Category: Statistics

Swiss Med Wkly. 2024 Aug 12;154:3616. doi: 10.57187/s.3616.

ABSTRACT

AIM OF THE STUDY: We aimed to evaluate the utilisation of all prescribed drugs during pregnancy dispensed in outpatient care in Switzerland between 2015 and 2021.

METHODS: We conducted a descriptive study using the Swiss Helsana claims database (2015-2021). We established a cohort of pregnancies by identifying deliveries and estimating the date of the last menstrual period. We analysed the drug burden during a 270-day pre-pregnancy period, during pregnancy (overall and by trimester), and during a 270-day postpartum period. Subsequently, we quantified 1) the median number of drug dispensations (total vs. unique drug claims); and 2) the prevalence of exposure to at least one dispensed drug and the number of dispensed drugs (0, 1, 2, 3, 4, and ≥5); and 3) the 15 most frequently dispensed drugs were identified during each period, overall and stratified by maternal age.

RESULTS: Among 34,584 pregnant women (5.6% of all successful pregnancies in Switzerland), 87.5% claimed at least one drug (not including vitamins, supplements, and vaccines), and 33.3% claimed at least five drugs during pregnancy. During trimester 1 alone, 8.2% of women claimed at least five distinct drugs. The proportion of women who claimed prescribed drugs was lower pre-pregnancy (69.1%) and similar postpartum (85.6%) when compared to during pregnancy (87.5%). The most frequently claimed drugs during pregnancy were meaningfully different during pregnancy than before and after.

CONCLUSIONS: This study suggests that 8 of 10 women in Switzerland are exposed to prescribed drugs during pregnancy. Most drugs dispensed during pregnancy are comparatively well investigated and are considered safe. However, the high drug burden in this vulnerable patient population underlines the importance of evidence on the benefit-risk profile of individual drugs taken during pregnancy.

PMID:39154296 | DOI:10.57187/s.3616

Prostate. 2024 Aug 18. doi: 10.1002/pros.24781. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate contemporary preoperative risk factors and subsequent postoperative management of incidental prostate cancer (iPCa) and incidental clinically significant prostate cancer (icsPCa, Grade Group [GG] ≥ 2 PCa).

METHODS: A retrospective cohort of 811 men undergoing Holmium enucleation of the prostate (HoLEP) (January 2021-July 2022) were identified. Advanced preoperative testing was defined as prostate health index (PHI), prostate MRI, and/or negative preoperative biopsy. Descriptive statistics (Whitney-Mann U test, Chi-squared test) and multivariable logistic regression were performed.

RESULTS: iPCa and icsPCa detection rates were 12.8% (104/811) and 4.4% (36/811), respectively. Advanced preoperative testing (406/811, 50%) was associated with younger age and higher (prostate specific antigen) PSA, prostate volume, and PSA density. On multivariable analysis, PHI ≥ 55 was associated with iPCa (OR 6.91, 95% CI 1.85-26.3, p = 0.004), and % free PSA (%fPSA) was associated with icsPCa (OR 0.83, 95% CI 0.67, 0.94, p = 0.01). GG1 disease comprised the majority of iPCa (65%, 68/104) with median 1% involvement. iPCa patients were followed with active surveillance (median follow up 9.3 months), with higher risk patients receiving prostate MRI and confirmatory biopsy. Three patients proceeded to radical prostatectomy or radiation.

CONCLUSIONS: In the era of MRI and advanced biomarkers, the majority of iPCa following HoLEP is low volume GG1 suitable for active surveillance. A tentative follow-up strategy is proposed. Patients with PHI ≥ 55 or low %fPSA, even with negative prostate MRI, can consider preoperative prostate biopsy before HoLEP.

PMID:39154284 | DOI:10.1002/pros.24781

Lupus. 2024 Aug 18:9612033241274599. doi: 10.1177/09612033241274599. Online ahead of print.

ABSTRACT

INTRODUCTION: Systemic Lupus Erythematosus (SLE) is an autoimmune disease having a variety of clinical symptoms because of multiple organs being affected at once or progressively over time. Cardiovascular system (CVS) involvement is the third most frequent cause of death in SLE, among other factors. The prognosis can be determined by looking at QT interval measurements, which have shown an elevated risk of mortality from cardiovascular causes.

METHODS: A case-control study was conducted on 80 patients (40 SLE patients and 40 controls) for a duration of 16 months. SLE patients and controls were identified from the general medicine and rheumatology outpatient department (OPD) based on the inclusion criteria. A thorough clinical examination was performed after obtaining a detailed clinical history. Baseline blood tests were then performed on the SLE patients and ECG was taken from both cases and controls. The serum uric acid level was measured using an automated analyzer, and the ESR was computed using Westergren’s Method. The corrected QT interval (QTc) was estimated using Bazett’s method. All the collected data were compared and analyzed using IBM SPSS Statistics version 23.0.

RESULTS: The majority of age distribution among SLE patients and controls was 21-25 years (37.5%) (Mean – 15.7 ± 14.9 years). Duration of SLE was predominantly reported between 1 and 12 months (62.5%). Very high (40%) and high (40%) lupus disease activity was recorded in the majority as per the SELENA-SLEDAI score. There was a significant difference between QTc values among SLE patients and controls (t- 8.117) (p-.0005). Upon correlating SLEDAI with the QTc, QTd, ESR, and Uric acid parameters among the SLE patients, ESR parameters were found to be moderately correlated (r-0.460) with the SLEDAI which was statistically significant (p– .003).

CONCLUSION: QTc interval and ESR values can be a simple and potential method for early detection of cardiac involvement in SLE patients with active disease activity. This will not only facilitate early diagnosis of disease activity, but it will also provide an affordable and accessible avenue for low and middle-income countries to decrease the SLE burden.

PMID:39154283 | DOI:10.1177/09612033241274599

Trop Biomed. 2024 Jun 1;41(2):214-219. doi: 10.47665/tb.41.2.013.

ABSTRACT

Leprosy continues to pose a significant challenge to public health, particularly in certain global regions. Accurate diagnosis and understanding of the disease’s etiology are crucial for effective management and prevention. This study aimed to explore the contribution of Natural resistance-associated macrophage protein 1 (NRAMP1) and its genetic variations, as well as the levels of anti-PGL-1 antibodies, to the pathology of multibacillary leprosy in affected individuals and their household contacts. The study included 23 multibacillary leprosy patients and 28 household contacts. NRAMP1 protein expression and anti-PGL-1 IgG and IgM levels were measured using PCR and ELISA techniques, respectively. Genotypic variants of the NRAMP1 gene were also examined. Statistical analyses, including Mann-Whitney tests and univariate logistic regression, were employed to evaluate the data. Significant differences were observed in NRAMP1 protein expression and IgG and IgM levels between the patient and household contact groups. The study also highlighted the role of the NRAMP1 gene and its D543N and 3’UTR polymorphisms in leprosy susceptibility. No significant differences were observed in the genotype variants of INT4 between the two groups. These findings emphasize the potential of integrating PCR technology with serological tests to enhance diagnostic precision in leprosy. They also suggest the need for further research to clarify the role of NRAMP1 and its polymorphisms in leprosy susceptibility and resistance.

PMID:39154276 | DOI:10.47665/tb.41.2.013

Med Oral Patol Oral Cir Bucal. 2024 Aug 18:26676. doi: 10.4317/medoral.26676. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of the study was to compare the efficacy of the use of 0.2% chlorhexidine irrigation and the oral antibiotics for the prevention of postoperative complication like pain, trismus, swelling and infection after the surgical extraction of IMTM.

MATERIAL AND METHODS: A randomised, double blinded clinical trial was planned with two equal groups. Patients were randomly divided into two groups using computer-generated codes with an allocation ratio of 1:1. Group I (Control): Standard preoperative and postoperative systemic oral antibiotics and Group II (Study): No systemic antibiotics and Chlorhexidine irrigation local delivery. The primary outcomes evaluated were postoperative pain, mouth opening, swelling and infection. The secondary outcome variables were the number of analgesics and antibiotics taken by the patient in the postoperative period, the satisfaction of the patient and adverse events, were followed up regulary for 7 days postoperatively.

RESULTS: A total of 84 patients, divided into two equal groups participated in the study. In intergroup comparison of swelling, the difference was non-significant on postoperative day (POD) 1 and 7, except for POD 3, where it showed significantly lower results in the antibiotic group (p = 0.012). However, there was no significant difference in pain found between both groups at any of the postoperative time points, and the study group had a lesser need for rescue analgesics than the control group. A statistically significant difference in incidence of dry socket was observed (p = 0.03) and gastrointestinal adverse symptoms, but it showed insignificant results for wound dehiscence and pus discharge. Also, patient satisfaction was higher in the study group.

CONCLUSIONS: both antibiotics and localised delivery demonstrated comparable results in terms of swelling, pain and trismus. However, with lesser adverse events, the localised chlorhexidine delivery with curved tips outperformed the antibiotic group.

PMID:39154253 | DOI:10.4317/medoral.26676

Catheter Cardiovasc Interv. 2024 Aug 18. doi: 10.1002/ccd.31176. Online ahead of print.

ABSTRACT

BACKGROUND: Predictors of permanent pacemaker implantation (PPMI) after self-expanding transcatheter aortic valve implant (TAVI) were described. Is unknown if PPMI predictors remain in the era of high implants using the cusp overlap (COP).

METHODS: Single-center, prospective, consecutive case series of patients undergoing self-expanding TAVI with the COP approach. The status of PPMI and other clinical events were ascertained at 30 days.

RESULTS: A total of 261 patients were included (84% with Evolut, n = 219). Implant depth >4 mm was infrequent (13.8%). TAVI depth (OR 1.259; p = 0.005), first or second-degree auriculo-ventricular block (OR 3.406; p = 0.033), right-bundle (OR 15.477; p < 0.0001), and incomplete left-bundle branch block (OR 7.964; p = 0.036) were found to be independent predictors of PPMI. The risk of PPMI with deep implant and no electrical disturbances was 3%, and 0% with high implant and no prior electrical disturbances. Those who received PPMI had no statistically significant increased risk of death, myocardial infarction, stroke, bleeding events, or vascular complications at 30 days, but longer hospital stay (mean difference 1.43 days more, p = 0.003).

CONCLUSIONS: Implant depth and prior conduction abnormalities remain the main predictors of PPMI using self-expanding TAVI in the COP era. Patients with high implants and no prior conduction abnormalities may be candidates for early discharge after uneventful self-expanding TAVI, while the rest may need inpatient monitoring regardless of achieving a high implant. The need for PPMI was associated with longer hospital stays.

PMID:39154247 | DOI:10.1002/ccd.31176

Cancer. 2024 Aug 18. doi: 10.1002/cncr.35525. Online ahead of print.

ABSTRACT

BACKGROUND: This study compared incident breast cancer cases in the National Cancer Database (NCDB) and Surveillance, Epidemiology, End Results Program (SEER) to a national population cancer registry.

METHODS: Patients with malignant or in situ breast cancer (BC) 2010-2019 in the NCDB and SEER were compared to the US Cancer Statistics (USCS). Case coverage was estimated as the number of patients in the NCDB/SEER as a proportion of USCS cases.

RESULTS: The USCS reported 3,047,509 patients; 77.5% patients were included in the NCDB and 46.0% in SEER. Case ascertainment varied significantly by patient sex (both registries, p < .001). For males, 84.1% were captured in the NCDB, whereas only 77.5% of females were included. Case coverage in SEER was better for females than males (46.1% vs. 43.5%). Registries varied significantly by race/ethnicity (both p < .001). Case coverage in the NCDB was highest for non-Hispanic White (78.2%), non-Hispanic Black (77.7%), and non-Hispanic Asian or Pacific Islander (72.5%) BC patients, and lowest for Hispanic (56.4%) and non-Hispanic American Indian/Alaska Native (41.1%) patients. In SEER, case coverage was highest for non-Hispanic Asian or Pacific Islander (78.1%) and Hispanic (69.6%) patients and it was significantly lower for all other subgroups (non-Hispanic Black, 44.8%; non-Hispanic White, 42.4%; and non-Hispanic American Indian/Alaska Native, 36.6%).

CONCLUSIONS: National US tumor registries provide data for a large sampling of breast cancer patients, yet significant differences in case coverage were observed based on age, sex, and race/ethnicity. These findings suggest that analyses using these data sets and interpretation of findings should account for these meaningful variances.

PMID:39154223 | DOI:10.1002/cncr.35525

Acta Otolaryngol. 2024 Aug 17:1-8. doi: 10.1080/00016489.2024.2391500. Online ahead of print.

ABSTRACT

BACKGROUND: Cochlear dimension measurements are critical in diagnosing and managing congenital sensorineural hearing loss.

OBJECTIVES: To evaluate the feasibility and reliability of an automated landmark approach for measuring cochlear dimensions (A-, B- and H-values).

MATERIAL AND METHODS: Cochlear parameters from 100 patients were measured by MPR, manual three-dimensional and ALPACA. We assessed intra- and inter-observer reliability as well as inter-method reliability. Statistical analyses were conducted to detect differences between the right and left ears, as well as to assess the relevance of the values obtained using ALPACA.

RESULTS: All A-, B-, and H-values measured by the various methods showed a high intra-observer reliability with intra-class correlation coefficients (ICC) ranging from 0.70 to 0.99, and values gained by ALPACA reaching the highest ICC. Inter-method reliability was at a good level with ICC ranging from 0.51 to 0.86. There were no significant differences between the right and left ears’ measured values. Obvious positive correlations existed among cochlear dimensions measured by ALPACA.

CONCLUSIONS AND SIGNIFICANCE: The ALPACA method can be used to measure cochlear dimensions. Values obtained by the method demonstrate high reliability and consistency with a significant reduction in intra-observer variability compared to results from conventional MPR and manual 3D measurements.

PMID:39154208 | DOI:10.1080/00016489.2024.2391500

Plant Dis. 2024 Aug 17. doi: 10.1094/PDIS-11-23-2503-PDN. Online ahead of print.

ABSTRACT

Maize (Zea mays) is vital as a staple food and livestock feed crop. Yunnan is one of the main maize-producing provinces in China (National Bureau of Statistics, 2022). While corn production in Yunnan is lower than the national average, the development of drought-tolerant varieties has contributed to improving productivity. In August 2021, a new leaf spot disease on maize was observed in Lancang, Yunnan (22°26’38.11″N to 22°48’38.68″N, 99°48’15.13″E to 99°59’20.03″E), causing serious damages to maize production with incidence up to 76.19 %. Initially, small light yellow lesions were seen scattered on diseased maize leaves, round or polygon, measuring 0.3 to 2.0 cm in diameter. In the intermediate phase, these lesions sank, ruptured, and turned white with dark brown borders. In severe cases, they merged into large irregular patches, reaching up to 10 cm, leading to complete leaf necrosis. Small black ascomata were seen on the lesions. Tissue sections reveal perithecium embedded in leaves, measuring 94~145 μm in diameter. Symptomatic tissues were sterilized in 1.5% NaClO for 60s, and washed twice withsterile purified water, then plated on potato dextrose agar (PDA) at 25℃, 90% relative humidity (RH), and a 12-hour light cycle. 6 isolates were obtained from 2 diseased maize cultivars. In 20 days, the colony reached the edge of the PDA plate, the center darkening from white, featuring white aerial mycelium on top and black on the reverse side. Brown ascomata, solitary or clustered, measured 80.1~176.7 × 55.57~138.9 μm. The ellipsoid to oblong ascospores were 17.9~39.7 × 10.9~14.1 μm, and the bitunicate, thick-walled asci were 90.1~133.3 × 26.6~33.5 μm. The genomic DNA was extracted using the Chelex-100 method (Möller et al. 1992). For molecular identification, the ITS, LSU, and β-tubulin (Tub2) genes were amplified using primer pairs ITS1/ITS4 (White et al. 1990), LR0R/LR5 (Vilgalys et al. 1990) and Btub2Fd/Btub4Rd (Woudenberg et al. 2009), respectively. Sequencing was performed by Sangon Biotech (Shanghai) Co., Ltd. The sequenced loci (GenBank accession nos.: LSU, OL687348-53; ITS, OL617009-10, and OL664058-61; Tub2, OL741678-83) of the isolates exhibited 100%/ 99%/ 100% similarities with L. australis genes: LSU, MH868885; ITS, KF381084; Tub2, GU237541, respectively. Using MEGA 11.0, phylogenetic trees were constructed using the maximum-likelihood algorithm on concatenated sequences of LSU, ITS, and Tub2 for isolates LCMB1 to 6. The isolates clustered with two L. australis strains with 100 % bootstrap support (1,000 replicates). The results were consistent with the Bayesian Inference tree. The pathogenicity test used strain LCMB4 on six healthy maize plants during the heading period under natural conditions. Three leaves pre-plant were wounded with sterile sandpaper and sprayed with conidial suspension (106 spores ml-1, diluted in sterilized water) in the greenhouse at 28℃, 90% RH, and a 12-hour light cycle, with sterilized distilled water used for control. Inoculated leaves developed symptoms consistent with the described after 10 days, while control leaves remained symptomless. The same pathogen was re-isolated from the infected leaves, fulfilling Koch’s postulates. Previously, L. australis has been isolated from turfgrass (Mitkowski et al. 2004), Alfalfa (Zhang et al. 2021), soil (Li et al. 2018), and Paris polyphylla var. chinensis (Fu et al. 2019), but not from maize. This is the first report of L. australis causing leaf spot on maize globally.

PMID:39154202 | DOI:10.1094/PDIS-11-23-2503-PDN

Ann Parasitol. 2024;70(2):91-101. doi: 10.17420/ap7002.526.

ABSTRACT

The study involved the estimation of the prevalence of Entamoeba spp. using microscopy and molecular techniques among symptomatic outpatients during April 2021 to March, 2022. Stool samples were collected from 2592 outpatients with amoebiasis symptoms of both sexes and different ages (≤ l to 60). Also, 107 stool samples were taken randomly from asymptomatic individuals and examined microscopically to detect infection with Entamoeba spp. the positive specimens were used for molecular analysis with positive symptomatic samples targeting the 18S rRNA gene by nested PCR. Microscopically 21.68% (562/2592) were positive, for Entamoeba spp. Males showed highest infection rate than females (67.43% vs 32.56%). Ages from 1-10 years showed the highest rate (54.09%), and urban inhabitant had somewhat a higher rate than rural one (58.54% vs 41.45%) which was statistically non-significant(P>0.05). Among asymptomatic individuals, 57% (61/107) were positive for Entamoeba spp. Nested PCR analysis yielded 73% positive samples for Entamoeba spp. with a fragment size of 897 bp. Three fragment sizes were produced, for E. histolytica, E. dispar and E. moshkovskii which were 439, 174 and 553 bps, respectively. Single infection occurred with, E. histolytica in 46%, of symptomatic and 6% of asymptomatic cases, E. dispar in 38% of asymptomatic and 10% of symptomatic cases, E. moshkovskii, reported at very low rate among both groups.

PMID:39154196 | DOI:10.17420/ap7002.526