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Nevin Manimala Statistics

The impact of concomitant Sjögren’s disease on rheumatoid arthritis disease activity: a systematic review and meta-analysis

Clin Exp Rheumatol. 2023 Dec;41(12):2484-2492. doi: 10.55563/clinexprheumatol/oxoeuo. Epub 2023 Dec 23.

ABSTRACT

OBJECTIVES: Rheumatoid arthritis (RA) and Sjögren’s syndrome (SS) frequently co-exist but the consequence for RA disease activity of having concomitant SS (RA/SS) is not well established. We conducted a systematic review and meta-analysis to investigate the impact of SS on disease outcomes in individuals with RA.

METHODS: We searched Web of Science (Core Collection, FSTA, Medline), PubMed and Cochrane databases, without language restriction. Studies reporting RA disease activity scores, joint counts, visual analogue scales (VAS), disability and joint damage, and comparing RA and RA/SS were selected. Outcomes reported in at least 3 studies in which the diagnosis of SS fulfilled classification criteria underwent meta-analysis, using a random effects model where heterogeneity was detected.

RESULTS: The literature search identified 2991 articles and abstracts; 23 underwent full-text review and 16 were included. The studies included a total of 29722 patients (8614 with RA/SS and 21108 with RA). Using studies eligible for meta-analysis (744 patients with RA/SS and 4450 with RA), we found higher DAS-28 ESR scores (mean difference 0.50, 95% CI -0.008-1.006; p=0.05), higher swollen joint count scores (mean difference 1.05, 95% CI 0.42-1.67; p=0.001), and greater functional disability as measured by HAQ (mean difference 0.19, 95% CI 0.05-0.34; p=0.009) in RA/SS compared to RA alone. Other outcome measures (tender joint count, fatigue VAS) showed a numerical trend towards higher scores in RA/SS but were not statistically significant.

CONCLUSIONS: RA/SS patients appear to have higher disease activity and more functional disability than patients with RA alone. The aetiology and clinical implications of this are unclear and warrant further investigation.

PMID:38149516 | DOI:10.55563/clinexprheumatol/oxoeuo

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Risk factors for surgical site infection after percutaneous endoscopic lumbar discectomy

Int Wound J. 2023 Dec 27. doi: 10.1111/iwj.14605. Online ahead of print.

ABSTRACT

The objective of this study was to investigate the risk factors associated with surgical site infection (SSI) after percutaneous endoscopic lumbar discectomy (PELD) in patients with lumbar disc herniation (LDH). A retrospective analysis was performed on a cohort of 335 patients who underwent PELD between January 2016 and January 2023. Data were derived from the Hospital Information System (HIS), and a comprehensive statistical assessment was performed using IBM SPSS Statistics version 25.0. Both univariate and multivariate logistic regression analyses assessed a range of risk determinants, such as age, body mass index (BMI), comorbidities, laboratory test parameters and surgery-related variables. The incidence of SSI after PELD was 2.7% (9/335). Univariate analysis highlighted BMI, diabetes mellitus, long-term corticosteroid consumption, surgical time and cerebrospinal fluid leakage as significant predictors of SSI. Multivariate logistic regression identified BMI, diabetes mellitus, long-term corticosteroid consumption, surgical time and cerebrospinal fluid leakage as significant risk factors for SSI after PELD. High BMI, diabetes mellitus, long-term corticosteroid consumption, long surgical time and postoperative cerebrospinal fluid leakage are predisposing factors for SSI in patients undergoing PELD. Precise interventions focused on such risk components, including careful preoperative assessment and strategic postoperative care, are essential to reduce the incidence of SSI and improve surgical efficacy.

PMID:38149500 | DOI:10.1111/iwj.14605

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Predictive role of monocyte count for significant coronary artery disease identification in patients with stable coronary artery disease

Cardiol J. 2023 Dec 27. doi: 10.5603/cj.95131. Online ahead of print.

ABSTRACT

BACKGROUND: The coronary artery disease (CAD) remains the leading cause of morbidity that is characterized by broad spectrum of symptoms. Up to 30% of performed angiographies reveal normal coronary arteries. The aim of the study was to find simple predictor for significant epicardial artery stenosis among patients with chronic coronary syndrome.

METHODS: There were 187 patients (131 (709%) men and 56 (30%) women) in the median (Q1-Q3) age of 67 [58-72] presenting with stable CAD symptoms enrolled into the present retrospective analysis. The demographical, clinical and laboratory characteristics between patients with normal and significant coronary artery stenosis were compared.

RESULTS: The multivariable analysis revealed coexistence of hypercholesterolemia as significant differentiation factor (odds ratio [OR]: 4.38, 95% confidence interval [CI]: 1.78-10.80, p = 0.001) for significant CAD and inverse relation to serum high density lipoprotein (OR: 0.19, 95% CI: 0.05-0.72, p = 0.015) and relation to creatinine concentration (OR: 1.03, 95% CI: 1.00-1.05, p = 0.012). Among whole peripheral blood count analysis, the significant relation was noticed to be hemoglobin concentration (OR: 1.09, 95% CI: 1.10-1.18, p = 0.022) and monocyte count (OR: 32.3, 95% CI: 1.09-653.6, p = 0.017). Receiver operator curve revealed (AUC: 0.641, p = 0.001) with the optimal cut-off value above 0.45 K/uL for monocyte, yelding sensitivity of 81.82% and specificity of 58.06%.

CONCLUSIONS: The peripheral monocyte count above 0.45 k/uL may be considered as a predictor of significant coronary artery disease in symptomatic patients with chronic coronary syndrome.

PMID:38149491 | DOI:10.5603/cj.95131

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The role of the neutrophil-lymphocyte ratio in predicting poor outcomes in COVID-19 patients

Cardiol J. 2023 Dec 27. doi: 10.5603/cj.98214. Online ahead of print.

ABSTRACT

BACKGROUND: This study examines how the neutrophil-lymphocyte ratio (NLR) predicts coronavirus disease 2019 (COVID-19) hospitalization, severity, length, and mortality in adult patients.

METHODS: A study was done using a retrospective, single-center, observational design. A total of 400 patients who were admitted to the Ziv Medical Center (Safed, Israel) from April 2020 to December 2021 with a confirmed diagnosis of COVID-19 through RT-PCR testing were included in the analysis. Two complete blood count laboratory tests were conducted for each patient. The first test was administered upon admission to the hospital, while the second test was conducted prior to the patient’s discharge from the hospital or a few days before their death.

RESULTS: Four hundred patients were included in the study, 206 males (51.5%) and 194 females (48.5%). The mean age was 64.5 ± 17.1 years. In the group of cases, there were 102 deaths, and 296 survivors were recorded, with a fatality rate of 25.5%. The median NLR was 6.9 ± 5.8 at the beginning of hospitalization and 15.1 ± 32.9 at the end of hospitalization (p < 0.001). The median length of hospital stay was 9.4 ± 8.8 days. NLR in the fatality group was 34.0 ± 49.9 compared to 8.4 ± 20.4 in the survivor group (p < 0.001). Comparison between the NLR at the time of admission of the patient and before discharge/death was 6.9 ± 5.8 vs. 15.1 ± 32.9 (p < 0.001).

CONCLUSIONS: The analyses conducted revealed a statistically significant correlation between the NLR and the severity, mortality rates, and the duration of hospitalization. The consideration of NLR should commence during the initial phases of the disease when assessing individuals afflicted with COVID-19.

PMID:38149489 | DOI:10.5603/cj.98214

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The Scabies Epidemic During the Covid-19 Pandemic

Turkiye Parazitol Derg. 2023 Dec 27;47(4):235-239. doi: 10.4274/tpd.galenos.2023.44154.

ABSTRACT

OBJECTIVE: The objectives of this study are to assess the coronavirus disease (Covid) pre-pandemic and pandemic period table of 2019 with relation to the change in the frequency of ascariasis and to contribute to the epidemiological data in our nation.

METHODS: Data for this study were obtained from the Adana Provincial Directorate of Health, Department of Public Health Services between January 2017 and May 2022. Percentages of the number of cases were compared with the total numbers for the pre- and pandemic periods and for each specified period. Results were analyzed statistically.

RESULTS: When the number of scabies cases by year was analyzed, it was determined that the highest incidence rate was 37.8% in 2021 and the lowest incidence rate was 3.7% in 2017. During the pandemic period, it was determined that the rate of scabies in men was higher than that in women. Likewise, it was determined that the rate of scabies in women was higher than that in men before the pandemic. During the pandemic period, the rate of scabies in those aged 0, 1-4, 5-9, 10-14, and 65 years and over was higher than that before the pandemic.

CONCLUSION: According to our findings, the prevalence of scabies has increased throughout the Covid-2019 pandemic.

PMID:38149445 | DOI:10.4274/tpd.galenos.2023.44154

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Spread of Intestinal Parasites in Patients Presenting with Gastrointestinal Complaints

Turkiye Parazitol Derg. 2023 Dec 27;47(4):224-228. doi: 10.4274/tpd.galenos.2023.93585.

ABSTRACT

OBJECTIVE: The aim of this study is to determine the prevalence of intestinal parasites in patients admitted to University of Health Sciences Türkiye (UHS) Van Training and Research Hospital.

METHODS: A total of 300 patients between the ages of 18-90 who applied to UHS Van Training and Research Hospital with gastrointestinal complaints and were referred to the parasitology laboratory between September 2021 and December 2021, and 100 patients without any chronic disease and gastrointestinal complaints in the control group were included in the study. Stool samples taken from patients included in the study and individuals in the control group were analyzed by native-lugol and modified acid-fast staining methods.

RESULTS: In the study, intestinal parasites were detected in 41 (13.3%) of 300 patients in the patient group and in seven (7%) of 100 individuals in the control group. The highest rate of Blastocystis species (Blastocystis spp.) (5.7%) was found in the patient group. Entamoeba coli 3%, G. intestinalis 2.7% and Cryptosporidium species (Cryptosporidium spp). 2.3% were found among the other species detected. In addition, a statistically significant correlation was found between the incidence of parasites and abdominal pain (p=0.022) and nausea (p=0.029).

CONCLUSION: As a result; it was concluded that intestinal parasites are still an important health problem in patients with gastrointestinal complaints and intestinal parasites should definitely be considered in this patient group.

PMID:38149443 | DOI:10.4274/tpd.galenos.2023.93585

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Investigation of Toxoplasma gondii Seroprevalence in Preeclampsic Pregnant

Turkiye Parazitol Derg. 2023 Dec 27;47(4):209-213. doi: 10.4274/tpd.galenos.2023.80664.

ABSTRACT

OBJECTIVE: Toxoplasma gondii is the causative agent of toxoplasmosis and is a parasite of high medical importance with a wide host variety. Bacterial, viral, and parasitic infections during pregnancy may predispose women to pregnancy complications. Preeclampsia of unknown etiology causes special conditions such as systemic vascular endothelial damage due to insufficient trophoblastic invasion and abnormal placentation. There are data of an association between various maternal infections and preeclampsia/eclampsias. The aim of the study was to compare and analyze the relationship between the presence of anti-Toxoplasma IgM and anti-Toxoplasma IgG antibodies in pregnant women with pre-eclampsia and in normotensive healthy pregnant women who were in the control group.

METHODS: In this study, 176 pregnant women who applied to our hospital between January 2019 and December 2020 were included. 88 (50%) of the pregnant women had pre-eclampsia and 88 (50%) were normotensive. The presence of anti-Toxoplasma IgM and IgG antibodies in blood taken from pregnant women with pre-eclampsia and control group was investigated using ELISA.

RESULTS: Because of the study, both groups were found to be seronegative in terms of anti-Toxoplasma IgM by ELISA. Anti-Toxoplasma IgG was found to be seropositive in 24 (27.3%) pregnant women with pre-eclampsia and 18 (20.5%) normotensive pregnant women. There was no statistically significant difference between the two groups in terms of anti-Toxoplasma IgM and anti-Toxoplasma IgG seropositivity (X2=0.289, p>0.05) (p<0.05).

CONCLUSION: Because of the study, no statistically significant difference was found between pregnant women with pre-eclampsia and those with toxoplasmosis. It was thought that further studies should be conducted to discuss the hormonal, vascular, etc. factors occurring in the pathogenesis of preeclampsia of T. gondii effect of preparing the ground for the changes and to reveal the existence of a possible relationship between pre-eclampsia and T. gondii seropositivity.

PMID:38149440 | DOI:10.4274/tpd.galenos.2023.80664

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Medication management in general surgical patients made nil by mouth perioperatively: A quality improvement study

J Perioper Pract. 2023 Dec 27:17504589231211442. doi: 10.1177/17504589231211442. Online ahead of print.

ABSTRACT

Perioperative medication management in patients who are nil by mouth for surgery or endoscopy is often suboptimal. Inappropriate medication management can prolong postoperative recovery and increase morbidity and mortality. This quality improvement study, carried out in general surgical patients at an 800-bed general hospital, aimed to improve perioperative medication management in accordance with the recommendations of the UK Clinical Pharmacy Association Handbook of Perioperative Medicine. Increasing awareness and educating general surgical team members, including doctors and non-medical prescribers, about perioperative medication management led to a non-significant improvement in medication management. However, a statistically significant improvement was achieved when nursing staff were also included. This study highlights the importance of involving different members of the multidisciplinary team in perioperative medication management.

PMID:38149434 | DOI:10.1177/17504589231211442

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Socio-economic status and access to fluoridated water in Queensland: an ecological data linkage study

Med J Aust. 2023 Dec 27. doi: 10.5694/mja2.52196. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the relationship between access to fluoridated drinking water and area-level socio-economic status in Queensland.

STUDY DESIGN: Ecological, geospatial data linkage study.

SETTING: Queensland, by statistical area level 2 (SA2), 2021.

MAIN OUTCOME MEASURES: Proportion of SA2s and of residents with access to fluoridated drinking water (natural or supplemented); relationship at SA2 level between access to fluoridated water and socio-economic status (Index of Relative Socio-economic Advantage and Disadvantage, IRSAD; Index of Economic Resources, IER).

RESULTS: In 2021, an estimated 4 050 168 people (79.4% of the population) and 397 SA2 regions (72.7%) in Queensland had access to fluoridated water. Access was concentrated in the southeastern corner of the state. After adjusting for SA2 population, log area, and population density, the likelihood of access to fluoridated drinking water almost doubled for each 100-rank increase in IRSAD (adjusted odds ratio [aOR], 1.93; 95% confidence interval [CI], 1.59-2.36) or IER (aOR, 1.77; 95% CI, 1.50-2.11).

CONCLUSIONS: The 2012 decision to devolve responsibility for water fluoridation decisions and funding from the Queensland government to local councils means that residents in lower socio-economic areas are less likely to have access to fluoridated water than those in more advantaged areas, exacerbating their already greater risk of dental disease. Queensland water fluoridation policy should be revised so that all residents can benefit from this evidence-based public health intervention for reducing the prevalence of dental caries.

PMID:38149410 | DOI:10.5694/mja2.52196

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Prognostic significance of T2 mapping in evaluating myocardium alterations in patients with ST segment elevation myocardial infarction

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 Dec;35(12):1304-1308. doi: 10.3760/cma.j.cn121430-20230914-00779.

ABSTRACT

OBJECTIVE: To investigate the value of T2 mapping in the assessment of myocardial changes and prognosis in patients with acute ST segment elevation myocardial infarction (STEMI).

METHODS: A retrospective study was conducted. A total of 30 patients with acute STEMI admitted to Tianjin First Central Hospital from January 2021 to March 2022 were enrolled as the experimental group. At the same time, 30 age- and sex-matched healthy volunteers and outpatients with non-specific chest pain with no abnormalities in cardiac magnetic resonance (CMR) examination were selected as the control group. CMR was performed within 2 weeks after the diagnosis of STEMI, as the initial reference. A plain CMR review was performed 6 months later (chronic myocardial infarction, CMI). Plain scanning includes film sequence (CINE), T2 weighted short tau inversion recovery (T2-STIR), native-T1 mapping, and T2 mapping. Enhanced scanning includes first-pass perfusion, late gadolinium enhancement (LGE), and post-contrast T1 mapping. Quantitative myocardial parameters were compared between the two groups, before and after STEMI myocardial infarction. The receiver operator characteristic curve (ROC curve) was used to evaluate the diagnostic efficacy of native-T1 before myocardial contrast enhancement and T2 values in differentiating STEMI and CMI after 6 months.

RESULTS: There were no statistically significant differences in age, gender, heart rate and body mass index (BMI) between the two groups, which were comparable. The native-T1 value, T2 value and extracellular volume (ECV) were significantly higher than those in the control group [native-T1 value (ms): 1 434.5±165.3 vs. 1 237.0±102.5, T2 value (ms): 48.3±15.6 vs. 21.8±13.1, ECV: (39.6±13.8)% vs. (22.8±5.0)%, all P < 0.05]. In the experimental group, 12 patients were re-examined by plain CMR scan 6 months later. After 6 months, the high signal intensity on T2-STIR was still visible, but the range was smaller than that in the acute phase, and the native-T1 and T2 values were significantly lower than those in the acute phase [native-T1 value (ms): 1 271.0±26.9 vs. 1 434.5±165.3, T2 value (ms): 34.2±11.2 vs. 48.3±15.6, both P < 0.05]. ROC curve analysis showed that the area under the ROC curve (AUC) of native-T1 and T2 values in differentiating acute STEMI from CMI was 0.71 and 0.80, respectively. When native-T1 cut-off value was 1 316.0 ms, the specificity was 100% and the sensitivity was 53.3%; when T2 cut-off value was 46.7 ms, the specificity was 100% and the sensitivity was 73.8%.

CONCLUSIONS: The T2 mapping is a non-invasive method for the diagnosis of myocardial changes in patients with acute STEMI myocardial infarction, and can be used to to evaluate the clinical prognosis of patients.

PMID:38149394 | DOI:10.3760/cma.j.cn121430-20230914-00779