Category: Nevin Manimala

Int J Ment Health Nurs. 2021 May 17. doi: 10.1111/inm.12878. Online ahead of print.

ABSTRACT

Literature shows that mental healthcare workers in Ghana face incessant fear of patient violence that compromise safe care delivery. However, the nature, scale, perceived causes, and consequences of these assaults and how they shape risk perceptions have received limited empirical attention, hence the need for this study. The study employed sequential explanatory mixed methods where questionnaire administration preceded and informed the design of an interview guide used for in-depth interviews with health workers in referral psychiatric hospitals. Descriptive statistics and multivariate logistic regressions were used to analyze the quantitative data. Qualitative data were transcribed and analyzed thematically. Findings showed that physical and non-physical violent assaults and risk perceptions of the hospitals were statistically and significantly associated with females (P < 0.01), nurses (P < 0.01), other clinical cadre (P < 0.01), and those with low job tenure (P < 0.05). About 57% and 71% of the sample reported experiencing physical and non-physical assaults, respectively. Major and minor injuries and psychosocial problems were frequent sequelae following physical violent assaults. As a result, 80% of the participants perceived the hospitals environment to be unsafe to provide care. Violent assaults compromises safety and care delivery efforts suggesting the need for systematic interventions to minimize mental healthcare workers exposure to patient violence.

PMID:33998754 | DOI:10.1111/inm.12878

J Magn Reson Imaging. 2021 May 17. doi: 10.1002/jmri.27702. Online ahead of print.

ABSTRACT

BACKGROUND: Perivascular spaces (PVSs) are important component of the brain glymphatic system. While visual rating has been widely used to assess PVS, computational measures may have higher sensitivity for capturing PVS characteristics under disease conditions.

PURPOSE: To compute quantitative and morphological PVS features and to assess their associations with vascular risk factors and cerebral small vessel disease (CSVD).

STUDY TYPE: Prospective.

POPULATION: One hundred sixty-one middle-aged/later middle-aged subjects (age = 60.4 ± 7.3).

SEQUENCE: 3D T1-weighted, T2-weighted and T2-FLAIR sequences, and susceptibility-weighted multiecho gradient-echo sequence on a 3 T scanner.

ASSESSMENT: Automated PVS segmentation was performed on sub-millimeter T2-weighted images. Quantitative and morphological PVS features were calculated in white matter (WM) and basal ganglia (BG) regions, including volume, count, size, length (L_maj ), width (L_min ), and linearity. Visual PVS scores were also acquired for comparison.

STATISTICAL TESTS: Simple and multiple linear regression analyses were used to explore the associations among variables.

RESULTS: WM-PVS visual score and count were associated with hypertension (β = 0.161, P < 0.05; β = 0.193, P < 0.05), as were BG-PVS rating score, volume, count and L_min (β = 0.197, P < 0.05; β = 0.170, P < 0.05; β = 0.200, P < 0.05; β = 0.172, P < 0.05). WM-PVS size was associated with diabetes (β = 0.165, P < 0.05). WM-PVS and BG-PVS were associated with CSVD markers, especially white matter hyperintensities (WMHs) (P < 0.05). Multiple regression analysis showed that WM/BG-PVS quantitative measures were widely associated with vascular risk factors and CSVD markers (P < 0.05). Morphological measures were associated with WMH severity in WM region and also associated with lacunes and microbleeds (P < 0.05) in BG region.

DATA CONCLUSION: These novel PVS measures may capture mild PVS alterations driven by different pathologies.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.

PMID:33998738 | DOI:10.1002/jmri.27702

Int J Clin Pract. 2021 May 17:e14368. doi: 10.1111/ijcp.14368. Online ahead of print.

ABSTRACT

OBJECTIVES: This study has aimed to determine the depression, psychological resilience, and burnout levels of caregivers of schizophrenic patients; to investigate the relationship of these parameters with various sociodemographic variables and to compare these variables with a control group.

METHOD: This cross-sectional study was conducted in 2019 with 80 caregivers of schizophrenia patients over 18 years of age who were living in Hatay and were admitted to the Psychiatric Outpatient Clinic of Hatay Mustafa Kemal University Hospital. Eighty healthy volunteers were also included in the study as a control group. Questionnaires including the Sociodemographic Data Form, Maslach Burnout Inventory, Beck Depression Inventory and Psychological Resilience Scale were applied. The resilience, depression and burnout levels were evaluated based on the results. Mann Whitney-U, Kruskal Wallis and Spearman correlation tests were used and p <0.05 was considered statistically significant.

RESULTS: A significant relationship was found between the scaled scores and the Positive and Negative Syndrom Scale (PANSS), Clinical Global Impression (CGI) severity score, physical comorbidity of caregivers, sharing the same household with the patient, the age of the caregivers, the duration of the caregiving role and the illness, and the duration of hospital stay (p<0.05). There was a moderate positive correlation (r=0.47) between the PANSS score and Beck Depression Inventory and a moderate negative correlation (r=-0.41, r=-0.34, r=-0.30) between the three sub-dimensions of the Psychological Resilience Scale and the PANSS score.

CONCLUSION: Caregivers of schizophrenia patients had higher levels of depression and burnout and less mental resilience compared to the control group. This result is associated with the sociodemographic and clinical findings. If the prevalence is not determined and the required intervention is not made, important consequences will develop both for the patients and the caregivers. The fact that these results could be related to sociodemographic and clinical findings may also be indicative of the importance of reviewing the psychological and social support systems available to carers of patients.

PMID:33998753 | DOI:10.1111/ijcp.14368

Eur J Neurosci. 2021 May 17. doi: 10.1111/ejn.15311. Online ahead of print.

ABSTRACT

Atypical processing of stimulus inputs across a range of sensory modalities in autism spectrum disorder (ASD) are widely reported. Sensory processing is known to be influenced by bodily internal states such as physiological arousal and anxiety. Since a sizeable proportion of ASD reportedly have co-morbid anxiety disorder that are linked with dysregulated arousal, we investigated if face-emotion arousal cues, influenced visual sensory sensitivity (indexed by temporal resolution) in ASD (n=20) compared to a matched group of typically-developed individuals (TD, n=21). We asked further if emotion-cued changes in visual sensitivity associated with individual differences in state- and trait-anxiety. Participants reported the laterality of the second of two consecutive Gaussian-blob flashes in a visual temporal order judgment task (v-TOJ), demanding higher-level visual processing. The key manipulation was presenting a task-irrelevant face emotion cue briefly at unexpected time points preceding the task-relevant flashes. Disgust vs Neutral emotion signals significantly enhanced the visual temporal resolution in ASD. Individual state-anxiety scores showed a fair correlative trend of with the emotion-cued changes of temporal resolution (Disgust vs Neutral) in ASD but missed statistical significance. Both these effects were absent in TD. The results show that individual state-anxiety levels likely modulate the effect of emotions on visual temporal sensitivity in ASD. The findings support a nuanced approach to understand the disparate sensory features in ASD, by factoring in the interplay of the individual reactivity to environmental affective information and the severity of anxiety.

PMID:33998735 | DOI:10.1111/ejn.15311

Ther Adv Hematol. 2021 May 7;12:20406207211012985. doi: 10.1177/20406207211012985. eCollection 2021.

ABSTRACT

BACKGROUND: High dose melphalan (HDMEL) is considered the standard conditioning regimen for autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients. Recent studies showed superiority of busulfan plus melphalan (BUMEL) compared to HDMEL as a conditioning regimen. We compared the efficacy of HDMEL and BUMEL in newly diagnosed Asian MM patients, who are often underrepresented.

METHODS: This is a single-center, retrospective study including MM patients who underwent ASCT after bortezomib-thalidomide-dexamethasone (VTD) triplet induction chemotherapy between January 2015 and August 2019.

RESULT: In the end, 79 patients in the HDMEL group were compared to 31 patients in the BUMEL group. There were no differences between the two groups with regards to sex, age at ASCT, risk group, and stage. The HDMEL group showed better response to pre-transplant VTD compared to BUMEL, but after ASCT the BUMEL group showed better overall response. In terms of progression-free survival (PFS), although BUMEL showed trends towards better PFS regardless of pre-transplant status and age, the difference did not reach statistical significance. The BUMEL group more often experienced mucositis related to chemotherapy, but there was no difference between the two groups with regards to hospitalization days, cell engraftment, and infection rates.

CONCLUSION: BUMEL conditioning deserves attention as the alternative option to HDMEL for newly diagnosed MM patients, even in the era of triplet induction chemotherapy. Specifically, patients achieving very good partial response (VGPR) or better response with triplet induction chemotherapy might benefit the most from BUMEL conditioning. Tailored conditioning regimen, based on patient’s response to induction chemotherapy and co-morbidities, can lead to better treatment outcomes.

PMID:33995990 | PMC:PMC8111524 | DOI:10.1177/20406207211012985

Pulm Circ. 2021 Apr 22;11(2):20458940211010371. doi: 10.1177/20458940211010371. eCollection 2021 Apr-Jun.

ABSTRACT

Recent studies have shown low high-density lipoprotein cholesterol (HDL-C) and dysregulated lipid metabolism in chronic thromboembolic pulmonary hypertension (CTEPH). Apolipoprotein A-I (ApoA-I) is the major protein component of HDL-C and mediates most of its functions. We hypothesize that ApoA-1 and its oxidative state might be more sensitive biomarkers in CTEPH. Plasma levels of HDL-C, ApoA-I, paraoxonase-1 enzyme activity (PON1), and the oxidized dysfunctional ApoA-I (oxTrp72-ApoA-I) were measured in patients with CTEPH and compared to those in healthy controls. Association with markers of disease severity in CTEPH was assessed. We included a total of 61 patients with CTEPH (age: 61.2 ± 15 years; male 52.5%) and 28 control subjects (age: 60.1 ± 8 years; male 59.3%). When adjusting for age, sex, body mass index, and statin use, ApoA-I was lower in CTEPH compared to controls (CTEPH:125.2 ± 27 mg/dl; control:158.3 ± 29.4 mg/dl; p < 0.001), but HDL-C levels were not statistically different. There were no significant differences in PON and oxTrp72-ApoA-I/ApoA-I ratio. In exploratory analyses, ApoA-I was associated with mean right atrial pressure (r_s = -0.32, p = 0.013) and N-terminal pro B-type natriuretic peptide (r_s = -0.31, p = 0.038). There were no significant associations between HDL-C, PON1, or oxTrp72-ApoA-I/ApoA-I ratio and markers of disease severity. We conclude that ApoA-I is a more sensitive biomarker than HDL-C in CTEPH, and may be associated with right heart dysfunction.

PMID:33996028 | PMC:PMC8071975 | DOI:10.1177/20458940211010371

Addict Health. 2021 Jan;13(1):52-65. doi: 10.22122/ahj.v13i1.298.

ABSTRACT

Substance use disorder (SUD) is a prevalent health issue with serious social and personal consequences. SUDs are linked to numerous physical health problems. In the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-V), the essential characteristic of a SUD is a collection of cognitive, behavioral, and psychological manifestations indicative of the subject’s unbaiting substance use despite experiencing significant problems due to continued use. Several alternative interventions have been indicated. Among them, mindfulness-based therapies are receiving growing attention. This article reviews evidence for the use of third-wave cognitive-behavioral therapies (CBTs) in addiction treatment. We have reviewed the literature published from 1990 to 2019. Further research is required to better understand the types of mindfulness-based interventions that work best for specific types of addiction, patients, and situations. Current findings increasingly support third-wave CBTs as a promising complementary therapy for the treatment and prevention of addiction.

PMID:33995960 | PMC:PMC8080172 | DOI:10.22122/ahj.v13i1.298

J Lasers Med Sci. 2020 Fall;11(Suppl 1):S67-S72. doi: 10.34172/jlms.2020.S11. Epub 2020 Dec 30.

ABSTRACT

Introduction: This randomized clinical trial was designed to investigate the effect of carbon dioxide laser on the treatment of minor recurrent aphthous stomatitis (miRAS) as a painful and common oral ulcer. Methods: Fifteen patients with miRAS entered into this study after compliance with the inclusion and exclusion criteria. The patients were assigned to three groups of pulsed CO₂ laser, continuous CO₂ laser, and control. A pulsed CO₂ laser with power of 261 W and pulse duration of 180 microseconds and continuous CO₂ lasers with the power of 1 W and radiation duration of 5-10 seconds were used. In the control group, topical triamcinolone ointment of 0.1% was used. The degree of pain was measured using the visual analogue scale (VAS). The patients were evaluated in terms of pain intensity before and immediately after the treatment and at follow-up hours, 12, 24, 48, and 72 hours after the intervention, and changes in the size of the ulcers were measured before the treatment and on third, fifth, and seventh days. Results: The effect of CO₂ laser with pulsed and continuous radiation on the pain intensity of aphthous lesions, immediately after the treatment and at subsequent follow-up hours were similar and even better than the control group (P<0.05). All three treatments had a similar effect on the size of the ulcer, which was not statistically significant (P>0.05). Conclusion: The results of this randomized controlled trial (RCT) showed that the carbon dioxide laser, whether with pulsed radiation or continuous radiation compared to the control group, had a better impact on the pain relief of aphthous lesions.

PMID:33995972 | PMC:PMC7956027 | DOI:10.34172/jlms.2020.S11

J Healthc Eng. 2021 Apr 26;2021:5539901. doi: 10.1155/2021/5539901. eCollection 2021.

ABSTRACT

With the increase of the incidence rate of digestive system diseases, digestive endoscopy has become an essential measure. The nursing quality of digestive endoscopy room will have a direct impact on the examination results and treatment effect, so improving the nursing quality of digestive endoscopy room has always been the focus of attention. In this paper, the smart electronic medical blockchain technology and hospital standardized nursing management mode are combined to develop the smart medical standardized nursing management mode. Firstly, 88 patients with digestive endoscopy in a hospital from October 2018 to October 2019 were selected as the experimental subjects: 44 cases in the control group and 44 cases in the experimental group. The control group implemented the traditional management mode of digestive endoscopy room, and the experimental group implemented the standardized nursing management mode of smart medicine. The blood pressure level before and after nursing and the probability of adverse reactions in the process of nursing were counted. After nursing, the patients were asked to fill in the nursing satisfaction questionnaire, evaluate the nursing quality of nursing staff, and make statistics and comparison on the occurrence of safety events in digestive endoscopy room. After nursing, the systolic pressure drop of the experimental group was 125.36 ± 7.27 mmhg, diastolic pressure drop was 73.24 ± 4.21 mmhg, and the incidence of adverse reactions was 11.36%. The satisfaction rate of the experimental group was 15%, 29.55%, and 22.73% higher than that of the control group. The average scores of nursing skills, operation level, and examination results of nursing staff in the experimental group were 94.49, 95.12, and 95.89, respectively; the qualified rate of disinfection of digestive endoscopy room in the experimental group was 100%, the degree of cooperation between doctors and nurses was 100%, the timely rate of emergency measures was 95.45%, and the incidence of accidents was 0%. This shows that, under the standardized nursing of smart medicine, the blood pressure of patients is more stable, the incidence of adverse reactions is lower, the nursing satisfaction is higher, and the nursing quality of nursing staff and the safety of digestive endoscopy room are also improved.

PMID:33995983 | PMC:PMC8096586 | DOI:10.1155/2021/5539901

Basic Clin Neurosci. 2021 Jan-Feb;12(1):105-114. doi: 10.32598/bcn.12.1.1650.2. Epub 2021 Jan 1.

ABSTRACT

INTRODUCTION: Patients with cancer may have many complications involving their psychosomatic systems, such as sleep disturbance, depression, and anxiety. Thus, many research studies were conducted to reduce these complications. Zolpidem, as a short-term non-benzodiazepine treatment of insomnia, and melatonin as a chronobiological functionregulatory hormone, are commonly used for improving sleep quality. This randomized clinical trial aims to compare the effects of zolpidem and melatonin on sleep quality, depression, and anxiety in patients with colorectal cancer.

METHODS: In this single-blinded trial, 90 patients with colorectal cancer undergoing chemotherapy who had obtained a score of 5 or higher on the Pittsburgh Sleep Quality Index (PSQI) were randomly divided into two groups (n=45). One group was treated with 10 mg zolpidem at bedtime, and the other group received 6 mg melatonin at bedtime for 30 days. PSQI on weeks 0, 4, 8, Groningen sleep quality scale, Hamilton rating scale for depression, and Hamilton anxiety rating scale questionnaires were performed to assess patients on weeks 0, 4, and 8. The outcome was then analyzed, and P≤0.05 was considered statistically significant.

RESULTS: Both zolpidem and melatonin had significant impacts on sleep quality in week 4 (P<0.05). After stopping the treatments, the conditions were noticeably reversed on week 8 (P<0.05). Zolpidem and melatonin were relatively similar in affecting sleep duration, latency, efficiency, and disturbance. None of the two study medications had any considerable influence on anxiety and depression.

CONCLUSION: Melatonin and zolpidem are promising agents for treating sleep complications and, to some extent, depression, and anxiety in cancer patients, according to the present study. However, further clinical trials are recommended to confirm the results of this study.

PMID:33995933 | PMC:PMC8114863 | DOI:10.32598/bcn.12.1.1650.2