Category: Statistics

J Cancer Educ. 2022 Apr 30. doi: 10.1007/s13187-022-02148-w. Online ahead of print.

ABSTRACT

Shared decision-making (SDM) helps patients weigh risks and benefits of screening approaches. Little is known about SDM visits between patients and healthcare providers in the context of lung cancer screening. This study explored the extent that patients were informed by their provider of the benefits and harms of lung cancer screening and expressed certainty about their screening choice. We conducted a survey with 75 patients from an academic medical center in the Southeastern U.S. Survey items included knowledge of benefits and harms of screening, patients’ value elicitation during SDM visits, and decisional certainty. Patient and provider characteristics were collected through electronic medical records or self-report. Descriptive statistics, Kruskal-Wallis tests, and Pearson correlations between screening knowledge, value elicitation, and decisional conflict were calculated. The sample was predominately non-Hispanic White (73.3%) with no more than high school education (53.4%) and referred by their primary care provider for screening (78.7%). Patients reported that providers almost always discussed benefits of screening (81.3%), but infrequently discussed potential harms (44.0%). On average, patients had low knowledge about screening (score = 3.71 out of 8) and benefits/harms. Decisional conflict was low (score = – 3.12) and weakly related to knowledge (R= – 0.25) or value elicitation (R= – 0.27). Black patients experienced higher decisional conflict than White patients (score = – 2.21 vs – 3.44). Despite knowledge scores being generally low, study patients experienced low decisional conflict regarding their decision to undergo lung cancer screening. Additional work is needed to optimize the quality and consistency of information presented to patients considering screening.

PMID:35488967 | DOI:10.1007/s13187-022-02148-w

J Interv Card Electrophysiol. 2022 Apr 30. doi: 10.1007/s10840-022-01147-7. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the changes of P wave indices in atrial fibrillation (AF) patients after catheter ablation and the association between P wave indices and AF recurrence.

METHODS: PubMed, Embase, and Cochrane Database were searched through September 15th 2021 for studies on the association between P wave indices and AF with catheter ablation. Heterogeneity was estimated using the I² statistic, the random effects model was used to calculate the pooled results, and summary receiver operating characteristic curve (SROC) was used to evaluate the predictive value.

RESULTS: Among included fourteen studies with 1674 AF patients, we found significantly decreased P wave dispersion (P_dis) (mean difference [MD]: – 6.5 ms, 95% confidence interval [95% CI]: – 11.81 to – 1.18, P = 0.02) after cryoballoon ablation (CBA) or radiofrequency ablation (RFA), and maximum P wave (P_max) (MD: – 8.57 ms, 95% CI: – 17.03 to – 0.10, P = 0.05) after RFA only, but increased minimum P wave (P_min) (MD: 3.43 ms, 95% CI: 1.07 to 5.79, P < 0.01) after CBA only. P_dis measured before ablation was remarkably higher (MD: 5.79 ms, 95% CI: 2.23 to 9.36, P < 0.01) in patients with recurrence than without; meanwhile, P_max was higher measured both before and after ablation (MD: 6.49 ms, 95% CI: 2.30 to 10.69, P < 0.01 and MD: 11.2 ms, 95% CI: 2.88 to 19.52, P < 0.01). Furthermore, SROC analysis showed acceptable predictive efficiencies of P_dis (AUC = 0.776) and P_max (AUC = 0.759) for AF recurrence.

CONCLUSION: P_dis was significantly decreased after AF catheter ablation. Higher P_dis and P_max may have predictive values for AF recurrence.

PMID:35488962 | DOI:10.1007/s10840-022-01147-7

Oral Maxillofac Surg. 2022 Apr 30. doi: 10.1007/s10006-022-01066-x. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study is to identify which patient-level factors, if any, influence the risk of infection following dog bite wounds to the face.

MATERIALS AND METHODS: This retrospective cohort study was conducted using the Kids’ Inpatient Database (KID). The primary predictor variable was the type of facial injury. The primary outcome variable was the presence of facial infection. SPSS was used to perform statistical analyses and statistical significance was set at a P-value of < 0.05.

RESULTS: Our final sample comprised a total of 4,420 patients who suffered dog bites to the face, of which 1,237 (28.0%) resulted in infection. Open wound (n = 4,176, 94.5%) was the most common facial injury, followed by bone fractures (n = 105, 2.4%). Relative to children 16-20 years old, children who were 0-5 years old were three times more likely to develop an infection (P < 0.01). Finally, open wounds (P < 0.01) were over seven times more likely to get infected relative to fractures.

CONCLUSIONS: Young children, particularly those below the age of five, are vulnerable to dog bite wounds to the face. Open wounds posed the greatest risk of getting infected.

PMID:35488948 | DOI:10.1007/s10006-022-01066-x

Eur Arch Otorhinolaryngol. 2022 Apr 30. doi: 10.1007/s00405-022-07413-8. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to investigate the possible role of raftlin (RFTN) in chronic rhinosinusitis with nasal polyps (CRSwNP). There is no study in the literature investigating the role of RFTN in the pathogenesis of CRSwNP.

METHODS: The present study was designed as a case-control study and conducted between 25.09.2020 and 01.01.2022. CRSwNP and control groups were formed in the study. Serum and tissue samples were taken from each patient in the study and their RFTN levels were measured. While nasal polyps were used for tissue samples in the CRSwNP group, middle meatus mucosa obtained during concha bullosa surgery was used in the control group.

RESULTS: The control group included 31 patients (8 female, 23 male) and the CRSwNP group included 49 patients (14 female, 35 male). The mean age of the control group was 40.42 ± 9.99 years, while the mean age of the CRSwNP group was 43.47 ± 10.19 years. When the groups are compared in terms of gender and age, there were no statistically significant differences (p = 0.78, p = 0.19, respectively). The serum RFTN levels in the control and CRSwNP groups were 7.85 ± 10.87 ng/ml, and 7.02 ± 8.59 ng/ml, respectively (p = 0.45). The tissue RFTN levels in the control group and CRSwNP group were 87.15 ± 69.91 ng/ml, and 66.50 ± 17.10 ng/ml, respectively (p = 0.04, statistically significant).

CONCLUSION: RFTN deficiency in nasal polyp tissue may be one of the reasons for the development of CRSwNP. Further studies are needed to elucidate the role of RFTN in CRSwNP.

PMID:35488906 | DOI:10.1007/s00405-022-07413-8

Arch Orthop Trauma Surg. 2022 Apr 30. doi: 10.1007/s00402-022-04451-z. Online ahead of print.

ABSTRACT

INTRODUCTION: One of the most important challenges faced by orthopedic surgeons is periprosthetic joint infection (PJI). PJI is a common cause for total joint arthroplasty failure with an incidence of 0.3-1.9%. PJI can be devastating for the patient and extremely costly for the healthcare system. There is concern that a major cause of PJI is intra-operative colonization and recent studies have shown a decrease in PJI with the use of dilute povidone-iodine (Betadine^®, Avrio Health L.P, Stamford, CT) irrigation prior to wound closure. This study presents our experience with the use of dilute Betadine^® irrigation prior to wound closure and its effect on our post-operative hip and knee arthroplasty acute infection rate.

MATERIALS AND METHODS: Retrospective chart review performed at our hospital looking at PJI amongst patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2013 and 2017 comparing different irrigation methods (n = 3232). The study group (n = 1207) underwent irrigation prior to wound closure with dilute Betadine for 3 min and the control group (n = 1511) underwent irrigation using normal saline (NS).

RESULTS: Using a logistic regression model where the following variables were adjusted for; ASA, age, sex, foley insertion, surgical duration and diabetes mellitus status a statistical significant reduction was seen in any infection (OR 0.45 [0.22; 0.89], p value < 0.05) and SSI (OR 0.30 [0.13; 0.70], p value 0.01) with the Betadine group. No significant reduction was seen with deep infections with the Betadine group compared to the NS group.

CONCLUSION: PJI is a devastating complication following total joint arthroplasty and we found Betadine compared to NS irrigation provides an inexpensive and simple method to lower any PJI and more specifically SSI in THA and TKA.

LEVEL OF EVIDENCE: III.

PMID:35488919 | DOI:10.1007/s00402-022-04451-z

Int Endod J. 2022 Apr 30. doi: 10.1111/iej.13758. Online ahead of print.

ABSTRACT

AIM: To evaluate the clinical and radiographic outcome of single-visit root canal retreatment and to compare the results with conventional two-visit root canal retreatment as control group.

METHODOLOGY: One hundred root canal-treated, single-rooted asymptomatic teeth with periapical lesion were retreated by one operator. Fifty of the teeth were randomly assigned to the single-visit group and the others were treated in two-visits. In both groups, root canal filling material was removed, and re-instrumentation of the root canal was performed using step-back technique with hand files using 2.5% NaOCl and 5% EDTA as irrigants. In the single-visit group 5 ml 2% chlorhexidine (CHX) were applied as the final irrigation and in the two-visit group, calcium hydroxide paste was placed into the root canal as an interappointment dressing. All root canal obturations were performed with lateral compaction. All patients were followed up for 24 months. Success was determined depending on both healed and healing cases. The chi-square or Fisher’s Exact test was used to analyse the differences between the groups for success rates and the factors affecting the outcome.

RESULTS: The recall rate was 89 (89%). At 24 months, 39 teeth (88.6%) were considered as healed, 3 teeth (6.8%) as healing, and 2 teeth (4.5%) were identified as failed in the single-visit group, while in the two-visit group 39 teeth (86.7%) had healed, 2 teeth (4.4%) were scored as healing, and 4 teeth (8.9%) as failed. There was no statistically significant difference in the success rates between the two groups (P > 0.05). Size of the lesion and the preoperative length of root canal filling had a statistically significant impact on the outcome (P < 0.05).

CONCLUSION: No statistically significant difference was observed in terms of healing in 24-month follow-up of retreatments completed in single-visit or two-visits in asymptomatic teeth with periapical lesions. Size of the periapical lesion and initial apical level of root canal filling have affected the outcome of root canal retreatment.

PMID:35488883 | DOI:10.1111/iej.13758

J Sep Sci. 2022 Apr 30. doi: 10.1002/jssc.202100973. Online ahead of print.

ABSTRACT

Lonicerae japonicae Flos, a traditional Chinese medicine, has the function of evacuating heat and detoxifying. To promote the optimization of Lonicerae japonicae Flos germplasms and improve the quality of medicinal materials, fifty-five batches of five Lonicerae japonicae Flos germplasms with the same origin were collected during different periods, a UHPLC-TOF-MS method was established, and twenty-two kinds of phenolic acids were found and qualitatively analysed. Seventeen phenolic acids were selected for quantitative analysis by UHPLC-QqQ-MS/MS, and the quantitative results were analysed by principal component analysis, orthogonal partial least squares-discriminant analysis, and partial least squares discriminant analysis. The contents of phenolic acids in periods S1∼S6 were found to be significantly different. There were also significant differences in the accumulation of phenolic acids in Lonicerae japonicae Flos during different growth periods. Ferulic acid, 5-O-caffeoylquinic acid, and caffeic acid were determined to be important components to distinguish the different growth periods of Lonicerae japonicae Flos. There were significant differences in the phenolic acid content of different germplasms of Lonicerae japonicae Flos, and the total amount of seventeen phenolic acids and total acids (chlorogenic acid, 3,5-di-O-caffeoylquinic acid, and 4,5-di-O-caffeoylquinic acid) in “Hua Jin No. 6” was highest, so the quality of “Hua Jin No. 6” was better than that of the four other germplasms. In addition, chlorogenic acid methyl ester and caffeic acid were the markers smallest in combination to distinguish the five germplasms of Lonicerae japonicae Flos. This article is protected by copyright. All rights reserved.

PMID:35488877 | DOI:10.1002/jssc.202100973

West Afr J Med. 2022 Apr 29;39(4):343-349.

ABSTRACT

BACKGROUND: Postoperative morbidities following impacted lower third molar (M3) surgery is of concern. The influence of platelets concentrates on postoperative inflammatory sequelae of M3 is promising. However, the comparative efficacy of platelet-rich fibrin (PRF) to platelet-rich plasma (PRP) in ameliorating postoperative morbidities remains controversial.

OBJECTIVE: The study aimed to compare the bioactive effects of PRP and PRF on postoperative pain, swelling, and trismus after impacted M3 surgery.

SUBJECTS AND METHODS: A randomized, parallel-group study of 50 subjects was designed. Preoperative and postoperative swelling, degree of mouth opening and pain were assessed on days 1, 3, and 7. Linear mixed model analysis was used to compare the effects of treatment, time-point assessment within the group, and treatment with time interaction.

RESULTS: Interaction estimates show statistically significant pain reduction with PRF (p = 0.00, 95% CI [-0.95, -0.25]. Trismus based on a time-point assessment within the PRP and PRF groups was significantly reduced (p =0.01, 95% CI [0.06, 0.38]) and (p = 0.00, 95% CI [0.12, 0.44]) respectively. Facial swelling within the PRP and PRF groups were significantly decreased (p = 0.00, 95% CI [-0.30, -0.06]) and (p = 0.00, 95% CI [-0.37, -0.13) respectively. There were no statistically significant differences between the groups for trismus and swelling. Age was a significant predictor of trismus in both groups (p = 0.04, 95% CI [-0.07, -0.01]).

CONCLUSION: PRF was more effective in reducing postoperative pain compared to PRP. Furthermore, the study shows that platelet concentrates positively modulate post-inflammatory sequelae of impacted M3 surgery.

PMID:35488875

J Osteopath Med. 2022 May 2. doi: 10.1515/jom-2021-0255. Online ahead of print.

ABSTRACT

CONTEXT: Research is lacking regarding osteopathic approaches in treating polycystic ovary syndrome (PCOS), one of the prevailing endocrine abnormalities in reproductive-aged women. Limited movement of pelvic organs can result in functional and structural deficits, which can be resolved by applying visceral manipulation (VM).

OBJECTIVES: This study aims to analyze the effect of VM on dysmenorrhea, irregular, delayed, and/or absent menses, and premenstrual symptoms in PCOS patients.

METHODS: Thirty Egyptian women with PCOS, with menstruation-related complaints and free from systematic diseases and/or adrenal gland abnormalities, prospectively participated in a single-blinded, randomized controlled trial. They were recruited from the women’s health outpatient clinic in the faculty of physical therapy at Cairo University, with an age of 20-34 years, and a body mass index (BMI) ≥25, <30 kg/m². Patients were randomly allocated into two equal groups (15 patients); the control group received a low-calorie diet for 3 months, and the study group that received the same hypocaloric diet added to VM to the pelvic organs and their related structures, according to assessment findings, for eight sessions over 3 months. Evaluations for body weight, BMI, and menstrual problems were done by weight-height scale, and menstruation-domain of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ), respectively, at baseline and after 3 months from interventions. Data were described as mean, standard deviation, range, and percentage whenever applicable.

RESULTS: Of 60 Egyptian women with PCOS, 30 patients were included, with baseline mean age, weight, BMI, and menstruation domain score of 27.5 ± 2.2 years, 77.7 ± 4.3 kg, 28.6 ± 0.7 kg/m², and 3.4 ± 1.0, respectively, for the control group, and 26.2 ± 4.7 years, 74.6 ± 3.5 kg, 28.2 ± 1.1 kg/m², and 2.9 ± 1.0, respectively, for the study group. Out of the 15 patients in the study group, uterine adhesions were found in 14 patients (93.3%), followed by restricted uterine mobility in 13 patients (86.7%), restricted ovarian/broad ligament mobility (9, 60%), and restricted motility (6, 40%). At baseline, there was no significant difference (p>0.05) in any of demographics (age, height), or dependent variables (weight, BMI, menstruation domain score) among both groups. Poststudy, there was a statistically significant reduction (p=0.000) in weight, and BMI mean values for the diet group (71.2 ± 4.2 kg, and 26.4 ± 0.8 kg/m², respectively) and the diet + VM group (69.2 ± 3.7 kg; 26.1 ± 0.9 kg/m², respectively). For the improvement in the menstrual complaints, a significant increase (p<0.05) in the menstruation domain mean score was shown in diet group (3.9 ± 1.0), and the diet + VM group (4.6 ± 0.5). On comparing both groups poststudy, there was a statistically significant improvement (p=0.024) in the severity of menstruation-related problems in favor of the diet + VM group.

CONCLUSIONS: VM yielded greater improvement in menstrual pain, irregularities, and premenstrual symptoms in PCOS patients when added to caloric restriction than utilizing the low-calorie diet alone in treating that condition.

PMID:35488711 | DOI:10.1515/jom-2021-0255

J Cardiovasc Electrophysiol. 2022 Apr 30. doi: 10.1111/jce.15516. Online ahead of print.

ABSTRACT

BACKGROUND: His bundle pacing (HBP) is the most physiologic form of pacing and has been associated with reduced risk for heart failure hospitalization (HFH) and mortality compared to right ventricular pacing. Left bundle branch area pacing (LBBAP) is a safe and effective alternative option for patients needing ventricular pacing.

OBJECTIVE: The aim of this study was to compare the clinical outcomes between LBBAP and HBP among a large cohort of patients undergoing permanent pacemaker implantation.

METHODS: This observational registry included consecutive patients with AV block/AV node ablation who underwent de novo permanent pacemaker implantations with successful LBBAP or HBP between April 2018 to October 2020. The primary outcome was the composite endpoint of time to death from any cause or HFH. Secondary outcomes included the composite endpoint among patients with prespecified ventricular pacing burden and individual outcomes.

RESULTS: The study population included 359 patients who met the inclusion criteria (163 in the HBP and 196 in the LBBAP group). Paced QRSd during LBBAP was similar to HBP (125 ± 20.2 vs 126 ± 23.5 ms, p=0.643). There were no statistically significant differences in the primary composite outcome in LBBAP (17.3%) compared to HBP (24.5%) (HR 1.15, CI 0.72-1.82, p = 0.552). Secondary outcomes of death (10 vs 17%; HR 1.3, CI 0.73-2.33, p=0.38) and HFH (10 vs 12%; HR 1.02,CI 0.54-1.94, p=0.94) were not different among both groups.

CONCLUSIONS: There were no statistically significant differences in the clinical outcomes of death or HFH in LBBAP when compared to HBP. This article is protected by copyright. All rights reserved.

PMID:35488749 | DOI:10.1111/jce.15516