Category: Statistics

Am J Audiol. 2023 Nov 2:1-6. doi: 10.1044/2023_AJA-23-00100. Online ahead of print.

ABSTRACT

PURPOSE: Dizziness and imbalance are common symptoms during the acute phase of traumatic brain injury (TBI). However, there is evidence to suggest that these symptoms persist into the chronic phase of injury. Few prospective studies have examined the frequency and type of dizziness and imbalance in adults with chronic moderate-severe TBI. The aim of this preliminary analysis was to investigate the prevalence of these symptoms in adults with chronic moderate-severe TBI.

METHOD: Twenty-four adults with chronic moderate-severe TBI and a group of 19 age-, sex-, and education-matched noninjured comparison participants were recruited. Self-reported dizziness and imbalance were measured using a modified version of a standard case history form. Significant associations between group (TBI group or noninjured comparison [NC] participants) and self-reports of dizziness, imbalance, and related symptoms (endorsed “yes” or “no”) were explored.

RESULTS: The TBI group most reported lightheadedness (75%), vertigo (38%), and imbalance and/or falling (46%). The most common related symptom reported by the TBI group was headache (63%) and nausea (46%). Significant associations revealed that the TBI group responded “yes” in higher percentages than the NC group across all categories (dizziness, imbalance, and related symptoms). There were no statistically significant relationships among dizziness, imbalance, or headache symptoms within the TBI group.

CONCLUSIONS: These preliminary findings suggest that dizziness and imbalance are prevalent in adults with chronic moderate-severe TBI. Persistent vertiginous symptoms may point to an underlying vestibular impairment. However, further research is needed to characterize vestibular function in chronic moderate-severe TBI.

PMID:37917920 | DOI:10.1044/2023_AJA-23-00100

Am J Audiol. 2023 Nov 2:1-12. doi: 10.1044/2023_AJA-23-00118. Online ahead of print.

ABSTRACT

PURPOSE: Hyperacusis often leads to debilitating psychosocial consequences, but there is no standard protocol for its diagnosis and management in the United States. In this study, we surveyed U.S. clinical audiologists to understand their education and clinical practices surrounding the evaluation and treatment of hyperacusis.

METHOD: An online survey was distributed to clinical audiologists across the United States. Survey responses were quantified using descriptive statistics and inductive content analysis.

RESULTS: Hyperacusis definitions and clinical practice patterns varied widely across the 102 respondents. Respondents cited a lack of education and training as the primary barrier to effective audiological diagnosis and management of hyperacusis, with most respondents reporting ≤ 5 hr of hyperacusis education. Other primary barriers to effective audiological management of hyperacusis included time constraints, reimbursement, poor sensitivity and specificity of available diagnostic tools, and poor efficacy of available treatments and management strategies. Most respondents (82.5%) agreed that audiologists are the primary professionals who are responsible for implementing hyperacusis interventions. However, 63.3% of respondents reported that their clinic does not have a hyperacusis management protocol, and 80.0% routinely recommend treatment that is outside their scope of practice to implement (cognitive behavioral therapy).

CONCLUSIONS: Clinical audiologists in the United States do not receive uniform education on hyperacusis, and they report multiple barriers to its evidence-based diagnosis and management. Effective hyperacusis management necessitates a multidisciplinary approach. The information obtained via this survey will pave the way toward the refinement of interprofessional education programs and the development of systematic, evidence-based clinical protocols for hyperacusis.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24431188.

PMID:37917915 | DOI:10.1044/2023_AJA-23-00118

Altern Ther Health Med. 2023 Nov 3:AT8865. Online ahead of print.

ABSTRACT

OBJECTIVE: The the intensive care unit (ICU), also known as intensive care medicine department and intensive intensive care unit, is a medical place for centralized treatment of critical diseases and continuous monitoring and treatment. To investigate the relationship between the length of intensive care unit (ICU) admission and long-term mortality in elderly critically ill patients.

METHODS: A total of 2694 critically ill ICU patients admitted to Xianning First People’s Hospital from April 2017 to April 2021 were selected. Inclusion criteria including: age ≥ 60 years; meet the diagnostic criteria for critical illness; admission to ICU ≥ 24h. According to admission time, patients were divided into 1684 patients admitted during working hours and 1010 patients admitted during non-working hours. The relationship between the admission time of ICU patients and long-term mortality was taken as the dependent variable. The evaluation was performed using the Acute Physiology and Chronic Health Status Assessment Scale (APACHE II score). Epidemiological questionnaire was used to investigate the status of time to hospital and mortality, and the independent risk factors affecting time to hospital and mortality were analyzed by univariate and multivariate analysis. SPSS 26.0 statistical software was used for analysis and processing.

RESULTS: Among 2694 critically ill patients in ICU, 1010 patients were hospitalized during non-working hours, with an admission rate of 37.49%. The acute physiology and chronic health evaluation (APACHE) II score of non-working hours was 19.91±6.62, which is significantly higher than that of working hours (18.21±6.42) (P < .05). The mortality rates of ICU patients hospitalized during non-working hours and during working hours accounted for 30.10 % and 19.71% of all patients, respectively, with statistical significance (P < .05). Comparing the mortality rates of the two groups at different time periods, there was a significant difference between the two groups (P < .05). In order to influence the independent variables of ICU mortality (non-occurrence = 0, occurrence = 1), the significant factors of univariate analysis were included in the logistic regression equation. Time of admission, combined cardiopulmonary disease, APACHE II score, nurse workload and other factors were independent risk factors for ICU mortality.

CONCLUSION: Out-of-hours admission is associated with an increased risk of death and is associated with changes in ICU organizational structure. Therefore, sending patients to ICU in time migh help improve their life.

PMID:37917912

Altern Ther Health Med. 2023 Nov 3:AT9641. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the effect of glutathione on serum oxidative stress, inflammatory reaction, and brain injury in patients with Sevoflurane inhalation general anesthesia based on iron metabolism pathway.

METHODS: From January 2018 to January 2023, 120 patients undergoing Sevoflurane inhalation anesthesia in Xingtai Third Hospital were divided into a control group and an observation group. The control group was given routine treatment, and the observation group patients were given oral glutathione tablets 2 weeks before anesthesia based on the control group. Relevant basic data of patients were collected 3 days before operation (T0), 1 day after the operation (T1), 3 days (T2), and 7 days (T3) respectively, and the serum oxidative stress indicators of patients in each group were measured by ELISA: SOD, MDA, GSH, Hif-1α, ferroptosis related indicators: SIRT3, GPX4; related inflammatory indicators: IL-1β, TGF-β, IL-33; neuronal injury related proteins: MBP, NGF, and statistical analysis of the data.

RESULTS: There was no significant difference in general conditions and operation time between the two groups (P > .05). Compared with the control group, the observation group showed significant differences in oxidative stress indicators: SOD in the observation group at T1, SOD, and Hif-1α in the observation group at T2, and SOD, MDA, GSH and Hif-1α in the observation group at T3. 1α, there were significant differences compared with the indicators of the control group at the same time (P < .001). In terms of inflammatory factor indicators, compared with the control group, there were significant differences in IL-1β at T1, TGF-β, and IL-33 at T2, and IL-1β, TGF-β and IL-33 at T3. (P < .001). In terms of ferroptosis indicators, compared with the control group, there were significant differences in SIRT3 at T1, SIRT3, and GPX4 at T2, and SIRT3 and GPX4 at T3 (P < .001). In terms of nerve injury-related proteins, in patients, MBP levels were negatively correlated with SIRT3 (r=-0.8979, P < .0001), MBP levels were positively correlated with GPX4 (r=0.528, P < .0001), and NGF levels were positively correlated with SIRT3 (r=0.8979, P < .0001), NGF level was negatively correlated with GPX4 (r=0.528, P < .0001).

CONCLUSION: Glutathione tablets can alleviate sevoflurane-induced ferroptosis and oxidative stress by elevating GPX4 protein levels, and glutathione tablets have an ameliorative effect on brain injury in patients with sevoflurane inhalation anesthesia.

PMID:37917909

Altern Ther Health Med. 2023 Nov 3:AT8067. Online ahead of print.

ABSTRACT

OBJECTIVE: Our aim was to evauate the application value of esesketamine and dexmedetomidine in preventing postoperative hyperalgesia in elderly patients who received thoracic anesthesia.

METHODS: A total of 94 elderly patients who underwent thoracic anesthesia in Sanmen People’s Hospital from January 2021 to October 2022 were selected and divided into a dexmedetomidine group (n = 47) and an esketamine group (n = 47) by the random number table method. All patients were continuously received intravenous (IV) remifentanil. In the dexmedetomidine group, dexmedetomidine 0.7 μg/kg was administered IV, followed by 0.2 to 0.5 μg/kg/h to maintain anesthesia, while in the esketamine group, esketamine 0.5 mg/kg was given IV 20 min after induction of anesthesia was completed.

RESULTS: Visual analogue scale (VAS) scores in the esketamine group were lower than in the dexmedetomidine group at 1, 6, 12 and 24 h postoperatively (P < .05), and Ramsay sedation scores were not statistically different from those in the dexmedetomidine group (P > .05). At 3 d postoperatively, the Mini-Mental State Examination (MMSE) scores in the dexmedetomidine group were lower than 1 d preoperatively; at 5 d postoperatively, the negative mood and Pittsburgh Sleep Quality Index (PSQI) scores were significantly higher in both groups than 1 d preoperatively; at 14 d postoperatively, the PSQI scores were higher in both groups than 1 d preoperatively, and there was no statistical difference between the negative mood scores at 1 d before surgery (P > .05). At 5 d postoperatively in the esketamine group, the negative mood scores were lower than in the dexmedetomidine group at 5 d postoperatively and the PSQI scores at 5 and 14 d postoperatively were lower than in the dexmedetomidine group (P < .05).

CONCLUSION: Both esketamine and dexmedetomidine can be used to prevent postoperative delirium and nociceptive hypersensitivity after anesthesia in elderly patients with thoracic surgery. However, esketamine is superior to dexmedetomidine in analgesic effect, improvement of negative mood and sleep and stabilization of intraoperative hemodynamics, leading to better effect in preventing delirium and hyperalgesia after anesthesia.

PMID:37917895

Altern Ther Health Med. 2023 Nov 3:AT8863. Online ahead of print.

ABSTRACT

OBJECTIVE: This retrospective cohort study is aimed to provide a certain reference for the clinical prevention and treatment of nasal bone fracture, and further formulated a more perfect diagnosis and treatment plan.

METHODS: In detailed cases, 2881 patients with nasal bone fracture were recorded. Its general clinical data, cause of injury, fracture site, and fracture typing were collected through the database. All hospitalized patients admitted to the Ninth People’s Hospital Affiliated to the School of Medicine of Shanghai Jiao Tong University with integrated medical records could be retrospectively included from June 2013 to July 2018 and comprehensively analyzed for their gender, age, fracture type and cause of injury.

RESULTS: The sex ratio of nasal bone fracture was 2.44:1. The most patients with nasal bone fracture were 19-29 years old (35.6%). The injury rate of traffic accidents was the highest, 33.8%, followed by violent strikes, 24.1%. Statistical analysis showed that the number of patients with nasal bone combined with maxillary frontal bone fracture and type II nasal bone fracture was significantly higher than other fracture types. Logistic multiple regression analysis showed that the relative risk of nasal bone fracture in men was lower (odds ratio, OR = 0.807, P < .05), and the risk of nasal bone fracture decreased with age (OR = 0.978, P < .001). Compared with car accident injury, the relative risk of simple nasal bone fracture comes from violence, exercise or collision [OR = 1.244, P < .05; OR = 1.410, P < .05; OR = 1.453, P < .05]).

CONCLUSION: Given these findings, it’s evident that nasal bone fractures exhibit distinct patterns based on individual characteristics, causes of trauma, and injury site, and relevant strategy research should be conducted.

PMID:37917892

Altern Ther Health Med. 2023 Nov 3:AT9596. Online ahead of print.

ABSTRACT

To investigate the effect of sevoflurane inhalation anesthesia on hemodynamics in children undergoing lower limb fracture surgery. Between January 2019 and December 2021, 187 kids at our hospital were randomly divided into two distinct categories: the experimental category (95 cases) and the control category (92 cases). Sevoflurane inhalation anesthesia was administered to the experimental cohort whereas Ketamine basic anesthesia was administered to the control cohort. Comparisons were made among the two categories’ hemodynamic indices, anesthetic quality, and VAS ratings. When the eyelash reflex vanished, immediately after skin incision, as well as 5 min after skin incision, the SaO2, as well as MAP in the experimental group, were higher than those in the control category, while HR, SBP, as well as DBP were less than those in the control category. These variations were statistically noteworthy (P < .05). The onset of the experimental group’s sensory blocks and the awakening of patients was faster than the control category, and the variations were of statistical importance (P < .05). At 24 hours, 48 hours, and 72 hours, the VAS score in the experimental category was substantially distinct from that in the control category (P < .05). In addition to lowering postoperative discomfort and stabilizing hemodynamics, sevoflurane inhalation anesthesia helps speed up the onset and recovery of anesthesia block in children having lower extremity fracture surgery.

PMID:37917891

Altern Ther Health Med. 2023 Nov 3:AT9098. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the diagnostic significance of the combination of alpha-fetoprotein (AFP), serum abnormal prothrombin (PIVKA-II), and α-L-Fucosidase (AFU) in hepatocellular carcinoma (LC).

METHODS: A total of 580 cases of chronic hepatitis B patients were collected, including 124 cases of hepatitis B-related liver cancer patients treated in our hospital from March 2021 to December 2022, 325 cases of simple chronic hepatitis B patients, and 189 cases of hepatitis B cirrhosis patients from our hospital in the same period. We measured serum levels of AFP, PIVKA-II, and AFU using ELISA. Statistical analysis was performed using SPSS software, employing t tests, ANOVA. ROC curves were used to assess the effectiveness of the three markers alone and in combination for screening hepatitis B-associated liver cancer from patients with chronic hepatitis B.

RESULTS: The serum levels of AFP and PIVKA-II were significantly higher in the hepatitis B liver cancer group compared to the cirrhotic hepatitis B group and the chronic hepatitis B group, with statistically significant differences (P < .05). The AFU level in the hepatocellular carcinoma group was also significantly higher than that in the chronic hepatitis B group (P < .05). When individually tested, the AUC of PIVKA-II was the largest, followed by AFP, and AFU had the smallest AUC (P < .05). When combined, the AUC was the greatest, reaching XX, outperforming individual markers alone or their combinations. This suggests that combining AFP, AFU, and PIVKA offers improved sensitivity (86.5%) and specificity (97.8%) for liver cancer diagnosis. These findings indicate the potential clinical relevance of utilizing these biomarkers together for accurate detection and monitoring of liver cancer.

CONCLUSION: The combination of AFP, AFU, and PIVKA-II demonstrates improved diagnostic accuracy in early detection of hepatitis B-related hepatocellular carcinoma, particularly in patients with chronic hepatitis B complicated by cirrhosis. These findings have significant clinical implications, as early diagnosis enables timely intervention and treatment, potentially improving patient outcomes and guiding appropriate therapeutic strategies for affected individuals.

PMID:37917888

Rambam Maimonides Med J. 2023 Oct 29;14(4). doi: 10.5041/RMMJ.10508.

ABSTRACT

BACKGROUND: Human papillomavirus (HPV) is considered to be responsible for 95% of virus-related cancers in many organs. Oropharyngeal carcinoma (OC) is distinguished by the transformation of the healthy epithelium into precancerous cells.

AIM: The current study sought to examine the uneven gene expression of 20 genes among those scanned by microarray for oropharyngeal cancer patients.

MATERIALS AND METHODS: The GSE56142 dataset was extracted from the Gene Expression Omnibus of the National Center for Biotechnology Information; 24 specimens were evaluated. Gene ontology (GO), the Kyoto Encyclopedia of Genes and Genomes, and the protein-protein interaction (PPI) were used to depict the biological roles of the genes under investigation using types of software.

RESULTS: Six genes out of 20 in patients with invasive OC had a binding correlation with high expression (PDGFRS, COL6A3, COL1A1, COL3A1, COL2A1, and COL4A1), and only two genes with low expression (CRCT1 and KRT78). The expression levels of 20 genes were examined for patients with OC versus head and neck squamous cell carcinoma (HNSCC). The correlation coefficient between highly expressed genes of the OC group was statistically significant at the P<0.05 level.

CONCLUSIONS: High expression levels of specific genes may serve as diagnostic tumor markers, particularly in the early stages of cancer, and testing should be performed in OC and HNSCC patients.

PMID:37917867 | DOI:10.5041/RMMJ.10508

Psychiatr Danub. 2023 Fall;35(3):335-343. doi: 10.24869/psyd.2023.335.

ABSTRACT

BACKGROUND: In this study, we aimed to investigate the relationship between affective temperament characteristics and obsessive-compulsive disorder (OCD) symptom dimensions and severity.

SUBJECTS AND METHODS: 100 patients diagnosed with OCD and 100 healthy controls by random sampling method were included in the study. SCID-5-CV was administered to all participants. Dimensional Obsessive-Compulsive Scale (DOCS), Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A), Beck Anxiety (BAI), Depression Inventories (BDI) were provided to all participants. p<0.05 was taken as statistically significant.

RESULTS: It was found that cyclothymic temperament predicted all OCD symptom dimensions except contamination dimension, and predicted the OCD severity. Moreover, irritable temperament predicted the OCD symmetry dimension.

CONCLUSION: In our study, the first study in terms of scrutinizing the relationship between symptom dimensions of OCD and affective temperament, it was revealed that irritable and cyclothymic temperament significantly predicted the dimensions of OCD, and cyclothymic temperament was associated with OCD severity. Affective temperaments appear to make a remarkable contribution to OCD heterogeneity.

PMID:37917839 | DOI:10.24869/psyd.2023.335