Nevin Manimala

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2022 May 3:1-10. doi: 10.1080/10934529.2022.2069977. Online ahead of print.

ABSTRACT

The objective of this study was to assess annual, seasonal and spatial trends in copper sediment concentrations in an agricultural California stream (Cache Slough) based on sampling 12 sites over two seasons (spring and fall) in 2012, 2013 and 2014. The relationship between copper sediment concentrations and precipitation was also evaluated. The results from this study showed that copper sediment concentrations from Cache Slough ranging from 19 to 63 ug/g dw were similar to concentrations reported in European agricultural streams. Copper sediment concentrations were not reported to increase over time in this agricultural waterbody where copper was used as a fungicide. However, spatial differences in copper sediment concentrations were reported among sites with the highest concentrations in the middle waterbody section. Seasonal analysis showed no significant difference in copper sediment concentrations for both spring and fall for 2012 and 2013 but 2014 spring concentrations were statistically higher than fall concentrations when precipitation was lower than the two previous years. There were no statistically significant relationships between copper sediment concentrations and precipitation for the three-year period based on an analysis by year and season.

PMID:35502608 | DOI:10.1080/10934529.2022.2069977

Gut Liver. 2022 May 3. doi: 10.5009/gnl210009. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Contradictory findings on the association between cholecystectomy and cancer have been reported. We aimed to investigate the risk of all types of cancers or site-specific cancers in patients who underwent cholecystectomy using a nationwide dataset.

METHODS: Subjects who underwent cholecystectomy from January 1, 2007, to December 31, 2014, who were older than 20 years and who underwent an initial baseline health check-up within 2 years were enrolled. Those who were diagnosed with any type of cancer before the enrollment or within 1 year after enrollment were excluded. Ultimately, patients (n=123,295) who underwent cholecystectomy and age/sex matched population (n=123,295) were identified from the database of the Korean National Health Insurance Service. The hazard ratio (HR) and 95% confidence interval (CI) for cancer were estimated, and Cox regression analysis was performed.

RESULTS: The incidence of cancer in the cholecystectomy group was 9.56 per 1,000 personyears and that in the control group was 7.95 per 1,000 person-years. Patients who underwent cholecystectomy showed an increased risk of total cancer (adjusted HR, 1.19; 95% CI, 1.15 to 1.24; p<0.001), particularly leukemia and malignancies of the colon, liver, pancreas, biliary tract, thyroid, pharynx, and oral cavity. In the subgroup analysis according to sex, the risk of developing cancers in the pancreas, biliary tract, thyroid, lungs and stomach was higher in men than in women.

CONCLUSIONS: Physicians should pay more attention to the possibility of the occurrence of secondary cancers among patients who undergo cholecystectomy.

PMID:35502586 | DOI:10.5009/gnl210009

Dermatol Ther. 2022 May 3:e15549. doi: 10.1111/dth.15549. Online ahead of print.

ABSTRACT

The use of antioxidants in atopic dermatitis (AD) is controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of antioxidants therapy in AD. Randomised clinical trials were identified from Medline, Embase and Cochrane library. Changes from baseline in severity and itch score were extracted from individual studies and pooled using random-effects. Eighteen trials including 763 AD patients were eligible. Overall, antioxidants were associated with statistically significant reductions in diseases severity (p < 0.0001), but not with itch score (p = 0.59). No serious adverse events were recorded. Subgroup analyses revealed that antioxidants were associated with a significant reduction in severity score regardless of disease severity at baseline and treatment duration (p < 0.05). However, antioxidants had additional benefit only in children (p = 0.02) but not in adults (p = 0.30). Oral supplementation with vitamin D, combined vitamins D and E, combined vitamins A, D and E and topical vitamin B₁₂ was associated with significantly lower severity score (p < 0.05). There was significant heterogeneity between studies (I² = 50%; p = 0.003). The effect estimates did not change statistically after excluding sources of study heterogeneity. This meta-analysis suggests that antioxidants may be a safe and effective treatment for AD patients, especially when supplemented with oral vitamin D and topical vitamin B₁₂ , as well as in pediatric patients. This article is protected by copyright. All rights reserved.

PMID:35502578 | DOI:10.1111/dth.15549

Curr Med Res Opin. 2022 May 3:1-14. doi: 10.1080/03007995.2022.2070379. Online ahead of print.

ABSTRACT

OBJECTIVE: Rivaroxaban is commonly prescribed to prevent venous thromboembolism (VTE). Although lower than standard dosages (under-dosing) may be administered in the real-world setting, data on subsequent clinical outcomes in Japanese patients are lacking.

METHODS: The prospective, multicenter, observational J’xactly study enrolled patients with acute symptomatic/asymptomatic deep vein thromboses (DVT), pulmonary embolism (PE), or both, who were prescribed rivaroxaban. This subanalysis investigated patient characteristics and outcomes associated with rivaroxaban under-dosing.

RESULTS: Among 1,016 evaluable patients, 667 (65.6%) received an initial standard dosage of rivaroxaban (30 mg/day) and 349 (34.4%) received an initial under-dosage (20 mg/day, n = 22; 15 mg/day, n = 282; and 10 mg/day, n = 45). Those receiving an under-dose had significantly lower body weight and slower pulse rate compared with the standard-dose group regardless of DVT or PE status. Under-dosing was common for distal DVTs, but less frequent for massive/submassive PEs. There were no differences between under-dose and standard-dose groups in the incidences of recurring symptomatic VTEs (DVT: 1.77% vs. 3.35% per patient-year, p = 0.138; PE: 0.84% vs. 2.84% per patient-year, p = 0.208) or major bleeding (DVT: 3.55% vs. 3.41% per patient-year, p = 0.960; PE: not observed vs. 2.83% per patient-year, p = 0.132).

CONCLUSIONS: In the real-world setting, rivaroxaban under-dosing for patients with VTE occurred in those with lower body weight, slower pulse rate, distal DVT, or non-massive PEs. There were no statistically significant differences in the clinical outcomes for patients received under-dose of rivaroxaban at the discretion of the physicians in the clinical practice compared with those received standard dose of rivaroxaban.

PMID:35502571 | DOI:10.1080/03007995.2022.2070379

Public Health Nurs. 2022 May 3. doi: 10.1111/phn.13086. Online ahead of print.

ABSTRACT

BACKGROUND: Immigrants comprise over 40% of the low-wage workforce. They are more likely to be employed in service industries, paid less, and experience more illness and injuries than their native counterparts.

DESIGN/OBJECTIVE: The aim of this cross-sectional pilot study was to explore the relationship between immigrant workers’ stressors and health.

SAMPLE: Twenty-five female Mexican immigrant hotel workers.

MEASUREMENTS: Surveys and blood samples were analyzed and compared to national data. Descriptive statistics and linear regression were used for analysis.

RESULTS: Longer length of stay, older age at migration, and higher Demands of Immigration (DI) were significantly associated with more chronic conditions. Higher DI were significantly associated with more depressive symptoms. This is comparable to national data (n = 468) which shows a significant relationship between length of stay, Allostatic Load (AL), and chronic conditions (β = 0.14, p = .043; β = 0.13, p = .025).

CONCLUSIONS: Immigrant-specific factors affect individuals’ health. More studies are needed to further explore the relationship between DI and health among foreign-born workers.

PMID:35502562 | DOI:10.1111/phn.13086

J Sex Marital Ther. 2022 May 3:1-9. doi: 10.1080/0092623X.2022.2067090. Online ahead of print.

ABSTRACT

The aim of this study is to determine the relationship between different sex positions and female sexual dysfunction. This comparative and descriptive study was conducted at a hospital in a province in Eastern Turkey between March 2019 – June 2019. The data were collected using the “Personal Data Form” and “Female Sexual Function Index/FSFI” via the closed envelope technique to protect the participants’ privacy. The study was conducted with 184 women. Number, mean, percentage distribution, and ANOVA tests were used to evaluate the data. The total mean score of the FSFI was determined to be 18.03 ± 4.17. When examining the mean scores of the sexual function index in terms of sex position, a statistically significant difference was found between both the FSFI total score and its subscales and all positions (p = 0.00). It was observed that based on the scores of the FSFI, the women had a form of sexual dysfunction and had higher mean scores in Desire, Arousal, Lubrication, Orgasm, and Satisfaction in the overall scale of female-on-top positions, and their mean scores for pain subscale were lower.

PMID:35502555 | DOI:10.1080/0092623X.2022.2067090

Brain Behav. 2022 May 2:e32546. doi: 10.1002/brb3.2546. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the association between disease duration and the severity of bilateral vestibulopathy in individuals with complete or incomplete CANVAS (Cerebellar Ataxia with Neuropathy and Vestibular Areflexia Syndrome) and biallelic RFC1 repeat expansions.

METHODS: Retrospective analysis of clinical data and the vestibulo-ocular reflex quantified by the video head impulse test in 20 patients with confirmed biallelic RFC1 repeat expansions.

RESULTS: Vestibulo-ocular reflex gain at first admittance 6.9 ± 5.0 years after disease onset was 0.16 [0.15-0.31] (median [interquartile range]). Cross-sectional analysis revealed that gain reduction was associated with disease duration. Follow-up measurements were available for ten individuals: eight of them exhibited a progressive decrease of the vestibulo-ocular reflex gain over time. At the first visit, six of all patients (30%) did not show clinical signs of cerebellar ataxia.

CONCLUSIONS: Our data suggest a pathological horizontal head impulse test, which can easily be obtained in many outpatient clinics, as a sign of bilateral vestibulopathy in genetically confirmed CANVAS that can precede clinically accessible cerebellar ataxia at least in a subset of patients. The presumably continuous decline over time possibly reflects the neurodegenerative character of the disease. Thus, genetic testing for RFC1 mutations in (isolated) bilateral vestibulopathy might allow disease detection before the onset of cerebellar signs. Further studies including a wider spectrum of vestibular function tests are warranted in a prospective design.

PMID:35502508 | DOI:10.1002/brb3.2546

Ann Pharmacother. 2022 May 2:10600280221091301. doi: 10.1177/10600280221091301. Online ahead of print.

ABSTRACT

OBJECTIVE: To review the pharmacology, efficacy, and safety of ibrexafungerp in the management of vulvovaginal candidiasis (VVC).

DATA SOURCES: Literature was sought using PubMed (1966-February 2022) and EMBASE (1973-February 2022), and clinicaltrials.gov. Search terms included ibrexafungerp, SCY-078, and VVC.

STUDY SELECTION AND DATA EXTRACTION: All studies including humans and published in English with data assessing the efficacy and safety of ibrexafungerp for the treatment of VVC were evaluated.

DATA SYNTHESIS: A phase 2 dose-finding study found ibrexafungerp had similar efficacy to fluconazole in the clinical cure of VVC (51.9% vs 58.3%, respectively). Two phase 3 clinical trials demonstrated ibrexafungerp had statistical superiority over placebo for clinical cure in moderate to severe VVC (P < 0.001 and P = 0.023, respectively). The most frequently reported adverse reactions in the clinical trials were gastrointestinal-related symptoms. To date, data comparing efficacy of ibrexafungerp and topical imidazoles in the treatment of VVC are nonexistent.

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Topical imidazoles and oral fluconazole are effective for the treatment of uncomplicated VVC. Due to increased resistance, limited fluconazole coverage for non-Candida albicans species, and potential for significant drug interactions associated with fluconazole use, alternative treatments for VVC are needed. Ibrexafungerp is a new oral triterpenoid antifungal agent indicated for the treatment of VVC. Additional clinical trials are needed to evaluate long-term safety data as well as efficacy and safety in specialty populations.

CONCLUSION: Ibrexafungerp, a recently approved triterpenoid antifungal agent, is an effective and well-tolerated option for the treatment of VVC.

PMID:35502451 | DOI:10.1177/10600280221091301

Risk Manag Healthc Policy. 2022 Apr 26;15:817-826. doi: 10.2147/RMHP.S346856. eCollection 2022.

ABSTRACT

PURPOSE: Using machine learning method to predict and judge unknown data offers opportunity to improve accuracy by exploring complex interactions between risk factors. Therefore, we evaluate the performance of machine learning (ML) algorithms and to compare them with logistic regression for predicting the risk of renal function decline (RFD) using routine clinical data.

PATIENTS AND METHODS: This retrospective cohort study includes datasets from 2166 subjects, aged 35-74 years old, provided by an adult health screening follow-up program between 2010 and 2020. Seven different ML models were considered – random forest, gradient boosting, multilayer perceptron, support vector machine, K-nearest neighbors, adaptive boosting, and decision tree – and were compared with standard logistic regression. There were 24 independent variables, and the baseline estimate glomerular filtration rate (eGFR) was used as the predictive variable.

RESULTS: A total of 2166 participants (mean age 49.2±11.2 years old, 63.3% males) were enrolled and randomly divided into a training set (n=1732) and a test set (n=434). The area under receiver operating characteristic curve (AUROC) for detecting RFD corresponding to the different models were above 0.85 during the training phase. The gradient boosting algorithms exhibited the best average prediction accuracy (AUROC: 0.914) among all algorithms validated in this study. Based on AUROC, the ML algorithms improved the RFD prediction performance, compared to logistic regression model (AUROC:0.882), except the K-nearest neighbors and decision tree algorithms (AUROC:0.854 and 0.824, respectively). However, the improvement differences with logistic regression were small (less than 4%) and nonsignificant.

CONCLUSION: Our results indicate that the proposed health screening dataset-based RFD prediction model using ML algorithms is readily applicable, produces validated results. But logistic regression yields as good performance as ML models to predict the risk of RFD with simple clinical predictors.

PMID:35502445 | PMC:PMC9056070 | DOI:10.2147/RMHP.S346856

Pharm Pract (Granada). 2022 Jan-Mar;20(1):2585. doi: 10.18549/PharmPract.2022.1.2585. Epub 2022 Jan 10.

ABSTRACT

OBJECTIVES: To assess pharmacists from Syria and Iraq on their knowledge, readiness, and perspectives on their roles during the COVID-19 pandemic. In addition to investigate pharmacists’ perceived barriers towards delivering their emergency roles during the COVID-19 pandemic and perceived policymakers’ responsibilities.

METHODS: This cross-sectional study design was conducted in Iraq and Syria during COVID-19 outbreak over one month (April 2020). The study objectives were addressed through a validated online questionnaire. Data was analyzed using statistical package for social science (SPSS).

RESULTS: A total of 916 individuals participated in this study (447 from Iraq and 439 from Syria). Most of Iraqi participants were students while most of Syrian participants were graduates and technicians. The mean age for the Iraqi participants was 22.5 (SD= 4.1) while the mean age for the Syrian participants was 28.7 (SD= 9.1). A significant difference (p< 0.001) was found in following the latest coronavirus updates on management among pharmacy graduates and technicians and undergraduate students. Media was reported as the most used source for knowledge about epidemics/pandemics among the Iraqi and the Syrian participants. Around 72% strongly agreed/agreed that the faculties of pharmacy have a role in preparing them to deal with epidemics/pandemics. In addition, 64.3% strongly agreed/agreed that pharmacist associations and societies have a role in preparing them to deal with epidemics/pandemics such as the coronavirus. Moreover, 82.9% believed that pharmacists should receive training programs on how to provide mental health support for people during epidemic and pandemic outbreaks.

CONCLUSION: Tertiary pharmacy education providers and pharmacy professional bodies have a strong role in preparing pharmacists to deal with pandemics. Therefore, the importance of providing beforehand training programs on epidemics/pandemics management, workshops, lectures, and online information resources for such circumstances is crucial for pharmacists.

PMID:35502433 | PMC:PMC9014893 | DOI:10.18549/PharmPract.2022.1.2585