Nevin Manimala

Br J Nutr. 2022 Sep 14:1-27. doi: 10.1017/S0007114522002938. Online ahead of print.

ABSTRACT

The objectives of this study were (1) to systematically review the literature on the association between birth weight in children born in the first and second generation; (2) to quantify this association by performing a meta-analysis. A systematic review was carried in six databases (Pubmed, Science Direct, Web of Science, Embase, Scopus, CINAHL and LILACS), in January 2021, for studies that recorded the birth weight of parents and children. A meta-analysis using random effects to obtain a pooled effect of the difference in birth weight and the association of low birth weight (LBW) between generations was performed. Furthermore, univariable meta-regression was conducted to assess heterogeneity. Egger’s tests were used to possible publication biases. Of the 9878 identified studies, 70 were read in full and 20 were included in the meta-analysis (10 prospective cohorts and 10 retrospective cohorts), 14 studies for difference in means and 11 studies for the association of LBW between generations (23 estimates). Across all studies, there was no statistically significant mean difference (MD) birth weight between first and second-generation (MD 19.26, 95% CI -28.85, 67.36; p= 0.43). Overall, children of LBW parents were 69% more likely to have low birth weight (pooled effect size (ES) 1.69, 95% CI 1.46, 1.95); I ² : 85,8%). No source of heterogeneity was identified among the studies and no publication bias. The average birth weight of parents does not influence the average birth weight of children, however the proportion of LBW among the parents seems to affect the offspring’s birth weight.

PMID:36102244 | DOI:10.1017/S0007114522002938

Ann Noninvasive Electrocardiol. 2022 Sep 14:e13006. doi: 10.1111/anec.13006. Online ahead of print.

ABSTRACT

BACKGROUND: It is difficult to insert cardiac pacing leads in patient with tricuspid valve surgery (TVS). The aim of this study was to evaluate safety and effectiveness of a novel technique applied for bedside temporary pacemaker placement (TPP) in patients with TVS.

METHODS: We investigated patients with TVS who required bedside TPP without X-ray guidance in cardiac intensive care unit between January 2019 and March 2022. They were divided into Novel pre-shaped group (N = 21) and Control group (routine pre-shaped group, N = 26). The ordinary bipolar electrodes were applied in both groups. In Novel pre-shaped group, electrodes were reshaped by a novel technique with three-curve with anterior tip method, while electrodes were shaped by traditional strategy in Control group. We evaluated the operation duration, first-attempt success rate of the lead placement, pacing threshold, success rate of lead placement, the rate of leads displacement, and complications.

RESULTS: Compared with that in Control group, the procedure time was significantly shortened and the first-attempt success rate of lead placement was obviously increased in Novel pre-shaped group (both p < 0.05). Although there was a slight reduction in complications in Novel pre-shaped group when compared with that in Control group. However, there were no statistical significance in pacing threshold, the success rate of lead placement, the rate of leads displacement, and complications when compared between two groups.

CONCLUSIONS: We propose a novel technique, three-curve with anterior tip method, is a feasible and effective bedside method to insert emergency temporary pacing leads in patients with TVS.

PMID:36102234 | DOI:10.1111/anec.13006

Orthop Surg. 2022 Sep 14. doi: 10.1111/os.13479. Online ahead of print.

ABSTRACT

OBJECTIVE: Traditional lateral soft tissue release (LSTR) was conducted by an additional dorsal first web incision, as the malformed thick scar and neuritis were common after surgery. A new method of lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) should be recommended. The objective is to investigate the clinical effectiveness and safety of scarf + Akin osteotomy (SAO) combined with lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) for moderate to severe hallux valgus.

METHODS: Patients who were performed surgery for hallux valgus from April 2014 to June 2020 were retrospectively reviewed. The visual analog scale (VAS) was recorded before surgery and during follow-up, as well as the forefoot score of the American Orthopaedic Foot and Ankle Society (AOFAS). Patient satisfaction was evaluated at the follow-up time. The preoperative and follow-up weightbearing X-ray were conducted in all patients. The radiological parameters of hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured. Tibial sesamoid position (TSP) was also recorded according to seven-part grading system. The quantitative data were performed as mean ± standard deviation or median ± interquartile range. Student’s t test was performed in HVA, IMA, and DMAA. The TSP, VAS, and AOFAS were statistical analyzed by Mann-Whitney U test. p value of <0.05 was considered significant.

RESULTS: There were 123 feet conducted surgery in 96 patients. The AOFAS score improved a lot which was preoperative 39 to 100 at the follow-up time and VAS was 4 to 0 (p < 0.001). A total of 63 (51.2%) patients were very satisfied, 47 (38.2%) were satisfied, five (4.1%) were undecided and eight (6.5%) were not satisfied. The HVA, IMA, DMAA, and TSP were all decreased after surgery and were statistically significant (p < 0.001).

CONCLUSION: The SAO combined with a LSTR-SMI-DFFM for moderate to severe hallux valgus is effective and safe with pretty good clinical and radiographic results, as well as minimal complications. The corrections of AOFAS and VAS conformed to the minimum clinically important difference (MCID).

PMID:36102216 | DOI:10.1111/os.13479

Pharmacol Res Perspect. 2022 Oct;10(5):e01007. doi: 10.1002/prp2.1007.

ABSTRACT

Pharmacy services within hospitals are changing, with more taking on medication reconciliation activities. This systematic review was conducted to determine the measured impacts of Pharmacy teams working in an acute or emergency medicine department. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was prospectively registered on PROSPERO, National Institute for Health and Care Research, UK registration number: CRD42020187487. The systematic review had two co-primary aims: a reduction in the number of incorrect prescriptions on admission by comparing the medication list from primary care to secondary care, and a reduction in the severity of harm caused by these incorrect prescriptions; chosen to determine the impact of pharmacy-led medication reconciliation services in the emergency and acute medicine setting. Seventeen articles were included. Fifteen were non-randomized controlled trials and two were randomized controlled trials. The number of patients combined for all studies was 7630. No studies included were based within the UK. All studies showed benefits in terms of a reduction in medicine errors and patient harm, compared to control arms. Nine articles were included in a statistical analysis comparing the pharmacy intervention arm with the non-pharmacy control arm, with a Chi² of 101.10 and I² value = 92%. However, studies were heterogenous with different outcome measures and many showed evidence of bias. The included studies consistently indicated that pharmacy services based within acute or emergency medicine departments in hospitals were associated with fewer medication errors. Further studies are needed to understand the health and economic impact of deploying a pharmacy service in acute medical settings including out-of-hours working.

PMID:36102210 | DOI:10.1002/prp2.1007

Clin Transplant. 2022 Sep 14:e14821. doi: 10.1111/ctr.14821. Online ahead of print.

ABSTRACT

Preemptive wait-listing of deceased donor kidney transplant candidates before maintenance dialysis increases the likelihood of transplantation and improves outcomes among transplant patients. Previous studies have identified substantial disparities in rates of preemptive listing, but a gap exists in examining geographic sources of disparities, particularly for sub-regional units. Identifying small area hot spots where delayed listing is particularly prevalent may more effectively inform both health policy and regionally appropriate interventions. We conducted a retrospective cohort study utilizing 2010-2020 Scientific Registry of Transplant Recipients data for all deceased donor kidney transplant candidates to examine overall and race-stratified geospatial hot spots of post-dialysis wait-listing in U.S. zip code tabulation areas. Three geographic clustering methods were utilized to identify robust statistically significant hot spots of post-dialysis wait-listing. Novel sub-regional hot spots were identified in the southeast, southwest, Appalachia, and California, with a majority existing in the southeast. Race-stratified results were more nuanced, but broadly reflected similar patterns. Comparing transplant candidates in hot spots to candidates in non-clusters indicated a strong association between residence in hot spots and high area deprivation (OR: 6.76, 95%CI: 6.52-7.02), indicating that improving access healthcare in these areas may be particularly beneficial. This article is protected by copyright. All rights reserved.

PMID:36102154 | DOI:10.1111/ctr.14821

J Clin Endocrinol Metab. 2022 Sep 14:dgac527. doi: 10.1210/clinem/dgac527. Online ahead of print.

ABSTRACT

OBJECTIVE: A hypothesis-free genetic association analysis has not been reported for patients with primary hyperparathyroidism (PHPT). We aimed to investigate genetic associations with PHPT using both genome-wide association study (GWAS) and candidate gene approaches.

METHODS: A cross-sectional study was done among patients of European Caucasian ethnicity recruited in Tayside (Scotland, UK). Electronic medical records were used to identify PHPT cases and controls, and linked to genetic biobank data. Genetic associations were performed by logistic regression models and Odds Ratios (ORs). The combined effect of the genotypes was researched by genetic risk score (GRS) analysis.

RESULTS: We identified 15,622 individuals for the GWAS that yielded 34 top single-nucleotide polymorphisms, and LPAR3-rs147672681 reached genome-wide statistical significance (P=1.2e-08). Using a more restricted PHPT definition 8,722 individuals with data on the GWAS-identified loci were found. Age-sex adjusted ORs for the effect alleles of SOX9-rs11656269, SLITRK5-rs185436526, and BCDIN3D-AS1-rs2045094 showed significant increased risks (P<1.5e-03). GRS analysis of 5482 individuals showed an OR of 2.51 (P=1.6e-04), 3.78 (P=4.0e-08) and 7.71 (P=5.3e-17) for the second, third and fourth quartiles respectively compared to the first, and there was a significant linear trend across quartiles (P<1.0e-04). Results were similar when stratifying by gender.

CONCLUSIONS: Using genetic loci discovered in a GWAS of PHPT carried out in a Scottish population, this study suggests new evidence for the involvement of genetic variants at SOX9, SLITRK5, LPAR3 and BCDIN3D-AS1. It also suggests that both male and female carriers of greater numbers of PHPT-risk alleles have a significant increased risk of PHPT.

PMID:36102151 | DOI:10.1210/clinem/dgac527

World J Biol Psychiatry. 2022 Sep 14:1-11. doi: 10.1080/15622975.2022.2124451. Online ahead of print.

ABSTRACT

OBJECTIVES: Believing that a neurodevelopmental pathology may cause bipolar affective disorder (BAD), we aimed to measure the concentrations of α-N-acetylgalactosaminidase (α-NAGAL), a lysosomal enzyme.

METHODS: The study included 32 patients with BAD and 32 healthy controls. The Young Mania Rating Scale was used to measure the severity of the disease. Serum α-N-acetylgalactosaminidase concentrations were measured in all blood samples using the human α-N-acetylgalactosaminidase ELISA Kit.

RESULTS: A statistically significant difference was found in the α-NAGAL values between the groups. The mean α-NAGAL values of BAD patients are lower than the mean α-NAGAL values of the control group. A strong negative and statistically significant relationship was found between the α-NAGAL values of patients with BAD and their Young Mania Rating Scale scores. And a positive strong correlation was found between the age of onset of the disease and α-NAGAL levels.

CONCLUSIONS: Low α-N-acetylgalactosaminidase concentrations may cause accumulation of some glycoproteins in the lysosomes in the brain during the gestational period, producing the clinical symptoms of BAD. α-N-acetylgalactosaminidase deficiency may not be the only cause of BAD, but it may be an important factor in the etiology of this disease.

PMID:36102137 | DOI:10.1080/15622975.2022.2124451

Endocrinol Diabetes Metab. 2022 Sep;5(5):e363. doi: 10.1002/edm2.363. Epub 2022 Aug 9.

ABSTRACT

INTRODUCTION: Diabetic ketoacidosis (DKA) is a serious acute complication of diabetes mellitus that carries a significant risk of mortality with delayed treatment in low-resource countries. This study aimed to determine the outcome of paediatric DKA patients’ managed with a modified DKA treatment protocol using intermittent bolus subcutaneous insulin administration.

METHODS: A cross-sectional study design with retrospective data collection was conducted among children younger than 14 years of age admitted from January 2013 to February 2017. A modified protocol was prepared based on a reference from the international society for paediatric and adolescent diabetes and other international guidelines. Data were analysed using Statistical package for social science (SPSS) version 22.0. Descriptive statistics were performed. Binary logistic regression was used to identify associations, and significant variables were further considered for multivariate logistic regression to determine the outcome of DKA patients.

RESULT: Among the 190 patients, 55.5% (n = 105) were newly diagnosed. The overall average time required for resolution of DKA was 48 ± 27.8 h. Mental status on presentation (p = .001), shock on presentation (p < .01) and severity of DKA (p < .001) were found to have a significant association with the mean time for clearance of DKA. Hypoglycaemia was the most common treatment-related complication, which occurred in 23.7% of patients (n = 45) followed by hypokalaemia in 4.3% of patients (n = 8), and no patient developed cerebral oedema and death.

CONCLUSION: The time required for clearance of DKA was prolonged, and hypoglyceamia was a common complication for children younger than 5 years of age. The modified protocol of DKA is reasonable management for low-resource settings with further modification.

PMID:36102127 | DOI:10.1002/edm2.363

Endocrinol Diabetes Metab. 2022 Sep;5(5):e365. doi: 10.1002/edm2.365. Epub 2022 Aug 14.

ABSTRACT

INTRODUCTION: Diabetes mellitus itself is a known predictor of physical disability and impairment in activities of daily living (ADL); however, there are existing controversies about the factors explaining the association between diabetes and disability. Therefore, we assessed the possible determinants associated with ADL impairment among people with diabetes in Dhaka city, Bangladesh.

METHODS: We conducted a cross-sectional study among 480 people with diabetes aged between 50 and 70 years, and attended a tertiary level hospital in Dhaka city. For determining the ADL impairment, we used the Katz Index Scoring (6 = no impairment; <6 = impairment). Age, sex, educational attainment, household expenditure, body mass index, the status of diabetes (controlled or uncontrolled), hypertension and medication adherence to anti-diabetic drugs were included in the statistical models, and we defined any ADL impairment (Katz score <6) as an event. Multivariable logistic regression was performed to assess the significance of relevant factors.

RESULTS: The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (76.3%) had at least some sort of physical disability. In multivariable logistic regression analysis after adjusting for all covariates simultaneously, age (odds ratio [95% confidence interval]: 1.35 [1.20 to 1.75] per 1-SD increment), BMI (1.32 [1.08 to 1.21] per 1-SD increment), higher educational attainment (0.34 [0.09-0.90]), multi-morbidity (2.79 [1.48-5.25]) and uncontrolled diabetes (1.35 [1.10-1.45]) were independently associated with ADL impairment.

CONCLUSIONS: Physical disability was common, and ADL impairment was associated with age, educational attainment, BMI, multi-morbidities and uncontrolled diabetes among the people with diabetes in Bangladesh.

PMID:36102126 | DOI:10.1002/edm2.365

World J Mens Health. 2022 Sep 2. doi: 10.5534/wjmh.220069. Online ahead of print.

ABSTRACT

PURPOSE: Overall, male factor infertility (MFI) accounts for up to 50% of etiologies of couple’s infertility, with almost 30% of MFI cases being idiopathic in nature. Idiopathic MFI does not support a tailored treatment work-up in clinical practice. To investigate rates of and characteristics of men presenting for idiopathic versus unexplained primary infertility as compared with same-ethnicity, age-comparable fertile men.

MATERIALS AND METHODS: Demographic, clinical and laboratory data from 3,098 primary infertile men consecutively evaluated were analyzed and compared with those of 103 fertile controls. Idiopathic male infertility (IMI) was defined for abnormality at semen analysis with no previous history of diseases affecting fertility and normal findings on physical examination and genetic and laboratory testing. Unexplained male infertility (UMI) was defined as infertility of unknown origin with completely normal findings at semen analysis. Descriptive statistics and logistic regression models tested the association between clinical variables and idiopathic infertility status.

RESULTS: Overall, 570 (18.5%) and 154 (5.0%) patients depicted criteria suggestive for either IMI or UMI, respectively. Groups were similar in terms of age, BMI, CCI, recreational habits, hormonal milieu, and sperm DNA fragmentation indexes. Conversely, testicular volume was lower in IMI (p<0.001). Vitamin D3 levels were lower in IMI vs. UMI vs. fertile controls (p=0.01). At multivariable logistic regression analysis only vitamin D3 deficiency (OR, 9.67; p=0.03) was associated with IMI. Characteristics suggestive for IMI versus UMI were observed in almost 20% and 5% of men, respectively. Overall, clinical differences between groups were slightly significant and certainly not supportive of a tailored management work-up.

CONCLUSIONS: Current findings further support the urgent need of a more detailed and comprehensive assessment of infertile men to better tailoring their management work-up in the everyday clinical setting.

PMID:36102103 | DOI:10.5534/wjmh.220069