Category: Nevin Manimala

Wiad Lek. 2022;75(11 pt 2):2765-2770. doi: 10.36740/WLek202211209.

ABSTRACT

OBJECTIVE: The aim: To investigate the pharmacists level of readiness to provide assistance to pharmacy visitors on COVID-19 and ways to expand their social role in society during the pandemic.

PATIENTS AND METHODS: Materials and methods: Based on the analysis of the statistical data, sociological research and mathematical analysis, as well as generalization of the obtained results have been used in the work. The objects of the study were pharmaceutical workers of pharmacies. The survey was conducted in August 2021 via online survey of the target audience in professional groups.

RESULTS: Results: The results of the survey of pharmaceutical workers indicate a high level of need (63.9% of respondents) for the continuous acquisition of relevant information on COVID-19. According to the results of the study, the growth of the social role of pharmacy specialists in combating coronavirus infection has been proved, which was supported by 86.2% of respondents in their daily activities. The possibility of introduction of 6 new functions to Ukrainian pharmacies has been considered.

CONCLUSION: Conclusions: The practical significance of the obtained results is that together they create a scientific and methodological basis for improving the process of pharmaceutical workers participation in combating coronavirus infection.

PMID:36591766 | DOI:10.36740/WLek202211209

World J Surg Oncol. 2023 Jan 2;21(1):1. doi: 10.1186/s12957-022-02879-6.

ABSTRACT

BACKGROUND: Self-expanding metal stents (SEMS) served as a bridge to surgery (BTS). However, this method may be associated with worse long-term prognosis and relapse of CRC patients. Therefore, we attempted to clarify this in the angle of circulating tumor cells (CTCs).

METHODS: A multicenter study was performed from March 2018 to January 2021. Thirty-two colorectal cancer patients with obstruction were selected, of which 21 patients were performed SEMS as a BTS while 11 patients were performed emergency surgery. Bloods samples were collected in two groups of patients for further detecting CTCs. In the SEMS group, the samples were collected before and after stent insert and after radical surgery performed. In the ES group, the samples were collected before stent insert and after emergency surgery performed.

RESULTS: The number of CTCs did not show statistically significant differences before and after stent placement (34.90 vs 38.33, p=0.90), neither between the SEMS group and ES group in initial CTC levels (34.90 vs 58.09, p=0.394). No significant differences (38.33 vs 58.09, p=0.632) were observed after stent insert in the SMES group and the initial CTC levels in the ES group. Moreover, no major differences (24.17 vs 42.27, p=0.225) were observed after radical operation performed in both groups.

CONCLUSION: The treatment of SEMS does not cause an increase in the number of CTC after stent insertion. Furthermore, there are may be other factors besides CTC to cause these poorer oncologic outcomes after SEMS placement.

PMID:36588150 | DOI:10.1186/s12957-022-02879-6

Ir J Med Sci. 2023 Jan 2. doi: 10.1007/s11845-022-03249-7. Online ahead of print.

ABSTRACT

BACKGROUND: In 2018, there were more than 12,000 self-harm presentations to emergency departments (EDs) in Ireland with 50% occurring between 7p.m. and 3a.m. There is evidence that the assessment quality and follow-up is variable across clinicians. To address this, The National Clinical Programme for the Management of Self-Harm in the ED (NCPSH 2016) was developed to set clear standards.

AIM: Our aim was to compare diagnosis and management of patients presenting to Beaumont Hospital (BH) ED, across a 3-year period, by the on-site Liaison Psychiatry Service, during normal working hours, to the off-site on call service outside of normal working hours (OOH).

METHODS: This is a retrospective audit of BH ED patients referred for psychiatric assessment between 2018 and 2020, using patient electronic records for data collection, and Pearson’s chi square testing for group differences. Post hoc analysis was performed using adjusted residuals and Bonferroni correction.

RESULTS: Of 3659 psychiatric referrals to Beaumont ED from 2018 to 2020, alcohol-related disorders were the most common diagnosis and were diagnosed more frequently during normal working hours (n = 592, 16.2%; 22.9% normal hours vs 8.5% OOH, p < 0.001), while personality disorder was diagnosed more frequently out of hours. (n = 432, 11.8%; 9.6% normal hours vs 14.4% out of hours, p < 0.001). There was a statistically significant difference in referral to voluntary services out of hours (7.2% normal hours vs 0.3% OOH).

CONCLUSION: In contrast to previous findings, our study found higher rates of alcohol-related disorders diagnosed during normal hours vs OOH. Furthermore, voluntary and addiction services were under-utilised OOH and this presents an important teaching opportunity.

PMID:36588147 | DOI:10.1007/s11845-022-03249-7

Neuropsychol Rev. 2023 Jan 2. doi: 10.1007/s11065-022-09572-1. Online ahead of print.

ABSTRACT

The aim of this meta-analysis is twofold: (a) to assess cognitive impairments in isolated rapid eye movement (REM) sleep behavior disorder (iRBD) patients compared to healthy controls (HC); (b) to quantitatively estimate the risk of developing a neurodegenerative disease in iRBD patients according to baseline cognitive assessment. To address the first aim, cross-sectional studies including polysomnography-confirmed iRBD patients, HC, and reporting neuropsychological testing were included. To address the second aim, longitudinal studies including polysomnography-confirmed iRBD patients, reporting baseline neuropsychological testing for converted and still isolated patients separately were included. The literature search was conducted based on PRISMA guidelines and the protocol was registered at PROSPERO (CRD42021253427). Cross-sectional and longitudinal studies were searched from PubMed, Web of Science, Scopus, and Embase databases. Publication bias and statistical heterogeneity were assessed respectively by funnel plot asymmetry and using I². Finally, a random-effect model was performed to pool the included studies. 75 cross-sectional (2,398 HC and 2,460 iRBD patients) and 11 longitudinal (495 iRBD patients) studies were selected. Cross-sectional studies showed that iRBD patients performed significantly worse in cognitive screening scores (random-effects (RE) model = -0.69), memory (RE model = -0.64), and executive function (RE model = -0.50) domains compared to HC. The survival analyses conducted for longitudinal studies revealed that lower executive function and language performance, as well as the presence of mild cognitive impairment (MCI), at baseline were associated with an increased risk of conversion at follow-up. Our study underlines the importance of a comprehensive neuropsychological assessment in the context of iRBD.

PMID:36588140 | DOI:10.1007/s11065-022-09572-1

Environ Sci Pollut Res Int. 2023 Jan 1. doi: 10.1007/s11356-022-24323-8. Online ahead of print.

ABSTRACT

Since the energy expenditure of households is an essential component of the total demand for energy, making the energy consumption in dwellings sustainable is vital to manage financial, environmental, and political risks related to energy import and consumption because controlled and sustainable energy expenditure, as one of the most prominent issues in today’s world, depends on a consensus of common sense regarding all the parties in the sector including households. This matter has rendered an investigation into the factors affecting the energy expenditure of households valuable and constituted the motivation of this study. The aim of the study is to determine the factors that affect the entire energy expenditure of households in Turkey, including heating, electricity, kitchen needs, and fuel needs for transportation, and to determine the quantities of these effects. In this regard, household budget research surveys conducted by the Turkish Statistical Institute were used in the study. The study concluded that socioeconomic indicators, particularly the age, marital status, educational background, and income of household responsible people and the technical characteristics of houses, have an effect on the energy expenditure of households. The results of the study provide valuable information to policy makers and decision makers in order to minimize the risks originating from energy import and expenditure by revealing the factors affecting the energy expenditure of households in Turkey.

PMID:36588133 | DOI:10.1007/s11356-022-24323-8

Ophthalmol Ther. 2023 Jan 2. doi: 10.1007/s40123-022-00640-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Photobiomodulation (PBM) represents a potential treatment for non-exudative age-related macular degeneration (AMD). PBM uses wavelengths of light to target components of the mitochondrial respiratory chain to improve cellular bioenergetic outputs. The aim of this study was to further investigate the effects of PBM on clinical, quality of life (QoL) and anatomical outcomes in subjects with intermediate stage non-exudative AMD.

METHODS: The multicenter LIGHTSITE II study was a randomized clinical trial evaluating safety and efficacy of PBM in intermediate non-exudative AMD. The LumiThera Valeda® Light Delivery System delivered multiwavelength PBM (590, 660 and 850 nm) or sham treatment 3 × per week over 3-4 weeks (9 treatments per series) with repeated treatments at baseline (BL), 4 and 8 months. Subjects were enrolled with 20/32 to 20/100 best-corrected visual acuity (BCVA) and no central geographic atrophy (GA) within the central fovea (500 μm).

RESULTS: LIGHTSITE II enrolled 44 non-exudative AMD subjects (53 eyes). PBM-treated eyes showed statistically significant improvement in BCVA at 9 months (n = 32 eyes, p = 0.02) with a 4-letter gain in the PBM-treated group versus a 0.5-letter gain in the sham-treated group (ns, p < 0.1) for patients that received all 27 PBM treatments (n = 29 eyes). Approximately 35.3% of PBM-treated eyes showed ≥ 5-letter improvement at 9 months. Macular drusen volume was not increased over time in the PBM-treated group but did show increases in the sham-treated group. While PBM and sham groups both showed GA lesion growth in the trial period, there was 20% less growth in the PBM group over 10 months, suggesting potential disease-modifying effects. No safety concerns or signs of phototoxicity were observed.

CONCLUSION: These results confirm previous clinical testing of multiwavelength PBM and support treatment with Valeda as a novel therapy with a unique mechanism of action as a potential treatment for non-exudative AMD.

TRIAL REGISTRATION: Clinicaltrial.Gov Registration Identifier: NCT03878420.

PMID:36588113 | DOI:10.1007/s40123-022-00640-6

Clin Transl Med. 2023 Jan;13(1):e1152. doi: 10.1002/ctm2.1152.

ABSTRACT

BACKGROUND: Gut-brain axis is widely implicated in the pathophysiology of Parkinson’s disease (PD). We take an integrated approach to considering the gut as a target for disease-modifying intervention, using continuous measurements of disease facets irrespective of diagnostic divide.

METHODS: We characterised 77 participants with diagnosed-PD, 113 without, by dietary/exogenous substance intake, faecal metabolome, intestinal inflammation, serum cytokines/chemokines, clinical phenotype including colonic transit time. Complete-linkage hierarchical cluster analysis of metabolites discriminant for PD-status was performed.

RESULTS: Longer colonic transit was linked to deficits in faecal short-chain-fatty acids outside PD, to a ‘tryptophan-containing metabolite cluster’ overall. Phenotypic cluster analysis aggregated colonic transit with brady/hypokinesia, tremor, sleep disorder and dysosmia, each individually associated with tryptophan-cluster deficit. Overall, a faster pulse was associated with deficits in a metabolite cluster including benzoic acid and an imidazole-ring compound (anti-fungals) and vitamin B3 (anti-inflammatory) and with higher serum CCL20 (chemotactic for lymphocytes/dendritic cells towards mucosal epithelium). The faster pulse in PD was irrespective of postural hypotension. The benzoic acid-cluster deficit was linked to (well-recognised) lower caffeine and alcohol intakes, tryptophan-cluster deficit to higher maltose intake. Free-sugar intake was increased in PD, maltose intake being 63% higher (p = .001). Faecal calprotectin was 44% (95% CI 5%, 98%) greater in PD [p = .001, adjusted for proton-pump inhibitors (p = .001)], with 16% of PD-probands exceeding a cut-point for clinically significant inflammation compatible with inflammatory bowel disease. Higher maltose intake was associated with exceeding this calprotectin cut-point.

CONCLUSIONS: Emerging picture is of (i) clinical phenotype being described by deficits in microbial metabolites essential to gut health; (ii) intestinal inflammation; (iii) a systemic inflammatory response syndrome.

PMID:36588088 | DOI:10.1002/ctm2.1152

J Emerg Nurs. 2022 Dec 30:S0099-1767(22)00276-8. doi: 10.1016/j.jen.2022.10.001. Online ahead of print.

ABSTRACT

INTRODUCTION: Emergency nurses are vulnerable to violence, because they closely face patients or caregivers in emergency situations, where tension and conflicts are heightened. This is known to increase their turnover intentions. This study aimed to analyze the effects of emergency nurses’ experiences of violence, resilience, and nursing work environment on turnover intentions.

METHODS: This descriptive study analyzed a questionnaire administered to emergency nurses from March 2020 to April 2020. Its participants included 100 emergency nurses from 4 emergency medical centers. The collected data were analyzed using the SPSS/WIN 25.0 program (IBM SPSS Statistics) by frequency, percentage, mean, SD, t test, analysis of variance, and multiple regression RESULTS: The main factors affecting the turnover intentions of emergency nurses were resilience (β = -0.32, P = .003), frequency of violence by patients (β = 0.27, P = .003), and nursing managers’ leadership and support for nurses (β = -0.25, P = .021). The explanatory power of these 3 variables was 29.3%.

DISCUSSION: To reduce emergency nurses’ turnover intentions, it may be necessary to conduct resilience programs for them. In addition, safety measures to prevent violence at the organizational level and improve nursing managers’ abilities, leadership, and support for nurses can reduce nurses’ intention to leave.

PMID:36588072 | DOI:10.1016/j.jen.2022.10.001

J Craniomaxillofac Surg. 2022 Dec 28:S1010-5182(22)00171-8. doi: 10.1016/j.jcms.2022.12.001. Online ahead of print.

ABSTRACT

The study aim was to identify risk factors associated with complications following open reduction and internal fixation of mandibular fractures. A retrospective cohort study was conducted in patients who were treated for mandibular fractures in a single center between January 2010 and December 2020. Authors classified postoperative complications as overall complications, infections, and reoperations. Factors that may be associated with these complications were grouped as patient, wound, and management variables. Statistical analysis was performed to determine whether these factors influenced complications. Among 175 patients, 125 underwent open reduction and internal fixation. Among patient variables, alcohol consumption was a risk factor for overall complications (p = 0.03) and reoperation (p = 0.02). Among wound variables, the more severe the external wound, the greater the incidence of overall complications (p = 0.001) and infections (p < 0.001). Presence of two or more fracture sites was a risk factor for reoperation (p = 0.038). Among management variables, intraoral and extraoral approaches increased the rates of overall complications, infections, and reoperation. In the multivariate analysis, only intraoral and extraoral approaches were associated with significant risks for overall complications (OR = 5.63, p = 0.017) and infections (OR = 11.53, p = 0.005). Alcohol consumption, external wound severity, multiple fracture site, and incision approach were related to postoperative complications. These findings can help guide surgical decisions and manage patient expectations after surgery.

PMID:36588069 | DOI:10.1016/j.jcms.2022.12.001

J Foot Ankle Surg. 2022 Dec 17:S1067-2516(22)00353-2. doi: 10.1053/j.jfas.2022.12.001. Online ahead of print.

ABSTRACT

Regarding the treatment of ankle arthritis, the choice of arthroscopic ankle arthrodesis (AAA) or open ankle arthrodesis (OAA) remains controversial. To guide clinical decision-making, we conducted a meta-analysis on the optimal treatment of ankle arthrodesis. We identified eligible studies published from June 1, 1969 to June 1, 2020 using the Cochrane Library, PubMed, OVID, Embase, and Medline searched the references of relevant studies. Randomized and non-randomized studies that compared outcomes of AAA and OAA were included. After the methodologic assessment, available data were extracted and statistically reviewed. The primary outcomes were overall complications rate, tourniquet time, length of the hospital stay, non-union rate, and rate to fusion. The secondary outcomes were delayed union and postoperative infection rate. We included 9 studies comparing arthroscopic and open in patients with ankle arthrodesis, comprising 467 participants. AAA had the advantage of demonstrating a lower overall complication rate (odds ratio [OR], 0.44 [95% confidence interval [CI], 0.26-0.73]; p = .002), shorter intraoperative tourniquet time (mean difference [MD], -16.49 [95% CI, -23.51 to -9.46]; p < .001), shorter length of the hospital stay (MD -1.75, 95% CI -1.94 to -1.2, p < .001),lower non-union rate (OR, -0.07 [95% CI, -0.13 to -0.02]; p <.01) and higher rate to fusion (OR, 4.2 [95% CI, 1.96-8.99]; p < .001) in comparison with OAA. Yet, no significant differences were found in delayed union (OR, 0.46 [95% CI, 0.10-2.04]; p = .30) and postoperative infection rate (OR, 0.45 [95% CI, 0.17-1.15]; p = .09) between the groups. Our results suggest that arthroscopic ankle arthrodesis is superior to open ankle arthrodesis alone in the treatment of ankle arthritis based on the overall complication rate, intraoperative tourniquet time, length of the hospital stay, non-union rate and rate to fusion. However, further high-quality randomized controlled trials with appropriate blinding methods are needed to confirm the findings.

PMID:36588066 | DOI:10.1053/j.jfas.2022.12.001