Category: Nevin Manimala

Med Sci (Basel). 2022 Dec 20;11(1):1. doi: 10.3390/medsci11010001.

ABSTRACT

The purpose of this study was to determine the effect of sublethal concentrations of nitrofurantoin, ciprofloxacin, and trimethoprim on biofilm formation in 57 uropathogenic Escherichia coli strains (UPEC). The minimum inhibitory concentration of nitrofurantoin, ciprofloxacin, and trimethoprim was determined and the biofilm formation for each isolate with and without sub-lethal concentrations of each antibiotic was then quantified. The statistical significance of changes in biofilm formation was ascertained by way of a Dunnett’s test. A total of 22.8% of strains were induced to form stronger biofilms by nitrofurantoin, 12% by ciprofloxacin, and 19% by trimethoprim; conversely 36.8% of strains had inhibited biofilm formation with nitrofurantoin, 52.6% with ciprofloxacin, and 38.5% with trimethoprim. A key finding was that even in cases where the isolate was resistant to an antibiotic as defined by EUCAST, many were induced to form a stronger biofilm when grown with sub-MIC concentrations of antibiotics, especially trimethoprim, where six of the 22 trimethoprim resistant strains were induced to form stronger biofilms. These findings suggest that the use of empirical treatment with trimethoprim without first establishing susceptibility may in fact potentiate infection in cases where a patient who is suffering from a urinary tract infection (UTI) caused by trimethoprim resistant UPEC is administered trimethoprim. This emphasizes the need for laboratory-guided treatment of UTI.

PMID:36649038 | DOI:10.3390/medsci11010001

Pharmacy (Basel). 2022 Dec 21;11(1):1. doi: 10.3390/pharmacy11010001.

ABSTRACT

The COVID-19 pandemic required pharmacists in a provincial Home Dialysis Clinic to adapt from in-person to telephone-based medication reviews. Studies have shown that in-person pharmacist interventions in patients with chronic kidney disease (CKD) lead to a reduction of drug therapy problems (DTPs), however, it’s unknown if telephone interventions provide similar outcomes. The purpose of this study was to evaluate whether differences in quality of care exist between in-person vs. telephone medication reviews in home dialysis patients and to evaluate patient satisfaction with telephone medication reviews. Data from the two most recent in-person medication reviews was compared with the two most recent telephone medication reviews for each patient (n = 46). There were no statistically significant differences in DTPs identified between in-person and telephone medication reviews (p = 0.431). Physician acceptance of pharmacist recommendations was higher for in-person medication reviews (p = 0.009). Patients were satisfied with the care they received with pharmacist-led telephone medication reviews, however, 29% (n = 7) would prefer an in-person medication review once per year with telephone medication reviews the rest of the time. Overall, patients were satisfied with the care they received from telephone medication reviews.

PMID:36649011 | DOI:10.3390/pharmacy11010001

Pediatr Rep. 2023 Jan 9;15(1):33-44. doi: 10.3390/pediatric15010005.

ABSTRACT

INTRODUCTION: Emotional and behavioral problems are growing among children ages birth to five, and racial/ethnic and socioeconomic disparities exist. Comprehensive, culturally responsive, family-driven systems of care, such as the one operated by California’s diverse, urban Alameda County, offer one potential intervention.

METHODS: We used client-level service data (n = 496 children) to calculate descriptive statistics and regression analyses (including multilevel models to account for observations for the same client at multiple points in time). We estimated the prevalence of mental health issues and assessed the association between the length of time using services and emotional and behavioral functioning.

RESULTS: Comprehensive mental health services and supports were associated with improved emotional and behavioral functioning outcomes for children over time, even after controlling for other risk factors.

DISCUSSION: Systems of care appear to support the multidimensional functioning of children and their families.

PMID:36649005 | DOI:10.3390/pediatric15010005

Tomography. 2023 Jan 12;9(1):105-129. doi: 10.3390/tomography9010010.

ABSTRACT

Mammography is the gold standard technology for breast screening, which has been demonstrated through different randomized controlled trials to reduce breast cancer mortality. However, mammography has limitations and potential harms, such as the use of ionizing radiation. To overcome the ionizing radiation exposure issues, a novel device (i.e. MammoWave) based on low-power radio-frequency signals has been developed for breast lesion detection. The MammoWave is a microwave device and is under clinical validation phase in several hospitals across Europe. The device transmits non-invasive microwave signals through the breast and accumulates the backscattered (returned) signatures, commonly denoted as the S21 signals in engineering terminology. Backscattered (complex) S21 signals exploit the contrast in dielectric properties of breasts with and without lesions. The proposed research is aimed to automatically segregate these two types of signal responses by applying appropriate supervised machine learning (ML) algorithm for the data emerging from this research. The support vector machine with radial basis function has been employed here. The proposed algorithm has been trained and tested using microwave breast response data collected at one of the clinical validation centres. Statistical evaluation indicates that the proposed ML model can recognise the MammoWave breasts signal with no radiological finding (NF) and with radiological findings (WF), i.e., may be the presence of benign or malignant lesions. A sensitivity of 84.40% and a specificity of 95.50% have been achieved in NF/WF recognition using the proposed ML model.

PMID:36648997 | DOI:10.3390/tomography9010010

Tomography. 2022 Dec 22;9(1):36-49. doi: 10.3390/tomography9010004.

ABSTRACT

Radiation therapy (RT) plays an integral role in treating thoracic cancers, despite the risk of radiation-induced cardiotoxicity. We hypothesize that our newly developed magnetic resonance imaging (MRI)-based contractility index (ContractiX) is a sensitive marker for early detection of RT-induced cardiotoxicity in a preclinical rat model of thoracic cancer RT. Adult salt-sensitive rats received image-guided heart RT and were imaged with MRI at 8 weeks and 10 weeks post-RT or sham. The MRI exam included cine and tagging sequences to measure left-ventricular ejection fraction (LVEF), mass, myocardial strain, and ContractiX. Furthermore, ventricular torsion, diastolic strain rate, and mechanical dyssynchrony were measured. Statistical analyses were performed between the sham, 8 weeks post-RT, and 10 weeks post-RT MRI parameters. The results showed that both LVEF and myocardial mass increased post-RT. Peak systolic strain and ContractiX significantly decreased post-RT, with a more relative reduction in ContractiX compared to strain. ContractiX showed an inverse nonlinear relationship with LVEF and continuously decreased with time post-RT. While early diastolic strain rate and mechanical dyssynchrony significantly changed post-RT, ventricular torsion changes were not significant post-RT. In conclusion, ContractiX measured via non-contrast MRI is a sensitive early marker for the detection of subclinical cardiac dysfunction post-RT, and it is superior to other MRI cardiac measures.

PMID:36648991 | DOI:10.3390/tomography9010004

Nurs Rep. 2023 Jan 10;13(1):85-95. doi: 10.3390/nursrep13010009.

ABSTRACT

BACKGROUND: Nurses have key roles in caring for patients with dementia. To prepare them for demand-oriented nursing care, there is a need for education. An online course with a focus on healthcare needs assessment was designed.

METHODS: A quantitative study with a qualitative component using questionnaire-based interviews was implemented. The recruitment of students used the following inclusion criteria: (a) second-year students, and (b) absent from less than three lectures. Overall, n = 48 met the inclusion criteria. Twenty-eight students participated. Quantitative data were analyzed using descriptive statistics. Qualitative data were evaluated using Kuckartz’s content analysis with the software MAXQDA.

RESULTS: Nursing students judged the overall course structure as very good (M 1.36, SD 0.48). The learning aims were clearly defined (M 1.61, SD 0.68) and the learning content was adequately demonstrated (M 1.68, SD 0.67). The exercise on geriatric assessment promoted the internal learning process (M 1.67, SD 1.00). The online simulation training made the lectures’ contents easier to understand (M 1.86, SD 0.89). Correlations were determined, among others, between the course structure and the clear definitions of the learning aims (r^Sp 0.566, p = 0.002).

CONCLUSIONS: The study describes the feasibility of the online course. To identify the impact on patients’ health and caregivers’ lives, further studies are needed.

PMID:36648983 | DOI:10.3390/nursrep13010009

Nurs Rep. 2023 Jan 9;13(1):73-84. doi: 10.3390/nursrep13010008.

ABSTRACT

Diabetic foot is a severe complication of diabetes, with serious consequences such as amputations and high mortality rates as well as elevated economic costs. To evaluate whether or not nursing staff follow the recommendations of national and international organizations regarding diabetic foot prevention, a cross-sectional and observational descriptive study was carried out using an ad hoc self-administered questionnaire validated by seven experts, with a Cronbach’s alpha of 0.731. Of the total 164 participants, 157 met the inclusion criteria. Findings showed that 96.58% asked their patients to remove their footwear, 78.34% performed thorough examinations, and 80.25% assessed the risk of developing diabetic foot. Participants educated their patients in self-care and evaluated skills related to diabetic foot control either frequently (84.07%) or very frequently (62.42%), and only 19.11% of them carried out group activity workshops. Significant statistical differences were found in the performance of activities in the groups by participant age intervals, whether working in primary health care or a hospital, having specific training, and the participant’s DM patient ratio. We obtained high percentages of compliance in the assessed activities in comparison to other studies. Nevertheless, we believe it is necessary to encourage screening in specialized care, skills testing, and the implementation of educational group activities and workshops.

PMID:36648982 | DOI:10.3390/nursrep13010008

Nurs Rep. 2022 Dec 28;13(1):29-42. doi: 10.3390/nursrep13010003.

ABSTRACT

AIM: The aim of this study is to investigate the compliance of mental health clinicians in applying the Zero Suicide (ZS) approach to their clinical practice in a rural and regional health community setting.

METHODS: A retrospective clinical audit of six mental health teams was undertaken at a single site. A clinical audit tool was developed and validated using a six-step approach. The data was extracted and analysed via descriptive and inferential statistics and compared to a specialised mental health team, experienced with the ZS approach.

RESULTS: A total of 334 clinical records were extracted for January, April, August, November 2019 and June 2020. The clinical audit and analysis confirmed that the mental health teams are not consistently using the assessments from their training and are therefore not implementing all of these elements into their practice. This could have implications for the risk formulation and treatment for people at risk of suicide.

CONCLUSIONS: The use of a validated clinical audit tool can be beneficial to establish compliance with the mental health clinicians and to determine any areas requiring further improvement. Further education and reinforcement may be required to ensure consistency with incorporating the elements of ZS into everyday clinical practice.

PMID:36648977 | DOI:10.3390/nursrep13010003

Methods Protoc. 2022 Dec 24;6(1):2. doi: 10.3390/mps6010002.

ABSTRACT

The gut microbiota has been immensely studied over the past years because of its involvement in the pathogenesis of numerous diseases. However, gut microbiota data in Africa are limited. Therefore, it is crucial to have studies that reflect various populations in order to fully capture global microbial diversity. In the proposed scoping review, we will describe the gut microbiota’s appearance in terms of gut microbiota markers, in both health and disease in African populations. Relevant publications will be searched for in the PubMed, Scopus, Web of Science, Academic Search Premier, Africa-Wide Information, African journals online, CINAHL, and EBSCOhost and Embase databases. We will focus on articles published between January 2005 and March 2023. We will also determine if the studies to be included in the review would provide enough data to identify quantifiable gut microbiome traits that could be used as health or disease markers, identify the types of diseases that were mostly focused on in relation to gut microbiota research in Africa, as well as to discover and analyze knowledge gaps in the gut microbiota research field in the continent. We will include studies involving African countries regardless of race, gender, age, health status, disease type, study design, or care setting. Two reviewers will conduct a literature search and screen the titles/abstracts against the eligibility criteria. The reviewers will subsequently screen full-text articles and identify studies that meet the inclusion criteria. This will be followed by charting the data using a charting tool and analysis of the evidence. The proposed scoping review will follow a qualitative approach such that a narrative summary will accompany the tabulated/graphical results which will describe how the results relate to the review objectives and questions. As a result, this review may play a significant role in the identification of microbiota-related adjunctive therapies in the African region where multiple comorbidities coexist. Scoping review registration: Open Science Framework.

PMID:36648951 | DOI:10.3390/mps6010002

JAMA Netw Open. 2023 Jan 3;6(1):e2251177. doi: 10.1001/jamanetworkopen.2022.51177.

ABSTRACT

IMPORTANCE: Patients with diabetes are at higher risk for obstructive airway disease (OAD). In recent meta-analyses of post hoc analyses of cardiorenal trials, sodium-glucose cotransporter 2 inhibitors (SGLT2Is) were suggested to reduce the risk of OAD adverse events. However, a clinical investigation of this association is warranted.

OBJECTIVE: This study aimed to investigate the association of SGLT2I use vs dipeptidyl peptidase-4 inhibitor (DPP4I) use with OAD incidence and exacerbation events in patients with type 2 diabetes.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective population-based cohort study used electronic health data from a territory-wide electronic medical database in Hong Kong. Data were collected for patients with type 2 diabetes who were prescribed SGLT2Is or DPP4Is between January 1, 2015, and December 31, 2018. Patients were followed for a median of 2.2 years between January 1, 2015, and December 31, 2020. A prevalent new-user design was adopted to match patients based on previous exposure to the study drugs. Propensity score matching was used to balance baseline characteristics.

EXPOSURES: Patients with type 2 diabetes using SGLT2Is (exposure of interest) or DPP4Is (active comparator).

MAIN OUTCOMES AND MEASURES: The main outcomes were the first incidence of OAD and the count of OAD exacerbations. The risk of incident OAD was estimated using a Cox proportional hazards regression model. The rate of exacerbations was estimated using zero-inflated Poisson regression. Statistical analysis was performed on November 13, 2022.

RESULTS: This study included 30 385 patients. The propensity score-matched non-OAD cohort (incidence analysis) consisted of 5696 SGLT2I users and 22 784 DPP4I users, while the matched OAD cohort (exacerbations analysis) comprised 381 SGLT2I users and 1524 DPP4I users. At baseline, 56% of patients in the non-OAD cohort were men and the mean (SD) age was 61.2 (9.9) years; 51% of patients in the OAD cohort were men and the mean age was 62.2 (10.8) years. Compared with DPP4I use, SGLT2I use was associated with a lower risk of incident OAD (hazard ratio, 0.65 [95% CI, 0.54-0.79]; P < .001) and a lower rate of exacerbations (rate ratio, 0.54 [95% CI, 0.36-0.83]; P = .01). The associations were consistent in sex subgroup analysis.

CONCLUSIONS AND RELEVANCE: The findings of this retrospective cohort study of patients with type 2 diabetes in Hong Kong suggest that SGLT2I use was associated with a reduced risk of incident OAD and a lower rate of exacerbations in a clinical setting compared with DPP4I use. These findings further suggest that SGLT2Is may provide additional protective effects against OAD for patients with type 2 diabetes and that further investigation is warranted.

PMID:36648944 | DOI:10.1001/jamanetworkopen.2022.51177