Tag: statistics

Braz J Cardiovasc Surg. 2022 Dec 19. doi: 10.21470/1678-9741-2022-0107. Online ahead of print.

ABSTRACT

INTRODUCTION: The aims of this study were to determine the incidence of severe and moderate primary graft dysfunction (PGD) in our center, to identify, retrospectively, donors’ and recipients’ risk factors for PGD development, and to evaluate the impact of PGD within 30 days after heart transplantation.

METHODS: Donors’ and recipients’ medical records of 64 consecutive adult cardiac transplantations performed between January 2016 and June 2017 were reviewed. The International Society for Heart and Lung Transplantation (ISHLT) criteria were used to diagnose moderate and severe PGD. Associations of risk factors for combined moderate/severe PGD were assessed with appropriate statistical analyses.

RESULTS: Sixty-four patients underwent heart transplantation in this period. Twelve recipients (18.7%) developed severe or moderate PGD. Development of PGD was associated with previous donor cardiopulmonary resuscitation and a history of prior heart surgery in the recipient (P=0.01 and P=0.02, respectively). The 30-day in hospital mortality was similar in both PGD and non-PGD patients.

CONCLUSION: The use of the ISHLT criteria for PGD is important to identify potential risk factor. The development of PGD did not affect short-term survival in our study. More studies should be done to better understand the pathophysiology of PGD.

PMID:36592073 | DOI:10.21470/1678-9741-2022-0107

Braz J Cardiovasc Surg. 2022 Dec 19. doi: 10.21470/1678-9741-2022-0254. Online ahead of print.

ABSTRACT

INTRODUCTION: Due to Brazilian population aging, prevalence of aortic stenosis, and limited number of scores in literature, it is essential to develop risk scores adapted to our reality and created in the specific context of this disease.

METHODS: This is an observational historical cohort study with analysis of 802 aortic stenosis patients who underwent valve replacement at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, from 1996 to 2018. With the aid of logistic regression, a weighted risk score was constructed based on the magnitude of the coeficients β of the logistic equation. Two performance statistics were obtained: area under the receiver operating characteristic curve and the chi-square (χ2) of Hosmer-Lemeshow goodness-of-fit with Pearson’s correlation coeficient between the observed events and predicted as a model calibration estimate.

RESULTS: The risk predictors that composed the score were valve replacement surgery combined with coronary artery bypass grafting, prior renal failure, New York Heart Association class III/IV heart failure, age > 70 years, and ejection fraction < 50%. The receiver operating characteristic curve area was 0.77 (95% confidence interval: 0.72-0.82); regarding the model calibration estimated between observed/predicted mortality, Hosmer-Lemeshow test χ2 = 3,70 (P=0.594) and Pearson’s coeficient r = 0.98 (P<0.001).

CONCLUSION: We propose the creation of a simple score, adapted to the Brazilian reality, with good performance and which can be validated in other institutions.

PMID:36592072 | DOI:10.21470/1678-9741-2022-0254

Braz J Cardiovasc Surg. 2022 Dec 19. doi: 10.21470/1678-9741-2022-0059. Online ahead of print.

ABSTRACT

INTRODUCTION: We compared transatrial closure, tricuspid valve septal detachment, and tricuspid valve chordal detachment techniques for ventricular septal defect (VSD) closure.

METHODS: Patients who had VSD closure with three different techniques in our clinic between September 2016 and December 2020 were retrospectively reviewed. A total of 117 patients were included in the study. The patients were divided into three groups: group 1, classical transatrial closure; group 2, closure with tricuspid valve septal detachment; and group 3, closure with tricuspid valve chordal detachment. The groups were evaluated by serial transthoracic echocardiography (preoperative, postoperative 1st day, postoperative 1st month). Cardiac rhythm checks and recordings were performed.

RESULTS: No residual VSD was observed in early or late periods in any of the groups whose VSD closure was performed with the three different techniques. No severe tricuspid regurgitation (TR) was detected during the early and late postoperative periods of all operating procedures. When the groups were compared in terms of early/late TR after the operation (without TR+trace amount of TR and mild TR+moderate TR were compared), no statistically significant difference was found (P>0,05; P=0,969 and P>0,05; P=0,502).

CONCLUSION: In this study, we found no statistically significant difference between three VSD closure techniques in terms of early TR, late TR, residual VSD, and permanent atrioventricular complete block during postoperative period. We hope that our results will be supported by the results of researches that are being made about this subject in large series.

PMID:36592069 | DOI:10.21470/1678-9741-2022-0059

Brief Bioinform. 2023 Jan 2:bbac585. doi: 10.1093/bib/bbac585. Online ahead of print.

ABSTRACT

The progress of single-cell RNA sequencing (scRNA-seq) has led to a large number of scRNA-seq data, which are widely used in biomedical research. The noise in the raw data and tens of thousands of genes pose a challenge to capture the real structure and effective information of scRNA-seq data. Most of the existing single-cell analysis methods assume that the low-dimensional embedding of the raw data belongs to a Gaussian distribution or a low-dimensional nonlinear space without any prior information, which limits the flexibility and controllability of the model to a great extent. In addition, many existing methods need high computational cost, which makes them difficult to be used to deal with large-scale datasets. Here, we design and develop a depth generation model named Gaussian mixture adversarial autoencoders (scGMAAE), assuming that the low-dimensional embedding of different types of cells follows different Gaussian distributions, integrating Bayesian variational inference and adversarial training, as to give the interpretable latent representation of complex data and discover the statistical distribution of different types of cells. The scGMAAE is provided with good controllability, interpretability and scalability. Therefore, it can process large-scale datasets in a short time and give competitive results. scGMAAE outperforms existing methods in several ways, including dimensionality reduction visualization, cell clustering, differential expression analysis and batch effect removal. Importantly, compared with most deep learning methods, scGMAAE requires less iterations to generate the best results.

PMID:36592058 | DOI:10.1093/bib/bbac585

Prostate. 2023 Jan 2. doi: 10.1002/pros.24480. Online ahead of print.

ABSTRACT

BACKGROUND: Genetic evaluation of men with advanced prostate cancer is recognized as imperative both to guide treatment decisions and to trigger cascade genetic testing of family members. Here we investigate utilization patterns of genetic testing among a contemporary cohort of men with advanced prostate cancer at our institution.

METHODS: We queried the Northwestern Electronic Data Warehouse from January 2021 to present for all men diagnosed with National Comprehensive Cancer Network high-risk/very high-risk, regional, or metastatic prostate cancer. Patients were excluded from analyses if treated at an outside institution and/or presented for a second opinion evaluation. Statistics were performed using t-test, Chi-squared test, and univariable and multivariable logistic regression with significance defined as p < 0.05.

RESULTS: Atotal of 320 men (52.5%) had local/regional disease and 290 (47.5%) had metastatic disease, 53 (18.3%) of whom had castrate resistant prostate cancer. Rates of germline genetic testing rate were low in patients with localized disease (9.4%) and metastatic disease (34.1%). Only 19 (35.8%) men diagnosed with metastatic castrate resistant prostate cancer underwent germline genetic evaluation. Germline testing was most frequently discussed or ordered by medical oncologists (52%) followed by urologists (20%). Men who underwent germline testing were younger (p < 0.001), more likely to have Medicaid or private insurance (p = 0.002), and more likely to have metastatic disease (p < 0.001). There were no statistically significant differences in baseline PSA, ethnicity, race, or castration sensitivity status. Age (odds ratio [OR]: 0.94, 95% confidence interval [CI]: 0.91-0.97, p < 0.001) and metastatic disease (OR: 5.71, 95% CI: 3.63-9.22, p < 0.001) were significant independent predictors of genetic testing on multivariable logistic regression.

CONCLUSIONS: Here we report that utilization of genetic testing is associated with metastatic disease and inversely associated with age. Overall, utilization rates of genetic testing remain low in all patient groups, including in the metastatic castrate resistant setting, where genetic testing can identify patients with homologous recombination repair deficiency who may benefit from use of targeted therapeutics such as PARP inhibitors. Genetic testing in men with aggressive prostate cancer is critical and barriers to routine implementation of testing require further study to develop strategies to improve utilization rates.

PMID:36591888 | DOI:10.1002/pros.24480

Eur Rev Med Pharmacol Sci. 2022 Dec;26(3 Suppl):78-86. doi: 10.26355/eurrev_202212_30797.

ABSTRACT

OBJECTIVE: The objective of the study was to evaluate the results and immediate postoperative complications following open reduction and internal fixation of mandibular fractures with or without postoperative maxillo-mandibular fixation MATERIALS AND METHODS: The study spanned over a period of 24 months, extending from October 2015 to October 2017. The study sample comprised 24 subjects between the age range of 18 to 65 years. They were randomly divided into two groups: Group A included subjects in whom open reduction and internal fixation was followed by maxilla-mandibular fixation for 15 days, and Group B subjects in whom only open reduction and internal fixation was done, followed by immediate mobilization. The outcomes evaluated were swelling, pain, simplified oral hygiene index and occlusion. The subjects were followed for all these outcomes on 1st, 7th and 15th days. The occlusion was assessed for 5 days. Any other intra/post-operative complications were additionally noted.

RESULTS: There was no statistical difference between the groups for swelling, pain and occlusion. The patients with postoperative maxilla-mandibular fixation had poorer oral hygiene when compared to the other group (p<0.001).

CONCLUSIONS: The use of maxilla-mandibular fixation post open reduction and internal fixation seems to offer no additional benefits to the patients. According to the results of the study, this traditional surgical dictum seems to be used by the surgeons due to the lack of any scientific evidence. However, further studies should be conducted to confirm this statement.

PMID:36591881 | DOI:10.26355/eurrev_202212_30797

J Drug Educ. 2023 Jan 2:472379221148384. doi: 10.1177/00472379221148384. Online ahead of print.

ABSTRACT

This study sought to examine the effects of substance use and stress-induced cognitive impairment on anxiety and depression among college students. The data for this study came from a sample of 328 undergraduate students from a public university. The subjects in this study completed a 101-item self-administered questionnaire, which was part of a larger study on college stress. This study included not only students who are typically expected to seek help at the counseling centers, but it expanded to include self-reported cases of students who do not have documented problems of substance use or anxiety/depression. To address the main objective of this study, an eight-variable model was developed and tested for each of the two outcome variables: anxiety and depression. The results that emerged from this study show that both substance use and stress-induced cognitive impairment have a positive and a statistically significant effect on anxiety and depression in college students.

PMID:36591867 | DOI:10.1177/00472379221148384

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9187-9194. doi: 10.26355/eurrev_202212_30670.

ABSTRACT

OBJECTIVE: The aim of the study was to investigate the clinical effect of single plane screw percutaneous internal fixation in the treatment of simple thoracolumbar fractures.

PATIENTS AND METHODS: The subjects of this study were 84 patients with simple thoracolumbar fractures treated in our hospital from January 2018 to December 2020. The patients were grouped by different treatment methods (42 cases in each group). The single plane group was treated by percutaneous single plane screw internal fixation and the universal group was treated with percutaneous universal screw. The surgery completion status and the incidence of complications were recorded. The visual analogue scale (VAS) and the Oswestry Disability Index (ODI) of the two groups were recorded before the surgery, 3 days after the surgery, and 7 days after the surgery. The anterior edge height ratio of the fractured vertebra and the kyphotic Cobb angle were marked before the surgery, immediately after the operation, and at the last follow-up.

RESULTS: Difference between groups in surgery time, blood loss and hospital stay was not statistically significant (p>0.05); the single plane group had a substantially lower incidence of complications than the universal group (p<0.05). At the last follow-up, the single plane group had greatly higher anterior edge height ratio of the injured vertebra than the universal group, while kyphotic Cobb angle was greatly higher in the universal group (p<0.05).

CONCLUSIONS: Both single plane screw and universal screw percutaneous internal fixation were feasible for the treatment of simple thoracolumbar fractures, but single plane screw showed better vertebral height recovery and kyphosis correction effect, which could reduce postoperative correction loss.

PMID:36591861 | DOI:10.26355/eurrev_202212_30670

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9480-9488. doi: 10.26355/eurrev_202212_30700.

ABSTRACT

OBJECTIVE: The aim of the study is to evaluate the awareness, comportment and attitude/perception of dentists regarding the use of photodynamic (PD) therapy before and during COVID-19 pandemic around the globe.

SUBJECTS AND METHODS: An online survey was performed by sending out an online questionnaire comprising 21 questions among dental practitioners working in four different countries: Saudi Arabia, Pakistan, Malaysia and United Kingdom. The survey evaluated dental practitioners’ level of awareness about the PD therapy, comportment and attitude for its implication and prevalence in daily clinical practice. For statistical significance the Chi-square analysis with Spearman Correlation coefficient was conducted to assess the sub-groups and correlating the factors with the level of awareness of the dental practitioners.

RESULTS: A total of 1,219 dental practitioners from four different countries (Saudi Arabia, Pakistan, Malaysia and United Kingdom) responded to the questionnaire. The median age of the respondents was 37, 34, 36 and 39 respectively. The majority of dental practitioners demonstrated to have an acceptable level of awareness regarding PD therapy. Nearly 76%, 74%, 79% and 80% of the individuals from Saudi Arabia, Pakistan, Malaysia and United Kingdom respectively were aware of the role/mechanism of action of the PD therapy. Moreover, in preponderance, practitioners were confident that the effect of PD therapy will not be reduced in patients infected with COVID-19. The majority of dental practitioners were convinced that successful dental treatment due to PD therapy is linked majorly with therapies done in relation to four major dental specialties: prosthodontics, endodontic, restorative dentistry and periodontology. Approximately more than 90% of the dentists were sure that the rate of COVID-19 transmission can be reduced by using PD therapy in oral treatments. The dental practitioners from Saudi Arabia (91%), Pakistan (82%), Malaysia (83%) and United Kingdom (82%) were contented to learn about PD therapy for its use in clinical practice. Nearly more than 95% of the practitioners from the four countries were keen to attend the lectures/hands-on workshops regarding PD therapy to enhance their skills and knowledge. More than 80% of dentists do not refuse the peripheral role of PD therapy with their patients.

CONCLUSIONS: The respondents from the four countries displayed passable level of awareness regarding basic information of PD therapy and its clinical implication in dental specialty. Nevertheless, there is a need to develop awareness regarding the use of PD therapy among dental practitioners during their undergraduate program. Furthermore, lectures and hands-on workshops should be arranged to train dental practitioners in order to enhance their skills for its solicitation in clinical practice. It is perceived by the dentists in the four countries that the use of PD therapy can effectively reduce COVID-19 rate of transmission.

PMID:36591857 | DOI:10.26355/eurrev_202212_30700

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9426-9436. doi: 10.26355/eurrev_202212_30694.

ABSTRACT

OBJECTIVE: Olaparib is the poly-[Adenosine diphosphate ribose (ADP-ribose)] polymerase inhibitor (PARPI) used in maintenance therapy of patients with platinum-sensitive ovarian cancer with mutations in breast cancer genes 1/2 (BRCA1/2). Oncologists still do not have recommendations of treatment depending on efficient plasma concentrations of the PARP inhibitor. The aim of the study was the assessment of plasma trough concentrations of olaparib at steady state (Ctrough) in ovarian cancer patients. The severity of olaparib adverse effects (AEs) was noted.

PATIENTS AND METHODS: The retrospective study involved 33 patients [mean standard deviation (SD)]; age 57.0 (8.4) years; weight 68.7 (13.7) kg; and body mass index (BMI) 26.4 (4.9) kg/m2, with ovarian cancer treated with olaparib (tablets in dose 300 mg/12 h, 250 mg/12 h, 200 mg/12 h or capsules 400 mg/12 h, 200 mg/12 h, 100 mg/12 h). Plasma drug levels were measured by HPLC-UV method (λ = 254 nm; Symmetry C8 column; gradient flow). The severity of olaparib AEs was assessed by Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale. Drug interactions were analyzed.

RESULTS: In total, 130 measurements (n) of Ctrough were determined in 33 patients (median sample frequency per patient was 4). The olaparib Ctrough in patients with AEs was 87.840-7,213.262 ng/mL [coefficient of variation (CV) = 91%], in patients without AEs 48.021-7,073.350 ng/mL (CV = 88%). AEs were the following: fatigue (modest, n = 4, severe, n = 2), anemia (grade G1 n = 66, G2 n = 6, G3 n = 3), neutropenia (grade G1 n = 15, G2 n = 4), prediabetes (n = 1). There was a correlation between Ctrough and olaparib-induced fatigue (p = 0.0015). The lower values of dose-adjusted olaparib concentrations (p = 0.0121) and dose/kg-adjusted olaparib concentrations (p = 0.0389) were correlated with higher grade of neutropenia.

CONCLUSIONS: There was a correlation between Ctrough, expressed as ng/ml, ng/ml/mg or ng/ml/mg/kg, and fatigue degree, but not anemia. Patients with neutropenia had statistically significant lower plasma concentrations of olaparib.

PMID:36591851 | DOI:10.26355/eurrev_202212_30694