Tag: pubmed

J Clin Nurs. 2022 Feb 3. doi: 10.1111/jocn.16238. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: To determine whether interventions that use the Specific Thematic Nursing Care Action Modules (STNC-AM) platform improve patients’ psychological health over a two-month period.

BACKGROUND: Stroke survivors often are left with a disability after a stroke, which can have an impact on their physical and mental health. Therefore, it is necessary for stroke patients to have tailored programmes in the face of post-stroke mental health concerns and the need for care information.

DESIGN: A non-randomised controlled pilot study was conducted.

METHODS: Participants included 44 post-stroke patients at a medical university hospital, between 1 August 2019-28 February 2021, of whom 24 were assigned to the control group and 20 were assigned to the intervention (STNC-AM). Data were analysed on an intention-to-treat basis. We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist (case-control studies) for this study.

RESULTS: There were no statistical differences between the two groups at baseline. At the end of two months, however, the scores for resilience, depression and positive factors illness representation were statistically different between the two groups (p < .05). The results of the generalised estimating equation model analysis indicated that resilience and anxiety remained more significant in decreasing depression in the intervention group than in the control group.

CONCLUSION: This preliminary trial suggests that, although action modules may be associated with a decrease in depression post-stroke, part of this effect was likely associated with an increase in resilience and a decrease in anxiety of the patients.

RELEVANCE TO CLINICAL PRACTICE: The STNC-AM platform provides a coaching platform that helps patients and caregivers to be effective and accessible.

PMID:35118746 | DOI:10.1111/jocn.16238

Nurs Crit Care. 2022 Feb 3. doi: 10.1111/nicc.12757. Online ahead of print.

ABSTRACT

BACKGROUND: Central line-associated bloodstream infections (CLABSI) have been a significant challenge in care, increasing healthcare costs and leading to adverse outcomes, including mortality.

AIMS AND OBJECTIVES: The present study aimed to assess the knowledge of intensive care unit (ICU) nurses on the prevention of CLABSI and the implementation barriers of evidence-based guidelines in practice.

DESIGN: A cross-sectional study.

METHODS: Data were collected from adult, paediatric, and neonatal ICU nurses working in seven hospitals in Iran, using census sampling from April to July 2020.

RESULTS: A number 209 out of 220 ICU nurses participated in the present study (response rate of 95%). The median score of knowledge of ICU nurses towards the prevention of CLABSI was 3.00 out of 11. 50.72% of ICU nurses had insufficient knowledge. The most critical implementation barriers of evidence-based guidelines were high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.

CONCLUSIONS: Overall, the knowledge of ICU nurses towards the prevention of CLABSI was insufficient. Study findings suggest that the knowledge of ICU nurses may be improved by reducing the workload, increasing the number of nursing staff in the ICU, having an adequate supply of equipment needed to ensure safe practice in the ICU, and providing regular related educational workshops for nurses working in the ICU.

RELEVANCE TO CLINICAL PRACTICE: The present study’s findings suggest that regular training programs should be developed to improve the knowledge of ICU nurses in the care and prevention of CLABSI. Nursing policymakers and managers need to identify and address implementation barriers of evidence-based guidelines to improve nursing, such as high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.

PMID:35118750 | DOI:10.1111/nicc.12757

J Prosthodont. 2022 Feb 4. doi: 10.1111/jopr.13490. Online ahead of print.

ABSTRACT

PURPOSE: To verify whether 3D surface deviation analysis software can detect the surface changes of composite veneered polyetheretherketone posterior crowns following wear simulation compared to optical digital profilometry.

MATERIALS AND METHODS: Twenty dental crowns, fabricated from computer-aided design and computer-aided manufacture polyetheretherketone (PEEK) and veneered with high impact polymer composite (HIPC), were subjected to wear test (50N, 5/55◦C; 120,000 chewing cycles). Optical digital profilometry and 3D surface deviation using Geomagic design X software was used before and after the wear test to measure volumetric wear loss (mm³ ). The data were statistically analyzed with Wilcoxon signed-rank test to compare the two methodologies. The significance level was set at p ≤ 0.05.

RESULTS: There was no statistically significant difference between the two assessment methods (P-value = 0.075, Effect size = 0.854). Regarding the optical digital profilometry analysis, HIPC veneered PEEK crowns showed 0.01686 (0.018-0.02155) mm³ as a median volumetric wear loss value. While the crowns analyzed by 3D surface deviation showed -0.0398 (-0.0913 – -0.0042) mm³ as a median volumetric loss value (P-value = 0.075, Effect size = 0.854). In addition, there was no statistically significant correlation between wear measurements by optical digital profilometry and 3D surface deviation analyses (ρ = -0.177, P-value = 0.685).

CONCLUSIONS: There was no significant difference or correlation between optical digital profilometry and 3D surface deviation analyses for volumetric wear loss of veneered PEEK crowns. This article is protected by copyright. All rights reserved.

PMID:35118735 | DOI:10.1111/jopr.13490

Int J Urol. 2022 Feb 3. doi: 10.1111/iju.14786. Online ahead of print.

ABSTRACT

OBJECTIVES: Penile urethral stricture disease not associated with hypospadias is rare, and there is a wide range of commonly used surgical repair techniques for this disease. We sought to compile a multi-institutional database of patients who had surgical correction of strictures in the penile urethra not limited to the meatus, and who had no history of hypospadias, for analysis using the Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology classification system.

METHODS: A retrospective database from 13 institutions was compiled of patients who had undergone surgical correction of Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology urethral stricture segments S2b/S2c and excluding E5, with a minimum follow-up time of 4 months. Failure was defined as cystoscopically confirmed recurrence of a stricture measuring less than 16-Fr.

RESULTS: We analyzed 222 patients with a median age of 57 years and a follow-up of 49 months. The overall surgical success rate was 80.2%. On multivariate analysis, the two variables identified that were predictive of surgical success were stricture length ≤2 cm as well as use of a buccal mucosa graft as compared to use of a fasciocutaneous flap, which had success rates of 83% and 52%, respectively (P = 0.0004). No statistically significant differences were found based on incisional approach or surgical technique, nor were outcomes different based on etiology or preoperative patient demographics.

CONCLUSIONS: Surgical repair of penile urethral strictures of non-hypospadiac origin have a favorable overall success rate, at 80.2%. Regardless of incisional approach or surgical technique, all operations appear to have similar outcomes other than repairs using fasciocutaneous flap, which were statistically less successful than those using buccal mucosa graft.

PMID:35118726 | DOI:10.1111/iju.14786

J Clin Lab Anal. 2022 Feb 4:e24271. doi: 10.1002/jcla.24271. Online ahead of print.

ABSTRACT

BACKGROUND: Diagnosing D-Dimer early is essential to optimize clinical treatment and quality of life and reduce mortality. This study aims to identify the difference of D-Dimer levels (ng/ml) in patients with stroke within the 6- and 24-h period compared to patients that mimic stroke.

METHODS: An electronic database search across PubMed/MEDLINE, Cochrane, Web of Science, CINAHL, EMBASE, and Scopus was conducted until December 10, 2021. Studies were eligible if they included adult patients with stroke compared to stroke mimics or controls reporting D-Dimer values. Quality assessment was conducted using GRADE. The standardized mean difference and 95% confidence intervals were calculated in addition to the difference of means in the crude form. Heterogeneity was assessed using Cochran’s Q statistic and the I² index. A random-effects model was used. The statistical analysis was conducted using RevMan 5.4.

RESULTS: Out of 2901, there were 318 (11%) participants from upper-middle-income countries, whereas the others were from high-income countries. Large positive effect size was found for D-Dimer in the stroke group (Cohen’s d = 2.82 [1.73-3.9]; p < 0.00001), meaning that those with stroke had higher D-Dimer values on presentation compared to the stroke mimics/controls. A large difference in means was found in the two groups (MD = 685.1 [324.2, 1045.99]; p < 0.00001), suggesting that there was a significantly higher laboratory value in the stroke group.

CONCLUSION: Our findings must be used in caution as the most reliable diagnostic tests for stroke are CT and MRI. Laboratory testing such as D-Dimer values is a valuable clinical adjuvant in diagnosing total stroke.

PMID:35118733 | DOI:10.1002/jcla.24271

Ultrasound Obstet Gynecol. 2022 Feb 3. doi: 10.1002/uog.24873. Online ahead of print.

ABSTRACT

INTRODUCTION: Outcomes of common arterial trunk (CAT) depend mainly on truncal valve function, coronary artery abnormalities and presence of interrupted aortic arch. The objective of this study was to evaluate the accuracy of prenatal diagnosis in CAT by analyzing: (1) anatomic subtypes, (2) truncal valve function and (3) the potential impact of prenatal CAT diagnosis on postnatal mortality and morbidity in the current era.

METHODS: Retrospective analysis of all prenatally diagnosed CAT patients with postnatal or fetopsy confirmation from 2011- 2019 in a single tertiary center. Cohen’s Kappa statistic was used to measure agreement for pre- and postnatal assessment of anatomic subtypes according to Van Praagh and of truncal valve function. Mortality and morbidity variables were compared.

RESULTS: 84 patients (62 live born with prenatal diagnosis/16 live born with postnatal diagnosis/ 6 terminations of pregnancy with fetopsy) met inclusion criteria. Diagnostic accuracy for prenatal diagnosis of CAT anatomic subtypes was 80.3%. However pre-and postnatal concordance for subtype diagnosis was only moderate (Kappa κ= 0.43) since no fetus had a prenatal diagnosis of CAT type A3, and only half of patients with CAT type A4 (8/17) were diagnosed prenatally. Fetal evaluation of truncal valve function underestimated the presence and severity of insufficiency (slight agreement; κ=0.19). However, 4 of 5 postnatally confirmed significant stenoses were diagnosed prenatally (moderate agreement; κ=0.38). Postoperative mortality was comparable in patients with or without prenatal diagnosis (p=0.87). CAT patients with fetal diagnosis underwent earlier intervention (p<0.001), had shorter intubation time (p=0.047) and shorter global hospital stay (p=0.01).

CONCLUSION: Prenatal accuracy of CAT diagnosis remains insufficient to tailor neonatal management and to predict outcomes. Fetal assessment of truncal valve dysfunction appears unreliable due to perinatal transition changes. Progress should be made to improve fetal diagnosis of anatomic subtypes requiring postnatal prostaglandin infusion. This article is protected by copyright. All rights reserved.

PMID:35118719 | DOI:10.1002/uog.24873

J Bone Miner Res. 2022 Feb 3. doi: 10.1002/jbmr.4519. Online ahead of print.

ABSTRACT

Mouse models suggest that undercarboxylated osteocalcin (ucOC), produced by the skeleton, protects against type 2 diabetes development, whereas human studies have been inconclusive. We aimed to determine if ucOC or total OC is associated with incident type 2 diabetes or changes in fasting glucose, insulin resistance (HOMA-IR), or beta-cell function (HOMA-Beta). A subcohort (N=338; 50% women; 36% Black) was identified from participants without diabetes at baseline in the Health, Aging, and Body Composition Study. Cases of incident type 2 diabetes (N=137) were defined as self-report at an annual follow-up visit, use of diabetes medication, or elevated fasting glucose during 8 years of follow-up. UcOC and total OC were measured in baseline serum. Using a case-cohort design, the association between biomarkers and incident type 2 diabetes was assessed using robust weighted Cox regression. In the subcohort, linear regression models analyzed the associations between biomarkers and changes in fasting glucose, HOMA-IR, and HOMA-Beta over 9 years. Higher levels of ucOC were not statistically associated with increased risk of incident type 2 diabetes (adjusted hazard ratio = 1.06 [95% confidence interval: 0.84, 1.34] per 1 SD increase in ucOC). Results for %ucOC and total OC were similar. Adjusted associations of ucOC, %ucOC, and total OC with changes in fasting glucose, HOMA-IR, and HOMA-Beta were modest and not statistically significant. We did not find evidence of an association of baseline undercarboxylated or total osteocalcin with risk of incident type 2 diabetes or with changes in glucose metabolism in older adults. This article is protected by copyright. All rights reserved.

PMID:35118705 | DOI:10.1002/jbmr.4519

Nutr Clin Pract. 2022 Feb 4. doi: 10.1002/ncp.10845. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative carbohydrate (CHO) loading improves patient outcomes but is not extensively studied in individuals with diabetes mellitus (DM), resulting in limited professional recommendations. This study examined postprandial glycemic responses and gastric emptying rates following consumption of a CHO drink in adults with and without DM.

METHODS: A single-arm, nonrandomized pilot trial was conducted in adults without DM (non-DM) (47.5 ± 2.5 years), with pre-DM (55.8 ± 3.0 years), and with type 2 DM (56.2 ± 2.5 years). Following an overnight fast, participants consumed a 50 g CHO drink followed by 1.5 g liquid paracetamol. Venous blood samples were collected at baseline (ie, t = 0 min) and 15, 30, 45, 60, 90, 120, 150, 180, 210, and 240 min for plasma glucose and serum insulin and paracetamol concentrations to assess gastric emptying.

RESULTS: Participants with DM were older and had a higher body mass index than non-DM participants (31.2 ± 0.9 vs 28.2 ± 0.9). Fasting glucose and hemoglobin A1c levels differed significantly across groups (non-DM: 95.4 ± 3.6 mg/dl and 5.2% ± 0.1%; pre-DM: 111.6 ± 3.6 mg/dl and 5.8% ± 0.1%; DM: 167.4 ± 3.6 mg/dl and 7.2% ± 0.1%). Compared with the non-DM group, DM had increased glucose responses at 30-180 min. Glucose returned to baseline at 150 min in the non-DM and pre-DM groups compared with 210 min in the DM group. Paracetamol concentrations were not significantly different between the non-DM and DM groups.

CONCLUSION: Blood glucose returned to baseline within ~2.5 h in non-DM and pre-DM groups and ~3.5 h in participants with DM following ingestion of a CHO drink. No consistent differences in gastric emptying rates were observed between participants with and without DM.

PMID:35118717 | DOI:10.1002/ncp.10845

Perspect Psychiatr Care. 2022 Feb 3. doi: 10.1111/ppc.13035. Online ahead of print.

ABSTRACT

PURPOSE: This study was conducted to determine the effects of 4-year nursing education on self-esteem and emotional intelligence levels of nursing students.

DESIGN AND METHODS: This descriptive longitudinal study was conducted with 73 nursing students between 2014 and 2018 at a foundation university in Istanbul.

FINDINGS: The nursing students’ self-esteem and emotional intelligence levels increased at the end of the 4-year nursing education. Nursing students’ self-esteem scores measured in the 2nd and 4th years, their emotional intelligence scores measured in the 3rd, 1st years, and 4th years were statistically significantly higher.

PRACTICE IMPLICATIONS: In the light of these results, in addition to the routine educational content, it is recommended that the courses related to self-esteem and emotional intelligence be added to the curriculum or trainings should be organized.

PMID:35118673 | DOI:10.1111/ppc.13035

Br J Haematol. 2022 Feb 4. doi: 10.1111/bjh.18039. Online ahead of print.

ABSTRACT

As treatments for second relapsed and refractory first relapsed paediatric AML transition from purely palliative to more commonly curative in nature, comparative data is necessary for evaluating the effectiveness of emerging treatment options. Furthermore, little is known about predictors of prognosis following third-line therapy. From 2004 until 2019, 277 of the 869 patients enrolled in NOPHO-DB SHIP consortium trials experienced a first relapse and, of these patients, 98 experienced refractory first relapse and 59 a second relapse. Data on patient and disease characteristics within this cohort of 157 patients was analysed to determine probability of overall survival (pOS) and to identify factors influencing survival. Data on early treatment response and complete remission were not available. One and 5-year pOS were 22 ± 3% and 14 ± 3%, respectively. There was no statistically significant difference in survival between refractory first relapsed and second relapsed AML. Factors influencing prognosis included: late relapse, type of third-line treatment, FLT3 mutational status, and original treatment protocol. These data provide a baseline for evaluating the effectiveness of emerging therapies for the treatment of children with refractory first relapsed and second relapsed paediatric AML and evidence that select patients receiving third-line therapy can be cured.

PMID:35118649 | DOI:10.1111/bjh.18039