Category: Nevin Manimala

J Am Coll Health. 2022 May 12:1-9. doi: 10.1080/07448481.2022.2060709. Online ahead of print.

ABSTRACT

Objective: This study examined the effects of a college mindfulness course on vital-signs and Five Facet Mindfulness Questionnaire (FFMQ) scores. Participants: Two independent groups of 20 students were enrolled in the mindfulness course during the Fall 2018 (Trial 1) and Spring 2019 (Trial 2) semesters. Methods: Blood pressure, heart rate, and respiration rate were recorded before and after in-class mindfulness meditations several times throughout each semester. FFMQ scores were recorded at the beginning and conclusion of each semester. Results: Statistical analyses indicated that 20 minutes of mindfulness meditation significantly decreased respiration rate (both trials) and heart rate (Trial 2) for female students. There were significant changes in the FFMQ mean scores for “non-react,” “observe,” “act aware,” and “non-judge.” Conclusions: These results suggest that mindfulness meditation may be beneficial for students to enhance their well-being. Recommendations are provided to further examine the implications of consistent mindfulness practices for college students.

PMID:35549653 | DOI:10.1080/07448481.2022.2060709

Acta Otolaryngol. 2022 May 12:1-6. doi: 10.1080/00016489.2022.2071987. Online ahead of print.

ABSTRACT

BACKGROUND: The effects of graft thickness on tympanoplasty is uncertain.

OBJECTIVE: To compare the results of endoscopic tympanoplasty using different thicknesses of autologous tissues.

METHODS: This retrospective analysis included 186 patients who received type I tympanoplasty, divided into three main groups based of grafting material: perichondrium (A), cartilage-perichondrium (B), or cartilage-perichondrium plus additional perichondrium (C). Group A was subdivided based on whether the placement was inside (A1) or outside (A2) of the malleus. The hearing improvement, graft success rate, and surgery duration were analysed.

RESULTS: Statistical analysis showed significant hearing improvement in the three main groups (p < .001); recovery in group A occurred the earliest. Six months postoperatively, group A1 showed significantly greater hearing recovery compared with groups B and C (p < .05). There were no statistical differences the other groups (p > .05) or in the graft success rate among the three main groups (p = .235). The surgery duration of group A was significantly longer than that of groups B and C (p < .001).

CONCLUSION AND SIGNIFICANCE: Our results suggest that graft thickness affects hearing recovery; however, graft thickness does not affect the rate of grafting success. Endoscopic transplantation of the perichondrium is more difficult and requires more time.

PMID:35549633 | DOI:10.1080/00016489.2022.2071987

J Am Coll Health. 2022 May 12:1-7. doi: 10.1080/07448481.2022.2068957. Online ahead of print.

ABSTRACT

Objective: To comparatively analyze nutrient intake and dietary adequacy on weekdays (WKDs) and weekends (WKNs) among undergraduate students. Participants: University students (N = 210), 18-30 years old. Methods: A two-day food record was used. Intake of energy, macronutrients, micronutrients and fiber were calculated, without and with an adjustment for 2000 kcal of energy and compared to the corresponding nutritional requirements. Results: Energy and macronutrients’ intake was higher on WKNs (1,776.84 ± 40.68 vs. 2,025.76 ± 52.46 kcal; p < .05). There was a high predominance of hypocaloric diet on both WKDs (72%) and WKNs (57%). A low prevalence (<50%) of favorable intake level of most micronutrients and fiber was found on WKDs, WKNs, or both. There was a lower favorable intake of vitamins A, C, iron, and magnesium on WKNs, after adjusting for 2000 kcal. Conclusion: Undergraduate students showed an unfavorable nutrient intake and poor dietary quality on WKNs. Interventions that promote healthy eating are needed.

PMID:35549621 | DOI:10.1080/07448481.2022.2068957

Expert Rev Vaccines. 2022 May 12. doi: 10.1080/14760584.2022.2077195. Online ahead of print.

ABSTRACT

INTRODUCTION: The Latin American Society of Pediatric Infectious Diseases (SLIPE by its Spanish acronyms) is working to understand the current situation, gaps, and opportunities for traceability of the quality vaccination process in Latin America and the Caribbean.

AREAS COVERED: On September 24th and 25th, a Latin American forum of experts in immunization programs was held through the Zoom platform; the topics discussed included: computerized systems for recording immunizations, vaccination programs traceability, challenges, and information systems for the integrated management of vaccination.

EXPERT OPINION: Latin American countries have transitioned from having a nominal registration system to a nominal tracking system, with many of them not migrating their platforms to new technologies; therefore, the low-quality data, fragmented databases, and slow information traffic present a challenge that must be taken on.

PMID:35549597 | DOI:10.1080/14760584.2022.2077195

Clin Toxicol (Phila). 2022 May 12:1-7. doi: 10.1080/15563650.2022.2072315. Online ahead of print.

ABSTRACT

BACKGROUND: Historically, the first step in treating cyanide (CN^–) toxicity utilized antidotes to induce methemoglobinemia. This is concerning in patients who are already hypoxemic or have elevated carboxyhemoglobin. Hydroxocobalamin (OHCbl) is now the first-line antidote for CN^– toxicity and is not known to induce methemoglobinemia. We observed elevated methemoglobin (MetHb) levels in several patients treated with OHCbl and sought to investigate the incidence of MetHb formation following administration of OHCbl.

METHODS: Chart review: A single-center, retrospective case series of patients who received 5 or 10 g of hydroxocobalamin from 01/01/2011 through 04/30/2019. Data was analyzed using descriptive statistics. In-vitro study: Discarded blood was separated into whole blood and plasma samples. OHCbl and normal saline was added to reach 0×, 1×, 2×, and 4× peak therapeutic concentrations and analyzed at times 0, 2, and 4 h after administration.

RESULTS: Chart review: Twenty-seven cases of OHCbl administration were identified. The median age was 53 years (IQR 38 – 64) and 20 (74.1%) were male. Exposure to a house fire or smoke inhalation was the reason for OHCbl administration in 21 (77.8%) patients. Five (18.5%) patients received 10 g of OHCbl while the rest received 5 g. Six (22.2%) patients developed methemoglobinemia, all after 5 g OHCbl administration; four had been exposed to fire and smoke, two received the medication for severe acidosis of unknown etiology not related to fire or smoke. The median peak level was 7.1% (IQR 2.2 – 16.4%) at a median time of 11.4 h post-administration. Two patients received methylene blue (MB), neither responded. Death occurred in 17 (63%) cases. In-vitro study: We observed a dose dependent elevation in total hemoglobin but did not detect any increase in MetHb.

CONCLUSION: We observed a noteworthy temporal association between the formation of methemoglobinemia and the administration of hydroxocobalamin. This does not appear to be an artifact of the CO-oximeters. This could have profound implications for patients who are already hypoxemic or have impaired oxygen carrying capacity from carboxyhemoglobin.

PMID:35549585 | DOI:10.1080/15563650.2022.2072315

Int J Soc Psychiatry. 2022 May 13:207640221094957. doi: 10.1177/00207640221094957. Online ahead of print.

ABSTRACT

BACKGROUND: Primary care physicians (PCPs) in rural township health centers are the most easily accessible doctors to the residents in rural China, which covers 35% of the population. High prevalence of depression was reported among rural left-behind elderly and children as many workers had migrated to urban cities.

AIM: This study explored mental health care provision by PCPs in rural China and the association with their training background.

METHODS: Rural township health centers in both developed and less developed counties of Zhejiang Province, China were chosen as the study sites. A total of 697 PCPs completed questionnaires between December 2019 and January 2020, and the number of valid questionnaires was 673, with a valid response rate of 79.3%.

RESULTS: The rural PCPs reported a median range of seeing 1 to 5 mental health patients per week. Over two-thirds (68.2%) of the respondents had never received any training on treating common mental health disorders (depression and anxiety) while 20.3% received at most 2 days of training; 6.4% received 3 to 20 days of training; and 5.1% received over 20 days of training. PCPs with mental health training were significantly associated with better mental health care in terms of confidence and practice characteristics (e.g. having patients who brought up mental health issues, providing follow-up), while years of practice made a difference in practice but not confidence.

CONCLUSIONS: Training is the key determinant of the practice of mental health care by the PCPs in rural China. Our findings have implications for national policy to target two-thirds of rural PCPs who received no mental health training.

PMID:35549586 | DOI:10.1177/00207640221094957

Stat Methods Med Res. 2022 May 12:9622802221097211. doi: 10.1177/09622802221097211. Online ahead of print.

ABSTRACT

In medical research, the receiver operating characteristic curve is widely used to evaluate accuracy of a continuous biomarker. The area under this curve is known as an index for overall performance of the biomarker. This article develops three new estimators of the area under the receiver operating characteristic curve in ranked set sampling. The first estimator is obtained under normality assumption. The two other estimators are constructed by applying a Box-Cox transformation on data, and then using either a parametric estimator or a kernel-density-based estimator. A simulation study is carried out to compare the proposed estimators with those available in the literature. It emerges that the new estimators offer some advantages in specific situations. Application of the methods is demonstrated using real data in the context of medicine.

PMID:35549545 | DOI:10.1177/09622802221097211

J Psychopharmacol. 2022 May 13:2698811221089035. doi: 10.1177/02698811221089035. Online ahead of print.

ABSTRACT

BACKGROUND: Major depressive disorder (MDD) is a prevalent neuropsychiatric illness for which it is important to resolve underlying brain mechanisms. Current treatments are often unsuccessful, precipitating a need to identify predictive markers.

AIM: We evaluated (1) alterations in brain responses to an emotional faces functional magnetic resonance imaging (fMRI) paradigm in individuals with MDD, compared to controls, (2) whether pretreatment brain responses predicted antidepressant treatment response, and (3) pre-post change in brain responses following treatment.

METHODS: Eighty-nine medication-free, depressed individuals and 115 healthy controls completed the fMRI paradigm. Depressed individuals completed a nonrandomized, open-label, 8-week treatment with escitalopram, including the option to switch to duloxetine after 4 weeks. We examined patient-control group differences in regional fMRI responses at baseline, whether baseline fMRI responses predicted treatment response at 8 weeks, including early life stress moderating effects, and change in fMRI responses in 36 depressed individuals rescanned following 8 weeks of treatment.

RESULTS: Task reaction time was 5% slower in patients. Multiple brain regions showed significant task-related responses, but we observed no statistically significant patient-control group differences (Cohen’s d < 0.35). Patient pretreatment brain responses did not predict antidepressant treatment response (area under the curve of the receiver operator characteristic (AUC-ROC) < 0.6) and brain responses were not statistically significantly changed after treatment (Cohen’s d < 0.33).

CONCLUSION: This represents the largest prediction study to date examining emotional faces fMRI features as predictors of antidepressant treatment response. Brain response to this fMRI emotional faces paradigm did not distinguish depressed individuals from healthy controls, nor was it predictive of antidepressant treatment response.Clinical Trial Registration: Site: https://clinicaltrials.gov, Trial Number: NCT02869035, Trial Title: Treatment Outcome in Major Depressive Disorder.

PMID:35549538 | DOI:10.1177/02698811221089035

Acta Radiol. 2022 May 12:2841851221100317. doi: 10.1177/02841851221100317. Online ahead of print.

ABSTRACT

BACKGROUND: Pisotriquetral joint (PTJ) disorders are an important cause of ulnar-sided wrist pain but are often underrecognized. Ulnar variance (UV) has been associated with several wrist pathologies.

PURPOSE: To determine the effect of UV on PTJ in patients with trauma.

MATERIAL AND METHODS: A total of 143 patients (77 men, 66 women; mean age=41.64 ± 18.07 years) were included. Patients with fractures, severe and high-energy trauma, arthritic conditions, avascular necrosis, congenital deformity, bone and soft-tissue tumors, suboptimal image quality, and incorrect joint position were excluded. UV and the amount of PTJ subluxation were evaluated using coronal and sagittal computed tomography images.

RESULTS: PTJ subluxation was divided into five grades. A statistically significant difference was found between the presence of PTJ subluxation and sex (P = 0.045). PTJ subluxation was more common in men (46.8%) than in women (30.3%). There was no significant difference between the presence of PTJ subluxation and age (P = 0.758). The patients were also divided into three groups as positive, neutral, and negative UV. A statistically significant relationship was found between the UV and presence of PTJ subluxation (P = 0.01). PTJ subluxation was significantly less in the neutral (none=51.1%, present=48.9%; P < 0.05) and negative (none=77.8%, present=22.2%; P < 0.05) groups.

CONCLUSION: PTJ subluxation was found to be less among the groups with neutral and negative UV in our study population. PTJ subluxation is more common in men while there is no relationship with age. UV and gender may be risk factors for PTJ subluxation by affecting force dynamics at the wrist joint.

PMID:35549516 | DOI:10.1177/02841851221100317

Scand J Rheumatol. 2022 May 12:1-8. doi: 10.1080/03009742.2022.2058178. Online ahead of print.

ABSTRACT

OBJECTIVE: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown aetiology that affects approximately 1% of the population. The disease presents a temporal variability in different geographic areas. We investigated RA incidence over a 40-year-period in a defined area of north-west Greece, with a total population of about 400 000 inhabitants.

METHOD: This incidence study was based on retrospective review of clinical records among adults with RA newly diagnosed from 1980 to 2019 at the referral university hospital of Ioannina. An incident case was defined as any patient diagnosed with RA based on the 1987 American College of Rheumatology criteria, over 16-years-old, and resident in the study area for at least 1 year before diagnosis.

RESULTS: Out of 1411 cases diagnosed, women constituted a 2.65-fold higher number than men, with a lower mean age at diagnosis. The overall age-adjusted annual incidence rate (95% confidence interval) was 9.5 (8.5-10.5) for the total observation period, 11.7 (10.7-13.0) in 1980-1989, 10.4 (9.4-10.8) in 1990-1999, 9.8 (8.9-10.8) in 2000-2009, and 6.1 (5.3-6.9) in 2010-2019, presenting a statistically significant decline over time, along with a constant decrease in rheumatoid factor (RF)-positive incidence for both sexes.

CONCLUSION: Our findings suggest a decrease in the incidence of RA over 40 years in a geographically defined Greek population. Also, the progressive decrease in the incidence of RF-positive disease may relate to less severe expression of RA in Greek patients. These trends could be explained by different clinical, serological, and genetic factors reported in Greece compared to northern European countries.

PMID:35545952 | DOI:10.1080/03009742.2022.2058178