Category: Nevin Manimala

Clin Lab. 2022 Mar 1;68(3). doi: 10.7754/Clin.Lab.2021.210421.

ABSTRACT

BACKGROUND: Over past decades, the instability of parathyroid hormone (PTH) causes great interference for the clinical laboratory. Contradictory results were reported in many reports about storage conditions and suitable blood collection tubes to ensure PTH stability in the pretreatment phase.

METHODS: This study recruited 30 participants including 10 healthy persons, 10 hemodialysis, and 10 hyperparathyroidism patients. Five types of blood collection tubes (EDTA-K3 tube, coagulant tube, heparin anticoagulant tube, gel separating tube, and plain tube) were included to determine whether they were suitable as blood-collecting vessels. The time points and conditions for testing samples included less than 2 hours, 4 hours, and 8 hours at room temperature, and, in parallel, 24 hours, 48 hours, and 72 hours in refrigeration. Two different judgement criteria were used to compare the stability of PTH in different blood vessels.

RESULTS: Purely statistical analysis showed that 4 types of blood collection tubes could not perform the same storage ability as EDTA-K3 tube at “T0” time point. Plain tube had the largest drop among all types of blood collection tubes. Compared by pairwise t-test, EDTA-K3 tube could maintain intact PTH for 8 hours (p = 0.998) at room temperature and 24 hours (p = 0.053) in refrigeration. When comparing the total change limit (TCL = 18.8%), at room temperature, EDTA-K3 tube (7.0%), heparin tube (12.7%), coagulant tube (16.2%), and plain tube (17.6%) could maintain intact PTH for 8 hours, and GST can preserve PTH for 4 hours (18.2%). In refrigeration, EDTA-K3 tube could maintain PTH for 72 hours (7.5%) and heparin tube could maintain 24 hours (18.4%). The other three blood collection tubes could not preserve PTH in refrigeration (GST = 22.1%, coagulant tube = 20.3%, plain tube = 20.8%).

CONCLUSIONS: PTH seems more stable in the EDTA-K3 tube than any other blood collection tubes and is followed next by the heparin anticoagulant tube. Plain tube and GST have faster degradation than other tubes and are not suggested to preserve intact PTH.

PMID:35254038 | DOI:10.7754/Clin.Lab.2021.210421

Clin Lab. 2022 Mar 1;68(3). doi: 10.7754/Clin.Lab.2021.210616.

ABSTRACT

BACKGROUND: We aimed to compare the level of hepatic FIB-4 scores between COVID-19 patients who had pneumonia and COVID-19 patients who had no pneumonia in an attempt to develop a risk assessment after the treatment and recovery of active COVID-19 infection.

METHODS: The study included 80 patients who were consecutively selected and admitted to an internal medicine outpatient clinic for a control examination after COVID-19 infection. Chest tomography was performed on all patients during the COVID-19 infection. Patients were divided into two groups as those with and without lung involvement on CT. COVID-19 infection was diagnosed using real-time reverse transcription-polymerase chain reaction (RT-PCR). The hepatic fibrosis 4 (FIB-4) index score was calculated for each patient. The statistical analyses were performed using Student’s t-test and chi-squared tests.

RESULTS: We found that the increased hepatic FIB-4 index score in patients with pneumonia group was statistically significant compared to the control group (p < 0.001). The regression analysis showed that the hepatic FIB-4 index has significant prognostic efficiencies in both uni- and multivariate models (p < 0.05).

CONCLUSIONS: The hepatic FIB-4 index appears to be a simple parameter with a good prognostic value in patients with COVID-19 infection.

PMID:35254026 | DOI:10.7754/Clin.Lab.2021.210616

Clin Lab. 2022 Mar 1;68(3). doi: 10.7754/Clin.Lab.2021.210639.

ABSTRACT

BACKGROUND: Covid-19 is a pandemic viral infection with high pathogenicity and contagiousness. Our aim is to evaluate the preliminary hematological findings analyzed during admission in order to determine the diagnostic value of hematological parameters in Covid-19 patients and to reveal their relationship with the severity of the disease.

METHODS: Our study includes a total of 169 patients, whose diagnosis was confirmed and 93 of whom were treated in the ward, 76 of whom were treated in the Intensive Care Unit (ICU), and 67 control patients. Neutrophil-to-lymphocyte ratio (NLR), monocyte-lymphocyte (MLR) ratio, platelet-lymphocyte ratio (PLR), mean platelet volume/platelet count ratio (MPV/PLT) data on admission were analyzed retrospectively and compared.

RESULTS: ICU patients had significantly higher values of NLR, MLR, PLR, and MPV/PLT (p < 0.001 for each) but had lower values of lymphocyte count and hemoglobin (p < 0.001 for each) compared to that of ward patients. According to the results of ROC analysis, the diagnostic values of NLR, MLR, PLR, and MPV/PLT parameters were statistically significant (p < 0.05).

CONCLUSIONS: According to the results of our study, abnormal routine peripheral blood examination results were detected in Covid-19 patients. NLR, MLR, and PLR can be considered as independent, reliable biomarkers for assessing disease severity, hospitalization, and clinical classification in Covid-19. Therefore, it was concluded that fast, cost-effective, easily accessible admission hemogram parameters are reasonably important to predict the prognosis of Covid-19 patients.

PMID:35254018 | DOI:10.7754/Clin.Lab.2021.210639

Clin Lab. 2022 Mar 1;68(3). doi: 10.7754/Clin.Lab.2021.210543.

ABSTRACT

BACKGROUND: Vitamin D is known to suppress the release of proinflammatory cytokines, increase the release of anti-inflammatory cytokines, and present an immunomodulatory effect. In light of the foregoing, it is suggested that vitamin D may play an important role in the course of COVID-19 infection. This study, therefore, aimed to examine the relationship between vitamin D levels and length of hospital stay of COVID-19 patients.

METHODS: This retrospective study was conducted between March 15th and October 15th, 2020, among 768 patients who were hospitalized due to the diagnosis of COVID-19 infection confirmed with PCR tests taken at the Health Sciences University, Antalya Training and Research Hospital. The study included 39 patients aged 18 – 65 years, whose 25 (OH) vitamin D levels were examined within 3 months prior to the diagnosis with PCR, and whose results were found ≥ 30 ng/mL, and those patients whose 25 (OH) vitamin D levels were examined within 3 months after the diagnosis with PCR, and whose results were found < 30 ng/mL. The patients were grouped according to 25 (OH) vitamin D levels and evaluated in terms of length of hospital stay.

RESULTS: Of all the 39 patients in this study, 61.5% were female, 38.5% were male, with a mean age of 48.64 ± 11.79 years. The average of 25 (OH) vitamin D levels of the patients was 21.44 ± 11.17 ng/mL, the average length of hospital stay was 9.41 ± 8.90 days. The length of stay was found to increase significantly in participants who were 45 years and older, who were male, those with chronic diseases, and those with lung involvement detected on thoracic CT imaging at the time of admission. No statistically significant difference appeared with respect to the length of hospital stay when the patients were evaluated according to their 25 (OH) vitamin D levels.

CONCLUSIONS: No statistically significant relationship was found between the patients’ length of hospital stay due to the COVID-19 infection and their 25 (OH) vitamin D levels in patients aged 18 – 65 years. Further prospective clinical studies still need to be conducted with large numbers of patients excluding independent risk factors such as the presence of a chronic disease.

PMID:35254024 | DOI:10.7754/Clin.Lab.2021.210543

Chem Rec. 2022 Mar 7:e202100326. doi: 10.1002/tcr.202100326. Online ahead of print.

ABSTRACT

Plastics around the globe have been a matter of grave concern due to the unavoidable habits of human mankind. Taking waste statistics in India for the year 2019-20 into account, the data of 60 major cities show that the generation of plastic waste stands tall at around 26,000 tonnes/day, of which only about 60 % is recycled. A majority of the non-recycled plastic waste is petrochemical-based packaging materials that are non-biodegradable in nature. Vegetative/food waste is another global issue, evidenced by vastly populated countries such as China and India accounting for 91 and 69 tonnes of food wastage, respectively in 2019. The mitigation of plastic packaging issues has led to key scientific developments, one of which is biodegradable materials. However, there is a way that these two waste-related issues can be fronted as the analogy of “taking two shots with the same arrow”. The presence of various bio-compounds such as proteins, cellulose, starch, lipids, and waxes, etc., in food and vegetative waste, creates an opportunity for the development of biodegradable packaging films. Although these flexible packaging films have limitations in terms of mechanical, permeation, and moisture absorption characteristics, they can be fine-tuned in order to convert the biobased raw material into a realizable packaging product. These strategies could work in replacing petrochemical-based non-biodegradable packaging plastics which are used in enormous quantities for various household and commercial packaging applications to combat the ever-increasing pollution in highly populated countries. This paper presents a systematic review based on modern scientific tools of the literature available with a major emphasis on the past decade and aims to serve as a standard resource for the development of biodegradable packaging films from food/vegetative waste.

PMID:35253984 | DOI:10.1002/tcr.202100326

Clin Lab. 2022 Mar 1;68(3). doi: 10.7754/Clin.Lab.2021.210806.

ABSTRACT

BACKGROUND: Acute myocardial infarction is one of the leading causes of morbidity and mortality worldwide. Eotaxin-1, an eosinophil-specific chemoattractant, has been shown to be overexpressed in human atherosclerotic lesions. Eotaxin-1 levels are higher in coronary artery disease patients than in healthy individuals. In this study, we aimed to determine the eotaxin-1 concentrations of patients with myocardial infarction and to investigate the role of eotaxin-1 in myocardial infarction.

METHODS: The study included 42 patients diagnosed with AMI (patients with suspected AMI based on history, physical examination, ECG, and biochemical markers and confirmed by angiography) and 40 healthy controls. Plasma eotaxin-1 levels were determined by enzyme-linked immunosorbent assay (ELISA).

RESULTS: Eotaxin-1, troponin-I, CK, and CKMB levels were statistically higher in the patient group than in the control group. ROC analysis demonstrated that eotaxin-1 gave a sensitivity of 93% and a specificity of 48% once the cutoff value was 341.6 pg/mL. Additionally, the ROC analysis showed that troponin I yielded a specificity of 100% and a sensitivity of 91% when the cutoff value was 0.025 µg/L.

CONCLUSIONS: Eotaxin-1/eosinophils appear to have a role in coronary artery disease independent of known risk factors. Accordingly, this study and recent studies suggest that eotaxin-1 may be useful in the diagnosis of AMI in addition to other cardiac markers.

PMID:35254015 | DOI:10.7754/Clin.Lab.2021.210806

J Cosmet Dermatol. 2022 Mar 7. doi: 10.1111/jocd.14901. Online ahead of print.

ABSTRACT

Hirsutism is associated with other androgen- dependent signs/symptoms. This study was designed with the aim of a comprehensive investigation of laboratory and ultrasonographic findings in hirsute women and their probable association with the “severity” of the disease. This cross-sectional study included 123 hirsute women. Comprehensive medical history of each patient was recorded and a broad physical examination was performed by a single dermatologist. Ferriman-Gallwey score was used to evaluate the hirsutism severity. Pelvic ultrasonography was done by a single radiologist for each patient and serum levels of the follicular stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH ratio, prolactin, thyroid-stimulating hormone , total testosterone, dehydroepiandrosterone sulfate, 17-alpha-hydroxyprogesterone, and cortisol were measured. The association of hirsutism severity and these paraclinical parameters was investigated. A statistically significant association was observed between polycystic ovary disease (PCOD) and the severity of hirsutism. A past medical history of PCOD was found to cause more severe forms of hirsutism in the involved patients, as well. The presence of hormonal abnormalities was also significantly associated with the severity of hirsutism. More than half of the hirsute patients have endocrine abnormalities and/or PCOD. These two disorders are associated with the severity of hirsutism.

PMID:35253960 | DOI:10.1111/jocd.14901

Cochrane Database Syst Rev. 2022 Mar 7;3:CD012892. doi: 10.1002/14651858.CD012892.pub2.

ABSTRACT

BACKGROUND: The demand for residential aged care is increasing due to the ageing population. Optimising the design or adapting the physical environment of residential aged care facilities has the potential to influence quality of life, mood and function.

OBJECTIVES: To assess the effects of changes to the physical environment, which include alternative models of residential aged care such as a ‘home-like’ model of care (where residents live in small living units) on quality of life, behaviour, mood and depression and function in older people living in residential aged care.

SEARCH METHODS: CENTRAL, MEDLINE, Embase, six other databases and two trial registries were searched on 11 February 2021. Reference lists and grey literature sources were also searched.

SELECTION CRITERIA: Non-randomised trials, repeated measures or interrupted time series studies and controlled before-after studies with a comparison group were included. Interventions which had modified the physical design of a care home or built a care home with an alternative model of residential aged care (including design alterations) in order to enhance the environment to promote independence and well-being were included. Studies which examined quality of life or outcomes related to quality of life were included. Two reviewers independently assessed the abstracts identified in the search and the full texts of all retrieved studies.

DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data, assessed the risk of bias in each included study and evaluated the certainty of evidence according to GRADE criteria. Where possible, data were represented in forest plots and pooled.

MAIN RESULTS: Twenty studies were included with 77,265 participants, although one large study included the majority of participants (n = 74,449). The main comparison was home-like models of care incorporating changes to the scale of the building which limit the capacity of the living units to smaller numbers of residents and encourage the participation of residents with domestic activities and a person-centred care approach, compared to traditional designs which may include larger-scale buildings with a larger number of residents, hospital-like features such as nurses’ stations, traditional hierarchical organisational structures and design which prioritises safety. Six controlled before-after studies compared the home-like model and the traditional environment (75,074 participants), but one controlled before-after study included 74,449 of the participants (estimated on weighting). It is uncertain whether home-like models improve health-related quality of life, behaviour, mood and depression, function or serious adverse effects compared to traditional designs because the certainty of the evidence is very low. The certainty of the evidence was downgraded from low-certainty to very low-certainty for all outcomes due to very serious concerns due to risk of bias, and also serious concerns due to imprecision for outcomes with more than 400 participants. One controlled before-after study examined the effect of home-like models on quality of life. The author stated “No statistically significant differences were observed between the intervention and control groups.” Three studies reported on global behaviour (N = 257). One study found little or no difference in global behaviour change at six months using the Neuropsychiatric Inventory where lower scores indicate fewer behavioural symptoms (mean difference (MD) -0.04 (95% confidence interval (CI) -0.13 to 0.04, n = 164)), and two additional studies (N = 93) examined global behaviour, but these were unsuitable for determining a summary effect estimate. Two controlled before-after studies examined the effect of home-like models of care compared to traditional design on depression. After 18 months, one study (n = 242) reported an increase in the rate of depressive symptoms (rate ratio 1.15 (95% CI 1.02 to 1.29)), but the effect of home-like models of care on the probability of no depressive symptoms was uncertain (odds ratio 0.36 (95% CI 0.12 to 1.07)). One study (n = 164) reported little or no difference in depressive symptoms at six months using the Revised Memory and Behaviour Problems Checklist where lower scores indicate fewer depressive symptoms (MD 0.01 (95% CI -0.12 to 0.14)). Four controlled before-after studies examined function. One study (n = 242) reported little or no difference in function over 18 months using the Activities of Daily Living long-form scale where lower scores indicate better function (MD -0.09 (95% CI -0.46 to 0.28)), and one study (n = 164) reported better function scores at six months using the Interview for the Deterioration of Daily Living activities in Dementia where lower scores indicate better function (MD -4.37 (95% CI -7.06 to -1.69)). Two additional studies measured function but could not be included in the quantitative analysis. One study examined serious adverse effects (physical restraints), and reported a slight reduction in the important outcome of physical restraint use in a home-like model of care compared to a traditional design (MD between the home-like model of care and traditional design -0.3% (95% CI -0.5% to -0.1%), estimate weighted n = 74,449 participants at enrolment). The remaining studies examined smaller design interventions including refurbishment without changes to the scale of the building, special care units for people with dementia, group living corridors compared to a non-corridor design, lighting interventions, dining area redesign and a garden vignette.

AUTHORS’ CONCLUSIONS: There is currently insufficient evidence on which to draw conclusions about the impact of physical environment design changes for older people living in residential aged care. Outcomes directly associated with the design of the built environment in a supported setting are difficult to isolate from other influences such as health changes of the residents, changes to care practices over time or different staff providing care across shifts. Cluster-randomised trials may be feasible for studies of refurbishment or specific design components within residential aged care. Studies which use a non-randomised design or cluster-randomised trials should consider approaches to reduce risk of bias to improve the certainty of evidence.

PMID:35253911 | DOI:10.1002/14651858.CD012892.pub2

Radiat Prot Dosimetry. 2022 Mar 7:ncac013. doi: 10.1093/rpd/ncac013. Online ahead of print.

ABSTRACT

Irradiated dose to the organs at risk surrounding the paranasal sinuses was compared in cone beam computed tomography (CBCT) and multi spiral computed tomography with respect to the organs’ relative positions to the imaging field. A head and neck Alderson-Rando phantom equipped with thermoluminescence dosemeters pellets was irradiated according to three routine CBCT protocols and one protocol in multi spiral computed tomography. Dose value of organs outside the imaging field as well as those measured dose of organs inside the field were assessed. The highest measured doses were obtained from CT scan for most of the organs investigated in this study, whereas the lowest one was associated with the low-resolution mode of CBCT. Also, statistical analysis showed no significant differences between the dose values of out-of-field organs in all CBCT modes, whereas significant differences were observed between the radiation doses of CT and CBCT modes for all organs at risk inside and outside of the imaging field. CBCT is recommended on the basis of having a lower dose; however, the image qualities were the same in the two employed modalities, so the approach of lower dose can be made.

PMID:35253875 | DOI:10.1093/rpd/ncac013

J Forensic Sci. 2022 Mar 7. doi: 10.1111/1556-4029.15012. Online ahead of print.

ABSTRACT

Silicone casts are widely used by practitioners in the comparative analysis of forensic items. Fractured surfaces carry unique details that can provide accurate quantitative comparisons of forensic fragments. In this study, a statistical analysis comparison protocol was applied to a set of 3D topological images of fractured surface pairs and their replicas to provide confidence in the quantitative statistical comparison between fractured items and their silicone cast replicas. A set of 10 fractured stainless steel samples were fractured from the same metal rod under controlled conditions and were replicated using a standard forensic casting technique. Six 3D topological maps with 50% overlap were acquired for each fractured pair. Spectral analyses were utilized to identify the correlation between topological surface features at different length scales of the surface topology. We selected two frequency bands over the critical wavelength (greater than two-grain diameters) for statistical comparison. Our statistical model utilized a matrix-variate t-distribution that accounts for overlap between images to model match and non-match population densities. A decision rule identified the probability of matched and unmatched pairs of surfaces. The proposed methodology correctly classified the fractured steel surfaces and their replicas with a posterior probability of match exceeding 99.96%. Moreover, the replication technique shows potential in accurately replicating fracture surface topological details with a wavelength greater than 20 μm, which far exceeds the feature comparison range on most metallic alloy surfaces. Our framework establishes the basis and limits for forensic comparison of fractured articles and their replicas while providing a reliable fracture mechanics-based quantitative statistical forensic comparison.

PMID:35253897 | DOI:10.1111/1556-4029.15012