Nevin Manimala

J Clin Hypertens (Greenwich). 2022 May 14. doi: 10.1111/jch.14500. Online ahead of print.

ABSTRACT

The authors aimed to explore the association between visit-to-visit blood pressure variability (BPV) in pregnant women and adverse neonatal outcomes. The study included 52 891 pregnant women. BPV was calculated as standard deviation (SD) and coefficient of variation (CV) of systolic blood pressure (SBP) or diastolic blood pressure (DBP). All participants were divided into four groups by the quartiles of BPV. When comparing the highest quartiles to the lowest quartiles of DBP SD in all participants, the fully adjusted ORs were 1.19 (95% CI 1.11-1.27, p for trend < .001) for fetal distress, 1.32 (95% CI 1.14-1.54, p for trend < .001) for small for gestational age, 1.32 (95% CI 1.06-1.63, p for trend = .003) for 1-min Apgar score ≤ 7. When comparing the highest quartiles to the lowest quartiles of DBP CV, ORs were 1.22 (95% CI 1.14-1.30, p for trend < .001) for fetal distress, 1.38 (95% CI 1.17-1.61, p for trend < .001) for small for gestational age, 1.43 (95% CI 1.14-1.79, p for trend < .001) for 1-min Apgar score ≤ 7. ORs for preterm birth and 5-min Apgar score ≤ 7 were not statistically significant. However, in participants with gestational hypertension or preeclampsia, ORs for preterm birth were 2.80 (95% CI 1.99-3.94, p for trend < .001) in DBP SD and 3.25 (95% CI 2.24-4.72, p for trend < .001) in DBP CV when extreme quartiles were compared. In conclusion, higher visit-to-visit BPV was associated with adverse neonatal outcomes.

PMID:35567772 | DOI:10.1111/jch.14500

Cardiovasc Drugs Ther. 2022 May 14. doi: 10.1007/s10557-022-07346-8. Online ahead of print.

ABSTRACT

AIMS: This study attempts to identify predictors associated with bleeding and stroke and systemic embolism (SSE) in Singaporean Asians taking rivaroxaban and apixaban.

METHODS: A total of 134 Singaporean patients on either rivaroxaban or apixaban for non-valvular atrial fibrillation were included for this study. Baseline characteristics were recorded at recruitment while bleeding and SSE events were recorded during a 1-year follow-up. Peak and trough drug plasma concentrations were collected based on the dosing interval and pharmacokinetics of the drugs and quantified using high performance liquid chromatography. Characteristics of patients with or without bleeds were compared using relevant statistical tests. Multivariable regression that included covariates with p < 0.1 from an initial univariable regression was performed to analyse predictors that resulted in higher risk of bleeding in patients.

RESULTS: Median creatinine clearance (CrCl) was significantly lower in patients on rivaroxaban who experienced bleeds as compared to patients who did not experience bleeds (61.5 vs 70.8 mL/min, p = 0.047), while concomitant simvastatin use was found to be independently associated with a sixfold increased risk of bleeding (adjusted OR = 6.14 (95% CI: 1.18-31.97), p = 0.031) for rivaroxaban after controlling for body mass index, CrCl and having experienced a previous SSE.

CONCLUSION: Our findings suggest that concomitant use of simvastatin with rivaroxaban may be associated with bleeding events in an Asian cohort. Further studies using physiologically based pharmacokinetic modelling are required to investigate the drug-drug interactions between these drugs.

PMID:35567727 | DOI:10.1007/s10557-022-07346-8

J Patient Rep Outcomes. 2022 May 14;6(1):49. doi: 10.1186/s41687-022-00456-9.

ABSTRACT

BACKGROUND: Clostridioides difficile infection (CDI) is associated with high recurrence rates impacting health-related quality of life (HrQOL). However, patient-reported data are lacking particularly in the outpatient setting. We assessed changes in HrQOL over time in patients treated with bezlotoxumab at US infusion centers and determined clinical factors associated with HrQOL changes.

METHODS: The HrQOL survey was conducted in adult patients with CDI, who received bezlotoxumab in 25 US outpatient infusion centers. The survey was adapted from the Cdiff32 instrument to assess anxiety-related changes to HrQOL and completed on the day of infusion (baseline) and at 90 days post bezlotoxumab (follow-up). Demographics, disease history, CDI risk factors, and recurrence of CDI (rCDI) at 90-day follow-up were collected. Changes in HrQOL scores were calculated and outcomes assessed using a multivariable linear regression model with P < 0.05 defined as statistically significant.

RESULTS: A total of 144 patients (mean age: 68 ± 15 years, 63% female, median Charlson index: 4, 15.9% rCDI) were included. The overall mean baseline and follow-up HrQOL scores were 26.4 ± 11.5 and 56.4 ± 25.0, respectively. At follow-up, this score was significantly higher for patients who had primary CDI (34.5 ± 21.7) compared to those with multiple rCDI (24.7 ± 21.0; P = 0.039). The mean HrQOL change at follow-up was significantly higher for patients without rCDI (34.1 ± 28.8 increase) compared to patients with rCDI (6.7 ± 19.5 increase; P < 0.001), indicating improvement in anxiety.

CONCLUSIONS: Using the Cdiff32 instrument, we demonstrated that HrQOL worsened significantly in patients with further rCDI. These findings support the use of Cdiff32 in assessing CDI-related humanistic outcomes.

PMID:35567724 | DOI:10.1186/s41687-022-00456-9

Sports Med. 2022 May 14. doi: 10.1007/s40279-022-01682-3. Online ahead of print.

ABSTRACT

BACKGROUND: Research has shown the effectiveness of sedentary behaviour interventions on reducing sedentary time. However, no systematic review has studied where the reduced sedentary time after such interventions is displaced to.

OBJECTIVE: Our objective was to synthesize the evidence from interventions that have reduced sedentary behaviour and test the displacement of sedentary time into physical activity (light physical activity [LPA], moderate-to-vigorous physical activity [MVPA], standing, and stepping).

METHODS: Two independent researchers performed a systematic search of the EBSCOhost, PubMed, Scopus, and Web of Science electronic databases. Meta-analyses were performed to examine the time reallocated from sedentary behaviour to physical activity during working time and the whole day in intervention trials (randomized/non-randomized controlled/non-controlled).

RESULTS: A total of 36 studies met all the eligibility criteria and were included in the systematic review, with 26 studies included in the meta-analysis. Interventions showed a significant overall increase in worksite LPA (effect size [ES] 0.24; 95% confidence interval [CI] 0.05 to 0.43; P < 0.013) and daily LPA (ES 0.62; 95% CI 0.34 to 0.91; P = 0.001). A statistically significant increase in daily MVPA was observed (ES 0.47; 95% CI 0.26 to 0.67; P < 0.001). There was a significant overall increase in worksite standing time (ES 0.76; 95% CI 0.56 to 0.95; P < 0.001), daily standing time (ES 0.52; 95% CI 0.38 to 0.65; P < 0.001), and worksite stepping time (ES 0.12; 95% CI 0.04 to 0.20; P = 0.002).

CONCLUSIONS: Effective interventions aimed at reducing sedentary behaviour result in a consistent displacement of sedentary time to LPA and standing time, both at worksites and across the whole day, whereas changes in stepping time or MVPA are dependent on the intervention setting. Strategies to reduce sedentary behaviour should not be limited to worksite settings, and further efforts may be required to promote daily MVPA.

TRIAL REGISTRATION: PROSPERO registration number CRD42020153958.

PMID:35567719 | DOI:10.1007/s40279-022-01682-3

J Community Health. 2022 May 14. doi: 10.1007/s10900-022-01098-0. Online ahead of print.

ABSTRACT

Understanding changes in substance use in a small population state is challenging. Many national datasets restrict data to reduce the probability of identifying persons. Alaska is a small population state (731,000 residents) with a large geographic region (25% the size of the lower 48), a diverse population, and highly variable seasons, with fewer than 10% of the state being road accessible. Given the uniqueness of Alaska, this project sought to understand what could be learned about addiction and its relationships with unemployment and median income in Alaska. National Survey on Drug Use and Health, State and Small Area Estimates (1999-2020) data were analyzed to measure prevalence changes. Outcome prevalence were independently correlated with median income and annual unemployment rate as the annual collection periods varied. Analyses were limited to simple bivariate analyses due to the data restrictions. Median income was found to have stronger correlational relationships and significant relationships with more negative outcomes compared to unemployment. While annual unemployment rates had statistically significant relationships with substance use outcomes, negative mental health outcomes appeared more related to unemployment than median income. Alcohol use in the past month, cigarette and tobacco use, and pain reliever misuse declined while binge drinking in the past month and illicit drug use increased. More people reported depression, serious mental illness, and suicidal ideation and planning over time peaking in the last year of data collection. While NSDUH data provide some idea of the changes in drug use over time, their effectiveness in Alaska is unknown. Many data sources claim they are nationally representative, but these statements cannot be objectively measured. We will use these outcomes and data as a baseline for future studies where we will explore state specific data sources.

PMID:35567711 | DOI:10.1007/s10900-022-01098-0

Int Ophthalmol. 2022 May 14. doi: 10.1007/s10792-022-02312-7. Online ahead of print.

ABSTRACT

PURPOSE: To report the prevalence of undiagnosed glaucoma, as well as demographic characteristics and risk factors among glaucoma suspects who were detected in a publicly promoted intraocular pressure (IOP) based glaucoma screening event.

METHODS: A total of 2468 subjects older than 18 years participated in the glaucoma screening event in Zagreb, in 2014, which included a medical interview and IOP measurement using Icare tonometer. 256 subjects (10.37%) were identified as glaucoma suspects, out of which 125 (5.06%) subjects underwent further detailed ophthalmic examination and were classified into five diagnostic groups.

RESULTS: The prevalence of all types of newly diagnosed glaucoma was 1.175%, while the prevalence of ocular hypertension (OH), primary open-angle glaucoma (POAG), primary angle closure (PAC) and secondary glaucoma (SG) was 0.16%, 0.89%, 0.16% and 0.12%, respectively. The prevalence of newly diagnosed glaucoma in glaucoma suspects was 23.2%. 17.60% of glaucoma suspects were diagnosed as POAG. Older age was statistically significantly associated with POAG (p = 0.001) and PAC (p = 0.029). At the univariate level, refractive errors were a statistically significant predictor of POAG, and those with hyperopia had more than three times larger odds for POAG. At the multivariate level, none of the predictors reached statistical significance.

CONCLUSION: Successful cooperation between healthcare institutions and media can be a useful way of increasing awareness and detection of individuals at an increased risk for developing glaucoma.

PMID:35567692 | DOI:10.1007/s10792-022-02312-7

Environ Sci Pollut Res Int. 2022 May 14. doi: 10.1007/s11356-022-20682-4. Online ahead of print.

NO ABSTRACT

PMID:35567690 | DOI:10.1007/s11356-022-20682-4

Environ Sci Pollut Res Int. 2022 May 14. doi: 10.1007/s11356-022-20727-8. Online ahead of print.

ABSTRACT

This paper aims to determine the level of sustainability reporting (SR) among Malaysian initial public offering (IPO) companies. Due to a lack of awareness about SR and its dimensions, these aspects have not been receiving the necessary push from the public domain. This study is exploratory in nature. Secondary data were used by conducting content analysis of the annual reports of 139 sampled IPO companies listed on Bursa Malaysia from 2007 to 2017. Data were analysed using descriptive statistics, with extent and quality being used as measures of SR. The results demonstrated gradual improvements of the extent and quality of SR among Malaysian IPO companies. The overall extent of SR was 20.70%, with employee disclosure scoring the highest (34.87%), followed by society disclosure (32.77%), environmental disclosure (22.48%), and finally product disclosure (9.88%). The overall quality of SR was 32.04%, with society disclosure scoring the highest (36.09%), followed by employee disclosure (34.13%), environmental disclosure (20.28%), and finally product disclosure (9.50%). SR dimensions, namely society, environmental, employee, and product received little interest from most of the IPO companies. This study proposes that additional studies can be conducted to investigate SR among IPO companies.

PMID:35567681 | DOI:10.1007/s11356-022-20727-8

Clin Oral Investig. 2022 May 14. doi: 10.1007/s00784-022-04537-3. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the present study was to investigate the influence of three grafting materials for cleft repair on orthodontic tooth movement in rats.

MATERIALS AND METHODS: Artificial alveolar clefts were created in 21 Wistar rats and were repaired 4 weeks later using autografts, human xenografts and synthetic bone substitute (beta-tricalcium phosphate/hydroxyapatite [β-TCP/HA]). A further 4 weeks later, the first molar was moved into the reconstructed maxilla. Microfocus computed tomography (μCT) was performed six times (T0-T5) to assess the tooth movement and root resorption. After 8 weeks, the affected reconstructed jaw was resected for histopathological investigation.

RESULTS: Total distances reached ranged from 0.82 ± 0.72 mm (β-TCP/HA) to 0.67 ± 0.27 mm (autograft). The resorption was particularly determined at the mesiobuccal root. Descriptive tooth movement slowed and root resorption increased slightly. However, neither the radiological changes during tooth movement (µCT T1 vs. µCT T5: autograft 1.85 ± 0.39 mm³ vs. 2.38 ± 0.35 mm³, p = 0.30; human xenograft 1.75 ± 0.45 mm³ vs. 2.17 ± 0.26 mm³, p = 0.54; β-TCP/HA: 1.52 ± 0.42 mm³ vs. 1.88 ± 0.41 mm³, p = 0.60) nor the histological differences after tooth movement (human xenograft: 0.078 ± 0.05 mm²; β-TCP/HA: 0.067 ± 0.049 mm²; autograft: 0.048 ± 0.015 mm²) were statistically significant.

CONCLUSION: The autografts, human xenografts or synthetic bone substitute used for cleft repair seem to have a similar effect on the subsequent orthodontic tooth movement and the associated root resorptions.

CLINICAL RELEVANCE: Development of root resorptions seems to have a secondary role in choosing a suitable grafting material for cleft repair.

PMID:35567639 | DOI:10.1007/s00784-022-04537-3

Arch Gynecol Obstet. 2022 May 14. doi: 10.1007/s00404-022-06587-0. Online ahead of print.

ABSTRACT

PURPOSE: To analyze endometrial metabolite profiles between patients with endometrial cancer and controls.

METHODS: Seventeen (17) women with endometrium cancer and 18 controls were enrolled in this study. ¹H HR-MAS (High Resolution-Magic Angle Spinning) NMR (Nuclear Magnetic Resonance) spectroscopy data obtained from endometrial tissue samples of patients with endometrial cancer and control group were analyzed with bioinformatics methods.

RESULTS: Principal component analysis (PCA) and the partial least squares discriminant analysis (PLS-DA) score plots obtained with the multivariate statistical analysis of pre-processed spectral data shows a separation between the samples from patients with endometrial cancer and controls. Analysis results suggest that the levels of lactate, glucose, o-phosphoethanolamine, choline, glycerophosphocholine, phosphocholine, leucine, isoleucine, valine, glutamate, glutamine, n-acetyltyrosine, methionine, taurine, alanine, aspartate and phenylalanine are increased in patients with endometrial cancer compared to the controls.

CONCLUSION: The metabolomics signature of patients with endometrial cancer is different from that of benign endometrial tissue.

PMID:35567635 | DOI:10.1007/s00404-022-06587-0