Nevin Manimala

J Med Virol. 2021 May 15. doi: 10.1002/jmv.27076. Online ahead of print.

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become a global health issue which develops a broad range of illness from asymptomatic to fatal respiratory diseases. SARS-CoV-2 infection is associated with oxidative stress that triggers cytokine production, inflammation, and other pathophysiological processes. Glutathione-S-transferase (GST) is an important enzyme that catalyses the conjugation of glutathione (GSH) with electrophiles to protect the cell from oxidative damage and participates in the antioxidant defense mechanism in the lungs. Thus, in this study, we investigated the role of GSTM1 and GSTT1 gene polymorphism with COVID-19 susceptibility, as well as its outcome. The study included 269 RT-PCR confirmed COVID-19 patients with mild (n=149) and severe (n=120) conditions. All subjects were genotyped for GSTM1 and GSTT1 by multiplex polymerase chain reaction (mPCR) followed by statistical analysis. The frequency of GSTM1^-/- , GSTT1^-/- and GSTM1^-/- /GSTT1^-/- was higher in severe COVID-19 patients as compared to mild patients but did not observe significant association. In cox hazard model, death was significantly 2.28-fold higher in patients with GSTT1^-/- genotype (P = 0.047). In combination, patients having GSTM1^+/+ and GSTT1^-/- genotypes showed poor survival rate (P = 0.02). Our results suggested that COVID-19 patients with GSTT1^-/- genotype showed higher mortality. This article is protected by copyright. All rights reserved.

PMID:33990973 | DOI:10.1002/jmv.27076

Transfusion. 2021 May 14. doi: 10.1111/trf.16451. Online ahead of print.

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare services worldwide. However, little has been reported regarding the impact on blood utilization. We quantified the impact of COVID-19 on blood utilization and discards among facilities reporting to the National Healthcare Safety Network Hemovigilance Module.

METHODS: Facilities continuously reporting data, during January 2016-June 2020, on transfused and discarded blood components, stratified by component type (red blood cells [RBC], platelets and plasma), were included. Interrupted time-series analysis with generalized estimating equations, adjusting for facility surgical volume and seasonality, was used to quantify changes in blood utilization and discards relative to a Centers for Medicare & Medicaid Services notification delaying non-essential medical procedures (March 2020).

RESULTS: Seventy-two facilities included in the analyses, on average, transfused 44,548 and discarded 2202 blood components monthly. Following the March 2020 notification and after multivariable adjustment, RBC and platelet utilization declined, -14.8% (p < 0.001) and – 16.6% (p = 0.017) respectively. Discards increased for RBCs (49.0%, p = 0.013) and platelets (60.4%, p = 0.002). No statistically significant change in plasma was found. Following these abrupt changes, blood utilization and discards rebounded towards baseline with RBC use increasing by 5.7% (p < 0.001), and platelet and RBC discards decreasing -16.4% (<0.001) and – 12.7 (p = 0.001), respectively.

CONCLUSION: Following notification delaying elective surgical procedures, blood utilization declined substantially while blood discards increased, resulting in substantial wastage of blood products. Ongoing and future pandemic response efforts should consider the impact of interventions on blood supply and demand to ensure blood availability. This article is protected by copyright. All rights reserved.

PMID:33990963 | DOI:10.1111/trf.16451

Headache. 2021 May 15. doi: 10.1111/head.14122. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of lasmiditan in Japanese adults with migraine.

BACKGROUND: Global clinical studies have demonstrated the efficacy and safety of lasmiditan in the acute treatment of migraine.

METHODS: This was a multicenter, randomized, double-blind, placebo-controlled, phase 2 study in Japan (NCT03962738), which enrolled adults with migraine with or without aura. Participants were randomized 7:3:7:6 to placebo, lasmiditan 50 mg, 100 mg, or 200 mg to be self-administered orally within 4 h of onset of a single moderate-to-severe migraine attack. Participants recorded their response to treatment prior to dosing and for 48 h postdose. The primary endpoint was headache pain freedom at 2 h postdose.

RESULTS: Participants (N = 846) were randomized and treated (N = 691, safety; N = 682, modified intent-to-treat). At 2 h postdose, a significantly higher proportion of participants were headache pain-free in the lasmiditan 200 mg (40.8%, 73/179; odds ratio 3.46 [95% confidence interval 2.17 to 5.54]; p < 0.001; primary objective) and 100 mg groups (32.4%, 67/207; odds ratio 2.41 [1.51 to 3.83]; p < 0.001) compared with the placebo group (16.6%, 35/211), whereas the lasmiditan 50 mg group had a numerically higher proportion of participants headache pain-free (23.5%, 20/85; odds ratio 1.55 [0.83 to 2.87]; p = 0.167) compared with placebo. A statistically significant linear dose-response relationship for pain freedom was achieved at 2 h by a Cochran-Armitage trend test (p < 0.001). Lasmiditan treatment was also associated with headache pain relief, most bothersome symptom freedom, and improvement on disability and Patient Global Impression of Change outcomes. The majority of treatment-emergent adverse events were mild and of short duration, the most common of which were dizziness (39.4%; 188/477), somnolence (19.3%; 92/477), and malaise (10.5%; 50/477) in all lasmiditan groups, with no serious adverse events reported.

CONCLUSIONS: Lasmiditan was well tolerated and effective for the acute treatment of Japanese patients with migraine, consistent with global phase 3 studies.

PMID:33990951 | DOI:10.1111/head.14122

J Cross Cult Gerontol. 2021 May 15. doi: 10.1007/s10823-021-09426-y. Online ahead of print.

ABSTRACT

Tobacco smoking is responsible for several health problems, including mouth diseases. The aim of the present study was to establish the association between smoking and dental status and self-perceived oral health in a large group of elderly Colombian adults. Analysis of 18,937 survey records of participants aged ≥ 60 years old was conducted. Information regarding age, sex, skin color, socioeconomic level, education, marital status, denture use, partial tooth loss or edentulism, Geriatric Oral Health Assessment Index (GOHAI) and tobacco smoking was retrieved from the database. A descriptive analysis and multivariate logistic regression analysis were performed. Half of the participants were edentulous in the maxilla while mandibular teeth were more frequently retained in more than 60% of the participants. After adjusting for sex and age, smoking consistently increased the odds of partial or complete edentulism in the maxilla (OR 1.05; 95% CI 1.02-1.09) and mandible (OR 1.04; 95% CI 1.00-1.08). Nonetheless, the increase in the odds in the mandible was not statistically significant. The habit of smoking was associated with increased tooth loss that in the long-term may result in poor oral health affecting the quality of life of elderly people.

PMID:33990901 | DOI:10.1007/s10823-021-09426-y

Health Econ Rev. 2021 May 14;11(1):16. doi: 10.1186/s13561-021-00314-2.

ABSTRACT

BACKGROUND: Mendelian Randomization is a type of instrumental variable (IV) analysis that uses inherited genetic variants as instruments to estimate causal effects attributable to genetic factors. This study aims to estimate the impact of obesity on annual inpatient healthcare costs in the UK using linked data from the UK Biobank and Hospital Episode Statistics (HES).

METHODS: UK Biobank data for 482,127 subjects was linked with HES inpatient admission records, and costs were assigned to episodes of care. A two-stage least squares (TSLS) IV model and a TSLS two-part cost model were compared to a naïve regression of inpatient healthcare costs on body mass index (BMI).

RESULTS: The naïve analysis of annual cost on continuous BMI predicted an annual cost of £21.61 [95% CI £20.33 – £22.89] greater cost per unit increase in BMI. The TSLS IV model predicted an annual cost of £14.36 [95% CI £0.31 – £28.42] greater cost per unit increase in BMI. Modelled with a binary obesity variable, the naïve analysis predicted that obese subjects incurred £205.53 [95% CI £191.45 – £219.60] greater costs than non-obese subjects. The TSLS model predicted a cost £201.58 [95% CI £4.32 – £398.84] greater for obese subjects compared to non-obese subjects.

CONCLUSIONS: The IV models provide evidence for a causal relationship between obesity and higher inpatient healthcare costs. Compared to the naïve models, the binary IV model found a slightly smaller marginal effect of obesity, and the continuous IV model found a slightly smaller marginal effect of a single unit increase in BMI.

PMID:33990897 | DOI:10.1186/s13561-021-00314-2

Acta Parasitol. 2021 May 15. doi: 10.1007/s11686-021-00396-2. Online ahead of print.

ABSTRACT

BACKGROUND: Ticks are blood-sucking ectoparasites and transmit various types of protozoal, bacterial, and viral diseases in a wild as well as domestic animals and humans globally. Only a few published reports are avaliable on the prevalence of tick-borne diseases in sheep and goats in Pakistan.

AIM AND OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the prevalence (2000-2020) of tick-borne disease (theileriosis, babesiosis, Crimean-Congo hemorrhagic fever infection, and anaplasmosis) in sheep and goats in Pakistan.

METHODS: A systematic review of articles published in English language (since 2000-2020) was conducted using PubMed and Google Scholar. Diagnostic methods used in the original reference articles were PCR, PCR-RLB, microscopy, and ELISA.

RESULTS: The overall prevalence of theileriosis, babesiosis, anaplasmosis, and Crimean-Congo hemorrhagic fever (CCHF) infections was 15.40%, 21.18%, 26.78%, and 11.62%, respectively. The prevalence of anaplasmosis was 22.06% (90/408) in sheep, 21.11% (76/360) in goats, and 40% (120/300) in both sheep and goats with substantial differences (P < 0.001). The prevalence of babesiosis among sheep was 29.88% (104/348) with highly significant differences (P < 0.001), in goats was 29.88% (25/60) with slightly significant differences (P < 0.031%), and in both sheep and goats were 7% (21/300) with highly significant differences (P < 0.001) according to subgroup analysis. The percentage of prevalence of theileriosis was 17.70% (207/1169) in sheep with highly substantial differences (P < 0.001), 4.51% (31/687) in goats with significant differences (P < 0.133), and 25% (125/500) in both sheep and goats with a significant difference among them (P < 0.001). The prevalence of CCHF among sheep was 18.63% (149/800) and 4.63% (37/800) in goats, respectively. The widely used detection method was microscopy (45.56%) followed by ELISA (38.38%), PCR (12.56%), and PCR-RLB (3.48%) test, respectively. This is a comprehensive report on the status of tick-borne disease in sheep and goats in Pakistan.

CONCLUSION: Based on our results, among tick-borne diseases anaplasmosis had the highest prevalence rate in sheep and goats. Due to its high prevalence, control measures should be taken to diagnose and prevent it.

PMID:33990896 | DOI:10.1007/s11686-021-00396-2

Ir J Med Sci. 2021 May 14. doi: 10.1007/s11845-021-02640-0. Online ahead of print.

ABSTRACT

BACKGROUND: Vaccine hesitancy is an important public health problem.

AIMS: Identifying and understanding COVID-19 vaccine hesitancy may aid future public health messaging. This study, in which we planned to study the determinants of COVID-19 vaccine hesitancy, aims to reveal the relationship between “intolerance of uncertainty,” “belief in conspiracy theories,” and “COVID-19 phobia” with vaccine hesitancy.

METHODS: This is a cross-sectional study conducted during a COVID-19 outbreak. Participants were reached via various social media platforms and e-mailing lists for convenience. Data were collected with an online survey using SurveyMonkey application. “Intolerance of Uncertainty Scale (IUS-12),” “Conspiracy Mentality Scale (CMS),” and “COVID-19 Phobia Scale” were applied to 488 participants. Statistical significance level was considered p < 0.05.

RESULTS: Four hundred eighty-eight people between the ages of 18 and 65 participated. Twenty-one participants were excluded from the analysis due to random marking and unreasonable filling times (< 10 min). In this way, analyzes were made with 467 people. We found a positive correlation between the belief in conspiracy theories and vaccine hesitancy (p < 0.05). And also found that individuals with low fear of COVID-19 would hesitate about vaccination (p < 0.05).

CONCLUSIONS: Vaccine hesitancy is an important public health problem, and it puts public health at risk, especially during the epidemic period we live in. Therefore, it is important to understand the psychological factors involved in vaccine hesitancy. It would be useful to look for ways to spread accurate information about the vaccine in a healthier way in this case.

PMID:33990893 | DOI:10.1007/s11845-021-02640-0

J Relig Health. 2021 May 14. doi: 10.1007/s10943-021-01276-9. Online ahead of print.

ABSTRACT

This study was conducted to determine the complementary and traditional-spiritual practices applied by individuals diagnosed with cancer when experiencing significant pain. This descriptive and cross-sectional study was conducted with 110 patients who were receiving chemotherapy treatment in a university hospital outpatient treatment unit (Chemotherapy Unit) between 1st March and 30th June 2019. The study sample size was calculated using the ‘unknown-population sample selection formula’ (n = t²·p·q·/d²). Study data were collected using a patient information form comprising 13 questions about the participants’ sociodemographic characteristics, diseases, and complementary practices. The data were analyzed using descriptive percentage tests and the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) software. The study found that 45.5% of the cancer patients took a walk, 38.2% listened to music, 27.3% watched movies, 24.5% received massages, 20.0% read newspapers or books, 20.0% did sports, and 10.9% dreamed in painful situations. Spiritual practices used by the patients were determined as praying (46.4%), engaging in salat (the daily ritual prayers of Islam) (30.9%) and reading religious books (23.6%). The herbal practices applied by the patients include the use of garlic, mulberry molasses, pomegranate, green tea; furthermore, herbs such as honey, sage, lime, black cumin, ginger, centaury, thyme, nettle, flaxseeds, and rosehip were also used. Most of the patients learned complementary practices from television programs (62.7%); only 8.2% learned these practices from healthcare professionals. Nurses should investigate patients’ use of complementary practices and provide them with the necessary evidence-based information to prevent unconscious use of these practices. Considering that determining patients’ spiritual needs and practices is seen as the first step in the holistic care of patients, it is important to satisfy cancer patients by providing necessary healthcare services and help them improve their physical and mental health.

PMID:33990887 | DOI:10.1007/s10943-021-01276-9

Acta Neurochir (Wien). 2021 May 15. doi: 10.1007/s00701-021-04861-9. Online ahead of print.

ABSTRACT

BACKGROUND: The goal of this survey-based study was to evaluate the current practice patterns of clinicians who assess patients with peripheral nerve pathologies and to assess variance in motor grading on the Medical Research Council (MRC) scale using example case vignettes.

METHODS: An electronic survey was distributed to clinicians who regularly assess patients with peripheral nerve pathology. Survey sections included (1) demographic data, (2) vignettes where respondents were asked to assess on the MRC scale, and (3) assessment of practice patterns regarding the use of patient-reported outcome measures. Inter-rater reliability statistics were calculated for the application of the MRC scale on example vignettes.

RESULTS: There were 109 respondents. There was significant dispersion in motor grading seen on the example vignettes. For the raw responses grading the example vignettes on the MRC scale, Krippendorff’s alpha was 0.788 (95% CI 0.604, 0.991); Gwet’s AC2 was 0.808 (95% CI 0.683, 0.932); Fleiss’ kappa was 0.416 (95% CI 0.413, 0.419). Most respondents reported not utilizing any patient-reported outcome measures across peripheral nerve pathologies.

DISCUSSION: Our data show that there is significant disagreement among providers when applying the MRC scale. It is important for us to reassess our current tools for patient evaluation in order to improve upon both clinical evaluation and outcomes reporting. Consensus guidelines for outcomes reporting are needed, and domains outside of manual muscle testing should be included.

PMID:33990886 | DOI:10.1007/s00701-021-04861-9

Support Care Cancer. 2021 May 14. doi: 10.1007/s00520-021-06271-0. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study is to investigate the influencing factors that may impact the clinical success, jaundice-free time, and overall survival in patients of malignant hilar biliary obstruction (MHBO) treated with a self-expanding metallic stent (SEMS).

MATERIALS AND METHODS: Patients diagnosed with MHBO and treated with SEMS through percutaneous access from 1 Jul. 2013 to 1 Jul. 2018 were enrolled in this monocentric study. Demographic information, disease baseline measurements, and interventional strategies were collected and examined. Bilirubin was measured 1-3 days before and 3-7 days after stenting using the unit of “μmol/L.” The bilirubin reduction ratio was compared between different study groups, which were separated by specific characteristics. Univariate and multivariate analyses were performed to evaluate each characteristic’s impact on jaundice-free time (JF) and overall survival time (OS). Statistical analyses were conducted using SPSS 14.0, p < 0.05 indicated significance.

RESULTS: Eighty patients were enrolled. Direct bilirubin (DB) and indirect bilirubin (IB) both significantly decreased after stenting (U = 1575.0, p < 0.001; U = 1541.0, p < 0.001). The DB reduction ratio of the “nearby lymph metastases” group was significantly higher (U = 566.0, p = 0.037). The IB reduction ratio in the “single stent” group was significantly higher (U = 554.0, p = 0.018). Sixty-six cases reached jaundice recurrence, the median JF was 6 months, and the 95% confidence interval was 4.411 ~ 7.589 months. Fifty-eight cases ended in death, the median OS was 7 months, and the 95% confidence interval was 5.759 ~ 8.241 months. “Nearby lymph metastases” and “distant metastases” independently impacted OS (OR = 2.344, p = 0.013; OR = 3.239, p = 0.042). “IB reduction ratio” independently impacted both JF and OS (OR = 0.422, p = 0.021; OR = 0.315, p = 0.001).

CONCLUSION: The goal of treatment in patients with MHBO is to recover liver function. However, the overall survival is greatly impacted by the presence of metastases. Managing to obtain adequate liver function recovery may improve the long-term outcomes in affected patients.

PMID:33990879 | DOI:10.1007/s00520-021-06271-0