Tag: pubmed

J Eur Acad Dermatol Venereol. 2021 Sep 20. doi: 10.1111/jdv.17673. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriasis has important physical and psychosocial effects that extend beyond the skin. Understanding the impact of treatment on health-related quality of life (HRQoL) and patient-perceived symptom severity in psoriasis is key in clinical decision-making.

OBJECTIVES: This post-hoc analysis of the PSO-LONG trial data assessed the impact of long-term proactive or reactive management with fixed-dose combination calcipotriene 50 µg/g and betamethasone dipropionate 0.5 mg/g (Cal/BD) foam on patient-reported outcomes (PRO) in patients with psoriasis vulgaris.

METHODS: Five hundred and twenty-one patients from the Phase 3, randomised, double-blind PSO-LONG trial were included. An initial 4-week, open-label phase of fixed-dose combination Cal/BD foam once daily (QD) was followed by a 52-week maintenance phase, at the start of which patients were randomised to a proactive management arm (Cal/BD foam twice weekly) or reactive management arm (vehicle foam twice weekly). Patient-perceived symptom severity and HRQoL were assessed using the Psoriasis Symptom Inventory (PSI), the Dermatology Life Quality Index (DLQI) and the EuroQol-5D for psoriasis (EQ-5D-5L-PSO).

RESULTS: Statistically and clinically significant improvements were observed across all PRO measures. The mean difference (standard deviation) from baseline to Week 4 was -8.97 (6.18) for PSI, -6.02 (5.46) for DLQI, and 0.11 (0.15) for EQ-5D-5L-PSO scores. During maintenance, patients receiving reactive management had significantly higher DLQI (15% [p=0.007]) and PSI (15% [p=0.0128]), and a numerically lower EQ-5D-5L-PSO mean area under the curve score compared with patients receiving proactive management (1% [p=0.0842]).

CONCLUSIONS: Cal/BD foam significantly improved DLQI, EQ-5D-5L-PSO, and PSI scores during the open-label and maintenance phases. Patients assigned to proactive management had significantly better DLQI and PSI scores, and numerically better EQ-5D-5L-PSO versus reactive management. Additionally, baseline flare was associated with worse PROs than the start of a relapse and patients starting a relapse also had worse PROs than patients in remission.

PMID:34543474 | DOI:10.1111/jdv.17673

J Athl Train. 2021 Sep 20. doi: 10.4085/1062-6050-0103.21. Online ahead of print.

ABSTRACT

CONTEXT: Inadequate hip active range of motion (AROM) may stifle the energy flow through the kinematic chain and decrease pitching performance while increasing the risk for pitcher injury.

OBJECTIVE: To examine the relationship of hip AROM and pitching biomechanics during a fastball pitch in adolescent baseball pitchers.

DESIGN: Cross-Sectional study.

SETTING: Biomechanics laboratory.

PARTICIPANTS: A voluntary sample of 21 adolescent baseball pitchers (16.1 ± 0.8 yrs.; 183.9 ± 5.2 cm; 77.9 ± 8.3 kg). Main Outcome Measure (s): Bilateral hip internal rotation (IR), external rotation (ER), flexion, extension, and abduction AROM were measured. Three-dimensional biomechanics were assessed as participants threw from an indoor pitching mound to a strike zone net at regulation distance. Pearson correlation coefficients were used to determine correlations between hip AROM and biomechanical metrics.

RESULTS: Statistically significant negative correlations were found at foot contact between back hip ER AROM and back hip abduction angle (p=0.030, r=-0.474), back hip ER AROM and torso rotation angle (p=0.032, r=-0.468),and back hip abduction AROM and lead hip abduction angle (p=0.037, r=-0.458). Back hip extension AROM was positively correlated with increased stride length (p=0.043, r=0.446). Lead hip abduction AROM was also positively correlated with normalized elbow varus torque (p=0.034, r=0.464).

CONCLUSIONS: There were several relationships between hip AROM and biomechanical variables during the pitching motion. The findings support the influence hip AROM can have on pitching biomechanics. Overall, greater movement at the hips allows for the kinematic chain to work at its maximal efficiency, increasing pitch velocity potential.

PMID:34543423 | DOI:10.4085/1062-6050-0103.21

Mov Disord. 2021 Sep;36(9):2207-2208. doi: 10.1002/mds.28721.

NO ABSTRACT

PMID:34543466 | DOI:10.1002/mds.28721

Gerontologist. 2021 Sep 20:gnab138. doi: 10.1093/geront/gnab138. Online ahead of print.

ABSTRACT

While Zimbabwe shares similar characteristics with other sub-Saharan countries that are generally regarded as ‘young populations’ the percentage of older adults has increased from 4,7% in 1982 to 6% in 2017. Research on ageing is mainly on social protection, health and quality of life. Emerging research points towards healthy ageing, gender relations and access to resources. The economic environment has been unstable for the greater part of the 41 years of independence. Poverty is increasing and the lives of older adults are vulnerable owing to inadequate and poorly targeted and funded social safety nets and social care services. The framework for addressing ageing in the country is adequate but implementation is lacking. Zimbabwe lacks longitudinal datasets on ageing; researchers mostly rely on data produced by Zimbabwe National Statistics Agency (ZIMSTAT), United Nations agencies and other International non-governmental organisations.

PMID:34543414 | DOI:10.1093/geront/gnab138

J Athl Train. 2021 Sep 20. doi: 10.4085/1062-6050-0165.21. Online ahead of print.

ABSTRACT

Context The combination of an excessive increase in running pace and volume is essential to consider when investigating associations between running and running-related injury. Objectives The purpose of the present study was to complete a secondary analysis on a dataset from a randomized trial, to investigate the interactions between relative or absolute weekly changes in running volume and running pace on running injury occurrence among a cohort of injury-free recreational runners in Denmark. Design Prospective cohort study Setting Running volume and pace were collected during a 24-week follow-up using global positioning systems (GPS) data. Training data was used to calculate relative and absolute weekly changes in running volume and pace. Patients or Other Participants A total of 586 recreational runners were included in the analysis. All participants were injury-free at inclusion. Main Outcome Measure(s) Running-related injury was the outcome. Injury data were collected weekly using a modified version of the OSTRC questionnaire. Risk difference (RD) was the measure of injury risk. Results A total of 133 runners sustained a running-related injury. A relative weekly change of progression >10% in running volume and progression in running pace (RD=8.1%, 95%CI: – 9.3;25.6%) and an absolute weekly change of progression >5km in running volume and progression in running pace (RD=5.2%, 95%CI: -12.0;22.5%), were not associated with a statistically significant positive interaction. Conclusions As coaches, clinicians and athletes may agree that excessive increase in running pace and excessive increase in running volume are important contributors to injury development, we analyzed the interaction between them. Although a statistically significant positive interaction on an additive scale in runners who progressed both running pace and running volume were not identified in the present study, readers of scientific articles should be aware that interaction is an important analytical approach that could be applied to other datasets in future publications.

PMID:34543419 | DOI:10.4085/1062-6050-0165.21

PLoS One. 2021 Sep 20;16(9):e0257520. doi: 10.1371/journal.pone.0257520. eCollection 2021.

ABSTRACT

INTRODUCTION: Previous work had shown that machine learning models can predict inflammatory bowel disease (IBD)-related hospitalizations and outpatient corticosteroid use based on patient demographic and laboratory data in a cohort of United States Veterans. This study aimed to replicate this modeling framework in a nationally representative cohort.

METHODS: A retrospective cohort design using Optum Electronic Health Records (EHR) were used to identify IBD patients, with at least 12 months of follow-up between 2007 and 2018. IBD flare was defined as an inpatient/emergency visit with a diagnosis of IBD or an outpatient corticosteroid prescription for IBD. Predictors included demographic and laboratory data. Logistic regression and random forest (RF) models were used to predict IBD flare within 6 months of each visit. A 70% training and 30% validation approach was used.

RESULTS: A total of 95,878 patients across 780,559 visits were identified. Of these, 22,245 (23.2%) patients had at least one IBD flare. Patients were predominantly White (87.7%) and female (57.1%), with a mean age of 48.0 years. The logistic regression model had an area under the receiver operating curve (AuROC) of 0.66 (95% CI: 0.65-0.66), sensitivity of 0.69 (95% CI: 0.68-0.70), and specificity of 0.74 (95% CI: 0.73-0.74) in the validation cohort. The RF model had an AuROC of 0.80 (95% CI: 0.80-0.81), sensitivity of 0.74 (95% CI: 0.73-0.74), and specificity of 0.72 (95% CI: 0.72-0.72) in the validation cohort. Important predictors of IBD flare in the RF model were the number of previous flares, age, potassium, and white blood cell count.

CONCLUSION: The machine learning modeling framework was replicated and results showed a similar predictive accuracy in a nationally representative cohort of IBD patients. This modeling framework could be embedded in routine practice as a tool to distinguish high-risk patients for disease activity.

PMID:34543353 | DOI:10.1371/journal.pone.0257520

PLoS One. 2021 Sep 20;16(9):e0257609. doi: 10.1371/journal.pone.0257609. eCollection 2021.

ABSTRACT

INTRODUCTION: The widespread use of face masks by the general public may help to prevent the spread of viruses. Face masks are thought to be a good strategy to protect against respiratory diseases such as the Coronavirus. Identifying student knowledge, attitude, and practice about the use of face masks is crucial to detect vulnerabilities and respond rapidly to avoid the spread of the infection. This study aimed to determine the knowledge, attitude, and practices of face mask utilization and associated factors in the COVID-19 pandemic among college students.

METHODS: A cross-sectional study was performed from February to March 2021 among 764 students from Wachemo University, Southern Ethiopia. A multistage sampling technique was used in the study. The sample size for each department was allocated in proportion to the number of students in that department, and each respondent was chosen using a simple random sampling procedure. Data were collected using a pre-tested self-administered questionnaire and analyzed using SPSS version 26. To predict the relationship between the predictor and outcome variables, a logistic regression model was used. At a p-value of 0.05, statistical significance was declared.

RESULTS: The study showed that the overall knowledge of the students was 223 (29.2%), their attitude was 673 (88.1%), and their practice was 684 (89.5%). The students from the college natural and computational sciences (AOR: 0.23; 95%CI: 0.13, 0.40) and students having good knowledge (AOR = 4.40; 95%CI; 2.13, 9.14) were found to be independently associated with face mask utilization.

CONCLUSION: When compared to other researches, the knowledge about the usage of face masks in this study was low, but the attitudes and practices were high. Authorities in areas that are in danger of a COVID-19 pandemic should plan and implement public awareness and education initiatives.

PMID:34543358 | DOI:10.1371/journal.pone.0257609

Blood Adv. 2021 Sep 20:bloodadvances.2020004079. doi: 10.1182/bloodadvances.2020004079. Online ahead of print.

ABSTRACT

B-cell maturation antigen-targeted chimeric antigen receptor T cell therapy (BCMA CAR-T) is an effective treatment for relapsed refractory multiple myeloma (RRMM). However the pattern of infectious complications is not well-elucidated. We performed a single-center retrospective analysis of infection outcomes up to 1-year post BCMA CAR-T for MM from 2018-2020. Fifty-five MM patients were treated with BCMA CAR-T. Prior to lymphodepletion (LD), 35% of patients had severe hypogammaglobulinemia and 18% had severe lymphopenia. Most patients (68%) received bridging chemotherapy (BC) prior to LD. In the first month post CAR-T, 98% patients had grade 3-4 neutropenia. At 1-year post infusion, 76% patients had hypogammaglobulinemia. With a median follow-up of 6.0 months (95% CI: 4.7 to 7.4), there were a total of 47 infection events in 29 (53%) patients, 40% bacterial, 53% viral and 6% fungal. Most (92%) were mild-moderate and of the lower/upper respiratory tract system (68%). Half of infections (53%) occurred in the first 100 days post CAR-T infusion. Though no statistically significant risk factors for infection were identified, prior lines of therapy, use of BC, recent infections, and post CAR-T lymphopenia were identified as possible risk factors that need to be further explored. This is the largest study to date to assess the infectious complications post BCMA CAR-T. Despite multiple risk factors for severe immunosuppression in this cohort, relatively few life-threatening or severe infections occurred. Further larger studies are needed to better characterize the risk factors for and occurrence of infections post BCMA CAR-T.

PMID:34543400 | DOI:10.1182/bloodadvances.2020004079

PLoS One. 2021 Sep 20;16(9):e0257613. doi: 10.1371/journal.pone.0257613. eCollection 2021.

ABSTRACT

This paper analyses COVID-19 patients’ dynamics during the first wave in the region of Castilla y León (Spain) with around 2.4 million inhabitants using multi-state competing risk survival models. From the date registered as the start of the clinical process, it is assumed that a patient can progress through three intermediate states until reaching an absorbing state of recovery or death. Demographic characteristics, epidemiological factors such as the time of infection and previous vaccinations, clinical history, complications during the course of the disease and drug therapy for hospitalised patients are considered as candidate predictors. Regarding risk factors associated with mortality and severity, consistent results with many other studies have been found, such as older age, being male, and chronic diseases. Specifically, the hospitalisation (death) rate for those over 69 is 27.2% (19.8%) versus 5.3% (0.7%) for those under 70, and for males is 14.5%(7%) versus 8.3%(4.6%)for females. Among patients with chronic diseases the highest rates of hospitalisation are 26.1% for diabetes and 26.3% for kidney disease, while the highest death rate is 21.9% for cerebrovascular disease. Moreover, specific predictors for different transitions are given, and estimates of the probability of recovery and death for each patient are provided by the model. Some interesting results obtained are that for patients infected at the end of the period the hazard of transition from hospitalisation to ICU is significatively lower (p < 0.001) and the hazard of transition from hospitalisation to recovery is higher (p < 0.001). For patients previously vaccinated against pneumococcus the hazard of transition to recovery is higher (p < 0.001). Finally, internal validation and calibration of the model are also performed.

PMID:34543345 | DOI:10.1371/journal.pone.0257613

PLoS One. 2021 Sep 20;16(9):e0257627. doi: 10.1371/journal.pone.0257627. eCollection 2021.

ABSTRACT

OBJECTIVES: Most research into the management of pelvic inflammatory disease (PID) is in younger women and focuses on sexually transmitted pathogens such as N. gonorrhoeae or C. trachomatis. Non-sexually transmitted bacterial pathogens and PID in older women are rarely examined. The objective of this study is to explore cervical culture pathogens in women of different age groups in a medical center in eastern Taiwan.

METHODS: We enrolled patients whose medical records were diagnosed with PID (ICD-9-CM 614.0 [N70.01-03], 614.1[N70.11-13], 614.9 [N73.5, N73.9]) at our hospital from October 2014 to March 2020. Patients were divided into three groups according to age: the age <25 years, age 25-44 years, and the ≥ 45 years group. Chi-square test, ANOVA and logistic regression were used for statistical analysis. In subgroup analysis, endocervical pathogens were further stratified into vaginal, respiratory, enteric, skin, oral, and other.

RESULTS: A total of 96 patients were included in the study. There were 31 patients in the age ≥ 45 years group, 52 patients in the age 25-44 years group, and 13 patients in the age <25 years group. Vagina and enteric pathogens were the most common pathogens among all groups. The isolated respiratory and other pathogens were more in the age ≥ 45 years group than in the other two groups. Prevotella bivia was more common in the age <25 years and 25-44 years groups.

CONCLUSIONS: This may be due to different pathogeneses of PID in the age ≥ 45 years patients. Our study can be used as a reference for antibiotic choice of non-sexually transmitted PID and to prevent long-term sequelae of PID.

PMID:34543349 | DOI:10.1371/journal.pone.0257627