Category: Statistics

Thorac Res Pract. 2023 Jan;24(1):29-33. doi: 10.5152/ThoracResPract.2022.22045.

ABSTRACT

OBJECTIVE: It is accepted that the only way to end severe acute respiratory syndrome coronavirus 2 epidemic is through community vaccination. The frequency and clinical features of infection after vaccination are not known clearly. The aim of this study is to determine the frequency and clinical features of coronavirus disease 2019 seen after either the first or second dose of CoronaVac vaccination in healthcare workers and their relatives.

MATERIAL AND METHODS: This is a cross-sectional retrospective survey study. The study was carried out in 2013 volunteers, including 1903 (94.5%) healthcare workers and 110 (5.5%) relatives of healthcare workers. The frequency and clinical features of coronavirus disease 2019 before and after the first or second dose of CoronaVac vaccination were retrospectively evaluated using an online questionnaire conducted in July 2021.

RESULTS: A total of 2013 people, 1312 women and 701 men, participated in the study. Of these individuals, 245 (12.1%) were polymerase chain reaction positive for coronavirus disease 2019 before vaccination. Of this group, 185 (75.5% of polymerase chain reaction positives and 9.1% of the whole population) received home-based therapy, while 38 (15.5%) received hospital admission. Asymptomatic polymerase chain reaction positivity before vaccination was seen in 22 (9%) individuals. There were 177 (8.8%) participants who developed polymerase chain reaction positivity at any time after vaccination. In 129 (72.8%) of these participants, polymerase chain reaction positivity occurred 21 days after the second dose of vaccine. While the number of patients hospitalized before vaccination was 38 (15.5% of the polymerase chain reaction positivity group and 1.89% of the general population), the number of patients hospitalized after the vaccination was 17 (10.1% of the polymerase chain reaction positivity group and 0.80% of the general population). The decrease in hospitalization proportion was statistically significant (P = .002).

CONCLUSION: The frequency of coronavirus disease 2019, severe illness, and hospitalization rates were found to be lower in postvaccination period. The vaccine is effective in preventing coronavirus disease 2019 and severe disease.

PMID:37503596 | DOI:10.5152/ThoracResPract.2022.22045

Thorac Res Pract. 2023 Jan;24(1):14-21. doi: 10.5152/ThoracResPract.2023.22058.

ABSTRACT

OBJECTIVE: Telemedicine has been defined as a valuable tool in delivering care for COVID-19 patients. However, clinicians and policymakers should be convinced that traditional and new technological methods of clinical management may be equally effective. The purpose of this study was to generate some initial recommendations based on the clinical utility of videoconference consultation in forward triage and follow-up for COVID-19 patients.

MATERIAL AND METHODS: This retrospective cross-sectional study evaluated the medical records of 100 COVID-19 patients consulted using a videoconference program (Skype), from September 1, 2020, to February 3, 2021. The data were analyzed on demographic characteristics, disease history, the need for physical examination after videoconference consultation, pre-diagnostics and diagnostics, treatment decisions, number of videoconference consultation sessions in follow-up, duration of sessions, and final outcome.

RESULTS: The male COVID-19 patients constituted 54% of the total sample. The median age was 51 (42-61) years. The median duration of the initial videoconference consultation session was 16 (12-21) minutes. Following the initial videoconference consultation session, 14 patients required follow-up with all face-to-face visits; the remaining patients were primarily followed with videoconference consultation sessions. For 25 patients, it was sufficient to provide only videoconference consultation sessions; they were not required to be in the hospital for physical examination or any subsequent investigation at all. A total of 14 patients were hospitalized. There was no statistically significant difference between the high-risk group and the other patients according to the components of the disease management process via videoconference consultation.

CONCLUSION: Videoconference consultation enables a holistic assessment regardless of the patient’s characteristics and allows for more time to be spent on each patient, particularly during the pandemic period without risk of contagion. It can be used as a forward triage and follow-up tool to identify patients in need of emergency hospitalization and continuous health care.

PMID:37503594 | DOI:10.5152/ThoracResPract.2023.22058

Eur J Orthod. 2023 Jul 28:cjad036. doi: 10.1093/ejo/cjad036. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: The aim of this trial was to investigate the effect of mastic mouthwash on halitosis using as a proxy the levels of the Volatile Sulfur Compounds (VSCs), and the effect on plaque and gingival indices in adolescents undergoing orthodontic treatment with fixed conventional labial appliances.

SUBJECTS/METHODS: The study was a double-blinded, placebo-controlled, parallel-group, randomized clinical trial. Thirty patients with fixed orthodontic appliances were randomly allocated at a 1:1 ratio, to either the mastic-mouthwash or the placebo-mouthwash group. Eligibility criteria included ages between 13 and 18, active orthodontic treatment with fixed appliances, good general health, and total initial VSCs levels above 150 ppb. The primary outcome was the objective hydrogen sulfide (H2S) level, measured with the Oral ChromaTM device. The secondary outcomes were (1.) the methyl-mercaptan (CH3SH) and (2.) dimethyl sulfide [(CH3)2S] levels, measured with the same device, (3.) the subjective perception of the own malodour via questionnaires, and (4.) the oral hygiene assessed with the use of the Modified Silness and Löe Plaque Index (PI-M) and the Silness and Löe Gingival Index (GI) at baseline (T0) and after 2 weeks (T1). Stratified randomization by gender was used, and allocation was concealed with opaque numbered sealed envelopes.

RESULTS: H2S level dropped from 221.00 ppb (T0) to 125.00 ppb (T1), and the difference between treatment groups was statistically significant in favour of the mastic group (coef: 72.34, 95% CI: 8.48, 136.27, P = 0.03). The levels of the other VSCs, the subjective measurements of oral malodour, and the oral hygiene indices did not differ between treatment arms.

LIMITATIONS: The objective organoleptic assessment by a calibrated examiner was not performed.

CONCLUSIONS/IMPLICATIONS: Mastic mouthwashes could be an alternative treatment for adolescent patients suffering from halitosis during orthodontic treatment with fixed appliances.

REGISTRATION: The trial was registered at ClinicalTrials.gov (identifier: NCT05647369).

PMID:37503575 | DOI:10.1093/ejo/cjad036

J Dermatolog Treat. 2023 Dec;34(1):2240455. doi: 10.1080/09546634.2023.2240455.

ABSTRACT

BACKGROUND: Acne vulgaris (AV) is a common skin disease. Fire needle is a method of quickly piercing the local skin lesions with red-hot needles for AV. This work aimed to evaluate the efficacy and safety of fire needle combined with chemical peels for AV.

METHODS: Eight databases including PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Internet, Wanfang, Sinomed, and VIP databases were searched to enrolled randomized controlled trials (RCTs) comparing fire needle therapy combined with chemical peels with chemical peels alone. The risk of bias was evaluated by the Cochrane Collaboration’s tool. Statistical analysis was completed by RevMan 5.3 and Stata 14.0.

RESULTS: Altogether 18 studies including 1213 patients were enrolled. Compared with chemical peels alone, fire needle adjuvant chemical peels therapy improved the total effective rate (RR = 1.37,95% CI [1.26,1.48], p < 0.00001) and skin lesions (MD = -2.11, 95% CI [-2.74, -1.47], p < 0.00001), and reduced the recurrence rate (RR = 0.50,95% CI [0.33,0.76], p = 0.0009).The application of fire needle was associated with few adverse reactions, all of which were well tolerated and transient.

CONCLUSION: Fire needle adjuvant chemical peels therapy is effective and safe for AV. Nevertheless, more large-scale, well-designed clinical studies are warranted to provide evidence-based medical support.

PMID:37503565 | DOI:10.1080/09546634.2023.2240455

Hosp Pediatr. 2023 Jul 28:e2023007199. doi: 10.1542/hpeds.2023-007199. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Numerous decision tools have emerged to guide management of febrile infants, but limited data exist to guide the care of young infants presenting with hypothermia. We evaluated the variation in care for well-appearing hypothermic young infants in the hospital and/or emergency department setting between participating sites.

METHODS: This is a retrospective cohort study of well-appearing infants ≤90 days old across 9 academic medical centers from September 1, 2016 to May 5, 2021. Infants were identified via billing codes for hypothermia or an initial temperature ≤36.0°C with manual chart review performed. Primary outcomes included assessment of variation in diagnostic evaluation, disposition, empirical antimicrobial therapy, and length of stay.

RESULTS: Of 14 278 infants originally identified, 739 met inclusion criteria. Significant interhospital variation occurred across all primary outcomes. Across sites, a full serious bacterial illness evaluation was done in 12% to 76% of hypothermic infants. Empirical antibiotics were administered 20% to 87% of the time. Performance of herpes simplex viral testing ranged from 7% to 84%, and acyclovir was empirically started 8% to 82% of the time. Hospital admission rates ranged from 45% to 100% of patients.

CONCLUSIONS: Considerable variation across multiple aspects of care exists for well-appearing young infants presenting with hypothermia. An improved understanding of hypothermic young infants and their risk of infection can lead to the development of clinical decision tools to guide appropriate evaluation and management.

PMID:37503559 | DOI:10.1542/hpeds.2023-007199

J Med Virol. 2023 Aug;95(8):e28956. doi: 10.1002/jmv.28956.

ABSTRACT

The possible benefits of inspiratory muscle training (IMT) on mechanical and clinical outcomes in patients with Coronavirus disease-2019 (COVID-19) remain controversial. We conducted a meta-analysis to evaluate the effect of IMT in the rehabilitation strategy of patients with COVID-19. The Pubmed, Embase, Web of Science (WOS), and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify trials evaluating the efficacy of IMT in the treatment of patients with COVID-19. The primary outcome included change from baseline of VO₂ max, maximal inspiratory pressure (PImax), 6-min walk test(6MWT), forced expiratory volume in the first second predicted (FEV1%pred), and quality of life (QOL). Six studies with 349 participants were analyzed. Significant improvements were found in change from baseline of VO₂ max (MD: 4.54, 95% confidence interval [CI]: 1.79-7.30, Z = 3. 32, I² = 0, p = 0.001), PImax (MD: 21.43, 95% CI: 1.33-41.52, Z = 2.09, I² = 90%, p = 0.04), 6MWD (MD: 40.13, 95% CI: 24.92-55.35, Z = 5.17, I² = 0, p < 0.00001) and FEV1%pred (MD: 8.73, 95% CI 3.07-14.39, Z = 3.02, p = 0.002) while no statistical improvements were found in QOL (SMD: 0.70, 95% CI: 0.37-1.03, Z = 4.15, I² = 89% p = 0.32) between IMT group and control group. The application of IMT might elicit mechanical and clinical improvement in patients with COVID-19. IMT could be recommended as an effective strategy of pulmonary rehabilitation for COVID-19. However, the proper timing, optimal duration, as well as appropriate frequency and intensity of IMT remain uncertain and further studies are needed.

PMID:37503550 | DOI:10.1002/jmv.28956

Cureus. 2023 Jun 26;15(6):e40989. doi: 10.7759/cureus.40989. eCollection 2023 Jun.

ABSTRACT

We noticed a subjective increase in psychosis admissions within our emergency department (ED) with the onset of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify trends concerning admissions due to psychosis in the ED before and after the beginning of the COVID-19 pandemic. We analyzed 508 psychiatric admissions through the ED from October 2019 to October 2020, of which 367 cases of psychosis were identified. Statistical analysis was performed using T-tests and Pearson’s correlation coefficient. T-testing showed mean psychosis admissions during the pandemic (March 2020 to July 2020) to be greater than admissions occurring during the pre-pandemic period (October 2019 to February 2020) (p = 0.04). Pearson’s correlation coefficient identified the relationships between COVID-19 admissions and psychosis admissions during this time as positive (r = 0.5) but did not reach statistical significance (p = 0.06). Therefore, within our time frame, we did see a noted increase in psychosis by 22.9% during the pandemic compared to pre-pandemic times. Current research remains conflicted concerning psychiatric ED admissions during COVID-19, with some stating an increase and others finding a decrease. Our data showed a significant statistical increase in the mean number of psychosis cases when comparing pre-pandemic and pandemic admissions. These findings help add pertinent data to understand how psychosis admissions trended before and during the beginning of the COVID-19 pandemic, specifically in South Miami, Florida. It also provides a foundation for future studies by providing data points concerning mental illness within the vulnerable population of patients served in our community.

PMID:37503505 | PMC:PMC10370826 | DOI:10.7759/cureus.40989

Cureus. 2023 Jun 25;15(6):e40951. doi: 10.7759/cureus.40951. eCollection 2023 Jun.

ABSTRACT

AIM AND OBJECTIVES: This study aims to determine the effect on shear bond strength (SBS) and adhesive remnant score between two color change adhesives (CCAs) with reduced curing time using different high-intensity light emitting diode (LED) units.

MATERIALS AND METHODS: A total of 108 human first maxillary premolar teeth were randomly allocated into three principal groups (n = 36) based on the type of adhesives used. The adhesives include two CCAs: Transbond Plus Color Change Adhesive (3M, St. Paul, MN, USA) and Grengloo (Ormco, Orange, CA, USA), and the conventional tooth-colored adhesive: Transbond XT (3M). Each principal group was further divided into three sub-groups (n = 12 each) based on the curing time and type of high-intensity LED units used for bonding the stainless steel brackets. Woodpecker iLED Light Curing Unit (Guilin Woodpecker Medical Instrument Co., Ltd., Guilin, China) was cured for three and six seconds, and the ELIPAR S10 LED Curing Light (3M) was cured for 20 seconds. Bonding of the brackets was done in a standardized manner following the manufacturers’ instructions. All the samples were submerged in distilled water at 37⁰C for 24 hours. SBS testing was performed using an Instron machine, and adhesive residue on the debonded surface was examined and scored using a stereomicroscope. Statistical analysis was conducted using one-way ANOVA and Tukey’s post-hoc test.

RESULTS: The results showed significant differences in SBS based on curing time and the type of adhesive resin used. The six seconds curing group exhibited the higher SBS values (15.5 – 22.82 Megapascals [MPa]) followed by the 20 seconds (12.17 – 18.14 MPa) and three seconds (11.31 – 11.74 MPa) groups. Grengloo adhesive demonstrated the highest SBS values among the three types of adhesives. The predominant adhesive remnant scores were 2 and 3.

CONCLUSIONS: Grengloo adhesive demonstrates superior bond strength compared to Transbond Plus and Transbond XT. Both Transbond Plus and Grengloo adhesives experience bond failure within the adhesive layer, regardless of the curing intensity or time.

PMID:37503503 | PMC:PMC10368936 | DOI:10.7759/cureus.40951

Cureus. 2023 Jun 26;15(6):e40965. doi: 10.7759/cureus.40965. eCollection 2023 Jun.

ABSTRACT

Background Renal calculi remain a major economic and health burden worldwide and are considered a systemic disorder associated with multiple other diseases. Several studies have observed that patients with idiopathic calcium renal stones show a reduction in bone mass. This study aimed to evaluate bone mass reduction on a non-contrast CT scan study in a group of idiopathic calcium-containing renal calculus disease patients in comparison with subjects without renal calculus disease. Methodology This non-interventional, cross-sectional study included a total of 300 patients with 150 cases (with renal calculi) and 150 controls (without renal calculi). Patients were divided according to age groups of 18-40, 40-60, and more than 60 years. The renal calculus size and the mean iliac bone thickness were calculated, and Spearman’s correlation test was used to determine the correlation between them. Results The mean iliac bone thickness was significantly lower in the cases (3.29 mm) compared to the controls (9.73 mm with a standard deviation of 1.341 mm). There was a statistically significant negative correlation between the size of the renal calculus and the mean iliac bone thickness. Conclusions Renal calculus disease associated with hypercalciuria caused by increased bone resorption is reflected by the decreased iliac bone thickness on CT scans. Our study used the iliac bone (cancellous bone) in predicting bone mass reduction which shows changes early in the course of the disease compared to the neck of the femur and lumbar vertebrae (compact bones). It helps in predicting osteoporosis early and prevents the progression of the disease through early and appropriate clinical and urological intervention.

PMID:37503501 | PMC:PMC10369481 | DOI:10.7759/cureus.40965

Cureus. 2023 Jun 26;15(6):e40995. doi: 10.7759/cureus.40995. eCollection 2023 Jun.

ABSTRACT

BACKGROUND: Guillain-Barré Syndrome (GBS) is the most common cause of acute, usually post-infectious, peripheral neuropathy resulting in a symmetrical, ascending paralysis. We evaluated the clinical and neurophysiological features, treatment, and outcomes of patients with GBS in our center.

METHODS: A retrospective chart review on patients with GBS admitted to King Abdulaziz Medical City, Riyadh, Saudi Arabia, from January 2011 to December 2020. Data were analyzed using JMP statistical software version 15 pro.

RESULTS: A total of 86 patients who met the criteria were included, 55 (64%) were males, with a mean age of 49.5+/-17.5 years. Antecedent infection was reported in 53 (61.6%), 51 (62.2%) presented within one week of symptoms onset. Ascending weakness was seen in 55 (70.5%), while 70 (81.4%) had areflexia. Acute motor axonal neuropathy (AMAN) was the commonest electrophysiological type of GBS in 41 (51.9%) patients. Albuminocytologic dissociation was seen in 48 (57%) who had lumbar puncture. Nearly half, 41 (47.7%) were admitted to the intensive care unit (ICU). Seventy (81.3%) were treated with intravenous immunoglobulin. There was no significant difference in the clinical presentation, management, ICU requirement, and discharge disposition between males and females. Females were more likely to have a higher disability at discharge (p=0.01). Patients younger than 60 years were more likely to require ICU admission (p=<0.01).

CONCLUSION: Our patients with GBS were slightly older than previously reported from the region. AMAN was the commonest type of GBS. Younger patients were more likely to need ICU admission, whereas females were more likely to have a more severe disability.

PMID:37503490 | PMC:PMC10371290 | DOI:10.7759/cureus.40995