Category: Nevin Manimala

Cardiovasc J Afr. 2023 Feb 8;34:1-8. doi: 10.5830/CVJA-2022-069. Online ahead of print.

ABSTRACT

BACKGROUND: Myxomas are primary cardiac tumours that may be detected incidentally due to embolic events, intracardiac obstructive features or non-specific structural symptoms. The aim of this study was to share our experience of clinical features, diagnostic methods, surgical procedures and postoperative follow up of surgically treated cardiac myxomas.

METHODS: Data of 34 patients who underwent surgery for a cardiac myxoma between January 2006 and June 2022 were retrospectively analysed. Group 1 (n = 19) consisted of patients who were symptomatic and group 2 ( n = 15) patients were asymptomatic. The medical records of the patients, their clinical status, diagnostic methods, operation information and postoperative course data were collected and recorded.

RESULTS: A total of 34 patients (16 female; mean age 54.5 ± 8.8 years) underwent cardiac myxoma resection with cardiopulmonary bypass. Fifteen (44.1%) patients were diagnosed incidentally with asymptomatic myxoma. An additional cardiac surgical procedure was performed in six patients (17.7%). The 34 cardiac myxomas that were surgically resected were localised in the left atrium in 25 patients (73.5%) and in the right atrium in nine patients (26.5%). Patients’ most common symptoms were dyspnoea (42.1%), palpitations (21.1%), ischaemic stroke (15.8%) and syncope (10.5%). There was no incident of 30-day mortality and no recurrence was observed in any patient during the follow-up period. The duration of surgical intervention in symptomatic patients was significantly shorter than in asymptomatic patients (p = 0.0001), but there was no statistical difference in terms of characteristics.

CONCLUSIONS: Myxomas are benign tumours, but they are serious pathologies that require early treatment because of signs of obstruction, embolic complications and confusion, with left atrial thrombus in the differential diagnosis.

PMID:36752152 | DOI:10.5830/CVJA-2022-069

Psychol Med. 2023 Feb 8:1-12. doi: 10.1017/S0033291722004007. Online ahead of print.

ABSTRACT

BACKGROUND: Cognitive dysfunction and brain structural connectivity alterations have been observed in major depressive disorder (MDD). However, little is known about their interrelation. The present study follows a network approach to evaluate alterations in cognition-related brain structural networks.

METHODS: Cognitive performance of n = 805 healthy and n = 679 acutely depressed or remitted individuals was assessed using 14 cognitive tests aggregated into cognitive factors. The structural connectome was reconstructed from structural and diffusion-weighted magnetic resonance imaging. Associations between global connectivity strength and cognitive factors were established using linear regressions. Network-based statistics were applied to identify subnetworks of connections underlying these global-level associations. In exploratory analyses, effects of depression were assessed by evaluating remission status-related group differences in subnetwork-specific connectivity. Partial correlations were employed to directly test the complete triad of cognitive factors, depressive symptom severity, and subnetwork-specific connectivity strength.

RESULTS: All cognitive factors were associated with global connectivity strength. For each cognitive factor, network-based statistics identified a subnetwork of connections, revealing, for example, a subnetwork positively associated with processing speed. Within that subnetwork, acutely depressed patients showed significantly reduced connectivity strength compared to healthy controls. Moreover, connectivity strength in that subnetwork was associated to current depressive symptom severity independent of the previous disease course.

CONCLUSIONS: Our study is the first to identify cognition-related structural brain networks in MDD patients, thereby revealing associations between cognitive deficits, depressive symptoms, and reduced structural connectivity. This supports the hypothesis that structural connectome alterations may mediate the association of cognitive deficits and depression severity.

PMID:36752136 | DOI:10.1017/S0033291722004007

Drug Chem Toxicol. 2023 Feb 8:1-8. doi: 10.1080/01480545.2023.2174988. Online ahead of print.

ABSTRACT

Vigabatrin (VGB) is a gammaaminobutyric acid-ergic (GABA-ergic) antiepileptic drug (AED) and is one of 2 approved drugs available to treat infantile spasms (IS). The aim of this study is to elucidate conflicting data on the toxic effects of VGB and to obtain detailed information about its possible cytogenotoxic effects in human lymphocytes. For this purpose, in vitro Chromosomal Aberration (CA), Sister Chromatid Exchange (SCE), Micronucleus (MN) tests, and Comet Assay were performed to determine possible genotoxic and cytotoxic effects of VGB. In addition, the binding energy level of VGB to DNA was determined in silico by molecular docking. The highest concentration (80 μg/ml) of VGB increased the SCE, CA, MN and micronucleated binuclear cell (BNMN) frequency significantly compared to the control after 24 and 48 hours of treatment. In the tail density and tail length parameters, the dose-dependent increase was found to be statistically significant compared to the control. At the 40 and 80 μg/ml concentrations of VGB for 48 hours caused a statistically significant increase in both CA/Cell and AC percentages, while MI and NDI decreased only significantly at the highest concentration (80 µg/ml) causing. In the Comet Assay head density, tail density and tail length parameters, the dose-dependent increase was found to be statistically significant compared to the control. Also, the in silico molecular docking analysis showed that VGB interacts with B-DNA close to the threshold binding energy. The lowest negative free binding energy (ΔG binding) was found as -5.13 kcal/mol. In conclusion, all results are evaluated together, it has been determined that VGB has cytogenotoxic effects in vitro and binds to DNA in silico with significant free binding energy.

PMID:36752088 | DOI:10.1080/01480545.2023.2174988

Dev Med Child Neurol. 2023 Feb 8. doi: 10.1111/dmcn.15538. Online ahead of print.

ABSTRACT

AIM: To report incidence, demographic and clinical characteristics, and symptom outcome of functional neurological disorder (FND) in children.

METHOD: Children diagnosed with FND at a regional children’s hospital were prospectively recruited by weekly active surveillance for 36 months. Demographic, clinical, and follow-up data were retrospectively extracted by review of electronic records. Descriptive statistical analyses were used.

RESULTS: Ninety-seven children (age range 5-15 years) met the case definition of FND (annual incidence 18.3 per 100 000 children). Children with FND were likely to be female (n = 68 [70%]) and older (median 13 years) with no difference in the Scottish Index of Multiple Deprivation (marker of socioeconomic status) compared with the general childhood population. Functional motor (41%) and sensory (41%) symptoms were most common; other somatic symptoms such as headache (31%) and pain (27%) were frequent. Self-reported psychiatric symptoms and infection/inflammation were the most common predisposing and precipitating factors respectively. At a median of 15 months follow-up, 49% of 75 children reported improvement or resolution of FND symptoms with no prognostic factors found.

INTERPRETATION: At this regional centre, FND in children had a higher incidence than previously reported and a less optimistic outcome than in some other studies.

PMID:36752054 | DOI:10.1111/dmcn.15538

Jpn J Nurs Sci. 2023 Feb 8:e12526. doi: 10.1111/jjns.12526. Online ahead of print.

ABSTRACT

AIM: This study aimed to examine the mediating effect of workplace social capital on the relationship between authentic leadership and the three dimensions of organizational commitment: affective, normative, and continuance.

METHODS: In January 2019, anonymous self-reported questionnaires were distributed to 1220 nurses working in the general wards of two university hospitals in Japan. Structural equation modeling was used to examine the mediating effects of workplace social capital on the relationship between nurse managers’ authentic leadership and the three dimensions of organizational commitment.

RESULTS: Six hundred and fifty-nine data points were analyzed (valid response rate = 54.0%). Participants’ average age was 28.6 years (standard deviation: 6.6), and 93.3% were female. The mediation indirect effect of workplace social capital between authentic leadership and organizational commitment was statistically significant in the models of affective organizational commitment and normative organizational commitment, but not in the model of continuance organizational commitment.

CONCLUSIONS: The effects of authentic leadership and workplace social capital had different impacts on each of the three dimensions of organizational commitment. Nurse managers’ authentic leadership and workplace social capital can enhance nurses’ positive commitment to the organization.

PMID:36752048 | DOI:10.1111/jjns.12526

J Int Med Res. 2023 Feb;51(2):3000605231153326. doi: 10.1177/03000605231153326.

ABSTRACT

OBJECTIVE: Redundant nerve root syndrome (RNRS) is characterized by tortuous, elongated, and enlarged nerve roots in patients with lumbar spinal stenosis. This study was performed to evaluate the effects of caudal block in patients with RNRS and assess factors associated with RNRS.

METHODS: Patients with lumbar spinal stenosis who underwent caudal block were retrospectively analyzed. A comparative analysis of pain reduction was conducted between patients with RNRS (Group R) and those without RNRS (Group C). Generalized estimating equation analysis was used to identify factors related to the treatment response. RNRS-associated factors were analyzed using logistic regression analysis.

RESULTS: In total, 54 patients were enrolled (Group R, n = 22; Group C, n = 32). Group R had older patients than Group C. The caudal block showed less pain reduction in Group R than in Group C, but the difference was not statistically significant. Generalized estimating equation analysis showed that RNRS was the factor significantly associated with the treatment response. The dural sac anteroposterior diameter and left ligamentum flavum thickness were associated with RNRS in the logistic regression analysis.

CONCLUSIONS: Caudal block tended to be less effective in patients with than without RNRS, but the difference was not statistically significant.

PMID:36752034 | DOI:10.1177/03000605231153326

Cancer Sci. 2023 Feb 8. doi: 10.1111/cas.15752. Online ahead of print.

ABSTRACT

Our previous real-world studies raised concerns that sequential biomarker testing may lead to increased time to treatment when compared with simultaneous single biomarker testing. The Oncomine Dx target test (ODxTT), a next-generation sequencing-based multiplex biomarker panel test approved in Japan in 2019, is expected to improve time to treatment due to changes in testing methods. This retrospective observational study examined data claims for reimbursement submitted for patients with lung cancer in Japan between June 1, 2019, and March 31, 2020. To evaluate the change in testing prevalence over time and associated improvements in time to treatment (TTT), descriptive statistics were used to characterize biomarker testing patterns and rates and evaluate the TTT in the time following the approval of ODxTT considering transitions over time during the evaluation period. EGFR and programmed death ligand 1 (PD-L1) were the most tested biomarkers in overall single and simultaneous single testing in the 6177 patients in this study. Individual single biomarker testing gradually decreased over time, except testing for PD-L1, which remained constant. The use of ODxTT gradually increased in this period. TTT was decreased from 29 to 22 days with ODxTT, in contrast with single biomarker tests (median, 21-23 days overall). These results indicate that biomarker testing frequency has changed in Japanese clinical practice during the study and that the use of ODxTT has increased over time, which potentially contributed to the shortening of TTT.

PMID:36751989 | DOI:10.1111/cas.15752

Bipolar Disord. 2023 Feb 8. doi: 10.1111/bdi.13308. Online ahead of print.

ABSTRACT

OBJECTIVE: While treatment with antipsychotics and antiepileptics have been associated with an increased risk of DM, lithium may have the opposite effect via inhibition of glycogen synthase kinase-3. The aim of this study was to investigate whether treatment of bipolar disorder with lithium, antipsychotics, or antiepileptics is associated with the risk of DM in a real-world clinical setting.

METHODS: Using nationwide registers, we identified all patients diagnosed with bipolar disorder in Danish Psychiatric Services from January 1, 1996, to January 1, 2019 (N=30,451). The risk of developing DM was operationalized via hospital diagnoses and redeemed prescriptions for glucose-lowering drugs. For lithium, antipsychotics, valproate, and lamotrigine, we calculated hazard rate ratios (HRR) for developing DM via adjusted Cox proportional hazards models. Potential cumulative dose-response-like associations were examined using the log-rank test.

RESULTS: During follow-up (245,181 person-years), 2107 (6.9%) patients developed DM. Compared to non-users of the respective drugs, we found no clinically or statistically significant difference in the risk of developing DM among patients receiving lithium (n=11,690; incidence rate of DM/1,000 person-years (IR)=8.87, 95%CI:8.02-9.90; HRR=0.94, 95%CI:0.84-1.06) or lamotrigine (n=11,785; IR=7.58, 95%CI:6.69-8.59; HRR=0.89, 95%CI:0.77-1.02), respectively. Conversely, for patients receiving valproate (n=5,171; IR=12.68, 95%CI:10.87-14.80; HRR=1.34, 95%CI:1.14-1.58) and antipsychotics (n=22,719; IR=12.00, 95%CI:11.14-12.94; HRR=1.65, 95%CI:1.45-1.88), respectively, there was increased risk of developing DM. For antipsychotics, we observed a clear cumulative dose-response-like association with the risk of DM.

CONCLUSIONS: Treatment with valproate and antipsychotics-but not with lithium and lamotrigine-was associated with increased risk of DM in a real-world cohort of patients with bipolar disorder.

PMID:36751986 | DOI:10.1111/bdi.13308

Matern Child Nutr. 2023 Feb 8:e13485. doi: 10.1111/mcn.13485. Online ahead of print.

ABSTRACT

Consumption of unhealthy commercial foods and beverages (UCFB) is common among infants and young children living in low- and middle-income countries. Such foods can displace other nutritious foods, however, there is limited evidence on how this consumption tracks across time. This study assessed and tracked UCFB consumption of children living in rural/peri-urban Cambodia during the complementary feeding period, identified UCFB consumption patterns of these children, and explored the association between UCFB consumption and growth. A 6-month longitudinal cohort study was implemented among 567 caregivers of children aged 10-14 months at recruitment. UCFB consumption was estimated each month via a telephone-administered 7-day food frequency questionnaire, and UCFB consumption patterns were identified based on changes in this frequency of consumption over time. The majority of children either maintained (45.7%, n = 246) or developed (43.5%, n = 234) an unhealthy consumption pattern and only 10.8% (n = 58) of children maintained/transitioned into a healthy consumption pattern. High consumers of UCFB at 10-14 months had a 4.7 (CI: 4.7 [3.1-7.2]) times odds of being high consumers of UCFB at 15-19 months (p < 0.001). There was a trend of lower length-for-age z-scores (LAZ) among children maintaining or developing an unhealthy consumption pattern (~-0. SD LAZ) compared to children maintaining/transitioning into a healthy consumption pattern, however, this association was not statistically significant. Findings indicate that high UCFB consumption begins during infancy and tracks into early childhood. National policies and programmes centred on early interventions addressing the use of UCFB for infant and young child feeding are needed.

PMID:36751966 | DOI:10.1111/mcn.13485

Med Educ Online. 2023 Dec;28(1):2171700. doi: 10.1080/10872981.2023.2171700.

ABSTRACT

AIMS: To explore the global trends in blended learning in undergraduate dental education during the COVID pandemic and during the recovery phase by engaging with the students and faculty and evaluate the implications for dental education in the post-COVID era.

METHODS: It was a pilot cross-sectional study which employed a convenience sampling technique to recruit representatives of dental faculty and undergraduate students in 80 dental institutions globally. A previously validated questionnaire consisting of a combination of closed and open-ended items was used for data collection. Responses to these online questionnaires were processed and analysed using the R statistical computing environment.

RESULTS: A total of 320 dental students and 169 faculty members from 47 different dental institutions participated in the study. Video and Live Online Tutorials were considered to be the most effective method of online learning followed by online question banks by both groups. Significant differences were noted between faculty and students regarding time spent and effectiveness of online teaching and learning, respectively, both before and after the start of COVID. The results highlight the faculty need to engage more closely with the students to address their learning needs. Finally, the participants provided several recommendations regarding the future development of teaching and learning strategies as well as assessments in the post-pandemic era.

CONCLUSIONS: This is the first study which explores blended learning in dental education with participants from multiple institutions in different regions of the globe. Compared to the faculty, students considered online learning to be less interactive and preferred learning activities and all assessments to be delivered face-to-face. The results underscore the need to adapt teaching practices to suit the learning needs of the students.

PMID:36751853 | DOI:10.1080/10872981.2023.2171700