Computer evaluation of statistical procedures, and a new quality-control statistical procedure

I describe a program for definitive comparison of different quality-control statistical procedures. A microcomputer simulates quality-control results generated by repetitive analytical runs. It applies various statistical rules to each result, tabulating rule breaks to evaluate rules as routinely applied by the analyst. The process repeats with increasing amounts of random and systematic error. Rate of false rejection and true error detection for currently popular statistical procedures were comparatively evaluated together with a new multirule procedure described here. The nature of the analyst's response to out-of-control signals was also evaluated. A single-rule protocol that is as effective as the multirule protocol of Westgard et al. (Clin Chem 27:493, 1981) is reported.     

Australian workers with back injury: a statistical overview

This paper reviews international and Australian data concerning the occurrence of back injuries amongst the labour force. Analyses of Australian Bureau of Statistics data for the period 1977 to 1986 revealed substantial differences between Australian states in their rates of back injury claims for work injuries, with a decline in rates over the ten years surveyed. Analyses of WorkCare data from the State of Victoria in Australia revealed that claimants with back injury claims of greater than 12 months standing were very costly. A total of 8,633 claimants accounted for 68.7% of all payments for back injury ($362 million out of a total of $527 million) when these claimants represented only 10.7% of all back injury claimants for the period September 1985 to May 1989. Substantial variations were found in claim rates across occupations and age levels. An almost linear (r = 0.98) association was found between age and proportion of long term claimants at each age level. It is suggested that these data could be used to identify 'at risk' groupings with a view to the implementation of preventive measures.     

2型糖尿病合并尿路感染417例临床分析

目的探讨近10年糖尿病患者尿路感染临床特点的变化。方法选择417例2型糖尿病合并尿路感染的住院患者。以2003年为界,根据入院时间分为A组和B组,对比两组一般资料、尿路感染危险因素和病原菌的分布情况。结果两组均以女性多见。与A组比较,B组年龄更小、分布更分散、糖尿病病程更短,病程分布以0—4年组最多（18．52％vs42．42％）差异均有统计学意义（t分别=2．62、24．67,P均〈0．05）。对真性菌尿影响有统计学意义的变量是“卧床”（OR：9．15;95％CI：1．77—47．24）。大肠埃希菌分离率最高（32．50％）。结论近年来糖尿病患者尿路感染的发病呈年轻化趋势,在较短糖尿病病程患者中也有增加,长期卧床是真性菌尿的独立危险因素。     

Interpreting scan data acquired from multiple scanners: a study with Alzheimer's disease

Large, multi-site studies utilizing MRI-derived measures from multiple scanners present an opportunity to advance research by pooling data. On the other hand, it remains unclear whether or not the potential confound introduced by different scanners and upgrades will devalue the integrity of any results. Although there are studies of scanner differences for the purpose of calibration and quality control, the current literature is devoid of studies that describe the analysis of multi-scanner data with regard to the interaction of scanner(s) with effects of interest. We investigated a data-set of 136 subjects, 62 patients with mild to moderate Alzheimer's disease and 74 cognitively normal elderly controls, with MRI scans from one center that were acquired over 10 years with 6 different scanners and multiple upgrades over time. We used a whole-brain voxel-wise analysis to evaluate the effect of scanner, effect of disease, and the interaction of scanner and disease for the 6 different scanners. The effect of disease in patients showed the expected significant reduction of grey matter in the medial temporal lobe. Scanner differences were substantially less than the group differences and only significant in the thalamus. There was no significant interaction of scanner with disease group. We describe the rationale for concluding that our results were not confounded by scanner differences. Similar analyses in other multi-scanner data-sets could be used to justify the pooling of data when needed, such as in studies of rare disorders or in multi-center designs.     

Variations in practice patterns regarding constipation in children with urinary tract infections

Studies suggest a correlation between constipation and urinary tract infections (UTIs) in children. Diagnoses and treatment of constipation are not clear. This clinical practice was documented in urology offices. Variation noted suggests more research is needed for evidence-based practice in this population.     

Nursing evaluation and treatment of geriatric outpatients with urinary incontinence. Geriatric day hospital model: a case study

Nurses have ideal skills to detect, assess, and treat urinary incontinence in elderly outpatients. A practical approach to promoting continence is presented. The Geriatric Day Hospital model provides an outpatient alternative for evaluating and treating frail elderly patients with multiple problems, including urinary incontinence.     

妊娠分娩相关性尿失禁及影像学评价

妊娠和分娩是女性盆底功能障碍性疾病发生的独立危险因素,妊娠期及产后的女性尿失禁发病率较高.影像学检查在评价妊娠分娩造成的盆底损伤中起着重要作用.本文就与妊娠分娩相关的女性尿失禁影像学评价作一综述,以期为临床诊治妊娠分娩相关性尿失禁提供依据.     

Capillary gas chromatographic measurement of neutral urinary steroids: evaluation and comparison with alternative methodology

The major neutral urinary steroids have been quantitated by capillary gas chromatography and the reproducibility and accuracy of the method have been fully evaluated. Typical intra- and inter-assay coefficients of variation for individual steroids ranged from 4.9 to 10.1% and from 15.6 to 21.5%, respectively. Comparison of steroid values with alternate and commonly employed procedures for measuring urinary 17-oxosteroids, total 17-oxogenic steroids, and cortisol and plasma dehydroepiandrosterone-sulphate yielded correlation coefficients between 0.71 and 0.79. A definite relationship between serum cortisol and urinary trihydroxy-pregnanedione was also shown. Urinary androstenedione metabolites, however, could not be significantly (P greater than 0.05) correlated with the normalised androgen ratio in plasma.     

CEA and CA 19.9: an evaluation by new statistical technics on a group of elderly patients

New parametric and non parametric statistical methods have been compared in the evaluation of experimental data of CEA and CA 19.9 using a brief program in BASIC. We have found that the distribution of the two markers is the same of that described in literature except for both the means that we have found being slightly higher than that ones described by other authors.     

Diagnostic patterns in the evaluation of patients hospitalized with syncope

BACKGROUND: Syncope accounts for 5% of all hospital admissions. The etiology of syncope varies broadly, and nonselective, inpatient diagnostic evaluations to determine the cause of syncope are often inconclusive. We analyzed the yield of inpatient diagnostic tests for syncope, comparing patients with and without an initial suspected diagnosis of vasovagal syncope. METHODS: We retrospectively reviewed the medical records of consecutive adult patients with a principal diagnosis of syncope (ICD-9 Code 780.2) who were admitted through the emergency department of an 800-bed teaching hospital from January 1, 2000, to May 31, 2001. RESULTS: A total of 267 patients (150 women, 117 men; mean age, 72.4 +/- 15.3 years) were identified. On admission, a diagnosis of vasovagal syncope was suspected in 47% of patients. Inpatient tests, including telemetry monitoring, echocardiography, and stress testing, were significantly lower yielding in patients with suspected vasovagal syncope when compared to patients with other suspected etiologies (P < 0.05). CONCLUSIONS: Despite the significant length of hospital stay (median 4 days), we found that inpatient diagnostic workups for patients with suspected vasovagal syncope were low yielding, especially with regard to cardiac testing. Furthermore, abnormal test results did not change the discharge diagnosis.     

腔镜技术联合ESWL治疗复杂性泌尿系结石的护理

[目的]探讨腔镜技术联合体外冲击波碎石术(ESWL)治疗复杂泌尿系结石的护理。[方法]对2010年5月—2011年11月采用腔镜技术联合ESWL治疗复杂性泌尿系结石31例病人的资料进行回顾性分析总结。[结果]31例复杂性泌尿系结石病人,随访1个月～3个月,28例结石排尽,排尽率93.3%,无严重并发症发生。[结论]腔镜技术联合ESWL治疗复杂性泌尿系结石碎石成功率高、创伤小,可以互为补充。     

Antimicrobial resistance patterns in respiratory pathogens isolated in an Italian university hospital during a period of eight years: a statistical analysis

The antimicrobial resistance patterns of respiratory pathogens isolated during an 8-year period (1990-1997) in an Italian hospital from patients with bronchopulmonary infections were investigated. A global variation in the resistance of Staphylococcus aureus to all relevant antibiotics was observed during the years 1990-1997. With the exception of penicillin and amoxicillin, to which Staphylococci were always resistant, and vancomycin, to which they were always susceptible, in the first period (1990-1992) the percentage of resistance to beta-lactams, aminoglycosides, macrolides, fluoroquinolones and cotrimoxazole was about 15%, while in the last period (1993-1997) it was about 35%. No global variation in resistance to the antimicrobials examined during the study period was observed for gram-negative bacteria. The percentages of resistance to the more recent beta-lactams, aminoglycosides and fluoroquinolones were generally less than 10% for the KES group, less than 20% for Pseudomonas aeruginosa, and less than 30% for other Pseudomonas species. A high percentage of resistance was observed for the KES group to amoxicillin + clavulanic acid (60%) and to cefoxitin (48%).     

Ultrasonic evaluation of urethrovesical junction in women with stress urinary incontinence

An ultrasonic evaluation of the bladder base and urethrovesical junction, at rest and during stress, using a transrectal probe, was performed on 24 continent and 67 incontinent patients. Forty-four of the incontinent patients had clinical and urodynamic diagnoses of stress urinary incontinence and 23 patients had detrusor instability incontinence. Thirty-eight of the 44 patients (86%) with urodynamically and urethroscopically proven genuine stress urinary incontinence and a weak urethral sphincter had a urethrovesical junction (UVJ) drop during stress of greater than or equal to 1 cm (mean 1.3 cm +/- 0.6 cm), as demonstrated on transrectal ultrasonic evaluation. All 23 patients with detrusor instability and 22 of the 24 continent (control) patients had UVJ drop on straining of less than 1 cm (mean 0.48 cm +/- 0.23 cm and 0.54 cm +/- 0.29 cm, respectively, p less than 0.05). The sensitivity of ultrasonic evaluation of women with stress urinary incontinence (when 1-cm drop of UVJ is considered as the upper boundary of normal) was 86% and the specificity was 91%. This ultrasound technique is quick, simple, and appears to be accurate. We believe this technique should be considered in the preoperative evaluation of women with stress urinary incontinence.     

健康教育对尿失禁妇女的护理效果评价

目的 探讨健康教育对尿失禁妇女护理效果的影响作用.方法 于2010年1月～12月对在我院参加妇科普查的1 943名成年妇女进行尿失禁知识健康教育及定期随访,分别于健康教育前、6个月回访时进行问卷调查,以评价健康教育前后尿失禁妇女的护理效果.结果 在1 943名妇女中,健康教育后参加盆底肌训练及坚持训练的人数明显高于健康教育前,健康教育后到医院咨询及治疗人数明显高于健康教育前,健康教育后SUI患病人数及中重度比例亦明显低于健康教育前(P＜0.001).结论 对妇女进行尿失禁知识健康教育,推广盆底肌训练和膀胱功能训练,能显著提高妇女对尿失禁的认知,降低尿失禁的发病率,减低中重度比例,是保障妇女生殖健康的重要措施.

Abstract：

Objective To discuss nursing effect of health education on women with urinary incontinence. Methods From January to december in 2010, 1 943 adult women who received gynecology general survey in our hospital were treated with health education for urinary incontinence and were followed up regularly. They were investigated by questionnaire survey before health education and 6 months later after health education respectively. The effect of nursing for women with urinary incontinence were assessed. Results In these women patients,after health education, there were more women who participated in pelvic floor muscle training and adhered to training than before health education, the number of patients who received consultation and treatment increased significantly more than before. Afterf health education, the incidence of SUI, the proportion of moderate and severe symptoms were also significantly lower than before (P ＜0. 001 ). The differences was statistically significant. Conclusions Making health education on women with urinary incontinence and promoting pelvic floor muscle training (PFMT) and bladder functional training can significantly improve women's awareness of urinary incontinence, reduce the incidence of urinary incontinence, reduce the proportion of moderate and severe symptoms. These measures are important to protect women's reproductive health.