506 Factors associated with appropriate treatment of obstetric hypertensive emergency

SARS-Cov-2 infection, a pandemic disease since March 2020, is associated with a high percentage of cardiovascular complications mainly of a thromboembolic (TE) nature. Although clinical patterns have been described for the assessment of patients with increased risk, many TE complications occur in patients with apparently moderate risk. Notably, a recent statement from the European Society of Cardiology (ESC) atherosclerosis and vascular biology working group pointed out the key role of vascular endothelium for the recruitment of inflammatory and thrombotic pathways responsible for both disseminated intravascular coagulation and cardiovascular complications. Therefore, a better understanding of the pathophysiological process linking infection to increased TE risk is needed in order to understand the pathways of this dangerous liaison and possibly interrupt it with appropriate treatment. In this review, we describe the histological lesions and the related blood coagulation mechanisms involved in COVID-19, we define the laboratory parameters and clinical risk factors associated with TE events, and propose a prophylactic anticoagulation treatment in relation to the risk category. Finally, we highlight the concept that a solid risk assessment based on prospective multi-center data would be the challenge for a more precise risk stratification and more appropriate treatment.

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404 - Factors associated with diagnostic delay in younger-onset dementia iagnostic delay in younger-onset dementia

International Psychogeriatrics ◽

10.1017/s1041610221001630 ◽

2021 ◽

Vol 33 (S1) ◽

pp. 31-31

Author(s):

Samantha M. Loi ◽

Anita M. Goh ◽

Dhamidhu Eratne ◽

Ramon Mocellin ◽

Sarah Farrand ◽

...

Keyword(s):

Symptom Onset ◽

Age Of Onset ◽

Genetic Disorders ◽

Diagnostic Delay ◽

Royal Melbourne Hospital ◽

Factors Associated ◽

Dementia Patients ◽

Appropriate Treatment ◽

Younger Age ◽

Niemann Pick

Background:Younger-onset dementia (YOD) is a dementia of which symptom onset occurs at 65 years or less. There are approximately 27000 people in Australia with a YOD and the causes can range from Alzheimer’s dementia (AD), frontotemporal dementia (FTD), metabolic and genetic disorders. It is crucial to obtain a definitive diagnosis as soon as possible in order for appropriate treatment to take place and future planning. Previous research has reported 4-5 years to get a diagnosis (Draper et al. 2016) and factors associated with delay include younger age (van Vliet et al. 2013) and psychiatric comorbidity (Draper et al. 2016). We report on our experience of diagnostic delay.Methods:This was a retrospective file review of 10 years of inpatients from Neuropsychiatry, Royal Melbourne Hospital, Australia. Neuropsychiatry is a tertiar service which provides assessment of people with cognitive, psychiatric, neurological and behavioural symptoms. Factors such as age of onset, number of services/specialists seen were extracted and analysed using multivariate regression.Results:Of the 306 individual patients who had a YOD, these were grouped into the major dementia groups (such as AD, FTD, Huntington’s disease, vascular dementia, alcohol-related dementia). The most commonly occurring dementia was AD (24.2%), followed by FTD (23%). There was an average of 3.7 years (SD=2.6), range 0.5-15 years, of delay to diagnosis. Cognitive impairment, as measured using the Neuropsychiatry Unit Cognitive Assessment (NUCOG) was moderate, with a mean score of 68.9 (SD=17.9). Within the groups of dementia, patients with Niemann-Pick type C (NPC) had the longest delay to diagnosis F(11,272)=3.677, p<0.0001, with 6.3 years delay. Age of symptom onset and number of specialists/services seen were the significant predictors of delay to diagnosis F(7, 212)=3.975, p<0.001, R211.6.Discussion and conclusions:This was an eclectic group of people with YOD. The results of regression suggests that there are other factors which contribute to the delay, which are not just demographic related. Rarer disorders, such as NPC which present at an early age, and present with symptoms that are not cognitive in nature, can contribute to diagnostic delay.

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SYPHILIS IN PREGNANCY, FACTORS ASSOCIATED WITH CONGENITAL SYPHILIS AND NEWBORN CONDITIONS AT BIRTH

Texto & Contexto - Enfermagem ◽

10.1590/1980-265x-tce-2020-0423 ◽

2021 ◽

Vol 30 ◽

Author(s):

Anelisa Soares de Almeida ◽

Juliane Andrade ◽

Rosemary Fermiano ◽

Milena Temer Jamas ◽

Maria Antonieta de Barros Leite Carvalhaes ◽

...

Keyword(s):

Pregnant Women ◽

Selection Criteria ◽

Congenital Syphilis ◽

Diagnostic Investigation ◽

Factors Associated ◽

Appropriate Treatment ◽

Syphilis Treatment ◽

Maternal Syphilis ◽

In Pregnancy

ABSTRACT Objectives: to investigate factors associated with the occurrence of congenital syphilis in pregnant women with syphilis and to describe the cases of this disease regarding the justification for notification and aspects related to the newborn. Method: cohort study, with data collection between July and September 2017 which included 158 pregnant women diagnosed with syphilis during pregnancy, reported between 2013 and 2015. The characteristics of pregnant women and newborns are presented descriptively. The outcome under study was the occurrence or not of congenital syphilis. Sociodemographic exposure variables related to prenatal care and the adequacy of maternal syphilis treatment were analyzed by the stepwise selection criteria, and those that presented p<0.20, included in adjusted analysis, when critical p <0.05 was adopted. Results: most pregnant women with syphilis were white, had nine or more years of schooling and did not work. Among the participants, 74 (46.8%) had a newborn with congenital syphilis. Independently, the number of prenatal consultations was the only factor associated with congenital syphilis: as the number of consultations increased, the occurrence decreased (p=0.013, OR=0.87, 95%CI=0.79-0.97). The non-treatment of the mother and partner were the most frequent justifications for defining the case of congenital syphilis, and 33 newborns with syphilis presented complications at birth. Conclusion: considering the association with the number of prenatal consultations, in order to reduce cases of congenital syphilis, the municipality should modify the follow-up in this period, offering consultations, developing health education actions, implementing diagnostic investigation and appropriate treatment for pregnant women, and partnership when necessary.

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Factors associated with dengue fatality in Fiji: a hospital-based case control study

Pacific Health Dialog ◽

10.26635/phd.2019.603 ◽

2019 ◽

Vol 21 (3) ◽

pp. 139-147

Author(s):

Aneley Getahun ◽

Anaseini Batikawai ◽

Sabiha Khan ◽

Devina Nand ◽

...

Keyword(s):

Case Control Study ◽

Case Control ◽

Factors Associated ◽

Appropriate Treatment ◽

Matched Case ◽

Collection Form ◽

Matched Case Control Study ◽

Similar Intensity ◽

Control Study ◽

Related Mortality

Introduction: Fiji experienced a dengue serotype 3 outbreak in 2013-14 with a higher number of fatalities compared to an earlier outbreak of similar intensity. This study was conducted to determine the factors associated with dengue mortality during the 2014 outbreak. Methods: A matched case control study was conducted. Cases were patients who died of dengue (n=30) and controls were patients with laboratory confirmed dengue who were hospitalized and survived (n=90). A standardized data collection form was used to extract information from medical folders. Findings: In this study predictors of dengue death included, haemorrhagic manifestations (odds ratio(OR) 2.63, 95% confidence interval (CI) 1.09,6.36), abdominal tenderness (OR 4.32, 95%CI 1.10,17.03), leucocytosis (OR 2.92, 95%CI 1.29,29.74) and serum creatinine > 150mg/dl (OR 6.19, 95%CI 1.29,29.74) at admission and development of shock (OR 40.05, 95%CI 5.26,305.19) during hospital stay. Living in urban location was also associated with dengue fatality (OR 5.78, 95%CI 1.57,21.22). Conclusion: Findings of this study should be used by clinicians for prompt identification and appropriate treatment of dengue as well as for public health measures to reduce dengue related mortality in Fiji.

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Factors Associated with Appropriate Treatment of Acute-Onset Severe Obstetric Hypertension

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.05.012 ◽

2021 ◽

Author(s):

Uma S. DESHMUKH ◽

Lisbet S. LUNDSBERG ◽

Jennifer F. CULHANE ◽

Caitlin PARTRIDGE ◽

Uma M. REDDY ◽

...

Keyword(s):

Acute Onset ◽

Factors Associated ◽

Appropriate Treatment

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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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