scholarly journals Latent cytomegalovirus infection does not influence long-term disease outcomes in Inflammatory Bowel Disease, but is associated with later onset of disease

2019 ◽  
Author(s):  
Kimberley van der Sloot ◽  
Michiel D. Voskuil ◽  
Marijn C. Visschedijk ◽  
Eleonora A.M. Festen ◽  
Hendrik M. van Dullemen ◽  
...  
Keyword(s):  
Clinical Care ◽  
Older Age ◽  
Cmv Infection ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
P Values ◽  
Disease Outcomes ◽  
General Dutch Population ◽  
Inflammatory Bowel

Abstract Background: Cytomegalovirus (CMV) infection is common in the general population. CMV infection negatively affects disease course in transplant recipients and HIV patients. Whereas primary CMV infections may occur sporadically in seronegative patients, all seropositive patients with inflammatory bowel syndrome (IBD) are at risk for CMV reactivation, due to the inflammatory mucosal and use of immunosuppressive medication. It’s unclear whether latent CMV infection, and risk of reactivations, influences long-term disease outcomes. In this study, we aim to explore whether CMV infection affects disease outcomes in IBD patients. Methods: We performed a cross-sectional cohort study with 1,404 patients with IBD from a single center. Clinical characteristics and disease outcomes were prospectively collected. We scrutinized CMV serology test results and performed additional CMV serology testing if serum was available. Results: Out of 699 IBD patients with CMV serology, 303 (43.3%) were seropositive, comparable to the general Dutch population. CMV seropositivity was associated with older age, longer IBD disease duration, non-Western origin, birth outside the Netherlands and a lower educational level (p-values≤0.004). CMV seropositivity was not associated with more complicated long-term disease outcomes of IBD (p-values>0.05). Seropositive patients presented with symptoms and were diagnosed at an older age compared to seronegative patients (p-values<0.01). Conclusions: CMV seropositivity does not influence disease outcomes of IBD patients and seems associated with a delay in IBD onset. Guidelines regarding CMV screening in patients with IBD are currently based on a low level of evidence. These data support the recommendation that routine CMV serology measurement isn’t necessary in the clinical care of IBD.

scholarly journals Factors Associated With Knee Pain and Heel Pain in Youth Soccer Players Aged 8 to 12 Years

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988337 ◽  
Author(s):  
Toshiyuki Iwame ◽  
Tetsuya Matsuura ◽  
Naoto Suzue ◽  
Joji Iwase ◽  
Hirokazu Uemura ◽  
...  
Keyword(s):  
Knee Pain ◽  
Cross Sectional Study ◽  
Heel Pain ◽  
Older Age ◽  
Soccer Players ◽  
Clinical Factors ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Youth Soccer ◽  
Study Participants

Background: Soccer is played by many children younger than 12 years. Despite its health benefits, soccer has also been linked to a high number of sport-related injuries. Purpose: To investigate the relationship between clinical factors and knee or heel pain in youth soccer players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants included 602 soccer players aged 8 to 12 years who were asked whether they had experienced episodes of knee or heel pain. Data were collected on age, body mass index, years of playing soccer, playing position, and training hours per week. Associations of clinical factors with the prevalence of knee or heel pain were examined by univariate and multivariate logistic regression analyses. Results: Episodes of knee and heel pain were reported by 29.4% and 31.1% of players, respectively. Multivariate analyses revealed that older age and more years of playing soccer were significantly and positively associated with the prevalence of knee pain ( P = .037 and P = .015 for trend, respectively) but did not identify any significant associations for heel pain. Conclusion: In this study of youth soccer players, knee pain was associated with older age and more years of play, but heel pain was not significantly associated with any factor.

Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth

2017 ◽  
pp. 74-81
Author(s):  
Elissa R. Weitzman ◽  
Rosemary E. Ziemnik ◽  
Quian Huang ◽  
Sharon Levy
Keyword(s):  
High School ◽  
Alcohol Use ◽  
Treatment Adherence ◽  
Marijuana Use ◽  
Sampling Frame ◽  
Cross Sectional ◽  
P Values ◽  
Vulnerable Youth ◽  
Inflammatory Bowel ◽  
School Youth

BACKGROUND AND OBJECTIVE Adolescents face peak risks for onset and intensification of alcohol and marijuana use. However, we know little about these behaviors and their associations with knowledge or treatment adherence among chronically ill youth, a medically vulnerable group. METHODS Cross-sectional assessment of consented youth ages 9 to 18 years receiving care for asthma/cystic fibrosis, type 1 diabetes, arthritis, or inflammatory bowel disease (IBD) by using a self-administered online tool. Prevalence and correlates of risk behaviors and associations with knowledge and treatment adherence were estimated using descriptive statistics and logistic regression, controlling for demographics, mental health, and the multiclinic sampling frame. RESULTS Of 403 consented youth (75.8% response), 51.6% were girls, 75.1% were white, and average age was 15.6 years. Of high school youth, 36.5% and 12.7% reported past-year alcohol use and binge drinking, respectively; 20% reported past-year marijuana use. Among high school youth, 53.1% and 37.2% answered correctly that alcohol can interfere with their medications and laboratory tests; youth answering incorrectly were 8.53 and 4.46 times more likely to drink and binge drink, respectively (P values &lt; .001). Thirty-two percent and 8.3% of high school youth reported regularly forgetting or skipping their medications in the past 30 days; compared with past-year nondrinking youth, drinkers were 1.79 and 1.61 times as likely to report regularly missing or skipping medications (P values &lt; .05). CONCLUSIONS Alcohol and marijuana use are common among youth with chronic medical conditions. Alcohol use is associated with treatment nonadherence. Education and preventive interventions are warranted to ameliorate risk.

scholarly journals Symmetries in Muscle Torque and Landing Kinematics Are Associated With Maintenance of Sports Participation at 5 to 10 Years After ACL Reconstruction in Young Men

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092326 ◽  
Author(s):  
Iftach Hetsroni ◽  
Yohay Wiener ◽  
David Ben-Sira ◽  
Antonio Dello Iacono ◽  
Niv Marom ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Young Men ◽  
Sports Participation ◽  
Level Of Evidence ◽  
Eccentric Load ◽  
Cross Sectional ◽  
Successful Recovery

Background: Long-term maintenance of sports participation is important for young men undergoing anterior cruciate ligament (ACL) reconstruction. Identifying biomechanical characteristics in patients who achieve this goal can assist in elaborating rehabilitation programs and in identifying successful recovery, but this has rarely been investigated. Purpose: To test the association between maintenance of sports participation at 5 to 10 years after ACL reconstruction and measures of force production and landing biomechanics in men. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 30 men who underwent isolated ACL reconstruction were examined. At 5- to 10-year follow-up, associations were tested between reported outcomes of sports maintenance and objective biomechanical measures. The biomechanical tests included isokinetic knee torque and lower limb kinetics and kinematics during landing tasks. Measurements for each limb were conducted separately, and side-to-side symmetry indices (SI) were calculated. Subgroups included SI greater than +10% (ie, extreme positive), SI lower than –10% (ie, extreme negative), and SI between –10% and +10% (ie, symmetric). Results: At follow-up, concentric knee torque in the operated limb correlated with Tegner and Marx scores ( r = 0.42-0.47; P ≤ .05). Regarding the SI of knee torque, the highest Tegner, Marx, and KOOS (Knee injury and Osteoarthritis Outcome Score) results were associated with symmetry, as opposed to patients with extreme positive or extreme negative SIs ( P < .05). As for landing kinematics, Tegner score negatively correlated with knee range of motion (ROM) in the operated limb ( r = –0.38; P ≤ .05). With regard to SI, hip and knee ROM correlated with Tegner, IKDC, and KOOS scores ( r = 0.41-0.51; P ≤ .05). Specifically, the highest sports participation levels were associated with achieving symmetric hip and knee ROM but also with extreme positive SIs, as opposed to patients with extreme negative SIs ( P < .03), indicating substantially higher ROM in the uninjured limb as compared with the operated limb. Conclusion: At 5 to 10 years after ACL reconstruction, maintenance of sports participation was associated with symmetric side-to-side concentric knee torque and with producing greater attenuation of hip and knee ROM during the drop jump landing in the operated limb. Therefore, eccentric load programs that can improve attenuation-phase kinematics during landing tasks may be valuable in addition to concentric training and may facilitate enhanced long-term outcomes.

scholarly journals Segurança do paciente: importância da identificação do paciente na prevenção de eventos adversos

2019 ◽  
Vol 87 (25) ◽  
Author(s):  
Jhennifer Silva Pereira ◽  
Ludmila Grego Maia ◽  
Marlene Andrade Martins ◽  
Kaio de Melo Mosqueira ◽  
Bruno Bordin Pelazza ◽  
...  
Keyword(s):  
Adverse Events ◽  
Nurse Practitioners ◽  
Analytical Study ◽  
Prevalence Ratio ◽  
Care Patient ◽  
Correct Identification ◽  
Attribute Importance ◽  
Cross Sectional ◽  
P Values

Objetivos: descrever a identificação dos pacientes e sua importância na prevenção de eventos adversos. Metodologia:estudo analítico e de corte transversal. Participaram 187 pacientes e 40 profissionais. Os dados foram coletados por meiode entrevistas. A variável finalidade e importância da identificação correta foi dicotomizada, aplicado regressão de Poissonbivariada, os valores p < 0,20, potenciais fatores de confusão e mediadores foram incluídos na regressão de Poisson. Resultados: entre os pacientes que atribuem importância na identificação, foi independentemente associado ter escolaridadesuperior há 12 anos, (Razão de Prevalência Ajustada: 1,69; IC 95%: 1,29-2,21; p < 0,001), possuir alguma identificação visível(Razão de Prevalência: 1,31; IC 95%: 1,04-1,64; p = 0,017) e acreditar que possuía condições de colaborar para evitareventos adversos (Razão de Prevalência: 1,57; IC 95%: 1,20-2,05; p < 0,001). Conclusão: os resultados revelam riscos evulnerabilidades quanto à forma de identificação dos pacientes no serviço e requerem ações de educação continuada nomanejo deste cenário.Palavras-chave: Assistência à Saúde; Assistência ao Paciente; Segurança do Paciente; Profissionais de Enfermagem; EfeitosAdversos de Longa Duração. ABSTRACTObjectives: to describe the identification of patients and their importance in the prevention of adverse events. Methodology: cross-sectional and analytical study. 187 patients and 40 professionals participated. Data were collected throughinterviews. The variable purpose and importance of correct identification was dichotomized, applied bivariate Poissonregression, p values <0.20, potential confounders and mediators were included in the Poisson regression. Results: amongthe patients who attribute importance to the identification, it was independently associated with higher education for 12years, (Adjusted Prevalence Ratio: 1.69, 95% CI: 1.29-2.21, p <0.001), had some visible identification (Prevalence Ratio: 1.31,95% CI 1.04-1.64, p = 0.017), and believed that it had conditions to collaborate to avoid adverse events (Prevalence Ratio:1.57, 95% CI: 1, 20-2.05, p <0.001). Conclusion: the results reveal risks and vulnerabilities regarding the way patients areidentified in the service and require continuous education actions in the management of this scenario.Keywords: Delivery of Health Care; Patient Care; Patient Safety; Nurse Practitioners; Long Term Adverse Effects.

scholarly journals Long-term Effects of Adolescent Sport Concussion Across the Age Spectrum

2017 ◽  
Vol 45 (6) ◽  
pp. 1420-1428 ◽  
Author(s):  
Douglas N. Martini ◽  
James T. Eckner ◽  
Sean K. Meehan ◽  
Steven P. Broglio
Keyword(s):  
Motor Performance ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Long Term Effects ◽  
Cross Sectional ◽  
P Values ◽  
Sport Concussion ◽  
Concussion History ◽  
Auditory Tasks

Background: Research in sport concussion has increased greatly over the previous decade due to increased scientific interest as well as the media and political spotlight that has been cast on this injury. However, a dearth of literature is available regarding the long-term (>1 year after concussion) effects of adolescent concussion on cognitive and motor performance of high school athletes. Purpose: To evaluate the potential for long-term effects of concussion sustained during high school on cognitive and motor performance across the lifespan. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Adults with (n = 30) and without (n = 53) a concussion history were recruited in 3 age groups: younger (18-30 years; n = 43), middle-aged (40-50 years; n = 18), and older (≥60 years; n = 22). Each participant completed a computerized neurocognitive assessment and continuous tracking and discrete temporal auditory tasks with the hand and foot. Root mean squared error and timing variability were derived from the tracking and temporal auditory tasks, respectively. Data were analyzed by regression analyses for each recorded variable. Results: The analysis revealed significant age effects on neurocognitive task, continuous tracking task, and discrete auditory timing task performance ( P values < .05). No concussion history or interaction (concussion history by age) effects were found for performance on any task ( P values > .05). Conclusion: While longitudinal investigations are still needed, this cross-sectional study failed to identify any observable effect of adolescent concussion history on cognition or motor performance with age.

Complementary and Alternative Therapy Use in Children with Cerebral Palsy

2020 ◽  
pp. 1-7
Author(s):  
Maryam Oskoui ◽  
Pamela Ng ◽  
Michele Zaman ◽  
David Buckley ◽  
Adam Kirton ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Clinical Care ◽  
Alternative Therapy ◽  
Process Of Care ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Complementary And Alternative Therapy ◽  
Children With Cerebral Palsy ◽  
Cam Use ◽  
Complementary And Alternative

ABSTRACT: Objective: To describe complementary and alternative medicine (CAM) use amongst children with cerebral palsy (CP) in Canada and to identify factors associated with CAM use. Methods: We conducted a cross-sectional study, utilising data from the Canadian CP Registry. We explored the association between CAM use and regional, socioeconomic and CP phenotypic variables, and parental perception of the family-centredness of clinical care using the Measures of Process of Care-56 (MPOC-56). Chi-square analyses were performed, and odds ratios (OR) and 95% confidence intervals (CI) were obtained. Mann–Whitney U tests were used to compare MPOC-56 scores between CAM users and non-CAM users. Results: The study sample consisted of 313 families of which 27% reported CAM use in the past year. Children with CP using CAM were more likely to reside in Western Canada (OR 3.3, 95% CI 1.6–6.7), live in a two-parent household (OR 3.5, 95% CI 1.5–8.4), have an ataxic/hypotonic or dyskinetic CP subtype (OR 3.0, 95% CI 1.5–6.1) and have a greater motor impairment (OR 2.8, 95% CI 1.7–4.9). MPOC-56 subscale scores were not significantly associated with CAM use. Conclusion: Physicians need to be aware of existing CAM therapies, the level of evidence supporting their efficacy (beneficence), their associated risks of adverse events (non-maleficence) and enable fair access to care that may be of benefit to each child.

PROMIS Physical Function Correlates with KOOS, JR in Patients with Knee Pain

2019 ◽  
Vol 33 (09) ◽  
pp. 903-911
Author(s):  
Joost T. P. Kortlever ◽  
Andrea Leyton-Mange ◽  
Mark H. F. Keulen ◽  
Tiffany C. Liu ◽  
Stein J. Janssen ◽  
...  
Keyword(s):  
Physical Function ◽  
Knee Pain ◽  
Clinical Care ◽  
Measurement Information ◽  
Alternative Measure ◽  
Linear Regression Models ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Patient Level ◽  
Patient Reported

AbstractUsing Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) computerized adaptive test instead of the Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) could reduce question burden for patients with knee pain. We aimed to prospectively determine the correlation between PROMIS PF and KOOS, JR to assess whether PROMIS PF could be a useful alternative measure for both research and clinical care of patients with knee pain. This was a cross-sectional study of 88 patients. We assessed the correlation between PROMIS PF and KOOS, JR using a Pearson's correlation test. Two multivariable linear regression models were used to determine the amount of variation explained by various patient-level factors. There was a strong correlation between PROMIS PF and KOOS, JR (r = 0.74, p < 0.001). KOOS, JR was an independent predictor of PROMIS PF when controlling for patient-level factors (β 0.26; p < 0.001). The results of this study support the idea of using PROMIS PF in place of joint-specific measures such as KOOS, JR for clinical care of patients with knee pain. The level of evidence for this study is Level III.

scholarly journals Tailored Cigarette Warning Messages: How Individualized Loss Aversion and Delay Discounting Rates Can Influence Perceived Message Effectiveness

2021 ◽  
Vol 18 (19) ◽  
pp. 10492
Author(s):  
Hollie L. Tripp ◽  
Justin C. Strickland ◽  
Melissa Mercincavage ◽  
Janet Audrain-McGovern ◽  
Eric C. Donny ◽  
...  
Keyword(s):  
Delay Discounting ◽  
Loss Aversion ◽  
Amazon Mechanical Turk ◽  
Control Group ◽  
Cross Sectional ◽  
P Values ◽  
Message Effectiveness ◽  
Cohen’S D ◽  
Cohen's D

Current text-only cigarette warning labels (long-term, loss-framed messages) may not motivate positive changes in smoking behavior. The current project was a cross-sectional study examining the effects of tailored cigarette warnings on perceived message effectiveness (PME) in adult smokers (n = 512) conducted using Amazon Mechanical Turk (M-Turk) in January–February 2020. Participants were an average age of 40.7 (SD = 11.6), with the majority of the sample being female (62.2%) and White (88.9%). Participants reported smoking an average of 14.6 cigarettes/day (SD = 9.2) with an average FTND score of 4.6 (SD = 2.2). Participants were asked to complete a tobacco use history questionnaire, and mixed gambles and delay discounting tasks before random assignment to one of five message groups. The groups were based on a 2 (gain versus loss framing) ×2 (short-term versus long-term framing) between-subject design; a fifth group served as the control group. All experimental messages reported higher PME scores than the control (p values < 0.001, Cohen’s d = 1.88–2.48). Participants with shallower delayed reward discounting and lower loss aversion rates reported higher total PME scores, p values < 0.05. Our findings also suggest that loss aversion rates vary widely among smokers and that individuals are more responsive to messages congruent with their behavioral economic profile. Specifically, smokers who viewed messages congruent with their loss aversion and delay discounting rates reported higher PME scores than those who viewed incongruent messages (p = 0.04, Cohen’s d = 0.24). These preliminary findings suggest that anti-smoking campaigns may best impact smokers by tailoring messages based on individual loss aversion and delay discounting rates versus a one-size-fits-all approach.

Erectile dysfunction after robotic radical prostatectomy: Real-life impact of vacuum erection device clinic

2020 ◽  
pp. 205141582094663
Author(s):  
Patrick Jones ◽  
Hector Sandoval Barba ◽  
Mark I Johnson ◽  
Naeem Soomro ◽  
Wendy Robson ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Radical Prostatectomy ◽  
Real Life ◽  
Cross Sectional Survey ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Holistic Needs Assessment ◽  
Patient Reported ◽  
Life Impact

Introduction: Post-radical prostatectomy erectile dysfunction (post-RPED) is a common and potentially devastating complication. The role of PDE5-inhibitors (PDE5-Is) in post-RPED is controversial and invasive pharmacological treatments are associated with poor long-term compliance. Vacuum erection devices (VEDs) are a non-pharmacological alternative. Little data regarding VED efficacy and associated patient satisfaction in post-RPED exists. This study aimed to investigate the outcomes of VED therapy in a post-robot assisted radical prostatectomy (post-RARP) population. Methods: All men who underwent RARP at a single centre between February 2015 and October 2017 attended a nurse-led holistic-needs-assessment (HNA) appointment at 10 weeks post-RARP. All men identifying ED as a concern at HNA were offered dedicated nurse-led post-RPED clinic and VED clinic appointments. A cross-sectional survey of patient reported outcomes in these men was performed. Results: In total 137/539 (25%) men reported ED as a concern at HNA. All 137 men attended the VED clinic, 124/137 (90%) responded to the survey. Commonest reason for choosing VED therapy was for combined psychological, penetration and lengthening purposes (48%). Median time from RARP to VED clinic and from VED clinic to survey was 122 days (range 56–595) and 462 days (range 66–932) respectively. At survey 88/124(70.9%) reported continued use of VED, 69/88 (78%) of this group perceived VED treatment to be successful. Of those who had stopped using VED, 7/36 (19%) felt it had been successful. Key reasons for discontinuation were either because men felt it ineffective (13/36 (37%)) or disliked the device (10/36 (29%)). Conclusion: VED therapy is an effective treatment for men with post-RARP ED that is well tolerated with good short- to medium-term compliance. Up to two-thirds of men may find overall satisfaction with their post-RPED after VED therapy. Level of Evidence: 3

scholarly journals Latent cytomegalovirus infection does not influence long-term disease outcomes in inflammatory bowel disease, but is associated with later onset of disease

2020 ◽  
Vol 55 (8) ◽  
pp. 891-896
Author(s):  
Kimberley W. J. van der Sloot ◽  
Michiel D. Voskuil ◽  
Marijn C. Visschedijk ◽  
Eleonora A. M. Festen ◽  
Hendrik M. van Dullemen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cytomegalovirus Infection ◽  
Disease Outcomes ◽  
Inflammatory Bowel
Sign in / Sign up

Export Citation Format

Share Document