Tag: nevin manimala

BJOG. 2021 Nov 14. doi: 10.1111/1471-0528.17013. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the relationship between preterm first birth and preterm second birth according to gestational age and to determine the role of placental disorder to recurrent preterm birth.

DESIGN: Population-based registry study.

SETTING: Medical Birth Registry of Norway and Statistics Norway.

POPULATION: Women (N=213,335) who gave birth to their first and second singleton child during 1999-2014 (N=426,670 births).

METHODS: Multivariate logistic regression analyses, adjusted for placental disorders, maternal, obstetric, and socioeconomic factors.

MAIN OUTCOME MEASURES: Extremely preterm (<28⁺⁰ weeks), very preterm (28⁺⁰ -33⁺⁶ weeks), and late preterm (34⁺⁰ -36⁺⁶ weeks) second birth.

RESULTS: Preterm birth (<37 weeks) rates were 5.6% for first births and 3.7% for second births. Extremely preterm second births (0.2%) occurred most frequent among women with an extremely preterm first birth (aOR 12.90; CI, 7.47-22.29). Very preterm second births (0.7%) occurred most frequent after an extremely preterm birth (aOR 12.98; CI 9.59-17.58). Late preterm second births (2.8%) occurred most frequent after a previous very preterm birth (aOR, 6.86; CI, 6.11-7.70). Placental disorders contributed with 30~40% of recurrent extremely and very preterm births and 10~20% of recurrent late preterm birth.

CONCLUSION: A previous preterm first birth was a major risk factor for a preterm second birth. The contribution of placental disorders was more pronounced for recurrent extremely and very preterm birth than for recurrent late preterm birth. Among women with any category of preterm first birth, more than one in six also had a preterm second birth (17.4%).

PMID:34775676 | DOI:10.1111/1471-0528.17013

J Biophotonics. 2021 Nov 14:e202100242. doi: 10.1002/jbio.202100242. Online ahead of print.

ABSTRACT

Mueller matrix (MM) polarimetry can provide comprehensive information about the polarization properties which are closely related to the microstructural features and has demonstrated its potential in biomedical studies and clinical practices, and bright-field microscopy is widely used in pathological diagnosis as the golden standard. In this work, we improve the throughput of MM microscopy by learning a statistical transformation between these two imaging systems based on deep learning. Using this approach, the MM microscope can generate image that is equivalent to a bright-field microscope image of the matching field of view. We add new transformative capability to the existing MM imaging system without requiring extra hardware. The translation model is based on conditional generative adversarial network with customized loss functions. We demonstrated the effectiveness of our approach on liver and breast tissues, and evaluated the performance by four quantitative similarity assessment methods in pixel, image and distribution levels respectively. This article is protected by copyright. All rights reserved.

PMID:34775685 | DOI:10.1002/jbio.202100242

Vet Comp Oncol. 2021 Nov 14. doi: 10.1111/vco.12782. Online ahead of print.

ABSTRACT

Overall prevalence of severe adverse events (sAE) has been poorly studied in veterinary medicine and peer-reviewed studies mostly focused on a single protocol, making it difficult to have a general overview. The aim of this retrospective study was to assess the frequency and risk factors of sAE secondary to various protocols of chemotherapy in dogs. Medical records of one hundred and fifty-five dogs receiving chemotherapy between January 2013 and December 2018 were reviewed. Adverse events (AE) were graded according to VCOG-CTCAE grading system. Statistical analyses were performed to determine whether demographic, cancer type and chemotherapy protocol were associated with development of sAE and their consequences. AE were reported at least once in 124 (80%) dogs and sAE were observed in 50 (32.3%) dogs. Among them, 23 (14.8%) had gastro-intestinal and 31 (20.0%) had myelotoxic events. sAE led to hospitalization in 37 (23.9%) dogs, to chemotherapy arrest in 12 (7.7%) dogs and to euthanasia or death in 9 (5.8%) dogs. Haematopoietic tumours were statistically associated with a higher frequency of sAE (p=0.004), gastrointestinal sAE (p=0.009), and hospitalization (p=0.004). A body weight over 10 kg was associated with less haematological sAE (p<0.001). The use of a multi-agent protocol was highlighted as a risk factor for sAE (p=0.038) and haematological sAE (p<0.001). sAE following chemotherapy and leading to hospitalization, chemo arrest or death were relatively common. A special attention during chemotherapy follow-up should be given to small dogs and those receiving multi-agent protocol or treated for haematopoietic tumours. This article is protected by copyright. All rights reserved.

PMID:34775666 | DOI:10.1111/vco.12782

J Card Surg. 2021 Nov 14. doi: 10.1111/jocs.16129. Online ahead of print.

ABSTRACT

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a less invasive treatment than surgery for severe aortic stenosis. However, its use is restricted by the fact that many patients eventually require permanent pacemaker implantation (PPMI). This meta-analysis was performed to identify predictors of post-TAVR PPMI.

METHODS: The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Relevant studies that met the inclusion criteria were included in the pooling analysis after quality assessment.

RESULTS: After pooling 67 studies on post-TAVR PPMI risk in 97,294 patients, balloon-expandable valve use was negatively correlated with PPMI risk compared with self-expandable valve (SEV) use (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.37-0.53). Meta-regression analysis revealed that history of coronary artery bypass grafting and higher Society of Thoracic Surgeons (STS) risk score increased the risk of PPMI with SEV utilization. Patients with pre-existing cardiac conduction abnormalities in 28 pooled studies also had a higher risk of PPMI (OR: 2.33, 95% CI: 1.90-2.86). Right bundle branch block (OR: 5.2, 95% CI: 4.37-6.18) and first-degree atrioventricular block (OR: 1.97, 95% CI: 1.38-2.79) also increased PPMI risk. Although the trans-femoral approach was positively correlated with PPMI risk, the trans-apical pathway showed no statistical difference to the trans-femoral pathway. The approach did not increase PPMI risk in patients with STS scores >8. Patient-prosthesis mismatch did not influence post-TAVR PPMI risk (OR: 0.88, 95% CI: 0.67-1.16). We also analyzed implantation depth and found no difference between patients with PPMI after TAVR and those without.

CONCLUSIONS: SEV selection, pre-existing cardiac conduction abnormality, and trans-femoral pathway selection are positively correlated with PPMI after TAVR. Pre-existing left bundle branch block, patient-prosthesis mismatch, and implantation depth did not affect the risk of PPMI after TAVR.

PMID:34775652 | DOI:10.1111/jocs.16129

Scand J Med Sci Sports. 2021 Nov 14. doi: 10.1111/sms.14098. Online ahead of print.

ABSTRACT

Individuals with chronic ankle instability (CAI) are believed to rely more on visual information during postural control due to impaired proprioceptive function, which may increase the risk of injury when their vision is limited during sports activities.

OBJECTIVES: To compare (1) the effects of balance training with and without stroboscopic glasses on postural control and (2) the effects of the training on visual reliance in patients with CAI.

DESIGN: A randomized controlled clinical trial.

METHODS: Twenty-eight CAI patients were equally assigned to one of 2 groups: strobe or control group. The strobe group wore stroboscopic glasses during a 4-week balance training. Static postural control, a single-leg hop balance test calculated by Dynamic Postural Stability Index (DPSI), and the Y-Balance test (YBT) were measured. During the tests, there were different visual conditions: eyes-open (EO), eyes-closed (EC), and strobe vision (SV). Romberg ratios were then calculated as SV/EO, and EC/EO and used for statistical analysis.

RESULTS: The strobe group showed a higher pre-posttest difference in velocity in the medial-lateral direction and vertical stability index under SV compared with the control group (p < 0.05). The strobe group showed higher differences in EC/EO for velocity in the medial-lateral and anterior-posterior directions, and 95% confidence ellipse area (p < 0.05), and in SV/EO for velocity in the medial-lateral, 95% confidence ellipse area, and YBT-anterior direction (p < 0.05).

CONCLUSION: The 4-week balance training with stroboscopic glasses appeared to be effective in improving postural control and altering visual reliance in patients with CAI.

PMID:34775656 | DOI:10.1111/sms.14098

Am J Ind Med. 2021 Nov 14. doi: 10.1002/ajim.23312. Online ahead of print.

ABSTRACT

BACKGROUND: The Minnesota Safe Patient Handling (MN SPH) Act requires health care facilities to implement comprehensive programs to protect their workers from musculoskeletal injuries caused by lifting and transferring patients. Nursing homes, hospitals, and outpatient facilities each face unique challenges implementing and maintaining SPH programs. The objective of the study was to compare patient handling injuries in these three health care settings and determine whether change in injury rate over time differed by setting following enactment of the law.

METHODS: Workers’ compensation data from a Minnesota-based insurer were used to describe worker and claim characteristics in nursing homes, hospitals, and outpatient facilities. Negative binomial models were used to compare claims and estimate mean annual patient handling claim rates by health care setting and time period following enactment of the law.

RESULTS: Consistent with national data, the patient handling claim rate was highest in Minnesota nursing homes (168 claims/$100 million payroll [95% confidence interval: 163-174]) followed by hospitals (35/$100 million payroll [34-37]) and outpatient facilities (2/$100 million payroll [1.8-2.2]). Patient handling claims declined by 38% over 10 years following enactment of the law (vs. 27% for all other claims). The change in claims over time did not differ by health care setting.

CONCLUSIONS: In this single-insurer sample, declines in workers’ compensation claims for patient handling injuries were consistent across health care settings following enactment of a state SPH law. Though nursing homes experienced elevated claim rates overall, results suggest they are not lagging hospitals and outpatient facilities in reducing patient handling injuries.

PMID:34775629 | DOI:10.1002/ajim.23312

J Clin Periodontol. 2021 Nov 14. doi: 10.1111/jcpe.13477. Online ahead of print.

ABSTRACT

AIMS: To compare tooth- (TSRP) and implant-supported (ISRP) removable prostheses in terms of abutment and prosthesis survival (PICO 1) and estimated cumulative survival of teeth/implants and prostheses (PICO 2) at ≥12-month post-prosthesis delivery in patients with stage IV periodontitis.

MATERIALS AND METHODS: Five databases were searched to identify RCTs, CCTs, single arms, prospective cohort studies, case series and retrospective studies. Duplicate screening was performed, and ranges for abutment and prosthesis survival were calculated.

RESULTS: Twenty-six studies were included in the qualitative assessment. Only one study with critical risk of bias comparing the two treatment modalities reported similar survival rates at 2 years. Overall, prospective studies on ISRPs indicated an implant survival rate ranging from 96.4% to 100% and a prosthesis survival rate of 100% with a follow-up from 12 to 54 months. Prospective studies on TSRPs indicated a tooth survival ranging from 85.71% to 100% at 1- to 10-years follow-up.

CONCLUSIONS: The available evidence is of poor quality, and it does not allow to make robust conclusions on the efficacy of these rehabilitations in stage IV periodontitis patients. Particularly for TSRPs, careful patient selection is crucial and a certain number of biological and prosthetic complications should be expected.

PMID:34775624 | DOI:10.1111/jcpe.13477

Am J Perinatol. 2021 Nov 14. doi: 10.1055/s-0041-1739409. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to compare the effectiveness of sustained uterine compression versus uterine massage in reducing blood loos after a vaginal delivery.

STUDY DESIGN: This was a prospective randomized trial conducted at the American University of Beirut Medical Center (AUBMC) between October 2015 and October 2017. Inclusion criteria were women with a singleton pregnancy at ≥36 weeks of gestation, with less than three previous deliveries, who were candidates for vaginal delivery. Participants were randomized into two groups, a sustained uterine compression group (group 1) and a uterine massage group (group 2). Incidence of postpartum hemorrhage (blood loss of ≥500 mL) was the primary outcome. We assumed that the incidence of postpartum hemorrhage at our institution is similar to previously published studies. A total of 545 women were required in each arm to detect a reduction from 9.6 to 4.8% in the primary outcome (50% reduction) with a one-sided α of 0.05 and a power of 80%. Factoring in a 10% dropout rate. Secondary outcomes were admission to intensive care unit (ICU), postpartum complications, drop in hemoglobin, duration of hospital stay, maternal pain, use of uterotonics, or of surgical procedure for postpartum hemorrhage.

RESULTS: A total of 550 pregnant women were recruited, 273 in group 1 and 277 in group 2. There was no statistically significant difference in baseline characteristics between the two groups. Type of anesthesia, rate of episiotomy, lacerations, and mean birth weight were also equal between the groups. Incidence of the primary outcome was not different between the two groups (group 1: 15.5%, group 2: 15.4%; p = 0.98). There was no statistically significant difference in any of the secondary outcomes between the two groups, including drop in hemoglobin (p = 0.79).

CONCLUSION: There was no difference in blood loss between sustained uterine compression and uterine massage after vaginal delivery.

KEY POINTS: · Transabdominal uterine compression and uterine massage are appropriate to prevent postpartum hemorrhage.. · No significant difference in blood loss or maternal discomfort observed between the two techniques.. · Both methods are equally effective and either one can be used based on provider preference..

PMID:34775581 | DOI:10.1055/s-0041-1739409

Br J Haematol. 2021 Nov 14. doi: 10.1111/bjh.17878. Online ahead of print.

ABSTRACT

Reinduction chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant (HDCT + ASCT) is second-line standard of care for transplant-eligible patients with relapsed/refractory classical Hodgkin lymphoma (r/r cHL) but has a high failure rate. Because response to reinduction is predictive of the outcome after HDCT + ASCT, we aimed to improve the standard dexamethasone, high-dose cytarabine and cisplatinum (DHAP) reinduction regimen by addition of the oral mammalian target of rapamycin inhibitor everolimus (everDHAP). Transplant-eligible patients aged 18-60 years with histologically confirmed r/r cHL were included in this experimental phase I/II trial. Everolimus (10 mg/day, determined in phase-I-part) was administered on day 0-13 of each DHAP cycle. From July 2014 to March 2018, 50 patients were recruited to the phase II everDHAP group; two were not evaluable, three discontinued due to toxicity. Randomization to a placebo group stopped in October 2015 due to poor recruitment after nine patients. The primary end-point of computed tomography (CT)-based complete remission (CR) after two cycles of everDHAP was expected to be ≥40%. With a CT-based CR rate of 27% (n = 12/45) after two cycles of everDHAP the trial did not meet the primary end-point. Adding everolimus to DHAP is thus feasible; however, the everDHAP regimen failed to show an improved efficacy.

PMID:34775591 | DOI:10.1111/bjh.17878

Environ Sci Pollut Res Int. 2021 Nov 13. doi: 10.1007/s11356-021-17343-3. Online ahead of print.

ABSTRACT

Despite the nutritional benefits, bivalves like mussels are also an excellent aquatic heavy metal biomonitoring agent due to their high tolerance to varying levels of temperature, salinity and oxygen, as well as pollutants. Although the accumulated toxic heavy metals may not exert direct negative impacts on the mussels, such toxicants in mussel tissues can give harmful effects on human body when consumed in toxic quantities and/or over prolonged period. The booming of urban and industrial activities, and consequently the increment of runoffs, as well as wastewater effluents and leaching, further exacerbated the magnitude of this issue. Hence, continuous monitoring of heavy metal contents in mussels is vital to ensure its compliance with food safety regulations, protecting consumers at large. This review paper discusses the occurrence of heavy metals in mussels especially that of Perna viridis in Malaysia and other parts of the world since year 2000 until 2021. Heavy metal concentration data and patterns from various coastal and/or estuaries were compared. Where applicable, statistical data that indicate variations between sampling sites, sampling months or years and chemical treatments for heavy metal removal were critically reviewed. Health risk assessment findings were also discussed. More importantly, related chemical-based interventions to minimize and/or eliminate toxic heavy metals from mussels are also reviewed.

PMID:34775561 | DOI:10.1007/s11356-021-17343-3