Tag: pubmed

J Asthma. 2022 May 27:1-9. doi: 10.1080/02770903.2022.2082308. Online ahead of print.

ABSTRACT

Objective: To identify features related to management of patients prior to referral from primary care physicians (PCPs) to pulmonologists and allergists.Methods: This is an analysis of patient claims data from Symphony Health (2013-2018). To characterize referrals, a longitudinal cohort included 12 months with no asthma claims prior to the index date, followed by 36 months of observation. We also assessed a cross-sectional cohort for 12 months at the end of the observational period to characterize disease control and treatment patterns. Referral was defined as the first appearance of a claim from an allergist or pulmonologist for a patient’s initial visit for asthma. Descriptive statistics were used to analyze the data.Results: The majority of patients with asthma were managed by PCPs (60%), followed by pulmonologists (16%) and allergists (8%). Forty-three percent had uncontrolled asthma. Only 8% of were referred to specialists within the first 24 months after initial diagnosis, of which 76% were seen by pulmonologists and 24% by allergists. Referrals resulted in treatment change in 55%-68% of the cases. Patients who received a referral were more likely to be on oral corticosteroids (OCS) and/or have more hospitalizations/ED visits.Conclusions: About one third of the patients managed by PCPs received intermittent and/or chronic OCS prior to referral which may be an indication of uncontrolled disease. The referral patterns in this analysis illustrate underutilization of specialists in the consultation and management of patients with uncontrolled asthma.

PMID:35620831 | DOI:10.1080/02770903.2022.2082308

Brain Behav. 2022 May 27:e2635. doi: 10.1002/brb3.2635. Online ahead of print.

ABSTRACT

OBJECTIVE: Deep brain stimulation (DBS) has been used on drug-resistant Gilles de la Tourette syndrome (GTS) for more than two decades until now, but the stimulating targets are still under exploration until now. In this study, the authors reported the efficacy of the bilateral posteroventral globus pallidus interna (GPi) DBS on tic severity and neuropsychiatry symptoms of seven individuals with GTS.

METHOD: Seven patients with drug-resistant GTS were enrolled in this study. The severity of these patients was evaluated with Yale Global Tics Severity Scale (YGTSS), Yale Brown Obsessive Compulsive Scale (YBOCS), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Global Assessment of Functioning Scale (GAF). Bilateral posteroventral GPi were selected as the permanent stimulating targets. Follow-up period was at least 5 years after surgery in the enrolled patients.

RESULTS: After surgery, one patient reported no improvement during the follow-up period, and a device removal surgery was performed. The other six patients reported minor to significant improvement. The overall YGTSS, YBOCS, HAMA HAMD, and GAF scores of these patients were changed positively after surgery, but only the improvement of the motor tic and HAMD scores had a statistical difference. No surgical complication was reported.

CONCLUSIONS: Bilateral posteroventral GPi DBS could relieve the motor tics and depressive symptoms of the enrolled patients significantly, but the vocal tics and other psychiatric symptoms presented a progression without statistical difference during the follow-up period. The results of this study suggested that bilateral posteroventral GPi are effective targets for the motor tics in GTS patients, especially with prominent depressive symptoms.

PMID:35620847 | DOI:10.1002/brb3.2635

Psychiatry Investig. 2022 May;19(5):394-400. doi: 10.30773/pi.2022.0014. Epub 2022 May 23.

ABSTRACT

OBJECTIVE: Baseline amyloid burden in mild cognitive impairment (MCI) has been linked to conversion to Alzheimer’s disease (AD), but the comparison of baseline and longitudinal changes in amyloid burden for predicting AD remains unresolved. The objectives of this study aimed to compare the prognostic ability of baseline and longitudinal changes in amyloid burden in MCI patients.

METHODS: Seventy-five individuals with MCI were recruited and examined annually by clinical interviews for a mean follow-up of 24 months (range, 11.6-42.0). [18F]Florbetaben positron emission tomography (PET) scans were performed. T1-weighted 3D volumes were acquired for co-registration, and to define regions of interest. We examined whether baseline and longitudinal amyloid burden changes can improve AD conversion by Cox proportional hazard model analysis and receiver operating characteristic (ROC) curve analysis.

RESULTS: Cox proportional hazards model analysis showed that baseline amyloid burden was significantly associated with increased risk of conversion to AD (hazard ratio [HR]=10.0; 95% confidence interval [CI], 1.15-85.39; p=0.04), but longitudinal amyloid burden changes was not (HR=0.2; 95% CI, 0.02-1.18; p=0.07). When predicting AD, longitudinal amyloid burden changes had better ROC accuracy of 65.2% (95% CI, 48.4-82.0) than baseline amyloid burden of 59.6% (95% CI, 40.3-79.0), without statistical significance in pairwise comparison.

CONCLUSION: A single baseline amyloid PET could be sufficient in the prediction of AD conversion in MCI.

PMID:35620825 | DOI:10.30773/pi.2022.0014

Psychiatry Investig. 2022 May;19(5):380-385. doi: 10.30773/pi.2021.0395. Epub 2022 May 23.

ABSTRACT

OBJECTIVE: Data processing in analysis of circadian rhythm was performed in various ways. However, there was a lack of evidence for the optimal analysis of circadian rest-activity rhythm. Therefore, we aimed to perform mathematical simulations of data processing to investigate proper evidence for the optimal analysis of circadian rest-activity rhythm.

METHODS: Locomotor activities of 20 ICR male mice were measured by infrared motion detectors. The data of locomotor activities was processed using data summation, data average, and data moving average methods for cosinor analysis. Circadian indices were estimated according to time block, respectively. Also, statistical F and p-values were calculated by zero-amplitude test.

RESULTS: The data moving average result showed well-fitted cosine curves independent of data processing time. Meanwhile, the amplitude, MESOR, and acrophase were properly estimated within 800 seconds in data summation and data average methods.

CONCLUSION: These findings suggest that data moving average would be an optimal method for data processing in a cosinor analysis and data average within 800-second data processing time might be adaptable. The results of this study can be helpful to analyze circadian restactivity rhythms and integrate the results of the studies using different data processing methods.

PMID:35620823 | DOI:10.30773/pi.2021.0395

Brain Behav. 2022 May 26:e2613. doi: 10.1002/brb3.2613. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to analyze the relationship between expression levels of chemerin, oxidized low density lipoprotein (ox-LDL), matrix metalloproteinase 9 (MMP-9) and pregnancy associated plasma protein A (PAPP-A) in ischemic cerebrovascular disease (ICVD) patients and the relationship between the mentioned indicators and the degree of neurological impairment.

METHODS: From January 2020 to February 2021, a total of 328 cases of ICVD patients were admitted to our hospital, and 240 cases of healthy people (control group) were prospectively recruited into this study. The 328 patients were divided into 2 ischemic subtypes, with 233 cases as acute cerebral infarction (ACI) and 95 cases as transient ischemic attack (TIA). Laboratory tests were compared among the groups. Spearman rank correlation was used to analyze the correlation between chemerin, ox-LDL, MMP-9, PAPP-A levels and neurological deficit. Unconditional logisitic regression was used to analyze the risk factors for neurological deficits.

RESULTS: The high density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), chemerin, ox-LDL, MMP-9, and PPAP-A levels in the ACI group were significantly higher than those in the TIA group and control group (p < 0.05, respectively), while the levels of the mentioned indicators in the TIA group were significantly higher than those in control group (p < 0.05, respectively). The levels of the given indicators decreased successively in the severe, moderate, and mild neurological deficits population and control group, with statistical difference. Spearman rank correlation analysis showed that chemerin, ox-LDL, MMP-9, and PPAP-A levels were positively correlated with the degree of neurological deficit in ICVD patients. Unconditional logistic regression analysis showed that chemerin, ox-LDL, MMP-9, and PPAP-A were the independent risk factors for neurological deficit in patients with ICVD.

CONCLUSION: LDL-C, FPG, chemerin, ox-LDL, MMP-9, and PPAP-A were highly expressed in ACI and neurological deficit patients. Chemerin, ox-LDL, MMP-9, and PPAP-A may be the independent risk factors for neurological deficit in patients with ICVD.

PMID:35620813 | DOI:10.1002/brb3.2613

J Sci Food Agric. 2022 May 26. doi: 10.1002/jsfa.12036. Online ahead of print.

ABSTRACT

BACKGROUND: After the harvest, green coffee beans are dried on the farm using several methods: the wet process, natural process, pulped natural process, or mechanical demucilaging. This study evaluated how the choice of a specific processing method influenced the volatile organic compounds of the coffee beans, before and after roasting, and the sensory characteristics of the beverage. Coffea arabica beans of two varieties (Mundo Novo and Catuai Vermelho) were subjected to these four processing methods on a single farm in the cerrado area of Brazil.

RESULTS: Analysis by GC-MS HS-SPME identified 40 volatile organic compounds in green coffee beans and 37 in roasted beans. The main difference between post-harvest treatments was that natural processed green beans of both varieties contained a different profile of alcohols, acids, and lactones. In medium-roasted beans, those differences were not observed. The coffee beverages had similar taste attributes but distinct flavor profiles. Some of the treatments resulted in specialty-grade coffee, while others did not.

CONCLUSION: The choice of a specific post-harvest processing method influences the volatile compounds found in green beans, the final beverage’s flavor profile, and the cupping score, which can have a significant impact on the profitability of coffee farms operations. This article is protected by copyright. All rights reserved.

PMID:35620803 | DOI:10.1002/jsfa.12036

J Am Psychiatr Nurses Assoc. 2022 May 26:10783903221096360. doi: 10.1177/10783903221096360. Online ahead of print.

ABSTRACT

BACKGROUND: Negative attitudes toward mental disorders are not only an interpersonal issue but also a concern of mental health care. Given that nursing students are future health care providers, it is pivotal to improve their attitudes toward individuals with mental disorders prior to their transition into clinical practice. However, research on nursing students’ attitudes in relation to schizophrenia in Taiwan remains unexplored.

AIM: The aim of this article is to examine the correlates of attitudes toward individuals with schizophrenia among Taiwanese undergraduate nursing students.

METHOD: A descriptive, correlational, and cross-sectional study was adopted. Self-reported questionnaires were conducted with a convenience sample of 306 Taiwanese undergraduate nursing students. Descriptive statistics, independent t tests, one-way analysis of variance, Pearson’s correlations, and a stepwise regression analysis were performed.

RESULTS: Nursing students expressed negative attitudes toward individuals with schizophrenia. Nursing students, who were female, had contact with individuals with mental disorders, and expressed greater empathy and personality traits held more favorable attitudes toward individuals with schizophrenia. The study found that empathy, personality traits, and academic year were the most crucial attributes contributing to attitudes of nursing students toward individuals with schizophrenia.

CONCLUSION: Findings suggest that nursing education programs with empathy- and personality-tailored modules in mental health are pivotal to provide humanistic approaches with supportive attitudes regarding schizophrenia.

PMID:35620801 | DOI:10.1177/10783903221096360

MethodsX. 2022 May 5;9:101717. doi: 10.1016/j.mex.2022.101717. eCollection 2022.

ABSTRACT

This study presents an approach developed to derive a Delayed-Multivariate Exposure-Response Model (D-MERF) useful to assess the short-term influence of temperature on mortality, accounting also for the effect of air pollution (O₃ and PM₁₀). By using Distributed, lag non-linear models (DLNM) we explain how city-specific exposure-response functions are derived for the municipality of Rome, which is taken as an example. The steps illustrated can be replicated to other cities while the statistical model presented here can be further extended to other exposure variables. We derive the mortality relative-risk (RR) curve averaged over the period 2004-2015, which accounts for city-specific climate and pollution conditions. Key aspects of customization are as follows: This study reports the steps followed to derive a combined, multivariate exposure-response model aimed at translating climatic and air pollution effects into mortality risk. Integration of climate and air pollution parameters to derive RR values. A specific interest is devoted to the investigation of delayed effects on mortality in the presence of different exposure factors.

PMID:35620759 | PMC:PMC9127213 | DOI:10.1016/j.mex.2022.101717

J Cardiovasc Thorac Res. 2022;14(1):61-66. doi: 10.34172/jcvtr.2022.02. Epub 2022 Mar 6.

ABSTRACT

Introduction: Ruptured abdominal aortic aneurysm (RAAA) is a catastrophic condition with in-hospital mortalities up to 89%. Patient survival depends on multiple factors; however, prompt surgery is essential to prevent mortality. We report the in-hospital outcomes of RAAA at a high-volume and teaching vascular surgery center in Iran. Methods: This study is a single-center retrospective analysis of patients with infrarenal RAAA during February 20, 2012 to December 21, 2019 at Shohada-Tajrish Medical Center, Tehran,Iran. We identified 66 patients with RAAA during the study period. The patients were dividedinto two groups based on their transfer status (Transfer group versus non-transfer group). The primary outcome was in-hospital death. The secondary outcomes were in-hospital myocardial infarction (MI), abdominal compartment syndrome (ACS) and postoperative renal dysfunction requiring dialysis. Results: The mean age of the patients was 74.2 ± 8.3 years. Forty-seven patients (71.2%) were transferred to our center from other institutions. There were 46 in-hospital deaths (69.7%) and three in-hospital MIs (4.5%). Three patients (4.5%) had postoperative ACS and six patients (9.1%)had postoperative renal dysfunction requiring dialysis. Transfer patients had an increased rate of in-hospital death compared to non-transferred patients (76.6.1% versus 52.6%); however, the difference was not statistically significant (P =0.055). Conclusion: We found no significant different between operative mortality of transferred and non-transferred RAAA patients. Transfer of patients to tertiary centers with experienced vascular surgeons may delay the surgery. However, the transfer may be inevitable in areas where the optimal care of RAAA patients is not possible.

PMID:35620745 | PMC:PMC9106941 | DOI:10.34172/jcvtr.2022.02

Int J Burns Trauma. 2022 Apr 15;12(2):45-51. eCollection 2022.

ABSTRACT

BACKGROUND: Burns are still one of the most prevalent injuries in the world. Allograft is in high demand as a biological dressing for any superficial open wounds, not just burn victims. Skin allograft is the gold standard for treating burns in people who do not have enough skin to cover all of the injured areas of their bodies. Studies have shown that skin allografts are superior to topical antimicrobial dressings in partial thickness burns and can reduce complications and length of hospital stay in burn patients. However, to the best of our knowledge very few studies have investigated these results in our country. The aim of the current study is to evaluate and report the outcomes of skin allograft on burn patient survival in Iran.

METHOD: This prospective clinical trial study was performed on patients admitted to the burn center of Imam Khomeini Hospital in Tehran between July 15, 2017 and April 27, 2021. The control group consisted of patients admitted to the burn ward who were not undergoing skin allografts. This group was matched with the case group in terms of sex, age, and percentage of burns. We compared the outcome of the study was the duration of hospitalization, and status of patients at discharge. The study protocol was approved by Iranian Registry of Clinical Trials (IRCT) under the code of IRCT2016112431074N1 (https://fa.irct.ir/trial/24517).

RESULT: Overall, 112 patients in the case group and 224 patients in the control group were studied. The length of hospital stay in the case group (41.13±11.7) was considerably longer than the control group (24.6±12.1) (P<0.001), but the mortality rate in the two groups was not statistically different (P=0.633). The average survival time of case group (53 days, 95% CI=45-56) was higher than the control group (49 days, 95% CI=39-58) (P=0.012). Number of allograft usage (OR=0.038, 95% CI=0.142-0.945) and also Age (OR=1.03, 95% CI=1.005-1.070) were predictors of death.

CONCLUSION: Although the use of skin allografts in large burns (more than 50%) reduced mortality in burn patients, their use in burns less than 50% has not been effective in reducing patient mortality. Due to the limited access to this valuable product, its use in burns less than 50% should be done with caution and, due to the limited access to skin allografts in most burn centers in Iran, patients with extensive burns (more than 50%) should be used as a priority.

PMID:35620737 | PMC:PMC9123452