Tag: pubmed

Cont Lens Anterior Eye. 2021 Jul 16:101489. doi: 10.1016/j.clae.2021.101489. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the ocular subclinical inflammatory response in two soft contact lens materials when used in combination with two different care systems (‘solutions’).

METHODS: Fifteen established soft contact lens wearers wore each of two lenses: Acuvue® 2 (CH) and Acuvue® Oasys® (SiH) or no lenses in random sequence for one week. Two care systems were used: a peroxide system: Oxysept 1 Step® (P) for the right lens and Opti-Free® Replenish® (MPS) for the left lens. After one week of lens/no lens wear, in vivo confocal microscopy (IVCM) of corneal and conjunctival regions was carried out. Density of presumed dendritic cells (DC) and ‘white spots’ (WS) were quantified. Impression cytology of the bulbar and upper eyelid margin conjunctivae was carried out and samples were analysed for CD45+, CD3+ and CD11c+ cells.

RESULTS: The SiH + MPS combination showed a greater inflammatory response compared to SiH + P in seven out of 12 parameters investigated (p < 0.05). The remaining five were not statistically different between the two solutions. The converse was found for the CH lens, with four of the 12 parameters showing a greater response with the P solution compared to the MPS (p < 0.05).

CONCLUSION: This study suggests that the SiH lens investigated demonstrated an upregulated response when used with a MPS compared to a P solution whereas the converse is true for the CH lens which showed a reduced response when used with a MPS compared to a P solution. This finding aids in the understanding of the biological underpinnings of manifest corneal inflammatory events during contact lens wear.

PMID:34281726 | DOI:10.1016/j.clae.2021.101489

J Formos Med Assoc. 2021 Jul 16:S0929-6646(21)00311-9. doi: 10.1016/j.jfma.2021.06.030. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: In this study we aimed to investigate the prevalence of abnormal nasality in patients with unilateral rhinosinusitis and their nasality outcomes following functional endoscopic sinus surgery (FESS).

METHODS: A total of 42 patients with unilateral chronic rhinosinusitis who underwent unilateral FESS between April 2016 and November 2017 were enrolled. Questionnaires on sinonasal symptoms and nasality were recorded. The change in the nasalance score of vowels [a], [i] [u], nasal consonant [m], 2 nasal syllable repetitions, and 2 Chinese sentences were measured. The patients were evaluated preoperatively, 6 months, and 12 months after the operation. The patients were divided into two groups, wide opening surgery and limited surgery, according to the severity of the disease.

RESULTS: Among 42 patients, the subjective reports showed that one-third of unilateral chronic rhinosinusitis (CRS) patients had abnormal nasality preoperatively and significant improvement following FESS. The Lund-Mackay score was significantly negatively correlated with preoperative nasalance of [i] and positively correlated with change of nasalance of [i]. The increase in the value of [i] is statistically significant (p = 0.01) following FESS. In the further subgroup analysis, the change in nasalance was significant in the wide opening surgery group, but not in the limited surgery group.

CONCLUSION: Although only one side of the nasal airway was involved, one-third of the patients reported abnormal nasality. In patients with more disease severity who underwent wide opening surgery, the nasalance significantly increased 1 year after FESS. The increase in the objective nasalance score was corresponded to a significant improvement of subjective self-reported nasality assessment postoperatively.

PMID:34281727 | DOI:10.1016/j.jfma.2021.06.030

J Voice. 2021 Jul 16:S0892-1997(21)00190-9. doi: 10.1016/j.jvoice.2021.05.019. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: The objectives of this study were to (1) identify optimal clusters of 15 standard acoustic and aerodynamic voice metrics recommended by the American Speech-Language-Hearing Association (ASHA) to improve characterization of patients with primary muscle tension dysphonia (pMTD) and (2) identify combinations of these 15 metrics that could differentiate pMTD from other types of voice disorders.

STUDY DESIGN: Retrospective multiparametric METHODS: Random forest modeling, independent t-tests, logistic regression, and affinity propagation clustering were implemented on a retrospective dataset of 15 acoustic and aerodynamic metrics.

RESULTS: Ten percent of patients seen at the New York University (NYU) Voice Center over two years met the study criteria for pMTD (92 out of 983 patients), with 65 patients with pMTD and 701 of non-pMTD patients with complete data across all 15 acoustic and aerodynamic voice metrics. PCA plots and affinity propagation clustering demonstrated substantial overlap between the two groups on these parameters. The highest ranked parameters by level of importance with random forest models-(1) mean airflow during voicing (L/sec), (2) mean SPL during voicing (dB), (3) mean peak air pressure (cmH2O), (4) highest F0 (Hz), and (5) CPP mean vowel (dB)-accounted for only 65% of variance. T-tests showed three of these parameters-(1) CPP mean vowel (dB), (2) highest F0 (Hz), and (3) mean peak air pressure (cmH2O)-were statistically significant; however, the log2-fold change for each parameter was minimal.

CONCLUSION: Computational models and multivariate statistical testing on 15 acoustic and aerodynamic voice metrics were unable to adequately characterize pMTD and determine differences between the two groups (pMTD and non-pMTD). Further validation of these metrics is needed with voice elicitation tasks that target physiological challenges to the vocal system from baseline vocal acoustic and aerodynamic ouput. Future work should also place greater focus on validating metrics of physiological correlates (eg, neuromuscular processes, laryngeal-respiratory kinematics) across the vocal subsystems over traditional vocal output measures (eg, acoustics, aerodynamics) for patients with pMTD.

LEVEL OF EVIDENCE: II.

PMID:34281751 | DOI:10.1016/j.jvoice.2021.05.019

J Pediatr Surg. 2021 Jul 8:S0022-3468(21)00485-1. doi: 10.1016/j.jpedsurg.2021.06.013. Online ahead of print.

ABSTRACT

Background In congenital diaphragmatic hernia (CDH) survivors, failure to thrive is a well-known complication, ascribed to several factors. The impact of lung volume on growth of CDH survivors is poorly explored. Our aim was to evaluate if, in CDH survivors, lung volume (LV) after extubation correlates with growth at 12 and 24 months of life. Methods LV (measured as functional residual capacity-FRC) was evaluated by multibreath washout traces with an ultrasonic flowmeter and helium gas dilution technique, shortly after extubation. All CDH survivors are enrolled in a dedicated follow-up program. For the purpose of this study, we analyzed the correlation between FRC obtained shortly after extubation and anthropometric measurements at 12 and 24 months of age. We also compared growth between infants with normal lungs and those with hypoplasic lungs according to FRC values. A p < 0.05 was considered as statistically significant. Results We included in the study 22 CDH survivors who had FRC analyzed after extubation and auxological follow-up at 12 and 24 months of age. We found a significant correlation between FRC and weight Z-score at 12 months, weight Z-score at 24 months and height Z-score at 24 months. We also demonstrated that CDH infants with hypoplasic lungs had a significantly lower weight at 12 months and at 24 months and a significantly lower height at 24 months, when compared to infants with normal lungs. Conclusion We analyzed the predictive value of bedside measured lung volumes in a homogeneous cohort of CDH infants and demonstrated a significant correlation between FRC and growth at 12 and 24 months of age. An earlier identification of patients that will require an aggressive nutritional support (such as those with pulmonary hypoplasia) may help reducing the burden of failure to thrive.

PMID:34281708 | DOI:10.1016/j.jpedsurg.2021.06.013

Clin Oncol (R Coll Radiol). 2021 Jul 16:S0936-6555(21)00262-4. doi: 10.1016/j.clon.2021.07.003. Online ahead of print.

ABSTRACT

Modern multimodality cancer treatment has led to a rise in cancer survivors, and by 2030 the survival rate is estimated to increase by 31.4%. This is an impressive survival statistic on which clinicians and services continue to build. One of the less well-acknowledged consequences of survivorship among health professionals and patients alike is female sexual dysfunction, despite it occurring in more than 60% of women diagnosed with cancer. The systematic assessment and management of late effects from cancer lack integration within current models of oncology follow-up. Although highly prevalent, issues linked to sexual health are often not addressed among survivors. This overview aims to focus on the sexual impact of gynaecological cancer treatment. Clinicians should raise the topic of the sexual consequences of cancer treatment as a legitimate aspect of survivorship and service provision. Increased focus on the sexual consequences of treatment and cancer survivorship may in time lead to greater clinical recognition, service development and, most importantly, increase research focused on the effective management of what remains a neglected aspect of cancer care.

PMID:34281725 | DOI:10.1016/j.clon.2021.07.003

Life Sci Space Res (Amst). 2021 Aug;30:39-44. doi: 10.1016/j.lssr.2021.05.001. Epub 2021 May 17.

ABSTRACT

Planetary Protection is applicable for missions to biologically sensitive targets of interest in the solar system. For robotic missions landing on the Martian surface, Earth-based biological contamination must be reduced, controlled, and monitored to adhere to forward planetary protection requirements. To address the overall biological load limit and microbial density requirements per spacecraft each component is tracked based on its manufacturing pedigree and/or directly assessed using a direct sampling technique with either a swab or wipe. The tracking and reporting of requirements compliance has varied from mission to mission and reporting of numbers has consistently leaned towards the conservative worst-case scenario. With an increase in the number of missions and mission complexities, the need to establish a technically sound, statistical, and biological solution that provides a single point solution which addresses the distribution of spacecraft contamination becomes critical. Select components of the InSight mission, launched in 2018, have been used as a test case to evaluate the efficacy of applying Bayesian statistics to planetary protection data sets. Eight representative components covering the various bounding cases of high and low surface area, biological count, and sampling devices were analyzed as well as an assembly level case to evaluate the rollup of directly sampled and manufacturing pedigree components. A Bayesian approach was developed leveraging different priors from the zero-inflated data sets and compared to the heritage and existing NASA bioburden assessment approaches. In addition, several non-informative priors were evaluated for use in performing bioburden calculations. The results have demonstrated a viable framework to enable a Bayesian statistical approach to be further developed and utilized for planetary protection requirements assessment.

PMID:34281663 | DOI:10.1016/j.lssr.2021.05.001

Injury. 2021 Jul 10:S0020-1383(21)00616-1. doi: 10.1016/j.injury.2021.07.011. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate changes in the Garden index and other radiological parameters during reduction of femoral neck fractures.

METHODS: Ten healthy, human femoral specimens were obtained. A 2.0 mm diameter Kirschner wire was implanted in the centre of the femoral head. A perpendicular osteotomy was made in the middle of the femoral neck. The distal osteotomy surface was used as the angle of rotation (pronation and supination up to 90° at 10° intervals). Anterior-posterior and lateral view radiographs were taken at different angles. The Garden index and other relevant data were analysed using the picture archiving and communication system. Changes in the area of the femoral head fovea at different rotation angles were measured.

RESULTS: There were no significant differences in the Garden index between 0-30° of pronation and supination (p > .05). For angles of 40-90°, there were statistically significant differences in the Garden index (p < .05). The area of femoral head fovea decreased with increasing pronation angle, and increased with increasing supination angle.

CONCLUSIONS: The Garden index does not change significantly if the angle of fracture rotation is 0-30° (in either pronation or supination) during femoral neck fracture reduction. Therefore, it is impossible to judge the rotation of fracture in this range of angles. The Garden index can detect the rotation of fracture for rotation angles of 40-90° (in either pronation or supination). Changes in the area of the femoral head fovea can help determine the rotation of femoral neck fractures.

LEVEL OF EVIDENCE: Level V.

PMID:34281692 | DOI:10.1016/j.injury.2021.07.011

Injury. 2021 Jul 10:S0020-1383(21)00619-7. doi: 10.1016/j.injury.2021.07.014. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Vertical femoral neck fractures (VFNFs) are one of the most difficult fractures to stabilize, with high non-union (17%), avascular necrosis (AVN, 21%), and femoral neck shortening (FNS, 29.0%) rates. The objective of this investigation was to directly compare the long-term clinical complication rates of VFNFs repaired by crossed (Alpha fixation) or parallel screws in non-geriatric patients.

PATIENTS AND METHODS: We conducted a retrospective comparative study of VFNFs in patients (<60 years) between January 2014 and December 2017, with at least 2 years of follow-up. VFNFs were fixed with either three parallel screws (G-TRI) or augmented with a crossed screw (G-ALP). Confounding variables included age, gender, initial displacement, ISS (Injury Severity Score), general comorbidities, combined fractures, Pauwels angle, reduction quality. Complications, including non-union, AVN of the femoral head and FNS were compared as outcome indicators. Risk factors associated with these variables were further analysed using multivariate analysis.

RESULTS: A total of 157 patients (97 G-TRI; 60 G-ALP) met inclusion criteria. G-ALP had a significantly lower rate of FNS (8.3% vs. 28.9%, p = 0.039) than that of G-TRI. non-union (3.3% vs. 11.3%), AVN (21.7% vs. 25.8%), and reoperation rates (21.7% vs. 23.7%) were lower in G-ALP than G-TRI but was not statistically significant. Multivariate analyses showed significant relationships between NU and unacceptable reduction quality (OR=7.610; 1.823-31.770, adjusted-p = 0.015); between AVN and initial displacement (Garden III and IV) (OR=7.885; 1.739-35.744, adjusted-p = 0.021); and between FNS and screw configuration (OR=5.713; 1.839-17.743, adjusted-p = 0.009).

CONCLUSION: For the treatment of VFNFs, satisfactory reduction still remains the key surgical goal that prevents NU, while the incidence of AVN strongly depends on the initial displacement at the time of injury. Crossed screws were associated with a markedly lower FNS rate than parallel screws, which promote further randomised controlled trials to establish a guideline for optimal fixation selection in VFNFs.

PMID:34281695 | DOI:10.1016/j.injury.2021.07.014

J Equine Vet Sci. 2021 Aug;103:103689. doi: 10.1016/j.jevs.2021.103689. Epub 2021 Jun 16.

ABSTRACT

Perineural anaesthesia is an essential part of lameness investigation in horses. Painful reactions to injections imply a high risk of accidents for veterinarians. To evaluate the efficacy of two topical anaesthetic creams on desensitization of the skin at two perineural injection sites and to evaluate the effects these formulations may have on pain perception distally to the application sites. Randomized, blind, prospective study. 14 healthy horses were randomly divided in two groups of 7 horses each, one treated with EMLA and one with PLIAGLIS preparations. The mechanical nociceptive threshold (MNT) was recorded via pressure algometer at the baseline and one hour after application (T1) on palmar and palmar digital nerve blocks sites. Skin sensation was also assessed on the distal limb, recording MNT on the coronary band and on both bulbs of the heels. Data were compared with a 3-way ANOVA statistical analyses. No significant difference was encountered in the MNT values between baseline records and records at T1 at the control sites. A significant difference of MNT values was detected between the two time points in the treated limbs. The significant sources of variation in our study were the time and the presence of anaesthetic cream. The type of treatment did not determine any differences. Furthermore, no significant difference of MNT values at sites distal to treatment was recorded between the two time points, both in the treated limb and control limbs. Both formulations are effective to obtain superficial skin desensitization.

PMID:34281641 | DOI:10.1016/j.jevs.2021.103689

J Equine Vet Sci. 2021 Aug;103:103644. doi: 10.1016/j.jevs.2021.103644. Epub 2021 Apr 30.

ABSTRACT

Equine asthma is a common condition in horses, for which few host-related risk factors have been identified. The objective of this study was to identify host-related risk factors for the development of equine asthma. A retrospective, case-control study was performed, utilizing horses presented to the Texas A&M University, Veterinary Medical Teaching Hospital from January 2014 December 2018. Incident cases of mild to severe equine asthma (n = 37), diagnosed clinically with cytologic support of disease were examined. For each case, two control populations were identified, including one temporal control (n = 37) and one age-matched control (n = 37). Data collected included signalment, dietary and stable management, prior medical history, metabolic status, physical examination findings, and results of cytologic evaluation via bronchoalvelolar lavage or tracheal wash. Conditional logistic regression was used to compare data on equine asthma cases with data from each set of controls. Results indicated that obesity (Body Condition Score ≥ 7) was the only statistically significant risk factor for equine asthma in this population of horses. These results may aid in identification of targets for management, prevention, and further investigation into the pathogenesis of equine asthma. Early identification and intervention of horses at risk of lower airway disease could ameliorate the impact of disease.

PMID:34281649 | DOI:10.1016/j.jevs.2021.103644