Distribution of Iliac Artery Calcification on Unenhanced Computed Tomography Scans Performed on Potential Recipients Prior to Renal Transplantation

Purpose: To investigate whether a significant difference exists between the calcification of the common iliac arteries (CIAs) and the external iliac arteries (EIAs) and test for associations between clinical factors and the distribution of calcification. Methods: A retrospective review of renal transplant candidates who underwent a routine preoperative unenhanced computed tomography yielded 214 patients. Agatston scores for the patients’ left CIA, left EIA, right CIA, and right EIA were assigned. A retrospective search of patient records screened for 5 clinical factors (diabetes, hypertension, coronary artery disease [CAD], smoking, and dialysis). Data were assessed using a 2-sided t test, odds ratio, and a multivariate linear regression calculated through generalized estimating equation (GEE). Results: The log-transformed Agatston scores in the CIA were found to be significantly greater than that in the EIA ( t = 9.57, P < .0001), with a mean difference of 1.5078 (95% confidence interval: 1.1962-1.8194), indicating relative EIA sparing. There were no significant differences in calcification between the right and left sides. Generalized estimating equation found that CAD and smoking demonstrated independent positive associations with EIA sparing (GEE = 2.6464 [ P = .0197] and 1.9092 [ P = .0470], respectively). Age was also significantly associated and indicated that EIA sparing remained relatively constant throughout patients’ lives (GEE = 1.0711 [ P < .0001]). Conclusion: This study has demonstrated statistically significant EIA sparing in end-stage renal disease patients and identified CAD and smoking as associated factors. This phenomenon warrants further investigation into its biological mechanisms and the impact of EIA sparing on outcomes following transplants.

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The Effect of Hollyhock (Althaea officinalis L) Leaf Compresses Combined With Warm and Cold Compress on Breast Engorgement in Lactating Women

Journal of Evidence-Based Complementary & Alternative Medicine ◽

10.1177/2156587215617106 ◽

2016 ◽

Vol 22 (1) ◽

pp. 25-30 ◽

Cited By ~ 3

Author(s):

Shahla Khosravan ◽

Hossein Mohammadzadeh-Moghadam ◽

Fatemeh Mohammadzadeh ◽

Samane Ajam Khames Fadafen ◽

Malihe Gholami

Keyword(s):

Significant Relationship ◽

Intervention Group ◽

Estimating Equation ◽

Generalized Estimating Equation ◽

Control Groups ◽

Lactating Women ◽

Significant Difference ◽

Althaea Officinalis ◽

And Control ◽

Generalized Estimating

Breast engorgement affects lactation. The present study was conducted to determine the effect of hollyhock combined with warm and cold compresses on improving breast engorgement in lactating women. Participants included 40 women with breast engorgement divided into intervention and control groups, with participants in both groups being applied routine interventions and warm compress before nursing and a cold compress after nursing; however, the intervention group was also applied hollyhock compress. Both groups received these treatments 6 times during 2 days. The data collected were analyzed in SPSS-16 using a generalized estimating equation. According to the results, a significant difference was observed in the overall breast engorgement severity in the intervention group ( P < .001). The severity of breast engorgement was also found to have a significant relationship with time ( P < .001). According to the findings, hollyhock leaf compress combined with performing routine interventions for breast engorgement can improve breast engorgement.

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Interprofessional Medication Adherence Program for Patients With Diabetic Kidney Disease: Protocol for a Randomized Controlled and Qualitative Study (PANDIA-IRIS)

JMIR Research Protocols ◽

10.2196/25966 ◽

2021 ◽

Vol 10 (3) ◽

pp. e25966

Author(s):

Carole Bandiera ◽

Jennifer Dotta-Celio ◽

Isabella Locatelli ◽

Dina Nobre ◽

Grégoire Wuerzner ◽

...

Keyword(s):

Medication Adherence ◽

Kidney Disease ◽

Clinical Outcomes ◽

Diabetic Kidney Disease ◽

Estimating Equation ◽

Generalized Estimating Equation ◽

Diabetic Kidney ◽

Electronic Monitors ◽

The Impact ◽

Generalized Estimating

Background Despite effective treatments, more than 30% of patients with diabetes will present with diabetic kidney disease (DKD) at some point. Patients with DKD are among the most complex as their care is multifactorial and involves different groups of health care providers. Suboptimal adherence to polypharmacy is frequent and contributes to poor outcomes. As self-management is one of the keys to clinical success, structured medication adherence programs are crucial. The PANDIA-IRIS (patients diabétiques et insuffisants rénaux: un programme interdisciplinaire de soutien à l’adhésion thérapeutique) study is based on a routine medication adherence program led by pharmacists. Objective The aim of this study is to define the impact of the duration of this medication adherence program on long-term adherence and clinical outcomes in patients with DKD. Methods This monocentric adherence program consists of short, repeated motivational interviews focused on patients’ medication behaviors combined with the use of electronic monitors containing patients’ medications. When patients open the electronic monitor cap to take their medication, the date and hour at each opening are registered. In total, 73 patients are randomized as 1:1 in 2 parallel groups; the adherence program will last 6 months in the first group versus 12 months in the second group. After the intervention phases, patients continue using their electronic monitors for a total of 24 months but without receiving feedback. Electronic monitors and pill counts are used to assess medication adherence. Persistence and implementation will be described using Kaplan-Meier curves and generalized estimating equation multimodeling, respectively. Longitudinal adherence will be presented as the product of persistence and implementation and modelized by generalized estimating equation multimodeling. The evolution of the ADVANCE (Action in Diabetes and Vascular disease: Preterax and Diamicron Modified-Release Controlled Evaluation) and UKPDS (United Kingdom Prospective Diabetes Study) clinical scores based on medication adherence will be analyzed with generalized estimating equation multimodeling. Patients’ satisfaction with this study will be assessed through qualitative interviews, which will be transcribed verbatim, coded, and analyzed for the main themes. Results This study was approved by the local ethics committee (Vaud, Switzerland) in November 2015. Since then, 2 amendments to the protocol have been approved in June 2017 and October 2019. Patients’ recruitment began in April 2016 and ended in October 2020. This study was introduced to all consecutive eligible patients (n=275). Among them, 73 accepted to participate (26.5%) and 202 (73.5%) refused. Data collection is ongoing and data analysis is planned for 2022. Conclusions The PANDIA-IRIS study will provide crucial information about the impact of the medication adherence program on the adherence and clinical outcomes of patients with DKD. Monitoring medication adherence during the postintervention phase is innovative and will shed light on the duration of the intervention on medication adherence. Trial Registration Clinicaltrials.gov NCT04190251_PANDIA IRIS; https://clinicaltrials.gov/ct2/show/NCT04190251 International Registered Report Identifier (IRRID) DERR1-10.2196/25966

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Models for Longitudinal Data: A Generalized Estimating Equation Approach

Biometrics ◽

10.2307/2531734 ◽

1988 ◽

Vol 44 (4) ◽

pp. 1049 ◽

Cited By ~ 2602

Author(s):

Scott L. Zeger ◽

Kung-Yee Liang ◽

Paul S. Albert

Keyword(s):

Longitudinal Data ◽

Estimating Equation ◽

Generalized Estimating Equation ◽

Equation Approach ◽

Generalized Estimating

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Numerical investigation of the fatal 1985 Manchester Airport B737 fire

The Aeronautical Journal ◽

10.1017/aer.2016.122 ◽

2017 ◽

Vol 121 (1237) ◽

pp. 287-319 ◽

Cited By ~ 4

Author(s):

E. R. Galea ◽

Z. Wang ◽

F. Jia

Keyword(s):

Wind Speed ◽

Numerical Investigation ◽

Computer Simulations ◽

Potential Benefit ◽

Fire Plume ◽

Significant Difference ◽

Actual Fire ◽

The Right ◽

The Impact ◽

Burn Through

ABSTRACTIn this paper, fire and evacuation computer simulations are used to reconstruct the 1985 Manchester Airport B737 fire that resulted in the loss of 55 lives. First the actual fire and evacuation are reconstructed. Secondly, the impact of exit opening times and external wind on the fire and evacuation are investigated. Finally, the potential benefit offered by modern materials is evaluated. The results suggest that the number of fatalities could have been reduced by 87% had the forward right exit not malfunctioned and by 36% had the right over-wing exit been opened without delay. Furthermore, given the fuel pool size and location, a critical wind speed of 1.5m/s is necessary to cause the fire plume to lean onto the fuselage eventually resulting in fuselage burn-through. Finally, it is suggested that the use of modern cabin materials could have made a significant difference to the fire development and survivability.

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Stiffness of the Masseter Muscle in Children—Establishing the Reference Values in the Pediatric Population Using Shear-Wave Elastography

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189619 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9619

Author(s):

Cyprian Olchowy ◽

Anna Olchowy ◽

Aleksander Pawluś ◽

Mieszko Więckiewicz ◽

Luca Maria Sconfienza

Keyword(s):

Shear Wave ◽

Masseter Muscle ◽

Pediatric Population ◽

Shear Wave Elastography ◽

Total Sample ◽

Healthy Children ◽

Significant Difference ◽

The Right ◽

The Impact ◽

Masseter Muscles

In children, the quality and muscle function are altered in many pathologic conditions, including temporomandibular disorders. Although several methods have been used to evaluate muscle tonus, none became a golden standard. Moreover, the masseter muscle characteristics in children have not been investigated to date. This study aimed to measure the stiffness of the masseter muscle using shear-wave elastography in healthy children. We enrolled 30 healthy children (mean age 10.87 ± 3.38 years). The stiffness of masseter muscles was measured with shear wave elastography. Stiffness for the total sample was 6.37 ± 0.77 kPa. A comparison of the measurements did not show significant differences between the right and the left masseter muscles (left—6.47 ± 0.78 kPa; right—6.24 ± 0.76 kPa; p = 0.3546). A significant difference was seen between boys and girls (boys—5.94 ± 0.50 kPa; girls—6.63 ± 0.80; p = 0.0006). Shear-wave elastography is a promising diagnostic tool. It may help to detect changes in the stiffness of the masseter muscle and draw attention to pathological processes within the jaw muscles. Directions for further research shall include determining stiffness values in pathological conditions and the impact of biological and functional factors on the stiffness of the masseter muscle.

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