Tag: pubmed

Arch Womens Ment Health. 2022 Mar 14. doi: 10.1007/s00737-021-01189-2. Online ahead of print.

ABSTRACT

It is well established that exercise can improve depressive symptoms in the general population; however, it is not clear if these benefits are also seen in pregnancy. This review aimed to synthesize the evidence that examines whether exercise during pregnancy impacts depressive and associated symptoms (e.g. anxiety) during the perinatal period. The review was conducted in accordance with PRISMA guidelines and reporting criteria; literature was searched using PubMed, Scopus and Web of Science database engines. Clinical trials published in English evaluating the effects of a defined exercise protocol during pregnancy on depressive and/or anxiety symptoms during the perinatal period were included. Studies without a control group were excluded. Risk of bias was conducted by Cochrane assessment to appraise the quality of the included studies. Twenty-seven articles, between 1994 and 2019, were included. Of these, only 5 specifically recruited women with depression (n = 334), which all assessed a yoga-based intervention; 4 of these studies showed a statistically significant improvement in depressive and/or anxiety symptoms in the intervention group compared to baseline; however, 2 of these studies also showed an improvement in the control group. The remaining 22 studies used various exercise interventions in pregnant women (n = 4808) with 20 studies reporting that exercise during pregnancy has the ability to improve depressive and/or anxiety measures in the perinatal period compared to either baseline or control. The evidence suggests that exercise of various types in pregnancy can reduce depressive and/or anxiety symptoms in the perinatal period in otherwise healthy women. Specifically in women with antenatal depression, the incorporation of yoga in pregnancy can improve depressive/anxiety symptoms in the perinatal period; however, this is based on a small number of studies, and it is not clear whether this is superior to non-exercise controls. Further studies are needed to determine the potential therapeutic effects of exercise of various types during pregnancy on symptoms of antenatal depression.

PMID:35286442 | DOI:10.1007/s00737-021-01189-2

Surg Endosc. 2022 Mar 14. doi: 10.1007/s00464-022-09161-6. Online ahead of print.

ABSTRACT

BACKGROUND: Inguinal hernia has a lifetime incidence of 27% in men and 3% in women. Surgery is the recommended treatment, but there is no consensus on the best method. Open repair is most popular, but there are concerns about the risk of chronic groin pain. Laparoscopic repair is increasingly accepted due to the lower risk of chronic pain, although its recurrence rate is still unclear. The aim of this overview is to compare the risk of recurrence and chronic groin pain in laparoscopic versus open repair for inguinal hernia.

METHODS: We searched Ovid MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for systematic reviews and meta-analyses. Only reviews of randomised controlled trials (RCTs) in adults published in English were included. Conference proceedings and editorials were excluded. The quality of the systematic reviews was assessed using the AMSTAR 2 checklist. Two outcomes were considered: hernia recurrence and chronic pain.

RESULTS: Twenty-one systematic reviews and meta-analyses were included. Laparoscopic repair was associated with a lower risk of chronic groin pain compared with open repair. In the four systematic reviews assessing any laparoscopic versus any open repairs, laparoscopic repair was associated with a statistically significant (range: 26-46%) reduction in the odds or risk of chronic pain. Most reviews showed no difference in recurrence rates between laparoscopic and open repairs, regardless of the types of repair considered or the types of hernia that were studied, but most reviews had wide confidence intervals and we cannot rule out clinically important effects favouring either type of repair.

CONCLUSION: Meta-analyses suggest that laparoscopic repairs have a lower incidence of chronic groin pain than open repair, but there is no evidence of differences in recurrence rates between laparoscopic and open repairs.

PMID:35286471 | DOI:10.1007/s00464-022-09161-6

Arch Gynecol Obstet. 2022 Mar 14. doi: 10.1007/s00404-022-06499-z. Online ahead of print.

ABSTRACT

BACKGROUND: Hypothermia is defined as a decrease in body core temperature to below 36 °C. If intraoperative heat-preserving measures are omitted, a patient’s temperature will fall by 1 – 2 °C. Even mild forms of intraoperative hypothermia can lead to a marked increase in morbidity and mortality. Using warm and humidified gas insufflation in laparoscopy may help in the maintenance of intraoperative body temperature.

METHODS: In this prospective randomized controlled study, we investigated effects of temperature and humidity of the insufflation gas on intra- and postoperative temperature management. 150 patients undergoing gynecologic laparoscopic surgery were randomly assigned to either insufflation with non-warmed, non-humidified CO₂ with forced air warming blanket (AIR), humidified warm gas without forced air warming blanket (HUMI) or humidified warm gas combined with forced air warming blanket (HUMI+). We hypothesized that the use of warmed laparoscopic gas would have benefits in the maintenance of body temperature and reduce the occurrence of hypothermia.

RESULTS: The use of warm and humidified gas insufflation alone led to more hypothermia episodes with longer duration and longer recovery times as well as significantly lower core body temperature compared to the other two groups. In the comparison of the AIR group and HUMI + group, HUMI + patients had a significantly higher body temperature at arrival at the PACU (Post Anaesthesia Care Unit), had the least occurrence of hypothermia and suffered from less shivering.

CONCLUSION: The use of warm and humidified gas insufflation alone does not sufficiently warm the patients. The optimal temperature management is achieved in the combination of external forced air warming and insufflation of warm and humidified laparoscopy gas.

PMID:35286431 | DOI:10.1007/s00404-022-06499-z

Arch Gynecol Obstet. 2022 Mar 14. doi: 10.1007/s00404-022-06494-4. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to evaluate and compare the diagnostic performance of ultrasonography (USG) assessment using structured reporting with intraoperative laparoscopic assessment in deep infiltrating endometriosis (DIE) using the recent update of the #ENZIAN classification.

METHODS: This was a retrospective study conducted in Tertiary Multi-disciplinary Endometriosis Care Hospital over a period of 8 months which included 50 patients who underwent a planned laparoscopic endometriosis excisional surgery after a dedicated USG assessment using International Deep Endometriosis Analysis (IDEA) protocol and #ENZIAN score (updated ENZIAN classification), between Feb 2021 and Sept 2021 at Apollo Hospitals, Hyderabad. The pre-operative USG findings were reported in a structured reporting format and intraoperative findings were classified using the standard #ENZIAN classification. No prospective interventions were done. A review of pre-operative ultrasound and laparoscopic findings as per the #ENZIAN was done.

RESULTS: Sensitivity and the negative predictive value of ultrasound were 86% and 84.2% for peritoneal lesions, 97% and 93.3% for left ovarian lesions, 93% and 91.6% for right ovarian lesions, 91% and 84% for left tubal lesions, 90% and 86.3% for right tubal lesions, 93% and 75% for uterosacral ligaments, 93.3% and 97% for rectal lesions and sensitivity and negative predictive values were 100% for rectovaginal lesions, adenomyosis, and ureteric lesions as confirmed on laparoscopy.

CONCLUSION: Dynamic ultrasound assessment with a structured report based on IDEA protocol and #ENZIAN score is accurate for mapping of pelvic endometriosis in all forms, and it correlates with laparoscopic findings, thus helps surgeon for better planning and providing a road map for surgeons. From a clinical perspective, a uniform and shared reporting system across imaging and therapeutic modalities will simplify communication, improving patient management by conservative or surgical treatments, avoiding multiple repeat surgeries, and improving quality of treatment.

PMID:35286430 | DOI:10.1007/s00404-022-06494-4

Abdom Radiol (NY). 2022 Mar 14. doi: 10.1007/s00261-022-03476-7. Online ahead of print.

ABSTRACT

PURPOSE: To compare the success rate, clinical outcomes, and complications of retroperitoneal (RP) versus transperitoneal (TP) percutaneous catheter drainage (PCD) of the necrotic pancreatic fluid collections.

MATERIALS AND METHODS: This retrospective study comprised consecutive patients with acute pancreatitis who underwent PCD of lesser sac collections amenable to drainage via both TP and RP routes. The patients were divided into two groups based on the route of drainage (group I, RP, and group II, TP). The technical success, clinical success, complications, and clinical outcomes were compared between the groups. Subgroup analysis was performed based on the timing of drainage (acute necrotic collections, ANC vs. walled-off necrosis, WON) and organ failure (OF).

RESULTS: Seventy-nine patients [mean age, 38.7 ± 12.3 years, 54 males] were included in the study. Group I and II comprised 22 (27.8%) and 57 (72.2%) patients, respectively. The procedures were technically successful in all the patients. There was no significant difference in the complication rate between the two groups. The clinical success was higher in group II (75.4%) as compared to group I (54.5%). However, the difference was not statistically significant (p = 0.070). There was no significant difference in the hospital stay (p = 0.298), intensive care unit stay (p = 0.401), need for surgical necrosectomy (p = 0.243), and mortality (p = 0.112) between the two groups. The outcomes in patients with OF and ANC were not affected by the route of PCD. Clinical success rate was significantly higher in WON undergoing TP drainage (p = 0.009).

CONCLUSION: Both RP and TP routes of PCD are safe and effective. Clinical success rate was significantly higher in WON undergoing TP drainage.

PMID:35286420 | DOI:10.1007/s00261-022-03476-7

Abdom Radiol (NY). 2022 Mar 14. doi: 10.1007/s00261-022-03460-1. Online ahead of print.

ABSTRACT

BACKGROUND: Routine management after abscess drainage includes CT or fluoroscopic imaging to assess for residual abscess cavity prior to catheter removal. It is unclear whether this practice is necessary in patients without residual infection signs and symptoms.

PURPOSE: To evaluate safety of abscess catheter removal without follow-up imaging in patients without residual clinical or laboratory signs of infection and catheter output < 10 cc/day for 2 consecutive days.

MATERIALS AND METHODS: In this IRB-approved, HIPAA compliant, retrospective study, consecutive patients that underwent percutaneous CT-guided drainage of a single abdominal or pelvic abscess between 01/2015 and 12/2017 in a single tertiary academic institution with or without follow-up imaging prior to catheter removal were included. In our institution, catheters are routinely removed without imaging if there are no clinical (fever, pain) or laboratory (elevated WBC count) signs of infection and catheter output is < 10 cc/day for 2 consecutive days. Patients’ and abscess’s characteristics, repeat imaging data, and need for re-interventions were obtained through medical records review. Statistical analysis was performed with Fisher’s exact test for independent data and Student’s t-test for comparison of group means.

RESULTS: 310 consecutive patients (age 56 ± 16 years, 48% female) were included in the study. In 265/310 (85%) patients, no routine follow-up imaging prior to catheter removal was obtained. In 2/265 (0.8%, 95% CI 0.02-0.27%) patients without routine pre-removal imaging, repeat abscess drainage was required 6 and 15 days after catheter removal in patient with perforated appendicitis and after laparoscopic renal cyst decortication, respectively. No patients, 0/45 (0%, 95% CI 0-0.07), that underwent routine imaging without clinical or laboratory signs infection needed to undergo a repeat abscess drainage.

CONCLUSION: There is a low rate (0.8%) of abscess recurrence if percutaneous abscess catheter is removed at the time cessation of drainage without routine imaging in clinically well patient.

PMID:35286421 | DOI:10.1007/s00261-022-03460-1

PLoS One. 2022 Mar 14;17(3):e0265072. doi: 10.1371/journal.pone.0265072. eCollection 2022.

ABSTRACT

OBJECTIVE: Simulation studies in adults and pediatrics demonstrate improvement in chest compression (CCs) quality as providers rotate every two minutes. There is paucity of studies in neonates on this matter. This study hypothesized that frequent rotation while performing CCs improves provider performance and decreases fatigue.

STUDY DESIGN: Prospective randomized, observational crossover study where 51 providers performed 3:1 compression-ventilation CPR as a pair on a term manikin. Participants performed CCs as part of 3 simulation models, rotating every 3, 5 and 10 minutes. Data on various CC metrics were collected. Participant vitals were recorded at multiple points during the simulation and participants reported their level of fatigue at completion of simulation.

RESULTS: No statistically significant difference was seen in any of the compression metrics. However, differences in the providers’ fatigue scores were statistically significant.

CONCLUSION: CC performance metrics did not differ significantly, however, providers’ vital signs and self-reported fatigue scores significantly increased with longer CC durations.

PMID:35286358 | DOI:10.1371/journal.pone.0265072

Turk J Pediatr. 2022;64(1):127-132. doi: 10.24953/turkjped.2017.271.

ABSTRACT

BACKGROUND: We aimed to determine whether MPV can be used as a marker for the activity and the severity index of alopesi areata (AA).

METHOD: The charts of 71 children who received a diagnosis of AA and 70 age and gender-matched healthy children were retrospectively evaluated. The severity of hair loss was classified as S1 ( < 25%), S2 (25-49%), S3 (50-74%), S4 (75-95%), S4b (96-99%) (according to the percent of the area involved), alopecia totalis (AT), and alopecia universalis (AU). In the laboratory tests, the results of the complete blood count, anti-nuclear antibody (ANA), thyroid function tests (TSH, free/total T4, free/total T3), and autoimmune thyroid antibodies [antithyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin antibody (AT)] were recorded.

RESULTS: A total of 141 cases including 61 (43.3%) males and 80 (56.7%) females were included. There was no statistically significant difference between the groups according to the mean age (p > 0.05). The MPV measurements were statistically significantly higher in the AA group (p < 0.01). There was no statistically significant difference between the types of AA according to the mean age, gender distribution, the presence of nail involvement, the presence of family history, and the presence of autoimmune disease (p > 0.05). There was no statistically significant difference between the severity of AA according to the mean age, gender distribution, the presence of nail involvement, the presence of family history, and the presence of autoimmune disease (p > 0.05).

CONCLUSION: MPV is helpful in assessing clinical activity in patients with AA. However, prospective studies involving more patients are needed to support our findings.

PMID:35286039 | DOI:10.24953/turkjped.2017.271

Turk J Pediatr. 2022;64(1):32-39. doi: 10.24953/turkjped.2021.4608.

ABSTRACT

BACKGROUND: With the onset of the COVID-19 pandemic, discussions regarding the prevalence of COVID-19 in children and the association of this with education have started. This study aimed to determine the prevalence of COVID-19 infection in asymptomatic school children within a limited period while face-to-face education continued.

METHODS: This is a descriptive and retrospective study. Screening was carried out in the schools in the three major districts of the metropolitan municipality when face-to-face education was practiced. COVID-19 RT-PCR swab samples were collected from 4,658 students from 46 schools at preschool, primary, secondary, and high school levels by using the stratified sampling method. Screening results were retrospectively analyzed by the researchers.

RESULTS: The mean age of the children included in the study was 10.6±3.2 (5-17). Only 46 students` COVID-19 RT-PCR results were positive; the positivity rate was higher in male students than in female students (p > 0.05); the students living in the third region had a higher positivity rate than the other students, there was a statistical difference between them (p < 0.001); there were no positive cases in 26 (56.7%) schools, and the spreader rate of the school children was 0.98%.

CONCLUSIONS: We determined in the study that the prevalence of COVID-19 infection was not high in asymptomatic school children in the period when schools were open. This may play a role in directing the education and training during the pandemic.

PMID:35286028 | DOI:10.24953/turkjped.2021.4608

Turk J Pediatr. 2022;64(1):110-121. doi: 10.24953/turkjped.2021.1264.

ABSTRACT

BACKGROUND: Adolescents are mostly considered as a healthy population; however, failure to acquire positive health behaviors during this period makes them vulnerable to poor health outcomes and long-term chronic disorders. Health literacy is one of the most influential parameters in promoting adolescent health. This study aimed to determine the level and promoters of health literacy in adolescents, emphasize the importance of internet use, and evaluate the relationship between self-efficacy and health literacy.

METHODS: A total of 756 adolescents aged 15 and 18 years attending two high schools in socioeconomically different districts in Ankara, Turkey were included in this cross-sectional study. A survey consisting of descriptive questions, a health literacy survey, and a general self-efficacy scale were used to collect data. p < 0.05 was considered statistically significant.

RESULTS: Among the adolescents who participated in the study, the level of health literacy was inadequatelimited in 56.1%, sufficient in 30.1%, and excellent in 13.8%. A statistically significant correlation was found between health literacy and general self-efficacy levels (r: .412, p < 0.001). There was also a statistically significant difference between the health literacy groups in terms of the education level of the adolescents` mothers, internet use frequency, and self-efficacy level. The multivariate logistic regression analysis revealed that the participants whose mothers had only received primary school education or no formal education, those that were not using the internet regularly, those that did not search health information on the internet, and those with poor self-efficacy levels were more likely to have an inadequate level of health literacy [odds ratio (OR)=2.6, 95% confidence interval (CI)=1.4-4.9; OR=5.5, 95% CI=1.2-25.1; OR=1.7, 95% CI=1.1-2.9; and OR=3.7, 95% CI=2.6- 5.2, respectively].

CONCLUSIONS: In this study, it was concluded that the adolescents` health literacy and general self-efficacy levels were related. Furthermore, the health literacy level of the adolescents was associated with internet use and maternal education status.

PMID:35286037 | DOI:10.24953/turkjped.2021.1264