Tag: pubmed

BMC Public Health. 2022 Jul 19;22(1):1385. doi: 10.1186/s12889-022-13724-6.

ABSTRACT

BACKGROUND: The development of liver cirrhosis is usually an asymptomatic process until late stages when complications occur. The potential reversibility of the disease is dependent on early diagnosis of liver fibrosis and timely targeted treatment. Recently, the use of non-invasive tools has been suggested for screening of liver fibrosis, especially in subjects with risk factors for chronic liver disease. Nevertheless, large population-based studies with cost-effectiveness analyses are still lacking to support the widespread use of such tools. The aim of this study is to investigate whether non-invasive liver stiffness measurement in the general population is useful to identify subjects with asymptomatic, advanced chronic liver disease.

METHODS: This study aims to include 30,000 subjects from eight European countries. Subjects from the general population aged ≥ 40 years without known liver disease will be invited to participate in the study either through phone calls/letters or through their primary care center. In the first study visit, subjects will undergo bloodwork as well as hepatic fat quantification and liver stiffness measurement (LSM) by vibration-controlled transient elastography. If LSM is ≥ 8 kPa and/or if ALT levels are ≥1.5 x upper limit of normal, subjects will be referred to hospital for further evaluation and consideration of liver biopsy. The primary outcome is the percentage of subjects with LSM ≥ 8kPa. In addition, a health economic evaluation will be performed to assess the cost-effectiveness and budget impact of such an intervention. The project is funded by the European Commission H2020 program.

DISCUSSION: This study comes at an especially important time, as the burden of chronic liver diseases is expected to increase in the coming years. There is consequently an urgent need to change our current approach, from diagnosing the disease late when the impact of interventions may be limited to diagnosing the disease earlier, when the patient is asymptomatic and free of complications, and the disease potentially reversible. Ultimately, the LiverScreen study will serve as a basis from which diagnostic pathways can be developed and adapted to the specific socio-economic and healthcare conditions in each country.

TRIAL REGISTRATION: This study is registered on Clinicaltrials.gov ( NCT03789825 ).

PMID:35854275 | DOI:10.1186/s12889-022-13724-6

BMC Cancer. 2022 Jul 19;22(1):796. doi: 10.1186/s12885-022-09902-9.

ABSTRACT

BACKGROUND: Multiple myeloma (MM) is an incurable plasma cell malignancy. Red cell distribution width (RDW) is a prognostic marker in various diseases, solid tumors, and hematologic neoplasms, but its prognostic significance in MM is controversial. In this study, we aimed to assess the relationship between RDW and the clinical prognosis of MM patients through a meta-analysis.

METHODS: Relevant literature were retrieved from PubMed, Embase, and Web of Science databases according to PRISMA guideline. All relevant parameters were extracted and combined for statistical analysis. The effect size was presented as hazard ratio (HR)/odds ratio (OR) and 95% confidence interval (CI). HR/OR > 1 in MM patients with high RDW suggested a worse prognosis. Heterogeneity test evaluation was performed using Cochran’s Q test and I2 statistics. A P_{heterogeneity} < 0.10 or I² > 50% suggested significant heterogeneity. P < 0.05 was considered statistically significant. Statistical analysis was performed using Stata 12.0 software.

RESULTS: 8 articles involving 9 studies with 1165 patients were included in our meta-analysis. Our results suggested that elevated RDW is significantly associated with poor prognosis in MM (OS: HR = 1.91, 95%CI: 1.48-2.46; PFS: HR = 2.87, 95% CI: 2.02-4.07). A significant correlation was not found between RDW and International Staging System (ISS) staging (ISS III VS ISS I-II: OR:1.53; 95%CI:0.97-2.42).

CONCLUSION: Our results suggested that RDW is a robust predictor of newly diagnosed MM outcomes.

PMID:35854269 | DOI:10.1186/s12885-022-09902-9

BMC Health Serv Res. 2022 Jul 20;22(1):934. doi: 10.1186/s12913-022-08311-9.

ABSTRACT

BACKGROUND: Hospital and pre-hospital emergency nurses are at the forefront of disaster response. Disaster incidents continue to pose a threat to healthcare systems by exposing them to an overwhelming surge of patients.

METHODS: This descriptive cross-sectional study was performed on 472 hospital and pre-hospital emergency nurses in Ardabil province, in the northwest Iran, from March to April 2021, were recruited by convenience sampling method. Data were collected using valid and reliable self-reported questionnaires, including the Emergency Preparedness Information questionnaire (EPIQ) and Triage Decision-making Inventory (TDMI). Data were analyzed using SPSS (Version 22) software using descriptive statistics, Pearson correlation coefficient test, t-test, ANOVA test, and multiple linear regression analysis.

RESULTS: Emergency nurses’ disaster preparedness knowledge was low according to the mean score of total disaster preparedness knowledge. Furthermore, multiple linear regression analysis showed triage decision-making, age, residence, disaster preparedness training, working on duty during a disaster, and training organization variables were predictors of disaster preparedness knowledge in hospital and pre-hospital emergency nurses (p < 0.05).

CONCLUSION: Emergency nurses who have higher disaster preparedness knowledge have higher triage decision-making skills. It is suggested that the managers of educational and medical centres and professional organizations provide favourable conditions for training and increasing disaster preparedness of emergency nurses according to their age and residence.

PMID:35854268 | DOI:10.1186/s12913-022-08311-9

Ital J Pediatr. 2022 Jul 19;48(1):120. doi: 10.1186/s13052-022-01279-6.

ABSTRACT

BACKGROUND: The bacterial load of the human lower respiratory tract is at least several times lower than that of the other parts of the body. This study aimed to identify the bacterial composition and colony structure of the lower respiratory tract in infants and children with recurrent wheezing compared with those of children with a bronchial foreign body and clarify whether the length of wheezing in infants can contribute to differences in the lower respiratory tract’s bacterial colony structure.

METHODS: We collected specimens of alveolar lavage fluid from 48 infants and children who underwent fiberoptic bronchoscopy and were divided into groups: A1 (multiple wheezing: wheezing more than three times in < 1 month), A2 (persistent wheezing: > 1 month), and B (bronchial foreign body; control group). We analyzed the bacterial community structure of alveolar lavage fluid using high-throughput sequencing. The richness and diversity of the microbial communities were assessed by α and β diversity analyses.

RESULTS: A total of 6,644 operational taxonomic units (OTUs) were obtained based on the Illumina Nova sequencing platform and clustered according to those that met the 97% identity threshold, followed by species annotation of the OTU sequences. In the annotation results, 2,608 (39.25%) OTUs were annotated at the genus level. At the genus level, Sphingomonas and Phyllobacterium were significantly higher in group A1 than in group B. There were significantly more Phyllobacterium in group A2 than in group B. Prevotella, Neisseria, and Haemophilus were higher in group B than in groups A1 and A2. The differences in the between-group α and β diversity analyses were statistically significant. The microbial diversity in groups A1 and A2 was significantly less than that in group B, but there was no statistical difference in bacterial community diversity between groups A1 and A2.

CONCLUSION: Recurrent wheezing in infants and children is more likely due to alterations in the overall bacterial microecology and disruption of host respiration and immune homeostasis than the effects of a single bacterium.

PMID:35854266 | DOI:10.1186/s13052-022-01279-6

BMC Psychiatry. 2022 Jul 19;22(1):480. doi: 10.1186/s12888-022-04124-6.

ABSTRACT

BACKGROUNDS: The study of the relationship between adult Attention deficit hyperactivity disorder (ADHD) and bipolar disorder has received more attention in recent years and there is limited information in this area. On the other hand, there is a significant comorbidity between ADHD and bipolar disorder with substance use disorder. In this study, we investigated the prevalence of comorbidity of adult ADHD and substance use disorder among a group of bipolar patients admitted to a psychiatric hospital.

METHODS: One hundred fifty patients from a total of 200 consecutive patients who were referred to the emergency department of Roozbeh Psychiatric Hospital in Tehran, diagnosed with bipolar disorder based on the initial psychiatric interview and needed hospitalization, were evaluated again by an experienced faculty member psychiatrist by using a subsequent interview based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition(DSM-5). They were evaluated using the Structured Clinical Interview for DSM-5 (SCID-5) questionnaire to confirm the diagnosis of bipolar disorder and the comorbidity of adult ADHD and substance use disorder.

RESULTS: From 150 patients diagnosed with bipolar disorder, 106 patients (70.7%) had adult ADHD. 89 patients (59.3%) had substance use disorder and 58 patients (38.7%) had both of these comorbidities with bipolar disorder. Comorbidity of adult ADHD was associated with the earlier onset of the first mood episode in bipolar disorder (p value = 0.025). There was no statistically significant relationship between substance use disorder and age of onset of the first episode. (P value = 0.57).

CONCLUSIONS: Due to the limitations of studies on adult ADHD comorbidity with bipolar disorder, especially in hospital settings, as well as the increased risk of association with substance use disorder, further multicenter studies in this area with larger sample sizes can increase awareness in this regard.

PMID:35854247 | DOI:10.1186/s12888-022-04124-6

BMC Cancer. 2022 Jul 19;22(1):798. doi: 10.1186/s12885-022-09904-7.

ABSTRACT

BACKGROUND: Gastric cancer (GC) is one of the most fatal cancers worldwide and is generally only detected after it has progressed to an advanced stage. Since there is a lack of comprehensive data on RHOA protein expression of patients with GC, this study utilized a systematic review and meta-analysis to address the limitation. The objective of this meta-analysis was to link GC clinical features with RHOA protein high- vs. low-expressing patients with GC.

METHODS: The PubMed and Web of Science were used for a systematic literature review of GC related to RHOA. The included studies were obtained from two literature databases from past to Aug 31, 2021, by searching keywords. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The odds ratios (ORs) and 95% confidential intervals (CIs) for clinical features were estimated according to the high and low protein expression levels of RhoA. The mean effect sizes of ORs were obtained using the random-effects and fixed-effects models of meta-analysis. Heterogeneity of the studies was assesed by using statistics: τ², I²; and Q values. The symmetry of funnel plots were inspected for publication bias.

RESULTS: Finally, 10 studies including 1,389 patients with GC (735 RHOA-positive and 654 RHOA-negative) were eligible for our meta-analysis to estimate associations between the protein expression and clinical features (e.g., Union for International Cancer Control [UICC] stage progression, differentiation, Lauren histological classification, and vascular invasion). In our meta-analysis, RHOA positive expression was determined to have a statistically significant association with UICC stage progression (P = 0.02) and poorly differentiated status (P = 0.02). The association between RHOA positivity and Lauren subtypes was not statistically significant (P = 0.07).

CONCLUSIONS: This meta-analysis suggested that RhoA protein expression in patients with GC was associated with clinical features: UICC stage progression and poorly differentiated status. Our findings are inconclusive but indicate that high RHOA protein expressing patients with GC could predict advanced UICC stages. A large prospective cohort study is required for validation in future.

PMID:35854253 | DOI:10.1186/s12885-022-09904-7

BMC Neurol. 2022 Jul 19;22(1):269. doi: 10.1186/s12883-022-02763-6.

ABSTRACT

BACKGROUND: Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a common, long-term condition characterised by post-exertional malaise, often with fatigue that is not significantly relieved by rest. ME/CFS has no confirmed diagnostic test or effective treatment and we lack knowledge of its causes. Identification of genes and cellular processes whose disruption adds to ME/CFS risk is a necessary first step towards development of effective therapy.

METHODS: Here we describe DecodeME, an ongoing study co-produced by people with lived experience of ME/CFS and scientists. Together we designed the study and obtained funding and are now recruiting up to 25,000 people in the UK with a clinical diagnosis of ME/CFS. Those eligible for the study are at least 16 years old, pass international study criteria, and lack any alternative diagnoses that can result in chronic fatigue. These will include 5,000 people whose ME/CFS diagnosis was a consequence of SARS-CoV-2 infection. Questionnaires are completed online or on paper. Participants’ saliva DNA samples are acquired by post, which improves participation by more severely-affected individuals. Digital marketing and social media approaches resulted in 29,000 people with ME/CFS in the UK pre-registering their interest in participating. We will perform a genome-wide association study, comparing participants’ genotypes with those from UK Biobank as controls. This should generate hypotheses regarding the genes, mechanisms and cell types contributing to ME/CFS disease aetiology.

DISCUSSION: The DecodeME study has been reviewed and given a favourable opinion by the North West – Liverpool Central Research Ethics Committee (21/NW/0169). Relevant documents will be available online ( www.decodeme.org.uk ). Genetic data will be disseminated as associated variants and genomic intervals, and as summary statistics. Results will be reported on the DecodeME website and via open access publications.

PMID:35854226 | DOI:10.1186/s12883-022-02763-6

Appl Neuropsychol Child. 2022 Jul 19:1-10. doi: 10.1080/21622965.2022.2099742. Online ahead of print.

ABSTRACT

Concussion is a heterogeneous injury involving symptoms and impairment that represent multiple domains (e.g., anxiety, cognitive, vestibular). Network analysis, a modeling technique that estimates relationships among symptoms, provides a statistically sound and clinically practical method for evaluating these interrelationships. The purpose of this study was to examine, using network analysis, relationships among clinical assessments and multidomain symptom report within a sample of adolescent patients following a concussion. Participants included 326 patients (49.7% female) aged 10-21 years presenting to a concussion specialty clinic within 28 days of a diagnosed concussion. Participants completed the Post-Concussion Symptom Scale (PCSS) and Vestibular-Ocular Motor Screening (VOMS) tool at initial visit. Network models were applied to PCSS symptoms initially, and then applied to VOMS and PCSS symptom data together. Dizziness (Expected influence (EI) = 1.10) and sadness (EI = 1.91) were most central (i.e., highest cumulative partial correlations) to the symptom network. Numerous interdomain relationships were supported, including irritability with mental fogginess (edgeweight = 0.12), dizziness with headache (edgeweight = 0.16), and dizziness with vision problems (edgeweight = 0.13). Community analyses resulted in VOMS groupings by domain (e.g., vestibular) and symptom (e.g., dizziness). The findings suggest a more direct focus on symptom interrelationships, such as how dizziness contributes to emotional symptoms, may help guide and better target treatments. Also, results suggest grouping VOMS assessment by symptom (e.g., dizziness) and item (e.g., vestibular-ocular reflex) may better reflect underlying impairments reflected by these symptom-item combinations.

PMID:35853233 | DOI:10.1080/21622965.2022.2099742

J Cardiovasc Pharmacol. 2022 Jun 6. doi: 10.1097/FJC.0000000000001313. Online ahead of print.

ABSTRACT

We sought to examine incidence and predictors of eosinophilic myocardial hypersensitivity (EMH) in a cohort of patients in the home inotrope program of a quaternary cardiac transplant centre. Patients on home inotropes with progression to heart transplantation or ventricular assist device between January 2000 to May 2020 were included. EMH was diagnosed by the presence of an interstitial predominate eosinophilic infiltrate within the myocardium by experienced cardiac pathologists. From a cohort of 74 patients, 58% (43) were on dobutamine and 42% (31) were on milrinone. Dobutamine was associated with EMH incidence of 14% (6/43), with zero cases in the milrinone cohort. Mean age was 52±12 years, 22% female. Majority (62%) were non-ischaemic dilated cardiomyopathies, the remainder were ischaemic cardiomyopathy. Dobutamine dose (250 [200-282] vs. 225 [200-291] mcg/min) and duration of therapy (41 [23-79] vs. 53 [24-91] days) was similar between those with and without EMH. Median change in eosinophil count was 0.31×109/L in the EMH group compared to only 0.03×109/L in the non-EMH cohort, p=0.02. Increase in peripheral eosinophil count of >0.20×109/L demonstrated good discrimination between those with and without EMH, c-statistic 0.83 (95% CI 0.66-1.0). Heart failure hospitalisation occurred in 83% of the EMH group versus 59% in the non-EMH group, p=0.26. Requirement for VAD was significantly higher in the EMH group (83% vs. 41%, p=0.05). In conclusion, EMH occurred in 14% of patients receiving home dobutamine. Rising eosinophil count should prompt physicians to consider EMH and switch to milrinone to avoid possible escalation to VAD.

PMID:35853194 | DOI:10.1097/FJC.0000000000001313

Spine (Phila Pa 1976). 2022 Jul 14. doi: 10.1097/BRS.0000000000004369. Online ahead of print.

ABSTRACT

STUDY DESIGN: Laboratory study.

OBJECTIVE: This study aimed to investigate the biomechanical competence and fracture characteristics of the odontoid process.

SUMMARY OF BACKGROUND DATA: Odontoid fractures of the second cervical vertebra (C2) is the most common fracture type in cervical- and spine in general in the elderly. However, very little is known about the underlying biomechanical fracture mechanisms.

METHODS: A total of 42 human C2 specimens were Scanned using a QCT, divided in 6 groups, and subjected to combined quasi-static loading at -15°, 0°, and 15° in sagittal plane and -50° and 0° in transverse plane until fracture. Bone mineral density (BMD), height, state of the fusion of the ossification centers, stiffness, yield load, and ultimate load were assessed.

RESULTS: While the lowest values for stiffness, yield, and ultimate load were observed at load inclination of 15° in the sagittal plane, no statistically significant differences could be observed between the six groups (P=0.235, P=0.646, and P=0.505, respectively). BMD was positively correlate with the yield (r²=0.350, P<0.001), and ultimate load (r²=0.955, P<0.001), but not with the stiffness (r²=0.082, P=0.07). The analysis of the mechanical quantitates for specimens with clearly distinguishable fusion of the ossification centers (26 specimens) reveled less differences between the mean values.

CONCLUSION: Load direction plays a subordinate role in traumatic fractures of the odontoid process. BMD was associated with significant correlation to the biomechanical outcomes. Thus, odontoid fractures appear to be the results of an interaction between the load magnitude and bone quality.

PMID:35853162 | DOI:10.1097/BRS.0000000000004369