Category: Nevin Manimala

Acta Paediatr. 2023 Feb 11. doi: 10.1111/apa.16705. Online ahead of print.

ABSTRACT

AIM: The immune status of children recovering from SARS-CoV-2 infection is not completely understood. We describe IgG anti-spike persistence in children infected during the first two pandemic waves. In addition, we compared with healthy controls their leukocyte populations and CD64 expression.

METHODS: Cross-sectional study. Done from October 2021 to February 2022 in non-reinfected and non-vaccinated children with SARS-CoV-2 in 2020. The presence of anti-spike IgG was studied using chemiluminescent immunoassay. Leukocyte populations were analysed using flow cytometry and marked for CD45, CD4, CD8, and CD64. Statistical minor than 0,05 was considered significant.

RESULTS: One hundred eighty-three control and 77 patients were included. IgG anti-spike determinations were performed after a median of 501 days (262-464); 52/77 children were positive. Cases showed significantly higher percentages of monocytes, lymphocytes, CD8+ and CD4+. In addition, CD64 expression was higher in monocytes and neutrophils. The presence of IgG anti-spike was accompanied by a higher percentage of CD64+ neutrophils.

CONCLUSION: In our series, the SARS-CoV-2 IgG anti-spike protein was usually positive beyond one year after infection. Furthermore, leukocyte populations from cases differ from controls, with higher CD64 expression on neutrophils and monocytes. Prospective clinical observations are required to confirm the implications of these findings.

PMID:36772991 | DOI:10.1111/apa.16705

Res Synth Methods. 2023 Feb 11. doi: 10.1002/jrsm.1627. Online ahead of print.

ABSTRACT

Outputs from living evidence syntheses projects have been used widely during the pandemic by guideline developers to form evidence-based recommendations. However, the needs of different stakeholders cannot be accommodated by solely providing pre-defined non amendable numerical summaries. Stakeholders also need to understand the data and perform their own exploratory analyses. This requires resources, time, statistical expertise, software knowledge as well as relevant clinical expertise to avoid spurious conclusions. To assist them, we created the metaCOVID application which, based on automation processes, facilitates the fast exploration of the data and the conduct of sub-analyses tailored to end-users needs. metaCOVID has been created in R and is freely available as an R-Shiny application. Based on the COVID-NMA platform (https://covid-nma.com/) the application conducts living meta-analyses of RCTs related to COVID-19 treatments and vaccines for several outcomes. Several options are available for subgroup and sensitivity analyses. The results are presented in downloadable forest plots. We illustrate metaCOVID through three examples involving well-known treatments and vaccines for COVID-19. The application is freely available from https://covid-nma.com/metacovid/. This article is protected by copyright. All rights reserved.

PMID:36772980 | DOI:10.1002/jrsm.1627

Am J Health Promot. 2023 Feb 11:8901171231156513. doi: 10.1177/08901171231156513. Online ahead of print.

ABSTRACT

PURPOSE: To examine the associations between dietary intake as assessed by a rapid, image-based digital tool and biomarkers of cardiometabolic health.

DESIGN: Retrospective analysis of adults with blood biomarkers performed by Boston Heart Diagnostics (BHD) between December 2020 and March 2022.

SETTING: Outpatient centers serviced by BHD.

SUBJECTS: 546 adults, excluding those taking relevant medications and/or supplements known to affect blood test results.

MEASURES: Laboratory assays of blood specimens were performed by Boston Heart Diagnostics. Nutrient intake and diet quality data were obtained using Diet Quality Photo Navigation (DQPN®; US Patent #11,328,810 B2) technique via Diet ID™ tool.

ANALYSIS: Pearson correlation coefficients (for continuous variables) and Spearman coefficients (for ordinal variables) were used to evaluate associations between nutrient intake data and laboratory data for the full study sample. Two-sided P-values < .05 were considered statistically significant.

RESULTS: Both continuous and ordinal measures of diet quality correlated significantly with HDL-C and triglycerides (n = 485; P < .0 01); with hs-CRP (n = 441; P < .001); with HgbA1c (n = 345; P < .01); with fasting insulin (n = 372; P < .001); and with HOMA-IR (n = 319; P < .001).

CONCLUSION: Findings affirm that rapid, digital diet quality and composition assessment by pattern recognition rather than recall tracks significantly with key biomarkers of cardiometabolic health.

PMID:36772929 | DOI:10.1177/08901171231156513

J Investig Med. 2023 Feb 11:10815589221140588. doi: 10.1177/10815589221140588. Online ahead of print.

ABSTRACT

Electronic cigarettes (e-cigarettes) provide a novel source of nicotine and may lead to experimentation by adolescents and eventually to their use of conventional cigarettes. The National Youth Tobacco Survey collected information from a nationally representative sample of students in 2016 to determine their experiences with conventional cigarettes and e-cigarettes, their intentions to use these products in the future, and their perceptions of harm and addiction associated with these products. We analyzed these data with ordered probit regression models to determine possible associations with the intention to try e-cigarettes and conventional cigarettes. This survey included 20,520 respondents, 50.6% were male, 5.9% had used conventional cigarettes, and 9.0% had used e-cigarettes. Approximately 10% thought e-cigarettes caused no harm, 3.7% thought that conventional cigarettes caused no harm, and 52.5% thought that e-cigarettes were less harmful than conventional cigarettes. Less than 1% of the students responded “Definitely yes” to the question, “Do you think you will try an e-cig?” The odds ratios for an intention to try e-cigarettes increased as the perception of harm decreased; these ratios increased from 1.0 for “A lot of harm” to 5.85 (95% CI: 3.51, 9.75) for “No harm.” In 2016, the majority of students thought that e-cigarettes could cause some harm. This survey indicates that most students have not tried e-cigarettes or conventional cigarettes. The minority of students who think that e-cigarettes pose no harm and students in the ages 14 and 16 are more likely to try them.

PMID:36772925 | DOI:10.1177/10815589221140588

Child Care Health Dev. 2023 Feb 11. doi: 10.1111/cch.13104. Online ahead of print.

ABSTRACT

BACKGROUND: Adverse childhood experiences (ACEs) such as abuse and neglect have an immediate impact on children and are associated with poorer health and behavioral outcomes in adulthood. This study examined the prevalence of ACEs and their association with socio-demographic factors, physical and mental health, morbidity, and health-harming behaviors in adulthood among Americans.

METHOD: Data for the study come from the Behavioral Risk Factor Surveillance System (BRFSS) 2019, covering a sample of 116,032 adult respondents from 22 states of the US. Descriptive and inferential statistical techniques, including multiple logistic regression models, were employed to analyze the data.

RESULTS: At least one kind of ACE was found to be quite common among American adults, as 60% of adults had at least one kind of ACE, 22.5% had one ACE, and 17% had four or more ACEs during 0-17 years of life. Of the total ACEs, 42.2% were due to abuse (physical, emotional, or sexual), and 46% were due to any kind of household dysfunction. There is an increasing trend in ACEs in the US. Adults with low socio-economic status, female, living in urban areas, gay or bisexual orientation, minority other than White, and unemployed had a significantly higher prevalence of ACEs than their counterparts. ACEs were found to be significantly associated with poor physical and mental health, health-harming behaviors such as binge drinking, heavy drinking, and smoking, as well as chronic morbidities.

CONCLUSION: Programs aimed at reducing ACEs and mitigating the harms of ACEs among those who have already experienced them should be strengthened to improve public health, quality of life, and reduce health-harming behaviors.

PMID:36772922 | DOI:10.1111/cch.13104

ANZ J Surg. 2023 Feb 11. doi: 10.1111/ans.18316. Online ahead of print.

ABSTRACT

BACKGROUND: Accurate placement of central venous access devices is important to avoid complications such as infection, thrombosis and migration. This audit aims to determine if there is a difference in complication rates and accuracy of tip position between two different intravenous jugular (IVJ) port device insertion techniques: fixation of port first (PF) versus tip first (TF).

METHODS: Patients who underwent port device insertions from 2019 to 2021 at the Cairns Hospital were identified from the Australia Vascular Audit database. The primary outcome of accurate catheter tip placement (based on radiological criteria), secondary outcomes of line infection, thrombosis and other outcomes such as removal rates were gathered and compared between the 2 groups of port first (PF) versus tip first (TF) insertion.

RESULTS: Two-hundred and twenty-seven patients underwent port device insertions during the period of interest. 98 (43.2%) patients had a PF insertion technique and 129 (56.8%) had a TF insertion technique. In the PF group, 81.6% (P < 0.05) of lines were accurately placed compared to 69.8% (P < 0.05) in the TF group. The line related thrombosis rate was 1% (P < 0.05) in the PF group compared to 6.2% (P < 0.05) in the TF group. Rate of line infections in the PF group was 5.1% (P = 0.92) compared to 6.2% (P = 0.92) in the TF group.

CONCLUSION: The port first technique for IVJ port device placement was associated with higher accuracy and lower thrombosis rates and this was statistically significant. Further studies should involve larger multicentre populations to compare results between practitioners.

PMID:36772890 | DOI:10.1111/ans.18316

Pediatr Blood Cancer. 2023 Feb 11:e30248. doi: 10.1002/pbc.30248. Online ahead of print.

NO ABSTRACT

PMID:36772889 | DOI:10.1002/pbc.30248

ANZ J Surg. 2023 Feb 11. doi: 10.1111/ans.18324. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) metastasis commonly occurs in the liver and lungs with bone metastasis rarely occurring in isolation. Disseminated carcinomatosis of bone marrow (DCBM) is extremely rare in CRC. We conducted a systematic review to provide more information on the diagnosis, treatment options, and prognosis of the condition.

METHODS: Studies were identified by performing searches on MEDLINE and EMBASE electronic databases according to the PRISMA statement standards. We included a single patient whom we treated for metastatic CRC presenting with DCBM in our study. Statistical analysis was performed using SPSS software version 23.0.

RESULTS: A search through 5502 unique studies yielded 14 studies that were eventually included. There was a total of 17 cases of DCBM in CRC with back pain and constitutional symptoms as the most common presenting complaints. DCBM in CRC was associated with markedly elevated CEA of 275.57 (95% CI 17.13-534.00). There was no predilection for site of primary tumour. Overall median survival was 120 days (95% CI 64.43-175.58). The median survival for patients who received chemotherapy was 240 days (95% CI 71.11-408.89), as compared to 9 days (95% CI 1.80-16.20) for patients who received best supportive treatment.

CONCLUSION: DCBM from CRC is extremely rare. Bone marrow examination remains the gold standard for diagnosis. Colonic stenting or surgical diversion may be more appropriate than primary resection in obstructed CRC in view of the poor prognosis. Systemic chemotherapy shows promise in increasing median survival.

PMID:36772885 | DOI:10.1111/ans.18324

Acta Ophthalmol. 2023 Feb 11. doi: 10.1111/aos.15642. Online ahead of print.

ABSTRACT

PURPOSE: To assess topographic characteristics of the optic nerve head (ONH) and retinal nerve fibre layer (RNFL) and study the effect of ocular and physiological factors on them in a middle-aged population.

METHODS: A 1552-person randomised sample from Northern Finland population aged 45-49 was examined. Laser scanning tomography and optical coherency tomography were performed to obtain measurements for ONH and RNFL morphology. Measurements of the RNFL included global thickness and the six zones used in automated structure-function analysis (S-F analysis). Influence of central corneal thickness (CCT), refractive correction, intraocular pressure (IOP), anterior chamber angle, gender, blood pressure, height, weight and body mass index (BMI) on tomographic data was analysed.

RESULTS: The optic disc area had a strong correlation with all other parameters of ONH morphology (R = 0.261 to 0.706) as did spherical equivalent (R = -0.280 to 0.280). The correlations between ONH and RNFL measurements were weaker (R = 0.057 to 0.180). Gender, CCT, anterior chamber angle, blood pressure, height and BMI had statistically significant, yet feeble, correlations with a number of ONH parameters.

CONCLUSION: Other than spherical equivalent, the studied anatomical and physiological attributes had little predictive value on the ONH morphology. The optic disc area itself had a significant effect on other measurements of ONH tomography and should be taken into consideration when the thresholds for normal ONH morphology are calculated.

PMID:36772874 | DOI:10.1111/aos.15642

J Med Virol. 2023 Feb 11. doi: 10.1002/jmv.28575. Online ahead of print.

ABSTRACT

Monkeypox, a zoonotic disease, is emerging as a potential sexually transmitted infection/disease, with underlying transmission mechanisms still unclear. We devised a risk-structured, compartmental model, incorporating sexual behavior dynamics. We compared different strategies targeting the high-risk population: a scenario of control policies geared towards the use of condoms and/or sexual abstinence (robust control strategy) with risk compensation behavior change, and a scenario of control strategies with behavior change in response to the doubling rate (adaptive control strategy). Monkeypox’s basic reproduction number is 1.464, 0.0066, and 1.461 in the high-risk, low-risk, and total populations, respectively, with the high-risk group being the major driver of monkeypox spread. Policies imposing condom use or sexual abstinence need to achieve a 35% minimum compliance rate to stop further transmission, while a combination of both can curb the spread with 10% compliance to abstinence and 25% to condom use. With risk compensation, the only option is to impose sexual abstinence by at least 35%. Adaptive control is more effective than robust control where the daily sexual contact number is reduced proportionally and remains constant thereafter, shortening the time to epidemic peak, lowering its size, facilitating disease attenuation, and playing a key role in controlling the current outbreak. This article is protected by copyright. All rights reserved.

PMID:36772860 | DOI:10.1002/jmv.28575