Category: Statistics

J Glob Health. 2023 Aug 4;13:04030. doi: 10.7189/jogh.13.04030.

ABSTRACT

BACKGROUND: Individuals with rare diseases (RD) have been historically understudied. Previous publications reported that existing primary health care (PHC) workforces and associated infrastructure had been shown to improve their access and health-related outcomes in low- and middle-income countries (LMICs). As current evidence about the impact of PHC on patients diagnosed with RD is yet highly dispersed, this scoping review aimed to collate available evidence of the impact of PHC on patients with RD and summarize published information from multiple stakeholders about the perceived usefulness and barriers to effective use of the PHC system.

METHODS: We searched Embase, Health System Evidence, PubMed, LILACS / BVS, and The Cochrane Library, from inception to September 1, 2022, for publications providing clear expert- or experience-based insights or data from patients living with RD at the PHC level of care. We included publications highlighting barriers to integrated care of patients with RD, reported by multiple social actors involved in caring for patients with RD. Two investigators screened publications, extracted data, and clustered information among records deemed eligible for inclusion. Data synthesis was performed using narrative and thematic-based analysis. Major findings identified and coded through a semantic-driven analysis were processed in vosViewer software and reported using descriptive statistics.

FINDINGS: Eighty publications were included in this review. Quali-quantitative analyses evidenced that the PHC level is essential for approaching patients with RD, mainly due to its longitudinal, multidisciplinary, and coordinated care delivery. In addition, several publications highlighted that the medical curriculum is inappropriate for preparing health care providers to deal with patients presenting unusual signs and symptoms and being diagnosed with RD. PHC teams are essential in orienting patients and families on emergency events. Technology-related concepts were reported in 19 publications, emphasizing their effectiveness on early diagnosis, optimal treatment definition, improvement of quality of life, and long-lasting follow-up.

CONCLUSIONS: We provided valuable information on the effectiveness of the PHC in fostering a creative, integrative, and supportive environment for patients living with RD. Our results can be helpful to several stakeholders in deciding what actions are still pending to achieve a solid and positive experience for patients with RD in the PHC.

REGISTRATION: PROSPERO (CRD42022332347).

PMID:37539555 | DOI:10.7189/jogh.13.04030

Rev Esp Enferm Dig. 2023 Aug 4. doi: 10.17235/reed.2023.9668/2023. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the effects of age, period and cohort (A-P-C) on gastric cancer (GC) mortality in Spain from 1980-2021.

METHODS: We conducted an ecological trend study (with aggregated data obtained from the National Institute of Statistics). Joinpoint regression software was used to estimate rates by sex and age group (<35, 35-64, >64 years) and mortality trends. National Cancer Institute A-P-C tools were used to assess the effects of age, time of death, and birth cohort.

RESULTS: GC mortality rates in Spain decreased significantly for both sexes in Spain. In the under-35 age group, rates were stable after an initial significant decline. In the 35-64 age group, the decline was more pronounced in men than in women. In the 65+ age group, rates fell significantly for both sexes, but more so for women than for men. The net drift and local drift also showed significant decreases for all age groups from 24 years onwards. GC mortality rates increased with age and decreased with calendar time and successive birth cohorts, regardless of sex. The ratio of age-specific rates between men and women increased with age, and birth cohort relative risk estimates followed a steady downward trend until the mid-1970s, after which the decline stabilized. The relative risk decreased for both sexes, with a more pronounced decrease in men.

CONCLUSION: GC mortality rates in Spain have been decreasing over time and across successive birth cohorts, with a stabilising trend observed for those under 35 years of age.

PMID:37539520 | DOI:10.17235/reed.2023.9668/2023

Ital J Dermatol Venerol. 2023 Aug;158(4):347-352. doi: 10.23736/S2784-8671.23.07588-6.

ABSTRACT

BACKGROUND: Recently, YouTube has been frequently used by non-physicians and physicians to share information and experiences about diseases. This study aims to compare videos uploaded to YouTube about urticaria in terms of quality, reliability, usefulness, and popularity based on the uploaded source.

METHODS: YouTube was searched using the keyword “urticaria”. From the search returns, we selected the first 60 videos created by physicians and the first 60 videos created by non-physicians. We compared the two sets of videos in terms of reliability, usefulness, quality, and popularity using the Video Power Index (VPI) score, DISCERN score, global quality score (GQS) and usefulness score.

RESULTS: The mean DISCERN score, GQS, and usefulness score were statistically significantly higher (P<0.001) for videos uploaded by physicians than those uploaded by non-physicians. Although not statistically significant, the median number of likes and comments, the rate of views, and the VPI scores were higher for videos uploaded by the non-physician group. The mean DISCERN scores, GQS, and usefulness scores were statistically significantly higher (P<0.001) for videos uploaded by specialist physicians (dermatologists and allergists) than for those uploaded by non-specialists. Specialist physicians mentioned medical treatment for the condition more than non-specialists, which was statistically significant (P<0.001).

CONCLUSIONS: YouTube videos about urticaria uploaded by physicians, especially specialists, are of higher quality, reliable and useful, but videos uploaded by non-physicians are more popular and have higher viewing rates.

PMID:37539503 | DOI:10.23736/S2784-8671.23.07588-6

J Cosmet Dermatol. 2023 Aug 4. doi: 10.1111/jocd.15894. Online ahead of print.

ABSTRACT

OBJECTIVE: To demonstrate the effects of PDO threads non-surgical rhinoplasty on patients’ quality of life (using FACE-Q Scale) and first impression assessments.

METHODS: This is a prospective cohort study of 10 adult patients who sought non surgical rhinoplasty to improve tip rotation or reduce the appearance of a dorsal hump. All patients fulfilled the study’s enrollment criteria. Prior to treatment, patients completed pre-treatment FACE-Q surveys and pre-treatment photos were obtained. Each patient was treated with the appropriate size and number of PDO threads necessary to achieve optimal correction result (OCR). Two weeks after treatment, the patient completed posttreatment FACE-Q surveys and posttreatment photos were obtained and analyzed. First impression surveys were created using pre- and posttreatment photos, and the survey was completed by 146 blinded evaluators.

RESULTS: There was statistically significant improvement in the FACE-Q scores for social function (p = 0.02), psychological function (p = 0.0009) and satisfaction with nose (p = 0.0001). There was significant reduction in scores for appearance related psychosocial distress (p = 0.03). For the first impression surveys, there was a statistically significant improvement (p = 0.029) in the attractiveness scale posttreatment. Although not statistically significant, there was reduction of the dorsal hump (p = 0.15) and increase in the nasolabial angle (p = 0.48) and Goode’s ratio (p = 0.16). There were no major adverse events or complications.

CONCLUSION: This study shows that the PDO threads alone can be used safely to achieve minor nasal changes especially in tip rotation and appearance of dorsal hump, to improve patients’ quality of life, and perceived attractiveness of treated patients.

PMID:37539496 | DOI:10.1111/jocd.15894

Aging Cell. 2023 Aug 4:e13940. doi: 10.1111/acel.13940. Online ahead of print.

ABSTRACT

Reactive oxygen species (ROS) play an important role in immune responses; however, their excessive production and accumulation increases the risk of inflammation-related diseases. Although irradiation is known to accelerate immunological aging, the underlying mechanism is still unclear. To determine the possible involvement of ROS in this mechanism, we examined 10,023 samples obtained from 3752 atomic-bomb survivors in Hiroshima and Nagasaki, who participated in repeated biennial examinations from 2008 to 2016, for the effects of aging and radiation exposure on intracellular ROS (H₂ O₂ and O₂ ^•- ) levels, percentages of T-cell subsets, and the effects of radiation exposure on the relationship between cell percentages and intracellular ROS levels in T-cell subsets. The cell percentages and intracellular ROS levels in T-cell subsets were measured using flow cytometry, with both fluorescently labeled antibodies and the fluorescent reagents, carboxy-DCFDA and hydroethidine. The percentages of naïve CD4⁺ and CD8⁺ T cells decreased with increasing age and radiation dose, while the intracellular O₂ ^•- levels in central and effector memory CD8⁺ T cells increased. Additionally, when divided into three groups based on the percentages of naïve CD4⁺ T cells, intracellular O₂ ^•- levels of central and effector memory CD8⁺ T cells were significantly elevated with the lowest radiation dose group in the naïve CD4⁺ T cells. Thus, the radiation exposure-induced decrease in the naïve CD4⁺ T cell pool size may reflect decreased immune function, resulting in increased intracellular ROS levels in central and effector memory CD8⁺ T cells, and increased intracellular oxidative stress.

PMID:37539495 | DOI:10.1111/acel.13940

Int J Speech Lang Pathol. 2023 Aug 4:1-9. doi: 10.1080/17549507.2023.2180094. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the present study was to adapt and validate the Speech Pathology-Specific Questionnaire for Persons with Multiple Sclerosis (SMS) into the Greek language.

METHOD: The study sample consisted of 124 people with multiple sclerosis (PwMS) and 50 healthy controls (HCs). All PwMS underwent cognitive assessment using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Both PwMS and HCs completed the SMS, the Eating Assessment tool (EAT-10), the Voice Handicap Index (VHI), and the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39).

RESULT: Significant difference was found between PwMS and HCs for the EAT-10, SAQOL-39, the total SMS, and the SMS subscales. Discriminant validity analyses revealed a statistically significant difference between PwMS and HCs for the total and subscales SMS. Convergent validity analyses between the total SMS and the SMS subscales, and scores on the BICAMS, EAT-10, SAQOL-39, and VHI in PwMS were significantly correlated, with exception of the SMS Speech/Voice with the Symbol Digit Modalities Test (SDMT) and the Greek Verbal Learning Test-II (GVLT-II). Scores on the EAT-10, SAQOL-39, and VHI in PwMS were also correlated with the total SMS and the SMS subscales in PwMS, HCs, and the total sample. Construct validity analyses revealed that the total SMS and the SMS subscales were significantly correlated with the Expanded Disability Status Scale (EDSS) and years of education, while no associations were found with regards to age, MS subtype (relapsing-remitting MS [RRMS] vs progressive MS [PMS]), disease duration, or sex. The internal consistency of all items was excellent in PwMS and the total sample (Cronbach’s alpha was >0.7 after deletion of one item), with the exception of two items, which still fell within the acceptable range (>0.6) for PwMS and the total sample.

CONCLUSION: The Greek version of the SMS is a reliable and valid patient-reported outcome measure to assess speech-language and swallowing pathology related symptoms in PwMS, and can be used for research and clinical purposes.

PMID:37539484 | DOI:10.1080/17549507.2023.2180094

Cureus. 2023 Jul 3;15(7):e41305. doi: 10.7759/cureus.41305. eCollection 2023 Jul.

ABSTRACT

BACKGROUND: Patients with life-threatening hemorrhages due to blunt torso trauma are at a particularly high risk of being underdiagnosed. The pulse pressure (PP) starts narrowing down before the traditional parameters start changing, making it a useful tool for assessing and planning early intervention.

OBJECTIVE: To assess the utility of low PP in predicting massive transfusion (MT) or operative intervention in patients with isolated blunt abdominal trauma.

MATERIAL AND METHODS: A total of 186 patients were included. The PP and mean arterial pressure (MAP) were calculated. Vitals, PP, and MAP were monitored every 15 min during the first 6 h, then every 30 min during the next 6 h, and afterward, every 4 h until discharge. A Chi-square test and an independent t-test (as appropriate) were applied to compare variables with PP at the time of presentation. Differences were considered statistically significant at p-value ≤ 0.05.

RESULTS: A total of 55.9% of these patients had injuries due to road traffic accidents (RTA). Emergency operative intervention was provided to 26.3% of the patients. Death was 4.3%. MT was required by 26.3% of the patients. There was a statistically significant association between low PP and sex, length of stay, repeat extended focused assessment with sonography in trauma (eFAST), emergency operational intervention, outcome, MT, number of crystalloids consumed within the first four hours after presentation, injury severity score, systolic blood pressure (SBP), and pulse rate.

CONCLUSION: The PP <30 mmHg was observed as a useful predictor for increased blood loss requiring blood transfusion or operative intervention.

PMID:37539430 | PMC:PMC10394963 | DOI:10.7759/cureus.41305

Cureus. 2023 Jul 2;15(7):e41293. doi: 10.7759/cureus.41293. eCollection 2023 Jul.

ABSTRACT

INTRODUCTION: Transplanting a tooth from one area of the mouth to another is known as autogenous tooth transplantation. It is a great choice for restoring young patients’ teeth with developing alveolar bone because it uses the patient’s own tooth as the replacement rather than a false one. This study aims to evaluate pain, infection, mobility, resorption, ankylosis, and success rate in the replacement of mandibular non-restorable molars through an immediate autotransplantation of the nonfunctional impacted mandibular third molar.

MATERIALS AND METHODS: In this in vivo study, 20 patients between the ages of 22 and 50 were selected. The cases in which the first or second mandibular molar was nonrestorable and had an impacted third molar for transplantation were selected. In all the cases, the nonrestorable molar was extracted and replaced with a nonfunctional, impacted third molar. All the cases were evaluated for pain, infection, mobility, ankylosis, and resorption at the postoperative second week, one month, third month, and six months. The pain was assessed on the visual analog scale (VAS), infection was assessed by the presence of purulent discharges, mobility was assessed on a clinical examination of tooth movements, ankylosis was seen radiographically as the obliteration of the periodontal ligament space, and the absence of the lamina dura and resorption were seen radiographically as radiolucency on the root surface. All the readings were tabulated and statistically analyzed.

RESULTS: Pain was seen to be maximal at two weeks and minimum at six months. Infection was not seen at all time intervals. Mobility was reduced with time. There was no significant ankylosis or resorption. Out of the 20 cases, four patients required extractions due to resorption and grade 3 mobility. One patient showed ankylosis. The success rate of the autotransplantation was 75%. Fifteen patients showed well-defined lamina dura without ankylosis or resorption.

CONCLUSION: Autotransplantation is a valuable tooth replacement option and more economical, especially when provided with proper case selection.

PMID:37539402 | PMC:PMC10394477 | DOI:10.7759/cureus.41293

Cureus. 2023 Jul 3;15(7):e41320. doi: 10.7759/cureus.41320. eCollection 2023 Jul.

ABSTRACT

BACKGROUND: The physical and mental health of parents can be adversely affected by their child’s disability, leading to a potential decline in their overall Quality of Life (QoL). This research aimed to determine the QoL of family caregivers and compare this based on sociodemographic factors and child characteristics.

MATERIALS AND METHODS: An analytical cross-sectional design was employed, and data were collected from multiple rehabilitation centers for children with special needs and learning disorders in the Kingdom of Saudi Arabia. The study sample comprised 95 family caregivers who completed a self-structured questionnaire. The questionnaire included sections on sociodemographic characteristics, child characteristics, and caregivers’ QoL assessed using the RAND 36-Item Short Form Health Survey (SF-36). The collected data were analyzed using the IBM Corp. Released 2022. IBM SPSS Statistics for Windows, Version 29.0. Armonk, NY: IBM Corp, employing descriptive statistics and multivariate linear regression analysis.

RESULTS: Our findings revealed that the overall mean QoL score among caregivers was 57, ranging from 12 to 94. There were no statistically significant differences in QoL scores based on caregivers’ age, gender, occupational status, or income. However, further analysis indicated significant associations between certain factors and specific domains of QoL. Specifically, caregiver education was found to be associated with role limitations due to emotional problems, while relationships with disabled children were linked to emotional well-being. The severity of the child’s disability and the presence of another child with a disability in the family were associated with the bodily pain domain. Additionally, the presence of another child with a disability had an impact on perceived change in the health domain.

CONCLUSIONS: The QoL of family caregivers varied, highlighting the significant challenges faced by certain individuals. Factors such as education level, the relationship with the child, the severity of the disability, and the presence of multiple disabled children in the family were identified as influencing caregivers’ QoL. These findings emphasize the importance of developing targeted interventions that can address emotional well-being and fatigue management while promoting a supportive society.

PMID:37539394 | PMC:PMC10395756 | DOI:10.7759/cureus.41320

Cureus. 2023 Jul 3;15(7):e41324. doi: 10.7759/cureus.41324. eCollection 2023 Jul.

ABSTRACT

Aim The study aims to substantiate the quantitative role of the predominant periodontopathogen (Porphyromonas gingivalis) associated with peri-implantitis and evaluate the reactive oxygen metabolite levels in peri-implantitis patients. Methodology A total of 40 participants were taken from the department of periodontology, Thai Moogambigai Dental College and Hospital, Chennai, and divided into groups I (control) and II (test). Group I included 20 participants with healthy peri-implant tissue, and group II included 20 participants with infected peri-implant tissues. The predominant periodontopathogen was detected by using a quantitative real-time polymerase chain reaction. Samples (gingival crevicular fluid (GCF), saliva, and plasma) were collected, and a biochemical assay was conducted for reactive oxygen metabolites (ROM) analysis in healthy implants (control group) and peri-implantitis conditions (test group). ROM levels of the patients were statistically analyzed. Results The qualitative and quantitative profiles of Porphyromonas gingivalis (P. gingivalis) associated with Peri-implantitis were analyzed, and the levels of ROM in periimplantitis patients were assessed. The study results substantiate the quantitative picture of Porphyromonas gingivalis in the detection of periimplantitis. The saliva and GCF samples showed significant differences in ROM levels between the test and control groups. Conclusion This is one of the few studies to detect the predominant bacterial pathogen associated with peri-implantitis and assess the ROM levels in periimplantitis patients. The study gives a correlation between the periopathogens and ROM levels, thereby facilitating the attainment of the best possible treatment options.

PMID:37539392 | PMC:PMC10396069 | DOI:10.7759/cureus.41324