Category: Statistics

Georgian Med News. 2023 Oct;(343):139-143.

ABSTRACT

There are many unresolved questions regarding the features of surgical aggression in the open method of treatment of severe forms of peritonitis. There are isolated publications in the literature on the risk features of these interventions, despite the high prevalence of the problem. The purpose of this study was to study the features of surgical aggression in the open method of treatment of severe forms of peritonitis. The study included 205 patients with severe forms of purulent peritonitis treated at the Emergency Hospital in Aktobe (n=205). To assess the factors of surgical aggression, the reliability of the results was evaluated by variational statistics according to the Student’s t-criterion, taking into account the degree of freedom, at p<0.05 and p<0.01, with the calculation of arithmetic averages and their average errors (M+m). The data are presented as an average value±standard deviation or median and percentiles, p-values less than 0.05 were considered significant. Based on the results obtained, it was found that the frequency of repeated laparosanation surgical interventions in one patient was 2.8±0.3 times against the background of purulent-inflammatory process in the abdominal cavity, a high degree of stress index of the regulatory systems of the body during sanitation was revealed – up to 1460.9±101.5 units, postural reactions of blood circulation and respiration in 7.55% and metabolic disorders homeostasis. Aggressive factors affecting patients and causing the risk of multiple laparosanation interventions at the stages of open surgical treatment of severe forms of peritonitis have been identified. The data obtained can be used to develop therapeutic and preventive measures to improve the results of treatment of severe peritonitis.

PMID:38096531

Georgian Med News. 2023 Oct;(343):127-133.

ABSTRACT

The design of studies on the immune system does not have gender peculiarities, but the information about the higher frequency of pathology of the female reproductive system in the presence of immunodeficiency condition determines the purpose of this study, namely, to identify the features of immune status in the presence of secondary immunodeficiency of infectious (i.e., HIV infection, AIDS stage) and non-infectious origin (alcohol dependence syndrome) and their combination in women of reproductive age. The material for the study of cellular and humoral immunity was a lymphocyte suspension obtained by centrifugation of peripheral blood (taken within 12 hours after death) in women of reproductive age with HIV infection (AIDS stage), alcohol dependence syndrome and their combination. Immunological examination included the determination of quantitative indicators of cellular immunity using monoclonal antibodies: T-lymphocytes (CD3) and their main subpopulations of T-helper cells (CD4), cytotoxic lymphocytes (CD8), CD4/CD8 immunoregulatory index; as well as indicators of humoral immunity: B-lymphocytes (CD19) and immunoglobulins of the main classes (IgA, IgG, IgM). Additionally, interleukins IL-6 and IL-10 were studied to determine the parameters of the cytokine profile. The study indicates that the number of leukocytes and lymphocytes in the group of deceased women with alcohol dependence syndrome was 3.6±0.38×109/l and 0.82±0.35×109/l; in deceased women with HIV/AIDS, these indicators were reduced – 2.9±0.03×109/l and 0.39±0.04×109/l, respectively; and in deceased women with combined pathology (AIDS and alcohol dependence syndrome), they were reduced even more intensively – 2.7±0.04×109/l and 0.35±0.06×109/l (p<0.01). Compared to the control group – 5.22±0.4×109/l and 1.73±0.21×109/l – the number of leukocytes and lymphocytes was reduced in all study groups. In the group of deceased women with alcohol dependence syndrome, significant impairments in the proliferative activity of T-lymphocytes (CD3) and their subpopulation (CD4), as well as B lymphocytes (CD19) and natural killer cells (CD16) were found compared to the group of healthy individuals. Thus, in the control group, the percentage, and absolute values of CD3 were 60.37±4.2% and 1.04±0.05×106/l, and in women suffering from chronic alcoholism, they were statistically significantly lower – 49.1±3.1% and 0.42±0.08×106/l, respectively, p<0.01. The same tendency was found when comparing the values of T-helper cells (CD4) in the control group (44.2±2.9% and 0.76±0.13×106/l) and in deceased patients suffering from chronic alcoholism (33.7±4.6% and 0.28±0.23×106/l), p<0.01. Secondary immunodeficiencies of infectious and non-infectious origin in women (in particular, those formed in HIV/AIDS, alcohol dependence syndrome and their combination) are characterized by negative changes in the cellular and humoral components of the immune system, as evidenced by the presence of transient immunodeficiency, activation of cytolytic and auto aggressive reactions. As a result of these processes, systemic and organ pathology develops, in particular, weakening of the body’s resistance to various infections and pathological changes in organs and tissues, which may be one of the links in the development of pathological processes in internal organs and tissues.

PMID:38096529

Georgian Med News. 2023 Oct;(343):84-90.

ABSTRACT

Aim of study – supra-physiologic level of PaO2, securing oxygen reserves and preventing perioperative hypoxia, may offset the reduced oxygen delivery during cardiac surgery. However, high FiO2 will speed up gas absorption in low V/Q regions, promote atelectasis formation and increase pulmonary shunt fraction. PaO2/FiO2, P(a-Et)CO2 and PEtCO2/PaCO2 are the variables linked to CO2 and O2 exchange impairment. The aim of our study was to assess pulmonary gas exchange performance while ventilating patients with different FiO2 during OPCABG. The seventy patients were randomly equally distributed in two groups: H (High) and L (Low). The patients in the group H were ventilated with FiO2 0.8 and the patients in the group L _ with FiO2 0.5. PaO2/FiO2 ratio, P(a-Et)CO2 gradient and PEtCO2/PaCO2 ratio were checked at the start and the end points of operations. PaO2/FiO2 decreased, P(a-Et)CO2 increased and PaCO2/PEtCO2 decreased at the end of operations compared with the start values in both groups. PaO2/FiO2, P(a-Et)CO2 and PaCO2/PEtCO2 ware different between H and L groups. The difference became statistically significant at the end of operations. (PaO2/FiO2 326±65 vs 290±63 p=0.020; P(a-Et)CO2 5.7±2.3 mmHg vs 7.5±2.4 mmHg p=0.003; PaCO2/PEtCO2 0.84±0.05 vs 0.80±0.06 p=0.001). The groups were comparable according to the outcomes such as hemodynamic and laboratory data, duration of postoperative mechanical ventilation and ICU length of stay. FiO2 0.8 was associated with more derangements of pulmonary gas exchange compared with FiO2 0.5. Although FiO2 did not have an impact on the outcomes we studied, using FiO2 0.5 seems to be safer in patients undergoing OPCABG.

PMID:38096522

Georgian Med News. 2023 Oct;(343):63-66.

ABSTRACT

An ovarian cyst is a common hormonal disorder that affects the ovaries in females of reproductive age. Environmental and genetic factors may contribute to the beginning of the disease, although the lack of a clear aetiology. Menstrual irregularities, increased hair growth, and acne are some of the most important signs. In order to control symptoms and prevent the development of chronic medical disorders, early identification is essential. The goal of this study was to assess fetuin-A levels and relationships in polycystic ovary syndrome (PCOS) patients. The connection between fetuin-A and asprosin and several biochemical parameters, including fasting blood sugar, insulin, cholesterol, and triglycerides in women patients with polycystic ovarian syndrome. Ninety females were included in the trial; 60 individuals (females) were selected who were diagnosed with PCOS by a gynaecological specialist and ranged in age from 15 to 45. The result was a change in the ovulation-inducing hormones LH and FSH as well as an increase in the proteins fetuin-A and Asprosin. On the other hand, 30 individuals (all female) were used as a control group. Their ages were recorded as well as the fact that they did not have PCOS. For all groups, laboratory tests were done to determine the levels of fetuin-A, Asprosin, fasting blood sugar, Insulin, total cholesterol, and triglyceride. For parents and a control group, investigators performed an asprosin analysis, The findings of the comparison were statistically not significant (P value=0.115). performed a Fetuin-A analysis as well, the results were statistically highly significant with a P value of 0.0002 when compared to the outcomes of the two sick groups and the healthy controls.

PMID:38096518

Georgian Med News. 2023 Oct;(343):44-49.

ABSTRACT

The aim of the study was to conduct approximate assessment of the prevalence of osteoporotic changes and evaluate quality of life (QoL) in postmenopausal women using ECOS-16 questionnaire in Yerevan city. The cross-sectional survey was conducted for data collection among 196 postmenopausal women. The research material about QoL was collected using ECOS-16 questionnaire. The sample was randomly selected through a two-stage cluster sampling from the population of women served by five policlinics of Yerevan. The majority of surveyed women (70.3%) were in age group under 60. Slightly more than half of the study participants (57.7%) had higher education and worked (59.2%). Almost two thirds of respondents were married (65.3%). Half of the respondents (51.0%) noted their income at the subsistence level. 71.9%±3.21 of women reported back pain for a long time. The scores of all the scales of ECOS-16, as well the total score were significantly higher in women who reported chronic back pain, indicating a lower quality of life for them. Women in age group under 60 years old, as well as women indicating absence of risk factors at workplaces, had significantly higher quality of life. A statistically significant difference was also observed between groups of women based on such social and demographic characteristics, as marital status, and average monthly income level. Pairwise comparison of groups based on these characteristics revealed a higher quality of life among married women compared to widows (p=0.043) and among women with income higher and at the subsistence level compared to the group of women with income below the subsistence level (p= 0.010). Poor QoL was associated with low self-reported health status and presence of chronic diseases in women. Pairwise post-hoc analysis showed lower level of QoL in the study participants with a below average/low level of health compared to both, those with above average (p<0.001) and average (p<0.001) level of health. QoL was also lower in women with four or more chronic diseases compared to both, women without chronic diseases (p=0.001) and the group of women with 1-3 diseases (p=0.001). The prevalence of chronic back pain, which was considered as one of the manifestations of undiagnosed osteoporosis in postmenopausal women, was quite high. The scores calculated for all dimensions of ECOS-16 questionnaire, as well the total score indicated lower quality of life among women reported chronic back pain compared to those who did not have such a health problem. Age older 60, spouse’s demise, income below the subsistence level, smoking, presence of risk factors at workplace, as well as poor self-reported health status, and presence of chronic diseases were the factors negatively affected the QoL of surveyed women.

PMID:38096514

Georgian Med News. 2023 Oct;(343):33-37.

ABSTRACT

Atopic dermatitis, despite its relatively wide distribution and low severity, was statistically often a disqualification condition for military service. The aim of our study is to determine correlations between characteristics of atopic dermatitis in military personnel. 144 people with atopic dermatitis were under our observation, 78 of them military personnel, 26 military family members and 40 civilians, 62 men and 82 women. We studied the following characteristics: gender, age, marital status, education, social status, place of service location, genetic anamnesis, recurrence during the year, laboratory indicators of attached infections, focus of localization, other skin diseases, comorbidities, compliance with hygienic conditions, wearing a military uniform, the frequency of changing bed linen. 3-5 times recurrence a year shows a reliable positive correlation with: wearing a uniform for 12-24 hours, SSA/eosinophilia, mycosis, pathology of the respiratory system, military personnel. Staphylococcus aureus is associated with other infections – St. hominis, fungus, also shows a reliable positive correlation: localization on the face and torso, wearing the uniform for 1 week and more. Staphylococcus hominis shows a reliable positive correlation: localization – torso, wearing uniform for 1 week or more,y. Shows a reliable positive correlation with fungus: localization scalp, neck, lower limb, military serviceman; reliable positive correlation with SSA/eosinophilia: increased IgE, localization on the upper limbs, mycosis, change of bed linen – once every 2 weeks; IgE – localization of dermatosis on the upper limbs and torso area, pathology of the digestive system, changing bed linen once every 2 weeks, military serviceman. It shows a reliable positive correlation with helminthiasis: Localization on the genitals, mycosis, pathology of the digestive system, change of bed linen once a month. Development and recurrence of atopic dermatitis in military personnel correlates with living conditions and infections. Determining the differences between civilian and military patient populations will allow clinicians to better investigate the risk factors that predispose to the manifestation of dermatitis in the military.

PMID:38096512

Georgian Med News. 2023 Oct;(343):6-13.

ABSTRACT

Medical aspects of the organization of replenishment of the Armed Forces with healthy and physically strong personnel are of great importance, and the deficit in the number of conscripts and their low-quality condition have become one of the main and important problems for the Armed Forces. The aim of the study was to improve the medical care of male conscripts aged 18-27 years by revealing the regularities and peculiarities of the expert assessment of surgical diseases among this category of young men on the basis of mathematical modeling. The object of the research was the study of the names of surgical profile articles, according to which these people were recognized as unfit or restricted fit for service, and the results of military medical expertise. Descriptive, social, and statistical methods were applied in the course of the study. The final stage was to conduct a systemic multifactor analysis in order to obtain a mathematical model of the process under study. The values of the influence coefficients of the mentioned indicators for 2013-2019 on the obtained mathematical models from the point of view of military-medical expertise of young men with surgical diseases both in the Republic of Armenia as a whole and in its separate regions are presented. Summarizing, it can be stated that from the point of view of military-medical expertise of young men with surgical diseases it is impossible to consider Yerevan city and the regions of RA as separate parts of the Republic of Armenia. Yerevan and the regions of the Republic of Armenia as separate parts, as they appear as a single whole according to the results of systemic multifactor analysis with mathematical modeling.

PMID:38096507

West Afr J Med. 2023 Nov 30;40(11):1192-1198.

ABSTRACT

BACKGROUND: Sleep health indicates how well an individual or population sleeps. Good sleep health is characterized by subjective satisfaction, sustained alertness during waking hours, appropriate timing, high efficiency, and adequate duration. Poor sleep health is associated with many short-term and long-term health consequences. There are limited data on the pattern of sleep health in Nigeria. Against this backdrop, we embarked on this study to determine the Pattern of Sleep Health among patients attending the Adult Neurology clinic in a Federal Teaching Hospital, in Abakaliki, Nigeria.

METHODS: This is a cross-sectional observational hospital-based study undertaken at the Adult Neurology clinic of the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria from July to September 2022.

RESULTS: Out of the 267 patients recruited for the study, 19% had good sleep health with SATED scores of 8 to 10 while 81% had poor sleep health. The absence of alcohol abuse, cigarette smoking, and neurological diagnosis were statistically associated with poor sleep health with no sex and age predilection. The mean sleep duration was 7.5± 1.5 hours (male = 7.6 hours, female = 7.3 hours, 18- 64 years= 7.4 hours, ≥ 65 years =7.9 hours). Timing of sleep (mean= 0.97) was the least rated while sleep satisfaction (mean= 1.54) was the best-rated sleep dimension.

CONCLUSION: Sleep health is very poor amongst patients attending the adult Neurology clinic at Abakaliki Nigeria and it is associated with smoking, absence of alcohol abuse, and neurological diagnosis.

CONTEXTE: La santé du sommeil indique à quel point un individu ou une population dort. Une bonne santé du sommeil se caractérise par une satisfaction subjective, une vigilance soutenue pendant les heures d’éveil, un timing approprié, une efficacité élevée et une durée adéquate. Une mauvaise santé du sommeil est associée à de nombreuses conséquences sanitaires à court et à long terme. Il existe des données limitées sur le schéma de santé du sommeil au Nigéria. Dans ce contexte, nous avons entrepris cette étude pour déterminer le schéma de santé du sommeil parmi les patients fréquentant la clinique de neurologie pour adultes dans un hôpital d’enseignement fédéral à Abakaliki, Nigeria.

MÉTHODES: Il s’agissait d’une étude observationnelle transversale réalisée à la clinique de neurologie pour adultes de l’hôpital universitaire fédéral Alex Ekwueme àAbakaliki, Nigeria, de juillet à septembre 2022.

RÉSULTATS: Sur les 267 patients recrutés pour l’étude, 19 % avaient une bonne santé du sommeil avec des scores SATED de 8 à 10, tandis que 81 % avaient une mauvaise santé du sommeil. L’absence d’abus d’alcool, de tabagisme et de diagnostic neurologique était statistiquement associée à une mauvaise santé du sommeil, sans prédilection pour le sexe et l’âge. La durée moyenne du sommeil était de 7,5 ± 1,5 heures (homme = 7,6 heures, femme = 7,3 heures, 18-64 ans = 7,4 heures, ≥ 65 ans = 7,9 heures). Le timing du sommeil (moyenne = 0,97) était la dimension la moins bien notée, tandis que la satisfaction du sommeil (moyenne = 1,54) était la dimension la mieux notée.

CONCLUSION: La santé du sommeil est très mauvaise chez les patients fréquentant la clinique de neurologie pour adultes à Abakaliki, au Nigéria, et elle est associée au tabagisme, à l’absence d’abus d’alcool et au diagnostic neurologique.

MOTS-CLÉS: :Santé du sommeil, Clinique de neurologie,Abakaliki, Nigeria.

PMID:38096460

J Hosp Palliat Nurs. 2023 Dec 14. doi: 10.1097/NJH.0000000000001005. Online ahead of print.

ABSTRACT

Palliative care is traditionally delivered by specialty-trained palliative care teams. Because of a national workforce shortage of palliative care specialists, there is an urgent need to explore alternative models of palliative care delivery to meet the needs of patients living with serious illness. As part of a multisite randomized controlled trial, 2 registered nurses without previous palliative care experience were trained to deliver a primary palliative care intervention to patients with newly diagnosed lung cancer. The intervention focused on assessing and managing symptoms, psychosocial needs, education, and initiating goals-of-care discussions. The primary outcome, improved symptom burden and quality of life, was not statistically significant. Despite this finding, nurses addressed 5 of the 8 National Consensus Project Guidelines domains of quality palliative care: structure and processes of care; physical, psychological, and social aspects of care; and ethical and legal aspects. Patients’ engagement in goals-of-care discussions, a measure of high-quality palliative care, increased. Clinical recommendations offered by the nurses to the patients’ clinicians were addressed and accepted on a timely basis. Most patients rated satisfaction with the intervention as “very or extremely” satisfied. These findings may inform future nurse-led palliative care interventions on the specific quality domains of palliative care.

PMID:38096450 | DOI:10.1097/NJH.0000000000001005

Stomatologiia (Mosk). 2023;102(6. Vyp. 2):37-43. doi: 10.17116/stomat202310206237.

ABSTRACT

AIM: Studying the duration of treatment in patients with temporomandibular joint pain dysfunction syndrome, and the relationship of the duration of treatment with the age of the patient at the beginning of therapy.

MATERIALS AND METHODS: The study was carried out using information from medical records of dental patients, information from additional examinations of patients who were treated at the National Medical Research Centre for Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia from 2016 to 2022. Statistical research methods: to evaluate the normality of the distribution, graphical methods were used, as well as the Shapiro-Wilk criterion.

RESULTS: The duration of splint therapy in patients with temporomandibular joint pain dysfunction syndrome varied from 4 to 27 months. The average duration of treatment of patients using occlusive splints was 10.5±5.3 months. Without abnormal observations, the average duration of splint therapy in patients with TMJ pain syndrome was 9.6±4.1 months. The obtained data allow stating the absence of a correlation between the age of patients and the duration of splint-therapy.

CONCLUSION: The majority of patients (68.4%) complete the splint therapy stage within 1 year, and a very small part (1.8%) are treated for more than 1.5 years. The duration of treatment of patients with temporomandibular joint pain dysfunction syndrome does not depend on age or gender.

PMID:38096393 | DOI:10.17116/stomat202310206237