Category: Nevin Manimala

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(5):74-82. doi: 10.17116/jnevro202312305174.

ABSTRACT

OBJECTIVE: To analyze the causes of violations of expressive speech in children 4-5 years old, to assess changes in neurological status in children with motor alalia without and during treatment with Cellex.

MATERIAL AND METHODS: Two groups of patients were recruited: the main group (n=30; treatment; Cellex) and the control group (n=12; without Cellex). The drug was administered in the first half of the day by 1.0 ml subcutaneously, 10 days, daily. The patient’s visit card was analyzed 4 times: before treatment, 10 days later, 1 and 2 months after the start of treatment. Statistical hypotheses were tested using the χ² and Fisher criterions, the odds ratio (OR) and the 95% confidence interval (CI) OR were determined.

RESULTS: In more than half of the cases, violations of the neurological status, the burden of the perinatal period, a decrease in cognitive tests, and a lack of fine motor skills were revealed. Left-handedness or two-handedness, overload of viewing or listening to gadgets from the age of up to a year, violations of opercular praxis were almost always noted. The effect of the drug Cellex on the «launch of speech» in children with motor alalia has been shown. It has been established that the drug is well tolerated, has no adverse side effects and has a positive effect on the «launch of speech». The progress of the dynamics of speech development, progress in play and cognitive activity was observed in all children of the main group.

CONCLUSION: The use of the drug Cellex can be effective in the treatment of children with motor alalia.

PMID:37315245 | DOI:10.17116/jnevro202312305174

Adv Mind Body Med. 2023 Spring;37(2):5-8.

ABSTRACT

CONTEXT: Diabetes is a metabolic disorder characterized by high blood sugar levels. Yoga has been shown to have positive effects on blood sugar levels in diabetes patients. However, there is limited research on the effects of specific yoga poses on blood sugar levels in patients with type 2 diabetes (T2DM).

OBJECTIVE: This study aimed to evaluate the effect of a single yoga asana, Ardha Matsyendrasana, on random blood glucose (RBG) levels in patients with T2DM. Specifically, we aimed to investigate whether a 15-minute practice of Ardha Matsyendrasana could reduce RBG levels in patients with T2DM.

DESIGN: This study employed a self-controlled design to evaluate the effect of Ardha Matsyendrasana on blood glucose levels in patients with type 2 diabetes mellitus.

PARTICIPANTS: 100 patients with type 2 diabetes mellitus (T2DM) were recruited for this study.

INTERVENTIONS: All participants underwent two sessions: a control session (CS) and an asana session (AS), each lasting 15 minutes. During the CS, participants rested in a sitting pose, while during the AS, they practiced Ardha Matsyendrasana. The order of the sessions was randomized, with half the participants undergoing the CS on day 1, the AS on day 2, and the other half undergoing the sessions in reverse order.

OUTCOME MEASURES: We measured participants’ random blood glucose (RBG) levels immediately before and after each intervention.

STATISTICAL ANALYSIS: The statistical package for the social sciences, version 16, was used to perform a paired t-test to compare RBG levels before and after each intervention.

RESULTS: The study demonstrated a significant reduction in random blood glucose (RBG) levels in the Ardha Matsyendrasana session compared to the control session. This trend was observed in both males and females with T2DM.

CONCLUSIONS: A single session of Ardha Matsyendrasana for 15 minutes can effectively reduce blood glucose levels in patients with T2DM. However, further studies are required to determine the long-term effects of this asana on glycemic control.

PMID:37315227

Blood Adv. 2023 Jun 14:bloodadvances.2023010133. doi: 10.1182/bloodadvances.2023010133. Online ahead of print.

ABSTRACT

Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of M-protein at diagnosis on outcomes in MZL patients in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared to those without M-protein at diagnosis. After adjusting for factors associated with inferior PFS in univariate models, presence of M-protein remained significantly associated with inferior PFS (HR=1.74, 95%CI=1.20-2.54, p=0.004). We observed no significant difference in the PFS based on the type or quantity of M-protein at diagnosis. There were differential outcomes in PFS according to first-line therapy in patients with M-protein at diagnosis in that those receiving immunochemotherapy had better outcomes compared to rituximab monotherapy. The cumulative incidence of relapse in stage 1 disease among the recipients of local therapy was higher in the presence of M-protein, however, this did not reach statistical significance. We found that M-protein at diagnosis was associated with a higher risk of histologic transformation. Because the PFS difference related to presence of M-protein was not observed in patients receiving bendamustine and rituximab, immunochemotherapy may be a preferred approach over rituximab monotherapy in this group and needs to be explored further.

PMID:37315169 | DOI:10.1182/bloodadvances.2023010133

Eur J Prev Cardiol. 2023 Jun 14:zwad198. doi: 10.1093/eurjpc/zwad198. Online ahead of print.

ABSTRACT

AIMS: For patients with diabetes, the European guideline updated the cardiovascular disease (CVD) risk prediction recommendations using diabetes-specific models with age-specific cut-offs, whereas American guidelines still advise models derived from the general population. We aimed to compare the performance of four cardiovascular risk models in diabetes populations.

METHODS: Patients with diabetes from CHERRY study, an electronic health record-based cohort study in China, were identified. Five-year CVD risk was calculated using original and recalibrated diabetes-specific models (ADVANCE and HK) and general-population-based models (PCE and China-PAR).

RESULTS: During a median 5.8-year follow-up, 46,558 patients had 2605 CVD events. C-statistics were 0.711 (95% CI: 0.693-0.729) for ADVANCE and 0.701 (0.683-0.719) for HK in men, and 0.742 (0.725-0.759) and 0.732 (0.718-0.747) in women. C-statistics were worse in two general-population-based models. Recalibrated ADVANCE underestimated risk by 1.2% and 16.8% in men and women, whereas PCE underestimated risk by 41.9% and 24.2% in men and women. With the age-specific cut-offs, the overlap of the high-risk patients selected by every model-pair ranged from only 22.6% to 51.2%. When utilizing the fixed cut-off at 5%, the recalibrated ADVANCE selected similar high-risk patients in men (7400) as compared to the age-specific cut-offs (7102), whereas age-specific cut-offs exhibited a reduction in the selection of high-risk patients in women (2646 under age-specific cut-offs vs 3647 under fixed cut-off).

CONCLUSION: Diabetes-specific CVD risk prediction models showed better discrimination for patients with diabetes. High-risk patients selected by different models varied significantly. Age-specific cut-offs selected fewer patients at high CVD risk especially in women.

PMID:37315163 | DOI:10.1093/eurjpc/zwad198

Eur J Prev Cardiol. 2023 Jun 14:zwad196. doi: 10.1093/eurjpc/zwad196. Online ahead of print.

ABSTRACT

AIMS: To quantify the trajectories from normoglycaemia to prediabetes, subsequently to type 2 diabetes (T2DM), cardiovascular diseases (CVD), and cardiovascular death, and the effects of risk factors on the rates of transition.

METHODS: We used data from the Jinchang cohort of 42,585 adults aged 20-88 free of coronary heart disease (CHD) and stroke at baseline. A multistate model was applied for analyzing the progression of CVD and its relation to various risk factors.

RESULTS: During a median follow-up of 7 years, 7,498 participants developed prediabetes, 2,307 developed T2DM, 2,499 developed CVD, and 324 died from CVD. Among 15 postulated transitions, transition from comorbid CHD and stroke to cardiovascular death had the highest rate (157.21/1000 person-years), followed by transition from stroke alone to cardiovascular death (69.31/1000 person-years.), and transition from prediabetes to normoglycaemia (46.51/1000 person-years). Prediabetes had a sojourn time of 6.77 years, and controlling weight, blood lipids, blood pressure, and uric acid within normal limits may promote reversion to normoglycaemia. Among transitions to CHD alone and stroke alone, transition from T2DM had the highest rate (12.21/1000 and 12.16/1000 person-years), followed by transition from prediabetes (6.81/1000 and 4.93/1000 person-years), and normoglycaemia (3.28/1000 and 2.39/1000 person-years). Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidemia, and hyperuricemia played crucial but different roles in transitions.

CONCLUSIONS: Prediabetes was the optimal intervention stage in the disease trajectory. The derived transition rates, sojourn time, and influence factors could provide scientific support for the primary prevention of both T2DM and CVD.

PMID:37315161 | DOI:10.1093/eurjpc/zwad196

J Magn Reson Imaging. 2023 Jun 14. doi: 10.1002/jmri.28861. Online ahead of print.

ABSTRACT

BACKGROUND: The fetal neurodevelopmental microstructural alterations of intrauterine exposure to preeclampsia (PE) or gestational hypertension (GH) remain unknown.

PURPOSE: To evaluate the differences in diffusion-weighted imaging (DWI) of the fetal brain between normotensive pregnancies and PE/GH pregnancies, with a focus on PE/GH pregnancies with fetal growth restriction (FGR).

STUDY TYPE: Retrospective matched case-control study.

POPULATION: 40 singleton pregnancies with PE/GH complicated by FGR, and 3 paired control groups (PE/GH without FGR, normotensive FGR, normotensive pregnancies) (28-38 gestational weeks).

FIELD STRENGTH/SEQUENCE: DWI with single-shot echo-planar imaging at 1.5 Tesla.

ASSESSMENT: The apparent diffusion coefficient (ADC) values were calculated in the centrum semi-ovale (CSO), parietal white matter (PWM), frontal white matter (FWM), occipital white matter (OWM), temporal white matter (TWM), basal ganglia, thalamus (THAL), pons, and cerebellar hemisphere.

STATISTICAL TESTS: Student t test or Wilcoxon matched test was used to reveal the difference of ADC values among the investigated brain regions. A correlation between gestational age (GA) and ADC values was determined by linear regression analysis.

RESULTS: Compared with fetuses in PE/GH without FGR and those with normotensive pregnancies, fetuses in the PE/GH with FGR group had significantly lower average ADC measurements of supratentorial regions (1.65 ± 0.09 vs. 1.71 ± 0.10 10^-3 mm² /sec; vs. 1.73 ± 0.11 10^-3 mm² /sec, respectively). Regions of significantly decreased ADC values in the fetal brain included CSO, FWM, PWM, OWM, TWM and THAL in cases of PE/GH with FGR. ADC values from supratentorial regions in PE/GH pregnancies were not significantly correlated with GA (P = 0.12, 0.26); however, this trend was statistically significant in the normotensive groups.

DATA CONCLUSION: ADC values may indicate fetal brain developmental alterations in PE/GH with FGR fetuses but more microscopic and morphological studies are necessary to provide additional evidence to offer a different interpretation of this trend in fetal brain.

LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE: 3.

PMID:37315155 | DOI:10.1002/jmri.28861

Sci Adv. 2023 Jun 16;9(24):eadf8332. doi: 10.1126/sciadv.adf8332. Epub 2023 Jun 14.

ABSTRACT

To understand how pharmacological interventions can exert their powerful effects on brain function, we need to understand how they engage the brain’s rich neurotransmitter landscape. Here, we bridge microscale molecular chemoarchitecture and pharmacologically induced macroscale functional reorganization, by relating the regional distribution of 19 neurotransmitter receptors and transporters obtained from positron emission tomography, and the regional changes in functional magnetic resonance imaging connectivity induced by 10 different mind-altering drugs: propofol, sevoflurane, ketamine, lysergic acid diethylamide (LSD), psilocybin, N,N-Dimethyltryptamine (DMT), ayahuasca, 3,4-methylenedioxymethamphetamine (MDMA), modafinil, and methylphenidate. Our results reveal a many-to-many mapping between psychoactive drugs’ effects on brain function and multiple neurotransmitter systems. The effects of both anesthetics and psychedelics on brain function are organized along hierarchical gradients of brain structure and function. Last, we show that regional co-susceptibility to pharmacological interventions recapitulates co-susceptibility to disorder-induced structural alterations. Collectively, these results highlight rich statistical patterns relating molecular chemoarchitecture and drug-induced reorganization of the brain’s functional architecture.

PMID:37315149 | DOI:10.1126/sciadv.adf8332

PLoS One. 2023 Jun 14;18(6):e0287171. doi: 10.1371/journal.pone.0287171. eCollection 2023.

ABSTRACT

OBJECTIVE: This randomized controlled pilot study investigated the feasibility of a future full-scale RCT to compare the effects of intolerance-of-uncertainty therapy (IUT) and metacognitive therapy (MCT) in primary health care patients with generalized anxiety disorder (GAD). Preliminary treatment effects were also evaluated.

MATERIALS AND METHODS: 64 patients with GAD at a large primary health care center in Stockholm, Sweden, were randomized to IUT or MCT. Feasibility outcomes included participant recruitment and retention, willingness to receive psychological treatment, and therapists’ competence in and adherence to treatment protocols. Self-reported scales were used to assess treatment outcomes, including worry, depression, functional impairment, and quality of life.

RESULTS: Recruitment was satisfactory, and dropout was low. On a scale from 0 to 6, participants were satisfied with participating in the study (M = 5.17, SD = 1.09). Following brief training, therapists’ competence was rated as moderate, and adherence was rated as weak to moderate. From pre- to post-treatment, reductions on the primary treatment outcome measure of worry were of a large effect size and statistically significant in both the IUT and MCT conditions (Cohen’s d for IUT = -2.69, 95% confidence interval [-3.63, -1.76] and d for MCT = -3.78 [-4.68, -2.90]). The between-group effect size from pre- to post-treatment was large and statistically significant (d = -2.03 [-3.31, -0.75]), in favor of the MCT condition.

CONCLUSION: It is feasible to carry out a full-scale RCT to compare the effects of IUT to MCT for patients with GAD in primary health care. Both protocols seem effective, and MCT seems superior to IUT, but a full-scale RCT is needed to confirm these conclusions.

TRIAL REGISTRATION: ClinicalTrials.gov (no. NCT03621371).

PMID:37315099 | DOI:10.1371/journal.pone.0287171

PLoS One. 2023 Jun 14;18(6):e0287317. doi: 10.1371/journal.pone.0287317. eCollection 2023.

ABSTRACT

OBJECTIVE: Patient sitters are frequently used in acute care hospitals to provide one-to-one care for agitated or disorientated patients to assure the safety and well-being of patients. However, there is still a lack of evidence on the use of patient sitters, especially in Switzerland. Therefore, the aim of this study was to describe and explore the use of patient sitters in a Swiss acute care hospital.

METHODS: In this retrospective, observational study we included all inpatients who were hospitalized between January and December 2018 in a Swiss acute care hospital and required a paid or volunteer patient sitter. Descriptive statistics were used to describe the extent of patient sitter use, patient characteristics, and organizational factors. For the subgroup analysis between internal medicine and surgical patients Mann-Whitney U tests and chi-square tests were used.

RESULTS: Of the total of 27’855 included inpatients, 631 (2.3%) needed a patient sitter. Of these, 37.5% had a volunteer patient sitter. The median patient sitter duration per patient per stay was 18.0 hours (IQR = 8.4-41.0h). The median age was 78 years (IQR = 65.0-86.0); 76.2% of patients were over the age of 64. Delirium was diagnosed in 41% of patients, and 15% had dementia. Most of the patients showed signs of disorientation (87.3%), inappropriate behavior (84.6%), and risk of falling (86.6%). Patient sitter uses varied during the year and between surgical and internal medicine units.

CONCLUSIONS: These results add to the limited body of evidence concerning patient sitter use in hospitals, supporting previous findings related to patient sitter use for delirious or geriatric patients. New findings include the subgroup analysis of internal medicine and surgical patients, as well as analysis of patient sitter use distribution throughout the year. These findings may contribute to the development of guidelines and policies regarding patient sitter use.

PMID:37315098 | DOI:10.1371/journal.pone.0287317

PLoS One. 2023 Jun 14;18(6):e0287113. doi: 10.1371/journal.pone.0287113. eCollection 2023.

ABSTRACT

Food festivals have been a growing tourism sector in recent years due to their contributions to a region’s economic, marketing, brand, and social growth. This study analyses the demand for the Bahrain food festival. The stated objectives were: i) To identify the motivational dimensions of the demand for the food festival, (ii) To determine the segments of the demand for the food festival, and (iii) To establish the relationship between the demand segments and socio-demographic aspects. The food festival investigated was the Bahrain Food Festival held in Bahrain, located on the east coast of the Persian Gulf. The sample consisted of 380 valid questionnaires and was taken using social networks from those attending the event. The statistical techniques used were factorial analysis and the K-means grouping method. The results show five motivational dimensions: Local food, Art, Entertainment, Socialization, and Escape and novelty. In addition, two segments were found; the first, Entertainment and novelties, is related to attendees who seek to enjoy the festive atmosphere and discover new restaurants. The second is Multiple motives, formed by attendees with several motivations simultaneously. This segment has the highest income and expenses, making it the most important group for developing plans and strategies. The results will contribute to the academic literature and the organizers of food festivals.

PMID:37315091 | DOI:10.1371/journal.pone.0287113