Epidemiological and clinical profile of hypertensive octogenarian patients and factors associated with uncontrolled hypertension: Observational study of 346 patients

ObjectivesHome-based rehabilitation programmes (H-RPs) could facilitate the implementation of pulmonary rehabilitation prior to resection for non-small cell lung cancer (NSCLC), but their feasibility has not been evaluated. The aim of this study was to identify determinants of non-completion of an H-RP and the factors associated with medical events occurring 30 days after hospital discharge.DesignA prospective observational study.InterventionAll patients with confirmed or suspected NSCLC were enrolled in a four-component H-RP prior to surgery: (i) smoking cessation, (ii) nutritional support, (iii) physiotherapy (at least one session/week) and (iv) home cycle-ergometry (at least three times/week).OutcomesThe H-RP was defined as ‘completed’ if the four components were performed before surgery.ResultsOut of 50 patients included, 42 underwent surgery (80% men; median age: 69 (IQR 25%–75%; 60–74) years; 64% Chronic Obstructive Pulmonary Disease (COPD); 29% type 2 diabetes). Twenty patients (48%) completed 100% of the programme. The median (IQR) duration of the H-RP was 32 (19; 46) days. Multivariate analysis showed polypharmacy (n=24) OR=12.2 (95% CI 2.0 to 74.2), living alone (n=8) (single vs couple) OR=21.5 (95% CI 1.4 to >100) and a long delay before starting the H-RP (n=18) OR=6.24 (95% CI 1.1 to 36.6) were independently associated with a risk of non-completion. In univariate analyses, factors associated with medical events at 30 days were H-RP non-completion, diabetes, polypharmacy, social precariousness and female sex.ConclusionFacing multiple comorbidities, living alone and a long delay before starting the rehabilitation increase the risk of not completing preoperative H-RP.Trial registration numberNCT03530059.

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Factors associated with prognosis of dysembryoplastic neuroepithelial tumors patients after surgical resection: a retrospective observational study

British Journal of Neurosurgery ◽

10.1080/02688697.2021.1878107 ◽

2021 ◽

pp. 1-6

Author(s):

Yuxiang Cai ◽

Dingyang Liu ◽

Zhuanyi Yang ◽

Xiaoyu Chen ◽

Jian Liu ◽

...

Keyword(s):

Observational Study ◽

Surgical Resection ◽

Retrospective Observational Study ◽

Neuroepithelial Tumors ◽

Factors Associated ◽

Dysembryoplastic Neuroepithelial Tumors

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POS0875 MYOSITIS-SPECIFIC ANTIBODIES IN A RETROSPECTIVE SINGLE-CENTER OBSERVATIONAL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3234 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 693.2-694

Author(s):

J. Álvarez Troncoso ◽

S. Carrasco Molina ◽

J. Valdivieso ◽

P. Nozal ◽

Á. Robles Marhuenda ◽

...

Keyword(s):

Risk Factors ◽

Observational Study ◽

Interstitial Pneumonia ◽

Usual Interstitial Pneumonia ◽

Older Age ◽

Single Center ◽

Specific Antibodies ◽

Factors Associated ◽

Risk Of Cancer ◽

Single Center Observational Study

Background:Myositis-specific antibodies (MSA) are highly specific and useful to classify patients as having syndromes with distinct clinical features and prognosis. MSA are almost always mutually exclusive and quite specific, adding value as a useful biomarker for diagnosis. Although individual autoantibodies aren’t sensitive enough to detect the full spectrum of idiopathic inflammatory myopathies (IIM), the sensitivity of a myositis panel is increasing as more autoantibodies are discovered, and as better assays become available.Objectives:We aimed to analyze the usefulness of a myositis-specific immunoblot for the diagnosis of IIM in a hospital cohort from January 2019 to December 2020. We also seek to correlate immunological findings with the risk of associated interstitial lung disease (ILD), cancer, or death.Methods:Retrospective single-center observational study conducted in a Spanish tertiary hospital. In patients with high clinical suspicion of IIM, a myositis immunoblot was performed including Jo1, PL-7, PL-12, EJ, SRP, Mi2, Ku, MDA-5, TIF1-γ, HMGCR, PM-Scl and Ro52 antibodies. The demographic characteristics, the risk of ILD, cancer and death were analyzed.Results:In a cohort of 313 patients with high suspicion of IIM, 87 patients (27.8%) presented a positive MSA (MSA+ve). The mean age at diagnosis was 56.7±16.9 years, with no significant differences between MSA+ve and MSA-ve (p=0.597). Most of the patients were women with significant differences between both groups (80.5% MSA+ve vs 68.1% MSA-ve, p=0.030).IIM were classified as antisynthetase syndrome (ARS) (38%), dermatomyositis (DM) (31%), overlap myopathy (OM) (16.9%) and necrotizing myopathy (NM) (14.1%) according to the manifestations and MSA found (Jo1, PL-12, PL-7, EJ in ARS; Mi-2, MDA-5 and TIF1-γ in DM; Ku and PM-Scl in OM; HMGCR and SRP in NM). The most frequent MSA were anti-Jo1 (16.9%), TIF1-γ (15.5%), Ku (12.7%), Mi-2 (9.9%), PL-7 (9.9%), HMCGR (8.5%), PL-12 (7%), MDA-5 (5.6%), SRP (5.6%) and EJ (4.2%). The presence of Ro52 associated with other MSA was found in 20 patients (22.9%).ILD was the most frequent manifestation (45.2% of the MSA+ve). Non-specific interstitial pneumonia (NSIP) was the most frequent ILD (39.5%), followed by usual interstitial pneumonia (34.2%). The main risk factors associated with IIM-ILD were some subtypes of the MSAs (p<0.001), the association of Ro52 (p<0.001), and older age (p=0.027). Among the IIM, ARS and OM (p<0.001) were more frequently associated with IIM-ILD. The MSAs most associated with IIM-ILD were Jo1, PL-7, PM-Scl, Ku and SRP (p<0.001).Cancer was found in 9.6% of MSA+ve patients. The most frequent tumors were gynecological (37.5%), followed by gastrointestinal (25%) and breast cancer (12.5%). Factors associated with cancer were age (p=0.010), TIF1-γ (p<0.001), SRP (p=0.004), PL-12 (p=0.013), PL-7 (p=0.047) and HMGCR (p=0.027).The mortality of these patients was 3.5%. There were no differences regarding MSA+ve/-ve (p = 0.911). However, MDA-5 (p=0.033) and older age (p=0.001) were associated with higher mortality. There were no significant differences between the IIM classifications, the associated SAD, the presence of cancer or ILD. However, longer follow-up periods and future studies are necessary to confirm these results.Conclusion:The use of a myositis blot allowed classifying, stratifying the risk of ILD, the risk of cancer and the risk of mortality in IIM. IIM-ILD was the most frequent complication, usually manifested as NSIP. The associated risk factors were ARS, OM, some MSAs, Ro52+ and older age. Cancer was a serious and frequent manifestation in these patients, especially in patients with TIF1-γ and other MSAs, so it is essential to know the risk factors and perform an early screening, especially in older patients.A better knowledge of the serological profiles of IIM will provide more individualized approaches and better risk stratification, helping in the management and treatment of these patients.References:[1]Satoh et al. Clin Rev Allergy Immunol. 2017 Feb;52(1):1-19.[2]Betteridge et al. J Intern Med. 2016 Jul;280(1):8-23.Disclosure of Interests:None declared

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Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

BMC Surgery ◽

10.1186/s12893-021-01172-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Reem M. Elsaid ◽

Ashraqat S. Namrouti ◽

Ahmad M. Samara ◽

Wael Sadaqa ◽

Sa’ed H. Zyoud

Keyword(s):

Logistic Regression ◽

Observational Study ◽

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Binary Logistic Regression ◽

Nausea And Vomiting ◽

Prior History ◽

Factors Associated ◽

Duration Of Surgery ◽

History Of

Abstract Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.

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