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Nevin Manimala Statistics

Paediatric hospital admissions for psychiatric and psychosocial reasons during the first year of the COVID-19 pandemic

Int Rev Psychiatry. 2022 Feb 17;34(2):128-139. doi: 10.1080/09540261.2022.2061840. Epub 2022 May 22.

ABSTRACT

Increases in youth psychiatric presentations to out-patient and emergency department settings during COVID-19 have been reported. This study, using data from five hospitals in Ireland, examines changes in the number and type of paediatric admissions during COVID-19 (March 2020 – February 2021) compared to the previous two years. ICD-10 classification was used to establish admissions with mental, behavioural, neuro-developmental disorders and psychosocial reasons (MBN-PS). Overall hospital admissions fell by 25.3%, while MBN-PS fell by only 2.6%, mostly during an initial lockdown. Admissions for MBN-PS increased in July-August (9.2%), increased further in September-December (28.3%), returning to pre-COVID-19 levels in January-February 2021. Significant increases were observed among youths with anorexia nervosa (47.8%), other eating disorders (42.9%), and admissions for anxiety (29.6%), with these effects relating to females only. Although admissions for self-harm increased (3%) and rates of ASD admissions reduced (17%), these were not statistically significant. The disproportionate increase in admissions for MBN-PS compared to medical admissions suggests an adverse effect of COVID-19 on youth mental health, for females in particular, and supports previous reports of a pandemic specific increase in eating psychopathology. Combined community and acute service delivery and capacity planning are urgently needed given the prior underfunding of services pre-pandemic.

PMID:35699100 | DOI:10.1080/09540261.2022.2061840

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Sequencing of selected chromatin remodelling genes reveals increased burden of rare missense variants in ASD patients from the Japanese population

Int Rev Psychiatry. 2022 Feb 17;34(2):154-167. doi: 10.1080/09540261.2022.2072193. Epub 2022 May 12.

ABSTRACT

Chromatin remodelling is an important process in neural development and is related to autism spectrum disorder (ASD) and schizophrenia (SCZ) aetiology. To further elucidate the involvement of chromatin remodelling genes in the genetic aetiology of ASD and SCZ in the Japanese population, we performed a case-control study. Targeted sequencing was conducted on coding regions of four BAF chromatin remodelling complex genes: SMARCA2, SMARCA4, SMARCC2, and ARID1B in 185 ASD, 432 SCZ patients, and 517 controls. 27 rare non-synonymous variants were identified in ASD and SCZ patients, including 25 missense, one in-frame deletion in SMRACA4, and one frame-shift variant in SMARCC2. Association analysis was conducted to investigate the burden of rare variants in BAF genes in ASD and SCZ patients. Significant enrichment of rare missense variants in BAF genes, but not synonymous variants, was found in ASD compared to controls. Rare pathogenic variants indicated by in silico tools were significantly enriched in ASD, but not statistically significant in SCZ. Pathogenic-predicted variants were located in disordered binding regions and may confer risk for ASD and SCZ by disrupting protein-protein interactions. Our study supports the involvement of rare missense variants of BAF genes in ASD and SCZ susceptibility.

PMID:35699097 | DOI:10.1080/09540261.2022.2072193

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Nevin Manimala Statistics

Confounders contributing to explain the association between sex and disease impact in patients with recent-onset psoriatic arthritis

Clin Exp Rheumatol. 2022 Jun 13. doi: 10.55563/clinexprheumatol/077ul6. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of potential confounders on the association between sex and disease impact in recent-onset psoriatic arthritis.

METHODS: We performed a multicentre observational prospective study (2-year follow-up, regular annual visits). The study population comprised patients aged ≥18 years who fulfilled the CASPAR criteria and less than 2 years since the onset of symptoms. The dataset was generated using data for each patient at the 3 visits (baseline, first year, and second year of follow-up) matched with the PsAID values at each of the 3 visits. Once variables associated with both PsAID ≥4 and sex were selected, those that led to a difference of >10% between the adjusted and crude estimations were identified as potential confounders in the association between sex and PsAID. Lastly, the final multivariate logistic regression model estimating the association between sex and PsAID was defined.

RESULTS: The dataset contained 418 observations (158 at baseline, 135 at the first follow-up visit, and 125 at the second visit). The confounders identified in the multivariate model were HAQ, global pain, level of physical activity, and joint pattern at diagnosis. After adjustment for these variables, no statistically significant association was observed between female sex and PsAID ≥4.

CONCLUSIONS: The association between female sex and greater disease impact could be explained by the influence of other variables, specifically higher HAQ score, greater intensity of pain, differences in the level of physical activity and in the joint pattern at diagnosis (lower frequency of the spondylitis pattern in women).

PMID:35699067 | DOI:10.55563/clinexprheumatol/077ul6

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Ischaemic heart disease in Behçet’s syndrome: a systematic review and meta-analysis

Clin Exp Rheumatol. 2022 Jun 6. doi: 10.55563/clinexprheumatol/1shqmz. Online ahead of print.

ABSTRACT

OBJECTIVES: Behçet’s syndrome (BS) has been reported with cardiovascular involvement. It’s still unclear that BS is associated with the increased risk of ischaemic heart disease (IHD). We aimed to conduct a meta-analysis concerning the incidence of IHD in BS and identify the relationship between IHD and BS.

METHODS: We performed a comprehensive literature search based on PubMed and Embase databases up to 7 July, 2021. Incidence of IHD was calculated by metaproportion. Pooled risk ratio and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.

RESULTS: Four studies with 9237 patients with IHD in BS and 40353 controls were identified and included in our meta-analysis. The pooled risk ratio of IHD in patients with BS was 1.30 and achieved statistical significance (95% CI 1.04-1.64). The statistical heterogeneity was low with an I2 of 39% (p=0.18).

CONCLUSIONS: In this meta-analysis the presence of BS was associated with an increased risk of IHD. Prospective researches should be done to determine the pathophysiological and prognostic implications of increased IHD in BS.

PMID:35699061 | DOI:10.55563/clinexprheumatol/1shqmz

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Understanding Causes for Admission in Planned Ambulatory Percutaneous Nephrolithotomy

J Endourol. 2022 Jun 14. doi: 10.1089/end.2021.0811. Online ahead of print.

ABSTRACT

INTRODUCTION: For treatment of nephrolithiasis, ambulatory percutaneous nephrolithotomy (aPCNL) is growing in popularity for select patients. The aim of this study was to investigate the safety and efficacy of a set of aPCNL selection criteria as well as search for predictors of failed aPCNL resulting in inpatient admission.

METHODS AND MATERIALS: We reviewed all PCNL patients from 2016-2020. A total of 175 met selection criteria for aPCNL and were included. Primary outcome was safety and efficacy, and secondary outcome was to identify predictors of inpatient stay. Demographic and peri-operative data were analyzed with both descriptive and inferential statistics.

RESULTS: In total, between 2016-2020, 552 patients underwent PCNL, with 175 of them meeting criteria for aPCNL. 134/175 (76.6%) of these patients were successfully discharged the same day as the surgery and 41 patients were admitted. On univariate analysis, patients who required upper pole access or multiple accesses, (p=0.038) ASA>2 (p=0.005), or postoperative nephrostomy tube (PCN) (p<0.001) were more likely to be admitted after surgery. On multivariate analysis, only postoperative PCN was significantly associated with admission (p=0.015). Regarding reasons for unsuccessful aPCNL, 19.5% of admissions were attributed to intraoperative complications, 7% to social causes, 12.2% to postoperative complications, 14.6% to uncontrolled pain, and 34.1% to unexpected intraoperative procedures.

CONCLUSIONS: Ambulatory PCNL using selection criteria is safe and effective, with postoperative PCN predicting the possible necessity for conversion to inpatient admission. Furthermore, our study provides a practical algorithm for those opting to provide ambulatory PCNL to patients.

PMID:35699065 | DOI:10.1089/end.2021.0811

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Nevin Manimala Statistics

Onset and temporal sequencing patterns of comorbidity between lifetime major depression, panic disorder and fibromyalgia

Clin Exp Rheumatol. 2022 Jun 13. doi: 10.55563/clinexprheumatol/ryp027. Online ahead of print.

ABSTRACT

OBJECTIVES: Fibromyalgia (FM) is a syndrome of unknown aetiology characterised by chronic widespread musculoskeletal pain and associated with high rates of psychiatric comorbidities, mainly mood and anxiety disorders.This study aims to determine the age at onset (AAO) and temporal sequencing patterns of FM and its frequent and distinguishable psychiatric comorbidities, the major depressive episode/s (MDE), and panic disorder (PD).

METHODS: Diagnosis of MDE and PD were assigned using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV). The AAO of FM, MDE, and PD was defined using the event history calendar. All patients completed a sociodemographic data form, self-report questionnaires measuring FM-related symptoms and function, and the Childhood Trauma Questionnaire-28 (CTQ-28).

RESULTS: 98 (83%) of the 118 recruited patients with FM had at least one psychiatric comorbidity. Two main temporal patterns were identified among the 83 patients (70.3 %) who could reliably report the age at onset of FM and psychiatric comorbidities. In the concurrent comorbidity pattern (CCP), MDE and/or PD co-occurred with the onset of FM. In the sequential pattern (SP), the patients first developed PD, then MDE, and finally FM. FM patients with SP are overweight and younger than those with a CCP (FM concurrent with MDE and PD) and reported more childhood adversities, mainly sexual abuse. AAO of psychiatric comorbidities significantly differed between the two patterns.

CONCLUSIONS: The presence of different temporal comorbidity patterns may suggest prevention/early treatment interventions, especially in patients with childhood adversities and early-onset PD.

PMID:35699055 | DOI:10.55563/clinexprheumatol/ryp027

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Indoor Radon Exposure and COPD, Synergic Association? A Multicentric, Hospital-Based Case-Control Study in a Radon-Prone Area

Arch Bronconeumol. 2021 Oct;57(10):630-636. doi: 10.1016/j.arbr.2020.11.020.

ABSTRACT

BACKGROUND: COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results.

METHODS: A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression.

RESULTS: 189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41-3.06) for individuals exposed to more than 200Bq/m3 compared to those exposed to less than 50Bq/m3. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71-36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls.

CONCLUSIONS: No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.

PMID:35699045 | DOI:10.1016/j.arbr.2020.11.020

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6-Year Risk of Developing Lung Cancer in Spain: Analysis by Autonomous Communities

Arch Bronconeumol. 2021 Aug;57(8):521-527. doi: 10.1016/j.arbr.2020.03.033.

ABSTRACT

INTRODUCTION: Lung cancer screening with low-dose computed tomography (LDCT) has been proposed as a strategy to reduce lung cancer mortality. Since LDCT has side effects there is a need to carefully select the target population for screening programmes. Because in Spain health competences are transferred to the seventeen Autonomous Communities (ACs), the present paper aims to identify individuals at high risk of developing lung cancer in the different ACs.

METHODS: We used the 2011-2012 data of the Spanish National Interview Health Survey (n=21,006) to estimate the proportion of individuals at high risk of developing lung cancer using a 6-year prediction model (PLCOm2012). This proportion was then extrapolated into absolute figures for the Spanish population, using the population census data of 2018 from the National Institute of Statistics.

RESULTS: The proportion of individuals aged 50-74 with a risk of lung cancer ≥2% was 9.5% (15.9% in men, 3.5% in women). This proportion ranged from 6.6% in Región de Murcia to 12.7% in Andalucía and 13.0% in Extremadura. When extrapolated to the Spanish population, it was estimated that a total of 1,341,483 individuals may have a 6-year risk of lung cancer ≥2%.

CONCLUSIONS: The present study is the first one that evaluated the number of individuals at high risk of developing lung cancer in the different Spanish ACs using a prediction model and selecting people with a 6-year risk ≥2%. Further studies should assess the cost and effectiveness associated to the implementation of a lung cancer screening programme to such population.

PMID:35699029 | DOI:10.1016/j.arbr.2020.03.033

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The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure

Arch Bronconeumol. 2021 Nov;57(11):673-676. doi: 10.1016/j.arbr.2021.05.026.

NO ABSTRACT

PMID:35699002 | DOI:10.1016/j.arbr.2021.05.026

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Nevin Manimala Statistics

Neopterin as a predictive biomarker of postoperative atrial fibrillation following coronary artery bypass grafting

Kardiol Pol. 2022 Jun 14. doi: 10.33963/KP.a2022.0143. Online ahead of print.

ABSTRACT

BACKGROUND: Pathophysiology of postoperative atrial fibrillation (POAF) is multifactorial. Inflammation and increased oxidative stress play a significant role in POAF development. Neopterin, a biomarker of cellular immune response that enhances oxidative stress and increases the cytotoxic potential of activated macrophages and dendritic cells, was recently found as an independent predictive biomarker of non-operative atrial fibrillation. However, as far as we know, neopterin has never been investigated in POAF.

AIM: The study aimed to assess neopterin concentration as a prognostic biomarker of POAF following coronary artery bypass grafting (CABG).

METHODS: 101 (80.2% males, 85% off-pump, 15% on-pump) patients were included. Blood samples were taken from patients at three-time points: (1) before operation (NP0); (2) on the first day after the operation (NP1); and (3) between the fifth and eighth day after the procedure (NP5-8) for analysis of serum neopterin and high-sensitive C-reactive protein (hs-CRP). All factors (preoperative, echocardiographic, and surgical) significant in univariate analysis were included in a multivariable logistic regression analysis.

RESULTS: POAF occurred in 30 patients (30%). In the analyzed multivariable logistic regression models, the independent predictors of POAF occurrence were: higher NP0 concentration (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.02-1.38 for continuous and OR, 3.75; 95%CI, 1.39-10.1 for NP0 cut-off >8.7 nM/l), higher body mass index (OR, 1.15; 95% CI 1.02-1.29), history of pulmonary disease (OR, 6.72; 95% CI 1.57-28), increased diastolic thickness of interventricular septum (OR, 1.45; 95% CI, 1.14-1.83), and duration of operation (OR, 1.01; 95% CI, 1.03-1.36).

CONCLUSIONS: We found that elevated neopterin concentration before CABG may be a predictive biomarker of POAF.

PMID:35698968 | DOI:10.33963/KP.a2022.0143