Tag: nevin manimala

Laryngoscope. 2022 Feb 17. doi: 10.1002/lary.30061. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: To evaluate the presence of laryngopharyngeal reflux (LPR) and the potential association between presence of LPR symptoms and obstructive sleep apnea (OSA) in a representative sample from a population-based study.

STUDY DESIGN: Cross-sectional study.

METHODS: Participants of the follow-up of the Epidemiological Sleep Study were evaluated. Sleep was assessed through questionnaires and polysomnography. The presence of LPR was based on the questionnaire Reflux Score Index (RSI), and scores higher than 13 were suggestive of LPR. A general linear model test was used for comparison of continuous data and Pearson’s chi-square test was used to compare categorical variables. Predictors of LPR were obtained by regression analysis.

RESULTS: 701 were enrolled (54.8% female, 45.2% male; mean age, 50.2 ± 13.3 years). The mean apnea-hypopnea index score was 17 ± 18.3 events/hr, and the mean RSI score was 7.0 ± 8.1. LPR was found in 17% of the volunteers, whereas OSA was present in 38.5% of the sample. Specifically, in those patients with OSA, the prevalence of LPR was 45.4%; however, there was no statistically significant association between LPR and the presence of OSA. The severity of OSA was not associated with RSI score. The presence of LPR was associated with older age, smoking, excessive daytime sleepiness and worse quality of life and sleep scores questionnaires.

CONCLUSIONS: Age, smoking, but not body mass index, were associated with LPR. There was not statistically significant association of LPR with OSA. Individuals with symptoms of LPR had greater drowsiness and worse quality of life and sleep.

LEVEL OF EVIDENCE: 3 Laryngoscope, 2022.

PMID:35174884 | DOI:10.1002/lary.30061

Biometrics. 2022 Feb 17. doi: 10.1111/biom.13644. Online ahead of print.

ABSTRACT

A popular design for clinical trials assessing targeted therapies is the two-stage adaptive enrichment design with recruitment in stage two limited to a biomarker-defined subgroup chosen based on data from stage one. The data-dependent selection leads to statistical challenges if data from both stages are used to draw inference on treatment effects in the selected subgroup. If subgroups considered are nested, as when defined by a continuous biomarker, treatment effect estimates in different subgroups follow the same distribution as estimates in a group-sequential trial. This result is used to obtain tests controlling the familywise type I error rate (FWER) for six simple subgroup selection rules, one of which also controls the FWER for any selection rule. Two approaches are proposed; one based on multivariate normal distributions suitable if the number of possible subgroups, k, is small, and one based on Brownian motion approximations suitable for large k. The methods, applicable in the wide range of settings with asymptotically normal test statistics, are illustrated using survival data from a breast cancer trial. This article is protected by copyright. All rights reserved.

PMID:35174875 | DOI:10.1111/biom.13644

Anthropol Anz. 2022 Feb 17. doi: 10.1127/anthranz/2022/1557. Online ahead of print.

ABSTRACT

Osteoarthritis (OA) is a widespread skeletal condition in the historical population, but it still raises many methodological and interpretative problems. The present study aimed to examine the osteoarthritic changes (osteophytes, porosity, eburnation) in the skeletal material from Radom (14^th-19^th century) (Poland), enriching knowledge about osteoarthritis and its prevalence in the past. Additionally, a comparison of OA changes prevalence in two chronological periods (the population from Radom during the 14^th-17^th century versus the 18^th-19^th century) was done. In the Late Medieval (14^th-17^th century) population from Radom, osteoarthritic changes were observed in 22% of individuals (males, 18%; females, 29%) and in the Modern Period Radom (18^th-19^th century) in 25% individuals (males, 25.7%; females, 26.5%). In both skeletal samples, the greatest number of OA changes was recorded in the hip and elbow. Knee and ankle were the least affected joints. Osteophytes were the most frequently observed type of lesions, while eburnation was the least frequent. Although the higher prevalence of osteoarthritis in the Modern Period in Radom is noted, the differences are not statistically significant. Taking the multifactorial etiology of osteoarthritic changes, and the fact that osteoarthritis, as a single indicator of health, could not tell much about the overall lifestyle of past human populations, one must be caution when drawing unambiguous conclusions according to the simple, linear effect of environmental changes on osteoarthritic changes formation.

PMID:35174849 | DOI:10.1127/anthranz/2022/1557

Nurs Adm Q. 2022 Feb 15. doi: 10.1097/NAQ.0000000000000517. Online ahead of print.

ABSTRACT

Telehealth in health care delivery grew exponentially throughout the COVID-19 pandemic. This growth occurred because of necessity, yet requires capacity building to maximize the technology’s use. In this article, we discuss the development, implementation, and evaluation of a telehealth fair to build capacity in the use of telehealth technology within primary care nursing. The telehealth fair consisted of didactic and simulation components. Undergraduate and graduate nursing students completed the telehealth fair supported by a team of 12 nursing faculty and 6 clinical partner sites. Findings suggest statistically significant increases in student self-assessment of knowledge in telehealth, self-confidence in the use of telehealth, and readiness in the use of telehealth technology. Participant satisfaction following completion of the telehealth fair was high, with average scores of 4.2 to 4.58 (out of 5) for the didactic and 4.57 to 4.86 for the simulation components. The telehealth fair provided an invaluable opportunity for participants to enhance their learning relative to telehealth within primary care nursing. The experience also provided an opportunity for students to gain clinical hours during a pandemic when clinical placements in the community were limited. The experience also enhanced telehealth practice readiness of nursing students entering the workforce.

PMID:35174796 | DOI:10.1097/NAQ.0000000000000517

Retina. 2022 Feb 7. doi: 10.1097/IAE.0000000000003424. Online ahead of print.

ABSTRACT

PURPOSE: To determine the association of uric acid (UA) and glucose in aqueous humor with diabetic macular edema (DME) in patients with type 2 diabetes.

METHODS: Patients with DME or diabetes mellitus without retinopathy were enrolled from August 2016 to December 2020. Non-diabetic patients with age-related cataract or age-related macular degeneration were included as controls.

RESULTS: A total of 585 eyes from 585 patients were included for this study. Statistical analysis showed that aqueous UA was associated with central retinal thickness (r=0.39, P<0.0001), with higher levels of UA in severe DME and lower levels in mild DME, suggesting an ocular source of UA from the diabetic retina. Aqueous UA (odds ratio [OR], 6.88 [95% CI, 2.61-18.12]), but not aqueous glucose (0.95 [95% CI, 0.73-1.23]) or serum UA (0.90 [95% CI, 0.66-1.23]), was a stronger predictor for DME than duration of DM (1.26 [95% CI, 1.12-1.42]) or hemoglobin A1c (1.35 [95% CI, 0.99-1.83]). If aqueous UA (<2.46 mg/dl) and aqueous glucose (<6.43 mmol/L) were used as reference, high UA (≥2.46 mg/dl) alone was associated with 5.83-fold increase in risk of DME, but high glucose (≥6.43 mg/dl) alone was not associated with DME.

CONCLUSIONS: Increased aqueous UA, but not glucose, is an independent risk factor for DME. These data suggest that an intravitreal UA-lowering therapy could be beneficial for DME.

PMID:35174802 | DOI:10.1097/IAE.0000000000003424

Ann Ital Chir. 2022;11:S0003469X22036193.

ABSTRACT

BACKGROUND E AIMS: We aimed to determine whether intraabdominal pressure change caused by pneumoperitoneum created during laparoscopic cholecystectomy (LC) has effects on abdominal and shoulder pain, nausea, vomiting, bowel movements, time of first flatus and defecation, and biochemical parameters.

METHODS: Seventy patients that were diagnosed with cholelithiasis and would undergo LC, between the ages of 18-75, with the Society of Anesthesia Physical Status (ASA) I-III classifications were included in the study. Patients were divided into two groups as whose intervention was defined as low pressure (8-10 mm/hg) and whose intervention was defined as high pressure (14-16 mm/hg). Differences in the prognoses of patients in both groups were observed for statistical significance.

RESULTS: Shoulder pain- visual analogue scale (VAS) values in 6th and 24th hours were lower in Group 1(p<0.005). There was no significant difference in abdominal pain-VAS values(p≥0.05). Mean intraoperative end-tidal carbon dioxide (ETCO2) values were higher in Group 2 (p<0.005). Differences in nausea and vomiting were not significant(p≥0.05). There was no significant difference in the first flatus times(p≥0.05). Bowel movements resumed earlier in Group 1(p<0.005). Changes were not significant for biochemical blood parameters in the preoperative and postoperative periods( p≥0.05).

CONCLUSION: The use of low-pressure and high pressure carbon-dioxide (CO2)-pneumoperitoneum created during LC does not cause a significant difference in terms of clinical and laboratory results. Therefore, the surgical team should prefer an easy-to-apply pressure level which they are used to and in which they have low complication rates.

KEY WORDS: Cholecystectomy, Pneumoperitoneum, Low-pressure CO2.

PMID:35174791

Ann Ital Chir. 2022 Jan 10;11:S0003469X22036375. Online ahead of print.

ABSTRACT

The study was supported by TUEK (Board of Education and Expertise in Medicine – grant number 2016-1201). Funding source had no involvement in conducting or reporting process of this study. Comparison of Antisperm Antibody level following extraperitoneal inguinal hernia repair and Lichenstein hernia >A randomzed rial PURPOSE: We compared laparoscopic totally extraperitoneal (TEP) hernia repair and open Lichtenstein hernia repair (LHR) in terms of Antisperm Antibody Levels (ASA), pain, operative times, return to work times, hernia recurrence, and postsurgery complications.

METHODS: The patients were randomly divided into two groups as LHR and TEP. Blood samples were obtained for analysis of levels of ASA. Postoperative pain scores were assessed on the first day after repair using the Visual Analog Scale (VAS), and hernia recurrence, operation times, return to work times, and early and late postoperative complications were recorded.

RESULTS: Sixty male patients enrolled in the study. All patients were negative for ASA presurgery. ASA were detected in two patients in the LHR group postsurgery. The VAS score of the patients in the TEP repair group was significantly lower than that in the LHR group (median: 4.0 vs. 6.0) (p <0.001). The mean operation time in the TEP hernia repair group (50 min) was significantly longer than that in the LHR group (40 min) (40.0) (p <0.011). The median return to work time in the TEP hernia repair group (7 d) was significantly shorter than that in the LHR group (15 d)(p <0.001). There was no statistically significant difference between the two methods in terms of ASA,recurrence, or postoperative complications (p> 0.05).

DISCUSSION: Many studies have compared the superiority of different inguinal hernia repair methods. Which CONCLUSION: It is not possible to determine the superiority of concerning technics in reducing infertility after surgery. TEP inguinal hernia repair is superior to LHR in in terms of postoperative pain and return to work times.

KEY WORDS: Lichtenstein, Antisperm antibody, İnfertility, Inguinal hernia, Totally extra peritoneal repair.

PMID:35174790

Med Educ Online. 2022 Dec;27(1):2033421. doi: 10.1080/10872981.2022.2033421.

ABSTRACT

PURPOSE: Medical scribing is an increasingly common way for pre-medical students to gain clinical experience. Scribes are a valuable part of the healthcare team and have high rates of matriculation into health professional programs. Little is known about the effects of scribing on the success of the student. This manuscript aims to determine the effect of scribing experience on clinical self-efficacy during medical school.

PARTICIPANTS AND METHODS: Perceived clinical self-efficacy was evaluated with validated survey questions using a 5-point Likert-type scale as well as free text responses. The survey was completed by 175 medical students at the Frank H. Netter, MD School of Medicine. Statistical analysis was conducted using SPSS. As part of the mixed methods study, free text responses were analyzed using thematic analysis.

RESULTS: Quantitative results showed no statistical difference in perceived clinical self-efficacy between medical students with scribing experience and those without. Analysis of free text responses showed that medical students believed their scribing experience improved comfort in the clinical setting and increased familiarity with medical terminology.

DISCUSSION AND CONCLUSIONS: Medical students with scribing experience did not demonstrate greater clinical self-efficacy than their peers without scribing experience. However, medical students with scribing experience have a perceived value of their pre-medical scribing experience on their success in medical school.

PMID:35174763 | DOI:10.1080/10872981.2022.2033421

J Chemother. 2022 Feb 17:1-10. doi: 10.1080/1120009X.2022.2040770. Online ahead of print.

ABSTRACT

The aim of this multicentre retrospective study was to compare the efficacy of adjuvant chemotherapy regimens both with and without oxaliplatin and tumor sidedness in stage IIB (pT4aN0) colon cancer patients. This study included patients with stage IIB colon cancer who underwent curative surgery and received adjuvant chemotherapy. The patients were divided into two groups (one with and one without oxaliplatin) to compare the overall survival (OS) in right- and left-sided tumors. The study population included 298 patients with stage IIB colon cancer (median age: 57) of whom 69.1% were male. Forty-four per cent of these patients (n = 131) were diagnosed with right-sided colon cancer. The median follow-up duration was 35.9 months. In the entire population, a median OS was not reached, and the five-year OS was 83%. The median disease-free survival (DFS) was 12 months. There was no significant difference in terms of the five-year OS between right- (82%) and left-sided (84%) colon tumors (p = 0.67). In addition, the five-year OS of patients treated with and without oxaliplatin were 76% and 89%, respectively, and there was no statistically significant difference (p = 0.23). The five-year OS of the patients treated with and without oxaliplatin were 83% and 96.5%, respectively, (p = 0.8) in right-sided colon tumors, while it was 75% and 93% (p = 0.06), respectively, in left-sided colon tumors. Tumor sidedness and the addition of oxaliplatin to adjuvant chemotherapy were not found to be associated with the OS in stage IIB colon cancer patients in our study. Further large prospective studies that also include MSI, RAS and BRAF status data are warranted in colon cancer patients.

PMID:35174772 | DOI:10.1080/1120009X.2022.2040770

Scand J Gastroenterol. 2022 Feb 17:1-5. doi: 10.1080/00365521.2022.2039281. Online ahead of print.

ABSTRACT

OBJECTIVES: The development of intestinal failure-related complications in Finnish adults is unknown. This study aimed to investigate the incidence of catheter-related bloodstream infections (CRBSI), and the longitudinal changes in biochemical liver and kidney tests in a nationwide cohort.

MATERIALS AND METHODS: The search for Finnish adults with intestinal failure (IF) utilized a survey to Finnish health-care providers (n = 111) with the potential to provide long-term parenteral support (PS) for adult IF. Our nationwide, cross-sectional cohort included all IF patients aged ≥ 18 years who had received PS for ≥ 120 d in 2017. Data regarding CRBSI and biochemical liver and kidney tests were collected from patient records at the start of PS up to the latest available measurement in 2017.

RESULTS: In the nationwide cohort of 52 patients, the CRBSI incidence was 1.35/1000 catheter days. Seventy-three percent of CRBSI in a long-term catheter led to catheter replacement. During a median PS duration of 27.5 (interquartile range [IQR] 11.3-57.3) months, a statistically significant median change occurred in estimated glomerular filtration rate (eGFR; -8.5 ml/min/1.73 m², IQR -30-7, p = .005) and alkaline phosphatase (ALP; 26 U/l, IQR -11-95, p = .019). In a multiple regression model for eGFR at data collection, baseline eGFR and age were strong explanatory variables.

CONCLUSIONS: Incidence of CRBSI, but not treatment strategies, in this nationwide adult IF population correspond well to those reported from specialized centers. Decreased kidney function and abnormal liver test results are frequent findings, and even more so over time, emphasizing the importance of regular monitoring.

PMID:35174757 | DOI:10.1080/00365521.2022.2039281