Tag: statistics

Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6572-6577. doi: 10.26355/eurrev_202209_29756.

ABSTRACT

OBJECTIVE: Varicocele is the abnormal enlargement of the pampiniform plexus in the scrotum and is one of the diseases that have negative consequences on reproduction in men today. The aim of this study is to investigate the pathophysiological role of inflammatory parameters in patients diagnosed with varicocele.

PATIENTS AND METHODS: Patients who applied to Viransehir state hospital urology outpatient clinic between January 2016 and January 2022 were evaluated retrospectively. Among the patients whose varicocele diagnosis was evaluated by physical examination, 112 patients diagnosed with Grade III varicocele were included in the study. Obtained hemogram results [red blood cell, red cell distribution width (RDW), mean red cell volume, white blood cell, hematocrit, hemoglobin, mean hemoglobin amount, platelet, platelet distribution width (PDW), neutrophil, lymphocyte, monocytes, and mean platelet volume (MPV)] were compared with the control group values.

RESULTS: There was no statistical difference between the two groups in terms of mean age (p=0.270). Statistically significant parameters between both groups were erythrocyte (p=0.011), MCV (p=0.028), RDW (p=0.018), and PDW (p=0.004), respectively. However, Neutrophil/Lymphocyte ratio (NLR), PLT/Lymphocyte ratio (PLR) and MPV/PLT ratio (MPVPR) values were found to be statistically significantly higher in the varicocele group (p=0.034, p=0.043 and p=0.045, respectively).

CONCLUSIONS: According to our results, it is possible to recommend using the inflammatory parameters as markers to screen for the pathophysiological basis of varicocele.

PMID:36196706 | DOI:10.26355/eurrev_202209_29756

Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6561-6568. doi: 10.26355/eurrev_202209_29754.

ABSTRACT

OBJECTIVE: This study aimed at assessing whether the dental and medical practitioners in Saudi Arabia are aware of the smoking cessation smartphone applications and their opinions about this method used in smoking cessation.

MATERIALS AND METHODS: A self-reporting questionnaire was designed to assess the level of knowledge and awareness among the dental and medical practitioners regarding the smartphone mobile applications for smoking cessation. The content of the questionnaire was validated and sent to individual physicians through email, WhatsApp, Twitter and other social media platforms, which also contained a consent form and explanation of the study. Responses were summarized using descriptive statistics by frequencies and percentages. A Chi-square test was used to observe the differences in opinions of smoking cessation apps between smokers and non-smokers among all the participants.

RESULTS: A total of 420 responses were obtained from the dental and medical professionals (291 males and 129 females) in different ranks. Among all the participants, 46.7% were in the age range of 30-40 years. The profession of the participants was divided into four groups and general dental practitioners are the most respondents compared to other practitioners. Among all the participants, 31% were smokers and the rest were non-smokers. Overall, 12.6% of participants and 20.8% of participants who were smokers were aware of the mobile applications which are used for smoking cessation.

CONCLUSIONS: The dental and medical practitioners in Saudi Arabia are not relatively acquainted with mobile apps for smoking cessation.

PMID:36196704 | DOI:10.26355/eurrev_202209_29754

Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6550-6560. doi: 10.26355/eurrev_202209_29753.

ABSTRACT

OBJECTIVE: The study aims to evaluate maxillary molars’ root and root canal morphology among the Saudi population using Cone-Beam Computed Tomography scanning (CBCT).

SUBJECTS AND METHODS: Retrospectively, the CBCT scans of 483 Saudi nationals were evaluated to identify the number of roots and root canals in maxillary first and second molars. The records were tabulated and classified according to Vertucci and a new system for root and canal classification given by Ahmed and Dummer. Fisher’s exact test was used to analyze the data statistically. To check for symmetry, comparisons were made between all the maxillary first molars (MFM’s) and maxillary second molars (MSM’s) on opposing quadrants. Inter Observer variability was seen using Cohen’s Kappa test.

RESULTS: MFM’s presented with three roots with Type II Vertucci canal configuration (VC) commonly seen among them. MSM’s had more variations in the number of roots and canals, although three roots and Type I VC were predominantly seen. When comparing the two genders statistically significant difference was observed in both maxillary molars at a 5% level using Fisher’s exact test. Three roots with four canals (3R4C) were predominantly observed in the MFM’s (85.6%) and three roots with three canals (3R3C) identified in 51.95% were more common than 3R4C (43.55%) in MSM’s. Both the maxillary molars bilaterally, exhibited a high percentage of symmetry in root and canal configurations.

CONCLUSIONS: Identification of root canal morphology of molars would reduce the chances of root canal failures by making sure all canals are obturated. This study provides supplemental information about the root canals of maxillary molars in a Saudi Arabian subpopulation.

PMID:36196703 | DOI:10.26355/eurrev_202209_29753

Int Endod J. 2022 Oct 5. doi: 10.1111/iej.13842. Online ahead of print.

ABSTRACT

AIM: To investigate the role of RAD54B in the proliferation of inflamed human dental pulp cells (hDPCs) induced by lipopolysaccharide (LPS).

METHODOLOGY: Normal, carious, and pulpitic human dental pulp tissues were collected. Total RNA was subjected to RNA-sequencing (seq) and gene expression profiles were studied by Gene Ontology (GO) and KEGG pathway analysis. Differentially expressed genes (DEGs) in homologous recombination repair (HRR) were validated with qRT-PCR. The expression of RAD54B and TNF-α in human dental pulp tissues was detected using immunohistochemistry. HDPCs were cultured and RAD54B level in hDPCs was detected after LPS stimulation using western blot. CCK-8 was used to investigate the proliferation of hDPCs transfected with negative control (Nc) small interfering RNA (siRNA), RAD54B siRNA, P53 siRNA or both siRNAs with or without LPS stimulation. Flow cytometry was used to detect the cell cycle distribution, and western blot and immunofluorescence were used to analyze the expression of RAD54B, P53 and P21 under the above treatments. One-way and two-way ANOVA followed by LSD posttest were used for statistical analysis.

RESULTS: RNA-seq results identified DEGs among the three groups. KEGG pathway analysis revealed enrichment of DEGs in the replication and repair pathway. HRR and non-homologous end joining (NHEJ) components were further verified and qRT-PCR results were basically consistent with the sequencing data. RAD54B, an HRR accessory factor highly expressed in carious and pulpitic tissues as compared to that in the normal pulps, was chosen as our gene of interest. High RAD54B expression was confirmed in inflamed human dental pulp tissues and LPS-stimulated hDPCs. Upon RAD54B knockdown, P53 and P21 expressions in hDPCs were upregulated whereas the proliferation was significantly downregulated, accompanied by increased G2/M phase arrest. After inhibiting P53 expression in RAD54B-knockdown hDPCs, P21 expression and cell proliferation were reversed.

CONCLUSIONS: Gene expression profiles of normal, carious and pulpitic human dental pulp tissues were revealed. HRR components was elucidated to function in dental pulp inflammation. Among the DEGs in HRR, RAD54B regulated the proliferation of inflamed hDPCs via P53/P21 signalling. This research deepens understanding of dental pulp inflammation and provides a new insight to clarify the underlying mechanisms.

PMID:36196684 | DOI:10.1111/iej.13842

Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6505-6511. doi: 10.26355/eurrev_202209_29749.

ABSTRACT

OBJECTIVE: The complicated gallbladder disorders are associated with increased mortality and morbidity. Thus, this study was aimed at evaluating the predictive value of immature granulocyte count and delta neutrophil index in the prediction of complicated cholecystitis.

PATIENTS AND METHODS: We retrospectively reviewed patients who underwent surgery for acute cholecystitis between January 2018 and April 2022. Overall, 351 patients fulfilling the inclusion criteria were included in the study. In all patients, demographic data, immature granulocyte count (IGC), delta neutrophil index (DNI), white blood cell (WBC) count, C-reactive protein (CRP), and albumin levels were recorded. Based on operative findings and histopathological examination, the patients were classified into 2 groups uncomplicated (group I) and complicated (e.g., perforation, gangrenous and emphysematous cholecystitis; group II) groups. The IBM SPSS version 26.0 (SPSS Corp, Armonk, NY, USA) was used to assess differences in blood parameters between groups. The predictive values of the parameters evaluated were estimated using ROC analysis. A p-value<0.05 was considered statistically significant.

RESULTS: Acute complicated cholecystitis was found in 138 of 351 patients. No significant difference was detected in age and gender distribution between groups (p=0.352 and p=0.214, respectively). When blood parameters were assessed, it was found that IGC, DNI, WBC, and CAR values were significantly higher in group II (p<0.001; p<0.001, p<0.001, and p=0.036, respectively), while there was no significant difference in CRP and albumin between groups (p=0.099 and p=0.53, respectively). In the ROC analysis, the highest AUC value was found for IG count and DNI (0.784 and 0.775, respectively). The sensitivity and specificity were found as 68.8% and 86.9% for IG count and 49.3% and 96.2% for DNI, respectively.

CONCLUSIONS: The IG count and DNI are two novel parameters with strong predictive value in the early diagnosis of acute complicated cholecystitis, which may support clinical findings, imaging studies, and other laboratory parameters.

PMID:36196699 | DOI:10.26355/eurrev_202209_29749

BJU Int. 2022 Oct 5. doi: 10.1111/bju.15913. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the incidence of ureteral injuries, clinical value of prophylactic ureteral stenting, and impact of intraoperative or postoperative detection of ureteral injuries in patients treated with gynecological or colorectal surgery.

METHODS: Multiple databases were searched for articles published before September 2021 according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Studies were deemed eligible if they evaluated the differences in the rate of ureteral injuries between laparoscopic and open surgery, prophylactic ureteral stenting or not, and those of final treatment success between intraoperative and postoperative detection in patients who underwent gynecological or colorectal surgery.

RESULTS: Overall, 46 studies were eligible for this meta-analysis. Compared to open surgery, laparoscopic hysterectomy was associated with a higher incidence of ureteral injuries (pooled odds ratio [OR]; 2.12, 95% confidence intervals [CI]; 1.71-2.62), but there was no statistically significant difference in colectomy (pooled OR; 0.89, 95% CI; 0.77-1.03). Prophylactic ureteral stenting was associated with a lower incidence of ureteral injuries during gynecological surgery (pooled OR; 0.61, 95%CI; 0.39-0.96). The number needed to perform ureteral stenting to prevent one ureteral injury was 224 in gynecological surgery. On the other hand, prophylactic ureteral stenting did not reduce the risk of ureteral injuries during colorectal surgery. Intraoperative detection of a ureteral injury was associated with a lower rate of complication management failure compared to postoperative detection (pooled OR; 0.22, 95%CI; 0.12-0.41).

CONCLUSIONS: Laparoscopic hysterectomy seems to be associated with a higher rate of ureteral injuries compared to an open approach. Prophylactic ureteral stenting seems to reduce this risk during gynecological surgery. Intraoperative detection of a ureteral injury during abdominal/pelvic surgery improves outcomes, suggesting the need for awareness and proactive problem identification. Further well-designed studies assessing the candidates who are more likely to benefit from prophylactic ureteral stenting including cost analysis are needed.

PMID:36196670 | DOI:10.1111/bju.15913

J Magn Reson Imaging. 2022 Oct 5. doi: 10.1002/jmri.28455. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic and hemodynamic alterations in metabolic syndrome (MetS) can cause a reduced myocardial energetic efficiency (MEE). Indexed MEE (MEEi), as a simple estimate of MEE, is emerging as a novel and useful imaging parameter.

PURPOSE: To investigate the impact of MetS on MEE and systolic myocardial strain and to assess any sex difference.

STUDY TYPE: Retrospective.

POPULATION: A total of 161 patients with MetS (female: n = 82, 52.2 ± 11.7 years; male: n = 79, 51.8 ± 10.6 years) and 77 healthy subjects (female: n = 46, 52.7 ± 8.2 years; male: n = 31, 54.1 ± 11.2 years). Patients with left ventricular (LV) ejection fraction <50% were excluded.

FIELD STRENGTH/SEQUENCE: A 3.0 T; balanced steady-state free precession sequence.

ASSESSMENT: LV volumes and mass (LVM) and global longitudinal strain (GLS) were obtained by MRI. Stroke volume (SV) divided by HR was used as a surrogate measure of MEE and normalized to LVM (MEEi).

STATISTICAL TESTS: Student’s t-test or Mann-Whitney U-test; Multivariable linear regression (coefficient of determination, R² ). P < 0.05 was considered statistically significant.

RESULTS: For both males and females, MEEi and GLS were lower in MetS patients than in the normal controls. Among MetS patients, men had significantly higher LVM (59.7 ± 13.4 g/m² vs. 48.8 ± 11.3 g/m² ) and significantly lower MEEi (0.68 ± 0.23 mL/g/s vs. 0.84 ± 0.23 mL/g/s) and GLS (-11.7% ± 2.8% vs. -13.9% ± 2.7%) than women. After adjustment for clinical variables, male gender (β = -0.291) was found to be inversely correlated with MEEi. Multivariable analysis showed that MEEi (β = 0.454) were independently associated with GLS (adjusted R² = 0.454) after adjustment for clinical and other MRI parameters.

DATA CONCLUSION: MEEi was significantly impaired in MetS without overt systolic dysfunction. There was a sex difference regarding the cardiac alterations in MetS, with men having significantly lower MEEi and GLS and significantly higher LVM than women. Further, MEEi was independently associated with GLS.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 3.

PMID:36196628 | DOI:10.1002/jmri.28455

J Clin Pharmacol. 2022 Oct 5. doi: 10.1002/jcph.2162. Online ahead of print.

ABSTRACT

Tacrolimus was frequently used in umbilical cord blood transplant (UCBT) pediatrics for prevention of graft-vs-host disease (GVHD). The aim of the present study was to evaluate the population pharmacokinetics (PPK) of tacrolimus among UCBT pediatrics and find potential influenced factors. A total of 275 concentrations from 13 pediatrics were used to build a PPK model using a non-linear mixed-effects modelling approach. The impact of demographic features, biological characteristics, and concomitant medications, including sex, age, body weight, postoperative day, white blood cell (WBC), red blood cell (RBC), hemoglobin (HB), platelet (PLT), hematocrit (HCT), urea nitrogen (BUN), creatinine (Cr), aspartate transaminase (AST), alanine transaminase (ALT), total bilirubin (TBil), albumin (ALB), and total protein (TP) were investigated. The pharmacokinetics of tacrolimus were best described by a one-compartment model with first- and zero-order mixed absorption and first order elimination. The clearance (CL) and volume of distribution (V) of tacrolimus were 1.93 L/h and 75.1 L, respectively. A covariate analysis identified that postoperative day and co-administration with trimethroprim-sulfamethoxazole (TMP-SMZ) were significant covariates influencing CL of tacrolimus. Frequent blood monitoring and dose adjustment might need with the prolongation of postoperative day and co-administration with TMP-SMZ. This article is protected by copyright. All rights reserved.

PMID:36196568 | DOI:10.1002/jcph.2162

Rev Esp Salud Publica. 2022 Oct 3;96:e202209075.

ABSTRACT

OBJECTIVE: Knowing the risk status of malnutrition and sarcopenia in institutionalized patients is essential to understand the current context after the impact of the coronavirus (COVID-19) pandemic.

METHODS: This research used a retrospective, observational study. The results of the Remote Malnutrition APP test (R-MAPP) are described: risk factors for malnutrition (including COVID-19), the Malnutrition Universal Screening Tool (MUST) and the SARC-F, in a selected sample of 402 residents of Castilla-La Mancha (Spain) during 2021. An inferential analysis was performed to determine which factors were related to the MUST (≥2 points) and SARC-F (≥4 points) response measures. With the factors that obtained statistical significance, a multivariate regression model was performed, adjusting for each one. of those factors.

RESULTS: Mean age was 84.2 years, 70.1% women. Most frequent risk factor for malnutrition was aging (85.1%). The mean body mass index was 26.5 (SD 11.6). MUST≥2 points was obtained in 16.2%, and a SARC-F≥4 in 69.9%. COPD (Chronic obstructive pulmonary disease / OR 0.35; 95% CI 0.13-0.92; p 0.03) was a protective factor against the risk of malnutrition. The risk of sarcopenia was related to aging (OR 8.16; 95% CI 4.13-16.20; p 0.00), COVID-19 (OR 1.96; 95% CI 1.17-3.29; p 0.01) and COPD (OR 2.44; 95% CI 1.21-4.89; p 0.01).

CONCLUSIONS: No relationship is found between COVID-19 and high risk of malnutrition. Aging, COVID-19 and COPD are risk factors for sarcopenia.

PMID:36196560

Rev Esp Salud Publica. 2022 Sep 29;96:e202209074.

ABSTRACT

Non-inferiority studies are increasingly more common for introducing new medicines in the market. Despite being situations where the use of this study design is justified, there is not a common analytical approach on how to conduct them. Pursuing a rigorous methodology, both in the study conduction and in its disseminations, is critical to ensure robust results to enable regulatory agencies and clinicians to reach valid conclusions and decisions which ultimately will benefit clinical practice. Most of the published reviews focus on the efficacy outcomes of non-inferiority clinical trials. We are unaware of other reviews that goes beyond and includes specific aspects for non-interventional designs and for studies focused on safety. Moreover, this review provides a simple and practical perspective with a minimum mathematical content on this complex type of studies.

PMID:36196559