Tag: statistics

J Obstet Gynaecol. 2021 Sep 27:1-5. doi: 10.1080/01443615.2021.1945010. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate whether the Serum Netrin-1 and Urinary KIM-1 (Kidney Injury Molecule-1) levels are associated with the detection of preeclampsia. A total of 90 patients, including 36 normal pregnant women, 29 patients with nonsevere preeclampsia and 25 patients with severe preeclampsia, were included in this study. Maternal serum Netrin-1 and Urinary KIM-1 levels were measured by using an enzyme-linked immunosorbent assay (ELISA). The results showed that the Levels of Netrin-1 and KIM-1 were statistically higher in women with preeclampsia as compared with normal pregnant women. Furthermore, the Netrin-1 level in women with severe preeclampsia was significantly higher than nonsevere preeclamptic women. inconclusion the current study showed that Maternal serum level of Netrin-1 and Urinary level of KIM-1 can be used as early biomarkers for the detection of preeclampsia.IMPACT STATEMENTWhat is already known on this subject? Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks’ gestation. Netrin-1 was found to promote angiogenesis. Alteration of placental angiogenesis in early pregnancy is a well-known reason for placental dysfunction such as preeclampsia. Kidney injury with proteinuria is a characteristic feature of preeclampsia. Urine KIM-1 is the most potential biomarker for renal injury in preeclampsia. Due to these facts, we aimed to investigate the role of maternal serum Netrin-1 and Urine KIM-1 levels in preeclampsia presence and severity.What the results of this study add? A significant relationship between Netrin-1 and KIM-1 levels with preeclampsia.What the implications are of these findings for clinical practice and/or further research? Based on these findings, we concluded that increased levels of Netrin-1 and KIM-1 are associated with severe preeclampsia.

PMID:34569430 | DOI:10.1080/01443615.2021.1945010

Glob Public Health. 2021 Sep 26:1-13. doi: 10.1080/17441692.2021.1983000. Online ahead of print.

ABSTRACT

Third-party disclosure by participants is inherent to much global health research. It presents ethical tensions with respecting the autonomy and privacy of non-consenting individuals whose data are disclosed but is neglected in ethics guidelines. Our aim was to describe and ethically reflect on, third party disclosure in a community-participatory demographic and health survey (DHS) implemented within participatory health research (PHR) about community-based care of children affected by AIDS in Eswatini. We collected DHS data and analysed it statistically. We studied the PHR process and outcomes ethnographically and analysed the data interpretively, using theories that conceptualise secrecy as relational and power-laden. We found that third parties’ data were disclosed by DHS respondents (typically women), including data about health conditions, abuse perpetration and being a caregiving burden. Ethnographic findings suggested that some third parties may not have consented to us collecting their data. However, respecting third parties’ autonomy and privacy presents ethical tensions related to silencing survey respondents and impairing knowledge creation. To minimise the ethical tensions surrounding third-party disclosure researchers can analyse risks, benefits and power dynamics and extend their ethical responsibilities to protect participants to also protect non-participants, and from data collection to also include reporting.

PMID:34569431 | DOI:10.1080/17441692.2021.1983000

Int Cancer Conf J. 2021 Jul 19;10(4):266-273. doi: 10.1007/s13691-021-00502-1. eCollection 2021 Oct.

ABSTRACT

Since colorectal metastases from primary lung cancer are rare, the location of metastatic lesion and prognostic factors have not been well evaluated. Therefore, we carried out a systematic review and meta-analysis to assess the clinicopathological characteristics and prognostic factors of Japanese patients with colorectal metastasis from lung cancer. We searched the Ichushi-Web database from January 1964 to December 2020. We found 59 colorectal metastases in 52 cases for this meta-analysis. Small cell carcinoma was shown to have significantly more metastases to the appendix than non-small cell carcinoma. However, there was no significant correlation between location and histology when classified into right and left colons (P = 0.247). The median overall survival after diagnosis was 6 months. Univariate analysis showed that adenocarcinoma (Hazard Ratio (HR) 0.383, P = 0.024), simultaneous metastasis (HR 0.325, P = 0.046), and chemotherapy group (HR 0.482, P = 0.044) were good prognostic factors. Multivariate analysis confirmed that chemotherapy (HR 0.38, P = 0.02) was an independent good prognostic factor for overall survival. In conclusion, although there was no statistical difference, right colon metastases were more frequent than left colon metastases. Chemotherapy may be effective for colorectal metastases from lung cancer.

PMID:34567936 | PMC:PMC8421478 | DOI:10.1007/s13691-021-00502-1

J Bone Oncol. 2021 Sep 2;30:100388. doi: 10.1016/j.jbo.2021.100388. eCollection 2021 Oct.

ABSTRACT

BACKGROUND: We present the 2-year results of a randomised trial comparing 4- versus 12-weekly bone-targeting agents (BTAs) in patients with bone metastases from breast or castration-resistant prostate cancer (CRPC).

PATIENTS AND METHODS: Patients with bone metastases from breast or CRPC, who were going to start or were already receiving BTAs, were randomised to 4- or 12-weekly BTA treatment for 2 years. The endpoints were: symptomatic skeletal events (SSE) rates, time to SSEs, toxicity and cost-effectiveness.

RESULTS: Of 263 patients (160 breast cancer, 103 CRPC), 133 (50.6%) and 130 (49.4%) were randomised to the 4- and 12-weekly groups, respectively. BTAs included denosumab (56.3%), zoledronate (24.0%) and pamidronate (19.8%). After 2 years, the cumulative incidence rate (95% CI) of SSEs was 32.7% (24.6% to 41.1%) and 28.1% (20.3% to 36.4%) for the 4- and 12-weekly intervention groups respectively. The hazard ratio for time to first SSE was 0.96 (95% CI = 0.63 to 1.47). However, in a post hoc analysis, those patients who had an on-study SSE, there was a small non-statistical increased risk of subsequent SSEs among patients on the 12-weekly dosing arm (HR = 1.14; 95% CI – 0.90-1.44). BTA-related toxicity rates were similar between study arms. A cost-utility analysis showed that 12-weekly BTA is cost-effective from a public payer’s perspective.

CONCLUSION: These results in addition to those previously reported for de-escalating zoledronate, would support that de-escalation of commonly used BTAs is a reasonable and economically valid treatment option. While not statistically significant, the increase in subsequent SSEs in the 12-weekly arm requires further exploration.

PMID:34567960 | PMC:PMC8449269 | DOI:10.1016/j.jbo.2021.100388

Diabetol Int. 2021 Feb 16;12(4):389-398. doi: 10.1007/s13340-021-00494-6. eCollection 2021 Oct.

ABSTRACT

Cancer is a major cause of death in patients with type 2 diabetes mellitus (T2DM) and lung cancer is one of the most prevalent cancers in patients with T2DM. In the present study, we examined the anti-cancer effect of the Sodium-glucose cotransporter 2 (SGLT2) inhibitor, canagliflozin, using a lung cancer model. In lung cancer tissues from non-T2DM human subjects, SGLT2 was detected by immunohistochemistry. SGLT2 mRNA and protein were also detected in A549, H1975 and H520 lung cancer cell lines by RT-PCR and immunohistochemistry, respectively. Canagliflozin at 1-50 µM significantly suppressed the growth of A549 cells in a dose-dependent manner. In BrdU assays, canagliflozin attenuated the proliferation of A549 cells, but did not induce apoptosis. In cell cycle analysis, S phase entry was attenuated by canagliflozin in A549 cells. In in vivo experiments, a xenograft model of athymic mice implanted with A549 lung cancer cells was treated with low and high dose oral canagliflozin. Despite the results of the in vitro experiments, tumor weight was not decreased by canagliflozin. In addition, the serum insulin level, but not body weight or blood glucose level, was decreased by canagliflozin. The number of cells positive for Ki67 was slightly decreased by canagliflozin, but this was not statistically significant. In conclusion, SGLT2 is expressed in human lung cancer tissue and cell lines, and the SGLT2 inhibitor, canagliflozin, attenuated proliferation of A549 lung cancer cells by inhibiting cell cycle progression in vitro but not in vivo.

PMID:34567921 | PMC:PMC8413406 | DOI:10.1007/s13340-021-00494-6

Diabetol Int. 2021 Feb 7;12(4):399-404. doi: 10.1007/s13340-021-00495-5. eCollection 2021 Oct.

ABSTRACT

OBJECTIVE: Multiple drug use (Polypharmacy) is common in Diabetes Mellitus (DM) patients. The purpose of this study was to evaluate the presence of polypharmacy and comorbid conditions in patients with DM.

METHOD: The sociodemographic data, comorbidity diseases, and prescription records of 607 patients diagnosed with type 2 DM were retrospectively analyzed. Polypharmacy was defined as the use of five or more different drugs.

RESULTS: The mean number of drugs used by the DM patients was 6.7 ± 2.5. It was observed that 77.9% of the DM patients had polypharmacy. The mean number of drugs used by the patients in the polypharmacy group was 7.7 ± 1.7. The most common comorbidities in DM patients were diseases of the musculoskeletal system. The use of drugs for musculoskeletal diseases and the number of drugs were statistically higher in female patients than in male patients. In the DM patients, polypharmacy was higher in the females, those older age, those having a longer history of DM disease, and those having a comorbid disease.

CONCLUSION: The total number of drugs used by the DM patients showed the presence of polypharmacy. Advanced age, long disease duration, female gender, and presence of comorbidities were predictive factors for polypharmacy in diabetic patients. Before starting additional medication for DM patients, it is necessary to pay attention to the interaction of the drugs to be used and to plan prescriptions considering the medications used by the patient continuously.

PMID:34567922 | PMC:PMC8413418 | DOI:10.1007/s13340-021-00495-5

Cureus. 2021 Aug 22;13(8):e17369. doi: 10.7759/cureus.17369. eCollection 2021 Aug.

ABSTRACT

Background Various Indian registries have documented a delay of more than five hours for acute coronary syndrome patients from onset of symptoms to reaching thrombolysis-enabled centres. We conducted this study to evaluate the factors responsible for pre-hospital delay in acute coronary syndrome patients. Methods This was a descriptive cross-sectional study conducted in consecutive acute coronary syndrome patients who reported to the tertiary care medical centre in North India. A standardized tool was used to record the demographic data, socioeconomic status and clinical presentation of patients. All factors which led to pre-hospital delay were noted and the appropriate statistical tests were used for analysis. Results A total of 130 patients (males=93, females=37) were included in the study. The median time at which the acute coronary syndrome patients presented to the thrombolysis and percutaneous coronary intervention enabled centre was 490 minutes (range: 20 – 810 minutes) and 710 minutes (range: 45 – 940 minutes) respectively. The various factors responsible for prehospital delay were rural residence (p-value <0.0001), visit to local dispensary (p-value=0.0023), delay in getting transport (p-value=0.03) and misinterpretation of cardiac symptoms (p-value=0.0004). A significant but weak negative correlation was found between per capita income, decision making time and time taken to receive thrombolytic therapy. Out of a total of 83 ST-elevation myocardial infarction patients, only 46 (51.80%) were thrombolysed. Though 69/83 (83.13%) ST-elevation myocardial infarction patients reached thrombolysis enabled centre directly, only nine (10.84%) were thrombolysed at first medical contact; the rest were transferred to the percutaneous coronary intervention-enabled centre without any prior information. Conclusion Our study concludes that besides socioeconomic and demographic variables, lack of public awareness, well established public transport & health insurance system lead to significant pre-hospital delays and increase the time to revascularization. Besides, judgemental error on the part of medical practitioners in the peripheries also significantly delays thrombolysis in ST-elevation myocardial infarction patients.

PMID:34567908 | PMC:PMC8455286 | DOI:10.7759/cureus.17369

Diabetol Int. 2021 Jan 25;12(4):356-363. doi: 10.1007/s13340-021-00490-w. eCollection 2021 Oct.

ABSTRACT

INTRODUCTION: Maintaining good glycemic control is the main therapeutic target for diabetes mellitus (DM) patients. Nevertheless, due to complex factors, the majority of patients worldwide persist poorly controlled. Hence the study was conducted to determine the association of anthropometric measurement and other factors with glycemic control among type 2 DM patients.

METHODS: An institutional-based cross-sectional study was conducted among 366 type 2 DM patients from October-1 to November 30/2019. Data were collected by a pre-tested structured questionnaire and data abstraction format. The collected data were edited in Epi-data-4.4.1.0 and exported to SPSS-25 for analysis. The degree of association was assessed using logistic regression analysis and expressed in terms of p value and odds ratio with a 95%CI. p value < 0.05 was considered statistically significant.

RESULTS: Of the total 366 participants, (66.1%) had poor glycemic control. Increased waist circumference (AOR 2.37, 95% CI 1.28-4.40 for overweight and AOR 3.31, 95% CI 1.28-8.58 for obesity), long duration of DM (AOR 2.12, 95% CI 1.14-3.95 for 5-10 years and AOR 5.67, 95% CI 1.76-11.30 for > 10 years), occupation (AOR 3.74, 95% CI 1.94-7.23 for government employee and AOR 4.90, 95% CI 2.19-10.94 for private employee), and family history of DM (AOR 1.93, 95% CI 1.08-3.43), were significantly associated with poor glycemic control.

CONCLUSION: Nearly two-thirds of study participants had poor glycemic control. Increased waist circumference, long duration of DM, occupational status, and family history of DM were independently associated with poor glycemic control. Therefore, type 2 DM patients with these identified factors should be strictly monitored to maintain good glycemic control.

PMID:34567918 | PMC:PMC8413419 | DOI:10.1007/s13340-021-00490-w

Cureus. 2021 Aug 22;13(8):e17364. doi: 10.7759/cureus.17364. eCollection 2021 Aug.

ABSTRACT

Objectives The aim of this study is to determine the appropriateness of histopathologic examination of the placenta at King Abdulaziz University Hospital (KAUH), Jeddah, based on the guidelines of the College of American Pathologists (CAP). Methods It is a retrospective review of obstetric and pathologic records for all deliveries at KAUH, between January 1, 2017, and April 30, 2019. The placentae were assessed for eligibility to undergo pathologic examination. Furthermore, examined and non-examined placentae meeting the CAP criteria were compared based on their actual indications. Results There were 8,929 deliveries, of which 1,444 (16.2%) placentae met the CAP guidelines. A total of 583/1,444 placentae (40.4%; 95% confidence interval [CI] = 37.8-43) were sent for pathologic examination. Of the 7,485 placentae that did not require submission for pathological examination, as determined by the pathologist, 7,456 (99.6%; 95% CI = 99.4-99.7) were not submitted appropriately. The labor and delivery staff were more likely to submit placentae with fetal/neonatal indications rather than those with maternal indications for examination, which was statistically significant (odds ratio = 6.5; 95% CI = 5.08-8.30). Conclusion While most of the examined placentae at KAUH met the CAP guidelines, there was a substantial under-submission of eligible placentae. Further studies are advised to reveal the reasons behind this underestimation so that correctional measures may be adopted, as placenta examination is a valuable tool to understand the risk factors and pathogenesis of deleterious maternal, neonatal, and fetal events.

PMID:34567903 | PMC:PMC8454601 | DOI:10.7759/cureus.17364

Cureus. 2021 Aug 21;13(8):e17343. doi: 10.7759/cureus.17343. eCollection 2021 Aug.

ABSTRACT

Background and objective Coronavirus disease 2019 (COVID-19) has become a public health emergency of international concern. Several characteristics of hospitalised cases, including variations in symptoms as well as radiological and laboratory findings, have been described. However, the exact clinical spectrum of hospitalised patients with COVID-19 in Oman is currently unclear. The objective of this paper was to describe the sociodemographic, clinical, laboratory, and radiological characteristics, as well as the treatment and clinical outcomes of the confirmed cases of COVID-19 at Al Nahdha Hospital, Oman. Additionally, factors associated with the severity of the disease were identified. Methodology This was a cross-sectional descriptive study of hospitalised COVID-19 patients. The required data were retrieved from the electronic health information system for the period from 3rd March to 9th May 2020. Information was recorded in a bespoke sheet and exported to SPSS Statistics (IBM, Armonk, NY) for analysis. Results A total of 102 admissions were included in this study. The mean age of the cohort was 49.9 (14.7) years. The majority were males (77.5%), and more than half were expatriates (56.9%). Diabetes and hypertension were found in 39.2% and 36.3% of the study population, respectively. Common symptoms encountered were dry cough (78.3%), fever (76.5%), and shortness of breath (SOB) (69.6%). Radiologically, bilateral infiltrations were present in 73.5% of the patients. Only 19 cases required critical care (18.6%), and those were mostly older [54.1 (13.4) years], males (89.5%), and non-nationals (63.2%). Significant factors associated with requiring critical care were symptoms of SOB (89.5% vs 65.1%, p=0.03), diabetes (68.4% vs 32.5%, OR=1.5, p=0.004), chronic artery disease (15.8% vs 3.6%, OR=1.7, p=0.04), and diagnosis of acute respiratory distress symptoms (63.2% vs 6.0%, p<0.001). Additionally, the mean ferritin levels were significantly higher in cases requiring critical care [2350.4 (423.8) vs 795.7 (554.3), p=0.005]. Depending on disease severity, the treatment included antibacterials, antivirals, heparin, and steroids. The utilisation of steroids was significantly higher in the cases requiring critical care (63.2% vs 26.5%, p=0.001). Among cases that required critical care (n=19), nine died (death rate=47.4%). Conclusions This study has provided fundamental information about the clinical characteristics of confirmed COVID-19 cases in Oman, including factors associated with the disease’s severity. Results from this study can be utilised to update the COVID-19 management guidelines for hospitalised patients.

PMID:34567884 | PMC:PMC8451160 | DOI:10.7759/cureus.17343