Nevin Manimala

Sao Paulo Med J. 2024 Jun 17;142(6):e2023241. doi: 10.1590/1516-3180.2023.0241.R2.25032024. eCollection 2024.

ABSTRACT

BACKGROUND: The magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs.

OBJECTIVE: To investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults.

DESIGN AND SETTING: Adults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014.

METHODS: Direct healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures.

RESULTS: In total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9% (95%CI: 25.2% to 32.4%) of the sample, while insufficient PA was reported by 84.8% (95%CI: 82.1% to 87.6%). The combination of sleep problems and insufficient PA explained 2.3% of all healthcare costs spent on these patients from 2010 to 2014, which directly accounts for approximately US$ 4,765.01.

CONCLUSION: The combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems.

PMID:38896745 | DOI:10.1590/1516-3180.2023.0241.R2.25032024

Codas. 2024 Jun 14;36(3):e20230098. doi: 10.1590/2317-1782/20242023098pt. eCollection 2024.

ABSTRACT

OBJECTIVE: To describe and analyze auditory and academic complaints of students and employees of a federal public university.

METHODS: The study was carried out using a non-probabilistic. The EAPAC Scale with adaptations was used to fulfill the research objectives. It has 14 questions about complaints related to listening skills and 12 questions related to the academic environment. Descriptive data analysis was performed through the frequency distribution of categorical variables and Pearson’s chi-square test was used for association analyses.

RESULTS: 646 individuals aged between 17 and 67 years old participated in the research. The most prevalent complaints were academic difficulty related to memory, concentration, and planning, hearing and understanding speech in noise, and memorization of tasks that were only heard. There was an association with bidirectional statistical significance between academic and auditory complaints.

CONCLUSION: It was possible to observe that there is an association between auditory and academic complaints in adults, marked by the relationship between cognitive and auditory aspects. It is relevant that these factors are considered when performing assessments of Central Auditory Processing when intervening in patients with auditory complaints, and in student life.

PMID:38896744 | DOI:10.1590/2317-1782/20242023098pt

Codas. 2024 Jun 14;36(3):e20230094. doi: 10.1590/2317-1782/20242023094pt. eCollection 2024.

ABSTRACT

PURPOSE: To verify the influence of verbal intellectual-cognitive skills on speech perception in noise, in elderly with sensorineural hearing loss, considering education, age, and degree of hearing loss.

METHODS: 36 elderly between 60 and 89 years old with bilateral sensorineural hearing loss participated in the study. After psychological assessment using the Wechsler Intelligence Scale for Adults (WAIS-III), they were grouped into (GI) 24 elderly without cognitive alteration and (GII) 12 elderly with risk of cognitive alteration. They underwent otorhinolaryngological assessment, audiological interview, pure tone audiometry, and assessment of speech perception in noise using the Hearing in Noise Test (HINT-Brazil). The Mann-Whitney U statistical test compared the results between the groups, and the Spearman correlation verified the variable’s age, degree of hearing loss, and level of education.

RESULTS: There was no difference between the groups in the ability to perceive speech in noise, except in the noise on the left condition, in which GII showed better performance in HINT-Brazil. The degree of hearing loss and level of education influenced the perception of speech in noise. The level of education was correlated with the WAIS-III results.

CONCLUSION: The decline in verbal intellectual-cognitive skills did not affect speech perception of noise in the elderly with hearing loss. The degree of hearing loss and level of education influenced the performance of the elderly in the speech perception test in noise. Performance in verbal cognitive skills varied according to the level of education.

PMID:38896743 | DOI:10.1590/2317-1782/20242023094pt

An Acad Bras Cienc. 2024 Jun 17;96(3):e20231343. doi: 10.1590/0001-3765202420231343. eCollection 2024.

ABSTRACT

Arapaima gigas, an emblematic species of the Amazon region and a longstanding primary fishing resource, currently holds a “Data Deficient” status on the International Union for Conservation of Nature Red List, and is listed as an endangered species in Brazil. The Tocantins River is the most extensively modified large tributary of the Amazon Basin, and thus can affect the dynamics of ichthyofaunal populations. Over a period of 1 year, representatives of the fishing communities and fishermen from 25 fishing communities from four municipalities in the lower Tocantins River region were interviewed, and the obtained information was evaluated based on the literature to survey the population abundance status of A. gigas in the region and its impact on local communities. Among the fishermen interviewed, only one reported still encountering and fishing A. gigas on Jaracuera Island. The disappearance of A. gigas in the region are viewed as having economically disastrous consequences for the residents. Additionally, other endemic fish species are no longer observed in this locality either. If fishery management officials do not work together with local communities, A. gigas could disappear from the northern region of Brazil, where information on the dynamics of A. gigas fishing is lacking.

PMID:38896742 | DOI:10.1590/0001-3765202420231343

J Bras Pneumol. 2024 Jun 17;50(3):e20230292. doi: 10.36416/1806-3756/e20230292. eCollection 2024.

ABSTRACT

OBJECTIVE: Cystic fibrosis (CF) affects multiple organs, the most severe consequences being observed in the lungs. Despite significant progress in developing CF transmembrane conductance regulator-specific treatments for CF lung disease, exploring alternative CF-targeted medications seems reasonable. We sought to evaluate the potential beneficial effects of oral benzbromarone as an adjuvant therapy in CF patients with reduced lung function.

METHODS: This was a prospective open-label pilot study of oral benzbromarone (100 mg/day) administered once daily for 90 days. Patients were followed at a tertiary referral center in southern Brazil. Safety was assessed by the number of reported adverse events. Secondary objectives included percent predicted FEV1 (FEV1%) and pulmonary exacerbations.

RESULTS: Ten patients were enrolled. Benzbromarone was found to be safe, with no serious drug-related adverse events. Eight patients completed the study; the median relative change in FEV1% tended to increase during the treatment, showing an 8% increase from baseline at the final visit. However, a nonparametric test showed that the change was not significant (p = 0.06). Of a total of ten patients, only one experienced at least one pulmonary exacerbation during the study.

CONCLUSIONS: Oral benzbromarone appears to be safe, and improved FEV1% has been observed in patients with CF. Further assessment in larger trials is warranted to elucidate whether oral benzbromarone can be a potential adjuvant therapy for CF.

PMID:38896732 | DOI:10.36416/1806-3756/e20230292

Crit Care Sci. 2024 Jun 17;36:e20240258en. doi: 10.62675/2965-2774.20240258-en. eCollection 2024.

ABSTRACT

RATIONALE: Evidence about long-term sequelae after hospitalization for acute respiratory distress syndrome due to COVID-19 is still scarce.

PURPOSE: To evaluate changes in pulmonary, cardiac, and renal function and in quality of life after hospitalization for acute respiratory distress syndrome secondary to COVID-19.

METHODS: This will be a multicenter case-control study of 220 participants. Eligible are patients who are hospitalized for acute respiratory distress syndrome due to COVID-19. In the control group, individuals with no history of hospitalization in the last 12 months or long-term symptoms of COVID-19 will be selected. All individuals will be subjected to pulmonary spirometry with a carbon monoxide diffusion test, chest tomography, cardiac and renal magnetic resonance imaging with gadolinium, ergospirometry, serum and urinary creatinine, total protein, and urinary microalbuminuria, in addition to quality-of-life questionnaires. Patients will be evaluated 12 months after hospital discharge, and controls will be evaluated within 90 days of inclusion in the study. For all the statistical analyses, p < 0.05 is the threshold for significance.

RESULTS: The primary outcome of the study will be the pulmonary diffusing capacity for carbon monoxide measured after 12 months. The other parameters of pulmonary, cardiac, and renal function and quality of life are secondary outcomes.

CONCLUSION: This study aims to determine the long-term sequelae of pulmonary, cardiac, and renal function and the quality of life of patients hospitalized for acute respiratory distress syndrome due to COVID-19 in the Brazilian population.

PMID:38896723 | DOI:10.62675/2965-2774.20240258-en

Rev Bras Enferm. 2024 Jun 14;77(2):e20230384. doi: 10.1590/0034-7167-2023-0384. eCollection 2024.

ABSTRACT

OBJECTIVE: To learn the strategies used regarding underreporting of pesticide use in rural areas.

METHODS: A qualitative study was carried out in eight primary healthcare units in rural areas and two emergency care units in a municipality in southern Brazil. Data collection took place in 2023 through interviews. Twenty professional nurses participated. The data was submitted to content analysis.

RESULTS: The strategies identified were lifelong and continuing education for the professionals who carry out the notification, active search and training of workers who deal directly with this type of substance, computerizing the notification by filling in the forms online, and carrying out research on the subject.

FINAL CONSIDERATIONS: Nurses play an important role in reporting occupational accidents caused by the use of pesticides, improving occupational safety in rural areas.

PMID:38896714 | DOI:10.1590/0034-7167-2023-0384

Elife. 2024 Jun 18;12:RP89712. doi: 10.7554/eLife.89712.

ABSTRACT

Durable serological memory following vaccination is critically dependent on the production and survival of long-lived plasma cells (LLPCs). Yet, the factors that control LLPC specification and survival remain poorly resolved. Using intravital two-photon imaging, we find that in contrast to most plasma cells (PCs) in the bone marrow (BM), LLPCs are uniquely sessile and organized into clusters that are dependent on APRIL, an important survival factor. Using deep, bulk RNA sequencing, and surface protein flow-based phenotyping, we find that LLPCs express a unique transcriptome and phenotype compared to bulk PCs, fine-tuning expression of key cell surface molecules, CD93, CD81, CXCR4, CD326, CD44, and CD48, important for adhesion and homing. Conditional deletion of Cxcr4 in PCs following immunization leads to rapid mobilization from the BM, reduced survival of antigen-specific PCs, and ultimately accelerated decay of antibody titer. In naïve mice, the endogenous LLPCs BCR repertoire exhibits reduced diversity, reduced somatic mutations, and increased public clones and IgM isotypes, particularly in young mice, suggesting LLPC specification is non-random. As mice age, the BM PC compartment becomes enriched in LLPCs, which may outcompete and limit entry of new PCs into the LLPC niche and pool.

PMID:38896451 | DOI:10.7554/eLife.89712

JMIR Public Health Surveill. 2024 Jun 19;10:e57807. doi: 10.2196/57807.

ABSTRACT

BACKGROUND: The World Health Organization declared mpox an international public health emergency. Since January 1, 2022, China has been ranked among the top 10 countries most affected by the mpox outbreak globally. However, there is a lack of spatial epidemiological studies on mpox, which are crucial for accurately mapping the spatial distribution and clustering of the disease.

OBJECTIVE: This study aims to provide geographically accurate visual evidence to determine priority areas for mpox prevention and control.

METHODS: Locally confirmed mpox cases were collected between June and November 2023 from 31 provinces of mainland China excluding Taiwan, Macao, and Hong Kong. Spatiotemporal epidemiological analyses, including spatial autocorrelation and regression analyses, were conducted to identify the spatiotemporal characteristics and clustering patterns of mpox attack rate and its spatial relationship with sociodemographic and socioeconomic factors.

RESULTS: From June to November 2023, a total of 1610 locally confirmed mpox cases were reported in 30 provinces in mainland China, resulting in an attack rate of 11.40 per 10 million people. Global spatial autocorrelation analysis showed that in July (Moran I=0.0938; P=.08), August (Moran I=0.1276; P=.08), and September (Moran I=0.0934; P=.07), the attack rates of mpox exhibited a clustered pattern and positive spatial autocorrelation. The Getis-Ord Gi^* statistics identified hot spots of mpox attack rates in Beijing, Tianjin, Shanghai, Jiangsu, and Hainan. Beijing and Tianjin were consistent hot spots from June to October. No cold spots with low mpox attack rates were detected by the Getis-Ord Gi^* statistics. Local Moran I statistics identified a high-high (HH) clustering of mpox attack rates in Guangdong, Beijing, and Tianjin. Guangdong province consistently exhibited HH clustering from June to November, while Beijing and Tianjin were identified as HH clusters from July to September. Low-low clusters were mainly located in Inner Mongolia, Xinjiang, Xizang, Qinghai, and Gansu. Ordinary least squares regression models showed that the cumulative mpox attack rates were significantly and positively associated with the proportion of the urban population (t_0.05/2,1=2.4041 P=.02), per capita gross domestic product (t_0.05/2,1=2.6955; P=.01), per capita disposable income (t_0.05/2,1=2.8303; P=.008), per capita consumption expenditure (PCCE; t_0.05/2,1=2.7452; P=.01), and PCCE for health care (t_0.05/2,1=2.5924; P=.01). The geographically weighted regression models indicated a positive association and spatial heterogeneity between cumulative mpox attack rates and the proportion of the urban population, per capita gross domestic product, per capita disposable income, and PCCE, with high R² values in north and northeast China.

CONCLUSIONS: Hot spots and HH clustering of mpox attack rates identified by local spatial autocorrelation analysis should be considered key areas for precision prevention and control of mpox. Specifically, Guangdong, Beijing, and Tianjin provinces should be prioritized for mpox prevention and control. These findings provide geographically precise and visualized evidence to assist in identifying key areas for targeted prevention and control.

PMID:38896444 | DOI:10.2196/57807

J Clin Gastroenterol. 2024 Jun 13. doi: 10.1097/MCG.0000000000002031. Online ahead of print.

ABSTRACT

OBJECTIVE: The diagnosis of RGERD in patients typically involves 24-hour esophageal pH monitoring, but due to its invasiveness and low patient compliance, new screening methods are needed. In this study, a lactulose breath test (LBT) was conducted to detect the growth of small intestine bacteria (SIBO) and explore the potential relationship between LBT and RGERD to identify a new treatment method for RGERD.

METHODS: A total of 178 patients with gastroesophageal reflux were enrolled from June 2020 to December 2022 in the Gastroenterology Department, Building 3, the First Affiliated Hospital of Kunming Medical University; these patients included 96 patients with nonrefractory GERD (NRGERD) and 82 patients with RGERD. The Gerd Q score, reflux symptom index (RSI) score, gastroscopy results, clinical symptoms, and other related indicators were collected. Statistical methods were used to analyze the gathered data.

RESULTS: The incidence of acid reflux and heartburn in patients with RGERD was significantly greater than that in patients with NRGERD (67.10% vs. 42.70%, P<0.01 and 65.00% vs. 34.40%, P<0.01). The CH4 values of patients with RGERD were significantly greater than those of patients with NRGERD at each time point, and there was a correlation between the CH4 values at 60 min and RGERD (P<0.05). For patients with RGERD, the incidence of abdominal pain, acid regurgitation, and heartburn was greater in the CH4-positive group than in the CH4-negative group (61.90% vs. 57.50%, 69.05% vs. 65.00%, 69.05% vs. 57.50%, P>0.05). The incidence of nausea was also greater in the CH4-positive group than in the CH4-negative group (61.90% vs. 35.00%, P<0.05).

CONCLUSION: Increased CH4 levels are correlated with RGERD. In addition, patients with RGERD may develop SIBO after long-term use of PPIs, and interventions involving SIBO could provide new ideas for the treatment of RGERD.

PMID:38896424 | DOI:10.1097/MCG.0000000000002031