Tag: statistics

Georgian Med News. 2022 Mar;(324):21-25.

ABSTRACT

The aim of our prospective study is to compare and analyze the results of two treatment methods of left-sided malignant colon obstruction: Hartmann’s procedure (HP) and Resection with primary anastomosis (RPA). 90 Patients with diagnosis of left-sided malignant colon obstructions were enrolled in this study. The patients were assigned into two groups: Hartmann’s procedure (HP) group and Resection and Primary anastomosis group (RPA). Several clinical characteristics were determined and compared between the groups: hospital stay days, duration of the surgery, postoperative complications (during 30 days after surgery) and mortality was assessed. 37 patients were enrolled in the Hartmann’s procedure (HP) group and 53 patients were enrolled in the Primary anastomosis (RPA) group and had undergone different types of colon resections with primary anastomosis. There was 1mortality in HP group and 1 in RPA group. In RPA group, there were 7 complications (13.2%). 1 intraabdominal abscess after colorectal anastomosis, which was cured with antibiotic therapy and percutaneous drainage; 5 cases of wound infections, 1- leak of colorectal anastomosis and in Hartmann’s procedure group there were 8 (21.6%) complications (7 – wound infections, 1-necrosis of colostomy). But this difference is not statistically reliable (p=0.110). In stenting RPA stay were – 6 days and in HP group, it was 8 days. This difference is statistically reliable (P=0.02). In case of left-sided malignant colon obstructions, Primary anastomosis intervention should be preferred, rather than Hartmann’s procedure. In the future it’s needed to perform the randomized trials, which will study the long-term outcomes (recurrence of cancer, survival rate) of this treatment method.

PMID:35417858

EBioMedicine. 2022 Apr 9;79:103994. doi: 10.1016/j.ebiom.2022.103994. Online ahead of print.

ABSTRACT

BACKGROUND: The effect of long-term exposure to air pollution on the development of chronic obstructive pulmonary disease (COPD) is still controversial, and the role of the interactions of air pollution with genetic risk and lifestyle in COPD risk is unclear.

METHODS: We included 452762 participants derived from the UK Biobank. Annual concentrations of air pollutions, including particle matter (PM_2.5, PM₁₀), nitrogen oxides (NO_x), and nitrogen dioxide (NO₂), were assessed using land-use regression model. We applied Cox proportional hazard model to evaluate the associations between air pollution and COPD risk. In addition, we constructed a polygenic risk score and a lifestyle score, and assessed whether genetic susceptibility and lifestyle modified the effect of air pollution on the COPD risk.

FINDINGS: Each interquartile range (IQR) increase in annual concentrations of PM_2.5, PM₁₀, NO_x, and NO₂ was associated with 1.17 (95% CI: 1.15,1.19), 1.05 (95% CI: 1.03,1.06), 1.13 (95% CI: 1.11,1.14), and 1.19 (95% CI: 1.16,1.21) times the risk of COPD, respectively. We observed an additive interaction between PM_2.5 and genetic risk (P-_interact=0.095), and a negative interaction between PM_2.5 and lifestyle (P-_interact=0.062). The HRs for each IQR increase in PM_2.5 were 1.21, (95% CI: 1.16-1.25) and 1.24, (95% CI: 1.21-1.26) in individuals with healthy and unfavourable lifestyle, respectively; and 1.16, (95% CI: 1.13-1.19) and 1.19, (95% CI: 1.16-1.22) in those with low genetic risk and high genetic risk, respectively. Participants with high air pollution exposure, high genetic risk and unfavourable lifestyle showed the highest risk of COPD.

INTERPRETATION: Long-term exposure to air pollution was associated with increased risk of COPD, especially in those with high genetic risk and unfavourable lifestyle.

FUNDING: None.

PMID:35417845 | DOI:10.1016/j.ebiom.2022.103994

Georgian Med News. 2022 Mar;(324):15-20.

ABSTRACT

Aim – in patients with knee meniscus injury, compare the therapeutic effectiveness of the use of meniscus suturing with anterior cruciate ligament (ACL) surgery with meniscus resection in combination with anterior cruciate ligament surgery to improve the treatment of such pathologies. The study examined patients (n=66) with knee meniscus injury who received surgical treatment in the traumatology department of the State Budgetary Healthcare Institution of the Moscow region “City Clinical Hospital № 12 of the Moscow City Health Department”. The patients were randomized by gender, age, clinical, biochemical and instrumental data and divided into 2 groups. The first group (n=33) – patients underwent resection of the anterior meniscus with simultaneous plasty of the anterior cruciate ligament (in 17 (51.6%) – medial, and in 16 (48.4%) – lateral), the age group was 26.8±6.33 years, the proportion of men was 19 (57.6%), and women – 14 (42.4%). The second group (n=33) – patients underwent suturing of the meniscus with ACL plastic surgery (in 23 (69.7%) – medial, and in 10 (30.3) – lateral), age – 27.2± 4.56 years, men – 18 (54.6%), women – 15 (45.4%). This work includes clinical, arthroscopic, ultrasound, X-ray and magnetic resonance research methods. The obtained results of clinical and instrumental research methods indicate that the use of both surgical techniques showed statistically significant positive results. At the same time, the use of stitching techniques in the restoration of the injured knee joint revealed the best results relative to the resection type of surgery: good progress was 75.8-100.0% (p<0.05), and unsatisfactory – 24.4-15.1% (p<0.05). In patients with an alternative (resection) method, the data were 60.7-72.8 and 40.0-27.7% (p<0.05), respectively. Comparative analysis showed that the therapeutic effectiveness of the stitching technique is better than resection: good progress was higher by 19.6% (p<0.05), and unsatisfactory less – by 17.9% (p<0.05). The above indicates that arthroscopic stitching demonstrates high reliability of use in the rupture of the meniscus of the knee joint.

PMID:35417857

J Environ Manage. 2022 Apr 10;314:115032. doi: 10.1016/j.jenvman.2022.115032. Online ahead of print.

ABSTRACT

The Sonora River and its tributary streams (Tinajas, Bacanuchi) were impacted in 2014 by an acid solution spill (approximately 40,000 m³). This study aims to presents a clear and supported overview to determining the spill’s consequences on the environment and the people inhabiting the area. The elements quantified were those found in the spilled solution: Al, As, Cu, Fe, Mn, Pb, and Zn. Potential Toxic Element (PTE) concentration means from 187 sediment samples were, in mg.kg^-1: Al = 7,307, As = 16.6, Ba = 128 Cu = 106 Fe = 15,764, Mn = 566, Pb = 46 and Zn = 99. Differences between PTE concentrations in the most impacted sediments and those of the local baseline, sampled in streams not affected by the spill and regional baseline values, were not statistically significant. The similarity of PTE concentrations among sediments may be explained by natural geological enrichment, historical mining impacts, and a low increase of PTE in sediments after the acid spill because of natural and anthropogenic attenuation. Mainly heavy rains, natural pedogenic carbonates, and remedial work done by the mining company (retaining dam, adding lime; precipitation, collecting formed solids, and transport to the mine). The Contamination Factor (C.F.), Enrichment Factor (E.F.), and Geo-accumulation Index (Igeo) were determined. The C.F. indicated low and moderate contamination in all elements. Cu exhibited the highest E.F., from moderate to significant enrichment. The Igeo generally ranged from -0.02 to 0.15. Cu and Zn were classified as moderately to heavily contaminated. In local baseline sediments, the Cu C.F. varied from moderate to very high contamination, the Cu E.F. from moderate to significant enrichment, while the As, and Pb Igeo ranged from uncontaminated to moderately contaminated. In general, normalization demonstrated a high degree of Cu enrichment at sites 1-14. Sequential extractions indicated that only Cu was found in all fractions, including a significant exchangeable fraction in the very impacted sediments (1-14). The other PTEs were distributed between the Fe/Mn oxide fraction and the residual phase. Principal Components Analysis for PTE concentrations indicated three different groups with similar geochemical patterns and allowing to identify the PTE potentially sources: the first sediments from sites 1-14 were the impacted sediments in accordance with pH and electrical conductivity results, the second group from sites 15-20 showed characteristics of the mineralized environment, and the third from sites 21-30 were unrelated to the spillage. The area impacted by the acid solution spill reached approximately 30 km downstream, just roughly 15% of the initially considered area.

PMID:35417836 | DOI:10.1016/j.jenvman.2022.115032

Seizure. 2022 Apr 4;98:37-43. doi: 10.1016/j.seizure.2022.03.023. Online ahead of print.

ABSTRACT

INTRODUCTION: Initiation of ketogenic diet therapies (KDT) for pediatric epilepsy is usually done on an inpatient basis and the diet is managed during clinical appointments following a protocol of visits and routine tests. Because of the 2019 coronavirus disease (COVID-19) pandemic and the associated lock-down measures, we switched from outpatient to telemedicine-based KDT initiation.

OBJECTIVE: To explore the feasibility, effectiveness, and safety of online KDT initiation and follow-up by comparing a group of children with drug-resistant epilepsy that was managed by telemedicine compared to a group that was treated on an outpatient basis.

MATERIALS AND METHODS: An observational study was conducted in two groups of patients with drug-resistant epilepsy who initiated KDT and were followed up with an online versus an outpatient modality by the interdisciplinary KDT team of Hospital Pediatria JP Garrahan in Buenos Aires, Argentina. Dietary compliance, ketosis, retention rate, adverse effects, number of contacts, and clinical outcome were evaluated at 1, 3, and 6 months on the diet.

RESULTS: Overall, 37 patients were included, of whom 18 started the KD by telemedicine and 19 on an outpatient basis. Minimum follow-up of the patients was 6 months. All patients received the classic ketogenic diet. No statistical differences between the two groups regarding efficacy and safety of the diet were found.

CONCLUSIONS: Our results support the feasibility and safety of initiating and management of KDT by telemedicine. Patients and their families should be carefully selected in order to guarantee a good outcome.

PMID:35417828 | DOI:10.1016/j.seizure.2022.03.023

Mult Scler Relat Disord. 2022 Mar 31;62:103775. doi: 10.1016/j.msard.2022.103775. Online ahead of print.

ABSTRACT

BACKGROUND: The strong link between innate immunity and thrombosis/coagulation has recently been investigated in the light of antibodies directed against serine proteases of the coagulation pathway. The antibodies have been proposed as contributing factors to venous thromboembolism development and as key molecules in the initiation of signaling inflammatory pathways in neuroinflammatory diseases. Preliminary studies of Multiple Sclerosis (MS) progression characteristics with the reactivity of antibodies against coagulant components are limited. Considering the development of thrombosis at the early onset of MS, our study aimed to detect antibodies against coagulant components in MS and evaluate their possible association with the clinical profile of the disease.

METHOD: A cross-sectional study was carried out to identify antibodies to factor(F)VIIa, thrombin, prothrombin, FXa, FXII, plasmin, and protein C in serum samples from 167 patients with MS and 40 healthy controls using the enzyme-linked immunosorbent assay. Statistical analysis was performed for the evaluation of the data.

RESULTS: The analysis revealed a significantly higher prevalence of IgG in MS patients (n = 72, 43%) compared to HCs (n = 8, 20%, p < 0.01). Specifically, elevated anti-FVIIa (n = 19, 11.4%, mean activity p < 0.0001), anti-FXII (n = 12, 7.2%, mean activity p < 0.001) and anti-plasmin (n = 20, 12%, mean activity p < 0.01) levels were observed in patients compared to controls. Additionally, the highest scores of clinical characteristics like the expanded disability status scale and MS severity score were linked with IgG seropositivity against thrombin, whilst anti-FXII levels corresponded with the lowest disease progression.

CONCLUSION: The findings of our study illustrate the presence of antibodies against serine proteases of the coagulation cascade in MS and demonstrate the association of antibody activity with disease progression. In particular, thrombin IgG seropositivity was demonstrated to be associated with worse outcomes and a severe disease phenotype. These observations suggest the implication of antibodies in patient monitoring and prognosis, and further evaluation may elucidate inflammatory cascades in which antibodies act as key mediators.

PMID:35417817 | DOI:10.1016/j.msard.2022.103775

Transl Oncol. 2022 Apr 10;20:101410. doi: 10.1016/j.tranon.2022.101410. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate the effect of demographic characteristics and disease stage on the survival outcomes of patients with myoepithelial carcinoma (MECA) of the salivary glands, and to assess the role of radiotherapy in these patients.

METHODS: The Epidemiology, Surveillance and End Results database was queried from 2000 to 2018 to identify patients with MECA. Data pertaining to the tumor stage, size, histological grade, and demographic characteristics were analyzed. The relationship between clinicopathological features and overall survival (OS) was assessed using statistical analyses.

RESULTS: In total, 290 patients (137 men and 153 women) were identified. The parotid gland was the most common tumor location (76.6% patients). Approximately half of the patients had locally advanced tumors, and 14.5 and 6.6% had lymph node and distant organ involvement, respectively. The median OS was 142 months, while the survival rates at 120 months and 180 months were 53% and 39%, respectively. In the cohort, 160 patients (55.2%) underwent surgery alone, while 130 patients (44.8%) underwent surgery combined with radiotherapy. Multivariate Cox analysis revealed that histopathological grade, stage, T3 stage (hazard ratio [HR]: 2.47, P = 0.039), T4 stage (HR: 3.33, P = 0.011), N2 stage (HR: 6.59, P = 0.002), and M1 stage (HR: 2.72, 95%confidence interval [CI]: 1.03-7.19; P = 0.044) were associated with poor prognosis. Radiotherapy (HR: 0.58, P = 0.042) was a favorable factor for OS, and it reduced the mortality risk by 42%.

CONCLUSIONS: Histological grade, stage, and radiotherapy are independent risk factors for OS. The decision to administer chemotherapy for MECA should be made with caution. Adjuvant radiotherapy is recommended in high-risk patients.

PMID:35417814 | DOI:10.1016/j.tranon.2022.101410

Pathol Res Pract. 2022 Apr 6;233:153888. doi: 10.1016/j.prp.2022.153888. Online ahead of print.

ABSTRACT

BACKGROUND: High endothelial venules (HEVs) are vessels specialized in the transport of lymphocytes shown to be implicated in various forms of cancer. They express peripheral node addressin (specifically recognized by the MECA-79 antibody). MECA-79 is also implicated in pregnancy through its expression by epithelial cells of the endometrium. However, the expression of MECA-79 by endothelial or epithelial (cancer) cells has never been studied in endometrial cancer.

MATERIAL AND METHODS: In this retrospective study, we investigated the immunohistochemical expression of MECA-79 in 40 endometrioid adenocarcinoma hysterectomy specimens and compared it with its expression in 30 non-cancer hysterectomies.

RESULTS: HEVs were found in 22% of tumor specimens and in none of the non-cancer hysterectomies (p = 0.005) and were positively associated with higher grade tumors (p = 0.04). MECA-70 was expressed in tumor cells of 70% of carcinomas and in epithelial cells of 46.6% of normal endometria (p = 0.04). It was inversely associated with parametrial invasion (p = 0.03) and larger tumors (statistical trend of p = 0.07). MECA-79 expression was not associated with overall or progression-free survival.

CONCLUSION: MECA-79 is found in HEVs and tumor cells in endometrial endometrioid adenocarcinoma.

PMID:35417805 | DOI:10.1016/j.prp.2022.153888

Mar Pollut Bull. 2022 Apr 10;178:113634. doi: 10.1016/j.marpolbul.2022.113634. Online ahead of print.

ABSTRACT

The groundwater salinization is a global problem that degrades water quality and endangers sustainable use of water resources, particularly in coastal areas. In this paper, 24 water samples were collected from 12 monitoring wells during the dry (January) and wet (June) seasons for analyzing the salinization and hydrogeochemical characteristics of groundwater in Dongshan Island of China through combined hydrogeochemical and multivariate statistical approaches. Results showed that groundwater in the study area is primarily Cl-Na and followed by Cl-Ca·Mg type in the dry season, Cl-Na and followed by Cl-Ca·Mg and HOC₃·Cl-Na type in the wet season. The groundwater chemistry is predominantly controlled by carbonate, gypsum, and silicate dissolution. However, some areas are strongly influenced by seawater intrusion, sewage infiltration and reverse ion exchange process. Around 40% of water samples from the dry season and 50% from the wet season are at injuriously, highly and severely saline levels while other samples at slightly and moderately saline levels, suggesting that groundwater in the area is partially recharged by seawater. Furthermore, the NO₃^–/Cl^– versus Cl^– diagram and principal component analysis (PCA) indicated nitrate pollution in groundwater that is subjected to anthropogenic activities such as domestic sewage, agricultural and industrial practices, which lead to degradation of groundwater quality in the area. The findings of this study provide helpful insights for understanding the genesis and hydrogeochemical evolution of groundwater in those coastal areas.

PMID:35417808 | DOI:10.1016/j.marpolbul.2022.113634

J Equine Vet Sci. 2022 Apr 10:103947. doi: 10.1016/j.jevs.2022.103947. Online ahead of print.

ABSTRACT

OBJECTIVE: Although equine strangles is reportable in all states, synchronous reporting of this disease does not occur across the country. States have variable regulations on reporting (actionable, notifiable, and monitored) and no mandatory comprehensive databases exist for tracking prevalence. In this study, we solicited veterinarians’ opinions on reporting of strangles and factors influencing their opinion.

SAMPLES: 250 veterinarians practicing within the United States PROCEDURES: A structured survey was administered online.

RESULTS: A total of 250 veterinarians participated: 84 participants (34%) believed that strangles should continue to be nationally monitored and that individual states should have jurisdiction over laboratory confirmed positive cases; 58 (23.2%) believed strangles should become nationally monitored with mandatory notification of positive cases to a central forum; 24 participants (9.6%) thought strangles should become notifiable nationally; and 44 (17.6%) thought strangles should become notifiable and actionable. While not quite achieving statistical significance, we noted that there was a large effect of currently reporting strangles on the desire for increased reporting (87% more likely, P = 0.054), as did veterinarians who ranked strangles as “very important” or “important” relative to other infectious disease (OR 3.77, P = 0.037). Veterinarians practicing in the Southwest (P=0.01) and West (P = 0.04) were significantly less likely than northeast practitioners to rank strangles of higher importance.

CLINICAL RELEVANCE: Opinions on equine strangles and desire for increased reporting were varied in the sampled veterinary community. Information obtained in this study regarding veterinarians’ current views on strangles reporting could inform future policy regarding the disease.

PMID:35417769 | DOI:10.1016/j.jevs.2022.103947