Tag: pubmed

Front Cardiovasc Med. 2023 Jun 27;10:1176984. doi: 10.3389/fcvm.2023.1176984. eCollection 2023.

ABSTRACT

BACKGROUND: With technological advancements, the incidence of most transcatheter aortic valve implantation (TAVI)-related complications, with the exception of conduction disturbances, has decreased. Bicuspid aortic valve (BAV) is also no longer considered a contraindication to TAVI; however, the effect of BAV on postoperative conduction disturbances after TAVI is unknown.

METHODS: We collected information on patients who met the indications for TAVI and successfully underwent TAVI at our center between January 2018 and January 2021. Patients with preoperative pacemaker implantation status or conduction disturbances (atrioventricular block, bundle branch block, and intraventricular block) were excluded. Based on imaging data, the patients were categorized into the BAV group and the tricuspid aortic valve (TAV) group. The incidence of new perioperative conduction disturbances was compared between the two groups.

RESULTS: A total of 187 patients were included in this study, 64 (34.2%) of whom had BAV. The incidence of third-degree block in the BAV group was 1.6%, which was lower than that (13.0%) in the TAV group (P < 0.05). Multivariate logistic regression results showed that the risk of third-degree conduction disturbances was 15-fold smaller in the BAV group than that in the TAV group [relative risk (RR) = 0.067, 95% CI = 0.008-0.596, P < 0.05]. The risk of other blocks in the BAV group was about half of that in the TAV group (RR = 0.498, 95% CI = 0.240-1.032); however, the difference was not statistically significant (P > 0.05).

CONCLUSION: The present study found that patients with BAV had a lower rate of third-degree conduction disturbances after TAVI than patients with TAV.

PMID:37441707 | PMC:PMC10333533 | DOI:10.3389/fcvm.2023.1176984

Front Med (Lausanne). 2023 Jun 27;10:1204144. doi: 10.3389/fmed.2023.1204144. eCollection 2023.

ABSTRACT

BACKGROUND: In recent years, platelet-rich plasma (PRP) injections for osteoarthritis (OA) have been widely promoted in clinical practice, but their effectiveness is controversial. Therefore, we conducted a meta-analysis of relevant randomized controlled trials (RCTs) to determine the efficacy and safety of PRP injections for the treatment of OA.

METHODS: We searched databases including Embase, Web of Science, Medline, PubMed, and the Cochrane Library for relevant studies. Two researchers (YQX and CG) performed literature screening, baseline data extraction, literature quality assessment, and heterogeneity analysis of RCTs from the retrieved studies. Based on the magnitude of heterogeneity I², random-effects or fixed-effects models were selected for the meta-analysis.

RESULTS: We included 24 RCTs comprising 1344 patients with OA who met the inclusion criteria, with the main types of morbidity being knee osteoarthritis (KOA), hip osteoarthritis (HOA), ankle osteoarthritis (AOA), and temporomandibular joint osteoarthritis (TMJOA). Our results indicate that PRP injections were effective in improving Visual Analog Scale (VAS) pain scores in patients with KOA, HOA, and AOA compared to controls (AOA, MD = -1.15, CI = 95% [-1.74, -0.56], I² = 40%, P < 0.05; KOA, MD = -1.03, CI = 95% [-1.16, -0.9], I² = 87%, P < 0.05; TMJOA, MD = -1.35, CI = 95% [-1.74, -0.97], I² = 92%, P < 0.05) but showed no significant efficacy in patients with HOA (MD = -0.27, CI = 95% [-0.8, 0.26], I² = 56%, P>0.05). Compared to controls, PRP injections were effective in improving Knee Injury and Osteoarthritis Outcome Score (KOOS), including the patient’s pain symptoms, activities of daily living (ADL), and adhesion symptomatology, but not for that of sports function (KOOS-pain, MD = 2.77, CI = 95% [0, 5.53], I² = 0%, P < 0.05; KOOS-symptoms, MD = 3.73, CI = 95% [0.76, 6.71], I² = 0%, P < 0.05; KOOS-ADL, MD = 3.61, CI = 95% [0.79, 6.43], I² = 0%, P < 0.05; KOOS-QOL, MD = 4.66, CI = 95% [0.98, 8.35], I² = 29%, P < 0.05, KOOS-sport, MD = 0.48, CI = 95% [-3.02, 3.98], I² = 0%, P > 0.05). PRP injections were effective in improving Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, including pain, stiffness, and functional joint motion, in patients with OA compared with the control group (WOMAC-pain, MD = -1.08, CI = 95% [-1.62, -0.53], I² = 87%, P < 0.05; WOMAC-stiffness, MD = -1.17, CI = 88% [-1.72, -0.63], I² = 87%, P < 0.05; WOMAC-function, MD = -1.12, CI = 95% [-1.65, -0.58], I² = 87%, P < 0.05). In addition, subgroup analysis showed that leukocyte-poor (LP) PRP injections were more effective than leukocyte-rich (LR) PRP injections in improving pain symptoms in patients with OA (VAS, LR-PRP, MD = -0.81, CI = 95% [-1.65, -0.03], I² = 83%, P = 0.06 > 0.05; LP-PRP, MD = -1.62, CI = 95% [-2.36, -0.88], I² = 92%, P < 0.05). A subgroup analysis based on injection sites showed that no statistical difference in efficacy between intra-articular (IA) combined with intra-osseous (IO) simultaneous PRP injections. IA PRP injections only improved VAS pain scores in patients with OA (IA+IO PRP injections, MD = -0.74, CI =95% [-1.29, -0.18], I² = 61%, P < 0.05; IA PRP injections, MD = -1.43, CI = 95% [-2.18, -0.68], I² = 87%, P < 0.05, test for subgroup differences, P > 0.05, I² = 52.7%).

CONCLUSION: PRP injection therapy can safely and effectively improve functional activity in patients with OA and produce positive analgesic effects in patients with KOA, TMJOA, and AOA. However, PRP injection therapy did not significantly reduce pain symptoms in patients with HOA. In addition, the analgesic effect of LP-PRP was greater than that of LR-PRP.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022362066.

PMID:37441691 | PMC:PMC10333515 | DOI:10.3389/fmed.2023.1204144

Front Med (Lausanne). 2023 Jun 27;10:1159015. doi: 10.3389/fmed.2023.1159015. eCollection 2023.

ABSTRACT

OBJECTIVE: The objective of this study is to determine whether restricted cervical mobility in ankylosing spondylitis (AS) is associated with increased fall frequency or fear of falling.

METHODS: A total of 134 AS patients and 199 age- and gender-matched control subjects (CS) with soft-tissue cervicothoracic pain were prospectively evaluated for fall risk. Subjects were divided into non-fallers, single fallers, and multiple fallers. Dynamic cervical rotations and static cervicothoracic axial measurements were compared between the groups. In total, 88 AS patients were reviewed more than once; Kaplan-Meier plots were constructed for fall risk as a function of cervical rotation amplitudes. Falls Efficacy Scale-International (FES-I) questionnaire measured the fear of falling.

RESULTS: In total, 34% of AS patients and 29% of CS fell (p = 0.271) in the year prior to evaluation. In AS, static anatomical measurements were unrelated to fall occurrence. The trends of multiple AS fallers to greater flexed forward postures and reduced dynamic cervical rotations were not statistically significant. Cervicothoracic pain (p = 0.0459), BASDAI (p = 0.002), and BASFI (p = 0.003) scores were greater in multiple fallers. FES-I scores were greater in fallers (p = 0.004). Of the 88 AS patients reviewed (or seen) on more than one occasion, 46.5% fell over the 9-year observation period, including all multiple fallers and 71.4% of single fallers. Survival curves showed increased fall risk as cervical rotational amplitudes decreased.

CONCLUSION: In AS, decreased cervical rotations increase fall risk and fear of falling. In multiple fallers, falls were associated with greater disease activity. Cervical muscle stiffness in AS may cause non-veridical proprioceptive inputs and contribute to increased fall frequency similar to individuals with soft-tissue cervicothoracic pain.

PMID:37441687 | PMC:PMC10333576 | DOI:10.3389/fmed.2023.1159015

Front Public Health. 2023 Jun 27;11:1170317. doi: 10.3389/fpubh.2023.1170317. eCollection 2023.

ABSTRACT

BACKGROUND: The COVID-19 epidemic has put an enormous strain on the world’s healthcare systems, lifestyles, and quality of life. Ethiopia attempted to meet the myriad needs of its people due to the COVID-19 epidemic and the government has demonstrated a strong commitment in order to lessen the epidemic’s impact on the populace. Despite this fact, the population’s compliance with measures was not as needed.

OBJECTIVES: To assess knowledge, attitude, and practice regarding COVID-19 transmission, prevention, and self-quarantine management among public employees in selected locations of the Sidama Region, Southern Ethiopia, in 2020.

METHODS: An institution-based cross-sectional study was conducted from 01 October to 30 October 2020, among 399 public servants in selected locations of the Sidama Region, Sothern Ethiopia. One-stage cluster sampling was used to randomly select 16 public service sector offices from the total 32 sector offices in the selected locations of the region. Simple random sampling was employed to select respondents following equal distribution of the samples to 16 sector offices. Data were collected using an adapted self-administered questionnaire. Data entered using EpiData version 3.1 and SPSS version 24 were used for statistical analysis. Descriptive statistics was used to compute frequencies, percentages, and means for independent and dependent variables.

RESULT: Overall, 42.36% of respondents had good knowledge of COVID-19, while the remaining 57.64% had poor knowledge. The percentage of favorable attitudes toward COVID-19 prevention and control were 65.2, 54.4% of respondents had a good level of practice of COVID-19 preventive and control measures, and 52.4% of the respondents had a good level of knowledge regarding self-quarantine management.

CONCLUSION: The level of knowledge, attitude, practice, and self-quarantine management in the area is insufficient for preventing and controlling the disease. Evidence-based awareness creation and law enforcement in the study areas and surroundings, with an emphasis on infection prevention and control (IPC) in the public sector and other public gathering areas, is recommended.

PMID:37441644 | PMC:PMC10335795 | DOI:10.3389/fpubh.2023.1170317

Front Public Health. 2023 Jun 27;11:1163867. doi: 10.3389/fpubh.2023.1163867. eCollection 2023.

ABSTRACT

AIMS: This study aimed to explore the dyadic effects of depression and anxiety on insomnia symptoms in Chinese older adults and their caregivers living in a community setting.

METHODS: Data were collected from 1,507 pairs of older adults and their caregivers who were in the Guangdong Mental Health Survey in China. The 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder module 7 (GAD-7), and Insomnia Severity Index (ISI) were used to measure depression, anxiety, and insomnia symptoms. Actor-Partner Interdependence Models (APIM) were used to determine whether anxiety or depression symptoms predicted individual or dyadic insomnia.

RESULTS: Older adults’ and caregivers’ depression and anxiety had significant positive correlations with their own and their caregivers’ insomnia symptoms (all P < 0.001). Actor effects were found between depression and insomnia symptoms in both older adults and caregivers (B = 0.695, P < 0.001; B = 0.547, P < 0.001, respectively), with one significant partner effects (B = 0.080, P = 0.007). Actor effects were also found between anxiety and insomnia symptoms in both older adults and caregivers (B = 0.825, P < 0.001; B = 0.751, P < 0.001, respectively), with one significant partner effects (B = 0.097, P = 0.004). However, the caregivers’ depression and anxiety were not associated with older adults’ insomnia symptoms in the APIM analyses.

CONCLUSIONS: Older adults and their caregivers had an interrelationship between psychological distress and insomnia. Consequently, healthcare providers might consider involving dyads when designing programs to reduce insomnia and improve psychological distress for family caregivers.

PMID:37441638 | PMC:PMC10333500 | DOI:10.3389/fpubh.2023.1163867

Data Brief. 2023 Jun 14;49:109314. doi: 10.1016/j.dib.2023.109314. eCollection 2023 Aug.

ABSTRACT

This article describes data related to the research paper entitled “Concurrent vs. retrospective temporal data collection: Attack-evolution-finish as a simplification of Temporal Dominance of Sensations?” [1]. Temporal sensory perception data of five dark chocolates that vary in cocoa content were collected from 129 consumers who evaluated the samples in two sessions, using a different sensory evaluation method in each session. A within-subject design was set-up to compare the two data collection methods: consumers in Panel 1 (36 men and 32 women aged 19 to 63 years old) started with the Temporal Dominance of Sensations (TDS) method, and consumers in Panel 2 (35 men and 26 women aged 19 to 61 years old) started with the Attack-Evolution-Finish dominance (AEF-D) method. For each chocolate, consumers had to report the sensations they perceived either concurrently (TDS) or retrospectively (AEF-D) to the tasting. After the descriptive task, consumers were asked to rate their liking for chocolates on a 9-point discrete scale. Finally, consumers had to answer questions related to the difficulty of the descriptive task. The dataset includes information on consumers’ gender, age and frequency of consumption of dark chocolates. The dataset can be reused by sensometricians to compare methods or develop new statistical models for data analysis. It can also be reused to compare at the individual level declarative sensory measures collected either concurrently or retrospectively to tasting. Thus, the impact of cognition (due to memorization, stress or complexity of measurements) on sensory description and liking can be investigated. More specifically, this dataset can be help understand how the dynamics of perception of texture, mouthfeel and flavour attributes are integrated when using static measures.

PMID:37441628 | PMC:PMC10333425 | DOI:10.1016/j.dib.2023.109314

Ther Adv Ophthalmol. 2023 Jun 30;15:25158414231180985. doi: 10.1177/25158414231180985. eCollection 2023 Jan-Dec.

ABSTRACT

BACKGROUND: Obesity affects microvascular structures. The effect of obesity on the ocular vascular system can be evaluated by changes in the choroidal thickness (CT) and retrobulbar blood flow (RBF).

OBJECTIVES: To evaluate the CT and RBF parameters in obese patients with various body mass index (BMI) values and compare these parameters with normal weight, healthy subjects.

DESIGN: A prospective study.

METHODS: The study included 102 eyes of 102 female patients. Patients were divided into three groups according to BMI as group 1 with a BMI of 18.5-24.99 (n = 32), normal weight group; group 2 with a BMI of 30-34.99 (n = 35), as obese class I; and group 3 with a BMI of 35-39.99 (n = 35), as obese class II. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index, and pulsatility index values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography. CT was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm by using the enhanced depth imaging technique of optical coherence tomography. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometry.

RESULTS: There was a significant difference in IOP values within the groups with the highest values in group 3 (17.6 ± 2.1 mmHg) and the lowest in group 1 (12.4 ± 1.7 mmHg). The CT in groups 2 and 3 was found to be statistically significantly lower than that in group 1 at all measurement points (p < 0.001). There was a statistically significant negative correlation between CT at all measurement points and BMI (p < 0.001). The mean CRA PSV, EDV, and OA EDV values were statistically significantly lower in each obese group than those values in group 1 (p < 0.001). The OA PSV values were significantly lower in group 3 (36.5 ± 5.9 cm/s) than those in group 2 (43.8 ± 4 cm/s) and group 1 (44.6 ± 5.2 cm/s) (p < 0.001). Also, significant associations were found between BMI and CRA PSV, CRA EDV, and OA PSV values (p < 0.001).

CONCLUSION: Obesity may predispose to eye pathologies by changing the ocular vascular circulation.

PMID:37441618 | PMC:PMC10333989 | DOI:10.1177/25158414231180985

Front Neurol. 2023 Jun 27;14:1212868. doi: 10.3389/fneur.2023.1212868. eCollection 2023.

ABSTRACT

BACKGROUND: Lymphoplasmapheresis (LPE) is a new therapy developed on the basis of traditional plasma exchange (PE) in combination with leukapheresis. Currently, it remains unclear whether PE and LPE show differences in efficacy for severe MG.

METHODS: A retrospective analysis was conducted on 198 MG patients, 75 in the PE group and 123 in the LPE group, and the patients’ Myasthenia Gravis Foundation of America (MGFA) Clinical Classification was Class IV. The treatment outcome was the change in Quantitative Myasthenia Gravis Score (QMGS) from baseline to the end of treatment. Propensity score matching (PSM) was applied for the balance of confounders between the two groups.

RESULTS: In this study cohort, the safety profile of LPE and PE was good and no serious adverse events were observed. Based on PSM, 62 patients treated with LPE and 62 patients treated with PE were entered into a comparative efficacy analysis. In the PE group, patients underwent a total of 232 replacements, with a mean of 3.74. PE significantly improved the patients’ QMGS performance, with the mean QMGS decreasing from 22.98 ± 4.03 points at baseline to 18.34 ± 5.03 points after treatment, a decrease of 4.68 ± 4.04 points (p < 0.001). A decrease of ≥3 points in QMGS was considered a significant improvement, with a treatment response rate of 67.7% in the PE group. In the LPE group, patients received a total of 117 replacements, with a mean of 1.89. The patients’ mean QMGS was 23.19 ± 4.11 points at baseline and was 16.94 ± 5.78 points after treatment, a decrease of 6.26 ± 4.39 points (p < 0.001). The improvement in QMGS was more significant in patients treated with LPE compared to the PE group (p = 0.039). The treatment response rate in the LPE group was 79%, which was not significantly different compared to the PE group (p = 0.16). The LEP group had a shorter mean length of stay compared to the PE group (10.86 ± 3.96 vs. 12.14 ± 4.14 days), but the difference was not statistically significant (p = 0.13). During the 2-month follow-up period, LPE may be associated with better functional outcomes for patients, with lower QMG score and relapse rate. LPE and PE were both effective in reducing the levels of inflammatory cytokines (TNF-α, IL-1β, and IL-6) and AChR-Ab. Compared to PE, LPE was superior in the reduction of AChR-Ab titer.

CONCLUSION: In severe MG, LPE may be a more preferred treatment option than PE. It achieves treatment outcomes that are not inferior to or even better than PE with fewer replacements. This study provides further evidence to support the application of LPE as a new treatment option for MG.

PMID:37441608 | PMC:PMC10335809 | DOI:10.3389/fneur.2023.1212868

Front Pediatr. 2023 Jun 27;11:1140556. doi: 10.3389/fped.2023.1140556. eCollection 2023.

ABSTRACT

BACKGROUND: Non-pharmaceutical interventions (NPIs), such as social distancing and hand washing, have been associated with a decline in the preterm birth rate worldwide. We aimed to evaluate whether the preterm birth rate in Korea during the coronavirus disease 2019 lockdown has changed compared to that in previous years.

METHOD: A birth registry from the Korea Statistical Information Service, which is a nationwide official database, was used to include all births claimed to have occurred between 2011 and 2020. Newborns with gestational age (GA) less than 22 weeks and birth weight less than 220 g were excluded. The pre-NPI period was designated as January 2011 to January 2020, and the NPI period was defined as February 2020 to December 2020. We assessed the effect of NPI on the incidence of prematurity per 100 births using an interrupted time-series quasi-experimental design and implementing an autoregressive integrated moving average (ARIMA) model.

RESULTS: From 2011 to 2020, a total of 3,931,974 live births were registered, among which 11,416 were excluded. Consequently, the final study population included 3,920,558 live births (both singleton and multiple births) among which 275,009 (7.0%) were preterm. The preterm birth rate was significantly higher during the NPI period (8.68%) compared to that in the pre-NPI period (6.92%) (P < 0.001). The ARIMA model showed that in all singleton and multiple births, except those in July (observed 9.24, expected 8.54, [95% prediction interval {PI} 8.13-8.96], percent difference 7.81%), September (observed 7.89, expected 8.35, [95% PI 7.93-8.76], percent difference -5.66%), and December (observed 9.90, expected 9.40, [95% PI 8.98-9.82], percent difference 5.2%), most observed values were within the 95% PI of the expected values and showed an increasing trend.

CONCLUSION: In this nationwide observational study, the trend in premature birth rate did not significantly change due to NPI implementation in Korea, as it had been increasing since 2011. The trend of Korea’s birth rate appears to be unaffected by the implementation of NPIs; however, further studies with a longer follow-up period are needed.

PMID:37441577 | PMC:PMC10333519 | DOI:10.3389/fped.2023.1140556

Nurs Res. 2023 Jul 11. doi: 10.1097/NNR.0000000000000681. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about where young adults with chronic illness die in the United States and factors associated with place of death.

OBJECTIVES: This study aimed to examine place of death and factors associated with place of death for young adults with chronic illness using the most recent national data.

METHODS: Our sample (N = 405,535) from the National Center for Health Statistics Division of Vital Statistics death certificate data (2003-2018) included young adults (age 18-39 years) who died from chronic conditions common in childhood or young adulthood. Conditions were grouped by underlying pathophysiology (oncological, cardiovascular, neuromuscular, metabolic, hematological/immunological, renal, chromosomal/congenital, gastrointestinal, respiratory). Place of death was dichotomized into acute care (inpatient, outpatient/emergency room, dead on arrival) or non-acute care (home, hospice, nursing home/long-term care, other, unknown). Examined factors were sex, year of death, age, race (White, Black, Asian/Pacific Islander, American Indian/Alaskan Native), cause of death, and city of residence population (100,000 or greater and under 100,000). Descriptive statistics and logistic regression were used to examine factors related to place of death.

RESULTS: Over half of young adults died in acute care settings. Young adults who were Asian/Pacific Islander or Black or who died from a respiratory or renal cause of death were most likely to die in an acute care setting. Rates of acute care death decreased over the studied years.

DISCUSSION: Many young adults died in an acute care setting. Race and cause of death were the most influential factors associated with place of death. Young adults with an oncological cause of death were less likely to die in an acute care setting than patients with other underlying causes. This may indicate that specific care needs or preferences at the end of life may differ in certain disease populations and may affect place of death. Previous research has shown similar results in other developmental populations; however, given the complex psychosocial concerns that often arise during young adulthood, further research is needed to describe how the young adult status may specifically affect place of death.

PMID:37440265 | DOI:10.1097/NNR.0000000000000681