Tag: pubmed

J Vasc Surg. 2023 Jul 14:S0741-5214(23)01613-0. doi: 10.1016/j.jvs.2023.07.004. Online ahead of print.

ABSTRACT

OBJECTIVE: This study characterizes racial differences in presentation, as well as short- and long-term outcomes following endovascular treatment of thoracic aortic aneurysm (TAA) and type B aortic dissection (TBAD).

METHODS: We queried the Gore Global Registry for Endovascular Aortic Treatment (GREAT) for thoracic endovascular aortic repairs (TEVARs) performed between 2010-2016 and followed through 2022. Pathologies represented were descending TAA, complicated TBAD, and uncomplicated TBAD. Using standard statistical tests, we compared overall and pathology-specific demographics, procedural factors, and outcomes among Black and White patients undergoing TEVAR.

RESULTS: We identified 438 TEVAR cases, including 236 descending TAA, 121 complicated TBAD, and 74 uncomplicated TBAD. Overall, Black patients were younger and had higher incidence of renal insufficiency (P=.001), whereas White patients had more chronic obstructive pulmonary disease (P=.003) and cardiac arrhythmias (P=.037). In patients treated for descending TAA, Black patients had increased device/procedure-related complications (34.3% vs 17.4%, P=.014), conversion to open repair (2.9% vs 0%, P=.011) and type II endoleak (5.7% vs 1.0%, P=.040) but no differences in mortality, length of hospital stay, or major adverse cardiovascular events. Whereas outcomes of TEVAR for uncomplicated TBAD were comparable, Black patients more frequently presented with complicated TBAD than White patients (Black: 40.5% vs White: 24.8%, P=.008) and had subsequently greater reintervention rate (28.1% vs 12.4%, P=.012), all-cause mortality (HR 4.28, 95% CI 1.74-10.5, P=.002) and aortic-related mortality (HR 16.7, 95% CI 1.49-186, P=.022).

CONCLUSION: Despite increased device- and procedure-related complications, similar short and long-term outcomes are achieved in Black and White patients undergoing TEVAR for descending TAA and uncomplicated TBAD. However, Black patients are more likely to present with, require reintervention, and suffer mortality from complicated TBAD.

PMID:37454953 | DOI:10.1016/j.jvs.2023.07.004

J Arthroplasty. 2023 Jul 14:S0883-5403(23)00743-X. doi: 10.1016/j.arth.2023.07.006. Online ahead of print.

ABSTRACT

BACKGROUND: Hemiarthroplasty (HA) for hip fractures can be performed with an unipolar or bipolar head.We describe the use of unipolar and bipolar HA after a hip fracture in the Netherlands and determined revision rates and risk factors.

METHODS: All HAs for an acute hip fracture registered in the Dutch Arthroplasty Register (LROI) during 2007 to 2021 were included; 44,127(88%) unipolar and 6,013(12%) bipolar HA. Competing risk survival analyses were performed with revision for any reason as endpoint. Multivariable Cox regression analyses were performed adjusted for patient and surgery related factors.

RESULTS: The 1, 5, and 10 year revision rates were comparable for unipolar and bipolar HA. Cox regression analysis showed a Hazard Ratio of 1.2 (95% confidence interval (CI) 1.0 to 1.4)) after adjustment for confounders for bipolar heads. In cases of a cemented stem the 1-year cumulative incidence of revision was lower (1.5% (CI 1.4 to 1.7%) compared to uncemented stems (2.4% (CI 2.1 to 2.7%); uncemented stems showed higher risks for revision after adjustment compared to cemented stems (HR1.4 (CI 1.2 to 1.5)). The anterior, antero-lateral and straight-lateral approach showed lower risk for revision compared to the postero-lateral approach.

CONCLUSION: The revision rate for bipolar HA and unipolar HA was comparable. However, after adjustment for potential confounders the risk for revision showed an estimated 20% increased revision risk for bipolar heads, although not statistically significant. For both head types, the risk for revision was significantly higher when an uncemented stem was chosen or the postero-lateral approach was used.

PMID:37454950 | DOI:10.1016/j.arth.2023.07.006

Am J Med Sci. 2023 Jul 14:S0002-9629(23)01256-9. doi: 10.1016/j.amjms.2023.07.002. Online ahead of print.

ABSTRACT

BACKGROUND: Sleep disturbances in patients with end-stage renal disease (ESRD) are common and more prevalent than in the general population. This study aims to assess the demographic and clinical risk factors for the diagnosis of sleep disorders in ESRD patients.

METHODS: This study is a retrospective analysis of the United States Renal Data System (USRDS) to evaluate risk factors for the diagnosis of sleep disorders, including hypersomnolence, insomnia, restless leg syndrome (RLS), or obstructive or central sleep apnea (OSA/CSA). All ESRD subjects enrolled in the USRDS between 2004-2015 were eligible for inclusion. The risk factors analyzed were age, race, sex, ethnicity, access type, dialysis modality, and the Charlson Comorbidity Index (CCI). All statistical analysis was performed using SAS 9.4, and statistical significance was assessed using an alpha level of 0.05. Descriptive statistics on all variables overall and by each sleep diagnosis were determined.

RESULTS: Increasing age, black race, other race, and Hispanic ethnicity were associated with decreased risk of each sleep diagnosis while CCI was associated with increased risk. Females were at increased risk of RLS and insomnia while males were at increased risk of OSA/CSA. Catheter and graft access decreased risk of RLS but increased risk of insomnia compared to AVF access. Catheter access increased risk of OSA/CSA compared to graft access. Hemodialysis increased risk of OSA/CSA compared to peritoneal dialysis.

CONCLUSIONS: Some ESRD patients are at an increased risk for diagnosis of sleep disorders based on age, race, sex, comorbid health conditions, and dialysis modality.

PMID:37454928 | DOI:10.1016/j.amjms.2023.07.002

Exp Parasitol. 2023 Jul 14:108587. doi: 10.1016/j.exppara.2023.108587. Online ahead of print.

ABSTRACT

Fasciola hepatica, the liver trematode, infects ruminants and causes economic loss. Because parasites are developing resistance to commercial drugs, the negative effects of parasitism are increasing. In this study, we aimed to evaluate the efficacy of cumin (Cuminum cyminum) essential oil against F. hepatica eggs and adults. The eggs were incubated with eight concentrations of the essential oil (0.031125-4.15 mg/mL), and viable eggs were counted after 14 days and classified as embryonated or non-embryonated. Adult flukes were incubated in Roswell Park Memorial Institute medium to ensure their viability and then incubated in essential oil. They were observed for 24 h after treatment. The adults were assessed with the two lowest effective oil concentrations used in the ovicidal test. Three controls were used for both tests: nitroxynil, a negative control, and Tween®80. After incubation in oil, the adult specimens were processed for histological analysis and stained with hematoxylin-eosin. In addition, the oil was tested for cytotoxicity using Madin-Darby bovine kidney cells to assess any possible effect on them. The oil was effective in ovicidal and adulticidal inhibition of the trematode, with statistically significant results. All concentrations assessed in the ovicidal test were 100% effective. The adult test was effective within 15 h and inactivated all the specimens at the highest concentration evaluated (0.06225 mg/mL). Histological analysis showed that cumin essential oil resulted in marked areas of vacuolization. The spines showed no structural changes but were surrounded by microvesicles. These findings indicated that cumin oil could be a potential compound in the control of fasciolosis.

PMID:37454922 | DOI:10.1016/j.exppara.2023.108587

Ann Vasc Surg. 2023 Jul 14:S0890-5096(23)00521-6. doi: 10.1016/j.avsg.2023.07.092. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to analyze the luminal changes in the iliocaval veins and their effects on the development of signs and symptoms of chronic venous disease manifesting from inferior vena cava filter placement.

METHODS: This was a retrospective observations study; deidentified patients with an Inferior Vena Cava (IVC) filter placed with subsequent luminal changes were included. All patients had a computerized tomography (CT) scan with or without ultrasound and those who underwent an intervention for the obstruction had also venography and intravascular ultrasound (IVUS). The diameter of IVC and iliac veins was measured from the near wall to the far wall. IVC diameters measured less than 12 mm were considered to be retractions. Signs and symptoms of chronic venous disease were obtained from patient charts and were reported according to the highest CEAP class. The data was analyzed using descriptive statistics, presenting diameter changes as a mean with standard deviation and a range of diameters included.

RESULTS: Overall, 76 patients were included in this study, of whom 66 had occlusion of the IVC or the Iliac veins. Luminal changes of the inferior vena cava were observed in all patients. A total of 58 patients presented with chronic post-thrombotic changes in both the inferior vena cava and iliac veins. There were 4 patients that had a luminal reduction with no filling defects or post-thrombotic changes. Average inferior vena cava diameter and iliac vein diameter was measured to be 8.3 ± 1.4 mm and 4.6 ± 1.4 mm, respectively. Patients most frequently presented with extremity swelling, but other signs such as venous ulceration or skin damage were observed.

CONCLUSION: Permanent luminal changes of the inferior vena cava and iliac veins were observed as a result of inferior vena cava filter placement and such patients commonly present with signs and symptoms of chronic venous disease. Together, with other known filter complications, these observations add more reasons for a timely retrieval. When such changes occur, patients’ appropriate symptoms can be successfully treated. The permanent changes made by filter placement in the IVC and iliac veins further support filter retrieval in a timely fashion. The luminal changes induced by filter placement should be recognized early, particularly in symptomatic patients who can be safely treated with endovenous procedures.

PMID:37454894 | DOI:10.1016/j.avsg.2023.07.092

Prev Med. 2023 Jul 14:107622. doi: 10.1016/j.ypmed.2023.107622. Online ahead of print.

ABSTRACT

We explored temporal trends and geographic variations in United States of America (US) mortality rates from smoking and firearms from 1999 to 2019. To do so, we used the publicly available Centers for Disease Control and Prevention (CDC) Wide Ranging Online Data for Epidemiologic Research (WONDER) with Multiple Cause of Death files from 1999 to 2019. Using age-specific rates and ArcGIS Pro Advanced software for Optimized Hot Spot Analyses from Esri, we generated maps of statistically significant spatial clusters with 90-99% confidence intervals with the Getis-Ord Gi* statistic for mortality from smoking-related causes and firearms. These data show temporal trends and geographic variations in mortality from smoking and firearms in the US. Smoking and firearm-related mortality from assault and suicide increased throughout the US and clustered in the Southeast. Firearm-related suicide also clustered in the continental West and Alaska. These descriptive data generate many hypotheses which are testable in analytic epidemiologic studies designed a priori to do so. The trends suggest smoking and firearm-related causes pose particular challenges to the Southeast and firearms also to the West and Alaska. These data may aid clinicians and public health authorities to implement evidence-based smoking avoidance and cessation programs as well as address firearm mortality, with particular attention to the areas of highest risks. As has been the case with cigarettes, individual behavior changes as well as societal changes are likely to be needed to achieve decreases in premature mortality.

PMID:37454875 | DOI:10.1016/j.ypmed.2023.107622

Plant Sci. 2023 Jul 14:111793. doi: 10.1016/j.plantsci.2023.111793. Online ahead of print.

ABSTRACT

Nutrient deficiencies considerably limit agricultural production worldwide. However, while single deficiencies are widely studied, combined deficiencies are poorly addressed. Hence, the aim of this paper was to study single and combined deficiencies of iron (Fe) and phosphorus (P) in barley (Hordeum vulgare) and tomato (Solanum lycopersicum). Plants were grown in hydroponics and root exudation was measured over the growing period. At harvest, root morphology and root and shoot ionome was assessed. Shoot-to-root-ratio decreased in both species and in all nutrient deficiencies, besides in -Fe tomato. Barley root growth was enhanced in plants subjected to double deficiency behaving similarly to -P, while tomato reduced root morphology parameters in all treatments. To cope with the nutrient deficiency barley exuded mostly chelants, while tomato relied on organic acids. Moreover, tomato exhibited a slight exudation increase over time not detected in barley. Overall, in none of the species the double deficiency caused a substantial increase in root exudation. Multivariate statistics emphasized that all the treatments were significantly different from each other in tomato, while in barley only -Fe was statistically different from the other treatments. Our findings highlight that the response of the studied plants in double deficiencies is not additive but plant specific.

PMID:37454818 | DOI:10.1016/j.plantsci.2023.111793

J Stomatol Oral Maxillofac Surg. 2023 Jul 14:101563. doi: 10.1016/j.jormas.2023.101563. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal management of cervical lymph nodes in N0M0 maxillary sinus squamous cell carcinoma (MSSCC) remains a subject of debate. This study aimed to investigate the impact of elective neck dissection (END) on the prognosis of N0M0 MSSCC patients and explore potential prognostic factors.

METHODS: A retrospective analysis was conducted using the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was employed to minimize bias between the END and non-END groups. Cox regression analysis was performed to identify prognostic factors, and subgroup analyses were conducted based on patient characteristics. Furthermore, the optimal number of lymph nodes in END was determined using maximally selected test statistics.

RESULTS: A total of 777 N0M0 MSSCC patients were included in the study. After PSM, patients who underwent END demonstrated significantly improved overall survival (OS) and cancer-specific survival (CSS) compared to those who did not undergo END (p < 0.05). Subgroup analyses revealed a favorable prognosis for patients receiving radiotherapy and END, with a hazard ratio of 0.729 (95% CI: 0.549-0.967; p = 0.029) for OS. Furthermore, patients with a lymph node count greater than 5 in END had significantly better OS and CSS compared to those with 5 or fewer lymph nodes (p = 0.013, p = 0.018, respectively).

CONCLUSION: Our findings suggest that END provides a survival benefit for N0M0 MSSCC patients. Additionally, a lymph node count greater than 5 in END is associated with improved staging accuracy and better prognosis. Prospective research is needed to validate these findings and inform clinical decision-making for N0M0 MSSCC patients.

PMID:37454815 | DOI:10.1016/j.jormas.2023.101563

Am J Pharm Educ. 2023 Jul 14:100571. doi: 10.1016/j.ajpe.2023.100571. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the economic considerations, including cost-saving strategies, associated with nonsterile compounding education for students in schools and colleges of pharmacy across the United States.

METHODS: An electronic survey was sent to American Association of Colleges of Pharmacy Pharmaceutics Section and Laboratory Instructor’s Special Interest Group members. Quantitative and qualitative data were collected about the institution, student cohorts, compounding courses, equipment, budgets, personnel, and cost-saving measures. Descriptive statistics were calculated using SPSS. Open-ended responses were used by respondents if the primary question could not adequately capture their institution specific information. These answers were added to the study findings.

RESULTS: Of 555 surveys sent, 46 were completed. Reported annual compounding budgets ranged from $3,000 and $96,000. Reported annual equipment maintenance costs ranged from $400 and $18,000. Fifty percent of respondents reported students shared equipment, and 29.6% collected a lab fee from students to offset costs. Approximately half of respondents reported use of cost-saving measures, including contract pricing, purchasing supplies in bulk, price comparisons, use of simulated drugs, re-use of personal protective equipment, and procurement of donations. Fifty percent of respondents employed laboratory assistants to support nonsterile compounding sessions, with paid positions ranging from $200-$1,000 per semester.

CONCLUSION: Findings from this study may assist pharmacy administrators and course directors in evaluating the costs associated with nonsterile compounding education across the Academy and, more importantly, determining ways to reduce such costs while maintaining the intent and quality of these courses.

PMID:37454811 | DOI:10.1016/j.ajpe.2023.100571

J Environ Manage. 2023 Jul 14;344:118532. doi: 10.1016/j.jenvman.2023.118532. Online ahead of print.

ABSTRACT

The management of Soil Organic Carbon (SOC) is a critical component of both nature-based solutions for climate change mitigation and global food security. Agriculture has contributed substantially to a reduction in global SOC through cultivation, thus there has been renewed focus on management practices which minimize SOC losses and increase SOC gain as pathways towards maintaining healthy soils and reducing net greenhouse gas emissions. Mechanistic models are frequently used to aid in identifying these pathways due to their scalability and cost-effectiveness. Yet, they are often computationally costly and rely on input data that are often only available at coarse spatial resolutions. Herein, we build statistical meta-models of a multifactorial crop model in order to both (a) obtain a simplified model response and (b) explore the biophysical determinants of SOC responses to management and the geospatial heterogeneity of SOC dynamics across Europe. Using 5600 unique simulations of crop growth from the gridded Environmental Policy Integrated Climate-based Gridded Agricultural Model (EPIC-IIASA GAM) covering 86,000 simulation units across Europe, we build multiple polynomial regression ensemble meta-models for unique combinations of climate and soil across Europe in order to predict SOC responses to varying management intensities. We find that our biophysically-explicit meta models are highly accurate (R² = 0.97) representations of the full mechanistic model and can be used in lieu of the full EPIC-IIASA GAM model for the estimation of SOC responses to cropland management. Model stratification by means of climate and soil clustering improved the performance of the meta-models compared to the full EU-scale model. In regional and local validations of the meta-model predictions, we find that the meta-models largely capture broad SOC dynamics such as the linear nature of SOC responses to residue application, yet they often underestimate the magnitude of SOC responses to management. Furthermore, we find notable differences between the results from the biophysically-specific models throughout Europe, which point to spatially-distinct SOC responses to management choices such as nitrogen fertilizer application rates and residue retention that illustrate the potential for these models to be used for future management applications. While more accurate input data, calibration, and validation will be needed to accurately predict SOC change, we demonstrate the use of our meta-models for biophysical cluster and field study scale analyses of broad SOC dynamics with basically zero fine-tuning of the models needed. This work provides a framework for simplifying large-scale agricultural models and identifies the opportunities for using these meta-models for assessing SOC responses to management at a variety of scales.

PMID:37454447 | DOI:10.1016/j.jenvman.2023.118532