Tag: pubmed

Int J Health Geogr. 2022 Jul 1;21(1):7. doi: 10.1186/s12942-022-00302-7.

ABSTRACT

BACKGROUND: A better understanding of lifestyle behaviours of children < 7 years and the relation with childhood overweight is needed. The aim of our prospective study was to examine how lifestyle patterns in young children are associated with the development of childhood overweight. As ecological models suggest focusing on not only the child as an individual, but also their environment, we also considered the role of socio-economic status (SES) and spatial clustering of lifestyle and body mass index (BMI).

METHODS: In 1792 children (aged 3-6 years) participating in the GECKO Drenthe cohort, diet, screen time, outdoor play and sleep were assessed by questionnaires and moderate-to-vigorous physical activity and sedentary time by accelerometry (Actigraph GT3X). At 10-11 years, height and weight were measured to calculate age- and sex-specific standardized BMI z-scores (zBMI). Lifestyle patterns were identified using principal component analysis. To assess spatial clustering for the lifestyle patterns and zBMI, we calculated the Global Moran’s I statistic. Linear- and logistic regression models, taking into account SES, were performed to examine the association between the lifestyle patterns and the development of overweight. For the spatial analyses, we added spatial terms for the determinants, the outcome, and the error term.

RESULTS: Three lifestyle patterns were identified: (1) ‘high activity’, (2) ‘low screen time, high sleep and healthy diet’, and (3) ‘high outdoor play’. No associations were observed between the ‘high activity’ or ‘high outdoor play’ patterns at young age with the development of childhood overweight (all p > 0.05). In contrast, children who adhered to the ‘low screen time, high sleep and healthy diet’ pattern had lower odds to become overweight and a lower zBMI at 10-11 years (odds ratio [95% CI] = 0.766 [0.65; 0.90]). These findings remained similar after taking SES into account. Regarding the spatial analyses, we found spatial clustering of zBMI, but no spatial clustering of the lifestyle patterns.

CONCLUSIONS: Low screen time, high sleep duration and a healthy diet cluster into a pattern that seems favourable in the prevention of childhood overweight, independent of individual SES. The spatial analyses suggest that there are likely other neighbourhood factors that contribute to the spatial clustering of childhood overweight.

PMID:35778749 | DOI:10.1186/s12942-022-00302-7

Contracept Reprod Med. 2022 Jul 2;7(1):11. doi: 10.1186/s40834-022-00179-8.

ABSTRACT

BACKGROUND: Despite different preventive strategies that have been implemented in the country, the prevalence of HIV/AIDS is still significantly increasing in Ethiopia. The concurrence of HIV and unintended pregnancy makes the use of dual contraception a back bone for the simultaneous protection against HIV, and unintended pregnancy. As a result, this systematic review and meta-analysis aimed to assess the prevalence and associated factors of dual contraceptive use among women living with HIV in Ethiopia.

METHOD: We used databases; (PubMed, Google Scholar, EMBASE, Cochrane Library, African Online Journals, and Hinary), other gray and online repository accessed studies were searched using different search engines. For critical appraisal of studies Newcastle-Ottawa Quality Assessment Scale (NOS) was used. The analysis was done using STATA 11 software. The Cochran Q test and I² test statistics were used to assess the heterogeneity. To detect publication bias funnel plot and Egger’s test were used. The pooled prevalence of dual contraception use and the odds ratio (OR) with a 95% confidence interval was presented by using forest plots.

RESULT: Eleven studies were included in this review, with a total of 4083 women living with HIV in Ethiopia. The pooled prevalence of dual contraception use in Ethiopia was 34.08% (95%CI: 20.77-47.38). Having open partner discussion (OR = 3.96, 95%CI:2.3,6.8), provision of post test counseling (AOR = 4.38, 95%CI:2.93,6.54), disclosed HIV status to sexual partners (OR = 5.9, 95%CI:4.19,8.33), partner involvement in post-test counseling (OR = 3.52, 95%CI:2.37,5.23), and being on highly active antiretroviral therapy (HAART) (OR = 2.9, 95%CI:1.56,5.46) were the determinant factors of dual contraceptive use in Ethiopia.

CONCLUSION: The overall prevalence of dual contraceptive use among women living with HIV in Ethiopia was low. Having open partner discussion, provision of post-test counseling, disclosed HIV status to sexual partner, partner involvement in post-test counseling, and currently on highly active antiretroviral therapy (HAART) were the associated factors of dual contraceptive use. Therefore, efforts should be made to provide post-test counseling, and initiate partner involvement in post-test counseling. Moreover, promoting open partner discussion, counseling to disclose HIV status to their sexual partner and to start HAART will be helpful in enhancing the use of dual contraceptive method use.

PMID:35778746 | DOI:10.1186/s40834-022-00179-8

Medicine (Baltimore). 2022 Jul 1;101(26):e29836. doi: 10.1097/MD.0000000000029836.

ABSTRACT

Spontaneous intracerebral hemorrhage (ICH) in the brain parenchyma accounts for 16.1% of all stroke types in Taiwan. It is responsible for high morbidity and mortality in some underlying causes. The objective of this study is to discover the predicting factors focusing on in-hospital outcomes of patients with spontaneous supratentorial ICH. Between June 2014 and October 2018, there were a total of 159 patients with spontaneous supratentorial ICH ranging from 27 to 91 years old in our institution. Twenty-three patients died during hospitalization, whereas 59 patients had an extended length of stay of >30 days. The outcomes were measured by inpatient death, length of stay, and activity of daily living (ADL). Both univariate and multivariate binary logistic regression, as well as multivariate linear regression, were used for statistical analysis. Multivariate binary linear regression analysis showed the larger hematoma in initial computed tomography scan of >30 cm3 (odds ratio [OR] = 2.505, P = .013) and concurrent in-hospital infection (OR = 4.173, P = .037) were both statistically related to higher mortality. On the other hand, in-hospital infection (≥17.41 days, P = .000) and surgery (≥11.23 days, P = .001) were correlated with a longer length of stay. Lastly, drastically poor change of ADL (ΔADL <-30) was associated with larger initial ICH (>30 cc, OR = 2.915, P = .049), in-hospital concurrent infection (OR = 4.695, P = .01), and not receiving a rehabilitation training program (OR = 3.473, P = .04). The results of this study suggest that age, prothrombin, initial Glasgow Coma Scale, computed tomography image, location of the lesion, and surgery could predict the mortality and morbidity of the spontaneous ICH, which cannot be reversed at the time of occurrence. However, effective control of international normalized ratio level, careful prevention against infection, and the aid of rehabilitation programs might be important factors toward a decrease of inpatient mortality rate, the length of stay, and ADL recovery.

PMID:35777064 | DOI:10.1097/MD.0000000000029836

Medicine (Baltimore). 2022 Jul 1;101(26):e29792. doi: 10.1097/MD.0000000000029792.

ABSTRACT

BACKGROUND: Idiopathic sudden sensorineural hearing loss (ISSNHL) is an acute condition that presents with sudden hearing loss, for which steroids remain the main treatment. N-acetylcysteine (NAC), as a precursor of glutathione, can reduce the production of reactive oxygen species to protect hair cells in the inner ear from damage. However, data regarding the therapeutic outcomes of oral steroid combined with oral NAC for ISSNHL are still limited. This study was performed to investigate this issue.

METHODS: Between June 2016 and October 2021, 219 patients (219 ears) diagnosed with ISSNHL and treated with oral prednisolone were enrolled in this retrospective study. Oral NAC was prescribed to 94 of these patients (NAC group) but not to the remaining 125 patients (non-NAC group). The clinical and audiological findings were assessed.

RESULTS: The NAC group showed a mean hearing level gain of 29.5 ± 21.8 dB, speech reception threshold (SRT) gain of 26.2 ± 34.4 dB, and speech discrimination score (SDS) gain of 25.5 ± 30.4%. Although the NAC group had better mean hearing level, SRT, and SDS gains than the non-NAC group, the differences were not statistically significant (all P > .05). The only significant difference between the NAC and non-NAC groups was the posttreatment pure tone audiometry (PTA) thresholds at 8 kHz, which were 54.2 ± 24.4 and 60.9 ± 34.1 dB, respectively (P = .046).

CONCLUSIONS: This study demonstrated the effect of oral steroid combined with oral NAC for ISSNHL. Both the NAC and non-NAC groups showed obvious improvement in all PTA thresholds, as well as mean hearing level, SRT, and SDS gains. The NAC group showed significantly better PTA performance at a high frequency (8 kHz) than the non-NAC group. Therefore, for oral treatment of ISSNHL, we advocate concurrent use of oral prednisolone and oral NAC.

PMID:35777063 | DOI:10.1097/MD.0000000000029792

Medicine (Baltimore). 2022 Jul 1;101(26):e29804. doi: 10.1097/MD.0000000000029804.

ABSTRACT

BACKGROUND: Vascular dementia (VD) is the only type of dementia that can be prevented and treated. Compared to conventional treatment methods, moxibustion therapy is more effective for VD. This study evaluated the effectiveness and safety of moxibustion in the treatment of VD through a meta-analysis, to provide a complete overview to the advantages of traditional Chinese medicine and provide guidance for clinical application.

METHODS: Clinical trials on the therapeutic effects of moxibustion or moxibustion combined with acupuncture on VD were retrieved from the VIP information database, Wanfang, CNKI, PubMed, EMBase, and other resources. The included studies were conducted from January 2000 to October 2020. Among the retrieved studies, the content met the standards upon being collated and extracted, and RevMan5.3 was used for meta-analysis.

RESULTS: Thirteen randomized controlled trials (RCTs) were included with 997 patients. The RevMan bias risk assessment revealed that the quality of the studies was generally low. The meta-analysis showed that compared to conventional treatments, moxibution therapy in terms of effective rate, posttreatment Hasegawa Dementia Scale, Mini-Mental State Examination (MMSE), Activity of Daily Living Scale (ADL), Somatostatin (SS), Arginine Vasopressin (AVP), and Syndrome Differentiation Scale of VD were more favorable, and the difference in efficacy was statistically significant. Furthermore, no adverse events were observed in either group. Sensitivity analysis showed strong homogeneity and stable results, whereas funnel plot analysis revealed no significant publication bias.

CONCLUSIONS: Moxibustion is effective and safe in the treatment of VD, but more high-quality evidence from further studies is required to support this.

PMID:35777054 | DOI:10.1097/MD.0000000000029804

Medicine (Baltimore). 2022 Jul 1;101(26):e29777. doi: 10.1097/MD.0000000000029777.

ABSTRACT

Studies with relatively large sample size as well as long-term follow-up focusing on adult craniopharyngioma (CP) patients are still lacking. We attempted to identify independent prognostic factors and establish a nomogram model to estimate survival rates for adult CP patients. The Surveillance, Epidemiology, and End Results database was used to obtain data on patients with CP. Univariable and multivariable Cox analyses were utilized to identify the prognostic factors of adult CP patients. A survival prediction model was constructed and its predictive performance was also assessed. A total of 991 patients (695 in training group and 296 in validation group) were eligible for final inclusion. Multivariate Cox analysis presented that age at diagnosis, marital status, race, tumor size, and surgery type were statistically significant prognostic factors for overall survival (all P < .05). A graphical predicting nomogram model was developed to calculate the predicted patients’ survival probabilities at 1, 2, 5, and 10 years. The concordance indexes were 0.708 ± 0.019 and 0.750 ± 0.025 for the training and validation samples, respectively, demonstrating favorable discrimination abilities. Similarly, the time-dependent area under curve also showed overall satisfactory discrimination ability. Favorable consistencies between the predicted and actual survival were presented according to the calibration curves. An easy-to-use nomogram, being proven to be with reliable discrimination ability and accuracy, was established to help predict overall survival for adult patients with CP using the identified significant prognostic factors.

PMID:35777048 | DOI:10.1097/MD.0000000000029777

Medicine (Baltimore). 2022 Jul 1;101(26):e29827. doi: 10.1097/MD.0000000000029827.

ABSTRACT

BACKGROUND: This study aimed to compare the risk of dementia between exposed to allopurinol and not exposed to allopurinol in persons who had gout and/or hyperuricemia.

METHODS: The meta-analysis was conducted to select case-control research written in English through the help of PubMed and Web of Science. The pooled odds ratio (OR) with 95% confidence interval based on the fixed-effect model was applied to compare the allopurinol exposure among cases (subjects with dementia) and controls (subjects without dementia).

RESULTS: A total of 4 case-control studies relating the allopurinol exposure to the risk of dementia were identified. The study duration was from 9 to 14 years. The number of study persons was from 3148 to 137,640. The male percentage of study subjects was from 36.9 to 62.5. The mean age of study persons was from 72.3 to 78.7 years. Overall, the odds of the allopurinol exposure among cases were lower than the odds of the allopurinol exposure among control subjects (OR = 0.91, 95% confidence interval = 0.87-0.95, P < .001). The heterogeneity between these eligible studies was low (I² = 0%). The sensitivity analysis revealed that after excluding the studies with concern, the pooled OR did not achieve statistical significance.

CONCLUSIONS: This is the first meta-analysis to report that there is a negative relationship between the allopurinol exposure and the risk of dementia. Although the results favor the hypothesis, currently it is unable to draw strong conclusions about the protective effect of allopurinol against dementia due to inclusion of only a few eligible studies. Randomized controlled trials are needed to explore the relationship between allopurinol exposure and the probability of dementia.

PMID:35777042 | DOI:10.1097/MD.0000000000029827

Medicine (Baltimore). 2022 Jul 1;101(26):e29816. doi: 10.1097/MD.0000000000029816.

ABSTRACT

Transcatheter aortic valve replacement (TAVR) is an effective treatment option for patients with severe symptomatic aortic stenosis. Nonetheless, there is a paucity of data regarding the differences in the clinical outcomes of TAVR procedures between elderly and super-elderly patients. This study aimed to compare the clinical characteristics and outcomes of patients aged 65 to 79 years and ≥80 years who underwent TAVR for aortic stenosis. The clinical characteristics and outcomes of 134 patients with aortic stenosis who underwent TAVR were analyzed. Patients were categorized into 2 groups: an elderly group (EG; 65-79 years) and a super-elderly group (SEG) (≥80 years). The in-hospital and follow-up clinical outcomes were compared between the 2 groups. The EG tended to be more overweight, obese, and diabetic than the SEG, whereas the SEG had a higher surgical risk but lower creatinine clearance, hematocrit level, and effective orifice area than the EG. However, no difference was found in in-hospital clinical outcomes between the 2 groups, except for atrial fibrillation. In the propensity score matching and inverse probability of treatment weighting-adjusted analyses, these results were similar. All follow-up clinical outcomes were similar, except for rehospitalization, which was statistically attenuated after propensity score matching and inverse probability of treatment weighting-adjusted analyses. TAVR was associated with similar safety outcomes in the EG (65-79 years) and the SEG (≥80 years). Advanced age is not negatively associated with clinical outcomes after the TAVR procedure.

PMID:35777026 | DOI:10.1097/MD.0000000000029816

Medicine (Baltimore). 2022 Jul 1;101(26):e29746. doi: 10.1097/MD.0000000000029746.

ABSTRACT

Inguinal hernia repair is one of the most frequently performed surgery. The ideal procedure for inguinal hernia repair remains controversial. Open Lichtenstein tension-free mesh repair (LMR) is one of the most preferred open techniques with satisfactory outcomes. Laparoscopic approach in inguinal hernia surgery remains controversial, especially in comparison with open procedures. In this study, we have reported a comparison of laparoscopic total extraperitoneal (TEP) inguinal hernia repair with LMR. Postoperative pain, operative time, complications like seroma, wound infection, chronic groin pain, and recurrence rate were parameters to evaluate the outcome. One hundred seventy-four patients were included in the study by consecutive randomized prospective sampling. The patients were divided into 2 groups: group A, laparoscopic TEP inguinal hernia repair, and group B, LMR. The procedures were performed by experienced surgeons. The primary outcomes were evaluated based on postoperative pain and recurrence rate. Secondary outcomes considered for evaluation were operative time, complications like seroma, infection, and chronic groin pain. Severe pain was reported in group A (7.9%) compared to group B (15.1%), which was statistically significant (P < .001). Moderate pain was reported more in group B (70.9%) compared to group A (29.5%) (P < .001). The mean operative time in group A was 84.6 ± 32.2, which was significantly higher than that in group B, 59.2 ± 14.8. There was no major complication in both groups. The chronic pain postoperatively was significantly in higher number of patients in group B vs group A (22.09% vs 3.4%). The postoperative hospital stay period was significantly lesser for group A vs for group B (2.68 ± 1.52 vs 3.86 ± 6.16). Time duration taken to resume normal activities was significantly lower in group A (13.6 ± 6.8) vs (19.8 ± 4.6) in group B (P < .001). Although there is definite evidence of longer operative time and learning curve, laparoscopic TEP has added advantages like less postoperative pain, early resumption of normal activities, less chronic groin pain, and comparable recurrence rate compared to open Lichtenstein repair. Laparoscopic TEP can be performed with acceptable outcomes and less postoperative complications if performed by experienced hands.

PMID:35777031 | DOI:10.1097/MD.0000000000029746

Medicine (Baltimore). 2022 Jul 1;101(26):e29700. doi: 10.1097/MD.0000000000029700.

ABSTRACT

Caudal and dorsal penile nerve blocks are commonly used regional anesthesia methods in hypospadias surgery. Some studies have reported that regional anesthesia methods are risk factor for the development of postoperative complications following hypospadias surgery. The aim of the current study is to evaluate the relationship between postoperative complications and regional anesthesia methods used in distal hypospadias surgery. Forty-nine distal hypospadias patients were included. Patients had either received caudal or ultrasound (US)-guided dorsal penile nerve block. The age, type of hypospadias, regional anesthesia method, operation time, and postoperative complications were recorded. Fisher exact test and Mann-Whitney U tests were used to compare the data. Caudal epidural block was used in 25 (51%) patients and US-guided dorsal penile nerve block in 24 (49%) patients. There was no statistically significant difference between the groups regarding the types of hypospadias, operation time, and age. Fistula developed in 4 (16%) patients in the caudal block group and in none of the patients in the dorsal penile nerve block group. Fistula rates were statistically significantly different between the groups (P = .030). Conflicting data are found in the literature on the long-term postoperative complications of the regional anesthesia techniques used in hypospadias surgery. In our study, all patients with urethrocutaneous fistula were in the caudal block group. We believe that our study will contribute to the literature as it is the only study comparing caudal block with US-guided dorsal penile nerve block using in-plane technique in terms of postoperative complications in hypospadias surgery.

PMID:35777019 | DOI:10.1097/MD.0000000000029700