Tag: pubmed

J Perianesth Nurs. 2025 Jan 6:S1089-9472(24)00450-7. doi: 10.1016/j.jopan.2024.08.022. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the project was to reduce the occurrence of nonclinical delays resulting in increased postanesthesia care unit length of stay for carpal tunnel release patients in an ambulatory orthopedic surgery center through the implementation of new workflow processes in both the preoperative and postoperative phases of care.

DESIGN: Pre-post design, with data being analyzed both before and after implementation of evidence-based quality improvement measures to assess for effectiveness of project interventions.

METHODS: At the ambulatory orthopedic surgery center, preintervention data were gathered for 6 months on carpal tunnel release patients (n = 185) to determine the root causes of discharge delays (January to June 2023). Subsequently, the following evidence-based workflow processes were implemented: the provision of preoperative discharge instructions to the patient, clearly delineated expectations for family members during their stay, early presence of family to the bedside during phase 1 of recovery, and extensive staff education. Postintervention data (n = 189) were collected on a biweekly basis throughout the 6 months of project implementation (September 2023 to February 2024) and were analyzed using the paired t test for statistical significance.

FINDINGS: The average length of stay decreased from 44.45 to 37.07 minutes with an increase in the percentage of patients meeting discharge goals from 13.5% to 35.4%. This is a statistically significant improvement in length of stay (P < .0001).

CONCLUSIONS: Interventions to maintain efficiency such as preoperative discharge teaching, early family presence at bedside, and clear expectations for family member participation can collectively contribute to a decrease in non-anesthesia-related delays and subsequently reduce postanesthesia care unit length of stay.

PMID:39772372 | DOI:10.1016/j.jopan.2024.08.022

J Am Coll Cardiol. 2024 Nov 28:S0735-1097(24)10316-6. doi: 10.1016/j.jacc.2024.10.104. Online ahead of print.

ABSTRACT

BACKGROUND: The results of ablation of sustained monomorphic ventricular tachycardia (SMVT) are suboptimal. For many patients with implantable cardioverter-defibrillators (ICDs), ICD electrograms (ICD-EGs) provide the only available information on SMVT. ICD-EGs have the ability to distinguish morphologically distinct SMVT and can be used for pace mapping.

OBJECTIVES: This study aimed to evaluate whether using ICD-EG information during an ablation procedure influences outcomes.

METHODS: Patients with structural heart disease and SMVT documented by an ICD-EG, undergoing ablation, were randomly assigned in a 1:1 ratio to either an ablation incorporating ICD-EG data during the procedure (intervention group) or to conventional ablation. The ICD-EG obtained during induced SMVT and pace mapping was compared to ICD-EG from spontaneous SMVT to target the “clinical” SMVT for ablation. Ablation could be performed during SMVT (if tolerated), during sinus rhythm (“substrate ablation”), or both.

RESULTS: A total of 15 centers randomized 260 patients. Characterization of induced SMVT as clinical/nonclinical and pace mapping were more frequent in the intervention group. Most patients underwent pure substrate ablation (65%), with complementary ablation during SMVT in 26%, showing no significant difference between groups. No differences were found in acute efficacy. In the intention-to-treat analysis, the primary endpoint of SMVT recurrence within 6 months postablation occurred in 46 (36%) patients in the intervention group and 59 (46%) in the conventional group (HR: 0.73; 95% CI: 0.49-1.07; P = 0.11). In the per-protocol analysis, SMVT recurrence at 6 months postablation reached statistical significance (HR: 0.66; 95% CI: 0.44-0.99; P = 0.045). During the entire follow-up period (44 ± 29 months), SMVT recurrence occurred in 67% and 76% (HR: 0.80; 95% CI: 0.60-1.08; P = 0.14). The number of SMVT episodes was significantly lower in the intervention group (HR: 0.45; 95% CI: 0.24-0.84; P = 0.013), as was the rate of electrical storm (23% vs 41%; HR: 0.54; 95% CI: 0.34-0.85; P = 0.007). There were no differences in ICD shocks.

CONCLUSIONS: In patients with structural heart disease and ICD-documented SMVT, using ICD-EG information during the ablation procedure to focalize ablation toward the clinical ventricular tachycardia is associated with a nonsignificant decrease in SMVT recurrence rate, a significant reduction in the number of ventricular tachycardia episodes, and a lower rate of arrhythmic storm.

PMID:39772368 | DOI:10.1016/j.jacc.2024.10.104

J Thorac Oncol. 2025 Jan 8:S1556-0864(24)02533-4. doi: 10.1016/j.jtho.2024.12.014. Online ahead of print.

ABSTRACT

INTRODUCTION: The phase 3 randomized controlled trial of extended pleurectomy decortication and chemotherapy versus chemotherapy alone for pleural mesothelioma (PM) (MARS2) reported “extended pleurectomy decortication was associated with worse survival to 2 years, and more serious adverse events for individuals with resectable PM, compared with chemotherapy alone.” These results have led to considerable discourse regarding the future role of surgery for PM, and there has not been unanimity in the mesothelioma surgical community regarding the trial interpretation. This “perspective” evaluates MARS2 using internationally renowned PM experts who either agreed with the trial interpretation or who found issues with its conduct which may have influenced the results.

METHODS: A facilitator (HP) worked with team leaders (GW, IO) to assemble individuals offering opinions regarding the trial and its conclusions. Arguments agreeing or not agreeing with the trial interpretation were written only after publication of the full trial. Once both arguments were received by the facilitator, the individual team manuscripts were combined and sent to each team allowing editing for changes in perceived factual errors.

FINDINGS: Insightful arguments include (but were not limited to) the difficulties yet advantages of randomization, quality assurance, selection of histologic subtypes, the timing of randomization, use of preoperative staging, statistical methods, and reasons for surgical mortality.

CONCLUSIONS: The decision to operate for PM in the future will continue to be defined by consensus guidelines and health payer willingness, and the interpretation of MARS2 may play an important role in modulating the role of surgery in the future.

PMID:39772349 | DOI:10.1016/j.jtho.2024.12.014

Am J Orthod Dentofacial Orthop. 2025 Jan 8:S0889-5406(24)00510-9. doi: 10.1016/j.ajodo.2024.11.006. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the stability of palatal rugae patterns after slow maxillary expansion (SME) treatment and the reliability of the rugae region as a reference region in digital superimposition.

METHODS: The SME group comprised 21 subjects with Angle Class I or Class II dental malocclusion with unilateral or bilateral crossbite and constricted maxilla and were selected before the pubertal peak. Intraoral scans were captured via the intraoral scanner iTero Element software (version 1.13; Align Technology, San Jose, Calif) before treatment and after completion of 12 rotations of the screw in the expansion appliance. Patients rotated the screw once a week by the established protocol. The digital data of the impressions were analyzed using GOM Inspect 3D analysis software (version 2018; GOM GmbH, Braunschweig, Germany). Dimensional changes in rugae after SME were measured with MeshLab software (version 2022.02, the Visual Computing Lab of CNR-ISTI, Italy). For the statistical analysis, the Shapiro-Wilk test was used to assess normality, whereas the Kruskal-Wallis and Mann-Whitney U tests were applied for group comparisons.

RESULTS: According to digital superimposition data, the root mean square value of the rugae region in the SME group was found to be 0.195 ± 0.086 mm. The greatest dimensional change was found in the third rugae (1.70 ± 0.42 mm, P <0.001). Post-hoc pairwise comparisons revealed a statistically significant difference between the dimensional changes of the first and third rugae (P <0.05). No statistically significant difference was found as a result of pairwise comparisons of the right and left rugae points (P = 0.083 and P = 0.200, respectively).

CONCLUSIONS: The observed transverse dimensional changes in the rugae, particularly in the third rugae, indicate that caution should be exercised in using the rugae region as a reference in superpositions after SME treatment.

PMID:39772337 | DOI:10.1016/j.ajodo.2024.11.006

Afr J Reprod Health. 2024 Dec 31;28(12):175-185. doi: 10.29063/ajrh2024/v28i12.18.

ABSTRACT

Folic acid (FA) plays a crucial role in various biological processes. Insufficient intake of FA during pregnancy can lead to serious clinical complications, including neural tube defect. The current study sought to assess the awareness, knowledge, and usage of FA among young females in Jazan region of Saudi Arabia. This cross-sectional descriptive study involved 472 adult females from October 1 to 9, 2023, in Jazan region, Saudi Arabia. The questionnaire of the study was randomly distributed among females. The data showed that awareness and usage of FA supplementation were poor to fair among females. Furthermore, socio-demographic variables, including age, marital status, monthly income, education levels, number of pregnancies, and current pregnancy status, were found to be associated with awareness and utilization of FA supplementation. The study highlights the need to enhance awareness and knowledge of FA supplementation among females in the Jazan region. Introducing educational programs is essential in Saudi Arabia, particularly in the Jazan region, to enhance the knowledge and awareness of FA within the community.

PMID:39772308 | DOI:10.29063/ajrh2024/v28i12.18

Afr J Reprod Health. 2024 Dec 31;28(12):148-164. doi: 10.29063/ajrh2024/v28i12.16.

ABSTRACT

With 25% of teenagers pregnant by age of 19 and about half of these married before their 18th birth day, Uganda exhibits one of the highest rates of teenage pregnancy and child marriage globally. Comprehensive data on the drivers and barriers to addressing repeat teenage pregnancies and early child marriages remains limited. Using the narrative inquiry approach, the paper explores the key socio-cultural drivers and barriers to addressing repeat teenage pregnancies and early/forced marriages among stakeholders in the districts of Mbale, Kween, Namayingo and Kalangala. Guided by purposive sampling, a total of 125 qualitative interviews (80 key informant interviews (KIIs) and 45 focus group discussions (FGDs) were conducted. Data analysis was done using deductive thematic analysis in Atlas ti software. The drives of repeat teenage pregnancy (RPT) include the distorted community understanding of repeat teenage pregnancy; poverty at the household; norms, traditions and beliefs; cultural and traditional practices; lack of comprehensive sex education, school dropout, Peer pressure and influence, and vulnerable populations. The results point to a strong relationship between teenage pregnancy, early child/forced marriage and repeat teenage pregnancy across all the four districts and to poverty as the driving force.

PMID:39772306 | DOI:10.29063/ajrh2024/v28i12.16

Afr J Reprod Health. 2024 Dec 31;28(12):127-138. doi: 10.29063/ajrh2024/v28i12.14.

ABSTRACT

Through implementing a bidirectional Mendelian randomization (MR) study, the causal effects between gut microbiome and polycystic ovary syndrome (PCOS) were analyzed. Summary statistics for PCOS were acquired from the FinnGen consortium R8 release data, which included 27,943 cases and 162,936 controls. The inverse-variance weighting (IVW) method was adopted for analysis. Additionally, the causality involving exposure plus the outcome was evaluated by means of MR-Egger, weighted median, simple mode methods, as well as weighted mode. The IVW estimate showed that the genera Streptococcus plus Enterorhabdus served as protectors of PCOS. By contrast, the phylum Tenericutes, genera Anaerofilum, Coprococcus 2, Lachnospiraceae ND3007 group and Ruminiclostridium 5 were identified as risk elements of PCOS. Based on reverse MR analyses from PCOS on the intestinal microbiome based on the IVW method, the phyla Tenericutes, Actinobacteria, class Actinobacteria, genera Ruminococcaceae UCG004 and Christensenellaceae R 7group exhibited a down-regulation effect after PCOS onset. The genera Bacteroides, Barnesiella, Erysipelotrichaceae UCG003, Ruminococcus gnavus group, and Veillonella were up-regulated. No horizontal pleiotropy or significant IV heterogeneity was observed. We conclude that there is a causality relationship between gut microbiome and PCOS, where some bacterial taxa can be used as biomarkers to promote targeted diagnosis and therapy for PCOS.

PMID:39772304 | DOI:10.29063/ajrh2024/v28i12.14

Afr J Reprod Health. 2024 Dec 31;28(12):116-126. doi: 10.29063/ajrh2024/v28i12.13.

ABSTRACT

This study investigated the professional values of midwifery students and the factors influencing these values. Conducted from January 6 to March 6, 2021, it involved 715 midwifery students who participated voluntarily. Data was collected using a Descriptive Data Sheet and the Professional Values of Midwives Scale. Statistical analysis included descriptive statistics, two-way ANOVA, Independent Samples T Test, and Bonferroni Correction. The mean age of participants was 20.63 years; 99.2% were single, and 29.7% were second-year students. Participants mostly graduated from the following schools to Anatolian high schools (57.5%) and predominantly lived in cities (55.1%), with 81.1% from nuclear families. A significant number of parents had a primary education (mothers: 50.8%, fathers: 35.4%). The mean score on the Professional Values of Midwives Scale was high. Significant differences in scores were noted based on age, high school type, long-term residence, family type, parental education, and interest in midwifery. However, the difference was not significant found. related to academic year, willingness to choose midwifery, preference ranking, self-suitability for the profession, or shifts in perspective before and after education. These findings emphasize the multifaceted nature of professional values in midwifery students and the various factors shaping their attitudes.

PMID:39772303 | DOI:10.29063/ajrh2024/v28i12.13

Vet Ital. 2024 Sep 30;60(3). doi: 10.12834/VetIt.2572.25516.2.

ABSTRACT

This cross-sectional study aimed to estimate the seroprevalence and the potential risk factors of Brucella infection among goats in family farms in the southern east of Algeria. A total of 196 sera samples were randomly collected from 59 family farms and tested in parallel by Rose Bengal test (RBT) and indirect ELISA (iELISA). A structured questionnaire was used to collect information on potential risk factors. Apparent seroprevalence values were 8.7% (95% CI: 5.49-13.45) and 2.04% (95% CI: 0.8-5.13) for RBT and iELISA respectively. The estimated true prevalence values were 11.1% (95% CI: 6.87-17.42) for the RBT test and 1.58% (95% CI: 0.3-4.74) for iELISA. Dog presence in family farm was significantly associated with Brucella spp. seropositivity (p=0.03) using iELISA, with at least 38 times the odds of brucellosis seropositivity (OR: 38.55, 95% CI: 1.42-1049.17). Goats with previous history of stillbirth were significantly associated with Brucella spp. seropositivity (p=0.04) using RBT, with almost six (6) times higher odds (OR: 6.62, 95% CI: 1.06-41.55). Origin of animals reared on family farms was also significantly associated with Brucella spp. seropositivity (p=0.05) using iELISA with higher odds in foreign goats (OR: 12.99, 95% CI: 1.03-163.22) and lower odds in goats born in farms (OR: 0.08, 95% CI: 0.01-0.97). Based on these findings, further epidemiological studies related to the perception of the disease by animal owners and brucellosis in herding dogs needed to be conducted.

PMID:39772293 | DOI:10.12834/VetIt.2572.25516.2

Viruses. 2024 Dec 20;16(12):1949. doi: 10.3390/v16121949.

ABSTRACT

Rotavirus group A (RVA) is a major cause of pediatric acute gastroenteritis (AGE). Vaccination is an effective public health strategy and Angola implemented it in 2014. This hospital-based study aimed to estimate the prevalence of RVA infection and the severity of AGE in children under five years of age treated at six hospitals in Luanda Province. Between April 2021 and May 2022, 1251 fecal samples were screened by an immunochromatographic rapid test (SD Bioline). Data on socio-demographic profile, nutritional status, and clinical assessment were obtained. The association of RVA infection and AGE severity with possible risk factors was evaluated with a binary logistic regression model. Overall, the detection rate was 57.8% and girls tend to be more often infected than boys (55.2%). Infection was more common in the youngest group (1 to 6 months, 60.3%). Important sources of RVA infection were drinking water kept in tanks (57.9%) and private sanitary facilities with piped water (61%). Surprisingly, according to the Vesikari Scale score, the most severe symptoms were observed in children vaccinated with two doses (80.7%). RVA prevalence remains high despite vaccination, and further studies should address the association between infection sources and disease severity, as well as the causes underlying vaccine (un)effectiveness.

PMID:39772256 | DOI:10.3390/v16121949