Tag: pubmed

BMC Endocr Disord. 2022 May 23;22(1):136. doi: 10.1186/s12902-022-01047-x.

ABSTRACT

BACKGROUND: Microvascular complications lead to disability, dependency, and accelerated morbidity and mortality. This study aimed to identify predictors of blood glucose change and time to microvascular complications among patients with type 2 diabetes.

METHODS: A retrospective cohort study was conducted among type 2 diabetes mellitus patients enrolled between December 2014 and December 2015 at Felege Hiwot and Debre Markos Referral Hospital. A total of 318 T2DM patients were included in the study. Joint modelling of longitudinal and survival analysis was employed to identify predictors of Blood Glucose Change and Microvascular Complications in Type 2 Diabetes Mellitus Patients.

RESULTS: The prevalence of microvascular complications in Type 2 diabetes patients was 26.3%, 95%confidence interval(CI):(21.5, 31.1). Of which, half of the patients developed a microvascular complication after 30 months from the onset of the follow-up. The significant predictors of developing microvascular complication were positive proteinurea (adjusted hazard ratio (AHR) = 1.418, 95%CI: 1.080, 1.861), Serum creatinine (AHR = 3.704, 95%CI: 1.992, 6.887), Weight (AHR = 1.058, 95%CI: 1.023, 1.094), and log fasting blood glucose(log(FBS))(AHR = 1.013, 95%CI: 1.010, 1.015). The predictors of fasting blood glucose progression were higher baseline FBS(est(estimate) = 0.002,95%CI:0.0018, 0.0022), Systolic blood pressure (SBP) (est = 0.003, 95%CI: 0.002, 0.004), diastolic blood pressure (DBP) (est = 0.002, 95%CI: 0.0002, 0.004), and age (est = 0.003, 95%CI: 0.001, 0.004).

CONCLUSION: The progression of the fasting blood glucose level for rural patients was faster than for urban patients. Patients having higher baseline FBS, previous hypertension history, higher SBP, higher DBP, older age, and fewer visits to the hospital have a relatively more progressive change in blood sugar levels. Patients having higher triglyceride levels, positive proteinuria, higher fasting blood sugar, higher weight, and a lesser number of hospital visits have a higher risk of developing a complication. In response to this finding, an aggressive intervention that targets to prevent microvascular complications is required.

PMID:35606785 | DOI:10.1186/s12902-022-01047-x

BMC Oral Health. 2022 May 23;22(1):197. doi: 10.1186/s12903-022-02234-x.

ABSTRACT

BACKGROUND: To examine the influence of mouth breathing on maxillofacial and airway development in children and adolescents with different cervical vertebral maturation stages.

METHODS: Lateral cephalometric radiograph of a total of 120 children and adolescents, 64 girls and 56 boys (7-15 years old), diagnosed with mouth breathing were examined. Maxillofacial hard tissue, soft tissue and airway measurements were obtained using both manual and digital techniques. Independent samples t-test was performed to compare the difference between the measured indexes and the standard values.

RESULTS: As for maxillofacial hard tissue, SNB (CS1-CS5), GoGn (CS1-CS5), ArGoNa (CS1-CS5), ArGo (CS1-CS2) and SNA (CS1-CS2) in mouth breathing children and adolescents were below the standard values (P < 0.05). NGoMe (CS1-CS5), SN-MP (CS1-CS4), SN-PP (CS1-CS4), PP-MP (CS1-CS3) and SN-GoGn (CS1-CS2) in mouth breathing children and adolescents were above the standard values (P < 0.05). As for maxillofacial soft tissue measurements, H angle (CS1-CS5), lower lip length (CS1-CS5), upper lip protrusion (CS1-CS5), upper lip length (CS1-CS4), lower lip protrusion (CS1-CS3), surface Angle (CS2-CS3) and nasolabial angle (CS2) in mouth breathing children and adolescents were above the standard values with statistically significance (P < 0.05). As for airway measurements, PAS (CS1, CS2, CS5) in mouth breathing children and adolescents was above the standard value with statistical significance (P < 0.05).

CONCLUSIONS: Mouth breathing had a real effect on maxillofacial and airway development, which differed among mouth breathing children and adolescents with different cervical vertebral maturation.

PMID:35606773 | DOI:10.1186/s12903-022-02234-x

BMC Med Educ. 2022 May 23;22(1):395. doi: 10.1186/s12909-022-03461-0.

ABSTRACT

BACKGROUND: Education plays a pivotal role in producing qualified human power that accelerates economic development and solves the real problems of a community. Students are also expected to spend much of their time on their education and need to graduate with good academic results. However, the trend of graduating students is not proportional to the trend of enrolled students and an increasing number of students commit readmission, suggesting that they did not perform well in their academics. Thus, the study aimed to identify the determinants of academic performance among university students in Southern Ethiopia.

METHOD: Institution-based cross-sectional study was conducted from December 1 to 28, 2020. A total of 659 students were enrolled and data was collected using a self-administered questionnaire. A multistage sampling technique was applied to select study participants. Data were cleaned and entered into Epi-Data version 4.6 and exported to SPSS version 25 software for analysis. Bivariable and multivariable data analysis were computed and a p-value of ≤0.05 was considered statistically significant. Smoking, age, and field of study were significantly associated with academic performance.

RESULT: Four hundred six (66%) of students had a good academic performance. Students aged between 20 and 24 years (AOR = 0.43, 95% CI = 0.22-0.91), and medical/ health faculty (AOR = 2.46, 95% CI = 1.45-4.20) were significant associates of good academic performance. Students who didn’t smoke cigarettes were three times more likely to score good academic grades compared to those who smoke (AOR = 3.15, 95% CI = 1.21-7.30).

CONCLUSION: In this study, increased odds of good academic performance were observed among students reported to be non-smokers, adults, and medical/health science students. Reduction or discontinuation of smoking is of high importance for good academic achievement among these target groups. The academic environment in the class may be improved if older students are invited to share their views and particularly their ways of reasoning.

PMID:35606767 | DOI:10.1186/s12909-022-03461-0

BMC Health Serv Res. 2022 May 23;22(1):687. doi: 10.1186/s12913-022-08068-1.

ABSTRACT

BACKGROUND: Physicians, who perform disability assessments for the Dutch Social Security Institute, were urged to conduct phone consultations from their homes to prevent the spread of COVID-19. The purpose of the study was to evaluate the perspectives of physicians regarding phone consultations during the COVID-19 pandemic. Additionally, to explore physicians’ views on a more widespread future use of phone consultations in the context of work disability assessments.

METHODS: An electronic survey conducted from June to August 2020 included 41 statements categorized into themes previously identified in both the literature on physicians’ phone consultations and emerging from daily practice. All 1081 physicians working at the Dutch Social Security Institute were invited by e-mail to participate in the survey. Participants indicated on a 5-point Likert scale whether they strongly disagreed, disagreed, neither agreed nor disagreed, agreed or strongly agreed with the statements. The collected data were analysed using descriptive statistics.

RESULTS: In general, physicians had become accustomed to perform phone consultations. Negative experiences included difficulties in getting an impression of patients and assessing patients’ functional limitations. About half of physicians found that phone consultations took more effort, 61% asked more questions due to no direct patient observations. According to 67%, it is mostly necessary to perform an in-person consultation to adequately assess functional limitations of a patient with persistent medically unexplained physical symptoms. A great majority did not prefer telephone consultations to in-person consultations. However, more than half of physicians perceive a greater preference for phone consultations in the future than previously. 56% thought that replacement of in-person consultations with phone consultations in the future might lead to more complaints.

CONCLUSIONS: Perspectives and future views varied among physicians performing disability assessments by phone. A majority of physicians experienced difficulties with different aspects of the assessment. Despite these difficulties, most physicians support to continue the wider use of phone consultations. To improve remote disability assessments it is required to gain more insights into conditions under which a phone assessment can be as diligent as an in-person assessment.

PMID:35606761 | DOI:10.1186/s12913-022-08068-1

BMC Cancer. 2022 May 24;22(1):576. doi: 10.1186/s12885-022-09674-2.

ABSTRACT

BACKGROUND: Advanced non-squamous non-small cell lung cancer (NS-NSCLC) patients without driver gene mutations are usually treated with immune checkpoint inhibitors (ICIs) plus pemetrexed as maintenance therapy after first-line ICIs plus 4-6 cycles of pemetrexed/platinum. Some patients in the real world receive ICIs monotherapy as maintenance therapy. No clinical study has compared the efficacy and safety of ICIs with or without pemetrexed as maintenance therapy.

METHODS: We performed a retrospective study analyzing clinical data of patients with NS-NSCLC who were diagnosed in Zhejiang Cancer Hospital from September 2018 to May 2021 and received maintenance therapy after 4-6 cycles of ICIs plus pemetrexed/platinum. Patients were divided into ICIs plus pemetrexed group and ICIs monotherapy group. Progression Free Survival 1 (PFS1) and PFS2, defined as the interval from the date of initial treatment and maintenance therapy to the date of systemic progression/death or the last follow-up, respectively.

RESULTS: A total of 120 patients received ICIs with or without pemetrexed as maintenance therapy. Eighty-two patients received ICIs plus pemetrexed as maintenance therapy, and 38 patients received ICIs monotherapy. There were no statistically significant difference in median PFS1 between the ICIs monotherapy group and ICIs plus pemetrexed group (12.00 months vs. 12.07 months, P = 0.979). Among patients with PD-L1 TPS < 1%, the median PFS1 was worse with ICIs monotherapy (9.50 months vs. 14.20 months, P = 0.039). Among patients with PD-L1 TPS ≥50% or 1-49%, the median PFS1 in both groups was not statistically significant (P = 0.866, P = 0.589, respectively). Results for median PFS2 were similar to median PFS1, with statistically significantly different only in patients with PD-L1 TPS < 1% (P = 0.008). The 2-year survival rates of the two groups were similar (66.7% vs. 69.5%, P = 0.812). The incidence of fatigue was significantly higher in the ICIs plus pemetrexed group (P = 0.023).

CONCLUSIONS: ICIs with or without pemetrexed can be used as maintenance therapy after first-line ICIs plus 4-6 cycles of pemetrexed/platinum in patients with advanced NS-NSCLC based on PD-L1 expression.

PMID:35606756 | DOI:10.1186/s12885-022-09674-2

BMC Pediatr. 2022 May 23;22(1):301. doi: 10.1186/s12887-022-03370-7.

ABSTRACT

BACKGROUND: Diarrhea is the second most common cause of death in under-five children. Fluid and food replacement during diarrheal episodes have a paramount effect to avert morbidity and mortality. However, there is limited information about feeding practices. This study aimed to assess the prevalence of drinking or eating more and associated factors during diarrhea among under-five children in East Africa using demographic and health surveys (DHSs).

METHODS: Secondary data analysis was done on DHSs 2008 to 2018 in 12 East African Countries. Total weighted samples of 20,559 mothers with their under-five children were included. Data cleaning, coding, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with drinking or eating more during diarrheal episodes. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value < 0.05 were used to declare statistical significance.

RESULTS: Prevalence of drinking or eating more than usual during diarrhea disease in East Africa was 26.27%(95% CI: 25.68-26.88). Mothers age > 35 years (AOR: 1.14, 95% CI: (1.03, 1.26), mothers primary education (AOR: 1.17, 95% CI: 1.06,1.28), secondary education (AOR: 1.43,95% CI: 1.27,1.61), and higher education (AOR: 1.42,95% CI: 1.11,1.81), occupation of mothers (agriculture, AOR: 2.2, 95% CI: 1.3-3.6), sales and services, AOR = 1.20, CI:1.07,1.34), manual, AOR =1.28,95% CI: 1.11,1.44), children age 1-2 years (AOR =1.34,95% CI: 1.22,1.46) and 3-4 years (AOR =1.36,95% CI: 1.20,1.55), four and more antenatal visits (AOR: 1.14,95% CI: 1.03,1.27), rich wealth status (AOR:1.27,95% CI: 1.16,1.40), birth in health facility (AOR = 1.19, 95%CI: 1.10, 1.30) and visit health facility (AOR = 1.12, 95%CI: 1.03, 1.22) were associated with drinking or eating more.

CONCLUSION: The prevalence of drinking or eating more is low in East Africa. Maternal age, occupation, antenatal care visit, marital status, educational status, wealth status, place of delivery, visiting health facility, and child age were significantly associated with drinking or eating more during diarrheal episodes. Health policy and programs should focus on educating mothers, improving the household wealth status, encouraging women to contact health facilities for better feeding practices of children during diarrheal episodes.

PMID:35606750 | DOI:10.1186/s12887-022-03370-7

BMC Pediatr. 2022 May 23;22(1):303. doi: 10.1186/s12887-022-03367-2.

ABSTRACT

BACKGROUND: The objective of the Swedish cleft lip and palate registry (CLP registry) is to promote quality control, research and improvement of treatment, by the comparison of long-term results. The aim was to compare data from the CLP registry among the six treatment centres, regarding data on surgery and speech outcomes at 5 years of age.

METHODS: The participants were 430 children born in Sweden from 2009 to 2014, with cleft palate with or without cleft lip and without known syndromes and/or additional malformations. The number of primary and secondary palatal surgeries up to 5 years of age, timing of the last primary palatal surgery, percentage consonants correct, percentage non-oral speech errors and perceived velopharyngeal competence at 5 years were assessed. Multivariable binary logistic regression adjusted for sex and cleft type was used to compare results between the six centres.

RESULTS: At one centre (centre 4), the palate was closed in one to three stages, and at the remaining centres in one or two stages. At centre 4, more children underwent a higher number of palatal surgeries, and the last primary palatal surgery was performed at a higher age. Children in centre 4 were also less likely to achieve ≥86% correct consonants (OR = 0.169, P = < 0.001), have no non-oral speech errors (OR = 0.347, P = < 0.001), or have competent or marginally incompetent velopharyngeal competence (OR = 0.244, P = < 0.001), compared to the average results of the other centres. No clear association between patient volume and speech outcome was observed.

CONCLUSIONS: The results indicated the risk of a negative speech result if the last primary palatal surgery was performed after 25 months of age. Whether the cleft in the palate was closed in one or two stages did not affect speech outcome. The Swedish CLP registry can be used for open comparisons of treatment results to provide the basis for improvements of treatment methods. If deviating negative results are seen consistently at one centre, this information should be acted upon by further investigation and analysis, making changes to the treatment protocol as needed.

PMID:35606744 | DOI:10.1186/s12887-022-03367-2

BMC Med Educ. 2022 May 23;22(1):394. doi: 10.1186/s12909-022-03463-y.

ABSTRACT

BACKGROUND: E-learning has found its way into dental teaching in general and endodontic teaching in particular. The present study aimed to implement a newly developed multimedia learning application and assess its effect on students’ first root canal treatment on real patients. With the COVID-19 outbreak, the application’s performance was investigated during the pandemic.

METHODS: A total of 138 students in the initial clinical endodontic course participated in this study. The control group (n = 49) followed the traditional curriculum, including practice on artificial teeth and face-to-face teaching events. In addition to the traditional curriculum, test group 1 (n = 54) had access to an endodontic e-learning application containing videos demonstrating artificial teeth and patient cases. With the COVID-19 outbreak, test group 2 (n = 35) had no face-to-face teaching; however, endodontic patient treatments were included. The quality of students’ first root canal treatment on real patients was compared using performance and radiographic assessment items. Statistical analysis was done using Kruskal-Wallis and chi-squared tests. Test groups received a questionnaire to assess the learning application. Test group 2 also completed a COVID-19-specific survey to measure students’ perceptions of how the pandemic affected their endodontic education.

RESULTS: The results of endodontic treatments were significantly better for test group 1 (P < 0.001) and 2 (P < 0.001) than for the control group. Likewise, there were significantly fewer treatment errors in test group 1 (P < 0.001) and 2 (P < 0.001). No significant differences were found between test groups 1 and 2. Students of the test groups positively evaluated the e-learning application. Students of test group 2 expressed their fear of negative impacts on their course performance.

CONCLUSION: The e-learning application was well-received and seemed to improve endodontic education. The results imply that the quality of education may be maintained by implementing e-learning to compensate for face-to-face teaching. As no difference was found between online and face-to-face teaching, students’ and lecturers’ concerns that endodontic education is suffering because of the pandemic may be eased.

PMID:35606729 | DOI:10.1186/s12909-022-03463-y

BMC Oral Health. 2022 May 23;22(1):200. doi: 10.1186/s12903-022-02236-9.

ABSTRACT

BACKGROUND: This study aimed to compare the age-related positional and morphological characteristics of the temporomandibular joint (TMJ) between individuals with anterior openbite or crossbite and controls.

METHODS: This multi-cross-sectional comparative study analysed cone-beam computed tomography images of 750 participants, equally divided into the openbite, crossbite, and control groups (OBG, CBG, and CG, respectively). Each group was further divided into five subgroups (8-11 years, 12-15 years, 16-19 years, 20-24 years, and 25-30 years). Measurements of the TMJ included the position of the condyles in their respective fossae and morphology of the condyles and fossae. Data were submitted to statistical analysis. The study adhered to the STROBE Statement checklist for reporting of cross-sectional studies.

RESULTS: Condyles were positioned more posteriorly with increasing age in all groups, and the condylar position was more posterior in the OBG than in the CBG. The articular eminence inclination increased with age in all the groups. There were significant differences in the articular eminence inclination among the three major groups at the age of > 15 years, and the condylar path was flatter in the CBG than in the OBG.

CONCLUSIONS: Age-related morphological and positional characteristics of the TMJ differed considerably among OBG, CBG and CG. Contrary to CBG, OBG was found to have relatively posterior condylar position and steeper condylar path.

PMID:35606730 | DOI:10.1186/s12903-022-02236-9

BMC Prim Care. 2022 May 24;23(1):124. doi: 10.1186/s12875-022-01731-w.

ABSTRACT

BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown benefits in patients with diabetes and cardiovascular disease (CVD), heart failure (HF), and chronic kidney disease (CKD).

OBJECTIVE: We assessed benchmark outcomes (Hemoglobin A1c, LDL-C, and blood pressure), identified the prevalence of cardiorenal indications for SGLT2i and GLP-1RA, and compared prescribing rates of GLP1-RA and SGLT2i in those with and without cardiorenal indications.

METHODS: We analyzed data from January 2018-June 2019 for 7168 patients with diabetes using electronic medical records from the Northern Alberta Primary Care Research Network, a regional network of the Canadian Primary Sentinel Surveillance Network (CPCSSN). Patients with and without cardiorenal comorbidities were compared using descriptive statistics and two proportion Z tests.

RESULTS: Hemoglobin A1c ≤ 7.0% was met by 56.8%, blood pressure < 130/80 mmHg by 62.1%, LDL-C ≤ 2.0 mmol/L by 45.3% of patients. There were 4377 patients on glucose lowering medications; metformin was most common (77.7%), followed by insulin (24.6%), insulin secretagogues (23.6%), SGLT2i (19.7%), dipeptidyl peptidase-4 inhibitor (19.3%), and GLP-1RA (9.4%). A quarter of patients had cardiorenal indications for SGLT2i or GLP-1RA. Use of SGLT2i in these patients was lower than in patients without cardiorenal comorbidities (14.9% vs 21.2%, p < 0.05). GLP-1RA use in these patients was 4.6% compared with 11% in those without cardiorenal comorbidities (p < 0.05).

DISCUSSION: Contrary to current evidence and recommendations, SGLT2i and GLP1-RA were less likely to be prescribed to patients with pre-existing CVD, HF, and/or CKD, revealing opportunities to improve prescribing for patients with diabetes at high-risk for worsening cardiorenal complications.

PMID:35606699 | DOI:10.1186/s12875-022-01731-w