Category: Nevin Manimala

J Clin Nurs. 2023 Jun 21. doi: 10.1111/jocn.16801. Online ahead of print.

ABSTRACT

AIMS: To assess the association of postoperative delirium developed in the post-anaesthetic care unit (PACU) with older patients’ ability to perform activities of daily living (ADL) during the first five postoperative days.

BACKGROUND: Previous studies have focused on the association between postoperative delirium and long-term function decline, however the association between postoperative delirium and the ability to perform ADL, particularly in the immediate postoperative period, needs further investigation.

DESIGN: A prospective cohort study.

METHODS: A total of 271 older patients who underwent elective or emergency surgery at a tertiary care hospital in Victoria, Australia, participated in the study. Data were collected between July 2021 and December 2021. Delirium was assessed using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The Katz Index of Independence in Activities of Daily Living (KATZ ADL) scale was used to measure ADL. ADL was assessed preoperatively and daily during the first five postoperative days. The STROBE checklist was used to report this study.

RESULTS: Results showed that 44 (16.2%) patients developed new episode of delirium. Postoperative delirium was independently associated with decline in ADL (RR = 2.83, 95% CI = 2.71-2.97; p < 0.001).

CONCLUSIONS: Postoperative delirium was associated with a decline in ADL among older people during the first five postoperative days. Screening for delirium in the PACU is essential to identify delirium during the early stages of postoperative period and implement a timely comprehensive plan.

RELEVANCE TO CLINICAL PRACTICE: Delirium assessment of older patients in the PACU, and for at least the first five postoperative days, is strongly recommended. We also recommend engagement of patients in a focused physical and cognitive daily activity plan, particularly for older patients undergoing major surgery.

PATIENT OR PUBLIC CONTRIBUTION: Patients and nurses helped in data collection at a tertiary care hospital.

PMID:37341067 | DOI:10.1111/jocn.16801

Acta Bioeng Biomech. 2022;24(4):21-30.

ABSTRACT

PURPOSE: Foot pronation is not an isolated factor influencing lower limb functions. Exploring gait variability and impact loading associated with the foot posture are crucial for understanding foot pronation-related injury mechanisms. This study aimed to evaluate how foot posture affects impact loading and running variability during running.

METHODS: Twenty-five male participants were recruited into this study. Pressure under the foot arch, acceleration and marker trajectory were recorded in the right limb for each runner after 1, 4, 7 and 10 km running, respectively. Linear mixed effects models were used to analyze the statistical difference of the data.

RESULTS: FPI-6 has significantly increased after the 10 km running (p〈0.01). For the tibial acceleration, peak resultant acceleration after 10 km running was significantly increased than after 4 km running (p=0.02). At the dorsum of the foot, the short-time largest Lyapunov exponent (LyE) after 10 km running decreased 0.28 bit/s compared with LyE after 7 km running ( p = 0.03). In the tibia, LyE after 4 km and 10 km running was decreased significantly ( p 〈 0.01 and p = 0.01).

CONCLUSIONS: The foot was significantly pronated at the middle and at the end of running. Foot pronation during distance running increased the distal tibia peak impact acceleration but did not increase running instability.

PMID:37341060

Acta Bioeng Biomech. 2022;24(4):159-167.

ABSTRACT

PURPOSE: The COVID-19 pandemic has reduced physical activity and increased the time spent sitting. Combined with the lack of ergonomics at home workplaces, the risk of discomfort has increased, especially around the cervical spine and upper limbs. Evaluation of the mentioned problem is the subject of the study.

METHODS: The study used an original questionnaire based on the Nordic Musculoskeletal Questionnaire. The analysis used responses from people who reported discomfort in the form of tingling or numbness in the cervical spine, shoulder, elbow and wrist during the pandemic. Statistical analysis of the results was carried out to formulate conclusions. In addition, individual data were presented as percentages.

RESULTS: Considering the working time exceeding 8 hours a day, discomfort in the wrist joint area was most often reported among people working remotely (15.1%). Shoulder complex discomfort was the most common symptom (22%) reported by people working more than 8 hours a day, under the age of 31. In young people, the risk of discomfort in the shoulder, hand and cervical spine area increased.

CONCLUSIONS: Extended working time is conducive to the appearance of symptoms within the hands. In future studies, it will be necessary to analyze the ergonomic factors responsible for this phenomenon.

PMID:37341051

Acta Bioeng Biomech. 2022;24(4):75-83.

ABSTRACT

PURPOSE: The aim of this study was to compare the effects of scapular stabilization exercise with and without cognitive functional therapy (CFT) on disability and scapular kinematics in people suffering from chronic neck pain.

METHODS: A total of 72 patients with chronic non-specific neck pain were randomized into scapular stabilization exercise alone, n = 24, combined (scapular stabilization exercise + CFT), n = 24, and a control group, n = 24. Scapular kinematic and disability were measured at baseline and after the intervention.

RESULTS: Statistically significant differences in neck pain and disability scale (NPAD) were found when the multimodal physiotherapy group including a cognitive functional approach was compared with stabilization exercises group at 6 weeks (effect size (95%CI) = -1.63 (-2.55, -.71); P = 0.019)). Regarding the neck disability index (NDI), a significant between-group difference was observed at six-week (effect size (95%CI) = -2.69 (-3.80, -1.58); P = 0.007), with the superiority of effect in multimodal physiotherapy group. A significant between-group difference was observed in the scapular upward rotation and scapular osterior tilt at 30°, 60°, 90° and 120° of shoulder adduction.

CONCLUSIONS: A group-based multimodal rehabilitation program including scapular stabilization exercise plus cognitive functional therapy was superior to group-based stabilization exercises alone for decreasing disability and, improving scapular kinematic in patients with chronic neck pain.

PMID:37341050

Br J Psychiatry. 2023 Jun 21:1-8. doi: 10.1192/bjp.2023.74. Online ahead of print.

ABSTRACT

BACKGROUND: Common postpartum mental health (PMH) disorders such as depression and anxiety are preventable, but determining individual-level risk is difficult.

AIMS: To create and internally validate a clinical risk index for common PMH disorders.

METHOD: Using population-based health administrative data in Ontario, Canada, comprising sociodemographic, clinical and health service variables easily collectible from hospital birth records, we developed and internally validated a predictive model for common PMH disorders and converted the final model into a risk index. We developed the model in 75% of the cohort (n = 152 362), validating it in the remaining 25% (n = 75 772).

RESULTS: The 1-year prevalence of common PMH disorders was 6.0%. Independently associated variables (forming the mnemonic PMH CAREPLAN) that made up the risk index were: (P) prenatal care provider; (M) mental health diagnosis history and medications during pregnancy; (H) psychiatric hospital admissions or emergency department visits; (C) conception type and complications; (A) apprehension of newborn by child services (newborn taken into care); (R) region of maternal origin; (E) extremes of gestational age at birth; (P) primary maternal language; (L) lactation intention; (A) maternal age; (N) number of prenatal visits. In the index (scored 0-39), 1-year common PMH disorder risk ranged from 1.5 to 40.5%. Discrimination (C-statistic) was 0.69 in development and validation samples; the 95% confidence interval of expected risk encompassed observed risk for all scores in development and validation samples, indicating adequate risk index calibration.

CONCLUSIONS: Individual-level risk of developing a common postpartum mental health disorder can be estimated with data feasibly collectable from birth records. Next steps are external validation and evaluation of various cut-off scores for their utility in guiding postpartum individuals to interventions that reduce their risk of illness.

PMID:37341030 | DOI:10.1192/bjp.2023.74

Eur Psychiatry. 2023 Jun 21:1-24. doi: 10.1192/j.eurpsy.2023.2422. Online ahead of print.

NO ABSTRACT

PMID:37341028 | DOI:10.1192/j.eurpsy.2023.2422

Urol J. 2023 Jun 21. doi: 10.22037/uj.v20i.7508. Online ahead of print.

ABSTRACT

PURPOSE: To explore the safety and efficacy of bipolar plasma-kinetic transurethral resection of the prostate in patients taking low-dose aspirin.

MATERIALS AND METHODS: Benign prostatic hyperplasia (BPH) patients who underwent surgical treatment from November 2018 to May 2020 were retrospectively analyzed,divided into two groups according to whether taking 100mg aspirin daily aspirin or not. The perioperative indexes, complications and sequelae also were used to evaluate safety. The efficacy was evaluated by the functional outcomes in 3,6,12 months.

RESULTS: There were no statistical differences in the baseline characteristics or perioperative indicators and complications and sequelae, except for a longer operative time(90.49 ± 14.34 vs 84.95 ± 15.49; 95%CI: 0.26-10.83; P = .040) and a shorter hospital stay time(HST) (8.52 ± 1.55 vs 9.09 ± 1 .50; 95% CI: 0.21-1.11; P = .042) in the non-aspirin group. During the 12-months follow-up period, the functional outcomes of the two groups were significantly improved except International Index of Erectile Function (IIEF-5).

CONCLUSION: Based on our research results, PKRP a safe and effective method for patients with BPH who taking 100mg aspirin daily.

PMID:37341011 | DOI:10.22037/uj.v20i.7508

Investig Clin Urol. 2023 May;64(3):296-305. doi: 10.4111/icu.20220293.

ABSTRACT

PURPOSE: We investigated the efficacy and optimal dosage of recombinant Bacillus Calmette-Guérin-dltA (rBCG-dltA) in a high-throughput 3D bio-printed bladder cancer-on-a-chip (BCOC) and orthotopic bladder cancer mouse model.

MATERIALS AND METHODS: We fabricated high-throughput BCOC with microfluidic systems, enabling efficient drug screening. The efficacy of rBCG-dltA was evaluated using BCOC by the cell viability assay, monocyte migration assay, and measuring cytokine levels. The anti-tumor effect was compared using the orthotopic bladder cancer mouse model.

RESULTS: The cell proliferation rates of T24 and 253J bladder cancer cell lines (mean±standard error) were measured at three days after treatment. In T24 cell line, there was significantly decreased T24 cells compared to control at rBCG 1 multiplicity of infection (MOI) and 10 MOI (30 MOI: 63.1±6.4, 10 MOI: 47.4±5.2, 1 MOI: 50.5±7.5, control: 100.0±14.5, p<0.05). In 253J cell line, a statistically significant decrease in 253J cell count compared to control and mock BCG 30 MOI (30 MOI: 11.2±1.3, 10 MOI: 22.5±2.3, 1 MOI: 39.4±4.7, Mock: 54.9±10.8, control: 100.0±5.6, p<0.05). The migration rates of THP-1 cells showed increased patterns after rBCG-dltA treatment in BCOC. The concentration of tumor necrosis factor-α and interleukin-6 after rBCG-dltA 30 MOI treatment was higher than control in T24 and 253J cell line.

CONCLUSIONS: In conclusion, rBCG-dltA has the potential to have better anti-tumor activity and immunomodulatory effects than BCG. Furthermore, high-throughput BCOCs have potential to reflect the bladder cancer microenvironment.

PMID:37341010 | DOI:10.4111/icu.20220293

Investig Clin Urol. 2023 May;64(3):242-254. doi: 10.4111/icu.20230058.

ABSTRACT

The oncologic outcomes of cytoreductive prostatectomy (CRP) in oligometastatic prostate cancer (OmPCa) are still controversial. Therefore, we conducted a systematic review and meta-analysis on the oncologic outcome of CRP in OmPCa. OVID-Medline, OVID-Embase, and Cochrane Library databases were searched to identify eligible studies published before January 2023. A total of 11 studies (929 patients), 1 randomized controlled trial (RCT) and 10 non-RCT studies, were included in the final analysis. RCT and non-RCT were further analyzed separately. End points were progression-free-survival (PFS), time to castration-resistant prostate cancer (CRPCa), cancer-specific-survival (CSS) and overall-survival (OS). It was analyzed using hazard ratio (HR) and 95% confidence intervals (CIs). In PFS, in RCT, HR=0.43 (CIs=0.27-0.69) was shown statistically significant, but in non-RCTs, HR=0.50 (CIs=0.20-1.25), there was no statistical difference. And, in time to CRPCa was statistically significant in the CRP group in all analyses (RCT; HR=0.44; CIs=0.29-0.67) (non-RCTs; HR=0.64; CIs=0.47-0.88). Next, CSS was not statistically different between the two groups (HR=0.63; CIs=0.37-1.05). Finally, OS showed better results in the CRP group in all analyses (RCT; HR=0.44; CIs=0.26-0.76) (non-RCTs; HR=0.59; CIs=0.37-0.93). Patients who received CRP in OmPCa showed better oncologic outcomes compared to controls. Notably, time to CRPC and OS showed significantly improved compared with control. We recommend that experienced urologists who are capable of managing complications consider CRP as a strategy to achieve good oncological outcomes in OmPCa. However, since most of the included studies are non-RCT studies, caution should be exercised in interpreting the results.

PMID:37341004 | DOI:10.4111/icu.20230058

Chem Biodivers. 2023 Jun 21:e202300669. doi: 10.1002/cbdv.202300669. Online ahead of print.

ABSTRACT

Propolis is one of the mixtures with the widest biological activity among natural products used in complementary medicine. HSV-1 is a highly contagious and endemic virus. Available drugs are insufficient for recurrent HSV-1 infections. Therefore, new approaches to treat HSV-1 infections are still being developed. In this study, it was aimed to investigate the inhibition effect of ethanolic Anatolian propolis extracts obtained from the Eastern Black Sea Region (Pazar, Ardahan, and Uzungöl) on HSV-1. In addition to the total phenolic (TPC) and the total flavonoid content (TFC), the phenolic profiles of the extracts were analyzed by HPLC-UV. The antiviral activity of the extracts were tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), quantitative Real Time Polymerase Chain Reaction (qRT-PCR), and plaque reduction tests, and the results were evaluated statistically. It was determined that the total amount of phenolic substances varied between 44.12 and 166.91 mg GAE/g, and the total flavonoid content of the samples varied between 12.50 and 41.58 (mgQUE/g). It was shown that all propolis samples used in the current study were effective against HSV-1, but the higher phenolic compounds contained in the samples showed the higher activity. The results show that ethanolic propolis extracts are promising candidates for HSV-1 treatment.

PMID:37340993 | DOI:10.1002/cbdv.202300669