Nevin Manimala

Infect Dis Ther. 2024 Feb 23. doi: 10.1007/s40121-024-00929-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Invasive infections caused by Salmonella are a significant global health concern. This population-based study aimed to comprehensively analyze invasive Salmonella infections in South Sweden, focusing on incidence, clinical presentation, risk factors, and outcomes.

METHODS: This population-based observational cohort study, conducted from 2012 to 2022, included all patients with Salmonella bloodstream infections (BSI) in the Skåne region, South Sweden. A control group consisted of patients with positive stool cultures/PCR for Salmonella but without BSI. Data were collected following a predefined study protocol from medical records. Standardized statistical analyses assessed patient characteristics, clinical presentation, and outcomes.

RESULTS: Between 2012 and 2022, 149 patients with SBSI were identified, with the majority having non-typhoidal Salmonella (NTS) infections (95%). A declining trend in the incidence of SBSI was observed, with the highest incidence in 2012 (1.5 per 100,000 person-years) and the lowest in 2020 (0.3 per 100,000 person-years). Patients with BSI were more likely to be older, have comorbidities, be immunosuppressed, and use proton pump inhibitors (PPIs). Additionally, patients with BSI presented with fewer gastrointestinal symptoms, had a higher respiratory rate, lower saturation, and higher SOFA scores, suggesting a more septic presentation. Patients with SBSI had significantly longer hospital stays and higher 30-day, 90-day, 180-day, and 365-day mortality rates compared to the control group.

CONCLUSION: Invasive Salmonella infections are rare in South Sweden. In a cohort of enteric and invasive Salmonella infection, the absence of classic gastroenteritis symptoms increases the risk of Salmonella bloodstream infection. This study highlights the importance of distinguishing between clinical presentations to guide appropriate treatment when Salmonella infection is suspected. The declining trend in incidence, particularly associated with international travel, necessitates further investigation to understand contributing factors.

PMID:38393503 | DOI:10.1007/s40121-024-00929-y

Intern Emerg Med. 2024 Feb 23. doi: 10.1007/s11739-024-03544-4. Online ahead of print.

ABSTRACT

Patients with heart failure with reduced ejection fraction (HFrEF) and diabetes mellitus (DM) have an increased risk of adverse events, including thromboembolism. In this analysis, we aimed to explore the association between DM and HFrEF using data from the “Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction” (WARCEF) trial. We analyzed factors associated with DM using multiple logistic regression models and evaluated the effect of DM on long-term prognosis, through adjusted Cox regressions. The primary outcome was the composite of all-cause death, ischemic stroke, or intracerebral hemorrhage; we explored individual components as the secondary outcomes and the interaction between treatment (warfarin or aspirin) and DM on the risk of the primary outcome, stratified by relevant characteristics. Of 2294 patients (mean age 60.8 (SD 11.3) years, 19.9% females) included in this analysis, 722 (31.5%) had DM. On logistic regression, cardiovascular comorbidities, symptoms and ethnicity were associated with DM at baseline, while age and body mass index showed a nonlinear association. Patients with DM had a higher risk of the primary composite outcome (Hazard Ratio [HR] and 95% Confidence Intervals [CI]: 1.48 [1.24-1.77]), as well as all-cause death (HR [95%CI]: 1.52 [1.25-1.84]). As in prior analyses, no statistically significant interaction was observed between DM and effect of Warfarin on the risk of the primary outcome, in any of the subgroups explored. In conclusion, we found that DM is common in HFrEF patients, and is associated with other cardiovascular comorbidities and risk factors, and with a worse prognosis.

PMID:38393500 | DOI:10.1007/s11739-024-03544-4

Community Ment Health J. 2024 Feb 23. doi: 10.1007/s10597-024-01253-y. Online ahead of print.

ABSTRACT

The objective of this randomized controlled trial was to examine the impact of a mindful self-compassion intervention on burden, express emotion, and mental well-being in family caregivers of patients with schizophrenia. Standardized measures, including the ZARIT Caregiving Burden Scale, Expressed Emotion Scale and Warwick-Edinburgh Mental Well-Being Scale, were administered at baseline, post-intervention. Statistical analysis was conducted to assess differences between the two groups. Significant reductions in caregiver burden, expressed emotion, and enhanced mental well-being in the intervention group compared to the control group at post-intervention. The results of this randomized controlled trial indicate that the mindful self-compassion intervention significantly reduces caregiver burden, expressed emotion, and improves mental well-being in family caregivers of patients with schizophrenia. These findings underscore the potential utility of mindful self-compassion interventions as effective support for this population, highlighting the importance of integrating such interventions into caregiver support programs.

PMID:38393493 | DOI:10.1007/s10597-024-01253-y

J Ultrasound. 2024 Feb 23. doi: 10.1007/s40477-023-00865-6. Online ahead of print.

ABSTRACT

The objective of the study was to compare measurements of length, thickness, and cross-section area (CSA) of the patellar tendon (PT) among cyclists, runners, triathletes, and physically active individuals (control group). Forty healthy individuals (10 cyclists, 10 runners, 10 triathletes, and 10 physically active individuals) aged between 18 and 45 years (30.3 ± 8.6 years) participated in the study. PT was measured by a B-mode ultrasound system. To measure the length and thickness (in 5, 10, 15, and 20 mm of the PT length) the probe was positioned parallel to the tendon and to measure the CSA the probe was positioned perpendicularly in 25, 50, and 75% of the PT length. PT length data were analyzed using a one-way ANOVA to compare between groups and PT CSA and thickness were analyzed using a two-way ANOVA (group vs. position) to compare the variables among the groups with the post-hoc Tukey test. All statistical analyses were performed considering p < 0.05. We observed a significant difference, where cyclists had smaller PT thickness (regardless of the location measured) compared to the group of triathletes (p = 0.001) and the physically active group (p = 0.043). All other variables (length, thickness, and CSA) and interactions (local and position) were not significant. We concluded that regardless of the position where PT thickness is measured, cyclists have smaller PT thickness compared to triathletes and physically active individuals but similar when compared to runners. And no differences in the length and CSA of the PT between groups.

PMID:38393454 | DOI:10.1007/s40477-023-00865-6

Neurol Sci. 2024 Feb 23. doi: 10.1007/s10072-024-07404-z. Online ahead of print.

ABSTRACT

There is wide variation in the time from the onset to secondary progressive multiple sclerosis (MS) and some controversy regarding the clinical characteristics of the courses (phenotypes) of MS. The present study aimed to characterize demographic and clinical factors that potentially influence long-term disability progression in the cohort of Latvian MS patients. A descriptive longitudinal incidence study was conducted using a cohort of 288 MS patients beginning in 2011 (disease duration from 1 to 51 years). Socio-demographic and clinical information from the first visit to 15/20 years was analysed in groups stratified by gender and visits at five-time points (the first visit; after a year or 2; after 5 ± 1 year; after 10 ± 2 years; after 15-20 years). Our study was dominated by patients from urban areas and non-smokers. The female/male ratio was 2.4:1; the distribution of clinical courses at the first visit was consistent with most European studies. The most common symptom at presentation in our study was optic manifestations, followed by sensory disturbances and motor deficits. In the Latvian study, gender was not a significant influencing factor on the rate of disease progression; however, patient age was statistically significantly associated with EDSS (Expanded Disability Status Scale) value at the first visit. Early clinical features of MS are important in predicting the disability accumulation of patients. Despite the small differences regarding the first MS symptoms, the disability outcomes in the cohort of Latvian patients are similar to other regions of the world.

PMID:38393441 | DOI:10.1007/s10072-024-07404-z

J Autism Dev Disord. 2024 Feb 23. doi: 10.1007/s10803-024-06291-9. Online ahead of print.

ABSTRACT

Autism Spectrum Disorder (ASD) and epilepsy represent a comorbidity that negatively influences the proper development of linguistic competencies, particularly in receptive language, in the pediatric population. This group displays impairments in the auditory comprehension of both simple and complex grammatical structures, significantly limiting their performance in language-related activities, hampering their integration into social contexts, and affecting their quality of life. The main objective of this study was to assess auditory comprehension of grammatical structures in individuals with ASD and epilepsy and compare the results among the three groups. A non-experimental cross-sectional study was designed, including a total of 170 participants aged between 7 and 9 years, divided into three groups: a group with ASD, a group with epilepsy, and a comorbid group with both ASD and epilepsy (ASDEP). The comprehension of grammatical structures was assessed using the CEG and CELF-5 instruments. Statistical analyses included MANOVA and ANOVA to compare scores between groups to verify associations between study variables. The results indicate that the group with ASD and epilepsy performed worse compared to the ASD and epilepsy-only groups, respectively. Additionally, a significant and directly proportional association was observed among all variables within the measures of grammatical structure comprehension. The neurological damage caused by epilepsy in the pediatric population with ASD leads to difficulties in understanding oral language. This level of functioning significantly limits the linguistic performance of these children, negatively impacting their quality of life and the development of core language skills.

PMID:38393436 | DOI:10.1007/s10803-024-06291-9

Lasers Med Sci. 2024 Feb 23;39(1):79. doi: 10.1007/s10103-024-04020-3.

ABSTRACT

The study investigates the effect of diode laser exposure on curcumin’s skin penetration, using turmeric extraction as a light-sensitive chemical and various laser light sources. It uses an in vivo skin analysis method on Wistar strain mice. The lasers are utilized at wavelengths of 403 nm, 523 nm, 661 nm, and 979 nm. The energy densities of the lasers are 20.566 J/cm², 20.572 J/cm², 21.162 J/cm², and 21.298 J/cm², which are comparable to one another. The experimental animals were divided into three groups: base cream (BC), turmeric extract cream (TEC), and the combination laser (L), BC, and TEC treatment group. Combination light source (LS) with cream (C) was performed with 8 combinations namely 523 nm ((L1 + BC) and (L1 + TEC)), 661 nm ((L2 + BC) and (L2 + TEC)), 403 nm ((L3 + BC) and (L3 + TEC)), and 979 nm ((L4 + BC) and (L4 + TEC)). The study involved applying four laser types to cream-covered and turmeric extract-coated rat skin, with samples scored for analysis. The study found that both base cream and curcumin cream had consistent pH values of 7-8, within the skin’s range, and curcumin extract cream had lower viscosity. The results of the statistical analysis of Kruskal-Wallis showed a significant value (p < 0.05), which means that there are at least two different laser treatments. The results of the post hoc analysis with Mann-Whitney showed that there was no significant difference in the LS treatment with the addition of BC or TEC when compared to the BC or TEC treatment alone (p > 0.05), while the treatment using BC and TEC showed a significant difference (p < 0.05). Laser treatment affects the penetration of the turmeric extract cream into the rat skin tissue.

PMID:38393433 | DOI:10.1007/s10103-024-04020-3

J Am Heart Assoc. 2024 Feb 23:e032784. doi: 10.1161/JAHA.123.032784. Online ahead of print.

ABSTRACT

BACKGROUND: Prior studies investigating the impact of residual mitral regurgitation (MR), tricuspid regurgitation (TR), and elevated predischarge transmitral mean pressure gradient (TMPG) on outcomes after mitral transcatheter edge-to-edge repair (TEER) have assessed each parameter in isolation. We sought to examine the prognostic value of combining predischarge MR, TR, and TMPG to study long-term outcomes after TEER.

METHODS AND RESULTS: We reviewed the records of 291 patients who underwent successful mitral TEER at our institution between March 2014 and June 2022. Using well-established outcomes-related cutoffs for predischarge MR (≥moderate), TR (≥moderate), and TMPG (≥5 mm Hg), 3 echo profiles were developed based on the number of risk factors present (optimal: 0 risk factors, mixed: 1 risk factor, poor: ≥2 risk factors). Discrimination of the profiles for predicting the primary composite end point of all-cause mortality and heart failure hospitalization at 2 years was examined using Cox regression. Overall, mean age was 76.7±10.6 years, 43.3% were women, and 53% had primary MR. Two-year event-free survival was 61%. Predischarge TR≥moderate, MR≥moderate, and TMPG≥5 mm Hg were risk factors associated with the primary end point. Compared with the optimal profile, there was an incremental risk in 2-year event-rate with each worsening profile (optimal as reference; mixed profile: hazard ratio (HR), 2.87 [95% CI, 1.71-5.17], P<0.001; poor profile: HR, 3.76 [95% CI, 1.84-6.53], P<0.001). Echocardiographic profile was statistically associated with the 2-year mortality end point (optimal as reference; mixed profile: HR, 3.55 [95% CI, 1.81-5.96], P<0.001; poor profile: HR, 3.39 [95% CI, 2.56-7.33], P=0.02).

CONCLUSIONS: The echocardiographic profile integrating predischarge TR, MR, and TMPG presents a novel prognostic stratification tool for patients undergoing mitral TEER.

PMID:38390821 | DOI:10.1161/JAHA.123.032784

Vox Sang. 2024 Feb 23. doi: 10.1111/vox.13592. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Nucleic acid amplification testing (NAT), in blood services context, is used for the detection of viral and parasite nucleic acids to reduce transfusion-transmitted infections. This project reviewed NAT for screening blood donations globally.

MATERIALS AND METHODS: A survey on NAT usage, developed by the International Society of Blood Transfusion Working Party on Transfusion-transmitted Infectious Diseases (ISBT WP-TTID), was distributed through ISBT WP-TTID members. Data were analysed using descriptive statistics.

RESULTS: Forty-three responses were received from 32 countries. Increased adoption of blood donation viral screening by NAT was observed over the past decade. NAT-positive donations were detected for all viruses tested in 2019 (proportion of donations positive by NAT were 0.0099% for human immunodeficiency virus [HIV], 0.0063% for hepatitis C virus [HCV], 0.0247% for hepatitis B virus [HBV], 0.0323% for hepatitis E virus [HEV], 0.0014% for West Nile virus [WNV] and 0.00005% for Zika virus [ZIKV]). Globally, over 3100 NAT-positive donations were identified as NAT yield or solely by NAT in 2019 and over 22,000 since the introduction of NAT, with HBV accounting for over half. NAT-positivity rate was higher in first-time donors for all viruses tested except WNV. During 2019, a small number of participants performed NAT for parasites (Trypanosoma cruzi, Babesia spp., Plasmodium spp.).

CONCLUSION: This survey captures current use of blood donation NAT globally. There has been increased NAT usage over the last decade. It is clear that NAT contributes to improving blood transfusion safety globally; however, there is a need to overcome economic barriers for regions/countries not performing NAT.

PMID:38390819 | DOI:10.1111/vox.13592

Biotechnol Bioeng. 2024 Feb 23. doi: 10.1002/bit.28681. Online ahead of print.

ABSTRACT

As the biopharmaceutical industry looks to implement Industry 4.0, the need for rapid and robust analytical characterization of analytes has become a pressing priority. Spectroscopic tools, like near-infrared (NIR) spectroscopy, are finding increasing use for real-time quantitative analysis. Yet detection of multiple low-concentration analytes in microbial and mammalian cell cultures remains an ongoing challenge, requiring the selection of carefully calibrated, resilient chemometrics for each analyte. The convolutional neural network (CNN) is a puissant tool for processing complex data and making it a potential approach for automatic multivariate spectral processing. This work proposes an inception module-based two-dimensional (2D) CNN approach (I-CNN) for calibrating multiple analytes using NIR spectral data. The I-CNN model, coupled with orthogonal partial least squares (PLS) preprocessing, converts the NIR spectral data into a 2D data matrix, after which the critical features are extracted, leading to model development for multiple analytes. Escherichia coli fermentation broth was taken as a case study, where calibration models were developed for 23 analytes, including 20 amino acids, glucose, lactose, and acetate. The I-CNN model result statistics depicted an average R² values of prediction 0.90, external validation data set 0.86 and significantly lower root mean square error of prediction values ∼0.52 compared to conventional regression models like PLS. Preprocessing steps were applied to I-CNN models to evaluate any augmentation in prediction performance. Finally, the model reliability was assessed via real-time process monitoring and comparison with offline analytics. The proposed I-CNN method is systematic and novel in extracting distinctive spectral features from a multianalyte bioprocess data set and could be adapted to other complex cell culture systems requiring rapid quantification using spectroscopy.

PMID:38390805 | DOI:10.1002/bit.28681