Counting Polar Symptoms: How to Represent Results?

Homeopathy ◽  
2020 ◽  
Author(s):  
Lex Rutten ◽  
José Eizayaga ◽  
Harleen Kaur ◽  
Chetna Deep Lamba ◽  
Jyoti Sachdeva ◽  
...  
Keyword(s):  
Observational Study ◽  
Frequency Distribution ◽  
Chronic Cough ◽  
Prognostic Value ◽  
Prospective Observational Study ◽  
Mean Value ◽  
Centre Of Mass ◽  
Central Council ◽  
The Mean

Abstract Background Polar symptoms (PS)—symptoms with opposite values—are frequently used in homeopathy, but have many misleading entries in the repertory. This is caused by using absolute occurrence of symptoms, causing the same medicine to appear in both (opposite) symptom rubrics, and by lack of comparison with other medicines. Some PS, like ‘aversion/desire for sweets’ have a frequency distribution that is not evenly distributed around the neutral value: a desire for sweets is much more common than aversion. A desire for sweets is an indication for a specific medicine only if this desire occurs more frequently in this specific medicine population than in the remainder of the population. We need to find the best way to represent this difference. Methods A multi-centre, explorative, prospective, observational study was conducted by nine centres of the Central Council for Research in Homoeopathy. Two-hundred and sixteen patients were enrolled with chronic cough lasting more than 8 weeks, and received usual homeopathic care. During intake, 30 general PS, 27 polar cough symptoms and 3 non-polar cough symptoms were checked. Different ways of representing results were explored, including two quantities borrowed from mechanics: Centre of Mass (CoM) and Leverage. Results At the fourth follow-up, three medicines with more than 10 cases with good results were identified: 20 Phosphorus, 19 Pulsatilla and 13 Sulphur. The mean value of the frequency distribution of some symptoms in the whole sample was considerably different from the neutral value. Comparing a medicine population with the remainder of the respective population can give results that differ from polarity analysis. For some symptoms, the ‘distance’ (Leverage) between the CoMs of the medicine population and the remainder of the population was clearer than the likelihood ratio (LR). Conclusion If the LR value is not clear about the prognostic value in PS, notions from mechanics such as CoM and Leverage can clarify how to interpret a polar symptom.

P0670DIFFUSIONAL KURTOSIS IMAGING PREDICTS THE PROGNOSIS OF CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yan Liu ◽  
Gu-mu-yang Zhang ◽  
Xiaoyan Peng ◽  
Xuemei Li ◽  
Hao Sun ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iga Nephropathy ◽  
Clinical Outcomes ◽  
Renal Fibrosis ◽  
Prognostic Value ◽  
Mean Value ◽  
Non Invasive ◽  
The Mean

Abstract Background and Aims Renal fibrosis is the strongest prognosis predictor of ESRD in chronic kidney disease (CKD), but non-invasive and repeatable imaging markers are missing. Magnetic resonance imaging (MRI) has wide range of applications in renal parenchymal diseases, and diffusional kurtosis imaging (DKI) is a new promising noninvasive method of MRI which can provide more information about non-Gaussian diffusion using a polynomial model. We had successfully used DKI to assess renal fibrosis in IgA nephropathy in our previous work. This study aimed to evaluate the prognostic value of DKI in CKD. Method We prospectively enrolled forty-two CKD patients in our study in Jan. 2017. On recruitment, the basic clinical data were documented, and DKI was performed on a clinical 3T MR scanner. Region-of-interest (ROI) measurements were performed to determine apparent diffusion coefficient (ADC), kurtosis (K) and diffusivity (D) of the cortex of the kidneys. We had followed up these patients for 3 years, and collected all the clinical data and outcomes. The prognostic value of DKI metrics and clinical parameters were investigated. Results Forty-two patients consisted of 26 males and 16 females with mean age of 41.3±15.4 years. The most common etiology was IgA nephropathy (25/42, 59.5%). At baseline, the mean value of serum creatinine (SCr) was 224.4±156.2μmol/L. Among them, 18 patients had eGFR≥45ml/min and 24 patients had eGFR<45ml/min. According to the etiology and CKD classification, all the patients had received appropriate treatment. Besides supportive treatment and management of CKD complications, 21 patients (50%) had received corticosteroid and/or immunosuppressants treatment. After 36 months follow up, 12 patients had progressed to end stage renal disease (ESRD), and the mean value of SCr of the remaining 30 patients was 153.0±78.8umol/L. The Kaplan-Meyer survival regression showed that the patients with eGFR<45ml/min had worse clinical outcomes (p=0.0006). ROC analysis and Kaplan-Meyer survival regression showed that DKI metrics (K≥0.66 or ADC<1.35) not only predicted severe renal fibrosis, but also had worse clinical outcomes (p=0.01 and p<0.0001) (Figure 1). According to the COX regression analysis, both K (K≥0.66, HR 4.676, 95%CI 1.262-17.325) and ADC (ADC<1.35, HR 13.118, 95%CI 3.499-49.178) values, but not age, gender and eGFR group (cut-off value: 45ml/min), were the independent risk factors for the progression to ESRD. Conclusion Renal ADC and K values obtained from DKI showed significant predictive value for the prognosis of CKD, could be a promising non-invasive technique in patients follow-up.

scholarly journals A study of monitoring of early postoperative serum calcium levels in total thyroidectomy and its role in predicting temporary or permanent hypocalcemia: a prospective observational study

2020 ◽  
Vol 7 (3) ◽  
pp. 697
Author(s):  
Suryanarayana Reddy V. ◽  
Ashrith Reddy Cheruku ◽  
Rammohan Cheeti ◽  
Vivek Acha ◽  
Prashanth Gunde
Keyword(s):  
Observational Study ◽  
Total Thyroidectomy ◽  
Serum Calcium ◽  
Prospective Observational Study ◽  
Post Operative Period ◽  
Permanent Hypocalcemia ◽  
Postoperative Serum ◽  
The Mean ◽  
Postoperative Hypocalcaemia

Background: This aim of study was to evaluate the ability of consecutive measurements of serum calcium levels to predict clinically relevant post-thyroidectomy hypocalcaemia and to assess risk factors for post-thyroidectomy hypocalcaemia.Methods: The study design was a prospective observational study, total 65 patients who undergoing completion or total thyroidectomy. Serum calcium level was measured at the time of first follow up (nearly 20th postoperative day) and patient was examined for signs of hypocalcemia.Results: In this study, 65 patients of all age group included from 19 years to 78 years. The mean (±SD) age of the patients was 47.65±12.35 years with range from 19 to 78 years. The mean difference of calcium values after 6 hours, 12 hours, 24 hours and 48 hours post-operative period were statistically significant (p<0.001) between patients with hypocalcaemia and patient with normokalaemia in unpaired t-test.Conclusions: There was no significant increase in morbidity (including postoperative hypocalcaemia) in completion thyroidectomy compared to primary total thyroidectomy.

scholarly journals Prognostic value of initial Glasgow Coma Score in comatosed patients on medical floor

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Muhammad Arif Nadeem ◽  
Khadija Irfan ◽  
Khawaja A Irfan Waheed
Keyword(s):  
Observational Study ◽  
Hospital Stay ◽  
Glasgow Coma Score ◽  
Prognostic Value ◽  
Prospective Observational Study ◽  
Medical Advice ◽  
Against Medical Advice ◽  
Lost To Follow Up ◽  
Category Score

Objective: An open non-randomized prospective observational study of comatosed patients was conducted to correlate initial Glasgow Coma Score (GCS) with the outcome in patients having medical coma at Mayo Hospital, Lahore between January 2002 to September 2003. Methods: A total of 273 patients were followed throughout their hospital stay to determine the outcome after the current episode of coma. A thorough history and examination was obtained for each case. The 3 category Glasgow Coma Score was recorded as an indication of the degree of unconsciousness. One of three possible outcome categories was established, recovery (discharge), death, and referral or self discharge (by attendants) against medical advice. Results: The outcome of 248 patients (90.84%) was established i.e. 152 (61.29%) were discharged after recovery and 96 (38.71%) died. The remaining 25 (09.16%) patients were lost to follow up. Four subcategories of the Glasgow Coma Score were made, at 3-point intervals. In the lowest score category ( score 3-5) there was 59.67% mortality and only 30.66% patients were successfully treated and discharged. In the category of GCS 6-8, 30.91% died and 60% were discharged, while in the 9-11 category, 26.47% died and 66.18% were discharged. In the highest score category (12-15), 27.27% deaths occurred, probably related to the severity of main event, and 62.50% were discharged. Conclusion: The depth of coma as reflected by the initial GCS can reliably be used to predict the outcome in comatosed patients.

scholarly journals Imaging and cytopathological correlation of space occupying lesions in liver: a prospective observational study

2017 ◽  
Vol 4 (5) ◽  
pp. 1687
Author(s):  
Sachinkumar Patel ◽  
P. B. Nichkaode ◽  
Prasad Y. Bansod ◽  
Murtaza Akhtar
Keyword(s):  
Longitudinal Study ◽  
Observational Study ◽  
Selection Criteria ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Liver Pathology ◽  
Common Site ◽  
Short Term ◽  
The Mean

Background: Liver is a common site for Space occupying lesions. It is difficult to distinguish these entities with imaging criteria alone. Development in liver surgery and liver pathology have led to many new types of primary hepatic space-occupying lesions (PHSOLS) being surgically resected and pathologically diagnosed, which has greatly increased the surgicopathological spectrum of PHSOLS.Methods: A 2-year tertiary care teaching hospital based longitudinal study with 77 participants was done. Selection criteria was defined and a prestructured proforma was made to assess and note the findings.Results: The mean age of occurrence of space occupying lesions of liver was 45.49±13.45 years with a range of 24 to 70 years. Space occupying lesions of liver was commonly observed in 4th Decade of life. 64.93% pathology of Space Occupying Lesions of Liver occur in males. 76.62% patients of space occupying lesions of liver present with pain in right upper quadrant.Conclusions: Majority of space occupying lesions were surgically managed with a short-term follow-up of 1 month in which no complications were noted.

scholarly journals Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study

Cardiology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Aharon Erez ◽  
Gregory Golovchiner ◽  
Robert Klempfner ◽  
Ehud Kadmon ◽  
Gustavo Ruben Goldenberg ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Bleeding Risk ◽  
The Elderly ◽  
High Dose ◽  
World Population ◽  
Younger Patients ◽  
End Point

<b><i>Introduction:</i></b> In patients with atrial fibrillation (AF) at risk for stroke, dabigatran 150 mg twice a day (DE150) is superior to warfarin for stroke prevention. However, there is paucity of data with respect to bleeding risk at this dose in elderly patients (≥75 years). We aimed to evaluate the safety of DE150 in comparison to warfarin in a real-world population with AF and low bleeding risk (HAS-BLED score ≤2). <b><i>Methods:</i></b> In this prospective observational study, 754 consecutive patients with AF and HAS-BLED score ≤2 were included. We compared outcome of elderly patients (age ≥75 tears) to younger patients (age &#x3c;75 years). The primary end point was the combined incidence of all-cause mortality, stroke, systemic emboli, and major bleeding event during a mean follow-up of 1 year. <b><i>Results:</i></b> There were 230 (30%) elderly patients, 151 patients were treated with warfarin, and 79 were treated with DE150. Fifty-two patients experienced the primary endpoint during the 1-year follow-up. Among the elderly, at 1-year of follow-up, the cumulative event rate of the combined endpoint in the DE150 and warfarin was 8.9 and 15.9% respectively (<i>p</i> = 0.14). After adjustment for age and gender, patients who were treated with DE150 had a nonsignificant difference in the risk for the combined end point as patients treated with warfarin both among the elderly and among the younger population (HR 0.58, 95% C.I = 0.25–1.39 and HR = 1.12, 95% C.I 0.62–2.00, respectively [<i>p</i> for age-group-by-treatment interaction = 0.83). <b><i>Conclusions:</i></b> Our results suggest that Dabigatran 150 mg twice a day can be safely used among elderly AF patients with low bleeding risk.

scholarly journals Z-osteotomy in hallux valgus: clinical and radiological outcome after Scarf osteotomy

2009 ◽  
Vol 1 (1) ◽  
pp. 4 ◽  
Author(s):  
Marcus Jaeger ◽  
Michael Schmidt ◽  
Alexander Wild ◽  
Bernd Bittersohl ◽  
Susanne Courtois ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Mean Value ◽  
Surgical Approaches ◽  
Radiological Outcome ◽  
Scarf Osteotomy ◽  
Post Surgery ◽  
The Mean

Correction osteotomies of the first metatarsal are common surgical approaches in treating hallux valgus deformities whereas the Scarf osteotomy has gained popularity. The purpose of this study was to analyze short- and mid-term results in hallux valgus patients who underwent a Scarf osteotomy. The subjective and radiological outcome of 131 Scarf osteotomies (106 hallux valgus patients, mean age: 57.5 years, range: 22-90 years) were retrospectively analyzed. Mean follow-up was 22.4 months (range: 6 months-5 years). Surgical indications were: intermetatarsal angle (IMA) of 12-23&deg;; increased proximal articular angle (PAA&gt;8&deg;), and range of motion of the metatarsophalangeal joint in flexion and extension &gt;40&deg;. Exclusion criteria were severe osteoporosis and/or osteoarthritis. The mean subjective range of motion (ROM) of the great toe post-surgery was 0.8&plusmn;1.73 points (0: full ROM, 10: total stiffness). The mean subjective cosmetic result was 2.7&plusmn;2.7 points (0: excellent, 10: poor). The overall post-operative patient satisfaction with the result was high (2.1&plusmn;2.5 points (0: excellent, 10: poor). The mean hallux valgus angle improvement was 16.6&deg; (pre-operative mean value: 37.5&deg;) which was statistically significant (p&lt;0.01). The IMA improved by an average of 5.96&deg; from a pre-operative mean value of 15.4&deg; (p&lt;0.01). Neither osteonecrosis of the distal fragment nor peri-operative fractures were noted during the follow-up. In keeping with our follow-up results, the Scarf osteotomy approach shows potential in the therapy of hallux valgus. 筻

scholarly journals The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014505 ◽  
Author(s):  
Mona Leandra Peikert ◽  
Laura Inhestern ◽  
Corinna Bergelt
Keyword(s):  
Observational Study ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Quantitative Study ◽  
Prospective Observational Study ◽  
Daily Life ◽  
Oncological Rehabilitation ◽  
Rehabilitation Measures

IntroductionFor ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment.Methods and analysisThis prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3). In study arm 1, children, parents and siblings are surveyed after treatment (baseline), 4–6 months after baseline measurement and at 12-month follow-up. In study arm 2, data are collected at the beginning and at the end of the rehabilitation measure and at 12-month follow-up. Families are assessed with standardised questionnaires on quality of life, emotional and behavioural symptoms, depression, anxiety, fear of progression, coping and family functioning. Furthermore, self-developed items on rehabilitation aims and reintegration into daily life are used. Where applicable, users and non-users of rehabilitation measures will be compared regarding the outcome parameters. Longitudinal data will be analysed by means of multivariate analysis strategies. Reference values will be used for comparisons if applicable. Qualitative data will be analysed using thematic analysis.Ethics and disseminationThis study has been approved by the medical ethics committee of the Medical Chamber of Hamburg. Data will be published in peer-reviewed journals and presented at conferences.

scholarly journals Lateral Antebrachial Cutaneous Nerve as a Donor Source for Digital Nerve Grafting: A Concept Revisited

2017 ◽  
Vol 11 (1) ◽  
pp. 1041-1048 ◽  
Author(s):  
Mehmet Bekir Unal ◽  
Kemal Gokkus ◽  
Evrim Sirin ◽  
Eren Cansü
Keyword(s):  
Pearson Correlation ◽  
Mean Value ◽  
Cutaneous Nerve ◽  
Digital Nerve ◽  
Mean Values ◽  
Nerve Grafts ◽  
The Mean ◽  
The Difference ◽  
Mean Time

Objective: The main objective of this study is to evaluate the availability of lateral antebrachial cutaneous nerve (LACN) autograft for acute or delayed repair of segmented digital nerve injuries. Patients and Methods: 13 digital nerve defects of 11 patients; treated with interposition of LACN graft that harvested from ipsilateral extremity were included in the study. Mean follow up period was 35, 7 months. The mean time from injury to grafting is 53, 3 days. The results of the mean 2PDT and SWMT values of injured /uninjured finger at the end of follow up period were evaluated with Paired T test. The correlation between the defect length and the difference of 2PDT, SWMT values between the uninjured and injured finger at the end of follow up period; were evaluated with Pearson - correlation analysis. Results: The mean value of our 2PDT and SWMT results are ~5,923, ~3, 52, respectively in which can be interpreted between the normal and diminished light touch. The defect length and difference percentage of SWMT values is positively and significantly correlated statistically. Mean length of interposed nerve grafts was 18.5 mm. The age of the patient and the mean values of 2PDT and SWMT with the difference % of 2PDT and % of SWMT are not statistically correlated. Conclusion: Based on results regarding sensory regaining at recipient side and negligible sensory deficit at harvesting side, we suggest that lateral antebrachial cutaneous nerve might be a valuable graft option for digital nerve defects.

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