Tag: pubmed

J Card Surg. 2021 Sep 21. doi: 10.1111/jocs.15996. Online ahead of print.

ABSTRACT

BACKGROUND: Pericardiectomy for postradiation constrictive pericarditis has been reported to generally have unfavorable outcomes. This study sought to evaluate surgical outcomes in a large cohort of patients undergoing pericardiectomy for radiation-associated pericardial constriction.

METHODS: A retrospective analysis of all patients (≥18 years) who underwent pericardiectomy for a diagnosis of constrictive pericarditis with a prior history of mediastinal irradiation from June 2002 to June 2019 was conducted. There were 100 patients (mean age 57.2 ± 10.1 years, 49% females) who met the inclusion criteria. Records were reviewed to look at the surgical approach, the extent of resection, early mortality, and late survival.

RESULTS: The overall operative mortality was 10.1% (n = 10). The rate of operative mortality decreased over the study period; however, the test of the trend was not statistically significant (p = .062). Hodgkin’s disease was the most common malignancy (64%) for which mediastinal radiation had been received. Only 27% of patients had an isolated pericardiectomy, and concomitant pericardiectomy and valve surgery were performed in 46% of patients. Radical resection was performed in 50% of patients, whereas 47% of patients underwent subtotal resection. Prolonged ventilation (26%), atrial fibrillation (21%), and pleural effusion (16%) were the most common postoperative complications. The overall 1, 5-, and 10-years survival was 73.6%, 53.4%, and 32.1%, respectively. Increasing age (hazard ratio, 1.044, 95% confidence interval 1.017-1.073) appeared to have a significant negative effect on overall survival in the univariate model.

CONCLUSION: Pericardiectomy performed for radiation-associated constrictive pericarditis has poor long-term outcomes. The early mortality, though high (~10%), has been showing a decreasing trend in the test of time.

PMID:34547827 | DOI:10.1111/jocs.15996

Clin Oral Implants Res. 2021 Sep 21. doi: 10.1111/clr.13848. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the osseointegration of calcium-coated (CS) and chemically modified, sandblasted, large-grit, acid-etched (MS) dental implants with a lack of primary mechanical stability.

MATERIALS AND METHODS: Eighteen implants in CS and MS groups each were loosely placed in the mandible of 6 mongrel dogs and allowed to heal for 2, 4 and 8 weeks. Implant stability quotient (ISQ) and implant stability test (IST) values recorded periodically and bone-to-implant contact (BIC) and the number of Haversian canals per 1 mm² measured histologically were statistically analyzed (p < 0.05).

RESULTS: All CS and MS implants placed survived. Compared with immediately after installation, ISQ and IST values in both groups increased significantly to over 76 at 2 weeks (p < 0.0083) and remained stable thereafter. BIC was significantly greater at 8 weeks (61.3 ± 13.6% in CS group; 57.6 ± 5.9% in MS group) compared to 2 and 4 weeks in both groups (p < 0.017). There were no significant intergroup differences in ISQ, IST or BIC at different time-points. Significantly more Haversian canals were observed in group CS (6.2 ± 1.0 /mm² ) compared to group MS at 4 weeks (3.7 ± 1.8 /mm² ; p < 0.05), while intergroup difference was not significant at 8 weeks.

CONCLUSION: Both CS and MS implants inserted without primary stability obtained osseointegration within 2 weeks, and lamellar bone adjacent to the implants was first observed at 8 weeks. The formation of primary osteons was more active at 4 weeks in group CS than in group MS.

PMID:34547819 | DOI:10.1111/clr.13848

J Community Psychol. 2021 Sep 21. doi: 10.1002/jcop.22712. Online ahead of print.

ABSTRACT

This study assessed the prediction of occupational stress through personality traits, gender and occupational stress among teachers of learners with special needs (TLSN) from the southwest, Nigeria. The transactional stress theory provided a framework for the study. Data were collected through a paper-pencil self-completed questionnaire. Data collected were analysed by descriptive and inferential statistics at 95% confidence intervals (CIs) and p < 0.05. The response rate was 94.4%. A total of 287 male and 185 female TLSN participated in this study. Findings revealed a significant association between extraversion, agreeableness; openness, conscientiousness, neuroticism and occupational stress of TLSN. Participants with extraversion and openness both has highest likelihood of exhibiting occupational stress. Male TLSN had a greater likelihood of exhibiting occupational stress. The study concluded that male TLSN with extraversion and openness personality traits has high proportion of occupational stress. Based on the findings, appropriate recommendations were made.

PMID:34547826 | DOI:10.1002/jcop.22712

Rev Bras Ginecol Obstet. 2021 Aug;43(8):608-615. doi: 10.1055/s-0041-1735229. Epub 2021 Sep 21.

ABSTRACT

OBJECTIVE: To establish a relationship between serum progesterone values on the day of frozen blastocyst transfer in hormone-replaced cycles with the probability of pregnancy, miscarriage or delivery.

METHODS: This was an ambispective observational study including all frozen-thawed embryo transfer cycles performed at our department following in vitro fecundation from May 2018 to June 2019. The outcomes evaluated were β human chorionic gonadotropin (β-hCG)-positive pregnancy and delivery. Groups were compared according to the level of serum progesterone on the day of embryo transfer: the 1^st quartile of progesterone was compared against the other quartiles and then the 2^nd and 3^rd quartiles against the 4^th quartile.

RESULTS: A total of 140 transfers were included in the analysis: 87 with β-HCG > 10 IU/L (62%), of which 50 (36%) delivered and 37 had a miscarriage (42%). Women with lower progesterone levels (< 10.7ng/mL) had a trend toward higher β-HCG-positive (72 versus 59%; p > 0.05), lower delivery (26 versus 39%; p > 0.05) and higher miscarriage rates (64 versus 33%; p < 0.01). Comparing the middle quartiles (P25-50) with those above percentiles 75, the rate of pregnancy was similar (60 versus 57%; p > 0.05), although there was a trend toward a higher number of deliveries (43 versus 31%; p > 0.05) and a lower number of miscarriages (28 versus 45%; p > 0.05). These differences were not statistically significant.

CONCLUSION: There were no differences in pregnancy and delivery rates related with the progesterone level when measured in the transfer day. The miscarriage rate was higher in the 1^st quartile group.

PMID:34547795 | DOI:10.1055/s-0041-1735229

Rev Bras Ginecol Obstet. 2021 Aug;43(8):616-621. doi: 10.1055/s-0041-1733998. Epub 2021 Sep 21.

ABSTRACT

OBJECTIVE: This study evaluated the risk of the hereditary breast and ovarian cancer (HBOC) syndrome in patients with breast cancer by using the Family History Screening 7 (FHS-7) tool, a validated low-cost questionnaire with high sensitivity able to screen the HBOC risk in the population.

METHODS: Women diagnosed with breast cancer (n = 101) assisted by the Unified Health System at the 8th Regional Health Municipal Office of the state of Paraná answered the FHS-7, and the results were analyzed using IBM SPSS Statistics for Windows, Version 25.0. software (IBM Corp., Armonk, NY, USA).

RESULTS: The risk of HBOC was 19.80% (n = 20). Patients at risk exhibited aggressive tumor characteristics, such as high-grade tumors (30%), presence of angiolymphatic emboli (35%), and premenopausal at diagnosis (50%). Significant associations between the prevalence of high-grade tumors were observed in women younger than 50 years at diagnosis with HBOC (p = 0.003).

CONCLUSION: Our findings suggest a possible family inheritance associated with worse clinical features in women with breast cancer in this population, indicating that HBOC investigation can be initially performed with low-cost instruments such as FHS-7.

PMID:34547796 | DOI:10.1055/s-0041-1733998

Diving Hyperb Med. 2021 Sep 30;51(3):240-247. doi: 10.28920/dhm51.3.240-247.

ABSTRACT

INTRODUCTION: Patients undergoing hyperbaric oxygen treatments (HBOT) have been shown to experience a reduction in blood glucose (BG) levels during a treatment. This necessitates frequent assessment of BG levels. Continuous glucose monitoring (CGM) may represent an alternative to the current finger prick monitoring method in-chamber, however, continuous sensor glucose (SG) data has not been validated in situ. The aim was to determine the validity of continuous SG and intermittent BG monitoring with serum BG levels in diabetic patients during HBOT.

METHODS: Measurements were obtained (finger prick [capillary sample], CGM [interstitial fluid], and serum [venous sample]) at baseline, and at 30, 60, 90 and 120 minutes during the hyperbaric treatment. Data were analysed by calculating intraclass correlation coefficients (ICC) and using mixed effects linear regression.

RESULTS: The ICC results (n = 10 patients) between the three methods indicated very high and statistically significant absolute agreement at baseline (pre-dive) (ICC = 0.90, 95% CI 0.74-0.97), at 30 minutes (ICC = 0.85, 95% CI 0.61-0.96), 60 minutes (ICC = 0.86, 95% CI 0.58-0.96), 90 minutes (ICC = 0.87, 96% CI 0.63-0.96) and 120 minutes (ICC = 0.90, 95% CI 0.70-0.97). Capillary glucose and CGM SG readings were each within 1 mmol·L-1 on average of the serum glucose reading, with multi-level linear regression finding the average difference between the CGM SG and capillary glucose methods of BG sampling was not statistically significant (P = 0.81).

CONCLUSIONS: The CGM SG data were comparable with glucose readings from capillary monitoring. Both CGM and capillary data were consistent with serum values.

PMID:34547774 | DOI:10.28920/dhm51.3.240-247

Rev Bras Ginecol Obstet. 2021 Aug;43(8):595-599. doi: 10.1055/s-0041-1733912. Epub 2021 Sep 21.

ABSTRACT

OBJECTIVE: To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women.

METHODS: A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation.

RESULTS: Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87 ± 66.92 fL for the case group versus 9.84 ± 1.2 fL for the control group; PDW: 14.82 ± 3.18 fL for the case group versus 13.3 ± 2.16 fL for the controls). The criterion value of the receiver operating characteristic (ROC) curve for PDW at a cutoff point of > 11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of > 10.17 fL showed a good diagnostic marker.

CONCLUSION: The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.

PMID:34547793 | DOI:10.1055/s-0041-1733912

Sleep Med. 2021 Sep 3;87:105-113. doi: 10.1016/j.sleep.2021.08.027. Online ahead of print.

ABSTRACT

Reduction in adiposity is considered a cornerstone in the treatment of obstructive sleep apnea (OSA). Exercise training is one of the interventions used in the treatment of OSA. However, it remains unclear whether exercise training alleviates OSA by improving body composition. This study aimed to verify the effect of exercise training on body composition and the apnea-hypopnea index (AHI) in patients with OSA. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO. PubMed/Medline, Scopus, and Cochrane databases were used for systematic review. Analyses were performed using Review Manager software (version 5.3; R Foundation for Statistical Computing, Vienna, Austria). Exercise training significantly reduced body mass index (mean difference = -0.55 kg/m²; 95% CI = -0.95 to -0.15), body fat percentage (mean difference = -1.19%; 95% CI = -2.03 to -0.35), neck circumference (mean difference = -0.55 cm; 95% CI = -1.08 to -0.02), total body weight (mean difference = -2.13 kg; 95% CI = -4.30 to 0.04), and AHI -8.06 events/hour; 95% CI = -10.47 to -5.66). Although body composition was improved by exercise, this improvement was clinically small. Moreover, improvement in AHI by exercise may not be entirely due to improvements in adiposity. PROSPERO #: CRD42020210509.

PMID:34547647 | DOI:10.1016/j.sleep.2021.08.027

J Stroke Cerebrovasc Dis. 2021 Sep 18;30(12):106108. doi: 10.1016/j.jstrokecerebrovasdis.2021.106108. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Post-stroke cognitive impairment is a common and well-known consequence of supra-tentorial infarct, but its prevalence and severity after infra-tentorial infarct is unclear. We compared the frequencies and prognostic value of domain-specific cognitive deficits after supra-tentorial and infra-tentorial infarct.

METHODS: In a consecutive cohort of patients with first-ever stroke (N = 244) admitted to Helsinki University Hospital, 37 patients had an infra-tentorial infarct. Patients were assessed with a comprehensive neuropsychological examination 3 months post-stroke covering 9 cognitive domains and functional disability was assessed at 15 months with the modified Rankin Scale.

RESULTS: There were no statistically significant differences between the frequencies of cognitive deficits in patients with infra-tentorial vs supra-tentorial infarct. Altogether 73% of patients with infra-tentorial infarct and 82% of patients with supra-tentorial infarct had impairment in at least one cognitive domain. Further 42% of patients with infra-tentorial infarct and 47% of those with supra-tentorial infarct had deficits in 3 or more cognitive domains. In patients with infra-tentorial infarct, visuo-constructional deficits were significantly associated with functional disability at 15 months (OR 9.0, 95%CI 1.3-62.5, p = 0.027). In patients with supratentorial infarct, executive deficits (OR 2.9, 95%CI 1.5-5.8, p = 0.002) and visuo-constructional deficits (OR 2.9, 95%CI 1.5-5.7, p = 0.001) showed associations with functional disability at 15 months.

CONCLUSION: Cognitive deficits are as common in patients with infra-tentorial infarct as in those with supra-tentorial infarct, and it is important to recognize them to meet the needs of rehabilitation.

PMID:34547675 | DOI:10.1016/j.jstrokecerebrovasdis.2021.106108

Int J Med Inform. 2021 Sep 13;155:104572. doi: 10.1016/j.ijmedinf.2021.104572. Online ahead of print.

ABSTRACT

PURPOSE: Femoral neck fracture is a frequent cause of hospitalization, and length of stay is an important marker of hospital cost and quality of care provided. As an extension of traditional statistical methods, machine learning provides the possibility of accurately predicting the length of hospital stay. The aim of this paper is to retrospectively identify predictive factors of the length of hospital stay (LOS) and predict the postoperative LOS by using machine learning algorithms.

METHOD: Based on the admission and perioperative data of the patients, linear regression was used to analyze the predictive factors of the LOS. Multiple machine learning models were developed, and the performance of different models was compared.

RESULT: Stepwise linear regression showed that preoperative calcium level (P = 0.017) and preoperative lymphocyte percentage (P = 0.007), in addition to intraoperative bleeding (p = 0.041), glucose and sodium chloride infusion after surgery (P = 0.019), Charlson Comorbidity Index (p = 0.007) and BMI (P = 0.031), were significant predictors of LOS. The best performing model was the principal component regression (PCR) with an optimal MAE (1.525) and a proportion of prediction error within 3 days of 90.91%.

CONCLUSION: Excessive intravenous glucose and sodium chloride infusion after surgery, preoperative hypocalcemia, preoperative high percentages of lymphocytes, excessive intraoperative bleeding, lower BMI and higher CCI scores were related to prolonged LOS by using linear regression. Machine learning could accurately predict the postoperative LOS. This information allows hospital administrators to plan reasonable resource allocation to fulfill demand, leading to direct care quality improvement and more reasonable use of scarce resources.

PMID:34547625 | DOI:10.1016/j.ijmedinf.2021.104572