Tag: pubmed

Swiss Med Wkly. 2021 Apr 1;151:w20462. doi: 10.4414/smw.2021.20462. eCollection 2021 Mar 15.

ABSTRACT

AIMS OF THE STUDY: Although many studies have investigated the influence of personal characteristics on recidivism, knowledge about the impact of correctional policies remains limited. The present study adds to this debate by investigating the effect of the dualistic system of custodial sanctions in Switzerland over time. Specifically, we: (1) tested the influence that different types of custodial sanctions – sentences (offering regular prison treatment) and measures (offering crime-related rehabilitation programmes) – have on reconviction rates; and (2) forecasted future reconviction rates to estimate their value in the year 2020.

METHODS: National level data from the Swiss Federal Statistical Office were collected, including 3-year reconviction rates after release from custody and the number of persons serving custodial sentences and measures. A time series framework was used for the analyses, which included data available from 1988 to 2013 (n = 26 years).

RESULTS: The number of persons serving custodial sentences had no effect on recidivism (p = 0.582); however, a higher number of persons serving custodial measures was significantly associated with a decrease in recidivism (p = 0.003). For the year 2020, a reconviction rate of 28% (range 23–33%) was predicted.

CONCLUSIONS: Custodial measures seem to be associated with a reduction in recidivism. However, owing to the indeterminate time associated with some custodial measures, often at the cost of the prisoners’ rights and the criminal justice system, future studies are needed to determine the optimal serving time for custodial measures.

PMID:33793962 | DOI:10.4414/smw.2021.20462

Cancer. 2021 Apr 1. doi: 10.1002/cncr.33516. Online ahead of print.

ABSTRACT

BACKGROUND: Endometrial cancers (ECs) with somatic mutations in DNA polymerase epsilon (POLE) are characterized by unfavorable pathological features, which prompt adjuvant treatment. Paradoxically, women with POLE-mutated EC have outstanding clinical outcomes, and this raises concerns of overtreatment. The authors investigated whether favorable outcomes were independent of treatment.

METHODS: A PubMed search for POLE and endometrial was restricted to articles published between March 1, 2012, and March 1, 2018, that provided individual patient data (IPD), adjuvant treatment, and survival. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines for IPD, the authors used univariate and multivariate one-stage meta-analyses with mixed effects Cox models (random effects for study cohorts) to infer the associations of treatment, traditional prognostic factors, and outcome, which was defined as the time from first diagnosis to any adverse event (progression/recurrence or death from EC).

RESULTS: Three hundred fifty-nine women with POLE-mutated EC were identified; 294 (82%) had pathogenic mutations. Worse outcomes were demonstrated in patients with nonpathogenic POLE mutations (hazard ratio, 3.42; 95% confidence interval, 1.47-7.58; log-rank P < .01). Except for stage (P < .01), traditional prognosticators were not associated with progression/recurrence or death from disease. Adverse events were rare (11 progressions/recurrences and 3 disease-specific deaths). Salvage rates in patients who experienced recurrence were high and sustained, with 8 of 11 alive without evidence of disease (range, 5.5-14.2 years). Adjuvant treatment was not associated with outcome.

CONCLUSIONS: Clinical outcomes for ECs with pathogenic POLE mutations are not associated with most traditional risk parameters, and patients do not appear to benefit from adjuvant therapy. The observed low rates of recurrence/progression and the high and sustained salvage rates raise the possibility of safely de-escalating treatment for these patients.

LAY SUMMARY: Ten percent of all endometrial cancers have mutations in the DNA repair gene DNA polymerase epsilon (POLE). Women who have endometrial cancers with true POLE mutations experience almost no recurrences or deaths from their cancer even when their tumors appear to have very unfavorable characteristics. Additional therapy (radiation and chemotherapy) does not appear to improve outcomes for women with POLE-mutated endometrial cancer, and this supports the move to less therapy and less associated toxicity. Diligent classification of endometrial cancers by molecular features provides valuable information to inform prognosis and to direct treatment/no treatment.

PMID:33793971 | DOI:10.1002/cncr.33516

Med Ultrason. 2021 Mar 14. doi: 10.11152/mu-2855. Online ahead of print.

ABSTRACT

AIM: To determine the early effects of excess weight on renal cortical stiffness in children and adolescents using point shear wave elastography (pSWE).

MATERIALS AND METHODS: One hundred and forty-six overweight and obese children (43.2% male; mean age, 12.6±2.9 years: range 4.3-18) and 48 lean children (27.1% male: mean age, 12.4±3.4: range 4.8-18.9) were included in the study and control group, respectively. pSWE measurements of the two kidneys were performed. The mean value of shear wave velocity was compared between groups.

RESULTS: The mean shear wave velocity was 2.79±0.53 m/s for the control subjects and 3.09±0.59 m/s for the overweight-obese subjects. The differences between the two groups were sta-tistically significant (p=0.001). There was no correlation between shear wave velocity and age or depth. A positive correlation was found between shear wave velocity and body mass index, body mass index-standard deviation score.

CONCLUSION: Renal cortical stiffness was higher in children with excess weight than in lean children. This study is the first attempt at applying pSWE to investigate the early adverse effects of excess weight.

PMID:33793699 | DOI:10.11152/mu-2855

Med Ultrason. 2021 Mar 14. doi: 10.11152/mu-2692. Online ahead of print.

ABSTRACT

AIMS: The aim of this study was to compare technical success and tolerability between hysterosalpingography (HSG) and hysterosalpingo-contrast ultrasonography (HyCoUs) as a first-line evaluation method in a single fertility center.

MATERIAL AND METHODS: The study included 56 infertile women: 27 patients underwent HSG and 29 patients underwent HyCoUs. Pain perception was measured by means of an 11-point visual analog scale (VAS) and the Stacy score. Side-effects, technical aspects, complications and variable correlations were documented.

RESULTS: The median VAS scale was 5 (4;6) for HSG and 1 (1;2) for HyCoUs. The median Stacy score was 2 (1;3) for HSG and 1 (0;1) for HyCoUs. The difference in pain perception was statistically significant for both pain scores (p<0.001). All patients undergoing HyCoUs reported a visual analog (VAS) pain score of <5 and 59.3% of patients undergoing an HSG reported a score of >5. Increased pain scores showed a statistically significant association with duration and total volume of substance infused. The type of procedure and volume infused were independently associated with the VAS scale. In the HSG group, 14.8% (4) of patients reported a vagal effect (p<0.001), one patient requiring hospitalization. No vagal effects were reported following HyCoUs and the method was technically successful in 100% (29) of cases. HSG was successful in 88.9% (24) of cases.

CONCLUSIONS: HyCoUs is a well-tolerated procedure with reduced frequency of adverse effects. Low pain perception is strongly correlated with a low volume infused. It is non-invasive and efficient in rendering good quality images.

PMID:33793700 | DOI:10.11152/mu-2692

J Pharm Pharmacol. 2021 Mar 4;73(2):247-262. doi: 10.1093/jpp/rgaa022.

ABSTRACT

OBJECTIVES: To explore the intervention mechanism of combining Polygala tenuifolia (PT) with Magnolia officinalis (MO) on gastrointestinal motility disorders caused by PT.

METHODS: Urine and faeces of rats were collected; the effects of PT and MO on the gastric emptying and small intestine advancing rates in mice were analysed via ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) to determine the potential metabolites. Changes in the metabolic profiles of the urine and faeces were revealed by untargeted metabolomics, followed by multivariate statistical analysis. The integration of urine and faeces was applied to reveal the intervention mechanism of PT-MO on PT-induced disorders.

KEY FINDINGS: PT + MO (1:2) improved the gastrointestinal function in mice suffering from PT-induced gastrointestinal motility disorder. Metabolomics indicated that the PT-MO mechanism was mainly associated with the regulations of 17 and 12 metabolites and 11 and 10 pathways in urine and faeces, respectively. The common metabolic pathways were those of tyrosine, purine, tricarboxylic acid cycle, pyruvate and gluconeogenesis, which were responsible for the PT-MO intervention mechanism.

CONCLUSIONS: The PT-MO (1:2) couple mechanism mitigated the PT-induced disorders, which were related to the energy, amino acid and fatty metabolisms.

PMID:33793803 | DOI:10.1093/jpp/rgaa022

PLoS One. 2021 Apr 1;16(4):e0248964. doi: 10.1371/journal.pone.0248964. eCollection 2021.

ABSTRACT

Emerging studies indicate that APOA-I binding protein (AIBP) is a secreted protein and functions extracellularly to promote cellular cholesterol efflux, thereby disrupting lipid rafts on the plasma membrane. AIBP is also present in the mitochondria and acts as an epimerase, facilitating the repair of dysfunctional hydrated NAD(P)H, known as NAD(P)H(X). Importantly, AIBP deficiency contributes to lethal neurometabolic disorder, reminiscent of the Leigh syndrome in humans. Whereas cyclic NADPHX production is proposed to be the underlying cause, we hypothesize that an unbiased metabolic profiling may: 1) reveal new clues for the lethality, e.g., changes of mitochondrial metabolites., and 2) identify metabolites associated with new AIBP functions. To this end, we performed unbiased and profound metabolic studies of plasma obtained from adult AIBP knockout mice and control littermates of both genders. Our systemic metabolite profiling, encompassing 9 super pathways, identified a total of 640 compounds. Our studies demonstrate a surprising sexual dimorphism of metabolites affected by AIBP deletion, with more statistically significant changes in the AIBP knockout female vs male when compared with the corresponding controls. AIBP knockout trends to reduce cholesterol but increase the bile acid precursor 7-HOCA in female but not male. Complex lipids, phospholipids, sphingomyelin and plasmalogens were reduced, while monoacylglycerol, fatty acids and the lipid soluble vitamins E and carotene diol were elevated in AIBP knockout female but not male. NAD metabolites were not significantly different in AIBP knockout vs control mice but differed for male vs female mice. Metabolites associated with glycolysis and the Krebs cycle were unchanged by AIBP knockout. Importantly, polyamine spermidine, critical for many cellular functions including cerebral cortex synapses, was reduced in male but not female AIBP knockout. This is the first report of a systemic metabolite profile of plasma samples from AIBP knockout mice, and provides a metabolic basis for future studies of AIBP regulation of cellular metabolism and the pathophysiological presentation of AIBP deficiency in patients.

PMID:33793635 | DOI:10.1371/journal.pone.0248964

PLoS One. 2021 Apr 1;16(4):e0249411. doi: 10.1371/journal.pone.0249411. eCollection 2021.

ABSTRACT

BACKGROUND: Preterm birth is a significant contributor of under-five and newborn deaths globally. Recent estimates indicated that, Tanzania ranks the tenth country with the highest preterm birth rates in the world, and shares 2.2% of the global proportion of all preterm births. Previous studies applied binary regression models to determine predictors of preterm birth by collapsing gestational age at birth to <37 weeks. For targeted interventions, this study aimed to determine predictors of preterm birth using multinomial regression models accounting for missing data.

METHODS: We carried out a secondary analysis of cohort data from the KCMC zonal referral hospital Medical Birth Registry for 44,117 women who gave birth to singletons between 2000-2015. KCMC is located in the Moshi Municipality, Kilimanjaro region, northern Tanzania. Data analysis was performed using Stata version 15.1. Assuming a nonmonotone pattern of missingness, data were imputed using a fully conditional specification (FCS) technique under the missing at random (MAR) assumption. Multinomial regression models with robust standard errors were used to determine predictors of moderately to late ([32,37) weeks of gestation) and very/extreme (<32 weeks of gestation) preterm birth.

RESULTS: The overall proportion of preterm births among singleton births was 11.7%. The trends of preterm birth were significantly rising between the years 2000-2015 by 22.2% (95%CI 12.2%, 32.1%, p<0.001) for moderately to late preterm and 4.6% (95%CI 2.2%, 7.0%, p = 0.001) for very/extremely preterm birth category. After imputation of missing values, higher odds of moderately to late preterm delivery were among adolescent mothers (OR = 1.23, 95%CI 1.09, 1.39), with primary education level (OR = 1.28, 95%CI 1.18, 1.39), referred for delivery (OR = 1.19, 95%CI 1.09, 1.29), with pre-eclampsia/eclampsia (OR = 1.77, 95%CI 1.54, 2.02), inadequate (<4) antenatal care (ANC) visits (OR = 2.55, 95%CI 2.37, 2.74), PROM (OR = 1.80, 95%CI 1.50, 2.17), abruption placenta (OR = 2.05, 95%CI 1.32, 3.18), placenta previa (OR = 4.35, 95%CI 2.58, 7.33), delivery through CS (OR = 1.16, 95%CI 1.08, 1.25), delivered LBW baby (OR = 8.08, 95%CI 7.46, 8.76), experienced perinatal death (OR = 2.09, 95%CI 1.83, 2.40), and delivered male children (OR = 1.11, 95%CI 1.04, 1.20). Maternal age, education level, abruption placenta, and CS delivery showed no statistically significant association with very/extremely preterm birth. The effect of (<4) ANC visits, placenta previa, LBW, and perinatal death were more pronounced on the very/extremely preterm compared to the moderately to late preterm birth. Notably, extremely higher odds of very/extreme preterm birth were among the LBW babies (OR = 38.34, 95%CI 31.87, 46.11).

CONCLUSIONS: The trends of preterm birth have increased over time in northern Tanzania. Policy decisions should intensify efforts to improve maternal and child care throughout the course of pregnancy and childbirth towards preterm birth prevention. For a positive pregnancy outcome, interventions to increase uptake and quality of ANC services should also be strengthened in Tanzania at all levels of care, where several interventions can easily be delivered to pregnant women, especially those at high-risk of experiencing adverse pregnancy outcomes.

PMID:33793638 | DOI:10.1371/journal.pone.0249411

PLoS One. 2021 Apr 1;16(4):e0249412. doi: 10.1371/journal.pone.0249412. eCollection 2021.

ABSTRACT

BACKGROUND: Anemia has severe public health significance in sub-Saharan Africa. In Ethiopia, anemia has been increasing in the last two decades, reaching the highest national level in 2016, however, the geospatial distribution and determinants of anemia in children weren’t well explored at a national level.

METHODS: We used the Ethiopian Demographic and Health Survey(EDHS) data from 2005-2016. The data consists of samples of households (HHs) obtained through a two-stage stratified sampling procedure. Our analysis included 19,699 children. Descriptive statistics, geospatial analysis, and Generalized Linear Mixed Model (GLMMs) were used.

RESULTS: The overall prevalence of anemia was 51.5%; the spatial distribution of anemia significantly different across clusters in each survey. Children from 6 to 11 months had higher odds of anemia compared to 24-59 months (Adjusted Odds ratio (AOR) = 3.4, 95%Confidence level (CI): 2.99-3.76). Children with the first and second birth order were less likely to be anemic compared to fifth and above (AOR = 0.60, 95%CI: 0.38-0.95, and AOR = 0.83, 95%C: 0.73-0.93) respectively. Mothers’ age 15 to 24 years was associated with higher odds of anemia compared to 35 to 49 years (AOR = 1.37, 95%CI: 1.20-1.55). Children from HHs with the poorest and poorer wealth category showed a higher odds of anemia compared to the richest (AOR = 1.67, 95%CI: 1.45-1.93, and AOR = 1.25, 95%CI: 1.08-1.45) respectively. Moreover, children from HHs with one to two under-five children were less likely to be anemic compared to those three and more (AOR = 0.83, 95%CI: 0.76-0.91).

CONCLUSIONS: The geospatial distribution of anemia among children varies in Ethiopia; it was highest in the East, Northeast, and Western regions of the country. Several factors were associated with anemia; therefore, interventions targeting the hotspots areas and specific determinant factors should be implemented by the concerned bodies to reduce the consequences of anemia on the generation.

PMID:33793640 | DOI:10.1371/journal.pone.0249412

PLoS One. 2021 Apr 1;16(4):e0249369. doi: 10.1371/journal.pone.0249369. eCollection 2021.

ABSTRACT

BACKGROUND: Tuberculosis (TB) is one of the major public health problems in Ethiopia. Determining treatment outcome of TB cases could help to understand the effectiveness of TB control efforts. The objective of this study was to assess TB treatment outcome and associated factors and determine the risk factors of death among TB cases who were on Directly Observed Treatment Short course (DOTS).

METHODOLOGY: We analyzed a retrospective data for TB cases who were on DOTS at Dilla Referral Hospital from July 2011- June 2016. The study population was TB cases with known HIV status and whose treatment outcome was evaluated at the Hospital. Data were entered, cleaned and analyzed using statistical package SPSS for windows, version 20.

RESULT: Out of 899 registered TB cases, 731 included in this analysis. Of these cases, 424 (58.0%) were male and 334 (45.7%) were in the age group of below 25 years. Treatment success rate of TB was 675 (92.3%) and death rate was 18 (2.5%). Treatment outcome showed statistically significant variation by HIV status (P < 0.001). HIV status of the TB cases and pretreatment weight were associated with TB treatment outcome. HIV status of the TB cases was associated with death of the TB cases (Adjusted Odds Ratio (AOR) 5.0; CI 95%: 1.8-13.5).

CONCLUSION: TB treatment success rate found in this study was high. Patient’s weight and HIV status were associated with treatment outcome. Moreover, HIV status predicted death of TB cases. Cautious treatment follow-up and defaulter tracing mechanisms for TB cases with these risk factors were suggested.

PMID:33793648 | DOI:10.1371/journal.pone.0249369

PLoS One. 2021 Apr 1;16(4):e0247912. doi: 10.1371/journal.pone.0247912. eCollection 2021.

ABSTRACT

BACKGROUND: Evaluation of patients`satisfaction towards pharmacy services is of utmost importance to ensure the quality of care. It helps in identifying domains requiring improvements to provide high quality pharmacy services to ensure the provision of enhanced pharmaceutical care. The current study aims to ascertain the extent of satisfaction towards pharmacy services among patients attending outpatient pharmacies in Kingdom of Saudi Arabia.

METHODS: A hospital-based cross-sectional study involving 746 patients attending outpatient pharmacies of various public hospitals was conducted from 01 January to 15 February 2020. Information on socio-demographic profile of the study subjects along with their satisfaction towards outpatient pharmacy was extracted by using a 23-items questionnaire. These questions were divided into two domains including 7 questions related to the pharmacy facilities (questions from 1F to 7F) and 8 questions for pharmacy services (questions from 1S to 8S), where F and S denotes facilities and services, respectively. The cumulative satisfaction score was estimated by a 5-item Likert scale with a maximum score of 5 for each item. The relationship between demographics and satisfaction scores was evaluated by using appropriate statistics.

RESULTS: There were 746 patients with male preponderance (58.8%). The overall satisfaction score was 2.97 ± 0.65. Satisfaction towards pharmacy services scored lower (mean score: 3.91 ± 0.77) than pharmacy facilities (mean score: 4.03 ± 0.66). Items related to patient`s counseling (3F, 2S, 3S, 6S) scored least during the analysis. Older patients (p = 0.006), male gender (p<0.001), Saudi nationality (0.035), patients attending primary care centers (p = 0.02), and patients with chronic illnesses were significantly associated with lower satisfaction score.

CONCLUSION: This study reported that the satisfaction level of patients attending outpatient pharmacies was low and differed among various socio-demographic groups. Approximately one-half of the patients were not satisfied with outpatient pharmacy services. These findings underscore the dire need for managerial interventions including the hiring of trained professionals, onsite training of pharmacy staff, initiation of clinical or patient centered pharmacy services, evaluation of patient`s response towards the services and appropriate controlling measures, irrespective to the type of hospitals.

PMID:33793604 | DOI:10.1371/journal.pone.0247912