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Nevin Manimala Statistics

The impacts of the national centralized drug procurement policy on the use of policy-related antibiotic agents: the case of Shaanxi Province, China

Expert Rev Anti Infect Ther. 2023 Apr 4. doi: 10.1080/14787210.2023.2199153. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of NCDP policy was to reduce the price of drugs. However, it is unclear that a reduction in the price of a single antibiotic will lead to an increase in other alternatives, which is crucial for antibiotic management. The aim of this study was to evaluate the impact of policy on the consumption of policy-related antibiotic.

METHODS: Quasi-experimental interrupted time series methods were used to assess the effects of the policy.

RESULTS: After the implementation of the policy, the consumption of the winning products increased rapidly, with a significant difference in growth (β2=88.03). For nonwinning products, the level of purchase volume decreased (β2=-22.83) in the intervention group, and after adding the comparison group, this number fell further in statistical significance (β2=-114.53). Among all the nonwinning products, the level of purchase volume (β2=-73.59) and expenditures (β2=-346.71) of the generic drugs that passed the conformance evaluation decreased significantly after the policy in the difference model. The purchase volume of J01DC, J01DD and total antibiotics significantly increased in control group compared with the intervention.

CONCLUSION: The implementation of the volume-based procurement policy promoted the use of winning products and decreased the usage of its alternative watch antibiotics.

PMID:37013799 | DOI:10.1080/14787210.2023.2199153

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Clinicopathological significance of SOX9 and β-catenin expression in pre-neoadjuvant chemotherapy cases of osteosarcoma: molecular and immunohistochemical study

J Histotechnol. 2023 Apr 4:1-12. doi: 10.1080/01478885.2023.2193526. Online ahead of print.

ABSTRACT

The molecular pathogenesis of osteosarcoma (OS), the most frequent primary malignant bone tumor of all age groups, is still obscure. Since multidrug chemotherapeutic regimens were introduced in the 1970s, survival rates have been stationary. The Wnt-β-catenin signaling cascade and SOX9 have a significant contribution to skeletal growth, development, and tumorigenesis. In the present work, an attempt was made to examine the role and clinicopathological significance of β-catenin and SOX9 in 46 cases of pre-neoadjuvant chemotherapy OS tissues compared to 10 cases of non-neoplastic bone. The mRNA levels of both markers were assessed by qRT-PCR, and protein levels of β-catenin were analyzed by immunohistochemistry. The results were correlated with different clinicopathological parameters. SOX9 mRNA levels were significantly elevated in OS compared to non-neoplastic bone, and higher levels were significantly associated with the occurrence of fluid-fluid levels (indicating blood-containing cystic spaces) and osteolytic radiological pattern. Although β-catenin mRNA and protein levels were higher in OS compared to non-neoplastic bone, only the protein levels reached statistical significance. Higher β-catenin mRNA levels were significantly associated with tumor size, while higher protein levels were significantly associated with the histologic subtype, mitotic count, and radiological pattern. No significant association was noted with any of the other evaluated parameters. OS showing higher SOX9 mRNA expression and lower β-catenin mRNA and protein expression exhibited longer estimated overall survival times approaching statistical significance. To conclude, while high expression of β-catenin and SOX9 suggests their possible involvement in OS development, their prognostic role may need further research.

PMID:37013797 | DOI:10.1080/01478885.2023.2193526

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Bullying Victimization and Suicidal Thoughts: Emotional Distress and Neighborhood Conditions

Arch Suicide Res. 2023 Apr 4:1-13. doi: 10.1080/13811118.2023.2192755. Online ahead of print.

ABSTRACT

The study aims to examine (1) the association between bullying victimization and suicidal thoughts and (2) neighborhood conditions as a moderated mediated model of the association between bullying victimization, emotional distress, and suicidal thoughts. The sample consists of 414 African American youths (ages 12-17) in Chicago’s Southside neighborhoods. Variables included suicidal thoughts, bullying victimization, emotional distress, neighborhood conditions, age, sex, and government assistance. Analyses included descriptive statistics, bivariate correlations, and multivariate regression analyses. The study found that bullying victimization was not directly associated with suicidal thoughts. However, bullying victimization was positively associated with emotional distress, which was related to suicidal thoughts. Moreover, emotional distress as a mediator of the association between bullying victimization and suicidal thoughts was observed when neighborhood conditions were a moderator. The findings suggest that bullying victimization and suicidal thoughts are major concerns for African American adolescents, and prevention and intervention need to be cost-effective.

PMID:37013796 | DOI:10.1080/13811118.2023.2192755

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Evaluation of maternal serum and umbilical cord brain-derived neurotrophic factor (BDNF) levels in COVID-19-infected pregnancies

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2692-2698. doi: 10.26355/eurrev_202303_31807.

ABSTRACT

OBJECTIVE: COVID-19 is a disease that affects and damages the neurological system. The aim of this study was to evaluate the fetal neurodevelopmental status through maternal serum and umbilical cord BDNF levels.

PATIENTS AND METHODS: In this prospective study, 88 pregnant women were evaluated. Demographic and peripartum characteristics of the patients were recorded. Samples were collected from pregnant women for maternal serum and the umbilical cord BDNF levels during delivery.

RESULTS: In this study, 40 pregnant women hospitalized with COVID-19 formed the infected group and 48 pregnant women without COVID-19 formed the healthy control group. Demographic and postpartum characteristics were similar in both groups. Maternal serum BDNF values were significantly lower in the COVID-19 infected group (1597.0 ± 337.3 pg/ml) than in the healthy group (1783.2 ± 394.1 pg/ml) (p=0.019). Fetal BDNF levels were 1794.9 ± 440.3 pg/ml in the healthy group and 1691.0 ± 368.6 pg/ml in COVID-19 infected pregnant women group and statistically similar between groups (p=0.232).

CONCLUSIONS: Results showed that while maternal serum BDNF levels decreased in the presence of COVID-19, there was no difference in umbilical cord BDNF levels. This may be an indication that the fetus is not affected and is protected.

PMID:37013788 | DOI:10.26355/eurrev_202303_31807

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Galectin-1 as a potential diagnostic biomarker in polycystic ovary syndrome

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2543-2551. doi: 10.26355/eurrev_202303_31788.

ABSTRACT

OBJECTIVE: This study was aimed at comparing the routine laboratory parameters and Galectin-1 levels of control and polycystic ovarian syndrome patients.

PATIENTS AND METHODS: 88 patients diagnosed with polycystic ovary syndrome and 88 healthy controls were considered for the study. Age groups of the patients ranged from 18 to 40. Serum TSH, Beta HCG, glucose, insulin, HOMA-IR, Hb1A1c, triglyceride, total cholesterol, LDL FSH, LH, E2, prolactin, testosterone, SHBG, DHESO4, HDL, Gal-1 levels were analyzed for each subject.

RESULTS: FSH, LH, LH/FSH, E2, prolactin, testosterone, SHBG, DHESO4, HDL and Gal-1 values of the subjects included in the study were statistically significantly different between the groups (p<0.05). Gal-1 and DHESO4 showed a strong positive connection (p=0.05). The sensitivity of Gal-1 level in PCOS patients was calculated as 0.997 and specificity as 0.716.

CONCLUSIONS: High levels of Gal-1 in PCOS patients suggest that it increases due to overexpression in response to inflammation.

PMID:37013772 | DOI:10.26355/eurrev_202303_31788

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Angiotensin-1 and vimentin expression and ultrastructural examination in severe preeclampsia complicated by HELLP syndrome changes in the structure of the umbilical cord

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2535-2542. doi: 10.26355/eurrev_202303_31787.

ABSTRACT

OBJECTIVE: The purpose of this study was to examine the histopathologic, ultrastructural and immunohistochemical changes in the umbilical cord in women diagnosed with HELLP syndrome.

MATERIALS AND METHODS: Postpartum umbilical cords of 40 patients at the 35-38th week of pregnancy were included. 20 severe preeclamptic (HELLP) and 20 normal umbilical cords were used. After the follow-up of tissue parts of 10% formaldehyde solution for histopathology and immunohistochemistry, histopathological and angiopoietin-1 and vimentin antibodies were examined as immunohistochemical after routine paraffin follow-up. For electron microscope analysis, umbilical cord samples were taken into 2.5% glutaral aldehyde solution.

RESULTS: In the statistical comparison, mean difference in increased diameter and additional anomaly on the ultrasound of preeclamptic patients was statistically different compared to control patients. In the HELLP group, hyperplasia and degenerative changes, pyknosis of the endothelial cell nuclei of the vessels and apoptotic changes in some regions were observed. Immunohistochemical analysis showed that endothelial cells, basal membrane and fibroblast cells in the HELLP group expressed high levels of vimentin. Angiotensin-1 expression was increased in amniotic epithelial cells, endothelial cells and some pericyte cells.

CONCLUSIONS: As a result, it was observed that the signaling that started with trophoblastic invasion with the effect of hypoxia in severe preeclampsia and continued with dysfunction in endothelial cells was parallel to the increase in angiotensin and vimentin receptors. It is thought that the ultrastructural change in endothelial cells may cause disruption of the collagenized structure in Wharton gel, which supports this, and may cause adverse effects in fetal development and nutrition.

PMID:37013771 | DOI:10.26355/eurrev_202303_31787

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Effects of epidural analgesia on the course of labor

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2522-2534. doi: 10.26355/eurrev_202303_31786.

ABSTRACT

OBJECTIVE: The aim of this study was to assess the effects of epidural analgesia on the course of labor.

SUBJECTS AND METHODS: The material for the study was obtained from the analysis of 300 medical records of patients delivering under epidural analgesia in the period 2015-2019. A questionnaire by the authors was used as the research tool. Statistical analysis was performed using Fisher’s test, Pearson’s Chi-square test of independence, and Cramer’s V-test.

RESULTS: The first stage of labor in primiparas usually lasted six to nine hours, and in multiparas under five hours (p = 0.041). The second stage was shorter in multiparas (p < 0.001). Our five-year analysis demonstrated that the second stage of labor was longer from year to year (p = 0.087). The fetal station had an effect on the duration of the first stage of labor (p = 0.057). After administration of epidurals, the majority of the women bore the pain well (p = 0.052).

CONCLUSIONS: Epidural analgesia reduces labor pain, but may also disturb the natural rhythm of labor. This happens even if the moment of application of the analgesia is chosen with the guidance of obstetric indications, and may result in the necessity for surgical intervention.

PMID:37013770 | DOI:10.26355/eurrev_202303_31786

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Predictive value of arm circumference (AC) and arm muscle circumference (AMC) with cardiovascular risk in healthy and diabetic males

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2477-2484. doi: 10.26355/eurrev_202303_31781.

ABSTRACT

OBJECTIVE: The predictive value of body simplified indices needs to be evaluated properly for cardiovascular risk. This study aimed to assess and compare the relative relationship of arm circumference (AC), arm muscle circumference (AMC), body mass index (BMI), and waist-hip ratio (WHR) with Ultra-Sensitive C-Reactive Protein (US-CRP) in healthy male subjects and with type 2 diabetes mellitus (T2DM).

PATIENTS AND METHODS: We performed the study at the department of Physiology, College of Medicine & King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. It was a cross-sectional study with 93 healthy male subjects and 112 type 2 diabetic male patients who underwent body composition analysis by BIA and fasting venous blood samples were collected. US-CRP and body composition were determined for all subjects.

RESULTS: US-CRP is correlated positively with AC (0.378) and BMI (0.394) more than AMC (0.282) and WHR (0.253) which have lower correlation both in control and DM group. BCM has the lowest correlation with US-CRP (0.105). The association between US-CRP and AC, AMC, Body Fat Percent (BFP), and body fat mass (BFM) are statistically significant except for BFP in DM group. In control group, AC is noticed to be a better predictor for US-CRP, with area under curve (AUC) 64.2% (p=0.019), WHR with AUC 72.6% (p<0.001), and BMI with AUC 65.4% (p=0.011) but AMC is not a good predictor in control group with AUC 57.5% (p=0.213). In DM group, AC is noticed to be a better predictor for US-CRP, with AUC 71.5% (p<0.001), WHR with AUC 67.4% (p=0.004), BMI with AUC 70.9% (p=0.001), and AMC with AUC 65.2% (p=0.011).

CONCLUSIONS: Simplified muscle mass body indices like AC and AMC have significant predictive value for assessing cardiovascular risk in both healthy population and patients with T2DM. Therefore, AC could be used as a future predictor for cardiovascular disease in healthy and DM patients. Further investigations are needed to confirm its applicability.

PMID:37013765 | DOI:10.26355/eurrev_202303_31781

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Negativity of the electromechanical window: relation to frequent premature ventricular complexes

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2385-2393. doi: 10.26355/eurrev_202303_31773.

ABSTRACT

OBJECTIVE: The electromechanical window (EMW) was investigated as a new predictor of arrhythmia in the presence of long QT. However, the use of EMW to predict idiopathic frequent ventricular premature complexes (PVCs) in those with normal QT intervals has not been clarified.

PATIENTS AND METHODS: This single-center study included consecutive patients who presented to the Cardiology Clinic with palpitations and were found to have idiopathic PVC on 24-hour Holter monitoring. Those with a PVC/24-hour frequency of < 1% were defined as group 1, 1-10% as group 2, and > 10% as group 3. The EMW was defined as the time difference (in ms) between the aortic valve closure and the end of the QT interval, measured from an ECG on the concurrent echocardiogram.

RESULTS: A total of 148 patients were included in the study, 64% (n = 94) of which were female. The patients’ mean age was 50.11 ± 14.7. The groups were similar in terms of the patients’ age, BMI, and comorbidities. There was a statistically significant difference between the three groups in terms of the EMW measurements (group 1: 3.78 ± 19.6, group 2: -7 ± 30.9, group 3: -34.83 ± 55.2 ms: p < 0.001). In the multivariate regression analysis, the EMW (OR 0.971, p = 0.007) and every 10-ms decrease in the EMW (OR 1.254, p = 0.011) were thus determined to be independent predictors of PVC > 10%. An EMW value of ≤ -15 ms was associated with the frequency of 24-h PVC > 10%, with a sensitivity of 70% and a specificity of 70% (AUC 0.716, 95% CI: 0.636-0.787 p < 0.001).

CONCLUSIONS: The results showed that a negative increase in the EMW may be associated with frequent idiopathic PVCs.

PMID:37013757 | DOI:10.26355/eurrev_202303_31773

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Correlation between the serum lumican level and the severity of coronary artery disease

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2350-2357. doi: 10.26355/eurrev_202303_31770.

ABSTRACT

OBJECTIVE: Several studies have previously shown that some small leucine-rich proteoglycans (SLRPs) are associated with atherosclerotic plaque. We aim to investigate the relationship between circulating lumican levels and the severity of coronary artery disease (CAD).

PATIENTS AND METHODS: This study included 255 consecutive patients who underwent coronary angiography for stable angina pectoris. All demographic and clinical data were collected prospectively. The severity of CAD was assessed based on the Gensini score and a value >40 was defined as advanced CAD.

RESULTS: Eighty-eight patients were in the advanced CAD group; these are older and the frequency of diabetes mellitus, cerebrovascular accidents, reduced ejection fraction (EF), left atrium diameter was higher. Serum lumican levels were found as higher in advanced CAD group (0.4 ng/ml vs. 0.6 ng/ml, respectively, p<0.001). When the Gensini score increased, a statistically significant increase was observed in lumican levels with a good correlation (r=0.556 and p<0.001). In multivariate analysis, diabetes mellitus, EF and lumican were predictive for advanced CAD. Lumican level predicts CAD seriousness with a sensitivity rate of 64%, specificity rate of 65%.

CONCLUSIONS: In this study, we reveal a relationship between serum lumican levels and CAD severity. More research is warranted to determine the mechanism and prognostic values of lumican in the atherosclerosis.

PMID:37013754 | DOI:10.26355/eurrev_202303_31770