Tag: pubmed

Cancer Med. 2022 Sep 2. doi: 10.1002/cam4.5185. Online ahead of print.

ABSTRACT

BACKGROUND: Blood neutrophil to lymphocyte ratio (NLR) or lymphocyte count may be important markers for immune function. Previous work has shown higher NLR was associated with higher risk of hepatitis B-related hepatocellular carcinoma (HCC). However, studies in non-alcoholic fatty liver disease (NAFLD) patients are lacking.

METHODS: Utilizing the University of Pittsburgh Medical Center (UPMC) electronic health records, we created a retrospective cohort of 27,834 patients diagnosed with NAFLD from 2004 to 2018 with complete NLR data. After an average 5.5 years of follow-up, 203 patients developed HCC. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of HCC incidence associated with different levels of NLR and lymphocyte count.

RESULTS: Compared with the lowest tertile of NLR (<1.97), the highest tertile of NLR (≥3.09) was statistically significantly associated with a 43% higher risk of HCC incidence (HR = 1.43, 95% CI: 1.01-2.03, p_trend = 0.031) after adjustment for age, sex, race, body mass index, smoking status, history of type 2 diabetes, hyperlipidemia, hypertension, and fibrosis-4 score category. Conversely the highest tertile of lymphocyte count (≥2.15 K/ul) was significantly associated with a 36% lower risk of HCC (HR = 0.64, 95% CI: 0.43-0.94, p_trend = 0.028) compared to the lowest tertile (<1.55 K/ul). There was no association between neutrophil count and HCC risk.

CONCLUSIONS: Higher NLR and lower lymphocyte count are associated with significantly higher risk of HCC among NAFLD patients. These findings warrant further investigation of immune response and surveillance in association with HCC development in NAFLD patients.

PMID:36052483 | DOI:10.1002/cam4.5185

Contemp Nurse. 2022 Sep 2:1-22. doi: 10.1080/10376178.2022.2107038. Online ahead of print.

ABSTRACT

AIM: To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).

METHODS: We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).

RESULTS: At 90-days, 47.9% (n = 69) had a good prognosis (mRS ≤ 2) including 22.2%(n = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (n =70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (p = 0.02), nasogastric tube (p＜0.001), indwelling urinary catheter (p＜0.001), central venous catheter (p = 0.03), health knowledge needs of pressure injury prevention (p = 0.03), National Institute of Health Stroke Scale (NIHSS) score (p＜0.001) and Activities of Daily Living (ADL) score (p＜0.001) at the time of discharge from hospital. The average hospitalisation time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalisation was $Y$21291.93 (SD 9165.01).

CONCLUSION: Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.

IMPACT STATEMENT: We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.

PMID:36052463 | DOI:10.1080/10376178.2022.2107038

Ann Ital Chir. 2022;92:369-373.

ABSTRACT

AIM: This single-tertiary non-Covid center retrospective study analyses the impact on Covid-19 pandemic on the presentation and the treatment in patients operated for acute appendicitis.

METHODS: Total number of 152 patients operated for acute appendicitis in two separate periods (April – August 2019, and April – August 2020), were subjected to retrospective analysis. Patients were divided in two groups: pre-pandemic Group A and pandemic Group B.

RESULTS: Eighty one patient was operated in the pandemic period and the rest 71 one year ago in the same period. Preoperative C-reactive protein levels presented statistically higher in the pandemic group (p = 0.0455). Time from admission to surgery was shorter in the pandemic group (7.5 ± 4.6 vs 5.8 ± 4.9; p = 0.0155). Overall operative time and the laparoscopic operative time were statistically longer in the pandemic group (68.8 vs. 76.8 minutes; p = 0.039 and 60.04 vs 74.0 minutes; p = 0.0141, respectively). Complicated appendicitis rates were similar, although periappendicular abscess was more common in the pandemic group, but without statistical significance. Length of stay was shorter in the pandemic group (p = 0.53).

CONCLUSION: Our data showed that during the Covid-pandemic, acute appendicitis surgery is safe and feasible with results equal to the prepandemic period.

KEY WORDS: Appendicitis, Appendectomy, Covid.

PMID:36052461

Ann Ital Chir. 2022;92:263-270.

ABSTRACT

AIM: We aimed to evaluate (immunohistochemically) the YAP expression in breast cancer patients undergoing neoadjuvant chemotherapy and to clarify the relationship between the molecular characteristics, treatment response and survival data and the YAP expression, and hence, to clarify the prognostic significance.

MATERIAL AND METHODS: One hundred and four patients who were diagnosed with Breast Cancer between 2015-2020 and underwent Neo Adjuvant Chemotherapy were included in the study. Estrogen Receptor(ER), Progesterone Receptor(PR), Human Epidermal Growth Receptor-2(HER2) and Ki-67. Expression are routinely stained immunohistochemically. In this study, existing immunohistochemical markers were reviewed and also, the relationship of YAP with these biological markers was evaluated by using immunohistochemistry and its effect on prognosis has been investigated.

RESULTS: The average age of the patients was 52.37. While YAP was positive in 78 patients (75%), it was negative in 26 patients (25%). In the evaluation after neoadjuvant therapy, pathological complete response (MillerPayne Grade5 response) in 28 patients (26.9%), relapse in 6 patients (5.8%), and exitus in 6 patients (5.8%) were detected. In the pathological evaluation, invasive Ductal Carcinoma was the most common one observed in 88 patients (84.6%). As a result of the statistical evaluation, no significant result was obtained between the parameters and YAP negative/positive.

CONCLUSION: As a result of staining with additional YAP in patients who were diagnosed with breast cancer and routinely stained with ER, PR, Cerb B2 and Ki-67 in pathology samples, we could not reach a result that would contribute positively to survival. Longer studies to be conducted prospectively will be meaningful.

KEY WORDS: Breast Cancer, Chemotherapy, Neoadjuvant, Yes Associated Protein.

PMID:36052460

J Interpers Violence. 2022 Sep 1:8862605221119515. doi: 10.1177/08862605221119515. Online ahead of print.

ABSTRACT

Violence against women has been the subject of scientific literature in many fields and poverty has been one of the most important companions in this field. It can be found lots of empirical studies about violence against women for countries as Turkey too. However, regional considerations relating to people’s socioeconomic condition have not been considered in these investigations although it has been indicated that these factors are important in terms of violence against women. Therefore, the main motivation of this study to investigate the impact of poverty on partner violence against women under the regional impacts in Turkey. The multinomial logit analysis preferred since the violence against women considered under three groups which are physical, sexual violence, and never experienced. The dataset received from the Survey on Domestic Violence Against Women in Turkey which was performed by Turkish Statistical Institute (TURKSTAT). This survey is performed in both 2008 and 2014 years. For this study, the 2008 data is chosen as it carries the information of “having a green card” which is a formal demonstration of being poor. Also, NUTS 2 (Nomenclature of territorial units for statistics) regions for Turkey are considered during the analysis. Based on the general results, the poverty status and regional effects of women, showed quite different results in terms of physical and sexual violence types. The poverty has a positive effect only on physical violence, not on sexual violence. Further, all regions have an important role on physical violence, while only less developed regions have a dominant impact on sexual violence. Also, the findings show that the intimate partners’ bad habits make women more vulnerable to violence. According to the results, it can be suggested that developing policies based on regional effects and types of violence would be more effective.

PMID:36052441 | DOI:10.1177/08862605221119515

Eur J Ophthalmol. 2022 Sep 1:11206721221124673. doi: 10.1177/11206721221124673. Online ahead of print.

ABSTRACT

AIM: To evaluate corneal morphology after use of 0.5% intracameral moxifloxacin (ICM) in cataract surgery in patients who presented late with hard cataracts.

METHODS: Cross-sectional study conducted from June-2021 to December-2021 at a tertiary eye-care center. 90 patients over 60 years with high-risk characteristics for Covid-19, who presented late with higher grades of nuclear-sclerosis (NS), were included. They underwent phacoemulsification and 0.5%moxifloxacin (0.1 ml) was injected intracamerally at the end of surgery. Best-corrected visual acuity (BCVA), intraocular pressures (IOP), endothelial cell density (ECD), coefficient of variation in cell-area (CoV), hexagonality (Hex) and central corneal thickness (CCT) were measured preoperatively and postoperatively on day1, day7 and day30. Statistical analysis was done by Anova test. p-value<0.05 was considered significant.

RESULTS: Mean age of presentation was 65.26±8.3 years. Mean preoperative BCVA (1/60-to-6/60), IOP (16.7±2.3 mm of Hg), CCT (523.93±39.6µ), ECD (2547±302.08cells/mm²), Hex (47.04±5.7%) and CoV (37.57±3.9) changed to BCVA (6/9-to-6/6), IOP (17.5±2.1 mm of Hg), CCT (538.42±36.9µ), ECD (2388.40±339.25cells/mm²), Hex (44.44±5.6%) and CoV (39.09±4.5) at day30 postoperative. Average rate of change at day30 was increase in CCT (2.89%), ECD loss (6.4%), decrease in Hex (4.9%) and increase in CoV (4.6%), though clinically insignificant. No case of endophthalmitis or toxic-anterior segment syndrome seen.

CONCLUSION: 0.5% moxifloxacin (0.1 ml) is safe as intracameral antibiotic to prevent postoperative infection in high-risk patients. The reported changes in the corneal parameters were within the range of any routine surgeries of hard senile cataracts. No specific effect could be attributed to ICM.

PMID:36052419 | DOI:10.1177/11206721221124673

Ther Adv Drug Saf. 2022 Aug 23;13:20420986221080795. doi: 10.1177/20420986221080795. eCollection 2022.

ABSTRACT

BACKGROUND: There has been a rising prevalence of polypharmacy among people living with HIV (PLWH). Uncertainty however remains regarding the exact estimates of polypharmacy among these cohorts of patients.

METHODS: We conducted a systematic search of PubMed; EMBASE, CROI, Cochrane Database of Systematic Reviews; Science Citation Index and Database of Abstracts of Reviews of Effects for studies between 1 January 2000 and 30 June 2021 that reported on the prevalence of polypharmacy (ingestion of > 5 non-ART medications) among PLWH on antiretroviral therapy regimen (ART). Prevalence of polypharmacy among HIV-positive patients on ART with Clopper-Pearson 95% confidence intervals were presented. The heterogeneity between studies was evaluated using I2 and τ2 statistics.

RESULTS: One hundred ninety-seven studies were initially identified, 23 met the inclusion criteria enrolling 55,988 PLWH, of which 76.7% [95% confidence interval (CI): 76.4-77.1] were male. The overall pooled prevalence of polypharmacy among PLWH was 33% (95% CI: 25-42%) (I ² = 100%, τ² = 0.9170, p < 0.0001). Prevalence of polypharmacy is higher in the Americas (44%, 95% CI: 27-63%) (I ² = 100%, τ² = 1.0886, p < 0.01) than Europe (29%, 95% CI: 20-40%) (I ² = 100%, τ² = 0.7944, p < 0.01).

CONCLUSION: The pooled prevalence estimates from this synthesis established that polypharmacy is a significant and rising problem among PLWH. The exact interventions that are likely to significantly mitigate its effect remain uncertain and will need exploration by future prospective and systematic studies.

REGISTRATION: PROSPERO: CRD42020170071.

PLAIN LANGUAGE SUMMARY: Background: In people living with HIV (PLWH), what is the prevalence of polypharmacy and is this influenced by sociodemographic factors?Methods and Results: In this systematic review and meta-analysis of 23 studies comprising 55,988 participants, we have for the first time found an estimated polypharmacy pooled prevalence of 33% among PLWH. There was a relatively higher pooled prevalence of polypharmacy among the America’s compared with European cohorts of PLWH.Conclusion: Polypharmacy among PLWH is a rising morbidity that needs urgent intervention both at policy and patient levels of care.

PMID:36052397 | PMC:PMC9425890 | DOI:10.1177/20420986221080795

Indian J Orthop. 2022 Jun 27;56(9):1601-1612. doi: 10.1007/s43465-022-00677-6. eCollection 2022 Sep.

ABSTRACT

INTRODUCTION: There is no distinct classification system to evaluate the bone defect in previously managed acetabular fractures. We propose a new classification system for bone defect evaluation in a previously managed acetabular fracture that will be helpful for total hip arthroplasty (THA).

MATERIALS AND METHODS: The preoperative pelvis radiographs of 99 THA patients with previous acetabular fractures with at least 2 years of follow-up were evaluated by 10 experienced surgeons (Paprosky and new classification systems). As per the new classification system, the five types of bone defects are circumferential, posterior wall, posterior column, both column defect, and anterior column. The interobserver and intraobserver reliability was calculated, and a consensus management plan based on the recommendation of the observers was formulated.

RESULTS: There was fair interobserver reliability for Paprosky classification (alpha coefficient 0.39) and substantial interobserver reliability for the new classification (alpha co-efficient 0.71). There was a substantial intraobserver agreement for the new classification (kappa value 0.80) and moderate intraobserver agreement for Paprosky classification (kappa value 0.55). Sixty-nine patients who were treated as per the management plan of the observers reported significant improvement in modified Harris hip score (improved from 25 to 85.88, p < 0.001). 89.7% of patients reported good to excellent outcomes. Overall best health as per EQ-5D VAS was obtained in THA following anterior column fracture (EQ-5D VAS 97.5), and relatively poor health was obtained after THA of posterior column nonunion (EQ-FD VAS 80).

CONCLUSIONS: The new classification system for bone defect evaluation in previously treated acetabular fractures is valid and reliable. The proposed surgical plan for the management of bone defects in THA provided good to excellent outcomes.

PMID:36052394 | PMC:PMC9385917 | DOI:10.1007/s43465-022-00677-6

J Am Anim Hosp Assoc. 2022 Sep 1;58(5):249-253. doi: 10.5326/JAAHA-MS-7249.

ABSTRACT

Antimicrobial stewardship is becoming more important every day with increasing bacterial resistance and limitations on antibiotics. Prophylactic antibiotics are not necessary with all procedures, which has been shown previously with a variety of human and veterinary surgeries. Medical records were retrospectively evaluated for cases who had a cutaneous punch biopsy performed between 2013 and 2018 including the following information: species, signalment, concurrent diseases, concurrent medications, location of biopsy, histopathologic diagnosis, and bacterial infections postoperatively. The prevalence of secondary infections, due to punch biopsies in all animals, was 1.9% and further divided into 2.3% (3/128) of dogs and 0% (0/26) of cats. It was determined that the relative risk of developing complications from punch biopsy was 0.06 (0.01-0.93) when diagnosing a dermatologic disease versus a cutaneous mass (neoplastic and nonneoplastic), which was statistically significant. The risk increased 2.16 (0.16-59.91) times if the biopsy site was the trunk, which includes the neck, thorax, and abdomen. These results indicate that in veterinary medicine, postoperative complications are uncommon with cutaneous punch biopsies. The administration of prophylactic antibiotics in dogs and cats is unnecessary when performing a punch biopsy when there is no infection present at the time of biopsy.

PMID:36049237 | DOI:10.5326/JAAHA-MS-7249

Horm Mol Biol Clin Investig. 2022 Sep 1. doi: 10.1515/hmbci-2022-0003. Online ahead of print.

ABSTRACT

OBJECTIVES: Secreted by white adipose tissue, asprosin is a newly recognized adipokine whose physiological function is not well comprehended. This study intended to determine the effect of spinning and stationary cycling on serum asprosin levels in overweight women.

METHODS: Forty-five overweight women with BMI>25 kg/m² in the age range of 30-40 years were assigned randomly to three groups of 15 participants: control, spinning (group cycling with music), and stationary bike (individual pedaling on a stationary bike). The participants performed the exercises three sessions per week for six weeks. Lipid profile and asprosin levels were measured by enzymatic and ELISA methods, respectively. Moreover, the paired t-test and one-way ANOVA were employed to make within-group and between-group comparisons, respectively.

RESULTS: The stationary cycling and spinning exercise groups experienced significant reductions in weight, BMI, serum triglyceride, and asprosin levels from the pretest to the posttest. The control group showed no statistically significant differences. Serum concentrations of total cholesterol and low-density lipoprotein only declined in the spinning group. In this regard, neither the control group nor the stationary bicycle exhibited no significant change over time. The spinning group demonstrated a significant rise in high-density lipoprotein levels, which was not observed in the control group. In addition, there was no significant difference in WHR index between the intervention groups.

CONCLUSIONS: By lowering the serum asprosin level, a spinning exercise program appears to be effective in reducing disorders linked to metabolic diseases in overweight women.

PMID:36049225 | DOI:10.1515/hmbci-2022-0003