Tag: pubmed

Clin Infect Dis. 2021 Jul 3:ciab610. doi: 10.1093/cid/ciab610. Online ahead of print.

ABSTRACT

BACKGROUND: The effect of primaquine in preventing P. vivax relapses from dormant stages is well established. For P. ovale, the relapse characteristics and the use primaquine is not as well studied. We set to evaluate the relapsing properties of these two species, in relation to primaquine use among imported malaria cases in a non-endemic setting.

METHODS: We performed a nationwide retrospective study of malaria diagnosed in Sweden 1995-2019, by reviewing medical records of 3254 cases. All episodes of P. vivax (n=972) and P. ovale (n=251) were selected for analysis.

RESULTS: First time relapses were reported in 80/857 (9.3%) P. vivax and 9/220 (4.1%) P. ovale episodes, respectively (p<0.01). Without primaquine, the risk for relapse was higher in P. vivax, 20/60 (33.3%), compared to 3/30 (10.0%) in P. ovale (HR 3.5, 95% CI 1.0-12.0). In P. vivax, patients prescribed primaquine had a reduced risk of relapse compared to episodes without relapse preventing treatment, 7.1% vs 33.3%, (HR 0.2, 95%CI 0.1-0.3). In P. ovale, the effect of primaquine on the risk of relapse did not reach statistical significance, with relapses seen in 2.8% of the episodes compared to 10.0% in patients not receiving relapse preventing treatment (HR 0.3, 95% CI 0.1-1.1).

CONCLUSION: The risk of relapse was considerably lower in P. ovale than in P. vivax infections indicating different relapsing features between the two species. Primaquine was effective in preventing P. vivax relapse. In P. ovale, relapse episodes were few and the supportive evidence for primaquine remains limited.

PMID:34216464 | DOI:10.1093/cid/ciab610

J Burn Care Res. 2021 Jul 3:irab129. doi: 10.1093/jbcr/irab129. Online ahead of print.

ABSTRACT

Split thickness skin grafts (STSG) are commonly required in reconstructive surgery but may cause significant pain. The goal of this investigator-initiated trial is to evaluate the effect of liposomal bupivacaine on donor site pain and opioid consumption. A parallel, randomized, controlled trial of adult acute burn patients with <20% total body surface area burns (TBSA) was conducted to evaluate the efficacy of liposomal bupivacaine at STSG donor sites. The control group received standard subcutaneous infiltration of dilute lidocaine solution at the STSG donor site, and the experimental group received dilute liposomal bupivacaine infiltration in a similar fashion. Donor site pain scores and opioid consumption in morphine equivalents (MEE) were evaluated. A total of 25 patients were enrolled in each group. There were no statistical differences in demographic variables, and TBSA was 4.0% in both groups (p=.94). There were no statistical differences in pain scores at any time point postoperatively (mean control range 3.1/10-4.9/10, experimental range 3.3/10-4.3/10, p=.12-.96). There were no statistical differences in opioid consumption at 24, 48, or 72 hours postoperatively between the groups (mean control MEE range 49.3-71.1, experimental MEE range 63.6-75.8, p=.34-.85). The average length of stay was 7.7 days in both groups (p=.88). No adverse events occurred in either group. There is no statistical benefit to the use of liposomal bupivacaine for infiltration at STSG donor sites compared to standard of care with respect to pain control, opioid use, or length of stay when evaluated in a randomized, controlled fashion.

PMID:34216466 | DOI:10.1093/jbcr/irab129

Acta Crystallogr C Struct Chem. 2021 Jul 1;77(Pt 7):435-440. doi: 10.1107/S2053229621006367. Epub 2021 Jun 28.

ABSTRACT

The crystal structures of difluorine derivatives of p-terphenyls (nTm) have been determined by single-crystal X-ray diffraction. For the unsymmetrical substituted compounds 2′,3′-difluoro-4-methyl-p-terphenyl (1T0, C₁₉H₁₄F₂) and 4-ethyl-2′,3′-difluoro-4”-methyl-p-terphenyl (1T2, C₂₁H₁₈F₂), the crystal structure is disordered, with molecules statistically entering the crystal in up and down orientations, with full superposition of all the atoms, except for those of the terminal groups (H/methyl for 1T0 and methyl/ethyl for 1T2). For triclinic 2′,3′-difluoro-4,4”-dimethyl-p-terphenyl (1T1, C₂₀H₁₆F₂), with the space group P-1, the two crystallographically independent molecules have the same conformation, which is different from monoclinic 1T0 (space group C2) and 1T2 (space group C2/c). A common feature of the conformation of the three compounds is the noncoplanar twisted arrangement of the three rings of the p-terphenyl moiety. Two-dimensional (2D) Hirshfeld fingerprint plots are consistent with H…H and C…H contacts in the crystal packing. For the three compounds, the phase behaviour has been investigated by POM (Petra/Osiris/Molinspiration) and differential scanning calorimetry (DSC) analysis. 1T2 is mesogenic, with enantiotropic nematic behaviour.

PMID:34216450 | DOI:10.1107/S2053229621006367

Med Ultrason. 2021 Jul 1. doi: 10.11152/mu-3119. Online ahead of print.

ABSTRACT

AIM: Contrast-enhanced ultrasound (CEUS) appears to be a promising application for the diagnosis of parotid gland tumours. We aimed to systematically review and meta-analyse the ability of CEUS in distinguishing benign from malignant parotid gland tumours.

MATERIAL AND METHODS: PubMed was searched for relevant studies. Data on area under time intensity curve (AUC) in arbitrary unit (AU), and mean transit time (MTT) in seconds (sec) were analysed using the Cochrane Review Manager Software.

RESULTS: Nine studies met the eligibility criteria comprising a total number of 498 parotid gland tumours (benign, number (n)=423; malignant, n=75). Descriptive evaluation of parotid gland tumours following CEUS administration showed overlap characteristics in benign and malignancies. Two publications assessed AUC and MTT in 72 and 60 parotid gland tumours, respectively. AUC was significantly lower in benign compared to malignant tumours following contrast administration (AUC, mean difference (MD) -266.77 AU, 95% confidence intervals (CI) -433.22, -100.33, p=0.002). No significant different in MTT between benign and malignant tumours (p=0.12). Heterogeneity was statistically significant in AUC (p=0.04) and MTT (p<0.00001).

CONCLUSION: Descriptive evaluation of parotid gland tumours showed overlap CEUS characteristics. Perfusion related CEUS parameters analysis is promising in differentiating benign parotid tumours from malignancies.

PMID:34216453 | DOI:10.11152/mu-3119

Med Ultrason. 2021 Jun 14. doi: 10.11152/mu-2954. Online ahead of print.

ABSTRACT

AIMS: To compare retrobulbar hemodynamic measured by colour Doppler imaging (CDI) in patients with a different severity of glaucoma and to correlate variables CDI with the structural parameters of the retina and optic disc.

MATERIAL AND METHODS: Of 89 eyes studied, 31 had preperimetric, 29 early, 12 moderate and 17 advanced glaucoma. Peak systolic velocity (PSV), end-diastolic velocity (EDV), resistance index (RI) in ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCAs) were evaluated by CDI and compared between study groups. Retinal nerve fibre layer thickness (RNFL) and optic disc parameters measured with optical coherent tomography (OCT) were correlated with the Doppler variables.

RESULTS: In eyes with advanced, moderate and early glaucoma EDV SPCAs were significantly lower as well as RI SPCAs were significantly higher compared to the eyes with preperimetric glaucoma. In eyes with advanced and moderate glaucoma RI CRA (0.74 and 0.71) were significantly higher than in eyes with preperimetric glaucoma (0.68) (p=0.014 and 0.026). In eyes with advanced glaucoma PSV OA and PSV CRA were significantly lower than in eyes with preperimetric glaucoma (32.5 vs. 40.7 cm/s p=0.034 and 8.25 vs. 9.7 cm/s p=0.022, respectively). Positive, variable correlations were found between RNFL and EDV of all measured arteries (0.21<R<0.50, p<0,05).

CONCLUSIONS: Statistically significant alterations in the Doppler parameters of retrobulbar arteries in association with thinning of the RNFL were observed in patients with glaucoma along with a greater severity of optic neuropathy.

PMID:34216458 | DOI:10.11152/mu-2954

Nurs Crit Care. 2021 Jul 3. doi: 10.1111/nicc.12676. Online ahead of print.

ABSTRACT

BACKGROUND: The role of medical emergency team (MET) in managing deteriorating patients and enhancing patient safety is greatly affected by teamwork.

AIMS: To identify teamwork-related needs of the MET from MET nurses’ perspectives. To assess the associations between MET nurses’ perceptions of teamwork and their work experience and education.

STUDY DESIGN: A quantitative, descriptive correlational design.

METHODS: Registered intensive care unit (ICU) nurses (n = 50) who were members of the MET in an acute tertiary care hospital answered a modified version of the team assessment questionnaire in 2017. Data were analysed using descriptive statistics, the Kruskal-Wallis test, and the univariate analysis of variance method. The reporting of this study adheres to the strengthening the reporting of observational studies (STROBE) guidelines.

RESULTS: Participants showed least agreement with the items presenting leadership skills (mean = 2.6, SD = 0.68). Approximately 50% nurses disagreed that the MET had adequate resources, training, and skills. The majority of nurses (80%) felt that their responsibilities as a MET member interfered with taking care of their own ICU patients. Many nurses (64%) felt that they did not have a voice in MET’s decision-making process. Approximately 50% nurses felt that they were not recognized for their individual contribution, and they were uncertain regarding MET’s policies for dealing with conflicts. The amounts of MET nurses’ work experience and education were associated with MET skills and function, respectively.

CONCLUSION: Key teamwork elements of the MET that need improvements include decision-making and conflict resolution skills, valuing team members, and team leadership. Practicing shared mental models, implementing the TeamSTEPPS curricula at hospitals for training ICU nurses, and simulation-based team-training programmes may be beneficial in improving teamwork of MET members.

RELEVANCE TO CLINICAL PRACTICE: This study revealed key teamwork elements of the MET that need improvements. Our findings may contribute to improve teamwork, thereby optimizing MET function, and enhancing patient outcomes.

PMID:34216412 | DOI:10.1111/nicc.12676

Int J Lab Hematol. 2021 Jul 3. doi: 10.1111/ijlh.13612. Online ahead of print.

ABSTRACT

INTRODUCTION: CEBPA mutation is a common mutation in normal karyotype AML. CEBPAdm AML has been recognized as a separate entity, but there is still controversy to the prognosis of CEBPAsm patients.

METHODS: A total of 151 newly diagnosed cytogenetically normal AML patients treated at the Second Hospital Center of Shanxi Medical University from February 2017 to December 2019 were the subjects of the study. According to the number of mutations in the CEBPA gene, the patients were divided into three groups, CEBPAsm, CEBPAdm, and CEBPAwt patients. The clinical characteristics, gene mutations, response, and prognosis were retrospectively compared among the three groups.

RESULTS: CEBPAsm patients had lower hemoglobin values compared to CEBPAdm (P = .049). There was no statistical difference between the CEBPAsm cases and the CEBPAdm cases in the mutation types and the distribution of mutation regions (P > .050). Compared with CEBPAdm, cases with CEBPAsm were more likely associated with multiple other gene mutations (P = .023). Patients with CEBPAdm had a higher CR, ORR, and OS than those CEBPAwt (P < .050). CEBPAsm patients had a similar OS with CEBPAdm and CEBPAwt patients (P = .281). These CEBPAsm patients with VAF<30% had lower OS than the patients with VAF≥30%. FLT3-ITD mutations could reduce CEBPAsm patients’ OS (P = .019).

CONCLUSION: Our data first highlighted the impact of CEBPAsm VAF on OS, and the results showed the lower the VAF was, the shorter the OS tended to. The VAF of CEBPAsm could provide specific significance in some extent for the prognosis of patients.

PMID:34216417 | DOI:10.1111/ijlh.13612

Environ Sci Pollut Res Int. 2021 Jul 3. doi: 10.1007/s11356-021-15073-0. Online ahead of print.

ABSTRACT

Vimba bream (Vimba vimba) individuals were collected from the Danube River near Belgrade, from May 2016 to May 2017. Samples of muscle and liver tissue were analyzed for concentrations of 25 elements (macro-, micro-, and toxic elements) using inductively coupled plasma optical emission spectrometry (ICP-OES). For both tissues, the highest concentrations of most elements were observed in late spring/early summer (months of May and June). Majority of statistically significant correlations between elements were positive in both tissues. Contributions of Ca, K, and Mg to human diet were in a similar range. The lowest contribution of all macroelements was observed for Na, while the contribution of Se was well above the recommended dietary allowance for this element. Levels of detected elements were well below MAC values prescribed by national and international regulations. The highest value of Hg liver/muscle index (>1) was observed in August, which could indicate a higher contamination of the sampling location in that month. Se:Hg molar ratio never drops below 1, which could indicate that Hg toxicity is prevented. THQ values showed little variation thought the year and were well below the threshold of 1, with the exception of THQ for Al in May (0.92). This element also strongly affects the hazard index.

PMID:34216343 | DOI:10.1007/s11356-021-15073-0

Biom J. 2021 Jul 3. doi: 10.1002/bimj.202000288. Online ahead of print.

ABSTRACT

The additive hazards model is one of the most commonly used models for regression analysis of failure time data and many inference procedures have been developed for it under various situations. In particular, Wang et al. (2018a, Computational Statistics and Data Analysis, 125, 1-9) discussed the situation where one observes informatively interval-censored data and proposed a likelihood estimation approach. However , it involves estimation of the unknown baseline cumulative hazard function and thus may be time-consuming . Corresponding to this, we propose two new procedures, an estimating equation-based one and an empirical likelihood-based one, and both do not need estimation of the cumulative hazard function and can be easily implemented. The asymptotic properties of the proposed methods are established and an extensive simulation study suggests that they work well in practical situations. An application is also provided.

PMID:34216403 | DOI:10.1002/bimj.202000288

Mol Biol Rep. 2021 Jul 3. doi: 10.1007/s11033-021-06502-x. Online ahead of print.

ABSTRACT

Recurrent implantation failure (RIF) is diagnosed when good-quality embryos repeatedly fail to implant after transfer in several in vitro fertilization (IVF) treatment cycles. Different expression profiles in maternal mRNAs could be referring to many diseases including RIF. This study aimed to reveal significantly dysregulated selected genes expression between healthy fertile women and RIF patients in the implantation window days of the natural menstrual cycle. MME, WWC1, TNC, and FOXP3 genes were chosen as target genes regarding their possible relations with the implantation process. Pathways with these genes were identified and the relationship between these pathways and RIF was investigated. In this study, the endometrial biopsy samples were collected in the secretory phase (cycle day 20-24) of the menstrual cycle from RIF patients (n = 34) and healthy fertile controls (n = 34). After “Pathway and network-oriented GWAS analysis” (PANOGA) and “Kyoto Encyclopedia of Genes and Genomes” (KEGG) pathway analysis; “Membrane Metalloendopeptidase” (MME), “WW and C2 Domain Containing 1” (WWC1), “Tenascin C” (TNC) and “Forkhead Box P3” (FOXP3) genes were chosen as target genes by regarding their possible relation with implantation process. Detection of differences in mRNA expressions between the control group and RIF patients has been performed with the droplet digital PCR (ddPCR) method. Results of the study showed that MME and WWC1 genes expression levels are significantly (p < 0,05) up-regulated 4.9 and 5.2 times respectively and TNC gene expression level is significantly (p < 0,05) down-regulated 9 times in the RIF samples compared to the control group. However, no statistically significant difference was observed between the patient group and the control group in the expression of the FOXP3 gene (p < 0.05). Changes are observed in the expression of the renin-angiotensin system pathway in which the MME gene is involved in the implantation process. The increase in MME gene expression can be speculated to cause implantation failure by restricting the invasion of trophoblast cells. Increasing WWC1 gene expression in the Hippo signaling pathway inhibits “Yes-associated protein 1” (YAP) expression, which is a transcriptional cofactor. Inhibition of YAP protein expression may impair the implantation process by causing the failure of endometrial decidualization. The TNC gene is located in the focal adhesion pathway and this pathway reduces cell adhesion on the endometrial surface to facilitate the attachment of the embryo to the endometrium. The reason for implantation failure might be that the intercellular connections are not suitable for implantation as a result of decreased expression of the focal adhesion pathway in which the TNC gene is effective. Considering the relations between the pathways of the target genes and the implantation process, changes in the expression of target genes might be a cause of RIF.

PMID:34216338 | DOI:10.1007/s11033-021-06502-x