Tag: pubmed

CJEM. 2023 Sep 24. doi: 10.1007/s43678-023-00597-w. Online ahead of print.

ABSTRACT

BACKGROUND: Older trauma patients have a higher mortality yet are more likely to be under-triaged compared to younger patients. Studies have suggested that current trauma team activation criteria are suboptimal for older patients.

OBJECTIVES: The objective was to describe trauma care delivered, patient outcomes, and to identify variables independently associated with mortality.

METHODS: We performed a health records review from 2014 to 2020 of older (age ≥ 65 years) trauma patients presenting to a level one trauma centre with any of the following: injury severity score (ISS) > 12, and all trauma team activations or admission to the trauma ward. The primary outcome was 30-day all-cause mortality. Secondary outcomes included injury mechanism and trauma care delivered. Multivariable logistic regression was used to identify factors independently associated with 30-day all-cause mortality. Multiple imputation was used to deal with missing data.

RESULTS: We enrolled 1,380 patients (mean age 80 years, mean ISS 18); 26.8% had multimorbidity (≥ 2 chronic conditions) and 65.9% met criteria for polypharmacy (≥ 5 medications). The most common mechanism was fall from standing height (61.1%). Thirty-day all-cause mortality occurred in 239 (17.3%) patients. A Glasgow coma scale (GCS) < 15 (odds ratio [OR] = 5.55; 95% CI 3.73-8.24), ISS > 15 (OR = 3.75, 95% CI 2.35-6.01), age ≥ 85 years (OR = 2.04, 95% CI 1.29-3.22), anticoagulation with a direct oral anticoagulant (DOAC) or warfarin (OR = 1.59, 95% CI 1.08-2.35) and multimorbidity (OR = 1.53, 95% CI 1.06-2.22) were significantly associated with increased risk 30-day mortality (C-statistic = 0.82, 95% CI 0.79-0.85). Dementia (OR = 0.61, 95% CI 0.40-0.95) and time to CT scan > 60 min (OR = 0.50, 95% CI 0.34-0.74) were associated with decreased mortality risk.

CONCLUSION: We identified five factors associated with increased 30-day mortality in older trauma patients: GCS < 15, ISS > 15, age ≥ 85 years, anticoagulation, and multimorbidity. These factors should be considered when developing modified trauma team activation criteria for older adults.

PMID:37742324 | DOI:10.1007/s43678-023-00597-w

Surg Radiol Anat. 2023 Sep 24. doi: 10.1007/s00276-023-03244-2. Online ahead of print.

ABSTRACT

PURPOSE: Peroneus tertius (PT) or Fibularis tertius, a muscle of the anterior compartment of the leg is very distinctive to the Homo sapiens. This is because of the evolutionary acquisition of bipedal gait along with the eversion of the foot, which are unique to humans. It is considered as the fifth tendon of the extensor digitorum longus. Variations in the attachments of PT can cause stress fractures like the Jones fracture. PT has been extensively used in tendoplasty, tendon transfer and resection of the foot. The study aims to transpose the knowledge in variations of the morphology of PT from bench to bedside.

METHODS: Routine dissection of a 64-year-old male cadaver revealed bilateral variations in the insertion of PT. This was documented photographically. The findings prompted a systematic literature review on the morphological variations of PT. An exhaustive search was undertaken through PubMed and Google Scholar databases to identify the published literature related to variations in the morphology of PT. Related anatomical studies of the variations in peroneus tertius were identified and a review of the literature was performed.

RESULTS: Variations in the insertion of PT were observed bilaterally in the cadaver dissected by us. Statistical analysis revealed the absence of PT in 7.03% of lower limbs. 10% of studies showed accessory and duplicated PT each. Out of 20 articles reviewed, 51 lower limbs showed variation in origin, 230 lower limbs showed variations in insertion and 161 lower limbs showed other variations.

CONCLUSION: PT muscle flap and tendon grafts are used in correcting the laxity of the ankle joint and foot drop. Absence of PT plays a crucial role in altering the mechanics of stress fractures of the 5th metatarsal. Thus, knowledge of the morphology of PT is crucial for plastic surgeons and orthopedic surgeons.

PMID:37742309 | DOI:10.1007/s00276-023-03244-2

Arch Orthop Trauma Surg. 2023 Sep 24. doi: 10.1007/s00402-023-05059-7. Online ahead of print.

ABSTRACT

PURPOSE: Hepatitis B and C are important and relatively common health issues. It is known that many patients who underwent total knee and hip arthroplasty were also diagnosed with hepatitis. These patients are at higher risk of periprosthetic joint infection (PJI). This study aimed to investigate the differences in PJI cases in hepatitis B and C patients.

METHODS: This is a retrospective case-controlled single-center study. A total of 270 patients with hepatitis and non-hepatitis (control group) who underwent one-stage septic exchange to the hip and knee joints were included in the study. All patients’ previous surgical histories, infective organisms, C-reactive protein (CRP) values before septic exchange, and demographic data were evaluated. All microbiological and laboratory evaluations were performed separately for knee and hip arthroplasty.

RESULTS: The mean CRP levels of Hep B- and C-positive patients, who underwent one-stage septic exchange in the knee joint, were 23.6 mg/L. In the control group, this value was 43.1 mg/L and a statistically significant difference was found between the groups (p = 0.004). Gram-negative organisms were identified in a larger proportion of patients with hepatitis who developed PJI in both hip and knee joints and underwent one-stage septic exchange (p = 0.041/p = 0.044).

CONCLUSION: PJIs caused by Gram-negative bacteria are encountered more frequently in patients with hepatitis than in the control group. In addition, the CRP rise is less in patients with hepatitis compared to PJI cases in the control group. Patient-specific evaluation is required in cases of PJI in patient groups with co-existing hepatitis.

PMID:37742285 | DOI:10.1007/s00402-023-05059-7

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):867-870. doi: 10.32687/0869-866X-2023-31-s1-867-870.

ABSTRACT

PURPOSE OF THE STUDY: to analyze the differences in the normative (reference) values of the body weight indicators of children and adolescents living in four ecological and geographical zones of the Republic of Sakha (Yakutia).

MATERIALS AND METHODS: Statistical data processing was carried out on 24,123 schoolchildren who do not have chronic diseases belonging to health groups I and II. Statistical, analytical, mathematical and sociological methods were used.

RESULTS: The analysis showed that the greatest differences in this indicator were recorded in groups of children of primary school age, both among boys and girls. The highest values of reference indicators for body weight were determined in the younger age groups of boys and girls living in Yakutsk, and in older age groups – in those living in the industrial regions of the Republic of Sakha (Yakutia). The lowest values of these indicators were determined in children in rural areas of the region.

PMID:37742265 | DOI:10.32687/0869-866X-2023-31-s1-867-870

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):862-866. doi: 10.32687/0869-866X-2023-31-s1-862-866.

ABSTRACT

PURPOSE OF THE STUDY: to analyze the differences in the normative (reference) values of the body length indicators of children and adolescents living in four ecological and geographical zones of the Republic of Sakha (Yakutia).

MATERIALS AND METHODS: Statistical data processing was carried out on 24,123 schoolchildren who do not have chronic diseases belonging to health groups I and II. Statistical, analytical, mathematical and sociological methods were used.

RESULTS: Among boys, the highest level of statistically significant differences in body length was observed in the age groups of 12, 13 and 15-17 years, among girls – in the age groups of 13, 14 and 16 years. Higher reference values of body length indicators for boys and girls living in the industrial regions of the Republic of Sakha (Yakutia), lower – for those living in the Arctic zone of the Far North and rural areas of the Republic of Sakha (Yakutia), where the population is represented mainly by the indigenous peoples of the Far North.

PMID:37742264 | DOI:10.32687/0869-866X-2023-31-s1-862-866

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):857-861. doi: 10.32687/0869-866X-2023-31-s1-857-861.

ABSTRACT

One of the directions to increase the effectiveness of medical organizations in the region is the development of managerial tools for improving the quality of medical services. The aim of the study is to develop an approach to improving the quality of medical services based on the results of measuring patient satisfaction with the quality of medical services, mapping satisfaction criteria to medical and technological characteristics of the quality of services, substantiation and selection of appropriate corrective measures. The method of measuring patient satisfaction with the quality of the provided medical service and the method of deploying quality functions ensuring transformation of patient needs and expectations into characteristics of service quality were used. The measurement of patients’ satisfaction with the quality of medical services is carried out during medical and sociological research. The measurement results are obtained by statistical processing using a software set. To determine measures to improve the quality of cardiological services, the results of changing patient satisfaction were used in accordance with the method of deploying quality functions, which consists in implementing a number of steps that ensure the determination of a minimum set of additional requirements for medical services in order to meet the requirements of patients. This technique is supported by specialized software. Implementation of the proposed approach makes it possible to form tools aimed at creating an information model of medical services and ensure the change in the quality of such services demanded by patients.

PMID:37742263 | DOI:10.32687/0869-866X-2023-31-s1-857-861

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):837-841. doi: 10.32687/0869-866X-2023-31-s1-837-841.

ABSTRACT

Adolescent girls aged 15-18 are in an active process of growth and development, as evidenced by the dynamics of changes in height and weight indicators. Low values of average growth indicators were determined among girls in Batken, on average 2 cm less than the average indicators of girls in Bishkek, however, the statistical analysis performed did not confirm the reliability of these differences. In 84.3% of the surveyed adolescent girls living in Naryn, iron deficiency anemia was detected. Kidney and urinary tract diseases (31.4%) took the first place in the structure of diseases among girls in Batken. Diffuse enlargement of the thyroid gland was found in 13% of women living in highlands. Inflammatory diseases of the genitourinary system are two or more times more common among girls in the middle and high mountains than in Bishkek: vulvitis in 8.7-11.4% of cases against 4.1% of cases, urogenital diseases in 6.5-17.4 versus 3.9 respectively. This indicates the need to introduce specific preventive programs for girls living in the middle and high mountains.

PMID:37742259 | DOI:10.32687/0869-866X-2023-31-s1-837-841

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):752-755. doi: 10.32687/0869-866X-2023-31-s1-752-755.

ABSTRACT

The article discusses the issues of including the image of persons with disabilities in marketing and advertising practice. The data reflecting the statistics of disability and consumer behavior in the market of goods and services for the disabled and persons with disabilities are presented. The purpose of the study is to analyze the current practice of marketing and advertising activities using the image of disability and persons with disabilities. It is concluded that both advertising and any other forms of marketing initiatives reflect society, and therefore most advertisers at some point create communication products that somehow reflect their target audience. Good examples of images of people with disabilities and a well-thought-out advertising campaign are designed to increase brand loyalty and at the same time make the product more popular with a wide audience.

PMID:37742245 | DOI:10.32687/0869-866X-2023-31-s1-752-755

Aging (Albany NY). 2023 Sep 23;15. doi: 10.18632/aging.204888. Online ahead of print.

ABSTRACT

BACKGROUND: An increasing number of studies are shown how crucial a role cellular senescence plays in tumor development. In this study, we developed a senescence-related lncRNA prognostic index (SRLPI) to forecast radiosensitivity and the probability of biochemical recurrence (BCR) in patients with prostate cancer (PCa).

METHODS: PCa cohorts in TCGA and GEO databases were downloaded. Senescence-and prognosis-related lncRNA with differential expression in tumor and normal samples were identified and used to establish the SRLPI score. Mutation landscape, function pathway, tumor stemness and heterogeneity and tumor immune microenvironment were also analyzed. We performed the analysis using R 3.6.3 and the appropriate tools.

RESULTS: A SRLPI score was constructed based on SNHG1 and MIAT in the TCGA cohort. Our classification of PCa patients into high- and low-risk groups was based on the median SRLPI score. When compared to the low-SRLPI group, the high-SRLPI group was more vulnerable to BCR (HR: 3.33). In terms of BCR-free survival and metastasis-free survival, the GSE116918 showed similar findings. Surprisingly, the SRLPI score demonstrated a high level of radiosensitivity for diagnosis (AUC: 0.98). Age, Gleason score, T stage, N stage, positive lymph nodes, and residual tumor were all significantly greater in patients with high SRLPI scores. Furthermore, this score was significantly related to markers of senescence. Protein secretion and androgen response were found to be substantially enriched in the low-SRLPI group, whereas E2F targets were found to be strongly enriched in the high-SRLPI group for pathway analysis. For the tumor microenvironment assessment, B cells, CD8+ T cells, immune score and TIDE score were positively related to SRLPI score while endothelial level was negatively associated with SRLPI score with statistical significance.

CONCLUSIONS: We developed a SRLPI score that was related to prognosis and radiosensitivity and might be helpful in clinical practice.

PMID:37742230 | DOI:10.18632/aging.204888

Aging (Albany NY). 2023 Sep 22;15. doi: 10.18632/aging.205050. Online ahead of print.

ABSTRACT

Epidemiological investigations have indicated a correlation between elevated plasma levels of Dickkopf-related protein 1 (DKK1) and the presence of atherosclerosis. However, the exact causal relationship of DKK1 with the development of coronary artery disease (CAD) and ischemic stroke (IS) remains unclear. To address this gap, our study aimed to explore their causal association using a two-sample Mendelian randomization (MR) approach. We obtained summary statistics from genome-wide association studies (GWAS) meta-analyses conducted by Folkersen et al. and Nikpay et al., which included data from 21,758 individuals for DKK1 and 42,096 cases of CAD. Additionally, we obtained data from the FinnGen biobank analysis round 5, which included 10,551 cases of IS. Eight MR methods were employed to estimate causal effects and detect directional pleiotropy. Our findings demonstrated that genetic liability to DKK1 was associated with increased risks of CAD (odds ratio [OR]: 1.087; 95% confidence interval [CI]: 1.024-1.154; P = 0.006) and IS (OR: 1.096; 95% CI: 1.004-1.195; P = 0.039). These results establish a causal link between genetic liability to DKK1 and elevated risks of CAD and IS. Consequently, DKK1 may represent a promising therapeutic target for the prevention and treatment of CAD and IS.

PMID:37742224 | DOI:10.18632/aging.205050