Tag: statistics

Eur J Clin Microbiol Infect Dis. 2021 Jun 26. doi: 10.1007/s10096-021-04297-0. Online ahead of print.

ABSTRACT

In our tertiary care center, the reported susceptibility of E. coli blood isolates to amoxicillin/clavulanic acid exceeded 90% in 2005 and showed a progressive decrease to 50% by 2017. In this study, we investigate whether there is a real increase in resistant E. coli strains or if this apparent decline in reported susceptibility might be attributed to the substitution of CLSI by EUCAST guidelines in 2014. We randomly selected 237 E. coli blood isolates (stored at – 80 °C) from 1985 to 2018 and reassessed their MIC values, applying both the CLSI (fixed ratio of clavulanic acid) and EUCAST guidelines (fixed concentration of clavulanic acid). In parallel, the susceptibility of these isolates was retested by disk diffusion, according to the EUCAST guidelines. Whole genome sequencing was successfully performed on 233 of the 237 isolates. In only 130 of the 237 isolates (55.0%), testing according to the EUCAST and CLSI criteria delivered identical MIC values for amoxicillin/clavulanic acid. In 64 of the 237 isolates (27.0%), the MIC values diverged one dilution; in 38 (16.0%), two dilutions; and in five (2.1%), three dilutions. From these 107 discrepant results, testing according to EUCAST methodology revealed more resistant profiles in 93 E. coli strains (94.1%). Also, phenotypical susceptibility testing according to EUCAST guidelines tends to correlate better with the presence of beta-lactamase genes compared to CLSI testing procedure. This study highlights the low agreement between EUCAST and CLSI methodologies when performing MIC testing of amoxicillin/clavulanic acid. More strains are categorized as resistant when EUCAST guidelines are applied. The low agreement between EUCAST and CLSI was confirmed by WGS, since most of EUCAST resistant/CLSI sensitive isolates harbored beta-lactamase genes.

PMID:34175999 | DOI:10.1007/s10096-021-04297-0

Oral Radiol. 2021 Jun 26. doi: 10.1007/s11282-021-00549-z. Online ahead of print.

ABSTRACT

Specialists need to know how accurate and effective each radiographic procedure is, and which ones can provide better images for bone resorption around the apical periodontitis. Therefore, the researcher decided to conduct the present study with the aim of evaluate the accuracy values of cone-beam CT regarding apical periodontitis. The PubMed, Embase, ISI, Scopus, and Medicine have been used to search articles over the last 15 years between 2005 and December 2020. Meta-analysis data with 95% confidence interval (CI), Random effect model, and restricted maximum-likelihood methods were calculated. Random effects were used to deal with potential heterogeneity and I² showed heterogeneity. I² values above 50% signified moderate-to-high heterogeneity. The meta-analysis has been evaluated with the statistical software Stata/MP v.16 (The fastest version of Stata). One hundred and fifty-eight studies were selected to review the abstracts, six papers met these crucial criteria to do a systematic review and meta-analysis. Sensitivity and specificity of digital periapical radiography was 50% (ES 0.50; 95% CI 0.05, 0.95) and 83% (ES 0.83; 95% CI 0.52, 1.15), respectively. Sensitivity and specificity of cone-beam computed tomographic was 95% (ES 0.95; 95% CI 0.80, 1.00) and 90% (ES 0.90; 95% CI 0.78, 1.03), respectively. In conclusion, CBCT imaging reports values with excellent accuracy vs digital periapical radiography.

PMID:34176005 | DOI:10.1007/s11282-021-00549-z

World J Surg. 2021 Jun 26. doi: 10.1007/s00268-021-06188-z. Online ahead of print.

ABSTRACT

BACKGROUND: Surgery for colon or rectal cancer is associated with a high incidence of complications, especially in patients with a low aerobic fitness. Those patients might benefit from a comprehensive preoperative workup including prehabilitation. However, time between diagnosis and treatment is often limited due to current treatment guidelines. To date, it is unclear whether the treatment interval can be extended without compromising survival.

METHODS: A systematic review concerning the association between treatment intervals and survival in patients who underwent elective curative surgery for colon or rectal cancer was performed. A search up to December 2020 was conducted in PubMed, Cinahl and Embase. Original research articles were eligible. Quality assessment was performed using the Downs and Black checklist.

RESULTS: Eleven observational studies were included (897 947 patients). In colon cancer, treatment intervals that were statistically significant associated with reduced overall survival or cancer-specific survival ranged between > 30 and > 84 days. In rectal cancer, only one out of four studies showed that treatment intervals > 49 days was associated with reduced cancer-specific survival.

CONCLUSIONS: This systematic review identified that studies investigating the association between treatment intervals and survival are heterogeneous with regard to treatment interval definitions, treatment interval time intervals and used outcome measures. These aspects need standardization before a reliable estimate of an optimal treatment interval can be made. In addition, further research should focus on establishing optimal treatment intervals in patients at high risk for postoperative complications, as particularly these patients might benefit from extended diagnosis to treatment intervals permitting comprehensive preoperative preparation.

PMID:34175967 | DOI:10.1007/s00268-021-06188-z

Eur Arch Otorhinolaryngol. 2021 Jun 27. doi: 10.1007/s00405-021-06952-w. Online ahead of print.

ABSTRACT

PURPOSE: Bleeding during Functional endoscopic sinus surgery (FESS) can have adverse effect on surgical outcomes. This study evaluates if there is any benefit of adding epinephrine to the saline nasal irrigation in patients undergoing elective FESS for chronic rhinosinusitis.

METHODS: A prospective, randomized, double-blinded study was performed. Fifty ASA I or II patients undergoing FESS were randomized to have irrigation either with normal saline or (1:100,000) epinephrine in normal saline during surgery. Outcomes measure included the Boezaart grading scale to assess the intraoperative surgical field, surgeon’s satisfaction with field visualization and bleeding which was evaluated in a 10 cm visual analog scale, estimated blood loss as well as hemodynamic parameters changes.

RESULTS: There was no statistically significant difference in the studied variables between both groups. However in patients with higher than 12 Lund-Mackay score the volume of blood loss was significantly less in the epinephrine group. All surgical procedures were completed and there were no operative complications or any reported perioperative cardiovascular events.

CONCLUSIONS: Intraoperative irrigation with saline-epinephrine solution at a concentration of (1:100,000) is safe and does not change heart rate or blood pressure but is unlikely to improve the setting of intraoperative surgical field except for decreasing the volume of blood loss in patients with high Lund-Mackay score.

PMID:34175968 | DOI:10.1007/s00405-021-06952-w

Eur J Trauma Emerg Surg. 2021 Jun 26. doi: 10.1007/s00068-021-01739-4. Online ahead of print.

ABSTRACT

PURPOSE: Under-vehicle explosions caused by improvised explosive devices (IED) came to the public’s attention during armed conflicts. However, IEDs are also used by criminals in the civilian setting. This study aimed to determine the pattern of injury, medical management, and outcomes of civilians injured during under-vehicle explosions caused by IEDs.

METHODS: This is a retrospective cohort study based on the Israeli National Trauma Registry of patients injured from under vehicle explosions caused by IEDs during 2006-2020. Injuries resulting from terror attacks and war were excluded. Descriptive statistics were used for data analysis.

RESULTS: During the study period, 58 incidents were recorded, resulting in 74 patients who arrived alive to the hospitals and 17 who died on scene. Seventy-one (95.9%) were male with a median age of 32 years (IQR 24-42). 42% were severely injured (ISS ≥ 16). There was an average of 2.4 injured regions per patient, with extremity injuries being the most common (70.3%). Face (34%), abdomen (28%), and chest (22%) injuries were frequent. 45% were immediately transferred to the operating theatre, and 72% underwent at least one operation. Orthopedic surgeries were the most common interventions. 27 amputations were performed.

CONCLUSIONS: Injuries caused by under-vehicle IEDs in civilian settings differ from those caused by IEDs used during military conflicts or acts of terrorism: they are associated with fewer victims per incident, more severe injuries, more truncal injuries, and more lower extremity injuries requiring amputations. This can be attributed to the lack of personal and vehicle protection, and the different explosive types.

PMID:34175970 | DOI:10.1007/s00068-021-01739-4

Turk J Med Sci. 2021 Jun 27. doi: 10.3906/sag-2104-68. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: In this study, we aimed to investigate the effects of antioxidant iloprost (ILO) and ß3 adrenergic receptor agonist (BRL) on transient receptor potential ankyrin 1 (TRPA1) and transient receptor potential canonical 1 (TRPC1) ion channels on an experimental ischemia and reperfusion injury model in 30 male Wistar albino rats aged 8?10 weeks.

MATERIALS AND METHODS: Wistar Albino rats aged were divided into 5 equal groups. Group I Sham operation, Group II IR (ischemia-reperfusion) procedure, Group III IR + intravenous ILO administration, Group IV IR + intraperitoneal BRL administration, Group V IR + intravenous ILO + intraperitoneal BRL administration group. 2ng/kg/min ILO intravenous infusion was applied to the ILO group. A single dose of 5 mcg/kg BRL intraperitoneal was applied to BRL group. TOS (total oxidant status), TRPA1 and TRPC1 levels were measured with ELISA (enzyme linked immunosorbent assay) in serum, immunohistochemical staining in musculus quadriceps femoris tissue.

RESULTS: Compared with the sham group, the IR group had a statistically significant increase in serum levels of TOS (p = 0.004), TRPA1 (p = 0.002), and TRPC1 (p = 0.008) along with TRPA1- and TRPC1-immunoreactivity (p = 0.005, each) in the tissue. When compared with the IR group in terms of serum levels of TRPA1 and tissue TRPA1-immunoreactivity, although there was no statistically significant difference in the IR+Ilo (p = 0.257 and p = 0.429, respectively), IR+Brl (p = 0.024 and p = 0.177, respectively), and IR+Ilo+Brl (p = 0.024 and p = 0.329, respectively) groups, serum levels of TOS and TRPC1 along with tissue TRPC1-immunoreactivity were statistically significantly reduced in the IR+Ilo (p = 0.002, p = 0.008, and p = 0.004, respectively), IR+Brl (p = 0.004, p = 0.008, and p = 0.004, respectively), and IR+Ilo+Brl groups (p = 0.002, p = 0.008, and p = 0.004, respectively).

CONCLUSION: In IR group serum TOS, TRPA1 and TRPC1 levels and tissue TRPA1 and TRPC1 immunoreactivity were statistically significant increased when compared to sham group. In IR+ILO, IR+BRL and IR+ILO+BRL groups serum TRPA1 and tissue TRPA1 immunoreactivity did not change when compared to IR group. Serum TOS and TRPC1 levels, tissue TRPC1 immunoreactivty were statistically significant decreased when compared to IR group. More detailed and expanded population studies are needed to discuss our results.

PMID:34174803 | DOI:10.3906/sag-2104-68

West Afr J Med. 2021 Jun 26;38(6):544-548.

ABSTRACT

OBJECTIVE: The involvement of community pharmacists (CPs) in oral health promotion is increasingly recognized and encouraged. However, a large proportion of interactions in community pharmacies take place with pharmacy counter assistants (PCAs) rather than the pharmacist. The study aimed to compare the knowledge and dispositions of PCAs and CPs in Plateau State, Nigeria, towards oral health.

METHODS: A cross-sectional study of community pharmacies in the state. PCAs (n=164) and CPs (n=119) were involved in the study. The PCAs and CPs were given a questionnaire containing 24-items on knowledge of oral health and other variables. One sample and independent sample t-tests were used to assess knowledge scores and mean differences between knowledge scores of PCAs and CPs.

RESULTS: The knowledge scores for CPs were between 11- 21, mean of 17.27±2.44. PCAs had a range of 6-21, mean of 16.05±2.56. Two PCAs had poor knowledge. Taking 16 (out of 24) as the minimum pass score, a one-sample t-test showed good knowledge for CPs: M=17.2, SD=2.44, t(118)=5.67, p<.001 but not PCAs M=16.1, SD=2.56, t(163)=.244, p=.808. Also, there was a statistically significant difference between the mean knowledge score of CPs and PCAs t(281) = -4.06, p<.001. Nearly all the CPs (93.9%) and the PCAs (96.3%) were willing to serve as oral health agents.

CONCLUSION: PCAs are not as knowledgeable as CPs on oral health in Plateau state though they both perceived a role for themselves in promoting oral health. Their disposition towards oral health could serve as a platform to help propagate oral health care and awareness in their communities.

PMID:34174804

Turk J Med Sci. 2021 Jun 27. doi: 10.3906/sag-2012-270. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the administration of cinnamon extract that is known to be effective in decreasing the high blood glucose and the distribution of NGF and Trk-A receptor in pancreas with immunohistochemistry way. The experimental groups were defined as control, sham, cinnamon, diabetes, and diabetes-cinnamon. At the end of the experiment, the pancreatic tissue samples were obtained for the rats. The Hematoxylin- Eosin and triple staining were used to examine histology. The immunohistochemical methods were performed on the sections of pancreatic tissue. In all groups, the body weight and fasting blood glucose obtained from the male and female rats and the values were statistically evaluated. The NGF immunoreactivity was observed in acinus, excretory pars, excretorius ducts and islets of Langerhans for the pancreatic tissues of female and male rats in all groups. The Trk-A immunoreactivity was observed in acinus and islets of Langerhans for the pancreatic tissues of female and male rats in the control, sham and cinnamon groups. As a result, it was determined that the cinnamon, which is effective on blood glucose levels, has a positive effect on the NGF production in pancreas.

PMID:34174790 | DOI:10.3906/sag-2012-270

Turk J Med Sci. 2021 Jun 27. doi: 10.3906/sag-2104-170. Online ahead of print.

ABSTRACT

AIM: We evaluated the feasibility of producing splints with 3D printer technology to prevent contractures in burned children in our clinical prospective study.

MATERIAL AND METHOD: After approvals, children with burns greater than 2nd degree were included in the study. Age, gender, burn percentages, printing time, filament types, number of filament trials, splint suitability, patient and doctor comments, pre-clinical clinical trials? significances and financial impact were evaluated statistically.

RESULTS: Seventy-six trials were conducted on 18 patients. Fourteen of the patients are male and 4 are female. Average age of boys and girls are 5 and 3 respectively. Burn percentage was 36,9±13. PLAFlex, PolyFlex, nGenFlex, TPU were the main filaments that were used in the study. Printing time differs from 4 to 29 hours according to body regions. Splints were suitable for 81,25% in upper extremity, for 66,7% in lower extremity and for 100% in mouth. Burn percentage was significantly correlated with total number of filament (p=0,049). Other statistical evaluations were insignificant.

CONCLUSION: The 3D printer seems to be useful in children with burns. However, there difficulties caused by some reasons like production must be overcome. By increasing clinical experience, this emerging custom-made technology may become standard, and documented problems can be solved.

PMID:34174795 | DOI:10.3906/sag-2104-170

JMIR Public Health Surveill. 2021 Jun 17. doi: 10.2196/29060. Online ahead of print.

ABSTRACT

BACKGROUND: Innovative approaches to the dissemination of evidence-based COVID-19 health messages are urgently needed to counter social media misinformation about the pandemic. To this end, we designed a short, wordless, animated, global health communication video (CoVideo) that was rapidly distributed through social media channels to an international audience.

OBJECTIVE: The objectives of this study were to: 1) establish the CoVideo’s effectiveness in improving COVID-19 prevention knowledge, and 2) establish the CoVideo’s effectiveness in increasing behavioral intent toward COVID-19 prevention.

METHODS: In May and June 2020, we enrolled 15,163 online participants from the United States of America, Mexico, United Kingdom, Germany, and Spain. We randomized participants to (i) the CoVideo arm, (ii) an attention placebo control (APC) arm, and (iii) a do-nothing arm, and presented 18 knowledge questions about preventive COVID-19 behaviors, which was our first primary endpoint. To measure behavioral intent, our second primary endpoint, we randomized participants in each arm to five list experiments.

RESULTS: Globally, the video intervention was viewed 1.2 million times within the first 10 days of its release and more than 15 million times within the first four months. Knowledge in the CoVideo arm was significantly higher (mean = 16.95; 95% CI: 16.91, 16.99) than in the do-nothing (mean = 16.86; 95% CI: 16.83, 16.90; p < 0.001) arm. We observed high baseline levels of behavioral intent to perform many of the preventive behaviors featured in the video intervention. We were only able to detect a statistically significant impact of the CoVideo on one of the five preventive behaviors.

CONCLUSIONS: Despite high baseline levels, the intervention was effective at boosting knowledge of COVID-19 prevention. We were only able to capture a measurable change in behavioral intent towards one of the five COVID-19 preventive behaviors examined in this study. The global reach of this health communication intervention and the high voluntary engagement of trial participants highlight several innovative features that could inform the design and dissemination of public health messages. Short, wordless, animated videos, distributed by health authorities via social media, may be an effective pathway for rapid global health communication during health crises.

CLINICALTRIAL: The study and its outcomes were registered at the German Clinical Trials Register (www.drks.de) on May 12th, 2020: #DRKS00021582.

PMID:34174778 | DOI:10.2196/29060