Tag: statistics

Ann Ital Chir. 2022;93:584-591.

ABSTRACT

AIM: The traditional treatment for appendiceal cancer with peritoneal spread is cytoreductive surgery (CRS) but added HİPEC chemotherapy to cytoreductive surgery and has shown that it improves overall survival. The aim of this study was to report the results of CRS and HIPEC treated patients with appendiceal cancers which is based on the experience of at Surgical oncology department.

MATERIAL-METHOD: Ankara University School of Medicine, Deparment of Surgical Oncology. The data of patients who underwent CRS + HIPEC for appendiceal cancer between January 2008 – January 2019 was retrospectively analysed. 40 patients who underwent CRS + HIPEC were evaluated retrospectively. Patients with unresectable liver metastasis, large retroperitoneal tumor, tumoral infiltration in the intestinal mesentery and liver hilum were excluded from the study.

RESULTS: The mean (±sd) PCI was 17.98 (±8.21). Twenty six patients’s completeness of cytoreduction score was 0(65.0%), 10(25.0%) CCS-1, 3(7.5%) CCS-2 and 1(2.5%) CCS-3. There was statistically significant difference with prognosis between ccr score, ASA, lymphovascular invasion, PCI score, albumin categories.

CONCLUSIONS: In selected patients survival can be increased. However, it is thought that cytoreductive surgery should be performed even if completeness of cytoreduction score is two. In our study we represent that >17PCI patients could be managed by CRS/HIPEC if the CC score ≤2 can be reached. Our results suggest that the CRS/HIPEC procedure can improve the benefits of larger patient group and provides longer survival.

KEY WORDS: Appendiceal Neoplasms, Cytoreductive Surgery, Hyperthermic Intraperitoneal Chemotherapy.

PMID:36254768

Multivariate Behav Res. 2022 Oct 18:1-17. doi: 10.1080/00273171.2022.2115965. Online ahead of print.

ABSTRACT

Network meta-analysis is an extension of standard meta-analysis. It allows researchers to build a network of evidence to compare multiple interventions that may have not been compared directly in existing publications. With a Bayesian approach, network meta-analysis can be used to obtain a posterior probability distribution of all the relative treatment effects, which allows for the estimation of relative treatment effects to quantify the uncertainty of parameter estimates, and to rank all the treatments in the network. Ranking treatments using both direct and indirect evidence can provide guidance to policy makers and clinicians for making decisions. The purpose of this paper is to introduce fundamental concepts of Bayesian network meta-analysis (BNMA) to researchers in psychology and social sciences. We discuss several essential concepts of BNMA, including the assumptions of homogeneity and consistency, the fixed and random effects models, prior specification, and model fit evaluation strategies, while pointing out some issues and areas where researchers should use caution in the application of BNMA. Additionally, using an automated R package, we provide a step-by-step demonstration on how to conduct and report the findings of BNMA with a real dataset of psychological interventions extracted from PubMed.

PMID:36254763 | DOI:10.1080/00273171.2022.2115965

Ann Ital Chir. 2022;93:578-583.

ABSTRACT

AIM: To evalue the short-term results obtained in endovenous laser ablation (EVLA) procedure of the varicose insufficiency of the lower limbs with Diode 1470 μm laser compared to Diode 1940 μm laser.

MATERIALS OF STUDY: A total of 55 patients were enrolled in the study. The patients were divided into two groups: those subjected to 1470 μm laser treatment in group A and those with 1940 μm laser treatment in group B. The endpoints were: Closure of the target vessel, complications and post-operative pain.

RESULTS: There are no intra-and post-operative complications. The occlusion rate of the target veins was 100% at 7- and 60-day controls. The pain perceived in the immediate post-operative and at the controls showed no statistically significant differences between the two groups. However in group B it was necessary to apply lower values of Power (W) and Linear Energy Density (LEED) with a statistically significant difference compared to group A.

DISCUSSION: Short-term results demonstrate closure rates comparable to those obtained with 1470 μm lasers. There were no statistically significant differences in the two groups in terms of primary and secondary endpoints. The advantage of using 1940 μm laser technology is that it is possible to dispense a lower linear energy density (LEED) at a lower power (Watt).

CONCLUSIONS: Endovenous laser ablation with Diode 1940 μm is particularly suitable and advantageous in the treatment of superficial and small vessels, as well as venous segment adjacent to nerve structures.

KEY WORDS: Diode laser, Intravenous ablation, Varicose, Venous insufficiency, Veins.

PMID:36254762

Ann Ital Chir. 2022;93:529-535.

ABSTRACT

OBJECTIVE: This study was designed to compare the incidence of nursing related complications in patients undergoing coronary intervention through either the radial or femoral artery and to analyze the advantages and disadvantages of the two nursing approaches.

METHODS: Between September 2012 and June 2017, 360 patients underwent coronary intervention in radiology department and were enrolled in this study, 196 of these patients being assigned to the radial artery group and 164 of them to the femoral artery group. The postoperative adverse reactions and complications in these two groups were observed and recorded, and the results of the two groups were compared using a chi-square test and logistic regression.

RESULTS: The incidences of limb pain, restlessness and insomnia, low back pain, urine retention, bleeding and subcutaneous hematoma were significantly lower in the radial artery group than in the femoral artery group, but the rate of shifting approach or giving-up intervention due to artery spasm or deformity was significantly higher than that in the femoral artery group. However, the differences in the incidence of aneurysms and compartment syndrome between the two groups were not statistically significant.

CONCLUSIONS: Compared with the femoral artery approach, the radial artery approach results in less trauma, fewer complications, and shorter bed rest time. It also puts less psychological pressure on patients, and is more easily accepted by them. Finally, it means simpler nursing, and, thus, it should be widely promoted.

KEY WORDS: Complications, Coronary intervention, Femoral artery, Nursing, Radial artery.

PMID:36254760

J Atten Disord. 2022 Oct 18:10870547221130113. doi: 10.1177/10870547221130113. Online ahead of print.

ABSTRACT

OBJECTIVE: ADHD is associated with increased sleep problems and circadian rhythm disturbances. This study aimed to examine ADHD patients and healthy controls in terms of chronotypic features and expression levels of CLOCK, PER1, lncRNA HULC, lncRNA UCA1.

METHOD: Eighty-three children were included (43 ADHD). Conner’s Parent Rating Scale-Revised Short Form, Childhood Chronotype Questionnaire, Children’s Sleep Disorders Scale were administered. Gene expression levels were studied from peripheral blood.

RESULTS: Evening chronotype, sleep initiation/maintenance disorder, sleep-wake transition disorder, excessive sleepiness disorder were higher in the ADHD group compared to the controls in the scales reported by the parents. Expression levels of all examined genes were statistically significantly higher in the ADHD group. There was no significant relationship between genes and sleep parameters in the ADHD group.

CONCLUSION: Our study provides the first evidence that lncRNA HULC and lncRNA UCA1 might have a role in the etiology of ADHD.

PMID:36254757 | DOI:10.1177/10870547221130113

Pediatr Pulmonol. 2022 Oct 18. doi: 10.1002/ppul.26184. Online ahead of print.

ABSTRACT

RATIONALE: Children contribute to 5% of COVID-19-related hospitalizations in the United States. There is mounting evidence suggesting childhood asthma is a risk factor for severe disease. We hypothesized that asthma is associated with longer length of stay (LOS) and need for respiratory support among children admitted to pediatric intensive care unit (PICU) with COVID-19.

METHODS: We reviewed 150 charts of children and young adults with a positive SARS CoV2 PCR test admitted to the PICU at Children’s National Hospital, Washington, DC between 2020 and 2021. We recorded demographics, anthropometrics, past medical history, clinical course, laboratory findings, imaging, medication usage, respiratory support, and outcomes. Functional Status Scale (FSS), that measures an ICU patient’s physical function, was used to characterize children with multiple co-morbidities; FSS and obesity were included as covariates in multivariate analysis. Statistical analysis was performed using SPSS v25.0.

RESULTS: Sixty-Eight patients ages 0-21 years met inclusion criteria. Median age was 14.9 years, 55.9% were female, median BMI percentile was 62, and 42.6% were African American. Compared to those without asthma, patients with asthma averaged longer LOS (20.7 vs. 10.2 days, p=0.02), with longer PICU stay (15.9 vs. 7.6 days, p=0.033) and prolonged maximum respiratory support (8.3 vs. 3.3 days, p=0.016). Adjusted for obesity and poor physical function (FSS>6), asthma remained a significant predictor of hospital LOS, PICU LOS, and days on maximum respiratory support.

CONCLUSION: Asthma can cause severe disease with prolonged need for maximum respiratory support among children with COVID-19. This article is protected by copyright. All rights reserved.

PMID:36254734 | DOI:10.1002/ppul.26184

Hypertension. 2022 Oct 18. doi: 10.1161/HYPERTENSIONAHA.122.20048. Online ahead of print.

ABSTRACT

BACKGROUND: Endovascular renal denervation reduces blood pressure (BP). We explored an alternative approach to renal denervation using radiofrequency energy delivered across the renal pelvis utilizing the natural orifice of the urethra and the ureters.

METHODS: This open-label, single-arm feasibility study enrolled patients with uncontrolled hypertension despite antihypertensive drug therapy. The primary effectiveness endpoint was the change in ambulatory daytime systolic BP (SBP) 2 months following renal pelvic denervation.

RESULTS: The 18 patients (mean age 56±12 years) enrolled were taking an average of 2.7 antihypertensive drugs daily. Renal pelvic denervation reduced mean daytime SBP by 19.4 mm Hg (95% CI, -24.9 to -14.0, P<0.001) from its baseline of 148.4±8.7 mm Hg. Mean nighttime (-21.4 mm Hg [95% CI, -29.5 to -13.3]) and 24-hour (-20.3 mm Hg [95% CI, -26.2 to -14.5]) SBP each fell significantly (P<0.001) as did the corresponding diastolic BPs (P<0.001). Office SBP decreased from 156.5±12.3 mm Hg to 22.4 mm Hg (95% CI, -31.5 to -13.3, P<0.001) by 2 months. Office SBP decreased over time (P=0.001 by linear trend test) starting by day 1 with a decrease of 8.3 mm Hg (95% CI, -16.9 to 0.3, P=0.057). There were no serious adverse events. Mild transitory back pain followed the procedure. Serum creatinine decreased by 0.08 mg/dL (P=0.02) and estimated glomerular filtration rate increased by 7.2 mL/min/1.73m² (P=0.03) 2 months following ablation procedure.

CONCLUSIONS: Based on these initial findings, a well-powered, sham-controlled trial of renal pelvic denervation to more fully establish its safety and effectiveness is now justified in patients with uncontrolled hypertension despite drug therapy.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT05440513.

PMID:36254733 | DOI:10.1161/HYPERTENSIONAHA.122.20048

Circulation. 2022 Oct 18:101161CIRCULATIONAHA122059606. doi: 10.1161/CIRCULATIONAHA.122.059606. Online ahead of print.

ABSTRACT

BACKGROUND: A clear patency benefit of a drug-eluting stent (DES) over a bare metal stent (BMS) for treating peripheral artery disease of the femoropopliteal segment has not been definitively demonstrated. The EMINENT study (Trial Comparing Eluvia Versus Bare Metal Stent in Treatment of Superficial Femoral and/or Proximal Popliteal Artery) was designed to evaluate the patency of the Eluvia DES (Boston Scientific, Marlborough, MA), a polymer-coated paclitaxel-eluting stent, compared with BMS for the treatment of femoropopliteal artery lesions.

METHODS: EMINENT is a prospective, randomized, controlled, multicenter European study with blinded participants and outcome assessment. Patients with symptomatic peripheral artery disease (Rutherford category 2, 3, or 4) of the native superficial femoral artery or proximal popliteal artery with stenosis ≥70%, vessel diameter of 4 to 6 mm, and total lesion length of 30 to 210 mm were randomly assigned 2:1 to treatment with DES or BMS. The primary effectiveness outcome was primary patency at 12 months, defined as independent core laboratory-assessed duplex ultrasound peak systolic velocity ratio ≤2.4 in the absence of clinically driven target lesion revascularization or surgical bypass of the target lesion. Primary sustained clinical improvement was a secondary outcome defined as a decrease in Rutherford classification of ≥1 categories compared with baseline without a repeat velocity ratio ≤2.4 in the absence of clinically driven target lesion revascularization. Health-related quality of life and walking function were assessed.

RESULTS: A total of 775 patients were randomly assigned to treatment with DES (n=508) or commercially available BMS (n=267). Baseline clinical, demographic, and lesion characteristics were similar between the study groups. Mean lesion length was 75.6±50.3 and 72.2±47.0 mm in the DES and BMS groups, respectively. The 12-month incidence of primary patency for DES treatment (83.2% [337 of 405]) was significantly greater than for BMS (74.3% [165 of 222]; P<0.01). Incidence of primary sustained clinical improvement was greater among patients treated with the DES than among those who received a BMS (83.0% versus 76.6%; P=0.045). The health-related quality of life dimensions of mobility and pain/discomfort improved for the majority of patients in both groups (for 66.4% and 53.6% of DES-treated and for 64.2% and 58.1% of BMS-treated patients, respectively) but did not differ significantly. At 12 months, no statistical difference was observed in all-cause mortality between patients treated with the DES or BMS (2.7% [13 of 474] versus 1.1% [3 of 263]; relative risk, 2.4 [95% CI, 0.69-8.36]; P=0.15).

CONCLUSIONS: By demonstrating superior 1-year primary patency, the results of the EMINENT randomized study support the benefit of using a polymer-based paclitaxel-eluting stent as a first-line stent-based intervention for patients with symptomatic peripheral artery disease attributable to femoropopliteal disease.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT02921230.

PMID:36254728 | DOI:10.1161/CIRCULATIONAHA.122.059606

Australas J Ageing. 2022 Oct 18. doi: 10.1111/ajag.13140. Online ahead of print.

ABSTRACT

OBJECTIVES: It is well known that there are associations between overall health, age, socioeconomic status and rural residency. The objective of this study was to determine the distribution of Australia’s aged population by socioeconomic status, as well as remoteness.

METHODS: The study employed the Australian Statistical Geography Standard (Statistical Area Level 1 and Remoteness Areas). The database of the geographic boundaries was integrated into the ageing population and socioeconomic data using the Geographic Information System. The socioeconomic data was analysed through the Index of Relative Socioeconomic Disadvantage.

RESULTS: Over a decade, the older population in Australia has increased noticeably. In 2016, there was a high percentage of older people (≥65 years) in Tasmania (Tas), 19%, while the lowest percentage was recorded in the Northern Territory (NT), 7%. Across the country, Tasmania had the highest percentage of older citizens living in the most disadvantaged areas since 2006, with 48% recorded in 2016. There was an association between the remoteness areas and the education and income levels of the ageing cohort. However, this association differed between the states and territories. This socioeconomic gap becomes more evident in the very remote areas of the country.

CONCLUSIONS: The ageing population in Australia is increasing rapidly; this was associated with an evolving socioeconomic disparity among this ageing society. Our results demonstrated that socioeconomic inequalities were to be found among the older people based on their distribution over the remoteness areas in Australia. This information should be used to target healthcare and ageing policies that meet the specific needs of older people.

PMID:36254700 | DOI:10.1111/ajag.13140

Palliat Support Care. 2022 Oct 18:1-10. doi: 10.1017/S1478951522001237. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the spiritual care needs and their attributes among Chinese elders hospitalized for severe chronic heart failure (CHF) based on the Kano model, in order to provide a reference for improving the quality and satisfaction of spiritual care.

METHODS: An observational design was implemented, and the STROBE Checklist was used to ensure quality reporting of the study. The demographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale, and the Kano model-based Nurse Spiritual Therapeutics Attributes Scale were used. A convenience sample of 451 patients were selected from 2 hospitals. Descriptive statistics, and Kano model were used to analyze the data.

RESULTS: The total score of spiritual care needs was 29.95 ± 7.51. Among the 12 items, 3 items were attractive attributes, all of which were located in Reserving Zone IV; 5 items were one-dimensional attributes, of which 3 were located in Predominance Zone I and 2 were located in Improving Zone II; 2 items were must-be attributes, all of which were located in Improving Zone II; and 2 items were indifference attributes, all of which were located in Secondary Improving Zone III.

SIGNIFICANCE OF RESULTS: The spiritual care needs among Chinese elders hospitalized for severe CHF were moderate. The must-be and one-dimensional attributes mainly focus on “creating a good atmosphere” and “sharing self-perception” dimensions, while attractive attributes mainly focus on “sharing self-perception” and “helping thinking” dimensions. It is suggested that hospital authority should develop and innovate attractive attributes on the basis of maintaining and perfecting must-be and one-dimensional attributes, and objectively analyze and optimize indifference attributes.

PMID:36254699 | DOI:10.1017/S1478951522001237