Tag: statistics

J Korean Med Sci. 2024 Jan 8;39(1):e9. doi: 10.3346/jkms.2024.39.e9.

ABSTRACT

BACKGROUND: Turner syndrome (TS) is a common chromosomal abnormality, which is caused by loss of all or part of one X chromosome. Hormone replacement therapy in TS is important in terms of puberty, growth and prevention of osteoporosis however, such a study has never been conducted in Korea. Therefore, the purpose of our study was to determine relationship between the starting age, duration of estrogen replacement therapy (ERT) in TS and develop a hormone replacement protocol suitable for the situation in Korea.

METHODS: This is retrospective study analyzed the medical records in TS patients treated at the Severance hospital, Yonsei University College of Medicine, Seoul, Korea from 1997 to 2019. Total of 188 subjects who had received a bone density test at least once were included in the study. Korean National Health and Nutrition Examination Survey (KNHANES) was used for achieving bone mineral density (BMD) of normal control group. Student’s t-test, Mann-Whitney U test, ANOVA and correlation analysis were performed using SPSS 18.0.

RESULTS: Each BMD measurement was significantly lower in women with TS than in healthy Korean women. Early start and longer duration of ERT is associated with higher lumbar spine BMD but not femur neck BMD. Femur neck BMD, but not lumbar spine BMD was significantly higher in women with mosaicism than 45XO group.

CONCLUSION: Early onset and appropriate duration of hormone replacement therapy is important for increasing bone mineral density in patients with Turner syndrome. Also, ERT affects differently to TS patients according to mosaicism.

PMID:38193328 | DOI:10.3346/jkms.2024.39.e9

Int J Gynaecol Obstet. 2024 Jan 9. doi: 10.1002/ijgo.15350. Online ahead of print.

ABSTRACT

OBJECTIVE: To consider the classical use of “pH < 7.0 and/or a base deficiency ≥12 mmol/L” as markers of the risk of neonatal hypoxic-ischemic encephalopathy (HIE), recalling various criticisms of the use of these markers in favor of that of neonatal eucapnic pH, which appears to be a better marker of this risk.

METHODS: Fifty-five cases of acidemia with pH < 7.00 were collected from a cohort from the Nice University Hospital with eight cases of HIE. We compared the receiver operating characteristics curves established from the positive likelihood ratio (+LR) for each case of: umbilical cord artery pH (pHa), neonatal eucapnic pH (pH euc-n) in isolation (not matched to pHa), and matched pHa to its own pH euc-n.

RESULTS: The areas under the curve (AUC) are identical for pHa and pH euc-n, but AUC for the matched pair pHa-pH euc-n appears superior but non-significant because of the small number in our cohort. However, using the bootstrap method, the partial AUC for a sensitivity greater than 75% indicates the significant superiority (P < 0.01) of the matched pair pHa-pH euc-n approach.

CONCLUSION: The originality of this study lies in the use of two methodologic approaches: (1) standardized partial analysis of the AUCs of the pHa curve and that of pHa matched to its own pH euc-n, and (2) bootstrap statistical technique, that allowed us to conclude (P < 0.01) that the combined use of pH measured at the cord coupled with its eucapnic correction is better for diagnosing metabolic acidosis and best predicting the risk of HIE.

PMID:38193307 | DOI:10.1002/ijgo.15350

J Dent Educ. 2024 Jan 9. doi: 10.1002/jdd.13447. Online ahead of print.

ABSTRACT

OBJECTIVES: This study examined results of a summative objective structured clinical examination (OSCE) at the end of preclinical periodontal education to identify deficient areas for dental students in patient care and to explore factors affecting the probability of passing the OSCE.

METHODS: The summative OSCE was administered to two consecutive cohorts, Classes A (class of 2024; n₁ = 134) and B (class of 2025; n₂ = 129). The questions for each station in the OSCEs were available to both classes 1 week before the OSCEs. Descriptive statistics were used to identify deficient areas. The multiple logistic regression model was built to predict the probability of passing the OSCE based on the cohort, gender, and the practical and written examination scores.

RESULTS: Fifty-one (38%) students in Class A and 66 (51%) students in Class B completed the OSCE by passing all stations. Students undergoing remediation showed deficiencies in demonstrating how to detect tooth mobility, performing periodontal probing, drawing the healthy positive bony architecture and the mucogingival junction, and using a universal and a Gracey 13/14 curette. The probability of passing the OSCE was significantly correlated with Class B (p = 0.035) and the practical examination score (p = 0.03) while not associated with gender (p = 0.53) and the written examination score (p = 0.11).

CONCLUSION: Students showed deficiencies in assessment skills at the end of preclinical education. The study findings suggest that the implementation of the OSCE at the conclusion of preclinical education would be beneficial since the written examination score might not accurately reflect student readiness for clinical patient care.

PMID:38193239 | DOI:10.1002/jdd.13447

Arch Ital Urol Androl. 2023 Dec 29;95(4):11691. doi: 10.4081/aiua.2023.11691.

ABSTRACT

BACKGROUND: Renal transplantation stands as the sole remedy for individuals afflicted with end-stage renal diseases, and safeguarding them from transplant rejection represents a vital, life-preserving endeavor posttransplantation. In this context, the impact of cytokines, notably IL-27, assumes a critical role in managing immune responses aimed at countering rejection. Consequently, this investigation endeavors to explore the precise function of IL-27 and its associated cytokines in the context of kidney transplant rejection.

METHODS: The study involved the acquisition of blood samples from a cohort of participants, consisting of 61 individuals who had undergone kidney transplantation (comprising 32 nonrejected patients and 29 rejected patients), and 33 healthy controls. The expression levels of specific genes were examined using SYBR Green Real-time PCR. Additionally, the evaluation encompassed the estimation of the ROC curve, the assessment of the relationship between certain blood factors, and the construction of protein-protein interaction networks for the genes under investigation.

RESULTS: Significant statistical differences in gene expression levels were observed between the rejected group and healthy controls, encompassing all the genes examined, except for TLR3 and TLR4 genes. Moreover, the analysis of the Area Under the Curve (AUC) revealed that IL-27, IL-27R, TNF-α, and TLR4 exhibited greater significance in discriminating between the two patient groups. These findings highlight the potential importance of IL-27, IL-27R, TNF-α, and TLR4 as key factors for distinguishing between individuals in the rejected group and those in the healthy control group.

CONCLUSIONS: In the context of kidney rejections occurring within the specific timeframe of 2 weeks to 2 months post-transplantation, it is crucial to emphasize the significance of cytokines mRNA level, including IL-27, IL-27R, TNF-α, and TLR4, in elucidating and discerning the diverse immune system responses. The comprehensive examination of these cytokines’ mRNA level assumes considerable importance in understanding the intricate mechanisms underlying kidney rejection processes during this critical period.

PMID:38193229 | DOI:10.4081/aiua.2023.11691

Arch Ital Urol Androl. 2024 Jan 2;95(4):12128. doi: 10.4081/aiua.2023.12128.

ABSTRACT

PURPOSE: The management of infertile patients with unilateral subclinical varicocele (SCV) and contralateral clinical varicocele (CV) remains controversial. We aimed to evaluate the effect of untreating SCV on the outcome of contralateral clinical varicocelectomy in infertile patients with oligoasthenozoospermia (OA).

MATERIALS AND METHODS: Infertile patients with the diagnosis of OA who underwent left varicocelectomy were retrospectively evaluated. While all patients in the study had left clinical varicocele (LCV), some patients had concomitant right SCV. Patients were divided into two groups according to the presence or absence of a right SCV accompanying LCV as group 1; (LCV n = 104) or group 2; (LCV with right SCV, n = 74). Patients were evaluated with spermiogram parameters, pregnancy rates and serum levels of follicle stimulating hormone, luteinizing hormone, total testosterone at the first year of the follow-up.

RESULTS: The mean sperm concentration increased significantly in both groups. However, group 1 showed significantly greater improvement than group 2. The ratio of progressive motile sperm in group 1 was increased significantly whereas no significant change was shown in group 2. Both the spontaneous pregnancy rate and the pregnancy rate with ART were statistically lower in the group of patients with right SCV. No statistically significant difference was detected in serum hormone levels in both groups after varicocelectomy operations.

CONCLUSIONS: Untreated right SCV may have adverse impact on the outcomes of left clinical varicocelectomy. In this context, the right testis can be considered in terms of treatment in patients with right SCV accompanying left CV.

PMID:38193220 | DOI:10.4081/aiua.2023.12128

Arch Ital Urol Androl. 2023 Dec 28;95(4):12130. doi: 10.4081/aiua.2023.12130.

ABSTRACT

OBJECTIVE: To report long-term functional and oncological outcomes of OPN Methods: We enrolled 182 patients who underwent consecutive OPN with a diagnosis of kidney tumor in our clinic between April 2002 and February 2020 and were selected from our prospective OPN database. Preoperative demographic and clinical characteristics, intraoperative and pathological results, and patients’ postoperative functional and oncological follow-up data were retrospectively analyzed. Overall survival (OS) and disease- free survival (DFS) were evaluated using Kaplan-Meier survival analysis. The time-dependent variation between preoperative and postoperative functional results was statistically analyzed and presented in a graph.

RESULTS AND LIMITATIONS: The mean age was 54.4 ± 10.8 yr, and the median age-adjusted Charlson comorbidity index (ACCI) was 1 (interquartile range [IQR] 0-1). The mean tumor size was 3.1 ± 1.2 cm, and the median RENAL score was 6 (IQR 5-8). The most common malign histopathological subtype was clear cell carcinoma with 76.6%, and five cases (3.4%) had positive surgical margins (PSMs). The most common surgical techniques were the retroperitoneal approach (98.9%) and cold ischemia (88.5%). Estimated glomerular filtration rate (eGFR) preservation was 92% (80.8-99.3, IQR), which translates to 32% chronic kidney disease (CKD) upstaging. Acute kidney injury (AKI) was detected in 27 (14.8%) patients according to RIFLE criteria. The intraoperative complication rate was 5.5%, and the postoperative overall complication rate (Clavien-Dindo 1-5) was 30.2%. Major complications (Clavien-Dindo 3-5) were observed in 13 (7.1%) patients. The median oncological follow-up was 42 mo (21.3- 84.6, IQR), and the 5- and 10-yr OS were 90.1% and 78.6%, 5 and 10-yr DFS were 99.4% and 92.1%, respectively. No local recurrence was observed in 5 (3.4%) patients with PSMs; only one had distant metastasis in the 8th postoperative month. The retrospective design, the small number of patients who underwent PN based on mandatory indication, and one type of surgical approach may limit the generalizability of our findings.

CONCLUSIONS: This study confirms excellent long-term oncologic and functional outcomes after OPN in a cohort of patients selected from a single institution. In light of the information provided by the literature and our study, our recommendation is to push the limits of PN under every technically feasible condition in the treatment of kidney tumors to protect the kidney reserve and achieve near-perfect oncological results.

PMID:38193219 | DOI:10.4081/aiua.2023.12130

Eur J Ophthalmol. 2024 Jan 9:11206721231225989. doi: 10.1177/11206721231225989. Online ahead of print.

ABSTRACT

PURPOSE: To analyse baseline imaging characteristics and factors affecting poor visual acuity in diabetic papillopathy.

METHODS: This was a retrospective, observational study conducted at a tertiary eye care centre in eyes with a diagnosis of diabetic papillopathy. Demographic data including age, gender, duration of diabetes, type of diabetes, HbA1c values and other systemic co-morbidities were recorded. Baseline best corrected visual acuity (BCVA), and various imaging characteristics were noted.

RESULTS: 37 eyes of 22 patients with diagnosis of diabetic papillopathy were included [mean age of 46.6 ± 13.5 years, five (22.7%) females and 17 (77.3%) males]. Bilateral involvement was seen in 15 (68.2%) patients. The mean baseline BCVA was 0.51 ± 0.49 logMAR (Snellen equivalent 20/60). Two eyes (5.4%) had features of concurrent mild NPDR, 9 eyes (24.3%) had moderate NPDR, 10 eyes (27.03%) had severe NPDR while 16 (43.2%) other had PDR. All eyes had optic disc edema while 4 had disc pallor at presentation. Telangiectatic vessels/ neovascularisation of disc was present in 17 eyes (45.9%) detected either clinically or on optical coherence tomography (OCT) angiography. 11 (29.7%) eyes had a peripapillary cuff of subretinal fluid accompanying the disc edema. Sixteen eyes (43.2%) had centre involving macular edema seen on OCT. In eyes with a macular edema, the mean central macular thickness was 407.4 ± 71.42 microns at baseline. On assessing the baseline factors that contribute to the final visual acuity, presenting visual acuity was the only variable found to be statistically significant.

CONCLUSION: Although described to have good visual outcome, eyes presenting with poor visual acuity tend to have worse vision on follow up. This may aid in prognosticating and guiding management plan.

PMID:38193207 | DOI:10.1177/11206721231225989

J Contemp Dent Pract. 2023 Aug 1;24(8):595-604. doi: 10.5005/jp-journals-10024-3511.

ABSTRACT

AIM: To investigate the dental arch dimension (width, length, and height) and facial measurements including inner-canthal width (ICW), bizygomatic width (BZW), inter-alar width (IAW), and mouth width (MW), and to assess the correlation between these facial measurements and dental arch width (canine width [CW], inter-first premolar width [I1PW], and inter-first molar width [I1MW]), to establish a preliminary reference for artificial teeth selection in Yemeni adult.

MATERIALS AND METHODS: The study included 80 individuals (40 males and 40 females) with symmetrical faces and normal class I occlusion ranging in age from 20 to 35. Maxillary and mandibular stone casts were made for each individual. The dimensions of dental casts and facial measurements, including ICW, BZW, IAW, and MW, were assessed using a digital caliper. The collected data were analyzed by using the SPSS software program. The descriptive statistics for each measurement were made. Differences between males and females were tested using an independent-sample t-test with p-values below 0.05 considered significant. Pearson correlation coefficient between facial measurements and dental arch width was also done.

RESULTS: Most dental arch dimensions and facial measurements exhibited larger mean values in the male than in the female group, with the greatest significant difference in the maxillary dental arch width and the lowest in mandibular dental arch length. A highly significant correlation is observed between ICW and maxillary canine width (CW) (r = 0.318, p = 0.004). In contrast, no significant correlation between dental arch width and BZW, IAW, and MW is shown.

CONCLUSIONS: Within this study’s limitations, the ICW can determine the ideal dimension of the artificial teeth in the anterior maxillary arch. While the other facial parameters, including BZW, IAW, and MW, cannot be used for artificial teeth selection in Yemeni populations.

CLINICAL SIGNIFICANCE: The findings of this study established a reference database of facial measurements and their correlation to dental arch and teeth width in Yemeni populations. So, it can be implemented in artificial teeth and dental prostheses design and construction.

PMID:38193184 | DOI:10.5005/jp-journals-10024-3511

J Contemp Dent Pract. 2023 Aug 1;24(8):587-594. doi: 10.5005/jp-journals-10024-3548.

ABSTRACT

AIM: The purpose of this research was to explore how various finishing and polishing techniques affect the surface roughness (Ra) and gloss of flowable bulk-fill injectable resin composite utilized for posterior teeth restoration, following exposure to a range of food-simulating liquids (FSLs) over three months.

MATERIALS AND METHODS: This study comprised fifty-six disk specimens of G-aenial™ Bulk Injectable flowable resin composite which were created using a Teflon mold (10 × 4 mm). Two techniques of finishing and polishing (F/P) were employed: The two-step 3M™ Sof-Lex™ F/P spiral wheels system and the multiple-step 3M™ Sof-Lex™ XT finishing disks supplemented by the Ultradent Jiffy HiShine polisher cup system. The Ra and gloss of the prepared specimens were measured using an interference microscope system and Horiba gloss checker respectively, immediately post-finishing and polishing and then reassessed after three months in artificial saliva and Coca-Cola.

RESULTS: The two-step system showed a statistically significant difference, exhibiting greater “surface roughness (Ra)” and lower “surface gloss (GU)” mean values compared to the multiple-step system under different storage conditions, particularly after 3 months of storage (p = 0.001).

CONCLUSION: The multiple-step polishing system improved the “Ra” and “GU” of resin composite, suggesting their suitability for posterior resin composite restorations. Acidic media had a deleterious impact on the “Ra” and “GU” of resin composite restoration.

CLINICAL SIGNIFICANCE: The quality of resin composite restorations can be significantly improved with the correct use of finishing and polishing systems, particularly in complex areas of posterior teeth restorations, leading to successful dental procedures.

PMID:38193183 | DOI:10.5005/jp-journals-10024-3548

J Contemp Dent Pract. 2023 Aug 1;24(8):576-581. doi: 10.5005/jp-journals-10024-3546.

ABSTRACT

AIM: To compare the fracture resistance and the mode of failure between monolith second-generation zirconia and bilayered first-generation zirconia single crowns cemented by resin cement and glass ionomer cement (GIC).

MATERIALS AND METHODS: A total of 36 maxillary first premolar crowns (5 mm in length × 4 mm in cervical diameter, with a base of 6 mm) were computer-aided design-computer-aided manufacturing (CAD-CAM) milled. They were divided into the following two groups (n = 18) according to the fabrication techniques: Group M – monolith zirconia crown (1-mm axial thickness and 2-mm occlusal thickness) and group B – bilayer zirconia crown (0.5-mm axial thickness and 1-mm occlusal thickness). Each group was further subdivided into the following two subgroups (n = 9) according to the cement used: Subgroup G – cemented using GIC; subgroup R – cemented using resin cement. All crowns were cemented to their corresponding resin dies and stored in distilled water for 72 hours. Each specimen was mounted to the lower member of the universal testing machine with a load cell of 5 kN and a crosshead speed of 0.5 mm/minute. Failure modes were analyzed for fractured parts using scanning electron microscopy (SEM).

RESULTS: Subgroup MR recorded the highest fracture resistance mean value (3616 ± 347.2 N) while the BG subgroup recorded the statistically significant lowest fracture resistance mean value (1728.7 ± 115.3 N). One-way analysis of variance (ANOVA) followed by pairwise Tukey’s post hoc tests revealed a statistically significant difference (p = 0.0001) between groups M and B. One-way ANOVA followed by pairwise Tukey’s post hoc tests also showed a statistically significant difference (p = 0.0297) between the types of cement used (subgroups G and R).

CONCLUSION: Monolith zirconia crowns had better mean fracture resistance than bilayered zirconia crowns. Resin cement improved the fracture resistance compared to GIC. Monolith zirconia crowns showed bulk fracture while bilayered zirconia crowns showed chipping fracture.

CLINICAL SIGNIFICANCE: Monolith zirconia crowns present a good prosthetic alternative overcoming the veneer chipping drawback of bilayered zirconia crowns. In addition, resin cement could increase the fracture resistance of zirconia crowns.

PMID:38193181 | DOI:10.5005/jp-journals-10024-3546