Nevin Manimala

J Med Virol. 2022 Apr 13. doi: 10.1002/jmv.27778. Online ahead of print.

ABSTRACT

BACKGROUND: The exposure of healthcare workers (HCWs) to SARS-CoV-2 has been a major concern since the beginning of the COVID-19 pandemic. The study aimed to investigate the relationship between vaccination status and the status of catching COVID-19 in HCWs working in a Training and Research Hospital in Turkey, and the clinical course of the disease in those who were caught.

METHODS: In the current study, the vaccination status of 1279 HCWs working at Siirt Training and Research Hospital during the period when the SARS CoV-2 Delta variant was dominant, their cases of catching COVID-19 during this period, and the clinical course of the disease in patients with COVID-19 were investigated retrospectively.

RESULTS: We found that the rate of COVID-19 transmission was lowest in fully vaccinated HCWs (p<0.05). The rate of COVID-19 transmission in HCWs who received 2 doses of BioNTech vaccine (4.4%) and 2 doses of CoronaVac+1 dose of BioNTech vaccines (2.7%) was considerably lower than those without vaccination (26.2%) (p<0.05). The transmission rate was lowest among those vaccinated with 2 doses of CoronaVac+1 dose of BioNTech. Hospitalization was not required in fully vaccinated HCWs. The lymphocyte count was found to be significantly higher in fully vaccinated patients than incompletely vaccinated and unvaccinated patients. Although CRP, d-dimer, ferritin values were higher in unvaccinated and partially vaccinated patients than in fully vaccinated patients, the differences were not statistically significant.

CONCLUSION: As a result, the transmission rate of COVID-19 was lowest in fully vaccinated HCWs and in those vaccinated with 2 doses of CoronaVac+1 dose of BioNTech. In fully vaccinated HCWs, hospitalization was not needed. This article is protected by copyright. All rights reserved.

PMID:35419851 | DOI:10.1002/jmv.27778

Clin Cardiol. 2022 Apr 14. doi: 10.1002/clc.23831. Online ahead of print.

ABSTRACT

BACKGROUND: Among subjects with exercise intolerance and suspected early-stage pulmonary hypertension (PH), early identification of pulmonary vascular disease (PVD) with noninvasive methods is essential for prompt PH management.

HYPOTHESIS: Rest gas exchange parameters (minute ventilation to carbon dioxide production ratio: V_E /VCO₂ and end-tidal carbon dioxide: ETCO₂ ) can identify PVD in early-stage PH.

METHODS: We conducted a retrospective review of 55 subjects with early-stage PH (per echocardiogram), undergoing invasive exercise hemodynamics with cardiopulmonary exercise test to distinguish exercise intolerance mechanisms. Based on the rest and exercise hemodynamics, three distinct phenotypes were defined: (1) PVD, (2) pulmonary venous hypertension, and (3) noncardiac dyspnea (no rest or exercise PH). For all tests, *p < .05 was considered statistically significant.

RESULTS: The mean age was 63.3 ± 13.4 years (53% female). In the overall cohort, higher rest V_E /VCO₂ and lower rest ETCO₂ (mm Hg) correlated with high rest and exercise pulmonary vascular resistance (PVR) (r ~ 0.5-0.6*). On receiver-operating characteristic analysis to predict PVD (vs. non-PVD) subjects with noninvasive metrics, area under the curve for pulmonary artery systolic pressure (echocardiogram) = 0.53, rest V_E /VCO₂ = 0.70* and ETCO₂ = 0.73*. Based on this, optimal thresholds of rest V_E /VCO₂ > 40 mm Hg and rest ETCO₂ < 30 mm Hg were applied to the overall cohort. Subjects with both abnormal gas exchange parameters (n = 12, vs. both normal parameters, n = 19) had an exercise PVR 5.2 ± 2.6* (vs. 1.9 ± 1.2), mPAP/CO slope with exercise 10.2 ± 6.0* (vs. 2.9 ± 2.0), and none included subjects from the noncardiac dyspnea group.

CONCLUSIONS: In a broad cohort of subjects with suspected early-stage PH, referred for invasive exercise testing to distinguish mechanisms of exercise intolerance, rest gas exchange parameters (V_E /VCO₂ > 40 mm Hg and ETCO₂ < 30 mm Hg) identify PVD.

PMID:35419844 | DOI:10.1002/clc.23831

Scand J Med Sci Sports. 2022 Apr 14. doi: 10.1111/sms.14166. Online ahead of print.

ABSTRACT

Nine months after anterior cruciate ligament (ACL) reconstruction, athletes who undergo surgery using a bone-patellar-tendon-bone (BPTB) autograft demonstrate higher loading asymmetries during vertical jumping than those with a hamstring tendon (HT) autograft. These asymmetries may transfer into sporting movements with a greater ACL injury risk. The aim of this study was to compare between-limb asymmetries in knee mechanics and task performance during an unplanned 90° change-of-direction (CoD) task in male field sport athletes reconstructed with BPTB or HT autografts. Seventy-eight male multidirectional field sport athletes with either a BPTB (n=39) or HT (n=39) autograft completed maximal unplanned CoD trials in a three-dimensional motion capture laboratory at approximately nine months post-surgery. A mixed model 2×2 ANOVA (autograft type x limb) was used to compare variables related to ACL injury risk (e.g. internal knee moments) and performance (e.g. completion time) between autografts and limbs. Statistical parametric mapping was used for a waveform comparison throughout stance, supplemented with a discrete point analyses of peak knee moments and performance variables. Interaction effects were found at the knee joint, with BPTB demonstrating greater asymmetries than HT in knee extension moment (p<0.001); resultant ground reaction force (p<0.001); peak knee external rotation moment (p=0.04); and knee adduction (p=0.05), medial rotation (p<0.001) and flexion (p<0.001) angles. No differences were found between autografts for any performance variable. BPTB demonstrated greater lower-limb biomechanical asymmetries than HT during CoD, which may influence knee loading and longer-term outcomes and should thus be targeted during rehabilitation prior to return to play.

PMID:35419809 | DOI:10.1111/sms.14166

Ginekol Pol. 2022 Apr 14. doi: 10.5603/GP.a2021.0243. Online ahead of print.

ABSTRACT

OBJECTIVES: To reveal the effect of surgeon’s experience on the outcomes of the total laparoscopic hysterectomy (TLH) surgery.

MATERIAL AND METHODS: Design: Retrospective case series.

SETTING: A tertiary care university hospital.

PATIENTS: 1295 cases with an indication for hysterectomy.

INTERVENTIONS: Total laparoscopic hysterectomy.

RESULTS: All cases were grouped according to the surgeon’s experience. For 30 different surgeons, their first 20 operations constituted Group A, 21st-50th operations Group B, 51st-100th operations Group C, and their operations after the 100th surgery Group D. Demographic data and post-operative results were compared between the groups. There were no statistical differences in terms of demographic data and major complications. A statistically significant decrease was observed in the post-operative fall in hemoglobin level and the duration of hospitalization in the groups with increased experience (p = 0.021, p < 0.001, respectively). There wasn’t an increase in uterine specimen weight with increased experience (p = 0.267).

CONCLUSIONS: We obtained that the peak value in the learning curve cannot be evaluated according to the operation time or complication rates. Although the complication rate seems unaffected by surgical experience, concerns about complications may decrease as experience increases. Since the trend of minimally invasive surgery will continue increasingly in the next century because of higher patient comfort, all gynecologists should gain competence in endoscopic surgery.

PMID:35419792 | DOI:10.5603/GP.a2021.0243

Ginekol Pol. 2022 Apr 14. doi: 10.5603/GP.a2021.0102. Online ahead of print.

ABSTRACT

OBJECTIVES: It is believed that there are still unclear areas in the formation mechanism of leiomyomas. In our study, it was aimed to investigate the formation mechanisms of leiomyomas due to local MED 12 gene exon 2 mutation and local microRNA-124 expression in a Turkish population.

MATERIAL AND METHODS: Thirty patients who underwent hysterectomy for leiomyoma uteri at Gaziantep University between January 2013 and January 2016 were included in our study. In the pathology specimens of these patients, the patient’s myometrium tissue and her own leiomyoma tissue were analysed via quantitative Realtime PCR in association with MED 12 exon 2 mutation and microRNA-124 expression.

RESULTS: The average age of the 30 patients included in our study is 46.67 ± 5.42 and 13 patients had single leiomyoma; 17 patients had more than one leiomyoma. There were significantly higher c.130G> T (p.G44C) mutation and c.131G> A (p.G44A) mutation of MED 12 gene exon in leiomyoma tissues than healthy myometrium tissues of same patients. There was a 3.7-fold decrease in the expression of microRNA-124 in leiomyoma tissues compared to intact eutopic myometrium tissues, but this difference was not statistically significant.

CONCLUSIONS: In recent studies, it has been suggested that MED 12 gene may play an active role in the formation of fibroids. MED12 and β-catenin / Wnt pathway were emphasized, and alternative genetic pathways are sought in fibroid formation. Also, tumour suppressor and oncogenesis effects of microRNAs have been demonstrated in many different studies. Since it is involved in the Wnt pathway, microRNA-124 has been blamed by some previous studies for the formation of fibroids. This study demonstrates that MED12 exon 2 mutations and probably microRNA-124 gene expressions might contribute to uterine leiomyoma pathology.

PMID:35419790 | DOI:10.5603/GP.a2021.0102

Handchir Mikrochir Plast Chir. 2022 Apr;54(2):149-154. doi: 10.1055/a-1794-5668. Epub 2022 Apr 13.

ABSTRACT

BACKGROUND: The biological mechanism of Dupuytren’s contracture needs to be further studied in order to minimize postoperative recurrence and provide a pathological basis for the development of new therapeutic targets.

METHODS: HE staining, immunohistochemistry, PCR and western blotting were performed in pathological palmar aponeurosis specimens and normal palmar aponeurosis tissues for comparative study.

RESULTS: (1) TNF-α expression was up-regulated: TNF-α mRNA was more highly expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (2) Dkk-1 expression was down-regulated: Dkk-1 mRNA was lower expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (3) TGF-β1 expression was up-regulated: TGF-β1 mRNA was higher expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (4) Pearson correlation analysis suggested that TNF-α expression was positively correlated with TGF-β1 expression, TNF-α expression was negatively correlated with DKK-1 expression, and TGF-β1 expression was negatively correlated with DKK-1 expression.

CONCLUSION: TNF-α, DKK-1 and TGF-β1 may play a role in the pathogenesis of palmar aponeurosis contracture, and there is a relationship between them. The study of the relationship between the three and their related signaling pathways provides a therapeutic target and a basis for the prevention and early treatment of palmar aponeurotic contracture.

PMID:35419784 | DOI:10.1055/a-1794-5668

Handchir Mikrochir Plast Chir. 2022 Apr;54(2):106-111. doi: 10.1055/a-1720-1681. Epub 2022 Apr 13.

ABSTRACT

INTRODUCTION: The improvement of health-related quality of life (HRQoL) via post-bariatric tightening operations and their effects on long term weight stability is considered to be ensured. This study investigates the relevancy of influencing factors.

PATIENTS, MATERIAL AND METHODS: For the data analysis, the HRQoL was ascertained before and after the abdominoplasty using the 36-Item Short-Form Health Survey questionnaire. In addition, the occurrence frequency of bloating-symptoms was recorded. It was checked whether this occurrence was related to a rectus plication simultaneously performed with the abdominoplasty. Inclusion criterion was obesity ≥ I° prior to the weight loss. Exclusion criteria were a postoperative, newly manifested and serious disease, as well as a pregnancy during the observation period. The results were compared to the German population (standard).

RESULTS: The postoperative HRQoL was significantly improved as far as the physical healthscale (KSK) is concerned (preOP: 40,19 ± 12,27; postOP: 47,72 ± 9,89; p < 0,001). Preoperatively, the KSK and the PSK (psychological health scale) were statistically significant below the value of the normal population (KSK: p < 0,001; PSK: p < 0,01). There were no significant differences postoperatively (KSK: p = 0,051; PSK: p = 0,118). Patients on which an additional rectus plication was performed (n = 9) suffered significantly more often from bloating-symptoms than patients without this surgical step (n = 21) (p < 0,05). Patients with bloating-symptoms < 4/W (vs > 4/W) had a significantly better vitality (< 4/W: 61,09 ± 24,95; > 4/W: 34,29 ± 21,49; p < 0,05) and a better general health (< 4/W: 68,04 ± 23,23; > 4/W: 44,71 ± 27,8; p < 0,05). Compared to the standard, patients with bloating-symptoms > 4/W had a poorer vitality (p < 0,05).

CONCLUSION: Based on the analysis, a postoperative improvement of the HRQoL in the formerly obese can be assumed. It can also be predicated that there is a postoperative adjustment of the HRQoL compared to that of the German population. Furthermore, a rectus plication that is performed in addition to the abdominoplasty more frequently leads to bloating-symptoms, which, in turn, worsen the HRQoL. The diagnosis of a depressive disorder is a good predictor for a worse HRQoL outcome.

PMID:35419780 | DOI:10.1055/a-1720-1681

Horm Metab Res. 2022 Apr 13. doi: 10.1055/a-1825-0316. Online ahead of print.

ABSTRACT

Polycystic ovary syndrome (PCOS) is an endocrine disorder that frequently affects women of reproductive age. In PCOS, the incidence of thyroid diseases has increased in addition to reproductive and metabolic problems. To compare thyroid nodule, volume, autoimmunity, and thyroid function tests of euthyroid PCOS and its phenotypes. The files of 178 patients with PCOS aged 18-45 years and 92 patients with no disease who were matched for body mass index were retrospectively scanned. Women with PCOS were divided into four phenotypes, ABCD, according to the Rotterdam guideline, as determined using thyroid ultrasonography (USG) of all participants, and PCOS phenotypes, as well as thyroid-stimulating hormone (TSH), fT4, fT3 thyroid peroxidase (anti-TPO), and thyroglobulin (anti-Tg) thyroid volume, nodule number, and nodule diameter were noted. Anti-TPO titer and prevalence, fT3, and thyroid volume were higher in the PCOS group compared with the control group (p=0.004, p=0.023, p=0.001, and p=0.001, respectively) in terms of anti-Tg levels, presence of nodules, and the number of nodules. There was no statistical difference between the PCOS group and the healthy controls. The number of nodules of 1 cm and above was found to be higher only in patients with PCOS compared with the control group (p=0.018). When the phenotypes were examined, thyroid dysfunction features were found in phenotype A, which was the most prominent. Thyroid autoimmunity, thyroid volume, and the number of nodules larger than 1 cm increased in patients with PCOS compared with controls. This situation is thought to be caused by the reproductive and metabolic properties of PCOS because thyroid dysfunction was detected more in phenotype A, which is called the full phenotype. Therefore, all patients with PCOS, especially phenotype A, should be evaluated for the presence of nodules with autoimmunity using USG, even if there are no symptoms, and thyroid functions.

PMID:35419775 | DOI:10.1055/a-1825-0316

J Gen Intern Med. 2022 Apr 13. doi: 10.1007/s11606-022-07494-5. Online ahead of print.

ABSTRACT

BACKGROUND: As health profession schools implement addiction curricula, they need survey instruments to evaluate the impact of the educational interventions. However, existing measures do not use current non-stigmatizing language and fail to capture core concepts.

OBJECTIVE: To develop a brief measure of health profession student readiness to work with people who use drugs (PWUDs) and establish its content validity.

METHODS: We conducted a literature review of existing instruments and desired clinical competencies related to providing care to PWUD and used results and expert feedback to create and revise a pool of 72 items. We conducted cognitive interviews with ten pre-clinical health profession students from various US schools of nursing, pharmacy, and medicine to ensure the items were easy to understand. Finally, we used a modified Delphi process with twenty-four health professions educators and addiction experts (eight each from nursing, pharmacy, and medicine) to select items for inclusion in the final scale. We analyzed expert ratings of individual items and interdisciplinary agreement on ratings to decide how to prioritize items. We ultimately selected 12 attitudes and 12 confidence items to include in the REadiness to Discuss Use, Common Effects, and HArm Reduction Measure (REDUCE-HARM). Experts rated their overall assessment of the final scale.

RESULTS: Twenty-two of twenty-four experts agreed or strongly agreed that the attitudes scale measures student attitudes that impact readiness to work with PWUDs. Twenty-three of twenty-four experts agreed or strongly agreed that the confidence scale measures student self-efficacy in competencies that impact readiness to work with PWUDs. Seven of 72 initial items and none of the 24 selected items had statistically significant differences between disciplines.

CONCLUSIONS: The REDUCE-HARM instrument has strong content validity and may serve as a useful tool in evaluating addiction education. Additional research is needed to establish its reliability, construct validity, and responsiveness to change.

PMID:35419741 | DOI:10.1007/s11606-022-07494-5

Support Care Cancer. 2022 Apr 13. doi: 10.1007/s00520-022-07051-0. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine the quality of life and its related factors in the caregivers of children with cancer.

METHODS: This cross-sectional study assessed the quality of life of 270 caregivers of children with cancer in Iran. Data collection tools were a personal information form and the Caregiver Quality of Life Index-Cancer. Data were analyzed by SPSS-18 software using descriptive and inferential statistics (independent t-test, analysis of variance, and linear regression model).

RESULTS: The mean score of quality of life was 78.3 ± 1.6 out of 140. Variables that were significantly associated with quality of life included age (p = .031), gender (p = .021), education (p = .048), occupation (p = .011), economic status (p = .038), average caring time (p = .021), and age of the child (p = .011).

CONCLUSION: The caregivers of children with cancer did not have a good quality of life. Healthcare providers need to provide comprehensive educational, emotional, social, and economic support to the caregivers of patients with cancer.

PMID:35419732 | DOI:10.1007/s00520-022-07051-0