Category: Nevin Manimala

J Shoulder Elbow Surg. 2021 Dec 29:S1058-2746(21)00865-X. doi: 10.1016/j.jse.2021.11.017. Online ahead of print.

ABSTRACT

BACKGROUND: Lateral Epicondylitis is common in workers who perform repetitive movements of the entire upper limb. Approximately 85% to 90% respond satisfactorily to conservative treatment, but in resistant patients, surgical treatment is considered. Classic open surgery is successful between 70% and 97%, similar to more modern techniques such as arthroscopy. We tried to demonstrate the superiority of the Wolf technique in clinical results. The goals of this study were to compare the functional and pain outcomes of arthroscopic surgery with open surgery using fasciotomy as the wolf technique in the treatment of lateral epicondylitis.

METHODS: This was a retrospective study of 47 working-age patients with resistant lateral epicondylitis: 27 underwent surgery arthroscopically, and 20 underwent open surgery. Pre- and postsurgical VAS and function were assessed using DASH, MEPS and BMRS scales, as well as the return to their previous work and the surgical time.

RESULTS: The reduction in VAS showed no statistically significant differences between the groups (5.26 in arthroscopy versus 5.75 in fasciotomy, p = 0.5), QuickDash (19 versus 19.4 with p = 0.9), MEPS (82 versus 81.5 with p = 0.8) or BMRS (81.9 versus 82.6 with p = 0.9). The differences in terms of time off were also not statistically significant. The days of work leave in the arthroscopy group corresponded on average 83.78 days, and in the Wolff group, it corresponded to 89.95 days. The mean surgical time in the arthroscopic intervention group was 44.2 minutes and in the fasciotomy group was 27.5 minutes, showing statistically significant results (p <0.001).

CONCLUSIONS: Arthroscopic surgery and open surgery in lateral epicondylitis techniques provide similar functional results and pain reduction.

LEVEL OF EVIDENCE: Level III; Retrospective Cohort Comparison; Treatment Study.

PMID:34973424 | DOI:10.1016/j.jse.2021.11.017

World Neurosurg. 2021 Dec 29:S1878-8750(21)01936-7. doi: 10.1016/j.wneu.2021.12.091. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the fact that bevacizumab (Bev) has been approved to treat recurrent GBM, GBM patients failed to demonstrate a significant overall survival (OS) advantage. In recent years, the advent of more bevacizumab (Bev) combination regimens seems to bring new hope for patients, nevertheless, there is still a lack of intuitive comparison among these therapies.

OBJECTIVE: To explore the efficacy and safety of various bevacizumab (Bev) combination regimens in patients with recurrent glioblastoma and to further explore the differences in the efficacy of each treatment in randomized controlled trials (RCTs) and nonrandomized controlled trials (non-RCTs).

METHODS: We comprehensively searched the PubMed, Cochrane Library, and OVID databases for relevant RCTs and non-RCTs of Bev in combined regimens for recurrent glioblastoma. The Cochrane quality assessment method was used to assess the quality of RCTs, and the Newcastle-Ottawa scale was used to assess the quality of non-RCTs. Excel software was used to extract data from the literature, and a network meta-analysis was performed using RevMan 5.3 and Stata 16 statistical software.

RESULTS: In patients with recurrent glioblastoma, the 6-month overall survival of patients receiving bevacizumab combination therapy was ranked from high to low as follows: Bev + rindopepimut, Bev + lomustine (CCNU), CCNU, Tumor Treating Fields (TTFields) + Bev, Bev, Bev + irinotecan (Iri), Bev + temozolomide (TMZ), Bev + vorinostat, Bev + onartuzumab, Bev + dasatinib, Bev + carboplatin, Bev + trebananib, Bev + VB-111, TMZ, PCV, VB-111, and carboplatin. The 6-month progression-free survival from high to low was ranked as follows: Bev + CCNU, Bev + rindopepimut, Bev + dasatinib, Bev + vorinostat, Bev, Bev + Iri, Bev + TMZ, CCNU, Bev + carboplatin, TMZ, Bev + VB-111, PCV, Bev + trebananib, carboplatin, and VB-111. We compared the total incidence of serious adverse events (≥ 3) and found that Bev + vorinostat and Bev + trebananib were safer than Bev, while other regimens were not as safe as Bev. A descriptive analysis showed that Bev + rindopepimut also appeared to be safer than Bev. Subgroup analysis: Among RCTs, Bev + CCNU therapy had the highest 6-month overall survival and 6-month progression-free survival. Among non-RCTs, Bev + Iri therapy showed the highest 6-month overall survival and good 6-month progression-free survival.

CONCLUSION: Both Bev + CCNU and Bev + rindopepimut could be considered as effective therapies for treating the recurrent glioblastoma according to the network meta-analysis results. Among them, Bev + rindopepimut therapy seems to be safer and more effective. Moreover, we found that Bev + Iri also appeared to be an effective therapy in a retrospective study.

PMID:34973444 | DOI:10.1016/j.wneu.2021.12.091

J Vasc Surg. 2021 Dec 29:S0741-5214(21)02735-X. doi: 10.1016/j.jvs.2021.12.055. Online ahead of print.

ABSTRACT

OBJECTIVES: To provide the midterm results of endovascular repair for acute zone 0 intramural hematoma patients with the most proximal tear or ulcer-like projection in the descending aorta.

METHODS: Information about acute zone 0 intramural hematoma patients with the most proximal tear or ulcer-like projection in the descending aorta from January 1, 2010, to December 31, 2019, were retrospectively reviewed. We performed Kaplan-Meier curves to calculate the intervention-free survival and survival after endovascular or open repair. We used propensity score matching to compare the outcomes of endovascular with surgical repair.

RESULTS: This study included 99 patients, 34 of them initially underwent medical treatment; the 0.5, 1, 3 years intervention-free survival rates were 23.5%, 17.6%, and 14.7%, respectively. 51 patients underwent endovascular therapy; most of them had a maximal diameter of ascending aorta＜50mm and maximal diameter of intramural hematoma in ascending aorta＜10mm, the 1, 3, 5 years survival rate were all 98.0%. 42 patients underwent open surgery, and the 1, 3, 5 years survival rates were all 92.9%. After propensity score matching, there was no statistical difference in 30 days and follow-up mortality, while the endovascular repair was associated with shorter operation time (69 vs. 314 minutes, p＜.001), shorter length of ICU stay (24 vs. 70 hours, p=.001), and shorter length of hospital stay (7 vs. 12 days, p=.011).

CONCLUSION: In acute zone 0 intramural hematoma patients with the most proximal tear or ulcer-like projection in the descending aorta, besides open surgery, endovascular repair is optional on the premise of the maximal diameter of ascending aorta＜50mm and maximal diameter of intramural hematoma in ascending aorta＜10mm.

PMID:34973400 | DOI:10.1016/j.jvs.2021.12.055

Asian Nurs Res (Korean Soc Nurs Sci). 2021 Dec 29:S1976-1317(21)00093-1. doi: 10.1016/j.anr.2021.12.004. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to develop website-based learning contents to activate voluntary monitoring and reporting of adverse drug reactions (ADRs) for clinical nurses and to verify their effectiveness.

METHOD: Using a quasi-experimental control group pretest-posttest design with random allocation, a total of 60 nurses with more than 1 year of clinical experience were recruited from a university hospital in Seoul, Korea. A website was developed that provides learning contents including real cases and the latest drug-related knowledge, as well as video lectures. Knowledge on ADRs monitoring, self-efficacy, ADRs practice behavior, and medication performance ability were measured at 2 weeks after intervention. A small notebook for monitoring ADRs of nurses was given to the control group. Data were analyzed using descriptive statistics, the ^χ2test, and the independent t-test using SPSS Statistics Software Version 21.0.

RESULTS: The scores of ADRs monitoring knowledge, self-efficacy, and ADRs monitoring practice in the experimental group significantly increased after the intervention compared with the control group (p<.05). However, there was no significant difference between the two groups in medication performance ability related to ADRs monitoring.

CONCLUSION: In order to spread a safety culture in which voluntary ADRs monitoring and reporting is activated, it is necessary for clinical nurses to share and communicate ADRs-related information and real cases through an open website.

PMID:34973410 | DOI:10.1016/j.anr.2021.12.004

Environ Pollut. 2021 Dec 29:118769. doi: 10.1016/j.envpol.2021.118769. Online ahead of print.

ABSTRACT

Urban rivers play a vital role in global methane (CH₄) emissions. Previous studies have mainly focused on CH₄ concentrations in urban rivers with a large amount of organic sediment. However, to date, the CH₄ concentration in gravel-bed urban rivers with very little organic sediment has not been well documented. Here, we collected water samples from an oxic urban river (Xin’an River, China; annual mean dissolved oxygen concentration was 9.91 ± 1.99 mg L^-1) with a stony riverbed containing very little organic sediment. Dissolved CH₄ concentrations were measured using a membrane inlet mass spectrometer to investigate whether such rivers potentially act as an important source of atmospheric CH₄ and the corresponding potential drivers. The results showed that CH₄ was supersaturated at all sampling sites in the five sampling months. The mean CH₄ saturation ratio (ratio of river dissolved CH₄ concentration to the corresponding CH₄ concentration that is in equilibrium with the atmosphere) across all sampling sites in the five sampling months was 204 ± 257, suggesting that the Xin’an River had a large CH₄ emission potential. The CH₄ concentration was significantly higher in the downstream river than in the upstream river (p < 0.05), which suggested that human activities along the river greatly impacted the CH₄ level. Statistical analyses and incubation experiments indicated that algae can produce CH₄ under oxic conditions, which may contribute to the significantly higher CH₄ concentration in August 2020 (p < 0.001) when a severe algal bloom occurred. Furthermore, other factors, such as heavy rainfall events, dissolved organic carbon concentration, and water temperature, may also be vital factors affecting CH₄ concentration. Our study enhances the understanding of dissolved CH₄ dynamics in oxic urban rivers with very little organic sediment and further proposes feasible measures to control the CH₄ concentration in urban rivers.

PMID:34973384 | DOI:10.1016/j.envpol.2021.118769

Am J Infect Control. 2021 Dec 29:S0196-6553(21)00859-2. doi: 10.1016/j.ajic.2021.12.014. Online ahead of print.

ABSTRACT

BACKGROUND: Poor securement potentiates PICC complications. A dressing device (KT FIX Plusࣨ) offers stronger skin attachment, which may reduce the risk of dressing disruption. We aimed to evaluate this device.

METHODS: We conducted a single-center parallel-group open-label randomized controlled trial. Hospitalized and outpatient consecutive adults requiring PICCs were randomized to KT FIX Plusࣨ or standard of care (SOC). The primary endpoint was the composite of PICC- associated complications until removal, including occlusion, migration, accidental withdrawal, infection, thrombosis and hematoma.

RESULTS: No statistically significant difference was observed in terms of complications: 67 (35%) in the KT FIX Plusࣨ group versus 36 (37%) in the SOC group (log-rank p=0.76). In multivariate Cox analysis, independent risk factors for PICC-associated complications were obesity (adjusted hazard ratio (aHR), 1.08, p<0.001) and diabetes (aHR, 1.85, p=0.039), adjusting for chronic renal failure, number of lumens, catheter/vein diameter ratio and duration of home- based care. Multiple lumen catheters increased the risk of accidental withdrawal and migration (HR, 2.4, p=0.008).

CONCLUSIONS: In our study, the use KT FIX Plus® did not reduce the risk of complications adjusting for other risk factors such as obesity and diabetes. The number of catheter lumens is one of the modifiable factors to reduce complications. Further studies are required to find the best securement and dressing system.

PMID:34973357 | DOI:10.1016/j.ajic.2021.12.014

Am J Infect Control. 2021 Dec 29:S0196-6553(21)00851-8. doi: 10.1016/j.ajic.2021.12.010. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to describe the effect of Dry Hydrogen Peroxide (DHP™), as an adjunct to environmental cleaning and disinfection, on the incidence of hospital-acquired infections (HAIs) at Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala City, Guatemala.

METHODS: A retrospective study of all HAI data from the hospital’s surveillance system, which follows Centers for Disease Control and Prevention (CDC) protocols, was conducted from January 2019 to November 2020. DHP was installed in all Pediatric Intensive Care Unit (PICU) rooms in January 2020, but nowhere else in the hospital, including the Intermediate Care Unit (IMCU).

RESULTS: There were 189 HAI cases during the study period, with 173 occurring in either the PICU or IMCU. A statistically significant decrease in HAI incidence rates occurred in the PICU in 2020 compared to 2019 (p=0.028), including Clostridiodes-associated gastroenteritis (p=0.048). Logistic multivariate regression yielded a significant association between DHP exposure and a reduced odds of developing an HAI during the study (OR=0.3857, p=0.029).

CONCLUSION: The use of DHP as an adjunct technology for environmental cleaning and disinfection contributed to the reduction in HAIs in the PICU. Our study highlights the value of such an approach as an addition to manual cleaning to decrease the risk of infection from environmental contamination.

PMID:34973358 | DOI:10.1016/j.ajic.2021.12.010

Sci Total Environ. 2021 Dec 29:152686. doi: 10.1016/j.scitotenv.2021.152686. Online ahead of print.

ABSTRACT

The rationale of this paper was to investigate whether earthquakes impact airborne pollen concentrations, considering some meteorological parameters. Atmospheric pollen concentrations in the Region of Murcia Aerobiological Network (Spain) were studied in relation to the occurrence of earthquakes of moment magnitude (up to M_w = 5.1) and intensity (intensity up to grade VII on the European Macroseismic Scale). In this study, a decade (2010-2019) was considered across the cities of the network. Earthquakes were detected in 12 out of 1535 days in the Olea Main Pollen Season in Cartagena, 49 out of 1481 days in the Olea Main Pollen Season in Lorca, and 39 out of 1441 days in the Olea Main Pollen Season in Murcia. The Olea pollen grains in this network were attributed to the species Olea europaea, i.e., the olive tree, a taxon that appears widely in the Mediterranean basin, in both cultivated and wild subspecies. Differences between the Olea concentration on days with and without earthquakes were only found in Lorca (Kruskal-Wallis: p-value = 0.026). The low frequency and intensity of the earthquakes explained these results. The most catastrophic earthquake felt in Lorca on May 11th, 2011 (IVII, M_w = 5.1, 9 casualties) did not result in clear variations in pollen concentrations, while meteorology (e.g., African Dust Outbreak) might have conditioned these pollen concentrations. The research should be broadened to other active seismological areas to reinforce the hypothesis of seismological impact on airborne pollen concentrations.

PMID:34973329 | DOI:10.1016/j.scitotenv.2021.152686

Sci Total Environ. 2021 Dec 29:152701. doi: 10.1016/j.scitotenv.2021.152701. Online ahead of print.

ABSTRACT

A study was made of the physicochemical properties (among others: pH, temperature, conductivity, hardness, chlorides, dissolved oxygen, ammonia, nitrites, nitrates, manganese, iron) and microbiological quality (coliform, psychrophilic and mesophilic microorganisms) of rainwater harvested from the roofs of three large buildings and from a parking lot, stored in three large underground tanks (with storage volume from 60 m³ to ca. 200 m³), including the variability of the quality. The underground tanks were located in the city of Poznań, and were characterized by different parameters, rainwater sources, rainwater treatment processes, and types of rainwater use. Samples of rainwater harvested in these tanks were collected from March 2019 to February 2020. Physicochemical and microbiological laboratory analyses were performed to determine selected parameters which have an impact on potential treatment and disinfection methods. The results obtained underwent statistical analysis. The laboratory tests showed that the physicochemical quality of rainwater collected in the three underground tanks met the Polish and EU requirements for drinking water standards. The main problem concerns microbiological quality: the number of coliform bacteria reached a value of 19,300 CFU/100 mL, the number of psychrophilic bacteria was over 264,000 CFU/1 mL, and the number of mesophilic bacteria was over 100,000 CFU/1 mL. Also the variability of microbiological quality was very high for all tanks. Analysis of the calcium carbonate equilibrium showed that the harvested water had corrosive properties. The treatment of the investigated rainwater for potable purposes should focus mainly on biological and chemical stability.

PMID:34973316 | DOI:10.1016/j.scitotenv.2021.152701

Sci Total Environ. 2021 Dec 29:152734. doi: 10.1016/j.scitotenv.2021.152734. Online ahead of print.

ABSTRACT

Today, the interest in hair as alternative matrix for human biomonitoring of environmental pollutants has increased, but available data on chemical levels in hair remain scarce. In this study, the measurement of 2 bisphenols (A and S), 3 parabens (methyl-, ethyl- and propylparabens) and 8 perfluroralkyl compounds (PFCs) namely perfluoroctanesulfonate (PFOS), perfluorohexanesulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluroroheptanoic acid (PFHpA), perfluoropentanoic acid (PFPeA) and perfluorohexanoic acid (PFHxA) was carried out, using a thoroughly validated UPLC-MS/MS method, in the hair from 114 adults living in Liege (Belgium) and surrounding areas. The most frequently quantified compounds in the population were: bisphenol S (97.4%, median = 31.9 pg·mg^-1), methylparaben (94.7%, median = 28.9 pg·mg^-1), bisphenol A (93.9%, median = 46.6 pg·mg^-1), ethylparaben (66.7%, median = 5.2 pg·mg^-1), propylparaben (54.8%, median = 16.4 pg·mg^-1) and PFOA (46.4%, median < 0.2 pg·mg^-1). The other PFCs were detected only in few samples although current exposure of the Belgian population to PFCs was previously demonstrated using blood analyses. Nonparametric statistical analyses were performed to evaluate the influence of gender, hair treatments and hair length, but no significant difference was observed. Only age was positively correlated with the propylparaben contamination. Although blood seems to remain more suitable for PFCs exposure assessment, the results of this study suggest that hair can be an appropriate matrix for biomonitoring of organic pollutants such as parabens or bisphenols.

PMID:34973319 | DOI:10.1016/j.scitotenv.2021.152734