Tag: pubmed

PLoS One. 2023 Dec 13;18(12):e0294557. doi: 10.1371/journal.pone.0294557. eCollection 2023.

ABSTRACT

BACKGROUND: General practitioners (GPs) often assess patients with acute infections. It is challenging for GPs to recognize patients needing immediate hospital referral for sepsis while avoiding unnecessary referrals. This study aimed to predict adverse sepsis-related outcomes from telephone triage information of patients presenting to out-of-hours GP cooperatives.

METHODS: A retrospective cohort study using linked routine care databases from out-of-hours GP cooperatives, general practices, hospitals and mortality registration. We included adult patients with complaints possibly related to an acute infection, who were assessed (clinic consultation or home visit) by a GP from a GP cooperative between 2017-2019. We used telephone triage information to derive a risk prediction model for sepsis-related adverse outcome (infection-related ICU admission within seven days or infection-related death within 30 days) using logistic regression, random forest, and neural network machine learning techniques. Data from 2017 and 2018 were used for derivation and from 2019 for validation.

RESULTS: We included 155,486 patients (median age of 51 years; 59% females) in the analyses. The strongest predictors for sepsis-related adverse outcome were age, type of contact (home visit or clinic consultation), patients considered ABCD unstable during triage, and the entry complaints”general malaise”, “shortness of breath” and “fever”. The multivariable logistic regression model resulted in a C-statistic of 0.89 (95% CI 0.88-0.90) with good calibration. Machine learning models performed similarly to the logistic regression model. A “sepsis alert” based on a predicted probability >1% resulted in a sensitivity of 82% and a positive predictive value of 4.5%. However, most events occurred in patients receiving home visits, and model performance was substantially worse in this subgroup (C-statistic 0.70).

CONCLUSION: Several patient characteristics identified during telephone triage of patients presenting to out-of-hours GP cooperatives were associated with sepsis-related adverse outcomes. Still, on a patient level, predictions were not sufficiently accurate for clinical purposes.

PMID:38091283 | DOI:10.1371/journal.pone.0294557

J Anim Physiol Anim Nutr (Berl). 2023 Dec 13. doi: 10.1111/jpn.13914. Online ahead of print.

ABSTRACT

This study aimed at investigating the effect of hydrolyzed soya lecithin; also called lysolecithin or lysophosphatidylcholine, on growth performance, caecal microbiota and fat depots in pre-breeding primiparous rabbits does. For this, 60 V-Line primiparous rabbits does (5-6 months) were used in a 30-day experiment. Does were allotted into three iso-nitrogenous iso-caloric dietary treatments (n = 20/group) as follows: (1) CON received 0% soya lecithin, (2) LECL group was fed a basal diet supplemented with 0.5% soya lecithin and (3) LECH group was fed a basal diet supplemented with 1% soya lecithin. Growth performance indices were measured, caecum samples were collected for measurement of specific bacteria via qPCR, and several fat depots including periovarian fat were sampled for adipocyte morphometry and fatty acid profiling. Statistical analysis was performed using GLM procedures of SAS v9.4. Soya lecithin increased feed intake (p < 0.05). The abundance of caecal Bifidobacteria species, Ruminococcus species and phylum Butryvibrio-specific genes increased (p < 0.05) in rabbits receiving soya lecithin in their diet, soya lecithin increased the level of polyunsaturated fatty acids in subcutaneous and perirenal fat (p < 0.05) and increased the level of monounsaturated fatty acids in periovarian fat (p < 0.05); additionally, the adipocyte area increased in periovarian and perirenal fat (p < 0.05). In conclusion, soya lecithin at a dose of 0.5% increased feed intake and energy storage in adipocytes and improved the fatty acid profile of periovarian fat.

PMID:38091274 | DOI:10.1111/jpn.13914

Environ Sci Pollut Res Int. 2023 Dec 13. doi: 10.1007/s11356-023-30997-5. Online ahead of print.

ABSTRACT

A growing number of companies are incorporating internal carbon pricing into their climate management strategies, making it one of the ways in which the private sector can combat carbon emissions and respond to the climate crisis. In this study, we used the synthetic control method in an attempt to discover whether the implementation of internal carbon pricing has an impact on the carbon reduction of typical firms at an individual level. As some of the firms cannot be properly fitted, statistical approaches were then applied to the S&P 500 constituent firms to test if there is any correlation between the emission cuts and internal carbon pricing. We also conducted a channel analysis. Through examining three possible channels, internal carbon pricing is found to affect firms’ carbon reduction mainly through two channels, namely the level of energy intensity and R&D investments. Among them, the energy intensity plays a positive mediating role between emission reduction and internal carbon pricing. As to another channel, contrary to expectations, internal carbon pricing, to some extent, suppresses the R&D investments which will promote carbon emission reduction. That is, the size of R&D investments has masking effects in the relationship between emission cuts and internal carbon pricing. Our findings contribute to researches on the carbon pricing, emission reduction, and climate management efforts from the private sector and have implications for practices.

PMID:38091215 | DOI:10.1007/s11356-023-30997-5

Neurol Sci. 2023 Dec 13. doi: 10.1007/s10072-023-07241-6. Online ahead of print.

ABSTRACT

BACKGROUND: About 15% to one third of migraineurs experience aura symptoms. Aura is a reversible focal neurological phenomenon involving visual, sensory, speech, and motor symptoms that usually precede migraine pain. Monoclonal antibodies against calcitonin-related peptide (anti- CGRP mAbs) are effective in preventing chronic and episodic migraine, but little is known about their effectiveness on specifically preventing migraine with aura.

METHODS: This is a pilot prospective observational cohort study, aiming at evaluating the effectiveness and safety of Erenumab, Fremanezumab or Galcanezumab for the treatment of migraine aura. We enrolled 14 patients at the Headache Centre of University Federico II of Naples. Duration of follow-up was 12 months. We assessed mean monthly days with aura symptoms, with or without subsequent headache, as well as mean monthly days with headache and mean monthly MIDAS score, by reviewing standardized paper patient headache diaries every three months.

RESULTS: A significant decrease in mean monthly aura days was observed throughout the observation period (median baseline: 13, interquartile range: 4-16; after 12 months: 1, interquartile range: 0-3, p < 0.001). We observed a statistically significant decrease in mean monthly headache days as well (median baseline 21, interquartile range: 16-30; after 12 months: 5, interquartile range: 4-7, p < 0.001). During the 12-month treatment period, none of the 14 patients reported mild or serious adverse events.

CONCLUSION: Our findings suggest that anti-CGRP mAbs are highly effective in migraine with aura, both in reducing mean monthly aura days and mean monthly days with headache.

PMID:38091211 | DOI:10.1007/s10072-023-07241-6

Behav Res Methods. 2023 Dec 13. doi: 10.3758/s13428-023-02312-0. Online ahead of print.

NO ABSTRACT

PMID:38091209 | DOI:10.3758/s13428-023-02312-0

Obes Surg. 2023 Dec 13. doi: 10.1007/s11695-023-06970-z. Online ahead of print.

ABSTRACT

PURPOSE: The growing rate of obesity led to an increased number of bariatric surgeries (BS) as a treatment option for obesity. The gastrointestinal tract (GIT) changes following BS can impact many drugs’ absorption. Levothyroxine (LT4) is a synthetic thyroxine (T4) replacement used commonly as tablets to manage hypothyroidism disorder, which is more prevalent among patients with obesity. This study aims to examine the LT4 oral tablet form therapy after sleeve gastrectomy.

MATERIALS AND METHODS: A retrospective cohort study was conducted in multi-center. The LT4 doses and TSH and T4 levels were compared before and after BS. The post-surgery readings were categorized into three periods: (one to three months), (four to six months), and (> six ) months after surgery. ANOVA test was used for analysis.

RESULTS: A total of 14374 patients who underwent BS from (1/2019 to 3/2022) were screened for eligibility, and n = 101 participants matched the inclusion criteria. The TSH and T4 were not statistically significant differences before and after surgery (P-values of 0.4864 and 0.5970, respectively). However, the doses significantly differed before and after surgery in all the follow-up time point periods (P < 0.002).

CONCLUSION: The LT4 required doses significantly reduced after sleeve gastrectomy, which can be related to the improved endogenous thyroid production in patients with obesity. However, the abnormality of the GIT induced by the sleeve gastrectomy may affect the exogenous LT4 absorption. Using liquid forms of LT4 while monitoring the thyroid function parameters can optimize the treatment after the procedure.

PMID:38091193 | DOI:10.1007/s11695-023-06970-z

Invest Ophthalmol Vis Sci. 2023 Dec 1;64(15):13. doi: 10.1167/iovs.64.15.13.

ABSTRACT

PURPOSE: To determine if circulating antiretinal antibodies (ARAs) differ between patients affected by retinitis pigmentosa (RP) and control participants and to assess whether ARAs are associated with clinical outcomes in patients with RP.

METHODS: Cross-sectional study involving a group of patients clinically diagnosed with RP and a control group of healthy participants. Serum autoantibodies against enolase, heat shock protein 70 (HSP70), and carbonic anhydrase II (CAII) were tested in all participants using Jess capillary Western blot. We compared ARA prevalence between the RP and control groups and investigated the association of serum ARA positivity with macular edema and vitreomacular disorders in patients affected by RP.

RESULTS: Thirty-six patients affected by RP and a control group of 39 healthy individuals were included. Overall, at least one ARA positivity was detected in 89% and 80% of participants in the RP and control groups, respectively. We observed a similar prevalence of anti-CAII and anti-enolase ARA between patients and controls (P = 0.87 and P = 0.35, respectively). Sera from patients with RP tested positive for anti-HSP70 ARAs more frequently than those from controls (53% vs. 36%), albeit without reaching statistical significance (P = 0.29). Among the 72 eyes with RP, 25% presented with macular edema (most often bilateral) and 33% with epiretinal membrane and/or lamellar macular hole. None of the three ARAs was associated with an increased risk of any macular complications in eyes affected by RP (all P > 0.05).

CONCLUSIONS: The prevalence of circulating ARAs against enolase, HSP70, and CAII is similar between patients affected by RP and healthy individuals. Our results provide evidence against the association of ARAs with macular edema and vitreomacular interface disorders in RP.

PMID:38088826 | DOI:10.1167/iovs.64.15.13

Pediatr Crit Care Med. 2023 Dec 13. doi: 10.1097/PCC.0000000000003427. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate for associations between a child’s neighborhood, as categorized by Child Opportunity Index (COI 2.0), and 1) PICU mortality, 2) severity of illness at PICU admission, and 3) PICU length of stay (LOS).

DESIGN: Retrospective cohort study.

SETTING: Fifteen PICUs in the United States.

PATIENTS: Children younger than 18 years admitted from 2019 to 2020, excluding those after cardiac procedures. Nationally-normed COI category (very low, low, moderate, high, very high) was determined for each admission by census tract, and clinical features were obtained from the Virtual Pediatric Systems LLC (Los Angeles, CA) data from each site.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Among 33,901 index PICU admissions during the time period, median patient age was 4.9 years and PICU mortality was 2.1%. There was a higher percentage of admissions from the very low COI category (27.3%) than other COI categories (17.2-19.5%, p < 0.0001). Patient admissions from the high and very high COI categories had a lower median Pediatric Index of Mortality 3 risk of mortality (0.70) than those from the very low, low, and moderate COI groups (0.71) (p < 0.001). PICU mortality was lowest in the very high (1.7%) and high (1.9%) COI groups and highest in the moderate group (2.5%), followed by very low (2.3%) and low (2.2%) (p = 0.001 across categories). Median PICU LOS was between 1.37 and 1.50 days in all COI categories. Multivariable regression revealed adjusted odds of PICU mortality of 1.30 (95% CI, 0.94-1.79; p = 0.11) for children from a very low versus very high COI neighborhood, with an odds ratio [OR] of 0.996 (95% CI, 0.993-1.00; p = 0.05) for mortality for COI as an ordinal value from 0 to 100. Children without insurance coverage had an OR for mortality of 3.58 (95% CI, 2.46-5.20; p < 0.0001) as compared with those with commercial insurance.

CONCLUSIONS: Children admitted to a cohort of U.S. PICUs were often from very low COI neighborhoods. Children from very high COI neighborhoods had the lowest risk of mortality and observed mortality; however, odds of mortality were not statistically different by COI category in a multivariable model. Children without insurance coverage had significantly higher odds of PICU mortality regardless of neighborhood.

PMID:38088770 | DOI:10.1097/PCC.0000000000003427

Pol J Vet Sci. 2023 Dec 12;26(4):733-739. doi: 10.24425/pjvs.2023.148293.

ABSTRACT

The most common problems in veterinary practice in bitches are bacterial infections of the reproductive tract associated with fertility problems. Research to determine the correlation between the health status of female dogs and bacterial flora of the genital tract has been ongoing for years, but the results obtained by different authors are often contradictory, and do not always concern breeding bitches. Our study identified the most common aerobic bacteria in the genital tract of numerous breeding bitches population. A total of 275 breeding dogs in anestrous phase of the estrous cycle were included in this study. 198 were qualified to the first group with no genital tract infections and no reproductive disorders. 68 bitches were qualified to the second group with complications such as: infertility, abortion, foetus resorptions and newborn mortality. The type of bacterial isolates was almost the same in the healthy bitches and the group with fertility problems. The most common bacteria obtained from the vaginal tract of the tested dogs were Streptococcus spp., Staphylococcus spp., Mycoplasma canis and Escherichia coli. There were no significant differences in bacterial prevalence in the group with reproductive problems versus healthy dogs; however, we found a statistically significant difference between both groups when the numbers of bacterial strains were compared. The number of one-strain bitches was statistically higher in the problematic group than in the non-problematic one. Bacterial culturing of vaginal swab specimens from breeding bitches without clinical signs of genital disease is of little value. Furthermore, it should always be preceded by an examination (clinical, cytological or vaginoscopy etc.). The request or requirement to perform vaginal cultures that is made by some breeders, while common, is not diagnostic for any pathologic condition and the results of these cultures should never be used to determine if antibiotic therapy is indicated.

PMID:38088743 | DOI:10.24425/pjvs.2023.148293

Arq Bras Cir Dig. 2023 Dec 8;36:e1779. doi: 10.1590/0102-672020230061e1779. eCollection 2023.

ABSTRACT

BACKGROUND: Liver transplantation (LT) is the only treatment that can provide long-term survival for patients with acute-on-chronic liver failure (ACLF). Although several studies identify prognostic factors for patients in ACLF who do not undergo LT, there is scarce literature about prognostic factors after LT in this population.

AIM: Evaluate outcomes of ACLF patients undergoing LT, studying prognostic factors related to 1-year and 90 days post-LT.

METHODS: Patients with ACLF undergoing LT between January 2005 and April 2021 were included. Variables such as chronic liver failure consortium (CLIF-C) ACLF values and ACLF grades were compared with the outcomes.

RESULTS: The ACLF survival of patients (n=25) post-LT at 90 days, 1, 3, 5 and 7 years, was 80, 76, 59.5, 54.1 and 54.1% versus 86.3, 79.4, 72.6, 66.5 and 61.2% for patients undergoing LT for other indications (n=344), (p=0.525). There was no statistical difference for mortality at 01 year and 90 days among patients with the three ACLF grades (ACLF-1 vs. ACLF-2 vs. ACLF-3) undergoing LT, as well as when compared to non-ACLF patients. CLIF-C ACLF score was not related to death outcomes. None of the other studied variables proved to be independent predictors of mortality at 90 days, 1 year, or overall.

CONCLUSIONS: LT conferred long-term survival to most transplant patients. None of the studied variables proved to be a prognostic factor associated with post-LT survival outcomes for patients with ACLF. Additional studies are recommended to clarify the prognostic factors of post-LT survival in patients with ACLF.

PMID:38088725 | DOI:10.1590/0102-672020230061e1779