Effectiveness Of Treatment Interventions Research Articles

Effectiveness of atrial fibrillation ablation in the presence of chronic myocarditis

Aim: To compare the effectiveness of interventional treatment of atrial fibrillation (AF) in patients with chronic myocarditis identified by endomyocardial biopsy and in patients without myocarditis.Material and Methods. The study sample included 40 patients. Of these, 27 (67.5%) are men. The age in the sample was 49 (44; 55) years. The study included 25 (62.5%) patients with paroxysmal AF, 10 (25.0%) with persistent and 5 (12.5%) with long-term persistent. All patients underwent surgical treatment of AF using radiofrequency ablation (RFA) or cryoablation (CA). Endomyocardial biopsy was performed in 18 patients to verify the diagnosis. The follow-up period for patients was 12 months.Results. All patients underwent surgical treatment of AF, in 7 cases (17.5%) CA of the left ventricle (LV) was performed; in 33 (82.5%) cases RFA was performed. According to the biopsy results, signs of myocarditis were detected in 9 patients (22.5%). Focal myocarditis was found in 7 patients, diffuse – in 2. The effectiveness of catheter treatment in general was 72.5%, for CA – 71.5%, for RFA 73.5%. The effectiveness of AF ablation with the presence of detected myocarditis was 88.9%, without myocarditis – 67.5%.Conclusions. The effectiveness of catheter treatment of AF in patients with signs of myocarditis was 88.9% and was higher than in patients without signs of myocarditis.

Understanding effect size: an international online survey among psychiatrists, psychologists, physicians from other medical specialities, dentists and other health professionals

Background and objectiveVarious ways exist to display the effectiveness of medical treatment options. This study examined various psychiatric, medical and allied professionals’ understanding and perceived usefulness of eight effect size...

Assessment of structural changes in the left atrium myocardium according to cardiac magnetic resonance with contrast before and after balloon cryoablation in patients with persistent atrial fibrillation

Aim. To study the structural changes of the left atrium myocardium according to magnetic resonance imaging with contrast in patients with persistent atrial fibrillation before and after balloon cryoablation and compare the results with the effectiveness of the intervention.Material and methods of research. The study included 28 patients with persistent form of atrial fibrillation. All patients before and after magnetic resonance imaging underwent cardiac magnetic resonance imaging with delayed contrast using a high-resolution MR pulse sequence (voxel size 1,25x1,25x1,25 mm) before and after cryoablation.The severity of atrial fibrous lesion was calculated automatically using a specialized LGE HEART Analyzer program using algorithms based on the myocardial contrast index with a threshold value of 1.38. The clinical efficacy of the intervention was evaluated after 12 months and the relationship was determined structural changes in the myocardium of the left atrium according to contrast magnetic resonance imaging data before and after the cryoablation.Results. The severity of fibrotic myocardial lesion of the left atrium before balloon cryoablation was 1,5 [0,16; 9,3]%. In Utah patients, stage 1 fibrosis was detected in 71,4% (n=20), stage 2 in 14,3% (n=4), stage 3 in 3,6% (n=1), stage 4 in 10,7% (n=3). 3 months after cryoablation, there was an increase in the severity of fibrosis of 2,7 [1,02; 18,8]% (p<0,001). Overall efficiency of the intervention rate was 57,1%. The construction of Kaplan- Meyer curves demonstrated that the intervention was most effective in patients with minimal severity of fibrosis before ablation (Utah I) and least effective in more pronounced fibrotic lesion (stage Utah III and IV)Conclusion. Magnetic resonance imaging of the heart with contrast allows to assess fibrotic lesion of the myocardium of left atrial, which may be one of the factors of the effectiveness of interventional treatment of persistent AF.

Efficacy of catheter treatment of atrial fibrillation in patients with myocarditis depending on the adrenoreaction of the body (a prospective single-center study)

Background. Worldwide, research continues into various factors that may influence the success of catheter treatment of atrial fibrillation. In this regard, the influence of the state of the sympathoadrenal system of the body has not been studied enough. Aims to evaluate the effectiveness of interventional treatment of atrial fibrillation (AF) in patients with and without myocarditis, depending on the level of beta-adrenergic responsiveness of the organism. Materials and methods. The study sample included 40 patients. Of these, 27 (67.5%) are men. The age in the sample was 49 (44; 55) years. The study included 25 (62.5%) patients with paroxysmal AF, 10 (25.0%) with persistent and 5 (12.5%) with long-term persistent. All patients underwent surgical treatment of AF using radiofrequency (RFA) or cryoablation (CBA). Endomyocardial biopsy was performed in 18 patients to verify the diagnosis. Beta-adrenergic responsiveness (beta-ARM) was assessed in dynamics 3 days after surgery, 3 months and 12 months. The follow-up period for patients was 12 months. Results. All patients underwent surgical treatment of AF, in 7 cases (17.5%) CBA of the pulmonary veins was performed, in 33 (82.5%) cases RFA was performed. According to the biopsy results, signs of myocarditis were detected in 9 patients (22.5%). Focal myocarditis was found in 7 patients, diffuse in 2. The effectiveness of catheter treatment in general was 72.5%, for CBA 71.5%, for RFA 73.5%. Beta-ARM before ablation was 19.16% [12.46; 27.46], 3 days after ablation 24.43% [15.38; 33.65], after 3 months was 20.27% [9.90; 27.71], in 4 patients after 12 months, beta-ARM was 32.5% [20.0; 43.2]. The dynamics and influence of beta-ARM on the effectiveness of interventional treatment of AF in patients with early and late relapses, the presence of myocarditis was assessed. Conclusions. The results obtained showed no effect of the level of beta-ARM on the effectiveness of RFA and CBA in patients with and without myocarditis. Beta-ARM showed no association with the development of early arrhythmia recurrences after ablation. No statistically significant differences were found when comparing beta-ARM levels in patients with and without diagnosed myocarditis.

Pulmonary artery blood flow dynamics in chronic thromboembolic pulmonary hypertension

Chronic thromboembolic pulmonary hypertension is caused by incomplete resolution and organization of thrombi. Blood flow dynamics are involved in thrombus formation; however, only a few studies have reported on pulmonary artery blood flow dynamics in patients with chronic thromboembolic pulmonary hypertension. Furthermore, the effects of treatment interventions on pulmonary artery blood flow dynamics are not fully understood. The aim of the study was to evaluate pulmonary artery blood flow dynamics in patients with chronic thromboembolic pulmonary hypertension before and after pulmonary endarterectomy and balloon pulmonary angioplasty, using computational fluid dynamics. We analyzed patient-specific pulmonary artery models of 10 patients with chronic thromboembolic pulmonary hypertension and three controls using computational fluid dynamics. In patients with chronic thromboembolic pulmonary hypertension, flow velocity and wall shear stress in the pulmonary arteries were significantly decreased, and the oscillatory shear index and blood stagnation volume were significantly increased than in controls. Pulmonary endarterectomy induced redistribution of pulmonary blood flow and improved blood flow dynamics in the pulmonary artery. Balloon pulmonary angioplasty improved pulmonary blood flow disturbance, decreased blood flow stagnation, and increased wall shear stress, leading to vasodilatation of the distal portion of the pulmonary artery following balloon pulmonary angioplasty treatment.

Bibliometric analysis of research articles on post-herpetic neuralgia published from 1991 to 2020.

Post-herpetic neuralgia (PHN) is one of the most painful diseases, which has made it a major concern for pain physicians. We aimed to quantitatively analyze the research outputs of studies on PHN published over the past 30 years using bibliometric analysis. We also aimed to analyze the research outputs of studies on interventional treatments for PHN and evaluate the academic achievements of Korean pain physicians. Bibliometric analysis was performed by searching the Web of Science database for PHN-related articles published between 1991 and 2020. Publication number, year, source, country, institution, and citation-related information were retrieved from the database. We also quantitatively analyzed publications related to interventional treatments for PHN. A total of 3285 publications were extracted from the database; 101 (3.1%) of the articles were published by South Korean authors, making South Korea the 11th in the order of countries that published the most articles. There were 185 articles on the effects of interventional treatments for PHN. South Korean authors published 30 (16.2%) articles out of these, making South Korea the 3rd in the order of countries that published the most articles on the effects of interventional treatment for PHN. Our results showed an increasing trend in the number of PHN-related publications and the academic achievements of Korean pain physicians in this field over the past 3 decades. However, the proportion of studies on interventional treatments is relatively small. Korean pain physicians need to establish academic evidence on interventional treatment to expand their role in this field and improve the outcomes of PHN patients.

Abstract 53: Long-term Treatment Risk Of Hemorrhage In Unruptured Brain Arteriovenous Malformation Patients

Introduction: The long-term effects of interventional treatment (with surgery, stereotactic radiosurgery, or endovascular embolization) for unruptured brain arteriovenous malformations (uBAVM) are uncertain. We address this in a large multi-center international cohort study comparing risk of intracranial hemorrhage (ICH) in the treated and untreated course of uBAVM patients. Methods: We pooled individual patient data (n=3,291) from 10 cohorts and imputed missing data. Survival analysis was performed from time of uBAVM diagnosis to intracranial hemorrhage (ICH) using Cox models, stratified by cohort, censoring at death or last follow-up, and including BAVM interventional treatment as a time-varying covariate. We tested for an interaction of treatment with follow-up time, then estimated the association of interventional treatment with ICH, adjusting for propensity quintile. Individual treatment propensity scores were calculated using logistic regression with Spetzler-Martin grade, sex, diagnosis age and year, cohort, and presence of presenting symptoms (seizures, headaches, and/or deficits). Results: Median cohort age was 36 years, 48% were female, and 77% received ≥1 treatment modality for uBAVM during follow-up. 373 ICH occurred during 32,054 person-years of follow-up (median=6.6y), for an ICH rate of 1.16 per 100 P-Y. Overall, treatment was not associated with risk of ICH (HR=1.12, 95% CI=0.89-1.51, p=0.33). However, we observed a strong interaction between treatment and follow-up time (p<0.001): between 0-1 year, treatment was associated with higher risk of ICH (HR=3.48, 95% CI: 2.26-5.37, p<0.001); between 1-10 years, we found no association between treatment and risk of ICH (HR=1.02, 95% CI: 0.73-1.45, p=0.87); after 10 years, treatment was associated with a lower risk of ICH (HR=0.46, 95% CI: 0.30-0.70, p<0.001). Survival curves for untreated and treated courses crossed around 17 years. Conclusion: After accounting for treatment propensity for uBAVM, we found an initial increased risk of ICH in the treated relative to untreated course, which continually declined over time with survival curves crossing around 17 years. These results require confirmation in a randomized controlled trial of uBAVM with long-term follow-up.

INTERVENÇÃO PSICOLÓGICA PÓS-TRAUMÁTICA EM ATLETAS UNIVERSITÁRIOS

ABSTRACT Introduction: Injuries will always be with an athlete throughout their career. When analyzing the factors that cause athletic injuries, their coaches usually consider environmental and physical training factors, ignoring psychological factors. Objective: Investigate the mental health status of college athletes after serious injuries during competition, discussing the impact of sports injuries on athletes' mental health. Methods: Twelve college athletes were selected as research volunteers. They were divided into two groups by randomization. The control group was followed by traditional psychotherapy while the experimental group received the post-traumatic mental intervention. A comparison was carried out and mainly the general situation of sports injuries and the effect of intervention treatment were analyzed. The impact of psychological intervention methods on athletes' mental health after injuries were also studied using mathematical statistics to analyze the data. Results: There were significant differences in STAI scores in the experimental group before and after the intervention. BFS scores in the experimental group were significantly higher than those in the control group before and after an intervention. There was no significant difference in the indicators in the control group. Conclusion: Post-traumatic psychological intervention positively affects the mental health recovery of college athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

HETEROGENEOUS TREATMENT EFFECTS OF NUDGE AND REBATE: CAUSAL MACHINE LEARNING IN A FIELD EXPERIMENT ON ELECTRICITY CONSERVATION

AbstractThis study investigates the different impacts of monetary and nonmonetary incentives on energy‐saving behaviors using a field experiment conducted in Japan. We find that the average reduction in electricity consumption from the rebate is 4%, whereas that from the nudge is not significantly different from zero. Applying a novel machine learning method for causal inference (causal forest) to estimate heterogeneous treatment effects at the household level, we demonstrate that the nudge intervention's treatment effects generate greater heterogeneity among households. These findings suggest that selective targeting for treatment increases the policy efficiency of monetary and nonmonetary interventions.

Differences in the effectiveness of sympathetic radiofrequency denervation of the renal arteries in patients with resistant arterial hypertension and hyperuricemia

Objective. To evaluate of differences in the effectiveness of sympathetic radiofrequency denervation (RDN) of renal arteries (RA) in patients with resistant arterial hypertension (RAH) with hyperuricemia (HUA) during 3 years of follow-up. Design and methods. The study included 80 patients with RAH, who were randomized to RDN RA group with medication therapy (MT) and MT group. Groups were comparable in age, gender, duration of hypertension and the number of antihypertensive medications. In 12 months, comparative study was completed, and RDN RA group of patients was examined in 24 and 36 months, results were analyzed depending on the initial level of uric acid (UA). Results. In RDN RA group, compared with MT group, beneficial antihypertensive effect was found both in terms of office blood pressure (BP) and ambulatory BP monitoring (ABPM). After RDN RA, significant decrease in BP persisted for 3 years. Analysis of antihypertensive effect of interventional treatment depending on UA level showed significant decrease in office BP and all indicators of ABPM in patients with normal levels of UA. In HUA patients, only decrease in office BP and mean daily systolic BP was revealed. The majority of patients with favorable response to RDN (“responders” group) showed normal UA (75 % vs. 83,3 %, respectively, at 24, 36 months of follow-up). The creatinine and cystatin C levels in dynamics were slightly increased, but within reference ranges. Conclusions. Obtained data indicated more pronounced clinical efficacy of RDN RA in patients without HUA.

Comparaison of Efficacy and Safety of Fentanyl Transdermal Patch with Oral Ketorolac for Pain Management in Dry Socket: A Randomized Clinical Trial.

The aim of this study was to compare the efficacy and safety of transdermal Fentanyl patch with oral Ketorolac for pain management in dry socket patients. Sixty patients who were diagnosed with dry socket (VAS > 40mm) were recruited in this prospective randomized controlled trial. Patients were divided into two groups. Group1 (n = 30) Transdermal Fentanyl patch (25mcg/hr) was given and in Group 2 (n = 30) Ketorolac 10mg Oral tablet was prescribed for pain management. The primary endpoint was the mean pain scores within 72h evaluated by visual analog scale (VAS). Secondary measures included the safety and tolerability, amount of rescue medication (analgesic and antiemetic) and effectiveness of treatment interventions by Brief Pain Inventory Questionnaire (BPI). The mean VAS pain scores were significantly less in group 1 (Fentanyl) as compared to group 2 (ketorolac) on all follow-up days. Significant difference was noted in the mean amount of rescue analgesic medication. It was 2.16 + 1.53 in group 1 and 8.50 + 3.98 in group 2. Side effects were seen in both the groups. Nausea (46%) and vomiting (43%) were reported in group 1 while headache (36.6%) and epigastric pain (53.3%) in group 2. Thus, transdermal Fentanyl was better in pain control than Ketorolac with less need for rescue analgesic medication in dry socket.

Evaluation of the effectiveness of interventional treatment of ventricular arrhythmias of rare localizations using non-invasive mapping

Background. Atypical localization of the focus of ventricular arrhythmias is a rather difficult group for invasive mapping and subsequent radiofrequency ablation. Invasive electroanatomical mapping, multipolar electrophysiological electrodes in combination with electrophysiological study for searching an early zone of arrhythmia focus, and substrate mapping, are aimed to identifying critical areas of the arrhythmia contour. However, there are still situations in which arrhythmia cannot be eliminated, despite the use of these systems. The method of superficial non-invasive mapping of the heart seems to be relevant, which makes it possible to estimate the volume of surgery and select the necessary technology to eliminate arrhythmias.Aim. To compare the effectiveness of interventional treatment of patients with ventricular arrhythmias of atypical localization with and without the use of superficial non-invasive mapping.Methods. The study included 40 patients with ventricular arrhythmias of rare localization. The patients were divided into two groups. Group I included 21 patients who underwent non-invasive superficial and invasive electrophysiological cardiac mapping. Group II included 19 patients who underwent invasive electrophysiological cardiac mapping.Results. Over a follow-up period of 12 months, the freedom from arrhythmia in group I was 76%, in group II — 61%. The total operation time, duration and dose of fluoroscopy were less in group I compared to the group II.Conclusion. The study results demonstrated that the method of non-invasive surface mapping of the heart is highly effective in ventricular arrhythmias of atypical localization. The time of radiofrequency ablation, interventional intervention, fluoroscopy is lower with the use of superficial non-invasive mapping, compared with the control group. Received 13 July 2021. Revised 20 October 2021. Accepted 9 December 2021. Funding: This work is supported by a grant of the Russian Science Foundation (project No. 19-15-00406). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: E.A. Artyukhina, A.Sh. RevishviliData collection and analysis: E.A. Artyukhina, M.V. Yashkov, E.V. Dedukh, I.A. Taymasova, A.Sh. RevishviliStatistical analysis: M.V. YashkovDrafting the article: E.A. Artyukhina, M.V. YashkovCritical revision of the article: E.A. Artyukhina, M.V. Yashkov, A.Sh. RevishviliFinal approval of the version to be published: E.A. Artyukhina, M.V. Yashkov, E.V. Dedukh, I.A. Taymasova, A.Sh. Revishvili

The effect of Kathak Dance Movement on Balance and Gait in Parkinson’s Disease- An Experimental Study

INTRODUCTION: Difficulties with gait and balance are common among individuals with Parkinson's disease (PD). Several different exercise programs have been suggested to address balance and gait problems to improve the quality of life and patient compliance with PD exercises. Dance may be an effective tool for addressing these problems because it includes key elements of dynamic balance, can improve functional mobility, and is, at the same time, enjoyable and engaging. OBJECTIVES: The purpose of this study was to assess the effect of Kathak dance movement in addition to conventional physiotherapy on balance and gait in Parkinson's disease patients. METHODS AND MATERIALS: A total of 44 patients diagnosed with Parkinson's disease were included in the study with a mean age of 63.20 + 8.5 years. Patients were randomly divided into two groups, the control group received conventional physiotherapy, and the experimental group received the same along with Kathak dance movements which were Tatkar and Gatnikas. The intervention was given three days a week for four weeks. Pre-and post-assessment for balance and gait was assessed by scales including TUG test, Tinetti, FOG-Q, and UPDRS-III. The within-group comparison was made using Wilcoxon Signed rank test and between the group using the Mann Whitney U test to see the effect of treatment intervention. Results: The mean age of participants for both groups were 64.18±8.53 and 62.23±6.21, respectively. The comparison showed a significant difference in TUG, Tinetti, and FOG-Q within the group with p<0.01. The between-group comparison showed no significant difference between the two treatments interventions with p=0.361 for TUG, p=0.479 for Tinetti, and p= 0.73 for FOG-Q. CONCLUSION: Both groups showed similar improvements in balance and gait in PD patients. Thus, we conclude that the Kathak Dance movement can be used to complement conventional physical therapy exercises.

Effectiveness of Cognitive-Behavioral Therapy for Improving Sleep Quality and Reducing Insomnia Severity in Afflicted Patients

Background: Based on the proven role of sleep quality in promoting health, the treatment of insomnia should be premised on identification of characteristics and severity of insomnia symptoms. This study aimed to investigate the effectiveness of Cognitive-Behavioral Therapy for Insomnia (CBT-I) in improving sleep quality and reducing insomnia severity among the afflicted patients.
 Methods: This was a semi-experimental study with a pre-test, post-test, and follow-up design and control group. The statistical population included all patients visiting the Sleep Disorder Clinic of Rasoul Akram Hospital and two private psychiatric clinics, selected using convenience sampling in Tehran in 2020. Twenty out of 60 patients with insomnia disorder, diagnosed based on the Diagnostic and Statistical Manual for Insomnia, were randomly selected using a lottery method. The participants were divided into the experimental and control groups. In the cognitive-behavioral group, each participant individually received a 6-week treatment intervention. All participants in both groups were evaluated at the beginning of the treatment, at the end of the treatment, and one month after the treatment. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used for data collection.
 Results: The results showed a significant between-group difference in the scores of sleep quality and insomnia severity at post-test stage (p<0.05). Moreover, the follow-up test results suggested the stability of the effect of treatment interventions on sleep quality and insomnia severity among the experimental and control groups relative to their pre-test scores (p<0.05).
 Conclusion: The results indicated that CBT-I could improve sleep quality and insomnia severity in afflicted patients.

The Effect of Interventional Treatment with Bronchoscopy in 10 Children with Acquired Subglottic Stenosis

To explore the effects of interventional therapy with bronchoscopy in children with acquired subglottic stenosis (SGS). The clinical data of ten pediatric inpatients with acquired SGS who were admitted to Children's Hospital of Chongqing Medical University, as well as their follow-up information obtained 1 week, 1 month, 3 months and 6 months after the procedure was done.were retrospectively analyzed to examine the effect of interventional bronchoscopic therapies, including balloon dilatation, holmium laser, and cryotherapy, in pediatric patients with acquired SGS. Among the 10 patients with acquired SGS, there were 5 boys and 5 girls aged between 1 month and 6 years and 5 months, with a median age of 11 months and 1 day. Among the 5 patients with acute acquired SGS, two were treated with balloon dilatation only, with one cured and one showing clinical improvement, while three received comprehensive interventional therapy combining balloon dilatation, holmium laser, and cryotherapy, with two cured and one showing improvement. Among the 5 patients with chronic acquired SGS, four cases were cured with comprehensive interventional therapy, while one case suffered from aggravated upper airway obstruction 4 + hours after balloon dilatation. The patient was subsequently put on invasive mechanical ventilation for 4 days, but was unable to be extubated. The parents signed do-not-resuscitate order and the patient died afterwards. Bronchoscopy performed 1 week, 1 month and 3 months after the procedure was done showed that the SGS was improved to varying degrees. Bronchoscopy intervention is an effective therapy for acquired SGS in children.

Clinical and Pathogenetic Assessment of Relationships Between the Dynamics of Body Weight Changes and Atrial Fibrillation in Patients with Primary Obesity

Aims.To evaluate the impact of body weight dynamics on the clinical course of atrial fibrillation in obese patients.Materials and methods. The study included 101 primary obese patients with paroxysmal or persistent atrial fibrillation. Study design: a retrospective, single-center, comparative study. Retrospectively аccording to the he body weight dynamics, patients were divided into 3 groups: those who increased their body weight by >3 % (Group 1, n=40), maintained their initial body weight by ±2.9 % (Group 2, n=29), and reduced their initial body weight by >3 % (Group 3, n=32). Follow-up examinations by a doctor were carried out at least once every 6 months for minimum 36 months. Change in AF type was determined by disease patterns and 7-day Holter monitoring results. The groups were comparable in gender (p=0,9267), age (p=0,3841), height (p=0,8900), and disease form (Paroxysmal atrial fibrillation /Persistent atrial fibrillation) (p=0,8826), the severity of symptoms on the European Heart Rhythm Association score of atrial fibrillations (p=0,8687) and systolic blood pressure at the beginning of the study (p=0,4500).Results. At the final control examination, the body weight of patients in Group 1 increased by an average of 11,4 [9,3; 13,1] kg (р <0,001*), while weight loss in Group 3 averaged -6,2 [-8,4; -5,3] kg (p <0,001*). The decrease in body weight of Group 2 patients was insignificant (p=0,5377) and amounted to -0,1 [-2,0; 1,3] kg. The progression of the disease from paroxysmal to persistent form was observed among 15 (37 %) patients in Group 1, 9 (31 %) patients — in Group 2, 2 (6 %) patients — in Group 3 (p=0,0079*). The regression of arrhythmia from persistent to paroxysmal form was not registered in group 1 (0 %), in group 2, the reverse development of the disease was noted in 1 patient (3 %) and in group 3 — in 6 patients (19 %) (p=0,0053*). There were no free from AF patients in Group 1 at the final follow-up, while 2 (7 %) patients were free from AF in Group 2 and 7 (22 %) — in Group 3 (р=0,0047*). In patients undergoing ablation, procedural success was determined after a 3-month blind period. The need for interventional procedures to restore the sinus rhythm and their multiplicity when comparing the groups did not differ significantly. However, in a pairwise comparison, the difference between groups 1 and 3 of participants was statistically significant (p=0,0079* and p=0,0374*, respectively). Conclusion. This study demonstrates the relationships between the dynamics of body weight and the clinical course of atrial fibrillation. The progression of obesity leads to the progression of the disease. Weight-loss management reverses the type and natural progression of AF, improves the prognosis and the course of disease, regardless of other significant risk factors, increases the anti-arrhythmic therapy effect and the effect of interventional treatment.

Prediction intervals reporting in orthodontic meta-analyses.

SummaryBackgroundA prediction interval represents a clinical interpretation of heterogeneity. The aim of this study was to determine the prevalence of prediction interval reporting in orthodontic random effect meta-analyses. The corroboration between effect size estimates with 95% confidence intervals (CIs) and prediction intervals were also explored.Materials and methodsSystematic reviews (SRs) published between 1 January 2010 and 31 January 2021 containing at least one random effects meta-analysis (minimum of three trials) were identified electronically. SR and meta-analyses characteristics were extracted and prediction intervals, where possible, were calculated. Descriptive statistics and the percentage of meta-analyses where the prediction interval changed the interpretation based on the 95% CI were calculated. Fisher’s exact test was used to examine associations between the study variables and reporting of prediction intervals.ResultsOne hundred and twenty-one SRs were included. The median number of SR authors was 5 (interquartile range: 4–6). The reporting of prediction intervals was undertaken in only 19.0% (N = 23/121) of meta-analyses. Out of 95 meta-analyses, only in 6 (6.3%, N = 6/95) were the 95% CI corroborated by the prediction interval. In 60 meta-analyses (63.3%, N = 60/95) despite a 95% CI indicating a statistically significant result, this was not corroborated by the corresponding prediction interval.ConclusionsWithin the study timeframe, reporting of prediction intervals is not routinely undertaken in orthodontic meta-analyses possibly due to a lack of awareness. In future orthodontic random effects models containing a minimum of three trials, reporting of prediction intervals is advocated as this gives an indication of the range of the expected effect of treatment interventions.

The Importance of Culture in Treating Substance Use Disorder: Example Application With Indigenous People.

Substance use is a common issue worldwide, but it disproportionately affects the Indigenous population in America. As culture affects many aspects of health and wellness, including the presentation and effectiveness of treatment interventions, it is vital that health care providers look at substance use within a cultural context. The Campinha-Bacote Model: The Process of Cultural Competemility in the Delivery of Healthcare Services model is a helpful tool to assess a cultural group in the context of health care. The knowledge and use of this model may assist health care professionals in providing culturally competent care for the Indigenous population in America, as well as other people from various cultural backgrounds. This model also promotes the consideration of cultural factors in nursing research and evidence-based interventions, which may assist in reducing the current disparities that exist within the Indigenous population. The current article addresses the Campinha-Bacote Model in reference to substance use disorder in the Indigenous population in America and the relation to nursing practice and research. [Journal of Psychosocial Nursing and Mental Health Services, 59(6), 7-12.].

Exercise Testing, Physical Training and Fatigue in Patients with Mitochondrial Myopathy Related to mtDNA Mutations.

Mutations in mitochondrial DNA (mtDNA) cause disruption of the oxidative phosphorylation chain and impair energy production in cells throughout the human body. Primary mitochondrial disorders due to mtDNA mutations can present with symptoms from adult-onset mono-organ affection to death in infancy due to multi-organ involvement. The heterogeneous phenotypes that patients with a mutation of mtDNA can present with are thought, at least to some extent, to be a result of differences in mtDNA mutation load among patients and even among tissues in the individual. The most common symptom in patients with mitochondrial myopathy (MM) is exercise intolerance. Since mitochondrial function can be assessed directly in skeletal muscle, exercise studies can be used to elucidate the physiological consequences of defective mitochondria due to mtDNA mutations. Moreover, exercise tests have been developed for diagnostic purposes for mitochondrial myopathy. In this review, we present the rationale for exercise testing of patients with MM due to mutations in mtDNA, evaluate the diagnostic yield of exercise tests for MM and touch upon how exercise tests can be used as tools for follow-up to assess disease course or effects of treatment interventions.

Effect of drying and/or warming piglets at birth under warm farrowing room temperatures on piglet rectal temperature over the first 24 h after birth.

Piglets experience a decline in body temperature immediately after birth, and both drying and warming piglets at birth reduce this. However, these interventions may be less effective at higher farrowing room temperatures. This study was carried out at a commercial facility to compare the effect of drying and/or warming piglets at birth on postnatal rectal temperature (RT) under relatively warm farrowing room temperatures (26.6 ± 2.09 °C). Forty-five sows/litters were used in a completely randomized design to compare three Intervention Treatments (applied at birth): Control (no treatment); Warming (piglets placed in a plastic box under a heat lamp for 30 min); and Drying+Warming (piglets dried with desiccant and warmed as above). Temperatures in the warming boxes over the study period averaged 37.7 ± 2.75 °C. At birth, piglets were weighed; RT temperature was measured at 0, 10, 20, 30, 45, 60, 120, and 1,440 min after birth. Blood samples were collected at 24 h after birth from a subsample of one piglet from each birth weight quartile within each litter to measure plasma immunocrit concentration. Data were analyzed using PROC MIXED of SAS with litter as the experimental unit, and piglet as a subsample of litter. The model for analysis of piglet rectal temperature included fixed effects of Intervention Treatment, measurement time (repeated measure), the interaction, and the random effect of sow. Compared with the Control, piglet RT were higher (P ≤ 0.05) for the Warming treatment between 10 and 60 min, and higher (P ≤ 0.05) for the Drying+Warming treatment between 10 and 120 min after birth. Rectal temperatures were higher (P ≤ 0.05) for the Drying+Warming than the Warming treatment between 20 and 120 min. Responses to drying and/or warming were greater for low-birth-weight piglets (<1.0 kg) than heavier littermates, but were generally less than observed in previous experiments with similar treatments carried out under cooler temperatures. Piglet immunocrit values were lower (P ≤ 0.05) for the Drying+Warming treatment compared to the other Intervention Treatments, which were similar (P > 0.05). Immunocrit values tended (P = 0.10) to be lower for light (<1.0 kg) compared with heavier birth weight piglets. In conclusion, drying and warming piglets at birth was more effective for reducing piglet RT decline after birth than warming alone, though the effect was less than observed in previous studies carried out under cooler farrowing room temperatures.