Tag: pubmed

J Leukoc Biol. 2024 Oct 21:qiae223. doi: 10.1093/jleuko/qiae223. Online ahead of print.

ABSTRACT

Although the SARS-CoV-2 infection has established risk groups, identifying biomarkers for disease outcomes is still crucial to stratify patient risk and enhance clinical management. Optimal efficacy of COVID-19 antiviral medications relies on early administration within the initial five days of symptoms, assisting high-risk patients in avoiding hospitalization and improving survival chances. The complete blood count can be an efficient and affordable option to find biomarkers that predict the COVID-19 prognosis due to infection-induced alterations in various blood parameters. This study aimed to associate hematological parameters with different COVID-19 clinical forms and utilize them as disease outcome predictors. We performed a complete blood count in blood samples from 297 individuals with COVID-19 from Belo Horizonte, Brazil. Statistical analysis, as well as ROC Curves and machine learning Decision Tree algorithms were used to identify correlations, and their accuracy, between blood parameters and disease severity. In the initial four days of infection, traditional hematological COVID-19 alterations, such as lymphopenia, were not yet apparent. However, the monocyte percentage and granulocyte-to-lymphocyte ratio proved to be reliable predictors for hospitalization, even in cases where patients exhibited mild symptoms that later progressed to hospitalization. Thus, our findings demonstrate that COVID-19 patients with monocyte percentages lower than 7.7% and a granulocyte-to-lymphocyte ratio higher than 8.75 are assigned to the hospitalized group with a precision of 86%. This suggests that these variables can serve as important biomarkers in predicting disease outcomes and could be used to differentiate patients at hospital admission for managing therapeutic interventions, including early antiviral administration. Moreover, they are simple parameters that can be useful in minimally equipped health care units.

PMID:39432758 | DOI:10.1093/jleuko/qiae223

Trends Psychiatry Psychother. 2024 Oct 22. doi: 10.47626/2237-6089-2024-0908. Online ahead of print.

ABSTRACT

OBJECTIVE: Approximately 6 to 13% of women suffer from antenatal depression (AD) around the world. AD can lead to several health problems for mother-baby. Vitamin D is a molecule that appears to have great preventive/therapeutic potential against neuropsychiatric disorders. The present study aimed to analyze the association between deficiency of vitamin D and AD in pregnant women in a city in the south of Brazil (Pelotas, RS). We hypothesize that pregnant women with a positive AD diagnosis have deficient levels of 25-hydroxyvitamin D (25(OH)D).

METHODS: This cross-sectional study was conducted in a cohort study (CEP/UCPEL 47807915.4.0000.5339). From this cohort, 180 pregnant women at up to 24 weeks gestation were selected (130 non-depressed and 50 depressed), and the diagnosis of depression was made using the MINI-Plus. Blood was collected and stored for the later analysis of vitamin D (25(OH)D) by chemiluminescence method. The SPSS program was used for data analysis, and p<0.05 was considered statistically significant.

RESULTS: In our study, we showed a significant association between Major Depressive Episode current in the antenatal period and vitamin D deficiency (OR: 0.9; CI 95%: 0.9;1.0, p=0.003).

CONCLUSION: Our results demonstrate that vitamin D deficiency may be involved in major depressive disorder in the antenatal period, in this way it advised a follow-up of vitamin D levels in the pregnancy-puerperal cycle to minimize mental health problems in women and prevent developmental deficits in children.

PMID:39432746 | DOI:10.47626/2237-6089-2024-0908

Chaos. 2024 Oct 1;34(10):103138. doi: 10.1063/5.0237801.

ABSTRACT

Analysis of correlation between time series is an essential step for complex system studies and dynamical characteristics extractions. Martingale difference correlation (MDC) theory is mainly concerned with the correlation of conditional mean values between response variables and predictor variables. It is the generalization and deepening of the Pearson correlation coefficient, Spearman correlation coefficient, Kendall correlation coefficient, and other statistics. In this paper, on the basis of phase space reconstruction, the generalized dependence index (GDI) is proposed by using MDC and martingale difference divergence matrix theories, which can measure the degree of dependence between time series more effectively. Moreover, motivated by the theoretical framework of the refined distance correlation method, the corresponding dependence measure (DE) is employed in this paper to construct the DE-GDI plane, so as to comprehensively and intuitively distinguish different types of data and deeply explore the operating mechanism behind the relevant time series and complex systems. According to the performances tested by the different simulated and real-world data, our proposed method performs relatively reasonably and reliably in dependence measuring and data distinguishing. The proposal of this complex data clustering method can not only recognize the features of complex systems but also distinguish them effectively so as to acquire more relevant detailed information.

PMID:39432719 | DOI:10.1063/5.0237801

Medicine (Baltimore). 2024 Oct 18;103(42):e40131. doi: 10.1097/MD.0000000000040131.

ABSTRACT

BACKGROUND: Endometriosis is a common benign disease in women of childbearing age, with a malignant change rate of about 1%. Endometriosis associated ovarian cancer (EAOC), which usually occurs in the ovaries, is a serious threat to women’s health. Early identification of high-risk groups of EMs malignant transformation is of great significance for the prevention and treatment of EAOC. However, there is still a lack of specific and sensitive prediction factors. In recent years, scholars at home and abroad have used traditional statistical methods and machine learning to explore EAOC related prediction factors and prediction models. This paper mainly reviews and evaluates the diagnosis and prediction model of EAOC.

METHODS: Studies were identified by searching the CNKI, PubMed and Web of Science Core Collection, (WOSCC) till 2023, Data which met the inclusion criteria of clinical studies were evaluated about the quality. This paper analyzes and summarizes the prediction factors and prediction models in the literature.

RESULTS: After screening, 7 relevant studies were finally obtained. Prediction factors included: age, menstruation, menopausal status, course of disease, infertility associated with endometriosis, history of single estrogen use during menopause, serological indexes: human epididymis protein 4, carbohydrate antigen 125(CA125), ovarian malignancy risk algorithm, indications for ultrasound examination: cyst shape, structure and blood flow signal, etc. Prediction models: Alignment diagram, Multivariate logistic regression model, Gail model, Gradient Boosting Decision Tree and Lasso-logistics regression.

CONCLUSION: Related models were in good agreement with the actual situation, and have good sensitivity and specificity. The relevant prediction factors and prediction models were summarized to provide reference and new thinking for the research of prediction models in the field of EAOC, in order to develop standardized long-term management strategies for high-risk groups of EAOC and realize the advance of the diagnosis threshold of patients with EAOC.

PMID:39432664 | DOI:10.1097/MD.0000000000040131

Medicine (Baltimore). 2024 Oct 18;103(42):e40091. doi: 10.1097/MD.0000000000040091.

ABSTRACT

Early diagnosis of gestational diabetes mellitus (GDM) reduces the risk of adverse perinatal and maternal outcomes. At present, the value of serum adiponectin (ADP) and pregnancy-associated plasma protein A (PAPP-A) in clinical practice for the diagnosis of GDM in early pregnancy is unclear. To investigate the predictive value of serum ADP and PAPP-A in GDM. The electronic medical record data of all pregnant women from Zhongshan People’s Hospital from 2018 to 2021 were retrospectively collected and divided into GDM group and control group according to whether GDM occurred. ADP and PAPP-A levels of the 2 groups were detected in early pregnancy, and the related factors of GDM were analyzed by binary logistic regression analysis. Receiver operating characteristic (ROC) curves of ADP and PAPP-A in predicting GDM in the early pregnancy were plotted and their clinical predictive value was analyzed. The significance level for all statistical tests is 0.05. Compared with the non-GDM group, the ADP of the GDM group was significantly lower than that of the non-GDM group [(8.19 ± 2.24) vs. (10.04 ± 2.73)]mg/L, the difference between groups was statistically significant (P < .05), and the multiple of median (MoM) of PAPP-A was significantly lower than that of the non-GDM group (1.13 ± 0.52) versus (1.45 ± 0.61) (P < .05). Binary logistic regression analysis showed that elevated serum ADP and PAPP-A levels were negatively correlated with the subsequent development of GDM [odds ratio (OR) 95% confidence interval (95% CI)] was 0.626 (0.536, 0.816), 0.934 (0.908, 0.961), respectively, P < .05.ROC curve analysis showed that the sensitivity and specificity of ADP and PAPP-A in predicting gestational diabetes were79.1% and 58.6%, respectively, 92.7% and 73.1%, and respectively. The area under curve (AUC) is 0.755 for ADP and 0.770 for PAPP-A. The AUC of the combined detection was 0.867, both of which were higher than that of single index diagnosis, and the sensitivity and specificity of the combined detection were 0.958 and 0.853, respectively. In summary, PAPP-A and ADP levels are independent related factors affecting the occurrence of GDM. The combined detection of PAPP-A and ADP should be utilized in diagnosing GDM to improve pregnancy outcomes for pregnant women.

PMID:39432661 | DOI:10.1097/MD.0000000000040091

Medicine (Baltimore). 2024 Oct 18;103(42):e39877. doi: 10.1097/MD.0000000000039877.

ABSTRACT

Although several studies have discussed the relationships among digital health literacy, health, and exercise behavior, few have integrated these 3 factors into a single model. This study aims to address this research gap. This article aims to analyze the impact of digital health literacy on the health of older adults, as well as the mediating mechanisms related to exercise frequency and duration. A cross-sectional survey was conducted in Luoyang and Zhengzhou urban areas from December 2023 to January 2024. Utilizing random sampling methods, data were collected from 661 older adults through the “digital health literacy scale,” “health scale,” and “count of exercise duration and frequency” questionnaires. The data were processed by employing SPSS 20 and Process, v3.0, and analyzed through independent samples t test, 1-way ANOVA (F-test), and mediation testing methods. The results indicate that no statistical significance (P > .05) is observed in terms of the 3 dimensions of digital health literacy, exercise behavior, and health status among older adults with different genders, living conditions, educational backgrounds, and economic status. In contrast, statistical significance (P < .05) is observed in terms of exercise frequency and health status among older adults with varying levels of smoking and drinking. The 3 dimensions of digital health literacy among older adults statistically impact (P < .05) their exercise duration, frequency, and health. The dimension of access and assessment exerts the most significant influence on exercise duration (β = 0.415) and a considerable impact on health (β = 0.214). Furthermore, the impact of exercise duration and frequency on health status is statistically significant (P < .05). In terms of the interactive capability dimension, exercise frequency exerts the most significant influence (β = 0.199). Digital health literacy has a significant impact on the health of older adults. The duration and frequency of exercise play a partial mediating role between older adults’ digital health literacy and their physical health status. Digital health literacy can encourage older adults to increase the duration and frequency of exercise, which, in turn, promotes their physical health.

PMID:39432656 | DOI:10.1097/MD.0000000000039877

Medicine (Baltimore). 2024 Oct 18;103(42):e40101. doi: 10.1097/MD.0000000000040101.

ABSTRACT

The purpose of this study was to analyze the impact of implementing a driver’s license-type scoring system on the quality management of hospital medical records. We collected relevant medical record quality control data before (from April to November 2021) and after (from April to November 2022) the use of the driver’s license-type scoring management in the medical record quality management of a Grade-A tertiary general hospital in a prefecture-level city (“R Hospital” for short). We evaluated the impact by statistically analyzing the data using the χ2 test and t test with the SPSSAU online statistical analysis software. Compared with before the implementation of the new system, the filling rate of discharge medical records within 2 days, logical rate of day diagnosis and treatment medical records, logical rate of day surgery medical records, and clinical tumor-node-metastasis staging evaluation rate before tumor treatment significantly increased, and the difference was statistically significant (P < .05); the rate of errors or omissions on the first page of inpatient medical records significantly decreased, and the difference between before and after implementation of the new system was statistically significant (P < .05). We found that the driver’s license-type scoring management adapted for use in the quality management of hospital medical records was effective in regulating the medical record writing behavior of physicians and improved the quality of medical records, thus meriting wide promotion.

PMID:39432653 | DOI:10.1097/MD.0000000000040101

Medicine (Baltimore). 2024 Oct 18;103(42):e39937. doi: 10.1097/MD.0000000000039937.

ABSTRACT

BACKGROUND: Various oral anticoagulants have been used for stroke prevention in older patients with atrial fibrillation (AF). However, the optimal anticoagulants for stroke prevention has not yet been developed. We performed a systematic review and network meta-analysis to determine the optimal instructions.

METHODS: We searched for randomized controlled trials (RCTs) from PubMed, Embase, and the Cochrane Library without restriction for publication date or language at January 2024. Any RCTs that compared the effectiveness of a direct oral anticoagulant and a vitamin K antagonist (VKA) for stroke prevention in older patients with AF were included in this network meta-analysis. The Bayesian network meta-analysis used a random effects model and surface under the cumulative ranking curve analysis to rank results. All analyses were done using R software with gemtc package, with statistical significance set at P < .05.

RESULTS: We included 7 RCTs (79,003 patients) comparing 8 different instructions including Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, Edoxaban 60 mg, Rivaroxaban 15 mg, Rivaroxaban 20 mg, and VKA. Apixaban 5 mg, Dabigatran 110 mg, and Dabigatran 150 mg was more effective than the VKA for reducing stroke or systemic embolism risks, and the difference was statistically significant (P < .05). Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, and Edoxaban 60 mg was associated with a reduction of the intracranial hemorrhage rate than the VKA (P < .05). The surface under the cumulative ranking curve shows that Dabigatran 110 mg ranked first for reducing stroke or systemic embolism risks. Edoxaban 60 mg ranked first for major bleeding. Dabigatran 110 mg ranked first for intracranial hemorrhage. Apixaban 5 mg ranked first for all bleeding events.

CONCLUSIONS: Direct oral anticoagulants were found to have lower rates of thromboembolic events compared to VKAs in older patients with AF. Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, and Edoxaban 60 mg were also associated with a reduction of intracranial hemorrhage than VKA.

PMID:39432641 | DOI:10.1097/MD.0000000000039937

Medicine (Baltimore). 2024 Oct 18;103(42):e39591. doi: 10.1097/MD.0000000000039591.

ABSTRACT

Many previous observational studies have disputed whether there is a link between uric acid and stroke. And the causal relationship between uric acid and stroke is unclear. To determine whether there is a causal relationship between uric acid and stroke by using mendelian randomization (MR). Uric acid dataset was obtained from Anna Kottgen et al, with a sample size of 110,347 people, including 2450,548 single nucleotide polymorphisms (SNPs). Stroke pooled data from Malik R et al, publicly available in MEGASTROKE genome-wide association study, included meta-analysis data from 40,585 stroke patients and 406,111 control patients, totaling 8211,693 SNPs. The summary data of genome-wide association study of uric acid and stroke were collected from publicly available online databases. Inverse variance weighting was used to determine the causal relationship between uric acid and stroke. MR-Egger and weighted median model were used for supplementary analysis. Results were then analyzed for heterogeneity, pleiotropy, and sensitivity to ensure no statistical pleiotropy and to reduce bias. A total of 27 SNPs were included in this study after the disequilibrium instrumental variables were excluded. Check the PhenoScanner database for SNPs associated with confounders. In the end, a total of 8 SNPs were excluded. Two SNPs were excluded because the correction direction was the same. Since the F statistic is >10, rs10761587 and rs1825043 are excluded. Finally, 15 SNPs were selected as uric acid instrumental variables. Inverse variance weighting-fixed effect model suggested that there was no causal relationship between uric acid and stroke (odds ratio = 1.004, 95% confidence interval = 0.940, 1.072). MR-Egger and weighted median model also showed the same result. In addition, the results of this study were robust without heterogeneity and pleiotropy. This MR study suggests no support of a causal relationship between uric acid and stroke.

PMID:39432637 | DOI:10.1097/MD.0000000000039591

Medicine (Baltimore). 2024 Oct 18;103(42):e40144. doi: 10.1097/MD.0000000000040144.

ABSTRACT

BACKGROUND: Despite the availability of numerous treatments for Crohn disease, there are patients who do not respond to any therapy, thereby diminishing their quality of life. The aim of this review is to analyze the efficacy and safety of autologous hematopoietic stem cell transplantation therapy for refractory Crohn disease.

METHODS: This work is a systematic review with meta-analysis conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses. Electronic databases such as PubMed, Scopus, Web of Science, and ClinicalTrials were consulted. The searches were carried out in August 2024. To evaluate the efficacy of autologous hematopoietic stem cell transplantation in inducing remission, the mean and standard deviation of the Crohn’s Disease Activity Index pre- and post- treatment were used, and a fixed-effects meta-analysis was conducted. Additionally, to assess the efficacy in perianal fistulas, a random-effects meta-analysis was performed, collecting data on the number of subjects with fistulas at the beginning and end of the intervention. All 95% confidence intervals were calculated, and the I2 statistic was used to assess the heterogeneity of the outcome variables.

RESULTS: A total of 609 records were identified from databases, with 12 studies selected for inclusion in the review. Immediate intervention proved effective in inducing a decrease in the Crohn Disease Activity Index compared to late intervention with conventional therapies. Moreover, the meta-analysis demonstrated efficacy for Crohn disease and associated fistulas with a mean decrease in the CDAI of -217.53 ± 14.3. When evaluating the efficacy of the procedure in perianal fistulas, a risk ratio of 0.47 with a 95% CI of [0.26, 0.86] was obtained. However, the procedure showed adverse effects, such as infections, acute renal failure or deaths.

CONCLUSION: Systemic autologous hematopoietic stem cell transplantation has shown efficacy in patients who fail to achieve remission of their Crohn disease with conventional therapies. This procedure has also demonstrated efficacy in treating perianal fistulas. However, it is essential to carefully evaluate de implementation of this procedure due to the associated risks.

PMID:39432634 | DOI:10.1097/MD.0000000000040144