Tag: pubmed

Brain. 2022 Mar 18:awab471. doi: 10.1093/brain/awab471. Online ahead of print.

NO ABSTRACT

PMID:35302165 | DOI:10.1093/brain/awab471

Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1450-1461. doi: 10.26355/eurrev_202203_28209.

ABSTRACT

OBJECTIVE: To compare corneal and anterior segment morphology among children and adolescents with and without diabetes.

MATERIALS AND METHODS: PubMed, Embase and Scopus databases were systematically searched. Studies that were observational in design were considered. Included studies should have been done in young children and/or adolescents and compared relevant outcomes of interest based on the diabetic status. The outcomes of interest were related to corneal morphology, morphology of lens, as well as important characteristics of anterior segment such as depth, pupillary diameter, intra-ocular pressure and axial length. The pooled effect sizes were reported as weighted mean difference (WMD). STATA software was used for statistical analysis.

RESULTS: The meta-analysis included 17 studies. Diabetic children had lower corneal endothelial cell density (cells/mm2) (WMD -215.7, 95% CI: -406.5, -24.9), higher central corneal thickness (µm) (WMD 12.66, 95% CI: 5.47, 19.84), higher lenticular thickness (mm) (WMD 0.25, 95% CI: 0.13, 0.36) and density (WMD 3.02, 95% CI: 2.23, 3.81) than non-diabetic children. The anterior chamber depth (mm) (WMD -0.17, 95% CI: -0.24, -0.09) and pupillary diameter (mm) (WMD -0.61, 95% CI: -1.12, -0.10) was significantly reduced in diabetic children, compared to non-diabetic children. No differences in the corneal curvature, corneal diameter, spherical equivalent, intra-ocular pressure, axial length, tear film breakup time and Schirmer test were noted among diabetic and non-diabetic children.

CONCLUSIONS: Significant structural changes in cornea and lens along with reduction in anterior chamber depth and pupillary diameter were found. These morphological changes may be indication for early and prompt management and underscore the need for more advanced ophthalmological evaluation techniques, in addition to routine examination.

PMID:35302189 | DOI:10.26355/eurrev_202203_28209

Int J Occup Med Environ Health. 2022 Mar 15:145167. doi: 10.13075/ijomeh.1896.01682. Online ahead of print.

ABSTRACT

OBJECTIVES: Chronic exposure to air pollution caused by particulate matter (PM) with aerodynamic diameters of <10 μm (PM₁₀) and <2.5 μm (PM_2.5), dependent on “low emissions” resulting from the combustion of solid fuels in households, significantly increases the risk of cardiovascular events. The aim of the study was to assess the impact of chronic exposure to air pollution in the place of residence on the occurrence of coronary artery disease, hypertension and the presence of electrocardiographic abnormalities in 24-hour Holter ECG recording.

MATERIAL AND METHODS: After considering the exclusion criteria, 100 consecutive patients of the cardiology outpatient clinic were enrolled in the study, including 50 patients living for ≥10 years in Warsaw districts with the lowest average concentrations of PM_2.5 (group I) and 50 living in the districts with the highest recorded exposure (group II). All patients underwent clinical and physical examination, 12-lead ECG, 2D cardiac echo, and Holter ECG. To avoid the impact of acute exposure, the study was carried out in May – the month with statistically the lowest recorded PM_2.5 concentrations.

RESULTS: In the group of patients exposed to higher concentrations of PM_2.5 in the place of residence, coronary artery disease and arterial hypertension were significantly more frequent, while in the Holter ECG examination, ventricular arrhythmias, conduction disturbances and ST-segment and T-wave changes were independently associated with exposure to air pollution.

CONCLUSIONS: Chronic exposure to air pollution in the place of residence contributes to the occurrence of chronic coronary syndrome and hypertension. Chronic exposure to air pollution seems to be a significant factor increasing the incidence of ventricular arrhythmia, conduction disturbances and ST-segment depression episodes in Holter monitoring.

PMID:35302115 | DOI:10.13075/ijomeh.1896.01682

Neurologist. 2022 Mar 18. doi: 10.1097/NRL.0000000000000430. Online ahead of print.

ABSTRACT

BACKGROUND: Therapeutic plasma exchange (TPE) is a conventional second-line treatment for patients with multiple sclerosis (MS) or clinically isolated syndrome with steroid-refractory relapses.

METHODS: MS and clinically isolated syndrome patients with a steroid-refractory relapse, who fulfilled the indications for TPE were enrolled in this study. An expert nurse recorded the data comprising age, sex, type of MS, disease modifying therapy, disease duration, relapse rate, vital signs at the beginning, during and at the end of each plasma exchange session, plasma exchange volume, normal saline volume, and TPE complications. Ultimately, the statistical association was estimated amongst the variables.

RESULTS: A total of 122 cases were assessed. Twelve cases (9.8%) received plasmapheresis for the second time. The mean age was 32.2±8.7 years and 107 (87.7%) were female. In total, 609 plasma exchange sessions were completed. Hypotension and skin reaction were the most clinical complications. Hemoglobin loss and hypokalemia were the most laboratory complications. Fifty-four cases (44.3%) had no complications, 40 (32.8%) had 1 complication, 21 (17.2%) 2 complications, 6 (4.9%) had 3 complications, and 1 (0.8%) disclosed 4 complications. The relapse rate in the past 12 months and the mean plasma volume exchange were significantly different between the groups.

CONCLUSIONS: We revealed that TPE could be considered as a safe second-line therapy in MS relapses. Hypotension, skin reaction, hemoglobin loss, and hypokalemia were the most complications of TPE in our patients.

PMID:35302053 | DOI:10.1097/NRL.0000000000000430

Sci Rep. 2022 Mar 17;12(1):4586. doi: 10.1038/s41598-022-08333-7.

ABSTRACT

Preventive chemotherapy (PC), the main strategy recommended by the World Health Organization to eliminate soil-transmitted helminthiasis (STH) and schistosomiasis (SCH), should be strengthened through identification of the remaining SCH transmission foci and evaluating its impact to get a lesson. This study was aimed to assess the prevalence of STH/SCH infections, the intensity of infections, and factors associated with STH infection among school-aged children (SAC) in Uba Debretsehay and Dara Mallo districts (previously not known to be endemic for SCH) in southern Ethiopia, October to December 2019. Structured interview questionnaire was used to collect household data, anthropometric measurements were taken and stool samples collected from 2079 children were diagnosed using the Kato-Katz technique. Generalize mixed-effects logistic regression models were used to assess the association of STH infections with potential predictors. A P-value less than 0.05 was considered statistically significant. The prevalence of Schistosoma mansoni in the Dara Mallo district was 34.3% (95%CI 30.9-37.9%). Light, moderate, and heavy S. mansoni infections were 15.2%, 10.9%, and 8.2% respectively. The overall prevalence of any STH infection was 33.2% with a 95% confidence interval (CI) of 31.1-35.3%. The intensity of infections was light (20.9%, 11.3% & 5.3%), moderate (1.1%, 0.1% & 0.4%) and heavy (0.3%, 0% & 0%) for hookworm, whipworm and roundworms respectively. The overall moderate-to-heavy intensity of infection among the total diagnosed children was 2% (41/2079). STH infection was higher among male SAC with Adjusted Odds Ratio (AOR) of 1.7 (95%CI 1.4-2.1); occupation of the household head other than farmer or housewife (AOR = 0.5; 95%CI 0.3-0.8), middle [AOR = 1.1; 95%CI 1.0-1.3] or high [AOR = 0.7; 95%CI 0.5-0.9] socioeconomic status. Dara Mallo district was moderate endemic for S. mansoni; and it needs sub-district level mapping and initiating a deworming campaign. Both districts remained moderate endemic for STH. Evidence-based strategies supplementing existing interventions with the main focus of the identified factors is important to realize the set targets.

PMID:35302056 | DOI:10.1038/s41598-022-08333-7

J Ment Health Policy Econ. 2022 Mar 1;25(1):21-34.

ABSTRACT

BACKGROUND: Uncertainty around economic recovery from a pandemic, in addition to restrictions on mobility and socializing, can be isolating and stressful. While preventive measures, such as mask mandates, are expected to mitigate spread of the disease and lower concerns of future job loss, state- and local-level mandates could signal that infection rates are worse in the mandated areas and decrease consumer confidence and mobility. Thus, the association between mask mandates and psychological well-being is unclear.

AIMS OF THE STUDY: Twenty-five states in the United States implemented statewide mask mandates early in the pandemic. This study seeks to examine the effect of mask mandates on self-reported job loss expectation and mental health.

METHODS: This study analyzes U.S. Census Bureau’s Household Pulse Survey data, collected between April 23rd and July 21st, 2020. Using a panel subset of the data, fixed effects models are estimated to understand statewide mask mandate’s effect on psychological well-being over a twelve-week period while controlling for individual-level unobserved heterogeneity. All data are then state-aggregated, and fixed effects models are estimated to examine average differences in job loss expectation and mental health between mandate and non-mandate states.

RESULTS: In the individual-level panel data, job loss expectation was lower by 1.1 percentage point by the second week of a statewide mask mandate and by 1.6 percentage point by the third week, compared to average job loss expectation in states without a mask mandate and to the mandate states before the policy implementation. Average job loss expectation was 6.5 percentage point lower by the twelfth week in the five states that were the first to implement statewide mask mandates. Mental health status improved steadily from the fourth week on in states with a mask mandate. Analysis of state-aggregated data indicates considerable variability and lack of uniformity in mask mandates’ impact on job loss expectation and mental health status.

DISCUSSION: Local-level mandates, such as those at the county-level, could not be identified in these data. The impact of a mask mandate could be underestimated when only state-level mandates are considered, and local regulations are excluded. This is a limitation of this study.

IMPLICATIONS FOR HEALTH CARE PROVISION: The staggered state-by-state approach to implementing mask mandates and the considerable variability in enforcement of mask rules has possibly contributed to lack of uniformity and consistency in how mask mandates impact subjective psychological well-being.

IMPLICATIONS FOR HEALTH POLICIES: The lack of statistically significant impact of statewide mask mandates on the two outcome variables in the state-aggregated data, and on long-run job loss expectation in the individual-level panel data, could be indicative of the complexities of effective science communication regarding behavioral recommendations to promote overall well-being.

IMPLICATIONS FOR FURTHER RESEARCH: Multiple variants of SARS-CoV-2, the virus that causes COVID-19, has emerged around the world. Further research could more clearly assess the degree to which communicating public health implications of these variants has evolved, and whether it has elicited behavior change and affected psychological well-being.

PMID:35302051

J Ment Health Policy Econ. 2022 Mar 1;25(1):3-10.

ABSTRACT

BACKGROUND AND AIMS: We study the trajectory of depressive symptoms among US adults before, during, and after the 2008/2009 Great Recession.

METHODS: We use repeated cross-sectional surveys of the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. Mental health is assessed with the Patient Health Questionnaire-9 (PHQ-9), with the following categorization for depressive symptoms: none or mild (score 0-9), moderate or severe (score 10-27). A parallel time series was calculated from the Behavioral Risk Factor Surveillance System (BRFSS) on self-reported number of days with poor mental health.

RESULTS: NHANES data show a statistically significant increase in depressive symptoms from 2005/2006 to 2007/2008 (the beginning of the Great Recession), but there were no significant or consistent changes after 2007/2008. In particular, the deterioration in the adjusted predicted PHQ-9 scores occurred prior to the large increase in unemployment rate (2009/2010). As the macroeconomic situations improved and unemployment rates recovered, mental health did not return to the previous level. In the latest wave of NHANES (2017/2018), unemployment rates were at the lowest level over the analysis period; however, the adjusted predicted PHQ-9 scores were higher than that at the beginning of the Great Recession. Trends of PHQ-9 scores were similar across income groups – all groups had an increase in depressive symptoms after 2005/2006 and PHQ-9 scores were still high in 2017/2018 after controlling for sociodemographic status. Group with the lowest income had higher levels of depressive symptoms at every time point. BRFSS data shows no consistent changes in the number of days with poor mental health that parallel economic conditions.

DISCUSSION: Depressive symptoms at the population level did not match the economic cycle before, during and after the Great Recession. Future research is needed to better understand the lack of correlation between population mental health and macroeconomic conditions.

PMID:35302049

J Cachexia Sarcopenia Muscle. 2022 Mar 17. doi: 10.1002/jcsm.12952. Online ahead of print.

ABSTRACT

Low muscle mass is prevalent among patients with cancer and a predictor of adverse clinical outcomes. To counteract muscle loss, β-hydroxy β-methylbutyrate (HMB) supplementation has been proposed as a potential therapy for older adults and various diseases states. This systematic review aimed to investigate the effects and safety of HMB supplementation in relation to muscle mass and function and other clinical outcomes in patients with cancer. A systematic search of MEDLINE, CINAHL, Embase, Cochrane Central Register of Controlled Trials, Scopus, ProQuest, and grey literature for reports published from inception to December 2021 was conducted. Included studies provided supplements containing any dose of HMB to adult patients with active cancer. A synthesis without meta-analysis was conducted using a vote-counting approach based solely on the direction of the effect (i.e. regardless of statistical significance). Risk of bias was assessed for each outcome domain, and evidence from higher-quality studies (i.e. those with either low or moderate risk of bias) was examined. Safety was evaluated using both lower-quality and higher-quality studies. Fifteen studies were included, in which six were randomized controlled trials in patients with various cancer types and treatments. Studies prescribed HMB combined with amino acids (73.3%), HMB in oral nutritional supplements (20.0%), or both supplement types (6.7%); Ca-HMB doses of 3.0 g/day were provided in 80.0% of the studies. Four studies had high risk of bias across all outcome domains. Considering the higher-quality studies, evidence of a beneficial effect of HMB supplementation was found in four of four studies for muscle mass, two of two for muscle function, three of three for hospitalization, and five of seven for survival. In contrast, no beneficial effects of HMB on quality of life or body weight was found in two of four and three of five studies, respectively. A limited number of higher-quality studies evaluating the impact of HMB on cancer therapy-related toxicity, inflammation, and tumour response were observed. No serious adverse effects directly related to the nutrition intervention were reported. Although limited, current evidence suggests that HMB supplementation has a beneficial effect on muscle mass and function in patients with cancer. Well-designed trials are needed to further explore the clinical benefit of HMB supplementation in this patient population.

PMID:35301826 | DOI:10.1002/jcsm.12952

J Clin Hypertens (Greenwich). 2022 Mar 17. doi: 10.1111/jch.14460. Online ahead of print.

ABSTRACT

Masked uncontrolled hypertension (MUCH) is at higher cardiovascular risk than controlled hypertension (CH). In previous studies, patients with MUCH were considered as a unique group though those receiving ≤2 drugs could be defined as having nonresistant MUCH (NRMUCH) and those receiving ≥3 drugs as having resistant MUCH (RMUCH). The aim of this study was to assess the prognostic value of NRMUCH and RMUCH detected by ambulatory blood pressure (BP) monitoring. Cardiovascular risk was evaluated in 738 treated hypertensive patients with normal clinic BP. Patients were classified as having CH or MUCH if daytime BP < or ≥ 135/85 mmHg, respectively, regardless of nighttime BP, or CH or MUCH if 24-h BP < or ≥ 130/80 mmHg, respectively, regardless of daytime or nighttime BP. By daytime or 24-h BP, the authors detected 523 (71%), 178 (24%), and 37 (5%) or 463 (63%), 231 (31%), and 44 (6%) patients with CH, NRMUCH, and RMUCH, respectively. During the follow-up (median 10 years), 148 events occurred. After adjustment for covariates, compared to CH, the hazard ratio (HR), 95% confidence interval (CI), for cardiovascular events was 1.81, 1.27-2.57, and 2.99, 1.73-5.16, in NRMUCH and RMUCH defined by daytime BP, respectively, and 1.58, 1.12-2.23, and 2.21, 1.27-3.82, in NRMUCH and RMUCH defined by 24-h BP, respectively. If RMUCH was compared with NRMUCH, the risk tended to be higher in RMUCH but did not attain statistical significance (P = .08 and P = .23 by daytime and 24-h BP thresholds, respectively). In conclusion, both NRMUCH and RMUCH are at increased cardiovascular risk than CH.

PMID:35301793 | DOI:10.1111/jch.14460

J Cachexia Sarcopenia Muscle. 2022 Mar 18. doi: 10.1002/jcsm.12967. Online ahead of print.

ABSTRACT

BACKGROUND: Chemotherapy-induced toxicities frequently occur in non-small cell lung cancer (NSCLC) patients treated with platinum-based chemotherapy. Low skeletal muscle mass (SMM) has been associated with a higher incidence of toxicities for several types of cancers and cytostatics. The aim of this study was to evaluate the association between skeletal muscle measures and chemotherapy-induced toxicity in a large cohort of NSCLC patients.

METHODS: A multicentre prospective follow-up study (PGxLUNG, NTR number NL5373610015) in NSCLC patients was conducted. Included were patients diagnosed with NSCLC (stage II-IV) treated with first-line platinum-based (cisplatin or carboplatin) chemotherapy of whom pretreatment imaging was available. Skeletal muscle area (SMA) segmentation was performed on abdominal imaging at the level of the third lumbar vertebra (L3). SMA at the level of L3 was corrected for squared height (m² ) to yield the lumbar skeletal muscle mass index (LSMI). Skeletal muscle density (SMD) was calculated as the mean Hounsfield Unit (HU) of the segmented SMA. SMM and SMD were categorized as low, intermediate, and high, based on LSMI and mean HU tertiles, respectively. Chemotherapy-induced toxicity was scored using CTCAE v4.03 and categorized into haematological (anaemia, leukocytopenia, neutropenia, and thrombocytopenia), non-haematological (nephrotoxicity, neurotoxicity, and esophagitis), and dose-limiting toxicity (DLT) (treatment switch, delay, de-escalation, discontinuation, or hospitalization). The relationship between SMM, SMD, and toxicities was assessed with logistic regression modelling taking into account potential confounders like gender and body mass index (BMI).

RESULTS: In total, 297 patients (male n = 167, median age 64 years) were included. Haematological toxicity grade 3/4 was experienced in 36.6% (n = 108) of the patients, 24.6% (n = 73) experienced any non-haematological toxicity grade ≥2, and 55.6% (n = 165) any DLT. Multivariate logistic regression analysis showed that low SMM (ORadj 2.41, 95% CI 1.31-4.45, P = 0.005) and age at diagnosis >65 years (ORadj 1.76, 95% CI 1.07-2.90, P = 0.025) were statistically significantly associated with overall haematological toxicity grade 3/4. No statistically significant associations were found between low SMM or low SMD and non-haematological toxicities. Low SMM (ORadj 2.23, 95% CI 1.23-4.04, P = 0.008) and high SMD (ORadj 0.41, 95% CI 0.23-0.74, P = 0.003) were statistically significantly associated with a higher respectively lower risk of DLT.

CONCLUSIONS: Non-small cell lung cancer patients with pretreatment low SMM are at significant higher risk for haematological toxicities grade 3/4 and DLT. NSCLC patients with high SMD are at significant lower risk for DLT. Further studies should be aimed to investigate whether platinum dosing based on skeletal muscle measurements and/or improvement of pretreatment SMM/SMD could reduce the risk of toxicity without compromising efficacy.

PMID:35301821 | DOI:10.1002/jcsm.12967