Tag: pubmed

Arthrosc Sports Med Rehabil. 2021 Aug 31;3(6):e1729-e1736. doi: 10.1016/j.asmr.2021.07.032. eCollection 2021 Dec.

ABSTRACT

PURPOSE: To compare the long-term oncological outcome of minimally invasive curettage (MIC) with conventional open curettage (OC).

METHODS: We studied patients with primary giant cell tumor of bone (GCTB) of extremities who underwent intralesional tumor curettage and cementation and perioperative bisphosphonates from February 2003 to June 2016. All cases were histology-confirmed diagnoses of GCTB. Recurrent GCTB, malignant GCTB, cases in the axial skeleton (pelvis and spine), or cases with bone grafting of the curetted cavity were excluded. The local recurrence-free (LR-free) estimates of the OC and MIC groups were compared. The hazard ratio of a local recurrence was calculated for the various factors of the patients, disease, and treatment.

RESULTS: At a mean follow-up of 8.8 years, the overall LR rate was 24.2% (8 out of 33 patients). There was no statistical difference in LR in MIC and OC groups (27.8 % vs 20%; P = .6). The mean time to LR was 33.1 months (8 to 75). The operative time was comparable in both MIC and OC groups. None of the risk factors studied led to a significantly higher hazard of LR.

CONCLUSIONS: At a long-term follow-up of 9 years, MIC showed similar LR-free survival to OC. Combining bisphosphonates and MIC with a less invasive approach showed reasonable LR-free survival in long-term follow-up.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:34977627 | PMC:PMC8689217 | DOI:10.1016/j.asmr.2021.07.032

Korean J Parasitol. 2021 Dec;59(6):625-634. doi: 10.3347/kjp.2021.59.6.625. Epub 2021 Dec 22.

ABSTRACT

Based on the field investigations in 91 investigation sites (counties) in southwest China between 2001 and 2019, the present paper reported the chigger mites on A. agrarius mice in southwest China for the first time by using a series of statistical methods. From 715 striped field mice captured in 28 of 91 investigated sites, only 255 chiggers were collected, and they were identified as 14 species, 6 genera in 3 subfamilies under 2 families. Of 715 A. agrarius mice, only 24 of them were infested with chigger mites with low overall prevalence (PM=3.4%), overall mean abundance (MA=0.36 mites/host) and overall mean intensity (MI=10.63 mites/host). The species diversity and infestation of chiggers on A. agrarius were much lower than those previously reported on some other rodents in southwest China. On a certain species of rodent, A. agrarius mouse in southwest China seems to have a very low susceptibility to chigger infestations than in other geographical regions. Of 14 chigger species, there were 3 dominant species, Leptotrombidium sialkotense, L. rupestre and Schoengastiella novoconfuciana, which were of aggregated distribution among different individuals of A. agrarius hosts. L. sialkotense, one of 6 main vectors of scrub typhus in China, was the first dominant on A. agrarius. The species similarity of chigger mites on male and female hosts was low with CSS=0.25, and this reflects the sex-bias of different genders of A. agrarius mice in harboring different chigger species.

PMID:34974669 | DOI:10.3347/kjp.2021.59.6.625

J Pak Med Assoc. 2021 Oct;71(10):2415-2419.

ABSTRACT

Couple Years of Protection (CYP) is a proxy indicator for birth control protection. Using data from Pakistan Bureau of Statistics, spatial distribution of CYP percent change from 2015-2016 with 2016-2017 was compared by district for Population Welfare Departments, Health departments, and Lady Health Workers in the Punjab province. Spatial profile of CYP showed discernable differences by the three service providers. Local indicators of spatial autocorrelation showed significant districts by type of spatial autocorrelation including high-high, low-low, spatial clusters, as well as spatial outliers. The three service providers had different profile of clusters for percentage change from 2016 to 2017. Cluster and significance maps depict districts where CYP percent change is statistically significantly different or same from the neighbouring districts, and as such underscoring districts where additional focus on service delivery in terms of contraceptives provision could yield improved outcomes.

PMID:34974581

Anesth Pain Med (Seoul). 2021 Dec 31. doi: 10.17085/apm.21056. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to explore the distribution of intraoperative lactic acid (LA) level during liver transplantation (LT) and determine the optimal cutoff values to predict post-LT 30-day and 90-day mortality.

METHODS: Intraoperative LA data from 3,338 patients were collected between 2008 to 2019 and all-cause mortalities within 30 and 90 days were retrospectively reviewed. Of the three LA levels measured during preanhepatic, anhepatic, and neohepatic phase of LT, the peak LA level was selected to explore the distribution and predict early post-LT mortality. To determine the best cutoff values of LA, we used a classification and regression tree algorithm and maximally selected rank statistics with the smallest P value.

RESULTS: The median intraoperative LA level was 4.4 mmol/L (range: 0.5-34.7, interquartile range: 3.0-6.2 mmol/L). Of the 3,338 patients, 1,884 (56.4%) had LA levels > 4.0 mmol/L and 188 (5.6%) had LA levels > 10 mmol/L. Patients with LA levels > 16.7 mmol/L and 13.5-16.7 mmol/L showed significantly higher 30-day mortality rates of 58.3% and 21.2%, respectively. For the prediction of the 90-day mortality, 8.4 mmol/L of intraoperative LA was the best cutoff value.

CONCLUSIONS: Approximately 6% of the LT recipients showed intraoperative hyperlactatemia of > 10 mmol/L during LT, and those with LA > 8.4 mmol/L were associated with significantly higher early post-LT mortality.

PMID:34974648 | DOI:10.17085/apm.21056

J Pak Med Assoc. 2021 Oct;71(10):2330-2334. doi: 10.47391/JPMA.01-107.

ABSTRACT

OBJECTIVE: To compare the characteristics of connective tissue disease-associated interstitial lung disease with idiopathic pulmonary fibrosis at a tertiary care hospital.

METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised demographical, clinical and radiological data of patients with interstitial lung disease between October 2016 and October 2017 accessed through the outpatient data registry. Data was compared in terms of characteristics and key features of patients with connective tissue disease-associated interstitial lung disease with those of idiopathic pulmonary fibrosis. Statistical analysis was done using STATA 12.

RESULTS: Of the 184 patients, 52(29.3%) had connective tissue disease-associated interstitial lung disease and 62(35%) had idiopathic pulmonary fibrosis. The most prevalent conditions among connective tissue disease-associated interstitial lung disease patients were rheumatoid arthritis 22(42.3%) and scleroderma 13(25%). Compared to patients with idiopathic pulmonary fibrosis, those with connective tissue disease-associated interstitial lung disease were predominantly younger (p<0.001) and female (p<0.001). History of gastroesophageal reflux disease was also significantly lower in connective tissue disease-associated interstitial lung disease (p=0.05).

CONCLUSIONS: Connective tissue disease-associated interstitial lung disease patients were found to be younger and predominantly female compared to patients of idiopathic pulmonary fibrosis.

PMID:34974565 | DOI:10.47391/JPMA.01-107

Clin J Pain. 2021 Dec 31. doi: 10.1097/AJP.0000000000001017. Online ahead of print.

ABSTRACT

OBJECTIVES: First, we aimed to determine the feasibility of virtual reality (VR) distraction for children with cancer undergoing subcutaneous port (SCP) access. Second, we aimed to estimate preliminary treatment effects of VR compared to an active distraction control (iPad).

METHODS: A single-site pilot randomized controlled trial (RCT) comparing VR to iPad distraction was conducted. Eligible children were aged 8-18 years undergoing treatment for cancer with upcoming SCP needle insertions. Intervention acceptability was evaluated by child, parent, and nurse self-report. Preliminary effectiveness outcomes included child-reported pain intensity, distress, and fear. Preliminary effectiveness was determined using logistic regression models with outcomes compared between groups using pre-procedure scores as covariates.

RESULTS: Twenty participants (mean age 12▒y) were randomized to each group. The most common diagnosis was acute lymphocytic leukemia (n=23, 58%). Most eligible children (62%) participated, and one withdrew after randomization to the iPad group. Nurses, parents, and children reported the interventions in both groups to be acceptable, with the VR participants reporting significantly higher immersion in the distraction environment (P=0.0318). Although not statistically significant, more VR group participants indicated no pain (65% vs. 45%) and no distress (80% vs. 47%) during the procedure compared to the iPad group. Fear was similar across groups, with approximately 60% of the sample indicating no fear.

DISCUSSION: VR was feasible and acceptable to implement as an intervention during SCP access. Preliminary effectiveness results indicate that VR may reduce distress and distress compared to iPad distraction. These data will inform design of a future full-scale RCT.

PMID:34974512 | DOI:10.1097/AJP.0000000000001017

J Pak Med Assoc. 2021 Oct;71(10):2325-2329. doi: 10.47391/JPMA.01-085.

ABSTRACT

OBJECTIVE: To evaluate the effect parental attitudes have on the dental caries experience of children.

METHODS: The cross-sectional observational study was conducted at Yeditepe University, Istanbul, Turkey, from March to September 2019, and comprised mothers of children who came to the Department of Paediatric Dentistry for treatment of children. Multi-variable poisson regression model was run to predict prevalence of dental caries. Mothers’ attitudes in family were measured using the parental attitude research instrument scores. Data was analysed using Stata 15.

RESULTS: There were 258 mothers of as many children aged 6-15 years. Among the children, 150(58%) were boys and 108(42%) were girls. ‘Rejection of traditional housewife role’ and ‘level of discipline’ had a statistically negative correlation (p<0.05), while ‘level of marital conflict’ had a statistically positive correlation with the prevalence of caries.

CONCLUSIONS: Healthy family environment and empowering parental style had a positive effect on the oral health of children.

PMID:34974564 | DOI:10.47391/JPMA.01-085

Cancer Nurs. 2021 Dec 30. doi: 10.1097/NCC.0000000000001052. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with advanced cancer are increasingly experiencing financial hardship (FH) and associated negative health outcomes.

OBJECTIVE: The aims of this study were to describe FH and explore its relationship to quality of life (QOL) in patients with advanced cancer receiving outpatient palliative care (PC).

METHODS: Validated questionnaires assessed FH, QOL dimensions, symptom burden, and sociodemographic and clinical characteristics. Descriptive statistics characterized the sample and described FH. Pearson correlation and linear regression assessed relationships between FH and QOL.

RESULTS: The average participant (n = 78) age was 56.6 (SD, 12.2) years. Most were female (56.4%), White (50%) or Black (46.2%), and had a range of education, partner statuses, and cancer diagnoses. Median time since cancer diagnosis was 35.5 months (interquartile range, 9-57.3 months). Highest mean symptom burden scores were for pain (2.5 [SD, 1.0]) and fatigue (2.0 [SD, 1.1]), on a 0- to 3-point scale (higher score representing worse symptom burden). The median COST (COmphrehensive Score for financial Toxicity) score was 15.0 (interquartile range, 9.0-23.0). Most (70%) had some (n = 43) or extreme (n = 9) difficulty paying for basic needs. Greater than 28% (n = 21) incurred cancer-related debt. Multivariate models indicated that FH negatively affected role limitations due to physical health (P = .008), pain (P = .003), and emotional well-being (P = .017) QOL dimensions.

CONCLUSIONS: Financial hardship, QOL, and symptom burden scores demonstrate need for continued support for and research among patients with advanced cancer. Data support links between FH and important QOL dimensions. Larger, longitudinal studies are needed to understand how FH affects QOL in patients with advanced cancer.

IMPLICATIONS FOR PRACTICE: Proactive financial assessment and interventions are needed to support patients with advanced cancer experiencing the cumulative effects of cancer and its treatment.

PMID:34974507 | DOI:10.1097/NCC.0000000000001052

J Clin Gastroenterol. 2021 Dec 31. doi: 10.1097/MCG.0000000000001655. Online ahead of print.

ABSTRACT

INTRODUCTION: Intravenous immunoglobulin (IVIG) has been shown in a small pilot series to be helpful for some patients with gastroparesis that is refractory to drugs, devices, and surgical therapies. Many but not all patients have serologic neuromuscular markers. We hypothesize that those patients with serologic markers and/or longer duration of therapy would have better responses to IVIG.

MATERIALS AND METHODS: We studied 47 patients with a diagnosis of gastroparesis and gastroparesis-like syndrome that had all failed previous therapies including available and investigational drugs, devices, and/or pyloric therapies. Patients had a standardized 12-week course of IVIG, dosed as 400 mg/kg per week intravenously. Symptom assessment was done with Food and Drug Administration (FDA) compliant traditional patient-reported outcomes. Success to IVIG was defined as 20% or greater reduction in average symptom scores from baseline to the latest evaluation.

RESULTS: Fourteen patients (30%) had a response, and 33 (70%) had no response per our definition. Patients responding had a higher glutamic acid decarboxylase 65 positivity (64% vs. 30%, P=0.049, missing=3) and longer duration of therapy (>12 wk/continuous: 86% vs. 48%, P=0.09).

CONCLUSIONS: In this moderately sized open-label series of refractory patients with gastroparesis symptoms treated with IVIG, 30% of patients responded. While serologic markers and extended therapies show a trend to greater response, neither was statistically significant, except for glutamic acid decarboxylase 65 which showed a higher positivity rate in responders. We conclude that a clinical trial of IVIG may be warranted in severely refractory patients with gastroparesis symptoms.

PMID:34974494 | DOI:10.1097/MCG.0000000000001655

Nurs Educ Perspect. 2021 Dec 21. doi: 10.1097/01.NEP.0000000000000920. Online ahead of print.

ABSTRACT

AIM: This study investigated the impact of an interprofessional mock code on students’ comfort and competency related to Parkinson’s disease (PD) medication administration during care transitions.

BACKGROUD: Patients with PD are at increased risk for medication errors during hospitalization. Individualization of PD medication creates vulnerability during care transitions.

METHOD: Four interprofessional groups took part in this study: baccalaureate degree senior nursing students (n = 113), master’s level nurse anesthesia students (n = 35), doctor of osteopathic medicine fourth-year students (n = 32), and doctor of clinical psychology fourth-year students (n = 22). Groups participated in an unfolding case study simulation involving a mock code with a focus on the omission of time-sensitive PD medication. Pre- and postsimulation test results were compared.

RESULTS: Findings indicated an increased understanding among three of the four groups relating to medication timing during care transitions.

CONCLUSION: All groups improved with respect to perceived comfort and competency.

PMID:34974503 | DOI:10.1097/01.NEP.0000000000000920