Tag: pubmed

Niger J Clin Pract. 2023 Sep;26(9):1249-1256. doi: 10.4103/njcp.njcp_449_22.

ABSTRACT

BACKGROUND: Severe neonatal hyperbilirubinemia is a known risk factor for sensorineural hearing loss which is usually undiagnosed in our environment until school age due to a lack of routine screening programs.

MATERIALS AND METHODS: This cross-sectional study conducted between August 2020 and February 2021 employed a universal sampling of consecutive eligible participants after their mothers’ consent. Hearing screening was conducted using an automated auditory brainstem response (AABR) device (Otoport OAE + ABR^®). The proportion of AABR screening failure was assessed while associated clinical risk factors were determined using logistic regression. Statistical significance was set at 5% for all comparative analyses.

RESULTS: One hundred and sixty newborns below 28 days of age, delivered at 34 weeks gestation and above, who had jaundice were recruited. The prevalence of screening AABR failure in at least one ear was 26.2%. Significant risk factors for AABR screening failure in addition to extreme and hazardous hyperbilirubinemia were acute bilirubin encephalopathy (ABE) (Odds Ratio (OR) =4.44, 95% CI = 3.19-6.17), birth weight below 2500 g (OR = 3.16, 95% CI = 1.48-6.77), dull tympanic membrane (TM) (OR = 5.94, 95% CI = 2.36-14.92) and exchange blood transfusion (OR = 4.84, 95% CI = 1.87-12.58).

CONCLUSION AND RECOMMENDATIONS: The prevalence of AABR screening failure was high, and a dull TM was its strongest predictor among late preterm and term neonates with hyperbilirubinemia. Otoscopy should be included in the care of newborn with hyperbilirubinemia and screening programs established to mitigate hearing loss among high-risk neonates in Abuja.

PMID:37794536 | DOI:10.4103/njcp.njcp_449_22

Niger J Clin Pract. 2023 Sep;26(9):1234-1241. doi: 10.4103/njcp.njcp_410_22.

ABSTRACT

BACKGROUND: Cervical spondylopathy is a common musculo-articular disorder, multiple exercises are recommended. Chinese fitness exercises are prevalent and used to treat various diseases.

AIM: To explore the efficacy of Chinese fitness exercise Yi Jin Jing exercise in intervening the cervical spondylopathy in adolescents.

PATIENTS AND METHODS: The study was conducted in 60 adolescent patients with cervical spondylopathy, with 30 patients in each group.

METHODS: The study was conducted in 60 adolescent patients with cervical spondylopathy, with 30 patients in each group. The observation group was required to take Yi Jin Jing exercise, and the control group took the brisk walking exercise. The first week was the preparatory period for the patients, and then the participants were required to do exercises three times a week for at least 30 minutes in the later 3 weeks. Before and after treatment, Neck Disability Index (NDI) scores, pain visual analog scale (VAS) scores, and cervical curvature in both groups were observed, and the incidence of adverse events in both groups was recorded during the trial.

RESULTS: The NDI and VAS scores in both groups statistically decreased after intervention and mildly increased at follow-up, while the reduction in scores of the Yi Jin Jing group was more significant. Cervical curvature in both groups improved on day 28 compared to day 0. There were no adverse reactions during the evaluation period.

CONCLUSION: The Chinese health-care qigong Yi Jin Jing exercise is more effective than brisk walking in improving the cervical range of motion and relieving pain in adolescents with cervical spondylopathy. Trial registration/Protocol registration: Clinical Trial Registry (ChiCTR2000030723).

PMID:37794534 | DOI:10.4103/njcp.njcp_410_22

Eur J Med Res. 2023 Oct 4;28(1):396. doi: 10.1186/s40001-023-01399-7.

ABSTRACT

AIMS: To evaluate the effect of antibiotic prophylaxis(AP) in the prognosis of Post-neurosurgical meningitis(PNM) patients.

METHODS: A cohort analysis was performed using the clinical database in Beijing Tiantan Hospital and Capital Medical University. Data were collected on patients with the diagnosis of PNM (n = 3931) during 2012.01 to 2022.04. The microbial distribution, types of AP, and 42 and 90 days survival analysis of AP patients were evaluated using probable statistical methods. Independent risk factors for mortality were established by constructing a logistic regression analysis.

RESULT: A total of 1,190 patients were included in this study, Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus occupied the highest proportion. Of them, 929 cases received AP, cefuroxime and ceftriaxone are the most frequent used antibiotics. In addition, We found that PNM patients without AP significantly increased the 42 days and 90 days all-cause mortality rates. The use of different levels of AP did not improve patient outcomes, and ICU admission and assisted mechanical ventilation (AMV) were identified as independent mortality risk factors for PNM patient received AP.

CONCLUSIONS: AP plays an important role in the prognosis of PNM patients and has a significant function in improving prognosis. The prevention of PNM with antibiotics prior to neurosurgery should be emphasized in clinical practice, and appropriate selection of antibiotics is necessary to prevent the occurrence of infection and inhibit the emergence of antibiotic-resistant bacteria.

PMID:37794524 | DOI:10.1186/s40001-023-01399-7

Trials. 2023 Oct 5;24(1):639. doi: 10.1186/s13063-023-07647-9.

ABSTRACT

BACKGROUND: Many infants in low-resourced settings at high risk of infectious disease morbidity and death are deprived of the immunological and nutritional benefits of breast milk, through an attenuated duration of breast milk exposure. South Africa has one of the lowest exclusive breastfeeding rates in Africa, with 8% of infants under 6 months of age. We assume that breastfeeding is sustained among women living with HIV receiving weekly text messages and motivational interviewing and that this contributes to improved infant health outcomes.

OBJECTIVES: (1) To evaluate the effectiveness of a combined intervention of mobile phone text messaging and motivational interviewing in promoting (a) exclusive breastfeeding and (b) any form of breastfeeding, until 6 months of child age, compared to usual care, among mothers living with HIV. (2) To evaluate the effectiveness of a combined intervention on (a) reduction in all-cause hospitalization and mortality rates and (b) improvements in infant linear growth, compared to usual care, among HIV-exposed infants aged 0-6 months.

METHODS: We are conducting a clinical trial to determine whether text messaging plus motivational interviewing prolongs breastfeeding and improves infant health outcomes. We are recruiting 275 women living with HIV and their HIV-exposed infants at birth and randomly assign study interventions for 6 months.

STATISTICAL METHODS: Breastfeeding rates are compared between the study groups using a standard proportion test and binomial regression. Survival endpoints are presented using Kaplan-Meier survival curves and compared between the study groups using the Cox proportional-hazards regression model. The count endpoint is analysed using the Poisson random-effects model and mean cumulative function. We use mixed linear regression models to assess the evolution of infant growth over time. The maximum likelihood method will be used to handle missing data.

DISCUSSION: The study findings may facilitate decision-making on (1) whether implementation of the breastfeeding policy achieved the desired outcomes, (2) interventions needed to sustain breastfeeding, and (3) whether the interventions do have an impact on child health.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05063240. Pan African Clinical Trial Registry PACTR202110870407786. Oct. 1, 2021.

PMID:37794523 | DOI:10.1186/s13063-023-07647-9

Syst Rev. 2023 Oct 4;12(1):186. doi: 10.1186/s13643-023-02346-7.

ABSTRACT

BACKGROUND: Emotional support is key to improve older adults’ subjective health, and psychological, social and emotional well-being. However, many older adults living in the community lack emotional support, increasing the risk for loneliness, depression, anxiety, potentially avoidable healthcare use and costs, and premature death. Multiple intersecting factors may influence emotional support of older adults in the community, but these are poorly understood. Studies have focused on specific populations (e.g., older adults with depression, cancer). Although relevant, these studies may not capture modifiable factors for the wider and more diverse population of older adults living in the community. Our scoping review will address these important gaps. We will identify and synthesize the evidence on factors that influence emotional support of older adults in the community.

METHODS: We will use the Johanna Briggs Institute updated methodological guidance for the conduct of scoping reviews to guide our review process. We will search MEDLINE, EMBASE, APA Psycinfo, CINAHL, Dissertations and Theses Global, and Scopus from inception. We will include studies published in English, examining factors influencing emotional support of older adults residing in community, without restrictions on the study design or year of publication. We will also include gray literature (dissertations and reports). Two independent reviewers will conduct title, abstract, and full-text screening, as well as risk of bias assessment, using validated quality appraisal tools based on study designs. Discrepancies will be resolved by consensus. The primary reviewer will extract the data from all studies, and the second reviewer will check the extractions of all the studies. We will use descriptive statistics and narrative synthesis for analysis. Family/friend caregivers and older adults involved as an advisory group will help with explaining the findings in terms of whether associations observed reflect their experiences and reality. We will analyze the discussion and generate themes, and summarize in a narrative form.

DISCUSSION: This scoping review may identify factors that could be modified or mitigated to improve emotional support provision for older adults residing in community. The knowledge will inform the development of tailored interventions directed to older adults and their caregivers.

SYSTEMATIC REVIEW REGISTRATION: https://doi.org/10.17605/OSF.IO/4TAEB (associated project link: osf.io/6y48t).

PMID:37794514 | DOI:10.1186/s13643-023-02346-7

Arthroplasty. 2023 Oct 5;5(1):51. doi: 10.1186/s42836-023-00207-1.

ABSTRACT

BACKGROUND: Few studies have investigated the kinematics after reverse total shoulder arthroplasty (RTSA). This study aimed to compare the shoulder kinematics in RTSA patients during shoulder abduction on the scapular plane with and without a load and yield information regarding the function of stabilizing the joints against gravity for the functional assessment of the shoulder after RTSA, which could lead to changes in postoperative rehabilitation treatment.

METHODS: Twenty RTSA patients (7 men, 13 women; mean age: 78.1 [64-90] years) were examined. First, active shoulder abduction in the scapular plane was captured using single-plane fluoroscopic X-ray images. Imaging was performed by stipulating that one shoulder abduction cycle should be completed in 6 s. Two trials were conducted: one under a load equivalent to 2% of body weight and one without a load. Next, a three-dimensional (3D) model of each humeral and scapular component was matched to the silhouette of the fluoroscopic image to estimate the 3D dynamics. By using the 3D dynamic model obtained, the kinematics of the glenosphere and humeral implant were calculated relative to the shoulder abduction angle on the scapular plane and were compared between groups with and without a load. A one-way analysis of variance and a post hoc paired t-test with a statistical significance level of 0.05 were performed.

RESULTS: The humeral internal rotation decreased with a load at shoulder abduction between 40° and 90° on the scapular plane (P < 0.01, effect size: 0.15). No significant differences in scapular upward rotation (P = 0.57, effect size: 0.022), external rotation (P = 0.83, effect size: 0.0083) and posterior tilting (P = 0.74, effect size: 0.013) were observed between groups with and without a load. The main effect was not observed with and without a load (P = 0.86, effect size: 0.0072). However, the scapulohumeral rhythm was significantly greater without a load during shoulder joint abduction between 40° and 60° on the scapular plane.

CONCLUSION: In RTSA patients, the glenohumeral joint was less internally rotated, and the scapulohumeral rhythm decreased under loaded conditions. It was stabilized against the load through the mechanical advantage of the deltoid muscle and other muscles.

PMID:37794512 | DOI:10.1186/s42836-023-00207-1

Clin Epigenetics. 2023 Oct 4;15(1):157. doi: 10.1186/s13148-023-01570-1.

ABSTRACT

BACKGROUND: Early detection has proven to be the most effective strategy to reduce the incidence and mortality of colorectal cancer (CRC). Nevertheless, most current screening programs suffer from low participation rates. A blood test may improve both the adherence to screening and the selection to colonoscopy. In this study, we conducted a serum-based discovery and validation of cfDNA methylation biomarkers for CRC screening in a multicenter cohort of 433 serum samples including healthy controls, benign pathologies, advanced adenomas (AA), and CRC.

RESULTS: First, we performed an epigenome-wide methylation analysis with the MethylationEPIC array using a sample pooling approach, followed by a robust prioritization of candidate biomarkers for the detection of advanced neoplasia (AN: AA and CRC). Then, candidate biomarkers were validated by pyrosequencing in independent individual cfDNA samples. We report GALNT9, UPF3A, WARS, and LDB2 as new noninvasive biomarkers for the early detection of AN. The combination of GALNT9/UPF3A by logistic regression discriminated AN with 78.8% sensitivity and 100% specificity, outperforming the commonly used fecal immunochemical test and the methylated SEPT9 blood test.

CONCLUSIONS: Overall, this study highlights the utility of cfDNA methylation for CRC screening. Our results suggest that the combination methylated GALNT9/UPF3A has the potential to serve as a highly specific and sensitive blood-based test for screening and early detection of CRC.

PMID:37794510 | DOI:10.1186/s13148-023-01570-1

Breast Cancer Res. 2023 Oct 4;25(1):115. doi: 10.1186/s13058-023-01721-5.

ABSTRACT

BACKGROUND: B7 homology 4 (B7-H4), a potential target for cancer therapy, has been demonstrated to inhibit T cell cytotoxicity in the early stages of breast cancer. However, B7-H4 manipulating breast tumor immune microenvironment (TIME) in the tumor progression remains unknown.

METHODS: We engineered T cells with B7-H4-specific chimeric antigen receptors (CARs) and performed a T cell co-culture assay to characterize B7-H4 expression level in breast cancer cells escaping from T cell cytotoxicity. We generated B7-H4 knockout (KO) and overexpression (OE) breast cancer cells to determine the epithelial-to-mesenchymal transition (EMT) and stemness characteristics in vitro and in vivo, including tumor proliferation, migration, metastasis and chemoresistance. The Cancer Genome Atlas breast cancer database was accessed to investigate the correlation between B7-H4 expression levels and EMT characteristics in patients with breast cancer.

RESULTS: Our result found that B7-H4 expression level was significantly reduced in a subset of breast cancer cells that escaped from the cytotoxicity of B7-H4 CAR-T cells. Compared with wild type cells, B7-H4 KO cells prompt EMT and stemness characteristics, including migration, invasion and metastasis, and OE cells vice versa. The increase in H3K27me3 in KO cells confirmed the epigenetic reprogramming of cancer stem cells. The IC50 of doxorubicin or oxaliplatin significantly increased in KO cells, which was in agreement with a decrease in OE cells. Moreover, a trend of downregulated B7-H4 from stage I to stage II breast cancer patients indicates that the low-expressing B7-H4 breast cancer cells escaping from TIME have spread to nearby breast lymph nodes in the cancer progression.

CONCLUSIONS: Our study illuminates the novel role of renouncing B7-H4 in breast cancer cells through immune escape, which contributes to EMT processes and provides new insights for breast cancer treatments.

PMID:37794509 | DOI:10.1186/s13058-023-01721-5

BMC Res Notes. 2023 Oct 4;16(1):251. doi: 10.1186/s13104-023-06536-3.

ABSTRACT

OBJECTIVE: HIV remains a global burden, with the Sub-Saharan Africa (SSA) region reporting the largest number of people living with HIV/AIDS (PLHIV). An exponential improvement in the accessibility and uptake of antiretroviral treatment across SSA has significantly improved outcomes for PLHIV. Hence, HIV care goals have shifted from reducing mortality and morbidity to improving health-related quality of life (HRQoL). This study uses generic and condition-specific HRQoL outcomes to holistically determine the HRQoL of Zimbabwean adult PLHIV and associated factors. HRQoL is a dynamic subject construct that warrants continuous evaluation to provide meaningful feedback to various stakeholders. We enrolled 536 adult PLHIV in Zimbabwe. Collected data were analyzed through descriptive statistics and multivariate binary logistic regression.

RESULTS: Our study shows a high HRQoL perception by Zimbabwean PLHIV. Anxiety, depression, and poor environmental health were widely reported domains influencing HRQoL. Also, being aware of HIV status for over a year, not experiencing an adverse event, being married, having adequate finances and food security and having higher educational status were associated with higher HRQoL. It is essential to integrate mental health care into routine HIV care to improve treatment outcomes and HRQoL. Last, implementing bespoke multisectoral HRQoL-enhancement interventions is paramount.

PMID:37794503 | DOI:10.1186/s13104-023-06536-3

J Cardiothorac Surg. 2023 Oct 4;18(1):268. doi: 10.1186/s13019-023-02370-7.

ABSTRACT

BACKGROUND: This study aims to investigate the outcomes of patients who received early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophagectomy due to esophageal cancer.

METHODS: A prospective randomized clinical trial was performed between March 2020 and June 2022. Patients who were scheduled for thoracoscopic and laparoscopic esophagectomy due to esophageal cancer were enrolled. Then, these patients were assigned to the control group (traditional postoperative care) and study group (traditional postoperative care with early bronchoscopic sputum aspiration and lavage). The outcomes, which included the length of hospital stay and medical expenses, and postoperative complications, which included pulmonary infection, atelectasis, respiratory dysfunction and anastomotic leakage, were compared between these two groups.

RESULTS: A total of 106 patients were enrolled for the present study, and 53 patients were assigned for the control and study groups. There were no statistically significant differences in gender, age, and location of the esophageal cancer between the two groups. Furthermore, the length of hospital stay was statistically significantly shorter and the medical expenses were lower during hospitalization in the study group, when compared to the control group (12.3 ± 1.2 vs. 18.8 ± 1.3 days, 5.5 ± 0.9 vs. 7.2 ± 1.2 Chinese Yuan, respectively; all, P < 0.05). Moreover, there were statistically significantly fewer incidences of overall complications in study group, when compared to the control group (20.7% vs.45.2%, P < 0.05).

CONCLUSIONS: For patients with esophageal cancer, early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophagectomy can shorten the length of hospital stay, and lower the medical expense and incidence of postoperative complications.

PMID:37794501 | DOI:10.1186/s13019-023-02370-7