Tag: statistics

Andrology. 2022 Apr 29. doi: 10.1111/andr.13194. Online ahead of print.

ABSTRACT

BACKGROUND: Nowadays pathogenesis of preeclampsia is still unknown. Among the different etiological hypotheses, some authors proposed that it might be due to an abnormal immunologic response to foreign fetal antigen derived from the father’s sperm. Indeed, the fetus is considered a semi allograft, being one half paternally derived in its antigenicity, and the first pathogenic insult of preeclampsia may be an abnormal maternal immune response towards this semi-allogenic implant. In the context of Artificial Reproductive Techniques, it has been shown that the use of donor and surgically retrieved spermatozoa (e.g. Testicular Sperm Extraction) increases the risk of preeclampsia, confirming the protective effect of sperm exposure on maternal complications.

OBJECTIVE: Determining whether the lack of exposure to sperm antigens is associated with worse maternal and neonatal outcomes in pregnancies obtained through intracytoplasmic sperm injection after testicular sperm extraction for obstructive azoospermia.

MATERIAL AND METHODS: This is a single-center case-control retrospective study, focusing on all first pregnancies obtained through intracytoplasmic sperm injection after testicular sperm extraction for obstructive azoospermia at Humanitas Fertility Center between January 1st, 2010 and December 31st, 2019. Controls included patients that achieved their first pregnancy with intracytoplasmic sperm injection and ejaculated sperm, for a diagnosis other than azoospermia, in the same time period. Cases were matched with controls in a 1:2 ratio, considering female age, female BMI and year of controlled ovarian stimulation. The primary outcome measure was the delivery rate, defined as the number of deliveries divided by the total number of clinical pregnancies. Secondary outcome measures focused on maternal and neonatal complications, such as miscarriage rate, rate of main obstetric complications, prematurity rate and rate of congenital malformations.

RESULTS: By analyzing overall 113 pregnancies among cases and 214 pregnancies among controls, this study showed that the delivery rate was higher in controls with respect to cases (92.06% vs 84.07%, p = 0.026); among deliveries, live births were respectively 98.95% and 100%, while only one stillbirth occurred in cases. The first trimester miscarriage rate was higher in the cases than controls (13.27% vs 6.07%, p = 0.027), while no difference was found among rate of second trimester miscarriages, therapeutic abortions and ectopic pregnancies. There was no difference regarding the rate of maternal complications, including gestational hypertension, preeclampsia, HELLP syndrome, gestational diabetes, placenta previa, placental abruption and premature rupture of the membranes. Considering neonatal complications, it was shown that twins belonging to controls had a higher prematurity rate with respect to cases (65.79% vs 50.00%) but without a statistical relevance. Lastly, the rate of congenital malformations did not differ among the two groups.

DISCUSSION: This study showed that, once couples diagnosed with obstructive azoospermia achieve a pregnancy, they have a much higher risk of miscarriage in the first trimester in respect to non-azoospermic patients. Moreover, controls had a higher delivery rate in respect to cases; however, when the fetal status at birth was compared, no difference was found between live births and stillbirths.

CONCLUSIONS: Differently from the findings in the literature, no association with preeclampsia was found. This might be related to a collider bias/left truncation bias: since azoospermic patients are at higher risk of early termination of pregnancy, it results that they do not have the possibility to develop preeclampsia and other adverse outcomes. This article is protected by copyright. All rights reserved.

PMID:35485252 | DOI:10.1111/andr.13194

Nurs Open. 2022 Apr 29. doi: 10.1002/nop2.1222. Online ahead of print.

ABSTRACT

AIM: To evaluate the effects of a person-centred and thriving-promoting intervention on nursing home residents´ experiences of thriving and person-centredness of the environment, and to evaluate if the effects varied between female and male residents.

DESIGN: A multi-centre, non-equivalent controlled group before-after intervention design.

METHODS: Six nursing homes in Australia, Norway and Sweden were allocated to either intervention or control group. The intervention comprised a staff educational programme. A survey using proxy-ratings by staff was administered before (T0), immediately after (T1) and six months after (T2) the intervention. The sample varied between 205 and 292 residents. Linear regression models were used to explore effects.

RESULTS: Statistically significant effects were found on experiences of thriving and person-centredness of the environment. These effects were significant for male residents but not for female residents. The results emphasize the importance of individually tailored social and recreational activities.

PMID:35485234 | DOI:10.1002/nop2.1222

Int J Dent Hyg. 2022 Apr 29. doi: 10.1111/idh.12594. Online ahead of print.

ABSTRACT

BACKGROUND: Nicotine replacement therapy is the first choice pharmacotherapy for smoking cessation. Oral side effects caused due to NRT lead to discontinuation of treatment. The objective of this meta-analysis is to look for the certainty of evidence on the number of patients that reported oral side effects due to the use of NRT.

METHOD: Eligible studies were selected and data extraction was carried out independently into a pre-tested data extraction form. Risk of Bias was assessed using Cochrane Tool. The heterogeneity between the studies was assessed using Chi-square and I2 tests. Mean difference and Odds ratio at 95% confidence interval were the effect estimates. GRADE working group approach was used to assess the quality of evidence.

RESULTS: 28 studies were included with moderate to low risk of Bias. The pooled estimates revealed a statistically significant number of patients developed mouth or throat irritation (2.54[1.23,5.25]), or oral soreness (2.22[1.40,3.55]) or gastric reflux or vomiting (1.97[1.34,2.90]) due to NRT.

CONCLUSION: It is important to understand that significant implications are caused due to NRT, on oral health. All patients on NRT must adhere to their regular dentist visits and must check their oral mucosa before initiating NRT.

PMID:35485245 | DOI:10.1111/idh.12594

Otolaryngol Pol. 2021 Dec 22;76(2):34-41. doi: 10.5604/01.3001.0015.6495.

ABSTRACT

<b> Aim:</b> The aim of the study was to analyze the impact of the COVID-19 pandemic and the related change of the teaching mode from stationary to distance learning on the severity of voice-related ailments among teachers. </br></br> <b> Materials and methods:</b> A questionnaire survey of teachers was conducted to assess voice disorders during stationary and remote work using the Vocal Tract Discomfort (VTDs) scale and Numeric Rating Scale (NRS), and the respondents’ subjective feelings were assessed. Demographic and environmental factors associated with voice work were examined. Data on sickness absence, which were obtained from the “Health Needs Maps 2020” Ministry of Health’s, were also analyzed. Responses were subjected to statistical analysis. A P-value level below 0.05 was considered statistically significant. </br></br> <b>Results:</b> 128 teachers participated in the survey. The overall assessment of voice disorders using VTDs and NRS scales showed no statistically significant differences for complaints between stationary and remote work. Detailed analysis revealed more se-vere voice disorders in teachers working more than 6 months remotely (P = 0.049) and having more than 20 lessons per week (P = 0.012). Subjective assessment confirmed a significantly lower percentage of teachers reporting voice disorders when wor-king remotely compared to stationary (P = 0.043). This resulted in less sickness absence and a 40% decrease in sick leave related to voice disorders in 2020 compared to 2019. </br></br> <b>Conclusions:</b> During the remote learning period of the COVID-19 pandemic, teachers reported lower severity of voice disor-ders and this influenced the reduction of sickness absences. There were no statistically significant differences in voice complaints as assessed by VTDs and NRS scales for both teaching modes. Several factors affecting the severity of vocal tract disorders were identified – the number of class hours per week (>20) for stationary teaching and a long period of remote teaching (>6 months).

PMID:35485225 | DOI:10.5604/01.3001.0015.6495

Otolaryngol Pol. 2022 Jan 14;76(2):7-14. doi: 10.5604/01.3001.0015.6959.

ABSTRACT

<br><b>Introduction:</b>The International Frontal Sinus Anatomy Classification (IFAC) is a consensus document created to standardize and specify the naming of cells within the region of the frontal recess and frontal sinus.</br> <br><b>Aim:</b> The aim of this study was to analyze the difficulties in identifying cells according to the IFAC in patients with diffuse primary chronic rhinosinusitis.</br> <br><b>Material and methods:</b> Three independent reviewers examined triplanar computed tomography (CT) scans to assess the anatomy of the frontal recess using the IFAC system. CT scans were chosen randomly and divided into 3 groups: CT scans of patients not presenting sinus complaints (control group), CT scans of patients affected by diffuse primary chronic rhinosinusitis non-type 2, and CT scans of patients affected by diffuse primary chronic rhinosinusitis type 2.</br> <br><b>Results:</b> Identification of all frontal cell types was accurate in patients not presenting sinus complaints (P-value < 0.05). Patients scoring 9 or more points in the Lund-Mackay scoring system demonstrated a statistically increased risk of improper identification of frontal recess cells (P-value < 0.0001).</br> <br><b>Conclusions:</b> Due to a large number of possible anatomical variants and changes caused by the chronic inflammatory disease, the IFAC nomenclatura is easier to apply to non-type 2 primary diffuse CRS patients with low scores in the L-M score scale than to primary diffuse type 2 CRS patients with higher M-L scores.</br&gt.

PMID:35485224 | DOI:10.5604/01.3001.0015.6959

Expert Rev Clin Pharmacol. 2022 Apr 29. doi: 10.1080/17512433.2022.2072292. Online ahead of print.

ABSTRACT

BACKGROUND: Several studies have reported an association between perinatal complications and the severity of the hypertensive disease. The increasing number of pregnancies complicated by hypertension and the small assurance about the perinatal effects of hypertensive drug use during pregnancy involves the need of studying the better management of hypertensive mothers.

OBJECTIVE: To evaluate the association between maternal use of antihypertensive drugs and maternal and neonatal outcomes in women with chronic hypertension.

STUDY DESIGN: We conducted a population-based study including all deliveries of hypertensive women that occurred between 2007-2017 in the Lombardy region, Italy. We evaluated the risk of several maternal and neonatal outcomes among women who filled antihypertensive prescriptions within the 20th week of gestation. Propensity score stratification was used to account for key potential confounders.

RESULTS: Out of 5,553 pregnancies, 2,138 were exposed to antihypertensive treatment. With respect to no-users, users of antihypertensive drugs showed an increased risk of preeclampsia (RR:1.68, 95%CI:1.42-1.99), low birth weight (1.30,1.14-1.48), and preterm birth (1.25,1.11-1.42). These results were consistent in a range of sensitivity and subgroup analyses.

CONCLUSION: Early exposure to antihypertensive drugs in the first 20 weeks of gestation was associated with an increased risk of preeclampsia, low birth weight, and preterm birth.

PMID:35485218 | DOI:10.1080/17512433.2022.2072292

Otolaryngol Pol. 2022 Jan 21;76(2):15-23. doi: 10.5604/01.3001.0015.7083.

ABSTRACT

<b>Introduction:</b> Cytological examination of exfoliated epithelial cells of the uterine cervix, oral cavity, or rectum has been successfully used in the diagnostics of pathological conditions of these organs for many years. In these cases, the test material is collected from the available regions. </br></br> <b>Aim:</b> The aim of the study consisted in the analysis of cytological smears of laryngeal epithelial cells from patients hospitalized at the Department of Otolaryngology, Head and Neck Surgery of the 4th Military Teaching Hospital and Polyclinic in Wrocław in years 2019-2020. The analysis was aimed at demonstrating whether representative laryngeal epithelial material could be obtained from brush biopsies. </br></br> <b>Material and methods:</b> The study was carried out in 92 subjects aged between 26 and 85 years, including 34 women (37.0%), from whom material for cytological examination had been collected from the larynx in the course of microsurgical procedures carried out using the Kleinsasser laryngeal instrument set in 2019-2020. </br></br> <b>Results: </b>Analysis was performed on 90 out of 92 cell smears (97.8%). Two smears were not qualified for analysis due to ille-gibility. The smears were assessed using a proprietary scale consisting in a modification of the Bethesda system. Abnormal results of cytological examinations were obtained in a majority of cases. HSILs with invasive features were the most common abnormal results of cytological examinations. </br></br> <b>Conclusions:</b> Laryngeal epithelial cells can be successfully evaluated by means of cytological examination. Abnormal presen-tation of cytological smear is frequently hypercellular, with inflammatory cells being observed less frequently. No statistically significant relationship was observed between the results of the cytological examination and the overall quality of the smear, number of cells, number of erythrocytes, or the severity of inflammation.

PMID:35485222 | DOI:10.5604/01.3001.0015.7083

J Bone Miner Res. 2022 Apr 29. doi: 10.1002/jbmr.4566. Online ahead of print.

ABSTRACT

Hypoparathyroidism is the only endocrine deficiency for which hormone replacement therapy is not the standard of care. While conventional treatments may control hypocalcaemia, other complications such as hyperphosphataemia, kidney stones, peripheral calcifications and bone disease remain unmet needs. This meta-analysis (PROSPERO registration number CRD42019126881) aims to evaluate and compare the efficacy and safety of PTH_1-34 and PTH_1-84, in restoring calcium metabolism in chronic hypoparathyroidism. EMBASE, PubMed, and CENTRAL databases were searched for randomized clinical trials or prospective studies published between January 1996 and March 2021. English-language trials reporting data on replacement with PTH_1-34 or PTH_1-84 in chronic hypoparathyroidism were selected. Three authors extracted outcomes, one author performed quality control, all assessed the risk of biases. Overall, data from 25 studies on 588 patients were analysed. PTH therapy had a neutral effect on calcium levels, while lowering serum phosphate (-0.21 mmol/l; 95%CI:-0.31 to -0.11 mmol/l; p<0.001) and urinary calcium excretion (-1.21 mmol/24h; 95%CI:-2.03 to -0.41 mmol/24h; p=0.003). Calcium phosphate product decreased under PTH_1-84 therapy only. Both treatments enabled a significant reduction in calcium and calcitriol supplementation. PTH therapy increased bone turnover markers and lumbar spine mineral density. Quality of life improved and there was no difference in the safety profile between PTH and conventionally treated patients. Results for most outcomes were similar for the two treatments. Limitations of the study included considerable population overlap between the reports, incomplete data, and heterogeneity in the protocol design. In conclusion, the meta-analysis of data from the largest collection to date of hypoparathyroid patients shows that PTH therapy is safe, well-tolerated and effective in normalizing serum phosphate and urinary calcium excretion, as well as enabling a reduction in calcium and vitamin D use and improving quality of life. This article is protected by copyright. All rights reserved.

PMID:35485213 | DOI:10.1002/jbmr.4566

Global Spine J. 2022 Apr 29:21925682221098667. doi: 10.1177/21925682221098667. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective analysis of a prospectively collected data.

OBJECTIVE: Lumbar flexibility(LF) is generally defined with preoperative side bending films;it is not clear what percentage of LF predicts the spontaneous lumbar curve correction (SLCC) at long term follow up. Aim of this study was to find out cut-off value of preoperative LF,apical vertebra rotation(AVR) and apical vertebral translation(AVT);which may predict more than 50%SLCC.

METHODS: Patients with Lenke 1C&2C curves,treated with posterior STF,with a minimum 10 years follow up were included.The patients who had more than 50% SLCC(Group A) or less than 50% (Group B) were compared in terms of LF,AVR and AVT to understand a cut-off value of those parameters.Statistically, Receiver Operating Characteristic(ROC) test was used.

RESULTS: Fifty five AIS patients (54F, 1M) with mean age 14 (11-17) were included to study.Thoracic curve correction rate was 75%;lumbar curve correction rate was 59% at the latest follow up.Group A included 45(82%) patients at the latest follow up.Three patients (5%) showed coronal decompensation at early postop and 2 of them became compensated at f/up.ROC analyses showed 69% flexibility as the cut-off value for SLCC (P < .01).The difference between groups in terms of preop mean AVRs was significant (P = .029) (Group A = 1.9; Group B = 2.4).

CONCLUSION: In Lenke 1C&2C curves,whenever LF on the preoperative bending x-ray is greater than 70% (P < .01)and AVR is equal or less than grade 2,STF provides satisfactory clinical and radiological SLCC with more than mean 10 years f/up.This flexibility rate and apical vertebral rotation can be helpful in decision making for successful STF.

PMID:35485204 | DOI:10.1177/21925682221098667

Zhongguo Gu Shang. 2022 Apr 25;35(4):390-9. doi: 10.12200/j.issn.1003-0034.2022.04.018.

ABSTRACT

OBJECTIVE: To study the incidence and risk factors of osteonecrosis of the femoral head (ONFH) after internal fixation in adult patients with femoral neck fracture (FNF) after 2000, and identify high-risk population of ONFH.

METHODS: PubMed, Medline, The Cochrane Library, CNKI, Wanfang and VIP Database were searched to collect all the literatures on ONFH and related risk factors after internal fixation of FNF from January 1th 2000 to July 1th 2020. Study extraction was performed according to inclusion and exclusion criteria. Endnote X9 and Excel 2019 were used for literatures extraction, management and data entry, and R Studio 3.6.5 software was used for Meta-analysis. Subgroup analysis, sensitivity analysis and publication bias detection were used to explore the sources of heterogeneity and the reliability of the evaluation results.

RESULTS: A total of 16 studies with 5521 patients were included. Meta-analysis showed that the incidence of ONFH after internal fixation for adult FNF was 14.5% [95% CI(0.126-0.165)]. Fracture displacement[OR=0.27, 95%CI(0.21-0.35)] and reduction quality [OR=0.15, 95%CI(0.09-0.27)] were related risk factors for ONFH. The results of subgroup rate analysis showed that the non-displaced fracture necrosis rate was 6.2%[95%CI(0.051-0.077)] and the displaced fracture necrosis rate was 20.4% [95%CI(0.166-0.249)];the good reduction fracture necrosis rate was 8.3%[95%CI(0.072-0.095)] and the poor reduction fracture necrosis rate was 35.5%[95%CI(0.233-0.500)]. The included literatures have good consistency and no publication bias.

CONCLUSION: After 2000, the total incidence of ONFH after internal fixation of adult FNF has decreased, while the necrosis rates of patients with displaced fracture and poor reduction are still at a high level. The interval between injury and surgery was not analyzed in this study because of the inconstant division in the original literature.

PMID:35485160 | DOI:10.12200/j.issn.1003-0034.2022.04.018