Nevin Manimala

Clin Neuropsychiatry. 2021 Aug;18(4):188-195. doi: 10.36131/cnfioritieditore20210402.

ABSTRACT

OBJECTIVE: Affecting more than 264 million people, depression is a systemic and multifactorial disorder that represents one of the leading causes of illness and disability worldwide. Several studies showed an inflammatory response in depressed patients, including the involvement of both chronic low-grade inflammatory response and activation of cell-mediated immunity. The present study aimed to verify the efficacy of a structured functional therapy program for patients with depressed mood, and to determine whether this program can significantly reduce levels of C-reactive protein.

METHOD: 28 outpatients with depressed mood received 20 individual sessions of Functional therapy. Data about socio-demographic variables, depression, self-esteem, and quality of life were collected; moreover, blood specimens were collected before and after treatment, and CRP measurement was performed by immunoenzymatic method. All measures were administered at baseline, at the end of treatment (i.e., 3 months after baseline), and at follow-up (i.e., 6 months after baseline).

RESULTS: A repeated measures ANOVA showed a significant difference after treatment on depression levels, levels of self-esteem, and all dimensions of quality of life, such as physical, psychological, social relationships, and environment. Furthermore, a statistically significant difference on levels of CRP was found. Moreover, at follow-up, improvements were maintained.

CONCLUSIONS: The study revealed initial evidence of the efficacy of a functional therapy program on treating depression and its psychological and inflammation-related markers.

PMID:34909034 | PMC:PMC8650180 | DOI:10.36131/cnfioritieditore20210402

Clin Neuropsychiatry. 2020 Dec;17(6):339-348. doi: 10.36131/cnfioritieditore20200603.

ABSTRACT

OBJECTIVE: Psychiatric morbidity, impulsive behaviour and use of dysfunctional and maladaptive defences are core features of personality disorder (PD). This study aims to evaluate the significance of the strength of the association between these three core dimensions and PD.

METHOD: Using a cross-sectional design, a sample of co-morbid Axis-I & -II disorders, and a sample of Axis-I disorders with no co-morbid PD were recruited at three general psychiatric mental health resource centres and then compared.PD as dependent variable was analysed both as a categorical and as a dimensional entity using the Structured Clinical Interview for DSM-IV. The Symptoms Checklist 90-R general severity index (GSI), the Barratt Impulsivity Scale (BIS) and the Defense Style Questionnaire (DSQ) were used to measure severity of psychiatric morbidity, impulsivity and defensive style, respectively.

RESULTS: BIS was a highly significant predictor of categorical PD (β = .13, SE = .03, p < .001), but not GSI and DSQ. BIS and GSI significantly predicted PD as a dimensional construct (β = 0.32, SE = .08, t = 4.05, p < 0.001; and β = 5.04, SE = 1.54, t = 3.28, p = 0.002, respectively). The diagnostic efficiency statistics found that BIS had greater sensitivity (.82) and specificity (.79), and overall predictive power (.87) of correctly identifying true positive and true negative PD diagnosis compared to the other two measures.

CONCLUSIONS: BIS may be used in routine clinical practice as a screening measure to identify the presence of PD in complex presentations.

PMID:34909012 | PMC:PMC8629056 | DOI:10.36131/cnfioritieditore20200603

J Geriatr Cardiol. 2021 Nov 28;18(11):897-907. doi: 10.11909/j.issn.1671-5411.2021.11.005.

ABSTRACT

OBJECTIVES: To investigate complications within 30-days following first-time ablation for atrial fibrillation (AF), including a composite of cardiac tamponade, hematoma requiring intervention, stroke or death, in patients ≥ 75 years of age, compared to patients aged 65-74 years. In addition, one-year all-cause mortality and AF relapse were compared.

METHODS & RESULTS: All patients receiving their first catheter ablation for AF between 2012 and 2016 were identified using Danish nationwide registries. Patients aged 65-74 years served as the reference group for patients ≥ 75 years. Relapse of AF within one year was defined as cardioversion following a three-month blanking period, re-ablation or confirmed relapse within follow-up. The composite complication outcome did not differ between the two age groups, with 39/1554 (2.8%) in patients 65-74 years of age, versus 5/199 (2.5%) in older patients (adjusted HR = 0.94), 95% CI: 0.37-2.39, P = 0.896). Patients ≥ 75 years or older had no increased hazard of death within 30 days after the procedure, with an incidence of 3/1554 (0.2%) in younger patients and 2/199 (1.0%) in patients ≥ 75 years of age (adjusted HR = 4.71, 95% CI: 0.78-28.40, P = 0.091). There was no difference in relapse of AF after one year between age groups (≥ 75 years adjusted HR = 1.00, 95% CI: 0.78-1.26, P = 0.969).

CONCLUSION: In patients ≥ 75 years of age selected for catheter ablation for AF, the incidence of periprocedural complications, as well as one-year freedom from AF showed no statistical difference, when compared to patients 65-74 years of age.

PMID:34908927 | PMC:PMC8648543 | DOI:10.11909/j.issn.1671-5411.2021.11.005

Cent Eur J Oper Res. 2021 Dec 10:1-18. doi: 10.1007/s10100-021-00792-z. Online ahead of print.

ABSTRACT

This articles provides a short summary of the research topics and latest research results of the European Working Group “Operations Research Applied to Health Services” (ORAHS) organized as an e-conference in Juli 2020 at the University of Vienna, Austria (https://orahs2020.univie.ac.at/). Furthermore, challenges for OR in health care including application areas, decision support systems, general trends, and modelling techniques are briefly illustrated from an European and international perspective by providing selected essential literature reviews.

PMID:34908906 | PMC:PMC8663758 | DOI:10.1007/s10100-021-00792-z

Risk Manag Healthc Policy. 2021 Dec 7;14:4897-4905. doi: 10.2147/RMHP.S320311. eCollection 2021.

ABSTRACT

BACKGROUND: Depression is the most common mental health disorder among HIV-positive pregnant mothers, which increases mortality, poor quality of life; it also increases the burden of disease. Depression hurts birth outcomes and maternal health.

OBJECTIVE: To assess depression and its associated factors among HIV-positive pregnant women attending antenatal care at Northwest Amhara referral hospitals, 2021.

METHODS: An institution-based cross-sectional study was conducted among 291 HIV-positive pregnant mothers from March 15, 2021 to April 30, 2021 at Northwest Amhara referral hospitals. Census was applied to reach the study participants. An interviewer-administered questionnaire was used for data collection. A binary logistic regression was conducted to see the relationship between dependent variables and independent. Those variables having a p-value of ≤0.05 were found to be statistically associated with the response.

RESULTS: Depression among HIV-positive pregnant women was found to be 28.7% [95% CI (24.8-33.40)] with a response rate of 96.04. Age ≥30 years [AOR = 1.32, 95% CI (1.24-3.35)], urban residency [AOR = 1.76, 95% CI (1.57-4.61)], having first pregnancy <18 years [AOR = 3.82, 95% CI (1.54-17.34)], known HIV serostatus during pregnancy [AOR = 1.29, 95% CI (1.08-2.47)], and COVID-19-related knowledge [AOR = 0.32, 95% CI (0.12-1.12) were significantly associated with depression.

CONCLUSIONS AND RECOMMENDATIONS: Nearly one-third of the pregnant women attending antenatal care were depressed. The age of the mother, residence, known HIV serostatus during pregnancy, age in the first pregnancy, and COVID-19-related knowledge were significantly associated with depression, and strengthening the existing care provided was the recalled interventions to combat antenatal depression during the COVID-19 pandemic.

PMID:34908887 | PMC:PMC8665771 | DOI:10.2147/RMHP.S320311

Cancer Manag Res. 2021 Dec 6;13:9007-9013. doi: 10.2147/CMAR.S341448. eCollection 2021.

ABSTRACT

BACKGROUND: Due to the poor healing of superficial malignant tumor ulcer wounds, patients suffer great pain and significantly reduced quality of life. Related research shows that oxygen therapy can reduce wound bleeding and promote wound healing.

OBJECTIVE: This study aims to explore the therapeutic effect of nano-silver antibacterial dressing combined with high-flow oxygen therapy on surface malignant tumor ulcers.

METHODS: In this retrospective analysis, 64 patients with superficial malignant tumors and ulcer infection were included and divided into the research group and the control group, with 32 cases in each group. After conventional debridement, the control group was treated with vaseline dressing, while the research group was treated with nano-silver medical antibacterial dressing combined with high-flow oxygen therapy. Both groups were treated for 7 days. The frequency of dressing change and the number of times of blood oozing between the two groups after treatment were recorded. The pain, clinical efficacy, and levels of procalcitonin (PCT) and C-reactive protein (CRP) were compared between the two groups before and after treatment.

RESULTS: The dressing changes and blood oozing were less frequent in the research group compared with the control group. The pain score and the levels of PCT and CRP in the research group were lower than those in the control group. The overall response rate was significantly higher in the research group as compared to the control group. All the above differences were statistically significant (P<0.05).

CONCLUSION: Nano-silver medical antibacterial dressing combined with high-flow oxygen therapy can reduce the frequency of dressing changes in patients, relieve pain, reduce inflammation, and accelerate the healing of superficial malignant tumor ulcer wounds.

PMID:34908876 | PMC:PMC8664651 | DOI:10.2147/CMAR.S341448

Breast Cancer (Dove Med Press). 2021 Dec 6;13:651-658. doi: 10.2147/BCTT.S338276. eCollection 2021.

ABSTRACT

INTRODUCTION: Increases in disease-free survival and overall survival (OS) with the use of adjuvant chemotherapy in early breast cancer (BC) are widely known; however, the optimal time to initiate treatment with adjuvant chemotherapy remains controversial.

OBJECTIVE: To evaluate the time elapsed between surgery and the initiation of adjuvant chemotherapy and its possible impact on OS in patients diagnosed with BC stages I-III.

MATERIALS AND METHODS: This retrospective study included 112 patients diagnosed with BC stages I-III who received adjuvant chemotherapy at the Mastology Unit of the Hospital de Clínicas in Uruguay from 2009 to 2019. OS was estimated using the Kaplan-Meier method, and a Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals.

RESULTS: No statistically significant association was found between the time from surgery to the initiation of chemotherapy and the described variables. OS was worse for patients initiating chemotherapy more than 90 days after breast surgery (n = 19) (HR 7.63; p = 0.004) and between 61 and 90 days after surgery (n = 46) (HR 4.58; p = 0.040) compared to those who started before 30 days (n = 23). Controlling by type of surgery and stage, the prognosis of patients who started chemotherapy between 61 and 90 days after surgery was similar to that of patients who underwent chemotherapy within the first 30 days, controlling for surgery (HR 4.10; p = 0.056) and controlling for stage (HR 3.76; p = 0.075). Prognosis was worse for patients with stage III disease (p = 0.022) who underwent a mastectomy and/or axillary lymph node dissection (p = 0.025).

CONCLUSION: Patients who started chemotherapy more than 90 days following surgery and those with stage III disease or underwent mastectomy and/or axillary lymph node dissection who initiated it between 61 and 90 days had a worse OS. Multiple factors are involved in the time between surgery and the initiation of chemotherapy, and further studies are needed to evaluate which of these factors influence the delay of chemotherapy in order to design strategies to avoid such delays and their negative impact on survival.

PMID:34908875 | PMC:PMC8664648 | DOI:10.2147/BCTT.S338276

Local Reg Anesth. 2021 Dec 7;14:167-178. doi: 10.2147/LRA.S303455. eCollection 2021.

ABSTRACT

BACKGROUND: Interscalene brachial plexus block is frequently utilized to provide perioperative analgesia to patients undergoing shoulder surgery to optimize recovery, minimize opioid consumption, and decrease overall hospital length of stay. The use of an indwelling perineural interscalene catheter provides extended analgesia and is efficacious in managing severe postoperative pain following major shoulder surgery. Currently, the only alternative to perineural catheters for extended analgesia with interscalene block involves the perineural infiltration of liposomal bupivacaine. However, there is limited published data regarding the overall analgesic effectiveness of using interscalene liposomal bupivacaine in the setting of shoulder surgery.

METHODS: We performed a retrospective review of 43 patients in the acute trauma setting who underwent major shoulder surgery and received extended analgesia via perioperative interscalene brachial plexus block with either an indwelling continuous catheter or single-dose liposomal bupivacaine to determine if comparable analgesia can be achieved. The primary outcomes of interest were postoperative pain scores and opioid consumption. Due to the ability to titrate and bolus local anesthetic infusions to a desired clinical effect, we hypothesized that opioid consumption and pain scores would be lower when using the continuous catheter technique.

RESULTS: After statistical analysis, our results demonstrated no significant difference between the two techniques in regards to opioid consumption as well as numeric pain scores during the 48-hour postoperative period, but did note a higher rate of complications with patients who received perineural interscalene continuous catheters. Secondary outcomes showed an increase in time required to complete the regional block procedure with the use of indwelling catheters.

CONCLUSION: Interscalene brachial plexus block with liposomal bupivacaine may be a viable alternative to indwelling continuous catheters for providing extended analgesia in patients undergoing major shoulder surgery.

PMID:34908874 | PMC:PMC8665777 | DOI:10.2147/LRA.S303455

Int J Gen Med. 2021 Dec 7;14:9433-9444. doi: 10.2147/IJGM.S329128. eCollection 2021.

ABSTRACT

BACKGROUND: Although thyroid cancer (THCA) is one of the most common type of endocrine malignancy, its highly complex molecular mechanisms of carcinogenesis are not completely known.

MATERIALS AND METHODS: In this study, weighted gene co-expression network analysis (WGCNA) was utilized to construct gene co-expression networks and evaluate the relations between modules and clinical traits to identify potential prognostic biomarkers for THCA patients. RNA-seq data and clinical data were downloaded from The Cancer Genome Atlas (TCGA). Other independent datasets from the Gene Expression Omnibus (GEO) database and the Human Protein Atlas database were performed to validate findings.

RESULTS: Finally, 11 co-expression modules were constructed and four hub genes, CCDC146, SLC4A4, TDRD9 and MUM1L1, were identified and validated statistically, which were considerably interrelated to worse survival of THCA patients.

CONCLUSION: This research study revealed four hub genes may be considered candidate prognostic biomarkers and potential therapeutic targets for THCA patients in the future.

PMID:34908870 | PMC:PMC8665846 | DOI:10.2147/IJGM.S329128

Infect Drug Resist. 2021 Dec 7;14:5199-5208. doi: 10.2147/IDR.S337647. eCollection 2021.

ABSTRACT

BACKGROUND: The present paper evaluates the genetic variability of HCV in patients with hepatocellular carcinoma (HCC).

METHODS: Amino acid substitutions (aas) in NS3, NS5A and core regions were analyzed in 17 patients with HCC (Cases) and 13 without HCC (Controls), all naïve to DAAs. For the Cases, a sample of neoplastic liver tissue, non-neoplastic liver tissue and a serum sample were collected; for the Controls, a sample of liver tissue was collected. Sanger sequencing of three regions was performed using homemade protocols.

RESULTS: Phylogenetic trees showed that there was no difference in the virus populations in the three compartments analyzed for the three HCV regions in patients with HCC. Low variability and no difference between the Cases and Controls were observed in the core and NS5A regions; however, in the NS3 region, a higher variability was observed in the Cases. No difference was observed in the core region between Cases and Controls. In NS3, aa substitutions at positions 103 and 122 were more frequently found in Cases than Controls (in both cases 50% vs 9.1%, p<0.05); moreover, aas in positions 32, 44 (p=0.035 for both), 79 (p=0.008) and 121 (p=0.018) were observed in the Cases and absent in the Controls. Finally, considering the NS5A region, aa substitutions at positions 37 and 54 were more frequently identified in the Cases than the Controls, but without statistical significance.

CONCLUSION: These data may suggest a higher aa variability in patients with HCC than in those without, especially in the NS3 region.

PMID:34908854 | PMC:PMC8665876 | DOI:10.2147/IDR.S337647