scholarly journals Body Weight at Birth: The Only Risk Factor Associated with Contralateral Clavicular Fracture in Patients with Congenital Muscular Torticollis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Zeeihn Lee ◽  
Joo Young Cho ◽  
Byung Joo Lee ◽  
Jong Min Kim ◽  
Donghwi Park

Abstract To date and to the best of our knowledge, there have been limited studies on the risk factor of clavicle fracture combined with congenital muscular torticollis (CMT), despite it being the most common fracture in newborns. So, the aim of this study was to investigate the risk factors associated with clavicular fracture combined with CMT, and its effect on prognosis. In this study, a total of 134 infants with CMT were included. The risk factors associated with clavicular fracture combined with CMT were analyzed. To analyze the correlation between the clinical parameters and the clavicular fracture in patients with CMT, demographic data, such as body weight at birth, maternal age, gender, gestational age, delivery method, sternocleidomastoid (SCM) thickness of ipsilateral side, its ratio between the ipsilateral and contralateral side, and the first visitation date after birth were evaluated. In the results of this study, the clavicular fracture was found in 15 of 134 patients with CMT (19%). In multivariate logistic analysis, the body weight at birth was the only significant parameter for predicting clavicular fracture in patients with CMT (p-value < 0.05). However, there was no significant difference of treatment duration between CMT infants with or without clavicular fracture. In infants with CMT, the area under the ROC curve of the body weight at birth for predicting clavicular fracture was 0.659 (95% CI, 0.564–0.745.; p < 0.05). The optimal cut-off value obtained from the maximum Youden index J was 3470 g (sensitivity: 57.14%, specificity: 75.76%), and the odd ratio of clavicular fracture in patients with CMT increased by 1.244 times for every 100 g of body weight at birth. In conclusion, birth weight appears to be a clinical predictor of clavicular fracture in infants with CMT. More studies and discussions are needed on whether any screening should be recommended for detecting the concurrent clavicular fracture in subjects with CMT.

Author(s):  
Aziz Eghbali MD ◽  
Roghaieh.Rahimi-Afzal MD ◽  
Sarvenaz Mehrabi MD ◽  
Seyed Amir Sanatkar MD ◽  
Morteza Mousavi-Hasanzadeh MD

Background: Thalassemia is one of the most common genetic disorders throughout the world. Blood transfusion plays an important role in the treatment of thalassemia but it leads to numerous complications such as iron overload and alloimmunization. This study evaluated the frequency and risk factors associated with alloimmunization in thalassemia major patients living in Markazi province, Iran. Materials and Methods: In this descriptive study, 48 thalassemia major patients who underwent blood transfusion at Amirkabir hospital were included. Patients' demographic data were recorded using a questionnaire. In order to perform alloimmunization screening and autoantibody assessment, patients were referred to Tehran Blood Transfusion Organization Laboratory. Results: The current study was performed on 48 patients with thalassemia major,. The mean age of patients was 12.5 ± 8.3 years. Among patients 26 (54.16%) were male and 22 (45.83%) were female, 13 patients (27.08%) had alloantibodies. Among 48 patients, 19 (39.58%) had undergone splenectomy. The patients' age of the first blood transfusion ranged from 1 month to 14 months      and the mean age of the first blood transfusion was 9.5 ± 7.08 months. The blood transfusion intervals in patients were from 21 days to 40 days and the blood volume received at each transfusion session was 10-15 cc/kg of the body weight. In the current study, the data analysis indicated no significant correlation between alloantibodies and RH phenotype (P=0.43), patients' gender (P=0.9), or blood groups (P=0.4); whereas, a significant correlation was found between alloantibodies and splenectomy (P=0.02) as an increase in the prevalence of alloantibodies was reported in splenectomised patients. Conclusion: No significant difference was found between the patients with and without alloantibodies in terms of the prevalence of Rh phenotype, gender, and blood groups. However, there was a significant difference between the patients with and without alloantibodies in terms of splenectomy. Key words: Allo-immunization, Risk factors, Thalassemia major  


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Amyna Jiwani ◽  
Tabish Chawla

Introduction. Benign and malignant lesions of the pancreas located at the body and tail of the pancreas are managed by the standard procedure of distal pancreatectomy (DP). The mortality associated with this procedure is reported as less than 5% in high-volume centers. The major proportion of morbidity is comprised of pancreatic fistula with a reported incidence of 5% to 60%. The most considered risk factors associated with pancreatic fistula formation are soft pancreatic texture, diameter of the pancreatic duct <3 mm, intraoperative blood loss >1000 ml and surgical techniques. Among all these factors, the modifiable factor is the surgical technique. Several surgical techniques have been developed and modified for closure of the pancreatic remnant in the recent past in order to minimize the risk of pancreatic fistula and other complications. The main objective of the study is to analyze the factors associated with formation of pancreatic fistula after distal pancreatectomy. Patients and Methods. We performed a single-center retrospective study at Aga Khan University Hospital from January 2004 till December 2015. The perioperative and postoperative data of 131 patients who underwent pancreatic resection were recorded by using ICD 9 coding. 45 patients underwent distal pancreatectomy, out of which 38 were included in the study based on inclusion criteria. Variables were grouped into demographics, indications, operative details, and postoperative course. Statistical analysis software (SPSS) was used for analysis. Quantitative variables were presented as mean with standard deviation or median with interquartile range depending on the distribution of data. Study endpoints for the risk factor analysis were surgical morbidity and development of pancreatic fistula. Univariate logistic regressions were performed associated with study endpoints. P value less than 0.05 was considered significant. Results. Postoperative pancreatic fistula was the most common perioperative morbidity. The significant associated risk factor for pancreatic fistula was multivisceral resection as compared to spleen-preserving distal pancreatectomy (P value 0.039). However, the technique of stump closure when opted for suture techniques was seen to be associated with a higher occurrence of postoperative pancreatic fistula. The mortality rate was 2.6%. Conclusion. Postoperative pancreatic fistula is the most common complication seen after distal pancreatectomy in our series. Multivisceral resection is associated with a high incidence of pancreatic fistula and is a statistical significant predictor of pancreatic fistula.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256105
Author(s):  
Ida C. N. Thøfner ◽  
Jan Dahl ◽  
Jens Peter Christensen

Keel bone fractures (KBF) in commercial poultry production systems are a major welfare problem with possible economic consequences for the poultry industry. Recent investigations suggest that the overall situation may be worsening. Depending on the housing system, fracture prevalences exceeding 80% have been reported from different countries. No specific causes have yet been identified and this has consequently hampered risk factor identification. The objective of the current study was to investigate the prevalence of KBF in Danish layer hens and to identify risk factors in relation to KBF in all major productions systems, including parent stock production. For risk factor identification, production data from the included flocks was used. In total, 4794 birds from 40 flocks were investigated at end-of-lay. All birds were euthanized on farm and underwent inspection and palpation followed by necropsy. All observations were recorded and subsequently analysed using the SAS statistical software package. In flocks from non-caged systems, fracture prevalence in the range 53%-100%, was observed whereas the prevalence in flocks from enriched cages ranged between 50–98%. Furthermore, often multiple fractures (≥4) were observed in individual birds (range 5–81% of the birds with fractures) depending on the flock. The localization of the fractures at the distal end of the keel bone is highly consistent in all flocks (>96%). Macroscopically the fractures varied morphologically from an appearance with an almost total absence of callus, most frequently observed in caged birds, to large callus formations in and around the fracture lines, which was a typical finding in non-caged birds. Despite being housed under cage-free conditions, parent birds had significantly fewer fractures (all flocks were 60 weeks old) per bird, than other birds from cage-free systems. The body weight at end-of-lay had an effect on the risk of having fractures, heavy hens have significantly fewer fractures at end-of-lay. The older the hens were at onset of lay, the lower was the flock prevalence at end-of-lay. Additionally, the daily egg size at onset of lay was of importance for the risk of developing fractures, the production of heavier eggs initially, resulted in higher fracture prevalence at depopulation. The odds ratio of body weight, (+100 g) was 0.97, age at onset of lay (+1 week) was 0.87 and daily egg weight at onset (+1 gram) was 1.03. In conclusion, the study demonstrated a very high prevalence of KBF in hens from all production systems and identified hen size, age at onset of lay and daily egg weight at onset of lay to be major risk factors for development of KBF in the modern laying hen. Further research regarding this is warranted to strengthen the longevity and enhance the welfare of laying hens.


2020 ◽  
Vol 8 (6) ◽  
pp. 927 ◽  
Author(s):  
Lorena Fábrega ◽  
Carlos M. Restrepo ◽  
Alicia Torres ◽  
Diorene Smith ◽  
Patricia Chan ◽  
...  

Stray animals such as dogs and cats have an important role in maintaining the transmission cycles and dissemination of Toxoplasma gondii. Therefore, the objective of this study was to evaluate the frequency of T. gondii in stray dogs and cats in six different regions of Panama and determine risk factors associated with the dynamics of infection in each of the studied regions. Data were obtained using serological tests for the detection of anti-T. gondii IgG and IgM antibodies. The results of this study revealed an overall infection frequency of 23.73%. The infection frequencies found in dog and cat populations were 25.70% and 21.93% respectively, showing no statistically significant difference. Risk factor correlations suggested different infection dynamics depending on the region analyzed. The San Miguelito, North and West regions were more associated with positive cases in dogs with an age range greater than 13 months. Conversely, the Metro, Central and East regions were more associated with negative cases in cats with age ranging between 0 and 5 months. Infection of the parasite in stray animals can be influenced by intrinsic characteristics of each region, which can potentiate different risk factors associated with the different routes of transmission.


2020 ◽  
Vol 11 (2) ◽  
pp. 143-150
Author(s):  
Olivera Pilipović-Spasojević ◽  
Nenad Ponorac ◽  
Mira Spremo

Introduction. The transition to university education as a stressful period and the need to be likeable where physical appearance is concerned can be a trigger for a change in attitudes towards eating patterns. Body composition is an essential component of nutritional status and the most common parameter used as an indicator of physical appearance. An unobtrusive onset of eating disorder can easily lead to a preoccupation with eating and body weight. The aim of the paper is to determine whether the parameters of body composition can qualitatively detect respondents with eating disorders. Methods. The epidemiological observational and analytical study included a representative sample comprised of 408 healthy female students, aged 19-22 years. A short socio-demographic questionnaire, a standardized questionnaire for assessment of eating disorders-Eating Attitudes Test-26 were used in the study while Omron BF 510 was used for anthropometric measurements of body weight and BMI. Results. The sample consisted of female students: agedmean = 20.5 years, with average height 168.65 cm (SD = 6.01), body weight 63.09 kg (SD = 9.9) and BMI 22.1 (SD = 3.2). According to EAT-26 (Mean = 13.24 and SD = 7.97), 16.7% of respondents with risk factors for eating disorders were detected. Conclusion. The maximum value of the Youden index of 0.24 ROC analysis confirms that the body composition parameters are not reliable indicators of eating disorders and EAT-26 is not reliable and acceptable as an independent test for assessing risk factors by means of considering different attitudes and deviant eating behaviors. Therefore, in order to achieve detection, monitoring, and perform preventive action, it is necessary to conduct regular systematic examinations among the student population.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S442-S443
Author(s):  
Denise Marie A Francisco ◽  
Liangliang Zhang ◽  
Ying Jiang ◽  
Adilene Olvera ◽  
Eduardo Yepez Guevara ◽  
...  

Abstract Background Antibiotic use is a risk factor for CDI. Few studies have correlated use of prior antibiotics with CDI severity in cancer patients. This study identified clinical and microbiology risk factors associated with severe CDI in patients with cancer. We hypothesized that previous antibiotic exposure and microbiome composition at time of CDI presentation, are risk factors for severe disease in cancer patients. Methods This non-interventional, prospective, single-center cohort study examined patients with cancer who had their first episode or first recurrence of CDI between Oct 27, 2016 and Jul 1, 2019. C. difficile was identified using nucleic acid amplification testing. Multivariate analysis was used to determine significant clinical risk factors for severe CDI as defined in the 2018 IDSA/SHEA guidelines. Alpha, and beta diversities were calculated to measure the average species diversity and the overall microbial composition. Differential abundance analysis and progressive permutation analysis were used to single out the significant microbial features that differed across CDI severity levels. Results Patient (n=200) demographics show mean age of 60 yrs., 53% female, majority White (76%) and non-Hispanic (85%). Prior 90 day metronidazole use (Odds Ratio OR 4.68 [1.47-14.91] p0.009) was a significant risk factor for severe CDI. Other factors included Horn’s Index &gt; 2 (OR 7.75 [1.05-57.35] p0.045), Leukocytosis (OR 1.29 [1.16-1.43] p&lt; 0.001), Neutropenia (OR 6.01 [1.34-26.89] p0.019) and Serum Creatinine &gt;0.95 mg/dL (OR 25.30 [8.08-79.17] p&lt; 0.001). Overall, there were no significant differences in alpha and beta diversity between severity levels. However, when identifying individual microbial features, the high presence of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were associated with protection from severe CDI (p&lt; 0.05). Table 1 - Results of multivariate logistic regression analysis of factors associated with severe CDI Figure 1. Microbiome features identified by progressive permutation analysis as seen in a volcano plot. Conclusion A number of risk factors for severe CDI were identified among this population, including prior 90 day metronidazole use. Also, increased relative abundance of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were linked to protection from severe CDI. Reducing metronidazole use in patients with cancer may help prevent subsequent severe CDI. Disclosures Adilene Olvera, MPH MLS (ASCP), MERK (Grant/Research Support, Scientific Research Study Investigator) Kevin W. Garey, PharmD, MS, FASHP, Merck & Co. (Grant/Research Support, Scientific Research Study Investigator) Ryan J. Dillon, MSc, Merck & Co., Inc., (Employee) Engels N. Obi, PhD, Merck & Co. (Employee)


2021 ◽  
Vol 11 (5) ◽  
pp. 638
Author(s):  
Ayataka Fujimoto ◽  
Keisuke Hatano ◽  
Toshiki Nozaki ◽  
Keishiro Sato ◽  
Hideo Enoki ◽  
...  

Background: A corpus callosotomy (CC) is a procedure in which the corpus callosum, the largest collection of commissural fibers in the brain, is disconnected to treat epileptic seizures. The occurrence of chemical meningitis has been reported in association with this procedure. We hypothesized that intraventricular pneumocephalus after CC surgery represents a risk factor for postoperative chemical meningitis. The purpose of this study was to analyze the potential risk factors for postoperative chemical meningitis in patients with medically intractable epilepsy who underwent a CC. Methods: Among the patients who underwent an anterior/total CC for medically intractable epilepsy between January 2009 and March 2021, participants were comprised of those who underwent a computed tomography scan on postoperative day 0. We statistically compared the groups with (c-Group) or without chemical meningitis (nc-Group) to determine the risk factors. Results: Of the 80 patients who underwent a CC, 65 patients (25 females and 40 males) met the inclusion criteria. Their age at the time of their CC procedure was 0–57 years. The c-Group (17%) was comprised of seven females and four males (age at the time of their CC procedure, 1–43 years), and the nc-Group (83%) was comprised of 18 females and 36 males (age at the time of their CC procedure, 0–57 years). Mann–Whitney U-tests (p = 0.002) and univariate logistic regression analysis (p = 0.001) showed a significant difference in pneumocephalus between the groups. Conclusion: Postoperative pneumocephalus identified on a computed tomography scan is a risk factor for post-CC chemical meningitis.


2021 ◽  
Vol 1 (3) ◽  
pp. 135-141
Author(s):  
KATSUYA MAKIHARA ◽  
YUKA SHIMEDA ◽  
TOMOKAZU MATSUMURA

Background/Aim: Docetaxel (DTX) is metabolized by liver cytochromes P450 (CYP) 3A4 (CYP3A4) and 3A5 (CYP3A5) CYP3A4 activity is considered the main factor affecting the effectiveness in DTX clearance. We, therefore, explored the association between DTX-induced febrile neutropenia (FN) and concomitant polypharmacy involving CYP3A4 inhibitors in cancer patients. Patients and Methods: Among patients who received docetaxel, we compared the number of concomitant medications between patients with and without FN, and risk factors associated with FN were identified. Results: The total number of concomitant CYP3A4 inhibitors and substrates used was significantly higher in patients with FN [mean: 2.1 (95% confidence interval (CI)=1.5-2.9)] than in those without FN [mean: 1.4 (95% CI=1.0-1.8)] (p=0.01). The only risk factor for FN was the use of ≥2 concomitant CYP3A4 inhibitors and substrates in total (OR=4.82, 95% CI=1.77-14.1; p=0.002). Conclusion: Polypharmacy involving CYP3A4 inhibitors and substrates increases the risk of DTX-induced FN.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Ali Razmara ◽  
Steven Cen ◽  
Diana L Jin ◽  
Nerses Sanossian ◽  
Amytis Towfighi

Intro: Thrombosis risk is increased during pregnancy and puerperium. There are no recent data on nationwide trends in thrombotic events during the delivery period. Objective: To determine risk factors for thrombotic events in women hospitalized for deliveries. Methods: Data from the Nationwide Inpatient Sample (2000-2010) were used to identify deliveries. Weighted proportion of pregnancy hospitalizations with comorbid thrombotic events, including TIA, ischemic stroke, hemorrhagic stroke, acute MI, and venous thromboembolism, was determined. Poisson regression was used to identify risk factors for thrombotic events. The first multivariable model adjusted for sociodemographic and hospital factors. The second model in addition adjusted for comorbid conditions. Results: There were 4,305,561 women hospitalized for delivery (21.5 million US deliveries), of which 7,242 (0.17%) had thrombotic events in the peripartum period. From 2000-2010, there was an increase in deliveries with associated thrombotic events observed from 7.46/10K to 34.8/10K. Compared to 2000, deliveries with thromboses was 8-fold more likely in 2010 (RR 7.94, 95% CI 1.98-31.93). There was no significant difference in rates from 2000 to 2010 after adjustment for sociodemographic and hospital factors. From 2000-2010, pregnant women with thrombotic events were older, more likely to be White, to smoke, to lack insurance, to be admitted to rural hospitals, and to be admitted in the South or Midwest. After multivariable adjustment for sociodemographics, hospital factors, and comorbidities, admissions in the South (RR 1.26, 95% CI 1.02-1.55) or Midwest (1.33, 95% CI 1.05-1.68), atrial fibrillation (1.28, 95% CI 1.01-1.62), pre-/eclampsia (5.78, 95% CI 4.37-7.66), dyslipidemia (1.72, 95% CI 1.42-2.09), atrial septal defect (14.38, 95% CI 6.76-30.58), and valvular heart disease (1.67, 95% CI 1.25-2.24) were independently associated with higher risk of thrombotic events. Conclusions: From 2000-2010, there was a sizeable increase in deliveries with associated thrombosis. Identification of factors associated with thrombotic events for women hospitalized for normal pregnancies will aid in targeted interventions to screen for, prevent and treat thrombosis related to pregnancy.


2016 ◽  
Vol 36 (9) ◽  
pp. 901-909 ◽  
Author(s):  
D Sheela ◽  
R Vijayaraghavan ◽  
S Senthilkumar

Buprenorphine drug cartridge was made for autoinjector device for use in emergency and critical situations to reduce the morbidity and mortality. Water-filled cartridges were prepared and buprenorphine was injected aseptically in the cartridge, to make 0.05 and 0.10 mg/mL. Rats were injected intraperitoneally, buprenorphine (0.3 and 0.6 mg/kg), repeatedly with the autoinjector and compared with manual injection (7 days and 14 days) using various haematological and biochemical parameters. No significant change was observed in the body weight, organ to body weight ratio and haematological variables in any of the experimental groups compared with the control group. Except serum urea and aspartate aminotransferase, no significant change was observed in glucose, cholesterol, triglycerides, bilirubin, protein, albumin, creatinine, uric acid, alanine aminotransferase, gamma glutamyltransferase and alkaline phosphatase. The autoinjectors deliver the drugs with spray effect and force for faster absorption. In the present study, the autoinjector meant for intramuscular injection was injected intraperitoneally in rats, and the drug was delivered with force on the vital organs. No significant difference was observed in the autoinjector group compared to the manual group showing tolerability and safety of the buphrenorphine autoinjector. This study shows that buprenorphine autoinjector can be considered for further research work.


Sign in / Sign up

Export Citation Format

Share Document