Tag: nevin manimala

Wiad Lek. 2021;74(6):1355-1359.

ABSTRACT

OBJECTIVE: The aim: To find out whether or not the presence of pregnancy loss and preterm birth was associated with the history of healthcare-associated infection (HAI) of women reproductive tract.

PATIENTS AND METHODS: Materials and methods: We performed a retrospective cohort study was based on surveillance data. This study included 1,027 fertile women aged 21-50 years admitted to 8 hospitals from 2017-2019 with complaints to pregnancy loss or preterm birth. Definitions HAI of women reproductive tract were used from the CDC/ NHSN.

RESULTS: Results: Of 1,027 fertile women with complaints to pregnancy loss or preterm birth, 702 (68.4%) HAIs of reproductive tract were detected. The predominant HAIs were: postpartum endometritis (19.1), bacterial vaginitis (15.8%), chorioamnionitis (11.3%), vaginal cuff infection (9.1%), and parametritis (5.6%). According to the statistical data, a significant association between HAI of women reproductive tract and the history of pregnancy loss (p < 0.05) was determined. The presence of HAI had no effect on the first trimester miscarriage (p > 0.05), but HAI women reproductive tract had strongly affected the second trimester pregnancy losses (p < 0.05). Main causative agents of HAI were Escherichia coli (31.5%), Enterobacter spp. (18.4%), Klebsiella pneumoniae (12.5%), Enterococcus faecalis (11.6%),Staphylococcus aureus (10.2%), Pseudomonas aeruginosa (8.4%).

CONCLUSION: Conclusions: This study identified a significant association between healthcare-associated infection of women reproductive tract and a history of miscarriage. However, there was no association between HAI and a history of preterm birth.

PMID:34159919

Wiad Lek. 2021;74(6):1365-1371.

ABSTRACT

OBJECTIVE: The aim: Is to investigate the influence of modern sports technologies (Crossfit classes) on health and professional activity of law enforcement officers.

PATIENTS AND METHODS: Materials and methods: The study involved 52 law enforcement officer graduates from the National Academy of Internal Affairs (Kyiv, Ukraine) aged 22-30 who attended Crossfit classes while studying. The duration of the study is 5 years (2016-2020). The level of officers’ health was examined according to the methodology of H. L. Apanasenko which consists in determining the amount of points for each of the 5 indicators: body mass index, vital capacity index, power index, Robinson index, heart rate recovery time. In order to estimate the effectiveness of the officers’ law enforcement activity we conducted a survey of the heads and commanders of units where the officers served using the rating card we developed of a five-point scale. Research methods include analysis and generalization of scientific and methodological works, pedagogic observation, questionnaire survey, medical and biological methods and methods of mathematical statistics.

RESULTS: Results: It was also clarified that the health level of the officers who attended Crossfit classes while studying at higher educational institutions with specific training environment remained stable after graduation for 5 years of service (р>0.05). The results of the units commanders’ evaluation of the officers’ law enforcement activities showed positive influence of Crossfit classes on the indicators that characterize the quality of service.

CONCLUSION: Conclusions: It has been established that Crossfit classes during training helped to maintain the level of health of law enforcement officers during 5 years of service on officers’ positions after graduation and provide high efficiency of professional activities.

PMID:34159921

Wiad Lek. 2021;74(6):1409-1413.

ABSTRACT

OBJECTIVE: The aim: To define the degree for glial acidic fibrillary protein expression on the structural components of cerebellum of the rats in health and when rats influenced by the food additives complex.

PATIENTS AND METHODS: Materials and methods: In order to determine the degree of expression of the immunohistochemical marker GFAP on the structural components of the cerebellum of rats we applied immunohistochemical, morphometric and statistical methods in our study.

RESULTS: Results: In histological specimens at the end of 1st week of observation in the gray matter of the cerebellum there occurred a gradual increase in 1.16 times of the average number of GFAP-positive cells. At the end of 4th week of the experimental study, the average number of GFAP-positive cells increased accurately (at p<0.05 compared to the control group) in 1.27 times, at the end of 8th week it has increased in 1.99 times, at the end of 12th week in 2.25, and at the end of 16th week in 2.39 times.

CONCLUSION: Conclusions: The outcomes of our study are as follows the increase in the average number of GFAP-positive cells is directly related to the decrease in the average number of major neurons of the gray matter of the brain, while the fluctuations in the average number of astrocytic glia cells represent a compensatory mechanism in the recovery of gray matter neurons of the brain from neural stem cells with the subsequent development of reactive astrogliosis and, thereafter the possible development of neuropathology.

PMID:34159929

Gut Microbes. 2021 Jan-Dec;13(1):1930872. doi: 10.1080/19490976.2021.1930872.

ABSTRACT

Bariatric surgery induces significant shifts in the gut microbiota which could potentially contribute to weight loss and metabolic benefits. The aim of this study was to characterize a microbial signature following Roux-en-Y Gastric bypass (RYGB) surgery using novel and existing gut microbiota sequence data. We generated 16S rRNA gene and metagenomic sequences from fecal samples from patients undergoing RYGB surgery (n = 61 for 16S rRNA gene and n = 135 for metagenomics) at pre-surgical baseline and one, six, and twelve-month post-surgery. We compared these data with three smaller publicly available 16S rRNA gene and one metagenomic datasets from patients who also underwent RYGB surgery. Linear mixed models and machine learning approaches were used to examine the presence of a common microbial signature across studies. Comparison of our new sequences with previous longitudinal studies revealed strikingly similar profiles in both fecal microbiota composition (r = 0.41 ± 0.10; p < .05) and metabolic pathways (r = 0.70 ± 0.05; p < .001) early after surgery across multiple datasets. Notably, Veillonella, Streptococcus, Gemella, Fusobacterium, Escherichia/Shigella, and Akkermansia increased after surgery, while Blautia decreased. Machine learning approaches revealed that the replicable gut microbiota signature associated with RYGB surgery could be used to discriminate pre- and post-surgical samples. Opportunistic pathogen abundance also increased post-surgery in a consistent manner across cohorts. Our study reveals a robust microbial signature involving many commensal and pathogenic taxa and metabolic pathways early after RYGB surgery across different studies and sites. Characterization of the effects of this robust microbial signature on outcomes of bariatric surgery could provide insights into the development of microbiome-based interventions for predicting or improving outcomes following surgery.

PMID:34159880 | DOI:10.1080/19490976.2021.1930872

Elife. 2021 Jun 23;10:e69454. doi: 10.7554/eLife.69454. Online ahead of print.

ABSTRACT

Targeting DNA repair pathway offers an important therapeutic strategy for Homo sapiens (human) cancers. However, the failure of DNA repair inhibitors to markedly benefit patients necessitates the development of new strategies. Here, we show that exosome component 1 (EXOSC1) promotes DNA damages and sensitizes human kidney renal clear cell carcinoma (KIRC) cells to DNA repair inhibitor. Considering that endogenous source of mutation (ESM) constantly assaults genomic DNA and likely sensitize human cancer cells to the inhibitor, we first analyzed the statistical relationship between the expression of individual genes and the mutations for KIRC. Among the candidates, EXOSC1 most notably promoted DNA damages and subsequent mutations via preferentially cleaving C site(s) in single-stranded DNA. Consistently, EXOSC1 was more significantly correlated with C>A transversions in coding strands than these in template strands in human KIRC. Notably, KIRC patients with high EXOSC1 showed a poor prognosis, and EXOSC1 sensitized human cancer cells to poly(ADP-ribose) polymerase inhibitor. These results show that EXOSC1 acts as an ESM in KIRC, and targeting EXOSC1 might be a potential therapeutic strategy.

PMID:34159897 | DOI:10.7554/eLife.69454

Ann Med. 2021 Dec;53(1):890-899. doi: 10.1080/07853890.2021.1921838.

ABSTRACT

BACKGROUND: We carried out this study to demonstrate the effects of outcome sensitivity, participant exclusions, and covariate manipulations on results of the epidemiological analysis of coronary heart disease (CHD) and its behaviour-related risk factors.

MATERIAL AND METHODS: Our study population consisted of 1592 54-year-old men, who participated in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. We used the Cox proportional-hazards model to predict the hazard of CHD and applied different sets of outcomes concerning outcome sensitivity and data preprocessing procedures regarding participant exclusions and covariate manipulations.

RESULTS: The mean follow-up time was 23 years, and 730 men received the CHD diagnosis. Cox regressions based on data with no participant exclusions most often discovered statistically significant associations. Loose inclusion criteria for study participants with any CVD during the follow-up and strict exclusion criteria for participants with no CVD were best in discovering the associations between risk factors and CHD. Outcome sensitivity affected the associations, whereas the covariate type, continuous or categorical, did not.

CONCLUSIONS: This study suggests that excluding study participants who are not disease-free at baseline is probably unnecessary for epidemiological analyses. Epidemiological research reports should present results based on no data exclusions together with results based on reasoned exclusions.

PMID:34159863 | DOI:10.1080/07853890.2021.1921838

Global Spine J. 2021 Jun 23:21925682211019696. doi: 10.1177/21925682211019696. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: To (1) define utilization trends for navigated instrumented posterior lumbar fusion (PLF), (2) compare reasons and rates of revision at 30-day, 60-day, 90-day, and 1-year follow-up, and (3) compare 90-day perioperative complications between navigated versus conventional instrumented PLF.

METHODS: Patients who underwent navigated or conventional instrumented PLF were identified from the Humana insurance database using the PearlDiver Patient Records between 2007-2017. Usage of navigation was characterized. Patient demographics and operative characteristics (number of levels fused, interbody usage) were compared between the 2 treatment groups. Propensity score matching was done and comparisons were made for revision rates at different follow-up periods (categorized by reasons) and other 90-day perioperative complications.

RESULTS: This study included 1,648 navigated and 23 429 conventional instrumented PLF. Navigated cases increased over the years studied to approximately 10% in 2017. Statistical analysis after propensity score matching revealed significantly lower rates of hardware-related revision at 90-day follow-up in the navigated cohort (0.49% versus 1.15%, P = .033). At 1-year follow-up, the navigated cohort continued to have significantly lower rates of hardware-related revision (1.70% versus 2.73%, P = .044) as well as all cause revision (2.67% versus 4.00%, P = .032). There were no statistical differences between the 2 cohorts in any of the 90-day perioperative complications studied, such as cellulitis and blood transfusion (P > .05 for all).

CONCLUSIONS: These findings suggest that navigation is associated with reductions in hardware-related revisions after instrumented PLF. However, these results should be interpreted cautiously in the setting of potential confounding by other unmeasured variables.

PMID:34159837 | DOI:10.1177/21925682211019696

Chronic Illn. 2021 Jun 23:17423953211023964. doi: 10.1177/17423953211023964. Online ahead of print.

ABSTRACT

OBJECTIVE: Instrumental activities of daily living (IADL) are important for managing multiple chronic conditions (MCC) and maintaining independence while aging. Using data from the National Health and Aging Trends Study (NHATS), we answered the question: are there differences in ability and performance of IADL among groups of older adults with 0-1 (no MCC), 2-4 (low MCC), and 5+ chronic conditions (multisystem morbidity: MM)?

METHODS: Cross-sectional study using Poisson regression and incidence rate ratios. Participants were 6,019 community-dwelling older adults who regularly take medications. We derived composite variables for ability and performance of IADL; MCC groups were based on count of 11 chronic conditions.

RESULTS: Older adults with MM had lower IADL count for ability (IRR = .81) and performance (IRR = .77), and MM group significantly predicted both ability and performance of IADL (p < .001); ‘low MCC’ group was not significantly different than ‘no MCC’ regarding disability.

DISCUSSION: Having MM is statistically and clinically different than having low MCC or no MCC; 5+ chronic conditions may be a meaningful inclusion criterion for interventions to decrease disability and 2-4 chronic conditions may be better for trials to prevent disability. Researchers should measure both ability and performance of daily activity.

PMID:34159840 | DOI:10.1177/17423953211023964

Am J Hosp Palliat Care. 2021 Jun 23:10499091211026675. doi: 10.1177/10499091211026675. Online ahead of print.

ABSTRACT

BACKGROUND: A critical aspect of pediatric palliative care consultations is the assessment and documentation of patient and family needs. While these assessments usually include a focus on physical pain, there is less standardization of assessments of other physical symptoms and psychosocial, emotional, or spiritual needs.

AIMS: To improve the breadth of assessment of psychosocial and emotional needs, screen for symptoms other than pain among pediatric patients utilizing palliative care services, and to increase documentation of assessment data from 30%-40% to 80% through practice changes implemented in 2 Plan-Do-Study-Act (PDSA) cycles.

METHODS: This quality improvement project involved implementing provider education and adapting the palliative care consultation template in the electronic health record to improve breadth and consistency of assessment and documentation during consultations by the interdisciplinary pediatric palliative care team. Two PDSA cycles were performed. Chi squared tests and statistical control charts were used for data analysis.

RESULTS: There was statistically significant improvement in the inclusion of documentation of a pediatric palliative care social work note from baseline (32%) to Cycle 2 (57%). Physical symptom screening declined slightly, but not significantly (p = .32) and socio-emotional discussions also declined but not significantly (p = .05).

CONCLUSIONS: Screening for physical symptoms and discussions with patients and families about psychosocial/emotional needs during the initial palliative care consultations are extremely important in providing effective, holistic, patient-centered care. There is a need for development of pediatric-centric guidelines and quality measures to evaluate pediatric palliative care programs; further research is indicated to determine methods for evaluating compliance with these guidelines.

PMID:34159810 | DOI:10.1177/10499091211026675

Can Assoc Radiol J. 2021 Jun 23:8465371211020630. doi: 10.1177/08465371211020630. Online ahead of print.

ABSTRACT

PURPOSE: Assess quality metrics of modified barium swallow studies (MBSS) with and without a radiologist present during the procedure.

METHODS: Retrospective review of MBSS performed on adult inpatients at a tertiary care hospital 6-months pre- and post-institutional change from having to not having a radiologist present during the examination.

FACTORS ASSESSED INCLUDED: fluoroscopy time; study duration; number of cine loops; number of images; efficiency of collimation (using a 5-point scoring system); time to final report; radiologist-speech language pathologist report disagreement; and recalls for inadequate studies. Statistical analysis was via Welch’s t-test and a test of proportions for continuous and count data under the normal approximation.

RESULTS: 106 and 119 MBSS were analyzed from the radiologist present and radiologist absent periods, respectively. No statistically significant differences were found for: average fluoroscopy time (116.1 s vs. 126.9 s; P = 0.161); study duration (400.4 s vs. 417.3 s; P = 0.453); number of cine loops (9.3 vs. 10.2; P = 0.075); number of images (620.5 vs. 581.1; P = 0.350); or report disagreement. There was improved performance without the radiologist present for collimation (1.92 vs. 1.43; P = 0.003) and fewer non-diagnostic images (6.5 vs. 4.5; P = 0.001). Time to final report was longer with the radiologist absent due to more reports with significant delays. There were no repeated studies because of inadequate technique in either group.

CONCLUSION: MBSS performed by technologists without radiologist supervision is not inferior to those performed with radiologist supervision on multiple performance measures. This supports technologist operated MBSS without radiologist supervision, while acknowledging a need to further address radiologist report time delay.

PMID:34159812 | DOI:10.1177/08465371211020630