A Retrospective Study of the Proportion of Women at High and Low Risk of Intrauterine Infection Meeting Sepsis Criteria

The Surviving Sepsis Campaign recently recommended that qSOFA not be used as a single parameter for identification of sepsis. Thus, we evaluated the efficacy of SIRS and qSOFA scores in identifying intrauterine infection. This case–control study evaluates SIRS and qSOFA criteria fulfillment in preterm premature rupture of membranes (n = 453)—at high infection risk—versus elective cesarean—at low infection risk (n = 2004); secondary outcomes included intrauterine infection and positive culture rates. At admission, 14.8% of the study group and 4.6% of control met SIRS criteria (p = 0.001), as did 12.5% and 5.5% on post-operation day (POD) 1 (p = 0.001), with no significant differences on POD 0 or 2. Medical records did not suffice for qSOFA calculation. In the study group, more cultures (29.8% versus 1.9%—cervix; 27.4% versus 1.1%—placenta; 7.5% versus 1.7%—blood; p = 0.001—all differences) and positive cultures (5.5% versus 3.0%—urine—p = 0.008; 4.2% versus 0.2%—cervix—p = 0.001; 7.3% versus 0.0%—placenta—p = 0.001; 0.9% versus 0.1%—blood—p = 0.008) were obtained. Overall, 10.6% of the study group and 0.4% of control met the intrauterine infection criteria (p = 0.001). Though a significant difference was noted in SIRS criteria fulfillment in the study group versus control, there was considerable between-group overlap, questioning the utility of SIRS in intrauterine infection diagnosis. Furthermore, the qSOFA scores could not be assessed.

Download Full-text

Extracorporeal Shockwave for Chronic Patellar Tendinopathy

The American Journal of Sports Medicine ◽

10.1177/0363546506298109 ◽

2007 ◽

Vol 35 (6) ◽

pp. 972-978 ◽

Cited By ~ 78

Author(s):

Ching-Jen Wang ◽

Jih-Yang Ko ◽

Yi-Sheng Chan ◽

Lin-Hsiu Weng ◽

Shan-Lin Hsu

Keyword(s):

Patellar Tendon ◽

Group Versus ◽

Patellar Tendinopathy ◽

Control Group ◽

Study Group ◽

Extracorporeal Shockwave Therapy ◽

Ultrasonographic Examination ◽

Extracorporeal Shockwave ◽

Shockwave Therapy ◽

Significant Difference

Background Chronic patellar tendinopathy is an overuse syndrome with pathologic changes similar to tendinopathies of the shoulder, elbow, and heel. Extracorporeal shockwave was shown effective in many tendinopathies. Hypothesis Extracorporeal shockwave therapy may be more effective than conservative treatment for chronic patellar tendinopathy. Study Design Randomized controlled clinical trial; Level of evidence, 2. Methods This study consisted of 27 patients (30 knees) in the study group and 23 patients (24 knees) in the control group. In the study group, patients were treated with 1500 impulses of extracorporeal shockwave at 14 KV (equivalent to 0.18 mJ/mm 2 energy flux density) to the affected knee at a single session. Patients in the control group were treated with conservative treatments including nonsteroidal anti-inflammatory drugs, physiotherapy, exercise program, and the use of a knee strap. The evaluation parameters included pain score, Victorian Institute of Sports Assessment score, and ultrasonographic examination at 1, 3, 6, and 12 months and then once a year. Results At the 2- to 3-year follow-up, the overall results for the study group were 43% excellent, 47% good, 10% fair, and none poor. For the control group, the results were none excellent, 50% good, 25% fair, and 25% poor. The mean Victorian Institute of Sports Assessment scores were 42.57 ± 10.22 and 39.25 ± 10.85, respectively, before treatment (P = .129) and 92.0 ± 10.17 and 41.04 ± 10.96, respectively, after treatment (P < .001). Satisfactory results were observed in 90% of the study group versus 50% of the control group (P < .001). Recurrence of symptoms occurred in 13% of the study group and 50% of the control group (P = .014). Ultrasonographic examination showed a significant increase in the vascularity of the patellar tendon and a trend of reduction in the patellar tendon thickness after shockwave treatment compared with conservative treatments. However, no significant difference in the appearance, arrangement, and homogeneity of tendon fibers was noted between the 2 groups. There were no systemic or local complications or device-related problems. Conclusion Extracorporeal shockwave therapy appeared to be more effective and safer than traditional conservative treatments in the management of patients with chronic patellar tendinopathy.

Download Full-text

Iliopsoas pathology, treatment, and outcomes in patients undergoing hip arthroscopy for femoroacetabular impingement: Findings from the [redacted] study group

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00429 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0042

Author(s):

Benjamin Kivlan ◽

Shane Nho ◽

Andrew Wolff ◽

John Salvo ◽

John Christoforetti ◽

...

Keyword(s):

Hip Arthroscopy ◽

Group Versus ◽

Labral Repair ◽

Controlled Study ◽

Control Group ◽

Symptom Duration ◽

Study Group ◽

Significant Difference ◽

Patient Reported ◽

Chi Square Analysis

Paste abstract here and remove the remaining text. *For structured abstracts, begin each section under a separate, bolded subheading. Suggested subheadings are below Objectives: The iliopsoas is a major hip flexor that provides anterior hip stability. Recent studies report significant compromise to these important functions with iliopsoas tenotomy. The purpose of this study is to report the prevalence, associated findings, rendered procedures, and outcomes of hips with iliopsoas involvement undergoing hip arthroscopy for FAI and/or chondrolabral pathology. The hypothesis is that there is a decrease in the incidence of tenotomy compared with historic controls and that tenotomy compromises patient-reported outcomes. Methods: Level of evidence 3 controlled study with prospectively-collected multicenter database from 7 centers. Enrolled patients that underwent isolated hip arthroscopy that reached 2-year minimum follow-up with iHOT-12 were assigned to Iliopsoas group defined as pre-operative diagnosis of iliopsoas tendonitis, internal snapping symptoms, intra-operative anteroinferior labral pathology (below 3 O’clock location) and/or preoperative psoas injection or the control group. The prevalence of iliopsoas pathology, radiographic and intra-operative findings, and rendered procedures between groups were compared using Chi square analysis. Minimum 2-year outcomes of Iliopsoas group versus control group were compared using analysis of variance (a priori alpha set at 0.05). Subanalysis within the Iliopsoas group was performed of patients with versus without tenotomy. Results: There were 97 study group subjects and 1053 control group subjects. There was no statistical difference in demographics between the groups (p>0.05) nor was there a difference in length of preoperative symptom duration (p=0.51). There were no significant differences in the incidence of cam impingement, pincer impingement or dysplasia between cohorts, nor were there significant differences between radiographic measures. There was a similar incidence of femoroplasty, acetabuloplasty, chondroplasty, microfracture, and synovectomy (p>0.05) regardless of iliopsoas involvement. There was not a significant effect on the surgical treatment of the labrum based on psoas involvement (p>0.16). Labral repair was performed in 55% of patients with iliopsoas involvement and 62% of patients without iliopsoas involvement. Although there was not a significant difference in capsular closure between cohorts (96% vs 93%, p=0.121), the overwhelming majority of patients with psoas involvement received capsular repair (87%) or plication (9%). Pre-operative iHOT-12 scores were similar 34 (SD: 18) for the iliopsoas group and 35 (SD 18) for the control group groups (p=0.51). Post-operative iHOT-12 scores improved to 72 for both the groups. The iliopsoas group achieved MCID, SCB, and PASS scores established for the iHOT-12 of 83%, 62%, and 58% which were similar to the control group. Ten subjects (10%) in the iliopsoas group received iliopsoas tenotomy. Subjects with tenotomy had lower 2-year post-op iHOT-12 scores compared to the non-tenotomy subgroup (55 vs 72, respectively; p=0.03) . This corresponded with lower achievement of MCID scores (60% vs 86%; p=0.03) and SCB scores (30% vs 70%, p=0.01) of patients with tenotomy compared to those without tenotomy. Conclusion: Iliopsoas tenotomy is rarely performed relative to its prevalence in patients undergoing hip arthroscopy by high volume surgeons for FAI and/or chondrolabral pathology. Surgical outcomes are not worsened with iliopsoas involvement but are worsened with tenotomy.

Download Full-text

Outcome of anal symptoms and anorectal function following two obstetric anal sphincter injuries (OASIS)—a nested case-controlled study

International Urogynecology Journal ◽

10.1007/s00192-020-04377-3 ◽

2020 ◽

Vol 31 (11) ◽

pp. 2405-2410

Author(s):

Nicola Adanna Okeahialam ◽

Ranee Thakar ◽

Madhu Naidu ◽

Abdul H. Sultan

Keyword(s):

Anal Sphincter ◽

Significant Risk ◽

Group Versus ◽

Subsequent Pregnancy ◽

Controlled Study ◽

Control Group ◽

Study Group ◽

Squeeze Pressure ◽

Sphincter Function ◽

Significant Difference

Abstract Introduction and hypothesis Obstetric anal sphincter injury (OASI) is a significant risk factor for developing anal incontinence. It can therefore be hypothesised that recurrent OASI in a subsequent delivery may predispose women to further anal sphincter dysfunction. Methods A nested case-controlled study based on data collected prospectively between 2006 and 2019. Women matched for age and ethnicity, with a history of one OASI and no sphincter damage in a subsequent delivery (control) were compared to women sustaining a second OASI. Assessment was carried out using the St Mark’s score (SMIS), anorectal manometry and endoanal ultrasound scan (findings quantified using the modified Starck score). Results Eighty-four women were included and equally distributed between the two groups, who were followed up 12 weeks postnatally. No difference in SMIS scores was found. Maximum resting pressure (MRP, mmHg) and maximum squeeze pressure (MSP, mmHg) were significantly reduced in the study group. Median (IQR) MRP in the study group was 40.0 (31.3–54.0) versus 46.0 (39.3–61.5) in the control group (p = 0.030). Median (IQR) MSP was 73.0 (58.3–93.5) in the study group versus 92.5 (70.5–110.8) (p = 0.006) in the control group. A significant difference (p = 0.002) was found in the modified Starck score between the study group (median 0.0 [IQR 0.0–6.0]) and control group (median 0.0 [IQR 0.0–0.0]). Conclusions We have demonstrated that women with recurrent OASI do not have significant anorectal symptoms compared to those with one OASI 12 weeks after delivery, but worse anal sphincter function and integrity. Therefore, on long-term follow-up, symptoms may possibly develop. This information will be useful when counselling women in a subsequent pregnancy.

Download Full-text

Hypothyroidism Affects Olfactory Evoked Potentials

BioMed Research International ◽

10.1155/2016/9583495 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Teodor Świdziński ◽

Kamila Linkowska-Świdzińska ◽

Hanna Czerniejewska-Wolska ◽

Bożena Wiskirska-Woźnica ◽

Maciej Owecki ◽

...

Keyword(s):

Subclinical Hypothyroidism ◽

Group Versus ◽

Olfactory Nerve ◽

Group Differences ◽

Control Group ◽

Study Group ◽

Process Factor ◽

Significant Difference ◽

Cortical Responses ◽

Trigeminal Nerves

Background. Objective electrophysiological methods for investigations of the organ of smell consist in recordings of olfactory cortex responses to specific, time restricted odor stimuli. In hypothyroidism have impaired sense of smell.Material and Methods. Two groups: control of 31 healthy subjects and study group of 21 with hypothyroidism. The inclusion criterion for the study group was the TSH range from 3.54 to 110 μIU/mL.Aim. Assessment of the latency time of evoked responses from the olfactory nerve N1 and the trigeminal nerve N5 using two smells of mint and anise in hypothyroidism.Results. The smell perception in subjective olfactory tests was normal in 85% of the hypothyroid group. Differences were noticed in the objective tests. The detailed intergroup analysis of latency times of recorded cortical responsesPN5andPN1performed by means between the groups of patients with overt clinical hypothyroidism versus subclinical hypothyroidism demonstrated a significant difference (p<0.05) whereas no such differences were found between the control group versus subclinical hypothyroidism group (p>0.05).Conclusion. We can conclude that registration of cortex potentials at irritation of olfactory and trigeminal nerves offers possibilities for using this method as an objective indicator of hypothyroidism severity and prognostic process factor.

Download Full-text

Evaluation of Podocalyxin level in pre-eclampsia with severe features' patients: a cross-sectional study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193545 ◽

2019 ◽

Vol 8 (8) ◽

pp. 3255

Author(s):

Ahmed F. Amin ◽

Hisham Abou-Taleb ◽

Mustafa Gamal ◽

Marwa M. Thabet ◽

Nashwa Azoz ◽

...

Keyword(s):

Univariate Analysis ◽

Group Versus ◽

Cross Sectional Study ◽

Control Group ◽

Study Group ◽

Sectional Study ◽

Cross Sectional ◽

Women Health ◽

Significant Difference ◽

And Control

Background: This study aims to evaluate the level of podocalyxin (PCX) in preeclampsia with severe features patients and correlate it with the results of laboratory tests.Methods: The current study was a cross-sectional study conducted in Assiut Women Health Hospital between April and October 2018. The study included 60 patients divided into two groups; Group (A): 30 patients diagnosed to have preeclampsia with severe features and Group (B): 30 patients as normal control group. Complete laboratory investigations with measurements of the PCX level was performed for all study participants.Results: No statistically significant difference between the study group and control group according to blood urea (p= 0.339) and serum creatinine (p= 0.801).There was statistically significant difference between the study group and control group according to PCX level (p= 0.001); the mean PCX was 3340.0 ± 2394.6 in the study group versus 1083.5±1400.2 in the control group. Univariate analysis revealed podocalyxin was not correlated with clinical data or laboratory investigations.Conclusions: Podocalyxin levels were significantly elevated in preeclampsia.

Download Full-text

Comparison of Intravenous Ondansetron versus Intravenous Tramadol on Post-Spinal Shivering and Nausea/Vomiting in Cesarean Sections

Life and Science ◽

10.37185/lns.1.1.102 ◽

2020 ◽

Vol 1 (4) ◽

pp. 6

Author(s):

Sanum Kashif ◽

Faisal Azam ◽

Khalid Mehmood ◽

Saira Tasneem ◽

Asad Shamim ◽

...

Keyword(s):

Placebo Group ◽

Group Versus ◽

Postoperative Nausea And Vomiting ◽

Study Groups ◽

Repeated Measure ◽

Elective Cesarean Section ◽

P Value ◽

Chi Square ◽

Significant Difference ◽

Elective Cesarean

Objective: To compare the effect of intravenous ondansetron versus intravenous tramadol on post-spinal shivering and nausea/vomiting in caesarean sections. Study Design: Prospective comparative study Place and Duration of Study: The study was carried out at Department of Anesthesia, Frontier Corps Hospital Quetta from 2nd July 2019 to 1st November 2019. Materials and Methods: Ninety patients, who were scheduled for elective cesarean section under spinal anesthesia were randomly allocated to one of three study groups to receive intravenous ondansetron (group O), tramadol (group T) or normal saline/placebo (group P). Intra- and post-operative shivering score, nausea/vomiting score and hemodynamic changes were recorded. Descriptive data was expressed as means and standard deviations (SD). Analysis of variance (ANOVA) and repeated measure analysis were used for continuous parametric variables. Within groups, comparisons were made using the Tukey's post-hoc analysis. Chi-square test was used for association of shivering and nausea/vomiting among the groups. Results: Both groups were comparable for the age and weight. Shivering was reported 0.35±0.59 in ondansetron group 0.73±0.55 in Tramadol group and 1.90±0.84 in Placebo group (p value< 0.001). Postoperative nausea and vomiting (PONV) was reported 0.25±0.53 in ondansetron group 1.04±0.63 in tramadol group and 0.99±0.71 in placebo group (p value<0.001).There was a significant difference in post- spinal shivering and nausea/vomiting in ondansetron (O) group versus tramadol (T) group and placebo group. Conclusion: The effect of intravenous ondansetron is better than intravenous tramadol in preventing shivering as well as nausea/vomiting.

Download Full-text

Comparative study of Clinical Characteristics in Patients with Mild and Severe Reflux Esophagitis

Acta Marisiensis - Seria Medica ◽

10.2478/amma-2020-0002 ◽

2020 ◽

Vol 66 (1) ◽

pp. 19-22

Author(s):

Melania Macarie ◽

Simona Maria Bataga ◽

Monica Pantea ◽

Razvan Opaschi ◽

Simona Mocan ◽

...

Keyword(s):

Risk Factors ◽

Sex Ratio ◽

Hiatal Hernia ◽

Statistical Significance ◽

Erosive Esophagitis ◽

Male Gender ◽

Consecutive Series ◽

Study Group ◽

Entire Study ◽

Significant Difference

AbstractObjective: This study aims to determine the correlation between risk factors and erosive esophagitis development.Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification.Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p < 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p < 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%).Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.

Download Full-text

Determination some Immunological Aspects in Pulmonary Tuberculosis Patients in Qadisiyah Province

International Journal of Pharmaceutical Quality Assurance ◽

10.25258/ijpqa.v9i2.13632 ◽

2018 ◽

Vol 9 (2) ◽

Author(s):

Syoof Khowman Alramahy ◽

Akram Hadi Hamza

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Statistical Difference ◽

Positive Culture ◽

Control Group ◽

Tuberculosis Patients ◽

Significant Difference ◽

Lowenstein Jensen ◽

The Mean ◽

Igg Level

This study was carried out to study of some immunological aspects among the pulmonary Tuberculosis patients infected with causative agent, Mycobacterium tuberculosis. A Total of 200 sputum samples were collected from patients attending the consultant Clinic for Chest and Respiratory disease center, Diwaniya. Control group (No=15) also included. According to acid fast stain of sputum, the patients were classified as positive (No=91,45.5%) and negative (No=109,54.5, Lowenstein Jensen medium used for the cultivation of samples, on which 70% of sputum samples where positive culture for this microorganism. The grown microorganism were identified as M. tuberculosis, based on positive A.F.B, Niacin producers ,negative for catlase at 68c. The mean IgG level was l184.053±76.684 mg/100 ml in tuberculosis group compared with 1016.533 ± 44.882 mg/100ml in control group, rendering the statistical difference significant. For IgA and IgM levels, they were at mean of 315.880±38.552 mg/100 ml and 119.527±8.464 mg/100 ml in control group compared with 396.358±38.776 mg/100 ml and 134.207±11.696 mg/100 ml in patients group respectively with significant difference

Download Full-text

Frequency-Following Response (FFR) in Military Pilots

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1718525 ◽

2020 ◽

Author(s):

Graziela Maria Martins-Moreira ◽

Alessandra Spada Durante

Keyword(s):

Pure Tone Audiometry ◽

Control Group ◽

Study Group ◽

Aircraft Accidents ◽

Frequency Following Response ◽

Significant Difference ◽

Qualitative Variables ◽

Chi Squared ◽

The Right ◽

Military Pilots

Abstract Introduction Good hearing in pilots, including central auditory skills, is critical for flight safety and the prevention of aircraft accidents. Pure tone audiometry alone may not be enough to assess hearing in the members of this population who, in addition to high noise levels, routinely face speech recognition tasks in non-ideal conditions. Objective To characterize the frequency-following response (FFR) of a group of military pilots compared with a control group. Methods Twenty military pilots in the Study Group and 20 non-pilot military personnel, not exposed to noise in their work, in the Control Group, all with normal hearing, aged between 30 and 40 years old, completed a questionnaire to assess their hearing habits, and their FFRs were measured with a /da/ syllable (duration 40 milliseconds, speed 10.9/s), at 80 dB NA in the right ear. All procedures were approved by the ethical committee of the institution. Statistical analysis was performed using the t-Student or Mann-Whitney tests for quantitative variables, and the Fisher or chi-squared tests for qualitative variables, and a value of p < 0.05 was considered to be statistically significant. Results There was no significant difference between the groups regarding auditory habits. In the FFR, wave amplitudes A (p = 0.01) and C (p = 0.04) were significantly lower in the Study Group. Conclusion Working as a military pilot can be a crucial factor in determining an individual's typical FFR pattern, demonstrated in the present study by statistically significant reductions in the amplitudes of the A and C waves.

Download Full-text

Cytokine profiles and Lactobacillus species presence in pre-menopausal subjects with genital Mycoplasma genitalium or Ureaplasma urealyticum colonization

Women s Health ◽

10.1177/17455065211009181 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110091

Author(s):

John Garza ◽

Kushal Gandhi ◽

Sarah Choi ◽

Asley Sanchez ◽

Gary Ventolini

Keyword(s):

Ureaplasma Urealyticum ◽

Mycoplasma Genitalium ◽

Interleukin 12 ◽

Lactobacillus Species ◽

Control Group ◽

Study Group ◽

Species Dominance ◽

Cytokine Profiles ◽

Menopausal Women ◽

Significant Difference

Background and Purpose: Lactobacilli play a vital role in protecting the vagina against pathogens. Cytokines are vital components of defense against infections in women. The genital mycoplasmas, Mycoplasma genitalium and Ureaplasma urealyticum, are associated with various infectious diseases in adults and infants. The objective of our study is to identify differences in cytokine profile and Lactobacillus species dominance between a study group of non-pregnant pre-menopausal women with genital M. genitalium or U. urealyticum colonization and a control group of non-pregnant pre-menopausal women without genital M. genitalium or U. urealyticum colonization. Methods: A real-time polymerase chain reaction was performed to measure Lactobacillus species in vaginal swab samples. Cytokine analysis was performed using multiplex immunoassay techniques. Analysis of variance confirmed a significant difference in cytokine profiles between patient groups, with t-tests identifying the most significantly different cytokines. Categorical data analysis identified significant patterns of relative Lactobacillus species dominance in the study group. Results: Lactobacillus iners was the predominant Lactobacillus species in the control group ( p = 0.005). There were no dominant Lactobacillus species observed in the study group. Vascular endothelial growth factor A ( p = 0.002), interleukin-8 ( p = 0.001), and interleukin-1β ( p = 0.049) were expressed significantly higher in the study group, whereas interleukin-1 receptor antagonist ( p < 0.001), interleukin-10 ( p = 0.001), interleukin-12 ( p = 0.002), and interferon-γ ( p = 0.022) were expressed higher in the control group. Association matrices for cytokines were significantly different between two groups ( p < 0.001), with mostly negative associations in the control group and mostly positive associations in the study group. Conclusion: Cytokine levels, their associations, and the patterns of Lactobacillus species dominance are observed to significantly diverge on the basis of M. genitalium and U. urealyticum colonization among non-pregnant pre-menopausal women.

Download Full-text