Tag: nevin manimala

Res Nurs Health. 2021 Jul 13. doi: 10.1002/nur.22168. Online ahead of print.

ABSTRACT

Prior literature has documented an association between cancer and depressive symptoms. There has been a limited understanding about whether the association between cancer and depressive symptoms varies by gender and whether social engagement moderates this association. Using seven waves of the Korean Longitudinal Study of Ageing (N = 10,055), we examine the association between cancer and depressive symptoms among middle- and older-aged adults in Korea. We conduct fixed-effects regression models to account for unobserved characteristics of individuals that may confound this association. We first investigate whether the association between cancer and depressive symptom differs by gender. We distinguish among cancer types to assess potentially distinctive mental health consequences of different types of cancer. Then, we explore whether social engagement moderates the cancer-depressive symptoms association. Naive OLS models yielded significant associations between cancer and depressive symptoms for both men and women. However, our preferred fixed effects estimates revealed that the association was statistically significant only for men, and not for women. This association was especially pronounced for lung cancer. We also found that one’s level of social engagement including informal connections and formal social activities moderates the link between cancer and depressive symptoms. Cancer is not only a leading cause of death, but also a serious threat to one’s mental health. This study sheds light on gender differences in psychological reactions to cancer among Korean adults. Findings of this study hold important implications for programs aiming to improve the mental health and quality of life of cancer patients.

PMID:34254692 | DOI:10.1002/nur.22168

J Clin Pharm Ther. 2021 Jul 12. doi: 10.1111/jcpt.13443. Online ahead of print.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: The benefits of local infiltration analgesia (LIA) in knee arthroplasty (KA) have been well-documented. However, it is unknown whether adding a corticosteroid to the composition of the LIA is beneficial. This study aimed to investigate the efficacy and safety of administering periarticular steroids intraoperatively in patients who underwent KA through a systematic review and meta-analysis.

METHODS: A systematic search was conducted to identify relevant randomized controlled trials in the PubMed, Embase, Web of Science and Cochrane databases up to January 19th, 2021 to perform a meta-analysis. Outcome variables included pain scores, total opioid consumption, knee range of motion (ROM) and postoperative complications.

RESULTS: Corticosteroid injections did not reduce pain scores at 6, 12, 24 or 72 h postoperatively, although a minimal degree of transient pain relief was achieved at 48 h postoperatively compared with those in the placebo group, nor was there a significant difference in total opioid consumption. However, patients receiving corticosteroids did exhibit a transient ROM increase on postoperative days 1, 2 and 3. Since the minimal clinically important difference (MCID) for ROM is unclear, it is unknown if the improvement in ROM is clinically significant.

WHAT IS NEW AND CONCLUSION: Our specific end-point analysis demonstrated that corticosteroid administration did not provide pain relief or reduce opioid consumption compared with placebo. However, corticosteroids might provide a statistically significant, though transient and minimal improvement in knee ROM after KA, although no firm conclusions about the benefits of administering corticosteroids in KA can be made based on the available evidence.

PMID:34254696 | DOI:10.1111/jcpt.13443

Laryngoscope. 2021 Jul 13. doi: 10.1002/lary.29664. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: The role of social determinants of health in chronic rhinosinusitis (CRS) is poorly characterized. Limited research examining CRS health disparities indicates that minority status is associated with worse CRS. However, many of these studies are retrospective or performed in populations without substantial ethnic minorities. Rhinologists need to characterize existing CRS disease disparities to develop targeted strategies for improving care in these populations. This prospective study assesses preoperative CRS disease burden in South Florida (SFL) Hispanic and non-Hispanic patients and examines potential factors contributing CRS disease disparities.

STUDY DESIGN: Prospective cohort study.

METHODS: The prospective cohort study included consecutive patients having primary endoscopic sinus surgery (ESS) for CRS between September 2019 and February 2020 with complete preoperative data. Data were collected in clinic and surgery. Descriptive statistics compare Hispanic and non-Hispanic cohorts. Linear regression adjusts for confounders. Relative risk (RR) compared CRS severity markers.

RESULTS: Thirty-eight Hispanic and 56 non-Hispanic patients met inclusion criteria. Age, sex, CT scores, insurance payer, and comorbidities were similar between cohorts. Hispanics presented with worse 22-item Sinonasal Outcome Test (SNOT-22) (55; SD = 18) compared to non-Hispanics (37; SD = 22) (P < .001). Hispanics tended to have a higher risk of severe CRS markers, including nasal polyps RR = 2.5 (95% CI: 1.0-5.9), neo-osteogenesis RR = 1.6 (95% CI: 0.5-4.7), extended procedures (i.e., draft III) RR = 2.97 (95% CI: 1.0-9.1), and tissue eosinophilia RR = 1.46 (95% CI: 0.6-3.5). Hispanics reported longer sinonasal symptom duration.

CONCLUSIONS: SFL hispanic patients presenting for primary ESS have worse sinonasal disease burden. SFL Hispanics have markers of greater CRS severity and report longer delays before receiving CRS care. These factors may contribute to increased sinonasal disease burden in Hispanic patients.

LEVEL OF EVIDENCE: 3 Laryngoscope, 2021.

PMID:34254684 | DOI:10.1002/lary.29664

J Adv Nurs. 2021 Jul 13. doi: 10.1111/jan.14969. Online ahead of print.

ABSTRACT

AIMS: To examine patients’ and families’ help-seeking intentions and actions when suspecting peritoneal dialysis-associated peritonitis.

DESIGN: A sequential explanatory mixed methods design was used, comprising a questionnaire and semi-structured interviews.

METHODS: A questionnaire was designed, piloted and used with patients and family members (n=75) using peritoneal dialysis from six hospital sites in Wales and England. Questionnaire data were analysed using descriptive statistics. A purposive sample of questionnaire participants (n=30) then took part in telephone or face-to-face semi-structured interviews. Interview data were analysed thematically. Data were collected between September 2017 and August 2018. Ethical and governance approvals were obtained; the study was reported on national research portfolios.

RESULTS: The quantitative data highlighted differences between participants’ knowledge of when they should seek help for suspected peritonitis and their actions when they subsequently experienced peritonitis. The interview data revealed the complexities involved with recognizing peritonitis, making the decision to seek help and accessing healthcare. Some participants struggled to recognize peritonitis when signs/symptoms started, leading to delays in deciding to seek help. Furthermore, some participants reported that they accessed help from renal or generic out-of-hours and were misadvised or misdiagnosed, delaying diagnosis and treatment. The data were integrated using conceptual analyses of help-seeking behaviour and access to healthcare, which informs understanding of the complexity of seeking help in this context.

CONCLUSIONS: This study revealed differences between participants’ help-seeking intentions and actions. Using the conceptual analyses of help-seeking behaviour and access to healthcare informs understanding of the complexity of the help-seeking process in this context. To safely use a home therapy, it is imperative that individuals recognize signs/symptoms of peritonitis, seek help promptly and are appropriately supported when they access healthcare. Further work is needed to examine how these individual and system changes can be enacted.

PMID:34254685 | DOI:10.1111/jan.14969

J Anat. 2021 Jul 13. doi: 10.1111/joa.13508. Online ahead of print.

ABSTRACT

Menisci are wedge-shaped cartilage discs that are divided into two parts: the avascular and vascular regions. They are formed by fibrocartilage tissue, which contains round cartilage-like cells and extracellular matrix. Meniscus injury in animals is a common orthopedic problem, but data on the natural healing process mainly deals with the vascular zone. The healing processes in the avascular zone of the meniscus are significantly limited. Thus, this study aimed to evaluate autologous growth plate chondrocytes’ impact on the healing process of a damaged meniscus in the avascular zone based on a growing animal model. The study group consisted of 10 pigs at about three months of age. From each animal, chondrocytes from the iliac growth plate and from concentrated bone marrow were taken. Knee joints were divided into right (R) and left (L). The medial meniscus of the R knee joint was treated with a hyaluronic acid based scaffold incubated with bone marrow cells from marrow aspirates (nCHON). The medial meniscus of the L knee joint was treated with a hyaluronic acid based scaffold incubated with bone marrow cells from marrow aspirates supplemented with immature chondrocytes isolated from growth plates (wCHON). The meniscus was damaged in the avascular zone in both knee joints. Followingly, the damaged part of the meniscus was filled with a scaffold with cells from the concentrated bone marrow and from growth plate chondrocytes. In the control group, a scaffold with concentrated bone marrow cells was used. After three months the animals were euthanized and preparations (microscopic slides) were made from the meniscus’ damaged part. A qualitative and quantitative analysis have been prepared. The wCHON group in comparison with the nCHON group showed a statistically significantly higher number of fusiform cells on the surface of the graft as well as better healing of the graft. In addition, the degree of vascularization was higher in specimens from the wCHON group than in the nCHON group. The results of our research on immature pig knees revealed that mesenchymal stem cell and growth plate chondrocytes could be treated as the cell source for meniscus reconstruction, and growth plate chondrocytes enhance healing processes in the avascular zone of the injured meniscus.

PMID:34254669 | DOI:10.1111/joa.13508

Anaesthesia. 2021 Jul 13. doi: 10.1111/anae.15537. Online ahead of print.

ABSTRACT

Self-reported postoperative functional recovery is an important patient-centred outcome that is rarely measured or considered in research and decision-making. We conducted a secondary analysis of the measurement of exercise tolerance before surgery (METS) study for associations of peri-operative variables with functional decline after major non-cardiac surgery. Patients who were at least 40 years old, had or were at risk of, coronary artery disease and who were scheduled for non-cardiac surgery were recruited. Primary outcome was a reduction in mobility, self-care or ability to conduct usual activities (EuroQol 5 dimension) from before surgery to 30 days and 1 year after surgery. A decline in at least one function was reported by 523/1309 (40%) participants at 30 days and 320/1309 (24%) participants at 1 year. Participants who reported higher pre-operative Duke Activity Status indices more often reported functional decline 30 days after surgery and less often reported functional decline 1 year after surgery. The odds ratios (95%CI) of functional decline 30 days and 1 year after surgery with moderate or severe postoperative complications were 1.46 (1.02-2.09), p = 0.037 and 1.44 (0.98-2.13), p = 0.066. Discrimination of participants who reported functional decline 30 days and 1 year after surgery were poor (c-statistic 0.61 and 0.63, respectively). In summary, one quarter of participants reported functional decline up to one postoperative year.

PMID:34254670 | DOI:10.1111/anae.15537

J Forensic Sci. 2021 Jul 13. doi: 10.1111/1556-4029.14793. Online ahead of print.

ABSTRACT

This article adds to the growth in data-driven analyses seeking to compare samples of violent extremists with other violent populations of interest. While lone-actor terrorists and public mass murderers are frequently treated as distinct offender types, both engage (or attempt to engage) in largely public and highly publicized acts of violence and often use similar weapons. This article investigates the (dis)similarities between both offender types. We use a series of bivariate and multivariate statistical analyses to compare demographic, psychologic and behavioral variables across 71 lone-actor terrorists and 115 public mass murderers. The results show little distinction in sociodemographic profiles, but significant differences in (a) the degree to which they interact with co-ideologues (b) antecedent event behaviors and (c) the degree to which they leak information before the attack. Overall, our data inform the emerging idea that lone-actor terrorists and public mass shooters are not distinct offender types. There is more that unites them than divides them. Although the over-arching focus of our results are on the few variables that distinguish them, the vast majority (80%+), of the 180+ variables showed no significant difference. We discuss implications for threat assessment and management in the context of these results.

PMID:34254683 | DOI:10.1111/1556-4029.14793

Agri. 2021 Jan;33(1):7-14. doi: 10.14744/agri.2020.77698.

ABSTRACT

OBJECTIVES: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes be the only symptom in these patients. This retrospective and prospective study was an investigation of any differences in terms of clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) and cases with other concomitant findings (non-isolated headache [NIH]).

METHODS: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled in this research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared.

RESULTS: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated by age group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IH group, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH group during follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group than in the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in the NIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group.

CONCLUSION: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an important role in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.

PMID:34254656 | DOI:10.14744/agri.2020.77698

Med Pr. 2021 Jul 13:136987. doi: 10.13075/mp.5893.01110. Online ahead of print.

ABSTRACT

BACKGROUND: Tuberculosis is a chronic infectious disease caused by acid-fast mycobacteria from the Mycobacterium tuberculosis complex group. The disease spreads when people with pulmonary tuberculosis excrete bacteria when they cough, sneeze, laugh or speak. Prisons are often called reservoirs of patients with tuberculosis, posing a great threat to their staff. Longer working hours in prison and penitentiary facilities aid latent contamination among the prison staff. So far, there have been few works discussing latent tuberculosis infection issues among the prisoners and prison staff.

MATERIAL AND METHODS: A total of 84 employees of penitentiary facilities located in the Lublin Voivodship were examined using the QuantiFERON-TB Gold In-Tube (QFT-GIT) test which was approved for use in 2005 by the U.S. Food and Drug Administration as an aid in the diagnosis of Mycobacterium tuberculosis. The material for the research included blood samples collected using the QFT-GIT.

RESULTS: Positive test results of latent tuberculosis infections were found in 16.6% of officers. The highest percentage with positive results of tuberculosis infections was found among the surveyed single women aged 36-57, working in penitentiary facilities. There have been no statistically significant differences between the position of officers and the risk factors increasing the chance of the latent tuberculosis infection. Work experience and contact with inmates were found to have an impact on tuberculosis infection.

CONCLUSIONS: The obtained results partially confirm other authors’ observations concerning the influence of the risk factors of latent tuberculosis infections in prisons. Work experience and contact with inmates have an impact on tuberculosis infections among the prison staff in the Lublin Voivodeship. Med Pr. 2021;72(4).

PMID:34254590 | DOI:10.13075/mp.5893.01110

Phys Chem Chem Phys. 2021 Jul 13. doi: 10.1039/d1cp02233d. Online ahead of print.

ABSTRACT

Changes in the structural dynamics of double stranded (ds)DNA upon ligand binding have been linked to the mechanism of allostery without conformational change, but direct experimental evidence remains elusive. To address this, a combination of steady state infrared (IR) absorption spectroscopy and ultrafast temperature jump IR absorption measurements has been used to quantify the extent of fast (∼100 ns) fluctuations in (ds)DNA·Hoechst 33258 complexes at a range of temperatures. Exploiting the direct link between vibrational band intensities and base stacking shows that the absolute magnitude of the change in absorbance caused by fast structural fluctuations following the temperature jump is only weakly dependent on the starting temperature of the sample. The observed fast dynamics are some two orders of magnitude faster than strand separation and associated with all points along the 10-base pair duplex d(GCATATATCC). Binding the Hoechst 33258 ligand causes a small but consistent reduction in the extent of these fast fluctuations of base pairs located outside of the ligand binding region. These observations point to a ligand-induced reduction in the flexibility of the dsDNA near the binding site, consistent with an estimated allosteric propagation length of 15 Å, about 5 base pairs, which agrees well with both molecular simulation and coarse-grained statistical mechanics models of allostery leading to cooperative ligand binding.

PMID:34254612 | DOI:10.1039/d1cp02233d