Tag: statistics

Gulf J Oncolog. 2022 Jan;1(38):31-37.

ABSTRACT

INTRODUCTION: The study aim is to determine the association of post-menopausal status with abnormal Pap smear cytology and cervical dysplasia detected by colposcopically-directed biopsy. We also study the association of biopsy-confirmed dysplasia with Pap smear results.

PATIENTS AND METHODS: This retrospective study included 480 women with abnormal Pap smear results who were referred for colposcopy. Covariates considered included demographic (age, race/ethnicity, smoking status), sexual activity (age first sexual intercourse, number lifetime partners, duration current partner), and disease (HIV, high-risk HPV, immunosuppression).

RESULTS: Post-menopausal status was not significantly associated with abnormal Pap smear cytology or cervical dysplasia. We found a statistically significant association of high-grade dysplasia with high-grade Pap smear results: ASC-H (B=3.43, SE=0.84, p< 0.001); HSIL (B=3.50, SE=0.84, p< 0.001) and AGC (B=3.47, SE=1.02, p< 0.01).

DISCUSSION AND CONCLUSION: Although clinicians may want to consider not requiring colposcopically-directed biopsy for certain post-menopausal patients, we recommend continuing with current cervical cancer guidelines of screening for all women regardless of menopausal status.

PMID:35156642

Eur J Rheumatol. 2022 Feb 14. doi: 10.5152/eurjrheum.2021.20166. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to examine the changes in physical activity level, fatigue, depression, and sleep quality in patients with Behçet’s disease during the COVID-19 pandemic.

METHODS: The study was designed as an online questionnaire applied to individuals who are being followed up with the diagnosis of Behçet’s disease in the rheumatology department. Data were collected using multiple scales including International Physical Activity Questionnaire (IPAQ), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Pittsburg Sleep Quality Index (PSQI), and Visual Analogue Scale (VAS) to evaluate physical activity level, fatigue, depression, sleep quality, and pain, respectively.

RESULTS: Sixteen patients diagnosed with Behçet’s disease were included in the study. No statistically significant difference was observed between the IPAQ, FSS, BDI, PSQI, and VAS assessment scores before COVID-19 and during COVID-19 period (P > .05 for all).

CONCLUSION: Thinking of the negative effects of aggressive clinical symptoms, Behçet’s disease patients should be supported in physical activity and psychosocial status.

PMID:35156635 | DOI:10.5152/eurjrheum.2021.20166

Eur J Rheumatol. 2022 Feb 14. doi: 10.5152/eurjrheum.2022.21135. Online ahead of print.

ABSTRACT

OBJECTIVE: Patients with undefined systemic autoinflammatory diseases (uSAIDs) are challenging to manage, as there are no guidelines or recommendations for targeted therapy. We aimed to evaluate the efficacy of empiric treatment with colchicine in our single-center uSAID population in the United States, as well as the patient characteristics associated with the most robust colchicine response.

METHODS: Children with uSAID 18 years old at initial evaluation during 2000-2019 were included if they received 3 months of colchicine therapy. Data on demographics, clinical features, laboratory/ genetic studies, and treatment responses were collected. Most statistics were based on chi-square analyses for categorical data. Complete response to colchicine was defined as resolution of episodes or the presence of minor residual symptoms that did not require any further therapy. A partial response was defined as a decrease in the frequency, severity, or length of episodes but still necessitating additional therapy. Patients were considered nonresponders if they did not experience any improvement with colchicine at target therapeutic dosing.

RESULTS: We identified 133 children diagnosed with uSAID who met our inclusion criteria. The median time to starting empiric colchicine was 5 months from the diagnosis of autoinflammatory disease. 92.5% (n ¼ 123) of patients had a beneficial response to colchicine, including 46.6% (n ¼ 62) partial responders and 45.9% (n ¼ 61) complete responders. The presence of a nonurticarial rash was associated with an incomplete colchicine response (29.2% (n ¼ 21) vs 13.1% (n ¼ 8), P ¼ .025). The presence of a heterozygous MEFV mutation in patients who did not fit Familial Mediterranean Fever diagnostic criteria (n ¼ 25) appeared to be associated with a greater likelihood of complete colchicine response, although this was not statistically significant (62.5% (n ¼ 14) vs 42.6% (n ¼ 11), P ¼ .08). In MEFV mutation-negative patients, a nonurticarial rash was even more strongly associated with incomplete colchicine response, with an OR of 27.53 (CI [1.59-477], P ¼ .023). The presence of oral ulcers also corresponded to incomplete colchicine response, although this did not reach clinical significance (38.9% (n ¼ 28) vs 24.6% (n ¼ 15), P ¼ .08). There was no significant association between episode duration or frequency and colchicine response.

CONCLUSION: Colchicine leads to clinical benefits in most children with uSAID. We, thus, recommend an early trial of colchicine in newly diagnosed patients with uSAID.

PMID:35156637 | DOI:10.5152/eurjrheum.2022.21135

Epidemiol Psychiatr Sci. 2022 Feb 14;31:e15. doi: 10.1017/S2045796022000014.

ABSTRACT

AIMS: To evaluate the quality of mental health care delivered to patients with schizophrenia and related disorders taken-in-care by mental health services in four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily).

METHODS: Thirty-one clinical indicators concerning accessibility, appropriateness, continuity and safety were defined and estimated using healthcare utilisation (HCU) databases, containing data on mental health treatments, hospital admissions, outpatient interventions, lab tests and drug prescriptions.

RESULTS: A total of 70 586 prevalent patients with schizophrenia and related disorders treated in 2015 were identified, of whom 1752 were newly taken-in-care by the facilities of regional mental health services. For most patients community care was accessible and moderately intensive. However, care pathways were not implemented based on a structured assessment and only half of the patients received psychosocial treatments. One patient out of ten had access to psychological interventions and psychoeducation. Activities specifically addressed to families involved a third of prevalent patients and less than half of new patients. One patient out of six was admitted to a community residential facility, and one out of ten to a General Hospital Psychiatric Ward (GHPW); higher values were identified in new cases. In general hospitals, few patients had a length of stay (LoS) of more than 30 days, while one-fifth of the admissions were followed by readmission within 30 days of discharge. For two-thirds of patients, continuity of community care was met, and six times out of ten a discharge from a GHPW was followed by an outpatient contact within 2 weeks. For cases newly taken-in-care, the continuity of community care was uncommon, while the readiness of outpatient contacts after discharge was slightly more frequent. Most of the patients received antipsychotic medication, but their adherence to long-term treatment was low. Antipsychotic polytherapy was frequent and the control of metabolic side effects was poor. The variability between regions was high and consistent in all the quality domains.

CONCLUSIONS: The Italian mental health system could be improved by increasing the accessibility to psychosocial interventions, improving the quality of care for newly taken-in-care patients, focusing on somatic health and mortality, and reducing regional variability. Clinical indicators demonstrate the strengths and weaknesses of the mental health system in these regions, and, as HCU databases, they could be useful tools in the routine assessment of mental healthcare quality at regional and national levels.

PMID:35156603 | DOI:10.1017/S2045796022000014

Psychol Med. 2022 Feb 14:1-16. doi: 10.1017/S0033291722000265. Online ahead of print.

ABSTRACT

BACKGROUND: Sex differences in brain structure and neurodevelopment occur in non-clinical populations. We investigated whether sex had a similar effect on developmental domains amongst boys and girls with a familial risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and controls.

METHODS: Through Danish registries, we identified 522 7-year-old children (242 girls) with FHR-SZ, FHR-BP, and controls. We assessed their performance within the domains of neurocognition, motor function, language, social cognition, social behavior, psychopathology, and home environment.

RESULTS: FHR-SZ boys compared with FHR-SZ girls had a higher proportion of disruptive behavior and attention-deficit hyperactivity disorder (ADHD) and exhibited lower performance in manual dexterity, balance, and emotion recognition. No sex differences were found between boys and girls within FHR-BP group. Compared with controls, both FHR-SZ boys and FHR-SZ girls showed impaired processing speed and working memory, had lower levels of global functioning, and were more likely to live in an inadequate home environment. Compared with control boys, FHR-SZ boys showed impaired manual dexterity, social behavior, and social responsiveness, and had a higher proportion of ADHD and disruptive behavior disorder diagnoses. Stress and adjustment disorders were more common in FHR-BP boys compared with control boys. We found no differences between FHR-BP girls and control girls.

CONCLUSIONS: Impairment within neurodevelopmental domains associated within FHR-SZ boys v. FHR-SZ girls was most evident among boys, whereas no sex differences were found within the FHR-BP group (FHR-BP boys v. FHR-BP girls). FHR-SZ boys exhibited the highest proportion of early developmental impairments.

PMID:35156599 | DOI:10.1017/S0033291722000265

Hematology. 2022 Dec;27(1):232-238. doi: 10.1080/16078454.2022.2030884.

ABSTRACT

OBJECTIVES: To establish a reliable XN-HPC cutoff, for an effective CD34 + cell count of ≥2 × 10⁶cells/kg of the recipient’s body weight, in harvested bone marrow products in allogenic transplantation.

METHODS: The study was carried out in two phases. In retrospective Phase 1, data from 47 donors were analyzed. Sysmex analyzer XN-20 and BD FACS Calibur were employed to process XN-HPC and CD34 + cell enumeration, respectively. To make the two variables comparable, both XN-HPC and CD34 + cell counts were reported as the number of cells/kg of the recipient’s body weight. Spearman’s rank correlation coefficient was calculated for CD34 + cells and XN-HPC, followed by the calculation of the receiver operating characteristic (ROC) curve to identify the XN-HPC value which could effectively predict the cutoff of ≥2 × 10⁶ CD34 + cells/kg of the recipient’s body weight. In Phase 2, the computed XN-HPC cutoff was validated in a prospective set of 53 donors by obtaining the positive and negative predictive values.

RESULTS: Statistically significant correlation was obtained between XN-HPC and CD34 + cell count with Spearman’s rho of 0.54 (p-value <0.001). The optimal XN-HPC cutoff, for the required CD34 + ve cell count of ≥2 × 10⁶ cells/kg of the recipient’s body weight, was calculated to be ≥2.80×10⁶ cells/kg of the recipient’s body weight with the specificity and sensitivity of 100% and 31%, respectively. The ROC curve demonstrated the area under the curve to be 0.74. Phase 2 validation revealed 100% PPV.

CONCLUSIONS: For harvested bone marrow products with XN-HPC of ≥2.80×10⁶ cell/kg of the recipient’s body weight, CD34 + cell enumeration by flow cytometry can safely be disposed of.

PMID:35156559 | DOI:10.1080/16078454.2022.2030884

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2022 Feb 14:1-15. doi: 10.1080/10934529.2022.2039551. Online ahead of print.

ABSTRACT

In recent years, several environmental pollutants have been monitored in surface waters and sediments. However, few studies apply multivariate statistics to identify the main components and correlate them temporally and spatially. In this sense, the present study sought to monitor the quality of water and sediments in the Rio Marrecas/Brazil, through the analysis of physicochemical parameters and trace elements, as well as to identifying sources of contamination, using multivariate statistics. For this purpose, sampling was carried out in nine locations for a period of 12 months. The Total Reflection X-ray Fluorescence (TXRF) technique was used to quantify the 15 elements identified in water and sediment samples. Through multivariate statistical analyses, the most significant elements, their correlations and possible pollutant sources were defined, and the pollution index (HPI) and assessment index (HEI) of heavy metals were applied. The parameters pH and BOD₅ do not comply with Brazilian legislation. Based on PCA and Spearman correlation, there was strong evidence of contamination of the water naturally, composed of the elements Ti, V, Mn, Fe, and of anthropogenic origin composed of the elements Ca, Ni, Cu, Zn. These findings provide insights to determine the impacts of heavy metals on human health and the environment.

PMID:35156550 | DOI:10.1080/10934529.2022.2039551

J Clin Exp Neuropsychol. 2022 Feb 12:1-13. doi: 10.1080/13803395.2022.2036706. Online ahead of print.

ABSTRACT

INTRODUCTION: The present study aims to be the first to validate the Tuokko version of the Clock Drawing Test (CDT) and estimate its cutoff score after its translation into the Greek language and administration in the Greek population.

METHODS: One hundred and thirty-two individuals participated in this study [60 with Good Cognitive Health (GCH), 24 with Parkinson’s Disease (PD), 24 with Parkinson’s Disease Dementia (PDD) and 24 with Alzheimer’s Disease (AD)]. The CDT was administered to all participants. Additionally, the cognitive and mental status of the sample were estimated through the use of the Mini Mental State Examination (MMSE), Abbreviated Mental Test Score (AMTS), Arizona Battery for Communication Disorders of Dementia (ABCD), Instrumental Activities of Daily Living (IADL), the Neuropsychiatric Inventory (H-NPI) and the Geriatric Depression Scale -15 (GDS-15).

RESULTS: Statistically significant differences were found between all groups on the CDT, with AD patients having lower scores than all subgroups in the study. The CDT showed a high internal consistency (Cronbach’s alpha = 0.832). The ROC analysis provided a cutoff point equal to 4.00 (AUC: 0.821, p < 0.001) between the Cognitively Unimpaired Group (CUG: GCH and PD group) and the Cognitively Impaired Group (CIG: PPD and AD patients), 5.00 (AUC: 0.845, p < 0.001) between the GCH group and the PDD group, and 4.00 (AUC: 0.780, p < 0.001) between the GCH group and the AD group. Finally, the cutoff point between the PD group and the PDD group was 4.00 (AUC: 0.896, p < 0.005), and 3.00 (AUC: 0.899, p < 0.001) between the PD group and the AD group. Significant positive Pearson’s correlations were observed between CDT and MMSE (r = 0.808, p < 0.001), CDT and AMTS (r = 0.688, p < 0.001), CDT and ABCD (r = 0.770, p < 0.001), CDT and the ABCD Visuospatial Construction subdomain (r = 0.880, p < 0.001); while a negative correlation was found between CDT and IADL (r = -0.627, p < 0.001) between the CUG and the CIG groups.

CONCLUSION: Given the results obtained, the CDT appears to be a clinically valid screening instrument for the assessment of visuospatial abilities, with high reliability in Greek populations with cognitive impairment.

PMID:35156553 | DOI:10.1080/13803395.2022.2036706

Physiother Theory Pract. 2022 Feb 12:1-16. doi: 10.1080/09593985.2022.2036278. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with chronic health conditions risk aggravation of their health status due to reduced access to health services during the COVID-19 related lockdown.

OBJECTIVES: To investigate the impact of Belgian COVID-19 measures on general health status (i.e. worse or stable/better) of patients, adult and pediatric, with chronic health conditions and how this change in health status relates to personal and health behavior-related factors.

DESIGN: A cross-sectional study using an online survey was conducted during the first COVID-19 related lockdown in Belgium.

METHODS: Associations between change in health status since the lockdown and (change in) personal and health behavior-related factors (including physical activity, access to health-care services and social activities) were investigated.

RESULTS: In adults (n = 561), almost all personal factors, including feelings of distress, depression, anxiety, somatization, and low self-efficacy, were significantly worse in patients with a worse health status during the lockdown (n = 293, 52%) compared to patients reporting a stable/better health status (p < .001-0.002). Also, these patients reported lower physical activity levels, more tele-consultations and less social activities (p < .001-0.006). In children (n = 55), all surveys were completed by a proxy (parent(s)/guardian) who reported a worse health status in 38% of the children. Level of distress of the child (p = .005) since the lockdown and somatization of the parent(s) (p = .0018) were significantly worse in children with a worse versus a stable/better health status.

CONCLUSION: Fifty-two percent of the adults and 38% of children with chronic health conditions reported worsening of their general health status during the lockdown in March-May 2020 in Belgium. Negative personal factors and unhelpful health behavior seems to be associated with a worse health status.

PMID:35156531 | DOI:10.1080/09593985.2022.2036278

Physiother Theory Pract. 2022 Feb 12:1-15. doi: 10.1080/09593985.2022.2036279. Online ahead of print.

ABSTRACT

BACKGROUND: Therapeutic climbing (TC) is a whole-body workout that stimulates and improves physical and psychosocial abilities. It has been used in neurological rehabilitation, but there is scarce evidence of specific benefits for people with Parkinson’s (PwP).

OBJECTIVE: To investigate and evaluate self-reported differences in health and well-being among trial participants, the overall feasibility of TC and clinical changes caused as a rehabilitation measure for PwP.

METHODS: A 3-level Likert scale survey was completed by 26 PwP (100% response rate) after a TC course (mean 16 sessions) at the Neurological Rehabilitation Center assessing self-perceived differences in health and well-being in terms of physical, psychological, and social parameters. We investigated the feasibility of TC in terms of adherence, practicability and acceptability during a multidisciplinary inpatient rehabilitation program and determined several clinical outcomes (10-meter distance and 2-minute duration walking tests, Functional Gait Assessment, Nine-Hole-Peg tests, and Tinetti Assessment Tool).

RESULTS: Improvements are based on self-reported perceptions of PwP. We observed an improvement of overall physical (average 65%), psychological (average 59%) and social (average 39%) aspects after TC. PwP improved strength (96%), balance (88%), range of motion (88%), body awareness (85%), physical well-being (77%), and fatigue (75%). Furthermore, they self-reported admiration in their social surrounding (42%) and felt more sociable and outgoing (40%). Concerning adherence, practicability and acceptability, TC seems to be feasible for PwP. Treatment adherence was 100%, 70% declared motivation to continue TC, and 96% intended to recommend TC to peers. Furthermore, PwP showed statistically significant improvements in 10-meter walking tests (T0: 7.5 (1.1-13.9), T1: 6.5 (0.1-12.9); p < .01; n = 16), 2-minute walking tests (T0: 149.5 (-111.0-410.0), T1: 177.0 (-140.7-494.7); p < .01; n = 19), Functional Gait Assessment (T0: 26.0 (-24.8-76.8), T1: 28.0 (2.6-53.4); p < .01; n = 15), and Nine-Hole-Peg tests (left: T0: 26.5 (24.3-28.7), T1: 24.1 (22.0-26.3); p < .01; n = 15; right: T0: 26.7 (24.1-29.2), T1: 23.3 (20.8-25.7); p < .01; n = 15).

CONCLUSION: The preliminary findings suggest that TC offers an effective and feasible training method that may positively affect PwP overall perceptions of physical and psychosocial health status. The methodological limitations and small sample size limit the study’s interpretability. More research is needed to definitely show the scientifically significant benefits of TC to PwP.

PMID:35156524 | DOI:10.1080/09593985.2022.2036279