Category: Nevin Manimala

Geriatr Nurs. 2021 Jun 12;42(5):983-992. doi: 10.1016/j.gerinurse.2021.06.003. Online ahead of print.

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused the coronavirus diseases 2019 (COVID-19) pandemic, continues to spread rapidly worldwide and is associated with high rates of mortality among older adults, those with comorbidities, and those in poor physiological states. This paper aimed to systematically identify the impact of frailty on overall mortality among older adults with COVID-19. We conducted a systematic review of the literature indexed in 4 databases. A random-effects model with inverse variance-weighted meta-analysis using the odds ratio was used to study the association of frailty levels with clinical outcomes among older adults with COVID-19. Heterogeneity was measured using the I² statistic and Egger’s test. We identified 22 studies that met our inclusion criteria, including 924,520 total patients. Overall, frailty among older adults was associated with high rates of COVID-19-related mortality compared with non-frail older adults (OR [odds ratio]:5.76; 95% confidence interval [95% CI]: 3.85-8.61, I²: 40.5%). Our results show that physical limitations, such as those associated with frailty among older adults, are associated with higher rates of COVID-19-related mortality.

PMID:34256158 | DOI:10.1016/j.gerinurse.2021.06.003

Geriatr Nurs. 2021 Jun 21;42(5):998-1005. doi: 10.1016/j.gerinurse.2021.06.020. Online ahead of print.

ABSTRACT

The purpose of this study was to examine the mental health of community-dwelling older adults as they adapted their everyday health behaviors during the COVID-19 pandemic. In response to a telephone survey, 126 older adults described perceived changes in physical and mental health, and adaptations in their everyday health behaviors. Descriptive statistics, bivariate correlations, and multiple regressions revealed that participants experienced changes in mental and physical health, reduced health service access, lower social engagement, and increased coping behaviors. Greater negative social impact of the pandemic was associated with higher levels of COVID-19 distress. Reduced mental health was significantly related to reductions in health service access, health changes, and fewer adaptive coping behaviors. Adaptive coping behaviors were helpful, just as reduced health access and social contact added risk for mental health problems. Suggestions were provided for alleviating mental health needs by increasing social contact and engaging in adaptive coping behaviors.

PMID:34256160 | DOI:10.1016/j.gerinurse.2021.06.020

J Vasc Interv Radiol. 2021 Jul 10:S1051-0443(21)01199-4. doi: 10.1016/j.jvir.2021.06.019. Online ahead of print.

ABSTRACT

PURPOSE: To review and compare outcomes of prostatic artery embolization (PAE) with three other minimally-invasive surgical treatments for benign prostatic hyperplasia (BPH), including photo selective vaporization (PVP), prostatic urethral lift (PUL), and water vapor thermal therapy (WV) for the treatment of benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS: A literature review identified 35 publications, which included 2653 patients (studies, patients): PVP (13, 949), PUL (9, 577), WV (3, 330), PAE (10, 728). International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and Quality of Life (QOL) were recorded at baseline, 6, and 12 months. Meta-analyses, pooling the standardized mean difference between pre and post-treatment scores, were conducted for each modality and time-point to assess the magnitude of a therapy’s effect to yield Pooled Effect Sizes. A negative score indicates IPSS and QOL improvement. A positive score indicates IIEF-5 improvement.

RESULTS: At 6 and 12 months, IPSS and QOL were most improved after PVP, then PAE, PUL, and lastly WV (measured only at 12 months). Between 6 and 12 months, IPSS and QOL improved with PAE, and worsened with PVP and PUL. Only PAE demonstrated statistical improvement of IIEF-5, which improved from 6 to 12 months.

CONCLUSION: PVP and PAE resulted in the largest improvements in IPSS and QOL. Only PAE resulted in improvement of IIEF-5.

PMID:34256123 | DOI:10.1016/j.jvir.2021.06.019

WMJ. 2021 Jul;120(2):152-155.

ABSTRACT

BACKGROUND: The objective of this study was to determine the associations between heart disease, obesity, and demographic factors and increased COVID-19 mortality.

METHODS: We extracted deidentified patient-level data from the Froedtert Health System and Children’s Hospital of Wisconsin and used descriptive statistics and multivariable logistic regression to characterize relationships between heart disease, obesity, age group, sex, race and ethnicity and mortality following COVID-19 diagnosis.

RESULTS: We found heart disease (adjusted odds ratio [AOR] 2.85; 95% CI, 2.11-8.83) and other demographic factors are significant predictors of increased mortality in COVID-19 patients. However, obesity was not a significant predictor of mortality (AOR 1.04; 95% CI, 0.53- 3.10).

DISCUSSION: These unique results indicate some comorbid conditions and patient demographics contribute more strongly to mortality in COVID-19 patients.

PMID:34255958

Eur J Neurol. 2021 Jul 13. doi: 10.1111/ene.15025. Online ahead of print.

ABSTRACT

BACKGROUND: Although body weight variability has been associated with mortality, cardiovascular disease, and dementia, the relationship between body weight variability and Parkinson’s disease (PD) has been rarely studied. We aimed to investigate the longitudinal association between body weight variability and PD incidence.

METHODS: A nationwide population-based, cohort study was conducted using the database from the Health Insurance Review and Assessment Service of the whole Korean population. We analyzed 2,815,135 participants (≥ 40 years old, mean age 51.7 (8.6) years, 66.8% men) without a previous PD diagnosis. We determined individual body weight variability from baseline weight and follow-up visits. We used Cox proportional hazards regression models.

RESULTS: The highest quartile group was associated with increased PD incidence compared with the lowest quartile group after adjustment for confounding factors (hazard ratio (HR), 1.18; 95% confidence interval (CI): 1.08-1.29). In contrast, baseline body mass index, baseline waist circumference, and waist circumference variability were not associated with increased PD incidence. In the body weight loss group, individuals within the quartile of the highest variation in body weight showed a higher HR of PD risk than those within other quartiles (HR, 1.41; 95% CI: 1.18-1.68).

CONCLUSION: Body weight variability, especially weight loss, was associated with higher PD incidence. This finding has important implications for clinicians and supports the need for preventative measures and surveillance for PD in individuals with fluctuating body weight.

PMID:34255908 | DOI:10.1111/ene.15025

Clin Psychol Psychother. 2021 Jul 13. doi: 10.1002/cpp.2644. Online ahead of print.

ABSTRACT

OBJECTIVE: COVID-19 pandemic has been a stressful condition. We explored life changes and health-related consequences of COVID-19 outbreak in Italian health care workers in comparison to the general population.

METHODS: A total of 593 subjects participated to the online CoRonavIruS Health Impact Survey. Life events and changes, physical health, and worries were evaluated referring to 2-week prior the survey. Mood states and daily behavior were retrospectively evaluated referring to 3-month before COVID-19 (T1) and 2-week prior the survey (T2). Student t-test, Mann-Whitney test, and multivariate logistic regression analyses were run.

RESULTS: Five hundred and twenty-one subjects were analyzed (healthcare workers: n= 163, 31.84%; general population: n = 349, 68.16%). Healthcare workers were more likely to report fatigue and have spent more time outside home during the 2-week prior the survey than the general population (x² (df)=266.03(17), p<0.001, R2=0.57). From T1 to T2, healthcare workers had a significant increase in negative mood, worry, restlessness, loneliness, and a decrease in happiness, while subjects from the general population had a statistically significant increase in negative mood, worry, attention, concentration difficulties, and a decrease in happiness, pleasure related to daily activities, time spent outdoors, alcohol use.

CONCLUSION: In the framework of a growing literature on health care workers’ status during the COVID-19 pandemic, the present study allowed to identify fatigue and loneliness as psychosomatic modifiable variables in need of being monitored and, possibly managed, to ameliorate the health status of health care workers.

PMID:34255890 | DOI:10.1002/cpp.2644

Acta Obstet Gynecol Scand. 2021 Jul 13. doi: 10.1111/aogs.14231. Online ahead of print.

ABSTRACT

INTRODUCTION: Previous evidence has been conflicting regarding the effect of Covid-19 pandemic lockdowns on obstetric intervention and preterm birth rates. The literature to date suggests potentially differential underlying mechanisms based on country economic setting. We aimed to study these outcomes in an Icelandic population where uniform lockdown measures were implemented across the country.

MATERIAL AND METHODS: The study included all singleton births (n=20,680) during 2016-2020 identified from the population-based Icelandic Medical Birth Register. We defined two lockdown periods during March-May and October-December in 2020 according to government implemented nationwide lockdown. We compared monthly rates of cesarean section, induction of labor and preterm birth during lockdown with the same time periods in the four years prior (2016-2019) using logit binomial regression adjusted for confounders.

RESULTS: Our results indicated a reduction in the overall cesarean section rate, which was mainly evident for elective cesarean section, both during the first (adjusted odd ratio (AOR) 0.71, 95% CI 0.51-0.99) and second (AOR 0.72, 95% CI 0.52-0.99) lockdown periods, and not for emergency cesarean section. No change during lockdown was observed in induction of labor. Our results also suggested a reduction in the overall preterm birth rate during the first lockdown (AOR 0.69, 95% CI 0.49-0.97) and in the months immediately following the lockdown (June-September) (AOR 0.67, 95% CI 0.49-0.89). The reduction during the first lockdown was mainly evident for medically indicated preterm birth (although not statistically significant) and the reduction during June-September was mainly evident for spontaneous preterm birth.

CONCLUSIONS: This study suggested a reduction in elective cesarean section during Covid-19 lockdown, possibly reflecting changes in prioritization of nonurgent health care during lockdown. We also found a reduction in overall preterm birth during the first lockdown and spontaneous preterm birth following the first lockdown, but further research is needed to shed light on the underlying mechanisms for these findings.

PMID:34255860 | DOI:10.1111/aogs.14231

Genet Epidemiol. 2021 Jul 13. doi: 10.1002/gepi.22425. Online ahead of print.

ABSTRACT

Transcriptome-wide association studies (TWAS) that integrate transcriptomic reference data and genome-wide association studies (GWAS) have successfully enhanced the discovery of candidate genes for many complex traits. However, existing methods may suffer from substantial power loss because they fail to effectively consider that expression of many genes tends to be consistent across tissues. Here we propose a computationally efficient testing method, referred to as Integrative Test for Associations via Cauchy Transformation (InTACT), that effectively combines information across multiple tissues and thus improves the power of identifying associated genes. Through simulation studies, we show that InTACT maintains high power while properly controls for Type 1 error rates. We applied InTACT to the largest GWAS of Alzheimer’s disease (AD) to date and identified 227 genome-wide significant genes, of which 130 were not identified by benchmark methods, TWAS and MultiXcan. Importantly, InTACT identified five novel loci for AD. We implemented InTACT in publicly available software, “InTACT.”

PMID:34255882 | DOI:10.1002/gepi.22425

Bioinformatics. 2021 Jul 13:btab495. doi: 10.1093/bioinformatics/btab495. Online ahead of print.

ABSTRACT

MOTIVATION: Log rank test is a widely used test that serves to assess the statistical significance of observed differences in survival, when comparing two or more groups. The log rank test is based on several assumptions that support the validity of the calculations. It is naturally assumed, implicitly, that no errors occur in the labeling of the samples. That is – that the mapping between samples and groups is perfectly correct. In this work we investigate how test results may be affected when considering some errors in the original labeling.

RESULTS: We introduce and define the uncertainty that arises from labeling errors in log rank test. In order to deal with this uncertainty, we develop a novel algorithm for efficiently calculating a stability interval around the original log rank p-value and prove its correctness. We demonstrate our algorithm on several datasets.

AVAILABILITY: We provide a Python implementation, called LoRSI, for calculating the stability interval using our algorithm. https://github.com/YakhiniGroup/LoRSI.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:34255820 | DOI:10.1093/bioinformatics/btab495

J Clin Endocrinol Metab. 2021 Jul 13:dgab516. doi: 10.1210/clinem/dgab516. Online ahead of print.

ABSTRACT

CONTEXT: Recent studies emphasize the importance of considering the metabolic status to develop personalized medicine approaches. This is especially relevant in prostate cancer (PCa), wherein the diagnostic capability of PSA dramatically drops when considering patients with PSA levels ranging 3-10 ng/mL, the so-called “grey-zone”. Hence, additional non-invasive diagnostic and/or prognostic PCa biomarkers are urgently needed, especially in the metabolic-status context.

OBJECTIVE: To assess the potential relation of urine In1-ghrelin (a ghrelin splicing variant) levels with metabolic-related/pathological conditions (e.g. obesity/diabetes/BMI/insulin-glucose levels), and to define its potential clinical value in PCa (diagnostic/prognostic capacity) and relationship with PCa-risk in patients with PSA in the grey-zone.

METHODS: Urine In1-ghrelin levels were measured by radioimmunoassay in a clinically/metabolically/pathologically well-characterized cohort of patients without (n=397) or with (n=213) PCa with PSA in the grey-zone.

RESULTS: Key obesity-related factors associated with PCa-risk (BMI/diabetes/glucose/insulin) were strongly correlated to In1-ghrelin levels. Importantly, In1-ghrelin levels were higher in PCa patients compared to control patients (with suspect of PCa but negative-biopsy). Moreover, high In1-ghrelin levels were associated with increased PCa-risk and linked to PCa-aggressiveness (e.g. tumour-stage/lymphovascular-invasion). In1-ghrelin levels added significant diagnostic value to a clinical model consisting of age, suspicious-DRE, previous-biopsy, and PSA levels. Furthermore, a multivariate model consisting of clinical and metabolic variables, including In1-ghrelin levels, showed high specificity and sensitivity to diagnose PCa (AUC=0.740).

CONCLUSIONS: Urine In1-ghrelin levels are associated with obesity-related factors and PCa risk/aggressiveness, and could represent a novel and valuable non-invasive PCa biomarker, as well as a potential link in the pathophysiological relationship between obesity and PCa.

PMID:34255835 | DOI:10.1210/clinem/dgab516