Categories
Nevin Manimala Statistics

Clinical and Radiographic Outcomes of Implants with Two Different Collar Surfaces in Treated Periodontitis Patients: A 10-Year Retrospective Study

Int J Periodontics Restorative Dent. 2021 Nov-Dec;41(6):e233-e242. doi: 10.11607/prd.4819.

ABSTRACT

This retrospective study compares clinical and radiographic results of implants with and without a laser-microtextured collar placed in patients with a past history of periodontitis after 10 years of follow-up. A total of 57 implants (29 implants with laser-microtextured collar, 28 implants with a smooth collar) were placed in 35 patients. After 10 years of follow up, the survival rates (SRs) were 87.9% and 84.8% for implants with and without a laser-microtextured collar, respectively. No statistically significant differences (P > .05) were found between groups in terms of full-mouth plaque and bleeding scores. However, a statistically significant difference (P < .05) was recorded in terms of probing depth (PD) and marginal bone loss (mBL). Within the limitations of this study, implants with a laser-microtextured collar and implants with a smooth collar placed in patients with a past history of periodontitis yielded no statistically significant differences in SRs after 10 years of follow-up. However, implants with a laser-microtextured collar showed lower PD and mBL compared to implants with a smooth collar.

PMID:34818389 | DOI:10.11607/prd.4819

Categories
Nevin Manimala Statistics

The association between involuntary alcohol treatment and subsequent emergency department visits and hospitalisations: a Bayesian analysis of treated patients and matched controls

Addiction. 2021 Nov 24. doi: 10.1111/add.15755. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Many nations have provisions for involuntary treatment of alcohol dependence where the person is at serious risk of harm to themselves. To date, there has been little thorough evaluation of its effectiveness. This study aimed to determine if there were differences between involuntary and voluntary treatment for alcohol dependence on subsequent emergency and hospital care.

DESIGN: A retrospective cohort design using linked routinely collected administrative data on health care utilisation.

SETTING: Hospital and community-based alcohol treatment, New South Wales, Australia.

PARTICIPANTS: 231 patients who were involuntarily treated for alcohol dependence, and 231 matched controls who received treatment as usual within the period May 2012 to April 2018.

INTERVENTION AND COMPARATOR: Involuntary treatment comprised a 28-day mandated hospital admission which included supervised withdrawal, comprehensive assessment, rehabilitation and support followed by voluntary aftercare support for up to 6 months. Treatment as usual comprised three not mutually exclusive forms of intensive voluntary alcohol treatment: withdrawal management, rehabilitation, and pharmacotherapies for alcohol dependence.

MEASUREMENTS: Outcome measures: changes in the number of emergency department (ED) visits and number of unplanned hospital admissions 12 months before and 12 months after completion of index treatment.

FINDINGS: Both groups showed a reduction in ED visits (Incidence Rate Ratio (IRR)=0.56, 95% Credible Intervals (CrI) 0.39-0.78) and unplanned hospital admissions (IRR=0.49, 95% CrI 0.37-0.65). There was no statistically significant difference between the two groups (IRR=0.77, 95% CrI: 0.58 – 1.03 for ED visits and IRR= 0.79, 95% CrI: 0.62-1.01 for hospital admissions). The Bayes factors were 0.925 and 0.936 for ED visits and unplanned hospital admissions, respectively, interpreted as weak evidence in support of the null hypothesis of no difference between the interventions.

CONCLUSIONS: Involuntary treatment of alcohol dependence was associated with reduced health service utilisation in the year following treatment, and the outcomes did not differ from those of a matched control group.

PMID:34817096 | DOI:10.1111/add.15755

Categories
Nevin Manimala Statistics

Preliminary Clinical Outcomes of VOIS-Implant in Patients With Unilateral Vocal Fold Paralysis

Laryngoscope. 2021 Nov 24. doi: 10.1002/lary.29958. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: Evaluation of the clinical outcomes after 6 months of treatment with a novel adjustable implant, the APrevent® Vocal-Implant-System (VOIS), in conjunction with medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis.

STUDY DESIGN: Prospective case series study at single tertiary referral center.

METHODS: Preoperative and 1 week, 7 weeks, and 6 months postoperative glottal efficiency (maximum phonation time [MPT]), voice quality (including GRBAS-scores and acoustic parameters) and self-perceived voice-related handicap (voice handicap index [VHI-30]) were measured and analyzed, whereas type of vocal fold closure was evaluated and determined by flexible videolaryngoscopy based on Södersten and Lindestad classification (Wilcoxon signed-rank test).

RESULTS: Thirteen patients underwent MT with VOIS under local anesthesia. Six months after surgery, the VHI-30 and MPT had improved from a preoperative mean of 75.0 ± 22.9 and 2.7 ± 2.1 s to a postoperative mean of 20.6 ± 19.7 and 6.3 ± 4.0 s, respectively. The mean GRBAS score improved from preoperative scores of Gpreop = 2.7, Rpreop = 2.6, Bpreop = 2.6, Apreop = 2.2, and Spreop = 2.0 to Gpostop = 0.3, Rpostop = 0.3, Bpostop = 0.2, Apostop = 0.2, and Spostop = 0.3 at 6 months postoperatively. Improved glottal closure was achieved in all patients (n = 13). Five patients received postoperative adjustment for the optimization of voice quality and glottal closure. No intra- or postoperative complications were observed. Significant improvements in acoustic parameters, including percentage jitter, percentage shimmer, and signal-to-noise ratio, were also observed after MT. All results were statistically significant (P < .05, Cohen’s d > .8).

CONCLUSIONS: APrevent® VOIS-Implantation is a safe procedure with good voice outcomes. Postoperative adjustments can be performed smoothly to optimize voice quality and glottal closure.

LEVEL OF EVIDENCE: III Laryngoscope, 2021.

PMID:34817072 | DOI:10.1002/lary.29958

Categories
Nevin Manimala Statistics

Bone microarchitecture, bone mineral density and bone turnover in association with glycemia and insulin action in women with prior gestational diabetes

Clin Endocrinol (Oxf). 2021 Nov 24. doi: 10.1111/cen.14641. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this cross-sectional study was to comprehensively assess bone health in women with prior gestational diabetes mellitus, including bone microarchitecture (TBS), bone mineral density (BMD, DXA) and bone turnover (osteocalcin).

DESIGN, PATIENTS AND MEASUREMENTS: Study participants underwent a detailed anthropometric, biochemical and hormone assessment, including insulin and osteocalcin measurement. BMD was measured at lumbar spine, femur neck and total hip using DXA and TBS derived from lumbar spine DXA images using TBS iNsight software.

RESULTS: A total of 240 women (mean age: 33.3 ± 5.0 years; median postpartum duration: 34 [interquartile range 13.0-54.5] months were evaluated. At the current visit, 115 (47.9%) and 36 (15%) women had prediabetes and diabetes, respectively. Women with dysglycemia (diabetes/prediabetes) had a higher BMD at all three sites, compared to those with normoglycemia; however, the difference was not statistically significant. Women with dysglycemia had a significantly lower TBS (1.32 ± 0.09 vs. 1.35 ± 0.09; p = .038). In the fully adjusted model, the odds ratio for association between diabetes and low TBS was 2.92 (95% confidence interval: 1.20, 7.08; p = .018). Women with dysglycemia had significantly lower serum osteocalcin levels (18.6 ± 8.5 ng/ml vs. 21.5 ± 9.7 ng/ml; p = .018). HOMA-IR (r = -.285, p < .001) was negatively correlated, while Matsuda index (r = .274, p < .001) and disposition index (r = .159, p = .016) were positively correlated with serum osteocalcin levels.

CONCLUSIONS: Bone health is affected early in the natural history of diabetes and is associated with an overall low bone turnover state.

PMID:34817083 | DOI:10.1111/cen.14641

Categories
Nevin Manimala Statistics

A bibliometric analysis of the top 100 most-cited case reports and case series in Endodontic journals

Int Endod J. 2021 Nov 24. doi: 10.1111/iej.13668. Online ahead of print.

ABSTRACT

AIM: To identify the top 100 most-cited case reports and case series published in Endodontic journals and to analyse their bibliometric characteristics.

METHODOLOGY: The Clarivate Analytics’ Web of Science (WoS), Scopus, and PubMed databases were used to identify the top 100 most-cited case reports and case series in Endodontic journals. Complete bibliographic records of the selected case reports and case series were exported in plain text or BibTeX format and imported into the R environment for statistical computing and graphics. The following parameters were then analysed: names and affiliations of the authors, title, year of publication, journal of publication, first author, corresponding author, literature cited within reports, language, citation counts, impact factor of the journal, keywords, Keywords Plus, and research topic.

RESULTS: In total, 88 case reports and 12 case series published in English between 1977 and 2016 were identified as the most-cited reports in the field of Endodontics. The terms ‘case report(s)’ or ‘case series’ were not included in the title of 57 articles. The number of authors per report ranged from one to seven, with the average number of co-authors per report being 3.14. The most cited author was M Trope (University of Pennsylvania, USA). The University of Washington and Private Practice, Cetraro, Italy were the most productive institutions. The country whose case reports received the largest total number of citations was the USA. The largest number of the most-cited reports appeared in 2002, 2004, and 2007 (n=7, respectively). According to the WoS database, the total number of citations ranged from 42 to 453, with the average number of citations per report being 79.97. The majority of the top 100 most-cited articles were published in the Journal of Endodontics and the International Endodontic Journal. The most frequently used author keywords were revascularization and mineral trioxide aggregate. The majority of the case reports and case series dealt with topics related to pulp regeneration.

CONCLUSION: This bibliometric study provides a comprehensive overview on the progress, trends and current directions in clinical practice within the field of Endodontics.

PMID:34817068 | DOI:10.1111/iej.13668

Categories
Nevin Manimala Statistics

Association between headache and tinnitus among medical students

Arq Neuropsiquiatr. 2021 Nov;79(11):982-988. doi: 10.1590/0004-282X-ANP-2021-0023.

ABSTRACT

BACKGROUND: Headache is a very common complaint and it is increasingly prevalent among university students. Tinnitus consists of subjectively perceived sounds that occur in the absence of an external auditory signal. Presence of headache and tinnitus in association has implications for therapy and prognosis, because this describes the temporality of the symptoms. Recognition of the epidemiological profile of symptomatic students might contribute to interventions.

OBJECTIVE: To investigate the prevalence of the association between headache and tinnitus, and to describe the epidemiological profile of the study population and the chronological order of appearance of these symptoms.

METHODS: Cross-sectional, observational and analytical study on a sample representative of an academic center. Data referring to the epidemiological and clinical profile of headache and tinnitus among medical students were collected through an online questionnaire built using the Google Forms tool.

RESULTS: Out of the 234 participants, 26.1% reported having tinnitus and headache (p < 0.001). The participants with headache were more likely to be women (p = 0.045), white (p = 0.009) and 21-25 years old (p = 0.356). Among right-sided, left-sided and non-unilateral headaches, tinnitus was present predominantly in the non-unilateral type, but without statistical significance. Regarding timing, 18.0% of the students said that tinnitus started before headache, 57.4% said that headache started before tinnitus and 24.6% said that they started simultaneously.

CONCLUSIONS: An important association between headache and tinnitus regarding lateralization and temporality was demonstrated. Thus, these data match the presumption that headache and tinnitus have a physiopathological connection.

PMID:34816995 | DOI:10.1590/0004-282X-ANP-2021-0023

Categories
Nevin Manimala Statistics

Cost-Effectiveness Analysis of Evolocumab Therapy in Patients at High Risk of Cardiovascular Events in the Context of the Brazilian Unified Health System

Arq Bras Cardiol. 2021 Nov;117(5):988-996. doi: 10.36660/abc.20200690.

ABSTRACT

BACKGROUND: Hypertrophic cardiomyopathy (HCM) and left ventricular hypertrophy (LVH) secondary to systemic hypertension (HTN) may be associated with left atrial (LA) functional abnormalities.

OBJECTIVES: We aimed to characterize LA mechanics in HCM and HTN and determine any correlation with the extent of left ventricular (LV) fibrosis measured by cardiac magnetic resonance (CMR) in HCM patients.

METHODS: Two-dimensional speckle tracking-derived longitudinal LA function was acquired from apical views in 60 HCM patients, 60 HTN patients, and 34 age-matched controls. HCM patients also underwent CMR, with measurement of late gadolinium enhancement (LGE) extension. Association with LA strain parameters was analyzed. Statistical significance was set at p<0.05.

RESULTS: Mean LV ejection fraction was not different between the groups. The E/e’ ratio was impaired in the HCM group and preserved in the control group. LA mechanics was significantly reduced in HCM, compared to the HTN group. LA strain rate in reservoir (LASRr) and in contractile (LASRct) phases were the best discriminators of HCM, with an area under the curve (AUC) of 0.8, followed by LA strain in reservoir phase (LASr) (AUC 0.76). LASRr and LASR-ct had high specificity (89% and 91%, respectively) and LASr had sensitivity of 80%. A decrease in 2.79% of LA strain rate in conduit phase (LASRcd) predicted an increase of 1cm in LGE extension (r2=0.42, β 2.79, p=0.027).

CONCLUSIONS: LASRr and LASRct were the best discriminators for LVH secondary to HCM. LASRcd predicted the degree of LV fibrosis assessed by CMR. These findings suggest that LA mechanics is a potential predictor of disease severity in HCM.

PMID:34817008 | DOI:10.36660/abc.20200690

Categories
Nevin Manimala Statistics

Maternal autonomy and the rights of the unborn child: a necessary discussion

Rev Assoc Med Bras (1992). 2021 Sep;67(9):1338-1341. doi: 10.1590/1806-9282.20210700.

ABSTRACT

OBJECTIVE: This study aimed to compare the opinion of freshmen and fifth-year students of the University of Sao Paulo School of Law in relation to the respect for maternal autonomy and knowledge of the existence and the need to protect the unborn child.

METHODS: Information was obtained from a questionnaire; responses were compared with appropriate statistical methods.

RESULTS: In total, 403 students answered the questionnaire, 75.2% being first-year students; 58.6% of the students were against State intervention in maternal autonomy, with no difference between groups. However, 55.1% of students were in favor of the defense of the welfare of the unborn, with the statistical difference between groups.

CONCLUSIONS: Among the first-year students, there is a contradiction about respect for maternal autonomy. Among the fifth-year students, most of them were unreservedly in favor of respect for maternal autonomy.

PMID:34816931 | DOI:10.1590/1806-9282.20210700

Categories
Nevin Manimala Statistics

Translation and cultural validation of the Revised Illness Perception Questionnaire for Healthcare Professionals for Brazilian Portuguese

Arq Neuropsiquiatr. 2021 Nov;79(11):995-1001. doi: 10.1590/0004-282X-ANP-2020-0451.

ABSTRACT

BACKGROUND: Multiple sclerosis progression and disability can be rated differently by healthcare professionals. Therefore, how physicians perceive the disease can impact treatment decisions. There are no previous studies on this matter.

OBJECTIVE: To translate and transculturally validate the Revised Illness Perception Questionnaire for Healthcare Professionals (IPQ-R HP), for use in Brazilian Portuguese.

METHODS: The process used to validate the IPQ-R HP was based on the steps presented in the guide proposed by Dorcas Beaton. The final version of the IPQ-R HP had 38 questions, divided into seven different dimensions to assess the patient’s disease. Also, two clinical cases that were representative of real-life patients with multiple sclerosis (MS) were assembled to consider the two main profiles of the disease. We applied the questionnaire to neurologists at the Federal University of São Paulo (UNIFESP) to assess their perception of MS. These doctors also answered a brief survey to establish the profile of the interviewees. For statistical analysis, we used Bayesian CFA models and kappa statistics.

CONCLUSIONS: The kappa statistics showed a general agreement of 0.4. For the Bayesian CFAs with seven-factor correlation solution, we had a poor fit for case 1 with a 95% confidence interval ranging from -52.893 to 273.797 and a PPP of 0.107. Regarding case 2, the model did not converge even after 50,000 iterations, which indicated that the specified model (i.e. seven-factor correlation solution) for case 2 was inadmissible. Thus, the IPQ-R HP questionnaire in Brazilian Portuguese has not been validated.

PMID:34816987 | DOI:10.1590/0004-282X-ANP-2020-0451

Categories
Nevin Manimala Statistics

Effects of the COVID-19 on the public interest in medical specialties in Brazil

Rev Assoc Med Bras (1992). 2021 Sep;67(9):1229-1232. doi: 10.1590/1806-9282.20201014.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the effects of the COVID-19 pandemic and the social isolation on the interest rates of different medical specialties in Brazil.

METHODS: The research was performed using the terms “Médico” (Doctor), “Infectologista” (Infectologist), “Cirurgião” (Surgeon), “Geriatra” (Geriatrician), “Otorrinolaringologista” (Otolaryngologist), and “Oftalmologista” (Ophthalmologist), related to several medical specialties, and “COVID-19,” which represented the public interest for the disease, utilizing the Brazilian version of Google Trends, where the data were acquired. The time range of this analysis was from 29 September, 2019 to 20 September, 2020. The data were tabulated in Microsoft Excel, exported to the Statistical Package for the Social Sciences software, and correlated with searches for the term “COVID-19” using Pearson’s correlation. 95% confidence interval was used for all analyses.

RESULTS: “Geriatra” (72.26±16.42) and “Cirurgião” (72.15±12.53) remained with the higher means among the evaluated specialties. In terms of standard deviation, “Oftalmologista” (64.71±16.72) and “Infectologista” (22.03±16.60) presented the most significant changes. After utilizing the Pearson’s analysis to identify the correlation between each medical specialty and the term “COVID-19,” all the evaluated specialties presented significant statistical correlations. “Oftalmologista” (r= -0.607) was notoriously the most negatively affected, while “Infectologista” (r=0.504) was pointed to have the highest positive correlation with the term.

CONCLUSIONS: Several changes in the interest rates of different medical specialties in Brazil were found during the time range of the COVID-19 pandemic.

PMID:34816912 | DOI:10.1590/1806-9282.20201014