Category: Statistics

J Pediatr Ophthalmol Strabismus. 2023 Apr 25:1-6. doi: 10.3928/01913913-20230331-02. Online ahead of print.

ABSTRACT

PURPOSE: To determine the normal values of optic nerve sheath diameter (ONSD) by computed tomography (CT) in the pediatric population.

METHODS: The CT scans of pediatric patients aged 1 to 16 years who underwent brain CT for different reasons, who did not have intracranial pathology or increased intracranial pressure, and who had no pathology on CT were included in the study. Four age groups were defined with the following ranges: 1 to 2, 3 to 6, 7 to 10, and 11 to 16 years. ONSD was measured from axial CT images, 3 and 10 mm behind the optic globe.

RESULTS: The normative values of ONSD measured on CT imaging in children aged 1 to 16 years were reported. The change in ONSD according to age was investigated. ONSD was found to increase with age at both levels measured. The difference was statistically significant.

CONCLUSIONS: Normal values should be known to detect pathologies that may cause an increase in optic nerve diameter. The values reported in this study can serve as a reference for normal optic nerve sheath diameter in the pediatric age group. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

PMID:37092660 | DOI:10.3928/01913913-20230331-02

J Adhes Dent. 2023 Apr 24;25(1):87-97. doi: 10.3290/j.jad.b4043039.

ABSTRACT

PURPOSE: To retrospectively evaluate the clinical behavior of direct anterior composite restorations performed with a universal adhesive or with a three-step etch-and-rinse (E&R) adhesive.

MATERIAL AND METHODS: Patients were randomly treated with a three-step E&R adhesive (Optibond FL, Kerr) or a universal adhesive (Clearfil Universal Bond Quick, Kuraray Noritake) applied in E&R mode. All restorations were performed with a nanohybrid composite (ClearFil Majesty ES-2, Kuraray Noritake) by the same experienced operator. Two calibrated examiners evaluated the restorations using a dental mirror and explorer, in accordance with modified United States Public Health Service (USPHS) procedures. Clinical events were registered and classified as either failure (F), survival (SR), or success (S).

RESULTS: 168 restorations were evaluated in 90 patients with an average follow-up period of 37.9 (± 22.9) months. A total of 132 restorations were performed on vital teeth, and 36 were performed on endodontically treated teeth (ETT). A total of 128 Class-IV and 40 Class-III restorations were performed. In 89 restorations, a three-step E&R adhesive was applied (14 Class-III and 75 Class-IV), while in 79, a universal adhesive was used (26 Class-III and 53 Class-IV, p = 0.0091). A Cox regression analysis was performed (p < 0.05) to analyze which factors were involved in the failure of the restorations, considering failure (F) as restorations that needed re-intervention at the follow-up period of 37.9 (± 22.9) months. No statistically significant differences were observed when considering parameters directly involved with the adhesives tested. Endodontically treated teeth were more prone to fractures (p = 0.0006) compared to vital teeth. Restorations made with universal adhesives failed by fracturing significantly more frequently (p = 0.0234), while restorations made on endodontically treated teeth had a significantly worse outcome (p = 0.0001). Restorations made on canines also failed significantly more frequently (HR = 3.8, 95% CI = 1.4-10.1, p = 0.0062).

CONCLUSIONS: Based on the obtained results, both the universal adhesive and the three-step E&R adhesive proved to be good treatment choices for direct anterior restorations after 37.9 (± 22.9) months of follow-up. Tooth vitality seems fundamental for the prognosis of a direct anterior composite restoration over time.

PMID:37093568 | DOI:10.3290/j.jad.b4043039

Probiotics Antimicrob Proteins. 2023 Apr 24. doi: 10.1007/s12602-023-10075-5. Online ahead of print.

ABSTRACT

Prebiotics are substrates selectively utilized by host microorganisms conferring a health benefit. The effects of prebiotics on the gut microbiome of individuals with inflammatory processes need further investigations. The purpose of this study was to evaluate the effects of prebiotics on the gastrointestinal microbiome of individuals with some types of inflammatory conditions. Randomized controlled clinical trials (RCTs) evaluating the effects of different prebiotics on the gut microbiome were included. A systematic review of the literature including searches in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus databases was performed until 23 March 2023. The risk of bias was assessed using the Cochrane Collaboration’s criteria. Qualitative data was tabulated to facilitate comparisons and represented in the form of descriptive statistics and summary tables. Thirty trials, ranging from 12 to 135 patients, were included. The most commonly used prebiotic type was inulin-type fructans, and the treatment duration ranged from 1 to 36 weeks. The majority of the trials investigated the gut microbiome using 16 s rRNA gene sequencing on the Illumina Miseq platform. In general, prebiotic therapy exerted positive effects on inflammatory conditions. An increase in Bifidobacterium genus was the most common shift in bacterial composition observed. Within the limits of this systematic review, it can be suggested that prebiotic therapy presents the potential to favorably modulate the gastrointestinal microbiome of individuals with different types of inflammatory conditions.

PMID:37093515 | DOI:10.1007/s12602-023-10075-5

J Robot Surg. 2023 Apr 24. doi: 10.1007/s11701-023-01597-9. Online ahead of print.

ABSTRACT

The objective of this study was to compare the surgical outcomes of robotic multi-site myomectomy (RMSM) with those of robotic single-site myomectomy (RSSM). We conducted a systematic search of the PubMed, CINAHL, Scopus, and Google Scholar databases for articles comparing RMSM and RSSM until March 2023. Data analysis was performed using Review Manager V5.3 (Cochrane), and the main outcomes examined were perioperative outcomes and complications. A total of five studies, covering 823 patients, were included in the analysis. The statistical analysis revealed no significant differences between RMSM and RSSM with regard to docking time (p = 0.9), console time (p = 0.37), estimated blood loss (p = 0.38), postoperative hemoglobin (Hb) loss (p = 0.61), transfusion rate (p = 0.25), length of stay (p = 0.08), conversion (p = 0.36), postoperative fever (p = 0.46), intraoperative complication (p = 0.23), or postoperative complication (p = 0.12). However, compared to RMSM, RSSM was found to have a shorter morcellation time (weighted mean difference [WMD] – 4.52 min; 95% confidence interval [CI] – 6.89 to 2.15; p = 0.0002), less total operative time (WMD – 9.83 min; 95% CI – 18.27 to – 1.38; p = 0.02), lower Hb change (WMD – 0.28 g/dL; 95% CI – 0.49 to – 0.07; p = 0.008), and fewer overall complications (odds ratio [OR] 0.55; 95% CI 0.32-0.92; p = 0.02). Our findings suggest that RSSM is a safe and effective alternative to RMSM for the most studied outcomes. Further randomized studies are necessary to validate these results.

PMID:37093509 | DOI:10.1007/s11701-023-01597-9

Obes Surg. 2023 Apr 24. doi: 10.1007/s11695-023-06615-1. Online ahead of print.

NO ABSTRACT

PMID:37093507 | DOI:10.1007/s11695-023-06615-1

Pulm Ther. 2023 Apr 24. doi: 10.1007/s41030-023-00221-3. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this work is to evaluate whether the addition of home oxygen therapy (HOT) would reduce readmission in chronic obstructive pulmonary disease (COPD) patients.

METHODS: PubMed, ScopeMed, Cochrane, Scopus, and Google Scholar databases were searched. The search strategy used the following keywords “chronic obstructive pulmonary disease”, the intervention “long-term oxygen therapy”, and the outcome “readmission” combined with the AND operator. The Newcastle-Ottawa Scale and Jadad Scale were used for assessing the quality of cohort studies and clinical trials, respectively. A random-effects model was employed in this study after calculating the standard errors by 95% confidence intervals. The I2 statistic and Cochran’s Q-test were used to measure heterogeneity. To address heterogeneity, subgroup analyses were carried out according to the length of LTOT, which was classified as “over 8 months” and “under 8 months”.

RESULTS: Seven studies were included in the analysis. In the pooled analysis, the RR [CI95%, p value], heterogeneity criteria for readmission reduced by 1.542 [1.284-1.851, < 0.001], I² = 60%, and 1.693 [1.645-1.744, < 0.001], I² = 60% for patients with a length of LTOT treatment under and above 8 months, respectively. A sensitivity analysis was conducted by systematically omitting each study, and it showed no influential studies. Egger’s test indicated no publication bias (p = 0.64).

CONCLUSIONS: Based on our results in this systematic review, long-tern oxygen therapy (LTOT) at home was associated with a significantly lower risk ratio of hospital readmission. However, the sample sizes in the studies necessitate larger RCTs to evaluate the effect of LTOT on readmission in COPD patients.

PMID:37093408 | DOI:10.1007/s41030-023-00221-3

J Cancer Res Clin Oncol. 2023 Apr 24. doi: 10.1007/s00432-023-04776-1. Online ahead of print.

ABSTRACT

PURPOSE: Early diagnosis of colorectal cancer (CRC) is critical to patient prognosis; however, there is lack of non-invasive biomarkers that are extremely sensitive and specific for early screening and diagnosis. Exosomes are a novel tool applied to the diagnosis and treatment of cancer. Changes in plasma exosomal proteins have a certain relationship with the development of various diseases including tumors. Here, we aimed to find exosomal biomarkers for early diagnosis of CRC.

METHODS: Exosomes obtained by ultracentrifugation from CRC patients and healthy donors were characterized by transmission electron microscopy (TEM), qNano and western blotting. Proteomic and functional enrichment analyses confirmed differences in the specific expression of exosomal proteins in plasma between CRC patients and healthy donors. Western blotting with enzyme-linked immunosorbent assay (ELISA) was used to verify the difference proteins. Statistical methods were used to analyze the relationship between protein levels and CRC.

RESULTS: The expression levels of serpin peptidase inhibitor clade A member 1 (SERPINA1) and fibrinogen (PLG) in CRC patients were significantly higher than those in healthy groups. Receptor operating characteristic (ROC) curves analysis was superior to CEA and CA19-9 for the diagnosis of colorectal cancer and early-stage colorectal cancer. The two were related to TNM staging and coagulation, and the difference was statistically significant.

CONCLUSION: The results of this study have potential value in advancing the clinical diagnosis of colorectal cancer.

PMID:37093347 | DOI:10.1007/s00432-023-04776-1

Hernia. 2023 Apr 24. doi: 10.1007/s10029-023-02771-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Evaluating groin pain still evades many clinicians at times as they have difficulty determining the cause of pain when no true hernia exists. This study’s aim was to evaluate a simple and novel scoring system which is reproducible, to help determine whether conservative measures or surgery is recommended for the management of groin pain attributable to inguinal disruption.

MATERIAL & METHODS: A retrospective analysis of all patients from 2018 to 2020 that underwent surgery or conservative management for inguinal disruption with at least a 1-year follow-up were evaluated. The scoring system is based on MRI and ultrasound imaging as well as clinical findings, with scores given from – 2 to + 2 based on the defined findings listed. A maximum total of four points scored for each assessment was used. Sensitivity and specificity analysis was conducted for each potential score cut off point.

RESULTS: A total of 172 patients were evaluated with 33 patients (19%) undergoing conservative management and 139 patients (81%) undergoing surgery. The median SPoRT score for the surgery group was 2.0 (1.0, 3.0), and – 1.0 (- 3.0, 0.0) in the physiotherapy group which was a significant difference (p < 0.001). An optimal cut off of ≤ 0 for physio and ≥ 1 for surgery was established, yielding a sensitivity of 90.9% (95% CI 75.7%-98.1%), a specificity of 89.2% (95% CI 82.8%-93.8%) and an area under the curve (AUC) of 0.936 (95% CI 0.874-0.997).

DISCUSSION: SPoRT score of ≤ 0 can recommend a patient should undergo conservative measures or physiotherapy as a mainstay of treatment with a score of ≥ 1 recommending surgery. Further validation of the score is necessary.

PMID:37093340 | DOI:10.1007/s10029-023-02771-6

Urolithiasis. 2023 Apr 24;51(1):77. doi: 10.1007/s00240-023-01442-6.

ABSTRACT

A retrospective study was performed on 200 patients who underwent miniaturized percutaneous nephrolithotomy (mini-PCNL) or retrograde intrarenal surgery (RIRS) for 10-20 mm sized lower pole renal calculi to investigate the relationship between computed tomography (CT) attenuation of calculi and surgical outcomes. CT was used to examine the location, size, and CT attenuation values of the calculi. Additionally, the operation time, hospital stay, hemoglobin (Hb) reduction, stone-free rate (SFR), and complication rate were also meticulously documented and subjected to comparative analysis. Complications were assessed using the Clavien-Dindo grading system. We observed no significant differences in hospitalization data and follow-up outcomes, except for a longer hospital stay and higher Hb drops in patients receiving mini-PCNL. Statistical analysis revealed an association between CT attenuation and operation time. Compared with mini-PCNL, RIRS could reduce bleeding, hospital stay, surgery time, and complications for 10-20 mm sized lower pole kidney stones with CT values < 1000 HU. RIRS resulted in longer operation time and lower stone-free rates despite shorter hospital stays and less bleeding than mini-PCNL for stones with CT values > 1000 HU. Therefore, selecting an appropriate surgical method based on CT attenuation might improve outcomes. For patients with stone attenuation values < 1000 HU, RIRS is the recommended option. When stone attenuation values > 1000 HU, the surgical method should be chosen based on the patient’s individual situation.

PMID:37093335 | DOI:10.1007/s00240-023-01442-6

Environ Monit Assess. 2023 Apr 24;195(5):606. doi: 10.1007/s10661-023-11236-3.

ABSTRACT

Precipitation is one of the most significant components for the basin’s hydrological cycle. Numerous features of a basin’s water circulation may be affected by the chronological, geographical, and seasonal fluctuation of precipitation. It could be an important factor that influences hydrometeorological phenomena including floods and droughts. In this research, the innovative trend risk analysis (ITRA), innovative trend pivot analysis (ITPAM), and trend polygon star (TPS) methodologies of visualizing precipitation data are used to detect precipitation changes at six stations in Algeria’s Wadi Ouahrane basin from 1972 to 2018. ITRA graphs show the direction of the precipitation trend (increasing-decreasing) and the trend risk class. Disparities in the polygons generated by the arithmetic mean and standard deviation ITPAM graphs demonstrate variations in precipitation seasonally and in the seasonal precipitation trends (increasing or decreasing) between sites. The TPS maps depict monthly variations in precipitation and highlight the autumn and spring transitions between the dry and wet seasons.

PMID:37093324 | DOI:10.1007/s10661-023-11236-3