Publications by authors named "B Burda"

46 Publications

Association of infra-patellar fat pad size with age and body weight in children and adolescents.

Ann Anat 2020 Nov 2;232:151533. Epub 2020 Jul 2.

Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; Department of Orthopedic Surgery & Traumatology, Landesklinik Tamsweg, Paracelsus Medical University, Tamsweg, Austria.

Background: The infra-patellar fat pad (IPFP) represents a potential mediator between obesity, low grade inflammation, and knee osteoarthritis via endocrine pathways. Yet, not only in adults, but also in childhood obesity negatively impacts knee structures.

Objective: The current study therefore investigated the sex-specific growth of the IPFP with age and body weight in healthy children and adolescents.

Materials And Methods: Thirty young healthy subjects (60% girls; age 4-17 years, body weight 14-90 kg in girls and 29-105 kg in boys; BMI 12.2-32.4 kg/m) without magnetic resonance imaging (MRI) knee pathology were studied. The IPFP volume was determined from sagittal T-1 weighted and proton-density spectral attenuated inversion recovery MRIs. The primary analysis focused on the sex-specific IPFP volume/body weight ratio as dependent, and age as independent variable, using linear regression models. A secondary analytic focus was the slope of the age-dependence of IPFP volume, without normalization to body weight.

Results: There was no statistically significant association of the IPFP volume/body weight ratio with age in girls (p = 0.57) or boys (p = 0.31), the R of ranging from -0.32 to 0.14. The ratio was greater in boys (0.54 ± 0.10 cm/kg) than in girls (0.45 ± 0.07 cm/kg) (p < 0.01). The IPFP volume increased by approx. 2 cm per annum in both girls and boys, without any indication of a non-linear relationship.

Conclusion: Our findings reveal that the ratio of the IPFP volume and body weight remains constant between age 4 and 17 in both normal weight girls and boys, and that the IPFP volume increases linearly with age throughout this period.
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November 2020

Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

JAMA 2018 08;320(7):687-705

University of California, Davis, Center for Healthcare Policy and Research, Sacramento.

Importance: Cervical cancer can be prevented with detection and treatment of precancerous cell changes caused primarily by high-risk types of human papillomavirus (hrHPV), the causative agents in more than 90% of cervical cancers.

Objective: To systematically review benefits and harms of cervical cancer screening for hrHPV to inform the US Preventive Services Task Force.

Data Sources: MEDLINE, PubMed, PsycINFO, and the Cochrane Collaboration Registry of Controlled Trials from January 2011 through February 15, 2017; surveillance through May 25, 2018.

Study Selection: Randomized clinical trials (RCTs) and cohort studies comparing primary hrHPV screening alone or hrHPV cotesting (both hrHPV testing and cytology) with cytology (Papanicolaou [Pap] test) screening alone.

Data Extraction And Synthesis: Two investigators independently reviewed abstracts and full-text articles and quality rated included studies; data were qualitatively synthesized.

Main Outcomes And Measures: Invasive cervical cancer; cervical intraepithelial neoplasia (CIN); false-positive, colposcopy, and biopsy rates; psychological harms.

Results: Eight RCTs (n = 410 556), 5 cohort studies (n = 402 615), and 1 individual participant data (IPD) meta-analysis (n = 176 464) were included. Trials were heterogeneous for screening interval, number of rounds, and protocol. For primary hrHPV screening, evidence was consistent across 4 trials demonstrating increased detection of CIN 3 or worse (CIN 3+) in round 1 (relative risk [RR] range, 1.61 [95% CI, 1.09-2.37] to 7.46 [95% CI, 1.02-54.66]). Among 4 hrHPV cotesting trials, first-round CIN 3+ detection was not significantly different between screening groups; RRs for cumulative CIN 3+ detection over 2 screening rounds ranged from 0.91 to 1.13. In first-round screening, false-positive rates for primary hrHPV screening ranged from 6.6% to 7.4%, compared with 2.6% to 6.5% for cytology. For cotesting, false-positives ranged from 5.8% to 19.9% in the first round of screening, compared with 2.6% to 10.9% for cytology. First-round colposcopy rates were also higher, ranging 1.2% to 7.9% for primary hrHPV testing, compared with 1.1% to 3.1% for cytology alone; colposcopy rates for cotesting ranged from 6.8% to 10.9%, compared with 3.3% to 5.2% for cytology alone. The IPD meta-analysis of data from 4 cotesting trials and 1 primary hrHPV screening trial found lower risk of invasive cervical cancer with any hrHPV screening compared with cytology alone (pooled RR, 0.60 [95% CI, 0.40-0.89]).

Conclusions And Relevance: Primary hrHPV screening detected higher rates of CIN 3+ at first-round screening compared with cytology. Cotesting trials did not show initial increased CIN 3+ detection. Both hrHPV screening strategies had higher false-positive and colposcopy rates than cytology, which could lead to more treatments with potential harms.
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August 2018