Tag: pubmed

Swiss Med Wkly. 2022 Feb 21;152:w30139. doi: 10.4414/smw.2022.w30139. eCollection 2022 Feb 14.

ABSTRACT

BACKGROUND: Cerebral Palsy (CP) is a group of permanent disorders of movement and posture that follow injuries to the developing brain. It results in motor dysfunction and a wide variety of comorbidities like epilepsy; pain; speech, hearing and vision disorders; cognitive dysfunction; and eating and digestive difficulties. Central data collection is essential to the study of the epidemiology, clinical presentations, care, and quality of life of patients affected by CP. CP specialists founded the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) in 2017. This paper describes the design, structure, aims and achievements of Swiss-CP-Reg and presents its first results.

METHODS: Swiss-CP-Reg records patients of any age diagnosed with CP who are born, are treated, or live in Switzerland. It collects data from medical records and reports, from questionnaires answered by patients and their families, and from data linkage with routine statistics and other registries. The registry contains information on diagnosis, clinical presentation, comorbidities, therapies, personal information, family history, and quality of life.

RESULTS: From August 2017 to August 2021, 546 participants (55% male, mean age at registration 8 years [interquartile range IQR: 5-12]), were enrolled in Swiss-CP-Reg. Most had been born at term (56%), were less than two years old at diagnosis (73%, median 18 months, IQR: 9-25), and were diagnosed with spastic CP (76%). Most (59%) live with a mild motor impairment (Gross Motor Function Classification System [GMFCS] level I or II), 12% with a moderate motor impairment (GMFCS level III), and 29% with a severe motor impairment (GMFCS level IV or V). In a subset of 170 participants, we measured intelligence quotient (IQ) and saw lower IQs with increasing GMFCS level. Swiss-CP-Reg has a strong interest in research, with four nested projects running currently, and many more planned.

CONCLUSIONS: Swiss-CP-Reg collects and exchanges national data on people living with CP to answer clinically relevant questions. Its structure enables retrospective and prospective data collection and knowledge exchange between experts to optimise and standardise treatment and to improve the health and quality of life of those diagnosed with CP in Switzerland.

PMID:35230014 | DOI:10.4414/smw.2022.w30139

Croat Med J. 2022 Feb 28;63(1):89-97.

ABSTRACT

AIM: To assess the determinants and reasons for coronavirus disease 2019 (COVID-19) vaccine hesitancy in Croatia.

METHODS: The data were collected through a sociological survey by using a mixed-mode approach (computer-assisted web interviewing and computer-assisted telephone interview) on a national sample of 765 adults aged 18 or above. Bivariate (χ2 test) and multivariate (binary logistic regression) statistical methods were used.

RESULTS: The rate of COVID-19 vaccine hesitancy was relatively high (35%), with unequal distribution across demographic groups. Binary logistic regression with demographic characteristics as predictors showed that women, younger age groups (especially 25-34-year-olds), persons residing in households with children, inhabitants of smaller settlements, and persons with lower levels of education had higher odds of vaccine hesitancy. Trust in the five main actors responding to the COVID-19 pandemic (the National Civil Protection Headquarters, Government, health care system, scientists-researchers, and media) was also a significant predictor of vaccine hesitancy. Risk perception was an even stronger predictor: persons who perceived SARS-CoV-2 infection as a small risk were more than ten times likelier to be vaccine hesitant than those who perceived it as a great risk.

CONCLUSION: Social groups that are more prone to vaccine hesitancy need to be approached through different channels and messages by taking into account their trust in institutions and risk perception.

PMID:35230010

Ultrasound Obstet Gynecol. 2022 Mar 1. doi: 10.1002/uog.24893. Online ahead of print.

NO ABSTRACT

PMID:35229932 | DOI:10.1002/uog.24893

Aust J Rural Health. 2022 Mar 1. doi: 10.1111/ajr.12858. Online ahead of print.

ABSTRACT

INTRODUCTION: Low retention is a significant contributor to medical workforce shortages in rural and remote regions of Australia, including in the Northern Territory (NT). Many of these areas are susceptible to climate change, which could exacerbate workforce retention problems.

OBJECTIVE: To examine factors influencing medical workforce retention in the NT, including the potential impact of climate change.

DESIGN: Cross sectional online survey of NT medical professionals, distributed via email through professional networks. Predominantly quantitative mixed methods (descriptive statistics, multivariate logistic regression, thematic analysis). Main 2 outcome measures reported were proportion of respondents intending to leave the NT, timeframe of intention to leave and motivating factors.

FINDINGS: Of 1407 registered practising medical professionals in the NT, 362 responded who met inclusion criteria (26% estimated response rate) and 351 completed all questions. Of the latter, 143 (41%) intended to leave the NT, 102 (29%) were unsure, and 106 (30%) did not intend to leave. Among doctors in training (DITs) 67 (55%) intended to leave and 29 (24%) were unsure. The best multivariable predictive model included only practice type (with general practitioners/rural generalists and non-GP specialists significantly less likely to intend to leave compared to DITs), and location of primary medical degree (with non-NT training non-significantly associated with greater intention to leave). Of those intending to leave 94 (66%) reported planning to do so within two years. Training and career development opportunities, job dissatisfaction, moving to a preferred location and family-related factors were all important motivators. Of those considering leaving, 58 (24%) identified climate change as a motivating factor.

CONCLUSION: Retention remains a key challenge in addressing rural workforce shortages. In addition to established factors, climate change is an important driver that has the potential to worsen workforce shortages in susceptible regions.

PMID:35229933 | DOI:10.1111/ajr.12858

Am J Reprod Immunol. 2022 Mar 1. doi: 10.1111/aji.13529. Online ahead of print.

ABSTRACT

PROBLEM: Intrauterine administration of autologous peripheral blood mononuclear cells (PBMCs) or human chorionic gonadotropin (hCG) has been proposed to facilitate embryo implantation, while its effect on clinical outcome of women with previous recurrent implantation failure in frozen/thawed embryo transfer (FET) cycles is still unclear.

METHOD OF STUDY: 523 patients having not experienced successful clinical pregnancy were enrolled in our study, including 207 repeat implantation failure (RIF) patients, and 316 patients with previous implantation failures but failed to meet the diagnostic criteria for RIF (non-RIF). Autologous PBMCs were cultured with hCG for 4 hours in the hCG-activated PBMC-treated group (n = 73 in RIF patients, n = 112 in non-RIF patients), and then intrauterine administered 2 days before FET. In the hCG-treated group (n = 67 in RIF patients, n = 100 in non-RIF patients), recombinant hCG was administered 2 days before FET. The control group (n = 67 in RIF patients, n = 104 in non-RIF patients) underwent FET without intrauterine administration.

RESULTS: In RIF patients, the clinical pregnancy rate of the above three groups are 56.16%, 53.73% and 43.28%, respectively (P = 0.276). The implantation rate and live birth rate showed no significant differences (P>0.05). For non-RIF patients, higher clinical pregnancy rate was also seen in PBMC intrauterine group (57.15%) and hCG intrauterine group (58.00%) than controls (50.96%) but without statistical significance. There were no significant differences of implantation rate and live birth rate (P>0.05).

CONCLUSION: Intrauterine administration of hCG-activated PBMC and hCG did not improve clinical outcomes for both RIF and non-RIF patients before FET embryo transfer. This article is protected by copyright. All rights reserved.

PMID:35229928 | DOI:10.1111/aji.13529

Aust Endod J. 2022 Mar 1. doi: 10.1111/aej.12611. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate the effect of calcium hydroxide (CH) and niobium pentoxide (NP) pretreatment on pH, dentin microhardness and sealing of Mineral Trioxide Aggregate (MTA; Angelus). The pH of CH, NP and CH-NP (3:1) was evaluated in neutral and acidic simulated tissue fluid over 28 days. The Vickers microhardness was measured in forty 4 mm coronal root slices filled with pretreatment materials stored in medium for 1, 7, 28 days. Forty 10 mm roots were packed with pretreatment materials, irrigated after 24 h, then a 3 mm MTA plug was placed. Sealing ability was evaluated after 7 days using fluid filtration method. Statistics was performed using ANOVA and post hoc Tukey HSD tests. Addition of NP to CH maintained the alkalinity of CH, increased the microhardness of root dentin and reduced the microleakage. CH-NP can be effectively used as a pretreatment medicament in root canals requiring placement of MTA under acidic conditions.

PMID:35229927 | DOI:10.1111/aej.12611

J Clin Pharm Ther. 2022 Mar 1. doi: 10.1111/jcpt.13631. Online ahead of print.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: Patients with tuberous sclerosis complex (TSC) demonstrate disrupted lipid homeostasis before and during treatment with mammalian target of rapamycin (mTOR) inhibitor. However, few previous reports focused on if the serum lipid status at baseline would influence lipid metabolic side-effects of mTOR inhibitors for TSC associated renal angiomyolipomas (TSC-AML). The present study was designed to evaluate the predictive function of serum lipid status at baseline for hyperlipidaemia by mTOR inhibitor treatment in TSC-AML patients.

METHODS: The clinical data of TSC-AML patients who took mTOR inhibitors in Department of Urology of Peking Union Medical College Hospital (PUMCH) from 1 January 2014 to 1 January 2021, were retrospectively analysed. The record of lipid parameters at baseline and the highest levels of total cholesterol (TC) and triglyceride (TG) after treatment at least ≥3 months were collected. The correlation of serum lipid parameters at baseline with incidence of hyperlipidaemia during mTOR inhibitor treatment was analysed. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the ability of the serum lipid parameters in predicting hyperlipidaemia.

RESULTS AND DISCUSSION: 19 patients experienced hyperlipidaemia and 13 patients still had normal TC and TG levels during mTOR inhibitor treatment. The levels of high-density lipoprotein cholesterol (HDL-C) (0.98 ± 0.30 mmol/L vs. 1.23 ± 0.31 mmol/L, p = 0.030), low-density lipoprotein cholesterol (LDL-C) (2.47 ± 0.69 mmol/L vs. 1.95 ± 0.53 mmol/L, p = 0.029) and apolipoprotein B (ApoB) (0.82 ± 0.21 g/L vs. 0.65 ± 0.16 g/L, p = 0.019) are higher in the patients who experienced hyperlipidaemia during mTOR inhibition therapy. TC, TG, LDL-C, ApoB and high-sensitivity C-reactive protein (hsCRP) at baseline had positive correlation with TC after treatment; ApoB at baseline had positive correlation, while HDL-C and free fat acid (FFA) at baseline had negative correlation with TG after treatment. Therefore, ApoB concentration at baseline has statistically significant correlation with both TC (p < 0.001) and TG (p = 0.012) levels after mTOR inhibitor treatment. ROC curve and AUC revealed that ApoB with a cut-off value of 0.640g/L may be the best parameter for predicting hyperlipidaemia during mTOR inhibitor treatment in TSC-AML patients. The incidence rates of hyperlipidaemia were 27.3% and 76.2% among the patients with ApoB level ≤0.640 g/L and >0.640 g/L respectively.

WHAT IS NEW AND CONCLUSION: Some baseline serum lipid parameters could be used for predicting incidence of hyperlipidaemia during mTOR inhibition therapy in TSC-AML patients, and ApoB with 0.640 g/L as a cut-off value may be a potentially optimal indicator, which could help for diagnosis and treatment decision-making.

PMID:35229896 | DOI:10.1111/jcpt.13631

Community Dent Oral Epidemiol. 2022 Mar 1. doi: 10.1111/cdoe.12735. Online ahead of print.

ABSTRACT

OBJECTIVE: The International Caries Classification and Management System (ICCMS™), a comprehensive, evidence-informed, best clinical practice system, comprises a 4D cycle: 1D-Determine risk; 2D-Detect and assess lesions; 3D-Decide on a personalized care plan; and 4D-Do preventive and tooth-preserving care. The aim of this study was to establish how Colombian dental practitioners, educators and students diagnose and manage caries risk and caries lesions using the COM-B model and the ICCMS™ system.

METHODS: A total of 1094 participants (practitioners: n = 277; educators: n = 212; students: n = 605) completed a previously validated 79-item questionnaire which explores, based on the COM-B model, the practitioners’ self-reported caries diagnosis and management behaviours. Descriptive statistics, Welch’s ANOVAs and multiple linear regressions were computed.

RESULTS: All groups generally performed the behaviours within the 4-D categories ‘Most of the time’ to ‘Always’ (students: 4.06 ± 0.95; educators: 3.94 ± 0.98; practitioners: 3.86 ± 1.01). The most frequently performed diagnosis behaviours (1D/2D) were for practitioners assessing initial/moderate lesions (4.09 ± 1.01) and for educators and students cleaning teeth before lesion assessment (4.41 ± 0.80 and 4.38 ± 0.77 respectively). The least frequently performed decision/management (3D/4D) behaviour was non-operative care for moderate-caries lesions (when applicable) (practitioners: 2.64 ± 1.23; educators: 2.68 ± 1.17; students: 3.22 ± 1.41). Opportunity (Resources and Relevance) was the best COM-B predictor for diagnostic behaviours, whereas capability and opportunity (Relevance) were the strongest predictors for management behaviours.

CONCLUSION: Colombian practitioners, educators and students diagnose and manage caries risk and caries lesions implementing best practice with a high to very high frequency.

PMID:35229897 | DOI:10.1111/cdoe.12735

J Am Geriatr Soc. 2022 Mar 1. doi: 10.1111/jgs.17708. Online ahead of print.

ABSTRACT

BACKGROUND: Few studies of social isolation, loneliness and associations with all-cause mortality in older adults have been conducted in non-Western countries. The aim of this study was to conduct such an analysis in a nationally representative sample of Chinese older adults.

METHODS: This study used eight waves of data from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2018 and focused on participants aged ≥60 years. A total of 21,570 people died (61.2%) over a median follow-up of 4.8 years. Social isolation, loneliness, demographic, health and lifestyle factors were measured at baseline. The primary outcome was all-cause mortality. Cox proportional hazard regression models were used to examine the associations of isolation and loneliness with all-cause mortality.

RESULTS: This study included 35,254 participants with mean age of 86.63 ± 11.39 years. Social isolation was significantly associated with an increased mortality (adjusted HR 1.22; 95% CI 1.18-1.25; p < 0.01). The association of loneliness with mortality was nonsignificant after adjustment for health indicators and low psychological well-being (HR 1.01; 95% CI 0.98-1.04; p = 0.69). However, when stratified by age, there was a significant association of loneliness with mortality among participants aged <80 years (HR 1.15; 95% CI 1.05-1.26; p < 0.01).

CONCLUSIONS: Social isolation was associated with an increased all-cause mortality among the older Chinese adults. However, loneliness was associated with an increased mortality only among younger participants. Public health interventions aimed at increasing social connectedness may potentially reduce excess mortality among older adults.

PMID:35229887 | DOI:10.1111/jgs.17708

Int J Epidemiol. 2022 Mar 1:dyac023. doi: 10.1093/ije/dyac023. Online ahead of print.

ABSTRACT

BACKGROUND: The association between body mass index (BMI) and oesophageal cancer (OC) has been consistently negative among Asians, whereas different associations based on histological OC subtypes have been observed in Europeans and North Americans. We examined the association between BMI and OC mortality in the Asia Cohort Consortium.

METHODS: We performed a pooled analysis to evaluate the association between BMI and OC mortality among 842 630 Asians from 18 cohort studies. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs.

RESULTS: A wide J-shaped association between BMI and overall OC mortality was observed. The OC mortality risk was increased for underweight (BMI <18.5 kg/m2: HR = 2.20, 95% CI 1.80-2.70) and extreme obesity (BMI ≥35 kg/m2: HR = 4.38, 95% CI 2.25-8.52) relative to the reference BMI (23-25 kg/m2). This association pattern was confirmed by several alternative analyses based on OC incidence and meta-analysis. A similar wide J-shaped association was observed in oesophageal squamous cell carcinoma (OSCC). Smoking and alcohol synergistically increased the OC mortality risk in underweight participants (HR = 6.96, 95% CI 4.54-10.67) relative to that in reference BMI participants not exposed to smoking and alcohol.

CONCLUSION: Extreme obesity and being underweight were associated with an OC mortality risk among Asians. OC mortality and BMI formed a wide J-shaped association mirrored by OSCC mortality. Although the effect of BMI on OSCC and oesophageal adenocarcinoma mortality can be different in Asians, further research based on a large case-control study is recommended.

PMID:35229874 | DOI:10.1093/ije/dyac023