Tag: pubmed

Eur J Nutr. 2024 Nov 28;64(1):30. doi: 10.1007/s00394-024-03547-z.

ABSTRACT

PURPOSE: Vitamin D supplementation positively impacts anemia, but the relationship between a ferritin-related dietary pattern, iron parameters, and vitamin D in anemia is unclear.

METHODS: This cross-sectional study analyzed data from the 2017-2019 National Nutrition and Health Survey, including 1423 pregnant women over 15 years old. Dietary intake was assessed using a semi-quantitative food frequency questionnaire and a 24-hour dietary recall. The FrDP was identified using reduced rank regression with blood parameters as response variables and 32 food groups as predictors. Linear and binomial logistic regression analyses evaluated the associations between the FrDP and serum biomarkers, adjusting for demographic and dietary variables. Risk associations between the FrDP and vitamin D concentrations were also assessed.

RESULTS: The FrDP explained 18.5% of the variation in 6 response variables and was characterized by high consumption of fish, soy, gluten pasta, nuts, organ meat, pickled vegetables, and marine plants. The FrDP correlated positively with serum hemoglobin (r = 0.76), iron (r = 0.52), ferritin (r = 0.79), folate (r = 0.86), and vitamin B₁₂ (r = 0.86). Linear regression revealed a positive association between the FrDP and serum iron. Women in the highest FrDP tertile were less likely to have low serum iron (OR = 0.65, 95% CI 0.50-0.85) but more likely to have low 25(OH) vitamin D concentrations (OR = 1.79, 95% CI 1.32-2.43).

CONCLUSIONS: The FrDP was positively associated with serum iron but negatively associated with serum 25(OH) vitamin D in pregnant women.

PMID:39607573 | DOI:10.1007/s00394-024-03547-z

Am J Hosp Palliat Care. 2024 Nov 28:10499091241304728. doi: 10.1177/10499091241304728. Online ahead of print.

ABSTRACT

Introduction: Measuring palliative care needs of patients with multiple complex illnesses and their family, is essential for providing quality clinical care. The integrated palliative care outcome scale (IPOS) is a scientifically verified measure of patients’ physical, emotional symptoms, and their palliative care communication and practical needs. The patients in this study require palliative care due to both their end-of-life heart failure (HF) and vascular dementia. Purpose: The purposes are to describe and compare home palliative care needs measured by the family caregivers (N = 20) and patients (N = 20) IPOS scores and to examine whether the patient IPOS total score can predict patient HF health status and caregiving burden scores. Methods: This study uses explanatory research design with rigorous methods for obtaining information from multiple sources. Descriptive, Cohen’s Kappa (k) statistics comparing patient and caregiver IPOS scores and regression analyses to examine the patient IPOS scores impact on patient HF health status and caregiving burden scores were used. Results: There was significant agreement between patient and caregiver ratings on 16 out of 17 IPOS items (k = .34 to .80). Regression analyses found that the patient IPOS total score significantly predicted patients’ HF health status (β = -.50, P < .05), and caregiving burden scores (β = .57, P < .01). Conclusion: Patients’ and their caregivers’ IPOS scores agreement indicates palliative care needs can be consistently identified. The patient IPOS total scores can predict patients’ HF health status and caregiving burden. These measures provide information directly applicable for health professionals guiding palliative home care.

PMID:39606853 | DOI:10.1177/10499091241304728

Prim Health Care Res Dev. 2024 Nov 28;25:e64. doi: 10.1017/S1463423624000574.

ABSTRACT

BACKGROUND AND OBJECTIVE: Early and collaborative interventions are desirable to prevent long-term sick leave and promote sustainable return-to-work (RTW). The aim of this study was to evaluate if the use of the Capacity Note – a brief intervention promoting early and structured communication between general practitioners (GPs), patients, and employers – had an impact on length of sick leave in patients with common mental disorders (CMDs) in primary healthcare.

METHOD: In a pragmatic trial, GPs at eight primary healthcare centres were randomized to provide the intervention or control and recruited eligible patients: employed women and men, 18-64 years, who visited a GP due to CMD and became or were (<4 months) full- or part-time sick-listed. Patients in the intervention group (n=28) used the Capacity Note in addition to usual care. Patients in the control group (n=28) received usual care. Outcomes of interest were time until full RTW, sick leave status at end of follow-up (17 months), number of sick leave episodes during follow-up, and number of sick leave days at 6, 12, and 17 months of follow-up.

RESULTS: The proportion of patients with full RTW at the end of follow-up was 79.2% in the intervention group and 84.6% in the control group. Time until full RTW was 102 and 90 days (median) in intervention and control group, respectively. We found no statistically significant differences between the groups for any of the outcomes.

DISCUSSION: Despite efforts to increase the number of participants, the study ended up with a small sample. This prohibited us from drawing any final conclusions about the effect of the intervention. Obstacles to recruitment of patients and use of the intervention are discussed.

PMID:39606847 | DOI:10.1017/S1463423624000574

J Med Microbiol. 2024 Nov;73(11). doi: 10.1099/jmm.0.001935.

ABSTRACT

Introduction. Cytomegalovirus (CMV) is a widely disseminated betaherpesvirus that typically induces latant infections. In immunocompromised populations, especially transplant and HIV-infected patients, CMV infection increases in-hospital mortality.Gap statement. Although machine learning models have been widely used in clinical diagnosis and prognosis prediction, reports on machine learning model predictions for the in-hospital mortality of HIV/AIDS patients with CMV infection have not been reported.Aim. Analyze the general gemographic and clinical characteristics of HIV/AIDS patients with CMV infection and identify the factors affecting the prognosis of this population, which will help to reduce their in-hospital mortality.Methods. Hospitalized HIV/AIDS patients with CMV infection were recruited from the Fourth People’s Hospital of Nanning, Guangxi, from 2012 to 2019. After dividing them into survival and death groups based on their in-hospital survival status, their general and clinical profiles were described. Following 1 : 3 propensity score matching to equalize baseline characteristics, three machine-learning models (Random Forest, Support Vector Machine and eXtreme Gradient Boosting) were deployed to forecast factors influencing prognosis. The SHapley Additive exPlanations tool explained the models.Results. A total of 1102 HIV/AIDS patients with CMV infection were analysed. There was no statistical difference in the general condition of the study subjects (P＞0.05). Prevalent complications/coinfections included pneumonia (63.6%), tuberculosis (47.2%) and oral fungal infections (44.6%). There were significant differences between the groups in pneumonia, cryptococcosis and hypoproteinaemia (P<0.05). The differences in laboratory indicators between patients were also statistically significant (P<0.05). The three machine learning models demonstrated good performance, identifying primary predictors of mortality. Pneumonia, urea, indirect bilirubin and platelet distribution width exhibited positive associations with death, with higher levels correlating with an increased mortality risk. Conversely, CD4 T-cell count, CD8 T-cell count and platelet displayed negative correlations with mortality.Conclusions. HIV/AIDS patients with CMV infection exhibit distinctive clinical features impacting survival outcomes. Machine learning models accurately identify key influencing factors and predict mortality risk in this population, which appears to be essential to reducing in-hospital mortality.

PMID:39606806 | DOI:10.1099/jmm.0.001935

Front Hum Neurosci. 2024 Nov 13;18:1497034. doi: 10.3389/fnhum.2024.1497034. eCollection 2024.

ABSTRACT

In hyperscanning studies, participants perform a joint task while their brain activation is simultaneously recorded. Evidence of inter-brain coupling is examined, in these studies, as a predictor of behavioral change. While the field of hyperscanning has made significant strides in unraveling the associations between inter-brain coupling and changes in social interactions, drawing causal conclusions between brain and behavior remains challenging. This difficulty arises from factors like the inherently different timescales of behavioral responses and measured cerebral activity, as well as the predominant focus of existing methods on associations rather than causality. Specifically, a question remains as to whether inter-brain coupling between specific brain regions leads to changes in behavioral synchrony, or vice-versa. We propose two novel approaches to addressing this question. The first method involves using dyadic neurofeedback, wherein instances of inter-brain coupling are directly reinforced. Such a system could examine if continuous changes of inter-brain coupling are the result of deliberate mutual attempts to synchronize. The second method employs statistical approaches, including Granger causality and Structural Equation Modeling (SEM). Granger causality assesses the predictive influence of one time series on another, enabling the identification of directional neural interactions that drive behavior. SEM allows for detailed modeling of both direct and indirect effects of inter-brain coupling on behavior. We provide an example of data analysis with the SEM approach, discuss the advantages and limitations of each approach and posit that applying these approaches could provide significant insights into how inter-brain coupling supports crucial processes that occur in social interactions.

PMID:39606786 | PMC:PMC11599244 | DOI:10.3389/fnhum.2024.1497034

Toxicol Rep. 2024 Nov 4;13:101799. doi: 10.1016/j.toxrep.2024.101799. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Oral isotretinoin is a powerful medication commonly used for treating severe Acne valgaris, particularly in cases that are resistant to conventional therapies like topical treatments and antibiotics. It is a retinoid derived from vitamin A, known for its ability to significantly reduce sebum production, prevent clogged pores, and decrease inflammation.

OBJECTIVE: This study investigates the changes in liver function tests and lipid profiles before and after the use of oral isotretinoin among Acne Vulgaris clients.

METHOD: A quantitative retrospective study was conducted using electronic medical records from 50 Acne Vulgaris patients aged 13-40 years who received oral isotretinoin at Ibri Polyclinic between 2012 and 2022. The obtained data were analyzed using SPSS version 20.

RESULTS: The analysis revealed significant changes in liver function tests, with elevated levels of total bilirubin and ALT post-treatment. Lipid profiles also showed marked alterations, including increased cholesterol, LDL, HDL, and triglyceride levels.

CONCLUSION: The findings highlight the substantial impact of isotretinoin on liver function and lipid metabolism in Acne Vulgaris patients. Further research is needed to explore the mechanisms behind isotretinoin-induced hepatotoxicity and dyslipidemia, potentially guiding future interventions.

PMID:39606776 | PMC:PMC11600753 | DOI:10.1016/j.toxrep.2024.101799

J Saudi Heart Assoc. 2024 Nov 15;36(4):316-334. doi: 10.37616/2212-5043.1399. eCollection 2024.

ABSTRACT

OBJECTIVES: Mitral valve surgery is the reference treatment for severe symptomatic mitral regurgitation (MR). Percutaneous mitral valve interventions, such as the MitraClip procedure, offer an alternative, particularly for high-risk patients. The aim of this systematic review and meta-analysis was to analyze the safety and effectiveness of transcatheter mitral valve repair (TMVR) compared to surgical mitral valve repair or replacement (SMVR) in elderly patients with mitral regurgitation.

METHODS: We searched PubMed, Scopus, Ovid, EBSCO, and ProQuest through July 2024. Eligible studies were randomized controlled trials and observational comparative studies of TMVR versus SMVR for patients with MR, reporting outcomes such as all-cause mortality, MR recurrence, stroke, myocardial infarction, and length of stay (LOS). Statistical analyses were performed using RevMan.

RESULTS: Our search identified 3166 records, with 2756 screened and 21 studies included after review. The studies, comprising 20 retrospective cohorts and 1 randomized controlled trial with 20,900 patients, compared TMVR to SMVR. TMVR patients were significantly older than SMVR patients (MD 3.44 years; P < 0.00001). Mortality rates were similar at 30 days (relative risk (RR) 1.08; P = 0.79) and one year (RR 1.27; P = 0.18), but SMVR showed lower mortality at three years (RR 1.82; P = 0.006). SMVR also significantly reduced MR ≥ 3+ recurrence at 30 days (RR 6.95; P < 0.00001), one year (RR 3.31; P = 0.0001), and three years (RR 4.37; P < 0.00001). TMVR was associated with higher myocardial infarction rates (RR 1.58; P = 0.02) but reduced LOS (MD -4.88 days; P < 0.00001). Sensitivity analysis showed consistent results for recurrence of MR ≥ 3+ and variable outcomes for other metrics. Evidence of publication bias was noted for mortality at 30 days and LOS.

CONCLUSION: While TMVR with the MitraClip offers shorter hospital stays and is less invasive, SMVR provides better long-term survival and lower MR recurrence rates, emphasizing the need for a tailored approach based on patient risk profiles.

PMID:39606773 | PMC:PMC11590862 | DOI:10.37616/2212-5043.1399

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231180. doi: 10.47626/1679-4435-2023-1180. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: The military police officer is exposed to several risk factors that could lead to physical and psychiatric disorders. However, there is a paucity of scientific literature on the health of special operations police officers.

OBJECTIVES: To identify the main causes and associated factors of forensic medical examinations among members of a Battalion of Special Police Operations.

METHODS: This cross-sectional study analyzed data from 210 forensic medical examinations performed between January 2019 and June 2021. The dependent variable was the reason for the appointment, and the independent variables were gender, age, military rank, and length of career. Bivariate analyses were performed using the chi-squared test or Fisher’s exact test.

RESULTS: Most police officers were men (98.1%), military (41.8%), with a mean age of 36.6 years and a mean length of service of 12.9 years. The most common reason for an examination was to obtain a physical fitness report (44.3%), followed by routine examination of healthy police officers (17.6%) and trauma (14.3%). There were no statistically significant associations between the independent variables and trauma appointments. However, there was a statistical association between appointments for physical fitness reports and being under 35 years of age.

CONCLUSIONS: Most common reasons for forensic medical examinations were physical fitness reports, routine examinations, and trauma. Examinations for physical fitness reports were statistically associated with younger age.

PMID:39606772 | PMC:PMC11595399 | DOI:10.47626/1679-4435-2023-1180

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231131. doi: 10.47626/1679-4435-2023-1131. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: The demands and conditions of work can lead to development of a range of health conditions, including repetitive stress injuries and work-related musculoskeletal disorders.

OBJECTIVES: To assess the prevalence of musculoskeletal symptoms and the working conditions of primary school teachers working for the public municipal education system in Cuiabá, Mato Grosso, Brazil.

METHODS: A cross-sectional study was conducted with teachers working for the public municipal education system in the capital of Mato Grosso state. The sample comprised 326 teachers. Data were collected using the Vocal Production Condition – Teacher instrument and the Nordic Musculoskeletal Questionnaire.

RESULTS: The mean age of the sample was 43.01 years and teachers were predominantly female (87.12%), were married or in a stable relationship (62.70%), had postgraduate qualifications (73.93%), worked at one school only (58.95%), and stated that the pace of their working routine was sometimes stressful (59.01%), that they always took work home with them (57.45%), and that there was sometimes stress at work (54.92%), and reported presence of musculoskeletal symptoms during the last 12 months (76.74%).

CONCLUSIONS: The highest prevalence rates of musculoskeletal symptoms were observed among married women, those with postgraduate qualifications, those who worked at one school only, and those who had a stressful working routine. It was therefore concluded that mapping working conditions could provide a foundation for reducing the occurrence of musculoskeletal symptoms and improving the health of this population.

PMID:39606762 | PMC:PMC11595378 | DOI:10.47626/1679-4435-2023-1131

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231215. doi: 10.47626/1679-4435-2023-1215. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: More than 500,000 work accidents were registered each year in Brazil from 2016 to 2018, representing more than BRL 300 million in expenditures.

OBJECTIVES: To analyze the prevalence of work accidents in Brazil between 2016 and 2020 according to geographic region, age group, and sex and analyze the prevalence according to the cause and economic activity type.

METHODS: Descriptive, cross-sectional study based on data from the Social Security Statistics Yearbook.

RESULTS: The work accident rate between 2016 and 2019 was lower than in previous years. The Southern and Southeastern regions had the highest prevalence of work accidents (11.7/1,000 workers and 9.10/1,000 workers, respectively), while the Northeastern region had the lowest rate (6.22/1,000 workers). There was a greater reduction in work accidents among men than women. The most prevalent types of work accidents involved injuries, poisoning, and other external causes, in addition to diseases of the musculoskeletal system and connective tissue.

CONCLUSIONS: Record keeping about work accidents must be improved, given that informal workers are not considered in social security data. More accurate data can also help increase prevention efforts, and can lead to more effective occupational health and safety policies to further reduce the work accident rate.

PMID:39606761 | PMC:PMC11595383 | DOI:10.47626/1679-4435-2023-1215