Nevin Manimala

J Burn Care Res. 2024 Apr 11:irae057. doi: 10.1093/jbcr/irae057. Online ahead of print.

ABSTRACT

Severe burn injuries pose diagnostic challenges, contributing to increased fatality rates with delayed diagnoses. This study aims to identify early risk factors and understand their impact on clinical outcomes by examining hematological dynamics in severe burn cases. The focus includes age-related patterns, Total Body Surface Area (TBSA) affected by burns, hospital stay duration, and changes in hematological markers during burn injuries. An analytical cross-sectional study at the Burn Care Centre involved 135 participants hospitalized between January 2018 and December 2021. Demographic data and hematological markers were recorded, with statistical analysis using IBM SPSS 25.0. Non-survivors exhibited a greater mean TBSA, shorter hospital stay, and an enhanced early immune response indicated by WBC count on the first day. Hematological markers, including HGB, RCC, and PLT, showed dynamic patterns over the study period. Marginal variations in platelet counts and intriguing patterns in RCC suggested potential consequences like disseminated intravascular coagulation. The study provides crucial insights into hematological responses to severe burn injuries. Early identification of risk factors, particularly age-related patterns and immune responses, informs clinicians about predicting outcomes and guiding therapeutic interventions. Despite limitations, this work underscores the need for further multi-center research to comprehensively understand the complex relationships between burn injuries, hematological responses, and clinical outcomes.

PMID:38602154 | DOI:10.1093/jbcr/irae057

BJOG. 2024 Apr 11. doi: 10.1111/1471-0528.17823. Online ahead of print.

ABSTRACT

BACKGROUND: There is a lack of robust evidence to recommend the use of perioperative ureteric catheterisation or stenting in complex gynaecological surgery.

OBJECTIVES: To evaluate the evidence on the benefits and risks of perioperative ureteric catheterisation or stenting in complex gynaecological surgery.

SEARCH STRATEGY: A literature search was performed in CINAHL, the Cochrane Library, Embase and MEDLINE, from 1946 to January 2024, using a combination of keywords and Medical Subject Headings (MeSH) terminology.

SELECTION CRITERIA: Randomised controlled trials (RCTs) and observational studies were included.

DATA COLLECTION AND ANALYSIS: Meta-analysis of the RCTs and observational studies were performed separately. Cochrane RevMan 6.5.1 was used to undertake meta-analysis. Risk ratios with 95% CIs were calculated for the outcome measures.

MAIN RESULTS: Ten studies were included: three RCTs and seven observational studies, comprising 8661 patients. The three RCTs, comprising a total of 3277 patients, showed no difference in the risk of immediate complications in the form of ureteric injury between the ureteric stent and the control groups (RR 0.9, 95% CI 0.49-1.65). The observational studies included 5384 patients. Four studies that explored the ureteric injury as an outcome did not show any difference between the two groups (RR 0.76, 95% CI 0.27-2.16). One case-control study with 862 participants found that the rate of ureteric injury was higher in the non-stented group, although this was observed in only three patients. The risk of urinary tract infection (UTI) was increased in the stent group, although not with statistical significance (RR 1.84, 95% CI 0.47-7.17). There was no significant difference in the risk of ureteric fistulae (RR 1.91, 95% CI 0.62-5.83), although the number of studies was limited.

CONCLUSIONS: Prophylactic ureteric catheterisation or stenting for complex gynaecological surgery is not associated with a lower risk of ureteric injury.

PMID:38602151 | DOI:10.1111/1471-0528.17823

Med Hist. 2024 Apr 11:1-22. doi: 10.1017/mdh.2024.2. Online ahead of print.

ABSTRACT

Doctors have played an important role in the development of health institutions in Latin America. However, they are not the only profession that has had a voice in these matters. There are also other factors influencing the development of ministries of health. This issue has gone unnoticed in the literature. This article suggests that it is possible to identify two distinct trends in the creation of health ministries in Latin America. The first, of an early nature, was seen principally in Central America and the Caribbean in countries dependent on or under the influence of the United States which, from the 1880s, promoted health Pan-Americanism. The second trend, which became apparent from 1924, was characterised by the emergence of ministries in a context of institutional breakdown and the appearance of new actors (military or populist leaders). This second trend was first seen in Chile in 1924. This article analyses the creation of the Ministerio de Higiene, Asistencia y Previsión Social (Ministry of Hygiene, Assistance and Social Security) in Chile in 1924 and its subsequent development through to 1931. The analysis looks at the health measures adopted, the context in which this occurred and the debates triggered by the ministry’s process of institutional development, based on parliamentary discussions, presidential speeches, official statistics, legislation, documents prepared by key actors and the press of the time.

PMID:38602141 | DOI:10.1017/mdh.2024.2

JBI Evid Implement. 2024 Apr 12. doi: 10.1097/XEB.0000000000000422. Online ahead of print.

ABSTRACT

INTRODUCTION: More than one in ten people globally live with a mental health illness. Adolescent mental health is a major contributor to that statistic, as 27% of adolescents have one or more mental, emotional, developmental, or behavioral problems. School-based health care clinics can provide mental health services for this age group.

OBJECTIVES: This project aimed to promote evidence-based practices regarding adolescent mental health screening in schools.

METHODS: This project used the JBI Evidence Implementation Framework to promote evidence-based practices for adolescent mental health screening in schools. The JBI framework is grounded in an audit and feedback process, along with a structured approach to identifying and managing barriers to compliance with best practices. Five audit criteria representing best practice recommendations were developed. A baseline audit was conducted, followed by the implementation of an improvement strategy. The project was finalized with a follow-up audit to determine any changes in compliance with best practice recommendations.

RESULTS: The baseline survey of students revealed a 25% average compliance for audit criteria 1 and 2. The primary barrier to compliance was students’ unawareness of the availability of mental health services. The improvement strategy included an educational presentation for students regarding mental health. The follow-up audit revealed an increase in compliance with best practices.

CONCLUSIONS: The project achieved a 29% increase in compliance with best practices, although only 23% of the students were reached via the improvement strategy.

SPANISH ABSTRACT: http://links.lww.com/IJEBH/A189.

PMID:38602126 | DOI:10.1097/XEB.0000000000000422

Hum Fertil (Camb). 2024 Dec;27(1):2338290. doi: 10.1080/14647273.2024.2338290. Epub 2024 Apr 11.

ABSTRACT

This study aims to compare the embryological and clinical parameters of intracytoplasmic sperm injection (ICSI) cycles using testicular versus ejaculated sperm in male patients with elevated sperm DNA fragmentation (SDF). A total of 73 ICSI cycles were examined in couples where the male partner exhibited high levels of SDF. ICSI was performed using either ejaculated or testicular sperm. The primary outcomes were rates of blastocyst formation, high-quality embryo development, and clinical pregnancy. The DNA fragmentation index (DFI) for testicular sperm (16.81 ± 17.51) was significantly lower than that of ejaculated sperm (56.96 ± 17.56). While the blastocyst formation rate was significantly higher in the testicular sperm group compared to the ejaculated sperm group, no statistically significant differences were noted in fertilization rate (72.15% vs. 77.23%), rate of high-quality embryo formation (47.17% vs. 46.53%), clinical pregnancy (50% vs. 56.52%), Cumulative pregnancy (70.2% vs. 55.6%), or live birth rate (43.75% vs.43.48%). Testicular spermatozoa have no additional advantage over ejaculated spermatozoa except for blastocyst quality in patients with high SDF, the use of testicular spermatozoa for the first ICSI cycle in male infertility patients with high SDF should be undertaken after much consideration at present.

PMID:38602121 | DOI:10.1080/14647273.2024.2338290

Arterioscler Thromb Vasc Biol. 2024 Apr 11. doi: 10.1161/ATVBAHA.123.318964. Online ahead of print.

ABSTRACT

BACKGROUND: CALCRL (calcitonin receptor-like) protein is an important mediator of the endothelial fluid shear stress response, which is associated with the genetic risk of coronary artery disease. In this study, we functionally characterized the noncoding regulatory elements carrying coronary artery disease that risks single-nucleotide polymorphisms and studied their role in the regulation of CALCRL expression in endothelial cells.

METHODS: To functionally characterize the coronary artery disease single-nucleotide polymorphisms harbored around the gene CALCRL, we applied an integrative approach encompassing statistical, transcriptional (RNA-seq), and epigenetic (ATAC-seq, chromatin immunoprecipitation assay-quantitative polymerase chain reaction, and electromobility shift assay) analyses, alongside luciferase reporter assays, and targeted gene and enhancer perturbations (siRNA and clustered regularly interspaced short palindromic repeats/clustered regularly interspaced short palindromic repeat-associated 9) in human aortic endothelial cells.

RESULTS: We demonstrate that the regulatory element harboring rs880890 exhibits high enhancer activity and shows significant allelic bias. The A allele was favored over the G allele, particularly under shear stress conditions, mediated through alterations in the HSF1 (heat shock factor 1) motif and binding. CRISPR deletion of rs880890 enhancer resulted in downregulation of CALCRL expression, whereas HSF1 knockdown resulted in a significant decrease in rs880890-enhancer activity and CALCRL expression. A significant decrease in HSF1 binding to the enhancer region in endothelial cells was observed under disturbed flow compared with unidirectional flow. CALCRL knockdown and variant perturbation experiments indicated the role of CALCRL in mediating eNOS (endothelial NO synthase), APLN (apelin), angiopoietin, prostaglandins, and EDN1 (endothelin-1) signaling pathways leading to a decrease in cell proliferation, tube formation, and NO production.

CONCLUSIONS: Overall, our results demonstrate the existence of an endothelial-specific HSF (heat shock factor)-regulated transcriptional enhancer that mediates CALCRL expression. A better understanding of CALCRL gene regulation and the role of single-nucleotide polymorphisms in the modulation of CALCRL expression could provide important steps toward understanding the genetic regulation of shear stress signaling responses.

PMID:38602103 | DOI:10.1161/ATVBAHA.123.318964

Public Health Nurs. 2024 Apr 11. doi: 10.1111/phn.13327. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the co-existing patterns of health-related behaviors among children and adolescents at different education stages and the association with obesity.

DESIGN: Cross-sectional study.

SAMPLE: A total of 5651 primary and secondary school students were drawn from the National Student Physical Health Survey in 2014 with an average age of 13.53 ± 2.87 years.

MEASUREMENTS: Physical measurements and questionnaires were completed, which concluded height, weight, and health-related behaviors (sleep, physical activity, dietary, and screen behavior et al.). Latent profile analysis (LPA) was conducted using Mplus 8.3 and SPSS 26.0 was used for other statistical analysis.

RESULTS: Three latent classes of health-related behaviors were fitted for each of the education stages. After adjustment for age, gender, and region, the high-screen behavior group were 2.217 (95%CI = 1.030-4.772, p = .042) times more likely to be obesity than the health-behavior group in primary school, and the poor-diet group and poor-diet and high-screen behavior group were 2.101 (95%CI = 1.396-3.396, p < .001) and 1.788 (95%CI = 1.003-3.190, p = .049) times more likely to be overweight than the health-behavior group in junior middle school respectively.

CONCLUSION: Obesity is mainly influenced by screen behavior and dietary patterns among children and adolescents. Health-related behavior patterns should be accurately identified and comprehensive joint interventions should be carried out to prevent obesity.

PMID:38602094 | DOI:10.1111/phn.13327

Cardiol Young. 2024 Apr 11:1-8. doi: 10.1017/S1047951124000532. Online ahead of print.

ABSTRACT

OBJECTIVES: Pulmonary valve-sparing repair of tetralogy of Fallot and double outlet right ventricle with pulmonary stenosis has the advantage of reduced incidence of late pulmonary valve regurgitation and better-preserved cardiac function. However, a right ventriculotomy is sometimes necessary in order to adequately relieve subvalvular pulmonary stenosis. We aimed to compare postoperative cardiac function and patients’ symptoms between pulmonary valve-sparing repair with and without right ventriculotomy.

MATERIALS AND METHODS: We retrospectively collected data from electronic medical records of Ramathibodi Hospital from 1^st January 2013 to 31^st October 2023. Patients diagnosed with tetralogy of Fallot and double outlet right ventricle with pulmonary stenosis who underwent pulmonary valve-sparing repair were included. Patients who underwent other types of repairs and whose medical record data were significantly missing were excluded. Demographic data, operative, and postoperative details were collected and reviewed.

RESULTS: There were 49 patients included in our study with 10 patients undergoing pulmonary valve-sparing repair with and the other 39 without right ventriculotomy. Before-discharge echocardiographic parameters were generally similar between both groups (tricuspid annular plane systolic excursion = 0.9 versus 0.89 cm, P = 0.737; pressure gradient across pulmonary valve across pulmonary valve = 24 versus 19 mmHg, P = 0.275; left ventricular end-systolic volume index = 17.84 versus 19.19 ml/m2, P = 0.437; left ventricular end-diastolic volume index = 63.79 versus 61.13 ml/m2, P = 0.436). Patients’ symptoms were also not statistically different. There was no early and late death up to the end date of our study.

CONCLUSIONS: Right ventriculotomy in pulmonary valve-sparing repair did not result in worse postoperative cardiac function and symptoms. This suggested that the previously thought-to-be hazardous incision could be strongly considered if mandated.

PMID:38602093 | DOI:10.1017/S1047951124000532

J Sports Med Phys Fitness. 2024 Apr 10. doi: 10.23736/S0022-4707.24.15691-5. Online ahead of print.

ABSTRACT

BACKGROUND: Jumping and linear sprinting performances show a moderate correlation with change of direction (COD) ability. However, the extent of these correlations remains unknown through statistical analysis. Thus, this study statistically compared correlation coefficients between COD, COD deficit (CODD), and jumping and linear sprint performances.

METHODS: National-level basketball (29) and baseball (18) intercollegiate female athletes performed 20-m linear sprint, proagility (5-10-5) test, squat jump (SJ), countermovement jump with (CMJarm) and without (CMJ) arm swing and modified reactive strength index (RSImod). Correlation analysis was used to assess factors correlated with COD performance and CODD; subsequently, correlation coefficient comparison test was used to determine better correlations with COD and CODD performance.

RESULTS: CMJ (r=-0.483) and CMJarm (r=-0.446) had stronger correlations with 10-m COD (both, P<0.018) than with 10-m linear sprint (r=0.431, P=0.002). For 20-m COD, RSImod, CMJ, and CMJarm (r=-0.491–0.543, P<0.001) better correlated with 20-m COD than with 20-m linear sprints (r=0.436, P=0.002), while RSI (both r=-0.317, P<0.030) and SJ (r=-0.359, r=-0.293, P=0.046) were weakly correlated with 10- and 20-m COD. The differences in correlation coefficients for RSImod, CMJ, and CMJarm were not significant in both 10- and 20-m COD. Ten-meter linear sprint performance only correlated with 10-m CODD, while no correlation was observed with 20-m CODD.

CONCLUSIONS: Stronger correlations of RSImod, CMJ, and CMJarm with 10-/20-m COD than with linear sprinting, RSI, and SJ suggest that training focused on improving countermovement and arm swings with jumping may enhance COD performance in female athletes.

PMID:38602034 | DOI:10.23736/S0022-4707.24.15691-5

Eur J Ophthalmol. 2024 Apr 11:11206721241247421. doi: 10.1177/11206721241247421. Online ahead of print.

ABSTRACT

PURPOSE: To compare non-syndromic and syndromic forms of USH2A-related retinitis pigmentosa (RP) by means of structural optical coherence tomography (OCT) and OCT-angiography (OCTA).

METHODS: Observational, cross-sectional, multicenter study. All patients underwent best corrected visual acuity (BCVA) measurement, OCT (Spectralis HRA + OCT, Heidelberg Engineering) and OCTA (OCT DRI Topcon Triton, Topcon Corporation). We compared subfoveal choroidal thickness (SCT), choroidal vascularity index (CVI), presence of cystroid macular edema (CME), macular vessel density (VD) at the superficial and deep capillary plexa, as well as VD of the radial peripapillary capillary (RPC) network, between syndromic and non-syndromic patients with USH2A-associated retinopathy.

RESULTS: Thirty-four eyes from 18 patients (7 females) were included. Thirteen patients (72.2%) were affected by Usher syndrome type 2, whereas the remaining 5 subjects (27.8%) had non-syndromic retinitis pigmentosa (nsRP). Syndromic patients were younger than nsRP (p = 0.01) and had a worse visual acuity than those with the exclusively retinal phenotype. Patients with Usher syndrome type 2 had a higher prevalence of CME and a thicker choroid compared to nsRP, although these results were not statistically significant (p = 0.775 and p = 0.122, respectively). Similarly, none of the other quantitative OCT and OCTA parameters was statistically different between the two groups.

CONCLUSIONS: Despite their younger age, patients with Usher syndrome type 2 displayed similar choroidal and microvascular changes compared to those with nsRP.

PMID:38602021 | DOI:10.1177/11206721241247421