Nevin Manimala

Health Inf Manag. 2023 Jan 21:18333583221144665. doi: 10.1177/18333583221144665. Online ahead of print.

ABSTRACT

BACKGROUND: Medical certification of cause of death (MCCD) provides valuable data regarding disease burden in a community and for formulating health policy. Inaccurate MCCDs can significantly impair the precision of national health information.

OBJECTIVE: To evaluate the accuracy of cause of death certificates prepared at two tertiary cancer care hospitals in Northern India during the study period (May 2018 to December 2020).

METHOD: A retrospective observational study at two tertiary cancer care hospitals in Varanasi, India, over a period of two and a half years. Medical records and cause of death certificates of all decedents were examined. Demographic characteristics, administrative details and cause of death data were collected using the WHO recommended death certificates. Accuracy of death certification was validated by electronic medical records and errors were graded.

RESULTS: A total of 778 deaths occurred in the two centres during the study period. Of these, only 30 (3.9%) certificates were error-free; 591 (75.9%) certificates had an inappropriate immediate cause of death; 231 (29.7%) certificates had incorrectly labelled modes of death as the immediate cause of death; and 585 (75.2%) certificates had an incorrect underlying cause of death. The majority of certificates were prepared by junior doctors and were significantly associated with higher certification errors.

CONCLUSION: A high rate of errors was identified in death certification at the cancer care hospitals during the study period. Inaccurate MCCDs related to cancers can potentially influence cancer statistics and thereby affect policy making for cancer control.

IMPLICATIONS: This study has identified the pressing need for appropriate interventions to improve quality of certification through training of doctors.

PMID:36680503 | DOI:10.1177/18333583221144665

Cell J. 2023 Jan 1;25(1):45-50. doi: 10.22074/cellj.2022.557259.1041.

ABSTRACT

OBJECTIVE: Preeclampsia (PE) is a pregnancy related disorder with prevalence of 6-7%. Insufficient trophoblastic invasion leads to incomplete remodeling of spiral arteries and consequent decrease in feto-placental perfusion. Altered placental expression of tissue inhibitors of matrix metalloproteinase (TIMPs) is considered to be involved in this process while the balance between matrix metalloproteinases (MMPs) and TIMPs contributes to remodeling of the placenta and uterine arteries by degradation and refurbishing of extracellular matrix (ECM). Therefore, TIMPs, fetal expression pattern was evaluated with the aim of its potential to be used as a determinant for the (early) detection of PE.

MATERIALS AND METHODS: In this case-control study, cell free fetal RNA (cffRNA) released by placenta into the maternal blood was used to determine expression patterns of TIMP1, 2, 3 and 4 in the severe preeclamptic women in comparison with the normal pregnant women. Whole blood from 20 preeclamptic and 20 normal pregnant women in their 28-32 weeks of gestational age was collected. The second control group consisted of 20 normal pregnant women in either 14 or 28 weeks of gestation (each 10). cffRNA was extracted from plasma and real-time polymerase chain reaction (PCR) was done to determine the expression levels of TIMP1, 2, 3 and 4 genes.

RESULTS: Statistical analysis of the results showed significant higher expression of TIMP1-4 in the preeclamptic women in comparison with the control group (P=0.029, 0.037, 0.037 and 0.049, respectively). Also, an increased level of TIMPs expression was observed by comparing 14 to 28 weeks of gestational age in the normal pregnant women in the second control group.

CONCLUSION: An increased cffRNA expression level of TIMPs may be correlated with the intensity of placental vascular defect and may be used as a determinant of complicated pregnancies with severe preeclampsia.

PMID:36680483 | DOI:10.22074/cellj.2022.557259.1041

Early Interv Psychiatry. 2023 Jan 21. doi: 10.1111/eip.13400. Online ahead of print.

ABSTRACT

AIM: The study aimed to assess changes in adolescent visits due to eating disorders (EDs) during the pandemic.

METHOD: A retrospective evaluation of adolescents diagnosed with an ED during two periods: June 2019-February 2020 (pre-pandemic) and June 2021-February 2022 (during the pandemic) at an adolescent medicine clinic in Tukey was conducted. The number of patients diagnosed with an ED between these dates was compared with the number of overall attended outpatient appointments. Baseline data for patients with Anorexia Nervosa (AN) and the requirement of hospitalization for all cases were compared.

RESULTS: Of the 3708 visits in the pre-pandemic period 46 (1.2%) were diagnosed with an ED. This was 69 (2.2%) of 3149 visits during the pandemic which was statistically significant (p = 0.003). The percentage of males to females changed from 2.2% to 11.6% (p = 0.065). Distribution of the type of ED did not change (p = 0.280), although the percentage of atypical AN increased from 6.5% to 17.4%. Mean age, BMI, calorie intake and hospital admissions did not significantly change.

CONCLUSION: Our findings support the increase in adolescent EDs during COVID-19. Particular attention should be given to males and Atypical AN cases.

PMID:36680467 | DOI:10.1111/eip.13400

Assessment. 2023 Jan 21:10731911221147038. doi: 10.1177/10731911221147038. Online ahead of print.

ABSTRACT

The Structured Clinical Interview for Gambling Disorder (SCI-GD) has the potential to bridge a diagnostic clinical gap, but psychometric evaluations have been scarce, in particular in relation to self-reported diagnostic criteria. This study analyzed existing data, including Swedish gamblers (N = 204) from treatment- and help-seeking contexts, self-help groups, and the general population, who were interviewed with the SCI-GD and completed self-report measures. The results indicated that fewer individuals fulfilled the diagnostic criteria for gambling disorder (GD) with the SCI-GD (n = 110, 54%), compared to a self-report Diagnostic and Statistical Manual of Mental Disorders:5th Edition (DSM-5) questionnaire on GD (n = 145, 71%; p < .001). Agreement between interviews and self-reported criteria was generally low (Fleiss kappa range: 0.31-0.52; r range: 0.35-0.55). A Rasch analysis showed that specific diagnostic criteria varied in difficulty, indicating a general pattern of higher item difficulty for the SCI-GD compared to self-reported DSM-5 criteria. Both the SCI-GD and the self-reported DSM-5 criteria performed well in terms of internal consistency, convergent, and discriminant validity. We conclude that the SCI-GD is a reliable and valid diagnostic tool to assess GD among individuals with various gambling behavior patterns. Further research-related and clinical implications are discussed.

PMID:36680458 | DOI:10.1177/10731911221147038

Anatol J Cardiol. 2023 Jan;27(1):41-46. doi: 10.14744/AnatolJCardiol.2022.2050.

ABSTRACT

OBJECTIVE: Malignant pericardial effusion may affect almost 15 of the patients with underlying malignancies which deteriorates the prognosis. The prognostic significance of pericardial fluid cytology is under-represented in previous studies.

METHODS: A total of 73 patients with symptomatic pericardial effusion treated with pericardiocentesis were included in this retrospective analysis. Macroscopic appearance, biochemical features, and cytological findings were obtained. Patients were divided into 3 groups: (i) without malignancy, (ii) with malignancy and negative cytology, and (iii) with malignancy and positive cytology. Survival data were searched via governmental death notification system.

RESULTS: Mean age of the study group was 62 ± 15, and 54% (40) of the patients were female. On the cytological evaluation, 17 patients (23.3%) revealed positive cancer cytology, whereas 56 patients (76.7%) revealed negative cancer cytology. The median follow-up period was 840 days, and 34 patients (46.5%) died during follow-up. The survival rate of Group 3 was found to be significantly worse compared to Groups 1 and 2, no statistical difference was found between Groups 1 and 2 in terms of survival (Group 1 vs. Group 2 P =.078; Group 1 vs. Group 3 P <.001; Group 2 vs. Group 3 P =.041).

CONCLUSION: Cytological evaluation is an important step in patients with malignant pericardial effusion. Positive pericardial fluid cytology indicates a poorer prognosis.

PMID:36680446 | DOI:10.14744/AnatolJCardiol.2022.2050

J Med Virol. 2023 Jan 21. doi: 10.1002/jmv.28517. Online ahead of print.

ABSTRACT

This study investigated outcomes of children born to women who seroconverted to rubella immune during pregnancy. In a prior 2012-2013 study of 296 women who were rubella non-immune, 26 (8.8%) seroconverted to rubella immune during pregnancy. These same women and their now 8-9 years-old children were queried as to the children’s developmental health. After removing exclusions and those lost to follow-up, the total response rate was 115/204 (56.4%). Three sets of twins in the non-immune group increased the total to 118. The seroconversion group had more autism (12.5% versus 3.9%, P=.19), ADHD (37.5% versus 18.6%, P=.10), and any developmental disability (43.8% versus 31.4%, P=.39) but none showed a statistical difference between the two groups. Compared to Autism and Developmental Disabilities Monitoring data, the seroconversion group had a greater prevalence of autism (OR 6.07, P=0.051, nonsignificant); and to data derived from the National Health Interview Survey, a nonsignificant higher odds of autism (OR 5.57, P=0.060), higher odds of ADHD (OR 5.65, P=0.0027) and of any developmental disability (OR 3.59, P=0.014).The non-immune group also demonstrated a statistically significant increase for both ADHD and any developmental disability, but not for autism. This article is protected by copyright. All rights reserved.

PMID:36680415 | DOI:10.1002/jmv.28517

Scand J Med Sci Sports. 2023 Jan 21. doi: 10.1111/sms.14319. Online ahead of print.

ABSTRACT

BACKGROUND: Markerless motion capture based on low-cost 2-D video analysis in combination with computer vision techniques has the potential to provide accurate analysis of running technique in both a research and clinical setting. However, the accuracy of markerless motion capture for assessing running kinematics compared to a gold-standard approach remains largely unexplored.

OBJECTIVE: Here we investigate the accuracy of custom-trained (DeepLabCut) and existing (OpenPose) computer vision techniques for assessing sagittal-plane hip, knee, and ankle running kinematics at speeds of 2.78 and 3.33 m∙s^-1 as compared to gold-standard marker-based motion capture.

METHODS: Differences between the markerless and marker-based approaches were assessed using statistical parameter mapping and expressed as root mean squared errors (RMSEs).

RESULTS: After temporal alignment and offset removal, both DeepLabCut and OpenPose showed no significant differences with the marker-based approach at 2.78 m∙s^-1 , but some significant differences remained at 3.33 m∙s^-1 . At 2.78 m∙s^-1 , RMSEs were 5.07, 7.91, and 5.60, and 5.92, 7.81, and 5.66 degrees for the hip, knee, and ankle for DeepLabCut and OpenPose, respectively. At 3.33 m∙s^-1 , RMSEs were 7.40, 10.9, 8.01, and 4.95, 7.45, and 5.76 for the hip, knee, and ankle for DeepLabCut and OpenPose, respectively.

CONCLUSION: The differences between OpenPose and the marker-based method were in line with or smaller than reported between other kinematic analysis methods and marker-based methods, while these differences were larger for DeepLabCut. Since the accuracy differed between individuals, OpenPose may be most useful to facilitate large-scale in-field data collection and investigation of group effects rather than individual-level analyses.

PMID:36680411 | DOI:10.1111/sms.14319

Int J Paediatr Dent. 2023 Jan 20. doi: 10.1111/ipd.13048. Online ahead of print.

ABSTRACT

BACKGROUND: Limited evidence regarding the post-COVID dental status of paediatric patients is available, with most studies assessing only children’s oral health habits.

AIM: To evaluate the effect of COVID-19 lockdown on the oral health of paediatric dental patients in Greece.

DESIGN: This was a retrospective cohort study that included a questionnaire reporting on children’s oral health behavior and a clinical examination assessing dental caries and dental treatment needs using the ICDAS criteria, dmft/DMFT, and Treatment Need Index. Wilcoxon sign ranked test was used for statistical comparison of questionnaire and clinical data before, during and after the lockdown.

RESULTS: A total of 102 children with a median age of 9 years-old were recruited from current patients attending the clinic that had their last dental exam 6 months prior to the lockdown. Results from the questionnaire showed decreased brushing frequency, increased eating frequency and sugar consumption during the lockdown period (p< 0.001). Moreover, 16.5% had to visit the dentist for urgent care during the lockdown, 13.6% experienced dental pain, while 51.5% did not experience any dental emergencies. Clinical examination, after the lockdown, recorded significant increased mean dmft/DMFT scores by 0.63 units in the primary dentition (p=0.01) and 0.52 units in the permanent (p=0.002). Significantly higher treatment needs, with more carious lesions requiring extensive treatment after the lockdown were recorded (p<0.001).

CONCLUSIONS: Covid-19 lockdown negatively affected children’s oral health behavior; caries prevalence increased while more complex dental treatments were required after the lockdown.

PMID:36680387 | DOI:10.1111/ipd.13048

Oral Dis. 2023 Jan 20. doi: 10.1111/odi.14514. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the association of SYN2, PPARG, RAF1, TIMP4 and IQSEC1 polymorphisms in 3p25 with oral squamous cell carcinoma (OSCC) in the Chinese Han population.

SUBJECTS AND METHODS: Genomic DNA was extracted from 494 subjects with or without OSCC. Basic information on the subjects, clinical data, and prognoses were collected. Fifteen candidate single nucleotide polymorphisms (SNPs) were selected and genotyped. The statistical analyses included descriptive statistics, logistic regression, survival, and functional annotation was performed.

RESULTS: IQSEC1-rs2686742 correlated with OSCC occurrence. In addition, RAF1-rs1051208, PPARG-rs10865710, PPARG-rs3856806, IQSEC1-rs2686742, PPARG-rs1175544, IQSEC1-rs9211, and IQSEC1-rs2600322 were significantly associated with the clinical characteristics of patients with OSCC. The log-rank test showed that IQSEC1-rs2600322 may play an important role in the survival of patients with OSCC. The Cox regression analysis suggested that PPARG-rs10865710, PPARG-rs7649970, IQSEC1-rs9211, IQSEC1-rs2600322, and IQSEC1-rs12487715 influenced survival outcomes. The functional annotation indicated that the transcript levels of IQSEC1 were upregulated in head and neck squamous cell carcinoma tissues, whereas PPARG gene transcription was downregulated.

CONCLUSIONS: IQSEC1-rs2686742 may be closely associated with OSCC onset. Multiple SNPs in IQSEC1 and PPARG genes correlated with the clinical characteristics of OSCC, among which PPARG-rs10865710, IQSEC1-rs9211, and IQSEC1-rs2600322 were associated with cancer prognosis.

PMID:36680374 | DOI:10.1111/odi.14514

J Investig Med. 2023 Jan 20:10815589221149186. doi: 10.1177/10815589221149186. Online ahead of print.

ABSTRACT

Hypochloremia has recently gained interest as a potential marker of outcomes in patients with heart failure (HF). The exact pathophysiologic mechanism linking hypochloremia to HF is unclear but is thought to be mediated by chloride-sensitive proteins and channels located in kidneys. This analysis aimed to understand whether renal dysfunction (RD) affects the association of hypochloremia with mortality in patients with HF. Using data from a nationwide registry, 438 cases with complete data on serum chloride concentration and 1-year survival were included in the analysis. Patients with an estimated glomerular filtration rate of <60 mL/min/m² at baseline were accepted as having RD. Hypochloremia was defined as a chloride concentration <96 mEq/L at baseline. For HF patients without RD at baseline, patients with hypochloremia had a significantly higher 1-year all-cause mortality than those without hypochloremia (41.6% vs 13.0%, log-rank p < 0.001) and the association remained significant after multivariate adjustment (odds ratio (OR): 2.55, 95% confidence interval (CI): 1.25-5.21). The evidence supporting the association was very strong in this subgroup (Bayesian Factor (BF)₁₀: 48.25, log OR: 1.56, 95% CI: 0.69-2.43). For patients with RD at baseline, there was no statistically significant difference for 1-year mortality for patients with or without hypochloremia (36.3% vs 29.7, log-rank p = 0.35) and there was no evidence to support an association between hypochloremia and mortality (BF₁₀: 1.18, log OR :0.66, 95% CI: -0.02 to 1.35). In patients with HF, the association between low chloride concentration and mortality is limited to those without RD at baseline.

PMID:36680353 | DOI:10.1177/10815589221149186