Tag: pubmed

BMJ Open. 2023 Sep 5;13(9):e068441. doi: 10.1136/bmjopen-2022-068441.

ABSTRACT

OBJECTIVE: To assess the uptake of human papillomavirus (HPV) vaccination and its associated factors among adolescents in Gambella town, Southwest Ethiopia.

DESIGN: A community-based cross-sectional study.

SETTING: Gambella town, Southwest Ethiopia.

PARTICIPANTS: A total of 882 adolescents were included between May and July 2022.

OUTCOME: Uptake of HPV vaccination.

METHODS: A cluster sampling technique was used to select study participants. An interviewer-administered and pretested questionnaire was used to collect the data. The collected data were entered into Epi-data V.4.6 and exported to STATA V.16 for cleaning, coding and analysis. A binary logistic regression model was used to test the association between independent and dependent variables. Variables with a p<0.05 in the multivariable logistic regression were considered statistically significant factors for the uptake of HPV vaccination.

RESULTS: A total of 825 adolescents participated in this study. Among participants, 48% (95% CI 44.6% to 51.4%) have been vaccinated for HPV. Ever heard of the HPV vaccine (AOR 2.5, 95% CI 1.23 to 5.08), good knowledge of HPV infection (AOR 3.62, 95% CI 2.17 to 6.02), good knowledge of the HPV vaccine (AOR 5.54, 95% CI 3.28 to 9.36) and attitude towards the HPV vaccine (AOR 2.74, 95% CI 1.88 to 3.98) were significantly associated HPV vaccination.

CONCLUSION: In the current study, the uptake of HPV vaccination was found to be low. The finding highlights the importance of promoting community health education about HPV infection and vaccines and providing behaviour change education, which plays a substantial role in promoting the uptake of HPV vaccination.

PMID:37669848 | DOI:10.1136/bmjopen-2022-068441

BMJ Open. 2023 Sep 5;13(9):e073049. doi: 10.1136/bmjopen-2023-073049.

ABSTRACT

INTRODUCTION: Medical patients, admitted acutely to hospital, are at risk of venous thromboembolism (VTE). Clinical guidelines advise thromboprophylaxis prophylaxis for those at high risk of VTE. VTE is a common sequela of cancer, but guidelines take little consideration of cancer as an independent risk factor and their utility in palliative care patients is unclear. The hospice inpatient deep vein thrombosis (DVT) detection study (HIDDen) reported a 28% prevalence of asymptomatic iliofemoral DVT in hospice patients of poor performance status (PS) and prognosis, calling into question the utility of thromboprophylaxis in the palliative care setting. However, the majority of cancer inpatients receiving palliative care are admitted to hospital through the acute medical setting, yet their risk factors for VTE may differ from those admitted to hospices.

OBJECTIVE: To better understand the prevalence and behaviours of VTE in patients with cancer receiving palliative care who are admitted as an acute medical emergency.

DESIGN: Multicentre, observational cohort study.

SETTING: Secondary care acute hospitals in South Wales, UK.

PATIENTS: We plan to recruit 232 patients≥18 years old with a diagnosis of incurable cancer, and/or receiving palliative or best supportive care who are admitted acutely to hospital. Patients will be followed up for a maximum of 6 months following registration.

PRIMARY OUTCOME: Presence of lower extremity DVT.

SECONDARY OUTCOMES: Symptom burden attributed to DVT or pulmonary embolism, patient PS, patient demographics and development of new VTE within 90 days of registration.

ANALYSIS: The study statistical analysis plan will document analysis, methodology and procedures.

ETHICS AND DISSEMINATION: Ethical approval was obtained from the Wales Research Ethics Committee, reference 22/WA/0037 (IRAS 306352)-the main trial results will be analysed as soon as practically possible and the publication shared with investigators and on sponsor website; applications to access trial data will be subject to sponsor review process.

PMID:37669841 | DOI:10.1136/bmjopen-2023-073049

Int J Gynecol Cancer. 2023 Sep 5:ijgc-2023-004658. doi: 10.1136/ijgc-2023-004658. Online ahead of print.

ABSTRACT

OBJECTIVE: Cytoreductive surgery in conjunction with hyperthermic intraperitoneal chemotherapy (HIPEC) is being explored in the upfront, interval, and recurrent setting in patients with ovarian cancer. The objective of this systematic review was to assess the rate of complications associated with HIPEC in epithelial ovarian cancer surgery over two time periods.

METHODS: This study was registered in PROSPERO (CRD42022328928). A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Ovid/Medline, Ovid/Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials were searched from January 2004 to April 2022. We included studies reporting on patients with advanced primary or recurrent epithelial ovarian cancer who underwent cytoreductive surgery and HIPEC. We evaluated two different time periods: 2004-2013 and 2014-2022. A random-effects meta-analysis was used to produce an overall summary. Subgroup analyses were planned according to recruited period for each specific complication type. Heterogeneity was assessed using the I² statistic.

RESULTS: A total of 4928 patients were included from 69 studies for this systematic review; 19 published from 2004-2013, and 50 published from 2014-2022. No significant differences were found between the two time periods in terms of blood transfusions (33% vs 51%; p=0.46; I²=95%) overall gastrointestinal complications (15% vs 21%; p=0.36; I²=98%), infectious diseases (16% vs 13%; p=0.62; I²=93%), overall respiratory complications (12% vs 12%; p=0.88; I²=91%), overall urinary complications (6% vs 12%; p=0.06; I²=94%), or thromboembolic events (5% vs 3%; p=0.25; I²=63%). Also, no differences were found in intensive care unit (ICU) admissions (89% vs 28%; p=0.06; I²=99%), reoperations (8% vs 7%; p=0.50; I²=37%), or deaths (3% vs 3%; p=0.77; I²=57%).

CONCLUSIONS: Our review showed that overall complications have not changed over time for patients undergoing HIPEC in the setting of primary or recurrent ovarian cancer. There was no decrease in the rates of ICU admissions, reoperations, or deaths.

PMID:37669829 | DOI:10.1136/ijgc-2023-004658

J Nucl Med Technol. 2023 Sep;51(3):196-203. doi: 10.2967/jnmt.123.265808.

ABSTRACT

The Nuclear Medicine Technology Certification Board performed an impact survey on the coronavirus disease 2019 pandemic to better assess the current state of nuclear medicine practice within the United States, as well as the perceptions and experiences of technologists working during the pandemic. Methods: A web-based automation platform was used to create, collect, and analyze the survey data. Results: The survey revealed many department protocol variations during the pandemic, a decrease in patient volume, and several other concerns and issues. Experiences regarding staffing and wage changes were varied. Conclusion: This research showed significant inconsistencies in practice and stresses to nuclear medicine technology during the pandemic, as well as concerns for the workforce pipeline. NMTCB decided to delay the JTA process and conduct additional research regarding the workforce.

PMID:37669814 | DOI:10.2967/jnmt.123.265808

Can J Ophthalmol. 2023 Sep 2:S0008-4182(23)00251-X. doi: 10.1016/j.jcjo.2023.08.005. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this research is to report on real-world anti-vascular endothelial growth factor (anti-VEGF) treatment patterns in retinal vein occlusions (RVO).

DESIGN: Retrospective cohort study.

PARTICIPANTS: Treatment-naive RVO patients initiating anti-VEGF injections between 2015 and 2021.

METHODS: Medical records available until June 2022 were reviewed. Demographics, diagnosis, number of injections, treatment length, reason for discontinuation, and baseline and final data (e.g., date, age, best-corrected visual acuity [BCVA], and central subfield thickness) were recorded. Statistical analyses performed with STATA 17.0 assessed differences between baseline and final values, branch (BRVO) and central retinal vein occlusion (CRVO), and treatment-discontinuation subgroups.

RESULTS: A total of 219 treatment-naive eyes were included (70.3 ± 13.2 years of age, 52.5% female), with 99 BRVOs and 120 CRVOs (2482 injections). The discontinuation rate was 76.7% (168 of 219), with 72.7% of patients (77 of 99) with BRVOs and 75.8% of patients (91 of 120) with CRVOs discontinuing injections. Reasons for discontinuation included stable off active therapy (98 eyes), severe comorbidity or death (17 eyes), switched to intraocular steroid (implant or injection) (12 eyes), lack of visual benefit (10 eyes), ocular comorbidity (5 eyes), patient decision (5 eyes), and patient transfer (5 eyes). Among the remaining 67 eyes, 16 (24%) were lost to follow-up. Reasons for discontinuation differed between BRVO and CRVO patients (p = 0.002). Eyes with CRVO presented with worse BCVA (p < 0.0001) and achieved worse final BCVA (p < 0.0001), but both groups experienced improvements (p < 0.0001). Younger age, better baseline BCVA, and a diagnosis of BRVO were independent predictors of better final visual acuity.

CONCLUSION: Over 7.5 years, treatment was discontinued for three-quarters of RVOs. Stable disease was the most common reason for discontinuation, with nearly half (45%) of all RVOs in the cohort stable off active therapy. Better visual outcomes were achieved in BRVO than in CRVO, although both groups benefited from treatment.

PMID:37669742 | DOI:10.1016/j.jcjo.2023.08.005

Int J Pharm. 2023 Sep 3:123368. doi: 10.1016/j.ijpharm.2023.123368. Online ahead of print.

ABSTRACT

The drying capacity of a continuous vibrated fluid bed dryer was studied using a DoE by varying microcrystalline cellulose content in the formulation, water amount in the twin-screw granulation, inlet air temperature, air flow rate and the acceleration of the horizontal fluid-bed. Temperature and humidity profiles were measured along the dryer using wireless sensors. For the parameter space explored in this study, acceleration was the most influential process parameter of the dryer regarding the resulting granule moisture content. An empirical model was developed that allowed for fast and accurate moisture content prediction that could be incorporated into an enhanced control strategy. In addition, a mechanistic model was formulated that allow for prediction of temperature and moisture profiles, and most importantly the moisture content of the granules inside the dryer. The mechanistic model can be integrated to other unit operation models to provide overall understanding of an integrated continuous process line. The mechanistic model also makes it possible to define the equipment design requirements (e.g., length of the dryer) to meet the specific needs in terms of drying capacity, temperature and moisture profile.

PMID:37669728 | DOI:10.1016/j.ijpharm.2023.123368

Photodiagnosis Photodyn Ther. 2023 Sep 3:103777. doi: 10.1016/j.pdpdt.2023.103777. Online ahead of print.

ABSTRACT

AIM: The objective of this study is to investigate and compare the superficial and deep vascular structures of the retina, as well as the changes in the choriocapillaris (CC) and optic disc microvasculature, using optical coherence tomography angiography (OCTA) in patients diagnosed with diabetes mellitus (DM) without diabetic retinopathy (DR), patients with non-proliferative and proliferative DR, and healthy individuals.

MATERIALS AND METHODS: This prospective study conducted between July 2020 and July 2021 included patients diagnosed with type 2 DM without DR, as well as patients with mild nonproliferative, moderate nonproliferative, and proliferative DR without macular edema. A control group of 25 age- and gender-matched healthy individuals was also included. OCTA parameters of the patients were examined.

RESULTS: In the DR groups, compared to the control group, there was a significant decrease in macular superficial, deep, and CC perfusion areas as the severity of DR increased (p<0.001). The vascular density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) exhibited a statistically significant decrease in all quadrants of the DR group compared to the control group (p=0.033 for SCP in the fovea, p<0.001 for all other quadrants). The superficial and deep FAZs showed a significant expansion in the DR group compared to the control group (p=0.003 for superficial FAZ, p<0.001 for deep FAZ). As the severity of DR increased, there was a statistically significant decrease in the perfusion areas of the optic nerve head (ONH), radial peripapillary capillary (RPC), and vitreous segments (p<0.001 for ONH, p=0.031 for RPC, p<0.001 for vitreous). There was a statistically significant decrease in RPC VD in all quadrants as the severity of DR increased. Moreover, as the severity of DR increased, a statistically significant decrease in the VD of the ONH was observed in all quadrants except for the inferior nasal (p=0.094), inferior temporal (p=0.111), superior temporal (p=0.18), and temporal (p=0.284) quadrants.

CONCLUSION: Our study demonstrated the involvement of macular and optic nerve perfusion areas (PA) and VD in diabetic patients. OCTA proved to be a valuable and noninvasive imaging modality, providing an easy and repeatable assessment of posterior segment vascular changes in patients with DR.

PMID:37669724 | DOI:10.1016/j.pdpdt.2023.103777

Arch Cardiol Mex. 2023 Sep 5. doi: 10.24875/ACM.22000118. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVES: The objective of this study is to compare the clinical characteristics and outcomes of contemporary cohorts of patients undergoing catheter ablation for atrial fibrillation (AF), stratified by age (< 70 years and ≥ 70 years).

METHODS: This retrospective cohort study included patients who underwent catheter ablation for refractory AF. The minimum follow-up duration per patient was 12 months.

RESULTS: A total of 239 patients were included in the study, with 171 (71.5%) in the < 70 years group and 68 (28.5%) in the ≥ 70 years group. The mean age of the study population was 62.4 years (SD 10.87). The < 70 years group had a mean age of 58.03 years (SD 9.71), while the ≥ 70 years group had a mean age of 73.4 years (SD 3.05). Furthermore, a higher proportion of paroxysmal AF was observed in patients < 70 years, whereas a higher proportion of persistent AF was found in patients ≥ 70 years. These differences were statistically significant. The recurrence rates after the initial ablation procedure were similar between the two groups (21.43% in the < 7 0 years group vs. 23.53% in the ≥ 70 years group, p = 0.79). Additionally, there were no significant differences in terms of complications. The < 70 years group experienced 18 complications, while the ≥ 70 years group had 5 complications (p = 0.472).

CONCLUSION: The findings of this study suggest that patients aged 70 years and older who undergo their first catheter ablation procedure for AF demonstrate similar clinical outcomes compared to patients younger than 70 years.

PMID:37669664 | DOI:10.24875/ACM.22000118

Acta Ortop Mex. 2022 Nov-Dec;36(6):373-378.

ABSTRACT

INTRODUCTION: the orthopedic shoe is usually prescribed during postoperative care after hallux valgus surgery to protect the osteotomy and provide functional comfort to the patient. In this regard, the superiority of rigid sole shoe (RSS) compared to the reverse camber shoe (RCS) remains controversial. The aim of this study is to compare the clinical, functional and radiological outcomes from using the rigid sole shoe (RSS) vs. the reverse camber shoe (RCS) after hallux valgus surgery.

MATERIAL AND METHODS: fifty-seven hallux valgus surgery patients were included and analyzed retrospectively. The 1st group included 28 patients using the RSS and the 2nd group included 29 patients using the RCS. The orthopedic shoe was used for six weeks postoperatively. Clinical data (lumbar and lower limb pain, need of crutches and problems with going up and down stairs), radiological data (IMA, HVA) and postoperative complications (displacement of osteotomy, metatarsal fracture or non-union) were collected.

RESULTS: the RSS showed less difficulty going up and down stairs (OR 3.8 (CI 95% 1.2-12.8), p 0.02), only going upstairs (OR 3.2 (CI 95% 1.1-10), p 0.03), as well as a decreased need for crutches (OR 1.7 (CI 95% 1.04-2.6), p < 0.03). Lumbar spine or lower limb pain did not show any statistical differences. No statistical differences in the epidemiological and radiological data were found between the groups.

CONCLUSIONS: the RSS seems to provide more comfort to the patients without worsening the radiological results.

PMID:37669657

Ann Clin Biochem. 2023 Sep 5:45632231202330. doi: 10.1177/00045632231202330. Online ahead of print.

ABSTRACT

BACKGROUND: The CELTIC Ranges project aims to deliver a comprehensive range of reference intervals for commonly ordered laboratory investigations suitable for use in an Irish population as well as enabling comparison with relevant international studies. In this paper, we describe our methodology used throughout the entire project and present paediatric reference intervals for renal profile tests in plasma (sodium, potassium, urea, and creatinine).

METHODS: 1023 children aged up to 17 years were recruited from our hospital’s general practitioner paediatric phlebotomy clinic. Clinical chemistry analyses were performed on the Roche Modular system and statistical analysis was completed in line with CLSI guideline EP28-A3c.

RESULTS: The plasma reference interval for sodium for ages 0.45-16.99 years was 137-143 mmol/L in 1000 subjects (combined genders). For plasma potassium, the corresponding ranges between 1-16.99 years (combined genders) were 3.6-4.8 mmol/L. Apart from neonates and in keeping with other studies, age-partitioning for electrolytes was not required. Data for plasma creatinine (enzymatic methodology) and urea is also presented and, as anticipated, required partitioning for both age and gender.

CONCLUSIONS: Our renal profile findings are broadly consistent with those of international studies e.g. CALIPER, HAPPI, NORDIC, Prince and KiGGs. Moreover, the CELTIC Ranges study is also based on over 1000 subjects whose samples were analysed on the widely used Roche Modular analytics system. We also expect the findings will improve knowledge of children’s metabolic health in Ireland.

PMID:37669625 | DOI:10.1177/00045632231202330