Tag: pubmed

Zentralbl Chir. 2022 Feb;147(1):42-53. doi: 10.1055/a-1712-4749. Epub 2022 Mar 2.

ABSTRACT

BACKGROUND: In sophisticated surgical procedures, e. g. colectomy, cardiac surgery, arterial reconstruction and liver resection, the individual surgeon is a major influence on postoperative morbidity. For the everyday procedure of cholecystectomy, clear data on the morbidity related to the individual surgeon are lacking.

AIMS: To assess the individual impact on the outcome of cholecystectomy in a cohort of experienced surgeons.

METHODS: The analysis covered n = 710 consecutive patients who had received cholecystecomy between January 2014 and December 2018 – performed by experienced surgeons (> n = 300 cholecystectomies before entry in the study and > 5 years after specialty registration). In a univariate analysis, the influence of patient characteristics, laboratory findings and surgical data on postoperative morbidity were investigated. Variables with statistical significance were entered into a multivariate logistic regression.

RESULTS: Mortality was 5/710 (0.7%), and morbidity was 58/710 (8.2%), including 37/710 patients with surgical morbidity and 21/710 patients with non-surgical morbidity. In a multivariable analysis the independent risk factors for overall morbidity were creatinine level (OR 1.29, CI 1.01-1.648, p = 0.042), GOT (OR 1.005, CI 1-1.01, p = 0.03), open/conversion surgery (OR 4.134, CI 1.587-10.768, p = 0.004) and the individual surgeon (OR up to 40.675, p = 0.001). In the analysis of surgical complications, open/conversion surgery (OR 8.104, CI 3.03-21.68, p < 0.001) and the individual surgeon (OR up to 79.69, p = 0.005) remained of significant influence.

CONCLUSIONS: The individual surgeon is of major influence on the outcome after an everyday procedure such as cholecystectomy in a group of experienced surgeons with specialty registration. The individual outcome of each surgeon should be measured as a basis of targeted improvement programs.

PMID:35235968 | DOI:10.1055/a-1712-4749

Am J Health Syst Pharm. 2022 Mar 2:zxac070. doi: 10.1093/ajhp/zxac070. Online ahead of print.

ABSTRACT

DISCLAIMER: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE: Although pharmacist-provided diabetes services have been shown to be effective, the effectiveness of telepharmacy (TP) in diabetes management has not been clearly established. This systematic review and meta-analysis aims to evaluate the effectiveness of diabetes TP services.

METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched (from inception through September 2021) to identify published studies that evaluated the effect of TP services in patients with diabetes mellitus and reported either glycosylated hemoglobin (HbA1c) or fasting blood glucose (FBG) outcomes. Mean difference (MD), weighted mean difference (WMD), relative risk (RR), and 95% confidence intervals were calculated using the DerSimonian and Laird random-effects model.

RESULTS: 36 studies involving 13,773 patients were included in the systematic review, and 23 studies were included in the meta-analysis. TP was associated with a statistically significant decrease in HbA1c (MD, -1.26%; 95% CI, -1.69 to -0.84) from baseline. FBG was not significantly affected (MD, -25.32 mg/dL; 95% CI, -57.62 to 6.98). Compared to non-TP service, TP was associated with a lower risk of hypoglycemia (RR, 0.48; 95% CI, 0.30-0.76). In a subset of studies that compared TP to face-to-face (FTF) pharmacy services, no significant difference in HbA1c lowering was seen between the 2 groups (WMD, -0.09%; 95% CI, -1.07 to 0.90).

CONCLUSION: Use of TP was associated with reduction of HbA1c and the risk of hypoglycemia in patients with diabetes mellitus. High-quality randomized controlled trials are needed to validate the effectiveness of diabetes TP services relative to FTF services.

PMID:35235950 | DOI:10.1093/ajhp/zxac070

Dev Neurosci. 2022 Mar 2. doi: 10.1159/000523866. Online ahead of print.

NO ABSTRACT

PMID:35235927 | DOI:10.1159/000523866

Neonatology. 2022 Mar 2:1-8. doi: 10.1159/000522288. Online ahead of print.

ABSTRACT

BACKGROUND: Gastric transposition (GT) is a possible option for esophageal replacement in long-gap esophageal atresia (LGEA). The present study aims to report and compare indications and outcome of laparoscopic-assisted GT (LAGT) versus open (OGT) GT for LGEA repair.

METHODS: Retrospective single-center analysis of all LGEA patients undergoing GT between 2002 and 2021.

RESULTS: Thirty-one children with LGEA underwent GT. Of these, 19 underwent LAGT (mean weight at surgery 5.6 kg; mean age 167 days) and 12 underwent OGT (6.1 kg; 233 days). Indications for OGT were previous surgery (n = 7), associated severe cardiac malformations (n = 4), and a simultaneous resection of a choledochal cyst (n = 1). The conversion rate was 1. The two procedures (LAGT/OGT) differed in anesthetic time (308/350 min), duration of ventilation (5.1/5.3 days), hospital stay (34/32 days), and complications (22/15). None of the differences reached statistical significance. Outcome was also comparable: completely oral nutrition uptake in 66%/73%, slow weight gain in the low centiles in both groups, no patient developed dumping syndrome, symptomatic reflux was seen in 1 patient after OGT.

CONCLUSION: In our cohort, LAGT for repair of LGEA provided similar outcomes as open surgery. The minimally invasive approach preserves thoracal structures, prevents additional thoracotomy or laparotomy, and is faster. To realize LAGT, a postpartal treatment concept including gastrostomy placement via a microincision to minimize adhesions is essential. The open surgical approach should be considered in cases of previous extensive surgical attempts of EA correction causing severe adhesions as well as associated anomalies or genetic syndromes causing hemodynamic instability.

PMID:35235935 | DOI:10.1159/000522288

Surg Oncol. 2022 Feb 24;41:101732. doi: 10.1016/j.suronc.2022.101732. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: PET-CTs are being increasingly utilized in sarcoma care. This study sought to investigate the impact of PET-CT acquisition on time to treatment initiation.

METHODS: The records of bone and soft tissue sarcoma patients treated at our institution were reviewed. Dates of initial presentation to a sarcoma-treating physician and dates of treatment initiation were recorded.

RESULTS: Time to treatment was greater in patients (p < 0.001) with median time to treatment of 26 days (IQR 17, 36) and 20 days (IQR 12, 29) for those who did and did not undergo PET-CT, respectively. Those who underwent PET-CT in addition to a plain chest CT also had significantly increased time to treatment (p < 0.001) with median time to treatment of 27 days (IQR 17, 36) and 20 days (IQR 13, 28) for those who underwent both studies and those who underwent plain CT alone, respectively.

CONCLUSIONS: Despite a statistically significant increase in time to treatment with the acquisition of a PET-CT scan, the added time is likely clinically insignificant. Additionally, PET-CT may offer additional benefits in potentially more accurate staging.

PMID:35235893 | DOI:10.1016/j.suronc.2022.101732

Comput Methods Programs Biomed. 2022 Feb 23;218:106709. doi: 10.1016/j.cmpb.2022.106709. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: In this work, a mathematical model based on differential equations is proposed to describe the propagation of polio in a human population. The motivating system is a compartmental nonlinear model which is based on the use of ordinary differential equations and four compartments, namely, susceptible, exposed, infected and vaccinated individuals.

METHODS: In this manuscript, the mathematical model is extended in order to account for spatial diffusion in one dimension. Nonnegative initial conditions are used, and we impose homogeneous Neumann conditions at the boundary. We determine analytically the disease-free and the endemic equilibria of the system along with the basic reproductive number.

RESULTS: We establish thoroughly the nonnegativity and the boundedness of the solutions of this problem, and the stability analysis of the equilibrium solutions is carried out rigorously. In order to confirm the validity of these results, we propose an implicit and linear finite-difference method to approximate the solutions of the continuous model.

CONCLUSIONS: The numerical model is stable in the sense of von Neumann, it yields consistent approximations to the exact solutions of the differential problem, and that it is capable of preserving unconditionally the positivity of the approximations. For illustration purposes, we provide some computer simulations that confirm some theoretical results derived in the present manuscript.

PMID:35235894 | DOI:10.1016/j.cmpb.2022.106709

Midwifery. 2022 Feb 21;108:103290. doi: 10.1016/j.midw.2022.103290. Online ahead of print.

ABSTRACT

OBJECTIVE: Postpartum women are a vulnerable population to pandemic stressors that challenge their psychological well-being. Thus, reliable and valid instruments are necessary to measure pandemic-related stress and to identify risk and protective factors. This work aimed to assess psychometric properties of the COVID-19 Pandemic-Related Stress Scale (PSS-10-C) and associations of maternal pandemic stress with demographic, reproductive and pandemic factors of Argentinian postpartum women during the second COVID-19 wave.

DESIGN: An online cross-sectional survey was conducted from April to June 2021.

SETTING: Online recruitment of postpartum women was carried out during the second wave of COVID-19 in Argentina. This study was conducted in accordance with the Declaration of Helsinki and had the corresponding ethical approval.

PARTICIPANTS: This study was performed on 300 women, aged 18-49 years, up to 12 months postpartum in Argentina.

MEASUREMENTS AND FINDINGS: Stress was assessed with PSS-10-C, with a sociodemographic questionnaire being used to collect demographic, reproductive and pandemic variables. Statistical analysis included psychometric procedures, structural equation modeling, and multiple regressions. PSS-10-C was a reliable and structurally valid instrument with two subscales, with entire scale, Stress and Coping subscales scoring 17.31 (6.52), 9.70 (4.61) and 7.61 (2.77), respectively. History of mood disorders, pregnancy loss, and unhealthy child during the pandemic predisposed to increased stress (β > 0.10, p < 0.05), whereas having work and practicing breastfeeding promoted coping to face it (β < -0.13, p < 0.05). This situation was impaired by mood changes, loss of happiness, economic changes, fear of contracting COVID-19 -own or by a loved one- (β > 0.11, p < 0.05).

KEY CONCLUSIONS: The study highlighted the vulnerability of postpartum women’s mental health in the pandemic context, with PSS-10-C being a useful instrument for clinicians and researchers to assess perceived stress. Targeting interventions toward women at higher risk can be highly beneficial for maternal and child health.

PMID:35235890 | DOI:10.1016/j.midw.2022.103290

Complement Ther Clin Pract. 2022 Feb 23;47:101550. doi: 10.1016/j.ctcp.2022.101550. Online ahead of print.

ABSTRACT

BACKGROUND: Guizhi Gancao Longgu Muli Decoction can make a good effect on the insomnia under the catalogue of traditional Chinese medicine.

METHOD: To search the databases:Pubmed, Web of Science, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), the China Biology Medicine disc (CBMdisc), the China Science and Technology Journal Database (VIP), the Wanfang.

RESULTS: Fifteen randomized controlled trials were included, totally including 1164 participants. After summarizing the observational index revised according to the “Guiding Principles for Clinical Research of New Chinese Medicines”, we found that the curative effect of the trial group is 2.29 times that of the control group in the fixed effect model which had a statistically significant difference [OR = 2.293681, 95%CI = 0.3266112-5.83]. And the Pittsburgh Sleep Quality Index (PSQI) which had 7 different dimensions, including subjective sleep quality[p = 0.001 < 0.05], sleep latency, sleep duration[p = 0.000 < 0.05], habitual SE[p = 0.000 < 0.05], sleep disorders[p = 0.002 < 0.05], use of sleep medications[p = 0.000 < 0.05], and daytime dysfunction[p = 0.000 < 0.05], showed a higher scores in the trial group than the one in the control group in every dimension. The final results of the total scores in PSQI also showed a higher scores in trial group with a p = 0.000 < 0.05 (Test of WMD), suggest a statistically significant difference. While the adverse effects showed a lower rate in the trial group than the one in the control group under a fixed-effect model, with a p = 0.000 < 0.05, indicate a statistically significant difference.

CONCLUSION: The efficacy and safety of GGLMD in the trial groups are better than the modern western medicine in the control groups.

PMID:35235882 | DOI:10.1016/j.ctcp.2022.101550

Psychiatry Res. 2022 Feb 17;310:114453. doi: 10.1016/j.psychres.2022.114453. Online ahead of print.

ABSTRACT

OBJECTIVES: Confirming the existence and composition of the shared genetic basis of Schizophrenia and cannabis and cigarette smoking has critical values for the clinical prevention and intervention of psychosis.

METHODS: To achieve this goal, we leveraged Genome-Wide summary statistics of Schizophrenia (n = 99,934), cigarette smoking (n = 518,633) and cannabis usage (n = 162,082). We applied Causal Analysis Using Summary Effect Estimates (CAUSE) and genomic structural equation modeling (GenomicSEM) to quantify the contribution of a common genetic factor of cannabis and cigarette smoking and schizophrenia (referred to as SCZ_SMO), then identified genome-wide loci that made up SCZ_SMO.

RESULTS: We estimated that SCZ_SMO explained 8.6% of Schizophrenia heritability (Z score <-2.5 in CAUSE, p<10^-20 in Genomic SEM). There were 20 independent loci showing association with SCZ_SMO at the genome-wide threshold of p<5 × 10^-8. At the top locus on chromosome 11, fine-mapping identified rs7945073 (posterior inclusion probability =0.12, p = 2.24 × 10^-32) as the top risk variants. Gene-level association and fine-mapping highlighted NCAM1, PHC2, and SEMA6D as risk genes of SCZ_SMO. Other risk genes were enriched in cortex, neuron, and dendritic spines (adjusted p<0.05). SCZ_SMO showed significant positive correlation (p<10^-6) with the genetic risk of attention deficit hyperactivity disorder (r = 0.50), lifestyle problems (r = 0.83), social deprivation (r = 0.58) and all-cause pregnant loss (r = 0.60).

CONCLUSION: Our result provided new evidence on the shared genetic basis model for the association between Schizophrenia and smoking and provided genetic and biological insights into their shared mechanism.

PMID:35235886 | DOI:10.1016/j.psychres.2022.114453

Eur J Cancer. 2022 Feb 27;165:136-145. doi: 10.1016/j.ejca.2022.01.023. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with cancer-associated venous thromboembolism (VTE) have a high risk of VTE recurrence and anticoagulant treatment-related bleeding, but the correlation of these risks with the cancer stage is unclear.

METHODS: We evaluated the risks of VTE recurrence and treatment-related major bleeding according to the cancer stage in patients with VTE and solid cancer randomised to apixaban or dalteparin in the Caravaggio study. Cancer stage was categorised by expert cancer physicians according to pre-specified criteria, and study outcomes were adjudicated by an independent committee unaware of cancer stage and treatment allocation.

RESULTS: Of the 1034 patients included in this analysis, 217 (21.0%) had localised cancer, 279 (27.0%) locally advanced cancer and 503 (48.7%) metastatic cancer. Cancer stage was undetermined in 35 patients (3.4%). VTE recurrence and major bleeding rates were 2.8% and 3.2% in patients with localised cancer, respectively. In comparison to patients with localised cancer, the VTE recurrence rate was higher in patients with locally advanced cancer (7.5%, hazard ratio [HR] = 2.8, 95% confidence interval [CI] = 1.1-6.9) and metastatic cancer (8.7%, HR = 3.3, CI = 1.4-7.7, CI). Patients with metastatic cancer had numerically increased major bleedings compared to those with localised cancer (5.2%, HR = 1.65, CI = 0.7-3.8). The efficacy and safety of apixaban and dalteparin across patients with different cancer stages were consistent with the findings observed in the overall patients with cancer randomised in the study.

CONCLUSIONS: Patients with locally advanced and metastatic cancer have a higher rate of VTE recurrence than patients with localised cancer with no statistically significant difference in treatment-related major bleeding.

PMID:35235870 | DOI:10.1016/j.ejca.2022.01.023