Tag: statistics

Ann Ital Chir. 2022 Jan 10;11:S0003469X22036375. Online ahead of print.

ABSTRACT

The study was supported by TUEK (Board of Education and Expertise in Medicine – grant number 2016-1201). Funding source had no involvement in conducting or reporting process of this study. Comparison of Antisperm Antibody level following extraperitoneal inguinal hernia repair and Lichenstein hernia >A randomzed rial PURPOSE: We compared laparoscopic totally extraperitoneal (TEP) hernia repair and open Lichtenstein hernia repair (LHR) in terms of Antisperm Antibody Levels (ASA), pain, operative times, return to work times, hernia recurrence, and postsurgery complications.

METHODS: The patients were randomly divided into two groups as LHR and TEP. Blood samples were obtained for analysis of levels of ASA. Postoperative pain scores were assessed on the first day after repair using the Visual Analog Scale (VAS), and hernia recurrence, operation times, return to work times, and early and late postoperative complications were recorded.

RESULTS: Sixty male patients enrolled in the study. All patients were negative for ASA presurgery. ASA were detected in two patients in the LHR group postsurgery. The VAS score of the patients in the TEP repair group was significantly lower than that in the LHR group (median: 4.0 vs. 6.0) (p <0.001). The mean operation time in the TEP hernia repair group (50 min) was significantly longer than that in the LHR group (40 min) (40.0) (p <0.011). The median return to work time in the TEP hernia repair group (7 d) was significantly shorter than that in the LHR group (15 d)(p <0.001). There was no statistically significant difference between the two methods in terms of ASA,recurrence, or postoperative complications (p> 0.05).

DISCUSSION: Many studies have compared the superiority of different inguinal hernia repair methods. Which CONCLUSION: It is not possible to determine the superiority of concerning technics in reducing infertility after surgery. TEP inguinal hernia repair is superior to LHR in in terms of postoperative pain and return to work times.

KEY WORDS: Lichtenstein, Antisperm antibody, İnfertility, Inguinal hernia, Totally extra peritoneal repair.

PMID:35174790

Med Educ Online. 2022 Dec;27(1):2033421. doi: 10.1080/10872981.2022.2033421.

ABSTRACT

PURPOSE: Medical scribing is an increasingly common way for pre-medical students to gain clinical experience. Scribes are a valuable part of the healthcare team and have high rates of matriculation into health professional programs. Little is known about the effects of scribing on the success of the student. This manuscript aims to determine the effect of scribing experience on clinical self-efficacy during medical school.

PARTICIPANTS AND METHODS: Perceived clinical self-efficacy was evaluated with validated survey questions using a 5-point Likert-type scale as well as free text responses. The survey was completed by 175 medical students at the Frank H. Netter, MD School of Medicine. Statistical analysis was conducted using SPSS. As part of the mixed methods study, free text responses were analyzed using thematic analysis.

RESULTS: Quantitative results showed no statistical difference in perceived clinical self-efficacy between medical students with scribing experience and those without. Analysis of free text responses showed that medical students believed their scribing experience improved comfort in the clinical setting and increased familiarity with medical terminology.

DISCUSSION AND CONCLUSIONS: Medical students with scribing experience did not demonstrate greater clinical self-efficacy than their peers without scribing experience. However, medical students with scribing experience have a perceived value of their pre-medical scribing experience on their success in medical school.

PMID:35174763 | DOI:10.1080/10872981.2022.2033421

J Chemother. 2022 Feb 17:1-10. doi: 10.1080/1120009X.2022.2040770. Online ahead of print.

ABSTRACT

The aim of this multicentre retrospective study was to compare the efficacy of adjuvant chemotherapy regimens both with and without oxaliplatin and tumor sidedness in stage IIB (pT4aN0) colon cancer patients. This study included patients with stage IIB colon cancer who underwent curative surgery and received adjuvant chemotherapy. The patients were divided into two groups (one with and one without oxaliplatin) to compare the overall survival (OS) in right- and left-sided tumors. The study population included 298 patients with stage IIB colon cancer (median age: 57) of whom 69.1% were male. Forty-four per cent of these patients (n = 131) were diagnosed with right-sided colon cancer. The median follow-up duration was 35.9 months. In the entire population, a median OS was not reached, and the five-year OS was 83%. The median disease-free survival (DFS) was 12 months. There was no significant difference in terms of the five-year OS between right- (82%) and left-sided (84%) colon tumors (p = 0.67). In addition, the five-year OS of patients treated with and without oxaliplatin were 76% and 89%, respectively, and there was no statistically significant difference (p = 0.23). The five-year OS of the patients treated with and without oxaliplatin were 83% and 96.5%, respectively, (p = 0.8) in right-sided colon tumors, while it was 75% and 93% (p = 0.06), respectively, in left-sided colon tumors. Tumor sidedness and the addition of oxaliplatin to adjuvant chemotherapy were not found to be associated with the OS in stage IIB colon cancer patients in our study. Further large prospective studies that also include MSI, RAS and BRAF status data are warranted in colon cancer patients.

PMID:35174772 | DOI:10.1080/1120009X.2022.2040770

Scand J Gastroenterol. 2022 Feb 17:1-5. doi: 10.1080/00365521.2022.2039281. Online ahead of print.

ABSTRACT

OBJECTIVES: The development of intestinal failure-related complications in Finnish adults is unknown. This study aimed to investigate the incidence of catheter-related bloodstream infections (CRBSI), and the longitudinal changes in biochemical liver and kidney tests in a nationwide cohort.

MATERIALS AND METHODS: The search for Finnish adults with intestinal failure (IF) utilized a survey to Finnish health-care providers (n = 111) with the potential to provide long-term parenteral support (PS) for adult IF. Our nationwide, cross-sectional cohort included all IF patients aged ≥ 18 years who had received PS for ≥ 120 d in 2017. Data regarding CRBSI and biochemical liver and kidney tests were collected from patient records at the start of PS up to the latest available measurement in 2017.

RESULTS: In the nationwide cohort of 52 patients, the CRBSI incidence was 1.35/1000 catheter days. Seventy-three percent of CRBSI in a long-term catheter led to catheter replacement. During a median PS duration of 27.5 (interquartile range [IQR] 11.3-57.3) months, a statistically significant median change occurred in estimated glomerular filtration rate (eGFR; -8.5 ml/min/1.73 m², IQR -30-7, p = .005) and alkaline phosphatase (ALP; 26 U/l, IQR -11-95, p = .019). In a multiple regression model for eGFR at data collection, baseline eGFR and age were strong explanatory variables.

CONCLUSIONS: Incidence of CRBSI, but not treatment strategies, in this nationwide adult IF population correspond well to those reported from specialized centers. Decreased kidney function and abnormal liver test results are frequent findings, and even more so over time, emphasizing the importance of regular monitoring.

PMID:35174757 | DOI:10.1080/00365521.2022.2039281

Cancer Med. 2022 Feb 16. doi: 10.1002/cam4.4584. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic dysfunction and inflammation have been associated with endometrial cancer risk; however, their influence on endometrial cancer survival is less understood.

METHODS: A prospective cohort study of 540 endometrial cancer cases diagnosed between 2002 and 2006 in Alberta were followed for survival outcomes to 2019. Baseline blood samples collected either pre- or post-hysterectomy were analyzed for glucose, insulin, adiponectin, leptin, tumor necrosis factor-α, interleukin-6, and C-reactive protein. Covariates were obtained during in-person interviews and via medical chart abstraction. Cox proportional hazard regression models were used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between each biomarker and disease-free and overall survival.

RESULTS: Blood samples were collected from 520 of the 540 participants (presurgical n = 235; postsurgical n = 285). During the median follow-up of 14.3 years (range 0.4-16.5 years), there were 125 recurrences, progressions, and/or deaths with 106 overall deaths. None of the biomarkers were associated with disease-free or overall survival in multivariable-adjusted analyses. In an exploratory stratified analysis, the highest level of presurgical adiponectin, compared to the lowest level, was associated with improved disease-free (HR = 0.42, 95% CI = 0.20-0.85) and overall (HR = 0.41, 95% CI = 0.18-0.92) survival, whereas no statistically significant associations were noted for postsurgical measures of adiponectin.

CONCLUSIONS: Overall, there was no evidence of an association between biomarkers of insulin resistance and inflammation with mortality outcomes in endometrial cancer survivors. Future cohort studies with serial blood samples are needed to understand the impact of changes in insulin resistance and inflammatory markers on endometrial cancer survival.

PMID:35174651 | DOI:10.1002/cam4.4584

Orthop Surg. 2022 Feb 17. doi: 10.1111/os.13230. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the feasibility and clinical efficacy of a modified medial collateral ligament indentation technique in total knee arthroplasty (TKA) with severe type II valgus deformity.

METHODS: Consecutive patients with Krackow type II valgus deformity >20° who underwent a primary unilateral TKA between May 2008 and June 2017 were studied retrospectively. A medial collateral ligament indentation technique was performed in 20 patients (MCLI group), and 23 patients received the routine lateral structures release technique (LSR group). Radiological parameters, such as the valgus angle (VA), and functional outcomes including the use of constraint implants, Knee Society Score (KSS), Knee Society Function score (KSF), and thickness of the polyethylene insert were compared between the two groups.

RESULTS: A total of 43 consecutive patients had a minimum 2-year follow-up. The preoperative VA was comparable between the MCLI (23.5° ± 5.8°) and LSR groups (21.3° ± 3.2°, P = 0.134), as was the postoperative VA (1.1° ± 2.1° and 2.5° ± 3.0°, respectively, P = 0.084). The mean KSS and KSF scores in the MCLI group were 30.2 ± 4.8 and 38.8 ± 4.8, respectively, before surgery, and they increased to 91.3 ± 2.6 and 86.5 ± 2.4 at the last follow-up. The scores in the LSR group were 31.5 ± 7.5 and 36.5 ± 7.8 before surgery and 92.4 ± 3.5 and 88.5 ± 3.6 at the last follow-up. While no statistically significant differences in pre- or postoperative functional scores were found between the two groups, the MCLI group had thinner polyethylene inserts (9.5 ± 1.1 mm vs 12.9 ± 1.5 mm) and less use of constrained condylar inserts (15% vs 69.6%). During follow-up, the MCLI group had fewer complications.

CONCLUSION: A modified MCLI technique can achieve good outcomes in TKA with type II valgus deformity of >20°. It can maintain a normal joint line level, reduce the use of constrained condylar knee prostheses, and is a reliable choice for severe genu valgum.

PMID:35174652 | DOI:10.1111/os.13230

Acta Ophthalmol. 2022 Feb 17. doi: 10.1111/aos.15115. Online ahead of print.

ABSTRACT

PURPOSE: The aim of our study was to compare metabolic (oxygen saturation; %) and anatomical (diameter; μm) retinal vessel parameters of patients with central serous chorioretinopathy (CSC) to those of controls.

METHODS: In this prospective cross-sectional cohort study, 72 eyes of patients with CSC were compared with 21 eyes of healthy controls. Of the 72 patients, 52 had chronic, nonactive CSC (subgroup nCSC) and 20 had active CSC (subgroup aCSC), according to activity on fluorescein angiography. Retinal vessel oximetry (RO) was performed using the Oxymap T1 oximeter. Oxygen saturation in all major peripapillary retinal arterioles (A-SO₂ ) and venules (V-SO₂ ) was measured, and their difference (A-V SO₂ ) was calculated. In addition, we evaluated the corresponding diameter in retinal arterioles (D-A) and venules (D-V). For statistical evaluation, ANOVA-based linear mixed-effects models were calculated (SPSS®; p < 0.05).

RESULTS: Central serous chorioretinopathy (CSC) patients had significantly higher A-SO₂ and V-SO₂ compared to that of controls (p = 0.031 and p = 0.018 respectively). Especially, the subgroup of aCSC patients showed significantly higher A-SO₂ and V-SO₂ values (p = 0.027 and p = 0.034, respectively). In addition, superotemporal and superonasal quadrant location showed significant interactions with A-SO₂ and V-SO₂ (p ≤ 0.03). Diameter in retinal arterioles (D-A), an venules (D-V) and A-V SO₂ findings showed no significant differences (p > 0.096).

CONCLUSION: These data indicate that patients with CSC have altered metabolic function. The presence of disease activity showed the greatest influence on RO measurement, both compared to controls and to those with inactive chronic CSC disease.

PMID:35174647 | DOI:10.1111/aos.15115

J Clin Hypertens (Greenwich). 2022 Feb 17. doi: 10.1111/jch.14431. Online ahead of print.

ABSTRACT

Severe hypertension (HTN) that develops during hospitalization is more common than admission for HTN; however, it is poorly studied, and treatment guidelines are lacking. Our goal is to characterize hospitalized patients who develop severe HTN and assess blood pressure (BP) response to treatment. This is a multi-hospital retrospective cohort study of adults admitted for reasons other than HTN who developed severe HTN. The authors defined severe inpatient HTN as the first documented BP elevation (systolic BP > 180 or diastolic BP > 110) at least 1 hour after admission. Treatment was defined as receiving antihypertensives (intravenous [IV] or oral) within 6h of BP elevation. As a measure of possible overtreatment, the authors studied the association between treatment and time to mean arterial pressure (MAP) drop ≥ 30% using the Cox proportional hazards model. Among 224 265 hospitalized adults, 10% developed severe HTN of which 40% were treated. Compared to patients who did not develop severe HTN, those who did were older, more commonly women and black, and had more comorbidities. Incident MAP drop ≥ 30% among treated and untreated patients with severe HTN was 2.2 versus 5.7/1000 person-hours. After adjustment, treated versus. untreated patients had lower rates of MAP drop ≥ 30% (hazard rate [HR]: 0.9 [0.8, 0.99]). However, those receiving only IV treatment versus untreated had greater rates of MAP drop ≥ 30% (1.4 [1.2, 1.7]). Overall, the authors found that clinically significant MAP drop is observed among inpatients with severe HTN irrespective of treatment, with greater rates observed among patients treated only with IV antihypertensives. Further research is needed to phenotype inpatients with severe HTN.

PMID:35174627 | DOI:10.1111/jch.14431

Can Rev Sociol. 2022 Feb 16. doi: 10.1111/cars.12375. Online ahead of print.

ABSTRACT

The rise of the Big Data paradigm has made it more feasible to track how personal networks evolve on social media, where auto-generated contact records and fine-grained temporal data sequences help capture how and when interpersonal ties and contacts change their roles. Using a sample of matched survey data and social media records, we investigated the mechanisms by which indirect contacts (“degree-2 alters”) transform into direct contacts (“degree-1 alters”) from a Facebook user’s (ego’s) point of view. To highlight the temporal sequences, we assigned different roles to the same alters depending on how each of them is connected with ego at different periods of time. Multilevel event history analyses pinpoint several online actions and network features of ego, degree-1 alters, and degree-2 alters, as the key factors that contribute to the transformation from indirect contacts into direct contacts.

PMID:35174632 | DOI:10.1111/cars.12375

Biol Rev Camb Philos Soc. 2022 Feb 16. doi: 10.1111/brv.12840. Online ahead of print.

ABSTRACT

Mercury contamination is a major threat to the global environment, and is still increasing in some regions despite international regulations. The methylated form of mercury is hazardous to biota, yet its sublethal effects are difficult to detect in wildlife. Body condition can vary in response to stressors, but previous studies have shown mixed effects of mercury on body condition in wildlife. Using birds as study organisms, we provide the first quantitative synthesis of the effect of mercury on body condition in animals. In addition, we explored the influence of intrinsic, extrinsic and methodological factors potentially explaining cross-study heterogeneity in results. We considered experimental and correlative studies carried out in adult birds and chicks, and mercury exposure inferred from blood and feathers. Most experimental investigations (90%) showed a significant relationship between mercury concentrations and body condition. Experimental exposure to mercury disrupted nutrient (fat) metabolism, metabolic rates, and food intake, resulting in either positive or negative associations with body condition. Correlative studies also showed either positive or negative associations, of which only 14% were statistically significant. Therefore, the overall effect of mercury concentrations on body condition was null in both experimental (estimate ± SE = 0.262 ± 0.309, 20 effect sizes, five species) and correlative studies (-0.011 ± 0.020, 315 effect sizes, 145 species). The single and interactive effects of age class and tissue type were accounted for in meta-analytic models of the correlative data set, since chicks and adults, as well as blood and feathers, are known to behave differently in terms of mercury accumulation and health effects. Of the 15 moderators tested, only wintering status explained cross-study heterogeneity in the correlative data set: free-ranging wintering birds were more likely to show a negative association between mercury and body condition. However, wintering effect sizes were limited to passerines, further studies should thus confirm this trend in other taxa. Collectively, our results suggest that (i) effects of mercury on body condition are weak and mostly detectable under controlled conditions, and (ii) body condition indices are unreliable indicators of mercury sublethal effects in the wild. Food availability, feeding rates and other sources of variation that are challenging to quantify likely confound the association between mercury and body condition in natura. Future studies could explore the metabolic effects of mercury further using designs that allow for the estimation and/or manipulation of food intake in both wild and captive birds, especially in under-represented life-history stages such as migration and overwintering.

PMID:35174617 | DOI:10.1111/brv.12840