Tag: statistics

Euro Surveill. 2024 Jul;29(29). doi: 10.2807/1560-7917.ES.2024.29.29.2300712.

ABSTRACT

BackgroundPeople who use drugs (PWUD) are a key target population to reduce the burden of hepatitis C virus (HCV) infection.AimTo assess risk factors and temporal trends of active HCV infection in PWUD in Madrid, Spain.MethodsWe conducted a retrospective study between 2017 and 2023, including 2,264 PWUD visiting a mobile screening unit. Data about epidemiology, substance use and sexual risk behaviour were obtained through a 92-item questionnaire. HCV was detected by antibody test, followed by RNA test. The primary outcome variable was active HCV infection prevalence, calculated considering all individuals who underwent RNA testing and analysed by logistic regression adjusted by the main risk factors.ResultsOf all participants, 685 tested positive for anti-HCV antibodies, and 605 underwent RNA testing; 314 had active HCV infection, and 218 initiated treatment. People who inject drugs (PWID) were identified as the main risk group. The active HCV infection rate showed a significant downward trend between 2017 and 2023 in the entire study population (23.4% to 6.0%), among PWID (41.0% to 15.0%) and PWUD without injecting drug use (7.0% to 1.3%) (p < 0.001 for all). These downward trends were confirmed by adjusted logistic regression for the entire study population (adjusted odds ratio (aOR): 0.78), PWID (aOR: 0.78), and PWUD non-IDU (aOR: 0.78).ConclusionsOur study demonstrates a significant reduction in active HCV infection prevalence among PWUD, particularly in PWID, which suggests that efforts in the prevention and treatment of HCV in Madrid, Spain, have had an impact on the control of HCV infection.

PMID:39027941 | DOI:10.2807/1560-7917.ES.2024.29.29.2300712

Euro Surveill. 2024 Jul;29(29). doi: 10.2807/1560-7917.ES.2024.29.29.2400438.

NO ABSTRACT

PMID:39027940 | DOI:10.2807/1560-7917.ES.2024.29.29.2400438

Euro Surveill. 2024 Jul;29(29). doi: 10.2807/1560-7917.ES.2024.29.29.2300661.

ABSTRACT

BackgroundThe COVID-19 pandemic and the emergence of Candida auris have changed the epidemiological landscape of candidaemia worldwide.AimWe compared the epidemiological trends of candidaemia in a Greek tertiary academic hospital before (2009-2018) and during the early COVID-19 (2020-2021) and late COVID-19/early post-pandemic (2022-2023) era.MethodsIncidence rates, species distribution, antifungal susceptibility profile and antifungal consumption were recorded, and one-way ANOVA or Fisher’s exact test performed. Species were identified by MALDI-ToF MS, and in vitro susceptibility determined with CLSI M27-Ed4 for C. auris and the EUCAST-E.DEF 7.3.2 for other Candida spp.ResultsIn total, 370 candidaemia episodes were recorded during the COVID-19 pandemic. Infection incidence (2.0 episodes/10,000 hospital bed days before, 3.9 during the early and 5.1 during the late COVID-19 era, p < 0.0001), C. auris (0%, 9% and 33%, p < 0.0001) and fluconazole-resistant C. parapsilosis species complex (SC) (20%, 24% and 33%, p = 0.06) infections increased over time, with the latter not associated with increase in fluconazole/voriconazole consumption. A significant increase over time was observed in fluconazole-resistant isolates regardless of species (8%, 17% and 41%, p < 0.0001). Resistance to amphotericin B or echinocandins was not recorded, with the exception of a single pan-echinocandin-resistant C. auris strain.ConclusionCandidaemia incidence nearly tripled during the COVID-19 era, with C. auris among the major causative agents and increasing fluconazole resistance in C. parapsilosis SC. Almost half of Candida isolates were fluconazole-resistant, underscoring the need for increased awareness and strict implementation of infection control measures.

PMID:39027938 | DOI:10.2807/1560-7917.ES.2024.29.29.2300661

F1000Res. 2024 Mar 15;12:612. doi: 10.12688/f1000research.129637.2. eCollection 2023.

ABSTRACT

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure. We aimed to investigate ERCP-induced perforations at our institution and conduct a comprehensive review of literature on ERCP-induced perforations (EIP) since the introduction of this procedure as a therapeutic intervention.

METHODS: This was a case-control study, in which charts of all patients diagnosed with ERCP-induced duodenal perforation were reviewed and compared to a control group without perforation. Patient’s sociodemographic and clinical data, including ERCP procedure-related data, were gathered.

RESULTS: A total of 996 ERCP procedures were performed; only 13 patients proved to have EIP. Obstructive jaundice was the most common indication for ERCP. The main predisposing factor was difficult cannulation (P = 0.003). In total, five patients required surgical treatment; the majority of them had type I perforation, whereas type IV was the most common in patients who were treated conservatively. The overall mortality rate was 15%, the surgical group had a slightly higher mortality rate.

CONCLUSIONS: Fifty years after the introduction of ERCP for therapy, it remains an invasive procedure that carries significant morbidity and mortality, even in skilled hands or at high- volume units. Conservative management of perforation yields favorable outcomes in selected patients.

PMID:39027921 | PMC:PMC11255546 | DOI:10.12688/f1000research.129637.2

Front Surg. 2024 Jul 3;11:1407484. doi: 10.3389/fsurg.2024.1407484. eCollection 2024.

ABSTRACT

OBJECTIVE: This study aims to compare the utilization of 3D-CT reconstruction in measuring pedicle outer width (POW) between younger/middle-aged patients (<60 years) and older patients (≥60 years) with thoracolumbar spine fractures (TSF).

METHODS: We conducted a retrospective study from January 2021 to December 2022, involving a total of 108 patients with TSF. The study population consisted of 62 patients aged ≥60 years (observation group) and 46 patients aged <60 years (control group). We compared the POW on both the right and left sides of the thoracolumbar spine between the two groups. Additionally, we analyzed the POW by gender within each group and calculated the incidence of patients falling below the critical values for arch root puncture (5 mm) and arch root nailing (7 mm) in both groups.

RESULTS: There were no statistically significant differences observed in the POW between the two groups on both the left and right sides of each corresponding vertebra (P > 0.05). In the observation group, both male and female patients had significantly smaller POW compared to the control group (P < 0.05). However, no significant difference in POW was observed between the same-sex groups in the L4 to L5 vertebrae (P > 0.05). In the observation group, the POW was less than 5 mm in 9.33% (81/868) of cases and less than 7 mm in 49.88% (433/868) of cases, primarily observed from T11 to L3. In the control group, 4.81% (31/644) of cases had a POW of less than 5 mm, and 13.81% (88/644) had a POW of less than 7 mm.

CONCLUSION: Utilizing preoperative 3D-CT reconstruction to measure POW in patients with TSF not only facilitates the assessment of surgical feasibility but also aids in surgical pathway planning, thus potentially reducing the incidence of postoperative complications.

PMID:39027918 | PMC:PMC11256024 | DOI:10.3389/fsurg.2024.1407484

Front Vet Sci. 2024 Jul 4;11:1380022. doi: 10.3389/fvets.2024.1380022. eCollection 2024.

ABSTRACT

The negative effects of pain are a constant concern in the surgical management of animals, leading to the search for new drugs or more effective analgesic protocols to control this negative emotion. This study aimed to evaluate the nociceptive response of cannabidiol (CBD) alone and in combination with meloxicam using infrared pupillometry in female dogs undergoing elective ovariohysterectomy (OVH) under isoflurane anesthesia. A total of 60 female dogs of different breeds were included. These dogs were randomly assigned to four study groups according to the treatment: Control Group (G₀: n = 15) receiving saline solution; group premedicated with meloxicam at a dose of 0.2 mg Kg^-1 IV (G_Melox: n = 15). Postoperatively this drug was used at 0.1 mg Kg^-1 IV every 24 h; the CBD-treated Group (G_CBD: n = 15) at a dose of 2 mg Kg^-1 orally in the preoperative. Postoperatively was administrated every 12 h; and the Group premedicated with the combination of meloxicam and CBD (G_Melox/CBD: n = 15) Meloxicam at a dose of 0.2 mg Kg^-1 IV preoperatively, and 0.1 mg Kg^-1 IV during the postoperative. CBD at a dose of 2 mg Kg^-1 orally in the preoperative, and every 12 h in the postoperative. Treatments were administered for 48 postoperative hours. After OVH, the pupillary neurologic index, pupillary size, minimum diameter (MIN), percentage change, constriction latency (Lat), constriction velocity, and maximum constriction velocity were recorded as pupillometric variables in both eyes during events (E): Baseline (30 min before drug administration), E_{30 min}, E_1h, E_2h, E_3h, E_4h, E_8h, E_12h, E_24h, and E_48h. The Short-Form of the Glasgow Composite Measure Pain Scale (GCMPS-SF) was used to assess pain during the same events. Overall, it was observed that the pupillometric variables Size, MIN., and Lat. were significantly higher in G₀ compared to the other groups during E_{30 min}, E_1h, and E_2h (p = 0.03), indicating greater pupil dilation in G₀ animals. Additionally, no statistically significant differences were observed in GCMPS-SF between G_Melox, G_CBD, and G_Melox/CBD during the postoperative period (p > 0.05). In contrast, the scores were statistically different compared to G₀ (p = 0.00001), where all animals in this group received rescue analgesia at 2 h post-surgery. According to pupillometry and scores on the GCMPS-SF scale, it was observed that monotherapy with cannabidiol provides a similar analgesic effect to meloxicam alone or in combination with cannabidiol to manage acute pain in dogs. Similarly, these findings suggest that infrared pupillometry could be a tool for recognizing acute pain in dogs.

PMID:39027908 | PMC:PMC11256235 | DOI:10.3389/fvets.2024.1380022

Plast Reconstr Surg Glob Open. 2024 Jul 18;12(7):e5996. doi: 10.1097/GOX.0000000000005996. eCollection 2024 Jul.

ABSTRACT

BACKGROUND: Nurtec, a versatile migraine medication, has gained popularity. However, the awareness of migraine surgery remains uncertain.

METHODS: Following a descriptive approach, this cross-sectional study used Google Trends data as of December 1, 2023, to analyze internet search patterns. Approval from Vanderbilt University’s institutional review board and adherence to Strengthening the Reporting of Observational Studies in Epidemiology guidelines were confirmed. Monthly relative search volume (RSV) data for “migraine surgery,” “Nurtec,” and “Rimegepant” were collected from January 1, 2004, to November 11, 2023, within the United States. Statistical analysis involved determining mean monthly RSV values and percentage changes for critical periods.

RESULTS: For “Nurtec,” a significant surge in RSV occurred from March 2020 to April 2020 (344%). Additional peaks were observed from June 2020 to July 2020 (66%), October 2020 to December 2020 (169%), May 2021 to June 2021 (33%), and May 2023 to June 2023 (14%). “Migraine surgery” exhibited a notable 400% increase in RSV, from March 2005 to May 2005. However, post-2006, RSV for “migraine surgery” consistently remained low without noticeable peaks.

CONCLUSIONS: The analysis of RSV trends for “Nurtec” and “migraine surgery” from 2004 to 2023 reveals the impact of pivotal events and marketing strategies on public interest. The distinct peaks in “Nurtec” RSV align with Food & Drug Administration approvals and marketing campaigns, highlighting the medication’s accessibility. Conversely, the consistently low RSV for “migraine surgery” indicates limited awareness, emphasizing the need for enhanced promotion and education regarding surgical interventions.

PMID:39027895 | PMC:PMC11257674 | DOI:10.1097/GOX.0000000000005996

Plast Reconstr Surg Glob Open. 2024 Jul 18;12(7):e5995. doi: 10.1097/GOX.0000000000005995. eCollection 2024 Jul.

ABSTRACT

BACKGROUND: Closed incision negative-pressure therapy (ciNPT) has become increasingly used on surgical sites to attempt to minimize postoperative complications. The literature describing the benefits of ciNPT in reducing donor site morbidity after free tissue transfer is limited. This review compares the effectiveness of ciNPT and conventional dressings in reducing donor site complications after free tissue transfer.

METHODS: A systematic review of PubMed and Ovid (MEDLINE) utilizing the search terms ((flap) AND (donor)) AND ((negative pressure) OR (vacuum)) was conducted. Bibliographies of selected articles were also searched. Relevant outcomes were collected and analyzed.

RESULTS: After screening 156 articles, 12 studies were included in the study with a total of 1074 donor sites. The following postoperative complications at the donor site after a free tissue transfer were analyzed: wound dehiscence, infection, seroma, hematoma, and skin necrosis. Use of ciNPT was associated with lower incidence of wound dehiscence compared with conventional dressings (OR: 0.37; 95% CI, 0.23-0.58). The incidence of infection, seroma, hematoma, and skin necrosis were overall lower in the ciNPT group; although, this was not statistically significant.

CONCLUSIONS: Use of ciNPT was associated with a significantly lower incidence of free flap donor site wound dehiscence compared with conventional dressings. The use of ciNPT on free flap donor sites appears to have overall lower rates of other wound complications such as seroma, hematoma, skin necrosis, and infection.

PMID:39027894 | PMC:PMC11257675 | DOI:10.1097/GOX.0000000000005995

Ann Appl Stat. 2023 Mar;17(1):815-837. doi: 10.1214/22-aoas1652. Epub 2023 Jan 24.

ABSTRACT

The growing number of available treatment options has led to urgent needs for reliable answers when choosing the best course of treatment for a patient. As it is often infeasible to compare a large number of treatments in a single randomized controlled trial, multivariate network meta-analyses (NMAs) are used to synthesize evidence from trials of a subset of the treatments, where both efficacy and safety related outcomes are considered simultaneously. However, these large-scale multiple-outcome NMAs have created challenges to existing methods due to the increasing complexity of the unknown correlations between outcomes and treatment comparisons. In this paper, we proposed a new framework for PAtient-centered treatment ranking via Large-scale Multivariate network meta-analysis, termed as PALM, which includes a parsimonious modeling approach, a fast algorithm for parameter estimation and inference, a novel visualization tool for presenting multivariate outcomes, termed as the origami plot, as well as personalized treatment ranking procedures taking into account the individual’s considerations on multiple outcomes. In application to an NMA that compares 14 treatment options for labor induction, we provided a comprehensive illustration of the proposed framework and demonstrated its computational efficiency and practicality, and we obtained new insights and evidence to support patient-centered clinical decision making.

PMID:39027887 | PMC:PMC11257173 | DOI:10.1214/22-aoas1652

Open Med (Wars). 2024 Jul 17;19(1):20230815. doi: 10.1515/med-2023-0815. eCollection 2024.

ABSTRACT

To investigate the renal function and fibrosis indexes of conventional western medicine with Chinese medicine for dredging collaterals in the treatment of renal fibrosis (RF). We searched articles from databases (PubMed, Embase, The Cochrane Library, CNKI, and Wanfang data) and references of included studies. The quality of literature was evaluated and data were extracted in regard to the inclusion and exclusion criteria. RevMan5.3 software was applied for all statistical analyses. Eleven eligible RCTs with a total of 898 patients were included in this meta-analysis. Compared with conventional western medicine alone, conventional western medicine with Chinese medicine for dredging collaterals in the treatment of RF has lower BUN levels and SCr levels (P < 0.05). As for fibrosis indexes, conventional western medicine with Chinese medicine for dredging collaterals has lower HA, laminin (LN), IV-Col, and PC-III levels (P < 0.05). Conventional western medicine with Chinese medicine for dredging collaterals with lower BUN, Scr, HA, LN, PC-III, and IV-Col levels, has an advantage in the treatment of RF. These lower serum levels may not be associated with the presence of RF. Ideally, kidney biopsies should be performed to confirm that these markers reduce RF. This is a major limitation of this study.

PMID:39027883 | PMC:PMC11255556 | DOI:10.1515/med-2023-0815