Category: Statistics

Endocr Relat Cancer. 2022 May 1:ERC-22-0038. doi: 10.1530/ERC-22-0038. Online ahead of print.

ABSTRACT

Radioiodine (RAI) is selectively recommended for intermediate-risk differentiated thyroid carcinomas (DTC). The information gleaned from pretherapy stimulated thyroglobulin levels (sTg) and diagnostic 131I whole body scans (DxWBS) to guide therapy remains controversial. The present study aimed at evaluating the impact of preablation sTg and DxWBS in the management of intermediate-risk DTC. A retrospective analysis of 301 intermediate-risk DTC patients submitted to total thyroidectomy and RAI therapy was performed. Pretherapy sTg and DxWBS and post-therapy WBS (RxWBS) findings were analyzed and compared to outcomes. Fifty-two patients (17.3%) had metastases diagnosed by DxWBS and/or RxWBS. The DxWBS identified 10.6% of patients with functioning metastases, including unexpected distant metastases. If combined with SPECT-CT, DxWBS detected RAI-avid metastases more frequently, particularly lymph node metastases (13.1% vs. 4.2% planar WBS, p=0.015). The DxWBS findings modified patient management in 8.3%. A pretherapy sTg <1 ng/mL was associated with a low false-negative rate for the presence of metastases (5.2%), and its performance in excluding metastasis was improved by a negative DxWBS (2.7%) of patients with both negative exams had metastases in RxWBS). A sTg <1 ng/mL predicted statistically significant lower rates of recurrent/persistent disease and biochemical/structural incomplete responses. In conclusion, preablation sTg and DxWBS contribute to the detection of unknown or persistent metastatic disease in intermediate-risk DTC patients. A sTg <1 ng/mL in combination with a negative DxWBS is highly suggestive of the absence of remaining malignant disease, and one may consider deferring RAI ablation if both exams are negative. A stunning effect is rarely observed and it does not impair proper treatment of metastases.

PMID:35613335 | DOI:10.1530/ERC-22-0038

Am J Hum Biol. 2022 May 25:e23771. doi: 10.1002/ajhb.23771. Online ahead of print.

ABSTRACT

OBJECTIVE: A Smedley hand dynamometer is one of the standard devices for measuring handgrip strength (HGS) for children and adults. The aim was to compare the HGS values using two different types of dynamometers (Grip-A or Grip-D) in young children. To enable comparison between the two devices, we have redesigned the Grip-D (i.e., modified Grip-D).

METHODS: Twenty-five preschool children (10 girls and 15 boys) performed maximal voluntary HGS in the right hand using two different types of dynamometers. We ran a paired sample t-test on the difference in HGS between the two devices.

RESULTS: The measured values of HGS were 9.95 kg for Grip-A and 8.56 kg for modified Grip-D, and the difference between the two devices [1.39 (SD 0.65) kg] was greater than we expected (95% limits of agreement: 0.11, 2.6 kg). Thus, we then calibrated both dynamometers ourselves using known weights. The measured values were corrected if there was an error between the known weight and each dynamometer. Following adjustment, there was still a statistical difference (p < 0.001) in HGS between Grip-A [10.65 (SD 1.52) kg] and modified Grip-D [9.98 (SD 1.85) kg]. However, the difference between the two devices was 0.67 (SD 0.69) kg with the 95% limits of agreement between -0.68 and 2.0 kg.

CONCLUSION: It is concluded that the HGS values of children measured with the company-calibrated new Grip-A and modified Grip-D could provide reasonably close estimates.

PMID:35613332 | DOI:10.1002/ajhb.23771

Rev Lat Am Enfermagem. 2022;30:e3565. doi: 10.1590/1518-8345.5653.3565.

ABSTRACT

OBJECTIVE: as a health care profession focused on caring for people, Nursing requires sound communication skills. Based on an international expert consensus, a proposal on learning outcomes in clinical communication for undergraduate Nursing education curricula in Spanish speaking countries is presented.

METHOD: a steering committee, consisting of 5 nurses and experts in communication in health care sciences, drew up the first list of communication skills specific to the Nursing degree. Their proposal was reviewed and improved by a committee of 7 international scientific advisers. 70 experts from 14 countries were selected using a snowball sampling procedure and invited to participate in a distance modified Delphi consensus process in two survey rounds. Statistical analysis was carried out to establish the final consensus level for each item.

RESULTS: a questionnaire with 68 learning outcomes in clinical communications was submitted for panel assessment. In the first Delphi round, the panel reached a statistical consensus on all the items assessed. There was no need for a second round to reconcile positions.

CONCLUSION: an academic proposal, approved by a high level of international consensus, is presented to guide and unify the learning outcomes on the clinical communication curriculum for undergraduate Nursing studies in Spanish speaking countries.

PMID:35613251 | DOI:10.1590/1518-8345.5653.3565

Dental Press J Orthod. 2022 May 23;27(2):e22205. doi: 10.1590/2177-6709.27.2.e22205.oar. eCollection 2022.

ABSTRACT

OBJECTIVE: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals.

METHODS: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed.

RESULTS: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p> 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p< 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß-thalassemia patients (p< 0.05).

CONCLUSIONS: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample.

PMID:35613245 | DOI:10.1590/2177-6709.27.2.e22205.oar

Dental Press J Orthod. 2022 May 23;27(2):e2220367. doi: 10.1590/2177-6709.27.2.e2220367.oar. eCollection 2022.

ABSTRACT

OBJECTIVE: To introduce newly structured and developed orofacial myofunctional therapy (OFMFT) protocols named Bio-Exercise (BioEx), and evaluate the treatment effect of this method, using lateral cephalometric analysis on malocclusion with low tongue posture in young patients.

METHODS: A retrospective preliminary study was performed using orthodontic records from 28 patients (mean age of 8.41±1.45-year-old, 13 males, 15 females) treated with BioEx therapy using tongue elevators for 18.14±9.04 months (range: 6 to 37 months). Pretreatment (T0) and post-BioEx therapy (T1) lateral cephalograms were subsequently analyzed for tongue posture changes by linear, anteroposterior and vertical measurements. The data were analyzed by paired t-test, considering a 5% significance level.

RESULTS: The tongue length (TGL) and tongue height (TGH) increased statistically significant between T0 and T1. The decrease of the dorsum of the tongue perpendicular to the palatal plane (Td-PP value) was statistically significant. The increase of the tip of the tongue perpendicular to the pterygomaxillary vertical line (TT-PMV) was not statistically significant.

CONCLUSIONS: These preliminary cephalometric results indicate that BioEx can be an effective OFMFT modality in increasing the tonicity of the tongue muscles to establish more normalized tongue position at rest.

PMID:35613244 | DOI:10.1590/2177-6709.27.2.e2220367.oar

Rev Gaucha Enferm. 2022 May 23;43:e20210088. doi: 10.1590/1983-1447.2022.20210088.en. eCollection 2022.

ABSTRACT

OBJECTIVE: To analyze how university students self-evaluate their academic performance during the COVID-19 pandemic in a public university in southern Brazil.

METHOD: A cross-sectional study was carried out with 527 students of undergraduate courses in the health field. Descriptive statistical analyses and the chi-square test were performed to assess associations.

RESULTS: For 49.5% of participants their academic performance was insufficient; for 24.1%, sufficient; 19.40%, good; 5.90% very good; and 1.10% excellent. It was found that there was an association between the variables, course (p=0.034), form of enrollment into the institution (p=0.016) and work activity (p=0.010) in academic performance during the COVID-19 pandemic.

CONCLUSION: Academic performance during the suspension of face-to-face classes is insufficient for many students, and groups of students from the occupational therapy course, who entered the university through the system of quotas and who work in addition to studying showed an inferior academic performance during the COVID-19 pandemic.

PMID:35613241 | DOI:10.1590/1983-1447.2022.20210088.en

Rev Gaucha Enferm. 2022 May 23;43:e20210003. doi: 10.1590/1983-1447.2022.20210003.en. eCollection 2022.

ABSTRACT

OBJECTIVE: To verify the parents’ satisfaction in relation to the care provided to their child admitted to the pediatric intensive care unit and associated clinical factors.

METHOD: Exploratory, cross-sectional study, with a total of 84 parents, in a private hospital in Sao Paulo, Brazil. Data collection took place from March 2019 to January 2020, in the post-discharge period. Data were analyzed using descriptive statistics and Spearman’s Correlation Coefficient.

RESULTS: Mean satisfaction was high (5.75) (SD=0.35). There was no correlation between parents’ satisfaction and length of hospital stay, severity and illness.

CONCLUSION: Parents showed high levels of satisfaction with the care received in pediatric intensive care, regardless of disease classification, length of hospital stay or severity. Greater satisfaction was observed in the domains of professional attitude, care and cure, information and parents’ participation.

PMID:35613234 | DOI:10.1590/1983-1447.2022.20210003.en

Rev Paul Pediatr. 2022 May 6;40:e2021177. doi: 10.1590/1984-0462/2022/40/2021177IN. eCollection 2022.

ABSTRACT

OBJECTIVE: To identify the dietary patterns and associated factors of children aged between 6 and 23 months, born prematurely and assisted at a University Hospital in Curitiba, state of Paraná, Brazil.

METHODS: The parents or guardians of the 135 children were asked about their children’s eating habits and the family’s socioeconomic and demographic conditions. Information regarding birth and health history were obtained from medical records. Data on food consumption were subjected to exploratory factor analysis and the principal component analysis method was used to estimate the factor loads. Multiple linear regression was performed to verify possible associations.

RESULTS: Two dietary patterns were observed: “unhealthy” and “healthy.” The “unhealthy” pattern was significantly associated with maternal age, the child’s corrected age, and gestational age at birth. The “healthy pattern” was associated with the child’s corrected age. Maternal age and child’s corrected age remained significant after multiple regression analyses. For the “unhealthy” pattern, a positive effect was observed, suggesting that the consumption of this pattern is higher as the child’s age increases and less intense for children with mothers aged 30 years or older. For the “healthy” dietary pattern, the same two variables showed statistical significance. The authors observed a direct proportion between the age and consumption of food groups in both patterns.

CONCLUSIONS: These results indicate the importance of nutritional education for younger mothers regarding their children’s eating practices, especially as the child grows.

PMID:35613219 | DOI:10.1590/1984-0462/2022/40/2021177IN

Arq Neuropsiquiatr. 2022 May 20:S0004-282X2022005010202. doi: 10.1590/0004-282X-ANP-2021-0136. Online ahead of print.

ABSTRACT

BACKGROUND: Idiopathic intracranial hypertension (IIH) is primarily a disorder of obese young women characterized by symptoms associated with raised intracranial pressure in the absence of a space-occupying lesion.

OBJECTIVE: To compare the mean optic nerve sheath diameter (ONSD) measured using ultrasonography (USG) in patients with idiopathic intracranial hypertension (IIH) and normal healthy individuals.

METHODS: A prospective study. Ninety-seven participants aged 18-80 years were divided into two groups as patients with IIH (n=47) and the control group (n=50). The ONSD was measured using ultrasound with a 10-MHz probe. ONSD was measured 3 mm behind the optic disc. Receiver operating characteristic (ROC) curve analysis was performed to determine patients with IIH using ONSD.

RESULTS: Body mass index was higher in the IIH group compared with the control group (p=0.001). The mean ONSD was statistically significantly thicker in the IIH group (6.4 mm) than in the control group (4.90 mm). The cut-off value of ONSD in patients with IIH was measured as 5.70 mm. There was a significant negative correlation between ONSD and age (r:-0.416 and p<0.001). There was a positive correlation between BMI and ONSD (r: 0.437 and p<0.001).

CONCLUSIONS: Ultrasound can be a reliable, non-invasive and rapid tool to measure ONSD in monitoring patients with IIH. After the first diagnosis of IIH, based on neuroimaging and measuring intracranial pressure using invasive methods, ONSD can be used in treatment and follow-up.

PMID:35613208 | DOI:10.1590/0004-282X-ANP-2021-0136

Arq Bras Cardiol. 2022 May;118(5):961-971. doi: 10.36660/abc.20210452.

ABSTRACT

BACKGROUND: Aortic stiffness is established as a marker of cardiovascular disease. Cardiovascular magnetic resonance (CMR) provides a comprehensive assessment of aortic stiffness and myocardial ischemia in a single examination. However, prognostic data concerning aortic stiffness in elderly patients remain limited.

OBJECTIVE: To determine the prognostic value of aortic stiffness using CMR-based pulse wave velocity (PWV) in elderly patients with known or suspected coronary artery disease (CAD).

METHODS: This study enrolled consecutive patients aged >70 referred for adenosine stress perfusion CMR including PWV between 2010 and 2014. Patients were followed up for occurrence of major adverse cardiovascular events (MACE), including cardiac mortality, nonfatal myocardial infarction, hospitalization for heart failure, late revascularization (>180 days after CMR), and ischemic stroke. Univariable and multivariable analyses were performed to determine the predictors of MACE. A p-value of <0.05 is considered statistically significant.

RESULTS: Mean PWV was 13.98±9.00 m/s. After a median follow-up period of 59.6 months in 263 patients (55% female, 77±5 years), 61 MACE occurred. Patients with elevated PWV (>13.98 m/s) had significantly higher rates of MACE (HR 1.75; 95% CI 1.05-2.94; p=0.03) than those with non-elevated PWV (<13.98 m/s). Multivariate analysis demonstrated diastolic blood pressure, left ventricular ejection fraction (LVEF), myocardial ischemia, and elevated PWV as independent predictors for MACE (p<0.05 for all). PWV provided an incremental prognostic value over clinical data, LVEF, and ischemia (increased global chi-square=7.25, p=0.01).

CONCLUSION: Aortic stiffness using CMR is a strong and independent predictor of cardiovascular events in elderly patients with known or suspected CAD.

PMID:35613197 | DOI:10.36660/abc.20210452