Tag: pubmed

J Gastroenterol Hepatol. 2021 Sep 23. doi: 10.1111/jgh.15695. Online ahead of print.

ABSTRACT

BACKGROUND: The RHEMITT score (Renal disease; Heart failure; Endoscopic findings; Major bleeding; Incomplete SBCE; Tobacco; Treatment by enteroscopy), was the first score to accurately predict the individual risk of small bowel rebleeding after capsule endoscopy (SBCE).

AIM: Prospective validation of the RHEMITT score.

METHODS: Cohort of consecutive patients with mid gastrointestinal bleeding (MGIB) submitted to SBCE and followed prospectively, during at least 12 months, since 2017 until 2020. Rebleeding was defined as an overt bleeding event (melena or hematochezia) or a haemoglobin decrease of at least 2 g/dL. The RHEMITT score was calculated for each patient and the rebleeding rates compared. The performance of the score was tested by calculating the area under curve (AUC) of the ROC curve. A rebleeding-free survival was assessed, corresponding to the period between the date of SBCE and the date of the first post-SBCE rebleeding event.

RESULTS: We included 162 patients, 102 (62.9%) were female, with a mean age of 64 years-old. The sensitivities and specificities of the score grades for predicting rebleeding were as following: for low-risk patients, 0% [0-10%] and 28.8% [21.1-36.5%]; for intermediate-risk patients, 23.3% [8.2-38.4%] and 72% [64.3-79.7%]; for high-risk patients, 76.7% [61.6-91.8%] and 99.2% [97.7-100%], corresponding to an AUC of the ROC of 0.988 (p<0.001). Kaplan Meyer plots were statistically different according to the attributed risk (Log-Rank p-value <0.001; Breslow-Wilcoxon p-value <0.001).

CONCLUSION: The RHEMITT score performed with excellent discriminative power in predicting rebleeding risk, and we herewith propose a surveillance of MGIB patients guided by the RHEMITT score.

PMID:34555864 | DOI:10.1111/jgh.15695

Facts Views Vis Obgyn. 2021 Sep;13(3):223-231. doi: 10.52054/FVVO.13.3.027.

ABSTRACT

BACKGROUND: The introduction of ultra-high-definition laparoscopic cameras (4K), by providing stronger monocular depth perception, could challenge the existing 3D technology. There are few available studies on this topic, especially in gynaecological setting.

OBJECTIVES: Prospective, single institution, randomised clinical trial (NCT04209036).

MATERIALS AND METHODS: The two laparoscopes utilised were the 0°ULTRA Telescopes with 4K technology and the 0°3D-HD by Olympus. The surgeons were all trainees and in their last year of residency and who had obtained the certificate of first or second level of the Gynaecological Endoscopic Surgical Education and Assessment program – GESEA program. Twenty-nine patients with benign uterine pathology were enrolled.

MAIN OUTCOME MEASURES: To compare if the use three-dimensional (3D) versus ultra-high-definition laparoscopic vision system (4K) for total laparoscopic hysterectomy performed by trainees was associated with a shorter operative time.

RESULTS: The 3D vision system did not prove to be superior to the 4K vision system. Operators reported significantly more vision-related side effects when using 3D than 4K. Completing the GESEA training program was the only factor with a positive and statistically significant impact on the overall time of the procedure, especially when greater dexterity and tissue handling were required.

CONCLUSIONS: Neither technology used proved superior to the other, although operators showed a preference for 4K over 3D due to the lower number of visual side effects. Attendance at courses on laparoscopic simulators and training programs allowed trainees to demonstrate excellent surgical skills.

PMID:34555876 | DOI:10.52054/FVVO.13.3.027

Urol Int. 2021 Sep 23:1-9. doi: 10.1159/000518603. Online ahead of print.

ABSTRACT

PURPOSE: Vesicoureteral reflux (VUR) is a risk factor for various renal problems like recurrent urinary tract infections (UTIs), pyelonephritis, renal scarring, hypertension, and other renal parenchymal defects. The interventions followed by pediatricians include low-dose antibiotic treatment, surgical correction, and endoscopy. This meta-analysis aimed to assess the advantages and drawbacks of various primary VUR treatment options.

SEARCH STRATEGY: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, reference lists of journals, and abstracts from conference proceedings were all used to find randomized controlled trials. The articles were retrieved from 1985 till 2020. Twenty articles were used for the data analysis. Criteria for Selection: Surgery, long-term antibiotic prophylaxis, noninvasive techniques, and any mix of therapies are also options for treating VUR. Collection and Interpretation of Data: Two authors searched the literature separately, determining research qualifications, assessing accuracy, and extracting and entering results. The odds ratio (OR) of these studies was used to construct the forest plot. The random-effects model was used to pool the data. Also, the random-effects model was used with statistical significance at a p value < 0.05 to assess the difference in side effects after treatment of VUR using different modalities.

RESULTS: We found no statistically significant differences between surgery plus antibiotics and antibiotic alone-treated patients in terms of recurrent UTIs (OR = 0.581; 95% confidence interval [CI] 0.259-1.30), renal parenchymal defects (OR = 1.149; 95% CI 0.75-1.754), and renal scarring (OR = 1.042; 95% CI 0.72-1.50). However, the risk of developing pyelonephritis after surgical treatment of VUR was lesser than that in the conservative approach, that is, antibiotics (OR = 0.345; 95% CI 0.126-0.946.), positive urine culture (OR = 0.617; 95% CI 0.428-0.890), and recurrent UTIs were more common in the placebo group than in the antibiotic group (p < 0.05; OR = 0.639; 95% CI 0.436-0.936) which is statistically significant.

CONCLUSION: Based on current research, we recommend that a child with a UTI and significant VUR be treated conservatively at first, with surgical care reserved for children who have issues with antimicrobials or have clinically significant VUR that persists after several years of follow-up.

PMID:34555831 | DOI:10.1159/000518603

Int Health. 2021 Sep 23:ihab058. doi: 10.1093/inthealth/ihab058. Online ahead of print.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has spurred an unprecedented paradigm shift to telemedicine across healthcare fields in order to limit exposure to the virus. At the West China Hospital of Sichuan University, telemedicine has been used to perform COVID-19-related tele-education to health professionals and the general population, as well as tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, many older adults could not make appointments with doctors due to difficulty using the internet-based platform. Careful attention needs to be paid by future researchers and policymakers in order to mitigate barriers older adults face when using telemedicine.

PMID:34555846 | DOI:10.1093/inthealth/ihab058

Aging (Albany NY). 2021 Sep 23;13(undefined). doi: 10.18632/aging.203564. Online ahead of print.

ABSTRACT

Renal cell carcinoma (RCC) is a lethal malignancy of the genitourinary system. Follistatin-like 3 (FSTL3), which mediates cell differentiation and growth, acts as a biomarker of tumors and participates in cancer development and progression. Presently, the FSTL3’s functions in RCC were investigated. Quantitative reverse transcription PCR (qRT-PCR), Western Blot, and enzyme linked immunosorbent assay (ELISA) were conducted to verify FSTL3 expression in RCC tissues and cell lines. BrdU assay and CCK8 experiment were made to monitor cell proliferation. Transwell was implemented to examine the invasion of the cells. Flow cytometry analyzed cell apoptosis, and Western Blot evaluated the protein levels of E-cadherin, Twist, and Slug. In the meantime, the protein profiles of the GSK-3β, β-catenin, and TGF-β signaling pathways were ascertained. Moreover, the Xenograft tumor model was constructed in nude mice for measuring tumor growth in vivo. The statistics showed that FSTL3 presented an overexpression in RCC, and patients with a lower expression of FSTL3 manifested a better prognosis. Down-regulated FSTL3 hampered the proliferation, invasion, EMT, and tumor growth of RCC cells and caused cell apoptosis. On the contrary, FSTL3 overexpression enhanced the malignant behaviors of RCC cells. Furthermore, FSTL3 knockdown bolstered GSK-3β, suppressed β-catenin, and reduced BMP1-SMAD pathway activation. Inhibited β-catenin substantially mitigated FSTL3-mediated promoting functions in RCC. In short, FSTL3 functions as an oncogene in RCC by modulating the GSK-3β/β-catenin signaling pathway.

PMID:34555811 | DOI:10.18632/aging.203564

J Phys Condens Matter. 2021 Sep 23. doi: 10.1088/1361-648X/ac296e. Online ahead of print.

ABSTRACT

In this work we report for the first time the appearance of non-decaying circular spin current in a magnetic ring with vanishing net magnetization, even in absence of any spin chirality. Breaking the symmetry in hopping integrals we can misalign up and down spin electronic energy levels which yields a net spin current in the magnetic quantum ring, threaded by an Aharonov-Bohm (AB) flux. Along with spin current, a net charge current also appears, and we compute both these currents using the second quantized approach. A tight-binding framework is employed to describe the magnetic ring where each site of the ring contains a finite magnetic moment. Itinerant electrons get scattered from the localized magnetic moments at different lattice sites, and the moments are arranged in such a way that the net magnetization vanishes. The interplay between magnetic moments and asymmetric hopping integrals leads to several atypical features in energy spectra, especially the existence of vanishing current carrying energy eigenstates together with the current carrying ones. The formation of such states those do not contribute any current is the artifact of different kinds of on-site energies and/or hopping integrals in different segments of the magnetic ring. The atypical signatures of energy levels are directly reflected into the charge and spin currents, and here we critically investigate the behaviors of circular currents as functions of electron filling, hopping integrals, strength of spin-moment interaction and ring size. Finally, we discuss briefly the possible experimental realization to implement our proposed magnetic system. The present analysis may provide a new route of generating persistent spin current in magnetic quantum rings with vanishing net magnetization, circumventing the use of spin-orbit coupled systems.

PMID:34555814 | DOI:10.1088/1361-648X/ac296e

Mar Pollut Bull. 2021 Sep 20;173(Pt A):112957. doi: 10.1016/j.marpolbul.2021.112957. Online ahead of print.

ABSTRACT

Marine debris is a persistent and pervasive threat worldwide including inside marine protected areas (MPAs). To assess marine debris accumulation rates and potential impacts, we counted and evaluated trap, non-trap fishing gear, and non-fishing debris in unprotected areas and MPAs with different management boundary regulations in the Florida Keys (USA). Analyses identified that neither MPA type nor size were strong drivers of debris density and that debris densities were not statistically different between unprotected areas and MPAs. Non-fishing and non-trap fishing gear debris densities were potentially related to unexplored local differences in human behavior, while trap debris density was likely associated with oceanographic forces that transported traps into the MPAs. Overall, our results suggested that the drivers of marine debris accumulation for each debris category were different and may vary with each individual MPA, and that marine debris is not constrained by MPA boundaries.

PMID:34555780 | DOI:10.1016/j.marpolbul.2021.112957

Environ Pollut. 2021 Sep 10;291:118140. doi: 10.1016/j.envpol.2021.118140. Online ahead of print.

ABSTRACT

In this biomonitoring study, we evaluated the concentrations of 8 polychlorinated biphenyls (PCBs), 11 organochlorinated pesticides (OCPs), 33 brominated flame retardants (BFRs), 7 novel brominated and chlorinated flame retardants (novel FRs) and 30 per- and polyfluoroalkylated substances (PFAS) in human serum samples (n = 274). A total of 89 persistent organic pollutants (POPs) were measured in blood serum samples of city policemen living in three large cities and their adjacent areas (Ostrava, Prague, and Ceske Budejovice) in the Czech Republic. All samples were collected during the year 2019 in two sampling periods (spring and autumn). The identification/quantification of PCBs, OCPs, BFRs, novel FRs and PFAS was performed by means of gas chromatography coupled to (tandem) mass spectrometry (GC-MS/(MS)) and ultra-high performance liquid chromatography coupled to triple quadrupole tandem mass spectrometry (UHPLC-MS/MS). The most frequently detected pollutants were perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorooctanesulfonate (PFOS), perfluorohexanesulfonate (PFHxS), 2,2′,3,4,4′,5′-hexachlorobiphenyl (CB 138), 2,2′,4,4′,5,5′-hexachlorobiphenyl (CB 153), 2,2′,3,3′,4,4′,5-heptachlorobiphenyl (CB 170), 2,2′,3,4,4′,5,5′-heptachlorobiphenyl (CB 180), hexachlorobenzene (HCB), and p,p’-dichlorodiphenyldichloroethylene (p,p’-DDE) quantified in 100% of serum samples. In the serum samples, the concentrations of determined POPs were in the range of 0.108-900 ng g^-1 lipid weight (lw) for PCBs, 0.106-1016 ng g^-1 lw for OCPs, <0.1-618 ng g^-1 lw for FRs and <0.01-18.3 ng mL^-1 for PFAS, respectively. Locality, sampling season, and age were significantly associated with several POP concentrations. One of the important conclusions was that within the spring sampling period, statistically significant higher concentrations of CB 170 and CB 180 were observed in the samples from Ostrava (industrial area) compared to Prague and Ceske Budejovice. Older policemen had higher concentrations of five PCBs and two OCPs in blood serum.

PMID:34555793 | DOI:10.1016/j.envpol.2021.118140

J Pediatr Nurs. 2021 Sep 15;61:340-345. doi: 10.1016/j.pedn.2021.09.013. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to determine the effects of restrictions that have been imposed during the COVID-19 pandemic, and contact with a COVID-19 positive individual on children and the practices adopted by parents to help their children cope with these effects.

DESIGN AND METHODS: The data for this descriptive study were collected through social media platforms. The study included 464 parents who have children between the ages of 3 and 18, use social media, and are willing to participate in the study. The Parent and Child Descriptive Characteristics Form, Assessment Form for Pandemic Effects, and Form of Parent’s Practices for Children during the Pandemic were used to collect the study data.

RESULTS: It was determined that the screen time of the children increased and their physical activity decreased during the restrictions. Following the restrictions imposed during the COVID-19 pandemic, the children’s body weight increased by an average of 3.87 ± 2.28 kg, and according to parents, most of the children were more tense, stressed, and angrier. A statistically significant relationship was found between having had contact with an individual diagnosed with COVID-19 and compliance with regular, balanced nutrition and hygiene rules in children (p < 0.05), as well as between having been quarantined and compliance with hygiene rules in children (p < 0.05).

PRACTICE IMPLICATIONS: Despite the relatively low case and mortality rates in children, the COVID-19 pandemic has been a significant health problem for children. From the study, it was determined that the COVID-19 pandemic affects the physical and psychological health of children.

PMID:34555746 | DOI:10.1016/j.pedn.2021.09.013

Epilepsy Behav. 2021 Sep 20;124:108303. doi: 10.1016/j.yebeh.2021.108303. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to investigate the association between telemedicine and the incidence of status epilepticus (SE) in patients with epilepsy (PWE) during the coronavirus disease 2019 (COVID-19) pandemic using a large population database in the United States.

METHODS: We performed a retrospective analysis of a private, cloud-based healthcare platform (Explorys Inc., Cleveland, Ohio, USA). We compared each of the previously reported risk factors for SE, such as child, male, and refractory epilepsy, using the chi-square test or Fisher’s exact test in two groups: PWE with SE or without SE. We determined whether telemedicine could be a risk factor for the incidence of SE using multivariate binary logistic regression analysis incorporating statistically significant variables in the chi-square test or Fisher’s exact test (p < 0.05). Statistical significance was set at p < 0.05.

RESULTS: We identified 1600 PWE with SE and 61,700 PWE without SE from May 2020 to May 2021. The proportion of children, males, refractory epilepsy, and telemedicine was higher in PWE with SE than in PWE without SE (children: 21.9% vs. 17.7%, p < 0.001; male: 52.5% vs. 48.2%, p = 0.001; refractory epilepsy: 20.6% vs. 8.2%, p < 0.001; telemedicine: 42.5% vs. 23.6%, p < 0.001). The multivariate binary logistic regression model identified four significant variables as follows: child (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.17-1.50), male (OR, 1.19; 95% CI, 1.07-1.31), refractory epilepsy (OR, 2.44; 95% CI, 2.15-2.77), and telemedicine (OR, 2.29; 95% CI, 2.07-2.54).

CONCLUSION: Telemedicine might be associated with an increased risk of SE in PWE during the COVID-19 pandemic.

PMID:34555700 | DOI:10.1016/j.yebeh.2021.108303