Tag: nevin manimala

J Health Pollut. 2021 Feb 25;11(29):210303. doi: 10.5696/2156-9614-11.29.210303. eCollection 2021 Mar.

ABSTRACT

BACKGROUND: There is no safe level of human exposure to lead (Pb). Detecting common early symptoms of low threshold Pb poisoning can help to prevent the damaging effects of higher doses and chronic low dose exposures. Panel beaters or auto body mechanics are exposed to Pb through their occupational duties.

OBJECTIVES: The present study aimed to determine common early symptoms associated with lower threshold Pb poisoning among roadside and organized panel beaters in Enugu Metropolis, Nigeria.

METHODS: This was a comparative cross-sectional study of 428 panel beaters in Enugu metropolis. A multi-stage sampling method was used to select 214 respondents each from the roadside and organized sectors. A semi-structured interviewer-administered questionnaire was used for data collection. Samples were collected under aseptic procedures. Blood Pb samples were extracted using the conventional wet acid digestion method and analyzed using a flame atomic absorption spectrometer (wavelength 283.3 nm). Comparative analysis was performed using the chi – square and Mann-Whitney U test. Statistical significance was set at P < 0.05.

RESULTS: Median Pb levels were 3.0 ug/dL and 16.0 ug/dL among roadside and organized panel beaters, respectively, with a significant difference. Numbness of limbs (P = 0.010) and fatigue (χ² = 5.294, P = 0.023) were found to be associated with roadside panel beaters, while weakness (χ² = 6.185, P = 0.019) and fatigue (χ² = 4.206, P = 0.046) were associated with organized panel beaters.

CONCLUSIONS: Nonspecific constitutional symptoms were common early symptoms of Pb poisoning irrespective of workplace occupational practices. These symptoms will help in early detection and control of occupational lead exposures.

PARTICIPANT CONSENT: Obtained.

ETHICS APPROVAL: Ethics approval was obtained from the Health Research Ethics Committee of the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu.

COMPETING INTERESTS: The authors declare no competing financial interests.

PMID:33815901 | PMC:PMC8009647 | DOI:10.5696/2156-9614-11.29.210303

J Clin Hypertens (Greenwich). 2021 Apr 4. doi: 10.1111/jch.14246. Online ahead of print.

ABSTRACT

Prehypertension is a risk factor for cardiovascular disease (CVD) and all-cause mortality. However, it is unclear whether prehypertension combined with diabetes associate with a higher risk for cardiovascular disease and all-cause mortality. The purpose of this study was to explore the relationship between prehypertension and the risk of CVD and all-cause mortality was different among individuals with or without diabetes. In the prospective community-based Kailuan study, 67 344 participants without hypertension or a history of CVD at baseline (2006) were included. Prehypertension was defined as systolic blood pressure of 120-139 mmHg or diastolic blood pressure of 80-89 mmHg. The outcomes were CVD and all-cause mortality were followed up through December 31, 2017. We performed Cox proportional hazards models to evaluate the relationships between prehypertension and CVD and all-cause mortality by diabetes status. During a median follow-up of 11.03 years, 2981 CVD events and 4655 all-cause mortality occurred. After adjusting age, sex, and other factors, the associations of prehypertension with risk of CVD and all-cause mortality were significant in participants without diabetes (hazard ratio and 95% confidence interval: 1.54 [1.38-1.71] and 1.27 [1.17-1.38]), but not in participants with diabetes (1.20 [0.93-1.56] and 0.88 [0.73-1.07]). The interactions between prehypertension and diabetes for the risk of CVD and all-cause mortality were all significant (all p < .05). Prehypertension was only associated with an increased risk for CVD and all-cause mortality in non-diabetes participants. Diabetes modifies the relation of prehypertension with the risk of CVD and all-cause mortality.

PMID:33813784 | DOI:10.1111/jch.14246

J Appl Microbiol. 2021 Apr 4. doi: 10.1111/jam.15096. Online ahead of print.

ABSTRACT

AIMS: The aim of this study was to isolate and characterize staphylococcal isolates from diabetic foot ulcers (DFU) in Jordanian patients.

METHODS AND RESULTS: Selected aerobic pathogens recovered from DFU specimens and patients’ nares with a focus on staphylococci were investigated. Antimicrobial susceptibilities and the prevalence of methicillin-resistant staphylococci (MRS) were determined. SCCmec types and toxigenic characteristics were analyzed and spa typing was performed for methicillin-resistant Staphylococcus aureus (MRSA) isolates. The relationship between toxigenic characteristics of MRSA and the Wagner ulcer grading system was statistically analyzed. A total number of 87 DFU patients were recruited for the study. The DFU cultures were polymicrobial. Members of the genus Staphylococcus were the most common among DFU-associated isolates found in 48.3% (n= 42) of all patients enrolled. Coagulase-negative staphylococci (CoNS) comprised 63.3% of staphylococci isolated from DFUs predominated by Staphylococcus epidermidis in both DFU (7.6%) and nares (39.2%). S. aureus was isolated from DFUs and nares in 14.2% and 9.8%, respectively, while 93% and 70% of these isolates were MRSA. Most of MRSA carried SCCmec type IV (76.2%) while SCCmec elements were non-typeable in most methicillin resistant coagulase negative staphylococci (MR-CoNS) (61.9%). The most frequent MRSA spa type was t386 (23.8%). Most MRSA and MR-CoNS exhibited resistance towards aminoglycosides, fluoroquinolones, and macrolides and susceptibility towards vancomycin, mupirocin and linezolid. No association was found between the possession of pvl, tst, sea, and hlg toxins and Wagner ulcer grading system (P- value > 0.05).

CONCLUSIONS: This analysis of Jordanian DFU culture demonstrated its polymicrobial nature with predominance of Staphylococcus spp.

SIGNIFICANCE AND IMPACT OF STUDY: This study is the first of its type to assess the microbiology of DFU among Jordanian patients. The results will help in the appropriate application of antimicrobial chemotherapy in the management of DFU.

PMID:33813786 | DOI:10.1111/jam.15096

Aust Endod J. 2021 Apr 4. doi: 10.1111/aej.12512. Online ahead of print.

ABSTRACT

The root fracture resistance (RFR) of premolars extracted from diabetic patients and the effect of biomaterials: white mineral trioxide aggregate (WMTA) and WMTA+Na₂ HPO₄ as an additive, on enhancing RFR were evaluated. Diabetic and non-diabetic teeth were divided into 4 subgroups (n = 5): root canals were obturated with WMTA, WMTA+Na₂ HPO₄ , gutta-percha and one unfilled (control). A plunger (1 mm diameter) applied a downward compressive load with crosshead speed of 1 mm min^-1 on the specimens mounted on resin blocks, and the ultimate force to fracture was measured. The mean RFR values of diabetic specimens were significantly lower. The lowest and highest means of RFR were recorded in the control and WMTA, in normal group and the control and WMTA+Na₂ HPO₄ in the diabetic group, respectively. The RFR in diabetic patients was significantly lower, indicating their higher susceptibility to fracture under vertical forces. The use of WMTA (with or without Na₂ HPO₄ ) for obturation enhances the RFR.

PMID:33813800 | DOI:10.1111/aej.12512

Biometrics. 2021 Apr 4. doi: 10.1111/biom.13468. Online ahead of print.

ABSTRACT

Cell migration, the process by which cells move from one location to another, plays crucial roles in many biological events. While much research has been devoted to understand the process, most statistical cell migration models rely on using time-lapse microscopy data from cell trajectories alone. However, the cell and its associated nucleus work together to orchestrate cell movement, which motivates a joint analysis of coupled cell-nucleus trajectories. In this paper we propose a Bayesian hierarchical model for analyzing cell migration. We incorporate a bivariate angular distribution to handle the coupled cell-nucleus trajectories, and introduce latent motility status indicators to model a cell’s motility as a time-dependent characteristic. An MCMC algorithm is provided for practical implementation of our model, which is used on real experimental data from MDA-MB-231 and NIH 3T3 cells. Through the fitted models, deeper insights into the migratory patterns of these experimental cell populations are gained, and their differences are quantified. This article is protected by copyright. All rights reserved.

PMID:33813733 | DOI:10.1111/biom.13468

Oral Dis. 2021 Apr 4. doi: 10.1111/odi.13867. Online ahead of print.

NO ABSTRACT

PMID:33813775 | DOI:10.1111/odi.13867

Pediatr Transplant. 2021 Apr 3:e14018. doi: 10.1111/petr.14018. Online ahead of print.

ABSTRACT

BACKGROUND: The clinical course of SARS-CoV-2 in the pediatric kidney transplant population is not well described.

METHODS: We performed a retrospective cohort study of a pediatric kidney transplant population at a New York transplant center. Baseline characteristics and clinical course of patients with SARS-CoV-2 positivity (Ab or PCR) were described, and comparison between COVID-positive and COVID-negative transplant patients was performed.

RESULTS: Twenty-two patients had COVID-19 IgG testing performed, eight of whom also had PCR testing. 23% of our cohort had evidence of COVID-19 infection. Four patients had positive IgG only, and one patient had a positive PCR. All five patients with a positive COVID test were female. Two patients had COVID-19 symptoms, which were mild. Of the symptomatic patients, one had a positive PCR at time of symptoms, while the other had a negative PCR during symptoms but subsequently had positive IgG. As compared to patients with COVID-19 negative results, those with COVID-19 positivity were significantly more likely to have a known COVID-19 exposure, and were also more likely to be female. There was no significant difference in time from transplant between the groups. Those in the COVID-positive group had higher baseline antimetabolite dose and CNI troughs, although these did not reach statistical significance.

CONCLUSIONS: Pediatric kidney transplant recipients are at risk for development of COVID-19 infection. While this population may be more at risk for SARS-CoV-2 infection due to their immunosuppressed status, their clinical course appears mild and similar to a healthy pediatric population.

PMID:33813782 | DOI:10.1111/petr.14018

Environ Sci Pollut Res Int. 2021 Apr 4. doi: 10.1007/s11356-021-13644-9. Online ahead of print.

ABSTRACT

Concentrations of As, Cd, Cr, Cu, Hg, Mn, Ni, Pb, Zn, and Fe measured at forty locations in the Boka Kotorska Bay were used to monitor the spatial and temporal quality of sediment and to assess surface sediment contamination over the last 15 years. This ecological geochemistry assessment was made using two classes of pollution indices: single indices concerning the investigated elements (contamination factor (Cf)) and integrated indices concerning the locations (pollution load index (PLI), potential ecological risk index (RI), mean effects range median quotient (MERMQ), toxic risk index (TRI), contamination severity index (CSI)). The distribution of all indices was geostatistically mapped and several hotspots were identified. Based on the indices applied in the risk assessment, the mean contribution of individual metal species to the total risk was determined and presented in the following order: Cd > Hg > As > Pb > Ni > Cu > Cr > Zn. This study revealed that Cd and Hg were at the top of the risk list among the examined elements. The temporal distribution of Hg has shown a decreasing trend during the period 2005-2019, while the presence of Cd in the Bay environment is of major concern. The results revealed that the most polluted part of the investigated area was Tivat bay within the Boka Kotorska Bay. Multivariate statistical analysis of pollution indices resulted in multicollinearity, which enabled the use of a reduced number of indices with an acceptable risk estimation.

PMID:33813708 | DOI:10.1007/s11356-021-13644-9

J Robot Surg. 2021 Apr 3. doi: 10.1007/s11701-021-01235-2. Online ahead of print.

ABSTRACT

Obesity is an independent risk factor for postoperative morbidity and mortality in laparoscopic colorectal surgery (LCRS). The technological advantages of robotic colorectal surgery (RCRS) may allow surgeons to overcome the limitations of LCRS in obese patients, but it is largely unknown if this translates to superior outcomes. The aim of this study was to compare perioperative, postoperative and short-term oncological outcomes in obese (BMI ≥ 30.0 kg/m²) and non-obese (BMI < 30 kg/m²) patients undergoing RCRS in a university teaching hospital. Demographic, perioperative and postoperative data along with short-term oncological outcomes of obese and non-obese patients that underwent RCRS for both benign and malignant colorectal disease were identified from a prospectively maintained database. A total of 107 patients (34 obese, 73 non-obese) underwent RCRS over a 4-year period. No statistically significant differences in the incidence of complications, 30-day reoperation, 30-day mortality, conversion to open surgery, anastomotic leak or length of inpatient stay were demonstrated. Obese patients had a significantly higher rate of surgical site infection (SSI) (p < 0.0001). Short-term oncological outcomes in both groups were favourable. There was no statistically significant difference in median duration of surgery between the two cohorts. The results demonstrate that obese patients undergoing RCRS in this institution experience similar outcomes to non-obese patients. These results suggest that RCRS is safe and feasible in obese patients and may be superior to LCRS in this cohort, where the literature suggests a higher complication rate compared to non-obese patients. The inherent advantages of robotic surgical platforms, such as improved visualisation, dexterity and ergonomics likely contribute to the improved outcomes in this challenging patient population.

PMID:33813713 | DOI:10.1007/s11701-021-01235-2

Eur Geriatr Med. 2021 Apr 4. doi: 10.1007/s41999-021-00489-1. Online ahead of print.

ABSTRACT

PURPOSE: Delirium is common and associated with poor outcomes, partly due to underdetection. We investigated if the delirium screening tool 4 A’s test (4AT) score predicts 1 year mortality and explored the sensitivity and specificity of the 4AT when applied as part of a clinical routine.

METHODS: Secondary analyses of a prospective study of 228 patients acutely admitted to a Medical Geriatric Ward. Physicians without formal training conducted the index test (the 4AT); a predefined cut-off ≥ 4 suggested delirium. Reference standard was delirium diagnosed by two geriatricians using the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). We calculated hazard ratios (HR) using Cox regression based on the groups 4AT = 0, 1-3, 4-7 and ≥ 8, first unadjusted, then adjusted for the covariates age, comorbidity, and personal activities of daily living. We calculated sensitivity, specificity, and the area under the receiver operating curve (AUC).

RESULTS: Mean age of patients was 86.6 years, 139 (61.0%) were female, 78 (34.2%) had DSM-5 delirium; of these, 56 had 4AT-delirium. 1 year mortality was 27.6% (63 patients). Compared to 4AT score 0, the group 4AT ≥ 8 had increased 1 year mortality (HR 2.86, 95% confidence interval 1.28-6.37, p = 0.010). The effect was reduced in multiadjusted analyses (HR 1.69, 95% confidence interval 0.70-4.07, p = 0.24). Sensitivity, specificity, and AUC were 0.72, 0.84, and 0.88, respectively.

CONCLUSIONS: 4AT ≥ 8 indicates increased mortality, but the effect was reduced in multiadjusted analyses. 4AT had acceptable sensitivity and specificity when applied as a clinical routine.

PMID:33813725 | DOI:10.1007/s41999-021-00489-1