Tag: pubmed

Neurologia (Engl Ed). 2021 Sep 17:S2173-5808(21)00133-4. doi: 10.1016/j.nrleng.2019.08.004. Online ahead of print.

ABSTRACT

BACKGROUND: Hospital on-call neurology shifts are frequently on-site, but some on-call services may be off-site or mixed. Intravenous tissue plasminogen activator (tPA) is one of the main reperfusion treatments for acute ischaemic stroke (AIS). This study assesses door-to-needle times (DNT) when the neurologist is on-site or off-site.

METHODS: We performed a prospective, observational study from 2012 to 2017, including patients with AIS and treated with tPA. Data were collected on sex, age, door-to-scan time, scan-to-needle time, and DNT. The on-duty neurologist was on-site from 08:00 to 20:00, and on call but off-site from 20:00 to 8:00. Three groups were formed: on-site, off-site, and off-site with resident present.

RESULTS: Our sample included 138 patients. The mean age was 69.7 years, and 45.7% of patients were women. Ninety-six patients were admitted during the on-site shift, 25 during the off-site shift, and 17 during the off-site-resident present shift. Patients admitted during the on-site and off-site shifts presented DNTs of 59 and 72 minutes, respectively (P = .003). DNTs were 59, 74, and 68 minutes (P = .001), respectively, for the on-site, off-site, and off-site-resident present shifts; the difference between DNTs for on-site and off-site shifts was statistically significant. No differences were observed between DNTs according to time of day (morning, afternoon, or night), or between weekdays and weekends.

CONCLUSION: DNT is influenced by whether the on-duty neurologist is on- or off-site at the time of code stroke activation. The presence of a neurology resident can reduce DNT.

PMID:34544671 | DOI:10.1016/j.nrleng.2019.08.004

P R Health Sci J. 2021 Jun;40(2):75-80.

ABSTRACT

OBJECTIVE: The objective of this study was to determine the age-related anatomical changes that take place at the cementodentinal junction (CDJ).

METHODS: Eighty-four teeth were extracted; 42 samples came from patients ranging in age from 18 to 30 years, and 42 came from patients aged from 40 to 60 years. Upper and lower and anterior and posterior teeth were included. Longitudinal slices were made, and 1% toluidine blue was used to stain all the samples prior to microscopic examination. Anatomical landmarks (apical foramen [AF], apical vertex, and cementoenamel junction) in the apical third were identified, and a pre-calibrated software package was employed to take digital measurements. Statistical analysis was performed by means of the Wilcoxon rank-sum test.

RESULTS: The data obtained showed that there were anatomical variations in the apical third in the older patients and that these changes were related to the age of the patient. Narrower root canals and smaller CDJ diameters were found in older patients’ samples.

CONCLUSION: The results of this study suggest that instrumentation and obturation should take place 1 mm from the AF in older patients, and not 0.5 mm, as is usually recommended.

PMID:34543565

P R Health Sci J. 2021 Jun;40(2):63-67.

ABSTRACT

OBJECTIVE: This study aims to describe the frequency of biologic therapy failure in psoriasis patients along with associated patient demographics and characteristics.

METHODS: This was a retrospective medical-record review of psoriasis patients evaluated from January 1st, 2013, through May 1st, 2018, and who failed at least once to adhere to their biologic therapy.

RESULTS: Seventy-seven patients with psoriasis who had discontinued biologic therapy at least once were included in this study. Hypertension (58.4%), diabetes (37.7%), dyslipidemia (27.3%), and psoriatic arthritis (23.4%) were the main comorbidities observed. Adalimumab (ADA, 80.5%), ustekinumab (UST, 70.1%), and etanercept (ETA, 14.2%) were the most frequently used biologics in our cohort. The biologic with the longest mean duration of use prior to its discontinuation was UST (17.0 months), followed by ADA (15.9 months) and ETA (13.6 months).

CONCLUSION: The most common reason for discontinuing biologic therapy was that said therapy was not effective, though for ETA and UST, the fact that biologic therapies are not universally covered by insurance company was found to be associated with their discontinuation, as well. There were no statistically significant associations found between biologic therapy discontinuation and age, gender, or comorbidities, which last included obesity, class I. Larger studies are warranted to identify risk factors associated with biologic therapy failure to help guide drug selection, decrease morbidity associated with such nonadherence and improve patient outcomes.

PMID:34543563

Klin Lab Diagn. 2021 Sep 10;66(9):517-524. doi: 10.51620/0869-2084-2021-66-9-517-524.

ABSTRACT

KIM-1 (kidney injury molecule 1), a marker of acute kidney injury, is produced by epithelial cells of renal proximal tubules. Elevated KIM-1 levels in urine and plasma are associated with renal cell carcinoma (RCC). The aim of this study was to compare the significance of non-normalized uKIM-1 values and those normalized to urine creatinine, as urinary biomarkers in RCC. The uKIM-1, urine creatinine and their ratio (uKIM-1/Cre) were studied in 118 RCC patients and 58 apparently healthy subjects. The median of uKIM-1 in the healthy group was 0.71 ng/ml (1st and 3rd quartiles were 0.35 and 1.23, respectively) and in RCC patients it was 2.36 (1.43; 5.93) ng/ml. The medians of uKIM-1/Cre were 0.77 (0.49; 1.18) and 2.42 (1.41; 4.61) ng/mgCre, respectively. Stage I RCC is statistically significantly different from stages II-III and stage IV using uKIM-1/Cre values (p = 0.0056 and p = 0.0012, respectively); using uKIM-1 values significant differences occur only when comparing stages I and IV (p = 0.015). In both healthy individuals and RCC patients, uKIM-1/Cre levels were slightly lower in subgroups younger than 50 years than in subgroups older than 50 years, whereas a similar trend was observed for uKIM-1 only in patients. In healthy men and male patients, uKIM-1 levels were higher than in the corresponding groups of women (the differences were not statistically significant), but the use of uKIM-1/Cre values eliminated the gender differences. A high correlation was found between the concentrations of uKIM-1 and urine creatinine in three healthy subjects followed up for 3 weeks (Spearman’s correlation coefficients were 0.758, 0.825 and 0.933, respectively). The data obtained are clear evidence of the need for normalization uKIM-1 to urine creatinine in RCC patients.

PMID:34543529 | DOI:10.51620/0869-2084-2021-66-9-517-524

Klin Lab Diagn. 2021 Sep 10;66(9):533-538. doi: 10.51620/0869-2084-2021-66-9-533-538.

ABSTRACT

The data of a comparative enzyme-linked immunosorbent assay of the content of the soluble form of the immunity checkpoint VISTA in the blood serum of 30 healthy donors (control group), 79 patients with primary malignant (osteosarcoma – 30, chondrosarcoma – 31, chordoma – 14) and 14 borderline (giant cell tumor) bone neoplasms are presented. In the general group of patients with malignant neoplasms of bones, the median sVISTA content in blood serum is statistically significant lower than in the control (p = 0.040). In patients with bone tumors and healthy donors over 18 years of age, there was a decrease with age in serum sVISTA levels. There were no significant differences in sVISTA concentration between patients with osteosarcoma, chondrosarcoma and healthy donors. Only in patients with chordoma were sVISTA levels statistically significant lower than in controls (p = 0.013). In the groups of patients with chondrosarcoma and osteosarcoma of the bone, there were no significant associations between the serum sVISTA content and the main clinical and morphological characteristics of the disease. In patients with osteosarcoma, no relationship was found between sVISTA levels and overall survival rates, while in patients with bone chondrosarcoma, there was a tendency towards a favorable prognosis with a high content of the marker in the blood serum.

PMID:34543531 | DOI:10.51620/0869-2084-2021-66-9-533-538

Klin Lab Diagn. 2021 Sep 10;66(9):565-570. doi: 10.51620/0869-2084-2021-66-9-565-570.

ABSTRACT

The concentration of bacterial plasmalogen 18a and endotoxin in the blood of elderly people 45-90 years old with the pathology of type 2 diabetes mellitus (DM 2) – the main group and without diabetes mellitus – the comparison group was investigated. The concentration of both plasmalogen 18a and endotoxin in the blood of individuals with DM 2 pathology is statistically significantly higher than in the blood of individuals without DM 2 pathology. To assess the state of microbiocenosis and predict type 2 diabetes mellitus, decisive rules have been determined in the form of threshold values of plasma concentrations 18a and endotoxin in the blood of elderly people with a suspected or established diagnosis of type 2 diabetes. Using ROC analysis, it was found that values above 20.66 μg / ml for plasmalogen 18a, and 0.48 nmol / ml for endotoxin, determine the presence of type 2 diabetes mellitus pathology in the 45-90 age group.

PMID:34543536 | DOI:10.51620/0869-2084-2021-66-9-565-570

Epilepsia Open. 2021 Sep 20. doi: 10.1002/epi4.12541. Online ahead of print.

ABSTRACT

Responsive neurostimulation is approved in patients above 18 years of age with drug resistant focal epilepsy. We aimed to investigate whether RNS outcomes and safety varied based on age. We included patients who had been implanted with RNS for >6 months (N=55), dividing them into older (N=11) and younger adults (N=44) depending on implantation age (≥50 and <50 years, respectively). Mean age at implantation in older adults was 54.9±3.5 years. Seizure onset age, epilepsy duration, and comorbidities were significantly higher in older adults (p<0.01). Stimulation parameters, treatment duration and median seizure frequency reduction (76% in older versus 50% in younger adults) were statistically comparable among the two cohorts. Post-treatment, anti-seizure medication burden was significantly decreased in older compared to younger adults (p=0.048). Post-operative and delayed adverse events among older adults were mild. Compared to 3 younger adults, none of the older adults required device explantation due to surgical site infection. Our study suggests that older adults treated with the RNS System achieve seizure outcomes comparable to younger adults with the additional benefit of a significant post-implantation medication reduction. With efficacy and safety similar to younger adults, brain-responsive neurostimulation was well-tolerated in older adults.

PMID:34543516 | DOI:10.1002/epi4.12541

Acta Ophthalmol. 2021 Sep 20. doi: 10.1111/aos.14983. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to compare ultrasound (US) consumption and central macular thickness (CMT) and volume changes with manual and femtosecond laser (FSL)-assisted cataract nucleus workup.

METHODS: Sixty patients scheduled for immediate sequential bilateral surgery underwent a prospective randomized intraindividual comparison of nucleus sector fragmentation performed manually in one eye and with low-energy FSL assistance in the partner eye, followed by high-fluidics phacoaspiration with a maximum US power of 30%. Ultrasound (US) energy consumption and macular thickness and volume were compared as measured by intraoperative effective phacoemulsification time (EPT) and high-resolution spectral domain optical coherence tomography pre- and 1 week, 3 weeks and 6 weeks postoperatively. Results are presented as means ± SD or medians [min; max].

RESULTS: Fifty-two patients completed the full follow-up. For the manual and FSL-assisted groups, nuclear hardness was almost identical with a mean LOCS III grade of 2.44 ± 1.08 and 2.50 ± 1.00 (p = 0.371). Median EPT was 1.40 [0.2; 8.3] and 1.25 [0.2; 9.4] seconds. Median preoperative CMT was 276.50 [263.25; 289.75] µm and 276.00 [262.00; 290.00] µm. Median postoperative CMT was 278.00 [260.50; 288.00] versus 275.50 [264.00; 290.50] µm at 1 week, 279.50 [266.75; 292.25] versus 280.00 [266.50; 294.50] µm at 3 weeks and 280.50 [268.00, 293.75] versus 279.50 [264.75; 295.25] µm at 6 weeks. Differences in CMT and total macular volume between the groups were not statistically significant at any point in time.

CONCLUSION: Femtosecond laser (FSL) prefragmentation of the nucleus into six sectors did not reduce US energy consumption compared with manual splitting of the nucleus into four quadrants in this particular surgical setting. Sectorial FSL-prechopping with the low-energy FSL used had no additional impact on postoperative macular thickness and volume.

PMID:34543523 | DOI:10.1111/aos.14983

J Appl Microbiol. 2021 Sep 20. doi: 10.1111/jam.15301. Online ahead of print.

ABSTRACT

AIMS: The efficacy of ambient mass spectrometry to identify and serotype Legionella pneumophila was assessed. To this aim, isolated waterborne colonies were submitted to a rapid extraction method and analysed by direct analysis in real time mass spectrometry (DART-HRMS).

METHODS AND RESULTS: The DART-HRMS profiles, coupled with partial least squares discriminant analysis (PLS-DA), were first evaluated for their ability to differentiate Legionella spp. from other bacteria. The resultant classification model achieved an accuracy of 98.1% on validation. Capitalising on these encouraging results, DART-HRMS profiling was explored as an alternative approach for the identification of L. pneumophila sg. 1, L. pneumophila sg. 2-15 and L. non-pneumophila; therefore, a different PLS-DA classifier was built. When tested on a validation set, this second classifier reached an overall accuracy of 95.93%. It identified the harmful L. pneumophila sg. 1 with an impressive specificity (100%) and slightly lower sensitivity (91.7%), and similar performances were reached in the classification of L. pneumophila sg. 2-15 and L. non-pneumophila.

CONCLUSIONS: The results of this study show the DART-HMRS method has good accuracy and it is an effective method for Legionella serogroup profiling.

SIGNIFICANCE AND IMPACT OF STUDY: These preliminary findings could open a new avenue for the rapid identification and quick epidemiologic tracing of L. pneumophila, with a consequent improvement to risk assessment.

PMID:34543502 | DOI:10.1111/jam.15301

J Appl Microbiol. 2021 Sep 20. doi: 10.1111/jam.15302. Online ahead of print.

ABSTRACT

AIMS: We investigated the antibacterial effect of seven essential oils (EOs) and one EO-containing liquid phytogenic solution marketed for poultry and pigs (‘Product A’) on chicken pathogens, as well as the relationship between MIC in EOs and antibiotics commonly administered to chicken flocks in the Mekong Delta (Vietnam).

METHODS AND RESULTS: Micellar extracts from oregano (Origanum vulgare), cajeput (Melaleuca leucadendra), garlic (Allium sativum), black pepper (Piper nigrum), peppermint (Mentha × piperita L.), tea tree (Melaleuca alternifolia), cinnamon (Cinnamomum zeylanicum) EOs and Product A were investigated for their Minimum Inhibitory Concentration (MIC) against Avibacterium endocarditidis (N=10), Pasteurella multocida (N=7), Ornitobacterium rhinotracheale (ORT) (N=10), Escherichia coli (N=10) and Gallibacterium anatis (N=10). Cinnamon EO had the lowest median MIC across strains (median 0.5mg/ml [interquartile range (IQR) 0.3-2.0mg/ml]), followed by Product A (3.8mg/ml [1.9-3.8mg/ml]), oregano EO (30.4mg/ml [7.6-60.8mg/ml]), garlic 63.1mg/ml [3.9->505.0mg/ml]. Peppermint, tea tree, cajeput and pepper EOs had all MIC≥219mg/ml. In addition, we determined the MIC of the 12 most commonly used antibiotics in chicken flocks in the area. After accounting for pathogen species, we found an independent, statistically significant (p<0.05) positive correlation between MIC of 10 of 28 (35.7%) pairs of EOs. For 67/96 (69.8%) combinations of EOs and antibiotics, the MICs were correlated. Of all antibiotics, doxycycline was positively associated with the highest number of EOs (peppermint, tea tree, black pepper and cajeput, all p<0.05). For cinnamon, the MICs were negatively correlated with the MICs of 11/12 antimicrobial tested (all except colistin).

CONCLUSIONS: Increases in MIC of antibiotics generally correlates with increased tolerance to EOs. For cinnamon EO, however, the opposite was observed.

SIGNIFICANCE AND IMPACT OF THE STUDY: Our results suggest increased antibacterial effects of EOs on multi-drug resistant pathogens; cinnamon EO was particularly effective against bacterial poultry pathogens.

PMID:34543506 | DOI:10.1111/jam.15302