Category: Nevin Manimala

Clin Cardiol. 2021 Aug 6. doi: 10.1002/clc.23708. Online ahead of print.

ABSTRACT

BACKGROUND: Recent reports have indicated the beneficial role of strain measurement in COVID-19 patients.

HYPOTHESIS: To determine the association between right and left global longitudinal strain (RVGLS, LVGLS) and COVID-19 patients’ outcomes.

METHODS: Hospitalized COVID-19 patients between June and August 2020 were included. Two-dimensional echocardiography and biventricular global longitudinal strain measurement were performed. The outcome measure was defined as mortality, ICU admission, and need for intubation. Appropriate statistical tests were used to compare different groups.

RESULTS: In this study 207 patients (88 females) were enrolled. During 64 ± 4 days of follow-up, 22 (10.6%) patients died. Mortality, ICU admission, and intubation were significantly associated with LVGLS and RVGLS tertiles. LVGLS tertiles could predict poor outcome with significant odds ratios in the total population (OR = 0.203, 95% CI: 0.088-0.465; OR = 0.350, 95% CI: 0.210-0.585; OR = 0.354, 95% CI: 0.170-0.736 for mortality, ICU admission, and intubation). Although odds ratios of LVGLS for the prediction of outcome were statistically significant among hypertensive patients, these odds ratios did not reach significance among non-hypertensive patients. RVGLS tertiles revealed significant odds ratios for the prediction of mortality (OR = 0.322, 95% CI: 0.162-0.640), ICU admission (OR = 0.287, 95% CI: 0.166-0.495), and need for intubation (OR = 0.360, 95% CI: 0.174-0.744). Odds ratios of RVGLS remained significant even after adjusting for hypertension when considering mortality and ICU admission.

CONCLUSION: RVGLS and LVGLS can be acceptable prognostic factors to predict mortality, ICU admission, and intubation in hospitalized COVID-19 patients. However, RVGLS seems more reliable, as it is not confounded by hypertension.

PMID:34355809 | DOI:10.1002/clc.23708

Echocardiography. 2021 Aug 6. doi: 10.1111/echo.15175. Online ahead of print.

ABSTRACT

BACKGROUND: The evaluation of the tricuspid annular plane systolic excursion (TAPSE) is recommended to assess the right ventricular (RV) systolic function. We performed an updated meta-analysis of the association between TAPSE and short-term mortality in COVID-19 patients.

METHODS: MEDLINE and Scopus databases were searched to locate all the articles published up to May 1, 2021, reporting data on TAPSE among COVID-19 survivors and non-survivors. The difference of TAPSE between the two groups was expressed as mean difference (MD) with the corresponding 95% confidence interval (CI) using the Mantel-Haenszel random effects model. Both Q value and I² statistics were used to assess heterogeneity across studies. Sensitivity analysis, meta-regression, and evaluation of bias were performed.

RESULTS: Twelve studies, enrolling 1272 COVID-19 patients (778 males, mean age 69.3 years), met the inclusion criteria and were included in the final analysis. Non-survivors had a lower TAPSE compared to survivors (MD = -3.089 mm, 95% CI = -4.087 to -2.091, p < 0.0001, I² = 79.0%). Both the visual inspection of the funnel plot and the Egger’s tests (t = 1.195, p = 0.259) revealed no evidence of publication bias. Sensitivity analysis confirmed yielded results. Meta-regression analysis evidenced that the difference in TAPSE between the two groups was only influenced by pre-existing chronic obstructive pulmonary disease (COPD, p = 0.02).

CONCLUSION: COVID-19 non-survivors have a lower TAPSE when compared to survivors, especially in COPD subjects. Current data suggest that the TAPSE assessment may provide useful information regarding the short-term prognosis of COVID-19 patients during the infection.

PMID:34355816 | DOI:10.1111/echo.15175

Cardiol J. 2021 Aug 6. doi: 10.5603/CJ.a2021.0083. Online ahead of print.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is the leading cause of stroke. The European Society of Cardiology (ESC) advises opportunistic AF screening among patients aged ≥ 65 years. Considering this, the aim herein, was compare the feasibility of two different systems of smartphone-based electrocardiogram (ECG) recordings to identify AF among those without a previous arrhythmia history.

METHODS: Prospective AF screening was conducted at six pharmacies using Kardia Mobile and Hartmann Veroval 2 in 1. A single-lead ECG was acquired by the placement of fingers on the pads. A cardiologist evaluated findings from both devices.

RESULTS: Atrial fibrillation was identified in 3.60% and previously unknown AF was detected in 1.92% of the study participants. Sensitivity and specificity of the Kardia application in detecting AF were 66.7% (95% confidence interval [CI] 38.4-88.2%) and 98.5% (95% CI 96.7-99.5%), and for Veroval 10.0% (95% CI 0.23-44.5%) and 94.96% (95% CI 92.15-96.98%), accordingly. Inter-rater agreement was k = 0.088 (95% CI 1.59-16.1%).

CONCLUSIONS: Mobile devices can detect AF, but each finding must be verified by a professional. The Kardia application appeared to be more user-friendly than Veroval. Cardiovascular screening using mobile devices is feasible at pharmacies. Hence it might be considered for routine use.

PMID:34355779 | DOI:10.5603/CJ.a2021.0083

Folia Morphol (Warsz). 2021 Aug 6. doi: 10.5603/FM.a2021.0075. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the relationship between the horizontal condylar angle (HCA), temporomandibular joint osteoarthritis (TMJ OA), and condylar position on cone-beam computed tomography (CBCT) images.

MATERIALS AND METHODS: Based on TMJ OA, joints were classified as affected and the unaffected. According to the OA condition of their joints, three groups of patients were formed: control group (n = 159, 41.1%), unilateral group (n = 121, 31.3%), and bilateral group (n = 107, 27.6%). In total, the HCAs of 774 TMJs of 387 patients were measured and their condylar positions were determined as concentric (n = 184, 23.8%), posterior (n = 338, 43.7%), and anterior (n = 252, 32.5%).

RESULTS: The mean HCA of the bilateral group (22.7° ± 7.6°) was greater than those in both the control (19.5° ± 6.4°) and the unilateral (20.5° ± 6.5°) groups (p < 0.05). However, the difference was not statistically significant between the control and unilateral group (p > 0.05). In total patients, unlike the unilateral group, the affected joints had a greater mean HCA than the unaffected joints (p < 0.05). The mean HCAs of the joints according to the condylar position were as concentric: 20.6° ± 6.7°, posterior: 21.1° ± 7.8°, and anterior: 20.2° ± 7.9° (p > 0.05).

CONCLUSIONS: While the HCA increased in the presence of TMJ OA, no relationship was found between HCA and three different condylar positions.

PMID:34355786 | DOI:10.5603/FM.a2021.0075

Folia Morphol (Warsz). 2021 Aug 6. doi: 10.5603/FM.a2021.0074. Online ahead of print.

ABSTRACT

BACKGROUND: Bone wax, a hemostatic agent, is widely used in craniospinal surgical procedures for a long time, inspite of controversial results regarding its negative influence upon bone regeneration. In this experimental study, the effects of Ankaferd Blood Stopper (ABS), as an alternative hemostatic agent, were evaluated through histochemical, immunohistochemical and scintigraphic studies.

MATERIALS AND METHODS: The total of 30 adult female Wistar-Albino rats was randomly divided into three groups: intact control group (n=10), bone wax group (n=10), and ABS group (n=10). Surgically, a 3.0 mm hole in diameter was drilled on the right side of calvarium of the rats using a Class Mini Grinder set in all three groups, as described previously. At the end of 8 weeks, bone healing and connective tissue alterations surrounding drilled calvarial defect areas of the rats were determined via Hematoxylin and Eosin (H&E) and the Mallory’s trichrome staining and anti-bone sialoprotein (BSP) immunohistochemistry. Image Pro Express 4.5 program was used for histomorphometric calculation of new bone and fibrotic tissue areas. All statistical analyzes were made with SPSS 25.0 and analysis of variance (one-way ANOVA) followed by Bonferroni post hoc test was performed, p<0.001 was considered as significance level.

RESULTS: Histomorphometrically, it was found that he had the largest hole diameter and the least fibrotic scar area in the bone-wax group. In the bone wax group, it was observed that the material closed the hole and there was only a fibrotic scar tissue in the area between the bone tissue at the edge of the hole and bone wax, and a fibrotic tissue was formed in the bone wax area. During the histological procedure, this bone-wax material was poured and the sections were seen as a gap in this area. In the ABS hemostat group, the smallest hole diameter and the least fibrotic scar tissue were observed. Fibrotic scar tissue close to each other was found in the ABS hemostat and bone wax groups. Histological analysis of samples also showed a statistical significance for fibrotic connective tissue area between groups (p <0.05). Scintigraphically, osteoblastic activity related to blood flow in the animal taken from the group with application of ABS hemostat was more pronounced compared to the other two groups.

CONCLUSIONS: In our study, it has been concluded that the ABS yields affirmative effects on the bone healing, while bone wax leads to negative impact on the bone regeneration. Scintigraphic, histochemical and immunohistochemical data support the affirmative impact of the ABS hemostat application upon the bone regeneration apart from the quick stop of hemorrhage.

PMID:34355787 | DOI:10.5603/FM.a2021.0074

Clin Chem. 2021 Aug 6:hvab115. doi: 10.1093/clinchem/hvab115. Online ahead of print.

ABSTRACT

BACKGROUND: Patient-based real-time quality control (PBRTQC) has gained increasing attention in the field of clinical laboratory management in recent years. Despite the many upsides that PBRTQC brings to the laboratory management system, it has been questioned for its performance and practical applicability for some analytes. This study introduces an extended method, regression-adjusted real-time quality control (RARTQC), to improve the performance of real-time quality control protocols.

METHODS: In contrast to the PBRTQC, RARTQC has an additional regression adjustment step before using a common statistical process control algorithm, such as the moving average, to decide whether an analytical error exists. We used all patient test results of 4 analytes in 2019 from Zhongshan Hospital, Fudan University, to compare the performance of the 2 frameworks. Three types of analytical error were added in the study to compare the performance of PBRTQC and RARTQC protocols: constant, random, and proportional errors. The false alarm rate and error detection charts were used to assess the protocols.

RESULTS: The study showed that RARTQC outperformed PBRTQC. RARTQC, compared with the PBRTQC, improved the trimmed average number of patients affected before detection (tANPed) at total allowable error by about 50% for both constant and proportional errors.

CONCLUSIONS: The regression step in the RARTQC framework removes autocorrelation in the test results, allows researchers to add additional variables, and improves data transformation. RARTQC is a powerful framework for real-time quality control research.

PMID:34355737 | DOI:10.1093/clinchem/hvab115

Int J Neuropsychopharmacol. 2021 Aug 6:pyab054. doi: 10.1093/ijnp/pyab054. Online ahead of print.

ABSTRACT

BACKGROUND: High placebo response in ADHD can reduce medication-placebo differences, jeopardizing the development of new medicines. This research aims to 1) determine placebo response in ADHD, 2) compare the accuracy of meta-regression and MetaForest in predicting placebo response, and 3) determine the covariates associated with placebo response.

METHODS: A systematic review with meta-analysis (SRMA) of RPCCTs investigating pharmacological interventions for ADHD was performed. Placebo response was defined as the change from baseline in ADHD symptom severity assessed according to the 18-item, clinician-rated, DSM-based rating scale. The effect of study design-, intervention- and patient-related covariates in predicting placebo response was studied by means of meta-regression and MetaForest.

RESULTS: Ninety-four studies including 6,614 patients randomized to placebo were analysed. Overall, placebo response was -8.9 points, representing a 23.1% reduction in the severity of ADHD symptoms. Cross-validated accuracy metrics for meta-regression were R 2 = 0.0012 and RMSE = 3.3219 for meta-regression and 0.0382 and 3.2599 for MetaForest. Placebo response amongst ADHD patients increased by 63% between 2001 and 2020 and was larger in the US than in other regions of the world.

CONCLUSIONS: Strong placebo response was found in ADHD patients. Both meta-regression and MetaForest showed poor performance in predicting placebo response. ADHD symptom improvement with placebo has markedly increased over the last two decades and is grater in the US than the rest of the world.

PMID:34355753 | DOI:10.1093/ijnp/pyab054

Cranio. 2021 Aug 6:1-12. doi: 10.1080/08869634.2021.1964052. Online ahead of print.

ABSTRACT

Objective: To discover the extent of the connection between occlusal plane asymmetry and the rest tone of the four muscle groups of the orofacial region with temporomandibular joint pathology.Methods: Eighty-seven subjects were divided into two groups. The following methods were applied: clinical examination, roentgenological examination, and electromyography. Data were evaluated and statistically analyzed.Results: The variability of occlusal plane inclination in relation to the porion plane was 0-4.6º.The tonus of masseter muscle was higher in the experimental group: 1.45 mV more than in the control group: 1.23 mV (p < 0.05).Conclusion: Asymmetry of the occlusal plane inclination was found for nearly all subjects in both groups. It can be compensated for by adaptation mechanisms and does not cause temporomandibular joint disorders. Undertaken research shows the existence of a proven correlation between TMJ disorders and the resting tonus of the masseter muscle.

PMID:34355675 | DOI:10.1080/08869634.2021.1964052

Curr Pharm Des. 2021 May 21. doi: 10.2174/1381612827666210521132737. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to assess the relationship between different dialysis modalities and depression in end-stage renal disease (ESRD) patients.

METHODS: We searched through the PsycINFO, PubMed, Cochrane Library, EMBASE and CNKI for all related studies from 1 January 1990 till 30 June 2019 without restriction on language. We selected papers that compared the depression levels among patients undergoing hemodialysis and peritoneal dialysis. Two authors independently selected studies, evaluated the quality of included studies, and extracted data according to Newcastle-Ottawa Scale (NOS). A discussion with a third author checked any disagreement to minimize the publication bias. PRISMA guidelines were used as the standards of reporting (PRISMA registration ID is 239172).

RESULTS: There was not enough evidence to prove the relationship between different dialysis modalities and depression (OR: 2.37, 95%CI: 0.88-6.40). We also found no statistical significance between the mean difference of depression level and dialysis modalities (Std mean difference=0.69, 95%CI: -2.09–3.46).

CONCLUSION: The available limited, deficient quality evidence assessed by ROBINS-I does not support an association between depression and dialysis modalities among ESRD patients. Further studies that provide data for different sex and age groups are needed to clarify whether a subgroup of dialysis modalities has a different risk of depression.

PMID:34355679 | DOI:10.2174/1381612827666210521132737

J Interprof Care. 2021 Aug 6:1-8. doi: 10.1080/13561820.2021.1951188. Online ahead of print.

ABSTRACT

This study aimed to develop a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC), which consists of six domains: Patient-/Client-/Family-/Community-Centered, Interprofessional Communication, Role Contribution, Facilitation Relationship, Reflection, and Understanding of Others. Validity of JASSIC was confirmed through a four-step process consisting of expert discussion, cognitive debriefing, feasibility, and statistical analysis. Confirmatory factor analysis (CFA) was performed by testing the correlation between the sum scores of JASSIC and the Assessment of Interprofessional Team Collaboration Scale-II(AITCS-II). First, 24 items were created through discussions among physicians, a nurse, a medical educator, and an information sociologist. Second, the items were modified by cognitive debriefing of a physician, nurse, pharmacist, occupational therapist, and social worker. Third, we provided the developed JASSIC for professionals at Hospital X (n = 139) and revised the wording and composition of the items. Finally, CFA among professionals at Hospital Y (n = 153) identified a 6-domain structure (GFI: 0.847, AGFI: 0.782, RMSEA: 0.088). Cronbach’s alpha was 0.92, and the correlation coefficient with AITCS-II was 0.72. Ongoing research into JASSIC will promote effective interprofessional collaborative practice not only in Japan but also other countries which share a similar culture and system.

PMID:34355655 | DOI:10.1080/13561820.2021.1951188