Category: Nevin Manimala

Zhonghua Gan Zang Bing Za Zhi. 2021 May 20;29(5):403-408. doi: 10.3760/cma.j.cn501113-20201224-00676.

ABSTRACT

Objective: To understand and compare the differences between age, sex and liver diseases-related mortality risk in patients with hepatitis B virus-related liver cirrhosis. Methods: Based on the front-page inpatient medical record database and the death registration system of Beijing patients with hepatitis B-related liver cirrhosis from 2008 to 2015 were included. The survival information of all patients were traced up to the occurrence of liver disease-related mortality event or until December 31, 2019. Kaplan-Meier method was used to calculate the cumulative incidence of liver disease-related mortality in patients with liver cirrhosis. Cox regression model was used to analyze the effect of age-gender interaction on liver disease-related mortality risk. Results: A total of 16 738 patients with hepatitis B-related liver cirrhosis were included, of which 13 969 cases (83.46%) were in compensated stage and 2 769 cases (16.54%) were in decompensated stage. Liver cirrhosis complications mortality risk in patients with compensated stage cirrhosis at 3, 5, and 8 years were 10.84%, 12.70%, and 14.37%, respectively; while in decompensated stage patients, the mortality risk was 16.70%, 19.02%, and 20.73%, respectively. The 3, 5, and 8-year liver cancer mortality rates of patients with compensated stage liver cirrhosis were 5.24%, 7.49%, and 10.25%, respectively; while those with decompensated stage liver cancer mortality rates were 9.01%, 11.16%, and 13.50%, respectively. Liver disease-related mortality risk was increased with age in patients with liver cirrhosis. Liver cirrhosis complications mortality risk in female patients with liver cirrhosis at age < 60 years was lower than that of male patients. Liver cirrhosis complications mortality risk in male and female patients aged 60-69 years were similar. Liver cirrhosis complications mortality risk in female patients aged ≥70 years was higher than that of male patients. However, female patients had a lower risk of liver cancer mortality than male patients in utmost age groups. Conclusion: Age is positively correlated with liver diseases-related mortality risk in patients with hepatitis B-related liver cirrhosis. Female sex is a protective factor for liver cancer mortality in patients with liver cirrhosis, and the protective effect on liver cirrhosis complications mortality risk gradually disappears with age.

PMID:34107575 | DOI:10.3760/cma.j.cn501113-20201224-00676

Bol Med Hosp Infant Mex. 2021 Apr 27. doi: 10.24875/BMHIM.20000247. Online ahead of print.

ABSTRACT

BACKGROUND: The sensitivity and specificity of the clinical audiological evaluation in newborns are debatable compared to neurophysiological methods of a hearing evaluation. This study aimed to determine the sensitivity and specificity of the cochleopalpebral reflex as a clinical test for hearing screening in newborns.

METHODS: A case-control study was designed. Newborns discharged from a neonatal intensive care unit (NICU) were included. Brainstem evoked auditory potentials were recorded. A wooden rattle was used to explore the cochleopalpebral reflex. The sensitivity and specificity of the cochleopalpebral reflex were calculated. Continuous data were analyzed with Student’s t-test, with statistically significant p-values < 0.05.

RESULTS: We selected 450 newborns who were divided into two groups: group A, with bilateral sensory neural hearing loss (n = 150), and group B, with normal hearing (n = 300). Group A showed a significantly lower gestation age at birth (p = 0.005) compared to group B (32.5 ± 2.6 vs. 34.4 ± 3.5 weeks). In group A, the cochleopalpebral reflex’s sensitivity was 80% using the wooden rattle. In group B, the specificity was 98%.

CONCLUSIONS: The NICU discharged newborns’ clinical hearing evaluation is not enough to exclude hearing loss. Although it may be the only diagnostic tool for hearing loss in some settings, its limitations should be considered.

PMID:34107532 | DOI:10.24875/BMHIM.20000247

Clin Implant Dent Relat Res. 2021 Jun 9. doi: 10.1111/cid.12996. Online ahead of print.

ABSTRACT

BACKGROUND: The need of decortication on the recipient site remains unclear for bone regeneration. To our knowledge, there are no human clinical trials that studied the influence of decortication on cancellous allogeneic block grafting.

PURPOSE: The aim of the present study is to evaluate the influence of perforating the cortex of the recipient site on cancellous allogeneic block graft integration and revascularization in the maxilla.

MATERIAL AND METHODS: Twenty-six patients referred for lateral bone augmentation were included in this clinical trial. Patients received freeze-dried bone allograft cancellous blocks obtained from the iliac crest; cortical perforations of the recipient bed were performed in the test group while in the control group it was left intact. After a 4-month healing period another surgery was performed to place dental implants, and a bone biopsy was collected using a trephine. All samples underwent micro-CT scans, and were processed for histomorphometric and immunohistochemical analysis. Implant survival comparisons were made using a repeated measures analysis of variance (ANOVA) while all other variables were compared using the analysis of covariance (ANCOVA).

RESULTS: One hundred and nineteen implants were placed into 110 augmented sites. One hundred percent implant survival rate was reported during 24 months follow-up period. No differences were reported in bleeding on probing at 1 (5.6 vs 9%) and 2 years (13.2 vs 12.1%), probing pocket depth at 1 (3.4 ± 0.95 vs 3.6 ± 1.12 mm) and 2 years (3.8 ± 1.02 vs 4.1 ± 1.46 mm), and marginal bone loss at 1 (0.2 ± 0.52 vs 0.3 ± 0.57 mm) and 2 years (0.6 ± 0.91 vs 0.5 ± 0.87 mm). No statistically significant differences were found in the micro-CT and histomorphometric analysis in terms of newly formed bone (25.7 ± 11.2% vs 22.3 ± 9.7%), soft tissue (33.0 ± 14.7% vs 36.5 ± 15.7%), remnant allograft (39.3 ± 20.4% vs 41.2 ± 22.7%), and bone mineralization (57.2 ± 10.6% vs 53.8 ± 8.7%). Perforating the cortex of the recipient site had no significant effect on angiogenesis as shown by immunohistochemical analysis of CD34 positive blood vessels (39.21 ± 10.53/mm² vs 34.16 ± 12.67/mm² ).

CONCLUSION: Cancellous allogeneic bone block grafts are a clinically acceptable alternative for horizontal bone augmentation. Cortical perforations of the recipient site in the maxilla did not improve angiogenesis nor bone formation within the block graft.

PMID:34107553 | DOI:10.1111/cid.12996

Nurs Educ Perspect. 2021 May 26. doi: 10.1097/01.NEP.0000000000000826. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to examine the existence of a relationship between the grading of reflective journals and student honesty in reflective journal writing.

BACKGROUND: Journal writing is often used to gauge skills and knowledge. However, disagreement exists as to whether journals should be graded as students may embellish experiences or write what the instructor wants to read. If students are not engaged in honest reflection, the benefit of reflective practice is reduced.

METHOD: Data were collected using an anonymous online survey. The nonprobability sampling technique was used to examine the existence of a relationship between the grading of reflective journals and student honesty in reflective journal writing.

RESULTS: Findings indicated a statistically significant positive relationship between grading of reflective journals and student honesty.

CONCLUSION: Instead of grading the written component, the process of reflective practice should be assessed, possibly changing to a grade of complete/incomplete.

PMID:34107520 | DOI:10.1097/01.NEP.0000000000000826

Bol Med Hosp Infant Mex. 2021 Jun 9. doi: 10.24875/BMHIM.20000255. Online ahead of print.

ABSTRACT

BACKGROUND: Unplanned extubations are safety events relatively frequent in the neonatal intensive care units (NICU). This study aimed to describe the frequency and characteristics of unplanned extubations in a NICU.

METHODS: We conducted a retrospective observational study of unplanned extubations in the NICU of a tertiary regional referral hospital. We reviewed medical records for data collection and performed the statistical analysis, comparing the cases of unplanned extubations with those in which it did not occur among all the cases that received intubation and invasive neonatal mechanical ventilation.

RESULTS: A total of 958 newborns were admitted to the NICU, of which 174 required assistance with invasive mechanical ventilation (18.1%) and 28 experienced unplanned extubations (16.1%): 25 patients with one episode, one with two episodes, and two with three episodes. The rate was 2.93 unplanned extubations for every 100 days of invasive mechanical ventilation in 5 years, with a significant decrease in the last three years (p = 0.0158). We found a statistically significant correlation between a weight < 1500 g and unplanned extubation in the multivariate analysis, although sedation appears to affect its interaction.

CONCLUSIONS: Unplanned extubations are a relatively frequent problem, although with a tendency to decrease in recent years. The weight of the patients at birth and sedation during ventilation are important factors in this safety problem.

PMID:34107531 | DOI:10.24875/BMHIM.20000255

Blood Purif. 2021 Jun 9:1-7. doi: 10.1159/000514149. Online ahead of print.

ABSTRACT

AIM: This study aimed to evaluate the efficacy of the resin hemoperfusion device (HA380 hemoperfusion cartridge) on inflammatory responses during adult cardiopulmonary bypass (CPB).

METHODS: Sixty patients undergoing surgical valve replacement were randomized into the HP group (n = 30) with an HA380 hemoperfusion cartridge in the CPB circuit or the control group (n = 30) with the conventional CPB circuit. The results of routine blood tests, blood biochemical indexes, and inflammatory factors were analyzed at V0 (pre-CPB), V1 (CPB 30 min), V2 (ICU 0 h), V3 (ICU 6 h), and V4 (ICU 24 h).

RESULTS: The HP group had significantly lower levels of IL-6, IL-8, and IL-10. Significant estimation of group differences in the generalized estimating equation (GEE) models was also observed in IL-6 and IL-10. The HP group had significantly lower levels of creatinine (Cr), aminotransferase (AST), and total bilirubin (TBil) compared to the control group. The estimation of differences of Cr, AST, and TBil all reached statistical significance in GEE results. The HP group had significantly less vasopressor requirement and shorter mechanical ventilation time and ICU stay time as compared to the control group.

CONCLUSION: The HA380 hemoperfusion cartridge could effectively reduce the systemic inflammatory responses and improve postoperative recovery of patients during adult CPB.

PMID:34107477 | DOI:10.1159/000514149

Med Sci Sports Exerc. 2021 Jun 7. doi: 10.1249/MSS.0000000000002713. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects of a single session of either peristaltic pulse dynamic leg compressions (PPDC) or local heat therapy (HT) following prolonged intermittent shuttle running on skeletal muscle glycogen content, muscle function and the expression of factors involved in skeletal muscle remodeling.

METHODS: Twenty-six trained individuals were randomly allocated to either a PPDC (n=13) or a HT (n=13) group. After completing a 90-min session of intermittent shuttle running, participants consumed 0.3 g/kg protein plus 1.0 g/kg carbohydrate and received either PPDC or HT for 60 min in one randomly selected leg, while the opposite leg served as control. Muscle biopsies from both legs were obtained prior to and after exposure to the treatments. Muscle function and soreness were also evaluated before, immediately after and 24 h following the exercise bout.

RESULTS: The changes in glycogen content were similar (P>0.05) between the thigh exposed to PPDC and the control thigh ~90 min (Control: 14.9±34.3 vs. PPDC: 29.6±34 mmol/kg wet wt) and ~210 min (Control: 45.8±40.7 vs. PPDC: 52±25.3 mmol/kg wet wt) after the treatment. There were also no differences in the change in glycogen content between thighs ~90 min (Control: 35.9±26.1 vs. HT: 38.7±21.3 mmol/kg wet wt) and ~210 min (Control: 61.4±50.6 vs. HT: 63.4±17.5 mmol/kg wet wt) following local HT. The changes in peak torque and fatigue resistance of the knee extensors, muscle soreness and the mRNA expression and protein abundance of select factors were also similar (P>0.05) in both thighs, irrespective of the treatment.

CONCLUSIONS: A single 1 hr session of either PPDC or local HT does not accelerate glycogen resynthesis and the recovery of muscle function following prolonged intermittent shuttle running.

PMID:34107509 | DOI:10.1249/MSS.0000000000002713

J Stroke Cerebrovasc Dis. 2021 Jun 6;30(8):105905. doi: 10.1016/j.jstrokecerebrovasdis.2021.105905. Online ahead of print.

ABSTRACT

PURPOSE: In the past years the significance of white matter hyperintensities (WMH) has gained raising attention because it is considered a marker of severity of different pathologies. Another condition that in the last years has been assessed in the neuroradiology field is cerebral microbleeds (CMB). The purpose of this work was to evaluate the association between the volume of WMH and the presence and characteristics of CMB.

MATERIAL AND METHODS: Sixty-five consecutive (males 45; median age 70) subjects were retrospectively analyzed with a 1.5 Tesla scanner. WMH volume was quantified with a semi-automated procedure considering the FLAIR MR sequences whereas the CMB were studied with the SWI technique and CMBs were classified as absent (grade 1), mild (grade 2; total number of CMBs: 1-2), moderate (grade 3; total number of CMBs: 3-10), and severe (grade 4; total number of CMBs: >10). Moreover, overall number of CMBs and the maximum diameter were registered.

RESULTS: Prevalence of CMBs was 30.76% whereas WMH 81.5%. Mann-Whitney test showed a statistically significant difference in WMH volume between subjects with and without CMBs (p < 0.001). Pearson analysis showed significant correlation between CMB grade, number and maximum diameter and WMH. The better ROC area under the curve (Az) was obtained by the hemisphere volume with a 0.828 (95% CI from 0.752 to 0,888; SD = 0.0427; p value = 0.001). The only parameters that showed a statistically significant association in the logistic regression analysis were Hemisphere volume of WMH (p = 0.001) and Cholesterol LDL (p = 0.0292).

CONCLUSION: In conclusion, the results of this study suggest the presence of a significant correlation between CMBs and volume of WMH. No differences were found between the different vascular territories.

PMID:34107418 | DOI:10.1016/j.jstrokecerebrovasdis.2021.105905

Water Res. 2021 May 16;200:117254. doi: 10.1016/j.watres.2021.117254. Online ahead of print.

ABSTRACT

Due to the increased availability of high-frequency measurements of stream chemistry provided by in situ sensors, researchers have gained more access to relationships between stream discharge and constituent concentrations (C-Q relationships) at event-scales. Existing studies reveal that event-scale C-Q relationships are mostly non-linear and exhibit temporal lags between peaks (or troughs) of hydrographs and chemographs, resulting in apparent hysteresis effects. In this paper, we summarize and introduce tools and methods in hysteresis analysis, especially the history and progresses of metrics to quantify hysteresis patterns. In addition, this paper provides a typical workflow to conduct event-scale hysteresis analysis, such as how to obtain the access to high-frequency measurements, existing methods to delineate storm events, approaches to classify and quantify hysteresis patterns, possible features/properties controlling hysteresis patterns, statistical methods to identify features at play, and strategies to deliver the inferences from hysteresis analysis. Lastly, we discuss some potential limitations that arise in the workflow and possible future work to address the challenges, including the development of advanced quantitative hysteresis metrics, generalized and standardized tools to delineate events and the integration of hysteresis analysis with numerical modeling. This paper aims to provide a critical overview of technical approaches for hysteresis analysis for researchers and hopefully foster their interests to advance our understanding of complex mechanisms in event-scale hydro-biogeochemical processes.

PMID:34107427 | DOI:10.1016/j.watres.2021.117254

Health Place. 2021 Jun 6;70:102599. doi: 10.1016/j.healthplace.2021.102599. Online ahead of print.

ABSTRACT

The role of intergenerational geographic proximity in individuals’ migration decisions has been well-established. The circumstances under which parents and their adult children move away from or remain close to each other are, however, less clear. Drawing on Norwegian register data for 2014-2016 and three-level logistic regression models, we examine whether formal care needs of older parents (aged ≥65) deter parent-child geographic divergence and whether variation in the likelihood of divergence is associated with municipal-level characteristics. After accounting for location-specific capital and parents’ and children’s sociodemographic characteristics, parents and children were less likely to diverge after the onset of parental care needs. Utilising in-home nursing decreased the likelihood of divergence for mothers while utilising institutionalised care decreased the likelihood of divergence for fathers. The use of in-home nursing care among single mothers further reduced the likelihood of divergence. Parents and adult children living in central areas were the least likely to diverge geographically. The likelihood of intergenerational divergence was lower for fathers and children living in municipalities with high healthcare spending.

PMID:34107444 | DOI:10.1016/j.healthplace.2021.102599