Tag: nevin manimala

Korean J Fam Med. 2022 Mar;43(2):125-131. doi: 10.4082/kjfm.21.0086. Epub 2022 Mar 17.

ABSTRACT

BACKGROUND: Many studies have assessed the risk factors for adverse drug reactions (ADRs) in elderly patients. However, most of these studies have focused on risk factors for ADRs, not serious ADRs (s-ADRs). s-ADRs are commonly found in hospitalized patients. s-ADRs warrant imminent but thorough investigations, given their critical impact on patient health. Therefore, this retrospective study aimed to assess the associated risk factors for s-ADRs in elderly hospitalized patients.

METHODS: In-patients aged >65 years having ADRs during hospitalization at a university hospital in Korea between 2010 and 2012 were included. Medical professionals spontaneously reported ADRs using an electronic submission system at the study hospital. Further, all descriptions of ADRs were characterized and categorized through the screening of electronic medical records. We compared the characteristics of patients having s-ADRs with those of patients not having s-ADRs.

RESULTS: There were 353 cases of ADRs, 67 of which were s-ADRs. Patients taking more than eight concomitant drugs showed the highest odds ratio (OR, 11.99; 95% confidence interval [CI], 3.42-42.03). The ratio of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) was also significantly related to s-ADRs (OR, 2.78; 95% CI, 1.33-5.81). The use of antibiotics (OR, 2.39; 95% CI, 1.13-5.02) and antineoplastics (OR, 4.17; 95% CI, 1.09-15.94) were significant risk factors.

CONCLUSION: Our findings highlight the importance of polypharmacy. Liver function tests (AST/ALT ratio) must be monitored carefully within high-risk groups for ADRs.

PMID:35320898 | DOI:10.4082/kjfm.21.0086

Klin Monbl Augenheilkd. 2022 Mar 23. doi: 10.1055/a-1738-9941. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the macular and optic disc vascular changes in vitamin B12 deficiency anemia.

METHODS: A total of 24 patients with vitamin B12 deficiency anemia and 24 healthy controls were involved in this study. All participants were evaluated for central macular thickness (CMT), peripapillary retina nerve fiber layer (RNFL) thickness, foveal avascular zone (FAZ) area, macular vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP), choriocapillaris flow area, and optic disc radial peripapillary capillary (RPC) VD using optic coherence tomography (OCT) and optic coherence tomography angiography (OCTA). Metabolic parameters were also noted.

RESULTS: Temporal RNFL thickness significantly decreased in the B12 deficiency anemia group (p = 0.04). Choriocapillaris flow area (p = 0.045) and macular vessel density in both SCP (p = 0.022) and DCP (p = 0.018) markedly declined in the study group. Optic disc RPC VD in the B12 deficiency anemia group was lower in all regions compared to that of the control group, but the difference was not statistically significant (p > 0.05). There were significant positive correlations between choriocapillaris flow area, macular VD, vitamin B12, and hemoglobin.

CONCLUSION: Retinal vascular alterations were observed in B12 deficiency anemia, and OCTA may be beneficial in the diagnosis and follow-up of ocular complications in these cases.

PMID:35320869 | DOI:10.1055/a-1738-9941

Klin Monbl Augenheilkd. 2022 Mar 23. doi: 10.1055/a-1741-7988. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the thickness of the outer retinal layer (ORL) together with macular thickness and changes in the retinal nerve fiber layer (RNFL) in patients with schizophrenia in comparison with healthy controls.

METHODS: This study included 114 eyes of 57 patients diagnosed with schizophrenia and 114 eyes of 57 healthy controls. Central foveal thickness (CFT), central macular thickness (CMT), and ORL thickness were measured in both groups via the images obtained by spectral-domain optical coherence tomography (SD-OCT). RNFL was also assessed in four quadrants (inferior, superior, temporal, nasal). CMT measurements were presented as the average thickness of the macula in the central 1 mm area on the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. The ORL thickness was defined as the distance between the external limiting membrane and retinal pigment epithelium at the center of the foveal pit.

RESULTS: The mean age of 57 patients was 37 ± 10 years, of whom 34 (60%) were male and 23 (40%) female. No statistically significant difference was found between groups in terms of age and gender (p = 0.8 for age, p = 0.9 for gender). There was no statistically significant difference in the mean CMT between the two groups (p = 0.1). The mean ORL thickness in the two groups was 99.8 ± 8.3 and 103.7 ± 6.2, respectively, and was significantly decreased in the schizophrenia group (p = 0.005). RNFL analysis demonstrated significant thinning in the inferior and superior quadrants compared to healthy controls (p < 0.001 and p = 0.017, respectively).

CONCLUSIONS: SD-OCT findings – especially ORL and RNFL thickness – may be related to the neurodegenerational changes in schizophrenia.

PMID:35320864 | DOI:10.1055/a-1741-7988

Klin Monbl Augenheilkd. 2022 Mar 23. doi: 10.1055/a-1766-7320. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the 2-year surgical treatment outcome in glaucoma patients.

METHODS: A retrospective, single-center, interventional study was performed on 160 eyes of 125 patients suffering glaucoma, including POAG (82 eyes), pseudoexfoliation (PEX) (59 eyes), pigment dispersion (8 eyes), and secondary glaucoma (2 eyes). Eyes with uncontrolled intraocular pressure (IOP) or signs of glaucoma progression despite medical treatment were included to undergo either trabeculectomy (TE), XEN implantation, combined TE with phacoemulsification (TE + IOL), or XEN implantation with phacoemulsification surgery (XEN + IOL). Primary efficacy outcome was the mean IOP reduction. Secondary outcome was the mean reduction in the number of medications. The data were compared at baseline vs.1 day, 1 week, and 1, 3, 6, 12, and 24 months following surgery. For statistical evaluation, ANOVA-based linear mixed-effects models were performed with SPSS.

RESULTS: The mean IOP reduction in a 2-year follow-up was 30.31% (22.17 vs. 15.45 mmHg, p < 0.001). The mean number of antiglaucoma medications was reduced from 2.87 to 0.58 (p = 0.001), where TE alone or combined surgeries seemed to be more effective than isolated XEN surgery. Transient IOP hypotony on the first postoperative day occurred in PEX patients following TE surgery (p = 0.024). At 6 months, PEX patients with isolated XEN surgery showed a transient IOP increase, whereas those after combined TE + IOL surgery showed the lowest IOP within the PEX group compared to other glaucoma patients (p < 0.026).

CONCLUSIONS: After 2 years, all performed glaucoma surgeries achieved a significant reduction in IOP and the number of antiglaucoma medications.

PMID:35320867 | DOI:10.1055/a-1766-7320

Klin Monbl Augenheilkd. 2022 Mar 23. doi: 10.1055/a-1743-3067. Online ahead of print.

ABSTRACT

OBJECTIVE: To conduct an evaluation of the effects of irregular astigmatism on the retinal nerve fiber layer (RNFL) and the retinal layers observed using spectral-domain optical coherence tomography (SD-OCT) in patients who had keratoconus (KC).

MATERIALS AND METHODS: A total of 255 eyes from 255 individuals, comprising 72 eyes of KC patients, 70 eyes of patients with astigmia, and 113 eyes of healthy controls were included in the analysis. RNFL scan maps (comprising global, temporal, superotemporal, inferotemporal, nasal, inferonasal, and superonasal maps) and macular thickness (MT) maps of a standard from the Early Treatment Diabetic Retinopathy Study (ETDRS) grid were assessed. The measurements were segmented automatically using Spectralis software, and included the RNFL, inner and outer plexiform layers (IPL, OPL), inner and outer nuclear layers (INL, ONL), ganglion cell layer, retinal pigment epithelium (RPE) in the central 6-mm ETDRS subfield.

RESULTS: The RNFL thickness in the KC group was lower when compared with the other two groups; however, statistically significant differences were noted in the global, temporal, superotemporal, and inferotemporal sectors (p < 0.05 for all). All of the central MT parameters showed significant variation among the groups, while a statistically significant decrease was noted in the KC group, except in the inferior outer sector (p = 0.741). In the segmentation analysis, the KC group had the significantly lowest IPL, ONL, RPE, and outer retinal layer (ORL) thickness among the groups (p < 0.05 for each). The astigmatic group was similar to the control group with regard to these parameters (p > 0.05 for each).

CONCLUSION: The eyes in the KC group appeared to have a thinner RNFL and MT when compared to those in the astigmatic and control groups. The ORLs, especially the ONL and RPE, were the most affected component of the macula in the KC group.

PMID:35320863 | DOI:10.1055/a-1743-3067

Parasitol Res. 2022 Mar 23. doi: 10.1007/s00436-022-07494-8. Online ahead of print.

ABSTRACT

Rock pigeons are synanthropic birds and live in close association within human settlements. Synanthropic birds are considered potential carriers of diseases and pose a subsequent risk of their transmission to humans. Neospora caninum and Toxoplasma gondii are intracellular protozoans infecting a wide range of hosts, as well as birds. Data related to the incidence of these protozoans in rock pigeons in Pakistan are scant. The aims of the study were to detect T. gondii and N. caninum DNA in tissue samples from rock pigeons (Columba livia) and to identify possible risk factors associated with infection. To accomplish this, pectoral muscle and brain samples were carefully collected from rock pigeons (n = 120) belonging to three zones located in ten districts of Punjab during a 4-month sampling span (July 2018 to October 2018). Data related to sex, age, sampling site, districts, seasonality, and ecological zones were recorded. DNA from brain and pectoral muscle samples was screened for both T. gondii and N. caninum by PCR assays. Chi-square analysis was used to check the association between positive samples and risk factors. The level of significance was p ≤ 0.05. T. gondii was detected in 46 (38.3%) brain samples, while 24 pectoral muscle samples (20%) were positive for N. caninum. Agroecological zones were statistically associated with the detection of N. caninum DNA. The outcomes of this study provide an understanding of the epidemiological pattern of N. caninum and T. gondii infection in rock pigeons in different regions of Punjab, Pakistan.

PMID:35320837 | DOI:10.1007/s00436-022-07494-8

Urol Int. 2022 Mar 23:1-8. doi: 10.1159/000522646. Online ahead of print.

ABSTRACT

INTRODUCTION: Knowledge gaps regarding available treatment and social stigmatization are barriers to care in patients with overactive bladder (OAB). We assessed the feasibility of an OAB education program targeting older community-dwelling females.

METHODS: Community-dwelling women over 55 years old were recruited. Eligible participants underwent an education program covering continence-promotion strategies. The Overactive Bladder Questionnaire-Short Form and Short Form-12 were completed at baseline, 1 week, 3 months, and 6 months post-intervention to measure symptom bother and condition-specific and general quality of life (QoL). Data were analyzed using a linear mixed-effects model for repeated measures.

RESULTS: Thirty-seven female patients with OAB symptoms at baseline were assessed with the majority from Latino/Hispanic or Black/African American ethnic/racial backgrounds. For our youngest subgroup (≤68 years old), significant improvements were observed at 3 and 6 months compared to 1 week post-intervention for symptom bother (3 months, -22.75, p = 0.006; 6 months, -25.76; p = 0.001) and condition-specific and health-related QoL subscale scores for concern (3 months, +23.76, p = 0.006; 6 months, +22.15, p = 0.011) and social interaction (3 months, +21.11, p = 0.017; 6 months, +20.51; p = 0.021). For all age subgroups, improvements in general QoL measures for mental health were seen at 3 and 6 months compared to baseline (3 months, +7.57, p = 0.02; 6 months, +6.70; p = 0.048).

CONCLUSIONS: Statistically significant improvements in symptom bother, condition-specific, and general QoL measures were observed following an OAB education program pilot study in a predominantly minority female population. Further studies are needed to support efficacy and optimize program design.

PMID:35320799 | DOI:10.1159/000522646

Audiol Neurootol. 2022 Mar 23:1-7. doi: 10.1159/000522281. Online ahead of print.

ABSTRACT

OBJECTIVE: All surgeons should inform the patients about complications and also their clinic’s complication rates of cochlear implantation (CI). We aimed to review the complications of CI in 1,148 pediatric and adult patients.

METHODS: It is a retrospective case review study enrolled in a tertiary referral center in Istanbul where CI was mostly performed. A total of 1,148 pediatric and adult CIs (unilateral or bilateral CI and revision surgery) performed by the same experienced surgeon in our institution were examined. Complications were noted as major and minor.

RESULTS: The mean age of first CI of 702 children and 157 adult patients was 10.2 years (1-75 years). The overall complication rate was 13.68%, comprising 8.28% of minor and 5.4% of major complications. Swelling (wound seroma or hematoma) was the most common minor complication. The most common cause of major complications was related to implanted devices. Despite the high rates of minor complications in children, there was no statistically significant difference between children and adults (p = 0,194).

CONCLUSIONS: Our clinic has a low major complication rate. Surgeons should be aware of postoperative complications, apply appropriate procedures, and inform patients about their surgical complication rates.

PMID:35320809 | DOI:10.1159/000522281

J Biomech. 2022 Mar 11;135:111036. doi: 10.1016/j.jbiomech.2022.111036. Online ahead of print.

ABSTRACT

Tissue-level brain responses to sport-related head impacts may be stronger predictors of brain injury risk than head kinematics alone. Despite the importance of accurate impact response estimation, the influence of head morphological variations has not been properly considered due to the limited sizes and shapes of existing computational head models. In this study, we developed 101 subject-specific finite element (FE) head-brain models based on CT scans and a parametric modeling approach to estimate tissue-level brain impact responses (maximal principal strain, MPS) under three head impact conditions. Principal component analysis (PCA) was used to quantify the geometric variations, with statistically significant PCs then selected to predict MPS using a stepwise linear regression model. High adjusted R² values (0.6-0.9) were achieved in the regression model, suggesting a good model predictability. Brain volume explained the largest variance of 51.3%, and it was highly correlated with MPS, indicating a significant size effect on brain impact responses. This is the first modeling study to systematically consider the influence of morphological variations in the inner skull and scalp on brain tissue impact response.

PMID:35320756 | DOI:10.1016/j.jbiomech.2022.111036

Comput Methods Programs Biomed. 2022 Mar 12;219:106756. doi: 10.1016/j.cmpb.2022.106756. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Atherosclerosis is a leading cause of potentially serious cardiovascular diseases such as heart attack, stroke, and peripheral artery disease. Due to the prolonged and non-reversible process of thickening arteries walls, atherosclerosis plaques in the blood vessels are formed that restrict the blood flow. Early detection plays a vital role in minimizing the risk as there is no reliable method to detect the early stage of the disease. This paper proposes a novel atherosclerosis detection method based on the emerging paradigm of molecular communications. The work could pave the way to implement a low-cost and straightforward early detection method of atherosclerosis in the future.

METHODS: We used COMSOL to model the physical field, coupled the fluid module and the fluid particle tracking module, and mapped the contrast agent into nanoparticles (NPs). The NPs are released at the entrance of the blood vessel and received at the exit of the blood vessel, while NPs are propagating through different arterial stenosis. The arrival probability of NPs is defined as the ratio of the number of NPs that reach the outlet to the total number of released NPs. As a result of atherosclerosis, the arrival probability of Nps is affected by the dynamic flow nature changes, thereby reflecting the arterial stenosis degree. Furthermore, we introduce the multi-release method in this study, which has a similar concept of Inter-symbol interference in traditional communication. This multi-release method leads the overlapping concentrations of NPs remaining in the vessels and enhances the differences of arrival probability in different degrees of stenosis, which increases the chance of more observable results.

RESULTS: The assessment of arterial stenosis degree can be from the early stage to the late stage of the disease. To evaluate the arterial stenosis degree, we analyzed the Poincaré maps, representing the arrival probability of NPs at different arterial stenosis. Moreover, we could directly use data to quantify the pathological process at various stages. The difference between the data results obtained through multiple release methods is more prominent than a single-released method.

CONCLUSIONS: This research proposes a new atherosclerosis detection method based on molecular communication, that is, to evaluate the arterial stenosis degree by modelling and using statistical data of NPs emission and reception in blood vessels. This method can not only use a simple method to detect the early stage of the disease. In addition, we can directly use data to quantify the pathological process of each stage, which is straightforward to assist doctors and may reduce the labour cost of traditional detection.

PMID:35320741 | DOI:10.1016/j.cmpb.2022.106756