Binominal Logistic Regression Analysis Research Articles

A new approach to radiofrequency catheter ablation of premature ventricular contractions: The diurnal variation index

Radiofrequency catheter ablation (RFA) is a frequently used method in the treatment of premature ventricular contractions (PVCs) resistant to drug therapy. RFA is recommended for patients with PVCs burden >10%. This study was aimed to investigate the presence of other parameters to enhance the indication of ablation in 24-hour rhythm Holter recordings. 202 patients with >10% PVCs in 24-hour rhythm Holter recordings were included in the study between January 2015 and August 2019. Patients were divided into two groups. Radiofrequency ablation was performed in 163 patients but not in 39 patients. Laboratory findings were compared between two groups. Total cholesterol (p=0.018), LDL cholesterol (p=0.013) and triglyceride (p<0.001) values were significantly higher in the RFA group, When the 24-hour rhythm Holter findings were compared, the diurnal variation index was significantly higher in the RFA group (p<0.001). Triglyceride (OR: 1.013, 95% CI: 1.001-1.025, p=0.032) and diurnal variation index (OR: 3.643, 95% CI: 1.440-9.216, p=0.006) were determined as independent predictors in binominal logistic regression analysis. In the ROC analysis, when the cut-off value of the diurnal variation index was taken as 1.5, it was found that it could predict patients who undergo effective RFA with 76.7% sensitivity and 60% specificity. Diurnal variation index may be a useful parameter for RFA indication with PVC burden in 24-hour rhythm Holter recordings.

Atypical immunohistochemical patterns can complement the histopathological diagnosis of oral premalignant lesions

The histopathological diagnosis of oral premalignant lesions (OPLs) such as oral epithelial dysplasia (ED) and carcinoma in situ (CIS), as well as epithelial hyperplasia (EHP), is important for the early detection and precise treatment of oral squamous cell carcinoma. However, the standardization of detection and treatment by histological criteria alone remains challenging owing to the complicated and varied histology. We evaluated practically useful immunohistochemical (IHC) markers that might complement the histopathological diagnosis of OPLs. We re-evaluated the histopathological diagnoses and IHC patterns of Ki-67, TP53, CK13, and CK17 in 200 cases of OPLs and performed multiple logistic regression analyses for their predictive accuracy. We identified and compared atypical IHC patterns in OPLs and in the normal epithelium. Ki-67 expression showed specific patterns in categorized OPLs as EHP, low-grade dysplasia (LED), high-grade dysplasia (HED), and CIS. Multiple logistic regression analyses in the quadrant categories revealed that EHP and CIS had high predictive accuracies of 90.1% and 96.2%, respectively, and in binary categories, combined EHP and LED versus combined HED and CIS showed predictive accuracies of 92.1% and 89.9%, respectively. Binominal logistic regression analysis between each quadrant category revealed satisfactory predictive accuracy of EHP vs. LED, LED vs. HED, and HED vs. CIS (75.2%, 78.9%, and 87.9%, respectively), and Ki-67 showed the highest adjusted odds ratio, followed by TP53. The proposed atypical IHC patterns might serve as useful markers to supplement the morphological diagnosis of OPLs, and established IHC methods for Ki-67 and TP53 might provide stable results.

Effects of Early Dysphagia Rehabilitation by Speech-language-hearing Therapists on Patients with Severe Aspiration Pneumonia.

ABSTRACTObjective:To clarify the effect of early dysphagia rehabilitation, early rehabilitation was started within 2 days of admission by speech-language-hearing therapists in patients with severe aspiration pneumonia.Methods:The subjects were inpatients with severe aspiration pneumonia (A-DROP≥3) admitted to our hospital between April 2014 and March 2019. We retrospectively investigated patient age, sex, A-DROP score, community-acquired or nursing- and healthcare-associated pneumonia, invasive and noninvasive ventilation, comorbidities, nutritional risk, admission from nursing home, discharge to nursing home, walking ability before admission and at discharge, Food Intake LEVEL Scale (FILS) score at the start of rehabilitation and at discharge, the achievement of oral intake, alternative nutrition in use at discharge, number of days from admission to the start of rehabilitation, and number of days from admission to oral intake. We compared the patient characteristics and rehabilitation outcomes between 159 patients who underwent early dysphagia rehabilitation and 67 patients who underwent later dysphagia rehabilitation. To assess the association between alternative nutrition at discharge and early dysphagia rehabilitation, binominal logistic regression analysis was performed.Results:Early dysphagia rehabilitation was significantly associated with shorter hospital stays, fewer discharges to nursing homes, higher likelihood of oral intake, the removal of alternative nutrition at discharge, fewer days from admission to oral intake, and higher FILS scores at discharge. Early dysphagia rehabilitation was significantly associated with no alternative nutrition at discharge in binominal logistic regression analysis (odds ratio 3.26; P <0.01).Conclusions:This study suggested that early dysphagia rehabilitation was effective in improving outcomes of severe aspiration pneumonia including the removal of alternative nutrition at discharge.

Relationship between diet quality and sarcopenia in elderly Koreans: 2008-2011 Korea National Health and Nutrition Examination Survey.

BACKGROUND/OBJECTIVESGiven the increasing proportion of the Korean population that is aged 65 years and older, the present study analyzed the relationship between diet quality and sarcopenia in elderly persons by using data from the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES).SUBJECTS/METHODSData for 3,373 persons aged 65 years and over (men: 1,455, 43.1%) were selected from the 2008–2011 KNHANES. Sarcopenia assessments are based on a formula that divides a subject's appendicular skeletal muscle mass (ASM) by their weight (wt) and multiplies that result by 100 ([ASM/wt] × 100). Sarcopenia is present if the subject's result was less than one standard deviation (SD) below the sex-specific mean for a young reference group. For evaluation of diet quality, data obtained via the 24-hour recall method were used to calculate the Diet Quality Index for Koreans (DQI-K). A general linear model was applied in order to analyze general information and nutritional intake according to sarcopenia status. For analysis of the relationship between diet quality and sarcopenia, a binominal logistic regression analysis was undertaken.RESULTSThe sarcopenia prevalence rate among the study subjects aged 65 years and over was 37.6%. The DQI-K of those without sarcopenia was 3.33 ± 0.04 points, while that of those with sarcopenia was 3.45 ± 0.04 points (P < 0.05). The relationship between diet quality and sarcopenia revealed that subjects aged 75 and older had a poor diet quality, and their odds ratio (OR) of sarcopenia presence was significantly higher (OR: 1.807, 95% confidence interval: 1.003–3.254, P < 0.05).CONCLUSIONSThis study revealed that poor diet quality was related to sarcopenia presence in Koreans aged 75 and older. In order to improve the diet quality of the elderly (aged 75 and older), it is necessary to develop dietary improvement guidelines.

Use of Alcohol, Tobacco, and Caffeine and Suicide Attempts: Findings From a Nationally Representative Cross-sectional Study.

In this study, the association between students’ substance use and suicide attempts in the past 1 year was examined using secondary data from the 13th Korea Risk Behavior Web-based Survey. Participants were 7th- to 12th-grade students and 50.9% were male. A binominal logistic regression analysis was used to investigate the association between past experience of substance use (alcohol, tobacco, and caffeine) and suicide attempts after controlling for sociodemographic and psychological factors. Compared with no use, daily use of alcohol (odds ratio [OR] = 8.00), caffeine (OR = 2.13), and tobacco (OR = 1.41) was associated with increased odds of suicide attempts. These results indicate that school-based suicide prevention programs should cover awareness, surveillance, and treatment referral for these 3 substances. Moreover, mental health professionals should monitor intake of these substances when evaluating risk of suicide attempts in youth.

Can peritoneal thickening and enhancement be used to determine perforation in patients with acute appendicitis?

Acute appendicitis (AA) is a common cause of abdominal pain in developed countries. In patients with suspected AA, computed tomography (CT) is considered as the gold standard with the highest sensitivity and specificity, and it is also an im-portant modality, especially in patients with complicated AA. In this study, we aimed to evaluate age and laboratory findings, as well as specific CT findings in differentiating between perforated and non-perforated appendicitis. We retrospectively analyzed 252 patients diagnosed with AA and underwent appendectomy between November 2015 and December 2019 in Somalia Mogadishu Recep Tayyip Erdogan Education and Research Hospital. Patients under 18 years of age and those with no pre-operative CT scans were excluded from the study. The demographic, laboratory, CT findings, and pathological data of all patients were evaluated. This study included 80 patients, 32 (40%) classified as perforated appendicitis (Group-1) and 48 (60%) as non-perforated appendicitis (Group-2). The C-reactive protein value was found to be statistically higher in Group-1 than in Group-2 (177.5±118.9 and 100.2±87.3 mg / L, respectively; p=0.001). The appendix lumen diameter (p=0.002), appendix wall defect (p<0.001), peritoneal thickening and enhancement (p<0.001), ascites (p=0.031), intra-abdominal abscess (p=0.003), jejunal thickening (p=0.019), ileal thick-ening (p=0.008), and ileus (p=0.035) values were significantly higher in Group-1. In the binominal logistic regression analysis performed with statistically significant data, an appendiceal wall defect (OR: 0.069, 95% CI=0.014-0.327, p=0.001) and peritoneal thickening and enhancement (OR: 0.131, 95% CI=0.024-0.714, p=0.019) were identified as independent variables for perforated appendicitis. Among CT findings, appendix wall defects and peritoneal thickening and enhancement play an important role in detecting perforation.

Predictors of Smoking Cessation in a Lifestyle-Focused Text-Message Support Programme Delivered to People with Coronary Heart Disease: An Analysis From the Tobacco Exercise and Diet Messages (TEXTME) Randomised Clinical Trial.

Background:Studies have demonstrated the effectiveness of text message-based prevention programs on smoking cessation, including our recently published TEXTME randomised controlled trial. However, little is known about the predictors of smoking cessation in this context and if other clinically important factors interact with the program to lead to quitting. Hence, the objective of this study was to first assess the predictors of smoking cessation in TEXTME and then determine if the effect of texting on quitting was modified by interactions with important clinical variables. This will allow us to better understand how text messaging works and thus help optimise future text-message based prevention programs.MethodsThis sub-analysis used data collected as part of the TEXTME trial which recruited 710 participants (377 current smokers at baseline) between September 2011 and November 2013 from a large tertiary hospital in Sydney, Australia. Smokers at baseline were analysed at 6 months and grouped into those who quit and those who did not. Univariate analyses were performed to determine associations between the main outcome and clinically important baseline factors selected a priori. A multiple binominal logistic regression analysis was conducted to develop a predictive model for the dependent variable smoking cessation. A test of interaction between the intervention group and baseline variables selected a priori with the outcome smoking cessation was performed.ResultsUnivariate analysis identified receiving text-messages, age, and mean number of cigarettes smoked each day as being associated with quitting smoking. After adjusting for age, receiving the text-messaging program (OR 2.34; 95%CI 1.43-3.86; p<0.01) and mean number of cigarettes smoked per day (OR 1.02; 95%CI 1.00-1.04; p=0.03) were independent predictors for smoking cessation. LDL-C showed a significant interaction effect with the intervention (High LDL*Intervention OR 3.77 (95%CI 2.05-6.94); Low LDL*Intervention OR 1.42 (95%CI 0.77-2.60); P=0.03).ConclusionsSmoking quantity at baseline is independently associated with smoking cessation and higher LDL-C may interact with the intervention to result in quitting smoking. Those who have a higher baseline risk maybe more motivated towards beneficial lifestyle change including quitting smoking, and thus more likely to respond to mHealth smoking cessation programs. The effect of text-messages on smoking cessation was independent of age, gender, psychosocial parameters, education, and baseline control of risk factors in a secondary prevention cohort.

Correlation of Plasma Klotho Levels and Carotid Intima- Media Thickness in CKD Patients on Regular Hemodialysis

Background: The incidence of heart death is 5-10 times more in patients with chronic kidney disease (CKD) with regular hemodialysis compared to the general population. Vascular calcification is a risk factor. In CKD patients there is a decrease in the distal renal cell cells which are the main producer of Klotho in the body. The functions of Klotho are maintaining integrity, endothelial permeability and endogenous inhibitors of vascular calcification. Previous studies reported an association between vascular calcification and Klotho plasma levels. Vascular calcification for heart disease can be determined by the thickness Intima Media (TIM) Carotid Artery. Objective: To determine the correlation of plasma Klotho levels with the Intima Media thickness of the Carotid Artery in CKD patients with regular hemodialysis. Methode: This cross-sectional study was conducted at the Rasyida Kidney General Hospital in Medan from April to July 2018. Patients with CKD who have undergone routine hemodialysis are examined for plasma levels of Klotho and real time ultrasound examinations to determine the thickness of arterial intima media carotid. Data are analyzed with Mann Whitney test, binominal logistic regression and Pearson correlation. Results: Seventy patients with CKD showed an average plasma Klotho level of 281.43 + 298.63 pg / ml with an average TIM of the carotid artery of 0.22 + 0.09 cm. Patients were divided into 2 groups, namely the calcification group (n = 39) and the noncalcified group (n = 31). Mann-Whitney test was performed with the results that there were differences in plasma Klotho levels between the calcification group and the noncalcified carotid artery group which were statistically significant (p = 0.001). The binominal logistic regression analysis test was performed on risk factors associated with the incidence of vascular calcification and the results of Klotho serum levels, Diabetes Mellitus and Hypertension were found to be significant risk factors for calcification (p &lt;0.05). With the Pearson correlation test, the negative correlation of plasma Klotho levels with the thickening of Intima Carotid Arterial Media was statistically significant with moderate correlation strength (p = 0.002; r = -0.368). Conclusion: Patients with chronic kidney disease with low plasma Klotho levels have thickening of the intima media of carotid artery.

Age-related changes in muscle elasticity around the shoulder joint in young male baseball players: A prospective longitudinal study

Longitudinal changes of elasticity in the muscle tissues around the shoulder joint during the growth period have not been assessed using shear wave elastography. This study enrolled male students aged 13-18 years who played baseball or rubber baseball as an extra-curricular activity during junior high or high school or on a baseball team outside of school. The exclusion criterion was a history of surgery for athletic injury. One hundred and twenty-one boys were included in the study. The elasticity of the superior part of the trapezius, the supraspinatus, and the infraspinatus were measured by ultrasound. The shear elastic modulus (SEM), which is the ratio of the strain ratio (SR) in the acoustic coupler to the SR of each muscle, was calculated as a representative value. Six months after the baseline assessment, subjects were evaluated regarding any newly developed pain in the joint of the throwing shoulder, and categorized into either the non-pain group or the pain group. Although all muscle SEMs tended to increase in both the throwing and non-throwing shoulders, no significant difference was observed in the prevalence of shoulder joint pain between ages (p=0.541). The results of a binominal logistic regression analysis, adjusted for age, body mass index, playing position in baseball, frequency of baseball practice, shoulder range of motion, and muscle strength showed that a decrease in SEM values of the supraspinatus was a risk factor for the development of new pain (odds ratio: 0.056; 95% confidence interval 0.011-0.299; p=0.001). The elasticity of muscle tissues around the throwing shoulder increased with age, and low tissue elasticity of the supraspinatus of the throwing shoulder was a factor that triggered pain during throwing motions.

Does the male gender govern conversion of laparoscopic cholecystectomy?

Introductions: Laparoscopic cholecystectomy (LC) occasionally demands conversion to open cholecystectomy (OC) because of multiple risk factors. This study was conducted to find out whether male gender is a stand-alone risk factors for conversion of LC to OC. &#x0D; Methods: This was a comparative analysis of conversion of LC to OC in patients operated for symptomatic cholelithiasis during June 2017 to May 2018 at Bir hospital, National Academy of Medical Sciences, Kathmandu, Nepal. The patients were divided into two groups: male (group 1) and female (group 2). Study variables included gender, America Society of Anesthesiologist class, history of upper abdominal pain within six weeks prior to surgery, upper abdominal surgery, emergency department visit due to upper abdominal pain, adhesion of gallbladder to adjacent structure and body mass index. Binominal logistic regression analysis of risk factors for conversion was conducted. Odds ratio (95% CI) was calculated. The p value ≤ 0.05 was considered statistically significant. &#x0D; Results: Among 151 patients (male 39, female 112), 7 (4.6%, male 3 and female 4) had conversion from LC to OC. Male gender itself as an isolated risk factor had no significant association to conversion (p=0.303). There was no significant difference found for age, operating time and hospital stay. Previous emergency visit (p=0.020) and adhesion (p&lt;0.030) were associated with conversion. &#x0D; Conclusions: Male gender had no significant association for conversion of LC to open. Previous emergency visit due to upper abdominal pain and adhesion of gallbladder were associated risk factors for conversion.

Pre- and Perioperative Risk Factors of Post Hip Fracture Surgery Walking Failure in the Elderly.

Introduction:Osteoporotic hip fractures are a major problem. They increase mortality, morbidity, and functional decline. Recovery of ambulatory status is an essential prerequisite for older adults living in a normal environment. The main objective of this study was to investigate walking failure at 3 to 6 months after hip fracture surgery with the aim of identifying pre- and perioperative risk factors associated with it.Methods:A total of 120 participants (>65 years) were recruited following hip fracture surgery at a teaching hospital. Walking status was assessed on average 4.4 ± 1.3 months after hip fracture surgery and compared with prefracture walking status. The participants were divided into 2 groups according to walking status (group 1: ambulatory; group 2: nonambulatory) and risk factors associated with a failure to walk were determined using binominal logistic regression analysis.Results:The rate of recovery to prefracture ambulatory status was about 18.3% and 25% of participants could not walk at all. Risk factors for not being able to walk at all included poor prefracture ambulatory status and living at a long care facility as nonmodifiable factors, whereas a shorter length of stay before surgery and having a longer total hospitalization periods were modifiable factors.Conclusion:Walking recovery after hip fracture surgery was very poor at 3 to 6 months after hip fracture surgery. Based on our findings, older adults living in a long care facility should be provided their medical and functional needs through professional health-care providers and systematic health delivery systems. The therapeutic management for underlying diseases affecting surgery should precede unconditional early surgery. Older adults hospitalized during longer periods should be focused on their functional care.

군인, 의경의 흡연 특성과 비만 간의 관련성 : 2009∼2017년 금연클리닉 참여 군인, 의경을 대상으로

Objectives: This study was performed to investigate trends of smoking characteristics and to identify the relationship between smoking characteristics and obesity among military personnel in Korea. Methods: The study participants were 50,680 military personnel who participated smoking cessation clinic from January in 2009 to December in 2017(excluded in 2011). Obesity was defined as body mass index≥25kg/m2. Smoking characteristics was included cigarettes of smoked per day, age of initial smoking, smoking duration, and nicotine dependence. Binominal logistic regression analysis was performed to confirm the relationship of smoking and obesity among military personnel. Results: The prevalence of obesity of study subjects was 20.4%. The military personnel were more likely to be obese if they who smoked more than 20 cigarettes per day(adjusted OR 2.271, CI 2.027-2.545), who smoked for more than 10 years(adjusted OR 2.046, CI 1.820-2.299), and who smoked their initial smoking at later than 20 years(adjusted OR 1.357, CI 1.223-1.493). Conclusions: Obesity is closely related to cigarettes of smoked per day, age of initial smoking and smoking duration among military personnel. Thus, intervention included both smoking cessation and weight control are necessary for smokers with obese who are interested in losing weight among military personnel.

T wave positivity in lead aVR is associated with mortality in patients with cardiac resynchronization therapy.

Positive T wave polarity in lead aVR (TPaVR) is associated with a poor prognostic indicator in patients with heart failure reduce ejection fraction (HFrEF). Our aim was to investigate the relationship between positive TPaVR and mortality in patients with cardiac resynchronization therapy defibrillator (CRT-D). We included retrospectively 224 HFrEF patients with CRT-D in sinus rhythm. Laboratory, electrocardiographic (ECG), and echocardiographic data were recorded. T wave polarity was measured in lead DI, DII, and aVR from surface ECG. The patients were divided as living and deceased. They followed for 2.5 ± 0.9years. Thirty-three patients (14.7%) died. Six patients (18.2%) were TPaVR positive before CRT-D and this number increased to 22 (66.6%) after CRT-D in the deceased group. Pulse (p = 0.049), hyperlipidemia (p = 0.022), and NT-proBNP levels were higher in the deceased group (p = 0.001). TPaVR before CRT-D (p < 0.001) and TPaVR after CRT-D (p < 0.001) were significantly positive in the deceased group. Positive TPaVR after CRT-D was the only independent predictor for mortality in binominal logistic regression analysis (OR 1.211, 95% CI 1.105-1.328, p < 0.001). In CRT-D patients, a positive TPaVR in surface ECG may be a strong mortality indicator.

Contribution of Opiate Analgesics to the Development of Infections in Advanced Cancer Patients

Literature is limited on the relationship between opiate analgesics and the development of infections in cancer patients. This study aimed to determine whether opiate analgesics contribute to the advancement of infections and how infection rates differ among the various opiates used for cancer management. From January 2013 to October 2014, we analyzed retrospectively 642 consecutive advanced cancer patients who received single types of opiates, including morphine, oxycodone, or fentanyl, or a combination of these drugs, continuously for >14 days. Binominal logistic regression analysis was used to analyze the factors that may promote the development of infections. A total of 303 patients were included in the final analysis. Of these patients, 85, 41, and 68 patients received only morphine, oxycodone, and fentanyl, respectively. Altogether, 87 (28.7%) patients developed infections; 20 (23.5%), 10 (24.4%), and 14 (20.6%) patients developed infections in the groups that received only morphine, oxycodone, and fentanyl, respectively (P>0.05). Logistic regression analysis found that the daily oral morphine equivalent (OME) is the an independent factor that influences the development of infection in the single-opiate group (odds ratio=1.002, P<0.01). The risk for developing infection increased by 2% per 10 mg increase in the daily OME. Our clinical results did not display any difference among the single-opiate groups in the development of infections. However, the increase in daily OME may serve as a risk factor for the development of infections in advanced cancer patients using one opiate type for pain management.

The association between health-related quality of life/dietary satisfaction and perceived food environment among Japanese individuals with spinal cord injury.

Cross-sectional. To examine the association between health-related quality of life (HRQOL)/dietary satisfaction and perceived food environment in community-dwelling individuals with spinal cord injury (SCI). Members of the Spinal Injuries Japan organization. Subjects were 2007 Japanese individuals with SCI. A questionnaire conducted in 2015 included items addressing sociodemographic characteristics, HRQOL, dietary satisfaction and eight perceived food environment items. Responses from 506 individuals were analyzed (valid response rate=25%). Dependent variables were the physical and mental summary scores of the HRQOL and dietary satisfaction. The independent variable was the perceived food environment. We used a univariate analysis (in Model 1) and a multivariate analysis (in Models 2 and 3) as part of a binominal logistic regression analysis. In Model 3, we divided and analyzed the perceived food environment variable into 'access to food' and 'access to information'. Both physical and mental summary scores were related to 'dietary information acquisition in the community'. Dietary satisfaction was related to 'balanced meals in the household', 'food and health information available from family' and 'right health and dietary information acquisition from the media'. HRQOL and dietary satisfaction were differentially associated with perceived food environment factors in community-dwelling individuals with SCI. HRQOL was positively related to dietary information of perceived food environment in the community. Dietary satisfaction was positively related to perceived food environment in the household.

Determinants for changing the treatment of COPD: a regression analysis from a clinical audit.

IntroductionThis study is an analysis of a pilot COPD clinical audit that evaluated adherence to guidelines for patients with COPD in a stable disease phase during a routine visit in specialized secondary care outpatient clinics in order to identify the variables associated with the decision to step-up or step-down pharmacological treatment.MethodsThis study was a pilot clinical audit performed at hospital outpatient respiratory clinics in the region of Andalusia, Spain (eight provinces with over eight million inhabitants), in which 20% of centers in the area (catchment population 3,143,086 inhabitants) were invited to participate. Treatment changes were evaluated in terms of the number of prescribed medications and were classified as step-up, step-down, or no change. Three backward stepwise binominal multivariate logistic regression analyses were conducted to evaluate variables associated with stepping up, stepping down, and inhaled corticosteroids discontinuation.ResultsThe present analysis evaluated 565 clinical records (91%) of the complete audit. Of those records, 366 (64.8%) cases saw no change in pharmacological treatment, while 99 patients (17.5%) had an increase in the number of drugs, 55 (9.7%) had a decrease in the number of drugs, and 45 (8.0%) noted a change to other medication for a similar therapeutic scheme. Exacerbations were the main factor in stepping up treatment, as were the symptoms themselves. In contrast, rather than symptoms, doctors used forced expiratory volume in 1 second and previous treatment with long-term antibiotics or inhaled corticosteroids as the key determinants to stepping down treatment.ConclusionThe majority of doctors did not change the prescription. When changes were made, a number of related factors were noted. Future trials must evaluate whether these therapeutic changes impact clinically relevant outcomes at follow-up.

Factors associated with regular dental visits among hemodialysis patients.

To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify the barriers to visiting the dentist. Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the χ(2) test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental check-ups. There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients (4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups (χ(2) test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist (P < 0.05). Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients.

Association between Premenstrual Syndrome and Daily Physical Activity Levels

Objective: The purpose of this study was to investigate the association between premenstrual syndrome (PMS) and daily physical activity. Methods: Three hundred forty-nine women (18-50 years) were analyzed. We investigated body mass index, PMS symptoms, physical activity level, and some factors related to PMS (age, sleep time, caffeine intake, alcohol intake, smoking status). Participants were grouped according to physical activity level into low, normal, and high physical activity groups. Binominal logistic regression analysis was used to examine the association between PMS and daily physical activity level. Results: The average physical activity levels of the low, normal and high physical activity groups were 301.4 ± 233.8 kcal, 975.0 ± 187.3 kcal, and 4558.7 ± 3798.5 kcal, respectively. The incidence of PMS was higher in both the low physical activity group (OR=2.45, 95% CI=1.18-5.11) and high physical activity group (OR=2.13, 95% CI=1.01-4.50) than in the normal physical activity group. Conclusion: PMS rates were higher in women who have either low or high daily physical activity levels than in those with normal physical activity levels. Therefore, women should be advised to avoid inactivity or excessive daily physical activity.

An analysis of factors affecting adolescent cyber swearing: Using binominal logistic regression analysis

An analysis of factors affecting adolescent cyber swearing: Using binominal logistic regression analysis

Reproductive risk factors differ among breast cancer patients and controls in a public hospital of Paraiba, northeast Brazil.

The incidence and mortality rates of breast cancer in Northeast Brazil are increasing and little is known about prevailing reproductive factors contributing to this increase. A case-control study was conducted in a public hospital of Campina Grande, state of Paraiba, including 81 women with diagnosed invasive breast cancer and 162 age matched (±5 years) controls. Binominal logistic regression analysis was applied to estimate odds ratio (OR) and confidence intervals (CI) of risk factors. In this model, age at menarche≤12 (OR=2.120; CI: 1.043-4.308; p=0.038), single parity (OR=3.748; CI: 1.459- 9.627; p=0.06) and reproductive period>10 years (OR=3.042; CI: 1.421- 6.512; p=0.04) were identified as independent variables that significantly increased breast cancer risk of parous women. Compared to parous women who never practised breastfeeding, total breastfeeding time>24 months decreased the risk of breast cancer (OR=0.258; CI: 0.084- 0.787; p=0.017). The results indicated that modifiable reproductive factors contribute to breast cancer risk in women included in the present study. Women's knowledge about factors such as the protective effect of breastfeeding could reduce the risk of breast cancer.