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Bao L, Du K, Gao J, Jiang R, Li B, Liu T. An analysis of the risk factors for invasive fungal infections in preterm infants and a discussion of prevention strategies. Technol Health Care 2024; 32:361-367. [PMID: 37302058 DOI: 10.3233/thc-230218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although the success rate of resuscitation in preterm infants is increasing, the long length of hospital stay in preterm infants and the need for more invasive operations, coupled with the widespread use of empirical antibiotics, have increased the prevalence of fungal infections in preterm infants in neonatal intensive care units (NICUs) year on year. OBJECTIVE The present study aims to explore the risk factors of invasive fungal infections (IFI) in preterm infants and to identify some prevention strategies. METHODS A total of 202 preterm infants with a gestational age of 26 weeks to 36+6 weeks and a birth weight of less than 2,000 g, admitted to our neonatal unit during the 5-year period from January 2014 to December 2018, were selected for the study. Among these preterm infants, six cases that developed fungal infections during hospitalization were enrolled as the study group, and the remaining 196 infants who did not develop fungal infections during hospitalization were the control group. The gestational age, length of hospital stay, duration of antibiotic therapy, duration of invasive mechanical ventilation, indwelling duration of the central venous catheter, and duration of intravenous nutrition of the two groups were compared and analyzed. RESULTS There were statistically significant differences between the two groups in the gestational age, length of hospital stay, and duration of antibiotic therapy. CONCLUSION A small gestational age, a lengthy hospital stay, and long-term use of broad-spectrum antibiotics are the high-risk factors for fungal infections in preterm infants. Medical and nursing measures to address the high-risk factors might reduce the incidence of fungal infections and improve the prognosis in preterm infants.
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Zhang L, Ding Z, Han J, Bi W, Nie C. Optimal range of lymph node dissection in patients with unilateral papillary thyroid carcinoma with lateral cervical lymph node metastasis. Front Oncol 2023; 13:1307937. [PMID: 38162482 PMCID: PMC10756853 DOI: 10.3389/fonc.2023.1307937] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Background Whether patients with unilateral papillary thyroid carcinoma (PTC) with lateral cervical lymph node metastasis (LLNM) require prophylactic central regional lymph node dissection (CLND) remains unclear. Herein, we investigated the independent risk factors associated with contralateral central lymph node metastasis (cCLNM) in unilateral PTC with LLNM and analyzed the optimal extent of lymph node dissection by comparing the 5-year recurrence-free survival rates. Materials and methods We retrospectively analyzed 695 patients with unilateral papillary thyroid carcinoma and lateral cervical lymph node metastasis. Factors including sex, age, multifocal, location of primary tumor, tumor diameter, capsule invasion, thyroid nodular goiter, Hashimoto thyroiditis, ipsilateral central lymph node metastasis(iCLNM), and lateral cervical lymph node metastasis were analyzed using univariate and multivariate logistic regression analyses to explore the independent risk factors of cCLNM. Propensity scores were matched to compare the 5-year recurrence-free survival rates in patients divided by different lymph node metastases and dissections. Results Of all patients who underwent bilateral (b)CLND, 52% (149/286) had cCLNM. Receiver operating characteristic (ROC) curve analysis was performed on 286 patients who underwent bCLND, for which a tumor diameter of 20.5 mm and number of LLNM of 3.5 were used as the thresholds for predicting cCLNM. The 5-year recurrence-free survival (RFS) rates in the cCLN-negative and cCLN-positive groups were 98.6% and 91.2%, with statistically significant differences (P=0.034). The 5-year RFS rates showed no significant difference between the ipsilateral (i)CLND and bCLND groups (P=0.235). Multifactorial regression analysis showed that tumor diameter >2 cm, presence of iCLNM, and number of LLNM >3 were independent risk factors of cCLNM.But male sex, young age (<45 years), multifocality, location of primary tumor, capsule invasion, thyroid nodular goiter, and Hashimoto thyroiditis were not associated with cCLNM. Conclusion Not all unilateral PTC with LLNM require prophylactic cCLND; however, prophylactic cCLND is necessary in cases which display high-risk factors for cCLNM, including primary diameter >2 cm, iCLNM, and number of LLNM >3.
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Affiliation(s)
| | | | | | | | - Chunlei Nie
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin, China
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He C, Zheng F, Lin J, Chen S, Yang W, Huang Q, Qin H, Wei J, Li J. A nomogram to predict the risk of scar pregnancy after caesarean section. J OBSTET GYNAECOL 2023; 43:2142767. [PMID: 36357216 DOI: 10.1080/01443615.2022.2142767] [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] [Indexed: 11/12/2022]
Abstract
The aim of this study was to identify the high-risk factors for caesarean scar pregnancy (CSP) and establish a nomogram to predict the risk of caesarean scar pregnancy in pregnant women with a history of caesarean section. Among 1273 pregnant women with a history of caesarean section, 70% of the patients (892 patients, training sample) were randomly selected for analysis, and a prediction model was generated. The remaining patients (381 patients, validation sample) were validated for the model. Four high-risk factors for CSP were established, including: parity, number of previous abortions, uterus position, and early vaginal bleeding. The area under the curve of the nomogram for the training set was 0.867 and that for the validation set was 0.881, indicating good performance. Calibration curves for predicting CSP showed good calibrations. Decision curve analyses showed good application prospects for the model. Our results show that our nomogram for predicting CSP risks can be a practical tool to help in the early identification of CSP.Impact StatementWhat is already known on this subject? The high-risk factors for "caesarean scar pregnancy", An simple nomogram could be constructed to predict the risk of the disease through these high-risk factors.What do the results of this study add? This study can quickly predict whether the patient is a high-risk group for uterine scar pregnancy based on the patient's previous pregnancy, early vaginal bleeding and uterine position.What are the implications of these findings for clinical practice and/or further research? Caesarean scar pregnancy was secondary Long-term complications after caesarean section that with a high risk of pregnancy. In this study, we established a nomogram based on the number of cases of CSP and a control group with a history of caesarean section delivery at term, The high-risk factors were assigned a certain risk value in the early stage, if the woman contains more high-risk factors, the higher the risk of developing CSP, it should be highly valued in the early stage, and the rate of visiting a doctor should be increased.
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Affiliation(s)
- Chunna He
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Fengque Zheng
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.,Department of Reproductive Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jiajing Lin
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Saiqiong Chen
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Weiwei Yang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Qinxi Huang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Huayi Qin
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Jiahan Wei
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Jingjing Li
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.,Department of Reproductive Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Chiloiro G, Cusumano D, Romano A, Boldrini L, Nicolì G, Votta C, Tran HE, Barbaro B, Carano D, Valentini V, Gambacorta MA. Delta Radiomic Analysis of Mesorectum to Predict Treatment Response and Prognosis in Locally Advanced Rectal Cancer. Cancers (Basel) 2023; 15:3082. [PMID: 37370692 DOI: 10.3390/cancers15123082] [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: 04/28/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The aim of this study is to evaluate the delta radiomics approach based on mesorectal radiomic features to develop a model for predicting pathological complete response (pCR) and 2-year disease-free survival (2yDFS) in locally advanced rectal cancer (LARC) patients undergoing neoadjuvant chemoradiotherapy (nCRT). METHODS Pre- and post-nCRT MRIs of LARC patients treated at a single institution from May 2008 to November 2016 were retrospectively collected. Radiomic features were extracted from the GTV and mesorectum. The Wilcoxon-Mann-Whitney test and area under the receiver operating characteristic curve (AUC) were used to evaluate the performance of the features in predicting pCR and 2yDFS. RESULTS Out of 203 LARC patients, a total of 565 variables were evaluated. The best performing pCR prediction model was based on two GTV features with an AUC of 0.80 in the training set and 0.69 in the validation set. The best performing 2yDFS prediction model was based on one GTV and two mesorectal features with an AUC of 0.79 in the training set and 0.70 in the validation set. CONCLUSIONS The results of this study suggest a possible role for delta radiomics based on mesorectal features in the prediction of 2yDFS in patients with LARC.
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Affiliation(s)
- Giuditta Chiloiro
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Davide Cusumano
- Mater Olbia Hospital, Strada Statale Orientale Sarda 125, 07026 Olbia, Italy
| | - Angela Romano
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Luca Boldrini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giuseppe Nicolì
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Claudio Votta
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Huong Elena Tran
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Brunella Barbaro
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Davide Carano
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Vincenzo Valentini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
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Li Q, Zhang X. Prediction of high-risk factors for ovarian metastasis in patients with endometrial cancer: A large-sample retrospective case-control study. Int J Gynaecol Obstet 2023; 161:144-150. [PMID: 36453189 DOI: 10.1002/ijgo.14606] [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: 05/11/2022] [Revised: 09/23/2022] [Accepted: 10/14/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To determine the high-risk factors of ovarian metastasis of endometrial cancer and their impact on prognosis. METHODS A retrospective case-control study was conducted on a large cohort of patients with endometrial cancer. RESULTS A total of 1240 patients with endometrial cancer were eligible for analysis, of whom 120 (9.7%) had ovarian metastasis. The patients with endometrial cancer with ovarian metastasis were more likely to have deep myometrial infiltration, lymph node metastasis, and elevated levels of CA125. The median survival was 39 months in patients with ovarian metastasis and 111 months in those without ovarian metastasis (P < 0.001). According to the stratified analysis, the progression-free survival (PFS) and overall survival in the low-risk group and PFS in the high-risk group of patients with endometrial cancer with ovarian metastasis were significantly shorter than those without ovarian metastasis (P < 0.0001, P = 0.0034, and P < 0.0001, respectively). CONCLUSION Deep myometrial invasion, lymph node metastasis, and elevated levels of CA125 may be independent high-risk factors for ovarian metastasis in patients with endometrial cancer. Ovarian metastasis has a greater impact on the prognosis of patients with low-risk endometrial cancer.
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Affiliation(s)
- Qian Li
- Department of Gynaecological Oncology, Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Liaoning, China
| | - Xin Zhang
- Department of Gynaecological Oncology, Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Liaoning, China
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Qiao J, Feng J, Hu W, Wu Y. Risk Factor Analysis of Postoperative Venous Thromboembolism in Patients After Thoracoscopic Lobectomy. Clin Appl Thromb Hemost 2023; 29:10760296231156908. [PMID: 36775882 PMCID: PMC9926371 DOI: 10.1177/10760296231156908] [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] [Indexed: 02/14/2023] Open
Abstract
OBJECTIVE To analyze independent risk factors for postoperative venous thromboembolism (VTE) in patients after thoracoscopic lobectomy and establish a risk model for predicting thrombosis. METHODS We selected 135 patients who underwent thoracoscopic lobectomy and assigned them to a VTE group (n = 31) and a non-VTE group (n = 104) according to the presence or absence of postoperative VTE. Univariate and multivariate logistic regression models were built to identify independent risk factors for postoperative thrombosis. A nomogram to predict the risk of thrombosis was generated, with the predictive performance of the model being evaluated by plotting calibration curve and the receiver operating characteristic (ROC) curve. RESULTS D-dimer on the first postoperative day and Caprini scores were independent high-risk factors for VTE after thoracoscopic lobectomy as revealed by univariate and multivariate logistic regression analyses (p < .05). The nomogram was evaluated, and the fitting degree of calibration curve indicated good accuracy of the model in predicting thrombosis. The area under the curve (AUC) value was 0.8654, suggesting favorable diagnostic efficacy of the model. CONCLUSION The D-dimer on the first postoperative day and Caprini scores were independent risk factors for VTE after thoracoscopic lobectomy. The nomogram that was generated to predict the risk of thrombosis had good accuracy and diagnostic efficacy, which can guide individual risk assessment and management decisions in clinical practice.
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Affiliation(s)
- Junkai Qiao
- Department of Thoracic Surgery, Dongyang People's Hospital, Dongyang City, China
| | - Jiang Feng
- Department of Thoracic Surgery, Dongyang People's Hospital, Dongyang City, China
| | - Weiwei Hu
- Department of Thoracic Surgery, Dongyang People's Hospital, Dongyang City, China
| | - Yueming Wu
- Department of Thoracic Surgery, Dongyang People's Hospital, Dongyang City, China,Yueming Wu, Department of Thoracic Surgery, Dongyang People's Hospital, No. 60 Wuning West Road, Dongyang City 322100, China.
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Chen T, Wang M, Cheng X, Wang Y, Jiang Y, Fang X, Xiao H. The complementary role of lymphovascular invasion and perineural invasion in the TNM staging process of rectal cancer. Medicine (Baltimore) 2022; 101:e30687. [PMID: 36181060 PMCID: PMC9524871 DOI: 10.1097/md.0000000000030687] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The aim of this study is to clarify the association between lymphovascular invasion (LVI) and/or perineural invasion (PNI) and the clinical characteristics and prognostic importance of rectal cancer, to provide a basis for early adjuvant treatment of rectal cancer. We retrospectively analyzed patients diagnosed with rectal cancer. This study involved rectal cancer tissue samples were obtained by surgical methods. Data on histological form, tumor classification, tumor size, gross growth pattern, blood and lymphatic vessel invasion, and PNI of the slice by HE staining were obtained from pathological examination. Immunohistochemical analysis of tissue samples was performed to determine p53 and EGFR expressions. There were 330 rectal cancer patients included in the study. LVI and/or PNI can be used as a high-risk factor for the prognosis of rectal cancer, predict prognostic survival, and guide adjuvant therapy. The detection rates of LVI and PNI were 32.1% and 16.1%. Differentiation grade, Union for International Cancer Control staging, tumor-lymph node-metastasis staging are significantly related to LVI or PNI. Multivariate logistic regression analysis shows that poor differentiation and N ≥ 1 can be used as independent risk factors and predictive factors for LVI. At the same time, poor differentiation and T > 3 is an independent risk factor for PNI. Only poor differentiation is the risk factor for poor prognosis in Cox risk regression analysis. In addition, the simultaneous occurrence of LVI and PNI is an independent prognostic factor.
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Affiliation(s)
- Tong Chen
- Department of Gastrointestinal, Colorectal, and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Mingchuan Wang
- Department of Gastrointestinal, Colorectal, and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xianbin Cheng
- Department of Thyroid Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Yizhuo Wang
- Department of Cancer Center, First Hospital of Jilin University, Changchun, China
| | - Yang Jiang
- Department of Gastrointestinal, Colorectal, and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xuedong Fang
- Department of Gastrointestinal, Colorectal, and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Huijie Xiao
- Department of Gastrointestinal, Colorectal, and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Huijie Xiao, Department of Gastrointestinal, Colorectal, and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China (e-mail: )
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Fu H, Zhou CC, Li DJ, Shen FM. [Abdominal Aortic Aneurysm:Pathological Mechanism and Animal Model]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022; 44:516-520. [PMID: 35791953 DOI: 10.3881/j.issn.1000.503x.13461] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Abdominal aortic aneurysm is defined as a dilated aorta with a diameter at least 1.5 times of the normal aorta.There is no effective drug for AAA.We summarized the high-risk factors,pathologic features,current therapies,and animal models in the pre-clinical study to gain comprehensive understanding of AAA.With this review,we aim to provide scientific support for the mining of therapeutic targets for AAA.
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Affiliation(s)
- Hui Fu
- Department of Pharmacy,Shanghai Tenth People's Hospital,Tongji University School of Medicine,Tongji University,Shanghai 200072,China
| | - Can-Can Zhou
- Department of Pharmacy,Shanghai Tenth People's Hospital,Tongji University School of Medicine,Tongji University,Shanghai 200072,China
| | - Dong-Jie Li
- Department of Pharmacy,Shanghai Tenth People's Hospital,Tongji University School of Medicine,Tongji University,Shanghai 200072,China
| | - Fu-Ming Shen
- Department of Pharmacy,Shanghai Tenth People's Hospital,Tongji University School of Medicine,Tongji University,Shanghai 200072,China
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Yaqoob N, Zia N, Hamid A, Kaleem B, Jamal S, Amin S, Qaddoumi I, Jamal S. Correlation of clinical and radiological predictors of retinoblastoma with high-risk histopathological features. Pediatr Blood Cancer 2022; 69:e29625. [PMID: 35253344 DOI: 10.1002/pbc.29625] [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: 10/05/2021] [Revised: 01/14/2022] [Accepted: 02/07/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Retinoblastoma (RB) tumors having high-risk histopathologic features (HRFs) have an increased risk of metastasis and disease relapse. However, RB has not been studied widely in Pakistan. Therefore, we evaluated the association of clinical, histopathologic, and radiological findings with HRFs in patients with RB who were treated at the Indus Health & Hospital Network in Karachi, Pakistan. METHODS We enrolled treatment-naïve patients with RB who received upfront enucleation from September 2017 to February 2021. We evaluated enucleated eyes with the Intraocular Classification of Retinoblastoma system and classified HRFs as invasion of the anterior chamber, including the iris and ciliary body, or massive invasion of the choroid, sclera, or optic nerve (postlaminar and/or up to the transection line). RESULTS Of 117 patients with RB treated at our institution during the study period, 54 received upfront enucleation. Unilateral disease was present in 92.6% of cases. The most frequent disease signs and symptoms included the presence of vitreous seeds (30.6%) and leukocoria (100%), respectively. The most frequent HRFs and radiological findings comprised massive choroidal invasion (15.1%) and anterior chamber enhancement (66.7%), respectively. The majority (62.9%) of patients did not exhibit any HRFs. Female sex, pseudohypopyon, iris neovascularization, buphthalmos, and glaucoma had significant predictive ability for HRF occurrence. CONCLUSION Pseudohypopyon, iris neovascularization, buphthalmos, and glaucoma are important clinical factors that should be taken into consideration before the management of RB. Early recognition of high-risk histopathological and radiological features is essential for appropriate treatment of RB.
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Affiliation(s)
- Nausheen Yaqoob
- Section of Histopathology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Nida Zia
- Department of Paediatric Oncology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Ahmer Hamid
- Department of Paediatric Oncology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Bushra Kaleem
- Indus Health Research Center, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saad Jamal
- Department of Radiology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saima Amin
- Layton Rahmatulla Benevolent Trust (LRBT), Karachi, Pakistan
| | - Ibrahim Qaddoumi
- Departments of Global Pediatric Medicine and Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Saba Jamal
- Section of Histopathology, Indus Hospital & Health Network, Karachi, Pakistan
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Yu Y, Lei D, He Q, Chen W. Analysis of the exposure to risk factors for strokes of the high-risk population in Zunyi City, Guizhou Province of China. Ann Palliat Med 2021; 10:11106-11116. [PMID: 34763471 DOI: 10.21037/apm-21-2914] [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] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/22/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND To determine the exposure rates of the risk factors and the distribution characteristics of the population at high risk for stroke in Zunyi City, and thereby provide references for health management of the population. METHODS Cluster sampling was applied to collect the medical histories, laboratory tests, and physical examinations of permanent residents in Zunyi City, Guizhou Province, for the purpose of analyzing the characteristics of risk factors in the population at high risk for stroke. RESULTS A total of 1,382 residents were screened as the high-risk population [681 males (49.3%), 701 females (50.7%)] with a detection rate of 11.11%. For the high-risk population, the top 5 risk factors for stroke were hypertension (78.9%), dyslipidemia (64.5%), obesity (54.1%), lack of exercise (48.8%), and smoking (35.1%). The exposure rates of females at high risk of hypertension, diabetes, dyslipidemia, and obesity were significantly higher than those of males, while the smoking rate of the high-risk males was significantly higher than that of the females. Significantly different exposure rates of stroke from hypertension, smoking, dyslipidemia, lack of exercise, overweight or obesity, and family history were shown in high-risk populations of different ages, while the incidence of stroke/transient ischemic attack (TIA) showed an increasing trend with aging. CONCLUSIONS Hypertension, dyslipidemia, and obesity are the main risk factors for stroke in Zunyi City, with the detection rate of high-risk females being slightly higher than that of the males, and the population with a history of stroke/TIA performed better than the population with more than 3 risk factors.
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Affiliation(s)
- Yanyan Yu
- Department of Cerebrovascular Diseases, Affiliated Hospital of Zunyi Medical University, Guizhou, China
| | - Dan Lei
- Department of Cerebrovascular Diseases, Affiliated Hospital of Zunyi Medical University, Guizhou, China
| | - Qiong He
- Department of Cerebrovascular Diseases, Affiliated Hospital of Zunyi Medical University, Guizhou, China
| | - Wei Chen
- Department of Cerebrovascular Diseases, Affiliated Hospital of Zunyi Medical University, Guizhou, China
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Zhao W, Wang G, Xu P, Wu T, Chen B, Ren H, Li X. Analysis of High-Risk Factors Associated with the Progression of Subaneurysmal Aorta to Abdominal Aortic Aneurysm in Rural Area in China. Clin Interv Aging 2021; 16:1573-1580. [PMID: 34465986 PMCID: PMC8402982 DOI: 10.2147/cia.s321921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/27/2021] [Accepted: 08/04/2021] [Indexed: 11/24/2022] Open
Abstract
Objective To determine the risk factors associated with the progress of subaneurysmal aorta (SAA) to abdominal aortic aneurysm (AAA) and provide a reference for the prevention of AAA in rural areas. Methods A total of 747 SAA patients screened by the Health Management Center of the Second Hospital of Lanzhou University from January 2015 to January 2016 were recruited. The ratio of SAA progressing to AAA was observed through 5 years of follow-up. Logistic stepwise regression analysis was performed to analyze the high-risk factors. The relevant clinical prediction model score table (Nom) was made and the C-index and calibration chart were used to verify the prediction ability of the model. Results Of the 747 patients diagnosed with SAA, 260 developed to AAA, with an incidence of 34.8%. Univariate analysis showed that age (62–65 years old), abdominal aorta diameter greater than 2.7 cm, smoking after 30 years old, moderate to severe hypertension, and blood pressure variability were the important high-risk factors of SAA progressing to AAA. Logistic regression analysis showed that these factors were statistically significant. The nomogram of clinical prediction model score showed that when 50–60% of SAA developed to AAA, the score was 189–201 and the C-index was 0.883, verifying the moderate predictive ability of this model. Conclusion Age, smoking habit, degree of hypertension, and control situation were high-risk factors associated with the progression of SAA to AAA. The control of the above high-risk factors was imperative for the prevention of AAA in rural areas without sufficient medical resources.
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Affiliation(s)
- Wenjun Zhao
- Department of Ultrasound, Imaging, Healthy Management Centre, The Second Hospital of Lanzhou University, Lanzhou City, 730000, Gansu Province, People's Republic of China
| | - Gang Wang
- Department of Neurosurgeon, Neurology, Neurologist, The Second Hospital of Lanzhou University, Lanzhou City, 730000, Gansu Province, People's Republic of China
| | - Ping Xu
- Department of Ultrasound, Imaging, Ultrasound Centre, The Second Hospital of Lanzhou University, Lanzhou City, 730000, Gansu Province, People's Republic of China
| | - Tingting Wu
- Department of Ultrasound, Imaging, Ultrasound Centre, The Second Hospital of Lanzhou University, Lanzhou City, 730000, Gansu Province, People's Republic of China
| | - Binjuan Chen
- Department of Ultrasound, Imaging, Ultrasound Centre, The Second Hospital of Lanzhou University, Lanzhou City, 730000, Gansu Province, People's Republic of China
| | - Haijun Ren
- Department of Neurosurgeon, Neurology, Neurologist, The Second Hospital of Lanzhou University, Lanzhou City, 730000, Gansu Province, People's Republic of China
| | - Xingjie Li
- Department of Ultrasound, Imaging, Healthy Management Centre, The Second Hospital of Lanzhou University, Lanzhou City, 730000, Gansu Province, People's Republic of China
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Lin J, Feng B, Tang H, Xu H, Tang Y. A systematic review and meta-analysis: pulmonary mycosis pathogen distribution. Ann Palliat Med 2021; 10:7919-7932. [PMID: 34353079 DOI: 10.21037/apm-21-1388] [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] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/25/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study sought to systematically evaluate the distribution characteristics and high-risk factors of pulmonary mycosis pathogens, and provide evidence for the clinical treatment and prognosis of patients with pulmonary mycosis. METHODS The Embase, Ovid, PubMed, Medline, and Springer databases were searched to find publications on the distribution characteristics and high-risk factors of pulmonary mycosis pathogens that had been published between the establishment of the databases and April 1, 2021. The Cochrane Handbook 5.0.2 was used to evaluate the risk of bias of the articles included in this study, and Review Manager 5.3 was used to conduct a meta-analysis of the included articles. RESULTS Eleven articles were included in this study, comprising 6,415 subjects. The meta-analysis results showed that pathogen infection significantly increased the mortality of patients [MD =2.67; 95% confidence interval (CI): (1.52, 4.68); Z=3.43; P=0.0006]. Patient age was significantly correlated with the incidence of pulmonary mycosis [MD =1.21; 95% CI: (0.78, 1.86); Z=0.84; P=0.40]. The use of antibiotics was significantly correlated to the incidence of pulmonary mycosis [MD =1.41; 95% CI: (1.15, 1.72); Z=3.30; P=0.001]. Glucocorticoid use was significantly correlated to the incidence of pulmonary mycosis [MD =1.81; 95% CI: (1.13, 2.91); Z=2.45; P=0.01]. However, gender had no obvious correlation with the incidence of pulmonary mycosis [MD =1.21; 95% CI: (0.78, 1.86); Z=0.84; P=0.40]. Further, no correlation was found between smoking history and the incidence of pulmonary mycosis [MD =0.86; 95% CI: (0.51, 1.45); Z=0.57; P=0.57]. DISCUSSION The main types of bacterial infections in patients with pulmonary mycosis were Pseudomonas aeruginosa, Haemophilus influenzae, Streptococcus pneumoniae, Candida albicans, and Helicobacter pylori. In addition to the lungs, pathogens were found to be distributed in the intestines, urinary tract, and digestive tract. Additionally, patient age, antibiotic use, and glucocorticoid use increased the incidence of pulmonary mycosis. Thus, these factors should be paid attention to in the clinical treatment of patients with pulmonary mycosis.
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Affiliation(s)
- Jun Lin
- Emergency Department, The Affiliated Urology and Nephrology Hospital of Ningbo University (Ningbo Yinzhou No. 2 Hospital), Ningbo, China
| | - Bo Feng
- Intensive Care Unit, ICU, The Affiliated Urology and Nephrology Hospital of Ningbo University (Ningbo Yinzhou No. 2 Hospital), Ningbo, China;
| | - Honglin Tang
- Intensive Care Unit, ICU, The Affiliated Urology and Nephrology Hospital of Ningbo University (Ningbo Yinzhou No. 2 Hospital), Ningbo, China;
| | - Hongna Xu
- Operation Theater, The Affiliated Urology and Nephrology Hospital of Ningbo University (Ningbo Yinzhou No. 2 Hospital), Ningbo, China
| | - Yeli Tang
- Emergency Department, The Affiliated Urology and Nephrology Hospital of Ningbo University (Ningbo Yinzhou No. 2 Hospital), Ningbo, China
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13
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Kilic F, Cakir C, Yuksel D, Korkmaz V, Kimyon Comert G, Boran N, Koc S, Turan T, Turkmen O. Analysis of the prognostic factors determining the oncological outcomes in patients with high-risk early-stage cervical cancer. J OBSTET GYNAECOL 2021; 42:281-288. [PMID: 33938363 DOI: 10.1080/01443615.2021.1882974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We aimed to evaluate clinicopathological data in high-risk early-stage cervical cancer and to define the prognostic factors determining the oncological outcomes. This retrospective study included 158 patients with stage IB-IIA cervical cancer who underwent radical hysterectomy plus lymph node dissection. Each patient had at least one high-risk factor. The median tumour diameter of the study group was 30 mm (range, 6-80). Seventy-five (47.5%) patients had parametrial invasion, 32 (20.3%) had positive surgical margins, and 108 (68.4%) had lymph node metastasis. The median duration of follow-up was 42 months (range, 1-228). During this period, 28 patients developed recurrence, and the recurrent disease occurred in a distant area in 18 patients. Five-year disease-free survival was 77.5%, and five-year disease-specific survival was 85%. In multivariate analysis, adjuvant radiotherapy was identified as an independent prognostic factor for recurrence and death. The recurrence (Odds ratio: 10.139, 95% CI: 1.477-69.590, p = .018) and mortality rates (Odds ratio: 16.485, 95% CI: 2.484-109.408, p =.004) were higher in patients who did not receive adjuvant therapy.IMPACT STATEMENTWhat is already known on this subject? The decision to proceed with adjuvant therapy in the patients with early-stage disease treated with surgery depends on the presence of risk factors in pathological examination. Various prognostic factors have been identified in cervical cancer (CC). However, there is a limited number of studies describing the prognostic factors in early-stage CC with high-risk factors.What do the results of this study add? In current study, the recurrence and mortality rates were higher in patients who did not receive adjuvant therapy. No relationship was found between the survival outcomes and the number of high-risk factors. Most of the patients who developed recurrence had the recurrence in the distant localisation. This result questioned the adequacy of adjuvant therapy.What are the implications of these findings for clinical practice and/or further research? There is still a debate over the prognostic factors and the adjuvant treatment options in the patients with early-stage cervical cancer who possess high-risk factors. Adjuvant RT or adjuvant concomitant chemoradiotherapy must definitely be used in this patients. However, adjuvant therapy fails approximately 14-32%, thus multimodal treatment modalities must be developed to improve the recurrence rates and the survival.
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Affiliation(s)
- Fatih Kilic
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Caner Cakir
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Dilek Yuksel
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gunsu Kimyon Comert
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Sevgi Koc
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Osman Turkmen
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
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Shao L. DNA Damage Response Signals Transduce Stress From Rheumatoid Arthritis Risk Factors Into T Cell Dysfunction. Front Immunol 2018; 9:3055. [PMID: 30619377 PMCID: PMC6306440 DOI: 10.3389/fimmu.2018.03055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 07/24/2018] [Accepted: 12/10/2018] [Indexed: 12/18/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune-mediated disease that is associated with significant cartilage damage and immunosenescence. Despite decades of research, the major signal pathways that initiate RA are still unclear. The DNA damage response (DDR) is a specific and hierarchical network that includes cell cycle checkpoints, DNA repair, and DNA-damage tolerance pathways. Recent studies suggest that this condition is associated with deficits in telomere maintenance and overall genomic instability in the T cells of RA patients. Analysis of the underlying mechanisms has revealed defects in DDR pathways. Particularly, the DNA repair enzyme, ataxia telangiectasia mutated (ATM), is downregulated, which leaves the damaged DNA breaks in RA-associated T cells unrepaired and pushes them to apoptosis, exhausts the T cell pool, and promotes the arthritogenesis effector function of T cells. This review discusses recent advancements and illustrates that risk factors for RA, such as viral infections, environmental events, and genetic risk loci are combat with DDR signals, and the impaired DDR response of RA-associated T cells, in turn, triggers disease-related phenotypes. Therefore, DDR is the dominant signal that converts genetic and environmental stress to RA-related immune dysfunction. Understanding the orchestration of RA pathogenesis by DDR signals would further our current knowledge of RA and provide novel avenues in RA therapy.
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Affiliation(s)
- Lan Shao
- The Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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15
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Liao Y, Li S, Chen C, He X, Lin F, Wang J, Yang Z, Lan P. Screening for colorectal cancer in Tianhe, Guangzhou: results of combining fecal immunochemical tests and risk factors for selecting patients requiring colonoscopy. Gastroenterol Rep (Oxf) 2017; 6:132-136. [PMID: 29780602 PMCID: PMC5952940 DOI: 10.1093/gastro/gox030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/16/2017] [Accepted: 07/20/2017] [Indexed: 01/16/2023] Open
Abstract
Objective To explore the performance of a protocol combining fecal immunochemical test (FIT) and a high-risk factor questionnaire (HRFQ) for selecting patients requiring colonoscopy as part of a population-based colorectal cancer (CRC) screening program in China. Methods From 2015 to 2016, we conducted a CRC screening program for all residents aged 45 years or older in Tianhe District, Guangzhou City, China. Participants underwent an FIT and received an HRFQ as part of primary screening. Those with positive FIT and/or HRFQ results were considered to be at high risk and were recommended to undergo colonoscopy. Results A total of 10 074 subjects were recruited and enrolled in the screening program. In the enrolled population, 17.5% had positive FIT results and 19.4% had positive HRFQ results. Of those recommended to undergo diagnostic colonoscopy, 773 did so. The screening method’s overall positive predictive value (PPV) was 4.9% for non-adenomatous polyps, 11.4% for low-risk adenomas (LRAs), 15.9% for high-risk adenomas (HRAs) and 1.6% for CRC. The PPVs of positive FIT results for non-adenomatous polyps, LRAs, HRAs and CRC were 5.2%, 15.9%, 22.5% and 2.5%, respectively. The PPVs of positive HRFQ results for non-adenomatous polyps, LRA, HRA and CRC were 4.1%, 10.2%, 14.3% and 1.4%, respectively. The PPVs associated with combined positive FIT and HRFQ results for non-adenomatous polyps, LRAs, HRAs and CRC were 4.5%, 16.4%, 23.7% and 2.8%, respectively. Conclusion Our results suggest that this two-step CRC screening strategy, involving a combination of FIT and HRFQ followed by colonoscopy, is useful to identify early-stage CRC. The high detection rates and PPVs for CRC and adenomas encourage this strategy’s use in ongoing screening programs.
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Affiliation(s)
- Yi Liao
- Department of Gastrointestinal Surgery.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease
| | - Senmao Li
- Department of Gastrointestinal Surgery.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease
| | - Chunyu Chen
- Department of Gastrointestinal Surgery.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease
| | - Xuan He
- Department of Gastrointestinal Surgery.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease
| | - Feng Lin
- Department of Gastrointestinal Surgery.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease
| | - Jianping Wang
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease.,Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China
| | - Zuli Yang
- Department of Gastrointestinal Surgery.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease
| | - Ping Lan
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease.,Department of Colorectal Surgery, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China
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Liu J, Yang N, Liu Y. High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study. Balkan Med J 2014; 31:64-8. [PMID: 25207170 PMCID: PMC4115996 DOI: 10.5152/balkanmedj.2014.8733] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 02/10/2013] [Accepted: 07/24/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Respiratory distress syndrome (RDS) is a common critical disease in term neonates, but reasons for the occurrence of RDS remains unclear. AIMS This study aimed to investigate the cause of RDS in full-term neonates by a retrospective case-control study. STUDY DESIGN Case-control study. METHODS Among the patients admitted to Bayi Children's Hospital between January 2008 and December 2010, a total of 205 full-term neonates with RDS were assigned to the study group, and 410 full-term neonates without RDS were assigned to the control group. Clinical information, including the presence or absence of premature rupture of membranes (PROM), gender of the neonates, mode of delivery, birth weight, and any conditions suffered by the neonates were recorded. RESULTS THE RESULTS OF LOGISTIC REGRESSION ANALYSIS SHOWED THAT THE FOLLOWING CAUSES WERE CLOSELY CORRELATED WITH TERM NEONATAL RDS: selective cesarean section (OR: 8.737; 95% CI: 5.232-14.588), severe birth asphyxia (OR: 6.988; 95% CI: 2.990-16.333), small gestational age (OR: 6.222; 95% CI: 2.001-8.993), maternal-fetal infection (OR: 5.337; 95% CI: 1.999-8.233), PROM (OR: 3.380; 95% CI: 1.986-5.754), male sex (OR: 2.641; 95% CI: 1.721-4.053), gestational glucose intolerance or diabetes (OR: 2.415; 95% CI:1.721-4.053), and low birth weight (OR: 2.323; 95% CI: 1.329-4.060). CONCLUSION Several high-risk factors, such as selective cesarean section, severe birth asphyxia, maternal-fetal infection, PROM, and male sex are closely correlated with full-term neonatal RDS. These could provide a significant reference for the diagnosis and treatment of term neonatal RDS.
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Affiliation(s)
- Jing Liu
- Department of Neonatology, NICU, Bayi Children’s Hospital Affiliated to Beijing Military General Hospital, Beijing, China
- Address for Correspondence: Dr. Jing Liu, Department of Neonatology, NICU, Bayi Children’s Hospital Affiliated to Beijing Military General Hospital, Beijing, China. Phone: +86 133 01 19 58 69 e-mail:
| | - Na Yang
- Department of Neonatology, NICU, Bayi Children’s Hospital Affiliated to Beijing Military General Hospital, Beijing, China
- Department of Neonatology, Maternal and Child Health Care Hospital of Hefei, Hefei City, China
| | - Ying Liu
- Department of Neonatology, NICU, Bayi Children’s Hospital Affiliated to Beijing Military General Hospital, Beijing, China
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