Nevin Manimala

Medicine (Baltimore). 2022 Sep 2;101(35):e30121. doi: 10.1097/MD.0000000000030121.

ABSTRACT

BACKGROUND: Activation of venous flow has been shown with different types of electrical stimulation. The aim of this study is to compare the hemodynamic effects of transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), and sham stimulation on healthy young people.

METHODS: This randomized crossover study was conducted during June 2018 in the Faculty of Physical Therapy of A Coruña (Spain). Twenty-four university students (50% male) received in a randomized order 5 Hz-TENS, NMES, and sham stimulation on soleus muscle. Flow volume (FV) and peak velocity (PV) from popliteal vein were recorded via Doppler ultrasound, and relative changes from baseline were determined. Discomfort among the 3 stimulations was also compared.

RESULTS: The differences among the 3 stimulations were assessed using the ANOVA for repeated measured, the Friedman test and the Kendall tau test, according to the type of measurement to be compared. FV (mL/min) and PV (cm/s) increased significantly after NMES (percentual increase 37.2 ± 62.0%, P = .002; 264.4 ± 152.2%, P < .001, respectively) and TENS (226.2 ± 190.3%, P < .001; 202.7 ± 144.6%, P < .001, respectively). These percentual changes from basal level in hemodynamics were statistically different to those after placebo, which was ineffective enhancing hemodynamics. The improvements in FV were statistically higher with TENS than with NMES (P < .001), but there was no statistical difference in PV (P = .531). Despite NMES was applied at a significantly lower amplitude than TENS (P < .001), NMES protocol was the worst tolerated, though the differences in discomfort were not statistically significant.

CONCLUSION: Both active electrical protocols but not sham stimulation increased hemodynamics in healthy people. TENS obtained higher flow volume increase from baseline than NMES, considered globally at not only in its on-time.

PMID:36107611 | DOI:10.1097/MD.0000000000030121

Medicine (Baltimore). 2022 Sep 2;101(35):e30382. doi: 10.1097/MD.0000000000030382.

ABSTRACT

This study aimed to investigate the value of the product of peripheral blood platelet and serum C-reactive protein (P-CRP), an inflammatory indicator, for the prognosis of patients with osteosarcoma. Patients with osteosarcoma who were diagnosed and treated at the First Affiliated Hospital of Guangxi Medical University, China, between January 2012 and December 2019 were included in this retrospective study. Receiver operating characteristic curves were used to calculate the optimal cut-off values for inflammatory indicators such as P-CRP, the C-reactive protein/albumin ratio (CRP/Alb), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in the peripheral blood of patients before treatment. Based on the cut-off values, the patients were divided into high P-CRP and low P-CRP groups, high CRP/Alb and low CRP/Alb groups, high NLR and low NLR groups, and high NLR and low NLR groups; the Kaplan-Meier method was used to compare the overall survival (OS) rates and OS times of the above groups. Univariate and multivariate Cox regression models were used to analyze the effects of various factors on the prognosis of osteosarcoma and to determine the independent influencing factors. The Kaplan-Meier survival analysis results suggested that the OS rate of the high P-CRP group was significantly lower than that of the low P-CRP group (14.0% vs 67.2%, P < .001). The univariate analysis results suggested that tumor volume, tumor stage, NLR, PLR, P-CRP and CRP/Alb were factors that affected the prognosis of patients with osteosarcoma, and the differences were statistically significant (P < .05). The multivariate analysis results showed that tumor volume (hazard ratio [HR] = 1.061; 95% CI, 1.001-1.125; P = .046) and preoperative P-CRP (HR, 1.037; 95% CI, 1.024-1.050; P < .01) were independent prognostic factors affecting the OS rate after osteosarcoma surgery. The results of our study showed that P-CRP is a novel and promising prognostic indicator for patients with osteosarcoma. The higher the P-CRP level in the peripheral blood of patients is before treatment, the worse the prognosis might be.

PMID:36107592 | DOI:10.1097/MD.0000000000030382

Medicine (Baltimore). 2022 Sep 2;101(35):e30148. doi: 10.1097/MD.0000000000030148.

ABSTRACT

The lack of knowledge on health literacy affects all segments of society, particularly health workers. The objectives were to identify nursing students’ means of accessing information during the coronavirus disease 2019 pandemic, their level of health literacy, and the factors that affect it. This cross-sectional study was conducted in Turkey among 398 nursing students of Çukurova University and Van Yüzüncü Yil University between June 1 and June 30, 2020. As a data collection tool, E-Health Literacy Scale was used, with students’ characteristics and personal information form related to Internet use. These forms were converted to the online format. The survey link was sent to the students’ smartphones and/or e-mails to ask them to participate. Majority of participants were Van Yüzüncü Yil University nursing students (63.8%). E-SYO score average of all students was found to be 29.42 ± 4.39 (min = 14, max = 40); it was is found be at a good level. They used the Internet as the first source of information about coronavirus disease 2019 (65.1%).Among the participants, 65.8% stated that it was important to access the health resource on the Internet and 19.1% of the participants thought that it was very important. It was found that Internet use was being used for >3 times a day (72.9%). The age, class, gender, family type, income level, high school from which they graduated from, and their working status significantly were statistically affecting their health literacy (P < .05). The health literacy scale scores were significant and higher than those who did not know the concept of health literacy, and those who perceived Internet skills well and very well than those who perceived them poorly (P < .05). Nursing students were found to have good average health literacy averages. Improving the health literacy is important for making individuals healthier.

PMID:36107588 | DOI:10.1097/MD.0000000000030148

Medicine (Baltimore). 2022 Sep 2;101(35):e30338. doi: 10.1097/MD.0000000000030338.

ABSTRACT

Acupuncture manipulation with needling direction is important for the therapeutic effect based on traditional Chinese medicine theory. However, there is controversy over directional manipulation and therapeutic effect, despite some research showing that acupuncture manipulations may have something to do with therapeutic effect. Moreover, research usually focuses on the therapeutic effects on the acupoints and acupuncture time rather than exploring the manipulation method. This study applies a semiconductor analyzer to investigate the effects of acupuncture manipulation. 10 healthy participants were recruited for the study. We used a cross-over design to compare the effect of different manipulation on individuals. This study employed an Agilent B1500A semiconductor analyzer to investigate the electric characteristics of meridians under directional supplementation and draining manipulation. We measured the electric current of meridians under different manipulation, and compared the difference between supplementation and draining manipulation in healthy individuals. The electric current was significantly larger in supplementation manipulation compared to draining manipulation in the meridians (P < .001). The measured electric current in the same manipulation methods did not show a statistical difference between meridians (P = .094). The different directional manipulation result in different electric currents in humans. Our finding implies that the supplementation and draining manipulation may result in different therapeutic effects clinically as the description of traditional Chinese medicine theory. Therefore, directional manipulation may need to be taken into consideration in future acupuncture studies and clinical management.

PMID:36107585 | DOI:10.1097/MD.0000000000030338

Medicine (Baltimore). 2022 Sep 2;101(35):e30361. doi: 10.1097/MD.0000000000030361.

ABSTRACT

The COVID-19 pandemic has disrupted medical care worldwide and caused delays in care for many illnesses and procedures unrelated to COVID-19; however, less clear is how it may have affected diagnosis of conditions that present with similar symptoms, such as primary pulmonary coccidioidomycosis (PPC). We conducted an observational cohort study of patients diagnosed with PPC between March 1 and December 1 in 2 years: 2019 (before COVID-19) and in 2020 (after COVID-19) to compare the time from symptom onset to PPC diagnosis. Relevant demographic and clinical variables were collected, and statistical analyses were performed with the χ2 test, Wilcoxon rank sum test, and Cox proportional hazards regression analysis. During 2019, 83 patients were diagnosed with PPC. During 2020, 113 patients were diagnosed with PPC. For both groups, the median time from symptom onset to diagnosis of PPC was 14 days (P = .13). No significant differences in time to diagnosis existed between the 2 years for location of diagnosis (outpatient clinic, emergency department, or in hospital), for computed tomographic imaging performed before diagnosis, or for number of COVID-19 tests received before PPC diagnosis. In addition, there were no differences in the 2 years between the total number of clinical visits before diagnosis. However, patients in the post-COVID-19 group who had fever were diagnosed with PPC earlier than those without fever (hazard ratio, 1.77; 95% confidence interval, 1.15-2.73; P = .01). Contrary to what we expected, no significant delay in diagnosis of PPC occurred during the COVID-19 pandemic.

PMID:36107584 | DOI:10.1097/MD.0000000000030361

Medicine (Baltimore). 2022 Sep 2;101(35):e30355. doi: 10.1097/MD.0000000000030355.

ABSTRACT

INTRODUCTION: Low-volume bowel preparation has been developed to increase patient compliance. We compared 1 L of polyethylene glycol/ascorbic acid (PEG/Asc) and oral sodium sulfate (OSS) with respect to bowel preparation efficacy, compliance, and safety.

METHODS: A multicenter, prospective, randomized, single-blinded, non-inferiority trial was conducted in 3 hospitals. Patients were randomized to receive a bowel-cleansing agent. Bowel-cleansing efficacy was evaluated using the Boston Bowel Preparation Scale (BBPS). Satisfaction, feeling, taste of the bowel cleanser, and adverse events after taking the bowel cleanser were investigated through a questionnaire. Additionally, blood samples were analyzed before and after bowel cleansing.

RESULTS: In total, 172 patients were analyzed (85 with 1 L PEG/Asc and 87 with OSS), and the mean BBPS scores were comparable between agents. The 1L PEG/Asc group tended to have a higher BBPS score in the right colon (2.22 vs 2.02; P = .08). The compliance of 1 L of PEG/Asc was comparable to that of OSS. Patients taking 1 L PEG/Asc reported greater thirst and dizziness (P = .04 and P = .047, respectively) than the OSS cohort. On the other hand, gastrointestinal symptoms such as vomiting and abdominal distension were more common in the OSS group, without statistical significance. In terms of laboratory adverse events, elevation of serum creatinine was found in both groups after taking the bowel cleansing agent (P < .001 for the 1L PEG/Asc group; P = .04 for the OSS group). However, most of the increased values were within the normal ranges.

DISCUSSION: The 1L PEG/Asc treatment was comparable to OSS in terms of bowel preparation efficacy, compliance, and safety.

PMID:36107563 | DOI:10.1097/MD.0000000000030355

Medicine (Baltimore). 2022 Sep 2;101(35):e30073. doi: 10.1097/MD.0000000000030073.

ABSTRACT

BACKGROUND: The respiratory system is the first line of defense against outside pollutants. Recently, respiratory health has been receiving increasing attention due to the increase in fine dust, which reduces respiratory function and increases incidence of chronic obstructive pulmonary disease, and in coronavirus pandemic, which can cause severe acute respiratory syndrome.

METHODS: This clinical pilot trial was designed to secure evidence for a main clinical trial and to confirm the efficacy and safety of Liriope platyphylla (LP) extract for improving respiratory function. We conducted a double-blind randomized placebo-controlled trial with 22 participants from June 30, 2021, to August 25, 2021. The primary outcome was Breathlessness, Cough, and Sputum Scale score. Secondary outcomes included forced vital capacity, forced expiratory volume at 1 second (FEV1), forced expiratory volume at 1 s/forced vital capacity ratio, cough assessment test score, chronic obstructive pulmonary disease assessment test score, peripheral blood mononuclear cell counts (white blood cells, eosinophils, T cells, and B cells), high-sensitivity C-reactive protein level, erythrocyte sedimentation rate, cytokine (interleukin-1β, interleukin-4, tumor necrosis factor-α, interleukin-6, interleukin-8, interferon-γ, and immunoglobulin E) levels, antioxidant (glutathione peroxidase and superoxide dismutase) levels, and nitric oxide level.

RESULTS: A total of 22 participants were randomly assigned to 2 groups: the LP group (n = 11), who took 1000 mg of LP extract per day, and the placebo group, who took 1000 mg of dextrin per day. Participants took 1 capsule twice a day for 4 weeks. For the Breathlessness, Cough, and Sputum Scale, the interaction between group and visit was statistically significant in a blend of analyses of variance. interleukin-8, tumor necrosis factor-α, and interferon-γ levels decreased more in the LP group than in the placebo group. The sample size required for large-scale clinical trials in the future was 50. There were no side effects.

CONCLUSION: LP extract can enhance respiratory function. The detailed data we obtained support conducting the future main large-scale clinical trial.

PMID:36107535 | DOI:10.1097/MD.0000000000030073

Medicine (Baltimore). 2022 Sep 2;101(35):e30118. doi: 10.1097/MD.0000000000030118.

ABSTRACT

Inflammatory bowel disease (IBD) is characterized by many clinical features. Anemia is 1 of the most frequent complications and/or extraintestinal manifestations of IBD. There are conflicting data regarding the relationship between changes in hemoglobin levels and disease prevalence in IBD patients with and without antitumor necrosis factor (antiTNF) therapy. In our study, we aimed to investigate the long-term effect of antiTNF agents on anemia in IBD. The records of IBD patients followed-up in our hospital between January 2011 and January 2021 were reviewed retrospectively. Demographic, clinical, endoscopic, radiological and medical treatment data of the patients were recorded. Complete blood count and laboratory markers of inflammation and disease activation, were recorded at the beginning and at the first year of treatment in all patients. The data of patients with and without antiTNF therapy were analyzed statistically. A total of 240 IBD patients who met the inclusion criteria were enrolled in the study. The number of patients with and without antiTNF therapy was 102 (42.5%) and 138 (57.5%), respectively. The change in all laboratory parameters between the beginning and the first year of treatment was statistically significant (P < .001) in all IBD patients with and without antiTNF therapy. The change in Hb level after 1 year of treatment was significantly different in patients with antiTNF therapy compared to those without therapy (3.00 ± 1.78 g/dL vs 1.19 ± 1.38 g/dL, P < .001). In the multiple regression analysis, male gender, antiTNF therapy, baseline Hb level and iron therapy were independent significant variables of hematopoietic response. This study showed that with appropriate treatment, hemoglobin levels of IBD patients with and without antiTNF therapy increased within 1 year, and the use of antiTNF agents in the treatment of IBD was an independent variable in correcting anemia.

PMID:36107528 | DOI:10.1097/MD.0000000000030118

Medicine (Baltimore). 2022 Sep 2;101(35):e30198. doi: 10.1097/MD.0000000000030198.

ABSTRACT

Secondary lymphedema is a clinically incurable disease that commonly occurs following surgical cancer treatment and/or radiation. One of the most common forms of lymphedema treatment is complete decongestive therapy (CDT). This study aimed to investigate the clinical effects of new compression bandages (Mobiderm® bandages) in patients with secondary lymphedema after cancer treatment. This study included 17 patients with ipsilateral limb lymphedema after cancer treatment (one male and 16 female patients; age, 45-80 years). Patients were divided into the Mobiderm® bandage group (n = 9) and classical bandage group (n = 8). The International Society of Lymphology (ISL) stage was also evaluated. Limb circumference was measured at 5 to 6 sites per limb to identify the maximal circumference difference (MCD) between the affected and unaffected limbs. Pre-and posttreatment MCD were analyzed. After intensive CDT, both the Mobiderm® bandage group (1.2 ± 0.56 cm) and classical bandage group (0.85 ± 0.40 cm) had a significant decrease in MCD compared to pretreatment (P < .05). However, in patients with ISL stage 2, the mean MCD decrease rate was greater in the Mobiderm® bandage group (22.82 ± 10.92 %) than in the classical bandage group (12.18 ± 8.1 1%)(P = .045). Both new bandages (Mobiderm® bandages and classical bandages) reduced the circumference of limb edema in patients with secondary lymphedema after cancer treatment. This study findings suggest that Mobiderm® bandages as an alternative modality for controlling ISL stage 2 lymphedema.

PMID:36107527 | DOI:10.1097/MD.0000000000030198

Medicine (Baltimore). 2022 Sep 2;101(35):e30146. doi: 10.1097/MD.0000000000030146.

ABSTRACT

BACKGROUND: There is currently no objective computed tomography (CT)-defined grading system for coronavirus disease (COVID-19)-related pulmonary fibrosis. We propose a CT-based radiological scale that adapts the histological fibrosis scale to pulmonary fibrosis CT findings, to evaluate possible predictive factors for the degree of fibrosis in these patients.

METHODS: A new radiological fibrosis grading system was created based on existing histological fibrosis scales. One hundred forty-seven COVID-19 patients with any degree of fibrosis on CT were evaluated. Smoking status, the presence of hypertension, the duration of hospital stays, the presence of comorbid diseases, and the levels of prognostic and predictive factors for COVID-19 were evaluated, and how these parameters affected the fibrosis scores was examined.

RESULTS: Of 147 patients, 17.7% had grade 1, 17% had grade 2, 51.7% had grade 3, and 13.6% had grade 4 fibrosis. ANOVA revealed statistically significant relationships between the fibrosis scores and lactate dehydrogenase values, lymphocyte count, C-reactive protein level, and length of hospital stay. Smoking, advanced age, hypertension, and male sex showed significantly higher scores for fibrosis.

CONCLUSIONS: Using our CT-defined lung fibrosis grading system, we could predict the severity of fibrosis as well as the resultant lung pathology in COVID-19 patients. Thus, disease exacerbation and development of permanent severe fibrosis can be prevented using the appropriate treatment methods in high-risk patients.

PMID:36107526 | DOI:10.1097/MD.0000000000030146