Nevin Manimala

Turk J Obstet Gynecol. 2022 Jun 27;19(2):145-151. doi: 10.4274/tjod.galenos.2022.04272.

ABSTRACT

OBJECTIVE: Today, thanks to its many advantages, hysteroscopy with a vaginoscopic approach (no-touch) is increasingly being used more in outpatient diagnoses and treatments. However, there are concerns that the “no-touch” technique increases ascending genital tract infections since a speculum is not inserted, and disinfection of the cervix cannot achieve.

MATERIALS AND METHODS: Between 2011 and 2017, 302 patients who underwent office hysteroscopy with the vaginoscopic approach (group 1) and 254 patients who underwent hysteroscopy with the standard method under anesthesia in the operating room (group 2) were compared in terms of early complications (within two weeks postoperatively). The primary outcome was early postoperative infection, and the secondary outcome was other early complications, such as bleeding and rupture.

RESULTS: In this study, the success rate of hysteroscopy with the vaginoscopic approach was 96.4%. According to the visual analog scale scoring system, 88.7% of the patients described mild-to-moderate pain. When group 1 and 2 were compared in terms of postoperative infection (3% and 2.4%, respectively) and other early complication rates (0% and 0.8%, respectively), no statistically significant difference was found (p>0.05).

CONCLUSION: Hysteroscopy with a vaginoscopic approach continues to be the gold standard method that is safe and well-tolerated by patients.

PMID:35770455 | DOI:10.4274/tjod.galenos.2022.04272

Reprod Domest Anim. 2022 Jun 30. doi: 10.1111/rda.14197. Online ahead of print.

ABSTRACT

The objectives of this study were to evaluate the effect of vitrification on the DNA fragmentation rate of equine cumulus cells and to assess its relationship to oocyte in vitro maturation (IVM) after vitrification. Cumulus cells (CC) from 14 mares were recovered from COCs, previously submitted to vitrification (VIT) and IVM. The DNA fragmentation rate of the cumulus cells (CC-DF) was assessed using a chromatin dispersion test. CC-DF rates between vitrified and control COCs were statistically compared by Student´s t-test. The rates of CC-DF from control COCs were lower than in vitrified COCs. The percentage of CC-DF was not significantly different (P > 0.05) between groups of COCs able to reach metaphase II (MII >0) and those in which oocyte maturation was not achieved (MII = 0) . In conclusion, vitrification has a deleterious effect on the DNA fragmentation of equine cumulus cells; however, this parameter cannot be used as a predictor for IVM success after COCs vitrification.

PMID:35770452 | DOI:10.1111/rda.14197

J Obes Metab Syndr. 2022 Jun 30;31(2):169-177. doi: 10.7570/jomes22024.

ABSTRACT

BACKGROUND: The global public health burden of obesity has increased with socio-economic development. The Korean Society for the Study of Obesity released the 2021 Obesity Fact Sheet to address trends in obesity prevalence and comorbid conditions by different age groups.

METHODS: Individuals ≥20 years old who underwent a health checkup provided by the Korean National Health Insurance Service between 2009 and 2019 were included. The prevalence of obesity and abdominal obesity was standardized by age and sex based on the 2010 population and housing census. The incidence of obesity-related comorbidities was tracked from 2009 to 2019, and the incidence per 1,000 person-years was calculated using Poisson regression adjusted for age and sex.

RESULTS: Obesity and abdominal obesity prevalence has increased for the entire population over the past 11 years. Obesity prevalence has risen rapidly in individuals in their 20s and 80s compared with other age groups. Additionally, class III obesity prevalence in both men and women has significantly increased by nearly threefold. The relative risk of developing type 2 diabetes, myocardial infarction, ischemic stroke, and cancers in people with obesity or abdominal obesity is greater than in people without obesity or abdominal obesity. The relative risk was higher in young and middle-aged individuals than in the older population.

CONCLUSION: The findings based on the 2021 Obesity Fact Sheet suggest the need to better understand obesity characteristics according to age and sex and to establish individualized treatment strategies.

PMID:35770450 | DOI:10.7570/jomes22024

Reprod Domest Anim. 2022 Jun 30. doi: 10.1111/rda.14196. Online ahead of print.

ABSTRACT

The study aimed to evaluate follicular dynamics and concentrations of estradiol-17β (E2), progesterone (P4), follicle stimulating hormone (FSH) and luteinizing hormone (LH) during the estrous cycle, and to determine ovulation time in Mithun cows. Ovaries of experimental cows (n=7) were examined daily by transrectal-ultrasonography for three consecutive estrous cycles (n=21). The characteristics of follicular waves, dominant follicle, largest subordinate follicle and corpus luteum, and ovulation time were evaluated. The plasma samples were analyzed throughout the interovulatory interval to determine the differences in the hormonal profiles (E2, P4, FSH and LH) between different follicular wave cycles. Out of eighteen estrous cycles analyzed, three-wave follicular cycles were maximum (n=12: 66.66%) followed by two (n=4: 22.22%) and four waves (n=2: 11.11%). The two and three waves were statistically compared, and no significant (p>0.05) differences were observed in day of wave emergence, number of follicles (≥3 mm) recruited, maximum diameter of the ovulatory dominant follicle, growth rates of ovulatory and anovulatory dominant follicles and maximum diameter of corpus luteum. The diameter of dominant follicles was significantly (p<0.05) greater than subordinate follicles in both ovulatory and anovulatory waves. No significant differences were observed in peak concentrations of estradiol-17β and follicle stimulating hormone between ovulatory and anovulatory waves in all wave cycles. A preovulatory luteinizing hormone surge was observed a day before ovulation in all wave cycles. Progesterone concentrations were lower than 0.5ng/mL during estrus and increased sharply to the maximum levels of ≥3.8ng/mL in all wave cycles. Ovulation time (mean±SEM), irrespective of follicular waves was 10.5±0.64 h after the end of estrus. It was concluded that Mithun cows have a preponderance of three follicular waves with little difference between the two- and three- follicular waves and ovulation occurred 10.5 h after the end of estrus.

PMID:35770446 | DOI:10.1111/rda.14196

Psychiatr Serv. 2022 Jun 30:appips202100689. doi: 10.1176/appi.ps.202100689. Online ahead of print.

ABSTRACT

OBJECTIVE: This study analyzed changes in prescription opioid street prices during the COVID-19 pandemic.

METHODS: Crowdsourced prescription opioid street prices were obtained from the Researched Abuse, Diversion and Addiction-Related Surveillance System StreetRx Program. Percentage changes in street price per milligram of different opioids between April and December 2020 compared with the same months in 2019 were calculated by using linear regression.

RESULTS: Street prices of high-potency drugs hydromorphone and oxycodone increased 23% and 12% per milligram, respectively. Prices of low-potency drugs hydrocodone and morphine increased 9% and 12% per milligram, respectively. Changes in prices of medications for opioid use disorder were not statistically significant.

CONCLUSIONS: Decreased access to opioid analgesics during the pandemic combined with contributors to opioid demand may have led to increases in street prices of prescription opioids. Measures taken to increase access to medications for opioid use disorder were not associated with changes in those drugs’ street prices.

PMID:35770425 | DOI:10.1176/appi.ps.202100689

BJPsych Open. 2022 Jun 30;8(4):e123. doi: 10.1192/bjo.2022.511.

ABSTRACT

BACKGROUND: Childhood adversity may lead to mental and somatic complications throughout life. General practitioners are equipped to identify and manage adverse events in households. The relationship between adversities and psychiatric symptoms has not been studied in primary care.

AIMS: We investigated the relationship of common adversities in families with respect to subsequent development of psychosocial and psychiatric problems in young children.

METHOD: We analysed data from seven general practices, including participants between 0 and 9 years of age. Adversity was defined as having a household member who was diagnosed with cancer, psychiatric disease or social problems. We compared these patients with controls matched for gender, age and general practice. The primary outcome was any new episode defined with a psychological and psychiatric label. Secondarily, the encounter rates at the general practices after adversity were analysed.

RESULTS: Participants in both groups were followed for an average of 12 years, whereby patients with an adversity were more likely to develop psychiatric morbidities compared with matched references (odds ratio 1.38, 95% CI 1.12-1.68, P = 0.002), also revealing higher encounter rates at general practices. We found no statistically significant association between adversities in the family and increased psychosocial symptoms.

CONCLUSIONS: The short- and long-term consequences of exposure to negative events in childhood are of great public health importance. Our data suggest screening more proactively for consequences of commonly occurring adversities in families, as they are a risk factor for subsequent psychiatric symptoms. Enhanced consultation frequency at general practitioners following adversities should be differentiated in more detail.

PMID:35770375 | DOI:10.1192/bjo.2022.511

BJU Int. 2022 Jun;130 Suppl 1:28-36. doi: 10.1111/bju.15724.

ABSTRACT

OBJECTIVES: To assess the correlation of pathological radical prostatectomy (RP) specimen features and prostate-specific antigen (PSA) characteristics to imaging findings on subsequent ¹⁸ F-DCFPyL positron emission tomography/computed tomography (PET/CT) in patients with biochemical failure (BF).

PATIENTS AND METHODS: Retrospective analysis of combined ¹⁸ F-DCFPyL PET/CT database of patients from centres in Australia and New Zealand was performed. A total of 205 patients presenting with BF after RP were included in this study. Imaging findings on ¹⁸ F-DCFPyL PET/CT were recorded and correlated with the PSA characteristics at BF and pathological features of the original tumour.

RESULTS: Of the 205 patients, 120 (58.5%) had evidence of abnormal prostate-specific membrane antigen (PSMA) expression compatible with recurrent prostate cancer. Increasing PSA velocity (P = 0.01), International Society of Urological Pathology (ISUP) Grade Group (P = 0.02), lymphovascular invasion (P = 0.05) and nodal positivity (P = 0.02) at the time of RP were more likely to demonstrate PSMA positivity. Multivariable logistic regression revealed a higher PSA level prior to PSMA PET/CT (P < 0.01), adjuvant radiotherapy (P = 0.09), Gleason score ≥8 (P < 0.01) and nodal positivity (P = 0.05) were all predictive of PSMA positivity.

CONCLUSION: ¹⁸ F-DCFPyL PET/CT positivity, both generally and site specific, correlates with PSA and RP pathological factors. Our results echo cohorts focussing on post-RP patients, those imaged with ⁶⁸ Ga-PSMA and those concerning biochemical persistence. Nomograms that include risk factors for ‘PSMA-positive recurrence’ in the BF population may increase the catchment of patients with disease confined to the prostate bed or pelvis who have a greater probability of prolonged disease-free survival.

PMID:35768883 | DOI:10.1111/bju.15724

BMC Rheumatol. 2022 Jun 30;6(1):44. doi: 10.1186/s41927-022-00275-x.

ABSTRACT

BACKGROUND: Increased cancer-risk has been reported with rheumatoid arthritis and systemic lupus erythematosus, but the risk is poorly studied in ankylosing spondylitis (AS). Conflicting data in AS have been reported in Asia and Europe, with lack of US population-based studies. Our objective is to study the prevalence of cancer in patients with AS in the US.

METHODS: Using the Explorys database, we performed a cross-sectional study. Data from AS patients and controls were stratified by 2 rheumatology visits, age groups, clinical characteristics, and frequency of cancers. The data were analyzed using a series of chi-square tests of independence as well as logistic regression to test for association between AS and cancer.

RESULTS: 1410 AS patients (12.88%) had cancer. Female AS patients had a lower prevalence of cancer compared to controls (OR 0.840, 95% CI [0.769, 0.916]), while male AS patients had no statistically significant difference (OR 1.011, 95% CI [0.929, 1.099]). Among patients with AS, Skin cancers (squamous cell, malignant melanoma, and basal cell) and head and neck cancers were significantly increased.

CONCLUSION: Our study demonstrated that the prevalence of “any-type-cancer” was not increased in AS patients compared to controls with no rheumatic disease. Skin, head, and neck cancers were more frequently seen in AS patients.

PMID:35768880 | DOI:10.1186/s41927-022-00275-x

BMC Nurs. 2022 Jun 29;21(1):171. doi: 10.1186/s12912-022-00950-x.

ABSTRACT

BACKGROUND: Whether knowledge, attitude and practice of nurses on nursing post-stroke dysphagia patients varies between different ranking hospitals is still unknown. This study aimed to compare the knowledge, attitude and practice level of nurses on nursing post-stroke dysphagia patients between iii-A and ii-A hospitals in China.

DESIGN: A cross-sectional study design was used.

METHODS: Data were collected from eighteen hospitals in Wuhan, Hubei in May-July 2020, and a total of 824 nurses were recruited by convenient sampling. After propensity score matching, 205 participants in iii-A hospitals were matched with 205 participants in ii-A hospitals.

RESULTS: There were no statistically differences in the socio-demographic characteristics between two groups after propensity score matching. Before matching, the regression coefficients between hospital ranking and knowledge, attitude, practice were -0.415, -0.718 and -1.855, respectively. After matching, the coefficients changed to -0.394, -0.824 and -1.278. Nurses from iii-A hospitals had higher knowledge and attitude scores than nurses from ii-A hospitals, but no significant practice scores difference was observed between various rankings of hospitals.

CONCLUSIONS: The KAP of nurses on nursing post-stroke dysphagia patients were different in iii-A and ii-A hospitals. Administrators should strengthen management, provide more learning resources and trainings to meet nurses’ needs about methods to deal with and recognize dysphagia, so as to further improve the quality of post-stroke dysphagia management.

PMID:35768870 | DOI:10.1186/s12912-022-00950-x

BMC Public Health. 2022 Jun 29;22(1):1266. doi: 10.1186/s12889-022-13508-y.

ABSTRACT

BACKGROUND: South Africa’s National Health Laboratory Service (NHLS), the only clinical laboratory service in the country’s public health sector, is an important resource for monitoring public health programmes.

OBJECTIVES: We describe NHLS data quality, particularly patient demographics among infants, and the effect this has on linking multiple test results to a single patient.

METHODS: Retrospective descriptive analysis of NHLS data from 1^st January 2017-1^st September 2020 was performed. A validated probabilistic record-linking algorithm linked multiple results to individual patients in lieu of a unique patient identifier. Paediatric HIV PCR data was used to illustrate the effect on monitoring and evaluating a public health programme. Descriptive statistics including medians, proportions and inter quartile ranges are reported, with Chi-square univariate tests for independence used to determine association between variables.

RESULTS: During the period analysed, 485 300 007 tests, 98 217 642 encounters and 35 771 846 patients met criteria for analysis. Overall, 15.80% (n = 15 515 380) of all encounters had a registered national identity (ID) number, 2.11% (n = 2 069 785) were registered without a given name, 63.15% (n = 62 020 107) were registered to women and 32.89% (n = 32 304 329) of all folder numbers were listed as either the patient’s date of birth or unknown. For infants tested at < 7 days of age (n = 2 565 329), 0.099% (n = 2 534) had an associated ID number and 48.87% (n = 1 253 620) were registered without a given name. Encounters with a given name were linked to a subsequent encounter 40.78% (n = 14 180 409 of 34 775 617) of the time, significantly more often than the 21.85% (n = 217 660 of 996 229) of encounters registered with a baby-derivative name (p-value < 0.001).

CONCLUSION: Unavailability and poor capturing of patient demographics, especially among infants and children, affects the ability to accurately monitor routine health programmes. A unique national patient identifier, other than the national ID number, is urgently required and must be available at birth if South Africa is to accurately monitor programmes such as the Prevention of Mother-to-Child Transmission of HIV.

PMID:35768861 | DOI:10.1186/s12889-022-13508-y