Tag: nevin manimala

Neurourol Urodyn. 2021 Jul 12. doi: 10.1002/nau.24737. Online ahead of print.

ABSTRACT

AIMS: To investigate the clinical characteristics of health care-seeking men presenting with lower urinary tract symptoms (LUTS) in China and to reveal risk factors for symptom severity.

METHODS: This multicenter, hospital-based, cross-sectional study recruited 1477 eligible male subjects, who were at least 45 years, seeking health care at 9 participating hospitals across the mainland China. The general medical information and subjective symptoms were recorded, followed by the measurement of prostate volume, urodynamic indices, and laboratory tests for kidney function, plus glucose/lipid metabolism. Univariate and multivariate linear regression were employed for the detection of risk factors for symptom severity.

RESULTS: The proportion of mild, moderate, and severe LUTS was 14.6%, 32.6%, and 52.8%, respectively, with 62.2% reporting the triple combination of storage, voiding, and postmicturition symptoms. Median prostate volume was 44.6 ml, and 71.1% were experiencing comorbidities. Thirteen independent risk factors for LUTS severity were identified, namely, nocturnal voiding episodes and the presence of straining and weak steam; the triple combination of symptom subtypes; general and nocturia quality of life; Q_max and bladder outlet obstruction index; and numbers of comorbidities, hypertension, estimated glomerular filtration rate, and cholesterol and glycosylated hemoglobin.

CONCLUSIONS: The majority of health care-seeking LUTS men present with moderate-to-severe and overlapping symptoms, with a high prevalence of both lower urinary tract dysfunction and systemic comorbidities. The evidence from both urological and nonurological independent risk factors demonstrate the multifactorial nature of LUTS, for which a multidisciplinary management is essential.

PMID:34252243 | DOI:10.1002/nau.24737

Mycoses. 2021 Jul 12. doi: 10.1111/myc.13352. Online ahead of print.

ABSTRACT

BACKGROUND: Detection of galactomannan (GM) from bronchoalveolar lavage fluid (BALF) or serum is broadly used for diagnosis of invasive aspergillosis (IA), although the sensitivity of GM from serum is lower in non-neutropenic patients. We evaluated the Aspergillus galactomannan lateral flow assay (LFA) with digital readout from serum in a mixed cohort of patients.

METHODS: We performed a retrospective two-center study evaluating the LFA from serum of patients with clinical suspicion of IA obtained between 2015 and 2021 at the University of California San Diego (UCSD) and the Medical University of Graz. The sensitivity and specificity was calculated for proven/probable aspergillosis versus no aspergillosis. Correlation with same-sample GM was calculated using Spearman correlation analysis and kappa statistics.

RESULTS: In total, 122 serum samples from 122 patients were analyzed, including proven IA (n=1), probable IA or coronavirus-associated pulmonary aspergillosis (CAPA) (n=27), and no IA/CAPA/non-classifiable (n=94). At a 0.5 ODI cutoff, the sensitivity and specificity of the LFA was 78.6% and 80.5%. Spearman correlation analysis showed a strong correlation between serum LFA ODI and serum GM ODI (rho 0.459, p<0.0001). Kappa was 0.611 when both LFA and GM were used with a 0.5 ODI cutoff, showing substantial agreement (p<0.001).

DISCUSSION: The LFA with digital read out from serum showed good performance for the diagnosis of probable/proven aspergillosis, with substantial agreement to GM from serum. Like the LFA from BALF, the LFA from serum may serve as a more rapid test compared to conventional GM, particularly in settings where GM is not readily available.

PMID:34252244 | DOI:10.1111/myc.13352

Cancer Sci. 2021 Jul 12. doi: 10.1111/cas.15060. Online ahead of print.

ABSTRACT

In Japan, the age-adjusted incidence of cervical cancer has been increasing constantly and rapidly among younger women. We set out to accurately confirm the effectiveness of the HPV vaccine in Japan. Data was collected for women born in the fiscal year (FY) 1990 to 1997, who became eligible for their 20-year-old cervical cancer screening between the FY 2010 to 2017. The adjusted incidence of CIN1+ in women born in FY 1990 to 1993, i.e., those who reached the national vaccination target age prior to the introduction of publicly-subsidized HPV vaccinations, referred here after as ‘the pre-introduction generation’, was 1.42% (242/17,040). The incidence in the ‘vaccination generation’ (women born in FY 1994 to 1997, i.e., those who were heavily vaccinated as a group when they were of the nationally targeted age of 13-16) was 1.66% (135/8,020). There was no significant difference between these incidence rates. However, our FY birth year-by-year analysis revealed that the incidence of CIN1+ was obviously lower than that predicted based on just the tendency for CIN1+ seen in the pre-introduction generation. Our analysis revealed that the incidence of CIN3+ was obviously lower in the vaccinated generation than in the pre-introduction generation (p=0.0008) . The incidence of CIN was already tending to increase in both the pre-introduction and vaccination generations. The changes in CIN incidence by individual birth FY must be examined to accurately determine the actual affects of the HPV vaccine for reducing mild cervical lesions.

PMID:34252250 | DOI:10.1111/cas.15060

J Am Geriatr Soc. 2021 Jul 12. doi: 10.1111/jgs.17363. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the age-related differences in the association between level of acculturation and perceptions about change in health status after migration in mid- to late-life immigrants.

DESIGN: Cross-sectional study.

SETTING: Nationally representative cohort of legal U.S. immigrants.

PARTICIPANTS: Legal immigrants ≥50 years of age.

MEASUREMENTS: The outcome was perceived change in health status, determined by the survey question, “compared with your health right before you most recently came to the United States to live, would you say that your health is better now, about the same or worse?” The main predictor included age group (50-64, 65-74, and ≥75 years) and secondary variable of interest was level of acculturation. Analyses were adjusted for demographic characteristics, medical, and functional comorbidities.

RESULTS: Immigrants age ≥75 years were more likely to report worse health after migration [RRR 1.93, 95% CI (1.17, 3.17), p < 0.01] compared with immigrants of 50-64 years, but this difference was not statistically significant in the adjusted model. Acculturation level was associated with increased likelihood of reporting worse health status, [RRR 2.10, (1.02, 4.35), p < 0.05] for somewhat acculturated and [RRR 2.55, (1.10, 5.88), p < 0.05] for most acculturated, compared with participants who were not acculturated.

CONCLUSION: The oldest immigrant group (≥75 years) was more likely to report worse health after migration, but this association was no longer significant after accounting for acculturation level and other covariates. Future work should be undertaken to identify specific health needs across older immigrant age groups and identify acculturative stressors that negatively impact health.

PMID:34252200 | DOI:10.1111/jgs.17363

Acta Anaesthesiol Scand. 2021 Jul 12. doi: 10.1111/aas.13949. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common complication of cardiopulmonary bypass (CPB), associated with increased mortality in surgical patients. It is well proven that Th17 and its hallmark cytokine, IL-17, contribute to AKI development. Since the RAR-related orphan receptor C (RORC) gene is a master regulator of the Th17 differentiation, we aimed to evaluate the association between its polymorphisms, CPB-AKI and plasma IL-17 levels among Iranian patients undergoing cardiopulmonary bypass.

METHOD: Totally, 138 patients undergoing cardiopulmonary bypass in Bandar Abbas, Iran, were enrolled. The allele and genotype frequencies of the selected SNPs were determined using PCR-SSP. IL-17 serum level was determined using an enzyme-linked immunosorbent assay.

RESULTS: Rs9017 GG genotype and G allele were associated with increased risk of CPB-AKI (OR=3, 95% CI=1.4-6.6 and OR=2.3, 95% CI=1.3-3.9 respectively) while A allele was protective against the disease (OR=0.4, 95% CI=0.3-0.7, P=0.02). There was not a statistically significant interaction between the three genotypes of rs9017 and AKI disease with IL-17 serum level before (P=0.9) and after (P=0.6) the operation. The IL-17 serum level before surgery was significantly higher in patients carrying GG genotype compared to GA genotype (P=0.017).

CONCLUSION: Our results showed that the rs9017 GG genotype was associated with an increased level of IL-17 and risk of CBP-AKI in the Iranian population. Our current results suggest that the rs9017 GG genotype could be a probable predictor of AKI after cardiac surgery.

PMID:34252205 | DOI:10.1111/aas.13949

Sleep. 2021 Jul 12:zsab175. doi: 10.1093/sleep/zsab175. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Sleep problems and problematic internet use have important implications for adolescent health; however, there have been no large-scale surveys using comprehensive measures. We examined the association between internet use duration and sleep problems among Japanese adolescents.

METHODS: We used data from the Lifestyle Survey of Adolescents collected in 2012, 2014, and 2017. We calculated the change in sleep status (insomnia, sleep duration, bedtime, and sleep quality) and internet usage (screen time and services such as internet surfing, social media use, streaming such as YouTube, and online gaming). A binary logistic model was estimated for insomnia. Generalized ordered logit models were employed for the ordinal outcomes (sleep duration, bedtime, sleep quality, and multidimensional sleep health). Sampling weights were constructed based on participation rate on survey years and selection rates from population statistics.

RESULTS: We analyzed data from 248,983 adolescents. Sleep status was unchanged; however, many adolescents used more internet services and for longer durations. The odds ratio of internet screen time for all sleep problems (insomnia, shorter sleep duration, later bedtime, and worse sleep quality) gradually declined. Longer internet screen time (> 5 hours) was strongly associated with all sleep problems. Internet services were also associated with sleep problems; particularly, social media use and online gaming were linked to later bedtimes.

CONCLUSIONS: Despite the decreased strength in the association between internet usage and sleep problems, longer internet time was strongly associated with sleep problems. Public health interventions should consider internet use as an intervention target to improve adolescents’ health.

PMID:34252182 | DOI:10.1093/sleep/zsab175

J Gerontol A Biol Sci Med Sci. 2021 Jul 12:glab205. doi: 10.1093/gerona/glab205. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiometabolic risk (CMR) is a key indicator of physiological decline with age; but age-related declines in a nationally representative older U.S. population have not been previously examined.

METHODS: We examined the trajectory of cardiometabolic risk (CMR) over 8 years of aging, from 2006/2008 to 2014/2016, among 3,528 people over age 50 in the Health and Retirement Study. We used growth curve models to examine change in total CMR as well as in individual cardiometabolic biomarkers to understand how baseline differences and rates of change vary across sociodemographic characteristics, by smoking status, and medication use.

RESULTS: Total CMR did not change among respondents who survived over 8 years. Despite significant differences in CMR across demographic and education groups at baseline, the pace of change with age did not differ by these characteristics. Among individual biomarkers, risk levels of diastolic blood pressure, resting heart rate, and total cholesterol decreased over 8 years while glycosylated hemoglobin, waist circumference, and pulse pressure increased over that time. Both the statistical significance levels and the magnitudes of the reduction over time with age in diastolic blood pressure, resting heart rate, and total cholesterol in models adjusted for age, race/ethnicity, gender, smoking, and education were reduced after controlling for blood pressure and cholesterol medication.

CONCLUSIONS: The relatively constant total CMR level over 8 years occurred because some indicators improved with age while some deteriorated in this period. Medication use contributed to the improvement in blood pressure, resting heart rate, and total cholesterol.

PMID:34252185 | DOI:10.1093/gerona/glab205

J Circ Biomark. 2021 Jul 7;10:9-13. doi: 10.33393/jcb.2021.2212. eCollection 2021 Jan-Dec.

NO ABSTRACT

PMID:34252174 | PMC:PMC8267854 | DOI:10.33393/jcb.2021.2212

Eur J Public Health. 2021 Jul 12:ckab114. doi: 10.1093/eurpub/ckab114. Online ahead of print.

ABSTRACT

BACKGROUND: 5A’s counselling is recommended for screening and treating patients with smoking addiction. The emergency department (ED) setting might be a suitable environment for conducting interventions for smoking cessation. The present study aims to determine the feasibility and effectiveness on smoking cessation of 5A’s counselling administered to ED patients by nurses.

METHODS: Parallel group randomized trial assessing 5A’s counselling for smoking cessation vs. usual care at a University Hospital in the North of Italy. The primary end-point was prevalence of tobacco-free patients. The secondary outcomes at 6- and 12-month follow-up were (i) consecutive past 30-day smoking abstinence; (ii) past 7-day 50%, or more, decrease in daily tobacco consumption over baseline; and (iii) number of attempts to quit smoking.

RESULTS: A total of 480 patients were randomized to intervention (n = 262) or usual care (n = 218). Intention to treat analysis displayed no differences in primary and secondary outcomes between groups. A slight but not statistically significant enhancement in cessation was recorded in the intervention group [relative risk (RR) = 1.04, 95% confidence interval (CI) = 0.58-1.87] at 6 months, whereas a reversed observation at 12 months (RR = 0.86, 95% CI = 0.50-1.47). Similar results were obtained for the secondary outcomes. Per protocol analysis increased the size of the results. Of the 126 smokers receiving counselling, 18 were visited and treated at the local smoking cessation centre, with 12 of them successfully completing the treatment.

CONCLUSION: The results of this study indicate that the ED is not a suited environment for 5A’s counselling.

PMID:34252178 | DOI:10.1093/eurpub/ckab114

PLoS One. 2021 Jul 12;16(7):e0254418. doi: 10.1371/journal.pone.0254418. eCollection 2021.

ABSTRACT

Interannual variability in euphausiid (krill) abundance and population structure and associations of those measures with environmental drivers were investigated in an 11-year study conducted in late August-early September 2005-2015 in offshelf waters (bottom depth > 40 m) in Barrow Canyon and the Beaufort Sea just downstream of Distributed Biological Observatory site 5 (DBO5) near Pt. Barrow, Alaska. Statistically-significant positive correlations were observed among krill population structure (proportion of juveniles and adults), the volume of Late Season Melt Water (LMW), and late-spring Chukchi Sea sea ice extent. High proportions of juvenile and adult krill were seen in years with larger volumes of LMW and greater spring sea ice extents (2006, 2009, 2012-2014) while the converse, high proportions of furcilia, were seen in years with smaller volumes of LMW and lower spring sea ice extent (2005, 2007, 2010, 2011, 2015). These different life stage, sea ice and water mass regimes represent integrated advective responses to mean fall and/or spring Chukchi Sea winds, driven by prevailing atmospheric pressure distributions in the two sets of years. In years with high proportions of juveniles and adults, late-spring and preceding-fall winds were weak and variable while in years with high proportions of furcilia, late-spring and preceding-fall winds were strong, easterly and consistent. The interaction of krill life history with yearly differences in the northward transports of krill and water masses along with sea ice retreat determines the population structure of late-summer krill populations in the DBO5 region near Pt. Barrow. Years with higher proportions of mature krill may provide larger prey to the Pt. Barrow area bowhead whale prey hotspot. The characteristics of prey near Pt. Barrow is dependent on krill abundance and size, large-scale environmental forcing, and interannual variability in recruitment success of krill in the Bering Sea.

PMID:34252123 | DOI:10.1371/journal.pone.0254418