Tag: pubmed

Sleep Breath. 2023 Oct 17. doi: 10.1007/s11325-023-02933-x. Online ahead of print.

ABSTRACT

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the effectiveness of aquatic therapy on pain, sleep quality, psychological symptoms, quality of life, and health status in people diagnosed with fibromyalgia.

METHODS: We searched PubMed, CINAHL, The Cochrane Library, PEDro and Scopus databases. Articles were eligible if they were randomised controlled trials (RCTs) analysing the effects of aquatic therapy in adult people diagnosed with fibromyalgia, and published by October of 2022 in English or Spanish. The Cochrane Risk of Bias tool was employed to conduct the methodological quality assessment of the encompassed studies, and the overall quality of evidence for each comparison was determined using the GRADE approach.

RESULTS: Of 375 articles found, 22 met the inclusion criteria. Forest plot analysis of Pittsburgh sleep quality index at short- and mid-term follow-up showed a trend in favour of aquatic therapy, although not statistically significant, with weighted mean difference (WMD) = -1.71 (95% CI: -4.17 to -0.75, p = 0.17). Heterogeneity was substantial (χ² = 8.74, df = 5 (p < 0.000001; I² = 95%). Relating the pain outcome by fibromyalgia impact questionnaire (FIQ) short term showed a trend in favour of the aquatic therapy group with WMD = -5.04 (95% CI: – 9.26 to – 0.82, p = = 0.02) with heterogeneity χ² = 11.07, df = 4 (p = 0.03; I² = 64%). Great heterogeneity was found between trials in medium term.

CONCLUSION: This systematic review and meta-analysis demonstrated the effectiveness of aquatic therapy as an adjunct treatment to usual care in people suffering from fibromyalgia. Aquatic therapeutic exercise improves the symptomats of sleep quality, pain, and quality of life of adults with fibromyalgia. Further research on long-term outcomes may contribute to the currently available evidence.

PMID:37847348 | DOI:10.1007/s11325-023-02933-x

Int Urol Nephrol. 2023 Oct 17. doi: 10.1007/s11255-023-03829-1. Online ahead of print.

ABSTRACT

OBJECTIVE: This study is planned based on the hypothesis that if bladder cancer is detected early, the disease would be less advanced and the possibility of treatment will increase, at least the recurrence-free survival will be longer. Regarding this hypothesis, it is aimed to investigate the effect of delayed diagnosis primarily on the disease factors.

MATERIALS AND METHODS: The study included 169 patients, who underwent TUR-BT with the suspicion of bladder cancer in the urology clinic of Afyonkarahisar Faculty of Medicine between April 2018 and April 2023. Demographic and clinical data of the patients were recorded and compared.

RESULTS: It was observed that the delay in diagnosis was significantly longer in patients with tumors larger than 3 cm compared to patients with tumors smaller than 3 cm (p < 0.001). In the correlation analysis between tumor size, duration of diagnosis delay, age, T stage, and tumor grade, a low level of positive correlation was observed between tumor size and duration of diagnosis delay, and it was statistically significant (r = 0.215, p = 0.005).

CONCLUSION: In our study, it was shown that the tumor size increases as the duration of diagnosis delay increases and this increase causes an increase of 0.088 mm in the pathological size of the tumor in the 1-day delay period. Considering that tumor size changes the risk group of the disease in bladder tumors, and relatedly the follow-up and treatment process changes, we believe that these data will be valuable in the management of bladder cancer.

PMID:37847325 | DOI:10.1007/s11255-023-03829-1

Int Urol Nephrol. 2023 Oct 17. doi: 10.1007/s11255-023-03838-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate clinicopathological characteristics, surgical treatments, and oncological outcomes of patients with localized primary unifocal urothelial carcinoma involving the ureterovesical junction (UC-UVJ).

PATIENTS AND METHODS: Localized primary unifocal UC-UVJ cases in patients admitted to our hospital from March 2013 to August 2021 were reviewed. Clinicopathological parameters, perioperative data, and oncological outcomes were compared between patients grouped by tumor location and surgical treatment.

RESULTS: A total of 130 patients with localized primary unifocal UC-UVJ were enrolled in this study. These included 72 cases of bladder cancer (BC) involving the ureteral orifice, and 58 cases of upper urinary tract urothelial carcinoma (UTUC) involving the intramural ureter. The proportion of male patients, hydronephrosis, flank pain/abdominal pain, and tumor size differed significantly between the BC and UTUC groups (all P < 0.05). During the median follow-up period of 32.9 months, 49 cases (37.7%) recurred and 29 (22.3%) died from urothelial carcinoma (UC), though no statistical difference in recurrence (P = 0.436) or cancer-specific mortality (P = 0.653) was observed between the BC and UTUC groups. Cox proportional hazards regression analysis identified age, tumor grade, and lymphovascular invasion (LVI) as independent predictors of cancer-specific survival (CSS), and sex, T stage, tumor grade, and LVI as independent predictors of recurrence-free survival (RFS).

CONCLUSION: Owing to positional properties, patients with localized primary unifocal UC-UVJ exhibited significant heterogeneity, leading to varied treatment strategies. No statistically significant differences in CSS or RFS were observed between the BC and UTUC groups. Furthermore, age, sex, T stage, tumor grade, and LVI should be carefully considered in clinical practice because of their associations with CSS and RFS.

PMID:37847324 | DOI:10.1007/s11255-023-03838-0

Eur J Ageing. 2023 Oct 17;20(1):39. doi: 10.1007/s10433-023-00787-6.

ABSTRACT

During the early stages of the COVID-19 pandemic, stringent measures were implemented in most countries to limit social contact between residents of long-term care facilities (LTCF) and visitors. The objective of this scoping review was to identify and map evidence of direct and indirect consequences of contact restrictions, guided by three conceptual perspectives: (1) stress and learned helplessness (i.e., failure to use coping behaviors even when they are available and actionalble); (2) social contact loss; and (3) ‘total institution’ (i.e., a facility operates following a fixed plan due to spelled-out rules and norms, controlled by institutional representatives). We used the framework for conducting a scoping review by Arksey and O’Malley; included were peer-reviewed manuscripts reporting on the outcomes of contact restrictions from the beginning of the pandemic until the end of 2020. After removing duplicates, 6,656 records were screened and 62 manuscripts included. Results pertaining to the stress and learned helplessness perspective primarily focused on depressive symptoms, showing substantial increases compared to the pre-pandemic period. Studies examining cognitive and functional decline, as well as non-COVID-19 related mortality, were limited in number and presented mixed findings. The majority of study outcomes related to the social contact loss perspective focused on loneliness, but the study designs did not adequately allow for comparisons with the pre-pandemic status. The evidence concerning outcomes related to the ‘total Institution’ perspective was inconclusive. Although detrimental effects of social isolation in the long-term care context found support particularly in the negative affect domain, other outcome areas did not allow for definitive conclusions due to considerable variations in findings and, in some cases, insufficient statistical power.

PMID:37847318 | DOI:10.1007/s10433-023-00787-6

Microsurgery. 2023 Oct 17. doi: 10.1002/micr.31124. Online ahead of print.

ABSTRACT

BACKGROUND: Abdomen-based free flaps represent the gold standard option in the armamentarium of breast reconstruction. The natural evolution to more preservation with less invasive forms of these flaps has been driven by both patient and surgeon satisfaction. Nevertheless, obese patients are challenging due to the increased risk of compromised flap perfusion and donor site morbidity. This challenge is compounded by the prevalence of obesity worldwide, resulting in more free abdominal flaps being performed for breast reconstruction in obese patients. The authors present the outcomes of a modified supra-arcuate fascial muscle-sparing transverse rectus abdominus myocutaneous (FMS-TRAM) technique compared to standard muscle-sparing transverse rectus abdominus myocutaneous (MS-TRAM) technique to reduce the donor site morbidity while providing a well-vascularized large volume of autologous tissue.

METHODS: A retrospective comparative data analysis was conducted at two centers: Cairo University Hospitals, Egypt, and University Hospitals Birmingham, United Kingdom. Standard MS-TRAM was performed in 65 patients between 2008 and 2011 (Group 1) versus 275 patients between 2011 and 2020 (Group 2) who underwent FMS-TRAM. The modified technique involved limiting the fascial incision to above or at the level of the arcuate line to preserve the integrity of the anterior rectus sheath caudally. All patients included were of the obese population (BMI≥30 kg/m² ) and underwent unilateral post-mastectomy reconstruction. Patient demographics, comorbidities, operative details, and outcomes focusing on donor site morbidity and flap complications were recorded and compared between the two groups.

RESULTS: The median age and BMI for Group 1 were 43 and 32, respectively. While for Group 2, they were 47 and 33, respectively. Flap weight ranged from 560 to 1470 g (Mean 705) for Group 1, while Group 2 ranged from 510 to 1560 (mean 715). The majority (280/340 [82%]) of the patients in both groups received radiotherapy. 7.7% of Group 1 were smokers, while in Group 2 it was 4.7%. The percentage of delayed versus immediate reconstruction in Group 1 was 60%/40%, while in Group 2, it was 43%/56%. The incidence of fat necrosis, partial necrosis, and total necrosis was 7.6%.1.5%, and 3%, respectively, for Group 1 and 8%, 1.4%, and 2.6%, respectively, for Group 2. The two-tailed p-value demonstrated a significant statistical difference (p < 0.00001) in donor site morbidity between both groups, with more bulge 20% (13/65) and hernia 1.5% (2/65) occurrence in Group 1 versus 1.9% (5/275) and 0.7% (2/275) in Group 2 respectively, over a follow-up period ranging from 24 to 60 months (mean 32).

CONCLUSION: FMS-TRAM flaps are safe, robust, and reliable with less donor site morbidity while maintaining optimal flap perfusion for large volume flaps in obese patients with excellent, durable outcomes. It should be considered a valuable tool in the reconstructive armamentarium of breast reconstruction.

PMID:37846651 | DOI:10.1002/micr.31124

Int J Cancer. 2023 Oct 17. doi: 10.1002/ijc.34765. Online ahead of print.

ABSTRACT

The proportion of lung cancer in never smokers is rising, especially among Asian women, but there is no effective early detection tool. Here, we developed a polygenic risk score (PRS), which may help to identify the population with higher risk of lung cancer in never-smoking women. We first performed a large GWAS meta-analysis (8595 cases and 8275 controls) to systematically identify the susceptibility loci for lung cancer in never-smoking Asian women and then generated a PRS using GWAS datasets. Furthermore, we evaluated the utility and effectiveness of PRS in an independent Chinese prospective cohort comprising 55 266 individuals. The GWAS meta-analysis identified eight known loci and a novel locus (5q11.2) at the genome-wide statistical significance level of P < 5 × 10^-8 . Based on the summary statistics of GWAS, we derived a polygenic risk score including 21 variants (PRS-21) for lung cancer in never-smoking women. Furthermore, PRS-21 had a hazard ratio (HR) per SD of 1.29 (95% CI = 1.18-1.41) in the prospective cohort. Compared with participants who had a low genetic risk, those with an intermediate (HR = 1.32, 95% CI: 1.00-1.72) and high (HR = 2.09, 95% CI: 1.56-2.80) genetic risk had a significantly higher risk of incident lung cancer. The addition of PRS-21 to the conventional risk model yielded a modest significant improvement in AUC (0.697 to 0.711) and net reclassification improvement (24.2%). The GWAS-derived PRS-21 significantly improves the risk stratification and prediction accuracy for incident lung cancer in never-smoking Asian women, demonstrating the potential for identification of high-risk individuals and early screening.

PMID:37846649 | DOI:10.1002/ijc.34765

J Perinat Med. 2023 Oct 18. doi: 10.1515/jpm-2023-0280. Online ahead of print.

ABSTRACT

OBJECTIVES: Although the knowledge on SARS-CoV-2 infection in pregnancy has greatly improved, there is still a lack of information on its role in the later stages of gestation. The aim of this study is to investigate whether SARS-CoV-2 discovered at delivery is associated with any obstetric or neonatal complications.

METHODS: A retrospective case-control study was conducted at Department of Obstetrics, University Hospital Maggiore della Carità, Novara, Italy, from March 2020 to March 2023. Pregnant women admitted were tested for SARS-CoV-2. 168 women resulted positive at the time of delivery; the women were asymptomatic or paucisymptomatic. 170 negative women were selected as controls, selecting, for each SARS-CoV-2 positive patient, the patient who gave birth right before, if negative. Demographic and anamnestic characteristics, pregnancy, labor, and neonatal outcomes were evaluated.

RESULTS: SARS-CoV-2 positive patients were more likely to have gestational diabetes (13.7 vs. 5.3 %) and required less frequently intrapartum analgesia (11.3 vs. 27 %) and labor augmentation (7.3 vs. 16.5 %). Post-partum hemorrhage rate was lower (13.7 vs. 22.9 %) and a shorter length of first and second stage of labor occurred. There were no statistically significant differences between the two groups regarding the mode of delivery and neonatal outcomes.

CONCLUSIONS: SARS-CoV-2 positive patients have shorter labor length and a lower incidence of postpartum hemorrhage. Fewer obstetric interventions, as well as less use of intrapartum analgesia and oxytocin, could explain these findings. Moreover, gestational diabetes could increase susceptibility to infection. SARS-CoV-2 infection discovered at the time of delivery in asymptomatic or paucisymptomatic patients does not appear to increase the rate of cesarean delivery or other obstetric complications, and neonatal outcomes have not worsened.

PMID:37846639 | DOI:10.1515/jpm-2023-0280

Am J Hosp Palliat Care. 2023 Oct 17:10499091231206561. doi: 10.1177/10499091231206561. Online ahead of print.

ABSTRACT

Objectives: Concurrent care is a unique care delivery system that allows patients to receive disease modifying treatments and other supportive interventions while also receiving the traditional benefits of hospice care. The objectives of our observational study were to examine health care utilization, use of cancer-directed therapies and palliative interventions, and location of death in patients enrolled in concurrent care. Methods: 72 hematology-oncology patients at the Hines Veteran’s Affairs Medical Center (VAMC) who enrolled in concurrent care from 12/2018-4/2021 were reviewed. Data were summarized with descriptive statistics including medians and percentages. Results: A minority of patients received cytotoxic chemotherapy (27.8%), immunotherapy (20.8%), palliative radiation (20.9%), blood products (11.1%), or invasive pain procedures (4.2%). Patients also used fewer cancer-directed treatments as they approached end of life (24.4% within 30 days of death compared to 13.3% within 14 days of death). Most patients died at home (62.9%) or in inpatient hospice (12.9%) as opposed to the hospital (2.9%). Conclusions: A minority of concurrent care patients received cancer-directed therapies or additional types of health care interventions despite the option to do so. Cancer-directed treatment utilization also decreased as patients approached end of life. Patients enrolled in concurrent care were able to appreciate its benefits for longer, as the average length of stay on concurrent care was nearly 3 months.

PMID:37846638 | DOI:10.1177/10499091231206561

Zhonghua Nan Ke Xue. 2022 Dec;28(12):1113-1118.

ABSTRACT

OBJECTIVE: To investigate the effect of pricking-reinforcing -reducing therapy (PRRT) on the semen quality and seminal plasma biochemical indexes of varicocele (VC) infertility patients.

METHODS: We randomly and equally assigned 160 patients with VC infertility into a PRRT and a control group, the former treated by PRRT and the latter with oral ShengjingCapsules. Before and after treatment, we obtained the semen parameters, sperm morphology, sperm survival rate, sperm acrosin activity, seminal plasma neutral α glucosidase and seminal plasma zinc in the patients and compared them between the two groups.

RESULTS: Before treatment, there were no statistically significant differences between the PRRT and control groups in sperm concentration (［16.81 ± 7.83］ vs ［16.80 ± 7.54］ ×106 /ml, P > 0.05), total sperm count (［42.01 ± 19.57］ vs ［41.99 ± 18.84］ ×106, P > 0.05), percentages of progressively motile sperm (PMS) (［15.37 ± 11.03］% vs ［14.68 ± 10.27］%, P > 0.05) and morphologically normal sperm ( MNS) (1.62 ± 1.51］% vs ［1.62 ± 1.13］%, P > 0.05), sperm survival rate (［28.11 ± 18.95］% vs ［28.23±18.38］%, P > 0.05) and sperm acrosin activity (［28.11 ± 14.64］ vs ［27.19 ± 14.07］ U/L, P > 0.05). After three months of treatment, all the patients showed evident increases in the above parameters (P < 0.05), even higher in the PRRT than in the control group, more significantly in sperm concentration (［38.88 ± 30.54］ vs ［25.60 ± 14.71］ ×106 /ml, P < 0.05), PMS (［32.60 ± 12.46］% vs ［27.67 ± 12.27］%, P < 0.05) and sperm acrosin activity (［65.74±31.81］ vs ［67.94±17.95］ U/L, P < 0.05), though not significantly in total sperm count (97.20 ± 76.35］ vs ［88.19 ± 39.56］ ×106, P > 0.05), MNS (［2.35 ± 1.83］% vs ［1.87 ± 1.20］%, P > 0.05) and sperm survival rate (［61.44 ± 20.02］% vs ［59.12 ± 22.48］%, P > 0.05). Compared with the baseline, after treatment, the patients in the PRRT group also exhibited elevated levels of neutral α-glucosidase (［14.42 ± 5.90］ vs ［28.43 ± 19.76］ U/L, P < 0.05) and seminal plasma zinc (［2.11 ± 1.22］ vs ［2.89 ± 1.23］ mmol/L, P < 0.05), and so did the controls (［14.44 ± 5.61］ vs ［26.66 ± 17.69］ U/L , P < 0.05) and (［2.09 ± 1.10］ vs ［2.82±1.08］ mmol/L, P < 0.05). No statistically significant difference, however, was observed between the two groups after treatment (P > 0.05).

CONCLUSION: PRRT can significantly improve semen quality in patients with VC infertility, even more effective than ShengjingCapsules in improving sperm concentration, PMS, sperm survival rate, and sperm acrosin activity, which may be related to its effect of elevating the levels of seminal plasma neutral-α glucosidase and zinc providing sufficient energy for basic sperm metabolism, maturation, energy acquisition and motility.

PMID:37846632

Zhonghua Nan Ke Xue. 2022 Dec;28(12):1107-1112.

ABSTRACT

OBJECTIVE: To study the clinical value of accelerated rehabilitation nursing (ARN) in improving the symptoms of PCa patients after surgery.

METHODS: This study included 80 cases of PCa treated surgically in our hospital from October 2020 to October 2021. We randomly divided the patients into two groups of an equal number to receive ARN and routine nursing care (the control group), respectively. We obtained the scores of the patients on IPSS, TCM syndromes, quality of life (QOL) and pain, incidence of postoperative complications, satisfaction with nursing care and Gleason scores, and compared them between the two groups.

RESULTS: The IPSS and TCM syndrome scores were significantly lower (P < 0.05 ), and the physical and psychological function score remarkably higher in the ARN than in the control group (P < 0.05), but there was no statistically significant difference in the social function scores between the two groups (P > 0.05). The postoperative pain score was also significantly lower in the ARN than in the control group (P < 0.05), and so was the incidence rate of postoperative complications (10% vs 37.5%, P < 0.05). The patients’ satisfaction with nursing care was markedly higher in the former than in the latter group (90% vs 80%, P < 0.05). No statistically significant difference was observed in the Gleason scores between the two groups of patients.

CONCLUSION: Accelerated rehabilitation nursing can effectively improve the symptoms of PCa patients after surgery and therefore deserves clinical application.

PMID:37846631