bluuebunny/crossref_metadata_2025 huggingface dataset:
Gli esiti dellâ€™Assistenza Infermieristica in Terapia Intensiva: protocollo di ricerca di una scoping review
Authors: Danielis Matteo , Destrebecq Anne lucia leona , Terzoni Stefano , Palese Alvisa
Published: August 2023

spinti dallâ€™attuale bisogno di costruire organizzazioni sanitarie sempre piÃ¹ affidabili e orientate ai bisogni dei pazienti, numerosi sforzi sono stati messi in atto per quantificare e qualificare il contributo degli infermieri in termini di Esiti Sensibili alle cure Infermieristiche (ESI) in area critica. Sebbene molti studi siano stati condotti in Terapia Intensiva (TI), gli ESI da considerare nella progettazione di nuoveÂ ricerche sono limitati e non ben definiti. In questo lavoro, abbiamo delineato un protocollo di ricerca per la conduzione di una scoping review, con lâ€™obiettivo di mappare le caratteristiche degli studi condotti finora sugli ESI in TI, e di formulare ipotesi di ricerca futura.
Abstract Congresso 2019
Authors: Aniarti Redazione
Published: August 2023

Abstract book
Rabbia, paura e determinazione negli infermieri italiani
Authors: Giusti Gian Domenico
Published: August 2023

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Igiene del cavo orale: Ã¨ arrivata lâ€™era post clorexidina?
Authors: Iozzo Pasquale , Lucchini Alberto , Trevisan Monica , Piemonte Guya , Manici Matteo , Comisso Irene , Marchese Filippo , Mattiussi Elisa , Elli Stefano , Fusi Cristian , Bulleri Enrico , Imbriaco Guglielmo , Negro Alessandra , Rasero Laura , Bambi Stefano
Published: August 2023

Introduzione: Lâ€™igiene del cavo orale rappresenta uno dei pilastri allâ€™interno dei â€œfundamental of careâ€, trovando nel paziente critico con device endotracheale, in particolar modo quello ricoverato in terapia intensiva, una particolare ragion dâ€™essere non soltanto nel mantenimento del comfort, ma anche e soprattutto nella prevenzione delle polmoniti associate a ventilazione meccanica (VAP). La clorexidina (CHX) collutorio o gel, usata in ambito odontoiatrico con ottimi risultati sullâ€™abbattimento della placca batterica dentale, Ã¨ diventata oggetto di attenzioni della ricerca clinica.
Positive feedback, feedback seeking and performance: Feedback orientation as a moderator
Authors: Su Weilin , Jiang Shangfeng
Published: August 2023

Purpose: Based on the feedback intervention theory, the main objective of this study was to explore the association of supervisor positive feedback with employee performance and the roles of feedback seeking and feedback orientation.Design/methodology/approach: Hierarchical regression and bootstrap analyses are used to test the above hypotheses and theoretical model on 368 dyad data obtained from Chinese employees and their direct supervisors at three different times.Findings/results: The results show that positive supervisor feedback has a positive effect on employee performance. Feedback seeking partially mediates the effect of positive feedback on employee performance. Feedback orientation positively moderates the influence of positive supervisor feedback on employee feedback seeking and performance, that is, for employees with high feedback orientation, the above two reinforcing effects are more obvious.Practical implications: The findings of this study demonstrate that supervisors should provide feedback to their employees in a positive manner in their daily work, so as to motivate employees to actively seek feedback and ultimately achieve the purpose of improving employee performance. Also, it is equally important for organisations and supervisors to actively cultivate the feedback orientation traits of employees.Originality/value: This study provides new insights into the impact mechanism and boundary conditions of positive feedback impact on employee performance and helps to complement the existing literature on feedback theory and performance management. In addition, applying feedback intervention theory to the research on the association between supervisor feedback and employee performance has made some contributions to the related research of feedback intervention theory.
Hemophagocytic Lymphohistiocytosis: A Scourge for the Physician and Bane to the Bone Marrow
Authors: Krishnan Gokul , Gosavi Siddharth , Gujral Meher , Basheer Nuzha , Kumar Bharath , Jain Priyanshu
Published: August 2023

Background:

Hemophagocytic lymphohistiocytosis (HLH) is a condition characterized by hyperinflammation. It can occur due to primary genetic defect or secondary to other etiology such as infection and rheumatological conditions. Clinical features include fever, cytopenia, organomegaly and several laboratory abnormalities. It can be a life-threatening condition secondary to worsening cytopenia and multiorgan dysfunction.

Aims and Objectives:

To study the clinical profile of HLH in a tertiary care hospital in Southern India.

Materials and Methods:

Our study has reviewed nine cases of HLH among adult patients presented over 5 years (2017-2022).

Results:

The majority of our cases were secondary to infection and had a hospital stay over two weeks and with a good response to steroid and immunomodulators.

Conclusion:

We would like to stress upon the importance of awareness of such a condition so that there can be early suspicion and workup including bone marrow examination, enabling early initiating of specific therapy for this fatal condition.
Conceptualizing a Rehabilitation ‘Model of Care’ for Improving the Quality of Life of People with Parkinson’s in India
Authors: Barretto Maria , D’souza Nicole
Published: August 2023

Given the rise in the elderly population and predicted increase in age-related diseases like Parkinson’s disease, as well as the treatment gaps in Low-and-Middle-Income Countries (LMICs), there is an urgent need to develop a culturally and socioeconomically viable Parkinson’s model of care that would be multidisciplinary, replicable, affordable, and accessible to those who need it the most. We present here an outline of a rehabilitation model of care, which incorporates a standardized group therapy format, community-based Parkinson’s Support Centers, collaboration with local stakeholders to ensure sustainability, and active engagement of People with Parkinson’s (PwPs) and caregivers (CGs) in rehabilitation programs. This model of care incorporates a unique 16-session multi-disciplinary community rehabilitation module for PwPs and CGs which is evidence-based, easily deliverable by non-medical facilitators, relevant to PwPs and CGs, adaptable to different groups, practical and beneficial, and effective in a group – format. This rehabilitation model of care, encompassing the multidisciplinary rehabilitation module, holds promise for implementation in LMICs due to its dynamic nature, cost-effectiveness, community-based approach and easy adaptability to telehealth platforms. We share our experience of developing the model and outline implications for practice and insights about community rehabilitation work in LMICs.
Efficacy of Sacubitril/Valsartan versus Losartan in Heart Failure Patients with Respect to Improvements in Ejection Fraction and New York Heart Association Functional Class
Authors: Sirimandla Vamsi Krishna , Chithirai Keerthana Kumar , Chakali Venkata Lakshman , Pydi Sai Niharika , Shaik Afsar , Harinadha Baba K. , Conjeevaram Jyothi
Published: August 2023

Background:

Heart failure (HF) is a complicated clinical disease that develops when the Left ventricular becomes symptomatic due to anatomical or functional ventricular malfunction. The symptoms emerge from a cardiac output that is insufficient to meet the body's metabolic needs. Globally, HF has emerged as a major health issue, with an estimated prevalence of >37.7 million. While HF with reduced ejection fraction (HFrEF) is more frequently seen in Indian patients, HF with preserved EF seems to be more prevalent in the western population.

Objective:

This study was conducted to determine the efficacy of sacubitril/valsartan (S/V) versus losartan in patients with HF with respect to improvements in EF and New York Heart Association (NYHA) functional class symptoms.

Materials and Methods:

A prospective cohort study was conducted on 62 HF patients who are either on angiotensin receptor-neprilysin inhibitor or angiotensin receptor blocker therapy for a period of 6 months, i.e., November 2021 to April 2022, who attended the Inpatient Cardiology Department of Narayana Medical College and Hospital. By using a semi-structured questionnaire, the data was gathered. The 2013 edition of Microsoft Excel and SPSS version 20.0 software were used for data analysis.

Results:

Subjects in the S/V group showed a 56% reduction in subjects with HFrEF from the beginning to end of the follow-up, while subjects in the losartan group showed only 16% reduction. With respect to NYHA functional class, subjects in the S/V group showed greater reduction in subjects in NYHA class III and NYHA class IV by the end of follow-up when compared to the losartan group.

Conclusion:

S/V showed better efficacy in improving EF and NYHA functional class when compared to losartan.
To Compare Limb Strength, Core Strength, and Respiratory Endurance between Post-COVID-19 and Healthy Population
Authors: Pathak Pardeep , Sharma Sunita , Gupta Nitin , Shrestha Diggaj , Bala Rosy , Chinubhai Raval R
Published: August 2023

Background:

Coronavirus disease (COVID-19) adversely affects the number of organs and systems of the human body. The most frequently affected organ is the lung, followed by skeletal muscles, which can lead to fatigue, weakness, and poor physical performance.

Objective:

The objective of this study was to compare the grip strength, core strength, 6-min walk test (6-MWT), and pulmonary function test (PFT) between healthy individuals and post-COVID-19 individuals.

Methodology:

A cross-sectional study was conducted for the comparison among the post-COVID-19 participants and the healthy ones. Their demographic characteristics were noted. We analyzed heart rate, oxygen saturation, and cardiac rhythm before and 10 min after the 6-MWT and also PFT, core strength, and hand grip strength. The correlations among the tests if any were noted.

Results:

Forty-six post-COVID-19 individuals and 44 healthy individuals were enrolled in the study. The mean age was 39.18 ± 13.12 years for healthy individuals and 37.28 ± 11.68 for post-COVID individuals with 62% of the female population. The mean distance for a 6-min walk distance was 506.68 ± 64.75 m for healthy individuals and 430.30 ± 52.96 for post-COVID-19 individuals (P < 0.000). The mean value for PFT was 85.59 ± 6.78 for healthy and 72.28 ± 6.20 for post-COVID individuals. We found a positive correlation between PFT with core endurance (P = 0.036) and hand strength (P = 0.037), core endurance with 6-MWT (P = 0.006) and hand strength (P = 0.00), and 6-MWT with hand strength (P ≤ 0.001) in post-COVID participants; whereas no correlation was found in healthy participants group.

Conclusion:

The PFT correlated significantly with core endurance and hand grip strength on post-COVID-19 individuals.
Comparative Evaluation of Clinical Efficacy of Systemically Administered Commercially Available Antioxidant Formulations as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis
Authors: Banerjee Aditya , Martande Santosh , Mangal Kashish , Swathi P V , Gopalakrishnan Dharmarajan , Kulloli Anita , Shetty Sharath , Thakur Shambhavi , Suryawanshi Krishna
Published: August 2023

Purpose:

Antioxidants are nutraceuticals that reduce the concentration of reactive oxygen species and thereby reduce the inflammatory burden. The current randomized controlled trial was designed to evaluate the clinical efficacy of commercially available antioxidant formulations, oxitard and lycopene tablets as adjuncts to scaling and root planning in the management of chronic periodontitis.

Materials and Methods:

Forty-five chronic periodontitis patients were randomly divided into three groups, namely Group A – only scaling and root planing (SRP), Group B – SRP with oxitard tablet, and Group C – SRP with lycopene tablet. Clinical parameters – plaque index, gingival index, probing pocket depth, and relative attachment level were evaluated at baseline, 1 month, 3 months, and 6 months.

Results:

All groups significantly reduced clinical parameters from baseline to 6 months (P < 0.05). Intragroup analysis showed Group B and Group C to be significantly better than Group A (P < 0.05), whereas Group B showed similar results when compared to Group C (P > 0.05).

Conclusion:

Oxitard and Lycopene showed better improvements in clinical parameters when compared to SRP alone. Thus, both oxitard and lycopene can be potential adjuncts to SRP in the treatment of chronic periodontitis in the near future.
Mining of Small Interacting Ligands with Cytoplasmic Polyadenylation Element-binding Protein 4
Authors: Yadav Ruchi
Published: August 2023

Cytoplasmic polyadenylation element-binding protein 4 (CPEB 4) is a family member of CPEB proteins that are involved in regulating posttranscriptional expression of mRNAs. These proteins act by binding to cytoplasmic polyadenylation element of genes at their untranslated region with the conservation site of UUUUUAU. CPEB 4 proteins are responsible for modulating gene expression by the process of translational activation or repression by polyadenylation event. Overexpression of CPEB 4 gene has been reported in several classes of cancer such as gastric cancer, neuronal cancer, and pancreatic cancer. CPEB 4 sometimes acts like oncogene and can cause different types of cancer. CPEB 4 protein has been studied in detail in the current research. CPEB 4 protein structure was retrieved from the PDB database with PDB ID: 5DIF and total of 25 ligands were selected through a literature survey, chemical databases, etc., to perform molecular interaction study, docking method was used. Glide docking was done using Schrodinger software, and results were analyzed. Result shows that 2-(2,4-dihydroxyphenyl)-3,5,7-trihydroxy-chromen-4-one (PubChem ID: 5281670) ligand has stable interaction with a Glide score of −8.26 and shows bonds with CPEB 4 protein at positions Lys(A: 924), Gly(B: 791), Asn(A: 879), and Thr(A: 878). These findings can help in modeling suitable ligands against the CPEB 4 protein responsible for several types of cancers.
Assessing the Comparative Efficacy of Multiple Whole-blood Count-based Testing Strategies for Thalassaemia Diagnosis
Authors: Samanta Abhishek , Bhattacharyya Nandan
Published: August 2023

Context:

Complete blood count (CBC) with confirmatory high-performance liquid chromatography (HPLC) is the gold standard for thalassemia screening. Because of the constraints of a high-pressure liquid chromatography facility, they develop alternative approaches to screening when the population to be screened is large.

Aims:

The objective of this meta-analysis is to evaluate the diagnostic accuracy of alternative approaches to thalassemia screening. This study is important, as accurate and accessible thalassemia screening can improve the quality of life for patients and reduce the burden on health-care systems.

Settings and Design:

The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Subjects and Methods:

The present systematic review comprises 74,284 thalassemia-positive patients, identified using CBC and conventional HPLC methods was published between 2012 and 2022. After further screening, 23 studies were included in the present study.

Statistical Analysis Used:

The Moses-Littenberg Summary Receiver Operating Characteristic (SROC) model, the bivariate model, and the SROC reporting model are the examples of models that also consider sensitivity and specificity.

Results:

The total diagnostic odds ratio was 88.981 (95% confidence interval 37.645–210.321). Subgroup analysis was determined by a mixed-effects model, with I
2 (residual heterogeneity/unaccounted variability) at 90% and Partial Area under ROC curve (restricted to observed False Positive Rates and normalized) was 0.951.

Conclusions:

This systematic review investigated the efficacy of using CBC parameters to distinguish between iron deficiency anemia and the thalassemia trait. This can help reduce health-care costs and improve the accuracy of the results.
Role of Diaphragmatic Breathing Exercise in the Rehabilitation of Chronic Low Back Ache
Authors: Nagaraj Sibbala , Dhanesh Kumar K. U. , Aaron Pravin
Published: August 2023

A 55-year-old male patient who has undergone physiotherapy sessions on and off for about 6 months has been admitted to the hospital for the recurrence of back pain along with it he has slight breathing issues while performing day-to-day activities, especially in forward bending activity and has been treated with pain killers and muscle relaxants during the medication periods. The patient is feeling better again, but his symptoms continue to worsen. Later, he was referred to a pulmonologist for additional evaluation after presenting with decreased diaphragm excursion, which was causing a disordered breathing pattern. He was treated with medication and referred to additional rehabilitation for low back pain management after a thorough physical examination that also included checking the patient's core and deep breathing muscles Activities of Daily Living (ADL) activities.
Efficacy of Single-shot Epidural with Bupivacaine and Dexamethasone as an Adjuvant for Postoperative Analgesia in Patients Undergoing Major Abdominal Surgeries
Authors: Dash Umesh Kumar , Mateen Mohammad Abdul , Mondal Prasanta , Dwivedi Deepak , Taneja Sameer , Haldar Arnab
Published: August 2023

Background:

Apart from being distressful, postoperative pain produces a range of harmful effects, including morbidity and mortality. Epidural analgesia is a safe and effective method for the control of postoperative pain.

Aim:

This study compared the analgesic efficacy of single-shot epidural bupivacaine plus dexamethasone versus single-shot epidural bupivacaine and intravenous (IV) dexamethasone after major elective abdominal surgery.

Methodology:

A cross-sectional cohort study was conducted on 30 adult patients undergoing major elective abdominal surgery. Fifteen minutes before the reversal of neuromuscular blockade, study Group “A” received an epidural of 0.125% bupivacaine at the dose of 1.0 mL/segment and dexamethasone 8 mg and Group “B” included data of 30 adult patients which was drawn from the well-matched historic cohort, from past anesthesia records, where patients received an epidural of 0.125% bupivacaine at the dose of 1.0 mL/segment, but an injection of dexamethasone 8 mg was administered intravenously.

Results:

The primary outcome was a significantly longer duration of analgesia (905.97 ± 110.89 min) in Group “A” patients in comparison to Group “B” patients (731.0 ± 112.59 min) (P < 0.0001). The secondary outcome included the requirement of total rescue analgesic dose of injection tramadol, which was significantly lower in Group “A” compared to Group “B” patients (163.90 ± 15.93 mg vs. 182.27 ± 30.61 mg, respectively), (P < 0.005). Postoperative nausea and vomiting incidence was lower in patients of Group “B” due to the antiemetic effect of IV dexamethasone.

Conclusion:

Single-shot bupivacaine with dexamethasone gives longer postoperative analgesia and lesser rescue analgesic requirement compared to epidural bupivacaine with IV dexamethasone.
In vitro-in vivo Correlation of Oral Biodegradable Curcumin Nanoparticles for Sustained Treatment Regimen of Diabetics
Authors: Shailaja K. , Senthilkumaran K. , Uthumansha Ubaidulla
Published: August 2023

Background:

Curcumin (CUR) has the potential to treat diabetes, but its low oral bioavailability makes it challenging to use in the treatment of chronic conditions.

Objectives:

To investigate in vitro–in vivo correlation (IVIVC) of oral biodegradable CUR nanoparticles (NPs) for sustained treatment regimen of diabetics.

Materials and Methods:

In this study, CUR biodegradable NPs were prepared using Box–Behnken design to optimize the concentration of polymer and process parameters.

Results:

The optimized formulation was prepared using the values obtained from the Box-Behenken method, 2.5 %w/v of polymer, 3 % w/v of TPP, and 2534 rpm of stirring speed and the actual response was observed 192.31±6.82 nm particle size, 84.26±2.87 % of entrapment efficiency, and 95.22±1.81 % of drug release (Q24 h) with the desirability function of 0.910 which indicated that the model is valid. In vitro release of curcumin from nanoparticles showed prolonged drug release up to 24 h. CUR-NPs administered orally were found to have longer Tmax, higher Cmax, larger AUC, and larger MRT compared to plain CUR. IVIVC model linear regression plots (R2= 0.9949) were obtained by plotting the graph with percent absorbed versus percent dissolved for CUR-NPs. IVIVCs were established for demonstrating the relationship between in vivo absorption and in vitro release.

Conclusions:

From the results, it can be concluded that this novel CUR-loaded NPs have potential to improve its therapeutic efficacy.
Knowledge and Compliance for Current Guidelines of Biomedical Waste Management among Dental Health Professionals of National Capital Region during COVID 19 Pandemic
Authors: Rohatgi Lavanya , Gupta Ritu , Arora Vikram , Sharma Anubhav , Varshney Shivangi , Bashir Sana
Published: August 2023

Introduction:

The highly contagious nature of the coronavirus and improper management of biomedical waste (BMW) may have severe ill effects on the ecosystem. Hence, a study was conducted to evaluate dental health professional knowledge, attitudes, and practice regarding biomedical waste management (BWM) during COVID-19 in the National Capital Region of India.

Materials and Methods:

A structured, self-administered questionnaire was developed regarding BMW management during COVID-19 and distributed among dental health professionals in dental teaching institution. The collected data was analyzed using Chi-square test along with the one-way analysis of variance, and P < 0.05 were considered significant.

Results:

More than half of the participants were unaware of the correct disposal of pharmaceutical waste and did not change their masks according to the guidelines given by the Central Pollution Control Board during pandemic. The mean knowledge score of faculty was found to be significantly higher when compared to undergraduate and postgraduate students.

Conclusions:

This study revealed that the level of knowledge regarding BMW management was inadequate among all the participants in the survey. Hence, dental health professionals should be educated regarding the hazards associated with improper waste disposal at all levels and trained in proper BMW management.
COVID-19-associated pulmonary aspergillosis in patients with severe SARS-CoV-2 infection
Authors: Ouranos Konstantinos , Tsakiri Kalliopi , Massa Eleni , Dourliou Vassiliki , Mouratidou Christina , Soundoulounaki Stella , Mouloudi Eleni
Published: August 2023

INTRODUCTION:

COVID-19-associated pulmonary aspergillosis (CAPA) is a serious complication affecting patients with severe SARS-CoV-2 infection, and is associated with increased mortality.

OBJECTIVE:

The objective of this study was to investigate potential risk factors, and to estimate the incidence and mortality in patients diagnosed with CAPA.

METHODS:

A single-center retrospective observational study was conducted on patients admitted to the intensive care unit (ICU) with severe COVID-19 from October 2020 to May 2022. Patients with deterioration of their clinical status were evaluated with serum galactomannan (GM) for probable CAPA. Baseline demographic patient characteristics, vaccination status, and time period during which each patient was infected with SARS-CoV-2 were obtained, and risk stratification according to underlying comorbidities was performed in an effort to assess various risk factors for CAPA. The incidence of CAPA in the entire cohort was measured, and mortality rates in the CAPA and non-CAPA groups were calculated and compared.

RESULTS:

Of 488 patients admitted to the ICU, 95 (19.4%) had deterioration of their clinical status, which prompted testing with serum GM. Positive serum testing was observed in 39/95 patients, with an overall CAPA incidence in the entire study cohort reaching 7.9% (39/488). The mortality rate was 75% (42/56) in the non-CAPA group that was tested for serum GM, and 87.2% (34/39) in the CAPA group (P = 0.041). Multivariable Cox regression hazard models were tested for 28- and 90-day survival from ICU admission. An invasive pulmonary aspergillosis (IPA) risk-stratified cox regression model corrected for the SARS-CoV-2 variant of the patient identified the diagnosis of probable CAPA and elevated procalcitonin (PCT) levels measured at least 10 days after ICU admission, as significantly associated with death in the IPA-risk subgroup only, with hazard ratio (HR): 3.687 (95% confidence interval [CI], 1.030–13.199, P = 0.045) for the diagnosis of probable CAPA, and HR: 1.022 (95% CI, 1.003–1.042, P = 0.026) for every 1 ng/mL rise in PCT.

CONCLUSIONS:

Patients in the IPA-risk subgroup that were diagnosed with CAPA had a lower 90-day survival when compared to patients in the same group without a CAPA diagnosis.
The impact of pulmonary cachexia on inpatient outcomes
Authors: Alahmad Mohamad Alhoda Mohamad , Gibson Cheryl A.
Published: August 2023

BACKGROUND:

Cachexia has been associated with chronic lung disease (pulmonary cachexia syndrome), which is associated with increased mortality. However, studies that looked into this association was relatively small, and national level data are lacking. Herein, we aim to study the association between chronic obstructive lung disease (COPD) and cachexia.

RESEARCH QUESTION:

Do patients with COPD and cachexia has worse inpatient outcomes in comparison to those with no cachexia?

STUDY DESIGN AND METHODS:

We used the Nationwide Readmissions Database from 2016 to 2019, extracting adult patients with a primary diagnosis of COPD who were admitted between January and November of each year studied. We excluded patients with missing data on event time or length of stay. Furthermore, we excluded all cases with cormobidities associated with cachexia. We used SAS 9.4 for data exploration and analysis.

RESULTS:

We included 1,446,431 COPD-related weighted hospitalizations for which 115,276 cases (7.9%) had a concurrent diagnosis of cachexia (or cachexia-related diagnoses). Overall, patients with cachexia (COPD-C), compared to patients with COPD and no cachexia (COPD-NC), were older (mean age 69 vs. 66 years, respectively, P < 0.001) with similar gender distribution (58%). COPD-C patients had more inpatient complications including cardiac arrest, and use of mechanical ventilation (P < 0.001). Furthermore, they had longer mean lengths of stay (5.2 days vs. 3.8 days, P < 0.001). In-hospital mortality during index, admission was significantly higher in these patients at 2.2% compared to 0.5% for COPD-NC (P < 0.001).

CONCLUSION:

COPD-related cachexia is associated with increased inpatient mortality, resource utilization, and prolonged hospitalization.
The most common pulmonary diseases length of stay, and characteristics of patients admitted to pulmonary service
Authors: AL-Jahdali Hamdan , Ahmed Anwar , AL-Harbi Abdullah , Khan Ayaz , ALGamedi Majed , Alyami Sami , Hayyan Hajar , Al-Moamary Mohamed , Almuttari Ahmed
Published: August 2023

BACKGROUND:

Although chronic respiratory diseases are prevalent in Saudi Arabia, there are limited data on the patient burden and associated factors. The aim of this study is to identify the chronic respiratory diseases frequently admitted to pulmonary services and to determine the patient’s characteristics, associated comorbidities readmission rate, and reason for a more extended stay in hospital.

METHODS:

A prospective study was conducted over a 5-year period at King Abdulaziz Medical City-Riyadh, Saudi Arabia, in the Pulmonary Division, between March 2015 and December 2019. Data on demographics, comorbidities, and chronic respiratory diseases were collected.

RESULTS:

Total patients admitted were 1315 patients, female 54.2%, the mean age was 62.4 (SD±17.6), and the ages ranged from 14 to 98 years. Overall, chronic obstructive pulmonary disease was the most common respiratory disease requiring admission (17.9%), followed by interstitial lung disease (15.8%), bronchiectasis (11.9%), and obesity hypoventilation syndrome (10.8%). The most common comorbidities were obesity (42.5%), diabetes 49.1%, and hypertension 54.9%. Only 135 (10.3%) were readmitted within 30 days posthospital discharge. Among the patients who were readmitted, 103 (76.3%) were readmitted due to issues related to previous admission diagnosis, noncompliance 75 (55.5%), social reasons, and premature discharges in 51 (37.8%) and 29 (21.5%) of the cases, respectively. The respiratory disease varied significantly by gender, age, obesity status, comorbidities, length of stay (LOS), and admissions.

CONCLUSION:

Chronic respiratory diseases are prevalent in our population and are mainly influenced by gender, age, obesity status, comorbidities, LOS, and admissions. Policymakers and health professionals need to recognize the burden of chronic respiratory diseases on patients and health systems and implement effective prevention programs.
Increased expiratory flows identify early interstitial lung disease
Authors: Alyami Sami Mohammed , Moran-Mendoza Onofre
Published: August 2023

BACKGROUND:

Most interstitial lung diseases (ILDs) manifest with a restrictive ventilatory defect as the common physiologic abnormality. Low carbon monoxide diffusing capacity (Dlco) is considered to be the earliest abnormality on pulmonary function tests (PFTs) in patients with ILD. However, its measurement requires complex and expensive equipment. Our study aimed to assess if high expiratory flows are the earliest PFT abnormality in patients with idiopathic pulmonary fibrosis (IPF) and ILD.

METHODS:

In a real-world cohort of incident cases with ILD, we identified the initial PFTs on all patients newly diagnosed with ILD at Kingston Health Sciences Center (in Kingston, Ontario, Canada) between 2013 and 2017. The diagnosis of ILD, including IPF, was established as per current guidelines. Among patients with normal forced vital capacity (FVC), total lung capacity (TLC), and Dlco, we assessed the frequency of high expiratory flows defined as forced expiratory volume in 1 s (FEV1)/FVC, FEF25, FEF25-75, FEF75, and peak expiratory flow > 95% confidence limit of normal. We adjusted for emphysema, increased airway resistance, and obesity.

RESULTS:

We assessed PFTs of 289 patients with ILD; 88 (30%) of them had normal FVC, TLC, and Dlco. Among these, high FEV1/FVC was the most common abnormality in 37% of patients, in 43% of nonobese patients, and in 58% of those with no emphysema and normal airway resistance. Results were similar in the 88 patients with IPF.

CONCLUSIONS:

High FEV1/FVC could allow identifying patients with ILD/IPF in the earliest stages of their disease with simple spirometry, leading to earlier diagnosis and treatment.
Prevalence of acute infection in adults with asthma exacerbation
Authors: Chen Xi , Zhang Pingan , Ma Yanliang
Published: August 2023

BACKGROUND:

Acute respiratory infections are a major trigger of asthma exacerbations. This study sought to estimate the overall proportion of viruses, atypical pathogens, and bacteria detected in adults with asthma exacerbations.

METHODS:

PubMed, EMBASE, and Cochrane Library databases and all related studies from the reviews and references were searched from inception to February 13, 2020. Two authors independently performed study selection, data extraction, as well as quality evaluation. Subsequently, meta-analysis, between-study heterogeneity, and publication bias assessment were conducted on RStudio.

RESULTS:

Forty-three eligible studies comprising 3511 adults were included, of which 21 publications mentioned multiple infections during acute asthma attacks. Meta-analysis showed an acute infection prevalence of 40.19% (95% confidence interval [CI] 34.53%–45.99%). Viruses, atypical pathogens, and bacteria were detected in 38.76% (95% CI 32.02%–45.71%), 8.29% (95% CI 2.64%–16.27%), and 7.05% (95% CI 3.34%–11.81%) of asthmatics during exacerbations, respectively. Rhinovirus infections are always the dominant trigger for exacerbations with a proportion of 20.02% (95% CI 14.84%–25.73%). Substantial heterogeneity across studies (Cochran Q test: 479.43, P < 0.0001, I
2 = 91.2%) was explained by subgroup analysis, indicating that year, region, population, respiratory secretion, detection method, pathogen, and study quality were all influencing factors.

CONCLUSION:

This meta-analysis provided the first quantitative epidemiological data for adults, and in the future, more research and health-care supports are necessary in this area.
Antioxidant content and activity of stem and leaf extracts of Gouania longipetala Hemsl. (Rhamnaceae)
Authors: Soh Desire , Choumessi Aphrodite Tchewonpi , Tsague Manfo Faustin Pascal , Ngum Miriam Niba N. , Mbouh Mariama , Nantia Edouard Akono
Published: August 2023

Background:

Gouania longipetala Hemsl. is a scandent shrub used in traditional medicine for the management of different ailments such as gout, female infertility, heart diseases, diabetes, and malaria. Pathophysiology of the diseases is generally associated with oxidative stress. Antioxidant properties of G. longipetala have not yet been well elucidated.

Aims:

This study aimed to evaluate the antioxidant content and antioxidant activity of methanol extracts from the plant's stems and leaves.

Materials and methods:

Methanol extracts from the plant stems and leaves were screened for phytochemical components with antioxidant properties (Vitamin C, total phenolics, and flavonoids). The antioxidant reducing power of the extracts as well as its effects on lipid peroxidation and catalase were also evaluated in vitro using biochemical assays.

Results:

Leaf extract was richer than stem extract in different antioxidants such as Vitamin C, phenolics, and flavonoids. Both leaf and stem extracts showed similar inhibitory effect on lipid peroxidation and stimulatory effect on catalase activity, while leaf extract had higher ferric antioxidant effect than stem extract.

Conclusion:

Both extracts from G. Longipetala possessed antioxidant content, though activities with leaf extract displayed higher antioxidant properties than stem extract.
Radiation treatment dropouts-Pitfalls and solutions: A retrospective observational study
Authors: Patro Kanhu Charan , Avinash Ajitesh , Bhattacharyya Partha Sarathi , Pilaka Venkata Krishna Reddy , Muvvala Mrutyunjayarao , Atchaiyalingam Mohanapriya , Karthikeyan Keerthiga , Radhakrishnan Kaviya Lakshmi , Voonna Muralikrishna
Published: August 2023

JOURNAL/crsat/04.03/02201859-202306020-00008/figure1/v/2023-08-03T140821Z/r/image-tiff

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Background:

Interruptions in radiation treatment are known to have a deleterious effect on oncologic outcomes,specifically, an increase in tumor recurrence and decrease in cancer cure rate.

Objectives:

Our primary aim was to determine the factors influencing radiotherapy interruptions and provide solutions to decrease these dropouts.

Materials and Methods:

This was a retrospective observational study conducted between May 2009 and July 2010 at Mahatma Gandhi Cancer Hospital and Research Institute, a tertiary cancer center in Vishakhapatnam, Andhra Pradesh, India, on patients with histopathologically proven cancer, who were receiving radiation, either as definitive concurrent chemoradiation or in the adjuvant or palliative setting. Before the start and during treatment, patients were counseled by radiation oncologists, radiation coordinators, and radiation therapy technologists. During radiotherapy, an interruption of more than five consecutive days was considered a treatment interruption. Following a treatment interruption, patients were called on the telephone, counseling was done, and the cause of the treatment interruption was recorded and attempts were made to resolve the problem.

Results:

We enrolled 1200 patients in the study. There were more male (n = 724 [60.4%]) than female (n = 476 [39.6%]) patients. The cohort included 379 patients (31.6%) with carcinoma of the head-and-neck and 301 patients (25.1%) with gynecological malignancies. There were 100 (8.3%) treatment interruptions recorded during the study period. The common causes of radiation interruption were radiation-induced toxicity (n = 20 [20%]), patient death (n = 15 [15%]), financial (n = 15 [15%]), and social (n = 12 [12%]) issues. After counseling over the telephone, treatment could be restarted in 25 (25%) of the 100 patients who had interrupted and stopped radiotherapy.

Conclusion:

Treatment interruption is relatively common in our patients receiving radiotherapy. To prevent such dropouts and increase compliance to treatment, adequate and frequent counseling before and during radiation treatment is needed.
A narrative review of particle therapy in cancer
Authors: Krishnan Mayakannan , Ranjith C. P.
Published: August 2023

The use of high-energy charged particles in radiotherapy has evolved into an advanced cancer treatment. Even though proton beams and carbon ions are currently the popular particles used for radiotherapy in cancer, ions such as pions, helium, argon, and neon were previously used. To prepare this article, reviewed the literature relevant to the history, current status, and clinical outcomes of particle therapy for specific types of tumors by searching in PubMed and Google Scholar using specific search terms. This article reviews the history, current status, physics, and radiobiological advantages of particle therapy. Outcomes of particle therapy for sites such as the head-and-neck, central nervous system, lung, and prostate have been discussed. The physical and biological properties of particle therapy have been shown to be effective in reducing radiation-induced acute toxicities to a large extent as well as reducing the integral dose, i.e., the sum of dose delivered at every point in a patient’s body, multiplied by the volume of tissue at each point and then added up over the entire treated volume. It is used to assess the potential risks associated with radiation therapy. The advantages of particle therapy over conventional photon therapy in terms of overall survival and local control rates have been described. Advances in image guidance and newer particle acceleration technologies have improved the efficiency of particle therapy treatment.
The impact of pathological complete response on survival in patients with breast cancer and occurrence in different intrinsic subtypes: A retrospective observational study
Authors: Radhakrishnan Anupama , Roy Pritha , Chowdhury Krishnangshu B. , Joarder Ritam , Dasgupta Partha
Published: August 2023

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Background:

Pathological complete response (pCR), defined as non-invasive or in situ disease in the breast and regional lymph nodes following neoadjuvant chemotherapy (NACT) predicts oncologic outcomes.

Objectives:

The primary objective was to study the impact of pCR on survival in patients with breast cancer. The secondary objective was to assess the pCR rates in various intrinsic subtypes of breast cancer.

Materials and Methods:

This was a retrospective observational study conducted between 2015 and 2020 in the Department of Radiotherapy at R.G. Kar Medical College and Hospital, a tertiary care institution in Kolkata in eastern India, in women with locally advanced breast cancer (LABC) who received NACT. Patients were categorized based on age, menopausal status, and tumor characteristics, including stage, grade, and immunohistochemistry (IHC). The pCR rate was assessed, along with the median disease-free survival (DFS) and overall survival (OS).

Results:

A total of 251 patients (median age, 50 years; interquartile range, 43–57) were enrolled; 42 (16.7%) attained a pCR. Among the patients who attained a pCR, 7 (16.7%) had Luminal A, 8 (19.0%) had Luminal B, 14 (33.3%) had triple-negative breast cancer (TNBC), and 13 (31%) had HER2-positive disease. The median DFS for the entire cohort was 65 months (95% CI, 59.7–70.3); the median OS was not reached. The 5-year DFS in patients who attained a pCR was 67% compared to 52% in those who did not; P = 0.04. The 5-year OS was 92% and 74% in patients who attained a pCR and those who did not, respectively; P = 0.024.

Conclusion:

Patients with LABC who attain a pCR following NACT have better survival, both DFS and OS, compared to those who do not. The implications of this are particularly relevant in patients with HER2 enriched and triple negative breast cancer and are crucial in guiding the intensification of therapy in the adjuvant setting.
Gated radiation therapy for patients with breast cancer to reduce the dose to the lung and heart: A comparative cross-sectional study
Authors: Vishwanath Lokesh , Mandal Sanjeet Kumar , Sunil R. A , Latha D Asha , Bhaskar Nithin , Palled Siddanna R. , Naveen T , Tanveer Pasha C.V , Joseph Bindhu , Krishna Uday
Published: August 2023

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Background:

Deep inspiratory breath hold (DIBH) is an established technique to treat left breast cancer with fewer side-effects to the surrounding organs at risk (OARs). However, studies assessing DIBH in resource-poor settings, especially in a government setup, are scarce.

Objectives:

Our primary objective was to assess and compare the dosimetric changes in the DIBH technique compared to the free breathing technique among patients with left-sided breast cancer undergoing radiation therapy.

Materials and Methods:

This was a comparative cross-sectional study conducted in the Department of Radiation Oncology, Kidwai Memorial Institute of Oncology (Bengaluru, India), over a period of 24 months. A total of 65 patients were treated with the three-dimensional conformal radiation therapy (3D-CRT) technique either using DIBH or free breathing as per the standard protocol. The dosimetric comparisons for the surrounding OARs, in terms of mean percentage volume receiving 15 Gy (V15Gy) and 20 Gy (V20Gy) in the left lung, V25Gy, V30Gy, V5Gy in the heart the mean dose in Gy received by 25% (V25%) and 40% (V40%) of the heart, V10% and V30% of the left anterior descending artery (LAD) and mean values of Dmean dose (Gy) received by the left lung, heart, and LAD artery were compared between both the techniques.

Results:

Among 65 patients, 25 (38.4%) were treated by the free breathing technique and 40 (61.6%) by DIBH. Various dosimetric parameters that were significantly lower in the DIBH compared to free breathing techniques included the mean percentage volume of left lung receiving 20 Gy (V20 Gy) (29.5% vs. 23.5%), heart receiving 25 Gy (V25Gy) (6.7% vs. 2.9%) and 30 Gy (12.8% vs. 2.0%), mean values of Dmean received by the heart (7.8 Gy vs. 4.5 Gy) and LAD artery (31.3 Gy vs. 16.9 Gy), mean dose received by 10% volume of LAD (V10%) (36.3 Gy vs. 29.0 Gy) and 30% of LAD artery (V30%) (34.3 Gy vs. 22.2 Gy) (P < 0.001).

Conclusion:

DIBH significantly decreases the radiation dose delivered to the heart, left lung, and LAD artery. Thus, in patients with left-sided breast cancer, DIBH leads to a lower radiation dose to the OARs, leading to potentially less side-effects.
Demographic profile and risk factors of head-and-neck squamous cell carcinoma in west Tamil Nadu: A cross-sectional observational study
Authors: Michaelraj Minu J. , Kuttiappan Karthikesh , Ramasamy Sivasamy , Rodrigues Fenwick Antony Edwin , Govindaraj Sangami
Published: August 2023

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Background:

Head-and-neck squamous cell carcinomas (HNSCC) comprise 30% of all cancer cases in India. The risk factors for HNSCC include tobacco and alcohol consumption.

Objectives:

Our primary objective was to evaluate the epidemiological profile of patients with HNSCC in the western Tamil Nadu population. Our secondary objective was to assess the association of the epidemiological profile with different anatomical sites and risk factors.

Materials and Methods:

This was a cross-sectional study of data compiled from the clinical records of Sri Ramakrishna Institute of Oncology and Research Department, Sri Ramakrishna Hospital, Coimbatore (Tamil Nadu, India) from January 2018 to December 2021. Clinicodemographic data like age, sex, primary tumor site, clinical staging, family history, and exposure to risk factors (smoking, tobacco chewing, alcohol) were collected from patients with histologically confirmed HNSCC using a specially designed questionnaire. Human papillomavirus (HPV) status was determined by p16 immunohistochemistry and validated using polymerase chain reaction (PCR) by employing consensus primers for HPV deoxyribonucleic acid (DNA).

Results:

We enrolled 150 patients. The male-to-female ratio was 3:1. The mean age was 54.4 ± 10.2 years; majority of patients (59 [39.3%]) were aged between 51 and 60 years. The most frequently affected site was the oral cavity (58 [38.7%]). Tobacco chewing was the most common and the only risk factor observed among female patients (23 [62.2%]), while smoking along with alcohol consumption was commonly observed among male patients (24 [21.2%]). Smoking in combination with other risk factors (44 [29.3%]) was more common than smoking alone (9 [8%]). Tobacco chewing was a predominant risk factor for nasopharyngeal (4 [63.6%]) and oral cavity cancer (19 [32.8%]), while smoking was a predominant risk factor for laryngeal cancer (3 [30%]). Smoking with alcohol consumption was largely seen in oropharyngeal cancer (5 [33.3%]), while all three risk factors were observed in hypopharyngeal cancer (4 [14.3%]). Out of 38 samples tested, only four were positive for HPV (10.5%).

Conclusions:

The most affected demographic group with regard to HNSCC is middle-aged men (51–60 years), and the oral cavity is the most commonly affected site. Tobacco chewing is the most prevalent risk factor among women while smoking and alcohol consumption are the most common risk factors among men. Spreading awareness about the risk factors of HNSCC and their prevention is crucial to optimizing disease control.
ALK-driven NSCLC: A narrative review - Part I
Authors: Nathany Shrinidhi , Sharma Mansi , Batra Ullas
Published: August 2023

Anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) is a molecularly distinct subgroup of oncogene-addicted NSCLC, accounting for 3-5% of cases. These are mainly genomic rearrangements resulting in a fusion oncoprotein, thus causing persistent constitutive signaling. Recent developments and approvals of various generations of ALK inhibitors have revamped the therapeutic and prognostic landscape of this disease entity. For the preparation of this review, we searched various databases such as PubMed, Embase, and Scopus, using the keywords “ALK,” “ALK crizotinib,” “Oncogene NSCLC,” and “Alectinib,” and we finally included 46 articles. In this review, we describe the molecular biology and pathologic and clinical characteristics of ALK-rearranged NSCLC. The detection methods, therapeutic strategies, and trials will be discussed in the next part of this biomarker review series.