Tag: nevin manimala

Ther Adv Drug Saf. 2022 Aug 23;13:20420986221080795. doi: 10.1177/20420986221080795. eCollection 2022.

ABSTRACT

BACKGROUND: There has been a rising prevalence of polypharmacy among people living with HIV (PLWH). Uncertainty however remains regarding the exact estimates of polypharmacy among these cohorts of patients.

METHODS: We conducted a systematic search of PubMed; EMBASE, CROI, Cochrane Database of Systematic Reviews; Science Citation Index and Database of Abstracts of Reviews of Effects for studies between 1 January 2000 and 30 June 2021 that reported on the prevalence of polypharmacy (ingestion of > 5 non-ART medications) among PLWH on antiretroviral therapy regimen (ART). Prevalence of polypharmacy among HIV-positive patients on ART with Clopper-Pearson 95% confidence intervals were presented. The heterogeneity between studies was evaluated using I2 and τ2 statistics.

RESULTS: One hundred ninety-seven studies were initially identified, 23 met the inclusion criteria enrolling 55,988 PLWH, of which 76.7% [95% confidence interval (CI): 76.4-77.1] were male. The overall pooled prevalence of polypharmacy among PLWH was 33% (95% CI: 25-42%) (I ² = 100%, τ² = 0.9170, p < 0.0001). Prevalence of polypharmacy is higher in the Americas (44%, 95% CI: 27-63%) (I ² = 100%, τ² = 1.0886, p < 0.01) than Europe (29%, 95% CI: 20-40%) (I ² = 100%, τ² = 0.7944, p < 0.01).

CONCLUSION: The pooled prevalence estimates from this synthesis established that polypharmacy is a significant and rising problem among PLWH. The exact interventions that are likely to significantly mitigate its effect remain uncertain and will need exploration by future prospective and systematic studies.

REGISTRATION: PROSPERO: CRD42020170071.

PLAIN LANGUAGE SUMMARY: Background: In people living with HIV (PLWH), what is the prevalence of polypharmacy and is this influenced by sociodemographic factors?Methods and Results: In this systematic review and meta-analysis of 23 studies comprising 55,988 participants, we have for the first time found an estimated polypharmacy pooled prevalence of 33% among PLWH. There was a relatively higher pooled prevalence of polypharmacy among the America’s compared with European cohorts of PLWH.Conclusion: Polypharmacy among PLWH is a rising morbidity that needs urgent intervention both at policy and patient levels of care.

PMID:36052397 | PMC:PMC9425890 | DOI:10.1177/20420986221080795

Indian J Orthop. 2022 Jun 27;56(9):1601-1612. doi: 10.1007/s43465-022-00677-6. eCollection 2022 Sep.

ABSTRACT

INTRODUCTION: There is no distinct classification system to evaluate the bone defect in previously managed acetabular fractures. We propose a new classification system for bone defect evaluation in a previously managed acetabular fracture that will be helpful for total hip arthroplasty (THA).

MATERIALS AND METHODS: The preoperative pelvis radiographs of 99 THA patients with previous acetabular fractures with at least 2 years of follow-up were evaluated by 10 experienced surgeons (Paprosky and new classification systems). As per the new classification system, the five types of bone defects are circumferential, posterior wall, posterior column, both column defect, and anterior column. The interobserver and intraobserver reliability was calculated, and a consensus management plan based on the recommendation of the observers was formulated.

RESULTS: There was fair interobserver reliability for Paprosky classification (alpha coefficient 0.39) and substantial interobserver reliability for the new classification (alpha co-efficient 0.71). There was a substantial intraobserver agreement for the new classification (kappa value 0.80) and moderate intraobserver agreement for Paprosky classification (kappa value 0.55). Sixty-nine patients who were treated as per the management plan of the observers reported significant improvement in modified Harris hip score (improved from 25 to 85.88, p < 0.001). 89.7% of patients reported good to excellent outcomes. Overall best health as per EQ-5D VAS was obtained in THA following anterior column fracture (EQ-5D VAS 97.5), and relatively poor health was obtained after THA of posterior column nonunion (EQ-FD VAS 80).

CONCLUSIONS: The new classification system for bone defect evaluation in previously treated acetabular fractures is valid and reliable. The proposed surgical plan for the management of bone defects in THA provided good to excellent outcomes.

PMID:36052394 | PMC:PMC9385917 | DOI:10.1007/s43465-022-00677-6

J Am Anim Hosp Assoc. 2022 Sep 1;58(5):249-253. doi: 10.5326/JAAHA-MS-7249.

ABSTRACT

Antimicrobial stewardship is becoming more important every day with increasing bacterial resistance and limitations on antibiotics. Prophylactic antibiotics are not necessary with all procedures, which has been shown previously with a variety of human and veterinary surgeries. Medical records were retrospectively evaluated for cases who had a cutaneous punch biopsy performed between 2013 and 2018 including the following information: species, signalment, concurrent diseases, concurrent medications, location of biopsy, histopathologic diagnosis, and bacterial infections postoperatively. The prevalence of secondary infections, due to punch biopsies in all animals, was 1.9% and further divided into 2.3% (3/128) of dogs and 0% (0/26) of cats. It was determined that the relative risk of developing complications from punch biopsy was 0.06 (0.01-0.93) when diagnosing a dermatologic disease versus a cutaneous mass (neoplastic and nonneoplastic), which was statistically significant. The risk increased 2.16 (0.16-59.91) times if the biopsy site was the trunk, which includes the neck, thorax, and abdomen. These results indicate that in veterinary medicine, postoperative complications are uncommon with cutaneous punch biopsies. The administration of prophylactic antibiotics in dogs and cats is unnecessary when performing a punch biopsy when there is no infection present at the time of biopsy.

PMID:36049237 | DOI:10.5326/JAAHA-MS-7249

Horm Mol Biol Clin Investig. 2022 Sep 1. doi: 10.1515/hmbci-2022-0003. Online ahead of print.

ABSTRACT

OBJECTIVES: Secreted by white adipose tissue, asprosin is a newly recognized adipokine whose physiological function is not well comprehended. This study intended to determine the effect of spinning and stationary cycling on serum asprosin levels in overweight women.

METHODS: Forty-five overweight women with BMI>25 kg/m² in the age range of 30-40 years were assigned randomly to three groups of 15 participants: control, spinning (group cycling with music), and stationary bike (individual pedaling on a stationary bike). The participants performed the exercises three sessions per week for six weeks. Lipid profile and asprosin levels were measured by enzymatic and ELISA methods, respectively. Moreover, the paired t-test and one-way ANOVA were employed to make within-group and between-group comparisons, respectively.

RESULTS: The stationary cycling and spinning exercise groups experienced significant reductions in weight, BMI, serum triglyceride, and asprosin levels from the pretest to the posttest. The control group showed no statistically significant differences. Serum concentrations of total cholesterol and low-density lipoprotein only declined in the spinning group. In this regard, neither the control group nor the stationary bicycle exhibited no significant change over time. The spinning group demonstrated a significant rise in high-density lipoprotein levels, which was not observed in the control group. In addition, there was no significant difference in WHR index between the intervention groups.

CONCLUSIONS: By lowering the serum asprosin level, a spinning exercise program appears to be effective in reducing disorders linked to metabolic diseases in overweight women.

PMID:36049225 | DOI:10.1515/hmbci-2022-0003

Am J Ther. 2022 Sep 1. doi: 10.1097/MJT.0000000000001536. Online ahead of print.

ABSTRACT

BACKGROUND: Pain is a common symptom in patients with advanced, metastatic, or terminal cancer. Neuropathic pain and psycho-emotional suffering are factors that increase the difficulty of pain management. Pain control in patients with cancer remains a challenge for medical professionals.

STUDY QUESTION: What is the evolution of neuropathic/mixed pain compared with nociceptive pain under standardized treatment in patients with cancer?

STUDY DESIGN: A prospective, longitudinal, open-label, nonrandomized study was conducted on patients with cancer pain.

MEASURES AND OUTCOMES: Pain type was assessed at admission using the modified Brief Pain Inventory, and pain intensity was assessed daily using the Numerical Rating Scale for 14 days and on days 21 and 28. Screening of depression was performed on days 1, 7, 14, 21, and 28 using the Hamilton Depression Rating Scale. Patients with pain and depression received analgesics with antidepressants, while patients without depression received analgesics or analgesics with an anticonvulsant depending on the pain subtype.

RESULTS: Of 72 patients, 23 had nociceptive pain and 49 had neuropathic/mixed pain. At admission, pain intensity was higher for patients with neuropathic/mixed pain compared with nociceptive pain (mean values: 7.06 vs. 5.82) with statistical significance (P = 0.001) and remained as such at the end of this study (mean values: 3.77 vs. 2.73). A decrease in the mean pain intensity was observed in all types of pain, but without statistical significance regardless of pain type and treatment protocol used (P = 0.77). If depression was present, antidepressants combined with analgesics decreased pain and depression scores significantly (P = 0.001).

CONCLUSIONS: Patients with neuropathic/mixed pain have higher levels of pain and lower response to treatment. Identifying psycho-emotional suffering can improve pain control by intervening in the physical and psycho-emotional components of pain.

PMID:36049186 | DOI:10.1097/MJT.0000000000001536

Int Health. 2022 Sep 1:ihac058. doi: 10.1093/inthealth/ihac058. Online ahead of print.

ABSTRACT

BACKGROUND: Early initiation breastfeeding (EIBF) is a sign of good health for both the mother and the newborn baby. The objective of this study was to estimate the prevalence of EIBF among mothers in Bangladesh and to identify its associated factors.

METHODS: The study used the most recent Bangladesh Demographic and Health Survey 2017-2018 data. A total of 4776 (weighted) respondents were included in the final analysis. The association between the outcome and the independent variables was determined using multilevel (mixed effects) logistic regression analysis.

RESULTS: The overall weighted prevalence of EIBF among Bangladeshi mothers was 61.19% (confidence interval [CI] 59.80 to 62.56). The study shows that non-poor wealth status (adjusted odds ratio [AOR] 0.81 [95% CI 0.68 to 0.95]), institutional delivery (AOR 0.77 [95% CI 0.61 to 0.96]) and caesarean delivery (AOR 0.31 [95% CI 0.26 to 0.38]) were associated with the lower odds of EIBF. Mother’s secondary education (AOR 1.34 [95% CI 1.01 to 1.83]), at least four antenatal care visits (AOR 1.36 [95% CI 1.04 to 1.53]), normal birthweight (AOR 1.42 [95% CI 1.09 to 1.85]) and placed on mother’s chest and bare skin after birth (AOR 1.33 [95% CI 1.11 to 1.60]) were associated with higher odds of EIBF.

CONCLUSION: In order to enhance EIBF in Bangladesh, health professionals should emphasise skin-to-skin contact after delivery.

PMID:36049132 | DOI:10.1093/inthealth/ihac058

J Phys Chem B. 2022 Sep 1. doi: 10.1021/acs.jpcb.2c04593. Online ahead of print.

ABSTRACT

A central problem in computational biophysics is the treatment of titratable residues in molecular dynamics simulations of large biological macromolecular systems. Conventional simulation methods ascribe a fixed ionization state to titratable residues in accordance with their pK_a and the pH of the system, assuming that an effective average model will be able to capture the predominant behavior of the system. While this assumption may be justifiable in many cases, it is certainly limited, and it is important to design alternative methodologies allowing a more realistic treatment. Constant-pH simulation methods provide powerful approaches to handle titratable residues more realistically by allowing the ionization state to vary statistically during the simulation. Extending the molecular mechanical (MM) potential energy function to a family of potential functions accounting for different ionization states, constant-pH simulations are designed to sample all accessible configurations and ionization states, properly weighted according to their Boltzmann factor. Because protonation and deprotonation events correspond to a change in the total charge, difficulties arise when the long-range Coulomb interaction is treated on the basis of an idealized infinite simulation model and periodic boundary conditions with particle-mesh Ewald lattice sums. Charging free-energy calculations performed under these conditions in aqueous solution depend on the Galvani potential of the bulk water phase. This has important implications for the equilibrium and nonequilibrium constant-pH simulation methods grounded in the relative free-energy difference corresponding to the protonated and unprotonated residues. Here, the effect of the Galvani potential is clarified, and a simple practical solution is introduced to address this issue in constant-pH simulations of the acid-sensing ion channel (ASIC).

PMID:36049129 | DOI:10.1021/acs.jpcb.2c04593

Braz J Psychiatry. 2022 Sep 1. doi: 10.47626/1516-4446-2022-2767. Online ahead of print.

ABSTRACT

OBJECTIVE: To re-evaluate a sample of older adults enrolled in a randomized controlled trial (RCT) using lithium for treatment of amnestic mild-cognitive impairment (MCI) after 11 to 15 years, by re-assessing their current (or last available) global cognitive and functional state.

METHODS: We recalled all former participants of the ‘Lithium-MCI’ trial conducted by our group between 2009 and 2012 to perform a single-blinded, cross-sectional evaluation of their global clinical state, in order to compare the long-term outcome of subjects previously allocated in lithium group vs. those who received placebo.

RESULTS: From the original sample (n=61), we were able to reach for 36 participants (59% of retention), of whom 22 had previously received lithium (61% of the recall sample), and 14 (39%) had received placebo. As 30.5% of recalled sample was deceased, psychometric data was collected only for 69.5% of our participants. We found statistically significant differences in current mean mini mental state examination score according to previous treatment groups (25.5 [5.3] vs. 18.3 [10.9], p=0.04). These subjects also had better performance in the phonemic verbal fluency test compared to non-users (34.4 [14.4] vs. 11.6 [10.10], p<0.001). Differences in these measures also displayed large effect sizes, as shown by Cohen’s d values of 0.92 and 1.78 respectively.

CONCLUSIONS: The present set of data suggests that older adults with amnestic MCI who had been treated with lithium during a previous RCT had a better long-term global cognitive outcome than those from a matched sample who did not receive the intervention.

PMID:36049127 | DOI:10.47626/1516-4446-2022-2767

Physiol Rev. 2022 Sep 1. doi: 10.1152/physrev.00028.2022. Online ahead of print.

NO ABSTRACT

PMID:36049113 | DOI:10.1152/physrev.00028.2022

Physiol Rev. 2022 Sep 1. doi: 10.1152/physrev.00011.2022. Online ahead of print.

ABSTRACT

Adaptation is an essential feature of auditory neurons, which reduces their responses to unchanging and recurring sounds and allows their response properties to be matched to the constantly changing statistics of sounds that reach the ears. As a consequence, processing in the auditory system highlights novel or unpredictable sounds and produces an efficient representation of the vast range of sounds that animals can perceive by continually adjusting the sensitivity and, to a lesser extent, the tuning properties of neurons to the most commonly encountered stimulus values. Together with attentional modulation, adaptation to sound statistics also helps to generate neural representations of sound that are tolerant to background noise and therefore plays a vital role in auditory scene analysis. In this review, we consider the diverse forms of adaptation that are found in the auditory system in terms of the processing levels at which they arise, the underlying neural mechanisms and their impact on neural coding and perception. We also ask what the dynamics of adaptation, which can occur over multiple timescales, reveal about the statistical properties of the environment. Finally, we examine how adaptation to sound statistics is influenced by learning and experience and changes as a result of aging and hearing loss.

PMID:36049112 | DOI:10.1152/physrev.00011.2022