Tag: statistics

Am J Emerg Med. 2021 Mar 11;46:90-96. doi: 10.1016/j.ajem.2021.03.025. Online ahead of print.

ABSTRACT

INTRODUCTION: In response to the COVID-19 pandemic in Detroit, an earlier termination of resuscitation protocol was initiated in March 2020. To characterize pre-hospital cardiac arrest careduring COVID-19 in Detroit, we analyzed out-of-hospital cardiac arrest (OHCA) rate of ROSC (return of spontaneous circulation) and patient characteristics before and during the COVID-19 pandemic.

METHODS: OHCA data was analyzed between March 10th, 2020 – April 30th, 2020 and March 10th, 2019 – April 30th, 2019. ROSC, patient demographics, arrest location, initial rhythms, bystander CPR and field termination were compared before and during the pandemic. Descriptive statistics were utilized to compare arrest characteristics between years, and the odds of achieving vs. not achieving ROSC. 2020 vs. 2019 as a predictor for ROSC was assessed with logistic regression.

RESULTS: 471 patients were included. Arrests increased to 291 during the pandemic vs. 180 in 2019 (62% increase). Age (mean difference + 6; 95% CI: +2.4 to +9.5), arrest location (nursing home OR = 2.42; 95% CI: 1.42-4.31; public place OR = 0.47; 95% CI: 0.25-0.88), BLS response (OR = 0.68; 95% CI: 0.47-0.99), and field termination of resuscitation (OR = 2.36; 95% CI: 1.36-4.07) differed significantly in 2020 compared to 2019. No significant difference was found in the confounder-adjusted odds of ROSC in 2020 vs 2019 (OR = 0.61; 95% CI: 0.34-1.11).

CONCLUSION: OHCA increased by 62% during COVID-19 in Detroit, without a significant change in prehospital ROSC. The rate of ROSC remained similar despite the implementation of an early termination of resuscitation protocol in response to COVID-19.

PMID:33740572 | DOI:10.1016/j.ajem.2021.03.025

Biomed Pharmacother. 2021 Mar 16;138:111469. doi: 10.1016/j.biopha.2021.111469. Online ahead of print.

ABSTRACT

BACKGROUND: Concerns have been raised on a potential interaction between renin-angiotensin system inhibitors (RASI) and the susceptibility to coronavirus disease 2019 (COVID-19). No data have been so far reported on the prognostic impact of RASI in patients suffering from ST-elevation myocardial infarction (STEMI) during COVID-19 pandemic, which was the aim of the present study.

METHODS: STEMI patients treated with primary percutaneous coronary intervention (PPCI) and enrolled in the ISACS-STEMI COVID-19 registry were included in the present sub-analysis and divided according to RASI therapy at admission.

RESULTS: Our population is represented by 6095 patients, of whom 3654 admitted in 2019 and 2441 in 2020. No difference in the prevalence of SARSCoV2 infection was observed according to RASI therapy at admission (2.5% vs 2.1%, p = 0.5), which was associated with a significantly lower mortality (adjusted OR [95% CI]=0.68 [0.51-0.90], P = 0.006), confirmed in the analysis restricted to 2020 (adjusted OR [95% CI]=0.5[0.33-0.74], P = 0.001). Among the 5388 patients in whom data on in-hospital medication were available, in-hospital RASI therapy was associated with a significantly lower mortality (2.1% vs 16.7%, OR [95% CI]=0.11 [0.084-0.14], p < 0.0001), confirmed after adjustment in both periods. Among the 62 SARSCoV-2 positive patients, RASI therapy, both at admission or in-hospital, showed no prognostic effect.

CONCLUSIONS: This is the first study to investigate the impact of RASI therapy on the prognosis and SARSCoV2 infection of STEMI patients undergoing PPCI during the COVID-19 pandemic. Both pre-admission and in-hospital RASI were associated with lower mortality. Among SARSCoV2-positive patients, both chronic and in-hospital RASI therapy showed no impact on survival.

PMID:33740523 | DOI:10.1016/j.biopha.2021.111469

Int J Hyg Environ Health. 2021 Mar 16;234:113718. doi: 10.1016/j.ijheh.2021.113718. Online ahead of print.

ABSTRACT

BACKGROUND: A compulsory school entrance examination of pre-school children (SEU) is administered in the German state of Bavaria. Every second year since 2004, the examinations are expanded in six study regions using a cross-sectional survey design (GME). However, the extent to which the results of the GME surveys are generalizable to the SEU population is unknown. Therefore, this study carried out a poststratification of two different GME surveys. The aim was to observe the impact of poststratification on an exemplary analysis of influencing factors for three allergy and asthma related outcomes (hay fever, asthma, wheezing) and thus to better understand this important question.

METHODS: First, poststratification was applied to correct for deviances of the GME sample in comparison to the SEU population. Logistic regression was used to determine the auxiliary variables for the poststratification. Following this, a composite variable as a linear combination was created to calculate weighting factors. Next, logistic regression analyses were applied to analyze possible influencing factors for three allergy and asthma related outcomes (hay fever, asthma and wheezing) in two GME surveys (2005/2006 and 2012/2013). Subsequently, the differences arising from poststratification were examined in more detail.

RESULTS: This study supports the hypothesis that the GME sample deviates from the SEU population. Mother tongue other than German of at least one parent, complete vaccination status and conspicuous visuomotor test results were positively associated with participation in both GME surveys. The prevalence for hay fever, asthma and frequent wheeze did not change statistically significant from 2005/2006 to 2012/2013. In the twelve analyses before and after poststratification, male sex was statistically significant associated with the three allergy and asthma related outcomes (e.g. asthma 2005/2006 after poststratification, aOR: 2.06, 95%-CI: 1.56-2.71). A high body mass index was positively associated with asthma (e.g. 2005/2006 after poststratification, aOR: 1.12, 95%-CI: 1.05-1.20). Poststratification caused a significant change in the sample composition.

CONCLUSIONS: It might be suggested that a poststratification should be performed for each GME survey. Poststratification tended to make results more comparable with previous research. In accordance with previous research, this study confirmed that male sex and high BMI are associated with asthma.

PMID:33740566 | DOI:10.1016/j.ijheh.2021.113718

Epilepsy Behav. 2021 Mar 16;117:107872. doi: 10.1016/j.yebeh.2021.107872. Online ahead of print.

ABSTRACT

This systematic review and meta-analysis was aimed to summarize the pooled prevalence of stigma and associated factors among people with epilepsy in Ethiopia. A systematic search of articles was conducted in PubMed, SCOPUS, African Journals Online (AJOL), and Journal Storage (JSTOR). A standardized data extraction format was used to extract data. The analysis was conducted using STATA version 11 software. Cochrane Q statistic was used to assess the presence of significant between-study heterogeneity. I² was used to quantify between-study heterogeneity. A leave-one-out sensitivity analysis was done. Subgroup analysis was conducted. Funnel plot, Begg’s test, and Egger’s regression tests were used to measure the presence of publication bias. Since the studies showed heterogeneity, the pooled estimated prevalence of stigma of people with epilepsy was conducted using DerSimonian-Laird’s random-effects model. The estimated pooled prevalence of stigma was 44.65(95%CI; 29.37-59.94). Begg’s rank correlation test (Z = 0.15, P = 0.881) and Egger’s linear regression test (t = 0.14, P = 0.894) showed the absence of publication bias. Factors associated with an increased likelihood of stigma were 6-10 years of duration of illness (p = 0.003), ≥11 years of duration of illness (p = 0.008), and ≥1/month of seizure frequency (p = 0.01). Comprehensive care that involves psychological, social, and medical components is required. Health education on effective coping mechanisms is recommended.

PMID:33740494 | DOI:10.1016/j.yebeh.2021.107872

Ultrasonics. 2021 Mar 6;114:106419. doi: 10.1016/j.ultras.2021.106419. Online ahead of print.

ABSTRACT

Grading red blood cell (RBC) aggregation is important for the early diagnosis and prevention of related diseases such as ischemic cardio-cerebrovascular disease, type II diabetes, deep vein thrombosis, and sickle cell disease. In this study, a machine learning technique based on an adaptive analysis of ultrasonic radiofrequency (RF) echo signals in blood is proposed, and its feasibility for classifying RBC aggregation is explored. Using an adaptive empirical wavelet transform (EWT) analysis, the ultrasonic RF signals are decomposed into a series of empirical mode functions (EMFs); then, dominant empirical mode functions (DEMFs) are selected from the series. Six statistical characteristics, including the mean, variance, median, kurtosis, root mean square (RMS), and skewness are calculated for the locally normalized DEMFs, aiming to form primary feature vectors. Random forest (RDF) and support vector machine (SVM) classifiers are trained with the given feature vectors to obtain prediction models for RBC classification. Ultrasonic RF echo signals are acquired from five groups of six types of porcine blood samples with average numbers of aggregated RBCs of 1.04, 1.20, 1.83, 2.31, 2.72, and 4.28, respectively, to test the classification performance of the proposed method. The best subset with regard to the variance, kurtosis, and RMS is determined according to the maximum accuracy based on the RDF and SVM classifiers. The classification accuracies are 84.03 ± 3.13% for the RDF classifier, and 85.88 ± 2.99% for the SVM classifier. The mean classification accuracy of the SVM classifier is 1.85% better than that of the RDF classifier. In conclusion, the machine learning method is useful for the discrimination of varying degrees of RBC aggregation, and has potential for use in characterizing and monitoring the RBC aggregation in vessels.

PMID:33740499 | DOI:10.1016/j.ultras.2021.106419

Biomed Pharmacother. 2021 Mar 16;138:111423. doi: 10.1016/j.biopha.2021.111423. Online ahead of print.

ABSTRACT

With the aging population, coronary syndrome is one of the leading causes of mortality. Atherosclerosis is the pathophysiological basis of coronary syndrome, which is caused by plaque rupture and predisposed or aggravated by many perioperative complications. Parecoxib is one of the most widely used nonsteroidal anti-inflammatory perioperative drugs. This study aims to evaluate the potential benefits of parecoxib on atherosclerosis progression. Apolipoprotein E-deficient (Apo E-/-) mice were intraperitoneally injected by parecoxib (par group) or saline (control group) and, meanwhile, were given a western diet for 12 weeks. The aorta and aortic root were examined by oil red O (ORO) staining for atherosclerotic lesions. The expression level of matrix metalloproteinases (MMPs), was investigated using immunofluorescence and western blot. Macrophage inflammation was investigated by Q-PCR. Parecoxib treatment increased the number of vascular smooth muscle cells (VSMC) and amount of collagen, while and decreased the number of macrophages in murine aortic walls. The expression of MMP1, 2, 9, and 13 as well as IL- 1β and IL-6 were also decreased in the par group. However, there was no statistical difference in lipid infiltration between the two groups. Parecoxib could improve plaque stability by suppressing inflammation and inhibiting MMPs production.

PMID:33740522 | DOI:10.1016/j.biopha.2021.111423

J Am Geriatr Soc. 2021 Mar 19. doi: 10.1111/jgs.17101. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: Coexistent seizures add complexity to the burden of Alzheimer’s disease (AD). We aim to estimate the incidence and prevalence of coexistent seizures and AD and summarize characteristics.

DESIGN: A systematic review and meta-analysis (PROSPERO protocol registration CRD42020150479).

SETTING: Population-, community-, hospital-, or nursing home-based.

PARTICIPANTS AND MEASUREMENTS: Thirty-nine studies reporting on seizure incidence and prevalence in 21,198 and 380,777 participants with AD, respectively, and AD prevalence in 727,446 participants with seizures. When statistical heterogeneity and inconsistency (assessed by Q statistic and I² ) were not shown, rates were synthesized using random effect.

RESULTS: Studies were conducted in Australia, Brazil, Finland, France, Ireland, Italy, Japan, Netherlands, Portugal, Sweden, Taiwan, United Kingdom, and United States. The incidence of seizures among people with clinically diagnosed AD ranged from 4.2 to 31.5 per 1000 person-years. Prevalence of seizures among people with clinically diagnosed AD ranged from 1.5% to 12.7% generally, but it rose to the highest (49.5% of those with early-onset AD) in one study. Meta-analysis reported a combined seizure prevalence rate among people with pathologically verified AD at 16% (95% confidence interval [CI] 14-19). Prevalence of seizure in autosomal dominant AD (ADAD) ranged from 2.8% to 41.7%. Being younger was associated with higher risk of seizure occurrence. Eleven percent of people with adult-onset seizures had AD (95%CI, 7-14).

CONCLUSION: Seizures are common in those with AD, and seizure monitoring may be particularly important for younger adults and those with ADAD.

PMID:33740274 | DOI:10.1111/jgs.17101

Vopr Pitan. 2021;90(1):6-14. doi: 10.33029/0042-8833-2021-90-1-6-14. Epub 2021 Jan 20.

ABSTRACT

Vitamin D with its steroid structure is currently considered as a hormone. New target cells of this hormone have been identified, including those in the organs of the reproductive system. The aim – to analyze modern sources of domestic and foreign scientific literature covering the role of vitamin D in the reproductive health of women of different ages. Results. The Russian Federation is endemic in terms of vitamin D deficiency. According to statistics, a lack of this vitamin is observed in 70-90% of the population of the USA and European countries, which brings this problem to the international level. It has been established that vitamin D affects not only bone-mineral homeostasis, but also many organs and tissues, including the reproductive system, namely the ovaries, uterus, placental tissue, pituitary gland and male reproductive organs. Studies have proven the positive effect of this hormone on the course of polycystic ovary syndrome, endometriosis, diabetes mellitus (including gestational). In addition, it has been shown that vitamin D is an important micronutrient during pregravid preparation, and the normalization of its level can improve the quality and increase the life expectancy of women after 50-60 years. Conclusion. Vitamin D plays an important role in many physiological processes, including the effects on the organs of the reproductive system. The significant influence of this vitamin can be traced from the beginning of intrauterine development to the end of life, which makes its further study an important area of modern medicine, including within the framework of obstetrics and gynecology.

PMID:33740323 | DOI:10.33029/0042-8833-2021-90-1-6-14

Vopr Pitan. 2021;90(1):15-32. doi: 10.33029/0042-8833-2021-90-1-15-32. Epub 2021 Jan 20.

ABSTRACT

Specialized products and dietary supplements, enriched with complexes of minor biologically active substances (BAS), are often offered as components of therapeutic diets in the treatment of obesity and metabolic syndrome. At the same time, the possible effects of the interactions of BAS when consuming a multicomponent product have not been studied enough. The aim – to study the action on rats’ organism of a complex supplement (RС), containing resveratrol (Res) and L-carnitine (L-Car), when consumed with a standard balanced or hypercaloric diet. Material and methods. Male Wistar rats received for 63 days a standard balanced diet (SD) or a high-fat-high-carbohydrate diet (HFCD) with an excess of total fat (30%) and fructose (20% solution instead of drinking water), or the same diets supplemented with RС in a low (25 mg/kg body weight as Res and 300 mg/kg body weight as L-Car) or high (50 and 600 mg/kg body weight, respectively) doses. The muscle grip strength, behavioral reactions in tests of the conditioned passive avoidance reflex (CPAR) and elevated plus maze (EPM) were studied. At the end of the experiment, the mass of adipose tissue and internal organs was determined together with the activity of microsomal and cytosolic liver enzymes for specific substrates, plasma biochemical parameters, liver morphology by lightoptical microscopy, accumulation of lipofuscin-like granules (LLG) in the liver and kidneys by laser confocal microscopy. Results. In the rats fed HFCD, compared with SD, there was an increase in the mass index of liver, total inguinal and retroperitoneal white adipose tissue, in the levels of glucose and triglycerides, in the activity of hepatic CYP1A1 and CYP3A monooxygenases, UDPglucuronosyltransferase, heme oxygenase, and simultaneous decrease of high and low density lipoprotein cholesterol, and quinone oxidoreductase activity. The RС intake stimulated the locomotor activity of rats in EPM, however, this effect was less pronounced against the background of HFCD consumption. In rats consuming SD (but not HFCD), the addition of RС caused an increase in search activity and anxiety according to the EPM and CPAR data. The effect on short- and long-term memory retention was statistically insignificant. RС intake did not have hypolipidemic and hypoglycemic properties but caused in low dose an increase in the ratio of the activity of transaminases AST/ALT in animals fed HFCD. The liver CYP3A activity increased in rats supplemented with RС in high dose fed HFCD. In the kidneys of animals, the consumption of RС resulted in increased accumulation of LLG. Conclusion. When studying the effect of the complex supplement RС on normal and obese rats according to the studied physiological, morphological and biochemical indexes, no positive effects were revealed, that would not have manifested themselves for Res and L-Car separate intake. No evidence of synergistic action of L-Car and Res were found, and some of the effects of the complex supplement can be considered as adverse. This requires careful assessment when combined using these substances in complex diet therapy of metabolic disorders in humans.

PMID:33740324 | DOI:10.33029/0042-8833-2021-90-1-15-32

Adv Ther. 2021 Mar 19. doi: 10.1007/s12325-021-01686-x. Online ahead of print.

ABSTRACT

INTRODUCTION: To evaluate the efficacy and safety of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farinae (Df) drops in monosensitized and polysensitized patients with allergic rhinitis (AR) and to analyze the adverse events (AEs).

METHODS: A retrospective analysis was performed using data for 68 patients with AR who received SLIT. The patients were divided into a monosensitized group (36 cases) and a polysensitized group (32 cases) based on serum-specific IgE test results. In the two groups of patients, total nasal symptoms score (TNSS), total medication score (TMS), visual analog scale (VAS) score, and AEs before treatment and at 1, 3, 6, and 12 months of treatment were evaluated.

RESULTS: Compared with that before treatment, the TNSS, TMS, and VAS score in the monosensitized and polysensitized groups all decreased significantly at 3, 6, and 12 months of SLIT (all P < 0.05). There were no significant differences in treatment efficacy indicators between the two groups at all treatment time points (all P > 0.05). In terms of safety, compared with 1 month after initiating SLIT, the incidence of AEs in the monosensitized and polysensitized groups at 6 and 12 months of treatment significantly decreased (all P < 0.05). There was a statistically significant decrease in the incidence of AEs in both groups at 6 months compared with 3 months of treatment (χ² = 1.92 and 5.85, respectively, all P < 0.05). The difference in incidence of AEs between the monosensitized and polysensitized groups was not statistically significant at any treatment time point (all P > 0.05). AEs in all patients were local mild reactions; no serious AEs were found.

CONCLUSION: SLIT with standardized Df drops has similar efficacy and safety for monosensitized and polysensitized patients with AR. AEs mostly occurred during the first 3 months of SLIT in both the monosensitized and polysensitized groups, and the incidence of AEs gradually decreased as the course of treatment extended.

PMID:33740216 | DOI:10.1007/s12325-021-01686-x