Nevin Manimala

Cardiovasc Intervent Radiol. 2022 Jan 1. doi: 10.1007/s00270-021-03023-9. Online ahead of print.

ABSTRACT

PURPOSE: To compare the safety and efficacy of left versus right internal jugular vein access for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with a small liver and short vertical puncture distance.

MATERIALS AND METHODS: The vertical distance from the hepatic vein orifice to the puncture point of the portal vein was measured by CT and DSA. A distance ≤ 30 mm is defined as a short vertical puncture distance. After 1:1 propensity score matching (PSM), 29 patients of left internal jugular vein-TIPS (LIJ-TIPS) and 29 patients of right internal jugular vein-TIPS (RIJ-TIPS) were included. The number of needle punctures, fluoroscopy time, and radiation dose during the puncture process were statistically analyzed.

RESULTS: There was no significant difference in the average vertical puncture distances on CT or DSA between LIJ-TIPS and RIJ-TIPS (19.10 ± 0.60 mm vs. 19.30 ± 0.60 mm, P = 0.840; 22.02 ± 0.69 mm vs. 22.23 ± 0.64 mm, P = 0.822, respectively). The average number of needle punctures, fluoroscopy time, and radiation dose in LIJ-TIPS were significantly lower than those in RIJ-TIPS (2.07 ± 0.20 vs. 4.10 ± 0.24, P < 0.001; 78.45 ± 12.80 s vs. 201.16 ± 23.71 s, P < 0.001; 31.55 ± 7.04 mGy vs. 136.69 ± 16.38 mGy, P < 0.001, respectively). Within three punctures, the technical success rate in LIJ-TIPS was significantly higher than that in RIJ-TIPS (86.2 vs. 27.6%, P < 0.001). The incidence of hemoperitoneum in LIJ-TIPS was significantly lower than that in RIJ-TIPS (0% vs. 13.8%, P = 0.038).

CONCLUSION: The left internal jugular vein could be used as primary access for TIPS creation in patients with a small liver and short vertical puncture distance.

PMID:34973068 | DOI:10.1007/s00270-021-03023-9

Eur J Nutr. 2022 Jan 1. doi: 10.1007/s00394-021-02757-z. Online ahead of print.

ABSTRACT

PURPOSE: In the Netherlands, margarines and other plant-based fats (fortified fats) are encouraged to be fortified with vitamin A and D, by a covenant between the Ministry of Health and food manufacturers. Frequently, these types of fats are also voluntarily fortified with other micronutrients. The current study investigated the contribution of both encouraged as well as voluntary fortification of fortified fats on the micronutrient intakes in the Netherlands.

METHODS: Data of the Dutch National Food Consumption Survey (2012-2016; N = 4, 314; 1-79 year.) and the Dutch Food Composition Database (NEVO version 2016) were used to estimate micronutrient intakes. Statistical Program to Assess Dietary Exposure (SPADE) was used to calculate habitual intakes and compared to dietary reference values, separate for users and non-users of fortified fats.

RESULTS: Of the Dutch population, 84% could be considered as user of fortified fats. Users consumed mostly 1 fortified fat a day, and these fats contributed especially to the total micronutrient intake of the encouraged fortified micronutrients (vitamins D and A; 44% and 29%, respectively). The voluntary fortification also contributed to total micronutrient intakes: between 7 and 32%. Vitamin D and A intakes were up to almost double among users compared to non-users. Intakes were higher among users for almost all micronutrients voluntarily added to fats. Higher habitual intakes resulted into higher risks of excessive vitamin A-intakes among boys and adult women users.

CONCLUSION: Consumption of fortified fats in the Netherlands resulted into higher vitamin A and D-intakes among users, compared to non-users of these products.

PMID:34973067 | DOI:10.1007/s00394-021-02757-z

Eur J Nutr. 2022 Jan 1. doi: 10.1007/s00394-021-02728-4. Online ahead of print.

ABSTRACT

PURPOSE: In the Netherlands, voluntary fortification of foods with micronutrients is allowed under strict regulations. This study investigates the impact of voluntary food fortification practices in the Netherlands on the frequency and type of fortified food consumption and on the micronutrient intakes of the Dutch population.

METHODS: Data of the Dutch National Food Consumption Survey (2012-2016; N = 4314; 1-79 year) and the Dutch Food Composition Database (NEVO version 2016) was used. To determine if voluntary fortified foods could be classified as healthy foods, criteria of the Dutch Wheel of Five were used. Habitual intakes of users and non-users of voluntary food fortification were calculated using Statistical Program to Assess Dietary Exposure (SPADE) and compared.

RESULTS: Within the Dutch population, 75% could be classified as user of voluntary fortified foods. Consumed voluntary fortified foods were mostly within food groups ‘Fats and Oils’, ‘Non-alcoholic Beverages’ and ‘Dairy products and Substitutes’ and fell mostly outside the Wheel of Five. Voluntary foods contributed between 9 and 78% to total micronutrient intake of users. Users had up to 64% higher habitual micronutrient intakes, compared to non-users. These higher intakes resulted into lower risks on inadequate intakes, and did not contribute to increased risks of excessive intakes.

CONCLUSION: Although voluntary fortified foods increased micronutrient intakes, most of these foods cannot be classified as healthy foods. Future studies should study the association between higher micronutrient intakes and (potential) excessive intakes of e.g. saturated fat and sugar to better understand the role of voluntary fortified foods in a healthy food pattern.

PMID:34973066 | DOI:10.1007/s00394-021-02728-4

J Trauma Stress. 2021 Dec 31. doi: 10.1002/jts.22771. Online ahead of print.

ABSTRACT

The Clinician-Administered PTSD Scale (CAPS) is used to measure posttraumatic stress symptoms (PTSS) and diagnose posttraumatic stress disorder (PTSD). However, its use, particularly in settings involving longitudinal assessment, has been complicated by changes in the diagnostic criteria between the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-IV and DSM-5, respectively). The current sample included trauma-exposed U.S. veterans who were deployed in support of military operations following the September 11, 2001, terrorist attacks (N = 371) and were enrolled in a longitudinal study focused on deployment-related stress and traumatic brain injury. A hybrid clinical interview using item wording from the CAPS for DSM-IV (CAPS-IV) with the addition of items unique to the CAPS for DSM-5 (CAPS-5) was used to assess both DSM-IV and DSM-5 PTSD diagnostic criteria, allowing for the calculation of separate total scores and diagnoses. Diagnostic agreement, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and interrater reliability between CAPS-IV and CAPS-5 were evaluated for the entire sample and stratified by gender. We found high diagnostic agreement (92.9%-95.4%), sensitivity (94.4%-98.2%), specificity (91.7%-92.8%), PPV (89.5%-93.0%), NPV (95.7%-98.1%), and interrater reliability,κ = 0.86-0.91,) for both men and women. The current study supports the use of a hybrid PTSD diagnostic interview assessing both DSM-IV and DSM-5 diagnostic criteria, particularly in situations such as longitudinal studies that may require a feasible method of incorporating changes in diagnostic criteria from the DSM-IV to the DSM-5.

PMID:34973042 | DOI:10.1002/jts.22771

J Trauma Stress. 2021 Dec 31. doi: 10.1002/jts.22762. Online ahead of print.

ABSTRACT

Posttraumatic negative thoughts about one’s self and the world are related to posttraumatic stress disorder (PTSD) symptom severity and change in cognitive behavioral treatment (CBT), but little is known about this association when CBT is delivered with medication. The current study presents a planned comparison of changes in negative posttraumatic thoughts during (a) prolonged exposure (PE) plus pill placebo (PE+PLB), (b) sertraline plus enhanced medication management (SERT+EMM), and (c) PE plus sertraline (PE+SERT) as part of a randomized clinical trial in a sample of 176 veterans. Lagged regression modeling revealed that change in posttraumatic negative thoughts was associated with PTSD symptom change in the conditions in which participants received sertraline, ds = 0.14-0.25, ps = 0.04-.001). However, contrary to previous research, the models that started with symptom change were also statistically significant, d = 0.23, p < .001, for the lagged effect of symptoms on negative thoughts about self in the SERT+EMM condition, indicating a bidirectional association between such thoughts and PTSD symptoms. In the PE+PLB condition, no significant association between posttraumatic thoughts and PTSD symptoms emerged in either direction. These results suggest that the previously demonstrated role of change in posttraumatic thoughts leading to PTSD symptom reduction in PE may be altered when combined with pill administration, either active or placebo.

PMID:34973039 | DOI:10.1002/jts.22762

Perspect Psychiatr Care. 2021 Dec 31. doi: 10.1111/ppc.13011. Online ahead of print.

ABSTRACT

AIM: This study was carried out to investigate the internalized stigma and recovery levels of patients registered in a Community Mental Health Center (CMHC).

MATERIAL AND METHODS: This descriptive study was completed with 230 psychiatric patients to a registered Community Mental Health Center is located in Turkey. Data were collected using a sociodemographic characteristics’ form, the Internalized Stigma of Mental Illness Scale (ISMI), and the Maryland Assessment of Recovery in Serious Mental Illness (MARS).

RESULTS: A statistically significant negative relationship was found between total ISMI and MARS scores (p < 0.05).

CONCLUSION: The internalized stigma and recovery levels of individuals diagnosed with mental illness registered at the CMHC were found to be normal.

PMID:34973035 | DOI:10.1111/ppc.13011

Adv Exp Med Biol. 2021;1337:371-378. doi: 10.1007/978-3-030-78771-4_42.

ABSTRACT

Vitamin D deficiency due to inadequate sun exposure and/or inadequate intake from food is very common worldwide, consisting a major public health problem. As prolonged exposure to ultraviolet radiation involves risks, food fortification of staple foods emerges as a favorable solution for addressing vitamin D deficiency. Bread is a suitable candidate for fortification as it is consumed often and is the main carbohydrate source in European countries.The purpose of this study was the evaluation of the bioavailability of vitamin D from a fortified Greek-type bread that was developed as a means for addressing vitamin D deficiency, by comparing the absorption curve of vitamin D in fortified bread in relation to that of plain vitamin supplementation. Two groups of clinically healthy volunteers consumed 25,000 international units (IU) of vitamin D₃ (cholecalciferol) either in fortified bread (Group A) or in a plain supplement form (Group B). The baseline plasma concentrations of cholecalciferol were 8.1 ± 6.0 ng/mL and 6.8 ± 3.4 ng/mL in Groups A and B, respectively. After 12, 24, and 48 h, the concentrations of cholecalciferol in Group A were 16.7 ± 4.8, 15.3 ± 8.3 and 11.9 ± 6.0 ng/mL, respectively, and in Group B, 15.2 ± 3.3, 11.6 ± 2.4, and 9.6 ± 3.6 ng/mL, respectively. In both groups, the concentrations of cholecalciferol at 12 and 24 h were significantly higher than the baseline concentrations (p < 0.01). There were no statistically significant differences between the concentrations of cholecalciferol between Groups A and B, at each time point.Cholecalciferol is bioavailable from Greek-type fortified bread and bread could be used for addressing vitamin D deficiency.

PMID:34972926 | DOI:10.1007/978-3-030-78771-4_42

Adv Exp Med Biol. 2021;1337:291-297. doi: 10.1007/978-3-030-78771-4_32.

ABSTRACT

Continued development in the field of cardiovascular modeling over the past few years has contributed to the production of precise three-dimensional models of main coronary arteries. Computational fluid dynamic-derived parameters such as smartFFR, a CT-FFR surrogate, and endothelial shear stress (ESS) can be assessed from non-invasive imaging techniques like computed tomography coronary angiography using novel 3D reconstruction methods and can be used to investigate the functional significance of an artery. The investigation of the different flow conditions for the calculation (steady state vs. transient) of the ESS presents that while there is a difference in the final values, it is not statistically significant. ESS in the whole vessel is higher compared to the lesion-specific segments and smartFFR calculated in lesion segment does not reflect accurately the flow capability of the vessel. Higher ESS is present in vessels with <0.85 smartFFR and both parameters are present higher values in vessels with abnormal PET myocardial perfusion imaging.

PMID:34972916 | DOI:10.1007/978-3-030-78771-4_32

Adv Exp Med Biol. 2021;1337:259-272. doi: 10.1007/978-3-030-78771-4_29.

ABSTRACT

The aim of this study was to investigate the effect of patients’ knowledge on adherence to the hemodialysis regimen and Quality of Life (QoL) of patients undergoing hemodialysis as well as the effect of adherence on QoL. Also, the effect of demographic and clinical characteristics on the above three variables was studied. In this cross-sectional study conducted between March and May 2017, 321 patients on hemodialysis from six hemodialysis units completed the Kidney Disease Questionnaire, the GR-Simplified Medication Adherence Questionnaire and the Missoula Vitas Quality of Life Index-15 to measure the patient knowledge, the adherence to hemodialysis regimen, and the QoL, respectively. The statistical analysis was performed via the Statistical Program SPSS 19.0. The statistical significance level was set up at 0.05. The knowledge was independently associated with the overall QoL and its dimension-transcendence-with total adherence and its dimension-diet/fluid adherence. The total adherence was independently associated with overall QoL and its dimensions-symptoms and interpersonal. The educational level, the type of vascular access, and the daily number of pills were independently associated with the total adherence and the overall QoL. Patient knowledge may have an important effect on adherence and QoL. Adherence may have an important effect on QoL. Demographic and clinical characteristics play, also, a crucial role in the above variables. The findings can help nephrology nurses to quantify the extent of non-adherence in hemodialysis and poor quality of life.

PMID:34972913 | DOI:10.1007/978-3-030-78771-4_29

Adv Exp Med Biol. 2021;1337:245-258. doi: 10.1007/978-3-030-78771-4_28.

ABSTRACT

INTRODUCTION: Approach to hemodialysis care from a gender perspective has received a great deal of attention globally since two sexes may have different experiences and manifestations of the same disease.

PURPOSE: To explore sex differences in anxiety and depression among hemodialysis patients.

METHOD AND MATERIAL: In the study were enrolled 200 patients (100 men and 100 women) who underwent hemodialysis. Data were collected by the completion of “The Hospital Anxiety and Depression Scale (HADS)” which included patients’ self-reported characteristics. The statistical significance level was p < 0.05.

RESULTS: In men and women, anxiety was statistically significantly associated with relations with nurses (p = 0.033 and p = 0.001, respectively), concealment of hemodialysis (p = 0.013 and p = 0.001, respectively), and insomnia (p = 0.001 and p = 0.001, respectively). Only in women, anxiety was statistically significantly associated with years under hemodialysis (p = 0.002), relation with doctors (p = 0.001), and their belief that life had changed (p = 0.002), whereas only in men, anxiety was associated with help in daily activities (p = 0.001). In men and women, depression was statistically significantly associated with relations with nurses (p = 0.002 and p = 0.001, respectively) and dependency on health professionals (p = 0.001 and p = 0.002, respectively). Only in women, depression was statistically significantly associated with years under hemodialysis (p = 0.002), level of information (p = 0.022), relations with doctors (p = 0.001), concealment of hemodialysis (p = 0.001), their belief that life had changed (p = 0.001), and insomnia (p = 0.001).

CONCLUSIONS: The development of an effective treatment that may alleviate anxiety and depression needs to capture how patients perceive and respond to hemodialysis.

PMID:34972912 | DOI:10.1007/978-3-030-78771-4_28