Category: Statistics

Turk Neurosurg. 2023 Apr 14. doi: 10.5137/1019-5149.JTN.43711-23.2. Online ahead of print.

ABSTRACT

AIM: Treatment of ongoing pain in patients undergoing disc surgery is extremely difficult, and there is no consensus. Our study aimed to evaluate the efficacy of percutaneous pain interventions in these patients.

MATERIAL AND METHODS: We retrospectively analyzed 48 patients with persistent / recurring complaints who underwent lumbar disc surgery (LDS) and were treated with percutaneous interventions. They were grouped into recurrent disc herniations (RDHs) and other discovertebral pathologies (ODVP). Moreover, patients were evaluated as those who received transforaminal injection (TFI) with facet blockage (FB) and who received both caudal injection (CI) and TFI in addition to FB. Patients were evaluated using Oswestry Disability Index (ODI) and visual analog scale (VAS).

RESULTS: Between the recurrent and ODVP groups, preoperative, 1 h postoperative, and 6 mo postoperative ODI (p = 0.867, p = 0.055, p = 0.892) and VAS (p = 0.902, p = 0.136, p = 0.462) scores did not show a statistically significant difference, respectively. Additionally, in the comparison of patients who underwent FB+TFI+CI and only FB+TFI, there was no statistically significant correlation between preoperative and 6 mo postoperative ODI (p = 0.284) and VAS (p = 0.248) scores in both recurrent and ODVP groups, respectively. The success rates at the 3rd and 6th mo of patients with RDH and ODVP were 47.61% (10/21) and 42.85% (9/21) and 70.37% (19/27) and 63.96% (17/27), respectively.

CONCLUSION: There was no statistically significant difference in ODI and VAS scores between recurrent and ODVP groups. The clinical success rate was numerically better in the ODVP group. Thus, we suggest that co-administration of TFI and CI did not significantly contribute to our clinical outcome.

PMID:37309640 | DOI:10.5137/1019-5149.JTN.43711-23.2

Turk Neurosurg. 2023 Jan 18. doi: 10.5137/1019-5149.JTN.42560-22.2. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to evaluate Paraoxonase (PON), total antioxidant status (TAS), total oxidant status (TOS), high-density lipoproteins (HDL), CRP, AST, ALT, GGT, ALP levels in patients with head and multiple organ traumas.

MATERIAL AND METHODS: The study included 29 male patients undergoing treatment for head and multiple organ traumas. Blood sample analysis was performed on the first, third, and seventh days after trauma.

RESULTS: The mean age, duration of hospitalization in the intensive care unit, and intubation period of the study sample was 45 years (range: 9 to 81 years), 4.29 days, and 2.94 days, respectively. One patient died, and 13 underwent surgical intervention. Comparison of PON, TAS, TOS, and CRP levels showed statistically significant differences between the first day and the third and seventh days, although no such differences were seen in HDL levels. A moderately positive correlation was observed between CRP/AST, CRP/ALT and between CRP/GGT, while a moderately negative correlation was seen between CRP/ALP.

CONCLUSION: The findings of this study suggest that some oxidative parameters may play a significant role in the prognosis and follow-up of intensive care patients. Moreover, biochemical markers can provide important information about patient response to trauma.

PMID:37309638 | DOI:10.5137/1019-5149.JTN.42560-22.2

Turk Neurosurg. 2022 Nov 30. doi: 10.5137/1019-5149.JTN.40007-22.3. Online ahead of print.

ABSTRACT

AIM: This study aimed to optimize the Spontaneous intracerebral hemorrhage (sICH) early hematoma expansion prediction scoring table based on the clinical data of sICH patients to adopt appropriate clinical treatment plans and improve the prognosis of sICH patients.

MATERIAL AND METHODS: A total of 150 patients with sICH were enrolled, and 44 had early hematoma expansion. According to the selection and exclusion criteria, the study subjects were screened, their NCCT characteristic signs and clinical data were analyzed statistically, and the prediction score table was established. The established prediction score was applied to the follow-up study cohort to conduct a pilot study, and the t-test and ROC curve were used to evaluate its predictive ability.

RESULTS: Statistical analysis found that initial hematoma volume, GCS score, and NCCT special signs were independent risk factors for early hematoma expansion after sICH (P 0.05). Thus, a score table was established. Subjects with ≥10 were divided into high-risk group, 6-8 comprised the medium-risk group, and ≤4 were divided into low-risk group. Among 17 patients with acute sICH, 7 developed early hematoma enlargement. The prediction accuracy was 92.41% in the low-risk group, 98.06% in the medium-risk group, and 84.61% in the high-risk group. It shows the high prediction accuracy of the prediction rating table.

CONCLUSION: This study established a sICH early hematoma expansion prediction score table based on the special signs of NCCT. This table has highly sensitive and accurate.

PMID:37309626 | DOI:10.5137/1019-5149.JTN.40007-22.3

Turk Neurosurg. 2022 Jun 24. doi: 10.5137/1019-5149.JTN.40397-22.3. Online ahead of print.

ABSTRACT

AIM: Medulloblastoma (MB) is a rare tumor whose clinical prognosis remains challenging. Therefore, in this study, we aimed to identify the prognostic factors associated with cancer-specific survival in MB and use them to establish a nomogram model to predict cancer-specific survival.

MATERIAL AND METHODS: In total, 268 patients with MB were included; they were rigorously respectively screened from the Surveillance, Epidemiology, and End Results database from 1988 to 2015 and statistically analyzed in R language. This study focused on cancer-specific death and used the cox regression analysis for variable filtering. The model was calibrated using C-index, area under the curve (AUC), and calibration curve.

RESULTS: As per our findings, it was determined that extension (localized: hazard ratio [HR] = 0.5899, p = 0.00963; further extension: indicator) and treatment modality (radiation after surgery chemotherapy sequence unknown: HR = 0.3646, p = 0.00192; no surgery: indicator) were statistically significant in the prognosis of MB and were finally utilized to construct a nomogram model for predicting the condition. The AUC values were 0.649, 0.629, and 0.64 at 2, 3, and 5 years, respectively.

CONCLUSION: Tumor extension and treatment modality were independent prognostic factors for MB.

PMID:37309623 | DOI:10.5137/1019-5149.JTN.40397-22.3

Am Surg. 2023 Jun 13:31348231183126. doi: 10.1177/00031348231183126. Online ahead of print.

ABSTRACT

OBJECTIVE: Surgery is an effective clinical approach that has been used for the treatment of gastric lymphoma. However, its specific effect on the prognosis of patients with gastric lymphoma remains largely unknown. The current meta-analysis aimed to identify the effect of surgery on the prognosis of gastric lymphoma.

METHODS: We searched the MEDLINE, Embase, and Cochrane Central databases to obtain relevant studies investigating the influence of surgery on overall survival (OS) and relapse-free survival (RFS). We extracted the hazard ratios (HRs) and associated 95% confidence intervals (CIs) of each included report for pooled analysis. We assessed heterogeneity (I² statistic) and funnel plots to select the data models and evaluate publication bias.

RESULTS: Ultimately, we included 12 studies containing 26 comparisons in the current quantitative meta-analysis. The analysis revealed that surgery had no significant effect on OS (HR .83, P = .13) or RFS (HR .78, P = .08). However, subgroup analysis revealed that the effect of surgery on OS differed significantly between the surgery plus conservative therapy subgroup and the conservative therapy alone groups, with HR = .69 (P = .01). No significant publication bias was detected regarding the main outcomes.

CONCLUSION: Surgery had a limited effect on the prognosis of patients with gastric lymphoma. However, the use of surgery as an additional therapy may confer potential benefits. This was an interesting research direction, and additional high-quality, large-scale randomized controlled trials should be conducted.

PMID:37309604 | DOI:10.1177/00031348231183126

Hum Exp Toxicol. 2023 Jan-Dec;42:9603271231183145. doi: 10.1177/09603271231183145.

ABSTRACT

The use of pesticides in farmland has increased considerably to protect crops against pests, weeds, and diseases. However, pesticides and/or their residues in ecosystems may affect non-target organisms. Indaziflam is a widely used herbicide in agricultural areas in the southern region of Turkey. Therefore, this study aimed to investigate the possible genotoxic and cytotoxic effects of indaziflam on HepG2 cells using comet assay, micronucleus assay, and xCELLigence. The HepG2 cells were treated with various concentrations of indaziflam for different duration of time based on xCELLigence results. Accordingly, the cells were incubated with indaziflam at final concentrations of 1, 5, 10, 20, 40, and 80 μg/mL for 96 h for cytotoxicity assay. To assess genotoxicity, cells were treated with indaziflam at final concentrations of 10, 40, and 100 μg/mL for 4 and 24 h. Ethanol was used as a solvent for indaziflam. Hydrogen peroxide (40 μM) was used as a positive control. Studies have revealed that indaziflam did not show a statistically cytotoxic effect at the tested doses. Nevertheless, genotoxicity studies showed that indaziflam induced both DNA strand breaks and micronucleus numbers depending on the exposure time and dose.

PMID:37309560 | DOI:10.1177/09603271231183145

Korean J Ophthalmol. 2023 Jun;37(3):236-244. doi: 10.3341/kjo.2023.0019. Epub 2023 Jun 5.

ABSTRACT

PURPOSE: To compare the corneal epithelial wound healing effects of RCI001, Solcoseryl, and polydeoxyribonucleotide (PDRN) in a rat alkali burn model.

METHODS: In 40 male Sprague-Dawley rats, we induced alkali burn using filter paper soaked in 0.2N sodium hydroxide. The rats were then treated with topical 0.5% RCI001, 1.0% RCI001, Solcoseryl, or PDRN twice a day for 2 weeks. Corneal epithelial integrity and epithelial healing rate were measured at day 0, 3, 5, 7, 10, and 14. Histologic and immunohistochemistry findings were also assessed.

RESULTS: Both the 0.5% and 1.0% RCI001 groups showed significantly more epithelial healing compared to the control group at day 5, 7, 10, and 14 (each p < 0.05). No statistical difference was found between the 0.5% and 1.0% RCI001 groups. Neither the Solcoseryl nor the PDRN groups showed a significant difference from the control. RCI001 treatment resulted in significantly reduced stromal edema, and a trend towards less inflammatory cell infiltration.

CONCLUSIONS: Topical application of RCI001 showed enhanced corneal epithelial wound healing in the murine corneal alkali burn model, presumably by suppressing inflammation. Meanwhile, Solcoseryl and PDRN did not show sufficient therapeutic effects compared to RCI001.

PMID:37309557 | DOI:10.3341/kjo.2023.0019

Korean J Ophthalmol. 2023 Jun;37(3):230-235. doi: 10.3341/kjo.2022.0135. Epub 2023 Jun 5.

ABSTRACT

PURPOSE: To investigate the effect of order of examination on the results of noninvasive keratograph tear film evaluation using Keratograph5M in dry eye patients.

METHODS: One hundred and four patients with dry eye symptoms were analyzed retrospectively. All patients underwent bilateral noninvasive tear film evaluation using measurements of tear meniscus height (TMH) and noninvasive keratograph break-up time (NIKBUT) obtained using Keratograph5M. Measurements were performed sequentially in the order of right TMH, left TMH, right NIKBUT, and left NIKBUT.

RESULTS: There was no statistically significant difference in TMH values between the right and left eyes (0.24 ± 0.08 and 0.23 ± 0.08 mm, respectively). Mean NIKBUT-first (time at first tear film break-up) and mean NIKBUT-average (the mean of all tear film break-up time over the entire cornea) were 6.17 ± 3.28 and 10.00 ± 3.97 seconds, respectively, for right, and 7.43 ± 3.86 and 11.57 ± 4.34 seconds, respectively, for left eyes. In addition, mean NIKBUT-first between right and left eyes, and mean NIKBUT-average between them were statistically significant (p = 0.013 and p = 0.007, respectively). Mean NIKBUT and mean TMH differences were not significantly influenced by right or left eyes, age, or sex (all p > 0.050). Spearman correlation analyses of TMH, NIKBUT-first, and NIKBUT-average results showed moderate positive correlations between right and left eyes (r = 0.470, r = 0.322, and r = 0.576, respectively; p < 0.001).

CONCLUSIONS: TMH evaluation was not affected by test order; however, NIKBUT measurement was affected by test order, because of reflex tearing due to forced eye opening during the examination. Therefore, TMH should be evaluated before NIKBUT, and sufficient time interval and caution should be needed between NIKBUT measurements on both eyes.

PMID:37309556 | DOI:10.3341/kjo.2022.0135

Korean J Ophthalmol. 2023 Jun;37(3):216-223. doi: 10.3341/kjo.2022.0146. Epub 2023 Jun 5.

ABSTRACT

PURPOSE: To evaluate the effect of intraoperative mitomycin C (MMC) on the surgical outcomes of ciliary sulcus (CS) Ahmed glaucoma valve (AGV) tube placement.

METHODS: A retrospective review of medical records of 54 consecutive patients who underwent AGV implantation with tube placed in CS was performed. Consecutive cases operated without the use of intraoperative MMC from 2017 to 2019 were compared with consecutive cases operated with MMC from 2019 to 2021. Surgical failure was defined as intraocular pressure (IOP) exceeding 21 mmHg in two consecutive visits after postoperative 3 months or ≤30% IOP reduction, IOP ≤5 mmHg in two consecutive visits, or loss of light perception. Kaplan-Meier survival analysis and log-rank test were performed to compare the surgical failure rates.

RESULTS: A total of 54 eyes of 54 patients were investigated. Mean follow-up period after AGV implantation was 1.4 ± 0.8 years. The MMC group showed significantly lower IOP during the 1st postoperative month (20.5 ± 8.6 mmHg vs. 15.8 ± 6.4 mmHg, p = 0.027), but the difference did not persist 6 months after the surgery (p = 0.805). The mean number of postoperative antiglaucoma medications was significantly lower in the MMC group in the 1st postoperative month (p = 0.047) but no difference was found at 6 months. No statistical difference was noted in the rates of postoperative complications. Kaplan-Meier survival analysis showed comparable survival rates between MMC group and no MMC group (p = 0.356).

CONCLUSIONS: The intraoperative use of MMC significantly lowered IOP in the 1st postoperative month but did not increase 6 months success rates in patients receiving AGV tube placement in CS.

PMID:37309554 | DOI:10.3341/kjo.2022.0146

Cureus. 2023 Jun 11;15(6):e40244. doi: 10.7759/cureus.40244. eCollection 2023 Jun.

ABSTRACT

BACKGROUND: Mechanical ventilation is a life-saving intervention for critically ill patients, but it can also lead to diaphragm atrophy, which may prolong the duration of mechanical ventilation and the length of stay in the intensive care unit. IntelliVent-ASV® (Hamilton Medical, Rhäzüns, Switzerland) is a new mode of ventilation that has been developed to reduce diaphragm atrophy by promoting spontaneous breathing efforts. In this study, we aimed to evaluate the effectiveness of IntelliVent-ASV® and pressure support-synchronized intermittent mandatory ventilation (PS-SIMV) mode in reducing diaphragm atrophy by measuring diaphragm thickness using ultrasound (US) imaging.

METHODS: We enrolled 60 patients who required mechanical ventilation due to respiratory failure and were randomized into two groups: IntelliVent-ASV^® and PS-SIMV. We measured the diaphragm thickness using US imaging at admission and on the seventh day of mechanical ventilation.

RESULTS: Our results showed that diaphragm thickness decreased significantly in the PS-SIMV group but remained unchanged in the IntelliVent-ASV^® group. The difference in diaphragm thickness between the two groups was statistically significant on the seventh day of mechanical ventilation.

CONCLUSIONS: IntelliVent-ASV^® may reduce diaphragm atrophy by promoting spontaneous breathing efforts. Our study suggests that this new mode of ventilation may be a promising approach to preventing diaphragm atrophy in mechanically ventilated patients. Further studies using invasive measures of diaphragm function are warranted to confirm these findings.

PMID:37309540 | PMC:PMC10257811 | DOI:10.7759/cureus.40244