Tag: pubmed

Infect Genet Evol. 2021 Mar 3:104801. doi: 10.1016/j.meegid.2021.104801. Online ahead of print.

ABSTRACT

Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) has first emerged from China in December 2019 and causes coronavirus induced disease 19 (COVID19). Since then researchers worldwide have been struggling to detect the possible pathogenesis of this disease. COVID19 showed a wide range of clinical behavior from asymptomatic to severe acute respiratory disease syndrome. However, the etiology of susceptibility to severe lung injury is not yet fully understood. Angiotensin-converting enzyme1 (ACE1) convert angiotensin I into Angiotensin II that was further metabolized by ACE 2 (ACE2). The binding ACE2 receptor to SARS-CoV-2 facilitate its enter into the host cell. The interaction and imbalance between ACE1 and ACE2 play a crucial role in the pathogenesis of lung injury. Thus, the aim of this study was to investigate the association of ACE1 I/D polymorphism with severity of Covid-19. The study included RT-PCR confirmed 269 cases of Covid-19. All cases were genotyped for ACE1 I/D polymorphism using polymerase chain reaction and followed by statistical analysis (SPSS, version 15.0). We found that ACE1 DD genotype, frequency of D allele, older age (≥46 years), unmarried status, and presence of diabetes and hypertension were significantly higher in severe COVID19 patient. ACE1 ID genotype was significantly independently associated with high socio-economic COVID19 patients (OR: 2.48, 95% CI: 1.331-4.609). These data suggest that the ACE1 genotype may impact the incidence and clinical outcome of COVID-19 and serve as a predictive marker for COVID-19 risk and severity.

PMID:33676010 | DOI:10.1016/j.meegid.2021.104801

Ann Anat. 2021 Mar 3:151715. doi: 10.1016/j.aanat.2021.151715. Online ahead of print.

ABSTRACT

BACKGROUND: Severe craniofacial and dental abnormalities, typical for patients with progressive Duchenne muscular dystrophy (DMD), are an exellcent demonstration of Melvin L. Moss “functional matrix theory”, highlighting the influence of muscle tissue on craniofacial growth and morphology. However, the currently best approved animal model for investigation of this interplay is the mdx-mouse, which offers only a limited time window for research, due to the ability of muscle regeneration, in contrast to the human course of the disease. The aim of this study was to evaluate craniofacial morphology after BTX-A induced muscle paralysis in C57Bl- and mdx-mice, to prove the suitability of BTX-A intervention to inhibit muscle regeneration in mdx-mice and thus, mimicking the human course of the DMD disease.

METHODS: Paralysis of the right masseter muscle was induced in 100 days old C57Bl- and mdx-mice by a single specific intramuscular BTX-A injection. Mice skulls were obtained at 21 days and 42 days after BTX-A injection and 3D radiological evaluation was performed in order to measure various craniofacial dimensions in the sagittal, transversal and vertical plane. Statstical analysis were performed using SigmaStat®Version 3.5. In case of normal distribution, unpaired t-test and otherwise the Mann Whitney-U test was applied. A statistical significance was given in case of p ≤ 0.05.

RESULTS: In contrast to C57Bl-mice, in mdx-mice, three weeks after BTX-A treatment a significant decrease of skull dimensions was noted in most of the measurements followed by a significant increase at the second investigation period.

CONCLUSIONS: BTX-A can induce changes in craniofacial morphology and presumably partially inhibit muscle regeneration in mdx-mice, but cannot completely intensify craniofacial effects elicited by dystrophy. Further research is necessary in order to fully understand muscle-bone interplay after BTX-A injection into dystrophic muscles.

PMID:33675949 | DOI:10.1016/j.aanat.2021.151715

J Shoulder Elbow Surg. 2021 Mar 3:S1058-2746(21)00148-8. doi: 10.1016/j.jse.2021.02.007. Online ahead of print.

ABSTRACT

BACKGROUND: Amid rising healthcare costs and recent advances in surgical and anesthetic protocols, outpatient joint arthroplasty has risen steadily in recent years. While the safety of outpatient total knee arthroplasty (TKA) and total hip arthroplasty (THA) has been well-established, outpatient shoulder arthroplasty is still in its infancy. The purpose of this study is to synthesize the current literature and to provide further data regarding the outcomes and safety of outpatient shoulder arthroplasty.

METHODS: A systematic review was conducted following the standard PRISMA guidelines. Included were papers that evaluated the outcomes of patients undergoing outpatient total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). Meta-analysis was conducted using Mantel-Haenszel statistics to generate odds ratios and their corresponding 95% confidence intervals comparing outpatient and inpatient shoulder arthroplasty.

RESULTS: Twelve studies were included with a total of 194,513 patients, of which, 7,162 were outpatients. Of the studies, eight were level III studies and four were level IV. The average age of the outpatients was 66.6 years and the average age of the inpatients was 70.1 years. The overall odds ratio of complications was significantly lower in outpatients (OR=0.40 [0.35-0.45]) than inpatients. There was no significant difference in 90-day readmission (OR=0.88 [0.75-1.03]), revision (OR=0.96 [0.65-1.41]), and infection rates (OR=0.93 [0.64-1.35]) when comparing outpatients to inpatients.

CONCLUSION: Outpatient total shoulder arthroplasty, in an appropriately selected patient population, is safe and results in comparable patient outcomes when compared to inpatient shoulder arthroplasty. Due to the expected increase in patients requiring total shoulder arthroplasty, surgeons, hospital administrators, and insurance carriers should strongly consider the merits of a cost and care efficient approach to total shoulder replacement.

PMID:33675972 | DOI:10.1016/j.jse.2021.02.007

Physiother Res Int. 2021 Mar 6. doi: 10.1002/pri.1902. Online ahead of print.

ABSTRACT

OBJECTIVES: To study the effectiveness of mirror therapy along with a Stroke rehabilitation program on oedema, pain intensity and functional activities in patients with shoulder-hand syndrome (SHS) after stroke.

DESIGN: Randomized controlled trial.

SETTINGS: Out-patient rehabilitation center.

METHODS: Thirty-eight SHS patients after stroke, were randomly allocated into two groups; both the groups received a 4-week stroke rehabilitation program, 30 min a day for 5 days a week. Control group patients performed all the exercises of stroke rehabilitation program, while directly visualizing their both limbs. Experimental group patients performed same exercises of stroke rehabilitation program in front of the mirror.

OUTCOME MEASURES: Oedema (figure-of-eight measurement method), pain intensity (0-10 Numeric Pain Rating Scale [0-10 NPRS]), functional activities (Functional Independence Measure [FIM]).

RESULTS: After intervention, both groups showed statistically significant (p < 0.05) improvement for all measures (oedema measurement, 0-10 NPRS and FIM). Improvements were more significant (p < 0.05) in the experimental group with mirror therapy for all three measures compared to the control group. Mean differences between groups were 1.40 cm for oedema measurement, 0.87 for NPRS score and 12.20 for FIM score. At 2-week follow-up, the improvements were sustained.

CONCLUSION: The current study may indicate mirror therapy as an effective central neuromodulatory rehabilitative program to reduce pain, improves functional activities. More distinctively, this preliminary study suggests a decrease in oedema by mirror therapy for SHS after stroke. Improvement of upper limb in SHS after stroke will be more perceptible with the decrease in oedema, being the characteristic sign, following mirror therapy. Clinically, patients during their daily functional activities, shall be more confident to use their upper limb following mirror therapy after reduction in oedema along with pain.

PMID:33675672 | DOI:10.1002/pri.1902

J Acquir Immune Defic Syndr. 2021 Feb 26. doi: 10.1097/QAI.0000000000002679. Online ahead of print.

ABSTRACT

BACKGROUND: Volatility in sexual contact rates has been recognized as an important factor influencing HIV transmission dynamics. One-time partnerships may be particularly important given the potential to quickly accumulate large number of contacts. Yet, empirical data documenting individual variation in contact rates remains rare. This study provides much needed data on temporal variation in one-time partners to better understand behavioral dynamics and improve the accuracy of transmission models.

METHODS: Data for this study from a longitudinal cohort study of young men who have sex with men (MSM) and transgender women in Chicago. Participants provided sexual network data every 6-months for 2 years. A series of random effects models examined variation in one-time partnership rates and disaggregated within and between associations of exposure variables. Exposure variables included prior number of one-time partners, number of casual partners, and having a main partner.

RESULTS: Results indicated substantial between and within person variation in one-time partners. Casual partnerships were positively associated and main partnerships negatively association with one-time partnership rates. There remained a small positive association between prior one-time partnerships and the current number of one-time partnerships.

CONCLUSIONS: Despite the preponderance of a low number of one-time partners, substantial variation in one-time partnership rates exists among young MSM and transgender women. Accordingly, focusing on high contact rate individuals alone may be insufficient to identify periods of highest risk. Future studies should utilize these estimates to more accurately model how volatility impacts HIV transmission and better understand how this variation influences intervention effectiveness.

PMID:33675616 | DOI:10.1097/QAI.0000000000002679

J Acquir Immune Defic Syndr. 2021 Feb 24. doi: 10.1097/QAI.0000000000002675. Online ahead of print.

ABSTRACT

BACKGROUND: Pillar 4 of the United States’ End the HIV Epidemic plan is to respond quickly to HIV outbreaks, but the utility of CDC’s tool for identifying HIV outbreaks via time-space cluster detection has not been evaluated. The objective of this evaluation is to quantify the ability of the CDC time-space cluster criterion to predict future HIV diagnoses and to compare it to a space-time permutation statistic implemented in SaTScan software.

SETTING: Washington state from 2017 to 2019.

METHODS: We applied both cluster criteria to incident HIV cases in Washington State to identify clusters. Using a repeated measures Poisson model, we calculated a rate ratio comparing the 6-months following cluster detection to a baseline rate from 24 to 12 months before the cluster was detected. We also compared the demographics of cases within clusters to all other incident cases.

RESULTS: The CDC criteria identified 17 clusters containing 192 cases in the 6-months following cluster detection, corresponding to a rate ratio of 1.25 (95% CI 0.95-1.65) relative to baseline. The time-space permutation statistic identified 5 clusters containing 25 cases with a rate ratio of 2.27 (95% CI 1.28-4.03). Individuals in clusters identified by the new criteria were more likely to be of Hispanic origin (61% vs 20%) and in rural areas (51% vs 12%).

CONCLUSIONS: The space time permutation cluster analysis is a promising tool for identification of clusters with the largest growth potential for whom interruption may prove most beneficial.

PMID:33675622 | DOI:10.1097/QAI.0000000000002675

Am J Clin Nutr. 2021 Mar 1:nqaa336. doi: 10.1093/ajcn/nqaa336. Online ahead of print.

ABSTRACT

BACKGROUND: Since December 2019, coronavirus disease 2019 (COVID-19) has been spreading steadily, resulting in overwhelmed health-care systems and numerous deaths worldwide. To counter these outcomes, many countries, including France, put in place strict lockdown measures, requiring the temporary closure of all but essential places and causing an unprecedented disruption of daily life.

OBJECTIVES: Our objective was to explore potential changes in dietary intake, physical activity, body weight, and food supply during the COVID-19 lockdown and how these differed according to individual characteristics.

METHODS: The analyses included 37,252 adults from the French web-based NutriNet-Santé cohort who completed lockdown-specific questionnaires in April-May 2020. Nutrition-related changes and their sociodemographic, lifestyle, and health-status correlates were investigated using multivariable logistic regression models. Clusters of participants were defined using an ascending hierarchical classification of change profiles derived from multiple correspondence analyses.

RESULTS: During the lockdown, trends of unfavorable changes were observed: decreased physical activity (reported by 53% of the participants), increased sedentary time (reported by 63%), increased snacking, decreased consumption of fresh food (especially fruit and fish), and increased consumption of sweets, cookies, and cakes. Yet, the opposite trends were also observed: increased home cooking (reported by 40%) and increased physical activity (reported by 19%). Additionally, 35% of the participants gained weight (mean weight gain in these individuals, 1.8 kg ± SD 1.3 kg) and 23% lost weight (2 kg ± SD 1.4 kg weight loss). All of these trends displayed associations with various individual characteristics.

CONCLUSIONS: These results suggest that nutrition-related changes occurred during the lockdown in both unfavorable and favorable directions. The observed unfavorable changes should be considered in the event of a future lockdown, and should also be monitored to prevent an increase in the nutrition-related burden of disease, should these diet/physical activity changes be maintained in the long run. Understanding the favorable changes may help extend them on a broader scale. This trial was registered at clinicaltrials.gov as NCT03335644.

PMID:33675635 | DOI:10.1093/ajcn/nqaa336

Ther Apher Dial. 2021 Mar 6. doi: 10.1111/1744-9987.13641. Online ahead of print.

ABSTRACT

INTRODUCTION: The specific tool for cardiovascular risk assessment in hemodialysis population has not yet been proposed, despite high prevalence of cardiovascular morbidity and mortality in clinically asymptomatic patients. Coronary artery calcium score (CACS), as a reliable predictor of future cardiovascular events, might be a valuable approach. We sought to evaluate coronary artery calcification burden and its association with clinical and laboratory parameters in asymptomatic patients who recently initiated hemodialysis.

METHODS: The cross-sectional study included 60 asymptomatic patients receiving chronic hemodialysis for no longer than 48 months. CACS was assessed by cardiac computed tomography. Intima-media thickness (IMT) of both common carotid and femoral arteries were measured using ultrasonography.

RESULTS: The mean total CACS was 160.50 (443). Patients’ age correlated significantly with CACS (σ=0.367; p=0.004), carotid (σ=0.375; p=0.004) and femoral IMT (σ=0.323; p=0.013). Patients with CACS=0 were significantly younger than patients with CACS >400: 52.4±7.91 vs. 63.88±8.37 years old, respectively (p=0.034). In patients receiving dialysis for longer than 24 months CACS, femoral and carotid IMT were higher than in those dialysed for less than 24 months; however none has reached significance. There was a significant positive correlation between CACS and right (σ=0.312; p=0.018) and left (σ=0.521; p<0.001) femoral IMT, while not with carotid. CACS showed significant negative correlation with the serum iron (σ=-0.351; p=0.007).

CONCLUSION: Calcification burden varies significantly in asymptomatic patients in early years of dialysis. It correlates with patients’ age and tends to increase with dialysis vintage. Femoral IMT might be useful for cardiovascular risk stratification in asymptomatic patients who recently initiated hemodialysis. This article is protected by copyright. All rights reserved.

PMID:33675568 | DOI:10.1111/1744-9987.13641

J Dig Dis. 2021 Mar 6. doi: 10.1111/1751-2980.12980. Online ahead of print.

ABSTRACT

AIM: Adiponectin is an adipokine that is involved in regulating hepatic fat and glucose metabolism, and also has anti-steatotic, anti-inflammatory and anti-fibrotic effects. How these different activities impact the development and progression of NAFLD is not well understood. The aim of this study was to evaluate both liver and serum adiponectin levels in patients with and without NAFLD and determine any clinical correlations.

METHODS: Liver tissue and serum samples were collected from patients undergoing liver biopsy between April 2014 and July 2020, and categorized based on histopathologic diagnosis into hepatic steatosis (HS), non-alcoholic steatohepatitis (NASH), and hepatitis control (HC). Luminex® xMAP assay was performed on both liver and serum samples to measure adiponectin levels. Statistical analysis compared liver adiponectin (LA) and serum adiponectin (SA) levels between groups.

RESULTS: 48 participants were included in the analysis with 4 in HS, 15 in NASH, and 29 in HC groups. The mean LA level was lowest in the HS group was 68.6% lower than that in the NASH group and 80.6% lower than that in the HC group (p=0.036). The mean SA level was 3.61 μg/ml for NAFLD group was significantly lower than that in the HC group, 7.51 μg/ml (p=0.001).

CONCLUSION: Adiponectin levels are lower in NAFLD compared to HC in both serum and in liver tissue. LA levels in HS patients were significantly lower than those both in NASH and HC groups, suggesting that adiponectin is related to inflammation in the liver, and probably reflects a role in pathogenesis of NAFLD. This article is protected by copyright. All rights reserved.

PMID:33675573 | DOI:10.1111/1751-2980.12980

J Neurol Phys Ther. 2021 Feb 24. doi: 10.1097/NPT.0000000000000349. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Individuals with benign paroxysmal positional vertigo (BPPV) are frequently referred to physical therapy for management, but little is known on how reliable therapists are at diagnosing BPPV. The purpose of the study was to examine the agreement between physical therapists in identifying nystagmus and diagnosing BPPV.

METHODS: Thirty-eight individuals with complaints of positional vertigo, 19 from each of 2 clinics (clinics 1 and 2) that specialize in vestibular rehabilitation, had eye movements recorded using video goggles during positioning tests including supine-to-sit, supine roll, and Dix-Hallpike tests. Three therapists from each of the clinics independently observed videos, documented nystagmus characteristics of each testing position, and made a diagnosis for each case. Kappa (κ) statistics were calculated between therapists within each clinic for nystagmus identification and diagnosis.

RESULTS: Clinic 1 therapists demonstrated substantial to almost perfect agreement in identifying nystagmus during positional tests (κ = 0.68-1, P < 0.005). Clinic 2 therapists showed moderate to almost perfect agreement for presence of nystagmus (κ = 0.57-1, P < 0.005). Therapists at both sites had almost perfect agreement of diagnosis side, canal, and mechanism (κ = 0.81-1, P < 0.005).

DISCUSSION AND CONCLUSION: Therapists utilized observations from multiple positional tests to determine diagnoses. This was evident by occasional disagreement in nystagmus presence and characteristics, but agreement in diagnosis, including ruling out BPPV. The results may not be generalizable to all physical therapists or therapists’ ability to diagnose central and atypical nystagmus presentations. Experienced physical therapists demonstrated strong agreement in diagnosing common forms of BPPV.Video Abstract available for more insight from the authors (see the Video Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A340).

PMID:33675601 | DOI:10.1097/NPT.0000000000000349