Category: Statistics

J Clin Immunol. 2024 Apr 17;44(4):101. doi: 10.1007/s10875-024-01709-6.

ABSTRACT

PURPOSE: Inborn errors of immunity (IEI) are a heterogeneous group of diseases with variable clinical phenotypes. This study was conducted to describe the epidemiology, clinical presentations, treatment, and outcome of IEI in Jordanian children.

METHODS: A retrospective data analysis was conducted for children under 15 years diagnosed with IEI from the pediatric Allergy, Immunology, and Rheumatology Division-based registry at Queen Rania Children’s Hospital, Amman, Jordan, between 2010 and 2022.

RESULTS: A total of 467 patients, 263 (56.3%) males and 204 (43.7%) females, were diagnosed with IEI. The mean age at symptom onset was 18 months (1 week to 144 months), a positive family history of IEI was reported in 43.5%, and the consanguinity rate was 47.9%. The most common IEI category was immunodeficiencies affecting cellular and humoral immunity at 33.2%, followed by predominantly antibody deficiencies at 16.9%. The overall median diagnostic delay (range) was 6 (0-135) months; patients with a positive family history of IEI had a statistically significant shorter diagnostic delay. Pulmonary and gastrointestinal clinical features were the most common at 55.2% and 45.6%, respectively. The overall mortality was 33.2%; the highest rate was reported in severe combined immunodeficiency at 56.2%.

CONCLUSIONS: The high minimal estimated IEI prevalence at 16.2/100,000 Jordanian children compared to the regional and worldwide data, with the diversities in clinical presentation and distribution of IEI categories in our cohort point to unique features of IEI in Jordanian children, call for national registry establishment, regional and international collaborative networks.

PMID:38630413 | DOI:10.1007/s10875-024-01709-6

Environ Sci Pollut Res Int. 2024 Apr 17. doi: 10.1007/s11356-024-33180-6. Online ahead of print.

ABSTRACT

Bisphenol A (BPA) is a widespread organic micro-pollutant, found in most environments, including alpine and Arctic regions, and several matrices such as waters and aerosols. Polar regions are characterized by periods of intense irradiation with no sunset due to the continuous sunlight, while alpine areas, despite following the day-night cycle of mid-latitudes, also undergo strong irradiation. For such conditions, it is possible that a fraction of the BPA present in snow may degrade through direct photolysis, producing other unknown species with different environmental mobility and possible ecotoxic effects. Furthermore, the snowpack is rich in species (known as photosensitizers) that facilitate indirect photodegradation processes through reactions involving hydroxyl radicals · OH , singlet oxygen (¹O₂), excited triplet states of the organic fraction (³CDOM*), and nitrite/nitrate. In this study, we investigated both direct and indirect photodegradation of BPA in the presence of specific photosensitizers producing · OH , ¹O₂, ³CDOM*, and NO₂^– to specifically explore the products of the reaction. The study was conducted in both liquid water and ice, under light and dark conditions. Results, obtained by HPLC-HRMS, revealed that the matrix in which the reaction takes place, in addition to the photosensitizer used, may influence the degradation by-products. This allows for the possibility of distinguishing the reaction environment based on the identified product.

PMID:38630396 | DOI:10.1007/s11356-024-33180-6

J Neurooncol. 2024 Apr 17. doi: 10.1007/s11060-024-04668-5. Online ahead of print.

ABSTRACT

PURPOSE: The impact of age on optimal management of glioblastoma remains unclear. A recent combined analysis of two randomised trials, GEINO14-01 and EX-TEM, found no benefit from extending post-radiation temozolomide in newly diagnosed glioblastoma. Here, we explore the impact of age.

METHODS: Relevant intergroup statistics were used to identify differences in tumour, treatment and outcome characteristics based on age with elderly patients (EP) defined as age 65 years and over. Survival was estimated using the Kaplan Meier method.

RESULTS: Of the combined 205 patients, 57 (28%) were EP. Of these, 95% were ECOG 0-1 and 65% underwent macroscopic resection compared with 97% and 61% of younger patients (YP) respectively. There were numerically less MGMT-methylated (56% vs. 63%, p = 0.4) and IDH-mutated (4% vs. 13%, p = 0.1) tumours in EP vs. YP. Following surgery, EP were more likely to receive short course chemoradiation (17.5% vs. 6%, p = 0.017). At recurrence, EP tended to receive or best supportive care (28.3% vs. 15.4%, p = 0.09) or non-surgical options (96.2% vs. 84.6%, p = 0.06), but were less likely to receive bevacizumab (23.1% vs. 49.5%, p < 0.01). Median PFS was similar at 9.3months in EP and 8.5months in YP, with similar median OS at 20months.

CONCLUSION: In this trial population of predominantly fit EP, survival was similar to YP despite a proportion receiving less aggressive therapy at diagnosis and recurrence. Advancing age does not appear to be an adverse prognostic factor for glioblastoma when patients are fit for treatment, and a less aggressive approach in selected patients may not compromise outcomes.

PMID:38630385 | DOI:10.1007/s11060-024-04668-5

EJNMMI Res. 2024 Apr 17;14(1):40. doi: 10.1186/s13550-024-01095-5.

ABSTRACT

BACKGROUND: The aim of this study was to assess the impact of the post-injection electrical seizure duration on the identification of the seizure onset zone (SOZ) in ictal brain perfusion SPECT in presurgical evaluation of drug-resistant epilepsy.

METHODS: 176 ictal SPECT performed with ^99mTc-HMPAO (n = 140) or -ECD (n = 36) were included retrospectively. Visual interpretation of the SPECT images (together with individual MRI and statistical hyperperfusion maps) with respect to lateralization (right, left, none) and localization (temporal, frontal, parietal, occipital) of the SOZ was performed by 3 independent readers. Between-readers agreement was characterized by Fleiss’ κ. An ictal SPECT was considered “lateralizing” if all readers agreed on right or left hemisphere. It was considered “localizing” if it was lateralizing and all readers agreed on the same lobe within the same hemisphere. The impact of injection latency and post-injection seizure duration on the proportion of lateralizing/localizing SPECT was tested by ANOVA with dichotomized (by the median) injection latency and post-injection seizure duration as between-subjects factors.

RESULTS: Median [interquartile range] (full range) of injection latency and post-injection seizure duration were 30 [24, 40] (3-120) s and 50 [27, 70] (-20-660) s, respectively. Fleiss’ κ for lateralization of the SOZ was largest for the combination of early (< 30 s) injection and long (> 50 s) post-injection seizure duration (κ = 0.894, all other combinations κ = 0.659-0.734). Regarding Fleiss’ κ for localization of the SOZ in the 141 (80.1%) lateralizing SPECT, it was largest for early injection and short post-injection seizure duration (κ = 0.575, all other combinations κ = 0.329-0.368). The proportion of lateralizing SPECT was lower with short compared to long post-injection seizure duration (estimated marginal means 74.3% versus 86.3%, p = 0.047). The effect was mainly driven by cases with very short post-injection seizure duration ≤ 10 s (53.8% lateralizing). Injection latency in the considered range had no significant impact on the proportion of lateralizing SPECT (p = 0.390). The proportion of localizing SPECT among the lateralizing cases did not depend on injection latency or post-injection seizure duration (p ≥ 0.603).

CONCLUSIONS: Short post-injection seizure duration is associated with a lower proportion of lateralizing cases in ictal brain perfusion SPECT.

PMID:38630381 | DOI:10.1186/s13550-024-01095-5

Clin Auton Res. 2024 Apr 17. doi: 10.1007/s10286-024-01028-1. Online ahead of print.

ABSTRACT

PURPOSE: To investigate sex-related differences in the clinical presentation of multiple system atrophy (MSA) through a literature review and an analysis of a retrospective cohort.

METHODS: The PubMed database was searched for articles including sex-related information in MSA. In a retrospective Innsbruck cohort, we investigated the baseline to last available follow-up clinical-demographic differences between men and women with MSA in a univariate fashion, followed by multivariable binary regression analysis.

RESULTS: The literature search yielded 46 publications with sex-related information in MSA. Most studies found comparable survival rates between the sexes, while some recent reports suggested a potential survival benefit for women, possibly due to initial motor onset and overall less severe autonomic failure compared to men. The retrospective Innsbruck MSA cohort comprised 56 female and 60 male individuals with a comparable median follow-up of 27 months. At baseline, female sex was independently associated with depression (odds ratio [OR] 4.7; p = 0.007) and male sex with severe orthostatic hypotension (OR 5.5; p = 0.016). In addition, at last follow-up, female sex was associated with the intake of central nervous system-active drugs (OR 4.1; p = 0.029), whereas male sex was associated with the presence of supine hypertension (OR 3.0; p = 0.020) and the intake of antihypertensive medications (OR 8.7; p = 0.001). Male sex was also associated with initiation of antihypertensive medications over the observation period (OR 12.4; p = 0.004).

CONCLUSION: The available literature and findings of the present study indicate sex-related differences in the clinical presentation of MSA and its evolution over time, highlighting the importance of considering sex in symptom exploration, therapeutic decision-making, and future clinical trial design.

PMID:38630378 | DOI:10.1007/s10286-024-01028-1

Environ Monit Assess. 2024 Apr 17;196(5):457. doi: 10.1007/s10661-024-12619-w.

ABSTRACT

This study aims to examine the health effects of smog on different age groups in Gujranwala and its associated health effects. To achieve this, primary data was gathered through a questionnaire survey focused on health issues faced by elderly individuals during the smog season. The results of the survey revealed that older adults in Gujranwala are particularly vulnerable to a range of health problems during this period, including coughing, throat infections, irritated eyes, runny noses, shortness of breath, chest pain while breathing, wheezing, asthma, heart problems, and respiratory issues. In order to analyze the spatial distribution of these health concerns, spatial and geo-statistical methods were employed utilizing ArcGIS 10.5. By integrating field data and secondary sources, hotspot and cold spot zones were identified. Employing the statistical model within ArcMap 10.5, hotspot analysis was performed to determine areas with elevated air quality index (AQI) values and associated health problems. The application of the inverse distance weighted approach, incorporating the Z value, facilitated a visual representation of areas with heightened and reduced AQI and health-related issues. The study’s outcomes underscore the prevalence of health challenges among older adults during the winter months in Gujranwala, particularly linked to smog-induced throat infections, irritated eyes, and runny noses. The research identified zones with escalated AQI values, encompassing regions such as Gujranwala, Chandaqella, Alam Chowk, Khali Shahpur, Sialkot Bypass, and Pindi Bypass. It was established that industrial pollutants and vehicular emissions are the primary contributors to smog in the area. Given the detrimental consequences of pollution on individuals of all age groups, it is imperative to take action to mitigate its impact. This can be achieved through addressing pollution sources, implementing effective emission control measures, and fostering public awareness. By adopting proactive measures, the adverse health effects of pollution can be minimized, thereby fostering a healthier and safer environment for the entire population. This study offers valuable insights for policymakers and environmentalists to implement targeted interventions and improve air quality, ultimately safeguarding the health of local populations.

PMID:38630374 | DOI:10.1007/s10661-024-12619-w

Intern Emerg Med. 2024 Apr 17. doi: 10.1007/s11739-024-03603-w. Online ahead of print.

ABSTRACT

The placement of peripheral venous catheters (PVC) is a frequent procedure in the emergency department (ED), which exposes patients to complications (hematoma, fluid leakage, phlebitis, edema, infection), increases hemolysis of blood samples, is time-consuming and costly. The main aim of this study is to analyze the rate of PVC nonuse in the ED and to identify predictive factors of their nonuse. This prospective single-center observational study was conducted in the ED of the Saint-Antoine Hospital in Paris, France between February and March 2022. Adult patients receiving a PVC were included. In addition to demographic and medical data, the reason for PVC prescription and the prescribing physician’s expectation of PVC use were collected. A total of 304 patients were included, with a median age of 61.5 years (IQR: 43-79 years), of whom 152 (50%) were men. PVC were primarily prescribed for intravenous medication administration. Seventy-two (23.7%) PVC were not used. In multivariable analysis, the predictive factors of nonuse were the prescribing physician’s expectation of nonuse [OR 6.35, CI 95% (2.64-15.29), for “no” and “not sure” vs. “yes” responses] and the reason for prescribing “just in case” [OR 3.54, CI 95% (1.37-9.17)]. PVC were not used in 23.7% of cases. Predictors of nonuse were the prescribing physician’s expectation of nonuse and the reason for prescribing “just in case”. A PVC should probably not be prescribed if the prescribing physician thinks it will not be used or prescribes it “just in case”.

PMID:38630346 | DOI:10.1007/s11739-024-03603-w

Lasers Med Sci. 2024 Apr 17;39(1):103. doi: 10.1007/s10103-024-04017-y.

ABSTRACT

Patellofemoral pain syndrome (PFPS) is a set of symptoms that negatively affect the daily life activities of the individual, leading to functional disability and significant loss of labor, especially in young adults. PFPS is usually due to weakness of the vastus medialis obliquus (VMO) resulting in abnormal patellar tracking and pain. Our study aims to compare the efficacy of high-intensity laser therapy (HILT) on pain and lower extremity function in the treatment of PFPS with different electrophysical agents (EPAs). The study was designed as a single-blind randomized controlled trial. Forty-five people with PFPS (aged 25-45 years) were included in the study. The patients were randomly divided into three groups and a total of ten sessions of treatment were administered to all three groups for 2 weeks, 5 days a week. High-intensity laser (HILT) and exercise program were applied to group 1. Ultrasound (US), transcutaneous electrical nerve stimulation (TENS), and exercise program were applied to group 2. In group 3, US, interferential current (IFC), and exercise program were applied. Both groups underwent three evaluations: pre-treatment, post-treatment, and 12 weeks after treatment. Outcome measures included the visual analog scale for pain severity (VAS), knee flexion range of motion (FROM), Q angle, pain threshold, muscle strength of quadriceps and hamstring, Kujala patellofemoral scoring, lower extremity functional scale (LEFS), and Timed Up and Go Test (TUG). The ANOVA was used for comparing the data of the groups, and two-way repeated measure ANOVA was used to compare at the pre-post and post-intervention 3rd month. The LSD and Bonferroni post hoc tests were also used to identify the between-group differences. Groups 2 and 3 were statistically effective in pain and functionality (p < 0.05). Group 1 was found to be statistically more effective than other groups in reducing pain (95% confidence interval (CI), 0.000/0.000; p = 0.000), increasing knee flexion angle (95% CI, 127.524/135.809; p = 0.000), and increasing lower extremity function (95% CI, 75.970/79.362; p = 0.000). This study indicated that high-intensity laser therapy was found to be a more effective method in the treatment of patellofemoral pain syndrome after 3 months of follow-up compared to US-TENS combination and US-interferential current combination treatments. Also, HILT can be used as an effective method in combination with an appropriate exercise program including vastus medialis strengthening to reduce pain and increase functionality in the patients with PFPS.

PMID:38630331 | DOI:10.1007/s10103-024-04017-y

Clin Oral Investig. 2024 Apr 17;28(5):256. doi: 10.1007/s00784-024-05649-8.

ABSTRACT

OBJECTIVES: To investigate the feasibility of MRI nerve-bone fusion imaging in assessing the relationship between inferior alveolar nerve (IAN) / mandibular canal (MC) and mandibular third molar (MTM) compared with MRI-CBCT fusion.

MATERIALS AND METHODS: The MRI nerve-bone fusion and MRI-CBCT fusion imaging were performed in 20 subjects with 37 MTMs. The Hausdorff distance (HD) value and dice similarity coefficient (DSC) was calculated. The relationship between IAN/MC and MTM roots, inflammatory, and fusion patterns were compared between these two fused images. The reliability was assessed using a weighted κ statistic.

RESULTS: The mean HD and DSC ranged from 0.62 ~ 1.35 and 0.83 ~ 0.88 for MRI nerve-bone fusion, 0.98 ~ 1.50 and 0.76 ~ 0.83 for MRI-CBCT fusion. MR nerve-bone fusion had considerable reproducibility compared to MRI-CBCT fusion in relation classification (MR nerve-bone fusion κ = 0.694, MRI-CBCT fusion κ = 0.644), direct contact (MR nerve-bone fusion κ = 0.729, MRI-CBCT fusion κ = 0.720), and moderate to good agreement for inflammation detection (MR nerve-bone fusion κ = 0.603, MRI-CBCT fusion κ = 0.532, average). The MR nerve-bone fusion imaging showed a lower ratio of larger pattern compared to MR-CBCT fusion (16.2% VS 27.3% in the molar region, and 2.7% VS 5.4% in the retromolar region). And the average time spent on MR nerve-bone fusion and MRI-CBCT fusion was 1 min and 3 min, respectively.

CONCLUSIONS: Both MR nerve-bone fusion and MRI-CBCT fusion exhibited good consistency in evaluating the spatial relationship between IAN/MC and MTM, fusion effect, and inflammation detection.

CLINICAL RELEVANCE: MR nerve-bone fusion imaging can be a preoperative one-stop radiation-free examination for patients at high risk for MTM surgery.

PMID:38630324 | DOI:10.1007/s00784-024-05649-8

World J Microbiol Biotechnol. 2024 Apr 17;40(6):170. doi: 10.1007/s11274-024-03980-6.

ABSTRACT

Biological control using edible mushrooms as natural enemies is a sustainable alternative for pest management. Despite the well-established literature on toxins and secondary metabolites produced by these fungi in the biochemical control of nematodes, the nematicidal activity of proteases from different Pleurotus species is yet to be investigated. Therefore, this study aimed to correlate protease to the nematicidal activity of different mushrooms, Pleurotus sp., P. ostreatus (SB), P. ostreatus (Pearl), and P. djamor. For such a purpose, we performed motility assays of Panagrellus sp. at different time intervals, 6, 12, and 24 h for each of the mushrooms. In addition, the protease activity was measured using different pH (5, 7, and 9) and fermentation time intervals (45 and 75 days). Furthermore, we also evaluated the effect of this cell-free extract on Panagrellus sp. In response to these experiments, all edible mushrooms showed a reduction over 82% for the nematode-feeding activity (p < 0.01). The cell-free crude extract of each of the fungi studied showed nematocidal activity (p < 0.01). For the 45-day fermentation, P. djamor exhibited statistical significance (p < 0.01) compared with the others, reaching a reduction percentage of 73%. For the 75-day fermentation, Pleurotus sp. and P. ostreatus (Pearl) showed significant differences compared with the other fungi (p < 0.01), with reduction percentages of 64 and 62%, respectively. Herein, protease activity was associated with the nematicidal action of different Pleurotus species in controlling Panagrellus sp.

PMID:38630319 | DOI:10.1007/s11274-024-03980-6