Tag: pubmed

J Basic Clin Physiol Pharmacol. 2022 Jan 14. doi: 10.1515/jbcpp-2021-0330. Online ahead of print.

ABSTRACT

OBJECTIVES: Diabetic peripheral neuropathy (DPN) is a common diabetes complication. The prevalence of neuropathy is 55% for type 1 and 66% for type 2 diabetes. In Unani medicine neuropathy is known as Khidr (numbness). It is treated with drugs possessing hypoglycemic and analgesic properties, etc. Habb-e-Asab, a polyherbal Unani formulation used for the treatment of Waja-ul-Asab (neuralgia) is routinely used for its indications in neurological pain in Unani medicine. The aim of this study to investigate the efficacy of Habb-e-Asab in diabetic peripheral neuropathy.

METHODS: Thirty patients with DPN were randomly assigned to test (n=20) and control (n=10) groups in a randomized single-blind placebo control study. For 45 days, the test group was given 250 mg Habb-e-Asab twice a day and the control group 250 mg placebo twice a day. The subjective parameters Pain in feet, burning in feet, and tingling in feet was assessed by the arbitrary scale and VAS fortnightly and objective parameters MNSI, and VPT was assessed in pre-post-treatment.

RESULTS: The research drug revealed highly statistically significant with p<0.001 on VAS score and MNSI whereas VPT is significant with p<0.01 on few points. But control group exhibits no significant effect in any of the parameters. No adverse effects had been reported in either group.

CONCLUSIONS: Our finding indicated that the Habb-e-Asab for 45 days improved and reduced the severity of DPN in a patient with diabetes (CTRI/2018/02/011725).

PMID:35026880 | DOI:10.1515/jbcpp-2021-0330

Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):1001-1005.

ABSTRACT

According to the European Commission’s 2020 Rule of Law Report, in regard to Croatia, the level of perceived judicial independence remains among the lowest in the European Union, mostly due to perceived political corruption. The authors analyse the causes of such a perception of the Croatian judicial system, especially the length of criminal proceedings in high profile cases, and try to evaluate it by comparing available statistical information concerning the judiciary in Croatia with that of other EU countries. The authors also take into account and describe the effect which contemporary issues like news coverage by increasingly partisan media have on public perception of the judicial system, and polarization of public opinion on key social and legal matters. In conclusion, the authors give an overview of recent studies which found that corruption has a detrimental effect on mental health.

PMID:35026835

Am J Perinatol. 2022 Jan 13. doi: 10.1055/a-1739-3529. Online ahead of print.

ABSTRACT

Objective As newborns are exposed to oxidative stress during delivery, cord clamping techniques play significant role on antioxidant status. In this study, we aimed to show the relationship between early cord clamping (ECC), delayed cord clamping (DCC) and cut umblical cord milking (C-UCM) techniques with total oxidant capacity (TOC), total antioxidant capacity (TAC) and peroxynitrite levels. Study Design Sixty-nine term infants were selected with APGAR score of 7 and above in the first and fifth minutes. The mothers of all infants had uncomplicated pregnancy, had no congenital anomaly, and delivered by cesarean section. Newborns were randomised to one of three groups: ECC (n: 23), DCC (n: 23) or C-UCM (n: 23). After all newborn babies were taken under radiant heater, blood samples were collected from the umbilical cord. The plasma samples were then frozen and stored at -80 °C until analysis and TOC, TAC and peroxynitrite levels were studied. Results The ages of the mothers participating in the study were between 17 and 42, with an average of 29.14 ± 6.28. 30 (43.5%) of the babies were girls and 39 (56.5%) were boys. The 5th minute APGAR score of the babies in early cord clamping group was significantly lower than the babies in delayed cord clamping and cut cord milking group (p = 0.034; p = 0.034; p <0.05). The TOC, OSI and Peroxynitrite measurements of three groups did not differ statistically. The TAC value of the C-UCM group was significantly higher than the patients with the ECC and DCC group (p = 0.002; p = 0.019; p <0.05). Conclusion C-UCM and DCC would be feasible methods by increasing antioxidant status and providing protective effect on the future health of the term newborns.

PMID:35026851 | DOI:10.1055/a-1739-3529

Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):994-1000.

ABSTRACT

The media are certainly in the service of health – following it with their information, advice, statistics, discoveries, innovations. There is a well-known saying that health is the greatest wealth. Being healthy and taking care of one’s health is a good thing. This article presents the media in the service of health and health care. The World Health Organization stresses that the media should cooperate with health services in promoting health. The introduction emphasizes the growing presence and availability of media in daily life, as well as its relevance in health education. In doing so, people of different ages, occupations and education are informed about health and advised about healthy living. The article goes on to discuss the importance of the media in the world. The media have various roles: information, education, instruction, and entertainment, but in doing so they must be ethical. The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being and not merely the simple absence of disease or infirmity. The article then discusses the importance of health in our lives. The mass media reaches a great number of readers, listeners, and viewers each day with up-to-date and varied information, making them the most essential source of information regarding health and a healthy living. They transmit information from the sender (doctors, experts, and institutions) to the recipient – the people themselves. Health awareness strongly influences the care and treatment of individuals. There is talk of cooperation between the media and health care institutions in the function of improving people’s health. Physician-media communication was also analyzed, contributing to better information on health and the health system. The article provides valuable information and guidance concerning the relationship between health and the media. The article concludes with a discussion of the media during the COVID-19 pandemic. Research is cited showing that demand for media content increased during the pandemic. The media has a critical role to play in alerting the public about the pandemic, the disease’s progress, and how to battle COVID-19. Unfortunately, the media has had a harmful influence on human health, particularly the propagation of fear, panic, and excitement, as well as cardiac and mental illnesses. The media inundates the public with varied facts on the proliferation of COVID-19 in Croatia and throughout the world with daily news broadcasts.

PMID:35026834

Nurs Res. 2022 Jan 12. doi: 10.1097/NNR.0000000000000576. Online ahead of print.

ABSTRACT

BACKGROUND: The Coronavirus 2019 (COVID-19) pandemic has negatively altered many families’ lifestyles and the mental well-being of parents, especially those who have a low income and young children. To improve low-income parents’ mental well-being, especially during a pandemic, understanding parents’ and children’s lifestyle behaviors and the relationship between their lifestyle behaviors and parents’ mental well-being is essential.

OBJECTIVE: This cross-sectional study examined relationships between lifestyle behaviors (sleep, physical activity, screen time, and eating behavior of parents and children) and low-income parents’ well-being (stress, anxiety, depression) during COVID-19.

METHODS: Parents were recruited from two Michigan Head Start organizations as well as across the United States; 408 parents completed an online survey. Demographic characteristics were assessed along with parents’ sleep, physical activity, screen time, and dietary intake; stress, anxiety, and depression were also examined. Children’s sleep time, physical activity, screen time, and fruit/vegetable intake were assessed. Descriptive statistics, correlations, and the multivariate general linear model procedure were used.

RESULTS: Approximately 69.4% of parents reported moderate stress levels, and 17.2% reported high levels. Most parents had sleep disturbances, attained minimal physical activity, and consumed <5 fruits/vegetables per day; average screen time was >2 hr per day. Only 41% of preschoolers were active 7 days a week and slept ≥10 hr per day. Two thirds had >2 hr per day of screen time, and less than one fifth consumed ≥5 fruits/vegetables per day. After adjusting for parents’ demographics and children’s lifestyle behaviors, parents’ sleep disturbance was positively correlated with their levels of stress, anxiety, and depression. After controlling for parents’ demographics and lifestyle behaviors, child sleep time was negatively associated with parents’ stress levels. Family demographics and parents’ and children’s lifestyle behaviors explained 33.4%, 29.8%, and 28.1% of the variances in parents’ stress, anxiety, and depression, respectively.

DISCUSSION: Most parents and preschoolers were not meeting many lifestyle behavior recommendations, indicating a need for interventions. Improving parents’ sleep quality and reducing bedtime challenges involving their preschoolers may be necessary for enhancing parental mental well-being.

PMID:35026803 | DOI:10.1097/NNR.0000000000000576

Curr Opin Clin Nutr Metab Care. 2022 Jan 12. doi: 10.1097/MCO.0000000000000814. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: The goal of this report is to delineate the correlation between constipation as a manifestation of impaired gastrointestinal transit with adverse clinical outcomes, to identify risk factors, which predispose to this condition, and outline a management scheme for prophylactic treatment.

RECENT FINDINGS: Constipation is common in the ICU, affecting upwards of 60-85% of critically ill patients. As suggested by case series and observational studies, constipation may be an independent prognostic factor identifying patients with greater disease severity, higher likelihood of organ dysfunction, longer duration of mechanical ventilation, prolonged hospital length of stay, and possibly reduced survival. Treating constipation is a low priority for intensivists often relegated to the nursing service, and few ICUs have well designed protocols in place for a bowel regimen. Small randomized controlled trials show improvement in certain outcome parameters in response to a daily lactulose therapy; hospital length of stay, sequential organ failure assessment scores, and duration of mechanical ventilation. However, aggregating the data from these studies in two separate meta-analyses showed that the effect of a bowel regimen on these three endpoints were not statistically different.

SUMMARY: No causal relationship can be determined between constipation and adverse outcomes. Nonetheless, a clinical correlation seems to exist. Whether constipation is an epiphenomenon or simply a reflection of greater severity of critical illness, at some point it may contribute to worsening morbidity in the ICU. A graded prophylactic bowel regimen should help reverse impairment of the gastrointestinal transit and aid in reducing its deleterious impact on the hospital course of the critically ill patient.

PMID:35026804 | DOI:10.1097/MCO.0000000000000814

Am J Med Qual. 2022 Jan 11. doi: 10.1097/JMQ.0000000000000036. Online ahead of print.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, frequently changing guidelines presented challenges to emergency department (ED) clinicians. The authors implemented an electronic health record (EHR)-integrated clinical pathway that could be accessed by clinicians within existing workflows when caring for patients under investigation (PUI) for COVID-19. The objective was to examine the association between clinical pathway utilization and adherence to institutional best practice treatment recommendations for COVID-19.

METHODS: The authors conducted an observational analysis of all ED patients seen in a health system inclusive of seven EDs between March 18, 2020, and April 20, 2021. They implemented the pathway as an interactive flow chart that allowed clinicians to place orders while viewing the most up-to-date institutional guidance. Primary outcomes were proportion of admitted PUIs receiving dexamethasone and aspirin in the ED, and secondary outcome was time to delivering treatment.

RESULTS: A total of 13 269 patients were admitted PUIs. The pathway was used by 40.6% of ED clinicians. When clinicians used the pathway, patients were more likely to be prescribed aspirin (OR, 7.15; 95% CI, 6.2-8.26) and dexamethasone (10.4; 8.85-12.2). For secondary outcomes, clinicians using the pathway had statistically significant (P < 0.0001) improvement in timeliness of ordering medications and admission to the hospital. Aspirin, dexamethasone, and admission order time were improved by 103.89, 94.34, and 121.94 minutes, respectively.

CONCLUSIONS: The use of an EHR-integrated clinical pathway improved clinician adherence to changing COVID-19 treatment guidelines and timeliness to associated medication administration. As pathways continue to be implemented, their effects on improving patient outcomes and decreasing disparities in patient care should be further examined.

PMID:35026785 | DOI:10.1097/JMQ.0000000000000036

Am J Phys Med Rehabil. 2022 Feb 1;101(2):135-138. doi: 10.1097/PHM.0000000000001754.

ABSTRACT

OBJECTIVE: The objective was to examine the 22 variables from the Sport Concussion Assessment Tool’s 5th Edition Symptom Evaluation using a decision tree analysis to identify those most likely to predict prolonged recovery after a sport-related concussion.

DESIGN: A cross-sectional design was used in this study. A total of 273 patients (52% men; mean age, 21 ± 7.6 yrs) initially assessed by either an emergency medicine or sport medicine physician within 14 days of concussion (mean, 6 ± 4 days) were included. The 22 symptoms from the Sport Concussion Assessment Tool’s 5th Edition were included in a decision tree analysis performed using RStudio and the R package rpart. The decision tree was generated using a complexity parameter of 0.045, post hoc pruning was conducted with rpart, and the package carat was used to assess the final decision tree’s accuracy, sensitivity and specificity.

RESULTS: Of the 22 variables, only 2 contributed toward the predictive splits: Feeling like “in a fog” and Sadness. The confusion matrix yielded a statistically significant accuracy of 0.7636 (P [accuracy > no information rate] = 0.00009678), sensitivity of 0.6429, specificity of 0.8889, positive predictive value of 0.8571, and negative predictive value of 0.7059.

CONCLUSIONS: Decision tree analysis yielded a statistically significant decision tree model that can be used clinically to identify patients at initial presentation who are at a higher risk of having prolonged symptoms lasting 28 days or more postconcussion.

PMID:35026775 | DOI:10.1097/PHM.0000000000001754

Am J Med Qual. 2022 Jan 11. doi: 10.1097/JMQ.0000000000000042. Online ahead of print.

ABSTRACT

Coding variation distorts performance/outcome statistics not eliminated by risk adjustment. Among 1596 community-acquired pneumonia patients hospitalized from 1998 to 2012 identified using an evidence-based algorithm, the authors measured the association of principal diagnosis (PD) with 30-day readmission, stratified by Pneumonia Severity Index risk class. The 152 readmitted patients were more ill (Pneumonia Severity Index class V 38.8% versus 25.8%) and less likely to have a pneumonia PD (52.6% versus 69.9%). Among patients with PDs of pneumonia, respiratory failure, sepsis, and aspiration, mortality/readmission rates were 3.9/8.5%, 28.8/14.0%, 24.7/19.6%, and 9.0/15.0%, respectively. The nonpneumonia PDs were associated with a greater risk of adjusted 30-day readmission: respiratory failure odds ratio (OR) 1.89 (95% confidence interval [CI], 1.13-3.15), sepsis OR 2.54 (95% CI, 1.52-4.26), and possibly aspiration OR 1.73 (95% CI, 0.88-3.41). With increasing use of alternative PDs among pneumonia patients, quality reporting must account for variations in condition coding practices. Rigorous risk adjustment does not eliminate the need for accurate, consistent case definition in producing valid quality measures.

PMID:35026784 | DOI:10.1097/JMQ.0000000000000042

Digestion. 2022 Jan 13:1-9. doi: 10.1159/000520892. Online ahead of print.

ABSTRACT

BACKGROUND: The effectiveness of prophylactic antibiotics in severe acute pancreatitis (SAP) remains a debatable issue. This meta-analysis aimed to determine the efficacy of prophylactic carbapenem antibiotics in SAP.

METHODS: This meta-analysis of prophylactic carbapenem antibiotics for SAP was conducted in PubMed, EMBASE, Web of Science, MEDLINE, and Cochrane Library up to February 2021. The related bibliographies were manually searched. The primary outcomes involved infected pancreatic or peripancreatic necrosis, mortality, complications, infections, and organ failure.

RESULTS: Seven articles comprised 5 randomized controlled trials and 2 retrospective observational studies, including 3,864 SAP participants. Prophylactic carbapenem antibiotics in SAP were associated with a statistically significant reduction in the incidence of infections (odds ratio [OR]: 0.27; p = 0.03) and complications (OR: 0.48; p = 0.009). Nevertheless, no statistically significant difference was demonstrated in the incidence of infected pancreatic or peripancreatic necrosis (OR: 0.74; p = 0.24), mortality (OR: 0.69; p = 0.17), extrapancreatic infection (OR: 0.64, p = 0.54), pulmonary infection (OR: 1.23; p = 0.69), blood infection (OR: 0.60; p = 0.35), urinary tract infection (OR: 0.97; p = 0.97), pancreatic pseudocyst (OR: 0.59; p = 0.28), fluid collection (OR: 0.91; p = 0.76), organ failure (OR: 0.63; p = 0.19), acute respiratory distress syndrome (OR: 0.80; p = 0.61), surgical intervention (OR: 0.97; p = 0.93), dialysis (OR: 2.34; p = 0.57), use of respirator or ventilator (OR: 1.90; p = 0.40), intensive care unit treatment (OR: 2.97; p = 0.18), and additional antibiotics (OR: 0.59; p = 0.28) between the experimental and control groups.

CONCLUSIONS: It is not recommended to administer routine prophylactic carbapenem antibiotics in SAP.

PMID:35026770 | DOI:10.1159/000520892