Tag: nevin manimala

Am J Prev Med. 2022 Jan 6:S0749-3797(21)00593-6. doi: 10.1016/j.amepre.2021.10.018. Online ahead of print.

ABSTRACT

INTRODUCTION: Research is equivocal about how the social relationship between victims and offenders is linked to the emotional, social, and physical consequences of violence. This study examines the association of victim-offender relationship with the adverse outcomes reported by injured and uninjured victims of violence.

METHODS: The study analyzed 16,723 violent victimizations recorded by the National Crime Victimization Survey from 2008 to 2018. Multivariable quasi-Poisson models estimated the associations between the victim-offender relationship and victims’ emotional distress, social distress, and physical and emotional symptoms. These models also estimated a statistical interaction between victim-offender relationship and violent injury to examine how this association differed for injured and uninjured victims. The analyses occurred during 2020 and 2021.

RESULTS: Uninjured victims were more likely to report emotional distress (risk ratio=1.41, 95% CI=1.33, 1.50), social distress (risk ratio=3.12, 95% CI=2.78, 3.51), more physical symptoms (symptom frequency ratio=1.68, 95% CI=1.51, 1.87), and more emotional symptoms (symptom frequency ratio=1.13, 95% CI=1.08, 1.18) in family member/intimate partner violence than in stranger violence. Victims also reported worse outcomes after acquaintance violence than after stranger violence. For injured victims, these differences narrowed-but were still significant-in emotional and social distress models. However, the number of emotional and physical symptoms reported by injured victims did not significantly vary across victim-offender relationships.

CONCLUSIONS: Relational closeness between victims and offenders is a risk factor for adverse outcomes after violent victimization, and it is more strongly associated with these outcomes for uninjured victims than for injured victims.

PMID:35000834 | DOI:10.1016/j.amepre.2021.10.018

J Nutr Educ Behav. 2022 Jan 6:S1499-4046(21)00861-7. doi: 10.1016/j.jneb.2021.10.003. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate if children of families with a longer duration of participation in the Special Supplementation Nutrition Program for Women, Infants, and Children (WIC) consume fewer sugar-sweetened beverages (SSB) and more water.

DESIGN: A repeated cross-sectional study.

SETTING: Conducted among representative samples of WIC-participating families in Los Angeles County, California, in 2014, 2017, and 2020.

PARTICIPANTS: Children aged 4-59 months participating in WIC.

MAIN OUTCOME MEASURES: Daily servings of total SSBs, daily servings of specific types of SSBs, and daily servings of water.

ANALYSIS: Multivariable count regression models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) for associations of the duration of family WIC participation with daily servings of total SSBs, water, and specific types of SSBs. Zero-inflated negative binomial regression models were used for total SSBs and specific types of SSBs, and Poisson regression was used for water.

RESULTS: Children of families with 2 years of WIC participation consumed significantly fewer daily servings of total SSBs (IRR, 0.95; 95% CI, 0.93-0.98; P = 0.002), fruit-flavored SSBs (IRR, 0.95; 95% CI, 0.91-0.99; P = 0.02), soda (IRR, 0.86; 95% CI, 0.76-0.98; P = 0.02), and water (IRR, 0.99; 95% CI, 0.98 to < 1.00; P = 0.03) than children of families with 1 year of WIC participation. Protective associations for total SSBs, fruit-flavored SSBs, and soda remained statistically significant and increased in magnitude through 10 years of family WIC participation.

CONCLUSIONS AND IMPLICATIONS: Duration of WIC participation was associated with decreased SSB intake by young children. Given the role that increasing water intake in lieu of SSBs plays in child obesity, improving the effectiveness of WIC nutrition education on parental perceptions and provision of fruit-flavored SSBs and water to their children merits detailed evaluation.

PMID:35000830 | DOI:10.1016/j.jneb.2021.10.003

Eur J Intern Med. 2022 Jan 6:S0953-6205(21)00437-4. doi: 10.1016/j.ejim.2021.12.027. Online ahead of print.

ABSTRACT

AIMS: In the absence of previous direct comparative studies, we aimed to evaluate the effectiveness of spironolactone and eplerenone in patients with heart failure and reduced ejection fraction (HFrEF) in a real-world clinical setting.

METHODS: Using Fine-Gray´s competing risk regression, we compared the clinical outcomes of 293 patients with chronic HF and left ventricular ejection fraction <40% treated with eplerenone and 293 propensity-score matched individuals treated with spironolactone. Study subjects were selected from a prospective cohort of 1404 ambulatory patients with HFrEF seen since 2010 to 2019 in a single specialized HF clinic, among which 992 received a mineralocorticoid receptor antagonist at baseline. Median follow-up was 3.95 years.

RESULTS: No statistically significant differences between patients treated with eplerenone versus spironolactone were observed with regard to the risk of the primary composite end-point cardiovascular death or HF hospitalization (HR 0.95; 95% CI 0.73-1.23; p= 0.677). However, eplerenone use was associated to lower cardiovascular mortality (HR 0.55; 95% CI 0.35-0.85; p= 0.008) and lower all-cause mortality (HR 0.67; 95% CI 0.47-0.95; p= 0.027). The incidence of drug suspension due to side effects (HR 0.58, 95% CI 0.40-0.85; p= 0.005) and drug suspension due to any reason (HR 0.70, 95% CI 0.51-0.97; p= 0.033) were lower among patients treated with eplerenone.

CONCLUSIONS: In this observational, real-world, propensity-score matched study of patients with HFrEF, eplerenone was associated to lower cardiovascular mortality and lower all-cause mortality than spironolactone.

PMID:35000806 | DOI:10.1016/j.ejim.2021.12.027

Eur Urol. 2022 Jan 6:S0302-2838(21)02216-8. doi: 10.1016/j.eururo.2021.12.008. Online ahead of print.

ABSTRACT

BACKGROUND: European kidney donation shortages mandate efficient organ allocation by optimizing the prediction of success for individual recipients.

OBJECTIVE: To develop the first European online risk tool for kidney transplant outcomes on the basis of recipient-only and recipient plus donor characteristics.

DESIGN, SETTING, AND PARTICIPANTS: We used individual recipient and donor risk factors and three outcomes (death, death with functioning graft [DWFG], and graft loss) for 32 958 transplants within the Eurotransplant kidney allocation system and the Eurotransplant senior program between January 2006 and May 2018 in eight European countries to develop and validate a risk tool.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Cox proportional-hazards models were used to analyze the association of risk factors with overall patient mortality, and proportional subdistribution hazard regression models for their association with graft loss and DWFG. Prediction models were developed with recipient-only and recipient-donor risk factors. Sensitivity analyses based on time-specific area under the receiver operating characteristic curve (AUC) with leave-one-country-out validation were performed and calibration plots were generated.

RESULTS AND LIMITATIONS: The 10-yr cumulative incidence rate was 37% for mortality, 12% for DWFG, and 41% for graft loss. In recipient-donor models the leading risk factors for mortality were recipient diabetes (hazard ratio [HR] 10.73), retransplantation (HR 3.08 per transplant), and recipient age (HR 1.08). Effects were similar for DWFG. For graft loss, diabetes (subdistributional HR [SHR] 1.32), increased donor age (SHR 1.02), and prolonged cold ischemia time (SHR 1.02) had increased SHRs. All p values were <0.001.

CONCLUSIONS: Previously identified risk factors for outcomes following kidney transplants allow for outcome prediction with 10-yr AUC values of up to 0.81.

PATIENT SUMMARY: Using European data, we estimated individual risks to predict the success of kidney transplants and support physicians in decision-making. An online tool is now available (https://riskcalc.org/ktop/) for predicting kidney transplant outcomes both before and after a donor has been identified.

PMID:35000822 | DOI:10.1016/j.eururo.2021.12.008

Am J Infect Control. 2021 Dec 7:S0196-6553(21)00741-0. doi: 10.1016/j.ajic.2021.11.005. Online ahead of print.

ABSTRACT

N95 respirators were reprocessed using vaporized hydrogen peroxide to supplement limited supplies during the COVID-19 pandemic. In this study, we found no statistically significant differences in qualitative and quantitative fit or filtration efficiency with reprocessing. Filtration efficiency remained above 95% even at 25 cycles of reprocessing without statistically significant change from cycle 20-25 compared to cycle 0 (P = .10, P = .05, respectively). Vaporous hydrogen peroxide is an effective option to augment N95 respirator supplies.

PMID:35000800 | DOI:10.1016/j.ajic.2021.11.005

Neurospine. 2021 Dec;18(4):839-844. doi: 10.14245/ns.2142560.180. Epub 2021 Dec 31.

ABSTRACT

OBJECTIVE: To identify potential risk factors of unsatisfactory screw position during robot-assisted pedicle screw fixation.

METHODS: A retrospective analysis of robot-assisted pedicle screw fixation performed in Beijing Jishuitan Hospital from March 2018 to March 2019 was conducted. Research data was collected from the medical record and imaging systems. Univariate tests were performed on the potential risk factors (patient’s characteristics and surgical factors) of unsatisfactory screw position during robot-assisted pedicle screw fixation. For statistically significant variables in univariate tests, a logistic regression test was used to identify independent risk factors for unsatisfactory screw position.

RESULTS: A total of 780 pedicle screws placed in 163 robot-assisted surgeries were analyzed. The rate of perfect screw positions was 93.08%, and the unsatisfactory rate was 6.92%. In patients with severe obesity (body mass index ≥ 30 kg/m2) (odds ratio [OR], 2.459; 95% confidence interval [CI], 1.199-5.044; p = 0.014), osteoporosis (T ≤ -2.5) (OR, 1.857; 95% CI, 1.046-3.295; p = 0.034), and the segments 3 levels away from the tracker (OR, 2.216; 95% CI, 1.119-4.387; p = 0.022), robot-assisted pedicle screw placement has a higher risk of screw malposition.

CONCLUSION: During robot-assisted pedicle screw placement for patients with severe obesity, osteoporosis, and segments 3 levels away from the tracker, vigilance should be maintained during surgery to avoid postoperative complications due to unsatisfactory screw position.

PMID:35000338 | DOI:10.14245/ns.2142560.180

Neurospine. 2021 Dec;18(4):786-797. doi: 10.14245/ns.2142712.356. Epub 2021 Dec 31.

ABSTRACT

OBJECTIVE: Ankylosing spondylitis (AS) is a rheumatic inflammatory disease marked by chronic inflammation of the axial skeleton. This condition, particularly when severe, can lead to increased risk of vertebral fractures attributed to decreased ability of the stiffened spinal column to sustain normal loads. However, little focus has been placed on understanding the locations of spinal fractures and associated complications and assessing the correlation between these. In this review, we aim to summarize the complications and treatment patterns in the United States in AS patients with spinal fractures, using the latest Nationwide Inpatient Sample (NIS) database (2016-2018).

METHODS: We analyzed the NIS data of years 2016-2018 to compare the fracture patterns and complications.

RESULTS: A total of 5,385 patients were included. The mean age was 71.63 years (standard deviation [SD], 13.21), with male predominance (83.8%). The most common population is Whites (77.4%), followed by Hispanics (7.9%). The most common fracture level was thoracic level (58.3%), followed by cervical level (38%). Multiple fracture levels were found in 13.3% of the patients. Spinal cord injury (SCI) was associated with 15.8% of the patients. The cervical level had a higher proportion of SCI (26.5%), followed by thoracic level (9.2%). The mean Elixhauser comorbidity score was 4.82 (SD, 2.17). A total of 2,365 patients (43.9%) underwent surgical treatment for the fractures. The overall complication rate was 40.8%. Respiratory complications, including pneumonia and respiratory insufficiency, were the predominant complications in the overall cohort. Based on the regression analysis, there was no significant difference (p = 0.45) in the complication rates based on the levels. The presence of SCI increased the odds of having a complication by 2.164 times (95% confidence interval, 1.722-2.72; p ≤ 0.001), and an increase in Elixhauser comorbidity score predicted the complication and in-hospital mortality rate (p ≤ 0.001).

CONCLUSION: AS patients with spinal fractures have higher postoperative complications than the general population. The most common fracture location was thoracic in our study, although it differs with few studies, with SCI occurring in 1/6th of the patients.

PMID:35000333 | DOI:10.14245/ns.2142712.356

Neurospine. 2021 Dec;18(4):667-680. doi: 10.14245/ns.2142206.253. Epub 2021 Dec 31.

ABSTRACT

To formulate the specific guidelines for the recommendation of thoracolumbar fracture regarding surgical techniques and nonfusion surgery. WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meeting. For nonfusion surgery and thoracolumbar fracture, a systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020. The search was further refined by excluding the articles which were duplicate, not in English or were based on animal or cadaveric subjects. After thorough shortlisting, only 50 articles were selected for full review in this consensus meeting. To generate a consensus, the levels of agreement or disagreement on each item were voted independently in a blind fashion through a Likert-type scale from 1 to 5. The consensus was achieved when the sum for disagreement or agreement was ≥ 66%. Each consensus point was clearly defined with evidence strength, recommendation grade, and consensus level provided. A magnitude of prospective papers were analyzed to formulate consensus on various surgical techniques that can be employed to address different types of thoracolumbar fractures. Surgical treatment of thoracolumbar fractures can be a better option over the nonoperative approach, especially for those who cannot tolerate months in an orthosis or cast, such as those with multiple extremity injuries, skin lesions, obesity, and so forth. It generally allows early mobilization, less hospital stay, reduced pulmonary complications, and better correction of sagittal balance. Current available literature fails to demonstrate any statistically significant benefit of fusion surgery over nonfusion in thoracolumbar fractures.

PMID:35000320 | DOI:10.14245/ns.2142206.253

Dermatol Ther. 2022 Jan 9:e15311. doi: 10.1111/dth.15311. Online ahead of print.

ABSTRACT

Acne vulgaris is one of the most common dermatologic complaints. Recently, isotretinoin has been used as an off-label indication for the treatment of mild-to-moderate grades of acne not responding to conventional treatment. Its conventional recommended dose is 0.5-1.0 mg/kg per day to the cumulative dose of 120-150 mg/kg.

OBJECTIVES: To qualify the state of evidence and analyze the efficacy of the low daily dose and the pulsed doses of isotretinoin in treating mild-to-moderate acne patients with regards to response and relapse rates.

METHOD: Systematic review and meta-analysis using an electronic literature search were performed. 320 potentially relevant articles were included and reviewed.

RESULTS: The level of evidence is moderate to low as conducted by the GRADE quality of evidence assessment. The pooled statistical estimate for response to treatment in the group comparing low daily doses with conventional dose showed an overall benefit for conventional dose. On the other hand, pooled data from the group comparing the low daily dose with the pulsed doses yielded an overall beneficial effect from using the low daily dose compared with the pulsed doses on achieving the response.

CONCLUSIONS: Given all of the available studies, the quality of evidence is low. It appears that conventional dose isotretinoin improves the odds of prolonged remission in adults with mild-to-moderate acne vulgaris compared to the low doses.

PMID:35000295 | DOI:10.1111/dth.15311

J Sep Sci. 2022 Jan 9. doi: 10.1002/jssc.202100732. Online ahead of print.

ABSTRACT

Pulsatillae Radix, the root of Pulsatilla chinensis (Bge.) Regel, is recorded in the Pharmacopoeia of the People’s Republic of China and has been widely used for its pharmacological activities, such as anti-inflammatory, antioxidant, antibacterial, antitumor, and cardiovascular benefits. However, there are several look-alike species that can be marketed as Pulsatillae Radix. To distinguish Pulsatilla chinensis (Bge.) Regel from its look-alikes, viz. Pulsatilla cernua (Thunb.) Bercht et Opiz., Pulsatilla dahurica (Fisch.) Spreng., Anemone tomeutosa (Maxim.) Pei., and Rhaponticum uniflorum (L.) DC, we used ultra-performance liquid chromatography/time-of-flight mass spectrometry combined with principal component analysis to compare their chemical compositions. Four ions, a (RT 8.98 min, m/z 1381.6671), b (RT 10.64 min, m/z 1219.6143), c (RT 11.52 min, m/z 1217.5978), and d (RT 13.6 min, m/z 749.4463) from Pulsatillae chinensis (Bge.) Regel were identified as potential chemical markers to distinguish it from look-alike species using an unsupervised statistical model combined with orthogonal partial least-squares discriminant analysis. The results of this study provide an effective method for identifying and distinguishing Pulsatilla chinensis (Bge.) Regel from similar plants. This article is protected by copyright. All rights reserved.

PMID:35000282 | DOI:10.1002/jssc.202100732