Tag: pubmed

J Diabetes Investig. 2024 Nov 21. doi: 10.1111/jdi.14340. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the risk of biliary diseases in patients with type 2 diabetes mellitus (T2DM) or obesity treated with tirzepatide.

METHODS: Literature searches were performed using the PubMed, Web of Science, Cochrane Library, and CNKI databases until 20 May 2024. Randomized controlled studies (RCTs) investigating the safety of tirzepatide vs placebo/other hypoglycemic drugs in patients with T2DM or obesity were included. The safety outcomes mainly included the incidence of cholelithiasis, pancreatitis, cholecystitis, and gallbladder/biliary diseases. Cochrane Collaboration’s tool for assessing the risk of bias was used to assess the quality of literature. Heterogeneity was evaluated using I² statistics.

RESULTS: A total of 12 high-quality RCTs (involving 12,351 patients) were included. The results of meta-analysis showed that tirzepatide was associated with gallbladder/biliary diseases (RR = 1.52; 95%CI: 1.17-1.98; I² = 0%, P = 0.76) and cholelithiasis (RR = 1.67; 95%CI: 1.14-2.44; I² = 0%, P = 0.95). Subgroup analysis based on the dose of tirzepatide found no dose-response relationship between different doses of tirzepatide and the risk of gallbladder/biliary diseases and cholelithiasis.

CONCLUSIONS: Based on the data currently available, tirzepatide is associated with the development of cholelithiasis in patients. However, the findings from RCTs still need to be further investigated in many post-marketing safety surveillance programs.

PMID:39569606 | DOI:10.1111/jdi.14340

J Orthop Res. 2024 Nov 21. doi: 10.1002/jor.26019. Online ahead of print.

ABSTRACT

Guided growth for correction of rotational deformities has been reported in several preclinical and clinical studies. Different adverse effects, like growth retardation, articular deformities, and rebound effect have been reported. We have tested a novel plate concept (RotOs Plate^TM) intended for the correction of rotational deformities of long bones by guided growth in a porcine model. The plate has sliding screw holes intended to allow for longitudinal growth. Fourteen skeletally immature female pigs were included in the study in a paired design. Mean duration of intervention was 88 days (83-98). CTscans and X-rays were performed at plate insertion and removal. From the CTscans, 3D-models of the left and right femora were made and used for measuring the achieved rotation. Three pigs were excluded for reasons not related to the plate design. The plates rotated as intended in all pigs. In two pigs, there was a cut-out of the proximal screw on the lateral side. Data from these two pigs were included in the results. We observed a mean difference in rotation between the left and right femur of 5.7° in the external direction (CI: 3.7°-7.7°). No statistically significant deformities in the coronal and sagittal plane were observed. The plate worked as intended, that is, the intended rotation was achieved. CLINICAL SIGNIFICANCE: This large animal study shows promising results for the feasibility of the method. It is an important first step in validating the technique and detecting possible adverse effects before clinical studies.

PMID:39569605 | DOI:10.1002/jor.26019

Child Neuropsychol. 2024 Nov 21:1-19. doi: 10.1080/09297049.2024.2426272. Online ahead of print.

ABSTRACT

This study aimed to assess the extent of cognitive impairment in children and adolescents with Juvenile Idiopathic Arthritis (JIA). While cognitive deficits are recognized in other systemic rheumatic diseases, exploration within the pediatric JIA population remains limited. The investigation utilized a comprehensive approach to examine neuropsychological test performance. A cohort of 160 participants (79 JIA, 81 healthy controls aged 8-17) underwent evaluations using the Pediatric Quality of Life Inventory (PedsQL), Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and the computerized neurocognitive test battery Central Nervous System Vital Signs (CNSVS). Children with JIA exhibited statistically significant cognitive deficits across various parameters (p < .05). This was associated with an increased prevalence of lifelong psychiatric illnesses and diminished overall quality of life compared to healthy counterparts (p < .05). Analysis highlighted that specific JIA subtypes, excluding Oligoarthritis, significantly elevated the risk of neurocognitive impairments, emphasizing the impact on various cognitive outcomes (OR range: 3.1-5.1, 95% CI: 1.163-19.980). Additionally, the active disease stage was identified as a specific risk factor, amplifying the likelihood of low executive functions by 4.3 times (OR: 4.363, 95% CI: 1.095-17.378). This study underscores the critical importance of recognizing and addressing neurocognitive impairments in children with JIA. Specific attention to disease subtypes and activity levels is crucial, with the potential for targeted interventions to enhance overall cognitive well-being and quality of life in this vulnerable population.

PMID:39569588 | DOI:10.1080/09297049.2024.2426272

Subst Use Addctn J. 2024 Nov 21:29767342241293334. doi: 10.1177/29767342241293334. Online ahead of print.

ABSTRACT

BACKGROUND: Populations disproportionately impacted by the opioid epidemic are less likely to receive medications for opioid use disorder (MOUD; OUD). The COVID-19 pandemic exacerbated these disparities. We performed an ecological survey of subpopulations to compare differences in MOUD receipt among Veterans with OUD before versus during the pandemic.

METHODS: Using 2 cross-sections of 2 time periods of national Veterans Health Administration electronic health record data, we calculated proportions of Veterans with any MOUD receipt by demographics, Elixhauser comorbidity index, and natural language processing (NLP)-derived substance use and social determinants of health in each time period. We evaluated differences in MOUD receipt before and during the pandemic by patient characteristics using Chi-square and Cohen’s h for effect size.

RESULTS: Among 62 195 patients with OUD before the pandemic, the proportion prescribed MOUD increased from 46.5% before to 47.5% (P = .0003) during the pandemic. Statistically significant increased receipt of MOUD was observed for patients who were ≥55 years, men, White, with Elixhauser comorbidity indices of 2 and ≥5, and with NLP-derived indicators of substance use. There was a decrease that did not achieve statistical significance in MOUD receipt from before to during the pandemic for patients who were women, Black, Latinx, and food insecure.

CONCLUSIONS: The proportions of patients with OUD prescribed MOUD increased from before to during the pandemic. However, Veterans who were women, Black, Latinx, and food insecure did not experience these increases. These patients may benefit from interventions such as targeted outreach efforts to improve MOUD engagement to reduce OUD harms.

PMID:39569566 | DOI:10.1177/29767342241293334

Int Nurs Rev. 2024 Nov 21. doi: 10.1111/inr.13072. Online ahead of print.

ABSTRACT

AIM: This systematic review and meta-analysis aimed to analyze studies that examined the relationship between psychological capital and burnout in registered nurses.

BACKGROUND AND INTRODUCTION: Registered nurses are subject to high rates of burnout, with negative consequences on health, well-being, and quality of care. Psychological capital could be an important element in preventing or reducing this condition.

METHODS: This research is based on the Joanna Briggs Institute Guidelines and Preferred Reporting Items for systematic reviews and meta-analysis. A total of 180 studies on psychological capital and burnout were retrieved from Web of Science, Scopus, PubMed, Medline, and PsycINFO. The articles were written in English, Spanish, French, and Portuguese. Then, 23 studies were included in several meta-analyses (random-effects models) performed with the R statistical program.

RESULTS: Analysis of the 23 studies revealed that psychological capital and burnout are significantly correlated. The Psychological Capital Questionnaire (PCQ) and the Maslach Burnout Inventory (MBI) were the most used scales to measure psychological capital and burnout, respectively. The meta-analyses showed an inverse correlation between psychological capital and burnout (r = -0.44, 95% CI [-0.51, -0.36], n = 6092), and emotional exhaustion (r = -0.32, 95% CI [-0.42, -0.21], n = 3349).

CONCLUSION: This review provides evidence of the negative relationship between psychological capital and burnout in registered nurses. Therefore, enhancing psychological capital is an effective strategy to prevent and reduce burnout in nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY: Psychological capital is a personal resource open to development over time and susceptible to interventions aimed at promoting optimism, efficacy, hope, and resilience. In that sense, training aimed at improving psychological capital, as a protective mechanism to prevent and reduce burnout and emotional exhaustion, should be considered together with organizational measures to promote nurses’ health and well-being.

PMID:39569557 | DOI:10.1111/inr.13072

Acta Radiol. 2024 Nov 21:2841851241296029. doi: 10.1177/02841851241296029. Online ahead of print.

ABSTRACT

BACKGROUND: Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), which indicates biological tissue attributes, may be applied to accurately assess breast tumors.

PURPOSE: To analyze the IVIM parameters of different molecular prognostic factors and subtypes to find out whether there are any connections.

MATERIAL AND METHODS: A total of 181 patients enrolled in this retrospective study had preoperative magnetic resonance imaging (MRI) examinations, and pathologies were verified as breast cancers. Regions of interest were placed at all slices of the parameter maps (D, tissue diffusivity; ADC, apparent diffusion coefficient; f, perfusion fraction; and D*, pseudo-diffusivity maps) of IVIM and generated parameter values to be used for comparative analysis among molecular prognostic factors and subtypes.

RESULTS: D and ADC were greater in estrogen receptor (ER)-negative, human epidermal growth factor receptor 2 (HER2)-positive, and Ki67-low expression groups (all P values < 0.05). The progesterone receptor (PR)-negative group had a higher D value (P < 0.05). f was larger in the lymph node metastasis-negative group and the PR-positive group (P = 0.012 and 0.046, respectively). Among breast cancer subtypes, D and ADC were different between the HER2-overexpression and the Luminal B (HER2-negative) subtypes (P = 0.019 and 0.028, respectively). The difference in D between the luminal and non-luminal subtypes was statistically significant (P = 0.008). The triple-negative subtype significantly differs from the other subtypes in D* and f (P = 0.012 and 0.016, respectively).

CONCLUSION: IVIM-related metrics exhibited relationships with breast cancer molecular prognosis factors and subtypes.

PMID:39569544 | DOI:10.1177/02841851241296029

Cancer Control. 2024 Jan-Dec;31:10732748241303425. doi: 10.1177/10732748241303425.

ABSTRACT

OBJECTIVES: The objective of this study was to assess the impact of the COVID-19 pandemic, after 2 years, on mammographic screening in Brazil evaluating BIRADS® results, breast cancer diagnosis rates, and breast cancer stage.

STUDY DESIGN: This was an ecological observational study based on retrospective data from Brazil’s mammographic screening program from 2015 to 2023.

METHODS: Data were obtained from the national screening database DATASUS – SISCAN (Cancer System Information) and retrieved in March 2024. Inclusion criteria comprised completeness of mammogram data (incomplete records were excluded), female participants aged 50 to 69 years, and mammograms exclusively performed for screening purposes. The study analyzed the number of mammograms conducted during the specified period, focusing on BIRADS® test results.

RESULTS: Out of 23,851,371 mammograms performed between 2015 and 2023, 15,000,628 were included for analysis. A significant reduction of 39.6% in mammograms was observed in 2020 compared to 2019, followed by a 12.6% decrease in 2021. Notably, a substantial rise in BIRADS categories 4 and 5 examinations was seen post-pandemic. Breast cancer staging analysis revealed a shift towards more advanced stages (III and IV) diagnosed post-pandemic, suggesting potential delays in detection and diagnosis.

CONCLUSIONS: In conclusion, the study highlighted significant discrepancies in mammographic screenings and breast cancer diagnosis rates over 9 years. The pandemic reflected significant influence on the timing and stage at diagnosis, suggesting potential delays in detection and diagnosis that resulted in later identification of more advanced disease stages.

PMID:39569512 | DOI:10.1177/10732748241303425

Am J Health Syst Pharm. 2024 Nov 21:zxae346. doi: 10.1093/ajhp/zxae346. Online ahead of print.

ABSTRACT

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE: A previous study at Ascension Seton Hospital Network (ASHN) found a 1:1 dose conversion to insulin detemir 100 units/mL (iDet100) from insulin glargine 300 units/mL (iGlar300) increased the incidence of hypoglycemia as compared to a 1:1 conversion from insulin glargine 100 units/mL. No studies have evaluated an automatic 20% dose reduction for this specific therapeutic interchange. The purpose of this study was to compare hypoglycemia rates following implementation of a protocol specifying a minimum 20% dose reduction when converting from iGlar300 to inpatient iDet100.

METHODS: This multicenter, retrospective chart review-based study was a before/after study evaluating the impact of an ASHN protocol implemented in April 2021 requiring a minimum 20% reduction when converting from home iGlar300 to inpatient iDet100. Previously, a 1:1 interchange was standard. Patients admitted between May 2019 and December 2022 were included if at least 1 dose of iDet100 was received following interchange from iGlar300. The primary endpoint was hypoglycemia incidence before and after protocol implementation. Secondary endpoints included time to first hypoglycemia and number of doses given before hypoglycemia. Logistic regression was performed to analyze the relationship between percent interchange from home dose and hypoglycemia rate.

RESULTS: A total of 284 patients were included: 128 in the preprotocol arm and 156 in the postprotocol arm. The incidence of hypoglycemia was significantly lower in the postprotocol arm than in the preprotocol arm (11.9% vs 24.7%; P = 0.018). The median time to first hypoglycemia was longer in the postprotocol versus the preprotocol arm, though the difference was not statistically significant (13 vs 18.5 hours, P = 0.082). For each percent reduction from iGlar300 to iDet100, the likelihood of hypoglycemia was reduced by 5.3%.

CONCLUSION: A protocol requiring a minimum 20% dose reduction from iGlar300 to inpatient iDet100 reduced the incidence of hypoglycemia. Health systems should consider adopting a similar approach to reduce the occurrence of hypoglycemia upon interchange.

PMID:39569508 | DOI:10.1093/ajhp/zxae346

Int Health. 2024 Nov 21:ihae083. doi: 10.1093/inthealth/ihae083. Online ahead of print.

ABSTRACT

BACKGROUND: We explored the relationship between adolescent physical activity levels, socio-economic conditions and body mass index (BMI) in order to gain a deeper understanding of the relevant factors affecting adolescent obesity.

METHODS: A stratified random sampling method was used to conduct a questionnaire survey of middle school students in the Chengdu-Chongqing Economic Zone. Multiple linear and logistic regression analysis methods were used to statistically analyse the data obtained.

RESULTS: The level of moderate to vigorous physical activity (MVPA) not only significantly reduces the incidence of obesity in adolescents, it also has a positive effect on avoiding underweight in adolescents. The impact of a father’s BMI on a son’s weight is higher than that of a daughter, while the impact of a mother’s BMI on a child’s weight is the opposite. High monthly income has a positive effect on reducing the BMI of male and female adolescents, but full-time working mothers actually increase the risk of obesity in their children. Teenagers who have exercise habits or view exercise as a form of enjoyment have a significantly reduced risk of obesity.

CONCLUSIONS: The level of MVPA and exercise habits are important factors in inhibiting the development of obesity in adolescent students.

PMID:39569471 | DOI:10.1093/inthealth/ihae083

Clin Exp Dermatol. 2024 Nov 21:llae515. doi: 10.1093/ced/llae515. Online ahead of print.

ABSTRACT

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that significantly impacts patients’ quality of life and mental health. Effective management often involves both medical and surgical interventions. The aim of the study was to assess the effectiveness of wide local excision and secondary intention healing in improving quality of life and mental health in patients with moderate to severe HS.

METHODS: A single-center prospective study was conducted with 40 patients suffering from moderate to severe HS, refractory to prior treatments. Pre-surgical ultrasound mapping of lesions was performed using Ultra High-Frequency Ultrasound (UHFUS). Patients underwent wide surgical excision followed by secondary intention healing based on HS-TIME principles. Quality of life was measured using Skindex-16, and mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with subscales for anxiety (HADS-A) and depression (HADS-D). Assessments were conducted at baseline, 4 weeks post-surgery, and after complete wound healing. Statistical analyses included paired t-tests and multiple linear regression to determine factors influencing outcomes.

RESULTS: The study included 14 males and 26 females with a mean age of 39 years. Significant improvements were observed in Skindex-16 scores (pre: 57.92, post: 16.03) and HADS scores (HADS-A: pre: 6.13, post: 2.63; HADS-D: pre: 5.50, post: 3.21), indicating reduced pain, discomfort, and psychological distress. Multivariate analysis revealed that improvements were associated with male sex, HS stage II, longer disease duration, and lower BMI.

CONCLUSION: Wide local excision combined with secondary intention healing significantly improves quality of life and mental health in HS patients. The findings suggest that a comprehensive approach addressing both surgical and psychological aspects can enhance patient outcomes. Future research should focus on long-term benefits and the development of standardized postoperative care protocols.

PMID:39569455 | DOI:10.1093/ced/llae515