Tag: pubmed

J Perinat Med. 2022 Mar 22. doi: 10.1515/jpm-2021-0247. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify antenatal risk factors that may predict the need for insulin treatment upon diagnosis of gestational diabetes (GDM), that is, to identify the specific characteristics of women diagnosed with GDM who did not achieve good glycemic control through lifestyle modifications.

METHODS: We performed a comprehensive literature search in PubMed, Science Direct, Ebsco, and Scielo for studies evaluating the associations between antenatal factors and the need for insulin treatment published until January 28th, 2021. Random-effects models were used to estimate risk ratios and their 95% confidence interval. The quality of studies was assessed using the Newcastle-Ottawa Scale. Random-effects models were used to estimate outcomes, and effects reported as risk ratio and their 95% confidence interval. The systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews.

RESULTS: Eighteen observational studies were selected, reporting 14,951 women with GDM of whom 5,371 received insulin treatment. There were statistically significant associations between the need for insulin treatment and BMI ≥ 30 (RR:2.2; 95%CI: 1.44-3.41), family history of type 2 diabetes mellitus (RR:1.74; 95%CI: 1.56-1.93), prior personal history of GDM (RR:2.10; 95%CI: 1.56-2.82), glycated hemoglobin value at GDM diagnosis (RR:2.12; 95%CI: 1.77-2.54), and basal glycemia obtained in the diagnostic curve (RR: 1.2; 95%CI: 1.12-1.28). Nulliparity and maternal age were not determinants factor. There was moderate-to-high heterogeneity among the included studies.

CONCLUSIONS: the strong causal association between BMI ≥ 30, family history of type 2 diabetes mellitus, prior history of GDM and glycosylated hemoglobin with the need for insulin treatment was revealed.

PMID:35313096 | DOI:10.1515/jpm-2021-0247

Clin Chem Lab Med. 2022 Mar 18. doi: 10.1515/cclm-2021-1176. Online ahead of print.

ABSTRACT

OBJECTIVES: Cholestasis and elevated serum bile¹ acid levels are common in critically ill patients. This study aims to define the specific pattern of bile acids associated with acute respiratory distress syndrome (ARDS) and the changes in pattern over time.

METHODS: Prospective observational study. Serum samples of 70 ARDS patients were analyzed for primary bile acids (cholic acid, chenodeoxycholic acid) and secondary bile acids (deoxycholic acid, litocholic acid, and ursodeoxycholic acid) as well as their glycine and taurine glycation products.

RESULTS: Primary bile acid levels increased from day zero to day five by almost 50% (p<0.05). This change bases on a statistically significant increase in all primary bile acids between day 0 and day 5 (cholic acid [CA] p=0.001, taurocholic acid [TCA] p=0.004, glycocholic acid [GCA] p<0.001, chenodeoxycholic acid [CDCA] p=0.036, taurochenodeoxycholic acid [TCDCA] p<0.001, glycochenodeoxycholic acid [GCDCA] p<0.001). Secondary bile acids showed predominantly decreased levels on day 0 compared to the control group and remained stable throughout the study period; the differences between day zero and day five were not statistically significant. Non-survivors exhibited significantly higher levels of TCDCA on day 5 (p<0.05) than survivors. This value was also independently associated with survival in a logistic regression model with an odds ratio of 2.24 (95% CI 0.53-9.46).

CONCLUSIONS: The individual bile acid profile of this ARDS patient cohort is unique compared to other disease states. The combination of changes in individual bile acids reflects a shift toward the acidic pathway of bile acid synthesis. Our results support the concept of ARDS-specific plasma levels of bile acids in a specific pattern as an adaptive response mechanism.

PMID:35313097 | DOI:10.1515/cclm-2021-1176

Clin Exp Dent Res. 2022 Mar 21. doi: 10.1002/cre2.558. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to compare porcelain veneer strength on screw-retained implant-supported fixed full-arch prostheses with a framework of either milled titanium (Ti), cobalt-chromium (CoCr), and yttria-stabilized zirconia (Y-TZP) in an in vitro loading model.

MATERIALS AND METHODS: Fifteen screw-retained maxillary implant-supported full-arch prostheses (FDP), five each of Ti, CoCr, and Y-TZP frameworks with porcelain veneers were included. All FDPs were subjected to thermocycling before loading until fracture of the veneer. The load was applied at the distal fossa of the occlusal area of the pontic replacing 24. Fracture loads were analyzed, and the fracture quality was assessed. Statistical analysis on the fracture load was performed using Kruskal-Wallis test. The statistical significance was set at p < .05.

RESULTS: There was no statistical significance found between the groups regarding fracture load. The highest and lowest load was seen within the CoCr FDP, varying between 340 and 1484 N. Different types of fracture appearances were seen. The Y-TZP FDPs had a higher number of fractures locally in the loaded area while CoCr and Ti more often showed cracks in the anterior region, at a distance from the loaded area.

CONCLUSIONS: Within the limitations of this study, the conclusion was that framework material may affect the fracture behavior of maxillary full-arch bridges; however, there were no differences in veneer fracture strength when frameworks of Ti, CoCr, or Y-TZP were compared.

PMID:35313086 | DOI:10.1002/cre2.558

Surg Technol Int. 2022 Mar 21;40:sti40/1566. Online ahead of print.

ABSTRACT

BACKGROUND: Gastroparesis, a chronic disorder distinguished by delays in gastric emptying, has been a concern for both health providers and hospitals due to several of its characteristics. Gastroparesis is heterogeneous in nature and is associated with several comorbidities and increasing mortality rates. It can often be caused by underlying conditions, most of which are not well understood. This lack of knowledge regarding its underlying mechanisms creates a need to better understand the risk factors involved in this patient population. This study was undertaken to understand the risk factors involved in the mortality of patients who present with gastroparesis.

METHODS: This retrospective study considered data from the National Inpatient Sample for patients who were admitted with a primary diagnosis of gastroparesis from 2005 to 2014. The data were stratified according to various factors of interest to identify risk factors involved in mortality using statistical tools, including a multivariable logistic regression model with backward elimination.

RESULTS: A total of 27,000 patients were admitted emergently with a primary diagnosis of gastroparesis. The mortality rate in adult patients (0.18%, N=39) was much lower than that in elderly patients (1.27%, N=71). Females accounted for the majority of patients in both the adult (73.7%) and elderly (71%) populations. The mean age of patients in the adult and elderly groups was 43 and 75 years, respectively. The association between mortality and age was significant in both adults (OR=1.04, 95%CI=1.005-1.08, p<0.025) and the elderly (OR=1.08, 95%CI=1.04-1.12, p<0.001). The hospital length of stay (HLOS, days) in adult females (5.08, SD=5.04) was significantly longer than that in adult males (4.41, SD=5.10) (p<0.001). The association between mortality and HLOS was significant in both adults (OR=1.12, 95%CI=1.09-1.15, p<0.001) and elderly patients (OR=1.10, 95%CI=1.06-1.14, p<0.001). A lower percentage of adults (6.6%, N=1,402) underwent an operation compared to the elderly (9.6%, N=538). The mean time to operation was 4.76 days for adult patients who survived and 17.50 days for adult patients who did not survive (SD=5.37 and 9.37, respectively, p=0.006). On the other hand, this value was 5.57 and 9.10 days for elderly patients (SD=6.50 and 7.15, respectively, p=0.037). Among patients who underwent an operation, the association between mortality and time to operation was significant for both adults (OR=1.17, 95%CI=1.094-1.247, p<0.001) and elderly patients (OR=1.05, 95%CI=1.005-1.124, p<0.001).

CONCLUSION: The risk of mortality in elderly patients with emergent gastroparesis was 7-fold greater than that in adult patients. The odds of mortality increased by 8% for every year increase in age in elderly patients and by 4% in adults.

PMID:35313001

Matern Child Nutr. 2022 Mar 21:e13351. doi: 10.1111/mcn.13351. Online ahead of print.

ABSTRACT

The International Code of Marketing of Breast-milk Substitutes (BMS) instituted to protect breastfeeding against unethical marketing, has been adopted by many countries, including Bangladesh. Despite national adoption, evidence suggests violations occur and inadequate BMS Code implementation is an issue. The study aimed to assess violations of the International BMS Code and the national ‘Breast-milk Substitutes, Infant Foods, Commercially Manufactured Complementary Foods and the Accessories Thereof (Regulation of Marketing) Act, 2013’ of Bangladesh in commercial settings (retail outlets and media) in Bangladesh, for different types of milk, bottles, and teats using a standardized Network for Global Monitoring and Support for Implementation of the Code and Subsequent relevant World Health Assembly Resolutions (NetCode) protocol. This cross-sectional quantitative study was conducted in Bangladesh from January to September 2018 in Dhaka, Chattogram, and Sylhet cities. Descriptive statistics were reported and χ² tests were conducted to assess differences between categorical variables of interest. Data were analysed using SPSS version 20. In retail outlets, there were higher proportion of violations observed in Dhaka than in Sylhet and Chattogram (p < 0.001). Significantly greater proportion of violations in product labels occurred among products sold without local distributors compared to others (p < 0.05); violations were higher among “other milk” for children aged 0 to <36 months compared to formulas and growing-up milk (p < 0.05). Among media channels, internet clips had significantly higher proportions of violations compared to television, radio and newspaper (p < 0.001). BMS Code violations were prevalent in product labels and promotion of products through retail outlets. The study findings highlight the need for specific multisectoral strategies for better enforcement of BMS Code and points to the need for periodic assessment of Code violations.

PMID:35313083 | DOI:10.1111/mcn.13351

Actas Esp Psiquiatr. 2022 Mar;50(2):106-113. Epub 2022 Mar 1.

ABSTRACT

There is a high prevalence of stigma among medical students towards mental illness, which can have far reaching negative consequences. It is essential to intervene and modify their preconceptions in order to fight against stigma.

PMID:35312996

J Racial Ethn Health Disparities. 2022 Mar 21. doi: 10.1007/s40615-022-01280-z. Online ahead of print.

ABSTRACT

Publication in leading medical journals is critical to knowledge dissemination and academic advancement alike. Leveraging a novel dataset comprised of nearly all articles published in JAMA and NEJM from 1990 to 2020, along with established reference works for name identification, we explore changing authorship demographics in two of the world’s leading medical journals. Our main outcomes are the annual proportion of male and female authors and the proportion of racial/ethnic identities in junior and senior authorship positions for articles published in JAMA and NEJM since 1990. We found that women remain under-represented in research authorship in both JAMA (at its peak, 38.1% of articles had a female first author in 2011) and NEJM (peaking at 28.2% in 2002). The rate of increase is so slow that it will take more than a century for both journals to reach gender parity. Black and Hispanic researchers have likewise remained under-represented as first and last authors in both journals, even using the best-case scenario. Their appearance as authors has remained stagnant for three decades, despite attention to structural inequalities in medical academia. Thus, analysis of authorship demographics in JAMA and NEJM over the past three decades reveals the existence of inequalities in high-impact medical journal authorship. Gender and racial/ethnic disparities in authorship may both reflect and further contribute to disparities in academic advancement.

PMID:35312972 | DOI:10.1007/s40615-022-01280-z

Ther Innov Regul Sci. 2022 Mar 21. doi: 10.1007/s43441-022-00399-9. Online ahead of print.

NO ABSTRACT

PMID:35312989 | DOI:10.1007/s43441-022-00399-9

J Cardiovasc Transl Res. 2022 Mar 21. doi: 10.1007/s12265-022-10229-w. Online ahead of print.

ABSTRACT

The ability to customize the size and shape of angioplasty balloons may be useful in many clinical and research applications of coronary and endovascular intervention. Fully customizable balloons are outside the reach of most researchers due to their prohibitive cost. A small-scale balloon-forming machine was developed to produce fully customizable balloons. This study describes the creation of this customizable balloon-forming machine and identifies the key components of manufacturing a patient-specific balloon. Using a standard balloon-shaped mold created with a novel application of 3D stereolithography-printed resin, 104 PET balloon formation tests were conducted. A statistical study was conducted in which molding temperature and inflation air pressure were independent variables ranging from 100 to 130 °C and from 3.7 to 6.8 atm, respectively. The criteria for balloon-forming success were defined; pressure and temperature combined were found to have a significant impact on the success (p = 0.011), with 120 °C and 4.76 atm resulting in the highest chance for success based on a regression model.

PMID:35312960 | DOI:10.1007/s12265-022-10229-w

Pain Ther. 2022 Mar 21. doi: 10.1007/s40122-022-00371-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Self-management education is the basis of any intervention for persons with chronic musculoskeletal pain. Given the biopsychosocial nature of chronic musculoskeletal pain, an educational approach based on the biopsychosocial model would seem to be an appropriate educational model for the treatment of these people during coronavirus disease 2019 (COVID-19). The aim of this study was to compare the effect of pain neuroscience education (PNE) and pain biomechanics education, using online and face-to-face sessions on pain and fear of movement, in people with chronic nonspecific neck pain during COVID-19.

METHODS: In this multicenter assessor-blinded randomized controlled trial, 80 patients (both male and female) with chronic nonspecific neck pain (based on the inclusion criteria of the study) participated in educational sessions (face-to-face and online) from the beginning September until the end of October 2021. The participants were randomly divided into two groups (through the selection of numbers from 1 to 80, hidden in a box), with one group receiving PNE (treatment group) and the other group receiving pain biomechanics education (control group). Pain and fear of movement before and after the intervention were measured on the Numerical Pain Rating Scale and the Tampa Scale of Kinesiophobia, respectively. A 2 × 2 variance analysis (treatment group × time) with a mixed-model design was applied to statistically analyze the data.

RESULTS: No significant change in pain (P = 0.23) was observed between the two groups (P = 0.24, Cohen’s d = 0.17, 95% confidence interval [CI] – 0.21 to 0.35), while changes in the fear of movement variable were reported to be significant (P = 0.04, Cohen’s d = 0.34, 95% CI 0.11-0.51), in favor of PNE. Intra-group change was seen only in the PNE group for the fear of movement variable (P = 0.04; 14.28%↓).

CONCLUSION: In our study population PNE did not affect the pain index, leading to the conclusion that PNE should not be used as the only treatment, but possibly in combination with other active/passive therapy to enhance the results for patients with nonspecific chronic neck pain. Moreover, online treatment may help clinicians to increase their interaction with patients during COVID-19 lockdown.

PMID:35312949 | DOI:10.1007/s40122-022-00371-3