211. Coxiella burnetii: 7 Years of Experience at a Tertiary-Care Center

Abstract Background Q fever is a zoonotic disease caused by Coxiella burnetii. Primary infection can progress to persistent infection irrespective of initial symptomatology. Our aim is to describe the clinical features, treatment, risk of progression, use of prophylaxis, and outcomes of Coxiella burnetii infection at our institution. Methods We did a retrospective review of all adult patients with positive Coxiella burnetii serology at Mayo Clinic, Rochester from 1st January 2012 to 31st December 2018. Centers for Disease Control and Prevention (CDC) case definition and classification were used to group the patients into confirmed and probable acute Q fever, and confirmed and probable chronic/persistent Q fever. Data on demographics, clinical presentation, comorbid conditions, exposure history, risk factors associated with progression, serology, treatment and outcomes were collected. Results We found 266 patients with positive titres of Coxiella IgG or IgM greater than 1:16, of which 49 patients met the CDC case definition for Q fever. Median age at presentation was 62 years. 45/49 (91. 8%) were men, while 4/49 (8%) were women. 20/49 (40. 8%) patients presented with acute Q fever of which 5 (25%) patients progressed to persistent infection. 29/49 (59%) patients presented with persistent Q fever of which 4 patients could recall symptoms suggestive of acute Q fever. The most common presentation of acute Q fever was acute febrile illness (65%). Endocarditis (11/29) was the most common presentation of chronic/persistent Q fever. Of the 5 patients with acute Q fever that progressed to persistent infection, 3/5(60%) progressed despite being on doxycycline and hydroxychloroquine. 8/29 patients with persistent Q fever had serological resolution at last follow-up. 2/4(50%) deaths were attributable to Q fever. Conclusion Minority of the patients tested met the case definition. 25% of patients with acute disease progressed to chronic Q fever out of which 60%(3/5) progressed despite prophylaxis. Endocarditis and vascular infections were the most common chronic cases. Interestingly we found 4 cases of MPGN in association with Q fever. Prosthetic valves are the most important risk factors for progression (P = 0.02). Serological cure often lags behind clinical cure (27% vs. 68% in persistent infection)(Table 4). Disclosures All authors: No reported disclosures.

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Study of risk factors of eclampsia in a tertiary care center

MedPulse International Journal of Gynecology ◽

10.26611/10121224 ◽

2019 ◽

Vol 12 (2) ◽

pp. 31-35

Author(s):

Padma Chandavathu ◽

◽

Akurathi Krishna Rao ◽

Keyword(s):

Risk Factors ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center

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POS-592 RISK FACTORS FOR MORTALITY AFTER INFECTIVE ENDOCARDITIS IN CHRONIC HEMODIALYSIS PATIENTS IN A TERTIARY CARE CENTER

Kidney International Reports ◽

10.1016/j.ekir.2021.03.621 ◽

2021 ◽

Vol 6 (4) ◽

pp. S259-S260

Author(s):

J.I. Lara-Prado ◽

M.I. Gil Arredondo

Keyword(s):

Risk Factors ◽

Infective Endocarditis ◽

Care Center ◽

Tertiary Care ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Tertiary Care Center

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Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery

Journal of the Turkish-German Gynecological Association ◽

10.5152/jtgga.2015.15071 ◽

2015 ◽

Vol 16 (4) ◽

pp. 231-236 ◽

Cited By ~ 6

Author(s):

Cuneyt Eftal Taner ◽

Atalay Ekin ◽

Ulas Solmaz ◽

Cenk Gezer ◽

Birgul Cetin ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Care Center ◽

Tertiary Care ◽

High Volume ◽

Tertiary Care Center

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Risk factors associated with birth defects at a tertiary care center in Pakistan

Italian Journal of Pediatrics ◽

10.1186/1824-7288-38-68 ◽

2012 ◽

Vol 38 (1) ◽

pp. 68 ◽

Cited By ~ 2

Author(s):

Mohammad Zeeshan Raza ◽

Asfandyar Sheikh ◽

Syed Salman Ahmed ◽

Sajid Ali ◽

Syed Mumtaz Ali Naqvi

Keyword(s):

Risk Factors ◽

Birth Defects ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Factors Associated

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Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

10.53350/pjmhs211592451 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2451-2453

Author(s):

Shahid Iqbal ◽

Muhammad Fareed Khan ◽

Raja Imtiaz Ahmed ◽

Shahab Saidullah ◽

Nisar Ahmed ◽

...

Keyword(s):

Risk Factors ◽

Folic Acid ◽

Congenital Heart ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Febrile Illness ◽

Care Hospital ◽

Younger Age ◽

History Of ◽

Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

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GASTRIC CANCER: A 5 YEAR RETROSPECTIVE ANALYSIS OF CLINICAL, PATHOLOGICAL AND TREATMENT ASPECTS FROM A TERTIARY CARE CENTER IN SOUTH INDIA.

10.36106/gjra/0711411 ◽

2021 ◽

pp. 129-132

Author(s):

B. Ramkumar ◽

J. Kannan ◽

Ingersal. N ◽

Srigopal mohanty ◽

Amit saklani ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

South India ◽

Care Center ◽

Tertiary Care ◽

Tumor Location ◽

Advanced Stage ◽

Tertiary Care Center ◽

Nodal Disease ◽

Female Ratio

Context: Gastric cancer(GC) is fth most common cancer worldwide. Mostly presents with advanced stage and poor overall survival. Methods: Retrospective study on clinical, pathological, pattern of distant metastasis(DM) , treatment aspect of GC treated between January 2014 to December 2018 in a tertiary care center in south India. Statistical analysis : Chi square test and multivariate analysis (MVA) were used for analysis. P <0.05 was considered signicant. Results: Median age at diagnosis is 57 years. Higher male : female ratio. Most common presentation was abdominal pain followed vomiting. Malignant Gastric outlet obstruction(MGOO) was present in 22.7%. Histologically , all patients had adenocarcinoma with predominantly moderate differentiation (51.1%). Liver (19.1%)was most common site of metastasis . Curative surgery was done in 35.5% of patients. D2 lymph node dissection was performed in 12.4% of patient. Patients were given perioperative /preoperative/ adjuvant / palliative chemotherapy. MVA revealed history of tobacco use, body of stomach tumor location, nodal disease were risk factors for DM. Conclusion : The present analysis revealed use of tobacco, alcohol intake were main risk factors for GC. Most of the patients present in advanced stage , so prevention by avoiding risk factors and early detection by signs , symptoms and endoscopy are necessary. Use of tobacco,site of tumor location, nodal disease were factors associated with DM. Aggressive management with both surgery and chemotherapy is warranted for locally advanced disease.

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Preoperative Albuminuria and Intraoperative Chloride Load: Predictors of Acute Kidney Injury Following Major Abdominal Surgery

Journal of Clinical Medicine ◽

10.3390/jcm7110431 ◽

2018 ◽

Vol 7 (11) ◽

pp. 431 ◽

Cited By ~ 5

Author(s):

Diamantina Marouli ◽

Kostas Stylianou ◽

Eleftherios Papadakis ◽

Nikolaos Kroustalakis ◽

Stavroula Kolyvaki ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Abdominal Surgery ◽

Care Center ◽

Chronic Kidney Disease Stage ◽

Tertiary Care ◽

Kidney Injury ◽

Major Abdominal Surgery ◽

Disease Stage ◽

Postoperative Aki

Background: Postoperative Acute Kidney Injury (AKI) is a common and serious complication associated with significant morbidity and mortality. While several pre- and intra-operative risk factors for AKI have been recognized in cardiac surgery patients, relatively few data are available regarding the incidence and risk factors for perioperative AKI in other surgical operations. The aim of the present study was to determine the risk factors for perioperative AKI in patients undergoing major abdominal surgery. Methods: This was a prospective, observational study of patients undergoing major abdominal surgery in a tertiary care center. Postoperative AKI was diagnosed according to the Acute Kidney Injury Network criteria within 48 h after surgery. Patients with chronic kidney disease stage IV or V were excluded. Logistic regression analysis was used to evaluate the association between perioperative factors and the risk of developing postoperative AKI. Results: Eleven out of 61 patients developed postoperative AKI. Four intra-operative variables were identified as predictors of AKI: intra-operative blood loss (p = 0.002), transfusion of fresh frozen plasma (p = 0.004) and red blood cells (p = 0.038), as well as high chloride load (p = 0.033, cut-off value > 500 mEq). Multivariate analysis demonstrated an independent association between AKI development and preoperative albuminuria, defined as a urinary Albumin to Creatinine ratio ≥ 30 mg·g−1 (OR = 6.88, 95% CI: 1.43–33.04, p = 0.016) as well as perioperative chloride load > 500 mEq (OR = 6.87, 95% CI: 1.46–32.4, p = 0.015). Conclusion: Preoperative albuminuria, as well as a high intraoperative chloride load, were identified as predictors of postoperative AKI in patients undergoing major abdominal surgery.

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Prevalence and risk factors of low back pain among operation room staff at a Tertiary Care Center, Makkah, Saudi Arabia: a cross-sectional study

Annals of Occupational and Environmental Medicine ◽

10.1186/s40557-016-0089-0 ◽

2016 ◽

Vol 28 (1) ◽

Cited By ~ 18

Author(s):

Moath Bin Homaid ◽

Doaa Abdelmoety ◽

Waleed Alshareef ◽

Amer Alghamdi ◽

Fareed Alhozali ◽

...

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Low Back ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

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Pilonidal sinus disease recurrence at a tertiary care center in Riyadh

Annals of Saudi Medicine ◽

10.5144/0256-4947.2021.179 ◽

2021 ◽

Vol 41 (3) ◽

pp. 179-185

Author(s):

Ibrahim Tawfiq Albabtain ◽

Abdullah Alkhaldi ◽

Lama Aldosari ◽

Lina Alsaadon

Keyword(s):

Risk Factors ◽

Sample Size ◽

Pilonidal Sinus ◽

Care Center ◽

Tertiary Care ◽

Disease Recurrence ◽

Pilonidal Sinus Disease ◽

Tertiary Care Center ◽

Sinus Disease ◽

Risk Factors For Recurrence

BACKGROUND: Pilonidal sinus disease (PSD) is a chronic inflammatory disease of the sacrococcygeal area. Pilonidal sinus recurrence is a matter of concern to both patients and healthcare providers. OBJECTIVES: Estimate the rate of PSD recurrence in our center and identify any risk factors contributing to disease recurrence. DESIGN: Retrospective. SETTING: Tertiary care center in Riyadh. PATIENTS AND METHODS: All patients who underwent surgery for primary or recurrent pilonidal sinus between 1 January 2016 to 30 June 2019 were included to allow for at least 1-year of follow-up at the time of data collection. MAIN OUTCOME MEASURE: Recurrence rate of PSD and risk factors for recurrence. SAMPLE SIZE AND CHARACTERISTICS: 369 patients: 329 males (89.2%) and 40 (10.8%) females. Median (interquartile range) age was 21 (18-26) years. RESULTS: Of the 369 included patients, recurrence was identified in 84 (22.8%) cases [95% confidence interval (CI) 18.6-27.4], and the mean timing of recurrence was 1.8 (1.6) years after the primary surgery. In a multivariate logistic regression analysis, increased age and post-operative seroma fluid discharge were independent risk factors for recurrence. In contrast, preoperative antibiotic prophylaxis and postoperative hair removal were effective in reducing recurrence. Type of surgery closure had no effect on recurrence, yet primary closure was associated with early onset of recurrence compared to secondary closure ( P =.02). CONCLUSION: Our findings on the factors associated with recurrence of PSD are consistent with many reports in the literature. Reported prevalence estimates vary widely. LIMITATION: Single center, small sample size, retrospective. CONFLICT OF INTEREST: None.

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