Tag: nevin manimala

Clin Exp Med. 2022 Jun 13. doi: 10.1007/s10238-022-00840-1. Online ahead of print.

ABSTRACT

To investigate the relationship between human immunodeficiency virus (HIV) infection and the risk of mortality among coronavirus disease 2019 (COVID-19) patients based on adjusted effect estimate by a quantitative meta-analysis. A random-effects model was used to estimate the pooled effect size (ES) with corresponding 95% confidence interval (CI). I² statistic, sensitivity analysis, Begg’s test, meta-regression and subgroup analyses were also conducted. This meta-analysis presented that HIV infection was associated with a significantly higher risk of COVID-19 mortality based on 40 studies reporting risk factors-adjusted effects with 131,907,981 cases (pooled ES 1.43, 95% CI 1.25-1.63). Subgroup analyses by male proportion and setting yielded consistent results on the significant association between HIV infection and the increased risk of COVID-19 mortality. Allowing for the existence of heterogeneity, further meta-regression and subgroup analyses were conducted to seek the possible source of heterogeneity. None of factors might be possible reasons for heterogeneity in the further analyses. Sensitivity analysis indicated the robustness of this meta-analysis. The Begg’s test manifested that there was no publication bias (P = 0.2734). Our findings demonstrated that HIV infection was independently associated with a significantly increased risk of mortality in COVID-19 patients. Further well-designed studies based on prospective study estimates are warranted to confirm our findings.

PMID:35695974 | DOI:10.1007/s10238-022-00840-1

Dig Dis Sci. 2022 Jun 13. doi: 10.1007/s10620-022-07518-4. Online ahead of print.

ABSTRACT

BACKGROUND: The utility of combination rectal NSAID and topical epinephrine (EI) or rectal NSAID and normal saline (SI) sprayed on duodenal papilla in the prevention of post-ERCP pancreatitis (PEP) has been studied but results have been conflicting.

AIMS: To evaluate the benefit of using combination prophylaxis in preventing PEP.

METHODS: A literature search was performed using Scopus, PubMed/MEDLINE, and Cochrane databases in May 2021. Randomized controlled trials (RCTs) involving adults patients who underwent ERCP and received EI versus SI were eligible for inclusion. The pooled effect was expressed as odds ratio (OR) to assess the rate of PEP, severity of PEP, and specific adverse events. The results were pooled using Reviewer Manager 5.4 software.

RESULTS: Six RCTs involving 4016 patients were included in the final analysis. The EI group did not demonstrate any significant benefit over SI group in preventing PEP (OR = 1.00, 95% CI [0.68, 1.45], P = 0.98), irrespective of gender or the epinephrine concentration used. The tests for subgroup differences were not statistically significant with P-values of 0.66 and 0.28, respectively. The addition of topical epinephrine to rectal NSAID did not improve the rate of moderate to severe PEP (OR = 0.94, P = 0.86) or PEP in high-risk patients (OR = 1.14, 95%, P = 0.73). The rates of infection, including cholangitis and sepsis (OR = 0.63, P = 0.07), gastrointestinal bleeding (OR = 1.25, P = 0.56) and procedure-related death (OR = 0.71, P = 0.59) were similar between both groups.

CONCLUSION: The addition of topical epinephrine did not demonstrate any benefit over rectal NSAID alone in preventing PEP or reducing other procedure-related adverse events.

PMID:35695971 | DOI:10.1007/s10620-022-07518-4

Environ Monit Assess. 2022 Jun 13;194(7):498. doi: 10.1007/s10661-022-10011-0.

ABSTRACT

Studies on historical patterns of climate variables and climate indices have attained significant importance because of the increasing frequency and severity of extreme events worldwide. While the recent events in the tropical state of Kerala (India) have drawn attention to the catastrophic impacts of extreme rainfall events leading to landslides and loss of human lives, a comprehensive and long-term spatiotemporal assessment of climate variables is still lacking. This study investigates the long-term trend analysis (119 years) of climate variables at 5% significance level over the state using gridded datasets of daily rainfall (0.25° × 0.25° spatial resolution) and temperature (1° × 1° spatial resolution) at annual and seasonal scales (south-west monsoon, north-east monsoon, winter and summer). Five trend analysis techniques including the Mann-Kendall test (MK), three modified Mann-Kendall tests and innovative trend analysis (ITA) test were performed in the study. It is evident from the trend analysis results that more than 83% of grid points were showing negative trends in annual and south-west monsoon season rainfall series (at a mean rate of 39.70 mm and 28.30 mm per decade respectively). All the trend analysis tests identified statistically significant increasing trends in mean and maximum temperature at annual and seasonal scales (0.10 to 0.20 °C/decade) for all grids. The K-means clustering algorithm delineated 59 grid points into five clusters for annual rainfall, illustrating a clear geographical pattern over the study area. There is a clear gradient in rainfall distribution and concentration inside the state at annual as well as seasonal scales. The majority of annual rainfall is concentrated in a few months of the year. That may lead the state vulnerable to water scarcity in non-rainy seasons.

PMID:35695969 | DOI:10.1007/s10661-022-10011-0

J Clin Monit Comput. 2022 Jun 13. doi: 10.1007/s10877-022-00873-7. Online ahead of print.

ABSTRACT

Common physiological time series and waveforms are composed of repeating cardiac and respiratory cycles. Often, the cardiac effect is the primary interest, but for, e.g., fluid responsiveness prediction, the respiratory effect on arterial blood pressure also convey important information. In either case, it is relevant to disentangle the two effects. Generalized additive models (GAMs) allow estimating the effect of predictors as nonlinear, smooth functions. These smooth functions can represent the cardiac and respiratory cycles’ effects on a physiological signal. We demonstrate how GAMs allow a decomposition of physiological signals from mechanically ventilated subjects into separate effects of the cardiac and respiratory cycles. Two examples are presented. The first is a model of the respiratory variation in pulse pressure. The second demonstrates how a central venous pressure waveform can be decomposed into a cardiac effect, a respiratory effect and the interaction between the two cycles. Generalized additive models provide an intuitive and flexible approach to modelling the repeating, smooth, patterns common in medical monitoring data.

PMID:35695942 | DOI:10.1007/s10877-022-00873-7

Oral Maxillofac Surg. 2022 Jun 13. doi: 10.1007/s10006-022-01086-7. Online ahead of print.

ABSTRACT

PURPOSE: The present study compared the absorbable gelatin sponge as a space-filling material versus anorganic bone bovine mineral (ABBM) in maxillary sinus augmentation with simultaneous endosseous dental implant placement.

METHODS: Eighteen maxillary sinus floor elevation cases were randomly allocated into two groups. The first group received ABBM, while the second group received an absorbable gelatin sponge as a space-filling material. For both groups, CBCT scans were obtained immediately postoperatively and six months later to calculate the difference in sinus floor bone gain. Osstell readings were recorded both at the time of implant placement and implant exposure with a total of twenty-three dental implant placements in relation to the eighteen elevated sinus floors.

RESULTS: The mean radiographic sinus floor gain in the ABBM group was 10.2 mm (± 2.5), while in the absorbable gelatin sponge group was 5.4 mm (± 2.0), with a mean difference of 4.8, which was statistically significant (p < 0.001). The mean implant stability for the ABBM was 77.3 (± 4.9), while in the absorbable gelatin sponge group was 74.2 (± 3.0), with a mean difference of 3.1, which was statistically insignificant (p = 0.1610).

CONCLUSION: The ABBM showed superior results regarding the amount of radiographic sinus floor bone gain. However, the implant stability was invariable between both groups.

PMID:35695945 | DOI:10.1007/s10006-022-01086-7

Acta Crystallogr B Struct Sci Cryst Eng Mater. 2022 Jun 1;78(Pt 3 Pt 1):385-391. doi: 10.1107/S2052520622003560. Epub 2022 May 11.

ABSTRACT

Single-crystal X-ray diffuse scattering measurements are reported of the compositional series KCl_1-xBr_x, a model system for the broader family of disordered rocksalts. Using a combination of Monte Carlo simulations and lattice dynamical calculations, we show that the observed diffuse scattering is well described in terms of (i) non-statistical anion distributions, (ii) local lattice relaxations accompanying Cl/Br substitution, and (iii) the contribution from low-energy phonons. It is found that a tendency for compositional domain formation broadens the thermal diffuse scattering by splitting and softening the acoustic phonon branches. This effect, which is strongest for intermediate compositions, is seen in both experiment and calculation alike. These results establish a link between local compositional order and unconventional lattice dynamics in this system, and reinforce emerging design principles of exploiting compositional fluctuations to tailor physical properties, such as thermal conductivity, that depend on phonon broadening.

PMID:35695112 | DOI:10.1107/S2052520622003560

Chin Clin Oncol. 2022 Jun 2:cco-21-87. doi: 10.21037/cco-21-87. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Patients with pancreatic cancer frequently develop postoperative disease recurrence, even after surgical resection with curative intent. Because of the heterogeneity of this patient population, phase III trials have never been conducted to establish a standard therapy for patients with post-surgical recurrence, and no uniform consensus based on high-level evidence exists as to which intervention might be the most appropriate. The aim of this review is to introduce globally popular treatment strategies for pancreatic cancer patients with postoperative recurrences.

METHODS: This is a narrative review, summarising the contemporary evidence and emerging studies with treatment for postoperative recurrence of pancreatic cancer.

KEY AND CONTENT AND FINDINGS: For patients with local recurrence alone, various therapeutic strategies have been attempted, including repeat surgical resection, chemoradiotherapy, and chemotherapy alone. Several studies have examined the outcomes of these therapies, but most are retrospective analyses of a small number of patients and statistically too underpowered to allow any solid recommendations to be made. Therefore, with the exception that there appears to be a potential benefit of repeat resection for isolated recurrences in the pancreatic remnant in a selected subgroup of patients, the patient outcomes remain dismal. In regard to the management of patients with distant recurrences, postoperative distant recurrences are generally not considered as being distinct from primary metastatic disease, and most patients with distant recurrence(s) with/without local tumor recurrence receive systemic chemotherapy as the standard therapy for metastatic disease; some studies have demonstrated a trend toward better survival outcomes in patients with a history of surgical resection than in those without a history of surgical resection.

CONCLUSIONS: Although no uniform consensus based on high-level evidence exists, systemic chemotherapy has been used as the main treatment option, and some regimens have been demonstrated to offer a survival benefit. There is an urgent need for prospective trials to establish the most appropriate treatment strategies for this patients’ population.

PMID:35695055 | DOI:10.21037/cco-21-87

Health Inf Manag. 2022 Jun 11:18333583221097724. doi: 10.1177/18333583221097724. Online ahead of print.

ABSTRACT

Background: Clinical quality registries provide rich and useful data for clinical quality monitoring and research purposes but are susceptible to data quality issues that can impact their usage. Objective: This study assessed the concordance between comorbidities recorded in the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and those in state-based hospital admission datasets. Method: All patients in New South Wales, South Australia, Tasmania, Victoria and Western Australia recorded in ANZDATA as requiring chronic kidney replacement therapy (KRT) between 01/07/2000 and 31/12/2015 were linked with state-based hospital admission datasets. Coronary artery disease, diabetes mellitus, cerebrovascular disease, chronic lung disease and peripheral vascular disease recorded in ANZDATA at each annual census date were compared overall, over time and between different KRT modalities to comorbidities recorded in hospital admission datasets, as defined by the International Classification of Diseases (ICD-10-AM), using both the kappa statistic and logistic regression analysis. Results: 29, 334 patients with 207,369 hospital admissions were identified. Comparison was made at census date for every patient comparison. Overall agreement was “very good” for diabetes mellitus (92%, k = 0.84) and “poor” to “fair” (21-61%, k = 0.02-0.22) for others. Diabetes mellitus recording had the highest accuracy (sensitivity 93% (±SE 0.2) and specificity 93% (±SE 0.2)), and cerebrovascular disease had the lowest (sensitivity 54% (±SE 0.2) and specificity 21% (±SE 0.3)). The false positive rates for cerebrovascular disease, peripheral vascular disease and chronic airway disease ranged between 18 and 33%. The probability of a false positive was lowest for kidney transplant patients for all comorbidities and highest for patients on haemodialysis. Conclusions and Implications: Agreement between the clinical quality registry and hospital admission datasets was variable, with the prevalence of comorbidities being higher in ANZDATA.

PMID:35695032 | DOI:10.1177/18333583221097724

Immunotherapy. 2022 Jun 13. doi: 10.2217/imt-2021-0208. Online ahead of print.

ABSTRACT

Background: In PD-L1-negative patients with advanced non-small-cell lung cancer (NSCLC), conclusive evidence in support of specific treatments remains lacking. Objectives: The efficacy of first-line chemoimmunotherapy versus chemotherapy alone was compared. Methods: Eligible randomized studies that included patients with advanced NSCLC irrespective of PD-L1 status who were treated with chemoimmunotherapy as the first line were identified. Kaplan-Meier curves were extracted and analyzed using restricted mean survival time (RMST). Patient-level data were reconstructed from progression-free survival (PFS) graphs. A Bayesian network meta-analysis (NETMA) was carried out. Results: In five trials selected, chemoimmunotherapy regimens, compared with chemotherapy alone, resulted in an improvement in PFS without statistical significance. In the NETMA, chemoimmunotherapy was found to slightly improve PFS. Conclusion: This analysis showed that the incremental benefit of chemoimmunotherapy versus chemotherapy is limited.

PMID:35695029 | DOI:10.2217/imt-2021-0208

Bone Jt Open. 2022 Jun;3(6):485-494. doi: 10.1302/2633-1462.36.BJO-2022-0024.R1.

ABSTRACT

AIMS: Two-stage exchange revision total hip arthroplasty (THA) performed in case of periprosthetic joint infection (PJI) has been considered for many years as being the gold standard for the treatment of chronic infection. However, over the past decade, there have been concerns about its safety and its effectiveness. The purposes of our study were to investigate our practice, collecting the overall spacer complications, and then to analyze their risk factors.

METHODS: We retrospectively included 125 patients with chronic hip PJI who underwent a staged THA revision performed between January 2013 and December 2019. All spacer complications were systematically collected, and risk factors were analyzed. Statistical evaluations were performed using the Student’s t-test, Mann-Whitney U test, and Fisher’s exact test.

RESULTS: Our staged exchange practice shows poor results, which means a 42% mechanical spacer failure rate, and a 20% recurrent infection rate over the two years average follow-up period. Moreover, we found a high rate of spacer dislocation (23%) and a low rate of spacer fracture (8%) compared to the previous literature. Our findings stress that the majority of spacer complications and failures is reflecting a population with high comorbid burden, highlighted by the American Society of Anesthesiology grade, Charlson Comorbidity Index, and Lee score associations, as well as the cardiac, pulmonary, kidney, or hepatic chronic conditions.

CONCLUSION: Our experience of a two-stage hip exchange revision noted important complication rates associated with high failure rates of polymethylmethacrylate spacers. These findings must be interpreted in the light of the patient’s comorbidity profiles, as the elective population for staged exchange has an increasing comorbid burden leading to poor results. In order to provide better results for this specific population, our conclusion suggests that comparative strategy studies are required to improve our therapeutic indication. Cite this article: Bone Jt Open 2022;3(6):485-494.

PMID:35695030 | DOI:10.1302/2633-1462.36.BJO-2022-0024.R1