Clinical Outcomes and Prognostic Determinants of Surgically Treated Depressed Skull Fracture in Addis Ababa University Neurosurgical Teaching Hospitals: A Prospective Multicenter Observational Study

2021 ◽  
Author(s):  
Abdulaziz Abdellah Hussein ◽  
Tsegazeab Laeke ◽  
Dagnachew Youhans
Keyword(s):  
Observational Study ◽  
Clinical Outcomes ◽  
Addis Ababa ◽  
Skull Fracture ◽  
Teaching Hospitals ◽  
Multicenter Observational Study ◽  
Depressed Skull Fracture ◽  
Addis Ababa University ◽  
Prospective Multicenter Observational Study

scholarly journals Sex Differences in Heart Failure With Preserved Ejection Fraction

2021 ◽  
Author(s):  
Yohei Sotomi ◽  
Shungo Hikoso ◽  
Daisaku Nakatani ◽  
Hiroya Mizuno ◽  
Katsuki Okada ◽  
...  
Keyword(s):  
Heart Failure ◽  
Observational Study ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Clinical Outcomes ◽  
Preserved Ejection Fraction ◽  
Multicenter Observational Study ◽  
Female Sex ◽  
End Point ◽  
Prospective Multicenter Observational Study

Background The female preponderance in heart failure with preserved ejection fraction (HFpEF) is a distinguishing feature of this disorder, but the association of sex with degree of diastolic dysfunction and clinical outcomes among individuals with HFpEF remains unclear. Methods and Results We conducted a prospective, multicenter, observational study of patients with HFpEF (PURSUIT‐HFpEF [Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction]: UMIN000021831). Between 2016 and 2019, 871 patients were enrolled from 26 hospitals (follow‐up: 399±349 days). We investigated sex‐related differences in diastolic dysfunction and postdischarge clinical outcomes in patients with HFpEF. The echocardiographic end point was diastolic dysfunction according to American Society of Echocardiography/European Association of Cardiovascular Imaging criteria. The clinical end point was a composite of all‐cause death and heart failure readmission. Women accounted for 55.2% (481 patients) of the overall cohort. Compared with men, women were older and had lower prevalence rates of hypertension, coronary artery disease, and chronic kidney disease. Women had diastolic dysfunction more frequently than men (52.8% versus 32.0%, P <0.001). The incidence of the clinical end point did not differ between women and men (women 36.1/100 person‐years versus men 30.5/100 person‐years, P =0.336). Female sex was independently associated with the echocardiographic end point (adjusted odds ratio, 2.839; 95% CI, 1.884–4.278; P <0.001) and the clinical end point (adjusted hazard ratio, 1.538; 95% CI, 1.143–2.070; P =0.004). Conclusions Female sex was independently associated with the presence of diastolic dysfunction and worse clinical outcomes in a cohort of elderly patients with HFpEF. Our results suggest that a sex‐specific approach is key to investigating the pathophysiology of HFpEF. Registration URL: https://upload.umin.ac.jp ; Unique identifier: UMIN000021831.

scholarly journals A Prospective Multicenter Observational Study of Venous Thromboembolism after Gastric Cancer Surgery (SHISA-1601)

2021 ◽  
pp. 1-10
Author(s):  
Sachiko Kaida ◽  
Toru Miyake ◽  
Satoshi Murata ◽  
Tsuyoshi Yamaguchi ◽  
Takeshi Tatsuta ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Venous Thromboembolism ◽  
Blood Transfusion ◽  
Observational Study ◽  
Characteristic Curve ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery ◽  
Multicenter Observational Study ◽  
Prospective Multicenter Observational Study ◽  
D Dimer

Introduction: This study aimed to clarify the frequency and risk factors of intercurrent venous thromboembolism (VTE) in patients undergoing major curative gastric cancer surgery. Methods: This prospective, multicenter, observational study included patients with gastric cancer who underwent radical gastrectomy at 5 hospitals between June 2016 and May 2018. Patients who were preoperatively administered anticoagulants were excluded. Results: A total of 126 patients were eligible to participate. VTE occurred within 9 days postoperatively in 5 cases (4.0%; 2 symptomatic and 3 asymptomatic). Postoperative day (POD) 1 plasma D-dimer and soluble fibrin (SF) levels were significantly higher in the VTE group than in the non-VTE group. Receiver-operating characteristic curve (ROC) analysis indicated a statistically significant ability of POD 1 D-dimer and SF levels to predict postoperative VTE development after gastrectomy; this finding was reflected by an area under the curve (AUC) of 0.97 (95% CI 0.92–1.0) and 0.87 (95% CI 0.74–1.0), respectively. Cutoff values of D-dimer (24.6 µg/mL) and SF (64.1 µg/mL) were determined. Intraoperative blood transfusion (odds ratio [OR] 7.86), POD 1 D-dimer ≥24.6 µg/mL (OR 17.35), and POD 1 SF ≥64.1 µg/mL (OR 19.5) were independent predictive factors for postoperative VTE (p < 0.05). Conclusion: VTE occurred in 4.0% patients (1.6% symptomatic and 2.4% asymptomatic) after gastric cancer surgery; however, with an early diagnosis and anticoagulant therapy, no patients experienced progression. Careful observation of patients with a high risk for VTE, including intraoperative blood transfusion and high POD 1 D-dimer or SF levels, would contribute to the early detection of VTE.

A Comparison Of The Improving In Major Depressive Symptoms As Reported By Romanian Physicians And Patients In a Prospective, Multicenter, Observational Study

2016 ◽  
Vol 33 (S1) ◽  
pp. S442-S442
Author(s):  
T. Purnichi ◽  
V. Marinescu ◽  
M. Ladea ◽  
M.C. Eda ◽  
I. Marinescu ◽  
...  
Keyword(s):  
Observational Study ◽  
Major Depressive Episode ◽  
Clinical Status ◽  
Response To Treatment ◽  
Major Depressive ◽  
Multicenter Observational Study ◽  
The Difference ◽  
Competing Interest ◽  
Major Depressive Symptoms ◽  
Prospective Multicenter Observational Study

IntroductionDepression leads to substantial suffering for the patients, their families and becomes an economic burden for system [1,2]. Patients and clinicians tend to rate the remission differently [3].Objectives and methodsWe investigate if clinicians and patients rate different the treatment response. This study assed the evolution of major depressive episode (MDE) in patients treated with Agomelatine, in Romania. It was designed as a multicentre, observational study that included 1213 adult patients evaluated in 75 sites in 2014. The design included 3 visits (baseline (V1); visit at 2/3 weeks (V2); visit 6/8 weeks (V3)). The scales used were: MADRS, SHAPS, CGI-I, CGI-S, PGI-I, PGI-S.ResultsThe MDE improvement was significant (P < 0.001) for all aspects evaluated. At baseline, more clinicians vs. patients considered the moderately or markedly ill as best descriptors of the state. The difference between the two assessments was even higher for V2 and V3. During V2 clinicians reported “minimally improvement” while patients reported “much improvement” in higher percentage. During V3, both, clinicians and patients reported a “very much improved” clinical status. Of the patients 42.60% reported at V3 “normal”, not at all ill’ in comparison to 34.81% of clinicians who reported the same (P < 0.001).ConclusionsThis could mean that patients are not aware of the severity of their disease. This data could be interpreted in the way that patients are more prone to rate higher the improvements as response to treatment and the clinicians to rate as response a more than 50% decrease of symptomatology.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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