Tag: pubmed

J Feline Med Surg. 2022 Nov 2:1098612X221121920. doi: 10.1177/1098612X221121920. Online ahead of print.

ABSTRACT

OBJECTIVES: The aims of this study were to determine owners’ perception of their cats’ quality of life (QoL), and whether there is a correlation with weight-loss variables, as well as to identify the main difficulties owners encounter during controlled weight loss in their obese cats.

METHODS: The study was carried out as an e-questionnaire survey addressed to owners of cats starting a weight-loss programme. The e-questionnaire was provided at a single time point after the conclusion of the study (24 weeks).

RESULTS: Nineteen completed questionnaires were included. Eighteen cats had a lower weight at the end of the weight-loss period, two of which had successfully reached their target weight. Mean weight loss was 13.84% body weight at a rate of 0.53% weight loss/week. Although the perceived QoL was not correlated with weight-loss variables (P >0.05), it increased over time, even in cats that did not reach their target weight, and was statistically correlated with increased activity (r = 0.73; P <0.01), mobility (r = 0.78; P <0.01) and play time (r = 0.61; P <0.01). The main difficulties encountered by owners were not giving (32%) or permitting the cat to eat extra food (26%). The main presumed difficulty for the cat was having its food decreased over time (53%). Most owners considered their cats happy (42%) and quite happy (53%) during the study, and no statistically significant correlations were found between the weight loss, food-seeking behaviour and stress parameters (P >0.05).

CONCLUSIONS AND RELEVANCE: Although several difficulties were encountered throughout the study, increased QoL and energy levels in their cats were noticed by owners. A positive perspective on weight-loss programmes is important to keep owners motivated and achieve the target weight in their cats. Furthermore, this survey provides insights into the perceived difficulties of weight-loss regimens in cats.

PMID:36322004 | DOI:10.1177/1098612X221121920

Pain Med. 2022 Nov 2:pnac166. doi: 10.1093/pm/pnac166. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the analgesic efficacy of quadratus lumborum block (QLB) in adults undergoing nephrectomy.

DESIGN: Systematic review and meta-analysis.

PATIENTS: Adult patients (≥ 18 years) received nephrectomy under general anesthesia.

METHODS: We searched PubMed, Embase, the Cochrane Library, and Web of Science on January 10, 2022, including randomized controlled trials (RCTs) that evaluated the analgesic efficacy of QLB for patients undergoing nephrectomy.

RESULTS: A total of 12 RCTs (N = 821 patients) were included in the study. Compared with the non-block, single-shot QLB reduced the postoperative opioid consumption (mean difference [MD], -8.37 mg intravenous morphine equivalent; 95% CI, -12.19 to -4.54 mg) and pain scores at 2 h, 6 h, 12 h, and 24 h at rest and during movement after nephrectomy. Single-shot QLB also prolonged the time to first analgesic request (MD, 6.44 h; 95% CI, 2.23 to 10.65 h), and shortened the length of hospital stay (MD, -0.32 d; 95% CI, -0.55 to -0.09 d) and decreased the incidence of postoperative nausea and vomiting (risk ratio, 0.48; 95% CI, 0.36 to 0.65). Compared with continuous epidural anesthesia, repeated QLB may provide comparable postoperative analgesic benefits.

CONCLUSIONS: Single-shot QLB provided a statistically significant, but clinically-small improvement in postoperative analgesia and recovery for patients undergoing nephrectomy. The QLB would be beneficial as part of multimodal analgesia. Future research may need to determine which approach of QLB is superior for postoperative analgesia after nephrectomy.

PMID:36321993 | DOI:10.1093/pm/pnac166

AJR Am J Roentgenol. 2022 Nov 2. doi: 10.2214/AJR.22.28402. Online ahead of print.

ABSTRACT

Background: FDG PET/CT has limited diagnostic performance for peritoneal metastasis. The 68Ga-fibroblast activation protein inhibitor (68Ga-FAPI) targets tumor stroma, leading to high accumulation across cancer types. Objective: To conduct a meta-analysis to compare the diagnostic performance of 68Ga-FAPI PET/CT and FDG PET/CT in detecting PM based on studies providing head-to-head comparisons between the two tests. Evidence Acquisition: PubMed, Embase, and Cochrane Library databases were searched through July 2022 to identify studies reporting head-to-head comparison of 68Ga-FAPI PET/CT and FDG PET/CT for detection of PM. Reference standard was classified as histopathology in all patients, or as combination of histopathology, clinical, imaging, laboratory, and follow-up information (i.e., multidisciplinary reference standard). Random-effects statistical model was applied to conduct a meta-analysis of tests’ diagnostic performances in patient-based and lesion-based analyses. QUADAS-2 and QUADAS-C tools were used to assess study quality. Evidence Synthesis: Eleven studies were included; patient-based analysis comprised nine studies with 340 patients, and lesion-based analysis comprised four studies with 222 lesions. Pooled sensitivity of 68Ga-FAPI PET/CT was significantly higher than that of FDG PET/CT in patient-based analysis [98.2% (95% CI: 96.1-100.0%) vs 55.9% (95% CI: 33.9-77.9%)] and lesion-based analysis [99.9% (95% CI: 99.5-100.0%) vs 27.3% (95% CI: 11.2-43.4%)]. Eight studies were rated as high risk of bias in the reference standard domain because the multidisciplinary reference standard was not sufficiently explained and may have included one of the two index tests, which would have artificially increased sensitivity. Specificity was reported in three studies as 100.0% for both tests; these studies were considered at uncertain risk of bias in the patient selection domain because patients with benign peritoneal conditions may have been excluded, resulting in underestimation of potential false-positive results. Conclusion: Current evidence suggests excellent sensitivity of 68Ga-FAPI PET/CT for the detection of PM, in comparison to poorer sensitivity of FDG PET/CT. However, most included studies had high risk of bias, with need for further studies that could more convincingly characterize true- and false-positive results. Clinical Impact: The use of 68Ga-FAPI PET/CT may offer substantially improved sensitivity compared with FDG PET/CT for the evaluation of PM, facilitating surgical candidate selection and planning.

PMID:36321984 | DOI:10.2214/AJR.22.28402

Laeknabladid. 2022 Nov;108(11):495-500. doi: 10.17992/lbl.2022.11.715.

ABSTRACT

BACKGROUND: Transient Global Amnesia (TGA) is a benign syndrome characterized by sudden anterograde memory loss, that resolves spontaneously within 24 hours. TGA appears without other focal neurological symptoms. The aim of this study was to study TGA in the greater Reykjavik-area.

METHODS: We retrospectively analysed the medical history of patients with a diagnosis of TGA (ICD-10 G45.4) at the University Hospital in Iceland in 2010-2021. Medical records were reviewed, and information about year and age at diagnosis, sex, symptoms, precipitating events, imaging results and risk factors were collected. Statistical processing was performed with Excel and Rstudio.

RESULTS: Overall, 348 attacks of TGA were identified with a mean frequency of 29 attacks/year, where 9.9% had an earlier history of TGA. The mean age was 64.1, with 50% of subjects between 58-70 years old. The sex distribution was equal (49.9% female). Possible precipitating events were found in 53.7% of cases, with physical activity being the most common one (24.4%), followed by sudden temperature change and emotional stress. In 96% of patients a computerized tomography was performed (no sign of acute changes were found), and magnetic resonance imaging (MRI) in 36.2% of cases. MRI showed restricted diffusion in the hippocampal area in 10.3% of cases.

DISCUSSION: TGA is not a rare but a benign syndrome. Our findings regarding age, sex distribution and precipitating events were in accordance with other studies. TGA is thought to result from a temporary hippocampal dysfunction supported by the clinical presentation and MRI findings. The cause of TGA is however still unknown.

PMID:36321932 | DOI:10.17992/lbl.2022.11.715

Fam Pract. 2022 Nov 2:cmac122. doi: 10.1093/fampra/cmac122. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore consultation patterns, management practices, and costs of foot, ankle, and leg problems in Australian primary care.

STUDY DESIGN: We analyzed data from the Bettering the Evaluation and Care of Health program, April 2000 to March 2016. Foot, ankle, and leg problems were identified using the International Classification of Primary Care, Version 2 PLUS terminology. Data were summarized using descriptive statistics examining general practitioner (GP) and patient characteristics associated with a foot, ankle, or leg problem being managed. Cost to government was estimated by extracting fees for GP consultations, diagnostic imaging, and pathology services from the Medicare Benefits Schedule (MBS) database. Costs for prescription-only medicines were extracted from the Pharmaceutical Benefits Schedule and for nonprescribed medications, large banner discount pharmacy prices were used.

RESULTS: GPs recorded 1,568,100 patient encounters, at which 50,877 foot, ankle, or leg problems were managed at a rate of 3.24 (95% confidence intervals [CIs] 3.21-3.28) per 100 encounters. The management rate of foot, ankle, or leg problems was higher for certain patient characteristics (older, having a health care card, socioeconomically disadvantaged, non-Indigenous, and being English speaking) and GP characteristics (male sex, older age, and Australian graduate). The most frequently used management practice was the use of medications. The average cost (Australian dollars) per encounter was A$52, with the total annual cost estimated at A$256m.

CONCLUSIONS: Foot, ankle, and leg problems are frequently managed by GPs, and the costs associated with their management represent a substantial economic impact in Australian primary care.

PMID:36321909 | DOI:10.1093/fampra/cmac122

Global Spine J. 2022 Nov 2:21925682221138261. doi: 10.1177/21925682221138261. Online ahead of print.

ABSTRACT

STUDY DESIGN: Diagnostic accuracy study.

OBJECTIVES: Previous studies have reported the clinical application of the Vertebral Bone Quality (VBQ) scores for assessing bone density in operative lumbar spine patients. We aim to explore whether the method could be modified and applicable for patients undergoing cervical spine surgery.

METHODS: Adult patients receiving cervical spine surgery for degenerative diseases between September 2020 and March 2022 with non-contrast T1-weighted MRI and DEXA were included. Correlation between cervical VBQ scores and DEXA T-scores was analyzed using Pearson’s correlation. Student’s t test was used to present the discrepancy between the VBQ of patients with normal bone density (T ≥ -1.0) and patients with osteopenia/osteoporosis (T < -1.0). Statistical significance was set at P < .05.

RESULTS: Eighty-three patients (20 patients with T ≥ -1.0 vs 63 patients with T < -1.0 ) were included. Significant difference was found between the cervical VBQ between groups (2.99 ± .79 vs 3.80 ± .81, P < .001). Interclass correlation coefficient for inter-rater reliability was .82 (95% CI: .70-.93) and .91(95% CI: .84-.97) for intra-rater reliability. The area under the ROC curve was .78 (95% CI: .65-.90). The DEXA T-score of the femoral neck, total hip and the lowest DEXA T-score were found to be significantly correlated with the cervical VBQ score according to Pearson correlation analysis (P < .001).

CONCLUSIONS: This is the first study to apply the VBQ method to assess the bone density in preoperative cervical spine patients. Cervical VBQ scores were significantly correlated with DEXA T-score. With an overall accuracy of .78, the radiation-free and cost-effective method could be a potential tool for screening patients with osteopenia and osteoporosis before surgery.

PMID:36321883 | DOI:10.1177/21925682221138261

J Med Entomol. 2022 Nov 2:tjac166. doi: 10.1093/jme/tjac166. Online ahead of print.

ABSTRACT

Tick-borne diseases (TBDs) pose a significant risk to humans and represent one of the major factors influencing readiness within the United States’ military worldwide. Additionally, ticks and TBDs constitute major animal health problems leading to economic losses at multiple levels affecting low- and middle-income countries the hardest. Tick control is frequently hampered by issues ranging from acaricide resistance to lack of data on tick distribution and infection rates. We conducted a cross-sectional study to assess tick species distribution, host use, and rickettsial pathogen infection rate of ticks in different areas of the Uganda Cattle Corridor. We identified 4,425 hard ticks (Ixodida: Ixodidae) comprised of seven species by morphological characters with 3,315 ticks collected from four locations during the dry season and 1,110 ticks from one location during the wet season. Rickettsial pathogen prevalence was assessed in ticks collected from two districts to determine the minimum infection rate compared across seasons, village location, and tick species. We found statistically significant differences in the abundance and distribution of tick species among districts in the dry season, host animal species, and the proportion of rickettsial positive pools between villages. Seasonality, village location, and tick species do not affect the minimum infection rate of rickettsial pathogens of ticks in Uganda, but village location affects the proportion of positive tick pools. These results indicate geographical and seasonal differences among pathogen-harboring ticks contributing to our understanding of the current distribution of ticks and TBDs in Uganda.

PMID:36321534 | DOI:10.1093/jme/tjac166

Prim Health Care Res Dev. 2022 Nov 2;23:e66. doi: 10.1017/S1463423622000573.

ABSTRACT

OBJECTIVES: Symptom awareness campaigns have contributed to improved early detection of lung cancer. Previous research suggests that this may have been achieved partly by diagnosing lung cancer in those who were not experiencing symptoms of their cancer. This study aimed to explore the relationship between frequency of chest x-ray in the three years prior to diagnosis and stage at diagnosis.

SETTINGS: Lung cancer service in a UK teaching hospital.

PARTICIPANTS: Patients diagnosed with lung cancer between 2010 and 2013 were identified. The number of chest x-rays for each patient in the three years prior to diagnosis was recorded. Statistical analysis of chest x-ray frequency comparing patients with early- and late-stage disease was performed.

RESULTS: One-thousand seven-hundred fifty patients were included – 589 (33.7%) with stage I/II and 1,161 (66.3%) with stage III/IV disease. All patients had at least one chest x-ray in the six months prior to diagnosis. Those with early-stage disease had more chest x-rays in this period (1.32 vs 1.15 radiographs per patient, P = 0.009). In the period 36 months to six months prior to lung cancer diagnosis, this disparity was even greater (1.70 vs 0.92, radiographs per patient, P < 0.001).

CONCLUSIONS: Increased rates of chest x-ray are likely to contribute to earlier detection. Given the known symptom lead time many patients diagnosed through chest x-ray may not have been experiencing symptoms caused by their cancer. The number of chest x-rays performed could reflect patient and/or clinician behaviours in response to symptoms.

PMID:36321523 | DOI:10.1017/S1463423622000573

Asia Pac J Public Health. 2022 Nov 2:10105395221135407. doi: 10.1177/10105395221135407. Online ahead of print.

ABSTRACT

Evidence on the associations between built environment and overweight in children outside developed countries is scarce. We examined associations between access to local food and physical activity environments and overweight in 5- to 17-year-old Malaysians in two states with differing overweight levels. Information on children was measured in the National Health and Morbidity Survey 2015 and combined with Geographic Information System-derived data on local food and physical activity environments. Access to the built environment was measured by presence and distance from child’s residence. Complete data were available for 880 children. Access to local food outlets and parks was higher and associated with higher occurrence of overweight in children living in the state with higher overweight prevalence. When adjusted for sociodemographic factors, higher presence of and shorter distance to convenience stores and parks were associated with overweight. Both built environment and children’s sociodemographic backgrounds should be considered when planning interventions to curb the overweight epidemic in Malaysia.

PMID:36321506 | DOI:10.1177/10105395221135407

J Anim Ecol. 2022 Nov 2. doi: 10.1111/1365-2656.13832. Online ahead of print.

ABSTRACT

1. Uncovering the mechanisms behind animal space use patterns is of vital importance for predictive ecology, thus conservation and management of ecosystems. Movement is a core driver of those patterns so understanding how movement mechanisms give rise to space use patterns has become an increasingly active area of research. 2. This study focuses on a particular strand of research in this area, based around step selection analysis (SSA). SSA is a popular way of inferring drivers of movement decisions, but, perhaps less well-appreciated, it also parametrises a model of animal movement. Of key interest is that this model can be propagated forwards in time to predict the space use patterns over broader spatial and temporal scales than those that pertain to the proximate movement decisions of animals. 3. Here, we provide a guide for understanding and using the various existing techniques for scaling up step selection models to predict broad-scale space use patterns. We give practical guidance on when to use which technique, as well as specific examples together with code in R and Python. 4. By pulling together various disparate techniques into one place, and providing code and instructions in simple examples, we hope to highlight the importance of these techniques and make them accessible to a wider range of ecologists, ultimately helping expand the usefulness of step selection analysis.

PMID:36321473 | DOI:10.1111/1365-2656.13832