Tag: pubmed

BMC Infect Dis. 2024 Dec 18;24(1):1424. doi: 10.1186/s12879-024-10312-4.

ABSTRACT

BACKGROUND: Bacteremia is prevalent in neonates, largely attributed to factors inherent in the neonatal period. However, the prevalence of proven bacteremia in Ethiopian neonates has not been previously synthesized. Accordingly, this systematic review and meta-analysis aimed to analyze the prevalence of bacteremia and pathogen profiles in neonates hospitalized for clinical sepsis in Ethiopia.

METHODS: This systematic review and meta-analysis followed the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020. The literature search was conducted across five databases including PubMed, Google Scholar, Web of Science, Science Direct, and Research for Life spanning from January 2015 to July 2023. The search strategy used MeSH terms and involved screening titles and abstracts, reviewing full-text articles, and including only observational studies published in English within the specified timeframe. Data extraction and quality assessment were performed by three experienced reviewers using a validated data collection tool and the Joanna Briggs Institute quality assessment tool, respectively. The prevalence of neonatal bacteremia was determined through a random effects model, with heterogeneity among studies assessed using the Q statistic and the I² statistic. Publication bias was evaluated using a funnel plot and Egger’s regression test, and STATA version 16.0 was used for all analysis at 95% confidence level.

RESULTS: A meta-analysis of nine studies revealed a bacteremia prevalence of 40.0% (95% CI: 34.0-46.0%). Subgroup analysis indicated variations in prevalence based on regions and study designs, with Oromia at 44.0% (95% CI: 28.0, 61.0%) and Amhara at 39.0% (95% CI: 27.0, 51.0%). Longitudinal studies exhibited a higher prevalence (47.0%, 95% CI: 27.0-68.0%) compared to cross-sectional designs (38.0%, 95% CI: 32.0-44.0%). Gram-negative bacteria were identified as the predominant etiological agents, representing 59.5% (95% CI: 56.8-62.3%) of cases. Among the bacterial species, Staphylococcus aureus emerged as the most prevalent (20.0%, 95% CI: 18.0%, 22.0%), followed by coagulase-negative staphylococci and Klebsiella pneumoniae, each contributing to 17.0% (95% CI: 15.0%, 20.0%) of bacteremia cases.

CONCLUSION: The study revealed a significant high prevalence of bacteremia, with differences noted across regions and study designs. Key pathogens identified were Staphylococcus aureus, Klebsiella pneumoniae and coagulase-negative staphylococci. It is advisable to implement surveillance systems, targeted prevention strategies, diagnostic stewardship, and further research on regional variations and bacterial profiles to effectively enhance the ominous future.

PMID:39695487 | DOI:10.1186/s12879-024-10312-4

BMC Public Health. 2024 Dec 18;24(1):3451. doi: 10.1186/s12889-024-20988-7.

ABSTRACT

INTRODUCTION: Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs.

METHODS: Data from 31,781 participants in the China National Health Survey conducted from 2012 to 2017 were analyzed. Linear and non-linear relationships between RBIs and CRFs (hyperuricemia, diabetes, dyslipidemia) were assessed using restricted cubic splines. Propensity score weighting was used to balance confounders between RBI groups in the multivariable logistic regression models.

RESULTS: Hemoglobin concentration, red blood cell count and hematocrit all showed a significant linear dose-response association with all CRFs (p values < 0.001). Higher RBIs levels were associated with increased risk of hyperuricemia, diabetes, high LDL, high triglycerides, and high total cholesterol, but decreased HDL. For example, compared to the lowest quantile of HGB, the highest quantile had a 26% (13-40%) higher risk for hyperuricemia, a 43% (25-63%) higher risk of diabetes, 87% (61%-1.18 fold) higher risk of high LDL, and 68% (52-85%) higher risk of high triglycerides. Non-linear relationships were revealed between RBIs and most CRFs except uric acid and glucose. Sex differences were observed, with stronger associations between RBIs and hyperuricemia in women but stronger links with high LDL in men.

CONCLUSIONS: Elevated RBIs indicated higher risk of multiple CRFs. These findings suggest incorporating RBIs into CVD screening strategies to facilitate early prevention efforts, with consideration of sex differences.

PMID:39695473 | DOI:10.1186/s12889-024-20988-7

BMC Geriatr. 2024 Dec 18;24(1):1001. doi: 10.1186/s12877-024-05607-9.

ABSTRACT

PURPOSE: This umbrella review aimed to summarise and synthesize the evidence on the outcomes reported and used to assess the value and or efficacy of geriatric assessments (GAs) for older adults with cancer.

METHODS: Six electronic databases, PsycINFO, MEDLINE, Embase, CINAHL, Cochrane Library and Web of Science databases, were searched to identify systematic reviews with or without meta-analyses that described the value or outcomes of GAs for older adults with cancer.

RESULTS: Twenty-six systematic reviews were included, of which six included a meta-analysis of the data. Thirteen associations and or outcomes were identified. Overall geriatric impairments predicted or were associated with majority of identified outcomes. However, the type of domains associated with outcomes differed within and across reviews. Only treatment toxicity was statistically significantly lower for patients allocated to the GA intervention group compared to standard care. Systematic reviews without meta-analyses demonstrated a positive impact of GA with management on treatment completion, communication and care planning and patient satisfaction with care.

CONCLUSION: There is evidence demonstrating the predictive value of GAs for older adults with cancer. GAs seems to be beneficial for older adults with cancer across some outcomes, with strong evidence demonstrating the impact of GA with management for treatment toxicity. However, there is mixed or limited evidence demonstrating the effect of GA in other treatment modalities, and on quality of life and economic outcomes.

PMID:39695448 | DOI:10.1186/s12877-024-05607-9

BMC Cancer. 2024 Dec 18;24(1):1519. doi: 10.1186/s12885-024-13279-2.

ABSTRACT

BACKGROUND: Every year, hundreds of thousands of patients receive an orthopaedic or dental implant containing metals such as cobalt, chromium and titanium. Since the European Chemicals Agency (2020) classified pure cobalt metal as a Category 1B carcinogen, manufacturers of products containing ≥ 0.1% of this metal must perform a risk assessment and justify that there are no viable alternatives. The up-classification of cobalt metal to a carcinogen without good evidence that its use in implants is carcinogenic may cause unnecessary concern to the many patients who have, or may require such implants. Although in vitro and animal studies have shown such metals to be carcinogenic, human epidemiological studies have not been definitive. In addition, although many advances have been made in the past few decades with regard to the materials used in implant metals, no recent review of their carcinogenic effects have been published.

METHODS: This scoping review aims to summarise epidemiological studies conducted in recent years (from 2010 to present) to outline the carcinogenic effects of orthopaedic metal implants that have been published. This encompasses implants of different materials and surfaces, including metal, polyethylene and ceramic orthopaedic implants, cemented and cementless joint replacement surgeries, and surgical techniques such as resurfacing and total joint replacements that are currently in use and the potential carcinogenicity related to their use. Research papers with various study designs published in the English language were included. Studies were excluded if participants had a prior history of cancer before receiving orthopaedic implants and if they focused solely on the carcinogenicity of metals or materials not related to orthopaedic implants.

RESULTS: A total of 16 studies, encompassing over 700,000 implant patients, were identified through PubMed and have been included in this review. In long term follow-up of up to 17.9 years, no increased risk of all-site cancer was seen in these patients. However, an increase in site-specific cancers, namely prostate, melanoma and haematological cancers have been identified. Specifically, an increase in prostate cancer was identified in three studies.

CONCLUSION: Based on the summarised evidence, there is no consistent evidence to show that patients with any type of orthopaedic implant has an increased risk of cancer, although slight (non-statistically significant) increases in prostate cancer was observed and this, in particular, deserves longer-term surveillance.

PMID:39695440 | DOI:10.1186/s12885-024-13279-2

BMC Gastroenterol. 2024 Dec 18;24(1):463. doi: 10.1186/s12876-024-03557-5.

ABSTRACT

BACKGROUND: Several studies have demonstrated that systemic immune inflammation index (SII) has a positive relationship with hepatic steatosis. However, it is lack of system evidence for the correlation between SII and hepatic fibrosis. The objective of this study was to evaluate the relationships between SII and hepatic steatosis or hepatic fibrosis.

METHODS: A cross-sectional analysis was performed from the National Health and Nutrition Examination Survey (NHANES). Fibrosis-4 index (FIB-4), NAFLD fibrosis score (NFS) and hepamet fibrosis score (HFS) were the indicators for hepatic fibrosis; fatty liver index (FLI), NAFLD liver fat score (LFS) and Framingham steatosis index (FSI) were the indicators for hepatic steatosis. Pearson’s test, generalized linear model (GLM) and restricted cubic splines (RCS) were used to analyze associations of SII with hepatic fibrosis and hepatic steatosis.

RESULTS: A total of 21,833 participants were enrolled in the study. Pearson’s test and GLM revealed that there were negative relationships between SII and hepatic fibrosis (FIB-4, NFS and HFS), while positive relationships between SII and hepatic steatosis (FLI, LFS and FSI). The corresponding β (95%CI) of SII and hepatic fibrosis were – 0.35(-0.46, -0.24), -0.67(-0.71, -0.63) and – 0.10(-0.12, -0.09), respectively. The corresponding β (95%CI) of SII and hepatic steatosis were 6.12(4.75, 7.50), 0.22(0.12, 0.31) and 0.27(0.20, 0.34), respectively. Statistically significant non-linear association were found in SII with hepatic fibrosis and hepatic steatosis in RCS model (all P < 0.001).

CONCLUSION: There was a negative significant association between SII and hepatic fibrosis, while a positive significant association between SII and hepatic steatosis.

PMID:39695411 | DOI:10.1186/s12876-024-03557-5

BMC Nephrol. 2024 Dec 18;25(1):461. doi: 10.1186/s12882-024-03914-2.

ABSTRACT

BACKGROUND: Heart failure often leads to hospitalization and can directly impact other organs, such as the kidneys. Acute kidney injury (AKI) is a common complication in patients hospitalized for acute decompensated heart failure (ADHF) and is associated with worse outcomes. However, there are limited data on the magnitude of AKI among hospitalized ADHF patients in resource-limited settings such as Ethiopia. This study sought to determine the prevalence of AKI and the factors associated with AKI in ADHF patients in Northwest Ethiopia.

METHOD: A hospital-based cross-sectional study was conducted at the University of Gondar Hospital in Northwest Ethiopia from June 1 to September 30, 2022. A total of 239 participants were included using consecutive sampling. Demographic information was collected through patient interviews, and relevant clinical and laboratory data were obtained from the patients’ medical records. The data were analyzed using STATA version 15.0. Bivariate and multivariate logistic regression analyses were carried out to identify independently associated factors of AKI among patients with ADHF. A P value < 0.05 was considered to indicate statistical significance.

RESULTS: The overall prevalence of AKI in ADHF patients was 25.1% (CI = 19.98-31.03). Older age ≥ 60 years(AOR = 2.95, 95%CI:1.34-6.21), diabetes mellitus (AOR = 9.55,95%CI:2.68-33.99),Hypertension (AOR = 2.34,95% CI:1.08-5.07), sepsis (AOR = 2.13,95%CI:1.09-4.8), use of loop diuretics (AOR = 4.03,95%CI:1.86-8.69) and previous history of AKI (AOR = 11.56,95%CI:4.02-33.26) were independently associated with the occurrence of AKI among ADHF patients.

CONCLUSION: A quarter of the patients admitted with ADHF developed AKI. Older age; comorbid diabetes mellitus, hypertension, or sepsis; a previous history of AKI; and the use of loop diuretics were associated with the occurrence of AKI. Such clinical characteristics available at hospital admission can be used to identify patients at increased risk for developing AKI.

PMID:39695409 | DOI:10.1186/s12882-024-03914-2

BMC Gastroenterol. 2024 Dec 18;24(1):459. doi: 10.1186/s12876-024-03515-1.

ABSTRACT

BACKGROUND: The worldwide incidence of constipation is exhibiting an increasing trend. The objective of this study was to assess the relationship between dietary components and the occurrence of constipation.

METHODS: Sociodemographic characteristics data of participants experiencing constipation and those without were sourced from the National Health and Nutrition Examination Survey (NHANES; 2000-2010; n = 1903; ≥20 years). Sociodemographic characteristics of participants experiencing constipation and those without were sourced from the National Health and Nutrition Examination Survey (NHANES). Data from two 24-hour dietary recalls (n = 1696; participants aged 20 years and older) were utilized to compare the dietary intake of various food components between constipated and non-constipated individuals, as well as to investigate the relationship between food component consumption and constipation. Odds ratios (OR) were calculated using an adjusted model. The distribution of the data was illustrated through a histogram. Based on this distribution, vegetable intake was categorized into five groups (0-0.733, 0.733-1.47, 1.47-2.2, 2.2-2.93, 2.93-8) for the purpose of subgroup analysis.

RESULTS: The median age of individuals experiencing constipation is 41.5 years, with women accounting for 65.3% and men accounting for 34.7%. The consumption of fruits (constipated people = 0.79 cups/d; non-constipated people = 0.93 cups/d), vegetables (1.21 cups/d; 1.59 cups/d), dairy (1.68 cups/d; 1.55 cups/d), and oils (15.31 g/d; 19.61 g/d) is below the recommended dietary intake for both groups. After multivariable adjustment, vegetable consumption (OR: 0.74, 95% CI: 0.59-0.92, p = 0.008) and female (OR: 2.12, 95% CI: 1.38-3.24, p < 0.001) were identified as significant predictors of constipation. The subgroup analysis concerning vegetable consumption indicated a statistically significant result within Group (2.93,8 ] [OR: 0.2, 95% CI: 0.069-0.57].

CONCLUSIONS: The findings of the research suggest that it is advisable for individuals to consume a minimum of 2.93 cups of vegetables daily. Furthermore, females exhibit a significantly elevated risk of experiencing constipation. However, no association has been identified between constipation and either age or educational level.

PMID:39695406 | DOI:10.1186/s12876-024-03515-1

BMC Pregnancy Childbirth. 2024 Dec 18;24(1):820. doi: 10.1186/s12884-024-07030-9.

ABSTRACT

BACKGROUND: Maternal morbidity and mortality remain critical health concerns globally. As a result, reducing the maternal mortality ratio (MMR) is part of goal 3 in the global sustainable development goals (SDGs), and previously, it was an important indicator in the Millennium Development Goals (MDGs). Therefore, identifying high-risk groups during pregnancy is crucial for decision-makers and medical practitioners to mitigate mortality and morbidity. However, the availability of accurate predictive models for maternal mortality and maternal health risks is challenging. Compared with traditional predictive models, machine learning algorithms have emerged as promising predictive modelling methods providing accurate predictive models.

METHODS: This work aims to explore the potential of machine learning (ML) algorithms in maternal risk level prediction using a nationwide maternal mortality dataset from Oman for the first time. A total of 402 maternal deaths from 1991 to 2023 in Oman were included in this study. We utilised principal component analysis (PCA) in the ML algorithms and compared them to the results of model performance without PCA. We employed and compared ten ML algorithms, including decision tree (DT), random forest (RF), K-Nearest Neighbors (KNN), Naïve Bayes (NB), Extreme Gradient Boosting (xgboost), Linear Discriminant Analysis (LDA), Quadratic Discriminant Analysis (QDA), Logistic Regression (LR), Support Vector Machine (SVM) and Artificial Neural Network (ANN). Different metrics, including, accuracy, sensitivity, precision, and the F1- score, were utilised to assess Model performance.

RESULTS: The results indicated that the RF model outperformed the other methods in predicting the risk level (low or high) with an accuracy of 75.2%, precision of 85.7% and F1- score of 73% after PCA was applied.

CONCLUSIONS: We applied several machine learning models to predict maternal risk levels for the first time using real data from Oman. RF outperformed the other algorithms in this classification problem. A reliable estimate of maternal risk level would facilitate intervention plans for medical practitioners to reduce maternal death.

PMID:39695398 | DOI:10.1186/s12884-024-07030-9

BMC Med Res Methodol. 2024 Dec 18;24(1):304. doi: 10.1186/s12874-024-02424-x.

ABSTRACT

BACKGROUND: Medical record abstraction (MRA) is a commonly used method for data collection in clinical research, but is prone to error, and the influence of quality control (QC) measures is seldom and inconsistently assessed during the course of a study. We employed a novel, standardized MRA-QC framework as part of an ongoing observational study in an effort to control MRA error rates. In order to assess the effectiveness of our framework, we compared our error rates against traditional MRA studies that had not reported using formalized MRA-QC methods. Thus, the objective of this study was to compare the MRA error rates derived from the literature with the error rates found in a study using MRA as the sole method of data collection that employed an MRA-QC framework.

METHODS: A comparison of the error rates derived from MRA-centric studies identified as part of a systematic literature review was conducted against those derived from an MRA-centric study that employed an MRA-QC framework to evaluate the effectiveness of the MRA-QC framework. An inverse variance-weighted meta-analytical method with Freeman-Tukey transformation was used to compute pooled effect size for both the MRA studies identified in the literature and the study that implemented the MRA-QC framework. The level of heterogeneity was assessed using the Q-statistic and Higgins and Thompson’s I² statistic.

RESULTS: The overall error rate from the MRA literature was 6.57%. Error rates for the study using our MRA-QC framework were between 1.04% (optimistic, all-field rate) and 2.57% (conservative, populated-field rate), 4.00-5.53% points less than the observed rate from the literature (p < 0.0001).

CONCLUSIONS: Review of the literature indicated that the accuracy associated with MRA varied widely across studies. However, our results demonstrate that, with appropriate training and continuous QC, MRA error rates can be significantly controlled during the course of a clinical research study.

PMID:39695394 | DOI:10.1186/s12874-024-02424-x

BMC Nephrol. 2024 Dec 18;25(1):455. doi: 10.1186/s12882-024-03870-x.

ABSTRACT

BACKGROUND: The relationship between serum klotho level and albuminuria is unknown in middle-aged and elderly participants without diabetes mellitus (DM). Therefore, we will investigate the association between serum klotho level and albuminuria in middle-aged and elderly participants without DM.

METHODS: Participants (aged 40-79) were from the five continuous cycles (2007-2016) of the National Health and Nutrition Examination Survey (NHANES). Multiple logistic regression was performed to investigate the association between serum klotho level and albuminuria.

RESULTS: 9217 participants were included in the present study. 47.6% of the participants were male. The average age of the overall participants was 56.3 years (40-79 years). Overall, 823 participants with albuminuria were identified. After adjusted confounders (age, gender, marital status, ethnicity, family income to poverty ratio, education, body mass index, smoke, charlson comorbidity index, hypertension, hyperlipidemia, angiotensin converting enzyme inhibitor/angiotonin receptor blocker, and estimated glomerular filtration rate), participants with a high serum klotho level had a decreased risk for albuminuria. Compared with the lowest serum klotho level (Tertile 1), participants in Tertile 2 (odds ratio [OR] 0.83, 95% CI 0.70-0.99, P = 0.044) and Tertile 3 (OR 0.76, 95% CI 0.63-0.91, P = 0.003) had a lower risk of albuminuria (P for trend = 0.002). The stratified analysis showed that serum klotho level was still negatively associated with albuminuria in the subgroups, and statistically significant interactions were not observed in the subgroups (all P values for interactions > 0.05, except for the hypertension subgroup).

CONCLUSIONS: In middle-aged and elderly participants without DM, a high serum klotho level is associated with a decreased risk of albuminuria. In the future, the mechanism of the interaction between klotho and albuminuria needs to be elucidated to find new treatment targets for individuals without DM who suffer from albuminuria.

PMID:39695385 | DOI:10.1186/s12882-024-03870-x