Tag: pubmed

N Engl J Med. 2022 Feb 10;386(6):521-530. doi: 10.1056/NEJMoa2108337.

ABSTRACT

BACKGROUND: Controversy exists over the use of bone cement in hip fractures treated with hemiarthroplasty. Only limited data on quality of life after cemented as compared with modern uncemented hemiarthroplasties are available.

METHODS: We conducted a multicenter, randomized, controlled trial comparing cemented with uncemented hemiarthroplasty in patients 60 years of age or older with an intracapsular hip fracture. The primary outcome was health-related quality of life measured with the use of utility scores on the EuroQol Group 5-Dimension (EQ-5D) questionnaire at 4 months after randomization (range of scores, -0.594 to 1, with higher scores indicating better quality of life; range for minimal clinically important difference, 0.050 to 0.075).

RESULTS: A total of 610 patients were assigned to undergo cemented hemiarthroplasty and 615 to undergo modern uncemented hemiarthroplasty; follow-up data were available for 71.6% of the patients at 4 months. The mean EQ-5D utility score was 0.371 in patients assigned to the cemented group and 0.315 in those assigned to the uncemented group (adjusted difference, 0.055; 95% confidence interval [CI], 0.009 to 0.101; P = 0.02). The between-group difference at 1 month was similar to that at 4 months, but the difference at 12 months was smaller than that at 4 months. Mortality at 12 months was 23.9% in the cemented group and 27.8% in the uncemented group (odds ratio for death, 0.80; 95% CI, 0.62 to 1.05). Periprosthetic fractures occurred in 0.5% and 2.1% of the patients in the respective groups (odds ratio [uncemented vs. cemented], 4.37; 95% CI, 1.19 to 24.00). The incidences of other complications were similar in the two groups.

CONCLUSIONS: Among patients 60 years of age or older with an intracapsular hip fracture, cemented hemiarthroplasty resulted in a modestly but significantly better quality of life and a lower risk of periprosthetic fracture than uncemented hemiarthroplasty. (Funded by the National Institute for Health Research; WHiTE 5 ISRCTN number, ISRCTN18393176.).

PMID:35139272 | DOI:10.1056/NEJMoa2108337

J Strength Cond Res. 2022 Jan 5. doi: 10.1519/JSC.0000000000004186. Online ahead of print.

ABSTRACT

Thompson, SW, Lake, JP, Rogerson, D, Ruddock, A, and Barnes, A. Kinetics and kinematics of the free-weight back squat and loaded jump squat. J Strength Cond Res XX(X): 000-000, 2021-The aim of this study was to compare kinetics and kinematics of 2 lower-body free-weight exercises, calculated from concentric and propulsion subphases, across multiple loads. Sixteen strength-trained men performed back squat 1 repetition maximum (1RM) tests (visit 1), followed by 2 incremental back squat and jump squat protocols (visit 2) (loads = 0% and 30-60%, back squat 1RM). Concentric phase and propulsion phase force-time-displacement characteristics were derived from force plate data and compared using analysis of variance and Hedges’ g effect sizes. Intrasession reliability was calculated using intraclass correlation coefficient (ICC) and coefficient of variation (CV). All dependent variables met acceptable reliability (ICC >0.7; CV < 10%). Statistically significant 3-way interactions (load x phase x exercise) and 2-way main effects (phase x exercise) were observed for mean force, velocity (30-60% 1RM), power, work, displacement, and duration (0%, 30-50% 1RM) (p < 0.05). A significant 2-way interaction (load x exercise) was observed for impulse (p < 0.001). Jump squat velocity (g = 0.94-3.80), impulse (g = 1.98-3.21), power (g = 0.84-2.93), and work (g = 1.09-3.56) were significantly larger across concentric and propulsion phases, as well as mean propulsion force (g = 0.30-1.06) performed over all loads (p < 0.001). No statistically significant differences were observed for mean concentric force. Statistically longer durations (g = 0.38-1.54) and larger displacements (g = 2.03-4.40) were evident for all loads and both subphases (p < 0.05). Ballistic, lower-body exercise produces greater kinetic and kinematic outputs than nonballistic equivalents, irrespective of phase determination. Practitioners should therefore use ballistic methods when prescribing or testing lower-body exercises to maximize athlete’s force-time-displacement characteristics.

PMID:35138069 | DOI:10.1519/JSC.0000000000004186

Brain Behav. 2022 Feb 9:e2517. doi: 10.1002/brb3.2517. Online ahead of print.

ABSTRACT

BACKGROUND: To improve understanding of gender differences on quality of life (QoL) in patients with Parkinson’s disease (PWP) of a different race, the differences of clinical features and health-related quality of life (HRQoL) between male and female PWP were studied in a small cohort early to middle stage of Chinese PWP.

METHODS: A cross-sectional study was carried out. PWP were consecutively included from April 2020 to July 2021 in Beijing Rehabilitation Hospital. HRQoL, motor symptoms, and nonmotor symptoms in each patient were evaluated. The differences of demographic, motor symptoms assessments, nonmotor symptoms assessments, and QoL between two gender groups were tested using t-test statistics, Mann-Whitney-Wilcoxon test, or χ² depending on the data type. To eliminate the possible factors contributing to the QoL, linear regression models were constructed to sort out the effect of gender.

RESULTS: One hundred and sixty-two Parkinson’s disease (PD) patients were included. Demographic, clinical characteristics, and symptom scale assessments had no statistical differences except for levodopa equivalent daily dose, Hamilton Anxiety Rating Score, REM sleep behavior disorder sleep questionnaire, and Hyposmia Rating Scale score. After baseline imbalance corrections, a significantly higher score of PD Questionnaire-39 (PDQ-39) in female than in male patients(p<.05) was found. In the questionnaire, summary Index and bodily discomfort, stigma, and emotional well-being subscores were the main contribution differences.

CONCLUSIONS: Gender differences are associated with the QoL in the early to middle stage PWP in China. Female patients have poorer QoL than male patients, especially bodily discomfort, stigma, and emotional well-being.

PMID:35138047 | DOI:10.1002/brb3.2517

J Card Surg. 2022 Feb 9. doi: 10.1111/jocs.16297. Online ahead of print.

ABSTRACT

The retrospectively presented by Xu et al. assessed the value of the systemic immune-inflammation index (SII) in the prediction of short-term outcomes in patients undergoing surgery for acute type A aortic dissection (ATAAD). The authors concluded that SII is a reliable biomarker that can predict postoperative short-term outcomes and this marker could be potentially applied to stratification and patient selection with ATAAD. Although the study is retrospective, it is well-matched and conducted in a large volume center and the surgical technique was standard for all procedures. In addition, there was no statistical difference in cardiopulmonary bypass, aortic cross-clamp and deep hypothermic time, comorbidities, blood and blood products transfusion between the study groups. In addition, 90.7% of patients underwent elephant trunk technique for ATAAD repair, while the 30-day mortality and postoperative temporary and permanent neurological dysfunctions were 14.8% and 11.1%, respectively. Randomized controlled and prospective studies are warranted to clarify these well-documented results to apply this useful biomarker in clinical practice for patients with the acute aortic syndrome.

PMID:35137980 | DOI:10.1111/jocs.16297

J Intellect Disabil Res. 2022 Feb 9. doi: 10.1111/jir.12917. Online ahead of print.

ABSTRACT

BACKGROUND: Young adults with intellectual disability (ID) are experiencing early mortality, and it is suggested that they are living with undiagnosed cardiovascular and metabolic risk factors (hereafter referred to as cardiometabolic).

METHODS: We investigated the association between modifiable risk factors and cardiometabolic health profile in adults with ID aged 18-45 years through clinical evaluation of traditional cardiometabolic parameters, and assessment of physical activity levels, diet and associated health knowledge.

RESULTS: We found that young adults with ID have an increased obesity (mean body mass index; ID group: 32.9 ± 8.6 vs. control group: 26.2 ± 5.5, P = 0.001), are engaging in less physical activity than the age-matched general population (total activity minutes per week; ID group: 172.2 ± 148.9 vs. control group: 416.4 ± 277.1, P < 0.001), and overall have unhealthier diets. Additionally, knowledge about nutrition and physical activity appears to be an important predictor of cardiometabolic risk in this population. If young people with ID are to improve their cardiometabolic health to reduce morbidity and early mortality, we need to further explore how to consistently apply health messaging to get lasting behavioural change in this population.

PMID:35137997 | DOI:10.1111/jir.12917

Zoo Biol. 2022 Feb 9. doi: 10.1002/zoo.21683. Online ahead of print.

ABSTRACT

Recommendations for the successful management and maintenance of bachelor groups of western lowland gorillas (Gorilla gorilla gorilla) in zoological settings have been an increasingly prevalent focus within the zoological community. Over the past two decades, studies have examined the impact of various environmental factors on the stability of bachelor groups, proposed management strategies for bachelor groups, and compared behavioral trends between bachelor and mixed-sex groups. These studies have clearly demonstrated that bachelor groups are complex social units that require specialized management approaches. In this study, we aimed to assess the extent to which bachelor group management across North American zoos accredited by the Association of Zoos and Aquariums aligns with established recommendations. We distributed a comprehensive survey broadly encompassing habitat and housing, aggression and wounding, group demographics, feeding, and training to the 22 zoos housing bachelor groups as of 2019. We received completed surveys from 19 zoos, representing a total of 21 social units and 59 individual gorillas. We used descriptive statistics to represent the range of current management strategies across the surveyed population and ANOVAs to assess significant variation in key demographic variables. Our results demonstrate that a majority of zoos have adopted the best practices for the formation of social groups established by Stoinski et al. in 2004. However, there is much less standardization across zoos in protocols surrounding training and feeding. Additionally, important variables in the assessment of wounding, such as time of day and location, are often unknown or not observed by animal care professionals. We highlight these two areas as being of particular focus in developing and adhering to consistent protocols across institutions.

PMID:35137977 | DOI:10.1002/zoo.21683

Epilepsia. 2022 Feb 9. doi: 10.1111/epi.17183. Online ahead of print.

ABSTRACT

OBJECTIVE: Postsurgical seizure outcome following laser interstitial thermal therapy (LiTT) for the management of drug-resistant mesial temporal lobe epilepsy (MTLE) has been limited to 2 years. Furthermore, its impact on presurgical mood and anxiety disorders has not been investigated. The objectives of this study were (1) to identify seizure outcome changes over a period ranging from 18 to 81 months; (2) to investigate the seizure-free rate in the last follow-up year; (3) to identify the variables associated with seizure freedom; and (4) to identify the impact of LiTT on presurgical mood and anxiety disorders.

METHODS: Medical records of all patients who underwent LiTT for MTLE from 2013 to 2019 at the University of Miami Comprehensive Epilepsy Center were retrospectively reviewed. Demographic, epilepsy-related, cognitive, psychiatric, and LiTT-related data were compared between seizure-free (Engel Class I) and non-seizure-free (Engel Class II + III + IV) patients. Statistical analyses included univariate and multivariate stepwise logistic regression analyses.

RESULTS: Forty-eight patients (mean age = 43 ± 14.2 years, range = 21-78) were followed for a mean period of 50 ± 20.7 months (range = 18-81); 29 (60.4%) achieved an Engel Class I outcome, whereas 11 (22.9%) had one to three seizures/year. Seizure-freedom rate decreased from 77.8% to 50% among patients with 24- and >61-month follow-up periods, respectively. In the last follow-up year, 83% of all patients were seizure-free. Seizure freedom was associated with having mesial temporal sclerosis (MTS), no presurgical focal to bilateral tonic-clonic seizures, and no psychopathology in the last follow-up year. Presurgical mood and/or anxiety disorder were identified in 30 patients (62.5%) and remitted after LiTT in 19 (62%).

SIGNIFICANCE: LiTT appears to be a safe and effective surgical option for treatment-resistant MTLE, particularly among patients with MTS. Remission of presurgical mood and anxiety disorders can also result from LiTT.

PMID:35137956 | DOI:10.1111/epi.17183

J Clin Apher. 2022 Feb 9. doi: 10.1002/jca.21969. Online ahead of print.

ABSTRACT

BACKGROUND: There are two conventional modalities used to perform therapeutic plasma exchange (TPE): centrifuge TPE (cTPE) or membrane TPE (mTPE). There is limited data on complications with mTPE.

OBJECTIVE: We sought to better understand the patient and machine complications of mTPE compared to cTPE. We hypothesize that our protocol for mTPE using heparin anticoagulation is well-tolerated.

METHODS: In this retrospective cohort study of children <21 years of age, we evaluated differences in patient and machine characteristics and complications between cTPE (with citrate anticoagulation) vs mTPE (with heparin anticoagulation).

RESULTS: Of the 105 patients who met inclusion/exclusion criteria, 63 received cTPE and 42 mTPE via Prismaflex. Those who used mTPE were younger (4.8 ± 2.8 years vs 15.2 ± 3.7 years, P = .0001) and weighed less (19.5 ± 10.6 vs 71.7 ± 28.5 kg, P = .0001). There were no significant differences in patient-related complications or indications for TPE between the two modalities. Of the 1031 therapies performed,1003 therapies were analyzed (646 using cTPE and 357 using mTPE) due to exclusion criteria. No significant difference in patient complications were detected between groups. Machine-related complications were infrequent in both approaches. More circuits clotted during mTPE than during cTPE (6.7% [24/357] vs 0% [0/646]; P < 0.001).

CONCLUSION: Although we use mTPE in smaller children, we showed low rates of complications that were not statistically different from cTPE performed in older children. While the overall rate of circuit clotting using mTPE was low, it occurred more commonly than with cTPE.

PMID:35137962 | DOI:10.1002/jca.21969

Cancer. 2022 Feb 9. doi: 10.1002/cncr.34127. Online ahead of print.

ABSTRACT

BACKGROUND: Invasive lobular carcinoma (ILC) is traditionally considered less responsive to chemotherapy. Although the Oncotype recurrence score (RS) has been validated to identify high-risk patients who benefit from chemotherapy, some studies have questioned its relevance in patients with ILC. The objective of this study was to better characterize potential use of the RS in these patients.

METHODS: The National Cancer Database was used to identify women with stage I through III, T1 through T3, N0 or N1, hormone receptor-positive, HER2-negative ILC or invasive ductal carcinoma (IDC) who had an available RS between 2010 and 2016. Multivariable Cox regression was used to model the effect of variables on 5-year overall survival (OS). The Kaplan-Meier method was used to estimate OS according to the RS, nodal status, and chemotherapy.

RESULTS: In total, 15,763 patients with ILC and 100,070 with IDC were identified. The mean age of patients with ILC and IDC was 59.2 ± 9.1 and 57.2 ± 9.8, respectively. A lower percentage of patients with ILC versus those with IDC had a high RS, defined as >25 (6.6% vs 16.0%; P < .0001). ILC patients with a high RS who had N0 or N1 disease received approximately 10% less chemotherapy compared with similar patients who had IDC. The results indicated that the RS had statistically significant prognostic value for patients with ILC. In addition, an absolute OS advantage was correlated with the receipt of chemotherapy by patients with ILC who had a high RS with N0 or N1 disease.

CONCLUSIONS: Patients with ILC who have a high RS are treated less often with chemotherapy compared with similar patients who have IDC. Nevertheless, the RS has a prognostic as well as a predictive value in ILC, with an association between OS benefit and chemotherapy receipt in patients who have ILC with a high RS, especially if they have N1 disease.

LAY SUMMARY: Invasive lobular carcinoma (ILC) is a subtype of breast cancer comprising about 15% of cases. The Oncotype recurrence score (RS) is a genetic test of breast tumors that helps predict which patients might benefit from chemotherapy. Some have doubted the relevance of the RS for patients with ILC. In this study, the authors show that the RS is relevant for patients who have ILC. The RS has the potential of predicting the risk of recurrence and identifying patients with ILC who might benefit from chemotherapy.

PMID:35137951 | DOI:10.1002/cncr.34127

Sao Paulo Med J. 2022 Feb 7:S1516-31802022005003202. doi: 10.1590/1516-3180.2021.0367.R1.23072021. Online ahead of print.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, universities have had to adopt remote education, a strategy that caused sudden changes of routine for everyone involved in academia.

OBJECTIVE: To assess the profile of medicine use by the employees of a Brazilian public university during the COVID-19 pandemic.

DESIGN AND SETTING: Cross-sectional study at a Brazilian public university.

METHODS: Employees were invited to answer an online self-administered questionnaire, containing questions on sociodemographic features, medicine use, mental health and lifestyle habits during the COVID-19 pandemic. The outcome variable was the use of medicines stratified according to occupation. Descriptive, bivariate and multivariate (Poisson regression) statistical analyses were performed.

RESULTS: A total of 372 employees participated in the study and use of medicine was reported by 53.2%. Among professors, suicide attempts (prevalence ratio [PR], 1.81; 95% confidence interval [CI], 1.20-2.74), physical activity (PR, 1.53; 95% CI, 1.11-2.11) and poor self-rated health (PR, 1.29; 95% CI, 1.01-1.66); and among technicians, decreased workload during the COVID-19 pandemic (PR, 1.41; 95% CI, 1.00-1.99), excess body weight (PR, 1.39; 95% CI, 1.02-1.88) and poor self-rated health (PR, 1.48; 95% CI, 1.14-1.92) were positively associated with use of medicines. In addition, among technicians, engaging in physical activity (PR, 0.60; 95% CI, 0.46-0.78) was a protective factor against medicine use.

CONCLUSION: The profile of medicine use among these employees was similar to that of the Brazilian population. However, some associated factors may have been influenced by the COVID-19 pandemic, thus highlighting the need to examine this topic in a longitudinal study.

PMID:35137907 | DOI:10.1590/1516-3180.2021.0367.R1.23072021