Tag: statistics

Medicine (Baltimore). 2022 Sep 9;101(36):e30426. doi: 10.1097/MD.0000000000030426.

ABSTRACT

Acute myocardial infarction (AMI) complicated by cardiogenic shock has high mortality and remains challenging even in the revascularization era. We conducted this study to understand patients’ outcomes. We retrospectively analyzed electronic medical records data from 1175 patients with AMI complicated by cardiogenic shock that developed within 3 days of admission to a multicenter medical care system between January 1, 2000, and July 31, 2018. Patients with AMI were classified into the ST-segment elevation MI (STEMI) group or the non-ST-segment elevation MI (NSTEMI) group. The short-term and 1-year mortality and adverse events after index admission were analyzed via logistic regression and a Cox proportional hazards model. When compared with NSTEMI, patients with STEMI tended to be younger (65.68 ± 14.05 years vs 70.70 ± 12.99 years, P < .001), men (73.29% vs 60.87%, P < .001), and have fewer underlying chronic diseases. Short-term mortality at index hospitalization was 14.83% in the STEMI group and 21.30% in the NSTEMI group; long-term mortality was 17.06% for the STEMI group and 24.13% for the NSTEMI group. No difference was observed between the 2 groups for patients who developed a cerebral vascular accident during the admission period. However, the major and gastrointestinal bleeding rates were higher in the STEMI group (2.66% vs 0.22%, P = .014; 3.36% vs 0.22%, P = .007, respectively). Age and respiratory failure were the most significant risk factors for short-term mortality. Revascularization may be beneficial for the short-term outcome but did not reach significance in multivariable analysis. In patients with AMI with cardiogenic shock, NSTEMI was associated with a significantly higher mortality rate in short-term results.

PMID:36086759 | DOI:10.1097/MD.0000000000030426

Medicine (Baltimore). 2022 Sep 9;101(36):e30386. doi: 10.1097/MD.0000000000030429.

ABSTRACT

BACKGROUND: Benign prostatic hyperplasia (BPH) is a disease that affects the quality of life by causing lower urinary tract symptoms (LUTS) in men. Electroacupuncture (EA) and moxibustion therapy have been suggested as an adjunct therapy for improving LUTS in patients with BPH, but clinical studies evaluating the effectiveness of EA and its cotreatment with electronic moxibustion (EM) in patients who have been prescribed alpha blockers have yet to be reported. Therefore, this study aimed to evaluate the effectiveness and safety of EA and EM.

METHODS: Twenty-eight patients diagnosed with BPH were randomized to treatment group (TG, n = 14) or control group (CG, n = 14). The TG continued to use the previously prescribed alpha blocker and received the cotreatment of EA and EM 3 times a week for 6 weeks. The CG continued to use the previously prescribed alpha blocker alone for 6 weeks. The primary outcome was the mean change in the international prostate symptom score (IPSS) from baseline to week 6. The secondary outcomes were IPSS at week 3 and 12, clinical relevance, IPSS life satisfaction, EuroQol-Five dimensions, average urinary flow rate, maximum urinary flow rate, and prostate volume.

RESULTS: The IPSS decreased at all time points with a statistically significant difference between the 2 groups (3W: P = .0313; 6W: P = .0010; 12W: P = .0304). Based on the minimal clinically important difference (MCID, 3 points), there were significant differences between the TG and the CG at week 3, 6, and 12 (3W: P = .0461; 6W: P = .0123; 12W: P = .0216). Significant group × week interaction effects were found for the IPSS score (P = .0018), as determined from analyses using repeated measures analysis of variance. There were no significant differences between the 2 groups in IPSS life satisfaction, EuroQol-Five dimensions, average urinary flow rate, maximum urinary flow rate, and prostate volume.

CONCLUSION: EA and its cotreatment with EM might have a beneficial effect as an adjunct therapy in improving LUTS in patients with BPH. Large-scale randomized controlled trials are warranted to confirm the effectiveness and safety of EA and its cotreatment with EM.

PMID:36086755 | DOI:10.1097/MD.0000000000030429

Medicine (Baltimore). 2022 Sep 9;101(36):e30480. doi: 10.1097/MD.0000000000030480.

ABSTRACT

To evaluate the feasibility and efficiency of our novel technique, ultrasound guided hysteroscopic catheter dilation (US-HCD), for the treatment of moderate to severe intrauterine adhesion (IUA). A total of 126 patients diagnosed with IUA and met the enrollment criteria were admitted in this historical cohort study from June 1, 2016 to December 31, 2018. All patients were divided into 2 groups according to the surgical techniques used. Group A (n = 68) were treated with traditional hysteroscopic adhesiolysis with scissors (THA) and Group B (n = 58) were treated with US-HCD. Their data for the next 2 years following the initial surgery were analyzed. Safety and feasibility (operation time, surgical complications and the third-look hysteroscopic surgery rate), and post-operation efficacy (reduction of American Fertility Society [AFS] scores, pregnancy and live birth rates) were evaluated between groups. Between the groups, there was no statistically significant differences in basic preoperative information and AFS scores (P > .05). While there were significant differences in the operation time of the initial surgery (P < .05) and reduction of AFS scores (P < .05). No surgical complications were recorded and only 3 patients (5.2%) received a third-look hysteroscopy in Group B, while there were 6 cases of complications and 13 cases (19.1%) of third-look hysteroscopy in Group A, indicating significant differences between Groups (P < .05). Both groups exhibited comparable pregnancy rate, live birth rate and obstetric complications (P > .05). Our new technique is a safe, feasible and effective procedure for moderate to severe IUA patients, which can be mastered more quickly and easily by surgeons and applied in areas with less affluent economy and without hysteroscopic scissors, thus worthy of further study.

PMID:36086753 | DOI:10.1097/MD.0000000000030480

Medicine (Baltimore). 2022 Sep 9;101(36):e30454. doi: 10.1097/MD.0000000000030454.

ABSTRACT

The degree of blood vessel stenosis significantly influences diabetic foot treatment. This study aimed to investigate the association between computed tomography angiography (CTA) stenosis and skin perfusion pressure (SPP), which are noninvasive vascular assessments used to evaluate diabetic foot wounds. Forty patients who reported diabetic foot wounds between November 2016 and December 2017 were included in the study. SPPand CTA were performed to evaluate the blood flow, and the rate of decrease in wound size was measured for the wounds corresponding to Meggitt-Wagner grade 1 at the first evaluation and 4-week intervals. The P value of the association between the degree of CTA stenosis and the SPP value was 0.915, and the P value of the association between CTA stenosis and decreasing rate of wound size was .235. There was no statistically significant association between SPP and the decreasing rate of wound size according to the degree of CTA stenosis. The association between SPP value and the decreasing rate of wound size was statistically significant (P < .05). The decreasing rate in diabetic foot wound size was significantly associated with SPP but not with CTA stenosis.

PMID:36086746 | DOI:10.1097/MD.0000000000030454

Medicine (Baltimore). 2022 Sep 9;101(36):e30399. doi: 10.1097/MD.0000000000030399.

ABSTRACT

This study investigated the association between antacid administration and lung cancer incidence in a real-world setting. This was a nationwide, retrospective cohort study. The cohort comprised random samples (n = 1,031,392) from the entire South Korean population in 2002. The duration of antacid administration between January 2006 and December 2010 was recorded for each participant. Newly developed lung cancers were counted during the 5-year observation period (January 1, 2006 to December 31, 2010). A total of 437,370 participants aged ≥ 40 years were included, of whom 301,201 (68.9%) had antacid exposure before the diagnosis of lung cancer. A total of 1230 (0.28%) antacid-exposed patients developed lung cancer. Among patients with no antacid exposure or underexposure (n = 136,171), 597 (0.44%) developed lung cancer. In the multivariable analysis, antacid exposure before the diagnosis of lung cancer was independently associated with a reduced incidence of lung cancer (hazard ratio: 0.64; 95% confidence interval: 0.55-0.74; P < .001). Antacid use might be independently associated with a decreased risk of lung cancer development in this cohort study.

PMID:36086741 | DOI:10.1097/MD.0000000000030399

Medicine (Baltimore). 2022 Sep 9;101(36):e30542. doi: 10.1097/MD.0000000000030542.

ABSTRACT

This retrospective analysis aimed to compare the risk of venous thromboembolism (VTE) between patients with diabetes mellitus who received hydrophilic statin treatment to those who receive lipophilic statin. There were 6639 patients receiving hydrophilic statin therapy and 10,854 patients receiving lipophilic statin therapy in the study. The hazard ratios and 95% confidence intervals for VTE were estimated using univariate and multivariate Cox proportional hazards models when the study cohorts were compared. Among all patients, the incidence rate of VTE was 4.27 per 1000 person-years in the control cohort, 4.18 per 1000 person-years in the hydrophilic statin use cohort, and 3.91 per 1000 person-years in the lipophilic statin use cohort. After adjusting for age, sex, and comorbidities, the risk of VTE in the hydrophilic statin use cohort was 0.90 (0.72, 1.12) lower than that in the control cohort, the risk of VTE in the lipophilic statin use cohort was 0.87 (0.72, 1.05) lower than that in the control cohort, and the risk of VTE in the lipophilic statin use cohort was 0.97 (0.78, 1.21) lower than that in the hydrophilic statin use cohort. However, all were not statistically significant. Our result showed that there was no significant difference among the study cohorts regarding the outcome of VTE.

PMID:36086736 | DOI:10.1097/MD.0000000000030542

Medicine (Baltimore). 2022 Sep 9;101(36):e30498. doi: 10.1097/MD.0000000000030498.

ABSTRACT

To describe imaging findings of pulmonary contusions (PC) in adults and children using multidetector computed tomography (CT) scanners. We conducted a retrospective single center study. All chest multidetector computed tomography (MDCT) scans of victims of blunt trauma admitted to the emergency unit of a reference trauma center of Brazil between January 2015 and December 2016 were reviewed in search of opacities compatible with PC. The CT images were analyzed in conjunction with medical records, that provided demographic and clinical data. The obtained data were analyzed in the overall population and comparing children and adults. Significant P value was defined as <.05. 52.7% of patients presented bilateral opacities. Middle third, posterior and peripheral portions of the lungs were more frequently affected, in the craniocaudal, anteroposterior and axial axes, respectively. A vast majority of patients (80.6%) presented multiple opacities, whereas a minority showed subpleural sparing (26.9%) and fissure crossing (22.6%), with similar frequencies in children and adults. Children, although, more frequently presented consolidation and more diffuse lesions in the anteroposterior axis compared to adults, with statistically significant differences. PC usually are multiple and predominate in middle, posterior and peripheral portions of the lungs. Subpleural sparing and fissure crossing seems to be infrequent and have similar frequencies between children and adults. Although, there are differences between these age groups, as younger people tend to have more consolidation and diffuse opacities in the anteroposterior axis than older ones.

PMID:36086733 | DOI:10.1097/MD.0000000000030498

Medicine (Baltimore). 2022 Sep 9;101(36):e30469. doi: 10.1097/MD.0000000000030469.

ABSTRACT

Because of the limitations of therapeutic approaches, patients suffering from lung adenocarcinoma (LUAD) have unsatisfactory prognoses. Studies have shown that neurotransmitters participated in tumorigenesis and development. In LUAD, the expression of neurotransmitter release cycle-related genes (NRCRGs) has been reported to be disordered. This study aimed to study the correlation between NRCRGs and LUAD. In this study, based on the Cancer Genome Atlas cohort, consensus clustering analyses were performed on ten neurotransmitter release cycle-related (NRCR) differentially expressed genes. Neurotransmitter release cycle (NRC) scores were derived by the Least Absolute Shrinkage and Selection Operator-Cox regression model constituted by 3 NRCRGs. Univariate and multivariate Cox regression analyses were performed to evaluate the prognosis value of the NRC score. In addition, single-Sample Gene Set Enrichment Analysis and CIBERSORT were conducted in the Cancer Genome Atlas cohort. Finally, gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses were also performed. As a result, the NRC-low group showed a good prognosis instead of the NRC-high group. NRC score was identified to be an independent prognosis factor for LUAD. In general, the NRC score based on the prognostic model was found to be closely correlated with immunotherapy-related anti-cancer immunity and inflamed tumor microenvironment. Functional enrichment results demonstrated that differentially expressed genes between 2 NRC groups were closely correlated with DNA replication, cell-substrate adhesion, Golgi vesicle transport, MAPK signal pathway, and many others. Novel biomarkers were offered for predicting the prognoses of LUAD patients. The NRC score might contribute to guiding LUAD patients with immunotherapy selection.

PMID:36086730 | DOI:10.1097/MD.0000000000030469

Medicine (Baltimore). 2022 Sep 9;101(36):e30547. doi: 10.1097/MD.0000000000030547.

ABSTRACT

CONTEXT: Nursing students experience psychosocial stress in their workplace. Available statistics are at variance, and hence, the need to know the overall prevalence of psychosocial stress among nursing students.

AIMS: This study aimed to determine the prevalence of psychosocial stress among nursing students through meta-analysis.

MATERIALS AND METHODS: PubMed, Cochrane, Web of Science, CNKI, and China Biomedical Literature Service System were searched for articles. Search terms include “psychosocial stress,” “nursing students.” Articles were included if they used validated psychosocial stress assessment instruments. Of the 15 articles with data on stress prevalence, 8 met all inclusion criteria. Each article was independently reviewed by the authors and relevant data were abstracted. Statistical analysis was done using Revman 4.1.

RESULTS: Overall, the average score for stress among nursing students was 3.70 (95% confidence interval [CI]: [3.33, 4.06]) based on the analyzed 15 articles with a sample size of 9202.

CONCLUSION: This study showed that the stress level of intern nursing students was mainly moderate.

PMID:36086725 | DOI:10.1097/MD.0000000000030547

Medicine (Baltimore). 2022 Sep 9;101(36):e30302. doi: 10.1097/MD.0000000000030302.

ABSTRACT

OBJECTIVES: Investigating the efficacy and safety of noninvasive cerebellar stimulation in improving the balance and walking function of patients with stroke.

METHODS: We searched 7 databases for randomized controlled trials (RCTs) related to noninvasive cerebellar stimulation in the treatment of stroke. The Berg Balance Scale (BBS), 6-minute walk test (6MWT), and Barthel Index (BI) were used as the outcome indexes to evaluate balance, walking and activities of daily living (ADL). The quality of the research was evaluated using the Cochrane Risk of Bias Tool. A meta-analysis was performed to evaluate the difference between the noninvasive cerebellar stimulation and control groups. Heterogeneity tests were performed to assess differences in treatment effects across noninvasive cerebellar stimulation modalities. A sensitivity analysis was performed to evaluate the robustness of the results.

RESULTS: Seven studies were included, and 5 articles (71.43%) were rated as having a low risk of bias. Among the primary outcome indicators, 4 of the 7 articles were combined into the fixed effect model (I2 = 38%, P = .18). Compared with the control group, noninvasive cerebellar stimulation improved the BBS score, and the difference was statistically significant (mean difference [MD]: 3.00, 95% confidence interval [CI]: 1.10-5.40, P = .03); the sensitivity analysis showed that the statistical model was still stable after sequentially eliminating each article. Compared with the control group, noninvasive cerebellar stimulation improved the 6MWT results of patients with stroke (MD: 25.29, 95% CI: 4.86-45.73, P = .02). However, noninvasive cerebellar stimulation did not improve the BI (MD: 15.61, 95% CI: -7.91 to 39.13, P = .19). No safety problems or adverse reactions to noninvasive cerebellar stimulation were observed.

CONCLUSIONS: Noninvasive cerebellar stimulation improves balance and walking function of patients with stroke, but its effect on ADL is uncertain. Due to the methodological weaknesses in the included trials, more RCTs are needed to confirm our conclusions.

PMID:36086722 | DOI:10.1097/MD.0000000000030302