Serum ionic dysequilibria in clinical opioid dependence: Cross-sectional and longitudinal studies

2017 ◽  
Vol 36 (8) ◽  
pp. 776-784
Author(s):  
AS Reece ◽  
A Norman ◽  
GK Hulse
Keyword(s):  
Linear Regression ◽  
Repeated Measures ◽  
Opioid Dependence ◽  
Clinical Pathology ◽  
Antibody Test ◽  
Cross Sectional ◽  
Electrophysiological Properties ◽  
Medical Control ◽  
Excitable Membranes ◽  
The Mean

Introduction: Despite an increasing awareness that the activity of excitable membranes is determined by the underlying ionic gradients across them, and their importance in drug dependency, we were not able to identify any reports of comparing the electrolyte composition of opioid-dependent and non-addicted controls. Methods: Linear regression was used to compare clinical pathology blood results taken from 2699 opioid-dependent patients (ODP) and 5307 medical control (MC) patients on a total of 21,734 occasions for the period 1995–2015. The presence of a hepatitis C antibody test was used to separate OPD and MC patients. Results: The mean age among ODP and MC was 33.51 ± 0.16 and 37.99 ± 0.23 years, respectively ( p < 0.0001). The groups were 71.5% and 54.2% male ( p < 0.0001). Drug use in this cohort has been reported previously. Analysis of sodium, haemoglobin and albumin were used to exclude marked effects of haemodilution/haemoconcentration. Repeated measures linear regression against age and time showed depressed levels of bicarbonate ( p < 0.0001) and potassium ( p < 0.05) and elevated levels of chloride ( p < 0.025) and anions ( p < 0.01) in ODP in both sexes. Multiple regression in mixed-effects models showed that these effects were all worse in females ( p = 0.0001). Conclusion: This data shows that opioid dependence is associated with significant changes in chloride, potassium, bicarbonate and anions in both sexes, and worse in females. This likely has implications for the electrophysiological properties of excitable membranes. It is consistent with the reported impairment of potassium-chloride exchangers in opioid dependence. Explication of the mechanisms responsible must await further studies.

scholarly journals Specifying Location–Scale Models for Heterogeneous Variances as Multilevel SEMs

2020 ◽  
Author(s):  
Daniel McNeish
Keyword(s):  
Random Effects ◽  
Repeated Measures ◽  
Multilevel Models ◽  
Scale Model ◽  
General Version ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Recent Developments ◽  
Multilevel Sem ◽  
The Mean

Standard multilevel models focus on variables that predict the mean while the within-group variability is largely treated as a nuisance. Recent work has shown the advantage of including predictors for both the mean (the location submodel) and the variability (the scale submodel) within a single model. Constrained versions of the model can be fit in standard mixed effect model software, but the most general version with random effects in each of the location and scale submodels has been noted for being difficult to fit and estimate in software. However, the latest release of Mplus includes new capabilities that facilitate fitting the general version of the model as a multilevel SEM. This paper introduces the general form of the model that includes location and scale random effects (called the location-scale model) and notes how it can be envisioned as a multilevel SEM. We provide a tutorial with example analyses and Mplus code for the model with two-level cross-sectional data and three-level repeated measures data and discuss how such a model has potential to extend recent developments in organizational science.

scholarly journals HITUNG TROMBOSIT DI SINDROM KORONER AKUT TERKAIT LOW MOLECULAR WEIGHT HEPARIN (LMWH)

2016 ◽  
Vol 18 (3) ◽  
pp. 191
Author(s):  
Cyntia Kornelius ◽  
Darwati Muhadi ◽  
Mansyur Arif
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Complete Blood Count ◽  
Clinical Pathology ◽  
Antibody Test ◽  
Wilcoxon Test ◽  
Low Molecular Weight ◽  
Pathology Laboratory ◽  
Coronary Syndrome ◽  
The Mean

Heparin and Low molecular weight heparin (LMWH) had been used widely for prevention and treatment of thrombosis in the patients with acute coronary syndrome (ACS). Actually, the administration of heparin may caused some adverse effect, such as heparin inducedthrombocytopenia (HIT). This study was aimed to reveal thrombocytes count in patients with ACS who underwent LMWH therapy. An observational study with cohort prospective design was performed in 30 patients with ACS. The thrombocytes count was obtained from complete blood count (CBC) by using haematology analyzer (Sysmex XT 2000i) that performed at Clinical Pathology Laboratory, Dr. Wahidin Sudirohusodo Hospital, Makassar. The obtained data was analyzed with Wilcoxon test. The mean thrombocytes count before the administration of LMWH was 236.800/μL, while mean thrombocytes count after the administration of LMWH was 280.270/μL. Suprisingly this data showed that in general thrombocytes count was increased significantly (P=0.004) five day after starting LMWH therapy. In this study only one (3.3%) of 30 patients who received LMWH had trombocytes count less than 150.000/μL. Based on this study an antibody test to PF4-heparin complex was needed to determined occurance of HIT in this patient. The thrombocytes count was increased significantly (P=0.004) in patients with ACS who had given LMWH therapy.

scholarly journals Info-metric Methods for the Estimation of Models with Group-Specific Moment Conditions

2020 ◽  
pp. 349-384
Author(s):  
Martyn Andrews ◽  
Alastair R. Hall ◽  
Rabeya Khatoon ◽  
James Lincoln
Keyword(s):  
Linear Regression ◽  
Statistical Models ◽  
Family Background ◽  
Cross Sectional ◽  
Moment Conditions ◽  
Dual Approach ◽  
Generalized Empirical Likelihood ◽  
The Mean ◽  
Dual Approaches ◽  
Comprehensive Framework

Motivated by empirical analyses in economics using repeated cross-sectional data, we propose info-metric methods (IM) for estimation of the parameters of statistical models based on the information in population moment conditions that hold at group level. The info-metric estimation can be viewed as the primary approach to a constrained optimization. The estimators can also be obtained via the dual approach to this optimization, known as generalized empirical likelihood (GEL). In Andrews, Hall, Khatoon and Lincoln (2019), we provide a comprehensive framework for inference based on GEL with the grouped-specific moment conditions. In this chapter, we compare the computational requirements of the primary and dual approaches. We also describe the IM/GEL inference framework in the context of a linear regression model that is estimated using the information that the mean of the error is zero for each group. For the latter setting, we use analytical arguments and a small simulation study to compare the properties of IM/GEL-based inferences to those of inferences based on certain extant methods. The IM/GEL methods are illustrated through an application to estimation of the returns to education in which the groups are defined via information on family background.

scholarly journals Attitude towards Antipsychotic Medications in Patients Diagnosed with Schizophrenia: A Cross-Sectional Study at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Tilahun Kassew ◽  
Demeke Demilew ◽  
Addis Birhanu ◽  
Mesele Wonde ◽  
Biks Liyew ◽  
...  
Keyword(s):  
Side Effects ◽  
Linear Regression ◽  
Associated Factors ◽  
First Generation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Antipsychotic Medications ◽  
Specialized Hospital ◽  
The Mean

Background. Poor attitude towards antipsychotic drugs is high, and it is a factor for non-adherence to treatment. This increases the risk of relapse, associated healthcare utilization, and costs. This study aimed to assess attitude towards antipsychotic medication among patients with schizophrenia. Objectives. The aim of this institution based cross-sectional study was to assess attitude towards antipsychotic medications and associated factors among patients with schizophrenia who attend the outpatient clinics at Amanuel Mental Specialized Hospital, 2018. Methods. In a cross-sectional study, 393 schizophrenic patients from Amanuel Mental Specialized Hospital were recruited by a systematic random sampling technique. Drug Attitude Inventory (DAI-10) was used to assess attitude, experience, and belief about antipsychotics. Glasgow antipsychotic side effect scale modified version, positive and negative syndrome scale, and Birch wood’s insight scale for psychosis were the instruments used to assess the associated factors. Simple and multiple linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% confidence interval was used. Results. The mean score of attitude towards antipsychotic medications was 6.51 with standard deviation (SD) of 2.22. In multiple linear regression, positive symptoms (β= -0.07, 95% CI: (-0.09, -0.05)), negative symptoms (β= -0.04, 95% CI: (-0.06,-0.02)), shorter (≤5 years) duration of illness (β= -0.39, 95% CI: (-0.63, -0.15)), first generation antipsychotics (β = -0.35, 95% CI: (-0.55,-0.14)), having sedation (β= -0.28, 95% CI: (-0.52, -0.02)), and extra-pyramidal side effects (β= -0.34, 95% CI: (-0.59,-0.09)) were factors negatively associated with attitude towards antipsychotic medication treatment. Insight to illness (β= 0.24, 95% CI: (0.20, 0.27) was a factor positively associated with attitude towards antipsychotic medications. Conclusion. The result suggests that the mean score of participants’ attitude towards antipsychotic medications was good. Prevention of side effects particularly due to first generation antipsychotics is necessary.

scholarly journals Perception of a New Prolonged-Release Buprenorphine Formulation in Patients with Opioid Use Disorder: The PREDEPO Study

2021 ◽  
pp. 1-12
Author(s):  
Francisco Salvador Pascual ◽  
Alvaro Muñoz ◽  
Rodrigo Oraa ◽  
Gerardo Flórez ◽  
Pilar Notario ◽  
...  
Keyword(s):  
Opioid Dependence ◽  
Opioid Use Disorder ◽  
Prolonged Release ◽  
Opioid Use ◽  
Cross Sectional ◽  
Likert Scales ◽  
Suitable Alternative ◽  
Response Options ◽  
Monthly Injection ◽  
The Mean

<b><i>Aim:</i></b> The aim of the study was to assess the acceptance of patients with opioid use disorder (OUD) to switching their opioid dependence treatment (ODT) for a prolonged-release buprenorphine (PRB) injection according to their prior ODT (buprenorphine/naloxone [B/N] or methadone). <b><i>Methods:</i></b> This was an observational, retrospective/cross-sectional, multicentre study of adult patients diagnosed with OUD on ODT. Data collected from diaries were analysed to know their interest and opinion on PRB. Questions with fixed response options were included, and several Likert scales were used. <b><i>Results:</i></b> A total of 98 patients were enrolled (B/N: 50.0%, methadone: 50.0%). The mean age was 46.9 ± 8.43 years and 79.6% were males. PRB was similarly perceived by both groups in most variables analysed, receiving a mean score of 7.2/10 (B/N: 7.4, methadone: 7.0; <i>p</i> = 0.520), and approximately 65% of patients said they were willing to switch to PRB (B/N: 63.3%, methadone: 65.3%; <i>p</i> = 0.833). Of these, a higher percentage in the B/N group considered that switching would be easy/very easy (B/N: 90.3%, methadone: 46.9%; <i>p</i> &#x3c; 0.001) and that they would start PRB when available (B/N: 64.5%, methadone: 34.3%; <i>p</i> = 0.005). More than 90% would prefer the monthly injection (B/N: 93.6%, methadone: 100%; <i>p</i> = 0.514). One-third of patients in both groups were unsure/would not switch their ODT to PRB (B/N: 36.7%, methadone: 34.7%; <i>p</i> = 0.833). The main reason was administration by injection. <b><i>Conclusion:</i></b> Two-thirds of patients would switch their treatment for PRB, and most patients on B/N considered that switching would be easy. PRB could be a suitable alternative for OUD management.

scholarly journals Specifying Location-Scale Models for Heterogeneous Variances as Multilevel SEMs

2020 ◽  
pp. 109442812091308 ◽  
Author(s):  
Daniel McNeish
Keyword(s):  
Random Effects ◽  
Repeated Measures ◽  
Structural Equation ◽  
Multilevel Models ◽  
Equation Model ◽  
Scale Model ◽  
General Version ◽  
Cross Sectional ◽  
Mixed Effect ◽  
The Mean

Standard multilevel models focus on variables that predict the mean while the within-group variability is largely treated as a nuisance. Recent work has shown the advantage of including predictors for both the mean (the location submodel) and the variability (the scale submodel) within a single model. Constrained versions of the model can be fit in standard mixed effect model software, but the most general version with random effects in each of the location and scale submodels has been noted for being difficult to fit and estimate in software. However, the latest release of Mplus includes new capabilities that facilitate fitting the general version of the model as a multilevel structural equation model (SEM). This article introduces the general form of the model that includes location and scale random effects (called the location-scale model) and notes how it can be envisioned as a multilevel SEM. We provide a tutorial with example analyses and Mplus code for the model with two-level cross-sectional data and three-level repeated measures data and discuss how such a model has potential to extend recent developments in organizational science.

scholarly journals Comparison of PPT and APTT in Pre and Post-Hemodialysis Patients as the Heparin-Exposed Effect

2019 ◽  
Vol 55 (3) ◽  
pp. 166
Author(s):  
Yetti Hernaningsih ◽  
Widodo Widodo ◽  
Koko Aprianto
Keyword(s):  
Clinical Pathology ◽  
Coagulation Factors ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Pathology Laboratory ◽  
Cross Sectional ◽  
Coagulation Study ◽  
Ckd Stage ◽  
Significant Difference ◽  
The Mean

Evaluations on Plasma Prothrombin Time (PPT) and Activated Partial Thromboplastin Time (APTT) are required in patients with Chronic Kidney Disease (CKD) stage V to determine the risk of bleeding after hemodialysis (HD) using heparin as the anticoagulant. This study aimed to compare the results of PPT and APTT in pre and post-hemodialysis patients with minimum dose of heparin. This was an observational-analytical study with cross-sectional design. The samples were collected in HD wards of Dr. Soetomo Hospital, Surabaya. There were 50 PPT and APTT samples collected from June to August 2017. The samples were evaluated using the tool CoaDATA 501. The examination of coagulation study was conducted in Clinical Pathology Laboratory of Dr. Soetomo Hospital, Surabaya. Paired t-test and Wilcoxon signed-rank test were performed in this study. In the 50 samples, pre-hemodialysis PPT ranged between 10.2-17.6 with the mean of 12.6±2.03 seconds, while for post-hemodialysis, the range was 10.1-20.9 with the mean of 13.41±2.43 seconds. Pre-hemodialysis APPT ranged between 19.5-75.2 with the mean of 30.32±10.43 seconds, while in post hemodialysis the range was 22.21-175 with the mean of 37.52±26.40 seconds. The results of PTT evaluation in pre and post-HD showed no significant difference (p=0.083), while those of APTT showed a significant difference (p=0.035 or p<0.05). Prolongation of APTT in post-HD is due to the use of heparin as an anticoagulant that increases PPT and APTT by inhibiting antithrombin III. HD procedures cause decreased activity of coagulation factors II, IX, X, XII leading to APTT prolongation in post-HD. A significant APTT prolongation was found in post-HD patients with CKD V.

scholarly journals KORELASI FUNGSI HATI TERHADAP DERAJAT PENYAKIT DEMAM BERDARAH DENGUE ANAK

2016 ◽  
Vol 18 (3) ◽  
pp. 172
Author(s):  
Ani Kartini ◽  
Mutmainnah Mutmainnah ◽  
Ibrahim Abdul Samad
Keyword(s):  
Clinical Pathology ◽  
Liver Function Tests ◽  
Dengue Haemorrhagic Fever ◽  
Haemorrhagic Fever ◽  
Cross Sectional ◽  
Liver Functions ◽  
Spearman Correlation Test ◽  
Grade Ii ◽  
The Mean ◽  
Using Data

Dengue Haemorrhagic Fever (DHF) may result acute liver failure. Although these cases are rare but is more common in children, and early identification of these infections is important to reduce the morbidity as well as mortality. The aim of this study was to know the determinations and the correlation of liver functions with the grade of Dengue Haemorrhagic Fever in children. This study was conducted by cross sectional, using data from the medical records of DHF patients who had liver function tests (AST, ALT, PT, aPTT and albumin) in the Laboratory of Clinical Pathology Dr. Wahidin Sudirohusodo Hospital Makassar from the period of July 2008 to June 2010. AST, ALT and albumin were tested using Cobas Integra 400, PT and aPTT were tested using Humaclot VA, and the data were analyzed with Spearman correlation test. There were fifty-five samples: 26 (47.3%) were males and 29 (52.7%) were females. We found 15 (27.3%) grade I, 13 (23.6%) grade II, 16 (29.1%) grade III and 11 (20%) grade IV patients. In this study are found that AST and ALT increased and there is a tendency of extending aPTT value but there was no significant correlation with the grade of DHF. The mean of albumin was lower in grade IV, there was a significant correlation between albumin and the grade of DHF (r=–0.375, p<0.05). In conclusion, there was a significant correlation between albumin and the grade of DHF. It is suggested that the routine albumin examination in DHF patients should be carried on to know whether a prevention of complications is needed to reduce the possibility of mortality.

scholarly journals Is leukopenia and lymphopenia a characteristic feature of COVID-19 in children?

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Attia Bari ◽  
Aimen CH ◽  
Iqbal Bano ◽  
Nazish Saqlain
Keyword(s):  
Characteristic Feature ◽  
Lymphocyte Count ◽  
Case Fatality ◽  
Antibody Test ◽  
Absolute Lymphocyte Count ◽  
Cross Sectional Study ◽  
Comorbid Condition ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
The Mean

Objectives: To analyze whether leucopenia and lymphopenia a characteristic feature of children with COVID-19 and to find out its association with the disease severity. Methods: This was a descriptive cross-sectional study conducted at The Children’s Hospital Lahore from March 2020 to October 2020. All confirmed cases of COVID-19 infection and post-COVID MIS-C/Kawasaki Disease diagnosed on the basis of RT-PCR and Antibody test respectively were included. Complete blood and differential counts were performed on the day of admission. Results: Out of a total of 83 patients 60 (72%) were diagnosed as COVID-19 and 23 (28%) as post-COVID MIS-C/KD. The mean age of children was 7.0±4.3 years (95%CI: 6.07 - 8.75) with a male preponderance 51 (61%). Twenty (24%) children had an underlying comorbidity and 7 (8%) were surgical cases. Our case fatality rate was 5 (6%) and all children who died had an underlying comorbid condition. In both, COVID and MIS-C/KD the mean leukocyte count was (14.0 ± 12.5 vs 13.6 ± 6.9 x109/L), respectively (p=0.888). The mean lymphocyte count in children with COVID was (39.1 ± 21.4%). Patients with MIS-C/KD showed significantly higher levels of neutrophil count (76.5 ± 15.0%) as compared to children with COVID (52.0 ± 22.1%), absolute lymphocyte count was (5.02±4.81 vs 2.13±0.95 x109/L) in COVID and MIS-C respectively (p=<0.001). In 60 COVID-19 patients, the mean neutrophil lymphocyte ratio (NLR) in mild-moderate and severe-critical group was 2.00 and 5.08 respectively (p=0.009). Conclusion: The blood picture of COVID-19 in children does not show leukopenia. NLR was a prognostic factor to assess the severity in COVID-19 patients. The presence of an underlying comorbid conditions is significant a risk factor for poor outcome. doi: https://doi.org/10.12669/pjms.37.3.3848 How to cite this:Bari A, Ch A, Bano I, Saqlain N. Is leukopenia and lymphopenia a characteristic feature of COVID-19 in children?. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3848 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals BIAKAN METODE TETRAZOLIUM MICROPLATE ASSAY TERKAIT DAHAK PASIEN TERDUGA TUBERKULOSIS PARU

2018 ◽  
Vol 21 (2) ◽  
pp. 115
Author(s):  
Rita Rachmayanti ◽  
Ida Parwati ◽  
Tiene Rostini ◽  
Sylvia Rachmayati
Keyword(s):  
Sputum Sample ◽  
Clinical Pathology ◽  
Cross Sectional Study ◽  
Detection Time ◽  
Microplate Assay ◽  
Culture Methods ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Tetrazolium Bromide ◽  
The Mean

The definitive diagnosis of pulmonary tuberculosis is the discovery of Mycobacterium tuberculosis from sputum culture, but theconventional culture methods using Ogawa media require between 3−10 weeks detection time. Therefore it is needed a prompt diagnostictools to shorten the detection time. Tetrazolium microplate assay (TEMA) that used tetrazolium bromide as a growth indicator also usemitochondrial dehydrogenate enzymes in the mitochondria of living M. tuberculosis may reduce yellow tetrazolium bromide into purpleformazan crystals. The aim of this study was to know the validity and speed of time detection of M. tuberculosis growth by analyzingit. This study was carried out from November 2012 up to February 2013, which obtained 105 subjects conducted in the Departmentof Clinical Pathology at Dr. Hasan Sadikin Hospital with a cross sectional study design. The subjects consisting of sputum sample frompatients who suspected pulmonary TB which is examined for culture of M. tuberculosis with TEMA method using Ogawa media. Statisticalanalysis was used a 2×2 table to test the validity and Mann Whitney test for the differences in growth detection time. The validity testof TEMA method got the sensitivity of 90.4% and specificity of 96.2%. The detection time of M. tuberculosis growth in TEMA methodswas found fastest in the third day while from the Ogawa media cultur was found on the 13th day with the M. tuberculosis growth mediausing TEMA methods detected in 12 days. While for those cultured on Ogawa’s media the mean duration is 22 days (p<0.001). Basedon this study, can be concluded the examination of M. tuberculosis culture from sputum patient suffer of pulmonary TB with with TEMAmethod has given high validity and faster in the time detection for the diagnosis of pulmonary TB.

Sign in / Sign up

Export Citation Format

Share Document