scholarly journals Diagnostic Dilemmas: A Multi-Institutional Retrospective Analysis of Adrenal Incidentaloma Pathology Based on Radiographic Size

2021 ◽  
Author(s):  
David Zekan ◽  
Robert Scott King ◽  
Ali Hajiran ◽  
Apexa Patel ◽  
Samuel Deem ◽  
...  
Keyword(s):  
Ct Scan ◽  
Imaging Modality ◽  
Univariate Analysis ◽  
Adrenal Incidentaloma ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Adrenal Cortical Adenoma ◽  
Simple Logistic

Abstract Introduction/Background Adrenal incidentalomas (AIs) are masses >1 cm found incidentally during radiographic imaging. They are present in up to 4.4% of patients undergoing CT scan, and incidence is increasing with usage and sensitivity of cross-sectional imaging. Most result in diagnosis of adrenal cortical adenoma, questioning guidelines recommending removal of all AIs with negative functional workup. This retrospective study analyzes histological outcome based on size of non-functional adrenal masses. Material and Methods 10 years of data was analyzed from two academic institutions. Exclusion criteria included patients with positive functional workups, those who underwent adrenalectomy during nephrectomy, <18 years, and incomplete records. AI radiologic and histologic size, histologic outcome, laterality, imaging modality, gender, and age were collected. T-test was used for comparison of continuous variables, and the two-sided Fisher’s exact or chi-square test were used to determine differences for categorical variables. Univariate analysis of each independent variable was performed using simple logistic regression. Results 73 adrenalectomies met the above inclusion criteria. 60 were detected on CT scan, 12 on MRI, and one on ultrasound. Eight of 73 cases resulted in malignant pathology, 3 of which were adrenocortical carcinoma (ACC). Each ACC measured >6 cm, with mean radiologic and pathologic sizes of 11.2 cm and 11.3 cm. Both radiologic and pathologic size were significant predictors of malignancy (p=0.008 and 0.011). Conclusions Our results question the generally-accepted 4 cm cutoff for excision of metabolically-silent AIs. They suggest a 6 cm threshold would suffice to avoid removal of benign lesions while maintaining sensitivity for ACC.

Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ultra Sound ◽  
Categorical Variables ◽  
Breast Lesions ◽  
Care Hospital ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

scholarly journals Non-Prescription Antibiotic Use For People Aged 15 Years Or Older For Cough In China: A Community-Based Survey

2021 ◽  
Author(s):  
Yan Luo ◽  
Xuewen Tang ◽  
Lingling Ding ◽  
Zhujun Shao ◽  
Jianxing Yu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Main Driver ◽  
Antibiotics Use ◽  
Chi Square Test ◽  
Use Behavior

Abstract Background Non-prescription antibiotic use at community is a main driver of antimicrobial resistance. Cough is a common condition and prevalent in all communities, including China. This study aims to investigate the non-prescription antibiotic use for cough in China and explore to which extent antibiotic use knowledge was correctly instructed in communities.Methods A probability-proportionate-to-size (PPS) sampling method was adopted to survey from all 14 communities in Yiwu city, China. All participants were investigated by face-to-face interview on Portable Android Devices (PADs). The continuous variables were presented by mean and standard deviation (SD) or medium and inter-quartile range (IQR). The categorical variables were presented using percentage or constituent ratio. Chi-square test for univariate analysis and logistic regression for multivariate analysis were conducted to assess the odds ratios (ORs) and 95% confidence intervals (CIs), respectively.Results A total of 3034 respondents across the 14 communities and the 50 natural villages/streets completed all key items of the questionnaire. Of 2400 (79.10%) respondents stated that they experienced cough in the past 12 months with the medium age of 36.5 (IQR: 26-49) and 12.21% (293/2400) respondents had the non-prescription antibiotic use behavior. Among those 293 respondents, the proportion of non-prescription antibiotic use for cough peaked at around 16% among people aged 30-39 years old. The major sources of antibiotics were pharmacy (77.70%) and/or family storage (43.92%). As for antibiotic knowledge in 3034 participants, 61.8% participants had minimal knowledge on broad-spectrum antibiotic and 53.76% were not familiar about the effects of joint use.Conclusions Non-prescription antibiotics use for cough is prevalent in the community, especially among people in their thirties. Strengthened drug purchase regulation and well-trained professional pharmacists would be promising alternatives to ameliorate AMR. Moreover, penetrating antibiotics knowledge to common citizens and is an urgent task to alleviate antimicrobial resistance. Therefore, proactive policies and regulations should be made to improve current situations.

scholarly journals Thrombocytosis in Febrile Illness in Children of Age Three Months to 14 Years at a Tertiary Care Hospital of Nepal

2018 ◽  
Vol 6 (1) ◽  
pp. 5-14
Author(s):  
Sajan Kumar Thakur ◽  
Pramod Kattel
Keyword(s):  
Bacterial Infection ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

Background and Objectives: Acute febrile illness is common presentation in children. Thrombocytosis can be used as a predictor of febrile illness in children. The objectives of this study were to find out the prevalence and causes of thrombocytosis among febrile children and to access the utility of platelet count as a potential predictor of serious bacterial infection alone or in association with other predictors.Material and Methods: A cross-sectional descriptive study was done in 290 febrile children following convenience sampling method. Statistical analysis was done using SPSS. Univariate analysis using chi-square test for categorical and independent samples and “t” test for continuous variables were done.Results: Thrombocytosis was present in 13.1% of cases. Most cases had mild thrombocytosis (10%) whereas moderate thrombocytosis was present in 2.8% of cases and 0.3% cases had severe thrombocytosis. Lymphocyte level, erythrocyte sedimentation rate and C-reactive protein also showed a significant association with thrombocytosis (p<0.05). Serious bacterial infection was present in 209 cases out of which 30 children had thrombocytosis but was not significant compared to children with non serious bacterial infection with thrombocytosis (p=0.171).Conclusion: Thrombocytosis was found to have an association with febrile illnesses. More so, it indicated a fair discriminate ability to diagnose infectious cause of disease. However there was no statistical significance between thrombocytosis and serious bacterial infection.

scholarly journals The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

2019 ◽  
Author(s):  
Julius Sama DOHBIT ◽  
Namanou Ines Emma WOKS ◽  
Carlin Héméry KOUDJINE ◽  
Willy TAFEN ◽  
Pascal FOUMANE ◽  
...  
Keyword(s):  
Good Practice ◽  
Lessons Learned ◽  
Qualitative Assessment ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Pediatric Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and engender improvement in maternal health. Objective: Evaluate the change in attitudes and practice of nurses and compare outcomes in cases where it was and was not used, 6 months after introduction of the safe childbirth checklist in a maternity setting. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data on the checklist from personnel of the maternity and another data collection form used to extract information from patient records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% recorded during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. Fewer cases of pre-eclampsia and eclampsia were associated with the use of the checklist, compared to patients in whom the checklist was not used (2·1% Vs 5·4%, p = 0·017). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the safe childbirth checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications overtime.

Ethnicity, age, and education influence perceptions of vegetable healthiness and macronutrient content

2021 ◽  
pp. 026010602110511
Author(s):  
McKenna Aram ◽  
Rachel Smallman ◽  
Sherecce A. Fields ◽  
Arianna Larez ◽  
Namino Glantz ◽  
...  
Keyword(s):  
Online Survey ◽  
Categorical Variables ◽  
Continuous Variables ◽  
College Degree ◽  
Nutritional Content ◽  
White Potato ◽  
Chi Square ◽  
Cross Sectional ◽  
Macronutrient Content ◽  
Diabetes Status

Objective: To assess perceptions of nutritional content and health value of popular vegetables. Design: Cross-sectional online survey. Participants: A total of 760 adults participated in the study. Main Outcome Measures: Likert scale ratings of healthy, calories, carbohydrates, protein, and fiber, for (i) avocado, (ii) romaine lettuce, (iii) white potato, (iv) white onion, and (v) red tomato. Analysis: ANOVAs for continuous variables and Chi-square for categorical variables. Outcomes for nutritional content were compared using separate one-way ANOVAs with ethnicity (Hispanic/Latino vs. non-Hispanic); education (college degree/no college degree); age (18–34, 35–50, 51–70, 70 + ); and diabetes status (with or without diabetes) as the grouping variables. Results: Significant ethnicity effects were found for avocado, lettuce, potato, onion, and tomato. Education level effects were found for avocado, lettuce, potato, and tomato. Age level effects were found for avocado, lettuce, potato, and tomato. Conclusions and Implications: Participant perceptions of the macronutrient content of common vegetables and fruits largely coincided with the US Department of Agriculture values. However, stratifying by ethnicity, age, and education revealed significant differences in both macronutrient perceptions and perceived healthiness. There were no consistent, significant results for interactions of ethnicity by education, nor ethnicity by age. These results suggest that dietary interventions may need to be adjusted based on participant sociodemographic characteristics linked to the perceptions of nutritional value and healthiness.

Association between parents’ physical activity and mode of commuting with their offsprings

2020 ◽  
Author(s):  
FERNANDO RODRIGUEZ ◽  
Francisco Javier Huertas-Delgado ◽  
Yaira Barranco-Ruiz ◽  
María Jesús Aranda-Balboa ◽  
Palma Chillón
Keyword(s):  
Physical Activity ◽  
Vigorous Physical Activity ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Ripple Effect ◽  
Inverse Association ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional

Abstract Background. Some studies have reported a positive association between parents and their offspring’s physical activity (PA), but few have examined the difference in these associations concerning both genders. The objective of this study was to establish the association between moderate-vigorous physical activity (MVPA) and mode of commuting (MC) of the parents with their offspring’s MC, by gender and age group. Methods. This cross-sectional study included 686 parents (mothers: 52.8%) and their offsprings (33.8% girls). Each participant completed a questionnaire on PA and MC. Chi-square test, Odds Ratio for categorical variables and lineal regressions for continuous variables were used to examine the associations between the parents and their offspring. Results. An inverse association was found between fathers-children in the weekend MVPA in children and between mothers-adolescents in out-of-school and weekend MVPA in adolescents, specifically, an inverse association was found in MVPA between mothers-girls and 2) the different parents’ MC to work were positively associated with the MC to school in children and adolescents except for the association AC parents-adolescents and specifically, the AC was mainly associated between mothers and girls and boys. Conclusion. This study emphasizes the importance of involving parents in school-based interventions to create a positive ripple effect in PA-related behaviours.

scholarly journals A Cross-sectional Analysis of Radiographic Ankle Osteoarthritis Frequency and Associated Factors: The Johnston County Osteoarthritis Project

2017 ◽  
Vol 44 (4) ◽  
pp. 499-504 ◽  
Author(s):  
Shahmeer Lateef ◽  
Yvonne M. Golightly ◽  
Jordan B. Renner ◽  
Joanne M. Jordan ◽  
Amanda E. Nelson
Keyword(s):  
Weight Bearing ◽  
Ankle Injury ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Older Individuals ◽  
Ankle Osteoarthritis ◽  
Chi Square ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
History Of

Objective.Because there are no epidemiologic data regarding the frequency of ankle osteoarthritis (OA) in a general population, we sought to analyze this disabling condition in a large, well-characterized, community-based cohort of older individuals.Methods.Cross-sectional data, including ankle radiographs, were from the most recent data collection (2013–2015) of the Johnston County OA Project. Radiographic ankle OA (rAOA) was defined as a Kellgren-Lawrence arthritis grading scale of ≥ 2 on weight-bearing lateral and mortise radiographs. The presence of pain, aching, or stiffness in the ankles as well as history of ankle injury (limiting ability to walk for at least 2 days) were assessed. Chi-square statistics (categorical variables) and Student t tests (continuous variables) were used to compare all participant characteristics by rAOA status. Joint-based logistic regression models with generalized estimating equations were used to examine associations of rAOA and covariates of interest [age, body mass index (BMI), sex, race, ankle symptoms, and injury history].Results.Of 864 participants with available data, 68% were women, 34% were African American, with a mean age of 72 years and BMI of 31 kg/m2. Nearly 7% of this sample had rAOA. Increasing age, high BMI, history of ankle injury, and presence of ankle symptoms were all independently associated with greater odds of having rAOA; no significant differences were seen by sex or race.Conclusion.The frequency of rAOA was higher than estimates generally quoted in the literature. While injury was an important contributor, other factors such as age, BMI, and symptoms were also significantly associated with rAOA.

scholarly journals Prevalence of Musculoskeletal Pain and Its Relation With Weight of Backpacks in School-Going Children in Eastern India

2021 ◽  
Vol 2 ◽  
Author(s):  
Sindhu Sankaran ◽  
Joseph John ◽  
Sameer Sekhar Patra ◽  
Rashmi Ranjan Das ◽  
Amit Kumar Satapathy
Keyword(s):  
Body Weight ◽  
Urban Schools ◽  
Musculoskeletal Pain ◽  
Rural Areas ◽  
Univariate Analysis ◽  
Categorical Variables ◽  
Maximum Effect ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Backpack Weight

Background: Recently, heavy school backpacks have become a significant concern among parents and health professionals, as well as the media, but evidence for the same is limited in the Indian context.Aim: To find the prevalence of musculoskeletal pain among school-going children and its relationship with backpack weight.Design: Cross-sectional study.Method: This study was carried out among school-going children from grade 6 to 10 with age of 10 to 16 years from an urban and rural location. Schools were selected randomly from all enlisted schools in the district of Khurdha, Odisha state of India. A structured questionnaire was administered to assess symptoms of musculoskeletal pain. Anthropometric measurements along with backpack weight were taken.Statistical Analysis: Chi-square test was performed for categorical variables and Student's t-test for continuous variables. Multivariate regression analysis was performed to identify factors with maximum effect on musculoskeletal pain.Results: The prevalence of musculoskeletal pain was 18.8% in the preceding year. Backpacks weights were higher among children of urban schools as compared with rural areas. Children from urban schools were more likely to have pain than those from rural schools (OR 1.88, 95% CI 1.41–2.49). Those children with a backpack weight more than 10% of body weight had almost twice the risk of musculoskeletal pain compared to backpack weight less than 10% (OR 1.91, 95% CI 1.4–2.6) in univariate analysis where as no significant association was found on multivariate analysis.Conclusion: The prevalence of musculoskeletal pain was high in school-going children. In children, carrying higher backpack weight, and a higher percentage of the backpack to bodyweight had a significant association with musculoskeletal pain. Gender, height, body mass index, and backpack weight to body weight &gt; 10% had no association with musculoskeletal pain.

scholarly journals Non-prescriptionxx antibiotic use for people aged 15 years or older for cough in China: a community-based survey

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Yan Luo ◽  
Xuewen Tang ◽  
Linling Ding ◽  
Zhujun Shao ◽  
Jianxing Yu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Main Driver ◽  
Antibiotics Use ◽  
Chi Square Test ◽  
Use Behavior

Abstract Background Non-prescription antibiotic use at community is a main driver of antimicrobial resistance. Cough is a common condition and prevalent in all townships, including China. This study aims to investigate the non-prescription antibiotic use for cough in China and explore to which extent antibiotic use knowledge was correctly instructed in communities. Methods A probability-proportionate-to-size sampling method was adopted to survey from all 14 townships in Yiwu city, China. All participants were investigated by face-to-face interview on Portable Android Devices. The continuous variables were presented by mean and standard deviation or medium and inter-quartile range (IQR). The categorical variables were presented using percentage or constituent ratio. Chi-square test for univariate analysis and logistic regression for multivariate analysis were conducted to assess the odds ratios and 95% confidence intervals, respectively. Results A total of 3034 respondents across all the 14 townships and the 50 natural villages/streets completed all key items of the questionnaire. Of 2400 (79.10%) respondents stated that they experienced cough in the past 12 months with the medium age of 36.5 (IQR: 26–49) and 12.21% (293/2400) respondents had the non-prescription antibiotic use behavior. Among those 293 respondents, the proportion of non-prescription antibiotic use for cough peaked at around 16% among people aged 30–39 years old. The major sources of antibiotics were pharmacy (77.70%) and/or family storage (43.92%). Conclusions Non-prescription antibiotics use for cough is prevalent in the community, especially among people in their thirties. Strengthened drug purchase regulation and well-trained professional pharmacists would be promising alternatives to ameliorate AMR. Moreover, penetrating antibiotics knowledge to common citizens and is an urgent task to alleviate antimicrobial resistance. Therefore, proactive policies and regulations should be made to improve current situations.

Androgen Receptor Overexpression in Patients With Prostate Cancer in Kampala, Uganda

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S86-S87 ◽  
Author(s):  
James Yahaya ◽  
Florence Ajok ◽  
Michael Odida ◽  
Henry Wabinga
Keyword(s):  
Androgen Receptor ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Specific Antigen ◽  
Staining Intensity ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Independent Expert

Abstract Objectives This study was aimed at determining the status of androgen receptor overexpression in patients with PCa and also correlating overexpression with Gleason score, patient age, and prostate-specific antigen (PSA). Methods This was a cross-sectional analytical laboratory-based study using retrospectively retrieved formalin-fixed, paraffin-embedded (FFPE) tissue blocks of 93 PCa patients who were diagnosed histologically between January and December 2018. Immunostaining was done using AR antibody. Cases with ≥10% positive cells having staining intensity of +1 and above were considered positive. Confirmation of the histological diagnosis and interpretation of the IHC-stained slides were done by two independent expert pathologists in a blinded manner. The association between AR overexpression and categorical variables was tested using the chi-square test, while continuous variables were tested using the t test with a 95% confidence interval (CI). A P < 0.05 was taken as statistically significant. Results AR overexpression was found in 54.8% (51/93) of the cases in this study. Majority of patients, 73.1% (68/93), had a Gleason score of 8 to 10, whereas a Gleason score of 6 to 7 was found in 26.9% (25/93). The mean Gleason score for the cases was 8.47 ± 1.52. Patients with a low Gleason score (≤7) had a higher proportion of AR overexpression than those with a high Gleason score (>8) and the difference was statistically significant (P = .013). Conclusion The clinical relevance of this study was that AR overexpression is associated with a Gleason score but not with age and prostate-specific antigen (PSA). AR overexpression was an independent predictor of PCa prognosis.

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