Nevin Manimala

Shock. 2021 Jun 24. doi: 10.1097/SHK.0000000000001827. Online ahead of print.

ABSTRACT

INTRODUCTION: Early diagnosis and treatment can reduce the risk of organ failure and mortality in systemic inflammatory conditions. Heart rate variability (HRV) has potential for early identification of the onset of systemic inflammation, as it may detect changes in sympathetic nervous system activity resulting from the developing inflammatory response before clinical signs appear. With the use of new methodologies, we investigated the onset and kinetics of HRV changes as well as several inflammatory parameters and symptoms during experimental human endotoxemia, a model of systemic inflammation in humans in vivo.

MATERIAL AND METHODS: Healthy volunteers were intravenously administered lipopolysaccharide (LPS, n = 15) or placebo (n = 15). HRV was determined using a wireless wearable device, and parameters low to high frequency (LF:HF) ratio, root mean square of the successive differences (RMSSD), and standard deviation of normal-to-normal R-R intervals (SDNN)were calculated through 1-min-rolling 6-minute windows. Plasma cytokine levels and flu-like symptoms and vital signs were serially assessed.

RESULTS: The increase in LF:HF ratio, reflecting sympathetic predominance, was more pronounced in the LPS group compared to the placebo group, with the difference becoming statistically significant 65 minutes following LPS administration (1.63 [1.42-1.83] vs. 1.28 [1.11-1.44], p = 0.005). Significant between-group differences in RMSSD and SDNN were observed from 127 and 140 minutes post-LPS administration onwards, respectively. Plasma cytokine levels showed significant between-group differences staring 60 minutes post-LPS. For symptom score, heart rate, temperature and diastolic blood pressure, significant differences compared with the placebo group were observed at 90, 118, 120, and 124 minutes post-LPS, respectively.

CONCLUSION: In a controlled human model of systemic inflammation, elevations in the LF:HF ratio followed very shortly after elevations in plasma cytokine levels and preceded onset of flu-like symptoms and alterations in vital signs. HRV may represent a promising non-invasive tool for early detection of a developing systemic inflammatory response.

PMID:34172613 | DOI:10.1097/SHK.0000000000001827

Cell Physiol Biochem. 2021 Jun 26;55(3):344-363. doi: 10.33594/000000381.

ABSTRACT

BACKGROUND/AIMS: Acute kidney injury (AKI) is a public health burden with increasing morbidity, mortality and health care cost. It is associated with increased risk for the development of chronic kidney disease and death. Acute tubular necrosis (ATN) is the most common cause of AKI. Apoptosis and tissue necrosis play an important role in ATN. Galectin 3 (GAL-3), a beta galactoside binding lectin, is known to have a role in inflammation, apoptosis and oxidative stress but its role in cisplatin induced acute tubular necrosis is not clearly elucidated.

METHODS: Male C57B6-J and C57BL-6 -GAL-3 knock-out mice were used to induce ATN using cisplatin mouse model of acute tubular necrosis. GAL-3 expression, apoptotic, necrotic and necroptotic proteins in kidneys were measured using standard histologic, immunohistochemical, and enzyme-linked immunosorbent assay techniques. Data were presented as mean ± S.E. Statistically significant differences (p<0.05) was calculated between experimental groups and corresponding control groups by one-way analysis of variance.

RESULTS: There was a significant increase in GAL-3 in kidneys of cisplatin treated GAL-3 wild mice when compared with its control mice. In addition, there were significant higher percentage of ATN, higher levels of plasma urea and creatinine, and higher levels of cathepsin B and cathepsin D, in kidneys of cisplatin-treated GAL-3 KO mice than cisplatin-treated GAL-3 wild mice. Likewise, there were significant higher levels of necroptosis proteins RIPK1, RIPK3, and MLKL in kidneys of cisplatin-treated GAL-3 KO mice than cisplatin-treated GAL-3 wild mice. Moreover, there were significant higher levels of kidney pro-apoptotic proteins; cleaved caspase-3, cleaved PARP, TRAIL and FAS in cisplatin treated GAL-3 KO mice when compared with cisplatin treated GAL-3 wild mice.

CONCLUSION: GAL-3 can affect cell survival and death through its interaction with necroptotic, apoptotic and pro-survival proteins in renal tubules during cisplatin-induced acute tubular necrosis.

PMID:34171186 | DOI:10.33594/000000381

Int J Clin Pract. 2021 Jun 25:e14573. doi: 10.1111/ijcp.14573. Online ahead of print.

ABSTRACT

BACKGROUND: A minimally invasive approach has been adopted to treat benign cystic nodules in recent years, with ethanol ablation (EA) being used as a more common method in routine treatment. For this study, we aimed to investigate the change of nodule volumes and cosmetic scores before and after EA in benign thyroid nodules and the effectiveness of treatment. Therefore, ultrasound data and cosmetic scores of pure cystic, mixed-type and spongy-type benign thyroid nodules undergoing EA in the last two years were reviewed retrospectively.

METHODS: Archive scanning was performed for all cases that were proven benign by fine-needle aspiration biopsy (FNAB) and who underwent EA. In all 46 patients included in the study, thyroid FNAB was performed. Ultrasound images were available to assess the size and volumes at pretreatment and 3 and 6 months after EA. The cosmetic scores obtained before the procedure and at 6 months after EA were compared.

RESULTS: There was a statistically significant difference when the sizes and volumes of the nodules were compared at pretreatment, 3 months and 6 months follow-up (p<0.001). The mean pretreatment cosmetic score was 3.09, and at 6 months, it was 1.20, with a statistically significant difference (p<0.001).

CONCLUSIONS: Recently, a minimally invasive approach has been adopted in the treatment of benign cystic nodules, with ethanol ablation becoming more common in routine treatment. Therefore, ethanol ablation is very valuable in minimizing complications that may arise from surgery.

PMID:34171155 | DOI:10.1111/ijcp.14573

Int J Clin Pract. 2021 Jun 25:e14575. doi: 10.1111/ijcp.14575. Online ahead of print.

ABSTRACT

Successful management of psychiatric disorders is affected by patient perspectives and several barriers, i.e., conceptual, psychological, social, or logistic reasons that can decrease patient adherence to therapy. In this perspective, pharmacists have a vital role in identifying patients in need of help and in dealing with barriers. The aim of this study was to investigate perspectives of patients diagnosed with psychiatric disorders, living in rural areas in Jerash, Jordan, regarding their awareness about their conditions, including religious and cultural factors, adherence to their treatment and related barriers, with special focus on pharmacist’s role. This cross-sectional survey study was conducted in Jordan from August to November 2019. A validated questionnaire was administered by two pharmacy students via a structured interview with patients waiting for their appointment in the psychiatric clinic. Data were analyzed using the Statistical Package for the Social Sciences. One hundred twenty patients (age 39.4±9.5, 66.7% males) completed the questionnaire. Most of them (71.0%) reported adherence to their medications, and 47.5% reported complete control of their symptoms with treatment. Most patients (59.2%) reported that they perceive their psychiatric problem in terms of religious faith as being counted for their favor in the Hereafter, and 52.5% of them always/usually looked at themselves positively and unaffected by their psychiatric problem; with both factors correlating significantly with better treatment adherence (p < 0.045 and p < 0.001; respectively). Barriers affecting adherence included mainly suffering from adverse effects (31.9%) and being unconvinced that they needed a medication (23.3%). Only 14.2% of patients reported that they refer to the pharmacist to get information about their medications. This study shows suboptimal symptom control of psychiatric patients in Jerash. Nonadherence is an issue, with barriers identified. Positive religious and self-image perspectives correlated with better adherence. Patient referral to pharmacists is minimal and needs to be optimized.

PMID:34171149 | DOI:10.1111/ijcp.14575

J Appl Microbiol. 2021 Jun 25. doi: 10.1111/jam.15192. Online ahead of print.

ABSTRACT

AIMS: This meta-analysis aims to assess the point prevalence of MRSA isolated from bovine mastitis cases at the global level.

METHODS AND RESULTS: Several electronic databases were searched for relevant publications (PubMed, EMBASE, Web of Knowledge and Cochrane Library). Heterogeneity between studies was assessed using the Cochrane Q test and I² test statistics based on the random-effect model. The potential sources of between-study heterogeneity were evaluated using subgroup analysis and meta-regression. Sensitivity and publication bias analyses were performed. Sixty-six studies with a total of 77644 mastitis cases were eligible and included in the analysis. The overall pooled prevalence of MRSA was 4.30% (95% CI, 3.24-5.50) with a significant heterogeneity (I² = 97.48%, p < 0.001). In the subgroup analysis by region, the highest prevalence was found in Asia (6.47%, 95% CI, 4.33-8.97), and the lowest prevalence was reported in Europe (1.18%, 95% CI: 0.18- 2.83). The pooled prevalence was significantly higher in clinical mastitis and cases published during 2016-2020.

CONCLUSIONS: The results of this study suggest that there is a lower prevalence of MRSA in bovine mastitis. However, its prevalence increased in the past four years. Therefore, continuous surveillance is urgently required for monitoring the dissemination of these clinically important bacteria.

SIGNIFICANCE OF THE STUDY: To our knowledge, this is the first meta-analysis to estimate the global prevalence of MRSA isolated from bovine mastitis cases.

PMID:34171143 | DOI:10.1111/jam.15192

Spec Care Dentist. 2021 Jun 25. doi: 10.1111/scd.12621. Online ahead of print.

ABSTRACT

AIMS: To compare the dental caries prevalence using the International Caries Detection and Assessment System (ICDAS) and the caries risk by Caries Management by Risk Assessment (CAMBRA) in individuals with cerebral palsy (CP) and normoactives (NAs).

METHODS AND RESULTS: Sixty children and adolescents aged 6-12 years (30 CP/30 NA) were clinically evaluated by one calibrated examiner using two-digit ICDAS criteria and converted into components of dmf/DMF indices: d2mf2/D2MF2 (enamel and dentin lesions) and d3mf3/D3MF3 (dentin lesions). An adapted CAMBRA was used for risk classification. The mean d2mf2s/d2mf2t and D2MF2S/D2MF2T for CP were 17.0 ± 16.8/7.5 ± 4.3 and 10.7 ± 17.6/5.3 ± 5.8, respectively, and for NA were 17.2 ± 16.9 /6.9 ± 4.8 and 11.1 ± 11.7/5.5 ± 4.7, respectively. The mean d3mf3s/d3mf3t and D3MF3S/D3MF3T for CP were 10.1 ± 16.7/3.0 ± 4.1 and 4.9 ± 15.6/0.2 ± 0.4, respectively, while for NA the mean values were 9.8 ± 13.0/3.5 ± 3.8 and 2.1 ± 5.7/0.9 ± 2.0, respectively. There were no statistically differences for caries prevalence and risk in both groups (p > 0.05).

CONCLUSIONS: Dental caries was highly prevalent in CP and NA children and adolescents. Enamel and dentin lesions and high caries risk were the most common condition.

PMID:34171134 | DOI:10.1111/scd.12621

J Adv Nurs. 2021 Jun 25. doi: 10.1111/jan.14930. Online ahead of print.

ABSTRACT

AIMS: Secondary prevention of coronary heart disease is of utmost importance to facilitate people to achieve health outcomes and behaviours. This study was to investigate the effect of a nursing intervention based on Cox’s interaction model of client health behaviour to improve health outcomes and behaviours of secondary prevention of coronary heart disease.

DESIGN: This study is a cluster randomised controlled trial.

METHODS: Participants were recruited between August and November 2019 in two community settings in Hengyang city, Hunan province, China. Participants in the intervention group received a nursing intervention based on Cox’s interaction model of client health behaviour and routine health education, while those in the control group received routine health education only. The outcome variables included selfߚmanagement, physical activity, medication compliance, anxiety, sexual knowledge, the ability to identify sexual health education needs, blood pressure, body mass index (BMI), and lowߚdensity lipoprotein cholesterol (LDLߚC). The influential statistical tests applied to analyse the data included χ² tests and t tests.

RESULTS: Seventyߚseven participants completed this study. Compared with the control group (n = 40), the intervention group (n = 37) showed statistically significant better health outcomes and behaviours regarding selfߚmanagement, physical activity (except for high energy consumption), medication compliance, anxiety, sexual knowledge, the ability to identify sexual health education needs, systolic blood pressure, BMI, and LDLߚC. However, there was no statistically significant difference in diastolic blood pressure and high energy consumption for physical activity.

CONCLUSION: A wellߚdeveloped nursing intervention based on Cox’s interaction model of client health behaviour could successfully improve health outcomes and behaviours of secondary prevention of coronary heart disease. Such an intervention may be incorporated into community healthcare practice by nurses to improve patient care.

IMPACT: This study provides a valuable insight to facilitate further development of effective nursing interventions to improve secondary prevention of coronary heart disease in community settings.

PMID:34171133 | DOI:10.1111/jan.14930

J Sci Food Agric. 2021 Jun 25. doi: 10.1002/jsfa.11403. Online ahead of print.

ABSTRACT

BACKGROUND: Toasted vine-shoots have recently been proposed as enological additives aimed at improving the sensorial profile of wines. However, so far, there is no simple method for classifying vine-shoots for this innovate enological practice. Therefore, in this study, it has been proposed for the first time an enological aptitude classification for toasted vine-shoots. Moreover, given the need for quick techniques to be used in wineries to determine the main phenolic compounds of vine-shoots, a near-infrared spectroscopy has been calibrated and validated.

RESULTS: By means of a detailed statistical analysis an enological classification of toasted vine-shoots has been proposed based on their total polyphenol index and (+)-catechin, (-)-epicatechin, ellagic acid and trans-resveratrol. Moreover, the NIR methodology developed showed a good validations statistics and acceptable accuracy.

CONCLUSIONS: Therefore, this work propose the first enological toasted vine-shoots classification and it provides a tool for rapid screening, mainly of phenolic compounds, in toasted vine-shoots. This article is protected by copyright. All rights reserved.

PMID:34171125 | DOI:10.1002/jsfa.11403

Adicciones. 2021 Jun 15;0(0):1612. doi: 10.20882/adicciones.1612. Online ahead of print.

ABSTRACT

There are no recent estimates of alcohol-attributable mortality in Spain with Spanish alcohol consumption data. The objective is to estimate it and know its evolution between 2001 and 2017 in people ≥15 years, according to sex, age, period, cause of death and type of drinker. The cause-specific approach and Levin’s equation were used. Survey consumption was corrected for underestimation with respect to sales statistics, and past consumption and binge drinking were considered. The average annual number of deaths attributable to alcohol in 2010-2017 was 14,927, 58.6% of which were premature (<75 years). The age-standardized alcohol-attributable mortality rate was 39.4/100,000 inhabitants, representing 3.9% of overall mortality. Using standardized percentages, 68.7% corresponded to heavy drinkers. The most frequent causes of alcohol-attributable mortality were cancer (44.7%) and digestive diseases (33.2%). The rate of alcohol-attributable mortality was 3.5 times higher in men than in women (with higher ratios for young people and external causes). Between 2001-2009 and 2010-2017, the average annual rate decreased 16.8% (60.7% in 15-34 years; 19.4% in men and 9.8% in women). The contribution of heavy drinkers, digestive diseases and external causes to the risk of alcohol-attributable mortality decreased slightly between the two periods, while the contribution of cancer and circulatory diseases increased. These estimates are conservative. The contribution of alcohol to overall mortality is significant in Spain, requiring collective action to reduce it.

PMID:34171111 | DOI:10.20882/adicciones.1612

Adicciones. 2021 Jun 15;0(0):1611. doi: 10.20882/adicciones.1611. Online ahead of print.

ABSTRACT

The objective is to describe and discuss methods and assumptions to estimate the mortality attributable to alcohol in Spain in 2001-2017. The annual mean number of deaths attributable to alcohol (DAAs) was estimated based on 19 groups of alcohol-related causes of death (18 partially attributable and one directly attributable), and 20 alcohol population-attributable fractions (PAFs), resulting from combining sex, 5 age groups, and the periods 2001-2009 and 2010-2017, for each cause group. Deaths from causes were obtained from the Spanish National Institute of Statistics. For partially attributable causes, Spain-specific PAFs were calculated using the Levin formula with alcohol exposure data from health surveys and sales statistics, and relative risks from international meta-analyses. Annual prevalences of ex-drinkers and seven levels of daily alcohol consumption were considered. The underestimation of self-reported daily average consumption with respect to the sales statistics was corrected by multiplying by a factor of 1.58-3.18, depending on the calendar year. DAA rates standardized by age and standardized proportions of general mortality attributable to alcohol, according to sex, age group, calendar period, type of drinker and autonomous community were calculated. Sensitivity analyses were performed to assess how the DAA estimates changed when changing some methodological options, such as the ex-drinker criterion or the introduction of a latency period.

PMID:34171110 | DOI:10.20882/adicciones.1611