Tag: pubmed

J Crit Care Med (Targu Mures). 2024 Apr 30;10(2):177-182. doi: 10.2478/jccm-2024-0019. eCollection 2024 Apr.

ABSTRACT

INTRODUCTION: Airway ultrasound has been increasingly used in correct positioning of endotracheal tube. We hypothesize that a safe distance between endotracheal tube tip and carina can be achieved with the aid of ultrasound.

AIM OF THE STUDY: Our primary objective was to determine whether ultrasound guided visualisation of proximal end of endotracheal tube cuff is better when compared to conventional method in optimal positioning of tube tip. The secondary objective was to find the optimal endotracheal tube position at the level of incisors in adult Indian population.

MATERIALS AND METHODS: There were 25 patients each in the conventional group and the ultrasound group. Conventional method includes auscultation and end tidal capnography. In the ultrasound group the upper end of the endotracheal tube cuff was positioned with an intent to provide 4 cm distance from the tube tip to the carina. X ray was used in both groups for confirmation of tip position and comparison between the two groups. Further repositioning of the tube was done if indicated and the mean length of the tube at incisors was then measured.

RESULTS: After x ray confirmation, endotracheal tube repositioning was required in 24% of patients in the USG group and 40 % of patients in the conventional group. However, this result was not found to be statistically significant (p = 0.364). The endotracheal tube length at the level of teeth was 19.4 ± 1.35 cm among females and 20.95 ± 1.37 cm among males.

CONCLUSIONS: Ultrasonography is a reliable method to determine ETT position in the trachea. There was no statistically significant difference when compared to the conventional method. The average length of ETT at the level of incisors was 19.5 cm for females and 21 cm for males.

PMID:39109274 | PMC:PMC11193950 | DOI:10.2478/jccm-2024-0019

Transgend Health. 2024 Jun 17;9(3):197-204. doi: 10.1089/trgh.2022.0079. eCollection 2024 Jun.

ABSTRACT

PURPOSE: The objective of this study is to determine the prevalence of certain autoimmune diseases in transgender and gender diverse (TGD) youth.

METHODS: A multicenter, retrospective analysis was conducted from January 2013 to January 2019 of youth ≤26 years of age with concurrent diagnoses of gender dysphoria (GD) and at least one of the studied autoimmune diseases. Prevalence rates were calculated and compared to previously reported rates. Statistical significance was determined using second generation p-values as pooled estimates of prevalence rates across study sites compared to a range of rates reported in the literature.

RESULTS: During the study period, 128 of 3812 (3.4%) youth evaluated for GD had a concurrent diagnosis of at least one of the studied autoimmune diseases. Three autoimmune diseases had prevalence rates significantly higher than those previously documented in the literature (second generation p-value=0.000): type 1 diabetes mellitus (112.8/10,000, 95% confidence interval [CI]: 83.8-151.8), systemic lupus erythematosus (13.1/10,000, 95% CI: 5.5-31.5), and Graves’ disease (12.3/10,000, 95% CI: 4.0-38.4).

CONCLUSION: There is an increased prevalence of certain autoimmune diseases in youth who identify as TGD presenting for subspecialty care. Limitations such as retrospective study design, selection bias, and reliance on electronic medical records make it difficult to draw wide-reaching conclusions about these findings. This study highlights the need for more research to delineate the impacts of unrecognized or untreated GD on autoimmune disease development and control.

PMID:39109261 | PMC:PMC11299103 | DOI:10.1089/trgh.2022.0079

Transgend Health. 2024 Jun 17;9(3):232-240. doi: 10.1089/trgh.2022.0099. eCollection 2024 Jun.

ABSTRACT

PURPOSE: Using an intersectionality framework, we compared stigma and HIV care and treatment outcomes across transgender and cisgender women sex workers living with HIV in the Dominican Republic (DR).

METHODS: In 2018-2019, data were collected in Santo Domingo, DR, using interviewer-administered surveys among 211 cisgender women and 100 transgender women. We used t-tests and chi-square tests to examine differences in sex work stigma, HIV stigma, and HIV care and treatment.

RESULTS: Transgender participants reported more anticipated HIV stigma (mean=13.61, standard deviation [SD]=2.39) than cisgender participants (mean=12.96, SD=2.21; p=0.018), but there were no statistically significant differences for internalized or enacted HIV stigma. Cisgender participants reported more anticipated sex work stigma (cisgender: mean=50.00, SD=9.22; transgender: mean=44.02, SD=9.54; p<0.001), but transgender women reported more enacted (cisgender: mean=49.99, SD=9.11; transgender: mean=59.93, SD=4.89; p<0.001) and internalized sex work stigma (cisgender: mean=50.00, SD=8.80; transgender: mean=57.84, SD=8.34; p<0.001), with no significant differences in resistance to sex work stigma. Cisgender women were significantly more likely to have received HIV care (cisgender: 99.53%, transgender: 91.00%, p<0.001), be currently taking antiretroviral therapy (cisgender: 96.21%, transgender: 84.00%, p<0.001), and be virally suppressed (cisgender: 76.19%, transgender: 64.00%, p=0.025).

CONCLUSIONS: Transgender participants consistently had poorer HIV care and treatment outcomes compared with cisgender participants. Differences in stigma experiences between transgender and cisgender participants depended on the type of stigma. Findings reflect the intersectional nature of distinct types and forms of stigma among sex workers. Understanding the shared and unique experiences of transgender and cisgender women will improve HIV care engagement and viral suppression.

PMID:39109259 | PMC:PMC11299095 | DOI:10.1089/trgh.2022.0099

Tob Induc Dis. 2024 Aug 6;22. doi: 10.18332/tid/190798. eCollection 2024.

ABSTRACT

INTRODUCTION: The effectiveness of nicotine replacement therapy (NRT) in critically ill patients remains uncertain, as conflicting research results have been reported. Despite potential side effects and inconsistent data on safety and efficacy, NRT is still prescribed in intensive care units (ICUs) to prevent withdrawal symptoms and manage agitation in patients who are smokers. This meta-analysis aimed to assess the effectiveness of nicotine replacement therapy in critically ill smoking patients.

METHODS: A systematic review and meta-analysis of randomized controlled trials investigated the outcomes of smokers admitted to ICUs and were randomized either to receive or not receive nicotine replacement therapy (NRT) during their ICU stay. The MEDLINE and Embase databases were searched from inception through 13 February 2023 using OVID. The primary outcome was ICU length of stay (LOS) for this systematic review and meta-analysis. Meta-analysis was conducted using both random-effects and fixed-effect models; the latter is recommended when meta-analysis is restricted to just a few studies. The study was registered in the Prospective International Register of Systematic Reviews (PROSPERO) under reference number CRD42023407804.

RESULTS: Of 28 studies initially identified, three, with 67 patients on NRT and 72 controls, were deemed eligible for pooled analysis. Patients who received NRT experienced a shorter LOS (mean difference, MD= -3.06; 95% CI: -5.88 – -0.25, p=0.0, I²=0%). The mechanical ventilation (MV) duration was also shorter in the NRT group, but this difference was not statistically significant (MD= -1.24; 95% CI: -3.21-0.72, p=0.22, I²=12.69%). Delirium duration was reported by two studies, from which pooled analysis revealed an MD of -0.50 (95% CI: -1.63-0.62, I²=0%). The vasopressor duration was assessed in two studies, and the overall MD for vasopressor duration was not statistically different between NRT patients and controls in the fixed-effects model (MD=0.11; 95% CI: -0.75-0.96, I²=0%).

CONCLUSIONS: Critically ill smoker patients who received NRT experienced a significantly shorter ICU LOS but no significant differences in the durations of MV, vasopressor use, or delirium.

PMID:39109253 | PMC:PMC11302334 | DOI:10.18332/tid/190798

Front Pain Res (Lausanne). 2024 Jul 23;5:1444401. doi: 10.3389/fpain.2024.1444401. eCollection 2024.

ABSTRACT

INTRODUCTION: Chronic back pain is one of the most prevalent conditions and has a large socio-economic impact. The lack of routine use of non-pharmacological options and issues associated with pharmacological treatments underscore high unmet needs in the treatment of back pain. Although blue light phototherapy has proven efficacy in dermatology, limited information is available about its use in back pain.

METHODS: In this proof-of-concept, randomized controlled trial, a pain relief patch (PRP) delivered blue light at the site of back pain for 30 min during five treatment sessions. The comparator device delivered green light for 5 s but was worn for 30 min. A follow-up visit took place after the last treatment. The primary objective was to demonstrate the superiority of treatment by PRP, compared to the control device, in reducing pain intensity at the end of the treatment period. The post-treatment visual analog scale (VAS) pain intensity score for each group was calculated across the five treatment sessions and compared to the baseline. Secondary objectives included the disability score (Roland-Morris Disability Questionnaire) and safety.

RESULTS: The full analysis set included 171 patients. A statistically significant reduction in pain intensity occurred after the use of PRP (p < 0.02), but the study did not meet its primary objective of a superiority trial aimed at demonstrating a 0.6 cm difference in favor of PRP on the VAS scale. There was no significant change in the disability scores. Subgroup analyses were performed to identify the treatment response by patient characteristics such as pain intensity at baseline and skin type. As expected, safety data showed erythema and skin discoloration in the PRP group but not in the control group.

DISCUSSION/CONCLUSION: This trial had multiple limitations that need to be addressed in future research. Although the primary objective was not achieved, this proof-of-concept study provides important efficacy and safety data in relation to the use of blue light in the treatment of chronic back pain and key insights that may support further research on similar devices.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT01528332.

PMID:39109241 | PMC:PMC11300367 | DOI:10.3389/fpain.2024.1444401

Food Waterborne Parasitol. 2024 Jul 11;36:e00235. doi: 10.1016/j.fawpar.2024.e00235. eCollection 2024 Sep.

ABSTRACT

This review analyzed reported data of Cryptosporidium prevalence in camels and the species/genotype distribution. Four databases (PubMed, Web of Science, Scopus, Google Scholar) were screened, and studies published by April 1, 2024, were included. Total estimates and 95% CIs were calculated using a random-effects model. The weighted prevalence of Cryptosporidium spp. in 7372 camels examined from 12 different countries was estimated at 13.8% with a 95% CI of 10.3-18.4%. The sensitivity analysis based on excluding the individual studies did not result in significant statistical changes in the final weighted prevalence. Subgroup prevalence of Cryptosporidium spp. in camels was analyzed by publication year, continent, WHO region, country, camel type, sample size, diagnostic method, age, and gender. A significant publication bias (P < 0.05) was reported in the present study. Limitations encountered in this study encompassed: insufficient study diversity, reliance on single study results, inadequate molecular and serological studies in comparison to microscopic studies, etc., all of which could impact the findings. The study identified eight Cryptosporidium spp. in camels: C. parvum, C. andersoni, C. bovis, C. muris, C. ratti, C. occultus, C. ubiquitum, and C. hominis. The first three species had pooled prevalence rates of 65.5%, 66%, and 19.2%, respectively. Each of the remaining five species was documented using a single dataset/study. Moreover, genotypes IIdA19G1, IIaA15G1R1, If-like-A15G2, IIdA15G1, IIaA15G2R1, IIaA17G2R1, and IIaA18G2R1 (C. parvum), genotype IV (C. ratti), genotype XIIa (C. ubiquitum), and genotype IkA19G1 (C. hominis) have been identified in camels globally. The findings suggest that camels can act as a source of infection for a variety of Cryptosporidium species/genotypes, and can therefore play a key role in disseminating this protozoan to humans and animals.

PMID:39109171 | PMC:PMC11298603 | DOI:10.1016/j.fawpar.2024.e00235

Inj Prev. 2024 Aug 6:ip-2023-045191. doi: 10.1136/ip-2023-045191. Online ahead of print.

ABSTRACT

INTRODUCTION: Household energy transitions have the potential to reduce the burden of several health outcomes but have narrowly focused on those mediated by reduced exposure to air pollution, despite concerns about the burden of injury outcomes. Here, we aimed to describe the country-level incidence of severe cooking-related burns in Ghana and identify household-level risk factors for adults and children.

METHODS: We conducted a national household energy use survey including 7389 households across 370 enumeration areas in Ghana in 2020. In each household, a pretested version of the Clean Cooking Alliance Burns Surveillance Module was administered to the primary cook. We computed incidence rates of severe cooking-related burns and conducted bivariate logistic regression to identify potential risk factors.

RESULTS: We documented 129 severe cooking-related burns that had occurred in the previous year. The incidence rate (95% CI) of cooking-related burns among working-age females was 17 (13 to 21) per 1000 person-years or 8.5 times higher than that of working-age males. Among adults, the odds of experiencing a cooking-related burn were 2.29 (95% CI 1.02 to 5.14) and 2.40 (95% CI 1.04 to 5.55) times higher among primary wood and charcoal users respectively compared with primary liquified petroleum gas users. No child burns were documented in households where liquified petroleum gas was primarily used.

CONCLUSION: Using a nationally representative sample, we found that solid fuel use doubled the odds of cooking-related burns compared with liquified petroleum gas. Ghana’s efforts to expand access to liquified petroleum gas should focus on safe use.

PMID:39107102 | DOI:10.1136/ip-2023-045191

J Am Assoc Lab Anim Sci. 2024 Aug 6. doi: 10.30802/AALAS-JAALAS-24-047. Online ahead of print.

ABSTRACT

Swine are widely used models in biomedical research due to their physiologic and anatomic similarities to humans. During transport from vendors to research facilities, pigs are subject to a number of stressors, including environmental, social, and stress as a result of deprivation from food and water. As stress can have a number of adverse psychologic and physiologic effects, an acclimation period, defined as the period of time that an animal has to adjust and stabilize in a new environment, is recommended. The literature indicates that swine should be conditioned to their new facility for 5 to 7 d prior to undergoing survival surgery; however, to date, there is no published scientific evidence to support this or any specific acclimation period for swine. To investigate whether a certain length acclimation period leads to decreased stress in swine, we measured 2 stress biomarkers, cortisol and chromogranin A (CgA), from the saliva of 12 naive Yorkshire swine (n = 6 males and 6 females) arriving at our facility for use in research protocols. Noninvasive saliva collection was performed on days 1, 3, 5, 7, 10, and 14 after arrival from the vendor (representing different acclimation periods). We hypothesized that longer acclimation periods would result in reduced levels of both cortisol and CgA, indicating reduced stress. Our data revealed that there was no statistical difference in cortisol levels over time (P = 0.8200), nor between the sexes (P = 0.9886) or individual animals (P = 0.6280). CgA, similarly to cortisol, showed no overall effect of time (P = 0.2017) or sex (P = 0.6598). For this analyte, individual animal was significant (P < 0.0001), which suggests high interanimal variation. Furthermore, there was a significant decrease (P = 0.0077) in salivary CgA from day 1 compared with day 14, suggesting that swine may benefit from an acclimation period of at least 14 d.

PMID:39107079 | DOI:10.30802/AALAS-JAALAS-24-047

BMJ Open Diabetes Res Care. 2024 Aug 6;12(4):e003841. doi: 10.1136/bmjdrc-2023-003841.

ABSTRACT

INTRODUCTION: The objective of this study was to determine the burden of influenza disease in patients with or without diabetes in a population of American adults to understand the benefits of seasonal vaccination.

RESEARCH DESIGN AND METHODS: We performed a retrospective cohort study using electronic medical records totaling 1,117,263 from two Louisiana healthcare providers spanning January 2012 through December 2017. Adults 18 years or older with two or more records within the study period were included. The primary outcome quantified was influenza-related diagnosis during inpatient (IP) or emergency room (ER) visits and risk reduction with the timing of immunization.

RESULTS: Influenza-related IP or ER visits totaled 0.0122-0.0169 events per person within the 2013-2016 influenza seasons. Subjects with diabetes had a 5.6-fold more frequent influenza diagnosis for IP or ER visits than in subjects without diabetes or 3.7-fold more frequent when adjusted for demographics. Early immunization reduced the risk of influenza healthcare utilization by 66% for subjects with diabetes or 67% for subjects without diabetes when compared with later vaccination for the 2013-2016 influenza seasons. Older age and female sex were associated with a higher incidence of influenza, but not a significant change in risk reduction from vaccination.

CONCLUSIONS: The risk for influenza-related healthcare utilization was 3.7-fold higher if patients had diabetes during 2013-2016 influenza seasons. Early immunization provides a significant benefit to adults irrespective of a diabetes diagnosis. All adults, but particularly patients with diabetes, should be encouraged to get the influenza vaccine at the start of the influenza season.

PMID:39107077 | DOI:10.1136/bmjdrc-2023-003841

Life Sci Alliance. 2024 Aug 6;7(10):e202402713. doi: 10.26508/lsa.202402713. Print 2024 Oct.

ABSTRACT

Probabilistic topic modelling has become essential in many types of single-cell data analysis. Based on probabilistic topic assignments in each cell, we identify the latent representation of cellular states. A dictionary matrix, consisting of topic-specific gene frequency vectors, provides interpretable bases to be compared with known cell type-specific marker genes and other pathway annotations. However, fitting a topic model on a large number of cells would require heavy computational resources-specialized computing units, computing time and memory. Here, we present a scalable approximation method customized for single-cell RNA-seq data analysis, termed ASAP, short for Annotating a Single-cell data matrix by Approximate Pseudobulk estimation. Our approach is more accurate than existing methods but requires orders of magnitude less computing time, leaving much lower memory consumption. We also show that our approach is widely applicable for atlas-scale data analysis; our method seamlessly integrates single-cell and bulk data in joint analysis, not requiring additional preprocessing or feature selection steps.

PMID:39107066 | DOI:10.26508/lsa.202402713