Tag: nevin manimala

J Clin Transl Res. 2022 Mar 19;8(2):160-165. eCollection 2022 Apr 29.

ABSTRACT

BACKGROUND: Percutaneous nephrolithotomy (PCNL) has evolved as a standard procedure to treat large-sized renal stones. A nephrostomy tube is used frequently in this procedure; however, data regarding tubeless PCNL procedures in elder patients is scarce.

AIM: The aim of this study was to review the results and outcomes associated with tubeless PCNL procedures in the elderly population.

MATERIALS AND METHODS: A retrospective review of patients aged ≥60 years at our hospital that was treated for renal stones by PCNL procedure. The patients were separated into two groups: Group 1 underwent tubed PCNL procedures and Group 2 received tubeless PCNL procedures. Information regarding variables were recorded in specified pro forma and then processed in Statistical Package for the Social Sciences statistics analyses. Statistical tests were utilized for continuous and categorical variables and a P<0.05 was considered statistically significant.

RESULTS: 121 patients with a mean age of 65±5 years were included in the analysis. Mean stone size and body mass index were 3.4±1.5 cm and 26.2±4.3 kg/m², respectively. Mean operative time was longer in tubed PCNL as compared to the tubeless group. Mean hospital stay was similar among the tubed and tubeless PCNL treated groups. Mean analgesic doses were significantly lower in the tubeless group. The overall stone-free rate was 89/121 patients (74%).

CONCLUSION: Tubeless PCNL can be safely undertaken in geriatric patients and has potential advantages associated with shorter operative times and reduced necessity for analgesia.

RELEVANCE FOR PATIENTS: Tubeless PCNL is considered advantageous as it can reduce post-operative pain and analgesia necessity; shorten hospitalization and lower cost in young patients. However, there is no clear evidence with reference to virtue of tubeless PCNL in the elderly age groups. This study will analyze and review results and outcomes associated with tubeless PCNL in a cohort of elderly patients.

PMID:35475270 | PMC:PMC9036081

Plast Reconstr Surg Glob Open. 2022 Apr 22;10(4):e4268. doi: 10.1097/GOX.0000000000004268. eCollection 2022 Apr.

ABSTRACT

BACKGROUND: The intercanthal distance (ICD) is central to our perception of facial proportions, and it varies according to gender and ethnicity. Current standardized reference values do not reflect the diversity among patients. Therefore, the authors sought to provide an evidence-based and gender/ethnicity-specific reference when evaluating patients’ ICD.

METHODS: As per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of PubMed, Medline, and Embase was carried out for studies reporting on the ICD. Demographics, study characteristics, and ICDs were extracted from included studies. ICD values were then pooled for each ethnicity and stratified by gender. The difference between men and women, and that across ethnicities and measurement types were compared by means of independent sample t-test and one-way ANOVA (SPSS v.24).

RESULTS: A total of 67 studies accounting for 22,638 patients and 118 ethnic cohorts were included in this pooled analysis. The most reported ethnicities were Middle Eastern (n = 6629) and Asian (n = 5473). ICD values (mm) in decreasing order were: African 38.5 ± 3.2, Asian 36.4 ± 1.6, Southeast Asian 32.8 ± 2.0, Hispanic 32.3 ± 2.0, White 31.4 ± 2.5, and Middle Eastern 31.2 ± 1.5. A statistically significant difference (P < 0.05) existed between all ethnic cohorts, between genders among most cohorts, and between most values stratified by measurement type.

CONCLUSIONS: Our standards of craniofacial anthropometry must evolve from the neoclassical canons using White values as references. The values provided in this review can aid surgeons in appreciating the gender- and ethnic-specific differences in the ICD of their patients.

PMID:35475286 | PMC:PMC9029890 | DOI:10.1097/GOX.0000000000004268

Cureus. 2022 Apr 18;14(4):e24261. doi: 10.7759/cureus.24261. eCollection 2022 Apr.

ABSTRACT

Background During anesthesia, atelectasis is frequent, and it is also seen in critically ill individuals with a variety of underlying causes and pathologies. Objective The present study was conducted to assess whether there is a correlation between perioperative atelectasis and duration of anesthesia, pneumoperitoneum, and length of surgery in patients undergoing laparoscopic cholecystectomy. Material and methods Seventy-two American Society of Anesthesiologists (ASA) grade I-III patients of either gender undergoing elective laparoscopic cholecystectomy who met the inclusion criteria were enrolled in this observational study. The lung ultrasound (LUS) score was used to determine the amount of aeration loss. LUS scoring was performed at five predetermined time points: preoperative period (time point A), five minutes after induction (time point B), five minutes after pneumoperitoneum insufflation (time point C), end of surgery before extubation (time point D), and one hour after extubation in the postoperative room (time point E). Results At time points A, B, C, D, and E, vital parameters such as pulse rate, respiratory rate, oxygen saturation, and noninvasive blood pressure were continuously monitored and recorded. Hemodynamics remained stable, and no clinically significant changes in parameters were seen at any stage during the procedure. At each time point, the change in the LUS score was statistically significant (p-value = 0.01). Following the induction of general anesthesia, there was an increase in LUS scores, which increased further after the creation of pneumoperitoneum. Throughout the pneumoperitoneum and anesthetic periods in our investigation, the LUS score steadily climbed. Conclusion Even during short-term surgeries such as laparoscopic cholecystectomy, atelectasis can occur. The duration of pneumoperitoneum and ASA status can contribute to atelectasis.

PMID:35475248 | PMC:PMC9018945 | DOI:10.7759/cureus.24261

J Am Geriatr Soc. 2022 Apr 26. doi: 10.1111/jgs.17828. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19 and influenza are important sources of morbidity and mortality among older adults. Understanding how outcomes differ for older adults hospitalized with either infection is important for improving care. We compared outcomes from infection with COVID-19 and influenza among hospitalized older adults.

METHODS: We conducted a retrospective study of 30-day mortality among veterans aged 65+ hospitalized with COVID-19 from March 1, 2020 – December 31, 2020 or with influenza A/B from September 1, 2017 to August 31, 2019 in Veterans Affairs Health Care System (VAHCS). COVID-19 infection was determined by positive PCR test and influenza by tests used in the VA system. Frailty was defined by the claims-based Veterans Affairs Frailty Index (VA-FI). Logistic regressions of mortality on frailty, age, and infection were adjusted for multiple confounders.

RESULTS: 15,474 veterans were admitted with COVID-19 and 7,867 with influenza. Mean (SD) ages were 76.1 (7.8) and 75.8 (8.3) years, 97.7% and 97.4% were male, and 66.9% and 76.4% were white in the COVID-19 and influenza cohorts respectively. Crude 30-day mortality (95% CI) was 18.9% (18.3% – 19.5%) for COVID-19 and 4.3% (3.8% – 4.7%) for influenza. Combining cohorts, the odds ratio for 30-day mortality from COVID-19 (versus influenza) was 6.61 (5.74 – 7.65). There was a statistically significant interaction between infection with COVID-19 and frailty, but there was no significant interaction between COVID-19 and age. Separating cohorts, greater 30-day mortality was significantly associated with older age (p: COVID-19: <0.001, Influenza: <0.001) and for frail compared with robust individuals (p for trend: COVID-19: <0.001, Influenza: <0.001).

CONCLUSION: Mortality from COVID-19 exceeded that from influenza among hospitalized older adults. However, odds of mortality were higher at every level of frailty among those admitted with influenza compared to COVID-19. Prevention will remain key to reducing mortality from viral illnesses among older adults.

PMID:35474510 | DOI:10.1111/jgs.17828

Arch Gynecol Obstet. 2022 Apr 27. doi: 10.1007/s00404-022-06526-z. Online ahead of print.

ABSTRACT

PURPOSE: To assess severe neonatal morbidity and mortality in induced labor in preterm breech deliveries, compared to spontaneous labor.

METHODS: This is a retrospective study conducted in a tertiary university center in France. Women with single live breech pregnancy between 28 + 0 and 36 + 6 weeks gestation were included. We excluded situations with medical contraindication to vaginal delivery and fetal malformations. We compared women with an unfavorable cervix, who had an indication for deliver and could receive cervical ripening to induce labor, to women in spontaneous labor. The primary outcome was a composite criterion of severe neonatal morbidity and mortality including perinatal death, traumatic event during delivery, Apgar score at 5-min < 4, moderate or severe encephalopathy, seizures within the first 24 h, Intra-Ventricular Hemorrhage grade 3 or 4, necrotizing enterocolitis grade 2 or 3.

RESULTS: We included 212 patients: 64 in the induced labor group and 136 in the spontaneous labor group. In the induced labor group, 45.3% of patients delivered vaginally, and 86% in spontaneous labor group. The neonatal morbidity and mortality rate were similar in both groups: 4.7% in the induced labor group, and 5.2% in the spontaneous labor group, p = 0.889, aOR = 1.5 (0.28-8.28).

CONCLUSION: Nearly half of the patient who received induction of labor delivered vaginally. The onset mode of labor does not appear to have an effect on severe neonatal morbidity and mortality in preterm breech fetuses. Induction of labor could be an option for patients in this setting.

PMID:35474495 | DOI:10.1007/s00404-022-06526-z

Jpn J Radiol. 2022 Apr 27. doi: 10.1007/s11604-022-01282-1. Online ahead of print.

ABSTRACT

IgG4-related disease (IgG4-RD) is an immune-mediated, multiorgan, chronic inflammatory disease. The three-step classification criteria proposed in 2019 by the American College of Rheumatology and the European League Against Rheumatism (ACR/EULAR) encompass a wide range of clinical, radiological, serological, and histopathological findings. The ACR/EULAR proposed a three-step classification process, i.e., entry step, exclusion step, and scoring system. Radiologists need to know that the radiological findings observed in the five domains of the lacrimal and salivary glands, chest, pancreas and biliary ducts, kidney, and retroperitoneum are independently weighted with different points in the scoring system. A total score < 20 points indicates that the patient should not be classified as having IgG4-RD; conversely, a total score ≥ 20 points indicates that the patient should be classified as having IgG4-RD. In this review, the 2019 ACR/EULAR classification criteria are discussed, focusing on the interpretation of each radiological item, with the aim of applying them to the diagnosis of IgG4-RD in clinical practice.

PMID:35474439 | DOI:10.1007/s11604-022-01282-1

Clin Exp Dermatol. 2022 Apr 26. doi: 10.1111/ced.15239. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriasis is a chronic inflammatory skin disorder characterized by inflammation, hyperproliferation, andneoangiogenesis. The disease pathogenesis has not been fully elucidated. ADAM17 and ADAM10 are important proteases serving as regulators of inflammation.

OBJECTIVES: This study aimed to determine the role of ADAM17 and ADAM10 in the pathogenesis of Psoriasis through the comparison of serum ADAM17 and ADAM10 levels between Psoriasis patients and healthy controls.

METHODS: A total of 179 subjects, including 90 psoriasis patients and 89 healthy controls, were included in the study. Serum ADAM17 and serum ADAM10 levels were measured by the ELISA method for each participant from the patient and control groups. The statistical data analysis was performed using the SPSS 19.0 program. P-value < 0.05 was considered statistically significant.

RESULTS: The mean values for serum ADAM10 and ADAM17 were respectively 3.1±2.2 and 76.5±31.1 in the patient group, whereas 8.6±3.7 and 29.5±22.4 in the control group. A statistically significant difference was detected between the patient and control groups regarding ADAM10 and ADAM17 levels (p=0.0001).

CONCLUSIONS: Considering the high levels of ADAM17 in Psoriasis patient group, ADAM17 protease might have a crucial role in the pathogenesis of psoriasis, while the low levels of ADAM10 might be attributed to its regulatory effect on keratinocyte differentiation and proliferation.

PMID:35474465 | DOI:10.1111/ced.15239

Jpn J Radiol. 2022 Apr 27. doi: 10.1007/s11604-022-01275-0. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the interstitial fluid status in a wide range of age groups using diffusion-weighted image analysis along the perivascular space (DWI-ALPS) method, which is a simplified variation of diffusion tensor image analysis along the perivascular space (DTI-ALPS).

MATERIALS AND METHODS: This retrospective study included data from 128 patients who underwent clinical magnetic resonance imaging (MRI) studies, including DWI, and were found to have no abnormal findings in the brain on MRI. Three motion-probing gradients of the DWI were applied in an orthogonal direction to the imaging plane. Apparent diffusion coefficient images in the x-, y-, and z-axes were retrospectively generated, and composite color images were created to locate the projection and association fiber area on the slice including the body of the lateral ventricle. ALPS indices were calculated, and correlations with age were evaluated using linear and second-degree regression analysis. Linear regression analysis was also performed for a subgroup of patients older than 40 years. In addition, an analysis of variance (ANOVA) test among the generations was performed.

RESULTS: The linear regression analysis between age and the ALPS index showed a correlation coefficient of -0.20 for all age group and -0.51 for the subgroup older than 40 years. The second-degree regression analysis showed a correlation coefficient of 0.39. ANOVA showed that the 40’s generation showed a statistically significant higher value of ALPS index compared to all other generations except for the 30’s generation. While, the 70’s generation showed a statistically significant lower value of the ALPS index compared to all other generations.

CONCLUSIONS: The analysis of the DWI-APLS method showed a correlation between age and the ALPS index in second-degree distribution which peaked in the 40’s generation. This finding in normal subjects may be fundamental in the analysis of disease cases. We tried to evaluate the glymphatic system status in a wide range of age groups using diffusion-weighted image analysis along the perivascular space (DWI-ALPS) method, and the results showed a correlation between age and the ALPS index in second-degree distribution which peaked in the 40’s generation.

PMID:35474438 | DOI:10.1007/s11604-022-01275-0

Environ Sci Pollut Res Int. 2022 Apr 27. doi: 10.1007/s11356-022-20417-5. Online ahead of print.

ABSTRACT

Today, as a result of the developments and widespread use of information and communication technologies, the weight of online shopping in the economy has increased. The environmental impacts of this new order, which is an important part of electronic finance, are discussed. In this study, the effect of electronic finance, economic growth, renewable energy consumption, and urbanization on emissions in EU member countries is examined using the panel vector autoregression (PVAR) approach for the period from 2005 to 2018. The main results suggest that e-finance has a positive and statistically significant effect on CO₂ emissions. However, the renewable energy consumption-increasing effect of e-finance is greater than its emission-reducing effect. Moreover, renewable energy consumption has a statistically insignificant effect on emissions. Therefore, the contribution of e-finance on environmental quality weakens. The requirement for EU member countries to prioritize the use of environmentally friendly energy to benefit from the environmental contribution of e-finance in the most optimal way is stated as the main policy implication of this study.

PMID:35474436 | DOI:10.1007/s11356-022-20417-5

Environ Sci Pollut Res Int. 2022 Apr 27. doi: 10.1007/s11356-022-20339-2. Online ahead of print.

ABSTRACT

Water is the most fundamental need for better yield in agriculture. Worldwide, diesel and electricity are typically used to pump water which contributes to atmospheric pollution. Besides, a power outage affects the irrigation process badly. Without water, the crop may wither away, causing a substantial economic loss. This paper discusses the resilience of a solar PV system during a power outage. HOMER Pro software was used to perform the techno-economic analysis of solar-based irrigation for four major divisions of Bangladesh, while 1-hour power outage was assigned in REopt lite to model the survivability of the system against the grid outage. The simulation outcomes showed that the energy cost is $0.1496/kWh, $0.1502/kWh, $0.1557/kWh, and $0.1576/kWh for Rajshahi, Sylhet, Dhaka, and Chattogram, respectively. About 45% of excess electricity can be stored after fulfilling all requirements. The system is more economical than a microgrid-based water pumping system and a diesel-based system, and the photovoltaic system is technically and economically suitable to pump water if the nearest grid connection is impossible. When connected to the main utility grid, the system can survive without grid power for several hours, subject to daytime outages.

PMID:35474434 | DOI:10.1007/s11356-022-20339-2