Lingual Frenulum Phenotypes in Brazilian Infants With Congenital Zika Syndrome

Objective: The present study aimed to evaluate lingual frenulum in children affected by congenital Zika syndrome (CZS) and to analyze the association of lingual frenulum phenotypes with other variables. Design: This present work had a cross-sectional, descriptive study design. Setting: This study was carried out in Fortaleza (Brazil). The health professionals provided tertiary level of care. Data collection occurred during a multidisciplinary task force for evaluating infants affected by CZS in December 2 to 3, 2016. Patients: Fifty-four patients with CZS (1-12 months old; 32 girls and 22 boys) were recruited from a population of 70 infants. Interventions: A multidisciplinary group comprised of speech-language pathologist/audiologists and pediatric dentists evaluated all patients through an intraoral examination and a specific tongue maneuver protocol for infants. Main Outcome Measures: Lingual frenulum visibility was the primary outcome measure. Before initiating the study, we hypothesized that children with CZS had an absent lingual frenulum. Results: Lingual frenula were visible in 34 (63%) infants, whereas in 20 (37%) infants lingual frenula visibility required a specific maneuver to retract the tongue. Six of 20 infants presented posteriorly positioned lingual frenula that were visible after maneuver. Lingual frenula were covered by mucous tissue in 14 infants. Presence of posterior frenulum was associated with dysphagia ( P = 0.038). However, the presence of dysphagia in a multivariate model did not associate with the presence of a posterior lingual frenulum ( P = .069) or neurologic symptoms ( P = .056). Conclusion: Children with CZS showed predominance of a posterior lingual frenula covered by an overlapping curtain-like mucous membrane.

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Who is at risk of occupational Q fever: new insights from a multi-profession cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-030088 ◽

2020 ◽

Vol 10 (2) ◽

pp. e030088 ◽

Cited By ~ 2

Author(s):

Tanja Groten ◽

Karola Kuenzer ◽

Udo Moog ◽

Beate Hermann ◽

Katrin Maier ◽

...

Keyword(s):

At Risk ◽

Primary Outcome ◽

Outcome Measure ◽

Q Fever ◽

Cross Sectional Study ◽

Primary Outcome Measure ◽

Sectional Study ◽

Cross Sectional ◽

Seroprevalence Data ◽

Regular Contact

ObjectivesQ fever is a zoonosis caused by the bacteriumCoxiella burnetii. It is recognised as an occupational hazard for individuals who are in regular contact with animal birth products. Data from the literature are not comparable because different serological assays perform very differently in detecting past infections. It is therefore essential to choose the right assay for obtaining reliable data of seroprevalence. Obstetricians are another profession potentially at risk of Q fever. They can be infected from birth products of women with Q fever during pregnancy. There is little data, however, for Q fever in this occupational group. Our study therefore had two purposes. The first was to obtain reliable seroprevalence data for occupational groups in regular contact with animal birth products by using an assay with proven excellent sensitivity and specificity for detecting past infections. The second purpose was to obtain primary data for obstetricians.DesignWe carried out a cross-sectional study.SettingThe study included shepherds, cattle farmers, veterinarians and obstetricians from Thuringia.Participants77 shepherds, 74 veterinarians, 14 cattle farmers, 17 office employees and 68 obstetricians participated. The control group consisted of 92 blood donors.Primary outcome measureThe primary outcome measure wasC. burnetiiphase II specific IgG. The assay used was evaluated for this purpose in a previous study.ResultsOf the 250 blood samples we analysed, the very highest seroprevalences (64%–77%) occurred in individuals with frequent animal contact. There were no significant differences between shepherds, cattle farmers and veterinarians. The seroprevalence in people working in administration was lower but still significantly greater than the control. No obstetricians or midwives tested positive.ConclusionsShepherds, cattle farmers and veterinarians have a high risk ofC. burnetiiinfection. However, our study clearly proves that there was no increased risk for people working in an obstetric department.

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Discrepancies between ClinicalTrials.gov recruitment status and actual trial status: a cross-sectional analysis

BMJ Open ◽

10.1136/bmjopen-2017-017719 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017719 ◽

Cited By ~ 13

Author(s):

Christopher W Jones ◽

Michelle R Safferman ◽

Amanda C Adams ◽

Timothy F Platts-Mills

Keyword(s):

Primary Outcome ◽

Outcome Measure ◽

Medical Knowledge ◽

Primary Outcome Measure ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Status Information ◽

Study Completion ◽

Sectional Analysis ◽

Actual Trial

ObjectivesTo determine the accuracy of the recruitment status listed on ClinicalTrials.gov as compared with the actual trial status.DesignCross-sectional analysis.SettingRandom sample of interventional phase 2–4 clinical trials registered between 2010 and 2012 on ClinicalTrials.gov.Primary outcome measureFor each trial which was listed within ClinicalTrials.gov as ongoing, two investigators performed a comprehensive literature search for evidence that the trial had actually been completed. For each trial listed as completed or terminated early by ClinicalTrials.gov, we compared the date that the trial was actually concluded with the date the registry was updated to reflect the study’s conclusion status.ResultsAmong the 405 included trials, 92 had a registry status indicating that study activity was either ongoing or the recruitment status was unknown. Of these, published results were available for 34 (37%). Among the 313 concluded trials, the median delay between study completion and a registry update reflecting that the study had ended was 141 days (IQR 48–419), with delays of over 1 year present for 29%. In total, 125 trials (31%) either had a listed recruitment status which was incorrect or had a delay of more than 1 year between the time the study was concluded and the time the registry recruitment status was updated.ConclusionsAt present, registry recruitment status information in ClinicalTrials.gov is often outdated or wrong. This inaccuracy has implications for the ability of researchers to identify completed trials and accurately characterise all available medical knowledge on a given subject.

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Individual factors influencing public's perceptions about the importance of COVID-19 immunity certificates: a cross-sectional online questionnaire survey in the UK

10.1101/2021.11.12.21266256 ◽

2021 ◽

Author(s):

Corina Elena Niculaescu ◽

Isabel Karen Sassoon ◽

Irma Cecilia Landa-Avila ◽

Ozlem Colak ◽

Gyuchan Thomas Jun ◽

...

Keyword(s):

Primary Outcome ◽

Outcome Measure ◽

Service Providers ◽

Primary Outcome Measure ◽

Individual Factors ◽

Cross Sectional ◽

Independent Variables ◽

Factors Influencing ◽

Perceived Importance ◽

The Uk

Objectives: To assess what were the main individual factors influencing people's perception of the importance of using COVID-19 immunity certificates. Design: Cross-sectional online survey. Setting: Nationally representative survey in the UK, conducted on the 3rd of August 2021. Participants: Responses from 534 participants, aged 18 and older, residents of the UK. Interventions: This was a cross-sectional survey and each participant replied to the same set of questions. Primary outcome measure and independent variables: The primary outcome measure (dependent variable) was the participants' perceived importance of using immunity certificates, computed as an index of six items. The following individual drivers were used as the independent variables: a) personal beliefs about COVID-19 (using constructs adapted from the Health Belief Model), b) personal views on vaccination, c) willingness to share immunity status with service providers, and d) variables related to respondents' lifestyle and socio-demographic characteristics. Results: Perceived importance of immunity certificates was higher among respondents who felt that contracting COVID-19 would have a severe negative impact on their health (β=0.2564, p=0.0000) and felt safer if vaccinated (β=0.1552, p=0.0000). The prospect of future economic recovery positively influenced perceived importance of immunity certificates. Respondents who were employed or self-employed (β=-0.2412, p=0.0010), or experienced an increase in income after the COVID-19 pandemic (β=-0.1287, p=0.0020) perceived less important the use of immunity certificates compared to those who were unemployed or had retired or those who had experienced reduction in their income during the pandemic. Conclusions: The findings of our survey suggest that more vulnerable members in our society (unemployed or retired and those believing that COVID-19 would have a severe impact on their health) and people who experienced a reduction in income during the pandemic perceived the severity of not using immunity certificates in their daily life as higher.

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Government’s subsidisation policy and utilisation of smoking cessation treatments: a population-based cross-sectional study in Taiwan

BMJ Open ◽

10.1136/bmjopen-2020-040424 ◽

2021 ◽

Vol 11 (1) ◽

pp. e040424

Author(s):

Sheng-Kuang Wang ◽

Chi-Wen Kao ◽

Hui-Wan Chuang ◽

Yi-Kai Tseng ◽

Wan-Chun Chen ◽

...

Keyword(s):

Smoking Cessation ◽

Primary Outcome ◽

Outcome Measure ◽

Primary Outcome Measure ◽

Cross Sectional ◽

Quit Smoking ◽

Combined Use ◽

Heavy Smokers ◽

Cessation Clinic ◽

Smoking Cessation Clinic

ObjectivesThis study examined the associations between the Second-Generation Cessation Payment Scheme (SCPS) and the use of smoking cessation treatments. Furthermore, these associations were compared between light and heavy smokers in Taiwan.DesignThis study had a cross-sectional design.SettingData were obtained from the Taiwan Adult Smoking Behaviour Surveillance System 2010–2011 and 2013–2014; data for each year consisted of a nationally representative sample of adults aged 18 years and older.ParticipantsCurrent smokers who had either quit or made a serious attempt to quit smoking were selected for the analysis.Primary outcome measureThe primary outcome measure was the use of a smoking cessation clinic or pharmacy in a twice daily to quit smoking.ResultsAccording to multivariate analysis, the SCPS was positively associated with the combined use of a smoking cessation clinic and a pharmacy (OR=3.947; 95% CI: 1.359 to 11.463) when individual-level predictors (gender, age, education level, marital status, monthly household income, daily cigarette consumption, smoking status and self-reported health) were controlled. Heavy smokers showed a signiﬁcant increase in the sole use of a pharmacy (OR=1.676; 95% CI: 1.094 to 2.569) and combined use of a smoking cessation clinic and pharmacy (OR=8.984; 95% CI: 1.914 to 42.173) after the SCPS was introduced. In addition, when related factors were controlled, the use of smoking cessation services was more frequent among heavy smokers than light smokers, including any treatment (OR=1.594; 95% CI: 1.308 to 1.942), a smoking cessation clinic (OR=1.539; 95% CI: 1.232 to 1.922), a pharmacy (OR=1.632; 95% CI: 1.157 to 2.302) and the combination of a smoking cessation clinic and pharmacy (OR=4.608; 95% CI: 1.331 to 15.949) .ConclusionsThe SCPS subsidisation policy increased the use of smoking cessation treatments, particularly among heavy smokers.

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Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan

Scientific Reports ◽

10.1038/s41598-021-88259-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yuta Seko ◽

Takao Kato ◽

Yuhei Yamaji ◽

Yoshisumi Haruna ◽

Eisaku Nakane ◽

...

Keyword(s):

Cardiovascular Events ◽

Primary Outcome ◽

Outcome Measure ◽

Conduction Block ◽

Primary Outcome Measure ◽

Excess Risk ◽

Major Adverse Cardiovascular Events ◽

Prognostic Impact ◽

Axis Deviation ◽

The Right

AbstractWhile the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding patients with a QRS duration of ≥ 110 ms, pacemaker placement, and an QRS-axis − 90° to − 180° (northwest axis). The study population was categorized into three groups depending on the mean frontal plane QRS axis as follows: patients with left axis deviation (N = 171), those with right axis deviation (N = 94), and those with normal axis (N = 3088). The primary outcome was a composite of all-cause death and major adverse cardiovascular events. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the left axis deviation group (26.4% in the left axis deviation, 22.7% in the right axis deviation, and 18.4% in the normal axis groups, log-rank P = 0.004). After adjusting for confounders, the excess risk of primary outcome measure remained significant in the left axis deviation group (hazard ratio [HR] 1.44; 95% confidence interval [CI] 1.07–1.95; P = 0.02), while the excess risk of primary outcome measure was not significant in the right axis deviation group (HR 1.22; 95% CI 0.76–1.96; P = 0.41). Left axis deviation was associated with a higher risk of a composite of all-cause death and major adverse cardiovascular events in hospital-based patients without conduction block in Japan.

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Computerised cognitive–behavioural therapy for adults with intellectual disability: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.117.198630 ◽

2017 ◽

Vol 211 (2) ◽

pp. 95-102 ◽

Cited By ~ 13

Author(s):

Patricia Cooney ◽

Catherine Jackman ◽

David Coyle ◽

Gary O'Reilly

Keyword(s):

Intellectual Disability ◽

Randomised Controlled Trial ◽

Primary Outcome ◽

Outcome Measure ◽

Controlled Trial ◽

Behavioural Therapy ◽

Primary Outcome Measure ◽

Cognitive Behavioural ◽

Randomised Controlled

BackgroundDespite the evidence base for computer-assisted cognitive–behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.AimsTo evaluate the utility of a CBT computer game for adults who have an intellectual disability.MethodA 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.ResultsA significant group x time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.ConclusionsAs the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population.

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Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.097048 ◽

2008 ◽

Vol 68 (10) ◽

pp. 1585-1590 ◽

Cited By ~ 61

Author(s):

U M. Dohn ◽

A Boonen ◽

M L Hetland ◽

M S Hansen ◽

L S Knudsen ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Computed Tomography ◽

High Resolution ◽

Primary Outcome ◽

Outcome Measure ◽

Primary Outcome Measure ◽

High Resolution Computed Tomography ◽

Follow Up Study ◽

Erosive Progression

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Telephone-guided self-help for mental health difficulties in neurological conditions: a randomised pilot trial

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-318577 ◽

2021 ◽

pp. archdischild-2019-318577

Author(s):

Sophie D Bennett ◽

Isobel Heyman ◽

Anna E Coughtrey ◽

Sophia Varadkar ◽

Terence Stephenson ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Primary Outcome ◽

Outcome Measure ◽

Mental Health Problems ◽

Pilot Trial ◽

Primary Outcome Measure ◽

Self Help ◽

Mental Health Difficulties ◽

Neurological Conditions

ObjectiveThis study aimed to conduct a randomised pilot trial to assess the feasibility of a randomised controlled trial (RCT) to investigate the effect of telephone-guided self-help for the treatment of mental health difficulties in children with neurological conditions.DesignPreliminary RCT. The primary outcome measure was the Strengths and Difficulties Questionnaire.SettingNeurology clinics in a national tertiary paediatric hospital.PatientsYoung people attending neurology clinics who met criteria for mental health difficulties according to the Development and Wellbeing Assessment.Interventions12 weeks of telephone-guided self-help based on a modular approach to psychological therapy for children delivered to children and/or their parents (n=17; eight males; mean age 12.04 years, SD=3.34) or a waiting list for telephone-guided self-help with no additional intervention over 12 weeks (n=17; nine males; mean age 10.53 years, SD=3.14).Results124 participants completed the DAWBA, and 34 children and young people were entered into the trial. 65% of those randomised to the intervention arm completed the full intervention, and the intervention was acceptable to those completing it. However, there were significant problems related to lack of data completion (38% data loss for primary outcome measure), choice of control comparator and outcome measures. Due to significant loss of data at follow-up, the effect size findings are considered unreliable.ConclusionsFurther feasibility work should be conducted to improve data completeness before progression to a definitive trial of guided self-help for mental health problems in children with neurological conditions can be recommended.Trial registration numberISRCTN21184717.

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COMPARISON RESULTS OF SURGICAL TREATMENT LOCALIZED AND EXTENDED UTERINE CANCER

Clinical Practice ◽

10.17816/clinpract1356-61 ◽

2010 ◽

Vol 1 (3) ◽

pp. 56-61

Author(s):

I I Ushakov ◽

E A Artoshina ◽

P G Brousov ◽

I V Nazvantsev ◽

S A Levakov ◽

...

Keyword(s):

Surgical Treatment ◽

High Risk ◽

Adjuvant Radiotherapy ◽

Primary Outcome ◽

Outcome Measure ◽

Uterine Cancer ◽

Primary Outcome Measure ◽

Pelvic Lymphadenectomy ◽

Peritoneal Washing ◽

Comparison Results

We selected 145 patients with endometrial carcinoma who had been treated with standard surgery (hysterectomy and BSO, peritoneal washing, palpation pelvic and para-aortic nodes) and with complete systematic pelvic lymphadenectomy (n=30 patients) or combined pelvic and para-aortic lymphadenectomy (n=30). Patients at intermediate or high risk of recurrence were offered adjuvant radiotherapy. The primary outcome measure was results of the surgical therapy.

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