Tag: nevin manimala

Medwave. 2022 Sep 9;22(8):e002517. doi: 10.5867/medwave.2022.08.002517.

ABSTRACT

INTRODUCTION: Medical reports of patients admitted to the emergency services has been modified due to the social distancing needed in the COVID-19 epidemic. For this reason, it is essential to know the family members’ perceptions about telephone medical reports.

OBJECTIVE: To determine the perception of care by family members of patients hospitalized due to COVID-19 on telephone medical reports in a tertiary hospital’s emergency room in Lima, Peru.

METHODS: A non-experimental cross-sectional study, through a survey of family members of patients with COVID-19 admitted during July and August 2020. The “External user satisfaction survey of the Ministry of Health” adapted to this setting was used due to the absence of similar studies. Information, respect for the user, efficiency, accessibility, suitability, security, and overall satisfaction were considered. The sample size for finite populations was selected from 2 936 family members, obtaining 347 surveys from 641 calls. Relatives were called by phone, and after acceptance, the survey was sent to them via WhatsApp in Google Forms format. Once the survey was received, it was analyzed using descriptive statistical techniques.

RESULTS: We made 641 telephone calls with a response rate of 54.1%, obtaining 347 surveys. The mean age was 40.12 years (standard deviation: 11.93 years), with 61.4% of females and 38.0% married. We found that 65.1% received higher education and that Chorrillos was the most prevalent district (10.1%). Moreover, 42.4% of those surveyed were children of hospitalized patients, 17.3% were spouses, and 85% were not health personnel. We found a high level of agreement in overall satisfaction (73.2%) and in most dimensions, including information (88.8%), respect for the user (82.1%), efficiency (70.3%), accessibility (75.8%), suitability (79.0%), and security (87.9%).

CONCLUSION: The telephone medical reports to relatives of patients hospitalized due to COVID-19 in the emergency room found an overall satisfaction of 73.2% . Telephone medical reports are essential alternatives to improve the quality of care during the COVID-19 epidemic.

PMID:36084348 | DOI:10.5867/medwave.2022.08.002517

Cancer Epidemiol Biomarkers Prev. 2022 Sep 9:EPI-22-0453. doi: 10.1158/1055-9965.EPI-22-0453. Online ahead of print.

ABSTRACT

BACKGROUND: Multivitamin use is a common health behavior but there is conflicting evidence from prospective studies about whether this behavior increases or decreases prostate cancer (PCa) risk.

METHODS: Associations of multivitamin (MVI) use and PCa risk were evaluated using data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Cox proportional hazards models estimated associations of MVI use with risk of total, low- and high-grade PCa. Longitudinal data were used to evaluate screening and biopsy patterns. To account for differential biopsy patterns, the probability of PCa was estimated for men with a positive screening value but no biopsy. Incidence Density Ratios were used to approximate hazards ratios, and associations of MVI use with predicted PCa risk were compared to observed.

RESULTS: Analyses of data from observed biopsies suggest a respective 19% (95% CI 10-28%) and 21% (12-31%) higher risk of high-grade PCa for current and long-term MVI use, compared to no use. Current and long-term MVI use was associated with a shorter time to first on-study biopsy, indicating the potential for detection bias. After accounting for differential acceptance of biopsy, associations of MVI use with PCa were attenuated and not statistically significant.

CONCLUSIONS: In SELECT, biopsy acceptance patterns differed by MVI use. Estimates of associations of MVI use with PCa risk based on observed biopsy data may be biased by differential acceptance of biopsy.

IMPACT: Differential biopsy ascertainment may impact associations of risk factors and PCa. Detailed screening and biopsy data can be used to analytically minimize such bias.

PMID:36084322 | DOI:10.1158/1055-9965.EPI-22-0453

J Nurs Care Qual. 2022 Sep 8. doi: 10.1097/NCQ.0000000000000648. Online ahead of print.

ABSTRACT

BACKGROUND: Poor leadership and teamwork in cardiopulmonary resuscitation (CPR) are associated with poor patient outcomes.

PROBLEM: Frontline nursing staff frequently identify patients in cardiac arrest but may not have the initial leadership and teamwork skills to organize their initial rescue response.

APPROACH: The Five-4-Life Quality Improvement (QI) program was pilot tested in a pediatric unit within a 510-bed acute care hospital in 2 phases: first, an educational program focused on leadership, team dynamics, and CPR skills, followed by sustaining interventions in the unit. Video recordings of 12 mock codes (4 pre-, 4 post-, 4 follow-up) were analyzed by trained observers.

OUTCOMES: Descriptive statistical tests indicated a significant improvement in leadership, teamwork, and task management scores pre- and post-program, and sustained after the program.

CONCLUSION: Implementing the Five-4-Life QI program is feasible in improving leadership, teamwork, and task management of first responding frontline nurses.

PMID:36084315 | DOI:10.1097/NCQ.0000000000000648

JCO Clin Cancer Inform. 2022 Sep;6:e2200066. doi: 10.1200/CCI.22.00066.

ABSTRACT

PURPOSE: To evaluate whether a custom programmatic workflow manager reduces reporting turnaround times (TATs) from a body oncologic imaging workflow at a tertiary cancer center.

METHODS: A custom software program was developed and implemented in the programming language R. Other aspects of the workflow were left unchanged. TATs were measured over a 12-month period (June-May). The same prior 12-month period served as a historical control. Median TATs of magnetic resonance imaging (MRI) and computed tomography (CT) examinations were compared with a Wilcoxon test. A chi-square test was used to compare the numbers of examinations reported within 24 hours and after 72 hours as well as the proportions of examinations assigned according to individual radiologist preferences.

RESULTS: For all MRI and CT examinations (124,507 in 2019/2020 and 138,601 in 2020/2021), the median TAT decreased from 4 (interquartile range: 1-22 hours) to 3 hours (1-17 hours). Reports completed within 24 hours increased from 78% (124,127) to 89% (138,601). For MRI, TAT decreased from 22 (5-49 hours) to 8 hours (2-21 hours), and reports completed within 24 hours increased from 55% (14,211) to 80% (23,744). For CT, TAT decreased from 3 (1-19 hours) to 2 hours (1-13 hours), and reports completed within 24 hours increased from 84% (82,342) to 92% (99,922). Delayed reports (with a TAT > 72 hours) decreased from 17.0% (4,176) to 2.2% (649) for MRI and from 2.5% (2,500) to 0.7% (745) for CT. All differences were statistically significant (P < .001).

CONCLUSION: The custom workflow management software program significantly decreased MRI and CT report TATs.

PMID:36084275 | DOI:10.1200/CCI.22.00066

Anal Chem. 2022 Sep 9. doi: 10.1021/acs.analchem.2c02833. Online ahead of print.

ABSTRACT

The refractive index (RI) is a fundamental physical property of materials. Although measurement of the RI of biological nanoparticles (BNPs) in aqueous media is of great importance to basic research and biomedical applications, it is hampered by their tiny size, large intrinsic heterogeneity, and weak scattering. Here, we report the development of a label-free technique that can determine the RI of individual viruses and small extracellular vesicles (sEVs) with high precision and an analysis rate up to 10 000 particles per minute. This was achieved via the combination of high-sensitivity light-scattering detection by nanoflow cytometry (nFCM) and the Mie theory calculation. With the measured RIs for T7 virions, T7 capsids, and sEVs, the concentrations of nucleic acid in viral particles and protein in the lumen of sEVs were estimated. Furthermore, building upon a simplified core-shell model, the RIs of sEVs ranging from 40 to 200 nm were obtained. By using these RIs, a statistically robust size distribution of sEVs was acquired in minutes with accuracy and resolution matched closely with those of cryo-TEM measurements. Our approach could become an important tool in the RI determination of single BNPs.

PMID:36084271 | DOI:10.1021/acs.analchem.2c02833

J Am Coll Health. 2022 Sep 9:1-9. doi: 10.1080/07448481.2022.2119404. Online ahead of print.

ABSTRACT

Objective: This study describes beliefs held by college students about cannabis use and examines the association between three specific cannabis beliefs and likelihood of use. Participants: 3,720 undergraduate students ages 18 to 25 attending ten colleges in one state. Methods: Data were gathered via online survey. Results: The majority (80%) of the sample was unsure or believed that cannabis was an effective way to reduce stress; 67% were unsure or believed that cannabis was not related to an increased risk for mental health problems; and 62% were unsure or believed that students who use cannabis are not more academically disengaged. Holding these beliefs, which are not supported by scientific evidence, was associated with a greater likelihood of cannabis use, even after statistically adjusting for covariates. Conclusions: These findings suggest that beliefs unsupported by scientific evidence are widespread among college students. Dispelling misinformation about cannabis might hold promise for reducing use.

PMID:36084270 | DOI:10.1080/07448481.2022.2119404

Arch Pathol Lab Med. 2022 Sep 9. doi: 10.5858/arpa.2021-0624-OA. Online ahead of print.

ABSTRACT

CONTEXT.—: The use of low-titer group O whole blood (LTOWB) in military and civilian trauma centers shows no significant difference in outcomes compared with component therapy.

OBJECTIVE.—: To compare the use of LTOWB with standard component therapy in nontrauma patients requiring massive transfusion at a major academic medical center.

DESIGN.—: This is a retrospective cohort study comparing nontrauma patients who received at least 1 unit of cold-stored LTOWB during a massive transfusion with those who received only blood component therapy during a massive transfusion. Primary outcomes are mortality at 24 hours and 30 days. Secondary outcomes are degree of hemolysis, length of inpatient hospital stay, and time to delivery of blood products.

RESULTS.—: One hundred twenty massive transfusion activations using 1570 blood products from 103 admissions were identified during the study period. Fifty-five admissions were included in the component cohort and 48 in the LTOWB cohort. There were no significant differences in primary outcomes: 24-hour mortality odds ratio, 2.12 (P = .14); 30-day mortality odds ratio, 1.10 (P = .83). Length of stay was found to be statistically significantly different and was 1.58 days shorter in the LTOWB cohort compared with the component cohort (95% CI, 1.44-1.73; P < .001). There were no significant differences in the remaining secondary outcomes.

CONCLUSIONS.—: LTOWB therapy appears no worse than using standard component therapy in nontrauma patients requiring a massive transfusion activation, suggesting that LTOWB is a reasonable alternative to component therapy in nontrauma, civilian hospital patients, even when blood type is known.

PMID:36084250 | DOI:10.5858/arpa.2021-0624-OA

J Orthop Trauma. 2022 Sep 6. doi: 10.1097/BOT.0000000000002487. Online ahead of print.

ABSTRACT

OBJECTIVES: Despite the use of systemic antibiotic prophylaxis, postoperative infection following fracture surgery remains an issue. The purpose of this systematic review and meta-analysis was to evaluate the effect of locally applied antibiotics on deep infection in fracture surgery in both open and closed fractures.

DATA SOURCES: A comprehensive search of Medline, EMBASE, and PubMed was performed from date of inception to April 15th, 2021 and included studies in all languages.

STUDY SELECTION: Cohort studies were eligible if they investigated the effect on infection rate of local antibiotic prophylaxis on deep infection following fracture surgery.

DATA EXTRACTION: The study was conducted according to the Cochrane Handbook for Systematic Reviews and reported as per the PRISMA guidelines. Risk of bias was assessed using Version 2 of the Cochrane risk-of-bias tool for randomized trials and the MINORS tool where applicable.

DATA SYNTHESIS: An inverse-variance random-effects model was the primary analysis model because of the anticipated diversity in the evaluated populations. Univariate models were employed when a single outcome was of interest.

CONCLUSIONS: The risk of deep infection was significantly reduced when local antibiotics were applied compared with the control group receiving systemic prophylaxis only. This beneficial effect was observed in open fractures but failed to reach statistical significance in closed fractures. This meta-analysis suggests there may be a significant risk reduction in deep infection rate following fracture surgery when local antibiotics are added to standard systemic prophylaxis, particularly in open fractures. Further high-powered Level I studies are needed to support these findings.

LEVEL OF EVIDENCE: III See Instructions for Authors for a complete description of levels of evidence.

PMID:36084224 | DOI:10.1097/BOT.0000000000002487

Neurosurgery. 2022 Sep 2. doi: 10.1227/neu.0000000000002117. Online ahead of print.

ABSTRACT

BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) represents an effective treatment for severe Parkinson’s disease (PD), but little is known about the long-term benefit.

OBJECTIVE: To investigate the survival rate and long-term outcome of DBS.

METHODS: We investigated all 81 patients including 37 males and 44 females who underwent bilateral STN DBS from March 2005 to March 2008 at a single institution. The current survival status of the patients was investigated. Preoperative and postoperative follow-up assessments were analyzed.

RESULTS: The mean age at the time of surgery was 62 (range 27-82) years, and the median clinical follow-up duration was 145 months. Thirty-five patients (43%) died during the follow-up period. The mean duration from DBS surgery to death was 110.46 ± 40.8 (range 0-155) months. The cumulative survival rate is as follows: 98.8 ± 1.2% (1 year), 95.1 ± 2.4% (5 years), and 79.0 ± 4.5% (10 years). Of the 81 patients, 33 (40%) were ambulatory up to more than 11 years. The Unified Parkinson’s Disease Rating Scale (UPDRS) score was significantly improved until 5 years after surgery although it showed a tendency to increase again after 10 years. The patient group with both electrodes located within the STN showed a higher rate of survival and maintained ambulation.

CONCLUSION: STN DBS is a safe and effective treatment for patients with advanced PD. This study based on the long-term follow-up of large patient populations can be used to elucidate the long-term fate of patients who underwent bilateral STN DBS for PD.

PMID:36084204 | DOI:10.1227/neu.0000000000002117

Lasers Surg Med. 2022 Oct;54(8):1051-1059. doi: 10.1002/lsm.23594.

ABSTRACT

BACKGROUND: Conventional high fluence Q-switched (HFQS) Alexandrite 755-nm are widely used in clinical café-au-lait macules (CALMs) treatment. There have been recent concerns regarding the efficacy and safety of low fluence Q-switched (LFQS) Nd: YAG 1064-nm lasers.

OBJECTIVE: To evaluate the efficacy and safety of the conventional HFQS and LFQS laser in the treatment of CALMs.

METHODS: Within 3 months, 20 patients underwent prospective self-controlled split-lesion treatments with HFQS once or twice depending on the recovery rate, and with LFQS six times biweekly. Then the more effective laser was selected for continued treatments. Efficacy outcomes were evaluated by a visual analog scale (VAS) biweekly during the comparative trail. Recovery process, side effects and recurrence were recorded during the trial and follow-up visit. Patient and physician preferences for laser selection were also recorded.

RESULTS: The average VAS scores of areas treated with HFQS and LFQS were 2.92 ± 0.86 and 2.93 ± 1.13, respectively (p > 0.05). The most significant efficacy change of LFQS was after the fourth laser treatment (VAS score: 1.82-2.37, p < 0.001). 11 lesions treated with LFQS and 7 with HFQS achieved an optimal treatment response (3.67 ≤ VAS ≤ 4). Three patients relapsed on one side (one on LFQS, two on HFQS) and five on both sides. Adverse effects included temporary hypopigmentation, hyperpigmentation, uneven pigmentation, and mottled hypopigmentation. Doctors thought 80% of patients were suitable for LFQS. 70% of patients preferred LFQS posttreatment.

CONCLUSIONS: The efficacy difference between the LFQS 1064-nm laser and HFQS 755-nm laser in treating CALMs in a 3-month comparative trial was statistically insignificant. LFQS is preferred by doctors and patients and is likely to help more patients achieve treatment efficacy than the HFQS within a short time, with fewer temporary adverse reactions, and a more even pigmentation. But it can cause mottled hypopigmentation. The LFQS had obvious lesion clearance after the fourth treatment.

PMID:36084202 | DOI:10.1002/lsm.23594