Tag: pubmed

Rev Gastroenterol Mex. 2021 Mar 19:S0375-0906(21)00014-8. doi: 10.1016/j.rgmx.2020.04.010. Online ahead of print.

ABSTRACT

INTRODUCTION: Clinical practice guidelines on the diagnosis and treatment of acute pancreatitis (CPGDTAP) have been designed in an effort to reduce the morbidity and mortality of that severe disease.

AIM: To identify the knowledge acquired from CPGDTAP in hospitals in Veracruz.

MATERIALS AND METHODS: A descriptive, observational, multicenter study was conducted at four hospitals in Veracruz, through the application of a survey to evaluate the knowledge of attending physicians and residents that treat patients with acute pancreatitis. Descriptive statistics were employed to analyze the results.

RESULTS: A total of 74 physicians were surveyed: 55.41% of whom were attending physicians and 44.59% of whom were resident physicians. The majority of physicians (67.57%) were familiar with CPGDTAP from the Asociación Mexicana de Gastroenterología (AMG), followed by those of the General Health Council of the Mexican Department of Health (CENETEC, the Spanish acronym) (54.05%) and the American College of Gastroenterology (ACG) (48.65%). A total of 97.30% of the physicians routinely use a nasogastric tube, 79.73% considered early enteral nutrition to be very important, as did 98.65% regarding generous fluid replacement, 85.14% did not routinely use antimicrobials, 63.51% ordered a CAT scan at 72h or later, and 87.84% answered that infected necrosis was the indication for surgery, preferably after the third week.

DISCUSSION AND CONCLUSIONS: In our hospital environment, the CPGDTAP issued by the AMG and CENETEC were the most well-known, but their recommended measures were given importance by under 85% of the physicians surveyed. Therefore, the diffusion of the knowledge they contain is advisable to guarantee optimal results in acute pancreatitis management.

PMID:33752942 | DOI:10.1016/j.rgmx.2020.04.010

Cognition. 2021 Mar 19:104653. doi: 10.1016/j.cognition.2021.104653. Online ahead of print.

ABSTRACT

Perceptual attunement to the native phonetic repertoire occurs over the first year of life: an infant’s discrimination of non-native phonetic contrasts declines while their discrimination of native phonetic contrasts improves, with the timing of change consistent with sensitive periods. The statistics of speech sound distributions is one source of input used to collapse non-native phonetic category boundaries, while sharpening native ones. Distributional learning can be a domain-general mechanism, yet given the timing of perceptual attunement, we hypothesized that this learning mechanism may be maturationally delimited in the content domain of phonetic categories. Here, we assessed whether sensitivity to the distribution of speech sounds in the environment declines as the period of perceptual attunement closes. We used electroencephalography (EEG) to investigate whether neuronal responses to native ‘ra’ and ‘la’ phones are modulated differently in older vs young infants by exposure to either a bimodal or unimodal sound distribution spanning the [r] ~ [l] phoneme space. The native contrast, ra-la, is discriminable at all three ages, ensuring that we were testing the distributional learning mechanism, rather than confounding it with a decline in discrimination to a non-native distinction. English monolingual infants (n = 131) at 5-, 9- and 12-months-old were familiarized to either a unimodal or bimodal distribution of /ra/-/la/ speech sounds. Immediately following familiarization, an ERP oddball task was used to assess discrimination. Results showed that brief exposure to a bi- vs uni-modal distribution is sufficient to alter neuronal responses to subsequent /ra/ vs /la/ speech sounds at 5-months and 9-months, but not at 12-months. These results are the first to capture a progressive decline in sensitivity to distributional statistics in the environment. A potential mechanistic explanation based on critical period biology is discussed.

PMID:33752869 | DOI:10.1016/j.cognition.2021.104653

Rev Colomb Psiquiatr. 2021 Mar 19:S0034-7450(21)00036-6. doi: 10.1016/j.rcp.2020.12.011. Online ahead of print.

ABSTRACT

OBJECTIVE: To establish the factors associated with burnout syndrome in dental specialists working in the city of Bucaramanga and its metropolitan area.

METHODS: A cross-sectional study was conducted in which the validated version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied to 117 dental specialists. The variables analysed were the scores obtained in the three dimensions of the instrument – sociodemographic and job-related characteristics, professional environment, and habits. Spearman’s correlation coefficient and the Mann Whitney or Kruskal-Wallis U test were used in the bivariate analysis, and a logistic regression was performed in the multivariate analysis. A value of p<0.05 was considered statistically significant. Each participant accepted their inclusion in the study after the Informed Consent process was done.

RESULTS: The average age was 44.0±7.8 years, and 57.3% were women. It was observed that 3.4%, 4.3% and 4.3% of respondents scored highly in emotional exhaustion, depersonalisation and lack of personal achievement, respectively. Cigarette smoking presented a direct association with the dimensions of depersonalisation (p=0.031) and lack of personal achievement (p=0.025). On the other hand, having completed the postgraduate degree 10 years or more ago showed a negative association in these two dimensions (p=0.049 and p=0.045, respectively).

CONCLUSIONS: The results suggest that burnout syndrome is not a frequent problem in dental specialists who work in Bucaramanga and its metropolitan area. However, it is important to keep in mind that a relationship was observed between the syndrome and smoking, and the years after graduating in the specialty.

PMID:33752891 | DOI:10.1016/j.rcp.2020.12.011

Curr Probl Cancer. 2021 Mar 6:100728. doi: 10.1016/j.currproblcancer.2021.100728. Online ahead of print.

ABSTRACT

Both chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are common hematological malignancies originating from mature B cells of different differentiation stage. However, it is quite rare that MM could develop after CLL diagnosed. We reported a 66-year-old female progressed forward myeloma 3 years after she was diagnosed as CLL and conducted an analysis to investigate the epidemiology and clinical features among these patients based on the Surveillance, Epidemiology, and End Results (SEER) database. Our data demonstrated that CLL patients were 19% less likely to develop myeloma than general U.S. population (standardized incidence ratio 0.81; 95% confidence interval 0.62-1.03), although without statistical difference. The median overall survival from CLL diagnosed was 90 (58.1-121.9) months, which was the same as general CLL patients according to historical data. But the outcomes of secondary MM was much poorer than general MM patients. Age and gender were independent factors that impact the survival among these patients.

PMID:33752897 | DOI:10.1016/j.currproblcancer.2021.100728

Br J Oral Maxillofac Surg. 2020 Sep 11:S0266-4356(20)30515-5. doi: 10.1016/j.bjoms.2020.09.006. Online ahead of print.

ABSTRACT

The purpose of this study was to undertake a retrospective cross-sectional analysis to compare the frequency and characteristics of facial injury presentations at a UK and an Australian tertiary referral hospital during the implementation of COVID-19 social-distancing measures. The primary predictor variables were a heterogeneous set of factors grouped into logical categories: demographics, injury mechanisms and site, and management. The primary outcome variable was the presentation of a hard or soft tissue facial injury. A descriptive statistical analysis was undertaken on the assembled data. The study found a clinical and statistically significant reduction in the frequency (absolute number) of facial injuries at each study site. In addition, a striking similarity common in both countries was an increase in the number of facial injuries due to falls and a reduction in facial injuries due to interpersonal violence. Conservative (non-operative) management of facial injury increased at both sites. The implementation of COVID-19 social-distancing public health measures, which aimed to limit community transmission of the coronavirus, had a secondary serendipitous effect of reducing the frequency of facial injury presentations and altering their epidemiological characteristics at both a UK and Australian tertiary referral hospital.

PMID:33752920 | DOI:10.1016/j.bjoms.2020.09.006

Elife. 2021 Mar 23;10:e64356. doi: 10.7554/eLife.64356. Online ahead of print.

ABSTRACT

We developed Genetic-Epigenetic Tissue Mapping (GETMap) to determine the tissue composition of plasma DNA carrying genetic variants not present in the constitutional genome through comparing their methylation profiles with relevant tissues. We validated this approach by showing that, in pregnant women, circulating DNA carrying fetal-specific alleles was entirely placenta-derived. In lung-transplant recipients, we showed that, at 72 hours after transplantation, the lung contributed only a median of 17% to the plasma DNA carrying donor-specific alleles and hematopoietic cells contributed a median of 78%. In hepatocellular cancer patients, the liver was identified as the predominant source of plasma DNA carrying tumor-specific mutations. In a pregnant woman with lymphoma, plasma DNA molecules carrying cancer mutations and fetal-specific alleles were accurately shown to be derived from the lymphocytes and placenta, respectively. Analysis of tissue origin for plasma DNA carrying genetic variants is potentially useful for noninvasive prenatal testing, transplantation monitoring and cancer screening.

PMID:33752803 | DOI:10.7554/eLife.64356

J Invest Dermatol. 2021 Apr;141(4):718-721. doi: 10.1016/j.jid.2020.10.005.

ABSTRACT

Several epidemiologic studies and GWASs have implicated genetic factors in the pathogenesis of vitiligo. The report by Kim et al. (2020) describes a prospective cohort study from Korea that has the greatest statistical power to date in addressing the epidemiology of vitiligo inheritance. The authors reported the incidence risk ratios in individuals whose first-degree relatives or spouses are affected, providing clear evidence that both genetic and nongenetic factors influence the pathogenesis of vitiligo.

PMID:33752810 | DOI:10.1016/j.jid.2020.10.005

J Med Vasc. 2021 Apr;46(2):53-65. doi: 10.1016/j.jdmv.2020.12.005. Epub 2021 Feb 5.

ABSTRACT

PURPOSE: Lung cancer and atherosclerosis share common risk factors. Literature data suggest that the prevalence of lung malignancy in patients with peripheral arterial disease (PAD) is higher than in the general population. Our goal was to determine, through a systematic literature review, the prevalence of lung cancer in patients with PAD.

METHODS: We consulted available publications in the Cochrane library, MEDLINE, PUBMED, EMBASE, and ClinicalTrials.gov. We included all articles, written in English or French, published between 1990 and 2020 reporting the prevalence of lung cancer in patients with PAD (atherosclerotic aortic aneurysm or peripheral occlusive diseases). Patients with coronary artery disease, cardiac valvulopathy or carotid stenosis were not included. We did not include case reports. We performed a critical analysis of each article. Data were collected from two independent readers. A fixed effect model meta-analysis allowed to estimate a summary prevalence rate.

RESULTS: We identified 303 articles, and selected 19 articles according to selection criteria. A total of 16849 patients were included (mean age 68.3 years, 75.1% of males). Aortic aneurysms were found in 29% of patients and atherosclerotic occlusive disease in 66% of patients. Lung cancer was identified in 538 patients, representing a prevalence of 3%.

DISCUSSION: Lung cancer is found in 3% of patients with atherosclerotic PAD. This prevalence is higher than that found in lung cancer screening programs performed in the general population of smokers and former smokers. These patients should be screened for lung cancer. Their selection may dramatically increase the benefit of lung cancer screening.

PMID:33752847 | DOI:10.1016/j.jdmv.2020.12.005

Inj Epidemiol. 2021 Mar 22;8(1):22. doi: 10.1186/s40621-021-00324-y.

ABSTRACT

BACKGROUND: The COVID-19 pandemic led to world-wide restrictions on social activities to curb the spread of this disease. Very little is known about the impact of these restrictions on trauma centers. Our objective was to determine the effect of the pandemic-associated lockdown on trauma admissions, patient’s demographics, mechanisms of injury, injury severity, and outcomes in the Puerto Rico Trauma Hospital.

METHODS: An IRB-approved quasi-experimental study was performed to assess the impact of the restrictions by comparing trauma admissions during the lockdown (March 15, 2020 – June 15, 2020) with a control period (same period in 2017-2019). Comparisons were done using the Pearson’s chi-square test, Fisher exact test, or Mann-Whitney U test, as appropriate. A negative binomial model was fitted to estimate the incidence rate ratio for overall admissions among pre-lockdown and during-lockdown periods. Statistical significance was set at p < 0.05.

RESULTS: A total of 308 subjects were admitted during the quarter of study for 2017; 323, for 2018; 347, for 2019; and 150, for 2020. The median (interquartile range) age of patients rose significantly from 40 (33) years to 49 (30) years (p < 0.001) for the lockdown period compared to the historical period. Almost all mechanisms of injury (i.e., motor vehicle accident, assault, pedestrian, burn, suicide attempt, other) had a slight non-significant reduction in the percentage of patients presenting with an injury. Instead, falls experienced an increase during the lockdown period (18.9% vs. 26.7%; p = 0.026). Moreover, the proportion of severe cases decreased, as measured by an injury severity score (ISS) > 15 (37.3% vs. 26.8%; p = 0.014); while there were no differences in the median hospital length of stay and the mortality rate between the comparison groups. Finally, the decrease in overall admissions registered during the lockdown accounts for a 59% (IRR 0.41; 95% CI 0.31-0.54) change compared to the pre-lockdown period, when controlling for sex, age, mechanism of injury, and ISS.

CONCLUSIONS: Following periods of social isolation and curfews, trauma centers can expect drastic reductions in their overall patient volume with associated changes in trauma patterns. Our findings will help inform new interventions and improve healthcare preparedness for future or similar circumstances.

PMID:33752760 | DOI:10.1186/s40621-021-00324-y

Health Technol Assess. 2021 Mar;25(18):1-96. doi: 10.3310/hta25180.

ABSTRACT

BACKGROUND: Preliminary studies using the FENIX™ (Torax Medical, Minneapolis, MN, USA) magnetic sphincter augmentation device suggest that it is safe to use for the treatment of adult faecal incontinence, but efficacy data are limited.

OBJECTIVE: To compare FENIX with sacral nerve stimulation for the treatment of adult faecal incontinence in terms of safety, efficacy, quality of life and cost-effectiveness.

DESIGN, SETTING AND PARTICIPANTS: Multicentre, parallel-group, unblinded, randomised trial comparing FENIX with sacral nerve stimulation in participants suffering moderate to severe faecal incontinence.

INTERVENTIONS: Participants were randomised on an equal basis to either sacral nerve stimulation or FENIX. Follow-up occurred 2 weeks postoperatively and at 6, 12 and 18 months post randomisation.

MAIN OUTCOME AND MEASURE: The primary outcome was success, defined as device in use and ≥ 50% improvement in Cleveland Clinic Incontinence Score at 18 months post randomisation. Secondary outcomes included complication rates, quality of life and cost-effectiveness. Between 30 October 2014 and 23 March 2017, 99 participants were randomised across 18 NHS sites (50 participants to FENIX vs. 49 participants to sacral nerve stimulation). The median time from randomisation to FENIX implantation was 57.0 days (range 4.0-416.0 days), and the median time from randomisation to permanent sacral nerve stimulation was 371.0 days (range 86.0-918.0 days). A total of 45 out of 50 participants underwent FENIX implantation and 29 out of 49 participants continued to permanent sacral nerve stimulation. The following results are reported, excluding participants for whom the corresponding outcome was not evaluable. Overall, there was success for 10 out of 80 (12.5%) participants, with no statistically significant difference between the two groups [FENIX 6/41 (14.6%) participants vs. sacral nerve stimulation 4/39 (10.3%) participants]. At least one postoperative complication was experienced by 33 out of 45 (73.3%) participants in the FENIX group and 9 out of 40 (22.5%) participants in the sacral nerve stimulation group. A total of 15 out of 50 (30%) participants in the FENIX group ultimately had to have their device explanted. Slightly higher costs and quality-adjusted life-years (incremental = £305.50 and 0.005, respectively) were observed in the FENIX group than in the sacral nerve stimulation group. This was reversed over the lifetime horizon (incremental = -£1306 and -0.23 for costs and quality-adjusted life-years, respectively), when sacral nerve stimulation was the optimal option (net monetary benefit = -£3283), with only a 45% chance of FENIX being cost-effective.

LIMITATIONS: The SaFaRI study was terminated in 2017, having recruited 99 participants of the target sample size of 350 participants. The study is, therefore, substantially underpowered to detect differences between the treatment groups, with significant uncertainty in the cost-effectiveness analysis.

CONCLUSIONS: The SaFaRI study revealed inefficiencies in the treatment pathways for faecal incontinence, particularly for sacral nerve stimulation. The success of both FENIX and sacral nerve stimulation was much lower than previously reported, with high postoperative morbidity in the FENIX group.

FUTURE WORK: Further research is needed to clarify the treatment pathways for sacral nerve stimulation and to determine its true clinical and cost-effectiveness.

TRIAL REGISTRATION: Current Controlled Trials ISRCTN16077538.

FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 18. See the NIHR Journals Library website for further project information.

PMID:33752794 | DOI:10.3310/hta25180