Tag: statistics

Pharmacoepidemiol Drug Saf. 2024 Aug;33(8):e5855. doi: 10.1002/pds.5855.

ABSTRACT

PURPOSE: Hypertension (HT), dyslipidemia (DL), and diabetes mellitus (DM) are major risk factors for cardiovascular diseases. Despite the wide availability of medications to reduce this risk, poor adherence to medications remains an issue. The aim of this study is to evaluate medication adherence of prevalent users in these disease medications (HT, DL, DM) using claims data. Factors associated with non-adherence were also examined.

METHODS: Of 7538 participants of the Tsuruoka Metabolomics Cohort Study, 3693 (HT: 2702, DL: 2112, DM: 661) were identified as prevalent users of these disease medications. Information on lifestyle was collected through a questionnaire. Adherence was assessed by a proportion of days covered (PDC) and participants with PDC ≥0.8 were defined as adherent. Predictors of non-adherence were determined by performing multivariable logistic regression.

RESULTS: Medication adherence differed by treatment status. Among those without comorbidities, those with HT-only showed the highest adherence (90.2%), followed by those with DM-only (81.2%) and those with DL-only (80.8%). Factors associated with non-adherence in each medication group were skipping breakfast and poor understanding of medications among those with HT medications, females, having comorbidities, having a history of heart disease, and drinking habit among those with DL medications, and good sleep quality and skipping breakfast among those with DM medications.

CONCLUSION: While participants showed high medication adherence, differences were observed across medication groups. The identified predictors of non-adherence could help target those in need of adherence support.

PMID:39145400 | DOI:10.1002/pds.5855

Clin Otolaryngol. 2024 Aug 15. doi: 10.1111/coa.14213. Online ahead of print.

ABSTRACT

PURPOSE: The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours.

METHODS: A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs).

RESULTS: In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (OR_adjusted = 2.6, 4.1% vs. 12.5%, p = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, p = 0.333).

CONCLUSION: Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.

PMID:39145398 | DOI:10.1111/coa.14213

Stroke. 2024 Aug 15. doi: 10.1161/STROKEAHA.123.046118. Online ahead of print.

ABSTRACT

BACKGROUND: Significant age and sex differences have been reported at each stage of the stroke pathway, from risk factors to outcomes. However, there is some uncertainty in previous studies with regard to the role of potential confounders and selection bias. Therefore, using German nationwide administrative data, we aimed to determine the magnitude and direction of trends in age- or sex-specific differences with respect to admission rates, risk factors, and acute treatments of ischemic and hemorrhagic stroke.

METHODS: We obtained and analyzed data from the Research Data Centres of the Federal Statistical Office for the years 2010 to 2020 with regard to all acute stroke hospitalizations, risk factors, treatments, and in-hospital mortality, stratified by sex and stroke subtype. This database provides a complete national-level census of stroke hospitalizations combined with population census counts. All hospitalized patients ≥15 years with an acute stroke (diagnosis code: I60-64) were included in the analysis.

RESULTS: Over the 11-year study period, there were 3 375 157 stroke events; 51.2% (n=1 728 954) occurred in men. There were higher rates of stroke admissions in men compared with women for both ischemic (378.1 versus 346.7/100 000 population) and hemorrhagic subtypes (75.6 versus 65.5/100 000 population) across all age groups. The incidence of ischemic stroke admissions peaked in 2016 among women (354.0/100 000 population) and in 2017 among men (395.8/100 000 population), followed by a consistent decline from 2018 onward. There was a recent decline in hemorrhagic stroke admissions observed for both sexes, reaching its nadir in 2020 (68.9/100 000 for men; 59.5/100 000 for women). Female sex was associated with in-hospital mortality for both ischemic (adjusted odds ratio, 1.11 [1.09-1.12]; P<0.001) and hemorrhagic stroke (adjusted odds ratio, 1.18 [95% CI, 1.16-1.20]; P<0.001).

CONCLUSIONS: Despite improvements in stroke prevention and treatment pathways in the past decade, sex-specific differences remain with regard to hospitalization rates, risk factors, and mortality. Better understanding the mechanisms for these differences may allow us to develop a sex-stratified approach to stroke care.

PMID:39145389 | DOI:10.1161/STROKEAHA.123.046118

Circ Cardiovasc Interv. 2024 Aug 15:e013979. doi: 10.1161/CIRCINTERVENTIONS.123.013979. Online ahead of print.

ABSTRACT

BACKGROUND: The ASTRAL trial (Angioplasty and Stenting for Renal Artery Lesions) recruited 806 patients between 2000 and 2007. Patients with atherosclerotic renal artery stenosis (RAS) and clinician uncertainty about the benefit of revascularization were randomized 1:1 to medical therapy with or without renal artery stenting. The initial results were presented in 2009 at a median 33.6-month follow-up, with no benefit of revascularization on renal or cardiovascular outcomes. Surviving patients remained under follow-up until the end of 2013, and the long-term results are presented in this study.

METHODS: Data were analyzed to assess whether there was a later impact of revascularization on renal function, cardiovascular events, and survival, including a composite outcome of renal and cardiovascular outcomes and death (as in the CORAL trial [Cardiovascular Outcomes in Renal Atherosclerotic Lesions]). Prespecified subgroup analyses included different categories of renal function, rapid deterioration in kidney function, and degree of RAS. Post hoc analyses of patients with severe RAS (bilateral 70% or >70% in a solitary kidney), those with or without proteinuria, and a per-protocol analysis were performed.

RESULTS: The mean age of the entry population was 70.5 years, the mean estimated glomerular filtration rate was 40 mL/min/1.73 m², the mean RAS was 76%, and the mean blood pressure was 150/76 mm Hg; 83% of the revascularization group underwent attempted stenting. The median follow-up was 56.4 months, with 108 patients lost to follow-up. By the end of follow-up, 50% of the evaluable population had died, 18% had suffered a first renal event, and 40% had suffered a first cardiovascular event. No statistical difference was observed for any outcome in the intention-to-treat and per-protocol analyses.

CONCLUSIONS: The long-term follow-up of the ASTRAL trial showed no overall benefit of renal revascularization to renal and cardiovascular outcomes. It has been highlighted that a proportion of the population had lower-risk RAS, and there is likely to be merit in further study in a higher-risk population.

REGISTRATION: URL: https://www.isrctn.com; Unique identifier: ISRCTN59586944.

PMID:39145377 | DOI:10.1161/CIRCINTERVENTIONS.123.013979

J Parasit Dis. 2024 Sep;48(3):450-459. doi: 10.1007/s12639-024-01673-3. Epub 2024 May 24.

ABSTRACT

Tick-borne pathogens pose a significant global threat, causing substantial economic losses to the dairy industry. In India, tropical theileriosis, anaplasmosis, babesiosis, and trypanosomiasis are major hemo-parasitic diseases affecting bovines. A cross-sectional study was conducted to determine the prevalence of hemo-parasites in different farms in India. PCR assays were employed to detect carrier status, using gene targets msp1b, tams1, rap-1, ama1, and ITS1 for A. marginale, T. annulata, B. bovis, B. bigemina, and Trypanosoma species, respectively. Out of the 578 apparently healthy animals screened, 30.45% (95% CI: 26.84-34.32%) were infected with at least one hemo-parasite. Cattle showed an overall positivity of 32.87%, while buffaloes had a prevalence of 15.19%, which was statistically significant (p < 0.001). Interestingly, prevalence was higher in indigenous cattle (47.81%) compared to cross-breeds (25.53%) and exotics (14.62%), with a statistically significant difference (p < 0.001). The prevalence of hemo-parasites varied widely among the farms, ranging from 5.77 to 100%. A. marginale was the most prevalent parasite (23.70% of animals), followed by T. annulata (13.67%), Babesia species (1.90%), and Trypanosoma species (1.56%). Enzootic instability was observed in six of the eight farms, indicating a potential for future outbreaks. Co-infection was detected in 60 out of 176 animals positive for hemo-parasites, with 59 animals co-infected with A. marginale and T. annulata, and only one cross-breed cattle infected with both Anaplasma marginale and Babesia bigemina. The findings highlight the prevalence of hemo-parasites in farms, underscoring the need for whole-herd screening, treatment of infected animals, and improvement in farm management practices to prevent production losses caused by these pathogens.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12639-024-01673-3.

PMID:39145369 | PMC:PMC11319688 | DOI:10.1007/s12639-024-01673-3

J Parasit Dis. 2024 Sep;48(3):624-629. doi: 10.1007/s12639-024-01703-0. Epub 2024 Jul 23.

ABSTRACT

Trichomoniasis is a parasitic disease that affects the human reproductive and urinary systems, representing a substantial non-viral sexually transmitted infection worldwide. Given its impact on reproductive health, and the limited available information on the prevalence of Trichomonas vaginalis, this study aimed to evaluate the prevalence of T. vaginalis among women referred to health centers in Tabriz, Northwest Iran. Study was conducted on 448 suspicious women who attended to 29Bahman hospital in Tabriz, Northwest Iran, during September 2020 to September 2021. Demographic data were collected according to the study protocol. Vaginal discharges were obtained using sterile swabs, and the prevalence of T. vaginalis was determined using Papanicolauo staining and PCR method. Among the 448 cases studied, 48 (10.7%) samples were suspected as a T. vaginalis infection, while 4 (0.89%) confirmed using the PCR method. The mean age of infected individuals was 41.7 ± 9.4 years. No statistical correlation was observed between inflammation, method of contraception and infection (p = 0.8). The present study revealed a relatively low prevalence of T. vaginalis infection within the study population. Additionally, the utilization of the PCR method can be beneficial in confirming suspected samples.

PMID:39145365 | PMC:PMC11319573 | DOI:10.1007/s12639-024-01703-0

J Parasit Dis. 2024 Sep;48(3):514-524. doi: 10.1007/s12639-024-01690-2. Epub 2024 Jun 12.

ABSTRACT

Iron deficiency anemia (IDA), which causes greater morbidity and mortality in children, has multifactorial causes, including many helminthic and protozoal infections. Herein, the study aimed to find out the frequency and associated risk of Blastocystis sp. infection among children with IDA, together with the estimation of the serum levels of iron, zinc, copper, and vitamin A. Both stool and blood samples were obtained from 90 children with a confirmed diagnosis of IDA and 90 non-anemic children. Blastocystis sp. was diagnosed by direct stool examination and Invitro cultivation methods. Different hematological parameters were recorded, and the serum level of iron, zinc, copper, and vitamin A was measured in serum samples. The overall predominance of Blastocystis in children was 36.7%, significantly higher (P < 0.001) in children with IDA (55.6%) compared to non-anemic controls (17.8%). Furthermore, Blastocystis infected children were 5.781 times more prone to be anemic (OR = 5.781). All IDA cases with positive Blastocystis infection had a mean hemoglobin level of 9.55 g/dl (moderate anemia). While in other non-infected IDA cases, it was 9.56 g/dl, showing no statistical difference (P = 0.845). Serum levels of zinc, iron, and vitamin A considerably decreased, whereas serum copper levels significantly increased in IDA children infected with Blastocystis. The current research is the first in Egypt to indicate that Blastocystis infection in children is a high-risk factor for developing IDA. Blastocystis infection significantly alters the metabolic and biochemical processes and interferes with the absorption of micronutrients and vitamin A in IDA children.

PMID:39145364 | PMC:PMC11319569 | DOI:10.1007/s12639-024-01690-2

J Parasit Dis. 2024 Sep;48(3):439-449. doi: 10.1007/s12639-024-01668-0. Epub 2024 Apr 28.

ABSTRACT

Three stations along the Ase River, Delta State Nigeria provided water and 85 fish samples which were analyzed. The fish were measured and examined for endoparasites according to established protocol. All water quality parameters investigated were within the WHO-acceptable values for surface waters. Station variation of physicochemical parameters was not statistically significant (p > 0.05). Fish body conformation indices positively correlated with the prevalence of parasites in Clarias gariepinus, Heterobranchus longifilis, Parachana africana, Chromidotilapia guntheri guntherii, and Denticeps clupeodes. The overall parasite prevalence of 63.53% was established with the most abundant parasite being Trichodina mutabillis. The parasites had a predilection for the gastrointestinal tract with a high occurrence of 307 individuals. Stations 1, 2, and 3 had 326, 213, and 259 parasites, respectively, out of a total of 798 parasites detected. P. laevis was absent in station 1. All parasites were found in stations 2 and 3. Statistically, there was a significant difference (p < 0.05) in the prevalence in all stations. The correlation index of T. mutabillis and R. congolensis in stations 1 and 3 was positively strong (p < 0.05) with the concentrations of water quality. However, water conditions in stations 1 and 3 had a deleterious impact on P. laevis. T. mutabillis maintained a high positive correlation with physicochemical water quality in all three stations. Shannon-Weiner’s index in station 3 (H = 1.337) shows that the parasites were more diverse. PCA and biodiversity indices have enabled us to comprehend how parasite-host-environment systems interact.

PMID:39145361 | PMC:PMC11319677 | DOI:10.1007/s12639-024-01668-0

Schizophr Bull Open. 2023 Jan 3;4(1):sgac076. doi: 10.1093/schizbullopen/sgac076. eCollection 2023 Jan.

ABSTRACT

BACKGROUND: This study attempts to replicate in a Chinese population an earlier UK report that eye movement abnormalities can accurately distinguish schizophrenia (SCZ) cases from healthy controls (HCs). It also seeks to determine whether first-episode SCZ differ from chronic SCZ and whether these eye movement abnormalities are enriched in psychosis risk syndrome (PRS).

METHODS: The training set included 104 Chinese HC and 60 Chinese patients with SCZ, and the testing set included 20 SCZ patients and 20 HC from a UK cohort. An additional 16 individuals with PRS were also enrolled. Eye movements of all participants were recorded during free-viewing, smooth pursuit, and fixation stability tasks. Group differences in 55 performance measures were compared and a gradient-boosted decision tree model was built for predictive analyses.

RESULTS: Extensive eye-movement abnormalities were observed in patients with SCZ on almost all eye-movement tests. On almost all individual variables, first-episode patients showed no statistically significant differences compared with chronic patients. The classification model was able to discriminate patients from controls with an area under the curve of 0.87; the model also classified 88% of PRS individuals as SCZ-like.

CONCLUSIONS: Our findings replicate and extend the UK results. The overall accuracy of the Chinese study is virtually identical to the UK findings. We conclude that eye-movement abnormalities appear early in the natural history of the disorder and can be considered as potential trait markers for SCZ diathesis.

PMID:39145342 | PMC:PMC11207660 | DOI:10.1093/schizbullopen/sgac076

Schizophr Bull Open. 2023 Nov 14;4(1):sgad032. doi: 10.1093/schizbullopen/sgad032. eCollection 2023 Jan.

ABSTRACT

BACKGROUND AND HYPOTHESIS: Based on the need-adapted approach, delaying antipsychotics could help identify first-episode psychosis (FEP) adolescents who might not require them. However, some individuals might need antipsychotics, and postponing could harm their prognosis. This nationwide register-based follow-up aimed to test these two hypotheses.

STUDY DESIGN: All adolescents aged 13-20 with a psychotic disorder (ICD-10 codes: F20-F29) in Finland between 2003 and 2013 were identified (n = 6354) from national registers. For each case, a fixed 1825-day follow-up period was established from the onset of psychosis or until death. The outcome was considered “good” if adolescents did not die and had not received psychiatric treatment and/or disability allowances during the final year of follow-up. Testing the first hypothesis involved all antipsychotic treatment-naïve adolescents with FEP (n = 3714). The second hypothesis was tested with a sub-sample of only those who had received antipsychotics during follow-up (n = 3258). To account for baseline confounders, hypotheses were tested via a stabilized inverse probability of treatment weighted generalized linear models with logit link function.

STUDY RESULTS: Immediate antipsychotic treatment after the onset of psychosis was associated with poor 5-year outcome (adjusted odds ratio [aOR]: 1.8, 95% CI: 1.6-2.1). There was no statistically significant association between antipsychotic postponement and treatment outcome in those who eventually received antipsychotic treatment (aOR: 1.02, 95% CI: 0.7-1.2, P: .8), thus not providing support for second hypothesis.

CONCLUSIONS: There is a significant subgroup of adolescent with psychosis who do not require immediate antipsychotic treatment. A more robust design is needed to evaluate the causality of the observed association.

PMID:39145341 | PMC:PMC11207772 | DOI:10.1093/schizbullopen/sgad032