Nevin Manimala

Nurs Open. 2022 Nov 6. doi: 10.1002/nop2.1449. Online ahead of print.

ABSTRACT

AIM: To systematically evaluate the efficacy of different topical treatments for PVC-related phlebitis in hospital in-patients.

DESIGN: A systematic review and meta-analysis.

METHODS: A selection was made of experimental and quasi-experimental studies published in English or Spanish. These should provide data on the degree of phlebitis, pain and infiltration (means and standard deviations, mainly) of hospitalized patients with phlebitis secondary to peripheral venous catheter. All those studies that reflected systemic or exclusive prevention treatments were excluded. Searches were from inception to April 2020. The date of data collection was from December 2020 to May 2021. The selection criteria were based on the PICOS model. Risk of bias was assessed using the Cochrane Collaboration tool.

RESULTS: Twelve studies (726 patients) met the inclusion criteria. With respect to the decrease in the degree of phlebitis, was found ichthammol glycerine, followed by heparinoids. As for degree of pain, sesame oil obtained the most marked reduction. In terms of degree of infiltration, heparinoids and ichthammol glycerine were the only products to achieve a statistically significant reduction. The most important limitations are the low quantity and quality of the trials included. Insufficient data are available to draw valid conclusions about the efficacy of any treatment.

PMID:36335576 | DOI:10.1002/nop2.1449

Eur J Epidemiol. 2022 Nov 6. doi: 10.1007/s10654-022-00932-y. Online ahead of print.

ABSTRACT

COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study ( www.icarestudy.com ). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.

PMID:36335560 | DOI:10.1007/s10654-022-00932-y

Eur J Nutr. 2022 Nov 6. doi: 10.1007/s00394-022-03030-7. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate whether the intake of specific fibers with prebiotic activity, e.g., inulin-type fructans (ITFs), fructo-oligosaccharides (FOSs), and galacto-oligosaccharides (GOSs), is associated with laryngeal cancer risk.

METHODS: Within the PrebiotiCa study, we used data from a case-control study (Italy, 1992-2009) with 689 incident, histologically confirmed laryngeal cancer cases and 1605 controls. Six prebiotic molecules (ITFs, nystose [FOS], kestose [FOS], 1F-β-fructofuranosylnystose [FOS], raffinose [GOS] and stachyose [GOS]) were quantified in various foods via ad hoc conducted laboratory analyses. Subjects’ prebiotic fiber intake was calculated by multiplying food frequency questionnaire intake by the prebiotic content of each food item. The odds ratios (OR) of laryngeal cancer for prebiotic fiber intake were calculated using logistic regression models, including, among others, terms for tobacco, alcohol, and total energy intake.

RESULTS: The intakes of kestose, raffinose and stachyose were inversely associated with laryngeal cancer, with ORs for the highest versus the lowest quartile of 0.70 (95% confidence interval, CI 0.50-0.99) for kestose, 0.65 (95% CI 0.45-0.93) for raffinose and 0.61 (95% CI 0.45-0.83) for stachyose. ITFs, nystose and 1F-β-fructofuranosylnystose were not associated with laryngeal cancer risk. Current smokers and heavy drinkers with medium-low intakes of such prebiotic fibers had, respectively, an over 15-fold increased risk versus never smokers with medium-high intakes and a five to sevenfold increased risk versus never/moderate drinkers with medium-high intakes.

CONCLUSION: Although disentangling the effects of the various components of fiber-rich foods is complex, our results support a favorable role of selected prebiotic fibers on laryngeal cancers risk.

PMID:36335543 | DOI:10.1007/s00394-022-03030-7

Pituitary. 2022 Nov 6. doi: 10.1007/s11102-022-01286-0. Online ahead of print.

ABSTRACT

PURPOSE: We present the results of transsphenoidal microsurgical treatment in 14 patients with gigantism. The influence on the prognosis of factors such as the tumor size and preoperative levels of GH and IGF-1 is also quantified.

MATERIALS AND METHODS: The patients, operated between 1982 and 2004, were reviewed retrospectively in June 2022. All patients had complete endocrinological studies in the preoperative period and a postoperative control between 6 days and 3 weeks. Follow-up has been supported with annual check-ups between 3 and 31 years. We have compared the preoperative levels of GH and IGF-1 of these patients with the levels of a series of acromegalic patients operated on in the same Center.

RESULTS: In this series there were 4 women and 10 men. The age ranged between 14 and 21 years. In 6 patients, postoperative hormone levels achieved the disease control criteria (42.8%). The CT/MRI studies revealed the existence of invasive tumors in 10 of the patients (71.4%). Postoperative CT/MRI showed no tumor tissue in 3 patients but in 7 patients there were tumor remains. The remaining 4 patients had abnormal images although not considered as tumor. A statistical comparison of preoperative serum GH and IGF-1 levels in patients with gigantism and patients with acromegaly showed a significant elevation in the former.

CONCLUSION: Pituitary adenomas that cause gigantism are generally large and invasive, which makes them difficult to cure. High preoperative levels of GH and IGF-1 are also factors that decrease remission.

PMID:36335516 | DOI:10.1007/s11102-022-01286-0

Ophthalmol Ther. 2022 Nov 6. doi: 10.1007/s40123-022-00606-8. Online ahead of print.

ABSTRACT

INTRODUCTION: This study evaluated vault changes in eyes implanted with an implantable Collamer lens (ICL) with a central hole (ICL V4c) for myopia and astigmatism correction as well as factors related to vault changes over time.

METHODS: This retrospective study enrolled 169 myopic eyes from 169 patients (137 women and 32 men) who underwent ICL V4c implantation to correct myopia and astigmatism. Vault values were measured quantitatively using a rotating Scheimpflug camera. Each patient underwent at least four postoperative follow-up visits at 1 month, 6 months, 1 year, and more than 2 years. We compared postoperative values between groups and identified factors affecting vault changes over time.

RESULTS: The mean vaults at 1 month (baseline), 6 months, 1 year, and the last follow-up time following ICL implantation were 540.83 ± 186.13, 520.00 ± 196.08, 503.79 ± 198.30, and 471.42 ± 211.35 μm, respectively. Eyes with baseline vaults of 250-750 and ≥ 750 μm exhibited a trend of vault decrease over time, and the differences were statistically significant (P < 0.05) at 6 months and 1 year postoperatively, respectively. The variables relevant to the value of vault decrease between baseline and last follow-up time were anterior chamber depth (ACD) and ICL power (adjusted R² = 0.121, P < 0.001).

CONCLUSIONS: We found a trend of decreased mean objective vault values over time, which was more obvious in eyes with higher baseline vault values. The vault value of the ICL decreased more in eyes with shallower ACDs, higher ICL power, or both. Moreover, the decrease in vault values became statistically significant earlier in eyes with higher baseline vaults or shallower ACDs.

PMID:36335511 | DOI:10.1007/s40123-022-00606-8

Methods Mol Biol. 2023;2590:127-138. doi: 10.1007/978-1-0716-2819-5_8.

ABSTRACT

WhatsHap is a command-line tool for phasing and phasing-related tasks. It allows to infer haplotypes in diploid and polyploid samples based on (preferably long) reads covering at least two heterozygous variants. It offers additional tools for working with phased variant calls such as computing statistics, comparing different phasings and assigning reads in alignment files to their haplotype.

PMID:36335496 | DOI:10.1007/978-1-0716-2819-5_8

Circulation. 2022 Nov 6. doi: 10.1161/CIRCULATIONAHA.122.062949. Online ahead of print.

ABSTRACT

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used for circulatory support in cardiogenic shock patients, although the evidence supporting its use in this context remains insufficient. The aim of the Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock (ECMO-CS) trial was to compare immediate implementation of VA-ECMO vs. an initially conservative therapy (allowing downstream use of VA-ECMO) in patients with rapidly deteriorating or severe cardiogenic shock. Methods: This multicenter, randomized, investigator-initiated, academic clinical trial included patients with either rapidly deteriorating or severe cardiogenic shock. Patients were randomly assigned to immediate VA-ECMO or no immediate VA-ECMO. Other diagnostic and therapeutic procedures were performed as per current standard(s) of care. In the early conservative group, VA-ECMO could be used downstream in case of worsening hemodynamic status. The primary endpoint was the composite of death from any cause, resuscitated circulatory arrest, and implementation of another mechanical circulatory support device at 30 days. Results: A total of 122 patients were randomized; after excluding 5 patients due to the absence of informed consent, 117 subjects were included in the analysis, of whom 58 randomized to immediate VA-ECMO and 59 to no immediate VA-ECMO. The composite primary endpoint occurred in 37 (63.8%) and 42 (71.2%) of patients in the immediate VA-ECMO and the no early VA-ECMO groups, respectively (hazard ratio, 0.72; 95% confidence intervals [CI], 0.46 to 1.12; P=0.21). VA-ECMO was used in 23 (39%) of no early VA-ECMO patients. The 30-day incidence of resuscitated cardiac arrest (10.3. % vs. 13.6%; risk difference [RD], -3.2; 95% CI, -15.0 to 8.5), all-cause mortality (50.0% versus 47.5%; RD, 2.5; 95% CI, -15.6 to 20.7), serious adverse events (60.3% vs. 61.0%; RD, -0.7; 95% CI, -18.4 to 17.0), sepsis, pneumonia, stroke, leg ischemia, and bleeding was not statistically different between the immediate VA-ECMO and the no immediate VA-ECMO groups. Conclusions: Immediate implementation of VA-ECMO in patients with rapidly deteriorating or severe cardiogenic shock did not improve clinical outcomes compared with an early conservative strategy that permitted downstream use of VA-ECMO in case of worsening hemodynamic status. Clinical Trial Registration: URL: https://www.clinicaltrials.gov; Unique identifier NCT02301819.

PMID:36335478 | DOI:10.1161/CIRCULATIONAHA.122.062949

Knee Surg Sports Traumatol Arthrosc. 2022 Nov 6. doi: 10.1007/s00167-022-07216-8. Online ahead of print.

ABSTRACT

PURPOSE: There is a paucity of data available on total knee prostheses combining dual-radius, ultra-congruency, posterior-stabilization and mobile-bearing insert. This prospective cohort study aimed to assess the clinical evolution of the FIRST^® prosthesis (Symbios Orthopédie, Yverdon, CH), the earliest prosthesis with this particular design. It was hypothesized that the primary outcomes, evaluating pain, stiffness, function and stability, would improve following arthroplasty and remain improved during the follow-up period of 10 years.

METHODS: All patients programmed for a total knee arthroplasty using a FIRST^® prosthesis at our university hospital between 2006 and 2008 were invited to participate. Study knees were evaluated pre-operatively as well as one, five and ten years post-operatively. Patients filled out questionnaires at each evaluation point and had a radiographic assessment at the five-year and ten-year follow-ups. Primary outcomes were the total, pain, stiffness and function measures of the Western Ontario and McMaster Universities Osteoarthritis questionnaire (WOMAC) and the knee and function measures of the Knee Society Score (KSS). Friedman and Wilcoxon’s rank-sum tests were used to compare measures across time points.

RESULTS: Hundred and twenty four prostheses were included (baseline demographics: 69.9 ± 8.3 years old, 28.1 ± 4.3 kg/m², 54% male) and 68 could be followed during ten years. Five prostheses underwent a revision. All other prostheses lost at follow-up were lost for reasons unrelated to the prosthesis. All primary measures reported statistically and clinically significant improvements between baseline and the three follow-up evaluations. Statistically significant improvements at the three follow-up evaluations were also observed for most secondary measures. There was no implant loosening. At ten-year follow-up, radiolucent lines were observed in 2.9% femoral implants and 1.5% tibial implants.

CONCLUSION: The positive results observed in all domains of assessment and the small revision rate demonstrated an effective functioning of the FIRST^® prosthesis during the ten-year follow-up period. The results, globally similar to those previously published for other prosthesis designs, encourage the development of assistive methods to select the most appropriate designs on an individual basis.

LEVEL OF EVIDENCE: IV, prospective cohort study.

PMID:36335473 | DOI:10.1007/s00167-022-07216-8

Soc Psychiatry Psychiatr Epidemiol. 2022 Nov 6. doi: 10.1007/s00127-022-02380-1. Online ahead of print.

ABSTRACT

PURPOSE: The associations of duration of subjective poverty and poverty status with mortality among older people remains inconclusive, and the underlying mechanisms of mental health on them are rarely discussed in population-based epidemiological studies.

METHODS: We used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2008-2018). The Cox regression model was used to estimate hazard ratio (HR) and 95% confidence intervals (CIs) for mortality. Mediation analysis was applied to assess the effect of mental health.

RESULTS: When compared with participants without subjective poverty, those who reported subjective poverty at one time point (2008 or 2011) or two time points (2008 and 2011) had a higher risk of death, with multivariable-adjusted HR (95% CIs) of 1.08 (1.00-1.16) and 1.22 (1.06-1.39), respectively. For poverty status, the multivariable-adjusted HR (95% CIs) of mortality were 0.81 (0.66-0.98) for “just objective poverty” and 0.78 (0.62-0.98) for “neither subjective nor objective poverty” compared with participants who reported “just subjective poverty”, while there was no statistically significant association between “poverty subjectively and objectively” and mortality (HR = 0.88, 95% CI 0.72-1.07). Besides, we found that the proportion mediated by mental health was 26.6%, and age was a significant effect modifier.

CONCLUSIONS: Subjective poverty may be associated with a higher risk of death among Chinese older people. This study showed that promoting mental health alone may not substantially reduce socioeconomic inequality in health. Further explorations of measures to tackle the social determinants of health are still needed.

PMID:36335472 | DOI:10.1007/s00127-022-02380-1

J Public Health (Oxf). 2022 Nov 3:fdac122. doi: 10.1093/pubmed/fdac122. Online ahead of print.

ABSTRACT

BACKGROUND: Differential attainment has been widely observed in United Kingdom (UK) medical training, with minority ethnicity being associated with reduced success in recruitment and progression through training. Specialty training in Public Health in the UK recruits candidates with medical as well as non-medical backgrounds. At the request of the UK Faculty of Public Health and Health Education England, we sought to examine whether differential attainment may or may not be occurring in the multi-stage recruitment process.

METHODS: We analysed 3 years of national recruitment data into Public Health specialty training to identify whether demographic characteristics including age, sex, ethnicity and professional background were associated with successful recruitment.

RESULTS: In total 2252 applications between 2018 and 2020 were analysed. Candidates who were older, Asian, black or from backgrounds other than medicine were significantly less likely to progress from the psychometric testing stage than the white British group. Fewer statistically significant differences were observed at the final stage of recruitment involving interviews, group work and a written task.

CONCLUSIONS: The findings suggest that older candidates those from some ethnic minority backgrounds and those from backgrounds other than medicine are disadvantaged by the current recruitment process, with differential attainment associated with the psychometric testing stage.

PMID:36335426 | DOI:10.1093/pubmed/fdac122