Tag: nevin manimala

Int Urol Nephrol. 2022 Sep 25. doi: 10.1007/s11255-022-03371-6. Online ahead of print.

ABSTRACT

BACKGROUND: The histopathological classification of ANCA-GN divides patients into four groups based on signs of glomerular injury. However, this classification did not consider age-related glomerulosclerosis. In this study, we aimed to compare the prediction of renal survival between Berden’s ANCA-GN histopathological classification and ANCA-GN histopathological classification modified with age-related glomerulosclerosis.

METHODS: Between January 2004 and December 2019, 65 patients diagnosed with ANCA-GN were enrolled. Demographic, laboratory, and histopathologic findings were retrospectively analyzed. Renal survival analyses were compared according to classical and modified ANCA-GN histopathological classifications. Multivariate Cox regression analysis for the factors affecting renal survival was performed.

RESULTS: In Berden’s ANCA-GN histopathological classification, 15 patients were in the focal group, 21 in the crescentic, 21 in the sclerotic, and 8 in the mixed group. The ANCA-GN histopathological classification model generated statistically significant predictions for renal survival (p = 0.022). When the histopathological classification was modified with age-related glomerulosclerosis, eight of the nine patients previously classified in the sclerotic group were classified in the mixed and one in the crescentic groups. Modification of histopathological classification with age-related glomerulosclerosis increases the statistical significance in renal survival analysis (p = 0.009). The multivariate Cox regression analysis showed that the disease-related global sclerotic glomeruli percentage and serum creatinine level were significant independent factors.

CONCLUSION: Modification of Berden’s ANCA-GN histopathological classification model with age-related glomerulosclerosis may increase the statistical significance of the histopathological classification model.

PMID:36153782 | DOI:10.1007/s11255-022-03371-6

Intern Emerg Med. 2022 Sep 25. doi: 10.1007/s11739-022-03092-9. Online ahead of print.

ABSTRACT

The COVID-19 pandemic caused unprecedented pressure over health care systems worldwide. Hospital-level data that may influence the prognosis in COVID-19 patients still needs to be better investigated. Therefore, this study analyzed regional socioeconomic, hospital, and intensive care units (ICU) characteristics associated with in-hospital mortality in COVID-19 patients admitted to Brazilian institutions. This multicenter retrospective cohort study is part of the Brazilian COVID-19 Registry. We enrolled patients ≥ 18 years old with laboratory-confirmed COVID-19 admitted to the participating hospitals from March to September 2020. Patients’ data were obtained through hospital records. Hospitals’ data were collected through forms filled in loco and through open national databases. Generalized linear mixed models with logit link function were used for pooling mortality and to assess the association between hospital characteristics and mortality estimates. We built two models, one tested general hospital characteristics while the other tested ICU characteristics. All analyses were adjusted for the proportion of high-risk patients at admission. Thirty-one hospitals were included. The mean number of beds was 320.4 ± 186.6. These hospitals had eligible 6556 COVID-19 admissions during the study period. Estimated in-hospital mortality ranged from 9.0 to 48.0%. The first model included all 31 hospitals and showed that a private source of funding (β = – 0.37; 95% CI – 0.71 to – 0.04; p = 0.029) and location in areas with a high gross domestic product (GDP) per capita (β = – 0.40; 95% CI – 0.72 to – 0.08; p = 0.014) were independently associated with a lower mortality. The second model included 23 hospitals and showed that hospitals with an ICU work shift composed of more than 50% of intensivists (β = – 0.59; 95% CI – 0.98 to – 0.20; p = 0.003) had lower mortality while hospitals with a higher proportion of less experienced medical professionals had higher mortality (β = 0.40; 95% CI 0.11-0.68; p = 0.006). The impact of those association increased according to the proportion of high-risk patients at admission. In-hospital mortality varied significantly among Brazilian hospitals. Private-funded hospitals and those located in municipalities with a high GDP had a lower mortality. When analyzing ICU-specific characteristics, hospitals with more experienced ICU teams had a reduced mortality.

PMID:36153772 | DOI:10.1007/s11739-022-03092-9

Environ Geochem Health. 2022 Sep 25. doi: 10.1007/s10653-022-01382-x. Online ahead of print.

ABSTRACT

As-containing chemical weapons (CWs) and their degraded products pose a great threat to the environment and to human health. In this study, concentration and distribution characteristics, source identification, and health risk assessments were determined for As, Cr, Ni, Cu, Zn, Cd and Pb in environmental samples from Lianhuapao (LHP), a typical site of Japanese abandoned chemical weapons (JACWs) in China. The results show that the concentration levels of As, Cr and Ni in the LHP soils are abnormally high, with 69.57%, 83.33% and 91.67%, respectively, of the total sample exceeding the risk screening values for soil contamination of agricultural land. As levels in water samples were generally within safety limits, with the exception of perched water in the core contamination area. In the study area, none of the dominant plant species were enriched with As, except for the Pteris vittata L. Pentavalent arsenic was found to be the predominant arsenic species in the topsoil and water samples. Source identification using statistical approaches indicated that the concentrations of As, Pb, Cu, Cd and Zn are likely influenced by JACWs, while Cr and Ni levels may be related to the natural weathering process. The total concentrations of As, Cr and Ni showed a significant degree of contamination, but only As displayed high potential ecological risk. The calculated indexes of health risk evaluation strongly indicate an unacceptable carcinogenic risk (1E-04) to children, and higher non-carcinogenic risk, relative to that of adults. Our data indicate that the health risk from the resulting As contamination is still a cause for concern, although the JACWs were excavated decades ago from these soils.

PMID:36153764 | DOI:10.1007/s10653-022-01382-x

Int J Epidemiol. 2022 Sep 24:dyac179. doi: 10.1093/ije/dyac179. Online ahead of print.

NO ABSTRACT

PMID:36153755 | DOI:10.1093/ije/dyac179

Rom J Intern Med. 2022 Sep 25. doi: 10.2478/rjim-2022-0016. Online ahead of print.

ABSTRACT

Introduction: This study aims to compare the predictive capacity of ABCD, DiaRem2, Ad-DiaRem, and DiaBetter scoring systems for type 2 diabetes mellitus (T2DM) remission in Turkish adult morbidly obese patients who underwent SG. Methods: This retrospective cohort study included 80 patients who underwent sleeve gastrectomy (SG) operation, were diagnosed with T2DM preoperatively, and had at least one-year follow-up after surgery. Because bariatric surgery is performed on patients with class III obesity (BMI ≥ 40 kg/m2) or class II obesity (BMI ≥ 35 kg/m2) with obesity releated comorbid conditions in our hospital, our study cohort consisted of these patients. Results: The diagnostic performance of the DiaBetter, DiaRem2, Ad-DiaRem and ABCD for identifying diabetes remission, assessed by the AUC was 0.882 (95% CI, 0.807-0.958, p < 0.001), 0.862 (95% CI, 0.779-0.945, p < 0.001), 0.849 (95% CI, 0.766-0.932, p < 0.001) and 0.726 (95% CI, 0.601-0.851, p = 0.002), respectively. The AUCs of the Ad-Diarem, DiaBetter and DiaRem2 were statistically higher than AUC of the ABCD (all p-value < 0.001). Besides, there was no statistically significant difference in AUCs of the Ad-Diarem, DiaBetter and DiaRem scores (all p-value > 0.05). Conclusion: Ad-Dairem, DiaBetter and DaiRem scoring systems were found to provide a successful prediction for diabetes remission in sleeve gastrectomy patients. It was observed that the predictive power of the ABCD scoring system was lower than the other systems. We think that the use of scoring systems for diabetes remission, which have a simple use, will become widespread.

PMID:36153731 | DOI:10.2478/rjim-2022-0016

Acta Dermatovenerol Croat. 2022 Jul;30(1):18-24.

ABSTRACT

Tests which have proven their efficacy and reliability in the follow-up of pemphigus patients are used only on a limited scale or take time to complete due to a lack of technical facilities in several centers. Therefore, more accessible methods are being considered for monitoring disease activity. We aimed to investigate the relationship between platelet function and disease activity based on the change in proinflammatory cytokine profile in pemphigus pathogenesis. The size of platelets correlates positively with their activity. Platelet sizes can be evaluated by the platelet volume index consisting of mean platelet volume (MPV), platelet-crit (PCT), and platelet distribution width (PDW). These indicators can be easily measured in complete blood count (CBC) with automatic blood counting devices, which do not require additional costs and are readily available. Patients diagnosed with pemphigus between April 2010 and February 2016 (n=18) in our center were retrospectively included in the study. Demographic data, follow-up period, clinical variants of the patients, platelet parameters (MPV, PDW, PCT), and platelet count (PLT) in CBC analysis with concurrent clinical activity, as well as indirect immunofluorescence (IIF) findings (positive highest titer) at the 6th and 12th month were recorded for each patient. MPV changes were consistent with the course of the disease. A statistically significant decrease in PCT levels was observed at the 12th month compared with the baseline levels (P<0.05). According to the baseline measurement, a statistically significant positive correlation (58.9%) was found between the 12-month difference measurements of IIF and PCT. Our data demonstrated that PCT decrease is correlated with IIF values. The significant correlation between PCT and IIF values in our study is important in showing the possible role of platelet index in the measurement of disease activity.

PMID:36153715

Health Rep. 2022 Sep 15;33(9):21-31. doi: 10.25318/82-003-x202200900003-eng.

ABSTRACT

BACKGROUND: In 2018, Canada legalized the use and sale of non-medical cannabis, with most provinces also permitting home cultivation. To advance the knowledge of home cultivation patterns in Canada within the context of legalization, this study examines (1) the demographics and use patterns of cannabis home growers before and after legalization and (2) the relationship between home cultivation and cannabis-related risks, including workplace use and driving after cannabis use(DACU).

DATA AND METHODS: The study is based on seven waves of the National Cannabis Survey, dating from 2018 to 2019. Descriptive statistics were used to analyze home cultivation across several individual and sociodemographic characteristics pre- and post-legalization. Logistic regression was used to examine whether home cultivation is correlated to selected cannabis-related risks.

RESULTS: The rate and demographics of home cultivation remained relatively unchanged post-legalization. Those most likely to cultivate cannabis post-legalization were male; 35 years and older; not single; married, common law, divorced, separated or widowed; lived in the Atlantic provinces; consumed cannabis medically or medically and non-medically on a daily or almost daily basis; had more than a high school diploma; and reported “smoking” as their primary consumption method. Home cultivation was correlated to workplace use but not to DACU.

INTERPRETATION: The research provides early insights into home cultivation within a legalized framework. It also shows a relationship between home cultivation and certain cannabis-related risks (e.g., workplace use), suggesting a need for future research to determine whether tailored education and policy interventions are needed to target cannabis home growers.

PMID:36153711 | DOI:10.25318/82-003-x202200900003-eng

Health Rep. 2022 Sep 15;33(9):11-20. doi: 10.25318/82-003-x202200900002-eng.

ABSTRACT

The Canadian Community Health Survey (CCHS) – Nutrition 2004 (n=35,107; interview dates from January 2004 to January 2005) linked to the Canadian Vital Statistics – Death Database (CVSD) (2011) represents a novel linkage of a population-based, nationally representative nutrition survey with routinely collected mortality records (including date and cause of death). The linkage was done through individual tax data in Canada, and contains longitudinal records for 29,897 Canadians aged 0 years and older-1,753 of whom died-in the 10 provinces of Canada. The median follow-up time was 7.49 years, with 102,953 person-years among males and 114,876 person-years among females (unweighted), and included a special sampling survey weight (for linked data) to account for those who did not agree to share and link their information. The CCHS – Nutrition 2004 linked to CVSD has been used to evaluate associations between lifestyle and sociodemographic characteristics and mortality. Using these data, statistical methods have been developed and tested to control random and systematic measurement errors when evaluating the relationship between different dietary exposures (evaluated using repeated 24-hour dietary recalls) and health outcomes. The linked data are available through Statistics Canada’s Research Data Centres.

PMID:36153710 | DOI:10.25318/82-003-x202200900002-eng

Health Rep. 2022 Sep 15;33(9):3-10. doi: 10.25318/82-003-x202200900001-eng.

ABSTRACT

BACKGROUND: Throughout the COVID-19 pandemic, Canadian public health officials have mandated and recommended precautions to slow the spread of COVID-19. This study examined which population groups were less compliant with precautions, such as mask-wearing and self-isolating, and where they were located in Canada.

DATA AND METHODS: Results are from the Canadian COVID-19 Antibody and Health Survey, a national survey aimed at estimating how many Canadians who were older than one year and living in private households had antibodies in their blood against the SARS-CoV-2 virus. Questionnaire data were collected in the 10 provinces and 3 territorial capitals, from November 2020 to April 2021. Respondents were asked about compliance with precautions related to COVID-19. Weighted prevalences and logistic regression models were used to identify which population groups were less compliant with precautions to prevent the spread of COVID-19, and where they were located in Canada.

RESULTS: Significant differences in compliance with precautions were found by sex, region, urban versus rural location, age, income, presence of chronic conditions, household size and work status. With covariate adjustment, Canadians who were less compliant with precautions were males, those living in the territorial capitals, those in rural areas, and people aged 34 and younger (compared with people aged 65 and older). Additional differences were found when analyzing compliance with consistently recommended precautions compared with those usually recommended.

INTERPRETATION: As Canada continues to navigate the waves of the pandemic, and with the emergence of new variants, precautions are still being mandated or recommended in many jurisdictions and locations. Continuing to understand which population groups were less compliant in earlier waves and where they were located in Canada can be beneficial to ongoing and future public health efforts to slow the transmission of COVID-19.

PMID:36153709 | DOI:10.25318/82-003-x202200900001-eng

J Clin Nurs. 2022 Sep 25. doi: 10.1111/jocn.16545. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: The study was conducted to describe long-term perceived health among patients after a percutaneous coronary intervention as well as clarify the associations between perceived health and various factors.

BACKGROUND: Perceived health is an important outcome for coronary heart disease patients who have undergone percutaneous coronary intervention. Poor perceived health predicts low adherence to treatment, morbidity and mortality.

DESIGN: An explanatory and descriptive survey with a six-year follow-up (STROBE Statement: File S1).

METHODS: Baseline data (n = 416) were collected in 2013, with follow-up data collected from the same study group in 2019 (n = 154) at two university hospitals and three central hospitals in Finland. The employed self-reported questionnaire was based on the EuroQoL visual analogue scale and EuroQol five-dimensional scale. Data were analysed using descriptive statistics and multivariate methods.

RESULTS: Perceived health did not significantly differ four months or six years after percutaneous coronary intervention. The respondents most commonly reported pain and discomfort (62.1%), problems in mobility (50.3%), issues with usual activities (27.5%), and anxiety and depression (24.0%). Managing self-care (8.5%) was least likely to be an issue for the respondents. A majority of the reported problems were of a mild nature. The consumption of an adequate amount of vegetables, lower systolic blood pressure, regular follow-up treatment, lack of prior invasive procedures, and younger age predicted better scores for both perceived health and its separate dimensions.

CONCLUSION: Regular follow-up is important to ensure after percutaneous coronary intervention to identify patients with pain and discomfort, mobility problems, depression and anxiety. Healthcare professionals should pay particular attention to elderly patients, who have undergone severe invasive procedures.

RELEVANCE TO CLINICAL PRACTICE: This study confirms the importance of regular follow-ups for post-percutaneous coronary intervention patients.

PATIENT OR PUBLIC CONTRIBUTION: Patients have completed a self-reported questionnaire based on informed consent.

PMID:36153702 | DOI:10.1111/jocn.16545