Category: Nevin Manimala

J Clin Gastroenterol. 2022 May 25. doi: 10.1097/MCG.0000000000001721. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: To help prevent delayed adverse events after endoscopic surgery, endoscopists often place clips at the site. This meta-analysis aimed to assess the efficacy and safety of prophylactic clipping in the prevention of delayed bleeding and perforation after endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR).

METHODS: Multiple databases were searched from the inception dates to April 2021. And we included all relevant studies. Pooled odds ratio comparing the prophylactic clipped group versus nonprophylactic clipped group were calculated using the random effects model.

RESULTS: Twenty-seven articles fulfilled the inclusion criteria, with a total size of 8693 participants. There was statistically significant difference in prophylactic clipping versus no prophylactic clipping for delayed bleeding and perforation found in all studies (odds ratio: 0.35, 95% confidence interval: 0.25-0.49, P<0.01; odds ratio: 0.42, 95% confidence interval: 0.21-0.83, P<0.05; respectively). Besides, statistically significant difference was also found in subgroup analyses based on patients with lesions larger than 20 mm. Prophylactic clipping was more protective for duodenal delayed adverse events than colorectum. The use of clip closure was more protective to ESD-related delayed adverse events than EMR.

CONCLUSIONS: Prophylactic clipping after ESD and EMR was beneficial in preventing delayed bleeding and perforation.

PMID:35648969 | DOI:10.1097/MCG.0000000000001721

Rev Paul Pediatr. 2022 May 27;40:e2021004. doi: 10.1590/1984-0462/2022/40/2021004IN. eCollection 2022.

ABSTRACT

OBJECTIVE: To describe the epidemiological profile and to analyze the trend in the incidence rate of exogenous poisoning concerning children and adolescents (0-19 years old) in the city of Arapiraca, Alagoas, Brazil, in the period from 2007 to 2015.

METHODS: Observational study with data extracted from the Notifiable Diseases Information System. The variables sex, age group, toxic agent, and circumstance were analyzed using descriptive statistics. For temporal analysis, cut-off rates of incidence/10,000 inhabitants were calculated and the inflection point regression model was used for analysis.

RESULTS: There were 5,539 cases of exogenous intoxication in individuals aged 0-19 years in the city, of which 53.1% (n=2,944) occurred in girls and 61.5% (n=3,405) in children aged 0-9 years. Medicines consisted in the main agent responsible for intoxications (28.5%; n=1,580), mainly by accidental use (18.2%; n=1,010). There was a significant increase in the events during the study period (Average Annual Percent Change: 12.7; 95%CI 1.1-25.6; p<0.001), with rates increasing from 56.52/10,000 inhabitants in 2007 to 56.64/10,000 inhabitants in 2015. The incidence of cases in girls increased from 57.34/10,000 inhabitants in 2007 to 62.27/10,000 inhabitants in 2015. In boys, the incidence of cases was stationary: 55.69/10,000 inhabitants to 50.9 /10,000 inhabitants in the same period.

CONCLUSIONS: The study showed a higher frequency of cases in girls aged 0 to 4 years and an increasing trend in the incidence rate during the study period. Implementation of actions and strategies, with emphasis on health education, is needed in order to prevent cases of exogenous intoxication.

PMID:35648984 | DOI:10.1590/1984-0462/2022/40/2021004IN

Opt Lett. 2022 Jun 1;47(11):2658-2661. doi: 10.1364/OL.458117.

ABSTRACT

In order to increase signal-to-noise ratio in optical imaging, most detectors sacrifice resolution to increase pixel size in a confined area, which impedes further development of high throughput holographic imaging. Although the pixel super-resolution technique (PSR) enables resolution enhancement, it suffers from the trade-off between reconstruction quality and super-resolution ratio. In this work, we report a high-fidelity PSR phase retrieval method with plug-and-play optimization, termed PNP-PSR. It decomposes PSR reconstruction into independent sub-problems based on generalized alternating projection framework. An alternating projection operator and an enhancing neural network are employed to tackle the measurement fidelity and statistical prior regularization, respectively. PNP-PSR incorporates the advantages of individual operators, achieving both high efficiency and noise robustness. Extensive experiments show that PNP-PSR outperforms the existing techniques in both resolution enhancement and noise suppression.

PMID:35648898 | DOI:10.1364/OL.458117

Sci Adv. 2022 Jun 3;8(22):eabg5244. doi: 10.1126/sciadv.abg5244. Epub 2022 Jun 1.

ABSTRACT

How neuronal variability affects sensory coding is a central question in systems neuroscience, often with complex and model-dependent answers. Many studies explore population models with a parametric structure for response tuning and variability, preventing an analysis of how synaptic circuitry establishes neural codes. We study stimulus coding in networks of spiking neuron models with spatially ordered excitatory and inhibitory connectivity. The wiring structure is capable of producing rich population-wide shared neuronal variability that agrees with many features of recorded cortical activity. While both the spatial scales of feedforward and recurrent projections strongly affect noise correlations, only recurrent projections, and in particular inhibitory projections, can introduce correlations that limit the stimulus information available to a decoder. Using a spatial neural field model, we relate the recurrent circuit conditions for information limiting noise correlations to how recurrent excitation and inhibition can form spatiotemporal patterns of population-wide activity.

PMID:35648863 | DOI:10.1126/sciadv.abg5244

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3787-3796. doi: 10.26355/eurrev_202205_28875.

ABSTRACT

OBJECTIVE: In a prospective study, SARS-CoV-2 IgG seroprevalence was assessed during the second pandemic wave (W2) in a cohort of Inflammatory Bowel Disease (IBD) patients using biologics. The secondary aim was to compare, in the same cohort, the frequency of seropositivity and of COVID-19 during the second vs. the first (W1) wave.

PATIENTS AND METHODS: From November 2020 to March 2021, SARS-CoV-2 IgG seropositivity and the prevalence of COVID-19 were assessed in a cohort of IBD patients using biologics already studied at W1.

INCLUSION CRITERIA: age ≥ 18 years; diagnosis of IBD; follow-up; written consent.

EXCLUSION CRITERIA: SARS-CoV-2 vaccination. Risk factors for infection, compatible symptoms, history of infection or COVID-19, nasopharyngeal swab test were recorded. Data were expressed as median [range]. The χ2 test, Student’s t-test, logistic regression analysis was used.

RESULTS: IBD cohort at W1 and W2 included 85 patients: 45 CD (52.9%), 40 UC (47.1%). When comparing the same 85 patients at W2 vs. W1, a higher SARS-CoV-2 seroprevalence at W2 was at the limit of the statistical significance (9.4% vs. 2.3%; p=0.05). The prevalence of COVID-19 at W2 vs. W1 was 3.5% (3/85) vs. 0% (0/85) (p=0.08). Contacts with COVID-19 patients and symptoms compatible with COVID-19 were more frequent at W2 vs. W1 (18.8 % vs. 0%; p=0.0001; 34.1% vs. 15.3%; p=0.004). At W2, history of contacts and new onset diarrhea were more frequent in seropositive patients [4/8 (50%) vs. 12/77 (15.6%); p=0.01 and 4/8 (50%) vs. 2/77 (2.6%); p=0.0001]. At W2, the risk factors for seropositivity included cough, fever, new onset diarrhea, rhinitis, arthromyalgia, dysgeusia/anosmia at univariate (p<0.05), but not at multivariate analysis. History of contacts was the only risk factor for seropositivity at univariate (p=0.03), but not at multivariate analysis (p=0.1).

CONCLUSIONS: During W2, characterized by a high viral spread, IBD and biologics appeared not to increase the prevalence of SARS-CoV-2 infection or COVID-19 disease. New onset diarrhea mimicking IBD relapse may be observed in patients with SARS-CoV-2 infection.

PMID:35647861 | DOI:10.26355/eurrev_202205_28875

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3718-3725. doi: 10.26355/eurrev_202205_28868.

ABSTRACT

OBJECTIVE: Our aim is to investigate the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients who received aminoglycoside antibiotics.

MATERIALS AND METHODS: A retrospective analysis was performed on the electronic medical record information of inpatients who received aminoglycoside (AG) antibiotics in our center from January 2018 to December 2020. The diagnosis of AKI was based on serum creatinine changes. Several statistical methods, including chi square test and two sample Wilcoxon rank sum test, were used to evaluate the epidemiological characteristics of aminoglycosides associated AKI. The multivariate logistic regression analysis was used to screen the risk factors.

RESULTS: Finally, 8,040 patients who received AGs were included in the study. Among them, 494 patients (6.14%) were judged as incidence with AKI, while only 29 patients were diagnosed with AKI in the medical record. The multiple logistic regression analysis suggested that admission to ICU, complicated with diabetes mellitus, heart failure, anemia, shock, combined use of diuretics, β-lactam antibiotics, proton pump inhibitors were independent risk factors for AKI related to aminoglycosides.

CONCLUSIONS: It is urgent to improve the understanding and attention of AKI for medical workers, and the assessment of risk factors before the use of aminoglycosides should be contributed to the early prevention, diagnosis, and treatment of AKI.

PMID:35647854 | DOI:10.26355/eurrev_202205_28868

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3686-3694. doi: 10.26355/eurrev_202205_28864.

ABSTRACT

OBJECTIVE: This study aims to investigate the relationship between postoperative infection-related mortality and lymphocyte-to-C-reactive protein ratio (LCR), a newly defined parameter with the combination of inflammatory and immune parameters, in patients undergoing cardiac surgery.

PATIENTS AND METHODS: Between January 2016 and November 2021, 236 patients who underwent on-pomp cardiac surgery with median sternotomy and developed postoperative infection were analyzed retrospectively. Patients were divided into six groups according to the types of postoperative infection. Preoperative, perioperative, and postoperative variables of the patient groups were compared, and factors affecting postoperative mortality were evaluated.

RESULTS: The mortality rate in the patient group we included in the study was 22.9%. Mortality rates did not differ significantly between the infection groups. However, when the LCR value was evaluated between the groups, there was a statistically significant difference (p<0.001). The preoperative LCR cut-off value, which predicts postoperative infection-related mortality, was determined as 133.46 (area under the curve (AUC): 0.607, p=0.017, 48.1% sensitivity, and 47.8% specificity). In the multivariate analysis, postoperative cerebrovascular event (OR: 78.365, 95% CI: 12.367-496.547, p<0.001) and Intensive Care Unit (ICU) stay (odds ratio (OR): 1.136, 95% confidence interval (CI): 1.004-1.284, p=0.042) variables were found to be independent predictive factors of postoperative infection-related mortality in the model. There was no positive differentiation of the type of infection in predicting mortality.

CONCLUSIONS: The calculated LCR value is a novel and remarkable parameter in estimating postoperative infection-related mortality in patients undergoing cardiac surgery.

PMID:35647850 | DOI:10.26355/eurrev_202205_28864

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3593-3598. doi: 10.26355/eurrev_202205_28855.

ABSTRACT

OBJECTIVE: Malnutrition is a common condition, especially among hospitalized patients which are overlooked by many clinicians. Malnutrition was found to be associated with increased hospitalization duration, increased admission frequency, increase in infection frequency and severity, bad wound healing, gait disturbances, fallings, and fractures. In this study, we aimed to determine malnutrition frequency in patients who were admitted to the emergency department for non-trauma causes and hospitalized.

PATIENTS AND METHODS: 245 patients were admitted to the Emergency Department for non-trauma causes and hospitalized and 245 control group patients were included in this study. Hospitalized patients were assessed with NRS-2002 (Nutritional Risk Screening) and Mini Nutritional Assessment (MNA). Age, gender, height, weight, body mass index (BMI), malnutrition status, and wards of the patients were screened.

RESULTS: 140 (57.1%) of the hospitalized patients had malnutrition according to NRS-2002 and MNA. There was a statistically significant difference between the control group and the hospitalized patients who were malnourished (Pearson chi-square test; p<0,001). There was a significant relation between hospitalized departments and malnutrition (p<0.05). There was a significant difference in age and height between hospitalized patients and the control group (p<0.0001) whereas no significant difference was found between the height and BMI (p>0.05). There was a significant relationship in terms of hospitalization and malnutrition.

CONCLUSIONS: The nutritional state of the patients admitted to the emergency department for non-trauma conditions is an important factor and should not be overlooked.

PMID:35647841 | DOI:10.26355/eurrev_202205_28855

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3522-3533. doi: 10.26355/eurrev_202205_28847.

ABSTRACT

OBJECTIVE: Glioblastoma (GBM) is the most common and aggressive primary malignant tumor of the central nervous system in adults with high recurrence and mortality rates. Although radiotherapy and temozolomide have become the standard therapeutic regimen for GBM as adjuvant chemoradiotherapy after surgical resection, clinical outcomes remain suboptimal. In recent years, targeted antiangiogenic therapy has attracted considerable attention, but its therapeutic efficacy and safety are still controversial.

MATERIALS AND METHODS: Randomized controlled trials (RCTs) of chemoradiotherapy with or without bevacizumab for the treatment of glioblastoma were collected by searching on the Pubmed, Embase, Cochrane, Ovid, Scopus, Web of Science, and Google Scholar databases from the date of database establishment to February 2022. Meta-analysis was performed using RevMan 5.3 software after two investigators independently screened the literature, extracted data, and assessed the risk bias of included studies.

RESULTS: A total of 7 RCTs were included. The meta-analysis showed that bevacizumab in combination with chemoradiotherapy was superior to chemoradiotherapy alone in terms of progression-free survival (PFS), with a statistically significant difference. Interestingly, bevacizumab in combination with chemoradiotherapy improved PFS more significantly in recurrent glioblastoma than in newly diagnosed glioblastoma. However, for overall survival (OS), the combination of bevacizumab with chemoradiotherapy was similar to chemoradiotherapy alone, which was not significantly different. With regard to safety, the incidence of most adverse events was higher in the combination of bevacizumab and chemoradiotherapy than in chemoradiotherapy alone, especially in terms of hematologic adverse events.

CONCLUSIONS: Current evidence suggests that angiogenesis inhibitor-containing chemoradiotherapy regimens are preferentially recommended for patients with recurrent glioblastoma to prolong their progression-free survival, provided that safety is acceptable, but this does not confer a significant benefit on overall patient survival.

PMID:35647833 | DOI:10.26355/eurrev_202205_28847

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3493-3505. doi: 10.26355/eurrev_202205_28844.

ABSTRACT

OBJECTIVE: Vitamin D deficiency is a significant problem that affects the population living in most countries. This issue is independent by place of residence, sex, age or skin color. It is mainly influenced by the environment we live in and by an unhealthy lifestyle, including bad eating habits. The aim of this study was to evaluate lipid profile, glucose levels, and vitamin D levels, considering sociodemographic variables, smoking and alcohol consumption in perimenopausal women. Depressive mood was also assessed considering sociodemographic variables and vitamin D levels.

PATIENTS AND METHODS: The study was conducted on a group of 191 women and performed in two stages. The first of them was carried out using a diagnostic survey with the use of a technique questionnaire. The applied research instruments were the author’s questionnaire (concerning sociodemographic and selected medical data), and the Beck Depression Inventory. The second stage of the study involved the collection of peripheral blood from each respondent, in order to determine lipid profile, glycemia and serum vitamin D levels.

RESULTS: The age of the female respondents ranged from 45 to 65 years, mean age was 53.1 ± 5.37 years, median 53 years. Vitamin D levels were below normal in 78%; 77% had elevated total cholesterol levels; 91.6% of the respondents had high density lipoprotein (HDL) cholesterol levels within the normal range; 64.4% was characterized by too high (low-density lipoprotein) LDL cholesterol, and 84.8% of the women showed normal triglyceride levels. Among the respondents, 91.1% had normal glycemic levels. Analysis of the collected data showed a weak negative correlation between serum vitamin D levels and the levels of total cholesterol (rho=-0.14; p=0.05), LDL cholesterol (rho=-0.16; p=0.026), and triglycerides (rho=-0.22; p=0.002). Only in the case of HDL cholesterol (p=0.067), there was no statistically significant correlation. There were also no statistically significant correlations between serum vitamin D levels and glycemia or severity of depression.

CONCLUSIONS: 1. The majority of the women did not manifest depressive disorders. Of all factors analyzed, only education was associated with the severity of depressiveness. 2. Smoking adversely affected serum vitamin D levels in the studied women. 3. The cessation of menstruation affected carbohydrate metabolism and vitamin D levels. Blood glucose levels increased with the age of the studied women. 4. Relationships were found between the levels of vitamin D and the levels of total cholesterol, LDL cholesterol, and triglycerides. Therefore, it is important to maintain normal vitamin D levels.

PMID:35647830 | DOI:10.26355/eurrev_202205_28844