Tag: pubmed

Curr Med Res Opin. 2021 Apr 23:1. doi: 10.1080/03007995.2021.1920899. Online ahead of print.

ABSTRACT

OBJECTIVES: This study examined the incidence and predictors of antimuscarinic medication use including non-selective antimuscarinics among older adults with dementia and overactive bladder (OAB).

METHODS: The study used a new-user cohort design involving older adults (≥65 years) with dementia and OAB based on 2013-2015 Medicare Data. Antimuscarinics included non-selective (oxybutynin, tolterodine, trospium, fesoterodine) and selective (solifenacin, darifenacin) medications. Descriptive statistics and multivariable logistic regression models were used to determine the incidence and predictors of new antimuscarinic use including non-selective antimuscarinics, respectively.

RESULTS: Of the 3.38 million Medicare beneficiaries with dementia, over one million (1.05) had OAB (31.03%). Of those, 287,612 (27.39%) were reported as prevalent antimuscarinics users. After applying continuous eligibility criteria, 21,848 (10.34%) incident antimuscarinic users were identified [77.6% non-selective; 22.4% selective]. Most frequently reported antimuscarinics were oxybutynin (56.3%) and solifenacin (21.4%). Multivariable analysis revealed that patients ≥75 years, of black race, and those with schizophrenia, epilepsy, delirium, and Elixhauser’s score were less likely to initiate antimuscarinics. Women, those with abnormal involuntary moments, bipolar disorder, gastroesophageal reflux disease, insomnia, irritable bowel syndrome, muscle spasm/low back pain, neuropathic pain, benign prostatic hyperplasia, falls/fractures, myasthenia gravis, narrow-angle glaucoma, Parkinson’s disease, syncope, urinary tract infection and vulvovaginitis were more likely to initiate antimuscarinics. Further, patients with muscle spasms/low back pain, benign prostatic hyperplasia and those taking higher anticholinergics had lower odds of receiving non-selective antimuscarinics, whereas white patients, black patients and those with schizophrenia and delirium were more likely to receive them.

CONCLUSIONS: Nearly one-third of dementia patients had OAB and over one-fourth of them used antimuscarinics. Majority of the incident users were prescribed non-selective antimuscarinics with several demographic and clinical factors contributing to their prescribing. Given the high prevalence of OAB among dementia patients, there is a need to optimize their antimuscarinics use, considering their vulnerability for anticholinergic adverse effects.

PMID:33890538 | DOI:10.1080/03007995.2021.1920899

Curr Med Res Opin. 2021 Apr 23:1. doi: 10.1080/03007995.2021.1920900. Online ahead of print.

ABSTRACT

INTRODUCTION: Favipiravir is a repurposed drug to treat coronavirus 2019 (COVID-19). Due to a lack of available real-world data, we assessed its effectiveness and safety in moderately to critically ill COVID-19 patients.

METHODS: This retrospective study was conducted in two public/specialty hospitals in Saudi Arabia. We included patients (≥ 18 years) admitted April-August 2020 with confirmed SARS-CoV-2 diagnosed by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab. Patients received either favipiravir (1800 mg or 1600 mg BID loading dose, followed by 800 mg or 600 mg QD) or supportive-care treatment. Patients were excluded if they were outside the study period, classified as having a mild form of the disease per WHO criteria, or had an incomplete patient file. Kaplan-Meier (KM) models were used to estimate median time to discharge. Discharge ratios, progression to mechanical ventilation, and mortality outcomes were estimated across the severity spectrum using Cox proportional-hazards models. As a sensitivity analysis, we performed propensity score-matching (PSM) analysis.

RESULTS: Overall, median time to discharge was 10 days (95%CI =9-10) in the favipiravir arm versus 15 days (95%CI =14-16) in the supportive-care arm. The accelerated discharge benefit was seen across the COVID-19 spectrum of severity. The adjusted discharge ratio was 1.96 (95%CI =1.56-2.46). Progression to mechanical ventilation was slower with favipiravir (HR_adj=0.10, 95%CI =0.04-0.29). There was no significant effect on mortality (HR_adj=1.56, 95%CI =0.73-3.36). There was a statistically non-significant trend toward worse outcomes in the critical category (HR_adj=2.80, 95%CI =0.99-7.89). Age was an independent risk factor for mortality in mechanically ventilated patients. PSM analyses confirmed these findings.

CONCLUSION: Favipiravir was associated with clinical benefits, including accelerated discharge rate and less progression to mechanical ventilation; however, no overall mortality benefits were seen across the severity spectrum.

PMID:33890544 | DOI:10.1080/03007995.2021.1920900

J Appl Anim Welf Sci. 2021 Apr 23:1-29. doi: 10.1080/10888705.2021.1902811. Online ahead of print.

ABSTRACT

This research focused on different aspects of play behavior including ethogram, ontogeny, and individual differences, in one male and one female captive bottlenose dolphin calves (Tursiops truncatus) from November 2003 to June 2004. We presented the first peer-reviewed description of a play ethogram in bottlenose dolphin calves whose behaviors were grouped into three hierarchical levels: two categories: solitary and social play; four subcategories: locomotor, object, bubble play, and in the presence of humans, and 35 entries. It was conducted in two phases: the descriptive phase – from 3 to 5 months old – with 29 entries and the quantitative phase – from 6 to 10 months old -with six entries. All social and solitary locomotor behaviors appeared when animals were 3 months old meanwhile more complex behaviors concerning playing with objects, bubbles, and in the presence of humans were observed for 6 months old. There were no statistically significant intra-individual and inter-individual differences in the play behavioral diversity, in the time invested in play and in the Shannon’s evenness index. However, we observed statistically significant inter-individual but not intra-individual differences for the Shannon’s diversity index.

PMID:33890533 | DOI:10.1080/10888705.2021.1902811

Strabismus. 2021 Apr 23:1-7. doi: 10.1080/09273972.2021.1914677. Online ahead of print.

ABSTRACT

To evaluate the effect of monocular blur induced by Bangerter filters (BF) on visual acuity (VA) and stereoacuity. Monocular blur was induced by a range of Trusetal BF strengths (0.1, 0.2, 0.4, 0.6) to 23 visually normal adult volunteers (aged 18-25, mean age 20.33 ± 1.79 years). The right monocular and binocular logMAR VA and distance stereoacuity using the FD2 were measured at 6 m with no filter (baseline) and with each filter strength. The order of testing the filters was randomized. Results were analyzed using one factor repeated measures ANOVAs, t-tests using Bonferroni correction and Pearson’s product moment correlation. All filters degraded right monocular distance VA from baseline, but less significantly between the 0.4 and 0.6 filters than the other filters (p < .05 and p < .001, respectively). Degradation was in concordance with the labeled filter density, excluding filter strength 0.4. For all filter strengths, binocular VA was significantly but not clinically reduced from baseline (p < .05). Filters statistically and clinically significantly degraded distance stereoacuity from baseline (p < .001). A significant negative correlation existed between the mean degraded right monocular VA and stereoacuity (r = -0.998, p < .02). Trusetal BF significantly reduced monocular VA and stereoacuity but binocular VA remained within normal levels. The impact on VA and stereoacuity in a normal population can be of clinical relevance when applied to the use of BF for management of amblyopia and intractable diplopia. It is advised that clinicians ensure the desired level of degradation has been achieved in clinic before prescribing a particular filter strength.

PMID:33890535 | DOI:10.1080/09273972.2021.1914677

Strabismus. 2021 Apr 23:1-8. doi: 10.1080/09273972.2021.1914685. Online ahead of print.

ABSTRACT

INTRODUCTION: Alcohol Dependence Syndrome (ADS) is defined as excessive alcohol consumption accompanied by psychological, physical, social, and economic disorders. Alcohol consumption affects motor and proprioceptive functions, decreasing motor and cognitive functions and causing attention deficits. We aim to evaluate visual function and attention, and psychological profiles in consumer and abstainer ADS patients.

METHODS: This quantitative, descriptive, cross-sectional and correlational study evaluates visual function in a sample of ADS patients. The Portuguese version of the Brief Symptom Inventory was used to assess patients’ psychological status. The orthoptic examination protocol for visual function consisted of 11 standardized tests: VA for distance and near, ocular movements, near convergence and accommodation point, cover and prismatic cover tests, fusional vergence for distance and near, near stereoacuity, chromatic vision, contrast sensitivity and visual attention.

RESULTS: The sample included 176 patients. 121 were consumers and 55 were abstainers, aged between 31 and 72. The most affected parameters of visual function were visual acuity (80.39%), contrast sensitivity (67.50%), convergence at distance (66.44%) and near stereopsis (62.75%). Visual function was impacted in both groups. Regarding psychological status, consumers had higher averages for the Depression subscale, followed by Paranoid Ideation and Obsession. Abstainers had the highest averages in the Obsession subscale, followed by Paranoid Ideation and Depression. Statistically significant differences existed between the groups in the subscales for depression (p=.046) and paranoid ideation (p =.042).

CONCLUSION: Changes in visual function and attention, as well as psychopathological function, should be considered in the rehabilitation of ADS patients.

PMID:33890536 | DOI:10.1080/09273972.2021.1914685

Phys Act Nutr. 2021 Mar;25(1):30-34. doi: 10.20463/pan.2021.0005. Epub 2021 Mar 31.

ABSTRACT

PURPOSE: Many studies have observed a high prevalence of erectile dysfunction among individuals performing physical activity in less leisure-time. However, this relationship in patients with type 2 diabetic patients is not well studied. In exposure outcome studies with ordinal outcome variables, investigators often try to make the outcome variable dichotomous and lose information by collapsing categories. Several statistical models have been developed to make full use of all information in ordinal response data, but they have not been widely used in public health research. In this paper, we discuss the application of two statistical models to determine the association of physical inactivity with erectile dysfunction among patients with type 2 diabetes.

METHODS: A total of 204 married men aged 20-60 years with a diagnosis of type 2 diabetes at the outpatient unit of the Department of Endocrinology at PSG hospitals during the months of May and June 2019 were studied. We examined the association between physical inactivity and erectile dysfunction using proportional odds ordinal logistic regression models and continuation ratio models.

RESULTS: The proportional odds model revealed that patients with diabetes who perform leisure time physical activity for over 40 minutes per day have reduced odds of erectile dysfunction (odds ratio=0.38) across the severity categories of erectile dysfunction after adjusting for age and duration of diabetes.

CONCLUSION: The present study suggests that physical inactivity has a negative impact on erectile function. We observed that the simple logistic regression model had only 75% efficiency compared to the proportional odds model used here; hence, more valid estimates were obtained here.

PMID:33887826 | DOI:10.20463/pan.2021.0005

Phys Act Nutr. 2021 Mar;25(1):35-41. doi: 10.20463/pan.2021.0006. Epub 2021 Mar 31.

ABSTRACT

PURPOSE: This pilot study aimed to develop a regression model to estimate the excess post-exercise oxygen consumption (EPOC) of Korean adults using various easy-to-measure dependent variables.

METHODS: The EPOC and dependent variables for its estimation (e.g., sex, age, height, weight, body mass index, fat-free mass [FFM], fat mass, % body fat, and heart rate_sum [HR_sum]) were measured in 75 healthy adults ( 31 males, 44 females). Statistical analysis was performed to develop an EPOC estimation regression model using the stepwise regression method.

RESULTS: We confirmed that FFM and HR_sum were important variables in the EPOC regression models of various exercise types. The explanatory power and standard errors of estimates (SEE) for EPOC of each exercise type were as follows: the continuous exercise (CEx) regression model was 86.3% (R2) and 85.9% (adjusted R2), and the mean SEE was 11.73 kcal, interval exercise (IEx) regression model was 83.1% (R2) and 82.6% (adjusted R2), while the mean SEE was 13.68 kcal, and the accumulation of short-duration exercise (AEx) regression models was 91.3% (R2) and 91.0% (adjusted R2), while the mean SEE was 27.71 kcal. There was no significant difference between the measured EPOC using a metabolic gas analyzer and the predicted EPOC for each exercise type.

CONCLUSION: This pilot study developed a regression model to estimate EPOC in healthy Korean adults. The regression model was as follows: CEx = -37.128 + 1.003 × (FFM) + 0.016 × (HR_sum), IEx = -49.265 + 1.442 × (FFM) + 0.013 × (HR_sum), and AEx = -100.942 + 2.209 × (FFM) + 0.020 × (HR_sum).

PMID:33887827 | DOI:10.20463/pan.2021.0006

New Phytol. 2021 Apr 22. doi: 10.1111/nph.17328. Online ahead of print.

ABSTRACT

Lateral gene transfer (LGT) occurs in a broad range of prokaryotes and eukaryotes, occasionally promoting adaptation. LGT of functional nuclear genes has been reported among some plants, but systematic studies are needed to assess the frequency and facilitators of LGT. We scanned the genomes of a diverse set of 17 grass species that span more than 50 Ma of divergence and include major crops to identify grass-to-grass protein-coding LGT. We identified LGTs in 13 species, with significant variation in the amount each received. Rhizomatous species acquired statistically more genes, probably because this growth habit boosts opportunities for transfer into the germline. In addition, the amount of LGT increases with phylogenetic relatedness, which might reflect genomic compatibility among close relatives facilitating successful transfers. However, genetic exchanges among highly divergent species indicates that transfers can occur across almost the entire family. Overall, we showed that LGT is a widespread phenomenon in grasses that has moved functional genes across the grass family into domesticated and wild species alike. Successful LGTs appear to increase with both opportunity and compatibility.

PMID:33887801 | DOI:10.1111/nph.17328

Phys Act Nutr. 2021 Mar;25(1):23-29. doi: 10.20463/pan.2021.0004. Epub 2021 Mar 31.

ABSTRACT

PURPOSE: This preliminary study aimed to develop a regression model to estimate the non-exercise activity thermogenesis (NEAT) of Korean adults using various easy-to-measure dependent variables.

METHODS: NEAT was measured in 71 healthy adults (male n = 29; female n = 42). Statistical analysis was performed to develop a NEAT estimation regression model using the stepwise regression method.

RESULTS: We confirmed that ageA, weightB, heart rate (HR)_averageC, weight × HR_averageD, weight × HR_sumE, systolic blood pressure (SBP) × HR_restF, fat mass ÷ height2G, gender × HR_averageH, and gender × weight × HR_sumI were important variables in various NEAT activity regression models. There was no significant difference between the measured NEAT values obtained using a metabolic gas analyzer and the predicted NEAT.

CONCLUSION: This preliminary study developed a regression model to estimate the NEAT in healthy Korean adults. The regression model was as follows: sitting = 1.431 – 0.013 × (A) + 0.00014 × (D) – 0.00005 × (F) + 0.006 × (H); leg jiggling = 1.102 – 0.011 × (A) + 0.013 × (B) + 0.005 × (H); standing = 1.713 – 0.013 × (A) + 0.0000017 × (I); 4.5 km/h walking = 0.864 + 0.035 × (B) + 0.0000041 × (E); 6.0 km/h walking = 4.029 – 0.024 × (C) + 0.00071 × (D); climbing up 1 stair = 1.308 – 0.016 × (A) + 0.00035 × (D) – 0.000085 × (F) – 0.098 × (G); and climbing up 2 stairs = 1.442 – 0.023 × (A) – 0.000093 × (F) – 0.121 × (G) + 0.0000624 × (E).

PMID:33887825 | DOI:10.20463/pan.2021.0004

Arch Cardiol Mex. 2021;91(2):178-185. doi: 10.24875/ACM.20000071.

ABSTRACT

OBJECTIVE: Evaluate safety and effects of training at moderate and high intensity intervals (MIIT, HIIT) compared to continuous moderate intensity training (MICT) in heart disease patient with very high cardiovascular risk (CVR).

METHOD: Quasi-experimental study of 81 patients in a cardiac rehabilitation (CR) program, after risk stratification, all patients presented at least 2 factors with high CVR. All patients were provided supervised concurrent training: aerobic: initially 2 weeks MICT. subsequently MICT group with same prescription, MIIT 3 intervals of 3 ‘to 70-80% FCR with active pause exercise of 3’ to 60 a 70% FCR, HIIT 3 intervals of 3’a 80-90% FCR with active pause exercise of 3 ’70 a 80% FCR, resistance training 3 weekly sessions isotonic exercises and 1 calisthenics and multidisciplinary intervention.

RESULTS: 81 patients assigned to: 61 MICT group, 13 MIIT and 7 HIIT, no significant differences were observed. Percentage gains were obtained in METs-load 45%, 60% and 86% (p = 0.17) and watts 51, 44 and 48 in MICT, MIIT, HIIT respectively (p = 0.54). Although there are no statistical significant intergroup differences if there is a greater improvement in MET-load in the HIIT group. There was no adverse outcome in any training.

CONCLUSIONS: In very high cardiovascular risk heart disease patient, supervised interval training (MIIT/HIIT) is safe, with a tendency to greater improvement in exercise tolerance (METs-load) with HIIT compared to MICT.

PMID:33887755 | DOI:10.24875/ACM.20000071