Tag: statistics

Medicina (B Aires). 2025;85(2):337-347.

ABSTRACT

INTRODUCTION: In-hospital mortality is influenced by various factors. Despite the trend toward decreased mortality from acute stroke in the Northern Hemisphere, reports in our region show variable figures. This study reports in-hospital mortality for the second time from a medical center in Ciudad de Buenos Aires. Factors associated with mortality in these patients were also identified.

MATERIALS AND METHODS: A retrospective study was conducted using data from the FLENI Stroke Database between 2010 and 2019, analyzing clinical characteristics, risk factors, complications, and mortality of hospitalized patients. Univariable and multivariable statistical analyses were used to identify risk factors associated with in-hospital mortality.

RESULTS: Data from 1645 patients were analysed, of which 1476 (90%) had ischemic stroke, 95 (6%) had hemorrhagic stroke, and 74 (4%) had aneurysmal subarachnoid hemorrhage (aSAH). There were 45 in-hospital deaths (2%): 26 deaths (1%) from ischemic stroke, 11 deaths (11%) from hemorrhagic stroke, and 8 deaths (10%) from aSAH. Factors associated with mortality include advanced age, low hemoglobin levels at admission, higher scores on the NIHSS scale at admission, and a history of diabetes mellitus.

DISCUSSION: In-hospital mortality from stroke remains low in our institution, with differences between ischemic and hemorrhagic stroke. Factors such as stroke severity, hemoglobin levels, and a history of diabetes mellitus are independent predictors of mortality.

PMID:40198170

Medicina (B Aires). 2025;85(2):314-321.

ABSTRACT

INTRODUCTION: Iodine is an essential micronutrient for the synthesis of thyroid hormones, crucial for neurological development. In 2002, a mild iodine deficiency was identified in schoolchildren from La Pampa, Argentina. This study aims to reassess iodine intake in the same rural school population in 2023 by analyzing urinary iodine concentration (UIC), goiter prevalence, and salt iodization.

MATERIALS AND METHODS: A cross-sectional study was conducted in 6- to 12-year-old schoolchildren from School No. 45 in Ataliva Roca, La Pampa. Parents provided informed consent. UIC, weight, height, blood pressure, and goiter were assessed. UIC was measured using the modified Sandell-Kolthoff method, and salt iodization was analyzed using sodium thiosulfate titration. The results were compared with those from 2002.

RESULTS: A total of 74 schoolchildren were evaluated in 2023. The median UIC was 145.45 υg/L, with 28.8% of students showing levels below 50 υg/L. Goiter prevalence was 21.6%, compared to 17.9% in 2002. In 85.5% of the salt samples, iodine levels were adequate. There were no statistically significant differences between the 2002 and 2023 cohorts in the prevalence of goiter or iodine fortification of salt.

DISCUSSION: Despite improvements in iodine intake since 2002, a considerable percentage of schoolchildren still show moderate iodine deficiency.

PMID:40198167

Medicina (B Aires). 2025;85(2):296-304.

ABSTRACT

INTRODUCTION: Although euthanasia is an issue on the Argentinean parliamentary agenda, there is still confusion about its conceptualisation and limitations to its study. Attitudes towards euthanasia among the seriously ill remain under-researched. We aimed to validate the Attitudes Towards Euthanasia scale in Argentina by cross-culturally adapting to the Spanish-Argentine language and exploring psychometric characteristics.

MATERIALS AND METHODS: A cross-sectional study used the Attitudes Toward Euthanasia Scale on a non-probabilistic sample of short-life expectancy patients. We selected Argentina’s sample from seven healthcare centres to recruit a broad socio-demographic spectrum of patients. Inclusion criteria were patients with advanced disease, over 18 years of age, aware that the disease was probably incurable, and able to sign an informed consent form.

RESULTS: The selected sample comprised 167 very sick patients. Among them, 72.5% had cancer. The average age of the participants was 68 (SD= 14.03), and 50.9% were female; 34.7% held university degrees; 58.7% reported being affiliated with a religious organisation. The scale’s psychometric properties, including reliability and validity, were assessed using an exploratory and confirmatory factor analysis. The internal consistency throughout Cronbach’s Alpha was 0.837. The range of items of homogeneity was from 0.179 to 0.745. The study found no significant differences in perceptions concerning euthanasia between variables such as diagnosis, gender, university studies level, and religious affiliation.

DISCUSSION: The validation of the Attitudes Towards Euthanasia scale to a sample of seriously ill Argentinean patients has shown adequate psychometric properties, with some limitations.

PMID:40198165

Medicina (B Aires). 2025;85(2):287-295.

ABSTRACT

INTRODUCTION: Health literacy (HL) is the ability to obtain, interpret, and comprehend medical information necessary for decision-making. The objective was to determine the understanding of medical terminology in adults over 60 years old and its predictors.

MATERIALS AND METHODS: Adults over 60 years old who were in the waiting room of scheduled clinics were surveyed using the SAHLSA-50 (Short Assessment of Health Literacy for Spanish Adults) questionnaire, validated in Spanish. Comprehension was considered inadequate if the score was 37 or lower. A linear regression model was constructed between sociodemographic predictors and the level of understanding with SAHLSA-50. Regression coefficients with their 95% CIs are presented.

RESULTS: A total of 323 participants with a mean age of 72.5 years (SD 6.6) were included, 53.0% had a primary education level. The median SAHLSA-50 score was 45 points (IQR 42-49). The 4.6% of participants had inadequate understanding. In the multivariate model, the only independent predictor of understanding was the educational level, with a coefficient of 0.89 (95% CI 0.68-1.09), acquiring a medical term for each increase in the educational stratum.

DISCUSSION: Educational level is a determining factor in the comprehension of medical terminology. Health professionals should adjust the level of their discourse to the population they serve.

PMID:40198164

Medicina (B Aires). 2025;85(2):261-280.

ABSTRACT

INTRODUCTION: New drugs contribute to improving people’s quality of life with more precise and effective treatments; however, their high acquisition prices continually put the sustainability of the health system and equitable access at risk throughout the world. A starting point for its approach should be to delimit the concept of “high-price” and “very high-price” drugs, but there is no global consensus and it is not defined for Argentina. The objective was to establish the definition of high-price and very high-price drugs for Argentina through a panel with modified Delphi technique with representatives of the health system.

MATERIALS AND METHODS: A descriptive study was conducted with a qualitative-quantitative approach in three phases that include a Phase 1 systematic review of the literature, a Phase 2 analysis of the profile of selected drugs, and a Phase 3 panel.

RESULTS: For the systematic review, 1895 publications were identified, of which 23 were included with some type of definition of high-cost or high-price drugs. A clinical and economic analysis was performed for ten reference drugs that provided examples to the panel. The modified Delphi panel consisted of a first round of 14 and a second round of consensus of 27 representatives, which resulted in the agreed definition.

DISCUSSION: This work collect the experience and vision of representatives of important institutions in our country and provides a key definition for addressing these technologies.

PMID:40198162

Ecol Food Nutr. 2025 Apr 8:1-22. doi: 10.1080/03670244.2025.2490530. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study is to investigate the prevalence, determinants, and patterns of malnutrition, specifically stunting, among Scheduled Tribe (ST) children aged 6-10 years in Reasi district of Jammu & Kashmir, India.

METHODS: A cross-sectional study of 200 ST children in Reasi district assessed nutritional status via anthropometry, socio-economic data, and HAZ scores. Independent t-tests and chi-square tests analyzed growth standards and socioeconomic links. SPSS 2024 provided descriptive statistics and prevalence across age and gender.

RESULTS: The study reveals high stunting rates among ST children, affecting both genders. Height and weight fall below WHO and ICMR standards. Key determinants include economic status, family income, sanitation, head of family and employment nature.

CONCLUSION: Findings highlight the urgent need for targeted, multi-sectoral interventions addressing malnutrition among ST children in Reasi. Collaborative efforts by governments, NGOs, and communities in healthcare, education, and food security are crucial to effectively tackle the issue.

PMID:40198144 | DOI:10.1080/03670244.2025.2490530

Int J Gynaecol Obstet. 2025 Apr 8. doi: 10.1002/ijgo.70062. Online ahead of print.

ABSTRACT

OBJECTIVES: To estimate the prevalence of cognitive dysfunction and associated behavioral changes and their prevalence among postpartum women, and also the prevalence of lactational failure and its determinants among postpartum women.

METHODS: A cross-sectional study was conducted involving 200 postpartum women (65% rural, 35% urban). Data were collected through structured interviews and assessments using the Indian version of the Montreal Cognitive Assessment and Depression, Anxiety, and Stress Scale-21. Statistical analyses included chi-square tests and regression models.

RESULTS: Cognitive dysfunction was observed in 25% of participants (21.5% mild, 3.5% moderate). Stress, anxiety, and depression were prevalent in 80.5%, 27%, and 30% of women, respectively. Lactational failure was reported by 21%, strongly correlated with cognitive dysfunction (P = 0.01) and mental health issues (stress, anxiety, and depression; P < 0.001). Key determinants of lactational failure included poor mother-partner relationships, lack of social support, low education levels, delayed breastfeeding initiation, childcare stress, comorbidities, mode of delivery, and low birth weight. Cognitive dysfunction was significantly associated with male offspring, insufficient milk production, lack of social support, and poor education levels (P < 0.001).

CONCLUSION: The study highlights a strong association between maternal mental health, cognitive dysfunction, and lactational failure. Addressing psychosocial and demographic determinants through targeted interventions is critical for improving maternal and child health outcomes in postpartum populations.

PMID:40198117 | DOI:10.1002/ijgo.70062

Ann Am Thorac Soc. 2025 Apr 8. doi: 10.1513/AnnalsATS.202411-1174OC. Online ahead of print.

ABSTRACT

RATIONALE: Persistent critical illness (PerCI) is costly, rising in incidence, and not reliably predicted with existing risk-prediction tools.

OBJECTIVE: To assess whether attending intensivists can identify patients at heightened risk of developing PerCI.

METHODS: We conducted a prospective longitudinal assessment from August 2020 to January 2023. Intensivists were assessed on each patient within 24 hours of admission to the medical intensive care unit (ICU) and on ICU day three. We measured intensivists’ prognostication of within-ICU events (late-onset shock and/or acute hypoxic respiratory failure [AHRF] and PerCI) and self-rated confidence in prognostications. Test characteristics were calculated for both outcomes, at each timepoint, and stratified by self-rated confidence.

RESULTS: 1,295 assessments were completed (response rate: 87.9%), assessing 875 ICU admissions by 18 intensivists. Late-onset shock/AHRF and PerCI occurred in 7.3% and 16.0% of ICU admissions, respectively. C-statistics for intensivist prognostication of late-onset shock/AHRF were 0.5 (95%CI:0.5-0.6) and 0.6 (95%CI:0.5-0.6) on admission and day three, respectively. C-statistics for PerCI were 0.7 (95%CI:0.7-0.7) and 0.7 (95%CI:0.7-0.8), respectively. C-statistics for late-onset shock/AHRF were no different for confident vs unconfident assessments. C-statistics for PerCI were higher for confident vs unconfident assessments (0.8 vs 0.6, p<0.01) on admission, but not different on day three (0.7 vs 0.7, p=0.20).

CONCLUSIONS: Intensivist prognostications have poor discriminatory accuracy for the development of late-onset shock/AHRF and moderate accuracy for development of PerCI. Further research is needed to understand what factors influence intensivists’ prognostications of within-ICU deterioration and how this information is conveyed to patients and families.

PMID:40198113 | DOI:10.1513/AnnalsATS.202411-1174OC

Int J Oral Maxillofac Implants. 2025 Apr 8;40(2):197-206. doi: 10.11607/jomi.11004.

ABSTRACT

PURPOSE: To compare survival rates and the marginal bone loss (MBL) of implants placed in patients with one-stage or two-stage maxillary sinus augmentation via the lateral window approach (MSALW) using only deproteinized bovine bone mineral (DBBM).

MATERIALS AND METHODS: The dental records and radiologic data of patients who had implants placed with MSALW were collected. The patients were divided according to the one-stage and two-stage MSALW, and the survival rate of each group was measured using the Kaplan-Meier method. The MBL of each group was measured through periapical radiographs at each defined time period. Statistical analysis of the differences between groups was conducted through the log-rank test and one-way analysis of variance (ANOVA). Univariate and multivariate regression tests wereperformed to analyze the degree of influence the interested variables had on the implant survival rate.

RESULTS: There was no significant difference in the 5-year cumulative survival rates between the one-stage and two-stage MSALW at the implant level (91.0% and 90.6%, respectively; P = .201) or at the patient level (89.7% and 89.7%, respectively; P = .330). There was a slight difference in MBL at the initial time point, but there was no significant difference for the total period (P = .289). Diabetes was found to have a negative effect on implant survival (P = .015; hazard ratio [HR] = 3.669).

CONCLUSIONS: There was no significant difference in the 5-year cumulative survival rate or the 2-year MBL of implants between the one-stage and two-stage MSALW using DBBM.

PMID:40198091 | DOI:10.11607/jomi.11004

JAMA Netw Open. 2025 Apr 1;8(4):e253443. doi: 10.1001/jamanetworkopen.2025.3443.

ABSTRACT

IMPORTANCE: Understanding the reciprocal association between post-intensive care syndrome (PICS) and caregiver burden is crucial for optimal care of patients and caregivers following critical illness.

OBJECTIVE: To evaluate the associations between patient post-intensive care impairments and caregiver burden.

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of the MIND-USA study, a multicenter randomized clinical trial, which enrolled patients admitted to intensive care units (ICU) from 16 academic medical centers across the US (December 2011 to August 2017), included 148 patient-caregiver dyads. Patients were adults aged 18 years or older with ICU delirium randomized to receive haloperidol, ziprasidone, or placebo. A caregiver who provided unpaid assistance to the patient was identified at enrollment. PICS and caregiver burden were assessed at 3 months and 12 months after randomization. Statistical analysis was performed from March 2023 to April 2024.

MAIN OUTCOMES AND MEASURES: ICU survivors were assessed for PICS domains, including physical and cognitive function, and posttraumatic stress disorder using the Katz Activities of Daily Living, the Functional Activities Questionnaire, the Telephone Interview for Cognitive Status, and the Posttraumatic Stress Disorder Checklist-Civilian version, respectively. Caregiver burden was assessed using the Zarit Burden Interview. The associations between patient PICS and caregiver burden at 3 and 12 months were examined using structural equation modeling.

RESULTS: Of 148 patients included in this study with a median (IQR) age of 58 (48-65) years, the majority identified as male (79 patients [53.4%]), and there were 16 (10.8%) Black, 139 (93.9%) non-Hispanic, and 127 (85.8%) White patients. PICS and caregiver burden at 3-month follow-up was positively associated with these outcomes at 12-month follow-up (PICS: β = 0.69; 95% CI, 0.50 to 0.88; P < .001; caregiver burden: β = 0.68; 95% CI, 0.53 to 0.82; P < .001). However, contrary to the study hypotheses, significant associations between 3-month PICS and 12-month caregiver burden and between 3-month caregiver burden and 12-month PICS were not observed (PICS→caregiver burden: β = 0.82; 95% CI, -0.02 to 1.66; P = .09; caregiver burden→PICS: β = 0.00; 95% CI, -0.03 to 0.03; P = .95). There was significant covariance between PICS and caregiver burden at each time point.

CONCLUSIONS AND RELEVANCE: In this secondary analysis of a randomized clinical trial of ICU survivors and their caregivers, patient PICS and caregiver burden were associated at concurrent time points but were not associated with each other longitudinally.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01211522.

PMID:40198074 | DOI:10.1001/jamanetworkopen.2025.3443