Tag: pubmed

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3718-3725. doi: 10.26355/eurrev_202205_28868.

ABSTRACT

OBJECTIVE: Our aim is to investigate the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients who received aminoglycoside antibiotics.

MATERIALS AND METHODS: A retrospective analysis was performed on the electronic medical record information of inpatients who received aminoglycoside (AG) antibiotics in our center from January 2018 to December 2020. The diagnosis of AKI was based on serum creatinine changes. Several statistical methods, including chi square test and two sample Wilcoxon rank sum test, were used to evaluate the epidemiological characteristics of aminoglycosides associated AKI. The multivariate logistic regression analysis was used to screen the risk factors.

RESULTS: Finally, 8,040 patients who received AGs were included in the study. Among them, 494 patients (6.14%) were judged as incidence with AKI, while only 29 patients were diagnosed with AKI in the medical record. The multiple logistic regression analysis suggested that admission to ICU, complicated with diabetes mellitus, heart failure, anemia, shock, combined use of diuretics, β-lactam antibiotics, proton pump inhibitors were independent risk factors for AKI related to aminoglycosides.

CONCLUSIONS: It is urgent to improve the understanding and attention of AKI for medical workers, and the assessment of risk factors before the use of aminoglycosides should be contributed to the early prevention, diagnosis, and treatment of AKI.

PMID:35647854 | DOI:10.26355/eurrev_202205_28868

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3787-3796. doi: 10.26355/eurrev_202205_28875.

ABSTRACT

OBJECTIVE: In a prospective study, SARS-CoV-2 IgG seroprevalence was assessed during the second pandemic wave (W2) in a cohort of Inflammatory Bowel Disease (IBD) patients using biologics. The secondary aim was to compare, in the same cohort, the frequency of seropositivity and of COVID-19 during the second vs. the first (W1) wave.

PATIENTS AND METHODS: From November 2020 to March 2021, SARS-CoV-2 IgG seropositivity and the prevalence of COVID-19 were assessed in a cohort of IBD patients using biologics already studied at W1.

INCLUSION CRITERIA: age ≥ 18 years; diagnosis of IBD; follow-up; written consent.

EXCLUSION CRITERIA: SARS-CoV-2 vaccination. Risk factors for infection, compatible symptoms, history of infection or COVID-19, nasopharyngeal swab test were recorded. Data were expressed as median [range]. The χ2 test, Student’s t-test, logistic regression analysis was used.

RESULTS: IBD cohort at W1 and W2 included 85 patients: 45 CD (52.9%), 40 UC (47.1%). When comparing the same 85 patients at W2 vs. W1, a higher SARS-CoV-2 seroprevalence at W2 was at the limit of the statistical significance (9.4% vs. 2.3%; p=0.05). The prevalence of COVID-19 at W2 vs. W1 was 3.5% (3/85) vs. 0% (0/85) (p=0.08). Contacts with COVID-19 patients and symptoms compatible with COVID-19 were more frequent at W2 vs. W1 (18.8 % vs. 0%; p=0.0001; 34.1% vs. 15.3%; p=0.004). At W2, history of contacts and new onset diarrhea were more frequent in seropositive patients [4/8 (50%) vs. 12/77 (15.6%); p=0.01 and 4/8 (50%) vs. 2/77 (2.6%); p=0.0001]. At W2, the risk factors for seropositivity included cough, fever, new onset diarrhea, rhinitis, arthromyalgia, dysgeusia/anosmia at univariate (p<0.05), but not at multivariate analysis. History of contacts was the only risk factor for seropositivity at univariate (p=0.03), but not at multivariate analysis (p=0.1).

CONCLUSIONS: During W2, characterized by a high viral spread, IBD and biologics appeared not to increase the prevalence of SARS-CoV-2 infection or COVID-19 disease. New onset diarrhea mimicking IBD relapse may be observed in patients with SARS-CoV-2 infection.

PMID:35647861 | DOI:10.26355/eurrev_202205_28875

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3686-3694. doi: 10.26355/eurrev_202205_28864.

ABSTRACT

OBJECTIVE: This study aims to investigate the relationship between postoperative infection-related mortality and lymphocyte-to-C-reactive protein ratio (LCR), a newly defined parameter with the combination of inflammatory and immune parameters, in patients undergoing cardiac surgery.

PATIENTS AND METHODS: Between January 2016 and November 2021, 236 patients who underwent on-pomp cardiac surgery with median sternotomy and developed postoperative infection were analyzed retrospectively. Patients were divided into six groups according to the types of postoperative infection. Preoperative, perioperative, and postoperative variables of the patient groups were compared, and factors affecting postoperative mortality were evaluated.

RESULTS: The mortality rate in the patient group we included in the study was 22.9%. Mortality rates did not differ significantly between the infection groups. However, when the LCR value was evaluated between the groups, there was a statistically significant difference (p<0.001). The preoperative LCR cut-off value, which predicts postoperative infection-related mortality, was determined as 133.46 (area under the curve (AUC): 0.607, p=0.017, 48.1% sensitivity, and 47.8% specificity). In the multivariate analysis, postoperative cerebrovascular event (OR: 78.365, 95% CI: 12.367-496.547, p<0.001) and Intensive Care Unit (ICU) stay (odds ratio (OR): 1.136, 95% confidence interval (CI): 1.004-1.284, p=0.042) variables were found to be independent predictive factors of postoperative infection-related mortality in the model. There was no positive differentiation of the type of infection in predicting mortality.

CONCLUSIONS: The calculated LCR value is a novel and remarkable parameter in estimating postoperative infection-related mortality in patients undergoing cardiac surgery.

PMID:35647850 | DOI:10.26355/eurrev_202205_28864

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3593-3598. doi: 10.26355/eurrev_202205_28855.

ABSTRACT

OBJECTIVE: Malnutrition is a common condition, especially among hospitalized patients which are overlooked by many clinicians. Malnutrition was found to be associated with increased hospitalization duration, increased admission frequency, increase in infection frequency and severity, bad wound healing, gait disturbances, fallings, and fractures. In this study, we aimed to determine malnutrition frequency in patients who were admitted to the emergency department for non-trauma causes and hospitalized.

PATIENTS AND METHODS: 245 patients were admitted to the Emergency Department for non-trauma causes and hospitalized and 245 control group patients were included in this study. Hospitalized patients were assessed with NRS-2002 (Nutritional Risk Screening) and Mini Nutritional Assessment (MNA). Age, gender, height, weight, body mass index (BMI), malnutrition status, and wards of the patients were screened.

RESULTS: 140 (57.1%) of the hospitalized patients had malnutrition according to NRS-2002 and MNA. There was a statistically significant difference between the control group and the hospitalized patients who were malnourished (Pearson chi-square test; p<0,001). There was a significant relation between hospitalized departments and malnutrition (p<0.05). There was a significant difference in age and height between hospitalized patients and the control group (p<0.0001) whereas no significant difference was found between the height and BMI (p>0.05). There was a significant relationship in terms of hospitalization and malnutrition.

CONCLUSIONS: The nutritional state of the patients admitted to the emergency department for non-trauma conditions is an important factor and should not be overlooked.

PMID:35647841 | DOI:10.26355/eurrev_202205_28855

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3522-3533. doi: 10.26355/eurrev_202205_28847.

ABSTRACT

OBJECTIVE: Glioblastoma (GBM) is the most common and aggressive primary malignant tumor of the central nervous system in adults with high recurrence and mortality rates. Although radiotherapy and temozolomide have become the standard therapeutic regimen for GBM as adjuvant chemoradiotherapy after surgical resection, clinical outcomes remain suboptimal. In recent years, targeted antiangiogenic therapy has attracted considerable attention, but its therapeutic efficacy and safety are still controversial.

MATERIALS AND METHODS: Randomized controlled trials (RCTs) of chemoradiotherapy with or without bevacizumab for the treatment of glioblastoma were collected by searching on the Pubmed, Embase, Cochrane, Ovid, Scopus, Web of Science, and Google Scholar databases from the date of database establishment to February 2022. Meta-analysis was performed using RevMan 5.3 software after two investigators independently screened the literature, extracted data, and assessed the risk bias of included studies.

RESULTS: A total of 7 RCTs were included. The meta-analysis showed that bevacizumab in combination with chemoradiotherapy was superior to chemoradiotherapy alone in terms of progression-free survival (PFS), with a statistically significant difference. Interestingly, bevacizumab in combination with chemoradiotherapy improved PFS more significantly in recurrent glioblastoma than in newly diagnosed glioblastoma. However, for overall survival (OS), the combination of bevacizumab with chemoradiotherapy was similar to chemoradiotherapy alone, which was not significantly different. With regard to safety, the incidence of most adverse events was higher in the combination of bevacizumab and chemoradiotherapy than in chemoradiotherapy alone, especially in terms of hematologic adverse events.

CONCLUSIONS: Current evidence suggests that angiogenesis inhibitor-containing chemoradiotherapy regimens are preferentially recommended for patients with recurrent glioblastoma to prolong their progression-free survival, provided that safety is acceptable, but this does not confer a significant benefit on overall patient survival.

PMID:35647833 | DOI:10.26355/eurrev_202205_28847

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3493-3505. doi: 10.26355/eurrev_202205_28844.

ABSTRACT

OBJECTIVE: Vitamin D deficiency is a significant problem that affects the population living in most countries. This issue is independent by place of residence, sex, age or skin color. It is mainly influenced by the environment we live in and by an unhealthy lifestyle, including bad eating habits. The aim of this study was to evaluate lipid profile, glucose levels, and vitamin D levels, considering sociodemographic variables, smoking and alcohol consumption in perimenopausal women. Depressive mood was also assessed considering sociodemographic variables and vitamin D levels.

PATIENTS AND METHODS: The study was conducted on a group of 191 women and performed in two stages. The first of them was carried out using a diagnostic survey with the use of a technique questionnaire. The applied research instruments were the author’s questionnaire (concerning sociodemographic and selected medical data), and the Beck Depression Inventory. The second stage of the study involved the collection of peripheral blood from each respondent, in order to determine lipid profile, glycemia and serum vitamin D levels.

RESULTS: The age of the female respondents ranged from 45 to 65 years, mean age was 53.1 ± 5.37 years, median 53 years. Vitamin D levels were below normal in 78%; 77% had elevated total cholesterol levels; 91.6% of the respondents had high density lipoprotein (HDL) cholesterol levels within the normal range; 64.4% was characterized by too high (low-density lipoprotein) LDL cholesterol, and 84.8% of the women showed normal triglyceride levels. Among the respondents, 91.1% had normal glycemic levels. Analysis of the collected data showed a weak negative correlation between serum vitamin D levels and the levels of total cholesterol (rho=-0.14; p=0.05), LDL cholesterol (rho=-0.16; p=0.026), and triglycerides (rho=-0.22; p=0.002). Only in the case of HDL cholesterol (p=0.067), there was no statistically significant correlation. There were also no statistically significant correlations between serum vitamin D levels and glycemia or severity of depression.

CONCLUSIONS: 1. The majority of the women did not manifest depressive disorders. Of all factors analyzed, only education was associated with the severity of depressiveness. 2. Smoking adversely affected serum vitamin D levels in the studied women. 3. The cessation of menstruation affected carbohydrate metabolism and vitamin D levels. Blood glucose levels increased with the age of the studied women. 4. Relationships were found between the levels of vitamin D and the levels of total cholesterol, LDL cholesterol, and triglycerides. Therefore, it is important to maintain normal vitamin D levels.

PMID:35647830 | DOI:10.26355/eurrev_202205_28844

Phys Chem Chem Phys. 2022 Jun 1. doi: 10.1039/d2cp01699k. Online ahead of print.

ABSTRACT

Nitration of benzene is a representative aromatic substitution reaction related to the σ-complex (arenium ion or “Wheland” intermediate) concept. This reaction is typically carried out in a mixed acid solution to generate nitronium ions, and how solvent molecules play roles in the reaction has been of great interest. Here we will shed new light on the reaction, namely the electronic structure and the microscopic insights of the solvation, which have been rarely discussed so far. We studied this process using the reference interaction site model-self consistent field with constrained spatial electron density distribution (RISM-SCF-cSED) method, considering sulfuric acid or water molecules as a solvent. In this method, the electronic structure of the solute and the solvation structure are self-consistently determined based on quantum chemistry and statistical mechanics of molecular liquids. The solvation free energy surfaces in solution and solvation structures were verified. In the bond formation process of benzene and nitronium ions, the solvation structure by sulfuric acid molecules drastically changes and the solvation effect on the free energy is quite large. We revealed largely contributing resonance structures in the π-electron system of the σ-complex in gas and solution phases by analysing the valence electronic structures.

PMID:35647764 | DOI:10.1039/d2cp01699k

Eur Rev Med Pharmacol Sci. 2022 May;26(10):3444-3449. doi: 10.26355/eurrev_202205_28838.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of 0.2% hyaluronic acid gel and 0.01% hyaluronic acid (HA) spray in the healing of extraction wounds using the ruler and digital planimetry method.

PATIENTS AND METHODS: 30 systemically healthy female participants aged between 20-60 years requiring extraction were selected. Extraction sockets receiving 0.2% HA gel Gengigel®, 0.01% HA spray Gengigel®, and where hyaluronic acid was excluded were allocated into three groups as test group A (HA gel group), test group B (HA spray group) and control group (without HA). Socket wound closure was measured post-operative on the day of extraction and 1-week post extraction using digital planimetry and ruler method. Patient satisfaction rate was evaluated for both the gel and spray.

RESULTS: The wound closure with the ruler method was 43.01% for the control group, 67.01%, and 65.82% for the gel group and spray group respectively. The wound closure with the digital planimetry method was 47.97% for the control group, 69.08% for the gel group, and 66.94% for the spray group. The gel showed better results of wound closure as compared to the spray. However, the results were not statistically significant.

CONCLUSIONS: Hyaluronic acid offers a beneficial effect in early post-operative healing after extraction.

PMID:35647824 | DOI:10.26355/eurrev_202205_28838

Nurs Crit Care. 2022 Jun 1. doi: 10.1111/nicc.12781. Online ahead of print.

ABSTRACT

BACKGROUND: A spontaneous breathing trial (SBT) is recommended to help patients to liberate themselves from mechanical ventilation as soon as possible in the ICU. The respiratory workload in SBT, which depends on being with or without respiratory support and a specific time, is more accurate to reflect how much support the weaning patients need compared with only considering SBT technologies.

AIM: To compare and rank the effectiveness of different respiratory workloads during SBT via differing technologies (Pressure Support Ventilation and T-piece) and differing duration (30 and 120 min) in SBTs.

STUDY DESIGN: A comprehensive literature search was performed in six English electronic databases to identify eligible randomized controlled trials (RCTs) published before September 2020. The pooled risk ratio (RR) with 95% confidence interval (CI) was calculated by Markov chain Monte Carlo methods. A Bayesian network meta-analysis was conducted using “gemtc” version 0.8.2 of R software. Each intervention’s ranking possibilities were calculated using the surface under the cumulative ranking analysis (SUCRA).

RESULTS: A total of nine RCTs including 3115 participants were eligible for this network meta-analysis involving four different commonly used SBT strategies and four outcomes. The only statistically significant difference was between Pressure Support Ventilation (PSV) 30 min and T-piece 120 min in the outcome of the rate of success in SBTs (RR = 0.91; 95% CI, 0.84-0.98). The cumulative rank probability showed that the rate of success in SBT from best to worst was PSV 30 min, PSV 120 min, T-piece 30 min and T-piece 120 min. PSV 30 min and PSV 120 min are more likely to have a higher rate of extubation (SUCRA values of 82.5% for 30 min PSV, 70.7% for 120 min PSV, 36.4% for T-piece 30 min, 10.4% for T-piece 120). Meanwhile, T-piece 120 min (SUCRA, 62.9%) and PSV 120 min (SUCRA, 60.9%) may result in lower reintubation rates, followed by T-piece 30 min (SUCRA, 41.8%) and PSV 30 min (SUCRA, 34.4%).

CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: In comprehensive consideration of four outcomes, regarding SBT strategies, 30-min PSV was superior in simple-to-wean patients. Besides, 120-min T-piece and 120-min PSV are more likely to achieve a lower reintubation rate. Thus, the impact of duration is more significant among patients who have a high risk of reintubation. It is still unclear whether the SBTs affect the outcome of mortality; further studies may need to explore the underlying mechanism.

PMID:35647738 | DOI:10.1111/nicc.12781

Pediatr Transplant. 2022 Jun 1:e14324. doi: 10.1111/petr.14324. Online ahead of print.

ABSTRACT

BACKGROUND: Cytomegalovirus infection represents a significant cause of morbidity and mortality after hematopoietic stem cell transplantation. This study aimed to evaluate the incidence of viremia and disease due to cytomegalovirus and the risk factors in pediatric patients with hematopoietic stem cell transplantation in our institution.

METHODS: This was a retrospective cohort of patients under 19 years of age who underwent allogeneic hematopoietic stem cell transplantation due to any indication between 2012 and 2019. The analysis included the diagnosis of cytomegalovirus viremia or disease during post-transplant follow-up, evaluation of risk factors, and outcomes. The statistical analysis included univariate and multivariate analyses, and the cumulative incidence of cytomegalovirus viremia was determined by the Kaplan-Meier method using STATA 14 statistical software.

RESULTS: A total of 182 transplants were included. At 100 days, the cumulative incidence of cytomegalovirus viremia was 70.5%, and that of cytomegalovirus disease was 4.7%. Overall survival at 2 years was 74%, and event-free survival was 64%. The remaining demographic characteristics were not predictors of infection. There was no association between viremia and relapse or survival of the patients. Higher mortality was noted in cytomegalovirus disease.

CONCLUSIONS: During the study period, the incidence of cytomegalovirus disease was similar to that of other pediatric reports, but the incidence of viremia was higher. Pre-emptive therapy has diminished disease rates and death due to infection. Viral load cutoff points should be standardized to guide treatment and avoid myelotoxicity.

PMID:35647735 | DOI:10.1111/petr.14324