Tag: pubmed

Int J Clin Pract. 2021 Jun 9:e14444. doi: 10.1111/ijcp.14444. Online ahead of print.

ABSTRACT

INTRODUCTION: Adverse drug reactions are an important public health concern that affects doctor and dentist prescriptions and healthcare workers’ practice. We planned to evaluate the knowledge, attitudes, and practices of healthcare workers in our country about drug hypersensitivity reactions in pediatric patients and to determine the risk factors that may affect them.

METHOD: This study was carried out in a capital-located university hospital. Healthcare workers who are authorized to intervene in children (0-18 age group) including medical doctors, nurses and dentists were enrolled to study. The study questionnaire was developed by pediatric allergy and immunology specialists and pediatric nurses by considering the other studies on the same subject.

RESULTS: 354(88.5%) out of 400 healthcare workers, whose study survey was distributed, returned to us by filling the questionnaire. According to the groups of the profession, there was a statistically significant difference between the average of correct answers given to the questions evaluating knowledge levels(p <0.001). The doctors’ knowledge score(mean ± SD 18.6 ± 2.1) was the highest. The general attitudes of healthcare workers towards drug hypersensitivity reactions in children were similar and were positive(p <0.053). However, general practice patterns were significantly different(p <0.001). Nurses were observed to practice more positively than doctors and dentists. As the healthcare worker gets older, his practice score increased by 0.546; on the other hand, being a resident reduced the score from the practice score by 3,770.

CONCLUSION: Our results suggest that advanced training programs must be provided for healthcare workers in learning drug hypersensitivity reactions, particularly in pediatric patients.

PMID:34105870 | DOI:10.1111/ijcp.14444

Cancer Med. 2021 Jun 9. doi: 10.1002/cam4.4033. Online ahead of print.

ABSTRACT

BACKGROUND: Given the growing incidence and aggressive biological behavior of proximal gastric cancer (PGC) as reported, it is important to understand which regional or racial populations are at poor prognosis so that interventions can be treated appropriately. We sought to explore regional treatment differences as well as racial genes influence survival outcomes in China and the US patients with PGC.

METHODS: PGC patients defined as tumors with the epicenter located in cardia (C16.0) or fundus (C16.1) from 1996 to 2016 were identified from the Surveillance Epidemiology and End Results (SEER) in the United States as well as data from a high-volume National Cancer Center Database in China. Overall survival (OS) curves were plotted for different regional or racial groups, respectively, using the Kaplan-Meier method and compared statistically using the log-rank test. Differentially expressed genes (DEGs) analysis was performed using TCGA database.

RESULTS: Finally, the cohort consistent of 40973 PGC patients who enrolled in SEER database (n = 36305) or China National Cancer Center (n = 4668), and divided into 4 racial groups: Chinese (n = 5179), Black (n = 2429), White (n = 31185), and Others (n = 2096). After controlling for confounding variables, racial factors were independently associated with poor survival included Black ethnicity (HR = 1.376, 95% CI: 1.066-1.7760, p = 0.014) and White ethnicity (HR = 1.262, 95% CI: 1.005-1.583, p = 0.045) when compared to Chinese ethnicity in total PGC patients. Even in the same region for only US group, Chinese PGC patients also showed better prognosis.

CONCLUSIONS: In conclusion, we demonstrated the different survival outcomes of PGC patients in different regions or races from two high-volume database SEER and China National Cancer Center database. These survival differences are likely influenced by a number of factors (e.g., access to screening, quality of gastrectomy, neo/adjuvant therapy, and biological genes itself). More importantly, a better understanding of these disparities could lead to interventions that may help to abolish these disparities.

PMID:34105890 | DOI:10.1002/cam4.4033

Int Wound J. 2021 Jun 9. doi: 10.1111/iwj.13638. Online ahead of print.

ABSTRACT

Fat grafting is a well-established method in plastic surgery. Despite many technical advances, standardised recommendations for the use of prophylactic antibiotics in fat grafting are not available. This retrospective multicentre study aims to analyse the use of prophylactic antibiotics in fat grafting and to compare complication rates for different protocols. A retrospective medical chart review of 340 patients treated with fat grafting of the breast from January 2007 to March 2019 was performed in three plastic surgery centres. Complications, outcomes, and antibiotic regimes were analysed. The Clavien-Dindo classification was applied. All patients received perioperative antibiotic prophylaxis: 33.8% (n = 115) were treated with a single shot (group 1), 66.2% (n = 225) received a prolonged antibiotic scheme (group 2). There was no significant difference in the number of sessions (P = .475). The overall complication rate was 21.6% (n = 75), including graft resorption, fat necrosis, infection, and wound healing problems. Complication rates were not significantly different between groups. Risk factors for elevated complication rates in this specific patient group are smoking, chemotherapy, and irradiation therapy. The complication rate for lipografting of the breast is low, and it is not correlated to the antibiotic protocol. The use of prolonged prophylactic antibiotics does not lower the complication rate.

PMID:34105891 | DOI:10.1111/iwj.13638

J Esthet Restor Dent. 2021 Jun 9. doi: 10.1111/jerd.12793. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of surface treatments on optical, colorimetric, and surface characteristics of lithium disilicate glass-ceramic.

MATERIALS AND METHODS: Specimens (n = 5, IPS e.max CAD) were randomly allocated to the following treatments: mirror-polished: SiC papers; as-cut: mimicking CAD-CAM milling; ground: 90-120 μm-grit diamond bur; ground polished: ground, finished (46-30 μm-grit diamond bur), polished (diamond cups, brush and diamond paste); ground glazed: ground, glazed; ground polished glazed: association of methods. CIELAB color coordinates were obtained by a spectrophotometer. CIEDE2000 color differences (ΔE₀₀ ) and the translucency parameter (TP₀₀ ) were calculated. Light transmittance was assessed with a colorimeter. Surface characteristics (topography and roughness) were analyzed. Statistical differences for each condition and outcome were detected using one-way ANOVA with Tukey’s post-hoc test (α = 0.05).

RESULTS: TP₀₀ data show statistical reduction after grinding (p < 0.05), which was only restored with polishing (solely or with glazing). ΔE₀₀ shows that grinding results in perceptible variations in color (above 0.81), which were restored after all post-processing protocols (exception to only glaze application in contact with a black background). Light transmittance data corroborated such performance. Polishing and glazing reduced roughness and improved surface topography.

CONCLUSION: Grinding statistically increased roughness, reduced translucency, light transmittance through the ceramic, and resulted on color differences. On contrary, polishing (followed or not by glazing) reduced roughness and enhanced ceramic translucency and light transmittance. Glaze also reduced roughness, but it still presented reduced translucency. The positioning (facing up or down) of the ceramic treated surface influenced the considered outcomes.

CLINICAL SIGNIFICANCE: Grinding with diamond burs results in a deleterious impact to the optical, colorimetric and surface characteristics of lithium disilicate ceramic. Thus, polishing (followed or not by glazing) is recommended for optical and topographical enhancements when lithium disilicate monolithic restorations require occlusal adjustments.

PMID:34105868 | DOI:10.1111/jerd.12793

Int J Clin Pract. 2021 Jun 9:e14453. doi: 10.1111/ijcp.14453. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to examine the relationship between urolithiasis and gastric wall fat halo sign (FHS).

MATERIAL-METHOD: The data of 382 patients who presented to our clinic with the complaint of flank pain were analyzed retrospectively. According to the results of non-contrast computed tomography, the patients were divided into two groups those with ureteral stones (Group 1) and those without urinary stones (Group 2). The patients’ age, gender, weight, height, body mass index (BMI), cholesterol, triglyceride, blood urea nitrogen, creatinine, and gastric wall FHS data were evaluated.

RESULTS: When Groups 1 and 2 were compared in terms of FHS positivity, FHS was detected in 140 (57.3%) of 244 patients in Group 1 and 24 (17%) of 138 patients in Group 2, indicating a statistically significant difference (p < 0.001).

CONCLUSION: A statistically significant relationship was found between urinary stone disease and gastric wall FHS.

PMID:34105869 | DOI:10.1111/ijcp.14453

Int J Clin Pract. 2021 Jun 9:e14451. doi: 10.1111/ijcp.14451. Online ahead of print.

ABSTRACT

AIM: The aim of the study is to determine the effects of constipation symptoms and nutritional status on disease-related parameters, such as disease duration, spirometry test and quality of life, of COPD patients.

METHODS: The research was performed with 48 COPD patients attending the center from January 2019 to August 2019. Assessment of constipation symptoms were done by Constipation Severity Instrument (CSI), while for quality of life assessment St George Respiratory Questionnaire (SGRQ) was used. Patient’s nutritional status was determined by food frequency questionnaire. Body mass index (BMI) and fat-free mass index (FFMI) of the patients were identified with the bioelectrical impedance analysis (BIA) method. Statistical assessment of data were done with SPSS 22 programme.

RESULTS: According to the relationship between CSI scores and COPD disease parameters there was a weak positive correlation between the CSI obstructive defecation subscale and SGRQ activity score and weak positive correlation between CSI colonic inertia subscale and COPD duration from the diagnosis. We found a weak negative correlation between protein intake percentage and SGRQ impact score. As the disease duration increased, the total fat, polyunsaturated fatty acids and vitamin E intake of individuals were determined to reduce.

CONCLUSION: According to our results, there were some changes in the nutrient intake depending on the duration of COPD and possible constipation in COPD patients may affect the quality of life.

PMID:34105860 | DOI:10.1111/ijcp.14451

J Int AIDS Soc. 2021 Jun;24(6):e25756. doi: 10.1002/jia2.25756.

ABSTRACT

INTRODUCTION: Achieving optimal adherence to antiretroviral therapy (ART) among adolescents living with HIV (ALWHIV) is challenging, especially in low-resource settings. To help accurately determine who is at risk of poor adherence, we developed and internally validated models comprising multi-level factors that can help to predict the individualized risk of poor adherence among ALWHIV in a resource-limited setting such as Uganda.

METHODS: We used data from a sample of 637 ALWHIV in Uganda who participated in a longitudinal study, “Suubi+Adherence” (2012 to 2018). The model was developed using the Least Absolute Shrinkage and Selection Operator (LASSO) penalized regression to select the best subset of multi-level predictors (individual, household, community or economic-related factors) of poor adherence in one year’s time using 10-fold cross-validation. Seventeen potential predictors included in the model were assessed at 36 months of follow-up, whereas adherence was assessed at 48 months of follow-up. Model performance was evaluated using discrimination and calibration measures.

RESULTS: For the model predicting poor adherence, five of the 17 predictors (adherence history, adherence self-efficacy, family cohesion, child poverty and group assignment) were retained. Its ability to discriminate between individuals with and without poor adherence was acceptable; area under the curve (AUC) = 69.9; 95% CI: 62.7, 72.8. There was no evidence of possible areas of miscalibration (test statistic = 1.20; p = 0.273). The overall performance of the model was good.

CONCLUSIONS: Our findings support prediction modelling as a useful tool that can be leveraged to improve outcomes across the HIV care continuum. Utilizing information from multiple sources, the risk prediction score tool applied here can be refined further with the ultimate goal of being used in a screening tool by practitioners working with ALWHIV. Specifically, the tool could help identify and provide early interventions to adolescents at the highest risk of poor adherence and/or viral non-suppression. However, further fine-tuning and external validation may be required before wide-scale implementation.

PMID:34105865 | DOI:10.1002/jia2.25756

Int J Clin Pract. 2021 Jun 9:e14455. doi: 10.1111/ijcp.14455. Online ahead of print.

ABSTRACT

AIM: Migraine is a common neurovascular disorder, which is associated with severe to moderate disabling headaches. Oxidative stress and inflammation might play a role in migraine pathogenesis and the mood disorders. Considering the antioxidant and anti-inflammatory properties of alpha-lipoic acid (ALA), this study was designed to investigate its effect on oxidative, inflammatory and mood conditions in women with episodic migraine.

METHODS: In total 92 women with episodic migraine participated in the study. The patients were randomly divided into two groups, receiving a 300 mg capsule of ALA or placebo twice daily for 3 months. To assess the oxidative and inflammatory status, the serum levels of total antioxidant capacity (TAC), total oxidant status (TOS), glutathione (GSH), malondialdehyde (MDA), oxidative stress index (OSI) and C – reactive protein (CRP) were determined at the beginning and at the end of the intervention. A depression, anxiety, stress scale (DASS-21-items) questionnaire was used to evaluate mood status.

RESULTS: Finally, 79 patients reached the final analysis stage. At the end of the intervention, a significant decrease in the serum levels of MDA (means difference (MD): -0.83, 95% confidence intervals (CI): -1.04,-0.62 nmol/ml vs MD: -0.32, CI: -0.48,-0.15 nmol/ml; P <0.001) and CRP (MD:-0.78, CI: -1.17,-0.39 mg/L vs MD:-0.63, CI: -1.80,0.52 mg/L; P <0.001) was observed in the ALA as compared with the placebo group. But changes in serum GSH (P=0.086), TAC (P=0.068), TOS (P=0.225), and OSI (P=0.404) were not statistically significant. In addition, depression, anxiety, and stress (with p<0.001, in all cases) had significantly decreased in the intervention as compared with the control group.

CONCLUSION: The results of this study suggest that ALA supplementation for 3 months has beneficial effects on improving the oxidative, inflammatory and mood conditions of patients suffering from episodic migraine.

PMID:34105866 | DOI:10.1111/ijcp.14455

Microcirculation. 2021 Jun 9:e12719. doi: 10.1111/micc.12719. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the distribution of capillary non-perfusion (CNP) in superficial and deep capillary plexuses (SCP and DCP) in eyes with diabetic retinopathy (DR).

METHODS: In this retrospective case series, macular optical coherence tomography angiography (OCTA) images were obtained from eyes with DR without diabetic macular edema. The area of CNP in SCP and DCP was delineated using an automated approach after excluding the foveal avascular zone and major retinal vessels. The distribution and spatial correlation of the CNP in each layer was analyzed.

RESULTS: Forty-three eyes of 27 patients with diabetic retinopathy with a mean age of 59.10± 9.05 years were included. The mean CNP area in SCP was statistically significantly higher than DCP (0.722± 0.437 mm² vs 0.184± 0.145 mm² , respectively, P<0.001). There was a statistically significant association between mean BCVA (0.28±0.21 logMAR) and CNP area in DCP (P=0.01). After automated subtraction of CNP areas in DCP from SCP, 25.43±15.05 % of CNP areas in the DCP had co-localized CNP areas in SCP. The CNP percentage was statistically significantly different between the concentric rings on foveal center, both in SCP and DCP (both P<0.001) showing a decreasing trend from the outer ring toward the center.

CONCLUSION: In DR, SCP is more ischemic than DCP. This is in contrast to the previously described oxygenation dependent ischemic cascade following acute retinal vascular occlusions. This study provides further insight into the retinal ischemia in DR.

PMID:34105840 | DOI:10.1111/micc.12719

Int J Clin Pract. 2021 Jun 9:e14457. doi: 10.1111/ijcp.14457. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is prevalent worldwide and for many patients, non-adherence to medication remains a problem. Motivational interviewing is a behavioural, communication strategy used as an intervention aimed to improve health outcomes.

AIMS: This systematic review sought to investigate the effect of motivational interviewing delivered as part of pharmacy care on medication adherence and the effect this has on clinical outcomes. These included systolic and diastolic blood pressure, haemoglobin A1C, lipid profiles and cardiovascular risk scores.

METHOD: A systematic review was conducted in six databases: PubMed Central UK, Cochrane Library, CINAHL (EBSCO), PsycINFO, EMBASE and MEDLINE from the inception of motivational interviewing in 1983 to November 2020. Randomised controlled trials that assessed motivational interviewing as part of pharmacy care interventions were selected. The Cochrane risk of bias tool was used to assess the risk of bias for each included study. This review was registered with PROSPERO (registration number CRD42020222954).

RESULTS: A total of eight randomised controlled trials met the inclusion criteria. Five out of eight studies demonstrated medication adherence significantly improved following motivational interviewing interventions. One study showed a significant improvement for systolic blood pressure (SBP) change by 7.2mmHg (95% CI 1.6-12.8mmHg); this reduction was observed in patients whose baseline blood pressure was above their target blood pressure. No statistically significant effect was seen across other clinical outcomes.

CONCLUSION: motivational interviewing could be an effective behavioural strategy to enhance medication adherence in patients with CVD. Although the evidence is promising thus far, further research is required to explore the impact of motivational interviewing on clinical outcomes as well as the feasibility of implementing motivational interviewing interventions within existing pharmacy care services.

PMID:34105858 | DOI:10.1111/ijcp.14457