Nevin Manimala

Psicothema. 2022 Aug;34(3):353-364. doi: 10.7334/psicothema2021.478.

ABSTRACT

BACKGROUND: Although some meta-analyses have identified potential moderators associated with treatment outcomes for pediatric obsessive-compulsive disorder (OCD), there is as yet no consensus regarding the influence of anxiety and depression symptoms on the recovery from pediatric OCD. A meta-analysis was conducted to investigate the effects of depression and anxiety symptoms and their comorbidities on the efficacy of CBT in pediatric OCD, as well as other potential moderators that may be associated with outcomes.

METHOD: An exhaustive literature search from 1983 to March 2021 located 22 published articles that applied cognitive-behavioral therapy (CBT) to pediatric OCD, producing a total of 26 treatment groups. Some of the moderator variables analyzed included age, gender, comorbidity baseline in anxiety, depression and obsession, and methodological quality.

RESULTS: Results showed that the psychological treatment of OCD achieves clinically significant effectiveness, both for measures of obsessions and compulsions ( d + = 2.030), and for anxiety ( d + = 0.613) and depression ( d + = 0.451). An explanatory model for the CY-BOCS effect sizes showed that three moderator variables were statistically related: the mean of the CY-BOCS (Children´s Yale Brown Obsessive Compulsive Scale) in pretest, the effect size for anxiety, and the mean age of the sample.

CONCLUSIONS: CBT reduced obsessive-compulsive symptoms and, to a lesser extent, anxiety and depression symptoms. Since anxiety symptoms are reduced with the same therapy, resources would be saved compared to other treatments.

PMID:35860997 | DOI:10.7334/psicothema2021.478

J Sports Med Phys Fitness. 2022 Aug;62(8):1023-1028. doi: 10.23736/S0022-4707.21.12664-7.

ABSTRACT

BACKGROUND: The Grooved Pegboard Test (GPT) is a widely adopted test to evaluate manual dexterity. A factor that could influence the cognitive process is physical and mental stress, which could be controlled by respiration. Stress can be monitored through heart variability. Consequently, the present study’s objective was to investigate the association between the breath relaxation technique and the GPT and correlate the findings with stress parameters.

METHODS: One hundred fourteen participants were recruited. Stress level test, GPT, and breathing exercise for relaxation were performed. Spearman test was adopted to evaluate the correlation, while the Friedman Test and the Dunn Test and the Mann-Whitney Test were performed to detect statistical differences.

RESULTS: Correlation existed between GPT and age (r=-0.02), height (r=0.22), weight (r=0.21), and handgrip (r=0.21). The Friedman and Dunn’s post-test resulted in significant differences in group 1 and 2 between GPT baseline vs. GPT rest (P<0.01) and GPT baseline vs. GPT relax in group 1 (P<0.01) and group 2 (P<0.0001).

CONCLUSIONS: A breath relaxation technique does not influence the GPT, and even not significantly, physical stress increases the time to complete the GPT. Instead, high mental stress, stress resistance, and heart frequency decrease the time to complete the GPT.

PMID:35860968 | DOI:10.23736/S0022-4707.21.12664-7

Przegl Epidemiol. 2022;76(1):58-66. doi: 10.32394/pe.76.07.

ABSTRACT

INTRODUCTION: The results of multiple studies indicate the negative impact of exposure to air pollution on human life expectancy. Epidemiological evidence on this relation is in large proportion provided by ecological studies, what causes interpretation difficulties. Poland is a country characterized by large territorial differences in ambient air pollution and in life expectancy. This promotes analyses of the mentioned relationship based on ecological model.

AIM: The aim of the study was to analyse the results of a simple ecological study concerning the relationship between life expectancy and air pollution with the focus on the difficulties in interpretation of the results.

MATERIAL AND METHODS: The study used a simple ecological study approach. We used the official data on sex-specific life expectancy for year 2018 and annual average ambient air concentrations of PM2.5 in years 2010-2018 for 10 large metropolitan areas in Poland. The data was used as a marker of long-term air pollution levels in particular areas. Associations between life expectancy and air pollution levels were assessed using Spearman correlation analysis.

RESULTS: The analysis concerning exposure to air pollution and life-expectancy in several Polish large agglomerations did not show statistically significant associations.

CONCLUSIONS: Our ecological study did not show statistically significant associations between life expectancy and ambient air pollution levels measured by means of PM2.5 concentrations. Ecological nature of the population’s exposure marker, without considering many important factors influencing length of life, may explain the negative results of the correlation analysis. This is an example of so called ecological fallacy, affecting the used model of epidemiological study.

PMID:35860962 | DOI:10.32394/pe.76.07

Przegl Epidemiol. 2022;76(1):37-50. doi: 10.32394/pe.76.05.

ABSTRACT

INTRODUCTION: The National Cancer Control Programme 2006-2015 (NCCP) was implemented to improve the health situation of Polish women in 2006. Its effectiveness was evaluated by analysing trends of changes in incidence rates of pre-invasive (D05) and invasive (C50) breast cancers in three age cohorts: pre-screening cohort (<50), screening cohort (50-69) and post-screening cohort (>69).

MATERIAL AND METHODS: Medical data of 13,089 women with C50 and 738 women with D05 diagnosed in 2005-2014 in the Lower Silesian Voivodeship (LS) were analysed.

RESULT: In 2009-2014, incidence rates of C50 (p=0.0224) and D05 (p=0.0003) were found to be higher in the LS than those recorded for Poland. During this period, there were approx. 1,400 cases of C50 and 90-100 cases of D05 per year. After the NCCP had been implemented, there was a gradual increase in the proportion of the female population included in the mammography screening, from 32% in 2007 to 45% in 2014. The age group included in the screening programme experienced a significant increase in the proportion of pre-invasive cancers – from 3% in 2005 to 7-10% in 2010-2013. In that group, cancer was statistically more frequently detected in Tis- or T1- stages (p=0.0002). Beneficial effects of screening were also observed in post-screening women. There was no similar trend in patients aged <50.

CONCLUSIONS: This analysis shows positive population effects of mammography screening. The least favourable changes in the detection of early stages of breast cancer were observed in female patients aged less than 50 years. This suggests that some modifications regarding both the age range and the screening interval in the Polish population should be considered.

PMID:35860959 | DOI:10.32394/pe.76.05

Geospat Health. 2022 Jul 20;17(s1). doi: 10.4081/gh.2022.1100.

ABSTRACT

The risk of coronavirus disease 2019 (COVID-19) may vary by age, biological, socioeconomic, behavioural and logistical reasons may be attributed to these variations. In Toronto, Canada, the aging population has been severely impacted, accounting for 92% of all COVID-19 deaths. Four age groups: 60-69 years, 70-79 years, 80-89 years and ≥90 years in Toronto neighbourhoods were investigated for clustering tendencies using space-time statistics. Cohen’s Kappa coefficient was computed to assess variations in risk by neighbourhood between different age groups. The findings suggest that knowledge of health risks and health behaviour varied by age across neighbourhoods in Toronto. Therefore, understanding the socioecological context of the communities and targeting age-appropriate intervention strategies is important for planning an effective mechanism for controlling the disease.

PMID:35860921 | DOI:10.4081/gh.2022.1100

Turk Kardiyol Dern Ars. 2022 Jul;50(5):348-355. doi: 10.5543/tkda.2022.21297.

ABSTRACT

OBJECTIVE: Cardiovascular diseases still play an important role in public health and epidemiol- ogy as the leading cause of death worldwide. Ischemic heart disease is the most common reason in this group. This study aims to analyze the latest trends in ischemic heart disease mor- tality rates in Turkey by age, gender, and region using the Turkish Statistical Institute mortality data and evaluate the results.

METHODS: We have obtained ischemic heart disease mortality data (2009-2019, in 12 regions) for Turkey from the mortality database of the Turkish Statistical Institute. Joinpoint analysis was used to estimate the annual percentage change and average annual percentage change to identify significant changes in trends.

RESULTS: The mean mortality rate for ischemic heart disease in Turkey was in an increasing trend from 2009 to 2019 (annual percentage change=1.7 (-0.8; 4.3), P=.166). This increase was more pronounced in women (annual percentage change=2.2 (-0.7; 5.2), P=.121) compared to men (annual percentage change=1.4 (-1.1; 3.9), P=.235). When the period between 2015 and 2019 was evaluated, it was determined that ischemic heart disease mortality was in a decreasing trend in the groups over 65 years of age. The death rate due to ischemic heart disease is almost 2 times higher in men than in women in Turkey, and this rate ratio is highest in the Istanbul region.

CONCLUSION: Although ischemic heart disease mortality trends have decreased globally, our country’s average is still on an increasing trend. However, significant decreases have been observed in ischemic heart disease mortality rates, especially in the group over 65 years of age, in the last 5 years.

PMID:35860887 | DOI:10.5543/tkda.2022.21297

Turk Kardiyol Dern Ars. 2022 Jul;50(5):320-326. doi: 10.5543/tkda.2022.21311.

ABSTRACT

OBJECTIVE: In this study, we aimed to determine whether potent agents affect in-hospital bleeding and mortality compared to clopidogrel in patients with the acute coronary syndrome in whom tirofiban and P2Y12 inhibitor are used together.

METHODS: Patients who were treated interventionally between 2015 and 2020 and were using tirofiban were retrospectively screened. Clinical, laboratory, and angiographic findings were obtained from the hospital database. Patients were analyzed by dividing them into clopidogrel and prasugrel/ticagrelor groups.

RESULTS: Acute coronary syndrome patients (n = 227) who were treated interventionally were included in this retrospective study. Clopidogrel was given to 93 (41%), ticagrelor to 112 (49.3%), and prasugrel to 22 of the patients (9.7%). Compared to the ticagrelor/prasugrel group, the clopidogrel group was older and more were women, and the history of hypertension and previous coronary artery disease was higher (P, respectively: <.001; .001; .008; .0045). The creatinine value was higher, the basal hemoglobin was lower, and the GRACE (Global Registry of Acute Coronary Events) and CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) scores were higher (P, respectively: .026; .002; .002; <.001). The in-hospital bleeding rate was signifi- cantly higher in the clopidogrel group (P < .001). Although the in-hospital mortality rate was higher, it was not statistically significant (P = .07). Regression analysis showed that GRACE score and gender were associated with in-hospital mortality (P < .001; P=.031, respectively), and only age was associated with in-hospital bleeding (P < .001). No relationship was found with P2Y12 inhibitor.

CONCLUSION: In our study, we found that the combined use of potent P2Y12 inhibitor with tiro- fiban in acute coronary syndrome patients treated interventionally was not different from the use of clopidogrel in terms of in-hospital bleeding and mortality.

PMID:35860883 | DOI:10.5543/tkda.2022.21311

Turk Kardiyol Dern Ars. 2022 Jul;50(5):314-319. doi: 10.5543/tkda.2022.21306.

ABSTRACT

OBJECTIVE: Cryptogenic stroke (CS) is considered to be the most common stroke subtype in young patients. The Risk of Paradoxical Embolism (RoPE) score is a tool that stratifies patients with CS according to the probability of patent foramen ovale (PFO). The aim of this retrospective study is to determine the prevalence of PFO in young patients with transesophageal echocardi- ography (TEE) and to evaluate the role of RoPE score in PFO-related strokes.

METHODS: The medical records of patients with acute arterial ischemic stroke, who underwent TEE between 2016 and 2020, were reviewed. Patients aged 18-55 years were included in the study. Presence of PFO, PFO characteristics, presence of atrial septal aneurysm (ASA) were detected by examining the image records of the patients from the archive system. RoPE score was calculated for all patients as determined in the literature.

RESULTS: Totally, 50 CS patients were included in the study (mean age: 39.6±9.4 years). PFO was detected in 19 (38%) patients and it was the most common cardiac abnormality in CS patients. ASA was detected in 7 (14%) patients. The mean RoPE score in patients with PFO was higher than patients without PFO, although it did not reach statistical significance (7.68±1.1 versus 6.77±1.9 P = .07). Eighteen of 19 patients with PFO had a RoPE score ≥7.

CONCLUSION: In our study, PFO prevalence in the CS patients was higher than normal popula- tion. In patients with cryptogenic stroke, the RoPE score can help determine the probability of PFO related stroke and which patients should undergo TEE.

PMID:35860882 | DOI:10.5543/tkda.2022.21306

Commun Dis Intell (2018). 2022 Jul 21;46. doi: 10.33321/cdi.2022.46.42.

ABSTRACT

BACKGROUND: Diphtheria is rare in Australia, but an increasing number of cases have been notified in recent years. Alongside notifications from 1999 to 2019, we analysed other relevant national data sources to evaluate trends over the past two decades.

METHODS: Diphtheria notifications (National Notifiable Diseases Surveillance System [NNDSS]), hospitalisations (National Hospital Morbidity Database [NHMD]) and deaths (Australian Bureau of Statistics and the Australian Coordinating Registry) were separately analysed by site of infection, age group, sex, state/territory, Aboriginal and Torres Strait Islander status, and vaccination status.

RESULTS: During the study period, eight (0.002 per 100,000 population per year) cases of respiratory diphtheria and 38 (0.008 per 100,000 population per year) cases of cutaneous diphtheria were recorded in the NNDSS, with 45/46 reported in the nine years since 2011. Corynebacterium diphtheriae accounted for 87% of notified cases, who had a median age of 31.5 years (respiratory diphtheria) and 52.5 years (cutaneous diphtheria); no respiratory diphtheria was notified in those under 15 years of age. A majority of the cutaneous diphtheria cases (27/38; 71%) were acquired overseas, as were 3/8 (38%) of the respiratory diphtheria cases. Rates of both presentation types were higher in Aboriginal and Torres Strait Islander people (respiratory: 0.007 per 100,000 population per year; cutaneous: 0.021 per 100,000 population per year) than were rates in the overall population. Queensland had the highest rate of notified respiratory cases (0.007 per 100,000 population per year), and the Northern Territory the highest rate of cutaneous notifications (0.043 per 100,000 population per year). There were 29 hospitalisations with a principal-diagnosis diphtheria code in the NHMD between 2002 and 2018, of which eight were designated as respiratory (0.002 per 100,000 population per year), eight as cutaneous (0.002 per 100,000 population per year), and 13 with an unknown site of infection. Among notified cases, two deaths were reported in unvaccinated people in Queensland.

CONCLUSIONS: Although diphtheria remains rare in Australia, 45 cases were notified in the years 2011-2019, compared with one case between 1999 and 2010. Robust surveillance remains important to detect all cases. High immunity will need to be maintained across all age groups to prevent outbreaks, and travel and adult booster doses should be encouraged.

PMID:35860872 | DOI:10.33321/cdi.2022.46.42

Cochlear Implants Int. 2022 Jul 20:1-6. doi: 10.1080/14670100.2022.2101534. Online ahead of print.

ABSTRACT

Objective: To compare cochlear duct length (CDL) between male and female patients by evaluating the diameter of the basal turn (distance A) on CT scans.Method: All temporal bone CT scans performed between 2014 and 2020 were reviewed in our medical center. Using multiplanar reconstructions, the length A, which is the greatest distance of the basal turn was measured on both sides. We performed an analysis of variance considering two factors: sex and side. Two different physicians carried out the measurements, an otolaryngologist and a neuroradiologist. The patients who had several CT scans allowed us to evaluate the reliability of our procedure.Results: Among the 888 CT scans reviewed, 8 were excluded because of cochlear malformations. The inter-sex difference of length A was found to be 0.29 millimeters(mm) 95% IC [0.26-0.34] and was longer in the male group (p < 0.0001). Using Alexiades’ equation, we found that CDL was 34.5mm [34.37-34.61] in the male group and 33.3mm [33.13-33.38] in the female group. When one side was compared to the other, there was no significant difference (p = 0.226). An intra-class correlation found a good absolute agreement between the two screeners of 0.79.Conclusion: Males have a statistically significant longer CDL than females.

PMID:35860840 | DOI:10.1080/14670100.2022.2101534