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Evaluation of the effect of different sedative doses of dexmedetomidine on the intestinal motility in clinically healthy donkeys (Equus asinus)

BMC Vet Res. 2022 Jul 14;18(1):274. doi: 10.1186/s12917-022-03376-4.

ABSTRACT

AIM: Gastrointestinal effects of different doses of dexmedetomidine in donkeys are still unidentified. The current study aimed to evaluate the impact of different doses of dexmedetomidine on the motility of selected parts of the gastrointestinal tracts in donkeys using transabdominal ultrasonography.

MATERIALS AND METHODS: An experimental crossover study was conducted on 30 healthy donkeys of both sexes (15 males and 15 females; 160 ± 60 kg). With a two-week washout period, each donkey received an injection of either a normal saline solution or three different doses of dexmedetomidine (3, 5, and 7 μg/kg, respectively). All medications were administered intravenously in equal volumes. The contractility of selected intestinal segments (duodenum, jejunum, left colon, right colon, and cecum) was measured 3 min before administration (zero time) and at 15, 30, 45, 60, 90, and 120 minutes after administration.

RESULTS: Small and large intestinal motility was within the normal ranges before IV injection of normal isotonic saline or dexmedetomidine at a dose of 3, 5, and 7 μg/kg. Two Way Repeated Measures ANOVA output of the data displayed a statistically significant the between time and treatments for the contractility of each of the duodenum (P = 0.0029), jejunum (P = 0.0033), left colon (P = 0.0073), right colon (P = 0.0035), and cecum (P = 0.0026), implying that the impact of treatment on the gastric motility varied among different time points. The simple main effect analysis revealed that the IV dexmedetomidine at 3, 5, and 7 μg/kg doses significantly inhibited (P ≤ 0.01) the bowel contractility compared to the administration of isotonic saline.

CONCLUSION: Dose-dependent inhibitory effect of dexmedetomidine on intestinal motility was reported in donkeys following intravenous administration. This inhibitory effect on intestinal motility should be considered in clinical practice.

PMID:35836159 | DOI:10.1186/s12917-022-03376-4

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Shoulder muscle changes in patients with type 2 diabetes mellitus who have a painful shoulder: a quantitative muscle ultrasound study

BMC Musculoskelet Disord. 2022 Jul 14;23(1):674. doi: 10.1186/s12891-022-05627-9.

ABSTRACT

BACKGROUND: It is assumed that in patients with diabetic neuropathy, muscle denervation can result in shoulder disorders. Muscle denervation will lead to changes in muscle architecture, which can be assessed by quantitative muscle ultrasound (QMUS). The aim was to investigate whether increased muscle echogenicity, as a sign of neuropathy, is more often present in patients with shoulder pain who have type 2 diabetes mellitus (T2DM) than in those without.

METHODS: Sixty-six patients with T2DM and 23 patients without diabetes mellitus (DM) having shoulder pain were included. Quantitative muscle ultrasound images were obtained bilaterally from the biceps brachii, deltoid, and supra- and infraspinatus muscles. The mean echogenicity (muscle ultrasound grey value) was transformed into z-scores and compared to reference values obtained from 50 healthy participants. Associations between muscle echogenicity and clinical variables were explored.

RESULTS: In painful shoulders of both patients with T2DM and patients without DM, mean echogenicity z-scores of all muscles were significantly increased compared to healthy controls. No significant differences in echogenicity between patients with T2DM and those without DM were found. In patients with T2DM, a distal symmetric polyneuropathy was significantly associated with increased echogenicity of all muscles except the infraspinatus muscle.

CONCLUSIONS: These findings indicate that patients with painful shoulders, irrespective of having T2DM, seem to have abnormal shoulder muscles. Future studies are needed to elucidate whether neuropathy or other conditions lead to these muscle changes.

PMID:35836153 | DOI:10.1186/s12891-022-05627-9

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The effect of a theory-based educational program on southern Iranian prisoners’ HIV preventive behaviors: a quasi-experimental research

BMC Public Health. 2022 Jul 14;22(1):1342. doi: 10.1186/s12889-022-13763-z.

ABSTRACT

BACKGROUND: The present research explored the effect of an educational program based on the health belief model (HBM) on prisoners’ HIV preventive behaviors in the south of Iran.

METHODS: The present quasi-experimental research was conducted in 2019-20 on 280 prisoners, 140 in the control group (CG) and 140 in the intervention group (IG). The sampling was simple randomized. The data were collected using a questionnaire in two parts, one exploring the demographic information and the other the HBM constructs. The final follow-up was completed 3 months after the educational intervention (8 sessions long) in November 2020.

RESULTS: After the intervention, statistically significant between-group differences were found in the healthy behavior score and all HBM constructs except for the perceived barriers (p < 0.001). Perceived severity and susceptibility were found to be the strongest predictors of HIV preventive behaviors.

CONCLUSION: The educational intervention showed to positively affect the adoption of preventive behaviors mediated by the HBM constructs. To remove barriers to HIV preventive behaviors or any other healthy behavior, researchers are suggested to develop multi-level interventions (beyond the personal level) to gain better findings.

PMID:35836148 | DOI:10.1186/s12889-022-13763-z

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Comparison of flash-free and conventional bonding systems: A systematic review and meta-analysis

Angle Orthod. 2022 Jul 14. doi: 10.2319/122221-932.1. Online ahead of print.

ABSTRACT

OBJECTIVES: To review the literature systematically to compare the performance of adhesive precoated flash-free bonding systems with conventional adhesive precoated (APC) and operator-coated (OPC) bonding systems.

MATERIALS AND METHODS: PubMed, Cochrane Library, Web of Science, and Embase were searched for potential eligible studies. Study selection and data collection were conducted independently. Statistical analysis was performed by Review Manager 5.3. The Cochran Q test was used to test heterogeneity in the included studies. Risk of bias was evaluated using Cochrane RoB 2.0 tool for randomized controlled trials.

RESULTS: Six studies were included and the overall risk-of-bias judgment was low risk of bias to some concerns. The results of the meta-analyses showed that flash-free required significantly less bonding time than APC (mean difference [MD]: -1.56; 95% confidence intervals [CIs]: -2.56 to -0.56), and no significant differences were found in bond failure rates (risk ratio [RR]: 1.54; 95% Cis: 0.27 to 8.89) and adhesive remnant index (ARI) (MD: -0.50; 95% CIs: -1.14 to 0.14) between them. Qualitative analysis showed that flash-free might have a positive effect on enamel demineralization compared to APC but the quantity of plaque did not differ between them.

CONCLUSIONS: The flash-free bonding system significantly reduced bonding time and it had comparable bond failure rates with APC. So far, there is not enough evidence to support its positive effect on reducing enamel demineralization and the pathogenic bacteria around brackets. In summary, flash-free might be a better choice for clinical bracket bonding.

PMID:35834818 | DOI:10.2319/122221-932.1

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Indirect bonding: an in-vitro comparison of a Polyjet printed versus a conventional silicone transfer tray

Angle Orthod. 2022 Jul 14. doi: 10.2319/122021-925.1. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate and compare transfer accuracy between a Polyjet printed indirect bonding (IDB) tray (SureSmile, Dentsply Sirona, Richardson, TX, USA) and a conventional two-layered silicone tray.

MATERIALS AND METHODS: Plaster models of 24 patients were digitized with an intraoral scanner, and brackets and tubes were positioned virtually on the provider’s homepage. IDB trays were designed over the planned attachments and Polyjet 3D-printed. For the conventional tray, brackets and tubes were bonded in their ideal positions manually before fabricating a two-layered silicone tray. For both trays, attachments were transferred indirectly to corresponding models. A second scan was performed of each bonded model to capture actual attachment positions, which were then compared to initial bracket positions using Geomagic Control (3D Systems Inc., Rock Hill, SC, USA). Linear and angular deviations were evaluated for each attachment within a clinically acceptable range of ≤0.2 mm and 1°. A descriptive statistical analysis and a mixed model were executed.

RESULTS: Both trays showed highest accuracy in the orobuccal direction (99.5% for the 3D-printed tray and 100% for the conventional tray). For the 3D-printed tray, most frequent deviations were found for torque (15.4%) and, for the silicone tray, for rotation (1.9%). A significant difference was observed for angular measurements (P = .004) between the trays.

CONCLUSIONS: Transfer accuracy of Polyjet printed IDB tray is not as high as transfer accuracy of the conventional silicone tray, though both trays show good results and are suitable for clinical application.

PMID:35834817 | DOI:10.2319/122021-925.1

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Telemedicine and Socioeconomics in Orthopaedic Trauma Patients: A Quasi-Experimental Study During the COVID-19 Pandemic

J Am Acad Orthop Surg. 2022 Jul 12. doi: 10.5435/JAAOS-D-21-01143. Online ahead of print.

ABSTRACT

INTRODUCTION: Socioeconomic factors may introduce barriers to telemedicine care access. This study examines changes in clinic absenteeism for orthopaedic trauma patients after the introduction of a telemedicine postoperative follow-up option during the COVID-19 pandemic with attention to patient socioeconomic status (SES).

METHODS: Patients (n = 1,060) undergoing surgical treatment of pelvic and extremity trauma were retrospectively assigned to preintervention and postintervention cohorts using a quasi-experimental design. The intervention is the April 2020 introduction of a telemedicine follow-up option for postoperative trauma care. The primary outcome was the missed visit rate (MVR) for postoperative appointments. We used Poisson regression models to estimate the relative change in MVR adjusting for patient age and sex. SES-based subgroup analysis was based on the Area Deprivation Index (ADI) according to home address.

RESULTS: The pre-telemedicine group included 635 patients; the post-telemedicine group included 425 patients. The median MVR in the pre-telemedicine group was 28% (95% confidence interval [CI], 10% to 45%) and 24% (95% CI, 6% to 43%) in the post-telemedicine group. Low SES was associated with a 40% relative increase in MVR (95% CI, 17% to 67%, P < 0.001) compared with patients with high SES. Relative MVR changes between pre-telemedicine and post-telemedicine groups did not reach statistical significance in any socioeconomic strata (low ADI, -6%; 95% CI, -25% to 17%; P = 0.56; medium ADI, -18%; 95% CI, -35% to 2%; P = 0.07; high ADI, -12%; 95% CI, -28% to 7%; P = 0.20).

CONCLUSIONS: Low SES was associated with a higher MVR both before and after the introduction of a telemedicine option. However, no evidence in this cohort demonstrated a change in absenteeism based on SES after the introduction of the telemedicine option. Clinicians should be reassured that there is no evidence that telemedicine introduces additional socioeconomic bias in postoperative orthopaedic trauma care.

LEVEL OF EVIDENCE: III.

PMID:35834815 | DOI:10.5435/JAAOS-D-21-01143

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The tension of the iliopsoas tendon more than doubles during extension of the dysplastic hip in open reduction

J Pediatr Orthop B. 2022 Jul 14. doi: 10.1097/BPB.0000000000000999. Online ahead of print.

ABSTRACT

The role of the iliopsoas as an obstructing and re-dislocating factor in developmentally dislocated hips is unclear. The purpose of this article is to determine the change in the iliopsoas’ tension during flexion and extension when performing an open reduction. We evaluated 34 hips undergoing an anterior open reduction for a developmental dislocation. At the time of surgery, we identified the iliopsoas, and before sectioning it as part of the open reduction, we measured the tension while cycling the reduced hip through flexion and extension. We performed statistical analysis using Pearson and Spearman correlation tests. We created an initial tension artificially at 20 N with the hip held in 90º of flexion, which then doubled to a mean of 42 N when placed in extension. We found a significant increase in tension when the hip went below 20º of flexion. We also found the correlation between the angle of the hip and the force of tension to be statistically significant (P = 0.003). This study provides quantitative support that the tension of the iliopsoas tendon increases significantly in extension when performing an open reduction of a developmentally dislocated hip.

PMID:35834787 | DOI:10.1097/BPB.0000000000000999

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Overall Survival Results From the POLO Trial: A Phase III Study of Active Maintenance Olaparib Versus Placebo for Germline BRCA-Mutated Metastatic Pancreatic Cancer

J Clin Oncol. 2022 Jul 14:JCO2101604. doi: 10.1200/JCO.21.01604. Online ahead of print.

ABSTRACT

PURPOSE: The phase III POLO study demonstrated significant progression-free survival (PFS) benefit for active olaparib maintenance therapy versus placebo for patients with metastatic pancreatic adenocarcinoma and a germline BRCA mutation. Here, we report the final analysis of overall survival (OS) and other secondary end points.

PATIENTS AND METHODS: Patients with a deleterious or suspected deleterious germline BRCA mutation whose disease had not progressed after ≥ 16 weeks of first-line platinum-based chemotherapy were randomly assigned 3:2 to active maintenance olaparib (300 mg twice daily) or placebo. The primary end point was PFS; secondary end points included OS, time to second disease progression or death, time to first and second subsequent cancer therapies or death, time to discontinuation of study treatment or death, and safety and tolerability.

RESULTS: In total, 154 patients were randomly assigned (olaparib, n = 92; placebo, n = 62). No statistically significant OS benefit was observed (median 19.0 v 19.2 months; hazard ratio [HR], 0.83; 95% CI, 0.56 to 1.22; P = .3487). Kaplan-Meier OS curves separated at approximately 24 months, and the estimated 3-year survival after random assignment was 33.9% versus 17.8%, respectively. Median time to first subsequent cancer therapy or death (HR, 0.44; 95% CI, 0.30 to 0.66; P < .0001), time to second subsequent cancer therapy or death (HR, 0.61; 95% CI, 0.42 to 0.89; P = .0111), and time to discontinuation of study treatment or death (HR, 0.43; 95% CI, 0.29 to 0.63; P < .0001) significantly favored olaparib. The HR for second disease progression or death favored olaparib without reaching statistical significance (HR, 0.66; 95% CI, 0.43 to 1.02; P = .0613). Olaparib was well tolerated with no new safety signals.

CONCLUSION: Although no statistically significant OS benefit was observed, the HR numerically favored olaparib, which also conferred clinically meaningful benefits including increased time off chemotherapy and long-term survival in a subset of patients.

PMID:35834777 | DOI:10.1200/JCO.21.01604

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Evaluation of Ring Amplitude and Factors Affecting Ring Amplitude in Multifocal Electroretinography in Diabetic Eyes

Semin Ophthalmol. 2022 Jul 14:1-7. doi: 10.1080/08820538.2022.2100714. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this paper was to evaluate the ring amplitudes in diabetic patients and to evaluate the effect of the risk factors for diabetic retinopathy on the ring amplitudes. We also aimed to investigate the success of ring amplitudes in classifying diabetic retinopathy.

METHODS: The study included 32 eyes of 32 diabetic patients without retinopathy (DM), 34 eyes of 34 patients with mild non-proliferative diabetic retinopathy (NPDR) without macular edema, and 62 eyes of 62 age- and sex-matched controls (CG). All subjects were evaluated using mfERG. The relationship between age, diabetes duration, HbA1c and ring amplitudes and the effect of diabetes and hypertension on ring amplitudes were evaluated. Three-way ROC analysis was performed to evaluate the discrimination power of the ring amplitudes.

RESULTS: In the comparison of the ring amplitudes, the amplitudes of the DM and NPDR groups were statistically significantly decreased compared to the CG (p < .05). A moderate to strong correlation was found between the duration of diabetes, HbA1c and ring amplitudes (p < .05). The effect of diabetes decreased towards the peripheral rings and hypertension did not affect ring amplitudes. Volume under the ROC surface of R1 = 0.65 had p < .05 and 95% CI [0.50-0.72], and the best cut-off point pair to differentiate the three classes was found to be c1 = 217.3, c2 = 151.2 in three-way ROC analysis.

CONCLUSION: In conclusion, the effects of diabetes are unevenly distributed on the retina topographically. Diabetes affects the central rings more than peripheral rings in multifocal ERG. Both ring densities and ring ratios are effective ways to identify early changes in retinal function.

PMID:35834721 | DOI:10.1080/08820538.2022.2100714

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Kinetic and Kinematic Characteristics of Running During Regular Training Sessions for Collegiate Distance Runners Using Shoe Based Wearable Sensors

J Athl Train. 2022 Jul 14. doi: 10.4085/1062-6050-0703.21. Online ahead of print.

ABSTRACT

CONTEXT: Assessment of running mechanics has traditionally been conducted in laboratory settings; the advancement of wearable technology permits data collection during outdoor training sessions. Exploring changes in running mechanics across training session types may assist runners, coaches, and sports medicine clinicians in improving performance and managing injury risk.

OBJECTIVE: The purpose of this investigation was to examine changes in running mechanics based on routine training session types.

DESIGN: Descriptive observational study.

SETTING: Field-based, university.

METHODS: Running mechanics data (i.e., impact g (PI), stride length(SL), braking g (BF), total shock, and cadence, and ground contact time (GCT)) for National Collegiate Athletic Association (NCAA) Division 1 distance runners (males, n=20) were collected using RunScribe™ sensors mounted to the laces during training sessions (long run (LR), interval run (IR), and/or recovery run (RR)) during a one-week period.

RESULTS: Repeated measures ANCOVA with Greenhouse Geisser correction, with training session pace as a covariate, determined no statistically significant differences in spatiotemporal or kinetic measures across the three training session types. Cadence and SL were inversely related in all training sessions (LR: r=-0.673, p=0.004; IR: r=-0.893, p=<0.001; RR: r=-0.549, p=0.023). Strong positive correlations were seen between PI and total shock in all training sessions (LR: r=0.894, p<0.001; IR: r=0.782, p=<0.001; RR: r=0.922, p<0.001). GCT increased with SL during LR training sessions (r=0.551, p=0.027) and decreased with BF in IR training sessions (r=-0.574, p=0.016) and cadence in RR training sessions (r=-0.487, p=0.048).

CONCLUSION: Running mechanics were not statistically different between training session type in collegiate distance runners when controlling for training session pace. The use of wearable technology provides a tool to provide necessary data during overland training to inform training and program design.

PMID:35834715 | DOI:10.4085/1062-6050-0703.21