Category: Nevin Manimala

J Pediatr Urol. 2023 Feb 11:S1477-5131(23)00053-0. doi: 10.1016/j.jpurol.2023.02.004. Online ahead of print.

ABSTRACT

INTRODUCTION: There is controversy surrounding the association between caudal block and complication rates after hypospadias repair. Conflicting results have been reported mostly from single-center, low volume studies and those that did not include relevant variables.

OBJECTIVES: We hypothesized that caudal block is not associated with increased rates of reoperation after primary repair and is associated with more complex hypospadias surgery.

STUDY DESIGN: The Clinical Practice Solutions Center database was queried to identify patients who received a primary hypospadias repair between 2009 and 2010. Primary hypospadias repair was further categorized as meatal advancement and glanduloplasty, distal, one-stage proximal, or one-stage perineal repair. Anesthesia coding was evaluated to identify those who received a caudal block. Any revision surgery was captured between 2009 and 2019 and the types of revision surgeries were identified. Variables such as caudal block, age, insurance type, surgeon volume, and surgeon years in practice were analyzed with mixed effects multiple logistic regression models.

RESULTS: The dataset query identified 3343 pediatric males who had primary hypospadias repair. The procedures were performed by 50 surgeons at 27 hospitals. Primary surgeries included meatal advancement and glanduloplasty (23%), distal (69%), proximal (6.9%), and perineal repairs (1%). Caudal block was administered to 42% of patients. Utilization of caudal block was not associated with type of primary surgery (p = 0.21). Adjusting for all other variables, increased patient age was associated with decreased usage of caudal block (p < 0.001). Analysis did not demonstrate a statistically significant association between utilization of caudal block with rates of revision surgery.

CONCLUSIONS: This large, multi-institution study demonstrates that the use of caudal block was not associated with more complex hypospadias surgery nor statistically significantly associated with increased rates of revision surgery after primary hypospadias repair.

PMID:36842912 | DOI:10.1016/j.jpurol.2023.02.004

Enferm Infecc Microbiol Clin (Engl Ed). 2023 Feb 24:S2529-993X(23)00058-8. doi: 10.1016/j.eimce.2022.12.015. Online ahead of print.

ABSTRACT

INTRODUCTION: The role of Aeromonas species in gastrointestinal disease is controversial. The aim was to analyze not only the virulence genes between different species of Aeromonas isolated from feces, but the distribution of these virulence genes between enterotoxigenic strains and co-pathogen strains.

METHODS: Retrospective study of isolates of Aeromonas spp. in feces (2016-2021). The protocol included coproculture, identification by MALDI-TOF and confirmation by multiplex PCR. SPSS Statistics program was used.

RESULTS: A total of 288 strains were studied for the virulence genes between different species of Aeromonas. To compare virulence genes between Aeromonas as co-pathogen and those isolated alone, 218 strains of the global set were used; 52 as co-pathogens compared with 166 Aeromonas without associated pathogen as controls.

CONCLUSIONS: We found no significant differences in the distribution of virulence genes versus co-existence of co-pathogens or not. A. hydrophila is the potentially most virulent species of our set.

PMID:36842908 | DOI:10.1016/j.eimce.2022.12.015

Ultrasound Med Biol. 2023 Feb 24:S0301-5629(23)00027-3. doi: 10.1016/j.ultrasmedbio.2023.01.013. Online ahead of print.

ABSTRACT

OBJECTIVE: Modelling ultrasound speckle to characterise tissue properties has generated considerable interest. As speckle is dependent on the underlying tissue architecture, modelling it may aid in tasks such as segmentation or disease detection. For the transplanted kidney, where ultrasound is used to investigate dysfunction, it is unknown which statistical distribution best characterises such speckle. This applies to the regions of the transplanted kidney: the cortex, the medulla and the central echogenic complex. Furthermore, it is unclear how these distributions vary by patient variables such as age, sex, body mass index, primary disease or donor type. These traits may influence speckle modelling given their influence on kidney anatomy. We investigate these two aims.

METHODS: B-mode images from n = 821 kidney transplant recipients (one image per recipient) were automatically segmented into the cortex, medulla and central echogenic complex using a neural network. Seven distinct probability distributions were fitted to each region’s histogram, and statistical analysis was performed.

DISCUSSION: The Rayleigh and Nakagami distributions had model parameters that differed significantly between the three regions (p ≤ 0.05). Although both had excellent goodness of fit, the Nakagami had higher Kullbeck-Leibler divergence. Recipient age correlated weakly with scale in the cortex (Ω: ρ = 0.11, p = 0.004), while body mass index correlated weakly with shape in the medulla (m: ρ = 0.08, p = 0.04). Neither sex, primary disease nor donor type exhibited any correlation.

CONCLUSION: We propose the Nakagami distribution be used to characterize transplanted kidneys regionally independent of disease etiology and most patient characteristics.

PMID:36842904 | DOI:10.1016/j.ultrasmedbio.2023.01.013

Curr Probl Diagn Radiol. 2023 Feb 8:S0363-0188(23)00022-1. doi: 10.1067/j.cpradiol.2023.02.002. Online ahead of print.

ABSTRACT

The purpose is to evaluate the trends in MR arthrogram utilization at a tertiary care academic institution and to determine if there are factors that can be implicated in the utilization trends. Number of MR arthrograms of the shoulder, hip, and elbow from 2013-2020 at our institution were identified (n = 1882). Patient demographics including age, sex, sports participation, history of prior surgery, and physician referral were obtained. Descriptive statistics were performed to determine the prevalence of MR arthrograms. Linear regression analyses were performed to determine the relationship of time with prevalence of arthrograms. Chi-square tests and posthoc analyses with Bonferroni correction were used to assess if categorical variables were different between the years. There was overall decrease in the prevalence of MR arthrograms of the shoulder, hip, and elbow despite an increase in the overall MR volume during the study period. Linear regression models significantly predicated decrease in arthrogram prevalence with each passing year (P < 0.001). The percentage of orthopedic referrals for arthrograms in the hip (P = 0.002) and shoulder (P = < 0.001) decreased significantly towards the end of the study period. None of the other variables assessed were significant. At our tertiary care academic institution, arthrogram utilization has been drastically decreasing over the past 8 years. The percentage of orthopedic referrals for shoulder and hip arthrograms significantly decreased at the end of the study period.

PMID:36842885 | DOI:10.1067/j.cpradiol.2023.02.002

Farm Hosp. 2023 Feb 24:S1130-6343(23)00004-1. doi: 10.1016/j.farma.2023.01.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the pharmacist’s contributions by analyzing potentially inappropriate prescription and home treatment reconciliation in the complex chronic patient unit of a tertiary hospital.

METHOD: Observational, prospective, multidisciplinary study of patients in the complex chronic patient unit of a hospital during February 2019-June 2020. Multidisciplinary team of the complex chronic developed a checklist with a selection of non-recommended drugs based on STOPP/START, Beers and Priscus criteria, and drugs susceptible to deprescription according to LESS-CHRON criteria. The pharmacist applied the checklist daily in patients admitted to the unit, in addition to reconciling home treatment by reviewing the prescribed treatment with that detailed in the electronic home prescription. Therefore, the following variables were collected: age, sex and number of drugs on admission as independent variables, and dependent variables: number of drugs at discharge, type of potentially inappropriate prescription, reasons for reconciliation, drugs involved and degree of acceptance of the recommendation by the prescribing physician to assess the pharmaceutical contribution. The statistical analysis was performed with IBM® SPSS® Statistics22.

RESULTS: We reviewed 621 patients with a median age of 84 years (56.4% women), and intervention was performed in 218 (35.1%). The median number of drugs was 11 (2-26) at admission and 10 (0-25) at discharge. 373 interventions were performed: 235 for medication reconciliation (78.3% accepted), 71 for non-recommended drugs (57.7% accepted), 42 for deprescription (61.9% accepted) and 25 for other reasons. Statistically significant differences were observed between the number of drugs at discharge and at admission in both intervention patients (n = 218) and complex chronic patients (n = 114) (p < 0.001 in both cases). Moreover, statistically significant differences were observed in the number of drugs at admission between patients included in the complex chronic programme and those not included (p = 0.001), and in the number of drugs at discharge (p = 0.006).

CONCLUSIONS: The integration of the pharmacist in the multidisciplinary team of the complex chronic patient unit improves patient safety and quality of care. The selected criteria were useful for detecting inappropriate drugs in this population and favored deprescription.

PMID:36842862 | DOI:10.1016/j.farma.2023.01.004

Trends Biochem Sci. 2023 Feb 24:S0968-0004(23)00033-6. doi: 10.1016/j.tibs.2023.01.009. Online ahead of print.

ABSTRACT

Over recent years many statisticians and researchers have highlighted that statistical inference would benefit from a better use and understanding of hypothesis testing, p-values, and statistical significance. We highlight three recommendations in the context of biochemical sciences. First recommendation: to improve the biological interpretation of biochemical data, do not use p-values (or similar test statistics) as thresholded values to select biomolecules. Second recommendation: to improve comparison among studies and to achieve robust knowledge, perform complete reporting of data. Third recommendation: statistical analyses should be reported completely with exact numbers (not as asterisks or inequalities). Owing to the high number of variables, a better use of statistics is of special importance in omic studies.

PMID:36842858 | DOI:10.1016/j.tibs.2023.01.009

J Pediatr Health Care. 2023 Feb 24:S0891-5245(23)00027-5. doi: 10.1016/j.pedhc.2023.01.005. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to gain knowledge about the impact of an extended postnatal home visiting program on parents’ comprehensive health literacy (CHL) in multicultural, socioeconomically disadvantaged Swedish settings.

METHOD: This quasi-experimental study adopted a case-control sampling method recruiting first-time parents through two Child Health Care Centers in Stockholm. Participants were interviewed twice through structured questionnaires when their child was aged between less than two months (n = 193) and 15-18 months (n = 151) from October 2017 to August 2020. Analyses used linear regression models and nonparametric tests.

RESULTS: A subgroup of parents that needed language interpreters demonstrated statistically significantly improved CHL from premeasures to postmeasures within the intervention group that received an extended home visiting intervention (F = 11.429; p <.001), and when compared with a corresponding subgroup that received merely the ordinary Swedish Child Health Care Centers program (F = 5.025; p = .027).

DISCUSSION: Postnatal home visiting interventions may reduce inequity in CHL for parents living in multicultural, socioeconomically disadvantaged settings.

PMID:36842842 | DOI:10.1016/j.pedhc.2023.01.005

Arch Psychiatr Nurs. 2023 Feb;42:61-67. doi: 10.1016/j.apnu.2022.12.015. Epub 2022 Dec 30.

ABSTRACT

PURPOSE: High work-family conflict affects nurses’ physical, mental and psychological health and reduces their job satisfaction and performance. This study was conducted to determine the effect of work stress experienced by nurses during the COVID-19 pandemic on family life and the factors affecting work stress and work-family conflict.

METHOD: This descriptive and cross-sectional study was conducted on 820 nurses who agreed to participate in the research working in a hospital serving only patients with confirmed COVID-19 in a province in eastern Turkey.

RESULTS: It was found that the average PJSS score of the nurses included in the study was 3.26 ± 0.56; the average WAFCS score was 3.00 ± 0.81. It was found that there was a moderately positive, statistically significant relationship between the PJSS and WAFCS average scores for the nurses, and the impact of work stress on the levels of work-family conflict was 28 % (p < 0.001).

CONCLUSION: It was determined that the work stress levels of the nurses included in the study were at a level that could threaten their health, the conflict levels in work-family life were high, and the conflict levels in work and family life increased as the levels of work stress increased.

PMID:36842830 | DOI:10.1016/j.apnu.2022.12.015

Arch Psychiatr Nurs. 2023 Feb;42:18-24. doi: 10.1016/j.apnu.2022.12.004. Epub 2022 Dec 18.

ABSTRACT

This study investigates the relationships between nursing students’ internet addiction levels, communication skills and difficulties in emotion regulation. This cross-sectional study included 463 nursing students who completed the Internet Addiction Scale (IAS), Communication Skills Scale (CSS) and Difficulties in Emotion Regulation Scale (DERS-16). Approximately half of the nursing students were risky internet users. A negative statistically significant was determined between from IAS and CSS; a positive statistically significant was determined between from IAS and DERS-16. It was found that internet addiction had an effect of 18.6 % (R² = 0.186) on difficulty in emotion regulation and 0.27 % on communication skills (R² = 0.027). The students who were in risky group in internet addiction had worse communication skills and higher levels of difficulties in emotion regulation.

PMID:36842823 | DOI:10.1016/j.apnu.2022.12.004

Arch Psychiatr Nurs. 2023 Feb;42:1-8. doi: 10.1016/j.apnu.2022.11.001. Epub 2022 Dec 2.

ABSTRACT

PURPOSE: The purpose of the current research was to identify the influence of university students’ personality traits on their fear of COVID-19 and psychological resilience levels.

DESIGN AND METHODS: A cross-sectional trial was completed with 690 students. Descriptive statistics and correlations were calculated, and a path analysis was employed with the objective of assessing the model fit and investigating direct and indirect impacts.

FINDINGS: Among personality traits, conscientiousness and neuroticism were observed to affect fear of COVID-19, and conscientiousness, neuroticism, and openness to experience had an effect on psychological resilience. The tested model has a good fit and explains the direct effects of the study variables.

PRACTICE IMPLICATIONS: Nurses should improve university students’ psychological resilience by supporting them with protective and improving factors. The role of the psychiatric nurse is important in providing conscious and need-oriented support in extraordinary events such as pandemics.

PMID:36842819 | DOI:10.1016/j.apnu.2022.11.001