Nevin Manimala

Rev Lat Am Enfermagem. 2022 Oct 7;30:e3648. doi: 10.1590/1518-8345.6106.3648. eCollection 2022.

ABSTRACT

OBJECTIVE: to assess the effectiveness of supplemental oxygenation with high FiO2 when compared to conventional FiO2 in the prevention of surgical site infection.

METHOD: an effectiveness systematic review with meta-analysis conducted in five international databases and portals. The research was guided by the following question: Which is the effectiveness of supplemental oxygenation with high FiO2 (greater than 80%) when compared to conventional FiO2 (from 30% to 35%) in the prevention of surgical site infections in adults?

RESULTS: fifteen randomized clinical trials were included. Although all the subgroups presented a general effect in favor of the intervention, colorectal surgeries had this relationship evidenced with statistical significance (I2=10%;X2=4.42; p=0.352).

CONCLUSION: inspired oxygen fractions greater than 80% during the perioperative period in colorectal surgeries have proved to be effective to prevent surgical site infections, reducing their incidence by up to 27% (p=0.006). It is suggested to conduct new studies in groups of patients subjected to surgeries from other specialties, such as cardiac and vascular. PROSPERO registration No.: 178,453.

PMID:36228236 | DOI:10.1590/1518-8345.6106.3648

Rev Lat Am Enfermagem. 2022 Oct 7;30:e3642. doi: 10.1590/1518-8345.6132.3642. eCollection 2022.

ABSTRACT

OBJECTIVE: to identify spatial clusters corresponding to abandonment of routine vaccines in children.

METHOD: an ecological study, according to data from the 853 municipalities of a Brazilian state. The records analyzed were those of the multidose pentavalent, pneumococcal 10-valent, inactivated poliomyelitis and oral human rotavirus vaccines of 781,489 children aged less than one year old. The spatial scan statistics was used to identify spatial clusters and assess the relative risk based on the vaccination abandonment indicator.

RESULTS: the spatial scan statistics detected the presence of statistically significant clusters for abandonment regarding the four vaccines in all the years analyzed. However, the highest number of clusters with high relative risk estimates was identified in 2020. The Vale do Aço and West, North and West, and Southwest regions stand out for the pentavalent, poliomyelitis and rotavirus vaccines, respectively.

CONCLUSION: in an attempt to mitigate the devastating impact of the COVID-19 pandemic, the immunization program experienced setbacks. The presence of clusters points to the need to implement integrated strategies that may involve different sectors for an active search for children and prevent outbreaks of vaccine-preventable diseases in the near future.

PMID:36228235 | DOI:10.1590/1518-8345.6132.3642

Rev Lat Am Enfermagem. 2022 Oct 7;30:e3636. doi: 10.1590/1518-8345.5866.3636. eCollection 2022.

ABSTRACT

OBJECTIVE: to analyze the association between resilience and occupational stress of Nursing professionals from a general hospital.

METHOD: an observational, cross-sectional study involving 321 Nursing professionals. The data collected were: socio-demographic and labour variables, stress and resilience, analyzed with descriptive and inferential statistics.

RESULTS: 54.5% of the participants presented moderate resilience and 36.4%, high; 73.5% were at risk of exposure to occupational stress; the relationship between psychological demands and professional category (p=0.009), between control over work and age (p=0.04), professional category (p<0.001), having a management position (p=0.009), being a specialist (p=0.006) and between social support and professional category (p<0.001), having a management position (p=0.03), daily working hours (p=0.03), being a specialist (p<0.001) were verified. There was an association between resilience Factor I – resolutions of actions and values and control over work (p=0.04) and social support (p=0.002).

CONCLUSION: the Nursing professionals of a general hospital have moderate to high resilience which, associated with high control over their work and high social support, may contribute to the reduction of exposure to occupational stress.

PMID:36228234 | DOI:10.1590/1518-8345.5866.3636

Braz Oral Res. 2022 Oct 10;36:e0123. doi: 10.1590/1807-3107bor-2022.vol36.0123. eCollection 2022.

ABSTRACT

The aim of this study was to determine the prevalence of dental trauma in schoolchildren 6 to 12 years of age and associated clinical, sociodemographic, and socioeconomic variables. A cross-sectional study was conducted in 477 children from public elementary schools in four locations in Mexico. The dependent variable was dental trauma, which was dichotomized in 0 = without dental trauma and 1 = with dental trauma. For the statistical analysis, a multivariate binary logistic regression model was generated in Stata. Average age was 9.06±1.94 years and 51.1% were girls. The prevalence of dental trauma was 18.2%. Falls, automobile accidents and sports had the highest number of instances (p < 0.01). In the multivariate model, it was observed that the risk of dental trauma increased with age (OR = 1.28) and among boys (OR = 1.45). Schoolchildren with decreased overjet (OR = 0.38) had lower dental trauma. Father’s age (OR = 1.03) and educational level (OR = 1.78) were associated with dental trauma. Schoolchildren without health insurance (OR = 0.62) presented dental trauma less often. This study provided important information regarding the association of different sociodemographic, socioeconomic and clinical variables with dental trauma in Mexican schoolchildren. Identifying factors associated with dental trauma may support health promotion opportunities to ameliorate the prevalence of dental trauma.

PMID:36228222 | DOI:10.1590/1807-3107bor-2022.vol36.0123

Braz Oral Res. 2022 Oct 10;36:e0122. doi: 10.1590/1807-3107bor-2022.vol36.0122. eCollection 2022.

ABSTRACT

Social determinants of health (SDH) are strongly associated with oral health outcomes, and oral health literacy (OHL) is a potential factor that can modify this association. This study evaluated the association between SDH and OHL, including functional and interactive dimensions of OHL. The cross sectional study was conducted with 354 adults recruited from public dental clinics in southern Brazil. Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14), for the evaluation of interactional OHL. SDH was evaluated through a structured questionnaire, and economic class was determined based on the Brazilian Economic Classification Criteria. The statistical analysis involved bivariate and multivariate Poisson regression with robust variance (α=0.05) to estimate rate ratios (RR) and 95% confidence intervals (CI). Among the 354 participants, 284 (80.2%) were women and the mean age was 22.9 ± 4.9 years. The median BREALD-30 score was 24 (1st/3rd quintile: 20/27) and the median HeLD-14 score was 45 (1st/3rd quintile: 37/50). Most participants had up to eight years of schooling (71.5%) and belonged to the “C” Economic Class or lower (94.1%). The multiple regression analysis showed that schooling and economic class were associated with the BREALD-30 and HeLD-14 scores, income and age were associated with the HeLD-14 score, and marital status and occupation were associated with the BREALD-30 score. Different dimensions of OHL were associated with SDH in Brazilian adults. This aspect should be incorporated into strategies for improving OHL levels in individuals or populations.

PMID:36228221 | DOI:10.1590/1807-3107bor-2022.vol36.0122

Rev Col Bras Cir. 2022 Oct 7;49:e20223303. doi: 10.1590/0100-6991e-20223303-en. eCollection 2022.

ABSTRACT

OBJECTIVE: we intend to demonstrate the clinical alterations and the postoperative evolution in patients with acute abdomen non-traumatic in conservative or surgical treatment during the pandemic compared to a similar period in the last year.

METHOD: a single-center retrospective study, including patients who received clinical-surgical treatment at Hospital do Trabalhador diagnosed with acute abdomen between March and August 2020 and a similar period in 2019.Variables studied ranged from demographic data to indices of social isolation.

RESULTS: 515 patients were included, 291 received treatment in a pre-pandemic period and 224 during. There was not statistical difference in relation to comorbidities (p=0.0685), time to diagnosis and seeking medical help. No statistical differences were observed in terms of days of hospitalization (p = 0.4738) and ICU need (p=0.2320). Regarding in-hospital deaths, there was statistical relevance in the age above 60 years (p=0.002) and there were more deaths during the pandemic period (p=0.032). However, when we analyze the factors associated with the number of days until diagnosis by a physician, there was no statistical difference.

CONCLUSION: the analyzed data showed that the pandemic period and age over 60 years were the variables that increased the odds ratio for the in-hospital death outcome. However, the length of stay, days in intensive care unit and postoperative surgical complications showed no significant difference.

PMID:36228198 | DOI:10.1590/0100-6991e-20223303-en

J Clin Oncol. 2022 Oct 13:JCO2201258. doi: 10.1200/JCO.22.01258. Online ahead of print.

ABSTRACT

PURPOSE: Primary prophylactic colony-stimulating factors (PP-CSFs) are prescribed to reduce febrile neutropenia (FN) but their benefit for intermediate FN risk regimens is uncertain. Within a pragmatic, randomized trial of a standing order entry (SOE) PP-CSF intervention, we conducted a substudy to evaluate the effectiveness of SOE for patients receiving intermediate-risk regimens.

METHODS: TrACER was a cluster randomized trial where practices were randomized to usual care or a guideline-based SOE intervention. In the primary study, sites were randomized 3:1 to SOE of automated PP-CSF orders for high FN risk regimens and alerts against PP-CSF use for low-risk regimens versus usual care. A secondary 1:1 randomization assigned 24 intervention sites to either SOE to prescribe or an alert to not prescribe PP-CSF for intermediate-risk regimens. Clinicians were allowed to over-ride the SOE. Patients with breast, colorectal, or non-small-cell lung cancer were enrolled. Mixed-effect logistic regression models were used to test differences between randomized sites.

RESULTS: Between January 2016 and April 2020, 846 eligible patients receiving intermediate-risk regimens were registered to either SOE to prescribe (12 sites: n = 542) or an alert to not prescribe PP-CSF (12 sites: n = 304). Rates of PP-CSF use were higher among sites randomized to SOE (37.1% v 9.9%, odds ratio, 5.91; 95% CI, 1.77 to 19.70; P = .0038). Rates of FN were low and identical between arms (3.7% v 3.7%).

CONCLUSION: Although implementation of a SOE intervention for PP-CSF significantly increased PP-CSF use among patients receiving first-line intermediate-risk regimens, FN rates were low and did not differ between arms. Although this guideline-informed SOE influenced prescribing, the results suggest that neither SOE nor PP-CSF provides sufficient benefit to justify their use for all patients receiving first-line intermediate-risk regimens.

PMID:36228177 | DOI:10.1200/JCO.22.01258

Cancer. 2022 Nov 1;128(21):3754. doi: 10.1002/cncr.34499.

NO ABSTRACT

PMID:36228160 | DOI:10.1002/cncr.34499

Retina. 2022 Oct 10. doi: 10.1097/IAE.0000000000003641. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine the ophthalmological involvement in patients with hereditary transthyretin (TTR) amyloidosis and its correlation with the mutations described in the literature.

METHODS: Cross-sectional, non-interventional study. 52 eyes of 26 consecutive patients diagnosed of hereditary TTR amyloidosis that visited Puerta de Hierro-Majadahonda University Hospital from September 2019 to March 2022. All patients underwent complete ophthalmologic examination and multimodal imaging. Cardiological, neurological, digestive and renal examinations were also recorded.

RESULTS: 18 eyes out of the total (34.61%) showed amyloid-related ocular involvement, being vitreous amyloid deposits (AD) the most common ocular manifestation (18/52). Statistically significant differences were found for the presence of vitreous AD (p<0.01), crystalline AD (p<0.05), parenchymal AD (p<0.01) and vascular alterations (p<0.01) when comparing affected and unaffected eyes. Moreover, affected eyes showed worse best corrected visual acuity (p<0.01).

CONCLUSION: Ocular manifestations are present in a substantial number of patients with ATTR that could potentially lead to devastating consequences to patients’ BCVA and quality of life. Therefore, it is important to emphasize the importance of multidisciplinary management and ophthalmological assessment, follow-up and surgical treatment when necessary. To the best of our knowledge, this represents the largest series in Spain of amyloidosis’ ophthalmologic involvement.

PMID:36228151 | DOI:10.1097/IAE.0000000000003641

J Clin Endocrinol Metab. 2022 Oct 14:dgac599. doi: 10.1210/clinem/dgac599. Online ahead of print.

ABSTRACT

CONTEXT/OBJECTIVE: To evaluate association of gestational weight gain (GWG) as low, within, or above (excessive) according to Institute of Medicine (IOM) guidelines, with pregnancy outcomes in women with gestational diabetes (GDM) and normal glucose tolerance (NGT).

DESIGN: Prospective cohort study.

SETTING: 7 Belgian hospitals.

PARTICIPANTS: 1843 women receiving universal GDM screening with 75 g oral glucose tolerance test.

MAIN OUTCOME MEASURE: Pregnancy outcomes and postpartum characteristics.

RESULTS: Women with GDM and low GWG (n = 97, 52.4%) had similar rates of small-for-gestational age infants and preterm delivery, were less often overweight or obese postpartum [35.7% (30) vs. 56.5% (26), p < 0.022] and had less often postpartum weight retention (PPWR) [48.8% (41) vs. 87.9% (40), p < 0.001] compared to GWG within range (n = 58, 31.3%). GDM with excessive GWG (n = 30, 16.2%) had more often neonatal hypoglycemia [30.8% (8) vs. 5.9% (3), aOR 7.15, 95% CI (1.52-33.63), p = 0.013] compared to GWG within range. NGT with excessive GWG [28.3% (383)] had more often instrumental delivery [15.9% (61) vs. 11.9% (64), aOR 1.53, 95% CI (1.03-2.27), p = 0.035] and more large-for-gestational age infants [19.3% (74) vs. 10.4% (56), aOR 1.67, 95% CI (1.13-2.47), p = 0.012] compared to GWG within range.

CONCLUSIONS: GWG below IOM guidelines occurred frequently in GDM women, without increased risk for adverse pregnancy outcomes and with better metabolic profile postpartum. Excessive GWG was associated with increased risk for neonatal hypoglycemia and worse metabolic profile postpartum in women with GDM, and with higher rates of LGA and instrumental delivery in NGT women.

PMID:36228141 | DOI:10.1210/clinem/dgac599