scholarly journals Toward Personalized Medicine Implementation: Survey of Military Medicine Providers in the Area of Pharmacogenomics

2019 ◽  
Vol 185 (3-4) ◽  
pp. 336-340 ◽  
Author(s):  
Jesse DeLuca ◽  
Daniel Selig ◽  
Lucas Poon ◽  
Jeffrey Livezey ◽  
Thomas Oliver ◽  
...  
Keyword(s):  
Personalized Medicine ◽  
Statistical Significance ◽  
The Body ◽  
P Value ◽  
Small Subset ◽  
Chi Square ◽  
Military Health ◽  
Direct To Consumer ◽  
Knowledge Question ◽  
The Right

Abstract Introduction Personalized medicine is the right treatment, to the right patient, at the right dose. Knowledge of genetic predisposition to variable metabolism and distribution of drugs within the body is currently available as pharmacogenomic testing and is one of the pillars of personalized medicine. Pharmacogenomic testing is growing. It has become part of guidelines for dosing on FDA labels and has been used by health care organizations to improve outcomes and reduce adverse events. Additionally, it has been FDA approved for direct-to-consumer purchase and has been cause of concern of patient self-dosing and medication changes. Presumably in the near future, pharmacogenomics will be impressed upon the military health system (MHS) provider from either a top-down, command requested, or from a bottom-up, patient requested, approach. To date, widespread implementation of pharmacogenomic testing does not seem to be established within the MHS. This survey sheds light on the knowledge, exposure, use, comfort, and interest among family medicine providers in the MHS. It compares similar results in other national and international surveys and compares results among a small subset of residents to staff. Materials and Methods The questions were part of a larger survey conducted by the Clinical Investigations Committee of the Uniformed Services Academy of Family Physicians (USAFP) at the USAFP 2019 annual meeting. The study received approval from the Uniformed Services University Institutional Review Board. Submitted questions were written using multiple choice, fill-in, five-point Likert scale, and best answer. Direct results are reported as well as chi-square statistics for categorical data with statistical significance to attain a P-value of < 0.05. Results Among the 532 USAFP-registered conference attendees eligible to complete the survey, 387 attendees responded to the survey, for a response rate of 72.7%. Some results included were a knowledge question in which 37% of respondents answered correctly. Less than half of respondents agreed that they could define pharmacogenomics, and resident respondents were more likely to have received teaching in graduate medical education. Additionally, 12% of providers responded to being exposed to direct-to-consumer results, and 28% of those exposed were influenced to change medications, while 14% were influenced to change medications on multiple occasions. Chi-square comparisons resulted in statistically significant direct relationships to exposure to direct to consumer testing, previous training, and confidence of those that answered the knowledge question correctly. Conclusions This survey establishes a baseline for the possible needs associated with implementation of a pharmacogenomic program, and it argues an actionable level for the use of pharmacogenomics among the patient population within the MHS.

scholarly journals Estado nutricional e desfechos clínicos em pacientes críticos internados em hospital universitário

2020 ◽  
Vol 34 (4) ◽  
pp. 361-366
Author(s):  
Edcleide Oliveira dos Santos Olinto ◽  
Gina Araújo Martins Feitosa ◽  
Izaura Odir Lima Gomes da Costa ◽  
Janine Maciel Barbosa ◽  
Ericka Vilar Bôtto Targino ◽  
...  
Keyword(s):  
Body Mass ◽  
Statistical Significance ◽  
Strong Relationship ◽  
The Body ◽  
University Hospital ◽  
Nutritional Risk ◽  
World Health ◽  
P Value ◽  
Chi Square ◽  
Length Of Hospitalization

Introduction: There is a strong relationship between malnutrition and increased length of hospitalization and morbidity and mortality. Studies have shown that malnourished patients can have up to twenty times more complications than eutrophic ones. In critically ill patients, there is a tendency to catabolism, resulting in the loss of lean body mass, which when it reaches 40% is usually lethal. Methods: A quantitative, descriptive study was conducted on adults from both genders, admitted to the intensive care unit (ICU) of a university hospital, from March to December 2018. The following variables were collected from the evaluation and nutritional records: length of hospitalization in the ICU, date of discharge or death, nutritional risk through specific screening, height, weight and arm circumference (AC). For the screening, the Nutric score was used. For the nutritional evaluation, the body mass index (BMI) and AC indicators and the classifications recommended by the World Health Organization (2004) and Blackburn and Thornton (1979) were used. After collecting the data, they were analyzed in the Statistical Package for Social Sciences (SPSS) 13.0 and for the association of the variables the Chi-square test was used, considering statistical difference when the p value <0.05. Results: The sample consisted of 116 patients, mostly female (53.4%) whose median age was 46 years (interquartile range IQR 31-53). Regarding the frequency of nutritional risk, most patients (61.5%) had a low score. There was an important frequency of malnutrition, according to the AC indicator (73%), although BMI (43.5%) showed eutrophy. Even though most patients had low nutritional risk, those with high nutritional risk (38.5%) had a higher tendency to mortality, however, not statistically confirmed (p> 0.05). There was also a tendency of association between death and malnutrition, although no statistical significance was shown(p> 0.05). Conclusion: Patients at nutritional risk and/or malnutrition appear to be vulnerable to worse clinical outcomes.

Awareness of radiation doses and risks among radiology residents, fellows, specialists, consultants and technologists in Jeddah, Saudi Arabia: Cross-Sectional Study. (Preprint)

2019 ◽  
Author(s):  
Bashayer Hassan Shuaib ◽  
Rahaf Hisham Niazi ◽  
Ahmed Haitham Abduljabbar ◽  
Mohammed Abdulraheem Wazzan
Keyword(s):  
Interventional Radiology ◽  
Ionizing Radiation ◽  
Statistical Significance ◽  
Knowledge Score ◽  
P Value ◽  
Radiation Doses ◽  
Cross Sectional ◽  
The Right ◽  
Interventional Radiology Procedures ◽  
Radiology Staff

BACKGROUND Radiology now plays a major role to diagnose, monitoring, and management of several diseases; numerous diagnostic and interventional radiology procedures involve exposure to ionizing radiation. Radiology now plays a major role to diagnose, monitoring, and management of several diseases; numerous diagnostic and interventional radiology procedures involve exposure to ionizing radiation. OBJECTIVE This study aimed to discover and compare the awareness level of radiation doses, protection issues, and risks among radiology staff in Jeddah hospitals. METHODS A cross-sectional survey containing 25 questions on personal information and various aspects of radiation exposure doses and risks was designed using an online survey tool and the link was emailed to all radiology staff in eight tertiary hospitals in Jeddah. The authors were excluded from the study. A P-value of < .05 was used to identify statistical significance. All analyses were performed using SPSS, version 21. RESULTS Out of 156 participants the majority 151 (96.8%) had poor knowledge score, where the mean scores were 2.4±1.3 for doses knowledge, 2.1±1.1for cancer risks knowledge, 2.3±0.6 for general information, and 6.7±1.9 for the total score. Only 34.6% of the participants were aware of the dosage of a single-view chest x-ray, and 9.0% chose the right answer for the approximate effective dose received by a patient in a two-view. 42.9% were able to know the correct dose of CT abdomen single phase. There is a significant underestimation of cancer risk of CT studies especially for CT abdomen where only 23.7% knew the right risk. A p-value of <0.05 was used to identify statistical significance. No significant difference of knowledge score was detected regarding gender (P =.2) or work position (P=.66). CONCLUSIONS Our survey results show considerable inadequate knowledge in all groups without exception. We recommended a conscientious effort to deliver more solid education and obtain more knowledge in these matters and providing periodic training courses to teach how to minimize the dose of radiation and to avoid risk related. CLINICALTRIAL not applicable

scholarly journals Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic

2021 ◽  
Author(s):  
Kemar J Brown ◽  
Njambi Mathenge ◽  
Daniela Crousillat ◽  
Jaclyn Pagliaro ◽  
Connor Grady ◽  
...  
Keyword(s):  
Statistical Significance ◽  
The Elderly ◽  
P Value ◽  
Chi Square ◽  
Cardiovascular Patients ◽  
Baseline Characteristics ◽  
Racial Ethnic ◽  
Cardiovascular Care ◽  
Zip Code ◽  
Hispanic White

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in the rapid uptake of telemedicine (TM) for routine cardiovascular care. Objectives To examine the predictors of TM utilization among ambulatory cardiology patients during the COVID-19 pandemic. Methods In this single centre retrospective study, all ambulatory cardiovascular encounters occurring between March 16th - June 19th, 2020 were assessed. Baseline characteristics by visit type (in-person, TM-phone, TM-video) were compared using Chi-square and student t-tests, with statistical significance defined by p value &lt; 0.05. Multivariate logistic regression was used to explore the predictors of TM versus in-person care. Results 8446 patients (86% Non-Hispanic White, 42% female, median age 66.8 +/- 15.2 years) completed an ambulatory cardiovascular visit during the study period. TM-phone (n = 4,981, 61.5%) was the primary mode of ambulatory care followed by TM-video (n = 2693, 33.2%). Non-Hispanic Black race (OR 0.56; 95% CI: 0.35 - 0.94, p-value=0.02), Hispanic ethnicity (OR 0.53; 95% CI: 0.29 - 0.98, p = 0.04), public insurance (Medicaid OR 0.50; 95% CI:0.32 – 0.79, p = 0.003, Medicare OR 0.65; 95% CI: 0.47– 0.89, p = 0.009), zip-code linked median household income (MHI) of &lt;$75,000, age &gt;85 years, and patients with a diagnosis of heart failure were associated with reduced access to TM-video encounters and a higher likelihood of in-person care. Conclusions Significant disparities in TM-video access for ambulatory cardiovascular care exist among the elderly, lower income, as well as Black and Hispanic racial/ethnic groups.

scholarly journals Characteristics, Treatment, and Prognosis of Cracked Teeth: A Comparison with Data from 10 Years Ago

2021 ◽  
Author(s):  
Tae Yeon Lee ◽  
Sung Eun Yang ◽  
Hye Min Kim ◽  
Min Joo Kye
Keyword(s):  
Root Canal ◽  
Statistical Significance ◽  
Treatment Method ◽  
Root Canal Treatment ◽  
Periodontal Pocket ◽  
P Value ◽  
Chi Square ◽  
Pocket Depth ◽  
Persistent Symptoms ◽  
Probing Depth

Abstract Objectives The purpose of this study was to analyze and to compare retrospectively the characteristics, the treatment process, and the prognosis of cracked teeth by comparing recent data with data from 10 years ago. Materials and Methods Sixty-eight cracked teeth from March 2009 to June 2010 (2009 data) and 185 cracked teeth from March 2019 to June 2020 (2019 data) were analyzed. The characteristics of cracked teeth and the treatment method depending on probing depth, caries, and symptoms, and prognosis depending on pocket depth and apical lesions were analyzed using R version 3.3.3 (R Foundation for Statistical Computing, Vienna, Austria) and T&F version 3.0 (YooJin BioSoft, Korea). To compare proportions, the two-sample proportion test was performed. The distribution of proportions within the samples from 2009 and 2019 data was analyzed using the Chi-square test or binomial test. A p-value <0.05 was considered to indicate statistical significance. Results Significantly fewer cracked teeth received root canal treatment before crown in 2019 than in 2009 (p = 0.032). In both 2009 and 2019, symptomatic cracked teeth and those with deep periodontal pockets (>6 mm) were significantly more likely to receive root canal treatment. In both years, cracked teeth with a probing depth less than 6 mm or without an apical lesion were significantly more likely to be asymptomatic at 3-month and 6-month follow-ups (p < 0.001). Conclusion Cracked teeth with a deep periodontal pocket or symptoms had a higher likelihood of endodontic treatment, and the presence of a deep periodontal pocket or apical lesion was associated with a higher risk of persistent symptoms. Therefore, clinicians should consider these factors when planning treatment and predicting patients’ prognosis.

scholarly journals Gloves Perforations in Minor Oral Surgical Procedures: A Comparison of Latex and Nitrile Gloves

2021 ◽  
Vol 30 (02) ◽  
pp. 103-106
Author(s):  
Ajeet Kumar ◽  
◽  
Naveed Iqbal ◽  
Javaria Farooq ◽  
Saad Uddin Siddiqui
Keyword(s):  
Local Anesthesia ◽  
Surgical Procedures ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
P Value ◽  
Dominant Hand ◽  
Chi Square ◽  
Oral Surgical Procedures ◽  
Latex Gloves ◽  
Chi Square Test

OBJECTIVE: This study was performed to compare incidence of perforations in Latex and Nitrile examination gloves during Minor Oral surgical procedures performed under local anesthesia. METHODOLOGY: 100 pairs of latex and 100 pairs of Nitrile examination gloves where used to perform 200 minor oral surgical procedures under local anesthesia. After completion of every minor oral surgical procedure each gloves was examined by Water Inflation method to observe presence or absence of Perforations. A data sheet was used to collect data including type of Gloves used (Latex or Nitrile) presence of perforations, sites of perforations and nature of minor oral surgical procedures. Data was entered and analyzed using SPSS version 20. Descriptive analysis was conducted to calculate frequency and percentages of Number and sites of perforations for both Nitrile and latex examination gloves. Chi Square test was used to find out statistical significance of difference of perforations rate between Nitrile and Latex gloves. P value of < 0.05 was considered significant. RESULTS: Out of 200 latex gloves 23 (11.5) had 29 perforations whereas out of total 200 Nitrile gloves 28 (14%) had 22 perforations. Nitrile gloves had a statistically significant higher rate of perforations as compared to Latex gloves. (P value 0.043). For both Nitrile and Latex gloves left non dominant hand had highest frequency of perforations Latex 18 (81.81%) perforations and Nitrile 18(62.06%). Index finger and thumb were most frequent sites of perforations in both Latex and Nitrile gloves. CONCLUSION: Gloves perforations were more common in Nitrile examination gloves however total number of perforations was more in Latex examination gloves.

scholarly journals ULTRASOUND PREDICTABILITY OF LOWER UTERINE SEGMENT CESAREAN SECTION SCAR THICKNESS

2020 ◽  
pp. 9-11
Author(s):  
Madhu Kumari ◽  
Kumari Bibha ◽  
Abha Sinha ◽  
Debarshi Jana
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Statistical Significance ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Uterine Scar ◽  
Age Range ◽  
The Given

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.

scholarly journals Incidences of Root Microcracks Caused by Hand and Rotary File System at Different Lengths

2019 ◽  
Vol 3 (9) ◽  
pp. 283-289
Author(s):  
Shuchi Sukul ◽  
Goldy Rathee ◽  
Parimal Anand ◽  
Sakshi Kataria ◽  
Pratibha Taneja
Keyword(s):  
File System ◽  
Statistical Significance ◽  
File Systems ◽  
In Vitro Study ◽  
Root Surface ◽  
P Value ◽  
Chi Square ◽  
Chi Square Test ◽  
Group B

OBJECTIVES: The present research was conducted to assess incidences of root microcracks caused by hand and rotary file system at different lengths MATERIAL AND METHODS: This in-vitro study was undertaken to assess incidence of root microcracks caused by hand and rotary file system at different lengths In total, 100 the mandibular premolar with straight roots determined with intact, fully formed apices were taken. Samples were randomly distributed into 5 groups based on the file system used: a) Group A: Control, b) Group B: Reciproc, c) Group C: WaveOne, d) Group D: One Shape and e) Group E: ProTaper. Pearson Chi-square test was used to determine the differences between groups. The dentinal defects were expressed as percentage of samples with microcracks in each group. Level of statistical significance was set at p-value less than 0.05. RESULTS: The chi square test was used to compare the Distribution of the number of teeth in which cracks were observed on the horizontal sections. It was found to be significant with group ProTaper showing maximum cracks at 3,6,9 mm level as compared to other file systemCONCLUSION: Nickel-titanium instruments causes cracks on the apical root surface or in the root canal wall. ProTaper causes maximum dentinal cracks as compared to other file systems

scholarly journals Utilization of MCH handbooks and attitudes of pregnant women regarding pregnancy and childbirth complications

2019 ◽  
Vol 27 (2) ◽  
pp. 71
Author(s):  
Dian Irawati ◽  
Agustin Dwi Syalfina
Keyword(s):  
Pregnant Women ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Live Births ◽  
Pregnancy And Childbirth ◽  
Independent Variable ◽  
The Right ◽  
Chi Square Analysis ◽  
The Relationship

Objectives: Maternal Mortality Rate (MMR) is closely related to maternal care. MMR in Indonesia based on the 2015 IDHS is 359 per 100,000 live births. By increasing the utilization of MCH handbooks, MMR would be decline. Therefore, this research investigated the relationship between of the utilization of MCH handbooks and attitudes pregnant women regarding pregnancy and childbirth complications.Materials and Methods: We conducted a cross sectional research with 54 pregnant women during March - June 2018 at the Sooko Health Center, Mojokerto. The independent variable was the utilization of MCH handbooks and the dependent variable was the attitude of pregnan women regarding pregnancy and childbirth complications. Data analysis included descriptive and bivariate analysis.Results: The results showed that 79.6% of respondents used the MCH handbook well. The results of the chi square analysis test showed a p value of 0.027 (<0.05).Conclusion: MCH handbook utilization effected the attitude of pregnant women regarding the complication of pregnancy and childbirth. Pregnant women who read and utilize MCH handbook would be have better alertness about the risk of complication so they would make the right decision for their pregnancy.

scholarly journals Neonatal and Maternal Outcomes in Spontaneously-Conceived Twin Pregnancies According to Mode of Delivery

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 468-476
Author(s):  
Samantha Mc Kenzie Stancu ◽  
Manuela Cristina Russu
Keyword(s):  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Mode Of Delivery ◽  
Statistical Correlation ◽  
P Value ◽  
Maternal Outcomes ◽  
Chi Square ◽  
Chi Square Test ◽  
Nicu Admission ◽  
Twin Pregnancies

Introduction: Appropriate intrapartum conduct in a twin delivery remains a challenging aspect of obstetric practice. The objective of this study was to compare neonatal and maternal outcomes in twin pregnancies according to mode of delivery.&nbsp; Materials and methods: This is a single centre retrospective cohort study of all consecutive spontaneously-conceived twin deliver-ies (&ge; 24 weeks, estimated fetal weight &ge; 500 grams) over a nine-year period between 01/01/2007 - 31/12/2016 at a tertiary-level centre. Neonatal outcomes included survival, APGAR score, prematurity-associated pathology (PAP), admission to the neonatal intensive care unit (NICU) and length of stay (LOS). Maternal outcomes included postpartum complications and LOS. Statistical analysis comprised Chi-square test with subsequent p-value and odds-ratio with 95% confidence interval. Statistical significance was set at p<0.05. Results: A total of 173 consecutive women with spontaneously-conceived twin deliveries were enrolled in this study, 129 (74.6%) women delivered by caesarean section (CS). The success rate of vaginal delivery (VD) was 93.6% (44/47). A strong statistical correlation was identified between CS and NICU admission; 53.2% vs. 1.5% (p=0.0001). Neonatal LOS in the NICU was significantly longer in the CS group. Prematurity-associated pathology (PAP) was noted in 75 pairs of twins (75/173); 61 pairs were delivered by CS, bearing strong statistical significance (p<0.0001). Postpartum complications occurred in 14.7% of CS compared to 13.6% of VDs.&nbsp; Conclusion: Neonates delivered by CS had a higher rate of PAP, NICU admission, lower birth weight and longer LOS. This study showed that VD is safe, especially when the first twin is in cephalic presentation

scholarly journals Evaluation of the Intermental Foramina Distance among Malaysian Population by using Orthopantomogram Radiograph

2016 ◽  
Vol 5 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Mohammed Jasim Aljuboori ◽  
Hussien Ali Al-Wakeel ◽  
Lor Yen Fang ◽  
Navenithamaria Eirutharajan ◽  
Santhanalaxmi A Balachandran
Keyword(s):  
Indian Population ◽  
Mental Foramen ◽  
P Value ◽  
Exclusion Criteria ◽  
Chi Square ◽  
Female Population ◽  
Malaysian Population ◽  
Chi Square Test ◽  
Malay Population ◽  
The Right

ABSTRACT Objectives Previous studies showed there were variations in the interforamina distance of mental foramen between races. The aim of our study is to determine the interforamina distance of mental foramen among Malaysian populations. Materials and methods A total of 503 orthopantomogram (OPG) radiographs were observed. Interexaminer calibration was estimated using the Kappa-Cohen formula. A sheet of transparent paper was superimposed on the panoramic film and the mental foramen was traced on it by using a fine marker pen. A vertical line marking the midline was drawn passing between the maxillary central incisors, the mandibular central incisors, or the nasal septum by using a ruler. The distance of the mental foramen from the midline was then recorded from both the left and the right side. The data were analyzed using chi-square test. Results According to our inclusion and exclusion criteria, 110 OPGs have been excluded and 393 OPGs were selected. In the Malay population, the most common interforamina distance for a male is between 55 and 60+ mm (n= 73, 54.8%). Also, the most common interforamina distance for a female is 55 to 60+ mm (n = 84, 50%). In the Chinese population, the most common interformina distance for a male is between 55 and 60+ mm (n=60, 66.8%). Similarly, the most common interforamina distance for a female is between 55 and 60+ mm (n= 73, 53.8%). Among the Indian population, the most common interforamina distance for a male falls between 55 and 60+ mm (n= 53, 43.4%) and for a female as well (n=50, 54%). According to the chi-square test, the results show that the study is statistically insignificant since the p-value is >0.05 for both the male and female population. Conclusion There is no relationship between the interforamina distance and the ethnicity. The most common interforamina distance for all the races falls between 55 and 60+ mm. How to cite this article Al-Juboori MJ, Saini R, Al-Wakeel HA, Fang LY, Eirutharajan N, Balachandran SA. Evaluation of the Intermental Foramina Distance among Malaysian Population by using Orthopantomogram Radiograph. Int J Experiment Dent Sci 2016;5(2):118-122.

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