Tag: pubmed

Int J Surg Case Rep. 2021 Dec 20;90:106699. doi: 10.1016/j.ijscr.2021.106699. Online ahead of print.

ABSTRACT

INTRODUCTION: We describe the demographic, preoperative, surgical, anesthetic, and postoperative characteristics of patients who required a rapid response team (RRT) activation after major hip surgery. We determined the characteristics and outcomes of patients that require RRTs after major hip surgery, and their associations with mortality.

PRESENTATION OF CASES: We retrospectively reviewed adult patients undergoing major hip surgery in a university teaching hospital. We included patients who had an RRT or “code blue” activation post-surgery and within the index hospital admission. We extracted patient, surgical, anesthetic, and postoperative variables. We explored differences between patients who survived their index hospital stay and those who died.

DISCUSSION: 187 (9%) patients had a postoperative RRT activation. The median age was 84.0 (78-90) years; 125 (67%) were female, and most patients had significant comorbidities. The median Charlson Comorbidity Index (CCI) was 5.0 (4.0-7.0). Patients were frail (68%), ASA physical status ≥Class 3 (91%) and underwent emergency surgery (88%). Death after RRT activation occurred in 1 in 7 patients. Compared to patients who survived RRT activation, those who died had a higher mean CCI (6.5 [1.8] vs. 5.5 [2.1], P = 0.02), were more frail (80.1% vs. 56.5%, OR = 3.2, 95% CI: 1.2,8.1; P = 0.03), and received less intraoperative opioids (intravenous morphine equi-analgesia: median = 5.8 (0.1-8.20 vs. 11.7 (3.7-19.0) mg, P = 0.03).

CONCLUSION: Mortality after RRT activation is associated with non-modifiable patients factors rather than surgical or anesthesia factors. Our findings provide opportunities for the implementation of strategies aimed at improving postoperative outcomes.

PMID:34953425 | DOI:10.1016/j.ijscr.2021.106699

J Mech Behav Biomed Mater. 2021 Dec 11;126:105041. doi: 10.1016/j.jmbbm.2021.105041. Online ahead of print.

ABSTRACT

PURPOSE: The deformation of lamina cribrosa (LC) under the elevated intraocular pressure (IOP) might squeeze the retinal ganglion cell (RGC) axons and impair the visual function. Mechanical behaviors of LC and RGC axons are supposed to be related to the optic nerve damage of glaucoma patients. However, they cannot be independently studied with the existing methods because the LC and RGC axons intertwine in the LC area. This study proposed a feasible method to evaluate the respective mechanical properties of glial LC and RGC axons of rats.

METHODS: The atomic force microscope (AFM) nano-indentation experiment was performed on unfixed cryosection samples acquired from the glial LC tissues of eight eyes from four rats. For each sample, three regions of interests (ROIs) with sizes of 20 × 20 μm² were selected from the ventral, central and dorsal regions of the sample, respectively, and the nano-indentation was performed on 128 × 128 points within each ROI to obtain a Young’s modulus image. The glial LC and RGC axons were segmented on each modulus images using Otsu thresholding segmentation method, and their respective Young’s modulus was further extracted for statistical analysis.

RESULTS: Young’s modulus of glial LC and RGC axons are 297 ± 98 kPa and 76 ± 36 kPa in ventral regions, 342 ± 84 kPa and 84 ± 32 kPa in central regions, 280 ± 104 kPa and 75 ± 30 kPa in dorsal regions, respectively. No significant differences are found among the Young’s modulus of different regions, both for glial LC and RGC axons.

CONCLUSIONS: This study takes the nature property of the LC area as a composite material into consideration, and proposes a feasible method to distinguish between the glial LC and RGC axons and measure their respective Young’s modulus. These findings may provide useful information for establishing finite element models of the optic nerve head and promote the study on the deformation of the optic nerve under high intraocular pressure, and finally contribute to the early diagnosis of glaucoma.

PMID:34953434 | DOI:10.1016/j.jmbbm.2021.105041

J Trace Elem Med Biol. 2021 Dec 16;70:126914. doi: 10.1016/j.jtemb.2021.126914. Online ahead of print.

ABSTRACT

BACKGROUND: Today, although gadolinium based contrast agents have been frequently used in the field of medicine, there is limited data available whether gadolinium based agents affect the genome.

AIM: The present study aimed to investigate the genotoxic and cytotoxic potentials of gadoteric acid and gadoversetamide used as gadolinium-based contrast agents for magnetic resonance (MR) imaging.

MATERIAL AND METHODS: The cytokinesis-block micronucleus assay was applied to human peripheral blood lymphocytes to assess the genotoxicity measured as micronucleus (MN), nucleoplasmic bridge (NPBs) and nuclear bud (NBUDs) frequencies. Furthermore, cytokinesis-block proliferation index (CBPI) was calculated to determine cytostasis. Lymphocytes were treated with gadoteric acid at concentrations of 1.0, 2.5, 5.0, and 25 mM and with gadoversetamide at concentrations of 0.25, 1.0, 2.5, and 5.0 mM for 48 h.

RESULTS: Gadoteric acid did not cause significant increase in MN, NBPs and NBUDs frequencies and CBPI values at any concentration. Gadoversetamide induced significantly increase MN formation at concentration of 2.5 mM, NBP formation at concentrations of 1.0 and 2.5 mM, and NBUD formation at concentrations of 0.25, 1.0 and 2.5 mM. Additionally, gadoversetamide exposure resulted in statistically significant decrease in CBPI values compared to the control at concentrations of 2.5 and 5.0 mM. In addition, CBPI levels in response to concentrations of gadoversetamide was negatively and significantly associated with concentration.

CONCLUSION: These findings show that gadoteric acid does not have genotoxic or cytotoxic potential, while gadoversetamide might have both genotoxic and cytotoxic potential on human peripheral blood lymphocytes. As a comparison, gadoversetamide was found more genotoxic and cytotoxic.

PMID:34953388 | DOI:10.1016/j.jtemb.2021.126914

Complement Ther Med. 2021 Dec 22;64:102797. doi: 10.1016/j.ctim.2021.102797. Online ahead of print.

ABSTRACT

OBJECTIVES: Vitamin C has anti-inflammatory effects. This review aimed to investigate the therapeutic effect of high-dose intravenous vitamin C (HDIVC) in patients with coronavirus disease 2019 (COVID-19).

METHODS: The following key phrases were searched for article inclusion: “Vitamin C OR ascorbic acid” AND “COVID-19 OR coronavirus disease 2019 OR severe acute respiratory syndrome coronavirus 2 OR SARS-CoV-2″. Articles that utilized HDIVC for the management of patients with COVID-19 were included, whereas review articles and case reports were excluded from this review. Moreover, we performed a meta-analysis to evaluate whether HDIVC can reduce the length of hospital stay and in-hospital mortality rate of patients with severe COVID-19.

RESULTS: In total, eight articles were included in this review, and five studies were included in the meta-analysis. The length of hospital stay was not significantly different between the HDIVC and control groups. Also, although our meta-analysis showed a tendency for HDIVC to reduce the in-hospital mortality rate in patients with severe COVID-19, the in-hospital mortality rate was not significantly different between patients treated with HDIVC and those who did not receive HDIVC.

CONCLUSIONS: Evidence supporting the therapeutic use of HDICV in COVID-19 patients is lacking. Further studies are required for drawing a clear conclusion on this topic.

PMID:34953366 | DOI:10.1016/j.ctim.2021.102797

Waste Manag. 2021 Dec 22;139:70-84. doi: 10.1016/j.wasman.2021.12.020. Online ahead of print.

ABSTRACT

The unprecedented population increase brings several consequences to the environment, including the rise of urbanization levels and municipal solid waste (MSW) production – one expects that it may reach 3.4 billion tons per year by 2050. This paper contributes to the debate of efficiency measurement of MSW utilities management using the Portuguese case study. Our objectives are twofold. First, we assess the efficiency levels of municipalities in MSW collection through the Data Envelopment Analysis model, choosing total costs, staff, and vehicles as inputs, and the quantity of MSW collected (selective and refuse waste) as outputs. The efficiency results point to an average inefficiency level of about 35% and potential cost savings of over €96 million yearly. Second, by using a set of fifteen performance indicators monitored by the regulatory agency, we evaluate their relationship with the efficiency of MSW utilities, through the order-m model. Our results suggest that, in opposition to the management model, the rural/urban nature of councils helps explain part of the inefficiency. In general, the conditional-to-unconditional efficiency ratios reached values statistically different from 1, meaning that those indicators help explaining their efficiency distribution and the benchmarks profile, and need to be considered in future performance analyses. Remarkable and influential indicators include the accessibility to the service (average ratio = 0.95), the recycling rate (0.94), the monetization of the vehicle fleet (0.92), the pollution resulting from greenhouse gas emissions of waste collection vehicles (0.81), and council size measured by the population or the number of households (0.47).

PMID:34953379 | DOI:10.1016/j.wasman.2021.12.020

Prev Vet Med. 2021 Dec 17;199:105562. doi: 10.1016/j.prevetmed.2021.105562. Online ahead of print.

ABSTRACT

Pig production is an important farm enterprise for an increasing number of smallholder farmers due to its potential for improving household incomes. The sector is however faced with high burden of health issues that limit most farmers from realizing the benefits. In order to improve management of pig health for smallholder farmers, an understanding of the major health issues and factors associated with farmers’ choice of the pig health management strategies are paramount. Using a cross-sectional survey of 240 smallholder pig farmers in northern Uganda, this study assessed the factors associated with the use of different pig health management practices adopted by smallholder pig farmers. Data analysis involved descriptive statistics and two different regression models. Binary Probit Regression model was used to assess factors associated with the use of a single pig health management strategy, while, Generalized Poisson Regression model was used to assess the factors associated with the number of pig health management strategies used by the farmers. Results showed that the common health issues were African Swine Fever, lice, worms and mange, while the common strategies for health management involved self-administering antibiotics, consulting veterinarians, deworming, spraying with acaricides, selling the sick pigs, treatment with local herbs, and burying dead pigs. These pig health management strategies were influenced by farmers location, experience, age, access to extension, use of information and communication technologies, and use of processed feeds. This study recommends improving farmers’ access to relevant information and expanding veterinary extension services by promoting the use of radio and mobile phones in pig health management.

PMID:34953300 | DOI:10.1016/j.prevetmed.2021.105562

Geriatr Nurs. 2021 Dec 21;43:219-226. doi: 10.1016/j.gerinurse.2021.12.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically research the impact of warming needle moxibustion (WNM) for Alzheimer’s Disease (AD).

METHODS: Four Chinese databases and six English databases were systematically searched. Randomized controlled trials (RCTs) involving the use of WNM to intervene in AD patients were included. Data were extracted from the included studies and methodological quality was evaluated according to the Cochrane Handbook for Systematic Reviews of Intervention 5.1.0. Meta-analysis was performed using RevMan 5.4 software.

RESULTS: 8 RCTs comprising 524 patients were included. Most studies had no significant bias. The study showed that WNM was more effective in the treatment of AD than acupuncture or pharmacotherapy. The findings were as follows: MMSE (MD = 1.01, 95%CI: 0.13, 1.90, P = 0.03) and CDR (MD = -0.73, 95%CI: -0.84, -0.61, P < 0.00001) for global cognitive function, ADL (MD = -1.84, 95%CI: -2.47, -1.22, P < 0.00001) for activities of daily living, Syndrome Differentiation Scale of Dementia (SDSD) (MD = -2.67, 95%CI: -3.62, -1.72, P < 0.00001), and the total effective rate of patients (OR = 3.20, 95%CI: 1.90 to 5.38, P < 0.0001). The differences in all indicators were statistically significant.

CONCLUSION: WNM might have a significant effect on improving cognitive function and daily living ability, reducing the symptoms of AD, and increase the total effective rate. WNM is an effective non-pharmacological therapy for patients with AD.

PMID:34953330 | DOI:10.1016/j.gerinurse.2021.12.004

Stomatologiia (Mosk). 2021;100(6):50-55. doi: 10.17116/stomat202110006150.

ABSTRACT

OBJECTIVE: The aim of the study was to develop a technique for 3D analysis of the occlusal balance of teeth.

MATERIAL AND METHODS: The development was carried out on the basis of the Avantis 3D software («Avantis 3D» LLC, Russia) using teeth scans of 50 subjects with Class I and II (Division 1) malocclusion and different degree of tooth wear. The algorithm and formulas for calculating the balance of symmetry and antero-posterior occlusal balance are presented. The essential features of the technique and the interpretation of the obtained indicators are explained on different clinical cases. Statistical analysis of the results of measuring occlusal balance of patients with different degree of teeth wear and malocclusion is presented.

RESULTS: It is determined that the balance of common contacts is more important than the balance of direct contacts.

CONCLUSION: Alignment of teeth without noticeable wear provides a better occlusal balance then before. The occlusal balance of worn teeth after alignment may be not good and require selective grinding or restoration of their occlusal surfaces.

PMID:34953189 | DOI:10.17116/stomat202110006150

J Contam Hydrol. 2021 Dec 7;245:103936. doi: 10.1016/j.jconhyd.2021.103936. Online ahead of print.

ABSTRACT

The spatiotemporal characteristics and sources identification of agricultural nitrogen (N) and phosphorus (P) emissions to the gulf are rarely reported in tropical regions of China, mainly due to the lack of local reliable data and quantitative tools for spatiotemporal changes. In this study, we constructed a high-resolution NUFER (NUtrient Flow in food chains, Environment and Resources use) model based on geology, meteorology, land use data, statistical data, and field investigation to quantify the spatiotemporal characteristics and sources of N and P emissions. Bamen Bay (BMB), a bay with a mangrove national wetland Park in the Hainan Island, China, was chosen as a case study. The results showed that agricultural N emission to water in 2018 increased fivefold compared to 1990. Leaching was the main method of agricultural N emission and was mainly distributed in farms in the west and north. The contribution of N emission from crop system to water increased 20.3% in 28 years. Poultry and fruits have contributed the most to N output, and the trend is continuing. P emission to water increased sevenfold compared 1990. The contribution of P emission from animal system to water increased from 86.8% in 1990 to 90.1% in 2018 due to low removal rate of livestock manure. P emission was mainly via direct discharge of manure, mainly distributed in livestock breeding sites near the bay. Poultry has consistently contributed the most to P output in 28 years, accounting for 49.1% in 2018. Fertilizers and fodder were the largest sources of N and P. The average N and P loss rates of BMB were 5.32 t km² yr^-1 and 0.26 t km² yr^-1. The future agricultural transformation is essential, and it is necessary to reduce the application of N fertilizer and increase the removal rate of livestock manure. These results can provide reference for other typical agricultural pollution bays in exploring the spatiotemporal characteristics of N and P emissions to water and the identification of agricultural sources.

PMID:34953199 | DOI:10.1016/j.jconhyd.2021.103936

Stomatologiia (Mosk). 2021;100(6):24-28. doi: 10.17116/stomat202110006124.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the effectiveness of hyaluronic acid and chlorhexidine mouthwash in the treatment of peri-implant mucositis.

MATERIAL AND METHODS: Clinical and microbiological studies were conducted before and 14 days, 1, 3 and 6 months after the periodontal treatment in 46 patients (144 implants with fixed dentures) with peri-implant mucositis. The patients were divided into 3 groups: test, comparison and control. Basic periodontal therapy in all groups included professional cleaning and individual oral hygiene training. Test group (15 patients) received basic periodontal therapy plus 0.20% chlorhexidine with hyaluronic acid mouthwash, the comparison group (15 patients) – basic periodontal therapy +0.05% chlorhexidine mouthwash. In control group (16 patients), treatment was limited to basic periodontal therapy only.

RESULTS: At the initial stages of observations, there was a statistically significant improvement in the clinical indices in all treatment groups (p<0.001). The use of 0.20% chlorhexidine with hyaluronic acid mouthwash revealed a higher quality of treatment. After 6 months of observation, the clinical features in patients of the control group was almost similar to the state before treatment. The patients of the test group had a more pronounced elimination of facultative and periodontal pathogens in comparison with other groups.

CONCLUSION: The use of 0.20% chlorhexidine with hyaluronic acid containing mouthwash allows the clinician to achieve a better results in the treatment of peri-implant mucositis. The evaluation the oral microflora in patients with peri-implant mucositis can be used as a prognostic criterion for the outcomes of rehabilitation.

PMID:34953184 | DOI:10.17116/stomat202110006124