Tag: pubmed

Immunol Invest. 2021 Jul 12:1-9. doi: 10.1080/08820139.2021.1948564. Online ahead of print.

ABSTRACT

Diabetic kidney disease (DKD) is one of the more limiting complications to the quality of life of diabetes mellitus patients. Studies including cultured cells, animal models, and case-control studies highlight the role of human β-defensin-1 (hBD-1) in diabetes.This study assessed the association of hBD-1 gene (DEFB1) functional variations -52 G/A (rs1799946), -44 C/G (rs1800972) and -20 G/A (rs11362) with type 2 diabetes mellitus (T2DM) in order to investigate its effects on genetic susceptibility and progression to DKD in a Mexican population. A total of 214 T2DM patients with and without DKD (n = 102 and n = 112, respectively) and 117 healthy subjects participated in this case-control study. Genotyping was made by PCR-RFLPs. Clinical and biochemical parameters of all patients were measured. There was no statistically significant difference in genotype or allele frequencies between patients and healthy individuals. Nevertheless, compared with patients without DKD, DKD patients have a reduced prevalence of AA genotype of -52 G/A (OR = 0.307, 95% CI = 0.104-0.905, p =.026), as well as a higher frequency of GA genotype of -20 G/A variant (OR = 1.875, 95%CI = 1.031-3.409, p = .038). Our results suggest that rs1799946 and rs11362 could be useful variants to stratify T2DM Mexican patients in order to prescribe closer follow-up to prevent or retard DKD. Further tests in different ethnic groups are encouraged.

PMID:34251960 | DOI:10.1080/08820139.2021.1948564

Isr Med Assoc J. 2021 Jul;23(7):408-411.

ABSTRACT

BACKGROUND: Our hospital used to perform cesarean delivery under general anesthesia rather than neuraxial anesthesia, mostly because of patient refusal of members of the conservative Bedouin society. According to recommendations implemented by the Israeli Obstetric Anesthesia Society, which were implemented due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, we increased the rate of neuraxial anesthesia among deliveries.

OBJECTIVES: To compare the rates of neuraxial anesthesia in our cesarean population before and during SARS-CoV-2 pandemic.

METHODS: We included consecutive women undergoing an elective cesarean delivery from two time periods: pre-SARS-CoV-2 pandemic (15 February 2019 to 14 April 2019) and during the SARS-CoV-2 pandemic (15 February 2020 to 15 April 2020). We collected demographic data, details about cesarean delivery, and anesthesia complications.

RESULTS: We included 413 parturients undergoing consecutive elective cesarean delivery identified during the study periods: 205 before the SARS-CoV-2 pandemic and 208 during SARS-CoV-2 pandemic. We found a statistically significant difference in neuraxial anesthesia rates between the groups: before the pandemic (92/205, 44.8%) and during (165/208, 79.3%; P < 0.0001).

CONCLUSIONS: We demonstrated that patient and provider education about neuraxial anesthesia can increase its utilization. The addition of a trained obstetric anesthesiologist to the team may have facilitated this transition.

PMID:34251121

Eur J Transl Myol. 2021 Jul 12. doi: 10.4081/ejtm.2021.9929. Online ahead of print.

ABSTRACT

Aging well is directly associated to a healthy lifestyle. The focus of this paper is to relate individual wellness with medical image features. Non-linear trimodal regression analysis (NTRA) is a novel method that models the radiodensitometric distributions of x-ray computed tomography (CT) cross-sections. It generates 11 patient-specific parameters that describe the quality and quantity of muscle, fat, and connective tissues. In this research, the relationship of these 11 NTRA parameters with age, physical activity, and lifestyle is investigated in the 3,157 elderly volunteers AGES-I dataset. First, univariate statistical analyses were performed, and subjects were grouped by age and self-reported past (youth-midlife) and present (within 12 months of the survey) physical activity to ascertain which parameters were the most influential. Then, machine learning (ML) analyses were conducted to classify patients using NTRA parameters as input features for three ML algorithms. ML is also used to classify a Lifestyle index using the age groups. This classification analysis yielded robust results with the lifestyle index underlying the relevant differences of the soft tissues between age groups, especially in fat and connective tissue. Univariate statistical models suggested that NTRA parameters may be susceptible to age and differences between past and present physical activity levels. Moreover, for both age and physical activity, lean muscle parameters expressed more significant variation than fat and connective tissues.

PMID:34251162 | DOI:10.4081/ejtm.2021.9929

Urologiia. 2021 Jun;(3):110-113.

ABSTRACT

AIM: To evaluate the efficiency of additional methods of intraoperative control during transurethral resection (TUR) for the treatment of non-muscle invasive bladder cancer.

MATERIAL AND METHODS: A total of 138 patients (92 men and 46 women) with non-muscle-invasive bladder cancer (Ta-T1N0M0) were treated in the urological clinic of Kazan State Medical University. The median age was 59 years. In 28 patients TUR was performed as monotherapy, in 28 patients TUR with photodynamic therapy (PDD) was done and other 26 patients undergone TUR under dynamic transurethral ultrasound control. In 29 patients, TUR was combined with a single intravesical instillation of a chemotherapy drug, and in 27 patients, TUR was combined with long-term intravesical chemotherapy. The frequency and type of relapses was evaluated depending on the treatment method during five-year follow-up period. Analysis of postoperative complications and their severity was performed according to the Clavien-Dindo classification. Statistical analysis was performed using the Statistica 7.0 and Microsoft Excel 2003 software package. Survival was assessed using the Kaplan-Meier method. Differences in survival between groups were determined using a log-rang test.

RESULTS: The total 5-years recurrence rate in the group 1 was 60.71% (n=17). There were 6 recurrences in the resection area (21.43%) and 8 recurrences outside the resection area (28.57%). The progression rate was 10.71% (n=3). In the group 2, the overall recurrence rate was 25% (n=7), including 2 (7.14%) and 4 (14.29%) recurrences in and outside resection area, respectively. The progression rate was 3.57% (n=1). In the group 3, where TUR was performed in combination with transurethral ultrasound, 7 recurrences were diagnosed over a five-year period (26.92%), including 1 recurrence in the resection area (3.84%) and 6 recurrences in other parts of bladder (23.07%). There was no progression of bladder cancer. In the group of patients who received a single intravenous chemotherapy after TUR, there were no significant differences with the group of patients where TUR was performed as monotherapy. The total number of recurrences was 55.16% (n=16). There were 4 recurrences in the resection area (13.79%) and 9 recurrences in other parts of bladder (31.03%), as well as 3 case of disease progression (10.34%). At the same time, in the group of patients where prolonged course of adjuvant intravesical chemotherapy was performed, a significant decrease in the recurrences rate in the resection area (7.4%; n=2) and progression (3.7%, n=1) was found. The number of recurrences outside the resection area was comparable with the group 1 (22.22%; n=6).

CONCLUSIONS: According to our data, we recommend to perform TUR in combination with PDD and transurethral ultrasound in order to improve the oncological results. Long-term intravesical chemotherapy is an effective alternative in case of inability to use additional intraoperative control and it should be included in the treatment scheme of patients with a high risk of recurrence.

PMID:34251111

Urologiia. 2021 Jun;(3):98-103.

ABSTRACT

OBJECTIVE: To compare the perioperative, functional, clinical and morphological results of a standard robot-assisted nerve-sparing radical prostatectomy and with the use of the Retzius-sparing technique.

MATERIALS AND METHODS: A prospective analysis was performed of two groups of patients (n=54) who underwent nerve-sparing robot-assisted radical prostatectomy (period from 2017 to 2018). The first group included 29 patients who underwent nerve-sparing robot-assisted radical prostatectomy with Retzius-sparing technique, the second – 25 patients operated on according to the standard method of bilateral nerve-sparing radical prostatectomy. All patients were comparable in baseline characteristics. In all cases, patients had histologically verified localized prostate cancer pT2a-2c.

RESULTS: In cases with use Retzius-sparing technique there is no statistically significant difference in the operation time (243.60 min vs 236.64 min, in groups 1 and 2, p>0.05) and intraoperative blood loss (131.20 ml vs 122.57 ml , in groups 1 and 2, p>0.05). Regarding the dynamics of the urinary continence recovery, the Retzius-sparing technique demonstrates advantages in speed and frequency at all follow-up periods (54.13% vs 41.81%; 68.12% vs 59.21%; 94.15% vs 90 , 63%; 98.54% vs 97.12%; 98.62% vs 97.31%; 98.83% vs 97.82% – in one week after removal of the urethral catheter, 1, 3, 6, 9, and 12 months in the first and second group, respectively). The frequency of erectile function recovery after 12 months was 82.17% and 71.14% in the first and second groups, respectively.

CONCLUSIONS: Retzius-sparing robot-assisted prostatectomy superior to standard operation in the speed and timing of recovery of urine continence and erectile function.

PMID:34251109

Urologiia. 2021 Jun;(3):61-69.

ABSTRACT

INTRODUCTION: Transurethral resection of the prostate (TURP) is the gold standard of BPH surgical treatment. It is of current interest to search for medications that can reduce the incidence of complications after TURP.

AIM: To evaluate the efficiency of Longidaza (rectal suppositories of 3000 IU) as part of combined therapy in order to prevent complications after TURP.

MATERIALS AND METHODS: The study included 202 patients who underwent TURP in 3 hospitals. The patients were divided into 2 groups: main group – 96 men taking standard postoperative therapy with Longidaza rectal suppositories N 20; control group – 106 men – taking standard postoperative therapy (tamsulosin 30 days; fluoroquinolone 5 days). Follow-up included IPSS, urinalysis, urine culture, ultrasound examination of the prostate volume (PV), post void residual urine, uroflowmetry at 1,2,3,6 months after surgery. Average preoperative indices: IPSS 27 [23; 30], Qol 5 [4; 6], prostate volume (PV) 71+/-19cc (30-272 c), Qmax 7.5+/-2.5ml/s (1,3-18,7 ml/s).

RESULTS: There was a significant improvement in IPSS, QoL, Qmax, PV, post void residual urine (PVR) compared to preoperative values during the entire observation period. There was no statistical difference between the main and control groups for these indexes in 6 months. In the main group had statistically lower incidence of bacteriuria at 3 (11% vs 17%) and 6 months (7% vs 17%), and leukocyturia at 3 (31% vs 46%) and 6 months of follow-up (20% vs 44%). Overall incidence of infectious complications and additional antibacterial drugs prescription was lower in the Longidaza group compared to the control group (17,7% vs 20,7%). Urethral strictures developed in 7 men in the main group, and 8 in the control group.

CONCLUSION: Our results show that prescription of Longidaza significantly reduces the incidence of leukocyturia and bacteriuria postoperatively, decreasing the rate of infectious complications in men after TURP.

PMID:34251103

Urologiia. 2021 Jun;(3):70-74.

ABSTRACT

INTRODUCTION: Benign prostatic hyperplasia (BPH), and chronic prostatitis (CP) are considered to be among the most common causes of lower urinary tract symptoms (LUTS) in men. The combination of BPH with CP raises many questions when choosing the right treatment strategy. For a long time, bioregulators isolated from the prostate gland of cattle have been successfully used in the treatment of CP.

OBJECTIVE: to evaluate the effectiveness of bioregulatory peptides, in particular vitaprost, in the treatment of men with benign prostatic hyperplasia and chronic prostatitis.

MATERIALS AND METHODS: The study included 60 patients with BPH and CP, who were divided into two groups of 30 people. In the comparison group (CG), complex therapy with drugs from the group of alpha-blockers and fluoroquinolones was performed. In the main group (MG), a similar complex therapy was performed in combination with vitaprost tablets. The effectiveness of the treatment was evaluated after two weeks (visit 2) and after 4 weeks (visit 3).

RESULTS: In the MG, a more effective reduction in the severity of LUTs and manifestations of the inflammatory process was noted than in the HS. After 2 weeks of therapy in OG, the average score on the IPSS, QOL and NICH-CPSI questionnaires was lower by 2.4 points, 1.2 points and 2.5 points, respectively, the number of white blood cells in the prostate secret was on average 1.5 times less, and Qmax was higher by 1.4 ml/sec. The revealed differences were statistically significant (p<0.05). This trend continued after 4 weeks of therapy.

CONCLUSION: Thus, the use of bioregulatory peptides, in particular the drug vitaprost, in patients with BPH and CP helps to reduce the severity of LUTs and pain in a shorter time, has a positive effect on the dynamics of the inflammatory process, which leads to an improvement in the quality of life of patients in this category.

PMID:34251104

Int J Geriatr Psychiatry. 2021 Jul 11. doi: 10.1002/gps.5602. Online ahead of print.

ABSTRACT

BACKGROUND: The characteristics of this pandemic increase the potential psychological impact on care homes workers (CHWs). The aims of this study were to analyze the mental health and health-related quality of life (HRQoL) of a broad sample of CHWs in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL.

METHOD: This descriptive study comprised 210 CHWs who completed the Generalized Anxiety Disorder 7-item Scale, the Patient Health Questionnaire-9, the Impact Event Scale-Revised, the Insomnia Severity Index, and the Health-related Quality of Life Questionnaire. Sociodemographic and clinical data in relation to COVID-19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL.

RESULTS: 86.19% of participants were female; 86.67% were aged under 55 years; 11% were physicians and 64.19% were nurses or auxiliaries; 77.62% have themselves tested positive for Covid-19, and 67.94% of CHWs have directly treated patients with Covid-19. 49.28% had clinical depression; over half (58.57%) had clinical anxiety; 70.95% had clinical stress; and 28.57% had clinical insomnia. Increased use of tranquilizers/sedatives appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our CHWs.

CONCLUSIONS: Our study confirms that symptomatology of anxiety, depression, stress, insomnia and HRQoL were affected amongst CHWs during the Covid-19 pandemic. This article is protected by copyright. All rights reserved.

PMID:34251057 | DOI:10.1002/gps.5602

Orthop Surg. 2021 Jun;13(4):1389-1397. doi: 10.1111/os.12985.

ABSTRACT

OBJECTIVE: To investigate the effects of improved perioperative sleep on pain, analgesic consumption, and postoperative nausea and vomiting (PONV) in patients who were undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).

METHODS: Original studies published from 1 January 1970 to 30 September 2020 were queried in three unique databases using a common search term. The searches sought randomized controlled trials (RCT) investigating the effectiveness of sleep quality or quantity interventions for pain control early after TKA or THA. Grey literature was also searched by screening trial registers. There was no limitation on published language and patients. Two reviewers then assessed studies for eligibility. Eligible studies should have primary outcomes including perioperativeWe have comfirmed the edits. visual analogue scale (VAS) pain score and analgesic consumption; and secondary outcomes including side effects, such as PONV. Data extracted from the literature were abstracted into a comma-separated database spreadsheet using Microsoft Excel. A meta-analysis was then performed. Pooled statistics were calculated with weighting by inverse variance assuming a random effect model. I² was calculated as a quantifier of heterogeneity and interpreted according to the Cochrane manual. All data analysis was performed using Revman software.

RESULTS: From a total of 1285 potential records identified in the electronic search, six studies eventually fulfilled the eligibility criteria. The six controlled RCTs consisted of 207 patients in the sleep-improving group and 209 patients in the control group. The severity of rest pain was significantly lower in the sleep-improving group compared with the control group at day 1 and day 3 postoperatively; the severity of active pain was significantly lower in the sleep-improving group compared with the control group at day 3 postoperatively. Data concerning analgesic drugs could not undergo a meta-analysis due to the difference of eligible studies. No significant difference was found in the incidence of PONV between the sleep-improving group and the control group.

CONCLUSION: Improved perioperative sleep, regardless of quality or quantity, could significantly reduce the pain level at the early stage after TKA or THA, thus the total amount of analgesic drugs consumed was decreased, without significant increase in the incidence of PONV.

PMID:34251091 | DOI:10.1111/os.12985

Urologiia. 2021 Jun;(3):33-38.

ABSTRACT

AIM: To study the pathogenetic and clinical features of nephrolithiasis in patients with concomitant chronic cardiovascular diseases (CVD), particularly the chemical composition of renal stones, the frequency of relapses, as well as the daily dynamics of the urine specific gravity and acidity level as the main factors of stone formation.

MATERIALS AND METHODS: A total of 270 patients were treated in the Department of the urology No. 1 of the “Main Military Clinical Hospital named after N. N. Burdenko” of the Ministry of Defense of the Russian Federation during the period from 2008 to 2018. The main group included 184 patients suffering from nephrolithiasis, of which 72 had hypertension in combination with coronary heart disease, and in other 112 patients chronic heart failure (CHF of stage I, IIA and IIB in 55, 37 and 20 patients, respectively) was previously diagnosed. Data on the CVD were obtained from medical records; if necessary, patients were referred to an internist and/or cardiologist. The CHF was staged in accordance with the Strazhesco-Vasilenko (1935) classification. In the control group there were 86 patients with urolithiasis without any cardiovascular disorders. A retrospective analysis of the stone composition was performed using a NICOLET iS10 spectral analyzer. The urine specific gravity and acidity (pH) was determined using a semi-automatic analyzer CLINITEK Status Plus three times a day (both during hospital stay and 3 months after discharge). Statistical analysis was done using the SPSS program v.19. The absolute values (M+/-m) were calculated, as well as Min, ME, Mo, Max. Relative values, including Fischer criterion, were evaluated, taking into account the Bonferroni correction. Differences were significant if p-value was < 0.05.

RESULTS: There was no difference between groups in age (32; 64; 83). In both groups men were predominated (~ 75-78%). According to chemical analysis, stone composition in the control group was as following: oxalates (76.6%), uric acid (9.3%), phosphates (8.1%); mixed stones (6.7%). Independent of stage of CHF, respective figures were 51.4, 23.6, 8.3 and 16%, respectively. The follow-up of patients for 5 years showed that patients were admitted to the urological hospital with a stone recurrence on average 1.8 times, compared to 3 and 3.8 times with concomitant CVD and CHF, respectively. The most concentrated (specific gravity of 1035) and the most acidic (pH =5.5-5) urine in patients with CHF was found in the evening.

CONCLUSION: Chronic CVD has a significant impact on the clinical manifestations of urinary stone disease. The most pronounced changes are associated with CHF. Features of nephrolithiasis in patients with a CVD include the predominance of uric acid and urate stones, more frequent recurrences, shift in the peak of acidity and urine specific gravity from morning to evening hours.

PMID:34251098