Tag: pubmed

Public Health Nurs. 2021 Sep 22. doi: 10.1111/phn.12972. Online ahead of print.

ABSTRACT

OBJECTIVE: The study was conducted to determine the vaccination rates and related factors among the elderly.

DESIGN: Cross-sectional study.

SAMPLE: This study was conducted with 984 elderly people living in a province in western Turkey.

MEASUREMENTS: The single-stage cluster sampling method was used in the sample selection. The descriptive statistics, the chi-square analysis, the Mann-Whitney U test and the logistic regression analysis for the multivariate analysis were used to evaluate the data.

RESULTS: It was determined that 45.6% of the elderly were vaccinated after the age of 65 and the most frequently administered vaccines were influenza (41.3%), pneumococcal (10.9%), and tetanus (5.5%) vaccines. Higher vaccination rates were determined in the following demographics, namely by 1.8-fold (95% CI, 1.4-2.4) in those living in urban areas, by 2.6-fold (95% CI, 1.8-3.9) in those with high school or higher education, by 1.5-fold (95% CI, 1.0-2.5) in those who did not work, by 1.7-fold (95% CI, 1.3-2.3) in those with chronic diseases and by 2-fold (95% CI, 1.1-3.4) in those who fulfilled their physical own needs themselves.

CONCLUSION: This study showed that more than half of the elderly did not receive any vaccinations in old age. The vaccination rates of the elderly were associated with many factors.

PMID:34551144 | DOI:10.1111/phn.12972

Clin Oral Implants Res. 2021 Sep 22. doi: 10.1111/clr.13851. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare peri-implant clinical and radiographic parameters between hydrophilic and hydrophobic narrow dental implants in patients with mandibular implant overdentures for 1 year.

MATERIALS AND METHODS: In a randomized, double-blind, split-mouth study with a 1-year follow-up, sixteen edentulous participants received two narrow-diameter implants in the anterior mandibular region with 2 types of surfaces: hydrophobic (Neoporos surface, NS) and hydrophilic (Acqua surface, AS). During the osseointegration period and after loading with mandibular implant overdentures, the outcomes monitored were i) peri-implant health: early healing index (EHI), visible plaque index (VPI), calculus presence (CP), peri-implant inflammation (PI), probing depth (PD), bleeding on probing (BOP); ii) implant stability quotient (ISQ), iii) crestal bone loss (CBL) and bone level change (BLC); and iv) implant success and survival rates.

RESULTS: The PD in NS implants decreased by 31.78% between 15 and 30 days, while a similar reduction (-31.28%) occurred in the 3^rd month in the AS group. The ISQ also decreased significantly during the 1^st month in both groups: -10.95% after 7 days in the NS group and -7.46% after 15 days in the AS group. At 12 months, statistically significance differences were not observed, however, the AS surface presented 50.6% smaller CBL and 41.3% smaller BLC values. The success and survival rates were 62.5% for AS implants and 87.5% for NS implants.

CONCLUSION: Narrow diameter implants with hydrophilic and hydrophobic surfaces loaded with mandibular implant overdentures showed no differences in peri-implant healing, stability, and peri-implant bone remodelling in the 1^st year of follow-up.

PMID:34551146 | DOI:10.1111/clr.13851

Laryngoscope. 2021 Sep 22. doi: 10.1002/lary.29863. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: To reanalyze the growth trajectory and assess longitudinal changes of children undergoing adenotonsillectomy (AT) versus watchful waiting (WW) enrolled in the Childhood Adenotonsillectomy Trial (CHAT) study and to determine if an AT increases the risk of obesity in children.

STUDY DESIGN: Reanalysis of prospective cohort investigation.

METHODS: The study analyzed publicly available data from CHAT, including 3 months visit data not previously included in a prior publication. Statistical comparisons and mixed-effects modeling were done using age- and sex-specific BMI expressed as a percentage of the 95th percentile (%BMIp95). P < .05 was considered significant.

RESULTS: Children in the AT group, especially if underweight at baseline, had an increased rate of weight gain, with 100% of underweight children in the AT group becoming normal weight compared to 20% for WW. However, the rate of weight gain, as measured by the %BMIp95 trajectory for both AT and WW groups, was not significantly different when baseline weight status and obstructive sleep apnea (OSA) resolution were accounted for. Comparisons of %BMIp95 between treatment groups at baseline, 3- and 7-month follow-up visits also failed to identify statistically significant differences (P > .05). Overall for the entire cohort, resolution of OSA was associated with a decreased weight trajectory (P < .001).

CONCLUSIONS: AT compared to WW is not associated with an increased risk of excessive weight gain. Otolaryngologists should be aware of this updated analysis when discussing AT surgical outcomes with families.

LEVEL OF EVIDENCE: 2 Laryngoscope, 2021.

PMID:34551129 | DOI:10.1002/lary.29863

Headache. 2021 Sep 22. doi: 10.1111/head.14206. Online ahead of print.

ABSTRACT

OBJECTIVE: This post hoc analysis in patients medically diagnosed with chronic migraine (CM) and medication-overuse headache (MOH) evaluated reductions in the use of acute headache medication (AHM) and sustained changes in the diagnostic status of CM and MOH following eptinezumab treatment in the PROMISE-2 study.

BACKGROUND: Eptinezumab, a monoclonal antibody that inhibits calcitonin gene-related peptide, is approved in the United States for the preventive treatment of migraine. A previous analysis showed that eptinezumab reduced monthly migraine days and was well tolerated in the subgroup of PROMISE-2 patients diagnosed with both CM and MOH.

METHODS: The phase 3, double-blind, placebo-controlled PROMISE-2 study (NCT02974153) randomized adults with CM to eptinezumab 100 mg, 300 mg, or placebo (administered intravenously every 12 weeks for up to two doses). MOH was prospectively diagnosed at screening by trained physicians based on 3 months of medication history and International Classification of Headache Disorders-3β criteria. This post hoc analysis evaluated changes in total and class-specific days of AHM usage, the percentage of patients using AHM at or above MOH diagnostic thresholds, and the percentage of patients experiencing monthly headache and migraine day frequency below diagnostic thresholds for MOH and/or CM.

RESULTS: In PROMISE-2, 431/1072 (40.2%) patients with CM were diagnosed with MOH (eptinezumab 100 mg, n = 139; 300 mg, n = 147; placebo, n = 145) and were included in this analysis. Total monthly AHM use decreased from 20.6 days/month at baseline to 10.6 days/month over 24 weeks of treatment (49% decrease) with eptinezumab 100 mg, from 20.7 to 10.5 days/month (49% decrease) with eptinezumab 300 mg, and from 19.8 to 14.0 days/month (29% decrease) with placebo. Numerically greater decreases from baseline with eptinezumab were also observed for individual drug classes. In each study month, the percentages of patients who were below MOH thresholds were numerically higher for both eptinezumab doses compared with placebo, as were the percentages of patients experiencing headache and migraine frequency below CM thresholds. Of patients with available data across the entire treatment period, 29.0% (58/200) of patients treated with eptinezumab stopped meeting and remained below diagnostic thresholds for both CM and MOH during Weeks 1-24, as well as 6.3% (6/96) of patients who received placebo.

CONCLUSIONS: Across 24 weeks of treatment, eptinezumab reduced AHM use in patients diagnosed with CM and MOH. More than one-fourth (29%) of patients treated with eptinezumab did not meet the diagnostic thresholds for either CM or MOH for the entire treatment period.

PMID:34551130 | DOI:10.1111/head.14206

Clin Pharmacol Ther. 2021 Sep 22. doi: 10.1002/cpt.2425. Online ahead of print.

ABSTRACT

Clinicians and patients often try a treatment for an initial period to inform longer-term therapeutic decisions. A more rigorous approach involves N-of-1 trials. In these single-patient crossover trials, typically conducted in patients with chronic conditions, individual patients are given candidate treatments in a double-blinded, random sequence of alternating periods to determine the most effective treatment for that patient. However, to date, these trials are rarely done outside of research settings and have not been integrated into general care where they could offer substantial benefit. Designating this classical, N-of-1 trial design as Type 1, there also are new and evolving uses of N-of-1 trials that we designate as Type 2. In these, rather than focusing on optimizing treatment for chronic diseases when multiple approved choices are available, as is typical of Type 1, a Type 2 N-of-1 trial tests treatments designed specifically for a patient with a rare diseases, to facilitate personalized medicine. While the aims differ, both types face the challenge of collecting individual-patient evidence using standard, trusted, widely accepted methods. To fulfill their potential for producing both clinical and research benefits, and to be available for wide use, N-of-1 trials will have to fit into the current healthcare ecosystem. This will require generalizable and accepted processes, platforms, methods, and standards. This also will require sustainable value-based arrangements among key stakeholders. In this article, we review opportunities, stakeholders, issues, and possible approaches that could support general use of N-of-1 trials and deliver benefit to patients and the healthcare enterprise. To assess and expand the benefits of N-of-1 trials, we propose multi-stakeholder meetings, workshops, and the generation of methods, standards, and platforms that would support wider availability and the value of N-of-1 trials.

PMID:34551122 | DOI:10.1002/cpt.2425

Allergy. 2021 Sep 22. doi: 10.1111/all.15107. Online ahead of print.

ABSTRACT

BACKGROUND: IgG2 responses are associated with repeated antigen exposure and display highly mutated variable domains. A recent study highlighted a role of IgG2+ memory B cells and allergen-specific IgG2 levels after a 3^rd consecutive pre-seasonal sublingual allergen immunotherapy (AIT) with grass pollen tablet. Herein, we aim to explore changes in allergen-specific IgG2 in individuals undergoing house dust mite immunotherapy (HDM-AIT) and explore whether the interrelationship with other humoral responses (i.e. IgG4 and IgE) may discriminate between high and low responders.

METHODS: Levels of serum D. pteronyssinus- and D. farinae-specific IgG2, IgG4 and IgE antibodies were measured by ELISA or ImmunoCap in a sub-group of individuals enrolled in a randomized, double-blind, placebo-controlled, sublingual AIT study evaluating the safety and efficacy of a 300 IR HDM tablet.

RESULTS: After 1-year sublingual AIT, HDM-specific serum IgG2 responses increase mostly in high versus low responders and are distinctive according to the clinical benefit. Higher correlation between HDM-specific IgG2, IgE and/or IgG4 responses are seen in subjects benefiting the most from HDM-AIT as indicated by changes in Average Total Combined Scores. More strikingly, statistically significant correlation between HDM-specific IgG2 and IgE responses are only observed in individuals stratified as high responders.

CONCLUSIONS: We provide evidence for coordinated serum immune responses upon AIT in HDM-allergic subjects exhibiting high clinical benefit when compared with low responders. Assessing HDM-specific IgE, IgG2 and IgG4 in serum could be used as follow-up combined markers to support decision as to AIT continuation and/or adaptation.

PMID:34551124 | DOI:10.1111/all.15107

Sleep. 2021 Sep 22:zsab232. doi: 10.1093/sleep/zsab232. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Increased phase synchronization in electroencephalography (EEG) bands might reflect the activation of compensatory mechanisms of cognitive decline in people with neurodegenerative diseases. Here, we investigated whether altered large-scale couplings of brain oscillations could be linked to the balancing of cognitive decline in a longitudinal cohort of people with idiopathic rapid eye-movement sleep behavior disorder (iRBD).

METHODS: We analyzed 18 patients (17 males, 69.7±7.5 years) with iRBD undergoing high-density EEG (HD-EEG), presynaptic dopaminergic imaging, and clinical and neuropsychological assessments at two time points (time interval 24.2±5.9 months). We thus quantified the HD-EEG power distribution, orthogonalized amplitude correlation and weighted phase lag index at both time points and correlated them with clinical, neuropsychological and imaging data.

RESULTS: Four patients phenoconverted at follow-up (three cases of parkinsonism and one of dementia). At the group level, neuropsychological scores decreased over time, without reaching statistical significance. However, alpha phase synchronization increased and delta amplitude correlations decreased significantly at follow-up compared to baseline. Both large-scale network connectivity metrics were significantly correlated with neuropsychological scores but not with sleep quality indices or presynaptic dopaminergic imaging data.

CONCLUSIONS: These results suggest that increased alpha phase synchronization and reduced delta amplitude correlation may be considered electrophysiological signs of an active compensatory mechanism of cognitive impairment in people with iRBD. Large-scale functional modifications may be helpful biomarkers in the characterization of prodromal stages of alpha-synucleinopathies.

PMID:34551110 | DOI:10.1093/sleep/zsab232

Int Nurs Rev. 2021 Sep;68(3):267-269. doi: 10.1111/inr.12702.

ABSTRACT

The International Council of Nurses is in a unique position to represent nurses at the World Health Organization, and its task has never been more urgent than this year. Amid the global COVID-19 pandemic, the death rates of nurses and other health care workers are truly shocking, with around 115 000 deaths. However, many countries do not collect statistics on health and care workers’ deaths and infections from COVID-19, so the full extent of this awful situation is not known. At this year’s World Health Assembly, the body that sets the World Health Organization’s agenda for the following year, the International Council of Nurses’ 50-strong delegation voiced the concerns of nurses and ensured that the views and advice of nurses were heard by the World Health Organization’s 194 member states’ delegates. Here, the International Council of Nurses’ Chief Executive Officer Howard Catton describes how the Council is influencing health and care policy worldwide. He urges nurses everywhere to hold their politicians to account.

PMID:34551116 | DOI:10.1111/inr.12702

Eur J Prev Cardiol. 2021 Sep 20;28(11):1214-1221. doi: 10.1177/2047487320901416.

ABSTRACT

AIMS: Our aim was to evaluate the predictive value of a battery of 10 non-invasive tests of cardiovascular structural and functional health on the future risk of cardiovascular morbid events.

METHODS AND RESULTS: A total of 1900 asymptomatic adults concerned about their risk for cardiovascular disease underwent non-invasive assessment with 10 tests of vascular and cardiac structure and function. A disease score (DS) was calculated for each individual based on these 10 tests. Follow-up (mean 9.2 years) for cardiovascular morbidity and mortality was available for 1442 individuals (mean age 53.2 years, 48.2% women). Those in the lowest DS tertile (0-2) experienced 0.16 cardiovascular events per 100 patient-years (PY), those in the middle tertile (3-5) experienced 0.86 events per 100 PY, and those in the highest tertile (6+) experienced 1.3 events per 100 PY (p < .001). Sensitivity analysis, assuming a neutral effect of DS on projected events in subjects not followed, did not alter statistical significance. Risk assessment using the Framingham risk score (FRS) also predicted morbid events but the two methods differed in identifying individuals at high risk. The net reclassification index was improved by 0.11 (p = 0.01) when DS was added to FRS.

CONCLUSIONS: Assessing the biological disease process in the arteries and heart of asymptomatic adults provides a guide to the risk of a future cardiovascular morbid event. Larger and longer studies are needed to determine whether risk factor algorithms, the severity of the biological process or some combination is the optimal method for identifying individuals in need of intervention to delay morbid events.

PMID:34551082 | DOI:10.1177/2047487320901416

Int J Yoga Therap. 2021 Sep 22. doi: 10.17761/2021-D-20-00060. Online ahead of print.

ABSTRACT

Cricket-bowling performance is known to be influenced by speed of ball release and accuracy. Currently, training sessions typically involve fielding-specific drills and conditioning exercises. Scientific evidence for inclusion of a comprehensive yoga intervention in daily training and exercise sessions remains unexplored. The present study explored the effect of yoga on bowling performance and physical fitness in cricket bowlers. Sports fitness testing and training were conducted among 60 non-elite recreational-club male cricket players aged 13-25 years. Cricket-bowling speed was e valuated using a speed radar gun, accuracy with a test developed by Portus et al., cardiorespiratory endurance using the yo-yo intermittent recovery test, lower-extremity and trunk strength using a back-leg dynamometer, upper-limb power using a medicine ball-throw test, power using a vertical-jump test, and flexibility using a sit-and-reach test. In addition to bowling practice, the yoga intervention group (n = 30) performed pranayama and standing and prone asana, whereas the control group (n = 30) practiced conventional conditioning exercises, for 45 minutes/day, three times a week, for 12 weeks. Improvement in bowling speed, accuracy, cardiorespiratory endurance, muscle strength, and flexibility were comparable between the two groups. Statistically significant improvements in baseline scores in bowling speed, accuracy, cardiorespiratory endurance, muscle flexibility, strength, and power were comparable between the two groups of non-elite male cricket players. Bowling speed improved by 6.52% in the yoga group and by 5.18% in the control group. Bowling accuracy improved by 35.40% in the yoga group and by 31.29% in the control group. Additional research on long-duration intervention in elite players may help to establish the role of yoga in conventional cricket-bowling training.

PMID:34551075 | DOI:10.17761/2021-D-20-00060