FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

A novel approach for longitudinal analysis of serum biomarkers of joint metabolism and knee injury in military officers

by Liubov Arbeeva, Virginia B. Kraus, Amanda E. Nelson, Maryalice Nocera, Leigh F. Callahan, Richard F. Loeser, Kenneth L. Cameron, Jesse R. Trump, Stephen W. Marshall, Yvonne M. Golightly

Purpose

To investigate the longitudinal relationships between serum biomarkers of joint metabolism, knee injury, and Knee Injury and Osteoarthritis Outcome Score (KOOS) using novel methodologies.

Methods

Data were collected from military officers who enrolled as cadets between 2004–2009, with follow-up conducted between 2015–2017. Analyses included 234 officers who had no history of knee ligament/meniscal injury at the time of military academy matriculation, had serum biomarker measurements at matriculation and graduation, demographic data, and KOOS assessment at follow-up. Biomarkers included Collagen Type II (C2C) and Type I and II (C1,2C) collagenase-generated cleavage epitopes, C-terminal propeptide of Type II collagen (CPII), and C- and N-terminal telopeptides of type I collagen (CTX and NTX). Angle-based Joint and Individual Variation Explained (AJIVE) was used to determine demographic determinants of biomarker levels and individual modes of variation specific to biomarker levels at matriculation and graduation, stratified by sex.

Results

We confirmed known associations of joint metabolism biomarkers with age in both sexes and with smoking in males. Matriculation biomarker data in males suggested a protective biomarker profile characterized by high cartilage synthesis and low cleavage of type I and II collagen in association with healthy KOOS scores at follow-up. CPII measured at matriculation was negatively associated with incident injuries after adjustment for smoking status (p = 0.03, logistic regression), confirming results from AJIVE.

Conclusion

These exploratory analyses suggest that CPII alone, or in combination with other joint metabolism biomarkers, may help identify individual risk of knee injury.

Mortality and associated factors among hospitalised COVID-19 patients in Lira regional referral hospital, a cross-sectional study

Por: Ongoli · A. · Opio · B. · Opollo · M. S. · Akello · A. R. · Kiweewa · F. · Omech · B.
Background

Coronavirus disease 2019 (COVID-19) caused a global public emergency between 2020 and 2022 with various morbidity and mortality across the regions. While the impact in sub-Saharan Africa appeared relatively limited, data from regional referral hospitals remain scarce.

Objective

To determine the in-hospital mortality rate, risk factors and clinical characteristics of COVID-19 patients admitted to the COVID-19 treatment unit (CTU) at Lira Regional Referral Hospital (LRRH) in northern Uganda

Design

Cross-sectional study with the use of secondary data

Setting

This study was conducted at LRRH between January 2023 and December 2023. The data used were for patients admitted from May 2020 to March 2022.

Participant

Records of 490 patients admitted with laboratory confirmed COVID-19 were collected and analysed. Selection was by simple census sampling technique. Inclusion criteria were moderately to critically ill patients and those with mild/asymptomatic infection but with comorbidities.

Results

Of the 490 participants, 52% were females and 41% were aged ≥60 years. The most common symptoms were cough (89.6%), difficulty in breathing (78.8%) and chest pain (69.3%). Hypertension (30%), diabetes mellitus (19.5%) and human immunodeficiency virus (10%) were the leading comorbidities. Severe and critical illness was observed in 40% and 7% of cases, respectively. The overall in-hospital mortality rate was 29%. Factors significantly associated with reduced mortality included normal oxygen saturation (SPO2) (adjusted odds ratios (aOR) 0.11, 95% CI 0.03 to 0.44), normal body temperature (aOR 0.22, 95% CI 0.05 to 0.99), absence of chronic liver disease (aOR 0.01, 95% CI 0.001 to 0.46) and younger age (31–45 years; aOR 0.14, 95% CI 0.03 to 0.74).

Conclusion

The study revealed a high in-hospital mortality rate of 29% among COVID-19 patients admitted to the CTU at LRRH, primarily driven by severe disease presentation and limited access to critical interventions such as oxygen therapy. Independent predictors of survival included younger age, normal oxygen saturation, absence of chronic liver disease and normal body temperature at admission. These findings underscore the urgent need for early identification of high-risk patients and improved access to supportive care, particularly oxygen delivery systems, to reduce mortality in future outbreaks. Strengthening diagnostic capacity, clinical monitoring and preparedness for respiratory pandemics—alongside prospective studies capturing broader patient data—will be essential to refine response strategies and improve outcomes.

Sedating with volatile anaesthetics for COVID-19 and non-COVID-19 acute hypoxaemic respiratory failure patients in ICU (SAVE-ICU): protocol for a randomised clinical trial

Por: Jerath · A. · Slessarev · M. · Martin · C. · DAragon · F. · Carrier · F. M. · Senaratne · J. · Meggison · H. · Hooper · J. · Alexandros Cavayas · Y. · Goligher · E. C. · Couture · E. J. · Randall · I. · Hatzakorzian · R. · Jacka · M. · Wiener-Kronish · J. · Xie · Z. · Pinto · R. L. · Cut
Introduction

Inhaled anaesthetics can be used in mechanically ventilated critically ill patients to provide sedation. This approach to sedation potentially improves patient and health system outcomes, but further supportive evidence is needed. The objective of the SAVE-ICU clinical trial is to compare the effectiveness of inhaled versus intravenous sedation in ventilated adults with acute hypoxaemic respiratory failure.

Methods and analysis

SAVE-ICU is a multicentre, open-label, pragmatic, randomised controlled trial conducted in 15 intensive care units (ICUs) in Canada and the USA. Eligible patients include mechanically ventilated and sedated adults with acute hypoxemic respiratory failure from COVID-19 or non-COVID causes with PaO2/FIO2 ratio 12 hour). A hierarchy of outcomes was identified at the time of trial design, as the trial was launched during the COVID-19 pandemic when study drug shortages, staffing challenges and healthcare system pressures were prevalent and there was a requirement for rapid evidence generation and implementation on this topic. The primary outcome and highest in the hierarchy is hospital mortality (requiring 758 participants). Secondary and lower hierarchical outcomes are ventilator-free days at day 30 (200 patients), quality of life at 3 months (144 participants) and ICU-free days at day 30 (128 participants). Additional secondary outcomes include median daily oxygenation at day 3 (PaO2/FIO2 ratio), need for adjunctive acute respiratory distress syndrome therapies (prone positioning, inhaled nitric oxide, paralysis with a neuromuscular blocking agent and extracorporeal membrane oxygenation) during ICU stay, days alive and free from delirium and coma at day 14, hospital-free days at day 60 and disability score at 3 months and 12 months after enrolment.

Ethics and dissemination

The protocol was approved by all hospital ethics committees and by Health Canada. Informed consent will be obtained from substitute decision makers or deferred consent (as permitted by site ethics board). Trial findings will be shared at the end of the study using peer-review publications, conference presentations and social media as part of the trial knowledge translation plan.

Trial registration number

NCT04415060.

National and international guidelines for young adults sexual health education: a scoping review protocol

Por: Borji-Navan · S. · Salehin · S. · NaseriBooriAbadi · T. · Goli · S. · Mirghafourvand · M.
Introduction

Effective young adults’ sexual health education is crucial for promoting informed decision-making and healthy behaviours. National and international guidelines provide a framework for developing and implementing effective programmes. However, these guidelines may vary in their content, focus and recommendations. This scoping review protocol details a plan to map the literature on national and international young adults’ sexual health education guidelines. The review will focus on identifying key dimensions and characteristics of these interventions.

Methods and analysis

Guideline selection will be conducted using the Population, Intervention, Professionals, Outcomes and Healthcare setting/context framework. A comprehensive three-stage search of academic databases, grey literature and citation tracking will be conducted to identify all relevant literature. Data extraction will be performed by two independent researchers using a standardised, piloted data charting form to ensure accuracy and minimise bias. The form will capture key guideline characteristics. The process will be iterative, allowing refinement of variables for comprehensive data capture. Findings will be synthesised and presented using diagrams, tables and a narrative summary to provide a clear overview of the existing literature.

Ethics and dissemination

Adhering to all relevant guidelines and regulations, this study will proceed under the approval of the Ethics Committee of Shahroud University of Medical Sciences, Semnan, Iran. This scoping review will identify and examine the dimensions and characteristics of national and international guidelines for young adults’ sexual health education. By analysing the dimensions and characteristics of these guidelines, this review will identify commonalities, differences and gaps in the current landscape. The findings will have significant implications for policymakers, educators and researchers engaged in the development and implementation of young adults’ sexual health programmes. The results will be disseminated through publication in a relevant peer-reviewed journal to inform future research and practice in this field.

Ethical code: IR.SHMU.REC.1403.085. URL: https://ethics.research.ac.ir/EthicsProposalView.php?id=494573.

❌