Tag: nevin manimala

Eur J Oncol Nurs. 2021 Apr 3;52:101954. doi: 10.1016/j.ejon.2021.101954. Online ahead of print.

ABSTRACT

PURPOSE: Several studies have shown that the warm water bath can be a beneficial approach in the management of fatigue. This experimental study was conducted to evaluate the effect of warm salt water foot bath in the management of chemotherapy-induced fatigue.

METHODS: This randomized controlled trial was perfomed between November 2017-February 2018. Seventy five patients who experienced moderate or higher level chemotherapy related fatigue were randomly assigned to the intervention or control group. A training booklet about chemotherapy-induced fatigue was given to all patients. In addition, the experimental group performed 20 min warm salt water footbath for a week. The primary outcome was the change in fatigue level over 7 days after chemotherapy. The secondary outcome was the difference in physical, affective, emotional, and cognitive fatigue scores of patients.

RESULTS: The level of fatigue was grade 2 and grade 3 for 65.3% and 33.3% of patients, respectively. There was no statistically significant difference between groups regarding the mean of total fatigue score before and after bath (p > 0.05). However, the amount of decrease observed in the experimental group was found to be statistically significantly higher than the control group (p = 0.012; p < 0.05). In addition; the score in behavioral/severity, sensory, affective and cognitive dimensions related to fatigue decreased in the experimental group but did not decrease in the control group.

CONCLUSION: This study shown that warm salt water footbath can be an effective approach in enhancing fatigue related quality of life cancer patients. More studies should be conducted to assess the effectiveness of this intervention.

PMID:33864994 | DOI:10.1016/j.ejon.2021.101954

Aten Primaria. 2021 Apr 14;53(7):102053. doi: 10.1016/j.aprim.2021.102053. Online ahead of print.

ABSTRACT

OBJECTIVE: To provide evidence about the efficacy of a community health intervention through a cognitive stimulation program at long term in older people with mild cognitive impairment.

DESIGN: Randomized controlled trial (CONSORT group norms).

LOCATION: San José Norte-Centro Primary Care Center and La Caridad Foundation (Zaragoza, Spain).

PARTICIPANTS: Twenty-nine people over 65 years old with a 24-27 MEC score that completed 48 months follow up. They were randomized between the intervention group (15) and the control group (14).

INTERVENTIONS: The intervention was applied in 10 sessions of 45min for 10 weeks using the red notebook tool for mental activation that works memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention and executive functions.

MAIN MEASUREMENTS: The main outcome variables were MEC-35, Set-test, Barthel index, Lawton-Brody scale, Goldberg anxiety scale and Yesavage geriatric depression scale short form.

RESULTS: Increases of the main result variable over the baseline level of MEC-35 were analyzed. On average, the intervention group obtained higher scores than control: 3.14 points post intervention, 3.76 points after 6 months and 2.26 points more than control group after 12 months. All the differences were statistically significant. After 48 months the intervention group obtained 2 points more than control group. The intervention did not improve verbal fluency, activity daily living and mood.

CONCLUSIONS: Our cognitive stimulation program seems to improve cognitive performance, measured with the variable MEC-35 at post intervention, 6, 12 and 48 months. There is no evidence of improvement in verbal fluency, activity daily livings and mood. Clinicaltrials.gov Identifier: NCT03831061.

PMID:33865010 | DOI:10.1016/j.aprim.2021.102053

Sleep Med. 2021 Mar 1;81:457-462. doi: 10.1016/j.sleep.2021.02.048. Online ahead of print.

ABSTRACT

OBJECTIVE: Obstructive sleep apnea syndrome in children is associated with significant morbidity. Polysomnography is the main diagnostic tool but is time consuming and requires skilled manpower to supervise the patient overnight and hence long referral to diagnosis time. However, there are limitations and underestimation of the apnoea hyponea index (AHI) with alternative home sleep apnoea testing (HSAT), such as type 3 respiratory polygraphy (RP). Prior studies have demonstrated pulse transit time (PTT) to be a reliable indicator of cortical arousals. In this study, the use of PTT together with RP will be studied to determine whether the derived AHI is comparable to that of PSG.

METHOD: Forty-five patients with suspected OSA met the inclusion criteria underwent PSG in the sleep laboratory for analysis. The raw data for either PSG or RP analysis were allocated separately to two different accredited sleep technicians. The primary outcome AHI derived from PTT with RP was compared to the AHI derived from PSG. Secondary outcomes compared were obstructive apnoea index (OAI), total hypopnoea index (THI) and arousal index (AI). Bland Altman analysis was used to compare the agreement of AHI derived from the 2 modalities and demonstrate whether RP is non inferior or equivalent to the gold standard for diagnosing OSAS.

RESULTS: The patients studied had a median age of 8.8 years (range 3-17 years). The patients were not limited to certain spectrum of severity OSA and had AHI results spread from mild to severe OSA (AHI 0.4/hr to 72.2/hr). The RP with PTT-derived AHI was strongly correlated to the PSG derived AHI as seen on the Spearman plot (r = 0.98). The Bland Altman plot showed no evidence of underestimation of the AHI due to missed arousal related hypopneas. The difference of AHI derived from RP and PSG results were clinically insignificant. The differences between the PSG and RP total hypopnoea index (THI) and arousal index (AI) were also statistically insignificant.

CONCLUSION: The study shows that RP with PTT can be considered a reliable diagnostic alternative compared with PSG. The role of PTT incorporated with RP was to minimize underestimation of AHI due to missed arousal associated hypopnea events. The results were apparent across mild to severe severity of OSA. There are advantages of RPs particularly in paediatrics. Overall this study offers promising preliminary insights that RP incorporated with PTT can be further explored as an acceptable home diagnostic tool for diagnosing OSA in children.

PMID:33865076 | DOI:10.1016/j.sleep.2021.02.048

J Surg Res. 2021 Apr 13;264:553-561. doi: 10.1016/j.jss.2021.02.027. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative nutritional therapy is of paramount importance for patients undergoing esophagectomy. The jejunostomy and nasoenteral tube are the popular routes for nutritional therapy. However, which one is the preferred route is unclear. This study aims to analyze the differences in safety and efficacy of the two routes for nutritional therapy.

MATERIALS AND METHODS: PubMed, Web of Science, Cochrane Library, and EMBASE (till September 17, 2020) were searched. The primary outcome was postoperative pneumonia. Secondary outcomes were the length of hospital stays (LOS), bowel obstruction, catheter dislocation, anastomotic leakage, overall postoperative complications, and postoperative albumin. Weighted mean differences (WMD) and odds ratios (OR) were calculated for statistical analysis.

RESULTS: Ten studies involving a total of 1,531 patients in the jejunostomy group and 1,375 patients in the nasoenteral tube group were included. Compared with patients in the nasoenteral tube group, those in the jejunostomy group had a lower incidence of postoperative pneumonia (OR = 0.68, P < 0.001), shorter LOS (WMD = -0.85, P < 0.001), and lower risk of catheter dislocation (OR = 0.15, P = 0.001). There were no significant differences in the incidence of anastomotic leakage (OR = 0.84, P = 0.43), overall postoperative complications (OR = 0.87, P = 0.59), and postoperative albumin (WMD = -0.40, P = 0.24). However, patients in the jejunostomy group had a higher risk of bowel obstruction (OR = 8.42, P = 0.002).

CONCLUSIONS: Jejunostomy for enteral nutrition showed superior outcomes in terms of postoperative pneumonia, LOS, and catheter dislocation. Jejunostomy may be the preferred enteral nutritional route following esophagectomy.

PMID:33864963 | DOI:10.1016/j.jss.2021.02.027

Int J Law Psychiatry. 2021 Apr 14;76:101700. doi: 10.1016/j.ijlp.2021.101700. Online ahead of print.

ABSTRACT

OBJECTIVE: Although drug treatment courts (DTCs) have demonstrated positive outcomes, participants with co-occurring mental health and substance use disorders (CODs) are a high-risk group that often struggle with treatment engagement not previously examined. This pilot study fills this gap by looking at six-month behavioral health and criminal justice outcomes among a hard to engage DTC COD participant sample in two Massachusetts DTCs receiving a wraparound-treatment (Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Criminal Justice – MISSION-CJ).

METHODS: Participants were evaluated at baseline and at six-month follow-up. Bivariate analyses examined baseline differences between clients with higher versus low engagement were examined. A mixed analysis of variance (ANOVA) for repeated measures with time as the within subject factor, and level of engagement as the between subject factor was performed for criminal justice (CJ) and behavioral health outcomes.

RESULTS: Participants were primarily male (86.6%), White (90.6%), living in unstable housing (86.2%), had an average of 18.94 years of criminal justice involvement, had an average of 15.49 years of regular illicit substance use, and mild mental health symptoms as measured by the BASIS-32 average total score (0.51), with no statistically significant differences at baseline from bivariate analyses. Mixed ANOVA results demonstrated significant effect time of time in MISSION-CJ on reducing nights in jail (p = 0.0266), opioid use (p = 0.0013), and mental health symptom (p = 0.0349). Additional improvements in nights in jail p = 0.0139), illicit substance use (p = 0.0358), and opioid use (p = 0.0013), were observed for clients that had high engagement in MISSION-CJ.

CONCLUSIONS: Wraparound services, such as MISSION-CJ, alongside DTC programming for a chronic relapsing DTC population can improve engagement in treatment and CJ and behavioral health outcomes. Future research is needed with MISSION-CJ that includes a randomized trial and a larger sample.

PMID:33864989 | DOI:10.1016/j.ijlp.2021.101700

Forensic Sci Int. 2021 Apr 14;323:110784. doi: 10.1016/j.forsciint.2021.110784. Online ahead of print.

ABSTRACT

Although recent studies explored using microbial succession during decomposition to estimate the postmortem interval (PMI) and postmortem submersion interval (PMSI), there is currently no published research using aquatic eukaryotic community succession to estimate the minimum postmortem submersion interval (PMSI_min). The goals of this study were to determine whether eukaryotic community succession occurs on porcine skeletal remains in a lentic environment, and, if so, to develop a statistical model for PMSI_min prediction. Fresh porcine bones (rib N = 100, scapula N = 100) were placed in cages (10” x 10”) attached to floatation devices and submerged in a fresh water lake (Crozet, VA), using waterproof loggers and a YSI Sonde to record temperature and water quality variables, respectively. In addition to baseline samples, one cage, containing five ribs and five scapulae, and water samples (500 mL) were collected approximately every 250 accumulated degree days (ADD). Nineteen sample cohorts were collected over a period of 5200 ADD (579 Days). Variable region nine (V9) of the 18S ribosomal DNA (rDNA) was amplified and sequenced using a dual-index strategy on the MiSeq FGx sequencing platform. Resulting sequences underwent quality control parameters and analysis in mothur v 1.42.3, R v 3.5.3, and R v 3.6.0. Permutational multivariate analysis of variance (PERMANOVA) revealed a significant difference in phylogenetic β-diversity among ribs, scapulae and water (p = 0.001) and among ADD (p ≤ 0.011), which was supported by distinct clustering of samples associated with each ADD in UniFrac distance based non-metric multidimensional scaling (NMDS) ordinations. Using similarity percentage (SIMPER) analysis of class and family level taxa, differences observed between bone types were attributed to Peronosporomycetes_cl, Eukaryota_unclassified, and Intramacronucleata (e.g., Armophorida), however these differences were not statistically significant. Alpha diversity revealed a non-linear increase in phylogenetic diversity with an increase in ADD. Random forest models for ribs and scapulae predicted PMSI_min with an error rate within±104 days (937 ADD) and±63 days (564 ADD), respectively. In conclusion, this study suggests that eukaryotic succession is capable of predicting long term PMSI_min in lentic systems.

PMID:33864992 | DOI:10.1016/j.forsciint.2021.110784

Int J Infect Dis. 2021 Apr 14:S1201-9712(21)00345-3. doi: 10.1016/j.ijid.2021.04.035. Online ahead of print.

ABSTRACT

BACKGROUND: We examined whether existing licensed pharmacotherapies could reduce the spread of coronavirus disease 2019 (COVID-19).

METHODS: An open-label parallel randomized controlled trial was performed among healthy migrant workers quarantined in a large multi-storey dormitory in Singapore. Forty clusters (each defined as individual floors of the dormitory) were randomly assigned to receive a 42-day prophylaxis regimen of either oral hydroxychloroquine (400 mg once, followed by 200 mg/day), oral ivermectin (12 mg once), povidone-iodine throat spray (3 times/day, 270 µg/day), oral zinc (80 mg/day)/vitamin C (500 mg/day) combination, or oral vitamin C, 500 mg/day. The primary outcome was laboratory evidence of SARS-CoV-2 infection as shown by either: (1) a positive serologic test for SARS-CoV-2 antibody on day 42, or (2) a positive PCR test for SARS-CoV-2 at any time between baseline and day 42.

RESULTS: A total of 3,037 asymptomatic participants (mean age, 33.0 years; all men) who were seronegative to SARS-CoV-2 at baseline were included in the primary analysis. Follow-up was nearly complete (99.6%). Compared with vitamin C, significant absolute risk reductions (%, 98.75% confidence interval) were observed for oral hydroxychloroquine (21%, 2-42%) and povidone-iodine throat spray (24%, 7-39%). No statistically significant differences were observed with oral zinc/vitamin C combination (23%, -5 to +41%) and ivermectin (5%, -10 to +22%). Interruptions due to side effects were highest among participants who received zinc/vitamin C combination (6.9%), followed by vitamin C (4.7%), povidone-iodine (2.0%) and hydroxychloroquine (0.7%).

CONCLUSIONS: Chemoprophylaxis with either oral hydroxychloroquine or povidone-iodine throat spray was superior to oral vitamin C in reducing SARS-CoV-2 infection in young and healthy men. CLINICALTRIALS.

GOV NUMBER: NCT04446104.

PMID:33864917 | DOI:10.1016/j.ijid.2021.04.035

Int J Surg. 2021 Apr 14:105941. doi: 10.1016/j.ijsu.2021.105941. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the study was to assess the feasibility, safety, and potential benefits of four approaches of robotic assisted thyroidectomy (RT). The approaches mentioned above are also compared with traditional open thyroidectomy (OPEN).

MATERIALS AND METHODS: Medline, Embase, Cochrane library (CENTRAL) and Web of Science databases were searched up to 13^rd Dec, 2019. Data of surgical outcomes and complications were extracted to conduct the statistical analyses.

RESULTS: A total of 30 studies with 6622 patients were included. Ten were prospective study and 1 declared prospective randomized comparative study. The number of retrieved lymph nodes (LNs) in central compartment were similar between gasless transaxillary approach (GAA), bilateral axillo-breast approach (BABA) and transoral approach (OA). OPEN retrieved more LNs than BABA and OA. More metastatic LNs were seen in GAA and BABA than OA, as was for OPEN. The operation time was significantly shorter in GAA and gasless unilateral transaxillary approach (GUAA) than BABA and OA, while shortest for OPEN. Lower incidence of transient hypoparathyroidism was found in BABA than OPEN. No significant difference was observed in other indexes.

CONCLUSIONS: BABA, GAA, GUAA and OA in RT appear to be feasible and safe for patients with thyroid cancer with unique benefits. Surgical outcomes of different approaches were not identical for operation time, cosmetic effects, central neck dissection. Surgeons would consider more about patients’ will.

PMID:33864953 | DOI:10.1016/j.ijsu.2021.105941

Laryngoscope. 2021 Apr 17. doi: 10.1002/lary.29574. Online ahead of print.

ABSTRACT

OBJECTIVES: Sinonasal mucosal melanoma (SNMM) is an aggressive cancer usually managed with surgical resection. This study evaluates the impact of treatment modality and positive surgical margin (PSM) on survival following resection of SNMM.

STUDY DESIGN: Retrospective study of a national cancer registry.

METHODS: The National Cancer Database was queried for cases of SNMM from 2010 to 2015. Data regarding patient demographics, tumor staging, and treatment modality were obtained. Survival rates were compared by margin status: PSM, negative (NSM), and no operation (0SM) using Kaplan-Meier analysis and log rank test.

RESULTS: A total of 446 patients met inclusion criteria. Most cases were elderly (>66 years-old) (67.3%), female (54.3%), and white (89.5%). Cases of SNMM most commonly involved the nasal cavity (81.6%), were Stage 3 (60.0%), and underwent surgical resection at an academic center (65.0%). NSM and PSM were present in 59.0% and 26.9% of cases, respectively, while 14.1% of cases did not undergo surgical resection (0SM). Factors predictive of PSM included resection at a community hospital (OR 2.47) and Stage 4 disease (OR 2.07). The 2-year survival rates were 72.1% (95% CI 69.4-75.4%), 36.3% (95% CI 22.0-48.9), and 16.0% (95% CI 8.2-25.4%) for NSM, PSM and 0SM, respectively. Survival was statistically significant between NSM and PSM (Log rank <0.001) but not between 0SM and PSM (Log rank = 0.062).

CONCLUSION: Our study emphasizes the need for NSM for SNMM as PSM did not demonstrate any significant improvement in survival when compared to 0SM. Our findings suggest that cases of SNMM are best managed at academic centers.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2021.

PMID:33864635 | DOI:10.1002/lary.29574

Diagn Cytopathol. 2021 Apr 17. doi: 10.1002/dc.24751. Online ahead of print.

ABSTRACT

BACKGROUND: The multigene genomic classifier ThyroSeq V3 has proven to be an effective triage modality in the management of indeterminate thyroid nodules. This study reports on the clinical management of patients with indeterminate thyroid nodules.

METHODS: ThyroSeq V3 testing at our institution was implemented April 1, 2019. Over a 17-month period (1 April 2019 through 31 August 2020). Thirty five indeterminate thyroid nodules were sent for testing; diagnoses included FLUS, suspicious for a follicular/Hurthle cell neoplasm (SFN/SHCN) and suspicious for papillary thyroid carcinoma (SPTC). There were 26 females, nine males; mean age 56 years. Aspirated nodules, mean size of 2 cm, were evaluated by rapid on site evaluation with adequacy assessed by the cytopathologist via telecytology.

RESULTS: Of the 35 nodules, 17 (49%) were positive and 18 (51%) were negative on ThyroSeq Testing. All of the 17 positive nodules (four FLUS, 10 SFN/SHCN, three SPTC) showed neoplastic lesions; five adenomas, one NIFTP and 11 carcinomas on surgical resection. Only 4 (22%) of the 18 nodules that were negative were resected and showed two colloid/adenomatous nodules, one NIFTP and one follicular variant of papillary thyroid carcinoma. As FLUS FNAs were the majority of the indeterminate nodules, a comparison was made pre-and post ThyroSeq testing. Prior to ThyroSeq testing the majority (69%) of the nodules were resected as compared to 36% post implementation; a statistically significant value (P < .005). Surgical resection yielded a majority of benign nodules pre-ThyroSeq testing, 68%, as compared to post-ThyroSeq testing, 25%.

CONCLUSION: Implementation of ThyroSeq V3 testing has led to improvements in clinical management of patients with indeterminate thyroid nodules.

PMID:33864719 | DOI:10.1002/dc.24751