DOZ047.51: Swallowing and pulmonary diagnoses in children with EA and TEF

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
J Maybee ◽  
J Deck ◽  
E Jensen ◽  
A Ruiz ◽  
B Corbett ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Chest Ct ◽  
Older Children ◽  
Exact Test ◽  
Abnormal Chest ◽  
Laryngeal Penetration ◽  
Delayed Initiation ◽  
Abnormal Test Result ◽  
Vocal Fold Immobility ◽  
Tracheal Collapse

Abstract Introduction Children with repaired congenital esophageal atresia/tracheoesophageal fistula (EA/TEF) are at high risk of aerodigestive morbidity. We hypothesized that age and coexisting pulmonary diagnoses are associated with dysphagia in this population. Methods Retrospective review of children with EA/TEF seen in the aerodigestive program between 2011 and 2015 was carried out and comorbidities, video fluoroscopic swallow studies (VFSS), chest CT, and bronchoscopy results were reviewed. VFSS was considered abnormal if there was aspiration, deep laryngeal penetration, significant residue, or delayed initiation. Mann–Whitney U test was used to examine VFSS results by age. Fisher's exact test was used to assess the relationship between VFSS result and comorbidities. Results Ninety VFSS were performed on 44 children with EA/TEF (median 2 studies per patient, range: 0–7). Fifty three percent (23/39) children had at least one abnormal VFSS. Seventeen children had VFSS change between normal and abnormal over time, with 11 normal on their most recent VFSS. Younger children (Mdn = 1.57 years) were more likely to have an abnormal test result than older children (Mdn = 3.55 years) (p = 0.001). Children with severe tracheomalacia (>90% tracheal collapse visualized on flexible bronchoscopy) had a higher incidence of abnormal VFSS (14/20; 70%) than the other children with EA/TEF (9/24; 38%) (P = 0.04). Children with other pulmonary and airway comorbidities, including gestation age <36 weeks (P = 0.24), vocal fold immobility (P = 0.1), abnormal chest CT (P = 0.1), tended to have an increased incidence of abnormal VFSS but did not reach statistical significance in this cohort. Discussion Dysphagia was prevalent in this cohort and related to age and severe tracheomalacia. This reinforces the need for a multidisciplinary evaluation including feeding and swallowing evaluation. In this rare disease, we must collaborate between sites to improve our understanding of aerodigestive diagnoses and disease outcomes.

Use of SAMe-TT₂R₂ Score to Predict the Quality of Anticoagulation Control in Patients with Atrial Fibrillation Receiving Warfarin in Thailand

2020 ◽  
Vol 103 (6) ◽  
pp. 548-552
Keyword(s):  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Statistical Significance ◽  
Discrimination Performance ◽  
Poor Quality ◽  
Chi Square ◽  
Exact Test ◽  
Time In Therapeutic Range ◽  
Anticoagulation Control

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR

scholarly journals Clinical and chest CT presentations from 27 patients with COVID-19 pneumonia in Mogadishu, Somalia: a descriptive study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Yahye Garad Mohamed ◽  
Mohamed Farah Yusuf Mohamud ◽  
M. Sabri Medişoğlu ◽  
Ihsan Yavuz Atamaca ◽  
Ibrahim Hussein Ali
Keyword(s):  
Sore Throat ◽  
Pulmonary Nodules ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
First Case ◽  
Abnormal Chest ◽  
Lower Lung ◽  
History Of ◽  
Normal Chest ◽  
Bilateral Lung

Abstract Background Coronavirus disease 2019 (COVID-19) is an acute viral pneumonia that had recently been found in humans. The first case was discovered in Wuhan, Hubei province, China, in December 2019. In this article, we aimed to demonstrate the clinical and radiological characteristics of COVID-19 patients in Somalia from 20 March 2020 to 20 April 2020. Results Twenty-seven patients that had a positive RT-PCR test between 20 March 2020 and 20 April 2020 were retrospectively observed. This study included 19 (70.4%) males and 8 (29.6%) females, and the mean age and range were 43 years (SD ± 14.0) and 27–70 years, respectively. The majority (59.3%) of COVID-19-infected patients had no obvious history of exposure to infected patients. The participants of our study mostly presented with dry cough 24 (88.9%) patients, fever 19 (70.4%), myalgia 18 (66.6%), and sore throat 16 (59.3%). Twenty-five of 27 patients had abnormal chest CT, while 2 (7.4%) patients had normal chest CT. The most common patterns of abnormality seen on chest CT in patients with COVID-19 were ground-glass opacity (GGO) 74.1%, crazy paving pattern 18.5%, consolidation 14.8%, and mixed GCO 11.1%. Also, the most common predominant lesion distributions were bilateral lung involvement (88.9%), peripheral distribution (77.8%), and lower lung predominance (63%). Particularly, lung cavitation, discrete pulmonary nodules, pleural effusion, and underlying pulmonary fibrosis or emphysema had not been observed. Conclusion Dry cough, fever, myalgia, and sore throat were the most clinical presentations. GGO, crazy paving pattern, patchy consolidation, and mixed GCO were the typical chest CT manifestations.

scholarly journals Antimicrobial resistance in Neisseria gonorrhoeae isolates and gonorrhoea treatment in the Republic of Belarus, Eastern Europe, 2009–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aliaksandra Aniskevich ◽  
Iryna Shimanskaya ◽  
Iryna Boiko ◽  
Tatyana Golubovskaya ◽  
Daniel Golparian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Eastern Europe ◽  
Treatment Guidelines ◽  
Statistical Significance ◽  
Antimicrobial Treatment ◽  
National Guidelines ◽  
First Line ◽  
Exact Test ◽  
The Republic

Abstract Background Limited antimicrobial resistance (AMR) data for Neisseria gonorrhoeae are available in Eastern Europe. We investigated AMR in N. gonorrhoeae isolates in the Republic of Belarus from 2009 to 2019, antimicrobial treatment recommended nationally, and treatment given to patients with gonorrhoea. Methods N. gonorrhoeae isolates (n = 522) cultured in three regions of Belarus in 2009–2019 were examined. Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest. Resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied where available. A Nitrocefin test identified β-lactamase production. Gonorrhoea treatment for 1652 patients was also analysed. Statistical significance was determined by the Z-test, Fisher’s exact test, or Mann-Whitney U test with p-values of < 0.05 indicating significance. Results In total, 27.8% of the N. gonorrhoeae isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, 14 (2.7%) isolates had a ceftriaxone MIC of 0.125 mg/L, exactly at the resistance breakpoint (MIC > 0.125 mg/L). Only one (0.2%) isolate, from 2013, produced β-lactamase. From 2009 to 2019, the levels of resistance to ciprofloxacin and tetracycline were relatively high and stable. Resistance to cefixime was not identified before 2013 but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n = 1), 2012 (n = 1), and 2018–2019 (n = 2). Overall, 862 (52.2%) patients received first-line treatment according to national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) were given non-recommended treatment. Conclusions The gonococcal resistance to ciprofloxacin and tetracycline was high, however, the resistance to azithromycin was low and no resistance to ceftriaxone was identified. Ceftriaxone 1 g can continuously be recommended as empiric first-line gonorrhoea therapy in Belarus. Fluoroquinolones should not be prescribed for treatment if susceptibility has not been confirmed by testing. Timely updating and high compliance with national evidence-based gonorrhoea treatment guidelines based on quality-assured AMR data are imperative. The need for continued, improved and enhanced surveillance of gonococcal AMR in Belarus is evident.

Do longitudinal orthodontic trials use appropriate statistical analyses? A meta-epidemiological study

2021 ◽  
Author(s):  
Samer Mheissen ◽  
Haris Khan ◽  
Mohammed Almuzian ◽  
Emad Eddin Alzoubi ◽  
Nikolaos Pandis
Keyword(s):  
Statistical Analysis ◽  
Epidemiological Study ◽  
Data Extraction ◽  
Statistical Significance ◽  
Repeated Measure ◽  
Exact Test ◽  
Optimal Analysis ◽  
Study Characteristics ◽  
Measure Analysis ◽  
Repeated Measure Analysis

Summary Background In orthodontic trials, longitudinal designs with multiple outcome measurements over time are common. The aim of this epidemiological study was to examine whether optimal statistical analysis approaches have been used in longitudinal orthodontic trials. Methods Pubmed was searched in August 2021 for longitudinal orthodontic trials with at least three time points of outcome assessment published in the 2017–20 period. Study selection and data extraction were done independently and in duplicate. The analysis approaches undertaken were tabulated and associations between study characteristics and the use of optimal analysis or not were assessed using Fisher’s exact test and logistic regression. Results One hundred forty-seven out of 563 unique records were deemed eligible for inclusion. Only 26.50% of these trials used an optimal statistical analysis for longitudinal data where the data structure is accounted for. None of the study characteristics except the statistical significance of the results were associated with the appropriateness of the statistical analysis. The odds of significant results in studies with suboptimal analyses were higher than that in studies with optimal longitudinal analyses (odds ratio: 3.48, 95% confidence interval: 1.62, 7.46, P = 0.001). For the studies with optimal analysis, the most frequent test was repeated-measure analysis of variance (RM-ANOVA). The reporting of the statistical analysis section was suboptimal in the majority of the trials. Conclusion Most longitudinal orthodontic trials are not analysed using optimal statistical approaches. Inferences and interpretation of their results are likely to be compromised.

scholarly journals Effect of Pitch Size on Technical-Tactical Actions of the Goalkeeper in Small-Sided Games

2018 ◽  
Vol 62 (1) ◽  
pp. 157-166 ◽  
Author(s):  
Daniel Jara ◽  
Enrique Ortega ◽  
Miguel-Ángel Gómez ◽  
Pilar Sainz de Baranda
Keyword(s):  
Ad Hoc ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
Male Youth ◽  
Zone Length ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Observational Tool ◽  
Fisher’S Exact Test

Abstract The aim of this paper was to determine how the size of the pitch affected technical and tactical actions of the goalkeeper when playing small-sided games. The participants were 13 male youth players, including 3 goalkeepers. Three different pitch sizes were used (62 x 44 m; 50 x 35 m; 32 x 23 m). On each pitch, the players played three matches of 8 minutes, with 5-minute breaks between matches. Numerous variables were recorded and examined: defensive and offensive technical and tactical actions, opponent’s shooting zone, length and zone of the offensive action, and goal zone where the shoot was directed. An ad hoc observational tool was used. A descriptive analysis was described. The Fisher’s exact test was used when the expected distribution was below 5 or included values below 1%. Statistical significance was set at p < 0.05. The results showed that the technical-tactical actions of the goalkeeper differed among pitch sizes. In defensive actions, when the pitch was larger, the 1-on-1 situations took precedence, whereas when the pitch was smaller, the proportion of blocks increased. In offensive actions, the goalkeepers did not show a wide variety of actions when the pitch was larger, but when the pitch was smaller, passes with a hand or foot increased. These results show that the size should be taken into account when planning and designing tasks.

scholarly journals Antibodies Can Last for More Than 1 Year After SARS-CoV-2 Infection: A Follow-Up Study From Survivors of COVID-19

2021 ◽  
Vol 8 ◽  
Author(s):  
Kaihu Xiao ◽  
Haiyan Yang ◽  
Bin Liu ◽  
Xiaohua Pang ◽  
Jianlin Du ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Exercise Testing ◽  
Statistical Significance ◽  
Severe Disease ◽  
Cardiopulmonary Exercise Testing ◽  
Chest Ct ◽  
Severe Condition ◽  
Lung Lesions ◽  
Cardiopulmonary Exercise ◽  
Severe Group

Background: COVID-19 is a global pandemic. The prevention of SARS-CoV-2 infection and the rehabilitation of survivors are currently the most urgent tasks. However, after patients with COVID-19 are discharged from the hospital, how long the antibodies persist, whether the lung lesions can be completely absorbed, and whether cardiopulmonary abnormalities exist remain unclear.Methods: A total of 56 COVID-19 survivors were followed up for 12 months, with examinations including serum virus-specific antibodies, chest CT, and cardiopulmonary exercise testing.Results: The IgG titer of the COVID-19 survivors decreased gradually, especially in the first 6 months after discharge. At 6 and 12 months after discharge, the IgG titer decreased by 68.9 and 86.0%, respectively. The IgG titer in patients with severe disease was higher than that in patients with non-severe disease at each time point, but the difference did not reach statistical significance. Among the patients, 11.8% were IgG negative up to 12 months after discharge. Chest CT scans showed that at 3 and 10 months after discharge, the lung opacity had decreased by 91.9 and 95.5%, respectively, as compared with that at admission. 10 months after discharge, 12.5% of the patients had an opacity percentage &gt;1%, and 18.8% of patients had pulmonary fibrosis (38.5% in the severe group and 5.3% in the non-severe group, P &lt; 0.001). Cardiopulmonary exercise testing showed that 22.9% of patients had FEV1/FVC%Pred &lt;92%, 17.1% of patients had FEV1%Pred &lt;80%, 20.0% of patients had a VO2 AT &lt;14 mlO2/kg/min, and 22.9% of patients had a VE/VCO2 slope &gt;30%.Conclusions: IgG antibodies in most patients with COVID-19 can last for at least 12 months after discharge. The IgG titers decreased significantly in the first 6 months and remained stable in the following 6 months. The lung lesions of most patients with COVID-19 can be absorbed without sequelae, and a few patients in severe condition are more likely to develop pulmonary fibrosis. Approximately one-fifth of the patients had cardiopulmonary dysfunction 6 months after discharge.

scholarly journals A Reappraisal of Rhythmic Coma Patterns in Children

2005 ◽  
Vol 32 (4) ◽  
pp. 518-523 ◽  
Author(s):  
Rajesh RamachandranNair ◽  
Rohit Sharma ◽  
Shelly K. Weiss ◽  
Hiroshi Otsubo ◽  
Miguel A. Cortez
Keyword(s):  
Statistical Significance ◽  
Prognostic Significance ◽  
Favourable Outcome ◽  
Category Scale ◽  
Rhythmic Pattern ◽  
Performance Category ◽  
Exact Test ◽  
Significant Difference ◽  
Overall Performance ◽  
Clinically Significant

ABSTRACT:Objective:This study was designed to determine the prevalence of rhythmic coma patterns in comatose children and to ascertain the prognostic significance of reactive rhythmic coma patterns.Methods:We retrospectively analyzed and classified electroencephalogram (EEGs) in comatose children between two months and 18 years of age during the period 1996 - 2003 according to modified Young's classification. Outcome at one-year was scored according to the Paediatric Cerebral and Overall Performance Category Scale. Outcomes were compared using Fisher's exact test and Mann-Whitney test.Results:Analysis of 63 electroencephalogram (EEG) records in 38 patients showed rhythmic patterns in 19 records (30.2%; 9 alpha, 4 spindle, 4 theta and 2 beta coma patterns, total number of children = 14). Aetiology and outcome of alpha coma patterns and other rhythmic coma patterns were similar. In five children, one type of rhythmic pattern changed to another. Records with reactive rhythmic coma 66.7% (6/9), were associated with favourable outcome. Sixty percent of the records (6/10 records in seven children) with non-reactive pattern were associated with unfavourable outcome. This clinically significant difference did not reach statistical significance (lower Paediatric Cerebral and Overall Performance Category Scale score p= 0.14; favourable outcome p=0.19).Conclusion:Rhythmic coma patterns in comatose children are not uncommon. Aetiology, reactivity and outcome of individual patterns are similar and thus make the rhythmic coma patterns distinct EEG signatures in comatose children. There was a clinically significant better outcome with reactive rhythmic coma patterns.

scholarly journals Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

2020 ◽  
Vol 7 (1) ◽  
pp. e000646 ◽  
Author(s):  
Bruce Kirenga ◽  
Winters Muttamba ◽  
Alex Kayongo ◽  
Christopher Nsereko ◽  
Trishul Siddharthan ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Sub Saharan Africa ◽  
Detailed Data ◽  
X Ray ◽  
Mild Disease ◽  
Clinical Recovery ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Sub Saharan ◽  
Muscle Ache

RationaleDetailed data on the characteristics and outcomes of patients with COVID-19 in sub-Saharan Africa are limited.ObjectiveWe determined the clinical characteristics and treatment outcomes of patients diagnosed with COVID-19 in Uganda.MeasurementsAs of the 16 May 2020, a total of 203 cases had been confirmed. We report on the first 56 patients; 29 received hydroxychloroquine (HCQ) and 27 did not. Endpoints included admission to intensive care, mechanical ventilation or death during hospitalisation.Main resultsThe median age was 34.2 years; 67.9% were male; and 14.6% were <18 years. Up 57.1% of the patients were asymptomatic. The most common symptoms were fever (21.4%), cough (19.6%), rhinorrhea (16.1%), headache (12.5%), muscle ache (7.1%) and fatigue (7.1%). Rates of comorbidities were 10.7% (pre-existing hypertension), 10.7% (diabetes) and 7.1% (HIV), Body Mass Index (BMI) of ≥30 36.6%. 37.0% had a blood pressure (BP) of >130/90 mm Hg, and 27.8% had BP of >140/90 mm Hg. Laboratory derangements were leucopenia (10.6%), lymphopenia (11.1%) and thrombocytopenia (26.3%). Abnormal chest X-ray was observed in 14.3%. No patients reached the primary endpoint. Time to clinical recovery was shorter among patients who received HCQ, but this difference did not reach statistical significance.ConclusionMost of the patients with COVID-19 presented with mild disease and exhibited a clinical trajectory not similar to other countries. Outcomes did not differ by HCQ treatment status in line with other concluded studies on the benefit of using HCQ in the treatment of COVID-19.

Association between 10 Microsatellite Markers and Nonsyndromic Cleft Lip Palate in the Chilean Population

2004 ◽  
Vol 41 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Rafael Blanco ◽  
José Suazo ◽  
JoséLuis Santos ◽  
Mónica Paredes ◽  
Hsiao Sung ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Statistical Significance ◽  
Positive Family History ◽  
Case Control ◽  
University Hospital ◽  
Control Group ◽  
Exact Test ◽  
Rehabilitation Centers ◽  
Cleft Lip Palate ◽  
Chilean Population

Objective The objective of this case-control study was to evaluate the possible association between nonsyndromic cleft lip/palate (NSCLP) and 10 genetic markers in four chromosomal regions in the admixed Spanish-Amerindian Chilean population. Setting Study participants included 56 patients with NSCLP identified and interviewed for positive family history during the course of clinical examinations at different rehabilitation centers in the cities of Santiago and Talca, Chile. A control group of 59 normal individuals without known familial antecedents of clefting was obtained from blood bank donors of the University Hospital, University of Chile. Cases and controls belonged to low- to low-middle socioeconomic strata. Results Ten markers from chromosome 4p, 4q, 6p, 17q, and 19q were assessed (MSX1, D4S175, D4S192, F13A1, EDN1, D6S89, D6S105, D6S109, D17S579, BCL3). Four of them showed significant deviations from Hardy-Weinberg expectations in controls, according to the exact test (D4S192, BCL3, F13A1, and D6S89). The case-control comparison by means of the CLUMP program showed significant differences only in BCL3, and D6S109 almost reached statistical significance. Conclusions Most of the genetic regions with positive results in Caucasian populations may not be involved in NSCLP in Chile, regardless of the positive evidence for the candidate region on chromosome 19. Similar findings have been reported recently in the Chinese population.

scholarly journals Clinical and surgical risk factors for consecutive exotropia

2018 ◽  
Vol 29 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Sophie Bryselbout ◽  
Veronique Promelle ◽  
Florent Pracca ◽  
Solange Milazzo
Keyword(s):  
Risk Factors ◽  
Age Of Onset ◽  
Statistical Significance ◽  
Ocular Motility ◽  
Refractive Errors ◽  
Surgical Risk ◽  
Exact Test ◽  
Convergence Insufficiency ◽  
Consecutive Exotropia ◽  
Angle Of Deviation

Introduction: Consecutive exotropia is one of the complications of esotropia surgery. Its prevalence is estimated at 4%–27%. The aim of this study was to identify the risk factors for consecutive exotropia in the aftermath of surgical treatment of esotropia. Methods: Seventy-four patients examined in our strabismus consultation for a consecutive exotropia from January 2010 to June 2016 were retrospectively included. The age of onset of esotropia, the presence of amblyopia, the age of esotropia surgery and chosen procedure, the refractive errors, the anomalies of ocular motility, the age of onset of the consecutive exotropia and its angle of deviation were reported. Statistical analyses were performed with Student’s test and Fisher’s exact test. Results: Esotropia occurred in 65% of cases before the age of 1 year, was associated with amblyopia in 51%, hyperopia in 55% or anisometropia in 31%. Surgery was performed before the age of 6 years for 55% of the patients and involved for 52% the both medial recti. The angle of deviation of consecutive exotropia was ≤20 prism dioptres (PD) in 39%, 21-40 PD in 39% and ≥ 40 PD in 22%, related to amblyopia (p = 0.028), and to high hypermetropia (p = 0.05). Discussion: Amblyopia and hyperopia were the most important risk factors of consecutive exotropia in our series. Early onset esotropia, stereopsis abnormalities, anisometropia, oblique dysfunction, convergence insufficiency appeared but did not reach statistical significance. Conclusion: Amblyopia is a major risk factor that should be taken into consideration during surgery of an esotropia.

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