Safety and Efficacy of Wharton's Jelly Connective Tissue Allograft for Rotator Cuff Tears: Findings from a Retrospective Observational Study.

With the increasing occurrence of rotator cuff injuries every year, there is a great need for a reliable treatment option. Wharton's Jelly contains several components that can positively impact the replacement and repair of musculoskeletal defects. The overall objective of this study is to evaluate the improvement of patient-reported pain scales after applying Wharton's Jelly (WJ) in rotator cuff defects. Eighty-seven patients with rotator cuff defects who failed at least eight weeks of conservative treatment were selected from the retrospective repository. A total of 2 cc of WJ flowable allograft was applied to the specific affected anatomy, the most common being supraspinatus tendon, biceps tendon insertion, labral tear, and subscapularis tear. No adverse reactions were reported. Statistically significant improvements were found from the initial to Day 90 in all scales. Patient satisfaction was calculated using minimal clinically important differences. No statistically significant differences were found in mean changes between gender, BMI, and age. Scanning electron microscopy images reveal the similarities between the collagen matrix in WJ and the rotator cuff. The significant improvement in patient outcomes coincides with the current literature analyzing WJ applications with other structural defects around the body. WJ is a promising alternative for musculoskeletal defects when the standard of care fails.

Serum P53 Protein Level and Some Haematologic Parameters among Women of Reproductive Age Living with HIV Infection.

Human immunodeficiency virus (HIV) infection remains a health challenge in Nigeria, and women of reproductive age are disproportionately infected. P53 protein, D-dimer, serum ferritin, CD4 cell count, haemoglobin concentration and haematocrit levels were measured among non-pregnant women of reproductive age living with HIV infection in order to assess the impact of HIV infection on maternal health. A hundred and sixty-two subjects categorised into three groups of 54 persons each involving; newly diagnosed, subjects on highly active antiretroviral therapy (HAART) and apparently healthy control subjects were recruited. Blood samples were analyzed for haemoglobin concentration, haematocrit, CD4 cell count, serum ferritin, D-dimer and p53 protein levels by standard methods. The CD4 cell count, serum p53 protein, and Hb Conc. were significantly lower, while serum ferritin was higher in the newly diagnosed group (p=0.001), followed by the group on HAART (p=0.001) compared to the controls. D-dimer level was significantly lower in the control group (2899.11±670.73pg/ml) than both newly diagnosed (4842.44±489.40pg/ml) and HAART (4660.31±519.83pg/ml) groups, while significant decrease in haematocrit was observed between the newly diagnosed group (0.336±0.07l/l) as against both treated (0.378±0.04l/l) and control (0.362±0.02l/l) groups. D-dimer correlated negatively with serum p53 protein level  among the newly diagnosed subjects  and with Hb Conc. among subjects undergoing treatment.  The study concludes that women of reproductive age living with HIV infection showed higher D-dimer and lower tumour suppression protein levels as well as anaemia and reduced immune response. The newly diagnosed subjects were more affected.

Differences in Breast and Cervical Cancer Screening Among U.S. Women by Nativity and Family History.

INTRODUCTION: System-level factors such as poor access to health services can help explain differential uptake in breast and cervical cancer screening between U.S.- and foreign-born women. However, few studies have explored the roles of family history and perceived risk of these cancers on screening rates. To address these gaps, this study investigates whether a family history of cancer, perceived risk, and system-level factors independently and additively predict differential screening rates of breast and cervical cancer between U.S.-born and foreign-born women living in the U.S. METHODS: Data were analyzed in 2019 from the 2015 National Health Interview Survey. Descriptive and multivariable logistic regression modeling was performed to test whether there were differences in breast and cervical cancer screening within and between the 2 groups and whether family history of cancer and perceived risk of breast cancer were predictors of uptake. RESULTS: The sample comprised women aged 21-74 years (n=14,047). The mean age of the sample was 45.5 (SD=14.8 years). The majority of the women were U.S.-born (77.5%). U.S.- and foreign-born women had more mammograms and Pap tests with a usual source of care (p<0.001) and insurance (p<0.001). Healthcare access and utilization factors were also predictive for both groups of women. Data analyses were conducted in 2019. CONCLUSIONS: These findings are consistent with previous work. Access and healthcare utilization were associated with screening uptake. However, differences in risk perception, family history of breast and cervical cancers, and screening uptake were found between U.S.- and foreign-born women.

Complementary and alternative medicine use among persons with multiple chronic conditions: results from the 2012 National Health Interview Survey.

BACKGROUND: Although a quarter of Americans are estimated to have multiple chronic conditions, information on the impact of chronic disease dyads and triads on use of complementary and alternative medicine (CAM) is scarce. The purpose of this study is to: 1) estimate the prevalence and odds of CAM use among participants with hypercholesterolemia, hypertension, diabetes, and obesity; and 2) examine the effects of chronic condition dyads and triads on the use of CAM modalities, specifically manipulative and body-based methods, biological treatments, mind-body interventions, energy therapies, and alternative medical systems. METHODS: Data were obtained from the 2012 National Health Interview Survey and the Adult Alternative Medicine supplement. Statistical analyses were restricted to persons with self-reported hypercholesterolemia, hypertension, diabetes, or obesity (n = 15,463). RESULTS: Approximately 37.2% of the participants had just one of the four chronic conditions, while 62.4% self-reported multiple comorbidities. CAM use among participants was as follows (p < 0.001): hypercholesterolemia (31.5%), hypertension (28.3%), diabetes (25.0%), and obesity (10.8%). All combinations of disease dyads and triads were consistently and significantly associated with the use of mind-body interventions (2-4%, p < 0.001). Two sets of three dyads were associated with use of manipulative methods (23-27%, p < 0.05) and energy therapies (0.2-0.3%, p < 0.05). Use of biological treatments (0.04%, p < 0.05) and alternative systems (3%, p < 0.05) were each significant for one dyad. One triad was significant for use of manipulative methods (27%, p < 0.001). CONCLUSIONS: These findings point to future directions for research and have practical implications for family practitioners treating multimorbid patients.

Socioeconomic Status, Family Functioning and Delayed Care Among Children With Special Needs.

Parents of children with special healthcare needs (CSHCN) face tremendous stress in caring for their children. Families of CSHCN face increased barriers to health services as evidence also reflects the influence of socioeconomic factors on access. This study investigates the impact of socioeconomic factors and family functioning on delayed care. Descriptive, bivariate, and adjusted multivariate logistic regression were performed using sampling weights. findings suggest that family dynamics are more impactful on delayed care than socioeconomic predictors. Promoting family-centered care that incorporates social support for families to reduce barriers is essential for improved quality of life and health outcomes.

Prostate and Colorectal Cancer Screening Uptake among US and Foreign-Born Males: Evidence from the 2015 NHIS Survey.

Research suggests that prostate and colorectal cancers disproportionately affect men in the US, but little is known about the determinants of prostate-specific antigen (PSA) and colorectal cancer (CRC) screening uptake among US and foreign-born males. The purpose of this study was to investigate what factors influence prostate and colorectal cancer screening uptake among US-native born and foreign-born men. Using the 2015 National Health Interview Survey, we conducted bivariate and multivariate analyses to highlight factors associated with the uptake of prostate and colorectal cancer screening among US-native born and foreign-born men. The sample size consisted of 5651 men respondents, with the mean age of 59.7 years (SD = 12.1). Of these, more than two-fifths (42%) were aged 50-64 years old. With respect to race/ethnicity, the sample was predominantly non-Hispanic Whites (65.5%), 863 (15.6%) Hispanics, and 710 (12.4%) Blacks. Our analysis found higher rates of both US-born and foreign-born men aged 65 years or older, who had either a PSA or CRC screening tests than those aged <65 years. Results of the general multivariate model suggest that men under 50 years old, US-born and foreign-born alike, are statistically significantly less likely to have prostate or colorectal cancer screenings than men aged 65 years or above. This study highlights the influencing factors that encourage or discourage PSA and CRC screening uptake between US-native born and foreign-born men. The results of this inquiry provide an evidence-based blueprint for policymakers and interventionists seeking to address prostate and colorectal cancer among men.

Complementary and Alternative Medicine Use by Normal Weight, Overweight, and Obese Patients with Arthritis or Other Musculoskeletal Diseases.

OBJECTIVES: The Centers for Disease Control and Prevention estimates that 50 million Americans have been diagnosed with arthritis and other musculoskeletal diseases. The purpose of the current study was to (1) estimate the prevalence of overall complementary and alternative medicine (CAM) use and (2) examine the role of body mass index (BMI) on CAM use among normal weight, overweight, and obese persons with chronic lower back pain, chronic neck pain, chronic/rheumatoid arthritis, or musculoskeletal diseases, while controlling for other covariates. DESIGN: Cross-sectional design using secondary data for 9724 adults from the 2007 National Health Interview Survey. Data were weighted and analyzed by using Stata 12 for Windows (Stata Corp., College Station, TX). Descriptive, bivariate, and multivariate logistic regression statistics were computed. PARTICIPANTS: The participants were randomly surveyed from U.S. households. OUTCOME MEASURES: CAM use was measured as reported use of any modality within the five National Center for Complementary and Integrative Health domains. RESULTS: CAM use was statistically significantly associated with female sex; race/ethnicity; having chronic neck pain, lower back pain, or chronic/rheumatoid arthritis; having limitations due to chronic disease; and geographic region (p < 0.05). Factors significantly associated with decreased odds of CAM use included age 50-64 years, income categorized as "other/missing," and having musculoskeletal diseases. Stratification by body mass index suggested increased odds of CAM use among normal/underweight persons with chronic neck pain but decreased odds for those with chronic musculoskeletal diseases. For overweight patients, increased odds of CAM use were significant for chronic lower back pain, musculoskeletal diseases, and chronic/rheumatoid arthritis. CONCLUSIONS: Musculoskeletal diseases and arthritis represent important public health problems with economic implications for the well-being of individuals and society. Identifying CAM use trends by patient weight can be used to improve strategies to increase awareness and access to CAM as part of comprehensive and cost-effective approaches for the management and treatment of these conditions.