Category: Statistics

Turk J Med Sci. 2023 Jun;53(3):761-770. doi: 10.55730/1300-0144.5639. Epub 2023 Jun 19.

ABSTRACT

BACKGROUND: Considering its early bactericidal activity, isoniazid (H) is an important first-line agent in tuberculosis (TB) treatment.The aim of this study was to evaluate the treatment regimens and results of H-resistant pulmonary TB patients.

METHODS: We retrospectively evaluated treatment regimens and results of 188 H-resistant pulmonary TB patients who were treated in our center between January 2015 and December 2017. Treatment regimens applied were noted and treatment outcomes were recorded. The long-term results were evaluated.

RESULTS: Totally 174 (92.6%) of 188 patients with H-resistant pulmonary TB achieved treatment success. Ninety-seven patients (51.6%)were cured and 77 patients (41.0%) completed treatment. Five patients (2.7%) had treatment failure. Four patients (2.1%) having treatment success relapsed during one-year follow-up. Eighteen patients (9.6%) had unfavorable outcomes, including treatment failure in five (2.7%), death in nine (4.8%), and relapse in four patients (2.1%). The treatment success rate was found to be statistically higher in group 1 (9-month regimen 2HREZ/7HRE) compared with those in group 2 (9HREZ) (97.4% vs. 85.9%; p = 0.010). Group 3 (HREZFQ) and group 1 had statistically significant favorable outcomes, compared to group 2 (group 2 vs. group 3, p = 0.048; group 1 vs. group 2, p = 0.022). Interestingly, no relapse and acquired rifampicin resistance in patients occurred who received an FQ-containing regimen.

DISCUSSION: Our study results show higher treatment success and positive results with the treatment regimen containing FQ and that treatment with HREZ for nine months is associated with a lower treatment success rate.

PMID:37476899 | DOI:10.55730/1300-0144.5639

Turk J Med Sci. 2023 Jun;53(3):685-691. doi: 10.55730/1300-0144.5631. Epub 2023 Jun 19.

ABSTRACT

BACKGROUND: Mechanisms to explain inflammation in male infertility of unknown cause are still being investigated. The inflammasome is a key regulator of innate immunity in the inflammatory response to infections. Our study aims to investigate the effects of varicocele on infertility, its relationship with antioxidant and inflammasome mechanisms, and how it could be guided in azoospermic or nonazoospermic patients.

METHODS: A cross-sectional cohort study was conducted at the department of urology in our university hospital. Eightyeight randomly selected men aged 20-45 admitted to our hospital because of infertility between September 2019 and July 2020 were included in the study. Patients were divided into four equal groups according to their clinical status, those with/without azoospermia and with/without varicocele. Blood and semen samples were taken from the patients. NOD-like receptor pyrin domain-containing 3 (NLRP3) and interleukin-1 beta (IL1β) and total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels were measured in serum and semen, and the groups were compared statistically.

RESULTS: Serum and semen NLRP3, IL1β, TAS, TOS, and OSI values of the patients with varicocele or azoospermia were significantlyhigher than those without either varicocele or azoospermia (p < 0.05). The oxidative stress markers TAS, TOS, and OSI values were significantly higher in the other groups than those without azoospermia and varicocele (p < 0.05).

DISCUSSION: Inflammasome mechanisms, such as NLRP3 and IL1-β molecules, may provide additional benefit in evaluating the need and benefit of surgical or medical treatment in infertility with and without vascular pathology and with and without azoospermia.

PMID:37476898 | DOI:10.55730/1300-0144.5631

Turk J Med Sci. 2023 Jun;53(3):803-813. doi: 10.55730/1300-0144.5643. Epub 2023 Jun 19.

ABSTRACT

BACKGROUND: Allergic rhinitis can be associated with bronchial hyperreactivity (BHR) and create an increased risk for allergic asthma development. We aimed to investigate the effects of subcutaneous immunotherapy (SCIT) on BHR and asthma development in adult patients with allergic rhinitis.

METHODS: The retrospective case-control study was carried out between November 2018 and May 2019 in Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital. In this study, data was recorded for patients with a mite and/or grasses/cereals pollen allergy who were tested for BHR before planned SCIT, and who had allergic rhinitis, with or without asthma. The SCIT group was selected as those who received SCIT for at least one year. The control group was selected from those who were scheduled to receive SCIT but were waived and still receiving medication. Symptom scores, prick test results, PC20 levels (methacholine challenge that is a provocative concentration causing a 20% fall in FEV1), and the presence of asthma were recorded and compared with data from at least one year after treatment.

RESULTS: A total of sixty-eight subjects (22 males, 46 females; mean age 40.54 ± 12.27 years; SCIT: 40, Control: 28) were enrolled.Although the changes in log PC20 levels were not statistically significant in both SCIT and control groups after an average of 30-35 months of treatment, it was found to be significant in favor of the SCIT group when two groups were compared in terms of the change in log PC20 (p = 0.026). The development and improvement of asthma were not significantly different between the SCIT and control group but tended to increase in the control group. The percentage of patients with progressed/BHR was significantly higher in the controls (70.6% vs. 38.1%, p = 0.046).

DISCUSSION: In our real life study we have demonstrated the preventative effect of SCIT on BHR, but not on asthma developmen.

PMID:37476897 | DOI:10.55730/1300-0144.5643

Turk J Med Sci. 2023 Jun;53(3):701-711. doi: 10.55730/1300-0144.5633. Epub 2023 Jun 19.

ABSTRACT

BACKGROUND: Texture analysis (TA) provides additional tissue heterogeneity data that may assist in differentiating peripheral zone(PZ) lesions in multiparametric magnetic resonance imaging (mpMRI). This study investigates the role of magnetic resonance imaging texture analysis (MRTA) in detecting clinically significant prostate cancer (csPCa) in the PZ.

METHODS: This retrospective study included 80 consecutive patients who had an mpMRI and a prostate biopsy for suspected prostate cancer. Two radiologists in consensus interpreted mpMRI and performed texture analysis based on their histopathology. The first-, second-, and higher-order texture parameters were extracted from mpMRI and were compared between groups. Univariate and multivariate logistic regression analyses were performed using the texture parameters to determine the independent predictors of csPCa. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance of the texture parameters.

RESULTS: : In the periferal zone, 39 men had csPCa, while 41 had benign lesions or clinically insignificant prostate cancer (cisPCa). Themajority of texture parameters showed statistically significant differences between the groups. Univariate ROC analysis showed that the ADC mean and ADC median were the best variables in differentiating csPCa (p < 0.001). The first-order logistic regression model (mean + entropy) based on the ADC maps had a higher AUC value (0.996; 95% CI: 0.989-1) than other texture-based logistic regression models (p < 0.001).

DISCUSSION: MRTA is useful in differentiating csPCa from other lesions in the PZ. Consequently, the first-order multivariate regressionmodel based on ADC maps had the highest diagnostic performance in differentiating csPCa.

PMID:37476894 | DOI:10.55730/1300-0144.5633

Turk J Med Sci. 2023 Jun;53(3):692-700. doi: 10.55730/1300-0144.5632. Epub 2023 Jun 19.

ABSTRACT

BACKGROUND: Pathophysiologic changes associated with chronic inflammation occur with aging and more prominently in patients with chronic kidney disease (CKD), and an association between chronic inflammation and muscle wasting has been identified. The microcirculation is extremely sensitive to the inflammatory process and actively participates in it. In a healthy adult, angiogenesis is a strictly controlled and rare occurrence. However, aberrant angiogenesis and the development of new tiny blood vessels are known in chronic inflammatory diseases. Superb microvascular imaging (SMI) is a noninvasive technique that can evaluate tiny vessels with low blood flow and provide quantitative data. Our goal was to detect increased blood flow secondary to low-grade chronic inflammation in micro-circulation in the rectus femoris (RF) muscle using SMI.

METHODS: This cross-sectional study involved 30 patients with CKD, 30 adults without CKD or other chronic illnesses, and 32 young healthy volunteers. This study was conducted in our university hospital between March and December 2021. The RF cross-sectional area (CSA) was measured, and vascular index (VI) values were obtained using SMI. All three groups’ RF-CSA and VI values were compared.

RESULTS: Although there was no statistically significant difference in RF-CSAs between the groups, the VI values of all three groups were statistically different (p < 0.001). The median (min-max) VI values were 0.90 (0.60-1.30), 0.50 (0.20-1.0), and 0.30 (0.10-0.50) for the CKD, adult control, and young healthy groups, respectively. The VI significantly differentiated patients with CKD from all other patients and the adult control group. When a cutoff value of 6.5 was used for the VI in detecting increased blood supply in RF muscle in patients with CKD, the accuracy, positive predictive value, and negative predictive value were 93.5%, 85.3%, and 98.3%, respectively.

DISCUSSION: SMI can detect increased blood supply caused by low-grade inflammation in the RF muscle.

PMID:37476893 | DOI:10.55730/1300-0144.5632

Turk J Med Sci. 2023 Jun;53(3):780-790. doi: 10.55730/1300-0144.5641. Epub 2023 Jun 19.

ABSTRACT

BACKGROUND: To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options.

METHODS: We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed.

RESULTS: Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advancedage, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions.

DISCUSSION: The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factorsfor antibacterial resistance individually. Community-acquired UTIs should be followed up time- and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.

PMID:37476892 | DOI:10.55730/1300-0144.5641

Turk J Med Sci. 2023 Apr;53(2):603-609. doi: 10.55730/1300-0144.5621. Epub 2023 Apr 19.

ABSTRACT

BACKGROUND: The Level of Sitting Scale (LSS) is a valid and reliable classification index that categorizes sitting ability. The aim of this study is to establish the Turkish validity and reliability of the LSS in children with cerebral palsy (CP).

METHODS: In total, 165 children (75 girls and 90 boys) between the ages of 4 and 18 years who were diagnosed with CP were included in the study. All children were evaluated by two independent physiotherapists for the interrater reliability analysis of the LSS and were reevaluated 1 week later by the same physiotherapist for the intrarater reliability analysis. The Gross Motor Function Classification System (GMFCS) was used for validity analysis.

RESULTS: The intrarater reliability analyses of the LSS showed an intraclass correlation coefficient of 0.999 (ICC 95% CI [0.999-1]),and the interrater reliability analyses showed an intraclass correlation coefficient of 0.998 (ICC 95% CI [0.998-0.999]). A statistically significant, negative, and strong correlation was found between the GMFCS and the LSS (p < 0.001, r = -0.770).

DISCUSSION: The Turkish version of the LSS in children with CP is a valid and reliable scale. The Turkish LSS can be used by researchersand clinicians in research and to determine the sitting level of children with CP.

PMID:37476883 | DOI:10.55730/1300-0144.5621

Turk J Med Sci. 2023 Apr;53(2):463-474. doi: 10.55730/1300-0144.5606. Epub 2023 Apr 19.

ABSTRACT

BACKGROUND: Renal ischemia-reperfusion (IR) related acute kidney injury (AKI) is an important health problem and has not yet been fully treated. Tarantula cubensis extract (TCE) is a homeopathic drug that has antiinflammatory and antioxidant effects. This study aimed to investigate the effects of TCE on renal ischemia-reperfusion injury in rats.

METHODS: This study was carried out on 48 Spraque-Dawley male rats, which were divided into six groups. The first, second, and third groups were control, sham, and IR groups, respectively. Group four received IR and 0.2 mL of 96% ethanol. Group five and six received ischemia and reperfusion and TCE 0.01 and 0.1 mg per rat (which correspond to approximately 0.04 mg/kg, and 0.4 mg/kg), respectively. Tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1β), total antioxidant status (TAS), and total oxidant status (TOS) levels in renal tissue were measured by enzyme-linked immunosorbent assay (ELISA). Oxidative stress index (OSI) was obtained by proportioning TAS and TOS. Superoxide dismutase (SOD), myeloperoxidase (MPO) activities, and malondialdehyde (MDA) levels were determined by manual spectrophotometric methods. The histopathological changes were evaluated via hematoxylineosin and immunohistochemical staining.

RESULTS: In IR group, renal tissue TNF-α and IL-1β levels were significantly higher than control group (p < 0.0001 for both), and low(p < 0.0001 for both) and high dose (p < 0.0001 for both) TCE administration decreased these markers. Low and high doses of TCE decreased OSI values compared with IR group (p = 0.04 and p = 0.001 respectively). Although TCE decreased MDA levels, it was not statistically significant. MPO levels significantly decreased. In addition, TCE has been found to prevent hemorrhage, cast formation, and dilatation caused by IR in renal tissues stained with hematoxylin-eosin. And also, the most intense nuclear factor kappa B (NFκB) and caspase-3 immunopositivity found in IR group was decreased in both of the TCE groups.

DISCUSSION: Although TCE showed a protective effect by inhibiting inflammation against IR damage in renal tissues, there was no clear effect on oxidative stress. Larger and more detailed studies are needed to clarify the issue.

PMID:37476882 | DOI:10.55730/1300-0144.5606

BMJ Glob Health. 2023 Jul;8(7):e012358. doi: 10.1136/bmjgh-2023-012358.

ABSTRACT

Civil Registration and Vital Statistics (CRVS) systems are the optimal source for data on births, deaths and causes of death for health policy, programme evaluation and research. In Indonesia, indicators such as life expectancy at birth, childhood and maternal mortality rates and cause-specific death rates need to be routinely monitored for national health policy. However, the CRVS system is not yet producing reliable vital statistics, which creates a challenge for evidence-based health action. In 2019, the Indonesian government released a national strategy for the CRVS system, with targets for improved coverage and data quality by 2024. This article describes findings from a programme of formative and implementation research to guide the application of the national strategy. At first, a detailed CRVS assessment and gap analysis were undertaken using an international framework. The assessment findings were used to develop a revised business process model for reporting deaths and their causes at village, subdistrict and district level. In addition, a field instruction manual was also developed to guide personnel in implementation. Two field sites in Java-Malang District and Kudus Regency were selected for pilot testing the reporting procedures, and relevant site preparation and training were carried out. Data compilations for Malang in 2019 and Kudus in 2020 were analysed to derive mortality indicators. High levels of death reporting completeness (83% to 89%) were reported from both districts, along with plausible cause-specific mortality profiles, although the latter need further validation. The study findings establish the feasibility of implementing revised death reporting procedures at the local level, as well as demonstrate sustainability through institutionalisation and capacity building, and can be used to accelerate further development of the CRVS system in Indonesia.

PMID:37474276 | DOI:10.1136/bmjgh-2023-012358

Psychogeriatrics. 2023 Jul 20. doi: 10.1111/psyg.13008. Online ahead of print.

ABSTRACT

BACKGROUND: Effects of a multicomponent exercise programme have an impact on the physical, cognitive, and psychological domains in elderly community-dwellers. However, some individuals aged 65 years or more have not shown positive effects after the intervention as reported in similar research. The objective of this quasi-experimental study was to clarify the effectiveness of a multicomponent programme based on reality orientation therapy (ROT) on the physical performance, cognitive ability, and psychological state in the elderly.

METHOD: Participants were recruited from the general public in 20 areas of Akita Prefecture, Japan, and they took part in each exercise programme for 90 min a day, once every 2 weeks, for 3 months, according to the group classification using cluster randomization into 20 cohorts in Akita. Physical, cognitive, and geriatric depression assessments were performed at baseline and after the 6-month intervention in both the ROT-based intervention group and the control group.

RESULT: The final samples for analysis consisted of 31 participants in the control group and 30 participants in the intervention group. The results of the statistical analysis comparing the two groups showed that the 5-repetition sit-to-stand test was performed significantly faster (P < 0.05) and that the results of the word list memory (WM) test and the Symbol Digit Substitution Task also had significantly improved (P < 0.05) after the intervention in both groups. The WM score did not show an interactive effect between the group and time factors, but it had a significant main effect on time in both groups (P < 0.05).

CONCLUSION: The results of our quasi-experimental study indicated that the multicomponent programme based on the ROT would be as effective as the original multicomponent programme combined with aerobic exercise and cognitive tasks, as highlighted in the WM.

PMID:37474259 | DOI:10.1111/psyg.13008