Nevin Manimala

Monaldi Arch Chest Dis. 2022 Jan 19. doi: 10.4081/monaldi.2022.2142. Online ahead of print.

ABSTRACT

The correct type and time of follow-up for patients affected by COVID19 ARDS is still unclear. The aim of this study was to evaluate at the survivors to COVID19 ARDS requiring non-invasive respiratory support (NRS) admitted to a Respiratory Intensive care unit (RICU) from March 8th till May 31th 2020 looking at all sequelae via a comprehensive follow up. All patients underwent a multi-disciplinary instrumental and clinical assessment within three months form admission to evaluate all infection related sequelae. Thirty-eight patients were enrolled Lung-Ultrasound (LUS) showed an outstanding discrimination ability (ROC AUC: 0.95) and a substantial agreement rate (Cohen’s K: 0.74) compared to chest CT-scan detecting improvement of lung consolidations. Youden’s test showed a cut-off pressure of 11 cmH2O ExpiratoryPAP-Continuous-PAP-max (EPAP-CPAP) applied at the airways during hospitalization to be significantly correlated (p value: 0.026) to the increased pulmonary artery common trunk diameter. A total of 8/38 patients (21.8%), 2 of whom during follow-up, were diagnosed with Pulmonary Emboli (PE) and started anticoagulant treatment. Patients with PE had a statistically significant shorter length of time of hospitalization, time to negative swab, CPAP/NIV duration, P/F ratio and D-dimers at follow-up compared to non PE. A comprehensive approach to patients with ARDS COVID19 requiring NRS is necessary. This study highlighted cardiopulmonary impairment related to the ARDS and to the high-EPAP-CPAP-max greater than 11mmHg provided during admission, the usefulness of LUS in monitoring post-infection recovery and the correct identification and treatment of patients with PE during follow up.

PMID:35044135 | DOI:10.4081/monaldi.2022.2142

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(12. Vyp. 2):56-61. doi: 10.17116/jnevro202112112256.

ABSTRACT

OBJECTIVE: Was to determine the proportion of patients with ischemic stroke (IS) who achieved functional independence by the end of the hospitalization, among those who underwent systemic thrombolytic therapy (STT) with two different alteplase preparations (Actilyse and Revelisa).

MATERIAL AND METHODS: An open, prospective observational non-interventional cohort study of the results of STT in patients with IS was carried out. The study included 195 patients, 123 men and 72 women aged 32 to 86 years, who received STT in the acute period of IS. Of these, 120 patients received Actilyse, 75 – Revelisa.

RESULTS: Patients who achieved independence in movement (0-2 points on the modified Rankin scale (MRS)) among those who received STT with Actilyse and Revelisa, the value of the χ² criterion was 0.014 (p=0.905), which showed that there was no statistical significance of the difference in the frequency of recovery of functional disorders on the MRS scale, in patients receiving STT with two different alteplase preparations.

CONCLUSION: After STT with alteplase preparations, patients with IS experienced a significant improvement, which was expressed in a statistically significant decrease in the severity of neurological deficit and a decrease in the degree of disability. When comparing the results of STT with two different alteplase preparations, no statistically significant differences were found in terms of mortality, survival, and independence during the acute period of IS.

PMID:35044127 | DOI:10.17116/jnevro202112112256

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(12. Vyp. 2):20-25. doi: 10.17116/jnevro202112112220.

ABSTRACT

OBJECTIVE: To study the effect of a comprehensive neurorehabilitation program based on biofeedback on the support response in poststroke patients.

MATERIAL AND METHODS: The article presents the results of treatment of 59 patients after ischemic stroke. The program included training using a force joystick for the upper limb based on a static stabilometric platform with biofeedback according to the support reaction, training in the position of the patient standing on a stabilometric platform, exercise therapy. Patients in the control group received standard therapy.

RESULTS: The use of the comprehensive program contributed to a statistically significantly better therapeutic effect, increased strength, and decreased spasticity in the paretic arm, decreased anxiety and depression, and improved cognitive functions compared with standard therapy in patients in the control group.

CONCLUSIONS: We show the efficacy of comprehensive program based on biofeedback on the support response in the restoring period of stroke.

PMID:35044122 | DOI:10.17116/jnevro202112112220

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(12. Vyp. 2):5-8. doi: 10.17116/jnevro20211211225.

ABSTRACT

OBJECTIVE: To analyze mortality rates, rehabilitation potential, and features of the course of stroke in patients with COVID-19.

MATERIAL AND METHODS: The study included 50 patients in the acute period of stroke who were diagnosed with a new coronavirus infection during treatment. For comparison, we selected a group of 50 patients who had stroke during this period.

RESULTS: In the study group, the virus was identified in 38 (76%) patients by polymerase chain reaction (PCR). The onset of symptoms of acute respiratory viral infection or fever was observed on average 11 days after the onset of neurological symptoms. Only in 10 (20%) patients, a PCR smear showed a positive result in the first 24 hours after the development of a stroke. In the main group, death was observed in 30% (n=15) of cases; in the comparison group – in 6% (n=3) cases. Also, in the main group of patients, a lower degree of recovery of impaired neurological functions was noted on the National Institutes of Health Stroke Scale (NIHSS). At discharge from the hospital, 33 (66%) patients had moderate and severe disabilities according to the modified Rankin scale (3-4 points). The differences were statistically significant, as in the main group there was more pronounced disability than in the control group. Lymphopenia was noted in 26 (52%) patients of the main group on admission.

CONCLUSION: Increased mortality rate, decreased recovery of neurological functions and severe disabilities are observed in the group of patients with stroke who were infected by COVID-19. Lymphopenia in a patient with stroke can serve as a prognostic marker of the possible presence of COVID-19 and the degree of lung tissue damage.

PMID:35044119 | DOI:10.17116/jnevro20211211225

J Popul Ther Clin Pharmacol. 2022 Jan 10;28(2):e47-e53. doi: 10.47750/jptcp.2022.855. eCollection 2022.

ABSTRACT

The aim of this research is to prepare a healthy psychological course and study its impact on the levels of serum uric acid (SUA) and pessimism and depression. The research sample was limited to teaching staff of the Iraqi State Universities in Baghdad, who were retired at 63-65 years of age. Data were collected by independent group experimental approach via pre- and posttest measurements. The study sample consisted of 21 people with cases of pessimism and depression. The sample was randomly chosen based on their consent to do pre- and posttests and to be subjected to healthy psychological approach. After collecting the data obtained from the samples and processing them statistically, the results showed that the healthy psychological course had a positive effect on the levels of SUA, pessimism, and depression of the research sample.

PMID:35044115 | DOI:10.47750/jptcp.2022.855

Vet Med Sci. 2022 Jan 19. doi: 10.1002/vms3.725. Online ahead of print.

ABSTRACT

BACKGROUND: Veterinarians and support staff have been reporting the negative mental health effects from client complaints (CC). A previous study was performed evaluating these effects in veterinarians however no such study has been performed on veterinary support staff (VSS).

OBJECTIV: The purpose of this study was to investigate the frequency and effects of CCs on VSS.

METHODS: A cross sectional anonymous survey using a web-based questionnaire was created evaluating the frequency, type, and effects from CC. The survey was distributed to five different VSS Facebook groups and respondents provided demographic information and reported the frequency and effects of such complaints.

RESULTS: A total of 681 questionnaires were collected during the study period but 130 were incomplete and were excluded from analysis. This resulted in 551 completed questionnaires available for review. One hundred and ninety (34.4%) VSS reported being subject to a CC in the previous 6 months with cost of care the most common reason (78.6%). Two hundred and sixty VSS (47.2%) reported feeling depressed because of CCs made against them, 295 VSS (53.5%) stated CCs negatively affected their enjoyment of their job, and 146 (26.5%) have considered changing their career because of CCs.

CONCLUSIONS: CC have detrimental effects on VSS career satisfaction, mental health and hospital practices. Further studies are warranted to mitigate the detrimental effects of CCs.

PMID:35044103 | DOI:10.1002/vms3.725

Influenza Other Respir Viruses. 2022 Jan 19. doi: 10.1111/irv.12923. Online ahead of print.

ABSTRACT

BACKGROUND: In the United States, infection with SARS-CoV-2 caused 380,000 reported deaths from March to December 2020.

METHODS: We adapted the Moving Epidemic Method to all-cause mortality data from the United States to assess the severity of the COVID-19 pandemic across age groups and all 50 states. By comparing all-cause mortality during the pandemic with intensity thresholds derived from recent, historical all-cause mortality, we categorized each week from March to December 2020 as either low severity, moderate severity, high severity, or very high severity.

RESULTS: Nationally for all ages combined, all-cause mortality was in the very high severity category for 9 weeks. Among people 18 to 49 years of age, there were 29 weeks of consecutive very high severity mortality. Forty-seven states, the District of Columbia, and New York City each experienced at least 1 week of very high severity mortality for all ages combined.

CONCLUSIONS: These periods of very high severity of mortality during March through December 2020 are likely directly or indirectly attributable to the COVID-19 pandemic. This method for standardized comparison of severity over time across different geographies and demographic groups provides valuable information to understand the impact of the COVID-19 pandemic and to identify specific locations or subgroups for deeper investigations into differences in severity.

PMID:35044097 | DOI:10.1111/irv.12923

J Appl Clin Med Phys. 2022 Jan 19:e13476. doi: 10.1002/acm2.13476. Online ahead of print.

ABSTRACT

PURPOSE: Calculating the adequate target margin for real-time tumor tracking using the Cyberknife system is a challenging issue since different sources of error exist. In this study, the clinical log data of the Cyberknife system were analyzed to adequately quantify the planned target volume (PTV) margins of tumors located in the lung and abdomen regions.

METHODS: In this study, 45 patients treated with the Cyberknife module were examined. In this context, adequate PTV margins were estimated based on the Van Herk formulation and the uncertainty estimation method by considering the impact of errors and uncertainties. To investigate the impact of errors and uncertainties on the estimated PTV margins, a statistical analysis was also performed.

RESULTS: Our study demonstrates five different sources of errors, including segmentation, deformation, correlation, prediction, and targeting errors, which were identified as the main sources of error in the Cyberknife system. Furthermore, the clinical evaluation of the current study reveals that the two different formalisms provided almost identical PTV margin estimates. Additionally, 4-5 mm and 5 mm margins on average could provide adequate PTV margins at lung and abdomen tumors in all three directions, respectively. Overall, it was found that concerning the PTV margins, the impact of correlation and prediction errors is very high, while the impact of robotics error is low.

CONCLUSIONS: The current study can address two limitations in previous researches, namely insufficient sample sites and a smaller number of patients. A comparison of the present results concerning the lung and abdomen areas with other studies reveals that the proposed strategy could provide a better reference in selection the PTV margins. To our knowledge, this study is one of the first attempts to estimate the PTV margins in the lung and abdomen regions for a large cohort of patients treated using the Cyberknife system.

PMID:35044071 | DOI:10.1002/acm2.13476

BJU Int. 2022 Jan 19. doi: 10.1111/bju.15693. Online ahead of print.

ABSTRACT

AIM: To compare between transurethral cystolithotripsy and percutaneous cystolithotripsy in the management of bladder stones in male children regarding efficacy and morbidity.

PATIENTS AND METHODS: One hundred boys younger than 14 years with a single bladder or urethral stone less than 30 mm were randomized into two equal groups. Initial diagnostic urethro-cystoscopy and push back of urethral stones were done for patients in both groups. Patients in group A had transurethral cystolithotripsy, while those in group B had percutaneous cystolithotripsy through a 20-Fr sheath using a 12-Fr nephroscope. The two groups were compared regarding preoperative criteria, intraoperative details and postoperative outcomes.

RESULTS: The patients in this study had a median (range) age of 36 (4-144) months and a median (range) stone size of 10 (5-26) mm. There was no statistically significant difference between the two groups regarding preoperative criteria. The assigned procedure was successful in 48(96%) patients in group A and 49 (98%) patients in group B (p = 1). Complications were encountered in 11(22%) patients in group A and five (10%) patients in group B (p = 0.171). The median (range) operative time was 21.5 (4-90) minutes in group A and 13 (5-70) minutes in group B (p < 0.001). Forty seven (94%) stones needed disintegration in group A versus 22 (44%) in group B (p < 0.001).

CONCLUSION: Both techniques have comparable success and complications rates. However, percutaneous cystolithotripsy has a shorter operative time and less need for stone disintegration.

PMID:35044035 | DOI:10.1111/bju.15693

Water Environ Res. 2021 Dec 29;94(1):e1683. doi: 10.1002/wer.1683. Online ahead of print.

ABSTRACT

The presence of reactive dyes in textile wastewater is a serious environmental concern due to their associated mutagenic and carcinogenic effects. The present study aims to analyze the effect of different anodic materials on the decolorization of a real textile wastewater effluent. For this purpose, four different anodic materials-TiO₂ -coated platine, TiO₂ -coated ruthenium dioxide (RuO₂ ) (viz., RuO₂ ), titanium dioxide (TiO₂ ), and graphite-were connected, respectively, to titanium dioxide (TiO₂ ) used as a cathode electrode. Color and cost optimization studies were performed using the response surface methodology and the Box-Behnken experimental design (BBD). According to ANOVA results, the R² values for Pt/TiO₂ , RuO₂ /TiO₂ , TiO₂ /TiO₂ , and graphite/TiO₂ electrode pairs were found to be 97.4%, 93.8%, 92.44%, and 92.2%, respectively, indicating a good compatibility as it is close to one. The results show that color removal efficiencies at the optimal conditions were 86.3%, 90.8%, 91.5%, and 93.6% for Pt/TiO₂ , graphite/TiO₂ , TiO₂ /TiO₂ , and RuO₂ /TiO₂ , respectively. Furthermore, energy consumption cost at the optimum conditions was also evaluated, and the results were as follows: Pt/TiO₂ (0.95 €/m³ ), graphite/TiO₂ (0.74 €/m³ ), TiO₂ /TiO₂ (0.31 €/m³ ), and RuO₂ /TiO₂ (0.26 €/m³ ). Consequently, this research paper shows that all of the tested anodic materials give satisfactory color removal efficiencies higher than 86%. When energy consumption and color removal are considered together, the use of TiO₂ /TiO₂ and RuO₂ /TiO₂ pairs would be preferred. PRACTITIONER POINTS: Anodic contribution was investigated for decolorization of textile wastewater by electrooxidation process. Graphite, TiO₂ -coated Pt, TiO₂ -coated RuO₂ , and TiO₂ were used as anode materials. Highest color removal with lowest energy consumption was achieved with TiO₂ -coated RuO₂ anode material (93.6%).

PMID:35044018 | DOI:10.1002/wer.1683