Tag: pubmed

BMC Med Inform Decis Mak. 2021 Sep 21;21(1):269. doi: 10.1186/s12911-021-01628-1.

ABSTRACT

BACKGROUND: Evidenced-based practice is a key component of quality care. This study aims to explore users’ expectations concerning paediatric local clinical practice guidelines.

METHODS: A mixed method approach was applied, including material from quantitative questionnaire and semi-structured interviews. Data were analysed using descriptive statistics and qualitative content analysis. Data were analysed with constant comparative method. Qualitative data were parsed and categorized to identify themes related to decision-making.

RESULTS: A total of 83 physicians answered the survey (response rate 83%). 98% of the participants wanted protocols based on international guidelines, 80% expected a therapeutic content. 24 semi-structured interviews were conducted to understand implementation processes, barriers and facilitators. Qualitative analysis revealed 5 emerging themes: improvement of local clinical practice guidelines, patterns of usage, reasons for non-implementation, alternative sources and perspectives.

CONCLUSION: Some criteria should be considered for the redaction of local clinical practice guidelines: focus on therapeutic, ease of access, establish local clinical practice guidelines based on international guidelines adapted to the local setting, document references and include trainees such as residents in the redaction.

PMID:34548068 | DOI:10.1186/s12911-021-01628-1

BMC Pregnancy Childbirth. 2021 Sep 21;21(1):642. doi: 10.1186/s12884-021-04114-8.

ABSTRACT

BACKGROUND: The aim of this study was to compare fear of childbirth, state and trait anxiety, and childbirth self-efficacy among primiparous and multiparous women in Ahvaz, southwest of Iran.

METHODS: This cross-sectional study was conducted with 200 pregnant women (100 primiparous and 100 multiparous women) who had been admitted to the maternity ward of hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. The instruments used for data collection in this study included a demographic questionnaire, Delivery Fear Scale (DFS), Spielberger’s State-Trait Anxiety Inventory (STAI), and Childbirth Self-Efficacy Inventory (CBSEI). The data were analyzed by chi-square test and independent t-test. Also, the univariate general linear model was used by adjusting for the socio-demographic and obstetric characteristics that were considered as possible confounding variables.

RESULTS: The mean score of DFS in primiparous women was significantly higher than that of multiparous women. The mean of the overall score of childbirth self-efficacy of primiparous women was significantly lower than that of multiparous women. The mean score of the outcome expectancies and self-efficacy expectancies was significantly lower in primiparous women compared with multiparous women. There was no statistically significant difference between the two groups in terms of the mean score of STAI. After adjusting for possible confounding variables, the differences between the two groups in terms of fear of childbirth scores, overall childbirth self-efficacy score and self-efficacy expectancies remained significant.

CONCLUSION: Given the high fear of childbirth and low childbirth self-efficacy in primiparous women compared to the multiparous women, appropriate interventions should be adopted by health care providers in order to reduce fear and improve childbirth self-efficacy in primiparous women.

PMID:34548055 | DOI:10.1186/s12884-021-04114-8

BMC Public Health. 2021 Sep 21;21(1):1715. doi: 10.1186/s12889-021-11750-4.

ABSTRACT

BACKGROUND: Caesarean section delivery is a major life-saving obstetric surgical intervention for mothers and babies from pregnancy and childbirth related complications. This paper attempts to investigate the geographical variations and correlating factors of caesarean section delivery in India, particularly focusing on the states of Bihar and Tamil Nadu, accounting for one of the lowest and highest prevalence states of caesarean section delivery respectively.

METHODS: This study is based on secondary data, collected from the fourth round of the National Family Health Survey (NFHS-4), 2015-16. We utilized 190,898 women aged 15-49 years who had a living child during the past 5 years preceding the survey. In this study, caesarean section delivery was the outcome variable. A variety of demographic, socio-economic, and pregnancy- and delivery-related variables were considered as explanatory variables. Descriptive statistics, bivariate percentage distribution, Pearson’s Chi-square test, and multivariate binary logistic regression models were employed to draw the inferences from data.

RESULTS: Of participants, about 19% of women had undergone caesarean section delivery in the country. The state-wise distribution shows that Telangana (60%) followed by Andhra Pradesh (42%) and Tamil Nadu (36%) represented the topmost states in caesarean delivery, while Bihar (7%), Madhya Pradesh (10%), and Jharkhand (11%) placed at the bottom end. Multivariate logistic models show that the likelihood of caesarean delivery was higher among older women (35-49 years), women with higher levels of education, Muslims, women belonging to the upper quintiles of the household wealth, and those who received antenatal care (ANC), experienced pregnancy loss and delivery complications. Moreover, the odds of caesarean section delivery were remarkably greater for the private health sector than the public health sector in both focused states: Bihar (odds ratio [OR] = 12.84; 95% confidence interval [CI]: 10.90, 15.13) and Tamil Nadu (OR = 2.90; 95% CI: 2.54, 3.31).

CONCLUSION: Findings of this study suggest that improvement in female education, providing economic incentives, and spreading awareness through mass media could raise the caesarean section delivery among women whose vaginal delivery could be unsafe for them as well as for their babies. Moreover, providing adequate ANC and well-equipped public healthcare services would facilitate caesarean delivery among needy women.

PMID:34548059 | DOI:10.1186/s12889-021-11750-4

J Card Surg. 2021 Sep 21. doi: 10.1111/jocs.15996. Online ahead of print.

ABSTRACT

BACKGROUND: Pericardiectomy for postradiation constrictive pericarditis has been reported to generally have unfavorable outcomes. This study sought to evaluate surgical outcomes in a large cohort of patients undergoing pericardiectomy for radiation-associated pericardial constriction.

METHODS: A retrospective analysis of all patients (≥18 years) who underwent pericardiectomy for a diagnosis of constrictive pericarditis with a prior history of mediastinal irradiation from June 2002 to June 2019 was conducted. There were 100 patients (mean age 57.2 ± 10.1 years, 49% females) who met the inclusion criteria. Records were reviewed to look at the surgical approach, the extent of resection, early mortality, and late survival.

RESULTS: The overall operative mortality was 10.1% (n = 10). The rate of operative mortality decreased over the study period; however, the test of the trend was not statistically significant (p = .062). Hodgkin’s disease was the most common malignancy (64%) for which mediastinal radiation had been received. Only 27% of patients had an isolated pericardiectomy, and concomitant pericardiectomy and valve surgery were performed in 46% of patients. Radical resection was performed in 50% of patients, whereas 47% of patients underwent subtotal resection. Prolonged ventilation (26%), atrial fibrillation (21%), and pleural effusion (16%) were the most common postoperative complications. The overall 1, 5-, and 10-years survival was 73.6%, 53.4%, and 32.1%, respectively. Increasing age (hazard ratio, 1.044, 95% confidence interval 1.017-1.073) appeared to have a significant negative effect on overall survival in the univariate model.

CONCLUSION: Pericardiectomy performed for radiation-associated constrictive pericarditis has poor long-term outcomes. The early mortality, though high (~10%), has been showing a decreasing trend in the test of time.

PMID:34547827 | DOI:10.1111/jocs.15996

Clin Oral Implants Res. 2021 Sep 21. doi: 10.1111/clr.13848. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the osseointegration of calcium-coated (CS) and chemically modified, sandblasted, large-grit, acid-etched (MS) dental implants with a lack of primary mechanical stability.

MATERIALS AND METHODS: Eighteen implants in CS and MS groups each were loosely placed in the mandible of 6 mongrel dogs and allowed to heal for 2, 4 and 8 weeks. Implant stability quotient (ISQ) and implant stability test (IST) values recorded periodically and bone-to-implant contact (BIC) and the number of Haversian canals per 1 mm² measured histologically were statistically analyzed (p < 0.05).

RESULTS: All CS and MS implants placed survived. Compared with immediately after installation, ISQ and IST values in both groups increased significantly to over 76 at 2 weeks (p < 0.0083) and remained stable thereafter. BIC was significantly greater at 8 weeks (61.3 ± 13.6% in CS group; 57.6 ± 5.9% in MS group) compared to 2 and 4 weeks in both groups (p < 0.017). There were no significant intergroup differences in ISQ, IST or BIC at different time-points. Significantly more Haversian canals were observed in group CS (6.2 ± 1.0 /mm² ) compared to group MS at 4 weeks (3.7 ± 1.8 /mm² ; p < 0.05), while intergroup difference was not significant at 8 weeks.

CONCLUSION: Both CS and MS implants inserted without primary stability obtained osseointegration within 2 weeks, and lamellar bone adjacent to the implants was first observed at 8 weeks. The formation of primary osteons was more active at 4 weeks in group CS than in group MS.

PMID:34547819 | DOI:10.1111/clr.13848

J Community Psychol. 2021 Sep 21. doi: 10.1002/jcop.22712. Online ahead of print.

ABSTRACT

This study assessed the prediction of occupational stress through personality traits, gender and occupational stress among teachers of learners with special needs (TLSN) from the southwest, Nigeria. The transactional stress theory provided a framework for the study. Data were collected through a paper-pencil self-completed questionnaire. Data collected were analysed by descriptive and inferential statistics at 95% confidence intervals (CIs) and p < 0.05. The response rate was 94.4%. A total of 287 male and 185 female TLSN participated in this study. Findings revealed a significant association between extraversion, agreeableness; openness, conscientiousness, neuroticism and occupational stress of TLSN. Participants with extraversion and openness both has highest likelihood of exhibiting occupational stress. Male TLSN had a greater likelihood of exhibiting occupational stress. The study concluded that male TLSN with extraversion and openness personality traits has high proportion of occupational stress. Based on the findings, appropriate recommendations were made.

PMID:34547826 | DOI:10.1002/jcop.22712

Rev Bras Ginecol Obstet. 2021 Aug;43(8):608-615. doi: 10.1055/s-0041-1735229. Epub 2021 Sep 21.

ABSTRACT

OBJECTIVE: To establish a relationship between serum progesterone values on the day of frozen blastocyst transfer in hormone-replaced cycles with the probability of pregnancy, miscarriage or delivery.

METHODS: This was an ambispective observational study including all frozen-thawed embryo transfer cycles performed at our department following in vitro fecundation from May 2018 to June 2019. The outcomes evaluated were β human chorionic gonadotropin (β-hCG)-positive pregnancy and delivery. Groups were compared according to the level of serum progesterone on the day of embryo transfer: the 1^st quartile of progesterone was compared against the other quartiles and then the 2^nd and 3^rd quartiles against the 4^th quartile.

RESULTS: A total of 140 transfers were included in the analysis: 87 with β-HCG > 10 IU/L (62%), of which 50 (36%) delivered and 37 had a miscarriage (42%). Women with lower progesterone levels (< 10.7ng/mL) had a trend toward higher β-HCG-positive (72 versus 59%; p > 0.05), lower delivery (26 versus 39%; p > 0.05) and higher miscarriage rates (64 versus 33%; p < 0.01). Comparing the middle quartiles (P25-50) with those above percentiles 75, the rate of pregnancy was similar (60 versus 57%; p > 0.05), although there was a trend toward a higher number of deliveries (43 versus 31%; p > 0.05) and a lower number of miscarriages (28 versus 45%; p > 0.05). These differences were not statistically significant.

CONCLUSION: There were no differences in pregnancy and delivery rates related with the progesterone level when measured in the transfer day. The miscarriage rate was higher in the 1^st quartile group.

PMID:34547795 | DOI:10.1055/s-0041-1735229

Rev Bras Ginecol Obstet. 2021 Aug;43(8):616-621. doi: 10.1055/s-0041-1733998. Epub 2021 Sep 21.

ABSTRACT

OBJECTIVE: This study evaluated the risk of the hereditary breast and ovarian cancer (HBOC) syndrome in patients with breast cancer by using the Family History Screening 7 (FHS-7) tool, a validated low-cost questionnaire with high sensitivity able to screen the HBOC risk in the population.

METHODS: Women diagnosed with breast cancer (n = 101) assisted by the Unified Health System at the 8th Regional Health Municipal Office of the state of Paraná answered the FHS-7, and the results were analyzed using IBM SPSS Statistics for Windows, Version 25.0. software (IBM Corp., Armonk, NY, USA).

RESULTS: The risk of HBOC was 19.80% (n = 20). Patients at risk exhibited aggressive tumor characteristics, such as high-grade tumors (30%), presence of angiolymphatic emboli (35%), and premenopausal at diagnosis (50%). Significant associations between the prevalence of high-grade tumors were observed in women younger than 50 years at diagnosis with HBOC (p = 0.003).

CONCLUSION: Our findings suggest a possible family inheritance associated with worse clinical features in women with breast cancer in this population, indicating that HBOC investigation can be initially performed with low-cost instruments such as FHS-7.

PMID:34547796 | DOI:10.1055/s-0041-1733998

Diving Hyperb Med. 2021 Sep 30;51(3):240-247. doi: 10.28920/dhm51.3.240-247.

ABSTRACT

INTRODUCTION: Patients undergoing hyperbaric oxygen treatments (HBOT) have been shown to experience a reduction in blood glucose (BG) levels during a treatment. This necessitates frequent assessment of BG levels. Continuous glucose monitoring (CGM) may represent an alternative to the current finger prick monitoring method in-chamber, however, continuous sensor glucose (SG) data has not been validated in situ. The aim was to determine the validity of continuous SG and intermittent BG monitoring with serum BG levels in diabetic patients during HBOT.

METHODS: Measurements were obtained (finger prick [capillary sample], CGM [interstitial fluid], and serum [venous sample]) at baseline, and at 30, 60, 90 and 120 minutes during the hyperbaric treatment. Data were analysed by calculating intraclass correlation coefficients (ICC) and using mixed effects linear regression.

RESULTS: The ICC results (n = 10 patients) between the three methods indicated very high and statistically significant absolute agreement at baseline (pre-dive) (ICC = 0.90, 95% CI 0.74-0.97), at 30 minutes (ICC = 0.85, 95% CI 0.61-0.96), 60 minutes (ICC = 0.86, 95% CI 0.58-0.96), 90 minutes (ICC = 0.87, 96% CI 0.63-0.96) and 120 minutes (ICC = 0.90, 95% CI 0.70-0.97). Capillary glucose and CGM SG readings were each within 1 mmol·L-1 on average of the serum glucose reading, with multi-level linear regression finding the average difference between the CGM SG and capillary glucose methods of BG sampling was not statistically significant (P = 0.81).

CONCLUSIONS: The CGM SG data were comparable with glucose readings from capillary monitoring. Both CGM and capillary data were consistent with serum values.

PMID:34547774 | DOI:10.28920/dhm51.3.240-247

Rev Bras Ginecol Obstet. 2021 Aug;43(8):595-599. doi: 10.1055/s-0041-1733912. Epub 2021 Sep 21.

ABSTRACT

OBJECTIVE: To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women.

METHODS: A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation.

RESULTS: Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87 ± 66.92 fL for the case group versus 9.84 ± 1.2 fL for the control group; PDW: 14.82 ± 3.18 fL for the case group versus 13.3 ± 2.16 fL for the controls). The criterion value of the receiver operating characteristic (ROC) curve for PDW at a cutoff point of > 11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of > 10.17 fL showed a good diagnostic marker.

CONCLUSION: The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.

PMID:34547793 | DOI:10.1055/s-0041-1733912