Tag: pubmed

J Trace Elem Med Biol. 2024 Nov 28;87:127573. doi: 10.1016/j.jtemb.2024.127573. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Accumulating evidence suggests that exposure to single heavy metal can facilitate the progression of age-related macular degeneration (AMD). However, the effects of exposure to mixtures of heavy metals on AMD remain largely unexplored. This study aims to investigate both the joint and individual impacts of arsenic (As), mercury (Hg), cadmium (Cd), and lead (Pb) on AMD within a co-exposure framework.

METHODS: Data from subjects participating the US National Health and Nutrition Examination Survey (NHANES, 2005-2008) were analyzed. Concentrations of As, Hg, Cd, and Pb were determined in urine by inductively coupled plasma dynamic reaction cell mass spectrometry (ICP-DRC-MS) for As and Hg, and inductively coupled plasma mass spectrometry (ICP-MS) for Cd and Pb. The weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) models were employed to assess the effects of heavy metal mixtures on AMD risk.

RESULTS: Both WQS and BKMR analyses consistently revealed a significant overall association between heavy metal mixtures and the risk of all types of AMD. The combined effect was more evident among patients with early AMD compared to those with late AMD. Cd and Hg were the main contributors driving these combined effects within the context of metal mixtures. Elevated urinary levels of Cd were positively correlated with an increased risk for all types as well as early AMD. Higher exposure to Hg corresponded with an elevated risk for early AMD. Furthermore, BKMR analysis indicated that the influence of Cd on early AMD exhibited a non-linear pattern.

CONCLUSIONS: Our findings suggest that co-exposure to As, Hg, Cd, and Pb is associated with an elevated risk for developing AMD, particularly in its early stages. Furthermore, excessive exposure to Cd and Hg has been identified as key contributing factors in this process.

PMID:39643952 | DOI:10.1016/j.jtemb.2024.127573

J Vasc Access. 2024 Dec 6:11297298241296570. doi: 10.1177/11297298241296570. Online ahead of print.

ABSTRACT

BACKGROUND: Distal radial artery access (DRA) has been emerged as an alternative for conventional transradial arterial access. While palpation of radial artery is mandatory prior coronary angiography, it remains unknown the clinical impact of palpation in DRA success. Aim of our study is to explore whether the palpability of distal radial artery is linked with higher rates of successful arterial access.

METHODS: We conducted a post-hoc analysis using data from two randomized-controlled trials on DRA. All patients with available data on distal radial artery palpability and cannulation’s success were included in our analysis. No procedure was performed with ultrasound guidance.

RESULTS: Data on the palpability of the distal radial artery and the DRA success were available for 435 patients. Successful distal radial artery cannulation was attempted in 255 and 98 of patients with and without palpable distal radial artery, respectively. No significant difference between the two groups was observed (81.5% vs 80.3%, p = 0.786). Univariate analysis revealed statistically significant difference in gender, height, known CAD, valvular disease as indication for angiography and number of skin punctures. Multivariate analysis included these variables, as well as palpability of the distal radial artery and found that number of skin punctures and valvular disease as indication are significantly associated with DRA success.

CONCLUSION: According our post-hoc analysis, the palpability of the distal radial artery is not associated with higher rates of DRA success. Further studies are required for the validation of these results.

PMID:39643945 | DOI:10.1177/11297298241296570

Musculoskeletal Care. 2024 Dec;22(4):e70022. doi: 10.1002/msc.70022.

ABSTRACT

INTRODUCTION: Enhanced Recovery after Surgery (ERAS) protocols adopt a multidisciplinary approach in perioperative care to reduce Length of Stay (LOS). This study aims to identify predictive factors resulting in short-stay following TKR with an ERAS programme.

METHODS: Retrospective analysis was performed on a consecutive series of patients who underwent unilateral TKR by a single surgeon in a tertiary institution between August 2019 and December 2021. Patient demographics, comorbidities and length of stay were collected using Electronic Medical Records. Short-stay was defined as LOS within 1 day or less, while standard-stay was defined as LOS exceeding 2 days or more. Statistical analysis was performed using R version 4.3.1. Logistic regression was performed for multivariate analysis.

RESULTS: Ninety-nine patients were included in the study, comprising 45 short-stay patients and 54 standard-stay patients. Short-stay patients were significantly younger (mean 66.1, 95% CI [64.5, 67.7], p = 0.0212) than standard-stay patients (mean 69.2, 95% CI [67.1, 71.2]). There was a significantly lower mean BMI among short-stay patients (26.98, 95% CI [25.52, 28.45], p = 0.021) than among standard-stay patients (29.31, 95% CI [27.96, 30.66]). A significantly higher proportion of short-stay patients (84.4%, 95% CI [73.4, 95.5], p = 0.00132) were premorbid community ambulant without aids than standard-stay patients (51.9%, 95% CI [38.1, 65.6]). There was no significant difference in sex, race, smoking, American Society of Anaesthesiologists score and Charlson Comorbidity Index (p > 0.05). Multivariate logistic regression revealed the following significant factors: Age < 75 (p = 0.0293), BMI < 25 (p = 0.00688), and premorbid community ambulant without aids (p = 0.0402).

CONCLUSIONS: In conclusion, predictive factors for short-stay after TKR include age < 75, BMI < 25 and being premorbid community ambulant without aids.

PMID:39643922 | DOI:10.1002/msc.70022

BMC Anesthesiol. 2024 Dec 6;24(1):449. doi: 10.1186/s12871-024-02837-7.

ABSTRACT

BACKGROUND: Postoperative sore throat is a frequent and distressing complication caused by airway instrumentation during general anesthesia. The discomfort can lead to immediate distress, delayed recovery and reduce patient satisfaction. The objective of this study was to determine the effectiveness of preoperative ketamine gargle on the occurrence of postoperative sore throat among adult patients who underwent surgery under general anesthesia with endotracheal tube.

METHOD: PubMed, Cochrane Library, Google Scholar, and World Clinical Trial Registry were searched to find the eligible randomized control trials comparing the effect of preoperative ketamine gargle and placebo gargle on the occurrence of postoperative sore throat after surgery with endotracheal tube in adult patients. We utilized Review Manager Version 5.4 to perform statistical analyses. Cochrane risk of bias tool for randomized control trials was used to assess the risk of bias of included studies. We explored heterogeneity using the I² test. In addition to this, subgroup analysis, and sensitivity analysis was conducted to confirm the robustness of findings. The risk of publication bias was tested using funnel plot Pooled risk ratio along with 95% confidence interval (CI) was used to analyze the outcome.

RESULT: In the present systematic review and metanalysis, seventeen [17] randomized controlled trials (RCTs) with 1552 participants were included. Compared with placebo, preoperative ketamine gargle is effective to reduce postoperative sore throat (RR = 0.48; 95%CI [0.45, 0.52] in adult patients undergoing surgery under general anesthesia with endotracheal tube.

CONCLUSION: Preoperative ketamine gargle before induction of general anesthesia is effective to reduce the occurrence of postoperative sore throat in adult patients undergoing surgery under general anesthesia with an endotracheal tube. Further studies with large sample size, better study quality and optimal reporting could be conducted to determine the long-term efficacy and safety of ketamine gargle in different surgical populations.

PMID:39643910 | DOI:10.1186/s12871-024-02837-7

J Health Popul Nutr. 2024 Dec 6;43(1):209. doi: 10.1186/s41043-024-00709-x.

ABSTRACT

BACKGROUND: Inflammation and nutrition are strongly linked to respiratory diseases, but the link between inflammation and nutrition-based indicators and chronic obstructive pulmonary disease (COPD) and its mortality has not been reported.

METHODS: We recruited adults no younger than 20 years old from the NHANES 1999-2018. Inflammation and nutrition-based indicators included NAR, PNI, MAR, RAR, HALP, and ALI. COPD were assessed through a self-report questionnaire. Participants’ mortality rates were determined by association with the National Death Index.

RESULTS: A total of 46,572 individuals were collected in this study, including 1,549 COPD patients. NAR, MAR, and RAR were positively linked with the prevalence of COPD. However, PNI and HALP were negatively linked with the prevalence of COPD. In participants with COPD, the highest quartile of NAR (HR = 1.43 [1.04-1.97]), MAR (HR = 1.66 [1.23-2.26]), and RAR (HR = 2.45 [1.90-3.17]) were linked with an increased risk of all-cause mortality compared to the lowest quartile. However, the highest quartile of PNI (HR = 0.48 [0.38-0.61]) and HALP (HR = 0.56 [0.44-0.71]) were linked with a decreased risk of all-cause mortality compared to the lowest quartile. Randomized survival forests (RSF) showed that RAR had the strongest predictive power for all-cause mortality in COPD individuals among all indicators.

CONCLUSION: We found that inflammation and nutrition-based indicators were linked to prognosis in COPD patients, with RAR having the highest predictive value.

PMID:39643902 | DOI:10.1186/s41043-024-00709-x

BMC Nutr. 2024 Dec 6;10(1):157. doi: 10.1186/s40795-024-00969-0.

ABSTRACT

BACKGROUND: Stunting remains a public health concern in sub-Saharan Africa. Despite the evolving awareness of the effect of family composition on child health outcomes, the influence of sibling gender on stunting has seldom been consistent. The current study investigated the association between sibling composition and stunting among children under five years in Ghana.

METHODS: This cross-sectional study utilized data from the most recent Ghana Demographic and Health Survey (GDHS 2022), focusing on 5416 mother-child dyads. Stunting prevalence was assessed through descriptive analysis, while logistic regression analysis was employed to examine the association between sibling composition and identify other risk factors associated with stunting.

RESULTS: The prevalence of stunting among children under five years of age was 18%. It was observed from the male sex-stratified model that having male siblings and having a combination of male and female siblings increased male children’s odds of being stunted. In contrast, having siblings of either gender or having a combination of male and female siblings may not pose any stunting threats to female children as observed in the female sex-stratified model. Furthermore, being a male child (OR: 1.54; 95% CI: 1.25, 1.90) and never being breastfed (OR: 2.07; 95% CI: 1.31, 3.21) increased children’s likelihood of stunting.

CONCLUSION: This study concludes that the extra nutrients boys require for healthy growth and development may increase their competition for nutrients, especially in households with limited resource. Parents and guardians are advised to be consciously aware of the subtle and apparent competition between male children and take appropriate measures to prevent children’s deprivation of nutrition by their male siblings.

PMID:39643899 | DOI:10.1186/s40795-024-00969-0

BMC Psychiatry. 2024 Dec 6;24(1):893. doi: 10.1186/s12888-024-06359-x.

ABSTRACT

BACKGROUND: The relationship between depression and dyslipidemia remains controversial, with inconsistent findings across studies. This study aimed to investigate the association between blood lipid levels and depression using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2018.

METHODS: This cross-sectional study included 12,819 adult participants from NHANES. Depression was assessed using a nine-item depression screening instrument. Serum lipid levels, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), were measured using Roche modular P and Roche Cobas 6000 chemistry analyzers. Survey-weighted multiple logistic regression was used to assess the relationships between serum lipid levels and depression.

RESULTS: We observed a statistically significant negative association between HDL levels and depression (odds ratio [OR]: 0.72, 95% confidence interval [CI]: 0.58-0.90). After adjustments for covariates, HDL-C, TG, and the triglyceride glucose (TyG) index showed significant associations with depression (ORs: 0.66, 1.08, and 1.01, respectively). A linear correlation was observed between HDL-C levels and depression (P < 0.01), while TG levels and the TyG index exhibited nonlinear associations (p < 0.01 and p < 0.05, respectively). No significant positive associations were observed between increased TC or LDL-C levels and the risk of depression.

CONCLUSIONS: High HDL-C levels were negatively associated with depression, while TG levels and the TyG index were positively associated with depression. Clinical attention should be given to the detection of lipid levels in patients with depression.

PMID:39643888 | DOI:10.1186/s12888-024-06359-x

BMC Oral Health. 2024 Dec 6;24(1):1483. doi: 10.1186/s12903-024-05272-9.

ABSTRACT

OBJECTIVES: The deterioration of oral function to a state of oral hypofunction (OHF) has been associated with malnutrition and frailty. This cross-sectional pilot study investigated for differences in OHF prevalence and its category measures across age groups and sex, as well as their associations with physical function.

METHODS: A total of 155 healthy adults (median age: 55 years, range: 22-89 years) participated in this study after providing informed consent. The cohort was age and sex matched. Seven oral function measures based on the concept of OHF were assessed: oral hygiene (Hygiene), oral dryness, maximum occlusal force (MOF), lip-tongue motor function (LTMF), maximum tongue pressure (MTP), masticatory function, and swallowing function. Hand grip strength (HGS) was also measured. The participants were divided into the young (20-39 years), middle (40-64 years), and old (≥ 65 years) age groups for linear regression analysis of differences in oral and physical function. Differences in OHF prevalence were tested by the chi-square test.

RESULTS: The prevalence of OHF was significantly higher in the old group than in the young and middle groups. Such OHF measures as Hygiene, MTP, LTMF, and MOF were significantly worse in the old group as well. The measures of Hygiene and LTMF showed a moderate correlation with age in the multiple regression model (standardized partial regression coefficient, β = 0.24 and -0.19, respectively). HGS was significantly associated with MTP (β = 0.58, p < 0.001) and LTMF (β = 0.38, p = 0.002) in both male and female participants.

CONCLUSIONS: Our findings suggest that OHF prevalence increases with age, especially after 65 years old. However, the pathological route may vary among OHF categories.

PMID:39643885 | DOI:10.1186/s12903-024-05272-9

BMC Pediatr. 2024 Dec 6;24(1):801. doi: 10.1186/s12887-024-05280-2.

ABSTRACT

BACKGROUND: Pneumonia is inflammation of the lung parenchyma and is a substantial cause of childhood morbidity and mortality in developing countries. Community-acquired pneumonia (CAP) is a type of pneumonia termed when patients who develop pneumonia in the outpatient setting and have not been in any health care facilities within 90days.

OBJECTIVE: The objective of this study was to determine treatment outcome of community acquired pneumonia among hospitalized pediatric patients.

METHOD: A retrospective cohort study was conducted from April 15, 2019 to July 15, 2019 and included patients who were admitted and hospitalized in pediatrics wards from September 1, 2015 to March 30, 2019. The study included pediatric age groups between one month and fifteen years old. Study Participants were selected based on the diagnosis of Community acquired pneumonia. Systematic sampling technique was used. All the statistical data were carried out using Statistical Package for Social Sciences (SPSS 20) and descriptive statistics were presented using means with standard deviation and percentages. Binary logistic regression model was fitted to measure the association between independent and dependent variables including duration of signs and symptoms. 95% Confidence interval was used. Statistically significant at P < 0.05.

RESULTS: A total of 385 patients with Community Acquired Pneumonia were included in this study of whom 368(95.65%) were discharged and 17(4.4%) of patients were dead. Drug therapy change (AOR 20.308(3.666-112.501), P = 0.001), Prescribing and taking of large number of drugs (above 5 drugs) (AOR 0.067, CI (0.015-0.313), P = 0.001), Loss of appetite (AOR 38.641, CI (5.454-273.769), P = 0.000), and Blood transfusion (AOR 10.514, CI (1.752-63.113), P = 0.01) have significant association with the treatment outcome of death.

CONCLUSION: Poor treatment outcome (death) was accounted for 4.4% of the pediatric patients hospitalized with community acquired pneumonia in this study setting. Based on the findings of this study Community acquired pneumonia is still a cause of substantial mortality of children under 15years old while on standardized treatment strategies. Antibiotic drug therapy change, taking increased number of drugs, loss of appetite and blood transfusion are the factors that contribute to this poor treatment outcome of CAP among children under 15years old.

PMID:39643882 | DOI:10.1186/s12887-024-05280-2

BMC Musculoskelet Disord. 2024 Dec 6;25(1):1006. doi: 10.1186/s12891-024-08050-4.

ABSTRACT

BACKGROUND: The COVID-19 pandemic had a significant impact on healthcare systems and the general population. However, it remains unclear to what extent these major societal changes have had an impact on the management of hip fractures in older people in Japan. Therefore, we investigated the effect of the COVID-19 pandemic on the number of patients with hip fractures, their characteristics, and their perioperative management as a retrospective multicentre study.

METHODS: We included 1894 patients aged ≥ 65 years who underwent surgery for hip fracture at three hospitals between January 2019-December 2021. Patients were classified according to the time of injury; patients treated between January-December 2019, January-December 2020, and January-December 2021 were divided into the pre-COVID-19 group, early COVID-19 group, and late COVID-19 group, respectively. We compared age, sex, body mass index, preadmission residence, surgical procedure, length of hospital stay, waiting time for surgery, in-hospital complications, and in-hospital death.

RESULTS: Our findings suggested that the early COVID-19 and late COVID-19 groups showed a 6.8% and 7.5% reduction in the number of HF patients, respectively, compared to the pre-COVID-19 group. Waiting days for surgery, length of hospital stay, and in-hospital mortality or complication rates did not significantly change before and after the pandemic. However, infection was increased in the early COVID-19 group regarding the subgroup of complications.

CONCLUSIONS: The COVID-19 pandemic altered the characteristics of hip fractures in older individuals.

PMID:39643881 | DOI:10.1186/s12891-024-08050-4