Category: Statistics

Int J Public Health. 2024 May 10;69:1607026. doi: 10.3389/ijph.2024.1607026. eCollection 2024.

ABSTRACT

OBJECTIVE: Workplace violence is a prevalent phenomenon in hospital settings which critical care nurses are particularly exposed to. The aim of this study was to research abuse against Critical Care Nurses in five European countries, and its association with and impact on Healthy Work Environments.

METHODS: This was a multinational cross-sectional study. The 1,183 participants were nurses working in intensive care units from five European countries: Croatia, Cyprus, Poland, Spain, and Romania. The participants were selected by the convenience sampling method from 1 January 2021 to April 2022.

RESULTS: Of 1,033 critical care nurses who answered questions about abuse, 646 reported at least one incident in the previous year. The highest number of incidents came from patients (2,050), followed by another nurse (1,453) and physicians (1,039).

CONCLUSION: Although nurses in ICUs are aware that a healthy working environment benefits them in their daily work, most of them still face some form of abuse. Organizations must take a realistic approach to prevent abuse and to educate nurses and nurse managers by implementing standards for healthy work environments.

PMID:38800831 | PMC:PMC11116648 | DOI:10.3389/ijph.2024.1607026

J Cutan Aesthet Surg. 2024 Apr-Jun;17(2):124-130. doi: 10.4103/JCAS.JCAS_218_22.

ABSTRACT

BACKGROUND: Severe post-acne scarring has been implicated as a cause of considerable psychological distress, mainly among adolescents. Subcision and microneedling are cutting-edge treatment options available nowadays.

AIM: In this study, we aimed to compare the efficacy of microneedling with platelet-rich plasma (PRP) against subcision with PRP in treating atrophic post-acne scars in a split-face study design.

MATERIALS AND METHODS: Fifty patients with atrophic post-acne facial scars were included in this prospective interventional study. Group A included the left side of the face managed by microneedling with PRP and group B included the right side of the face that was subjected to subcision with PRP. Results were assessed based on Goodman and Baron qualitative and quantitative grading.

RESULTS: In our study, at the end of the treatment, on the left side, 5 (10%) had 1 grade of improvement showing good response, 35 (70%) had 2 grades of improvement showing very good response, and 10 (20%) had 3 grades of improvement showing excellent response. On the right side, 1 (2%) patient had no improvement in acne grade showing poor response, 9 (18%) had 1 grade of improvement showing good response, 25 (50%) had 2 grades of improvement showing very good response, whereas 15 (30%) had 3 grades of improvement showing excellent response.

CONCLUSION: Till date, apart from ours no other study has compared the two modalities head-to-head with adjuvant PRP in both groups. Although both modalities showed statistically significant results individually, there was no significant difference in qualitative improvement of acne scars between the two groups.

PMID:38800819 | PMC:PMC11126223 | DOI:10.4103/JCAS.JCAS_218_22

J Cutan Aesthet Surg. 2024 Apr-Jun;17(2):94-99. doi: 10.4103/JCAS.JCAS_76_23.

ABSTRACT

INTRODUCTION: Acanthosis Nigricans (AN) is an acquired disorder of keratinization. It presents as hyperpigmentation, velvety texture of skin that can involve any part of the body including the face. Different topical, systemic therapies, or physical therapies including laser have been explored. However, there are not many randomized controlled studies for the majority of therapy alternatives besides lifestyle modifications and weight reduction.

OBJECTIVES: The aim of this study was to compare the effectiveness of 15% trichloroacetic acid (TCA) and 35% glycolic acid (GA) peel for AN.

MATERIALS AND METHODS: Forty participants were included and randomized into two groups. In groups A and B, peeling with 15% TCA and 35% GA was done, respectively. The effectiveness of each peel was assessed using changes in the Acanthosis Nigricans Area and Severity Index Score (ANASI) and Physician Assessment Score. Statistical analysis included Wilcoxon-Mann-Whitney test, Friedman test, and generalized estimating equations.

RESULTS: The overall change in ANASI over time was compared in the two groups using the generalized estimating equations method. A significant difference was observed in the trend of ANASI over time between the two groups (P < 0.001). TCA peel group showed more change in ANASI as compared with GA peel group.

CONCLUSION: In our research, 15% TCA has a better efficacy when compared with 35% GA peel after three sessions of chemical peeling. We therefore recommend the use of 15% TCA peel in AN as a safe and effective treatment option. However, more comprehensive randomized control studies are required for supporting data.

PMID:38800813 | PMC:PMC11126224 | DOI:10.4103/JCAS.JCAS_76_23

J Cutan Aesthet Surg. 2024 Apr-Jun;17(2):112-123. doi: 10.4103/JCAS.JCAS_48_23.

ABSTRACT

INTRODUCTION: Facial pigmentation is a common presentation of patients attending dermatology out patient department (OPD) and is of great concern to patients. Facial pigmentation may be multifactorial and is only rarely diagnosed accurately by a detailed history and clinical examination. Pigmentary disorders cause psychological distress and negatively impact the quality of life of an individual.

AIMS AND OBJECTIVES: (1) To study different dermoscopic patterns in facial melanosis. (2) To estimate the frequency of different dermoscopic patterns.

MATERIALS AND METHODS: Patients with facial hyperpigmentation attending the dermatology OPD were recruited after taking their written consent. A detailed history was taken to collect demographic data. Clinical examination and dermoscopy were done in all patients. Biopsy was done as and when required. Descriptive statistics has been used to describe the quantitative data. Qualitative data were presented as frequency and percentage for clinical and dermoscopic patterns.

RESULTS: The study included 100 patients with 15 different facial melanoses. The most common age group affected was 21-40 years in 53 (53%) cases. The female-to-male ratio was 1.63:1. Melasma was reported as the most common cause of facial melanosis constituting 49 (49%) of the total cases. Out of the total melasma cases, epidermal melasma constituted 22 (45%) cases, dermal melasma constituted four (4%) cases and mixed melasma constituted 23 (47%) cases. Other cases included were lichen planus pigmentosus (14; 14%), facial acanthosis nigricans (14; 14%), periorbital hyperpigmentation (7; 7%), post-inflammatory hyperpigmentation (4; 4%), exogenous ochronosis (2; 2%), lentigines (2; 2%), frictional melanosis (2;2%), and one case each of Becker’s nevus, nevus of Ota, olanzapine-induced hyperpigmentation, Riehl’s melanosis, macular amyloidosis, and tanning.

CONCLUSIONS: Melasma was reported as the most common cause of facial melanosis. The most common dermoscopic feature was accentuated pseudopigment network. The study is beneficial in understanding the different clinical and dermoscopic patterns of facial melanosis, thus helping the physician to effectively manage the conditions and reduce the need of biopsy.

LIMITATIONS: (1) A small sample size. (2) Histopathological correlation was not done in all cases.

PMID:38800811 | PMC:PMC11126221 | DOI:10.4103/JCAS.JCAS_48_23

J Cutan Aesthet Surg. 2024 Apr-Jun;17(2):137-145. doi: 10.4103/JCAS.JCAS_64_23.

ABSTRACT

CONTEXT: Scarring is a biological process of wound repair which leads to a difference in the normal structure and function of the skin and manifests as a depressed or raised area. Treatment of scars is challenging. A number of therapeutic approaches like surgical techniques and non-surgical techniques are performed to improve scarring.

AIMS AND OBJECTIVES: The aim of this study was to compare the outcome of subcision followed by microneedling versus subcision followed by microneedling and topical platelet-rich plasma (PRP) in atrophic scars.

MATERIALS AND METHODS: A comparative prospective study was conducted at a tertiary care hospital in North India to compare the efficacy of subcision followed by microneedling versus subcision followed by microneedling and topical PRP. A total of 40 cases were taken and were randomly divided into two groups, A and B of 20 patients in each group. Topical PRP was applied as an additional therapy in Group B in the same sitting. Minimum three sittings were done in each patient at an interval of 4 weeks and results were assessed after 1 month of the third session. The statistical software used is Microsoft Excel and SPSS software program, version 24.0 for analysis of data and Microsoft Word to generate graphs and tables.

RESULTS: Improvement in scar grading was more in Group B as compared to Group A with statistically significant difference (P = 0.032). There was an improvement in scar grading from grade 4 scar to grade 2 in 15% and 30% patients of Groups A and B, respectively, with improvement in skin texture and pigmentation more in Group B.

CONCLUSION: PRP proved to add to the improvement of grade of atrophic scars when combined with subcision and microneedling.

PMID:38800810 | PMC:PMC11126227 | DOI:10.4103/JCAS.JCAS_64_23

EClinicalMedicine. 2024 May 17;72:102630. doi: 10.1016/j.eclinm.2024.102630. eCollection 2024 Jun.

ABSTRACT

BACKGROUND: Diarrhoeal disease poses a significant global health challenge, especially in children under three years old. Despite the effectiveness of oral rehydration therapy (ORT), its adoption remains low. Glucose-based ORS (GORS) is the standard, but novel formulations like glucose-free amino acid-based VS002A have emerged as potential alternatives. This study aimed to compare the safety and efficacy of VS002A against the standard WHO-ORS in treating non-cholera acute watery diarrhoea in children.

METHODS: A triple-blind, randomized trial enrolled 310 male infants and children aged 6-36 months, who were assigned to receive WHO-ORS or VS002A over a 16-month period, from June 2021 to September 2022. Both groups received standard of care, including zinc supplementation. The Primary study outcome measured was the duration of diarrhoea. Secondary outcomes included stool output, treatment failure and adverse events. Exploratory endpoints included urinary output, body weight changes, blood biochemistry, stool microbiology and gut health biomarkers.

FINDINGS: Both VS002A and WHO-ORS were well-tolerated with a low adverse event rate. While not different statistically (p = 0.10), duration of diarrhoea was shorter in children treated with VS002A vs. WHO-ORS (65.4 h vs. 72.6 h). Similarly, stool output was also lower vs. WHO-ORS in children treated with VS002A, though not statistically different (p = 0.40). Serum citrulline levels, an indicator of gut health, were higher in the VS002A group at 24 h suggesting a potential protective effect (p = 0.06).

INTERPRETATION: The findings of this study support the non-inferiority of VS002A, a glucose-free amino acid-based ORS compared to the WHO-ORS standard of care. VS002A was shown to be safe and effective in treating non-cholera acute watery diarrhoea in young children. VS002A may offer advantages in pathogen-driven diarrhoea, supported by trends toward a lower duration of diarrhoea and stool output within the per protocol group. Furthermore, individuals with prolonged diarrhoea, severe malnutrition, environmental enteric dysfunction or have issues with obesity or insulin resistance, could benefit from a glucose-free ORS. This research contributes to addressing the persistent challenge of childhood diarrhoea by presenting an alternative glucose-free ORS formulation with potential advantages in select scenarios, offering a promising avenue for improving paediatric diarrhoea management worldwide.

FUNDING: The study was funded by Entrinsic Bioscience, LLC., Norwood, MA, USA.

PMID:38800804 | PMC:PMC11127191 | DOI:10.1016/j.eclinm.2024.102630

Addict Biol. 2024 May;29(5):e13402. doi: 10.1111/adb.13402.

ABSTRACT

Increases in harmful drinking among older adults indicate the need for a more thorough understanding of the relationship between later-life alcohol use and brain health. The current study investigated the relationships between alcohol use and progressive grey and white matter changes in older adults using longitudinal data. A total of 530 participants (aged 70 to 90 years; 46.0% male) were included. Brain outcomes assessed over 6 years included total grey and white matter volume, as well as volume of the hippocampus, thalamus, amygdala, corpus callosum, orbitofrontal cortex and insula. White matter integrity was also investigated. Average alcohol use across the study period was the main exposure of interest. Past-year binge drinking and reduction in drinking from pre-baseline were additional exposures of interest. Within the context of low-level average drinking (averaging 11.7 g per day), higher average amount of alcohol consumed was associated with less atrophy in the left (B = 7.50, pFDR = 0.010) and right (B = 5.98, pFDR = 0.004) thalamus. Past-year binge-drinking was associated with poorer white matter integrity (B = -0.013, pFDR = 0.024). Consuming alcohol more heavily in the past was associated with greater atrophy in anterior (B = -12.73, pFDR = 0.048) and posterior (B = -17.88, pFDR = 0.004) callosal volumes over time. Across alcohol exposures and neuroimaging markers, no other relationships were statistically significant. Within the context of low-level drinking, very few relationships between alcohol use and brain macrostructure were identified. Meanwhile, heavier drinking was negatively associated with white matter integrity.

PMID:38797559 | DOI:10.1111/adb.13402

Clin Gastroenterol Hepatol. 2024 Jun;22(6):1151-1156. doi: 10.1016/j.cgh.2024.02.030.

NO ABSTRACT

PMID:38797533 | DOI:10.1016/j.cgh.2024.02.030

Br J Haematol. 2024 May 26. doi: 10.1111/bjh.19559. Online ahead of print.

ABSTRACT

Methotrexate (MTX), although an indispensable part of contemporary treatment protocols for childhood acute lymphoblastic leukaemia (ALL)/lymphomas (LBL) in improving outcomes, can lead to serious neurotoxicity with long-term consequences. The aetiopathogenesis, predisposing factors and treatment for MTX-induced neurotoxicity are not yet well defined. The aim of our study was to detect the incidence, risk factors and to assess the overall outcomes of MTX-induced neurotoxicity among large cohort of paediatric ALL/LBL patients treated on a uniform protocol. We conducted retrospective audit of medical records of 622 consecutive children (≤14 years) diagnosed with ALL and LBL between January 2018 and December 2022 and treated on modified BFM-95 protocol at the Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram. Risk factors predisposing to MTX-induced neurotoxicity were identified using binary logistic regression analysis. Forty-three children were diagnosed with MTX-induced neurotoxicity with an incidence rate of 6.9%. More than two-thirds of them had high-grade MTX-induced neurotoxicity CTCAE v5.0 with a median age of 9 years (range: 9 months to 14 years). Almost half of them developed MTX neurotoxicity during Protocol M followed by Phase-Ib consolidation (15%). Majority of these patients (84%, 36/43) were challenged again with MTX, with 11% (4/36) developing recurrence. Fifteen per cent had persistent neurological deficits at last follow-up. Univariate analysis found older age (age > 5 years) (p < 0.001), T-cell phenotype (p = 0.040), tumour lysis syndrome during induction (p < 0.001), baseline renal problems prior to MTX exposure (p < 0.001) and CNS leukaemic involvement (p < 0.003) to be significantly associated with MTX neurotoxicity. On multivariate analysis, older age (>5 years), tumour lysis during induction and CNS leukaemia retained statistical significance (p < 0.05). Methotrexate-induced neurotoxicity during paediatric acute lymphoblastic leukaemia/lymphoma therapy is a transient phenomenon in majority and re-challenge with MTX is generally safe. Older age children who develop tumour lysis during induction and CNS leukaemic involvement are at increased risk for MTX-induced neurotoxicity during ALL/LBL treatment.

PMID:38797523 | DOI:10.1111/bjh.19559

Water Environ Res. 2024 May;96(5):e11041. doi: 10.1002/wer.11041.

ABSTRACT

The aim of the study is to investigate the leaching of fluorescent dissolved organic matter (fDOM) from microplastics. In addition, this study identifies the connection between fDOM and microplastics in the aquatic environment. Three-dimensional excitation-emission matrix identified five fluorophores, that is, peak A, M, T, T_uv, and W_uv, and the parallel factor analysis modeling identified five components, that is, tryptophan-like, p-hydroxy acetophenone, humic acid (C-like), detergent-like, and fulvic acid (M-like) in the urban surface water. Mimic experiments using commonly used synthetic plastic (like microplastics) in Mili-Q water under solar radiation and dark environments demonstrate the release of fDOM from plastic. Two fluorophore peaks were observed at Ex/Em = 250/302 nm and Ex/Em = 260/333 nm for the expanded polystyrene plastic polymer and one fluorophore peak at Ex/Em = 260/333 nm for the low-density polyethylene. Fluorophore and component intensity exhibited notable associations with microplastics in the aquatic environment. These findings indicated that the characteristics and dynamics of fDOM in urban surface water are influenced by microplastics. PRACTITIONER POINTS: Fluorescent dissolved organic matters were identified in urban surface waters. Expanded polystyrene (EPS) had shown two fluorophores at Em/Ex = 250/302 and Em/Ex = 260/333. Low-density polyethylene (LDPE) had one fluorophore at Em/Ex = 260/333. Fluorophore and component intensity in the aquatic settings exhibited associations with microplastics.

PMID:38797514 | DOI:10.1002/wer.11041