Nevin Manimala

Zhongguo Zhen Jiu. 2023 Aug 12;43(8):907-10. doi: 10.13703/j.0255-2930.20220621-k0002.

ABSTRACT

OBJECTIVE: To observe the clinical effect and safety of acupuncture in treatment of neck pain due to cervical spondylosis.

METHODS: According to the patients’ preference and acceptance for the interventions of neck pain induced by cervical spondylosis, an acupuncture group (221 cases) and a non-acupuncture group (251 cases) were divided. After the control of confounding factors with propensity score matching, 218 cases were included in either acupuncture group or non-acupuncture group. In the acupuncture group, acupuncture was applied to Dazhui (GV 14), Baihui (GV 20), ashi points, bilateral neck-Jiaji (EX-B 2), Fengchi (GB 20), Houxi (SI 3), Shenmai (BL 62), etc. The treatment was given once daily, one course of intervention was composed of 5 treatments and 3 courses were included. In the non-acupuncture group, the oral administration of imrecoxib tablets and cobalt tablets was prescribed for 2 weeks. Before and after treatment, the scores of Northwick Park questionnaire (NPQ) and the simplified McGill pain questionnaire (SF-MPQ) were observed, and the safety was assessed in patients of the two groups.

RESULTS: After treatment completion, the scores of NPQ and SF-MPQ were all reduced when compared with those before treatment in each group (P<0.001), and the scores of NPQ and SF-MPQ in the acupuncture group were lower than those of the non-acupuncture group (P<0.001). The incidence of adverse reactions was 6.0% (13/218) in the acupuncture group and was 10.1% (22/218) in the non-acupuncture group, without statistical significance in comparison (P>0.05).

CONCLUSION: Acupuncture is effective and safe in the relief of neck pain and the improvement of comprehensive quality of life in the patients with cervical spondylosis.

PMID:37577886 | DOI:10.13703/j.0255-2930.20220621-k0002

Zhongguo Zhen Jiu. 2023 Aug 12;43(8):881-6. doi: 10.13703/j.0255-2930.20230329-k0012.

ABSTRACT

OBJECTIVE: To explore the manifestations of jingjin (sinews/fascia) lesions and summarize their distribution rules in the patients with neck-type cervical spondylosis so as to provide the evidences for the development of clinical diagnosis and treatment scheme of acupuncture for cervical spondylosis.

METHODS: A total of 120 patients with neck-type cervical spondylosis were collected. The meridian diagnostic method was used to examine the upper back of each patient, the manifestation category of jingjin lesions, locations and the affected muscle regions of twelve meridians were recorded.

RESULTS: (1) The punctate lesions of jingjin were detected in 15 regions, and the highest frequency of lesion occurred in the region from the inner upper corner of the scapula to Quyuan (SI 13) (113 cases, 94.2% of lesion frequency). The lesion frequency of 10 regions was ≥50.0%. The punctate lesions were mainly distributed in the muscle regions of hand-shaoyang (349 cases) and foot-taiyang (333 cases). (2) The linear lesions of jingjin were detected in 10 regions, and the highest frequency of lesion occurred in the region from the inner upper corner of the scapula to Quyuan (SI 13) (77 cases, 64.2% of lesion frequency). The lesion frequency of 2 regions was ≥50.0%. The linear lesions occurred mainly in the muscle region of foot-taiyang (251 cases). (3) Eight regions were examined to be the planar lesions of jingjin, and the highest frequency of lesion was found in the site of Jianjing (GB 21) (84 cases, 70.0% of lesion frequency). The lesion frequency of 3 regions was ≥50.0%. The muscle region of foot-taiyang (260 cases) was predominated in the planar lesions. (4) The distribution of all of the punctate, linear and planar lesions of jingjin was analyzed statistically. It was found that 25 regions were involved and those with the high lesion frequency were distributed in the area from the inner upper corner of the scapula to Quyuan (SI 13), the sites of Jianjing (GB 21) and Dazhui (GV 14), transverse processes of C₃ to C₅ and the area from the lateral border of the scapula to the teres minor, separately. The muscle regions of foot-taiyang, hand-shaoyang and hand-yangming were involved in various kinds of jingjin lesions.

CONCLUSION: Jingjin lesions in patients with neck-type cervical spondylosis can be divided into three categories, namely, punctate, linear and planar lesions; of which, the punctate lesions are dominated. A majority of jingjin lesions is related to the muscle region of foot-taiyang, and the lesion frequency is higher compared with the lesions to the muscle regions of hand-shaoyang and hand-yangming. Jingjin lesions are commonly distributed in the area from the inner upper corner of the scapula to Quyuan (SI 13).

PMID:37577882 | DOI:10.13703/j.0255-2930.20230329-k0012

Blood Coagul Fibrinolysis. 2023 Jul 19. doi: 10.1097/MBC.0000000000001238. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the risk of readmissions for major bleeding within one year between apixaban and rivaroxaban as a component of triple antithrombotic therapy.

METHODS: This study was a multicenter, retrospective cohort study conducted at two academic medical centers in the Western New York and New York City region between July 1, 2011 and September 25, 2019. Adult patients were included if they were diagnosed with atrial fibrillation or venous thromboembolism and discharged on new triple antithrombotic therapy. The primary outcome compared the rates of 1-year readmission for major bleeding between apixaban and rivaroxaban groups. Secondary outcomes included rate of ischemic outcomes. Time to event analysis was determined with a Kaplan-Meier plot and Cox proportional hazard ratios (HR).

RESULTS: A total of 378 patients were included in the study, 212 in the apixaban group and 166 in the rivaroxaban group. Within 1 year, readmission for major bleeding events occurred in six (2.8%) patients in the apixaban group and four (2.4%) patients in the rivaroxaban group (P = 1.000). After adjustment, the major bleeding event rate was not statistically significantly different between apixaban and rivaroxaban [adjusted hazard ratio (aHR) 0.68, 95% confidence interval (CI) 0.12-3.77; P = 0.6624]. Higher albumin levels were identified to be protective against major bleeding related readmission events (aHR 0.18, 95% CI 0.05-0.63; P = 0.0072). The ischemic outcome occurred in seven (3.3%) patients in the apixaban group and three (1.8%) in the rivaroxaban group (P = 0.7368).

CONCLUSION: Use of apixaban or rivaroxaban in a triple antithrombotic regimen was not associated with bleeding or ischemic outcomes.

PMID:37577874 | DOI:10.1097/MBC.0000000000001238

J Cardiovasc Med (Hagerstown). 2023 Aug 8. doi: 10.2459/JCM.0000000000001541. Online ahead of print.

ABSTRACT

AIMS: Takotsubo syndrome (TTS) is a serious heart disease associated with significant morbidity and mortality. TTS has been related to SARS-CoV-2 infection and COVID-19 vaccine; however, the current data are scarce. We aimed to examine the associations between SARS-CoV-2 infection and its vaccine with TTS.

METHODS: We conducted a nested case-control study in a cohort of 3 237 909 adults from the largest healthcare provider in Israel. Patients were followed from 1 March 2020 until 31 December 2021 for the occurrence of TTS. Ten randomly selected controls were matched to each case of TTS on age, sex, and duration of follow-up. Exposure to SARS-CoV-2 infection and COVID-19 vaccine in the prior 30 days was assessed in cases and controls.

RESULTS: During the follow-up 144 patients developed TTS and were matched to 1440 controls. The mean age of cases and their matched controls was 71.4 ± 12 years, and 136 (94.4%) of them were women. Conditional logistic regression analysis showed that SARS-CoV-2 infection and COVID-19 vaccine were not associated with an increased risk of TTS; odds ratio (OR) = 2.04 [95% confidence interval (CI), 0.50-8.2] and 0.87 (0.49-1.54), respectively. The absolute number of TTS cases in the prepandemic period (March-December 2018-2019) was 82 in 2018 and 80 in 2019. The number of TTS cases decreased to 56 during the corresponding period of 2020 (first pandemic year) and increased back to 81 in 2022.

CONCLUSION: No significant association was found between SARS-CoV-2 infection or COVID-19 vaccination and TTS occurrence.

PMID:37577873 | DOI:10.2459/JCM.0000000000001541

Public Health Rep. 2023 Aug 14:333549231186776. doi: 10.1177/00333549231186776. Online ahead of print.

ABSTRACT

OBJECTIVE: Food safety progress depends on the ability of public health agencies to detect and investigate foodborne disease outbreaks. The Integrated Food Safety Centers of Excellence identify and implement best practices and serve as resources for public health professionals who investigate enteric disease outbreaks. To target the needs of this diverse workforce, the Integrated Food Safety Centers of Excellence developed and assessed a professional tier framework and competencies.

METHODS: We described the characteristics of public health professionals who investigate enteric disease outbreaks in the epidemiology role in a conceptual tiered framework. We mapped core competencies to each tier and disseminated a survey to practitioners at local (June 2019) and state (August 2018) US public health agencies to evaluate the importance and frequency of each competency.

RESULTS: We developed 15 competencies on surveillance, outbreak detection, interview skills, investigation team, specimen testing, data analysis, hypothesis generation, study design, communication, enteric disease biology, control measures, legal authority, quality improvement, environmental health, and reporting to surveillance. The 286 survey respondents selected interview skills, surveillance, control measures, and hypothesis generation as the competencies most important to their work and most frequently performed.

CONCLUSION: The Integrated Food Safety Centers of Excellence created the first published workforce framework and competencies for public health professionals who detect and investigate enteric disease outbreaks in the epidemiology role, in collaboration with local, state, and federal public health agencies and national organizations. These tools have been integrated into existing programs and can be used to develop training curricula, assess workforce competency over time, and identify priorities for continuing education and training.

PMID:37577854 | DOI:10.1177/00333549231186776

Eur J Gastroenterol Hepatol. 2023 Jul 31. doi: 10.1097/MEG.0000000000002616. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Celiac disease is a risk factor for osteopenia and osteoporosis. Our aim was to evaluate the possible correlation between villous atrophy extension and dual-energy X-ray absorptiometry (DXA)-derived parameters of bone status.

METHODS: We have retrospectively analyzed data of 47 celiac patients (36 women, 52 ± 14 years of age) who underwent video capsule endoscopy and DXA scans within 1 year of interval from 2006 to 2019. Quantitative, qualitative and geometric DXA parameters were collected only from the most recent DXA measurements.

RESULTS: . Patients were divided into three categories; the first included those with no lesions at video capsule endoscopy (23 patients), the second those with typical lesions (mucosal atrophy, mosaicism and scalloping) in less than one-third of the small bowel (SB) (16 patients) and the third those with typical lesions in more than one-third of the SB (7 patients). In the third group, bone mineral density seemed to be lower in both the lumbar spine and the hip (P = 0.026 and P = 0.011, respectively). The deterioration of bone structure in patients with severe and extended SB atrophy was statistically significant (P = 0.032). Furthermore, bone density, structure and geometry did not correlate with the duration of the gluten-free diet. Notably, autoimmune comorbidities did not affect DXA results.

CONCLUSION: Neither endoscopic nor histological atrophy itself can explain the deterioration of bone mineralization and structure, whereas atrophy extension appeared to be responsible for bone impairment.

PMID:37577844 | DOI:10.1097/MEG.0000000000002616

Int Nurs Rev. 2023 Aug 14. doi: 10.1111/inr.12874. Online ahead of print.

ABSTRACT

AIM: This study investigated anxiety, depression, and stress and their influencing factors among nurses during the COVID-19 pandemic and after the flood in Henan Province, China. It aimed to provide the theoretical foundation for the management of relevant hospital departments, improvement of nursing quality, implementation of antiepidemic work, and other relevant studies.

BACKGROUND: In December 2019, COVID-19 was reported in Wuhan, China and became a global pandemic. In July 2021, unprecedented flooding occurred in Henan Province, China. Under the dual pressure of COVID-19 and the flood, nurses’ mental health problems deteriorated.

METHODS: In August 2021, 1229 nurses from various departments of the First Affiliated Hospital of Xinxiang Medical University in Xinxiang City, Henan Province,China were invited to participate in a questionnaire survey using a general condition questionnaire and the Chinese version of the Depression-Anxiety-Stress Scale. Descriptive statistics were used to analyze the status of nurses’ anxiety, depression, and stress. Analysis of variance, t-test, and multiple linear regression models were used to analyze the factors influencing anxiety, depression, and stress among nurses.

RESULTS: Of the participants, 36.1%, 10.1%, and 15.5% had moderate to high levels of anxiety, stress, and depression, respectively. Moreover, 42 (3.4%) participants experienced high to severe levels of stress, anxiety, and depression. The scores showed significant differences based on gender, harmonious family relationships, department position, work intensity, sleep quality, physical exercise, participation in leisure activities, health status, involvement in emotion management-related training, and attending self-care-related training (all P < 0.05). Gender, work intensity, harmonious family relationships, health condition, sleep quality, and participation in leisure activities influenced stress, anxiety, and depression scores. Department position influenced anxiety and stress scores, and average monthly earnings influenced anxiety scores.

CONCLUSION: All the nurses experienced various levels of stress, anxiety, and depression. Related departments should pay special attention to male nurses and nurses with high work intensity, unharmonious family relationships, poor health, and sleep quality, and who engage in fewer leisure activities.

IMPLICATIONS FOR NURSING AND HEALTH POLICY: It is recommended that departments allocate human resources and arrange schedules reasonably, encourage nurses to participate in more recreational activities, and implement emotion management and self-care-related training to relieve emotional distress, and ultimately maintain nurses’ mental health.

PMID:37577826 | DOI:10.1111/inr.12874

Diabet Med. 2023 Aug 14:e15199. doi: 10.1111/dme.15199. Online ahead of print.

ABSTRACT

AIMS: This study aimed to devise and validate a clinical scoring system for risk prediction of bladder cancer to guide urgent cystoscopy evaluation among diabetes patients.

METHODS: Diabetes patients who received cystoscopy from a large database in a Chinese population (2009-2018). We recruited a derivation cohort based on random sampling from 70% of all individuals. We used the adjusted odds ratios (aORs) for independent risk factors to devise a risk score, ranging from 0 to 5: 0-2 ‘average risk’ (AR) and 3-5 ‘high risk’ (HR).

RESULTS: A total of 5,905 diabetes patients, among which 123 patients with BCa were included. The prevalence rate in the derivation (n=4,174) and validation cohorts (n=1,731) was 2.2 and 1.8%. Using the scoring system constructed, 79.6% and 20.4% in the derivation cohort were classified as AR and HR. The prevalence rate in the AR and HR groups was 1.57% and 4.58%. The risk score consisted of age (18-70: 0; >70: 2), male (1), ever/ex-smoker (1), duration of diabetes (≥ 10 years: 1). Individuals in the HR group had 3.26-fold (95% CI=1.65 to 6.44, p=0.025) increased prevalence of bladder than the AR group. The concordance (c-) statistics was 0.72, implying a good discriminatory capability of the risk score to stratify high risk individuals who should consider earlier cystoscopy.

CONCLUSIONS: The risk prediction algorithm may inform urgency of cystoscopy appointments, thus allowing a more efficient use of resources and contributing to early detection of BCa among patients planned to be referred.

PMID:37577820 | DOI:10.1111/dme.15199

Eur J Gastroenterol Hepatol. 2023 Aug 14. doi: 10.1097/MEG.0000000000002627. Online ahead of print.

ABSTRACT

OBJECTIVES: Pegylated interferon α-2b (PegIFNα-2b) therapy can help inactive hepatitis B surface antigen (HBsAg) carriers (IHCs) achieve clinical cure. To explore and compare the efficacy, safety, and relevant influential factors of PegIFNα-2b monotherapy and PegIFNα-2b-based immunotherapy for IHCs.

METHODS: This exploratory, prospective, single-center, randomized controlled trial enrolled 40 IHCs who were randomized into group A (PegIFNα-2b treatment for 68 weeks) and group B (two cycles of PegIFNα-2b treatment with a lead-in period of GM-CSF and vaccine treatment before each cycle). The primary endpoint was 68-week HBsAg loss rate.

RESULTS: At week 68, the HBsAg loss rates were 45.45% [full analysis set (FAS)] and 46.67% [per-protocol set (PPS)]. There was no statistically significant difference in HBsAg loss rate between groups A and B (P > 0.05). Univariate analysis revealed that age ≤40 years old, baseline HBsAg <200 IU/ml, and 24-week HBsAg decline ≥2 log10 IU/ml were significantly associated with HBsAg loss in FAS population (P < 0.05). Multivariate analysis showed that only 24-week HBsAg decline ≥2 log10 IU/ml was the independent influencing factor in both FAS and PPS populations (P < 0.05). The adverse events were common and mild, and the therapies were well-tolerated.

CONCLUSION: Treatment of IHCs with PegIFNα-2b-based therapy could result in a high HBsAg loss rate. The HBsAg loss rate of combined immunotherapy was similar to that of PegIFNα-2b monotherapy, and the safety was good.

CLINICALTRIALSGOV ID: NCT05451420.

PMID:37577817 | DOI:10.1097/MEG.0000000000002627

J Enzyme Inhib Med Chem. 2023 Dec;38(1):2245168. doi: 10.1080/14756366.2023.2245168.

ABSTRACT

The formal mechanism of linear mixed and non-competitive enzyme inhibition implies the binding of inhibitors to both the active site of the free enzyme in competition with the substrate, and to an allosteric site on the enzyme-substrate complex. However, it is evident from a review of the scientific literature that the two-site mechanism is frequently mistaken as the actual underlying mechanism of mixed inhibition. In this study, we conducted a comprehensive assessment of the mechanistic relevance of this type of inhibition using a statistical approach. By combining a statistical analysis of the inhibition cases documented in the BRENDA database with a theoretical investigation of inhibition models, we conclude that mixed inhibitors exclusively bind to the active site of enzymes. Hence ruling out any implication of allosteric sites and depriving the two-site model of any mechanistic relevance.

PMID:37577806 | DOI:10.1080/14756366.2023.2245168