Tag: statistics

Hum Vaccin Immunother. 2024 Dec 31;20(1):2410065. doi: 10.1080/21645515.2024.2410065. Epub 2024 Oct 16.

ABSTRACT

In China, children aged 12 months receive only a single dose of the varicella vaccine and the incidence of varicella remains high. This study aims to evaluate the changes in immunity among children aged 1-3 years following a single dose of the varicella vaccine, providing a scientific basis for determining the optimal age for a second vaccination. This prospective cohort study employed glycoprotein enzyme-linked immunosorbent assay (gpELISA) for antibody detection. The changes in IgG antibody levels over time post-vaccination were analyzed using a restricted cubic spline (RCS) fitted binary logistic regression model. Varicella surveillance data were collected from the National Notifiable Disease Reporting System (NNDRS). Following a peak in varicella incidence in 2019, the incidence shifted toward older age groups. The cohort study results revealed a seropositivity rate of 100% in children during the 18 months post-vaccination, which subsequently declined to 71.6% by the 42 months. The geometric mean concentration (GMC) decreased from 307.6mIU/mL to 115.2mIU/mL. Additionally, 14 children contracted varicella during the follow-up period, resulting in a breakthrough rate of 2.85%. RCS analysis indicated that antibody levels fell below the protective threshold 18.69 months post-vaccination, with a non-linear decline in the odds ratio(OR) of maintaining antibody concentrations ≥ 50mIU/mL(p < .001, Pnonlinear ≤ 0.001). This study demonstrates that the long-term protective efficacy of a single dose of the varicella vaccine diminishes over time in children, underscoring the necessity of implementing a two-dose vaccination strategy. The findings provide scientific evidence for determining the optimal timing for administering the second dose of the vaccine.

PMID:39411866 | DOI:10.1080/21645515.2024.2410065

Nurs Crit Care. 2024 Oct 16. doi: 10.1111/nicc.13193. Online ahead of print.

ABSTRACT

BACKGROUND: Open-heart surgery patients face many problems because of post-sternotomy pain. Care protocols can eliminate pain and pain-related problems by providing holistic care.

AIM: The aim of this study was to examine the effect of an open-heart surgery patient care protocol developed in the study on post-sternotomy pain, anxiety and quality of care.

STUDY DESIGN: The study was carried out as a double-blind randomized controlled trial. The sample size was calculated. Considering some attrition, the sample size was increased by 10% for each group, and a total of 68 participants, including 34 in each group, were included in the sample. Data were collected using a ‘Patient Information Form’, a ‘Post-Sternotomy Pain Follow-up Form’, the ‘Numeric Rating Scale’, the ‘State Anxiety Inventory’ and the ‘Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire’. The patients in the experimental group were given care in accordance with the protocol, which was developed in the study, on postoperative days 0, 1 and 2.

RESULTS: The statistical evaluation showed a significant difference between the mean scores of the experimental (F = 7.28; p < .001) and control groups (F = 2.42; p < .05) on the pain assessment scale. It was determined that the number of analgesics used in the experimental group was statistically significantly lower than in the control group. Intra-group comparisons showed that there was a difference between the mean pre-test and post-test state anxiety scale scores of the groups (p < .001). The experimental group had higher mean scores on the Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire than that of the control group (p < .001).

CONCLUSIONS: The protocol developed in the study was found to be effective in reducing pain, the use of NSAIDs and opioids, and anxiety levels and increasing the level of quality of care.

RELEVANCE TO CLINICAL PRACTICE: The protocol was original and feasible in that it included independent nursing interventions to improve the quality of care by reducing pain and anxiety. Particularly, the use of protocols in intensive care units was nurses’ strongest resource in patient care management. Thus, the protocol, which was prepared for intensive care patients who most frequently experience pain and anxiety, was promising for nurses in improving the quality of care by reducing pain and anxiety. However, it is necessary to conduct further studies involving longitudinal follow-up in samples and institutions with similar conditions.

PMID:39411842 | DOI:10.1111/nicc.13193

Physiol Rep. 2024 Oct;12(20):e70039. doi: 10.14814/phy2.70039.

ABSTRACT

Kilohertz-frequency alternating currents (KFACs) have been indicated to minimize muscle atrophy and weakness. However, the optimal stimulation parameters still need to be determined.

OBJECTIVE: This study aimed to investigate the effects of different KFACs on evoked torque, current efficiency, and perceived discomfort.

DESIGN: KFACs with frequencies of 1 kHz (Aussie current) and 2.5 kHz (Russian current), along with two duty cycles (10% and 20%), were randomly applied to the triceps surae muscle of healthy participants using a crossover design. The NMES intensity, NMES-evoked torque, NMES efficiency, and NMES discomfort were measured in maximal and submaximal conditions. Statistical analyses were conducted using a two-way mixed-model ANOVA with repeated measures. Forty-four participants were included.

RESULTS: Aussie currents produced higher evoked torque and efficiency in maximal and submaximal efforts, with higher perceived discomfort in maximal effort. Although the Australian current may cause greater discomfort at maximal efforts, it matches the Russian current in perceived discomfort at submaximal levels. The 20% duty cycle produced the highest efficiency in submaximal efforts.

CONCLUSION: In both maximal and submaximal efforts, the Aussie current demonstrated superior NMES efficiency, yielding higher torque with lower amplitude than the Russian current. Clinicians should take these findings into consideration when prescribing KFACs to optimize clinical outcomes.

PMID:39411829 | DOI:10.14814/phy2.70039

Glob Health Action. 2024 Dec 31;17(1):2414527. doi: 10.1080/16549716.2024.2414527. Epub 2024 Oct 16.

ABSTRACT

BACKGROUND: Child stunting is a significant challenge for most districts in Rwanda and much of sub-Saharan Africa and persists despite multisectoral efforts. There is a notable lack of population-based studies examining the correlation between violence against women and child stunting in Rwanda.

OBJECTIVE: We aimed to investigate the association between Rwandan women’s exposure to intimate partner violence (IPV) and child stunting in children under 3 years of age.

METHODS: In December 2021, a population-based cross-sectional study was conducted in the Northern Province of Rwanda, including 601 women and their children <3 years of age. The World Health Organization (WHO) Women’s Health and Life Experiences Questionnaire for IPV research was utilized. Child stunting was assessed using the WHO criteria for low height for age. Multivariable logistic regression was used to examine the association between IPV and child stunting before and during pregnancy.

RESULTS: Of 601 women, 47.4% (n = 285) experienced any form of IPV during pregnancy. The prevalence rates of the types of IPV associated with child stunting varied: 33% for psychological, 31.4% for sexual, and 25.7% for physical violence. Exposure to physical violence before pregnancy and sexual violence during pregnancy was associated with higher odds of child stunting; the adjusted odds ratios were 1.29 (95% CI, 1.01-2.03) and 1.25 (95% CI, 1.04-2.01), respectively.

CONCLUSION: Women’s exposure to physical and psychological violence is associated with an increased risk of child stunting. Urgent targeted interventions and support systems are needed to address the complex relationship between women’s exposure to IPV and adverse effects on child growth.

PMID:39411828 | DOI:10.1080/16549716.2024.2414527

Ginekol Pol. 2024 Oct 16. doi: 10.5603/gpl.100274. Online ahead of print.

ABSTRACT

OBJECTIVES: This meta-analysis aims to explore the association between MMP-9-C1562T polymorphism and susceptibility to preeclampsia (PE).

MATERIAL AND METHODS: Four English databases were searched to collect relevant records up to April 2024. The pooled odds ratio (OR) was calculated using Stata 15.0.

RESULTS: A total of 10 studies were enrolled in our systematic review. The results showed that genotype CT at MMP-9-C1562T locus increased the risk of PE versus genotype TT (Genotype CT vs TT: OR = 2.32, 95% CI: 1.27-4.24, P = 0.006), but no significant differences were found in other gene models (C vs T: OR = 0.88, 95% CI: 0.71-1.08, P = 0.225; Genotype CC vs TT: OR = 1.51, 95% CI: 0.87-2.61, P = 0.139; Genotype CC + CT vs TT: OR = 1.63, 95% CI: 0.95-2.81, P = 0.079; Genotype CC vs CT + TT: OR = 0.80, 95% CI: 0.63-1.03, P = 0.086). Subgroup analysis by ethnicity showed a statistically significant difference in the heterozygous model in China (Genotype CT vs TT: OR = 2.38, 95% CI: 1.15 -4.91, P = 0.019).

CONCLUSIONS: Association of MMP-9-C1562T polymorphism with susceptibility to PE exists. Specifically, genotype CT increases the risk of PE versus genotype TT, particularly in Caucasian populations.

PMID:39411825 | DOI:10.5603/gpl.100274

Ginekol Pol. 2024 Oct 16. doi: 10.5603/gpl.99832. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the relationship between controlling nutritional status index (CONUT) and prognostic nutrition index (PNI) scores that are used to evaluate nutritional status and GDM. Also, lipid abnormalities and albumin levels in pregnant women with normal glucose tolerance and GDM were researched.

MATERIAL AND METHODS: This study was conducted as a retrospective study at Ankara Etlik City Hospital, Turkey. The study included 67 pregnant women with singleton pregnancies (32 pregnant diagnosed with GDM and 35 pregnant known to be normoglycemic).

RESULTS: There were no statistical differences between the groups in terms of maternal age, gravidity, parity, history of miscarriage and weight gain during pregnancy. Body mass index (BMI) was higher in the GDM group (p = 0.001). There was no difference in the CONUT score between the groups (p = 0.254). The PNI score was lower in the GDM group (p = 0.003). Of the laboratory data, only fasting blood glucose, triglycerides (TG) and total cholesterol (TC) were statistically significantly higher, and albumin was lower in the GDM group (p = 0.026, p = 0.007, p = 0.003 and p = 0.003, respectively).

CONCLUSIONS: PNI has the potential to be a useful predictor of GDM, whereas CONUT does not. Low albumin levels and increased TG, and TC in the first trimester seem to be significant in the development of GDM.

PMID:39411823 | DOI:10.5603/gpl.99832

Ginekol Pol. 2024 Oct 16. doi: 10.5603/gpl.101419. Online ahead of print.

ABSTRACT

OBJECTIVES: Endometriosis is a complex, chronic inflammatory disease in which immune system disorders play an important role. Soluble mediators of the immune and inflammatory response, including cytokines, are involved in these processes. Therefore, the aim of the conducted research was to understand the role of selected cytokines belonging to the Interleukin-1(IL-1) family, including IL-36α, IL-36β, IL-36γ, IL-36R, IL-37 and IL-38, in the onset and development of endometriosis by analysing the concentration of the tested molecules and to determine whether their concentration depends on the stage of the disease.

MATERIAL AND METHODS: The study group included 60 women who had pelvic endometriosis diagnosed during laparoscopy and subsequently confirmed by histopathology. The reference group consisted of 20 women who had no endometriosis or other pelvic lesions during laparoscopy.

RESULTS: Immunoenzymatic assays were used to determine the concentration of the cytokines studied. In the peritoneal fluid of women with endometriosis, a statistically significant increase in the concentrations of all parameters tested was observed: IL-36α, IL-36β, IL-36γ, IL-36R, IL-37 and IL-38. The concentration of these cytokines depended on the severity of the disease.

CONCLUSIONS: Disturbances of the immune system involving the network of cytokines belonging to the IL-1 family occurring in the peritoneal fluid environment testify to the involvement of these molecules in the development of the disease and are one of many factors involved in the pathogenesis of endometriosis. The use of some of them in the treatment of endometriosis may be a hope for effective causal treatment of this disease, but this requires further, more advanced research.

PMID:39411821 | DOI:10.5603/gpl.101419

Ginekol Pol. 2024 Oct 16. doi: 10.5603/gpl.92611. Online ahead of print.

ABSTRACT

OBJECTIVES: The main goal is to analyze factors related to brachial plexus injury (BPI) after Shoulder Dystocia (SD).

MATERIAL AND METHODS: Longitudinal prospective analysis of SD arose in a tertiary hospital from 1/1st/ 2019 to 12/31st/ 2020. A multivariable logistic regression for BPI after SD and a survival analysis for BPI recovery after SD were performed.

RESULTS: In this period 13,414 deliveries were attended, 10,676 of those were vaginal deliveries (79.6%) reporting 69 cases of SD, with an incidence of 0.65%. SD required 102.1 seconds (SD) 10.8) as an average for solving it. Internal maneuvers were needed in 42.0% of SD reported. Neonatal BPI was suspected in 23 newborns (33.3%) at birth. Neonatal BPI at 48 hours of life was statistically associated with maternal BMI above 30 kg/m² (OR = 7.91; CI95% 1.3-47.7; p = 0.024), > 120 seconds for solving SD (OR = 14.4; CI95% 1.7-121.82; p = 0.014) and operative delivery (OR = 6.8; CI 95% 1.2-37.6; p = 0.028). The BPI recovery was statistically associated with clavicle fracture (HR = 0.31 CI95% 0.10-0.96 p = 0.042) and specific rehabilitation treatment (HR = 9.2 CI 95% 1.87-45.23 p = 0.006).

CONCLUSIONS: The following factors were associated with neonatal BPI at 48 hours of life: Maternal BMI above 30 kg/m², operative delivery, or shoulder dystocia that requires more than 120 seconds for solving it. The BPI recovery was associated with clavicle fracture and specific rehabilitation treatment.

PMID:39411814 | DOI:10.5603/gpl.92611

Acta Gastroenterol Belg. 2024 Jul-Sep;87(3):381-387. doi: 10.51821/87.3.13036.

ABSTRACT

BACKGROUND: Bile acid malabsorption (BAM) is a common entity in patients experiencing chronic watery diarrhea. However, literature suggests that BAM is underdiagnosed and undertreated. In many countries 75SeHCAT is the gold standard for diagnosing BAM (1-5). The aim of this retrospective study was to investigate the frequency of BAM using 75SeHCAT scintigraphy and the response to treatment with bile acid sequestrants.

METHODS: We retrospectively evaluated the clinical data of 420 patients who had a 75SeHCAT scan from January 2016 to January 2023. Electronic medical records were investigated for risk factors of BAM. BAM was defined as a 75SeHCAT retention of less than 15%. Response to bile acid sequestrants was evaluated based on outpatient clinical reports.

RESULTS: Median age at the time of 75SeHCAT test was 47 years (range 14-87). Out of 420 patients, 192 (46%) had a positive result for BAM. Cholecystectomy and ileal resection were significant predictors for BAM (p<0.001). BAM type 1 is statistically more likely to be more severe compared to type 2 (p<0.0001) and compared to type 3 (p=0.0021). In patients who fulfilled Rome IV criteria for IBS-D or functional diarrhea, 75 out of 121 (38%) tested positive for BAM. Overall, treatment with bile acid binders was effective in 76%.

CONCLUSIONS: This retrospective study of patients who underwent SeHCAT scanning confirms that about 1/3 patients presenting with therapy-resistant chronic diarrhea in secondary care suffer from BAM. Including the test in clinical management protocols of chronic diarrhea allows early and quantitative diagnosis and treatment of BAM.

PMID:39411791 | DOI:10.51821/87.3.13036

Acta Gastroenterol Belg. 2024 Jul-Sep;87(3):373-380. doi: 10.51821/87.3.10078.

ABSTRACT

BACKGROUND AND OBJECTIVES: Metabolic dysfunction-associated fatty liver disease (MAFLD) has been reported as a complication after pancreatic surgery. The aim of this study is to assess this phenomenon in a Belgian population, specifically in a period in time when less perioperative chemotherapy was given.

METHODS: We performed a retrospective monocentric cohort study with 124 selected patients who underwent pancreatic surgery – pancreaticoduodenectomy (PD), distal pancreatectomy (DP) or total pancreatectomy – between 2005 and 2014. Steatosis was assessed radiologically, using Hounsfield units on liver and spleen. Data on imaging, liver function, weight and other relevant parameters were gathered preoperatively as well as 2 and 6 months, 1 and 2 years after surgery.

RESULTS: Thirty-eight (31%) out of 124 patients developed liver steatosis at least at one point in time in the two years following surgery, with a prevalence of 21.0% at 2 months, 28.6% at 6 months, 16.4% at 1 year and 20.8 % at 2 years. A statistically significant association with preoperative AST and ALT values, administration of pancreatic enzyme supplementation as a surrogate for pancreatic exocrine insufficiency (PEI) and weight loss at 2 years was detected.

CONCLUSION: MAFLD is seen in 31% of patients with PD or DP pancreatic resection in this retrospective analysis of a monocentric Belgian cohort. Both early and late onset of MAFLD was observed, implying that long-term follow-up is necessary. Clinical impact as well as a direct correlation with patients’ weight and oral enzyme supplements needs to be further investigated.

PMID:39411790 | DOI:10.51821/87.3.10078