Tag: nevin manimala

Euro Surveill. 2024 Nov;29(48). doi: 10.2807/1560-7917.ES.2024.29.48.2400138.

ABSTRACT

BackgroundLate HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing.AimTo determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece.MethodsThis multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019-21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis.ResultsAmong 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis.ConclusionMOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.

PMID:39611208 | DOI:10.2807/1560-7917.ES.2024.29.48.2400138

Euro Surveill. 2024 Nov;29(48). doi: 10.2807/1560-7917.ES.2024.29.48.2400347.

ABSTRACT

BackgroundGlobal data highlight the disproportionate burden of HIV and sexually transmitted infections (STIs) among transgender individuals. However, scant data exist for both transgender and non-binary individuals in European HIV/STI surveillance.AimTo assess self-reported prevalence of HIV and bacterial STIs (syphilis, gonorrhoea, chlamydia) in the past 6 months among transgender and non-binary individuals, comparing the likelihoods of recent STIs between groups.MethodsUsing data from the cross-sectional PROTECT survey conducted in 20 European countries from October 2023 to April 2024, we analysed a subset of 452 participants, 178 transgender and 274 non-binary individuals. Logistic regression was used to compare the risk of each recent bacterial STI, and Poisson regression to compare the risk of the number of recent STIs.ResultsAmong transgender individuals, 5 (2.8%) self-reported HIV infection, and recent STI prevalence was 6.7% for syphilis, 15.6% for gonorrhoea and 19.6% for chlamydia. For non-binary individuals, 15 (5.5%) self-reported HIV infection and recent STI prevalence was 15.0% for syphilis, 18.7% for gonorrhoea and 20.8% for chlamydia. Non-binary individuals had significantly higher risk for syphilis (aOR: 1.81; 95% CI: 1.01-4.05) and multiple recent STIs (aOR: 1.46; 95% CI: 1.11-1.91) compared with transgender individuals.ConclusionWhile both transgender and non-binary individuals showed high self-reported prevalence of HIV and bacterial STIs, non-binary individuals showed greater prevalence of STIs, particularly syphilis. Efforts aimed at HIV/STI prevention and surveillance should encourage inclusion of those who identify as non-binary and other gender-diverse individuals alongside transgender individuals to enhance the provision of tailored prevention and treatment services in Europe.

PMID:39611207 | DOI:10.2807/1560-7917.ES.2024.29.48.2400347

Rheumatol Adv Pract. 2024 Nov 5;8(4):rkae135. doi: 10.1093/rap/rkae135. eCollection 2024.

ABSTRACT

OBJECTIVES: Real-world evidence is needed to inform treatment strategies for patients with PsA and axial SpA (axSpA) who have non-musculoskeletal manifestations (NMMs), various risk factors and comorbidities. International collaboration is required to ensure statistical power and to enhance generalizability. The first step forward is identifying which data are currently being collected. Across 17 registries participating in the European Spondyloarthritis Research Collaboration (EuroSpA), we aimed to map recording practices for NMMs, comorbidities and safety outcomes in patients with PsA and axSpA.

METHODS: Through a survey with 4,420 questionnaire items, we explored the recording practices of 58 pre-defined conditions (i.e. NMMs, comorbidities and safety outcomes) covering 10 disease areas. In all registries we mapped for each condition whether it was recorded, the recording procedure and the potential to identify it through linkage to other national registries.

RESULTS: Conditions were generally recorded at entry into the registry and clinical follow-up visits using a pre-specified list or a coding system. Most registries recorded conditions within the following disease areas: NMMs (number of registries, n = 15-16), cardiovascular diseases (n = 10-14), gastrointestinal diseases (n = 12-13), infections (n = 10-13) and death (n = 14). Nordic countries had the potential for data linkage and generally had limited recording of conditions in their registry, while other countries had comprehensive recording practices.

CONCLUSION: A wide range of conditions were consistently recorded across the registries. The recording practices of many conditions and disease areas were comparable across the registries. Our findings support the potential for future collaborative research.

PMID:39611201 | PMC:PMC11604170 | DOI:10.1093/rap/rkae135

J Clin Orthop Trauma. 2024 Nov 7;59:102800. doi: 10.1016/j.jcot.2024.102800. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is expected to relieve pain and reduce the use of analgesics in patients with advanced knee osteoarthritis. However, in some cases, there is no relief in the pain of the patients and the use of analgesics continues. The aim of this study was to compare analgesic consumption one year before and after TKA in the same patient group and to evaluate whether there is a decrease in analgesic consumption after TKA.

METHOD: The cumulative amounts of analgesia used by the patients in the one-year periods before and after the operation were checked from the automated patient records system and the national systems showing drug prescriptions. The dosages of all the analgesics used in the one-year periods before and after the operation were calculated and converted to oral morphine equivalents (OME). The demographic data of the patients, cumulative OME and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used in the assessment.

RESULTS: It was observed that there was a statistically significant improvement in Womac scores after the treatment compared to the pre-treatment. Although the mean amount of analgesics decreased compared to pre-treatment, it was not statistically significant. Also, age and preoperative analgesic use were found to be the two most important factors in relation to total postoperative analgesic consumption.

CONCLUSION: The results of this study indicate that there may not be a substantial reduction in the use of analgesic by patients within the first year after TKA. Furthermore, the age and preoperative analgesic use were identified as the two primary factors influencing postoperative analgesic consumption.

LEVEL OF EVIDENCE: Retrospective Cohort Study.

PMID:39611163 | PMC:PMC11600055 | DOI:10.1016/j.jcot.2024.102800

Front Cell Infect Microbiol. 2024 Nov 14;14:1439143. doi: 10.3389/fcimb.2024.1439143. eCollection 2024.

ABSTRACT

BACKGROUND: The accurate and sensitive diagnosis of intracranial infection continues to pose a critical challenge. This study aimed to probe into the clinical value of heparin binding protein (HBP) in bacterial intracranial infection.

METHODS: Patients suspected of having bacterial intracranial infection and admitted to Shanghai General Hospital from November 2021 to November 2023 were selected as study subjects and divided into an infected group and a non-infected group. The receiver operating characteristic (ROC) curve was constructed to compare the diagnostic accuracy of HBP, procalcitonin (PCT), and C-reactive protein (CRP), as well as their value in differentiating Gram-positive bacteria and Gram-negative bacterial infections.

RESULTS: According to the results of bacterial identification, the infected groups were divided into a Gram-negative bacteria group (n = 142) and a Gram-positive bacteria group (n = 128), while the non-infected group comprised 120 patients after neurosurgery involving dura opening. Statistically significant differences were observed in the levels of HBP, PCT, and CRP between the infected group and the non-infected group (all p< 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of HBP was 0.935, and the AUCs of PCT and CRP were 0.931 and 0.863, respectively. In the comparison of HBP, PCT, and CRP levels in the Gram-negative bacteria and Gram-positive bacteria groups, the AUCs were 0.816, 0.602, and 0.591, respectively. When the cutoff value of HBP was 72.34 ng/mL, its specificity reached 96.1% and its sensitivity was 57.8%. When PCT and CRP levels were less than 1.67 ng/mL and 23.12 ng/mL, respectively, both the sensitivity (52.3%, 53.1%) and specificity (66.9%, 59.9%) were relatively low.

CONCLUSION: HBP, PCT, and CRP can be employed as diagnostic indicators for bacterial intracranial infection. HBP (>72.34 ng/mL) can act as an important index for the diagnosis of Gram-negative bacteria in patients with intracranial infection.

PMID:39611102 | PMC:PMC11602516 | DOI:10.3389/fcimb.2024.1439143

Front Microbiol. 2024 Nov 14;15:1480022. doi: 10.3389/fmicb.2024.1480022. eCollection 2024.

ABSTRACT

BACKGROUND: Epilepsy is a prevalent chronic neurological disorder that is strongly associated with a wide range of psychological, cognitive and social problems. It affects a significant proportion of the global population and has a number of complex etiologies. A growing body of research indicates that there is a strong association between epilepsy and the gut microbiota. Indeed, a substantial body of research has investigated the potential role of epilepsy in relation to the gut microbiota, examining alterations in the abundance, diversity, and relative abundance of the gut microbiota in patients with epilepsy.

METHODS: This study was conducted in accordance with the PRISMA guidelines and included multiple studies that met specific criteria. A keyword search was conducted in the following databases: PubMed, Embase, and Web of Science. The data extraction and quality assessment were conducted by two independent researchers. A systematic review and meta-analysis of the relationship between patients with epilepsy and gut flora was conducted using the R 4.3.4 software.

RESULTS: The results of the analyses indicated that the intestinal flora of patients with epilepsy did not differ significantly in alpha diversity compared to healthy controls. However, the relative abundance of specific flora, such as Verrucomicrobia and Ackermannia was significantly increased in patients, whereas Lactobacillus was significantly decreased.

CONCLUSION: The relationship between epilepsy and gut flora is reciprocal. The present meta-analysis demonstrated that there were no statistically significant alterations in the overall characteristics of the intestinal flora of the patients. However, significant changes were observed in the relative abundance of certain phyla and genera. Consequently, it is hypothesized that epilepsy can cause changes in the relative abundance of specific flora in patients. Furthermore, in conjunction with previous studies, it is believed that changes in intestinal flora can also have an effect on seizures. For example, Lactobacillus may be a beneficial genus that potentially reduces seizures. Conversely, the effect of Akkermansia is two-sided.

PMID:39611090 | PMC:PMC11602489 | DOI:10.3389/fmicb.2024.1480022

npj Quantum Inf. 2024;10(1):124. doi: 10.1038/s41534-024-00918-6. Epub 2024 Nov 26.

ABSTRACT

Quantum computing platforms are subject to contradictory engineering requirements: qubits must be protected from mutual interactions when idling (‘doing nothing’), and strongly interacting when in operation. If idling qubits are not sufficiently protected, information ‘leaks’ into neighbouring qubits, becoming ultimately inaccessible. Candidate solutions to this dilemma include many-body localization, dynamical decoupling, and active error correction. However, no protocol exists to quantify this effect in a similar way to e.g. SPAM errors. We develop a scalable, device non-specific, protocol for quantifying idle information loss by exploiting tools from quantum information theory. We implement this protocol in over 3500 experiments carried out across 4 months (Dec 2023-Mar 2024) on IBM’s entire Falcon 5.11 processor series. After accounting for other error sources, we detect information loss to high degrees of statistical significance. This work thus provides a firm quantitative foundation from which the protection-operation dilemma can be investigated and ultimately resolved.

PMID:39611079 | PMC:PMC11599043 | DOI:10.1038/s41534-024-00918-6

Front Physiol. 2024 Nov 14;15:1258175. doi: 10.3389/fphys.2024.1258175. eCollection 2024.

ABSTRACT

OBJECTS: Anterograde renal pelvis perfusion manometry is an effective method to assist in the diagnosis of upper urinary tract obstruction.

METHODS: To established a rat model of partial ureteral obstruction to explore the perfusion rate, renal pelvis volume, obstruction sites, contralateral upper urinary tract, and lower urinary tract functions, which may affect anterograde renal pelvis perfusion manometry. To measure the renal pelvis volume using ultrasound. Depending on whether clamped the contralateral ureter and it continuously emptied the bladder, perfused the renal pelvis at rate of 15, 30, 60, 90, or 120 mL/h to measure the pressure synchronously.

RESULTS: The research showed the renal pelvis volume of UPJ and UVJ at 1, 2, 3, and 4 weeks respectively, significantly increased compared with the control group. Comparison of the renal pelvis volume between the UPJ and UVJ groups was not statistically significant. The renal pelvis pressure of UPJ and UVJ was significantly increased compared with the control group, and the UVJ group was greater than the UPJ group. The renal pelvic pressure increased as the perfusion rate increased. Comparing the renal pelvis pressure measured using synchronous bladder emptying with the renal pelvis pressure measured singly, the difference was statistically significant. Comparing the renal pelvis pressure measured using synchronous bladder emptying with measured with a clamped contralateral ureter, the difference was not statistically significant; however, in some groups, the difference was statistically significant. Measuring the renal pelvis pressure singly and clamping the contralateral ureter, the difference was not statistically significant, except in some groups, the difference was significant.

CONCLUSION: The study suggested that ureter obstruction sites, perfusion rates, renal pelvis volumes, and synchronous bladder emptying affects the renal pelvis pressure. The function of the contralateral upper urinary tract did not affect renal pelvis pressure in the short term.

PMID:39611076 | PMC:PMC11602502 | DOI:10.3389/fphys.2024.1258175

Cureus. 2024 Nov 21;16(11):e74171. doi: 10.7759/cureus.74171. eCollection 2024 Nov.

ABSTRACT

This study evaluated the comparative efficacy of different beta blockers bisoprolol, carvedilol, and metoprolol in reducing mortality and hospitalizations among 120 heart-failure (HF) patients. The sample had an equal gender distribution (50% male, 50% female) with a mean age of 69.28 years. Baseline characteristics, such as systolic blood pressure (mean: 134.36 mmHg) and left ventricular ejection fraction (LVEF) (mean: 40.24%), were comparable across the treatment groups. Patients were treated with either bisoprolol (30%), carvedilol (30%), or metoprolol (40%) for an average of 27.54 weeks. The study utilized Poisson and negative binomial regression models to assess hospitalization rates, and chi-square tests to compare mortality outcomes. Results revealed that mortality was 44.2% across the entire cohort, with no significant differences between the three beta-blocker groups (p = 0.301). Similarly, no significant differences were observed in hospitalizations (p = 0.276) or ICU admissions (p = 0.797). However, patients on bisoprolol and carvedilol exhibited a slight improvement in New York Heart Association (NYHA) class and LVEF, though this was not statistically significant (p = 0.145 and p = 0.477, respectively). Side effects, including bradycardia, fatigue, and hypotension, were noted in 32.5%, 21.7%, and 23.3% of patients, respectively. These findings suggest that all three beta blockers are similarly effective in reducing mortality, though bisoprolol and carvedilol may offer better control of HF symptoms.

PMID:39611070 | PMC:PMC11604132 | DOI:10.7759/cureus.74171

Front Clin Diabetes Healthc. 2024 Nov 14;5:1464365. doi: 10.3389/fcdhc.2024.1464365. eCollection 2024.

ABSTRACT

The purpose of the study is to investigate the importance of education and re-education for the proper use of the insulin pump (IP) in order to maintain stable glycemic control over an extended period.

METHODS: The study was designed as a cross-sectional retrospective study. A total of 168 patients participated in a five-day structured education program in a small group. Following the initial education, 42 patients who met the criteria for continuation of IP treatment continued to be monitored every six months (period I). After six years of follow-up (period II) data from 36 patients were taken and analyzed. The data from the IP were downloaded from the IP Paradigm 754 “VEO” (Medtronic Inc., Illinois, USA) on the personal computer via the CareLink Pro software (Medtronic, Inc., Illinois).

RESULTS: The number of patients using the bolus calculator (BC+) for at least 50% of all administered boluses remained high in both periods. However, BC+ patients statistically significantly increased their A1C value in period II. The average number of hypoglycemias was statistically significantly increased in the group of BC+ patients in period II compared to period I (p=0.009). The continuous glucose monitors (CGM) were used only in period II, so the number of hypoglycemias in period I were roughly estimated.

CONCLUSIONS: The long-term success of IP therapy primary depends on the proper use of the device, highlighting the importance of good education and regular re-education for both patients and health professionals. Advanced hybrid technology systems could be particularly in settings with poorly organized healthcare, where re-education is not routinely provided and diabetes control relies heavily on the patient engagement.

PMID:39611060 | PMC:PMC11602451 | DOI:10.3389/fcdhc.2024.1464365