Nevin Manimala

Rheumatol Int. 2024 Dec 28;45(1):10. doi: 10.1007/s00296-024-05763-6.

ABSTRACT

BACKGROUND: Hematological markers such as the neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are reliable indicators of inflammation. This study aims to investigate the potential role of these markers in assessing disease activity and treatment response in biologic-naive Ankylosing Spondylitis (AS) patients following the initiation of biological agents.

MATERIALS AND METHODS: We designed this study as a retrospective cohort study with data obtained from a single center. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and The Bath Ankylosing Spondylitis Functional Index (BASFI) were used to evaluate disease activity and functional status of AS patients. Laboratory results at baseline, 3rd, 6th, and 12th months were documented. We calculated hematologic inflammatory markers for each visit. Mean platelet volume (MPV) and red cell distribution width (RDW) were also noted.

RESULTS: 54 biologic-naive patients with AS were included in this study. These inflammatory markers, except RDW, decreased over time. BASDAI, BASFI, CRP and ESR were significantly lower at 3rd, 6th, and 12th months compared to baseline values (all p < 0.001). Furthermore, NLR, PLR, and MLR showed a statistically significant decrease at 3rd, 6th, and 12th months compared to baseline values (all p < 0.001). However, when comparing the values at the 3rd, 6th, and 12th months, no statistically significant differences were observed. We also found no correlation between hematological inflammatory markers and BASDAI scores, despite observing some correlations between hematological markers and acute phase reactants.

CONCLUSION: These markers could be valuable assessment tools for indicating disease activity and monitoring patients with AS after initiating biological treatment.

PMID:39733134 | DOI:10.1007/s00296-024-05763-6

Sci Rep. 2024 Dec 28;14(1):31493. doi: 10.1038/s41598-024-83076-1.

ABSTRACT

Technological disasters in the Americas have significant public health and environmental implications, but there is limited epidemiological analysis of these events. This study aims to characterize the epidemiological profile of technological disasters in the Americas from 2000 to 2021, focusing on morbidity and mortality trends. A retrospective cross-sectional study was conducted. The ANOVA test was applied in the mean rates calculated for each type of disaster. The Mann-Kendall test assessed the presence or absence of temporal trends, and the Dickey-Fuller augmented test was used to determine if the time series were stationary. Predictions were made up to the year 2030 to mean mortality rate per million inhabitants, mean rate of people affected per million inhabitants, and mean rate of people injured per million inhabitants. A total of 733 technological disasters were recorded in the Americas. Statistically significant differences were found between the mean rates of people affected and the mean mortality rates per million inhabitants for each type of technological disaster. No trends were identified. The highest mean mortality rates occurred because of industrial accidents.

PMID:39733127 | DOI:10.1038/s41598-024-83076-1

Sci Rep. 2024 Dec 28;14(1):31393. doi: 10.1038/s41598-024-82970-y.

ABSTRACT

Although the connection between muscular strength and flatfoot condition is well-established, the impact of corrective exercises on these muscles remains inadequately explored. This study aimed to assess the impact of intrinsic- versus extrinsic-first corrective exercise programs on muscle morphometry and navicular drop in boys with flexible flatfoot. Twenty-five boys aged 10-12 with flexible flatfoot participated, undergoing a 12-week corrective exercise program, with a shift in focus at six weeks. Ultrasound imaging measured muscle thickness and cross-sectional area (CSA), and the navicular drop test assessed flatfoot severity. The results demonstrated a significant interaction between exercise type and sequencing on muscle morphometry. Initiating with intrinsic exercises led to sustained improvement, even after transitioning to extrinsic exercises, while extrinsic-first exercises caused deterioration in intrinsic muscle morphometry, which was recovered after transitioning to intrinsic exercises. Statistical analysis revealed significant improvements in muscle thickness and CSA over time, particularly when initiating intrinsic exercises first. The intrinsic-first group also exhibited a more pronounced reduction in navicular drop. In conclusion, initiating corrective exercises with intrinsic muscles proved more effective in improving foot muscle morphometry and reducing navicular drop in boys with flatfoot. Therefore, commencing correction with intrinsic muscle exercises is recommended before progressing to extrinsic muscle exercises.

PMID:39733109 | DOI:10.1038/s41598-024-82970-y

Sci Rep. 2024 Dec 28;14(1):31345. doi: 10.1038/s41598-024-82821-w.

ABSTRACT

The prevalence of prostate-specific antigen (PSA) testing has consistently fallen for several years. This study explored how the decreasing trend differs by selected variables and reasons for taking the PSA test. Analyses involved men, aged 40 years or older, who completed the Behavior Risk Factor Surveillance System (BRFSS) survey in even number years from 2008 through 2022. Trends in PSA testing rates within the past year declined by 46% from 2008 to 2020 and then increased 21% from 2020 to 2022. The greatest changes corresponded with the years of new USPSTF guidelines. Declining PSA testing rates occurred across the levels of all variables considered but were more pronounced in younger men and men never married, less educated, and without health care coverage. After adjusting for these variables, declining PSA testing rates did not significantly differ between racial/ethnic groups or between income groups. The level of several variables influenced the decline, as a function of perceived risk, accessibility, and desire for the test. Inconsistencies with the USPSTF’s guidelines were seen in higher PSA testing in older and more educated men. The distribution of main reasons for taking the test (part of a routine exam [72%], prostate problem/cancer [12%], family history [6%], and other [10%]) remained constant. PSA testing as part of a routine exam (vs. no PSA test) increased with age and was higher in non-Hispanic Blacks, married (or cohabitating), and in men with higher education, higher income, and health care coverage. PSA testing because of a prostate problem/cancer or family history of prostate cancer according to these variables are also described in this study.

PMID:39733093 | DOI:10.1038/s41598-024-82821-w

Sci Rep. 2024 Dec 28;14(1):31408. doi: 10.1038/s41598-024-83016-z.

ABSTRACT

The aim of this study was to evaluate how COVID-19 affected acute stroke care and outcome in patients with acute ischemic or hemorrhagic stroke. We performed a retrospective analysis on patients who were admitted with acute ischemic (AIS) or hemorrhagic (ICH) stroke from September 2020 to May 2021 with and without COVID-19. We recorded demographic and clinical data, imaging parameters, functional outcome and mortality at one year. Beside descriptive statistics we performed χ²-probe, Mann-Witney U-test, Student t-probe and multivariate testing. We found a 29%-reduction in the number of AIS cases during the pandemic. The number of the large vessel occlusions /LVOs/ (N = 83, 41.7%), from them 37 (17.7%) had mechanical thrombectomy (MT), was higher than before the COVID-19 period (p = 0.02 and p = 0.001, respectively). From all patients needing acute revascularization therapy (N = 137) 118 patients received it, among them 20 (16.9%) had COVID-19. Those positive for COVID-19 were more likely to have a higher median NIHSS score at baseline and at 24 h (p = 0.02 and p = 0.03, respectively). They also had a lower rate of favourable outcome at discharge (15% vs. 41.8%; p = 0.024) and at three months (25% vs. 52%, p = 0.02), longer median hospitalization (p < 0.0001), and a higher mortality rate (52% vs. 25%; p = 0.03). The incidence of symptomatic intracerebral hemorrhage (sICH) did not differ between the groups. Regarding the ICH patients, NIHSS score at 24 h (p = 0.036), mortality at 3 months (p = 0.004) and at one year (p = 0.00) were higher in the COVID-19 group. We concluded that the pandemic resulted fewer admission due to AIS with an increased number of LVOs and MTs. AIS patients with concomitant SARS-CoV-2 infection have more severe strokes and unfavorable long term outcome. The risk of sICH was not increased in COVID-19 positive patients therefore reperfusion therapies appear to be safe and beneficial for some individuals. Patients with ICH and comorbid COVID-19 have a very poor prognosis.

PMID:39733029 | DOI:10.1038/s41598-024-83016-z

Support Care Cancer. 2024 Dec 28;33(1):59. doi: 10.1007/s00520-024-09106-w.

ABSTRACT

OBJECTIVE: This study aims to enhance compliance with lower limb lymphedema (LLL) prevention care measures post-gynecologic oncology surgery (GOS) through quality control circle (QCC) activity, aiming to improve patient recovery outcomes and reduce postoperative complications.

METHODS: A 6-month QCC activity was conducted within the hospital, employing the ten-step plan-do-check-act model for QCC activity. The root causes of inadequate implementation of LLL prevention care measures were analyzed, leading to the development of relevant strategies and protocols. Compliance rates of preventive care measures pre- and post-QCC activity were compared.

RESULTS: The focus of this improvement initiative was on “inadequate postoperative preventive measures” and “lack of standardized discharge preventive measures.” Strategies included ensuring nurses proficiently assess LLL following gynecologic malignancy surgeries, enhancing standardized preventive measures for LLL post-GOS, and establishing personalized and diversified education models. Following the implementation of QCC activity, there was a significant improvement in the compliance rate of LLL prevention care measures. The compliance rate increased from 74.00% before the activity to 92.80%, surpassing the target rate by 119.00%, with an improvement rate of 25.40%. Comprehensive evaluations of circle members’ abilities showed significant improvement, with notable increases in problem-solving abilities, initiative, and confidence.

CONCLUSION: Implementation of QCC activity resulted in a substantial improvement in compliance with LLL prevention care measures following GOS, ensuring safer and more effective patient care services.

PMID:39733009 | DOI:10.1007/s00520-024-09106-w

Pediatr Surg Int. 2024 Dec 28;41(1):52. doi: 10.1007/s00383-024-05952-1.

ABSTRACT

BACKGROUND: In middle-income countries, healthcare systems face unique challenges in ensuring timely antenatal detection of congenital abnormalities that require pediatric surgical intervention. Early detection can significantly improve outcomes, yet resource constraints often limit access to diagnostic technologies. This study evaluates the antenatal detection rate of congenital abnormalities referred to pediatric surgical services in three Malaysian tertiary centers and examines its effect on maternal anxiety.

METHODS: A prospective observational study was conducted at Hospital Raja Permaisuri Bainun (HRPB), Hospital Sultanah Aminah (HSA), and University of Malaya Medical Centre (UMMC) over a 8 month period. Data were collected from mothers of neonates born with congenital abnormalities, and the Spielberg State-Trait Anxiety Inventory (STAI) was used to assess maternal anxiety.

RESULTS: A total of 58 patients were recruited. The overall antenatal detection rate for congenital abnormalities was 43.1%, comparable to high-income countries despite resource limitations. Antenatal counselling by pediatric surgeons was rare (6.9%) and showed no significant reduction in maternal anxiety (p = 0.374).

CONCLUSION: The antenatal detection rates at the three Malaysian centers align with those in more developed nations, underscoring the potential of middle-income healthcare systems to deliver high-quality prenatal care. However, improving access to diagnostic technologies and involving pediatric surgical teams in antenatal counselling could further enhance care.

PMID:39733003 | DOI:10.1007/s00383-024-05952-1

Sci Rep. 2024 Dec 28;14(1):31263. doi: 10.1038/s41598-024-82644-9.

ABSTRACT

The COVID-19 pandemic has not only posed alarming health challenges but also exacerbated the scenarios of intimate partner violence (IPV) against women globally. While global studies indicate a conspicuous increase in IPV during COVID-19 lockdowns; Indian studies exhibit mixed evidence. This ambiguity in world’s most populous country underscores a greater need to examine the nexus between exposure to COVID-19 and IPV using a large nationally representative sample of India. This study employs an ‘intent-to-treat (ITT) framework’ approach to assess the effect of COVID-19 exposure on IPV for women with “exposure (or cases)” compared to those with “no exposure (or controls)”. Using data from National Family Health Survey-5, the study employs a methodology comprising three stages: first, descriptive and bivariate statistics that characterize the sample population. Second, a multivariable logistic regression model was employed to examine the influence of COVID-19 on IPV reporting. Finally, the study validated its main findings using the Propensity Score Matching (PSM) tool with an ITT framework. The result from multiple statistical approaches indicates a reduction in IPV during COVID-19 – primarily suggesting significant under-reporting of domestic violence cases in the data collected during its exposure period. This underreporting remains consistent across diverse socioeconomic backgrounds. The study advances that reduction in the incidents of IPV among women surveyed after exposure to COVID-19 compared to their counterparts can be attributable to underreporting or greater socio-emotional cohesion among partners during menaces like COVID-19. While the under-reporting of cases can also be attributed to the lack of accessibility to peer groups and social and community networks, who often help women to identify and report IPV. Further, it can also possible due to the reduction in alcohol consumption and greater dependency of female on male partners due to jobloss during COVID-19 lockdown. This study, thereby, underscores the need for innovative survey tools to capture Violence Against Women (VAW) in general and IPV in particular during an extraordinary situation like COVID-19.

PMID:39733000 | DOI:10.1038/s41598-024-82644-9

Sci Rep. 2024 Dec 28;14(1):31542. doi: 10.1038/s41598-024-83360-0.

ABSTRACT

Helicobacter pylori (H. pylori) is one of the most globally prevalent bacteria, closely associated with gastrointestinal diseases such as gastric ulcers and chronic gastritis. Current clinical methods primarily involve Carbon-13 and Carbon-14 urea breath test, both carrying potential safety risks. Fourier-transform infrared (FTIR) spectroscopy can detect human exhaled gases, which may change under disease conditions. This preliminary study aims to explore the application value of FTIR-based breath analysis in detecting H. pylori infection, providing theoretical basis and clinical references for new clinical detection methods. A cross-sectional survey was conducted from August 2021 to May 2022 at Renmin Hospital of Wuhan University. Breath samples were collected before and half an hour after ingesting unlabeled urea. Gas samples were analyzed using FTIR breath spectra. Individual exhalation spectral data after deducting baseline spectral data were used as the basis for the training and test sets through K-center clustering algorithm. Results: A total of 278 samples were collected (63 H. pylori infection cases, 215 healthy controls). There were no statistically significant differences in general data (age, gender, smoking history, alcohol consumption history, comorbidities, etc.) between the two groups. The predictive model was successfully established, with recognition rates of 94.12%, 98.39%, and 91.30% for the training set, test set, and validation set, respectively. Exhaled gas analysis based on Fourier-transform infrared spectroscopy has the potential to diagnose H. pylori infection.

PMID:39732993 | DOI:10.1038/s41598-024-83360-0

NPJ Prim Care Respir Med. 2024 Dec 28;34(1):46. doi: 10.1038/s41533-024-00404-8.

ABSTRACT

Digital health platforms for asthma self-management have demonstrated promise in improving clinical and quality of life outcomes. However, few studies have examined such an approach in a real-world, fully remote setting. As such, we evaluated the benefit of an evidence-based digital self-management platform for asthma-both on its own and when integrated into an established virtual clinical service. We compared six-month outcomes of a digital self-management program plus virtual clinical oversight, called a therapeutic resource center, (DP + TRC) with a digital self-management-only (DP) program in patients with uncontrolled asthma. The DP included electronic medication sensors that captured the date and time of both short-acting beta agonist (SABA) and controller medication usage. The TRC included remote care oversight to promote inhaler adherence and address symptom worsening. SABA usage, controller adherence and program retention were assessed retrospectively using regression models controlling for age, enrollment year, controller/SABA use, and baseline asthma control status.18,584 DP patients (mean age (SD): 33 (14.6) yrs; 89.9% uncontrolled asthma) and 3440 DP + TRC patients (mean age (SD): 43.7 (15.6) yrs); 48.6% uncontrolled) were assessed. We observed significantly better six-month program retention (55% vs. 41%, p < 0.001) and controller adherence (54% vs. 45%, p < 0.001), but no statistically significant differences in mean SABA use (0.76 vs. 0.87 mean puffs/day; p = 0.158) for the DP + TRC vs. DP groups, respectively. From baseline to six months, both groups had similar reductions in mean daily SABA use (both p < 0.001) and improvements in the percent of SABA-free days (both p < 0.001). The proportion of patients with ≥80% controller adherence declined in both groups, but a larger relative decline was noted in the DP vs. DP + TRC group. A digital self-management platform for asthma management combined with virtual clinical oversight may offer a scalable solution that not only achieves reduced SABA use, but also promotes medication adherence and increases program retention.

PMID:39732726 | DOI:10.1038/s41533-024-00404-8