Tag: nevin manimala

Rev Lat Am Enfermagem. 2025 Mar 14;33:e4440. doi: 10.1590/1518-8345.7402.4440. eCollection 2025.

ABSTRACT

BACKGROUND: (1) Health literacy of riverine populations is inadequate. (2) Health literacy was not associated with quality of life. (3) Health literacy was associated with sociodemographic aspects of riverine populations. (4) Quality of life was related to the sociodemographic profile of riverine populations.

to analyze functional health literacy and health-related quality of life in riverine populations using primary care services, according to sociodemographic variables.

an analytical, cross-sectional study with 312 users of the riverine family health strategy. Data were collected using a health literacy test, the 12-item Health Survey, and a socioeconomic questionnaire adapted by the researchers. Spearman correlation, Mann-Whitney and Kruskal-Wallis tests, as well as multiple logistic regression were performed, considering p≤0.05.

65.7% presented inadequate functional health literacy, with higher risk for men (p<0.001), aged 40-49 (p=0.010) and 50-59 years (p=0.031), incomplete (p<0.001) and complete (p=0.024) elementary education, and residing far from health services (p<0.001). Quality of life showed no association with health literacy. However, lower quality of life was related to female gender (p=0.049), incomplete elementary education (p=0.016), use of mobile phones with internet and radio (p=0.013), advanced age (p<0.001), increased number of children (p=0.002), and lower age at the start of work activities (p<0.001).

functional health literacy of riverine populations is inadequate and not associated with quality of life. However, both are influenced by the sociodemographic profile.

PMID:40105656 | DOI:10.1590/1518-8345.7402.4440

J Rural Health. 2025 Jan;41(1):e70016. doi: 10.1111/jrh.70016.

ABSTRACT

PURPOSE: Sexual minority young adults (SMYAs) residing in rural (vs. urban) areas report higher tobacco use rates. Less work has assessed associations of rural-urban residential movement/stability with SMYAs’ tobacco use and factors driving these associations.

METHODS: We analyzed 2023 survey data from 1082 US SMYAs (aged 18-34). Multivariable regressions controlling for sociodemographics examined associations of: (1) rural-urban movement/stability (urban stability, rural-urban movement, rural stability [REF]) with minority stress-related factors (mental health symptoms, internalized stigma), perceived tobacco norms (peer tobacco use, social acceptability of tobacco use), and tobacco use (past-month cigarette, e-cigarette, any tobacco use, number of products used); and (2) minority stress-related factors and tobacco norms with tobacco use.

FINDINGS: Relative to SMYAs reporting rural stability, those reporting rural-urban movement and urban stability displayed lower odds of any tobacco use and mental health symptoms, and less peer tobacco use. Those reporting rural-urban movement also reported lower odds of cigarette use and less internalized stigma. Peer tobacco use was associated with higher odds of cigarette and any tobacco use; reporting ≥ moderate mental health symptoms and greater internalized stigma and social acceptability was associated with higher odds of cigarette use.

CONCLUSIONS: These novel findings provide preliminary evidence that, relative to their SM peers who reside in rural areas, SMYAs who move from rural to urban areas may experience less minority stress-related factors and lower tobacco use norms, which may reduce risk for cigarette and other tobacco use. Findings highlight the need for public health messaging interventions targeting SMYAs in rural communities.

PMID:40102197 | DOI:10.1111/jrh.70016

Anaesthesia. 2025 Mar 18. doi: 10.1111/anae.16563. Online ahead of print.

ABSTRACT

INTRODUCTION: Intravenous lidocaine is a promising complementary strategy for sedation during surgical procedures. We performed a systematic review and meta-analysis to compare intravenous lidocaine with placebo as an adjuvant to propofol-based sedation in patients undergoing colonoscopy.

METHODS: We searched MEDLINE, Embase and Cochrane databases for randomised controlled trials comparing sedation with propofol and lidocaine vs. propofol and placebo in patients undergoing colonoscopy. The primary outcome was total propofol dose. A random-effects model was used to estimate the mean differences and risk ratios.

RESULTS: We included eight trials with 520 patients. Compared with placebo, intravenous lidocaine reduced propofol consumption during the procedure (mean difference (95%CI): -42.93 mg (-62.89 to -22.97)); shortened awakening time (mean difference (95%CI): -3.38 minutes (-5.92 to -0.84)); reduced post-procedural pain scores (mean difference (95%CI): -1.38 (-2.72 to -0.04)); and increased patient satisfaction scores (mean difference (95%CI): 0.50 (0.30 to 0.70)). There were no significant differences between the groups in procedure duration; endoscopist satisfaction scores; and risk of hypoxia or hypotension.

DISCUSSION: In patients undergoing colonoscopy, the addition of intravenous lidocaine to propofol-based sedation reduced propofol consumption, shortened awakening time, mitigated post-procedural pain and enhanced patient satisfaction compared with placebo. Although the findings are statistically significant, clinical relevance and cost-effectiveness are unclear.

PMID:40102176 | DOI:10.1111/anae.16563

Med Phys. 2025 Mar 18. doi: 10.1002/mp.17764. Online ahead of print.

ABSTRACT

BACKGROUND: To minimize radiation exposure while obtaining high-quality Positron Emission Tomography (PET) images, various methods have been developed to derive standard-count PET (SPET) images from low-count PET (LPET) images. Although deep learning methods have enhanced LPET images, they rarely utilize the rich complementary information from MR images. Even when MR images are used, these methods typically employ early, intermediate, or late fusion strategies to merge features from different CNN streams, failing to fully exploit the complementary properties of multimodal fusion.

PURPOSE: In this study, we introduce a novel multimodal feature-guided diffusion model, termed MFG-Diff, designed for the denoising of LPET images with the full utilization of MRI.

METHODS: MFG-Diff replaces random Gaussian noise with LPET images and introduces a novel degradation operator to simulate the physical degradation processes of PET imaging. Besides, it uses a novel cross-modal guided restoration network to fully exploit the modality-specific features provided by the LPET and MR images and utilizes a multimodal feature fusion module employing cross-attention mechanisms and positional encoding at multiple feature levels for better feature fusion.

RESULTS: Under four counts (2.5%, 5.0%, 10%, and 25%), the images generated by our proposed network showed superior performance compared to those produced by other networks in both qualitative and quantitative evaluations, as well as in statistical analysis. In particular, the peak-signal-to-noise ratio of the generated PET images improved by more than 20% under a 2.5% count, the structural similarity index improved by more than 16%, and the root mean square error reduced by nearly 50%. On the other hand, our generated PET images had significant correlation (Pearson correlation coefficient, 0.9924), consistency, and excellent quantitative evaluation results with the SPET images.

CONCLUSIONS: The proposed method outperformed existing state-of-the-art LPET denoising models and can be used to generate highly correlated and consistent SPET images obtained from LPET images.

PMID:40102174 | DOI:10.1002/mp.17764

J Voice. 2025 Mar 17:S0892-1997(25)00093-1. doi: 10.1016/j.jvoice.2025.02.047. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess the clinical efficacy of injection laryngoplasty using ultrasound marking in patients with unilateral vocal fold paralysis after thyroidectomy compared with injection laryngoplasty without ultrasound marking.

METHODS: Ten patients with unilateral vocal fold paralysis after thyroidectomy were retrospectively analyzed. There were five patients in the ultrasound marking group and matched five patients in the non-ultrasound marking group. Auditory-perceptual evaluation, acoustic analysis, aerodynamic analysis, and Voice Handicap Index-30 were performed on all patients before and 1 month after injection laryngoplasty.

RESULTS: In all patients, auditory-perceptual parameters and the Voice Handicap Index-30 revealed statistically significant improvements following injection laryngoplasty. No adverse effects were observed in any patient. The Voice Handicap Index-30 and the injection laryngoplasty procedure time were substantially reduced in the ultrasound marking group compared to that in the non-ultrasound marking group. However, other parameters did not exhibit a statistically significant difference between the two groups before and 1 month after injection laryngoplasty.

CONCLUSION: Injection laryngoplasty with ultrasound marking is an easy, rapid, and convenient method for patients who experienced unilateral vocal fold paralysis following thyroidectomy.

PMID:40102159 | DOI:10.1016/j.jvoice.2025.02.047

Allergol Int. 2025 Mar 17:S1323-8930(25)00013-9. doi: 10.1016/j.alit.2025.02.003. Online ahead of print.

NO ABSTRACT

PMID:40102152 | DOI:10.1016/j.alit.2025.02.003

J Pediatr Urol. 2025 Mar 4:S1477-5131(25)00130-5. doi: 10.1016/j.jpurol.2025.02.039. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the short-term efficacy of modified plate reconstruction and tubularization urethroplasty for posterior hypospadias.

MATERIAL AND METHOD: We retrospectively collected the clinical data of posterior hypospadias patients who were newly diagnosed and underwent plate reconstruction and tubularization urethroplasty (PRTU) or modified PRTU. Surgical modifications were to reconstruct the glans segment of the urethra with a free flap, thus presenting an orthotopic urethral opening, and to preserve the Buck’s fascia at the coronal sulcus for approximately 1 cm to enhance coverage of the shaped urethra. Regular follow-up was taken in clinic or online. We compared complication rate, HOSE score and uroflowmetry testing results between these two groups.

RESULTS: A total of 107 children underwent either PRTU or modified PRTU, and 102 of them were fully followed-up (55 cases of PRTU and 47 cases of modified PRTU). All of the patients were diagnosed with posterior hypospadias. The age at operation ranged from 1 year to 1 month to 14 years old (mean age 3 years and 2 months). The postoperative follow-up period ranged from six to 63 months, with an average follow-up period of 23.2 months, and 102 patients provided comprehensive post-operative data, exhibiting a comprehensive follow-up rate of 95.3 %. There’s a statistically significant difference in the incidence of dehiscence of urethra between PRTU group (10 cases) and modified PRTU group (2 cases).

CONCLUSION: Modified PRTU is a safe, practical, and effective method for hypospadias. This procedure is appropriate for repairing posterior-type hypospadias combined with penoscrotal transposition, while reducing the risk of postoperative urethral dehiscence and achieve good appearance.

PMID:40102138 | DOI:10.1016/j.jpurol.2025.02.039

Transplant Proc. 2025 Mar 17:S0041-1345(25)00147-2. doi: 10.1016/j.transproceed.2025.01.008. Online ahead of print.

ABSTRACT

BACKGROUND: Nonadherence to immunosuppressive therapy after heart transplantation, driven by factors such as patient, caregiver, institutional, policy-related issues, and health literacy, leads to rejection and increased mortality. This study aimed to investigate the relationship between health literacy and adherence to immunosuppressive therapy in heart transplant patients.

METHODS: The sample of this cross-sectional study consisted of 57 patients who underwent heart transplantation in a university hospital in Izmir, Turkey. “Sociodemographic and Descriptive Characteristics Form”, “Data on Immunosuppressive Drug Therapy Form”, “Rapid Estimate of Adult Health Literacy in Medicine (REALM) Scale”, and “Immunosuppressive Therapy Adherence Scale (ITAS)” were used to collect the data..

RESULTS: The median score on the REALM scale was 64.00 (IQR = 3.00, min = 18.00, max = 66.00) and 80.7% of the patients scored adequately. The median score of the immunosuppressive therapy adherence scale was 11.00 (IQR= 1.00, min= 5.00, max= 12.00) and 42.1% of the patients scored full score. There was no statistically significant relationship between the median total scores of the REALM and ITAS scales in heart transplant patients (r = 0.181, P = .178).

CONCLUSIONS: In this study, the majority of heart transplant patients had adequate health literacy. It was found that less than half of these patients adhered to immunosuppressive therapy. Less than half of these patients were found to comply with immunosuppressive therapy. In this study, no relationship was found between health literacy and adherence to immunosuppressive therapy.

PMID:40102130 | DOI:10.1016/j.transproceed.2025.01.008

Transplant Proc. 2025 Mar 17:S0041-1345(25)00140-X. doi: 10.1016/j.transproceed.2025.02.051. Online ahead of print.

ABSTRACT

BACKGROUND: Liver failure constitutes a critical medical condition marked by the rapid decline in hepatic functions. Novel therapeutic approaches, including therapeutic plasma exchange (TPE) and continuous venovenous hemodiafiltration (CVVHDF), have emerged as promising modalities for mitigating the effects of this condition by facilitating detoxification and enhancing liver function. The efficacy of these interventions, whether administered individually or in combination, is a prominent area of investigation in the management of liver failure among adult populations. This study aims to evaluate the role and effectiveness of TPE, both as a standalone treatment and in conjunction with CVVHDF, in the management of liver failure in adult patients.

METHODS: This retrospective study was conducted in a Liver Transplant Intensive Care Unit (LTICU), focusing on the medical records of adult patients aged 35 to 62 years. The patient cohort consisted of individuals admitted between January 1, 2021, and June 1, 2024, due to acute liver failure or acute-on-chronic liver failure. The analysis specifically included patients who underwent therapeutic plasma exchange (TPE) or those who received continuous renal replacement therapy in conjunction with TPE. For the statistical analysis, a P-value of less than .05 was deemed indicative of statistical significance. The study encompassed a total of 47 patients with liver failure, comprising 23 males and 24 females. Among these patients, 25 (53.2%) received only TPE, while 22 (46.8%) were treated with a combination of TPE and continuous venovenous hemodiafiltration (CVVHDF).

RESULTS: In the cohort of patients who received only therapeutic plasma exchange (TPE), the median International Normalized Ratio (INR) improved significantly, decreasing from 2 (1.6-2.6) to 1.3 (1.1-1.7). Similarly, alanine aminotransferase levels reduced from 351 (66-1482) to 166 (71-367), while aspartate aminotransferase levels decreased from 259 (132-1392) to 86 (35-160). In the group receiving a combination of TPE and continuous venovenous hemodiafiltration (CVVHDF), notable reductions were also observed: INR decreased from 3 (2.4-4.7) to 1.5 (1.3-2.4), alanine aminotransferase levels dropped from 691 (59-2397) to 162 (70-1060), and aspartate aminotransferase levels fell from 916 (134-1828) to 69 (45-503). These changes were statistically significant, with P-values of less than .05 for each parameter in both treatment groups. Overall, 21 patients achieved survival without requiring a liver transplant, while 7 patients underwent liver transplantation, resulting in a transplant-free survival rate of 44.7%.

CONCLUSION: The findings from our study on the management of liver failure in adults demonstrate that both therapeutic plasma exchange (TPE) administered alone and in conjunction with continuous venovenous hemodiafiltration (CVVHDF) are effective treatment modalities, particularly as a bridging strategy to liver transplantation. The observed transplant-free survival rate of 44.7% underscores the significant clinical advantages of these therapies. However, to enhance the validity of these results and their applicability in broader clinical contexts, additional multicenter studies are essential for further exploration of these treatment approaches in liver failure management.

PMID:40102129 | DOI:10.1016/j.transproceed.2025.02.051

Transplant Proc. 2025 Mar 17:S0041-1345(25)00151-4. doi: 10.1016/j.transproceed.2025.02.038. Online ahead of print.

ABSTRACT

BACKGROUND: Determining effective ways to make prognostic predictions after kidney transplantation of patients is essential for the management of patients. This study examines how the PNI score affects renal outcomes after kidney transplantation. The potential impact of PNI on renal function beyond the overall nutritional status was also examined.

METHODS: In this retrospective study, 100 kidney transplant patients were divided into three groups according to PNI scores: low (<40), intermediate (40-45) and high (>45). Demographic characteristics, clinical parameters, serum creatinine levels, estimated glomerular filtration rate (eGFR) and parenchymal thickness were evaluated. Logistic regression analysis was applied for the risk of graft rejection. Patients who were followed up for at least 6 months after kidney transplantation and had complete clinical data were included in the study. The mean follow-up period was 36 months (range: 6-60 months).

RESULTS: There was no statistically significant correlation between PNI scores and renal function (P > .05). The mean creatinine level was 1.73 ± 1.11 mg/dL in the low PNI group and 1.37 ± 0.52 mg/dL in the high PNI group. Although this difference was close to the limit of statistical significance, it was not significant (P = .083). In logistic regression analysis, no significant effect of PNI score on graft rejection was observed (OR: 1.0015, 95% CI: 0.7975-1.2576, P = .9899). However, age (OR: 0.9247, P = .0347) and serum creatinine levels (OR: 2.8396, P = .0151) significantly affected the risk of graft rejection. No significant effect of PNI score on complication rates was observed.

CONCLUSIONS: This study demonstrated that PNI score alone is not a sufficient predictor of renal prognosis and graft rejection risk after kidney transplantation. Factors such as age and serum creatinine levels were found to be more predictive of the risk of graft rejection.

PMID:40102127 | DOI:10.1016/j.transproceed.2025.02.038