Category: Nevin Manimala

Psychiatr Danub. 2021 Dec;33(Suppl 11):100-115.

ABSTRACT

BACKGROUND: Intra-operative anxiety is a commonly experienced feeling amongst patients undergoing surgery. Moreover, conscious patients are exposed to the multiple environmental factors triggering this emotion. Apprehension and fear are common emotions interlinked with associated intra-operative anxiety. Several concerning complications are associated with this emotion during surgery, many of which include severe cardiac related events, such as heart failure and acute myocardial infarction, extreme postoperative pain, increased requirement of analgesic, sedation and anaesthetic demand, extended hospital stay, and reduced patient satisfaction. In this review, the effect of intra-operative music therapy to alleviate anxiety in adults undergoing surgery will be studied in order to establish whether intra-operative music alleviates anxiety in adults undergoing local anaesthetic surgical interventions.

METHODS: The Population studied was adults aged 18-80 years old undergoing local anaesthetic interventions. The Intervention observed was the exposure of intra-operative music therapy. The Comparison was against patients undergoing surgery without being subject to music therapy. The desired Outcome was the alleviation of intra-operative anxiety. The intention was to develop a systematic review of the available data. In orderto develop the literature search, Key elements of the question were identified and utilized to generate alternative terms. Subsequently, Boolean Operators were used to combine these terms. Search results were narrowed down by means of limiters and selected databases; EBSCO, PubMed and ScienceDirect were used to execute the search. The PRISMA 2009 framework was used as a guideline in excluding irrelevant studies. Assessment of study eligibility was done byapplying inclusion/exclusion criteria. Appraisal of literature was done by using The Critical Appraisal Skills Programme (CASP) tool as a framework.

RESULTS: A total of five studies were identified. These included randomised control trials. Two of these studies demonstrated statistical significance whilst the remaining three failed to do so. The overall result of these studies was inconclusive and inconsistent in attempting to determine whether intra-operative music therapy alleviates anxiety in patients undergoing local anaesthetic interventions.

CONCLUSION: The presentation of a definite conclusion is not possible. However, evidence is promising and pointing towards the likelihood of beneficial outcomes resulting from the intervention of interest. However, further research is required.

IMPLICATIONS AND RECOMMENDATIONS: It is recommended that the patients be offered the choice of selecting their preferred music if they give consent to undergo surgery while being exposed to music therapy. Various cost-effective audio devices could be installed in operating theatres. The general public and healthcare professionals should be educated about the benefits of intra-operative music therapy. Future studies should use larger sample sizes, and attrition rate should be reduced through better communication with patients and thorough taking into account the demographic characteristics of the patients.

PMID:34862901

Psychiatr Danub. 2021 Dec;33(Suppl 11):121-132.

ABSTRACT

BACKGROUND: Violence Against Women and Girls (VAWG) (physical, sexual, and psychological/emotional) is a type of structural discrimination that violates the basic human rights of females on a global scale. Cultural norms that glorify male dominance, power imbalances, and abuse of authority are the most encountered reasons for VAWG. Emotional abuse, which can start in childhood, is widely recognised as the most prevalent form of VAWG. However, although victims of emotional abuse usually suffer terribly, perpetrators often evade accountability. Emotional abuse is underestimated in part because it is normalized by victims who are mostly women and girls. The normalization of VAWG is contributing to the propagation and perpetuation of biased perceptions of sexism. The intergenerational transmission of parenting styles – which is an important contributory factor for child development – often includes gender-stereotyping norms, or patriarchy. Hitherto, limited focus has been directed towards the consequences that emotional abuse related to patriarchal upbringing has on children. Aim – to investigate if emotional abuse related to patriarchal upbringing influences the perception of sexism and gender stereotyping across genders, and the development of unresolved trauma in children.

METHODS: Participants were recruited via social media platforms to complete online questionnaires assessing parental emotional abuse, control, trauma, misogyny, and perceptions of sexism. Parametric analyses were conducted on the 188 participants (158 women and 30 men) recruited. Trauma and perceptions of sexism were statistically analysed using correlation and multiple linear regression.

RESULTS: Our findings show that parental emotional abuse and control in females predicted for unresolved traumatic experiences (16.6%). Misogynistic culture and male gender predicted for hostile sexism (9.9%), whereas emotional abuse predicted for benevolent sexism (40%).

CONCLUSION: Emotional abuse related to patriarchal upbringing contributes to the genesis of gender inequality and unresolved trauma in children. Given that parental styles are transmitted from one generation to the next, to reduce sexism and improve mental health outcomes, the patriarchal parental cycle must be broken.

PMID:34862904

Psychiatr Danub. 2021 Dec;33(Suppl 11):5-9.

ABSTRACT

BACKGROUND: While many studies have investigated depression risk factors, few attempts have been made to weight, and compare them. Therefore, we conducted a prospective comparison of a sample of subjects suffering from major depressive disorder and a group of healthy subjects. We compared classic risk factors with internal elements such as personality, family dynamics and health locus of control. We also looked for prognostic factors.

METHODS: Forty people with major depressive disorder (the MDD group) were randomly assigned to different treatment groups and followed for two years. In parallel, we followed a group of 21 healthy subjects (healthy group). At the beginning of the study, sociodemographic data were recorded and all subjects were asked to complete the Multidimensional Health Locus of Control (MHLC) scale, the NEO Five-Factor Inventory (NEO-FFI), and the Family Adaptation and Cohesion Scale (FACES III). During the study, subjects were regularly assessed using the Hamilton Depression Scale (HDS) and the Short Form Health Survey (SF-12).

RESULTS: Of the 23 explanatory variables, 13 were statistically different (p≤0.05): age, gender, number of people living together, income, extravert personality and neuroticism, Internal HLC, Powerful others HLC, Adaptability of the current couple and the family of origin, and Cohesion of the ideal and nuclear family and family of origin. The accumulation of risk factors doubles the chances of suffering from MDD (odds ratio 1.905**). Independent of treatment, among the 13 variables, the first nine explain 34.1% of change in depression measured on the HDS scale (p<0.001).

CONCLUSION: While the size of our sample limits the robustness of our results, our study suggests that some risk factors are also prognostic. The respective weights of these factors vary as a function of age group. Finally, some, such as health locus of control, family dynamics or extraversion, can be modified as an adjunct to pharmacological treatment.

PMID:34862881

Psychiatr Danub. 2021 Dec;33(Suppl 11):79-90.

ABSTRACT

BACKGROUND: Attitudes of physicians toward intellectual disability (ID) impact access and quality of the health care services provided to individuals with ID. Attitudes are conceptualized as composed of cognitive, affective, and behavioral dimensions. However, research on attitudes toward ID frequently neglects to define the underlying theoretical framework. This work aimed to review research over the past 20 years on physicians’ attitudes toward and health care practices for individuals with ID. Findings are reported on the cognitive, affective, and behavioral dimensions of attitudes.

METHODS: A systematic review was conducted following the PRISMA guidelines. Articles published in English between 2000 and October 2021 were searched in Scopus and Web of Science. Descriptive statistics and frequencies were used to describe the attitudes of physicians.

RESULTS: A total of 14 studies were included in the review. Considering the cognitive dimension of attitudes, physicians had a medium to good but almost always incomplete knowledge of ID and its associated conditions, rights and capabilities of individuals with ID, and health care practices for this population. Concerning the affective dimension, approximately half of physicians expressed feelings of pity, unsatisfaction, frustration, discomfort, and lack of confidence. With respect to the behavioral dimension of attitudes, approximately half of physicians preferred to avoid patients with ID.

CONCLUSIONS: Physicians’ attitudes are rather complex. From this work emerges a clear need to change these generally unfavorable attitudes, especially in the aspects regarding emotions and behaviors, to provide better health care to individuals with ID. Educational and training programs on ID for physicians should be developed to improve attitudes toward ID and consequently foster the wellbeing of this population.

PMID:34862898

Pak J Pharm Sci. 2021 Sep;34(5(Special)):2021-2025.

ABSTRACT

The objective of this study was to investigate the effects of curcumin combined with oxaliplatin on human colon carcinoma Colo205 cells and to analyze the anti-cancer mechanism. Sixty nude mice were inoculated with Colo205 cells as tumor transplanted models which were randomly divided into control group, curcumin group, oxaliplatin group and curcumin plus oxaliplatin group (n=15 in each group). The volume of tumor and the tumor suppressor rate was calculated after continuous administration of the curcumin or oxaliplatin for 10 times. The routine blood tests, the liver function and kidney tests were performed. The cell cycle, apoptosis rate and the pathological morphology of tumor tissues was observed. The expression of Bcl-2 and Bax related to apoptosis was detected. The turned out degree of tumor inhibition varied when compared to the control group while the curcumin plus oxaliplatin group served for highest inhibition rate. Statistically insignificant difference (P>0.05) was observed among the groups in routine blood, liver and kidney function tests. The tumor apoptosis rate was significantly increased in other three groups when compared to the control group. There was insignificant difference (P>0.05) in Bax expression of tumor tissue of control group, curcumin group and oxaliplatin group while in curcumin plus oxaliplatin group, it was significantly increased. The expression of Bcl-2 in oxaliplatin group was significantly lower and the value of Bcl-2/Bax in curcumin plus oxaliplatin group was decreased most obviously.

PMID:34862868

Community Dent Health. 2021 Nov 8. doi: 10.1922/CDH_00154Samman07. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, the consumption of sugar sweetened beverages has been declining, while low calorie sweetener and diet beverage consumption is increasing. Evidence about the effect of diet drinks on dental caries is insufficient, and has not accounted for the complexity of beverage consumption patterns. Therefore, the aim of this study is to examine the association between consuming diet drinks and dental caries among US adults.

METHODS: We analyzed 2011-2014 NHANES dietary data of adults using cluster analysis, with individuals grouped based on their beverage consumption. Clusters were identified based on the R-square statistic and the local peak of the pseudo F statistic. Survey procedure and sample weights were used to account for the complex NHANES sampling design.

RESULTS: Four beverage consumption patterns were identified: “high soda”, “high diet drinks”, “high coffee/tea” and “high water”. The “High soda” cluster was the only one associated with higher DMFT after controlling for confounders (β=1.02, 95% CI=0.42 – 1.63), whereas DT was associated with “high soda” (β=0.45, 95% CI=0.25 – 0.64) and “high coffee/tea” (β=0.24, 95% CI=0.01 – 0.47). On the other hand, the “high diet drinks” cluster was neither associated with DMFT (β=0.69, 95% CI=0.51 – -0.35) nor DT (β=0.07, 95% CI=-0.21 – 0.35).

CONCLUSION: Diet drinks consumption may not be associated with increased risk of dental caries. However, more studies should be conducted in order to confirm this finding.

PMID:34862864 | DOI:10.1922/CDH_00154Samman07

Thorac Cancer. 2021 Dec 4. doi: 10.1111/1759-7714.14260. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with primary lung adenocarcinoma are at increased risk of venous thromboembolism (VTE). However, lung adenocarcinoma characteristics differ across histological subtypes. Therefore, we performed comprehensive analyses on the clinicopathological characteristics of lung adenocarcinoma and risk of VTE.

METHODS: A total of 952 surgically resected lung adenocarcinoma cases were reviewed and classified according to criteria of the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS) /European Respiratory Society (ERS). The correlation between this classification and VTE risk was retrospectively analyzed. The risks of other clinicopathological features including pleural invasion, vascular invasion and associated surgical intervention risks were also assessed.

RESULTS: Of the 952 patients, 100 (10.4%) cases experienced VTE events during the follow-up period. Among those with VTE, 28 (28%) were found before surgery, 47 (47%) were found within 1 month after surgery, and 91 (91%) were found in hospital. Univariate analysis revealed that ages, extent of resection and presence of micropapillary features were predictive of VTE risk. Furthermore, multivariable analysis demonstrated that the presence of micropapillary features (subdistribution hazard ratio [SHR] 1.560, 95% CI: 1.043-2.330) and age >60 (SHR: 2.270, 95% CI:1.491-3.470) were associated with increased risk of VTE. After one year, the probability of developing VTE was 13.1% and 8.3% in patients with micropapillary features and those without, respectively.

CONCLUSIONS: VTE is a common complication for lung adenocarcinoma patients who undergo surgery, especially during the perioperative process and hospitalization. Presence of micropapillary subtype and age are positively associated with VTE risk.

PMID:34862856 | DOI:10.1111/1759-7714.14260

Eur J Prosthodont Restor Dent. 2021 Nov 30. doi: 10.1922/EJPRD_2332Lee12. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the surface roughness of lithium disilicates (LS2s) polished using various polishing systems.

MATERIALS AND METHODS: Two types of LS2 (A, Amber Mill and E, IPS e.max CAD) were polished using LS2-specific polishing systems (L-Edenta, L-Jota), a zirconia-specific polishing system (Z-Jota), and a conventional ceramic polishing system (P-Shofu) (n = 8 per group). The compositions of different polishing systems were analyzed using EDS. Surface roughness was measured using confocal laser scanning microscopy and analyzed using EDS and SEM. ANOVA and Tukey’s tests were used for the statistical analyses (p = 0.05).

RESULTS: The polishing systems were mainly composed of C, O, and Si. The L-Jota group exhibited rougher surfaces than the other groups. Amber Mill exhibited higher surface roughness than IPS e.max CAD (p⟨0.001). Among the polishing systems, the L-Jota group presented the highest roughness value (pp⟨0.001). The surface roughness of the AL-Jota group was higher than that of the other groups.

CONCLUSIONS: A sufficiently smooth surface can be achieved without a LS2-specific polishing system. Further, the same polishing system can have different effects depending on the type of LS2.

PMID:34862863 | DOI:10.1922/EJPRD_2332Lee12

Brain Behav. 2021 Dec 4:e2449. doi: 10.1002/brb3.2449. Online ahead of print.

ABSTRACT

BACKGROUND: Synthetic MRI (SyMRI) is a quantitative technique that allows measurements of T1 and T2 relaxation times (RTs). Brain RT evolution across lifespan is well described for the younger population. The aim was to study RTs of brain parenchyma in a healthy geriatric population in order to define the normal value of structures in this group population. Normal values for geriatric population could help find biomarker for age-related brain disease.

MATERIALS AND METHODS: Fifty-four normal-functioning individuals (22 females, 32 males) with mean age of 83 years (range 56-98) underwent SyMRI. RT values in manually defined ROIs (centrum semiovale, middle cerebellar peduncles, thalamus, and insular cortex) and in segmented whole-brain components (brain parenchyma, gray matter, white matter, myelin, CSF, and stromal structures) were extracted from the SyMRI segmentation software. Patients’ results were combined into the group age. Main ROI-based and whole-brain results were compared for the all dataset and for age group results as well.

RESULTS: For white matter, RTs between ROI-based analyses and whole-brain results for T2 and for T1 were statistically different and a trend of increasing T1 in centrum semiovale and cerebellar peduncle was observed. For gray matter, thalamic T1 was statistically different from insular T1. A difference was also found between left and right insula (p < .0001). T1 RTs of ROI-based and whole-brain-based analyses were statistically different (p < .0001). No significant difference in T1 and T2 was found between age groups on ROI-based analysis, but T1 in centrum semiovale and thalamus increased with age. No statistical difference between age groups was found for the various segmented volumes except for myelin between 65-74 years of age and the 95-105 years of age groups (p = .038).

CONCLUSIONS: SyMRI is a new tool that allows faster imaging and permits to obtain quantitative T1 and T2. By defining RT values of different brain components of normal-functioning elderly individuals, this technique may be used as a biomarker for clinical disorders like dementia.

PMID:34862855 | DOI:10.1002/brb3.2449

Health Serv Res. 2021 Dec 4. doi: 10.1111/1475-6773.13921. Online ahead of print.

ABSTRACT

OBJECTIVE: To establish a case-adjusted hospital-specific performance evaluation tool using machine learning methodology for cesarean delivery.

DATA SOURCES: Secondary data were collected from patients between 1/1/2015-2/28/2018 using a hospital’s “Electronic Data Warehouse” database from Illinois, USA.

STUDY DESIGN: The machine learning methodology of Optimal Classification Trees (OCT’s) was used to predict cesarean delivery rate by physician group, thereby establishing the case-adjusted benchmarking standards in comparison to the overall hospital cesarean delivery rate. Outcomes of specific patient populations of each participating practice were predicted, as if each were treated in the overall hospital environment. The resulting OCTs estimate physician group expected cesarean delivery outcomes, both aggregate and in specific clinical situations.

DATA COLLECTION/EXTRACTION METHODS: 12,841 singleton, vertex, term deliveries, cared for by practices with ≥50 births.

PRINCIPAL FINDINGS: The overall rate of cesarean delivery was 18.6% (n = 2384), with a range of 13.3%-33.7% amongst 22 physician practices. An optimal decision tree was used to create a prediction model for the overall hospital which defined 23 patient cohorts, divided by 46 nodes. The model’s performance for prediction of cesarean delivery is as follows: area under the curve- 0.73, sensitivity- 98.4%, specificity- 16.1%, positive predictive value 83.7%, negative predictive value 70.6%. Comparisons with the overall hospital’s specific-case adjusted benchmark groups revealed that several groups outperformed the overall hospital and some practice groups underperformed in comparison to the overall hospital.

CONCLUSIONS: OCT benchmarking can assess physician practice specific case-adjusted performance, both overall and clinical situation specific, and can serve as a valuable tool for hospital self-assessment and quality improvement. This article is protected by copyright. All rights reserved.

PMID:34862801 | DOI:10.1111/1475-6773.13921