Tag: statistics

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9382-9392. doi: 10.26355/eurrev_202212_30689.

ABSTRACT

OBJECTIVE: Microscopic colitis (MC) has been of major concern worldwide due to its relapsing and remitting nature of chronic diarrhea. Quality of life of patients suffering from this disease is quite debilitating.

PATIENTS AND METHODS: In order to understand the role and importance of fecal calprotectin (FC) we performed a statistical analysis on the patients suffering from chronic diarrhea and admitted to our hospital from 2014 to 2020, and who were prescribed Loperamide (Imodium) or Budesonide or a combination of both and had undergone FC detection test.

RESULTS: FC was found to be significantly correlated to the age, alcohol consumption and beta blocker use. A high level of the FC concentrations increases the chances of having flare-ups of diarrhea episodes making the quality of life of such patients worse.

CONCLUSIONS: FC concentrations should be monitored frequently and precautionary measures to avoid a relapse should be aimed. Measures to improve quality of life, should be of prime concern. In-depth research is required to better understand MC and to find better treatment options which can be used on a long-term basis, instead of anti-motility drugs which are able to control the acute episodes, but when discontinued result in an increased tendency to have relapses.

PMID:36591847 | DOI:10.26355/eurrev_202212_30689

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9240-9249. doi: 10.26355/eurrev_202212_30677.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the change of morphology and hemodynamics in a relatively large number of patients with atrial septal defect (ASD) and provide the initial result in Vietnamese patients.

PATIENTS AND METHODS: This longitudinal, prospective case-control study was done at the Vietnam National Heart Institute from January 2012 to December 2017. The participants were divided into two groups: the ASD group, which included patients with ASDs, and the control group, which included healthy individuals or individuals without cardiac-related disorders.

RESULTS: There were 94 participants in the ASD group and 83 participants in the control group. Most patients with ASDs in the study group were female, and the average age was 38.65 ± 14.8. The success rate of the ASD group was 98.9%. The right ventricle morphology and function showed right ventricular diameter, pulmonary trunk gradually decreased, FAC and ET increased, IVCT and IVRT decreased, and Tei index gradually decreased after each examination. Morphology and function of the left ventricle after ASD closure showed that the left ventricular diameter gradually increased, and EF% in 3 months after ASD closure increased statistically significantly. IVCT, IVRT, and LV Tei index decreased, and ET increased statistically significantly. After six months from ASD closure, the proportion of patients with NYHA I was 90.3%, with no patient with NYHA IV, and pulmonary vascular resistance gradually decreased.

CONCLUSIONS: Percutaneous trans-catheter closure in Vietnamese adult atrial septal defect was an effective technique. Ventricle morphological and hemodynamic abnormalities following closure recovered statistical significance over time, particularly in the left ventricle.

PMID:36591836 | DOI:10.26355/eurrev_202212_30677

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9258-9269. doi: 10.26355/eurrev_202212_30679.

ABSTRACT

OBJECTIVE: Cardiovascular disease (CVD) and cerebrovascular disease are the leading cause of death around the world all the time. A novel marker described as the stress hyperglycemia ratio (SHR) can reflect the acute hyperglycemic status and is associated with poor outcomes in patients with acute illness, such as stroke and myocardial infarction (MI). Our previous study has shown that SHR was strongly related to the clinical outcomes of stroke patients. Nevertheless, the association between SHR and clinical outcomes in patients with CVD is still unclear and controversial. Consequently, in the current study, we analyzed the association of SHR and clinical outcomes in CVD patients by systematic review and meta-analysis.

MATERIALS AND METHODS: We searched the electronic databases to identify SHR studies of patients who met the eligibility criteria for CVD. We performed our study complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We utilized a ten terms tool to assess the potential bias of included studies. Major adverse cardiovascular and cerebrovascular events (MACCEs), all-cause death, left ventricular ejection fraction (LVEF), and other exciting outcome data were extracted for statistical analysis. Moreover, we used the DerSimonian and Laird random-effects model to perform the meta-analysis and conducted subgroup analyses to identify factors associated with substantial heterogeneity.

RESULTS: The study cohort included nine studies comprising 32,292 patients with CVD. Our meta-analysis found that MACCEs in the high SHR group were 1.68 folds compared with that in the low SHR group [odds ratio (OR) 1.68, 95% confidence interval (CI) 1.41-2.00, p < 0.00001]. Besides, all-cause death in the high SHR group was 1.52 folds compared with that in the low SHR group (OR 1.52, 95% CI 1.15-2.01, p < 0.00001). Higher SHR meant the lower LVEF (mean difference [MD] -2.03, 95% CI [-3.28-0.79], p = 0.001). The risk of cardiogenic shock and stroke were 2.47 and 1.53 folds in the high SHR group, respectively, compared with the low SHR group. Yet, no statistically significant difference was observed for revascularization (OR 0.88, 95% CI 0.77-1.01, p = 0.08), recurrent MI (OR 1.27, 95% CI 0.69-2.33, p = 0.44), and left ventricular end-diastolic diameter (LVEDD) (MD 0.61, 95% CI [-1.65, 2.87], p = 0.60) between the two groups. Subgroup analyses identified that different study design was associated with heterogeneity about MACCEs and LVEF. Besides, studies from different countries were associated with heterogeneity about all-cause death.

CONCLUSIONS: Higher SHR significantly increases the occurrence of MACCEs and all-cause death and decreases LVEF. Moreover, Higher SHR means a higher risk of cardiogenic shock and stroke. Nevertheless, SHR had no relationship with revascularization, recurrent MI, and LVEDD. As a novel and non-invasive marker, SHR should be paid more attention to in clinical practice. Future investigation should focus on the diagnostic value of SHR in CVD and the early control of stress hyperglycemia. Although no randomized, double-blind studies have been conducted, the available massive sample studies reflect the actual situation in the clinic and assist clinical decision-making.

PMID:36591838 | DOI:10.26355/eurrev_202212_30679

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9195-9203. doi: 10.26355/eurrev_202212_30672.

ABSTRACT

OBJECTIVE: This study aimed at examining if prior failed debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infection have an impact on the success of subsequent two-stage revision arthroplasty (2SRA).

MATERIALS AND METHODS: Search was conducted on PubMed, Embase, and Google Scholar up to 14th April 2022 for studies comparing 2SRA with and without a history of DAIR.

RESULTS: Six retrospective studies were included. The success of 2SRA was defined as either absence of additional surgical intervention for infection or absence of antibiotic suppression or both. We noted no statistically significant difference in the odds of success between failed DAIR and no DAIR group, albeit with an inclination of reduced success with prior failed DAIR (OR 0.63 95% CI 0.33, 1.19 I2=66% p=0.16). Five studies reported adjusted outcomes. The meta-analysis demonstrated no statistically significant difference in the odds of success between failed DAIR and no DAIR groups (OR 0.57 95% CI 0.26, 1.26 I2=66% p=0.17). During sensitivity analysis, the removal of a single study changed the effect size indicating significantly lower success rates in failed DAIR group.

CONCLUSIONS: Our results indicate that patients undergoing 2SRA after failed DAIR may have a non-significant tendency of lower success rates as compared to patients directly undergoing 2SRA. However, current evidence is scarce and fraught with several limitations and there is a need for further research to delineate the impact of failed DAIR on the success of 2SRA.

PMID:36591831 | DOI:10.26355/eurrev_202212_30672

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9098-9106. doi: 10.26355/eurrev_202212_30659.

ABSTRACT

OBJECTIVE: Fibromyalgia (FM) is a clinical syndrome characterized by prominent physical and psychological impairment and widespread pain on both sides of the body, above and below the waist, and along the axial skeleton. It often causes sleep difficulties, memory impairment, mood changes, irritable bowel syndrome, and fatigue. Our study aimed to investigate the relationship between FM and prolidase (peptidase D) and histone H3 protein levels by comparing a patient group with a healthy control group.

PATIENTS AND METHODS: In total, 176 people were examined in our study, 88 of whom were healthy and 88 of whom had FM. Serum level was measured by ELISA. Then the results were analyzed using SPSS. All p < 0.05 were considered statistically significant.

RESULTS: A significant increase in the levels of prolidase was observed in the patient group compared with the control group (6.28-4.68, p <0.001). Histone H3 protein values were not significantly different between the patient and control groups (p=0.184). The ROC analysis indicated that prolidase was statistically significant in disease prediction (p<0.001, AUC: 0.795 (0.697-0.893), while histone H3 protein was statistically insignificant in predicting disease.

CONCLUSIONS: The results of the study show that prolidase activity may play a role in diagnosing FM. In addition, since no study like ours has been performed before, it can bring a new perspective to the literature.

PMID:36591822 | DOI:10.26355/eurrev_202212_30659

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9089-9097. doi: 10.26355/eurrev_202212_30658.

ABSTRACT

OBJECTIVE: To evaluate the bond efficacy and failure rates of rebonded metallic brackets after enamel reconditioning with chemical 37% phosphoric acid (PA) and natural and synthetic photosensitizers activated by PDT.

MATERIALS AND METHODS: A total of 50 non-cavitated, and cautiously extracted human premolars were congregated after sample size calculation. The enamel exterior was etched, washed, dried for adhesive application, and cured. Metallic brackets were then oriented and adapted to enamel surface using composite. Later, brackets were debonded from the surface via a Weingart plier. Enamel was finished for ensuing surface reconditioning. Ultimately, specimens were randomly distributed into five groups (n=10). Enamel surface before rebonding was reconditioned with curcumin photosensitizer (CP), riboflavin photosensitizer (RP), rose bengal photosensitizer (RBP), methylene blue photosensitizer (MBP), and 37% PA (control) respectively. After following reconditioning protocol, brackets were rebonded to the enamel exterior employing a composite adhesive system. Then, specimens were subjected to the universal testing machine for analyzing shear bond strength (SBS), and bond failures were predicted using an ARI index. One-way ANOVA and Tukey multiple comparison tests were used for statistical analysis at a variance value of p < 0.05.

RESULTS: Enamel reconditioned with 37% PA demonstrated the highest SBS for bracket rebonding, and the lowest SBS was presented by CP actuated by PDT. Enamel reconditioned with RP and RBP corroborated the analogous SBS outcome to 37% PA. Likewise, enamel surface treatment with MBP revealed a statistically significant result to CP for metallic bracket rebonding. The most prevalent failure scores anticipated among groups were 0 and 1 indicating an adhesive failure with the exemption of group 5 (control) that encountered more score 2 cohesive failure on debonding metallic brackets from enamel exterior.

CONCLUSIONS: Rose bengal and riboflavin photosensitizers activated by photodynamic therapy with low ARI scores have the potential to be used as viable enamel reconditioning alternatives to 37% phosphoric acid for rebonding metallic brackets.

PMID:36591821 | DOI:10.26355/eurrev_202212_30658

Eur Rev Med Pharmacol Sci. 2022 Dec;26(24):9079-9088. doi: 10.26355/eurrev_202212_30657.

ABSTRACT

OBJECTIVE: Immunoglobulin A nephropathy (IgAN) and membranous nephropathy (MN) are common types of primary glomerulonephritis (PGD). A lack of specific clinical features makes diagnosis difficult. Kidney function indicators have been used for their diagnosis. However, the diagnostic performance of these indicators is undetermined. The purpose of this paper is to evaluate their diagnostic potential.

PATIENTS AND METHODS: 101 patients with PGD were enrolled, including 50 with MN and 51 with IgAN. The healthy controls included 110 volunteers. The indicators related to kidney function, including TP, ALB, Cre, CysC, eGFR, C1q, Ure, Anti-PLA2R, complement C3, and complement C4 in serum, ACR in urine, and antinuclear antibody profile, IgG staining, IgA staining, IgM staining, C3 staining and C1q staining in tissue samples were evaluated.

RESULTS: Statistical differences were found in TP, ALB, Ure, CysC, eGFR, C1q, Anti-PLA2R, complement C3, complement C4 and ACR among the three groups of subjects. ROC analysis showed that Anti-PLA2R and ACR had the highest specificity for identifying IgAN and/or MN from the healthy controls, ACR had the highest sensitivity. The Sp and Se of IgA and IgG in tissue samples for the identification of IgAN and MN were both high. Both IgAN and MN were predicted by anti-PLA2R, especially MN. In tissue samples, MN patients were more likely to be IgG positive and IgAN patients were more likely to be IgA positive.

CONCLUSIONS: IgAN and MN may be differentiated using serum Anti-PLA2R, tissue IgG, and tissue IgA. Cre is only useful in middle and late stages of GPDs, ACR is an exclusion marker, and CysC and C1q cannot be used to identify MN.

PMID:36591820 | DOI:10.26355/eurrev_202212_30657

Pediatr Transplant. 2023 Jan 2:e14458. doi: 10.1111/petr.14458. Online ahead of print.

ABSTRACT

BACKGROUND: Despite ubiquitous exposure to sensitizing events, most Fontan PLE patients have low panel reactive antibodies (PRA). To assess whether they are at risk for donor-specific antibody (DSA) memory response following heart transplantation (HT) when their PLE resolves, DSA profiles, incidence of rejection, and graft outcomes in Fontan recipients with and without PLE were compared.

METHODS: Patient characteristics, appearance of newly detected DSA (nDSA), and graft outcomes were compared between patients with and without PLE using Wilcoxon rank-sum and Chi-squared tests. DSA burden was quantified using titers and time to nDSA, incidence of rejection, and graft outcomes were compared using Kaplan-Meier curves and the log-rank test.

RESULTS: Characteristics of patients with and without PLE were similar. Lymphocyte and albumin levels were lower in the PLE group, and flow PRA were comparable. Graft failure, CAV, and ACR were similar between the two groups, but AMR occurred more frequently in the PLE group (p = .03). Nearly 50% of PLE patients experienced class II nDSA by 1-year post-HT, compared to 30% of non-PLE patients, but this difference was statistically not significant. Antibody burden did not differ between groups.

CONCLUSIONS: In this cohort, PLE was associated with AMR within the first-year post-HT, despite no significant difference in nDSA. Small patient numbers limited statistical comparison of nDSA in this cohort. PLE may be a risk factor for AMR post-HT, and the possibility of a clinically important DSA memory response remains. Larger studies are necessary to better understand these preliminary findings.

PMID:36591815 | DOI:10.1111/petr.14458

Neoplasma. 2022 Dec;69(6):1490-1498. doi: 10.4149/neo_2022_221014N1020.

ABSTRACT

We aimed to investigate the relationship between the degree of mast cells’ (MCs) infiltration and clinicopathological features of prostate cancer (PCa) malignancy and to find out the possible mechanisms of the involvement of these cells in the formation of the aggressive course of the PCa development. The study was conducted on the clinical material of 60 patients with PCa of stages II-III. MCs in the PCa tissue were determined by a histochemical method using toluidine blue. The expression of osteopontin (OPN) was studied by the immunohistochemical method. The expression of miRNA-21, -126, -146a, -181a, and -221 was investigated by quantitative real-time PCR. Statistical processing of the results was performed using the GraphPad Prism 8 program. Our results demonstrated that the increased level of infiltration and degranulation of MCs in the PCa tissue was associated with such indices of the malignancy of the tumor process as the Gleason score and the preoperative PSA level in the blood serum of patients. A high level of MCs infiltration of the PCa tissue was associated with a significant decrease in the two-year recurrence-free survival rates of the patients by 23.3% (р=0.0455). A high degree of MCs infiltration of the PCa tissue was associated with 1.2 times (p=0.0347) higher level of OPN expression and 1.7 (p=0.0051) and 1.65 (p=0.0087) times lower levels of miR-126 and miR-181a expression, respectively. The obtained results indicate the participation of MCs as a factor of the tumor microenvironment in the PCa progression.

PMID:36591806 | DOI:10.4149/neo_2022_221014N1020

Neoplasma. 2022 Dec;69(6):1480-1489. doi: 10.4149/neo_2022_220619N649.

ABSTRACT

The clinical data of stage I invasive lung adenocarcinoma patients with spread through air spaces (STAS) who underwent lobectomy from January 1, 2013 to January 1, 2016 at the Department of Thoracic Surgery of Hebei Medical University were analyzed retrospectively, and statistical analysis was carried out to explore their clinical features and prognostic value of EGFR mutation. A total of 280 patients were included in the study cohort, and EGFR mutations were detected in 154 patients. EGFR mutations were more common in non-smokers (p=0.045), females (p<0.001), without vascular tumor thrombus (p=0.037), and histological subtype LPA/APA/PPA (p=0.001). Multivariate analysis of the Cox risk regression model showed that EGFR gene mutation (p=0.807) was not an independent influencing factor of recurrence-free survival (RFS), but EGFR mutation was an independent influencing factor of overall survival (OS) (p=0.012), and OS of patients with EGFR mutation was better. The EGFR mutation also significantly increased the progression-free survival (PFS) of relapsed patients (p<0.001), but the PFS of relapsed EGFR mutation patients who received adjuvant chemotherapy after the operation was worse than that of patients who did not receive adjuvant chemotherapy (p=0.029). EGFR gene mutation is not a risk factor for postoperative recurrence in patients with stage I lung adenocarcinoma with STAS but the 5-year survival rate of patients with EGFR gene mutation is better than that of wild-type. Postoperative adjuvant chemotherapy for patients with EGFR mutation should be carefully considered.

PMID:36591802 | DOI:10.4149/neo_2022_220619N649