bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of infrapatellar neuropathy post-total knee replacement and arthroscopic surgery in Egyptian patients
Authors: Saif Dalia Salah , Eltabl Mohamed Ahmed 
Published: October 2020

Abstract
Background
The infrapatellar branch of the saphenous nerve (IPBSN) contains only sensory fibers that innervate the knee regarding its anteromedial aspect and the anterior-inferior portion of its capsule. IPBSN damage has been recorded as a postoperative complication of surgery about the knee, which is manifested by pain, numbness and reflex sympathetic dystrophy. The incisions made for arthroscopy, medial arthrotomy, and anterior cruciate ligament surgery also, can causes IPBSN damage in about 0.5 to 30% of cases. We aimed to study the frequency of infrapatellar branches of the saphenous nerve entrapment/injured in Egyptian patients to find the incidence of its affection in post-operative knee surgeries and to increase the awareness of this condition.

Results
Ninety patients complaining pain at the antero-medial aspect of the knee were collected and divided into 3 groups: G1 included 30 patients with a history of total knee replacement, G2 included 30 patients with a history of knee arthroscopy and G3 included 30 patients with non-specific knee pain. All patients went to clinical, electrophysiological study and laboratory measures.
There was a significant statically differences of sensory nerve conduction study regarding latency and amplitude of infrapatellar nerve between the three groups and significant statically differences of clinical signs among patients of the studied groups regarding Hofmann-Tinel sign and pain provocation test.

Conclusion
The entrapment/injury of IPBSN is an underestimated sometimes unrecognized cause of post-operative knee pain to many clinicians. Awareness of this condition would probably help in managing these cases to decrease post-operative pain and disability as the frequency of infrapatellar neuropathy post total knee replacement was 56.6% and post arthroscopic surgery was 63.3% in cohort of Egyptian patients.
Aldosterone is Aberrantly Regulated by Various Stimuli in a High Proportion of Patients with Primary Aldosteronism
Authors: St-Jean Matthieu , Bourdeau Isabelle , Martin Marc , Lacroix André 
Published: October 2020

Abstract

Context
In primary aldosteronism (PA), aldosterone secretion is relatively independent of the renin–angiotensin system, but can be regulated by several other stimuli.

Objective
To evaluate aldosterone response to several stimuli in a series of patients with PA secondary either to bilateral adrenal hyperplasia (BAH) or unilateral aldosterone-producing adenoma (APA).

Design and setting
Prospective cohort study conducted in a university teaching hospital research center.

Patients
Forty-three patients with confirmed PA and subtyped by adrenal vein sampling (n = 39) were studied, including 11 with BAH, 28 with APA, and 4 with undefined etiology. We also studied 4 other patients with aldosterone and cortisol cosecretion.

Interventions
We systematically explored aberrant regulation of aldosterone using an in vivo protocol that included the following stimulation tests performed over 3 days under dexamethasone suppression: upright posture, mixed meal, adrenocorticotropin (ACTH) 1-24, gonadotropin-releasing hormone (GnRH), vasopressin, and serotonin R4 agonist.

Main outcome measures
Positive response was defined as &gt;50% renin or ACTH-independent increase in plasma aldosterone/cortisol concentration following the various stimulation tests.

Results
Renin-independent aldosterone secretion increased in response to several aberrant stimuli (upright posture, GnRH) in up to 83% of patients with APA or BAH in whom ACTH 1-24 and HT4R agonists also produced aldosterone oversecretion in all patients. The mean significant aberrant responses per patient was similar in BAH (4.6) and in APA (4.0).

Conclusions
Aldosterone secretion in PA is relatively autonomous from the renin–angiotensin system, but is highly regulated by several other stimuli, which contributes to the large variability of aldosterone levels in PA patients.
Weight Loss for Obese Prostate Cancer Patients on Androgen Deprivation Therapy
Authors: WILSON REBEKAH L. , NEWTON ROBERT U. , TAAFFE DENNIS R. , HART NICOLAS H. , LYONS-WALL PHILIPPA , GALVÃO DANIEL A. 
Published: October 2020

ABSTRACT

Purpose
Excess fat mass (FM) contributes to poor prostate cancer (PCa) prognosis and comorbidity. However, FM gain is a common side effect of androgen deprivation therapy (ADT). We examined the efficacy of a 12-wk weight loss intervention to reduce FM and maintain lean mass (LM) in ADT-treated obese PCa patients.

Methods
Fourteen ADT-treated obese PCa patients (72 ± 9 yr, 39.7% ± 5.4% body fat) were recruited for a self-controlled prospective study, with 11 completing the 6-wk control period, followed by a 12-wk intervention comprising 300 min·wk−1 of exercise including supervised resistance training and home-based aerobic exercise, and dietitian consultations advising a daily energy deficit (2100–4200 kJ) and protein supplementation. Body composition was assessed by dual x-ray absorptiometry. Secondary outcomes included muscle strength (one-repetition maximum), cardiorespiratory fitness (maximal oxygen consumption), and blood biomarkers.

Results
There were no significant changes during the control period. Patients attended 89% of supervised exercise sessions and 100% of dietitian consultations. No changes in physical activity or energy intake were observed. During the intervention, patients experienced significant reductions in weight (−2.8 ± 3.2 kg, P = 0.016), FM (−2.8 ± 2.6 kg, P < 0.001), and trunk FM (−1.8 ± 1.4 kg, P < 0.001), with LM preserved (−0.05 ± 1.6 kg, P = 0.805). Muscle strength (4.6%–24.7%, P < 0.010) and maximal oxygen consumption (3.5 ± 4.7 mL·min−1·kg−1, P = 0.041) significantly improved. Leptin significantly decreased (−2.2 (−2.7 to 0.5) ng·mL−1, P = 0.016) with no other changes in blood biomarkers such as testosterone and lipids (P = 0.051–0.765); however, C-reactive protein (r
s = −0.670, P = 0.024) and triglycerides (r = −0.667, P = 0.025) were associated with individual changes in LM.

Conclusions
This study shows preliminary efficacy for an exercise and nutrition weight loss intervention to reduce FM, maintain LM, and improve muscle strength and cardiorespiratory fitness in ADT-treated obese PCa patients. The change in body composition may affect blood biomarkers associated with obesity and PCa progression; however, further research is required.
Impact of PI-RADS Category 3 lesions on the diagnostic accuracy of MRI for detecting prostate cancer and the prevalence of prostate cancer within each PI-RADS category: A systematic review and meta-analysis
Authors: Wadera Akshay , Alabousi Mostafa , Pozdnyakov Alex , Kashif Al-Ghita Mohammed , Jafri Ali , McInnes Matthew DF , Schieda Nicola , van der Pol Christian B , Salameh Jean-Paul , Samoilov Lucy , Gusenbauer Kaela , Alabousi Abdullah 
Published: October 2020

Objective:
To evaluate Prostate Imaging Reporting and Data System (PI-RADS) category 3 lesions’ impact on the diagnostic test accuracy (DTA) of MRI for prostate cancer (PC) and to derive the prevalence of PC within each PI-RADS category.

Methods:
MEDLINE and Embase were searched until April 10, 2020 for studies reporting on the DTA of MRI by PI-RADS category. Accuracy metrics were calculated using a bivariate random-effects meta-analysis with PI-RADS three lesions treated as a positive test, negative test, and excluded from the analysis. Differences in DTA were assessed utilizing meta-regression. PC prevalence within each PI-RADS category was estimated with a proportional meta-analysis.

Results:
In total, 26 studies reporting on 12,913 patients (4,853 with PC) were included. Sensitivities for PC in the positive, negative, and excluded test groups were 96% (95% confidence interval [CI] 92–98), 82% (CI 75-87), and 95% (CI 91-97), respectively. Specificities for the positive, negative, and excluded test groups were 33% (CI 23-44), 71% (CI 62-79), and 52% (CI 37-66), respectively. Meta-regression demonstrated higher sensitivity (p &lt; 0.001) and lower specificity (p &lt; 0.001) in the positive test group compared to the negative group. Clinically significant PC prevalences were 5.9% (CI 0-17.1), 11.4% (CI 6.5–17.3), 24.9% (CI 18.4–32.0), 55.7% (CI 47.8–63.5), and 81.4% (CI 75.9–86.4) for PI-RADS categories 1, 2, 3, 4 and 5, respectively.

Conclusion:
PI-RADS category 3 lesions can significantly impact the DTA of MRI for PC detection. A low prevalence of clinically significant PC is noted in PI-RADS category 1 and 2 cases.

Advances in knowledge:
Inclusion or exclusion of PI-RADS category 3 lesions impacts the DTA of MRI for PC detection.
Ultrasound in the diagnosis of parotid duct obstruction not caused by sialolithiasis: diagnostic value in reference to direct visualization with sialendoscopy
Authors: Goncalves Miguel , Mantsopoulos Konstantinos , Schapher Mirco , Iro Heinrich , Koch Michael 
Published: October 2020

Objectives: The aim of this study was to evaluate the diagnostic value of ultrasound in the obstructive pathology of the parotic gland not caused by sialolithiasis using sialendoscopy as reference standard. Methods: Retrospective analysis of all patients who presented with suspected diagnosis of obstructive ductal pathology of the parotid gland other than sialolithiasis between January 2011 and December 2017. 538 patients, for a total of 691 parotid glands were included in the study. Ultrasound was performed, followed by sialendoscopy in all cases. Duct diameter and parenchyma echogenicity were assessed. Direct sialendoscopic examination of the parotid duct was regarded as the reference standard. Results: Parotid glands with normal sialendoscopic findings (21.6%, n = 149) had a duct diameter of 0.3 mm (0–2.7 mm) and homogeneous hyperechoic parenchyma on ultrasound in 98.7%. Ductal inflammation/sialodochitis (32.9%, n = 227) on sialendoscopy had significantly larger ductal diameter of 0.7 mm (0–4.3 mm, p = 0.001) and hypoechoic parenchyma in 78.0% (p < 0.001). Parotid glands with stenosis (45.6%, n = 315) had hypoechoic parenchyma in 52.6% and a ductal diameter of 4.1 mm (0–19.0 mm; p = 0.001). The ductal diameter was ≥2.7 mm in 95.6% of the stenosis (AUC 0.886, p = 0.001). Using 5.1 mm as benchmark ductal diameter, stenosis with ductal anomaly (68/315) were identifiable with a sensitivity of 92.6% and a specificity of 96.8% (AUC 0.986, p = 0.001). Conclusion: Ultrasound parameters can be used to distinguish different types of obstructive ductal pathology of the parotid gland, supporting the use of this imaging modality as diagnostic tool of first choice.
Impact of Gastric Sleeve Surgery on Plasma Retinol Binding Protein 4 and Adipsin Levels in Healthy Male Population
Authors: Alshubrami Suad , Al-Regaiey Khalid , Al-Fadda Assim , Iqbal Muhammad 
Published: October 2020

Objectives: Bariatric surgery provides most substantial and sustainable weight loss measures in individuals with obesity. Caloric restriction is not only intervention, changes in hormonal secretions are also leading contributory mechanisms to reduce body weight and improve the glycaemic control. The aim of this study was to evaluate the impact of gastric sleeve surgery on plasma retinol binding protein 4 (RBP4) and adipsin levels among Saudi male obese population.
Methods: This prospective study was conducted in the Departments of Physiology and Surgery, College of Medicine, King Saud University. Thirty-three obese (BMI>38.3) male patients age ranged from 25 to 50 years were recruited. RBP4 and adipsin levels were analyzed before and 6-12 months after gastric sleeve surgery by ELISA along with plasma glucose, insulin, HOMA-IR and lipid profile.
Results: Circulating RBP4 levels were not significantly changed by bariatric surgery (4382.85±40.35 ng before, and 4393.28±33.13 ng after surgery, p=0.842), neither did adipsin (2949.68±46.86 pg before, and 2917.90±41.90 pg after surgery, p=0.535). Segregation of study participants into two age groups, 25-35 and 35-50 years of age, revealed that before surgery older age group (35-50) had higher RBP4 levels compared to younger group (25-35) (p=0.016). However, after surgery RBP4 levels were decreased in older group but not to a significant level (p=0.174). In younger age group after surgery, there was a near significant increase in RBP4 levels (p=0.052). There were no significant changes in RBP4 levels in both age groups after surgery (p=0.461). For adipsin, there were no significant differences before and after surgery in both age groups. Insulin, BMI and HOMA-IR index were decreased after surgery, however there was no correlation with RBP4 and adipsin levels.
Conclusions: The present study findings do not suggest a role for RBP4 and adipsin in the improvement of insulin sensitivity in Saudi male obese population after gastric sleeve surgery. However, a decrease in RBP4 levels in older individuals after surgery needs further investigations to understand its effect on weight and glycemic control.
doi: https://doi.org/10.12669/pjms.36.7.2329
How to cite this:Alshubrami S, Al-Regaiey K, Alfadda AA, Iqbal M. Impact of Gastric Sleeve Surgery on Plasma Retinol Binding Protein 4 and Adipsin Levels in Healthy Male Population. Pak J Med Sci. 2020;36(7):1495-1499. doi: https://doi.org/10.12669/pjms.36.7.2329
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states
Authors: Kane Sumit , Dayal Prarthna , Mahapatra Tanmay , Kumar Sanjiv , Bhasin Shikha , Gore Aboli , Das Aritra , Reddy Sandeep , Mahal Ajay , Krishnan Suneeta , Kermode Michelle 
Published: October 2020

Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by analyzing the implementation of an organizational change intervention in a large, hierarchical and bureaucratic public service in a LMIC health system. Methods: Using qualitative methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.
Has COVID-19 affected the number and severity of visits to a traumatology emergency department?
Authors: Esteban Pedro L. , Querolt Coll Jordi , Xicola Martínez Marina , Camí Biayna Joan , Delgado-Flores Luis 
Published: October 2020

Aims To assess the impact of the declaration of the state of emergency due to the COVID-19 pandemic on the number of visits to a traumatology emergency department (ED), and on their severity. Methods Retrospective observational study. All visits to a traumatology ED were recorded, except for consultations for genitourinary, ocular and abdominal trauma and other ailments that did not have a musculoskeletal aetiology. Visit data were collected from March 14 to April 13 2020, and were subsequently compared with the visits recorded during the same periods in the previous two years. Results The number of visits dropped from a mean of 3,212 in 2018 to 2019 to 445 in 2020. Triage 1 to 3 level visits rose from 21.6% in 2018 to 2019% to 40.4% in 2020, meaning a reduction in minor injury visits and an increase in major ones. There was a relative reduction of 13.2% in femoral fractures in the elderly. The rate of justified visits rose from 22.3% to 48.1%. Conclusion A marked drop in the total number of visits to our traumatology ED was observed, as well as a relative increase in major injury visits and a relative fall in the minor ones. Cite this article: Bone Joint Open 2020;1-10:617–620.
The theoretical impact on corrective upper limb elective services following analysis of distal radius fractures managed nonoperatively during COVID-19 pandemic
Authors: Baawa-Ameyaw Joanna , Kabariti Rakan , Chandra Arjun , Rhee Jae 
Published: October 2020

Aims To assess the proportion of patients with distal radius fractures (DRFs) who were managed nonoperatively during the COVID-19 pandemic in accordance with the British Orthopaedic Association BOAST COVID-19 guidelines, who would have otherwise been considered for an operative intervention. Methods We retrospectively reviewed the radiographs and clinical notes of all patients with DRFs managed nonoperatively, following the publication of the BOAST COVID-19 guidelines on the management of urgent trauma between 26 March and 18 May 2020. Radiological parameters including radial height, radial inclination, intra-articular step-off, and volar tilt from post-reduction or post-application of cast radiographs were measured. The assumption was that if one radiological parameter exceeds the acceptable criteria, the patient would have been considered for an operative intervention in pre-COVID times. Results Overall, 92 patients formed the cohort of this study with a mean age of 66 years (21 to 96); 84% (n = 77) were female and 16% (n = 15) were male. In total, 54% (n = 50) of patients met at least one radiological indication for operative intervention with a mean age of 68 years (21 to 96). Of these, 42% (n = 21) were aged < 65 years and 58% (29) were aged ≥ 65 years. Conclusion More than half of all DRFs managed nonoperatively during the COVID-19 pandemic had at least one radiological indication to be considered for operative management pre-COVID. We anticipate a proportion of these cases will require corrective surgery in the future, which increases the load on corrective upper limb elective services. This should be accounted for when planning an exit strategy and the restart of elective surgery services. Cite this article: Bone Joint Open 2020;1-10:612–616.
Standard operating procedures for re-establishing dental services in an acute NHS trust following COVID-19
Authors: Rasaratnam Lakshmi , Elder Andrew , Parker Donna 
Published: October 2020

As consultants in restorative dentistry working within an acute NHS trust, our role primarily involves working as part of a multidisciplinary head and neck service alongside our orthodontics and maxillofacial colleagues to provide treatment for patients with head and neck cancer, cleft lip and palate, hypodontia, and dentoalveolar and facial trauma. In March 2020, the provision of these essential services was brought to an abrupt halt; with the exception of urgent head and neck cancer care, due to the COVID-19 pandemic. This virus not only impacted how we lived our lives but how we provided key services in hospital dentistry. This article provides clear guidance on personal protective equipment (PPE), infection prevention and control guidance; the role of amber cleans and the integration of laboratory services into safe working environments. We understand that the standard operating procedures in this article are accurate at the time of publication but may be subject to change due to updated government guidelines. Managing risks and alleviating concern: new protocols for patient and staff safety.
Radiotherapy quadrant doses in oropharyngeal cancer treated with intensity modulated radiotherapy
Authors: Patel Vinod , Humbert-Vidan Laia , Thomas Christopher , Sassoon Isabel , McGurk Mark , Fenlon Michael , Guerrero Urbano Teresa 
Published: October 2020

Dental assessment prior to head and neck radiotherapy (RT) is a mandatory requirement. Treatment recommendations are based on perceived doses to the jaw; however, these are poorly understood. In the pre-RT dental assessment phase, oropharyngeal cancer patients present with more teeth than other head and neck cancer patients. Hence, prior knowledge of likely RT doses specific to the dentition would allow the dental oncologist to provide a patient centred dental treatment plan. Identifying dental regions at risk of osteoradionecrosis from post-radiotherapy events provides invaluable information.
Redeployment of dental trainees: challenges and opportunities during the COVID-19 pandemic
Authors: Martin Katy , Archer Natalie , Johnston Laura 
Published: October 2020

Dental trainees require a degree of adaptability to navigate a training pathway. We outline the transferrable skills that can be adapted and utilised during the process of redeployment in response to COVID-19. Despite the challenging circumstances, opportunities can arise for trainees redeployed to different areas of healthcare, and contribute towards the formation of a holistic and rounded professional. Transferable skills acquired from different areas of healthcare contribute towards the formation of a holistic dental professional.
Nesting Ecology of Polistes Species (hymenoptera, Vespidae) in Urban Areas of South-western Iberian Peninsula
Authors: Pérez-Bote José Luis , Mora-Rubio Carlos 
Published: October 2020

Urbanization is increasing across the globe and it is recognized as a major factor affectingspecies, populations and assemblages. Although urbanization is recognized as a major threat to biodiversity, there is increasing evidence that urban habitats may play a role in conservation. The objective of this work was to verify the occurrence of Polistes species (Vespidae) and the substrates used for nesting in urban areas in south-western Iberian Peninsula. The study was carried out from March to August of 2018 in three small towns in the Llanos de Olivenza region (SW Spain). Active searching was conducted for colonies of social wasps along and for each colony that was found we identified the species, type of substrate used for nesting, height of the colony in relation to the ground level and orientation. 753 colonies of social wasps were found belonging to two species: Polistes dominula and P. gallicus. The most used nesting substrate was clay roof tile followed by metals. The height of the nests was related to the height of the buildings on which they were built. In all the tree towns nests exposure were oriented to the SE with mean angle values oscillating between 127.42° and 140.68°. In addition, our results confirm the prediction that wasps are more abundant in less or non-urbanized areas even if they are small urban areas such as those studied in our case.