Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?

Background. Parenteral nutrition (PN) is an effective method of nourishing the neonate who is unable to receive full enteral feeds. Cholestasis can be a complication of PN and can lead to severe liver damage.Aim. We describe our patient population and determine risk factors for developing PN cholestasis.Methods. Retrospective chart review of newborns admitted from January 2006 to May 2011 to the Neonatal Intensive Care Unit at our institution and received PN >14 days. Cholestasis was defined as serum conjugated bilirubin >50 μmol/L.Results. Eighty-seven newborns were included; 18 (20.7%) developed PN cholestasis. The most frequent surgical condition for both groups was gastroschisis (8/87; 9.2%). No significant differences were found between the cholestasis and control groups for the following parameters: birth weight, gestational age, intrauterine growth restriction, Apgar scores, and day of life at initiation of enteral feeds. Duration of PN in days and dosage of carbohydrates in g/kg/day were significantly higher in the cholestasis group than the control group.Conclusion. PN-related cholestasis presented in one-fifth of neonates receiving PN for more than two weeks. Longer duration of PN and higher dosage of carbohydrates were independent risk factors for the development of PN cholestasis in this population.

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Incisional Hernia of Elective Midline Caesarean Section: Incidence and Risk Factors

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v25i1.13724 ◽

2013 ◽

Vol 25 (1) ◽

pp. 9-14 ◽

Cited By ~ 3

Author(s):

Md Hasan Al-Dahamsheh

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Incisional Hernia ◽

Wound Complications ◽

Control Group ◽

Postoperative Fever ◽

Parity Number ◽

Potential Risk Factors ◽

Independent Risk Factors ◽

And Control

Objective: To analyze the incidence and risk factors for development hernia after elective lower midline caesarean section(ElMCS).Method: A prospective cohort study of 284 women for development of incisional hernia after repeated elective midline CS. Patients enrollment done from April 13th 2001 and December 12th 2002. follow up to two years for hernia development. Hernias were identified radiographically or during physical exam. 2-year hernia rates were calculated. Patients were distributed in two groups, study group consisted of women who had incisional hernia and control group consisted from women who had not within 2-years postoperatively. Within the two groups potential risk factors (age, body mass index (BMI), parity, number of previous cesareans, chronic cough, diabetes mellitus(DM), heart disease, low serum albumin, type of previous incision, anesthesia type, presence of postoperative fever and wound complications) were collected and statistically analyzed with the development of incisional hernia (IH). Setting: Prince Hashem Ben Al-Hussein Hospital, Jordanian Royal Medical Services of Jordan / Zarqa. Results: The 2-year hernia was 5.6 % .Independent risk factors of IH development include: increase in number of previous CSs, wound complications and obesity. Conclusion: An incisional hernia is higher than previously estimated in women undergoing ElMCS. Counseling on the family size will reduce the chance for further CS with its associated risk. Also measures to reduce wound infection after surgery may reduce the incidence of incisional hernia following ElMCS. DOI: http://dx.doi.org/10.3329/bjog.v25i1.13724 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 9-14

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Pathophysiology and Risk Factors for Cholelithiasis in Patients with Crohn’s Disease

Physiological Research ◽

10.33549/physiolres.934302 ◽

2019 ◽

pp. S173-S182

Author(s):

I. STURDIK ◽

A. KRAJCOVICOVA ◽

Y. JALALI ◽

M. ADAMCOVA ◽

M. TKACIK ◽

...

Keyword(s):

Risk Factors ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Parenteral Nutrition ◽

Univariate Analysis ◽

Abdominal Ultrasound ◽

Control Group ◽

Healthy Population ◽

Retrospective Case ◽

Independent Risk Factors

Cholelithiasis is more common in patients with Crohn’s disease (CD) than in the healthy population. The aim here was to examine risk factors for cholelithiasis in a cohort of CD patients and to compare the prevalence of cholelithiasis in a cohort of CD patients with that in a control group. This was a single-center retrospective case-control study. The cohort comprised all consecutive CD patients who underwent abdominal ultrasound from January 2007 to January 2018. The control group comprised age- and gender-matched non-CD patients referred for upper gastrointestinal tract dyspepsia. The study included 238 CD patients and 238 controls. The prevalence of cholelithiasis in the CD and control groups was 12.6 % and 9.2 %, respectively (risk ratio (RR), 1.36; p=0.24). Univariate analysis revealed that cholelithiasis was associated with multiple risk factors. Multivariate analysis identified age (OR, 1.077; 95 % CI, 1.043–1.112; p<0.001) and receipt of parenteral nutrition (OR, 1.812; 95 % CI, 1.131–2.903; p=0.013) as independent risk factors for cholelithiasis in CD patients. The prevalence of cholelithiasis in CD patients was higher than that in the control group; however, the difference was not statistically significant. Age and receipt of parenteral nutrition were independent risk factors for cholelithiasis in CD patients.

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Donepezil Improves Gait Performance in Patients with an Acute Cerebral Infarction: A Prospective Observational Cohort Study

Current Neurovascular Research ◽

10.2174/1567202617666200413130101 ◽

2020 ◽

Vol 17 (3) ◽

pp. 304-311 ◽

Cited By ~ 1

Author(s):

Ying-Ying Lin ◽

Shi-Jie Guo ◽

Hui Quan ◽

Yan-Xin Zhao ◽

Dong-Ya Huang

Keyword(s):

Risk Factors ◽

Cerebral Infarction ◽

Acute Cerebral Infarction ◽

Control Group ◽

Observation Group ◽

Gait Performance ◽

Nihss Score ◽

Significant Difference ◽

Independent Risk Factors ◽

And Control

Background: Hemiplegia is a common symptom after acute cerebral infarction. Objective: This study aimed to explore the influence factors of gait performance and investigate whether donepezil could improve gait performance in patients with an acute cerebral infarction. Methods: A total of 107 patients who experienced unilateral paresis after an acute cerebral infarction incident were enrolled in this prospectively observational study. Participants underwent a 3- month assessment. At the study's conclusion, patients were divided into 2 groups-those who received donepezil daily (observation Group) and those who did not (Control Group). Results: There was a significant difference (t=3.269, P=0.001) of Wisconsin Gait Scale (WGS) score between single site infarction (27.11±6.65) and multiple sites infarction (31.54±6.42). For gender, smoking, drinking, hypertension, hyperlipidemia and diabetes, there was no difference in WGS scores between subgroups (P>0.05), respectively. The patient's admission National Institute of Health Stroke Scale(NIHSS) score had a strongly positive correlation with WGS score (r=0.850, P<0.001). Besides, age (r=0.218, P=0.024), glycosylated hemoglobin (r=0.274, P=0.004), MMSE (r=-0.261, P=0.007) and Montreal Cognitive Assessment (MoCA) (r=-0.272, P=0.005) had a weak correlation with WGS scores. Multivariate analysis showed age (95% CI: 0.042~0.188, P=0.002), admission NIHSS score (95% CI: 2.405~3.137, P<0.001) and multiple sites infarction (95% CI: 0.044~2.983, P=0.044) were independent risk factors of WGS scores. WGS scores of both observation and control groups gradually decreased after admission (P<0.001). At 3 months after admission, WGS score of the observation group was significantly lower than the control group (t=2.468, P=0.015). There were no significant differences between observation and control group at admission and 1 month after admission (P>0.05) and WGS scores of both single site and multiple sites infarction gradually decreased at one month and three months after admission (P<0.001), while there was no significant difference between two groups (P>0.05). Conclusion: Admission NIHSS score, age and multiple sites infarction were independent risk factors of WGS score. Donepezil could improve gait performance in patients with acute cerebral infarction.

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Epidemiology, Risk Factors, and Outcomes of Opportunistic Infections after Kidney Allograft Transplantation in the Era of Modern Immunosuppression: A Monocentric Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm8050594 ◽

2019 ◽

Vol 8 (5) ◽

pp. 594 ◽

Cited By ~ 4

Author(s):

Philippe Attias ◽

Giovanna Melica ◽

David Boutboul ◽

Nathalie De Castro ◽

Vincent Audard ◽

...

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Opportunistic Infections ◽

Control Group ◽

Kidney Allograft ◽

Extended Criteria Donor ◽

Allograft Transplantation ◽

Kidney Recipients ◽

Independent Risk Factors ◽

Kidney Transplantations

Epidemiology of opportunistic infections (OI) after kidney allograft transplantation in the modern era of immunosuppression and the use of OI prevention strategies are poorly described. We retrospectively analyzed a single-center cohort on kidney allograft adult recipients transplanted between January 2008 and December 2013. The control group included all kidney recipients transplanted in the same period, but with no OI. We analyzed 538 kidney transplantations (538 patients). The proportion of OI was 15% (80 and 72 patients). OI occurred 12.8 (6.0–31.2) months after transplantation. Viruses were the leading cause (n = 54, (10%)), followed by fungal (n = 15 (3%)), parasitic (n = 6 (1%)), and bacterial (n = 5 (0.9%)) infections. Independent risk factors for OI were extended criteria donor (2.53 (1.48–4.31), p = 0.0007) and BK viremia (6.38 (3.62–11.23), p < 0.0001). High blood lymphocyte count at the time of transplantation was an independent protective factor (0.60 (0.38–0.94), p = 0.026). OI was an independent risk factor for allograft loss (2.53 (1.29–4.95), p = 0.007) but not for patient survival. Post-kidney transplantation OIs were mostly viral and occurred beyond one year after transplantation. Pre-transplantation lymphopenia and extended criteria donor are independent risk factors for OI, unlike induction therapy, hence the need to adjust immunosuppressive regimens to such transplant candidates.

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Effect of Instruction on Preventing Delayed Bleeding after Colorectal Polypectomy and Endoscopic Mucosal Resection

Journal of Clinical Medicine ◽

10.3390/jcm10050928 ◽

2021 ◽

Vol 10 (5) ◽

pp. 928

Author(s):

Takuya Okugawa ◽

Tadayuki Oshima ◽

Keisuke Nakai ◽

Hirotsugu Eda ◽

Akio Tamura ◽

...

Keyword(s):

Risk Factors ◽

Medical Records ◽

Colorectal Polyp ◽

Control Group ◽

Single Center ◽

Antithrombotic Agents ◽

Delayed Bleeding ◽

Factors Associated ◽

Independent Risk Factors ◽

Continuous Use

Background: The frequency of delayed bleeding after colorectal polypectomy has been reported as 0.6–2.8%. With the increasing performance of polypectomy under continuous use of antithrombotic agents, care is required regarding delayed post-polypectomy bleeding (DPPB). Better instruction to educate endoscopists is therefore needed. We aimed to evaluate the effect of instruction and factors associated with delayed bleeding after endoscopic colorectal polyp resection. Methods: This single-center, retrospective study was performed to assess instruction in checking complete hemostasis and risk factors for onset of DPPB. The incidence of delayed bleeding, comorbidities, and medications were evaluated from medical records. Characteristics of historical control patients and patients after instruction were compared. Results: A total of 3318 polyps in 1002 patients were evaluated. The control group comprised 1479 polyps in 458 patients and the after-instruction group comprised 1839 polyps in 544 patients. DPPB occurred in 1.1% of polyps in control, and 0.4% in after-instruction. Instruction significantly decreased delayed bleeding, particularly in cases with antithrombotic agents. Hot polypectomy, clip placement, and use of antithrombotic agents were significant independent risk factors for DPPB even after instruction. Conclusion: The rate of delayed bleeding significantly decreased after instruction to check for complete hemostasis. Even after instruction, delayed bleeding can still occur in cases with antithrombotic agents or hot polypectomy.

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Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit

BMC Infectious Diseases ◽

10.1186/s12879-021-06295-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhijie Zhang ◽

Yu Cao ◽

Yanjian Li ◽

Xufang Chen ◽

Chen Ding ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Biofilm Formation ◽

Prevention And Control ◽

Neonatal Intensive Care ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Anti Fungal ◽

Hospital Acquired ◽

And Control

Abstract Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.

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Optimization of tactics of auxiliary genesial technologies at married couples with the burdened genetic anamnesis

HEALTH OF WOMAN ◽

10.15574/hw.2018.134.103 ◽

2018 ◽

pp. 103-106

Author(s):

O.S. Darii ◽

Keyword(s):

Risk Factors ◽

Correlation Analysis ◽

Clinical Laboratory ◽

Genetic Research ◽

Married Couples ◽

Control Group ◽

Scientific Justification ◽

Sterility Treatment ◽

Laboratory Tool ◽

And Control

The objective: rising of efficiency of treatment of sterility at married couples with the burdened genetic anamnesis on the basis of scientific justification and introduction of advanced algorithm of prognostic and treatment-and-prophylactic actions. Materials and methods. For the purpose of detection of risk factors of development of sterility and carrying out the correlation analysis were allocated the main group – 100 married couples with sterility in the anamnesis and control group of patients who had labors (n=100) in the anamnesis. The complex of the conducted researches included clinical, laboratory, tool and statistical methods of research. Results. Rising of efficiency of treatment of sterility at married couples with the burdened genetic anamnesis requires carrying out medicogenetic consultation with simultaneous planned preimplantation genetic research in programs of auxiliary genesial technologies. At a choice of this or that method of auxiliary genesial technologies at women with the burdened genetic anamnesis it is necessary to use a technique at which one spermatozoon is entered into an oocyte cytoplasma by means of equipment of a micromanipulation. In the program of training of doctors the obstetrician-gynecologists and urologists of an out-patient link it is necessary to loop thematic improvement concerning sterility treatment at married couples with use of auxiliary genesial technologies. Conclusion. Results of the conducted researches testify to need of rising of efficiency of auxiliary genesial technologies at married couples with the burdened genetic anamnesis. Use by our algorithm of prognostic and treatment-and-prophylactic actions allows to increase efficiency of auxiliary genesial technologies at married couples with the burdened genetic anamnesis for 26.7%. Key words: sterility at married couples, the auxiliary genesial technologies, the burdened genetic anamnesis.

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Risk Factors for Failure of Direct Current Cardioversion in Patients with Type 2 Diabetes Mellitus and Atrial Fibrillation

BioMed Research International ◽

10.1155/2018/5936180 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Handrean Soran ◽

Moulinath Banerjee ◽

Jamal B. Mohamad ◽

Safwaan Adam ◽

Jan Hoong Ho ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Left Atrial ◽

Control Group ◽

Left Atrial Size ◽

Direct Current Cardioversion ◽

Atrial Size ◽

Independent Risk Factors ◽

Lv Ejection Fraction

Introduction. Type 2 diabetes mellitus (T2DM) is a well-recognised risk factor for cardiovascular disease and the prevalence of atrial fibrillation (AF) is higher among patients with T2DM. Direct current cardioversion (DCCV) is an important management option in persistent AF. We sought to determine independent risk factors for immediate and short-term outcomes of DCCV for treatment of AF in patients with T2DM. Methods. Retrospective outcome analysis of DCCV for persistent AF in 102 T2DM patients compared with 102 controls. Results. DCCV was successful in 68 (66.6%) people with T2DM compared to 86 (84.3%) in the control group (P=0.003). After initial successful cardioversion, only 38 (37.2%) T2DM patients remained in sinus rhythm compared to 63 (61.8%) in the control group (P=0.007) at a median follow-up of 74.5 days (IQR 69.4–77.4). Multiple logistic regression analysis showed that the presence of T2DM (P=0.014), digoxin use (P=0.01), statin use (P=0.005), left-atrial size (P=0.01), and LV ejection fraction (P=0.008) were independent risk factors for immediate DCCV failure. T2DM (P=0.034) was an independent risk factor for AF relapse. Among patients with T2DM, previous DCCV (P=0.033), digoxin use (P=0.035), left-atrial size (P=0.01), LV ejection fraction (P=0.036), and HbA1c (P=0.011) predicted immediate failure of DCCV whilst digoxin use (P=0.026) was an independent risk factor for relapse of AF. Conclusion. T2DM, higher HbA1c, digoxin treatment, and structural and functional cardiac abnormalities are independent risk factors for immediate DCCV failure and AF relapse.

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Risk factors for methicillin-resistantStaphylococcus aureusbacteraemia differ depending on the control group chosen

Epidemiology and Infection ◽

10.1017/s0950268813000174 ◽

2013 ◽

Vol 141 (11) ◽

pp. 2376-2383 ◽

Cited By ~ 4

Author(s):

M. POGORZELSKA-MAZIARZ ◽

E. Y. FURUYA ◽

E. L. LARSON

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Organ Transplant ◽

Severity Of Illness ◽

Venous Catheter ◽

Case Control ◽

Control Group ◽

Major Organ ◽

Independent Risk Factors ◽

Nested Case Control

SUMMARYMethicillin-resistantStaphylococcus aureus(MRSA) bacteraemia cause significant morbidity and mortality in hospitalized patients. Using a nested case-control design, 204 MRSA bacteraemia cases were compared to 301 unmatched methicillin-susceptibleStaphylococcus aureus(MSSA) bacteraemia controls and were matched 1:2 with non-infected controls. The independent risk factors for MRSA bacteraemia compared to MSSA bacteraemia were older age (P = 0·048), major organ transplant during current hospital stay (P = 0·016) and quinolone use (P = 0·016). Cases were more likely than non-infected controls to have renal failure (P = 0·003), cirrhosis (P = 0·013), and a central venous catheter (P = 0·003) after controlling for other risk factors. This large case-control study made it possible to assess risk factors for MRSA bacteraemia using two sets of controls and showed that risk factors differed greatly depending on the control group chosen. These results confirm the need for careful selection of appropriate control groups and the need to carefully adjust for underlying severity of illness.

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Dropout Prevention for Youth with Disabilities: Efficacy of a Sustained School Engagement Procedure

Council review ◽

10.1177/001440299806500101 ◽

1998 ◽

Vol 65 (1) ◽

pp. 7-21 ◽

Cited By ~ 144

Author(s):

Mary F. Sinclair ◽

Sandra L. Christenson ◽

David L. Evelo ◽

Christine M. Hurley

Keyword(s):

Treatment Group ◽

Dropout Prevention ◽

School Engagement ◽

Behavioral Disabilities ◽

Control Group ◽

Youth With Disabilities ◽

Engagement Strategies ◽

Overall Performance ◽

And Control ◽

To Receive

The purpose of this study was to examine the efficacy of a sustained dropout prevention procedure that incorporated monitoring and school engagement strategies. Ninety-four students with learning and emotional/behavioral disabilities received interventions in Grades 7 and 8; half of the students (treatment group) continued to receive intervention through Grade 9. Results of this experimental study indicated that, for two of three measures, students in the treatment group were significantly more likely to be engaged in school than were control group students. The overall performance of both treatment and control students, however, points to the need for early and sustained support for students with learning and behavioral disabilities to attain academic and behavioral standards.

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