Tag: nevin manimala

Salud Colect. 2023 Mar 23;19:e4247. doi: 10.18294/sc.2023.4247.

ABSTRACT

The objective is to analyze the effect of multiple homicides on male and female life expectancy and to provide empirical evidence of the temporal and spatial associations between male and female homicide rates by age group during the period 2002-2020. Using data from the National Institute of Statistics and Geography (INEGI) and population projections from the National Population Council (CONAPO), mortality rates due to homicide from 2002-2020 were estimated for both men and women, and the adjacency of homicides of men and women was analyzed, along with the spatial proximity between multiple homicides of men and women, along with changes in life expectancy due to homicide. Individual homicides have caused the greatest decrease in life expectancy for both men and women. The negative impact of multiple homicides on both female and male life expectancy began to draw attention in 2008. By analyzing the murders of women adjacent to the homicides of one or more men questions are raised about whether these crimes are primarily the result of criminal violence, and to a lesser extent the role of gender.

PMID:37311137 | DOI:10.18294/sc.2023.4247

Arq Bras Cardiol. 2023 Jun 9;120(6):e20220671. doi: 10.36660/abc.20220671. eCollection 2023.

ABSTRACT

BACKGROUND: In addition to coronary artery disease, non-high-density lipoprotein(non-HDL-C) provides short and long-term predictive information for many chronic inflammatory diseases such as stroke, hemodialysis, post-renal transplant, non-alcoholic hepatosteatosis, and human immunodeficiency virus.

OBJECTIVES: This study examined the predictive value of non-HDL-C measured before SARS-CoV-2 for mortality in COVID-19 infection.

METHODS: This study retrospectively included 1435 patients diagnosed with COVID-19 and treated in the thoracic diseases ward in a single center between January 2020 and June 2022. All patients included in the study had clinical and radiological features and signs of COVID-19 pneumonia. The COVID-19 diagnosis of all patients was confirmed by a polymerase chain reaction studied from an oropharyngeal swab. Statistical significance was set at p < 0.05.

RESULTS: The study patients, including 1435 subjects, were divided into 712 patients in the non-surviving group and 723 in the surviving group. While there was no difference between the groups regarding gender, there was a statistically significant age difference. The non-surviving group was older. Age, lactate dehydrogenase(LDH), C reactive protein(CRP), triglycerides, D-dimer, and non-HDL-C were independent risk factors for mortality in regression analyses. In correlation analysis, age, CRP, and LDH were positively correlated with non-HDL-C. In the ROC analysis, sensitivity for non-HDL-C was 61.6%, and specificity was 89.2%.

CONCLUSION: We believe that the non-HDL-C level studied before COVID-19 infection can be used as a prognostic biomarker for the disease.

PMID:37311127 | DOI:10.36660/abc.20220671

JMIR Public Health Surveill. 2023 Jun 13. doi: 10.2196/45586. Online ahead of print.

ABSTRACT

BACKGROUND: Both COVID-19 and pregnancy are associated with hypercoagulability. Due to increased risk for thrombosis, the United States National Institute of Health’s recommendation for prophylactic anticoagulant use for pregnant patients has expanded from patients hospitalized for severe COVID-19 manifestation to all patients hospitalized for the manifestation of COVID-19 (no guideline: ~12-26-2020, first update: 12-27-2020~02-23-2022, second update: 02-24-2022~present). However, no study has evaluated this recommendation.

OBJECTIVE: The objective of this study was to characterize prophylactic anticoagulant use among hospitalized pregnant people with COVID-19 from 03-20-2020~10-19-2022.

METHODS: This was a retrospective cohort study in large US healthcare systems across seven states. The cohort of interest was pregnant patients who were hospitalized with COVID-19, without prior coagulopathy or contraindication to anticoagulants (n=2,767). The treatment group consisted of patients prescribed prophylactic dose anticoagulation during -2~+14 days from COVID-19 treatment onset (n=191). The control group was patients with no anticoagulant exposure during -14~+60 days of the SARS-CoV-2 infection date (n=2,534). We ascertained the use of prophylactic anticoagulants with attention to the updates in guidelines and emerging SARS-CoV-2 variants. We propensity score matched the treatment and control group 1:1 on the most important features contributing to the prophylactic anticoagulant administration status classification. Outcome measures included coagulopathy, bleeding, COVID-19-related complications, and maternal-fetal health outcomes. Additionally, the inpatient anticoagulant administration rate was validated in a nationwide population from Truveta, a collective of 700 hospitals across the United States.

RESULTS: The overall administration rate of prophylactic anticoagulants was 7.0% (191/2,725). It was lowest after the second guideline update (no guideline: 10.4%, first update: 9.0%, second update: 2.5%; P<.05) and during the omicron-dominant period (WT:8.3%, Alpha:14.0%, Delta:16.6%, Omicron:3.5%; P<.05). Models developed on retrospective data showed that the variable most associated with administration of inpatient prophylactic anticoagulant. The patients who administered prophylactic anticoagulant were also more likely to receive supplementary oxygen (33.0% versus 4.8%; P<.05). There was no statistical difference in new diagnosis of coagulopathy, bleeding, or maternal-fetal health outcomes between those who received treatment and the matched control group.

CONCLUSIONS: Most hospitalized pregnant COVID-19 patients did not receive prophylactic anticoagulants across healthcare systems as recommended by guidelines. Guideline recommended treatment was administered more frequently to patients with greater COVID-19 illness severity. Given the low rate of administration and differences between treated and untreated cohorts, efficacy could not be assessed.

PMID:37311123 | DOI:10.2196/45586

J Occup Environ Med. 2023 Jun 12. doi: 10.1097/JOM.0000000000002904. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was identified seeking treatment on hypertension and diabetes among male shift workers.

METHOD: This retrospective cohort study included nine large companies in Japan. Data were collected from health checkup, health insurance records, self-administered questionnaires in 2017 and 2020. Data were analyzed using Kaplan-Meier curves and cox regression.

RESULT: Person-days shift workers and day workers seeking treatment for hypertension were 41,604 and 327,301, respectively; for diabetes, were 7,326 and 60,735, respectively. The log-ranks were statistically significant. Shift workers were 46% and 56% less likely to seek treatment for hypertension and diabetes, respectively, than day workers were after adjustment for age, marital status, education level and intention to modify lifestyle (model two) (p < 0.01).

CONCLUSION: Male shift workers is less likely to seek treatment for hypertension and diabetes compared to day workers.

PMID:37311081 | DOI:10.1097/JOM.0000000000002904

J Bras Nefrol. 2023 Jun 9:S0101-28002023005019501. doi: 10.1590/2175-8239-JBN-2022-0179en. Online ahead of print.

ABSTRACT

INTRODUCTION: Acute Kidney Injury (AKI), a frequent manifestation in COVID-19, can compromise kidney function in the long term. We evaluated renal function after hospital discharge of patients who developed AKI associated with COVID-19.

METHODS: This is an ambidirectional cohort. eGFR and microalbuminuria were reassessed after hospital discharge (T1) in patients who developed AKI due to COVID-19, comparing the values with hospitalization data (T0). P < 0.05 was considered statistically significant.

RESULTS: After an average of 16.3 ± 3.5 months, 20 patients were reassessed. There was a median reduction of 11.5 (IQR: -21; -2.1) mL/min/1.73m2 per year in eGFR. Forty-five percent of patients had CKD at T1, were older, and had been hospitalized longer; this correlated negatively with eGFR at T1. Microalbuminuria was positively correlated with CRP at T0 and with a drop in eGFR, as well as eGFR at admission with eGFR at T1.

CONCLUSION: There was a significant reduction in eGFR after AKI due to COVID-19, being associated with age, length of hospital stay, CRP, and need for hemodialysis.

PMID:37311051 | DOI:10.1590/2175-8239-JBN-2022-0179en

Surg Laparosc Endosc Percutan Tech. 2023 Jun 7. doi: 10.1097/SLE.0000000000001190. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the perioperative outcomes of patients with benign and malignant liver lesions scheduled for laparoscopic and open surgery using a propensity score-matched approach to analyze additional cofactors influencing outcomes.

PATIENTS AND METHODS: In this study, we retrospectively reviewed 270 patients who underwent laparoscopic or open liver resection at our institute between October 2016 and November 2021. Patients were divided into open and laparoscopic liver resection groups and compared according to the intention to treat principle. In the purification process for the nonrandom nature of the study, a matching analysis was performed at a 1:1 case-control ratio. The PS model included selected data on body mass index, additional data on the American Society of Anesthesiology score, cirrhosis, lesion <2 cm from the hilum, lesion <2 cm from the hepatic vein or inferior vena cava, and type of neoadjuvant chemotherapy.

RESULTS: The operation time and 30- and 90-day mortality rates were similar between the groups. The average length of hospital stay was 11 days in the open surgery group and 9 days in the laparoscopic surgery group after matching (P=0.011). The 30-day morbidity rate was statistically different between the groups before and after matching, favoring the laparoscopic group (P=0.001 and 0.006, respectively). After the propensity score-matched approch, the open group’s Pringle time was shorter than that of the laparoscopic group. The total operative time was longer in the laparoscopic than in the open surgery group. This did not change after matching (300 vs. 240 min).

CONCLUSIONS: Laparoscopic surgery is a feasible and safe treatment option for patients with liver tumors, with promising results in terms of morbidity and hospital stay.

PMID:37311047 | DOI:10.1097/SLE.0000000000001190

Sci Signal. 2023 Jun 13;16(789):eadd3184. doi: 10.1126/scisignal.add3184. Epub 2023 Jun 13.

ABSTRACT

The activation of at least 23 different mammalian kinases requires the phosphorylation of their hydrophobic motifs by the kinase PDK1. A linker connects the phosphoinositide-binding PH domain to the catalytic domain, which contains a docking site for substrates called the PIF pocket. Here, we used a chemical biology approach to show that PDK1 existed in equilibrium between at least three distinct conformations with differing substrate specificities. The inositol polyphosphate derivative HYG8 bound to the PH domain and disrupted PDK1 dimerization by stabilizing a monomeric conformation in which the PH domain associated with the catalytic domain and the PIF pocket was accessible. In the absence of lipids, HYG8 potently inhibited the phosphorylation of Akt (also termed PKB) but did not affect the intrinsic activity of PDK1 or the phosphorylation of SGK, which requires docking to the PIF pocket. In contrast, the small-molecule valsartan bound to the PIF pocket and stabilized a second distinct monomeric conformation. Our study reveals dynamic conformations of full-length PDK1 in which the location of the linker and the PH domain relative to the catalytic domain determines the selective phosphorylation of PDK1 substrates. The study further suggests new approaches for the design of drugs to selectively modulate signaling downstream of PDK1.

PMID:37311034 | DOI:10.1126/scisignal.add3184

Surg Laparosc Endosc Percutan Tech. 2023 May 23. doi: 10.1097/SLE.0000000000001183. Online ahead of print.

ABSTRACT

OBJECTIVE: Our study aims to compare the effects of different levels of access on postoperative neck bulge and swallowing disorder and provide a better level for endoscopic thyroidectomy.

MATERIALS AND METHODS: The patients were selected retrospectively between March 2021 to September 2021 by the Department of Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University. They were divided into two groups according to the level of the free flap during surgery: group A (the superficial cervical fascial level) and group B (the superficial deep cervical fascial level). Age, sex, body mass index, diameter of the primary lesion, postoperative neck bulge, and swallowing disorders and other complications were compared between the two groups.

RESULTS: A total of 40 patients who underwent endoscopic unilateral lobectomy plus central region lymph node dissection were enrolled in our study. Twenty in group A and 20 in group B. The age, gender, body mass index, diameter, and the proportion of benign and malignant primary lesions were not significantly different between the two groups (P>0.05), and there was also no difference in thyroid function between the two groups (P>0.05). No significant differences were observed in terms of bleeding and operation time during the operation (P>0.05). There were also no statistical differences in terms of recurrent laryngeal nerve injury or hypoparathyroidism (P>0.05). However, patients in group B were superior to those in group A in the occurrence of neck bulge and swallowing disorders (P<0.05). These symptoms were most evident one month after surgery. Six months after the operation, only 4 patients in group B still complained of neck “swelling” and uncomfortable straining which did not resolve until 1 year after the operation. No statistical significance between long-term results and complication rates could be observed in either group.

CONCLUSION: In endoscopic thyroidectomy, the superficial cervical fascial level may be a better option for reducing postoperative neck bulge and swallowing disorders, which needs further validation by conducting a large sample study.

PMID:37311030 | DOI:10.1097/SLE.0000000000001183

Surg Laparosc Endosc Percutan Tech. 2023 May 30. doi: 10.1097/SLE.0000000000001186. Online ahead of print.

ABSTRACT

BACKGROUND: Over the last decade, there has been growing diffusion of minimally invasive surgery in the setting of abdominal emergencies. However, right-colon diverticulitis is still mainly approached by conventional celiotomy.

MATERIALS AND METHODS: A video vignette is presented showing the details of an emergent laparoscopic right colectomy as performed to treat a 59-year-old woman who presented with clinical signs of peritonitis, and radiologic findings suggestive of acute right-colon diverticulitis complicated by perforation of the hepatic flexure and periduodenal abscess. We also aimed to evaluate the relative outcomes of laparoscopic versus conventional surgery by meta-analyzing the currently available comparative evidence on the argument.

RESULTS: A total of 2848 patients were included in the analysis, of which 979 patients received minimally invasive surgery and 1869 had conventional surgery. Laparoscopic surgery had a longer operating time and resulted in an abbreviated hospital stay. Overall, patients receiving laparoscopy had significantly lower morbidity than those whose surgery was undertaken by laparotomy, while there was no statistically significant difference in terms of postoperative mortality.

CONCLUSIONS: According to the existing literature, minimally invasive surgery improves the postoperative outcomes of patients receiving surgery for right-sided colonic diverticulitis.

PMID:37311024 | DOI:10.1097/SLE.0000000000001186

J Glaucoma. 2023 May 25. doi: 10.1097/IJG.0000000000002242. Online ahead of print.

ABSTRACT

PRCIS: Optic nerve head changes were detected with swept-source optical coherence tomography after intraocular pressure-lowering glaucoma surgeries.

PURPOSE: The aim of this study was to detect changes in the optic nerve head with swept-source optical coherence tomography (SS-OCT) after intraocular pressure-lowering procedures.

METHODS: Patients with progressing glaucoma who were referred for intraocular pressure-lowering procedures were included. The participants underwent a 24-2 visual field test and SS-OCT (DRI OCT Triton Plus; Topcon, Tokyo, Japan). Intraocular pressure and SS-OCT scans were obtained during the preoperative period and up to 7 days and 30-90 days postoperatively. Optic nerve head parameters were measured with a B-scan at the center of the optic disc and an average of 5 central B-scans. The hypotenuse of the optic nerve head cup was calculated using the Pythagorean theorem: hypotenuse2 = leg12 + leg22, considering the length and depth of the cup as the legs of a right triangle. We also evaluated changes in Bruch’s membrane opening-to-Bruch’s membrane opening diameter. Statistical analysis was performed using generalized estimating equations.

RESULTS: A total of 15 eyes were included. The mean patient age was 70 (SD, 11.04) years. The mean circumpapillary retinal nerve fiber layer was 60.13 (SD, 23.21) µm and the visual field mean deviation was -13.29 (SD, 8.5) dB. The mean intraocular pressure at each visit was: 20.5 (SD, 4.99); 11 (SD, 4.95) and 15.7 (SD, 5.04), respectively. The mean hypotenuse of the optic nerve head cup, the mean depth and length of the optic nerve head cup, and the Bruch’s membrane opening-to-Bruch’s membrane opening diameter decreased significantly after the intraocular pressure-lowering procedures.

CONCLUSIONS: The hypotenuse of the optic nerve head cup evaluated with SS-OCT significantly decreased after intraocular pressure-lowering surgeries. This parameter was useful for evaluating short-term changes in the optic nerve head.

PMID:37311019 | DOI:10.1097/IJG.0000000000002242