Matched Case-control Study Research Articles

Comparison of failure rates between full-barium and striped barium distal shunt catheters: a matched case–control study

PurposeWe hypothesize that distal shunt catheters fully impregnated with barium are more prone to failure compared to distal catheters with only a barium stripe. We sought to evaluate this distinction using a matched case–control study.MethodsPatient records over an 8-year period were queried for distal shunt revisions for fracture or disconnection (cases). A control group of patients with confirmed functioning distal catheters was queried from the same period and matched based on patient age at exploration/revision. Data were collected via chart review, including demographics, hydrocephalus etiology, distal catheter type, and patient age at revision. Independent T-test, chi-squared, and binomial logistic regression analyses were performed.ResultsThere were 194 patients included in the study: 97 patients with distal shunt revision and 97 controls with a functional distal shunt system. The mean patient age at distal catheter revision was 12.87 ± 4.59 years, and the mean patient age of the control group was 12.81 ± 4.59 years. The most common etiology was premature intraventricular hemorrhage (32%). Of the distal failures, 41.2% had fully impregnated barium catheters, while 58.8% had striped barium catheters. Of the control group, 76/97 (78%) patients had barium-striped distal shunt catheters and 21/97 (22%) had fully impregnated catheters. Logistic regression analysis showed that fully impregnated catheters were more likely than striped barium to fail, p = 0.004 (OR = 2.54, 95% CI 1.35–4.77).ConclusionIn a matched case–control format, odds of failure of fully impregnated distal catheters were 2.54 greater than striped barium catheters.

An evaluation study of direct economic losses from surgical site infections in adults: structural equation modeling

IntroductionSurgical site infection (SSI) represents a significant postoperative complication, resulting in extended hospital stays and substantial economic burdens. Previous research on the direct economic impact of SSIs using recursive systems modeling is limited. This study aims to quantify the direct economic losses attributable to SSIs and to dissect the various factors to these losses.MethodsA retrospective 1:1 matched case–control study was conducted from January 2023 to March 2024 in three tertiary hospitals in Xinjiang, China. Patients with SSIs were matched on a 1:1 basis by hospital, department, age (±5 years), sex, primary diagnosis, and procedure with controls to form case and control groups. Wilcoxon Signed Ranks Test was utilized to quantify the direct economic loss from SSIs. Influencing factors were analyzed using a recursive system model.ResultsAmong the 74,258 patients surveyed, 226 developed SSIs, resulting in an infection rate of 0.3%. The total direct economic loss from SSIs at three hospitals was $467,867, with an average loss of $1,364.37 per SSI patient. SSI patients experienced hospital stays 11 days longer than uninfected patients. Multivariate linear regression identified the duration of hospital stay, catheter and ventilator usage, age, number of surgeries, and duration of antibiotic treatment as influencing factors. Recursive system modeling revealed the indirect contributions of the number of surgeries (indirect effect: 0.074), antibiotic use for 17–36 days (indirect effect: 0.063) and ≥ 37 days (indirect effect: 0.045), and debridement procedures (indirect effect: 0.054), as well as the direct contributions of hospital days (direct effect: 0.276), indwelling catheter days (direct effect: 0.260), ventilator days (direct effect: 0.221), and age (direct effect: 0.182).ConclusionRecursive system modeling helped identify the key factors influencing the economic losses from SSIs. These findings provide a theoretical basis for healthcare departments to develop targeted policies.

Clonal Hematopoiesis of Indeterminant Potential as a Predictor of Colorectal Cancer Risk: Insights from the UK Biobank Cohort.

Clonal hematopoiesis of indeterminate potential (CHIP) has been shown to be associated with the occurrence of solid tumors, but its relationship with colorectal cancer still needs to be studied. We conducted a prospective matched case-control study using data from the UK Biobank, including 5,310 incident colorectal cancer (CRC) cases and 26,550 controls matched for age, sex, and body mass index (BMI). Analysis of the UK Biobank data revealed that the presence of CHIP was associated with an increased risk of CRC. The odds ratio (OR) for CRC in the presence of CHIP was 1.20 (P = 0.006). This association remained significant even after excluding participants with a family history of bowel cancer (multivariate OR, 1.19, P = 0.007). Subgroup analyses demonstrated that CHIP independently increased the risk of CRC in females (multivariate OR, 1.25, P = 0.018) and in individuals older than 60 years (multivariate OR, 1.17; P=0.046). Gene-specific analyses revealed that mutations in TET2 and ATM were particularly significant in relation to CRC risk, with OR of 1.62 (P = 0.002) for TET2 and 2.98 (P < 0.001) for ATM. Our findings indicate that CHIP is associated with an increased risk of CRC, particularly in individuals over 60 years of age or in females. Screening for CHIP in the population may improve the early detection and diagnosis rates of CRC.

Green space at school and attention in primary school children in Belgium: a stratified matched case-control study

Green space at school and attention in primary school children in Belgium: a stratified matched case-control study

Association of plasma BDNF and MMP-9 levels with mild cognitive impairment: a matched case-control study

The prevalence of Alzheimer’s disease (AD) is on the rise globally, and everyone who develops AD eventually experiences mild cognitive impairment (MCI) first. Timely intervention at an early stage of the disease may mitigate disease progression. Recent studies indicate that BDNF and MMP-9 play a significant role in the pathogenesis of AD. Therefore, this study aims to ascertain whether there are differences in plasma BDNF and MMP-9 levels between individuals with mild cognitive impairment due to AD and those with normal cognition, and to analyze the factors influencing mild cognitive impairment.This case-control study included 102 individuals with mild cognitive impairment and 102 controls, matched by age and sex. Participants completed a series of questionnaires, neuropsychological assessments, and clinical examinations. Plasma concentrations of BDNF and MMP-9 of the participants were quantified using ELISA. Subsequently, the factors influencing MCI were analyzed using univariate and multivariate logistic regression. The differences in plasma BDNF levels, MOCA total scores, and scores in various cognitive domains (including visuospatial and executive abilities, abstract thinking, attention, language, naming, and delayed memory) between the MCI and the control groups showed statistically significant (p < 0.05). Logistic regression analysis revealed that plasma BDNF levels and years of formal education were significantly negatively associated with MCI. This study indicates that plasma BDNF and years of formal education are protective factors influencing cognitive function.

Transcriptome of capsular contracture around breast implants mimics allograft rejection: a matched case-control study.

Capsular contracture is a frequent and severe complication following breast implant surgery. Although several theories on the pathophysiology exist, the exact molecular mechanisms remain unclear. This study aimed to identify the specific genes, signaling pathways, and immune cells associated with capsular contracture. Breast implant capsule biopsies were collected from women undergoing implant replacement after breast augmentation. Patients with capsular contracture (Baker III/IV) and healthy controls (Baker I) were included in equal numbers and matched based on implant brand, surface, plane, and rupture status. Whole transcriptome RNA-sequencing was used for gene expression profiling. We analyzed biopsies from 51 breasts of 50 women, revealing 1,500 differentially expressed genes based on capsular contracture status. Our findings revealed that capsular contracture signaling pathways mimic allograft rejection with activation of both the innate immune system (e.g., IL1A/B, CXCl9, TREML4, CR1) and the adaptive immune system (e.g., CD80 and IFN-γ). Capsular contracture was associated with increased expression of macrophages, CD4+ T cells, B cells, and plasma cells with upregulation of several immunoglobulin genes (e.g., IGHD/IGHE). Moreover, several fibrosis-related genes were significantly upregulated (e.g., MMP1, MMP1, MMP12) and downregulated (TIMP4) in breasts with capsular contracture. The results indicate that B cells play a more crucial role in the development of capsular contracture than previously assumed. The disease mechanism resembles allograft rejection, indicating that capsular contracture is a form of immunological rejection of the breast implant. This study identified key genes associated with capsular contracture, suggesting new drug candidates e.g., MMP1 inhibitors to improve breast implant surgery outcomes. Synergizing research on allograft rejection and capsular contracture could also lead to new treatment strategies.

Haptoglobin 2-2 genotype is associated with increased risk of cardiovascular disease in patients with rheumatoid arthritis: a matched case-control study.

Traditional risk factors do not fully explain the increased risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA). The Haptoglobin (Hp) 2-2 genotype confers a lower anti-oxidant and higher inflammatory effect on the vasculature compared to the non-Hp 2-2 genotype. This study investigates the association of the Hp genotype with CVD in patients with RA. Data from 69 RA patients with CVD and 207 sex- and ethnicity-matched RA patients without CVD, collected from 1 January 2000 to 31 December 2020, were retrieved from the Tan Tock Seng Hospital RA Registry. CVD was examined against demographics, clinical and laboratory variables in univariate models. Associations between the Hp genotypes and CVD were analyzed using conditional logistic regression. We studied 276 patients (65.2% female, 82.6% Chinese, median age 60.9 years). Most participants were in low disease activity or remission (79.3%). The Hp 2-2 genotype was present in 49.6% (137/276). In the group with CVD, the prevalence of the Hp 2-2 genotype was 50.9% (29/57) in the Chinese, 100% (5/5) in the Indians, and 28.6% (2/7) in the Malays. In the non-CVD group, the respective prevalence was 46.8% (80/171), 66.7% (10/15), and 52.4% (11/21). In univariate analysis, the matched odds ratio (OR) of the Hp 2-2 genotype for CVD in RA was 1.34 [95% confidence interval (CI): 1.22-1.47; p < 0.001]. The Hp 2-2 genotype was significantly associated with CVD (adjusted matched OR: 1.13; 95% CI: 1.01-1.27; p = 0.033) in the multivariate logistic regression model after adjusting the confounding factors, including age, smoking, diabetes, hypertension, hyperlipidemia, anti-CCP autoantibodies, and disease activity. The Hp 2-2 genotype is associated with an increased risk of CVD in patients with RA in this multi-ethnic cohort.

Association of early-onset diabetes with socioeconomic, and health factors: a matched case-control study controlling for age, gender, and BMI.

This study examines the link between early-onset diabetes and health factors in South Korean young adults (20-39) using data from the Korea National Health and Nutrition Examination Survey (2010-2020). A matched case-control study was conducted in 2022 with 103 patients with diabetes and 103 controls, matched by age, gender, and BMI. All data, including socioeconomic status (income, education, occupation), health behaviors (smoking, alcohol consumption, physical activity), and medical histories, were extracted from the KNHANES database. We analyzed socioeconomic status, health behaviors, and medical histories using descriptive statistics, chi-square tests, and binary logistic regression. The study revealed that educational attainment and economic status are substantial predictors of diabetes, with those holding only a high school diploma showing a nearly threefold increased risk compared to college graduates (OR = 2.986; 95% CI = 1.334-6.687). Additionally, participants with a higher number of chronic diseases (OR = 3.534; 95% CI: 1.547-8.073) and those who felt unwell in the past two weeks (OR = 4.010; 95% CI: 1.388-11.585) also demonstrated significantly increased odds of diabetes. And having a parent with diabetes was an exceptionally strong predictor, with these participants having a significantly increased risk of diabetes (OR = 47.022; 95% CI = 4.206-525.704). The study emphasizes that improving educational and economic conditions, coupled with targeted screening programs for individuals with a family history of diabetes, may be effective in curbing the tide of early-onset diabetes in South Korea. These strategies may have profound implications for public health policies aimed at mitigating the risk in this increasingly vulnerable group.

Gabapentinoid use and the risk of fractures in patients with inflammatory arthritis: nested case–control study in the Clinical Practice Research Datalink Aurum

BackgroundGabapentinoids are increasingly prescribed in inflammatory arthritis (IA), despite no trial evidence for efficacy at managing pain in this population. Observational studies in non-IA populations suggest gabapentinoids are associated with fractures but are limited by methodological heterogeneity/potential residual confounding. Patients with IA generally have an increased risk of fracture so may be particularly vulnerable. We examined the relationship between fractures and gabapentinoids in patients with IA who had all been prescribed a gabapentinoid at some point (to minimise confounding by indication).MethodsOur matched case–control study used linked national data from English primary care (Clinical Practice Research Datalink Aurum) and Hospital Episode Statistics. A cohort was constructed of adults with IA, contributing data 01/01/2004–31/03/2021, and ever prescribed oral gabapentinoids. Cases with an incident fracture post-cohort inclusion were ascertained and 1:5 risk set-matched (on age/gender/gabapentinoid type) with controls. Gabapentinoid prescription exposure was categorised as follows: (a) current (overlapping with fracture date); (b) recent (ending 1–60 days pre-fracture); and (c) remote (ending > 60 days pre-fracture). Conditional logistic regression models determined ORs with 95% CIs for fractures with current or recent vs. remote gabapentinoid use, adjusting for confounders.ResultsA total of 2485 cases (mean age 63.0 years; 79.4% female) and 12,244 controls (mean age 62.7 years; 79.6% female) were included. Of cases: 1512 received gabapentin, 910 pregabalin, and 63 both drugs; 65.6% were remote, 5.5% recent, and 28.9% current users. In adjusted models, current gabapentinoid use had an increased risk of fracture (OR vs. remote: 1.36 [95% CI 1.22, 1.51]). Similar associations were seen with gabapentin (OR 1.38 [1.19, 1.60]) and pregabalin (OR 1.40 [1.18, 1.66]). Similar or higher levels of association were seen for all gabapentin/pregabalin doses except moderate/very high dose gabapentin. Associations were strongest in those starting gabapentinoids more recently.ConclusionsOur study suggests a modest association between current gabapentinoid use and fractures in patients with IA, after accounting for measured and time-invariant unmeasured confounding. Whilst other unmeasured confounding remains possible, given the absence of evidence for gabapentinoid efficacy in patients with IA who are particularly vulnerable to fractures, this highlights a need for efforts to deliver safer gabapentinoid prescribing in this population.

Investigating the relationship between opium use and coronary slow flow: a propensity score matched case–control study

ObjectivesRecent studies have suggested a potential link between opium consumption and microvascular dysfunction in coronary arteries, which may contribute to the development of coronary slow-flow syndrome. This study aims to...

Long-Term Evaluation of Ocular Surface and Meibomian Gland Function after Laser Assisted in Situ Keratomileusis surgery.

Laser-assisted in Situ Keratomileusis (LASIK) is a common refractive surgery. But it may lead to temporary dry eye due to reversible damage to the corneal sub-basal nerve plexus. However, chronic ocular surface changes are unclear. This study reports the ocular surface changes, partial blinking rate, and meibomian gland status in eyes that underwent LASIK for at least 48 months. Cross-sectional, matched case-control comparison study, including 48 post-LASIK patients and 48 sex-, age-, smoking-, and axial length-matched healthy controls, recruited from a community eye screening program. Outcome measures include anterior segment clinical findings, keratographic and meibographic imagings. Totally 48 right eyes of 48 post-LASIK Chinese patients (39 females, 2 smokers) were analyzed with 48 right eyes of 48 matched healthy controls. The age on ocular surface examination was 50±11 years, and the axial length 26±1mm. Post-LASIK eyes had a lower quality of meibum (P=0.008) compared to healthy controls. Post-LASIK eyes were associated with a shorter Schimer test (P=0.03). The ocular surface disease index (OSDI) score was higher in post-LASIK patients (P=0.00001). Other anterior segment examination parameters, partial blinking rate, meibomian gland dropout, lipid layer thickness, non-invasive tear break-up time, and tear meniscus height were comparable between the 2 groups. Up to 75% of post-LASIK patients complained of chronic dry eye symptoms. Post-LASIK eyes were associated with a reduced aqueous tear production. Post-LASIK patients with chronic dry eye symptoms should have comprehensive ocular surface evaluation. Treatment should be commenced in patients with poor tear film stability.

Factors associated with the admission of moderate to late preterm and term neonates within 72 hours of birth at Dedza and Mangochi District Hospitals, Malawi: a matched case-control study

ObjectiveTo investigate the demographic characteristics, maternal, and perinatal factors associated with the hospitalization of moderate to late preterm and term neonates within 72 h of birth in the Dedza and Mangochi districts of Malawi.MethodsThis case-control study was conducted with one-to-one matching for age, location, and sex. Cases were sick neonates who were admitted in the Sick Intensive Neonatal Care Unit (SINCU) within 72 h of life, while controls were non-sick neonates delivered within two weeks of the birth dates of cases. Prenatal data were extracted from case files, while other maternal practices and demographic characteristics were obtained by interviewing primary care takers or legal guardians after obtaining consent. Descriptive analyses and logistic regression were used to identify factors associated with hospitalization of moderate to late preterm and term neonates within 72 h of birth.ResultsApplication of tetracycline eye ointment (AOR: 0.41, 95% CI: 0.20–0.82, p = 0.012) applying chlorhexidine to the umbilical cord stump (AOR: 0.30, 95% CI: 0.10–0.88, p = 0.027), and stimulation resuscitation (AOR: 0.20, 95% CI: 0.05–0.78, p = 0.020) were associated with a reduced odd of hospitalization. An increased odds of hospitalization was significantly associated with low birth weight (AOR: 10.48, 95% CI: 4.25–25.89, p = 0.001), Apgar score < 5 (AOR: 5.0, 95% CI: 2.14–11.63, p = 0.001), suctioning resuscitation (AOR: 2.82, 95% CI: 1.17–6.83, p = 0.021), and resuscitation using O2 (AOR: 4.23, 95% CI: 1.32–13.56, p = 0.015). Maternal factors associated with reduced odds of hospitalization included the mother testing positive and successfully treated for syphilis antenatally (AOR: 0.06, 95% CI: 0.02–0.18, p = 0.001) and the mother being married (AOR: 0.39, 95% CI: 0.16–0.93, p = 0.34). Maternal factors associated with an increased odds of hospitalization include premature rupture of membranes (AOR: 2.49, 95% CI: 1.12–5.52, p = 0.025) and presence of meconium stain during delivery (AOR: 3.14, 95% CI: 1.63–6.06, p = 0.001).ConclusionThe research findings indicate that several interventions significantly reduce infections in neonates within their initial 72 h of life. These include the application of ophthalmic ointment to all neonates, utilization of chlorhexidine on the umbilical cord stump, and provision of antenatal treatment for syphilis and HIV in infected mothers. Conversely, certain factors increase the likelihood of neonatal morbidity and potential hospitalization during this critical period. These risk factors include low birth weight, a low Apgar score, and conditions necessitating suctioning or oxygen resuscitation at birth. Furthermore, infants born to mothers who experienced premature rupture of membranes or meconium-stained amniotic fluid during parturition are more susceptible to infectious conditions, which may necessitate hospitalization within the first 72 h postpartum. We recommend that stimulation be used as the core procedure for resuscitation, whereas suctioning should be used with caution and only when it is essential. Infection prevention measures should always be adhered to during all procedures on neonates. We recommend intensifying HIV and syphilis testing and treating during the antenatal period to reduce neonatal infection.

Symptoms Prior to Diagnosis of Multiple Sclerosis in Individuals Younger Than 18 Years

A growing body of literature suggests the presence of a prodromal period with nonspecific signs and symptoms before onset of multiple sclerosis (MS). To systematically assess diseases and symptoms diagnosed in the 5 years before a first MS- or central nervous system (CNS) demyelinating disease-related diagnostic code in pediatric patients compared with controls without MS and controls with another immune-mediated disorder, juvenile idiopathic arthritis (JIA). This population-based, matched case-control study included children and adolescents (aged <18 years) in Germany with statutory health insurance from January 2010 to December 2020. The study population consisted of 3 groups: case individuals with MS, control individuals without MS, and control individuals with JIA. Data were analyzed from November 2023 to April 2024. Diagnoses coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification (ICD-10-GM). The main outcome was incident cases of MS, defined as the first confirmed diagnosis of MS (ICD-10-GM code G35) in 1 quarter between 2013 and 2020 and at least 1 additional diagnosis in the following quarters. In total, 163 ICD-10-GM codes before a first MS diagnosis were assessed using univariable and multivariable logistic regression analyses. The study population consisted of 1091 children and adolescents with MS, 10 910 without MS, and 1068 with JIA. Of the children and adolescents with MS, 788 (72.2%) were female. Mean (SD) age at disease diagnosis was 15.7 (1.7) years. Nine ICD-10-GM codes were present more frequently among children and adolescents with MS in the 5 years before their first MS diagnosis than among controls without MS: obesity (adjusted odds ratio [AOR], 1.70; 95% CI, 1.42-2.02), disorders of eye refraction and accommodation (AOR, 1.26; 95% CI, 1.09-1.47), visual disturbances (AOR, 1.31; 95% CI, 1.10-1.55), gastritis and duodenitis (AOR, 1.35; 95% CI, 1.08-1.70), patella disorders (AOR, 1.47; 95% CI, 1.13-1.90), heartbeat abnormalities (AOR, 1.94; 95% CI, 1.27-2.96), flatulence (AOR, 1.43; 95% CI, 1.01-2.01), skin sensation disturbances (AOR, 12.93; 95% CI, 8.98-18.62), as well as dizziness and giddiness (AOR, 1.52; 95% CI, 1.22-1.89). Four of these ICD-10-GM codes were significantly more prevalent in children and adolescents with MS than in controls with JIA: obesity (AOR, 3.19; 95% CI, 2.03-5.02), refraction and accommodation disorders (AOR, 3.08; 95% CI, 2.33-4.08), visual disturbances (AOR, 1.62; 95% CI, 1.13-2.33), and skin sensation disturbances (AOR, 27.70; 95% CI, 6.52-117.64). In this population-based, matched case-control study, children and adolescents with MS had diverse metabolic, ocular, musculoskeletal, gastrointestinal, and cardiovascular symptoms, signs, or diagnoses within 5 years before their first MS diagnosis. Better characterization of early symptoms and/or risk factors, comorbid disorders, and possible prodromal features of MS may have considerable implications for early recognition and subsequent progression of the disease.

Oral microbiota in preschoolers with rampant caries: a matched case–control study

Rampant caries is identified by rapid onset, severe decay affecting multiple surfaces, and early pulp infection. This case–control study was conducted to investigate the disparities in oral microbiota between children affected by rampant caries and their caries-free counterparts. A total of 88 preschool children, with matched distribution of sex and age in both the case and control groups, participated in this study. Children’s oral health–related behaviors were reported by parents, salivary pH levels were assessed using a portable pen-type pH meter, and supragingival dental plaque was analyzed by 16S rRNA gene sequencing. Children with rampant caries exhibited lower salivary pH levels, poorer toothbrushing habits, and more frequent consumption of sugary snacks. Veillonella, enriched in caries-free children, showed a positive correlation with salivary pH levels and a negative correlation with candy consumption. Conversely, Fusobacterium and Neisseria, more abundant in children with rampant caries, positively correlated with the frequency of candy consumption. Furthermore, Streptococcus mutans, Porphyromonas gingivalis, and Bacteroides acidifaciens were identified as potential oral microbiome markers for differentiating preschoolers with rampant caries from their caries-free peers. B. acidifaciens, typically found in the gut, has been rarely reported in the field of oral health. More well-designed cohort studies are recommended to elucidate the mechanisms through which gut microbiota influences rampant caries in pediatric patients and offer insights into effective strategies for caries management in young children.Key points• Lower salivary pH levels in children with rampant caries.• Biomarkers for predicting rampant caries.• Impact of oral health–related behaviors on oral microbiota.

Postvoid Residual Volume Correlates With Bladder Outlet Obstruction and Not With Detrusor Contraction Strength Parameters in Women: A Matched Case-Control Study.

To compare voiding parameters in women with and without increased postvoid residual (PVR) volume, to correlate these parameters with PVR volume and PVR percentage, and to describe their ability to predict an increased PVR volume. Retrospective cross-sectional study of urodynamics data prospectively acquired from consecutive symptomatic women over a 5-year period. Patients with spinal cord disorders and with abdominal straining during voiding (abdominal pressure ≥10 cm H2O over baseline at maximum flow rate [Qmax]) were excluded. Increased PVR volume was defined as ≥50 mL. Patients with and without increased PVR volume were matched by age, presence of urodynamic stress urinary incontinence and premicturition bladder volume. Female bladder outlet obstruction (BOO) index (female-BOOI), urethral resistance (UR), projected isovolumetric pressure 1 (PIP1), and relative BOO indexes (female-BOOI/PIP1 and UR/PIP1 ratios) were calculated. Linear regression analysis was applied to correlate the voiding indexes with PVR volume and PVR percentage. The area under the curve (AUC) of the receiver operating characteristic (ROC) analysis was calculated to describe diagnostic accuracy of these indexes for increased PVR volume. One-hundred ten women with mean age 65.9±13.7 (range, 20-87) years were included. All voiding parameters were significantly different between women with and without increased PVR volume, except for PIP1. Female-BOOI showed the best correlation with increased PVR volume (R2=0.2509, P<0.001) and PVR percentage (R2=0.3677, P<0.001). PIP1 showed no correlation. Relative BOOI indexes did not improve these correlations. ROC curve analyzes confirmed that female-BOOI and UR had good ability to predict increased PVR volume (AUC=0.841 and AUC=0.856, respectively). PVR volume and PVR percentage correlated with BOO but not to detrusor contraction strength parameters in symptomatic women that void without abdominal straining. The results of this study contribute to the understanding of the pathophysiology of increased PVR volume in women.

Contribution of domestic animals’ feces to the occurrence of diarrhoea among children aged 6–48 months in Sidama region, Ethiopia: a laboratory-based matched case-control study

BackgroundIn developing countries, due to improper management of domestic animals’ exposures, under-five (U5) children have been affected by diarrhoea. However, there is no evidence that shows the presence of diarrhoea-causing...

The diagnostic value of an upright chest radiograph in diagnosing acromioclavicular joint dislocation.

A chest radiograph (CXR), whether supine or upright, is the primary tool for assessing blunt thoracic and abdominal trauma. Thoracic injuries often come with shoulder girdle injuries such as scapular or clavicular fractures, and acromioclavicular joint (ACJ) dislocations. The Zanca view is standard for diagnosing ACJ dislocation. While upright CXR can screen for high-grade ACJ dislocation, its diagnostic value in these cases remains unreported. This study aimed to determine the diagnostic value of upright CXR, compared to the standard Zanca view in diagnosing ACJ dislocation. Upright CXRs from 70 patients with ACJ dislocation were matched 1:1 by age and gender with 70 control CXRs from individuals with no shoulder disorders. A total of 140 CXRs were randomized and blinded to clinical information, then assessed for coracoclavicular distance (CCD) differences by two independent evaluators. The study compared the diagnostic accuracy of the upright CXR against the Zanca view, the gold standard. Interobserver and intraobserver agreements on ACJ dislocation categorization using upright CXRs were also measured. There were 55 male and 15 female patients, with an average age of 46 in both cases and controls. In the disease group, the percentage of CCD difference compared to the unaffected side (DCCD) was not statistically significantly different (p value​=​0.052) between the upright CXR and Zanca view. The median of DCCD was 121.64 (interquartile range​=​69.45, 159.76) and 135.57 (interquartile range​=​88.64, 200.18) in upright CXR and Zanca view, respectively. Totally, 140 CXRs, Zanca as the gold standard, the upright CXRs with the definition of an abnormal CCD difference of ≥25%, revealed 95.71% sensitivity, 85.71% specificity, 6.7 of the positive likelihood ratio, and 0.05 of the negative likelihood ratio. The accuracy was 90.71%. The intraobserver reliability was 94.29% agreement and 0.94 of weighted kappa coefficient (95% confidence interval [CI]​=​0.89-0.98). The interobserver reliability was 95.7% agreement and 0.95 with a weighted kappa coefficient (95% CI​=​0.92-0.99). Upright CXR is a reliable diagnostic screening tool for ACJ dislocation, particularly for displacements of ≥25%. It provides high sensitivity and specificity compared to the Zanca view, with nearly perfect interobserver and intraobserver reliabilities. This was a retrospective matched case-control study.

Phase angle as a predictor of mortality in elderly patients with multimorbidity: a matched case-control study.

We aimed to investigate the value of phase angle (PhA) as a prognostic marker for mortality in elderly patients with multimorbidity using a matched case-control study. This study was conducted with patients 70 years of age or older with multimorbidity at Beijing Geriatric Hospital. The body composition parameters including PhA were determined using bioelectrical impedance analysis. Common hematological indices were determined using blood tests. The outcome was mortality 1 year after admission. A multivariate logistic regression analysis was employed to identify independent risk factors for death. A receiver-operating characteristic (ROC) curve analysis was used to evaluate the performance of risk factors in predicting death. A total of 30 deceased patients were included in the death group. The living patients were matched 1:1 with the deceased patients in age, gender, and Cumulative Illness Rating Scale-Geriatric score to generate a survival group of 30. The death group exhibited higher levels of blood urea nitrogen and extracellular water to total body water ratio and lower levels of PhA and prealbumin than the survival group. The multivariate logistic regression analysis identified PhA as the only independent risk factor for mortality (OR = 3.296, 95% CI [1.201-9.044], P < 0.05). For the ROC curve analysis, PhA had an area of 0.854 (95% CI [0.755-0.955], P = 000). The Youden index was 0.700, and the optimal cutoff value associated with the Youden index was 2.45°. PhA serves as a good prognostic marker for mortality in elderly patients with multimorbidity.

Left Atrial Size and Strain in Hypertensive Children Compared to Age-, Sex-, and Race/Ethnicity-Matched Controls.

Left atrial (LA) volume and peak longitudinal strain (LA strain) are indicators of left ventricular (LV) diastolic function in adults, but little is known about LA volume and strain in pediatric patients with hypertension (HTN). We evaluated LA volume and strain in pediatric cases with HTN compared to age-, sex-, and race/ethnicity-matched controls. This was a retrospective matched case-control study of patients who presented to the HTN clinic at CHOP from 12/2011 to 9/2018. Coarctation of the aorta, cardiomyopathy or heart transplantation cases were excluded. HTN was defined by an abnormal ambulatory blood pressure result. LA volume was measured by biplane area-length method and indexed to body surface area (BSA). LA strain and strain rate were measured using TOMTEC® software. Left ventricular mass index (LVMI) was measured by M-mode and the 5/6 area-length method indexed to height2.7. LV global longitudinal strain (LV GLS) was measured during the echocardiographic examination on the GE ultrasound machine for cases and offline using TOMTEC® software for controls. Measurements were compared using Chi-square, McNemar, or Wilcoxon signed rank tests. We included 47 cases and 47 controls. There was no difference in LA volume z-scores (-1.9 vs. -0.9, p = 0.068), LA strain (37.8% vs. 38.0%, p = 0.735) or LA strain rate (1.4 vs. 1.5, p = 0.852) in cases compared to controls. LVMI by M-mode and 5/6 area-length method was higher in cases compared to controls (40.0 vs. 33.7g/m2.7, p < 0.001 and 29.9 vs 24.4g/m2.7, p = < 0.001, respectively). LV GLS was decreased (less negative) in cases compared to controls. In summary there was no difference in LA volume or LA strain in cases compared to controls. In cases, LVMI was significantly elevated and LV GLS was significantly decreased, which may be the first response to HTN, prior to affecting LA size.

Pigmented pathological type and depth of follicular extension as predictors of treatment failure in 5-aminolevulinic acid photodynamic therapy for actinic keratosis: A retrospective, matched nested case-control study

Background: While 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) is widely used to treat actinic keratosis (AK), treatment resistance and recurrence after ALA-PDT remain significant clinical challenges. Methods: This single-site, retrospective, matched case-control study included 119 patients with histologically confirmed AK to identify clinical and pathological predictors for effectiveness of ALA-PDT. Patients received four consecutive ALA-PDT sessions at intervals of 1 or 2 weeks. Initial complete clearance (ICC) at 3 months and sustained complete clearance (SCC) at 12 months were assessed. Case patients were those with treatment-resistant or recurrent AK, matched with controls based on age, sex, and the treatment date. Baseline characteristics were collected and compared between the case and control groups. Results: ICC at 3 months was achieved in 106 out of 119 patients (89.07%), with 65 out of 82 patients (79.27%) maintaining SCC at 12 months. Pigmented AK emerged as an independent predictor of treatment resistance (OR=44.05, p=0.00). Furthermore, follicular extension to the isthmus or deeper was significantly associated with recurrence within 1 year (OR=17.26, p=0.00). Conclusion: Pigmented AK and AK with follicular extension to the isthmus or deeper may serve as independent predictors of treatment resistance and recurrence, respectively. These findings highlight the importance of these specific features when assessing prognosis and tailoring treatment strategies for individual AK patients.