Factors associated with vascular and neurological complications of hand‐arm vibration syndrome among tire shop workers in Kelantan, Malaysia

Abstract Background Zika virus (ZIKV) is an important flavivirus, but severity of infection is poorly described in adults. We investigated factors associated with hospitalization and neurologic complications as measures of severity. Methods ZIKV cases from December 1, 2015 to October 31, 2016 were identified from clinical samples tested in VA, state and commercial laboratories, and patients were followed until 3/31/2017. ZIKV positive patients (RT-PCR or screening IgM positive confirmed by a plaque-reduction neutralization test [PRNT] IgM positive for ZIKV alone or including dengue virus) were reviewed for demographic and clinical factors. Logistic regression analysis was performed to evaluate factors associated with 1) hospitalization and 2) neurologic complications in VA ZIKV positive patients. Results 736 of 1,538 (48%) patients tested were ZIKV positive; 655 (89%) were male and 683 (93%) were diagnosed at the VA Caribbean Healthcare System (VACHCS). In total, 94 (13%) were hospitalized with 91 (12%) at VACHCS. 19 (3%) patients, all at VACHCS, died from any cause after ZIKV diagnosis. Hospitalization was more likely with increased age, co-morbidities, neurologic symptoms, thrombocytopenia, or preadmission glucocorticoid use, and less likely if rash was present (Table 1). Hospitalization, prior cerebrovascular disease and dementia were associated with neurologic complications. Conclusion Older Veterans with multiple comorbidities or presenting with neurologic symptoms were more likely to be hospitalized after ZIKV infection, and those with a prior history of cerebrovascular disease and dementia were at increased risk for neurological complications. Disclosures All authors: No reported disclosures.

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CARDIOLOGICAL ASPECTS OF THE PERIOPERATIVE MANAGEMENT OF PATIENTS WITH CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION FOR PULMONARY THROMBOENDARTERECTOMY

Eurasian heart journal ◽

10.38109/2225-1685-2020-3-94-104 ◽

2021 ◽

pp. 94-104

Author(s):

D. D. Tsyrenov ◽

R. S. Akchurin ◽

K. V. Mershin ◽

E. A. Tabakyan ◽

E. E. Vlasova ◽

...

Keyword(s):

Postoperative Period ◽

Perioperative Complications ◽

Circulatory Arrest ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Kidney Injury ◽

Neurological Complications ◽

Pulmonary Thromboendarterectomy ◽

Factors Associated ◽

History Of ◽

D Dimer

Aim. To analyze the factors associated with a poor outcome of pulmonary thromboendarterectomy (PTE) and complications of the hospital postoperative period; on the basis of this analysis to optimize preoperative preparation and therapeutic support of the operation. Materials and methods. The study included 47 patients with operable CTEPH, who underwent PTE in the Department of cardiovascular surgery of the national medical research center of cardiology from 2010 to 2018. Patients were observed during the intrahospital period, all were evaluated for clinical, instrumental, hemodynamic, and laboratory parameters. Diagnosis and treatment of complications, assessment of the relationship of factors associated with the development of these pathological conditions were carried out. Results. A comprehensive assessment of the parameters revealed that age over 50 years, the presence of proven antiphospholipid syndrome (AFS) were independently associated with a higher frequency of adverse surgical outcomes and in-hospital complications. Older age and a history of smoking were independently associated with a greater likelihood of developing reperfusion pulmonary edema. The probability of developing transient neurological complications is independently associated with a long duration of deep hypothermic circulatory arrest (DHCA), an increased level of D-dimer. A greater age and longer duration of ventilation are independently associated with the likelihood of developing acute kidney injury (AKI). A higher level of antithrombin III and the presence of AFS were independently associated with the likelihood of developing prolonged ventilation. Conclusion. When selecting candidates for surgery, in addition to the generally accepted clinical and instrumental parameters, it is necessary to take into account a history of Smoking, an increase in d-dimer, and the presence of AFS. Patients with this pathology need a more thorough risk assessment, correction of target levels of activated partial thromboplastin time (aPTT), activated clotting time (ACT) due to their falsely inflated indicators, and further development of standards for perioperative support. The main principle of cardiological support of the operation is the earliest possible diagnosis of all known perioperative complications and the rapid start of their treatment, which ensures the stabilization of the patient’s condition in 85% of cases in the hospital period. In the postoperative period, an early transition from ventilator to independent breathing is indicated for the prevention of associated complications, including AKI.

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Repeat Extracorporeal Membrane Oxygenation Support Is Appropriate in Selected Children With Cardiac Disease: An Extracorporeal Life Support Organization Study

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/21501351211025004 ◽

2021 ◽

Vol 12 (5) ◽

pp. 597-604

Author(s):

Bahaaldin Alsoufi ◽

Jaimin Trivedi ◽

Peter Rycus ◽

Pranava Sinha ◽

Shriprassad Deshpande

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Life Support ◽

Extracorporeal Life Support ◽

Myocardial Dysfunction ◽

Neurological Complications ◽

Cardiac Pathology ◽

Extracorporeal Life Support Organization ◽

Factors Associated ◽

Membrane Oxygenation ◽

Support Organization

Objective: Children requiring multiple consecutive extracorporeal membrane oxygenation (ECMO) runs likely have ongoing cardiac pathology (eg, residual lesions, myocardial dysfunction) and are exposed to increased complications and end-organ failure. Often, repeat back-to-back ECMO is suggested to be futile due to poor reported survival. Methods: Using Extracorporeal Life Support Organization (ELSO) data (2011-2019), we evaluated children (n = 669) who received multiple cardiac ECMO runs (≥2) within 30 days interval. Factors associated with hospital mortality were evaluated using multivariable regression analysis. Results: Median ECMO runs was 2 (range: 2-5) including 294 (44%) patients who received extracorporeal cardiopulmonary resuscitation (ECPR). There were 250 (37%) hospital survivors. Survivors were more likely older, Caucasian, and less likely to have hypoplastic left heart syndrome, require >2 runs, receive longer support duration, require inotropes or have acidosis while on ECMO, or develop renal and neurological complications. On multivariable analysis, factors associated with death included neonates (odds ratio [OR] = 3.6, 95% CI = 1.8-7.5, P = .0002), African Americans (OR = 2.7, 95% CI = 1.4-4.9, P = .0307), longer ECMO duration (OR = 1.1, 95% CI = 1.05-1.11, P < .0001, per 10 hours), central cannulation at initial run (OR = 1.7, 95% CI = 1.1-2.8, P = .0285), renal failure (OR = 3.0, 95% CI = 1.9-4.6, P < .0001), and neurological complications (OR = 3.8, 95% CI = 2.2-6.8, P < .0001). Conclusions: In selected children with cardiac pathology, multiple back-to-back ECMO and/or ECPR runs are associated with 37% hospital survival. Although registry data limit the ability to clearly determine selection criteria for repeat ECMO, our findings suggest that in properly selected patients, repeat ECMO support is not futile. Ongoing assessment of support adequacy, end-organ function, and cardiopulmonary recovery is necessary as longer support and emerging complications are associated with poor survival.

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Timing and Spectrum of Neurological Complications After Flow Diverter Implantation for Intracranial Aneurysms

Frontiers in Neurology ◽

10.3389/fneur.2021.590383 ◽

2021 ◽

Vol 12 ◽

Author(s):

Guillaume Charbonnier ◽

Jean-Philippe Desilles ◽

Simon Escalard ◽

Benjamin Maier ◽

Gabriele Ciccio ◽

...

Keyword(s):

Intracranial Aneurysms ◽

Neurological Complication ◽

Neurological Complications ◽

Flow Diverter ◽

Factors Associated ◽

Long Term Follow Up ◽

Ischemic Complications ◽

Ischemic Events

Background and Purpose: The aim of this study was to characterize neurological complications after flow diverter (FD) treatment on a long follow-up cohort and identify predictive factors associated with these complications.Methods: This study was conducted on a monocentric cohort of patients treated for intracranial aneurysms by FD.Results: Between September 2008 and July 2018, 413 patients were treated for 514 aneurysms: 18% of the patients presented with at least one neurological complication during a median follow-up of 446 days (IQR 186–1,210). Sixty-one patients presented with ischemic complications, 13 with hemorrhagic ones and 10 with compressive processes. Among 89 neurological complications 64.5% were peri-operative (occurring within the 30 days following the procedure) and 35.5% were delayed after 1 month.Conclusions: Overall, neurological complications after FD implantation were overrepresented by cerebrovascular ischemic events occurring during the peri-operative period, but also in a delayed manner after 1 year. Long-term follow-up is relevant after aneurysm intervention using FD.

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Factors Associated with a Poor Treatment Outcome among Children Treated for Malaria in Ibadan, Southwest Nigeria

Epidemiology Research International ◽

10.1155/2014/974693 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Adesola O. Sangowawa ◽

Olukemi K. Amodu ◽

Subulade A. Olaniyan ◽

Folakemi A. Amodu ◽

Peter E. Olumese ◽

...

Keyword(s):

Treatment Outcome ◽

Neurological Complication ◽

Age Groups ◽

Significant Proportion ◽

Neurological Complications ◽

Severe Anaemia ◽

Malarial Parasite ◽

Factors Associated ◽

Poor Treatment ◽

Poor Treatment Outcome

We present data on factors associated with poor treatment outcome (death or recovery with a neurological complication) among children treated for malaria in Ibadan, Nigeria. A total of 2468 children (1532 with uncomplicated and 936 with severe malaria) were recruited from three government facilities. History was obtained from caregivers and malarial parasite test was carried out on each child. About 76.0% of caregivers had instituted home treatment. Following treatment, 2207 (89.5%) children recovered without complications, 9.1% recovered with neurological complications, and 1.4% died. The possibility of poor treatment outcome increased with decreasing child’s age (P<0.0001). A statistically significant proportion of children with pallor, jaundice, hepatomegaly, splenomegaly, respiratory distress, and severe anaemia had poor treatment outcome. Following logistic regression, child’s age < 12 months compared to older age groups (O.R = 5.99, 95% C.I = 1.15–31.15, and P=0.033) and loss of consciousness (O.R = 4.55, 95% CI = 1.72–12.08, and P=0.002) was significantly associated with poor treatment outcome. We recommend interventions to improve caregivers’ awareness on the importance of seeking medical care early. This will enhance early diagnosis and treatment and reduce the likelihood of complications that lead to poor treatment outcomes.

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Contralateral Occlusion Increases the Risk of Neurological Complications Associated with Carotid Endarterectomy

International Journal of Vascular Medicine ◽

10.1155/2015/942146 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Laura Capoccia ◽

Enrico Sbarigia ◽

Anna Rita Rizzo ◽

Chiara Pranteda ◽

Danilo Menna ◽

...

Keyword(s):

Carotid Stenosis ◽

Brain Infarction ◽

Arterial Disease ◽

Neurological Complications ◽

Minor Stroke ◽

Complication Rates ◽

Brain Infarct ◽

Factors Associated ◽

Neurological Risk ◽

Peripheral Arterial

Objective. To report on the incidence and factors associated with the development of perioperative neurological complications following CEA in patients affected by carotid stenosis with contralateral occlusion (CO) and to compare results between those patients and the whole group of patients submitted to CEA at our vascular division from 1997 to 2012.Methods. Our nonrandomized prospective experience including 1639 patients consecutively submitted to CEA was retrospectively reviewed. 136 patients presented a CO contralateral to the treated carotid stenosis. Outcomes considered for analysis were perioperative neurological death rates, major and minor stroke rates, and a combined endpoint of all neurological complications.Results. CO patients more frequently were male, smokers, younger, and symptomatic (P< 0.001), presented with a preoperative brain infarct and associated peripheral arterial disease (P< 0.0001), and presented with higher perioperative major stroke rate than patients without CO (4.4% versus 1.2%, resp.,P= 0.009). Factors associated with the highest neurological risk in CO patients were age >74 years and preoperative brain infarct (P= 0.03). The combination of the abovementioned factors significantly increased complication rates in CO patients submitted to CEA.Conclusions. In our experience CO patients were at high risk for postoperative neurological complications particularly when presenting association of advanced age and preoperative brain infarction.

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Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States

Scientific Reports ◽

10.1038/s41598-021-01641-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Raees Tonse ◽

Alexandra Townsend ◽

Muni Rubens ◽

Vitaly Siomin ◽

Michael W. McDermott ◽

...

Keyword(s):

High Risk ◽

Brain Metastasis ◽

Readmission Rate ◽

The United States ◽

Neurological Complications ◽

Infectious Complications ◽

Unplanned Readmission ◽

Factors Associated ◽

High Risk Patients ◽

Risk Patients

AbstractThe purpose of this study was to critically analyze the risk of unplanned readmission following resection of brain metastasis and to identify key risk factors to allow for early intervention strategies in high-risk patients. We analyzed data from the Nationwide Readmissions Database (NRD) from 2010–2014, and included patients who underwent craniotomy for brain metastasis, identified using ICD-9-CM diagnosis (198.3) and procedure (01.59) codes. The primary outcome of the study was unplanned 30-day all-cause readmission rate. Secondary outcomes included reasons and costs of readmissions. Hierarchical logistic regression model was used to identify the factors associated with 30-day readmission following craniotomy for brain metastasis. During the study period, 44,846 index hospitalizations occurred for patients who underwent resection of brain metastasis. In this cohort, 17.8% (n = 7,965) had unplanned readmissions within the first 30 days after discharge from the index hospitalization. The readmission rate did not change significantly during the five-year study period (p-trend = 0.286). The median per-patient cost for 30-day unplanned readmission was $11,109 and this amounted to a total of $26.4 million per year, which extrapolates to a national expenditure of $269.6 million. Increasing age, male sex, insurance status, Elixhauser comorbidity index, length of stay, teaching status of the hospital, neurological complications and infectious complications were associated with 30-day readmission following discharge after an index admission for craniotomy for brain metastasis. Unplanned readmission rates after resection of brain metastasis remain high and involve substantial healthcare expenditures. Developing tools and interventions to prevent avoidable readmissions could focus on the high-risk patients as a future strategy to decrease substantial healthcare expense.

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74 Pre- and Post-Operative Risk Factors Associated with Neurological Complications in Patients Supported by Ventricular Assist Device

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2011.01.081 ◽

2011 ◽

Vol 30 (4) ◽

pp. S32-S33

Author(s):

T.S. Kato ◽

E. Chan ◽

J. Yang ◽

H. Akashi ◽

K. Shahzad ◽

...

Keyword(s):

Risk Factors ◽

Ventricular Assist Device ◽

Neurological Complications ◽

Operative Risk ◽

Assist Device ◽

Ventricular Assist ◽

Factors Associated

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The Impact of Haemophilus Influenzae and Streptococcus Pneumoniae Vaccination in Bacterial Meningitis in a Pediatric Referral Hospital in Mexico

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0041-1731040 ◽

2021 ◽

Author(s):

Mercedes Macias Parra ◽

Isabel Medina-Vera ◽

Eduardo Arias De la Garza ◽

Miguel A. Rodriguez Weber ◽

Ximena León-Lara

Keyword(s):

Risk Factors ◽

Streptococcus Pneumoniae ◽

Bacterial Meningitis ◽

Haemophilus Influenzae ◽

Conjugate Vaccine ◽

Neurological Complications ◽

Immunization Schedule ◽

Conjugate Vaccines ◽

Factors Associated ◽

Before And After

Abstract Objective The study aimed to compare the epidemiology of bacterial meningitis (BM) before and after vaccination, and identify possible risk factors associated with mortality. Methods The medical and microbiologic records of children (1 month–18 years) with a discharge diagnosis of BM in a third level children's hospital in Mexico from 1990 to 2018 were reviewed. The epidemiology, pathogens, and outcomes were compared before and after introducing Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines to the Mexican immunization schedule. Risk factors associated with mortality were determined. Results In the 28-year period, 226 cases with BM were included 55.8% (1990–1999), 27.4% (2000–2008), and 16.8% (2009–2018) (p = 0.0001). The most frequent pathogen was Hib, documented in 39% of cases. There was a reduction in neurological complications after introducing the Hib conjugate vaccine (59 vs. 39%; p = 0.003) and sequelae after the Streptococcus pneumoniae conjugate vaccine (43 vs. 35%; p = 0.05). Independent risk factors associated with mortality were coma (odds ratio [OR]: 15 [2.9–78]), intracerebral bleeding (OR: 3.5 [1.4–12]), and pneumococcal meningitis (OR: 9.4 [2.2–39]). Conclusion Since the introduction of Hib and pneumococcal conjugate vaccines to the national immunization schedule, there was a reduction in BM cases, mainly associated with the Hib vaccine, with the consequent reduction of neurological complications and sequelae.

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Stain contamination and embedding in electron microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100141986 ◽

1986 ◽

Vol 44 ◽

pp. 50-53

Author(s):

Hilton H. Mollenhauer

Keyword(s):

Electron Microscopy ◽

Information Retrieval ◽

Epoxy Resins ◽

Image Contrast ◽

Sample Preservation ◽

Factors Associated ◽

Amount Of Information ◽

Electron Microscopical ◽

Contrast Information

Many factors (e.g., resolution of microscope, type of tissue, and preparation of sample) affect electron microscopical images and alter the amount of information that can be retrieved from a specimen. Of interest in this report are those factors associated with the evaluation of epoxy embedded tissues. In this context, informational retrieval is dependant, in part, on the ability to “see” sample detail (e.g., contrast) and, in part, on tue quality of sample preservation. Two aspects of this problem will be discussed: 1) epoxy resins and their effect on image contrast, information retrieval, and sample preservation; and 2) the interaction between some stains commonly used for enhancing contrast and information retrieval.

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