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Nevin Manimala Statistics

Ovarian function following use of various hemostatic techniques during treatment for an endometrioma: A randomized controlled trial

Int J Gynaecol Obstet. 2021 Sep 3. doi: 10.1002/ijgo.13912. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effect of hemostatic techniques (bipolar energy versus hemostatic sealants versus suture) on the ovarian reserve of patients submitted to laparoscopic cystectomy for the surgical excision of a unilateral endometrioma.

METHODS: A randomized controlled trial conducted in a teaching hospital included 84 patients with a unilateral endometrioma. The patients underwent laparoscopic stripping for excision of the unilateral endometrioma between March 2018 and February 2020. Three different hemostatic techniques – bipolar energy (Group 1), hemostatic sealants (Group 2) and suture (Group 3) – were compared. Anti-Müllerian hormone (AMH) levels were measured prior to and 1 and 6 months after surgery to determine changes in ovarian function.

RESULTS: Following surgery, AMH levels decreased in all the groups; however, this decrease was not statistically significant. Comparison between groups showed no statistically significant differences in AMH levels between the three hemostatic techniques used. Six months after surgery, median AMH levels were: 1.65 (interquartile range [IQR]: 0.62-2.08) ng/ml in Group 1, 1.87 (IQR: 1.27-2.97) in Group 2, and 1.53 (IQR: 1.18-2.44) in Group 3.

CONCLUSION: The present study suggests that there is no difference between the different hemostatic techniques used in laparoscopic cystectomy for the treatment of unilateral endometriomas.

PMID:34478564 | DOI:10.1002/ijgo.13912

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Correction of More Hallux Valgus Pathologic Disorders with a Single Distal Osteotomy: A New Surgical Technique

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_10. doi: 10.7547/18-147.

ABSTRACT

BACKGROUND: Hallux valgus, one of the most common deformities of the great toe, may cause pain, dysfunction, and impaired gait pattern. In this retrospective study we report the results of a new type of distal metatarsal osteotomy combined with distal soft-tissue release in patients with mild-to-moderate hallux valgus deformity.

METHODS: This new technique was used in the management of 32 feet of 31 patients (eight men and 23 women) with mild-to-moderate hallux valgus. Hallux valgus angle, intermetatarsal angle, and distal metatarsal articular angle were measured on preoperative, early postoperative (6-8 weeks), and late (1 year) postoperative radiographs. American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal score was calculated. Sesamoid position, by considering medial sesamoid position, and metatarsal shortness were also measured.

RESULTS: Statistically significant differences were detected between the preoperative and late postoperative measurements of the hallux valgus angle, distal metatarsal articular angle, intermetatarsal angle, and sesamoid position parameters in patients operated on with this technique. Improvement was 14° for the hallux valgus angle, 4° for the distal metatarsal articular angle, and 4° for the intermetatarsal angle. Sesamoid position was also improved, and the mean American Orthopaedic Foot and Ankle Society score was significantly improved. Metatarsal shortness greater than 2 mm was observed in two patients without resulting in any clinical discomfort.

CONCLUSIONS: This new technique was easy, safe, and promising in patients diagnosed as having mild-to-moderate hallux valgus deformity.

PMID:34478540 | DOI:10.7547/18-147

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Fluoride Release from Glass Ionomer Cement and Resin-modified Glass Ionomer Cement Materials under Conditions Mimicking the Caries Process

Oper Dent. 2021 Sep 3. doi: 10.2341/19-296-L. Online ahead of print.

ABSTRACT

The anticaries potential of restorative ionomeric materials should be evaluated under a pH-cycling regime that simulates the caries process of demineralization and remineralization. Ten glass ionomer cement (GIC) materials and five resin-modified glass ionomer cement (RMGIC) materials were evaluated. A resin composite was used as a negative control. Six discs of each material were immersed for 6 and 18 hours each day in demineralizing (De-) and remineralizing (Re-) solutions, respectively. The solutions were changed daily over 12 days, during which the fluoride concentration was determined using an ion-specific electrode. The results were expressed as (1) the daily fluoride concentration in the De- and Re- solutions (μg F/ml), (2) the amount of fluoride released daily in the De- + Re- solution per area of specimens (μg F/cm2/day), and (3) the cumulative release over the 12-day period (μg F/cm2). During the first days, all materials showed a surge in fluoride release, followed by a gradual decline; however, three distinct patterns were observed, specifically: (1) greater fluoride release in the De- solution compared to the Re- solution during the study period; (2) an initial higher release in De- solution; and (3) a similar release in both solutions over the whole period. The materials differed statistically (p<0.05) with respect to daily and cumulative fluoride release. One GIC (Maxxion R) and one RMGIC (Resiglass R) had the highest and lowest ability to release fluoride, respectively. In conclusion, the GICs and RMGICs evaluated exhibited distinct qualitative and quantitative patterns of fluoride release under conditions simulating the caries process, which might reflect their anticaries potential.

PMID:34478544 | DOI:10.2341/19-296-L

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Multivariate Model Update Chemometric Methods for Determination of Prednisolone and Esomeprazole in Spiked Human Plasma: a Comparative Study

J AOAC Int. 2021 Sep 3:qsab114. doi: 10.1093/jaoacint/qsab114. Online ahead of print.

ABSTRACT

BACKGROUND: Prednisolone is immunosuppressant and anti-inflammatory drug; it may cause peptic ulcers as a side effect. Esomeprazole is used for treatment of peptic ulcers therefore; the two drugs are co-administered in case of organ transplantation and autoimmune diseases.

OBJECTIVE: This work aims to determine simultaneously the two drugs together in bulk and spiked human plasma by eliminating the overlapping between the spectra of each other and the interference of plasma matrix.

METHODS: Two simple and effective model updated chemometric models called principal component analysis (PCA) and partial least square (PLS) were established using UV spectrophotometric data.

RESULTS: The two updated models have been validated according to the U.S. Food and Drug Administration guidelines with accepted results. The results were statistically compared with those of the reported methods, where no significant difference was found, indicating the validity of the developed methods. The two updated models have been successfully applied for prediction of the proposed drugs with good results regarding accuracy and precision.

CONCLUSION: The two updated models are simple, rapid, sensitive, and precise and could be easily applied in quality control laboratories for determination of PRD and ESO, without any preliminary separation steps or interference from plasma matrix.

HIGHLIGHTS: Two model updated chemometric models called PCA and PLS were established for determination of prednisolone and esomeprazole in spiked human plasma using UV spectrophotometric data.

PMID:34478551 | DOI:10.1093/jaoacint/qsab114

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Comparison of Arthroscopic Treatment Methods in Talar Osteochondral Lesions: A Multicenter, Prospective, Randomized Clinical Trial

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_5. doi: 10.7547/20-218.

ABSTRACT

BACKGROUND: The aim of the present study was to contribute new and updated information to the literature by comparing the clinical and radiologic results of arthroscopic microfracture, platelet-rich plasma (PRP) after arthroscopic microfracture, and BST-Cargel scaffold application after arthroscopic microfracture in the treatment of talar osteochondral lesions.

METHODS: Sixty-two talar osteochondral lesion patients (31 women and 31 men) who underwent ankle arthroscopy in two different centers were randomized into three groups. The first group consisted of patients who underwent only arthroscopic microfracture (MF) (n = 22); the second group consisted of patients who underwent the PRP procedure after arthroscopic MF (PRP; n = 19); and the third group consisted of patients who underwent the BST-Cargel procedure after arthroscopic MF was (BST-Cargel; n = 21). The talar osteochondral lesions in the three groups were classified according to magnetic resonance and arthroscopic images. American Orthopedic Foot and Ankle Society, Foot and Ankle Ability Measurement (overall pain, 15-minute walking, running function), and visual analog scale scores were evaluated preoperatively and postoperatively, and postoperative return time to sports activities was performed.

RESULTS: Compared to the preoperative score, postoperative American Orthopedic Foot and Ankle Society score increased 48.80 ± 9.60 in the BST-Cargel group, whereas there was an increase of 46.68 ± 3.65 in the PRP group and 29.63 ± 3.69 in the MF group, which were statistically significant (P < .05).There was a statistically significant postoperative change in the visual analog scale scores of the patients in all three groups compared to the preoperative scores (P < .05). At the end of the follow-up, the Foot and Ankle Ability Measurement overall pain, 15-minute walking, and running function results of all three groups increased significantly postoperatively compared to the preoperative values (P < .005).

CONCLUSIONS: BST-Cargel application with microfracture is a method that can be applied easily and safely with arthroscopy to lesions larger than 1.5 cm2 regardless of the size of the cartilage defect, and it has been found to be superior to the other two methods in terms of pain, functional score, radiologic recovery, and return to sports activities.

PMID:34478532 | DOI:10.7547/20-218

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Follow-up Evaluation of Medial Clear Space and Talar Tilt After Bimalleolar Equivalent Fracture Fixation Without Primary Deltoid Repair

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_7. doi: 10.7547/19-047.

ABSTRACT

BACKGROUND: We sought first to determine the efficacy of lateral ankle fixation alone in maintenance of medial clear space and talar valgus in bimalleolar equivalent ankle fractures not receiving primary deltoid repair, and second to assess perceived outcomes via the Foot and Ankle Outcome Score. To our knowledge, no study has quantified the reduction of medial clear space and talar valgus in bimalleolar equivalent ankle fractures receiving lateral ankle fixation alone.

METHODS: We compared preoperative, initial postoperative, and greater than 1-year follow-up radiographs of medial clear space and talar valgus in individuals who received lateral ankle fixation alone in bimalleolar equivalent ankle fractures. Subjective outcomes were measured via the Foot and Ankle Outcome Score.

RESULTS: Thirty-seven patients participated in the study and showed a statistically significant reduction of medial clear space and restoration of talar position, and maintenance with this fixation method during follow-up in patients with bimalleolar equivalent ankle fractures. Adjunctively, patients perceived their outcomes to be satisfactory, as demonstrated by the results of the Foot and Ankle Outcome Score.

CONCLUSIONS: We aimed to assess the efficacy of lateral ankle fixation in the maintenance of medial clear space and talar valgus reduction at midterm follow-up. Although some authors contend that primary deltoid repair in bimalleolar equivalent ankle fractures is warranted, these midterm study results suggest that isolated lateral ankle fixation is adequate for medial ankle stabilization in bimalleolar equivalent fractures, and thus primary deltoid repair is not indicated.

PMID:34478535 | DOI:10.7547/19-047

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Healing Rate of Diabetic Foot Wounds When Treated with Serial Debridement in the Presence of Antithrombotic Therapy

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_4. doi: 10.7547/20-075.

ABSTRACT

BACKGROUND: Previous study indicates that pharmacologic antithrombotic therapy may be an inhibitory factor for wound healing and should merit consideration among the other core factors in wound healing optimization.

METHODS: This study provides a retrospective analysis of the effect of antithrombotic therapy on wound healing rates of uncomplicated diabetic foot ulcerations. Wounds treated with standard of care in the presence of clinical anticoagulation were compared to control wounds.

RESULTS: The results indicate a statistically significant negative correlation between antithrombotic therapy and diabetic foot wound healing rate. This represents the first study focusing on this correlation in the uncomplicated diabetic foot wound.

CONCLUSIONS: This retrospective study demonstrates that antithrombotic therapy has a statistically significant negative effect on healing rates of uncomplicated diabetic foot ulcerations. Both wound area and depth improvement over 4 weeks was significantly better in treated patients who were not on antithrombotic therapy for comorbidity not associated with peripheral arterial disease.

PMID:34478530 | DOI:10.7547/20-075

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Using Google Trends to Identify Seasonal Variation in Foot and Ankle Pathology

J Am Podiatr Med Assoc. 2021 Jul 1;111(4):Article_18. doi: 10.7547/20-054.

ABSTRACT

BACKGROUND: Google Trends proves to be a novel tool to ascertain the level of public interest in pathology and treatments. From anticipating nascent epidemics with data-driven prevention campaigns to identifying interest in cosmetic or bariatric surgery, Google Trends provides physicians real-time insight into the latest consumer trends.

METHODS: We used Google Trends to identify temporal trends and variation in the search volume index of four groups of keywords that assessed practitioner-nomenclature inquiries, in addition to podiatric-specific searches for pain, traumatic injury, and common podiatric pathology over a 10-year period. The Mann-Kendall trend test was used to determine a trend in the series, and the Wilcoxon signed-rank test was used to determine whether there was a significant difference between summer and winter season inquiries. Significance was set at P ≤ .05.

RESULTS: The terms “podiatrist” and “foot doctor” experienced increasing Search Volume Index (SVI) and seasonal variation, whereas the terms “foot surgeon” and “podiatric surgeon” experienced no such increase. “Foot pain,” “heel pain,” “toe pain,” and “ankle pain” experienced a significant increase in SVI, with “foot pain” maintaining the highest SVI at all times. Similar results were seen with the terms “foot fractures,” “bunion,” “ingrown toenail,” and “heel spur.” These terms all experienced statistically significant increasing trends; moreover, the SVI was significantly higher in the summer than in the winter for each of these terms.

CONCLUSIONS: The results of this study show the utility in illustrating seasonal variation in Internet interest of pathologies today’s podiatrist commonly encounters. By identifying the popularity and seasonal variation of practitioner- and pathology-specific search inquiries, resources can be allocated to effectively address current public inquiries. With this knowledge, providers can learn what podiatric-specific interests are trending in their local communities and market their practice accordingly throughout the year.

PMID:34478531 | DOI:10.7547/20-054

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PREVALENCE OF BLASTOCYSTIS SUBTYPES IN HEALTHY VOLUNTEERS IN NORTHEASTERN POLAND

J Parasitol. 2021 Sep 1;107(5):684-688. doi: 10.1645/20-170.

ABSTRACT

Blastocystis is a common enteric protist that is linked to intestinal and extra-intestinal diseases. At least 24 subtypes (STs) have been described, with the main colonization of ST1-ST4 in humans. In our attempt to determine the distribution of Blastocystis STs in Olsztyn and surroundings in northeastern Poland, 319 stool samples from volunteers were subjected to copro-ELISA and PCR testing. Positive findings were identified in 77, 48, and 46 of the samples via copro-ELISA, PCR, and sequencing, respectively. Blastocystis colonization was not associated with gender or dwelling place but was statistically higher in people age 60-69 yr (32.6%). Five STs (ST1-ST4, ST7) were identified, in which ST3 (37%) was most prevalent, followed by ST2 (19.6%), ST1 (17.4%), ST4 (13%), and ST7 (8.7%). The current study revealed a similar rate of microorganism colonization in Polish volunteers compared to other developed countries, without significant differences in gender and dwelling place. Significant statistical differences were found in different age groups, where Blastocystis was highly detected in elderly people. In the current study, PCR was the most plausible method based on the sequencing results.

PMID:34478522 | DOI:10.1645/20-170

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Healthcare Navigation of Black and White Adolescents Following Sport-Related Concussion: A Path Towards Achieving Health Equity

J Athl Train. 2021 Sep 3. doi: 10.4085/1062-6050-0330.21. Online ahead of print.

ABSTRACT

CONTEXT: Care-seeking behaviors for sport-related concussion (SRC) are not consistent across demographic subgroups. These differences may not only stem from health inequities but can further perpetuate disparities in care for SRCs.

OBJECTIVE: To determine whether racial differences exist in the care pathway from injury to SRC clinic within adolescent athletes.

DESIGN: Retrospective cohort Setting: Regional SRC center Participants: Of 582 total athletes, 486 (83.5%) White and 96 (16.5%) Black adolescent athletes were diagnosed with SRC and evaluated within 3 months at the SRC clinic.

MAIN OUTCOME MEASURES: Race was the defined exposure, dichotomized as Black or White. The four primary outcomes included: 1)location of first health system contact, 2)time from injury to first health system contact 3) time to in-person SRC clinic visit, and 4) whether the athlete established care (>1 visit), was released immediately to an athletic trainer, or lost to follow-up.

RESULTS: Black and White athletes mostly presented directly to SRC clinic (61.5% vs 62.3%) at a median[interquartile range] of 3[1,5] vs 4[1,8] days respectively (p=0.821). Similar proportions of Black and White athletes also first presented to the ED (30.2% vs 27.2%) at a median of 0[0,1] vs 0[0,1] days (p=0.941). Black athletes more frequently had care transferred to their athletic trainer (39.6% vs 29.6%) and less frequently established care (56.3% vs 64.0%), however these differences were not statistically significant (p=0.138). Lost to follow-up was uncommon among Black and White athletes alike (4.2% vs 6.4%).

CONCLUSIONS: This study demonstrated that within an established SRC referral network and multidisciplinary clinic, there were no observed racial disparities in how athletes were initially managed and/or ultimately presented to SRC clinic despite racial differences in school type and insurance coverage. SRC center assimilation and affiliation with school systems may be helpful in improving access and providing equitable care across diverse patient demographics.

PMID:34478524 | DOI:10.4085/1062-6050-0330.21