Nevin Manimala

Georgian Med News. 2022 Mar;(324):112-121.

ABSTRACT

Determining the influence of body composition on stress resistance, endothelial function and wellness and as a function of daily physical activity level and gender is of great medical-preventive importance․ The aim of this study was to analyse the influence of body composition on the stress resistance, endothelial function and wellness in different physical activity groups. A cross-sectional study was conducted with 2000 participants (829 men and 1171 women) aged 10-90 years. The Multiscan BS_OXI instrument was applied to measure the integral indicators․ For the study, statistical analysis was performed using Primer of Biostatistics version 4.03 by Stanton A. Glantz. Data analysis showed: (i) in the high physical activity group there was a significantly weak correlation between body composition and stress resistance in male (Rxy=0.24, p=0.000) and female (Rxy=0.28, p=0.0000) groups. In the case of low physical activity, a reliable weak correlation was registered only in the male group (ii) in the low physical activity group, there was a significant correlation between the body composition index and the change in the endothelium in the male (Rxy=0.4, p=0.000) and female group (Rxy=0.3, p=0.000) and in the group of participants with moderate physical activity, there was a significant correlation only in female group. (iii) In the high physical activity participant group, the correlation between body composition and wellness index was directly proportional in the male group (Rxy=0.33, p=0.000); in moderate and low physical activity, the correlation was directly proportional in the male and female groups. Thus, our study showed that the association of body composition with stress resistance, endothelial function and well-being depends on the level of physical activity and gender. However, further research is recommended to determine the influence of body composition ranges on various health indicators and to make recommendations and implement appropriate health and fitness programmes for the Armenian population, which should also focus on disease prevention.

PMID:35417871

Georgian Med News. 2022 Mar;(324):107-112.

ABSTRACT

There is a paucity of data on the occurrence of fibromyalgia (FM) in chronic obstructive pulmonary disease (COPD). The objective of this study was to determine the frequency of fibromyalgia in a group of patients with COPD in Mosul, as well as characterization of the features of COPD patients with concomitant FM. Participants included seventy COPD-patients plus se-venty controls. The “2011 modification of the 2010 American College of Rheumatology’s preliminary diagnostic criteria for fibromyalgia” was employed to make the diagnosis of FM. The demographic features and COPD data of the patients were documented. Pulmonary function tests and Chest-X-ray were evaluated for all patients. FM was present in 16 (22.9%) of 70 COPD patients, and only in 4 (5.7%) of the 70 controls, and the difference was significant. FM was found in 58.33% of female COPD patients compared to 15.52% of male COPD patients (p=0.004). There was no statistically significant difference in COPD patients with and without FM in respect to their age or BMI. However, patients with FM tended to have a longer duration of COPD (8.06±2.69 vs. 4.78±2.13, P value < 0.001), and higher scores on the Beck Depression Inventory (BDI) (20.7±9.200 vs. 14.8±7.900, P value=0.0139), and greater COPD severity (P< 0.001). The frequency of FM in patients with COPD was higher than control. FM is more likely to occur in female patients. Patients with comorbid FM and COPD tended to report more depressive symptoms, have longer disease duration, and higher disease severity.

PMID:35417870

Georgian Med News. 2022 Mar;(324):92-101.

ABSTRACT

Aims – to identify association between maternal stress during pregnancy and the developemnt of the attention deficiency hyperactivity syndrom in young children We conducted a case-control study sequentially recruiting 200 children from the “Early detection of disease and screening” State Program, from them 100 children with ADHD diagnose, and 100 subjects, as a control group, without Disruptive Behavior Disorder (DBD), aged between 1 and 6 years. The children were diagnosed with ADHD according to the DSM-IV-R and a clinical interview of the parents that used the Diagnostic Interview Schedule for Children Version IV (DISC-IV). We investigated the effect of cumulative exposure separately for life events considered as dependent and independent.The mother’s stress level was scored from 1 to 5 on the DSM-III and DSM-III-R axis IV scales, according to the highest level of stress experienced during the pregnancy. The presence of stress factor plays an important role in the development of ADHD syndrome, but does not play a statistically significant role in which type of syndrome develops: F90.0, F90.1, F90.2: p=.258. A statistically significant relationship between ADHD diagnosis and stress degree was not confirmed at p=.503. Our data revealed that moderate-grade stress is caused by dependent causes, severe stress by independent causes, this association is statistically significant(p=.001 Cramer’s V=.750). A statistically significant negative association was also found between the presence of prenatal stress and the length and weight of the baby at birth. For our study population, the risk of developing the syndrome in children of stress-relieved mothers was 2 times higher than in children of non-stressed mothers RR = 2.042. These findings show that there is an association between maternal stress during pregnancy and ADHD symptoms in offspring and support the hypothesis that prenatal stress causes offspring ADHD through a programming effect and future research should focus on exploring other prenatal factors that might be causally related to ADHD.

PMID:35417868

Georgian Med News. 2022 Mar;(324):78-86.

ABSTRACT

Metabolic syndrome (MеtS) is a combination of clinical and laboratory abnormalities that increase the risk of cardiovascular diseases and type 2 diabetes mellitus. Purpose – to detect and identify peculiarities of MetS and its criteria in children depending on gender. MetS was estimated in 89 (5.9%) children from 1520 examined children: in 39 (2.6%) girls and 50 (3.3%) boys (p>0.05) aged from 9 to 18 years. Children were selected for examination of anthropometric data, blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides, fasting glucose and insulin, index HOMA-IR, glucose/insulin ratio and QUICKI. Heart rate variability (HRV) study and echocardiography were done. Diagnosis of MetS was provided according to IDF Consensus (2007). Abdominal obesity was diagnosed in all children with MetS. Boys had essentially more large body mass, height, body surface area, neck and waist circumferences, weight/height ratio than girls (p<0,001). Blood pressure in boys was higher than in girls, arterial hypertention in boys (72,0%) was diagnosed more often than in girls (46,2%). Insulin resistance was identified 1,5 falled more often in girls than in boys (p<0,05). Statistically significant difference in lipid metabolism in boys and girls was not estimated. According to HRV boys had higher activity of the autonomous nervous system than girls. Left ventricular (LV) myocardial mass and thickness of the LV posterior wall in boys were significantly larger than in girls that proved a higher risk of LV hypertrophy and concentric remodeling. Attention to gender differences of MetS must be paid and gender-specific strategies for the prevention of cardiovascular diseases and type 2 diabetes mellitus should be formulated.

PMID:35417866

Georgian Med News. 2022 Mar;(324):32-37.

ABSTRACT

The aim of this study was to optimize the diagnosis of postpartum inflammatory complications. 150 puerperas who gave written informed consent to participate in clinical and laboratory studies were divided into two groups: the main group included puerperas with developed postpartum complications (n = 100), the comparison group included puerperas with a physiological course of the postpartum period (n = 50). The data of biochemical blood tests and bacteriological analysis of aspirated vaginal contents under aseptic conditions after childbirth were used as material. Against the background of the development of the inflammatory process in the early postpartum period, a decrease in quantitative indicators of hemoglobin and changes in white blood parameters with an increase in the level of leukocytes to 10.6±0.08×109/l in the main group, against 6.2±0.13×109/l in the control group group (P=0.001). It is important to note the relatively high level of ESR, which in puerperas of the main group was 23.1±0.22 mm/hour, against 8.4±0.16 mm/hour in the control group (P=0.001). Significant distinguishing features between the groups are recorded by the frequency of occurrence in the anamnesis of medical and spontaneous abortions, which were significantly higher in women of the main group (p=0.004). Patients of different groups have statistically significant differences in the somatic history data – in the puerperas of the main group, chronic pyelonephritis and inflammatory diseases of the upper respiratory tract (chronic tonsillitis, sinusitis) were more often diagnosed. Significant deviations also affected the quantitative indicators of lymphocytes (P=0.001). Among past sexually transmitted infections, the development of early puerperal inflammatory complications can be influenced by trichomoniasis (p=0.035), chlamydia (p=0.036), the frequency of which in the main group is quite significant compared to the control. The presence of inflammatory postpartum complications in patients of the main group increases the contamination, possibly also due to a significant increase in the frequency of inoculation of Mycoplasma Hominis (titer≥104) 38.0±4.85%, Ureaplasma urealiticum (titer≥104) – 73.0±4.44% (p<0.05). Comparative analysis showed that the incidence of Staphylococcus spp in patients of the main group was higher in comparison with the control group. A significant difference in patients of the main group with the control group was observed in relation to the frequency of occurrence of Streptococcus spp. Microorganisms of the Enterobacteriaceae family were also frequently sown species.

PMID:35417860

Georgian Med News. 2022 Mar;(324):21-25.

ABSTRACT

The aim of our prospective study is to compare and analyze the results of two treatment methods of left-sided malignant colon obstruction: Hartmann’s procedure (HP) and Resection with primary anastomosis (RPA). 90 Patients with diagnosis of left-sided malignant colon obstructions were enrolled in this study. The patients were assigned into two groups: Hartmann’s procedure (HP) group and Resection and Primary anastomosis group (RPA). Several clinical characteristics were determined and compared between the groups: hospital stay days, duration of the surgery, postoperative complications (during 30 days after surgery) and mortality was assessed. 37 patients were enrolled in the Hartmann’s procedure (HP) group and 53 patients were enrolled in the Primary anastomosis (RPA) group and had undergone different types of colon resections with primary anastomosis. There was 1mortality in HP group and 1 in RPA group. In RPA group, there were 7 complications (13.2%). 1 intraabdominal abscess after colorectal anastomosis, which was cured with antibiotic therapy and percutaneous drainage; 5 cases of wound infections, 1- leak of colorectal anastomosis and in Hartmann’s procedure group there were 8 (21.6%) complications (7 – wound infections, 1-necrosis of colostomy). But this difference is not statistically reliable (p=0.110). In stenting RPA stay were – 6 days and in HP group, it was 8 days. This difference is statistically reliable (P=0.02). In case of left-sided malignant colon obstructions, Primary anastomosis intervention should be preferred, rather than Hartmann’s procedure. In the future it’s needed to perform the randomized trials, which will study the long-term outcomes (recurrence of cancer, survival rate) of this treatment method.

PMID:35417858

Georgian Med News. 2022 Mar;(324):15-20.

ABSTRACT

Aim – in patients with knee meniscus injury, compare the therapeutic effectiveness of the use of meniscus suturing with anterior cruciate ligament (ACL) surgery with meniscus resection in combination with anterior cruciate ligament surgery to improve the treatment of such pathologies. The study examined patients (n=66) with knee meniscus injury who received surgical treatment in the traumatology department of the State Budgetary Healthcare Institution of the Moscow region “City Clinical Hospital № 12 of the Moscow City Health Department”. The patients were randomized by gender, age, clinical, biochemical and instrumental data and divided into 2 groups. The first group (n=33) – patients underwent resection of the anterior meniscus with simultaneous plasty of the anterior cruciate ligament (in 17 (51.6%) – medial, and in 16 (48.4%) – lateral), the age group was 26.8±6.33 years, the proportion of men was 19 (57.6%), and women – 14 (42.4%). The second group (n=33) – patients underwent suturing of the meniscus with ACL plastic surgery (in 23 (69.7%) – medial, and in 10 (30.3) – lateral), age – 27.2± 4.56 years, men – 18 (54.6%), women – 15 (45.4%). This work includes clinical, arthroscopic, ultrasound, X-ray and magnetic resonance research methods. The obtained results of clinical and instrumental research methods indicate that the use of both surgical techniques showed statistically significant positive results. At the same time, the use of stitching techniques in the restoration of the injured knee joint revealed the best results relative to the resection type of surgery: good progress was 75.8-100.0% (p<0.05), and unsatisfactory – 24.4-15.1% (p<0.05). In patients with an alternative (resection) method, the data were 60.7-72.8 and 40.0-27.7% (p<0.05), respectively. Comparative analysis showed that the therapeutic effectiveness of the stitching technique is better than resection: good progress was higher by 19.6% (p<0.05), and unsatisfactory less – by 17.9% (p<0.05). The above indicates that arthroscopic stitching demonstrates high reliability of use in the rupture of the meniscus of the knee joint.

PMID:35417857

EBioMedicine. 2022 Apr 9;79:103994. doi: 10.1016/j.ebiom.2022.103994. Online ahead of print.

ABSTRACT

BACKGROUND: The effect of long-term exposure to air pollution on the development of chronic obstructive pulmonary disease (COPD) is still controversial, and the role of the interactions of air pollution with genetic risk and lifestyle in COPD risk is unclear.

METHODS: We included 452762 participants derived from the UK Biobank. Annual concentrations of air pollutions, including particle matter (PM_2.5, PM₁₀), nitrogen oxides (NO_x), and nitrogen dioxide (NO₂), were assessed using land-use regression model. We applied Cox proportional hazard model to evaluate the associations between air pollution and COPD risk. In addition, we constructed a polygenic risk score and a lifestyle score, and assessed whether genetic susceptibility and lifestyle modified the effect of air pollution on the COPD risk.

FINDINGS: Each interquartile range (IQR) increase in annual concentrations of PM_2.5, PM₁₀, NO_x, and NO₂ was associated with 1.17 (95% CI: 1.15,1.19), 1.05 (95% CI: 1.03,1.06), 1.13 (95% CI: 1.11,1.14), and 1.19 (95% CI: 1.16,1.21) times the risk of COPD, respectively. We observed an additive interaction between PM_2.5 and genetic risk (P-_interact=0.095), and a negative interaction between PM_2.5 and lifestyle (P-_interact=0.062). The HRs for each IQR increase in PM_2.5 were 1.21, (95% CI: 1.16-1.25) and 1.24, (95% CI: 1.21-1.26) in individuals with healthy and unfavourable lifestyle, respectively; and 1.16, (95% CI: 1.13-1.19) and 1.19, (95% CI: 1.16-1.22) in those with low genetic risk and high genetic risk, respectively. Participants with high air pollution exposure, high genetic risk and unfavourable lifestyle showed the highest risk of COPD.

INTERPRETATION: Long-term exposure to air pollution was associated with increased risk of COPD, especially in those with high genetic risk and unfavourable lifestyle.

FUNDING: None.

PMID:35417845 | DOI:10.1016/j.ebiom.2022.103994

J Environ Manage. 2022 Apr 10;314:115032. doi: 10.1016/j.jenvman.2022.115032. Online ahead of print.

ABSTRACT

The Sonora River and its tributary streams (Tinajas, Bacanuchi) were impacted in 2014 by an acid solution spill (approximately 40,000 m³). This study aims to presents a clear and supported overview to determining the spill’s consequences on the environment and the people inhabiting the area. The elements quantified were those found in the spilled solution: Al, As, Cu, Fe, Mn, Pb, and Zn. Potential Toxic Element (PTE) concentration means from 187 sediment samples were, in mg.kg^-1: Al = 7,307, As = 16.6, Ba = 128 Cu = 106 Fe = 15,764, Mn = 566, Pb = 46 and Zn = 99. Differences between PTE concentrations in the most impacted sediments and those of the local baseline, sampled in streams not affected by the spill and regional baseline values, were not statistically significant. The similarity of PTE concentrations among sediments may be explained by natural geological enrichment, historical mining impacts, and a low increase of PTE in sediments after the acid spill because of natural and anthropogenic attenuation. Mainly heavy rains, natural pedogenic carbonates, and remedial work done by the mining company (retaining dam, adding lime; precipitation, collecting formed solids, and transport to the mine). The Contamination Factor (C.F.), Enrichment Factor (E.F.), and Geo-accumulation Index (Igeo) were determined. The C.F. indicated low and moderate contamination in all elements. Cu exhibited the highest E.F., from moderate to significant enrichment. The Igeo generally ranged from -0.02 to 0.15. Cu and Zn were classified as moderately to heavily contaminated. In local baseline sediments, the Cu C.F. varied from moderate to very high contamination, the Cu E.F. from moderate to significant enrichment, while the As, and Pb Igeo ranged from uncontaminated to moderately contaminated. In general, normalization demonstrated a high degree of Cu enrichment at sites 1-14. Sequential extractions indicated that only Cu was found in all fractions, including a significant exchangeable fraction in the very impacted sediments (1-14). The other PTEs were distributed between the Fe/Mn oxide fraction and the residual phase. Principal Components Analysis for PTE concentrations indicated three different groups with similar geochemical patterns and allowing to identify the PTE potentially sources: the first sediments from sites 1-14 were the impacted sediments in accordance with pH and electrical conductivity results, the second group from sites 15-20 showed characteristics of the mineralized environment, and the third from sites 21-30 were unrelated to the spillage. The area impacted by the acid solution spill reached approximately 30 km downstream, just roughly 15% of the initially considered area.

PMID:35417836 | DOI:10.1016/j.jenvman.2022.115032

Seizure. 2022 Apr 4;98:37-43. doi: 10.1016/j.seizure.2022.03.023. Online ahead of print.

ABSTRACT

INTRODUCTION: Initiation of ketogenic diet therapies (KDT) for pediatric epilepsy is usually done on an inpatient basis and the diet is managed during clinical appointments following a protocol of visits and routine tests. Because of the 2019 coronavirus disease (COVID-19) pandemic and the associated lock-down measures, we switched from outpatient to telemedicine-based KDT initiation.

OBJECTIVE: To explore the feasibility, effectiveness, and safety of online KDT initiation and follow-up by comparing a group of children with drug-resistant epilepsy that was managed by telemedicine compared to a group that was treated on an outpatient basis.

MATERIALS AND METHODS: An observational study was conducted in two groups of patients with drug-resistant epilepsy who initiated KDT and were followed up with an online versus an outpatient modality by the interdisciplinary KDT team of Hospital Pediatria JP Garrahan in Buenos Aires, Argentina. Dietary compliance, ketosis, retention rate, adverse effects, number of contacts, and clinical outcome were evaluated at 1, 3, and 6 months on the diet.

RESULTS: Overall, 37 patients were included, of whom 18 started the KD by telemedicine and 19 on an outpatient basis. Minimum follow-up of the patients was 6 months. All patients received the classic ketogenic diet. No statistical differences between the two groups regarding efficacy and safety of the diet were found.

CONCLUSIONS: Our results support the feasibility and safety of initiating and management of KDT by telemedicine. Patients and their families should be carefully selected in order to guarantee a good outcome.

PMID:35417828 | DOI:10.1016/j.seizure.2022.03.023