Category: Nevin Manimala

Curr Rheumatol Rev. 2024 Oct 17. doi: 10.2174/0115733971309885241011105213. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite advances in the treatment of Chronic Inflammatory Rheumatic Disease (CIRD), pain remains a significant burden for patients and doctors. This study explored the prevalence and associated factors of central sensitization (CS) in patients with CIRD.

METHODS: This is a cross-sectional study that included patients with CIRD followed at the University Hospital Center in Tangier. Sociodemographic and clinical data were collected. Nociceptive pain was assessed by the Visual Analogue Scale (VAS), disease activity by DAS-28 and ASDAS, and CS by the validated Moroccan version of the Central Sensitization Inventory part A (CSI-A). The Pain Catastrophizing Scale (PCS) was used to assess pain-related catastrophic thoughts, and the PHQ-9 (Pain Health Questionnaire) was used to determine the severity of depressive symptoms.

RESULTS: We included 189 patients; 107 (56.61%) had rheumatoid arthritis. The median duration of evolution of CIRD was 8 years, and the mean age was 47.49 ± 13.70 years, and 75.7% were women. The mean pain VAS was 4.77+-2.76, and 37.6% of patients were in remission. The mean central sensitization score was 37.42+- 16.75, with 44.9% having a CSI score≥40. In univariate and multivariate analysis, our study showed that central sensitization is associated with pain severity (β = 1.945(0.050-1.916), p = 0.039) and depression (β = 1.790(1.221-2.154), p ≤0.001)(8). A statistically significant correlation was found between the CSI-A score and pain VAS (r = 0.32, p <0.001).

CONCLUSION: Our study showed that almost half of our patients with CIRD had CS. The main factors associated with CS in our patients were pain severity and depression. We also found a significant correlation between pain VAS and CSI.

PMID:39421987 | DOI:10.2174/0115733971309885241011105213

Euro Surveill. 2024 Oct;29(42). doi: 10.2807/1560-7917.ES.2024.29.42.2400058.

ABSTRACT

BackgroundSweden reached the UNAIDS 90-90-90 target in 2015. It is important to reassess the HIV epidemiological situation due to ever-changing migration patterns, the roll-out of PrEP and the impact of the COVID-19 pandemic.AimWe aimed to assess the progress towards the UNAIDS 95-95-95 targets in Sweden by estimating the proportion of undiagnosed people with HIV (PWHIV) and HIV incidence trends.MethodsWe used routine laboratory data to inform a biomarker model of time since infection. When available, we used previous negative test dates, arrival dates for PWHIV from abroad and transmission modes to inform our incidence model. We also used data collected from the Swedish InfCareHIV register on antiretroviral therapy (ART).ResultsThe yearly incidence of HIV in Sweden decreased after 2014. In part, this was because the fraction of undiagnosed PWHIV had decreased almost twofold since 2006. After 2015, three of four PWHIV in Sweden were diagnosed within 1.9 and 3.2 years after infection among men who have sex with men and in heterosexual groups, respectively. While 80% of new PWHIV in Sweden acquired HIV before immigration, they make up 50% of the current PWHIV in Sweden. By 2022, 96% of all PWHIV in Sweden had been diagnosed, and 99% of them were on ART, with 98% virally suppressed.ConclusionsBy 2022, about half of all PWHIV in Sweden acquired HIV abroad. Using our new biomarker model, we assess that Sweden has reached the UNAIDS goal at 96-99-98.

PMID:39421951 | DOI:10.2807/1560-7917.ES.2024.29.42.2400058

J Glob Health. 2024 Oct 18;14:03041. doi: 10.7189/jogh.14.03041.

NO ABSTRACT

PMID:39421946 | DOI:10.7189/jogh.14.03041

J Glob Health. 2024 Oct 18;14:04188. doi: 10.7189/jogh.14.04188.

ABSTRACT

BACKGROUND: Antenatal care (ANC) quality is important to maternal and neonatal mortality. However, trends in the quality of ANC received by pregnant women in India have been understudied. This paper seeks to fill this gap by examining the long-term patterns nationwide and the state-specific prevalence of inadequate ANC quality received by pregnant women in India.

METHODS: We utilised data from four National Family Health Surveys (NFHS) conducted in 1999 (NFHS-2), 2006 (NFHS-3), 2016 (NFHS-4), and 2021 (NFHS-5) across India’s 36 states/union territories (UTs). The sample includes mothers who had given birth within three years (NFHS-2) and five years (NFHS-3, NHFS-4, and NFHS-5) before each survey. We define inadequate ANC quality as not completing seven essential ANC services (weight measurement, blood pressure measurement, urine sampling, blood sampling, provision of iron supplements, provision of tetanus vaccination, and ultrasound scans) during pregnancy. We calculated the standardised absolute change to quantify the change in the share of women receiving inadequate quality ANC nationally and by each state/UT. Additionally, we estimated the population headcount of mothers who received inadequate-quality ANC in 2021 and identified the socioeconomic correlates associated with inadequate ANC quality.

RESULTS: The prevalence of inadequate ANC quality substantially declined between 1999-2021, from 84.8% (95% confidence interval (CI) = 84.1-85.5) to 28.8% (95% CI = 28.5-29.2). However, between-state inequality in ANC quality has increased over this time. We identified a weak correlation between prevalence and population headcounts in 2021. Socioeconomically disadvantaged groups exhibited a higher prevalence of inadequate quality of ANC than less disadvantaged groups.

CONCLUSIONS: The proportion of pregnant women receiving inadequate ANC quality has decreased over time throughout India. However, multi-faceted efforts at national and state levels are necessary to enhance the effectiveness of existing policies. Additionally, innovative and targeted approaches are required to ensure the timely and equitable provision of high-quality ANC.

PMID:39421936 | DOI:10.7189/jogh.14.04188

J Glob Health. 2024 Oct 18;14:05029. doi: 10.7189/jogh.14.05029.

ABSTRACT

BACKGROUND: In this study, we aimed to identify bone mineral density (BMD) trajectories of hospitalised patients with coronavirus disease 2019 (COVID-19) and to determine the prognostic role of the trajectory groups.

METHODS: This is a retrospective study of hospitalised patients with COVID-19 treated in our hospital from November 2022 to February 2023. BMD was manually measured from the thoracic 12 (T12) and lumbar one (L1) vertebra using chest computed tomography images. We constructed group trajectory models using group-based trajectory modelling. We performed the logistic regression analysis to associate the BMD trajectory pattern with clinical outcomes.

RESULTS: This study included 1767 patients. The mean follow-up time after discharge was 181.5 days (standard deviation (SD) = 9.7). There were 1137 (64.3%) male patients, and more than 80% of patients were aged >60 years. We successfully identified three latent BMD trajectories to reveal the dynamic effects of COVID-19 infection on bone health in patients, namely, the early low-normal decline group, the average, and the early high-rapid decline group. All groups demonstrated consistent overall declining trends. A significant association was observed between BMD trajectory pattern (T12 or L1) and baseline characteristics of sex, age, and penetrating keratoplasty (P < 0.05). Our study showed that the BMD trajectories were significantly associated with mortality. Furthermore, we found that these trajectories were also associated with the length of hospital stay.

CONCLUSIONS: This study provided evidence for the COVID-19 process to bone health, as well as evidence on strengthening bone health management before and after COVID-19 infection. BMD trajectories may help manage bone health and guide treatment in patients with COVID-19.

PMID:39421935 | DOI:10.7189/jogh.14.05029

SAR QSAR Environ Res. 2024 Oct 18:1-21. doi: 10.1080/1062936X.2024.2417250. Online ahead of print.

ABSTRACT

Per- and polyfluoroalkylated organic compounds (PFAs) are versatile compounds extensively used in global industries. However, they are also persistent organic pollutants (POPs). This study aimed to develop new models for assessing oral and inhalation toxicity in rat and mice models. A set of 407 PFAs from the literature was divided into four groups based on the endpoints of interest. The models were constructed using only 2D structure descriptors derived from SMILES strings. The resulting models showed a strong statistical quality for all endpoints. They present an applicability domain (AD) that ensures good reliability, and provided meaningful interpretation, which are partially supported by existing literature. Consequently, these models are valuable for understanding how PFAs exert their toxic effect on mammals and for predicting the risk associated with these significant industrial chemical agents.

PMID:39421934 | DOI:10.1080/1062936X.2024.2417250

Phys Chem Chem Phys. 2024 Oct 18. doi: 10.1039/d4cp03076a. Online ahead of print.

ABSTRACT

The ultraviolet (UV) photodissociation dynamics of the 2-buten-2-yl (C₄H₇) radical were studied using the high-n Rydberg atom time-of-flight (HRTOF) technique in the photolysis region of 226-246 nm. 2-Buten-2-yl radicals were generated by 193 nm photodissociation of the precursor 2-chloro-2-butene. The H-atom photofragment yield (PFY) spectrum of 2-buten-2-yl is broad, peaking at 234 nm. Quantum chemistry calculations show that the UV absorption is due to the 3p_y and 3p_x Rydberg states (parallel to the plane of CC double bond). The translational energy distributions of the H-atom loss product channel, P(E_T)’s, of 2-buten-2-yl show a bimodal distribution indicating two dissociation pathways. The major pathway peaks at E_T ∼ 7 kcal mol^-1 with a nearly constant fraction of average E_T in the total excess energy, 〈f_T〉, at ∼0.11-0.12. This main pathway has an isotropic product angular distribution with β ∼ 0, consistent with the unimolecular dissociation of a hot 2-buten-2-yl radical following internal conversion from the electronically excited state, resulting in the formation of 2-butyne + H (∼84%) and 1,2-butadiene + H (∼16%). Additionally, there is a minor non-statistical pathway with an isotropic angular distribution. The minor pathway peaks at E_T ∼ 35 kcal mol^-1 in the P(E_T) distributions and exhibits a large 〈f_T〉 of ∼0.40-0.46. This fast pathway suggests a direct dissociation of the methyl H-atom on a repulsive excited state surface or on the repulsive part of the ground state surface, forming 1,2-butadiene + H. The fast/slow pathway branching ratio is in the range of 0.03-0.08.

PMID:39421930 | DOI:10.1039/d4cp03076a

Early Interv Psychiatry. 2024 Oct 18. doi: 10.1111/eip.13624. Online ahead of print.

ABSTRACT

INTRODUCTION: Multinational treatment guidelines support providing cognitive remediation to people recently diagnosed with schizophrenia, but the feasibility of implementing the treatment on a large scale is less well understood.

METHODS: This study took place between 2019 and 2023 at 14 clinics within a large network of programs providing early intervention services to people aged 16-30 experiencing nonaffective psychosis. Clinics were randomly assigned to deliver cognitive remediation as twice-weekly clinician-led groups (N = 5), cognitive remediation as once-weekly clinician-led groups with homework (N = 6), or treatment as usual (N = 3). All clinics screened for cognitive health need to guide treatment planning. Clinical teams (N = 11) received training to provide cognitive remediation. Program evaluation data were analysed for feasibility and acceptability.

RESULTS: Screening for cognitive health needs was completed on 77% of the 1193 participants enrolled at the 11 clinics offering cognitive remediation. Clinicians identified cognitive difficulties in 53.9% (n = 496) of screened participants and referred 27% (n = 134) of these participants to cognitive remediation. Of referred participants, 77.6% (n = 104) initiated treatment, and n = 41 completed the treatment. The rate of referral was nearly double, and treatment initiation was significantly higher at programs delivering once-weekly (84.3%) than twice-weekly (64.4%) treatment but the difference in the rate of treatment completion was statistically nonsignificant. Satisfaction among treatment completers was high.

CONCLUSIONS: Referrals to cognitive remediation required systemic support of a feasible cognitive health screening process. About a quarter of people with clinician-identified cognitive health needs were referred to cognitive remediation. Feasibility data suggest a flexible model of treatment delivery may facilitate implementation in this service setting.

PMID:39421910 | DOI:10.1111/eip.13624

Cardiol Young. 2024 Oct 18:1-7. doi: 10.1017/S1047951124026519. Online ahead of print.

ABSTRACT

BACKGROUND: Children with left aortic arch and aberrant right subclavian artery may present with either respiratory or swallowing symptoms beyond the classically described solid-food dysphagia. We describe the clinical features and outcomes of children undergoing surgical repair of an aberrant right subclavian artery.

MATERIALS AND METHODS: This was a retrospective review of children undergoing repair of an aberrant right subclavian artery between 2017 and 2022. Primary outcome was symptom improvement. Pre- and post-operative questionnaires were used to assess dysphagia (PEDI-EAT-10) and respiratory symptoms (PEDI-TBM-7). Paired t-test and Fisher’s exact test were used to analyse symptom resolution. Secondary outcomes included perioperative outcomes, complications, and length of stay.

RESULTS: Twenty children, median age 2 years (IQR 1-11), were included. All presented with swallowing symptoms, and 14 (70%) also experienced respiratory symptoms. Statistically significant improvements in symptoms were reported for both respiratory and swallowing symptoms. Paired (pre- and post-op) PEDI-EAT-10 and PEDI-TBM-7 scores were obtained for nine patients, resulting in mean (± SD) scores decreasing (improvement in symptoms) from 19.9 (± 9.3) to 2.4 (± 2.5) p = 0.001, and 8.7 (± 4.7) to 2.8 (± 4.0) p = 0.006, respectively. Reoperation was required in one patient due to persistent dysphagia from an oesophageal stricture. Other complications included lymphatic drainage (n = 4) and transient left vocal cord hypomobility (n = 1).

CONCLUSION: Children with a left aortic arch with aberrant right subclavian artery can present with oesophageal and respiratory symptoms beyond solid food dysphagia. A thorough multidisciplinary evaluation is imperative to identify patients who can benefit from surgical repair, which appears to be safe and effective.

PMID:39421900 | DOI:10.1017/S1047951124026519

Cephalalgia. 2024 Oct;44(10):3331024241289930. doi: 10.1177/03331024241289930.

ABSTRACT

BACKGROUND: Migraine, a condition affecting 12% of the population, is a prevalent cause of disability, significantly impacts individuals during their most productive working years. Several studies have established that a migraine patient’s job performance is often limited by absenteeism and presenteeism. The present study aimed to investigate the impact of migraines on occupational burnout, which affects up to 40% of workers.

METHODS: A subset of participants from the Negev Migraine Cohort, including both migraine patients and non-migraine controls, were asked to complete the study questionnaire. The main exposures of interest were migraine diagnosis and severity. The primary outcome was occupational burnout. Migraine severity and associated disability were evaluated using the Migraine Disability Assessment (MIDAS) score, psychiatric comorbidities using the Depression, Anxiety and Stress Scale – 21 Items (DASS-21) scale and occupational burnout using the Maslach Burnout Inventory (MBI-GS version) scale. Statistical analyses included multivariable quantile regression models to identify associations and adjust for potential confounders.

RESULTS: In total, 675 migraine patients and 232 non-migraine participants participated in the study. Migraine patients exhibited higher rates of depression (mean DASS-21: 0.864 vs. 0.664, standardized mean difference (SMD) = 0.262), tended to work longer hours (median weekly hours: 40.0 vs. 36.0, SMD = 0.148) and expressed a preference for remote work (20.3% vs. 10.3%, SMD = 0.097). Migraine patients reported significantly higher levels of occupational burnout (mean burnout score: 3.46 vs. 2.82, SMD = 0.469). Controlling for depression, anxiety and stress, migraine diagnosis (25th percentile estimate = 0.67, p = 0.002, 75th percentile estimate = 0.92, p = 0.032) and migraine severity (estimates: 2.2-5.3, p < 0.001 for all) were associated with higher levels of occupational burnout.

CONCLUSIONS: Migraine diagnosis and severity is associated with an occupational burnout, after controlling for various psychological and work-related factors. The findings underscore the need for workplace adjustments to support migraine patients’ participation in the work market.

PMID:39421886 | DOI:10.1177/03331024241289930