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Nevin Manimala Statistics

Percutaneous catheter drainage in retroperitoneal abscesses: a single centre’s 8-year experience

Pol J Radiol. 2022 Apr 29;87:e238-e245. doi: 10.5114/pjr.2022.115815. eCollection 2022.

ABSTRACT

PURPOSE: We have investigated the technical and clinical success of percutaneous catheter drainage (PCD) in retroperitoneal abscesses and factors that may affect the outcome.

MATERIAL AND METHODS: The study cohort included 45 patients (17 females and 29 males, with mean age of 56.3 years) that were treated between 2012 and 2020. Forty-seven abscesses were managed with PCD under ultrasonography, computed tomography, or fluoroscopy guidance. Patients’ demographics, lesion locations, predisposing factors, clini-cal presentation, etiology, radiological findings, technical factors, and outcome parameters were presented using exploratory and descriptive statistics.

RESULTS: Abscesses were located in the psoas (n = 25, 55.3%), renal-perirenal (n = 7, 14.8%), and pararenal (n = 14, 29.7%) compartments. The mean preprocedural volume was 263.3 (30-1310) ml. Pain (abdominal and back) (57.4%) and fever (17%) were the most frequent presenting symptoms. The most common predisposing factors were previous surgery (n = 17, 36.1%) and diabetes mellitus (n = 11, 25.5%). Clinical success was attained in 89.3% of abscesses (definitive treatment 72.3% and partial success 17.0%). There was a statistically significant difference between the iatrogenic and non-iatrogenic groups regarding clinical success (p = 0.031). No mortality was encountered. The complication rate was 6.6% and were all minor. The average rate of recurrence was 10.6%. The mean time to catheter removal was 15.8 ± 13.2 days.

CONCLUSIONS: PCD is a safe and effective procedure in the treatment of retroperitoneal abscesses. Procedure-related mortality, morbidity, and complication rates are low. Underlying etiology is a significant factor affecting the outcome. Nevertheless, PCD may provide definitive treatment in the majority of patients.

PMID:35582601 | PMC:PMC9093211 | DOI:10.5114/pjr.2022.115815

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Optic nerve sheath diameter and its implications in the evaluation of cerebral venous sinus thrombosis

Pol J Radiol. 2022 Apr 1;87:e202-e206. doi: 10.5114/pjr.2022.115706. eCollection 2022.

ABSTRACT

PURPOSE: To ascertain the role of optic nerve sheath diameter (ONSD) in the evaluation of cerebral venous sinus thrombosis (CVST).

MATERIAL AND METHODS: A retrospective study with convenient sampling was done during the period November 2018 to January 2020. Forty-one patients across all age groups with magnetic resonance venography (MRV) diagnosis of CVST and 82 gender-matched controls were included in the study. ONSD was measured on axial T2-weighted magnetic resonance images. CVST was identified on axial TOF-MRV including the stage, degree, and location. Intraparenchymal infarction and haemorrhage were also noted with their stage and size. The distribution of values for ONSD was tested for equality of variances using independent samples t-test. A cut-off value for ONSD was derived using ROC analysis.

RESULTS: The mean difference between ONSD of cases and controls was 0.84 mm (95% CI: 0.61-1.06) and was statistically significant at p < 0.001. Mean ONSD in cases was 5.33 ± 0.66, and in the control group it was 4.49 ± 0.31. The cut-off value for ONSD was taken as 4.57 mm, derived using the ROC analysis (AUC was 0.876 suggesting good diagnostic accuracy). ONSD showed a sensitivity of 87% and a negative predictive value of 89% in predicting CVST. However, we found no statistical significance between ONSD in patients with acute or chronic thrombosis or in those with neuroparenchymal complications.

CONCLUSIONS: ONSD is a valid triage tool with high sensitivity and negative predictive value, and it can be used in the evaluation of CVST.

PMID:35582599 | PMC:PMC9093208 | DOI:10.5114/pjr.2022.115706

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Comparison of COVID-19 Inactivated Virus Vaccine Immunogenicity Between Healthy Individuals and Patients on Hemodialysis: A Single-Center Study From Pakistan

Cureus. 2022 Apr 15;14(4):e24153. doi: 10.7759/cureus.24153. eCollection 2022 Apr.

ABSTRACT

Introduction This study compares the immune response after coronavirus disease 2019 (COVID-19) inactivated virus vaccine between healthy individuals (HI) and patients on hemodialysis (HD). Methods In this cross-sectional, comparative study, the presence or absence of immunoglobulin G (IgG) anti-S antibody and IgG anti-S antibody titer was compared between HI, and patients on HD after two doses of COVID-19 vaccine. Results A total of 81 participants, 50 (61.7%) HD patients and 31 (38.3%) HI, were studied. The mean age was 52.9±12 in HD patients and 42±12.4 in HI. Vaccination responder rates were 80.6% in HI and 72% in HD patients after the first dose (p=0.38) and 93.5% in HI and 94% in HD at the third week of the second dose of the vaccine (p=0.93). The mean IgG antibody titer was 156.3±113.8 in HI and 143.4 ± 117.8 in HD patients (p=0.538) after the first dose and 186.7 ± 97.9 in HI and 180.6 ± 105.8 in HD patients (p=0.552) at three weeks of the second dose. No statistically significant difference was found in antibody titer with respect to gender, age, vaccine (BBIBP-CorV or Conovac), and hypertension. Diabetic HD patients had a lower antibody titer than non-diabetic HD patients (p=0.03) while participants who had a history of COVID-19 infection had a higher IgG titer (p = 0.001). The levels of IgG titer in the same patient increased, corresponding to the doses of vaccine (p <0.001). No HD patient developed COVID-19 infection till the third week of vaccination. Conclusion This study demonstrates a similar humoral response after COVID-19 inactivated virus vaccination in HD patients and HI. The response was lower among diabetic patients on HD and better in those with previous COVID-19 infection.

PMID:35582560 | PMC:PMC9107616 | DOI:10.7759/cureus.24153

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What Is the Effect of Inguinal Hernia Operations on Sexual Functions?

Cureus. 2022 Apr 14;14(4):e24137. doi: 10.7759/cureus.24137. eCollection 2022 Apr.

ABSTRACT

OBJECTIVE: The study aimed to evaluate sexual function before and after inguinal hernia surgery using a standard, internationally approved, patient-administered questionnaire.

METHODS: 57 male inguinal hernia cases operated with the Lichtenstein hernioplasty technique were prospectively included in the study. Patients who agreed to participate in the study had the IIEF (International Index of Erectile Function) scoring system form consisting of 15 questions filled in preoperatively, during the first and sixth months after surgery. Patients’ age, BMI, comorbidity, employment status, hernia type, hernia size, and single or bilateral hernia were recorded. The relationship between these variables was evaluated by statistical analysis.

RESULTS: A statistically significant difference was found in terms of erectile function, sexual desire, intercourse function, and overall satisfaction, when the preop-postop first month, preop-postop sixth month, and postoperative first month-postop six-month scores were compared (p < 0.05).

CONCLUSIONS: Pain and swelling due to an inguinal hernia can negatively affect the sexual functions of the patient, and most of the patients benefit from this after the surgery. Sexual dysfunction may be one of the indications for an inguinal hernia operation.

PMID:35582559 | PMC:PMC9107293 | DOI:10.7759/cureus.24137

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Mechanism underlying the immune checkpoint inhibitor-induced hyper-progressive state of cancer

Cancer Drug Resist. 2022 Feb 8;5(1):147-164. doi: 10.20517/cdr.2021.104. eCollection 2022.

ABSTRACT

Immune checkpoint inhibitors (ICIs) are gradually replacing chemotherapy as the cornerstone of the treatment of advanced malignant tumors because of their long-lasting and significant effect in different tumor types and greatly prolonging the survival time of patients. However, not all patients can respond to ICIs, and even rapid tumor growth after treatment with ICI has been observed in a number of clinical studies. This rapid progression phenomenon is called hyper-progressive disease (HPD). The occurrence of HPD is not uncommon. Past statistics show that the incidence of HPD is 4%-29% in different tumor types, and the progression-free survival and overall survival of patients with HPD are significantly shorter than those of the non-HPD progressor group. With the deepening of the study of HPD, we have established a preliminary understanding of HPD, but the diagnostic criteria of HPD are still not unified, and the addition of biomarkers may break this dilemma. In addition, quite a few immune cells have been found to be involved in the occurrence and development of HPD in the tumor microenvironment, indicating that the molecular mechanism of HPD may be triggered by a variety of ongoing events at the same time. In this review, we summarize past findings, including case reports, clinical trials, and fundamental research; compare the diagnostic criteria, incidence, and clinical prognostic indicators of HPD in different studies; and explore the molecular mechanism and future research direction of HPD.

PMID:35582541 | PMC:PMC8992596 | DOI:10.20517/cdr.2021.104

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Prevalence of Aggressive Behavior Toward Fellows, Residents, and Nurses at a Tertiary Care Hospital in Riyadh, Saudi Arabia

Cureus. 2022 Apr 14;14(4):e24142. doi: 10.7759/cureus.24142. eCollection 2022 Apr.

ABSTRACT

Background Workplace bullying (WPB) is a form of mistreatment toward an individual manifested by physical, verbal, or indirect aggression. Affected victims display a wide range of signs and symptoms that impact their health. This study aimed to investigate the prevalence of aggressive behavior toward healthcare workers and its effects on job satisfaction, general health, and mental health. Methodology An online survey comprising a revised version of the Negative Acts Questionnaire-Revised (NAQ-R) was distributed to the fellows, residents, and nurses working in a tertiary care hospital. The survey collected information regarding the group’s demographics and their exposure to WPB encountered in the work environment while maintaining confidentiality. Survey results were analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA). Results Among the 339 participants who filled the survey, 53% of healthcare practitioners in different services had experienced some form of WPB. Among the targeted group, it was noted that female gender (50%), age between 31 and 41 years (57.03%), nurses (51.98%), non-Saudi practitioners (41.94%), and those working in inpatient settings (49.74%) were the most commonly affected individuals in the medical facility. Furthermore, higher bullying prevalence was correlated with lower job satisfaction and mental health levels. Conclusions Age, gender, job, and nationality were factors associated with increased susceptibility to WPB. WPB in any facility is an unfortunate event, especially in a healthcare setting. It affects health practitioners by decreasing job satisfaction, jeopardizing health, and increasing the risk of harm to patients. WPB will eventually have a negative impact on the medical facility and the healthcare sector. Hence, hospital administrations should be alarmed about the rise in WPB, and adequate measures must be taken to deal with the root cause of the problem.

PMID:35582558 | PMC:PMC9107312 | DOI:10.7759/cureus.24142

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Effects of early physical therapy on motor development in children with Down syndrome

North Clin Istanb. 2022 Apr 18;9(2):156-161. doi: 10.14744/nci.2020.90001. eCollection 2022.

ABSTRACT

OBJECTIVE: The objective of the study was to compare the motor development of children with Down syndrome (DS) who received physical therapy (PT) and did not receive PT, and to show the effect of PT programs started before the age of one on movement development.

METHODS: The study included aged between 6 and 42 months, 58 children with DS. Children with DS were divided into two groups as receiving PT and non-receiving PT. Children with DS who received PT were further divided into two groups according to the age of starting PT as before and after 1 year of age. Gross motor and fine motor development of the cases were evaluated with Bayley Scales of Infant and Toddler Development III.

RESULTS: Gross motor scaled scores (GM-SS: 3.88±3.46-1.67±1.23), fine motor scaled scores (FM-SS: 4.29±3.24-1.79±0.93), and composite scores (64.4±19.5-50.38±5.38) of PT group were statistically higher than the non-PT group (p<0.05). In addition, GM-SS (5.22±4.23-2.38±1.20), FM-SS; (5.61±3.85-2.81±1.37), and composite scores (72.33±23.85-55.56±5.7) of the cases who started PT before the age of one were statistically higher than those who started after the age of one (p<0.05).

CONCLUSION: Our results revealed that PT especially when started early childhood under had a positive effect on the development of gross and fine motor in children with DS and provided a scientific basis for referring children with DS to PT programs before the age of one. Clinicians should recommend PT for children with DS in the early period.

PMID:35582517 | PMC:PMC9039636 | DOI:10.14744/nci.2020.90001

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Anidulafungin biliary passage in liver transplant patients

Transpl Infect Dis. 2022 May 17. doi: 10.1111/tid.13848. Online ahead of print.

NO ABSTRACT

PMID:35579962 | DOI:10.1111/tid.13848

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Impact of Nodal Metastases in HPV-negative Oropharyngeal Cancer

Cancer Epidemiol Biomarkers Prev. 2022 May 17:cebp.0776.2021. doi: 10.1158/1055-9965.EPI-21-0776. Online ahead of print.

ABSTRACT

BACKGROUND: The updated American Joint Committee on Cancer (AJCC) 8th Edition staging manual restructured nodal classification and staging by placing less prognostic emphasis on nodal metastases for HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). However, there was no change for HPV-negative OPSCC. The purpose of our study is to examine the impact of nodal metastases on survival in HPV-negative OPSCC.

METHODS: HPV-negative OPSCC were queried from the NCDB and SEER databases. Univariable and multivariable models were utilized to determine the impact of nodal status on overall survival. These patients were reclassified according to AJCC 8 HPV-positive criteria (TNM8+) and risk stratification was quantified with C-statistics.

RESULTS: There were 11,147 cases of HPV-negative OPSCC in the NCDB and 3,613 cases in SEER that were included in the nodal classification analysis. Unlike non-oropharyngeal malignancies, increased nodal stage is not clearly associated with survival for patients with OPSCC independent of HPV status. When the TNM8+ was applied to HPV-negative patients, there was improved concordance in the NCDB cohort, 0.561 {plus minus} 0.004 to 0.624 {plus minus} 0.004 (difference +0.063) and the SEER cohort, 0.561 {plus minus} 0.008 to 0.625 {plus minus} 0.008 (difference +0.065).

CONCLUSIONS: We demonstrated a reduced impact of nodal metastasis on OPSCC survival, independent of HPV-status and specific to OPSCC.

IMPACT: We demonstrate, that when nodal staging is de-emphasized as a part of overall staging, we see improved concordance and risk stratification for HPV-negative OPSCC. The exact mechanism of this differential impact remains unknown but offers a novel area of study.

PMID:35579907 | DOI:10.1158/1055-9965.EPI-21-0776

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Community, Time, and (Con)text: A Dynamical Systems Analysis of Online Communication and Community Health among Open-Source Software Communities

Cogn Sci. 2022 May;46(5):e13134. doi: 10.1111/cogs.13134.

ABSTRACT

Free and open-source software projects have become essential digital infrastructure over the past decade. These projects are largely created and maintained by unpaid volunteers, presenting a potential vulnerability if the projects cannot recruit and retain new volunteers. At the same time, their development on open collaborative development platforms provides a nearly complete record of the community’s interactions; this affords the opportunity to study naturally occurring language dynamics at scale and in a context with massive real-world impact. The present work takes a dynamical systems view of language to understand the ways in which communicative context and community membership shape the emergence and impact of language use-specifically, sentiment and expressions of gratitude. We then present evidence that these language dynamics shape newcomers’ likelihood of returning, although the specific impacts of different community responses are crucially modulated by the context of the newcomer’s first contact with the community.

PMID:35579857 | DOI:10.1111/cogs.13134