Category: Statistics

Khirurgiia (Mosk). 2023;(6):27-33. doi: 10.17116/hirurgia202306127.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of the drug aminodihydrophthalazinedione sodium (Galavit) for the prevention of the development of additional purulent-septic complications associated with a reduced reactivity in patients with peritonitis.

MATERIAL AND METHODS: Patients diagnosed with peritonitis were included in a prospective, non-randomized, single-centre study. Two groups of patients were formed, the main and control, 30 people each. In the main group, patients received aminodihydrophthalazinedione sodium at a dose of 100 mg/day for 10 days, in the control group they did not receive the drug. During 30 days of observation, the development of purulent-septic complications and the number of days of hospitalization were recorded. Biochemical and immunological blood parameters were recorded at the time of inclusion in the study and for 10 days of therapy. Information about adverse events were collected.

RESULTS: Each study group included 30 patients (60 in total). The additional complications developed in 3 (10%) patients who received the drug and in 7 (23.3%) in the group that did not receive the drug (p=0.166). The risk ratio is up to 0.556 and the risk ratio is 0.365. The average number of bed-days in the group that received the drug was 5, and in the group that did not receive the drug – 7 days (p=0.108). No statistically significant differences between groups in biochemical parameters were identified. However, there were estimated statistical differences in immunological parameters. Thus, CD3+, CD4+, CD19+, CD16+/CD56+, CD3+/HLA-DR+, IgG were higher in the group taking the drug, and the CIC level was lower than in patients of the group that did not receive the drug. There were no adverse events.

CONCLUSION: Aminodihydrophthalazinedione sodium (Galavit) is effective and safe for preventing the development of additional purulent-septic complications associated with a reduced reactivity in patients with peritonitis, decreases the incidence of purulent-septic complications.

PMID:37313698 | DOI:10.17116/hirurgia202306127

Asia Pac J Clin Oncol. 2023 Jun 14. doi: 10.1111/ajco.13971. Online ahead of print.

ABSTRACT

BACKGROUND: The number of cycles of neoadjuvant therapy programmed cell death 1 (PD-1) inhibitor for locally advanced non-small cell lung cancer (NSCLC) remains controversial.

METHODS: From October 2019 to March 2022, neoadjuvant chemoimmunotherapy followed by radical surgery for NSCLC patients with stage II-III were retrospectively reviewed in Shanghai Pulmonary Hospital. The radiologic response was assessed according to the Response Evaluation Criteria for Solid Tumors version 1.1. The major pathological response was defined as no more than 10% residual tumor. Student’s t-test, chi-square test, and Mann-Whitney test were used for univariate analysis, logistic regression analysis was used for multivariate analysis. All statistical analyses were calculated by SPSS software (version 26).

RESULTS: Among 108 patients, the number of patients who received 2-cycle (2-cycle group) and more than 2-cycle (>2-cycle group) neoadjuvant chemoimmunotherapy were 75 (69.4%) and 33 (30.6%), respectively. Compared with patients in the >2-cycle group, patients in the 2-cycle group had significantly smaller diagnostic radiological tumor size (37.0 mm vs. 49.6 mm, p = 0.022) and radiological tumor regression rate (36% vs. 49%, p = 0.007). However, no significant difference in pathological tumor regression rate was observed between patients in the 2-cycle group and >2-cycle group. Further logistic regression analysis demonstrated that the neoadjuvant chemoimmunotherapy cycle could independently affect the radiographic response (odds ratio [OR]: 0.173, 95% confidence interval [CI]: 0.051-0.584, p = 0.005) but not for pathological response (OR: 0.450, 95% CI: 0.161-1.257, p = 0.127).

CONCLUSIONS: For patients diagnosed with stage II-III NSCLC, the number of neoadjuvant cycles administered can significantly influence the radiographic efficacy of chemoimmunotherapy.

PMID:37313687 | DOI:10.1111/ajco.13971

J Evid Based Med. 2023 Jun 14. doi: 10.1111/jebm.12540. Online ahead of print.

NO ABSTRACT

PMID:37313680 | DOI:10.1111/jebm.12540

Acute Crit Care. 2023 May;38(2):226-233. doi: 10.4266/acc.2023.00570. Epub 2023 May 25.

ABSTRACT

BACKGROUND: This study aimed to determine the predictive power of the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale Pupil (GCS-P) score in determining outcomes for traumatic brain injury (TBI) patients. The Glasgow Outcome Scale (GOS) was used to evaluate patients at 1 month and 6 months after the injury.

METHODS: We conducted a 15-month prospective observational study. It included 50 TBI patients admitted to the ICU who met our inclusion criteria. We used Pearson’s correlation coefficient to relate coma scales and outcome measures. The predictive value of these scales was determined using the receiver operating characteristic (ROC) curve, calculating the area under the curve with a 99% confidence interval. All hypotheses were two-tailed, and significance was defined as P<0.01.

RESULTS: In the present study, the GCS-P and FOUR scores among all patients on admission as well as in the subset of patients who were mechanically ventilated were statistically significant and strongly correlated with patient outcomes. The correlation coefficient of the GCS score compared to GCS-P and FOUR scores was higher and statistically significant. The areas under the ROC curve for the GCS, GCS-P, and FOUR scores and the number of computed tomography abnormalities were 0.912, 0.905, 0.937, and 0.324, respectively.

CONCLUSIONS: The GCS, GCS-P, and FOUR scores are all excellent predictors with a strong positive linear correlation with final outcome prediction. In particular, the GCS score has the best correlation with final outcome.

PMID:37313669 | DOI:10.4266/acc.2023.00570

Acute Crit Care. 2023 May;38(2):209-216. doi: 10.4266/acc.2022.01550. Epub 2023 May 16.

ABSTRACT

BACKGROUND: Percent fluid overload greater than 5% is associated with increased mortality. The appropriate time for fluid deresuscitation depends on the patient’s radiological and clinical findings. This study aimed to assess the applicability of percent fluid overload calculations for evaluating the need for fluid deresuscitation in critically ill patients.

METHODS: This was a single-center, prospective, observational study of critically ill adult patients requiring intravenous fluid administration. The study’s primary outcome was median percent fluid accumulation on the day of fluid deresuscitation or intensive care unit (ICU) discharge, whichever came first.

RESULTS: A total of 388 patients was screened between August 1, 2021, and April 30, 2022. Of these, 100 with a mean age of 59.8±16.2 years were included for analysis. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15.4±8.0. Sixty-one patients (61.0%) required fluid deresuscitation during their ICU stay, while 39 (39.0%) did not. Median percent fluid accumulation on the day of deresuscitation or ICU discharge was 4.5% (interquartile range [IQR], 1.7%-9.1%) and 5.2% (IQR, 2.9%-7.7%) in patients requiring deresuscitation and those who did not, respectively. Hospital mortality occurred in 25 (40.9%) of patients with deresuscitation and six (15.3%) patients who did not require it (P=0.007).

CONCLUSIONS: The percent fluid accumulation on the day of fluid deresuscitation or ICU discharge was not statistically different between patients who required fluid deresuscitation and those who did not. A larger sample size is needed to confirm these findings.

PMID:37313667 | DOI:10.4266/acc.2022.01550

J Cosmet Dermatol. 2023 Jun 14. doi: 10.1111/jocd.15834. Online ahead of print.

ABSTRACT

BACKGROUND: Melasma is a distressing disfiguring acquired pigmentary disorder especially affecting females and it is of high tendency of recurrence. Up till now, treatment of melasma is a challenging problem.

OBJECTIVES: We evaluated the effectiveness of microneedling with glutathione versus microneedling alone in treatment of melasma.

PATIENTS AND METHODS: In this study, 29 adult females with epidermal type of melasma (confirmed with Wood’s light examination) were enrolled. The affected area was subjected to microneedling using dermapen followed by application of glutathione solution on the right side only. This session was performed every 2 weeks for 3 months (six sessions for every patient). The response to therapy was measured using modified melasma area and severity index (m MASI) that were calculated on each side of the face (Hemi- m MASI) before treatment sessions.

RESULTS: There was statistically significant reduction in the mean of Hemi- m MASI score over the sessions on both sides of the face but the right side (microneedling with glutathione) showed more reduction and earlier response to therapy than the left side (microneedling alone). On the left side, mean of Hemi- m MASI score before and after sessions was (4.06 ± 1.91, 2.31 ± 1.450) and on the right side, it was (4.21 ± 2.08, 1.96 ± 1.30), respectively and this was statistically significant. Percentage of improvement on the left side was 46.92 ± 16.30 (%) while on the right side was 55.17 ± 15.50 (%) and this was statistically significant.

CONCLUSIONS: Microneedling is an effective promising tool in treatment of melasma and its combination with glutathione as a whitening agent, increases and accelerates its efficacy. So, combined therapy is more preferred than monotherapy in treatment of facial melasma.

PMID:37313658 | DOI:10.1111/jocd.15834

Sports Biomech. 2023 Jun 14:1-23. doi: 10.1080/14763141.2023.2223556. Online ahead of print.

ABSTRACT

Changes in surface hardness are likely to alter an athlete’s movement strategy. Anterior cruciate ligament (ACL) injury risk assessments that are performed on a different surface to that used for training and competition may, therefore, not represent an athlete’s on-field movement strategies. The aim of this study was to examine the influence of surface hardness on multidirectional field sport athletes’ movement strategies in movements that are commonly used in ACL injury risk assessments (bilateral and unilateral drop jumps, and a cutting manoeuvre). Ground reaction forcesand three-dimensional lower limb kinematics were recorded from 19 healthy, male, multidirectional field sport athletes performing bilateral and unilateral drop jumps, and a 90° cutting task on Mondo track (harder surface) and artificial turf (softer surface). Continuous (statistical parametric mapping) and discrete analyses revealed alterations in vertical and horizontal braking forces and knee and hip moments between surfaces of different hardness in all three movements (p ≤ 0.05, d > 0.5). Injury risk assessments performed on a harder surface (e.g. Mondo track) can misrepresent an athlete’s risk of ACL injury compared to the same movements performed on a softer more cushioned surface that is typically used for training and/or matches (e.g. artificial turf).

PMID:37313654 | DOI:10.1080/14763141.2023.2223556

J Cosmet Dermatol. 2023 Jun 14. doi: 10.1111/jocd.15805. Online ahead of print.

ABSTRACT

BACKGROUND: Alopecia areata (AA) is a common disease characterized by hair loss with an autoimmune background. There are many lines of therapy, but no standard line for all cases. Consequently, treating severe forms of AA is challenging.

OBJECTIVE: This study aimed to compare the efficacy and safety of the combination of diphenylcyclopropenone (DPCP) and platelet-rich plasma (PRP) with DPCP alone in treating patients with severe or refractory AA.

PATIENTS AND METHODS: Our randomized clinical trial was conducted on patients with severe and recalcitrant AA. Group A included 13 patients who received only DPCP, while Group B included 11 patients who received both DPCP and PRP. After sensitization in both groups of patients, DPCP was applied to half the scalp weekly. In addition, PRP injection in all scalp was performed once a month in group B. The patients in both groups completed the study for six months.

RESULTS: The regrowth scale results were 53.85% and 54.5% for groups A and B, respectively. Although the response rate of group B was higher than that of group A, there is no statistically significant difference between the two groups.

CONCLUSION: From our clinical trial, it can be concluded that DPCP alone or combined with PRP is an effective and safe method for treating severe or recalcitrant AA.

PMID:37313640 | DOI:10.1111/jocd.15805

Protein Sci. 2023 Jun 14:e4700. doi: 10.1002/pro.4700. Online ahead of print.

ABSTRACT

We investigated the relationship between mutations and dynamics in Escherichia coli dihydrofolate reductase (DHFR) using computational methods. Our study focused on the M20 and FG loops, which are known to be functionally important and affected by mutations distal to the loops. We used Molecular Dynamics simulations and developed position-specific metrics, including the Dynamic Flexibility Index (DFI) and Dynamic Coupling Index (DCI), to analyze the dynamics of wild-type DHFR and compared our results with existing deep mutational scanning data. Our analysis showed a statistically significant association between DFI and mutational tolerance of the DHFR positions, indicating that DFI can predict functionally beneficial or detrimental substitutions. We also applied an asymmetric version of our DCI metric (DCI_asym ) to DHFR and found that certain distal residues control the dynamics of the M20 and FG loops, whereas others are controlled by them. Residues that are suggested to control the M20 and FG loops by our DCI_asym metric are evolutionarily non-conserved; mutations at these sites can enhance enzyme activity. On the other hand, residues controlled by the loops are mostly deleterious to function when mutated and are also evolutionary conserved. Our results suggest that dynamics-based metrics can identify residues that explain the relationship between mutation and protein function or can be targeted to rationally engineer enzymes with enhanced activity. This article is protected by copyright. All rights reserved.

PMID:37313628 | DOI:10.1002/pro.4700

Expert Rev Anticancer Ther. 2023 Jun 14. doi: 10.1080/14737140.2023.2219899. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common clinical malignant tumors, and patients undergoing interventional treatment often experience emotional and physical distress in the postoperative period. This meta-analysis aimed to evaluate the effects of quality control circle (QCC) intervention on patient awareness of health education and postoperative complications following hepatocellular carcinoma (HCC) intervention.

METHODS: A systematic search was conducted to identify relevant controlled trials on the impact of QCC on patients’ knowledge of health education and complications after HCC intervention. The search was conducted using various online databases from the earliest available date to July 2022. Following inclusion and exclusion criteria, data were analyzed using RevMan 5.3 software, and the heterogeneity of the studies was explored.

RESULTS: A total of 120 articles were retrieved, and 11 controlled trials were included according to the inclusion and exclusion criteria. Meta-analysis showed that QCC reduced postinterventional fever (OR: 0.41, 95% CI: 0.26, 0.65, P=0.0002), nausea and vomiting (OR: 0.36, 95% CI: 0.22, 0.58, P<0.0001), abdominal pain (OR: 0.34, 95% CI: 0.20, 0.56, P<0.0001), loss of appetite (OR: 0.37, 95% CI: 0.21, 0.68, P=0.001), improved patient knowledge of health education (OR: 4.84, 95% CI: 3.03, 7.74, P<0.0001), and increased patient satisfaction with nursing care (OR: 6.63, 95% CI: 4.21, 10.45, P<0.00001). All differences were statistically significant.

CONCLUSIONS: QCC after HCC intervention can reduce postoperative fever, nausea and vomiting, abdominal pain, and loss of appetite. It also improves patient knowledge of health education and satisfaction with care.

PMID:37313599 | DOI:10.1080/14737140.2023.2219899