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Nevin Manimala Statistics

Assessment of lateral pterygoid muscle and temporomandibular joint disc after Le Fort I osteotomy with and without intentional pterygoid plate fracture and sagittal split ramus osteotomy in class II and class III patients

J Craniomaxillofac Surg. 2021 Sep 25:S1010-5182(21)00204-3. doi: 10.1016/j.jcms.2021.09.008. Online ahead of print.

ABSTRACT

The aim of the study was to examine lateral pterygoid muscle (LPM) and temporomandibular joint (TMJ) disc before and after Le Fort I osteotomy with and without intentional pterygoid plate fracture and sagittal split ramus osteotomy (SSRO) in class II and class III patients. Le Fort I osteotomy and SSRO were performed in class II and class III patients. LPM measurements using oblique sagittal computed tomography (CT) images and TMJ disc position using magnetic resonance imaging (MRI) were examined. Statistical comparisons were performed for the LPM and TMJ between class II and class III patients and between those with and without intentional pterygoid plate fracture in Le Fort I osteotomy. The subjects comprised 60 female patients (120 sides), with 30 diagnosed as class II and 30 as class III. Preoperatively, the width of the condylar attachment, width at eminence, length of the LPM, angle of the LPM, and square of the LPM were significantly smaller in the class II group than in the class III group (p < 0.05). After 1 year, the width of the condylar attachment, width at eminence, and angle of the LPM remained significantly smaller in the class II group than in the class III group (p < 0.0001). TMJ disc position was significantly related to the width of the condylar attachment of the LPM, both pre- and postoperatively (p < 0.0001). However, postoperative disc position did not change in all patients. Next, the class II patients (60 sides) were divided into two groups who underwent Le Fort I osteotomy with or without intentional pterygoid plate fracture. Changes in all measurements of the LPM showed no significant differences between these two groups. Our study suggested that TMJ disc position classification could be associated with the width of condylar attachment of the LPM before and after surgery, while the surgical procedure, including Le Fort I osteotomy with intentional pterygoid plate fracture, might not affect postoperative LMP or disc position in class II patients.

PMID:34598864 | DOI:10.1016/j.jcms.2021.09.008

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Nevin Manimala Statistics

The effectiveness of user-focused mobile health applications in paediatric chronic disease management: A systematic review

J Pediatr Nurs. 2021 Sep 28:S0882-5963(21)00286-4. doi: 10.1016/j.pedn.2021.09.018. Online ahead of print.

ABSTRACT

PROBLEM: This systematic review aims to evaluate the effectiveness of user-focused mobile health (mHealth) applications in paediatric chronic disease management.

ELIGIBILITY CRITERIA: Articles were included under the Population Intervention Comparator Outcome Study (PICOS) design framework for (P) children with a chronic disease, (I) mHealth user-focused apps, (C) usual care/control groups, (O) health outcomes related to chronic diseases, and (S) randomised controlled trials. This study followed the guidelines provided by Cochrane, Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and Mobile Health Evidence Reporting and Assessment.

SAMPLE: A comprehensive literature search screening was conducted via CINAHL, PubMed, CENTRAL, ELSEVIER, SAGE, Science Direct, Scopus, Taylor Francis, WoS, and IEEE XPLORE from inception to November 15, 2020.

RESULTS: The review included seven articles, which combined provided data for a total of 755 children. The effects of the mHealth applications on the investigated 31 unique outcomes of five chronic paediatric diseases were mixed, ranging from effective to no effect. The risk of bias in the included studies was mostly either high or concerning according to Risk of Bias tool 2.0. The mobile apps that were evaluated were not standalone apps but were designed to interact with and provide data to healthcare providers.

CONCLUSION: Some mHealth interventions in this systematic review produced clinically meaningful and statistically relevant reductions in health outcomes related to chronic disease management. However, based on the available data, it is not possible to make definitive conclusions concerning the preferred target population of the interventions.

IMPLICATION: mHealth apps may be beneficial in improving selected patient outcomes in chronic disease management. Our results may assist the digital health services of hospitals, paediatric nurses who are interested in mHealth, and children who have a chronic disease.

PMID:34598848 | DOI:10.1016/j.pedn.2021.09.018

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Geographic remoteness from a multidisciplinary team is associated with an increased clinical staging of head and neck cancer: a Newcastle (Australia) study

Int J Oral Maxillofac Surg. 2021 Sep 28:S0901-5027(21)00325-8. doi: 10.1016/j.ijom.2021.09.005. Online ahead of print.

ABSTRACT

The purpose of this study was to investigate the relationship between a patient’s residential distance from a tertiary referral regional multidisciplinary team (MDT) and the clinical staging of their head and neck cancer (HNC) at presentation. A retrospective cohort study was performed of all attendees with HNC who had undergone an MDT assessment. The period of study was January 2016 to January 2017. The primary predictor variable was the patient’s residential distance from the MDT. Demographic and clinicopathological factors were recorded. The primary outcome variable was the clinical staging conferred by the MDT. Descriptive and ordinal logistical regression analyses were conducted to examine the data. There were 286 observations; 230 patients were male and 56 were female. The mean age of the cohort was 66.52 years. The average residential distance from the MDT was 68.16 km. Regression analysis, while not statistically significant, indicated that those living more than 100 km (range 102-592 km) from the MDT had a 1.49 times increased risk of being diagnosed with an advanced stage of cancer when compared to those living less than 100 km away. This study provides insights into the potential adverse effect geographic remoteness has on initial staging of HNC and the need for further strategies to serve this at-risk population.

PMID:34598849 | DOI:10.1016/j.ijom.2021.09.005

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Effect of insulin resistance on lung function in asthmatic children

J Pediatr Endocrinol Metab. 2021 Oct 1. doi: 10.1515/jpem-2021-0351. Online ahead of print.

ABSTRACT

OBJECTIVES: Insulin resistance may be associated with impaired lung function. The objective of this study was to examine the relationship between insulin resistance and lung function in asthmatic children.

METHODS: We performed a cross-sectional study on asthmatic children aged 6-18 years at Tertiary Care Center, India. Fasting serum glucose and insulin levels were analyzed to calculate the homeostatic model assessment of insulin resistance (HOMA-IR) in 90 children. Lung function tests were performed. Spearman correlation was used to assess the relationship between insulin resistance and lung function. Linear regression was done to adjust the potential confounders.

RESULTS: Insulin resistance was present in 15.5% of patients. We found a statistically significant inverse relationship between HOMA-IR and spirometric parameters such as forced expiratory volume in 1 s/forced vital capacity ratio and forced expiratory flow between 25 and 75% on Spearman correlation. However, adjusted regression for age, gender, and body mass index showed no significant association of lung function parameters with HOMA-IR.

CONCLUSIONS: Insulin resistance may be considered for the decline in lung function in asthmatic children.

PMID:34598376 | DOI:10.1515/jpem-2021-0351

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Nevin Manimala Statistics

Spike detection for calcium activity

Int J Biostat. 2021 Sep 30. doi: 10.1515/ijb-2020-0043. Online ahead of print.

ABSTRACT

We present in this paper a global methodology for the spike detection in a biological context of fluorescence recording of GnRH-neurons calcium activity. For this purpose we first propose a simple stochastic model that could mimic experimental time series by considering an autoregressive AR(1) process with a linear trend and specific innovations involving spiking times. Estimators of parameters with asymptotic normality are established and used to set up a statistical test on estimated innovations in order to detect spikes. We compare several procedures and illustrate on biological data the performance of our procedure.

PMID:34598374 | DOI:10.1515/ijb-2020-0043

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Study of correlations between CT properties of retrieved cerebral thrombi with treatment outcome of stroke patients

Radiol Oncol. 2021 Sep 27. doi: 10.2478/raon-2021-0037. Online ahead of print.

ABSTRACT

BACKGROUND: All the patients with suspected stroke are directed to whole-brain CT scan. The purpose of this scan is to look for early features of ischemia and to rule out alternative diagnoses than stroke. In case of ischemic stroke, CT diagnostics (including CT angiography) is used mainly to locate the occlusion and its size, while the Hounsfield Units (HU) values of the thrombus causing the stroke are usually overlooked on CT scan or considered not important. The aim of this study was to demonstrate that the HU value is relevant and can help in better treatment planning.

PATIENTS AND METHODS: There were 25 patients included in the study, diagnosed with ischemic stroke in the middle cerebral artery (MCA) territory. In all patients, systemic thrombolysis was not successful and the mechanical recanalization was needed. The retrieved thrombi were also analyzed histologically for the determination of red blood cells (RBC) proportion. CT of the proximal MCA (M1) segment was analyzed for average HU value and its variability both in the occluded section and the symmetrical normal site. These CT parameters were then statistically studied for the possible correlations with different clinical, histological and procedure parameters using the Linear Regression and the Pearson correlation coefficient.

RESULTS: Relevant positive correlations were found between average HU value of thrombus and outcome modified Rankin Scale (mRS), initial mRS, number of passes with thrombectomy device as well as RBC proportion.

CONCLUSIONS: Results of the present study suggest that measured HU values in CT images of the cerebral thrombi may help in the assessment of thrombus compaction and therefore better treatment planning.

PMID:34598375 | DOI:10.2478/raon-2021-0037

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Low-Level Laser and Antimicrobial Photodynamic Therapy Reduce Peri-implantitis-related Microorganisms Grown In Vitro

Eur J Dent. 2021 Oct 1. doi: 10.1055/s-0041-1731926. Online ahead of print.

ABSTRACT

OBJECTIVE: Currently, dental implants are a predictable treatment option for oral rehabilitation; however, complications such as peri-implant diseases are increasing every day. Thus, the aim of this study was to verify the efficacy, in vitro, of two protocols against cultures of periodontal biofilm and Staphylococcus aureus.

MATERIAL AND METHODS: Petri dishes for each of the following groups were used: control groups (C)-plates inoculated with periodontal biofilm (C.B; n = 4) or S. aureus (C.SA; n = 4) without any treatment; laser groups-plates inoculated with periodontal biofilm (low-level laser therapy [LLLT].B; n = 4) or S. aureus (LLLT.SA; n = 4) and treated with LLLT (660 nm, 30 mW, 50 J/cm2, and 47 seconds); antimicrobial photodynamic therapy groups (aPDT)-plates inoculated with periodontal biofilm (aPDT.B; n = 4) or S. aureus (aPDT.SA; n = 4) and treated with aPDT (red laser 660 nm, 30 mW, 50 J/cm2, 47 seconds + toluidine blue O (TBO) 100 µg/mL, and 1 minute). After treatments were performed, the contents of all plates were diluted and seeded for counting colony-forming units (CFUs).

STATISTICAL ANALYSIS: Results were analyzed with one-way analysis of variance (ANOVA), Tukey’s test, comparison of percentages, and independent t-tests with a 5% significance level.

RESULTS: Both treatments, LLLT and aPDT, significantly reduced the number of CFUs for the two types of culture, LLLT.B (3.69 × 106 ± 0.20), aPDT.B (2.79 × 106 ± 0.13), LLLT.SA (4.10 × 106 ± 0.12), and aPDT.SA (3.23 × 106 ± 0.10) when compared with control groups C.B (5.18 × 106 ± 0.43) and C.SA (5.81 × 106 ± 0.16; p = 0.000). When treatment groups were compared separately, there was also a statistically significant difference (p = 0.000). None of the protocols were able to eliminate cultured microorganisms.

CONCLUSION: The LLLT and aPDT protocols effectively reduced cultures of periodontal biofilm and S. aureus in vitro, with the superiority of aPDT.

PMID:34598294 | DOI:10.1055/s-0041-1731926

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Periodontitis and Helicobacter pylori Infection: Eradication and Periodontal Therapy Combination

Eur J Dent. 2021 Oct 1. doi: 10.1055/s-0041-1731928. Online ahead of print.

ABSTRACT

OBJECTIVES: This study was aimed to assess (1) the prevalence of salivary and gastric Helicobacter pylori (HP) infection in patients with and without periodontitis, (2) the prevalence of HP infection in patients with periodontitis according to its clinical classification, (3) the effect of periodontitis treatment in patients with or without gastric HP infection, and (4) if gastric HP eradication in combination with periodontitis treatment influences periodontitis clinical outcome.

MATERIALS AND METHODS: Thirty-three adults with periodontitis treated by quadrant scaling and root planning (QSRP). The simplified plaque index (PI), bleeding on probing index (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed pretreatment and 3 months of posttreatment. The patients were tested for oral and gastric HP. Gastric HP (+) patients received eradication therapy. A control group of 32 periodontically healthy volunteers was tested for oral and gastric HP. Saliva samples were evaluated by real-time polymerase chain reaction (rtPCR); gastric HP was detected by urea breath test (UBT).

STATISTICAL ANALYSIS: Normality of variables assessed by the Kolmogorov-Smirnov test, while the differences of pre- and post-treatment were analyzed by paired samples t-test. Differences between subgroups were compared by a Student’s t-test or a Mann-Whitney U-test. Comparisons of nominal variables were made by Pearson’s Chi-square test.

RESULTS: No saliva samples were positive for HP. Gastric HP was detected in six patients with periodontitis and seven controls (p > 0.05). HP infection affected patients with higher disease stages and grades. All HP (+) patients underwent successful eradication treatment. All clinical periodontitis indices improved following QSRP. HP (+) patients who received QSRP as adjunctive to eradication treatment showed improvement in BOP (p < 0.001), PI (p < 0.013), and CAL (p < 0.004) compared with HP (-) patients who received QSRP alone.

CONCLUSION: Periodontitis was not associated with gastric HP infection. Saliva was not a gastric HP supply reservoir. Gastric HP infection was associated with advanced stages and degrees of periodontitis. Although all periodontal clinical markers improved after QSRP, BOP, PI, and CAL, they were further improved when combined with eradication treatment. Periodontal evaluation and treatment combined with HP eradication are recommended in patients with HP gastric infection.

PMID:34598295 | DOI:10.1055/s-0041-1731928

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Nevin Manimala Statistics

The Efficacy of Hydrodilatation for the Prevention of Vasospasm following Microsurgical Anastomosis

J Reconstr Microsurg. 2021 Oct 1. doi: 10.1055/s-0041-1735834. Online ahead of print.

ABSTRACT

INTRODUCTION: Vasospasm is a major problem following microsurgical reconstruction which can result in the partial or complete loss of the flap tissue. The aim of this study was to investigate the efficiency of hydrodilatation for the prevention of vasospasm.

MATERIAL AND METHODS: Thirty male Wistar rats were used for this experimental study. Femoral arteries of were exposed, photographed, and transected. In group 1, group 2, and group 3 papaverine solution, hydrodilatation, and minimal mechanical dilatation (control group) was performed, respectively. The anastomosis was completed and the arteries were photographed again 10 minutes after completion of the anastomosis. Following 7-day period samples for transmission electron microscopy (TEM) and light microscopy were obtained.

RESULTS: The mean vessel diameters prior to transection were 0.43, 0.45, and 0.52 mm in the papaverine, hydrodilatation, and control groups, respectively. The mean vessel diameter 10 minutes following the completion of anastomosis was 0.76, 0.75, and 0.51 mm in the papaverine, hydrodilatation, and control groups, respectively. Median score for papaverine group regarding histological parameters of regular endothelial lining and lumen, neutrophil infiltration, vascular congestion, and edema in tunica adventitia was 2, 3, 2, and 3 positive, respectively. Median score for the papaverine group regarding histological parameters of regular endothelial lining and lumen, neutrophil infiltration, vascular congestion, and edema in tunica adventitia was 3, 3, 3, and 3 positive, respectively. All the histological scores were negative in the control group. The difference between the control group and the experiment groups 1 and 2 was significant regarding all four histological parameters (p < 0.05).

CONCLUSION: Hydrodilatation and papaverine application were both effective in preventing vasospasm following microsurgical intervention but papaverine caused slightly less damage to the endothelial lining and less edema in the tunica adventitia when compared with the hydrodilatation. Hydrodilatation group showed a vasodilatory effect that was statistically similar to that of papaverine, which has a proven efficacy.

PMID:34598279 | DOI:10.1055/s-0041-1735834

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Nevin Manimala Statistics

Comparative Evaluation of Resin Dentin Interface using Universal and Total- Etch Adhesive Systems on Sound and Eroded Dentin: In Vitro Study

Eur J Dent. 2021 Oct 1. doi: 10.1055/s-0041-1734469. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to compare the resin-dentin interface of sound and eroded dentin using universal and total-etch adhesive systems.

MATERIAL AND METHODS: Forty caries-free extracted human premolars were collected, and the occlusal surfaces were ground by using slow speed diamond disc with copious water supply until a flat superficial dentin was exposed. The test group underwent erosive cycle (n = 20), and another group (n = 20) was reserved for control group. Erosive protocol consisted of immersion in 1.23% citric acid for 1 minute every 12 hours and stored in artificial saliva. Both the control and eroded teeth were further subdivided (n = 10) for composite restoration by using either self-etch or total-etch systems. Then the tooth samples were sectioned longitudinally and observed under confocal laser scanning microscope at ×10 magnification to evaluate resin tag length and hybrid layer thickness.

STATISTICAL ANALYSIS: The data obtained were analyzed by using independent t-test.

RESULTS: The highest mean value of the resin tag length and thickness of hybrid layer was observed with total-etch system in sound dentin group compared with other groups (p < 0.001).

CONCLUSION: The resin-dentin interface of sound dentin was found to be better than eroded dentin by using total-etch system. The resin-dentin interface of eroded dentin was superior to sound dentin by using self-etch adhesive system.

PMID:34598293 | DOI:10.1055/s-0041-1734469