3 research outputs found
Risk factors associated with positional plagiocephaly in healthy Iranian infants: a case-control study
Abstract
Objectives
Deformation of the skull by external forces in the absence of synostosis has been defined as positional plagiocephaly. The aim of this investigation was to determine the risk factors of positional plagiocephaly (PP) in healthy Iranian infants.
Materials & Methods
This case-control study was performed on 300 healthy Iranian infants aged 8-12 weeks who referred to pediatric neurology clinic at Shahid Beheshti Hospital of Kashan. Plagiocephaly evaluations were done by using Argentaâs scale.
Results
Based on multivariate logistic regression analysis, there was significant association between PP and male gender (OR=2.26; P=0.002), head circumference (OR=1.22; P=0.006), multiple pregnancy (OR=2.55; P=0.03), abnormal presentation in uterine (OR=2.18; P=0.02), primiparity (OR=2.43; P=0.003), and supine sleep position (OR=2.97; P<0.001). But type of delivery, firmness of headrest, oligohydramnios, and prolonged labor were not correlated with PP.
Conclusions
The current investigation supports the idea that head circumference, male gender, primiparity, multiple pregnancy, supine sleep position, and abnormal presentation in uterine are correlated with a greater incidence of PP. Further investigations should be undertaken to fully understand PP and its related risk factors
Analyzing Gensini Score as a Semi-Continuous Outcome
Background: Investigators frequently encounter continuous outcomes with plenty of values clumped at zero called semi-continuous outcomes. The Gensini score, one of the most widely used scoring systems for expressing coronary angiographic results, is of this type. The aim of this study was to apply two statistical approaches based on the categorization and original scale of the Gensini score to simultaneously assess the association between covariates and the presence and severity of coronary artery disease (CAD).
Methods: We considered the data on 1594 individuals admitted to Tehran Heart Center with CAD symptoms from July 2004 to February 2008. The participantsâ baseline demographic and clinical characteristics were collected, and their coronary angiographic results were expressed through the Gensini score. The generalized ordinal threshold and two-part models were applied for the statistical analyses.
Results: Totally, 320 (20.1%) individuals had a Gensini score of zero. The results of neither the two-part model nor the generalized ordinal threshold model showed a significant association between Factor V Leiden and the occurrence of CAD. However, based on the two-part model, Factor V Leiden was associated with the severity of CAD, such that the Gensini score increased by moving from a wild genotype to a heterozygote (β = 0.44; 95% CI: 0.20-0.69 in logarithm scale) or a homozygote mutant (β = 0.70; 95% CI: 0.28- 1.12 in logarithm scale). The proportional odds assumption was not met in our data ( = 54.26; p value < 0.001); however, a trend toward severe CAD was also observed at each category of the Gensini score using the generalized ordinal threshold model.
Conclusion: We conclude that besides loss of information by sorting a semi-continuous outcome, violation from the proportional odds assumption complicates the final decision, especially for clinicians. Therefore, more straightforward models such as the two-part model should receive more attention while analyzing such outcomes
The therapeutic effect of Nâacetylcysteine as an addâon to methadone maintenance therapy medication in outpatients with substance use disorders: A randomized, doubleâblind, placeboâcontrolled clinical trial
Abstract Objective Patients with substance use disorders (SUD) under methadone maintenance therapy (MMT) are susceptible to a number of complications (psychological and metabolic disorders). Evidence studies have shown the roles of the glutamatergic system in addiction. NâAcetylcysteine (NAC) enhances extracellular glutamate, and is effective in the treatment of neuropsychiatric disorders. We assessed oral NAC as an addâon to MMT medication for the treatment of SUD. Methods In the current randomized, doubleâblind, placeboâcontrolled clinical trial, outpatients with SUD under MMT who were 18â60 years old received 2400 mg/day NAC (n = 30) or placebo (n = 30) for 12 weeks. Psychological status and metabolic biomarkers were assessed at baseline and the end of the trial. Results Compared with the placebo group, NAC treatment resulted in a significant improvement in depression score (β â2.36; 95% CI, â3.97, â0.76; p = .005), and anxiety score (β â1.82; 95% CI, â3.19, â0.44; p = .01). Furthermore, NAC treatment resulted in a significant elevation in total antioxidant capacity levels (β 72.28 mmol/L; 95% CI, 11.36, 133.19; p = .02), total glutathione (GSH) levels (β 81.84 Οmol/L; 95% CI, 15.40, 148.28; p = .01), and a significant reduction in highâsensitivity Câreactive protein levels (β â0.89 mg/L; 95% CI, â1.50, â0.28; p = .005), and homeostasis model of assessmentâinsulin resistance (β â0.33; 95% CI, â0.65, â0.009; p = .04), compared with the placebo group. Conclusion In the current study, improvement in depression and anxiety symptoms as well as some metabolic profiles with NAC treatment for 12 weeks in outpatients with SUD under MMT was detected