Tag: pubmed

Public Health. 2021 Dec 5;202:26-31. doi: 10.1016/j.puhe.2021.10.016. Online ahead of print.

ABSTRACT

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is one of the most common lower respiratory chronic diseases. The aim of this study was to analyze the COPD mortality trends in Croatia for the period 2010-2019 and to identify possible changes and differences by age group and gender.

STUDY DESIGN AND METHODS: In data analysis were included COPD death cases for the period 2010-2019 defined as ICD-10 code J44.0 – J44.9. Mortality data were obtained from the Croatian Institute of Public Health based on death certificates. To model temporal changes in mortality rates joinpoint regression analysis was carried out.

RESULTS: The number of COPD deaths increased in men from 878 in 2010 to 1083 in 2019 and in women from 520 in 2010 to 737 in 2019. Over the 10-year period, there was a stable age-standardized COPD mortality rate among men and statistically significant increasing age-standardized COPD mortality rate among women at the national level.

CONCLUSIONS: The findings show a narrowing of the gender gap of COPD mortality. Observed higher COPD mortality rates with age in both men and women confirm previous data and imply that the number of COPD deaths will continue to increase in the future. The healthcare system should focus on the improvement of the quality of care and investment in health promotion and prevention programs aimed at reducing risk factors for COPD, especially tobacco smoking, as well as raising awareness and knowledge about COPD as a chronic disease.

PMID:34879319 | DOI:10.1016/j.puhe.2021.10.016

Respir Med. 2021 Dec 2;191:106705. doi: 10.1016/j.rmed.2021.106705. Online ahead of print.

ABSTRACT

Diffusing capacity for carbon monoxide (DLCO) was measured in a phase I single ascending dose study after inhalation of AZD8154 or placebo in healthy participants at baseline (DLCO_Baseline) and follow-up (DLCO_Follow-up) 6 days after dosing. Initially, DLCO_Follow-up timepoint was 2 h earlier than the DLCO_Baseline timepoint and clinically significant decreases in DLCO_Follow-up (absolute change up to 19% from baseline and DLCO_%predicted values less than 70) were observed then. The observed reduction in DLCO_Follow-up was confirmed as a false positive finding after alignment of DLCO timings. As a consequence, when DLCO is used in clinical studies, measurements should be strictly standardized in relation to time of the day.

PMID:34879298 | DOI:10.1016/j.rmed.2021.106705

J Stroke Cerebrovasc Dis. 2021 Dec 5;31(2):106205. doi: 10.1016/j.jstrokecerebrovasdis.2021.106205. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to make a reasonable and accurate assessment of the prognosis of patients with pontine infarction. We assessed the changes in structure and function in the whole brain after pontine infarction from the acute to chronic phase using diffustion tensor imaging and functional magnetic resonance imaging.

MATERIALS AND METHODS: Sixteen individuals with a recent pontine infarction and sixteen healthy controls were recruited and underwent 3.0T DTI, resting-state fMRI and upper extremity Fugl-Myer (UE-FM) functional evaluation at five time points: within one week (T1), half a month (T2), one month (T3), three months (T4), and six months (T5) after onset. Tract-based spatial statistics was used to conduct a voxelwise analysis.

RESULTS: The fractional anisotropy (FA) values were significantly lower in the pontine infarction group than in the control group. Then, specific ROIs were analyzed. The FA values of 10 regions of interest were significantly increased at T2 compared with those at T1. The FA value of the corticospinal tract was significantly increased at T3 compared with that at T2. Regional brain activity results showed that the amplitude of low frequency fluctuations value of the frontal lobe decreased at T1, then increased. Finally, The UE-FM scores showed the same increased trend.

CONCLUSION: These findings show that the microstructure changes most significantly within half a month after pontine infarction and stabilizes after one month. The recovery of motor function in the later period is mainly caused by changes in the cortex. This facilitates more treatment options.

PMID:34879300 | DOI:10.1016/j.jstrokecerebrovasdis.2021.106205

Photodiagnosis Photodyn Ther. 2021 Dec 5:102674. doi: 10.1016/j.pdpdt.2021.102674. Online ahead of print.

ABSTRACT

PURPOSE: To compare the differences in retinal vascular structure and choroidal thickness between the active disease and post-recovery periods in COVID-19 patients and healthy controls.

MATERIAL AND METHODS: This prospective, cross-sectional study included 30 eyes from 30 patients with severe COVID-19 and 30 eyes of 30 sex-matched healthy controls. Central macular thickness (CMT), subfoveal choroidal thickness (CT) and retinal vascular changes of patients were measured after positive polymerase chain reaction (PCR) (where the patient had COVID-19-related symptoms) and then three months after two negative PCRs. Laboratory parameters, including C-reactive protein and D-dimer levels, were also recorded.

RESULTS: The mean age of the patients was 47.90 ± 9.06 years in patients group, 49.07 ± 8.41 years in control goups (p=0.467). In terms of choroidal thicknesses subfoveal, nasal and temporal region were significantly higher in the active disease period than control group (p=0.019, p=0.036, p=0.003, respectively). When the after recovery period was compared with the control group in terms of choroidal thickness, although the choroidal thickness was higher in all regions, this difference was not found statistically significant. There was no statistically significant difference in CMT between groups (p=0.506).The mean venous and arterial wall thicknesses were significantly higher in the active period than after recovery (p=0.023, p=0.013, respectively) but there were no differences between after recovery and control groups in the pairwise comparison (p=0.851, p=0.715, respectively).

CONCLUSION: In patients with severe COVID-19, there are changes in thickness of the choroid and retinal vessel walls. While vascular wall thickness increases due to inflammation, the absence of lumen changes may be associated with hemodynamic variables.

PMID:34879296 | DOI:10.1016/j.pdpdt.2021.102674

J Gynecol Obstet Hum Reprod. 2021 Dec 5:102281. doi: 10.1016/j.jogoh.2021.102281. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the thymic-thoracic ratio (TT ratio) on fetal ultrasound and its association with conotruncal heart defects.

METHODS: A case control study was carried out to retrospectively assess the TT ratio on fetal echocardiograms performed between 19 and 39 weeks of gestation, showing congenital heart defects, from January to December 2018. The control group was comprised of fetuses with no echocardiogram evidence of congenital cardiac malformations. Cases of multiple pregnancies and patients where the TT ratio could not be established have been excluded.

RESULTS: A total of 338 pregnancies have been analysed. Fifty-two pregnancies were diagnosed with fetal heart defects (15%), 17 of which showed conotruncal heart defects (32.7%). The TT ratio in normal fetuses (286 pregnancies) increased with gestational age, and had an average of 0.43 ± 0.06. Compared to the control group (normal fetuses), fetuses with conotruncal heart defects had significantly lower mean TT ratio (0.33 ± 0.07). Those that were diagnosed with nonconotruncal heart defects did not show any statistically significant difference in the TT ratios compared with the control group (0.40 ± 0.09 vs. 0.43 ± 0.06, respectively).

CONCLUSION: The TT ratio was significantly lower in fetuses with conotruncal heart defects compared with both the control group (normal fetuses) and the fetuses with nonconotruncal heart defects.

PMID:34879297 | DOI:10.1016/j.jogoh.2021.102281

J Affect Disord. 2021 Dec 5:S0165-0327(21)01326-4. doi: 10.1016/j.jad.2021.12.009. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aims to investigate the association between PM_2.5 exposure and major depressive disorder, and to examine whether vitamin D and physical activity could attenuate the impact of PM_2.5 on major depressive disorder.

METHODS: 39168 elderly adults (age≥60 years) who had valid estimates on exposure of PM_2.5 in 2010 and data on major depressive disorder were extracted from the UK Biobank. Major depressive disorder was assessed by lifetime experience of mild, moderate, and severe major depression with validated instruments. Logistic regression models were used to estimate the association between PM_2.5 exposure and major depressive disorder.

RESULTS: A total of 9079 participants had major depressive disorder, with a prevalence of 23.2%. The odds ratio (OR) of major depressive disorder was 1.096 (1.023, 1.175) for participants in the highest quartile compared with the lowest quartile of PM_2.5. The correlation of PM_2.5 with major depressive disorder generally increased with the decreasing levels of vitamin D. For instance, in participants with the highest quartile of PM_2.5, the corresponding ORs were 1.141 (0.951, 1.369), 1.232 (1.027, 1.478), 1.286 (1.072, 1.543), and 1.390 (1.159, 1.667) for those who had adequate, desirable, insufficient, and deficient levels of vitamin D, respectively. Additionally, significant modification effects of physical activity on the relationship between PM_2.5 and major depressive disorder were also observed.

CONCLUSIONS: Our study suggests that high levels of vitamin D and physical activity may attenuate the relationship between PM_2.5 and major depressive disorder among elderly adults.

PMID:34879260 | DOI:10.1016/j.jad.2021.12.009

Int J Infect Dis. 2021 Dec 5:S1201-9712(21)01204-2. doi: 10.1016/j.ijid.2021.12.310. Online ahead of print.

NO ABSTRACT

PMID:34879227 | DOI:10.1016/j.ijid.2021.12.310

J Dent. 2021 Dec 5:103918. doi: 10.1016/j.jdent.2021.103918. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy.

METHODS: Class I and class II resin composite restorations (n=220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer – GL) to form groups XXGL and ERGL. A bulk-fill resin composite (Tetric N-Ceram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months.

RESULTS: No significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05).

CONCLUSIONS: The previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used.

CLINICAL SIGNIFICANCE: The use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.

PMID:34879245 | DOI:10.1016/j.jdent.2021.103918

Hosp Pract (1995). 2021 Dec 8. doi: 10.1080/21548331.2021.2016334. Online ahead of print.

ABSTRACT

OBJECTIVES: Our project aimed to increase knowledge of non-invasive diagnostic modalities (including bone radiotracer scintigraphy), raise suspicion of transthyretin cardiac amyloidosis (ATTR-CA) and improve cardiology team member’s awareness and knowledge of shared decision-making (SDM) as well as the quality of SDM communication between cardiology team members and patients.

METHODS: An online educational module and survey was developed and cardiology team members in Colorado, USA were invited to participate. This online educational module included various important topics related to ATTR-CA (e.g., the cause of ATTR-CA, endomyocardial biopsy, and non-invasive methods to diagnose ATTR-CA) and SDM (e.g., benefits of SDM, the role of SDM in the diagnosis of ATTR-CA, implementation SDM in your cardiology practice and the 3-talk model).

RESULTS: There were 34 survey respondents, over one-third of whom were cardiologists. Most respondents agreed on the importance of diagnosing ATTR-CA at the early stage, and about three-quarters of the survey takers agreed that bone scintigraphy can reliably diagnose ATTR-CA without the need for endomyocardial biopsy. Concern for increased time commitment was the leading barrier to the implementation of SDM in respondents’ clinical practice. The majority of respondents identified the correct answer regarding ATTR-CA and SDM after reading the online educational module. This improvement in scores after exposure to the online educational module was statistically significant.

CONCLUSION: Baseline knowledge and awareness of various issues related to ATTR-CA was relatively low among cardiology team members. Participants’ knowledge was enhanced through our effective online educational program. Prospective educational projects focused on various methods of detecting ATTR-CA as well as other amyloid conditions in diverse clinical settings will remain important.

PMID:34879213 | DOI:10.1080/21548331.2021.2016334

Semin Thorac Cardiovasc Surg. 2021 Dec 5:S1043-0679(21)00494-9. doi: 10.1053/j.semtcvs.2021.12.003. Online ahead of print.

ABSTRACT

Anticoagulation could not be currently stopped even after successful thoracoscopic ablation of atrial fibrillation for at least two months. The aim of this study is to compare the safety and efficacy outcomes between a new oral anticoagulant and warfarin after thoracoscopic ablation. This trial was a single-center, prospective, randomized controlled study comparing edoxaban and warfarin in patients undergoing thoracoscopic ablation of atrial fibrillation. This study enrolled 60 patients randomly assigned into two groups. The primary endpoint was efficacy outcomes, including stroke and systemic thromboembolic events. The secondary endpoint was safety outcomes including major bleeding and pericarditis. The patients were evaluated at discharge, two weeks, three months, and six months postoperatively. No stroke and thromboembolic events were noted in both treatment groups during the follow-up period. During the 6 months follow-up period, 4 (13%) of 30 patients in the edoxaban group experienced minor bleeding events, whereas none were noted in the warfarin group. Five anticoagulation-related events (bleeding, and prolongation of international normalized ratio), including pericarditis, were noted in both the edoxaban and warfarin groups. No statistically significant difference existed between the two groups. In conclusion, this study showed the comparable results of edoxaban to warfarin during the window period of post-thoracoscopic ablation of atrial fibrillation. Moreover, anticoagulation-related events were rather affected by patient factors and not by the anticoagulant type.

PMID:34879226 | DOI:10.1053/j.semtcvs.2021.12.003