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Nevin Manimala Statistics

The relationship of frontal QRS-T angle between patients with newly diagnosed true and white coat hypertension

Blood Press Monit. 2022 Apr 18. doi: 10.1097/MBP.0000000000000597. Online ahead of print.

ABSTRACT

OBJECTIVES: The frontal QRS-T (f-QRST) angle is a measure of depolarization and repolarization heterogeneity and may be a predictor of poor ventricular health. We aimed to investigate whether the f-QRST angle indicates myocardial damage and predicts newly diagnosed true hypertension (HT) in patients with white coat hypertension.

METHODS: We measured the f-QRST angle of 63 subjects with WHC and 105 patients with newly diagnosed HT. Laboratory tests and ABPM were followed up in all patients. The f-QRST angle was calculated on the surface ECGs.

RESULTS: Of the patients in the study, 38.9% were female and 61.1% were male. The mean age was calculated as 59 ± 11 years. A comparison between both groups with the f-QRST angles was seen to be statistically significantly higher in the true HT group. The results of the receiving operating characteristic curve showed that the AUC value of the f-QRST angle was 0.94 (95% confidence interval, 0.91-0.97), the cutoff value was 60.5°, the sensitivity was 89.5%, and the specificity was 81%.

CONCLUSION: In our study, the f-QRST angle was found to be lower in patients with WHC than in true hypertensive patients. We think that ECG, which is a simple test, can be used to distinguish between true HT and WHC.

PMID:35438080 | DOI:10.1097/MBP.0000000000000597

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Perceived Physical and Mental Health and Healthy Eating Habits During the COVID-19 Pandemic in Korea

J Korean Med Sci. 2022 Apr 18;37(15):e118. doi: 10.3346/jkms.2022.37.e118.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has disrupted the lives of people around the world since 2020. This study aims to reveal perceived impact of the coronavirus pandemic on physical and mental health and eating behaviors among people with disabilities and without disabilities in South Korea, as compared to other countries.

METHODS: A secondary analysis of a prospective cross-sectional study which was conducted with a web-based global survey.

RESULTS: Among the 3,550 responses from 65 countries, 2,621 responses with nation information were set as full data, 189 for South Korea and 2,432 for other countries. In Korea, there was no significant difference in healthy lifestyle behaviors between people with and without disabilities before the COVID-19 pandemic. Perceived physical and mental health and changes in eating habits during the COVID-19 pandemic showed no significant difference between people with and without disabilities in Korea. There were significant differences in physical health and dietary habits, but no differences in its effect on mental health between people living in Korea and other countries in both people with and without disabilities groups. In other words, more than 60% of people in all groups (disability vs. non-disability, Korea vs. non-Korea) reported worse mental health than before the COVID-19 pandemic.

CONCLUSION: In Korea and other countries, mental health showed a tendency to deteriorate regardless of the presence or absence of disability during the COVID-19 pandemic. In terms of healthy eating habits, Koreans were relatively less affected than people from other countries.

PMID:35437966 | DOI:10.3346/jkms.2022.37.e118

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Comparison of the efficacy and safety of transurethral laser versus open prostatectomy for patients with large-sized benign prostatic hyperplasia: A meta-analysis of comparative trials

Investig Clin Urol. 2022 Apr 12. doi: 10.4111/icu.20210281. Online ahead of print.

ABSTRACT

PURPOSE: The selection of open prostatectomy (OP) over transurethral laser surgery is controversial for large volume prostates. Thus, we aim to compare the efficacy and safety of transurethral laser versus OP, and provide the latest evidence of clinical practice for large-sized benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS: This meta-analysis used Review Manager V5.3 software and the systematic literature search of Cochrane Library, Embase, PubMed, and Web of Science datasets was performed for citations published from 2000 to 2020 that compared transurethral laser with OP for the treatment of large BPH. Variables of interest assessing the two techniques included clinical characteristics, and the perioperation-, effectiveness-, and complication-related outcomes.

RESULTS: The meta-analysis included twelve studies containing 1,514 patients, with 792 laser and 722 OP. The transurethral laser group was associated with shorter hospital stay and catheterization duration, and less hemoglobin decreased in the perioperative variables. There was no significant difference in the international prostate symptom score, post-void residual urine volume, maximum flow rate, and quality of life score. Transurethral laser group had a significantly lower incidence of blood transfusion than OP group (odds ratio, 0.10; 95% confidence interval, 0.05 to 0.19; p<0.001; I²=8%), and no statistical differences were found with respect to the other complications.

CONCLUSIONS: Both OP and transurethral laser prostatectomy are effective and safe treatments for large prostate adenomas. With these advantages of less blood loss and transfusion, and shorter catheterization time and hospital stay, laser may be a better choice for large BPH.

PMID:35437960 | DOI:10.4111/icu.20210281

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Sacubitril/valsartan attenuates atrial structural remodelling in atrial fibrillation patients

ESC Heart Fail. 2022 Apr 18. doi: 10.1002/ehf2.13937. Online ahead of print.

ABSTRACT

AIMS: Radiofrequency catheter ablation (RFCA) is now an established therapeutic option for patients with atrial fibrillation (AF), but the long-term recurrence rate of AF is still high. Sacubitril/valsartan (Sac/Val) is superior to valsartan in attenuating ventricular remodelling and improving clinical outcomes in heart failure patients, but whether this additional benefit exists in reversing atrial remodelling and reducing AF recurrence of RFCA-treated AF patients remains uncovered.

METHODS AND RESULTS: Patients that had undergone RFCA were enrolled and randomly assigned 1:1 to valsartan (160 mg/day) or Sac/Val (200 mg/day) treatment group, in addition to other standard treatment of AF. Patients were followed up for 24 weeks. Echocardiography and ambulatory Holter monitoring for 24 h was performed at 24 weeks after RFCA. The primary end point was the change of atrial diameter from baseline to 24 weeks after RFCA. Second end points included the recurrence rate of AF, all-cause hospitalization and all-cause death. A total of 64 AF patients were enrolled, 32 of which received Sac/Val and 32 received valsartan treatment. There was no difference in the age (64.8 ± 9.8 vs. 63.7 ± 9.0, P = 0.634), gender (per cent of male: 59.4% vs. 50.0%, P = 0.616), heart rate (84.7 ± 4.1 b.p.m. vs. 80.9 ± 2.6 b.p.m., P = 0.428), systolic (127.5 ± 15.4 mmHg vs. 130.0 ± 17.8 mmHg, P = 0.549) or diastolic (81.7 ± 9.8 mmHg vs. 79.9 ± 12.6, P = 0.537) blood pressure upon admission between valsartan and Sac/Val treatment groups. The percentage of persistent AF was also comparable (43.8% vs. 53.1%, P = 0.617) in both treatment groups. Patients receiving Sac/Val treatment displayed significant decrease in the left atrial diameter (4.3 ± 0.5 cm to 3.8 ± 0.5 cm, P < 0.001), volume index (48.0 ± 6.4 mL/m2 to 41.7 ± 7.0 mL/m2 , P < 0.001), and right atrial diameter (4.4 ± 0.8 cm to 3.9 ± 0.7 cm, P = 0.017) from baseline to 24 weeks after RFCA. This effect was not observed in valsartan treatment group. There was a numerical decrease in AF recurrence rate in the Sac/Val group compared with valsartan group (9.4% vs. 15.6%), although this difference did not reach a statistical significance (P = 0.708). No difference in all-cause hospitalization rate (6.3% in each group) or all-cause death rate (0% in each group) was observed.

CONCLUSIONS: Our data indicate that Sac/Val is superior to valsartan in attenuating atrial structural remodelling in catheter ablation-treated AF patients.

PMID:35437929 | DOI:10.1002/ehf2.13937

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Clinical outcomes of EGFR+/METamp+ vs. EGFR+/METamp- untreated patients with advanced non-small cell lung cancer

Thorac Cancer. 2022 Apr 18. doi: 10.1111/1759-7714.14429. Online ahead of print.

ABSTRACT

BACKGROUND: MET dysregulation has been implicated in the development of primary and secondary resistance to EGFR tyrosine kinase inhibitor (TKI) therapy. However, the clinicopathological characteristics and outcomes of patients harboring EGFR-sensitive mutations and de novo MET amplifications still need to be explored.

METHODS: A total of 54 patients from our hospital with non-small cell lung cancer harboring EGFR-sensitive mutations and/or de novo MET amplifications were included in this study. Survival rates were estimated by the Kaplan-Meier method with log-rank statistics. Lung cancer organoids (LCOs) were generated from patient-derived malignant pleural effusion to perform drug sensitivity assays.

RESULTS: Fifty-four patients with the appropriate clinicopathological characteristics were enrolled. MET FISH was performed in 40 patients who were stratified accordingly into two groups: EGFR+/METamp- (n = 22) and EGFR+/METamp + (n = 18). Survival rates for EGFR+/METamp- and EGFR+/METamp + patients respectively, were as follows: the median progression-free survival (PFS) was 12.1 and 1.9 months (p<0.001); the median post-progression overall survival (pOS) was 25.6 and 11.6 months (p = 0.023); the median overall survival (OS) was 33.2 and 12.7 months (p = 0.013). Drug testing conducted in LCOs derived from malignant pleural effusion from EGFR+/METamp + patients showed that dual targeted therapy was more effective than TKI monotherapy.

CONCLUSION: EGFR+/METamp + patients treated with first-line TKI monotherapy had poor clinical outcomes. Dual targeted therapy showed potent anticancer activity in the LCO drug testing assay, suggesting that it is a promising first-line treatment for EGFR+/METamp + patients. Randomized controlled trials are needed to further validate these results.

PMID:35437920 | DOI:10.1111/1759-7714.14429

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Preoperative skin asepsis protocols using chlorhexidine versus povidone-iodine in veterinary surgery: A systematic review and meta-analysis

Vet Surg. 2022 Apr 18. doi: 10.1111/vsu.13810. Online ahead of print.

ABSTRACT

OBJECTIVE: To provide a systematic assessment of the efficacy of preoperative skin asepsis using chlorhexidine versus povidone-iodine based protocols for surgical site infection (SSI) prevention in veterinary surgery.

STUDY DESIGN: Systematic meta-analytical review according to PRISMA-P guidelines.

SAMPLE POPULATION: Studies comparing preoperative skin asepsis protocols using chlorhexidine versus povidone-iodine in veterinary surgery identified by systematic search between 1990 and 2020.

METHODS: A search using MEDLINE/Pubmed, Web of Science and CAB Abstracts was performed, followed by secondary searches of Google Scholar, Proquest Dissertation and Theses, and relevant bibliographic articles. Primary and secondary outcome measures were the efficacy of skin asepsis protocols using chlorhexidine versus povidone-iodine on SSI incidence and skin bacterial colonization, respectively. A meta-analysis was performed with a random-effect model, with effect size calculated as risk ratio (RR) or mean standard deviation (MSD) with 95% CI. Statistical significance was set at P < .05.

RESULTS: Among 1067 publications that met the initial search criteria, 9 relevant studies were eligible for analysis. No difference in the incidence of postoperative SSI or skin bacterial colonization between preoperative asepsis protocols using chlorhexidine versus povidone-iodine was found. Insufficient information and detail were frequent among studies and precluded a clear assessment of bias.

CONCLUSION: This study showed that asepsis protocols using chlorhexidine were comparable to povidone-iodine in preventing postoperative SSI and reducing skin bacterial colonization.

CLINICAL SIGNIFICANCE: Given the limitations of the studies that were included in terms of both quality and quantity, more high-quality randomized controlled trials are needed to confirm these conclusions.

PMID:35437786 | DOI:10.1111/vsu.13810

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No significant association between SNPs in the CLOCK and ADH4 genes and susceptibility to cluster headaches: A systematic review and meta-analysis

Ann Hum Genet. 2022 Apr 18. doi: 10.1111/ahg.12467. Online ahead of print.

ABSTRACT

BACKGROUND: The circadian locomotor output cycles kaput (CLOCK) gene and the alcohol dehydrogenase 4 (ADH4) gene are promising candidates for susceptibility to cluster headaches (CH). Associations of the three single nucleotide polymorphisms (SNPs)-CLOCK SNP rs1801260 and ADH4 SNPs rs1800759, and rs1126671-with CH were studied previously, but the results were inconsistent.

METHODS: Associations between the three SNPs (rs1801260, rs1126671, and rs1800759) and CH risk were separately assessed by pooled odds ratios (ORs) along with 95% confidence intervals (95% CIs) based on five different genetic models. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). All statistical analyses were carried out with RevMan 5.3 software.

RESULTS: Eight studies involving 1437 CH patients and 2541 healthy controls were selected for quantitative synthesis, from five studies on CLOCK rs1801260, five on ADH4 rs1800759, and three on ADH4 rs1126671. Our pooled data did not support associations between the three SNPs (rs1801260 in the CLOCK gene, rs1800759 and rs1126671 in the ADH4 gene) and susceptibility to CH (rs1801260: OR 1.10, 95% CI: 0.95-1.28; p = 0.19; rs1800759: OR 1.06, 95% CI: 0.93-1.22; p = 0.37; and rs1126671: OR 1.09, 95% CI: 0.92-1.28; p = 0.32).

CONCLUSION: We found no significant associations between the three SNPs (rs1801260 in the CLOCK gene and rs1800759 and rs1126671 in the ADH4 gene) and the susceptibility to CH across both Caucasian and Asian ethnicities in our meta-analysis.

PMID:35437765 | DOI:10.1111/ahg.12467

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“On a night like this”: A mixed-methods approach to understanding high-risk drinking events in college students

Alcohol Clin Exp Res. 2022 Apr 18. doi: 10.1111/acer.14844. Online ahead of print.

ABSTRACT

BACKGROUND: Previous research indicates college students report heavier drinking on certain events (e.g., 21st birthday). While past research has identified heavier drinking events, students’ own reports of what events are associated with elevated drinking remains understudied. The current study utilized mixed methods to explore potential high-risk drinking events for college student drinkers and how these events differed from typical drinking and each other.

METHODS: College student drinkers (N=204) reported number of drinks consumed on nine predetermined events (e.g., Halloween). Students also responded to open-ended questions listing five events during which they had elevated drinking, and indicating amount consumed on each event. Open-ended responses were coded into similar event categories. Descriptive statistics for drinks consumed were calculated for predetermined and coded open-ended events. Chi-square analyses assessed differences in endorsement of open-ended events by birth sex, age, and Greek membership. Two multilevel count regressions assessed within-person differences in number of drinks consumed between participants’ typical drinking occasions and 1) highly endorsed open-ended events and 2) predetermined events.

RESULTS: For all open-ended event categories, average number of drinks consumed exceeded heavy episodic drinking thresholds; however, there was substantial variability. Comparing predetermined events to participants’ typical drinking indicated elevated drinking on participants’ birthdays, New Year’s Eve, Halloween, Finals, and Spring Break; significant differences between events also emerged. Comparison of open-ended categories to participants’ typical drinking indicated elevated drinking on birthdays, celebrations, parties, and holidays; however, there were no significant differences between open-ended events.

CONCLUSIONS: Students who drink alcohol report heavier drinking on specific calendar-based events (e.g., Spring Break). However, students also report non-calendar related events (e.g., non-specific parties) as some of their highest drinking events. More research is needed to understand how intervention and prevention programs can be adapted to target both known calendar-based high-risk drinking events, and unknown, idiosyncratic high-risk drinking events.

PMID:35437763 | DOI:10.1111/acer.14844

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Histomorphological and functional contralateral symmetry in the gastrocnemius muscles of the laboratory rat

J Anat. 2022 Apr 18. doi: 10.1111/joa.13674. Online ahead of print.

ABSTRACT

It is usual in anatomical and physiological research to assess the effects of some intervention on extremities (e.g., training programmes or injury recovery protocols) using one muscle for the intervention and its contralateral as control. However, the existence of laterality (left-handedness or right-handedness) in athletes of different specialities is widely recognized. In rats, gastrocnemius is one of the muscles most widely used because of its importance in locomotion and high relative limb mass. Since we have not found studies reporting laterality assessment on the morphology and function in rat gastrocnemius, our study aimed to evaluate the fibre histochemical, morphometrical and muscle force contractile properties between right and left gastrocnemius of the laboratory rat. Fibre-type proportion, fibre morphometrical measurements, muscle capillarization and muscle force properties were analysed in the right and left gastrocnemius of six male rats. No statistically significant differences (p = 0.265) were found in gastrocnemius to body weight ratio (‰) between right (6.55 ± 0.40) and left (6.49 ± 0.40) muscles. The muscles analysed showed a great degree of heterogeneity in fibre type distribution, having three clearly distinguished regions named red, mixed and white. In the three regions, there were no statistical differences in fibre type proportions between right and left gastrocnemius, as is indicated by the p-values (from 0.203 to 0.941) obtained after running t-Student paired tests for each fibre type. When analysing fibre cross-sectional area, individual fibre capillarization and fibre circularity, no significant differences between right and left gastrocnemius in any of these morphometrical parameters were found in any muscle region or fibre type. Most of the p-values (70%) resulting from running t-Student paired tests were higher than 0.400, and the lowest p-value was 0.115. Seemingly, global capillary and fibre densities were not statistically different between right and left sides in all muscle regions with p-values ranging from 0.337 to 0.812. Force parameters normalized to gastrocnemius mass (mN g-1 ) did not show any significant difference between right (PF = 74.0 ± 13.4, TF = 219.4 ± 13.0) and left (PF = 70.9 ± 10.7, TF = 213.0 ± 18.0) muscles with p = 0.623 (PF) and p = 0.514 (TF). Twitch time parameters (ms) also lacked significant differences between the two sides (CT: 43.4 ± 8.6 vs. 45.0 ± 14.3, p = 0.639; HRT: 77.6 ± 15.0 vs. 82.3 ± 25.3, p = 0.475). Finally, both muscles also showed similar (p = 0.718) fatigue properties. We did find an absence of laterality at the morphological and functional levels, which raises the possibility of using right and left gastrocnemius muscles interchangeably for experimental designs where one muscle is used to analyse data after a physiological intervention and its contralateral muscle plays the control role, thus allowing unbiased paired comparisons to derive accurate conclusions.

PMID:35437750 | DOI:10.1111/joa.13674

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Markers of respiratory function response to high-carbohydrate and high-fat intake in patients with lung diseases: a systematic review with meta-analysis of randomized clinical trials

JPEN J Parenter Enteral Nutr. 2022 Apr 19. doi: 10.1002/jpen.2385. Online ahead of print.

ABSTRACT

BACKGROUND: Macronutrients can differently affect respiratory function markers such as VO2 , VCO2 , PaO2 , PaCO2 and respiratory quotients (RQ), but systematic appraisal of the evidence on randomized clinical trials (RCTs) is lacking.

OBJECTIVE: To compare the response of respiratory function markers to high-carbohydrate and high-fat intake in patients with lung diseases.

METHODS: Systematic review conducted according to Cochrane Collaboration recommendations, reported following PRISMA 2020. PubMed, EMBASE, Scopus, and Cochrane CENTRAL were searched up to July/2021. Two reviewers selected the RCTs and extracted the data. Risk of bias and the certainty of evidence were assessed by RoB 2 and GRADE, respectively. Statistical and graphical data guided the publication bias investigation. Meta-analyses were conducted.

RESULTS: We included 14 RCTs (362 participants), four of which were parallel. Most studies included patients with COPD. High-fat intake decreased VCO2 [MD = -35.89(95%CI -45.24; -26.21) ml/min; I²=0%], VO2 [MD= -29.30(95% CI -40.94, -17.66) ml/min; I² = 0%], PaCO2 [MD = -4.62(95%CI -7.67; -1.58) mmHg; I²=84%], and RQ [MD = -0.08(95%CI -0.09; -0.06); I² = 0%] in the subset of parallel RCTs. In crossover RCTs, there was generally no evidence of effect except for a greater decrease in RQ [MD = -0.09(95%CI -0.12; -0.02); I² = 96%] in favor of high fat intake.

CONCLUSION: High-fat intake resulted in greater reductions ​​of VCO2 , VO2 , PaCO2 , and RQ in adult patients with lung diseases. The certainty of the evidence is very low/ low, and it precludes a specific recommendation on macronutrients contribution to energy intake of these patients. This article is protected by copyright. All rights reserved.

PMID:35437762 | DOI:10.1002/jpen.2385