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Perspectives on COVID-19 prevention and treatment using herbal medicine in Vietnam: A cross-sectional study

Ann Ig. 2021 Dec 9. doi: 10.7416/ai.2021.2484. Online ahead of print.

ABSTRACT

INTRODUCTION: The significance of herbal medicine (HM) during the COVID-19 pandemic has been confirmed. Nevertheless, limited studies have included the people perspectives on COVID-19 prevention/treatment using herbal medicine in Vietnam. Thus, this study tackled the aforementioned issue.

METHODS: Online-based cross-sectional study was conducted in Vietnamese adults between February- April 2021. Descriptive analysis, regression and Chi-squared tests were implemented for the statistical purposes.

RESULTS: A total of 787 respondents attended the study, 368 (46.8%) confirmed that they use herbal medicine/ nutritional supplements for COVID-19 prevention/treatment. Over 50% of the respondents possessed positive perspective on vitamin C ingestion. Using herbal medicine for external use as a disinfectant was mostly preferred. Respondents who had a ‘very good’ health self-perception or who lived in rural areas, were more likely to have a positive opinion in the COVID-19 prevention/treatment using herbal medicine. The main barrier for herbal medicine utilization was the deficiency of personal experience or expert advice.

CONCLUSION: The Vietnamese people commonly utilize herbal medicine for the COVID-19 prevention/ treatment. These data might help policy-makers in managing the public knowledge and practice on herbal medicine use in Vietnam.

PMID:34882168 | DOI:10.7416/ai.2021.2484

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Efficacy of Treatment With Armodafinil for Cancer-Related Fatigue in Patients With High-grade Glioma: A Phase 3 Randomized Clinical Trial

JAMA Oncol. 2021 Dec 9. doi: 10.1001/jamaoncol.2021.5948. Online ahead of print.

ABSTRACT

IMPORTANCE: Nearly 96% of patients with high-grade glioma (HGG) report moderate-to-severe fatigue. Armodafinil is a psychostimulant that might help cancer-related fatigue in patients with HGG.

OBJECTIVE: To determine whether armodafinil reduces fatigue in patients with HGG and moderate-to-severe fatigue.

DESIGN, SETTING, AND PARTICIPANTS: In this randomized multicenter, phase 3, double-blinded, placebo-controlled clinical trial, adults with HGG and moderate-to-severe fatigue who were clinically stable at least 4 weeks after completing radiation therapy were randomized to receive armodafinil daily (150 mg or 250 mg) or placebo over 8 weeks. A score of at least 6 out of 10 on severity scale for the brief fatigue inventory scale, with 10 being the worst, was required to suggest moderate-to-severe fatigue. Patients were allowed stable doses of corticosteroids but were excluded if they required increasing amounts of corticosteroids, were receiving some other treatment for fatigue, or had an uncontrolled seizure disorder. The study was conducted from June 2013 to December 15, 2019.

INTERVENTIONS: Patients were randomized to 150 mg of armodafinil, 250 mg of armodafinil, or placebo for a total of 8 weeks with assessments at weeks 4 and 8.

MAIN OUTCOMES AND MEASURES: The primary outcome was efficacy in treating cancer-related fatigue. Secondary outcomes included safety, neurocognitive function, and quality of life. Patients were evaluated at baseline and at weeks 4 and 8. Efficacy between the placebo and the 2 doses of study drug was determined by an improvement by 2 points on the 0 to 10 brief fatigue inventory scale. Kruskal-Wallis and χ2 tests were used and followed by confirmatory analyses.

RESULTS: A total of 328 patients were enrolled, of whom 297 had evaluable end point data. Of these, 103 received 150 mg of armodafinil (mean [SD] age, 58.5 [11.9] years; 42 women [40.8%]), 97 250 mg of armodafinil (mean [SD] age, 56.6 [12.5] years; 37 women [38.1%]), and 97 placebo (mean [SD] age, 57.1 [12.5] years; 39 women [40.2%]). There was no difference in the proportion of patients who achieved clinically meaningful fatigue reduction between arms (28% [95% CI 20%-30%] for 150 mg of armodafinil, 28% [95% CI 19%-38%] for 250 mg of armodafinil, and 30% [95% CI 21%-40%] for placebo). There was a statistically significant reduction in global fatigue for corticosteroid users compared with nonusers (-0.7 [95% CI, -1.5 to -0.3] vs -1.7 [95% CI, -2.1 to -1.3]; P < .001). More patients (2 vs 7) reported insomnia with treatment with 250 mg of armodafinil.

CONCLUSIONS AND RELEVANCE: The results of this randomized clinical trial found no meaningful benefit of using treatment with armodafinil to reduce cancer-related fatigue in patients with HGG.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01781468.

PMID:34882169 | DOI:10.1001/jamaoncol.2021.5948

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Cardioprotective potential of chronopharmacotherapy in patients with arterial hypertension who had a transient ischemic attack

Kardiologiia. 2021 Nov 30;61(11):33-41. doi: 10.18087/cardio.2021.11.n1854.

ABSTRACT

Aim Analysis of the cardioprotective effectivity of chronopharmacotherapy in patients with arterial hypertension (AH) after transient ischemic attack (TIA).Material and methods 174 patients with AH and TIA were evaluated. All patients were randomized to three groups based on the dosing schedule of chronopharmacotherapy: group 1 (n=59), patients receiving indapamide retard 1.5 mg and valsartan 160 mg, both in the morning; group 2 (n=58), indapamide retard 1.5 mg in the morning and valsartan 160 mg in the evening; group 3 (n=57), indapamide retard 1.5 mg in the morning and valsartan 80 mg in the morning and evening. Echocardiography (EchoCG) (ALOKA SSD 2500, Japan) was performed for all patients at baseline and at 12 months of the treatment. Statistical analysis of results was performed with the Statistica 12.0 (StatSoftInc, USA) software.Results Before the treatment, EchoCG parameters did not significantly differ between the patient groups. After 12 months of the treatment, positive changes in the end-systolic dimension (ESD), interventricular septal thickness (IVST), thickness of the left ventricular posterior wall (TLVPW), LV myocardial mass (LVMM), LVMM index (LVMMI), ejection fraction (EF), ratio of transmitral early peak flow velocity and late filling flow velocity (E/A), and isovolumetric velocity relaxation time (IVRT) were more pronounced in the group of sartan evening dosing (group 2) than in the group of sartan single morning dosing (group 1) (p&lt;0.05). In group 3, the changes in ESD, IVST, TLVPW, LVMM, LVMMI, EF, E/A ratio, deceleration time (DT) of LV, and IVRT were significantly greater than those in group 1, whereas the dynamics of ESD, IVST, TLVPW, LVMM, LVMMI, E/A ratio, and DT were better in group 3 than in group 2 (p&lt;0.05). In addition, a significantly greater number of patients with normalized LV geometry was registered in group 3 compared to groups 1 and 2 (p&lt;0.05). The number of patients with normal LV diastolic function after the treatment was also significantly greater in group 3 than in group 1 (p&lt;0.05) and comparable with group 2.Conclusion The morning dosing of indapamide retard and the b.i.d. dosing of valsartan provided more pronounced beneficial changes in major EcoCG indexes and improvement of LV geometry and diastolic function than the sartan single dosing only in the morning or evening in combination with the diuretic.

PMID:34882076 | DOI:10.18087/cardio.2021.11.n1854

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Remote working forced by COVID-19 pandemic and its influence on neck pain and low back pain among teachers

Med Pr. 2021 Dec 9:143538. doi: 10.13075/mp.5893.01189. Online ahead of print.

ABSTRACT

BACKGROUND: Following the declaration of the COVID-19 pandemic by the WHO, many people in the public sector have switched to remote work, including teachers. This could have contributed to the occurrence of back pain in this group. The aim of the study was to assess back pain in a group of teachers before and after the introduction of distance learning due to the COVID-19 pandemic.

MATERIAL AND METHODS: The study was based upon an online diagnostic survey and included 361 teachers and university lecturers from 16 provinces of Poland. In order to assess the intensity of pain, a Numerical Rating Scale (NRS) was used. Statistical analysis was performed using IBM SPSS Statistics 26 and Microsoft Excel 2021. The level of statistical significance was adopted on the level p < 0.05.

RESULTS: Among the surveyed teachers, the mean degree of declared cervical and lumbar spine pain increased significantly after the COVID-19 pandemic (p < 0.001). The mean value of the declared degree of cervical pain increased from 2.49±2.81 before the pandemic to 5.44±1.83 during the pandemic. Before the pandemic, the mean low back pain intensity was 2.81±2.73 on the NRS, while after the introduction of remote working, it was 5.53±2.20.

CONCLUSIONS: There is a relationship between the occurrence of back pain and the change in the nature of work in the group of teachers in connection with the declaration of the COVID-19 pandemic. There has been a statistically significant increase in teachers’ back pain intensity since the introduction of distance learning. Depending on the number of hours spent at the computer, the average degree of the declared back pain in the study group increased statistically significantly. There is a need to set the goals of physioprophylaxis and introduce education in the field of ergonomics of computer work in a group of teachers. Med Pr. 2021;72(6).

PMID:34882125 | DOI:10.13075/mp.5893.01189

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Tumor Properties Mediate the Relationship Between Peripheral Blood Monocytes and Tumor-Associated Macrophages in Breast Cancer

Cancer Invest. 2021 Dec 9:1-20. doi: 10.1080/07357907.2021.2016803. Online ahead of print.

ABSTRACT

In cancer patients, circulating monocytes show functional alterations. Since monocytes are precursors of tumor-associated macrophages (TAMs), TAMs ensuring tumor viability are potentially replenished through the recruitment of monocytes with specific properties. We demonstrated that locoregional metastasis and circulating factors, such as CD45-EpCAM + CD44 + CD24-/low circulating tumor cells, and serum MCP-1 and HMGB1 were statistically associated with modulation of the monocyte features in breast cancer patients. The count of circulating CD45-EpCAM + cells correlated with CD68+, CD163 + monocyte in blood, and with density of CD68 + TAM in breast cancer tumors. Overall, the relationship between monocytes and TAMs is mediated by the tumor in breast cancer patients.

PMID:34882039 | DOI:10.1080/07357907.2021.2016803

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The impact of the COVID-19 pandemic on the mental health of women seeking treatment for postpartum depression

J Matern Fetal Neonatal Med. 2021 Dec 9:1-7. doi: 10.1080/14767058.2021.2014810. Online ahead of print.

ABSTRACT

BACKGROUND: While research has examined the mental health of general population samples of postpartum women during the COVID-19 pandemic, the pandemic’s impact on women seeking treatment for postpartum depression (PPD) is not well known. This study compared levels of depression and anxiety, the quality of social relationships, and the temperament of infants of treatment-seeking mothers in Ontario, Canada prior to and during the pandemic.

METHODS: Mothers with Edinburgh Postnatal Depression Scale scores ≥10 and seeking treatment for PPD prior to COVID-19 (n = 100) were compared to those who sought treatment during the pandemic (n = 120). Mothers self-reported symptoms of depression, worry/anxiety, partner relationship quality, social support, as well as aspects of the mother-infant relationship and infant temperament.

RESULTS: There were no statistically significant differences in symptoms of depression, anxiety, or the quality of social relationships between women seeking treatment for PPD before or during the pandemic. However, mothers reported poorer relationships with their infants, and there was evidence of more negative emotionality in their infants during COVID-19.

CONCLUSIONS: The pandemic may not have worsened depression, anxiety, relationships with partners, or social support in mothers seeking treatment for PPD, but appears to have contributed to poorer mother-infant interactions and maternal reports of more negative emotionality in their infants. These findings highlight the importance of identifying women with possible PPD, supporting mother-infant interactions, and monitoring their infants during COVID-19 and beyond.

PMID:34882058 | DOI:10.1080/14767058.2021.2014810

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Association between vitamin D status and risk of covid-19 in-hospital mortality: A systematic review and meta-analysis of observational studies

Crit Rev Food Sci Nutr. 2021 Dec 9:1-11. doi: 10.1080/10408398.2021.2012419. Online ahead of print.

ABSTRACT

Some earlier studies reported higher risk of COVID-19 mortality in patients with vitamin D deficiency, while some others failed to find such as association. Due to inconsistences between earlier meta-analyses and needs for an updated study, we conducted current systematic review and meta-analysis on the association between vitamin D status and risk of COVID-19 in-hospital mortality among observational studies. We searched PubMed, Scopus and Web of Science up to 27 July 2021. We conduct our systematic review and meta-analysis in according to PRISM statement. Two authors independently screened studies and extracted data from the relevant ones. All types of observational studies about the association between vitamin D status and in hospital COVID-19 mortality were included. Data was pooled using a random-effect model. P-values ˂ 0.05 was assumed as statistically significant. We identified 13 observational studies. Pooling 9 studies which categorized vitamin D level, a significant positive relationship was found between vitamin D deficiency and risk of COVID-19 in-hospital mortality (Odds Ratio (OR): 2.11; 95% Confidence Interval (CI): 1.03, 4.32). All subgroup analyses also showed significant relationship between vitamin D deficiency and risk of COVID-19 in-hospital mortality. In the other analysis, pooling data from 5 studies in which vitamin D level was entered as a continues variable, we found an inverse significant association between each unit increment in serum vitamin D concentrations and risk of COVID-19 in-hospital mortality (OR: 0.94; 95% CI: 0.89, 0.99). We found a significant direct association between vitamin D deficiency and elevated risk of COVID-19 in-hospital mortality. Moreover, each unit increment in serum vitamin D levels was associated to significant reduction in risk of COVID-19 mortality. Further prospective studies are needed to confirm our findings.

PMID:34882024 | DOI:10.1080/10408398.2021.2012419

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Does failed mapping predict sentinel lymph node metastasis in cN0 breast cancer?

Future Oncol. 2021 Dec 9. doi: 10.2217/fon-2021-0470. Online ahead of print.

ABSTRACT

Aims: The clinical significance of nonvisualized sentinel lymph nodes (non-vSLNs) is unknown. The authors sought to determine the incidence of non-vSLNs on lymphoscintigraphy, the identification rate during surgery, factors associated with non-vSLNs and related axillary management. Patients & methods: A total of 30,508 consecutive SLN procedures performed at a single institution from 2000 to 2017 were retrospectively studied. Associations between clinicopathological factors and the identification of SLNs during surgery were assessed. Results: Non-vSLN occurred in 525 of the procedures (1.7%). In 73.3%, at least one SLN was identified intraoperatively. Nodal involvement was only significantly associated with SLN nonidentification (p < 0.001). Conclusion: Patients with non-vSLN had an increased risk for SLN metastasis. The detection rate during surgery was consistent, reducing the amount of unnecessary axillary dissection.

PMID:34882010 | DOI:10.2217/fon-2021-0470

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The effects of artificial- and stevia-based sweeteners on lipid profile in adults: a GRADE-assessed systematic review, meta-analysis, and meta-regression of randomized clinical trials

Crit Rev Food Sci Nutr. 2021 Dec 9:1-17. doi: 10.1080/10408398.2021.2012641. Online ahead of print.

ABSTRACT

It has been posited that Non-nutritive sweeteners (NNS) intake may affect lipid profile. However, its proven effects on lipid profile are unclear, as clinical studies on this topic have produced inconsistent results. To fill this gap in knowledge, this systematic review and meta-analysis of randomized controlled trials (RCTs) sought to evaluate the effects of artificial- and stevia-based sweeteners consumption on lipid profile markers. To identify eligible RCTs, a systematic search up to April 2021 was completed in PubMed/Medline, Scopus, and EMBASE, using relevant keywords. A random-effect model was utilized to estimate the weighted mean difference (WMD) and 95% confidence (95% CI) for TG, TC, and LDL. On the other hand, a fixed-effect model was used to estimate the WMD and 95% CI for HDL. Fourteen RCTs were included in the present meta-analysis. The pooled analysis revealed that NNS did not affect TG (WMD:-1.31, 95% CI:-5.89, 3.27 mg/dl), TC (WMD:-2.27,95% CI:-7.61,3.07 mg/dl), LDL (WMD:1,95% CI: -2.72, 4.71 mg/dl), and HDL (WMD:0.06, 95% CI:-0.62,0.73 mg/dl). Subgroup analysis showed that NNS may be related to a small, but statistically significant, increase in LDL (WMD:4.23, 95% CI:0.50,7.96 mg/dl) in subjects with normal levels of LDL (<100 mg/dl). We found that consumption of artificial- and stevia-based sweeteners is not associated with lipid profile changes in adults. This study has been registered at PROSPERO (registration number: CRD42021250025).

PMID:34882023 | DOI:10.1080/10408398.2021.2012641

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Advantages masquerading as “issues” in Bayesian hypothesis testing: A commentary on Tendeiro and Kiers (2019)

Psychol Methods. 2021 Dec 9. doi: 10.1037/met0000415. Online ahead of print.

ABSTRACT

Tendeiro and Kiers (2019) provide a detailed and scholarly critique of Null Hypothesis Bayesian Testing (NHBT) and its central component-the Bayes factor-that allows researchers to update knowledge and quantify statistical evidence. Tendeiro and Kiers conclude that NHBT constitutes an improvement over frequentist p-values, but primarily elaborate on a list of 11 “issues” of NHBT. We believe that several issues identified by Tendeiro and Kiers are of central importance for elucidating the complementary roles of hypothesis testing versus parameter estimation and for appreciating the virtue of statistical thinking over conducting statistical rituals. But although we agree with many of their thoughtful recommendations, we believe that Tendeiro and Kiers are overly pessimistic, and that several of their “issues” with NHBT may in fact be conceived as pronounced advantages. We illustrate our arguments with simple, concrete examples and end with a critical discussion of one of the recommendations by Tendeiro and Kiers, which is that “estimation of the full posterior distribution offers a more complete picture” than a Bayes factor hypothesis test. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34881956 | DOI:10.1037/met0000415