Tag: statistics

J Cancer Res Clin Oncol. 2022 Apr 13. doi: 10.1007/s00432-022-04002-4. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the protein expression of DNA mismatch repair (MMR) proteins in patients with cutaneous melanoma (CM) under immune checkpoint inhibitor (ICI) therapy.

METHODS: Immunohistochemistry was performed on tumor tissue for MMR proteins MLH1, MSH2, MSH6, and PMS2 in 50 metastatic CM patients treated with ICI (ipilimumab, nivolumab, pembrolizumab).

RESULTS: Best overall response (BOR) rate was 48% (24/50). Reduced MMR protein expression (nuclear expression in < 80% of tumor cells) was observed in 8 patients (16%). Compared to other clinical parameters, baseline neutrophil/lymphocyte ratio and reduced intratumoral MMR protein expression (P = 0.0033) were determined as the only parameters significantly associated with favorable BOR. However, in this small study population, reduced MMR protein expression did not reach statistical significance in multivariate analysis.

CONCLUSION: Reduced MMR protein expression is observed in CM and might predict favorable BOR in patients treated with ICI, as was observed for other entities. However, these findings need to be substantiated in larger patient cohorts.

PMID:35419731 | DOI:10.1007/s00432-022-04002-4

Diagnosis (Berl). 2022 Apr 14. doi: 10.1515/dx-2022-0010. Online ahead of print.

ABSTRACT

BACKGROUND: Diagnostic errors are frequently the product of cognitive biases that arise when heuristic-based approaches fail. The efficiency-thoroughness tradeoff (ETTO) principle states sacrificing thoroughness for efficiency is normal and occurs frequently in medicine. The goal of a diagnostic timeout was to provide an actionable template for when providers transition to an analytical mindset and to help incorporate the ETTO principle during the diagnostic process.

METHODS: A diagnostic time-out was adapted for use in pediatric hospital medicine (PHM). In this prospective study, a group of eight PHM providers piloted the time-out in the hospitalized setting. Data was collected over 12 months and descriptive statistics were used for analysis.

RESULTS: Cases were most frequently chosen for time-out use due to clinician intuition. In more than half the cases the time-out didn’t confirm the initial diagnosis and alternate diagnoses for the wrong diagnosis were pursued. There was only one case of the time-out being burdensome from a time perspective. Learners participated in all cases. As a result of the diagnostic time-out, new actions were taken in all cases.

CONCLUSIONS: Implementation of a diagnostic time out provides an actionable template for providers to actively change their mindset to an analytical thinking process to counteract cognitive biases and potentially reduce diagnostic errors in the pediatric inpatient setting.

PMID:35417931 | DOI:10.1515/dx-2022-0010

Georgian Med News. 2022 Mar;(324):170-175.

ABSTRACT

The purpose of the work was to analyze the pro-inflammatory reaction caused by different duration of ischemic-reperfusion of intestinal damage in occlusion of anterior mesenteric artery in the experiment. Ischemic reperfusion damage of the intestinal wall was simulated using reversible occlusion of the anterior mesenteric artery with 30 rats. Two types of operations were carried out: operation 1 – the duration of ischemia 20 minutes, reperfusion – 40 minutes, operation 2 – 30 and 30 minutes, respectively. Four groups were formed by simple sampling: the first – false-operated animals (n=5), the second – model-operation 1 (n=8), the third – model-operation 2 (n=6), the 4th – control group (n=7). Lactate level was determined by BM-Lactat test strips and the number of blood leukocytes was calculated before and after the surgery. During the postoperative period, interleukin-1β (IL-1β), tumor necrosis factor α (TNF-α), monocytic chemotoxic factor-1 (MCF-1) in serum were determined. In groups 2 and 3 it was established: a decrease in leukocytes in peripheral blood by 15-20% and an increase in lactate level by 20-120% during the postoperative period with the establishment of direct statistically significant connections between the number of leukocytes in the blood and lactate content (r=+0.83, p=0.01); between the number of leukocytes in the blood and IL-1β blood level (r=+0.96; p=0,00002); reduction of IL-1β level in blood with the animals of group 3 as compared with false-operated and MCF-1 level with the animals of group 2 as compared with false-operated, which may be related to the influence of corrective action of anti-inflammatory response. The increase of TNF-a level with the animals of the second group by 1.5-2 times and in the third group by 3 times compared to false-operated animals, which is the most significant manifestation of pro-inflammatory response to ischemia/reperfusion, depends on the degree of the damage due to the duration of ischemic period. The development of systemic pro-inflammatory reactions in the simulation of reversible occlusion of anterior mesenteric artery is the basis for the rehabilitation of patients after various surgical interventions in the intestine in order to prevent abdominal postoperative complications.

PMID:35417880

J Phys Condens Matter. 2022 Apr 13. doi: 10.1088/1361-648X/ac671c. Online ahead of print.

ABSTRACT

As a fundamental type of topological spin textures in two-dimensional (2D) magnets, a magnetic meron carries half-integer topological charge and forms a pair with its antithesis to keep the stability in materials. However, it is challenging to quantitatively calculate merons and their dynamics by using the widely used continuum model because of the characteristic highly inhomogeneous spin textures. In this work, we develop a discrete method to address the concentrated spin structures around the core of merons. We reveal a logarithmic-scale interaction between merons when their distance is larger than twice their core size and obtain subsequent statistics of meron gas. The model also predicts how these properties of single and paired merons evolve with magnetic exchange interactions, and the results are in excellent agreement with the Monte Carlo simulations using the parameters of real 2D van der Waals magnetic materials. This discrete approach not only shows equilibrium static statistics of meron systems but also is useful to further explore the dynamic properties of merons through the quantified pairing interactions.

PMID:35417893 | DOI:10.1088/1361-648X/ac671c

Georgian Med News. 2022 Mar;(324):121-126.

ABSTRACT

Aim – to assess the DNA damage of lymphocytes before and after the use of Metformin in obese individuals by two indicators: the diameter and the number of DNA breaks in blood lymphocytes. The sample included 27 obese patients aged 18-61 years. Among the participants, persons with chronic decompensated diseases, with bad habits (smokers, drug users, alcohol) were excluded. In order to study the dynamics of blood lymphocyte DNA breaks, patients were prescribed Metformin (Acino) at a daily dose of 850 mg/day for 3 months. DNA damage analysis was performed by assessing foci of phosphorylated histone protein HAX (γ-H2AX) on blood lymphocytes (AKLIDES, Nuk Human Lymphocyte Complete, Medipan, Blankenfelde-Mahlow, Germany). With the appointment of Metformin, the diameter of the ruptures changed and amounted to 0.45±0.23 before treatment, and 0.44±0.27 after treatment, but no statistically significant differences were found. When evaluating the dynamics, a significant decrease in the indicator was revealed, and it amounted to 2.60% (p<0.0001; z=9.97). Before treatment, the value of the indicator “Mean number of ruptures per 1 cell” was 0.57±1.32, after the appointment of Metformin it decreased to 0.27±0.56, but the differences are insignificant and after treatment, there is a decrease in the indicator by 52.18% (p<0.0001; z=9.97). The use of metformin 850 mg/day for 3 months in obesity leads to a decrease in the diameter of cell ruptures and the average number of γ-H2AX foci per cell of serum lymphocyte DNA, which may affect the reduction in the risk of oncopathology. Further research is needed to determine the protective mechanisms of Metformin against genomic instability, especially in relation to DNA damage reactions and epigenetic changes.

PMID:35417872

Georgian Med News. 2022 Mar;(324):112-121.

ABSTRACT

Determining the influence of body composition on stress resistance, endothelial function and wellness and as a function of daily physical activity level and gender is of great medical-preventive importance․ The aim of this study was to analyse the influence of body composition on the stress resistance, endothelial function and wellness in different physical activity groups. A cross-sectional study was conducted with 2000 participants (829 men and 1171 women) aged 10-90 years. The Multiscan BS_OXI instrument was applied to measure the integral indicators․ For the study, statistical analysis was performed using Primer of Biostatistics version 4.03 by Stanton A. Glantz. Data analysis showed: (i) in the high physical activity group there was a significantly weak correlation between body composition and stress resistance in male (Rxy=0.24, p=0.000) and female (Rxy=0.28, p=0.0000) groups. In the case of low physical activity, a reliable weak correlation was registered only in the male group (ii) in the low physical activity group, there was a significant correlation between the body composition index and the change in the endothelium in the male (Rxy=0.4, p=0.000) and female group (Rxy=0.3, p=0.000) and in the group of participants with moderate physical activity, there was a significant correlation only in female group. (iii) In the high physical activity participant group, the correlation between body composition and wellness index was directly proportional in the male group (Rxy=0.33, p=0.000); in moderate and low physical activity, the correlation was directly proportional in the male and female groups. Thus, our study showed that the association of body composition with stress resistance, endothelial function and well-being depends on the level of physical activity and gender. However, further research is recommended to determine the influence of body composition ranges on various health indicators and to make recommendations and implement appropriate health and fitness programmes for the Armenian population, which should also focus on disease prevention.

PMID:35417871

Georgian Med News. 2022 Mar;(324):107-112.

ABSTRACT

There is a paucity of data on the occurrence of fibromyalgia (FM) in chronic obstructive pulmonary disease (COPD). The objective of this study was to determine the frequency of fibromyalgia in a group of patients with COPD in Mosul, as well as characterization of the features of COPD patients with concomitant FM. Participants included seventy COPD-patients plus se-venty controls. The “2011 modification of the 2010 American College of Rheumatology’s preliminary diagnostic criteria for fibromyalgia” was employed to make the diagnosis of FM. The demographic features and COPD data of the patients were documented. Pulmonary function tests and Chest-X-ray were evaluated for all patients. FM was present in 16 (22.9%) of 70 COPD patients, and only in 4 (5.7%) of the 70 controls, and the difference was significant. FM was found in 58.33% of female COPD patients compared to 15.52% of male COPD patients (p=0.004). There was no statistically significant difference in COPD patients with and without FM in respect to their age or BMI. However, patients with FM tended to have a longer duration of COPD (8.06±2.69 vs. 4.78±2.13, P value < 0.001), and higher scores on the Beck Depression Inventory (BDI) (20.7±9.200 vs. 14.8±7.900, P value=0.0139), and greater COPD severity (P< 0.001). The frequency of FM in patients with COPD was higher than control. FM is more likely to occur in female patients. Patients with comorbid FM and COPD tended to report more depressive symptoms, have longer disease duration, and higher disease severity.

PMID:35417870

Georgian Med News. 2022 Mar;(324):78-86.

ABSTRACT

Metabolic syndrome (MеtS) is a combination of clinical and laboratory abnormalities that increase the risk of cardiovascular diseases and type 2 diabetes mellitus. Purpose – to detect and identify peculiarities of MetS and its criteria in children depending on gender. MetS was estimated in 89 (5.9%) children from 1520 examined children: in 39 (2.6%) girls and 50 (3.3%) boys (p>0.05) aged from 9 to 18 years. Children were selected for examination of anthropometric data, blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides, fasting glucose and insulin, index HOMA-IR, glucose/insulin ratio and QUICKI. Heart rate variability (HRV) study and echocardiography were done. Diagnosis of MetS was provided according to IDF Consensus (2007). Abdominal obesity was diagnosed in all children with MetS. Boys had essentially more large body mass, height, body surface area, neck and waist circumferences, weight/height ratio than girls (p<0,001). Blood pressure in boys was higher than in girls, arterial hypertention in boys (72,0%) was diagnosed more often than in girls (46,2%). Insulin resistance was identified 1,5 falled more often in girls than in boys (p<0,05). Statistically significant difference in lipid metabolism in boys and girls was not estimated. According to HRV boys had higher activity of the autonomous nervous system than girls. Left ventricular (LV) myocardial mass and thickness of the LV posterior wall in boys were significantly larger than in girls that proved a higher risk of LV hypertrophy and concentric remodeling. Attention to gender differences of MetS must be paid and gender-specific strategies for the prevention of cardiovascular diseases and type 2 diabetes mellitus should be formulated.

PMID:35417866

Georgian Med News. 2022 Mar;(324):92-101.

ABSTRACT

Aims – to identify association between maternal stress during pregnancy and the developemnt of the attention deficiency hyperactivity syndrom in young children We conducted a case-control study sequentially recruiting 200 children from the “Early detection of disease and screening” State Program, from them 100 children with ADHD diagnose, and 100 subjects, as a control group, without Disruptive Behavior Disorder (DBD), aged between 1 and 6 years. The children were diagnosed with ADHD according to the DSM-IV-R and a clinical interview of the parents that used the Diagnostic Interview Schedule for Children Version IV (DISC-IV). We investigated the effect of cumulative exposure separately for life events considered as dependent and independent.The mother’s stress level was scored from 1 to 5 on the DSM-III and DSM-III-R axis IV scales, according to the highest level of stress experienced during the pregnancy. The presence of stress factor plays an important role in the development of ADHD syndrome, but does not play a statistically significant role in which type of syndrome develops: F90.0, F90.1, F90.2: p=.258. A statistically significant relationship between ADHD diagnosis and stress degree was not confirmed at p=.503. Our data revealed that moderate-grade stress is caused by dependent causes, severe stress by independent causes, this association is statistically significant(p=.001 Cramer’s V=.750). A statistically significant negative association was also found between the presence of prenatal stress and the length and weight of the baby at birth. For our study population, the risk of developing the syndrome in children of stress-relieved mothers was 2 times higher than in children of non-stressed mothers RR = 2.042. These findings show that there is an association between maternal stress during pregnancy and ADHD symptoms in offspring and support the hypothesis that prenatal stress causes offspring ADHD through a programming effect and future research should focus on exploring other prenatal factors that might be causally related to ADHD.

PMID:35417868

Georgian Med News. 2022 Mar;(324):32-37.

ABSTRACT

The aim of this study was to optimize the diagnosis of postpartum inflammatory complications. 150 puerperas who gave written informed consent to participate in clinical and laboratory studies were divided into two groups: the main group included puerperas with developed postpartum complications (n = 100), the comparison group included puerperas with a physiological course of the postpartum period (n = 50). The data of biochemical blood tests and bacteriological analysis of aspirated vaginal contents under aseptic conditions after childbirth were used as material. Against the background of the development of the inflammatory process in the early postpartum period, a decrease in quantitative indicators of hemoglobin and changes in white blood parameters with an increase in the level of leukocytes to 10.6±0.08×109/l in the main group, against 6.2±0.13×109/l in the control group group (P=0.001). It is important to note the relatively high level of ESR, which in puerperas of the main group was 23.1±0.22 mm/hour, against 8.4±0.16 mm/hour in the control group (P=0.001). Significant distinguishing features between the groups are recorded by the frequency of occurrence in the anamnesis of medical and spontaneous abortions, which were significantly higher in women of the main group (p=0.004). Patients of different groups have statistically significant differences in the somatic history data – in the puerperas of the main group, chronic pyelonephritis and inflammatory diseases of the upper respiratory tract (chronic tonsillitis, sinusitis) were more often diagnosed. Significant deviations also affected the quantitative indicators of lymphocytes (P=0.001). Among past sexually transmitted infections, the development of early puerperal inflammatory complications can be influenced by trichomoniasis (p=0.035), chlamydia (p=0.036), the frequency of which in the main group is quite significant compared to the control. The presence of inflammatory postpartum complications in patients of the main group increases the contamination, possibly also due to a significant increase in the frequency of inoculation of Mycoplasma Hominis (titer≥104) 38.0±4.85%, Ureaplasma urealiticum (titer≥104) – 73.0±4.44% (p<0.05). Comparative analysis showed that the incidence of Staphylococcus spp in patients of the main group was higher in comparison with the control group. A significant difference in patients of the main group with the control group was observed in relation to the frequency of occurrence of Streptococcus spp. Microorganisms of the Enterobacteriaceae family were also frequently sown species.

PMID:35417860