Eur J Nutr. 2024 Apr 17. doi: 10.1007/s00394-024-03374-2. Online ahead of print.
NO ABSTRACT
PMID:38630305 | DOI:10.1007/s00394-024-03374-2
Urolithiasis. 2024 Apr 17;52(1):65. doi: 10.1007/s00240-024-01570-7.
ABSTRACT
Extracorporeal shock wave lithotripsy (ESWL) is a safe and efficient treatment option for urinary stone disease. The overall stone-free rate (SFR) varies significantly. This study aimed to assess the influence of stone size, location, stone density, and skin-to-stone distance (SSD), on the outcome of ESWL. We assessed whether pre-treatment non-contrast-enhanced CT scan (NCCT) confers significant advantages compared to kidney-ureter-bladder film (KUB) only. We reviewed the medical records of 307 cases (165 men, 142 women) with renal and ureteral stones treated consecutively at our institution with ESWL between 2020 and 2023. 44 of these underwent a NCCT. The outcome of ESWL was defined in two ways: visible stone fragmentation on KUB, and the need for further treatment. Overall success of fragmentation was 85% (261 patients). 61% of patients (n = 184) didn’t need any further treatment. Stone size and location correlated significantly with treatment outcomes regarding the need for further treatment (p = 0.004) and stone fragmentation (p = 0.016), respectively. Unlike mean SSD (p = 0.462), the mean attenuation value (MAV) significantly correlated with the need for retreatment (p = 0.016). MAV seems to be a better predictor of treatment success (AUC of the ROC curve: 0.729), compared to stone size (AUC: 0.613). The difference between groups (with and without NCCT) in both treatment outcomes did not reach statistical significance. During decision-making, information regarding SSD and MAV can be useful in more dubious scenarios. However, it appears that their inclusion doesn’t provide substantial advantages when compared to relying solely on KUB.
PMID:38630281 | DOI:10.1007/s00240-024-01570-7
Eur J Appl Physiol. 2024 Apr 17. doi: 10.1007/s00421-024-05483-6. Online ahead of print.
ABSTRACT
PURPOSE: The purpose of this study was to statistically compare the rate of torque development normalized by maximal strength (relative RTD) across ankle angles. Additionally, this study was aimed at exploring the correlation coefficients between relative RTD and passive stiffness of the medial gastrocnemius (MG) at different ankle angles.
METHODS: Twenty-two healthy men and women (age: 31 ± 4 years) performed randomly-ordered explosive isometric plantar flexions at plantarflexed (15°), neutral (0°), and dorsiflexed (- 15°) angles; relative RTD comprised the slope of the time-torque curve normalized to maximal torque. The shear wave velocity (SWV; index of stiffness) of the MG at rest was measured at each angle using ultrasound shear wave elastography.
RESULTS: The relative RTD was greater at 15° than – 15° for 0-50, 0-100, and 0-150 ms time-windows and at 15° than 0° for the 0-150 ms time-window (P < 0.05), although peak torque was lower at 15° than 0° and – 15° (P < 0.05). The relative RTD for the 0-50 ms time-window correlated with SWV at – 15° (rs = 0.475, P < 0.05), but not at 15º and 0º. Furthermore, the correlation coefficient of RTD for the 0-100 ms time-window with SWV was significantly greater at – 15° (rs = 0.420) than 0 ° (rs = – 0.109).
CONCLUSIONS: A greater relative RTD occurs at plantarflexed angles (i.e., the ascending limb of the force-length curve) in the triceps surae, and relative RTD is strongly related to passive MG stiffness at dorsiflexed angles (i.e., longer muscle lengths).
PMID:38630263 | DOI:10.1007/s00421-024-05483-6
Pediatr Pulmonol. 2024 Apr 17. doi: 10.1002/ppul.27012. Online ahead of print.
ABSTRACT
BACKGROUND: Tracheobronchomalacia (TBM) is characterized by excessive dynamic airway collapse. Severe TBM can be associated with substantial morbidity. Children with secondary TBM associated with esophageal atresia/tracheoesophageal fistula (EA/TEF) and vascular-related airway compression (VRAC) demonstrate clinical improvement following airway pexy surgery. It is unclear if children with severe primary TBM, without secondary etiologies (EA/TEF, vascular ring, intrinsic pulmonary pathology, or complex cardiac disease) demonstrate clinical improvement following airway pexy surgery.
MATERIALS AND METHODS: The study cohort consisted of 73 children with severe primary TBM who underwent airway pexy surgery between 2013 and 2020 at Boston Children’s Hospital. Pre- and postoperative symptoms as well as bronchoscopic findings were compared with Fisher exact test for categorical data and Student’s t-test for continuous data.
RESULTS: Statistically significant improvements in clinical symptoms were observed, including cough, noisy breathing, prolonged respiratory infections, pneumonias, exercise intolerance, cyanotic spells, brief resolved unexplained events (BRUE), and noninvasive positive pressure ventilation (NIPPV) dependence. No significant differences were seen regarding oxygen dependence, ventilator dependence, or respiratory distress requiring NIPPV. Comparison of pre- and postoperative dynamic bronchoscopy findings revealed statistically significant improvement in the percent of airway collapse in all anatomic locations except at the level of the upper trachea (usually not malacic). Despite some initial improvements, 21 (29%) patients remained symptomatic and underwent additional airway pexies with improvement in symptoms.
CONCLUSION: Airway pexy surgery resulted in significant improvement in clinical symptoms and bronchoscopic findings for children with severe primary TBM; however, future prospective and long-term studies are needed to confirm this benefit.
PMID:38629381 | DOI:10.1002/ppul.27012
Curr Pediatr Rev. 2024 Apr 15. doi: 10.2174/0115733963279420240402083916. Online ahead of print.
ABSTRACT
BACKGROUND: Bronchopulmonary Dysplasia (BPD) has a multifactorial etiology. Vitamin E and vitamin D play an important role in lung development and can potentially be beneficial in the prevention of BPD.
OBJECTIVE: The study aimed to compare the risk of BPD occurrence in preterm neonates supplemented with vitamin D or E versus those who did not get supplementation.
METHODS: The literature search was conducted for this systematic review by searching the PubMed, Scopus, and Web of Science databases up to December 2022. Randomized controlled trials involved administering vitamin D or E to preterm neonates and examining the occurrence of BPD. We excluded non-English articles, and articles with non-relevant and insufficient data. We used the Critical Appraisal Skills Programme (CASP) checklist to assess the quality of the included studies. We used Egger’s test to evaluate the risk of bias among the included studies. Heterogeneity was also assessed through Q-test and I2. We applied the random effect model for analysis. A P-value less than 0.05 was considered as significant. All the statistical analysis in the current study was performed using STATA 14. The Relative Risk (RR) was calculated as the effect size with 95% Confidence Interval (CI).
RESULTS: Three eligible studies seeking the role of vitamin D in the prevention of BPD were analysed. Meta-analysis revealed that receiving vitamin D supplementation can significantly reduce the risk of BPD in preterm infants (RR = 0.357, 95% CI: 0.189-0.675, I2 = 0.0%; p = 0.002). Similarly, for assessing the role of Vitamin E in the prevention of BPD, three eligible studies were analysed. Vitamin E supplementation was not found to play a significant role in the reduction of BPD (RR = 0.659, 95%CI = 0.243-1.786, I2 = 38.7%; p = 0.412).
CONCLUSION: Vitamin D supplementation could be beneficial in preventing BPD in preterm infants. However, evidence is not enough regarding vitamin E’s role in reducing the incidence of BPD in preterm infants.
PMID:38629361 | DOI:10.2174/0115733963279420240402083916
Curr Rev Clin Exp Pharmacol. 2024 Apr 16. doi: 10.2174/0127724328291047240409062436. Online ahead of print.
ABSTRACT
BACKGROUND: Pancreatic Cancer (PC) is one of the most malignant tumors and highly invasive neoplasms around the world.
OBJECTIVE: This systematic review and meta-analysis aims to study the relationship between the use of renin-angiotensin-aldosterone system inhibitors and the incidence and mortality of PC.
METHODS: The electronic search was conducted systematically until October 10, 2023. in databases, including Scopus, Web of Science (WOS), PubMed/MEDLINE, Cochrane Library, and Embase. The required data were extracted from the articles and were analyzed by Stata 15 using statistical tests (Chi-square and I2), Forest plots, and publication bias tests (Begg’s and Egger’s tests).
RESULTS: A total of four studies (2011-2019; n=314,856) investigated the relationship between RAS antagonists and PC risk. No significant associations were found between angiotensin receptor blockers (ARBs) (OR=0.94, 95% CI: 0.77-1.14, p=0.513), angiotensin-converting enzyme inhibitors (ACEIs) (OR=0.96, 95% CI: 0.84-1.09, p=0.505), or combination therapy (ARBs + ACEIs) (OR=0.97, 95% CI: 0.87-1.09, p=0.627) and PC risk. Also, nine studies (2010-2023; n=20,483) examined the association between renin-angiotensin-aldosterone system inhibitors and PC mortality. Significant reductions in PC mortality were found for ARBs (OR=0.81, 95% CI: 0.66-0.98, p=0.032), ACEIs (OR=0.89, 95% CI: 0.80-0.99, p=0.038), and combination therapy (OR=0.83, 95% CI: 0.70-0.97, p=0.022). No evidence of publication bias was found in the study results.
CONCLUSION: In summary, while renin-angiotensin-aldosterone system inhibitors did not appear to impact PC risk, their use was associated with lower PC mortality based on this meta-analysis of the current evidence. More rigorous and well-designed studies are required to validate and support these findings.
PMID:38629353 | DOI:10.2174/0127724328291047240409062436
Anatol J Cardiol. 2024 Apr 17. doi: 10.14744/AnatolJCardiol.2024.4112. Online ahead of print.
ABSTRACT
BACKGROUND: Radial artery cardiac catheterization is a common diagnostic and interventional procedure for cardiovascular conditions. Pain and hemorrhage at the access site can cause patient discomfort and complications. This pilot study investigates the potential of local forearm heating to reduce pain and hemorrhage in patients undergoing radial artery cardiac catheterization.
METHODS: We enrolled 100 patients scheduled for radial artery cardiac catheterization and randomly assigned them to the heating or control group. The heating group received local forearm heating before sheath removal, while the control group did not. Pain intensity was assessed with a visual analog scale, and hemorrhage was measured by assessing ecchymosis or hematoma size at the catheterization site. Hemodynamic parameters were also monitored. Statistical analysis compared outcomes between the groups.
RESULTS: Patients who received local forearm heating had significantly lower pain intensity (4.15 ± 2.73) compared to the control group (5.84 ± 3.34) (P =.009). Hemodynamic parameters and the extent of hemorrhage at the catheterization site did not significantly differ between the heating and control groups (P >.05). No adverse effects related to forearm heating were reported.
CONCLUSION: Local forearm heating is a promising intervention to reduce pain intensity without increasing hemorrhage or affecting hemodynamic parameters during radial artery cardiac catheterization. This simple, noninvasive approach has the potential to enhance patient comfort and safety post procedure.
PMID:38629351 | DOI:10.14744/AnatolJCardiol.2024.4112
J Clin Nurs. 2024 Apr 17. doi: 10.1111/jocn.17169. Online ahead of print.
ABSTRACT
AIMS: To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors.
METHODS: An online cross-sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES-NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines.
RESULTS: A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses’ age, patients’ use of illegal substances, attitude of individual nurses and considering effective the organization’s procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients’ cultural aspects and patients’ agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards.
CONCLUSION: Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses’ workplace environment and implementing violence-free policies for hospitals.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Impact Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID-19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high-quality care in a totally safe environment.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
PMID:38629335 | DOI:10.1111/jocn.17169
Pol Przegl Chir. 2023 Oct 17;96(2):50-58. doi: 10.5604/01.3001.0053.9352.
ABSTRACT
<b><br>Introduction:</b> The imbalance of external and internal forces acting on the lower eyelid can result in entropion and ectropion, both of which cause ocular irritation and loss of proper eye protection. Potential complications of untreated cases include recurrent inflammation of the conjunctiva and cornea, conjunctival neovascularization, corneal abrasion or perforation, and ultimately even loss of vision. Although various surgical techniques are used to address this problem, their long-term outcome and effectiveness are still under discussion. </br> <b><br>Aim:</b> To evaluate outcomes of surgery for entropion and ectropion, including a modified Wheeler’s method for entropion correction.</br> <b><br>Methods:</b> A non-comparative study (prospective and retrospective groups) included 100 patients operated on in two university hospitals’ plastic surgery departments for lower eyelid entropion or ectropion, following formal ethics approval. The prospective group included 50 patients assessed preoperatively and at 3 and 12 months postoperatively. The retrospective group was comprised of 50 patients (2012-2018), whose preoperative documentation and clinical examinations were analyzed. The main outcome measures were change between pre- and postoperative patient-reported symptoms (VAS scale), ectropion/entropion grading scale (EGS/EnGS), quality of life (WHOQOL-BREF), and occurrence of complications.</br> <b><br>Results:</b> The differences in the severity of all symptoms before and after surgery evaluated with the VAS scale were statistically significant in both groups (p <0.05). We observed 6 recurrences (12%) in the prospective group and 9 (18%) in the retrospective group, with minor complications. Very good functional and esthetic postoperative results were confirmed in 70% (79) of the whole group and in 13 patients (81.3%) treated with the modified Wheeler’s method. In the prospective group, the Mann- Whitney U test for dependent variables revealed significant improvement in the somatic, psychological, and environmental domains, with no significant change in the social relationships domain.</br> <b><br>Conclusions:</b> The results following entropion/ectropion surgery prove the effectiveness of the methods used. Complementing them with the modified Wheeler’s method brought an increase in the number of very good outcomes. Surgery of lower eyelid malposition contributed to reduced symptoms and improved quality of life. The rates of postoperative sequelae were low.</br>.
PMID:38629275 | DOI:10.5604/01.3001.0053.9352
Interv Neuroradiol. 2024 Apr 17:15910199241247886. doi: 10.1177/15910199241247886. Online ahead of print.
ABSTRACT
BACKGROUND: The Tigertriever stent retriever (Rapid Medical) can be actively expanded and contracted by the operator, which allows for several actuation-related parameters to be optimized to potentially improve device efficacy. These parameters have not yet been evaluated. We conducted a benchtop study to evaluate the effect of actuation frequency on clot integration within the stent.
METHODS: A Tigertriever 17 device was deployed within a biological clot analog placed in a straight tube. The device was actuated between the maximally contracted and maximally expanded states with three different frequencies: passive (one-time opening, n = 6), slow (20 s/cycle, n = 6), and fast (5 s/cycle, n = 7). A flat-detector CT scan was acquired, the clot and stent wires were segmented, and the boundaries of the clot and stent wires were calculated on each axial slice. The intersection between the stent and clot boundaries throughout the volume was defined as the volume of clot integrated within the stent. The clot integration factor (ratio of integrated clot volume to total clot volume) was then statistically compared between the three frequencies as an estimate of clot capture efficiency.
RESULTS: The clot integration factor was significantly higher (23% increase, p = 0.01) with the fast actuation as compared to the passive and slow actuations, with a post hoc test showing no difference (p > 0.05) between the passive and slow groups.
CONCLUSIONS: Faster actuation frequencies may result in improved clot integration with the Tigertriever device. This effect needs to be validated by clinical data.
PMID:38629263 | DOI:10.1177/15910199241247886