Category: Statistics

Med Sci (Basel). 2025 Mar 12;13(1):29. doi: 10.3390/medsci13010029.

ABSTRACT

BACKGROUND: Synthetic 2D mammography was developed to decrease radiation exposure, but to our knowledge there have been no studies evaluating the impact of implementation of full field synthetic mammography/digital breast tomosynthesis (FFSM/DBT) on indications for stereotactic biopsy.

OBJECTIVE: To compare indications and biopsy outcomes for stereotactic biopsy for full field digital mammography (FFDM/DBT) to those of FFSM/DBT.

METHODS: Retrospective chart review of stereotactic biopsies performed from July 2014 to September 2018. Reports were reviewed and indication for biopsy, lesion size, and final pathology were recorded. Comparison between the two groups following transition to FFSM/DBT in 2016 was performed.

RESULTS: 66 of 361 stereotactic biopsies performed in the FFDM/DBT group were malignant (PPV 18.3%), compared to 60 of the 391 biopsies performed in the FFSM/DBT group (PPV 15.4%) with no significant difference in PPV (p = 0.281). There were statistically significant changes in indications for biopsies after transitioning to FFSM/DBT: with a decrease in calcifications referred for biopsy (68.03% vs. 89.75%; p < 0.001), and a statistically significant increase in referral of masses (10.74% vs. 4.43%; p < 0.001), asymmetries (15.60% vs. 5.26%; p < 0.001), and architectural distortion (5.63% vs. 0.55%; p < 0.001). PPV across all indications (21.8% in FFSM/DBT vs. 20.3% in FFDM; p = 0.213), and invasive cancer yield (5.63% vs. 3.32%; p = 0.129) remained comparable following transition to FFSM/DBT without statistically significant differences.

CONCLUSIONS: Following transition to FFSM/DBT, statistically significant shifts in indications for biopsies were observed with a decrease in referral of calcifications and an increase for masses, asymmetries and architectural distortions. PPV for stereotactic biopsy was not significantly different and cancer yield across all indications remained similar, with an increase in invasive cancer diagnosis.

PMID:40137449 | DOI:10.3390/medsci13010029

Med Sci (Basel). 2025 Mar 1;13(1):25. doi: 10.3390/medsci13010025.

ABSTRACT

Background/Objectives: Stress urinary incontinence (SUI) is a common and often under-reported condition that significantly impacts quality of life. SUI is more than just a physical issue; it can also affect social interactions, mental health, and emotional well-being due to the embarrassment and limitations it can cause. SUI is often acquired during pregnancy and childbirth as a result of pelvic floor muscle weakness. The aim of this study was to evaluate the effectiveness of an innovative dual-wavelength laser system (CO₂ + 1540 nm) in SUI management. Methods: A total of 56 women affected by SUI were enrolled in this study. Half of the patients were treated with CO₂ alone, while the other half were treated with the combination of CO₂ + 1540 nm wavelengths. The patients were split into four groups based on the type of treatment they received and their menopausal status. Data were acquired at baseline and at various follow-ups (T1, T2, and T3, respectively, after the first, second, and third treatment). The Visual Analog Scale (VAS) (score 0-10) was used. Cystoscopic images were acquired before and at the end of the laser treatment cycle. Results: At the end of the treatment, the patients in each group were very satisfied, on average. In each group, the treatment led to a statistically significant improvement in the SUI VAS score between baseline and follow-up after the first treatment; in both groups 3 and 4, the treatment led to a significant change in the dryness score, both from baseline to T1 (p < 0.05) and also for T2 and T3 compared to baseline. Finally, cystoscopic photos showed an evident increase in mucosa epithelial thickness after the laser treatment cycle. Conclusions: The use of a dual-wavelength laser system (CO₂ + 1540 nm) was proven to be well tolerated and safe, with promising outcomes in reducing SUI symptoms, especially in non-menopausal patients.

PMID:40137445 | DOI:10.3390/medsci13010025

Med Sci (Basel). 2025 Mar 1;13(1):22. doi: 10.3390/medsci13010022.

ABSTRACT

BACKGROUND: Urinary incontinence and low back pain are often present during pregnancy and after childbirth. The aim of this study was to examine the relationship between the number of children with the occurrence of urinary incontinence and low back pain after pregnancy in the Greek population.

MATERIALS AND METHODS: Seventy-one Greek women (M = 35.0 age, SD = ±4.3) with specific inclusion criteria completed just once the International Consultation on Incontinence Questionnaire and the Oswestry Disability Questionnaire after five years from childbirth.

RESULTS: A total of 28.2% of the participating women experienced urinary incontinence, and 38% experienced low back pain after pregnancy. No relationship has been found between urinary incontinence and the number of births (r = 0.062, p = 0.609) and low back pain with the number of births (r = -0.076, p = 0.529). Statistically significant correlations were found between urinary incontinence and low back pain (r = 0.33, p < 0.01) and the urinary incontinence and the maternal age at first delivery (r = -0.264, p = 0.026) in women who underwent a vaginal delivery in second birth had fewer urinary incontinence symptoms and increased low back pain.

CONCLUSIONS: Few correlations emerged in the present study. Future research is necessary to be conducted to examine the relationship between postpartum women’s demographic data, urinary incontinence, and low back pain.

PMID:40137442 | DOI:10.3390/medsci13010022

Expert Rev Vaccines. 2025 Mar 26. doi: 10.1080/14760584.2025.2485252. Online ahead of print.

ABSTRACT

BACKGROUND: As the COVID-19 pandemic transitions into its fourth year, understanding the dynamics of immunity is critical for implementing effective public health measures. This study examines vaccine-induced, natural, and hybrid immunity to SARS-CoV-2 in Hong Kong, focusing on their protective effectiveness and waning characteristics against infection during the Omicron BA.1/2 dominant period.

RESEARCH DESIGN AND METHODS: We conducted a territory-wide retrospective cohort study using vaccination and infection records from the Hong Kong Department of Health. The analysis included over 6.5 million adults, applying the Andersen-Gill model to estimate protective effectiveness while addressing selection bias through inverse probability weighting.

RESULTS: Vaccine-induced immunity peaked one month after the first dose but waned rapidly, while boosters significantly prolonged protection. Infection-induced immunity showed higher initial effectiveness but declined faster than vaccine-induced immunity. Hybrid immunity provided the most durable protection. mRNA vaccines (Comirnaty) demonstrated greater effectiveness and slower waning compared to inactivated vaccines (CoronaVac).

CONCLUSIONS: Hybrid immunity represents the most effective strategy for sustained protection against SARS-CoV-2. Public health policies should emphasize booster campaigns and hybrid immunity pathways to enhance population-level immunity and guide future COVID-19 management in Hong Kong.

PMID:40137440 | DOI:10.1080/14760584.2025.2485252

JMIR Form Res. 2025 Mar 26;9:e65767. doi: 10.2196/65767.

ABSTRACT

BACKGROUND: Children with autism spectrum disorders (ASDs) often struggle with processing information, which can impact their coordination, balance, and other motor skills. Studies have demonstrated that intervention programs based on sensory integration can enhance motor performance in these children.

OBJECTIVE: The objective of this study is to evaluate the applicability of a standardized battery of gross motor skill tests for Moroccan children aged 6 to 12 years with ASD. The objective is to assess the potential efficacy of an innovative pedagogical approach focused on sensorimotor integration and hyperstimulation. This approach will be compared to traditional physical education (PE) sessions to determine its feasibility and potential to bridge the developmental gaps in motor skills between children with ASD and those with a neurotypical profile.

METHODS: A convenience sample of 14 Moroccan children with ASD aged 6 to 12 years participated in this exploratory study. Children with ASD were divided into an experimental group (n=7) and a control group (n=7) based on age, sex, motor performance, and socioeconomic status. The control group followed the standard PE program, while the experimental group underwent a specialized program combining sensorimotor integration and hyperstimulation for a period of 15 weeks. All participants were classified as level 2 (moderate) on the Autism Severity Rating Scale based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria. Gross motor skills were measured at baseline and after 15 weeks of intervention using the UQAC-UQAM (University of Québec in Chicoutimi-University of Québec in Montréal) test battery protocol, which includes 10 items.

RESULTS: At baseline (T1), no significant difference was observed between the control and experimental groups of children with ASD. Following the 15-week intervention, the group participating in traditional PE showed an overall improvement in motor skills of approximately 14.5%. Conversely, the results of the ASD experimental group suggest a more substantial improvement of 44.5%. Additionally, the experimental group exhibited significant better performance across all motor skill variables compared to the control group (minimum P values of <.02) with large effect sizes (>0.80). In this regard, a 2-way repeated measures ANOVA confirms the efficiency of the program implemented within the experimental group, demonstrating significant effects associated with both group and time factors as well as a clinically highly significant group×time interaction across all measured variables (η²p>0.14).

CONCLUSIONS: The results of this study suggest that the approach that emphasizes sensorimotor integration and management of hyperstimulation was more effective in improving motor skills in this population. However, other more exhaustive studies will need to be carried out in order to be able to more precisely measure the full potential of this approach.

PMID:40137439 | DOI:10.2196/65767

J Pers Med. 2025 Mar 11;15(3):108. doi: 10.3390/jpm15030108.

ABSTRACT

Background/Objectives: Tibial plateau fractures (TPFs) are commonly associated with complex patterns requiring advanced surgical strategies. High-energy trauma often results in severe soft tissue damage, complicating surgical outcomes. Despite advancements in soft tissue management, postoperative complications such as surgical site infections (SSIs) remain prevalent, with rates ranging from 9.9% to 30%. This study aims to analyze risk factors and surgical approaches influencing acute SSIs following TPF fixation. Methods: A retrospective analysis was conducted on 365 patients treated for TPFs with open or arthroscopy-assisted reduction and internal fixation (ORIF/ARIF) at a single center between January 2018 and December 2023. Inclusion criteria encompassed fractures classified by the Schatzker system and definitive management through ORIF/ARIF. Exclusion criteria included non-tibial plateau fractures, polytrauma, multiligament injuries and associated femoral fractures. Patient demographics, fracture patterns, surgical interventions, and postoperative complications were reviewed. Statistical analysis was performed using chi-square and ANOVA tests, with significance set at p < 0.05. Results: The final cohort included 364 patients (mean age: 45.4 ± 17.4 years; 59.2% male). High-energy fractures (Schatzker IV-VI) accounted for 47.7%, with 6.86% being open fractures. The mean interval to surgery was 14.9 ± 20.6 days. Superficial infections occurred in 21 cases (5.8%), predominantly at external fixator pin sites, while 15 cases (4.1%) involved deep infections. A statistically significant correlation was observed between SSIs and preoperative fasciotomy (p < 0.0001), damage control orthopedic protocols (p < 0.0001), and delays in definitive treatment of 10-30 days (p < 0.0001). No significant associations were found between infection rates and fracture type, dual surgical approaches, or the use of arthroscopy. Conclusions: External fixation, preoperative fasciotomy, and delayed definitive treatment are independent risk factors for SSIs following TPF fixation. High-energy injuries and soft tissue damage exacerbate infection risk. A personalized surgical approach, based on minimally invasive techniques and optimized surgical timing may mitigate these complications and significantly improve clinical outcomes in TPFs.

PMID:40137424 | DOI:10.3390/jpm15030108

J Pers Med. 2025 Mar 9;15(3):106. doi: 10.3390/jpm15030106.

ABSTRACT

Background: Diabetes mellitus (DM) is a global healthcare concern with a rising prevalence. Patients with DM have a severely diminished quality of life due to the extensive range of connected complications. One of the most impactful diabetes-associated pathologies is diabetic macular edema (DME), as it is a major cause of blindness globally. Patients with DME present many concomitant diseases that influence their prognosis. The present research seeks to describe the most frequent DME-related comorbidities. Method: This study enrolled 105 participants previously diagnosed with type 1 DM (T1DM) or type 2 DM (T2DM) (77 presenting with DME), who were evaluated regarding other associated comorbidities. Results: Patients in the DME group presented a median age of 65, with a mean disease duration of 15 years and inadequate glycemic control, reflected by a mean HbA1c of 7.5%. All patients presented at least one comorbidity, with hypertension (100%) and dyslipidemia (62.3%) being the most prevalent. Spearman analysis revealed a statistically significant correlation between DME and diabetes duration (p = 0.01), proliferative diabetic retinopathy (p = 0.004), and chronic kidney disease (p = 0.034). Conclusions: Patients with DME often present multiple comorbidities that must be screened for and addressed through a multidisciplinary approach.

PMID:40137422 | DOI:10.3390/jpm15030106

J Pers Med. 2025 Feb 28;15(3):95. doi: 10.3390/jpm15030095.

ABSTRACT

Background/Objectives: Degenerative lumbar spine conditions are a major cause of disability, particularly in elderly patients or those with comorbidities. Surgical treatment often combines decompression and stabilization to address pain and instability. Pedicle screws are the gold standard for stabilization but pose challenges in patients with compromised bone quality. Interspinous devices have emerged as a less invasive alternative, but comparative studies are limited. This study aimed to compare clinical and surgical outcomes of lumbar decompression with stabilization using pedicle screws versus interspinous devices. Methods: A retrospective cohort study was conducted on patients who underwent lumbar decompression with either pedicle screw fixation or interspinous device stabilization at Mater Olbia Hospital between February 2020 and February 2023. Outcomes were evaluated using VAS for back and leg pain, SF-36 for quality of life, EQ-5D, and SCL-90 for psychological factors. Statistical analysis included paired t-tests, chi-square tests, and multivariate regression. Results: A total of 728 patients were included. The interspinous device group consisted of older patients with higher comorbidity burdens (mean age: 68.4 vs. 59.2 years, p < 0.001). Surgical time and incision size were significantly shorter in the interspinous group (p < 0.001), and no postoperative complications were reported, compared to 3.5% in the pedicle screws group (p < 0.05). Both groups demonstrated significant improvements in pain (VAS), quality of life (SF-36, EQ-5D), and psychological outcomes (SCL-90). Somatization and paranoid ideation were significant predictors of worse postoperative pain, particularly in the pedicle screws group. No significant differences in quality-of-life improvements were observed between the groups. Conclusions: Both stabilization techniques are effective for lumbar spine surgery, with interspinous devices offering a safer and less invasive option for high-risk patients. Psychological factors significantly influence pain outcomes, underscoring the need for a comprehensive approach addressing both physical and psychological aspects to optimize patient recovery.

PMID:40137410 | DOI:10.3390/jpm15030095

J Pers Med. 2025 Feb 28;15(3):93. doi: 10.3390/jpm15030093.

ABSTRACT

Background: Certain CYP2D6 genotypes are linked to a lower efficacy of tamoxifen therapy. This study aimed to observe CYP2D6 polymorphisms and examine the impact of CYP2D6 genotyping among tamoxifen-treated breast cancer patients in Indonesia. Methods: 150 breast cancer participants were recruited. Buccal swab samples were collected; gDNA was extracted and genotyped using the qPCR method. Blood samples were collected, and measurement of tamoxifen metabolite levels was performed using UPLC-MS/MS. Results: 43.3% (n = 65) of participants were IMs. *10 was the most common haplotype (n = 89, 29.7%), followed by *36 (n = 73, 29.7%), making *10/*36 the most common diplotype (n = 34, 22.7%) in this study. The difference in endoxifen levels between the NM and IM-PM groups at baseline was statistically significant (p ≤ 0.001). A dose increase in tamoxifen to 40 mg daily successfully increased endoxifen levels in IMs to a similar level with NMs at baseline (p > 0.05) without exposing IMs to serious side effects. No statistically significant differences were observed between the 20mg group and the 40 mg group on the adjusted OS (p > 0.05) and the adjusted PFS (p > 0.05). Conclusions: Our study observed a considerably high proportion of CYP2D6 IMs. The dose adjustment of tamoxifen was proven to significantly and safely improve the level of endoxifen and survival.

PMID:40137409 | DOI:10.3390/jpm15030093

J Pers Med. 2025 Feb 26;15(3):87. doi: 10.3390/jpm15030087.

ABSTRACT

Background/Objectives: Anterior cervical spine surgery (ACSS) is an effective surgical procedure used to treat degenerative cervical spine disease. Enhanced recovery after surgery (ERAS) is a new and promising paradigm for ACSS. The purpose of this study is to investigate the role of neuromuscular monitoring with sugammadex in the ERAS protocol, which had not been confirmed in ACSS. Methods: In this retrospective study, the electronic medical records of patients aged 20 to 80 years who had undergone first-time ACSS performed in the period from 1 December 2018 to 31 December 2023 were reviewed. Patients were divided into ERAS and non-ERAS groups. Inverse probability of treatment weighting (IPTW) was used to balance differences between the groups. Statistical analyses were conducted using SPSS 20, including independent samples t-tests, chi-square tests, linear regression, and logistic regression. Results: A total of 394 patients were included in this study: 163 in the non-ERAS group and 231 in the ERAS group. In the ERAS group, significant reductions were observed in several key outcomes compared with the non-ERAS group: LOS was reduced by 0.62 days (p < 0.001), hospital costs were lowered by NTD 13,174.40 (p < 0.001), ventilator time was decreased by 149.40 min (p < 0.001), time to first oral intake was shortened by 4.71 h (p < 0.001), and time to first ambulation was reduced by 8.00 h (p < 0.001). No significant differences in complication rates were observed between the two groups. Conclusions: The ACSS-tailored ERAS pathway with NMM and sugammadex can reduce LOS, cost, and speed of patient recovery without increasing complications.

PMID:40137403 | DOI:10.3390/jpm15030087