Tag: statistics

J Genet Eng Biotechnol. 2024 Mar;22(1):100343. doi: 10.1016/j.jgeb.2023.100343. Epub 2024 Jan 22.

ABSTRACT

BACKGROUND: The endocrine system of vitamin D regulates about 3 % of the human genome. Vitamin D exerts its actions via a nuclear vitamin D receptor (VDR) which in turn regulates insulin secretion from the pancreas. VDR gene polymorphisms could have an impact on how autoimmune illnesses like Type 1 diabetes mellitus (T1DM) develop. We aimed to explore the relation between T1DM and VDR gene polymorphisms in Egyptian diabetic children and their siblings.

METHODS: Enzyme-linked immunosorbent assay was used to quantify 25(OH) vitamin D in the study, which had 179 participants (group 1 = 85 diabetic children, group 2 = 57 siblings of the patients, group 3 = 37 healthy controls). Real-time polymerase chain reaction (RT-PCR) was used to analyze the genotyping of the VDR gene polymorphisms Apa-I (rs7975232), Fok-I (rs2228570), Taq-I (rs731236) and Bsm-I (rs1544410).

RESULTS: The mean serum 25(OH) vitamin D levels was significantly lower in T1DM patients (14.99 ± 9.24 ng/mL) and siblings (16.31 ± 7.96 ng/mL) compared to the controls (19.48 ± 7.42 ng/mL) (p = 0.031). The genotypes distribution of VDR Fok-I (rs2228570) and Bsm-I (rs1544410) polymorphisms showed a significant difference between patients, siblings and controls as P = 0.001 and 0.026 respectively, while the VDR ApaI and TaqI polymorphisms did not. FokI-A allele frequency was significantly lower in T1DM patients and siblings than in controls (p < 0.001). FokI-AA genotype had a statistical significant higher vitamin D levels than other genotypes with p value of 0.024.

CONCLUSION: Our study found that T1DM children had lower vitamin D levels, and VDR FokI and BsmI gene polymorphisms were linked to T1DM in Egyptian children. Determining the relationship between vitamin D levels and VDR polymorphisms, particularly the FokI and other genetic analyses may aid in the early diagnosis of T1DM in children.

PMID:38494252 | DOI:10.1016/j.jgeb.2023.100343

J Minim Invasive Surg. 2024 Mar 15;27(1):33-39. doi: 10.7602/jmis.2024.27.1.33.

ABSTRACT

PURPOSE: This study aims to explore the feasibility and implications of Ramadan fasting for patients who have undergone laparoscopic sleeve gastrectomy (LSG), assessing impacts on hydration, nutrient intake, weight management, and gastrointestinal symptoms.

METHODS: A prospective online survey was conducted among 218 LSG patients and 83 control individuals with obesity who had not undergone surgery. Participants were surveyed before and after Ramadan, providing data on fasting practices, hunger and satiety levels, fluid and nutrient intake, and the occurrence of gastrointestinal symptoms. Statistical analysis was used to compare outcomes between fasting and non-fasting periods and between LSG patients and control participants.

RESULTS: A total of 70.2% of LSG patients completed the entire month of Ramadan fasting, with a significant correlation found between the duration post-surgery and the ability to fast. Fasting LSG patients reported decreased hunger, increased satiety, and significant reductions in fluid and nutrient intake during Ramadan. Weight loss was reported in 90.8% of fasting patients, with an average total weight loss of 7.2%. Gastrointestinal symptoms were mild and manageable.

CONCLUSION: The majority of LSG patients can successfully fast during Ramadan with appropriate precautions, including adequate fluid and protein intake. The study highlights the need for patient education and tailored nutritional guidance to ensure safe and effective fasting post-LSG. In order to fast for the entire month, patients may be advised to consider postponing surgery for a few months after Ramadan, avoid overeating during non-fasting hours, and ensure sufficient fluid consumption and protein intake during fasting.

PMID:38494184 | DOI:10.7602/jmis.2024.27.1.33

J Minim Invasive Surg. 2024 Mar 15;27(1):14-22. doi: 10.7602/jmis.2024.27.1.14.

ABSTRACT

PURPOSE: This study was performed to evaluate the safety and feasibility of skin adhesives and to compare postoperative and cosmetic outcomes after wound closure in single-port laparoscopic appendectomy (SPLA) between skin adhesives and steri-strips.

METHODS: This was a single-center retrospective study. We included 22 and 47 patients in whom skin adhesive and steri-strips were used respectively, for skin closure after subcuticular suturing in SPLA between August 2014 and 2020. The patient scar assessment questionnaire (PSAQ) was completed postoperatively to assess postoperative cosmetic outcomes.

RESULTS: On the postoperative day, patients in whom skin adhesive was used had significantly lower numeric rating scores than in whom steri-strips were used (2.8 ± 0.8 vs. 3.9 ± 0.8, p < 0.001). The frequency of analgesic administration within 24 hours and between 24 and 48 hours after surgery was significantly lower in the skin adhesive group compared to the wound closure strip group (1.4 ± 0.8 vs. 2.7 ± 1.2, p = 0.013 and 0.2 ± 0.4 vs. 0.7 ± 0.9, p = 0.002, respectively). In the PSAQ, “satisfaction with appearance” and “satisfaction with symptoms” subitem scores were significantly lower in patients in whom skin adhesive was used (11.3 ± 3.0 vs. 15.1 ± 4.5, p = 0.006 and 6.5 ± 1.8 vs. 9.5 ± 3.3, p = 0.003), whereas, “appearance” and “consciousness” subitems revealed no statistically significant differences between the groups.

CONCLUSION: Liquid skin adhesive closures seem to be safe and feasible and cause less postoperative pain, resulting in greater patient satisfaction with postoperative scars than wound closure strip closure after subcuticular suturing in SPLA.

PMID:38494182 | DOI:10.7602/jmis.2024.27.1.14

Int Wound J. 2024 Mar;21(3):e14829. doi: 10.1111/iwj.14829.

ABSTRACT

This review aims to systematically evaluate the association between hypertension and pressure ulcer (PU). PubMed, Embase, Web of Science, and Cochrane Library were searched for studies from their inception until September 12, 2023. Literature search, data extraction, and quality assessment were conducted independently by two researchers. The random-effects model was used to calculate the combined odds ratio (OR) and corresponding 95% confidence interval (CI) of hypertension in patients with PU; subgroup analyses were performed to explore the source of between-study heterogeneity; sensitivity analysis was used to test the robust of the combined result; and funnel plot and Egger’s test were used to assess the publication bias. Finally, a total of 19 studies with 564 716 subjects were included; the overall pooled result showed no significant association between hypertension and risk of developing PU (OR = 1.15, 95% CI = 0.90-1.47, p = 0.27); and the sensitivity analysis and publication bias analysis showed robust of the combined result. Subgroup analysis indicated a significant association between hypertension and PU when the primary disease was COVID-19 (OR = 1.73, 95% CI = 1.35-2.22, p < 0.0001). No association between hypertension and PU was seen in subgroup analysis on the patient source and study design. In sum, there is no significantly statistical association between hypertension and the occurrence of PU in most cases, while the risk of PU significantly elevates among COVID-19 patients combined with hypertension regardless of patient source and study design.

PMID:38494175 | DOI:10.1111/iwj.14829

Am J Obstet Gynecol MFM. 2024 Mar 15:101354. doi: 10.1016/j.ajogmf.2024.101354. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify evidenced-based peripartum interventions for people with a body mass index (BMI) ≥40kg/m².

DATA SOURCES: PubMed, MEDLINE, EMBASE, Cochrane, CINAHL and ClinicalTrials.gov were searched from inception to 2022 without date, publication type, or language restrictions.

STUDY ELIGIBILITY CRITERIA: Cohort and randomized controlled trials (RCT) that implemented an intervention and evaluated peripartum outcomes of people with a BMI≥40kg/m² were included. The primary outcome depended on the intervention but commonly related to wound morbidity after cesarean delivery (i.e., infection, separation, hematoma).

STUDY APPRAISAL AND SYNTHESIS METHODS: Meta-analysis was completed for interventions with at least 2 studies. Pooled risk ratios (RR) with 95% confidence intervals (CI) and heterogeneity (I² statistics) were reported.

RESULTS: Of 20,301 studies screened, 30 studies (17 cohort, 13 RCT) encompassing 10 types of interventions were included. Interventions related to delivery planning (induction of labor, planned cesarean delivery), antibiotics during labor induction or for surgical prophylaxis, six types of cesarean delivery techniques, and anticoagulation dosing after a cesarean delivery. Planned cesarean delivery compared to planned vaginal delivery did not improve outcomes based on 3 cohort studies. One cohort study compared 3g to 2g of cephazolin prophylaxis for cesarean delivery and found no differences in surgical site infections. According to 3 cohort studies and 2 RCTs, there was no improvement in outcomes with a non-low transverse skin incision. Ten studies (4 cohort, 6 RCT) met inclusion criteria for the meta-analysis. Two RCTs compared subcuticular closure with suture vs. staples after cesarean delivery and found no differences in wound morbidity within 6 weeks of cesarean delivery (n=422; RR 1.09, 95% CI [0.75-1.59], I²=9%). Prophylactic negative pressure wound therapy was compared to standard dressing in 4 cohort and 4 RCTs and found no differences in wound morbidity (cohort n=2200; RR 1.19, 95% CI [0.88-1.63], I²=66.1%) or surgical site infections (RCT n=1262; RR 0.90, 95% CI [0.63-1.29], I²=0).

CONCLUSION: Few studies address interventions in people with a BMI≥40kg/m² and most studies did not demonstrate a benefit. Either staples or suture are recommended for subcuticular closure, but available data do not support prophylactic NPWT after cesarean delivery for people with a BMI ≥40kg/m².

PMID:38494155 | DOI:10.1016/j.ajogmf.2024.101354

J Am Pharm Assoc (2003). 2024 Mar 15:102069. doi: 10.1016/j.japh.2024.102069. Online ahead of print.

ABSTRACT

BACKGROUND: Community pharmacy practice has incurred significant changes in scope of responsibility and workplace environment, particularly during the COVID-19 pandemic. The trends may impact how student pharmacists perceive community pharmacy practice and their future career opportunities.

OBJECTIVE: To determine current perceptions that student pharmacists have towards community pharmacy practice.

METHODS: A 15-item electronic, cross-sectional questionnaire was distributed to approximately 2200 student pharmacists from March to April 2023. To be included, respondents needed to be a current adult pharmacy student. The questionnaire included items about career interests, perceptions towards 12 different aspects of community pharmacy practice, and demographics. Data were analyzed primarily using descriptive statistics. A priori stratifications included interest to pursue community pharmacy according to class year and according to level of work experience.

RESULTS: A total of 146 responses were included (response rate 6.6%). A total of 101 (69.2%) respondents were women, 108 (74.0%) were white, and the mean age was 24 years. Respondents represented all four pharmacy professional years and 113 (77.4%) respondents reported current or previous work experience in community pharmacy. Most respondents were not interested in pursuing community pharmacy directly after graduation 77 (52.7%), nor as a long-term career 87 (59.6%). Student pharmacists found the most appealing aspects of community pharmacy practice to be salary/benefits, job availability and security, interactions with coworkers in the pharmacy, interactions with other medical professionals, relationships and interactions with patients, and teaching responsibilities. Student pharmacists found the work hours and schedule, business management responsibilities, navigating insurance-related tasks, and the pace of the work environment to be unappealing.

CONCLUSIONS: Student pharmacists report a low interest in pursuing community pharmacy practice. Minimizing deterrents and enhancing the appealing aspects of community pharmacy as perceived by student pharmacists may help improve recruitment and retainment, as well as improve perceptions of the practice.

PMID:38494115 | DOI:10.1016/j.japh.2024.102069

J Foot Ankle Surg. 2024 Mar 15:S1067-2516(24)00051-6. doi: 10.1053/j.jfas.2024.02.004. Online ahead of print.

ABSTRACT

Time spent in the operating room is valuable to both surgeons and patients. One of the biggest rate-limiting factors when it comes to arthrodesis procedures of the foot and ankle is cartilage removal and joint preparation. Power instrumentation in joint preparation provides an avenue to decrease joint preparation time, thus decreasing operating room time and costs. Arthrodesis of 47 joints (n) from 27 patients were included. Power rasp joint preparation in 26 joints was compared to traditional osteotome and curette joint preparation in 21 joints in both time (seconds), cost (total operating room time cost per minute), and union rate. The overall mean joint preparation time using power rasp for the subtalar joint was 268.3 seconds, talonavicular joint 212.3 seconds, calcaneocuboid joint 142.6 seconds, 1^st TMT 107.2 seconds. Mean joint preparation time using traditional method for subtalar joint 509.8 seconds, talonavicular joint 393.0 seconds, calcaneocuboid joint 400.0 seconds, 1^st TMT 319.6 seconds. Mean cost of joint preparation using power rasp for subtalar joint $165.47, talonavicular joint $130.89, calcaneocuboid joint $87.94, 1^st TMT $66.11. Mean cost of joint preparation using traditional techniques for subtalar joint $314.34, talonavicular joint $242.35, calcaneocuboid joint $246.67, 1^st TMT $197.33. Overall union rate was 98% (1 asymptomatic non-union). Increasing efficiency in the operating room is vital to every surgeon’s practice. Power rasp joint preparation is a viable option to increase efficiency and decrease operative time, this study shows no statistically significant differences in union rate, with comparable rates to existing literature. LEVEL OF CLINICAL EVIDENCE: 4, Retrospective Case Series/Cost Analysis.

PMID:38494112 | DOI:10.1053/j.jfas.2024.02.004

J Foot Ankle Surg. 2024 Mar 15:S1067-2516(24)00055-3. doi: 10.1053/j.jfas.2024.03.001. Online ahead of print.

ABSTRACT

Tibiotalocalcaneal arthrodesis has been shown in literature to have good results in regards to low complication rates and deformity correction. While previous studies have investigated functional outcomes and complication rates, no large-scale studies have looked at pain outcomes. The present study used a retrospective review of 154 extremities to analyze how a patient’s comorbidities and characteristics influence pain outcomes following a tibiotalocalcaneal arthrodesis. The present study found an average change of pain from 7.1 to 3.0 in at least a 6 month follow up. We found a diagnosis of chronic pain and tobacco use had statistically significant less pain improvement compared to patients without chronic pain or current tobacco use. We found no statistically significant difference in pain outcomes for patients with or without Charcot deformity. Lastly, we found that with older patients there was more pain improvement observed. We physicians can educate current tobacco users of the improved pain outcomes with tobacco cessation prior to surgery. We recommend a multidisciplinary approach for pain in patients with a pre-operative diagnosis of chronic pain and to educate patients on realistic postoperative pain outcomes. Level of Evidence: 3.

PMID:38494111 | DOI:10.1053/j.jfas.2024.03.001

Brain Res. 2024 Mar 15:148852. doi: 10.1016/j.brainres.2024.148852. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study was to examine N-acetyl aspartate (NAA)/creatine (Cr) and glutamate, glutamine, and gamma-aminobutyric acid complex (Glx)/Cr levels in patients with obsessive compulsive disorder (OCD) and healthy controls’ orbitofrontal cortex (OFC) and caudate nucleus (CN) by proton magnetic resonance spectroscopy (1H-MRS) method and to investigate their relationship with oxidative stress markers glutathione peroxidase (GPx) and superoxide dismutase (SOD).

METHODS: This study included patients with OCD (n = 25) and healthy controls (n = 25) ranging in age from 18 to 65. We used the ELISA method to evaluate serum SOD and GPx levels. Levels of NAA/Cr and Glx/Cr in the orbitofrontal cortex and caudate nucleus were measured using the 1H-MRS method.

RESULTS: Our study did not detect statistically significant differences in the orbitofrontal cortex Glx/Cr and NAA/Cr levels between the OCD patients and the control group. OCD patients exhibited a decrease in NAA/Cr levels, consistent with impaired neuronal integration, and an increase in Glx/Cr levels, consistent with hyperactivation, in the caudate nucleus compared to the control group. We observed a negative correlation between NAA/Cr levels in the caudate nucleus and the levels of SOD and GPx.

CONCLUSIONS: Our study is the first to assess CN and OFC together in OCD patients using 3 T MR, investigating the relationship between neurometabolite concentrations and oxidative stress parameters. The negative correlation we observed between NAA/Cr levels and SOD and GPx in the caudate nucleus suggests that increased oxidative stress in this brain region in OCD patients may contribute to impaired neuronal integration and functionality.

PMID:38494099 | DOI:10.1016/j.brainres.2024.148852

Magn Reson Imaging. 2024 Mar 15:S0730-725X(24)00072-9. doi: 10.1016/j.mri.2024.03.016. Online ahead of print.

ABSTRACT

Purpose To evaluate the tubular function in an alloxan-induced type 1 diabetes mellitus (DM) rabbit model measured by renal oxygenation (R2*), oxygen extraction fraction (OEF), and renal blood flow (RBF) using blood oxygenation level dependent, asymmetric spin echo, and arterial spin labeling MRI. Methods Twenty-six rabbits were randomized into the 3-day DM group (n = 13) and the 7-day DM group (n = 13). We performed pairs of multiparametric MRIs (before and after furosemide injection) at baseline and 3/7 days post-DM, and scored pathological kidney injury. We performed statistical analyses using non-parametric, chi-square, and Spearman correlation tests. Results At baseline, medullary R2* significantly decreased by 24.97% and 16.74% in the outer and inner stripes of the outer medulla (OS and IS, p = 0.006 and 0.003, respectively) after furosemide administration. While the corresponding OEF decreased by 15.91% for OS and 16.67% for IS (both p = 0.003), and no significant change in medullary RBF was observed (p > 0.05). In the 3-day DM group, the decrease of medullary R2* and OEF post-furosemide became unremarkable, suggesting tubular dysfunction. We noticed similar changes in the 7-day DM group. Correlation analysis showed pathological tubular injury score significantly correlated with medullary ∆R2* (post-furosemide – pre-furosemide difference, r = 0.82 for OS and 0.82 for IS) and ∆OEF (r = 0.82 for OS and 0.82 for IS) (p < 0.001, respectively). Conclusion: The combination of medullary OEF and R2* in response to furosemide could detect renal tubular dysfunction in early DM.

PMID:38494095 | DOI:10.1016/j.mri.2024.03.016