Tag: nevin manimala

Transplantation. 2024 Nov 8. doi: 10.1097/TP.0000000000005259. Online ahead of print.

ABSTRACT

BACKGROUND: Ex vivo lung perfusion (EVLP) can increase the donor pool by allowing high-risk lungs to be further evaluated for transplant. Several EVLP platforms are currently in use. This study examines whether different EVLP platforms have any association with post-transplant outcomes.

METHODS: The United Network for Organ Sharing registry was queried from February 28, 2018, to March 31, 2024, for adult double lung transplant recipients with EVLP data. EVLP platform was categorized as hospital EVLP, EVLP facility, mobile EVLP, or No EVLP. Recipients of EVLP lungs were statistically matched to recipients of No EVLP lungs on donor characteristics.

RESULTS: After matching, the final cohort included 1542 in the No EVLP group and 771 who received EVLP. Lungs placed on EVLP had significantly longer ischemic time than No EVLP (P < 0.001). Patients who received EVLP lungs had significantly longer post-transplant length of stay (≥25 d versus 21 d No EVLP, P < 0.001). Ischemic time (OR = 1.04, P = 0.008) and being in the ICU at the time of transplant (OR = 2.22, P < 0.001) were associated with higher rates of primary graft dysfunction (PGD3). After adjusting for hospital status and ischemic time, there was no association between the EVLP modality and PGD3. Subgroup analysis showed that DCD recipients did not have worse short- or long-term outcomes.

CONCLUSIONS: There is no relationship between EVLP modality, PGD3, and post-transplant survival after matching donor quality and adjusting for ischemic time. Work should continue to focus on reducing ischemic times so EVLP can continue to increase the donor pool while limiting adverse effects.

PMID:40101107 | DOI:10.1097/TP.0000000000005259

J Clin Hypertens (Greenwich). 2025 Mar;27(3):e70030. doi: 10.1111/jch.70030.

ABSTRACT

We aimed to study trends in achieving blood pressure (BP) goals, antihypertensive prescribing, and whether clinician behavior changed in temporal relationship to the JNC-8 (October 1, 2014), SPRINT results (November 9, 2015), and the 2017 hypertension guideline (November 13, 2017). We used the National Cardiovascular Data Registry (NCDR) Practice INNovation and CLinical Excellence (PINNACLE) registry and studied patients with hypertension aged >65 years (n = 3 678 774). We found a statistically significant, albeit small and minimally relevant, increase from 2013 to 2018 in achieving office-based SBP.

PMID:40101103 | DOI:10.1111/jch.70030

Medicine (Baltimore). 2025 Mar 14;104(11):e41746. doi: 10.1097/MD.0000000000041746.

ABSTRACT

Although studies have indicated causality between brisk walking and various diseases, the relationships between walking pace and respiratory diseases lack thorough investigation. The underlying relationships between walking pace and various respiratory diseases were examined through univariable Mendelian randomization (MR) analyses. Furthermore, we performed multivariable MR analyses to observe whether relationships between walking pace and respiratory diseases change after adjustment of body mass index (BMI). The genome-wide association study data of self-reported walking pace, BMI, and 42 respiratory diseases were retrieved from publicly available datasets. We employed the inverse-variance weighted, weighted median, and MR-Egger methods for MR analysis. Using the inverse-variance weighted method in univariable MR, we identified statistically significant negative causal associations between self-reported walking pace and 4 respiratory traits, including chronic lower respiratory diseases (odds ratio [OR], 0.27 [95% confidence interval [CI], 0.18-0.41]), asthma (OR, 0.23 [95% CI, 0.14-0.38]), chronic obstructive pulmonary disease (OR, 0.15 [95% CI, 0.08-0.30]), and diseases of the respiratory system (OR, 0.54 [95% CI, 0.41-0.70]). Similar results were observed with the MR-Egger and weighted median methods. These associations remained significant, though slightly attenuated, after adjusting for BMI. A brisk walking pace may significantly benefit respiratory health and aid in disease prevention and risk stratification.

PMID:40101097 | DOI:10.1097/MD.0000000000041746

Medicine (Baltimore). 2025 Mar 14;104(11):e41821. doi: 10.1097/MD.0000000000041821.

ABSTRACT

The COVID-19 pandemic has significantly impacted the mental health of healthcare workers globally. Given the critical role these professionals play, understanding the prevalence and predictors of post-traumatic stress disorder (PTSD) among healthcare workers is crucial for developing targeted interventions. Comprehensive data on the predictors of PTSD symptoms within this population remain limited. This cross-sectional study surveyed 852 healthcare workers across 4 Polish regions between 2021 and 2022. Data were collected using the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), which was culturally adapted and validated for Polish respondents. To identify key predictors of PTSD symptoms, researchers employed various statistical methods: Descriptive Statistics summarized key variables (e.g. age, job tenure) to provide an overview of data distribution and sample characteristics. Pearson Correlations examined linear relationships among variables like age, work experience, and PTSD severity, ensuring no multicollinearity through variance inflation factor checks. t-Tests and Mann-Whitney U tests compared PTSD symptom severity across demographic and professional subgroups, accounting for normality using the Kolmogorov-Smirnov test. And Hierarchical Regression Analysis identified significant predictors, incorporating demographic factors first and work-related variables (e.g. fear for personal health) in a second step. A total of 88.1% of participants were female, and 82.6% were nurses. The overall prevalence of PTSD symptoms was high, with a mean total PTSD score of 37.87. Gender differences were significant, with women reporting higher scores across the PTSD subscales, including avoidance and hyperarousal. Nurses had significantly higher intrusion symptoms compared to other professionals. Fear for personal health was the strongest predictor of PTSD symptoms (β = 0.15, P < .001), explaining 11% of the variance in the final regression model (R2 = 0.11, P < .001). The findings underscore the urgent need for targeted mental health interventions, particularly for women and nurses, who are disproportionately affected by PTSD during the pandemic. Predictive models should guide the development of support programs to mitigate the long-term psychological impact of COVID-19 and ensure better preparedness for future pandemics. The significant influence of fear for personal health on PTSD outcomes highlights the importance of protective measures and psychological support for frontline healthcare workers.

PMID:40101094 | DOI:10.1097/MD.0000000000041821

Medicine (Baltimore). 2025 Mar 14;104(11):e41880. doi: 10.1097/MD.0000000000041880.

ABSTRACT

Endolymphatic hydrops (EH) has been visualized on magnetic resonance imaging (MRI) in patients with various inner ear diseases. The purpose of this study was to evaluate the prevalence and risk factors of significant EH on inner ear MRI in patients with 1 or more audiovestibular symptoms and to predict the incidence of significant EH using multivariate analysis and multilayer perceptron artificial neural network modeling. This retrospective study included a total of 135 patients with 1 or more audiovestibular symptoms who do not meet the diagnostic criteria for MD and underwent inner ear MRI at our institution from July 2021 to January 2024. The EH grade of each patient was evaluated, and “significant EH” was considered grade II or III. Of 135 patients with 1 or more audiovestibular symptoms, 48 patients (35.6%) presented with significant EH and 87 patients (64.4%) without significant EH on inner ear MRI. The prevalence of significant EH was higher in males, which was statistically significant (P = .007). The prevalence of significant EH was higher in the right ear, and the mean age of patients with significant EH was 1.94 years higher, but no statistical significance was observed (P = .660 and .456, retrospectively). The odds ratio for significant EH development was 2.696 (95% confidence interval: 1.296-5.607) times higher in men, which was statistically significant. Predicting the incidence of significant EH development using multivariate analysis, sex was the only variable that was statistically significant (P = .008). Based on a predictive model using multilayer perceptron (MLP), the classification accuracy of the model was 79.5%. In our study, the male gender could be related to the risk of developing significant EH in patients with audiovestibular symptoms. The accuracy of our suggested MLP model for predicting the incidence of significant EH was 79.5%, with sex being the highest predictor importance. In the future, inner ear MRI and MLP neural network modeling can be combined as a noninvasive and precise support system in the diagnosis of EH.

PMID:40101092 | DOI:10.1097/MD.0000000000041880

Medicine (Baltimore). 2025 Mar 14;104(11):e41646. doi: 10.1097/MD.0000000000041646.

ABSTRACT

To analyze the effects of drug treatments and types of drugs on pregnancy outcomes in pregnant women at different gestational ages. The records of 526 pregnant women from our hospital from September 2018 to January 2024 were analyzed retrospectively. Women were categorized into 3 groups: normal delivery, artificial abortion, and spontaneous abortion. Data on maternal age, gestational age, smoking, drinking, radiation, medication timing, and types were collected and compared. Pearson correlation analysis assessed relationships between pregnancy outcomes, gestational age at medication, and medication types. After comparing multiple potential influencing factors, it was found that smoking history, timing of medication, and the use of antitussive and phlegm-reducing medications differed significantly among the different pregnancy outcome groups (P < .05). Multiple regression analysis showed that the gestational age at which pregnant women took medication was a significant positive influencing factor for adverse pregnancy outcomes, specifically artificial abortion (Coefficient = 0.210, P = .002). In addition, the use of antitussive and phlegm-reducing medications had a positive directional influence on adverse pregnancy outcomes, specifically spontaneous abortion (Coefficient = 0.294, P = .016). Further analysis showed that as the gestational age at the time of medication increased, the normal delivery rate initially increased and then decreased. The rate of artificial abortion first increased and then stabilized, while the spontaneous abortion rate showed minimal fluctuation. The use of medications by pregnant women and the duration of pregnancy significantly impact induced abortion rates. Cough and mucus-reducing medications can lead to miscarriage, while other drugs in early pregnancy generally do not affect outcomes. Antitussive and mucus-reducing drugs specifically increase the risk of spontaneous abortion. Raising awareness about proper medication use and conducting research on this topic is crucial for enhancing prenatal and postnatal care, reducing induced abortions, and promoting population growth.

PMID:40101089 | DOI:10.1097/MD.0000000000041646

Medicine (Baltimore). 2025 Mar 14;104(11):e41742. doi: 10.1097/MD.0000000000041742.

ABSTRACT

To evaluate the relationship between serum endothelial cell specific molecule-1 (Endocan), asymmetric dimethylarginine (ADMA) values, and penile Doppler ultrasonography (USG) findings in patients with severe erectile dysfunction (ED). This prospective study included 73 patients who were classified as severe ED and had an indication for penile Doppler USG in our urology outpatient clinic between April 2017 and January 2020. Fasting blood sugar, lipid profile, thyroid function tests, total testosterone, and serum Endocan and ADMA values were sampled, and penile Doppler USG examination data were recorded. Vasculogenic ED was detected in 51 (69.86%) of 73 patients, while the flow rates were normal in 22 (30.14%). Among those with vasculogenic ED, 15 (29.41%) had arterial insufficiency, 22 (43.13%) had venous leakage, and 14 (27.46%) had mixed. There was no statistically significant difference between the mean ADMA and Endocan values of ED with normal flow (14.44 ± 6.20 ng/mL and 0.18 ± 0.14 ng/mL) and the vasculogenic ED (12.31 ± 5.86 ng/mL and 0.21 ± 0.16 ng/mL) groups (P = .097 for ADMA and P = .315 for Endocan, respectively). Endocan and ADMA levels were not predictors of severe ED. There is a need for multicenter studies with larger patient populations to be conducted with different biomarkers that may have a higher predictive value in the future.

PMID:40101085 | DOI:10.1097/MD.0000000000041742

Medicine (Baltimore). 2025 Mar 14;104(11):e41676. doi: 10.1097/MD.0000000000041676.

ABSTRACT

This study aimed to explore the rule of acupoint selection in the treatment of somnolence by ancient acupuncture and moxibustion. Using “Duomei” and other words as search terms in the Encyclopaedia of Traditional Chinese Medicine, a table containing elements such as literature sources, acupoint names, and frequency of acupoint selection was created. The table data was imported into the Traditional Chinese Medicine Inheritance Calculation Platform Software V3.5 (TCMICS) for statistical analysis to summarize the rules of acupoint selection. In the ancient medical books, the high-frequency acupoints of acupuncture and moxibustion in the treatment of somnolence were KI(Kidney)4(Dazhong)(24times,9.76%),KI3(Taixi)(23times,9.35%),LI(Large Intestine)3Sanjian(23times,9.35%) from high to low, and the high-frequency acupoints used for specific acupoints were Shu, Luo, and Bahui points from high to low. Association rule analysis showed that the core combination of high-frequency related acupoints was 3 groups, namely,”KI3(Taixi)KI6(Zhaohai)”(5times,2.03%),”KI4(Dazhong)HT(Heart)5(Tongli)”(5times,2.03%), and “LI3(Sanjian) ST(Stomach)45(Lidui) SJ(SanJiao)10(Tianjing)”(5times,2.03%). Cluster analysis showed that the effective cluster combination of acupoints was “LI3(Sanjian), LI2(Erjian),KI3(Taixi),ST45(Lidui),SJ10(Tianjing),KI6(Zhaohai),””HT5(Tongli),KI4(Dazhong),””RN(Ren) 12(Zhongwan),BL(Bladder)43(Gaohuang),ST36(Zusanli),RN6(Qihai).” In the ancient medical books, acupuncture and moxibustion was used to treat somnolence with distal point selection, and acupuncture and moxibustion prescriptions often used “KI3(Taixi)KI6(Zhaohai)” and other core acupoint combinations from the perspective of tonifying deficiency, relieving excess and giving consideration to both deficiency and excess, combined with acupoint selection and coordination based on syndrome differentiation and meridian differentiation, and focused on overall adjustment.

PMID:40101083 | DOI:10.1097/MD.0000000000041676

Medicine (Baltimore). 2025 Mar 14;104(11):e41830. doi: 10.1097/MD.0000000000041830.

ABSTRACT

BACKGROUND: With the COVID-19 pandemic and the serious sequelae, foreign factor-induced Guillain-Barré syndrome (GBS) has become a research focus in autoimmune peripheral neuropathies. The study employs a bibliometric system to illustrate the research hotspots and trends in GBS based on pertinent literature from January 2013 to October 2023.

METHODS: The Web of Science Core Collection retrieved articles on GBS from January 1, 2013, to October 28, 2023. These articles were then visualized and statistically evaluated using VOSviewer, CiteSpace software, R version 4.2.1, and Microsoft Office Excel 2019.

RESULTS: A total of 4269 articles on GBS were gathered. The United States of America produced the most publications (28.55%, 1219/4269), followed by China (14.22%, 607/4269). The world’s leading country was the United States of America, with the most publications, the most substantial international cooperation, and the highest centrality (0.17). Union of French Research Universities (UDICE)-French Research Universities in France was the most productive organization (189 articles). Lancet was the highest cocited journal (2428), and Professor Jacobs, Bart C., was the most prolific author (93). The most significant increases were shown for the keywords coronavirus, respiratory failure, and coronavirus disease 2019. The novel coronavirus is an emerging virus that may cause GBS, indicating a promising area of research.

CONCLUSIONS: The study on GBS was illustrated using bibliometrics, and it covers trends in international collaboration, publications, and research hotspots. These findings allow the scientific community to pinpoint the novel ideas and directions that will drive future GBS research.

PMID:40101082 | DOI:10.1097/MD.0000000000041830

Medicine (Baltimore). 2025 Mar 14;104(11):e41768. doi: 10.1097/MD.0000000000041768.

ABSTRACT

Colorectal cancer (CRC) is one of the most common cancers worldwide, necessitating the identification of risk factors and preventive measures. Fatty acids, vital nutrients involved in various bodily functions, have been linked to CRC; however, findings are inconsistent. This Mendelian randomization study utilized data from the UK Biobank and included 18 fatty acid-related phenotypes. We used single-nucleotide polymorphisms as instrumental variables to examine the Causal connections between fatty acids and CRC. Statistical analysis involved the inverse-variance-weighted, Mendelian randomization-Egger, and weighted median methods to ensure robust findings. Our analysis revealed that docosahexaenoic acid and omega-3 fatty acids were positively associated with CRC risk. No significant associations were found between CRC and total fatty acids, saturated fatty acids, polyunsaturated fatty acids, or monounsaturated fatty acids. The degree of unsaturation was positively associated with CRC, while the ratio of omega-6 to omega-3 fatty acids was negatively associated. The study highlights a positive association between docosahexaenoic acid, omega-3 fatty acids, and CRC, suggesting that specific fatty acids may influence CRC risk. Further research in diverse populations is needed to confirm these findings and explore the underlying mechanisms.

PMID:40101081 | DOI:10.1097/MD.0000000000041768