The Influence of the Obstetrician in the Relationship between Epidural Analgesia and Cesarean Section for Dystocia 

1999 ◽  
Vol 91 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Scott Segal ◽  
Robert Blatman ◽  
Melissa Doble ◽  
Sanjay Datta
Keyword(s):  
Risk Factors ◽  
Linear Regression ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Patient Risk ◽  
Frequency Of Use ◽  
Number Of Patients ◽  
Provider Volume ◽  
Practice Style ◽  
The Relationship

Background The association between epidural analgesia for labor and the risk of cesarean section for dystocia remains controversial The authors hypothesized that if epidural analgesia were an important factor in determining cesarean section rates, then obstetricians with higher rates of utilization of epidural analgesia for labor would have higher rates of cesarean section for dystocia. Methods The frequency of use of epidural analgesia and frequency of occurrence of various patient risk factors for cesarean section were calculated for 110 obstetricians caring for > or = 50 low-risk parturients. These frequencies were compared by linear regression to obstetricians' rates of cesarean section for dystocia. Stepwise regression was used to attempt to predict obstetricians' cesarean rates from the incidence of various patient and provider risk factors. Results There was no relationship between frequency of epidural analgesia and rate of cesarean section for dystocia across practitioners (R2 = 0.019; P = 0.156). Weighting each obstetrician's data for the number of patients cared for during the study period did not change this result. Stepwise linear regression only modestly predicted obstetricians' cesarean section rates for dystocia, yielding a model containing 12 variables not including epidural analgesia (gestational age, induction of labor, maternal age, provider volume, nulliparity, and seven interactions; adjusted R2 = 0.312; P < 0.0001). Conclusions The frequency of use of epidural analgesia does not predict obstetricians' rates of cesarean section for dystocia. After accounting for a number of known patient risk factors, obstetrical practice style appears to be a major determinant of rates of cesarean section.

scholarly journals Prediction of Phenytoin Dosage in Epilepsy Using Multiple Linear Regression

1982 ◽  
Vol 19 (3) ◽  
pp. 141-144 ◽  
Author(s):  
S P Gray
Keyword(s):  
Body Weight ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Multiple Regression ◽  
Therapeutic Range ◽  
Drug Dosage ◽  
The Body ◽  
Clinical Value ◽  
Number Of Patients ◽  
The Relationship

Analysis of plasma phenytoin in a group of patients treated for epilepsy showed that only 36% had values in the therapeutic range. The relationship between plasma phenytoin, body weight, and daily dosage of the drug were explored, and the data were analysed by multiple regression. The resultant equation, relating all three factors, was used to optimise drug dosage, and the importance of using the body weight of the patient before starting a phenytoin regimen is emphasised. An increase in the number of patients with plasma phenytoin in the therapeutic range was achieved, and the clinical value of being in that range is shown.

Risk factors for failure to extend labor epidural analgesia to epidural anesthesia for Cesarean section

2006 ◽  
Vol 50 (8) ◽  
pp. 1014-1018 ◽  
Author(s):  
S. Orbach-Zinger ◽  
L. Friedman ◽  
A. Avramovich ◽  
N. Ilgiaeva ◽  
R. Orvieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Epidural Anesthesia ◽  
Labor Epidural

scholarly journals Variability in blood lipid affects the neutrophil to lymphocyte ratio in patients who have undergone elective percutaneous coronary intervention: A retrospective study

2020 ◽  
Author(s):  
Liding Zhao ◽  
Tian Xu ◽  
Ya Li ◽  
Yi Luan ◽  
Qingbo Lv ◽  
...  
Keyword(s):  
Risk Factors ◽  
Linear Regression ◽  
Subgroup Analysis ◽  
Blood Lipid ◽  
Total Sample ◽  
Multivariate Linear Regression ◽  
Neutrophil To Lymphocyte Ratio ◽  
P Value ◽  
Lymphocyte Ratio ◽  
The Relationship

Abstract Background Atherosclerosis is associated with chronic inflammation and lipid metabolism. The neutrophil to lymphocyte ratio (NLR) as an indicator of inflammation has been confirmed to be associated with cardiovascular disease prognosis. However, few studies have explored the effects of blood lipid variability on NLR. We aimed to explore the relationship between variability in blood lipid levels and NLR. Methods The association between variability in blood lipids and NLR was assessed with both univariate and multivariate linear regression. Multivariate linear regression was also performed for a subgroup analysis. Results The variability of HDL-C ([ꞵ] 4.008, SE 0.503, p-value<0.001) and LDL-C ([ꞵ] 0.626, SE 0.164, p-value<0.001) were risk factors for the NLR value, although baseline LDL-C and HDL-C were not risk factors for NLR values. Variability of HDL-C ([ꞵ] 4.328, SE 0.578, p-value<0.001) and LDL-C ([ꞵ] 0.660, SE 0.183, p-value<0.001) were risk factors for NLR variability. Subgroup analysis demonstrated that the relationship between variability of LDL-C and NLR was consistent with the trend of the total sample for those with or without diabetes mellitus, controlled blood lipid, statins, atorvastatin or rosuvastatin. The relationship between the variability of HDL-C and NLR was consistent with the trend of the total sample in all subgroups. Conclusion The variability of HDL-C and LDL-C are risk factors for the value and variability of NLR, while the relationship between variability of HDL-C and NLR is more stable than the variability of LDL-C in the subgroup analysis.

scholarly journals DNA methylation in the APOE gene: its link with Alzheimer’s and cardiovascular health

2019 ◽  
Author(s):  
Jure Mur ◽  
Daniel L. McCartney ◽  
Rosie M. Walker ◽  
Archie Campbell ◽  
Mairead L. Bermingham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Dna Methylation ◽  
Genetic Variation ◽  
Linear Regression ◽  
Cardiovascular Health ◽  
Hdl Cholesterol ◽  
Blood Cholesterol ◽  
Generation Scotland ◽  
The Relationship

AbstractGenetic variation in the apolipoprotein E (APOE) gene is associated with Alzheimer’s disease (AD) and risk factors for cardiovascular disease (CVD). DNA methylation at APOE has been linked to altered cognition and AD. It is unclear if epigenetic marks could be used for predicting future disease. We assessed blood-based DNA methylation at 13 CpGs in the APOE gene in 5828 participants from the Generation Scotland (GS) cohort. Using linear regression, we examined the relationship between APOE methylation, cognition, cholesterol, and the risks for AD and CVD. DNA methylation at two CpGs was associated with the ratio of total-to-HDL cholesterol, but not with cognition, or the risks of AD or CVD. APOE methylation could be involved in the levels of blood cholesterol, but there is no evidence for the utility of APOE methylation as a biomarker for predicting AD or CVD.

scholarly journals Conversion of epidural analgesia to anesthesia for cesarean section

Pain medicine ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 4-7
Author(s):  
Yevhenii Grizhimalsky ◽  
Andrii Harha ◽  
Yevhenii Sulimenko
Keyword(s):  
Risk Factors ◽  
Pain Relief ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Sodium Bicarbonate ◽  
Epidural Anaesthesia ◽  
Regional Anaesthesia ◽  
Anesthetic Management ◽  
Cesarean Sections ◽  
Spinal Epidural

The frequency of cesarean sections is increasing from year to year, and the choice of optimal anesthetic management is important. Regional anaesthesia is the anaesthesia of choice for the cesarean section because it reduces maternal and neonatal risks. If an epidural pain relief of labor is performed, then this epidural catheter can be successfully used for conversion to epidural anaesthesia. The choice of drug for conversion depends on the degree of urgency; the highest rate of onset of anesthesia is shown by lidocaine with adjuvants (fentanyl, sodium bicarbonate). Conversion failure occurs in 0–21% of cases; the main risk factors for conversion failure are inadequate epidural analgesia and patient height. The management of failed conversion depends on the category of urgency and other factors and may include spinal, combined spinal-epidural, or general anesthesia

Risk factors for failure to extend labor epidural analgesia to epidural anesthesia for Cesarean section*

2006 ◽  
Vol 50 (7) ◽  
pp. 793-797 ◽  
Author(s):  
S. Orbach-Zinger ◽  
L. Friedman ◽  
A. Avramovich ◽  
N. Ilgiaeva ◽  
R. Orvieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Epidural Anesthesia ◽  
Labor Epidural

MALNUTRITION-INFLAMMATION-ATHEROSCLEROSIS (MIA) SYNDROME IN HEMODIALYSIS PATIENTS

2016 ◽  
pp. 99-104
Author(s):  
Thi Khanh Trang Ngo ◽  
Bui Bao Hoang
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
High Risk ◽  
Cardiovascular Events ◽  
Inflammatory Marker ◽  
Hemodialysis Patients ◽  
Dialysis Patients ◽  
Number Of Patients ◽  
The Relationship ◽  
Mia Syndrome

Background: Mortality resulting from cardiovascular disease in patients with end-stage renal disease (ESRD) is high. In this study we study characteristics of the malnutrition, inflammation, atherosclerosis (MIA) syndrome; relationship between MIA syndrome and the cardiovascular events in hemodialysis patients. Subjects and methods: A total of 61 hemodialysis patients were enrolled. Inflammatory marker (hs CRP) and nutritional parameters (albumin, prealbumin, BMI) were determined. Carotid atherosclerosis was investigated by ultrasonographically evaluated carotid intima-media thickness (cIMT). Results: -The characteristics of the malnutrition, inflammation, atherosclerosis(MIA) syndrome in in peritoneal dialysis patients: + MIA2-3 group had an average age lower than MIA0 group + MIA2-3 group had lower albumin levels and BMI than MIA0 group. + The prevalence of malnutrition (50.8%), inflammation (27.9%), and atherosclerosis (52.5%); 24 (39.3%) of the patients had one risk factor; 22 (36.1%) of the patients had two risk factors; 4 (6.6%) of the patients had all three risk factors. No signs of either malnutrition, inflammation or atherosclerosis were seen in 11 (18.0%) of patients. Note that a considerable number of patients with malnutrition (23/31 patients) had signs of inflammation or atherosclerosis or both; 12/32 patients with atherosclerosis had signs of inflammation or malnutrition or both. - The relationship between MIA syndrome and the cardiovascular events in peritoneal dialysis patients: We have found the relationship between component M (malnutrition) and the cardiovascular events in syndrome MIA (HR: 4.23 95% CI: 1.89-9.50). Our study suggests that high risk cardiovascular events in patients with 2 or more elements in MIA syndrome (HR: 2.40 95% CI: 1.16-5.00). Conclusion: We had demonstrated an association between malnutrition, inflammation and atherosclerosis; component M (malnutrition) and the cardiovascular events in hemodialysis patients; high risk cardiovascular events in patients with 2 or more elements in MIA syndrome. Key words: Malnutrition-inflammation-atherosclerosis syndrome, hemodialysis

Variability in blood lipids affects the neutrophil to lymphocyte ratio in patients undergoing elective percutaneous coronary intervention: A retrospective study

2020 ◽  
Author(s):  
Liding Zhao ◽  
Tian Xu ◽  
Ya Li ◽  
Yi Luan ◽  
Qingbo Lv ◽  
...  
Keyword(s):  
Risk Factors ◽  
Linear Regression ◽  
Subgroup Analysis ◽  
Blood Lipids ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Total Sample ◽  
P Value ◽  
Lymphocyte Ratio ◽  
The Relationship

Abstract Background: Atherosclerosis is associated with chronic inflammation and lipid metabolism. The neutrophil to lymphocyte ratio (NLR) as an indicator of inflammation has been confirmed to be associated with cardiovascular disease prognosis. However, few studies have explored the effects of blood lipid variability on NLR. The aim of this study was to explore the relationship between variability in blood lipid levels and NLR. Methods: The association between variability in blood lipids and NLR was assessed with both univariate and multivariate linear regression. Multivariate linear regression was also performed for a subgroup analysis. Results: The variability of high-density lipoprotein cholesterol (HDL-C) (regression coefficients [β] 4.008, standard error (SE) 0.503, P-value<0.001) and low-density lipoprotein cholesterol (LDL-C) ([β] 0.626, SE 0.164, P-value<0.001) were risk factors for the NLR value, although baseline LDL-C and HDL-C were not risk factors for NLR values. Variability of HDL-C ([β] 4.328, SE 0.578, P-value<0.001) and LDL-C ([β] 0.660, SE 0.183, P-value<0.001) were risk factors for NLR variability. Subgroup analysis demonstrated that the relationship between variability of LDL-C and NLR was consistent with the trend of the total sample for those with diabetes mellitus, controlled blood lipid, statins, atorvastatin. The relationship between the variability of HDL-C and NLR was consistent with the trend of the total sample in all subgroups. Conclusion: The variability of HDL-C and LDL-C are risk factors for the value and variability of NLR, while the relationship between variability of HDL-C and NLR is more stable than the variability of LDL-C in the subgroup analysis, which provides a new perspective for controlling inflammation in patients undergoing PCI.

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