Tag: statistics

EJIFCC. 2021 Dec 7;32(4):458-466. eCollection 2021 Dec.

ABSTRACT

INTRODUCTION: Clozapine is an antipsychotic drug used to treat resistant schizophrenia and other disorders. Based on the actual Spanish legislation, patients treated with clozapine must undergo periodical haematological examinations and treatment should be reviewed when the haemogram shows either a leukocyte count of ≤ 3500/mm³ or neutrophil count < 2000/mm³. An automatic notification system has been developed to optimize patient management and it’s utility was assessed following the implementation of the new system.

MATERIAL AND METHODS: When clozapine (CLO) laboratory test request was made, a reflex complete blood count test was also done. An automatic e-mail was sent by the laboratory information system to the physician when a CLO was ordered and low leukocyte or neutrophil counts were detected, or when a patient with an ordered CLO test did not attend the laboratory for blood drawing.

RESULTS: For patients with haemogram alterations, the time to take clinical action was significantly decreased from 23 to 7 days (p = 0.02). Moreover, the adherence to Spanish Agency of Drugs and Sanitary Devices recommendations significantly increased from 45% to 76% (p = 0.02). For not attending patients, the days out of control decreased from 29 to 12 days, although it was not statistically significant (p = 0.06).

CONCLUSIONS: This strategy has allowed the compliance of legal requirements, the improvement of patient safety, and the optimisation of clinical and laboratory procedures.

PMID:35046764 | PMC:PMC8751398

EJIFCC. 2021 Dec 7;32(4):421-431. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: We aim to study the utility of Google Trends search history data for demonstrating if a correlation may exist between web-based information and actual coronavirus disease 2019 (COVID-19) cases, as well as if such data can be used to forecast patterns of disease spikes.

PATIENTS & METHODS: Weekly data of COVID-19 cases in Pakistan was retrieved from online COVID-19 data banks for a period of 60 weeks. Search history related to COVID-19, coronavirus and the most common symptoms of disease was retrieved from Google Trends during the same period. Statistical analysis was performed to analyze the correlation between the two data sets. Search terms were adjusted for time-lag over weeks, to find the highest cross-correlation for each of the search terms.

RESULTS: Search terms of ‘fever’ and ‘cough’ were the most commonly searched online, followed by coronavirus and COVID. The highest peak correlations with the weekly case series, with a 1-week backlog, was noted for loss of smell and loss of taste. The combined model yielded a modest performance for forecasting positive cases. The linear regression model revealed loss of smell (adjusted R² of 0.7) with significant 1-week, 2-week and 3-week lagged time series, as the best predictor of weekly positive case counts.

CONCLUSIONS: Our local analysis of Pakistan-based data seemingly confirms that Google trends can be used as an important tool for anticipating and predicting pandemic patterns and pre-hand preparedness in such unprecedented pandemic crisis.

PMID:35046760 | PMC:PMC8751396

EJIFCC. 2021 Dec 7;32(4):432-441. eCollection 2021 Dec.

ABSTRACT

INTRODUCTION: Serum total lactate dehydrogenase (LDH) activity was elevated and showed a positive correlation with disease severity and outcome in severe COVID-19 disease. However, it is still unknown whether the relative abundance or calculated activity of any LDH isoenzyme is predominately increased in COVID-19 subjects.

METHODS: Twenty-two consecutive patients suffered from moderate or severe COVID-19 pneumonia were recruited into this study who showed enhanced total LDH activity. The ratio of LDH isoenzyme activities was further investigated using gel electrophoresis (Hydragel^®, Sebia) with densitometric evaluation. Calculated activity values of these isoenzymes were correlated with routine laboratory parameters, the degree of lung parenchymal affection based on chest CT and clinical outcome.

RESULTS: Total LDH activity was raised in the range of 272-2141 U/L and significantly correlated with calculated LDH-3 and LDH-4 activities (r=0.765, P=0.0001; and r=0.783, P=0.0001, respectively). In contrast, the relative abundance of neither LDH isoenzyme was exclusively abnormal in COVID-19 patients. Calculated activity of LDH-3 and LDH-4 demonstrated a modest but statistically significant association with serum ferritin (r=0.437, P=0.042; r=0.505, P=0.016, respectively). When the relationship between the severity of pulmonary affection by SARS-CoV-2 infection and relative abundance of LDH isoenzymes was studied, a larger ratio of mid-zone fractions was observed in the presence of ≥ 50% lung parenchymal involvement. Finally, regardless of LDH isoenzyme pattern, abnormal relative ratio of LDH-4 and higher calculated LDH-3 and LDH-4 activity values were detected in subjects with unfavorable outcome.

CONCLUSION: No characteristic profile of LDH isoenzymes can be detected in COVID-19 pneumonia, however, elevated activities of LDH-3 and LDH-4 are associated with worse clinical outcomes.

PMID:35046761 | PMC:PMC8751399

Clin Optom (Auckl). 2022 Jan 10;14:1-12. doi: 10.2147/OPTO.S337920. eCollection 2022.

ABSTRACT

PURPOSE: To evaluate the impact of prosthetic replacement of the ocular surface ecosystem (BostonSight PROSE) treatment on symptom outcomes based on the Ocular Surface Disease Index (OSDI).

PATIENTS AND METHODS: This was a single-center, retrospective analysis of consecutive patients who initiated PROSE treatment between September 2017 and December 2019 by the same clinician. The primary outcome measure was to compare OSDI survey scores at baseline prior to PROSE treatment and at follow-up, after PROSE treatment. Indication for treatment, sex, age, device diameter, average wear time, preexisting mental illness, duration of PROSE wear, and status of PROSE wear at follow-up were also studied.

RESULTS: A total of 134 patients underwent PROSE treatment and completed a baseline OSDI survey during the study period. Forty-three patients completed a follow-up OSDI survey and were included in the study analysis. The most common treatment indications were keratoconjunctivitis sicca (n=27) and corneal ectasia (n=16). Baseline average OSDI score was 56.9±23.7 for the 43 subjects who completed a subsequent OSDI survey. The last documented average follow-up OSDI for those 43 subjects was 23.8±15.6, median (IQR) of 22.9 (10.4 to 32.3), and a statistically significant 54.7±27.6% average improvement from baseline (p<0.01). All patients, except for two, showed improvement in OSDI score. Statistically significant improvement occurred regardless of underlying diagnosis with no statistically significant difference based on age, sex, mental illness, or device diameter and no statistical correlation with average wear time, or duration of PROSE wear.

CONCLUSION: PROSE treatment improves visual function and symptom relief as demonstrated by the OSDI survey. Sex, age, preexisting mental illness, device diameter, average wear time, and duration of wear had no statistically significant impact on OSDI outcomes.

PMID:35046743 | PMC:PMC8760101 | DOI:10.2147/OPTO.S337920

Adv Med Educ Pract. 2022 Jan 13;13:47-58. doi: 10.2147/AMEP.S348062. eCollection 2022.

ABSTRACT

PURPOSE: Mindfulness meditation was used to reduce stress and its responses such as cortisol and C-reactive protein (CRP) among healthy and ill individuals in various cultures, but its effect has not yet been studied among nursing students, experiencing tremendous stress. The objective of this study was to examine the effects of mindfulness meditation on trait mindfulness, perceived stress, serum cortisol, and serum C-reactive proteins (CRP) in nursing students.

PATIENTS AND METHODS: Using a two-arm, randomized, parallel study (conducted in a large university in Jordan, 108 nursing students were randomly assigned to experimental group receiving five 30-minute weekly sessions of mindfulness meditation and control group sitting quiet during the experimental sessions. Trait mindfulness, perceived stress, serum cortisol, and CRP were measured at baseline and end of the intervention.

RESULTS: Using one-way MANOVA and post-hoc comparisons, the results showed that mindfulness meditation was significantly effective in decreasing serum cortisol levels and perceived stress. The mindfulness meditation also decreased CRP and increased trait mindfulness although the results did not reach statistically significant levels.

CONCLUSION: These findings underscore the need for serious consideration of mindfulness meditation in nursing colleges to improve stress and raise immunity in this vulnerable population.

TRIAL REGISTRATION: Mindfulness Meditation for Nursing Students: clinicaltrials.gov, identifier: NCT05099224.

PMID:35046747 | PMC:PMC8763207 | DOI:10.2147/AMEP.S348062

Open Access Emerg Med. 2022 Jan 11;14:15-24. doi: 10.2147/OAEM.S344744. eCollection 2022.

ABSTRACT

PURPOSE: Obstructive uropathy (OU) is a potentially life-threatening urologic emergency that requires urgent decompression. Percutaneous nephrostomy (PCN) is a commonly performed procedure to decompress OU. The objective of this study is to assess disease patterns and treatment outcome at two urologic centers in Ethiopia.

METHODS: A cross-sectional study was conducted on 110 patients who underwent emergency PCN from October 1, 2019 to September 30, 2020. Data were collected by a retrospective chart review. SPSS 25 was used for analysis. Descriptive statistics and logistic regression were utilized to assess disease pattern and significant predictors. A p-value of <0.05 on multivariate logistic regression was considered statistically significant.

RESULTS: Females accounted for 70% of cases and mean age at presentation was 48 ± 12.9 years. Bilateral OU was diagnosed in 60% of patients and 77.3% of obstructions occurred at the level of the ureter. Malignancies were diagnosed in >80% of patients among which cervical cancer was the commonest (37.3%) followed by bladder cancer (17.3%). Acute kidney injury (AKI) accounted for 70% of the presenting indications for PCN. Success rate after emergency PCN was 75.5% and 41.8% of the cases developed post-procedure complications. Factors that predicted successful outcome include male gender [AOR = 5.72 (1.13-28.92), 95% CI; p = 0.035], severe hydronephrosis pre-operatively [AOR = 7.12 (1.32-38.45), 95% CI; p = 0.022], and use of combined imaging (ultrasound and fluoroscope) to guide PCN [AOR = 12.91 (1.13-46.54), 95% CI; p = 0.039]. On the other hand, postoperative complication is a negative predictor [AOR = 0.26 (0.08-0.86), 95% CI; p = 0.027].

CONCLUSION: In this study, overall success of emergency PCN is low. Presence of severe hydronephrosis predicts technical ease and better outcome of PCN. Procedures performed under ultrasound and fluoroscope guidance also improve outcome. Postoperative complication rate is high in this study and mandates strict preventive measures as it predicts unfavorable outcome.

PMID:35046735 | PMC:PMC8761074 | DOI:10.2147/OAEM.S344744

J Exp Pharmacol. 2022 Jan 11;14:1-5. doi: 10.2147/JEP.S336304. eCollection 2022.

ABSTRACT

The IRIDIUM and ARGON studies provided positive findings concerning the benefits of the once-daily triple mometasone furoate/indacaterol/glycopyrronium (MF/IND/GLY) fixed-dose combination (FDC) for the treatment of uncontrolled asthma, at the least by a strict statistical point of view. In the IRIDIUM study patients received medium-dose (MD) or high-dose (HD) MF/IND/GLY or MF/IND oncex daily or HD fluticasone/salmeterol (FLU/SAL) twice daily; in the ARGON study patients received MD or HD MF/IND/GLY once daily or HD FLU/SAL twice daily + tiotropium (TIO) once daily. Since a detailed interpretation of clinical results has not yet been performed, we provided the clinical interpretation of efficacy outcomes resulting from the IRIDIUM and ARGON studies according to the currently available minimal clinically important difference (MCID) thresholds. The triple MF/IND/GLY FDC elicited beneficial clinically relevant effects compared to active comparators in asthmatic patients, according to the levels of ICS doses, by generally achieving and overcoming the MCID. The level of clinical benefit was usually greater in patients treated with HD-MF/IND/GLY compared to those treated with MD-MF/IND/GLY. Overall, HD-MF/IND/GLY induced greater clinically relevant benefits even when compared to HD-FLU/SAL + TIO. Considering that a balanced triple MF/IND/GLY FDC with MD ICS resulted as effective as HD-MF/IND in preventing moderate or severe exacerbations, thus triple ICS/LABA/LAMA FDCs with MD ICS should be considered for the treatment not only of uncontrolled asthma but also for those patients suffering from less severe forms of disease with airflow limitation as well as a possible as-needed therapeutic option.

PMID:35046733 | PMC:PMC8762517 | DOI:10.2147/JEP.S336304

J Exp Pharmacol. 2022 Jan 11;14:7-15. doi: 10.2147/JEP.S328954. eCollection 2022.

ABSTRACT

BACKGROUND: Currently, malaria elimination is intimidated by the emergence of antimalarial drug and insecticide resistance. This scenario urges scientists to develop new antimalarial drugs, where plant-based compounds are the major candidates.

OBJECTIVE: The objective of this experiment was to examine the antimalarial activities of the solvent fractions of the stem bark of P. linearifolia in mice.

METHODS: The dried hydromethanolic extract was treated with n-hexane, chloroform, and ethyl acetate solvents based on increasing order of polarity. For the suppressive test, after three hours post-inoculation of P. berghei, the first group was administered the vehicle 2 mL/100 g. The second group was given chloroquine 25 mg/kg, whereas the remaining nine groups were administered 100, 200, and 400 mg/kg of each of the chloroform, ethyl acetate and aqueous fractions. Furthermore, the aqueous fraction was evaluated using Rane’s model for the curative test. The result was statistically analyzed using a one-way analysis of variance (ANOVA). The results were considered significant at P < 0.05.

RESULTS: In the suppressive test, the solvent fractions suppressed parasitemia level significantly (P < 0.01 for 100 mg/kg, P < 0.001 for 200 and 400 mg/kg of the aqueous and P < 0.01 for 200 mg/kg, P < 0.001 for 400 mg/kg of chloroform fractions) as compared to vehicle-treated mice, whereas in the curative model 400 mg/kg of the aqueous fraction (P < 0.01) showed a significant parasitemia level reduction.

CONCLUSION: The results of this study indicated that the solvent fractions have promising antiplasmodial activity against Plasmodium berghei, which is consistent with the earlier in vivo study of the hydromethanolic extract.

PMID:35046734 | PMC:PMC8761000 | DOI:10.2147/JEP.S328954

Drug Healthc Patient Saf. 2022 Jan 10;14:1-8. doi: 10.2147/DHPS.S332162. eCollection 2022.

ABSTRACT

PURPOSE: Perioperative cardiac arrests (CAs) are a rare but catastrophic perioperative complication. Much about incidence, risk factors, and outcomes of such events are still unknown. This study investigated anesthesia-related CAs at a tertiary teaching hospital.

METHODS: CA incidence within 24 hours of anesthesia administration was prospectively identified from May 1, 2016 to April 31, 2019. Each CA was matched by four other cases without CA receiving anesthesia on the same date and under similar operating conditions. The CA cases were reviewed and assigned to one of three groups: anesthesia-related, anesthesia-contributing, and anesthesia not related.

RESULTS: A total of 58,303 patients underwent 73,557 procedures under anesthesia during the study period. In sum, 27 CAs were reported for incidence of 3.7 per 10,000 anesthesia administrations (95% CI 2.3-5.1). Eleven CA were anesthesia-related for incidence of 1.5 per 10,000 anesthesia administrations. Four CA cases were anesthesia-contributing for incidence of 0.5 per 10,000 anesthesia administrations, while 53% of the anesthesia-related and -contributing CAs were due to respiratory problems. American Society of Anesthesiologists (ASA) physical status score, cardiovascular surgery, emergency surgery, and increased duration of surgery were significantly correlated with CA incidents when compared to the control group. ASA physical status score is an independent risk factor of the occurrence of perioperative CA (OR 7.6, 95% CI 2.6-22.4; P<0.001).

CONCLUSION: Identifying factors associated with increased risk for anesthesia-related CA is of great importance in risk stratification for surgical patients. ASA physical status score was found to be a major factor in predicting perioperative CA, since patients with higher ASA scores had a statistically significant increased risk of CA. Therefore, extra precautions must be taken when dealing with unprepared patients who have uncontrolled medical illnesses, especially those who will be undergoing emergency surgery.

PMID:35046730 | PMC:PMC8759986 | DOI:10.2147/DHPS.S332162

Int J Womens Health. 2022 Jan 11;14:9-14. doi: 10.2147/IJWH.S341603. eCollection 2022.

ABSTRACT

PURPOSE: To evaluate the quality of life (QoL) of women with endometrioma and explore the associated factors.

PATIENTS AND METHODS: A cross-sectional study was conducted between August 2020 and March 2021. A total of 99 women diagnosed with ovarian endometrioma with at least one endometriosis-associated symptom completed the Endometriosis Health Profile 30 (EHP-30) questionnaire for their QoL score before treatment for ovarian endometrioma. The questionnaire comprises a central questionnaire (30 items) and a modular questionnaire (23 items divided into 6 sections). Demographics and QoL scores were analyzed using descriptive statistics and multivariable linear regression or median regression.

RESULTS: The mean QoL score was 35.0±15.8 (range, 16.0±21.2 in the social support dimension to 45.1±24.4 in the control and powerlessness dimension). In the modular questionnaire, the highest score was in the infertility domain, while the lowest was in the relationship with the physician domain. The pain score and chronic pelvic pain (CPP) were independent correlation factors for a higher total EHP-30 score: the higher the total EHP-30, the poorer the QoL. CPP was positively correlated with the QoL score in the work domain.

CONCLUSION: The present study revealed that CPP was the factor associated with a worse QoL and work performance in women with endometrioma based on a disease-specific, EHP-30 questionnaire.

PMID:35046731 | PMC:PMC8760997 | DOI:10.2147/IJWH.S341603