Tag: pubmed

Am J Hypertens. 2022 Mar 25:hpac042. doi: 10.1093/ajh/hpac042. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare prevalence of hypertension and stage II hypertension assessed by two blood pressure observation protocols.

METHODS: Participants aged 18 years and older (n = 4,689) in the National Health and Nutrition Examination Survey (NHANES 2017-2018) had their blood pressure (BP) measured following two protocols: the legacy auscultation protocol [AP] and oscillometric protocol [OP]. The order of protocols was randomly assigned. Prevalence estimates for hypertension (BP ≥130/80 mm Hg or use of medication for hypertension) and stage II hypertension (BP ≥140/90 mm Hg) were determined overall, by demographics, and by risk factors for each protocol. Ratios (OP% ÷ AP%) and Kappa statistics were calculated.

RESULTS: Age-adjusted hypertension prevalence was 44.5% (95% CI: 41.1%-48.0%) using OP and 45.1% (95%CI: 41.5%-48.7%) using AP, prevalence ratio=0.99, (95% CI=0.94-1.04)). Age-adjusted Stage II hypertension prevalence was 15.8% (95% CI: 13.6%-18.2%) using AP and 17.1% (95% CI: 14.7%-19.7%) using OP, prevalence ratio=0.92, (95% CI=0.81-1.04)). For both hypertension and Stage II hypertension, the prevalence ratios by demographics and by risk factors all included unity in their 95% CI, except for Stage II hypertension in adults 60+ years (ratio: 0.88 (95% CI: 0.78-0.98)). Kappa for agreement between protocols for hypertension and stage II hypertension were 0.75 (95% CI=0.71-0.79) and 0.67 (95% CI=0.61-0.72), respectively.

CONCLUSIONS: In adults and for nearly all subcategories there were no significant differences in prevalence of hypertension and stage II hypertension between protocols, indicating that protocol change may not affect the national prevalence estimates of hypertension and stage II hypertension.

PMID:35333925 | DOI:10.1093/ajh/hpac042

Soc Psychiatry Psychiatr Epidemiol. 2022 Mar 25. doi: 10.1007/s00127-022-02274-2. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to investigate the changes in psychosocial and psychiatric services in the German city of Leipzig during the COVID-19-pandemic.

METHODS: A participatory, mixed-methods study was used involving a quantitative online survey and qualitative semi-structured interviews with professionals. Quantitative findings were reported with descriptive statistics, and thematic analysis was conducted for qualitative data.

RESULTS: Fifty professionals from various mental health services participated in the survey and eleven professionals were interviewed. Quantitative findings showed that some services were closed intermittently and that there was a stiff increase in use of digital/telephonic service and a decrease in face-to-face services. Staff or funding did not change considerably during the pandemic. Psychosocial groups were suspended or reduced, while access to services became more difficult and professional training for staff was stopped. Thematic analysis of the interviews showed that professionals experienced different phases and levels of change during the pandemic, including changes on a structural level, on the users’ level, and on the staff’ level. Professionals particularly criticised the equivocality of COVID-19 regulations, a defective flow of information and lack of attention for mental healthcare in public policies. They also saw positive aspects, such as the capacity of users and the outpatient care system to adapt to the new situation.

CONCLUSION: This study suggests directions for policy and service development, such as communicating clearly in infection-control measures, fostering outpatient care and networks between services.

PMID:35333930 | DOI:10.1007/s00127-022-02274-2

Cancer Epidemiol Biomarkers Prev. 2022 Mar 25:cebp.1318.2021. doi: 10.1158/1055-9965.EPI-21-1318. Online ahead of print.

ABSTRACT

BACKGROUND: Results of previous observational studies examining the risk of cancer among chronic kidney disease (CKD) patients are conflicting. We here explore the causal relationship between estimated glomerular filtration rate (eGFR) and albuminuria, two principal measurements of CKD, and 19 site-specific cancers using Mendelian randomization (MR) analysis.

METHODS: Single nucleotide polymorphisms reported to be strongly correlated with eGFR and albuminuria in recent large genome-wide association studies were used as instrumental variables to investigate the causal relationship with cancer using summary-level statistics from several cancer-specific consortia, as well as data of 347,408 participants in the UK Biobank and 260,405 participants in the FinnGen.

RESULTS: Our data showed that impaired kidney function was associated with higher odds of leukemia (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.06-1.43, P = 0.007), cervical cancer (OR 1.22, 95% CI 1.04-1.43, P = 0.017) and female renal cell carcinoma (OR 1.4, 95% CI 1.12-1.77, P = 0.004), per 10% decrease in eGFR. The odds ratios were 1.21 (95% CI 1.07-1.36, P = 0.002) for colorectal cancer and 0.76 (95% CI 0.62-0.92, P = 0.006) for non-Hodgkin lymphoma, per doubling odds of albuminuria. In multivariable MR, effect sizes of eGFR-cervical cancer remained strong after adjusting for confounders.

CONCLUSIONS: The current study indicates that progression of CKD contributes to carcinogenesis of renal cell carcinoma, leukemia, cervical and colorectal cancer.

IMPACT: The potential association of kidney function and albuminuria with certain cancers warrants further investigation in order to provide appropriate recommendations regarding cancer screening among patients with CKD.

PMID:35333923 | DOI:10.1158/1055-9965.EPI-21-1318

PLoS One. 2022 Mar 25;17(3):e0265730. doi: 10.1371/journal.pone.0265730. eCollection 2022.

ABSTRACT

In the context of wildlife population declines, increasing computer power over the last 20 years allowed wildlife managers to apply advanced statistical techniques that has improved population size estimates. However, respecting the assumptions of the models that consider the probability of detection, such as N-mixture models, requires the implementation of a rigorous monitoring protocol with several replicate survey occasions and no double counting that are hardly adaptable to field conditions. When the logistical, economic and ecological constraints are too strong to meet model assumptions, it may be possible to combine data from independent surveys into the modelling framework in order to understand population dynamics more reliably. Here, we present a state-space model with an error process modelled on the log scale to evaluate wintering waterfowl numbers in the Camargue, southern France, while taking a conditional probability of detection into consideration. Conditional probability of detection corresponds to estimation of a detection probability index, which is not a true probability of detection, but rather conditional on the difference to a particular baseline. The large number of sites (wetlands within the Camargue delta) and years monitored (44) provide significant information to combine both terrestrial and aerial surveys (which constituted spatially and temporally replicated counts) to estimate a conditional probability of detection, while accounting for false-positive counting errors and changes in observers over the study period. The model estimates abundance indices of wintering Common Teal, Mallard and Common Coot, all species abundant in the area. We found that raw counts were underestimated compared to the predicted population size. The model-based data integration approach as described here seems like a promising solution that takes advantage of as much as possible of the data collected from several methods when the logistic constraints do not allow the implementation of a permanent monitoring and analysis protocol that takes into account the detectability of individuals.

PMID:35333894 | DOI:10.1371/journal.pone.0265730

PLoS One. 2022 Mar 25;17(3):e0265337. doi: 10.1371/journal.pone.0265337. eCollection 2022.

ABSTRACT

BACKGROUND: Although antiretroviral therapy has significantly altered the natural history of human immunodeficiency virus infection and improved the quality of life of patients, there are conflicting reports regarding its impact on hematological outcomes. Thus, this study aimed at investigating the prevalence and predictors of anemia among adults on antiretroviral therapy in Northeast Ethiopia.

MATERIALS AND METHODS: A retrospective cohort study was carried out among adults who began antiretroviral treatment between September 2005 and January 2019 at two governmental hospitals in Dessie town. Data were collected from patients’ medical records using a pretested data extraction instrument. Anemia was the primary outcome variable of the study. It was defined based on WHO criteria after adjustment for altitude and smoking status of measured values. Data were entered and validated using EpiData Version 3.1 and then exported to SPSS Version 20.0 for analysis. Descriptive analysis was done for prevalence and binary logistic regression was carried out to assess whether covariates were associated with experiencing anemia. Statistical significance has been considered at p-value <0.05.

RESULTS: Medical records of 392 patients (mean age: 35.58 ± 9.46 years) were reviewed. Of the total 392 patients, 218 (55.6%) were females, 261 (66.6%) were categorized under WHO clinical stage III/IV and 134 (34.2%) had a baseline CD4 cell count of <100 cells/mm3. The mean baseline CD4 cell count was 179 cells/mm3 (range: 2 to 853 cells) and 230 (58.7%) of the participants were on zidovudine-based regimen. Anemia was diagnosed among 162 (41.3%) patients. After adjustment for other confounding factors, risk of anemia was significantly associated with low baseline CD4 cell count (AOR 1.80, 95% CI 1.05-3.06) and tenofovir based regimen (AOR 2.05, 95% CI 1.31-3.21). On the other hand, being educated was found to be protective (AOR 0.40, 95% CI 0.21-0.78).

CONCLUSION: In this research, the prevalence of anemia was relatively high. Low baseline CD4 cell count and tenofovir based regimen were independent predictors of anemia; while being educated was protective. Treatment programs should focus on early diagnosis and treatment of HIV as well as routine screening and proper treatment of anemia.

PMID:35333889 | DOI:10.1371/journal.pone.0265337

PLoS Negl Trop Dis. 2022 Mar 25;16(3):e0010233. doi: 10.1371/journal.pntd.0010233. Online ahead of print.

ABSTRACT

BACKGROUND: Rift Valley fever (RVF) is an emerging, neglected, mosquito-borne viral zoonosis associated with significant morbidity, mortality and expanding geographical scope. The clinical signs and symptoms in humans are non-specific and case definitions vary. We reviewed and analysed the clinical manifestations of RVF in humans.

METHODS: In this systematic review and meta-analysis we searched on different dates, the Embase (from 1947 to 13th October 2019), Medline (1946 to 14th October 2019), Global Health (1910 to 15th October 2019), and Web of Science (1970 to 15th October 2019) databases. Studies published in English, reporting frequency of symptoms in humans, and laboratory confirmed RVF were included. Animal studies, studies among asymptomatic volunteers, and single case reports for which a proportion could not be estimated, were excluded. Quality assessment was done using a modified Hoy and Brooks et al tool, data was extracted, and pooled frequency estimates calculated using random effects meta-analysis.

RESULTS: Of the 3765 articles retrieved, less than 1% (32 articles) were included in the systematic review and meta-analysis. Nine RVF clinical syndromes were reported including the general febrile, renal, gastrointestinal, hepatic, haemorrhagic, visual, neurological, cardio-pulmonary, and obstetric syndromes. The most common clinical manifestations included fever (81%; 95% Confidence Interval (CI) 69-91; [26 studies, 1286 patients]), renal failure (41%; 23-59; [4, 327]), nausea (38%; 12-67; [6, 325]), jaundice (26%; 16-36; [15, 393]), haemorrhagic disease (26%; 17-36; [16, 277]), partial blindness (24%; 7-45; [11, 225]), encephalitis (21%; 11-33; [4, 327]), cough (4%; 0-17; [4, 11]), and miscarriage (54%) respectively. Death occurred in 21% (95% CI 14-29; [16 studies, 328 patients]) of cases, most of whom were hospitalised.

DISCUSSION: This study delineates the complex symptomatology of human RVF disease into syndromes. This approach is likely to improve case definitions and detection rates, impact outbreak control, increase public awareness about RVF, and subsequently inform ‘one-health’ policies. This study provides a pooled estimate of the proportion of RVF clinical manifestations alongside a narrative description of clinical syndromes. However, most studies reviewed were case series with small sample sizes and enrolled mostly in-patients and out-patients, and captured symptoms either sparsely or using broad category terms.

PMID:35333856 | DOI:10.1371/journal.pntd.0010233

PLoS One. 2022 Mar 25;17(3):e0265495. doi: 10.1371/journal.pone.0265495. eCollection 2022.

ABSTRACT

INTRODUCTION: Recruitment is essential for the success of clinical trials. We are conducting a randomized clinical trial to test the effect of a Mediterranean dietary intervention with or without 1700 mg/day of metformin for the prevention of age-related chronic diseases, the MeMeMe trial (Trial registration number: EudraCT number: 2012-005427-32 ClinicalTrials.gov ID: NCT02960711). MeMeMe recruiting experience, highlighting strengths, limitations encountered and results is reported.

PATIENTS AND METHODS: Statistical analysis focused on the reasons for withdrawal according to the recruitment method (“active” versus “passive” criterion) and the time of withdrawal. Logistic regression models were used to explore the associations between the risk of withdrawal and sex, recruitment method, randomization arm, and with markers of compliance to the intervention, such as one-year change in body weight.

RESULTS: Out of 2035 volunteers, 660 (32.4%) were recruited “actively” and 1375 (67.6%) “passively”. Among people who dropped out of the trial after randomization, there were 19.5% for the “active” and 22.0% for the “passive” method (p = 0.28). The risk of withdrawal was significantly higher in women (OR:1.91; 95% CI:1.17-3.12; p = 0.01), in volunteers older at recruitment (OR:1.25; 95% CI:1.07-1.45; p = 0.004), and in those with a higher BMI at baseline (OR:1.23; 95% CI:1.07-1.43; p = 0.004). Volunteers who lost at least 2 kg (the median weight change) in the first year of intervention were significantly less (53%) likely to withdraw from the trial (OR:0.48; 95% CI:0.30-0.75; p = 0.001).

CONCLUSION: Our findings suggest that the “passive” recruitment method was more effective than the “active” one to advance recruitment. The benefits of “passive” recruitment hardly outweighed the drawbacks.

TRIAL REGISTRATION: Trial registration number: EudraCT number: 2012-005427-32. ClinicalTrials.gov ID: NCT02960711.

PMID:35333878 | DOI:10.1371/journal.pone.0265495

J Cataract Refract Surg. 2022 Mar 24. doi: 10.1097/j.jcrs.0000000000000946. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to assess the efficiency of an index derived from multiple logistic regression analysis (MLRA) to measure differences in corneal tomography findings between subclinical keratoconus (SKC) in one eye, corneal ectasia, and healthy corneas.

SETTING: Two private Brazilian ophthalmological centers.

DESIGN: Multicenter, case-control study.

METHODS: This study included 187 eyes with very asymmetric ectasia and normal corneal topography and tomography (VAE-NTT) in the VAE-NTT group (G), 2,296 eyes with healthy corneas in the control group (CG), and 410 eyes with ectasia in the ectasia group. An index, termed as Boosted Ectasia Susceptibility Tomography Index (BESTi), was derived using MLRA to identify a cutoff point to distinguish patients in the three groups. The groups were divided into two subgroups with equal number of patients: validation set and external validation (EV) set.

RESULTS: BESTi had an area under the curve (AUC) of 0.91 with 86.02% sensitivity (Se) and 83.97% specificity (Sp) between CG and VAE-NTT G in the EV set, which were significantly greater than those of the Belin-Ambrósio Deviation Index (BAD-D; AUC: 0.81; Se: 66.67%; Sp: 82.67%; P < .0001) and Pentacam Random Forest Index (PRFI; AUC: 0.87; Se: 78.49%; Sp: 79.88%; P = .021).

CONCLUSIONS: BESTi facilitated early detection of ectasia in SKC. BESTi demonstrated higher Se and Sp than PRFI and BAD-D for detecting SKC.

PMID:35333829 | DOI:10.1097/j.jcrs.0000000000000946

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13566-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic ankle instability (CAI), which is characterized by deficient postural control, is associated with functional limitations and diminished self-reported quality of life. Recent studies have suggested that balance training can improve postural control, but high-quality evidence-based research to confirm the effect of balance training on dynamic postural stability in CAI patients is lacking.The purpose of this study was to synthesize current evidence regarding the effect of balance training on dynamic postural stability in Chronic ankle instability (CAI) patients.

EVIDENCE ACQUISITION: PubMed, Embase, Web of Science and Cochrane Library databases were searched for clinical trials that evaluated the effect of balance training on posture and balance in CAI patients from their inception to 15 July 2021. All statistical analyses were performed in RevMan 5.4. The risk of bias was assessed by the Cochrane Collaboration’s risk of bias tool, and studies that reported statistically comparable outcomes were analysed in meta-analyses using random effects models. Heterogeneity was assessed using the I2 statistic index.

EVIDENCE SYNTHESIS: A total of 12 RCTs included in this meta-analysis and revealed that balance training was effective for improving the dynamic posture stability of CAI patients (SMD=0:90; 95%CI: 0.54 to 1.26; P<0:00001, I2 = 71%; Star Excursion Balance Test). Subgroup analysis (balance training vs. other training) revealed a small negative effect size, but this was not statistically significant (SMD=-0.12, 95% CI=-0.53 to 0.29, P=0.56, I² = 9%). Another subgroup analysis (balance training vs. no training) revealed that balance training was more likely to have greater improvement on the dynamic posture stability of CAI patients (SMD=0.94, 95% CI: 0.71 to 1.17; P<0.00001, I² = 0%).

CONCLUSIONS: Balance training yielded a statistically significant and clinically meaningful improvement in dynamic postural stability in CAI patients. Limited evidence indicates that balance training was more effective than other training methods.

PMID:35333029 | DOI:10.23736/S0022-4707.22.13566-8

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13655-8. Online ahead of print.

ABSTRACT

BACKGROUND: female soccer players are often diagnosed with medial shin pain, which includes tibial stress fracture, medial tibial stress syndrome, and chronic exertional compartment syndrome. As the possibility of varied sites of pain affecting sports activities has not been fully researched, an urgent discussion and evidence is required. This study investigates the prevalence and effect of sites of pain on the sports activities of female soccer players with medial shin pain.

METHODS: a questionnaire survey was conducted for 196 female soccer players with medial shin pain to assess symptom duration, the effect of practice and performance, and sites of pain. The players were classified into three conditions (tibial stress fracture, medial tibial stress syndrome, or medial shin pain with neurological symptoms) and compared based on sites of pain.

RESULTS: we observed that medial tibial stress syndrome had a lower impact on performance compared to that of tibial stress fracture and medial shin pain with neurological symptoms. While participants with tibial stress fracture had to suspend practice sessions more frequently, the difference in symptom duration between the classified groups was not statistically significant. The effect of sites of pain on sports activities was not significantly different in participants with medial tibial stress syndrome.

CONCLUSIONS: medial shin pain should be evaluated carefully to differentiate between medial tibial stress syndrome and medial shin pain with neurological symptoms. Restriction of sports activities may help improve the patient’s condition early, regardless of the presentation.

PMID:35333031 | DOI:10.23736/S0022-4707.22.13655-8