Tag: pubmed

Int Health. 2022 Nov 4:ihac067. doi: 10.1093/inthealth/ihac067. Online ahead of print.

ABSTRACT

BACKGROUND: Utilization of adequate and quality prenatal healthcare services confers critical benefits to women and their unborn children. However, utilization rates remain low in many countries in Africa. Several studies have attempted to understand the primary drivers behind these low statistics. This article contributes to this discourse by examining the associations between birth interval and timing and number/frequency of antenatal care visits in Africa.

METHODS: We pooled data from the publicly available Demographic and Health Surveys conducted in the last decade (2010-2020) for 32 African countries. Data were analysed using descriptive proportions and mixed effect binary logistic regression.

RESULTS: The results illustrate moderate significant associations between spacing on the most recent birth by ≥36 months and early (first trimester) first antenatal care contact in both our bivariate (odds ratio [OR] 1.18, p<0.001) and multivariate (OR 1.106, p<0.001) analyses. The benefits on optimal antenatal contacts predicted on spacing are also noticed with birth intervals of 24-35 months (OR 1.08, p<0.001) and ≥36 months (OR 1.48, p<0.001).

CONCLUSIONS: Optimal birth spacing is beneficial for ANC utilization in terms of timing and total number of contacts. Post-partum family planning/contraceptive use can be an effective pathway to prolonging birth intervals. We argue that maternal and child health programmes strengthen prioritizing contraceptive use between births.

PMID:36331288 | DOI:10.1093/inthealth/ihac067

Biostatistics. 2022 Nov 4:kxac043. doi: 10.1093/biostatistics/kxac043. Online ahead of print.

ABSTRACT

Most of the literature on joint modeling of longitudinal and competing-risk data is based on cause-specific hazards, although modeling of the cumulative incidence function (CIF) is an easier and more direct approach to evaluate the prognosis of an event. We propose a flexible class of shared parameter models to jointly model a normally distributed marker over time and multiple causes of failure using CIFs for the survival submodels, with CIFs depending on the “true” marker value over time (i.e., removing the measurement error). The generalized odds rate transformation is applied, thus a proportional subdistribution hazards model is a special case. The requirement that the all-cause CIF should be bounded by 1 is formally considered. The proposed models are extended to account for potential failure cause misclassification, where the true failure causes are available in a small random sample of individuals. We also provide a multistate representation of the whole population by defining mutually exclusive states based on the marker values and the competing risks. Based solely on the assumed joint model, we derive fully Bayesian posterior samples for state occupation and transition probabilities. The proposed approach is evaluated in a simulation study and, as an illustration, it is fitted to real data from people with HIV.

PMID:36331265 | DOI:10.1093/biostatistics/kxac043

Invest Ophthalmol Vis Sci. 2022 Nov 1;63(12):8. doi: 10.1167/iovs.63.12.8.

ABSTRACT

PURPOSE: To study the circumpapillary retinal nerve fiber layer (RNFL) birefringence (BIR) of early glaucoma and age-matched healthy eyes using polarization-sensitive optical coherence tomography (PS-OCT).

METHODS: In this prospective cross-sectional study, we compared virtual circular PS-OCT B-scans with a diameter of 3.5 mm centered on the optic disc (OD) acquired with a PS-OCT prototype (860 nm center wavelength). Early glaucoma was defined by the glaucomatous appearance of the OD and a pathologic visual field test with a mean deviation (MD) better than -6 dB. The main outcome parameters were BIR, RNFL-thickness (RNFL-T), and phase retardation (RET). The BIR value at each virtual A-scan position was the quotient of the RET measured at the inner segment/outer segment junction divided by the RNFL-T.

RESULTS: The dataset comprised 49 early glaucoma patients (mean ± standard deviation [SD]: 64 ± 10 years) and 49 healthy control subjects (61 ± 9 years). Glaucomatous eyes showed a statistically significant lower BIR globally (mean ± SD: 0.108 ± 0.008°/µm vs. 0.112 ± 0.009°/µm, P = 0.033), superiorly (0.116 ± 0.017°/µm vs. 0.126 ± 0.013°/µm, P = 0.0001), and inferiorly (0.112 ± 0.011°/µm vs. 0.121 ± 0.011°/µm, P < 0.0001), and increased BIR in the temporal quadrant (0.088 ± 0.015°/µm vs. 0.078 ± 0.014°/µm, P = 0.0001) compared to healthy eyes.

CONCLUSIONS: We report a reduced BIR of the RNFL in early perimetric glaucoma, which can be interpreted as a sign of loss or change of intracellular microtubules and may contribute to a better understanding of early disease development. Prospective longitudinal studies are needed to determine whether BIR is altered in pre-perimetric human glaucoma before RNFL-T decline.

PMID:36331260 | DOI:10.1167/iovs.63.12.8

Pediatr Int. 2022 Jan;64(1):e15341. doi: 10.1111/ped.15341.

ABSTRACT

BACKGROUND: Precordial Doppler ultrasound technology can be used to confirm correct peripheral intravenous access in children. Changes in precordial Doppler sound from the baseline after injecting normal saline are detected using a correct peripheral intravenous access. However, the location of the precordial Doppler probe has been inconsistent in previous studies. Our study aimed to determine whether the right or left parasternal border is the optimal location for precordial Doppler probe placement.

METHODS: This single-center, prospective interventional study was conducted between July 2021 and January 2022 and included children aged 1-6 years. The Doppler probe was placed under general anesthesia at the most audible site on the right and left parasternal borders of patients. Baseline heartbeat was recorded by the Doppler for 10 s on the right and left parasternal borders. After randomizing the order of the recorded data, two blinded raters separately listened to the data and decided the audibility of the sounds.

RESULTS: A total of 77 patients were enrolled in the study. The proportion of the audible baseline heartbeat was significantly higher on the left parasternal borders than on the right by both rater 1 (96.1%, 22.1%, p < 0.001) and rater 2 (96.1%, 27.3%, p < 0.001). Regarding inter-rater reproducibility, Cohen’s kappa statistics for the left and right parasternal borders were significant (0.65 and 0.79, both p < 0.001).

CONCLUSIONS: The baseline heartbeat was more audible on the left parasternal border than on the right parasternal border with acceptably high interrater reproducibility. This is inconsistent with the interpretations of previous reports.

PMID:36331222 | DOI:10.1111/ped.15341

Afr J Prim Health Care Fam Med. 2022 Oct 31;14(1):e1-e9. doi: 10.4102/phcfm.v14i1.3500.

ABSTRACT

BACKGROUND: The World Health Organization recommends medical male circumcision (MMC) to prevent human immunodeficiency virus (HIV). More research is needed in South Africa on factors influencing the uptake of MMC.

AIM: To evaluate factors associated with uptake of MMC.

SETTING: Diepsloot, Johannesburg, South Africa.

METHODS: An observational case-control study. Cases (men attending a private general practice (GP) offering free MMC) were compared to controls (uncircumcised men attending a local shopping mall) for a variety of demographic, sociocultural and financial factors. Factors were analysed using bivariate and multiple-variable binary forward logistic regression with the Statistical Package for Social Sciences.

RESULTS: There were 350 cases and 350 controls. Four factors were associated with the uptake of MMC: being a student (adjusted odds ratio [AOR]: 6.29, 95% confidence interval [CI]: 2.29-17.26), attending a mainline Christian denomination (AOR 2.85, 95% CI: 1.39-5.78), speaking an African language other than Zulu (range of AORs: 2.5-6.8, p 0.05) and being South African (AOR: 2.50, 95% CI: 1.58-3.96). MMC was associated with feeling susceptible to HIV, seeing it as a serious health problem and being encouraged by partners. Men who were sterilised, not sexually active and without symptoms of a sexually transmitted infection felt less susceptible. Other barriers included the pain of the procedure, indirect costs, anticipated impact on sexual activity, lack of information, cultural beliefs, embarrassment and access to health services.

PMID:36331198 | DOI:10.4102/phcfm.v14i1.3500

Psychol Health Med. 2022 Nov 4:1-9. doi: 10.1080/13548506.2022.2141280. Online ahead of print.

ABSTRACT

During the COVID-19 pandemic, undergraduate medical students (UMS) exposed to isolation, social distancing and complete or partial face-to-face educational activities interruption may present increased stress, depression and anxiety. This study was undertaken to evaluate if, during isolation, UMS involved in online group activities as investigators of a research project (volunteer group) would present better mental health than their colleagues, not involved in that research (control group). A Web-based survey, via the Google Forms platform, including details on demographic data, life habits, previous health conditions, worries with the COVID-19 pandemic, sleep pattern modifications and depression, anxiety and mental stress, using the DASS-21 (Depression, Anxiety and Stress Scale) was implemented from 20 July to 31 August 2020. Statistical analysis was performed using the SPSS version 20.0. A p-value <0.05 was significant. A total of 684 UMS were included, 228 as a volunteer group and 456 as a control group. Mean age was 23.15 (3.16) years. The groups were paired for age, gender, ethnicity, life habits and previous health conditions. Older age, male gender, participation in the research project, unchanged sleep pattern during the pandemic, lack of fear from getting the COVID-19 and lack of previous health conditions were associated with lower DASS21 scores (better mental health). Participating as investigators of a research project foreseeing frequent interaction with patients, colleagues and professors (other investigators) lead to better mental health during the COVID-19 quarantine in Brazil.

PMID:36331176 | DOI:10.1080/13548506.2022.2141280

J Stomatol Oral Maxillofac Surg. 2022 Oct 29:S2468-7855(22)00337-8. doi: 10.1016/j.jormas.2022.10.023. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this systematic review is to determine if the zirconia implants present better clinical results when compared to titanium implants.

METHODS: Searches were conducted in 5 databases including, until March 2022, by 2 independent reviewers, according to the inclusion and exclusion criteria established in the study and according whit this question: Do zirconia dental implants present better clinical results than titanium dental implants?

RESULTS: 3235 studies were initially found in the researched databases. 03 randomized clinical trials were included in this systematic review and meta-analysis. A total of 71 patients with 192 implants (87 titanium and 105 zirconia) were evaluated, showing an effectiveness of 87,4% and 78,1% respectively and there was no statistically significant difference in terms of survival rate in the meta-analysis (P = 0.70; I² = 0%). Still in the meta-analysis, there was no statistically significant difference between titanium and zirconia implants in relation to the pink esthetich score or bleeding on probing, however, a favorable difference was observed for titanium in relation to marginal bone loss (P = 0.001; I² = 0%). None of the studies evaluated had a low risk of bias.

CONCLUSION: Oral rehabilitation with zirconia implants showed no advantages over titanium in this systematic review. However, the small number of studies included and the uncertain risk of bias may raise doubts in this interpretation and the results should be analyzed with caution. New studies with greater methodological rigor, follow-up time and number of interventions should be performed in order to safely determine the indication for the use of zirconia implants.

PMID:36330865 | DOI:10.1016/j.jormas.2022.10.023

Int J Gynaecol Obstet. 2022 Nov 4. doi: 10.1002/ijgo.14545. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the effect of female age on pregnancy outcome after in vitro fertilization/embryo transfer (IVF-ET).

METHODS: A prospective study was conducted involving 266 women who had IVF-ET at Nisa Fertility and Genetic Center, Abuja, Nigeria. All eligible consenting women were recruited to the study. The main outcome measure was clinical pregnancy. Data were analyzed using IBM SPSS Statistics version 25. P<0.05 at 95% confidence intervals was taken as significant.

RESULTS: A total of 266 patients were recruited and included in the study; 104 pregnancies were recorded, giving an overall pregnancy rate of 39.1%. The age range of the patient was 26-43 years (mean age 33.9±2.41 years) while the mean number of embryo transfers per patient was 2.2. The clinical pregnancy rate for women aged below 30 years was 69.4% while the pregnancy rate for patients aged 30-34 years, 35-39 years, and 40-43 years was 52.6%, 24.7%, and 9.4%, respectively (P<0.0001) CONCLUSION: The study found that the success rate of IVF-ET decreases significantly in women aged over 34 years. Women should be counseled about the age-related risk of infertility and referred to a fertility center as early as possible.

PMID:36330818 | DOI:10.1002/ijgo.14545

Cardiol Young. 2022 Nov 4:1-7. doi: 10.1017/S1047951122003353. Online ahead of print.

ABSTRACT

INTRODUCTION: Burden of CHD in Africa is generally underestimated mainly due to significant under-reporting and early-related fetal and neonatal mortality.

OBJECTIVES: Determine the prevalence and factors associated with late diagnosis of CHD seen at three tertiary care hospitals in Kenya.

DESIGN: A cross-sectional study on paediatric patients with CHDs, aged 0-18 years, seen over a 5-year period, between January, 2011 and December, 2016.

SETTING: Aga Khan University Hospital Nairobi, Mater Hospital, and Kenyatta National Hospital.

METHODS: Patients were stratified into those diagnosed late (>1 year of age) and those diagnosed early (<1 year of age). Multiple logistic regression analysis was done to determine factors associated with late diagnosis.

RESULTS: The study enrolled 411 patients, with equal gender distribution. Prevalence of late diagnosis (>1 year of age) of CHD was 60.6% (95% CI 55.7-65.3). Median age at diagnosis was 15 (IQR 5-48) months. Presence of a cardiac murmur (OR = 0.87; 95% CI 0.72-0.92, p-value = 0.016) and level of parental education (OR = 4.99; 95% CI 2.25-11.40, p-value <0001) were associated with a decreased odds of late diagnosis. Other factors like cyanosis, an increase in the number of healthcare workers and healthcare facilities per 10,000 population showed some association with decreased odds of late diagnosis of CHD, but these were not statistically significant.

CONCLUSION: Late diagnosis of CHD remains alarmingly high in our setting. Initiatives to enhance early detection and screening of CHD should be adopted to reduce related mortality and morbidity.

PMID:36330814 | DOI:10.1017/S1047951122003353

J Genet. 2022;101:49.

ABSTRACT

Spirulina platensis has gradually gained more attention for its therapeutic, antioxidant, and anti-inflammatory potential worldwide. However, the current molecular knowledge about the effects of spirulina on stress-related genes is rather limited. The effects of dietary intake of spirulina on the HSP70 gene expression were assessed in a controlled in vivo experimental design. Moreover, alterations in serum corticosterone levels, IL-2, IL-4, IFN-Υ, triglyceride, ALT, AST, relative gene expression values, and the correlations between them were evaluated. A total of 36 rats were divided into four groups: control group, stress-only group, spirulina group, and spirulina+stress group. To control the dose administration, S. platensis was applied by a gastric gavage in stress groups. Crowded environment stress and hosting alone stress were applied to the stress-only group and spirulina + stress group. RNA was extracted from brain samples using TRIpure and the relative gene expression assessment was performed using Roche-LightCycler-480-II real-time PCR-System. Gene expression values were remarkably different among the four experimental groups. The differences between stress-only and the spirulina groups were statistically significant (P<0.05). The correlation between the HSP70 gene expression and the IFN-Υ was found to be statistically significant (P<0.05; r=0.50). Results indicate a novel effect of spirulina on the HSP70 expression related to the stress-response. Data presented in this study may be useful for further studies to define not only the molecular genetic aspects through dietary S. platensis but also the effects of spirulina on stress-response and animal welfare.

PMID:36330789