Tag: nevin manimala

Shock. 2022 Aug 16. doi: 10.1097/SHK.0000000000001978. Online ahead of print.

ABSTRACT

PURPOSE: To determine if initiating vasopressin earlier in septic shock reduces organ dysfunction and in-hospital all-cause mortality.

METHODS: This multicenter, retrospective, cohort study evaluated patients admitted to the medical intensive care unit (ICU) between October 2011 and August 2018 with septic shock who received vasopressin within 48 hours of shock onset. The primary composite outcome was the proportion of patients with a change in the sequential organ failure assessment (SOFA) score of >3 from baseline to 72 hours after initiation of vasopressin and/or in-hospital all-cause mortality. Secondary outcomes included time to hemodynamic stability, acute kidney injury, and ICU length of stay.

RESULTS: A total of 385 patients included in the final evaluation with a mean APACHE II score of 31 and a mean baseline SOFA score of 13. Median time to initiation of vasopressin after norepinephrine was 7.3 hours. The primary composite outcome was significantly reduced in patients who had vasopressin initiated earlier in septic shock (OR = 1.08; 95% CI 1.03-1.13; p < 0.001). After controlling for baseline data in a multivariable regression model the primary outcome remained statistically significant (OR = 1.04; 95% CI 1.02-1.07, p = 0.001).

CONCLUSION: Early initiation of vasopressin in septic shock may reduce the risk of in-hospital all-cause mortality and/or organ dysfunction.

PMID:36018257 | DOI:10.1097/SHK.0000000000001978

J Hypertens. 2022 Aug 23. doi: 10.1097/HJH.0000000000003280. Online ahead of print.

ABSTRACT

OBJECTIVE: Multiple trials on sodium-glucose cotransporter (SGLT) inhibitors have been performed recently demonstrating blood pressure (BP) reduction benefits in both diabetic and nondiabetic patients. Hence, we conducted a systematic review and meta-analysis to determine the effect of different SGLT inhibitors on BP in both patients with and without diabetes mellitus.

METHODS: Four electronic databases (PubMed, Embase, Cochrane, and SCOPUS) were searched on 4 November 2021 for articles published from 1 January 2000 up to 21 November 2021, for studies evaluating the BP effects of SGLT inhibitors. Pair-wise meta-analysis and random effects metaregression models were utilized.

RESULTS: In total, 111 studies examining SBP (108 studies, 104 304 patients) and/or DBP (82 studies, 74 719 patients) were included. In patients with diabetes, the random effects model demonstrated SGLT inhibitor produced a mean reduction in SBPs of -3.46 mmHg (95% confidence interval: -3.83, -3.09) compared with placebo. There were no statistically significant changes in BP among patients without diabetes. Drug response relationship was not observed in SGLT inhibitors and BP, except for Canagliflozin and DBP.

CONCLUSION: Sodium-glucose cotransporter 2 inhibitors and combined sodium-glucose cotransporter 1/2 inhibitors produced small reductions in BP in patients with diabetes.

PMID:36018229 | DOI:10.1097/HJH.0000000000003280

Afr J Paediatr Surg. 2022 Oct-Dec;19(4):203-208. doi: 10.4103/ajps.ajps_109_21.

ABSTRACT

BACKGROUND: In managing paediatric spinal deformities, the currently-in-use growth maturity assessment parameters (clinical or radiological) are based mostly on Caucasian populations. They may be adequate for general treatment planning but may not accurately predict the remaining growth potential. Some therapies (e.g. growing rod distractions or growth modulation surgeries) require more accurate predictions of remaining growth potential and race-specific values. Lumbar lordosis (LL) development ceases at spinal bone maturity. The age-of-cessation seems a more accurate predictor of remaining spinal bone growth potential, compared to currently-in-use growth maturity assessment parameters, but is rarely included in the growth maturity assessment parameters.

AIMS AND OBJECTIVES: As a predictor of remaining spinal growth potential, age-of-cessation of LL development (Race-specific of Black populations) was quantified.

MATERIALS AND METHODS: In archival normal lateral lumbosacral radiographs of patients of a tertiary hospital in South-East Nigeria, LL development across five age groups (Birth- 9, 10-15, 16-20, 21-25 and 26-30 years) was quantified with lumbosacral joint angle (LSJA) in 215 (110 males, 105 females), and lumbosacral angle (LSA) in 238 (119 males, 119 females). Data were analysed with IBM SPSS Statistics 23.0 (NY, USA). P ≤ 0.05 was considered statistically significant.

RESULTS: Both LSJA and LSA age groups’ mean values progressively increased with age, and plateaued at 21-25 years range, with LSJA mean of 23.4 ± 1.3 years, and LSA mean 23.5 ± 1.3 years; the means difference was insignificant (P = 0.680).

CONCLUSION: With ageing, there is progressive increment, and later, cessation of LL. Age-of-cessation indirectly infers spinal-maturity-age, and could indirectly be an assessment parameter of spinal-maturity-status.

PMID:36018198 | DOI:10.4103/ajps.ajps_109_21

Future Oncol. 2022 Aug 26. doi: 10.2217/fon-2022-0330. Online ahead of print.

ABSTRACT

Aim: To further evaluate the antiemetic efficacy of single-dose versus multiple-dose dexamethasone (DEX) against nausea and vomiting caused by cisplatin. Materials & methods: Two similar non-inferiority studies were pooled. Patients were randomized to single-day DEX or multiple-day DEX plus palonosetron and neurokinin-1 receptor-antagonists (NK-1RAs). The primary endpoint was complete response (CR; no vomiting and no rescue medication) during the overall phase. Results: The combined analysis included 242 patients. The absolute risk difference between single day versus multi-day DEX for CR was -2% (95% CI, -14 to 9%). Conclusion: Administration of single-dose DEX offers comparable antiemetic control to multiple-day DEX when combined with palonosetron and an NK-1RA in the setting of single-day cisplatin.

PMID:36017782 | DOI:10.2217/fon-2022-0330

Brain Behav. 2022 Aug 26:e2719. doi: 10.1002/brb3.2719. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to determine the prevalence of fatigue and cognitive impairment in patients with neuroborreliosis (NB) posttreatment and to determine whether delayed treatment initiation led to higher levels of fatigue and cognitive impairment.

METHODS: The study population consisted of 88 patients with NB included between October 10, 2014, and August 21, 2020, at the Clinical Center for Emerging and Vector-borne Infections at Odense University Hospital, Denmark. The Symbol Digit Modalities Test (SDMT) was used as a cognitive screening test, and the Modified Fatigue Impact Scale (MFIS) was used to assess the patients’ level of fatigue over the course of a year.

RESULTS: Overall, 14.3% of patients had an SDMT score indicative of cognitive impairment, and 38.8% of patients reported experiencing fatigue 12 months posttreatment. We found no statistically significant differences in fatigue or cognitive impairment when comparing the patients who had a treatment delay of ≤14 days and those with a treatment delay of >14 days (p > .05) 12 months posttreatment. A random effects regression model showed a significant positive correlation between longer treatment delay and higher MFIS scores, indicating higher levels of fatigue.

CONCLUSIONS: The results of this study show that both the early and late treatment groups improved significantly over a 12-month period in terms of both cognitive symptoms and fatigue. However, it also showed that a substantial subgroup of patients with NB still suffer from fatigue and cognitive impairment 12 months posttreatment.

PMID:36017773 | DOI:10.1002/brb3.2719

Orthop Surg. 2022 Aug 26. doi: 10.1111/os.13417. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the mortality of patients with fragile hip fractures and assess the death-associated risk factors.

METHODS: A total of 690 patients with osteoporotic hip fractures (age, 50-103 years) that were treated from January 2010 to December 2015 were enrolled and followed-up in this study and the clinical data were retrospectively collected. Three months, 1 year, and the total mortality were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications. The mortality of each group was compared by chi-square test or corrected chi-square test for univariate analysis, and the factors with statistically significant mortality difference confirmed by univariate analysis were analyzed by binary logistic multivariate analysis.

RESULTS: The 3-month mortality was 7.69%, the 1-year mortality was 15.60%, and the total mortality of the follow-up time was 24.06%. The 1-year and total mortality during the follow-up of the patients were higher in the >75-year-old group than those in the ≤75-year-old group (p = 0.000, respectively); were higher in the male patients than that in the female patients (p = 0.042; p = 0.017, respectively); were significantly lower in the operation group than that in the non-operation group (p = 0.000, respectively); were significantly lower in the patients that underwent the operation in ≤5 days than the patients that underwent the operation within >5 days (p = 0.008; p = 0.000, respectively); were significantly lower in patients with >2 kinds of combined medical diseases than those with ≥2 kinds of chronic diseases (p = 0.000, respectively); were significantly lower in patients receiving anti-osteoporosis treatment than in patients not receiving anti-osteoporosis treatment (p = 0.000, p = 0.002, respectively). Binary logistic regression analysis showed that the independent risk factors affecting mortality included advanced age >75-years-old (OR = 5.653, p = 0.000), male (OR = 1.998, p = 0.001), non-surgical treatment (OR = 9.909, p = 0.000), the number of combined medical diseases ≥2 (OR = 1.522, p = 0.042), and non-anti-osteoporosis treatment (OR = 1.796, p = 0.002).

CONCLUSION: Age, whether or not surgical treatment was performed, the number of medical diseases, and whether or not anti-osteoporosis treatment was performed were independent risk factors for 3-month and 1-year mortality in patients with fragile hip fractures.

PMID:36017769 | DOI:10.1111/os.13417

Orthop Surg. 2022 Aug 26. doi: 10.1111/os.13471. Online ahead of print.

ABSTRACT

OBJECTIVE: Reconstruction of acetabular defects has been extremely challenging in both primary and revision total hip arthroplasty (THA). Impaction bone grafting (IBG) can restore the acetabulum bone mass and anatomically reconstruct the acetabulum. Our study aimed to report the short and medium-term clinical and radiographic outcomes of IBG for acetabular reconstruction in the cemented THA in the Chinese population.

METHODS: This was a single-center retrospective review enrolling 57 patients between May 2013 and July 2019. The patients with acetabular defects were treated with IBG, using low dose irradiated freeze-dried allograft bone with or without autograft bone, in the cemented THA performed by one senior surgeon. Harris hip score (HHS), standard pelvis anterior-posterior radiograph and lateral hip radiograph were obtained before operation and at 1 week, 3 months, 12 months, and yearly. Graft osteointegration was evaluated by Oswestry’s criteria, and complication was documented at the last follow-up. Independent sample ANOVA test and Pearson chi-square tests are used for statistical analysis.

RESULTS: There were 61 hips in 57 patients. The average follow-up time was 35.59 months (5-77 months). According to AAOS classification, a total of 18 hips were identified as segmental bone deficiency (type I), with 21 and 22 hips for cavitary bone deficiency (type II) and the combined bone deficiency (type III), respectively. The average HHS was improved from 44.49 (range: 32-58) preoperatively to 86.98 (range: 78-93) postoperatively. Graft osteointegration was satisfactory (Oswestry score ≥2) in all patients. No dislocation occurred in the 57 patients (61 hips) during follow-up. Although one cup migrated, no revision, re-revision, radiographic loosening, graft bone lysis, or postoperative complications were detected at the final follow-up.

CONCLUSIONS: IBG with low-dose irradiated freeze-dried allograft bone in acetabular bone defect reconstruction is a reliable technique for restoring acetabular bone defects in THA.

PMID:36017764 | DOI:10.1111/os.13471

Clin Exp Dent Res. 2022 Aug 26. doi: 10.1002/cre2.642. Online ahead of print.

ABSTRACT

OBJECTIVE: Operating time is one of the main advantages attributed from the literature to the use of self-ligating brackets (SLB). The aim of this study is to investigate the time needed for a complete archwire change procedure with conventional brackets (CB) and SLBs in a standardized in vitro research setting, comparing operators with different expertise.

MATERIALS AND METHODS: Thirty-three participants were divided into three equal groups: undergraduate students, postgraduate students, and orthodontists. Three sets of typodonts bonded with three types of brackets, including passive SLBs, active SLBs, and CBs using both steel and elastic ligatures were investigated. Operators had to insert, ligate, deligate, and remove wires in sets of typodonts representing an actual dentition before and after orthodontic treatment, mounted in phantoms. Archwire change procedure times were compared between the different bracket/ligation systems, between the before- and after-treatment typodonts, and between operators.

RESULTS: There were significant differences between SLBs and CBs, the greatest difference being 11 min 16 s between passive SLBs and CBs ligated with metallic ligatures at T0, for the total archwire change procedure by the operators overall. For all the operators, there was a statistically significant difference in total archwire change procedure time between the systems. The undergraduate students were the slowest when using CBs, but they showed no significant difference compared to the other users when using SLBs.

CONCLUSION: SLBs can offer a significant operating time reduction compared to CBs, and time saving is not dependent on the operator’s experience and training.

PMID:36017763 | DOI:10.1002/cre2.642

Reprod Domest Anim. 2022 Aug 26. doi: 10.1111/rda.14238. Online ahead of print.

ABSTRACT

The study aimed to validate the double versus single freezing protocol for Beetal buck (Capra hircus) spermatozoa in tris-citric acid (TCA) based extender both in terms of quality and fertilization potential. Computer-assisted sperm motion and kinematic (CASA) variables i.e., total (%), and progressive motilities (TM and PM, %), and rapid velocity (RV, %), average path (VAP, μm/s), straight line (VSL, μm/s), and curved line velocities (VCL, μm/s), straightness, (VSL/VAP, %), and linearity, (VSL/VCL, %) as well as supra-vital plasma membrane integrity (SV-PMI, %), mitochondrial membrane potential (MMP, %), viable / intact acrosome (V-IACR, %) and DNA integrity (DNA-I, %) had significantly greater values (P<0.05) during single freeze-thawing as compared to the double freeze-thawing at 0, 30, 90, 150 and 210 days, respectively. All CASA and other assays alone did not show significant differences (P>0.05) between both freeze-thaw cycles at all treatment durations, respectively. No statistical significance (P>0.05) was observed for the in vivo fertility between single (n = 84/141 = 59.72%) and double freeze-thawing (n =72/136 = 52.90%) cycles, respectively. In conclusion, sperm motion, kinematics, plasma membrane, acrosome, mitochondria and DNA integrities and in vivo fertility are acceptable after the double freezing protocol despite being lower than after one freeze cycle in Beetal buck (Capra hircus).

PMID:36017761 | DOI:10.1111/rda.14238

Chem Biodivers. 2022 Aug 26. doi: 10.1002/cbdv.202200361. Online ahead of print.

ABSTRACT

Background Curcumae Radix (CW) is traditionally used to treat dysmenorrhea caused by uterine spasm. However, the changes of its composition and anti-uterine spasms during vinegar processing and the mechanism in treating dysmenorrhea are not clear. Objective To elucidate the changes of anti-uterine spasm and its substance basis, and the mechanism of treating dysmenorrhea before and after vinegar processing. Methods The uterine spasm contraction model was established, and the uterine activity and its inhibition rate were calculated to evaluate the differences. The main chemical constituents of CW were quickly analyzed by UPLC-Q-TOF-MS/MS technology, and the differences between them were explored by multivariate statistical analysis. Then, the regulatory network of “active ingredients-core targets-signal pathways” related to dysmenorrhea was constructed by using network pharmacology, and the combination between differential active components and targets was verified by molecular docking. Results CW extract relaxed the isolated uterine by reducing the contractile tension, amplitude, and frequency. Compared with CW, the inhibitory effect of vinegar products was stronger, and the inhibition rate was 70.08%. 39 compounds were identified from CW and 13 differential components were screened out ( p <0.05). Network pharmacology screened 11 active components and 32 potential targets, involving 10 key pathways related to dysmenorrhea. The results of molecular docking showed that these differentially active components had good binding activity to target. Conclusion It was preliminarily revealed that CW could treat dysmenorrhea mainly through the regulation of inflammatory reaction, relaxing smooth muscle and endocrine by curcumenone, 13-hydroxygermacrone, (+)-cuparene, caryophyllene oxide, zederone, and isocurcumenol.

PMID:36017755 | DOI:10.1002/cbdv.202200361