scholarly journals Analysis of Risk Factors for First Seizure after Stroke in Chinese Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Guoqing Wang ◽  
Haiyan Jia ◽  
Chunfu Chen ◽  
Senyang Lang ◽  
Xinfeng Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Early Onset ◽  
Late Onset ◽  
Chinese Patients ◽  
Onset Seizure ◽  
Large Lesion ◽  
Related Risk ◽  
Independent Risk Factors ◽  
Cortical Involvement

The aim of this study is to assess related risk factors and predict early- and late-onset seizure after first-ever stroke. A total of 2474 consecutive patients with initial stroke in China from 1997 to 2007 were retrospectively investigated, in which, 24 clinical and radiological indexes were used for evaluation. Odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression. A total of 232 (11.1%) of patients developed seizures during a mean follow-up period of 18 months, with 123 experiencing early-onset and 109 late-onset seizure. The independent risk factors for early-onset seizure were large lesion (OR=9.36), subarachnoid hemorrhage (OR=5.28), initial hyponatremia (OR=2.10), and cortical involvement (OR=1.33). The independent risk factors for late-onset seizure were cortical involvement (OR=11.84) and large lesion (OR=1.87). These results demonstrated that the risk factors for early seizure after stroke are large lesion, subarachnoid hemorrhage, and cortical involvement. Surprisingly, hyponatremia also predicts seizure in stroke patients. Cortical involvement is a major risk factor for late-onset seizure after stroke.

Superiority of Outcome for Patients with Late-Onset EBV Viremia Post Allogeneic Stem Cell Transplantation: A Chinese Multicenter Survey

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5443-5443
Author(s):  
Jia Chen ◽  
Feng Chen ◽  
Yang Xu ◽  
Ying Wang ◽  
Ziling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Cumulative Incidence ◽  
Early Onset ◽  
Late Onset ◽  
Conditioning Regimens ◽  
Independent Risk Factors ◽  
Ebv Dna ◽  
The Impact ◽  
Ebv Viremia

Abstract Introduction EBV reactivation and associated diseases have been well recognized as one of the life threatening complications after SCT, which leads to the establishment of prophylactic and preemptive treatment for EBV viremia. However since then, few epidemic data was shown in SCT recipients, especially in China. Patients and Methods An observational data base study was conducted in patients with hematological disorders who received allo-SCT from Jun 2011 through Jun 2014. EBV-negative status was confirmed before transplant for both donors and recipients. EBV-DNA was screened weekly until Day 100 post SCT by qPCR, and then every 2-4 weeks until 1 year. Additional tests were carried out when clinically indicated. All patients received ganciclovir during conditioning regimen, and then switched to acyclovir or valaciclovir after stem cell infusion until 1 year post SCT. Ganciclovir and/or foscarnet were used when DNAemia developed, as well as rituximab for high risk patients such as high viral load or persistent DNAemia. Results This study recruited 892 evaluable cases, including 91 cases of benign diseases and 801 cases of malignancies. Until Jun 2015, EBV-DNA was detected in 178 cases with a median duration of 55 days (16-990days) post SCT, and the long-term cumulative incidence of DNAemia was 22.8¡À1.6%(Fig 1A). Log-rank test showed the onset of EBV-DNAemia had impact on neither OS nor NRM. However, For patients with late-onset EBV viremia (later than 100 days post-SCT), superiority of 3 year-OS (75.6¡À7.9% vs 65.2¡À1.8%, P=0.013) and 3 year-NRM (19.2¡À8.0% vs 25.4¡À1.7%, P=0.028) were observed(Fig 1B and Fig 1C). Furthermore, late-onset of EBV viremia was confirmed as independent protective factor for both OS£¨RR 0.466 [95%CI 0.253-0.859], P=0.014) and NRM (RR 2.271 [95%CI 1.056-4.882], P=0.036) in multivariate analysis. Cox model analysis revealed that the haploidentical donor£¨RR 4.745 [95%CI 1.624-13.866], P=0.004) and the use of ATG/ALG were independent risk factors for late-onset of EBV viremia, as well as the graft of bone marrow (RR 2.188 [95%CI 0.991-4.835], P=0.053) with a marginal significance(Figure 2). Conclusion This work showed the cumulative incidence of EBV viremia after allogeneic SCT was around 22.8% based on virus prophylaxis. As shown in multivariate analysis, late-onset of EBV viremia had independent impact on OS and NRM. Haploidentical donors, the use of ATG/ALG and graft type were independent risk factors for late-onset EBV viremia.. This work was funded by grants of Jiangsu Provincial Special Program of Medical Science (BL2012005), Jiangsu Province¡¯s Key Medical Center (ZX201102) and the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD). Figure 1. A. Cumulative incidence of EBV DNAemia; B. Comparison of OS between early-onset and late-onset of EBV viremia; C. Comparison of NRM between early-onset and late-onset of EBV viremia; Figure 1. A. Cumulative incidence of EBV DNAemia; B. Comparison of OS between early-onset and late-onset of EBV viremia; C. Comparison of NRM between early-onset and late-onset of EBV viremia; Figure 2. Independent risk factors for late-onset of EBV viremia: A. the impact of donor types; B. the impact of conditioning regimens with and without ATG/ALG; C. the impact of graft types. Figure 2. Independent risk factors for late-onset of EBV viremia: A. the impact of donor types; B. the impact of conditioning regimens with and without ATG/ALG; C. the impact of graft types. Disclosures No relevant conflicts of interest to declare.

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Premature Rupture ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

scholarly journals Differences in initial versus recurrent diabetic foot ulcers at a specialized tertiary diabetic foot care center in China

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098739
Author(s):  
Yuxia Cheng ◽  
Ping Zu ◽  
Jie Zhao ◽  
Lintao Shi ◽  
Hongyan Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Blood Glucose Control ◽  
Diabetes Duration ◽  
Chinese Patients ◽  
Foot Care ◽  
Vascular Intervention ◽  
History Of ◽  
Independent Risk Factors ◽  
Recurrence Group

Objective To investigate the characteristics of diabetic foot ulcer (DFU) recurrence. Methods A total of 573 patients with DFUs were recruited and divided into an initial group (395 patients) and a recurrence group (178 patients). The factors related to recurrence were analyzed using multivariate regression. Results The recurrence group had longer diabetes duration (odds ratio [OR] 192; 95% confidence interval 120, 252 vs. 156; 96, 240); lower glycated hemoglobin levels (OR 8.1; 95% CI 6.8, 9.6 vs. 9.1; 7.4, 10.5), and higher rates than the initial group of amputation (37.5% vs. 2.0%), history of vascular intervention (21.3% vs. 3.9%), retinopathy (77.7% vs. 64.7%), callus (44.4% vs. 20.8%), foot deformity (51.2% vs. 24.6%), and outdoor sports shoe wearing (34.0% vs. 21.2%). Multiple factor logistic regression analysis showed that diabetes duration (OR 1.004), callus (OR 2.769), vascular intervention (OR 2.824) and amputation (OR 22.256) were independent risk factors for DFU recurrence. Conclusion Diabetes duration, callus, history of vascular intervention, and amputation were independent risk factors for recurrent DFUs in a cohort of Chinese patients with active DFU. The prevention and treatment of DFUs, especially callus treatment, foot care, and blood glucose control, should be improved in China.

Clinical and Neuroimaging Characterization of Chinese Dementia Patients with PSEN1 and PSEN2 Mutations

2014 ◽  
Vol 39 (1-2) ◽  
pp. 32-40 ◽  
Author(s):  
Zhihong Shi ◽  
Ying Wang ◽  
Shuai Liu ◽  
Mengyuan Liu ◽  
Shuling Liu ◽  
...  
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Novel Mutation ◽  
Chinese Patients ◽  
Phenotypic Traits ◽  
Chinese Han ◽  
Risk Variants ◽  
Dementia Patients ◽  
Positron Emission ◽  
Neurodegenerative Dementia

Background: Alzheimer's disease (AD) and frontotemporal dementia (FTD) are two common forms of primary neurodegenerative dementia. Mutations in 3 genes (PSEN1, PSEN2, and APP) have been identified in patients with early-onset AD. Methods: We performed gene sequencing in PSEN1, PSEN2, and APP in 61 AD and 35 FTD Chinese patients. Amyloid load using 11C-labeled Pittsburgh compound B (11C-PIB) positron emission tomography (PET) and cerebral glucose metabolism using 18F-fludeoxyglucose PET were evaluated in patients carrying mutations. Results: We identified 1 known pathogenic PSEN1 (p.His163Arg, c.488A>G) mutation and 3 novel PSEN2 mutations in 6 patients. The novel mutation PSEN2 (p.His169Asn, c.505C>A) was identified in 1 patient with familial late-onset AD and in 1 sporadic FTD patient. The PSEN2 (p.Val214Leu, c.640G>T; p.Lys82Arg, c.245A>G) mutations were identified in 2 early-onset AD patients and 1 early-onset AD patient, respectively. Three patients with PSEN2 mutations were observed to have PIB retention on the cortex and striatum. One patient with the FTD phenotype was not observed to have PIB retention. Conclusion: PSEN2 mutations are common in the Chinese Han population with a history of AD and FTD. Pathogenic mutations or risk variants in the PSEN2 gene can influence both FTD and AD phenotypic traits and show variations in neuroimaging characterization. © 2014 S. Karger AG, Basel

scholarly journals Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

2022 ◽  
Vol 8 ◽  
Author(s):  
Han Zhang ◽  
Yingying Wu ◽  
Yuqing He ◽  
Xingyuan Liu ◽  
Mingqian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Population Based ◽  
Male Gender ◽  
Poor Correlation ◽  
Age Related ◽  
Related Risk ◽  
Independent Risk Factors

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

Retrospective Study of Cerebral Vasospasm-related Risk Factors in Elderly Patients With Subarachnoid Hemorrhage

2010 ◽  
Vol 20 (4) ◽  
pp. 258-262
Author(s):  
Guang Jian Liu ◽  
Yun Fu Wang ◽  
Yong Liu ◽  
Guo Hou He ◽  
Jun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Subarachnoid Hemorrhage ◽  
Elderly Patients ◽  
Cerebral Vasospasm ◽  
Related Risk

scholarly journals Maternofetal outcomes in early versus late onset pre-eclampsia: a comparative study

2019 ◽  
Vol 8 (2) ◽  
pp. 548
Author(s):  
Poornima Shankar ◽  
Kavitha Karthikeyan ◽  
Amrita Priscilla Nalini ◽  
Sindhura M. ◽  
Gowtham Kim
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Fetal Outcomes ◽  
Chi Square ◽  
Onset Type ◽  
Significant Difference ◽  
Early Onset Preeclampsia

Background: Preeclampsia is being increasingly recognized as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset disease occurring at 34 or more weeks of gestation. Early-onset and late-onset pre-eclampsia are found to have different implications for the mother and neonate. The aim of this study is to compare the risk factors, maternal and fetal outcomes in early (<34 weeks) versus late (≥34weeks) onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Chettinad Academy of Research and Education over a period of three years (From January 2014 to December 2016) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on risk factors, maternal and fetal outcomes were collected and analyzed using Chi Square and Fisher’s test and compared.Results: The overall preeclampsia rate was 6.3%. Early onset and late onset were 34.6% and 65.3% respectively and the rate increased with increasing gestational age.35.3% of patients with late onset preeclampsia and 55.6% patients of early onset type required more than one drug which is a statistically significant difference. Proteinuria more than 3gm/l/day was significantly more in late onset preeclampsia than in early onset preeclampsia. 55.5% of patients with early onset pre-eclampsia required MgSO4 when compared to 17.4%. There was no statistically significant difference in the rate of caesarean section (61.1% vs 73.5%). Altered coagulation profile was significantly more in early onset preeclampsia (11.1%). The incidence of oligohydramnios, SGA and low APGAR at 5 minutes of birth were significantly high in early onset pre-eclampsia when compared to late onset type.Conclusions: Patients with early onset pre-eclampsia are found to have significantly higher rates of specific maternal and fetal morbidity when compared to the late onset type.

scholarly journals Clinical and molecular characteristics of 69 Chinese patients with ornithine transcarbamylase deficiency

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Deyun Lu ◽  
Feng Han ◽  
Wenjuan Qiu ◽  
Huiwen Zhang ◽  
Jun Ye ◽  
...  
Keyword(s):  
Early Onset ◽  
Orotic Acid ◽  
Late Onset ◽  
Peak Plasma ◽  
Laboratory Data ◽  
Ornithine Transcarbamylase ◽  
Chinese Patients ◽  
Molecular Characteristics ◽  
Common Mutation ◽  
Ornithine Transcarbamylase Deficiency

Abstract Background This study aimed to describe the clinical and biochemical features of Chinese patients with ornithine transcarbamylase deficiency (OTCD), and to investigate the mutation spectrum of OTC gene and their potential correlation with phenotype. Methods Sixty-nine patients with OTCD were enrolled between 2004 and 2019. Clinical and laboratory data were reviewed retrospectively from medical records. Results Fifteen cases (13 males, 2 females) presented with early onset; 53 cases (21 males, 32 females) had late onset, and one female was asymptomatic. The median onset age was 1.5 years (range 1 day–56 years). Urine orotic acid levels were increased in all patients tested, while only 47.6% of patients showed decreased serum levels of citrulline. The peak plasma ammonia levels were higher in early-onset patients than in late-onset patients (P < 0.01). Fifty-four different mutations of OTC gene were identified and 18 of them were novel. R277W (10.6%) was the most common mutation, followed by G195R (4.6%) and A209V (3.0%). By June 2019, 41 patients had survived, 24 were deceased, and 4 were lost to follow-up. Among the survivors, 13 patients had received liver transplantation at a median age of 3 years, with a one-year survival rate of 100%. The mortality of OTCD is extremely high among patients with early onset (80.0% versus 24.5% in patients with late onset). Conclusions The evaluation of serum citrulline level is of limited value in diagnosis of OTCD, while urine orotic acid detection and genetic testing are more helpful.

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