Nevin Manimala

Nurse Educ Pract. 2021 Jun 28;54:103130. doi: 10.1016/j.nepr.2021.103130. Online ahead of print.

ABSTRACT

AIM: To investigate medical and nursing students’ education on hand hygiene, their attitude on hand hygiene education and how this education influences their hand hygiene knowledge and practices.

BACKGROUND: Hospital-acquired infections are associated with prolonged hospitalisation and mortality. The most effective measure for their control is healthcare workers’ hand hygiene compliance. Since medical and nursing students constitute the future healthcare workers, our study focuses on them.

DESIGN: Cross-sectional study METHODS: This study was conducted during the academic year 2016-2017, using a modified World Health Organisation questionnaire. Our sample consisted of 132 medical and 111 nursing students from National and Kapodistrian University of Athens, Greece. In data analysis, the Mann-Whitney and Fisher’s exact tests were applied to compare differences in continuous variables and proportions in categorical variables, respectively. Knowledge and practices overall scores were calculated per student group. Multiple linear regression analyses were performed to assess the influence of potential confounders on these scores.

RESULTS: We found that 73.1% of medical and 98.2% of nursing students had received relevant education, which was reported as “only theoretical” by 77.4% of the former and as “hands-on and theoretical” by 88.1% of the latter group. Besides the risk of infection, knowledge acquired in lectures and trainer’s behaviour were also considered very influential factors shaping hand hygiene attitude in both groups. Overall, medical students reported better hand hygiene practices than nursing ones (69.9% and 59.7%, respectively; p < 0.001). The opposite finding was observed regarding their overall knowledge on hand hygiene (57.2% of medical versus 60.4% of nursing students, p = 0.04). The majority of students (86.6% of all participants; p < 0.001) supported the inclusion of compulsory hand hygiene education in their curriculum. Compulsory education and seminars were assessed as the most effective measures to increase hand hygiene compliance (71.4% of all students).

CONCLUSION: In our study, medical students scored better in practices questions than nursing students; this did not apply for the knowledge score. The majority of students supported the inclusion of compulsory education on hand hygiene principles in their Departments’ curricula, highlighting compulsory education and seminars as the most effective measures to increase compliance with hand hygiene.

PMID:34246184 | DOI:10.1016/j.nepr.2021.103130

Pregnancy Hypertens. 2021 Jul 1;25:204-212. doi: 10.1016/j.preghy.2021.06.011. Online ahead of print.

ABSTRACT

BACKGROUND: In 2017, the American College of Cardiology/ American Heart Association (ACC/AHA) guidelines redefined the threshold of high blood pressure (BP) for non-pregnant adults. Several studies aimed to determine whether lowering these thresholds should be considered for pregnancies to prevent poor neonatal outcomes, but the results were inconclusive.

METHODS: We perform a systematic review and meta-analysis to evaluate the association between BP groups defined by the 2017 ACC/AHA guidelines and pregnancy outcomes. Relevant literature was searched in PubMed, Google Scholar, Embase, and Web of Science up to 18 May 2021.

RESULTS: Sixteen eligible studies from twelve articles with a total of 303,131 pregnancies were identified, encompassing 233,084, 20,859, 39,379 individuals with normal BP, elevated BP, and stage 1 hypertension, respectively. When compared with normal BP, the combined odds ratio (95% confidence interval) of elevated BP for adverse pregnancy outcomes was not significant; whereas, that of stage 1 hypertension were 1.25 (1.13-1.39), 1.16 (1.03-1.31), 1.50 (1.28-1.77) and 1.12 (1.00-1.25) for preterm delivery, small for gestational age, low birth weight, and early-term delivery, respectively.

CONCLUSION: Our results indicated that stage 1 hypertension increased the risk of poor neonatal outcomes, highlighting the importance of recognition of stage 1 hypertension as a risk indicator for poor pregnancy outcomes.

PMID:34246173 | DOI:10.1016/j.preghy.2021.06.011

J Chromatogr B Analyt Technol Biomed Life Sci. 2021 Jul 2;1179:122844. doi: 10.1016/j.jchromb.2021.122844. Online ahead of print.

ABSTRACT

Hepatolenticular degeneration (HLD) is an inherited disorder associated with human copper metabolism. Gandou decoction (GDD), a traditional Chinese medicinal formula, has been used as a therapeutic agent for the treatment of HLD in China for decades. Recent pharmacological evaluation in our laboratory has demonstrated that GDD exerts positive and beneficial effects on HLD model rats. However, its underlying therapeutic mechanisms are not yet well understood. To explore the potential therapeutic effects of GDD against HLD, liver and urine metabolomics approach combined with histopathological examination were performed to reveal the underlying mechanisms. Changes in metabolic profiles were estimated by ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) coupled with multivariate statistical analyses. The results indicated that GDD could significantly improve liver pathological variations. Moreover, 19 and 11 significantly altered metabolites were found in the liver and urine between the normal and model groups, respectively. After GDD treatment, the levels of all these disordered metabolites showed different degrees of improvement compared with the model group, including lysoPC(18:2), lysoPE(20:2/0:0), PC(18:1/14:1), alpha-linolenic acid, sphinganine, taurochenodesoxycholic acid, tetracosahexaenoic acid, 13-OxoODE, and 13-L-hydroperoxyl inoleic acid. Metabolic pathway enrichment suggested that lipid and oxidative stress metabolism were the two main pathways that participated in copper-laden rat models with GDD administration. This work indicates that GDD could achieve a therapeutic effect on HLD by ameliorating the associated metabolic disturbances.

PMID:34246170 | DOI:10.1016/j.jchromb.2021.122844

Appl Radiat Isot. 2021 Jul 3;176:109855. doi: 10.1016/j.apradiso.2021.109855. Online ahead of print.

ABSTRACT

Activity concentration (AC) in foods produced and commonly consumed in a High Background Radiation Area (HBRA) was analyzed. The AC were obtained by spectrophotometry and by the radiochemical separation method. The AC were up to 10⁴ times higher than the AC for both UNSCEAR suggested values and non-HBRA. It was noted that the lifetime cancer risk was increased in 4 decimal places, taking the risk from the “statistically negligible range” (<10^-6) to “middle range” (between 10^-4 and 10^-6).

PMID:34246164 | DOI:10.1016/j.apradiso.2021.109855

Food Chem. 2021 Jun 30;365:130500. doi: 10.1016/j.foodchem.2021.130500. Online ahead of print.

ABSTRACT

There is a growing interest in exploiting Antarctic fisheries for human consumption. However, information on how the nutritional qualities of these resources will respond to the predicted seawater warming in the region for the next century is poor. The present research investigates changes in various nutritional indices of dietary importance (e.g. the ratio polyunsaturated to saturated fatty acids, the atherogenicity index, the thrombogenicity index, the hypo-cholesterolemic to hyper-cholesterolemic index, the health-promoting index, the flesh lipid quality and the ratio omega-3 to omega-6 index) by determining the fatty acid composition in muscle of Trematomus bernacchii (an Antarctic fish species) in its natural habitat (-1.87 °C) and warmer temperatures (0.0, 1.0, 2.0 °C). Comparison of the estimated nutritional indices at -1.87 °C with those at warmer temperatures revealed that seawater warming caused changes in the nutritional indices in the range of -12%<Δ < 30%. The observed changes were not statistically significant and ascribed to biological variability. Therefore, the nutritional values of T. bernacchii muscle were preserved after increasing the temperature of its natural habitat by + 4 °C. The present research is the first report describing the nutritional quality indices for an Antarctic fish species and the consequences of seawater warming on the nutritional value of T. bernacchii.

PMID:34246152 | DOI:10.1016/j.foodchem.2021.130500

Complement Ther Clin Pract. 2021 Jul 5;44:101439. doi: 10.1016/j.ctcp.2021.101439. Online ahead of print.

ABSTRACT

INTRODUCTION: Active treatments focused on improvement in motor function are postulated in chronic low back patients (CLBP).

OBJECTIVE: to establish the acute effects of PNF exercise on the postural control strategy.

METHODS: The sway of the body was tested before intervention in fifty-three CLBP patients and after that participants were randomly assigned into the intervention PNF group (n = 25). Mean velocity (VEL) and sample entropy (SEn), over the center of pressure in the mediolateral (ML) and anterior-posterior (AP) planes served to estimate the postural strategy and automaticity levels in the neuromuscular controller. Tandem and one-leg standing tests (OLST) with eyes open and eyes closed were used.

RESULTS: Pain intensity decreased after the intervention. The VEL was no longer vision-dependent in both planes. The SEn decreased immediately after the exercise and either returned to or even exceeded the baseline values in the OLST ML plane.

CONCLUSION: A single session of PNF exercise may have a beneficial effect on pain and postural control in CLBP patients. The statistically significant pain relief combined with newly acquired better control of posture may have encouraged the PNF group participants to a subconscious exploration of the stability area. Postural movements were more automatized in OLST in the delayed test.

PMID:34246129 | DOI:10.1016/j.ctcp.2021.101439

Epilepsy Res. 2021 Jun 30;176:106706. doi: 10.1016/j.eplepsyres.2021.106706. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to evaluate seizure outcomes and postoperative neurologic complications, with an emphasis on the recovery period of activities of daily living (ADL) between anterior partial corpus callosotomy (ACC) and total corpus callosotomy (TCC) in adolescent and young adults with drop attacks and severe mental retardation.

METHODS: We retrospectively reviewed the clinical records of consecutive patients with intractable epilepsy who underwent corpus callosotomy (CC) for drop attacks between 2010 and 2019 in the Department of Neurosurgery, Hiroshima University hospital, with a minimum follow-up of one year. Inclusion criteria of this study were 1) age at surgery: 11-39 years, 2) preoperative intelligence quotient <35, and 3) preoperative Barthel index (BI) ≥30. Postoperative full ADL recovery was defined as complete recovery to the preoperative BI score. We compared the postoperative days required for 1) recovery of oral intake ability, 2) discharge from our hospital, 3) returning home from any hospital, 4) returning home with full ADL recovery, and 5) seizure outcomes in patients with ACC versus those with one-stage TCC.

RESULTS: Ten patients with ACC and 14 patients with one-stage TCC met the inclusion criteria. The period for returning home with full ADL recovery was a median of 15 days (range 9-45 days) after ACC, while the median was 21.5 days (range 10-62 days) after one-stage TCC (p = 0.2904). Although there was a tendency for the ADL recovery period to be longer after one-stage TCC, there were no statistically significant differences in any category of ADL recovery period. Eleven of 14 (78.6 %) patients who received a one-stage TCC showed favorable seizure outcomes, with drop attack cessation, which was significantly better than 1 of 10 (10 %) patients with ACC (p = 0.0009).

CONCLUSIONS: From the viewpoint of postoperative seizure outcomes and ADL recovery period, one-stage TCC is preferred to ACC for adolescent and young adults with severe mental retardation.

PMID:34246117 | DOI:10.1016/j.eplepsyres.2021.106706

Public Health. 2021 Jul 7;196:179-185. doi: 10.1016/j.puhe.2021.05.015. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of the study was to explore the association between adherence to antihypertensive medications (AHMs) and the risk of recurrence of cardiovascular disease (CVD) events in patients with a history of CVD events from cohort studies.

STUDY DESIGN: This is a dose-response meta-analysis.

METHODS: PubMed and Embase databases were searched up to March 4, 2021, to identify English-language reports of cohort studies that assessed the association of AHM adherence with risk of recurrence of CVD events. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated by using a fixed- or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear association.

RESULTS: We included nine cohort studies (54,349 patients) in the present meta-analysis. The pooled RR of CVD events was 0.66 (95% CI, 0.54-0.78) for the highest versus lowest AHM adherence category. We did not find any evidence of non-linearity association between AHM adherence and risk of CVD events (P_{non-linearity} = 0.534); for patients with a history of CVD events, the risk of CVD events was reduced by 9% for each 20% increase in AHM adherence (RR, 0.91; 95% CI, 0.85-0.97). The results of sensitivity analysis and subgroup analysis were virtually unchanged.

CONCLUSIONS: The high level of adherence to AHM is an effective strategy for preventing recurrence of CVD events. Patients with a history of CVD events should adhere to AHM.

PMID:34246104 | DOI:10.1016/j.puhe.2021.05.015

Chemosphere. 2021 Jul 6;285:131441. doi: 10.1016/j.chemosphere.2021.131441. Online ahead of print.

ABSTRACT

The Canary Islands are home to many cetacean species, many of which are resident species. The present work aims to analyze, for the first time to the best of the authors’ knowledge, the macronutrients, micronutrients and trace elements and toxic heavy metals in muscle and liver tissue of six species of stranded cetaceans in the Canary Islands. The study species were: Tursiops truncatus, Stenella frontalis, Delphinus delphis, Grampus griseus, Globicephala macrorynchus and Physeter macrocephalus. Statistical analysis studied the significant differences between the concentrations in muscle and liver tissues, with the differences in element content depending on the type of diving and length of the species. The results indicate that there are differences between muscle and liver for Ca, Cd, Co, Cu, K, Mg, Mn, Mo, Ni, Pb, Sr, V and Zn. Deep-diving animals differ in their concentrations of Cr, Cu, Mg, Mn, Mo, and Zn with respect to shallow-diving animals in muscle and in liver in Al, B, Cr, K, Mn and Mo. As for the differences between sex, the males present differences in their concentrations of B, Cd, K and Mg in muscle tissue with respect to the females, while differences in the liver were only detected in the Fe content. The study of the correlations shows that as the size of the animal increases, the concentration of Cd increases while the concentrations of Al, Cu and Zn decrease. The specimens foraging in shallower waters had the highest concentration of the macronutrient.

PMID:34246100 | DOI:10.1016/j.chemosphere.2021.131441

Nutrition. 2021 May 26;91-92:111354. doi: 10.1016/j.nut.2021.111354. Online ahead of print.

ABSTRACT

OBJECTIVES: We sought to compare complications associated with tunneled peripherally inserted central catheters (tPICCs) and tunneled-cuffed centrally inserted central catheters (tCICCs) in adult home parenteral nutrition (HPN).

METHODS: The study (2017-2019) identified 257 people with type III chronic intestinal failure requiring HPN. The data were analyzed for tPICC- and tCICC-related complications. The rate of catheter-related complications was recorded as the number of complications analyzed per 1000 d of catheter use, and rates were compared using the Mann-Whitney Wilcoxon test.

RESULTS: A total of 273 venous access devices were included to the analyses: 150 (55%) non-cuffed tPICCs and 123 (45%) tCICCs. In-dwelling time for tPICCs and tCICCs were 23 045 and 43 789 catheter d, respectively. Median (interquartile range) catheter days and duration of HPN, for tPICCs and tCICCs, were respectively 119 (166) and 324 (314) d and 108 (159) and 324 (322) d. The overall complication rates per 1000 catheter d for tPICCs and tCICCs were 1.52 and 0.8, respectively (P = 0.565). On analysis, there was no statistical difference between complication rates per 1000 catheter d. The removal rate and conversion ratio due to complications were similar for tPICCs and tCICCs.

CONCLUSIONS: Both tPICCs and tCICCs have similar complication rates per 1000 d. This study highlights that tCICCs, the preferred and currently used venous access devices in HPN, can be effectively and safely replaced by tPICCs, depending on the indications.

PMID:34246088 | DOI:10.1016/j.nut.2021.111354