Comparison of a single-use, digital flexible ureteroscope with a reusable, fiberoptic ureteroscope for management of patients with urolithiasis

Objectives: Ureteroscopy is one of the commonest procedures performed to manage urolithiasis. Flexible ureteroscopy has been traditionally based on reusable, fiber-optic ureteroscopes. Technology advancements permitted the development of single-use scopes with digital image. The aim of this study is to compare efficacy and safety between a reusable, fiberoptic ureteroscope with a single-use, digital scope. Patients and methods: We collected data based on chart review from a prospectively collected database on a tertiary, high-volume hospital in Greece. Baseline, perioperative and postoperative data were gathered and analyzed. Chi-square and Fisher's exact test was used to compare qualitative data and unpaired t-test for continuous data, with a statistical significance set at a = 0.05. Results: 40 patients underwent flexible ureteroscopy with a single- use digital scope, while 37 with the reusable scope. The two groups were matched regarding baseline characteristics and stone-related parameters. After data analysis, a shorter operative time in favor of single-use flexible ureteroscope was detected (45 vs 65 min, p = 0.001), while safety was also in favor of this type of scope with a significantly higher immediate stonefree rate (70% vs 43%, p = 0.005). Overall complications did not differ between the two groups, although a lower sepsis rate was detected in patients treated with single-use scope. Conclusions: Our findings indicate that single-use, digital ureteroscopes are a viable alternative for flexible ureteroscopy and management of urolithiasis, especially in centers with deficient facilities for sterilization and ensured funds for more expensive reusable scopes.

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Use of SAMe-TT₂R₂ Score to Predict the Quality of Anticoagulation Control in Patients with Atrial Fibrillation Receiving Warfarin in Thailand

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.06.10827 ◽

2020 ◽

Vol 103 (6) ◽

pp. 548-552

Keyword(s):

Atrial Fibrillation ◽

Therapeutic Range ◽

Statistical Significance ◽

Discrimination Performance ◽

Poor Quality ◽

Chi Square ◽

Exact Test ◽

Time In Therapeutic Range ◽

Anticoagulation Control

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR

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Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztab039 ◽

2021 ◽

Author(s):

Kemar J Brown ◽

Njambi Mathenge ◽

Daniela Crousillat ◽

Jaclyn Pagliaro ◽

Connor Grady ◽

...

Keyword(s):

Statistical Significance ◽

The Elderly ◽

P Value ◽

Chi Square ◽

Cardiovascular Patients ◽

Baseline Characteristics ◽

Racial Ethnic ◽

Cardiovascular Care ◽

Zip Code ◽

Hispanic White

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in the rapid uptake of telemedicine (TM) for routine cardiovascular care. Objectives To examine the predictors of TM utilization among ambulatory cardiology patients during the COVID-19 pandemic. Methods In this single centre retrospective study, all ambulatory cardiovascular encounters occurring between March 16th - June 19th, 2020 were assessed. Baseline characteristics by visit type (in-person, TM-phone, TM-video) were compared using Chi-square and student t-tests, with statistical significance defined by p value < 0.05. Multivariate logistic regression was used to explore the predictors of TM versus in-person care. Results 8446 patients (86% Non-Hispanic White, 42% female, median age 66.8 +/- 15.2 years) completed an ambulatory cardiovascular visit during the study period. TM-phone (n = 4,981, 61.5%) was the primary mode of ambulatory care followed by TM-video (n = 2693, 33.2%). Non-Hispanic Black race (OR 0.56; 95% CI: 0.35 - 0.94, p-value=0.02), Hispanic ethnicity (OR 0.53; 95% CI: 0.29 - 0.98, p = 0.04), public insurance (Medicaid OR 0.50; 95% CI:0.32 – 0.79, p = 0.003, Medicare OR 0.65; 95% CI: 0.47– 0.89, p = 0.009), zip-code linked median household income (MHI) of <$75,000, age >85 years, and patients with a diagnosis of heart failure were associated with reduced access to TM-video encounters and a higher likelihood of in-person care. Conclusions Significant disparities in TM-video access for ambulatory cardiovascular care exist among the elderly, lower income, as well as Black and Hispanic racial/ethnic groups.

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In Vivo Bonding of Orthodontic Brackets to Fluorosed Enamel using an Adhesion Promotor

The Angle Orthodontist ◽

10.2319/020207-53.1 ◽

2008 ◽

Vol 78 (2) ◽

pp. 357-360 ◽

Cited By ~ 16

Author(s):

James Noble ◽

Nicholas E. Karaiskos ◽

William A. Wiltshire

Keyword(s):

Dental Fluorosis ◽

Statistical Significance ◽

High Volume ◽

Aluminum Silicate ◽

Control Group ◽

Adhesion Promoter ◽

Bond Failure ◽

Chi Square ◽

Chi Square Analysis

Abstract Objectives: To determine the success of bracket retention using an adhesion promoter with and without the additional microabrasion of enamel. Materials and Methods: Fifty-two teeth with severe dental fluorosis were bonded in vivo using a split-mouth design where the enamel surfaces of 26 teeth were microabraded with 50 μm of aluminum silicate for 5 seconds under rubber dam and high volume suction. Thirty-seven percent phosphoric acid was then applied to the enamel, washed and dried, and followed by placement of Scotchbond Multipurpose Plus Bonding Adhesive. Finally, precoated 3M Unitek Victory brackets were placed and light cured. The remaining teeth were bonded using the same protocol but without microabrasion. Results: After 9 months of intraoral service, only one bond failure occurred in the control group where microabrasion was used. Chi-square analysis revealed P = .31, indicating no statistical significance between the two groups. Conclusions: Bonding orthodontic attachments to fluorosed enamel using an adhesion promoter is a viable clinical procedure that does not require the additional micro-mechanical abrasion step.

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Positive association of gastric cancer surgery outcome with surgeon specialization in a Shanghai high-volume general hospital.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.4092 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 4092-4092

Author(s):

Zhenbin Shen ◽

Yihong Sun ◽

Cong Wang ◽

Naiqing Zhao ◽

Weidong Chen ◽

...

Keyword(s):

Gastric Cancer ◽

General Hospital ◽

Surgical Training ◽

Statistical Significance ◽

Postoperative Mortality ◽

High Volume ◽

Cancer Surgery ◽

Specialty Training ◽

Gastric Cancer Surgery ◽

High Volume Hospital

4092 Background: Numerous studies suggest positive relationship between hospital volume and cancer treatment outcomes, the surgeon’s experience and specialty training may also be important. This was examined in a high volume hospital in Shanghai among patients who underwent gastric cancer (GC) surgery. Methods: Data on consecutive patients (pts) undergoing R0 or R1 GC resection in Zhongshan hospital between January 2003 and June 2010 were collected and analyzed. Follow-up on pts who were non-Shanghai residents were less complete therefore excluded. Post-operative mortality, pathologic results and survival outcome for pts treated by surgical training, i.e., sub-specialized vs., non-specialized, were obtained. Survival was calculated by the Kaplan-Meier method and Log-rank test was used to determine statistical significance. To determine whether sub-specialty surgical training was an independent factor for overall survival (OS), univariate and multivariate analyses were performed using Cox proportional hazards regression. Results: Total 5,046 pts underwent R0 or R1 GC resection were identified.1594 pts had complete covariate data, survival information and were included in the study. Of them, the sub-specialized group included 217 cases treated by 3 surgeons, while the non-specialized group included 1377 cases treated by 52 surgeons. 5-year cumulative OS was higher in the sub-specialized group (62.9% vs. 54.6%, p=0.032). Multivariate analysis showed that tumor stage(p<0.001), location of tumor (p=0.003), vascular invasion (p<0.001) and surgeon (HR=1.54, p=0.001) were all associated with OS. The incidence of positive margin was higher in non-specialized group (2.0% vs. 2.7%, p<0.001) and the probability of retrieved lymph nodes less than 15 was more in non-specialized group (25.9% vs. 7.3%, p<0.001). Postoperative mortality was also higher in non-specialized group than in specialized group(1.5% vs. 0.9%, p<0.001). Conclusions: In high volume general hospital, sub-specialty training is desirable in gastric cancer surgery, the quality of gastric cancer surgery can be further improved by sub-specialty training leading to better treatment outcome.

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Abstract WP226: Isolated Aphasia in the Emergency Department: Prevalence and Characteristics of Isolated Aphasia Due to Stroke Within a Population

Stroke ◽

10.1161/str.48.suppl_1.wp226 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Elisheva R Coleman ◽

Jane C Khoury ◽

Charles J Moomaw ◽

Kathleen Alwell ◽

Brett M Kissela ◽

...

Keyword(s):

Chart Review ◽

Retrospective Chart Review ◽

Left Middle Cerebral Artery ◽

Chi Square ◽

Exact Test ◽

The Public ◽

Language Deficit ◽

Wilcoxon Rank Sum Test ◽

The Mean ◽

Left Middle

Background: Aphasia is a disabling consequence of ischemic stroke (IS), usually caused by strokes in the territory of the left middle cerebral artery. It is often seen as part of a larger syndrome with right hemiparesis and other left hemisphere signs. Isolated aphasia may be difficult to recognize given the lack of motor symptoms, potentially delaying treatment. Our study seeks to determine the prevalence of isolated aphasia, the rate at which these patients call 911, and the rate and speed of treatment with rt-PA compared with the general IS population. Methods: Adult IS patients in 2005 and 2010 in the Greater Cincinnati/Northern KY region (pop. 1.3 million) were ascertained from all local hospitals via ICD-9 codes 430-436, using retrospective chart review. We limited analysis to acute IS cases that presented to an ED. Isolated aphasia was defined by a score >0 on item 9 of the initial rNIHSS (indicating language deficit) and scores of 0 on all other items except 1b and 1c. We compared rates of EMS use and rt-PA administration and median times to presentation and treatment for those with isolated aphasia versus not, using chi-square, Fisher’s exact test, t-test, or Wilcoxon rank-sum test. Results: In 2005 and 2010, 3814 IS cases presented to EDs in the region; 22% were black, 56% were female, and the mean (SD) age was 70 (15) years. Of these, 120 (3.2%) presented with isolated aphasia. Characteristics of the isolated aphasia group are compared with all other IS in Table 1. Isolated aphasia patients showed a trend toward later arrival and lower rate of treatment with rt-PA. Discussion: The trend toward later arrival in patients with isolated aphasia, though not statistically significant, suggests a need to better educate the public on recognizing this stroke syndrome. Isolated aphasia was significantly associated with atrial fibrillation and was associated with decreased small vessel and increased cardioembolic and undetermined stroke subtypes, a finding that merits further study.

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Vanishing congenital lung malformations: What is the incidence of true regression?

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-210740 ◽

2021 ◽

pp. 1-7

Author(s):

C. Griggs ◽

M. Schmaedick ◽

C. Gerall ◽

W. Fan ◽

C. Orlas ◽

...

Keyword(s):

Neonatal Intensive Care ◽

Statistical Significance ◽

Multivariable Analysis ◽

Retrospective Chart Review ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Exact Test ◽

Congenital Lung Malformation ◽

Nicu Admission

BACKGROUND: A congenital lung malformation (CLM) that is diagnosed on prenatal ultrasound exam may subsequently become undetectable on later scans, a “vanishing” CLM. OBJECTIVE: The purpose of our study is to characterize the prenatal natural history and postnatal outcomes of “vanishing” lesions treated at our institution. METHODS: We performed a retrospective chart review of 107 patients diagnosed prenatally with CLM at our institution. Comparisons were made using Kruskal-Wallis or t-test for continuous variables and Fisher’s exact test or Chi-Square test for categorical variables. Multivariable analysis using logistic regression was performed. RESULTS: Of the 104 patients, 59 (56.7%) had lesions that became sonographically undetectable on serial ultrasound scans. Patients with lesions that vanished prenatally tended to need less Neonatal Intensive Care Unit (NICU) admission at birth (persistent CLM: 54.8%vs vanished CLM: 28.8%), decreased need for supplemental O2 at birth (persistent CLM: 31.0%vs vanished CLM: 11.9%), and decreased delay in feeds (persistent CLM: 26.2%vs vanished CLM: 8.5%) compared to those with persistent CLM. After multivariate analysis controlling for maternal steroid administration and sex, admission to NICU maintained a slight statistical significance, with patients in the vanishing CLM group 2.5 times less likely to be admitted to the NICU. None of our patients whose lesions vanished prenatally required mechanical ventilation. Eighty-six patients underwent postnatal computed tomography (CT) chest. Only 2 patients had lesions that regressed on postnatal CT. CONCLUSION: Lesions that vanish on prenatal imaging may be associated with improved clinical outcomes. The rate of true regression at our institution was as low as 2.3%.

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Breast Arterial Calcifications on Mammography: A Survey of Practicing Radiologists

Journal of Breast Imaging ◽

10.1093/jbi/wbab009 ◽

2021 ◽

Author(s):

Fernando Collado-Mesa ◽

Monica M Yepes ◽

Kristopher Arheart

Keyword(s):

Breast Imaging ◽

Statistical Significance ◽

Fisher Exact Test ◽

Chi Square ◽

Exact Test ◽

Chi Square Test ◽

Artery Disease ◽

Α Level ◽

Training Practice ◽

Question Survey

Abstract Objective To explore current practice patterns of reporting and issuing recommendations based on the presence of breast arterial calcifications on mammography and existing knowledge of their prevalence and associated factors. Methods An online anonymous 19-question survey was distributed to 2583 practicing radiologists who were members of the Society of Breast Imaging. Questions covered demographics, breast imaging training, practice type, and knowledge regarding the epidemiology and potential clinical significance of breast arterial calcifications detected on mammograms. Differences between groups were calculated using the chi-square test or Fisher exact test. An α level of 0.05 was used to determine statistical significance. Results Response rate was 22% (364/1662). The median age of respondents was 51 years (range: 29–76) and most were female (248/323, 77%). The most prevalent characteristics among respondents were as follows: 69% (223/323) had completed a breast imaging fellowship, 55% (179/323) were in private practice, 49% (158/323) practiced dedicated breast imaging, and 38% (124/323) had been in practice for more than 20 years. The prevalence of breast arterial calcifications was correctly estimated to be 1%–30% by 39% (125/323) of respondents. Most respondents correctly recognized the growing evidence of an association between breast arterial calcifications and coronary artery disease (275/323, 85%). However, only 15% (48/323) always reported the presence of these calcifications, and of those who report them at any time, only 0.7% (2/274) always issued recommendations. Conclusion There are differences in both knowledge of the epidemiology of breast arterial calcifications and practices around their reporting amongst breast radiologists.

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QTc Prolongation in Patients Acutely Admitted to Hospital for Psychosis and Treated with Second Generation Antipsychotics

Schizophrenia Research and Treatment ◽

10.1155/2013/375020 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Erik Johnsen ◽

Kristina Aanesen ◽

Sanjeevan Sriskandarajah ◽

Rune A. Kroken ◽

Else-Marie Løberg ◽

...

Keyword(s):

Antipsychotic Drugs ◽

Statistical Significance ◽

Torsade De Pointes ◽

Positive Association ◽

Qtc Interval ◽

Qtc Prolongation ◽

Chi Square ◽

Exact Test ◽

Second Generation Antipsychotics ◽

Qtc Interval Prolongation

QTc interval prolongation is a side effect of several antipsychotic drugs, with associated risks of torsade de pointes arrhythmias and sudden cardiac death. There is an ongoing debate of whether or not electrocardiogram (ECG) assessments should be mandatory in patients starting antipsychotic drugs. To investigate QTc prolongation in a clinically relevant patient group 171 adult patients acutely admitted to an emergency ward for psychosis were consecutively recruited. ECGs were recorded at baseline and then at discharge or after 6 weeks at the latest (discharge/6 weeks), thus reflecting the acute phase treatment period. The mean QTc interval was 421.1 (30.4) ms at baseline and there was a positive association between the QTc interval and the agitation score whereas the QTc interval was inversely associated with the serum calcium level. A total of 11.6% had abnormally prolonged QTc intervals and another 14.3% had borderline prolongation. At discharge/6 weeks, the corresponding proportions were reduced to 4.2% and 5.3%, respectively. The reduction of the proportion with prolonged QTc intervals reached statistical significance (chi-square exact test:P=0.046). The finding of about one-quarter of the patients with borderline or prolonged QTc intervals could indicate mandatory ECG recordings in this population. This trial is registered with ClinicalTrials.gov ID:NCT00932529.

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identification risk for falls diagnosis in the elderly serviced by the elderly care program

Revista de Enfermagem UFPE on line ◽

10.5205/reuol.2133-15571-1-le.0510201123 ◽

2011 ◽

Vol 5 (10) ◽

pp. 2507 ◽

Cited By ~ 2

Author(s):

Erika Cássia Lopes Chaves ◽

Laís De Andrade Martins Cordeiro ◽

Sueli Leiko Takamastu Goyatá ◽

Mônica Lá-Salette da costa Godinho ◽

Valéria Cruz Meirelles ◽

...

Keyword(s):

Elderly Care ◽

Statistical Significance ◽

Care Program ◽

The Elderly ◽

Diagnostic Study ◽

Chi Square ◽

Significance Level ◽

Exact Test ◽

The North ◽

Nursing Diagnosis

ABSTRACT Objective: identifying the frequency of nursing diagnosis Risk for falls in the elderly and assess their risk factors. Method: retrospective study based on data recorded in the medical records of elderly patients in the Elderly Care Program. Data collection was done between May-June 2009, by means of a questionnaire with information on the epidemiological and diagnostic study, classified according to the North American Nursing Diagnosis Association (NANDA-I), after approval by the Ethics Committee of the Federal University of Alfenas (protocol 23087.001613/2009-01). For tabulation and analysis of data the statistical program Statistical Package for Social Sciences (SPSS) was used. Descriptive statistics allowed us to describe and summarize the data obtained which were compared using the chi-square (X2) and Fisher's exact test. The statistical significance level adopted was 5% (p

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Abstract WMP113: Coated-Platelet Levels are Elevated in Subarachnoid Hemorrhage and Inversely Associated with Mortality at 30 Days

Stroke ◽

10.1161/str.44.suppl_1.awmp113 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Calin I Prodan ◽

Andrea S Vincent ◽

Angelia C Kirkpatrick ◽

Steven L Hoover ◽

George L Dale

Keyword(s):

Subarachnoid Hemorrhage ◽

Chi Square ◽

Exact Test ◽

Telephone Interviews ◽

Agonist Stimulation ◽

Chi Square Test ◽

Baseline Characteristics ◽

Continuous Measures ◽

Dual Agonist ◽

Made In

Background: Coated-platelets are a subset of platelets with high procoagulant potential observed upon dual agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in non-lacunar ischemic stroke compared to either lacunar stroke or controls. In contrast, coated-platelet levels are decreased in patients with spontaneous intracerebral hemorrhage (ICH) and inversely correlated with bleed size. We now report the first investigation of coated-platelet production in patients with subarachnoid hemorrhage (SAH). Methods: Coated-platelet levels were determined in 38 consecutive patients with non-traumatic SAH within 48 hours from symptom onset and in 40 controls frequency-matched for gender, race and age. Results are reported as percent of cells converted to coated-platelets. Mortality at 1 month was obtained through chart reviews or telephone interviews. Baseline characteristics were compared either with a t-test for continuous measures or a Chi-square test for categorical measures. Results: Coated-platelet levels (mean±SD) were significantly higher in patients with SAH compared to controls (41.0±10.7% vs. 30.0±12.1%, p<0.0001). No differences were detected between patients and controls for demographics, medication use or pertinent comorbidities (p values >0.17). Among all patients, mortality at 1 month was 21% (8 deaths). Patients were then analyzed according to tertiles of coated-platelet levels (split at ≤36.6%, 36.6-45.5%, >45.6%). The 1-month mortality differed significantly between the coated-platelet tertiles (p=0.019, Fisher’s exact test), with 50% mortality (6/12) among patients in the lowest tertile (lowest levels) compared to 7.7% (1/13) among those in the middle and highest tertiles. Conclusions: Coated-platelet levels are elevated in SAH compared to controls for reasons not currently clear. However, the association between lower coated-platelet levels and mortality in SAH patients is compatible with prior observations made in ICH. These data also provide further evidence of the role played by these prothrombotic platelets in events leading to thrombosis or hemorrhage. Supported by Award 1I01CX000340 from the Clinical Science R&D Service of the VA ORD (Prodan)

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