Patient‐reported outcomes (PROs) in chronic urticaria

Chronic urticaria is an itching skin disease which persists for more than 6 weeks. Chronic urticaria has great impact on the daily life of the patient, and the fluctuating nature of the symptoms complicates the monitoring and treatment of the disease. Currently, there are no reliable biomarkers to identify and measure disease activity in chronic spontaneous urticaria. Consequently, use of patient‐reported outcomes (PROs) is crucial when evaluating and monitoring different aspects of chronic urticaria such as disease activity/severity, disease control, and quality of life. We present an overview of seven different PROs used in chronic urticaria and highlight their strengths, limitations, and use in clinical practice and research.     

Reliability and Differences Between Sexes in Landing Mechanics when Performing the Lateral Bound Test

Background and PurposeAnterior cruciate ligament injuries are prevalent among the athletic population, imposing a heavy economic burden, and the risk of re-injury. Most current biomechanical screening tasks are performed in the sagittal plane, and there is a need for more screening tools that assess sports specific movements in the frontal plane. The purpose of this study was to determine the reliability of and examine differences between sexes in the performance of the Lateral Bound Test (LBT).Materials/MethodsEach subject performed three trials of a LBT which included jumping laterally from one leg over a hurdle and landing on the opposite leg. Two cameras were placed six feet from the landing marker. Maximum dynamic knee valgus using the frontal plane projection angle and knee flexion angle at initial contact and maximal knee flexion were measured upon landing leg using 2D video analysis software. Additionally, video of 10 individuals’ trials were analyzed twice with one week between the analyses to obtain intra-rater reliability while 12 participants were retested one week later to determine test-retest reliability.ResultsThirty healthy subjects, 16 males, 14 females participated. Intra-rater reliability was determined to be excellent for all variables (ICC>0.96). In contrast, the test-retest reliability had greater disparity. Test-retest reliability ranged from poor (ICC = 0.47) to excellent (ICC > 0.90). Significant differences existed between the sexes, including males being significantly taller, weighing more, and demonstrating greater bilateral dynamic knee valgus (p < 0.05). No significant differences existed between sexes for knee flexion angles.ConclusionThe new LBT had excellent intra-rater reliability for assessing dynamic knee valgus and initial and maximum knee flexion angle when performing a functional movement in the frontal plane. Furthermore, males landed with more dynamic knee valgus than females which is contradictory to what has been observed with functional screening tools performed in the sagittal plane.Level of Evidence3b (reliability study)     

Correlation between Body Mass Index and the Occurrence of Postoperative Complications after Surgical Removal of the Lower Third Molar

ObjectivesSwelling, pain and trismus after the surgical removal of the mandibular third molars are the most common and expected postoperative complications. The aim of this cross-sectional study was to assess the association of those postoperative complications and BMI after surgical removal of the mandibular third molars.Material and methods84 patients who required the surgical removal of their lower third molar were enrolled in this study and were divided into 4 groups dependent on their BMI. Data were tested by one-way analysis of variance (Welch''s ANOVA). The differences were tested by the intragroup using the Games-Howell test.ResultsThe effect of BMI on pain had a statistically significant difference within the first 24 postoperative hours: 4 hours (p=0.014), 6 hours (p=0.034, p=0.049), 12 hours (p= 0.00.P=0.023), and 24 hours (p=0.010). For swelling and trismus in the exception on first postoperative day between underweight and normal weight groups (p=0.026), and underweight and overweight groups (p=0.014) no statistically significant correlation was foundConclusionBMI has an impact on a patient’s early postoperative recovery     

Post-cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study

OBJECTIVES: The aim of this study was to document the true incidence of post-cesarean surgical site infections (SSI), according to the definition of the US Centers for Disease Control and Prevention (CDC), and to identify independent risk factors for infection. DESIGN: Prospective population-based cohort study in Norway. Setting. Sykehuset Asker og Baerum HF, a secondary community hospital, associated with the University of Oslo (UiO), Norway, accounting for 2,000 deliveries per year. Participants. All cesarean deliveries during a 12-month period from September 2003. Main outcome measures. Rate and risk factors for SSI. RESULTS: The total rate of SSI was 8.9%, with an observation period of 30 days post-operatively, compared to 1.8% registered at hospital discharge. The total response rate was 100%. There was no significant difference in SSI rate in elective or emergency cesarean section (CS), respectively. All SSI were superficial. We found 2 significant independent risk factors: operating time > or =38 min and body mass index (BMI) >30. CONCLUSION: The rate of SSI is underestimated if the observation time is limited to the hospital stay. Operating time exceeding 38 min substantially increases the risk of SSI. The finding of no significant difference in SSI rate between elective and emergency CS should lead to a different approach concerning the use of antibiotics: subgroup at risk (operating time > or =38 min and BMI >30) may benefit from antibiotics in relation to the operation, whether the CS is an emergency or elective operation.     

Nowcasting (Short-Term Forecasting) of COVID-19 Hospitalizations Using Syndromic Healthcare Data,Sweden, 2020

We report on local nowcasting (short-term forecasting) of coronavirus disease (COVID-19) hospitalizations based on syndromic (symptom) data recorded in regular healthcare routines in Östergötland County (population ≈465,000), Sweden, early in the pandemic, when broad laboratory testing was unavailable. Daily nowcasts were supplied to the local healthcare management based on analyses of the time lag between telenursing calls with the chief complaints (cough by adult or fever by adult) and COVID-19 hospitalization. The complaint cough by adult showed satisfactory performance (Pearson correlation coefficient r>0.80; mean absolute percentage error <20%) in nowcasting the incidence of daily COVID-19 hospitalizations 14 days in advance until the incidence decreased to <1.5/100,000 population, whereas the corresponding performance for fever by adult was unsatisfactory. Our results support local nowcasting of hospitalizations on the basis of symptom data recorded in routine healthcare during the initial stage of a pandemic.     

The origin of volatile elements in the Earth–Moon system

The origin of volatile species such as water in the Earth–Moon system is a subject of intense debate but is obfuscated by the potential for volatile loss during the Giant Impact that resulted in the formation of these bodies. One way to address these topics and place constraints on the temporal evolution of volatile components in planetary bodies is by using the observed decay of ⁸⁷Rb to ⁸⁷Sr because Rb is a moderately volatile element, whereas Sr is much more refractory. Here, we show that lunar highland rocks that crystallized ∼4.35 billion years ago exhibit very limited ingrowth of ⁸⁷Sr, indicating that prior to the Moon-forming impact, the impactor commonly referred to as “Theia” and the proto-Earth both must have already been strongly depleted in volatile elements relative to primitive meteorites. These results imply that 1) the volatile element depletion of the Moon did not arise from the Giant Impact, 2) volatile element distributions on the Moon and Earth were principally inherited from their precursors, 3) both Theia and the proto-Earth probably formed in the inner solar system, and 4) the Giant Impact occurred relatively late in solar system history.

Understanding the formation of the Moon has long been a topic of intense interest, although hard constraints on this event only developed after the Apollo program returned lunar samples to Earth. Based on the thousands of lunar rocks that have been studied to date, arguably one of the most stringent of these constraints is that the Moon is strongly depleted in volatile elements relative to the solar photosphere, primitive meteorites, and Earth. Recognition of such a depletion of volatile elements, combined with the orbital mechanics of the Moon and geochemical evidence that it differentiated from a mostly molten state, led to the now widely accepted “Giant Impact” hypothesis, in which the Moon accreted from a volatile element–depleted debris disk produced by an impact between a Mars-sized body (Theia) and the proto-Earth (1). Yet, the formation of the Moon through such an impact scenario raises questions about the composition of the proto-Earth and Theia and their respective contributions to the makeup and subsequent evolution of the Earth–Moon system. Of particular interest is how and when the Moon and Earth obtained their present allotments of volatile components, including, and most importantly, water. Did the Moon and Earth form with their current allotments of volatile elements, or were these elements lost during the Giant Impact and reintroduced to Earth by later accretion of volatile element–laden materials? Here, we address this issue using the Rb–Sr isotopic systematics of lunar samples to provide time constraints on the history and distribution of volatile elements in the Earth–Moon system.