Tag: pubmed

Perspect Psychiatr Care. 2022 Jan 13. doi: 10.1111/ppc.13025. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness of the psychoeducational programme “Living together with dementia” applied to a group of family caregivers of people with dementia.

DESIGN AND METHODS: A quasi-experimental study with pretest and posttest and a 4-month follow-up. Fifteen family caregivers of people with dementia were recruited in a community care unit in northern Portugal.

RESULTS: A positive and statistically significant impact on these caregivers’ burden was found.

PRACTICE IMPLICATIONS: The programme could be an important mechanism to train family caregivers of home-dwelling people with dementia.

PMID:35023574 | DOI:10.1111/ppc.13025

Eur Heart J. 2021 Nov 22:ehab777. doi: 10.1093/eurheartj/ehab777. Online ahead of print.

ABSTRACT

AIMS: The complementary studies FIDELIO-DKD and FIGARO-DKD in patients with type 2 diabetes and chronic kidney disease (CKD) examined cardiovascular and kidney outcomes in different, overlapping stages of CKD. The purpose of the FIDELITY analysis was to perform an individual patient-level prespecified pooled efficacy and safety analysis across a broad spectrum of CKD to provide more robust estimates of safety and efficacy of finerenone compared with placebo.

METHODS AND RESULTS: For this prespecified analysis, two phase III, multicentre, double-blind trials involving patients with CKD and type 2 diabetes, randomized 1:1 to finerenone or placebo, were combined. Main time-to-event efficacy outcomes were a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure, and a composite of kidney failure, a sustained ≥57% decrease in estimated glomerular filtration rate from baseline over ≥4 weeks, or renal death. Among 13 026 patients with a median follow-up of 3.0 years (interquartile range 2.3-3.8 years), the composite cardiovascular outcome occurred in 825 (12.7%) patients receiving finerenone and 939 (14.4%) receiving placebo [hazard ratio (HR), 0.86; 95% confidence interval (CI), 0.78-0.95; P = 0.0018]. The composite kidney outcome occurred in 360 (5.5%) patients receiving finerenone and 465 (7.1%) receiving placebo (HR, 0.77; 95% CI, 0.67-0.88; P = 0.0002). Overall safety outcomes were generally similar between treatment arms. Hyperkalaemia leading to permanent treatment discontinuation occurred more frequently in patients receiving finerenone (1.7%) than placebo (0.6%).

CONCLUSION: Finerenone reduced the risk of clinically important cardiovascular and kidney outcomes vs. placebo across the spectrum of CKD in patients with type 2 diabetes.

KEY QUESTION: Does finerenone, a novel selective, nonsteroidal mineralocorticoid receptor antagonist, added to maximum tolerated renin-angiotensin system inhibition reduce cardiovascular disease and kidney disease progression over a broad range of chronic kidney disease in patients with type 2 diabetes?

KEY FINDING: In a prespecified, pooled individual-level analysis from two randomized trials, we found reductions both in cardiovascular events and kidney failure outcomes with finerenone. Because 40% of the patients had an estimated glomerular filtration rate of >60 mL/min/1.73m2 they were identified solely on the basis of albuminuria.

TAKE HOME MESSAGE: Finerenone reduces the risk of clinical cardiovascular outcomes and kidney disease progression in a broad range of patients with chronic kidney disease and type 2 diabetes. Screening for albuminuria to identify at-risk patients among patients with type 2 diabetes facilitates reduction of both cardiovascular and kidney disease burden.

PMID:35023547 | DOI:10.1093/eurheartj/ehab777

Wiad Lek. 2021;74(11 cz 1):2789-2793.

ABSTRACT

OBJECTIVE: The aim: To reveal the organizational factors of psychological safety in the workplace.

PATIENTS AND METHODS: Materials and methods: Methods of psychological survey, statistical assessment and analysis of the received data were used.

RESULTS: Results: Psychological safety is regarded in the paper as a state of preservation of mind that involves maintaining a balance between the negative effects of the environment and a person’s resilience, that is, the ability to overcome such effects. In the structure of the psychological safety of the organization member three components were identified and explored: cognitive, emotional and “confidence in the future”. The results of the survey study confirmed that such organizational factors as level of organizational culture, working team cohesion, working team self-organization, management style of the immediate supervisor, work autonomy, role ambiguity have positive effect on psychological safety.

CONCLUSION: Conclusions: The results imply the importance of purposeful implementation of company policies aiming to improve the revealed factors: providing autonomy to employees and work groups within the organization, establishing clear job descriptions, work performance requirements and interaction principles, improving works design, internal communications.

PMID:35023494

Wiad Lek. 2021;74(11 cz 1):2806-2811.

ABSTRACT

OBJECTIVE: The aim: To determine the differences in the ability of young people with low and high economic statuses towards emotional self-regulation, and characterize their frame of mind by analyzing functional and dysfunctional emotions in healthy and unhealthy states.

PATIENTS AND METHODS: Materials and methods: Theoretical – analysis, generalization, interpretation of the collected data; a set of empirical methods – “Attitude to health” by Berezovskaya, the scale “Quality of life” in the adaptation by Vodopyanova, self-assessment income scale and validated questionnaire “Subjective economic well-being” by Khashchenko. The author has applied Pearson’s chi-squared test, Student’s t-test, and Kruskal-Wallis test.

RESULTS: Results: The affective component of health manifests in the predominance of happiness (t=0.3, p≤0.01) and peace (t=1.7, p≤0.1) as components of a positive frame of mind among young people with high economic status. Such emo≤ions such as fear (t=2.1, p≤0.03), anxiety (t=2, p≤0.04) and irritability (t=1.8, at p≤0.07) are more common among young people with low economic status. Young people who have high economic status show stronger ability to emotional self-regulation in comparison to the ones with low economic status (χ² = 11.9, p≤0.001).

CONCLUSION: Conclusions: In this research, we have found a statistically significant difference in the ability towards emotional self-regulation between young people with low and high economic status: the latter group is able to control dysfunctional emotions such as anger and resentment more when communicating with others; they are more likely to find internal psychological resources. When the health deteriorates, the young people with high economic status are prone to show independence, and manage their own time and life, which is a sign of stable mental health.

PMID:35023497

Wiad Lek. 2021;74(11 cz 1):2779-2783.

ABSTRACT

OBJECTIVE: The aim: To research the indicators of teachers’ mental health in a destabilizing organization of professional activities.

PATIENTS AND METHODS: Materials and methods: The study was conducted at the Poltava M. V. Ostrogradsky Regional Institute of Postgraduate Pedagogical Education, Poltava V. G. Korolenko National Pedagogical University, Volodymyr Vynnychenko Central State Pedagogical University and Poltava State Medical University in 2018-2020. The sample size of 1817 respondents (Ukraine) included 388 men and 1429 women aged 20 to 57 years. The following methods were used: “Scale of threats to occupational health” (Dziuba, 2015) and “Scale of subjective well-being” (Sokolova, 2007) adapted by T. Dziuba. The study used mathematical and statistical analysis (descriptive statistics, correlation analysis) using IBM SPSS Statistics (version 21.0).

RESULTS: Results: It was found that an unstable level of emotional comfort is dominant (57.2%). This is shown by the following indicators: “self-assessment of mental health” 61.0%, “tension and sensitivity” 54.3% and “signs of psychiatric symptoms” 53.0%. Correlation analysis revealed a significant negative impact of the threat factors “daily and weekly overtime” (p <0.01) and “overwork” (p <0.01) on mental health. There is an increase in emotional discomfort in a situation of daily and weekly overtime and overwork. There is a positive correlation between the teachers’ mental health and the indicator “significance of the professional environment” (p <0.01).

CONCLUSION: Conclusions: The study showed that teachers’ mental health in Ukrainian educational organizations is characterized by unstable emotional comfort and increased emotional discomfort, which is a consequence of unbalanced (destabilizing) working conditions: overwork, overtime. The obtained data motivates the need to conduct targete psychotherapeutic and corrective work with teachers who demonstrate professional distress.

PMID:35023492

Wiad Lek. 2021;74(11 cz 1):2784-2788.

ABSTRACT

OBJECTIVE: The aim: To clarify motivation trends of alcohol consumption by adults in the city of Lviv and Lviv region and their mental health risk factors as compared to the specificity of motivation for alcohol consumption by the representatives of other European countries.

PATIENTS AND METHODS: Materials and methods: The study is based on the data of the representative survey of Lviv region residents (1,200 persons) following the methodology RARHA adjusted for Ukraine and its statistical processing.

RESULTS: Results: The results of the study point to the prevalence of social and recreational, traditional motives for alcohol consumption by Lviv region residents (consumption during solemn ceremonies and celebrations). Extremely important, as compared to other European countries, are social motives (the sense of belonging to an important social group). The importance of social factors for the respondents decreases a bit with age and considerably depends on the specific features of religious practices. A wide-spread motive is the striving for changing the emotional state, combined with higher abuse risk as compared to the people who drink on social occasions.

CONCLUSION: Conclusions: The results of the study characterize the specificity of the motivational structure of alcohol consumption by Ukrainians as compared to the general European trends and can be used for the development of targeted regional prevention programs.

PMID:35023493

J Clin Neurol. 2022 Jan;18(1):71-78. doi: 10.3988/jcn.2022.18.1.71.

ABSTRACT

BACKGROUND AND PURPOSE: A multifactorial antiepileptic mechanism underlies the ketogenic diet (KD), and one of the proposed mechanisms of action is that the KD inhibits the mammalian target of rapamycin (mTOR) pathway. To test this clinically, this study aimed to determine the efficacy of the KD in patients with pathologically confirmed focal cortical dysplasia (FCD) due to genetically identifiable mTOR pathway dysregulation.

METHODS: A cohort of patients with pathologically confirmed FCD after epilepsy surgery and who were screened for the presence of germline and somatic mutations related to the mTOR pathway in peripheral blood and resected brain tissue was constructed prospectively. A retrospective review of the efficacy of the prior KD in these patients was performed.

RESULTS: Twenty-five patients with pathologically confirmed FCD and who were screened for the presence of detectable somatic mTOR pathway mutations had received a sufficient KD. Twelve of these patients (48.0%) had germline or somatic detectable mTOR pathway mutations. A response was defined as a ≥50% reduction in seizure frequency. The efficacy of the KD after 3 months of dietary therapy was superior in patients with detectable mTOR pathway mutations than in patients without detectable mTOR pathway mutations, although the difference was not statistically significant (responder rates of 58.3% vs. 38.5%, p=0.434).

CONCLUSIONS: A greater proportion of patients with mTOR pathway responded to the KD, but there was no statistically significant difference in efficacy of the KD between patients with and without detectable mTOR pathway mutations. Further study is warranted due to the smallness of the sample and the limited number of mTOR pathway genes tested in this study.

PMID:35021279 | DOI:10.3988/jcn.2022.18.1.71

World J Mens Health. 2022 Jan 2. doi: 10.5534/wjmh.210147. Online ahead of print.

ABSTRACT

PURPOSE: Diabetes mellitus erectile dysfunction (DMED) is a common resulting complication of diabetes. Studies have shown mesenchymal stem cell (MSC)-based therapy was beneficial in alleviating erectile function of DMED rats. While the pathogenesis of DMED and the mechanism MSCs actions are unclear.

MATERIALS AND METHODS: We constructed a rat model of DMED with or without intracavernous injection of MSCs, and performed microRNA (miRNA) sequencing of corpora cavernosa tissues.

RESULTS: We identified three overlapping differentially expressed miRNAs (rno-miR-1298, rno-miR-122-5p, and rno-miR-6321) of the normal control group, DMED group, and DMED+MSCs group. We predicted 285 target genes of three miRNAs through RNAhybrid and miRanda database and constructed a miRNA-target gene network through Cytoscape. Next, we constructed protein-protein interaction networks through STRING database and identified the top 10 hub genes with highest connectivity scores. Five GO terms including cellular response to growth factor stimulus (GO:0071363), ossification (GO:0001503), response to steroid hormone (GO:0048545), angiogenesis (GO:0001525), positive regulation of apoptotic process (GO:0043065), and one Reactome pathway (Innate Immune System) were significantly enriched by 10 hub genes using the Metascape database. We selected the GSE2457 dataset to validate the expression of hub genes and found only the expression of B4galt1 was statistically different (p<0.001). B4galt1 was highly expressed in penile tissues of diabetic rats and would be negatively regulated by rno-miR-1298.

CONCLUSIONS: Three key miRNAs were identified in DMED rats with stem cell therapy and the miR-1298/B4GalT1 axis might exert function in stem cell therapy for ED.

PMID:35021304 | DOI:10.5534/wjmh.210147

Semin Thromb Hemost. 2022 Jan 12. doi: 10.1055/s-0041-1742091. Online ahead of print.

ABSTRACT

The clinical course of coronavirus disease 2019 (COVID-19) is often complicated by the onset of venous thrombosis and thromboembolism (VTE), encompassing also pulmonary thrombosis. Recent statistics attests that the cumulative frequency of VTE can be as high as 30% in COVID-19 hospitalized patients, increasing to nearly 40 to 70% (depending on systematic screening) in those with severe illness, mechanical ventilation, or intensive care unit admission. The risk of venous thrombosis seems mostly limited to the active phase of disease, and is directly associated with some genetic (i.e., inherited prothrombotic predisposition) and demographical factors (male sex, overweight/obesity), disease severity (risk increasing progressively from hospitalization to development of severe illness, being the highest in patients needing mechanical ventilation and/or intensive care), presence and extent of pulmonary disease, coexistence of multiple risk factors (immobilization, mechanical ventilation, co- or superinfections), along with increased values of inflammatory and thrombotic biomarkers. At least three different phenotypes of pulmonary thrombosis may develop in COVID-19 patients, one caused by typical embolization from peripheral venous thrombosis (e.g., deep vein thrombosis), a second type triggered by local inflammation of nearby pulmonary tissue, and a third one mostly attributable to the prothrombotic state consequent to the pronounced systemic inflammatory response (i.e., the so-called cytokine storm) that is frequently observed in COVID-19. Although the pathogenesis of these three conditions has different features, their discrimination is essential for diagnostic and therapeutic purposes. The prognosis of COVID-19 patients who develop pulmonary thrombosis is also considerably worse than those who do not, thus probably needing frequent monitoring and more aggressive therapeutic management.

PMID:35021250 | DOI:10.1055/s-0041-1742091

Nurs Crit Care. 2022 Jan 12. doi: 10.1111/nicc.12741. Online ahead of print.

ABSTRACT

BACKGROUND: Environmental factors such as loud sounds and bright lights in intensive care units can cause sleep disorders and delirium.

AIM: The present study aims to investigate the effects of the overnight use of earplugs and eye masks by intensive care patients on their sleep quality and the degree of delirium.

STUDY DESIGN: This randomized controlled experimental study was conducted on the patients admitted to a coronary intensive care unit.

METHODS: The patients in the experimental group used earplugs and eye masks during the night, while those in the control group received only routine care. Data were collected using an information form, the Richards-Campbell sleep questionnaire (RCSQ), and the intensive care delirium screening checklist (ICDSC).

RESULTS: The study included a total of 84 patients, 42 in the experimental group and 42 in the control group. The baseline average score of the patients in the experiment group on the RCSQ was 40.11 ± 16.55, with a Time 1 average score of 64.09 ± 14.07 and a Time 2 average score of 72.07 ± 11.75; their baseline average score on the ICDSC was 0.47 ± 0.50, with a Time 1 average score of 0.33 ± 065 and a Time 2 average score of 0.19 ± 039. The baseline average score of the patients in the control group on the RCSQ was 44.07 ± 7.30, with a Time 1 average score of 46.97 ± 9.22 and a Time 2 average score of 47.04 ± 11.53; the baseline average score of the control group on the ICDSC was 0.42 ± 0.50, with a Time 1 average score of 0.50 ± 0.70 and a Time 2 average score of 0.57 ± 0.66. A statistically significant difference was found between the Time 1 and Time 2 average scores of the experimental and control groups on the RCSQ and between the Time 2 average scores of the experimental and control groups on the ICDSC (U = 198.00, P < .001; U = 70.000, P < .001; U = 614.000, P = ·004 respectively).

CONCLUSIONS: The earplugs and eye masks used by the intensive care patients overnight were associated with an increase in sleep quality and a decrease in the degree of delirium.

RELEVANCE TO CLINICAL PRACTICE: The use of earplugs and eye masks is recommended for intensive care units in supporting sleep quality and preventing delirium.

PMID:35021263 | DOI:10.1111/nicc.12741