Tag: pubmed

J Atten Disord. 2022 Oct 18:10870547221130113. doi: 10.1177/10870547221130113. Online ahead of print.

ABSTRACT

OBJECTIVE: ADHD is associated with increased sleep problems and circadian rhythm disturbances. This study aimed to examine ADHD patients and healthy controls in terms of chronotypic features and expression levels of CLOCK, PER1, lncRNA HULC, lncRNA UCA1.

METHOD: Eighty-three children were included (43 ADHD). Conner’s Parent Rating Scale-Revised Short Form, Childhood Chronotype Questionnaire, Children’s Sleep Disorders Scale were administered. Gene expression levels were studied from peripheral blood.

RESULTS: Evening chronotype, sleep initiation/maintenance disorder, sleep-wake transition disorder, excessive sleepiness disorder were higher in the ADHD group compared to the controls in the scales reported by the parents. Expression levels of all examined genes were statistically significantly higher in the ADHD group. There was no significant relationship between genes and sleep parameters in the ADHD group.

CONCLUSION: Our study provides the first evidence that lncRNA HULC and lncRNA UCA1 might have a role in the etiology of ADHD.

PMID:36254757 | DOI:10.1177/10870547221130113

Pediatr Pulmonol. 2022 Oct 18. doi: 10.1002/ppul.26184. Online ahead of print.

ABSTRACT

RATIONALE: Children contribute to 5% of COVID-19-related hospitalizations in the United States. There is mounting evidence suggesting childhood asthma is a risk factor for severe disease. We hypothesized that asthma is associated with longer length of stay (LOS) and need for respiratory support among children admitted to pediatric intensive care unit (PICU) with COVID-19.

METHODS: We reviewed 150 charts of children and young adults with a positive SARS CoV2 PCR test admitted to the PICU at Children’s National Hospital, Washington, DC between 2020 and 2021. We recorded demographics, anthropometrics, past medical history, clinical course, laboratory findings, imaging, medication usage, respiratory support, and outcomes. Functional Status Scale (FSS), that measures an ICU patient’s physical function, was used to characterize children with multiple co-morbidities; FSS and obesity were included as covariates in multivariate analysis. Statistical analysis was performed using SPSS v25.0.

RESULTS: Sixty-Eight patients ages 0-21 years met inclusion criteria. Median age was 14.9 years, 55.9% were female, median BMI percentile was 62, and 42.6% were African American. Compared to those without asthma, patients with asthma averaged longer LOS (20.7 vs. 10.2 days, p=0.02), with longer PICU stay (15.9 vs. 7.6 days, p=0.033) and prolonged maximum respiratory support (8.3 vs. 3.3 days, p=0.016). Adjusted for obesity and poor physical function (FSS>6), asthma remained a significant predictor of hospital LOS, PICU LOS, and days on maximum respiratory support.

CONCLUSION: Asthma can cause severe disease with prolonged need for maximum respiratory support among children with COVID-19. This article is protected by copyright. All rights reserved.

PMID:36254734 | DOI:10.1002/ppul.26184

Hypertension. 2022 Oct 18. doi: 10.1161/HYPERTENSIONAHA.122.20048. Online ahead of print.

ABSTRACT

BACKGROUND: Endovascular renal denervation reduces blood pressure (BP). We explored an alternative approach to renal denervation using radiofrequency energy delivered across the renal pelvis utilizing the natural orifice of the urethra and the ureters.

METHODS: This open-label, single-arm feasibility study enrolled patients with uncontrolled hypertension despite antihypertensive drug therapy. The primary effectiveness endpoint was the change in ambulatory daytime systolic BP (SBP) 2 months following renal pelvic denervation.

RESULTS: The 18 patients (mean age 56±12 years) enrolled were taking an average of 2.7 antihypertensive drugs daily. Renal pelvic denervation reduced mean daytime SBP by 19.4 mm Hg (95% CI, -24.9 to -14.0, P<0.001) from its baseline of 148.4±8.7 mm Hg. Mean nighttime (-21.4 mm Hg [95% CI, -29.5 to -13.3]) and 24-hour (-20.3 mm Hg [95% CI, -26.2 to -14.5]) SBP each fell significantly (P<0.001) as did the corresponding diastolic BPs (P<0.001). Office SBP decreased from 156.5±12.3 mm Hg to 22.4 mm Hg (95% CI, -31.5 to -13.3, P<0.001) by 2 months. Office SBP decreased over time (P=0.001 by linear trend test) starting by day 1 with a decrease of 8.3 mm Hg (95% CI, -16.9 to 0.3, P=0.057). There were no serious adverse events. Mild transitory back pain followed the procedure. Serum creatinine decreased by 0.08 mg/dL (P=0.02) and estimated glomerular filtration rate increased by 7.2 mL/min/1.73m² (P=0.03) 2 months following ablation procedure.

CONCLUSIONS: Based on these initial findings, a well-powered, sham-controlled trial of renal pelvic denervation to more fully establish its safety and effectiveness is now justified in patients with uncontrolled hypertension despite drug therapy.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT05440513.

PMID:36254733 | DOI:10.1161/HYPERTENSIONAHA.122.20048

Circulation. 2022 Oct 18:101161CIRCULATIONAHA122059606. doi: 10.1161/CIRCULATIONAHA.122.059606. Online ahead of print.

ABSTRACT

BACKGROUND: A clear patency benefit of a drug-eluting stent (DES) over a bare metal stent (BMS) for treating peripheral artery disease of the femoropopliteal segment has not been definitively demonstrated. The EMINENT study (Trial Comparing Eluvia Versus Bare Metal Stent in Treatment of Superficial Femoral and/or Proximal Popliteal Artery) was designed to evaluate the patency of the Eluvia DES (Boston Scientific, Marlborough, MA), a polymer-coated paclitaxel-eluting stent, compared with BMS for the treatment of femoropopliteal artery lesions.

METHODS: EMINENT is a prospective, randomized, controlled, multicenter European study with blinded participants and outcome assessment. Patients with symptomatic peripheral artery disease (Rutherford category 2, 3, or 4) of the native superficial femoral artery or proximal popliteal artery with stenosis ≥70%, vessel diameter of 4 to 6 mm, and total lesion length of 30 to 210 mm were randomly assigned 2:1 to treatment with DES or BMS. The primary effectiveness outcome was primary patency at 12 months, defined as independent core laboratory-assessed duplex ultrasound peak systolic velocity ratio ≤2.4 in the absence of clinically driven target lesion revascularization or surgical bypass of the target lesion. Primary sustained clinical improvement was a secondary outcome defined as a decrease in Rutherford classification of ≥1 categories compared with baseline without a repeat velocity ratio ≤2.4 in the absence of clinically driven target lesion revascularization. Health-related quality of life and walking function were assessed.

RESULTS: A total of 775 patients were randomly assigned to treatment with DES (n=508) or commercially available BMS (n=267). Baseline clinical, demographic, and lesion characteristics were similar between the study groups. Mean lesion length was 75.6±50.3 and 72.2±47.0 mm in the DES and BMS groups, respectively. The 12-month incidence of primary patency for DES treatment (83.2% [337 of 405]) was significantly greater than for BMS (74.3% [165 of 222]; P<0.01). Incidence of primary sustained clinical improvement was greater among patients treated with the DES than among those who received a BMS (83.0% versus 76.6%; P=0.045). The health-related quality of life dimensions of mobility and pain/discomfort improved for the majority of patients in both groups (for 66.4% and 53.6% of DES-treated and for 64.2% and 58.1% of BMS-treated patients, respectively) but did not differ significantly. At 12 months, no statistical difference was observed in all-cause mortality between patients treated with the DES or BMS (2.7% [13 of 474] versus 1.1% [3 of 263]; relative risk, 2.4 [95% CI, 0.69-8.36]; P=0.15).

CONCLUSIONS: By demonstrating superior 1-year primary patency, the results of the EMINENT randomized study support the benefit of using a polymer-based paclitaxel-eluting stent as a first-line stent-based intervention for patients with symptomatic peripheral artery disease attributable to femoropopliteal disease.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT02921230.

PMID:36254728 | DOI:10.1161/CIRCULATIONAHA.122.059606

Australas J Ageing. 2022 Oct 18. doi: 10.1111/ajag.13140. Online ahead of print.

ABSTRACT

OBJECTIVES: It is well known that there are associations between overall health, age, socioeconomic status and rural residency. The objective of this study was to determine the distribution of Australia’s aged population by socioeconomic status, as well as remoteness.

METHODS: The study employed the Australian Statistical Geography Standard (Statistical Area Level 1 and Remoteness Areas). The database of the geographic boundaries was integrated into the ageing population and socioeconomic data using the Geographic Information System. The socioeconomic data was analysed through the Index of Relative Socioeconomic Disadvantage.

RESULTS: Over a decade, the older population in Australia has increased noticeably. In 2016, there was a high percentage of older people (≥65 years) in Tasmania (Tas), 19%, while the lowest percentage was recorded in the Northern Territory (NT), 7%. Across the country, Tasmania had the highest percentage of older citizens living in the most disadvantaged areas since 2006, with 48% recorded in 2016. There was an association between the remoteness areas and the education and income levels of the ageing cohort. However, this association differed between the states and territories. This socioeconomic gap becomes more evident in the very remote areas of the country.

CONCLUSIONS: The ageing population in Australia is increasing rapidly; this was associated with an evolving socioeconomic disparity among this ageing society. Our results demonstrated that socioeconomic inequalities were to be found among the older people based on their distribution over the remoteness areas in Australia. This information should be used to target healthcare and ageing policies that meet the specific needs of older people.

PMID:36254700 | DOI:10.1111/ajag.13140

Palliat Support Care. 2022 Oct 18:1-10. doi: 10.1017/S1478951522001237. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the spiritual care needs and their attributes among Chinese elders hospitalized for severe chronic heart failure (CHF) based on the Kano model, in order to provide a reference for improving the quality and satisfaction of spiritual care.

METHODS: An observational design was implemented, and the STROBE Checklist was used to ensure quality reporting of the study. The demographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale, and the Kano model-based Nurse Spiritual Therapeutics Attributes Scale were used. A convenience sample of 451 patients were selected from 2 hospitals. Descriptive statistics, and Kano model were used to analyze the data.

RESULTS: The total score of spiritual care needs was 29.95 ± 7.51. Among the 12 items, 3 items were attractive attributes, all of which were located in Reserving Zone IV; 5 items were one-dimensional attributes, of which 3 were located in Predominance Zone I and 2 were located in Improving Zone II; 2 items were must-be attributes, all of which were located in Improving Zone II; and 2 items were indifference attributes, all of which were located in Secondary Improving Zone III.

SIGNIFICANCE OF RESULTS: The spiritual care needs among Chinese elders hospitalized for severe CHF were moderate. The must-be and one-dimensional attributes mainly focus on “creating a good atmosphere” and “sharing self-perception” dimensions, while attractive attributes mainly focus on “sharing self-perception” and “helping thinking” dimensions. It is suggested that hospital authority should develop and innovate attractive attributes on the basis of maintaining and perfecting must-be and one-dimensional attributes, and objectively analyze and optimize indifference attributes.

PMID:36254699 | DOI:10.1017/S1478951522001237

Acta Otorhinolaryngol Ital. 2022 Aug;42(4):380-387. doi: 10.14639/0392-100X-N0612.

ABSTRACT

OBJECTIVE: Otosclerosis is an osteodystrophic disease of the otic capsule, determining conductive or mixed hearing loss, which can be successfully treated with stapedotomy. The aim of the present multicentric retrospective study was to identify prognostic factors related to better auditory outcomes in stapes surgery.

METHODS: 581 patients affected by otosclerosis were submitted to stapedotomy under local anaesthesia in two different hospitals. Both Teflon and titanium prostheses were adopted.

RESULTS: A statistically significant decrease of postoperative air-conduction thresholds and air-bone gap (ABG) values was seen, whereas the mean bone-conduction threshold did not differ from the preoperative condition. Among the various parameters investigated, the prosthetic material, duration of surgery and intraoperative detection of unexpected anatomical anomalies of the middle ear were found to be related to lower postoperative ABG values.

CONCLUSIONS: All the previously mentioned parameters played a significant role in determining the postoperative auditory outcomes and can therefore be considered prognostic factors for the success of the stapedotomy.

PMID:36254654 | DOI:10.14639/0392-100X-N0612

Bratisl Lek Listy. 2022;123(11):846-852. doi: 10.4149/BLL_2022_135.

ABSTRACT

BACKGROUND: Abnormal neutrophil extracellular traps are associated with lung diseases, thrombosis, increased mucosal secretion in the airways. The aim of this study is to evaluate the possible place of the most specific NETosis marker Cit-H3 protein in diagnostic algorithms by revealing its relationship with the severity, mortality and prognosis of SARS-CoV-2 pneumonia.

PATIENTS AND METHODS: Patients (n = 78) who applied to the Emergency Department between March 11, 2020 and June 10, 2020, with positive SARS-CoV-2 polymerase chain reaction (PCR) test and lung involvement were included in the prospective study. Serum Cit-H3 levels and critical laboratory parameters were measured at baseline on the day of clinical deterioration and before recovery/discharge/death. Cit-C3 levels were determined by enzyme immunassay method.

RESULTS: Cit-H3 levels in patients with SARS-CoV-2 pneumonia during their first admission to the hospital were significantly higher compared to the healthy control group (p < 0.05). Repeated measurements of Cit-H3 levels of the patients significantly correlated with D-dimer, procalcitonin, Neutrophil/ Lymphocyte ratio, lymphocyte, CRP, and oxygen saturation. Cit-H3 levels of the patients who died were significantly higher than that of those who survived (p < 0.05). Cit-H3 levels were found to be statistically significantly higher in patients who developed acute respiratory distress syndrome, were admitted to the intensive care unit, and had mortality (p < 0.05).

CONCLUSIONS: Cit-H3 plays a role in inflammatory processes in SARS-CoV-2 pneumonia, and changes in serum Cit-H3 levels of these patients can be used to determine prognosis and mortality (Tab. 5, Fig. 1, Ref. 21).

PMID:36254644 | DOI:10.4149/BLL_2022_135

Bratisl Lek Listy. 2022;123(11):840-845. doi: 10.4149/BLL_2022_134.

ABSTRACT

OBJECTIVES: We aimed to assist in the diagnosis of cerebral venous sinus thrombosis (CVST) with the neutrophil-lymphocyte ratio (NLR).

BACKGROUND: Diagnosis of CVST is difficult.

METHODS: Patients, who visited the emergency department between March 1, 2013 and March 1, 2021 and underwent magnetic resonance (MR) venography were included. The patients’ MR venography results, ages, gender, NLR, were collected. The patients were categorized according to their CVST diagnosis status, and NLR were compared.

RESULTS: Of the 530 patients included in the study, 366 (69.1 %) were female, and the median age was 40 (31-58) years. CVST was detected in 57 (10.8 %) patients, no pathological diagnosis was detected in 251 (47.4 %) patients. The median NLR of the patients with CVST was statistically significantly higher than in the patients without CVST and in the patients without any diagnosis ((3.94 [2.5-6.47] vs 3.03 [1.93-5.43], p = 0.023) (3.94 [2.5-6.47] vs 2.92 [1.86-4.95], p = 0.009). In the ROC analysis performed with reference to the patients without any diagnosis, NLR obtained 0.612 AUC.

CONCLUSION: Significantly higher NLR levels were found in CVST patients compared to the patients, who were not diagnosed with CVST and the patients without any diagnosis (Tab. 5, Fig. 2, Ref. 22).

PMID:36254643 | DOI:10.4149/BLL_2022_134

Bratisl Lek Listy. 2022;123(11):833-839. doi: 10.4149/BLL_2022_133.

ABSTRACT

BACKGROUND AND OBJECTIVES: Numerous studies have been conducted on the psychological effects of the COVID-19 pandemic. However, how the mental health of health workers will be affected among the number of peaks during the pandemic has not been evaluated yet. The study aims to investigate the effects of the first, second, and third peaks of COVID-19 on anxiety, depression, and stress symptoms in healthcare workers.

METHODS: The current study included 4031 healthcare workers, 1051 during the first peak period, 1409 during the second peak period, and 1571 during the third peak period. The Depression-anxiety-stress scale-21(DASS-21) was used to assess the participants’ levels of anxiety, depression, and stress symptoms.

RESULTS: The mean age of the participants was 33.74 ± 7.95, and 2634 (66.3 %) were female. 36.9 %(n = 1486) of the participants were physicians, 41.1 % (n = 1655) were nurses and 22.1 % (n = 890) were other healthcare workers. A statistically significant difference was documented in the DASS-21 anxiety (F(2:4028) = 502.893, p 2. Peak > 1. Peak), DASS-21 depression (F(2:4028) = 46.034, p 2. Peak > 1. Peak), DASS-21 stress (F(2:4028) = 65.548, p 1. Peak), and DASS-21 total scores (F(2:4028) = 156.860, p 2. Peak > 1. Peak) of healthcare workers during all three peak periods.

CONCLUSIONS: Our findings show that as the peak number rises, so do the levels of anxiety and depression among healthcare workers. As a result, it is possible to assert that prolongation of the COVID-19 pandemic worsens mental problems (Tab. 2, Fig. 3, Ref. 35).

PMID:36254642 | DOI:10.4149/BLL_2022_133