Tag: pubmed

J Am Pharm Assoc (2003). 2021 Apr 20:S1544-3191(21)00160-6. doi: 10.1016/j.japh.2021.04.005. Online ahead of print.

ABSTRACT

BACKGROUND: As a result of the coronavirus disease 2019 (COVID-19) pandemic, institutions needed innovative solutions to provide care. With implementation of telehealth, a cystic fibrosis (CF) pharmacist was able to incorporate a virtual medication tour during appointments.

OBJECTIVE: The purpose of our study was to describe the uptake and impact of pharmacist-led virtual medication tours during telehealth visits in the CF clinic setting.

PRACTICE DESCRIPTION: Before the COVID-19 pandemic, a CF pharmacist participated in in-person multidisciplinary team visits to complete medication history reconciliation, assess adherence, assess efficacy and address possible adverse effects of medications, and work collaboratively with the CF care team and patient to create therapeutic plans. The virtual medication tour described in this study was completed in addition or as a complement to these pre-existing pharmacist roles and responsibilities.

PRACTICE INNOVATION: Patients seen via telehealth visit were asked to provide a virtual tour of their medications. A pharmacist completed medication history and evaluated whether storage conditions were appropriate in regard to temperature, humidity, light exposure, and accessibility to children.

EVALUATION METHODS: A pharmacist recorded findings from the virtual medication tours and made interventions when appropriate. Descriptive statistics were used for analysis.

RESULTS: Of 20 patients seen via telehealth for a quarterly visit during the first 3 months after implementation, 13 were willing to participate in a virtual medication tour. Before the visit, 25% had information missing from their medication list. Virtual medication tour allowed for resolution of this information 80% of the time. Three of the 4 participating patients with a child under 12 years old had medications stored in a location accessible to children.

CONCLUSION: A virtual medication tour led by a pharmacist can be successfully incorporated into telehealth visits and was accepted by a majority of patients. Most patients stored medications appropriately but might benefit from education on poison prevention practices.

PMID:33931355 | DOI:10.1016/j.japh.2021.04.005

J Plast Reconstr Aesthet Surg. 2021 Mar 30:S1748-6815(21)00132-7. doi: 10.1016/j.bjps.2021.03.042. Online ahead of print.

ABSTRACT

BACKGROUND: There is a lack of consensus regarding the superiority of the common free flaps for the reconstruction of circumferential pharyngeal defects.

METHODS: A systematic literature search was conducted to identify studies reporting the complications of circumferential pharyngeal reconstruction between 2005 and 2020. Anterolateral thigh free flaps (ALTFF), jejunal free flaps (JFF), and radial forearm free flaps (RFFF) were compared. Various complications were compared by meta-analysis. Primary endpoints were fistula and stricture rates.

RESULTS: Forty studies were included (2230 patients). Stricture rate was similarly low with tubed ALTFF (13.3%, n = 36/270) and JFF (13.2%, n = 176/1334). Fistula rate was the lowest with JFF (9.2%, n = 58/634). ALTFF was associated with the lowest rates of partial and complete flap failure (3.8%, n = 6/157, and 2.8%, n = 5/178), infection (2.8%, n = 3/106), donor site morbidity (3.9%, n = 5/130), and mortality (0%, n = 0/101) within 30 days. A meta-analysis demonstrated that there was no statistically significant difference in stricture and fistula rates between ALTFF and JFF. Moreover, JFF was associated with a significantly lower fistula rate than that of RFFF (p < 0.001). ALTFF was associated with a significantly lower infection rate than that of JFF (p = 0.013).

CONCLUSIONS: The data suggest the use of ALTFF for circumferential pharyngeal defects. In the absence of randomized, prospective data, the authors hope the results presented can be used as an evidence-based reference.

PMID:33931325 | DOI:10.1016/j.bjps.2021.03.042

J Plast Reconstr Aesthet Surg. 2021 Mar 29:S1748-6815(21)00124-8. doi: 10.1016/j.bjps.2021.03.034. Online ahead of print.

ABSTRACT

INTRODUCTION: Indocyanine Green Angiography (ICG-A) is an imaging technique used to visualize tissue perfusion in real time. The aim of this systematic review and meta-analysis is to evaluate all published papers on breast reconstruction using ICG-A, which provides information on complication rates and to investigate whether the use of this peroperative method decreases the risk of complications.

MATERIALS AND METHODS: MEDLINE/PubMed, EMBASE, Cochrane, and UpToDate were searched using relevant terms. The literature was assessed using the PRISMA guidelines. Inclusion criteria were: original articles written in English assessing ICG-angiography in breast reconstruction. The individual studies were evaluated according to Cochrane guidelines.

RESULTS: The search yielded 243 papers on ICG-A and breast reconstruction. Twenty-six of these were included for analysis. The risk of overall major complications ([OR] = 0.53, 95% confidence interval (CI) = 0.43-0.66, p = 0.00001) and overall loss of reconstruction ([OR] = 0.58, 95% CI = 0.37-0.92, and p = 0.020) was significantly lower when peroperative ICG-A was used. When using ICG-A to evaluate mastectomy flaps, a statistically lower risk of major complications ([OR] = 0.56 and p = 0.0001) and the loss of reconstruction was found ([OR] = 0.46, p = 0.006). ICG-A used in autologous breast reconstruction significantly reduced the risk of minor ([OR] = 0.62 and p = 0.001) and major complications ([OR] = 0.53 and p = 0.0028).

CONCLUSIONS: This is the first systematic review to analyze the use of ICG-A on both mastectomy flaps and autologous reconstruction. The results obtained in the current study indicate that the use of ICG-A in breast reconstructive procedures reduces the complications as well as the loss of reconstruction.

PMID:33931326 | DOI:10.1016/j.bjps.2021.03.034

Parkinsonism Relat Disord. 2021 Apr 24:S1353-8020(21)00152-8. doi: 10.1016/j.parkreldis.2021.04.019. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s Disease (PD) is among one of the common comorbidities in older patients. People with PD may be more vulnerable to severe pneumonia, due to the impairment of pulmonary function. Currently, the association between PD and COVID-19 is not yet established. This study aims to analyze the relationship between PD and in-hospital outcomes of COVID-19.

MATERIALS AND METHODS: We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until December 25th, 2020. All articles published on COVID-19 and Parkinson’s Disease were retrieved. The quality of the study was assessed using the Newcastle Ottawa Scale (NOS) tool for observational studies and Joanna Briggs Institute (JBI) Critical Appraisal Tools for cross-sectional studies. Statistical analysis was done using Review Manager 5.4 software.

RESULTS: A total of 12 studies with 103,874 COVID-19 patients were included in this meta-analysis. This meta-analysis showed that Parkinson’s Disease was associated with poor in-hospital outcomes [[OR 2.64 (95% CI 1.75-3.99), p < 0.00001, I² = 81%] and its subgroup which comprised of severe COVID-19 [OR 2.61 (95% CI 1.98-3.43), p < 0.00001, I² = 0%] and mortality from COVID-19 [RR 2.63 (95% CI 1.50-4.60), p = 0.0007, I² = 91%]. Meta-regression showed that the association was influenced by age (p = 0.05), but not by gender (p = 0.46) and dementia (p = 0.23).

CONCLUSIONS: Extra care and close monitoring should be provided to Parkinson’s Disease patients to minimize the risk of infections, preventing the development of severe and mortality outcomes.

PMID:33931304 | DOI:10.1016/j.parkreldis.2021.04.019

Clin Lung Cancer. 2021 Mar 27:S1525-7304(21)00069-3. doi: 10.1016/j.cllc.2021.03.015. Online ahead of print.

ABSTRACT

INTRODUCTION: We investigated whether adding computed tomography (CT) and/or ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET radiomics features to conventional prognostic factors (CPFs) improves prognostic value in locally advanced non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS: We retrospectively identified 39 cases with stage III NSCLC who received chemoradiotherapy and underwent planning CT and staging ¹⁸F-FDG PET scans. Seven CPFs were recorded. Feature selection was performed on 48 CT and 49 PET extracted radiomics features. A penalized multivariate Cox proportional hazards model was used to generate models for overall survival based on CPFs alone, CPFs with CT features, CPFs with PET features, and CPFs with CT and PET features. Linear predictors generated and categorized into 2 risk groups for which Kaplan-Meier survival curves were calculated. A log-rank test was performed to quantify the discrimination between the groups and calculated the Harrell’s C-index to quantify the discriminatory power. A likelihood ratio test was performed to determine whether adding CT and/or PET features to CPFs improved model performance.

RESULTS: All 4 models significantly discriminated between the 2 risk groups. The discriminatory power was significantly increased when CPFs were combined with PET features (C-index 0.82; likelihood ratio test P < .01) or with both CT and PET features (0.83; P < .01) compared with CPFs alone (0.68). There was no significant improvement when CPFs were combined with CT features (0.68).

CONCLUSION: Adding PET radiomics features to CPFs yielded a significant improvement in the prognostic value in locally advanced NSCLC; adding CT features did not.

PMID:33931316 | DOI:10.1016/j.cllc.2021.03.015

Int J Clin Pract. 2021 Apr 30:e14300. doi: 10.1111/ijcp.14300. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of the current study was to investigate Erectile dysfunction (ED) in asthma patients without comorbidity and the relationship between the level of asthma control and ED.

METHODS: Forty male patients aged 24-50 years with controlled-to-uncontrolled asthma and 20 healthy volunteers were included in this study. The International Index of Erectile Function Questionnaire (IIEF) for ED was used.

RESULTS: Evaluation of the IIEF scores for ED showed that 23 (57.5%) of the asthma patients and 4 (20.0 %) of the controls had various degrees of ED, and the difference was statistically significant. In total, 25% of asthma patients had mild ED, 22.5 %moderate ED,and10% severe ED. Severe, moderate and mild ED was more frequent in the asthma group. Of the 23 patients who had various degrees of ED, 13 were in the uncontrolled asthma group. While all asthma patients with severe ED were in the uncontrolled asthma group,of the 9 asthma patients with moderate ED, 6 were in the uncontrolled asthma group, 2 were in the partially controlled asthma group and one was in the controlled asthma group. Additionally, of the 10 asthma patients with mild ED, 3 were in the uncontrolled asthma group, 2 were in the partially controlled asthma group and 5 were in the controlled asthma group.

CONCLUSION: The current study showed that ED is frequent and more severe in asthma patients than controls with same age. A highly negative correlation was found between ED degree and asthma control severity.

PMID:33930236 | DOI:10.1111/ijcp.14300

J Nurs Manag. 2021 Apr 30. doi: 10.1111/jonm.13354. Online ahead of print.

ABSTRACT

AIM: To determine the relationship of nursing work environment and innovation support with nurses’ innovative behaviors and innovation outputs.

BACKGROUND: According to the Social Exchange Theory, nursing work environment must be regulated to support innovation for nurses’ innovative behaviors which results in useful innovation outputs.

METHODS: The sample of the research determined using the convenience sampling method consisted of 618 nurses working in four hospitals in Istanbul. In statistical analysis of the data, descriptive analyses, correlation and linear regression analysis were used.

RESULTS: It was found a significant correlation between nursing work environment and innovation support with innovative behavior and innovation outputs. It was found that innovative behavior was the variable that had a significant impact on nurses’ innovation outputs and the model explained 40.1% of the variance of innovation outputs. The model created for innovative behavior was determined to have an explanatory variance of 19.4%.

CONCLUSIONS: This study reveals the necessity for developing nurses’ innovative behaviors to increase innovation outputs, and examines the relationship of nurses’ innovative behaviors with nursing work environment and innovation support.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should create a nursing work environment that supports and develops nurses’ innovative behaviors.

PMID:33930243 | DOI:10.1111/jonm.13354

Int J Clin Pract. 2021 Apr 30:e14292. doi: 10.1111/ijcp.14292. Online ahead of print.

ABSTRACT

BACKGROUND: The objective of the study was to evaluate the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and interleukin (IL)-6 in Chronic HBV-Infected patients.

METHODS: The present study was a single center, prospective, and randomized controlled trial. Twenty healthy volunteers and 30 HBeAg-negative patients with planned liver biopsy and treatment-naive diagnosed with Chronic hepatitis B (CHB) were included in the study. TNF-α, IL-1β, and IL-6 levels were measured in the serum of CHB patient and control groups using an ELISA. Results were compared statistically using a Mann Whitney U-test.

RESULTS: The mean age of the CHB group (20 men, 10 women) and the control group (10 men, 10 women) was 33.3 ± 9.7 (17-55) and 26.1 ± 12.3 (16-57), respectively. When the two groups were compared with the Mann Whitney U-test, TNF-α and IL-6 levels were found to be significantly higher in the CHB group compared to the control group (p = 0.003, p < 0.0001, respectively.). Although IL-1β levels were not statistically significant, they were higher in the CHB group compared to the controls (p = 0.07).

CONCLUSIONS: The results of our study showed that serum levels of TNF-α and IL-6 are increased in CHB patients.

PMID:33930244 | DOI:10.1111/ijcp.14292

J Neuroimaging. 2021 Apr 30. doi: 10.1111/jon.12864. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: The first pass effect has been reported as a mechanical thrombectomy (MT) success metric in patients with large vessel occlusive stroke. We aimed to compare the clinical and neuroimagign outcomes of patients who had favorable recanalization (mTICI 2c or mTICI 3) achieved in one pass versus those requiring multiple passes.

METHODS: In this “real-world” multicenter study, patients with mTICI 2c or 3 recanalization were identified from three prospectively collected stroke databases from January 2016 to December 2019. Clinical outcomes were a favorable functional outcome at 90 days (modified Rankin Scale score 0-2), and the rate of symptomatic intracranial hemorrhage (ICH) any ICH, and 90-day mortality.

RESULTS: Favorable recanalization was achieved in 390/664 (59%) of consecutive patients who underwent MT (age 71.2 ± 13.2 years, 188 [48.2%] women). This was achieved after a single thrombectomy pass (n = 290) or multiple thrombectomy passes (n = 100). The rate of favorable clinical outcome was higher (41% vs. 28 %, p = .02) in the first pass group with a continued trend on multivariate analysis that did not reaching statistical significance (OR 1.68 95% confidence interval [CI] 1.0-2.95, p = .07). Similarly, the odds of any ICH were significantly lower (OR 0.56 CI 0.32-0.97, p = .03). A similar trend of favorable clinical outcomes was noticed on subgroup analysis of patients with M1 occlusion (OR 1.81 CI 1.01-3.61, p = .08).

CONCLUSION: The first-pass reperfusion was associated with a trend toward favorable clinical outcome and lower rates of ICH. These data suggest that the first-pass effect should be the mechanical thrombectomy procedure goal.

PMID:33930218 | DOI:10.1111/jon.12864

Int J Clin Pract. 2021 Apr 30:e14302. doi: 10.1111/ijcp.14302. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetic peripheral neuropathy (DPN) is a chronic complication of diabetes mellitus associated with high morbidity and mortality. Major risk factors for DPN include metabolic changes, duration of diabetes, nerve ischaemia and derangements in regeneration and nerve repair programs. Chemokines have been previously implicated in the pathogenesis of various neuropathies and neuropathic pain processes. The aim of this pilot study was to evaluate the association between plasma levels of chemokines (CXCL9, CXCL10 and CXCL11) with the presence of DPN in a cohort of type 2 diabetes (T2D) patients.

MATERIALS AND METHODS: We studied 73 patients with T2D: 36 with DPN and 37 without DPN. DPN was established through the Semmes-Weinstein test (SW). Plasma levels of circulating chemokines CXCL9, CXCL10, and CXCL11 were determined using Duoset ELISA kits (Abingdon, UK).

RESULTS: We found that levels of CXCL10 were significantly higher in patients with DPN than among patients without DPN (57.6 ± 38.3 vs. 38.1 ± 33.4 pg/mL, respectively; p = 0.034). Serum levels of chemokine CXCL9 were also higher among patients with DPN but did not reach statistical significance (188.1 ± 72.7 and 150.4 ± 83.6 pg/mL, respectively, p = 0.06).

CONCLUSIONS: Increased circulating levels of CXCL10 were associated with DPN in T2D patients, suggesting a role of this chemokine in the DPN. Determination of CXCL10 levels could be used as a marker for early detection and implementation of therapeutic strategies in order to reverse and prevent the DPN.

PMID:33930221 | DOI:10.1111/ijcp.14302