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Study about Food Choice Determinants According to Six Types of Conditioning Motivations in a Sample of 11,960 Participants
No full textMany aspects linked to personal characteristics, society and culture constitute some of the motivators that drive food choice. The aim of this work was to determine in what extent the eating behaviors of individuals are shaped by six different types of determinants, namely: health, emotions, price and availability, society and culture, environment and politics, and marketing and commercials. This is a descriptive cross-sectional study, involving a non-probabilistic sample of 11,960 participants from 16 countries. The objective of this work was to validate the questionnaire, so as to make it suitable for application in different contexts and different countries. For that, six scales were considered for validation by confirmatory factor analysis with structural equation modelling. The obtained results showed that the six individual scales evaluated presented good or very good fitting indices, with saturation in goodness-of-fit index in all cases. The values of chi-square ratio were 6.921 (for health), 0.987 (environment), 0.610 (emotions) and 0.000 in the remaining cases (convenience, society, marketing). Furthermore, the fit was perfect, with saturation for all indices, in three of the six models (convenience, society and marketing). The results of this wok allowed the validation of the six scales, and the assessing of different types of factors that can influence food choices and eating behaviors, namely in the categories: health, emotions, price and availability, society and culture, environment and politics, and marketing and commercials
Myasthenia Gravis after Thymectomy: Prognostic Factors, Clinical Characteristics and Treatment Features
No full textMyasthenia gravis after thymectomy: prognostic factors, clinical characteristics and treatment features, by Živilė Vaičekauskytė. Aim: The aim of this study is to evaluate prognostic factors, clinical characteristics and treatment features in myasthenia gravis patients after thymectomy. Objectives: 1. To evaluate retrospectively myasthenia gravis patients after thymectomy and assess prognostic factors for disease course. 2. To estimate the clinical characteristics in myasthenia gravis patients after thymectomy. 3. To evaluate treatment features of thymectomized myasthenia gravis patiens. Methods: In this study, case histories of patients that have been treated in 2014 – 2018 in Lithuanian Health Sciences University hospital Kaunas clinics Neurology department retrospectively have been reviewed. Data about patients gender, age, clinical characteristics and treatment features of myasthenia gravis was collected. Collected data was analyzed using IBM SPSS 23.0. Results: In 73,2% of patients, myasthenia gravis manifested as an early onset form of the disease. Ocular form at onset appeared in 24,4% of patiens and for the rest of the patients it started with a generalized myasthenia. Secondary generalization when myasthenia begins with ocular form was detected in 70% of patients. In 65,85% of patients had seropositive myasthenia and 96,29% of them had positive acetylcholine receptors (AchR) antibodies in blood serum. Thymoma was diagnosed for 75,6% of patients, thymus hyperplasia for 12,2% and 12,2% of patients had normal thymus. More commonly imunosupresive treatment in combination with acetilcholinesterase inhibitors was received in patients with seronegative myasthenia than with seropositive myasthenia (86,7% vs 53,8%)(p=0.033). Imunosupressive treatment after thymectomy was required for patients that have been diagnosed with myasthenia gravis sooner than later (median 6 months vs 12 months)(p=0.045). Male gender was associated with longer remission after thymectomy (men median 24 months; women median 9 months)(p=0.003). Conclusions: 1. Male gender could be a prognostic factor to longer remission period for myasthenia gravis patients after thymectomy (p=0.003). 2. Early onset form of myasthenia gravis is more often for women (83,3%). Disease usually manifests with generalized symptoms (75,6%) and only few cases retain ocular form from the begining (30%). In myasthenia gravis the common pathology of thymus is timoma (75,6%) which more often appears in late onset myasthenia gravis patients (90,9%). Seropositive myasthenia is diagnosed in more than a half of patients (65,85%). AchR antibodies are common in seropositive myasthenia gravis patients (96,29%). 3. Acetylcholinesterase inhibitors are prescribed for all myasthenia gravis patients after thymectomy. Combined treatment with imunossupressive drugs is required in seronegative patients more often than in seropositive (p=0.033). Also, combined treatment with imunossupressive drugs is required for those patients who had been diagnosed with myasthenia gravis sooner, after symptoms occured (p=0.045)
Diagnostic value of imaging modalities in detecting axillary lymph node metastases in breast cancer
No full textAim of the study To optimize the diagnostic process of breast cancer and to evaluate the diagnostic value of imagining modalities in detecting the spread of breast cancer to axillary lymph nodes. Objectives of the study 1. To determine the features indicative of metastatic involvement of axillary lymph nodes in breast cancer by different imaging modalities. 2. To evaluate the diagnostic value of ultrasound in detecting axillary lymph nodes with metastases. 3. To evaluate the diagnostic value of mammography in detecting metastatic involvement of axillary lymph nodes. 4. To evaluate the diagnostic value of magnetic resonance imaging in detecting metastatic involvement of axillary lymph nodes. 5. To determine the features indicative of metastatic involvement of axillary lymph nodes in breast cancer by thermography and to evaluate the diagnostic value of this imaging modality. 6. To develop an informative prognostic model, involving tumor biological characteristics and features of imaging modalities, for discriminating a benign from a malignant axillary lymph node.Scientific novelty. This study is the first prospective study conducted in Lithuania that has analyzed the diagnostic value of imaging modalities in evaluating the status of axillary lymph nodes in breast cancer. Recently, there are doubts on necessity to apply surgical interventions in detecting the metastases of breast cancer to axillary lymph nodes. There is an ongoing discussion on the outcomes of lymphadenectomy and sentinel lymph node biopsy and quality of life among women with breast cancer. Therefore, more attention has been paid to biological tumor characteristics in choosing the strategies of breast cancer treatment and predicting survival [...]
Effect of graphene oxide and silver nanoparticles hybrid composite on P. aeruginosa strains with acquired resistance genes
No full textBackground: In the last decades, nosocomial infections caused by drug-resistant Pseudomonas aeruginosa became a common problem in healthcare facilities. Antibiotics are becoming less effective as new resistant strains appear. Therefore, the development of novel enhanced activity antibacterial agents becomes very significant. A combination of nanomaterials with different physical and chemical properties enables us to generate novel multi-functional derivatives. In this study, graphene oxide and polyvinylpyrrolidone-stabilized silver nanoparticles hybrid nanocomposite (GO-Ag HN) were synthesized. The relation between antibiotic resistance and GO-Ag HN potential toxicity to clinical P. aeruginosa strains, their antibiotic resistance, and molecular mechanisms were assessed. Methods: Chemical state, particle size distribution, and morphology of synthesized GO-Ag NH were investigated using spectroscopy and microscopy techniques (UV-Vis, FTIR, XPS, TEM, SEM, AFM). Broad-spectrum antibiotic resistance of P. aeruginosa strains was determined using E-test. Antibiotic resistance genes were identified using polymerase chain reaction (PCR). Results: In this study, the toxicity of the GO-Ag NH to the isolated clinical P. aeruginosa strains has been investigated. A high antibiotic resistance level (92%) was found among P. aeruginosa strains. The most prevalent antibiotic resistance gene among tested strains was the AMPC beta-lactamase gene (65.6%). UV-vis, FTIR, and XPS studies confirmed the formation of the silver nanoparticles on the GO nanosheets. The functionalization process occurred through the interaction between Ag nanoparticles, GO, and polyvinylpyrrolidone used for nanoparticle stabilization. SEM analysis revealed that GO nanosheets undergo partial fragmentation during hybrid nanocomposite preparation, which remarkably increases the number of sharp edges and their mediated cutting effect. TEM analysis showed that GO-Ag HN spherical Ag nanoparticles mainly 9– 12 nm in size were irregularly precipitated on the GO nanosheet surface. A higher density of Ag NPs was observed in the sheets’ wrinkles, corrugations, and sharp edges. This hybrid nanocomposite poses enhanced antibacterial activity against carbapenem-resistant P. aeruginosa strains through a possible synergy between toxicity mechanisms of GO nanosheets and Ag nanoparticles. With incubation time increasing up to 10 minutes, the survival of P. aeruginosa decreased significantly. Conclusion: A graphene oxide and silver nanoparticles hybrid composite has been shown to be a promising material to control nosocomial infections caused by bacteria strains resistant to most antibiotics
Acid suppression therapy, gastrointestinal bleeding and infection in acute pancreatitis - An international cohort study
No full textBACKGROUND: Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of gastrointestinal (GI) bleeding and GI infection in patients with AP. METHODS: We initiated an international survey and performed retrospective data analysis on AP patients hospitalized between January 2013 and December 2018. RESULTS: Data of 17,422 adult patients with AP were collected from 59 centers of 23 countries. We found that 23.3% of patients received ASDs before and 86.6% during the course of AP. ASDs were prescribed to 57.6% of patients at discharge. ASD administration was associated with more severe AP and higher mortality. GI bleeding was reported in 4.7% of patients, and it was associated with pancreatitis severity, mortality and ASD therapy. Stool culture test was performed in 6.3% of the patients with 28.4% positive results. Clostridium difficile was the cause of GI infection in 60.5% of cases. Among the patients with GI infections, 28.9% received ASDs, whereas 24.1% were without any acid suppression treatment. GI infection was associated with more severe pancreatitis and higher mortality. CONCLUSIONS: Although ASD therapy is widely used, it is unlikely to have beneficial effects either on the outcome of AP or on the prevention of GI bleeding during AP. Therefore, ASD therapy should be substantially decreased in the therapeutic management of AP
Balancing nurses’ workload: a case study with nurse anaesthetists and intensive care nurses
No full textOver the last two decades, intensive care has changed significantly. The nursing care intensity and the workload of nurses in the intensive care units have increased. In order to distribute tasks among nurse anaesthetists and intensive care nurses effectively and to balance their workload there is a need to implement nurses’ workload calculation techniques on a daily basis. The presented study aims to estimate the nurse anaesthetists and intensive care nurses’ workload by assessing nursing care intensity and patients’ severity in intensive care unit. The descriptive cross-sectional study design was employed for this study. The data was collected at a university hospital cardio-surgery intensive care unit. The total of 1147 assessments of nurses’ workload were performed. The relationship between TISS-28 components and nurses’ workload was analysed and a significant positive correlation among nurses’ workload, patients’ age and length of stay in the unit was determined. An excessive nursing workload increased by the overall nursing actions, support of cardiovascular, renal and metabolic system actions. The implementation of TISS-28 into nursing practice could help with showing the value of nursing practice and nurses’ input, also it would help calculating the nurses’ workload more accurately and improving the distribution of nurses in the workplace
Descriptive analysis of low versus elevated intracranial pressure on cerebral physiology in adult traumatic brain injury: a CENTER-TBI exploratory study
No full textBackground: To date, the cerebral physiologic consequences of persistently elevated intracranial pressure (ICP) have been based on either low-resolution physiologic data or retrospective high-frequency data from single centers. The goal of this study was to provide a descriptive multi-center analysis of the cerebral physiologic consequences of ICP, comparing those with normal ICP to those with elevated ICP. Methods: The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) High-Resolution Intensive Care Unit (HR-ICU) sub-study cohort was utilized. The first 3 days of physiologic recording were analyzed, evaluating and comparing those patients with mean ICP 20 mmHg. Various cerebral physiologic parameters were derived and evaluated, including ICP, brain tissue oxygen (PbtO2), cerebral perfusion pressure (CPP), pulse amplitude of ICP (AMP), cerebrovascular reactivity, and cerebral compensatory reserve. The percentage time and dose above/below thresholds were also assessed. Basic descriptive statistics were employed in comparing the two cohorts. Results: 185 patients were included, with 157 displaying a mean ICP below 15 mmHg and 28 having a mean ICP above 20 mmHg. For admission demographics, only admission Marshall and Rotterdam CT scores were statistically different between groups (p = 0.017 and p = 0.030, respectively). The high ICP group displayed statistically worse CPP, PbtO2, cerebrovascular reactivity, and compensatory reserve. The high ICP group displayed worse 6-month mortality (p < 0.0001) and poor outcome (p = 0.014), based on the Extended Glasgow Outcome Score. Conclusions: Low versus high ICP during the first 72 h after moderate/severe TBI is associated with significant disparities in CPP, AMP, cerebrovascular reactivity, cerebral compensatory reserve, and brain tissue oxygenation metrics. Such ICP extremes appear to be strongly related to 6-month patient outcomes, in keeping with previous literature. This work provides multi-center validation for previously described single-center retrospective results
Illicit Tobacco in Lithuania: A Cross-Sectional Survey
No full textTaxation policies are the most cost-effective measure to reduce overall tobacco consumption. However, cigarettes in Lithuania are among the cheapest in the European Union. The threat of the illicit trade is often used to compromise evidence-based policies, pricing policies particularly. The aim of this study was to determine the extent of illicit cigarette consumption in Lithuania and identify the main characteristics of illicit cigarette smokers. The national cross-sectional survey with direct observation of the latest purchased pack of cigarettes was conducted between August and September 2019. In total, 1050 smokers aged ≥18 were interviewed face-to-face. The illicit share of the total consumption of cigarettes per year was 10.7% with 9.7% of smokers showing or describing illicit cigarette packs compared to 17% reported by industry-funded studies. Older smokers, smokers with lower education and heavy smokers were more likely to regularly purchase illicit cigarettes. The average price of an illicit pack was almost two times lower than licit. Although the illicit trade of tobacco products is a serious policy challenge, the threat of an increase in illicit trade should not delay tobacco taxation improvements
Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis
No full textPurpose: To describe ICU stay, selected management aspects, and outcome of Intensive Care Unit (ICU) patients with traumatic brain injury (TBI) in Europe, and to quantify variation across centers. Methods: This is a prospective observational multicenter study conducted across 18 countries in Europe and Israel. Admission characteristics, clinical data, and outcome were described at patient- and center levels. Between-center variation in the total ICU population was quantified with the median odds ratio (MOR), with correction for case-mix and random variation between centers. Results: A total of 2138 patients were admitted to the ICU, with median age of 49 years; 36% of which were mild TBI (Glasgow Coma Scale; GCS 13–15). Within, 72 h 636 (30%) were discharged and 128 (6%) died. Early deaths and long-stay patients (> 72 h) had more severe injuries based on the GCS and neuroimaging characteristics, compared with short-stay patients. Long-stay patients received more monitoring and were treated at higher intensity, and experienced worse 6-month outcome compared to short-stay patients. Between-center variations were prominent in the proportion of short-stay patients (MOR = 2.3, p < 0.001), use of intracranial pressure (ICP) monitoring (MOR = 2.5, p < 0.001) and aggressive treatments (MOR = 2.9, p < 0.001); and smaller in 6-month outcome (MOR = 1.2, p = 0.01). Conclusions: Half of contemporary TBI patients at the ICU have mild to moderate head injury. Substantial between-center variations exist in ICU stay and treatment policies, and less so in outcome. It remains unclear whether admission of short-stay patients represents appropriate prudence or inappropriate use of clinical resources
Endogenous motion of liver correlates to the severity of portal hypertension
No full textDegree of portal hypertension (PH) is the most important prognostic factor for the decompensation of liver cirrhosis and death, therefore adequate care for patients with liver cirrhosis requires timely detection and evaluation of the presence of clinically significant PH (CSPH) and severe PH (SPH). As the most accurate method for the assessment of PH is an invasive direct measurement of hepatic venous pressure gradient (HVPG), the search for non-invasive methods to diagnose these conditions is actively ongoing. AIM To evaluate the feasibility of parameters of endogenously induced displacements and strain of liver to assess degree of PH. METHODS Of 36 patients with liver cirrhosis and measured HVPG were included in the casecontrol study. Endogenous motion of the liver was characterized by derived parameters of region average tissue displacement signal (dantero, dretro, dRMS) and results of endogenous tissue strain imaging using specific radiofrequency signal processing algorithm. Average endogenous strain μ and standard deviation σ of strain were assessed in the regions of interest (ROI) (1 cm × 1 cm and 2 cm × 2 cm in size) and different frequency subbands of endogenous motion (0-10 Hz and 10- 20 Hz). RESULTS Four parameters showed statistically significant (P < 0.05) correlation with HVPG measurement. The strongest correlation was obtained for the standard deviation of strain (estimated at 0-10 Hz and 2 cm × 2 cm ROI size).[...]