Brace-Related Stress and Quality-of-Life Parameters in Adolescents with Idiopathic Scoliosis.

Introduction: This study investigated brace-related stress, trunk appearance perception, and quality of life in adolescent girls with idiopathic scoliosis who wear the Milwaukee brace for treatment. Methods: Fifty-two adolescent girls with idiopathic scoliosis participated in this study. They had been under treatment with Milwaukee brace for at least three months. They filled out four questionnaires, including the revised 22-item Scoliosis Research Society questionnaire (SRS-22r), the Brace Questionnaire (BrQ), the Bad Sobernheim Stress Questionnaire-Brace (BSSQ-Brace), and the Trunk Appearance Perception Scale (TAPS). Results: Twenty participants had high stress levels, and thirty-two had moderate stress levels. The total score and emotional and social function scores of the BrQ were significantly higher in participants with high stress compared to those with moderate stress. There was no significant difference between the two groups in the SRS-22r and TAPS questionnaires scores. However, a high Cobb angle had significantly worsened their perception of trunk appearance. Conclusions: It seems that among quality-of-life parameters, social and emotional functions are more affected by stress level in treating adolescent girls with idiopathic scoliosis with a brace. In addition, patients with high stress levels have a worse perception of their trunk appearance.

The Italian Spine Youth Quality of Life questionnaire: reliability and validity of the Persian version in adolescents with spinal deformities.

PURPOSE: To assess the reliability and validity of the Persian version of the Italian Spine Youth Quality of Life (P-ISYQOL) questionnaire. METHODS: Forward/backward translations and cultural adaption processes of the ISYQOL questionnaire into Persian were conducted by an expert committee. We recruited 178 adolescents with idiopathic scoliosis (AIS) and Scheuermann's kyphosis (SK) and 103 age-matched adolescents with no spinal deformity. Reliability was assessed by evaluating internal consistency and test-retest reliability using Cronbach's alpha and intraclass correlation coefficient (ICC). Convergent construct validity was assessed by measuring the association between the ISYQOL and revised 22-item Scoliosis Research Society (SRS-22r) questionnaires scores. Known-groups construct validity was assessed regarding curve magnitude, deformity, age, sex, and treatment type. RESULTS: Cronbach's alpha and ICC for P-ISYQOL total score was 0.8 and 0.9, respectively. An acceptable association was observed between P-ISYQOL and SRS-22r total scores (r = - 0.5, p < 0.01). The P-ISYQOL could discriminate between adolescents with spinal deformities and adolescents with no spinal deformity as well as those with different types of deformity and treatment (p < 0.01). CONCLUSIONS: The P-ISYQOL is a reliable and valid survey to assess the outcomes of adolescents with spinal deformities. LEVEL OF EVIDENCE: Level I-diagnostic studies.

Predictive Factors for Outcomes of Overcorrection Nighttime Bracing in Adolescent Idiopathic Scoliosis: A Systematic Review.

Predictive clinical and radiological factors can potentially identify adolescent idiopathic scoliosis (AIS) most likely to benefit from overcorrection nighttime bracing. These factors can provide helpful information in clinical decision making. However, the relationship between these factors and outcomes of overcorrection nighttime bracing is unclear. This systematic review determined the predictive factors for identifying outcomes of overcorrection nighttime bracing in AIS. A systematic search was conducted on PubMed, MEDLINE, Scopus, and Embase from January 1986 to January 2021. Studies on AIS patients, aged 10-18 years, with a Risser sign of 0-2 and an initial Cobb angle of 20°-45°, who were treated with overcorrection nighttime bracing and for whom at least one predictive factor of treatment outcome (failure and/or success) was assessed were included. Two blinded reviewers independently evaluated the studies using a quality assessment tool. To determine predictive factors, the level of evidence was rated through best-evidence synthesis. A total of nine studies met the inclusion criteria. A Providence brace was used in six of the included studies, while a Charleston bending brace was used in three. Findings from two high-quality studies provided strong evidence of the association between curve flexibility and brace treatment success. In terms of the Risser sign, this evidence was obtained from three high-quality studies. Moderate evidence indicated a positive association between premenarchal status and nighttime bracing failure. Inconclusive evidence indicated that poor brace compliance is associated with treatment failure. Conflicting evidence of treatment failure was indicated for initial curve magnitude, curve type, in-brace correction, age, Risser sign, curve apex, and sex. These findings show that greater curve flexibility and a higher Risser sign are associated with overcorrection nighttime bracing success.

The effects of bracing on sagittal spinopelvic parameters and Cobb angle in adolescents with idiopathic scoliosis: A before-after clinical study.

OBJECTIVES: This study aims to evaluate the effects of bracing on the Cobb angle and sagittal spinopelvic parameters in adolescent idiopathic scoliosis (AIS) patients. PATIENTS AND METHODS: A total of 25 adolescents (2 males, 23 females; mean age 12.7±1.6; range, 10-15 years) with AIS who received bracing between January 2000 and June 2017 were retrospectively analyzed. The initial and final out-of-brace radiographs of 25 AIS patients were analyzed with regard to the spinopelvic parameters. The pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), Cobb angle, thoracic kyphosis (TK), and lumbar lordosis (LL) were measured. RESULTS: The mean age at the initiation of bracing was 12.7±1.6 years. The mean initial Cobb angle was 31.8°±5.9°. There were no statistically significant differences between the baseline and the final measurements of the PI, PT, and SS. However, there were statistically significant differences between the baseline and the final measurements of the TK, LL, and Cobb angle. A significant correlation was observed between the PI and Cobb angle and TK and between the LL and SS. CONCLUSION: Our study results show significant associations between the sagittal pelvic parameters and the spinal parameters during the brace treatment of adolescents with idiopathic scoliosis.

National Minimum Data Set for Antimicrobial Resistance Management: Toward Global Surveillance System.

BACKGROUND: Success of infection treatment depends on the availability of accurate, reliable, and comprehensive data, information, and knowledge at the point of therapeutic decision-making. The identification of a national minimum data set will support the development and implementation of an effective surveillance system. The goal of this study was to develop a national antimicrobial resistance surveillance minimum data set. METHODS: In this cross-sectional and descriptive study, data were collected from selected pioneering countries and organizations which have national or international antimicrobial resistance surveillance systems. A minimum data set checklist was extracted and validated. The ultimate data elements of the minimum data set were determined by applying the Delphi technique. RESULTS: Through the Delphi technique, we obtained 80 data elements in 8 axes. The resistance data categories comprised basic, clinical, electronic reporting, infection control, microbiology, pharmacy, World Health Organization-derived, and expert-recommended data. Relevance coding was extracted based on the Iranian electronic health record coding system. CONCLUSION: This study provides a set of data elements and a schematic framework for the implementation of an antimicrobial resistance surveillance system. A uniform minimum data set was created based on key informants' opinions to cover essential needs in the early implementation of a global antimicrobial resistance surveillance system in Iran.

The p.Arg435His Variation of IgG3 With High Affinity to FcRn Is Associated With Susceptibility for Pemphigus Vulgaris-Analysis of Four Different Ethnic Cohorts.

IgG3 is the IgG subclass with the strongest effector functions among all four IgG subclasses and the highest degree of allelic variability among all constant immunoglobulin genes. Due to its genetic position, IgG3 is often the first isotype an antibody switches to before IgG1 or IgG4. Compared with the other IgG subclasses, it has a reduced half-life which is probably connected to a decreased affinity to the neonatal Fc receptor (FcRn). However, a few allelic variants harbor an amino acid replacement of His435 to Arg that reverts the half-life of the resulting IgG3 to the same level as the other IgG subclasses. Because of its functional impact, we hypothesized that the p.Arg435His variation could be associated with susceptibility to autoantibody-mediated diseases like pemphigus vulgaris (PV) and bullous pemphigoid (BP). Using a set of samples from German, Turkish, Egyptian, and Iranian patients and controls, we were able to demonstrate a genetic association of the p.Arg435His variation with PV risk, but not with BP risk. Our results suggest a hitherto unknown role for the function of IgG3 in the pathogenesis of PV.

Smart article: application of intelligent platforms in next generation biomedical publications.

Production of scientific data has been accelerated exponentially though ease of access to the required knowledge is still challenging. Hence, the emergence of new frameworks to allow more efficient storage of information would be beneficial. Attaining intelligent platforms enable the smart article to serve as a forum for exchanging idea among experts of academic disciplines for a rapid and efficient scientific discourse.

Persian mHealth Apps: A Cross Sectional Study Based on Use Case Classification.

Mobile health apps play an important role in healthcare processes and health promotion. In recent years many Persian mhealth apps were developed and are available in various national app markets. Cafebazaar is the largest Persian app store that contains more than 3500 android apps in medical and health & fitness categories. In this study some characteristics of 200 top Persian medical apps of Cafebazaar were investigated and then categorized by their use cases. Results showed that only 6% of apps declare the involvement of at least one health professional in the conception or development of the apps. In 35% of studied apps, no contact information was provided for the users and 10.5% applied reliable sources for their content. 13 distinct use cases were found in all 200 apps of which two were new to an already published use-case model. This study shows that Persian mHealth apps, like other existing apps in the world, have a long way to improve and reach some basic standards. Lack of regulatory agencies and absence of a dynamic evaluation system for mHealth apps might be the main reason of these defects. This study also shows that 20 use cases existing in international health related apps are not yet used in Persian apps and therefore there is a reach potential of creating new apps in mHealth field.

A novel missense mutation in oncostatin M receptor beta causing primary localized cutaneous amyloidosis.

Primary localized cutaneous amyloidosis (PLCA) is a chronic skin disorder, caused by amyloid material deposition in the upper dermis. Autosomal dominant PLCA has been mapped earlier to pathogenic missense mutations in the OSMR gene, which encodes the oncostatin M receptor ß subunit (OSMRß). OSMRß is interleukin-6 family cytokine receptors and possesses two ligands, oncostatin M and interleukin-31, which both have biologic roles in inflammation and keratinocyte cell proliferation, differentiation, and apoptosis. Here, we identified a new OSMR mutation in a Kurdish family for the first time. Blood samples were taken from all the affected individuals in the family. DNA extraction was performed using salting out technique. Primers were designed for intron flanking individual exons of OSMR gene which were subjected to direct sequencing after PCR amplification for each sample. Sequencing showed a C/T substitution at position 613 in the proband. This mutation results in an L613S (leucine 613 to serine) amino acid change. The identified mutation was observed in all affected family members but not in 100 ethnically matched healthy controls. Elucidating the molecular basis of familial PLCA provides new insight into mechanisms of itch in human skin and may lead to new therapeutic targets for pruritus.

Auricular enlargement: an atypical presentation of old world cutaneous leishmaniasis.

The auricle is an extremely rare site for cutaneous leishmaniasis (CL) in Old World, which tends to be a benign disease with self-healing small nodules such as the "oriental sore". However, in the New World, there is a type of CL of the ear, named as "chiclero's ulcer" which is caused by Leishmania mexicana. Herein, we describe a case of massive auricular enlargement due to Old World CL.

Four familial cases of epidermodysplasia verruciformis: mother and three sons.

Epidermodysplasia verruciformis (EV) is a rare genodermatosis associated with a high risk of skin cancer. In this report, we present three Iranian brothers and their mother with extensive seborrheic keratosis-like (SK-like) viral warts. Initial facial lesions developed in the first decade and disseminated with time. The patients showed SK-like viral warts characterized by dark brown or black pigmented proliferative lesions with hyperkeratotic surfaces. The histopathological findings were consistent with the diagnosis of EV. There are few reports of familial epidermodysplasia verruciformis especially in a mother and her three sons.

Lipoid proteinosis: report of three siblings.

Lipoid proteinosis is a very rare genodermatosis characterized by infiltration of hyaline material into the skin, oral cavity, larynx and internal organs. It usually presents in infancy with hoarseness. Although about 300 cases have been reported in the literature, the occurrence of the disease is rare in siblings. In this report we introduce three siblings with this disease.