Tag: pubmed

Int J Neurosci. 2022 May 14:1-12. doi: 10.1080/00207454.2022.2078207. Online ahead of print.

ABSTRACT

BACKGROUND: Neurocysticercosis is a leading cause of acquired epilepsy. Calcified granulomas are known to cause seizure recurrence. Researchers have reported that vitamin D deficiency is associated with brain calcification and reduction in calcification occurs with vitamin D receptor agonist calcitriol through upregulation of SLC20A2. Based on these observations, a hypothesis was proposed that the occurrence of calcification could be reduced by optimizing vitamin D levels, resulting in early resolution of neurocysticercosis.

METHODOLOGY: A case-control (retrospective and prospective) study on 60 children with solitary intraparenchymal neurocysticercosis, 20 new cases prior to starting cysticidal therapy and other 40 resolved cases was carried out. Among new cases, children deficient in vitamin D were given megadose of vitamin D and vitamin D levels were rechecked after 30 days. Children having normal vitamin D were taken as cases and the deficient ones were taken as controls. Standard treatment for neurocysticercosis was given. Three monthly MRI scans were done. Outcome was evaluated as resolution/persistence of neurocysticercosis at 3, 6, 9 and 12 months. Statistics & Results: Pearson chisquare/Fisher’s exact test was used along with Kaplan Meier and log rank test. Of 60 patients, at 6 months 3 cases and 4 controls (p value 0.43), at 9 months 2 cases and 6 controls (p value 0.037) and at 12 months 3 cases and 6 controls (p value 0.029) had complete resolution of NCC.

CONCLUSION: The results do not show that adequate vitamin D levels result in early resolution of neurocysticercosis.

PMID:35574655 | DOI:10.1080/00207454.2022.2078207

J Gastrointestin Liver Dis. 2022 May 15. doi: 10.15403/jgld-4219. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Several computed tomographic (CT) imaging features have been proposed to describe the infection of postoperative abdominal fluid collections; however, these features are vague, and there is a significant overlap between infected and non-infected collections. We assessed the role of textural parameters as additional diagnostic tools for distinguishing between infected and non-infected peritoneal collections in patients operated for gastric cancer.

METHODS: From 527 patients operated for gastric cancer, we retrospectively selected 82 cases with intraperitoneal collections who underwent CT exams. The fluid component was analyzed through a novel method (texture analysis); different patterns of pixel intensity and distribution were extracted and processed through a dedicated software (MaZda). A univariate analysis comparing the parameters of texture analysis between the two groups was performed. Afterwards, a multivariate analysis was performed for the univariate statistically significant parameters.

RESULTS: The study included 82 patients with bacteriologically verified infected (n=40) and noninfected (n=42) intraperitoneal effusions. The univariate analysis evidenced statistically significant differences between all the parameters involved. The multivariate analysis highlighted 10 parameters as being statistically significant, adjusted to Bonferroni correction.

CONCLUSIONS: Our evidence supports the fact that textural analysis can be used as a complementary diagnostic tool for the detection of infected fluid collections after gastric cancer surgery. Further studies are required to validate the accuracy of this method.

PMID:35574623 | DOI:10.15403/jgld-4219

Blood Press. 2022 Dec;31(1):100-108. doi: 10.1080/08037051.2022.2071674.

ABSTRACT

PURPOSE: Out-of-office blood pressure (BP) measurements are essential for the diagnosis and monitoring of hypertension. Current guidelines vary in their recommendations on the protocol for home blood pressure monitoring (HBPM). We aimed to assess the number of blood pressure (BP) measurement days needed for a reliable estimation of true home BP (the expected BP level over time) and hypertension status, using the European guideline-based 7-day HBPM protocol as a reference.

MATERIALS AND METHODS: Data from 567 adults who performed a 7-day HBPM were analysed. Blood pressure was measured twice daily (morning and evening readings) using the Microlife Average Mode (MAM), which takes a weighted average of 3 consecutive BP readings. The variability of average BP for an increasing number of measurements was assessed using a linear mixed model including a random intercept per individual and correlated residuals. The reliability of home hypertension status was assessed by the κ statistic.

RESULTS: Mean home BP of the population was 143 ± 16/84 ± 10 mm Hg. On average, the first BP measurements gave the highest values which then decreased over time. Systolic BP in the morning was systematically lower than systolic BP in the evening (142 ± 17mm Hg versus 144 ± 17 mm Hg, p <0.05). The average of 7 twice-daily MAM BP measurements was at most 5.2/3.3 mm Hg higher and 9.5/4.8 mm Hg lower than the true home BP for 95% of the individuals. Reducing this protocol to 3 days increased this variability by 1.5/1.0 mm Hg and 4.8/2.3 mm Hg, respectively. For diagnosing home hypertension, there was good agreement with a minimum of 4.5 days of HBPM (ĸ-statistic 0.88; 95% Confidence Interval: 0.82-0.94).

CONCLUSION: Twice-daily MAM BP measurements for 3 consecutive days provide a reliable estimate of home BP. At least 4.5 consecutive days of HBPM are required for a reliable diagnosis of home hypertension.

PMID:35574599 | DOI:10.1080/08037051.2022.2071674

CPT Pharmacometrics Syst Pharmacol. 2022 May 15. doi: 10.1002/psp4.12812. Online ahead of print.

ABSTRACT

Stan is an open-source probabilistic programing language, primarily designed to do Bayesian data analysis. Its main inference algorithm is an adaptive Hamiltonian Monte Carlo sampler, supported by state of the art gradient computation. Stan’s strengths include efficient computation, an expressive language which offers a great deal of flexibility, and numerous diagnostics that allow modelers to check whether the inference is reliable. Torsten extends Stan with a suite of functions that facilitate the specification of pharmacokinetic and pharmacodynamic models, and makes it straightforward to specify a clinical event schedule. Part I of this tutorial demonstrates how to build, fit, and criticize standard pharmacokinetic and pharmacodynamic models using Stan and Torsten.

PMID:35570331 | DOI:10.1002/psp4.12812

Clin Exp Dent Res. 2022 May 15. doi: 10.1002/cre2.592. Online ahead of print.

ABSTRACT

OBJECTIVES: Evidence on the biocompatibility of three-dimensional (3D)-printed and milled resins for oral splints is limited. This in vitro study assessed the influence of the manufacturing method on the cytotoxicity of oral splint resins on L929 cells and human gingival fibroblasts (GF1).

MATERIALS AND METHODS: Standardized specimens of four 3D-printed, two-milled, one-thermoformed, and one-pressed splint resin were incubated with L929 and GF1 cells for 24 h. Immunofluorescence and WST-8 assay were performed to evaluate cytotoxic effects. One-way analysis of variance and Tukey’s multiple comparison test were applied with the variables “splint resin” and “manufacturing method” (p < .05).

RESULTS: Immunofluorescence showed attachment of L929 and GF1 cells to the splint resins. Irrespective of the manufacturing method, the WST-8 assay revealed significant differences between splint resins for the viability of L929 and GF1 cells. L929 cells generally showed lower viability rates than GF1 cells. The evaluation of cell viability by the manufacturing method showed no significant differences between 3D printing, milling, and conventional methods.

CONCLUSIONS: The cytotoxic effects of 3D-printed, milled, and conventional oral splint resins were similar, indicating minor influence of the manufacturing method on biocompatibility. Cytotoxicity of the resins was below a critical threshold in GF1 cells. The chemical composition might be more crucial than the manufacturing method for the biocompatibility of splint resins.

PMID:35570327 | DOI:10.1002/cre2.592

BMC Res Notes. 2022 May 15;15(1):178. doi: 10.1186/s13104-022-06067-3.

ABSTRACT

OBJECTIVE: The relationship of sagittal spinal shape in the pathogenesis of adolescent idiopathic scoliosis (AIS) is recognised. What is not clear is the relationship between the sagittal shape of those without scoliosis and the potential development of AIS, including the greater prevalence in females. The use of a new parameter, the kyphosis-lordosis (KL) difference, was developed to explore this further.

RESULTS: The KL difference was calculated for 117 males and 79 females over seven years with 831 measures made. For females, the KL difference, between the ages of 9 and 12 ½ years, decreases from 5° to nearly 0° until starting to climb again from the age of 14 years, back to 5° by the age of 16 ½ years. For males, there is a gradual decline from 9° at age 9 years to 5° at age 17 years. Both age and sex were statistically significant in the development of the parameter. When comparing to previously published data around the true, de-rotated, sagittal shape of the scoliotic spine, the KL difference has utility in explaining the female predominance in the prevalence of AIS. This adds to the weight of evidence behind understanding why AIS develops.

PMID:35570316 | DOI:10.1186/s13104-022-06067-3

Arch Physiother. 2022 May 16;12(1):14. doi: 10.1186/s40945-022-00137-2.

ABSTRACT

BACKGROUND: Establishing the biopsychosocial profile of patients with low back pain (LBP) is essential to personalized care. The Pain and Disability Drivers Management model (PDDM) has been suggested as a useful framework to help clinicians establish this biopsychosocial profile. Yet, there is no tool to facilitate its integration into clinical practice. Thus, the aim of this study is to develop a rating scale and validate its content, to rapidly establish the patient’s biopsychosocial profile, based on the five domains of the PDDM.

METHODS: The tool was developed in accordance with the principles of the COSMIN methodology. We conducted three steps: 1) item generation from a comprehensive review, 2) refinement of the scale with clinicians’ feedback, and 3) statistical analyses to assess content validity. To validate the item assessing with Likert scales, we performed Item level-Content Validity Index (I-CVI) analyses on three criteria (clarity, presentation and clinical applicability) with an a priori threshold of > 0.78. We conducted Average-Content Validity Index (Ave-CVI) analyses to validate the overall scale with a threshold of > 0.9.

RESULTS: In accordance with the PDDM, we developed a 5-item rating scale (1 per domain) with 4 score options. We selected clinical instruments to screen for the presence or absence of problematic issues within each category of the 5 domains. Forty-two participants provided feedback to refine the scale’s clarity, presentation, and clinical applicability. The statistical analysis of the latest version presented I-CVI above the threshold for each item (I-CVI ranged between 0.94 and 1). Analysis of the overall scale supported its validation (Ave-CVI = 0.96 [0.93;0.98]).

CONCLUSION: From the 51 biopsychosocial elements contained within the 5 domains of the PDDM, we developed a rating scale that allows to rapidly screen for problematic issues within each category of the PDDM’s 5 domains. Involving clinicians in the process allowed us to validate the content of the first scale to establish the patient’s biopsychosocial profile for people with low back pain. Future steps will be necessary to continue the psychometric properties analysis of this rating scale.

PMID:35570310 | DOI:10.1186/s40945-022-00137-2

BMC Public Health. 2022 May 15;22(1):979. doi: 10.1186/s12889-022-13392-6.

ABSTRACT

BACKGROUND: In India, there is currently a lack of data on socioeconomic inequalities in HIV testing on a national scale; thus, understanding socioeconomic inequalities in response to expanded HIV testing is critical for assessing and ensuring equity of HIV programmes in accordance with the Sustainable Development Goals. The specific objective of the study was to determine the factor associated with HIV testing during antenatal care and assess the socio-economic inequalities in HIV testing during antenatal care (ANC) among Indian women aged 15-49 years with a live birth in the two years preceding the survey.

METHODS: The results drawn from the state module of women data file of fourth round of National Family Health Survey (NFHS-4, 2015-16), considering HIV testing during antenatal care among women aged 15-49 who gave live birth in the two years preceding the survey and received the result of HIV test as a matter of fact. Method, such as, descriptive statistics, binary ogistic regression, concentration index were used in the analysis.

RESULTS: The findings of the study show that HIV testing during antenatal care was low (30%) among women in India. Our findings reveal that there were significant inequalities exist in HIV testing during ANC between richer and poorer quintile of women. Education, place of residence, comprehensive knowledge of HIV/AIDS, and regular exposure of mass media were substantially contributing to socioeconomic inequality in HIV testing during ANC among women in India.

CONCLUSIONS: The socioeconomic inequities in HIV testing during pregnancy should be monitored and addressed in order to ensure an equitable distribution of the benefits specially among children and accomplishments of HIV programs in India.

PMID:35570285 | DOI:10.1186/s12889-022-13392-6

J Egypt Natl Canc Inst. 2022 May 16;34(1):21. doi: 10.1186/s43046-022-00123-6.

ABSTRACT

BACKGROUND: Multiple myeloma (MM) predominantly affects older patients; many of whom do not undergo autologous hematopoietic stem cell transplant (AHSCT) despite the associated survival benefits. This study was conceived to investigate the patterns of AHSCT among MM patients with due regard to their age and standardized fitness assessments.

METHODS: Fitness scores as per the hematopoietic stem cell transplant-comorbidity index (HSCT-CI) and risk scores as per the revised-myeloma comorbidity index (R-MCI) of MM patients treated between January 2017 and December 2019 were analyzed to assess fitness for AHSCT. Proportions of patients who underwent AHSCT were calculated with regard to age and fitness for AHSCT.

RESULTS: Of the 81 eligible patient records with a median age of 62 years, the HSCT-CI classified 79.6% and 77.8% of patients aged ≤65 years and >65 years as AHSCT eligible (p 1). Using the R-MCI, 96.3% and 81.5% of patients aged ≤65 years and >65 years, respectively, were classified as eligible for AHSCT (p 0.0381). Overall, patients aged ≤65 years underwent AHSCT with a greater frequency compared to those aged >65years (38.9 vs. 14.8%, p 0.0402). Irrespective of the age group, there was a statistically significant difference (p 0.0167) in terms of survival which favored those who underwent AHSCT.

CONCLUSIONS: Both the HSCT-CI and the R-MCI revealed that nearly 80% of patients aged >65 years were fit enough to receive AHSCT. However, far fewer patients of this age group underwent AHSCT. We propose that the routine inclusion of objective fitness assessment could ensure that fit older patients undergo AHSCT and thus do not miss out on the benefits of the same.

PMID:35570260 | DOI:10.1186/s43046-022-00123-6

BMC Geriatr. 2022 May 16;22(1):425. doi: 10.1186/s12877-022-03115-2.

ABSTRACT

BACKGROUND: The number of people with multimorbidity is surging around the world. Although multimorbidity has been introduced in policy and practice in developed countries, developing countries like Nepal have not considered it as a matter of public health urgency due to the lack of enough epidemiological data. Multimorbidity profoundly affects older adults’ wellbeing; therefore, it is crucial to estimate its prevalence and determinants. This study aimed to estimate the prevalence of multimorbidity among older adults in Eastern Nepal and identify its correlates.

METHODOLOGY: A community-based cross-sectional survey was conducted in three districts of Eastern Nepal. Data were collected between July and September 2020, among 847 Nepali older adults, aged 60 and older, where study participants were recruited through a multi-stage cluster sampling technique. Semi-structured interviews were conducted at the community settings to collect data. Logistic regression assessed correlates of multimorbidity. SAS 9.4 was used to run all statistical tests and analyses.

RESULTS: More than half (66.5%) of the participants had at least one of the five non-communicable chronic conditions; hypertension (31.6%), osteoarthritis (28.6%), chronic respiratory disease (18.0%), diabetes (13.5%), and heart disease (5.3%). The prevalence of multimorbidity was 22.8%. In the adjusted model, increased age (for 70-79 years, OR: 3.11, 95% CI: 1.87-5.18; for 80 + years, OR: 4.19, 95% CI: 2.32-7.57), those without a partner (OR: 1.52, 95% CI: 1.00-2.30), residing in urban areas (OR: 1.71, 95% CI: 1.16-2.51), and distant from health center (OR: 1.66, 95% CI: 1.04-2.64) were significantly associated with multimorbidity.

CONCLUSIONS: This study found one in five study participants had multimorbidity. The findings will assist policymakers and stakeholders in understanding the burden of multimorbidity among the older population and identifying the groups in most need of health promotion intervention. Future interventions may include developing horizontal multimorbid approaches and multisectoral strategies specifically tailored to meet the needs of those populations.

PMID:35570271 | DOI:10.1186/s12877-022-03115-2