Category: Statistics

Retina. 2021 Jul 1;41(7):1379-1388. doi: 10.1097/IAE.0000000000003059.

ABSTRACT

PURPOSE: To investigate the vascular remodeling of optical coherence tomography angiography in full-thickness macular hole surgery.

METHODS: This retrospective, observational case series included 33 eyes of 33 patients with a full-thickness macular hole who underwent epiretinal membrane removal. Data were collected on best-corrected visual acuity, structural B-scan optical coherence tomography, and optical coherence tomography angiography preoperatively and at 1, 3, and 6 months postoperatively. Optical coherence tomography angiography was used to assess the retinal vascular density (VD) of the superficial vascular plexus and deep vascular plexus (DVP). Vascular density was assessed using the Early Treatment Diabetic Retinopathy Study grid for the whole, inner, and outer grids.

RESULTS: A statistically significant correlation was found between the VD (whole, inner, and outer grids) of the superficial vascular plexus alone from baseline to 1-month postoperatively (P < 0.001). Similarly, VD was correlated from baseline to 1, 3, and 6 months postoperatively to the whole (P < 0.0005, F = 23.22), inner (P < 0.0005, F = 28.23), and outer Early Treatment Diabetic Retinopathy Study grids of DVP (P = 0.033, F = 3.49). The best-corrected visual acuity and VD were significantly correlated with the superficial vascular plexus and DVP at baseline and 6 months (P < 0.05, all correlations). The most significant correlation was observed at 6 months between best-corrected visual acuity and DVP in the whole, inner, and outer Early Treatment Diabetic Retinopathy Study grids (P < 0.001).

CONCLUSION: Superficial vascular plexus and DVP are affected by full-thickness macular holes, with the most significant effects being on the DVP. Full-thickness macular hole surgery leads to an improvement in the best-corrected visual acuity in many eyes and the restoration of the VD, especially of the DVP.

PMID:34137384 | DOI:10.1097/IAE.0000000000003059

Genet Mol Biol. 2021 Jun 11;44(2):e20200448. doi: 10.1590/1678-4685-GMB-2020-0448. eCollection 2021.

ABSTRACT

The inclusion of a genetic risk score (GRS) can modify the risk prediction of coronary artery disease (CAD), providing an advantage over the use of traditional models. The predictive value of the genetic information on the recurrence of major adverse cardiovascular events (MACE) remains controversial. A total of 33 genetic variants previously associated with CAD were genotyped in 1587 CAD patients from the GENEMACOR study. Of these, 18 variants presented an hazard ratio >1, so they were selected to construct a weighted GRS (wGRS). MACE discrimination and reclassification were evaluated by C-Statistic, Net Reclassification Index and Integrated Discrimination Improvement methodologies. After the addition of wGRS to traditional predictors, the C-index increased from 0.566 to 0.572 (p=0.0003). Subsequently, adding wGRS to traditional plus clinical risk factors, this model slightly improved from 0.620 to 0.622 but with statistical significance (p=0.004). NRI showed that 17.9% of the cohort was better reclassified when the primary model was associated with wGRS. The Kaplan-Meier estimator showed that, at 15-year follow-up, the group with a higher number of risk alleles had a significantly higher MACE occurrence (p=0.011). In CAD patients, wGRS improved MACE risk prediction, discrimination and reclassification over the conventional factors, providing better cost-effective therapeutic strategies.

PMID:34137427 | DOI:10.1590/1678-4685-GMB-2020-0448

Acta Anaesthesiol Scand. 2021 Jun 17. doi: 10.1111/aas.13940. Online ahead of print.

ABSTRACT

BACKGROUND: Acute acidosis can increase the plasma potassium concentration. However, data on the effects of acute respiratory acidosis on plasma potassium concentration is conflicting. This study aimed to determine whether acute respiratory acidosis induces an immediate increase in plasma potassium concentration.

METHODS: This observational study was conducted on participants undergoing apnoea testing prior to final radiological examination, registered in an internal quality registry at Oslo University Hospital between 25, April 2013 and 1, May 2020. A total of 124 donors were assessed for inclusion. Sixteen donors with blood glucose concentrations exceeding 10 mmol l^-1 were excluded; finally, data from 108 donors were included in the study. The apnoea test, which is a standard neurological test performed in potential organ donors prior to radiological confirmation of ceased brain circulation, induces respiratory acidosis. The arterial plasma potassium concentration, pH, and PaCO₂ before and after the apnoea test were compared. Statistical analysis was conducted using the paired t-test.

RESULTS: The pre- and post-apnoea mean plasma potassium concentrations were 3.79 (95% confidence intervals [CI] 3.70-3.87) and 3.79 mmol l^-1 (95% CI 3.70-3.88), respectively. The mean difference was -0.002 mmol l^-1 (95% CI -0.04 to 0.04); the difference was not significant. The pre- and post-apnoea mean pH were 7.39 and 7.21, respectively and the mean difference was 0.175 (p<0.01). The pre- and post-apnoea mean PaCO₂ were 5.66 and 9.48 kPa, respectively and the mean difference was -3.83 (p<0.01).

CONCLUSIONS: Acute respiratory acidosis does not lead to rapid changes in plasma potassium concentration during apnoea testing in potential organ donors.

PMID:34137462 | DOI:10.1111/aas.13940

Gynecol Endocrinol. 2021 Jun 17:1-8. doi: 10.1080/09513590.2021.1940127. Online ahead of print.

ABSTRACT

INTRODUCTION: Both obesity and diabetes play a significant role in reproductive disorders in women and insulin resistance (IR) is a confirmed trait d’union. We evaluated the relationship between IR and an established ovarian reserve biomarker such as anti-mullerian hormone (AMH) together with other potential modulators of ovarian physiology (adiponectin and kisspeptin) in young reproductive-aged group women with obesity and type 1 diabetes (T1D).

PATIENTS AND METHODS: We recruited 32 female youths: 14 of them presented with T1D (14.6 ± 2.6 years) and 18 with obesity (15.1 ± 2.6 years). The control group included 20 age-matched normal weight females. Each patient underwent physical examination and hormonal assessment. AMH, kisspeptin and adiponectin levels were also measured. IR was calculated as the homeostasis model assessment for insulin resistance (HOMA-IR) and the glucose disposal rate (eGDR) in patients with obesity and with T1D, respectively.

RESULTS: adiponectin and kisspeptin levels were significantly different into groups (p ≤ .001), whereas AMH levels were not. Adiponectin values were higher in controls compared to patients with obesity (p < .001) and T1D (p = .02). Kisspeptin levels were lower in controls compared to patients with obesity (p = .001), without reaching statistical significance when compared to T1D (p = .06). IR was associated with lower adiponectin and higher kisspeptin levels (p < .001 and p = .02, respectively), but not with AMH.

CONCLUSIONS: IR displays a relationship with adiponectin and kisspeptin in young reproductive-aged women with obesity and T1D. Interventions to correct IR in adolescents could be part of an early approach to prevent reproductive disorders and to promote factors associated with longevity in adult women.

PMID:34137355 | DOI:10.1080/09513590.2021.1940127

J Laryngol Otol. 2021 Jun 17:1-4. doi: 10.1017/S0022215121001274. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate serum otolin-1 levels in patients with benign paroxysmal positional vertigo and to compare these levels with healthy individuals.

METHOD: This was a case-control study. After obtaining institutional ethical committee clearance, the serum level of otolin-1 was calculated in adult individuals (18-75 years old) who were divided into group 1 (patients presenting with benign paroxysmal positional vertigo) and group 2 (healthy patients without benign paroxysmal positional vertigo as the control group). Data analysis was carried out to compare the serum levels in the cases and controls. A p-value less than 0.05 was considered significant.

RESULTS: A total of 70 age-matched individuals (cases, n = 40; controls, n = 30) were included in the study. The mean serum level of otolin-1 was 636.8 pg/ml (range, 259-981 pg/ml) in the group of patients with benign paroxysmal positional vertigo and 236.2 pg/ml (range, 189-370 pg/ml) in the control group. The difference was statistically significant (p = 0.0000).

CONCLUSION: The serum levels of otolin-1 in patients with benign paroxysmal positional vertigo are significantly higher compared with individuals without benign paroxysmal positional vertigo.

PMID:34137365 | DOI:10.1017/S0022215121001274

J Oral Sci. 2021 Jun 16. doi: 10.2334/josnusd.21-0167. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to examine morphological changes in the superstructure of implants in relation to the degree of attrition of the implant superstructure and its antagonists.

METHODS: Thirty-three patients participated. The implant superstructures of the first molar and its antagonists were scanned with an intraoral scanner every 3 months. The amount of attrition was calculated in relation to the various materials used for the superstructure, and differences were analyzed statistically (P < 0.05).

RESULTS: Attrition of the implant superstructure was 110 ± 30 µm for monolithic zirconia and 105 ± 27 µm for resin-veneered metal after 12 months. No statistically significant difference was found between the two groups. In contrast, attrition of the antagonists was 75 ± 25 µm for zirconia and 105 ± 20 µm for resin-veneered metal after 12 months. A statistically significant difference in the attrition levels between the two groups was observed after 9 and 12 months.

CONCLUSION: During the 12-month observation period, there was no difference in superstructure attrition between zirconia and resin-veneered metal. Attrition of the antagonists was higher for hybrid composite resin-veneered metal than for zirconia, suggesting that surface roughness affected the degree of attrition.

PMID:34135265 | DOI:10.2334/josnusd.21-0167

J Am Acad Orthop Surg. 2021 Jul 1;29(13):e675-e680. doi: 10.5435/JAAOS-D-20-00726.

ABSTRACT

INTRODUCTION: Studies have shown that antipsychotic medication use may lead to venous thromboembolisms (VTEs); however, this association has not been demonstrated in patients undergoing primary total knee arthroplasty (TKA). Therefore, the purpose of this study was to investigate whether patients taking antipsychotic medications at the time of their primary TKA have higher rates of in-hospital lengths of stay (LOS), VTEs, and costs of care.

METHODS: Patients taking antipsychotic medications were identified and matched to a cohort in a 1:5 ratio by age, sex, and medical comorbidities. Patients who had a history of VTEs or hypercoagulable states before their TKA were excluded. The query resulted in 439,579 patients within the study (n = 73,285) and matching cohorts (n = 366,294). Outcomes analyzed included rates of in-hospital LOS, VTEs, and costs of care. A P value less than 0.01 was considered statistically significant.

RESULTS: We found statistically significant longer in-hospital LOS for patients taking antipsychotic medications (3.27 versus 3.02 days, P < 0.0001). Study patients were also found to have a higher incidence and odds ratio of VTEs (2.37 versus 1.04%; odds ratio: 1.86, 95% confidence interval: 1.75-1.97, P < 0.0001). Ninety-day costs of care were also significantly higher in the study cohort ($17,332.70 versus $15,975.00, P < 0.0001).

CONCLUSION: After adjusting for confounders, patients taking antipsychotic medication were found to have higher rates of in-hospital LOS, VTEs, and costs of care. The study can be used by orthopaedic surgeons to counsel patients taking these medications concerning the potential complications after their procedure.

PMID:34135297 | DOI:10.5435/JAAOS-D-20-00726

Indian J Public Health. 2021 Apr-Jun;65(2):185-189. doi: 10.4103/ijph.IJPH_1407_20.

ABSTRACT

BACKGROUND: Under programmatic settings, routine monitoring and evaluation of household consumption of iodized salt are recommended to track the reach of universal salt iodization strategy. The program needs evaluation in different settings and locations.

OBJECTIVE: The objective of this study was to assess urine-based estimation for recent iodine intake among pregnant women living in hilly terrains of two districts of northern state of India.

METHODS: A community-based cross-sectional observational study was conducted during September- December 2019 among 202 randomly selected pregnant women in two districts of Himachal Pradesh. With a predesigned schedule, data regarding sociodemographic and behavioral factors and salt consumption were collected by interview. Iodine level of salt was assessed by spot iodine testing kit and urinary iodine concentration (UIC) was measured using ammonium persulfate digestion using spectrophotometer.

RESULTS: Women had a mean age of about 26 years, and the period of gestation was of mean 163.7 days. The consumption of iodized salt (>15 ppm) at family level was found to be 83.7%, and the median UIC was 169.0 μg/L. Among assessed, 26.7% had an acceptable level of UIC, whereas 41.1% and 32.2% of women had less (<150 μg/L) and excessive (>250 μg/L) level of UIC, respectively.

CONCLUSION: Recent iodine intake among pregnant women was observed to be adequate, but efforts are to be done to assess the reasons for less and excessive UIC among women.

PMID:34135189 | DOI:10.4103/ijph.IJPH_1407_20

Indian J Public Health. 2021 Apr-Jun;65(2):172-177. doi: 10.4103/ijph.IJPH_1395_20.

ABSTRACT

BACKGROUND: Disclosure of human immunodeficiency virus (HIV) status has potential benefits for both the individual and society.

OBJECTIVES: This study aimed to determine the disclosure rate and its associated factors in people living with HIV receiving care in Enugu, Nigeria.

METHODS: A cross-sectional study using mixed methods was carried out in 5 comprehensive treatment facilities in Enugu, Nigeria during March to August 2019. 300 participants for the quantitative aspect were selected using a simple random sampling method and 30 participants for the qualitative aspect were selected purposively. Interviewer administered questionnaire and focus group discussion were applied for data collection. The quantitative data was analyzed using Epi info version 7; Chi-square test and multivariable logistic regression were applied and a level of statistical significance was set at P < 0.05. The qualitative data were analyzed using thematic analysis.

RESULTS: Among 300 participants, 241 (80.3%) had voluntarily disclosed their status to someone within their social network. 228 respondents had sexual partners and 122 (52.4%) had disclosed to their sexual partners. Twenty-five (11.0%) disclosed to their partners on the day of diagnosis. Predictors of disclosure were being female, having a formal education and being 35 years or more.

CONCLUSION: This study revealed high voluntary disclosure rate to someone within the social network, but lower and delayed disclosure rate to sexual partners.

PMID:34135187 | DOI:10.4103/ijph.IJPH_1395_20

Indian J Public Health. 2021 Apr-Jun;65(2):103-109. doi: 10.4103/ijph.IJPH_1351_20.

ABSTRACT

BACKGROUND: Smoking is a significant risk factor for morbidity and mortality. Health education by health promotion is such a gauge to control tobacco epidemic at both national and multinational levels.

OBJECTIVES: The objectives of the study were to systematically review the literature to identify models for health behavior change and evaluate evidence for their effectiveness in smoking cessation.

METHODS: A systematic review of the literature identified four peer-reviewed studies describing two smoking cessation behavioral interventional models (transtheoretical model [TTM] and health belief model [HBM]) between 2008 and 2018. Electronic databases MEDLINE (PubMed) and Google Scholar and Trip database were carried out. There were two randomized controlled trials and two nonrandomized controlled interventional studies. There was a high degree of homogeneity of design, definition of smoking and smoking abstinence, and implementation, followed by comparison of studies. All included studies have evaluated outcome by stage of changes (component of TTM model) and therefore show the reduction of smoking rate. All studies did not have blinding of study participants, leading to a higher risk of bias in the outcome.

RESULTS: There was a statistically significant difference between TTM-based interventional group and control group in smoking cessation rate. While comparing HBM- and TTM-based behavioral counseling, there was no statistically significant difference in smoking cessation rate.

CONCLUSION: Both HBM- and TTM-based trainings were found to have positive effects on both smoking cessation and progression between the stages.

PMID:34135176 | DOI:10.4103/ijph.IJPH_1351_20