scholarly journals PROGNOSTIC SIGNIFICANCE OF VIRAL MARKER DETECTION IN PROGRESSION OF HIGH RISK HUMAN PAPILLOMA VIRUS ASSOCIATED CANCER CERVIX

2020 ◽  
pp. 1-4
Author(s):  
Ananya Pal ◽  
Rajat Kanti Biswas
Keyword(s):  
Capsid Protein ◽  
Prognostic Significance ◽  
P Value ◽  
Lower Grade ◽  
Cervical Lesions ◽  
Viral Marker ◽  
Chi Squared ◽  
The Difference ◽  
L1 Protein ◽  
Marker Detection

The objective was to detect the viral marker HPV16 L1 capsid protein in cervical neoplasia to analyse its association with different grades of cervical lesions and its implication as a prognostic marker. Detection of L1 capsid protein of HPV16 by immunostaining was done using anti-HPV16 mouse monoclonal antibody against L1 fusion protein in cervical scraping or biopsy specimens obtained from the subjects. Total 84 cases of cervical cancerous lesions in a graded spectrum were observed for expression of L1 capsid protein of HPV16, among which 30 cases showed L1 expression and 54 cases did not. The expression rates of L1 protein among ASCUS, ASC-H, LSIL and HSIL were 33.33%, 62.50%, 80% and 36.36% respectively. Among invasive lesions, the L1 expression rates were 23.53%, 14.29% and 7.69% in well, moderately and poorly differentiated SCC respectively. Overall the L1 positivity rate was 35.71%. The expression of L1 proteins decreased with increase in lesion grade. This declining trend of L1 positivity rate with increasing grade of lesion was extremely significant (p value for chi squared for trend is 0.0002). The difference of L1 expression between preinvasive and invasive group was also significant (p<0.0001).Expression of L1 capsid protein of HPV16 was high in lower grade preinvasive lesions and it steadily declined with increasing grade of lesion. Therefore, detection of viral marker HPV16 L1 Protein can be used as a prognostic tool and a marker of immune response against HPV16.

scholarly journals Perception of Dentofacial Aesthetics in School Children and Their Parents

2020 ◽  
Author(s):  
Alisa Tiro ◽  
Enita Nakas ◽  
Amra Arslanagic ◽  
Nina Markovic ◽  
Vildana Dzemidzic
Keyword(s):  
Age Groups ◽  
P Value ◽  
Older Children ◽  
School Students ◽  
Children And Parents ◽  
Chi Squared ◽  
Dental Aesthetics ◽  
The Difference ◽  
Post Hoc ◽  
The City

Abstract Objective The aim of this research was to examine the attitudes and perceptions of dentofacial aesthetics among different age groups. Materials and Methods The sample consisted of elementary-school students from the city of Sarajevo, Bosnia and Herzegovina, and their parents. This study included 314 subjects: 157 children and 157 parents. The children’s group consisted of 85 (54.14%) males and 72 (45.85%) females, aged 9 to 15 years. Statistical Analysis Descriptive statistics were used to determine frequency distribution and percentages for all variables. A chi-squared (x 2) test was used to determine the association between variables and a p-value < 0.05 was considered significant for all the differences and associations. Results For the dentofacial appearance with no teeth irregularity or with severe teeth irregularity, an analysis of variance (ANOVA) (post-hoc tests—Tukey’s HSD) indicated that the difference is not statistically significant (p = 0.06) relative to rank matching between all three subject groups.For dentofacial appearance with mild teeth irregularity, an ANOVA (post-hoc tests—Tukey’s HSD) showed statistical difference (p = 0.07) between the teenage group of subjects relative to pre-teenage group of subjects and adult group of subjects. Conclusion Attitudes about desirable and acceptable dental aesthetics differ in younger children compared with older children and parents. Ten years old children find good function with poor aesthetics more pleasing, while 14 years old children find aesthetics with bad function as more pleasing.

scholarly journals Poststroke Cognitive Decline: A Longitudinal Study from a Tertiary Care Center

2019 ◽  
Vol 10 (03) ◽  
pp. 459-464 ◽  
Author(s):  
Rameshwar Nath Chaurasia ◽  
Jitendra Sharma ◽  
Abhishek Pathak ◽  
Vijay Nath Mishra ◽  
Deepika Joshi
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Care Center ◽  
Tertiary Care ◽  
Rank Test ◽  
P Value ◽  
Stroke Patients ◽  
Stroke Registry ◽  
Chi Squared ◽  
The Difference

Abstract Objectives Poststroke cognitive decline (PSCD) is a serious disabling consequence of stroke. The purpose of this study is to find the prevalence of PSCD and sociodemographic and clinical determinants of risk factors of PSCD. Materials and Methods This study was a prospective, hospital-based study conducted on 200 stroke patients from stroke registry during October 2015 to April 2017. Detailed clinical evaluation was done. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were used to determine PSCD after 3 and 6 months as per the Diagnostic and Statistical Manual of Mental Disorders V. Chi-squared test was used to find the association between two variables. The Wilcoxon signed-rank test was used to compare the difference in cognitive impairment between two follow-ups at 3 and 6 months, respectively. A p-value < 0.05 was considered statistically significant. Results The prevalence of PSCD measured by MoCA scale at 3 and 6 months was 67 and 31.6%, respectively. By MMSE scale, cognitive decline prevalence at 3 months was found to be 87 (46.3%), which reduced to 22 (17.1%) at 6 months. The association between MMSE scale and type of stroke was significant at 3 months. Conclusion One-third of the stroke patients developed PSCD within 3 months of onset of stroke, with different levels of severity. The major predictors of new-onset poststroke cognitive impairment were diabetes and hypertension. The prevalence of PSCD reduced significantly at 6 months of stroke on follow-up.

scholarly journals Increased plasma levels of interleukin-6 in sepsis [see comments]

Blood ◽  
1989 ◽  
Vol 74 (5) ◽  
pp. 1704-1710 ◽  
Author(s):  
CE Hack ◽  
ER De Groot ◽  
RJ Felt-Bersma ◽  
JH Nuijens ◽  
RJ Strack Van Schijndel ◽  
...  
Keyword(s):  
Septic Shock ◽  
Interleukin 6 ◽  
Cell Injury ◽  
Prognostic Significance ◽  
Inverse Correlation ◽  
P Value ◽  
Classical Pathway ◽  
Significance Levels ◽  
Lethal Complications ◽  
The Difference

Interleukin-6 (IL-6) is likely to be an important mediator of the inflammatory response. We measured levels of this cytokine in plasma samples from 37 patients with sepsis or septic shock obtained at the time of admission to the intensive care unit and related these levels to hemodynamic and biochemical parameters as well as to clinical outcome. In 32 of the 37 patients, increased levels of IL-6 were found, occasionally up to 7,500 times the normal level. The highest IL-6 levels were encountered in patients who suffered from septic shock (P value of the difference between patients with and without shock less than .0001). In addition, IL-6 significantly correlated with plasma lactate (P less than .0001), heart rate (P = .05) and, inversely, with mean arterial pressure (P = .01) and platelet counts (P = .0002). Significant correlations of IL-6 with the anaphylatoxins C3a (P = .0001) and C4a (P = .0002) and with the main inhibitor of the classical pathway of complement, C1-inhibitor (inverse correlation, P = .05), were also observed. IL-6 on admission appeared to be of prognostic significance: levels were higher in septic patients who subsequently died than in those who survived (P = .0003), in particular when only patients with septic shock were considered (P less than .0001). All nine septic patients with levels of less than 40 U/mL on admission survived, whereas 89% of the nine patients with levels exceeding 7,500 U/mL died. These data provide evidence for a role of IL-6 in the pathophysiology of septic shock. Further studies are needed to reveal whether IL-6 in sepsis is directly involved in mediating lethal complications or whether it is to be considered as an “alarm hormone” that reflects endothelial cell injury probably mediated by the anaphylatoxines.

scholarly journals Reclassification of tumor size for solitary HBV-related hepatocellular carcinoma by minimum p value method: a large retrospective study

2020 ◽  
Author(s):  
Hongzhi Liu ◽  
Yuan Yang ◽  
Chuanchun Chen ◽  
Lei Wang ◽  
Qizhen Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Size ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Clinicopathologic Characteristics ◽  
B Virus ◽  
The Difference

Abstract Background and Objectives Tumor size is one of the most important issues for hepatocellular carcinoma (HCC) treatment and prognosis but the classification of it still controversial. The aim of this study was to screen appropriate cutoffs for size of solitary hepatitis B virus (HBV) related HCC.Methods A cohort of 1760 patients with solitary HBV-related HCC undergoing curative liver resection were divided into 11 groups based on tumor size in 1-cm interval. The minimum p value method was used to screen the appropriate size cutoff according to overall survival (OS). If multiple cutoffs meet the above standard, univariate analysis will be performed by using the Cox proportional hazards regression model, and hazard ratio (HR) will be considered as a criterion to assess the difference in survival.Results There are 8 dichotomy, 8 trichotomy and no inquartation cutoffs were screened when classifying tumor sizes in accordance with OS. The HR values of tumor size at these trichotomy cutoffs for OS were compared, the highest HR value is 2.79 when size cutoff is 3/9cm. Then, we reclassified patients into three new classifications: ≤ 3cm (n = 422), > 3 and ≤ 9cm (n = 1072), and > 9cm (n = 266). The comparison of clinicopathologic characteristics among these three classifications showed that the increase of tumor size was associated with the increase of α-fetoprotein (AFP), microvascular invasion (MVI), tumor differentiation, and liver cirrhosis. And the comparison of the OS among three classifications showed statistical differences. Conclusions This study suggested that size criteria of 3cm and 9cm in solitary HBV-related HCC patients were appropriate based on biological characteristics and prognostic significance.

scholarly journals Increased plasma levels of interleukin-6 in sepsis [see comments]

Blood ◽  
1989 ◽  
Vol 74 (5) ◽  
pp. 1704-1710 ◽  
Author(s):  
CE Hack ◽  
ER De Groot ◽  
RJ Felt-Bersma ◽  
JH Nuijens ◽  
RJ Strack Van Schijndel ◽  
...  
Keyword(s):  
Septic Shock ◽  
Interleukin 6 ◽  
Cell Injury ◽  
Prognostic Significance ◽  
Inverse Correlation ◽  
P Value ◽  
Classical Pathway ◽  
Significance Levels ◽  
Lethal Complications ◽  
The Difference

Abstract Interleukin-6 (IL-6) is likely to be an important mediator of the inflammatory response. We measured levels of this cytokine in plasma samples from 37 patients with sepsis or septic shock obtained at the time of admission to the intensive care unit and related these levels to hemodynamic and biochemical parameters as well as to clinical outcome. In 32 of the 37 patients, increased levels of IL-6 were found, occasionally up to 7,500 times the normal level. The highest IL-6 levels were encountered in patients who suffered from septic shock (P value of the difference between patients with and without shock less than .0001). In addition, IL-6 significantly correlated with plasma lactate (P less than .0001), heart rate (P = .05) and, inversely, with mean arterial pressure (P = .01) and platelet counts (P = .0002). Significant correlations of IL-6 with the anaphylatoxins C3a (P = .0001) and C4a (P = .0002) and with the main inhibitor of the classical pathway of complement, C1-inhibitor (inverse correlation, P = .05), were also observed. IL-6 on admission appeared to be of prognostic significance: levels were higher in septic patients who subsequently died than in those who survived (P = .0003), in particular when only patients with septic shock were considered (P less than .0001). All nine septic patients with levels of less than 40 U/mL on admission survived, whereas 89% of the nine patients with levels exceeding 7,500 U/mL died. These data provide evidence for a role of IL-6 in the pathophysiology of septic shock. Further studies are needed to reveal whether IL-6 in sepsis is directly involved in mediating lethal complications or whether it is to be considered as an “alarm hormone” that reflects endothelial cell injury probably mediated by the anaphylatoxines.

Motivasi dan kepuasan kerja pegawai puskesmas BLUD dan non-BLUD Kabupaten Semarang

2018 ◽  
Vol 2 (3) ◽  
pp. 111
Author(s):  
Aswindar Adhi Gumilang ◽  
Tri Pitara Mahanggoro ◽  
Qurrotul Aini
Keyword(s):  
Public Health ◽  
Job Satisfaction ◽  
Financial Management ◽  
Work Motivation ◽  
P Value ◽  
The Public ◽  
The Status ◽  
The Difference ◽  
Demand For Health ◽  
Public Demand

The public demand for health service professionalism and transparent financial management made some Puskesmas in Semarang regency changed the status of public health center to BLUD. The implementation of Puskesmas BLUD and non-BLUD requires resources that it can work well in order to meet the expectations of the community. The aim of this study is to know the difference of work motivation and job satisfaction of employees in Puskesmas BLUD and non-BLUD. Method of this research is a comparative descriptive with a quantitative approach. The object of this research are work motivation and job satisfaction of employees in Puskesmas BLUD and non-BLUD Semarang regency. This Research showed that Sig value. (P-value) work motivation variable was 0.019 smaller than α value (0.05). It showed that there was a difference of work motivation of employees in Puskemas BLUD and non-BLUD. Sig value (P-value) variable of job satisfaction was 0.020 smaller than α value (0.05). It showed that there was a difference of job satisfaction of BLUD and non-BLUD. The average of non-BLUD employees motivation were 76.59 smaller than the average of BLUD employees were 78.25. The average of job satisfaction of BLUD employees were 129.20 bigger than the average of non-BLUD employee were 124.26. Job satisfaction of employees in Puskesmas BLUD was higher than non-BLUD employees.

Perbedaan Penggunaan Antikoagulan K2EDTA DAN K3EDTA Terhadap Hasil Pemeriksaan Indeks Eritrosit

2018 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Wahdaniah Wahdaniah ◽  
Sri Tumpuk
Keyword(s):  
Screening Test ◽  
Venous Blood ◽  
The Body ◽  
Ethylene Diamine ◽  
P Value ◽  
Cross Sectional ◽  
Significant Difference ◽  
Ethylene Diamine Tetra Acetate ◽  
The Difference ◽  
Index Value

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk  K2EDTA dan  K3EDTA. K3EDTA  biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.

Planning for End of Life

2021 ◽  
pp. 104990912110141
Author(s):  
Natasha Ansari ◽  
Eric Johnson ◽  
Jennifer A. Sinnott ◽  
Sikandar Ansari
Keyword(s):  
End Of Life ◽  
Treatment Options ◽  
Stage Iv ◽  
P Value ◽  
Life Planning ◽  
Number Of Patients ◽  
End Of Life Planning ◽  
The Difference ◽  
Alternative Medications ◽  
Patient’S Perception

Background: Oncology provider discussions of treatment options, outcomes of treatment, and end of life planning are essential to care for patients with advanced malignancies. Studies have shown that despite this, many patients do not have adequate care planning, including end of life planning. It is thought that the accessibility of information outside of clinical encounters and individual factors and/or beliefs may influence the patient’s perception of disease. Aims: The objective of this study was to evaluate if patient understanding of treatment goals matched the provider and if there were areas of discrepancy. If a discrepancy was found, the survey inquired further into more specific aspects. Methods: A questionnaire-based survey was performed at a cancer hospital outpatient clinic. 100 consecutive and consenting patients who had stage IV non-curable lung, gastrointestinal (GI), or other cancer were included in the study. Patients must have had at least 2 visits with their oncologist. Results: 40 patients reported their disease might be curable and 60 reported their disease was not curable. Patients who reported their disease was not curable were more likely to be 65 years or older (P-value: 0.055). They were more likely to report that their doctor discussed the possibility of their cancer getting worse (78.3% VS 55%; P-value 0.024), that their doctor discussed end of life plans (58.3% VS 30%; P- value: 0.01), and that they had appointed a health care decision-maker (86.7% VS 62.5%; P-value: 0.01). 65% of patients who thought their disease might be curable reported that their doctor said it might be curable, compared with only 6.7% of patients who thought their disease was not curable (p < 0.001). Or, equivalently, 35% of patients who thought their disease might be curable reported that their doctor’s opinion was that it was not curable, compared with 93% of patients who thought their disease was not curable (p < 0.001). Patients who had lung cancer were more likely to believe their cancer was not curable than patients with gastrointestinal or other cancer, though the difference was not statistically significant (p = 0.165). Patients who said their disease might be curable selected as possible reasons that a miracle (50%) or alternative medicine (66.7%) would get rid of the cancer, or said their family wanted them to believe the cancer would go away (16.7%) or that another doctor said it would (4.2%). Patients who said their disease might be curable said they did so due to alternative medications, another doctor, or their family. Restricting to the 70 patients who reported their doctors telling them their disease was not curable, 20% of them still said that they personally felt their disease might be curable. Patients below 65 years of age were more likely to disagree with the doctor in this case (P-value: 0.047). Conclusion: This survey of patients diagnosed with stage IV cancer shows that a significant number of patients had misunderstandings of the treatment and curability of their disease. Findings suggest that a notable proportion kept these beliefs even after being told by treating physicians that their disease is not curable.

scholarly journals A Comparison of the Clinical and Radiological Extent of Denosumab (Xgeva®) Related Osteonecrosis of the Jaw: A Retrospective Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2390
Author(s):  
Zineb Assili ◽  
Gilles Dolivet ◽  
Julia Salleron ◽  
Claire Griffaton-Tallandier ◽  
Claire Egloff-Juras ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Cumulative Incidence ◽  
Side Effect ◽  
Osteonecrosis Of The Jaw ◽  
Exposed Group ◽  
Severe Side Effect ◽  
Dental Arch ◽  
P Value ◽  
The Difference ◽  
Bone Exposure

Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive medication. The aim of this study was to evaluate the incidence of denosumab-related osteonecrosis of the jaw and to compare the clinical and radiological extent of osteonecrosis. A retrospective study of patients who received Xgeva® at the Institut de Cancérologie de Lorraine (ICL) was performed. Patients for whom clinical and radiological (CBCT) data were available were divided into two groups: “exposed” for patients with bone exposure and “fistula” when only a fistula through which the bone could be probed was observed. The difference between clinical and radiological extent was assessed. The p-value was set at 0.05, and a total of 246 patients were included. The cumulative incidence of osteonecrosis was 0.9% at 6 months, 7% at 12 months, and 15% from 24 months. The clinical extent of MRONJ was significantly less than their radiological extent: in the “exposed” group, 17 areas (45%) were less extensive clinically than radiologically (p < 0.001) and respectively 6 (67%) for the “fistula” group (p < 0.031). It would seem that a CBCT is essential to know the real extent of MRONJ. Thus, it would seem interesting to systematically perform a CBCT during the diagnosis of MRONJ, exploring the entire affected dental arch.

scholarly journals Measuring the effectiveness of catch-up MMR delivered by school nurses compared to signposting to general practice on improving MMR coverage

2020 ◽  
Vol 42 (2) ◽  
pp. 416-422 ◽  
Author(s):  
F Altinoluk-Davis ◽  
S Gray ◽  
I Bray
Keyword(s):  
General Practice ◽  
School Nurse ◽  
School Nurses ◽  
Sample Population ◽  
School Year ◽  
South Central ◽  
Chi Squared ◽  
Immunization Services ◽  
Catch Up ◽  
The Difference

Abstract Background This study assesses whether increased coverage of the measles, mumps and rubella (MMR) vaccination differs between areas where school nurses deliver catch-up MMR doses to adolescents in school settings, compared to signposting to general practice. Methods A retrospective cohort study was conducted using Child Health Information Services records within the NHS England South (South Central) commissioning boundary. The sample population included children born 1 September 2000–31 August 2001, in school year 9 during the 2014–15 academic year. Results The primary outcome findings show an increase in coverage of at least one dose of MMR by 1.6% (n = 334) in the cohort receiving catch-up MMR, compared to 0.2% (n = 12) in the cohort signposted to general practice. Over time, the difference in increase between the two cohorts was 1.4%, analysed using the chi-squared comparison of proportions test, providing strong evidence (P &lt; 0.0001) that school nurse delivery of catch-up MMR is effective at increasing coverage. The findings also suggest that school nurse delivery of catch-up MMR may benefit Black, Asian and minority ethnic children and those from more deprived backgrounds. Conclusions It is recommended that commissioners of school-aged immunization services incorporate the delivery of catch-up MMR doses in their contracts with school nurses.

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