Tag: nevin manimala

BMC Res Notes. 2023 Jul 27;16(1):158. doi: 10.1186/s13104-023-06395-y.

ABSTRACT

OBJECTIVE: To examine the clinical efficacy of prophylactic metoclopramide in reducing the incidence of nausea and vomiting in emergency department (ED) patients with acute pain who were treated with intravenous tramadol.

RESULTS: We conducted a single-center randomized, double-blinded, placebo-controlled trial. A total of 99 ED patients presented with acute pain were recruited. Sixty-four patients were randomized, 31 patients in the treatment arm and 33 in the control arm. Overall, there were no significant differences in baseline characteristics between treatment arm and control arm. Only one patient within each arm reported having nausea symptom. No patients reported vomiting episode. There was no statistically significant difference in the proportion of patients with nausea or vomiting symptoms between the two groups (3.2% in the treatment arm vs. 3.0% in the control arm, p = 1.000). The administration of prophylactic metoclopramide may not provide additional benefit in reducing the occurrence of nausea and/or vomiting episode in ED patients with acute pain treated with intravenous tramadol. Trial registration Randomized clinical trial TCTR20220525001; registration date: 21 October 2021. Retrospectively registered.

PMID:37501098 | DOI:10.1186/s13104-023-06395-y

Chaos. 2023 Jul 1;33(7):073151. doi: 10.1063/5.0159675.

ABSTRACT

Dynamical systems that are used to model power grids, the brain, and other physical systems can exhibit coexisting stable states known as attractors. A powerful tool to understand such systems, as well as to better predict when they may “tip” from one stable state to the other, is global stability analysis. It involves identifying the initial conditions that converge to each attractor, known as the basins of attraction, measuring the relative volume of these basins in state space, and quantifying how these fractions change as a system parameter evolves. By improving existing approaches, we present a comprehensive framework that allows for global stability analysis of dynamical systems. Notably, our framework enables the analysis to be made efficiently and conveniently over a parameter range. As such, it becomes an essential tool for stability analysis of dynamical systems that goes beyond local stability analysis offered by alternative frameworks. We demonstrate the effectiveness of our approach on a variety of models, including climate, power grids, ecosystems, and more. Our framework is available as simple-to-use open-source code as part of the DynamicalSystems.jl library.

PMID:37499248 | DOI:10.1063/5.0159675

JCO Oncol Pract. 2023 Jul 27:OP2300146. doi: 10.1200/OP.23.00146. Online ahead of print.

ABSTRACT

PURPOSE: Burkitt lymphoma is an aggressive B-cell lymphoma requiring intensive therapy, which places patients at risk for severe toxicity. However, few studies have described these patients’ clinical outcomes and health care utilization, particularly among older adults.

METHODS: We conducted a retrospective analysis of adults 40 years and older with Burkitt lymphoma at Massachusetts General Hospital and Dana-Farber Cancer Institute from February 1999 to December 2020 (N = 97). We abstracted patient characteristics, clinical outcomes, and health care utilization (unplanned hospitalizations, intensive care unit [ICU] admissions) during therapy from the electronic health record. Using univariate logistic regression, we examined factors associated with rates of unplanned hospitalization and ICU admission during therapy.

RESULTS: Among evaluable patients (median age, 69 years; 23.7% female; 19.3% with bone marrow involvement), 45.8% (38 of 83) experienced unplanned hospitalization and 23.2% (19 of 82) experienced ICU admission during therapy. Among those 70 years and older, rates of unplanned hospitalization and ICU admission were 36.8% (14 of 38) and 29.0% (11 of 38), respectively. Bone marrow involvement (odds ratio [OR], 3.00; P = .069) was associated with a nonsignificantly greater likelihood of unplanned hospitalization. Older age (OR, 1.06; P = .039), Charlson comorbidity index >0 (OR, 3.14; P = .038), and hypoalbuminemia (OR, 3.22; P = .035) were associated with greater likelihood of ICU admission. Overall, 8.7% (8 of 92) of patients died during treatment, all of whom were 70 years and older.

CONCLUSION: Adults with Burkitt lymphoma experience substantial rates of unplanned hospitalizations and ICU admissions, with older adults at especially high risk for ICU admission and death during treatment. Our findings underscore the need to develop supportive care interventions for patients with Burkitt lymphoma to help improve clinical outcomes and health care utilization.

PMID:37499211 | DOI:10.1200/OP.23.00146

J Holist Nurs. 2023 Jul 27:8980101231186033. doi: 10.1177/08980101231186033. Online ahead of print.

ABSTRACT

Purpose: To evaluate the impact of an abbreviated (4-week) and asynchronous, mindfulness-based intervention (MBI) on nurses’ perceived stress and mindful attention and awareness. Design: An evidence-based quality improvement pilot program. Methods: The participants (n = 15 nurses) attended a 4-week, asynchronous MBI. The participants attended a 90-minute webinar on mindfulness as a prerequisite, followed by 4 weeks of guided meditation and informal mindfulness practice materials. The MBI was offered remotely with self-modulated practice. Participants also provided the number of days per week they participated in formal meditation practice. Project participants completed pre- and post-intervention questionnaires. Project instruments included the Mindful Attention Awareness Scale (MAAS) and the 10-item Perceived Stress Scale (PSS). Findings: 12 complete pre-and post-intervention surveys were analyzed. Significant improvements were noted in participant mean MAAS scores post-intervention (p = .004). Cumulative PSS scores also decreased post-intervention (p = .009). Conclusion: The 4-week MBI demonstrated a statistically significant impact on nurses’ perceived stress and mindful attention and awareness. Additionally, this Doctor of Nursing Practice (DNP) student led program was offered in an asynchronous and remote format, which was received well by program participants and may be a practical option for future MBIs.

PMID:37499197 | DOI:10.1177/08980101231186033

Eur J Prev Cardiol. 2023 Jul 27:zwad243. doi: 10.1093/eurjpc/zwad243. Online ahead of print.

ABSTRACT

BACKGROUND: It is unclear whether the future risk of cardiovascular events in breast cancer (BC) survivors is greater than in the general population.

OBJECTIVES: This meta-analysis quantifies the risk of cardiovascular disease development in breast cancer patients, compared to the risk in a general matched cancer-free population and reports the incidence of cardiovascular events in patients with BC.

METHODS: We searched PubMed, Scopus, and Web of Science databases (up to March 23, 2022) for observational studies and post-hoc analyses of RCTs. Cardiovascular death, heart failure (HF), atrial fibrillation (AF), coronary artery disease (CAD), myocardial infarction (MI), stroke were the individual endpoints for our meta-analysis. We pooled incidence rates (IRs) and risk in hazard ratios (HRs), using random-effects meta-analyses. Heterogeneity was reported through the I^2 statistic, and publication bias was examined using funnel plots and Egger’s test in the meta-analysis of risk.

RESULTS: 142 studies were identified in total, 26 (836,301 patients) relevant to the relative risk, and 116 (2,111,882 patients) relevant to IRs. Compared to matched cancer-free controls, BC patients had higher risk for cardiovascular death within five years of cancer diagnosis (HR = 1.09; 95% CI: 1.07, 1.11), HF within ten years (HR = 1.21; 95% CI: 1.1, 1.33), and AF within three years (HR = 1.13; 95% CI: 1.05, 1.21). The pooled IR for cardiovascular death was 1.73 (95% CI 1.18, 2.53), 4.44 (95% CI 3.33, 5.92) for HF, 4.29 (95% CI 3.09, 5.94) for CAD, 1.98 (95% CI 1.24, 3.16) for MI, 4.33 (95% CI 2.97, 6.30) for stroke of any type, and 2.64 (95% CI 2.97, 6.30) for ischemic stroke.

CONCLUSION: breast cancer exposure was associated with the increased risk for cardiovascular death, HF and AF. The pooled incidence for cardiovascular endpoints varied depending on population characteristics and endpoint studied.

PMID:37499186 | DOI:10.1093/eurjpc/zwad243

JCO Glob Oncol. 2023 Jul;9:e2200244. doi: 10.1200/GO.22.00244.

ABSTRACT

PURPOSE: Acute leukemias are associated with substantial morbidity and mortality, particularly in the adult population. Despite an increasing burden of acute leukemia in developing countries, there are limited data on clinical outcomes and prognostic factors in this setting. In this study, we aimed to describe the clinical characteristics, survival, and prognostic factors of adults with acute leukemia at the Uganda Cancer Institute (UCI).

METHODS: A retrospective cohort study was conducted between January 2009 and December 2018, reviewing data of patients 18 years or older with a cytopathologic diagnosis of acute leukemia at UCI. Data were extracted on clinical and laboratory characteristics, response to treatment, and survival. Cox-proportional hazards regression and survival analysis were performed to determine survival rates and associated factors. P < .05 was considered statistically significant.

RESULTS: In total, 233 participants were enrolled. Most (59.2%. n = 138) participants were male, with a median age of 32 years (IQR, 23-48 years), and 136 (58.4%) had AML. Overall, the 1-year survival was 16.5%, with a median survival time of 47 (IQR, 21-219) days. Predictors of mortality were being a female (adjusted hazard ratio [aHR], 2.8; 95% CI, 1.2 to 6.7; P = .022) and overweight (aHR, 4.2; 95% CI, 1.3 to 13.4; P = .015). Among the patients who had AML, the predictors were poor Eastern Cooperative Oncology Group (ECOG; aHR, 3.1; 95% CI, 1.6 to 6.2; P = .001) and HIV (aHR, 6.0; 95% CI, 1.7 to 20.5; P = .004). Among the patients who had ALL, the predictors were poor ECOG (aHR, 2.3; 95% CI, 1.3 to 4.1; P = .006).

CONCLUSION: Patients with acute leukemia in Uganda have poor overall survival. Prospective studies are recommended to better understand causes of early mortality.

PMID:37499182 | DOI:10.1200/GO.22.00244

Lang Speech Hear Serv Sch. 2023 Jul 27:1-25. doi: 10.1044/2023_LSHSS-22-00192. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated the effects of Sketch and Speak strategy intervention on expressive and receptive expository discourse for adolescents with language-related learning disabilities (LLD).

METHOD: Three participants completed baseline and twelve 45- to 60-min individual treatment sessions in a multiple-baseline across participants design. In treatment, participants learned to take notes using pictography and conventional bulleted notes, orally generate sentences from their notes, and orally practice full sentences and oral reports. Session tests with varied levels of instructional support were used to collect outcome data on free-recall oral reports, short-answer question responses, and participant notes. A distal, age- referenced expository task and social validity questionnaires were administered pre-/postintervention.

RESULTS: Visual and statistical analyses revealed significant effects of treatment on the primary outcome measure of Oral Report Quality and on secondary outcomes of Note Quantity and Quality. There was no significant effect of treatment on Short-Answer Recall questions. Two participants generalized strategies during the treatment phase to independent performance on Oral Reports and one improved on Note Quality. All three participants improved on the distal expository measure. Social validity questionnaires showed participant awareness and buy-in of taught strategies, with potential for generalization at the high school level.

CONCLUSIONS: These adolescent students benefited from explicit instruction in note-taking strategies and systematic oral practice of expository discourse even within the challenging delivery setting of telepractice. This study provides evidence for the use of Sketch and Speak expository intervention with adolescents with LLD to improve comprehension and expression of grade-level material.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23681505.

PMID:37499173 | DOI:10.1044/2023_LSHSS-22-00192

Altern Ther Health Med. 2023 Jul 28:AT8270. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the potential of miRNA-21-5p as a diagnostic and prognostic marker for acute ischemic stroke (AIS), specifically examining its relevance in distinguishing between AIS and transient ischemic attack (TIA) and its predictive ability for short-term prognosis.

METHODS: A total of 84 AIS patients (AIS group), 39 TIA cases (TIA group), and 30 healthy volunteers (Control group) were enrolled in this study. The relative expressions of miRNA-21-5p in serum upon admission were recorded and compared. The statistical analysis involved employing Student’s t-test or analysis of variance (ANOVA) to compare means. Additionally, linear correlations were evaluated to determine the associations between different variables.

RESULTS: The expression of miRNA-21-5p was significantly upregulated in the AIS group compared to the TIA and Control groups (P < .001), with no statistical difference observed between the TIA and Control groups. Furthermore, within the AIS group, the expression of miRNA-21-5p was found to be significantly increased in the poor prognosis subgroup (mRS 3-6 points) compared to the good prognosis subgroup (mRS 0-2 points) (P < .05). The area under the curve (AUC) of miRNA-21-5p for predicting AIS from TIA and 30-day poor prognosis of AIS were 0.710 and 0.641, respectively. Additionally, miRNA-21-5p showed positive correlations with the National Institutes of Health Stroke Scale (NIHSS) score and modified Rankin Scale (mRS) score of AIS patients, respectively.

CONCLUSIONS: Serum miRNA-21-5p levels exhibit considerable potential as a promising biomarker. They play a crucial role in distinguishing between AIS and TIA. Additionally, these levels offer valuable predictive insights into the severity and short-term prognosis of AIS.

PMID:37499158

Altern Ther Health Med. 2023 Jul 28:AT877. Online ahead of print.

ABSTRACT

OBJECTIVE: This research aims to investigate the effectiveness of 3D computer-assisted customized guided positioning of the lateral femoral tunnel compared to conventional methods for Anterior Cruciate Ligament (ACL) reconstruction surgery.

METHODS: A total of 80 patients with a complete ACL tear who underwent arthroscopic reconstruction with autologous tendon transplantation (semitendinosus-gracilis tendon) were included in this study. The patients were admitted to our hospital between March 2020 and January 2022 and were randomly divided into two groups: the conventional group (n = 40) and the personalized guide group (n = 40), based on the positioning method. The conventional group underwent ACL restoration using standard surgical techniques, while the personalized guide group opted for the more precise computer-assisted personalized guide method. The lateral femoral tunnel times were compared between both groups. Additionally, the International Knee Documentation Committee (IKDC) and Lysholm scores were assessed, and the lateral femoral location was evaluated using X-ray imaging at 2 weeks postoperatively.

RESULTS: After surgery, both groups showed a statistically significant increase (P < .05) in Lysholm and IKDC scores compared to their pre-surgery scores. However, the two groups had no evident difference (P > .05). X-ray evaluation at 2 weeks post-surgery revealed no significant difference between the two groups in NL/ML, AL/BL, α, and β angles (P > .05). The preparation time for the femoral tunnel was significantly shorter in the personalized guide group (6.18 ± 0.92 min) compared to the traditional group (15.94 ± 3.12 min) (P < .05).

CONCLUSIONS: The computer-assisted 3D personalized guide positioning method is more effective in locating the lateral femoral tunnel for ACL reconstruction of the knee and can substantially reduce the positioning time. This study provides valuable insights for clinicians when selecting surgical methods.

PMID:37499157

Altern Ther Health Med. 2023 Jul 28:AT8584. Online ahead of print.

ABSTRACT

OBJECTIVE: Wound healing is delayed because of swelling after upper limb fracture, and the traditional rehabilitation device used in physical therapy cannot flexibly adjust the fixation. This study aims to evaluate the effect of the designed elbow joint airbag protection device used in patients with upper arm fractures.

METHODS: This is a quasi-randomized controlled trial. From November 2022 to March 2023, 70 hospitalized patients with unilateral upper arm fractures were recruited from a general tertiary hospital in eastern China. The patients were divided into an experimental group and a control group according to the random number table at 1:1. Among them, 35 patients who received elbow joint airbag protection for post-traumatic limb swelling were assigned to the experimental group, and the other 35 patients were assigned to the control group. The degree of swelling regression, a score of resting pain, and patient comfort level was compared between the two groups.

RESULTS: The waiting time from swelling to allowing for surgery and pain score at rest were significantly lower in the experimental group than in the control group (P < .05 and P < .001 respectively). The comfort score of the experimental group was higher than that of the control group (P < .05), and these differences were statistically significant.

CONCLUSIONS: The elbow joint airbag protection can significantly reduce the waiting time for surgery, lessen the degree of swelling regression, reduce the pain in patients’ hands caused by swelling, and significantly improve the comfort level. Hence, it is worth promoting in the clinical practice of orthopedic nursing.

PMID:37499154