Tag: statistics

Georgian Med News. 2022 Nov;(332):113-117.

ABSTRACT

The aim of the study is to determine the single nucleotide polymorphism of the ADH3 gene, which is involved in the development of chronic alcoholic pancreatitis in the Azerbaijani population. Seventy patients (51 with chronic alcoholic pancreatitis, 19 with chronic non-alcoholic pancreatitis) and 90 healthy individuals (55 smokers and 35 non- drinkers) were included in the study. Genomic DNA was isolated from venous blood based on the kit protocol. Genotypes were determined on agarose gel using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) methods. To study the specificity of the ADH3 gene polymorphism in alcohol-dependent people, genotypes and alleles were compared in patients with chronic alcoholic pancreatitis (CAP) and “practically healthy ” alcohol abusers. It was found that in both groups, the ADH3*1/ADH3*2 genotype predominates. It was also found that in the Azerbaijani population the frequency of ADH3*1 and ADH3*2 alleles is equally divided. From the data obtained, it can be clearly stated that the correlation of the ADH3*1 allele of the ADH3 gene polymorphism with an increased risk of the disease is not detected (p=0.876). When comparing genotypes and alleles in patients with chronic pancreatitis of non-alcoholic origin and non-drinkers, the predominance of the heterozygous ADH3*1 gene in both groups was also revealed without statistical significance (p=0.777). In the Azerbaijani population, the association between the polymorphism of the ADH3 gene genotypes and the development of CAP was not revealed. The predominance of the ADH3*1/ADH3*2 genotype explains the low incidence of both CAP and alcohol-dependent people in the Azerbaijani population.

PMID:36701787

Georgian Med News. 2022 Nov;(332):76-84.

ABSTRACT

The high frequency of complicated forms of gastric cancer in young and middle-aged patients is associated with faster and more biologically aggressive tumor growth, as well as with a delay in diagnosis. The study aimed to evaluate the efficacy, safety, and technical feasibility of surgical interventions for complicated forms of gastric cancer in young and middle-aged patients. We studied 98 patients with complicated forms of gastric cancer from IIB to stage IV according to the TNM8 classification with a predominant lesion of the antrum and body of the stomach. We performed open, laparoscopic, or robot-assisted surgeries of various scopes (R0 or R1), mostly gastrectomy and subtotal distal resection of the stomach. We compared the clinical manifestations of the disease, the time of surgery, intraoperative blood loss, postoperative complications, survival, and quality of life in 2 groups of patients divided by age: 19 young patients (mean age 39.4±4.4 years) and 79 middle-aged patients (mean age 53.9±5.8 years). Clinical manifestations of gastric cancer were more pronounced in young patients. The number of postoperative complications in patients of Group 2 was significantly higher (7.8% to 5.26%) compared to Group 1 (p<0.05). Rehabilitation in patients who underwent laparoscopic surgery was significantly (p<0.05) faster than with the traditional method. The overall survival of young patients with IIB-IV stages of gastric cancer was 0.8 months less, and among patients with III-IV stages it was 2.4 months less than in the group of middle-aged patients and did not depend on the surgery scope. There were no statistically significant differences between the groups in terms of intraoperative blood loss, duration of surgery and hospital stay. Increased surgery duration of in middle-aged patients significantly correlated with the number of postoperative complications. Extended surgeries do not significantly increase the number of lethal, life-threatening complications. Combined surgeries in the R0 scope in patients with advanced gastric cancer (including with carcinomatosis) improved the quality of life of patients yet did not increase in overall survival, which determines the reasonable limits of surgical aggression.

PMID:36701781

Georgian Med News. 2022 Nov;(332):71-75.

ABSTRACT

The purpose of the study is to characterize irreparable facial disfigurement through the prism of medical science and from the perspective of legal criteria in the pre-trial investigation of criminal offenses. The practical basis of the research is the statistical and analytical materials of the Ministry of Internal Affairs of Ukraine and the National Police of Ukraine, the General Prosecutor’s Office, the State Judicial Administration of Ukraine for 2016 – 2021 regarding the commission of criminal offenses, namely infliction of grievous bodily harm on the grounds of irreparable facial disfigurement of the victim; summarized data of the study of 50 materials of criminal proceedings based on the specified facts (resolution on the appointment of forensic and other examinations, as well as relevant conclusions), materials of the mass media. As a result of the research, it was established that the medical criteria for irreparable facial disfigurement specified in the legal acts need to be improved due to the wide application and systemic nature of the problems, due to the wide application and systemic nature of the problems, which entail both complication of qualification of the committed act and other difficulties in the process of pre-trial investigation. The studied views of researchers in the area of medical and legal sciences made it possible to substantiate the essence and content of irreparable facial disfigurement not only as a legal criterion, but also as a primarily negative phenomenon in the provision of public health care.

PMID:36701780

Georgian Med News. 2022 Nov;(332):64-70.

ABSTRACT

In the context of global health challenges in the 21st century, against the background of a fundamentally changed pharmaceutical landscape, pharmaceutical sector needs to be newly understood and regulated. To assess how effective, the state is in managing pharmaceutical risks, how ready it is to curb the expansion of substandard drugs on the market, to ensure access to high quality and effective drugs. The aim of the preparation of above article was to analyze the legislative and legal norms of the Georgian pharmaceuticals market, their comparison with corresponding international standards. Identifying the main challenges in the sector and proposing recommendations. Legislations, Laws, and government orders for improving the supply of medicine to the population served as information bases for the study. During the work, reports from the Agency of the Regulation for Medical and Pharmaceutical Activities, Georgian Representatives of International organizations, the State Statistical Service, and industry experts were used. High prices for medicines, their irrational consumption and direct (out-of-pocket) payments, along with quality, safety, and efficiency, have been and remain the main challenge of the Georgian healthcare system. Georgia’s population spends an average of 3% of GDP annually on drugs each year, twice as much as the Organization for Economic Co-operation and Development (OECD) member states. It varies within. Thus, due to the urgency of the issue, we have made it a priority to work on drug policy issues in terms of containment of financial expenditures, both in terms of reducing the total cost of medicines and in terms of direct payments made by the population. To consider all the above, it can be said that the research of the pharmaceutical business policy was selected due to the high public interest, the challenges of the field and the scarcity of study in this regard. In order to highlight the shortcomings and deficits in the regulation, to suggest ways to correct them.

PMID:36701779

Georgian Med News. 2022 Nov;(332):44-55.

ABSTRACT

In spite of all clinical manifestation of undifferentiated dysplasia of connective tissue (UDCT) including joint hypermobility syndrome still there are no exact morphological characteristics of structural articular cartilage changes on the background of UDCT.

THE AIM: to determine the structural peculiarities of articular cartilage reactive changes in rats with an experimental undifferentiated dysplasia of connective tissue.

STUDY DESIGN: animal experience.

METHODS: The object of the study was 162 knee joints of white laboratory rats, which were divided into 3 groups: – The 1st one – intact animals; the 2nd group consisted of experimental animals, each of which at the 18th day of fetal development was injected by 0.05 ml of antigen in 0.9% NaCl; the 3rd group consisted of control rats, injected by 0.05 ml of 0.9% NaCl at the 18th day of dated pregnancy. Morphological structure of articular cartilage of knee joints was examined at days 1st, 11th, 14th, 21st, 30th, 45th, 60th, 90th, 120th after birth. Fixation of histological material was carried out in 10% neutral formaldehyde. Histochemical, histological methods, statistic methods were used in the work.

RESULTS: Experiencing aggressive exposure from osteoblasts of the subchondral bone, along with increasing mechanical stress, the articular cartilage of rats with experimental UDCT, first compensatory turns thicker, and then irreversibly thin down, which is a prerequisite for the development of primary osteoarthrosis.

CONCLUSIONS: In rats with experimental UDCT the articular cartilage is isolated on the 11th day during the formation of the subchondral bone, in contrast to control rats in which articular cartilage differentiates on the 14th day after birth. In rats with experimental UDCT, the content of sulfated glycosaminoglycans in the matrix of the articular cartilage decreases. There is an accelerated replacement of the deep zone of the articular cartilage by the subchondral bone and the thinning of the articular cartilage on the 90th day after birth.

PMID:36701776

Georgian Med News. 2022 Nov;(332):22-28.

ABSTRACT

It has been more than 34 months since the severe acute respiratory syndrome coronavirus 2 that causes the COVID-19 pandemic emerged. However, understanding of COVID-19 is still evolving, and COVID-19 statistics are dynamic. The purpose of this study was to investigate the pattern of distribution of COVID-19 in the six continents by the end of October 2022 and compare it to the end of 2020 and 2021. Online data of distribution was successfully recruited from the “Worldometer” website. By the end of October 2022, nearly 6.8 billion COVID-19 tests have been performed, resulting in around 636 million cases detected, while about 6.6 million deaths were registered. The year 2021 was worse than 2020, while the first 10 months of 2022 witnessed the largest number of detected cases (55% of all cases recorded). The distribution of deaths and cases has not been consistent between continents. The number of cases/deaths is proportional to the number of tests performed. The largest share of tests was carried out in Europe (41%), while fewer tests were conducted in Africa (1.6%), and therefore, fewer cases and deaths were recorded. In conclusion, between countries, as well as across continents, the number of COVID-19 cases/deaths/tests and the case-fatality rate vary significantly, and over time, which suggest considerable uncertainty over the exact COVID-19 statistics worldwide. The definition of suspected cases should be clear, appropriate, and internationally standardized. Only when an international standard is agreed upon will we be able to make fair comparisons.

PMID:36701773

J Osteopath Med. 2023 Jan 27. doi: 10.1515/jom-2022-0127. Online ahead of print.

ABSTRACT

CONTEXT: Lymphatic treatments are gentle and passive techniques believed to enhance movement of lymph back into the central circulatory system. Animal studies provide supportive evidence, yet there are few studies in humans.

OBJECTIVES: The aim of this study is to investigate whether the osteopathic pedal pump protocol reduces volume in the lower limbs of healthy subjects.

METHODS: A total of 30 first- and second-year medical students were recruited. Subjects were excluded from participating if they had acute asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure, active infections, fractures of the lower extremities, or metastatic cancer. A within-subjects study design with pre- and posttreatment measurement of lower limb volume was utilized. Pretreatment lower limb volume measurements were obtained utilizing a volumetric water gauge prior to myofascial thoracic inlet release and a 5 min pedal lymphatic pump protocol treatment. Posttreatment lower limb measurements were taken immediately following the protocol treatment. A telephone interview was conducted 2-3 days after the treatment to assess the participants’ experience of the treatment and whether the treatment elicited a subjective change from baseline. A paired t test was utilized to determine the statistical significance of volume displacement posttreatment.

RESULTS: The mean change of pretreatment to posttreatment lower limb volume was -45.63 mL with a standard deviation of 37.65 mL. The change between the pretreatment and posttreatment volume measurements was statistically significant (p<0.001). The minimum displacement was +19 mL, and the maximum displacement was -167 mL. The majority of participants perceived the treatment as effective and enjoyable, were likely to recommend it to others, and were willing to have it performed on them at routine office visits if there was a need.

CONCLUSIONS: The osteopathic pedal pump technique, when utilized on those without leg lymphedema, reduces lower limb volume as measured by the volumetric water gauge. Further studies are warranted, especially in persons with excess lower-extremity edema, lymphedema or venous stasis.

PMID:36701752 | DOI:10.1515/jom-2022-0127

J Athl Train. 2023 Jan 27. doi: 10.4085/1062-6050-0233.22. Online ahead of print.

ABSTRACT

Previous studies commonly utilized a multi-select checklist method to assess an athlete’s ability to recognize true sports-related concussion (SRC) signs and symptoms (S&S) amongst incorrect distractor options. However, this may overinflate the evaluation of participants’ knowledge since the multi-select method does not test athletes’ ability to retrieve knowledge from their long-term memory. To test this hypothesis, an online survey was sent to registered members of the Japan Lacrosse Association (n=8,530) to examine differences in reported SRC S&S by an open-ended question and multi-select formats. We also examined whether previous exposure to SRC education and a history of SRC influenced athletes’ SRC S&S knowledge. The number and proportions of responses by participants were calculated using descriptive statistics. Pearson’s correlation was used to analyze the relationship between scores from two question formats. Unpaired sample t-tests were used to compare mean scores of each question format by previous SRC education and history of diagnosed SRC. Odds ratio was calculated to express the relationship between the proportion of correct answers by question format per symptom. The response rate of the survey was 35.9% (n=3,065) and revealed that scores from two question formats were correlated (r=0.34, 95%CI=0.31, 0.37; p<0.001). For both question formats, athletes with previous exposure to SRC education and a history of SRC reported a greater number of correct answers; however, the mean differences were trivial. In conclusion, researchers and clinicians should acknowledge the difference between multi-select (recognition) and open-ended (free recall) when assessing one’s understanding of SRC and managing athletes with a suspected SRC.

PMID:36701744 | DOI:10.4085/1062-6050-0233.22

Medicine (Baltimore). 2023 Jan 20;102(3):e32728. doi: 10.1097/MD.0000000000032728.

ABSTRACT

BACKGROUND: This paper aimed to comprehensively evaluate the effectiveness and safety of Inclisiran in treating hyperlipidemia through an overview of systematic reviews (SRs).

METHODS: The Cochrane Library, EMBASE, PubMed, CNKI, WANGFANG database, VIP database, ClinicalTrials.gov, and ICRT were searched electronically to collect SRs and meta-analysis of Inclisiran in hyperlipidemia treatment from the establishment of the database till May 2022. Two researchers independently screened the relevant literature, then the assessment of multiple systematic reviews tool was made into assess the methodological quality of the included studies. Data extracted were used to perform the study through RevMan5.3 software. The grading of recommendations assessment, development, and evaluation tool was used to grade the quality of the evidence of the outcomes included in the SRs. Prospero ID: CRD 42022326845.

RESULTS: A total of 10 relevant SRs were included, involving 7 randomized controlled trials. The assessment results of the assessment of multiple systematic reviews tool suggested that the quality of the SRs included needed to be improved. The reduced level of low-density lipoprotein cholesterol of the experimental group was lower than the control group, and the difference in the amount of effectiveness was statistically significant (MD = -50.13, 95%CI: -56.2 to -44.06, P < .00001). The grading of recommendations assessment, development, and evaluation results showed that out of 27 outcomes, 8 were high-quality, 3 were of medium quality, 6 were of low quality, and 10 were of the most inferior quality.

CONCLUSION: 300mg Inclisiran with 2 injections a year has the best therapeutic effect, which can significantly reduce low-density lipoprotein cholesterol and total cholesterol, and increase high-density lipoprotein cholesterol levels in patients with hyperlipidemia. Inclisiran has a favorable safety profile, with no significant difference in the incidence of adverse reactions compared to a placebo. Most of the adverse effects were associated with the reaction on the injection site.

PMID:36701738 | DOI:10.1097/MD.0000000000032728

Medicine (Baltimore). 2023 Jan 20;102(3):e32624. doi: 10.1097/MD.0000000000032624.

ABSTRACT

To analyze the clinical effect of standardized nursing for lymphoma patients and the influencing factors of nosocomial infection, a total of 360 diffuse large B-cell lymphoma patients with disease recurrence or progression after first-line treatment were retrospectively selected from our hospital from January 2021 to July 2022. After standardized nursing, the overall infection rate of lymphoma patients was 2.50% (9/360), which was significantly lower than the overall infection rate of our hospital in 2021 (7.44%, 844/11342) (P < .05). The proportion of 3 kinds of pathogenic bacteria detected were G+ bacteria (33.5%), G- bacteria (53.3%), and fungi (13.2%). The pathogenic bacteria genus with the most G+ bacteria is Enterococcus, the pathogenic bacteria genus with the most G+ bacteria is Enterobacteriaceae, and the pathogenic bacteria with the most fungi is Candida albicans. Female infection rate was significantly higher than male (P < .05). There was no significant difference in nosocomial infection among different marital status/fertility status (P > .05). The nosocomial infection of patients with different hospitalization times was statistically significant (P < .05). The duration of hospitalization in the infected group was significantly higher than that in the non-infected group (P < .05). The clinical effect of standardized nursing for lymphoma patients is significant, and the influencing factors of nosocomial infection include patient gender, hospitalization frequency, and hospitalization duration.

PMID:36701737 | DOI:10.1097/MD.0000000000032624