Tag: statistics

Turk Neurosurg. 2024;34(2):314-324. doi: 10.5137/1019-5149.JTN.44200-23.2.

ABSTRACT

AIM: To examine the effect of cerebellar damage on the process of fracture healing.

MATERIAL AND METHODS: A total of forty-two male rats were selected at random and subsequently allocated into three distinct groups. The experimentals were divided into two subgroups within each group, with the intention of sacrificing them during the third and sixth weeks. Group 1 had isolated femoral fracture, Group 2 had femoral fracture after craniotomy, and Group 3 had femoral fracture accompanying cerebellar injury after craniotomy. Left femoral fractures in rats in all groups were treated using an intramedullary Kirschner wire. Radiological, histological, and biochemical evaluations were conducted at 3 and 6 weeks to assess the processes of fracture healing. To determine the effects of fracture healing and cerebellar injury on oxidant-antioxidant systems, catalase (CAT), malondialdehyde, superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities were measured.

RESULTS: Between the time frame of 3 to 6 weeks, Group 3 had higher radiography scores, alkaline phosphatase levels, callus/ diaphyse ratio, callus improvement, and bone mineral density in comparison to the other groups. The activity of SOD was found to be statistically negligible in all groups, suggesting that SOD does not have a substantial impact on fracture healing in cerebellar injury. However, notable increases in the activity of GPx and CAT enzymes were observed, showing their considerable involvement in the process of fracture healing.

CONCLUSION: Cerebellar injury reduces the oxidative stress in the fracture area and contributes positively to fracture healing by means of radiologically, biochemically and histopathologically.

PMID:38497185 | DOI:10.5137/1019-5149.JTN.44200-23.2

Turk Neurosurg. 2024;34(2):263-267. doi: 10.5137/1019-5149.JTN.43318-23.2.

ABSTRACT

AIM: To examine the effects of regulating increased blood glucose levels on plasma ET-1 levels after severe head trauma in rats.

MATERIAL AND METHODS: Traumatic diffuse brain injury-induced rats were followed for 7 days and were randomly divided into two groups of 36 rats. Pre- and posttraumatic blood glucose and ET-1 levels were measured in group 1 (control). Posttraumatic blood glucose levels were maintained at normal levels using insulin and both blood glucose and ET-1 levels were measured at 2, 6, 12, 24, and 48 h and 7 days posttrauma in group 2. The study excluded animals that died and had skull fractures.

RESULTS: Posttraumatic plasma ET-1 levels (n=36) were significantly higher than baseline values in group 1 (p < 0.05). ET-1 levels in group 2 at the 7-day follow-up after trauma were significantly higher than baseline values (n=36) (p < 0.05). However, the increased ET-1 levels were statistically significantly lower in group 2 than in group 1 (p < 0.05).

CONCLUSION: The increased ET-1 levels were significantly prevented by keeping blood glucose levels within normal limits with insulin after severe head trauma. Thus, secondary injury to cerebral blood flow can be prevented by reducing the occurrence of vasospasm that starts in the early posttraumatic period or by stimulating the release of nitric oxide. Therefore, further studies on the role of ET-1 and insulin in developing secondary injuries after severe head trauma would be beneficial.

PMID:38497179 | DOI:10.5137/1019-5149.JTN.43318-23.2

Turk Neurosurg. 2024;34(2):256-262. doi: 10.5137/1019-5149.JTN.42746-22.2.

ABSTRACT

AIM: To evaluate the outcomes of dynamic stabilization in the multilevel degenerative spondylotic spine, and to compare the two dynamic systems (Dynesys® and Orthrus®) to reveal the increasing role of dynamic systems in the management of the degenerative spine.

MATERIAL AND METHODS: A total of 74 patients who received dynamic stabilization for degenerative pathologies were retrospectively analyzed. Demographic details: preoperative data including neurological status, pain scores, and radiology; and intraoperative data including blood loss, duration of surgery, complications, and postoperative data including the neurologic status, duration of hospital stay, and pain scores were examined.

RESULTS: Patients in both groups showed statistically significant improvements in their Visual Analog Scale and Oswestry Disability Index scores. Significant corrections of thoracic kyphosis (T2-T12), the sagittal vertical axis, and T10-L2 thoracolumbar kyphosis were obtained in our cohort (p < 0.05). A total of 4 patients received revision surgery due to screw loosening. Patients were discharged after 3-4 days and mobilized on the first postoperative day.

CONCLUSION: We did not experience any serious issues in terms of stabilization in the cases in which we employed both systems. Our patients’ clinical results were satisfactory in both systems. Existing systems can be used safely even in long-segment stabilization surgeries.

PMID:38497178 | DOI:10.5137/1019-5149.JTN.42746-22.2

Turk Neurosurg. 2024;34(2):250-255. doi: 10.5137/1019-5149.JTN.43052-22.2.

ABSTRACT

AIM: To compare the clinical and radiological outcomes of unilateral percutaneous kyphoplasty (PKP) surgeries performed using 3D printing technology in patients with osteoporotic compression fractures to conventional unilateral PKP surgeries.

MATERIAL AND METHODS: Patients with acute painful single-level osteoporotic vertebral compression fracture (OVCF) who need surgical treatment were divided into two groups: group A (patients who had 3D template-guided PKP) and group B (patients who conventional PKP). To compare the two surgical procedures, Total Absorbed Radiation Dose (TARD), pre- and postoperative visual analog scale (VAS) scores, and Total Surgery Time (TST) were calculated and compared between groups in both surgical groups.

RESULTS: A total of 44 patients with single-level OVCF who were experiencing acute pain were successfully operated on, with 22 patients in each group. TARD (2.6 ± 0.4 mGy vs. 6.1 ± 1.9 mGy, p < 0.05) and TST (12.4 ± 2.6 min vs. 20.2 ± 3.2 min, p < 0.05) differed significantly different between groups A and B. There was no statistically significant difference between the patient groups in preoperative and postoperative VAS values (p > 0.05). Cement leakage was lower in group A (3/22, 13.6%) than in group B (6/22, 27.3%) (p > 0.05). There were no neurological complications or infections in either group.

CONCLUSION: When compared to the conventional procedure, the unilateral percutaneous kyphoplasty method was supported by a 3D printing guide template. By reducing operative time and radiation exposure, tt has resulted in a more effective surgical procedure for patients and a safer surgical procedure for surgeons and anaesthesiologists.

PMID:38497177 | DOI:10.5137/1019-5149.JTN.43052-22.2

Urologia. 2024 Mar 18:3915603241237563. doi: 10.1177/03915603241237563. Online ahead of print.

ABSTRACT

OBJECTIVE: As key stakeholders in educational settings, teachers’ awareness on Urinary Tract Infections (UTI) will ultimately enhance its management in schools and community. This study aimed to assess the level of knowledge, attitudes, and practices (KAP) on UTIs among teachers in Sri Lanka.

MATERIALS AND METHODS: Conveniently selected 373 school teachers were assessed using a pre-tested questionnaire. Each of the individual was scored and categorized as either satisfactory or poor. Descriptive statistics and chi-square tests were performed to describe the outcomes.

RESULTS: Around 80% of respondents demonstrated awareness regarding the microbial origin of UTIs, while 42% possessed knowledge of women’s increased susceptibility to UTIs. Over 90% of participants had favorable attitudes toward drinking adequate amounts of water, personal hygiene, and consulting doctors for UTI symptoms. Each inquiry demonstrated significant disparities between individuals with satisfactory and poor attitudes (p = 0.000), with over 95% adhered to effective hygiene practices as a preventive measure against UTIs. The demographics of the participants did not show any significance over the KAP results of the study (p < 0.05).

CONCLUSIONS: The study revealed satisfactory levels of awareness and favorable attitudes among respondents on UTIs. However, there is a further need for increased awareness, specifically regarding the risk factors associated with UTIs.

PMID:38497160 | DOI:10.1177/03915603241237563

Haematologica. 2024 Mar 14. doi: 10.3324/haematol.2023.284281. Online ahead of print.

ABSTRACT

CNS relapse in patients with diffuse large B-cell lymphoma (DLBCL) carries a dismal prognosis with most clinical guidelines recommending CNS prophylaxis to patients deemed at high risk for CNS relapse. However, results from observational studies investigating the effect of CNS prophylaxis have yielded conflicting results.

OBJECTIVES: To evaluate: 1) whether addition of prophylactic intravenous HD-MTX reduces the risk of CNS relapse in high-risk DLBCL patients treated with R-CHOP or similar and 2) whether HD-MTX prophylaxis confers an overall survival benefit, irrespective of CNS relapse.

METHODS: A systematic search of MEDLINE/PubMed and EMBASE on DLBCL patients at high risk of CNS relapse treated with R-CHOP or similar receiving HD-MTX as intervention and a comparator arm receiving no prophylaxis and/or IT prophylaxis. Risk of Bias was estimated using the ROBINS-I tool and the quality of the evidence by the GRADE approach. Finally, a meta-analysis based on the systematic review was conducted.

RESULTS: A total of 1812 studies were screened. No RCT’s were identified. Seven observational studies comprising 1661 patients met inclusion criteria. We found a statistically non-significant relative risk of 0.54 [0.27-1.07, 95% CI] of CNS relapse for patients receiving HD-MTX vs. controls. The meta-analysis investigating mortality demonstrated a relative risk of death of 0.70 [0.44-1.11, 95% CI] for HD-MTX treated vs. controls. The overall risk of bias was adjudged as “serious” and the quality of the evidence was rated as low.

CONCLUSION: Our data indicate that HD-MTX does not prevent, or at best, only slightly reduces the risk of CNS relapse and confers no survival benefit.

PMID:38497149 | DOI:10.3324/haematol.2023.284281

Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241231610. doi: 10.1177/15330338241231610.

ABSTRACT

BACKGROUND: Clinical studies have shown that programmed cell death-1 (PD-1) inhibitors can activate T cells and inhibit cancer growth. Therefore, the use of a PD-1 inhibitor plus chemotherapy as neoadjuvant chemotherapy for locally advanced esophageal cancer is worth further exploration.

METHODS: Patients with locally advanced esophageal squamous cell carcinoma were enrolled in this study to receive two cycles of a preoperative combination of toripalimab, paclitaxel, and cisplatin. Efficacy was evaluated after two treatment cycles. The patients’ postoperative pathological staging was analyzed and compared. Surgery was performed within 42 days of the start date of the last chemotherapy cycle.

RESULTS: Neoadjuvant immunochemotherapy achieved a high pathologic complete response (pCR) rate (29.0%), major pathological response rate (41.9%), and objective response rate (80.6%) and demonstrated statistically significant downstaging after neoadjuvant therapy (P < .05) with manageable treatment-related adverse effects. No significant association was found between PD-L1 level and pCR (P = .365). In addition, R0 resection was achieved in all 31 (100%) patients during surgery. For all the included patients, the one-year progression-free survival rate was 87.1% (95% CI: 75.3%-98.9%), the one-year overall survival (OS) rate was 96.8% (95% CI: 79.8%-95.9%), and the two-year OS rate was 83.9% (95% CI: 71.6%-92.2%).

CONCLUSIONS: Our findings indicate that this combination may be a potential neoadjuvant therapy regimen in this setting.

PMID:38497137 | DOI:10.1177/15330338241231610

BJOG. 2024 Mar 18. doi: 10.1111/1471-0528.17811. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the clinical utility of point-of-care (POC) capillary blood glucose (CBG) testing in the assessment of gestational diabetes mellitus (GDM) during oral glucose tolerance test (OGTT).

DESIGN: Prospective cohort study.

SETTING: Antenatal clinics at King’s College Hospital.

POPULATION: Women screened for GDM between March and June 2020.

METHODS: The CBG was measured using the POC StatStrip® test and the venous plasma glucose (VPG) was measured by Roche analyser (Cobas 8000 c702). GDM was diagnosed based on the 2015 National Institute for Health and Clinical Excellence (NICE) Clinical Guideline criteria. The two methods were compared statistically using Analyse-It 5.40.2.

MAIN OUTCOME MEASURES: Diagnostic sensitivity, specificity, positive and negative predictive values (PPV and NPV) for the POC StatStrip® test, compared with VPG measured by reference laboratory method.

RESULTS: A total of 230 women were included. The number and percentage of women with glucose concentrations above the GDM threshold using the POC StatStrip® test versus laboratory VPG measurement was 15 (6.5%) versus eight (3.4%) at fasting and 105 (45.6%) versus 72 (31.1%) at 2 h, respectively. The sensitivity and specificity values (and 95% CIs) for the POC StatStrip® test were 88% (52%-99%) and 97% (93%-98%) at fasting and 97% (91%-99%) and 79% (71%-84%) at 2 h, respectively. However, the specificity and the NPV for the POC StatStrip® test for concentrations of ≤5.0 mmol/L at fasting or <7.5 mmol/L at 2 h were 100%, and the sensitivity and the PPV for concentrations of >9.5 mmol/L at 2 h were 100%.

CONCLUSIONS: In our cohort the POC measurement of CBG cannot entirely replace the laboratory method for the OGTT; however, it can be used to rule out/rule in GDM for glucose concentrations of ≤5.0 mmol/L at fasting or <7.5/>9.5 mmol/L at 2 h.

PMID:38497098 | DOI:10.1111/1471-0528.17811

Twin Res Hum Genet. 2024 Mar 18:1-11. doi: 10.1017/thg.2024.4. Online ahead of print.

ABSTRACT

In this cohort profile article we describe the lifetime major depressive disorder (MDD) database that has been established as part of the BIObanks Netherlands Internet Collaboration (BIONIC). Across the Netherlands we collected data on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lifetime MDD diagnosis in 132,850 Dutch individuals. Currently, N = 66,684 of these also have genomewide single nucleotide polymorphism (SNP) data. We initiated this project because the complex genetic basis of MDD requires large population-wide studies with uniform in-depth phenotyping. For standardized phenotyping we developed the LIDAS (LIfetime Depression Assessment Survey), which then was used to measure MDD in 11 Dutch cohorts. Data from these cohorts were combined with diagnostic interview depression data from 5 clinical cohorts to create a dataset of N = 29,650 lifetime MDD cases (22%) meeting DSM-5 criteria and 94,300 screened controls. In addition, genomewide genotype data from the cohorts were assembled into a genomewide association study (GWAS) dataset of N = 66,684 Dutch individuals (25.3% cases). Phenotype data include DSM-5-based MDD diagnoses, sociodemographic variables, information on lifestyle and BMI, characteristics of depressive symptoms and episodes, and psychiatric diagnosis and treatment history. We describe the establishment and harmonization of the BIONIC phenotype and GWAS datasets and provide an overview of the available information and sample characteristics. Our next step is the GWAS of lifetime MDD in the Netherlands, with future plans including fine-grained genetic analyses of depression characteristics, international collaborations and multi-omics studies.

PMID:38497097 | DOI:10.1017/thg.2024.4

Saudi Pharm J. 2024 Apr;32(4):102022. doi: 10.1016/j.jsps.2024.102022. Epub 2024 Mar 6.

ABSTRACT

BACKGROUND: Single nucleotide polymorphisms in the gene encoding proteins involved in mercaptopurine metabolism can influence drug efficacy and safety. This study aims to assess clinical pharmacists’ knowledge about mercaptopurine-related genes and their polymorphisms and investigate their attitudes, perceptions, and beliefs about the need for and importance of pharmacogenetic testing for mercaptopurine.

METHODS: A cross-sectional descriptive study was conducted among oncology/hematology clinical pharmacists in Saudi Arabia using an online-questionnaire developed by experts in the field. The questionnaire consists of four-sections exploring clinical pharmacists’ knowledge, attitudes, perceptions, and beliefs about the importance of gene testing and genes polymorphism when prescribing mercaptopurine. Descriptive statistics were used to analyze the data in the study.

RESULTS: A total of 41 oncology/hematology clinical pharmacists responded to the survey invitation. Almost half of them had more than 10 years of work experience, but only 17 % of them received formal training in pharmacogenetics. The overall level of knowledge about pharmacogenetics among participants was low, with a mean score of 2.8 points (1.7) out of 8 items. However, around 76 % agreed that it is important to perform pharmacogenetic screening prior to prescribing mercaptopurine, and almost 93 % state that it will influence their dosage recommendation. Most of the participants had a good perception (95.1 %) of their role in genetic testing for medication selection, dosing, and monitoring; however, about 10 % of surveyed pharmacists reported not being completely responsible about recommending pharmacogenetic testing. The surveyed pharmacists had a good belief in the importance of pharmacogenetic testing and their overall attitude was positive toward the use of pharmacogenetic testing, with emphasis on the importance of training on the proper assessment and interpretation of pharmacogenetic tests.

CONCLUSIONS: Pharmacists demonstrated good perception and positive attitude toward pharmacogenetic testing, despite the low level of knowledge and limited formal training. Thus, more attention to developing national guidelines on pharmacogenetic testing is warranted to ensure successful pharmacogenetic testing implementation.

PMID:38497085 | PMC:PMC10940172 | DOI:10.1016/j.jsps.2024.102022