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Journal of the American Heart... Jun 2024Wild-type transthyretin amyloid (ATTRwt) cardiomyopathy is increasingly recognized in the development of heart failure. The link between cardiac performance,...
BACKGROUND
Wild-type transthyretin amyloid (ATTRwt) cardiomyopathy is increasingly recognized in the development of heart failure. The link between cardiac performance, hemodynamics, and mitochondrial function in disease stages of ATTRwt has not previously been studied but may provide new insights into the pathophysiology and clinical performance of the patients.
METHODS AND RESULTS
The study investigated 47 patients diagnosed with ATTRwt at Aarhus University Hospital, Denmark. Patients were stratified according to the disease stages of the National Amyloidosis Centre (NAC) as NAC I with low levels of NT-proBNP (N-terminal pro-B-type natriuretic peptide) (NAC I-L, n=14), NAC I with high levels NT-proBNP (NAC I-H, n=20), and NAC II-III (n=13). Exercise testing with simultaneous right heart catheterization was performed in all patients. Endomyocardial biopsies were collected from the patients and the mitochondrial oxidative phosphorylation capacity was assessed. All NAC disease groups, even in the NAC I-L group, a significant abnormal increase in biventricular filling pressures were noted during exercise while the filling pressures was normal or near normal at rest. The inotropic response to exercise was reduced with diminished increase in cardiac output which was significantly more pronounced in the NAC I-H (Diff. -2.4, 95% CI (-4.2: -0.7), =0.00) and the NAC II-III group (Diff: -3.1 L/min, 95% CI (-5.2: -1.1), =0.00) compared with the NAC I-L group. The pulmonary artery wedge pressure to cardiac output ratio at peak exercise was significantly different between NAC I-L and NAC II-III (Diff: 1.6 mm Hg*min/L, 95% CI (0.01:3.3, =0.04)). Patients with ATTRwt had a reduced oxidative phosphorylation capacity which correlated to left ventricular mass but not to cardiac output capacity.
CONCLUSIONS
An abnormal restrictive left ventricle and right ventricle response to exercise was demonstrated, even present in patients with early-stage ATTRwt. In more advanced disease stages a progressive impairment of the pressure-flow relationship was noted. The myocyte energetics is deranged but not associated to the contractile reserve or restrictive filling characteristics in ATTRwt.
PubMed: 38934860
DOI: 10.1161/JAHA.124.034213 -
Journal of the American Heart... Jun 2024With the increase in popularity of cannabis and its use and the lack of large-scale data on cannabis use and venous thromboembolism and pulmonary embolism (PE), we used...
Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in-Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis.
BACKGROUND
With the increase in popularity of cannabis and its use and the lack of large-scale data on cannabis use and venous thromboembolism and pulmonary embolism (PE), we used a nationally representative cohort of young adults (aged 18-44 years) to compare the odds of admissions and in-hospital mortality of PE with and without cannabis use disorder (CUD).
METHODS AND RESULTS
Identified patients with PE using the National Inpatient Sample (2018) were compared for baseline, comorbidities, and outcomes. Multivariable regression analysis, adjusted for covariates, was used to compare the odds of PE in young patients with CUD (CUD+) versus those without (CUD-) and those with prior venous thromboembolism. Propensity score-matched analysis (1:6) was also performed to assess in-hospital outcomes. A total of 61 965 (0.7%) of 8 438 858 young adult admissions in 2018 were PE related, of which 1705 (0.6%) had CUD+. On both unadjusted (odds ratio, 0.80 [95% CI, 0.71-0.90]; <0.001) and adjusted regression analyses, the CUD+ cohort had a lower risk of PE admission. The CUD+ cohort had fewer routine discharges (58.3% versus 68.3%) and higher transfers to short-term (7.9% versus 4.8%) and nursing/intermediate care (12.6% versus 9.5%) (<0.001). The PE-CUD+ cohort of in-hospital mortality did not differ from the CUD- cohort. Propensity score-matched (1:6) analysis revealed comparable mortality odds with higher median hospital stay and cost in the CUD+ cohort.
CONCLUSIONS
Young adults with CUD demonstrated lower odds of PE hospitalizations without any association with subsequent in-hospital mortality. The median hospital stay of the CUD+ cohort was longer, they were often transferred to other facilities, and they had a higher cost.
PubMed: 38934855
DOI: 10.1161/JAHA.123.032787 -
Journal of the American Heart... Jun 2024The aim of this study was to evaluate the association between early postpartum weight change and (1) hospital readmission and (2) 2-week blood pressure trajectory.
BACKGROUND
The aim of this study was to evaluate the association between early postpartum weight change and (1) hospital readmission and (2) 2-week blood pressure trajectory.
METHODS AND RESULTS
This retrospective study cohort included 1365 individuals with a hypertensive disorder of pregnancy enrolled in a postpartum hypertension remote monitoring program. Exposure was percentage weight change from delivery to first weight recorded within 10 days postpartum. We first modeled likelihood of hospital readmission within 8 weeks postpartum using logistic regression adjusting for age, race, insurance, type of hypertensive disorder of pregnancy, early body mass index, gestational weight gain, mode of delivery, and any discharge antihypertensive medications. We then performed case-control analysis additionally matching in a 1:3 ratio on breastfeeding, early body mass index, discharge on antihypertensive medications, and days between weight measurements. Both analytic approaches were repeated, limiting to readmissions attributable to hypertension or heart failure. Finally, we compared blood pressure trajectories over first 2 weeks postpartum. Individuals who did not lose weight in the early postpartum period had more admissions compared with weight loss groups (group 3: 14.1% versus group 2: 5.8% versus group 1: 4.5%). These individuals had 4 times the odds of postpartum readmissions (adjusted odds ratio [aOR], 3.9 [95% CI, 1.8-8.6]) to 7 (aOR, 7.8 [95% CI, 2.3-26.5]) compared with those with the most weight loss. This association strengthened when limited to hypertension or heart failure readmissions. These individuals also had more adverse postpartum blood pressure trajectories, with significant differences by weight change group.
CONCLUSIONS
Weight change is readily accessible and may identify individuals at high risk for postpartum readmission following a hypertensive disorder of pregnancy who could benefit from targeted interventions.
PubMed: 38934854
DOI: 10.1161/JAHA.123.032820 -
Indian Journal of Public Health Oct 2023In Thailand, public health service roles have been defined by the Ministry of Public Health, while essential public health functions (EPHFs) were not assigned as...
BACKGROUND
In Thailand, public health service roles have been defined by the Ministry of Public Health, while essential public health functions (EPHFs) were not assigned as necessity health-care service activities responding to the missions of primary care units.
OBJECTIVES
The aims were to determine the EPHFs and compare the necessity of performance and the actual performance according to the EPHFs of public health personnel in the subdistrict health-promoting hospitals (SHPHs).
MATERIALS AND METHODS
The exploratory sequential design of mixed methods was employed. The first phase consisted of three methods: a focus group discussion, a nominal group technique, and a cross-sectional survey used to determine the EPHFs. The second phase was to compare the necessity of performance and the actual performance according to the EPHFs of the personnel using a cross-sectional survey. The 285 SHPH directors in the second health region as samples were selected by random clusters.
RESULTS
The findings revealed that 14 EPHFs and the necessity of performance average were higher than the actual performance average in the 14 EPHFs and 212 indicators with significance at a level of 0.05. The means of health assessment and primary medical care (EPHF3) presented the smallest difference, whereas Thai traditional and alternative medicines (EPHF11) indicated the largest average difference.
CONCLUSIONS
EPHFs would be applied for setting a framework of working scope as policies and EPHFs could be recommended for use as individual guidelines or organizational assessment manuals to develop organizations efficiently.
Topics: Thailand; Humans; Cross-Sectional Studies; Focus Groups; Health Promotion; Male; Female; Public Health; Primary Health Care; Adult
PubMed: 38934836
DOI: 10.4103/ijph.ijph_1663_22 -
Indian Journal of Public Health Oct 2023Yuva Spandana (YS) is a unique community-based youth mental health promotion program implemented across Karnataka.
BACKGROUND
Yuva Spandana (YS) is a unique community-based youth mental health promotion program implemented across Karnataka.
OBJECTIVE
We assessed factors affecting PD among the population served by YS between January 1, 2017, and December 31, 2021.
MATERIALS AND METHODS
A retrospective cross-sectional analysis was done utilizing the visit forms of 10,340 YS's care recipients. A conceptual framework was developed, and all hypothesized variables within this framework were considered exposures. All exposure variables significant at P < 0.10 in univariate analysis were included in multivariable analysis. Multivariable logistic regression analysis was performed by including each of the significant potential exposure variables from univariate analysis using a forward-stepping process.
RESULTS
Care recipients with health and lifestyle issues were at almost two times increased risk for PD (adjusted odds ratio [AOR] =1.74 and 95% confidence interval [CI] - 1.52-2.00), and those with self-development issues were almost 2.5 times more likely to have PD (AOR = 2.44 and 95% CI - 2.12-2.79). Those who reported emotional statuses of feeling worried, lost, incapable, lonely, and distrusting were at 21.4, 3.5, 26.3, 37.9, and 4.7 times higher odds of having PD, respectively.
CONCLUSIONS
Isolating the risk factors associated with PD will help tailor the mental health promotion provided by YS to at-risk groups.
Topics: Humans; India; Cross-Sectional Studies; Male; Female; Adolescent; Retrospective Studies; Psychological Distress; Health Promotion; Child; Risk Factors; Socioeconomic Factors
PubMed: 38934826
DOI: 10.4103/ijph.ijph_1010_22 -
Indian Journal of Public Health Oct 2023We measured COVID-19-related stigma and discrimination and its drivers using a concurrent mixed-methods design in Punjab. The simple random sampling was used to select...
We measured COVID-19-related stigma and discrimination and its drivers using a concurrent mixed-methods design in Punjab. The simple random sampling was used to select blocks, subcenters, and urban primary healthcenters from each of the four selected districts. The systematic random sampling was used to select households. A sample of 423 adults was interviewed using a structured questionnaire and 10 in-depth interviews were conducted using an interview guide. Binary logistic regression was performed to find the predictors. Stigma prevalence was mild 18%, moderate 45%, and severe 37%. Logistic regression indicated that stigma was lower in the rural compared to the urban population (P < 0.01). Hospitalized patients faced discrimination more often compared to those who were treated/quarantined at home. People feared police (71%), testing (69%), and contracting the infection (65%). Fear of screening, disclosure of status, and transmission of the virus were the drivers of stigma and discrimination. Co-occurrence of labeling, stereotyping, and cognitive separation was observed.
Topics: Humans; COVID-19; India; Social Stigma; Male; Female; Adult; SARS-CoV-2; Middle Aged; Stereotyping; Rural Population; Urban Population; Social Discrimination; Young Adult
PubMed: 38934816
DOI: 10.4103/ijph.ijph_1255_22 -
Indian Journal of Public Health Oct 2023LAMP assay is widely used for detecting pathogens. We observed that the conventional and gradient polymerase chain reaction (PCR) could not detect the extracted...
Electrophoresis of Amplicons is a Better Method to Understand the Performance of Loop-mediated Isothermal Amplification Assay for Screening the Presence of Escherichia coli in Water.
LAMP assay is widely used for detecting pathogens. We observed that the conventional and gradient polymerase chain reaction (PCR) could not detect the extracted Escherichia coli DNA; real-time PCR was able to detect up to a certain limit (10-8 bacterial dilution). At the same time, the LAMP assay could detect the bacteria at a much lower concentration (10-14 dilution). The results of the LAMP assay were evaluated using agarose gel electrophoresis and DNA binding dye (PicoGreen), but only gel electrophoresis gave reliable results. Therefore, we propose using electrophoresis-based amplicon detection to overcome the limitations of dye-based detection. We believe that this amplicon detection will go a long way in the screening of potable drinking water.
Topics: Escherichia coli; Nucleic Acid Amplification Techniques; Water Microbiology; Real-Time Polymerase Chain Reaction; Humans; Electrophoresis, Agar Gel; DNA, Bacterial; Molecular Diagnostic Techniques; Drinking Water
PubMed: 38934812
DOI: 10.4103/ijph.ijph_1628_22 -
Indian Journal of Dental Research :... Jan 2024Wet oral environment may have deleterious effects on performance of the composites due to influences of water sorption and solubility. The study evaluated the hydrolytic...
INTRODUCTION
Wet oral environment may have deleterious effects on performance of the composites due to influences of water sorption and solubility. The study evaluated the hydrolytic degradation caused because of water sorption and solubility of silorane and methacrylate-based dental composites.
METHODS
Ten disc samples (2 mm × 10 mm) were prepared. Samples were analyzed for water solubility and sorption according to ISO 4049:2000 regulations and tested for mass gain or loss following immersion in water or in artificial saliva at 1 day, 15 days, and 30 days period. Student's 't' test, repeated measures analysis of variance (ANOVA), and Tukey's post-hoc tests determined statistical significance of the experimental results with global significance set at P = 0.05.
RESULTS
Considerable sorption and solubility was observed with time in both materials on immersion. Silorane composites showed lower water sorption and solubility than methacrylate-based composite (MBC). Artificial saliva demonstrated higher sorption and solubility compared to distilled water.
CONCLUSION
Silorane composites display enhanced hydrolytic stability even after a month of immersion in contrast to conventional methacrylate-based composites (MBCs), making it a better alternative to MBC resins clinically.
Topics: Solubility; Methacrylates; Composite Resins; Water; Silorane Resins; Saliva, Artificial; Materials Testing; Hydrolysis; Dental Materials
PubMed: 38934754
DOI: 10.4103/ijdr.ijdr_195_23 -
Indian Journal of Dental Research :... Jan 2024Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the...
BACKGROUND
Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the soft tissues. Thus, the perception of pain with three intraoral radiographic methods in children was evaluated using three subjective pain rating scales.
AIM
To evaluate the discomfort with three different techniques, that is, intraoral periapical (IOPA) radiograph, charge-coupled device (CCD), and photostimulable phosphor (PSP) luminescence (PSPL), using the Wong-Baker Faces Pain Rating Scale (WBFPRS), numerical rating scale, and visual analog scale (VAS).
MATERIALS AND METHODS
A sample of 35 children aged 6-12 years were divided into two groups: group 1 (6-8 years) and group 2 (9-12 years). For each child, simulations of the three radiological methods (IOPA, CCD, and PSPL) were performed. The meaning of each facial expression on the WBFPRS, VAS, and the numbers on the numerical rating scale was explained to each child before the procedure.
STATISTICAL ANALYSIS USED
A one-way analysis of variance (ANOVA) test and paired-samples t-test are used.
RESULTS
The results revealed that the CCD sensors elicited higher pain scores than those obtained with IOPA and PSPL, whereas the IOPA film showed the least pain score. Higher score values were obtained in group 1 than in group 2, indicating that children aged 6-8 years felt higher discomfort than the 9- to 12-year age group for the same procedure. This difference was statistically significant (P < 0.001).
CONCLUSION
It was concluded that conventional IOPA films were tolerated better by children when compared to PSP plates and CCD sensors.
Topics: Humans; Child; Pain Measurement; Male; Female; Radiography, Dental, Digital; Pain Perception; Radiography, Dental
PubMed: 38934750
DOI: 10.4103/ijdr.ijdr_78_23 -
Indian Journal of Dental Research :... Jan 2024To compare preparation times using manual, rotary, and reciprocating files during pulpectomy treatment of primary molars. (Comparative Study)
Comparative Study Randomized Controlled Trial
AIM
To compare preparation times using manual, rotary, and reciprocating files during pulpectomy treatment of primary molars.
SETTINGS AND DESIGN
This study was an in vitro, randomised, cross-sectional study.
METHODS
The study was performed on 60 extracted human primary mandibular second molars. Only mesiobuccal canals were prepared using one of three preparation techniques; each preparation technique group comprised 20 canals. Canal preparations were performed by a single, skilled operator using stainless-steel (ss) K-files (ISO size 20-35), a ProTaper Gold SX file, and a WaveOne Gold Medium file following glide path preparation. Preparation times were recorded in second (s) with a digital stopwatch.
STATISTICAL ANALYSIS
Preparation times were compared using analysis of variance and the Kruskal-Wallis analysis of variance, where appropriate. The level of significance was set at P ≤ 0.05.
RESULTS
The mean preparation time using the ss K-files was significantly longer (186.4 s) than when using the ProTaper Gold SX (29.6 s) or WaveOne Gold Medium files (30.5 s) (P < 0.001). Similar preparation times were recorded when using the ProTaper Gold SX and WaveOne Gold Medium files (P = 0.939).
CONCLUSION
Preparation times with the ProTaper Gold SX and WaveOne Gold Medium files were significantly faster than when using the ss K-files to prepare primary tooth root canals for pulpectomy. Similar preparation times were noted when using the rotary and reciprocation instrumentation groups (P > 0.05).
Topics: Humans; Molar; Tooth, Deciduous; Root Canal Preparation; Cross-Sectional Studies; Pulpectomy; Dental Instruments; Equipment Design; Time Factors; In Vitro Techniques
PubMed: 38934748
DOI: 10.4103/ijdr.ijdr_495_23