scholarly journals Enlarged subarachnoid space on cranial ultrasound in preterm infants: Neurodevelopmental implication

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sook Kyung Yum ◽  
Soo Ah Im ◽  
Yu Mi Seo ◽  
In Kyung Sung

AbstractThe role of enlarged subarachnoid space (ESS) in preterm infants has not been described in concrete. We aimed to evaluate whether ESS should be considered a risk factor potentially associated with adverse neurodevelopmental outcomes in prematurity. Electronic medical records of 197 preterm infants (median 32.1 weeks' gestation) including cranial ultrasound (cUS) images, head circumferences, and Korean Developmental Screening Tests for Infants and Children (K-DST) results at 18–24 months corrected age were reviewed. The clinical characteristics and K-DST results were compared in infants with and without ESS (sinocortical width > 3.5 mm). A multivariable logistic regression analysis was performed to identify potential risk factors associated with positive K-DST results. At a median corrected age of 39.0 weeks, 81/197 (41.1%) infants presented ESS. A significantly greater percent of infants in the ESS group screened positive on the K-DST than in the no ESS group (27.2% vs 12.1%, p = 0.007). Within the ESS group, micro-/macrocephaly at term-equivalent age was not different with regard to the K-DST results. From the multivariable logistic regression analysis, gestational age (p = 0.016, OR = 0.855, 95% CI = 0.753–0.971) and ESS (p = 0.019, OR = 1.310, 95% CI = 1.046–1.641) were two significant risk factors associated with positive K-DST results. ESS identified on cUS at term-equivalent age in preterm infants is associated with possible developmental delays. Macrocephaly at term-equivalent age does not guarantee a benign prognosis. Future studies are required to verify ESS as a potential marker for neurodevelopmental delay in preterm infants.

2019 ◽  
Vol 76 (11) ◽  
pp. 1178-1183 ◽  
Author(s):  
Admir Sabanovic ◽  
Natasa Maksimovic ◽  
Mirjana Stojanovic-Tasic ◽  
Marijan Bakic ◽  
Anita Grgurevic

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ?9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (?2 = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (?2 = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (?2 = 10.74; p = 0.005). The presence of diabetic polyneuropathy (?2 = 6.04; p = 0.014) and cataract (?2 = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.


2018 ◽  
Vol 8 (2) ◽  
pp. 204589401876016 ◽  
Author(s):  
Sook Kyung Yum ◽  
Min-Sung Kim ◽  
Yoojin Kwun ◽  
Cheong-Jun Moon ◽  
Young-Ah Youn ◽  
...  

We aimed to evaluate the association between the presence of histologic chorioamnionitis (HC) and development of pulmonary hypertension (PH) during neonatal intensive care unit (NICU) stay. Data of preterm infants born at 32 weeks of gestation or less were reviewed. The development of PH and other respiratory outcomes were compared according to the presence of HC. Potential risk factors associated with the development of PH during NICU stay were used for multivariable logistic regression analysis. A total of 188 infants were enrolled: 72 in the HC group and 116 in the no HC group. The HC group infants were born at a significantly shorter gestational age and lower birthweight, with a greater proportion presenting preterm premature rupture of membrane (pPROM) > 18 h before delivery. More infants in the HC group developed pneumothorax ( P = 0.008), and moderate and severe bronchopulmonary dysplasia (BPD; P = 0.001 and P = 0.006, respectively). PH in the HC group was significantly more frequent compared to the no HC group (25.0% versus 8.6%, P = 0.002). Based on a multivariable logistic regression analysis, birthweight ( P = 0.009, odds ratio [OR] = 0.997, 95% confidence interval [CI] = 0.995–0.999), the presence of HC ( P = 0.047, OR = 2.799, 95% CI = 1.014–7.731), and duration of invasive mechanical ventilation (MV) > 14 days ( P = 0.015, OR = 8.036, 95% CI = 1.051–43.030) were significant factors. The presence of HC and prolonged invasive MV in infants with lower birthweight possibly synergistically act against preterm pulmonary outcomes and leads to the development of PH. Verification of this result and further investigation to establish effective strategies to prevent or ameliorate these adverse outcomes are needed.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Asmamaw Atnafu ◽  
Adane Kebede ◽  
Bisrat Misganaw ◽  
Destaw Fetene Teshome ◽  
Gashaw Andargie Biks ◽  
...  

Background. The maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skill birth attendant (SBA), and postnatal care (PNC) within 48 hours of delivery. It is one of the essential strategies for reducing maternal and newborn mortality. This study aimed to assess the factors associated with the completion of a continuum of maternal healthcare services among mothers who gave birth in the past five years. Methods. A community-based cross-sectional study was conducted from May 01 to June 29, 2019, among 565 randomly selected mothers who gave birth in five years before the study in primary healthcare project implementation districts of north Gondar zone, Amhara National Regional State, Ethiopia. Bivariable and multivariable logistic regression analysis were computed, and in the multivariable logistic regression analysis, adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p value of less than 0.05 were used to identify the associated factors with completion of the continuum of maternal healthcare services. Results. The study revealed that the overall completion of the continuum of maternal healthcare services was 21.60% (95% CI: 18.20, 24.90). Women who were able to read and write (AOR: 2.70, 95% CI: 1.22, 6.04), using car/motorcycle as a means of transportation to get the health facility (AOR: 5.59, 95% CI: 2.29, 9.50), travel time less than an hour to get the health facility (AOR: 4.98, 95% CI: 2.97, 8.38), being satisfied with the service delivery (AOR: 1.89, 95% CI: 1.15, 3.11), and getting health education on maternal healthcare services in the last 6 months (AOR: 2.77, 95% CI: 1.52, 5.05) were factors associated with the completion of the continuum of maternal healthcare services. Conclusions. The completion of the continuum of maternal healthcare services was relatively low, indicating that women were not getting the likely health benefit from the present health services. Therefore, interventions should focus on increasing women’s awareness, improving the availability of services at nearby health facilities, and improving service delivery by considering women’s preferences and needs to increase their satisfaction are essential to increase the completion of maternal healthcare services.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Si-Yuan Qin ◽  
Ming-Yang Yin ◽  
Wei Cong ◽  
Dong-Hui Zhou ◽  
Xiao-Xuan Zhang ◽  
...  

Chlamydia abortus, an important pathogen in a variety of animals, is associated with abortion in sheep. In the present study, 1732 blood samples, collected from Tibetan sheep between June 2013 and April 2014, were examined by the indirect hemagglutination (IHA) test, aiming to evaluate the seroprevalence and risk factors ofC. abortusinfection in Tibetan sheep. 323 of 1732 (18.65%) samples were seropositive forC. abortusantibodies at the cut-off of 1 : 16. A multivariate logistic regression analysis was used to evaluate the risk factors associated with seroprevalence, which could provide foundation to prevent and controlC. abortusinfection in Tibetan sheep. Gender of Tibetan sheep was left out of the final model because it is not significant in the logistic regression analysis (P>0.05). Region, season, and age were considered as major risk factors associated withC. abortusinfection in Tibetan sheep. Our study revealed a widespread and high prevalence ofC. abortusinfection in Tibetan sheep in Gansu province, northwest China, with higher exposure risk in different seasons and ages and distinct geographical distribution.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18101-e18101
Author(s):  
Achuta Kumar Guddati ◽  
Gagan Kumar ◽  
Iuliana Shapira ◽  
Parijat Saurav Joy

e18101 Background: Chemotherapy induced cardiomyopathy is an important complication of some chemotherapeutic agents. The stress of a cancer diagnosis and ongoing chemotherapy may contribute to cardiac morbidity in these patients. The burden of Takotsubo Cardiomyopathy (TCP) in cancer patients is unknown. The incidence of TCP and related outcomes in cancer patients was investigated in this study. Methods: The 2007-2013 National Inpatient Sample (NIS) was analyzed for patients with a prior and new diagnosis of TCP with and without malignancy. Risk factors for mortality were adjusted for associated conditions by multivariable logistic regression analysis. Results: From 2007 through 2013, an estimated 122,750 adults were admitted with a diagnosis of TCP. In 2013, the incidence of admissions in US of patients with coexisting TCP and malignancy was 1.13%. Admissions in 34,957 patients were for a primary diagnosis of TCP with 91.7% females; overall, 665 (2.1%) had solid organ cancer, 237 (0.74%) had hematological malignancy and 354 (1.11%) had metastatic cancer. Patients admitted for TCP with coexisting malignancy had a significantly higher mortality (13.8% vs. 2.9%, p < 0.0001), length of stay (7 vs. 4 days, p < 0.0001) and total charges ($29291 vs. $ 36231, p < 0.0001), compared to those with no malignancy. In patients with a primary diagnosis of TCP and without any underlying malignancy, males had a higher mortality (4.02% vs. 1.03%, p < 0.0001) whereas there was no gender difference in mortality in those with coexisting malignancy (6.25% vs 6.45%, p = 0.965). On multivariable logistic regression analysis, risk factors associated with mortality were solid cancer (OR 3.43, p = 0.008), stroke (OR 18.33, p < 0.0001), venous thromboembolic disease (OR 4.52, p = 0.004), malnutrition (OR 2.41, p = 0.006) and heart failure (OR 1.918, p = 0.004). Conclusions: Outcomes are significantly worse in patients with TCP and solid malignancy. Hence, this patient population must be regarded as high-risk and early diagnostic consideration for TCP is warranted. Early intervention may help lower mortality, decrease resource utilization and reduce the health care costs in these patients.


2020 ◽  
Vol 187 (3) ◽  
pp. 112-112 ◽  
Author(s):  
Rachel H Kinsman ◽  
Rachel A Casey ◽  
Toby G Knowles ◽  
Séverine Tasker ◽  
Michelle S Lord ◽  
...  

BackgroundPuppy acquisition decisions may impact upon the health and behaviour of these dogs in later life. It is widely recommended by welfare organisations and veterinary bodies that puppies should not leave maternal care until at least eight weeks (56 days) of age, and that when acquiring a puppy it should be viewed with its mother.MethodsOwner-reported prospective data were used to explore risk factors for puppy acquisition age, and whether the mother was viewed during acquisition, within a cohort of dog owners participating in an ongoing longitudinal project.ResultsA quarter (461/1844) of puppies were acquired under eight weeks of age and 8.1 per cent were obtained without viewing the mother (n=149). Only 1.6 per cent of puppies were obtained under eight weeks of age and without the mother being seen (n=30). Multivariable logistic regression analysis revealed that owners who intended their puppy to be a working dog, visited their puppy prior to acquisition, and/or obtained a puppy of unknown breed composition had increased odds of acquiring a puppy under eight weeks of age. The odds also increased as the number of dogs in the household increased but decreased as annual income rose. Owners who visited their puppy prior to acquisition, obtained a Kennel Club registered puppy, viewed the puppy’s father, and/or collected their puppy from the breeder’s home had decreased odds of acquiring a puppy without viewing the mother.ConclusionTargeting interventions towards identified owners who are more likely to acquire a puppy against current recommendations could help reduce these types of acquisitions.


2020 ◽  
Vol 32 (S1) ◽  
pp. 167-167
Author(s):  
Kazuki Honda ◽  
Tomohisa Ishikawa ◽  
Ryuji Fukuhara ◽  
Seiji Yuki ◽  
Yusuke Miyagawa ◽  
...  

[Background]Sleep disturbance is a common symptom in elderly people. However, the associated risk factors have not been completely clarified. We examined possible risk factors associated with sleep disturbance in a community-based Japanese cohort study.[Methods]1521 community-dwelling individuals aged 65 years or older were selected from a consecutive series at a cohort study from 2016 to 2018 in Arao city, where located at south part of Japan. In this survey, the clinical valuables were collected as follows: age, sex, occupational status, education, lifestyle information, medical history, EuroQoL(EQ)-5D (a score of health-related quality of life [QOL]), Barthel index (a score of performance in activities of daily living), a score of Geriatric Depression Scale (GDS) and a score of Mini-Mental State Examination (MMSE). Sleep disturbance was assessed by the Pittsburgh Sleep Quality Index (when the global score was 6 or over, sleep disturbance was determined to be present). Multiple logistic regression analysis was used to examine the association between clinical valuables and sleep disturbance. This research was supported by AMED (Japan Agency for Medical Research and Development) under Grant Number JP18dk0207025h0003 and has been approved by the research ethics committee of Kumamoto University. Informed consent was obtained from all participants and their family members.[Results]Multiple logistic regression analysis revealed that Parkinson disease (Odds ratio[OR]=5.59), living alone (OR=1.93), liver disease (OR=1.89), hyperlipidemia (OR=1.36), higher score of GDS (OR=1.14), lower scores of both EQ-5D index (OR=1.11) and Barthel index (OR=1.03) were significantly associated as risk factors with sleep disturbance. Unexpectedly, lower score of MMSE was not a significant risk factor.[Conclusion]These results suggest that several physical illnesses, solitude, depressive symptoms and lower QOL, but not cognitive impairment, might be crucial risk factors associated with sleep disturbance in elderly population.


2021 ◽  
Vol 11 (9) ◽  
pp. 836
Author(s):  
Jun-Young Park ◽  
Jihion Yu ◽  
Jun Hyuk Hong ◽  
Bumjin Lim ◽  
Youngdo Kim ◽  
...  

Acute kidney injury (AKI) is related to mortality and morbidity. The De Ritis ratio, calculated by dividing the aspartate aminotransferase by the alanine aminotransferase, is used as a prognostic indicator. We evaluated risk factors for AKI after radical retropubic prostatectomy (RRP). This retrospective study included patients who performed RRP. Multivariable logistic regression analysis and a receiver operating characteristic (ROC) curve analysis were conducted. Other postoperative outcomes were also evaluated. Among the 1415 patients, 77 (5.4%) had AKI postoperatively. The multivariable logistic regression analysis showed that estimated glomerular filtration rate, albumin level, and the De Ritis ratio at postoperative day 1 were risk factors for AKI. The area under the ROC curve of the De Ritis ratio at postoperative day 1 was 0.801 (cutoff = 1.2). Multivariable-adjusted analysis revealed that the De Ritis ratio at ≥1.2 was significantly related to AKI (odds ratio = 8.637, p < 0.001). Postoperative AKI was associated with longer hospitalization duration (11 ± 5 days vs. 10 ± 4 days, p = 0.002). These results collectively show that an elevated De Ritis ratio at postoperative day 1 is associated with AKI after RRP in patients with prostate cancer.


Rheumatology ◽  
2020 ◽  
Author(s):  
Aprajita Jagpal ◽  
Elizabeth J Rahn ◽  
Amy S Mudano ◽  
Nicola Dalbeth ◽  
William Taylor ◽  
...  

Abstract Objective To investigate the factors associated with discordance between patient and physician on the presence of a gout flare. Methods Patients’ self-reports of current gout flares were assessed with the question, ‘Are you having a gout flare today?’ which was then compared with a concurrent, blinded, physician’s assessment. Based on agreement or disagreement with physicians on the presence of a gout flare, flares were divided into concordant and discordant groups, respectively. Within the discordant group, two subgroups—patient-reported flare but the physician disagreed and physician-reported flare but the patient disagreed—were identified. The factors associated with discordance were analysed with multivariable logistic regression analysis. Results Of 268 gout flares, 81 (30.2%) flares were discordant, with either patient or physician disagreeing on the presence of a flare. Of the discordant flares, in 57 (70.4%) the patient reported a flare but the physician disagreed. In multivariable logistic regression analysis adjusted for demographics, disagreement among patients and physicians on the presence of a gout flare was associated with lower pain scores at rest [odds ratio (OR) for each point increase on 0–10 point pain scale 0.81 (95% Wald CI 0.73, 0.90), P &lt; 0.0001] and less presence of joint swelling [OR 0.24 (95% CI 0.10, 0.61), P = 0.003] or joint warmth [OR 0.39 (95% CI 0.20, 0.75), P = 0.005]. Conclusion Although patients and physicians generally agree about the presence of gout flare, discordance may occur in the setting of low pain scores and in the absence of swollen or warm joints.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gianluca Villa ◽  
Raffaele Mandarano ◽  
Caterina Scirè-Calabrisotto ◽  
Valeria Rizzelli ◽  
Martina Del Duca ◽  
...  

Abstract Background Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods Women aged 18+ undergoing oncological or reconstructive breast surgery from Jan until Apr 2018 at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was measured at 0 h, 3 h, 6 h, 12 h, 24 h, 48 h, and 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results Among the 307 patients considered in this study, the incidence of CPBS was 28% [95% CI 23.1–33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95% CI], 2.99 [1.13–7.87], p = 0.03), preoperative use of pain medications (OR [95% CI], 2.04 [1.20–3.46], p = 0.01), and higher dynamic NRS values at 6 h postoperatively (OR [95% CI], 1.28 [1.05–1.55], p = 0.01) were all independent predictors for CPBS. Conclusions Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for pre-existing chronic pain, axillary surgery, and higher dynamic NRS values at 6 h postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation. Trial registration ClinicalTrials.gov registration NCT04309929.


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