Tag: pubmed

Holist Nurs Pract. 2021 Jul-Aug 01;35(4):182-190. doi: 10.1097/HNP.0000000000000457.

ABSTRACT

Chronic low back pain (CLBP) is a major problem throughout the world and getting worse because of population increase and aging. The cost of treatment increases as the population of people with CLBP increases. This study aimed to examine the effect of auricular acupressure (AA) on pain and disability in elders with chronic low back pain. The randomized, single-blinded, and placebo-controlled study was conducted on 51 elders with CLBP in South Korea from June 2019 to August 2019. The experimental group (n = 26) received AA on low back pain-related points, whereas the placebo control group (n = 25) received AA on points unrelated to low back pain. Participants received 6 weeks of AA in weekly cycles. Collected data were analyzed using IBM SPSS Statistics, version 25. Statistically significant differences between the 2 groups emerged in the visual analog scale (P < .001), pain threshold (P < .001), and Oswestry Disability Index (P < .001). This study showed that 6 weeks of AA improved CLBP and pain-related disability. Therefore, AA can be used as a noninvasive and self-managed alternative intervention for CLBP in older adults.

PMID:34115736 | DOI:10.1097/HNP.0000000000000457

PLoS Comput Biol. 2021 Jun 11;17(6):e1008979. doi: 10.1371/journal.pcbi.1008979. Online ahead of print.

ABSTRACT

Existing software tools for topology-based pathway enrichment analysis are either computationally inefficient, have undesirable statistical power, or require expert knowledge to leverage the methods’ capabilities. To address these limitations, we have overhauled NetGSA, an existing topology-based method, to provide a computationally-efficient user-friendly tool that offers interactive visualization. Pathway enrichment analysis for thousands of genes can be performed in minutes on a personal computer without sacrificing statistical power. The new software also removes the need for expert knowledge by directly curating gene-gene interaction information from multiple external databases. Lastly, by utilizing the capabilities of Cytoscape, the new software also offers interactive and intuitive network visualization.

PMID:34115744 | DOI:10.1371/journal.pcbi.1008979

Clin Nucl Med. 2021 Jun 10. doi: 10.1097/RLU.0000000000003738. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the diagnostic performance of 18F-choline PET and MRI in patients with primary hyperparathyroidism. Furthermore, the additional value of software-based PET/MRI scan fusion was analyzed.

PATIENTS AND METHODS: This retrospective study includes 42 patients (38 women) with an age between 32.5 and 79.1 years. PET/CT scans were performed on a dedicated system after injection of 250 to 350 MBq 18F-choline. For the MRI examination, T1-weighted images of the cervical region were used. The image fusion was made by anatomical coregistration using an automated algorithm based on mutual information.

RESULTS: A total of 46 lesions were discovered and histologically confirmed in 42 patients. Histopathological examination revealed 38 adenomas and 8 hyperplasias. This means that, in 4 of these 42 patients, 2 lesions per patient were discovered. PET/CT also detected 46 abnormal findings, but only 43 were correctly recognized, whereas the other 3 were false-positive (FP). Six lesions could not be detected correctly: 3 were FP and 3 false-negative, which resulted in a sensitivity of 93.5% and a specificity of 97.5%. The site-specific evaluation showed 18 true-positive enlarged parathyroid glands with MRI, but also produced 13 FP findings and failed to detect 28 lesions; the sensitivity and specificity are thus 39.1% and 89.3%, respectively. The difference in detection rate between 18F-choline PET/CT and MRI was statistically significant (P < 0.001).

CONCLUSIONS: 18F-choline PET/CT is clearly superior to MRI for localization diagnostics in primary hyperparathyroidism. Image fusion of both modalities can be helpful for more precise anatomical assignment.

PMID:34115700 | DOI:10.1097/RLU.0000000000003738

J Am Assoc Nurse Pract. 2021 Jun 9. doi: 10.1097/JXX.0000000000000621. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatitis C virus (HCV) infections have increased significantly in the United States recently, having tripled by 2014. Seventy-five percent of those with HCV are aging baby boomers, which places increased pressure on the medical system to provide treatment. There are not enough specialists available to treat everyone infected with HCV.

PURPOSE: The aim of this research was to determine whether treatment of hepatitis C with new direct-acting antivirals in primary care settings resulted in equivalent cure rates when compared with those patients treated by specialists.

METHODOLOGY: A retrospective cohort design was used. Participants were those treated for hepatitis C in specialty care at large public hospitals by gastroenterologists and/or hepatologists and those treated in two primary care community health centers in Seattle. Multivariate logistic regression was used to determine differences of sustained virologic response between those treated in primary care and those treated in specialty care. Treatment failure and those lost to follow-up were combined into one category.

RESULTS: Failure rates were only 4% in primary care and 1.1% in specialty care. After adjustment, patients treated in primary care were statistically significantly less likely to have failure/lost to follow-up than those treated in specialty care. Hepatitis C treatment can be successfully provided in primary care with equivalent treatment outcomes.

IMPLICATIONS FOR PRACTICE: Primary care advanced practice nurses are in a good position to identify and treat hepatitis C. In addition, as patients are typically more engaged with their primary care provider, follow-up rates may be better versus referring these patients to a specialty provider.

PMID:34115717 | DOI:10.1097/JXX.0000000000000621

J Glaucoma. 2021 Jun 10. doi: 10.1097/IJG.0000000000001882. Online ahead of print.

ABSTRACT

PRECIS: Chronic hypotony is not uncommon following deep sclerectomy, but only a minor proportion of patients develop hypotony-associated complications. Numerical hypotony does not affect the visual outcomes. This study identifies factors associated with hypotony.

PURPOSE: To investigate the incidence and risk factors of hypotony and hypotony-associated complications after deep sclerectomy (DS).

METHODS: Retrospective cohort study of 1,765 eyes (1,385 patients) undergoing DS with or without cataract extraction between 2001-2020 in two UK centers. Chronic hypotony was defined as intraocular pressure (IOP) ≤5▒mmHg in ≥2 consecutive visits lasting >90 days or as any IOP≤5▒mmHg associated with hypotony-related complications or requiring surgical intervention. Clinical hypotony was defined as the presence of: serous or hemorrhagic choroidal detachment, hypotony maculopathy, flat anterior chamber requiring reformation, decompression retinopathy. The incidence of hypotony was calculated with Kaplan-Meier statistics, and Cox regression was used to identify risk factors.

RESULTS: The median (IQR) age and follow-up were 76 (67-82) years and 45.4 (20.9-79.8) months, respectively. The incidence (95% CI) of chronic and clinical hypotony at 5 years was 13.4% (11.5-15.3%) and 5.6% (4.3-6.9%) respectively. Sixteen eyes (15.7%) with hypotony-associated complications had IOP >5▒mmHg. Male gender (HR:1.89, P=0.018), non-Caucasian ethnicity (HR:2.49, P=0.046), intraoperative bevacizumab (HR:3.96, P=0.01), pigmentary glaucoma (HR:3.59, P=0.048), previous vitreoretinal surgery (HR:5.70, P=0.009), intraoperative microperforation (HR:4.17, P<0.001) and macroperforation (HR:20.759, P<0.001), and avascular bleb (HR:1.80, P=0.036) were associated with clinical hypotony.

DISCUSSION: Chronic hypotony is not uncommon following DS, but clinical hypotony is infrequent. Hypotony associated-complications can occur in eyes without statistical hypotony.

PMID:34115726 | DOI:10.1097/IJG.0000000000001882

J Clin Gastroenterol. 2021 Jun 11. doi: 10.1097/MCG.0000000000001571. Online ahead of print.

ABSTRACT

BACKGROUND AND GOALS: There is variation in polypectomy techniques for resection of small polyps. Aim was to compare techniques for 4 to 6 mm polyps for recurrent adenoma, efficiency, and adverse events and to establish methodological factors for definitive trial.

MATERIALS AND METHODS: The study was a randomized controlled trial. Outpatients with ≥1, 4 to 6 mm polyps were randomized to cold forceps (CF), cold snare (CS), and hot snare (HS). Polypectomy site was marked with SPOT to assess for recurrence at the original polypectomy site during surveillance colonoscopy. To assess feasibility of a definitive trial we measured (1) rates of patient refusal, participation, ineligibility; (2) retention; (3) recurrent neoplasia; and (4) sample size for a definitive trial.

RESULTS: Three hundred fifty-three patients were randomized to 1 of the 3 polypectomy techniques, of whom 260 (73.6%) completed the initial colonoscopy (mean age 57 y, 50.4% women), with 91, 87, and 82 patients randomized to CF, CS, and HS polypectomy, respectively. Mean time for polyp resection for CF, CS, and HS were 198.8, 58.5, and 96.8 seconds, respectively, with CS and HS requiring less time than CF (P<0.001). One hundred sixty-four (63.1%) completed surveillance colonoscopy. Polyp recurrences were 9 (14.5%) with CF, 5 (9.6%) with CS, and 0 (0%) with HS. Although the recurrence relative risks with CF and CS polypectomy were 1.84 and 1.65 as compared with HS, respectively, neither was statistically significant.

CONCLUSIONS: CS and HS polypectomy require less time than CF. HS polypectomy may have a lower risk for recurrent neoplasia. High attrition rate is a challenge in conducting randomized controlled trial with polyp recurrence as endpoint.

PMID:34115660 | DOI:10.1097/MCG.0000000000001571

J Addict Nurs. 2021 Jun 10. doi: 10.1097/JAN.0000000000000410. Online ahead of print.

ABSTRACT

BACKGROUND: The challenges experienced by mothers supporting an adult child with substance use problems suggest intervention is needed to improve such mothers’ psychosocial well-being through adaptive coping.

AIMS: This study examined beliefs about journaling as well as changes in stress, cortisol levels, and mental health after a 6-week intervention by mothers whose adult children had substance use problems. In addition, the study explored coping methods used and the experience of writing among these mothers.

METHODS: A purposeful sample of 17 mothers completed the pretest and posttest. Participating mothers were asked to make journal entries at least 3 times per week for 6 weeks.

RESULTS: The mothers used diverse adaptive coping methods to manage stress. In particular, they frequently used religious and meaning-focused coping. The mothers perceived journaling as a highly valuable coping method for daily stress. The findings of paired t tests indicated no statistically significant differences in the stress, mental health variables, and cortisol levels between pretest and posttest. However, participants shared the positive experiences of journaling: emotional well-being, stress management, perspective changes, focus, self-regulation, clarity, and gratitude.

CONCLUSION: The present finding suggests journaling is a practical means to promoting adaptive coping in mothers with adult children who have substance use problems.

PMID:34115696 | DOI:10.1097/JAN.0000000000000410

Coron Artery Dis. 2021 Jun 10. doi: 10.1097/MCA.0000000000001080. Online ahead of print.

ABSTRACT

BACKGROUND: Several studies have reported that prophylactic dialysis can reduce the mortality of non-dialysis-dependent chronic kidney disease (CKD) patients after cardiac surgery. However, the results of complications in these randomized controlled trials (RCTs) were not consistent. We aimed to perform a meta-analysis to systematically evaluate the effect of prophylactic dialysis in these non-dialysis-dependent CKD patients.

METHODS: We systematically searched Medline, Embase, Cochrane’s Library and other online sources for related RCTs. Effects of prophylactic dialysis on the incidence of 30 days’ mortality and postoperative complications were analyzed.

RESULTS: Four RCTs comprising 395 patients were included, all of them treated by coronary artery bypass grafting. Treatment of preoperative and intraoperative prophylactic dialysis significantly reduced the rate of 30-day all-cause mortality (risk ratio [RR]: 0.27, 95% confidence interval [CI], 0.13-0.58, P < 0.001, I2 = 0%) and the incidence of pulmonary complications (RR: 0.39, 95% CI, 0.20-0.77, P = 0.007, I2 = 0%), low cardiac output (RR: 0.29, 95% CI, 0.09-0.99, P = 0.05, I2 = 0%), and acute kidney injury (RR: 0.19, 95% CI: 0.07-0.52, P = 0.001, I2 = 0%). However, there were no statistically significant differences between the dialysis group and the control group in gastrointestinal bleeding, sepsis or multiple organ failure, wound infection, arrhythmia, transient neurologic deficit, stroke and re-exploration for bleeding.

CONCLUSION: Prophylactic dialysis can improve the 30-day clinical outcomes of non-dialysis-dependent CKD patients undergoing cardiac surgery, it was associated with the 30-day mortality benefit and led to a decrease in the incidence of pulmonary complications, as well as low cardiac output, and acute kidney injury.

PMID:34115642 | DOI:10.1097/MCA.0000000000001080

Nat Commun. 2021 Jun 10;12(1):3517. doi: 10.1038/s41467-021-23243-4.

ABSTRACT

Epigenome-wide association studies of Alzheimer’s disease have highlighted neuropathology-associated DNA methylation differences, although existing studies have been limited in sample size and utilized different brain regions. Here, we combine data from six DNA methylomic studies of Alzheimer’s disease (N = 1453 unique individuals) to identify differential methylation associated with Braak stage in different brain regions and across cortex. We identify 236 CpGs in the prefrontal cortex, 95 CpGs in the temporal gyrus and ten CpGs in the entorhinal cortex at Bonferroni significance, with none in the cerebellum. Our cross-cortex meta-analysis (N = 1408 donors) identifies 220 CpGs associated with neuropathology, annotated to 121 genes, of which 84 genes have not been previously reported at this significance threshold. We have replicated our findings using two further DNA methylomic datasets consisting of a further >600 unique donors. The meta-analysis summary statistics are available in our online data resource ( www.epigenomicslab.com/ad-meta-analysis/ ).

PMID:34112773 | DOI:10.1038/s41467-021-23243-4

Sci Rep. 2021 Jun 10;11(1):12262. doi: 10.1038/s41598-021-90739-w.

ABSTRACT

Body image disturbance (BID) is a core feature of eating disorders, for which there are few objective markers. We examined the feasibility of a novel digital tool, “Somatomap”, to index BID related to anorexia nervosa (AN) severity. Fifty-five AN inpatients and 55 healthy comparisons (HC) outlined their body concerns on a 2-Dimensional avatar. Next, they indicated sizes/shapes of body parts for their current and ideal body using sliders on a 3-Dimensional avatar. Physical measurements of corresponding body parts, in cm, were collected for reference. We evaluated regional differences in BID using proportional z-scores to generate statistical body maps, and multivariate analysis of covariance to assess perceptual discrepancies for current body, ideal body, and body dissatisfaction. The AN group demonstrated greater regional perceptual inaccuracy for their current body than HC, greater discrepancies between their current and ideal body, and higher body dissatisfaction than HCs. AN body concerns localized disproportionately to the chest and lower abdomen. The number of body concerns and perceptual inaccuracy for individual body parts was strongly associated with Eating Disorder Examination Questionnaire (Global EDE-Q) scores across both groups. Somatomap demonstrated feasibility to capture multidimensional aspects of BID. Several implicit measures were significantly associated with illness severity, suggesting potential utility for identifying objective BID markers.

PMID:34112818 | DOI:10.1038/s41598-021-90739-w