Tag: pubmed

Int Ophthalmol. 2024 Jul 24;44(1):335. doi: 10.1007/s10792-024-03245-z.

ABSTRACT

PURPOSE: This study evaluates the long-term adjunctive use of netarsudil ophthalmic solution 0.02% in lowering IOP in patients with refractory glaucoma.

METHODS: This retrospective chart review study was conducted at a tertiary care center. Patients who were prescribed add-on netarsudil therapy and on ≥ 3 topical glaucoma medications from 01/01/2018 to 08/31/2020 were reviewed. 47 patients (69 eyes) met the inclusion criteria. Baseline IOPs prior to the addition of netarsudil were compared to IOPs measured at 3-, 6-, and 12-month intervals. Any patients with inadequate follow-up or who had glaucoma surgery after netarsudil initiation were excluded.

RESULTS: Median baseline IOP (± SD) was 21 ± 5.8 mmHg (median of 2 visits prior to initiation of netarsudil). At 3-month follow-up, 64 eyes had a median IOP of 16 ± 6.7 mmHg (p < 0.01). At 6-month follow-up, 56 eyes had a median IOP of 18 ± 4.6 mmHg (p < 0.01). At 12-month follow-up, 44 eyes had a median IOP of 15 ± 6.8 mmHg (p < 0.01). At the conclusion of the study, 64% of eyes reached 1 year follow-up due to several reasons.

CONCLUSIONS: Patients with refractory glaucoma showed statistically and clinically significant IOP reductions on netarsudil. IOP reduction was stable long-term with the largest decrease in IOP seen at 12 months. Although some patients will still go on to require further laser or incisional surgery, for most patients netarsudil is an effective treatment for adjunctive use in refractory glaucoma.

PMID:39046674 | DOI:10.1007/s10792-024-03245-z

Environ Monit Assess. 2024 Jul 24;196(8):758. doi: 10.1007/s10661-024-12901-x.

ABSTRACT

Spanning across Bangladesh and India, the Sundarban Delta consists of over a thousand islands, the majority of which are protected. These islands are important for the rich biodiversity and unique species found here. However, these islands are also at the forefront of climate change due to the impact of rising sea levels and extreme weather events. Therefore, we analyzed the long-term transformations in the land use land cover (LULC) between 1999 and 2020. We used a variety of geostatistical methods, including optimized hot spots cold spots and join count statistics, to examine the spatial patterns of changes in LULC across the study area. The results of our analysis revealed substantial changes in the spatial patterns of mangroves and pond aquaculture. The changes revealed a distinct north-south demarcation in spatial patterns, in the form of clustering of mangroves in the uninhabited islands located in the south and pond aquaculture clustered in the northern inhabited islands. The loss of area under mangroves was concentrated in the southern edges of the islands, which were most exposed to erosion in the open ocean. Nevertheless, we observed an increase in the area under mangroves in some of the northern riverine islands (17 km²). In the case of pond aquaculture, it was mostly concentrated in inhabited islands in the north. Most of the expansions were concentrated in the Indian part of the delta (631 km²). It is noteworthy that because of effective conservation measures, there was very limited overlap between mangroves and pond aquaculture, denoting the conversion of agricultural land to pond aquaculture instead of mangroves. Thus, the results of our study revealed the importance of local level conservation policies and anthropogenic activities, such as deforestation and local level disturbance like over-extraction of water and pollution, on the changing patterns of LULC across this unique, fragile ecosystem. Future studies may incorporate a finer resolution time series of LULC changes over time and space to enable more detailed analysis.

PMID:39046650 | DOI:10.1007/s10661-024-12901-x

Neurosurg Rev. 2024 Jul 24;47(1):349. doi: 10.1007/s10143-024-02594-8.

ABSTRACT

Many studies revealed that the sphenoid sinus pneumatization (SSP) affects the protrusion/dehiscence of adjacent structures including optic canal (OC), foramen rotundum (FR), vidian canal (VC), and carotid canal (CC). Knowledge of this relationship bears vital importance to identify the safest surgical route during transsphenoidal procedures. Therefore, we aimed to determine the individualized prevalence of the protrusion/dehiscence of adjacent structures based on sagittal and coronal SSP (SSSP and CSSP) patterns. Computed tomography images of 300 patients were analysed to identify the SSSP and CSSP types, and the protrusion/dehiscence of adjacent structures was determined. The relationship between the variables was examined using statistical analysis in terms of age, gender, and laterality. The most prevalent SSSP type was postsellar (62.7%), followed by sellar (30%), presellar (6.6%), and conchal (0.7%). In 71.3% of patients, five types of CSSP were observed, with 23.6% and 21.7% exhibiting Type IV and V, respectively. Our results indicated that postsellar type, Type IV and V CSSP associated with the highest likelihood of protrusion/dehiscence of OC, FR, VC, and CC. Furthermore, no significant correlation was observed between these qualitative variables and gender, with the exception of the VC dehiscence, the protrusion of OC and CC. No notable differences were identified with respect to laterality. Also, the probability of having postsellar type, Type IV and V CSSP, as well as the protrusion of OC, VC, and CC, decreased with increasing age. Further detailed analysis of this association is required to predict the size of the surgical window and to prevent neurovascular injury.

PMID:39046640 | DOI:10.1007/s10143-024-02594-8

Environ Sci Pollut Res Int. 2024 Jul 24. doi: 10.1007/s11356-024-34404-5. Online ahead of print.

ABSTRACT

Hydrological simulation in karstic areas is a hard task due to the intrinsic intricacy of these environments and the common lack of data related to their geometry. Hydrological dynamics of karstic sites in Mediterranean semiarid regions are difficult to be modelled mathematically owing to the existence of short wet episodes and long dry periods. In this paper, the suitability of an open-source SWAT method was checked to estimate the comportment of a karstic catchment in a Mediterranean semiarid domain (southeast of Spain), which wet and dry periods were evaluated using box-whisker plots and self-developed wavelet test. A novel expression of the Nash-Sutcliffe index for arid areas (ANSE) was considered through the calibration and validation of SWAT. Both steps were completed with 20- and 10-year discharge records of stream (1996-2015 to calibrate the model as this period depicts minimum gaps and 1985-1995 to validate it). Further, SWAT assessments were made with records of groundwater discharge and relating SWAT outputs with the SIMPA method, the Spain’s national hydrological tool. These methods, along with recurrent neural network algorithms, were utilised to examine current and predicted water resources available to supply urban demands considering also groundwater abstractions from aquifers and the related exploitation index. According to the results, SWAT achieved a “very good” statistical performance (with ANSE of 0.96 and 0.78 in calibration and validation). Spatial distributions of the main hydrological processes, as surface runoff, evapotranspiration and aquifer recharge, were studied with SWAT and SIMPA obtaining similar results over the period with registers (1980-2016). During this period, the decreasing trend of rainfalls, characterised by short wet periods and long dry periods, has generated a progressive reduction of groundwater recharge. According to algorithms prediction (until 2050), this declining trend will continue reducing groundwater available to meet urban demands and increasing the exploitation index of aquifers. These results offer valuable information to authorities for assessing water accessibility and to provide water demands in karstic areas.

PMID:39046638 | DOI:10.1007/s11356-024-34404-5

Emerg Radiol. 2024 Jul 24. doi: 10.1007/s10140-024-02269-3. Online ahead of print.

ABSTRACT

BACKGROUND: Many radiology programs utilize a night-float system to mitigate the effects of fatigue, improve patient care, and provide faster report turnaround times. Prior studies have demonstrated an increase in discrepancy rates during night-float shifts.

OBJECTIVES: This study was performed to examine the effects of night-float shift work on radiology resident cognition. We hypothesized that there would be diminished cognitive function on testing following night-float shifts when compared to testing following day shifts.

METHODS: Diagnostic radiology residents in their second to fifth years of residency at a single institution were recruited to participate in this pilot study. Cognitive function was evaluated using the Lumosity Neurocognitive Performance Tests (NCPT), standardized performance tests that provide real-time, objective measurements of cognitive function. Study participants completed the NCPT in 5 sessions following 5 consecutive day shifts to evaluate their baseline cognitive function. The tests were re-administered at the end of consecutive night-float shifts to assess for any changes. Sleep was objectively monitored using actigraphy devices worn around the wrist during all study weeks. Descriptive and summary statistics were performed.

RESULTS: 23 prospectively recruited diagnostic radiology residents working night-float shifts took a mean 13.6 (± 5.1) neurocognitive performance tests during the study period. There was a statistically significant decline in 2 of the 6 cognitive tests administered, signifying a decrease in attention, speed, and complex reasoning ability. Night-float shifts were significantly longer than the day shifts and associated with a significantly higher study volume and cross-sectional study volume. Fitbit data demonstrated that there were no significant differences in level of activity while awake. However, participants slept significantly longer during day shifts.

CONCLUSIONS: A sample of 23 radiology residents working night-float shifts demonstrated declines in attention, speed, and complex reasoning ability following sequential administration of standardized neurocognitive performance tests. While the sample size is small, these findings demonstrate the potential deleterious effects of night-float shift work and provide evidence to support further inquiry into this phenomenon.

PMID:39046634 | DOI:10.1007/s10140-024-02269-3

J Gen Intern Med. 2024 Jul 24. doi: 10.1007/s11606-024-08836-1. Online ahead of print.

ABSTRACT

BACKGROUND: The pandemic rapidly expanded telemedicine, which has persisted as a widely available primary care modality. The uptake of telemedicine among people with dementia specifically in the primary care setting, who have more complex care needs but also benefit from more accessible primary care, is unknown.

OBJECTIVE: Among people with dementia, assess uptake of telemedicine-based primary care in the post-pandemic period and determine associations with key socio-demographic characteristics.

DESIGN: Retrospective observational study.

SUBJECTS: People with dementia at UCSF and Kaiser Permanente Northern CA (KPNC) with at least one primary care encounter in pre- (3/1/2019-2/29/2020) or post-COVID (3/1/2021-2/28/2022) periods, post-COVID sample: N= 419 individuals (UCSF), N=18,037 (KPNC).

MAIN MEASURES: Encounter modality: in-person, video telemedicine, or telephone telemedicine. Focal socio-demographic characteristics: age, limited English proficiency, socioeconomic status, driving distance to clinic, and caregiver at encounter.

KEY RESULTS: There was a large increase in telemedicine among people with dementia in the post-pandemic period at both sites. At KPNC, those with only in-person primary care visits shrunk from 60.47% (pre) to 26.95% (post). At UCSF, the change was even greater: 98.99% to 35.08%. Across both sites, the only measure significantly associated with use of telemedicine was greater driving distance from home to clinic. At KPNC, those over age 90 were most likely to use telemedicine while patients with limited English proficiency and those with a caregiver at the encounter used telemedicine at lower levels. The relationships were similar at UCSF but not statistically significant.

CONCLUSIONS: Telemedicine use is high for people with dementia in the primary care setting in the post-pandemic period. Those with longer drives to clinic and the oldest patients were most likely to use telemedicine, likely due to challenges traveling to appointments. Still, not all people with dementia used telemedicine equally-particularly those with limited English proficiency.

PMID:39046633 | DOI:10.1007/s11606-024-08836-1

Obes Surg. 2024 Jul 24. doi: 10.1007/s11695-024-07367-2. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic bariatric surgery (MBS) is standardized and safe. Nevertheless, complications such as anastomotic leakage (AL) or staple-line leakage (SLL) can occur. In upper GI or colorectal surgery, endoluminal vacuum therapy (EVT) offers a therapeutic alternative to revisional surgery. Data on EVT in patients with leakage after MBS remain scarce. The aim of this study is to evaluate the efficacy of EVT and its potential as endoscopic alternative to revisional surgery.

MATERIAL AND METHODS: All patients treated for AL or SLL with EVT after MBS between 01/2016 and 08/2023 at the Department for General Surgery, Medical University Vienna, were included in this retrospective, single-center study. Therapeutic value of EVT as management option for acute postoperative leakage after MBS in daily practice was evaluated. Statistical analyses were performed descriptively.

RESULTS: Twenty-one patients were treated with EVT within the observational period of 7 years. In 11 cases (52.4%), the index surgery was a primary bariatric intervention; in 10 cases (47.6%), a secondary surgery after initial MBS was performed. Favored approach was a combination of revisional surgery and EVT (n = 18; 85.7%), intermediate self-expanding metal stent (SEMS) in 16 (76.2%) cases. EVT was changed six times (0-33) every 3-4 days. Mean EVT time was 25.1 days (3-97). No severe associated complications were detected and EVT showed an efficacy of 95.2%.

CONCLUSION: This small case series supports the trend to establish EVT in daily clinical practice when revisional surgery after MBS is needed, thus preventing further reoperation and reducing associated morbidity and mortality in critically ill patients.

PMID:39046624 | DOI:10.1007/s11695-024-07367-2

Qual Life Res. 2024 Jul 24. doi: 10.1007/s11136-024-03738-5. Online ahead of print.

NO ABSTRACT

PMID:39046618 | DOI:10.1007/s11136-024-03738-5

Qual Life Res. 2024 Jul 24. doi: 10.1007/s11136-024-03741-w. Online ahead of print.

ABSTRACT

PURPOSE: Very little is known about the subjective well-being (SWB) of adults with a congenital corpus callosum disorder (CCD), the extent to which they feel satisfied with their lives, and what might be helpful in improving their SWB and quality of life. This study measured SWB among Australian adults with a CCD and compared the results with normative data for the wider Australian adult population.

METHODS: Online surveys were completed independently by 53 Australian adults with a CCD. Data included demographic profiles and answers to questions about satisfaction with life, employing the Personal Wellbeing Index (PWI) and one open ended question. Domains measured included life as a whole, standard of living, health, achieving in life, personal relationships, safety, community connectedness and future security. The PWI results were statistically analysed and means compared with Australian normative data. The qualitative data were analysed using deductive thematic analysis.

RESULTS: Australian adults with a CCD responded with ratings significantly below what might be expected of the adult Australian population in all domains except for standard of living and safety. Quantitative analysis results were supported by qualitative thematic analysis, expressing particular challenges and barriers to feeling satisfaction with life as a whole, personal relationships, achieving in life, health and future security.

CONCLUSION: Evidence from the PWI and accompanying qualitative responses indicate that SWB of Australian adults with CCD is significantly reduced compared with the general population. Further research is needed to examine the lived experience and explore solutions for support of this community.

PMID:39046617 | DOI:10.1007/s11136-024-03741-w

Qual Life Res. 2024 Jul 24. doi: 10.1007/s11136-024-03743-8. Online ahead of print.

ABSTRACT

PURPOSE: Symptom management among patients diagnosed with advanced cancer is a high priority in clinical care that often involves the support of a family caregiver. However, limited studies have examined parallel patient and caregiver symptom burden and associations with their own and each other’s quality of life (QOL). This study seeks to identify patient and caregiver symptom clusters and investigate associations between identified clusters and demographic, clinical, and psychosocial factors (cognitive appraisals and QOL).

METHODS: This study was a secondary analysis of self-reported baseline survey data collected from a randomized clinical trial of 484 adult advanced cancer patients and their caregivers. Latent class analysis and factor analysis were used to identify symptom clusters. Bivariate statistics tested associations between symptom clusters and demographic, clinical, and psychosocial variables.

RESULTS: The most prevalent symptom for patients was energy loss/fatigue and for caregivers, mental distress. Low, moderate, and high symptom burden subgroups were identified at the patient, caregiver, and dyad level. Age, gender, race, income, chronic conditions, cancer type, and treatment type were associated with symptom burden subgroups. Higher symptom burden was associated with more negative appraisals of the cancer and caregiving experience, and poorer QOL (physical, social, emotional, functional, and overall QOL). Dyads whose caregivers had more chronic conditions were more likely to be in the high symptom burden subgroup.

CONCLUSION: Patient and caregiver symptom burden influence their own and each other’s QOL. These findings reinforce the need to approach symptom management from a dyadic perspective.

PMID:39046614 | DOI:10.1007/s11136-024-03743-8