Tag: nevin manimala

J Endourol. 2024 Nov 29. doi: 10.1089/end.2024.0091.fts24. Online ahead of print.

ABSTRACT

Background: Scoring metrics are important to compare outcomes of different percutaneous treatments for small renal masses (RMs). The concept of trifecta (no complications, kidney function preservation, and absence of local recurrence) has been recently introduced in percutaneous thermal ablation of RM. In this context, previous studies have shown that cryoablation (CA) and microwave ablation (MWA) have similar outcomes. We aimed to validate the trifecta in CA and MWA and factors associated with treatment success. Materials and Methods: A retrospective comparative analysis of two cohorts was carried out on 190 consecutive patients with RMs treated using percutaneous CA or MWA. Nephrometry scores described RM complexity. Postoperative complications were categorized according to the Clavien-Dindo system. Glomerular filtration rate (GFR) at the last follow-up was calculated through the chronic kidney disease-epidemiology collaboration (EPI) formula, whereas detection of contrast enhancement during follow-up defined local recurrence. Last, trifecta was defined by the combination of no major (Clavien >2) complications, estimation of GFR (eGFR) decline <10%, and absence of local recurrence. Descriptive statistics and logistic regression models tested the association between predictors and trifecta achievement. Factors associated with recurrence were compared by the log-rank test. Results: Of 175 patients, 121 (69.1%) and 54 (30.8%) patients underwent CA and MWA, respectively. Median (interquartile range [IQR]) age and RM diameter were 75 years (66-80) and 2.4 cm (1.8-3.0). The CA group had a lower preoperative GFR but also had a lower rate of comorbidities (both p = 0.01). Other demographics and tumor characteristics were comparable between groups. In the CA and MWA groups, major complications occurred after 1.6% and 4.8% of procedures (p = 0.33), whereas an eGFR decline >10% was found in 31.5% and 38.8% of cases (p = 0.40), respectively. Similarly, in the CA and MWA groups, at a median follow-up of 21 (8-39) and 24 (9.5-36) months, local recurrence was observed after 10 (8.3%) and 5 (9.3%) cases (p = 0.78), trifecta was accomplished after 72 (59.5%) and 32 (59.3%; p = 1.00) procedures, respectively. Of note, recurrence-free survival (RFS) was comparable among groups (p = 0.57). Moreover, trifecta achievement was comparable when stratifying for demographics and tumor characteristics in the whole cohort and in the CA group (p > 0.05). Conversely, logistic regression showed a lower odds ratio (OR) of trifecta for lesions close to renal collecting system treated by MWA, even when accounting for maximum diameter and preoperative GFR (OR 0.21, confidence interval 0.60-0.72, p = 0.010). Of note, this factor was also associated with a significantly lower RFS (log-rank p = 0.002). Conclusions: Both percutaneous CA and MWA of RM can safely accomplish good oncological outcomes while preserving renal function. Approximately 6 out of 10 patients achieved trifecta after each procedure. Patient selection should account for tumor proximity to the collecting system, as this factor seems to impact the outcomes of MWA.

PMID:39612165 | DOI:10.1089/end.2024.0091.fts24

Child Obes. 2024 Nov 29. doi: 10.1089/chi.2024.0340. Online ahead of print.

ABSTRACT

Background: The high prevalence of obesity in Latino families with low income necessitates prevention beginning in pregnancy and continuing through infancy. Due to systemic inequities, adverse social determinants of health (SDoH) and mental health symptoms may limit program efficacy by presenting barriers to attendance. We sought to assess: (1) the feasibility of the Starting Early Program (StEP) Prenatal, a 17-session intervention beginning early in pregnancy and continuing to 18 months postpartum; and (2) the effects of adverse SDoH (material hardship, low social support) and mental health symptoms (depression, anxiety, stress) on program attendance. Methods: We conducted a single-arm feasibility trial of StEP Prenatal, enrolling from December 2018 to February 2020 (n = 231). We assessed feasibility (recruitment, retention, fidelity, attendance) and direct and interactive effects of adverse SDoH and mental health symptoms on attendance. We used zero-inflated Poisson regression, adjusting for maternal age, marital status, nativity, education, and pandemic timing. Results: We recruited 57% of eligible participants, with 213 remaining eligible to receive the full program. Retention was 75%. Median fidelity for group format was 64%; median attendance per session was 69%; median number of program sessions attended was 13. Baseline material hardship and high perceived stress predicted approximately one additional session attended. Similar effects were seen for low social support in the absence of anxiety symptoms. Conclusion: Despite pandemic disruptions, StEP Prenatal was feasible to deliver and participants with adverse SDoH at baseline were particularly motivated to attend. Futures studies should tailor programs to baseline SDoH and test flexible implementation models.

PMID:39612164 | DOI:10.1089/chi.2024.0340

Infection. 2024 Nov 29. doi: 10.1007/s15010-024-02446-z. Online ahead of print.

ABSTRACT

PURPOSE: To explore the role of supplementing vitamin D in the prevention and treatment of tuberculosis infection through a meta-analysis of randomized controlled trials.

METHODS: The databases of PubMed, Cochrane Library, Embase, and Web of Science were systematically searched from inception to April 21, 2024, to identify studies comparing vitamin D supplementation with non-vitamin D supplementation for tuberculosis infection prevention or treatment. The inclusion criteria were randomized controlled trials involving participants diagnosed with either no tuberculosis or tuberculosis, with the intervention group receiving vitamin D supplementation and the control group receiving a placebo or standard treatment, and reporting outcomes related to tuberculosis prevention or treatment effects. The exclusion criteria were studies without full text and those not meeting the specific participant or treatment criteria. The analysis was performed using the Inverse Variance method with a random-effects model. Subgroup analyses were conducted to explore the impact of different administration routes. The stability of the pooled results was assessed using the leave-one-out method. Publication bias was evaluated with Egger’s and Begg’s tests.

RESULTS: We identified a total of 26 eligible trials, involving 19,586 participants. Four trials compared the preventive effects of vitamin D supplementation on tuberculosis infection, and the results (RR 0·75; 95% CI 0·56 to 1·01) were inconclusive. Regarding the role of vitamin D supplementation in anti-tuberculosis treatment, there were no significant statistical differences between the vitamin D and non-vitamin D groups in sputum smear conversion, sputum culture conversion, or time to sputum culture conversion. However, patients in the vitamin D group showed significantly lower Tuberculosis scores at 8 weeks (MD – 0·39; 95% CI -0·57 to -0 22) and 12 weeks (MD – 0·53; 95% CI – 0·84 to – 0·22). There were similar safety profiles between the two groups. Subgroup analysis based on the frequency of vitamin D intake revealed that patients who received daily vitamin D supplementation had higher rates of sputum smear conversion at 6 weeks and 8 weeks. They also had lower TB scores at 8 weeks.

CONCLUSION: Supplementing with vitamin D during anti-tuberculosis treatment does not accelerate the clearance of tuberculosis bacteria, but it can improve patient symptoms.

PMID:39612153 | DOI:10.1007/s15010-024-02446-z

Aging Clin Exp Res. 2024 Nov 29;36(1):228. doi: 10.1007/s40520-024-02884-7.

ABSTRACT

BACKGROUND: The COVID-19 pandemic impacted worldwide. The Basque Country was one of the regions in Spain most affected by the virus.

METHODS: In this retrospective study, we took advantage of the Basque Health Service electronic health records data lake of over 20,000 deceased individuals, including 5000 positives for COVID-19, between 2020 and 2022 in Gipuzkoa (Basque Country, Spain).

RESULTS: Comparison between COVID-19-positive and negative individuals’ showed that the prevalence of infections was higher inside nursing homes and COVID-19 promoted a significant rise in hospitalizations, emergency entrances, and ICU admissions. No differences were observed between genders in terms of infections or survival but were detected in health resources and vaccination showed a strong protective effect against the disease.

CONCLUSIONS: Our results provided a complete characterization of the impact of COVID-19 on the Basque population, which expands the knowledge of the pandemic on older individuals and the health system. Our study also highlights the benefit of the use of Electronic Health Records in studying human diseases.

PMID:39612148 | DOI:10.1007/s40520-024-02884-7

Matern Child Health J. 2024 Nov 29. doi: 10.1007/s10995-024-04021-2. Online ahead of print.

ABSTRACT

OBJECTIVE: Existing research has shown that parental exposure to violence has negative consequences on health outcomes, but the effect of such exposure on unmet health care and social service need is unknown. This study aims to investigate the association between unmet health care and social services and parental violence exposure among parents with children.

STUDY DESIGN: This study used the data of 6289 parents aged 18-60 years who had at least one child under 18 years living in the same household. Parental violence exposure was measured. Unmet child and adult health care and social service need was operationalized through questions on the services needed, those that had not been received, and those that were considered inadequate.

RESULTS: Parents who experienced any kind of violence had more unmet service need. There were more women among parents with violence experience (65.4%) than those with no violence experience (51.9%). Violence experience increased the odds of unmet need for general adult healthcare services (OR 2.02, CI 1.64-2.57), maternity and child health clinics (OR 2.52, CI 2.00-3.18), family guidance clinics and home help (OR 2.38, CI 1.60-3.54), mental health or child welfare services (OR 2.05, CI 1.52-2.75), and school health care (OR 1.99, 1.50-2.65). After adjusting for sociodemographic factors, the associations between exposure to violence experience and unmet needs for healthcare and social services remained statistically significant.

CONCLUSION: Violence in close relationships profoundly impacts health and well-being. By addressing unmet health care needs and supporting parents, we can break the cycle of violence and promote better mental health outcomes. Preventive policies and early interventions are essential to mitigate the consequences of violence in families.

PMID:39612136 | DOI:10.1007/s10995-024-04021-2

Health Econ Rev. 2024 Nov 29;14(1):101. doi: 10.1186/s13561-024-00582-8.

ABSTRACT

BACKGROUND: Healthcare-associated infections (HCAI) are common in long-term care facilities (LTCF) and cause significant burden. Infection prevention and control (IPC) measures include the clinical best practices (CBP) of hand hygiene, hygiene and sanitation, screening, and basic and additional precautions. Few studies demonstrate their cost-effectiveness in LTCF, and those that do, largely focus on one CBP. An overarching synthesis of IPC economic analyses in this context is warranted. The aim of this paper is to conduct a systematic review of economic evaluations of CBP applied in LTCF.

METHODS: We twice queried CINAHL, Cochrane, EconLit, Embase, Medline, Web of Science and Scopus for studies published in the last three decades of economic evaluations of CBP in LTCF. We included controlled and randomized clinical trials, cohort, longitudinal, follow-up, prospective, retrospective, cross-sectional, and simulations studies, as well as those based on mathematical or statistical modelling. Two reviewers conducted study selection, data extraction, and quality assessment of studies. We applied discounting rates of 3%, 5% and 8%, and presented all costs in 2022 Canadian dollars. The protocol of this review was registered with Research Registry (reviewregistry1210) and published in BMC Systematic Reviews.

FINDINGS: We found 3,331 records and then 822 records; ten studies were retained. The economic analyses described were cost-minimization (n = 1), cost-benefit (n = 1), cost-savings (n = 2), cost-utility (n = 2) and cost-effectiveness which included cost-utility and cost-benefit analyses (n = 4). Four studies were high quality, three were moderate, and three were low quality. Inter-rater agreement for quality assessment was 91⋅7%. All studies (n = 10) demonstrated that CBP associated with IPC are clinically effective in LTCF and many (n = 6) demonstrated their cost effectiveness.

INTERPRETATION: Ongoing economic evaluation research of IPC remains essential to underpin healthcare policy choices guided by empirical evidence for LTCF residents and staff.

PMID:39612116 | DOI:10.1186/s13561-024-00582-8

Environ Sci Pollut Res Int. 2024 Nov 29. doi: 10.1007/s11356-024-35550-6. Online ahead of print.

ABSTRACT

The mercury content in the hair of residents in the industrial city of Cherepovets (0.297 mg/kg) is three times lower than that of residents in the specially protected natural area of Kirillovsky district (0.877 mg/kg), which is approximately 110 km away from Cherepovets. In both the residents of the industrial city and in the protected area, the mercury content in hair increases with the age of the individuals. In the population of the city, there is no difference between the mercury content in the hair and the frequency of fish consumption. The mercury content in the hair of the population from the protected area depends on the frequency of fish consumed in their diet. The average value of the ratio of stable nitrogen isotopes (δ¹⁵N) in the hair of the participants is 10.11‰. No differences have been established between the ratio of stable nitrogen isotopes (δ¹⁵N) in the hair of residents of the industrial city (10.00‰) and the protected area (10.19‰). People with a mercury content in their hair above the median value had statistically significantly higher δ¹⁵N values in both residents of industrial city and protected area. A correlation was established between the isotopic signature of nitrogen and the amount of mercury in the hair both in the whole sample (Rs = 0.515, at p = 0.000), and in the industrial city (Rs = 0.425, at p = 0.002) and in the protected area residents (Rs = 0.706, at p = 0.000). That may be due to the differences in diet, as rural population has a traditionally high level of consumption of wild freshwater fish from local reservoirs while people from industrial city mainly purchase fish (seafood, marine fish, freshwater fish) from supermarkets.

PMID:39612094 | DOI:10.1007/s11356-024-35550-6

Environ Sci Pollut Res Int. 2024 Nov 29. doi: 10.1007/s11356-024-35548-0. Online ahead of print.

ABSTRACT

Air, water, and soil pollution pose significant threats to environmental and human health, particularly in rapidly urbanising regions. This comprehensive review evaluates the scientific literature on plant biomonitoring in the State of São Paulo, Brazil, from 2009 to 2019, aiming to compile data for future research, assess the distribution of biomonitoring studies, and analyse their relationship to human health outcomes. To the extent of our knowledge, a review according to the criteria of this article has not yet been carried out. The review followed the ENTREQ protocol and employed a systematic search methodology, with thematic synthesis and descriptive statistics (percentage). Of the 656 studies identified, only 56 met the inclusion criteria. Air pollution was the most researched (91% of studies), and the city of São Paulo was the most frequent (40.2%). Leaves were the most analysed plant part (48.5%), and Tibouchina tipu was the most studied species (8.6%). Only five studies included here related the data to human health, focusing on respiratory diseases. The review presents an integrative framework illustrating the interplay between urbanisation, pollution, biomonitoring, and health outcomes. Despite limitations, plant biomonitoring offers valuable insights into the environmental and health impacts of pollution in São Paulo and can also serve as a guide for students and researchers on plant biomonitoring and its relationship with the diversity of pollutants and contaminants present in the biosphere, serving as support for the development of public policies regarding the improvement of environmental quality.

PMID:39612093 | DOI:10.1007/s11356-024-35548-0

Geroscience. 2024 Nov 29. doi: 10.1007/s11357-024-01457-w. Online ahead of print.

ABSTRACT

Obesity is a significant modifiable risk factor for dementia. This study aims to quantify the global impact of obesity on dementia burden and examine how national strategies for managing overweight/obesity and dietary factors influence dementia prevalence and mortality, with a focus on sex-specific differences. We used data from the Global Burden of Disease (GBD) and World Health Organization (WHO) to evaluate the association between obesity age-standardized prevalence rate (ASPR) and dementia age-standardized mortality rate (ASMR) and ASPR across 161 countries. A two-step multivariate analysis adjusted for socioeconomic and lifestyle factors was performed. Temporal trends in dementia were analyzed based on the presence of national obesity management strategies and varying dietary scores. A 1% increase in national obesity prevalence was associated with a 0.36% increase in dementia mortality (OR: 1.0036; 95% CI: 1.0028-1.0045) in males and 0.12% in females (OR: 1.0012; 95% CI: 1.0007-1.0018). A 1% increase in national obesity ASPR was associated with an increase in ASPR of dementia by 0.26% for males (OR: 1.0026, 95% CI: 1.0024-1.0028) and 0.05% for females (OR: 1.0005, 95% CI: 1.0004-1.0006). Males exhibited a higher susceptibility to obesity-related dementia. Countries with national obesity management strategies showed a significantly greater reduction in dementia mortality, particularly among females (P = 0.025). Higher dietary scores were associated with a more significant decrease in dementia prevalence across both sexes. Rising obesity prevalence is linked to increased dementia burden globally, with males being more vulnerable to this relationship. National management of overweight/obesity and healthier dietary habits may help mitigate the dementia burden, emphasizing the need for integrated public health interventions.

PMID:39612068 | DOI:10.1007/s11357-024-01457-w

J Autism Dev Disord. 2024 Nov 29. doi: 10.1007/s10803-024-06667-x. Online ahead of print.

ABSTRACT

ABSRACT: PURPOSE: The several prior studies assessing gender identity in young autistic individuals mostly included a mix of child and adolescent participants, heavily relied on parent-reported measures, and yielded mixed findings. A single parent-reported item from the Child Behavior Checklist assessing “wish to be of the opposite sex” was employed in most of these studies. Only one prior study focused specifically on children, but that study employed parent-reported measures.

METHODS: Using self-reported multidimensional measures, the present study assessed gender identity in autistic and non-autistic children aged 4 to 11 years (30 autistic boys, 35 non-autistic boys, 20 autistic girls, 35 non-autistic girls). Child-friendly measures were used to assess own-gender similarity, other-gender similarity, gender contentedness, and wish to be of the other gender. Vocabulary and non-verbal reasoning were also assessed.

RESULTS: Based on descriptive statistics, compared with non-autistic boys, autistic boys showed increased gender identity variance across all four dimensions (lower own-gender similarity, higher other-gender similarity, lower gender contentedness, greater wish to be of the other gender). These group differences between autistic and non-autistic boys were medium and statistically significant for three of the four dimensions and small-to-medium and marginally significant for the remaining dimension. Autistic girls and non-autistic girls did not show consistent or significant differences in gender identity. There were no differences between the autistic and non-autistic groups in vocabulary or non-verbal reasoning in either boys or girls.

CONCLUSION: Gender identity variance may emerge early in development in autistic individuals, but the trajectory may differ for boys and girls.

PMID:39612065 | DOI:10.1007/s10803-024-06667-x