Tag: pubmed

Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6505-6511. doi: 10.26355/eurrev_202209_29749.

ABSTRACT

OBJECTIVE: The complicated gallbladder disorders are associated with increased mortality and morbidity. Thus, this study was aimed at evaluating the predictive value of immature granulocyte count and delta neutrophil index in the prediction of complicated cholecystitis.

PATIENTS AND METHODS: We retrospectively reviewed patients who underwent surgery for acute cholecystitis between January 2018 and April 2022. Overall, 351 patients fulfilling the inclusion criteria were included in the study. In all patients, demographic data, immature granulocyte count (IGC), delta neutrophil index (DNI), white blood cell (WBC) count, C-reactive protein (CRP), and albumin levels were recorded. Based on operative findings and histopathological examination, the patients were classified into 2 groups uncomplicated (group I) and complicated (e.g., perforation, gangrenous and emphysematous cholecystitis; group II) groups. The IBM SPSS version 26.0 (SPSS Corp, Armonk, NY, USA) was used to assess differences in blood parameters between groups. The predictive values of the parameters evaluated were estimated using ROC analysis. A p-value<0.05 was considered statistically significant.

RESULTS: Acute complicated cholecystitis was found in 138 of 351 patients. No significant difference was detected in age and gender distribution between groups (p=0.352 and p=0.214, respectively). When blood parameters were assessed, it was found that IGC, DNI, WBC, and CAR values were significantly higher in group II (p<0.001; p<0.001, p<0.001, and p=0.036, respectively), while there was no significant difference in CRP and albumin between groups (p=0.099 and p=0.53, respectively). In the ROC analysis, the highest AUC value was found for IG count and DNI (0.784 and 0.775, respectively). The sensitivity and specificity were found as 68.8% and 86.9% for IG count and 49.3% and 96.2% for DNI, respectively.

CONCLUSIONS: The IG count and DNI are two novel parameters with strong predictive value in the early diagnosis of acute complicated cholecystitis, which may support clinical findings, imaging studies, and other laboratory parameters.

PMID:36196699 | DOI:10.26355/eurrev_202209_29749

BJU Int. 2022 Oct 5. doi: 10.1111/bju.15913. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the incidence of ureteral injuries, clinical value of prophylactic ureteral stenting, and impact of intraoperative or postoperative detection of ureteral injuries in patients treated with gynecological or colorectal surgery.

METHODS: Multiple databases were searched for articles published before September 2021 according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Studies were deemed eligible if they evaluated the differences in the rate of ureteral injuries between laparoscopic and open surgery, prophylactic ureteral stenting or not, and those of final treatment success between intraoperative and postoperative detection in patients who underwent gynecological or colorectal surgery.

RESULTS: Overall, 46 studies were eligible for this meta-analysis. Compared to open surgery, laparoscopic hysterectomy was associated with a higher incidence of ureteral injuries (pooled odds ratio [OR]; 2.12, 95% confidence intervals [CI]; 1.71-2.62), but there was no statistically significant difference in colectomy (pooled OR; 0.89, 95% CI; 0.77-1.03). Prophylactic ureteral stenting was associated with a lower incidence of ureteral injuries during gynecological surgery (pooled OR; 0.61, 95%CI; 0.39-0.96). The number needed to perform ureteral stenting to prevent one ureteral injury was 224 in gynecological surgery. On the other hand, prophylactic ureteral stenting did not reduce the risk of ureteral injuries during colorectal surgery. Intraoperative detection of a ureteral injury was associated with a lower rate of complication management failure compared to postoperative detection (pooled OR; 0.22, 95%CI; 0.12-0.41).

CONCLUSIONS: Laparoscopic hysterectomy seems to be associated with a higher rate of ureteral injuries compared to an open approach. Prophylactic ureteral stenting seems to reduce this risk during gynecological surgery. Intraoperative detection of a ureteral injury during abdominal/pelvic surgery improves outcomes, suggesting the need for awareness and proactive problem identification. Further well-designed studies assessing the candidates who are more likely to benefit from prophylactic ureteral stenting including cost analysis are needed.

PMID:36196670 | DOI:10.1111/bju.15913

J Magn Reson Imaging. 2022 Oct 5. doi: 10.1002/jmri.28455. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic and hemodynamic alterations in metabolic syndrome (MetS) can cause a reduced myocardial energetic efficiency (MEE). Indexed MEE (MEEi), as a simple estimate of MEE, is emerging as a novel and useful imaging parameter.

PURPOSE: To investigate the impact of MetS on MEE and systolic myocardial strain and to assess any sex difference.

STUDY TYPE: Retrospective.

POPULATION: A total of 161 patients with MetS (female: n = 82, 52.2 ± 11.7 years; male: n = 79, 51.8 ± 10.6 years) and 77 healthy subjects (female: n = 46, 52.7 ± 8.2 years; male: n = 31, 54.1 ± 11.2 years). Patients with left ventricular (LV) ejection fraction <50% were excluded.

FIELD STRENGTH/SEQUENCE: A 3.0 T; balanced steady-state free precession sequence.

ASSESSMENT: LV volumes and mass (LVM) and global longitudinal strain (GLS) were obtained by MRI. Stroke volume (SV) divided by HR was used as a surrogate measure of MEE and normalized to LVM (MEEi).

STATISTICAL TESTS: Student’s t-test or Mann-Whitney U-test; Multivariable linear regression (coefficient of determination, R² ). P < 0.05 was considered statistically significant.

RESULTS: For both males and females, MEEi and GLS were lower in MetS patients than in the normal controls. Among MetS patients, men had significantly higher LVM (59.7 ± 13.4 g/m² vs. 48.8 ± 11.3 g/m² ) and significantly lower MEEi (0.68 ± 0.23 mL/g/s vs. 0.84 ± 0.23 mL/g/s) and GLS (-11.7% ± 2.8% vs. -13.9% ± 2.7%) than women. After adjustment for clinical variables, male gender (β = -0.291) was found to be inversely correlated with MEEi. Multivariable analysis showed that MEEi (β = 0.454) were independently associated with GLS (adjusted R² = 0.454) after adjustment for clinical and other MRI parameters.

DATA CONCLUSION: MEEi was significantly impaired in MetS without overt systolic dysfunction. There was a sex difference regarding the cardiac alterations in MetS, with men having significantly lower MEEi and GLS and significantly higher LVM than women. Further, MEEi was independently associated with GLS.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 3.

PMID:36196628 | DOI:10.1002/jmri.28455

J Clin Pharmacol. 2022 Oct 5. doi: 10.1002/jcph.2162. Online ahead of print.

ABSTRACT

Tacrolimus was frequently used in umbilical cord blood transplant (UCBT) pediatrics for prevention of graft-vs-host disease (GVHD). The aim of the present study was to evaluate the population pharmacokinetics (PPK) of tacrolimus among UCBT pediatrics and find potential influenced factors. A total of 275 concentrations from 13 pediatrics were used to build a PPK model using a non-linear mixed-effects modelling approach. The impact of demographic features, biological characteristics, and concomitant medications, including sex, age, body weight, postoperative day, white blood cell (WBC), red blood cell (RBC), hemoglobin (HB), platelet (PLT), hematocrit (HCT), urea nitrogen (BUN), creatinine (Cr), aspartate transaminase (AST), alanine transaminase (ALT), total bilirubin (TBil), albumin (ALB), and total protein (TP) were investigated. The pharmacokinetics of tacrolimus were best described by a one-compartment model with first- and zero-order mixed absorption and first order elimination. The clearance (CL) and volume of distribution (V) of tacrolimus were 1.93 L/h and 75.1 L, respectively. A covariate analysis identified that postoperative day and co-administration with trimethroprim-sulfamethoxazole (TMP-SMZ) were significant covariates influencing CL of tacrolimus. Frequent blood monitoring and dose adjustment might need with the prolongation of postoperative day and co-administration with TMP-SMZ. This article is protected by copyright. All rights reserved.

PMID:36196568 | DOI:10.1002/jcph.2162

Rev Esp Salud Publica. 2022 Oct 3;96:e202209075.

ABSTRACT

OBJECTIVE: Knowing the risk status of malnutrition and sarcopenia in institutionalized patients is essential to understand the current context after the impact of the coronavirus (COVID-19) pandemic.

METHODS: This research used a retrospective, observational study. The results of the Remote Malnutrition APP test (R-MAPP) are described: risk factors for malnutrition (including COVID-19), the Malnutrition Universal Screening Tool (MUST) and the SARC-F, in a selected sample of 402 residents of Castilla-La Mancha (Spain) during 2021. An inferential analysis was performed to determine which factors were related to the MUST (≥2 points) and SARC-F (≥4 points) response measures. With the factors that obtained statistical significance, a multivariate regression model was performed, adjusting for each one. of those factors.

RESULTS: Mean age was 84.2 years, 70.1% women. Most frequent risk factor for malnutrition was aging (85.1%). The mean body mass index was 26.5 (SD 11.6). MUST≥2 points was obtained in 16.2%, and a SARC-F≥4 in 69.9%. COPD (Chronic obstructive pulmonary disease / OR 0.35; 95% CI 0.13-0.92; p 0.03) was a protective factor against the risk of malnutrition. The risk of sarcopenia was related to aging (OR 8.16; 95% CI 4.13-16.20; p 0.00), COVID-19 (OR 1.96; 95% CI 1.17-3.29; p 0.01) and COPD (OR 2.44; 95% CI 1.21-4.89; p 0.01).

CONCLUSIONS: No relationship is found between COVID-19 and high risk of malnutrition. Aging, COVID-19 and COPD are risk factors for sarcopenia.

PMID:36196560

Rev Esp Salud Publica. 2022 Sep 29;96:e202209074.

ABSTRACT

Non-inferiority studies are increasingly more common for introducing new medicines in the market. Despite being situations where the use of this study design is justified, there is not a common analytical approach on how to conduct them. Pursuing a rigorous methodology, both in the study conduction and in its disseminations, is critical to ensure robust results to enable regulatory agencies and clinicians to reach valid conclusions and decisions which ultimately will benefit clinical practice. Most of the published reviews focus on the efficacy outcomes of non-inferiority clinical trials. We are unaware of other reviews that goes beyond and includes specific aspects for non-interventional designs and for studies focused on safety. Moreover, this review provides a simple and practical perspective with a minimum mathematical content on this complex type of studies.

PMID:36196559

Dent Med Probl. 2022 Jul-Sep;59(3):421-425. doi: 10.17219/dmp/133645.

ABSTRACT

BACKGROUND: Pain from dental injections is a common reason why people fear dentistry and avoid dental treatment. Thus, researchers have attempted to find methods to decrease dental injection pain.

OBJECTIVES: Considering the analgesic effect of the photobiomodulation therapy (PBMT), the aim of this study was to evaluate the effects of PBMT on the pain caused by dental anesthetic injections.

MATERIAL AND METHODS: This randomized, split-mouth, triple-blind clinical trial evaluated 60 bilateral canine teeth in 30 dental students. After the random selection of the test (laser) quadrant, the injection site was irradiated with a 940 nm diode laser. Buccal infiltration anesthesia was then administered by injecting lidocaine plus epinephrine with a short needle. The level of pain experienced during the injection was determined using a 100-millimeter visual analog scale (VAS). The same procedure was performed for the control (no laser) quadrant, with the difference being that the laser handpiece was turned on, but no radiation was administered. The 2 groups were compared using the non-parametric Wilcoxon signed-rank test.

RESULTS: The mean VAS pain scores were 21.2 ±15.7 for the laser quadrant and 27.9 ±18.9 for the control quadrant; this difference was statistically significant (p = 0.030), but did not seem to be clinically relevant.

CONCLUSIONS: The photobiomodulation therapy prior to dental anesthetic injections has no clinical advantage for reducing injection pain.

PMID:36196515 | DOI:10.17219/dmp/133645

Ren Fail. 2022 Dec;44(1):1623-1631. doi: 10.1080/0886022X.2022.2129064.

ABSTRACT

BACKGROUND: A large number of studies have shown that proton pump inhibitors (PPIs) are associated with infection events. Therefore, we retrospectively evaluated the association of PPI therapy with the occurrence of first pneumonia and peritoneal dialysis(PD)-related peritonitis events in the maintenance PD patients.

METHODS: We collected PD patients in two large hospitals from January 1, 2012 to December 31, 2016, and divided them into the PPI group and the non-PPI group. Multivariate Cox proportional hazards models were applied to evaluate the cumulative incidence and hazard ratios (HRs). Inverse probability of treatment weight (IPTW) method was used to adjust for covariate imbalance between the two groups and further confirm our findings.

RESULTS: Finally, 656 PD patients were included for data analysis, and the results showed that PPI usage was associated with an increased risk of pneumonia [HR 1.71; 95% CI 1.06-2.76; p = 0.027] and peritonitis [HR 1.73; 95% CI 1.24-2.40; p = 0.001]. IPTW-adjusted HRs for the association of PPIs with pneumonia and peritonitis were 1.58 (95% CI:1.18-2.12; p = 0.002) and 2.33 (95% CI:1.91-2.85; p < 0.001), respectively. Moreover, the competitive risk model proved that under the conditions of competition for other events(including transfer to hemodialysis therapy, kidney transplant, transfer from our research center, loss to follow-up, and death), the differences in endpoints events between the two groups were still statistically significant (p = 0.009, p < 0.001, respectively).

CONCLUSIONS: PPIs was associated with an increased risk of first pneumonia and PD-related peritonitis events in PD patients, which reminds clinicians to be cautious when prescribing acid-suppressing drugs for PD patients.

PMID:36195979 | DOI:10.1080/0886022X.2022.2129064

Phys Occup Ther Pediatr. 2022 Oct 4:1-14. doi: 10.1080/01942638.2022.2128973. Online ahead of print.

ABSTRACT

AIM: To systematically review evidence of the effectiveness of sticky mittens training to improve reaching skills and manual exploration of full-term and at-risk infants and optimal training dosage.

METHODS: The Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this systematic review. The electronic search was performed from September 2017 to August 2021 on PubMed, Scopus, Science Direct, and Cochrane databases. Eligibility criteria followed PICO terms: clinical trials investigating the effects of sticky mittens training on reaching skills and manual exploration of full-term and at-risk infants. PEDro scale and GRADE assessed methodological quality and quality of evidence, respectively.

RESULTS: Eight studies (313 children) were included. Five studies found statistically significant differences between experimental and control groups (62.6%). One study presented high methodological quality. Evidence synthesis showed very low and low evidence of the beneficial effects of sticky mittens training in full-term and at-risk infants, respectively.

CONCLUSIONS: Findings suggest that sticky mittens training facilitates reaching skills and manual exploration. However, results should interpretation with caution because studies targeted full-term infants. Future research should focus on infants at risk or with motor impairments since sticky mittens training seems to show positive effects and is easy to apply.

PMID:36195977 | DOI:10.1080/01942638.2022.2128973

J Health Popul Nutr. 2022 Oct 4;41(1):45. doi: 10.1186/s41043-022-00326-6.

ABSTRACT

BACKGROUND: Medically unnecessary caesarean section (CS) is now an ongoing concern worldwide including in Bangladesh. This intensifies the occurrence of adverse maternal and child health outcomes. We investigated the associations of CS with some basic health and behavioural outcomes of the mothers and their children in Bangladesh.

METHODS: We conducted a community-based case-control study from May to August 2019. A total of 600 mother-child dyads were interviewed using a structured questionnaire, 300 of them had CS, and 300 had vaginal delivery (VD) in their most recent live births. The exposure variable was the mode of delivery, classified as 1 if mothers had CS and 0 if mothers had VD. The outcome variables were a group of health and behavioural problems of the mothers and their children. Multivariate or multiple logistic regression model, separately for each health and behavioural outcome, was used to determine the effect of exposure variable on outcome variable after adjusting for possible confounders.

RESULTS: The mean age and weight of mothers were 25.1 years and 53.1 kg, respectively. Likelihoods of headache, after delivery hip pain, problem of daily activities, and breastfeeding problem were reported higher among mothers who had CS in their most recent live birth than mothers who had VD. Similarly, children who were born through the CS operation were more likely to report breathing problem, frequent illness, lower food demand and lower hours of sleeping.

CONCLUSION: The use of CS increases the risks of health and behavioural problems of the mothers and their children. Policies and programs to avoid medically unnecessary CS and increase awareness over its adverse effects are important.

PMID:36195965 | DOI:10.1186/s41043-022-00326-6