The association among insomnia symptom severity, comorbid symptoms, and suicidal ideation in two veteran cohorts meeting diagnostic criteria for insomnia disorder

alexandrossfakianakis shared this article with you from Inoreader The association among insomnia symptom severity, comorbid symptoms, and suicidal ideation in two veteran cohorts meeting diagnostic criteria for insomnia disorder via Journal of Clinical Psychology Abstract Objective Examine the association between insomnia symptom severity and suicidal ideation (SI), after adjusting for clinical comorbidity in veterans meeting diagnostic criteria for insomnia disorder. Methods Secondary data analyses of psychometrically validated baseline assessments of depression, posttraumatic stress disorder (PTSD), and anxiety symptoms from two online insomnia intervention randomized clinical trials (n = 232; n = 80) were conducted. Multiple linear regression was used to determine the association between insomnia symptom severity and SI, after controlling for clinical comorbidity and demographics. Results Insomnia symptom severity was significantly correlated with comorbid depression, PTSD, and anxiety symptoms in both cohorts and significantly correlated with SI in one. After controlling for demographics and clinical comorbidity, insomnia symptom severity was not significantly associated with SI in linear regression models. Conclusion Findings extend insomnia-suicide research by providing evidence that insomnia symptom severity may not confer a unique risk for SI above comorbid mental health symptoms in veterans meeting diagnostic criteria for insomnia disorder. View on Web

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Analgesic Effectiveness of Preoperative Ultrasound‐Guided Erector Spinae Plane Block versus Paravertebral Nerve Block for Breast Surgery: A Systematic Review and Meta Analysis of Four Randomized Controlled Trials

alexandrossfakianakis shared this article with you from Inoreader Analgesic Effectiveness of Preoperative Ultrasound‐Guided Erector Spinae Plane Block versus Paravertebral Nerve Block for Breast Surgery: A Systematic Review and Meta Analysis of Four Randomized Controlled Trials via Pain Practice Abstract Objective Our meta-analysis aimed to compare the analgesic effectiveness of ultrasound-guided preoperative erector spinae plane block (ESPB) versus paravertebral nerve block (PVB) in breast surgery. Methods PubMed, EMBASE and the Cochrane Library were searched for randomized controlled trials (RCTs) between January 1, 1980 and April 31, 2021 . The primary endpoints were perioperative pain score, analgesic consumption and assessment of block procedure. The secondary endpoints were intraoperative haemodynamic response, duration of surgery, postoperative antiemetic consumption and adverse effects. Results Four RCTs comprised of a total of 310 patients were included in our meta-analysis. No significant differences in the perioperative pain score and analgesic consumption were observed between ESPB and PVB in the operating room, post-anaesthesia care unit (PACU) and ward (at 1, 16, 12, and 24 hour, and the morning of postoperative day 1 (POD1) (all P > 0.05). Similarly, no significant differences in the duration of block, time to first analgesic, haemodynamic response, duration of surgery, postoperative antiemetic consumption and adverse effects were observed (all P > 0.05). However, our meta-analysis revealed that ultrasound-guided preoperative ESPB significantly reduced the duration of procedure time and frequency of guidance interventions, as well as increasing the block success rate among residents (all P < 0.05). Conclusions Both ultrasound-guided preoperative ESPB and PVB showed comparable analgesic effects in patients undergoing breast surgery. However, with a significantly shorter procedure time and higher block success rate, our findings suggest that ESPB may be a simple alternative to PVB in breast surgery. View on Web

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Prevalence of cervical human papillomavirus and the risk of anal co‐infection in kidney transplant recipients: Results from a Danish clinical study

alexandrossfakianakis shared this article with you from Inoreader Prevalence of cervical human papillomavirus and the risk of anal co‐infection in kidney transplant recipients: Results from a Danish clinical study via Transplant Infectious Disease Abstract Background : Kidney transplant recipients (KTRs) have increased risk of human papillomavirus (HPV)-related cancers, including cervical and anal cancer. In this cross-sectional clinical study, we investigated the prevalence of cervical high-risk HPV (hrHPV) and low-risk (lrHPV), risk factors for cervical hrHPV infection, and the prevalence of cervical and anal hrHPV co-infection in KTRs and immunocompetent controls. Methods : During 2016–2017, we recruited 125 female KTRs and 125 female immunocompetent controls from one dermatology department (KTRs and controls) and five nephrology departments (KTRs) in Denmark. Liquid-based cervical and anal cytology samples were tested for HPV DNA using the INNO-LiPA test and participants answered a questionnaire on lifestyle. Odds ratios (ORs) were estimated using logistic regression, adjusting for age, lifetime sexual partners, smoking, and (in models concerning anal HPV) receptive anal sex. Results : KTRs had higher prevalence of cervical hrHPV than controls (35.5% vs 18.2; ORadjusted = 2.9, 95% CI, 1.5–5.5). In contrast, the prevalence of lrHPV was similar in KTRs and controls (25.6% vs 23.1; ORadjusted = 1.2, 95% CI, 0.7‒2.3). KTRs were more likely than controls to have cervical and anal hrHPV co-infection (27.3% vs. 6.6%, ORadjusted = 6.3, 95% CI, 2.7–15.0). Conclusions : Female KTRs had high prevalence of cervical hrHPV, and co-infection with anal and cervical hrHPV was common. Our results underline that KTRs are an important target group for preventive efforts against HPV-related diseases. This article is protected by copyright. All rights reserved View on Web

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