Tag: statistics

Gut Liver. 2022 Sep 2. doi: 10.5009/gnl220060. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: The discrepancies between the diagnosis of preoperative endoscopic forceps biopsy (EFB) and endoscopic submucosal dissection (ESD) in patients with early gastric neoplasm (EGN) exist objectively. Among them, pathological upgrading directly influences the accuracy and appropriateness of clinical decisions. The aims of this study were to investigate the risk factors for the discrepancies, with a particular focus on pathological upgrading and to establish a prediction model for estimating the risk of pathological upgrading after EFB.

METHODS: We retrospectively collected the records of 978 patients who underwent ESD from December 1, 2017 to July 31, 2021 and who had a final histopathology determination of EGN. A nomogram to predict the risk of pathological upgrading was constructed after analyzing subgroup differences among the 901 lesions enrolled.

RESULTS: The ratio of pathological upgrading was 510 of 953 (53.5%). Clinical, laboratorial and endoscopic characteristics were analyzed using univariable and binary multivariable logistic regression analyses. A nomogram was constructed by including age, history of chronic atrophic gastritis, symptoms of digestive system, blood high density lipoprotein concentration, macroscopic type, pathological diagnosis of EFB, uneven surface, remarkable redness, and lesion size. The C-statistics were 0.804 (95% confidence interval, 0.774 to 0.834) and 0.748 (95% confidence interval, 0.664 to 0.832) in the training and validation set, respectively. We also built an online webserver based on the proposed nomogram for convenient clinical use.

CONCLUSIONS: The clinical value of identifying the preoperative diagnosis of EGN lesions is limited when using EFB separately. We have developed a nomogram that can predict the probability of pathological upgrading with good calibration and discrimination value.

PMID:36052614 | DOI:10.5009/gnl220060

Gut Liver. 2022 Sep 2. doi: 10.5009/gnl210404. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy.

METHODS: Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated.

RESULTS: A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively).

CONCLUSIONS: In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.

PMID:36052612 | DOI:10.5009/gnl210404

Turk J Orthod. 2022 Sep 2. doi: 10.5152/TurkJOrthod.2022.21072. Online ahead of print.

ABSTRACT

OBJECTIVE: To comparatively evaluate the perception of patients’ soft tissue profiles treated with Herbst and Twin Block appliances and correlate the perception with cephalometric parameters.

METHODS: The record of 30 patients (15 Herbst and 15 Twin Block) treated for a period of 6 months (±1.1 months) was included in the study. A total of 60 resulting profile silhouettes (from pre- and post-functional profile photographs) were evaluated by 30 examiners and were divided into 3 groups: orthodontists, general dentists, and laypersons. The profiles were arranged in a randomized order, and the examiners rated the profiles using a visual analog scale. Paired t-test and independent t-test were performed to find a significant difference within and between the appliances, respectively. A treatment outcome correlation was done using Pearson’s correlation test between the visual analog scale scores and cephalometric parameters.

RESULTS: Within the appliances, the orthodontist perceived a difference with only the Twin Block appliance (P = .02). The general dentists perceived a significant difference with both Herbst (P = .02) and Twin Block (P = .001) appliances, whereas the laypersons did not perceive any profile improvement on treatment with functional appliances. However, between the appliances, no statistically significant profile difference was seen with all 3 groups of examiners. The ANB angle had a significant negative correlation (P = .007) to the visual analog scale scores given by the orthodontists for the Herbst appliance.

CONCLUSION: No perceptible difference was found in the profile enhancement between Herbst and Twin Block appliances with all 3 groups of examiners. The ANB angle contributed to the difference in profile perception between the appliances for the orthodontists.

PMID:36052579 | DOI:10.5152/TurkJOrthod.2022.21072

Psychol Med. 2022 Sep 2:1-10. doi: 10.1017/S003329172200188X. Online ahead of print.

ABSTRACT

BACKGROUND: Major depressive disorder (MDD) has been associated with alterations in brain white matter (WM) microstructure. However, diffusion tensor imaging studies in biological relatives have presented contradicting results on WM alterations and their potential as biomarkers for vulnerability or resilience. To shed more light on associations between WM microstructure and resilience to familial risk, analyses including both healthy and depressed relatives of MDD patients are needed.

METHODS: In a 2 (MDD v. healthy controls, HC) × 2 (familial risk yes v. no) design, we investigated fractional anisotropy (FA) via tract-based spatial statistics in a large well-characterised adult sample (N = 528), with additional controls for childhood maltreatment, a potentially confounding proxy for environmental risk.

RESULTS: Analyses revealed a significant main effect of diagnosis on FA in the forceps minor and the left superior longitudinal fasciculus (p_tfce-FWE = 0.009). Furthermore, a significant interaction of diagnosis with familial risk emerged (p_tfce-FWE = 0.036) Post-hoc pairwise comparisons showed significantly higher FA, mainly in the forceps minor and right inferior fronto-occipital fasciculus, in HC with as compared to HC without familial risk (p_tfce-FWE < 0.001), whereas familial risk played no role in MDD patients (p_tfce-FWE = 0.797). Adding childhood maltreatment as a covariate, the interaction effect remained stable.

CONCLUSIONS: We found widespread increased FA in HC with familial risk for MDD as compared to a HC low-risk sample. The significant effect of risk on FA was present only in HC, but not in the MDD sample. These alterations might reflect compensatory neural mechanisms in healthy adults at risk for MDD potentially associated with resilience.

PMID:36052484 | DOI:10.1017/S003329172200188X

Cancer Med. 2022 Sep 2. doi: 10.1002/cam4.5185. Online ahead of print.

ABSTRACT

BACKGROUND: Blood neutrophil to lymphocyte ratio (NLR) or lymphocyte count may be important markers for immune function. Previous work has shown higher NLR was associated with higher risk of hepatitis B-related hepatocellular carcinoma (HCC). However, studies in non-alcoholic fatty liver disease (NAFLD) patients are lacking.

METHODS: Utilizing the University of Pittsburgh Medical Center (UPMC) electronic health records, we created a retrospective cohort of 27,834 patients diagnosed with NAFLD from 2004 to 2018 with complete NLR data. After an average 5.5 years of follow-up, 203 patients developed HCC. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of HCC incidence associated with different levels of NLR and lymphocyte count.

RESULTS: Compared with the lowest tertile of NLR (<1.97), the highest tertile of NLR (≥3.09) was statistically significantly associated with a 43% higher risk of HCC incidence (HR = 1.43, 95% CI: 1.01-2.03, p_trend = 0.031) after adjustment for age, sex, race, body mass index, smoking status, history of type 2 diabetes, hyperlipidemia, hypertension, and fibrosis-4 score category. Conversely the highest tertile of lymphocyte count (≥2.15 K/ul) was significantly associated with a 36% lower risk of HCC (HR = 0.64, 95% CI: 0.43-0.94, p_trend = 0.028) compared to the lowest tertile (<1.55 K/ul). There was no association between neutrophil count and HCC risk.

CONCLUSIONS: Higher NLR and lower lymphocyte count are associated with significantly higher risk of HCC among NAFLD patients. These findings warrant further investigation of immune response and surveillance in association with HCC development in NAFLD patients.

PMID:36052483 | DOI:10.1002/cam4.5185

Contemp Nurse. 2022 Sep 2:1-22. doi: 10.1080/10376178.2022.2107038. Online ahead of print.

ABSTRACT

AIM: To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).

METHODS: We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).

RESULTS: At 90-days, 47.9% (n = 69) had a good prognosis (mRS ≤ 2) including 22.2%(n = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (n =70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (p = 0.02), nasogastric tube (p＜0.001), indwelling urinary catheter (p＜0.001), central venous catheter (p = 0.03), health knowledge needs of pressure injury prevention (p = 0.03), National Institute of Health Stroke Scale (NIHSS) score (p＜0.001) and Activities of Daily Living (ADL) score (p＜0.001) at the time of discharge from hospital. The average hospitalisation time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalisation was $Y$21291.93 (SD 9165.01).

CONCLUSION: Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.

IMPACT STATEMENT: We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.

PMID:36052463 | DOI:10.1080/10376178.2022.2107038

Ann Ital Chir. 2022;92:369-373.

ABSTRACT

AIM: This single-tertiary non-Covid center retrospective study analyses the impact on Covid-19 pandemic on the presentation and the treatment in patients operated for acute appendicitis.

METHODS: Total number of 152 patients operated for acute appendicitis in two separate periods (April – August 2019, and April – August 2020), were subjected to retrospective analysis. Patients were divided in two groups: pre-pandemic Group A and pandemic Group B.

RESULTS: Eighty one patient was operated in the pandemic period and the rest 71 one year ago in the same period. Preoperative C-reactive protein levels presented statistically higher in the pandemic group (p = 0.0455). Time from admission to surgery was shorter in the pandemic group (7.5 ± 4.6 vs 5.8 ± 4.9; p = 0.0155). Overall operative time and the laparoscopic operative time were statistically longer in the pandemic group (68.8 vs. 76.8 minutes; p = 0.039 and 60.04 vs 74.0 minutes; p = 0.0141, respectively). Complicated appendicitis rates were similar, although periappendicular abscess was more common in the pandemic group, but without statistical significance. Length of stay was shorter in the pandemic group (p = 0.53).

CONCLUSION: Our data showed that during the Covid-pandemic, acute appendicitis surgery is safe and feasible with results equal to the prepandemic period.

KEY WORDS: Appendicitis, Appendectomy, Covid.

PMID:36052461

Ann Ital Chir. 2022;92:263-270.

ABSTRACT

AIM: We aimed to evaluate (immunohistochemically) the YAP expression in breast cancer patients undergoing neoadjuvant chemotherapy and to clarify the relationship between the molecular characteristics, treatment response and survival data and the YAP expression, and hence, to clarify the prognostic significance.

MATERIAL AND METHODS: One hundred and four patients who were diagnosed with Breast Cancer between 2015-2020 and underwent Neo Adjuvant Chemotherapy were included in the study. Estrogen Receptor(ER), Progesterone Receptor(PR), Human Epidermal Growth Receptor-2(HER2) and Ki-67. Expression are routinely stained immunohistochemically. In this study, existing immunohistochemical markers were reviewed and also, the relationship of YAP with these biological markers was evaluated by using immunohistochemistry and its effect on prognosis has been investigated.

RESULTS: The average age of the patients was 52.37. While YAP was positive in 78 patients (75%), it was negative in 26 patients (25%). In the evaluation after neoadjuvant therapy, pathological complete response (MillerPayne Grade5 response) in 28 patients (26.9%), relapse in 6 patients (5.8%), and exitus in 6 patients (5.8%) were detected. In the pathological evaluation, invasive Ductal Carcinoma was the most common one observed in 88 patients (84.6%). As a result of the statistical evaluation, no significant result was obtained between the parameters and YAP negative/positive.

CONCLUSION: As a result of staining with additional YAP in patients who were diagnosed with breast cancer and routinely stained with ER, PR, Cerb B2 and Ki-67 in pathology samples, we could not reach a result that would contribute positively to survival. Longer studies to be conducted prospectively will be meaningful.

KEY WORDS: Breast Cancer, Chemotherapy, Neoadjuvant, Yes Associated Protein.

PMID:36052460

J Interpers Violence. 2022 Sep 1:8862605221119515. doi: 10.1177/08862605221119515. Online ahead of print.

ABSTRACT

Violence against women has been the subject of scientific literature in many fields and poverty has been one of the most important companions in this field. It can be found lots of empirical studies about violence against women for countries as Turkey too. However, regional considerations relating to people’s socioeconomic condition have not been considered in these investigations although it has been indicated that these factors are important in terms of violence against women. Therefore, the main motivation of this study to investigate the impact of poverty on partner violence against women under the regional impacts in Turkey. The multinomial logit analysis preferred since the violence against women considered under three groups which are physical, sexual violence, and never experienced. The dataset received from the Survey on Domestic Violence Against Women in Turkey which was performed by Turkish Statistical Institute (TURKSTAT). This survey is performed in both 2008 and 2014 years. For this study, the 2008 data is chosen as it carries the information of “having a green card” which is a formal demonstration of being poor. Also, NUTS 2 (Nomenclature of territorial units for statistics) regions for Turkey are considered during the analysis. Based on the general results, the poverty status and regional effects of women, showed quite different results in terms of physical and sexual violence types. The poverty has a positive effect only on physical violence, not on sexual violence. Further, all regions have an important role on physical violence, while only less developed regions have a dominant impact on sexual violence. Also, the findings show that the intimate partners’ bad habits make women more vulnerable to violence. According to the results, it can be suggested that developing policies based on regional effects and types of violence would be more effective.

PMID:36052441 | DOI:10.1177/08862605221119515

Eur J Ophthalmol. 2022 Sep 1:11206721221124673. doi: 10.1177/11206721221124673. Online ahead of print.

ABSTRACT

AIM: To evaluate corneal morphology after use of 0.5% intracameral moxifloxacin (ICM) in cataract surgery in patients who presented late with hard cataracts.

METHODS: Cross-sectional study conducted from June-2021 to December-2021 at a tertiary eye-care center. 90 patients over 60 years with high-risk characteristics for Covid-19, who presented late with higher grades of nuclear-sclerosis (NS), were included. They underwent phacoemulsification and 0.5%moxifloxacin (0.1 ml) was injected intracamerally at the end of surgery. Best-corrected visual acuity (BCVA), intraocular pressures (IOP), endothelial cell density (ECD), coefficient of variation in cell-area (CoV), hexagonality (Hex) and central corneal thickness (CCT) were measured preoperatively and postoperatively on day1, day7 and day30. Statistical analysis was done by Anova test. p-value<0.05 was considered significant.

RESULTS: Mean age of presentation was 65.26±8.3 years. Mean preoperative BCVA (1/60-to-6/60), IOP (16.7±2.3 mm of Hg), CCT (523.93±39.6µ), ECD (2547±302.08cells/mm²), Hex (47.04±5.7%) and CoV (37.57±3.9) changed to BCVA (6/9-to-6/6), IOP (17.5±2.1 mm of Hg), CCT (538.42±36.9µ), ECD (2388.40±339.25cells/mm²), Hex (44.44±5.6%) and CoV (39.09±4.5) at day30 postoperative. Average rate of change at day30 was increase in CCT (2.89%), ECD loss (6.4%), decrease in Hex (4.9%) and increase in CoV (4.6%), though clinically insignificant. No case of endophthalmitis or toxic-anterior segment syndrome seen.

CONCLUSION: 0.5% moxifloxacin (0.1 ml) is safe as intracameral antibiotic to prevent postoperative infection in high-risk patients. The reported changes in the corneal parameters were within the range of any routine surgeries of hard senile cataracts. No specific effect could be attributed to ICM.

PMID:36052419 | DOI:10.1177/11206721221124673