Tag: pubmed

Cureus. 2023 Sep 9;15(9):e44939. doi: 10.7759/cureus.44939. eCollection 2023 Sep.

ABSTRACT

Background Modified triple antibiotic paste (MTAP) helps in the elimination of microorganisms which is imperative for the success of endodontic therapy. The intracanal medicament powders must be mixed with vehicles for better handling and penetration in the root canals. The purpose of this study is to compare the effect of six low-surface-tension vehicles on the penetration of MTAP in dentinal tubules. Methodology The root apices of 60 single-rooted human mandibular premolars were resected to obtain 12mm length. After biomechanical preparation, intracanal medicaments were prepared by mixing with the six vehicles (Group 1- Bupivacaine, Group 2- Sodium ether lauryl sulfate, Group 3- Neosporin H, Group 4- Chlorhexidine gluconate, Group 5- Chitosan, and Group 6- Polyethylene glycol) with MTAP and Rhodamine B dye. Middle and apical transverse sections were scanned under a confocal laser scanning microscope. The data were statistically analyzed using the one-way ANOVA test and the level of significance was p<0.05. Results The maximum depth of penetration was seen in Group 2 (MTAP with sodium ether lauryl sulfate) followed by Group 5 (MTAP with chitosan), Group 4 (MTAP with chlorhexidine gluconate), Group 1 (MTAP with bupivacaine), and Group 6 (MTAP with polyethylene glycol), and the least penetration by Group 3 (MTAP with Neosporin H). The depth of penetration in the middle level was in the order of Group 2 followed by Group 4, Group 5, Group 3, Group 6, and Group 1. The depth of penetration in the apical level was in the order of Group 2 followed by Group 5, Group 1, Group 4, Group 6, and Group 3. The overall depth of penetration was significantly higher at the middle level than at the apical level. Conclusion Group sodium ether lauryl sulfate showed the maximum depth of penetration in both the middle and apical areas. The least depth of penetration in the middle area was seen in group bupivacaine and the apical area by group Neosporin H.

PMID:37818510 | PMC:PMC10561130 | DOI:10.7759/cureus.44939

Cureus. 2023 Sep 9;15(9):e44956. doi: 10.7759/cureus.44956. eCollection 2023 Sep.

ABSTRACT

Introduction Burnout is a common issue in the medical field, particularly in specialties like anaesthesiology and intensive care. It carries significant personal and professional consequences for healthcare providers and can impact the relationship between caregivers and patients. Despite its seriousness, there’s been limited research on its causes in North Africa. In this study, our aim was straightforward: we wanted to find out how prevalent burnout is among Moroccan healthcare workers in anaesthesiology and intensive care and identify the main factors contributing to it. Methods To achieve this, we conducted a comprehensive multicenter cross-sectional study that included hospitals from different regions of Morocco. We focused on anesthesiologists and nurse anesthetists currently practicing in these settings. We measured burnout using the French version of the Maslach Burnout Inventory. Results We distributed 500 questionnaires and received and analyzed 396 of them, accounting for an 84% response rate. The results were striking: 48% of participants experienced high emotional exhaustion, 43.2% had a significant level of depersonalization, and 21% exhibited a low sense of personal accomplishment. When we looked at various factors, such as age, income, on-call duties, years of experience, and work location, our analysis showed statistically significant differences in all three dimensions of burnout. In our more complex multivariate analysis, we found that the risk factors for all three dimensions of burnout were practicing for 5 to 15 years and participating in on-call rotations. Surprisingly, practicing for over 25 years seemed to be a protective factor against all dimensions of burnout. Conclusion Our study clearly indicates that burnout is a shared issue among healthcare professionals in anaesthesiology and intensive care units in Morocco. Importantly, we’ve pinpointed specific risk factors that should be the foundation for a national strategy to prevent burnout in these critical healthcare sectors.

PMID:37818505 | PMC:PMC10561900 | DOI:10.7759/cureus.44956

Cureus. 2023 Sep 9;15(9):e44959. doi: 10.7759/cureus.44959. eCollection 2023 Sep.

ABSTRACT

Background Children with sickle cell disease (SCD) are prone to bacterial infections, culminating in life-threatening incidences. Early evaluation of children with SCD helps in effective management and support. Methodology A retrospective study was conducted using medical records for febrile episodes in SCD children ≤14 years of age who presented to the Emergency Department of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from 2015 to 2018. A total of 304 episodes were encountered in the Emergency Department during this period. Results The clinical diagnosis included confirmed bacterial infection (4.5%), presumed bacterial infection (24.6%), and those without bacterial infection (57.5%). The incidence of bacteremia was found in 3.0% of the episodes and urinary tract infection in 1.5%. The most common isolates were Staphylococcus aureus, Streptococcus viridians, Salmonella species, and Escherichia coli. Overall, 52% of the febrile episodes resulted in hospitalization, of which 74% had at least one prior hospitalization. The hospitalization probability across the two sexes was statistically insignificant (p = 0.029). The likelihood of admission increased with age (p < 0.001) and temperature (p < 0.001). The study included 140 children with SCD who had at least one abdominal sonogram performed at our hospital between 2015 and 2018. There were changes in the radiographic appearance of the spleen in patients with SCD who were expected to undergo autosplenectomy between the ages of five and 17 years. Conclusions The study envisages the risk associated with febrile episodes and the prompt recovery of such patients through clinical confirmations. Parents should be aware and observant of the complications of infectious illnesses for speedy medical assistance.

PMID:37818503 | PMC:PMC10561955 | DOI:10.7759/cureus.44959

Cureus. 2023 Sep 9;15(9):e44951. doi: 10.7759/cureus.44951. eCollection 2023 Sep.

ABSTRACT

BACKGROUND: Sleep quality has an important role in brain functioning and development. Affected sleep quality and mental health can negatively affect the academic performance of college students.

OBJECTIVE: To assess the effect of sleep quality and mental health on the academic performance of medical students at King Abdulaziz University, Jeddah, Saudi Arabia.

METHODS: We conducted a cross-sectional study among medical students at King Abdulaziz University. The dependent variable was the current grade point average (GPA). For the independent variables, two validated tools were used in the study: the Pittsburgh Sleep Quality Index (PSQI) for sleep assessment; and the Depression, Anxiety and Stress Scale (DASS-21) for mental health assessment.

RESULTS: A total of 382 responses were analyzed. The majority of students (86.6%) had GPAs greater than 3.75/5, while only 1% of the sample had a GPA lower than 2.75/5. The PSQI showed a median and interquartile range of (9, 6-11). Normal DASS-21 represented the majority as follows: depression at 67%, anxiety at 63.1%, and stress at 82.2%. In the statistical analyses, sleep quality, depression, anxiety, and stress were not statistically significant with the student’s GPA.

CONCLUSION: Low levels of sleep quality were found among medical students in our study. While sleep quality and mental health status did not show an effect on the GPA of the medical students, lower sleep quality was significantly correlated with increased scores of depression, anxiety, and stress. Our findings mandate interventions directed at improving sleep quality among medical students.

PMID:37818494 | PMC:PMC10561659 | DOI:10.7759/cureus.44951

Surg Open Sci. 2023 Sep 21;16:68-72. doi: 10.1016/j.sopen.2023.09.018. eCollection 2023 Dec.

ABSTRACT

BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric surgeries. The steep associated learning curve is dependent on the training facility, laparoscopic experience, and overall procedural volume. William Beaumont Army Medical Center (WBAMC) has been accredited as a bariatric center of excellence and trains resident surgeons in the performance of RYGB.

OBJECTIVE: This study aimed to investigate the accuracy and precision of a bariatric center of excellence’s training of surgical residents in terms of laparoscopic measurements of simulated small bowel. This will act as a surrogate for how well surgical residents learn to run the small bowel during bariatric procedures and how their accuracy and precision change over time in training.

SETTING: This study took place at William Beaumont Army Medical Center, a bariatric center of excellence and training institution.

METHODS: Participants included surgical residents from WBAMC. Participants used a laparoscopic trainer and two bowel graspers to measure both a collapsing garden hose (simulated bowel) and a nylon rope (control material) to 75 cm (cm) and 125 cm (cm), three times each, with recordings of time required to do so, actual distance measured, and technique used.

RESULTS: Fifteen residents participated in the study. Residents displayed accuracy of 21.6 %. 33%of residents were precise for the 75 cm measurement, and 53 % of residents were precise for the 125-cm measurement. PGY-4 residents were the most accurate while PGY-3 residents were the most precise. There were no statistical differences between junior (PGY 1-4) and senior residents (PGY 5-6) in accuracy or precision in the measurement of 75-cm or 125-cm. No statistical differences were found measuring the hose versus rope in accuracy nor precision. PGY-4 residents completed the task in the least amount of time while PGY-2 residents took the longest to complete each task.

CONCLUSIONS: In general, residents are neither precise nor accurate in measurements of simulated bowel lengths, and experience does not contribute to either. Time in residency correlates with laparoscopic speed but not with accuracy nor precision. Extrapolating this data to attending surgeons suggests that estimated lengths of small bowel that are ‘run’ or measured during laparoscopic cases are neither accurate nor precise. More investigation must be performed in this area.

PMID:37818460 | PMC:PMC10561113 | DOI:10.1016/j.sopen.2023.09.018

Echo Res Pract. 2023 Oct 11;10(1):16. doi: 10.1186/s44156-023-00026-9.

ABSTRACT

BACKGROUND: Pre-participation cardiac screening (PCS) of “Super-League” rugby football league (RFL) athletes is mandatory but may be completed at any time point. The aim of this study was to assess cardiac electrical, structural and functional variation across the competitive season.

METHODS: Elite, male, RFL athletes from a single Super-League club underwent cardiac evaluation using electrocardiography (ECG), 2D echocardiography and speckle tracking echocardiography (STE) at four time points across the RFL season; (1) End pre-season (ENDPRE), (2) mid-season (MIDCOMP), (3) end-season (ENDCOMP) and (4) End off-season (ENDOFF). Training loads for each time point were also determined. One-way ANOVA with post-hoc Bonferroni were used for statistical analyses.

RESULTS: Total workload undertaken by athletes was lower at both MIDCOMP and ENDCOMP compared to ENDPRE (P < 0.001). ECG patterns were normal with training-related changes that were largely consistent across assessments. Structural data did not vary across assessment points. Standard functional data was not different across assessment points but apical rotation and twist were higher at ENDPRE (9.83˚ and 16.55˚, respectively compared to all other time points (MIDCOMP, 6.13˚ and 12.62˚; ENDCOMP, 5.84˚ and 12.12˚; ENDOFF 6.60˚ and 12.35˚).

CONCLUSIONS: Despite some seasonal variation in training load, the athletes’ ECG and cardiac structure were stable across a competitive season. Seasonal variation in left ventricular (LV) apical rotation and twist, associated with higher training loads, should be noted in the context of PCS.

PMID:37817231 | DOI:10.1186/s44156-023-00026-9

Respir Res. 2023 Oct 10;24(1):245. doi: 10.1186/s12931-023-02536-w.

ABSTRACT

INTRODUCTION: Interstitial lung abnormalities (ILA) often represent early fibrotic changes that can portend a progressive fibrotic phenotype. In particular, the fibrotic subtype of ILA is associated with increased mortality and rapid decline in lung function. Understanding the differential gene expression that occurs in the lungs of participants with fibrotic ILA may provide insight into development of a useful biomarker for early detection and therapeutic targets for progressive pulmonary fibrosis.

METHODS: Measures of ILA and gene expression data were available in 213 participants in the Detection of Early Lung Cancer Among Military Personnel (DECAMP1 and DECAMP2) cohorts. ILA was defined using Fleischner Society guidelines and determined by sequential reading of computed tomography (CT) scans. Primary analysis focused on comparing gene expression in ILA with usual interstitial pneumonia (UIP) pattern with those with no ILA.

RESULTS: ILA was present in 51 (24%) participants, of which 16 (7%) were subtyped as ILA with a UIP pattern. One gene, pro platelet basic protein (PPBP) and seventeen pathways (e.g. TNF-α signalling) were significantly differentially expressed between those with a probable or definite UIP pattern of ILA compared to those without ILA. 16 of these 17 pathways, but no individual gene, met significance when comparing those with ILA to those without ILA.

CONCLUSION: Our study demonstrates that abnormal inflammatory processes are apparent in the bronchial airway gene expression profiles of smokers with and without lung cancer with ILA. Future studies with larger and more diverse populations will be needed to confirm these findings.

PMID:37817229 | DOI:10.1186/s12931-023-02536-w

J Clin Neurosci. 2023 Oct 8;117:151-155. doi: 10.1016/j.jocn.2023.09.031. Online ahead of print.

ABSTRACT

INTRODUCTION: Medical Students applying to neurosurgery residency programs incur substantial costs associated with interviews, away rotations, and application fees. However, few studies have compared expenses prior to and during the COVID-19 pandemic. This study evaluates the financial impact of COVID-19 on the neurosurgery residency application and identifies strategies that may alleviate the financial burden of prospective neurosurgery residents.

METHODS: The TEXAS STAR database was surveyed for applicants of neurosurgical residency programs during the COVID-19 pandemic (2021) and post-pandemic (2022). 66 applicants for the 2021 application cycle and 50 applicants for the 2022 application cycle completed the survey. We compared application fees, away rotations cost, interview cost, and total expenses as reported by the neurosurgery applicants of the 2021 and 2022 application cycle. A Shapiro-Wilk test was used to test for data normality, and a Mann-Whitney U-Test was used to compare costs during the 2021 and 2022 neurosurgery application cycle.

RESULTS: There was a statistically significant reduction in total expenses in 2021 vs 2022 ($3,934 vs $9,860). Interview and away rotation expenses decreased in 2021 vs 2022 (interview expenses $786 vs $4511, away rotation $1,083 vs $3,000, p < 0.001). Application fee expenses were not different between 2021 and 2022. The greatest reduction in application cost ($11,908) was seen in the South for 2021.

CONCLUSIONS: The COVID-19 pandemic significantly reduced total fees associated with the neurosurgical residency application. Virtual platforms in place of in-person interviews could lessen the financial burden on applicants and alleviate socioeconomic barriers in the neurosurgical application process after COVID-19.

PMID:37816269 | DOI:10.1016/j.jocn.2023.09.031

Econ Hum Biol. 2023 Oct 6;51:101311. doi: 10.1016/j.ehb.2023.101311. Online ahead of print.

ABSTRACT

This paper investigates the causal effect of wildfire exposure on birth outcomes and older people’s health outcomes in United States (US). The study focuses on three sub-questions for each health outcome: (1) the causal effect of each of the five largest wildfires on individual health, (2) the causal impact of multiple large wildfires on individual health outcomes, and (3) the causal influence of wildfires larger than different sizes within different distances of counties on health outcomes at the county level. The analysis exploits data from National Vital Statistics System, Behavioural Risk Factor Surveillance System and FIRESTAT. In terms of birth outcomes, the findings show that the largest wildfire slightly increased the risk of other circulatory or respiratory anomalies. Multiple large wildfires moderately raised the risk of prematurity and led to a small decline in the probability of getting omphalocele and cleft lip. The county-level analysis suggests an increased risk of macrosomia following maternal exposure to wildfires. As for the elderly aged 65 + , the results indicate that exposure to multiple massive wildfires led to frequent occurrence of asthma symptoms, while the largest wildfire led to sleeping difficulty caused by asthma symptoms. The number of days older people experienced psychological problems was increased following exposure to multiple large wildfires.

PMID:37816268 | DOI:10.1016/j.ehb.2023.101311

Spectrochim Acta A Mol Biomol Spectrosc. 2023 Sep 26;305:123458. doi: 10.1016/j.saa.2023.123458. Online ahead of print.

ABSTRACT

This study describes the enhancement of the weak native fluorescence of loratadine (LOR) by dual strategy via photoinduced electron transfer (PET) blocking followed by micellization into sodium dodecyl sulfate micelles. The enhanced fluorescence was employed as a basis for the development of a novel microwell spectrofluorimetric assay (MW-SFA) for the determination of LOR in its pharmaceutical dosage forms and urine samples. The assay was conducted in 96-microwell assay plates, and the enhanced fluorescence signals were measured by a microplate reader at 290 and 435 nm for excitation and emission, respectively. The optimum conditions of the assay were established, calibration curve was generated, and the linear regression equation was computed. The relation between the fluorescence signals and LOR concentrations was linear with good determination coefficients (0.9992) in the range of 10 – 2000 ng mL^-1. The assay limits of detection and quantitation were 4.1 and 12.5 ng mL^-1, respectively. The precision was satisfactory, with values of relative standard deviation not exceeding 1.68%, and the assay’s accuracy was ≥ 99.1%. The proposed was successfully applied to the analysis of LOR in its pharmaceutical dosage forms with acceptable accuracy and precision. The label claims were 99.3 – 100.5% (±0.95 – 1.59%). Statistical analysis comparing the results of the proposed assay with those obtained by a reported pre-validated assay revealed no significant difference between both methods in terms of the accuracy and precision at the 95% confidence level. The assay was also applied to the analysis of urine samples containing LOR with accuracy ≥ 98.24%. The greenness of the proposed assay was confirmed by three efficient metric tools. In overall conclusion, the proposed assay is characterized by high sensitivity, procedure simplicity, and high throughput, enabling the simultaneous analysis of many samples in a short time. Therefore, it is a valuable tool for rapid routine application in pharmaceutical quality control units and clinical laboratories for the determination of LOR.

PMID:37816264 | DOI:10.1016/j.saa.2023.123458