No abstract available.
Humans ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Polymorphism, Genetic*

No abstract available.
Female ; Hypertension, Pregnancy-Induced* ; Lipoprotein Lipase* ; Lipoproteins* ; Pregnancy

Background: The COVID-19 pandemic has significantly affected the psychological and mental health of seafarers and maritime workers, and a considerable proportion have experienced depression. Cognizant of the different work-related factors and pandemic-related factors which may contribute to depression, it is imperative to determine the prevalence of depression among seafarers and maritime workers to develop appropriate intervention and management Objective: To determine the prevalence of depression among seafarers and maritime workers during the COVID-19 pandemic. Methods: This is a random-effects meta-analysis of cross-sectional studies estimating the prevalence of depression among seafarer and maritime workers during the COVID-19 pandemic period. The proportion of respondents with depression, using standardized depression assessment tools, and the sample sizes of each study were extracted and recorded in an abstraction form. Pooled estimate of depression was analyzed using the metaprop command of STATA MP Results: The search yielded a total of 555 articles, with only 4 eligible articles included for analyses. From the included studies, 75% had good quality of evidence while 25% had fair quality. Analysis showed that the overall pooled prevalence of depression at 28% (ES=0.28, z=4.69, p=0.001, 95% CI=0.16–0.39) was statistically significant during the COVID-19 pandemic. However, there was a substantially high heterogeneity among the included the studies (χ2=125.41, p=0.001, I2=97.61%, τ2=0.01). Conclusion Depression is a real-life, yet underreported and underdiagnosed problem among seafarers and maritime workers before and during the COVID-19 pandemic. This result stresses the need for policy and practice changes such as implementation of screening programs to determine and evaluate depression or depressive symptoms; modification of existing protocols in performing pre-employment medical examinations with additional focus on the psychological health and well-being; and, provision of appropriate intervention such as psychological health education, counseling, and appropriate referral.
Depression ; COVID-19

Central venous catheter (CVC) placement is a commonly performed procedure. More than 5 million CVC placements are performed annually in the United States, with nearly 45% of critical care patients and 8% of all inpatients requiring a CVC during their hospitalization. A novel wire-guided scalpel (GuideBlade; Ambitus Medical Supplies LLC, Oceanside, NY, USA) has recently been introduced into clinical practice. In this communication, we will describe how to use the device and discuss possible advantages associated with its routine use during CVC placement.

Central venous catheter (CVC) placement is a commonly performed procedure. More than 5 million CVC placements are performed annually in the United States, with nearly 45% of critical care patients and 8% of all inpatients requiring a CVC during their hospitalization. A novel wire-guided scalpel (GuideBlade; Ambitus Medical Supplies LLC, Oceanside, NY, USA) has recently been introduced into clinical practice. In this communication, we will describe how to use the device and discuss possible advantages associated with its routine use during CVC placement.

Pre-operative localization of abnormal parathyroid tissue helps in deciding whether surgery begins with a neck or mediastinal exploration. In this study we aimed to evaluate the usefulness of parathyroid scintigraphy in pre-operative localization of parathyroid adenomas and treatment. From February 2006 to October 2008, patients with signs and symptoms of hyperparathyroidism were recruited to join the study. The study group consisted of 3 males and 8 females. All subjects had a pre-operative parathyroid scintigraphy with Tc99m Sestamibi followed by parathyroidectomy. Ten patients had a positive scintigraphic finding which correlated to the actual location of the adenoma determined during the operation. Almost all patients (10 out of 11) underwent minimally invasive parathyroidectomy (MIP) while only one patient underwent bilateral neck dissection. The average incision length was 3.73 + 0.65 cm. Only one patient had an adverse event (transient hypocalcemia and bleeding necessitating a drain) which resolved later. The average hospital stay was 2.5 + 0.7 days. Parathyroid Tc99m-sestamibi scan is a reliable, non-invasive, and cost effective imaging modality in pre-operative localization of parathyroid adenomas for first time parathyroidectomy. This can help and guide surgeons to perform focused parathyroid surgery with minimal incision, successful localization, less complications, and shorter hospital stays.

Human ; Male ; Female ; Adenoma ; Hyperparathyroidism ; Hypocalcemia ; Length Of Stay ; Neck Dissection ; Parathyroid Glands ; Parathyroid Neoplasms ; Parathyroidectomy ; Surgeons ; Technetium Tc 99m Sestamibi ; Endocrine Gland Neoplasms

There has been a conscious effort to address osteoporosis in the aging population. As bisphosphonate and intermittent parathyroid hormone (PTH) therapy become more widely prescribed to treat osteoporosis, it is important to understand their effects on other physiologic processes, particularly the impact on spinal fusion. Despite early animal model studies and more recent clinical studies, the impact of these medications on spinal fusion is not fully understood. Previous animal studies suggest that bisphosphonate therapy resulted in inhibition of fusion mass with impeded maturity and an unknown effect on biomechanical strength. Prior animal studies demonstrate an improved fusion rate and fusion mass microstructure with the use of intermittent PTH. The purpose of this study was to determine if bisphosphonates and intermittent PTH treatment have impact on human spinal fusion. A systematic review of the literature published between 1980 and 2015 was conducted using major electronic databases. Studies reporting outcomes of human subjects undergoing 1, 2, or 3-level spinal fusion while receiving bisphosphonates and/or intermittent PTH treatment were included. The results of relevant human studies were analyzed for consensus on the effects of these medications in regards to spinal fusion. There were nine human studies evaluating the impact of these medications on spinal fusion. Improved fusion rates were noted in patients receiving bisphosphonates compared to control groups, and greater fusion rates in patients receiving PTH compared to control groups. Prior studies involving animal models found an improved fusion rate and fusion mass microstructure with the use of intermittent PTH. No significant complications were demonstrated in any study included in the analysis. Bisphosphonate use in humans may not be a deterrent to spinal fusion. Intermittent parathyroid use has shown early promise to increase fusion mass in both animal and human studies but further studies are needed to support routine use.
Aging ; Animals ; Consensus ; Diphosphonates ; Humans* ; Lumbar Vertebrae ; Models, Animal ; Osteoporosis ; Parathyroid Hormone ; Spinal Fusion*

OBJECTIVE: To investigate the effectiveness of radiographic parameters on segmental instability in the lumbar spine using Kinetic magnetic resonance imaging (MRI). METHODS: Segmental motion, defined as excessive (more than 3 mm) translational motion from flexion to extension, was investigated in 309 subjects (927 segments) using Kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration (DD), facet joint osteoarthritis (FJO), and ligament flavum hypertrophy (LFH). These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. RESULTS: The overall incidence of segmental instability was 10.5% at L3-L4, 16.5% at L4-L5, and 7.3% at L5-S1. DD and LFH at L3-L4 and FJO and LFH at L4-L5 were individually associated with segmental instability (p<0.05). At L4-L5, the following combinations had a higher incidence of segmental instability (p<0.05) when compared to other segments : (1) Grade IV DD with grade 3 FJO, (2) Grade 2 or 3 FJO with the presence of LFH, and (3) Grade IV DD with the presence of LFH. At L5-S1, the group with Grade III disc and Grade 3 FJO had a higher incidence of segmental instability than the group with Grade I or II DD and Grade 1 FJO. CONCLUSION: This study showed that the presences of either Grade IV DD or grade 3 FJO with LFH at L4-L5 were good indicators for segmental instability. Therefore, using these parameters simultaneously in patients with segmental instability would be useful for determining candidacy for surgical treatment.
Humans ; Hypertrophy ; Incidence ; Intervertebral Disc Degeneration ; Ligaments ; Magnetic Resonance Imaging ; Osteoarthritis ; Spine ; Zygapophyseal Joint

PURPOSE: The authors investigated the effect of lumbar facet tropism (FT) on intervertebral disc degeneration (DD), facet joint degeneration (FJD), and segmental translational motion. MATERIALS AND METHODS: Using kinetic MRI (KMRI), lumbar FT, which was defined as a difference in symmetry of more than 7degrees between the orientations of the facet joints, was investigated in 900 functional spinal units (300 subjects) in flexion, neutral, and extension postures. Each segment at L3-L4, L4-L5, and L5-S1 was assessed based on the extent of DD (grade I-V) and FJD (grade 1-4). According to the presence of FT, they were classified into two groups; one with FT and one with facet symmetry. For each group, demographics, DD, FJD and translational segmental motion were compared. RESULTS: The incidence of FT was 34.5% at L3-L4, 35.1% at L4-L5, and 35.2% at L5-S1. Age and gender did not show any significant relationship with FT. Additionally, no correlation was observed between DD and FT. FT, however, wasfound to be associated with a higher incidence of highly degenerated facet joints at L4-L5 when compared to patients without FT (p < 0.01). Finally, FT was not observed to have any effects upon translational segmental motion. CONCLUSION: No significant correlation was observed between lumbar FT and DD or translational segmental motion. However, FT was shown to be associated significantly with the presence of high grades of FJD at L4-L5. This suggests that at active sites of segmental motion, FT may predispose to the development of facet joint degeneration.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Humans ; Intervertebral Disk Displacement/*etiology/pathology ; Joint Diseases/*complications/pathology ; Lumbar Vertebrae/*pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Sex Factors ; Zygapophyseal Joint/*pathology/physiopathology

Relationships between gastrointestinal viscera and human emotions have been documented by virtually all medical traditions known to date. The focus on this relationship has waxed and waned through the centuries, with noted surges in interest driven by cultural forces. Here we explore some of this history and the emerging trends in experimental and clinical research. In particular, we pay specific attention to how the hygiene hypothesis and emerging research on traditional dietary patterns has helped re-ignite interest in the use of microbes to support mental health. At present, the application of microbes and their structural parts as a means to positively influence mental health is an area filled with promise. However, there are many limitations within this new paradigm shift in neuropsychiatry. Impediments that could block translation of encouraging experimental studies include environmental forces that work toward dysbiosis, perhaps none more important than westernized dietary patterns. On the other hand, it is likely that specific dietary choices may amplify the value of future microbial-based therapeutics. Pre-clinical and clinical research involving microbiota and allergic disorders has predated recent work in psychiatry, an early start that provides valuable lessons. The microbiome is intimately connected to diet, nutrition, and other lifestyle variables; microbial-based psychopharmacology will need to consider this contextual application, otherwise the ceiling of clinical expectations will likely need to be lowered.
Allergy and Immunology ; Anxiety ; Depression ; Diet ; Dysbiosis ; Hand ; Humans ; Hygiene Hypothesis ; Life Style ; Mental Health* ; Microbiota* ; Neuropsychiatry ; Psychopharmacology ; Viscera ; Child Health