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Nevin Manimala Statistics

Knowledge, practice and perceived barriers towards chemotherapy induced nausea and vomiting in prophylaxis guideline adherence among nurses in oncology units at selected hospitals, in Addis Ababa, Ethiopia, a cross-sectional study

BMC Nurs. 2022 Aug 11;21(1):223. doi: 10.1186/s12912-022-01009-7.

ABSTRACT

BACKGROUND: Chemotherapy-induced emesis can be prevented by the use of recommended guidelines for antiemetic regimens but a research study indicates that in Ethiopia the use of standard antiemetic drug guidelines is very limited.

OBJECTIVES: To assess knowledge, practice, and perceived barriers towards chemotherapy-induced nausea and vomiting in prophylaxis guideline adherence among nurses in oncology units.

METHODS: A cross-sectional study design was conducted among 81 oncology nurses selected in the two public hospitals of Addis Ababa, from March 1 to 30, 2020. The study participants were selected by using the population census method from the source population of nurses in oncology units. Data has collected by using semi-structured questionnaires with the self-administrated method. Data were analyzed by using Statistical Package for the Social Sciences software version 24. Descriptive statistics and logistic regression including bivariate and multivariate were conducted to examine the association between independent and outcome variables. The level of significance was determined at a p-value < 0.05 and a 95% confidence interval.

RESULT: Seventy-nine nurses participated with a 96% of response rate. All participants were aged greater than 24 with a mean age of 28.8 ± 6 years and nearly two-thirds of the respondents (60.8%) were females. Nurses were not trained in chemotherapy-induced nausea and vomiting management shows 54.4%. nurses’ knowledge of chemotherapy-induced nausea and vomiting prophylaxis Guidelines was 78.5%. The means score of oncology nurses’ practice toward guideline recommendation was 41.8%. Knowledge of nurses associated with the use of chemotherapy-induced nausea and vomiting prophylaxis guideline recommendations working in the outpatient department, inpatient ward, and chemotherapy administration unit has a significant association with chemotherapy-induced nausea and vomiting management knowledge. In the multiple logistic regression analysis, nurses who have trained for chemotherapy-induced nausea and vomiting management were 1.64-fold more aware than those who were not trained.

CONCLUSION: The study reveals that nurses working in the oncology unit of the study hospitals have a poor practice of Chemotherapy-Induced Nausea and Vomiting. Therefore, recommended providing Training for the Nurses working in the oncology unit and encourage them to apply standard guidelines.

PMID:35953790 | DOI:10.1186/s12912-022-01009-7

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Population-based comparison of cancer survival outcomes in patients with and without psychiatric disorders

BMC Psychiatry. 2022 Aug 11;22(1):543. doi: 10.1186/s12888-022-04191-9.

ABSTRACT

BACKGROUND: Individuals with psychiatric disorders (PD) have a high prevalence of tobacco use. Patients with PD also potentially receive substandard care in comparison to the general population. Previous research has shown that individuals with PD have a decreased risk of receiving a tobacco related (TR) cancer diagnosis. To further assess this trend, this study assesses the survival of patients with a TR cancer with or without a PD.

MATERIALS AND METHODS: Our study utilized multiple databases, with methods described elsewhere,6 to identify people in British Columbia that have been diagnosed with psychiatric disorders and appendicitis (our control group). From these groups, we selected individuals who also had a TR cancer. We subsequently extracted information pertaining to these patients from these databases.

RESULTS: Thirty-nine thousand eight hundred forty-one patients with cancer were included in our study. Analyses of these patients were controlled for by age, gender, cancer type and diagnosis year. This analysis displayed shorter survival time among patients who were diagnosed with depression (HR = 1.16; p = 0.01; 95% CI: 1.04-1.29), schizophrenia (HR = 1.62; p < 0.01; 95% CI: 1.43-1.84), or bipolar disorder (HR = 1.35; p < 0.01; 95% CI: 1.12-1.64) compared to the cancer patients without a PD, all of which were statistically significant. People that were diagnosed with anxiety disorders did not have a survival time that was significantly different from our control population (HR = 1.07; p = 0.22; 95% CI: 0.96-1.19).

CONCLUSIONS: Individuals with PD, except for those with anxiety, were found to have a shorter survival time following diagnosis with a TR cancer as compared to our control group. We hypothesize several factors, which may account for this statistically significant difference: (1) delayed diagnosis, (2) poor access to care, (3) poor assessment or follow-up, or (4) physician beliefs of poor treatment adherence.

PMID:35953787 | DOI:10.1186/s12888-022-04191-9

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Effectiveness of power training compared to strength training in older adults: a systematic review and meta-analysis

Eur Rev Aging Phys Act. 2022 Aug 11;19(1):18. doi: 10.1186/s11556-022-00297-x.

ABSTRACT

BACKGROUND: Research suggests that muscle power is a more critical determinant of physical functioning in older adults than muscle strength. The objective of this study was to systematically review the literature on the effect of power training compared to strength training in older adults on tests for muscle power, two groups of activity-based tests under controlled conditions: generic tests and tests with an emphasis on movement speed, and finally, physical activity level in daily life.

METHODS: A systematic search for randomized controlled trials comparing effects of power training to strength training in older adults was performed in PubMed, Embase, Ebsco/CINAHL, Ebsco/SPORTDiscus, Wiley/Cochrane Library and Scopus. Risk of bias was assessed using the Cochrane Collaboration Tool, and quality of evidence was evaluated using GRADEpro Guideline Development Tool. Standardized mean differenences (SMD) and 95% confidence intervals (CI) were calculated for outcomes separately using a random effects model.

RESULTS: Fifteen trials and 583 participants were included in the meta-analysis. Results indicated a statistically significant benefit of power training on all reported outcomes (muscle power SMD: 0.99, 95% CI: 0.54 to 1.44, p < 0.001; generic activity-based tests SMD: 0.37, 95% CI 0.06 to 0.68; p = 0.02, activity-based tests emphasizing movement speed SMD: 0.43, 95% CI 0.23 to 0.62, p < 0.001). None of the included studies used physical activity level in daily life as outcome.

CONCLUSIONS: Power training offers more potential for improving muscle power and performance on activity tests in older adults compared to strength training. Future research should assess exercise parameters for power training in older adults. In addition, the validity and reliability of the tests used must be evaluated to establish a standardized test protocol. This protocol should also include measurements of physical activity in daily life.

PMID:35953775 | DOI:10.1186/s11556-022-00297-x

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Acceptability and feasibility of a screening protocol for antenatal depression (SPADe) in Blantyre District, Malawi

BMC Psychiatry. 2022 Aug 12;22(1):544. doi: 10.1186/s12888-022-04195-5.

ABSTRACT

BACKGROUND: Depression is one of the most common perinatal mental health problems that affect pregnant women. Antenatal depression can adversely affect the well-being of the pregnant woman and her foetus. Depression is rarely detected by midwives due to the unavailability of relevant screening instruments in Malawi. A Screening Protocol for Antenatal Depression (SPADe) was developed and recommended for possible use to screen for depression in antenatal clinics in the country. The acceptability and feasibility of using the SPADe protocol to screen for depression has not been established. The aim of this study was to assess the acceptability and feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre district.

METHODS: This study used a quantitative survey design to collect data among 60 midwives in three antenatal clinics in primary care settings. All inclusive sampling of all 60 midwives were used. The Structured Assessment of FEasibility and Ottawa Acceptability of Decision Rules Instruments were used to collect the data. Descriptive statistics and Chi square tests were used to analyse the data.

RESULTS: This study found that it was feasible to implement SPADe and the following enablers for screening depression had the highest ratings: the SPADe is applicable to pregnant women (M = 3.9, sd = 0.4); the intended goal of the SPADe matches the prioritised goals of Malawi Ministry of Health (M = 3.9, sd = 0.5); and the SPADe is likely to be effective (M = 3.8, sd = 0.6). On the other hand, barriers for implementing the SPADe were: the need for specific training to deliver the SPADe (M = 3.7, sd = 0.7); ongoing support and supervision (M = 3.5, sd = 0.8); and additional resources (M = 3.0, sd = 0.9). This study also found that the implementation of the SPADe was acceptable to respondents. The overall mean score for respondents on acceptability of screening antenatal depression using SPADe was found to be high (M = 4.6, sd = 0.6). However the differences in the respondents’ mean scores on acceptability of screening for depression in antenatal clinics using SPADe in relation to their demographic characteristics were not significant (p > .05).

CONCLUSION: This study suggests that midwives feel that it is feasible and acceptable for them to implement the SPADe in antenatal clinics with ongoing training, support and clinical supervision.

PMID:35953774 | DOI:10.1186/s12888-022-04195-5

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Antibodies in the breastmilk of COVID-19 recovered women

BMC Pregnancy Childbirth. 2022 Aug 11;22(1):635. doi: 10.1186/s12884-022-04945-z.

ABSTRACT

OBJECTIVE: Human milk contains antibodies against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which may serve as a protective factor through passive immunization in infants. The objective of this study was to measure the levels of anti-SARS-CoV-2 IgG and IgA in human milk and serum after a SARS-CoV-2 infection.

DESIGN: Breast milk and serum samples from 72 lactating mothers with confirmed SARS-CoV-2 asymptomatic or symptomatic infection were collected 1-229 days after the onset of clinical symptoms related to COVID-19. Seventeen mothers with no history of COVID-19 served as a control group. Enzyme-Linked ImmunoSorbent Assay was performed to analyze antibodies against SARS-CoV-2.

RESULTS: SARS-CoV-2-IgA human milk antibodies were detected in mothers and their concentrations were consistently higher than SARS-CoV-2-IgG antibodies. The serum and breastmilk samples of women with COVID-19 was characterized by a higher concentration of anti-RBD IgA and IgG than the serum from the control group without COVID-19. No statistically significant difference was observed between the antibody levels in the serum samples obtained from symptomatic and asymptomatic women exposed to SARS-CoV-2 and between the antibody level and the time from a positive SARS-CoV-2 test result over the period studied.

CONCLUSION: Our results confirm the presence of SARS-CoV-2 IgA and IgG antibodies in the breastmilk of COVID-19 recovered women and the possibility of these antibodies in providing specific immunologic benefits to breastfeeding infants such as protection against the virus transmission and severity of the acquired COVID-19 disease.

PMID:35953773 | DOI:10.1186/s12884-022-04945-z

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GAWMerge expands GWAS sample size and diversity by combining array-based genotyping and whole-genome sequencing

Commun Biol. 2022 Aug 11;5(1):806. doi: 10.1038/s42003-022-03738-6.

ABSTRACT

Genome-wide association studies (GWAS) have made impactful discoveries for complex diseases, often by amassing very large sample sizes. Yet, GWAS of many diseases remain underpowered, especially for non-European ancestries. One cost-effective approach to increase sample size is to combine existing cohorts, which may have limited sample size or be case-only, with public controls, but this approach is limited by the need for a large overlap in variants across genotyping arrays and the scarcity of non-European controls. We developed and validated a protocol, Genotyping Array-WGS Merge (GAWMerge), for combining genotypes from arrays and whole-genome sequencing, ensuring complete variant overlap, and allowing for diverse samples like Trans-Omics for Precision Medicine to be used. Our protocol involves phasing, imputation, and filtering. We illustrated its ability to control technology driven artifacts and type-I error, as well as recover known disease-associated signals across technologies, independent datasets, and ancestries in smoking-related cohorts. GAWMerge enables genetic studies to leverage existing cohorts to validly increase sample size and enhance discovery for understudied traits and ancestries.

PMID:35953715 | DOI:10.1038/s42003-022-03738-6

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Associations of multiple chronic disease and depressive symptoms with incident stroke among Chinese middle-aged and elderly adults: a nationwide population-based cohort study

BMC Geriatr. 2022 Aug 12;22(1):660. doi: 10.1186/s12877-022-03329-4.

ABSTRACT

BACKGROUND: With the population aging, multiple chronic diseases, depressive symptoms, and stroke are increasingly common among middle-aged and elderly adults worldwide. This study aimed to explore the independent associations of multiple chronic diseases and depressive symptoms as well as their combination with incident stroke in a prospective cohort of Chinese middle-aged and elderly adults, and to sensitively estimate the association between each type of chronic disease and incident stroke.

METHODS: This study used data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 8389 participants meeting the inclusion criteria at baseline (between 2011 and 2012) survey were included, and 7108 eligible participants completed the follow-up survey over 8 years (Wave 4, in 2018). Questionnaire information, physical examination, and clinical and biochemical measurements were collected.

RESULTS: The mean (SD) age at baseline was 58.5 (± 9.1) years. Multiple chronic disease and depressive symptoms were independently associated with incident stroke. After adjusting for control variables, patients having 1 type of chronic disease and depressive symptoms were at 1.943 (95% CI = 1.166-3.238) times higher risk of incident stroke than those without chronic disease and depressive symptoms, and patients having at least 2 types of chronic diseases and depressive symptoms were at 3.000 (95% CI = 1.846-4.877) times higher risk of incident stroke; the magnitudes of the associations increased by the numbers of having chronic diseases and depressive symptoms. Sensitivity analyses incorporating all five types of chronic disease (i.e., hypertension, dyslipidemia, heart disease, diabetes, and chronic kidney disease) showed that the magnitude of the associations between hypertension and incident stroke was most significant.

CONCLUSIONS: We identified significant independent and combined longitudinal associations of multiple chronic diseases and depressive symptoms with incident stroke, and the combined associations reflected a dose-response relationship. The association between hypertension and incident stroke was strongest among the five chronic diseases.

PMID:35953770 | DOI:10.1186/s12877-022-03329-4

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Pseudoprogression and peritumoral edema due to intratumoral necrosis after Gamma knife radiosurgery for meningioma

Sci Rep. 2022 Aug 11;12(1):13663. doi: 10.1038/s41598-022-17813-9.

ABSTRACT

Peritumoral cerebral edema is reported to be a side effect that can occur after stereotactic radiosurgery. We aimed to determine whether intratumoral necrosis (ITN) is a risk factor for peritumoral edema (PTE) when gamma knife radiosurgery (GKRS) is performed in patients with meningioma. In addition, we propose the concept of pseudoprogression: a temporary volume expansion that can occur after GKRS in the natural course of meningioma with ITN. This retrospective study included 127 patients who underwent GKRS for convexity meningioma between January 2019 and December 2020. Risk factors for PTE and ITN were investigated using logistic regression analysis. Analysis of variance was used to determine whether changes in tumor volume were statistically significant. After GKRS, ITN was observed in 34 (26.8%) patients, and PTE was observed in 10 (7.9%) patients. When postoperative ITN occurred after GKRS, the incidence of postoperative PTE was 18.970-fold (p = 0.009) greater. When a 70% dose volume ≥ 1 cc was used, the possibility of ITN was 5.892-fold (p < 0.001) higher. On average, meningiomas with ITN increased in volume by 128.5% at 6 months after GKRS and then decreased to 94.6% at 12 months. When performing GKRS in meningioma, a 70% dose volume ≥ 1 cc is a risk factor for ITN. At 6 months after GKRS, meningiomas with ITN may experience a transient volume expansion and PTE, which are characteristics of pseudoprogression. These characteristics typically improve at 12 months following GKRS.

PMID:35953695 | DOI:10.1038/s41598-022-17813-9

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What are the factors associated with the duration of remission of intra-articular corticosteroid injection in juvenile idiopathic arthritis?

Clin Rheumatol. 2022 Aug 11. doi: 10.1007/s10067-022-06327-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Intra-articular corticosteroid injection (IACI) is generally used in the management of juvenile idiopathic arthritis (JIA) to obtain rapid relief of active synovitis and functional recovery and to prevent the need for regular systemic therapy. The aim of this study was to investigate the outcome of IACI treatment and the factors associated with remission of synovitis.

METHODS: The clinical records of JIA patients who received IACI between January 2014 and December 2020 in two pediatric rheumatology centers were reviewed. The procedure was evaluated in terms of efficacy, factors that may affect the duration of remission, procedural and drug-related complications.

RESULTS: During the study period, 134 patients received 227 injections and 37 joints were injected more than once. One hundred and six (79%) patients had persistent oligoarticular disease. At the time of injection, all patients were receiving non-steroidal anti-inflammatory drugs, 74 patients were on methotrexate, and 14 patients were on biologics. The median duration of remission without exacerbation of synovitis treated with IACI was 15 (range 1-64) months. The inactivity rate was 81% at the 6th month after the injection. It has been shown that being less than 7 years old at disease onset and low initial CRP levels were correlated with a long remission period (p < 0.05). Despite the differences were not statistically significant, the duration of remission was longer in boys, in ANA positives, in HLA-B27 negatives, in patients with concurrent methotrexate treatment and in patients not receiving biologic therapy (p > 0.05). Only two patients (1.5%, 95% CI – 0.6 to 3.5) developed cutaneous hypopigmentation and subcutaneous atrophy as side effects of injection.

CONCLUSION: Intra-articular corticosteroid injection was more effective especially in patients with low initial CRP levels and younger than 7 years of age. The duration of remission was longer in these patients. Key Points • Intra-articular corticosteroid injection is an effective method for controlling joint inflammation and achieving long-term remission without significant side effects. • Intra-articular corticosteroid injection can be preferred in all forms of juvenile idiopathic arthritis as primary therapy or to relieve the patient while waiting for the effect of systemic agents or to avoid increasing the dose of systemic drugs. • It can be recommended as a treatment option at any stage of the disease, especially in young patients and patients with low initial CRP values.

PMID:35953685 | DOI:10.1007/s10067-022-06327-4

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Ecological effects of selective oral decontamination on multidrug-resistance bacteria acquired in the intensive care unit: a case-control study over 5 years

Intensive Care Med. 2022 Aug 11. doi: 10.1007/s00134-022-06826-7. Online ahead of print.

ABSTRACT

PURPOSE: This case-control study investigated the long-term evolution of multidrug-resistant bacteria (MDRB) over a 5-year period associated with the use of selective oropharyngeal decontamination (SOD) in the intensive care unit (ICU). In addition, effects on health care-associated infections and ICU mortality were analysed.

METHODS: We investigated patients undergoing mechanical ventilation > 48 h in 11 adult ICUs located at 3 campuses of a university hospital. Administrative, clinical, and microbiological data which were routinely recorded electronically served as the basis. We analysed differences in the rates and incidence densities (ID, cases per 1000 patient-days) of MDRB associated with SOD use in all patients and stratified by patient origin (outpatient or inpatient). After propensity score matching, health-care infections and ICU mortality were compared.

RESULTS: 5034 patients were eligible for the study. 1694 patients were not given SOD. There were no differences in the incidence density of MDRB when SOD was used, except for more vancomycin-resistant Enterococcus faecium (0.72/1000 days vs. 0.31/1000 days, p < 0.01), and fewer ESBL-producing Klebsiella pneumoniae (0.22/1000 days vs. 0.56/1000 days, p < 0.01). After propensity score matching, SOD was associated with lower incidence rates of ventilator-associated pneumonia and death in the ICU but not with ICU-acquired bacteremia or urinary tract infection.

CONCLUSIONS: Comparisons of the ICU-acquired MDRB over a 5-year period revealed no differences in incidence density, except for lower rate of ESBL-producing Klebsiella pneumoniae and higher rate of vancomycin-resistant Enterococcus faecium with SOD. Incidence rates of ventilator-associated pneumonia and death in the ICU were lower in patients receiving SOD.

PMID:35953676 | DOI:10.1007/s00134-022-06826-7