Importance of the Pneumococcus in Community-acquired Pneumonia in Tender-age Infants on the Background of Vaccination

«IMPORTANCE OF THE PNEUMOCOCCUS IN COMMUNITY-ACQUIRED PNEUMONIA IN TENDER-AGE INFANTS ON THE BACKGROUND OF VACCINATION» The authors of the manuscript provide data demonstrating that una pneumonia against the background of vaccination is accompanied by a change in the etiological structure. The article is a new idea and overall it is well written and structured. However, simple study design, lack of patient baseline and follow-up data limit the conclusion of withdrawal. I invite the authors to solve the following questions: 1) There are many spelling, grammatical and punctuation errors. Authors should correct mistakes and rewrite the article in a clear and understandable style. I have visited the authors with the help of a language expert on rewriting. 2) The main problem of the manuscript is poor statistical processing and statistical reporting. The authors stated: “All data were expressed as confidence intervals. Thus, it is unclear whether the etiological structure was normally distributed. Moreover, following normal scientific practice, authors should indicate specific statistical significance values when comparing each test parameter. 3) The cited literature is relevant to the research and meets the requirements of the journal. But mentions of 9/19 were published over 10 years ago. I recommend reading current research on this topic. In conclusion, the work makes a good impression. On the other hand, it can be published after significant changes with reference to the comments mentioned above, including bug fixes and rewriting of the article in a clear and easily understandable style.

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Subclinical rheumatic valvitis: a long-term follow-up

Cardiology in the Young ◽

10.1017/s104795110300091x ◽

2003 ◽

Vol 13 (5) ◽

pp. 431-438 ◽

Cited By ~ 27

Author(s):

Cristina Costa Duarte Lanna ◽

Edward Tonelli ◽

Marcio Vinicius Lins Barros ◽

Eugenio Marcos Andrade Goulart ◽

Cleonice Carvalho Coelho Mota

Keyword(s):

Mitral Regurgitation ◽

Rheumatic Fever ◽

Aortic Regurgitation ◽

Confidence Intervals ◽

Doppler Echocardiography ◽

The Other ◽

Control Group ◽

Healthy Children ◽

Long Term Follow Up

In order prospectively to investigate the frequency and evolution of subclinical valvitis, we selected 40 consecutive patients suffering their initial attack of rheumatic fever, seen in our clinic from 1992 to 1994, and followed-up until 2001, with a mean period of follow-up of 8.1 years, and a standard deviation of 0.6 year. We also assembled a matched control group of 37 healthy children and adolescents. We discovered a murmur of mitral regurgitation in 28 (70.0%) of the patients. In 3 (7.5%) of these patients, there was also a murmur of aortic regurgitation. In the group of 28 symptomatic patients, Doppler echocardiography showed mitral regurgitation in all, and aortic regurgitation in 17. In the group of 12 patients without clinical evidence of cardiac involvement, Doppler echocardiography identified mitral regurgitation in 2, isolated in one and associated with aortic regurgitation in the other. Thus, the frequency of subclinical valvitis was 16.7%. In patients with subclinical valvitis only the aortic regurgitation regressed during the period of follow-up. In the group of 28 symptomatic patients, mitral regurgitation disappeared in 6 (21.4%), aortic regurgitation in 7 of the 17 having this feature (41.2%), while 2 patients (7.1%) developed mitral stenosis. The sensitivity and specificity of cardiac auscultation were, respectively, 93.3%, with 95% confidence intervals between 72.3% and 97.4%, and 100%, with 95% confidence intervals between 65.5% and 100%, for the diagnosis of mitral regurgitation, and 16.7%, with 95% confidence intervals between 4.4% and 42.3%, and 100%, with 95% confidence intervals between 81.5% and 100%, for that of aortic regurgitation. We conclude that the Doppler echocardiogram is an important means of diagnosing and assessing the evolution of subclinical rheumatic valvar lesions, which are not always transient. We suggest that Doppler echocardiography should be performed in all patients with acute rheumatic fever. Subclinical valvitis should be considered as mild carditis, provided that strict criterions are observed in the differential diagnosis from physiological regurgitation, and Doppler echocardiographic findings are analyzed in the context of the other manifestations of the disease.

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The Risk of Thrombosis in Patients with Lupus Anticoagulants Is Predicted by their Specific Coagulation Profile

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614556 ◽

1999 ◽

Vol 81 (05) ◽

pp. 695-700 ◽

Cited By ~ 49

Author(s):

Guido Finazzi ◽

Francesca Norbis ◽

Stefana Marziali ◽

Roberto Marchioli ◽

Tiziano Barbui ◽

...

Keyword(s):

Antiphospholipid Antibodies ◽

Odds Ratio ◽

Statistical Significance ◽

Thrombotic Event ◽

Anticardiolipin Antibodies ◽

The Other ◽

Historical Cohort ◽

Lupus Anticoagulants ◽

Coagulation Profile

SummaryLupus anticoagulants belong to the family of antiphospholipid antibodies. They include two phospholipid-dependent inhibitors of coagulation that may be distinguished on the basis of specific coagulation profiles generated from the comparison of the ratios of the Kaolin Clotting Time (KCT) and the dilute Russell’s Viper Venom Time (dRVVT): when the ratio of the KCT exceeds that of the dRVVT, the plasma is allocated to the “KCT” coagulation profile, when the opposite occurs, the plasma is defined to belong to the “dRVVT” coagulation profile group. We prospectively followed-up a historical cohort of 100 consecutive patients with lupus anticoagulants referred to our Institution between January 1988 and October 1997 to investigate the relationship between their coagulation profile at diagnosis and the development of thrombosis during a median follow-up time of 37.5 months (range 1-115 months). Fifty-six patients were allocated to the “dRVVT” coagulation profile, whereas the other 44 displayed the “KCT” profile. Lupus anticoagulants were transient in 17 patients, without differences between the two groups. None of these patients developed clinical events before disappearance of the phospholipid-dependent inhibitors of coagulation. The 83 cases with persistent lupus anticoagulants consistently displayed the same coagulation profile they had been allocated to at entry. Fourteen patients developed 18 thromboembolic events during the follow-up, with an overall rate of thrombosis of 4.2% patients-year. Twelve of them belonged to the “dRVVT” coagulation profile, whereas the other 2 to the “KCT” profile (p = 0.03). The “dRVVT” coagulation profile gave an odds ratio of thrombosis of 5.25 (95% confidence interval [C.I.]: 1.17-23.50). Ten of the 14 patients who developed thrombosis during follow-up had already experienced thrombosis: a previous thrombotic event caused an odds ratio of recurrency of 2.72 (95% C.I.: 0.85-8.73) (p = 0.09). By multivariate analysis, the “dRVVT” coagulation profile was still associated with a trend to a higher risk of thrombosis, but the difference did not reach statistical significance. Increased levels of anticardiolipin antibodies (> 40 GPL and/or MPL units) were found in all the 14 patients (p = 0.0064). The “KCT” coagulation profile was significantly associated (p = 0.005) with moderate thrombocytopenia (platelets 50-150 × 109/l). Neither profile was found to represent a risk factor for the development of recurrent miscarriages, neoplastic diseases and death. In conclusion, the “dRVVT” profile appears to have predictive value with respect to the thrombotic complications suffered by patients with antiphospholipid antibodies.

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Psychiatric Morbidity in First-Year Undergraduates and the Effect of Brief Psychotherapeutic Intervention—A Pilot Study

The British Journal of Psychiatry ◽

10.1192/bjp.149.1.75 ◽

1986 ◽

Vol 149 (1) ◽

pp. 75-80 ◽

Cited By ~ 8

Author(s):

T. Krystyna Szulecka ◽

Nigel R. Springett ◽

Karel W. de Pauw

Keyword(s):

Statistical Significance ◽

General Health Questionnaire ◽

Psychiatric Morbidity ◽

Intervention Group ◽

The Other ◽

First Year ◽

Health Questionnaire ◽

Psychotherapeutic Intervention ◽

Psychological Disturbance

Out of 1279 first-year undergraduates, two matched groups of students potentially vulnerable to psychological disturbance were identified. One was left to its own resources; the other was offered psychotherapeutic intervention, the effects of which were measured by the number of consultations with general practitioners, type of treatment and rate of withdrawal from university. Although the students in the intervention group had fewer consultations, lower General Health Questionnaire scores at follow-up, and fewer withdrew from university, due to the small numbers involved none of these differences achieved statistical significance.

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Identification of Prognostic Immunophenotypes at First Diagnosis in Patients with Acute Myeloid Leukemia (AML) By a Standardized Multicolor Flow Cytometry (MFC) Panel Originally Designed to Detect Measurable Residual Disease (MRD) at Follow-up

Blood ◽

10.1182/blood-2020-138683 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 35-35

Author(s):

Maximilian Alexander A Rohnert ◽

Malte von Bonin ◽

Michael Kramer ◽

Philipp Ensel ◽

Nadja Holtschke ◽

...

Keyword(s):

Flow Cytometry ◽

Board Of Directors ◽

Research Funding ◽

Prognostic Value ◽

Statistical Significance ◽

The Other ◽

Advisory Committees ◽

Prognostic Relevance ◽

Aberrant Phenotype

Aims In AML, several risk factors obtained at first diagnosis (FD) have been reported to be associated with shorter RFS and OS. The primary prognostic relevance of multicolour flow cytometry (MFC) has been a matter of debate for years. During follow-up (FU), the prognostic relevance of MRD as detected by MFC is less controversial and MFC is recommended in particular (but not exclusive) for those patients (pts) with no reliable genetic marker. We thought to evaluate the prognostic value at FD of a recently established antigen panel and a corresponding analysis strategy, which had been originally developed for MRD-detection. Methods Based on an 8-colour antibody panel (CD45, CD34, CD117, HLA-DR, CD13, CD33, CD7, CD56), we have developed a hierarchical gating strategy with mainly fixed gates. That allows to detect MRD with a high level of standardization and inter-observer reliability (Röhnert M., et al. 25th EHA 2020). Four distinct categories of aberrations (deficiency of CD13 or CD33, cross-lineage expression of CD7 or CD56) detectable on at least 10% of the myeloid blast population were used to define aberrant phenotypes termed leukemia associated immunophenotypes (LAIP) at FD. These categories were also chosen to define MRD during FU. MRDpos by LAIP was defined as the (re-)occurrence of an aberrant category already detectable at FD, while MRDpos by DfN (different from normal) was defined by the de-novo detection of an aberrant category at FU. The prognostic value of the aberrant phenotypes at FD was examined in a cohort of 528 pts. In 122 pts, we further analysed MRD (LAIP/DfN) after completion of intensive induction chemotherapy (IT). Consolidation therapy consisted of allogeneic hematopoietic stem cell transplantation (n=77) or chemotherapy (n=45). The bone marrow samples were measured centrally and analysed independently by three different investigators. Results The probability to achieve a complete remission (CR) varied between the different aberrant phenotypes (LAIP) at FD. Compared to pts without aberrant phenotype (CR rate=68%, n/N=100/148), pts with CD56only (the sole aberrant category was a cross-lineage expression of CD56=only) had a significantly lower CR rate (46%, n/N=15/33, p=0.019). The other exclusive aberrant categories did not significantly influence CR rates compared to pts without LAIP: CD13only (75%, n/N=53/71, p=0.286), CD33only (64%, n/N=59/97, p=0.28) and CD7only (62%, n/N=31/50, p=0.472). In pts with possibly co-occurring aberrant categories (compound aberrant phenotype=comp), the CR rate was significantly higher in CD13comp compared to all other patients (75% vs. 64%, 107/143 vs. 246/385, p=0.018). The other compound aberrancies did not significantly influence CR rates: CD33comp (63% vs. 68%, 90/143 vs. 263/385, p=0.244), CD7comp (66% vs. 67%, 72/109 vs. 281/419, p=0.842) and CD56comp (68% vs. 66%, 84/123 vs. 269/405, p=0.699). Regarding overall survival (OS), just CD56only retained its statistical significance (HR 2.5, CI 1.4-4.7, p=0.004). CD13comp was associated with favourable outcome but without reaching statistical significance (HR 0.7, CI 0.4-1.0, p=0.059). In the cohort of pts with MRD assessment at the end of IT, 67% were classified as responders (CR n=62, CRi n=19) and 33% as non-responders (PR n=14, refractory n=26) by cytomorphology. By MFC, 71% of these pts were classified as MRDpos (n=51/36 responders/non-responders) and 29% as MRDneg (n=30/4). MRDpos was defined by LAIP only (23%), DfN only (44%) or concordantly by LAIP+DfN (33%). OS of MRDneg pts was significantly longer compared to MRDpos patients (HR 4.3, CI 1.0-18.1, p=0.033). Conclusions Using our analysis approach originally developed for MRD monitoring, MFC could provide additional information for initial risk stratification. The presence of an isolated cross-lineage expression of CD56 (CD56only) was associated with a lower CR rate and significant shorter OS. In contrast, CD13comp (CD13 deficiency ± other aberrant categories) was associated with a higher CR rate and prolonged OS. Furthermore, MRDpos as defined by the combined LAIP/DfN strategy provided significant prognostic information. The presented results are currently refined and validated using genetically defined subcategories. The approach has to be confirmed in an independent cohort of pts. Disclosures Rollig: Amgen, Astellas, BMS, Daiichi Sankyo, Janssen, Roche: Consultancy; Abbvie, Novartis, Pfizer: Consultancy, Research Funding. Buecklein:Pfizer: Consultancy; Novartis: Research Funding; Celgene: Research Funding; Amgen: Consultancy; Gilead: Consultancy, Research Funding. Subklewe:Novartis: Consultancy, Research Funding; Janssen: Consultancy; Roche AG: Consultancy, Research Funding; AMGEN: Consultancy, Honoraria, Research Funding; Celgene: Consultancy, Honoraria; Morphosys: Research Funding; Seattle Genetics: Research Funding; Pfizer: Consultancy, Honoraria; Gilead Sciences: Consultancy, Honoraria, Research Funding. Krause:Pfizer: Honoraria; MSD: Honoraria; Takeda: Honoraria; Gilead: Other: Travel Support; Celgene: Other: Travel Support; Siemens: Research Funding. Schlenk:Roche: Research Funding; AstraZeneca: Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; PharmaMar: Research Funding; Daiichi Sankyo: Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accomodations, Expenses, Research Funding, Speakers Bureau; Novartis: Speakers Bureau.

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Clinical value of comorbidity of affective disorders and alcohol dependence

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2019-4-110-118 ◽

2020 ◽

Vol 18 (4) ◽

pp. 110-118 ◽

Cited By ~ 1

Author(s):

O. V. Roshchina ◽

A. I. Rozin ◽

E. D. Schastnyy ◽

N. A. Bokhan

Keyword(s):

Alcohol Dependence ◽

Negative Impact ◽

Statistical Significance ◽

Heavy Drinking ◽

Statistical Processing ◽

Dynamic Features ◽

Clinical Value ◽

The Third ◽

Affective Symptoms

The aim was to study the clinical-psychopathological, clinical-follow-up, clinical-dynamic features of mood disorders (MD) and alcohol use disorder (AUD) with their comorbidity combinations.Materials and methods. The study included 88 people with AUD and MD: 33 women (37.5%) and 55 (62.5%) men. The first group was 31 patients (35,0%) with AUD without comorbid affective symptoms, the second was 29 patients (33.0%) with MD without alcohol dependence, and the third was 28 patients (32.0%) with comorbid AUD and MD. There were no statistically significant differences between the groups by age and sex composition, by the level of statistical significance of differences (p = 0.115 – by sex, ð = 0.248 – by age). The study used clinical, psychopathological, clinical and follow-up, clinical, dynamic and statistical methods. Statistical processing was performed using Pearson’s χ2, Mann – Whitney U-test for comparing independent samples and Spearman’s correlation analysis (r).Results. Patients of the second and third groups were diagnosed with dysthymia more rarely in statistically significant values by the level of statistical significance of differences (10.4% and 32.1% respectively, p = 0.023) and this testifies to MD taking chronic course in patients with AUD. The average duration of bout of heavy-drinking in the first group was longer than in the third group – 7 (4; 17) and 5,5 (3.5; 9.5) days accordingly (p = 0.043). Duration of the disease in the first and third groups was 10 (6; 18.5) and 14 (10; 19.75) years, respectively (p = 0.036). It confirms the negative impact of comorbidity on the clinicaldynamic features in the case of co-existing of AUD and MD.Conclusion. The coexistence of alcohol dependence and affective pathology enhances the suicidal risk of certain diseases. A tendency to the early appearance of symptoms of AUD and their rapid dynamics, a shorter duration of light intervals of MD and AUC, a relatively low tolerance to alcohol and pronounced depressogenic effect of alcohol in the case of comorbidity were found.

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Cost comparison of asthma treatments in 12-week study: caution about matching and short observational follow-up

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2016.346 ◽

2016 ◽

Vol 11 ◽

Author(s):

David B. Price ◽

Job F.M. Van Boven ◽

Lisa M. Law ◽

Alessandra Cifra ◽

R. Brett McQueen

Keyword(s):

Observational Study ◽

Cost Analysis ◽

Study Design ◽

Observational Studies ◽

The Other ◽

Cost Comparison ◽

Treatment Groups ◽

Matching Methods ◽

Key Characteristics

In the absence of randomisation, observational studies must take extra care to create treatment groups that are comparable in terms of key characteristics. Various matching methods exist which can create sound comparisons, minimising confounding where possible. A recent observational study by Dal Negro et al. carried out a cost analysis comparing two asthma medications. They report strong conclusions which favour one treatment over the other, however they include little discussion on the limitations of their study. The purpose of this letter is to comment on the weaknesses of the study design, including the level of matching used, and to urge readers to consider these issues alongside the interpretation of results.

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The Carpentier-Edwards Classic and Physio Mitral Annuloplasty Rings: A Randomized Trial

The Heart Surgery Forum ◽

10.1532/hsf.419 ◽

2006 ◽

Vol 8 (5) ◽

pp. 389 ◽

Cited By ~ 9

Author(s):

Ghada M. M. Shahin ◽

Geert J. M. G. van der Heijden ◽

Michiel L. Bots ◽

Maarten-Jan Cramer ◽

Wybren Jaarsma ◽

...

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Absolute Risk ◽

Statistical Significance ◽

Nyha Class ◽

Left Ventricular ◽

Mitral Annuloplasty ◽

Risk Of Death ◽

Late Failure

Objective: To evaluate clinical and echocardiographic outcomes for the semi-flexible Carpentier-Edwards Physio and the rigid Classic mitral annuloplasty ring. Methods: Ninety-six patients were randomized for either a Classic (n = 53) or a Physio (n = 43) ring from October 1995 through July 1997. Mean follow-up was 5.1 years (range .1-6.6). We included standard patient characteristics at baseline and during follow-up. Analyses were adjusted for age and gender, and for factors that differed across groups at baseline. In 2002, echocardiography was performed in 74% of the survivors. Results: We found a 16% difference in mortality: 14% in the Physio group (n = 6) and 30% in the Classic group (n = 16) (adjusted P = .41). Life table analysis shows that the absolute risk of death after 30 months is lower in the Physio group. Intra-operative repair failure occurred in 3 patients (6%) of the Classic group, and in 4 (9%) of the Physio group, resulting in mitral valve replacement. Late failure occurred in 1 patient (2%) in the Classic group, and in 4 (9%) in the Physio group. At follow-up, left ventricular function did not differ across groups (ejection fraction 45% and 48% (adjusted P = .65)). The combined NYHA class III-IV had improved for the Classic group in 42% and for the Physio group in 34%. Conclusion: Although the 16% difference in mortality did not reach statistical significance, it is considered clinically important. No differences in morbidity, valve function, and left ventricular function were found. Further research to explain the difference in mortality is required.

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Statistical Processing and Correlations Between Concentrations of Some Atmospheric Pollutants in Suceava and Botosani Counties

Revista de Chimie ◽

10.37358/rc.20.7.8235 ◽

2020 ◽

Vol 71 (7) ◽

pp. 175-186

Author(s):

Doina Lutic ◽

Danut-Gabriel Cozma

Keyword(s):

Nitrogen Monoxide ◽

Statistical Processing ◽

Geographic Area ◽

The Other ◽

Atmospheric Pollutants ◽

Climate Conditions ◽

National Network ◽

Different Seasons ◽

Official Site ◽

Social Wealth

The abundance of some pollutants from the air depend on the geographic area, the human activities intensity, the climate, the season and even on the hour within a day. The nitrogen oxides are the most abundant and most dangerous toxic species from the air, and these emissions are tightly connected to human polluting activities. Therefore, in our work, the first part is assigned for a wide literature search concerning the incidence of the keywords �nitrogen oxide� and searching the connections with other significant related terms and formulas, investigated by the researches worldwide. Then, a statistic approach was applied trying to correlate the values of the concentration in air of nitrogen monoxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, benzene and particulate matter PM10, all of these being generated to a large extent from the exhaust gases from different automotives. The data were collected from the official site of the National Network of Air Quality Monitoring from Romania, and processed by statistical methods, using specific software and methods, in order to find significant differences between the pollutants concentrations values in two neighbor counties (Suceava and Botosani), with relatively similar climate conditions, but different social wealth. The findings of these statistical processing indicate that the PM10 values do not present significant differences between the two locations, neither the time within a day, while the other parameters exhibit distinctions between the values of the other pollutants concentrations in different seasons (summer and winter) and hourly intervals within a day (night, morning, afternoon and evening).

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The Influence of the Established Links between University Courses on the Quality of Teaching

Lifelong Learning ◽

10.11118/lifele2018080235 ◽

2018 ◽

Vol 8 (2) ◽

pp. 35-48

Author(s):

Jiří Rybička ◽

Petra Čačková

Keyword(s):

Higher Education ◽

Empirical Study ◽

The Other ◽

Coherent System ◽

University Courses ◽

Quality Of Teaching ◽

Education Courses ◽

Initial Knowledge

One of the tools to determine the recommended order of the courses to be taught is to set the prerequisites, that is, the conditions that have to be fulfilled before commencing the study of the course. The recommended sequence of courses is to follow logical links between their logical units, as the basic aim is to provide students with a coherent system according to the Comenius' principle of continuity. Declared continuity may, on the other hand, create organizational complications when passing through the study, as failure to complete one course may result in a whole sequence of forced deviations from the recommended curriculum and ultimately in the extension of the study period. This empirical study deals with the quantitative evaluation of the influence of the level of initial knowledge given by the previous study on the overall results in a certain follow-up course. In this evaluation, data were obtained that may slightly change the approach to determining prerequisites for higher education courses.

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MAPPING AND ENHANCING DESIGN STUDIES WITH PSI META-THEORETIC DESIGN FRAMEWORK

Proceedings of the Design Society ◽

10.1017/pds.2021.462 ◽

2021 ◽

Vol 1 ◽

pp. 2007-2016

Author(s):

Yoram Reich ◽

Eswaran Subrahmanian

Keyword(s):

Design Research ◽

The Other ◽

Design Studies ◽

Abstraction Level ◽

Follow Up Studies ◽

The One ◽

The Right ◽

Abstract Framework ◽

Tools And Methods

AbstractDesign research as a field has been studied from diverse perspectives starting from product inception to their disposal. The product of these studies includes knowledge, tools, methods, processes, frameworks, approaches, and theories. The contexts of these studies are innumerable. The unit of these studies varies from individuals to organizations, using a variety of theoretical tools and methods that have fragmented the field, making it difficult to understand the map of this corpus of knowledge across this diversity.In this paper, we propose a model-based approach that on the one hand, does not delve into the details of the design object itself, but on the other hand, unifies the description of design problem at another abstraction level. The use of this abstract framework allows for describing and comparing underlying models of published design studies using the same language to place them in the right context in which design takes place and to enable to inter-relate them, to understand the wholes and the parts of design studies.Patterns of successful studies could be generated and used by researchers to improve the design of new studies, understand the outcome of existing studies, and plan follow-up studies.

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