Tag: nevin manimala

Pediatr Pulmonol. 2023 Apr 21. doi: 10.1002/ppul.26425. Online ahead of print.

ABSTRACT

INTRODUCTION: Although impaired lung function after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been described in adults, it is unclear whether lung function might be altered in children, especially among asymptomatic or mildly symptomatic patients. In this study, we report the results of lung function testing performed after SARS-CoV-2 infection in a large pediatric population.

METHODS: The study included 589 patients with previous confirmed SARS-CoV-2 infection aged 0-18 years. Both symptomatic and asymptomatic patients during acute infection were enrolled in the study. A spirometry was performed in all cooperating patients.

RESULTS: The mean age of enrolled patients was 9.6 years and the mean time from infection to enrollment was 171 days. Spirometry was performed and deemed evaluable in 433 patients. No patient had reduced forced vital capacity (FVC) and only 14 patients (3.2%) had a forced expiratory volume in the First second (FEV1) < 80%. The mean spirometry values recorded were in the normal range. There were no statistically significant differences in spirometry values between patients with respiratory symptoms during infection and those without. Similarly, there were no differences in spirometry parameters according to the time elapsed between infection and enrollment.

CONCLUSION: Lung function, according to spirometry values, does not appear to be impaired long after infection in the pediatric population. The presence of respiratory symptoms during SARS-CoV-2 infection would not represent a risk factor for impaired lung function in this cohort of patients.

PMID:37083203 | DOI:10.1002/ppul.26425

Rev Esp Salud Publica. 2023 Apr 21;97:e202304031.

ABSTRACT

OBJECTIVE: Prescribing errors and drug-drug interactions constitute a relevant topic for health professionals in these hospital settings and for the strengthening of strategies to mitigate these errors. The aim of this article was to determine the prescribing errors and drug-drug interactions present in adult patients hospitalized in an intensive care unit in the city of Barranquilla (Colombia).

METHODS: A quantitative study was conducted in which 158 medical records of adult patients who were hospitalized in an Intensive Care Unit (ICU) in the city of Barranquilla during 2019 were analyzed. Medication errors and drug-drug interactions were determined by means of the Medscape application. Statistical analysis was performed using the RStudio program, descriptive and inferential statistics were applied to the data.

RESULTS: Sociodemographically, male sex prevailed, the most frequent pathological history was arterial hypertension, most patients were receiving between one±five drugs, the most common errors were related to omission of dosage, route and time of administration. Drug-drug interactions were reported in 64.5% (102) of the histories and, in terms of the level of severity of the interactions, moderate interactions predominated in 32.9% (52).

CONCLUSIONS: It is evident that there is a high number of medication prescription errors in hospitalized adults, among which pharmacological interactions associated mainly with the number of medications received by individuals in the ICUs stand out.

PMID:37083193

Future Oncol. 2023 Apr 21. doi: 10.2217/fon-2022-0932. Online ahead of print.

ABSTRACT

Aim: The correlation between response and survival has not been well-studied in relapsed or refractory multiple myeloma (RRMM). Materials & methods: A systematic literature review of Medline, Embase and Cochrane databases (2010-06/2020) and relevant congresses (2018-2020) was performed to identify randomized clinical trials in RRMM reporting median overall survival (mOS), progression-free survival and response endpoints. The relationship between mOS and response endpoints was analyzed using Pearson’s product-moment correlation. Results: A total of 81 records for 65 original studies, representing 12,827 patients were included. The correlation was moderate for mOS with overall response rate (Pearson r = 0.79), very good partial response (r = 0.73) and duration of response (r = 0.78); all were statistically significant. In linear regression models, estimated mOS gain was 0.48, 0.47 and 1.94 months per percentage point of overall response rate, very good partial response and complete response, respectively (all p < 0.001). Significance was maintained after adjustment for age, relapsed versus refractory multiple myeloma and study year. The analysis was limited by small sample sizes and inconsistent reporting of study-level covariates. Conclusion: These findings support short-term response-based endpoints as surrogates to survival in RRMM.

PMID:37083162 | DOI:10.2217/fon-2022-0932

J Cutan Med Surg. 2023 Apr 21:12034754231168851. doi: 10.1177/12034754231168851. Online ahead of print.

ABSTRACT

BACKGROUND: There is limited real-life evidence with brodalumab in patients with plaque psoriasis in Canada.

OBJECTIVES: To examine real-world effectiveness of brodalumab in Canadian routine care with a focus on clinician and patient-reported outcomes, as well as measuring continuation rates and persistency.

METHODS: Retrospective analysis was conducted on data collected through the brodalumab patient support program (PSP) in Canada for patients initiating brodalumab between June 2018 (PSP launch)- June 2020 with a minimum of 16 weeks follow-up from first dose. Effectiveness was assessed by improvements in PASI, BSA and DLQI; continuation rates and persistency on therapy were reported.

RESULTS: Overall, 864 patients (male, 59%; median age, 52 years) were included in the analysis. In a subset of patients with both baseline and follow-up scores, statistically significant improvements were observed: PASI improved from 13.9 to 1.8, BSA improved from 16.6% to 2.5% and DLQI improved from 16.2 to 2.9. Brodalumab demonstrated high continuation rates (89.9%), with similar rates in biologic-naïve and biologic-experienced patients (92.1% and 88.6%, respectively) and in patients who received secukinumab or ixekizumab as their most recent biologic therapy (89.0% and 86.2%, respectively). Persistence at 6, 12, and 18 months was 82.0%, 69.9%, and 63.4%, respectively.

CONCLUSIONS: The effectiveness of brodalumab was demonstrated in this Canadian routine care study, with significant improvements in disease severity and patient-reported outcomes. High continuation rates were achieved; including in patients previously treated with IL-17A inhibitors. Future studies will provide further evidence of brodalumab’s benefits for the management of plaque psoriasis in the real-world setting.

PMID:37083148 | DOI:10.1177/12034754231168851

Clin Anat. 2023 Apr 21. doi: 10.1002/ca.24046. Online ahead of print.

ABSTRACT

The traditional approach to anatomy teaching is still the most common. Recently, there has been a demand for methods that make students more active and open to communication and cooperation, and are well integrated with technology. Our aim in this study was to determine the social media usage characteristics and anatomy learning experiences of medical and dentistry students, and their expectations about learning via social media. A questionnaire was prepared and distributed to faculties of Medicine and Dentistry in 10 different universities in Türkiye via Google forms. The questionnaire was voluntarily answered by 762 students. Frequency, exploratory factor and confirmatory factor analyses were applied to the data acquired, and a structural equation modeling (SEM) approach was used. The results showed that 54.3% of the students spent more than 90 min/day on social media; 96.5% of the participants preferred to follow anatomical content pages on social media (acpSM) administered by an academic. They stated that the instant responses from acpSM’s admin had a positive effect on motivation to learning (4.08 ± 0.89, mean ± SD, on 5-point Likert-type scale). The SEM revealed a statistically significant correlation between the students’ learning motivation and the sufficiency and suitability of acpSM content (p < 0.010). Thus, medical and dental students are eager to learn anatomy via social media. However, they found acpSM to be insufficient in quality and quantity and wanted future content to be administered by academics. An acpSM optimized for content sufficiency and suitability increased students’ learning motivation.

PMID:37083146 | DOI:10.1002/ca.24046

J Magn Reson Imaging. 2023 Apr 21. doi: 10.1002/jmri.28724. Online ahead of print.

ABSTRACT

BACKGROUND: The suitability of hepatectomy among patients with multinodular hepatocellular carcinoma (MHCC) beyond the Milan criteria remains controversial. There is a need for a reliable risk stratification tool among these patients for the selection of ideal candidates of curative resection.

PURPOSE: To determine the clinicoradiological prognostic factors for patients with MHCC beyond the Milan criteria to further develop a stratification system.

STUDY TYPE: Retrospective.

SUBJECTS: 176 patients with pathologically confirmed MHCC beyond the Milan criteria.

FIELD STRENGTH/SEQUENCE: The 1.5 T scanner, including T1-, T2-, diffusion-weighted imaging, in/out-phase imaging, and dynamic contrast-enhanced imaging.

ASSESSMENT: Conventional MRI features and preoperative laboratory data including aspartate aminotransferase (AST) and α-fetoprotein (AFP) were collected and analyzed. Two nomograms incorporating clinicoradiological variables were independently constructed to predict recurrence-free survival (RFS) and overall survival (OS) with Cox regression analyses and verified with 5-fold cross validation. Based on the nomograms, two prognostic stratification systems for RFS and OS were further developed.

STATISTICAL TESTS: The Cohen’s kappa/intraclass correlation coefficient, C-index, calibration curve, Kaplan-Meier curve, log-rank test. A P value <0.05 was considered statistically significant.

RESULTS: AST > 40 U/L, increased tumor burden score, radiological liver cirrhosis and nonsmooth tumor margin were independent predictors for poor RFS, while AST > 40 U/L, AFP > 400 ng/mL and radiological liver cirrhosis were independent predictors for poor OS. The two nomograms demonstrated good discrimination performance with C-index of 0.653 (95% confidence interval [CI], 0.602-0.794) and 0.685 (95% CI, 0.623-0.747) for RFS and OS, respectively. The 5-fold cross validation further validated the discrimination capability of the nomograms. Based on the nomogram models, MHCC patients beyond the Milan criteria were stratified into low-/medium-/high-risk groups with significantly different RFS and OS.

DATA CONCLUSION: The proposed MRI-based prognostic stratification system facilitates the refinement and further subclassification of patients with MHCC beyond the Milan criteria.

EVIDENCE LEVEL: 4.

TECHNICAL EFFICACY: 2.

PMID:37083126 | DOI:10.1002/jmri.28724

J Esthet Restor Dent. 2023 Apr 21. doi: 10.1111/jerd.13057. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of activated charcoal-based (AC) products on color alteration, remineralizing potential and surface roughness of dental enamel.

MATERIALS AND METHODS: Bovine incisors were cut into 6 × 6 × 2 mm fragments. Initial color (EasyShade, Vita) and surface roughness (Surfcorder SE1700, Kosakalab) readings were performed. Fragments were separated into five groups (n = 17) according to the treatment: Control: Fluoride toothpaste (Colgate Total 12, Colgate); Charcoal + NaF: AC toothpaste (ACT) with sodium fluoride (Colgate Natural Extracts, Colgate); Charcoal + MFP + n-HA: ACT with sodium monofluorophosphate and nanohydroxyapatite (Black is White, Curaprox); Charcoal: Fluoride-free ACT (ProActive, Hinode); and Charcoal powder: AC powder. Simulated toothbrushing was performed and final color and surface roughness readings were obtained. Fragments were then polished, and initial microhardness (HMV-2, Shimatzu) readings were done. Samples were artificially demineralized and brushed again. Final microhardness readings were taken. Data were statistically analyzed.

RESULTS: Fluoride-free charcoal presented the lowest surface roughness alteration (p < 0.05). Charcoal powder had the lowest color change (p < 0.05) and negative values for whiteness index for dentistry alteration. All the groups presented values below whiteness acceptability threshold and negative relative microhardness values. Control showed the highest remineralizing potential (p < 0.05).

CONCLUSIONS: ACPs did not produce color alteration different from the fluoride toothpaste, except for Charcoal powder that caused less color change. ACPs caused surface roughness alteration similar to the fluoride toothpaste. ACT with fluoride and AC powder did not have remineralizing potential.

CLINICAL SIGNIFICANCE: Activated charcoal-based products (ACP) promise effective tooth whitening and quick results, without teeth damage. In addition, some ACPs contain fluoride in toothpaste composition and promise rehardening potential. However, ACPs are not as effective as other whitening agents and can alter the surface roughness of the enamel. Even if the ACPs contain fluoride or other remineralizing agents, they might be ineffective.

PMID:37083113 | DOI:10.1111/jerd.13057

Acta Derm Venereol. 2023 Apr 21;103:adv4868. doi: 10.2340/actadv.v103.4868.

ABSTRACT

Chronic pruritus is a prevalent interdisciplinary symptom with a strong influence on health-related quality of life. Patients need extensive diagnostics and long-term treatment. This retrospective and prospective cohort study compared routine and university-based specialized care in terms of cost-effectiveness and patient benefit. Direct medical and non-medical costs and patient-reported outcomes (PRO; pruritus intensity, quality of life, treatment needs and benefits) were assessed. Data analyses were conducted using descriptive methods and non-parametric statistical tests. A total of 300 adult patients (54.3% female) participated in the study. Six months after the treatment start in a specialized German pruritus care unit, the total costs were significantly reduced (mean total costs 686 € vs 433 € per patient per half year (total cohort); p < 0.001; mean out-of-pocket costs 198 € vs 124 € per half year (total cohort), p < 0.001). Pruritus intensity (numerical rating scale 5.3 vs 3.7, p < 0.001), quality of life (Dermatology Life Quality Index 8.9 vs 5.7, p < 0.001) and patient benefit (Patient Benefit Index Pruritus 1.2 vs 2.1, p < 0.001) improved significantly (total cohort). The results of this study show, that treatment of chronic pruritus patients in a specialized itch centre leads to an improvement in patient benefit and reduces the economic burden at the same time.

PMID:37083094 | DOI:10.2340/actadv.v103.4868

Ophthalmic Physiol Opt. 2023 Apr 21. doi: 10.1111/opo.13148. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the feasibility and repeatability of IOLMaster 700 biometry measurements in an adult population. Furthermore, to assess the value of the Quality Indicators (QIs) provided by the device.

METHOD: As part of the large population-based Leipzig Research Centre for Civilization Diseases (LIFE) Adult-Study, randomly selected participants from Leipzig, Germany were evaluated with the ZEISS IOLMaster 700. Age range was 26-85 years, with 53% of participants above 70 years of age. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and keratometry (K) were assessed in 1767 right eyes. Measurements were repeated twice and in a subset of 1331 eyes, three times. Measurement feasibility was evaluated for three levels; successful, with warnings and failed, using the inbuilt QIs. Repeatability was assessed as within-subject standard deviation (SD) and repeatability limits were calculated.

RESULTS: First measurement success rate for phakic eyes was over 99% for AL, CCT, ACD, over 98% for LT and over 97% for K. K had 16% eyes with warnings and the recommendation to repeat the measurement. Excluding the measurements with warnings resulted in a reduction of mean SD for AL from 48 to 4 μm and for mean K from 0.08 to 0.04 D. Repeatability for phakic eyes was 8 μm for AL, CCT, ACD and LT and 2.3 μm for CCT; 0.07 D and 0.12 D for mean K and delta K, respectively, for phakic cases without warnings (two measurements).

CONCLUSIONS: In our population-based sample, the IOLMaster 700 collected data for AL, CCT, ACD, LT and K from the vast majority of eyes. Considering the built-in QIs improved the measurement variability substantially. Repeatability measurements indicate that clinically meaningful changes can be detected reliably with this instrument.

PMID:37083081 | DOI:10.1111/opo.13148

Biotechnol Genet Eng Rev. 2023 Apr 21:1-11. doi: 10.1080/02648725.2023.2203002. Online ahead of print.

ABSTRACT

We investigate the role and mechanism of imbalance via Th9 cells and Th17/Treg cells in the inflammatory and fibrotic phases of pulmonary fibrosis in mice. A total of mice were split into normal saline (control group) and inflammation and fibrosis mouse models (study group) randomly, and lung tissues and bronchoalveolar lavage fluid (BALF) were obtained from mice at the inflammatory and fibrotic phases on the 7th and 28th day, respectively. The degenerative changes in the mouse lung tissue were then visible using H&E staining. The expression of CCR6 and IL-9 in the lung tissues of two groups was examined through an immunohistochemistry assay. Fluorescence PCR was used to assess the expression of PU.1 mRNA in BALF, and flow cytometry was performed to identify the expression of Th17 and Treg. (1). The level of pulmonary fibrosis and lung inflammation in the research group was significantly higher than in the control group. (2). The expression of Th17, CCR6, IL-9 and PU.1 mRNA was substantially higher (P<0.05) in the research group at different time points; the expression level of Treg cells was considerably lower (P<0.05) in the research group than in the control group. (3). CCR6, IL-9 and PU.1 mRNA levels were statistically directly associated (P<0.05) with Th17 and inversely correlated 40 with Regulatory T cells (Tregs). CCR6 and Th9 cells may be involved in 45 developing Th17/Treg imbalance in the immune inflammation of pulmonary fibrosis, which promotes fibrocyte proliferation in lung tissue.

PMID:37083059 | DOI:10.1080/02648725.2023.2203002