Tag: pubmed

Int J Gynaecol Obstet. 2022 Mar 25. doi: 10.1002/ijgo.14191. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the predictive accuracy of admission cardiotocography as a screening test for perinatal asphyxia in high-risk parturients.

METHODS: A prospective study was done on a group of 180 high-risk parturients in the labor ward of Aminu Kano teaching Hospital were subjected to a 30-minute admission cardiotocography. Results were categorized based on the RCOG criteria. Those with normal results were allowed to progress in labor, while those with abnormal results had their delivery expedited. Umbilical artery blood gas analysis was done at delivery. Measured variables were expressed in descriptive statistics. Tests of association for categorical variables were done using the non-parametric chi-square test (p-value of ≤ 0.05). The Binary logistic regression model was used to control potential confounders.

RESULTS: After excluding five cord blood samples, 175 samples were analyzed. The CTG was reassuring in 149 (85.1%), non-reassuring in 15 (8.6%) and abnormal in 11 (6.3%) women. Fetal distress developed in 5 (3.4%) and 7 (46.7%) of reassuring and non-reassuring respectively. The test had 91% sensitivity, specificity was 68.8%, and the predictive accuracy was 88.6% for asphyxia using base deficit.

CONCLUSION: The admission CTG is useful in detecting fetuses at risk of perinatal asphyxia in high- risk deliveries.

PMID:35332538 | DOI:10.1002/ijgo.14191

Environ Sci Pollut Res Int. 2022 Mar 25. doi: 10.1007/s11356-022-18699-w. Online ahead of print.

ABSTRACT

Today, according to the occurrence of numerous disasters in allover over the world, designing the proper and comprehensive plan for relief logistics has received a lot of attention from crisis managers and people. Besides, considering resilience capability along with operational and disruption risks leads to the robustness of the humanitarian relief chain (HRC), and this comprehensive framework ensures the essential supplies delivery to the beneficiaries and is close to real-world problems. The resilience parameters used for the second objective are obtained by a strong Best Worst Method (BWM). Another supposition of the model is the consideration of uncertainty in all stages of the proposed problem. Moreover, the multiple disasters (sub-sequent minor post disasters) which can increase the initial demand are considered. Furthermore, the proposed model is solved using three well-known metaheuristic algorithms includes non-dominated sorting genetic algorithm (NSGA-II), network reconfiguration genetic algorithm (NRGA), and multi-objective particle swarm optimization (MOPSO), and their performance is compared by several standard multi-objective measure metrics. Finally, the obtained results show the robustness of the proposed approaches, and some directions for future researches are provided.

PMID:35332457 | DOI:10.1007/s11356-022-18699-w

Intern Emerg Med. 2022 Mar 24. doi: 10.1007/s11739-022-02971-5. Online ahead of print.

ABSTRACT

Insufficient information is available about co-factors favoring the progression of non-alcoholic fatty liver disease (NAFLD) toward cirrhosis. We aimed to evaluate the impact of a limited alcohol intake and of occult hepatitis B virus (HBV) infection (OBI) on the severity of NAFLD. Three-hundred-seventy-four alcohol non-abusers and HBV surface antigen negative NAFLD patients (223 males; mean age 55.4 years), consecutively admitted to the outpatients clinic of a referral liver unit from January 1st, 2018 to December 31st, 2019, were studied. Anti-HBV core antigen antibody [(anti-HBc), a surrogate marker of OBI] was assessed in all patients. Patients were distinguished between teetotal and moderate alcohol consumers (intake of less than 30 g and 20 g if males or females, respectively). Liver fibrosis was non-invasively assessed by FIB-4 and transient elastography. Uni- and multivariate analyses were performed to identify predictors of advanced fibrosis. Patients had a mean BMI of 28.5 kg/m², and the majority presented metabolic and cardio-vascular comorbidities [258 patients (69%) had insulin resistance/diabetes, 249 (66.6%) dyslipidemia, 200 (53.5%) arterial hypertension]. Multivariate analysis showed that anti-HBc positivity (p = 0.046, OR 2.153) was a factor associated with advanced fibrosis at FIB-4 score testing, whereas moderate alcohol intake was not associated with severe NAFLD both at FIB-4 and transient elastography evaluations. The study showed that a moderate alcohol intake has no impact on NAFLD severity and suggested that OBI might negatively affect the NAFLD outcome.

PMID:35332431 | DOI:10.1007/s11739-022-02971-5

Pharmacoeconomics. 2022 Mar 25. doi: 10.1007/s40273-022-01141-x. Online ahead of print.

ABSTRACT

Evidence about the relative effects of new treatments is typically collected in randomised controlled trials (RCTs). In many instances, evidence from RCTs falls short of the needs of health technology assessment (HTA). For example, RCTs may not be able to capture longer-term treatment effects, or include all relevant comparators and outcomes required for HTA purposes. Information routinely collected about patients and the care they receive have been increasingly used to complement RCT evidence on treatment effects. However, such routine (or real-world) data are not collected for research purposes, so investigators have little control over the way patients are selected into the study or allocated to the different treatment groups, introducing biases for example due to selection or confounding. A promising approach to minimise common biases in non-randomised studies that use real-world data (RWD) is to apply design principles from RCTs. This approach, known as ‘target trial emulation’ (TTE), involves (1) developing the protocol with respect to core study design and analysis components of the hypothetical RCT that would answer the question of interest, and (2) applying this protocol to the RWD so that it mimics the data that would have been gathered for the RCT. By making the ‘target trial’ explicit, TTE helps avoid common design flaws and methodological pitfalls in the analysis of non-randomised studies, keeping each step transparent and accessible. It provides a coherent framework that embeds existing analytical methods to minimise confounding and helps identify potential limitations of RWD and the extent to which these affect the HTA decision. This paper provides a broad overview of TTE and discusses the opportunities and challenges of using this approach in HTA. We describe the basic principles of trial emulation, outline some areas where TTE using RWD can help complement RCT evidence in HTA, identify potential barriers to its adoption in the HTA setting and highlight some priorities for future work.

PMID:35332434 | DOI:10.1007/s40273-022-01141-x

Oral Radiol. 2022 Mar 24. doi: 10.1007/s11282-022-00605-2. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine the diagnostic usefulness and procedures of ultrasonography (US) for mass lesions in the soft tissue of the oral region.

METHODS: This study involved patients with mass lesions (tumorous lesions and cysts) who had undergone US and histopathological examinations from January 2017 to December 2019. The following points were evaluated by two observers using an evaluation scale: vascularity, echo intensity level, boundary, margin shape, distribution of internal echoes, and capsule. The usefulness of each point for differential diagnosis of tumorous lesions and cysts was statistically analyzed.

RESULTS: Forty-five mass lesions in the soft tissue of the oral region (33 tumorous lesions and 12 cysts) were analyzed. There were significant differences in four evaluation points between the tumorous lesions and cysts: vascularity, echo intensity level, boundary, and margin shape. Cysts were almost completely excluded diagnostically, especially when vascularity was observed. There were also significant differences in two evaluation points between nonvascular tumorous lesions and cysts: echo intensity level and boundary.

CONCLUSIONS: In US examination for mass lesions in the oral region, it was possible to diagnose tumorous lesions and exclude cysts when vascularity was observed. When vascularity was not observed, however, tumorous lesions and cysts could be identified using two evaluation points: echo intensity level and boundary.

PMID:35332418 | DOI:10.1007/s11282-022-00605-2

Aesthetic Plast Surg. 2022 Mar 24. doi: 10.1007/s00266-022-02838-2. Online ahead of print.

ABSTRACT

BACKGROUND: Prominent ear deformity is an autosomal dominant inherited deformity. Surgery is the most effective treatment method for prominent ear patients. Different prominent ear operations have been described in the literature. In this study, it is aimed to compare the transcutaneous fixation-assisted method that we described in prominent ear repair with the classical needle-assisted method.

METHODS: Patients who were operated for bilateral prominent ear deformity between January 2017 and January 2020 were included in the study. Two different approaches were used in the operations. In the first group, conventional needles were used to adjust the position of the concha-scaphal sutures. In the second group, transcutaneous suturing was used to adjust the position of the concha-scaphal sutures. The duration of the operation was recorded. Patients were called for controls in 1-3-6 and 12th months; photographs were taken. Measurements were made in the preoperative period, in the intraoperative and at the postoperative 12th month. SPSS program was used for statistical analysis.

RESULTS: A total of 52 patients were included in the study. There were 27 patients in Group 1and 25 patients in Group 2. There was no significant difference between the groups in terms of demographic characteristics (p>0.05). While the average operation time was 80.37 minutes in Group 1, the average operation time was 60.40 minutes in Group 2. The operative times between the groups were statistically significant (p<0.05). There was no statistically significant difference between the groups in preoperative, intraoperative and postoperative measurements (p>0.05).

CONCLUSIONS: As a result, transcutaneous fixation-assisted method is performed faster than the classical needle-assisted method and the results are understood right at the beginning of the operation.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:35332407 | DOI:10.1007/s00266-022-02838-2

J Clin Rheumatol. 2022 Apr 1;28(3):113-119. doi: 10.1097/RHU.0000000000001811.

ABSTRACT

BACKGROUND: Identification of infection in patients with systemic lupus erythematosus (SLE) is a major challenge in clinical practice.

OBJECTIVE: This medical records review study evaluated clinical markers, including the performance of C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in the diagnosis of infection in SLE patients.

METHODS: One hundred four SLE patients hospitalized between 2014 and 2018 were allocated into 3 groups, namely, infection, infection and disease activity, and isolated disease activity. Groups were compared in relation to clinical and laboratory variables. Accuracy measures were calculated for CRP, NLR, and PLR.

RESULTS: C-reactive protein, NLR, and PLR differed between the groups with higher values observed in the infected group, intermediate values in the mixed group, and lower values in the group with isolated activity-CRP (56 vs 26 vs 15 mg/dL, p = 0.002), NLR (7.9 vs 4.0 vs 3.1, p = 0.005), and PLR (270 vs 227 vs 134, p = 0.025). Fever, tachypnea, and PLR were independently associated with infection. The cutoff points of the CRP of 20 mg/L, NLR of 3.5, and PLR of 151.4 presented values of sensitivity and specificity for the prediction of infection equal to 67% and 67%, 65% and 58%, and 71% and 53%, respectively. The developed algorithm showed a sensitivity of 86.6% and specificity of 81% for the diagnosis of infection.

CONCLUSIONS: The combined use of clinical and laboratory markers presented superior accuracy than their isolated use, suggesting a great potential for the application of the algorithm in clinical practice.

PMID:35325899 | DOI:10.1097/RHU.0000000000001811

Altern Ther Health Med. 2022 Mar 24:AT7140. Online ahead of print.

ABSTRACT

CONTEXT: The onset of the COVID-19 pandemic has resulted in an increasingly sedentary lifestyle among people working from home (WFH), including 71% of Information and Technology (IT) workers. The lifestyle lacks physical activity and also affects people emotionally, which can lead to serious ailments.

OBJECTIVE: The study aimed to identify and understand the burden from gastrointestinal complaints on individuals in the IT sector, who have been working from home due to the COVID-19 pandemic and lockdown.

DESIGN: The researcher designed an online, cross-sectional survey, which was prepared on Google Forms.

SETTING: The study was conducted in Dr. D. Y. Patil Homoeopathic Medical College and Research Centre, Pune, India.

PARTICIPANTS: Participants were 101 WFH workers in the IT sector in the Maharashtra state of India.

OUTCOME MEASURE: The survey comprised a set of 28 questions on gastrointestinal health. The responses were analyzed to understand the types of gastric troubles that respondents had experience. Descriptive statistics were used to analyze the data.

RESULTS: The study included 101 responses for analysis. Most respondents were from 26 to 30 years of age (47.5%). Gender was not identified as an affecting variable. The author did not find any correlation between the variables. Of the 101 respondents, 49 (48.5%) of respondents had experienced gastric troubles since working from home in lockdown.

CONCLUSIONS: The complaints of the current study’s respondents suggest an incidence of diseases after lockdown, such as acid peptic disease, first degree hemorrhoids, fissure in ano, gastritis, and irritable bowel syndrome. Together with physical ailments, many people have had a varied mental symptomatology that can be likely to give rise to psychosomatic diseases.

PMID:35325873

Biomed Phys Eng Express. 2022 Mar 24. doi: 10.1088/2057-1976/ac60c4. Online ahead of print.

ABSTRACT

The Gleason grade system is the main standard to quantify the aggressiveness and progression of prostate cancer. Currently, exists a high disagreement among experts in the diagnosis and stratification of this disease. Deep learning models have emerged as an alternative to classify and support experts automatically. However, these models are limited to learn a rigid stratification rule that can be biased during training to a specific observer. Therefore, this work introduces an embedding representation that integrates an auxiliary task learning to deal with the high inter and intra appearance of the Gleason system. The proposed strategy implements as a main task a triplet loss scheme that builds a feature embedding space with respect to batches of positive and negative histological training patches. As an auxiliary task is added a cross-entropy that helps with inter-class variability of samples while adding robust representations to the main task. The proposed approach shows promising results achieving an average accuracy of 66% and 64%, for two experts without statistical difference. Additionally, reach and average accuracy of 73% in patches where both pathologists are agree, showing the robustness patterns learning from the approach.

PMID:35325887 | DOI:10.1088/2057-1976/ac60c4

Int J Pediatr Otorhinolaryngol. 2022 Mar 17;156:111112. doi: 10.1016/j.ijporl.2022.111112. Online ahead of print.

ABSTRACT

OBJECTIVES: To reveal the risk situations of ROP patients in terms of hearing loss by examining the newborn hearing screening test results.

METHODS: Hearing screening test results of ROP patients and newborns with similar congenital risk factors(control group) treated in our hospital were retrospectively screened. Both groups were compared in terms of newborn hearing screening test results.

RESULTS: In the first screening test, the rate of ”refer” result in the ROP group was significantly higher than the control group (p < 0.05). There was no significant difference between the two groups in terms of second hearing screening test results (p > 0.05). In the second screening test, 100% of stage 3 ROP patients failed from the right ear and 80% in the left ear, and this difference was statistically significant compared to the other two groups (p < 0.05).

CONCLUSION: Newborn hearing screenings of patients with advanced stage ROP patients should be followed up more sensitively, since stage 3 ROP patients had more failure results from the screening test in our study.

PMID:35325847 | DOI:10.1016/j.ijporl.2022.111112