Significant Difference In Median Scores Research Articles

Quality of life of eye amputated patients

To evaluate eye-amputated patients' health-related quality of life, perceived stress, self-rated health, job separation because of illness or disability and socioeconomic position. Patients were recruited from a tertiary referral centre situated in Copenhagen. Inclusion criteria were eye amputation, i.e. evisceration, enucleation, orbital exenteration or secondary implantation of an orbital implant during the period 1996-2003, and participation in a previous investigation (2005). In total, 159 eye-amputated patients were included, and completed a self-administered questionnaire containing health-related quality of life (SF-36), the perceived stress scale and answered questions about self-rated health, job changes because of illness or disability and socioeconomic status. These results were compared with findings from the Danish Health Interview Survey 2005. The eye-amputated patients had significantly (p < 0.05) lower scores (poorer health) on all SF-36 subscales and more perceived stress compared to the general population. In all, 43.3% of the patients rated their health as excellent or very good compared to 52.1% of the general population. In total, 25% of the study population has retired or changed to a part-time job because of eye disease. The percentage of eye amputated patients, who were divorced or separated, was twice as high as in the general population. The impact of an eye amputation is considerable. The quality of life, perceived stress and self-rated health of many eye-amputated patients are drastically changed. Eye amputation has a marked negative influence on job separation because of illness or disability and on socioeconomic position.

An Investigation of Alternating Group Dissections in Medical Gross Anatomy

Background: Reduction in contact hours has led to the use of more efficient teaching approaches in medical education, yet the efficacy of such approaches is often not fully investigated. Purpose: This work provides a detailed analysis of alternating group dissections with peer-teaching in Medical Anatomy (MA). Methods: MA I and II percentages of the alternating (ALT) and nonalternating (NALT) groups were compared, scores of ALT subgroups (A and B) were compared, and subgroup performance on practical exam questions was compared. Results: MA I and MA II percentages indicated no significant difference in median scores (pMAI = 0.581, pMAII = 0.223) between ALT and NALT. Subgroup analysis and assessment of question types showed that student performance and ability to identify a structure were not dependent on dissection group assignment. Conclusion: Alternating dissections offered students more unscheduled time for independent learning activities, such as studying or shadowing preceptors, and reduced student-to-cadaver and student-to-faculty ratios by 50%. Alternating dissections with peer teaching were not detrimental to student performance.

The polymorphous light eruption–severity assessment score does not reliably predict the results of phototesting

Polymorphous light eruption (PLE) is a very common photodermatosis in which patient history is highly specific. Phototesting is used to confirm the diagnosis and to determine the action spectrum and the severity of this disease. In daily practice and in research studies, it would be convenient to assess disease severity by patient history only. This study aims to assess PLE disease severity via patient history and compares this with severity assessment via phototesting. Sixty-one patients with PLE were asked 10 standard questions and all were phototested. The answers to the standard questions were coded with linear scores ranging from 0 to 10. The score of each question was plotted as independent variable in a multiple linear regression model against the score of the phototest (minimal number of irradiations necessary to elicit a positive skin lesion, with a maximum of 6 irradiations) as dependent variable using an enter approach. Furthermore, the scores of the separate questions were added to form a total score, the PLE-severity assessment score (PLE-SAS). The medians of these PLE-SASs were compared with the result scores obtained by phototesting. Phototesting was done with ultraviolet A and ultraviolet B irradiation. Fifty-seven of the 61 patients had a positive test result (93%). Using the multiple linear regression model, the severity assessment by patient history (PLE-SAS) compared with the result of phototesting showed two significant contributing questions (adjusted PLE-SAS) (P < 0.05) but with a regression coefficient of 0.2. A significant difference in median scores with the severity assessment (PLE-SAS and adjusted PLE-SAS) between patients testing positive after 1-3 irradiations compared with those testing positive after 4-6 irradiations was present (P < 0.05). However, the overlap quartile range between both groups was such that the PLE-SAS and the adjusted PLE-SAS have little predictive value in individual patients. We showed that in PLE, disease severity as determined using the PLE-SAS or adjusted PLE-SAS did not reliably predict severity as assessed by phototesting. Two significant contributing questions were not discriminating enough to be used as predicting questions to assess severity. Accurate patient history proved to be a reliable method to diagnose PLE. Phototesting is useful to determine the responsible ultraviolet action spectrum and to exclude differential diagnoses like photosensitive eczema, lupus erythematosus or chronic actinic dermatitis. PLE-SAS cannot replace phototesting for determining the severity of PLE.

A NEUROLOGICAL SCORE FOR HOSPITALIZED NEONATAL FOALS

A 15‐point neurological score for foals was developed, and tested on foals (&lt;8 days old) presenting to the Marion duPont Scott Equine Medical Center (n=75) and the Royal Veterinary College (n=11). The score consists of 2 scales, which are added together to provide the total score. The points and descriptors for the first scale are as follows: Bright, alert, nursing, follows mare (0); Depressed, nursing, follows mare (1); Depressed, nursing, wanders away from mare (2); Depressed, standing, not nursing, will not follow mare (3); Recumbent, able to maintain sternal recumbency part of the time, strong suckle reflex (4); Recumbent, unable to maintain sternal recumbency, suckle reflex (5); Recumbent, no suckle reflex, responds to finger in ear (6); Recumbent, no suckle reflex, legs extended most of the time and muscles tense (7); Comatose, muscles relaxed, no response to finger in ear (8). Foals with a physical cause of recumbency (e.g., flexural deformity) are scored on this scale as if they were standing. The second scale is as follows: No seizure activity (0); Single seizure of less than 10 seconds (3); Single seizure of more than 10 seconds or two seizures of less then 10 seconds (4); Multiple seizures (5); Status epilepticus (7). All scores were assigned at admission by a single investigator.The median admission neurological scores for hospital survivors and non‐survivors, and for blood culture positive and negative foals were compared with the Mann Whitney U‐test. The correlation of admission neurological scores and arterial lactate concentrations (measured on a NOVA Stat profile M or CCX analyzer) and mean arterial pressure (measured indirectly with a tail cuff) was tested with Spearman's rho coefficient. Analysis of these data was performed using SPSS version 12. Results for all tests were considered significant if the p value was less than 0.05. The median neurological score on admission of all 86 foals was 4, and the range was from 0 to 12. The median score of survivors (2) was less than that of non‐survivors (5) (p&lt;0.001; n=86). There was no significant difference in median score between blood culture positive (4) and negative (3) foals (p=0.109; n=84). The neurological score was moderately correlated with admission lactate concentration (correlation coefficient 0.528, p&lt;0.001, n=68), but only weakly correlated with mean arterial pressure (correlation coefficient −0.285, p=0.011, n=78). This neurological score is statistically associated with clinically important parameters (hospital survival, blood lactate concentration), and warrants further study, including investigation of inter‐observer variation in scoring.

Sphincter-sparing surgery after preoperative radiotherapy for low rectal cancers: feasibility, oncologic results and quality of life outcomes.

The present study assesses the choice of surgical procedure, oncologic results and quality of life (QOL) outcomes in a retrospective cohort of 53 patients with low-lying rectal cancers (within 6 cm of the anal verge) treated surgically following preoperative radiotherapy (RT, median dose 45 Gy) with or without concomitant 5-fluorouracil. QOL was assessed in 23 patients by using two questionnaires developed by the QOL Study Group of the European Organization for Research and Treatment of Cancer: EORTC QLQ-C30 and EORTC QLQ-CR38. After a median interval of 29 days from completion of RT, abdominoperineal resection (APR) was performed in 29 patients (55%), low anterior resection in 23 patients (20 with coloanal anastomosis) and transrectal excision in one patient. The 3-year actuarial overall survival and locoregional control rates were 71.4% and 77.5% respectively, with no differences observed between patients operated by APR or restorative procedures. For all scales of EORTC QLQ-C30 and EORTC QLQ-CR38, no significant differences in median scores were observed between the two surgical groups. Although patients having had APR tended to report a lower body image score (P = 0.12) and more sexual dysfunction in male patients, all APR patients tended to report better physical function, future perspective and global QOL. In conclusion, sphincter-sparing surgery after preoperative RT seems to be feasible, in routine practice, in a significant proportion of low rectal cancers without compromising the oncologic results. However, prospective studies are mandatory to confirm this finding and to clarify the putative QOL advantages of sphincter-conserving approaches. © 2000 Cancer Research Campaign