scholarly journals Cognitive development of children with Kawasaki disease and the parenting stress of their caregivers in Taiwan: a case–control study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042996
Author(s):  
Liang-Jen Wang ◽  
Zi-Yu Tsai ◽  
Ling-Sai Chang ◽  
Ho-Chang Kuo
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Parenting Stress ◽  
Case Control Study ◽  
Short Form ◽  
Case Control ◽  
Stress Index ◽  
Secondary Outcome ◽  
Healthy Children ◽  
Control Study

ObjectiveKawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multisystemic vasculitis common in patients with KD may influence blood perfusion in the brain, and thus caregivers of children with KD may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (coronary artery lesion (CAL)). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.DesignA case–control study with consecutive sampling.SettingA medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan).ParticipantsThis study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% boys) and 85 healthy children (mean age: 6.4 years, 54.1% boys).Primary and secondary outcome measuresBased on the children’s age, each patient with KD and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index (PSI)-Short Form.ResultsWe observed no significant differences in any developmental index, cognitive function or parenting stress between patients with KD and controls. Among the children with KD, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL. Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college or lower.ConclusionCaregivers’ education is associated to parenting stress, and caregivers of patients with KD who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfil their parenting roles.

scholarly journals IL-10 Promoter Genetic Polymorphisms and Risk of Kawasaki Disease in Taiwan

2011 ◽  
Vol 30 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Kai-Sheng Hsieh ◽  
Tsung-Jen Lai ◽  
Yu-Tung Hwang ◽  
Ming-Wei Lin ◽  
Ken-Pen Weng ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Case Control Study ◽  
Serum Levels ◽  
High Plasma ◽  
Case Control ◽  
Healthy Children ◽  
Increased Risk ◽  
Family Based ◽  
Control Study

Kawasaki disease (KD) is the most common cause of pediatric acquired heart disease. KD patients have spontaneously high plasma/serum levels of IL-10 during the acute phase. Therefore, two independent studies were carried out to investigate the association between genetic variants in IL-10 promoter (−1082, −819, and −592) and risk of KD. A total of 134 trios were included for the family-based association study. A significantly preferential transmission of the C allele at loci −819 T > C and −592 A > C for KD cases was observed (Ppermutation= 0.029 and Ppermutation= 0.034, respectively). There was a significant increase in the transmission of haplotype CC (p= 0.016) at the above two loci (OR, 1.632; 95% CI, 1.090–2.443; Ppermutation= 0.019). We also carried out a follow-up case-control study that included 146 KD cases and 315 unrelated healthy children. {The haplotype CC (−819, −592) showed an increased risk of KD (but statistically non-significant; OR, 1.332; 95% CI, 0.987–1.797;p= 0.061). In diplotype analysis, a trend was found between number of CC haplotype and risk of KD (but non-significant,p= 0.061). In conclusion, CC genotype and CC/CC diplotype at IL-10-819T > C and −592A > C were significantly associated with risk of KD in case-parent trio study, which were replicated partially in our follow-up case-control study.

Cognitive development of children with Kawasaki Disease and the parenting stress of their caregivers

2020 ◽  
Author(s):  
Liang-Jen Wang ◽  
Zi-Yu Tsai ◽  
Ling-Sai Chang ◽  
Ho-Chang Kuo
Keyword(s):  
Cognitive Function ◽  
Kawasaki Disease ◽  
Parenting Stress ◽  
Short Form ◽  
Systemic Vasculitis ◽  
Stress Index ◽  
Healthy Children ◽  
Ivig Infusion ◽  
Cross Sectional ◽  
Developmental Index

Abstract Background Kawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multi-systemic vasculitis common in KD patients may influence blood perfusion in the brain, and thus caregivers of KD children may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (CAL). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress. Methods This cross-sectional study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% male) and 85 healthy children (mean age: 6.4 years, 54.1% male). Based on the children’s age, each KD patient and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index-Short Form (PSI). Results We observed no significant differences in any developmental index, cognitive function, or parenting stress between KD patients and controls. Among the KD children, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL (p = 0.019). Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college (p = 0.010) or lower (p = 0.021). Conclusion No significant differences in developmental index, cognitive function or parenting stress between KD patients and controls. In KD patients, neither IVIG response nor CAL appear to have a relationship with development milestones or cognitive function. However, caregivers’ education is associated to parenting stress, and caregivers of KD patients who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfill their parenting roles.

Percutaneous coronary intervention in spontaneous coronary artery dissection: a case-control study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kotecha ◽  
A.D.P.E Premawardhana ◽  
M Garcia-Guimaraes ◽  
D Pellegrini ◽  
A.D Wood ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Case Control Study ◽  
Case Control ◽  
Artery Dissection ◽  
Funding Source ◽  
Complication Rates ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Control Study ◽  
Reduced Flow

Abstract Background Spontaneous Coronary Artery Dissection (SCAD) is an important cause of acute coronary syndrome particularly in young-middle aged women. Revascularisation is challenging due to an underlying disrupted and friable coronary vessel wall leading to widely reported worse outcomes than for atherosclerotic coronary disease. Therefore, a conservative approach where possible is favoured however in some cases haemodynamic instability, ongoing ischaemia and reduced distal flow mandates consideration of revascularisation. Purpose To compare SCAD survivors managed with PCI or conservatively in terms of presentation characteristics, complications and long-term outcomes. Methodology and results 226 angiographically confirmed SCAD survivors (95% female,47±9.7yrs) who underwent PCI were compared in a case control study with two hundred and twenty-five angiographically confirmed SCAD survivors (92% female, 49±9.9yrs) who were conservatively managed. Patients were recruited from UK, Spanish and Dutch SCAD registries and both groups were well matched in terms of baseline demographics. Those treated with PCI were more likely to present with proximal SCAD (30.8% vs 7.6% P<0.01) and ST elevation myocardial infarction (STEMI) or cardiac arrest with reduced flow (32.3% vs 6.3% P<0.01). Intervention was performed with stents in 72.4%, plain old balloon angioplasty in 21.1% and wiring in 6.4% of cases and more often for multi-segment disease (40.8% vs 26.3% P<0.01). In cases with initial reduced flow undergoing PCI an improvement in flow was seen in 83%. Analysis of UK PCI cases (n=144) reveal complications in 56 (38.8%). However, when assessed for significance defined by a reduction in flow in a proximal/mid vessel, stent extension into left main stem, iatrogenic dissection requiring PCI and CABG as a consequence of PCI only 13 cases (9%) met criteria. Iatrogenic dissection accounts for the majority (76.9%). SCAD lesion length was associated with presence of complications (P=0.025). There was a non-significant trend towards major adverse cardiovascular events (MACE) occurring more frequently in those undergoing PCI (18% vs 11% P=0.067) driven by revascularisation (5% vs 1% P=0.036). Median follow up was 2.7 years. Conclusions PCI in SCAD is often performed in higher risk patients; in those presenting with reduced flow, the majority demonstrate improvement. Importantly whilst overall complication rates were similar to those widely reported, clinically significant complications were low. Multivariate modelling will reveal factors associated with complications to aid future decision making in this challenging patient group. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation

scholarly journals 1185. Association Between Blood Product Transfusion and Development of Hospital Acquired Infections or Mortality in Patients Admitted to the Hospital Wards. A Retrospective Case-Control Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S617-S617
Author(s):  
Arunmozhi S Aravagiri ◽  
Ayutyanont Napatkamon ◽  
Sabhyata Sharma ◽  
Timothy Collins ◽  
Chimezie Ubbaonu ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Secondary Outcome ◽  
Blood Products ◽  
Multivariable Model ◽  
Retrospective Case ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
Hospital Wards ◽  
Control Study

Abstract Background Transfusion of blood products has been shown to be associated with increased mortality and risk of infections in critically ill patients and following cardiac surgery [1-2]. However, there is scarce data evaluating this association in patients admitted to hospital wards. Here we seek to see if transfusion of blood products carries the same risk of infection and mortality in more stable patients. Methods This was a retrospective case-control study of patients admitted to the internal medicine wards who received packed red blood cells (PRBC), fresh frozen plasma (FFP) or platelet transfusions, using data from the HCA Healthcare administrative database from 2016 to 2019. Patients admitted with an infection, on steroids or other immunosuppressant medications were excluded. ICD-10 codes at discharge were used to determine hospital acquired infections (HAI). The presence of HAI was the dependent variable. A multivariable logistic regression was used to determine the effects of the independent variables on development of HAI after adjusting for age and Carlson’s Comorbidity Index. Odds ratios and 95% confidence intervals were calculated. Primary outcome of study was presence of HAI, while secondary outcome was mortality in transfused vs. non-transfused patients. Results A total of 1952 subjects were included in the study analysis. Of these, 653 or 33.4% had a HAI during their admission. Adjusted multivariable model showed transfusion of PRBC (OR 1.14, 95%CI 0.85-1.52), platelets (OR 1.41, 95% CI 0.93-2.10) or FFP (OR 1.27 95%CI 0.90-1.75) was not associated with increased odds of having a HAI. The multivariable model however, did show an increase in odds of mortality in patients who were transfused with PRBC (OR 2.51, 95%CI 1.78-3.54), platelets (OR 3.17, 95%CI 2.01-5.0) or FFP (OR 2.78, 95% CI 1.89-4.08) compared to non-transfused. Conclusion Our data failed to show association between transfusion of blood products and HAI. However, it showed there was significant increase in mortality in patients that had received blood products during their admission. Disclosures All Authors: No reported disclosures

scholarly journals Association of smoking with coronary artery disease in Nepalese populations: a case control study

2019 ◽  
Vol 8 (5) ◽  
pp. 677-685
Author(s):  
Til Bahadur Basnet ◽  
Cheng Xu ◽  
Manthar Ali Mallah ◽  
Wiwik Indayati ◽  
Cheng Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Case Control Study ◽  
Case Control ◽  
Psychosocial Risk ◽  
Psychosocial Risk Factor ◽  
Artery Disease ◽  
Control Study

Abstract There are well-known traditional risk factors for coronary artery disease (CAD). Among them, smoking is one of the most prominent and modifiable risk factors. This study aims to determine the magnitude of smoking as a risk factor for CAD in the Nepalese population. A hospital-based age- and sex-matched case–control study was carried out with a total of 612 respondents. Bivariate analysis showed that the risk of developing CAD in ex-smokers and current smokers was higher (odds ratio (OR): 1.81 (confidence interval (CI): 1.21–2.7) and OR: 5.2 (CI: 3.4–7.97)), with p-values less than 0.004 and <0.00001, respectively, compared to the risk in never smokers. From stratified socio-demographic, cardio-metabolic, behavioural and psychosocial risk factor analysis, smoking was found to be associated with CAD in almost all subgroups. In the subsequent multivariate analysis, adjustment for socio-demographic, cardio-metabolic and psychosocial risk factors showed a steady increase in risk. However, further adjustment for behavioural risk factors (alcohol use and physical activity) showed that the risk was attenuated by 59% in current smokers. After adjusting for the covariates, current smokers and ex-smokers had an increased risk of CAD (OR: 6.64, 95% CI: 3.64–12.12, p < 0.00001; OR: 1.89, 95% CI: 1.08–3.31, p < 0.012, respectively) compared with non-smokers. In conclusion, smoking was found to increase the risk of CAD in the Nepalese population.

Dietary inflammatory index and odds of coronary artery disease in a case-control study from Jordan

Nutrition ◽  
2019 ◽  
Vol 63-64 ◽  
pp. 98-105 ◽  
Author(s):  
Lana M. Agraib ◽  
Mohammed Azab ◽  
Abdel-Ellah Al-Shudifat ◽  
Sabika S. Allehdan ◽  
Nitin Shivappa ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Case Control Study ◽  
Case Control ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Artery Disease ◽  
Control Study
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