Tag: statistics

J Appl Res Intellect Disabil. 2021 Mar 23. doi: 10.1111/jar.12866. Online ahead of print.

ABSTRACT

PURPOSE: People with Down syndrome (DS) have a unique medical profile which may impact views of health. We aimed to explore the use of global health measures in DS.

METHODS: Prospective survey in the Mass General Hospital Down Syndrome Program (MGH DSP) from December 2018 to July 2019 with Patient Reported Outcomes Measurement Information System (PROMIS)® instruments of global health. Analyses included use of scoring manuals, descriptive statistics and dependent samples t test.

RESULTS: Seventeen adolescents, 48 adults with DS and 88 caregivers returned surveys; 137 were complete. Incomplete responses and notes showed limitations of the instruments in this population. Global health T-scores did not differ from the available comparative standardized scores to these measures from PROMIS® reference population (p > 0.05).

CONCLUSIONS: In the MGH DSP, pilot global health instruments were completed by some adults with DS and caregivers, with some limitations and scores similar to the PROMIS® reference population.

PMID:33759305 | DOI:10.1111/jar.12866

Int J Clin Pract. 2021 Mar 23:e14170. doi: 10.1111/ijcp.14170. Online ahead of print.

ABSTRACT

AIMS: The aim of the study was to evaluate the possible changes in sleep behavior and nutrition in children during the pandemic period.

METHODS: 114 parents who accepted to participate in the study aged 18 and over and who had children between the ages of 6 and 16 were included in the study. A questionnaire was carried out after written consents were obtained. In the first part of the questionnaire, there were a total of 9 questions including socio-demographic information and nutritional characteristics, and the second part included the “Sleep Disturbance Scale for Children” (SDSC). The data were analyzed with the SPSS 20 statistical program.

RESULTS: The total number of participants was 114 parents; 64 (56%) of the children were girls and 50 (43.9%) were boys. Among the participants, the number of children who had COVID-19 was 38 (33.3%). There was no statistically significant relationship between going through COVID-19 status and the variables examined in general. The proportion of participants who stated that if the pandemic period was prolonged, COVID-19 would not change their diet was found to be statistically significant (p=0.038). The SDSC score was found to be significantly high in girls (p<0.05).

CONCLUSION: Sleep and nutritional disorders affect the quality of life for all ages for both genders, and their importance increases even more in extraordinary periods such as pandemic. Sleep problems increasing especially with an accompanying anxiety state may lead to developmental problems as well as deepening psychological disorders.

PMID:33759311 | DOI:10.1111/ijcp.14170

Int J Clin Pract. 2021 Mar 24:e14161. doi: 10.1111/ijcp.14161. Online ahead of print.

ABSTRACT

OBJECTIVE: Our study was carried out on patients admitted to the emergency ward with acute stroke symptoms that were subsequently diagnosed with cerebrovascular disease. We aimed to examine the relationship between these patients’ admission lactate levels and their 1, 3, and 12-month mortality rates in order to evaluate the prognostic value of lactate levels.

METHODS: Our data was obtained retrospectively from 568 patients diagnosed with acute ischemic stroke at our emergency department between 01/01/2017 and 01/01/2018. Patient data was accessed via the hospital patient database. Included patients’ files were assessed for examination and history taken at admission, comorbid diseases, demographic characteristics, treatments utilized, and laboratory results. Hyperlactatemia was defined as a lactate level of over 2mmol/L. The relationship between lactate levels and survival was investigated. Patients’ complication rates after discharge were assessed alongside their 1, 3, and 12-month mortality.

RESULTS: Our study assessed 568 patients. Out of these patients, 400 patients met our inclusion criteria and constituted the study population. These patients were separated into two groups according to their lactate levels. The hyperlactatemic group had a statistically significant increase in 1, 3, and 12-month mortality rates in comparison to the other group.

CONCLUSIONS: Our study found that hyperlactatemia was associated with a higher risk of 1, 3, and 12 month mortality, suggesting that it has predictive prognostic value. In the future, we believe that prospective observational studies and/or large-scale retrospective studies will be of great value in providing more insight into this topic.

PMID:33759312 | DOI:10.1111/ijcp.14161

Muscle Nerve. 2021 Mar 23. doi: 10.1002/mus.27241. Online ahead of print.

ABSTRACT

Pain as a significant symptom in patients with Periodic Paralysis- A cross-sectional survey INTRODUCTION/AIMS: Periodic paralysis (PP) is thought to be limited to episodes of muscle weakness, however, there are reports of fibromyalgia-like pain in PP. We aimed to evaluate pain and comorbid sleep, fatigue, and mood disorders in PP patients.

METHODS: We administered a cross-sectional survey to PP patients at the 2019 Periodic Paralysis Conference. The survey consisted of the Brief Pain Inventory (BPI), Widespread pain index (WPI), Pittsburgh Sleep Quality Index (PSQI), Modified Fatigue Impact Scale (MFIS) and ten question Center for Epidemiologic Studies Depression Scale (CESD-10). Descriptive statistics for PP patients were calculated and compared to prior studies.

RESULTS: 44 persons with PP took the survey. 52.3% reported a moderate to severe interference of pain on their lives. 45.5% of patients met the study criteria for fibromyalgia. Patients with SCN4A mutations had higher rates of fibromyalgia than the next most prevalent gene mutation, CACNA1S. In patients with pain, there were increased rates of comorbid fatigue, depression, and poor sleep quality.

DISCUSSION: Pain, akin to fibromyalgia, is a significant symptom of PP and can affect quality of life. Pain in PP was more prevalent than in the general population, at a rate comparable to other chronic neuromuscular disease groups. PP patients could benefit from a multidisciplinary approach to assess their pain, sleep, fatigue and mood.

PMID:33759219 | DOI:10.1002/mus.27241

Eur J Neurosci. 2021 Mar 23. doi: 10.1111/ejn.15199. Online ahead of print.

ABSTRACT

Emotion regulation is related to recovery after mild traumatic brain injury (mTBI). This longitudinal tractography study examined white matter tracts subserving emotion regulation across the spectrum of mTBI, with a focus on persistent symptoms. Four groups were examined: (1) symptomatic (n=33) and (2) asymptomatic (n=20) patients with uncomplicated mTBI (i.e., no lesions on computed tomography (CT)), (3) patients with CT-lesions in the frontal areas (n=14), and (4) healthy controls (n=20). Diffusion and conventional MRI were performed approximately one and three months post-injury. Whole brain deterministic tractography followed by region of interest analyses were used to identify forceps minor, uncinate fasciculus, and cingulum bundle as tracts of interest. An adjusted version of the ExploreDTI Atlas Based Tractography method was used to obtain reliable tracts for every subject. Mean fractional anisotropy (FA), radial and axial diffusivity (MD, RD, AD), and number of streamlines were studied per tract. Linear mixed models showed lower FA, and higher MD, and RD of the right uncinate fasciculus in asymptomatic patients with uncomplicated mTBI relative to symptomatic patients and healthy controls. Diffusion alterations were most pronounced in the group with frontal lesions on CT, particularly in the forceps minor and uncinate fasciculus; these effects increased over time. Within the group of patients with uncomplicated mTBI, there were no associations of diffusion measures with number of symptoms nor with lesions on conventional MRI. In conclusion, mTBI can cause microstructural changes in emotion regulation tracts, however, no explanation was found for the presence of symptoms.

PMID:33759227 | DOI:10.1111/ejn.15199

J Viral Hepat. 2021 Mar 24. doi: 10.1111/jvh.13508. Online ahead of print.

ABSTRACT

Antiviral therapy improves survival in patients with hepatitis B virus (HBV)-induced hepatocellular carcinoma (HCC). However, the effect of antiviral therapy in patients with low-level viremia HBV-HCC receiving non-curative therapy remains unclear. We aimed to evaluate the role of antiviral therapy in patients with low-level viremia and treated with transarterial chemoembolization (TACE). This retrospective study evaluated 206 patients with HBV-HCC who underwent TACE as an initial treatment. Of those, 135 patients received antiviral therapy (antiviral group), and 71 did not (non-antiviral group). The definition of low-level viremia was an HBV DNA level <2,000 IU/mL. Kaplan-Meier curves, log-rank tests, and Cox regression analysis were used for statistical analyses. The median follow-up duration was 39 months (1-174 months). Overall survival (OS) did not differ between groups (P = 0.227). Barcelona Clinic Liver Cancer stage (BCLC), Child-Pugh (CP) class, and α-fetoprotein level were independent prognostic factors for OS. Antiviral therapy (hazard ratio [HR], 0.503, P = 0.022) was a prognostic factor for 2-year survival. On subgroup analysis, antiviral therapy improved short-term survival in patients with BCLC stage 0 and A (P = 0.037) and CP class A (P = 0.04). In patients with low-level viremia, antiviral therapy yielded short-term survival benefits, particularly in patients with early-stage HCC.

PMID:33759295 | DOI:10.1111/jvh.13508

Eur J Neurol. 2021 Mar 23. doi: 10.1111/ene.14834. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD) is considered a clinical and biological continuum identified via cerebrospinal fluid (CSF) or imaging biomarkers. Chronic hypoperfusion is held as one of the main features of Alzheimer’s disease, as part of the processes causing neuronal degeneration. The mechanism responsible for such condition is still debated, though recently a direct connection with amyloid peptides has been shown. Here we aimed at investigating whether measures of hypoperfusion change along the AD continuum.

METHODS: 70 patients with mild AD were recruited and stratified according to their CSF biomarkers profile – as indicated by the NIA-AA research framework – into patients with either isolated amyloid pathology (A+T-) or full-blown AD (A+T+), and further layered according to ApoE genotype. After evaluation of vascular risk factors, we performed a Trans Cranial Doppler (TCD) on each patient, to evaluate mean flow velocity and pulsatility index in the middle cerebral artery, and to calculate the breath holding index (BHI). Patients were compared to a cohort of 17 healthy controls.

RESULTS: The BHI was reduced in the AD continuum and resulted inversely correlated to CSF Aβ42 levels. Such correlation was stronger in the A+T+ than in A+T- group, and unexpectedly reached statistical significance only in the E3 and not in the E4 genotype carriers.

CONCLUSIONS: These results suggest a tight and effective relationship between Aβ42, vascular hypoperfusion, cerebrovascular reactivity and epsilon genotype.

PMID:33759296 | DOI:10.1111/ene.14834

Turk Neurosurg. 2020 Nov 11. doi: 10.5137/1019-5149.JTN.30092-20.1. Online ahead of print.

ABSTRACT

AIM: In radiogenomics, certain MRI features have been recently associated to predict genetic alterations. We analyzed certain MRI features as well as six major genetic biomarkers, investigated their associations, and evaluated their prognostic roles in glioblastomas (GBMs).

MATERIAL AND METHODS: Strict criteria included newly diagnosed GBM with optimal treatments. Simple manual imaging characteristics (tumor side, location, enhancement, diameter, depth, radiographic necrosis, and edema) were obtained from preoperative conventional MRI. Furthermore, all the status of the MGMT promoter, Chromosome 1p and 19q, IDH, TERT, and BRAF in tumor tissues were detected.

RESULTS: Among 126 inpatients, 60 cases were selected and enrolled in the study. The status of the MGMT promoter was significantly associated with the grade of radiographic necrosis (p = 0.033). The rate of 19q deletion was significantly higher in tumors with the ring-shaped peritumoral edema (PTE) (p = 0.035) and in tumors with the ring-enhanced trait (p = 0.023). Univariate analysis showed that a low PTE index and MGMT promoter methylation were both unfavorable prognostic factors. While the PTE index statistically dropped out, the status of the MGMT promoter and the depth of the tumor were observed to be independent prognostic factors in multivariate analysis.

CONCLUSION: Based on simple neuroimaging metrics, novel connections between features of preoperative conventional MRI and status of major genetic biomarkers were observed, especially for the MGMT promoter and 19q.

PMID:33759171 | DOI:10.5137/1019-5149.JTN.30092-20.1

Turk Neurosurg. 2020 Nov 5. doi: 10.5137/1019-5149.JTN.31778-20.2. Online ahead of print.

ABSTRACT

AIM: This study aimed to assess the craniocervical junction (CCJ) by using radiological measurements in patients with Adolescent Idiopathic Scoliosis (AIS) and Scheuermann’s Kyphosis (SK) compared to normal adolescent population.

MATERIAL AND METHODS: Patients were assigned to three groups. Group 1 consisted of AIS patients, Group 2 consisted of patients with SK, and Group 3 was the control group who had no spinal disorder. The groups were matched based on age and gender. Major Cobb angle and kyphosis angle were measured on X-Ray. Basion-axial interval (BAI), basion-dens interval (BDI), posterior atlantodental interval (PADI), anterior atlantodental interval (ADI), atlanto-occipital interval (AOI), and Power’s ratio were measured by computer tomography. The results were compared in each group statistically.

RESULTS: A total of 120 participants, comprised of 78 (65%) female and 42 (35%) male were included in the study. There was no statistically difference between 3 groups based on age and gender (p 0.05). According to the measurements, Group 3 had significantly higher PADI measurements than Group 1 (p=0.01). The ADI measurements of Group 2 were significantly higher than those of Group 1 and Group 3 (p=0.01). Group 3 had significantly higher BDI measurements than Group 1 and Group 2. (p=0.01). The Power ratios of Group 1 and Group 3 were statistically higher than that of Group 2 (p=0.01). There were no statistically significant differences between the groups in terms of AOI and BAI measurements (p=0.84, p=0.18, respectively).

CONCLUSION: The presence of AIS and Scheuermann’s kyphosis may affect the measurement of CCJ and it may be considered to evaluate instability of the region.

PMID:33759172 | DOI:10.5137/1019-5149.JTN.31778-20.2

Turk Neurosurg. 2021 Mar 8. doi: 10.5137/1019-5149.JTN.33332-20.3. Online ahead of print.

ABSTRACT

AIM: An increasing number of biomarkers of primary glioblastoma (GBM) have recently been described. We aimed to investigate the biological and clinical factors that affect survival in Turkish patients with primary GBM.

MATERIAL AND METHODS: The clinical and demographic data of all patients with primary GBM diagnosed between 2007 and 2016 were evaluated. In all the patients’ pathological specimens, O6 methylguanine-DNA methyltransferase (MGMT) methylation and isocitrate dehydrogenase (IDH) 1 mutation were detected retrospectively by immunohistochemistry. Kaplan-Meier survival analysis, log-rank test, and multivariate analyses of the Cox hazard proportional model for all the variables were performed using the SPSS statistical package. The treatment details and other patient-related factors were identified, and their correlations were analyzed.

RESULTS: We enrolled 137 primary GBM patients to the study. Median progression free survival (PFS) was 8.57 months (95% CI: 6.8-9.5) and median overall survival (OS) was 12 months (95 % CI: 10.8-13.3). IDH-1 mutations were detected in 21 primary GBMs (15.3%). PFS was 15.43 ± 1.95 months. Survival rates were higher, but no statistically significant difference (p: 0.074). MGMT methylation was detected in 40 primary GBMs (29.2%). OS and PFS of MGMT (+) cases were higher than MGMT(-)cases (p: 0.001; p: 0.001 respectively). Ki67 (%) measurement (10%-90%) average is 32.64 ± 16.56.No statistically significant between higher and lower ki67 levels (p : 0.510, p: 0.505 respectively). KPS(%) more than 70 at the time of diagnosis statistically significant longer median OS and PFS (p: 0.001) .PFS and OS were higher in all treatment modalities.

CONCLUSION: The most important factors that affected survival were performance score, MGMT methylation status, systemic oncologic therapy, and IDH mutation in the Turkish population with primary GBM. We demonstrated that MGMT methylation and higher KPS levels were associated with significiantly longer OS and PFS.

PMID:33759174 | DOI:10.5137/1019-5149.JTN.33332-20.3