Tag: pubmed

Ortop Traumatol Rehabil. 2021 Jun 30;23(3):157-165. doi: 10.5604/01.3001.0014.9152.

ABSTRACT

BACKGROUND: Adhesive Capsulitis of shoulder (AdCS) is a treatment dilemma for surgeons. Intraarticular Corticosteroid Injection (IACI) has shown only short-term benefit in improving shoulder-related disability. Suprascapular nerve block (SSNB) has shown promise in trials in reducing chronic shoulder pain. Thus a RCT was conducted to compare the efficacy of SSNB versus IACI in the treatment of AdCS.

MATERIAL AND METHODS: 86 patients with AdCS were divided into SSNB and IACI groups by block randomization. SSNB group received single Suprascapular Nerve Block with 10ml of 0.5% Bupivacaine while IACI group received single injection of 40mg Triamcinolone and 1ml 2% Lignocaine in the shoulder; both followed by physiotherapy and followed-up and evaluated with SPADI and modified Constant scores at 1, 6 and 12 weeks.

RESULTS: Statistically significant improvements occurred in both groups. At 12 weeks, the SPADI and Con-stant score for SSNB improved to 9.62±10.07 and 36.95±3.43 respectively (p<0.001); and for IACI improved to 11.65±5.56 and 35.07±3.32 respectively (p <0.001). The difference in the scores between the 2 groups at 1st and 6th week was insignificant, but was statistically significant in favour of SSNB at 12 weeks (p=0.002).

CONCLUSIONS: 1. Thus, from the present study it can be concluded that both Suprascapular Nerve Block and Intra-articular Corticosteroid injection are effective mo-dalities of treatment for Adhesive Capsulitis of the shoulder. 2. Suprascapular Nerve Block increased patients’ pain tolerability for effective mobilization, the effect be-ing persistent even at 12 weeks following injection. 3. It was safer than Intra-articular Corticosteroid in-jection with less incidence of adverse effects in our study and the literature. 4. It is an easy-to-perform outpatient procedure, with minimal chance of infection and other complications. 5. In light of the above, we may recommend Su-prascapular Nerve Block as the initial procedure of choice in patients with Adhesive Capsulitis of Shoulder.

PMID:34187937 | DOI:10.5604/01.3001.0014.9152

Ortop Traumatol Rehabil. 2021 Jun 30;23(3):193-203. doi: 10.5604/01.3001.0014.9157.

ABSTRACT

BACKGROUND: The aim of the study was to assess the activity of the vastus lateralis (VAL) and vastus medialis (VAM) within 3-5 years after anterior cruciate ligament (ACL) reconstruction with a LARS synthetic ligament (the Ligament Advanced Reinforcement System) compared to muscle activity in the non-operated limb and in the limbs of the controls during selected functional tests.

MATERIAL AND METHODS: 20 men after ACL reconstruction using LARS synthetic ligament were qualified to the study group. The control group included 20 healthy men. Lysholm scale used to assess the functionality of the knee joint. To test muscle activity, TELEMYO DTS surface electromyography (sEMG) recording kit by Noraxon was used. The examined muscles on both limbs were the VAL and the VAM. The subjects were asked to perform the test-movements (dynamic ascent and descent from 25 cm step and slowly squats).

RESULTS: Statistically significant differences were noted only for the values of VAL SA_SD (the quotients of mean sEMG values of the VAL muscle during step ascent – SA and descent -SD; Z=2.83; p=0.0047) and VAM SA_SD (Z=1.98; p=0.0401) parameters. In each analyzed parameter higher values were recorded among people from the control group. Weak but significant correlations were found between the VAL and VAM: SA_SD and the results obtained on the Lysholm Scale.

CONCLUSIONS: 1. In the group of patients after LARS, quadriceps activity disorders persisted in tested dynamic activities. 2. In the therapy planning or sports training in the distant period after ACL reconstruction with LARS, emphasis should be placed on quadriceps muscle training, and the sEMG test may be helpful in optimizing the management strategy.

PMID:34187938 | DOI:10.5604/01.3001.0014.9157

Saudi Med J. 2021 Jul;42(7):728-734. doi: 10.15537/smj.2021.42.7.20200797.

ABSTRACT

OBJECTIVES: To estimate the prevalence mono-resistant tuberculosis (MR-TB) and multidrug resistant TB (MDR-TB), and evaluate the risk factors associated with the drug-resistant tuberculosis (DR-TB).

METHODS: A descriptive, retrospective study was applied, utilizing the TB patients’ medical records at King Fahd Armed Forces Hospital (KFAFH), Jeddah, Saudi Arabia. The records of patients notified between 2000 and 2018 were reviewed and culture positive cases for Mycobacterium tuberculosis species were included. Moreover, the risk factors included were age, gender, smoking history, renal disease, liver disease, hyperbilirubinemia, diabetes mellitus, and human immunodeficiency virus (HIV).

RESULTS: Nine hundred and one cases in entirety were involved in the research, out of which 193 had drug-resistant tuberculosis (DR-TB) (21.4%). Out of the 21.4% DR-TB, 91.7% were MR-TB and 8.3% were MDR-TB. The highest MR prevalence was for pyrazinamide at 33.4%, while the lowest resistance was for ethambutol at 7.1%. For the risk factors of drug-resistant TB, only age depicted a statistically significant (p<0.01) but weak negative (r= -0.145) correlation with anti-TB drug resistance.

CONCLUSION: Rates of DR-TB reported in the study are considered higher compared to the recently reported national and international rates. According to the results, only younger people are at risk of developing DR-TB. Moreover, genetic mutation may play a role in drug resistance among our cases specifically for pyrazinamide monoresistance.

PMID:34187916 | DOI:10.15537/smj.2021.42.7.20200797

Saudi Med J. 2021 Jul;42(7):769-775. doi: 10.15537/smj.2021.42.7.20200750.

ABSTRACT

OBJECTIVES: To compare the clinicopathological, histological and immunohistochemical features of breast cancer (BC) in between young (≤40 years) and older (>40 years) patients.

METHODS: This retrospective study included histopathological reports of all patients with primary BC diagnose at the King Fahad Hospital, Madinah, Saudi Arabia between January 2006 and November 2020.

RESULTS: During the study period, a total of 708 patients with BC were identified; 173 cases (24.4%) were ≤40 years old and 535 (75.6%) were above 40 years. There were significant differences in tumor size (p=0.046), tumor grade (p<0.0001), tumor stage (p=0.047), lymphovascular invasion (p<0.0001), and distant metastasis (p<0.0001) between the 2 groups. Comparing the status of the hormone receptors and molecular subtypes between the 2 age groups, BCs in the younger patients were triple-negative (p=0.008) in majority of the cases and less likely to be estrogen receptor (ER) and progesterone receptor (PR) hormone receptors-positive (p=0.0001, p<0.0001). Young patients exhibited the HER2/neu type with more frequent statistical significance (p=0.016) and the tumor type luminal A (p=0.002) with less frequent statistical significance compared to old patients.

CONCLUSION: Although BC in young women is uncommon, it may be different with regards to poor prognostic outcomes, which are attributed to more aggressive histopathological features and less favorable receptor status when compared to the cases diagnosed in older women.

PMID:34187921 | DOI:10.15537/smj.2021.42.7.20200750

Ortop Traumatol Rehabil. 2021 Jun 30;23(3):181-192. doi: 10.5604/01.3001.0014.9155.

ABSTRACT

BACKGROUND: Traumatic musculoskeletal injuries are more and more frequently regarded as an important health, social and economic problem. According to WHO statistics, injuries are a major present-day health problem. The main aim of the study is to identify the number of new patients who sustained knee structure injuries during a year and to classify them based on data on services provided under National Health Fund agreements.

MATERIAL AND METHODS: Information on the number of patients with a knee injury was obtained in a three stage process. First an inventory of relevant diagnoses was determined. Then, the National Health Fund data from 2016-2019 was queried in accordance with the adopted methodology and assumptions. The analysis was based on the report submitted by the NHF in response to the query.

RESULTS: According to the NHF reporting data, knee injuries affect approx. 244,000 people per year. There are slightly more men (approx. 52%) than women (48%). People aged 11-20 years constitute the most numerous group of patients with knee injuries, with approx. 41,342 cases per year. The most frequently reported diagnoses in both groups were S80.0 Contusion of knee (approx. 30%), S83.6 Sprain and tear of other and unspecified parts of knee (approx. 21%) and M23.8 Other internal derangements of knee (approx. 9%). According to available data, the overall rate of knee injuries in 2019 was 6.4 per 1000 population.

CONCLUSIONS: 1. Knee injuries pose a major health problem. In Poland, according to the reporting data, approx. 244,000 knee injuries occur every year. 2. Knee injuries are more common among men than women, and people aged 11-20 years constitute the most numerous group of patients. 3. The National Health Fund reporting data is a very valuable source of information on the magnitude of the problem of injuries.

PMID:34187936 | DOI:10.5604/01.3001.0014.9155

Proc Natl Acad Sci U S A. 2021 Jul 13;118(28):e2026664118. doi: 10.1073/pnas.2026664118.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic is heterogeneous throughout Africa and threatening millions of lives. Surveillance and short-term modeling forecasts are critical to provide timely information for decisions on control strategies. We created a strategy that helps predict the country-level case occurrences based on cases within or external to a country throughout the entire African continent, parameterized by socioeconomic and geoeconomic variations and the lagged effects of social policy and meteorological history. We observed the effect of the Human Development Index, containment policies, testing capacity, specific humidity, temperature, and landlocked status of countries on the local within-country and external between-country transmission. One-week forecasts of case numbers from the model were driven by the quality of the reported data. Seeking equitable behavioral and social interventions, balanced with coordinated country-specific strategies in infection suppression, should be a continental priority to control the COVID-19 pandemic in Africa.

PMID:34187879 | DOI:10.1073/pnas.2026664118

Saudi Med J. 2021 Jul;42(7):714-720. doi: 10.15537/smj.2021.42.7.20210082.

ABSTRACT

OBJECTIVES: To develop an externally validated multivariable prognostic model for an underprivileged dialysis population.

METHODS: This was a multicenter retrospective cohort study of 5 years duration from January 2013 to December 2017. A total of 758 patients (37.5% female; mean±SD age, 44.26±14.77 years) were enrolled for construction of the prognostic model. The data were analyzed using a proportional hazards model to identify predictors of survival. Three risk groups were identified at the 25th and 75th percentiles of the resultant prognostic index. The model was externally validated with another dataset of 622 dialysis patients.

RESULTS: The prognostic index included 5 predictor variables: hemoglobin, serum potassium, interdialytic weight gain, serum albumin, and duration of dialysis, which had good predictive performance on the calibration and discrimination aspects of the model (Harrell’s c statistic: 0.748, Gonen and Heller k statistic: 0.647, Somers’ D statistic: 0.496, calibration slope: 1.156). There were significant interaction effects between weight and hemoglobin, weight and albumin, albumin and potassium, and albumin and hemoglobin.

CONCLUSIONS: We developed an externally validated model that contained 5 routinely collected prognosticators and confirmed its calibration and discrimination abilities in obtaining reliable prognostic estimates in developing countries. The model will assist clinicians in deciding the prognosis of dialysis patients. The application of this model in different clinical settings of developing countries can indicate interesting findings regarding public health.

PMID:34187914 | DOI:10.15537/smj.2021.42.7.20210082

J Neurol Neurosurg Psychiatry. 2021 Jun 29:jnnp-2021-326920. doi: 10.1136/jnnp-2021-326920. Online ahead of print.

NO ABSTRACT

PMID:34187868 | DOI:10.1136/jnnp-2021-326920

Cancer Epidemiol Biomarkers Prev. 2021 Jun 29:cebp.0404.2021. doi: 10.1158/1055-9965.EPI-21-0404. Online ahead of print.

ABSTRACT

BACKGROUND: Results of observational studies of the association between dietary fat and risk of invasive breast cancer (BC) have been inconsistent. In the Women’s Health Initiative Dietary Modification (DM) randomized trial designed to lower fat intake, the intervention was not associated with a statistically significant reduction of overall BC risk. However, the DM association with risk of ductal carcinoma in situ (DCIS) of the breast, a putative breast cancer precursor, has not been reported.

METHODS: A total of 48,835 postmenopausal women, ages 50-79 years (y) at enrollment, with no BC history and {greater than or equal to}32% of total energy intake from fat, were randomly assigned either to a dietary intervention (n=19,541) designed to reduce total fat intake to 20% of energy and to increase vegetable, fruit and grain consumption, or to a comparison group (n=29,294). Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for the association between the intervention and DCIS risk.

RESULTS: During 18.7y (median) cumulative follow-up, including intervention (~8.7y) and post-intervention phases (~13.0y), 817 DCIS cases were ascertained. No evidence of an association between the DM intervention and DCIS risk was observed overall, or by trial phase (intervention and post-intervention). Similarly, no associations were found in subgroups defined by potential risk factors for DCIS.

CONCLUSIONS: Dietary modification aiming to reduce fat intake was not associated with altered risk of DCIS.

IMPACT: These results do not provide evidence of an association between dietary fat reduction and the risk of DCIS among postmenopausal women.

PMID:34187856 | DOI:10.1158/1055-9965.EPI-21-0404

BMJ Open. 2021 Jun 29;11(6):e046913. doi: 10.1136/bmjopen-2020-046913.

ABSTRACT

INTRODUCTION: Metacarpal shaft fractures (MSF) are common traumatic hand injuries that usually affect young people of working age. They place a significant burden on healthcare resources and society; however, there is a lack of evidence to guide their treatment. Identifying the most beneficial and cost-efficient treatment will ensure optimisation of care and provide economic value for the National Health Service. The aim of this study is to assess the feasibility of a randomised controlled trial comparing surgical and non-surgical treatment for MSF in adults.

METHODS AND ANALYSIS: This is a multicentre prospective cohort study, with a nested qualitative study consisting of patient interviews and focus groups, and an embedded factorial randomised substudy evaluating the use of text messages to maximise data collection and participant retention. The outcomes of interest include eligibility, recruitment and retention rates, completion of follow-up, evaluation of primary outcome measures, calculation of the minimal clinically important difference (MCID) for selected outcome measures and establishing the feasibility of data collection methods and appropriate time-points for use in a future trial. Data will be captured using a secure online data management system. Data analyses will be descriptive and a thematic inductive analysis will be used for qualitative data. Minimum clinically important effects for each patient-reported outcome measure will be estimated using anchor-based responsiveness statistics and distribution-based methods.

ETHICS AND DISSEMINATION: This study has received ethical approval from the Research Ethics Committee and the Health Research Authority (REC reference 20/EE/0124). Results will be made available to patients, clinicians, researchers and the funder via peer-reviewed publications and conference presentations. Social media platforms, local media and feedback from the Patient Advisory Group will be used to maximise circulation of findings to patients and the public.

TRIAL REGISTRATION NUMBER: ISRCTN13922779.

PMID:34187822 | DOI:10.1136/bmjopen-2020-046913