Tag: pubmed

Environ Health. 2022 Jun 18;21(1):60. doi: 10.1186/s12940-022-00869-5.

ABSTRACT

BACKGROUND: The Italian mesothelioma registry (ReNaM) estimates mesothelioma incidence and addresses its etiology by assessing cases’ exposures but cannot provide relative risk estimates.

OBJECTIVES: i) To estimate pleural mesothelioma relative risk by industry and occupation and by ReNaM categories of asbestos exposure; and ii) to provide quantitative estimates of the exposure-response relationship.

METHODS: A population-based mesothelioma case-control study was conducted in 2012-2014 in five Italian regions. Cases and age and gender frequency-matched controls were interviewed using a standard ReNaM questionnaire. Experts coded work histories according to international standard classifications of industries/occupations and assigned asbestos exposure according to ReNaM categories. Job codes were further linked to SYN-JEM, a quantitative job-exposure matrix. Cumulative exposure (CE, f/mL-years) was computed by summing individual exposures over lifetime work history. Unconditional logistic regression analyses adjusted by gender, centre and age were fitted to calculate odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: Among men we observed increased risks of mesothelioma in many industries and associated occupations, including: asbestos-cement (OR = 3.43), manufacture of railroad equipment (OR = 8.07), shipbuilding and repairing (OR = 2.34), iron and steel mills (OR = 2.15), and construction (OR = 1.94). ORs by ReNaM exposure categories were as follows: definite/probable occupational exposure (OR = 15.8, men; OR = 8.80, women), possible occupational (OR = 2.82, men; OR = 3.70, women), sharing home with an exposed worker (OR = 2.55, men; OR = 10.3, women), residential (OR = 2.14, men; OR = 3.24, women). Based on SYN-JEM, mesothelioma risk increased by almost 30% per f/mL-year (OR = 1.28, CI 1.16-1.42).

CONCLUSIONS: Out study involved five regions with historically different types and levels of industrial development, encompassing one third of the Italian population and half of Italian mesothelioma cases. As expected, we found increased pleural mesothelioma risk in the asbestos industry and in trades with large consumption of asbestos materials. Clear associations were found using both qualitative (ReNaM classifications) and quantitative estimates (using SYN-JEM) of past asbestos exposure, with clear evidence of an exposure-response relationship.

PMID:35717324 | DOI:10.1186/s12940-022-00869-5

Eur J Surg Oncol. 2022 Jun 9:S0748-7983(22)00490-5. doi: 10.1016/j.ejso.2022.06.007. Online ahead of print.

ABSTRACT

INTRODUCTION: Surgery is the cornerstone of the treatment for advanced ovarian cancer. Reaching complete cytoreduction resulting in no gross residual disease often requires complex surgery. The aim of this study was to assess the impact of increased surgical radicality on the risk of complications in the treatment of advanced ovarian cancer.

MATERIALS AND METHODS: All consecutive patients with advanced ovarian cancer (FIGO Stage IIIB-IVB) who had undergone primary or interval debulking surgery during a six-year study period were identified. In the midst of the study period, a surgical practice change towards maximal surgical effort occurred. Two groups were formed for the analysis: cohort A, that consisted of patients operated before the surgical paradigm shift and cohort B, that consisted of patients operated under the period of increased surgical radicality.

RESULTS: 252 patients were included in the analysis. Complete resection (R0) was achieved in 21.3% of surgeries in cohort A and in 51.2% in cohort B. The total postoperative complication rate was 76.2%. Most of the complications (86.5%) were minor (Clavien-Dindo I-IIIA). The patients in cohort B were at increased risk for complications, OR 2.94 (95%CI 1.58-5.47; p = 0.001). As for the approach to cytoreduction (primary vs. interval debulking), there was no statistically significant association with the occurrence of postoperative complications (p = 0.659).

CONCLUSION: In the present study more extensive surgeries led to better surgical results but increased postoperative morbidity. Postoperative complication rates were similar in both primary and interval debulking surgeries.

PMID:35717320 | DOI:10.1016/j.ejso.2022.06.007

Braz J Otorhinolaryngol. 2022 Jun 9:S1808-8694(22)00080-5. doi: 10.1016/j.bjorl.2022.05.009. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the acquisition of surgical skills by otolaryngology residents and established the minimum number of dissections of a lamb’s model to be performed before practicing on human patients.

METHODS: Nineteen second-year otolaryngology residents performed ten dissections each, five on each nasal cavity, always practicing the same three surgical procedures on the lamb model. Each student’s training lasted 2-months, and the entire training intervention lasted 4-years, over four generations of residents. All dissections were recorded and were selected at random for examination by two independent otolaryngology surgeons, who were otherwise not involved in the research. Assessment of the 190 dissections used an instrument validated for surgical training of medical residents.

RESULTS: To a 1% significance level, statistical analysis revealed increased performance and satisfactory results were observed after the sixth dissection. Furthermore, after the eighth dissection, skill acquisition was relevant and sustained.

CONCLUSION: Training in endoscopic nasal surgery on a lamb’s head model improves surgical skills and handling of surgical instruments. Our results showed the relevance of the lamb model for training in otolaryngology surgery, impacting on patient safety.

PMID:35717307 | DOI:10.1016/j.bjorl.2022.05.009

Pilot Feasibility Stud. 2022 Jun 18;8(1):129. doi: 10.1186/s40814-022-01080-6.

ABSTRACT

BACKGROUND: There is a paucity of evidence to support interventions that address the social needs of children and families with chronic medical conditions. The primary objective of this pilot randomized controlled trial (RCT) is to assess the feasibility of an intervention that screens for and addresses the social needs of children and families enrolled in a pediatric weight management clinic.

METHOD: We will conduct a single-center, pilot RCT of 40 families with children enrolled in a pediatric weight management program at a tertiary children’s hospital in Ontario, Canada. Families who are experiencing unmet social needs will be randomized to either a community navigator or self-navigation of community resources. The primary feasibility outcomes and criteria for success include the following: (1) recruitment rates, will be successful if 80% of our target sample is met in the 6 months of recruitment; (2) uptake of intervention, will be considered successful if > 80% of families complete the intervention; and (3) follow-up of participants, will be considered successful if > 90% of participants complete all the study visits. The secondary outcomes include estimating the preliminary effects on body mass index, body composition, and quality of life at 6 months. The analysis of feasibility outcomes will be based on descriptive statistics, and analysis of secondary clinical outcomes will be reported as estimates of effect. We will not perform tests of significance since these analyses are purely exploratory.

DISCUSSION: This study is important because it will aim to improve the treatment of pediatric obesity by testing the feasibility of an intervention that addresses unmet social needs.

TRIAL REGISTRATION: ClinicalTrias.gov : NCT04711707 (Registered January 13, 2021).

PMID:35717284 | DOI:10.1186/s40814-022-01080-6

J Perinat Med. 2022 Jun 20. doi: 10.1515/jpm-2022-0085. Online ahead of print.

ABSTRACT

OBJECTIVES: Prolonged fetal exposure to maternal bile acids have been linked to fetal lung injury, but it is not known if it affects production of surfactant or fetal lung maturity tests. We set out to determine if elevated total bile acid (TBA) levels predict delayed fetal lung maturity (FLM) in patients with intrahepatic cholestasis of pregnancy (ICP).

METHODS: A retrospective cohort study examining patients with ICP who underwent amniocentesis between 36+0 and 37+6 between 2005 and 2014. Primary goal was to identify if a relationship exists between TBA levels and FLM defined as Lecithin:Sphingomyelin >2.5, detectable Phosphatidylglycerol, or lamellar body count of >50,000.

RESULTS: Among the 113 patients, there was no statistically significant difference in TBA levels between women with FLM and those with immaturity (31.3 [21.6, 44.5] μmol/L and 34.9 [23.9, 62.3] μmol/L respectively; p=0.16). Logistic regression performed using predefined TBA levels of 20, 30, 40 and 50 μmol/L revealed that TBA levels did not predict a negative FLM test at time of amniocentesis.

CONCLUSIONS: TBA levels do no predict presence or absence of FLM between 36+0 and 37+6 weeks of gestation. Though certain pregnancy complications can affect FLM, we could not identify a correlation between TBA levels and an accelerated or delayed lung maturation process.

PMID:35716390 | DOI:10.1515/jpm-2022-0085

J Appl Microbiol. 2022 Jun 18. doi: 10.1111/jam.15671. Online ahead of print.

ABSTRACT

AIMS: To examine the interaction of diagnostic techniques, initial titers of Leifsonia xyli subsp. xyli (Lxx), sugarcane genotype, and thermotherapy on ratoon stunt (RSD) control.

METHODS AND RESULTS: Single buds of RB867515, RB92579, and RB966928 submitted to 50°C/2h or 52°C/30min under factorial block design and five replications; results checked nine months later by serological (DBI) and molecular (PCR) techniques. A 10,000 bootstrapping simulation were performed to infer best plot size based on the experimental coefficient of variation. Analysis of variance showed significance only on initial Lxx titers and RSD-control. Despite absence of significance in the overall analysis, minor differences in control success with different methods and cultivars is predicted to have a major epidemiological impact on RSD considering successive harvests and vegetative increase. According to an epidemiological interpretation, the 50°C/2h treatment was more effective, cultivar RB966928, the most susceptible, and the PCR-based method was most the sensitive for pathogen detection. The minimum required plants per plot was 15, indicating high precision of our experiment.

CONCLUSIONS: Data interpretation considered both the statistics analysis and the epidemiology aspect of RSD in order to improve RSD management. The Brazilian sugarcane industry will benefit from this approach since it is not using it.

SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study that examined multiples factors that affect RSD control. Our work pinpointed the importance of the thermotherapy, its best combination as well as the diagnostic test. Also, the effect of the cultivar to respond to management strategies. Because the epidemiological aspect of RSD was taking into consideration, results of our work can have an impact on RSD control in the field.

PMID:35716383 | DOI:10.1111/jam.15671

J Gastroenterol Hepatol. 2022 Jun 18. doi: 10.1111/jgh.15917. Online ahead of print.

ABSTRACT

BACKGROUND: The efficacy and safety of amoxicillin-vonoprazan (VA) dual therapy remained unclear.

MATERIALS AND METHODS: This systematic review was conducted in accordance with the PRISMA 2009 guidelines. A systematic search of the Pubmed, Embase, and Cochrane database was conducted using the combination of “”Helicobacter pylori or H. pylori or Hp”, “amoxicillin penicillin” and “Vonoprazan or TAK-438 or Takecab or (potassium AND competitive) or potassium-competitive”. The initial and secondary outcome of this meta-analysis was to evaluate the efficacy and safety of VA dual therapy.

RESULTS: 3 studies and 668 H. pylori infected patients were included in this meta-analysis. The crude eradication rate of VA dual therapy was 87.5% and 89.6% by ITT and PP analysis, respectively. No significant differences were observed regarding the VA dual therapy and vonoprazan-amoxicillin-clarithromycin (VAC) triple therapy according to ITT (RR = 0.99, 95% CI, 0.93-1.05, P = 0.65) and PP (RR =0.99, 95% CI, 0.94-1.05, P =0.82) analysis. The side effect of VA dual therapy was 19.1% (95% CI, 5.9-32.4), which was lower than that of VAC triple therapy but there was no statistical significance (RR = 0.75, 95% CI, 0.59-1.06, P = 0.12).

CONCLUSION: VA dual therapy shows acceptable efficacy, good safety and avoid unnecessary antibiotic use in the first-line treatment for H. pylori infection. However, its application in other regions need to be further explored.

PMID:35716370 | DOI:10.1111/jgh.15917

Laryngoscope. 2022 Jun 18. doi: 10.1002/lary.30251. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study is to identify objective perioperative diagnostic factors for acute invasive fungal rhinosinusitis (AIFS) to create a diagnostic scoring system using objective criteria.

METHODS: Retrospective case-control study performed at an academic, tertiary care center. Biopsy-proven cases of AIFS identified from pathology records (2015-2019) were compared to patients the otolaryngology service was consulted to “Rule out AIFS” in the year 2019, only including those with underlying hematologic malignancy. Eighteen patients with AIFS and 20 patients without were included. One and two tailed T-tests were used for p-values. Receiver operating characteristic curves were generated for the significant data, and Youden’s J-statistic was used to create the ideal cutoff values for each. Likelihood ratios were used to give a power for the scoring system.

RESULTS: Compared to patients with non-hematologic malignancy-related AIFS, patients with hematologic malignancy-related AIFS have significantly elevated C-reactive protein (CRP) and blood glucose; while albumin, hematocrit, platelet count, and absolute neutrophil count (ANC) were found to be significantly lower. In addition, Lund-Mackay score asymmetry, extra-sinus spread, aspergillus antigen, and pre-existing diabetes mellitus correlated with disease. A scoring system with three categories: AIFS Unlikely, Indeterminate/AIFS Suspicious, and AIFS Highly Likely was developed.

CONCLUSION: Patients with hematologic malignancy-related AIFS have measurable differences in lab values and standard imaging that could be used in determining the diagnostic probability of AIFS including: CRP, albumin, hematocrit, platelets, ANC, blood glucose, aspergillus antigen, Lund-Mackay score asymmetry, extra-sinus spread, and pre-existing diabetes mellitus. A novel scoring system was proposed that will require prospective validation.

LEVEL OF EVIDENCE: 3 Laryngoscope, 2022.

PMID:35716357 | DOI:10.1002/lary.30251

Ann Intensive Care. 2022 Jun 18;12(1):55. doi: 10.1186/s13613-022-01026-4.

ABSTRACT

BACKGROUND: Hyperammonaemia is frequent in Intensive Care Unit patients. Some drugs have been described as associated with this condition, but there are no large-scale studies investigating this topic and most descriptions only consist of case-reports.

METHODS: We performed a disproportionality analysis using VigiBase, the World Health Organization Pharmacovigilance Database, using the information component (IC). The IC compares observed and expected values to find associations between drugs and hyperammonaemia using disproportionate Bayesian reporting. An IC_0.25 (lower end of the IC 95% credibility interval) > 0 is considered statistically significant. The main demographic and clinical features, confounding factors, and severity of cases have been recorded.

RESULTS: We identified 71 drugs with a disproportionate reporting in 2924 cases of hyperammonaemia. Most of the suspected drugs could be categorised into 4 main therapeutic classes: oncologic drugs, anti-epileptic drugs, immunosuppressants and psychiatric drugs. The drugs most frequently involved were valproic acid, fluorouracil, topiramate, oxaliplatin and asparaginase. In addition to these molecules known to be responsible for hyperammonaemia, our study reported 60 drugs not previously identified as responsible for hyperammonaemia. These include recently marketed molecules including anti-epileptics such as cannabidiol, immunosuppressants such as basiliximab, and anti-angiogenics agents such as tyrosine kinase inhibitors (sunitinib, sorafenib, regorafenib, lenvatinib) and monoclonal antibodies (bevacizumab, ramucirumab). The severity of cases varies depending on the drug class involved and high mortality rates are present when hyperammonaemia occurs in patients receiving immunosuppressant and oncologic drugs.

CONCLUSIONS: This study constitutes the first large-scale study on drug-associated hyperammonaemia. This description may prove useful for clinicians in patients’ care as well as for trial design.

PMID:35716335 | DOI:10.1186/s13613-022-01026-4

Eur J Health Econ. 2022 Jun 18. doi: 10.1007/s10198-022-01482-6. Online ahead of print.

ABSTRACT

OBJECTIVES: Preference information is increasingly being elicited to support decision-making. Although discrete choice experiments (DCEs) are commonly used, little is known about how respondents’ relative experience of a health issue, and its treatment, might impact the results of preference studies. The aim of this study was to explore how preferences differ between groups of individuals with varying levels of experience of a health issue and its treatment, using a weight loss maintenance (WLM) programme as a case study.

METHODS: An online DCE survey was provided to four groups, each differing in their level of experience with weight loss and WLM programmes. One group was recruited from a randomised controlled trial of a WLM programme (ISRCTN14657176) and the other three from an online panel. Choice data were analysed using mixed logit models. Relative attribute importance scores and willingness-to-pay (WTP) estimates were estimated to enable comparisons between groups.

RESULTS: Preferences differed between the groups across different attributes. The largest differences related to the outcome (weight re-gain) and cost attributes, resulting in WTP estimates that were statistically significantly different. The most experienced group was willing to pay £0.35 (95% CI: £0.28, £0.42) to avoid a percentage point increase in weight re-gain, compared with £0.12 (95% CI: £0.08, £0.16) for the least experienced group.

CONCLUSION: This study provides evidence in a public health setting to suggest that preferences differ based on respondent experience of the health issue and its treatment. Health preference researchers should therefore carefully consider the appropriate composition of their study samples.

PMID:35716317 | DOI:10.1007/s10198-022-01482-6