Perceived stress is associated with primary dysmenorrhea in Brazilian women: a cross- sectional study
Pâmela Calixto de MoraesAna Beatriz BalãoCaren Beatriz FirãoVanessa Patrícia Soares de SousaPatrícia Driusso
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Perceived Stress Scale
Cross-sectional study
Hepatic retransplantation is controversial because the results are inferior to primary transplants and organs are so scarce. To determine the factors that are associated with poor outcome within the first year following retransplantation, we performed a multivariate analysis, using stepwise logistic regression, of 418 hepatic retransplantations performed at a single institution from November 1987 to December 1993. The minimum follow-up was 1 year. Seven variables were found to be independently associated with subsequent graft failure (defined as either patient death or retransplantation): donor age (odds ratio 2.2 for each 10-year increase over age 45, 95% CI 1.3 to 3.7), female donor sex (odds ratio 1.7, 95% CI 1.05 to 2.7), recipient age (odds ratio 1.6 for each 10-year increase over age 45, 95% CI 1.2 to 2.3), need for preoperative mechanical ventilation (odds ratio 1.8, 95% CI 1.1 to 2.9), pretransplant serum creatinine (odds ratio 1.24 for each increase of 1 mg/dl, 95% CI 1.1 to 1.4), pretransplant total serum bilirubin(odds ratio 1.4 for each 10-mg/dl increase over 15 mg/dl, 95% CI 1.1 to 1.8), and the primary immunosuppressant, using tacrolimus as the reference category(odds ratio for cyclosporine-based immunosuppression 3.9, 95% CI 2.3 to 6.8). Although not part of the logistic regression model, the timing of retransplantation was also found to be important, with the overall probability of failure increasing from 0.58 on day 0 to a peak of 0.8 on day 38 and decreasing slowly after that. The implications of these results regarding the appropriateness of retransplantation are discussed.
Immunosuppression
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Currently the application of statistical methods in medical research papers has reached a higher level,but in practice the confusion between of and significant always exists.Statistical conclusion shows statistical significance or no statistical significance,and does not denote professional size of difference.Although the difference with statistical significance or no statistical significance was called significance or no significance,statistical significance or no statistical significance is not equivalent to Significant difference or no Significant difference.
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Confusion
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Objective:To study the effectiveness of treating dysfunction in knee by rehabilitative community.Methods:To choice 40 patients about dysfunction in knee from 2010.1 to 2012.5.When stabilized condition,beginning a rehabilitation.To divide randomly two groups(20 cases in each group).One therapist treated one patient by tradition therapy in the control group.In the experimental group,there is rehabilitative community with one therapist and many patients except tradition therapy.Before the therapy,the therapy end of 15 days,the first month,the second month and the third month,studied the changing about HAMD,ROM,VAS and Lysholm.Results:① Pre treatment,difference of the HAMD hadn't statistical significance in two groups.Before the second month end,it had statistical significance(P 0.01).In the end of third month,it hadn't statistical significance(P 0.05).②On the VAS in two groups,difference of changing in short term had statistical significance(before the first month,P0.05).In long term,it hadn't statistical significance(after the second month,P0.05,the third month,on pain).③On the AROM of flexion in knee,difference in two groups had statistical significance(P0.05),and difference of degree tendency in different time section by different therapy had statistical significance(P0.01,P0.05).Specially,degrees in experimental group fluctuated steady.On the PROM of flexion in knee,difference in two groups hadn't statistical significance(P0.05),but difference of degree tendency in different time section by different therapy had statistical significance(P0.01,P0.05),degrees in experimental group fluctuated steady.④On the ROM of extension in knee,the difference of the AROM / PROM in two groups had statistical significance in the short term(before the first month,P 0.05),it hadn't statistical significance in the long term(after second month,P0.05).⑤On the Lysholm,difference in two groups had statistical significance(P0.05),and difference of degree tendency in different time section by different therapy had statistical significance(P0.01,P0.01).Specially,experimental group changed obviously.Conclusion:The rehabilitative community was effective in treating dysfunction in knee.The effectiveness of AROM / PROM,locomotivity,psychological condition and easement of pain were improved.
Clinical Significance
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Objective: To evaluate the clinical effects of pioglitazone hydrochliride in treatment of type 2 diabetes. Methods: 86 cases with 2 diabetic were enrolled, they were divided into two groups: Group A and Group B. in Group A the patients were treated only with sulphonylureas oral antihyperglycemic agents(men 24 and women 26); Group B the patients were treated with sulphonylureas oral antihyperglycemic agents and pioglitazone hydrochliride (men 19 and women 17) .A statistical analysis of the changes that took place in the patient's weight、lipid and sugar metablism before and after the treatment was performed. Results:The blood glucose lev-els(PBG、FBG、HbAlc)of the cases in Group B decreased more quickly than the cases in Group A after the treament,and the blood glucose levels between cases of the two groups were statistically different (P 0.05); After 12 weeks' treatment,the changes of the insulin level was that Group A increased and Group B decreased (the PINS'decrease reached statistical significance (P 0.01) ,but the FINS' decrease didn' s reach statistical significance), and the difference of FINS between the two groups reached statistical significance ( P 0.05). Although after 12 weeks' treatment, the TC and TG of the cases in Group B decreased obviously, they were not different from the cases in Group A in statistical significance.The changes of HDL-c and BMI in the two groups didn't show statistical significance. Conclusion: Pioglitazone hydrochliride can reduce insulin resistance in the cases with type 2 diabetes,and adjust the disorder of lipid and sugar metablism without the increase of weight.
Pioglitazone
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Group B
Blood sugar
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It has been hypothesized that a high dietary intake of nitrosamines and their precursors, nitrites and nitrates, is a risk factor for brain tumors. Vitamins C and E inhibit the formation of nitrosamines and thus may be protective.
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The relationship between passive smoking and the onset of Legg-Calvè-Perthes disease is still controversial. Therefore, we conducted the study to systematically evaluate and analyze the relationship. A comprehensive search was conducted. Meta-analysis was performed with RevMan 5.3 software, with the odds ratio as the effect size. Eight English articles with a total of 1379 Legg-Calvè-Perthes disease patients were eventually included. Passive smoking type of family members smoking in indoor (odds ratio = 2.53), paternal smoking (odds ratio = 2.76), maternal smoking (odds ratio = 2.02), maternal smoking during pregnancy (odds ratio = 1.68), using stove indoor (odds ratio = 2.56) are statistically significant ( P < 0.05). For the family members smoking indoor, region may be a confounding factor (European group I 2 = 92%, odds ratio = 2.51; USA group I 2 = 5%, odds ratio = 3.26; and Asian group I 2 = 0%, odds ratio = 2.25). In addition, the type of maternal smoking (odds ratio = 0.80, for 1–10 per day; odds ratio = 2.73, for 10–20 per day; odds ratio = 2.78, for >20 per day) and the type of maternal smoking during pregnancy (odds ratio = 1.36, for 1–9 per day; odds ratio = 2.02, for ≥10 per day) may show a dose-effect relationship. Passive smoking is a risk factor for the onset of Legg-Calvè-Perthes disease, but the specific types of passive smoking (haze, etc.), dose, dose-effect relationship, regional confounding, pathological mechanisms, etc. also require clinicians and researchers to continue exploring.
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Cross-sectional study
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Background: Studies about the influence of patient characteristics on mechanical failure of cups in total hip replacement have applied different methodologies and revealed inconclusive results. The fixation mode has rarely been investigated. Therefore, we conducted a detailed analysis of the influence of patient characteristics and fixation mode on cup failure risks. Methods: We conducted a case-control study of total hip arthroplasties in 4420 patients to test our hypothesis that patient characteristics of sex, age, weight, body mass index, and diagnosis have different influences on risks for early mechanical failure in cemented and uncemented cups. Results: Women had significantly reduced odds for failure of cups with cemented fixation (odds ratio = 0.59; 95% confidence interval, 0.43 to 0.83; p = 0.002) and uncemented fixation (odds ratio = 0.63; 95% confidence interval, 0.5 to 0.81; p = 0.0003) compared with that for men (odds ratio = 1). Each additional year of patient age at the time of surgery reduced the failure odds by a factor of 0.98 for both cemented cups (odds ratio = 0.98; 95% confidence interval, 0.96 to 0.99; p = 0.016) and uncemented cups (odds ratio = 0.98; 95% confidence interval, 0.97 to 0.99; p = 0.0002). In patients with cemented cups, the weight group of 73 to 82 kg had significantly lower failure odds (odds ratio = 0.63; 95% confidence interval, 0.4 to 0.98) than the lightest (<64 kg) weight group or the heaviest (>82 kg) weight group (odds ratios = 1.00 and 1.07, respectively). No significant effects of weight were noted in the uncemented group. In contrast, obese patients (a body mass index of >30 kg/m2) with uncemented cups had significantly elevated odds relative to patients with a body mass of <25 kg/m2 (odds ratio = 1.41; 95% confidence interval, 1.03 to 1.91) for early failure of the cups compared with an insignificant effect in the cemented arm of the study. Compared with osteoarthritis as the reference diagnosis (odds ratio = 1), developmental dysplasia (odds ratio = 0.52; 95% confidence interval, 0.28 to 0.97) and hip fracture (odds ratio = 0.38; 95% confidence interval, 0.16 to 0.92) were significantly protective in cemented cups. Conclusions: Female sex and older age have similarly protective effects on the odds for early failure of cemented and uncemented cups. Although a certain body-weight range has a significant protective effect in cemented cups, the more important finding was the significantly increased risk for failure of uncemented cups in obese patients. Patients with developmental dysplasia and hip fracture were the only diagnostic groups with a significantly decreased risk for cup failure, but only with cemented fixation. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
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Objectives: To determine the risk of early onset Parkinson's disease (PD) associated with well water consumption and other risk factors. Design: A case control study with strata matching by age group, gender and current urban or rural residence. Setting: Republic of Ireland, between 1993 to 1995. Participants: Cases with Parkinson's disease, fulfilling at least two of the four cardinal features, with date of birth from 1st January 1926 and disease onset before 56 years. Controls were selected using stratified random sampling from the electoral register. Outcome measures: Odds ratio and 95% confidence interval for well water consumption and other risk factors. Results: Increased risk was associated with well water consumption (odds ratio per 20 years exposure 1.33, 95% CI 1.00 to 1.77), family history of PD (odds ratio 2.15, 95% CI 1.09 to 4.27), and serious head injury (odds ratio 3.08, 95% CI 1.66 to 5.71). Decreased risk was associated with childhood contact with a dog (odds ratio 0.44, 0.25 to 0.78), recall of chicken pox (odds ratio 0.51, 95% CI 0.32 to 0.83), smoking status (odds ratio for 30 or more pack years for smokers 0.19, 95% CI 0.07 to 0.57), exposure to insecticides (odds ratio 0.44, 95% CI 0.25 to 0.77), glue (odds ratio 0.52, 95% CI 0.29 to 0.93), paints (odds ratio 0.37, 95% CI 0.22 to 0.60) and cumulative socioeconomic position (odds ratio for a point reduction in socioeconomic position 0.74, 95% CI 0.61 to 0.90). Conclusions: These results have identified a wide range of exposures from childhood to adulthood that may influence the risk of PD across the life course. Because of potential biases, it is important that these results are replicated in other designs such as occupational or population based cohort studies.
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The relationship between upper gastrointestinal hemorrhage and drug use was studied in 251 Chinese patients (179 men, 72 women) admitted to the Prince of Wales Hospital, Hong Kong, and control subjects matched for age and sex. There was a highly significant difference between the cases and control subjects in the use of NSAIDs (odds ratio 14.0, p < 0.00001), ulcer healing drugs (odds ratio 12.5, p < 0.00001), and Chinese proprietary medicines (odds ratio 16.0, p < 0.00001). There was also a significant difference in the use of analgesics (odds ratio 14.0, p = 0.001), paracetamol (odds ratio 2.5, p = 0.01), antacids (odds ratio 2.7, p < 0.001) and unknown drugs (odds ratio 4.7, p < 0.001). Cases also differed from control subjects regarding the use of tobacco (odds ratio 2.3, p < 0.001) and alcohol (odds ratio 1.7, p = 0.02), and the presence of peptic ulcer symptoms (odds ratio 29.8, p < 0.00001). Significantly more control subjects than cases were receiving aspirin, cardiovascular drugs, bronchodilators, oral hypoglycemic drugs/lipid-lowering drugs, and anticonvulsants/hypnotics, due to the inevitable differences in disease pattern between the 2 groups. NSAID use was a major factor associated with upper gastrointestinal hemorrhage from primarily peptic ulcers. Differences in the use of other drugs may reflect variations in disease patterns between cases and controls, the common practice of self-medication in Hong Kong, and the concomitant use of NSAIDs and ulcer healing drugs/antacids.
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