Tag: pubmed

Eur Heart J. 2022 Oct 27:ehac611. doi: 10.1093/eurheartj/ehac611. Online ahead of print.

ABSTRACT

AIMS: This network meta-analysis aimed to assess the effect of early coronary angiography (CAG) compared with selective CAG (late and no CAG) for patients after out-of-hospital cardiac arrest without ST-elevation myocardial infarction (NSTE-OHCA).

METHODS AND RESULTS: A systematic literature search was performed using the EMBASE, MEDLINE and Web of Science databases without restrictions on publication date. The last search was performed on 15 July 2022. Randomized controlled trials (RCTs) and non-randomized studies (NRS) comparing the effect of early CAG to selective CAG after NSTE-OHCA on survival and/or neurological outcomes were included. Meta-analyses were performed based on a DerSimonian-Laird random effects model. A total of 18 studies were identified by the literature search. After the exclusion of two studies due to high risk of bias, 16 studies (six RCTs, ten NRS) were included in the final analyses. Meta-analyses showed a statistically significant increase in survival after early CAG compared with selective CAG in the overall analysis [OR: 1.40, 95% confidence interval (CI): (1.12-1.76), P < 0.01, I2 = 68%]. This effect was lost in the subgroup analysis of RCTs [OR: 0.89, 95% CI: (0.73-1.10), P = 0.29, I2 = 0%]. Random effects model network meta-analysis of NRS based on a Bayesian method showed statistically significant increased survival after late compared with early CAG [OR: 4.20, 95% CI: (1.22, 20.91)].

CONCLUSION: The previously reported superiority of early CAG after NSTE-OHCA is based on NRS at high risk of selection and survivorship bias. The meta-analysis of RCTs does not support routinely performing early CAG after NSTE-OHCA.

PMID:36300362 | DOI:10.1093/eurheartj/ehac611

Phys Chem Chem Phys. 2022 Oct 27. doi: 10.1039/d2cp02659g. Online ahead of print.

ABSTRACT

Graphdiyne (GDY), a two-dimensional (2D) carbon, uniquely possesses mixed sp-sp² hybridization, uniform nano-sized porous structure, semiconducting character, and excellent electrical conductivity. These features beneficially promote its applications in many fields, especially gas sensing. Based on density functional theory (DFT) and statistical thermodynamics, this study reports the sensing capabilities of pristine and selected transition metal (i.e., Fe, Sc, and Ti)-decorated GDY to detect environmentally hazardous arsine (AsH₃) and phosphide (PH₃) gases. We discover that Fe-doped GDY is a high-performance sensing material for detecting AsH₃ and PH₃ because of its selectivity and ultra-high sensitivity at the part-per-million (ppm) level. The presence of these gases induces measurably drastic changes in the electronic properties of Fe-doped GDY. The promising detection capabilities are fundamentally rooted in the appropriate chemical binding energies (i.e., ranging from -0.80 to -1.80 eV), which are basically rooted in the prominent orbital overlap among Fe-3d and As(P)-4p states. This study has raised the need to design efficient nanosensors using GDY-based materials.

PMID:36300345 | DOI:10.1039/d2cp02659g

World J Pediatr Congenit Heart Surg. 2022 Nov;13(6):707-715. doi: 10.1177/21501351221111998.

ABSTRACT

BACKGROUND: The AHA/ACC Adult Congenital Heart Disease guidelines recommend that most adults with congenital heart disease (CHD) follow-up with CHD cardiologists every 1 to 2 years because longer gaps in care are associated with adverse outcomes. This study aimed to determine the proportion of patients in North Carolina who did not have recommended follow-up and to explore predictors of loss to follow-up.

METHODS: Patients ages ≥18 years with a healthcare encounter from 2008 to 2013 in a statewide North Carolina database with an ICD-9 code for CHD were assessed. The proportion with cardiology follow-up within 24 months following index encounter was assessed with Kaplan-Meier estimates. Cox regression was utilized to identify demographic factors associated with differences in follow-up.

RESULTS: 2822 patients were identified. Median age was 35 years; 55% were female. 70% were white, 22% black, and 3% Hispanic; 36% had severe CHD. The proportion with 2-year cardiology follow-up was 61%. Those with severe CHD were more likely to have timely follow-up than those with less severe CHD (72% vs 55%, P < .01). Black patients had a lower likelihood of follow-up than white patients (56% vs 64%, P = .01). Multivariable Cox regression identified younger age, non-severe CHD, and non-white race as risk factors for a lower likelihood of follow-up by 2 years.

CONCLUSION: 39% of adults with CHD in North Carolina are not meeting AHA/ACC recommendations for follow-up. Younger and minority patients and those with non-severe CHD were particularly vulnerable to inadequate follow-up; targeted efforts to retain these patients in care may be helpful.

PMID:36300264 | DOI:10.1177/21501351221111998

Acta Biomed. 2022 Oct 26;93(5):e2022219. doi: 10.23750/abm.v93i5.12794.

ABSTRACT

BACKGROUND: Reactive lesions (RLs) are the most common oral mucosal lesions that are benign in nature and are more likely to reoccur if the lesion or local irritants at the site are not completely removed. The histopathology is usually determined by the stage of the lesion, which includes neovascularization, inflammation, and fibrosis etc. Aim: To evaluate and compare mast cell counts in different reactive lesions with normal gingiva (NG) and to determine the correlation between mast cell count and inflammation, fibrosis, and angiogenesis using immunohistochemistry.

MATERIALS & METHODS: 10 pyogenic granulomas (early and late), 10 irritational fibromas, 5 inflammatory fibrous hyperplasia, and 5 peripheral cemento-ossifying fibromas 5 normal gingiva were evaluated. Mast cell counts were compared. ANOVA and t-tests were used to analyze the data. Spearman correlation was used to compare the mast cell count to the inflammation, fibrosis, and vascular components. A p-value of 0.05 was considered statistically significant.

RESULTS: The mean number of mast cells were increased in oral reactive lesions when compared to NG. Although mast cells were significantly higher in IFH and IF, there was no correlation found among mast cells and fibrosis/inflammation/vascularity.

CONCLUSION: Reactive process involves multiple interactions among mast cells, endothelial cells, fibroblasts, and other immune cells, among which the role of mast cells has been evaluated. Mast cell count increases in these reactive lesions, possibly reflecting an important role in microenvironment modification, but it is not the sole cause of these lesions’ pathogenesis.

PMID:36300240 | DOI:10.23750/abm.v93i5.12794

Acta Biomed. 2022 Oct 26;93(5):e2022313. doi: 10.23750/abm.v93i5.13402.

ABSTRACT

BACKGROUND AND AIM: The pandemic caused by SARS-COV-2 has increased Semi-Intensive Care Unit (SICU) admission, causing an increase in healthcare-associated infection (HAI). Mostly HAI reveals the same risk factors, but fewer studies have analyzed the possibility of multiple coinfections in these patients. The study aimed was to identify patterns of co-presence of different species describing at the same time the association between such patterns and patient demographics and, finally, comparing the patterns between the two cohorts of COVID-19 patients admitted at Policlinico during the first wave and the second one).

METHODS: All the patients admitted to SICUs during two COVID-19 waves, from March to June 2020 months and from October to December 2020, were screened following the local infection control surveillance program; whoever manifested fever has undergone on microbiological culture to detect bacterial species. Statistical analysis was performed to observe the existence of microbiological patterns through DBSCAN method.

RESULTS: 246 patients were investigated and 83 patients were considered in our study because they presented infection symptoms with a mean age of 67 years and 33.7% of female patients. During the first and second waves were found respectively 10 and 8 bacterial clusters with no difference regarding the most frequent species.

CONCLUSIONS: The results show the importance of an analysis which considers the risk factors for the possibility of co- and superinfection (such as age and gender) to structure a good prognostic tool to predict which patients will encounter severe coinfections during hospitalization.

PMID:36300221 | DOI:10.23750/abm.v93i5.13402

Acta Biomed. 2022 Oct 26;93(5):e2022309. doi: 10.23750/abm.v93i5.13803.

ABSTRACT

BACKGROUND AND AIM: Medication administration errors represent a topic of great scientific interest. Medication administration is considered by nursing students a complex process during which it is easy to make mistakes; therefore, institutional measures have been adopted in order to reduce medication errors. However, it remains a critical issue in nursing practice for which several causes have been identified, including environmental factors and individual knowledge. Mistakes can be made by nurses and especially by students who must cope with additional causal factors including anxiety management. The aim was to investigate state anxiety levels among nursing students when it comes to medication administration.

RESEARCH DESIGN AND METHODS: An observational study involving a convenience sample of 150 nursing students from a Northern Italy University has been conducted; they were asked to complete a questionnaire to measure the levels of state anxiety in relation to medication administration. Results. There were no particularly high levels of state anxiety among students associated with medication administration; however, state anxiety levels were slightly higher in third-year students than in second-year students, and this is most likely due to the growing complexity of the medication administration process compared to the lack of experience. Conclusions. Although the results don’t show statistically significant data, the effectiveness of nursing education plays a crucial role in reducing medication errors, which is why it is essential to provide suitable tools for the professionals of the future and invest in clinical simulations.

PMID:36300204 | DOI:10.23750/abm.v93i5.13803

Policy Polit Nurs Pract. 2022 Oct 26:15271544221130052. doi: 10.1177/15271544221130052. Online ahead of print.

ABSTRACT

Systemic and structural racism in nursing have profound impacts on Black People, Indigenous Peoples, and People of Color. They contributed to underrepresentation in faculty, senior nurse executives, and presidents’ positions in academic and healthcare organizations, physical and mental health issues in racialized groups. This quality improvement study described ways in which the Black Nurses Task Force of the Registered Nurses Association of Ontario can build solidarity with nursing and government organizations to dismantle systemic and structural racism in nursing. This study used a structured online survey, comprised of quantitative and qualitative questions. The qualitative data were analyzed using interpretative thematic analysis and the quantitative data were analyzed with descriptive statistics. Findings showed that 88% of participants experienced racism and 63% said racism affected their mental health. Three themes emerged from the qualitative data: Social support for Black nurses, accountability of leaders and solidarity with Black nurses. These findings demonstrated the urgent need to dismantle systemic and structural racism in nursing.

PMID:36300199 | DOI:10.1177/15271544221130052

Public Health Pract (Oxf). 2022 Oct 17;4:100330. doi: 10.1016/j.puhip.2022.100330. eCollection 2022 Dec.

ABSTRACT

OBJECTIVES: On June 26, 2015, the Supreme Court legalized same-sex marriages in the United States. This change has had some positive implications for the health of Lesbian, gay, bisexual, and transgender (LGBT) individuals and public health in general. Sexually transmitted infections (STIs) are common among LGBT individuals and legalization of same sex marriage effected the rate of emergency department (ED) visits for STIs. We examined the effect of same-sex marriage legalization on emergency department visits related to STIs among LGBT individuals.

STUDY DESIGN: Quasi-experimental difference-in-difference negative binomial design is used with state and time fixed-effects. We used data for 16 states from State Emergency Department Database and State Inpatient Database from January 2007-December 2015. People over 18 years of age visited the ED for STIs were included.

RESULTS: At 5% significance level, number of STIs cases decreased by 6.1% (95% CI, 0.906-0.973; P = 0.001) after same-sex marriage legalization. When adjusting for sex, these cases decreased by 7.6% (95% CI, 0.885-0.966; P < 0.001) for females, and 4.7% (95% CI, 0.914-0.995; P = 0.027) for males. By age cohorts, 18-24 aged had 8.5% (95% CI, 0.875-0.957; P < 0.001) decrease, while older age cohorts was statistically insignificant.

CONCLUSIONS: Our results show that there is an association between legalization and decreased STIs cases in ED visits. Policy makers need to focus on encouraging a positive attitude towards LGBT community, as it leads to better quality of health for sexual minority groups and leads to positive externalities for general community.

PMID:36300196 | PMC:PMC9589203 | DOI:10.1016/j.puhip.2022.100330

Front Neurosci. 2022 Oct 10;16:975189. doi: 10.3389/fnins.2022.975189. eCollection 2022.

ABSTRACT

BACKGROUND: Apathy is among the most prevalent and incapacitating non-motor symptoms of Parkinson’s disease (PD). PD patients with apathy (PD-A) have been reported to have abnormal spontaneous brain activity mainly in 0.01-0.08 Hz. However, the frequency-dependence of brain activity in PD-A remains unclear. Therefore, this study aimed to examine whether abnormalities in PD-A are associated with specific frequency bands.

MATERIALS AND METHODS: Overall, 28 patients with PD-A, 19 PD patients without apathy (PD-NA), and 32 gender-, age-matched healthy controls (HCs) were enrolled. We collected resting-state functional magnetic resonance imaging (rs-fMRI) data, demographic information, and neuropsychological assessments, including apathy, depression, anxiety and cognitive function for every participant. The amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF), percent amplitude of fluctuation (PerAF), regional homogeneity (ReHo), and degree centrality (DC) were calculated in the conventional (0.01-0.08 Hz), slow-4 (0.027-0.073 Hz), and slow-5 (0.01-0.027 Hz) frequency bands based on statistical parametric mapping (SPM12) and RESTplus V1.25. Two-sample t-tests were performed to compare the differences among the three groups.

RESULTS: PD-A reduced ALFF in the right anterior cingulate gyri in the slow-5 band and decreased fALFF in the right middle frontal gyrus in the conventional band, compared to patients with PD-NA. However, PerAF, ReHo, and DC could not distinguish PD-A from PD-NA in the three bands. PD-A had higher ALFF and fALFF in the left middle occipital gyrus and lower fALFF in the bilateral insula in the slow-5 band compared to the HCs. Furthermore, abnormal DC value in hippocampus and parahippocampus was observed separately in the conventional band and in the slow-4 band between PD-A and HCs. Moreover, PD-A and PD-NA showed lower ReHo in cerebellum in the three bands compared to the HCs.

CONCLUSION: Our study revealed that PD-A and PD-NA might have different neurophysiological mechanisms. Concurrently, the ALFF in the slow-5 band and fALFF in the conventional band were sensitive in differentiating PD-A from PD-NA. The influence of apathy on the disease can be considered in the future research on PD, with the effects of frequency band taken into account when analyzing spontaneous brain activities in PD-A.

PMID:36300172 | PMC:PMC9589053 | DOI:10.3389/fnins.2022.975189

Transl Gastroenterol Hepatol. 2022 Oct 25;7:39. doi: 10.21037/tgh-20-280. eCollection 2022.

ABSTRACT

BACKGROUND: Gastrointestinal procedures generally require pre-procedural fasting to optimize sedation safety. While the American Society of Anesthesiologists (ASA) recommends no intake of clear liquids and solid food 2-4 and 6-8 hours respectively prior to endoscopic procedures, the actual nil per os (NPO) duration for these procedures in practice is unknown. Our objective was to analyze NPO duration for patients undergoing these procedures and to determine its association with clinical and administrative variables.

METHODS: Inpatient data from 2016-2018 for the three procedures was extracted from electronic medical records and administrative data at a single-center tertiary academic medical center. Various statistical tests (Kruskal-Wallis, Wilcoxon, Pearson) were employed depending on the outcome type and data distribution.

RESULTS: One thousand three hundred and twenty-five esophagogastroduodenoscopies (EGDs), 753 colonoscopies, and 550 endoscopic retrograde cholangiopancreatographies (ERCPs) were included. The median NPO time for all procedures was 12.6 hours (IQR, 9.6-16.1 hours). The median NPO times were 12.6, 11.9, and 13.1 hours for EGD, colonoscopy, and ERCP respectively. NPO duration was greater for Hispanic than non-Hispanic patients (median 13.9 vs. 12.4, P=0.018). NPO duration was also associated with increased age (r=0.041, P=0.027) and inversely related to hospital occupancy (r=-0.08, P<0.0001). There were no statistically significant associations with provider type, hospital location or service, length of stay, and total number of comorbidities.

CONCLUSIONS: NPO times for common inpatient gastroenterology (GI) procedures generally exceeded 12 hours, suggesting there is an opportunity to adopt changes to decrease NPO duration for low-risk patients while maintaining adherence to guidelines and best practice.

PMID:36300152 | PMC:PMC9469011 | DOI:10.21037/tgh-20-280