Validation of an on-screen application-based measurement of shoulder range of motion over telehealth medium

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Heart rupture as an acute complication of cocaine abuse: A case report

The purpose of this study is to show a very rare complication of acute cocaine poisoning, namely heart rupture. In the present case report, acute cocaine intoxication caused massive myocardial infarction, resulting in heart rupture and cardiac tamponade. A crime scene investigation found a dead body on the street in a drug dealing district. Examination of the body showed no external injuries. A thorough autopsy was performed showing massive cardiac tamponade with 510 ml of blood within the pericardium and full-thickness tissue lesion at the posterior wall of the left ventricle of 3.5 × 3 cm. Histological examination in hematoxylin and eosin was performed and confirmed the interruption of the posterior wall of the left ventricle with the presence of blood. In fact, although the correlation between cocaine and myocardial damage is well established, the relationship between heart rupture and acute cocaine intoxication is an extremely rare event. Moreover, since there are, to date, few reports of similar deaths, our report provides useful information regarding sudden death in a cocaine abuser. It is, therefore, of crucial importance to report this case to the scientific community.     

Epidemiological study of post-traumatic ankle osteoarthritis after ankle sprain in 195,393 individuals over middle age using the National Health Insurance Database: A retrospective design

ObjectivesThis study aimed to determine the risk of ankle OA onset after an incidence of sprain, relative to the risk of onset in healthy population, and to investigate the effect of gender, age, BMI, and exercise on the development of ankle OA after sprain.DesignRetrospective cohort study.MethodsUsing a sample cohort dataset from 2002 to 2013 provided by the Korean National Health Insurance Sharing Service, we calculated the mean survival time and cumulative incidence rate in sprained and healthy populations using Kaplan-Meier analysis. A Cox proportional hazards model was used to analyze the adjusted hazard ratio (HR) of sprain for the development of OA with 95% confidence intervals (CIs). Adjusted HRs of gender, age, BMI, and exercise (yes/no) were analyzed in the sprained group.ResultsAmong the selected population of 195,393 individuals, 40,876 (20.9%) were diagnosed with an ankle sprain, and 1543 (3.85%) of those individuals developed ankle OA. Of the 154,517 healthy individuals (79.1%), 4062 (2.66%) cases had progressed to OA. The sprained group had 46% (HR, 1.46; 95% CI, 1.38–1.55) greater rate of progression to ankle OA than did healthy individuals. In the sprain group, individuals who were female, obese, and overweight had 40% (HR, 1.40; 95% CI, 1.26–1.55), 43% (HR, 1.43; 95% CI, 1.12–1.82), and 22% (HR, 1.22; 95% CI, 1.10–1.35) higher incidence to develop ankle OA, respectively, compared to those who were male, underweight and normal.ConclusionsThis study found that ankle sprain was a significant risk factor for a diagnosis of early OA. Female gender and high BMI increased the incidence of ankle OA after sprain.     

Prognostic models to predict survival in patients with pancreatic cancer: a systematic review

BackgroundPancreatic ductal adenocarcinoma (PDAC) has poor survival. Current treatments offer little likelihood of cure or long-term survival. This systematic review evaluates prognostic models predicting overall survival in patients diagnosed with PDAC.MethodsWe conducted a comprehensive search of eight electronic databases from their date of inception through to December 2019. Studies that published models predicting survival in patients with PDAC were identified.Results3297 studies were identified; 187 full-text articles were retrieved and 54 studies of 49 unique prognostic models were included. Of these, 28 (57.1%) were conducted in patients with advanced disease, 17 (34.7%) with resectable disease, and four (8.2%) in all patients. 34 (69.4%) models were validated, and 35 (71.4%) reported model discrimination, with only five models reporting values >0.70 in both derivation and validation cohorts. Many (n = 27) had a moderate to high risk of bias and most (n = 33) were developed using retrospective data. No variables were unanimously found to be predictive of survival when included in more than one study.ConclusionMost prognostic models were developed using retrospective data and performed poorly. Future research should validate instruments performing well locally in international cohorts and investigate other potential predictors of survival.     

Evaluation of six anti-SARS-CoV-2 antibody test kits and practical approaches to optimize the diagnostic performance

In an investigation of six anti-SARS-CoV-2 antibody kits with different target antigen and methodology, each kit showed comparable performance. As false-positive reactions occurred independently with different kits, specificity increased to 100% when pairs of kits were used. With three-kit combination, both sensitivity (99.1%) and specificity (100%) increased.     

Immediate effects of rhythmic joint mobilization of the temporomandibular joint on pain,mouth opening and electromyographic activity in patients with temporomandibular disorders

BackgroundRhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD.Materials and methodsThis was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package.ResultsA statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85–1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49).ConclusionIn this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.