Tag: pubmed

Scand J Work Environ Health. 2022 Oct 30:4066. doi: 10.5271/sjweh.4066. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the relationship between occupational radiation exposure and circulatory disease (CD) mortality among medical radiation workers.

METHODS: The study included 53 860 male diagnostic medical radiation workers enrolled in the National Dosimetry Registry (NDR) between 1996 and 2011 in South Korea. NDR data were linked with mortality data obtained from the national registry at the end of 2019. Observed CD mortality rates in this population were compared to those in the general population using the standardized mortality ratio (SMR). The relative risk (RR) for occupational history was estimated by use of internal comparisons, and the excess relative risk (ERR) was used to quantify the radiation dose-response relationship.

RESULTS: A total of 320 deaths due to CD were identified among 53 860 male medical radiation workers. The SMR of CD was significantly lower among male workers than the general population. A linear dose-response model provided an estimated ERR per 100 mGy for CD [0.85, 95% confidence interval (CI) -0.11-1.82], ischemic heart disease (1.18, 95% CI -0.69-3.05), and cerebrovascular disease (0.23, 95% CI -0.48-0.94) with a 10-years lag, showing no statistical evidence of a radiation dose-response relationship. Additional adjustments for non-radiation factors did not affect the findings on occupational radiation risk for CD mortality. Sensitivity analyses excluding workers employed <1 year or who had exposure to a cumulative badge dose of ≥1 mSv showed similar results.

CONCLUSIONS: Occupational radiation doses were non-significantly positively associated with CD mortality among male diagnostic medical radiation workers. However, cautious interpretation is needed due to the limitations of short follow-up.

PMID:36309988 | DOI:10.5271/sjweh.4066

Musculoskeletal Care. 2022 Oct 30. doi: 10.1002/msc.1707. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Therapeutic glucocorticosteroid injections are commonly utilised to manage musculoskeletal (MSK) complaints. Following the SARS-CoV-2 pandemic, national guidelines advised against their use due to potential immunosuppressant effects. The aim of the study was to determine whether steroid injections for MSK conditions impacts on positive COVID 19 infection rates.

PATIENTS AND METHODS: This retrospective evaluation involved primary care participants who received a steroid injection for a MSK condition. 291 participants receiving a total of 299 steroid injections entered the study between the 25 September 2020 and the 29 April 2021.

RESULTS: Six participants had positive polymerase chain reaction (PCR) tests, averaging 22.83 days (SD 10.48) after the injection. An infection rate of 2.06% was demonstrated in the injection group with the control group demonstrating 6.97% (p = 0.000752) with statistical significance set at p = 0.05. The odds ratio was identified as 0.27 indicating a lower odds of a positive PCR test compared with the control group.

CONCLUSIONS: This retrospective evaluation found a low risk of positive PCR tests for low and moderate COVID-19 risk patients injected during the COVID-19 pandemic. Glucocorticosteroid injections within the COVID-19 pandemic were not associated with higher COVID-19 rates compared to the local population, in fact, they were related to lower rates. For future studies, large scale studies and meta analyses are needed to provide greater generalisation to the population.

PMID:36309979 | DOI:10.1002/msc.1707

CPT Pharmacometrics Syst Pharmacol. 2022 Oct 30. doi: 10.1002/psp4.12877. Online ahead of print.

ABSTRACT

The analysis aimed at identifying subject-specific characteristics (covariates) influencing exposure to daridorexant and quantification of covariate effects to determine clinical relevance. Data from 13 Phase 1, 2 Phase 2, and 2 Phase 3 studies were pooled to develop a population pharmacokinetic model describing daridorexant concentration over time. Covariate effects were quantified based on model predictions. A two-compartment model with dose-dependent bioavailability, absorption lag time, linear absorption, and nonlinear elimination described the data best. Statistically significant covariates were food status on absorption (lag time and rate constant), time of drug administration (morning, bedtime) on absorption rate constant, lean body weight on central volume of distribution and elimination, fat mass on peripheral volume of distribution and intercompartmental drug transfer, and age and alkaline phosphatase on elimination. Age, lean body weight, fat mass, and alkaline phosphatase influence exposure (AUC, t_max , C_max , and next-morning concentration) to a limited extent, i.e., less than 20% difference from a typical subject. Morning administration is not relevant for daridorexant use by insomnia patients. The food effect with simultaneous intake of high-fat high-calorie food is an extreme-case scenario unlikely to occur in clinical practice. Body composition, alkaline phosphatase, and age showed clinically negligible effects on exposure to daridorexant. Lean body weight and fat mass described the pharmacokinetics of daridorexant better than other body size descriptors (body weight, height, body mass index), suggesting a convenient physiological alternative to reduce the number of covariates in population pharmacokinetic models. The results indicate that differences between subjects do not require dose adjustments.

PMID:36309969 | DOI:10.1002/psp4.12877

Pest Manag Sci. 2022 Oct 30. doi: 10.1002/ps.7262. Online ahead of print.

ABSTRACT

BACKGROUND: Oryzophagus oryzae (Costa Lima) (Coleoptera: Curculionidae) is a major pest of flooded rice paddies throughout South America, and species with very similar life histories are present in many rice-producing regions of the world (collectively referred to here as RWWs). The damage caused by RWW larvae on rice cultivars with contrasting levels of resistance (‘BRS Pampa CL’= “Pamp”: susceptible, ‘BRS Atalanta’= “Atal”: resistant-antibiosis) was evaluated in two consecutive years in the field under seven infestation levels: 0, 2, 4, 6, 8, 10, and 20 adult couples per cage with plants.

RESULTS: Higher densities of adults increased the number of leaf-feeding scars and larvae on roots, respectively, at the rate up to 2.14 and 2.75 in “Pamp” and 2.23 and 2.48 in “Atal”, with the total number of larvae generated being lower in “Atal”. Grain yield was negatively impacted with increasing larval density on the roots, mainly by decreasing root volume and the number of grains per panicle. Root injury intensity and yield loss showed a non-linear relationship. It was found that significant yield losses occurred from 8.37 larvae per plant in “Pamp” and 9.80 larvae per plant in “Atal”.

CONCLUSION: The results provided the first evidence of a tolerance limit for RWW larval damage that, even though similar between cultivars of contrasting resistance, corresponds to twice the current conventional level for larval control in Brazil. We also discuss here the potential of applying tolerance limits to manage the RWW adult population in rice fields. This article is protected by copyright. All rights reserved.

PMID:36309968 | DOI:10.1002/ps.7262

Ann Nucl Med. 2022 Oct 30. doi: 10.1007/s12149-022-01797-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was performed to evaluate the prognostic meaning of volumetric and semi-quantitative parameters measured using [18F]FDG PET/CT and somatostatin receptor (SSTR) imaging in patients with typical lung carcinoid (TC), and their relationship with proliferative index (Ki67).

METHODS: We retrospectively reviewed 67 patients (38-94 years old, mean: 69.7) with diagnosis of TC who underwent [18F]FDG PET/CT and/or SSTR scintigraphy/SPECT with [111In]DTPA-Octreotide plus contrast-enhanced CT (CECT) at staging evaluation. All patients had Ki67 measured and a follow-up (FU) of at least 1 year. SSTR density (SSTRd) was calculated as the percentage difference of tumor/non-tumor ratio at 4 and 24 h post-injection. At PET/CT, metabolic activity was measured using SUVmax and SUVratio; volumetric parameters included MTV and TLG of the primary tumor, measured using the threshold SUV41%. ROC analysis, discriminant analysis and Kaplan-Meier curves (KM) were performed.

RESULTS: 11 patients died during FU. Disease stage (localized versus advanced), SUVratio, SUVmax, Ki67, MTV and TLG were significantly higher in non-survivors than in survivors. ROC curves resulted statistically significant for Ki67, SUVratio, SUVmax, MTV and TLG. On multivariate analysis, stage of disease and TLG were significant independent predictors of overall survival (OS). In KM curves, the combination of disease stage and TLG identified four groups with significantly different outcomes (p < 0.005). Metabolic activity (SUVmax and SUVratio) was confirmed as significant independent prognostic factor for OS also in patients with advanced disease, with the best AUC using SUVmax. In patients with advanced and localized disease, SSTRd proved to be the best imaging prognostic factor for progression and for disease-free survival (DFS), respectively. In localized disease, SSTRd 31.5% identified two subgroups of patients with significant different DFS distribution and in advanced disease, a high cutoff value (58.5%) was a significant predictor of adverse prognosis.

CONCLUSION: Volumetric and semi-quantitative parameters measured using [18F]FDG PET/CT and SSTR imaging combined with Ki67 may provide a reference for prognosis evaluation of patients with TC, to better stratify risk groups with the goal of developing individualized therapeutic strategies.

PMID:36309948 | DOI:10.1007/s12149-022-01797-7

AIDS Behav. 2022 Oct 30. doi: 10.1007/s10461-022-03906-z. Online ahead of print.

ABSTRACT

In South Africa, little is known about interrelationships between syndemic problems among people with HIV (PWH). A better understanding of syndemic problems may yield important information regarding factors amenable to mitigation. We surveyed 194 PWH in Khayelitsha, outside of Cape Town, South Africa. We used network analysis to examine the frequency of 10 syndemic problems and their interrelationships. Syndemic problems among PWH in South Africa were common; 159 (82.8%) participants reported at least 2 co-occurring syndemic problems and 90 (46.9%) endorsed 4 or more. Network analysis revealed seven statistically significant associations. The most central problems were depression, substance use, and food insecurity. Three clusters of syndemics were identified: mood and violence; structural factors; and behavioral factors. Depression, substance use, and food insecurity commonly co-occur among PWH in sub-Saharan Africa and interfere with HIV outcomes. Network analysis can identify intervention targets to potentially improve HIV treatment outcomes.

PMID:36309936 | DOI:10.1007/s10461-022-03906-z

Ann Neurol. 2022 Oct 30. doi: 10.1002/ana.26541. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the effect of additional mobile stroke unit (MSU) dispatch on functional outcomes among the full spectrum of stroke patients, regardless of subtype or potential reperfusion therapies contraindications.

METHODS: We used data from the nonrandomized Berlin-based B_PROUD study (02/2017-05/2019), in which MSUs were dispatched based solely on availability, and the linked B-SPATIAL stroke registry. All patients with final stroke or transient ischemic attack (TIA) diagnosis were eligible. The intervention under study was the additional dispatch of an MSU, an emergency physician-staffed ambulance equipped to provide prehospital imaging and thrombolytic treatment, compared to conventional ambulance alone. The primary outcome was the 3-month modified Rankin Scale (mRS) score, and the co-primary outcome was a 3-tiered disability scale. We identified confounders using Directed Acyclic Graphs and obtained adjusted effect estimates using inverse probability of treatment weighting.

RESULTS: MSUs were dispatched to 1,125 patients (mean age: 74y, 46.5% female), while for 1,141 only conventional ambulances were dispatched (75y, 49.9% female). After confounding adjustment, MSU dispatch was associated with more favorable 3-month mRS scores (common odds ratio, cOR=0.82; 95%CI: 0.71-0.94). No statistically significant association was found with the co-primary outcome (cOR=0.86; 0.72-1.01) or seven-day mortality (OR=0.94; 0.59-1.48).

INTERPRETATION: When considering the entire population of stroke/TIA patients, MSU dispatch improved 3-month functional outcomes without evidence of compromised safety. Our results are relevant for decision-makers since stroke subtype and treatment eligibility are unknown at time of dispatch. This article is protected by copyright. All rights reserved.

PMID:36309933 | DOI:10.1002/ana.26541

Int J Health Plann Manage. 2022 Oct 30. doi: 10.1002/hpm.3588. Online ahead of print.

ABSTRACT

BACKGROUND: Intermittent Preventive Therapy using Sulfadoxine Pyrimethamine (IPTp-SP) is a malaria control strategy to reduce cases of malaria in pregnancy in endemic countries. However, the administration of the recommended three doses of Intermittent Preventive Therapy (IPTp) throughout the stages of pregnancy still remains low in Nigeria. Limited knowledge by health workers on the administration of the recommended doses of IPTp to pregnant women receiving antenatal care (ANC) services is partly responsible for this gap. This study applied Quality Improvement (QI) approach to improve knowledge and practice among healthcare providers with respect to the administration of IPTp-SP.

METHODS: A quasi-experimental study design was carried out to evaluate the effect of QI approach consisting of training and coaching of healthcare providers to improve the administration of IPTp during ANC services. Primary Healthcare Centre Samaru was purposively selected and 11 healthcare providers participated in the study. The total duration of the intervention was for a period of 4 weeks which comprises of four training sessions conducted over a period of 2 weeks and four coaching sessions conducted for a period of another 2 weeks. The training package involved the use of the Information, Education and Communication approach of healthcare providers on IPTp administration while the coaching package involved supervision and follow-up meetings guiding healthcare providers on the protocol of IPTp administration. Antenatal care daily register was reviewed pre-intervention, intervention and post-intervention period of the study. Data were analysed using line graphs and run charts.

RESULTS: A total of 36 ANC visit weeks were observed between 21 November 2016 and 27 July 2017. There was overestimation of first dose of IPTp (IPTp1) as 8 of the 16 Weeks in the pre-intervention period had more than 100% of eligible women administered IPTp1. There was evidence indicating the process of IPTp1 was relatively stable post-intervention as the data crosses the median line only six times that is, 7 runs. This indicates that the process of IPTp1 was within normal variation over the post-intervention period. The patterns of IPTp2+ administrations shows the levels of IPTp2+ administration were erratic. There was an upward shift showing immediate improvement of the administration of IPTp2+ post-intervention.

CONCLUSIONS: The integrated training and coaching intervention approach improved the administration of the recommended three doses of IPTp within the context of a Primary Healthcare Centre. The data quality of the ANC daily register improved post-intervention.

PMID:36309932 | DOI:10.1002/hpm.3588

Transfusion. 2022 Oct 30. doi: 10.1111/trf.17165. Online ahead of print.

ABSTRACT

BACKGROUND: Platelets are part of innate immunity and comprise the cellular portion of hemostasis. Platelets express sex hormone receptors on their plasma membrane and sex hormones can alter their function in vitro. Little is known about how age and sex may affect platelet biology; thus, we hypothesized that platelets from males and females have different metabolomic profiles, which may be altered by age and in vitro treatment with sex hormones.

METHODS: Day 1 apheresis platelets were drawn from five 18-53-year-old, premenopausal younger females (YF), five ≥54-year-old, postmenopausal, older females (OF), five 18-44-year-old younger males (YM), and four ≥45-year-old older males (OM). Platelets were normalized to a standard concentration and metabolomics analyses were completed. Unsupervised statistical analyses and hierarchical clustering with principal component analyses were completed.

RESULTS: Platelets from OM had (1) elevated mono-, di- and tri-carboxylates, (2) increased levels of free fatty acids, acyl-carnitines, and free amino acids, and (3) increased purine breakdown and deamination products. In vitro incubation with sex hormones only affected platelets from OM donors with trends towards increased ATP and other high-energy purines and decreases in L-proline and other amino acids.

CONCLUSION: Platelets from OM’s versus YF, OF, and YM have a different metabolome implying increased energy metabolism, more free fatty acids, acylcarnitines, and amino acids, and increased breakdown of purines and deamination products. However, only platelets from OM were affected by sex hormones in vitro. Platelets from OM are metabolically distinct, which may impart functional differences when transfused.

PMID:36309927 | DOI:10.1111/trf.17165

J Burn Care Res. 2022 Oct 30:irac163. doi: 10.1093/jbcr/irac163. Online ahead of print.

ABSTRACT

Chronic airway illness is a well-documented inhalation injury side effect. Many pulmonary function impairments persisted for several months after lung parenchymal injury. Thus, the purpose of this study was to investigate the effects of inspiratory muscle training on respiratory muscle strength and pulmonary function (PFT) in patients who had suffered an inhalation injury. This study included male patients with inhalation injuries aged 20-35 years. Patients were chosen at random and assigned to an exercise group, which received inspiratory muscle training and routine chest physiotherapy, including early ambulation, coughing, and deep breathing, three times weekly for 4 weeks, and the control group, which only received routine chest physiotherapy. All participants were assessed for PFT and respiratory muscle strength at enrollment and the end of the study. The statistical analysis for outcome variables between both groups revealed no significant differences before treatment (P > 0.05) of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), maximal inspiratory pressure, and maximal expiratory pressure. According to the findings of this study, including IMT as part of a physical therapy program led to significant gains (P ˂ 0.05) in FVC and FEV1. However, after treatment, there was not a substantial difference found in either the MIP or the MEP between the groups. The exercise group performed better in terms of FVC, FEV1, MIP, and MEP after receiving treatment, according to these significant and non-significant differences.

PMID:36309913 | DOI:10.1093/jbcr/irac163