficiently slow. We illustrate some of our results for a nonlinear indirect response model of metformin.

PMID:35156179 | DOI:10.1007/s10928-022-09808-w