Tag: pubmed

Adv Neonatal Care. 2024 Dec 1;24(6):569-577. doi: 10.1097/ANC.0000000000001204. Epub 2024 Nov 26.

ABSTRACT

BACKGROUND: The challenging transition to parenthood affects both mothers and fathers; yet, the strain intensifies with a premature birth in the neonatal intensive care unit (NICU), underscoring the importance of acknowledging and addressing potential differences in parental roles.

PURPOSE: This paper aimed to investigate how parental role conflicts among mothers and fathers of preterm-born infants hospitalized in German NICUs manifest and investigated potential parental resources.

METHODS: Twenty-four participants, 17 mothers, and seven fathers of very low birth-weight infants were interviewed. A thematic content analysis was performed at a semantic level.

RESULTS: Fathers feel pressured to fulfill the role expectations, often leading to the suppression of paternal feelings and needs. For mothers, deviating from societal expectations regarding their expressive roles can be distressing, as they worry that such deviation might hinder their infants from having a successful start in life. Consulting with healthcare professionals shows to ease challenges for both parental roles.

IMPLICATIONS FOR PRACTICE AND RESEARCH: Maternal and paternal challenges are often rooted in expectations placed on their societal roles. Highlighting these challenges can be essential for increasing awareness and effectively addressing them. Tailored nursing practices may have the potential to facilitate individuals’ navigation of uncertainties and fulfillment of caregiving roles.

PMID:39602093 | DOI:10.1097/ANC.0000000000001204

Adv Neonatal Care. 2024 Dec 1;24(6):517-524. doi: 10.1097/ANC.0000000000001212. Epub 2024 Nov 26.

ABSTRACT

BACKGROUND: In 2020, the rate of newborns diagnosed with neonatal abstinence syndrome (NAS) in the United States was 6.3 for every 1000 newborn hospitalizations. Resources used to care for this population, particularly NICU beds, are being overwhelmed. In 2020, the state of Ohio saw a rate of 9.5 newborns with NAS for every 1000 newborn hospitalizations.

PURPOSE: To determine if using the Eat, Sleep, Console (ESC) model of care to guide management of neonates with NAS instead of the Finnegan Scale would reduce the number of admissions of neonates diagnosed with NAS to the neonatal intensive care unit (NICU).

METHODS: The PDSA (Plan, Do, Study, Act) method was used in the planning and implementation of this pilot quality improvement project. Education regarding the ESC model of care was provided to the Mother/Infant Unit (MIU), with ongoing education and resources provided and readily available on the unit.

RESULTS: Fifteen neonates were managed with ESC. Of the 5 who would have been admitted to the NICU for pharmacological treatment if Finnegan Scores were the determining factor for admission, 2 were discharged home from the MIU having been managed with ESC.

IMPLICATIONS FOR PRACTICE AND RESEARCH: The use of the ESC model of care can be a useful tool in the management and assessment of neonates with NAS. Resource allocation for care of this population must be assessed to provide optimal non-pharmacological interventions.

PMID:39602091 | DOI:10.1097/ANC.0000000000001212

Transfus Med. 2024 Nov 27. doi: 10.1111/tme.13115. Online ahead of print.

ABSTRACT

BACKGROUND: Granulocyte transfusions represent a therapeutic option for severely neutropenic patients with bacterial or fungal infections that are otherwise unresponsive to conventional therapy. Prior clinical studies suggest that patients receiving higher granulocyte doses achieve superior outcomes. Consequently, suboptimal donor stimulation and collection leading to lower granulocyte doses likely correlate with worse clinical outcomes.

STUDY DESIGN: A retrospective analysis was conducted on mobilisation data from 312 granulocyte collections from healthy donors between January 2020 and May 2023. This study was performed in a single blood donor center exclusively supporting a comprehensive cancer center. Donors underwent stimulation with 480 mcg of filgrastim (granulocyte colony stimulating factor [G-CSF]) subcutaneously and 8 mg of dexamethasone orally administered 12 to 14 h before collection. The correlation between donor characteristics (age, gender, body weight (BW), body mass index (BMI), baseline haemoglobin (Hgb), and platelet (PLT) counts) and mobilisation efficiency (Δ WBC, defined as post-mobilisation WBC count-baseline WBC count) was examined to identify factors associated with enhanced mobilisation efficiency. Additionally, the impact of multiple donations on Δ WBC in repeat donors was assessed.

RESULTS: The median donor age was 43 years (range 18-81), with 224 male and 88 female donors. Female donors exhibited significantly higher baseline PLT counts and post-mobilisation WBC counts. However, donor gender did not significantly affect Δ WBC. A negative correlation was observed between Δ WBC and age (r = -0.235, p = 0.001), with older donors (61-81 years) exhibiting significantly lower mobilisation efficiency. BW and BMI differences had no significant effect on Δ WBC. A positive correlation was identified between baseline PLT count and Δ WBC (r = 0.140, p = 0.014), with females having significantly higher baseline PLT counts (p = 0.0004). No correlation was found between Δ WBC and baseline Hgb (r = 0.004, p = 0.477). Repeat donors showed no statistically significant change in Δ WBC with subsequent donations, with a mean interval of 136.5 days between collections.

CONCLUSION: Mobilisation efficiency was not impacted by donor BW or BMI suggesting that BW-based G-CSF stimulation is not essential for optimising WBC mobilisation. Rather, a fixed single dose of 480 mcg of G-CSF and 8 mg of dexamethasone was sufficient to mobilise donors, thus reducing the procedural costs and the potential risks for medication-related side effects. The positive correlation found between baseline PLT count and Δ WBC suggests that PLT count could be used as a potential predictor of mobilisation efficiency. Mobilisation response in up to four collections in repeat granulocytes donors was not affected in subsequent donations. However, sample size is a limitation, and more data is needed for a meaningful conclusion of whether frequent granulocyte donations are safe and effective.

PMID:39601217 | DOI:10.1111/tme.13115

Am J Mens Health. 2024 Nov-Dec;18(6):15579883241296881. doi: 10.1177/15579883241296881.

ABSTRACT

Infertility was reported in approximately 15% of all heterozygous couples, with the male factor accounting for nearly half of the cases. This typically occurs due to low sperm production, sperm dysfunction, and sperm delivery obstruction. In this randomized controlled single-blind clinical trial, 90 infertile male subjects diagnosed with oligospermia, hypospermia, asthenozoospermia, or necrozoospermia were recruited. Semen samples were obtained with the masturbation method and an assessment of semen volume, sperm count, and motility was performed. Five milliamps of electrical shock was delivered to the participants through the fertility improvement device. Semen analysis was collected 4 months post-intervention from all subjects. Data were collected and an analysis of pre- and post-intervention results was performed. There was an improvement in the count, volume, and motility of the patient’s sperm after electrical shock treatment compared with the control group. By using the analysis of variance (ANOVA) test, there were statistically significant differences between the first and the second seminal analysis results (<.05). All other results were found to be independently correlated. This study demonstrated that using a painless, convenient at-home device, which is designed to contain all the testis tissue as a cup and then extend to include the scrotal roots reaching the penile root to include the epididymis, could significantly improve sperm motility and count. This device can be utilized to tackle the significant issue of infertility in a cost-effective, safe, and efficacious manner. An ultrasound was done before and after using the device as well as years after with no changes noted.Clinical Trial’s Registration Number: NCT04173052.

PMID:39601214 | DOI:10.1177/15579883241296881

Aging Male. 2024 Dec;27(1):2429456. doi: 10.1080/13685538.2024.2429456. Epub 2024 Nov 27.

ABSTRACT

OBJECTIVE: To investigate the risk factors of bladder neck contracture (BNC) after transurethral endoscopic surgery for benign prostatic hyperplasia (BPH), and to provide a reference basis for the clinic.

METHODS: Clinical data of patients who underwent transurethral endoscopic surgery in our hospital from December 2019 to May 2023 were retrospectively collected. The incidence and risk factors of BNC after transurethral endoscopic surgery were analyzed by multivariate logistic regression analysis.

RESULTS: A total of 420 cases were included in this study, of which 246 were treated with bipolar transurethral resection of the prostate (bTURP) and 174 with green light laser vaporization of the prostate (GL-PVP), and there was no statistically significant difference in the incidence of BNC when comparing these two types of operations. A total of 18 patients developed BNC after surgery, and the overall incidence of BNC was 4.29%. Multivariate logistic regression analysis showed that smaller preoperative prostate volume (p = 0.042), smoking history (p = 0.009), positive preoperative urine culture (p = 0.001), and prolonged postoperative catheterization days (p = 0.003) were independent risk factors of BNC.

CONCLUSION: Smaller preoperative prostate volume, smoking history, positive preoperative urine culture, and prolonged postoperative indwelling catheterisation were independent risk factors for BNC.

PMID:39601210 | DOI:10.1080/13685538.2024.2429456

J Cosmet Dermatol. 2024 Nov 27:e16695. doi: 10.1111/jocd.16695. Online ahead of print.

ABSTRACT

BACKGROUND: One of the worst long-term effects of acne is scarring, which leads to significant physical, psychological, and economic burdens. Limited studies have specifically studied the risk factors for acne scarring. This study aims to explore risk factors associated with facial acne scarring in Thai patients with acne.

METHODS: Exploratory cross-sectional risk factor research was conducted using an online questionnaire on Thai patients aged ≥ 18 years who were diagnosed with acne between September and December 2023. The primary objective was to identify significant determinants of acne scars in patients with acne, including sociodemographic factors, clinical factors of acne, lifestyle factors, dietary habits factors, and treatment factors. Univariable and multivariable logistic regression were used to identify significant risk determinants.

RESULTS: Of 225 patients with 61.33% prevalence of acne scarring, acne scarring was found to be independently associated with the following variables: moderate acne (mOR 3.51, 95% CI 1.31-9.40, p = 0.012) or severe-to-very severe acne (mOR 8.98, 95% CI 2.71-29.73, p < 0.001), sometimes squeezing and picking behaviors (mOR 2.69, 95% CI 2.71-29.73, p = 0.033), and postacne erythema (PAE) (mOR 4.46, 95% CI 1.96-10.14, p < 0.001).

CONCLUSION: The risk factors associated with acne scarring in individuals include the severity of acne, squeezing and picking behaviors, and experiencing PAE. One of this study’s essential findings confirms that PAE is a notable component that could contribute to the development of acne scars. Early treatment of individuals at risk is crucial to reduce scar formation.

PMID:39601200 | DOI:10.1111/jocd.16695

Head Neck. 2024 Nov 27. doi: 10.1002/hed.28003. Online ahead of print.

ABSTRACT

BACKGROUND: There is currently a lack of consensus regarding neuropsychiatric symptoms as an indication for parathyroidectomy in primary hyperparathyroidism (pHPT). The purpose of this study is to perform a systematic review and meta-analyses of pre- and postoperative Beck Depression Inventory-II (BDI-II) scores in patients with pHPT undergoing parathyroidectomy.

METHODS: A search of the literature was performed using Embase, PubMed, Web of Science, PsycINFO, and OvidAll EBM Reviews. Studies were included if they evaluated BDI-II scores in pHPT patients before and after parathyroidectomy.

RESULTS: The literature search returned 1554 studies, of which nine articles met criteria for inclusion. Baseline BDI-II scores were significantly higher in pHPT patients compared to control patients. pHPT patients experienced a statistically significant decrease in BDI-II scores at ≤ 1 and 6 months postoperatively.

CONCLUSIONS: Based on the results of this study, a BDI-II score ≥ 14 could potentially advocate for parathyroidectomy in patients with pHPT.

PMID:39601197 | DOI:10.1002/hed.28003

J Med Virol. 2024 Nov;96(11):e70089. doi: 10.1002/jmv.70089.

ABSTRACT

The risks of uveitis development among monkeypox (MPOX) patients are unclear. To determine the uveitis risks after (MPOX) diagnosis. Population-based, retrospective cohort study used the TriNetX database and recruited those with and without MPOX diagnosis from January 1, 2016, to December 31, 2023. The non-MPOX cohort consisted of randomly selected control patients matched by covariates, including age, gender, ethnicity, race, relevant comorbidities, previous medications, and the inflammatory marker C-reactive protein. Statistical analysis on uveitis risk included hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated over 8 years (2016-2023). A separate analysis of the risk of uveitis among MPOX patients aged 20 years and older was also conducted. (MPOX) diagnosis, identified using electronic diagnostic codes. Cumulative incidence of new-onset uveitis. A total of 5449 MPOX patients of all ages (25.45% female; mean age at index 35.17 ± 15.70 years) and 5449 propensity-matched non-MPOX comparators (23.97% female; mean age at index 35.30 ± 15.91 years) were recruited from the TriNetX database. For both the overall MPOX patient population and the adult MPOX patients, the risk of uveitis was significantly higher compared to the non-MPOX cohort. This increased risk mainly happened in patients with anterior uveitis. Specifically, the hazard ratio for uveitis in all MPOX patients was 2.59 (95% CI: 1.40-4.79). Among MPOX patients aged 20 years or older, the hazard ratio for uveitis was 2.14 (95% CI: 1.17-3.94). There is a notable association between new-onset uveitis and patients with MPOX. Our real-world findings underscore the importance of being aware of the potential risk of anterior uveitis in this patient population.

PMID:39601175 | DOI:10.1002/jmv.70089

J Med Virol. 2024 Nov;96(11):e70093. doi: 10.1002/jmv.70093.

ABSTRACT

Hematopoietic stem cell transplantation is a curative therapy for pediatric patients with malignancies and blood or immune system disorders. However, recipients are at risk of opportunistic infections, including cytomegalovirus infection, due to immunosuppression from conditioning regimens. This retrospective study analyzed 439 pediatric hematopoietic stem cell transplantation patients to identify risk factors for cytomegalovirus infection and assess the impact of conditioning regimens. Significant factors included graft source, graft versus host disease, and pre-transplant clinically significant cytomegalovirus infection. Myeloablative conditioning regimens and the use of anti-thymocyte globulin increased the risk of clinically significant cytomegalovirus infection. Additionally, the risk of cytomegalovirus infection in patients was found to be statistically significant in the myeloablative subgroup analyses who received anti-thymocyte globulin alone and those who received both anti-thymocyte globulin and total body irradiation. In our study, total body irradiation did not significantly affect the risk of clinically significant cytomegalovirus infection. This study covers a 10-year period and a large pediatric patient population from a single center. Our findings highlight the importance of understanding risk factors for clinically significant cytomegalovirus infection to guide preventive strategies in pediatric HSCT recipients.

PMID:39601160 | DOI:10.1002/jmv.70093

Stroke. 2024 Nov 27. doi: 10.1161/STROKEAHA.124.045607. Online ahead of print.

ABSTRACT

BACKGROUND: Lack of a dedicated thrombectomy device for cerebral venous thrombosis hinders the recanalization ability of endovascular treatment (EVT). Novel NiTi-braided stent retriever (Venous-TD) is a dedicated venous sinus thrombectomy device. This study aims to demonstrate the safety and efficacy of Venous-TD.

METHODS: In this pilot, prospective, randomized, single-blind, parallel-group control, single-center clinical study, patients with cerebral venous thrombosis from Beijing Xuanwu Hospital were included. Randomization was performed to EVT with either the Venous-TD or Angioguard with Sterling balloon (control group). The primary efficacy outcome was the proportion of immediate complete recanalization during EVT. Secondary outcomes included the proportion of functional independence and moderate to severe residential headache at 180 days after EVT. Safety outcomes included peri-procedural complications, all-cause mortality, and symptomatic intracranial hemorrhage after EVT.

RESULTS: A total of 61 patients were enrolled and randomized. Thirty-one patients were randomized to the Venous-TD group, and 30 were randomized to the control group. The median (interquartile range) age was 28 (21-45) in the Venous-TD group and 34 (24-43) in the control group. The proportion of patients with a National Institutes of Health Stroke Scale score >8 on admission was 8 (25.8%) in the Venous-TD group and 11 (36.7%) in the control group. During EVT, Venous-TD significantly improved the proportion of complete recanalization compared with Angioguard (23 [76.7%] versus 6 [20.0%]; relative risk, 3.833 [95% CI, 1.825-8.054]). The proportions of long-term functional independence at 180 days in the Venous-TD group and the control group were not significantly different. The proportion of patients with severe residual headache at 180 days in the Venous-TD group was significantly lower than that in the control group (3 [9.7%] versus 10 [35.7%]; relative risk, 0.271 [95% CI, 0.083-0.886]). Safety outcomes showed no statistically significant difference between the 2 groups.

CONCLUSIONS: This trial indicated that Venous-TD did not increase complications in EVT of cerebral venous thrombosis and can significantly increase the proportion of complete recanalization. A multicenter phase III randomized control trial assessing efficacy and safety of Venous-TD is warranted.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05291585.

PMID:39601121 | DOI:10.1161/STROKEAHA.124.045607