Objective:To conduct nutrition-related analyses on large-scale health surveys, two aspects of the survey must be incorporated into the analysis: the sampling weights and the sample design; a practice which is not always observed. The present paper compares three analyses: (1) unweighted; (2) weighted but not accounting for the complex sample design; and (3) weighted and accounting for the complex design using replicate weights.Design:Descriptive statistics are computed and a logistic regression investigation of being overweight/obese is conducted using Stata.Setting:Cross-sectional health survey with complex sample design where replicate weights are supplied rather than the variables containing sample design information.Participants:Responding adults from the National Nutrition and Physical Activity Survey (NNPAS) part of the Australian Health Survey (2011–2013).Results:Unweighted analysis produces biased estimates and incorrect estimates of se. Adjusting for the sampling weights gives unbiased estimates but incorrect se estimates. Incorporating both the sampling weights and the sample design results in unbiased estimates and the correct se estimates. This can affect interpretation; for example, the incorrect estimate of the OR for being a current smoker in the unweighted analysis was 1·20 (95 % CI 1·06, 1·37), t= 2·89, P = 0·004, suggesting a statistically significant relationship with being overweight/obese. When the sampling weights and complex sample design are correctly incorporated, the results are no longer statistically significant: OR = 1·06 (95 % CI 0·89, 1·27), t = 0·71, P = 0·480.Conclusions:Correct incorporation of the sampling weights and sample design is crucial for valid inference from survey data.
Around 11-12% of tympanostomy tubes are reported to become blocked by middle ear secretions or blood immediately following surgery, and so no longer function. Many otologists routinely instil an antibiotic and steroid-containing solution at the time of surgery in the belief that this may reduce this complication. The aim of the study was to investigate the efficacy of instilling the antibiotic and steroid-containing solution Sofradex at the time of grommet insertion in preventing grommet blockage. Double-blind randomized-controlled trial, comparing rates of grommet blockage in ears treated with Sofradex drops against control (no drops) in patients undergoing bilateral grommet insertion. Sixty-one pairs of results were obtained. There was a significant difference between the rates of grommet blockage in the two groups. Grommets with Sofradex drops instilled perioperatively were nine times less likely to be blocked than controls [1.6%versus 13.1%, odds ratio (Sofradex/control) = 9.06, 95% confidence interval (CI): 1.04-78.82, P = 0.05]. There was no association between grommet blockage and perioperative bleeding or the nature and presence of middle ear secretions. Sofradex eardrops are effective in reducing the rate of grommet blockage when instilled perioperatively.
Öz Introduction Renal angiomyolipoma (AML) is a benign tumor composed of adipose tissue, abnormal blood vessels and smooth muscle. AML is usually diagnosed incidentally on ultrasound but symptoms may vary from flank pain, palpable flank mass and hematuria to life-threatening hemorrhage (52%-91%) especially in those larger than 4 cm. Giant AML is usually managed by transarterial embolization (TAE), partial nephrectomy or total nephrectomy as described in the literature. Our case represents the largest AML with a dimension of up to 40 cm which was managed by nephron-sparing surgery in the form of partial nephrectomy without prior embolization. Case Presentation A 35-year-old female patient presented with bloating sensation and increasing abdomen girth since last 3 years. Ultrasound Literatürde çeşitli boyutlarda renal anjiyomiyolipom olguları bildirilmiştir ve 10 cm'den daha büyük olanlar için dev AML terimi genel ortak görüştür. Olgumuz, son üç yıldır artan karın şişliği ile başvurdu. Kontrastlı batın tomografisi hem sol böbrekte küçük ve çok odaklı hem de sağ böbreğin üst ve orta bölümünden köken alan büyük boyutlarda anjiyomiyolipomlar saptadı. Sağ böbreğin orta ve üst bölümüne uygulanan parsiyel nefrektomiye ek olarak alt kutuptaki küçük odaklara da enükleasyon uygulanarak, nefron koruyucu cerrahi yapıldı. Cerrahi örnek 40 cm × 20 cm × 15 cm boyutlarında ve 7000 g ağırlığında olup, histopatolojik açıdan AML olduğu doğrulandı. Bu, 40 cm'ye kadar bir boyuta sahip en büyük AML olgusudur ve öncesinde anjiyoembolizasyon olmaksızın nefron koruyucu cerrahi yapılmıştır. Boyutu genellikle 10 cm'den büyük olan AML, literatürde dev AML olarak kabul edilir.
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