Computed Tomography–Guided Microcoil Localization of Pulmonary Nodules: Effects of Multiple Punctures

Author(s):  
Ye Tian ◽  
Jianli An ◽  
Zibo Zou ◽  
Yanchao Dong ◽  
Jingpeng Wu ◽  
...  

Abstract Background The aim of the study is to analyze the effect of multiple punctures in computed tomography (CT)-guided microcoil localization of pulmonary nodules with other risk factors for common complications. Methods Consecutive patients who underwent CT-guided microcoil localization and subsequent video-assisted thoracoscopic surgery (VATS) between January 2020 and February 2021 were enrolled. Nodules successfully located after only one puncture were defined as the single puncture group, and nodules requiring two or more punctures were defined as the multiple puncture group. Binary logistic regression analysis was performed to assess the relationship between the number of punctures and pneumothorax and intrapulmonary hemorrhage. Results A total of 121 patients were included. There were 98 (68.1%) pulmonary nodules in the single puncture group compared with 46 (31.9%) nodules in the multiple puncture group. The frequencies of pneumothorax and intrapulmonary hemorrhage were higher in the multiple puncture group than in the single puncture group (p = 0.019 and <0.001, respectively). Binary logistic regression demonstrated that independent risk factors for developing pneumothorax included lateral positioning of the patient (p < .001) and prone positioning (p = 0.014), as well as multiple punctures (p = 0.013). Independent risk factors for intrapulmonary hemorrhage included the distance between the distal end of the coil and the surface of the pleura (p = 0.033), multiple punctures (p = 0.003), and passage through the pulmonary vasculature (p < 0.001). Conclusion Multiple punctures resulted in an increased incidence of pneumothorax and intrapulmonary hemorrhage compared with single puncture during CT-guided microcoil localization of pulmonary nodules and were independently associated with both pneumothorax and intrapulmonary hemorrhage.

2021 ◽  
Vol 9 ◽  
Author(s):  
Yuwei Zhao ◽  
Lei Liang ◽  
Guanghui Liu ◽  
Hong Zheng ◽  
Liying Dai ◽  
...  

Aim: Not all the neonates respond with improvement in oxygenation following inhaled nitric oxide treatment (iNO) treatment. The aim of this study was to assess the independent risk factors associated with non-response to iNO during the 2 weeks of postnatal treatment in neonates diagnosed with persistent pulmonary hypertension (PPHN).Materials and Methods: This retrospective cohort study included all newborns with PPHN who received iNO treatment for more than 24 h. Demographic, obstetric, perinatal data and clinical complications were extracted from the hospitalization records. Subjects were divided into two groups according to their response to iNO inspiration during the first 24 h of iNO treatment. No response was defined as an increase in SpO2 &lt; 5% or the inability to sustain saturation levels in the first 24 h of iNO treatment. For descriptive statistics, χ2 and t-test analysis were used to compare categorical and continuous variables between the two groups. To evaluate independent risk factors of non-responsiveness to iNO treatment, binary logistic regression analysis were performed.Results: A total of 75 newborns were included in the study. Sixty-two cases were in the responders group, and 13 cases were in the non-responders group. Univariate analysis showed that asphyxia, neonatal respiratory distress syndrome (NRDS), pulmonary surfactant administration, meconium aspiration syndrome (MAS), the severity of pulmonary hypertension (PH), and high-frequency oscillatory ventilation (HFOV) therapy were the high-risk factors affecting the response to iNO treatment in the newborns with PPHN. The binary logistic regression analysis indicated that asphyxia and NRDS incidence were independent predictors of non-responsiveness to iNO treatment [asphyxia: OR 4.193, 95% CI 1.104–15.927, P = 0.035; NRDS: OR 0.154, 95% CI 0.036–0.647, P = 0.011]. The patients in the non-responders group had shorter iNO inspiration followed by MV duration, supplemental oxygen and hospital stay, and higher mortality. There were no significant differences in IVH, PVL, and BPD between two groups.Conclusion: In the newborns with PPHN, asphyxia and NRDS resulted as the independent risk factors of non-responsiveness to iNO therapy. Asphyxia in the newborns with PPHN is detrimental to the response to iNO treatment, while NRDS is beneficial.


2021 ◽  
Vol 12 ◽  
Author(s):  
Meiling Yao ◽  
Hongjie Li ◽  
Ying Luo ◽  
Ling Li ◽  
Jian Yu

Objective: Post-stroke anxiety (PSA) is a common affective disorder in patients with ischemic stroke. The elderly are more susceptible to mental health issues, however, few studies have so far focused on PSA in elderly patients, especially in the context of the COVID-19, causing psychological issues in the general population. The aim of the present study was to assess the prevalence and risk factors of PSA in elderly patients following COVID-19 outbreak.Methods: We retrospectively analyzed 206 elderly inpatients with newly diagnosed acute ischemic stroke in the First Affiliated Hospital, Sun Yat-sen University, from January 2020 to December 2020. Patients were categorized into the PSA group and the non-PSA group based on Hamilton Anxiety Scale scores at admission (within 1 week after stroke onset). Demographic and clinical data, mental state by Mini-Mental State Examination, depression by Hamilton Depression Scales (HAMD), and stroke severity and outcome by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to analyze risk factors associated with PSA. We determined the cutoff scores for significant predictors of PSA using the area under the curve (AUC) and receiver operating characteristic.Results: Of the 206 stroke patients, 62 (30.1%) developed anxiety. Binary logistic regression analysis showed that female gender [adjusted odds ratio (aOR): 2.288, 95% confidence interval (CI):1.021–5.128, P = 0.044], high NIHSS scores [aOR: 1.264, 95% CI: 1.074–1.486, P = 0.005] and HAMD scores [aOR: 1.345, 95% CI: 1.215–1.490, P &lt; 0.001] were independent risk factors for PSA. The cutoff threshold for the NIHSS scores was 3.5 points with an AUC of 0.64 and the cutoff threshold for HAMD scores was 5.5 points with an AUC of 0.89.Conclusion: Our results showed a high incidence of PSA in elderly patients after the COVID-19 outbreak. Female gender, high NIHSS and HAMD scores were the independent risk factors for PSA.


2020 ◽  
Author(s):  
Zhigang Wang ◽  
Min Ge ◽  
Tao Chen ◽  
Cheng Chen ◽  
Qiuyan Zong ◽  
...  

Abstract Objective: The study objective was to investigate the incidence and risk factors of continuous renal replacement treatment (CRRT) in patients undergoing emergency surgery for type A acute aortic dissection (TA-AAD) and evaluate the perioperative and long-term outcomes. Methods: From January 2014 to December 2018, 712 consecutive patients were enrolled in the study. These patients were divided into two groups according to whether or not needed severe postoperative acute kidney injury (AKI) requiring CRRT: the CRRT group vs the control group. Univariate analysis and binary logistic regression analysis were used to analyze the risk factors of CRRT. Significant variables by univariate analysis were included in binary logistic regression analysis. To avoid the selection bias and confounders, baseline characteristics were matched for propensity scores. One-to-one pair matching was performed using nearest neighbor matching without replacement within 0.02 standard deviations of the logit of the propensity score as caliper width. Kaplan-Meier curves were generated to provide survival estimates at postoperative points in time. Differences between the 2 groups were determined by log-rank tests. Results: Before propensity score matching, univariate analysis showed that there significant differences in age, preoperative hypertension, pericardial effusion, preoperative serum creatinine (sCr), intraoperative need for combined coronary artery bypass grafting (CABG) or mitral valve or tricuspid valve surgery, cardiopulmonary bypass (CPB) time, extracorporeal circulation assistant time, aortic cross-clamp time, drainage volume 24 hours after surgery and ventilator time between two groups. All were higher in the CRRT group (p<0.05). These risk factors were included in binary logistic regression. It showed that preoperative sCr (OR=1.008, 95% CI:1.002-1.014, P=0.005) and CPB time (OR=1.022, 95% CI:1.003-1.042, P=0.026) were independent risk factors for CRRT patients undergoing surgery for TA-AAD. And there were significant differences regarding 30-day mortality (P<0.001) and long-term overall cumulative survival (P<0.001) with up to a 6-year follow-up. After propensity scoring, 29 pairs (58 patients) were successfully matched. Among these patients, the analysis showed that CPB time was still significantly longer in the CRRT group (P = 0.004), and the 30-day mortality rate was also higher in this group (44.8% vs 10.3%; P = 0.003).Conclusion: CRRT after TA-AAD is common and worsened short- and long- term mortality. The preoperative sCr and CPB time are independent risk factors for postoperative CRRT patients. Shorten the CPB time as much as possible is recommended to reduce the risk of CRRT after the operation.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Tang ◽  
Qian-Min Ge ◽  
Rong Huang ◽  
Hui-Ye Shu ◽  
Ting Su ◽  
...  

Purpose: To detect lung metastases, we conducted a retrospective study to improve patient prognosis.Methods: Hypertension patients with ocular metastases (OM group; n = 58) and without metastases (NM group; n = 1,217) were selected from individuals with lung cancer admitted to our hospital from April 2005 to October 2019. The clinical characteristics were compared by Student's t-test and chi-square test. Independent risk factors were identified by binary logistic regression, and their diagnostic value evaluated by receiver operating characteristic curve analysis.Results: Age and sex did not differ significantly between OM and NM groups; There were significant differences in pathological type and treatment. Adenocarcinoma was the main pathological type in the OM group (67.24%), while squamous cell carcinoma was the largest proportion (46.43%) in the NM group, followed by adenocarcinoma (34.10%). The OM group were treated with chemotherapy (55.17%), while the NM group received both chemotherapy (39.93%) and surgical treatment (37.06%). Significant differences were detected in the concentrations of cancer antigen (CA)−125, CA-199, CA-153, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cytokeratin fraction 21-1 (CYFRA21-1), total prostate-specific antigen, alkaline phosphatase, and hemoglobin (Student's t-test). Binary logistic regression analysis indicated that CA-199, CA-153, AFP, CEA, and CYRFA21-1 were independent risk factors for lung cancer metastasis. AFP (98.3%) and CEA (89.3%) exhibited the highest sensitivity and specificity, respectively, while CYRFA21-1 had the highest area under the ROC curve value (0.875), with sensitivity and specificity values of 77.6 and 87.0%, respectively. Hence, CYFRA21-1 had the best diagnostic value.


2020 ◽  
Author(s):  
Xiao-huan Ma ◽  
Fang Yin ◽  
Jie Zhang ◽  
Meng-yun Peng ◽  
Hong Guan ◽  
...  

Abstract Methods: In this single-center, retrospective, observational study, we enrolled patients with confirmed severe COVID-19 admitted to Renmin Hospital of Wuhan university (Wuhan, China) from 1 February 2020 to 26 March 26 2020. Epidemiological, clinical, and laboratory data, and treatments and outcomes upon hospital admission, were obtained from electronic medical records. Sequential organ failure assessment (SOFA) scores were calculated.Results: Of 54 patients with severe COVID-19, HFNC was successful in 28 (51.9%) and unsuccessful in 26 (48.1%). HFNC failure was seen more commonly in patients aged ≥60 years and in men. In addition, compared with patients successfully treated with HFNC, patients with HFNC failure had the following characteristics: higher percentage of fatigue and anorexia as well as cardiovascular disease; increased time from onset to diagnosis and SOFA scores; elevated body temperature, respiratory rate, and heart rate; more complications including ARDS, septic shock, myocardial damage, and acute kidney injury; increased neutrophil counts and prothrombin time; and decreased arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) (all P < 0.05). However, binary logistic regression analysis showed that only male gender and PaO2/FiO2 were independent risk factors significantly associated with HFNC failure (both, P < 0.05). Conclusion: Patients with severe COVID-19 had a high HFNC treatment failure rate. Male gender and decreased PaO2/FiO2 were independent risk factors associated with HFNC failure in severe COVID-19 patients.


2021 ◽  
Author(s):  
Tie Sun ◽  
Jing Tang ◽  
Yi-Cong Pan ◽  
Chen-Yu Yu ◽  
Biao Li ◽  
...  

Objective: Intraocular metastasis(IOM) of renal cell carcinoma is rare. In this study, we studied the relationship between different biochemical indicators and the occurrence of IOM in renal cancer patients, and identified the potential risk factors. Methods: A retrospective analysis of the clinical data of 214 patients with renal cell carcinoma from October 2001 to August 2016. Analyze the difference and correlation of various indicators between the two groups with or without IOM, and use binary logistic regression analysis to explore the risk factors of IOM in renal cancer patients. Calculate the diagnostic value of each independent related factor according to the receiver operating curve (ROC). Results: The level of neuron specific enolase (NSE) in renal cell carcinoma patients with IOM was significantly higher than that in patients without IOM (P &lt; 0.05). There was no significant difference in ALP, Hb, serum calcium concentration, AFP, CEA, CA-125 etc. between IOM group and non-intraocular metastasis (NIOM) group (P &gt; 0.05). Binary logistic regression analysis showed that NSE was an independent risk factor for IOM in renal cell carcinoma patients (P &lt; 0.05). ROC curve shows that the factor has high accuracy in predicting IOM, and the area under the curve is 0.774. The cut-off value of NSE was 49.5U/L, the sensitivity was 72.2%, and the specificity was 80.1%. Conclusion:NSE concentration is a risk factor for IOM in patients with renal cell cancer. If the concentration of NSE in the patient's body is ≥49.5U/L, disease monitoring and eye scans should be strengthened.


Author(s):  
Qilin Zhang ◽  
Yanli Wu ◽  
Tiankuo Han ◽  
Erpeng Liu

Background: The cognitive function of the elderly has become a focus of public health research. Little is known about the changes of cognitive function and the risk factors for cognitive impairment in the Chinese elderly; thus, the purposes of this study are as follows: (1) to describe changes in cognitive function in the Chinese elderly from 2005–2014 and (2) to explore risk factors for cognitive impairment of the Chinese elderly. Design and setting: A total of 2603 participants aged 64 years and above participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and were followed up from 2005 to 2014. Cognitive function and cognitive impairment were assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Binary logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) of cognitive impairment. Results: Results revealed that the cognitive function of the Chinese elderly shows diversified changes: deterioration (55.09%), unchanged (17.21%) and improvement (27.70%). In addition, there are significant demographic differences in gender, age, education, marriage and other aspects when it comes to the changes of cognitive function in Chinese elderly. In the binary logistic regression analysis, female, increased age, lower education level, no spouse, less income, worse PWB (psychological well-being), less fresh fruit and vegetable intake, more activities of daily living (ADL) limitations, lower social engagement were significantly associated with higher odds for cognitive impairment. Conclusions: Various interventions should be implemented to maintain cognitive function in Chinese elderly.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guanghui Zheng ◽  
Yanfei Cao ◽  
Chunhong Liu ◽  
Lingye Qian ◽  
Yumeng Cai ◽  
...  

Abstract Background To determine the phenotype, molecular characterisation and risk factors of postoperative meningitis induced by Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (EPE) in China. Methods We performed a multi-centre comparative cohort study of postoperative meningitis patients infected with Enterobacteriaceae in 4 neurosurgical centres in China from January 2014 to December 2019. Phenotype and molecular characteristics of the isolates were reviewed and tested, and independent risk factors of the EPE meningitis were evaluated by binary logistic regression. Results In total, 220 Enterobacteriaceae include 78 EPE were available in this study. 85.6% (67/78) ESBL-related genes were tested, and blaSHV (14.9%) and blaSHV + blaTEM + blaCTX-M-9 (20.9%) were found to be the most frequent mono and combined ESBL-related genes harboured by Enterobacteriaceae. On binary logistic analysis, craniotomy (OR. 2.583, 95% C.I. 1.274–5.235, P = 0.008) and malignancy (OR. 2.406, 95% C.I. 1.299–4.456, P = 0.005) were the associated independent risk factors to meningitis induced by EPE. Conclusions To the best of our knowledge, this is the largest series focusing on risk factors of EPE meningitis which has been conducted in China. Craniotomy and malignancy were independent risk factors for EPE meningitis. The risk factors identified may be further utilized in clinical practice and research to avoid and reduce the mortality in future.


2021 ◽  
Author(s):  
Jing Tang ◽  
Tie Sun ◽  
Qian-Min Ge ◽  
Rong-Bin Liang ◽  
Ting Su ◽  
...  

Abstract Background At present, little is known about the specific risk factors of brain metastasis in patients with lung cancer. This study aims to explore the risk factors of brain metastasis. Methods From April 1999 to July 2017, a total of 1,615 lung cancer patients were included in this retrospective study. The patients were divided into two groups, namely brain metastasis group and non-brain metastasis group. Student's t test, non-parametric rank sum test and chi-square test were used to describe whether there is a significant difference between the two groups. We compared the serum biomarkers of the two groups of patients, including alkaline phosphatase (ALP), Calcium, calcium hemoglobin (HB), alpha fetoprotein (AFP), cancer embryonic antigen (CEA), CA-125, CA-199, CA- 153, CA-724, cytokeratin fragment 19 (CYFRA 21 − 1), total prostate specific antigen (TPSA), squamous cell carcinoma antigen (SCC-Ag) ,and neuron specific enolase (NSE). Binary logistic regression analysis was used to determine its risk factors, and receiver operating curve (ROC) analysis was used to evaluate its diagnostic value for brain metastases in patients with lung cancer. Results In the analysis of brain metastases in patients with lung cancer, binary logistic regression analysis showed that CYFRA21-1 and CEA are independent risk factors for brain metastases in patients with lung cancer (both P < 0.001). The sensitivity and specificity of diagnosing brain metastasis were CYFRA21-1, 38.0% and 87.4%, respectively; CEA was 39.7% and 79.3%, respectively. Conclusion Serum CYFRA21-1 and CEA have predictive value in the diagnosis of brain metastases in patients with lung cancer.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Cheng-Yi Wang ◽  
Chao-Min Song ◽  
Guang-Hua Liu

Background: Mycoplasma pneumoniae pneumonia (MPP) is common in pediatric patients. Many studies showed that recurrent respiratory tract infections (RRTIs) are common in the year following treatment of MPP in infants, but the factors associated with the occurrence of RRTIs are rarely reported. Therefore, the present study aimed to identify these factors. Methods: This retrospective observational study included infants (< one year) who were clinically treated for MPP from January 2015 to December 2018. Clinical features and relevant data were collected on admission. The cases of the occurrence of RRTIs and the presence of related factors after one year of follow-up were investigated by questionnaires. The questionnaires contained the number of upper respiratory infections, tracheobronchitis, and pneumonia, the titers and course of MP-IgG and positive IgM antibody, eczema, pet ownership, interior decoration, inhaled or ingested allergens, exposure to environmental tobacco smoke, and gastrointestinal function. Independent significant risk factors for RRTIs were identified using binary logistic regression. Results: A total of 300 MPP cases were included, among which RRTIs occurred in 134 (44.7%) cases in the year following MPP treatment. Binary logistic regression analysis showed that a history of prematurity (OR = 6.336, 95% CI: 2.337 - 17.116, P ≤ 0.001), a history of exposure to inhaled or ingested allergens (OR = 2.527, 95% CI: 1.289 - 4.956, P = 0.007), and co-infection involving Chlamydia pneumoniae (OR = 2.787, 95% CI: 1.145 - 6.784, P = 0.024) were significantly and positively associated with RRTIs after MPP, while age (OR = 0.894, 95% CI: 0.825 - 0.970, P = 0.007) showed a negative correlation with RRTIs. Conclusions: RRTIs in the year following clinical treatment of MPP in infants are relatively common and significantly associated with the patient’s age, history of prematurity, history of exposure to inhaled or ingested allergens, and C. pneumoniae co-infection. Thus, these factors should be carefully assessed in pediatric MPP cases to predict the risk of RRTIs and appropriately manage the patient.


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