Tag: pubmed

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 May;31(3):319-323. doi: 10.32687/0869-866X-2023-31-3-319-323.

ABSTRACT

The health of children population is one of the indicators of the social and epidemiological well-being of society. The purpose of the study was to study main trends of propagation of various classes of diseases in children population in conditions of propagation of the new coronavirus infection. The data of Rosstat for the Udmurt Republic covering the pre-COVID period (2017-2019) and the period of COVID-19 propagation (2020-2021). The analytical method, descriptive statistics technique, the calculation of intensive and extensive indicators were applied. It is established that in 2017-2019, general morbidity of the children population aged 0-7 years decreased by 8.7%, while in conditions of higher propagation of COVID-19 (2020-2021) there was an increase by 11.0 %. In the children population aged 0-14 years, general morbidity decreased by 10%, and hereinafter it increased on 12.1%. At that, in the pre-COVID period in children population aged from 0 to 17 years, morbidity rate decreased for 14 classes of diseases, for 15 classes in children population aged from 0 to 14 years. During the period of higher propagation of COVID-19 morbidity rate for only 5 classes of diseases decreased in both age groups of children population.

PMID:37427503 | DOI:10.32687/0869-866X-2023-31-3-319-323

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 May;31(3):315-318. doi: 10.32687/0869-866X-2023-31-3-315-318.

ABSTRACT

The COVID-19 pandemic has its own objective features associated with density of residence, organization and accessibility of medical care, migration characteristics of population, etc. Therefore, analysis of current situation with coronavirus in the Russian Federation, its Federal Okrugs and subjects is needed. The coronavirus infection resulted in significant changes in indicators of primary morbidity and mortality of population of the Russian Federation. The purpose of the study – to apply the results of analysis of primary morbidity of population of Moscow, the Central Federal Okrug and the Russian Federation in conditions of COVID-19 pandemic in developing recommendations on population health preservation. The monographic, statistical, analytical methods were applied. The official statistics data of Minzdrav of Russia and Rosstat were used. The comparative analysis of for the first time diagnosed morbidity (in 2020) in Moscow, the Central Federal Okrug and the Russian Federation established similar distribution of incidence rates for three key classes of diseases. The first rank place took respiratory diseases, the second one took traumas, poisoning and some other consequences of external causes and the third rank place took COVID-19. The decreasing of primary morbidity of population in the Russian Federation in 2019-2020 was established for almost all classes of diseases that is related to diminishing of dispensary and preventive activities concerning population. The morbidity rate of COVID-19 in the Federal Okrugs of the Russian Federation is presented. The ranking of subjects of the Russian Federation according to indicators of established pandemic was applied. The difference between the highest and the lowest morbidity rates of COVID-19 in the subjects of the Russian Federation made up to 16.8 times. The analysis established that COVID-19 determined increasing of life losses because of respiratory diseases (pneumonia in particular); circulatory system diseases (ischemic heart disease in particular); diabetes mellitus, etc. The statistical accounting of causes of death associated with COVID-19 is not accompanied by noticeable improvement of coding quality of other causes of death. The results of the analysis is be applied in developing management decisions.

PMID:37427502 | DOI:10.32687/0869-866X-2023-31-3-315-318

Infect Dis (Lond). 2023 Jul 10:1-10. doi: 10.1080/23744235.2023.2232445. Online ahead of print.

ABSTRACT

BACKGROUND: Omicron-1 COVID-19 is less invasive in the general population than previous viral variants. However, clinical course and outcome of hospitalised patients with SARS-CoV-2 pneumonia during the shift of the predominance from Delta to Omicron variants are not fully explored.

METHODS: During January 2022 consecutively hospitalised patients with SARS-CoV-2 pneumonia were analysed. SARS-CoV-2 variants were identified by a 2-step pre-screening protocol and randomly confirmed by whole genome sequencing analysis. Clinical, laboratory and treatment data split by type of variant were analysed along with logistic regression of factors associated to mortality.

RESULTS: 150 patients [mean age (SD) 67.2(15.8) years, male 54%] were analysed. Compared to Delta (n = 46), Omicron-1 patients (n = 104) were older [mean age (SD): 69.5(15.4) vs 61.9(15.8) years, p = 0.007], with more comorbidities (89.4% vs 65.2%, p = 0.001), less obesity (BMI >30Kg/m² in 24% vs 43.5%, p = 0.034) but higher vaccination rates for COVID-19 (52.9% vs 8.7%, p < 0.001). Severe pneumonia (48.7%), pulmonary embolism (4.7%), need for invasive mechanical ventilation (8%), administration of dexamethasone (76%) and 60-day mortality (22.6%) did not significantly differ. Severe SARS-CoV-2 pneumonia independently predicted mortality [OR 8.297 (CI95% 2.080-33.095), p = 0.003]. Remdesivir administration (n = 135) was protective from death both in unadjusted and adjusted models [OR 0.157 (CI95% 0.026-0.945), p = 0.043.

CONCLUSIONS: In a COVID-19 department the severity of pneumonia that did not differ between Omicron-1 and Delta variants predicted mortality whilst remdesivir remained protective in all analyses. Death rates did not differ between SARS-CoV-2 variants. Vigilance and consistency with prevention and treatment guidelines for COVID-19 is mandatory regardless of the predominant SARS-CoV-2 variant.

PMID:37427461 | DOI:10.1080/23744235.2023.2232445

Langmuir. 2023 Jul 10. doi: 10.1021/acs.langmuir.3c01070. Online ahead of print.

ABSTRACT

Titanium dioxide (TiO₂) nanoparticles have been extensively used to modify the optical properties of various types of materials. In particular, they have been intensively loaded onto polymer fibers to quench the light reflection. In situ polymerization and online addition are two common strategies for fabricating TiO₂-loaded polymer nanocomposite fibers. The former does not require separate preparation of masterbatches as the latter does and therefore has its advantages in terms of decreasing the fabrication steps and economic costs. Moreover, it has been found that in situ-polymerized TiO₂-loaded polymer nanocomposite fibers (e.g., TiO₂/poly(ethylene terephthalate) fibers) usually have enhanced light-extinction properties over those prepared by the online addition process. Intuitively, there should be a difference in the filler particle dispersion for the two fabrication processes. This hypothesis has not yet been tackled due to the technical difficulty in acquiring the three-dimensional (3D) filler morphology inside the fiber matrix. In this paper, we report a study using the powerful focused ion beam-scanning electron microscopy (FIB-SEM) with a resolution of 20 nm to directly acquire the 3D microstructure of TiO₂/poly(ethylene terephthalate) nanocomposite (TiO₂/PET) fibers. This microscopy technique allows us to characterize the particle size statistics and the dispersion inside TiO₂/PET fibers. We have found that the particle size of TiO₂ inside the fiber matrix can be well modeled by Weibull statistics. Surprisingly, we find that TiO₂ nanoparticles form more significant agglomeration in the in situ-polymerized TiO₂/PET fibers. This observation is contrary to our common understanding of the two fabrication processes. Namely, slightly altering the particle dispersion with increased TiO₂ filler size helps improve the light-extinction properties. The slightly increased filler size may have altered the Mie scattering between the nanoparticles and the incident visible light, leading to enhanced light-extinction properties of in situ-polymerized TiO₂/PET nanocomposite fibers.

PMID:37427414 | DOI:10.1021/acs.langmuir.3c01070

HCA Healthc J Med. 2021 Dec 29;2(6):423-431. doi: 10.36518/2689-0216.1306. eCollection 2021.

ABSTRACT

BACKGROUND: Patients with syncope often undergo costly testing, despite current guidelines and data supporting the contrary.

OBJECTIVE: To determine the diagnostic value through positivity rate of electrocardiogram (EKG), computed tomography (CT) of the brain, magnetic resonance imaging (MRI) of the brain, transthoracic echocardiogram, nuclear and pharmacologic cardiac stress test, tilt table test and carotid ultrasound in patients diagnosed with syncope.

METHODS: This is a retrospective study of 10,036 adults presenting to the emergency department or hospitalized with a primary diagnosis of syncope at 8 acute care facilities in the southwest United States from January 1, 2019, to December 31, 2019. A chi-square analysis was performed for each testing modality to evaluate for a statistically significant difference. The cost of each test was estimated based on published national averages per Medicare.

RESULTS: Of our sample, 903 patients (9%) received a test that yielded any positive finding. The results in the order of highest percent positivity rate to lowest were EKG (5.7%), carotid ultrasound (4.84%), transthoracic echocardiogram (2.56%), tilt table test (1%), MRI brain (0.99%), CT brain (0.82%) and cardiac stress test (0.09%). The total sum spent on testing was estimated at $43,347,332. Only $489,170 of this total was spent on a positive test. If this data is expanded to the 6,146 hospitals across the United States, a yearly $33 billion are wasted on syncope workups.

CONCLUSION: Costly testing continues to be performed on syncope patients despite guidelines discouraging testing. The necessity of these tests should be carefully evaluated for each patient based on diagnostic value.

PMID:37427395 | PMC:PMC10324800 | DOI:10.36518/2689-0216.1306

HCA Healthc J Med. 2021 Dec 29;2(6):411-421. doi: 10.36518/2689-0216.1295. eCollection 2021.

ABSTRACT

BACKGROUND: Pharmacy-led medication reconciliation identifies and corrects medication errors that can potentially cause moderate to severe harm. This research sought to identify the impact of pharmacy-led medication reconciliation on patient outcomes and describe the changes in healthcare workers’ perceptions of the program.

METHODS: A pharmacy-led admission medication reconciliation program pilot started in July 2019, and a discharge medication reconciliation proof of concept was tested in September 2020 at a 432-bed hospital. The following periods were compared: August 2018 to February 2019 (pre-program implementation) and August 2019 to February 2020 (post-program implementation). Endpoints included patient outcomes, workforce productivity and interdisciplinary healthcare team satisfaction through program surveys. Patient outcomes were assessed with chisquared tests. Survey responses were assessed using the Likert scale. Descriptive statistics were used for productivity outcomes and the number of discharge medication reconciliations completed.

RESULTS: Approximately 18,000 admissions were recorded for each period. The adverse drug event (ADE) rate decreased 49% (p < 0.001), and the complication rate decreased 29.7% (p = 0.001). During post-pilot implementation, 6,530 medication histories were completed, and 70,050 medications were reviewed. Of medication histories completed, 22.6% of patient allergies/adverse drug reactions were updated, 52.3% of medications were clarified, and 54.7% of preferred outpatient pharmacies were updated. Pharmacy services completed medication histories in 38.8% of inpatients. In the proof of concept, 168 discharge medication lists were drafted. Survey results showed statistically significant improvement in healthcare team satisfaction.

CONCLUSION: A pharmacy-led medication reconciliation program involving designated pharmacists and pharmacy technicians has shown to decrease ADEs and complications while improving interdisciplinary healthcare team satisfaction.

PMID:37427394 | PMC:PMC10324798 | DOI:10.36518/2689-0216.1295

Acta Stomatol Croat. 2023 Jun;57(2):177-189. doi: 10.15644/asc57/2/8.

ABSTRACT

OBJECTIVES: The primary aim was to compare the amount of bone height change that occurs around the tooth and the implant when having tooth-implant-supported prosthetic restorations versus bone height change that appears around implants in only implant-supported prosthetic restorations. The secondary aim was to examine the influence of various factors such as the number of teeth involved in the construction, their endodontic treatment, number of implants, the type of implantology construction, the jaw in which the construction is located, the condition of the opposite jaw, gender, age, and working time, as well as to examine whether the initial bone level influenced the amount of change in bone height itself.

MATERIALS AND METHODS: With a total of 50 respondents, 25 X-ray panoramic images were representing tooth-implant-supported prosthetic restorations, while the other 25 were representing implant-supported prosthetic restorations. Bone measures were taken (from enamel-cement junction/implant neck to the most apical bone point) from 2 panoramic radiographs. The first one is immediately after the implant placement and the second and the last one again in half a year up to seven years after, depending on the time when the photo was taken for each patient. The obtained difference represented the bone resorption, the bone formation, or a state without change. Influence of different factors, such as sex, age of the patient, working time, the number of teeth involved in the construction, endodontic treatment, number of implants, the type of implant construction, the jaw where the construction is located, the condition of the opposite jaw, as well as the initial bone condition, was examined. During the statistical analysis, frequency tables, basic statistical parameters, the Mann-Whitney U test, the Kruskal-Wallis Anova, Wilcoxon test, and regression analysis were used, and the results were presented in tabular form and the form of the Pareto diagram of t-values.

RESULTS: No statistically significant difference in bone change (whether we are talking about the place of the implant (-0.359±1.009 and median value 0.000), the place of a tooth (-0.428±0.746 and median value -0,150) in tooth-implant supported restorations, or the place of the implant in case of implant-supported structures (-0,059±0,200 and median value -0,120)) was proven. When talking about the influence of other factors, by regression analysis, the number of implants was shown to be the only factor with a statistically significant influence (β=0.54; P=0.019) in a change of bone level, but only when talking about implant-supported restorations.

CONCLUSION: No significant difference was proven between bone height change, neither around the tooth nor the implant in tooth-implant-supported prosthetic restorations compared to the bone height changes around the implant in only implant-supported prosthetic restorations. Among all the examined factors, the number of implants has shown to have statistically significant contribution to the amount of bone height change in implant-supported prosthetic restorations.

PMID:37427363 | PMC:PMC10323935 | DOI:10.15644/asc57/2/8

Acta Stomatol Croat. 2023 Jun;57(2):145-154. doi: 10.15644/asc57/2/5.

ABSTRACT

OBJECTIVE: Due to the consideration that oral/dental health is an important part of general health, well-being, and an individual’s quality of life, the need for appropriate instruments assessing oral health-related quality of life is emphasized. This study aimed to evaluate the psychometric properties of the Oral health-related quality of life questionnaire consisting of 14 questions among the Macedonian language-speaking adults (OHIP-MAC 14).

MATERIAL AND METHODS: A total of 270 adults participated in the study. The reliability of the questionnaire was examined by testing the internal consistency and reproducibility (test-retest). The responsiveness of the instrument was tested by computing the pre-intervention and post-intervention OHIP-14 scores using the paired t-test followed by the determination of the effect-size. The two aspects of the construct validity were evaluated: concurrent validity and discriminative validity.

RESULTS: A concurrent validity analysis confirmed that the instrument performed well. Discriminative validity also confirmed good psychometric properties (P<0.01). The ICC statistics and the Cronbach alpha coefficients indicated the appropriate reliability of the instrument for the included groups of participants. The responsiveness of the questionnaire was also acceptable (P<0.01) demonstrating the large effect-size of 1.43.

CONCLUSION: The OHIP 14 MAC showed acceptable psychometric properties and can be recommended as a valuable instrument in assessments of the Oral health-related quality of life in the Republic of North Macedonia.

PMID:37427359 | PMC:PMC10323931 | DOI:10.15644/asc57/2/5

Acta Stomatol Croat. 2023 Jun;57(2):167-176. doi: 10.15644/asc57/2/7.

ABSTRACT

OBJECTIVES: The study aimed to determine the relationship between the mandibular asymmetry index according to Kjellberg between patients with painful unilateral anterior disc displacement (DD) and asymptomatic volunteers without disc displacement. Vertical measurements were performed on a panoramic single-image radiograph, and the disc status was confirmed by magnetic resonance imaging (MRI).

MATERIAL AND METHODS: Two groups of subjects were retrospectively selected, 40 patients (the overall mean age was 35.5 years; 75% female) with temporomandibular disorder symptoms confirmed by RDC/TMD axis I and manual functional analysis. Unilateral DD was determined by MRI. A comparative group of asymptomatic volunteers (20 dental students with a mean age of 23.4 years; 72% female) had the physiological position of the disc determined by MRI. The vertical asymmetry of the condyle was determined by the method of Kjellberg et al. The symmetry of the gonial angle of the mandible was also measured.

RESULTS: A comparison of the mean of the asymmetry index between patients (average 90.89±7.08%) and asymptomatic volunteers (mean 95.86±4.44%) showed a statistically significant difference (p=0.0029). There was no difference (p=0.088) in gonial angle symmetry between the patients (mean 96.48±2.96°) and the asymptomatic volunteers (mean 97.52±2.31°). The distribution of the presence of individual DD diagnoses (partial and total displacement with reduction, displacement without reduction) in patients diagnosed with asymmetry of the mandible was without statistical significance (p>0.05).

CONCLUSION: This study actually points to the asymmetry of the mandible as a potential morphological risk of anterior DD.

PMID:37427358 | PMC:PMC10323934 | DOI:10.15644/asc57/2/7

Eur Heart J Open. 2023 Jun 20;3(4):oead065. doi: 10.1093/ehjopen/oead065. eCollection 2023 Jul.

ABSTRACT

AIMS: In patients undergoing catheter ablation for atrial fibrillation (AF), direct oral anticoagulants (DOACs) are as effective and safe as the vitamin K antagonist (VKA) warfarin. Phenprocoumon has a different pharmacokinetic profile compared with warfarin and is the most used VKA in Germany. The aim of the study was to compare DOAC with phenprocoumon.

METHODS AND RESULTS: In this retrospective single-centre cohort study, 1735 patients who underwent 2219 consecutive catheter ablations for AF between January 2011 and May 2017 were included. All patients were in-hospital for at least 48 h after catheter ablation. The primary outcome was defined as peri-procedural thrombo-embolic events. The secondary outcome was any bleeding according to the International Society on Thrombosis and Haemostasis (ISTH). The mean age of the patients was 63.3 years. Phenprocoumon was prescribed in 929 (42%) of the cases, and in 697 (31%) dabigatran, 399 (18%) rivaroxaban, and 194 (9%) apixaban. During hospitalization, 37 (1.6%) thrombo-embolic events occurred, including 23 transient ischaemic attacks (TIAs). Compared with the use of phenoprocoumon, the use of DOAC was significantly associated with a lower thrombo-embolic risk [16 (1.2%) vs. 21 (2.2%), odds ratio (OR)], 0.5 [95% confidence interval (CI) 0.2-0.9], P = 0.04. No statistically significant association with bleeding risk was observed [phenprocomoun: 122 (13%); DOAC: 163 (12.6%); OR 0.9 (95% CI 0.7-1.2); P = 0.70]. Interruption of oral anticoagulation (OAC) was associated with an increased risk for thrombo-embolic complications [OR 2.2 (1.1-4.3); P = 0.031], and bleeding [OR 2.5 (95% CI 1.8-3.2), P = 0.001].

CONCLUSION: In patients undergoing catheter ablation for AF, the use of DOAC was associated with a reduced risk of thrombo-embolic events compared with phenprocoumon. Non-interrupted oral anticoagulation (OAC) therapy was associated with a reduced risk of peri-procedural thrombo-embolic and any bleeding complications.

PMID:37427356 | PMC:PMC10329261 | DOI:10.1093/ehjopen/oead065