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Kittiudomtham S, Muengtaweepongsa S, Srivilaithon W. Incidence of neurological manifestations and complications in patients with COVID-19 infection: a propensity score matching analysis. Ir J Med Sci 2024; 193:967-972. [PMID: 37823950 DOI: 10.1007/s11845-023-03541-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND The novel coronavirus, SARS-CoV-2, can lead to potential neurological complications in COVID-19 patients. This study aims to assess the prevalence and associated risk factors of these complications among Thai individuals. METHODS We conducted a retrospective study on hospitalized adults with COVID-19 at Thammasat University Hospital from April 2020 to September 2021, totaling 990 patients. We used propensity score matching and logistic regression to determine associated risk factors. RESULTS Of the patients, 21.7% (215 individuals) manifested neurological complications, categorized as follows: Skeletal muscle injury: 16.3% Acute cerebrovascular disease: 0.8% Delirium: 2.4% Impaired consciousness: 2.6% Seizures: 0.5% Post-matching revealed risk factors significantly associated with neurological complications: overweight status, hypertension, diabetes mellitus, dyslipidemia, and severe infection. However, in a multivariable analysis, only severe infection remained significant (adjusted OR 3.71; p = 0.010). The presence of neurological complications was linked with an elevated mortality risk (OR 1.77, p = 0.005). CONCLUSIONS In the Thai COVID-19 patient cohort, roughly 22% experienced neurological complications, with severe infection standing out as a major risk factor. This underscores the importance of closely monitoring neurological symptoms in COVID-19 patients.
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Affiliation(s)
- Suttapa Kittiudomtham
- Center of Excellence in Stroke, Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Sombat Muengtaweepongsa
- Center of Excellence in Stroke, Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
| | - Winchana Srivilaithon
- Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
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202
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El Haidari R, Hoballa MH, Cheato A, Baydoun K, Husseini A, Chahrour M, Mansour S, Hoballah A. Prevalence and determinants of non-communicable diseases and risk factors among adults in Lebanon: a multicentric cross-sectional study. Public Health 2024; 229:185-191. [PMID: 38452563 DOI: 10.1016/j.puhe.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/12/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Evidence on non-communicable disease (NCD) prevalence and associated risk factors informs primary health care consolidation regarding prevention and treatment strategies. In Lebanon, the government and many international organisations are still working to decrease the burden of NCDs. The aim of this study was to assess the prevalence of selected NCDs and their risk factors among adults in Lebanon, and to investigate the relationship between these risk factors and NCDs. STUDY DESIGN A multicentric cross-sectional study was conducted over one year, from 1 June 2022 to 31 June 2023, across five Lebanese governorates. METHODS Participants aged ≥18 years were considered eligible for enrolment in the study. Data on the sociodemographic, behavioural and medical characteristics of participants were collected. RESULTS From the total study population (n = 4540), 52.4% reported one or more NCDs. The prevalence of most prominent NCDs were hypertension (32.8%), diabetes (26.8%), cardiovascular disease (16.1%), asthma (7.1%) and cancer (3.7%). Results showed a significant association between gender and smoking, high-fibre diet and asthma (P-value <0.05). Findings showed a highly significant association between age categories and smoking, high-fibre diet, physical activity, diagnosis with NCDs, hypertension, diabetes and cardiovascular disease (P-value <0.0001). CONCLUSIONS This study showed a high prevalence of NCDs among adults living in Lebanon. Prevention, treatment and control of NCDs and their risk factors are a public health priority in Lebanon, and resources are required to provide targeted interventions with a multisectoral approach.
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Affiliation(s)
- R El Haidari
- Faculty of Public Health, Lebanese University, Hadath, Lebanon; INSPECT-LB (Institut National de Santé Publique, Epidemiologie Clinique Et Toxicologie-Liban), Beirut, Lebanon.
| | - M H Hoballa
- Department of Informatics, Islamic Health Society, Baabda, Lebanon
| | - A Cheato
- Faculty of Sciences, Lebanese University, Hadath, Lebanon
| | - K Baydoun
- Department of Social Health, Islamic Health Society, Baabda, Lebanon
| | - A Husseini
- Department of Medical Affaires, Islamic Health Society, Baabda, Lebanon
| | - M Chahrour
- Dar El Hawraa Primary Healthcare Center, Islamic Health Society, Baabda, Lebanon
| | - S Mansour
- Department of Informatics, Islamic Health Society, Baabda, Lebanon
| | - A Hoballah
- General Director of Islamic Health Society, Baabda, Lebanon
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203
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Worku A, Molla W, Kenubih A, Gizaw D, Muluneh A, Admassu B, Ejo M, Dagnaw GG, Bitew AB, Fentahun T, Getnet K, Dejene H, Berrie K, Ibrahim SM, Gessese AT, Fenta MD, Dessalegn B, Birhan M, Kinde MZ. Seroprevalence and associated risk factors of equine herpesvirus type-1/-4 in selected districts of Northwest Amhara, Ethiopia. Comp Immunol Microbiol Infect Dis 2024; 107:102155. [PMID: 38460360 DOI: 10.1016/j.cimid.2024.102155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/11/2024]
Abstract
This study aimed to estimate the prevalence, determine the distribution, and identify the epidemiological risk factors of EHV-1/-4 infections in selected districts of Northwest Amhara Region. 460 serum samples were collected from equines using multistage cluster sampling technique, and a competitive Enzyme-linked immunosorbent assay (cELISA) was performed. Various risk factors for the occurrence of EHV-1/-4 were considered. Statistical analysis was performed using R version 4.3.1. 65.9% (303) equids were tested positive for antibodies against EHV-1/-4. Based on district, the highest prevalence was recorded in Wogera (86.1%), while the lowest was in Debark (47.4%). There was a significant difference (p <0.05; 95% CI: 1.1067993-3.682843) in the prevalence of EHV-1/-4 among species and donkeys are 2.019 times more likely to get an EHV infection than horses. The prevalence of EHV-1/-4 was highest in equids with the age of 3-8 years and lowest in < 3 years, and the difference was statistically significant (p <0.05; 95% CI: 1.9812042-6.771820). Statistically significant variation (p <0.05; 95% CI: 1.1173822-2.684013) was also observed between sex of equids in which females had 1.73 times higher chance to get EHV infection than males. Higher prevalence was found in lactating equids (81.6%), followed by pregnant equids (74.6%), and dry equids (66.4%). Generally, this study indicated a high and wide distribution of EHV-1/-4 infection in the study area, which needs due attention. Devising strategies to prevent and minimize the spread and occurrence of the infection is crucial.
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Affiliation(s)
- Anmut Worku
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Wassie Molla
- Department of Veterinary Epidemiology and public health, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Ambaye Kenubih
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Daniel Gizaw
- Animal Health Institute (AHI), Ministry of Livestock and Fishery, P. O. Box 04, Sebeta, Ethiopia
| | - Ayelech Muluneh
- Animal Health Institute (AHI), Ministry of Livestock and Fishery, P. O. Box 04, Sebeta, Ethiopia
| | - Bemrew Admassu
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Mebrat Ejo
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Gashaw Getaneh Dagnaw
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Abebe Belete Bitew
- Department of Veterinary Epidemiology and public health, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Tewodros Fentahun
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Kalkidan Getnet
- Department of Veterinary Epidemiology and public health, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Haileyesus Dejene
- Department of Veterinary Epidemiology and public health, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Kassahun Berrie
- Department of Veterinary Epidemiology and public health, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Saddam Mohammed Ibrahim
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Abebe Tesfaye Gessese
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Melkie Dagnaw Fenta
- Department of Clinical Medicine, College of Veterinary Medicine and Animal Sciences, University of Gondar, P. O. Box 196, Ethiopia
| | - Bereket Dessalegn
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Mastewal Birhan
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia
| | - Mebrie Zemene Kinde
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, P.O.Box 196, Ethiopia.
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204
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Golightly YM, Renner JB, Helmick CG, Jordan JM, Nelson AE. Looking back on 30+ years of the Johnston County Osteoarthritis Project while looking forward with the Johnston County Health Study: A narrative review. Osteoarthritis Cartilage 2024; 32:430-438. [PMID: 38237761 DOI: 10.1016/j.joca.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/29/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
Over the last 30 years, knowledge of the epidemiology of osteoarthritis (OA) has dramatically advanced, and Osteoarthritis and Cartilage has been on the forefront of disseminating research findings from large OA cohort studies, including the Johnston County OA Project (JoCoOA). The JoCoOA is a population-based, prospective longitudinal cohort that began roughly 30 years ago with a key focus on understanding prevalence, incidence, and progression of OA, as well as its risk factors, in a predominantly rural population of Black and White adults 45+ years old in a county in the southeastern United States. Selected OA results that will be discussed in this review include racial differences, lifetime risk, biomarkers, mortality, and OA risk factors. The new Johnston County Health Study will also be introduced. This new cohort study of OA and comorbid conditions builds upon current OA knowledge and JoCoOA infrastructure and is designed to reflect changes in demographics and urbanization in the county and the region.
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Affiliation(s)
- Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Jordan B Renner
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amanda E Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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205
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Díez-Vidal A, Gómez López J, Rodríguez Fuertes P, Tejeda Jurado F, Berrocal Espinosa P, Martínez Ballester JF, Rodríguez Roca S, Rivera Núñez MA, Martínez Virto AM, Tung-Chen Y. Superficial vein thrombosis and its relationship with malignancies: a prospective observational study. J Thromb Thrombolysis 2024; 57:650-657. [PMID: 38491266 DOI: 10.1007/s11239-024-02963-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND The interrelation of cancer with venous thromboembolism is established, yet the specific impact on the incidence and progression of superficial vein thrombosis (SVT) remains unclear. OBJECTIVES To investigate the association between SVT and malignancies, focusing on risk factors, presentation, course and complications. METHODS A single-center prospective observational study of patients diagnosed with DVT or SVT referred to a venous thromboembolism clinic between January 2013 and April 2018. RESULTS Of the 632 patients, 205 presented with SVT at referral, 16.6% having active cancer. Significant associations were found between active cancer and the risk of developing proximal SVT (RR 1.54 [1.18-2.03] p < 0.01), SVT within 3 cm from junction (RR 2.01 [1.13-3.72] p = 0.019), bilateral SVT (RR 8.38 [2.10-33.43] p < 0.01) and SVT affecting multiple veins (RR 2.42 [1.40-4.20] p < 0.01), with a higher risk of persistence (RR 1.51 [1.18-1.95] p < 0.01) and progression (RR 5.75 [2.23-14.79] p < 0.01) at initial assessment. Patients with SVT and no malignancy history demonstrated an elevated risk for new-onset cancer during follow-up (RR 1.43 [1.13-1.18] p = 0.022), especially in cases of proximal or bilateral SVT, initial progression or subsequent DVT or PE. No significant differences were observed in persistence, recurrence or complications during initial evaluation or follow-up across different pharmacological treatments. CONCLUSIONS Research suggests a probable link between cancer history and the development of SVT. SVT presented more severely in cancer patients. SVT, especially in its more complex forms, could serve as a predictive marker for the future development of cancer. Treatment approaches varied, no significant differences in outcomes were noted.
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Affiliation(s)
- Alejandro Díez-Vidal
- Department of Internal Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain.
| | - Javier Gómez López
- Department of Emergency Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain
| | - Pablo Rodríguez Fuertes
- Department of Emergency Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain
| | - Fabián Tejeda Jurado
- Department of Emergency Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain
| | - Paula Berrocal Espinosa
- Department of Emergency Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain
| | | | - Sonia Rodríguez Roca
- Department of Emergency Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain
| | | | - Ana María Martínez Virto
- Department of Emergency Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain
| | - Yale Tung-Chen
- Department of Internal Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain
- Department of Medicine, Alfonso X El Sabio University, Avenida Universidad 1, Villanueva de la Cañada, Madrid, 28691, Spain
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206
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Wang X, Zhang L, Lin X, Nian S, Wang X, Lu Y. Prevalence and risk factors of postpartum depressive symptoms at 42 days among 2462 women in China. J Affect Disord 2024; 350:706-712. [PMID: 38244787 DOI: 10.1016/j.jad.2024.01.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/07/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Postpartum depression is a common and serious mental health problem that is affecting an increasing percentage of the world's population. We aimed to evaluate the prevalence of postpartum depressive symptoms in Beijing, China, during the COVID-19 pandemic and identify several potential risk factors. METHODS This was a cross-sectional observational study conducted at Peking University First Hospital from 2020 to 2021. Women who delivered and had postpartum reviews at 42 days after delivery were invited to complete the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) under the guidance of trained nurses. A score of ≥10 was used as the threshold of postpartum depression. t-tests, chi-square tests or Mann-Whitney U tests were applied. A multivariate logistic regression analysis was conducted to assess the risk factors for postpartum depressive symptoms. RESULTS A total of 2462 mothers were included in this study, 20.2 % of whom were considered to have postpartum depressive symptoms. Multivariate logistic regression analysis showed that formula feeding (OR = 2.219, 95 % CI: 1.300-3.786, P = 0.013), preterm birth (OR = 1.619, 95 % CI: 1.108-2.367, P = 0.013), cervical insufficiency (OR 3.022, 95 % CI: 1.200-7.615, P = 0.019) and history of depression (OR = 6.519, 95 % CI: 1.537-27.659, P = 0.011) were associated with a high prevalence of postpartum depressive symptoms. CONCLUSION There is a high prevalence of postpartum depressive symptoms in developed regions of China during the COVID-19 pandemic. More attention should be given to mothers with risk factors for PPD, and follow-up care is needed.
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Affiliation(s)
- Xiaoxiao Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Lei Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xiufeng Lin
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Songwen Nian
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xiaoqing Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Ye Lu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
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207
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Zeng Q, Lu G, Yuan J, Ding J, Chen J, Gao X, Huang Y, Shi T, Yu H, Ni H, Li Y. Prevalence, characteristics, and risk factors of venous thromboembolism in patients with brain tumor undergoing craniotomy: a meta-analysis. Neurol Sci 2024; 45:1565-1580. [PMID: 37947983 DOI: 10.1007/s10072-023-07160-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Brain tumor patients undergoing craniotomy are significantly associated with the development of venous thromboembolism (VTE), while the contributing factors remains controversial. Our study aimed to investigate the prevalence and risk factors for VTE in postoperational brain tumor patients. METHODS We searched the PubMed, Embase, Web of Science, Medline, and Cochrane Library databases from their inception to July 2023. Article selection, data extraction, and study quality assessment were performed independently by two reviewers. Publication bias was assessed using Egger's and Begg's tests. Stata 15.0 software was used for data analysis. RESULTS A total of 25 studies were considered, with a total of 49,620 brain tumor individuals. The pooled prevalence of VTE during hospitalization in postoperational brain tumor patients was 9% [95% CI: (0.08, 0.10)]. Moreover, our results demonstrated that patients with VTE were older than those without VTE [mean difference [MD] = 8.14, 95% CI: (4.97, 11.30)]. The following variables were significantly associated with VTE: prior history of VTE [OR = 7.81, 95% CI: (3.62, 16.88)], congestive heart failure [OR = 2.33, 95% CI: (1.08-5.05)], diabetes [OR = 1.87, 95% CI: (1.12-3.10)], hypertension [OR = 1.27, 95% CI: (1.07-1.50)], steroid use [OR = 1.63, 95% CI: (1.41, 1.88)], high white blood cells counts [MD = 0.32, 95% CI: (0.01, 0.63)], and high fibrinogen levels [MD = 0.19, 95% CI: (0.08, 0.30)]. CONCLUSION This meta-analysis identified risk factors for postoperational VTE in patients with brain tumor, which can serve as a theoretical foundation for medical staff to manage and treat VTE. TRIAL REGISTRATION CRD42023357459.
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Affiliation(s)
- Qingping Zeng
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Jing Yuan
- Department of Echocardiography, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Jiali Ding
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Juan Chen
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Xianru Gao
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Yujia Huang
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Tian Shi
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Hailong Yu
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China
- Department of Neurology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Hongbin Ni
- Department of Neurosurgery, Nanjing Drum Tower Hospital, School of Medicine, Clinical College of Nanjing Medical University, Nanjing, 210008, Jiangsu, China.
| | - Yuping Li
- Department of Neuro Intensive Care Unit, Clinical Medical College of Yangzhou University, Yangzhou, China.
- Neuro-Intensive Care Unit, Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China.
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Lee YY, Slade T, Chatterton ML, Le LKD, Perez JK, Faller J, Chapman C, Newton NC, Sunderland M, Teesson M, Mihalopoulos C. Age at first drink and its influence on alcohol use behaviours in young adulthood: Evidence from an Australian household-based panel study. Prev Med 2024; 181:107898. [PMID: 38367869 DOI: 10.1016/j.ypmed.2024.107898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Public health guidelines recommend delaying the initiation age for alcohol. However, the causal link between age-at-first-drink (AFD) and future alcohol use in young adulthood is uncertain. This study examined the association between AFD and alcohol-related outcomes at age 20 years using an Australian sample. METHODS Data were obtained from Waves 1-19 (years 2001-2019) of the Household, Income and Labour Dynamics in Australia Survey on 20-year-olds with responses across ≥3 consecutive waves (n = 2278). The AFD for each respondent (between 15 and 20 years) was analysed relative to Australian legal drinking age (18 years). Inverse probability treatment weighting was used to evaluate associations between AFD and four outcomes at age 20 years: risk of current alcohol use; quantity of weekly alcohol consumption; risk of binge drinking; and frequency of binge drinking. Adjustments were made for confounders (e.g., heavy drinking by parents). Robustness of study findings was evaluated using several diagnostic tests/sensitivity analyses. RESULTS Among 20-year-olds, those with an AFD of 15-16 years consumed significantly more alcohol per week compared to an AFD of 18 years. Additionally, 20-year-old drinkers with an AFD of 16 years were significantly more likely to binge drink (though this association was likely confounded). An inverse dose-response relationship was observed between AFD and weekly alcohol consumption at 20 years, where a higher AFD led to lower alcohol consumption. CONCLUSION Study findings indicate an association between a higher AFD and consuming less alcohol in young adulthood, which could potentially support the scale-up of prevention programs to delay AFD among Australian adolescents.
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Affiliation(s)
- Yong Yi Lee
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Public Health, The University of Queensland, Brisbane, Australia; Queensland Centre for Mental Health Research, Brisbane, Australia.
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Mary Lou Chatterton
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Long Khanh-Dao Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joahna K Perez
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jan Faller
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
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209
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Li Y, Merriman TR, Chen H, Lv Q, Yan Y, Xu X, Ji A, Cheng Z, Wang X, Lu D, Han L, Cui L, Wang C, Sun W, Li C, Lu J. Clinical characteristics of adolescent-onset gout in Chinese: A hospital-based cross-sectional study. Semin Arthritis Rheum 2024; 65:152405. [PMID: 38335695 DOI: 10.1016/j.semarthrit.2024.152405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/12/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Adolescent-onset gout has a greater impact on the lives and health of patients than adult-onset gout. However, there is a relative lack of clinical information on adolescent-onset gout. Hence, we analyzed a Chinese cohort. METHODS We studied clinical features of 9,003 Chinese patients. Gout onset age of 12 - 19 years is defined as adolescent-onset group (AG), 20 - 40 years as early-onset group (EG), and 41 - 64 years as late-onset group (LG). Multivariable regression analysis evaluated factors associated with recurrent flares, serum urate (SU) levels, and underexcretion type in AG. RESULTS Compared with EG and LG, the AG had higher SU levels [AG: 9.5 (2.2) mg/dL, EG: 8.6 (2.1) mg/dL, LG: 7.73 (2.0) mg/dL, P < 0.001], higher percentage of positive family history of gout (AG: 41.8 %, EG: 29.6 %, LG: 24.6 %, P < 0.001), underexcretion type (AG: 62.4 %, EG: 62.5 %, LG: 58.8 %, P = 0.04), recurrent flares (AG: 78.1 %, EG: 70.3 %, LG: 68.9 %, P = 0.01). Urate-lowering therapy (ULT) initiated [OR 6.58 (95 % CI 1.35 - 32.00)] and hypercholesterolemia [OR 4.16 (95 % CI 1.28 - 13.53)] were associated with recurrent flares. eGFR was identified to be a significant variable of increasing SU levels [beta -0.24 (95 % CI -0.04 to -0.01)]. Hypertriglyceridemia [OR 0.35 (95 % CI 0.17 - 0.71)] was related to underexcretion type. CONCLUSION Adolescent-onset gout patients had clinically distinctive features with higher SU levels, BMI, positive gout family history, underexcretion type and recurrent flares. These specific populations were less likely to achieve ULT target, requiring more clinical attention.
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Affiliation(s)
- Yushuang Li
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Institute of Metabolic Diseases, Qingdao University, 266003 Qingdao, PR China
| | - Tony R Merriman
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Institute of Metabolic Diseases, Qingdao University, 266003 Qingdao, PR China; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Haibing Chen
- Department of Endocrinology and Metabolism, Shanghai 10th People's Hospital, Tongji University, 200072 Shanghai, PR China
| | - Qingguo Lv
- Department of Endocrinology and Metabolism, Center for diabetes and metabolism research, West China Hospital of Sichuan University, 610041 Chengdu, PR China
| | - Yinkun Yan
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045 Beijing, PR China
| | - Xinmiao Xu
- Department of Endocrinology and Metabolism, Yantai Yeda Hospital, 265599 Yantai, PR China
| | - Aichang Ji
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China
| | - Zan Cheng
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China
| | - Xiaxia Wang
- Department of Cardiology, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China
| | - Di Lu
- Department of the Third Chest, Qingdao Chest Hospital, 266043 Qingdao, PR China
| | - Lin Han
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China
| | - Lingling Cui
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China
| | - Can Wang
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China
| | - Wenyan Sun
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China
| | - Changgui Li
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Institute of Metabolic Diseases, Qingdao University, 266003 Qingdao, PR China
| | - Jie Lu
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, 266003 Qingdao, PR China; Institute of Metabolic Diseases, Qingdao University, 266003 Qingdao, PR China.
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Swaminathan SM, Bhojaraja MV, Attur RP, Nagri SK, Rao IR, Rangaswamy D, Shenoy SV, Nagaraju SP. Study of prevalence, clinical profile, and predictors of rapid progression in diabetic kidney disease. Ir J Med Sci 2024; 193:1047-1054. [PMID: 37851330 DOI: 10.1007/s11845-023-03544-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/29/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND A significant proportion of diabetic kidney disease (DKD) experience a rapid decline in eGFR, leading to end-stage kidney disease (ESKD) within months. This single-centered retrospective cohort study aimed to assess the prevalence, clinical profile, and predictors for rapid progression in type 2 diabetes mellitus (T2DM) patients with DKD. METHOD Three hundred fifty-nine T2DM patients with DKD between January 2018 and 2022 were included and those with superimposed non-diabetic kidney disease, chronic kidney disease 5, and < 6 months follow-up were excluded. They were classified as rapid and non-rapid progressors based on the annual eGFR decline of > 5 ml/min/1.73 m2/year. The primary outcome analyzed was the progression to ESKD. The secondary outcomes were the onset of microvascular and macrovascular complications and predictors for rapid progression as well as ESKD. RESULTS In a median follow-up of 3.5 years, 61.3% were rapid progressors (mean eGFR decline of 15.4 ml/1.73m2/year) and 38.7% were non-rapid progressors (mean eGFR decline 1.8 ml/1.73m2/year. Among rapid progressors, 61.4% reached ESKD. Severe proteinuria, the presence of retinopathy, and acute kidney injury (AKI) episodes were strong predictors of rapid progression. Cardiovascular disease and diabetic retinopathy (microvascular complications) were significantly higher among rapid progressors and had a mortality rate of 7.2%. CONCLUSION The majority of type 2 DKD patients were rapid progressors and two-thirds of them developed ESKD. The prevalence of hypertension, cardiovascular disease, diabetic retinopathy, AKI episodes, and mortality was higher in rapid progressors. Severe proteinuria and diabetic retinopathy were found to be strong predictors for rapid eGFR decline and its progression to ESKD.
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Affiliation(s)
- Shilna Muttickal Swaminathan
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Mohan V Bhojaraja
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Ravindra Prabhu Attur
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Shivashankara Kaniyoor Nagri
- Department of Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Indu Ramachandra Rao
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Dharshan Rangaswamy
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Srinivas Vinayak Shenoy
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Shankar Prasad Nagaraju
- Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
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211
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Bui M, Nijmeijer WS, Hegeman JH, Witteveen A, Groothuis-Oudshoorn CGM. Systematic review and meta-analysis of preoperative predictors for early mortality following hip fracture surgery. Osteoporos Int 2024; 35:561-574. [PMID: 37996546 PMCID: PMC10957669 DOI: 10.1007/s00198-023-06942-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/04/2023] [Indexed: 11/25/2023]
Abstract
Hip fractures are a global health problem with a high postoperative mortality rate. Preoperative predictors for early mortality could be used to optimise and personalise healthcare strategies. This study aimed to identify predictors for early mortality following hip fracture surgery. Cohort studies examining independent preoperative predictors for mortality following hip fracture surgery were identified through a systematic search on Scopus and PubMed. Predictors for 30-day mortality were the primary outcome, and predictors for mortality within 1 year were secondary outcomes. Primary outcomes were analysed with random-effects meta-analyses. Confidence in the cumulative evidence was assessed using the GRADE criteria. Secondary outcomes were synthesised narratively. Thirty-three cohort studies involving 462,699 patients were meta-analysed. Five high-quality evidence predictors for 30-day mortality were identified: age per year (OR: 1.06, 95% CI: 1.04-1.07), ASA score ≥ 3 (OR: 2.69, 95% CI: 2.12-3.42), male gender (OR: 2.00, 95% CI: 1.85-2.18), institutional residence (OR: 1.81, 95% CI: 1.31-2.49), and metastatic cancer (OR: 2.83, 95% CI: 2.58-3.10). Additionally, six moderate-quality evidence predictors were identified: chronic renal failure, dementia, diabetes, low haemoglobin, heart failures, and a history of any malignancy. Weak evidence was found for non-metastatic cancer. This review found relevant preoperative predictors which could be used to identify patients who are at high risk of 30-day mortality following hip fracture surgery. For some predictors, the prognostic value could be increased by further subcategorising the conditions by severity.
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Affiliation(s)
- Michael Bui
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, The Netherlands.
| | - Wieke S Nijmeijer
- Biomedical Signals and Systems Group, Faculty of Electrical Engineering Mathematics and Computer Science, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, The Netherlands
- Department of Surgery, Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609, PP, Almelo, The Netherlands
| | - Johannes H Hegeman
- Biomedical Signals and Systems Group, Faculty of Electrical Engineering Mathematics and Computer Science, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, The Netherlands
- Department of Surgery, Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609, PP, Almelo, The Netherlands
| | - Annemieke Witteveen
- Biomedical Signals and Systems Group, Faculty of Electrical Engineering Mathematics and Computer Science, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, The Netherlands
| | - Catharina G M Groothuis-Oudshoorn
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, The Netherlands
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212
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Saucedo M, Deneux-Tharaux C. [Maternal mortality in France, 2016-2018, frequency, causes and women's profile]. Gynecol Obstet Fertil Senol 2024; 52:185-200. [PMID: 38373492 DOI: 10.1016/j.gofs.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To describe, for the 2016-2018 period, the frequency, causes and risk factors of maternal deaths in France. METHOD Data from the National Confidential Enquiry into Maternal Deaths for 2016-2018. RESULTS For 2016-2018, 272 maternal deaths occurred in France up to 1 year after the end of pregnancy, i.e a maternal mortality ratio of 11.8 per 100,000 live births (95 % CI 10.4-13.3), and 8.5 (IC 95 % 7.4-9.8) for maternal mortality up to 42 days. Compared to women aged 20-24, the risk of maternal death is multiplied by 2.6 for women aged 35-39, by 5 for women aged 40 and over. Obese women are twice as frequent among maternal deaths (26 %) than in the general population of parturients (11 %). There are territorial disparities -the maternal mortality ratio in the French overseas departments is 2 times higher than in metropolitan France (significant difference but smaller than in 2013-2015)-, and social disparities -the mortality of migrant women remains higher than that of women born in France, particularly for women born in sub-Saharan Africa whose risk is 3 times higher than that of native women. One in three women who died (34 %) had socio-economic vulnerability versus 22 % in the overall population of parturients. Among causes of maternal deaths, the predominant role of psychiatric conditions (mostly suicides) is confirmed for the period 2016-2018, leading cause of maternal mortality considered up to 1 year (17 %), MMR of 1.9/100,000 NV. i.e. approximately one death from psychiatric causes every 3 weeks. Cardiovascular diseases are the second leading cause of maternal mortality up to one year (14 %) and the leading cause up to 42 days (16 %), with 1.3 deaths per 100,000 NV. Amniotic fluid embolism ranks as the third cause (8 %) (2nd cause, 11 %, for MM limited to 42 days), i.e. MMR of 0.9 per 100,000 NV. After a regular decline over the last decade, maternal mortality from obstetric hemorrhage is at a stable level compared to the previous triennium 2013-2015, MMR of 0.9/100,000 NV, i.e 5th cause of MM up to one year (7 %) and 4th cause of MM up to 42 days. CONCLUSION The overall national maternal mortality ratio does not show a downward trend, even with constant surveillance method. Territorial inequalities persist but change in their magnitude and in the regions concerned. The profile of the causes of maternal mortality up to one year of the pregnancy end shows the leading role of suicides and cardiovascular diseases, which illustrates that the health of pregnant women or those who have recently given birth is not limited to the obstetric domain, and highlights the importance of multidisciplinarity in the management and organization of care for women in this period.
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Affiliation(s)
- Monica Saucedo
- Équipe EPOPé, épidémiologie obstétricale périnatale et pédiatrique, CRESS U1153, Inserm, université Paris Cité, 123, boulevard Port-Royal, 75014 Paris, France.
| | - Catherine Deneux-Tharaux
- Équipe EPOPé, épidémiologie obstétricale périnatale et pédiatrique, CRESS U1153, Inserm, université Paris Cité, 123, boulevard Port-Royal, 75014 Paris, France
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213
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Sinha AK, Durrani AF, Li KX, Zhou Y, Musch DC, Zacks DN, Huvard MJ. Retinal Detachments after Open-Globe Injury: Risk Factors and Outcomes. Ophthalmol Retina 2024; 8:340-349. [PMID: 37844658 DOI: 10.1016/j.oret.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/21/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To identify risk factors for retinal detachment (RD) after open-globe injury (OGI) and evaluate outcomes of RD repair after OGI. DESIGN Case-control study. PARTICIPANTS Overall, 769 patients presented with 786 OGIs, which were surgically managed with ≥ 30 days of follow-up. Of the 786 eyes, 223 developed RD, the other 551 served as controls, and RD status of 12 eyes was unknown. METHODS A retrospective chart review was performed of all OGIs presented to the University of Michigan between 2000 and 2022. Multivariable regression identified risk factors for RD after OGI and predictors of poor vision after RD repair. Kaplan-Meier analysis estimated time from OGI to RD. MAIN OUTCOME MEASURE Predictors of visual outcome after RD repair after OGI. RESULTS After OGI, 223 (28.4%) of 786 eyes were diagnosed with RD, with > 73% diagnosed within a month. Predictors of RD include posterior injury (zone II vs. I odds ratio [OR], 1.60 [95% confidence interval {CI}, 1.04-2.46]; P = 0.0331; zone III vs. I OR, 2.29 [1.53-3.41]; P < 0.0001), vitreous hemorrhage (OR, 2.29 [1.54-3.1]; P < 0.0001), and presenting acuity worse than count fingers (CFs) (OR, 2.65 [1.69 - 4.16]; P < 0.0001). Retinal detachment repair took place in 142 of 223 eyes. The mean logarithm of minimal angle of resolution visual acuity (VA) improved from 2.3 ± 0.8 to 1.7 ± 0.9 after RD repair at 6-month follow-up, with 51.2% of eyes achieving CF or better vision. Single surgery anatomic success rate was 69.7% and final anatomic success was 88%. Predictors of vision worse than CF include history of ocular surgery (OR, 0.32 [0.11-0.94]; P = 0.039), proliferative vitreoretinopathy (PVR; OR, 0.39 [0.16 - 0.92]; P = 0.032), aphakia (OR, 0.25 [0.08 - 0.77]; P = 0.016), and redetachment (OR, 0.26 [0.1 - 0.63]; P = 0.003). CONCLUSIONS Most RD occur within the first month after OGI. Patients with posterior injuries, vitreous hemorrhage, or poor presenting VA were more likely to develop RD after OGI. Anatomic success was achieved in the majority, as was final VA of CF vision or better. History of ocular surgery, PVR at time of repair, aphakia, and redetachment were risk factors for a poor outcome. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Alina K Sinha
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri; Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - Asad F Durrani
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia
| | - Katie X Li
- Department of Ophthalmology and Visual Sciences, Yale Eye Center, Yale School of Medicine, New Haven, Connecticut (5)Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Yunshu Zhou
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - David N Zacks
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - Michael J Huvard
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan.
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Stumpf U, Schmidmaier R. [Secondary fracture prevention/Update osteoporosis guidelines 2023 of the Umbrella Organization Osteology]. Unfallchirurgie (Heidelb) 2024; 127:283-289. [PMID: 38526813 DOI: 10.1007/s00113-024-01415-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 03/27/2024]
Abstract
The S3 guidelines on the prophylaxis, diagnostics and treatment of osteoporosis 2023 were completely revised and updated between 2021 and 2023 in accordance with the Association of the Scientific Medical Societies of Germany (AWMF) regulations. The guideline committee consisted of delegates from the 20 specialist societies of the Umbrella Organization Osteology (Dachverband Osteologie, DVO) as well as delegates from the German Society of General Medicine and Family Medicine (DEGAM), the German Society for Nephrology (DGfN) and the Federal Self-help Association for Osteoporosis (BfO).The guidelines focus on preventive measures, diagnostic procedures and treatment approaches for osteoporosis in men aged 50 years and over and postmenopausal women. The main aim is the optimization of care processes, reduction of fracture incidences and maintenance or improvement of the quality of life and functional capacity of patients affected by fractures. A major update to the guidelines includes the introduction of a new risk calculator that can take more risk factors (n = 33) into account and that can estimate the risk of vertebral body and proximal femoral fractures for a 3-year period (previously 10 years). This results in new thresholds for diagnostics and treatment. The programmed app is currently not yet certified as a medical product and a paper version is therefore currently available for patient care with the planned integration of a web-based version of the risk calculator. From the perspective of trauma surgery, the recommendations and innovations for manifest osteoporosis are of particular clinical importance. The focus of the DVO guidelines update is therefore on the implementation of secondary fracture prevention in trauma surgery, orthopedic and geriatric traumatology in the clinical and practical daily routine.
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Affiliation(s)
- Ulla Stumpf
- MUM - Muskoloskelettales Universitätszentrum München, Klinik für Orthopädie und Unfallchirurgie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland.
- Osteologisches Schwertpunktzentrum DVO der LMU, LMU Klinikum, LMU München, München, Deutschland.
| | - Ralf Schmidmaier
- Osteologisches Schwertpunktzentrum DVO der LMU, LMU Klinikum, LMU München, München, Deutschland
- Medizinische Klinik IV, LMU Klinikum, LMU München, München, Deutschland
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215
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Wang Q, Zhou FY, Ding JX. Factors associated with the persistence of human papillomavirus after surgery in patients with cervical cancer. Diagn Microbiol Infect Dis 2024; 108:116201. [PMID: 38340484 DOI: 10.1016/j.diagmicrobio.2024.116201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 01/14/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To determine the rate of human papillomavirus (HPV) persistence after surgery in patients with cervical cancer, and to analyze the factors associated with HPV persistence and viral load after surgery. METHODS Medical records of women who underwent surgery for treatment of cervical cancer between 1 January 2018 and 30 June 2019 at Obstetrics and Gynecology Hospital of Fudan University in Shanghai, China, were retrospectively analyzed. Patients with persistent HPV infection after 2 years of follow-up were identified. Univariate and multivariate analyses were employed to determine the impact of various factors including patient age, menopausal status, parity, and surgical margin status on HPV persistence. The Wilcoxon test was used to analyze the factors that influenced postoperative HPV viral load. RESULTS Altogether, 607 women were eligible for the final analysis. The persistence rates of HPV at 6 months, 1 year, and 2 years after surgery were 17.3, 13.7, and 10.2 %, respectively. In univariate analysis, the factors that were predictive of the persistence of HPV infection were old age, postmenopausal status, and positive vaginal incision margin with cancer. In multivariate analysis, the significant independent predictive factors were postmenopausal status and positive vaginal incision margin with cancer (P < 0.05, odds ratio (OR) = 2.289, 95 % confidence interval (CI): 1.262-4.150 and OR = 3.271, 95 % CI: 1.253-8.537, respectively). A vaginal lesion with cancer or squamous intraepithelial lesion (SIL) and positive vaginal incision margin influenced HPV viral load at 6 months after surgery (P < 0.05). CONCLUSIONS Postmenopausal patients and those with positive vaginal incision margin with cancer are at an increased risk of HPV persistence after surgical treatment for cervical cancer. Vaginal lesions with cancer or SILs and positive vaginal incision margin are risk factors for high HPV viral load after surgery.
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Affiliation(s)
- Qing Wang
- Department of Gynecology, the Obstetrics and Gynecology Hospital of Fudan University, 419 Fang-xie Road, Shanghai 200011, PR China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China; Zhabei Central Hospital, Jing 'an District, Shanghai, PR China
| | - Fang-Yue Zhou
- Department of Gynecology, the Obstetrics and Gynecology Hospital of Fudan University, 419 Fang-xie Road, Shanghai 200011, PR China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China; International Peace Maternal and Child Health Hospital, Shanghai, PR China
| | - Jing-Xin Ding
- Department of Gynecology, the Obstetrics and Gynecology Hospital of Fudan University, 419 Fang-xie Road, Shanghai 200011, PR China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, PR China.
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Maruyama JM, Tovo-Rodrigues L, Santos IS, Murray J, Matijasevich A. Adolescent Mental Health Before and During COVID-19: Longitudinal Evidence From the 2004 Pelotas Birth Cohort in Brazil. J Adolesc Health 2024; 74:729-738. [PMID: 38310505 DOI: 10.1016/j.jadohealth.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE There is great interest in examining the consequences of the COVID-19 pandemic on adolescent mental health, but most studies were conducted in high-income countries. The identification of overall effects and protective factors is essential to understand the determinants of mental wellbeing in contexts of stress. We aimed to study changes in adolescent mental health during the pandemic and the risk and protective factors associated with these changes in a Brazilian birth cohort. METHODS One thousand nine hundred forty nine adolescents from the 2004 Pelotas Birth Cohort were assessed prepandemic (T1, November 2019 to March 2020, mean age 15.69 years) and mid-pandemic (T2, August to December 2021, mean age 17.41 years). Mental health was assessed using the Strengths and Difficulties Questionnaire. Prepandemic and pandemic-related predictors were examined as predictors of change in multivariate latent change scores models. RESULTS There was a mean increase in adolescent total mental health difficulties (M = 1.071, p < .001), hyperactivity/inattention (M = 0.208, p < .001), emotion symptoms (M = 0.409, p < .001), and peer problems (M = 0.434, p < .001) during the pandemic. This increase was associated with several negative family context variables, including harsh parenting and maternal depressive symptoms at T2. Higher emotion regulation levels protected against increases in adolescent mental health difficulties related to the COVID-19 pandemic. DISCUSSION Family-context variables emerged as important risk factors for the deterioration of adolescent mental health during the COVID-19 pandemic. Interventions promoting emotion regulation strategies are a promising approach to protecting adolescent wellbeing in periods of stress.
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Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
| | | | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Bergamin G, Hudson J, Currie BJ, Mounsey KE. A systematic review of immunosuppressive risk factors and comorbidities associated with the development of crusted scabies. Int J Infect Dis 2024:107036. [PMID: 38570134 DOI: 10.1016/j.ijid.2024.107036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVES Crusted scabies (CS, Norwegian scabies) is a severe form of scabies, characterised by hyper-infestation of Sarcoptes scabiei mites. CS is commonly associated with immunosuppression but is also reported in overtly immunocompetent individuals. We reviewed immunosuppressive risk factors and comorbidities associated with CS. METHODS The National Library of Medicine (PubMed) database was reviewed for patient case reports of CS from January 1998 to July 2023. Two authors screened records for eligibility, extracted data, and one critically appraised the quality of the studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023466126. RESULTS 436 records were identified, of which 204 were included for systematic review. From these, 683 CS patients were included. CS impacted both genders equally. Adults (21-59 years) were more commonly affected (45.5%) compared to children (0-20 years, 21%). Corticosteroid use was the most prevalent immunosuppressive risk factor identified (27.7% of all cases). 10.2% of reports were associated with HIV/AIDS, and 8.5% with HTLV-1 infection. 10.5% of patients were overtly immunocompetent with no known risk factors. Overall, 41 (6.0%) died, many subsequent to secondary bacteremia. CONCLUSION This study represents the first systematic review undertaken on immunosuppressive risk factors associated with CS. This provides insights into trends of immunosuppression and mechanisms of CS development.
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Affiliation(s)
- Gianni Bergamin
- School of Health, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, Queensland, 4558, Australia.; School of Medicine and Dentistry, Griffith University, Birtinya, Queensland, Australia.; Sunshine Coast Health Institute, Birtinya, Queensland, Australia
| | - Joshua Hudson
- School of Health, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, Queensland, 4558, Australia.; School of Medicine and Dentistry, Griffith University, Birtinya, Queensland, Australia.; Sunshine Coast Health Institute, Birtinya, Queensland, Australia
| | - Bart J Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.; Department of Infectious Diseases, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Kate E Mounsey
- School of Health, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, Queensland, 4558, Australia.; Sunshine Coast Health Institute, Birtinya, Queensland, Australia..
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Abbas TO, Khalil IA, Hatem M, Boyko A, Zorkin S. Plate Objective Scoring Tool (POST) in distal hypospadias: Correlation with post-repair complications. J Pediatr Urol 2024; 20:238.e1-238.e6. [PMID: 38071112 DOI: 10.1016/j.jpurol.2023.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/10/2023] [Accepted: 11/20/2023] [Indexed: 04/22/2024]
Abstract
OBJECTIVES The Plate Objective Scoring Tool (POST) accurately reflects configuration of the urethral plate in distal hypospadias. Here we assessed whether POST score also correlates with patient risk of complications after surgical repair. METHODS Data were obtained prospectively from pre-pubertal boys who underwent primary hypospadias repair between January 2020 and February 2023. Both POST and Glans-Urethral Meatus-Shaft (GMS) scores were determined in triplicate by three independent reviewers before evaluating correlation with complications after surgery. RESULTS POST ratios were strongly correlated with incidence of post-repair complications in n = 121 patients. Mean POST score was 1.10 (range 0.5-1.62) and average GMS value was 5.29 ± 1.36 (median G = 2, M = 2, S = 1). Bivariate correlation analysis indicated that POST score can accurately predict risk of complications after surgery (Pearson correlation coefficient r = 0.821 [0.724-0.918], 95 % CI). A POST threshold of 1.2 provided the highest specificity for risk of post-operative complications, which occurred in 4.4 % of patients with POST score ≥1.2 (2/45 cases), compared with 25 % among patients with POST score <1.2 (19/76 cases). CONCLUSIONS This study confirms that POST index can be used as a surrogate marker of urethral plate quality and accurately predicts the outcome of distal hypospadias repair. Objective scoring of POST revealed that low ratios were significantly associated with high risk of postoperative complications. In future, this approach could be used to stratify patients and better identify cases that require close follow-up care.
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Affiliation(s)
- Tariq O Abbas
- Urology Devision, Department of Surgery, Sidra Medicine, Doha, Qatar; College of Medicine, Qatar University, Doha, Qatar; Weill Cornell Medicine - Qatar, Doha, Qatar.
| | | | - Mohamed Hatem
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Andrey Boyko
- Pediatric Municipal Clinical Hospital, Barnaul, Russia
| | - Sergei Zorkin
- National Medical Research Center for Children's Health, Moscow, Russia
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Melville LA, Innocent G, Dijk JV, Mitchell S, Bartley DJ. Refugia, climatic conditions and farm management factors as drivers of adaptation in Nematodirus battus populations. Vet Parasitol 2024; 327:110120. [PMID: 38266372 DOI: 10.1016/j.vetpar.2024.110120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
Parasites are known for their ability to rapidly adapt to changing conditions. For parasitic helminths, changes in climate, along with farming and management practices associated with the intensification of livestock farming, provide novel challenges which can impact on their epidemiology and control. The sustainability of livestock production partially relies on effective control of helminth infection. Therefore, understanding changes in parasite behaviour, and what drives these, is of great importance. Nematodirus battus is an economically important helminth in the UK and temperate regions. Its infective larvae typically overwinter in eggs on pasture and hatch synchronously in spring, causing acute disease in lambs. Attempts to control disease typically rely on whole-flock benzimidazole (BZ) treatments. In recent years, the emergence of BZ-resistance, alongside the hatching of eggs without the classical over-winter 'chill stimulus', have made N. battus more difficult to control. In three previous studies, after collecting a large number of N. battus populations alongside farm management data from commercial farms, we explored the prevalence of genetic mutations associated with BZ-resistance (n = 253 farms), the ability of eggs to hatch with and without a chill stimulus (n = 90 farms) and how farm management practices varied throughout the UK (n = 187 farms). In the present study, we identify factors which may be acting as drivers, or barriers, to either the development of resistance or the variable hatching behaviour of N. battus eggs. Generalised linear mixed effect models were applied to regress experimental hatching and genotyping data on farm management and additional environmental data. Both variable hatching and resistance development appeared associated with the maintenance of parasite refugia as well as grazing management, particularly reseeding of pasture routinely grazed by young lambs each spring and the practice of set-stocked grazing. Effective quarantine measures were identified as the main protective factor for the development of BZ-resistance whereas set stocked grazing and population bottlenecks, resulting from reseeding heavily contaminated pastures, were risk factors. Spring maximum temperature and other climatic factors were associated with 'typical' hatching of eggs following a chill stimulus whilst several management factors were linked with hatching without prior chilling. For example, practices which reduce parasite numbers on pasture (e.g. re-seeding) or restrict availability of hosts (e.g. resting fields), were found to increase the odds of non-chill hatching. Retention of the timing of lambing and infection level of the host within the fitted model indicated that requirement for a chill stimulus prior to hatching may be plastic, perhaps subject to change throughout the grazing season, in response to immune development or parasite density-dependence within the host. Further investigation of the influence of the factors retained within the fitted models, particularly the theme of parasite refugia which was highlighted in relation to both the presence of BZ-resistance alleles and alternative hatching, is required to establish robust, sustainable parasite control and farm management strategies.
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Affiliation(s)
- Lynsey A Melville
- Department of Disease Control, Moredun Research Institute, Pentlands Science Parks, Bush Loan, EH26 0PZ, UK.
| | - Giles Innocent
- Biomathematics and Statistics Scotland, JCMB, King's Buildings, Peter Guthrie Tait Road, Edinburgh EH9 3FD, UK
| | - Jan Van Dijk
- Zoetis UK Ltd, Birchwood Building, Springfield Drive, Leatherhead KT22 7LP, UK
| | - Sian Mitchell
- Animal and Plant Health Agency, Job's Well Road, Johnstown, Carmarthen SA31 3EZ, UK
| | - David J Bartley
- Department of Disease Control, Moredun Research Institute, Pentlands Science Parks, Bush Loan, EH26 0PZ, UK
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Hasnain N, Arif TB, Shafaut R, Zakaria F, Fatima SZ, Haque IU. Association between sex and Huntington's disease: an updated review on symptomatology and prognosis of neurodegenerative disorders. Wien Med Wochenschr 2024; 174:87-94. [PMID: 35723821 DOI: 10.1007/s10354-022-00941-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
Huntington's disease is a rare autosomal dominant disorder presenting with chorea, rigidity, hypo-/akinesia, cognitive decline, and psychiatric disturbances. Numerous risk factors have been defined in the onset of this disease. However, the number of CAG repeats in the genes are the most crucial factor rendering patients susceptible to the disease. Studies have shown significant differences in onset and disease presentation among the sexes, which prompts analysis of the impact of different sexes on disease etiology and progression. This article therefore discusses the evidence-based role of sex in aspects of symptomatology, pathogenesis, biomarkers, progression, and prognosis of Huntington's disease, with a secondary review of sex-linked differences in Alzheimer's and Parkinson's disease.
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Affiliation(s)
- Nimra Hasnain
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
- Department of Medicine, Dr. Ruth K. M. Pfao Civil Hospital, Karachi, Pakistan
| | - Taha Bin Arif
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
- Department of Medicine, Dr. Ruth K. M. Pfao Civil Hospital, Karachi, Pakistan.
| | - Roha Shafaut
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Faiza Zakaria
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Ibtehaj Ul Haque
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
- Department of Medicine, Dr. Ruth K. M. Pfao Civil Hospital, Karachi, Pakistan
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Marcos-Mangas M, Revilla-Orodea A, Sevilla T, González-Bartol E, Sánchez-Lite I, Urueña-Martínez N, Arnold R, Gómez I, San Román JA. Different prognostic significance of coronary artery and aortic valve calcium in patients with chest pain. Eur Radiol 2024; 34:2658-2664. [PMID: 37731095 DOI: 10.1007/s00330-023-10229-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/09/2023] [Accepted: 07/30/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES Coronary artery calcification (CorCa) identifies high cardiovascular risk in the general population. In this setting, aortic valve calcification (AoCa) showed contradictory results. Our goal has been to assess the prognostic power of CorCa and AoCa in patients with chest pain who underwent an ECG-gated cardiac multidetector CT (cardiac-MDCT). METHODS A total of 528 patients without previous known coronary artery disease, with chest pain who underwent a cardiac-MDCT multidetector, were retrospectively recruited. The primary endpoint included death, acute coronary syndrome, stroke, and heart failure. RESULTS A total of 61 patients (11.6%) had an event during a mean follow-up of almost 6 years (5.95 ± 2.98). The most frequent event was acute coronary syndrome (6.4%). Total mortality was 4.5%. Patients with CorCa > 0 had more events than those without CorCa (17.3% versus 4.3%; p < 0.001). Likewise, when only patients without AoCa were considered (n = 118), clinical events were more frequent in those with CorCa (12.7% versus 3.6%; p = 0.004). After excluding patients with coronary artery disease, events were more frequent in those with CorCa (12.6% versus 4.3%; p = 0.004). The higher the Agatston score, the more frequent the events. Patients with AoCa > 0 had more events than those without (16.5% versus 7.3%; p < 0.001), but in patients without CorCa, no difference in events was seen (6.2% versus 3.6%; p = 0.471). A Cox regression analysis showed age, smoking, prior stroke, and CorCa but not AoCa to be independently related to events. CONCLUSIONS In summary, CorCa, but not AoCa, is related to cardiovascular events in patients with chest pain who undergo a cardiac-MDCT. CLINICAL RELEVANCE STATEMENT We show that coronary artery calcification, but not aortic valve calcification, detected in a coronary CT scan is tightly related to cardiovascular events. Although this is a message already shown by other groups in the general population, we do believe that this work is unique because it is restricted to patients with chest pain sent to coronary CT. In other words, our work deals with what we face in our routine everyday practice. KEY POINTS • The presence and the amount of coronary artery calcification are associated with cardiovascular events in patients with chest pain. • Aortic valve calcification is not associated with cardiovascular events in patients with chest pain.
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Affiliation(s)
- Marta Marcos-Mangas
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
| | - Ana Revilla-Orodea
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Teresa Sevilla
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Esther González-Bartol
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Israel Sánchez-Lite
- Servicio de Radiodiagnóstico, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Noelia Urueña-Martínez
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Roman Arnold
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Itziar Gómez
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - J Alberto San Román
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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Pettersson SD, Skrzypkowska P, Pietrzak K, Och A, Siedlecki K, Czapla-Iskrzycka A, Klepinowski T, Fodor T, Filo J, Meyer-Szary J, Fercho J, Sunesson F, Olofsson HKL, Ali S, Szmuda T, Miekisiak G. Evaluation of PHASES Score for Predicting Rupture of Intracranial Aneurysms: Significance of Aneurysm Size. World Neurosurg 2024; 184:e178-e184. [PMID: 38246529 DOI: 10.1016/j.wneu.2024.01.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Recent data have identified that certain risk factors for rupture differ between small and larger intracranial aneurysms (IAs). Such differing risk factors make up 5 out of the 6 predictor variables used in the PHASES score, which raises the question on whether IA size has a significant effect on the score's performance. METHODS Patients who were diagnosed with an IA incidentally or due to a subarachnoid hemorrhage between 2015 and 2023 were selected for potential inclusion. The median IA size of the cohort was chosen as the cutoff point to categorize small and large (6 mm). The PHASES score was calculated for all patients, and a receiver operating characteristic curve analysis was performed to evaluate the classification accuracy of PHASES in predicting rupture for small and large IAs. RESULTS A total of 677 IAs were included. Among the IAs, 400 (58.9%) presented as UIAs and 279 (41.0%) as subarachnoid hemorrhage. The average PHASES score was 2.9 and 6.5 for small (n = 322) and large (n = 355) IAs, respectively. The PHASES score performed significantly lower for predicting rupture in smaller IAs (area under the curve: 0.634) compared with the larger (area under the curve: 0.741) (P = 0.00083). CONCLUSIONS PHASES was shown to underperform on small IAs. The decision to treat small unruptured IAs remains highly controversial, and the development of a new score to estimate the annual rupture rate while accounting for IA morphology is of great need. Our findings can help encourage future researchers to develop such a score.
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Affiliation(s)
- Samuel D Pettersson
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland; Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Krzysztof Pietrzak
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland
| | - Aleksander Och
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland
| | - Kamil Siedlecki
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland
| | | | - Tomasz Klepinowski
- Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczeci, Poland
| | - Thomas Fodor
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jean Filo
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jarosław Meyer-Szary
- Department of Pediatric Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Justyna Fercho
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland
| | - Fanny Sunesson
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland
| | - Hanna K L Olofsson
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland
| | - Shan Ali
- Neurology Department, Mayo Clinic, Jacksonville, Florida, USA
| | - Tomasz Szmuda
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland
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Pojskic M, Bisson E, Oertel J, Takami T, Zygourakis C, Costa F. Lumbar disc herniation: Epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations. World Neurosurg X 2024; 22:100279. [PMID: 38440379 PMCID: PMC10911853 DOI: 10.1016/j.wnsx.2024.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Objective To formulate the most current, evidence-based recommendations regarding the epidemiology, clinical diagnosis, and radiographic diagnosis of lumbar herniated disk (LDH). Methods A systematic literature search in PubMed, MEDLINE, and CENTRAL was performed from 2012 to 2022 using the search terms "herniated lumbar disc", "epidemiology", "prevention" "clinical diagnosis", and "radiological diagnosis". Screening criteria resulted in 17, 16, and 90 studies respectively that were analyzed regarding epidemiology, clinical diagnosis, and radiographic diagnosis of LDH. Using the Delphi method and two rounds of voting at two separate international meetings, ten members of the WFNS (World Federation of Neurosurgical Societies) Spine Committee generated eleven final consensus statements. Results The lifetime risk for symptomatic LDH is 1-3%; of these, 60-90% resolve spontaneously. Risk factors for LDH include genetic and environmental factors, strenuous activity, and smoking. LDH is more common in males and in 30-50 year olds. A set of clinical tests, including manual muscle testing, sensory testing, Lasegue sign, and crossed Lasegue sign are recommended to diagnose LDH. Magnetic resonance imaging (MRI) is the gold standard for confirming suspected LDH. Conclusions These eleven final consensus statements provide current, evidence-based guidelines on the epidemiology, clinical diagnosis, and radiographic diagnosis of LDH for practicing spine surgeons worldwide.
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Affiliation(s)
- Mirza Pojskic
- Department of Neurosurgery, University of Marburg, Germany
| | - Erica Bisson
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Joachim Oertel
- Department of Neurosurgery, Saarland University Medical Centre, Homburg, Saarland, Germany
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Japan
| | - Corinna Zygourakis
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, USA
| | - Francesco Costa
- Spine Surgery Unit (NCH4) - Department of Neurosurgery - Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Erkan HN, Soyer Er Ö. The Retained Surgical Items Risk Assessment Scale: Development and Psychometric Characteristics. J Surg Res 2024; 296:581-588. [PMID: 38340492 DOI: 10.1016/j.jss.2023.12.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/27/2023] [Accepted: 12/24/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Retained surgical items in operating rooms (ORs) continue to contribute significantly to medical errors. The first step in addressing the problem of retained surgical items is to identify the main risk factors. Identification of risk factors can impact OR standards and reduce such errors. METHODS The research included 270 participants. The data of the study were collected with the Sociodemographic and Clinical Characteristics Form, Operating Room Count Control Form and the Retained Surgical Items Risk Assessment Scale developed. In the analysis of the data, Content Validity Index, Cronbach α, item-total score correlation, Kuder-Richardson, Kappa, exploratory and confirmatory factor analysis, and Receiver Operating Characteristic (ROC) curve analysis were performed. RESULTS The Content Validity Index of the scale was 0.92. Kappa value was 0.993. The explained variance in the exploratory factor analysis of the scale was 50.03%. After confirmatory factor analysis, two factors were obtained for the final version of the 15 items. Factors had been determined as "Count and Surgery" and "Equipment". Among the subdimensions of the scale, Cronbach's α values were between 0.742 and 0.760, and 0.722 for the entire scale. When the ROC analysis results were examined, the cut-off point was ≥8, the specificity was 93.13%, and the sensitivity was 87.50%. The area under the ROC curve was calculated as 0.938. CONCLUSIONS The scale was presented as a valid and reliable measurement tool developed to assess the Retained Surgical Items Risk in ORs. If high-risk patients are checked and necessary precautions are taken before leaving the ORs, the incidence of retained surgical items can be significantly reduced.
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Affiliation(s)
- Hamide Nur Erkan
- Surgical Nursing Department, Afyonkarahisar Health Sciences University, Graduate Education Institute, Afyonkarahisar, Turkey
| | - Özlem Soyer Er
- Assistant Professor, Surgical Nursing Department, Afyonkarahisar Health Sciences University, Faculty of Health Sciences, Afyonkarahisar, Turkey.
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Milani GP, Ronchi A, Agostoni C, Marchisio P, Chidini G, Pesenti N, Bellotti A, Cugliari M, Crimi R, Fabiano V, Pietrasanta C, Pugni L, Mosca F. Long-lasting effects of COVID-19 pandemic on hospitalizations and severity of bronchiolitis. Eur J Pediatr 2024; 183:1751-1758. [PMID: 38236404 PMCID: PMC11001736 DOI: 10.1007/s00431-023-05395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024]
Abstract
Bronchiolitis is a common cause of hospitalization in infants. The long-lasting impact of hygiene and social behavior changes during the pandemic on this disease is debated. We investigated the prevalence of hospitalized cases, clinical severity, and underlying risk factors before and during pandemic. The study was conducted in 27 hospitals in Italy and included infants hospitalized for bronchiolitis during the following four periods: July 2018-March 2019, July 2020-March 2021, July 2021-March 2022, and July 2022-March 2023. Data on demographics, neonatal gestational age, breastfeeding history, underlying chronic diseases, presence of older siblings, etiologic agents, clinical course and outcome were collected. A total of 5330 patients were included in the study. Compared to 2018-19 (n = 1618), the number of hospitalizations decreased in 2020-21 (n = 121). A gradual increase was observed in 2021-22 (n = 1577) and 2022-23 (n = 2014). A higher disease severity (need and length of O2-supplementation, need for non-invasive ventilation, hospital stay) occurred in the 2021-22 and, especially, the 2022-23 periods compared to 2018-19. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity. Conclusions: Compared to adults, COVID-19 in infants is often asymptomatic or mildly symptomatic and rarely results in hospitalization. This study indicates that the pandemic has indirectly induced an increased burden of bronchiolitis among hospitalized infants. This shift, which is not explained by the recognized risk factors, suggests the existence of higher infant vulnerability during the last two seasons. What is known: • The pandemic led to a change in epidemiology of respiratory diseases • Large data on severity of bronchiolitis and underlying risk factors before and during COVID-19 pandemic are scarce What is new: • Compared to pre-pandemic period, hospitalizations for bronchiolitis decreased in 2020-21 and gradually increased in 2021-22 and 2022-23 • Compared to pre-pandemic period, higher disease burden occurred in 2021-22 and, especially, in 2022-23. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity • The interplay among viruses, preventive measures, and the infant health deserves to be further investigated.
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Affiliation(s)
- Gregorio Paolo Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Andrea Ronchi
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Paola Marchisio
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Giovanna Chidini
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Pesenti
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anita Bellotti
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Marco Cugliari
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Riccardo Crimi
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Valentina Fabiano
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Carlo Pietrasanta
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenza Pugni
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Wagner N, Berking C. [Recognition and management of relevant comorbidities in chronic spontaneous urticaria]. Dermatologie (Heidelb) 2024; 75:289-294. [PMID: 38411698 DOI: 10.1007/s00105-024-05311-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/28/2024]
Abstract
Various mechanisms contributing to the activity of chronic spontaneous urticaria (CU) have been postulated. Associated comorbidities are increasingly leading to the discovery of further signaling pathways which may support the activity of chronic urticaria or contribute to low-grade systemic inflammation. Moreover psychoimmunological factors may also be involved. The aim of this work is to improve the clinical care of patients with CU by increasing knowledge regarding optional influencing factors due to comorbidities and to possibly influence disease activity. Chronic urticaria due to autoimmune mechanisms may dispose to other autoimmune diseases, especially autoimmune thyroiditis, which can trigger chronic disease. Association of CU with metabolic syndrome has received little attention to date. Obesity may contribute to low-grade systemic inflammation by cytokine-secreting adipose tissue and hence to mediator-release of mast cells. Furthermore, neuroimmunological pathways, especially increased release of substance P, an activating ligand of Mas-related G protein-coupled receptor X2 (MRGPX2) on mast cells, should be addressed when optimizing therapy.
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Affiliation(s)
- Nicola Wagner
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Deutschland.
| | - Carola Berking
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Deutschland
- Hautklinik, Uniklinikum Erlangen, 91054, Erlangen, Germany
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227
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He Q, Dong C, Song Y, Tang Y, Chu F, Liu W, Zhang Y, Du J, Yu Z, Ma X. Prediction model for haematoma after tissue expander placement: A retrospective cohort study of 7080 cases over 20 years. J Plast Reconstr Aesthet Surg 2024; 91:119-127. [PMID: 38412602 DOI: 10.1016/j.bjps.2024.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/27/2023] [Accepted: 01/29/2024] [Indexed: 02/29/2024]
Abstract
Haematoma is an early complication of tissue expander placement and can lead to infection, capsule contracture and various complications, hindering successful reconstruction. However, no scientific models can accurately predict the risk of haematoma following tissue expansion. Therefore, this study aimed to develop and validate a prediction model for haematoma following tissue expander placement. The medical records of patients who underwent expander placement between 2001 and 2021 were obtained from the clinical database of the Department of Plastic Surgery at the Xijing Hospital. A total of 4579 consecutive patients with 7080 expanders and 179 expanded pocket haematomas were analysed. Multivariate logistic regression analysis identified adult age (P = 0.006), male sex (P < 0.001), scar reconstruction (P = 0.019), perioperative hypertension (P < 0.001), face and neck location (P = 0.002) and activated partial thromboplastin time above the normal range (P < 0.001) as risk factors for haematoma. Therefore, these were included in the prediction model, and a nomogram was constructed. The discrimination of the nomogram was robust (area under the curve: 0.78; 95% confidence interval: 0.72-0.83). Further, the prediction model had a strong fit (Hosmer-Lemeshow test, P = 0.066) and maintained similar discrimination after considering performance optimism (bootstrapped area under the curve: 0.79; 95% confidence interval: 0.73-0.84). This clinical prediction model was created using a generalisable dataset and can be utilised to obtain valid haematoma predictions after expander placement, assisting surgeons in implementing preventive measures or interventions to reduce the occurrence of haematoma.
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Affiliation(s)
- Qiang He
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Chen Dong
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yajuan Song
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yinke Tang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Feifei Chu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Liu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu Zhang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jing Du
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhou Yu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Xianjie Ma
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
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228
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Ajmera Y, Paul K, Khan MA, Kumari B, Kumar N, Chatterjee P, Dey AB, Chakrawarty A. The evaluation of frequency and predictors of delirium and its short-term and long-term outcomes in hospitalized older adults'. Asian J Psychiatr 2024; 94:103990. [PMID: 38447233 DOI: 10.1016/j.ajp.2024.103990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Delirium is a common complication in hospitalized older adults with multifactorial etiology and poor health outcomes. AIM To determine the frequency and predictors of delirium and its short-term and long-term outcomes in hospitalized older adults. METHODS A prospective observational study was performed in patients aged ≥60 years consecutively admitted to geriatric ward. Potential risk factors were assessed within 24 hours of hospital admission. Delirium screening was performed on admission and daily thereafter throughout the hospital stay using Confusion Assessment Method (CAM). Patients were followed up at 1-year post-discharge. RESULTS The study included 200 patients with mean age 73.1 ± 8.83 years. Incidence and prevalence rate of delirium were 5% and 20% respectively. Multivariable regression analysis revealed emergency admission (OR= 5.12 (1.94-13.57), p=0.001), functional dependency (Katz index of Independence in Activities of Daily Living (Katz-ADL) score <5) 2 weeks before admission (OR= 3.08 (1.30-7.33), p=0.011) and more psychopathological symptoms (higher Brief Psychiatric Rating Scale (BPRS) total score) (OR=1.12 (1.06-1.18), p=0.001) to be independently associated with delirium. Patients in delirium group had significantly high in-hospital mortality (OR= 5.02 (2.12-11.8), p=0.001) and post-discharge mortality (HR= 2.02 (1.13-3.61), p=0.017) and functional dependency (Katz-ADL score <5) (OR= 5.45 (1.49-19.31), p=0.01) at 1-year follow up. CONCLUSION Delirium is quite frequent in geriatric inpatients and is associated with high in-hospital and post-discharge mortality risk and long-term functional dependency. Emergency admission, pre-hospitalization functional dependency, and more general psychopathological symptoms are independently associated factors. Hence, earliest identification and treatment with early implementation of rehabilitation services is warranted.
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Affiliation(s)
- Yamini Ajmera
- Department of Geriatric Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Karandeep Paul
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Maroof Ahmad Khan
- Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Bharti Kumari
- Department of Geriatric Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Nand Kumar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Prasun Chatterjee
- Department of Geriatric Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Aparajit Ballav Dey
- Department of Geriatric Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Avinash Chakrawarty
- Department of Geriatric Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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229
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Liao F, Shen Z, Rong J, Zhu Z, Pan X, Wang C, Long S, Zhou X, Li G, Zhu Y, Chen Y, Shu X. Nomogram for predicting electrocoagulation syndrome after endoscopic submucosal dissection of esophageal tumors. Surg Endosc 2024; 38:1877-1883. [PMID: 38307960 DOI: 10.1007/s00464-024-10685-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/03/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) was widely used for the removal of esophageal tumors, and post-endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was one of the postoperative adverse events. The aim of this research was to develop and validate a model to predict electrocoagulation syndrome after endoscopic submucosal dissection of esophageal tumors. MATERIALS AND METHODS Patients who underwent esophageal ESD in our hospital were retrospectively included. A predictive nomogram was established based on the results of multivariate logistic regression analysis, and bootstrapping resampling was used for internal validation. Besides, the clinical usefulness of the nomogram was evaluated using decision curve analysis (DCA) and clinical impact curve. RESULTS A total of 552 patients who underwent esophageal ESD were included in the study, and the incidence of PPECS was 12.5% (69/552). Risk factors associated with PEECS (p < 0.1) were analyzed by multivariate logistic regression analysis, and the final model included four variables, namely gender, diabetes, tumor size and operation time. The predictive nomogram was constructed based on the above four variables, and the area under the ROC curve (AUC) was 0.811 (95% CI 0.767-0.855). The calibration curve of the nomogram presented good agreement between the predicted and actual probabilities. DCA showed that the model improved patient outcomes by helping to assess the risk of PEECS in patients compared to an all-or-no treatment strategy. In addition, the clinical impact curve of the model also indicates that the nomogram has a high clinical net benefit. CONCLUSION In conclusion, we have developed a predictive nomogram for PEECS after ESD for esophageal tumors with good predictive accuracy and discrimination. This predictive nomogram can be effectively used to identify high-risk patients with PEECS, which will help clinicians in clinical decision-making and early intervention.
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Affiliation(s)
- Foqiang Liao
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Zhiying Shen
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jianfang Rong
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Zhenhua Zhu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
- Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Xiaolin Pan
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
| | - Chong Wang
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
| | - Shunhua Long
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
| | - Xiaojiang Zhou
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
| | - Guohua Li
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
| | - Yin Zhu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
| | - Youxiang Chen
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China
| | - Xu Shu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi, China.
- Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
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230
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Fanstone R, Price P. Global perspectives on risk factors for major joint burn contractures: A literature review. Burns 2024; 50:537-549. [PMID: 37977897 DOI: 10.1016/j.burns.2023.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/31/2023] [Accepted: 09/22/2023] [Indexed: 11/19/2023]
Abstract
Contractures are a frequent consequence of burn injuries, yet our knowledge of associated risk factors is limited. This paper provides an extensive review of relevant literature from both High-Income Countries (HICs) and Low-Middle Income Countries (LMICs). Ninety-four papers (up to June 2019) and eight subsequent publications (up to March 2022) were included, 76% of which were from HICs. The majority of publications were either descriptive studies (4 from HICs, 9 from LMICs) or papers citing putative risk factors (37 from HICs, 10 from LMICs). Seventeen publications (all from HICs) reported on the effects of individual non-surgical therapeutic interventions, often with conflicting results. Two published systematic reviews emphasised the poor quality of evidence available. Only fifteen studies (3 from LMICs) examined potential contracture risk factors with statistical comparisons of outcomes; significant findings from these included demographic, burn, comorbidities, and treatment risk factors. LMIC papers included socioeconomic and healthcare system factors as potential risks for contracture; these were rarely considered in HIC publications. Methodological issues identified from this review of literature included differences in contracture definitions, populations studied, standards of care, joints included and the timing and nature of contracture assessments.This review is the first to collate existing knowledge on risk factors for burn contractures from both HIC and LMIC settings, revealing a surprising lack of robust evidence for many accepted risk factors. In LMICs, where burns are particularly common, universal health provision is lacking and specialist burn care is both scarce and difficult to access; consequently, socioeconomic factors may have more immediate impact on contracture outcomes than specific burn treatments or therapies. Much more work is indicated to fully understand the relative impacts of risk factors in different settings so that context-appropriate contracture prevention strategies can be developed.
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Affiliation(s)
- RuthAnn Fanstone
- Centre for Global Burn Injury Policy and Research, Swansea University, UK.
| | - Patricia Price
- Centre for Global Burn Injury Policy and Research, Swansea University, UK
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231
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Abuduxike G, Cali S, Vaizoğlu SA, Aşut Ö, Çavuş M, Olgu M, Çavuş SN, Arkut M, Idehen BO, Almezghwi HAS, Asswayeh HMA, Abawu JJ, Hossain MJ, Almawali NA. An Analysis of the Mode of Delivery, Risk Factors, and Subgroups with High Caesarean Birth Rates Using Robson Classification System. Matern Child Health J 2024; 28:667-678. [PMID: 37840109 DOI: 10.1007/s10995-023-03783-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE We aimed to understand the utilization of the mode of delivery and related risk factors. Further aimed to apply the Robson classification system to evaluate the data quality and analyze the CS rates in subgroups. METHODS We conducted a retrospective descriptive study by reviewing the medical records of all women who delivered at the State Hospital in 2019. A proforma was developed for extracting data from patient records. All women with six obstetric parameters were categorized into Robson groups to determine the absolute and relative contributions of each group to the overall CS rate. RESULTS Of 797 deliveries, 401 (50.2%) were CSs. Being older, being Turkish Cypriot, having preterm births, previous CS, multiple fetuses, and having breech or transverse fetal presentations were related to having higher risks of CS. The most common medical indication for CSs (52.3%) was a history of previous CSs. Robson Group 5 contributed the most (50.7%) to the overall CS rate, with the highest absolute contribution of 21.8%. Group 10 and Group 8 were the second and third highest contributors to the overall CS rate, with relative contributions of 25.3% and 9.0%, respectively. CONCLUSIONS Findings revealed the substandard quality of obstetric data and a noticeably high overall CS rate. The top priority should be given to improving the quality of medical records. It underscored the necessity of implementing the Robson classification system as a standard clinical practice to enhance data quality, which helps to effectively evaluate and monitor the CS rates in obstetric populations.
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Affiliation(s)
- Gulifeiya Abuduxike
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus.
| | - Sanda Cali
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus
| | - Songül Acar Vaizoğlu
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus
| | - Özen Aşut
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus
| | - Mahmut Çavuş
- Dr. Burhan Nalbantoğlu State Hospital Obstetrics and Gynaecology Department, Nicosia, Northern Cyprus
| | - Musa Olgu
- Dr. Burhan Nalbantoğlu State Hospital Obstetrics and Gynaecology Department, Nicosia, Northern Cyprus
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232
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Teramoto M, Tamaki H, Kaida K, Samori M, Takahashi-Hirata S, Utsunomiya N, Katayama A, Fukunaga K, Inoue T, Yoshihara K, Ikegame K, Okada M, Yoshihara S. Pretransplantation predictors of survival in nonremission acute myeloid leukemia treated with haploidentical transplantation using steroid-based GVHD prophylaxis. Ann Hematol 2024; 103:1363-1372. [PMID: 38393656 DOI: 10.1007/s00277-024-05654-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Haploidentical hematopoietic cell transplantation (HCT) using glucocorticoids for acute graft-versus-host disease prophylaxis (GC-haplo) may become a curative treatment option for nonremission acute myeloid leukemia (AML). This retrospective study aimed to identify pre-HCT predictors of survival in a cohort of 97 nonremission AML treated with GC-haplo in Hyogo Medical University Hospital between 2010 and 2020. Relapse and primary induction failure included in 70 (72%) and 27 (28%) patients, respectively. Sixty-one patients (63%) had undergone previous HCT. Multivariate analysis revealed that ≤ 6 months' duration between first complete remission (CR1) and first relapse (Rel1) (CR1-Rel1 interval) (hazard ratio 2.11, 95% confidence interval [CI] 1.15-3.89, P = 0.016) and serum albumin before starting the conditioning treatment of ≤ 3.5 g/dL (hazard ratio 1.80, 95%CI 1.09-2.96, P = 0.022) as risk factors for overall survival. Among three groups categorized according to serum albumin and CR1-Rel1 interval, the best 3-year overall survival was observed in patients with albumin > 3.5 g/dL and CR1-Rel1 interval > 6 months or primary induction failure (50.2%, 95%CI 28.9%-68.3%, P < 0.001), revealing that survival could be predicted using albumin and past CR duration in patients with very high-risk AML not in remission before GC-haplo.
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Affiliation(s)
- Masahiro Teramoto
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Hiroya Tamaki
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan.
| | - Katsuji Kaida
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Mami Samori
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Saki Takahashi-Hirata
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Nobuto Utsunomiya
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Atsushi Katayama
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Keiko Fukunaga
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
- Department of Hematology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Takayuki Inoue
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Kyoko Yoshihara
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Kazuhiro Ikegame
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
| | - Masaya Okada
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
- First Department of Internal Medicine, Kansai Medical University Medical Center, Moriguchi, Osaka, Japan
| | - Satoshi Yoshihara
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
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233
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Ou Y, Li J, Liang C, Hu C, Yao M, Huang Y, Cai X, Yan Y. Risk factors analyses associated with postoperative infection in choledochoscopy for intrahepatic bile duct stones (IHDs): a single-center retrospective study in real-world setting. Surg Endosc 2024; 38:2050-2061. [PMID: 38429573 DOI: 10.1007/s00464-024-10737-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Choledochoscopy is a highly effective approach for managing intrahepatic bile duct stones (IHDs). However, postoperative infection is a common complication that significantly impacts treatment outcomes. Despite its clinical relevance, the risk factors associated with this procedure remain largely unexplored. METHODS This study focused on a consecutive cohort of patients who underwent choledochoscopy for IHDs at our institution between January 2016 and December 2022. The primary objective was to analyze the relationship between various clinical factors and postoperative infection, and to compare the postoperative infection of different choledochoscopic procedures. RESULTS The study cohort consisted of 126 patients, with 60 individuals (47.6%) experiencing postoperative infection. Notably, preoperative biliary obstruction (odds ratio [OR] 1.861; 95% confidence interval [CI] 1.314-8.699; p = 0.010) and operation time (OR 4.414; 95% CI 1.635-12.376; p = 0.004) were identified as risk factors for postoperative infection. Additionally, biliary tract infections (60.00%) were primarily responsible for postoperative infection, with Escherichia coli (47.22%) being the predominant bacterial strain identified in bile cultures. Furthermore, biliary tract obstruction (OR 4.563; 95% CI 1.554-13.401; p = 0.006) and body mass index (BMI) (OR 1.186; 95% CI 1.015-1.386; p = 0.031) were determined to be independent risk factors for postoperative biliary tract infection. CONCLUSIONS The occurrence of postoperative infection in patients undergoing choledochoscopy was primarily associated with the duration of the operation and the presence of preoperative biliary obstruction.
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Affiliation(s)
- Yangyang Ou
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Jianjun Li
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Chunfeng Liang
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Chongyuan Hu
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Ming Yao
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Yubin Huang
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Xiaoyong Cai
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Yihe Yan
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China.
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Carmona Agúndez M, Gallarín Salamanca IM, Salas Martínez J. Free perforation during the first episode of acute diverticulitis: can it be avoided? Updates Surg 2024; 76:521-528. [PMID: 38168842 DOI: 10.1007/s13304-023-01743-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
The aims of the present study are to compare the severity of acute diverticulitis in the first episode and in later bouts, and to determine whether there are risk factors for the presence of free perforation at the onset of diverticulitis. A single-center retrospective study was conducted of patients who developed a first episode of acute diverticulitis between January 2011 and August 2021 diagnosed by computed tomography and followed up for at least 1 year. Free perforation was considered to be present in patients with diverticulitis stage III and IV according to the Hinchey classification (modified by Wasvary). The analysis included 394 patients (224 men and 170 women) with a mean age of 58 years. Forty-eight patients (12.2%) presented free perforation at some point in the course of the disease, 43 during the first episode and 5 during subsequent bouts. The perforation subgroup showed higher rates of stoma creation and mortality (relative risks of 12.3 and 23.5, respectively). In the multivariate analysis, age (OR: 1.041 95% CI 1.016-1.067), lung disease (OR 2.154 95% CI 1.038-4.472) and immunosuppression (OR: 2.812 95% CI 1.315-6.015) were independent factors for free perforation at diverticulitis onset. Free perforation occurs more frequently during the first episode of acute diverticulitis. Older patients, immunosuppressed patients and those with respiratory disease have a greater risk of presenting freely perforated diverticulitis. Therefore, it is essential to maintain a high level of clinical suspicion in these patients to activate early focus control and thus avoid fatal outcomes.
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Affiliation(s)
- María Carmona Agúndez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Badajoz, Badajoz, Spain.
| | | | - Jesús Salas Martínez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Badajoz, Badajoz, Spain
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235
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Jang S, Hwang SO. The risk factors for premalignant and malignant endometrial polyps in premenopausal and postmenopausal women and trends over the past decade: A retrospective study in a single center, South Korea. Eur J Obstet Gynecol Reprod Biol 2024; 295:118-123. [PMID: 38354603 DOI: 10.1016/j.ejogrb.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/09/2024] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES To assess the prevalence and risk factors for premalignancy and malignancy in endometrial polyps and to evaluate trends over the past decade. STUDY DESIGN This was a retrospective study of patients who underwent hysteroscopic polypectomy at Inha University Hospital, South Korea between January 2013 and June 2023. The demographic and clinical characteristics of the patients reviewed to identify risk factors for premalignancy and malignancy in endometrial polyps included the following: age, parity, body mass index, menopausal status, abnormal uterine bleeding symptoms, diabetes mellitus, hypertension, polycystic ovarian syndrome, use of menopausal hormonal therapy or oral contraceptives, tamoxifen treatment in patients with breast cancer, and the number of polyps. RESULTS In total, 725 patients were enrolled, among whom 52 (7.2 %) had premalignant and malignant lesions. In logistic regression analysis, menopause (OR: 8.37, 95 % CI [3.33-21.04]), abnormal uterine bleeding (OR: 7.42, 95 % CI [2.13-25.86]), obesity (OR: 3.22, 95 % CI [1.53-6.77]), multiple polyps (OR: 2.86, 95 % CI [1.39-5.88]) and nulliparity (OR: 2.64, 95 % CI [1.13-6.19]) were significantly associated with premalignancy and malignancy in polyps. Annual trends during the study period showed an increase in the number of patients with three of the five risk factors (obesity, multiple polyps, and nulliparity) and an increase in the prevalence of premalignancy and malignancy in polyps. CONCLUSIONS Menopause, abnormal uterine bleeding, obesity, multiple polyps, and nulliparity increase the risk of premalignancy and malignancy in endometrial polyps. The prevalence of premalignant and malignant polyps has been increasing over the past decade. The risk factors that have contributed to this trend were obesity, nulliparity, and multiple polyps.
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Affiliation(s)
- Shina Jang
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
| | - Sung Ook Hwang
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
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236
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Maimin D, Mentz A, Thomas M, Van Heerden TM, Horn A. The Etiologic Risk Factors for Cerebral Palsy at an Orthopedic Surgery Clinic in South Africa. Pediatr Neurol 2024; 153:175-178. [PMID: 38412782 DOI: 10.1016/j.pediatrneurol.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/07/2024] [Accepted: 01/25/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Cerebral palsy (CP) is a group of disorders that affect movement and posture caused by injury to the developing brain. Although prematurity and low birth weight are common causes in developed countries, birth asphyxia, kernicterus, and infections have been identified as predominant etiologies in Africa. There is, however, very little information on the etiology of CP in South Africa. We aimed to determine the etiology, severity, and topographic distribution of CP in children undergoing orthopedic surgery at our tertiary pediatric unit. METHOD A retrospective folder review was performed for patients with CP who underwent orthopedic surgery from July 2018 to June 2022. Data were collected on perinatal circumstances, etiologic risk factors for developing CP, severity of disability as classified by the Gross Motor Function Classification Scale (GMFCS), and topographic distribution. Descriptive analysis was performed. RESULTS A total of 202 patients were included in the analysis. Prematurity (gestational age less than 37 weeks) was noted in 41.6% of the cohort and was the most common risk factor. Hypoxic-ischemic encephalopathy (30.7%), postnatal infections (13.4%), congenital brain malformations (10.4%), and cerebral infections were the next most common etiologic risk factors. Forty-eight percent of patients were classified as GMFCS IV or V. There was a predominance of bilateral (69.5%) compared with unilateral (21.3%) subtypes. CONCLUSION Most patients undergoing orthopedic surgery for musculoskeletal sequelae of CP had GMFCS levels of IV or V and were bilateral subtypes, emphasizing the need for intervention at a primary care level to decrease the incidence of this frequently preventable condition.
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Affiliation(s)
- Dane Maimin
- Orthopaedic Research Unit, Division of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
| | - Anlume Mentz
- Medical Student, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Michaela Thomas
- Medical Student, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Tao-Mae Van Heerden
- Medical Student, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Anria Horn
- Orthopaedic Research Unit, Division of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Boriboonhirunsarn D, Jetsadakraisorn K. Risk factors of late-onset gestational diabetes diagnosed during 24-28 weeks of gestation after normal early screening: a case-control study. Diabetol Int 2024; 15:187-193. [PMID: 38524937 PMCID: PMC10959907 DOI: 10.1007/s13340-023-00666-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/22/2023] [Indexed: 03/26/2024]
Abstract
Objective To determine the risk factors associated with late-onset GDM (diagnosed between 24 and 28 weeks of gestation) after normal early screening. Methods A case-control study was conducted in 600 singleton pregnant women who started antenatal care before 20 weeks with normal early GDM screening. Repeat screening was performed at 24-28 weeks. Cases were 120 women with late-onset GDM and 480 controls were those without GDM. Risk factors for late-onset GDM were evaluated and pregnancy outcomes were compared. Results Cases were significantly older, and more likely to be overweight or obese. 50-g GCT of ≥ 160 mg/dL and abnormal 1 value of 100-g OGTT significantly increased the risk of late-onset GDM (p = 0.004 and < 0.001 respectively). Independent risk factors were abnormal 1 value of 100-g OGTT from first screening (adjusted OR 5.49, 95% CI 2.70-11.17, p < 0.001), age ≥ 30 years (adjusted OR 2.71, 95% CI 1.66-4.43, p < 0.001), DM in family (adjusted OR 1.76, 95% CI 1.07-2.88, p = 0.025), and BMI ≥ 25 kg/m2 (adjusted OR 1.86, 95% CI 1.17-2.97, p = 0.009). Late-onset GDM significantly increased the risk of preeclampsia, cesarean delivery, LGA, and macrosomia. Conclusion Independent factors associated with late-onset GDM included abnormal 1 value of 100-g OGTT from first screening, age ≥ 30 years, DM in family, and being overweight or obese.
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Affiliation(s)
- Dittakarn Boriboonhirunsarn
- Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand
| | - Kwanjutha Jetsadakraisorn
- Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand
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238
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Bachmann D, von Rickenbach B, Buchmann A, Hüllner M, Zuber I, Studer S, Saake A, Rauen K, Gruber E, Nitsch RM, Hock C, Treyer V, Gietl A. White matter hyperintensity patterns: associations with comorbidities, amyloid, and cognition. Alzheimers Res Ther 2024; 16:67. [PMID: 38561806 PMCID: PMC10983708 DOI: 10.1186/s13195-024-01435-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND White matter hyperintensities (WMHs) are often measured globally, but spatial patterns of WMHs could underlie different risk factors and neuropathological and clinical correlates. We investigated the spatial heterogeneity of WMHs and their association with comorbidities, Alzheimer's disease (AD) risk factors, and cognition. METHODS In this cross-sectional study, we studied 171 cognitively unimpaired (CU; median age: 65 years, range: 50 to 89) and 51 mildly cognitively impaired (MCI; median age: 72, range: 53 to 89) individuals with available amyloid (18F-flutementamol) PET and FLAIR-weighted images. Comorbidities were assessed using the Cumulative Illness Rating Scale (CIRS). Each participant's white matter was segmented into 38 parcels, and WMH volume was calculated in each parcel. Correlated principal component analysis was applied to the parceled WMH data to determine patterns of WMH covariation. Adjusted and unadjusted linear regression models were used to investigate associations of component scores with comorbidities and AD-related factors. Using multiple linear regression, we tested whether WMH component scores predicted cognitive performance. RESULTS Principal component analysis identified four WMH components that broadly describe FLAIR signal hyperintensities in posterior, periventricular, and deep white matter regions, as well as basal ganglia and thalamic structures. In CU individuals, hypertension was associated with all patterns except the periventricular component. MCI individuals showed more diverse associations. The posterior and deep components were associated with renal disorders, the periventricular component was associated with increased amyloid, and the subcortical gray matter structures was associated with sleep disorders, endocrine/metabolic disorders, and increased amyloid. In the combined sample (CU + MCI), the main effects of WMH components were not associated with cognition but predicted poorer episodic memory performance in the presence of increased amyloid. No interaction between hypertension and the number of comorbidities on component scores was observed. CONCLUSION Our study underscores the significance of understanding the regional distribution patterns of WMHs and the valuable insights that risk factors can offer regarding their underlying causes. Moreover, patterns of hyperintensities in periventricular regions and deep gray matter structures may have more pronounced cognitive implications, especially when amyloid pathology is also present.
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Affiliation(s)
- Dario Bachmann
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland.
- Department of Health Sciences and Technology, ETH Zürich, 8093, Zurich, Switzerland.
| | | | - Andreas Buchmann
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
| | - Martin Hüllner
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, 8091, Zurich, Switzerland
| | - Isabelle Zuber
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
| | - Sandro Studer
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
| | - Antje Saake
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
| | - Katrin Rauen
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, 8032, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, 8057, Zurich, Switzerland
| | - Esmeralda Gruber
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
| | - Roger M Nitsch
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
- Neurimmune AG, 8952, Zurich, Schlieren, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
- Neurimmune AG, 8952, Zurich, Schlieren, Switzerland
| | - Valerie Treyer
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, 8091, Zurich, Switzerland
| | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich, Campus Schlieren, Wagistrasse 12, 8952, Zurich, Schlieren, Switzerland
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, 8032, Zurich, Switzerland
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239
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Schwartz J, Rhodes RE, Oh P, Bredin SSD, Perotto MB, González AG, Warburton DER. Increasing Health Behaviors and Psychological Measures with an Adapted Version of the ACCELERATION Program. Int J Behav Med 2024:10.1007/s12529-024-10279-1. [PMID: 38557740 DOI: 10.1007/s12529-024-10279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Recent evidence highlights the importance of interventions tackling physical inactivity and unhealthy eating in lower-income countries. The purpose of this study was to examine the effectiveness of the Canadian ACCELERATION lifestyle program adapted to Brazilians. The main outcomes of the study were changes in the engagement in weekly moderate-to-vigorous physical activity (MVPA) and in the daily consumption of fruits/vegetables. METHODS The adapted intervention consisted of a 12-week quasi-randomized controlled trial delivered through email. The data from the original Canadian experimental group (CE, n = 194) and the two groups of Portuguese-speaking Brazilians living in Canada in the adapted program - Brazilian experimental (BE, n = 41) and Brazilian control (BC, n = 35) - were assessed at baseline and post-intervention. The data of the 270 participants were analyzed using two-way repeated measures factorial ANCOVA (group x time) for ratio variables and Chi-square and McNemar tests for the categorical variables. RESULTS The BE group had a significant increase in MVPA (mean difference, 95% CI: 86.3, 38.1-134.4 min/week) and fruits/vegetables intake (3.2, 1.4-5.1 servings/day) after the intervention (both p < 0.001). The proportion of participants engaging in ≥ 150 min of MVPA increased from 4.9% to 73.2%, while adoption of a healthy diet increased from 4.9% to 53.7% in the BE group (both p < 0.001). The CE group also improved on these variables (p < 0.05) with no difference vs the BE group (p > 0.05), whereas BC did not show changes (p > 0.05). CONCLUSION The Brazilian version of the ACCELERATION program effectively promoted positive health behavior changes in its participants and has the potential to contribute to the fight against risk factors for chronic diseases in Brazilians.
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Affiliation(s)
- Juliano Schwartz
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada.
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Paul Oh
- Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Shannon S D Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
| | - Maira B Perotto
- West Toronto Diabetes Education Program, LAMP Community Health Centre, Toronto, ON, Canada
| | - Alejandro Gaytán González
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Institute of Applied Sciences for Physical Activity and Sport, University of Guadalajara, Guadalajara, Mexico
| | - Darren E R Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
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240
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Zangpo T, Tsheten, Tenzin P, Dorji C, Nima G, Dorjee S, Sultana R. Demographic risk factors for extra-pulmonary tuberculosis: a rising public health threat in Bhutan. Indian J Tuberc 2024; 71:137-146. [PMID: 38589117 DOI: 10.1016/j.ijtb.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/16/2023] [Accepted: 04/20/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Recently, extra-pulmonary tuberculosis (EPTB) has been increasingly reported in Bhutan, rising from 26% in 2001 to 39% in 2010. In 2016, almost half (49%) of all reported TB cases were classified as EPTB. Thus, this study was conducted to understand the epidemiology and identify risk factors contributing to increasing notification of EPTB in Bhutan. METHODS A case-control study was conducted by recruiting all 110 cases of nationally notified EPTB (Extrapulmonary bacteriologically confirmed/EPBC) as cases and 235 Pulmonary TB (Pulmonary bacteriologically confirmed/PBC) as controls. Data were collected on socio-demography, clinical and diagnostic, behavioral and lifestyle and environmental exposures using a structured questionnaire between April and September, 2018. RESULTS The median age of the cases was 25 years, ranged 9-79 years. Lymphatic TB was predominant (n = 78; 70.91%) followed by genitourinary TB (n = 4 (3.64%). The likelihood of EPTB decreased with increase in age (p = 0.023). The odds of EPTB in females was 1.65 times higher than the males (p = 0.038). Increase in Body Mass Index (adjusted odds ratio (AOR): 1.1; 95% confidence interval (CI): 1.052-1.200) and urban residency were (AOR 1.6; 95% CI 1.016-2.805) were found to have higher odds of developing EPTB. CONCLUSION Females, urban residents, and those with higher BMI are at increased risk of developing EPTB. These at-risk groups can be used to target limited public health resources to control EPTB in Bhutan.
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Affiliation(s)
- Tandin Zangpo
- Communicable Disease Division, Department of Public Health, Ministry of Health, Thimphu, Bhutan.
| | - Tsheten
- Royal Centre for Disease Control, Department of Public Health, Ministry of Health, Bhutan
| | - Phurpa Tenzin
- National Tuberculosis Control Program, Department of Public Health, Ministry of Health, Bhutan
| | - Chencho Dorji
- Gidakom Hospital, Ministry of Health, Thimphu, Bhutan
| | - Gaki Nima
- Jigme Dorji Wangchuk National Referral Hospital, Thimphu, Bhutan
| | - Sithar Dorjee
- Khesar Gyalpo University of Health Sciences of Bhutan, Thimphu, Bhutan
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241
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Bruyneel A, Miesse I, Mathieu D, Djuidjé Yuemo C, Simon A. Prevalence and factors associated with methicillin-resistant Staphylococcus aureus colonization on admission to geriatric care units: impact on screening practices. J Hosp Infect 2024; 146:109-115. [PMID: 38309666 DOI: 10.1016/j.jhin.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/04/2024] [Accepted: 01/14/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Universal screening for methicillin-resistant Staphylococcus aureus (MRSA) entails additional costs, and there is no consensus for targeted screening for high-risk units. The aims of this study were to determine the prevalence of MRSA in geriatric care units, and to identify the factors associated with MRSA colonization on admission. METHODS This retrospective case-control study (1:1) in the geriatric care unit of six Belgian hospitals covered the period from 1st January 2021 to 31st December 2022. Cases were patients with a positive MRSA screening result within 48 h of admission to the geriatric care unit, and controls were patients with a negative screening result. RESULTS In total, 556 patients were included in this study (278 in each group). Prevalence per 100 admissions for the total sample was 2.3 [95% confidence interval (CI) 2.2-2.6]. Significant multi-variate factors associated with MRSA carriage on admission were: history of MRSA, nursing home origin, and chronic skin lesions. Applying these three factors would give an area under the receiver operating characteristic (ROC) curve of 0.73 (95% CI 0.71-0.77), and would allow screening to be carried out in only 55.4% of cases (95% CI 51.2-59.6%). CONCLUSIONS Using these factors as screening criteria in geriatric care units could significantly reduce the number of patients screened for MRSA, while maintaining satisfactory sensitivity and specificity.
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Affiliation(s)
- A Bruyneel
- Hospital Outbreak Support Team, Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium; Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Belgium.
| | - I Miesse
- Hospital Outbreak Support Team, Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium
| | - D Mathieu
- Hospital Outbreak Support Team, Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium; Infectiology - Infection Prevention and Control Department, CHU Tivoli, La Louviere, Belgium
| | | | - A Simon
- Infection Control Team, CHU HELORA, Belgium
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Buffarini R, Coll CV, Esposti MD, Murray J. Unique and shared risk factors for early childhood victimisation and polyvictimisation in a Brazilian population-based birth cohort. Lancet Reg Health Am 2024; 32:100715. [PMID: 38510789 PMCID: PMC10950884 DOI: 10.1016/j.lana.2024.100715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 02/02/2024] [Accepted: 03/01/2024] [Indexed: 03/22/2024]
Abstract
Background Identifying modifiable risk factors for child victimisation and polyvictimisation (exposure to multiple types of victimisation) is critical for informing prevention efforts, yet little evidence is available in low- and middle-income countries. The authors aimed to estimate the prevalence of child victimisation and polyvictimisation, and examine unique and shared risk factors in a population-based cohort in Southern Brazil. Methods Lifetime child victimisation was based on maternal report when children were aged 4 years old (N∼3900) and included five types of victimisation (conventional crime, child maltreatment, peer/sibling victimisation, sexual victimisation, and witnessing/indirect victimisation) and polyvictimisation. Based on a socioecological model, possible risk factors were examined in four levels: community, maternal and family, parent, and child. Findings Conventional crime and peer/sibling victimisation were the most common types of victimisation (46.0 and 46.5%, respectively), followed by witnessing/indirect victimisation (27.0%), and child maltreatment (11.3%). Sexual victimisation had the lowest prevalence (1.4%). One in 10 (10.1%) children experienced polyvictimisation. In general, boys had higher victimisation rates than girls. There were few risk factors related only to specific types of victimisation (e.g., child disability was uniquely associated with child maltreatment and peer/sibling victimisation). Instead, most risk factors were shared across nearly all victimisation types and also associated with polyvictimisation. These shared risk factors were: violent neighbourhood and low social cohesion, maternal adverse childhood experiences, younger maternal age, parental antisocial behaviour, intimate partner violence against mothers, and maternal depression. Interpretation These findings reveal a general pattern of accumulative risk effects for different types of victimisation and polyvictimisation, rather than unique risk profiles in children aged four year Prevention efforts should target risk factors at multiple levels (e.g.,: community, maternal and family and parent) during early childhood. Funding Wellcome Trust grant 10735_Z_18_Z.
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Affiliation(s)
- Romina Buffarini
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
| | - Carolina V.N. Coll
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
| | - Michelle Degli Esposti
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
| | - Joseph Murray
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, RS, Brazil
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Giribabu P, Karan N, Sriganesh K, Shukla D, Devi BI. Incidence, risk factors and impact of anemia after elective neurosurgery: A retrospective cohort study. World Neurosurg X 2024; 22:100289. [PMID: 38444872 PMCID: PMC10914572 DOI: 10.1016/j.wnsx.2024.100289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 02/20/2024] [Indexed: 03/07/2024] Open
Abstract
Objectives Anemia after surgery is common and is associated with adverse clinical outcomes. Understanding the incidence and risk factors for postoperative anemia is important to reduce anemia-related complications and blood transfusion. There is lack of data regarding postoperative anemia and its contributing factors in neurosurgery. This study evaluates the incidence and risk factors of postoperative anemia, and its impact on clinical outcomes. Methods This was a single centre, retrospective study of patients who underwent elective neurosurgery over seven months. Data regarding age, gender, body mass index, American Society of Anesthesiologists (ASA) physical status, diagnosis, surgery, preoperative hemoglobin, surgery duration, intraoperative blood loss and red blood cell (RBC) transfusion, dose of tranexamic acid, intraoperative fluid balance, years of surgeon's experience, postoperative hemoglobin, postoperative RBC transfusion, Glasgow Coma Scale (GCS) score at hospital discharge, and duration of postoperative intensive care unit and hospital stay were collected. Logistic regression was used to identify predictors of postoperative anemia. Results The incidence of postoperative anemia was 11.3% (116/1025). On univariate analysis; age, preoperative hemoglobin, surgery duration, gender, ASA grade, surgery type, and surgeon's experience were associated with postoperative anemia. Lower preoperative hemoglobin (p<0.001) and non-tumor surgery (p<0.001) were predictive of postoperative anemia on multivariate analysis. Postoperative anemia resulted in increased RBC transfusion (p<0.001) and lower GCS score at discharge (p=0.012). Conclusions Atleast one in ten patients undergoing elective neurosurgery develop postoperative anemia. Lower preoperative hemoglobin and non-tumor surgery predict anemia. Anemia results in increased RBC transfusion and lower discharge GCS score.
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Affiliation(s)
- Parthiban Giribabu
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences Bengaluru, India
| | - Nupur Karan
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences Bengaluru, India
| | - Kamath Sriganesh
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences Bengaluru, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - B Indira Devi
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Voltin CA, Paccagnella A, Winkelmann M, Heger JM, Casadei B, Beckmann L, Herrmann K, Dekorsy FJ, Kutsch N, Borchmann P, Fanti S, Kunz WG, Subklewe M, Kobe C, Zinzani PL, Stelljes M, Roth KS, Drzezga A, Noppeney R, Rahbar K, Reinhardt HC, von Tresckow B, Seifert R, Albring JC, Blumenberg V, Farolfi A, Flossdorf S, Gödel P, Hanoun C. Multicenter development of a PET-based risk assessment tool for product-specific outcome prediction in large B-cell lymphoma patients undergoing CAR T-cell therapy. Eur J Nucl Med Mol Imaging 2024; 51:1361-1370. [PMID: 38114616 PMCID: PMC10957657 DOI: 10.1007/s00259-023-06554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The emergence of chimeric antigen receptor (CAR) T-cell therapy fundamentally changed the management of individuals with relapsed and refractory large B-cell lymphoma (LBCL). However, real-world data have shown divergent outcomes for the approved products. The present study therefore set out to evaluate potential risk factors in a larger cohort. METHODS Our analysis set included 88 patients, treated in four German university hospitals and one Italian center, who had undergone 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (PET) before CAR T-cell therapy with tisagenlecleucel or axicabtagene ciloleucel. We first determined the predictive value of conventional risk factors, treatment lines, and response to bridging therapy for progression-free survival (PFS) through forward selection based on Cox regression. In a second step, the additive potential of two common PET parameters was assessed. Their optimal dichotomizing thresholds were calculated individually for each CAR T-cell product. RESULTS Extra-nodal involvement emerged as the most relevant of the conventional tumor and patient characteristics. Moreover, we found that inclusion of metabolic tumor volume (MTV) further improves outcome prediction. The hazard ratio for a PFS event was 1.68 per unit increase of our proposed risk score (95% confidence interval [1.20, 2.35], P = 0.003), which comprised both extra-nodal disease and lymphoma burden. While the most suitable MTV cut-off among patients receiving tisagenlecleucel was 11 mL, a markedly higher threshold of 259 mL showed optimal predictive performance in those undergoing axicabtagene ciloleucel treatment. CONCLUSION Our analysis demonstrates that the presence of more than one extra-nodal lesion and higher MTV in LBCL are associated with inferior outcome after CAR T-cell treatment. Based on an assessment tool including these two factors, patients can be assigned to one of three risk groups. Importantly, as shown by our study, metabolic tumor burden might facilitate CAR T-cell product selection and reflect the individual need for bridging therapy.
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Affiliation(s)
- Conrad-Amadeus Voltin
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Andrea Paccagnella
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Michael Winkelmann
- Department of Radiology, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Jan-Michel Heger
- Department of Internal Medicine I, Center for Integrated Oncology Aachen-Bonn-Cologne-Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cologne Lymphoma Working Group (CLWG), Cologne, Germany
| | - Beatrice Casadei
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- 'L. e A. Seràgnoli' Institute of Hematology, Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS) 'Azienda Ospedaliero-Universitaria Di Bologna', University of Bologna, Bologna, Italy
| | - Laura Beckmann
- Department of Internal Medicine I, Center for Integrated Oncology Aachen-Bonn-Cologne-Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Essen, Germany
| | - Franziska J Dekorsy
- Department of Nuclear Medicine, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Nadine Kutsch
- Department of Internal Medicine I, Center for Integrated Oncology Aachen-Bonn-Cologne-Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cologne Lymphoma Working Group (CLWG), Cologne, Germany
| | - Peter Borchmann
- Department of Internal Medicine I, Center for Integrated Oncology Aachen-Bonn-Cologne-Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cologne Lymphoma Working Group (CLWG), Cologne, Germany
| | - Stefano Fanti
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- Division of Nuclear Medicine, Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS) 'Azienda Ospedaliero-Universitaria Di Bologna', University of Bologna, Bologna, Italy
| | - Wolfgang G Kunz
- Department of Radiology, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Marion Subklewe
- Department of Medicine III, Comprehensive Cancer Center Munich (CCCM), University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, Gene Center Munich, Ludwig Maximilian University Munich, Munich, Germany
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF) Partner Site Munich, Munich, Germany
| | - Carsten Kobe
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Pier Luigi Zinzani
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- 'L. e A. Seràgnoli' Institute of Hematology, Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS) 'Azienda Ospedaliero-Universitaria Di Bologna', University of Bologna, Bologna, Italy
| | - Matthias Stelljes
- Department of Medicine A-Hematology, Oncology, and Pneumology, West German Cancer Center (WTZ) Network Partner Site, University Hospital Münster, University of Münster, Münster, Germany
| | - Katrin S Roth
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Richard Noppeney
- German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Essen, Germany
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kambiz Rahbar
- Department of Nuclear Medicine, University Hospital Münster, University of Münster, Münster, Germany
| | - H Christian Reinhardt
- German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Essen, Germany
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Bastian von Tresckow
- German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Essen, Germany
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Robert Seifert
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Essen, Germany
- Department of Nuclear Medicine, University Hospital Münster, University of Münster, Münster, Germany
| | - Jörn C Albring
- Department of Medicine A-Hematology, Oncology, and Pneumology, West German Cancer Center (WTZ) Network Partner Site, University Hospital Münster, University of Münster, Münster, Germany
| | - Viktoria Blumenberg
- Department of Medicine III, Comprehensive Cancer Center Munich (CCCM), University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, Gene Center Munich, Ludwig Maximilian University Munich, Munich, Germany
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF) Partner Site Munich, Munich, Germany
| | - Andrea Farolfi
- Division of Nuclear Medicine, Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS) 'Azienda Ospedaliero-Universitaria Di Bologna', University of Bologna, Bologna, Italy
| | - Sarah Flossdorf
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Philipp Gödel
- Department of Internal Medicine I, Center for Integrated Oncology Aachen-Bonn-Cologne-Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cologne Lymphoma Working Group (CLWG), Cologne, Germany
| | - Christine Hanoun
- German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Essen, Germany
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Mpakaniye P, Boven A, Callens S, Engstrand L, Vlieghe E, Brusselaers N. Clostridioides difficile recurrence in individuals with and without cancer: a Swedish population-based cohort study. Infection 2024; 52:649-660. [PMID: 38407777 PMCID: PMC10954957 DOI: 10.1007/s15010-024-02193-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/19/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE Patients with cancer are vulnerable to Clostridioides difficile infection (CDI) due to their disease, treatment and regular hospital contact, yet if CDI-recurrence is more common remains unclear, and differences among cancer types remain unexplored. METHODS This Swedish nationwide population-based cohort included all 43,150 individuals with recorded CDI (2006-2019) to assess CDI-recurrence in individuals with and without cancer, with binary multivariable logistic regression, stratified by anatomical location, and survival status. RESULTS Compared to those without cancer (N = 29,543), ongoing cancer (diagnosis < 12 months; N = 3,882) was associated with reduced recurrence (OR = 0.81, 95% CI 0.73-0.89), while there was no association with cancer history (diagnosis ≥ 12 months; N = 9,725). There was an increased 8-week all-cause mortality (Ongoing cancer: OR = 1.58, 95% CI 1.43-1.74; Cancer history: OR = 1.45, 95% CI 1.36-1.55) compared to those without cancer. Among CDI-survivors, those with ongoing cancer presented with a decreased odds of recurrence (OR = 0.84, 95% CI 0.76-0.94), compared to those without cancer history, with no association for those with cancer history (OR = 1.04, 95% CI 0.97-1.1). Large variations were seen across cancer types, with the highest observed proportion of recurrence in oral and mesothelial cancer, and the lowest for esophageal cancer, although no statistically significant OR were found. CONCLUSION The population-based study indicates that individuals with cancer may have fewerrecurrences than expected, yet variations by cancer type were large, and mortality was high.
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Affiliation(s)
- Peace Mpakaniye
- Centre for Translational Microbiome Research, Department Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Annelies Boven
- Centre for Translational Microbiome Research, Department Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
- The Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Steven Callens
- General Internal Medicine and Infectious Diseases, Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Lars Engstrand
- Centre for Translational Microbiome Research, Department Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Erika Vlieghe
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
- Infectious Diseases, Department of General Medicine, Antwerp University Hospital, Antwerp, Belgium
| | - Nele Brusselaers
- Centre for Translational Microbiome Research, Department Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
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Varon B, Palacios-Baena ZR, de Kraker MEA, Rodríguez-Baño J, Leibovici L, Paul M. Universal Risk Factors for Mortality in Bloodstream Infections (UNIFORM): a systematic review and Delphi survey. Clin Microbiol Infect 2024; 30:453-461. [PMID: 38182050 DOI: 10.1016/j.cmi.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/27/2023] [Accepted: 12/31/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Significant variations in the variables collected in clinical studies focusing on bacteraemia lead to inconsistency in the evaluation of risk factors for mortality. OBJECTIVE We aimed to define a minimum set of risk factors that should be assessed and reported in all studies assessing survival in bacteraemia. STUDY ELIGIBILITY We conducted a systematic review including observational prospective and retrospective cohort studies that assessed all-cause mortality among patients with bacteraemia. We included only studies computing an adjusted analysis for mortality, with >500 participants. EXPOSURES Independently significant risk factors for all-cause, preferably 30-day, mortality. DATA SOURCES PubMed was used to identify eligible studies published between 2000 and 2020. A Delphi survey among experts was used to evaluate and prioritize the factors identified by the systematic review. RISK OF BIAS SIGN checklist complemented by risk of bias assessment of the adjusted analysis. DATA SYNTHESIS Definite universal risk factors were defined as those assessed in >50% of all included studies and significant in >50% of those. Potential universal risk factors were defined as those significant in >50% of studies evaluating the factor and a subgroup analysis was performed for studies of Staphylococcus aureus bacteraemia. RESULTS We included in the systematic review 62 studies, comprising more than 300,000 patients, from which a list of 17 risk factors was derived, whose association with all-cause mortality was statistically significant in most studies. The factors address baseline patient variables, the setting of infection acquisition, factors associated with the specific infection, the inflammatory response at onset of sepsis and management parameters where relevant. There were 14 risk factors for S. aureus bacteraemia. CONCLUSION We identified a minimum set of universal factors to be collected, reported, and assessed, in all future studies evaluating factors associated with mortality in bacteraemia to improve study quality and harmonization.
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Affiliation(s)
- Ben Varon
- Medicine B and H, Rambam Healthcare Campus, Haifa, Israel
| | - Zaira R Palacios-Baena
- Infectious Diseases Division, Hospital Universitario Virgen Macarena, Seville, Spain; Department of Medicine, University of Seville/Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Marlieke E A de Kraker
- Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Jesús Rodríguez-Baño
- Infectious Diseases Division, Hospital Universitario Virgen Macarena, Seville, Spain; Department of Medicine, University of Seville/Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Leonard Leibovici
- Research Authority, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
| | - Mical Paul
- Infectious Diseases Institute, Rambam Healthcare Campus, Haifa, Israel; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
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Sun Y, Wang Y, Cheng X, Wu W, Liu Q, Chen X, Ren F. Risk factors for pelvic and para-aortic lymph node metastasis in non-endometrioid endometrial cancer. Eur J Surg Oncol 2024; 50:108260. [PMID: 38484492 DOI: 10.1016/j.ejso.2024.108260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/20/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE The aim of this study was to evaluate the risk factors for pelvic lymph node metastasis (LNM) and para-aortic LNM in non-endometrioid endometrial cancer (non-EEC). METHODS A total of 283 patients with non-EEC hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were included. Various characteristics were retrospectively analyzed in relation to LNM. RESULTS Univariable and multivariable logistic regression analysis revealed cervical stromal invasion (OR = 3.441, 95% CI = 1.558-7.6, p = 0.002), myometrial invasion ≥1/2 (OR = 2.661, 95% CI = 1.327-5.337, p < 0.006), lymphovascular space involvement (LVSI) (OR = 4.118, 95% CI = 1.919-8.837, p < 0.001), positive peritoneal cytology (OR = 2.962, 95% CI = 1.344-6.530, p = 0.007), CA125 (OR = 1.002, 95% CI = 1-1.004, p = 0.026) were the independent risk factors for pelvic LNM. And myometrial invasion ≥1/2 (OR = 5.881, 95% CI = 2.056-16.427, p = 0.001), LVSI (OR = 4.962, 95% CI = 1.933-12.740, p = 0.001), adnexal (OR = 5.921, 95% CI = 2.003-17.502, p = 0.001) were the independent risk factors for para-aortic LNM. With the increase of independent risk factors, the rates of LNM were increased significantly. CONCLUSIONS Cervical stromal invasion, myometrial invasion ≥1/2, LVSI, positive peritoneal cytology, and CA125 were risk factors for pelvic LNM. Myometrial invasion ≥1/2, LVSI and involvement of the adnexa were risk factors for para-aortic LNM which could provide a good basis to help predict which non-EEC patients are at higher risk for LNM.
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Affiliation(s)
- Yi Sun
- Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Yuanpei Wang
- Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xiaoran Cheng
- Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Weijia Wu
- Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Qianwen Liu
- Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xuerou Chen
- Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Fang Ren
- Deparment of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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Tang B, Liu L, Cui L, Wang Y, Yuan X, Liu Y, Chen X. Analysis of adjacent vertebral fracture after percutaneous vertebroplasty: do radiological or surgical features matter? Eur Spine J 2024; 33:1524-1532. [PMID: 38315225 DOI: 10.1007/s00586-023-08092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 03/30/2023] [Accepted: 04/18/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE To report the incidence and risk factors of adjacent vertebral fracture (AVF) after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fractures (OVCFs). We focused to investigate effect of radiological or surgical features on AVF. METHODS All patients with OVCFs who were treated with PVP between January 2016 and December 2019 were retrospectively reviewed. Patients were followed up at least 12 months after procedure according to treatment protocol. AVF was defined as postoperatively recurrent intractable back pain and subsequently presence of fracture on magnetic resonance imaging (MRI) in adjacent levels. Clinical, radiological, and surgical factors potentially affecting occurrence of AVF were recorded and analyzed using univariate and multivariate analysis. RESULTS Totally, 1077 patients with 1077 fractured vertebrae who underwent PVP were enrolled in the study, after inclusion and exclusion criteria were met. Mean follow-up time was 24.3 ± 11.9 months (range, 12-59 months). AVF was identified in 98 (9.1%) patients. Univariate analysis showed that seven significant factors related to AVF were older age, non-traumatic fracture, cortical disruption on anterior wall, cortical disruption on lateral wall, basivertebral foramen, type-B leakage and type-C leakage. In multivariate analysis, two clinical factors, older age (P = 0.031) and non-traumatic fracture (P = 0.002), were significantly associated with AVF. However, any radiological or surgical factor did not reach significance in final model analysis. CONCLUSIONS Incidence of AVF after PVP in patients with OVCFs was 9.1% (98/1077). Older age and non-traumatic fracture were two clinical risk factors for AVF. Neither radiological nor surgical feature was significantly correlated with AVF.
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Affiliation(s)
- Benqiang Tang
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, No.82, Xinhua South Road, Touzhou District, Beijing, China
| | - Liang Liu
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, No.82, Xinhua South Road, Touzhou District, Beijing, China
| | - Libin Cui
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, No.82, Xinhua South Road, Touzhou District, Beijing, China
| | - Yanhui Wang
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, No.82, Xinhua South Road, Touzhou District, Beijing, China
| | - Xin Yuan
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, No.82, Xinhua South Road, Touzhou District, Beijing, China
| | - Yadong Liu
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, No.82, Xinhua South Road, Touzhou District, Beijing, China
| | - Xueming Chen
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, No.82, Xinhua South Road, Touzhou District, Beijing, China.
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Yamazaki Y, Fujihara K, Sato T, Harada Yamada M, Yaguchi Y, Matsubayashi Y, Yamada T, Kodama S, Kato K, Shimano H, Sone H. Usefulness of New Criteria for Metabolic Syndrome Optimized for Prediction of Cardiovascular Diseases in Japanese. J Atheroscler Thromb 2024; 31:382-395. [PMID: 37981330 PMCID: PMC10999718 DOI: 10.5551/jat.64380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/11/2023] [Indexed: 11/21/2023] Open
Abstract
AIMS We attempted to clarify whether the multiple criteria for metabolic syndrome (MetS) can sufficiently predict cardiovascular disease, whether waist circumference (WC) should be required, and whether sex-specific thresholds for each component are necessary. Only a few large-scale studies among East Asians have addressed the ability of MetS to predict cardiovascular disease. METHODS We analyzed the data of 330,051 men and 235,028 women aged 18-74 years with no history of coronary artery disease (CAD) or cerebrovascular disease (CVD) from a nationwide Japanese claims database accumulated during 2008-2016. The association of each MetS component with CAD or CVD (CAD/CVD), MetS associated with CAD/CVD according to various criteria, and utility of modified criteria with more specific optimal values for each component were examined using multivariate Cox regression and receiver operating characteristic (ROC) analysis. RESULTS During the study, 3,934 men (1.19%) and 893 women (0.38%) developed CAD/CVD. For each current MetS criteria, there was a 1.3- to 2.9-fold increased risk of CAD/CVD. Optimal thresholds for predicting CAD/CVD were WCs of 83 and 77 cm, triglycerides levels of 130 and 90 mg/dl, high-density lipoprotein cholesterol levels of 50 and 65 mg/dl, blood pressures of 130/80 and 120/80 mmHg, and fasting plasma glucose levels of 100 and 90 mg/dl for men and women, respectively. The existing MetS criteria and modified criteria were not significantly different in predicting CAD/CVD, but using the modified criteria markedly increased the prevalence of MetS and percentage of people with MetS developing CAD/CVD. CONCLUSIONS Although various criteria for MetS similarly predicted CAD/CVD, the new criteria greatly reduced the number of high-risk individuals, especially women, overlooked by the current criteria.
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Affiliation(s)
- Yurie Yamazaki
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Takaaki Sato
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Mayuko Harada Yamada
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yuta Yaguchi
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yasuhiro Matsubayashi
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Takaho Yamada
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Kiminori Kato
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Hitoshi Shimano
- Department of Endocrinology and Metabolism, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
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Kim LY, Halperin SJ, Grauer JN. Surgical site infection following isolated lumbar discectomy increases odds of revision lumbar surgery within first 6 months, but not beyond. Spine J 2024:S1529-9430(24)00158-X. [PMID: 38570035 DOI: 10.1016/j.spinee.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND CONTEXT Lumbar discectomy is a commonly performed surgery following which surgical site infection (SSI) may occur. Prior literature has suggested that, following SSI related to lumbar fusion, the rate of subsequent lumbar surgeries is increased over prolonged periods of time. This has not been studied specifically for lumbar discectomy. PURPOSE To define factors associated with SSI following lumbar discectomy and determine if subsequently matched cohorts with and without SSI have differential rates of subsequent lumbar surgery beyond irrigation and debridement (I&Ds) over time. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE Adult patients undergoing isolated primary lumbar laminotomy/discectomy were identified from the 2010-2021 M157PearlDiver database. Exclusion criteria included: age<18 years, preoperative diagnosis of infection, neoplastic, or traumatic diagnoses within 90 days prior to index surgery, additional spinal surgeries on the same day as lumbar discectomy, and not being active in the database for at least 90 days postoperative. From this study population, those who developed SSI were identified based on undergoing I&D within 90 days after surgery. Those with versus without SSI were then matched 1:4 based on age, sex, Elixhauser Comorbidity Index (ECI), and obesity. OUTCOME MEASURES Following initial I&D, incidence of revision lumbar surgery (revision lumbar discectomy, lumbar laminectomy, lumbar fusion) out to 5 years after lumbar discectomy. METHODS Following index isolated lumbar discectomy, those with versus without SSI requiring I&D were matched and compared for incidence of secondary surgery in defined time intervals (0-6 months, 6-12 months, 1-2 years, 2-5 years) using multivariable logistic regression, controlling for patient age, sex, ECI, and obesity status. RESULTS Of 323,025 isolated lumbar discectomy patients, SSI requiring I&D was identified for 583 (0.18%). Multivariable analysis revealed several independent predictors of these SSIs: younger age (odds ratio [OR] 0.85 per decade increase), ECI (OR 1.22 per 2-point increase), and obesity (OR 1.30). Following matching of those with versus without SSI requiring I&D, rates of subsequent surgery beyond I&D were compared. Those with SSI had significantly increased odds of lumbar revision in the first six months (OR 5.26, p<.001), but not 6-12 months (p=.462), 1-2 years (p=.515), or 2-5 years (p=.677). CONCLUSIONS Overall, SSI requiring I&D is a rare postoperative complication following lumbar discectomy. If occurring, subsequent surgery beyond I&D was higher in the first six months, but then not increased at subsequent time points out to five years.
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Affiliation(s)
- Lucas Y Kim
- Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
| | - Scott J Halperin
- Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
| | - Jonathan N Grauer
- Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA.
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