Tag: pubmed

Turk J Pediatr. 2021;63(6):1056-1063. doi: 10.24953/turkjped.2021.06.014.

ABSTRACT

BACKGROUND AND OBJECTIVES: Acute bronchiolitis is one of the most common reasons for hospitalization in infants. Although patients with acute bronchiolitis generally have a good prognosis, death can also occur. In this study, we evaluate the immature platelet fraction (IPF) as an indicator of the severity of acute bronchiolitis.

METHODS: In our study, 179 patients diagnosed with acute bronchiolitis were divided into three groups as mild (n: 48; 26.8%), moderate (n: 104; 58.10%) and severe (n: 27; 15.1%) bronchiolitis. There were 80 healthy children in the control group. The diagnostic capacity of IPF and hematological parameters (platelet distribution width (PDW), mean platelet volume (MPV), white blood cell count (WBC), and platelet count (PLT)) values to predict severity of acute bronchiolitis was evaluated using receiver operating characteristic (ROC) curves and their respective areas under the curves (AUCs) calculated with 95% confidence intervals.

RESULTS: The IPF value of patients with acute bronchiolitis was significantly higher than the healthy group (p < 0.001). In addition, a positive correlation was observed between clinical severity of bronchiolitis and IPF. The ROC curve analysis indicated that the IPF cut-off point for predicting severity of acute bronchiolitis was > 3.2% (Sensitivity of 84%, specificity of 97%). We found that the AUCs for IPF, MPV, PDW, WBC and PLT were statistically significant for bronchiolitis relative to the healthy control group. The parameter with the greatest AUC value was IPF.

CONCLUSION: The IPF may present for diagnosing and evaluating the clinical severity of acute bronchiolitis in children.

PMID:35023656 | DOI:10.24953/turkjped.2021.06.014

Turk J Pediatr. 2021;63(6):978-985. doi: 10.24953/turkjped.2021.06.005.

ABSTRACT

BACKGROUND: The widespread use of biological treatments has increased the frequency of opportunistic infections such as tuberculosis (TB). The primary objective of our study was to determine the rate of tuberculin skin test (TST) conversion during biological therapy. The secondary objective was to monitor the side effects related to isoniazid (INH) prophylaxis, in the selected subgroup.

METHODS: Children with rheumatologic diseases receiving treatment with tumor necrosis factor-alpha (TNF-α) inhibitors, and tocilizumab and canakinumab were included in the study. If baseline screening was negative, TST was performed annually after initiation of biologic therapy. TST conversion was accepted as an increase of at least 6 mm and becoming positive or an increase of 10 mm or more, even in the absence of positivity.

RESULTS: 121 patients (female n: 63, 52%) were included in the study. The mean follow-up period was 26.10±14.8 months. 85 of the patients were using TNF-α inhibitors and 18 tocilizumab, and 18 canakinumab. Forty patients had positive TST before biological agents and received chemoprophylaxis with INH. The rate of TST conversion among the 3 biological agents was not statistically significant (20.4% of TNF-α inhibitors, 25% of canakinumab and 33.3% of tocilizumab users). All patients with LTBI received INH prophylaxis, and none of them had active TB.

CONCLUSIONS: There was no statistically significant difference among the three biological agents, regarding the seroconversion rates. Patients receiving tocilizumab and canakinumab should also be screened for TB during follow-up. INH related side effects are rare.

PMID:35023647 | DOI:10.24953/turkjped.2021.06.005

Nicotine Tob Res. 2022 Jan 12:ntac012. doi: 10.1093/ntr/ntac012. Online ahead of print.

ABSTRACT

INTRODUCTION: Clinical practice guidelines(CPGs) are important tools for medical decision making. Given the high prevalence and financial burden associated with tobacco use disorder(TUD), it is critical that recommendations within CPGs are based on robust evidence. Systematic reviews(SRs) are considered the highest level of evidence, thus, we evaluated the quality of SRs underpinning CPG recommendations for TUD.

METHODS: We used PubMed to search for CPGs relating to TUD published between January 1, 2010 and May 21, 2021. SRs were extracted from CPG references and evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) and A MeaSurement Tool to Assess Systematic Reviews(AMSTAR-2) tools. We then compared SRs conducted by the Cochrane Collaboration with non-Cochrane SRs using a Mann-Whitney U test and determined associations between PRISMA and AMSTAR-2 extracted characteristics using multiple regression.

RESULTS: Our search generated 10 CPGs with 98 SRs extracted. Mean PRISMA completion was 74.7%(SD=16.7) and mean AMSTAR-2 completion was 53.8%(SD=22.0) across all guidelines. Cochrane SRs were more complete than non-Cochrane studies in the PRISMA and AMSTAR-2 assessments. The regression model showed a statistically significant association between PRISMA completion and AMSTAR-2 rating, with those classified as “low” or “moderate” quality having higher PRISMA completion than those with “critically low” ratings.

CONCLUSION: We found substandard adherence to PRISMA and AMSTAR-2 checklists across SRs cited in TUD CPGs. A lack of recent SRs in CPGs could lead to outdated recommendations. Therefore, frequent guideline updates with recently published evidence may ensure more accurate clinical recommendations and improve patient care.

IMPLICATIONS: Systematic reviews used to underpin clinical practice guideline recommendations influence treatment decisions and, ultimately, patient outcomes. We found that many systematic reviews underpinning tobacco use disorder guideline recommendations were out of date and unsatisfactory in reporting and quality. Thus, including newer systematic reviews containing more recently conducted trials and better reporting could alter recommendations and improve the rate of successful tobacco cessation attempts.

PMID:35023556 | DOI:10.1093/ntr/ntac012

Perspect Psychiatr Care. 2022 Jan 13. doi: 10.1111/ppc.13025. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness of the psychoeducational programme “Living together with dementia” applied to a group of family caregivers of people with dementia.

DESIGN AND METHODS: A quasi-experimental study with pretest and posttest and a 4-month follow-up. Fifteen family caregivers of people with dementia were recruited in a community care unit in northern Portugal.

RESULTS: A positive and statistically significant impact on these caregivers’ burden was found.

PRACTICE IMPLICATIONS: The programme could be an important mechanism to train family caregivers of home-dwelling people with dementia.

PMID:35023574 | DOI:10.1111/ppc.13025

Eur Heart J. 2021 Nov 22:ehab777. doi: 10.1093/eurheartj/ehab777. Online ahead of print.

ABSTRACT

AIMS: The complementary studies FIDELIO-DKD and FIGARO-DKD in patients with type 2 diabetes and chronic kidney disease (CKD) examined cardiovascular and kidney outcomes in different, overlapping stages of CKD. The purpose of the FIDELITY analysis was to perform an individual patient-level prespecified pooled efficacy and safety analysis across a broad spectrum of CKD to provide more robust estimates of safety and efficacy of finerenone compared with placebo.

METHODS AND RESULTS: For this prespecified analysis, two phase III, multicentre, double-blind trials involving patients with CKD and type 2 diabetes, randomized 1:1 to finerenone or placebo, were combined. Main time-to-event efficacy outcomes were a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure, and a composite of kidney failure, a sustained ≥57% decrease in estimated glomerular filtration rate from baseline over ≥4 weeks, or renal death. Among 13 026 patients with a median follow-up of 3.0 years (interquartile range 2.3-3.8 years), the composite cardiovascular outcome occurred in 825 (12.7%) patients receiving finerenone and 939 (14.4%) receiving placebo [hazard ratio (HR), 0.86; 95% confidence interval (CI), 0.78-0.95; P = 0.0018]. The composite kidney outcome occurred in 360 (5.5%) patients receiving finerenone and 465 (7.1%) receiving placebo (HR, 0.77; 95% CI, 0.67-0.88; P = 0.0002). Overall safety outcomes were generally similar between treatment arms. Hyperkalaemia leading to permanent treatment discontinuation occurred more frequently in patients receiving finerenone (1.7%) than placebo (0.6%).

CONCLUSION: Finerenone reduced the risk of clinically important cardiovascular and kidney outcomes vs. placebo across the spectrum of CKD in patients with type 2 diabetes.

KEY QUESTION: Does finerenone, a novel selective, nonsteroidal mineralocorticoid receptor antagonist, added to maximum tolerated renin-angiotensin system inhibition reduce cardiovascular disease and kidney disease progression over a broad range of chronic kidney disease in patients with type 2 diabetes?

KEY FINDING: In a prespecified, pooled individual-level analysis from two randomized trials, we found reductions both in cardiovascular events and kidney failure outcomes with finerenone. Because 40% of the patients had an estimated glomerular filtration rate of >60 mL/min/1.73m2 they were identified solely on the basis of albuminuria.

TAKE HOME MESSAGE: Finerenone reduces the risk of clinical cardiovascular outcomes and kidney disease progression in a broad range of patients with chronic kidney disease and type 2 diabetes. Screening for albuminuria to identify at-risk patients among patients with type 2 diabetes facilitates reduction of both cardiovascular and kidney disease burden.

PMID:35023547 | DOI:10.1093/eurheartj/ehab777

Wiad Lek. 2021;74(11 cz 1):2789-2793.

ABSTRACT

OBJECTIVE: The aim: To reveal the organizational factors of psychological safety in the workplace.

PATIENTS AND METHODS: Materials and methods: Methods of psychological survey, statistical assessment and analysis of the received data were used.

RESULTS: Results: Psychological safety is regarded in the paper as a state of preservation of mind that involves maintaining a balance between the negative effects of the environment and a person’s resilience, that is, the ability to overcome such effects. In the structure of the psychological safety of the organization member three components were identified and explored: cognitive, emotional and “confidence in the future”. The results of the survey study confirmed that such organizational factors as level of organizational culture, working team cohesion, working team self-organization, management style of the immediate supervisor, work autonomy, role ambiguity have positive effect on psychological safety.

CONCLUSION: Conclusions: The results imply the importance of purposeful implementation of company policies aiming to improve the revealed factors: providing autonomy to employees and work groups within the organization, establishing clear job descriptions, work performance requirements and interaction principles, improving works design, internal communications.

PMID:35023494

Wiad Lek. 2021;74(11 cz 1):2806-2811.

ABSTRACT

OBJECTIVE: The aim: To determine the differences in the ability of young people with low and high economic statuses towards emotional self-regulation, and characterize their frame of mind by analyzing functional and dysfunctional emotions in healthy and unhealthy states.

PATIENTS AND METHODS: Materials and methods: Theoretical – analysis, generalization, interpretation of the collected data; a set of empirical methods – “Attitude to health” by Berezovskaya, the scale “Quality of life” in the adaptation by Vodopyanova, self-assessment income scale and validated questionnaire “Subjective economic well-being” by Khashchenko. The author has applied Pearson’s chi-squared test, Student’s t-test, and Kruskal-Wallis test.

RESULTS: Results: The affective component of health manifests in the predominance of happiness (t=0.3, p≤0.01) and peace (t=1.7, p≤0.1) as components of a positive frame of mind among young people with high economic status. Such emo≤ions such as fear (t=2.1, p≤0.03), anxiety (t=2, p≤0.04) and irritability (t=1.8, at p≤0.07) are more common among young people with low economic status. Young people who have high economic status show stronger ability to emotional self-regulation in comparison to the ones with low economic status (χ² = 11.9, p≤0.001).

CONCLUSION: Conclusions: In this research, we have found a statistically significant difference in the ability towards emotional self-regulation between young people with low and high economic status: the latter group is able to control dysfunctional emotions such as anger and resentment more when communicating with others; they are more likely to find internal psychological resources. When the health deteriorates, the young people with high economic status are prone to show independence, and manage their own time and life, which is a sign of stable mental health.

PMID:35023497

Wiad Lek. 2021;74(11 cz 1):2779-2783.

ABSTRACT

OBJECTIVE: The aim: To research the indicators of teachers’ mental health in a destabilizing organization of professional activities.

PATIENTS AND METHODS: Materials and methods: The study was conducted at the Poltava M. V. Ostrogradsky Regional Institute of Postgraduate Pedagogical Education, Poltava V. G. Korolenko National Pedagogical University, Volodymyr Vynnychenko Central State Pedagogical University and Poltava State Medical University in 2018-2020. The sample size of 1817 respondents (Ukraine) included 388 men and 1429 women aged 20 to 57 years. The following methods were used: “Scale of threats to occupational health” (Dziuba, 2015) and “Scale of subjective well-being” (Sokolova, 2007) adapted by T. Dziuba. The study used mathematical and statistical analysis (descriptive statistics, correlation analysis) using IBM SPSS Statistics (version 21.0).

RESULTS: Results: It was found that an unstable level of emotional comfort is dominant (57.2%). This is shown by the following indicators: “self-assessment of mental health” 61.0%, “tension and sensitivity” 54.3% and “signs of psychiatric symptoms” 53.0%. Correlation analysis revealed a significant negative impact of the threat factors “daily and weekly overtime” (p <0.01) and “overwork” (p <0.01) on mental health. There is an increase in emotional discomfort in a situation of daily and weekly overtime and overwork. There is a positive correlation between the teachers’ mental health and the indicator “significance of the professional environment” (p <0.01).

CONCLUSION: Conclusions: The study showed that teachers’ mental health in Ukrainian educational organizations is characterized by unstable emotional comfort and increased emotional discomfort, which is a consequence of unbalanced (destabilizing) working conditions: overwork, overtime. The obtained data motivates the need to conduct targete psychotherapeutic and corrective work with teachers who demonstrate professional distress.

PMID:35023492

Wiad Lek. 2021;74(11 cz 1):2784-2788.

ABSTRACT

OBJECTIVE: The aim: To clarify motivation trends of alcohol consumption by adults in the city of Lviv and Lviv region and their mental health risk factors as compared to the specificity of motivation for alcohol consumption by the representatives of other European countries.

PATIENTS AND METHODS: Materials and methods: The study is based on the data of the representative survey of Lviv region residents (1,200 persons) following the methodology RARHA adjusted for Ukraine and its statistical processing.

RESULTS: Results: The results of the study point to the prevalence of social and recreational, traditional motives for alcohol consumption by Lviv region residents (consumption during solemn ceremonies and celebrations). Extremely important, as compared to other European countries, are social motives (the sense of belonging to an important social group). The importance of social factors for the respondents decreases a bit with age and considerably depends on the specific features of religious practices. A wide-spread motive is the striving for changing the emotional state, combined with higher abuse risk as compared to the people who drink on social occasions.

CONCLUSION: Conclusions: The results of the study characterize the specificity of the motivational structure of alcohol consumption by Ukrainians as compared to the general European trends and can be used for the development of targeted regional prevention programs.

PMID:35023493

J Clin Neurol. 2022 Jan;18(1):71-78. doi: 10.3988/jcn.2022.18.1.71.

ABSTRACT

BACKGROUND AND PURPOSE: A multifactorial antiepileptic mechanism underlies the ketogenic diet (KD), and one of the proposed mechanisms of action is that the KD inhibits the mammalian target of rapamycin (mTOR) pathway. To test this clinically, this study aimed to determine the efficacy of the KD in patients with pathologically confirmed focal cortical dysplasia (FCD) due to genetically identifiable mTOR pathway dysregulation.

METHODS: A cohort of patients with pathologically confirmed FCD after epilepsy surgery and who were screened for the presence of germline and somatic mutations related to the mTOR pathway in peripheral blood and resected brain tissue was constructed prospectively. A retrospective review of the efficacy of the prior KD in these patients was performed.

RESULTS: Twenty-five patients with pathologically confirmed FCD and who were screened for the presence of detectable somatic mTOR pathway mutations had received a sufficient KD. Twelve of these patients (48.0%) had germline or somatic detectable mTOR pathway mutations. A response was defined as a ≥50% reduction in seizure frequency. The efficacy of the KD after 3 months of dietary therapy was superior in patients with detectable mTOR pathway mutations than in patients without detectable mTOR pathway mutations, although the difference was not statistically significant (responder rates of 58.3% vs. 38.5%, p=0.434).

CONCLUSIONS: A greater proportion of patients with mTOR pathway responded to the KD, but there was no statistically significant difference in efficacy of the KD between patients with and without detectable mTOR pathway mutations. Further study is warranted due to the smallness of the sample and the limited number of mTOR pathway genes tested in this study.

PMID:35021279 | DOI:10.3988/jcn.2022.18.1.71