scholarly journals Correlation between Levels of Serum Lipoprotein-Associated Phospholipase A2 and Soluble Suppression of Tumorigenicity 2 and Condition of Acute Heart Failure Patients and Their Predictive Value for Prognosis

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jinjin Zhang ◽  
Lei Wang ◽  
Zhikun Zhao ◽  
Liang Li ◽  
Yunfeng Xia

Objective. To explore the correlation between levels of serum lipoprotein-associated phospholipase A2 (LP-PLA2) and soluble suppression of tumorigenicity 2 (sST2) and condition of acute heart failure (AHF) patients and their predictive value for prognosis. Methods. The data of patients who complained of acute dyspnea and were treated in our hospital (January 2018–January 2020) were selected for review analysis, and those diagnosed with AHF by means of chest films, physical examination, cardiogram, and color Doppler ultrasonography (CDS) were selected as the study objects. The patients were split into the mild group (I or II, 55 cases) and the severe group (III or IV, 50 cases) according to the clinical condition grading standard in Guidelines for Diagnosis and Treatment of Acute Heart Failure. In addition, 105 healthy individuals examined in our medical center in the same period were selected as the control group. The serum LP-PLA2 and sST2 levels of all study objects were measured to analyze the correlation between these levels and AHF condition. Readmission due to heart failure and all-cause death were regarded as the endpoint events, and after one year of follow-up visits, the occurrence of the endpoint events in patients of the two groups was recorded, and with the endpoint events as the variable, the patients were divided into the event group and nonevent group to establish a logistic regression analysis model and analyze the merit of serum LP-PLA2 and sST2 in evaluating patient outcome. Results. The patients’ general information such as age and gender between the severe group and the mild group were not statistically different ( P > 0.05 ), and the levels of high-sensitivity c-reactive protein (CRP), hemoglobin, creatinine, and uric acid of the severe group were greatly different from those of the mild group ( P < 0.001 ), the comparison result of serum LP-PLA2 and sST2 levels was severe group > mild group > control group ( P all <0.001), and the serum LP-PLA2 and sST2 levels of the severe group were, respectively, 275.98 ± 50.68 ng/ml and 2,122.65 ± 568.65 ng/ml; among 105 AHF patients, 50 of them had endpoint events (47.6%), including 36 in the severe group (36/50, 72.0%) and 14 in the mild group (14/55, 25.5%), and the event group presented greatly higher serum LP-PLA2 and sST2 levels than in the nonevent group ( P < 0.001 ); according to the logistic regression analysis, serum LP-PLA2 and sST2 had independent predictive value for prognosis of AHF patients, which could be used as the independent predictive factors for 1-year prognosis. Conclusion. Serum LP-PLA2 and sST2 have a good diagnosis value for the condition and prognosis of AHF patients, which shall be promoted and applied in practice.

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047230
Author(s):  
Jae-Sung Nam ◽  
Yun Ho Roh ◽  
Wasan Almazouq Fahad ◽  
Hae-Eun Noh ◽  
Jong-Gyun Ha ◽  
...  

ObjectivesWe performed a cross-sectional analysis of data from the nationwide Korea National Health and Nutrition Examination Survey to evaluate the association between obesity and chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyp (CRSsNP).DesignRetrospective cross-sectional analysis of health survey data.SettingVoluntary survey of representative South Korean populations.ParticipantsIn total, 32 384 individuals aged 19 years or older with available data on CRS and obesity were included.Primary and secondary outcome measuresDiagnosis of CRSwNP or CRSsNP was performed by trained otolaryngologists through sinus endoscopy and surveys of medical history. General and central obesity was diagnosed using body mass index (BMI) and waist circumference (WC), respectively.MethodsA multivariate logistic regression analysis was used to clarify the association between CRSwNP or CRSsNP and obesity according to BMI and WC. Non-obese individuals were recruited as controls.ResultsThe prevalence of CRSwNP was higher in the general (OR, 1.438; 95% CI, 1.170 to 1.768; p<0.001) and central (OR, 1.251; 95% CI, 1.031 to 1.520; p=0.033) obesity groups than in the control group. Prevalence of CRSsNP was not correlated with obesity. In a logistic regression analysis, olfactory dysfunction (OR, 1.329; 95% CI, 1.137 to 1.553; p<0.001) and purulent discharge (OR, 1.383; 95% CI, 1.193 to 1.603; p<0.001) showed a higher incidence in the central obesity group than in the control group.ConclusionsWe demonstrated an association between CRSwNP and general and central obesity. Further investigations on the mechanism underlying this correlation are necessary for an improved understanding of the pathogenesis of CRSwNP.


2018 ◽  
Vol 6 (2) ◽  
pp. 128
Author(s):  
I Gusti Ayu Rai Widowati ◽  
I Made Ady Wirawan ◽  
Ni Made Sri Nopiyani ◽  
Komang Ayu Kartika Sari

Background and objectives: Reported microbial resistance to antibiotics is increasing. One of the main factors is patient non-compliance in use of antibiotics. Pharmacist counseling has been shown to be effective in increasing compliance with the use of several types of medications, but its effectiveness of on compliance with antibiotic use has not been widely published. The purpose of this study was to determine the effectiveness of pharmaceutical counseling in a pharmacy setting to increase compliance with antibiotic use.Method: A randomized controlled trial was conducted on 104 adult patients aged 18 years and over who purchased antibiotics by prescription at a pharmacy in Denpasar City, Bali Province. The number of subjects was determined with a confidence level of 95% and a power of 90% with the effect size of 20%. Subjects were divided into two groups using the block randomization method, namely 52 subjects in the intervention group and 52 subjects in the control group. The intervention group was provided with pharmaceutical counseling by a pharmacist at the time of delivery of the drug at the pharmacy, while the control group was provided drug information according to the pharmacy service standard. Subject compliance was measured by telephone interview using the Morisky Medication Adherence Scale-8 questionnaire within 3-5 days after purchasing the medication. Statistical analysis with the Mann Whitney U Test was performed to determine the difference in mean rank of compliance scores between the intervention group and the control group. The proportion of compliance among the intervention group was divided by proportion of compliance in the control group to get the compliance ratio. Logistic regression analysis was conducted to determine the adjusted compliance ratio.Results: The number of subjects analyzed was 98, as 5 subjects could not be contacted by telephone and 1 subject was hospitalized. The mean rank of compliance scores in the intervention group (61.05) was significantly higher (p<0.001) than the comparison group (37.95). The proportion of compliance in the intervention group was 65.3% and the control group was 18.4%, with the proportion ratio (PR) of 3.56 (95%CI=1.90-6.64). Logistic regression analysis showed that variables which significantly increased compliance with antibiotic use were pharmacist counseling (APR=9.33; 95%CI: 3.24-26.87), frequency of taking medication (APR=6.94; 95%CI: 2.01-23.92) and method of payment (APR=4.30; 95%CI: 1.18-15.66).Conclusion: Pharmaceutical counseling at a pharmacy setting was found to increase compliance of antibiotic use. Compliance of antibiotic use is also influenced by the frequency of taking medication and the method of payment. Pharmacist counseling when accessing medication at a pharmacy is crucial for improving patient compliance of antibiotic use.


2021 ◽  
Vol 27 (4) ◽  
pp. 391-399
Author(s):  
Weihong Yuan ◽  
Charles B. Stevenson ◽  
Mekibib Altaye ◽  
Blaise V. Jones ◽  
James Leach ◽  
...  

OBJECTIVE The aim of this study was to investigate diffusion tensor imaging (DTI), an objective and noninvasive neuroimaging technique, for its potential as an imaging biomarker to predict the need and timing of CSF diversion surgery in patients after prenatal myelomeningocele (MMC) repair. METHODS This was a retrospective analysis of data based on 35 pediatric patients after prenatal MMC repair (gestational age at birth 32.68 ± 3.42 weeks, range 24–38 weeks; 15 females and 20 males). A logistic regression analysis was used to classify patients to determine the need for CSF diversion surgery. The model performance was compared between using the frontooccipital horn ratio (FOHR) alone and using the FOHR combined with DTI values (the genu of the corpus callosum [gCC] and the posterior limb of the internal capsule [PLIC]). For patients who needed to be treated surgically, timing of the procedure was used as the clinical outcome to test the predictive value of DTI acquired prior to surgery based on a linear regression analysis. RESULTS Significantly lower fractional anisotropy (FA) values in the gCC (p = 0.014) and PLIC (p = 0.037) and higher mean diffusivity (MD) values in the gCC (p = 0.013) were found in patients who required CSF diversion surgery compared with those who did not require surgery (all p values adjusted for age). Based on the logistic regression analysis, the FOHR alone showed an accuracy of performance of 0.69 and area under the receiver operating characteristic curve (AUC) of 0.60. The performance of the model was higher when DTI measures were used in the logistic regression model (accuracy = 0.77, AUC = 0.84 for using DTI values in gCC; accuracy = 0.75, AUC = 0.84 for using DTI values in PLIC). Combining the DTI values of the gCC or PLIC and FOHR did not improve the model performance when compared with using the DTI values alone. In patients who needed CSF diversion surgery, significant correlation was found between DTI values in the gCC and the time interval between imaging and surgery (FA: ρ = 0.625, p = 0.022; MD: ρ = −0.6830, p = 0.010; both adjusted for age and FOHR). CONCLUSIONS The authors’ data demonstrated that DTI could potentially serve as an objective biomarker differentiating patients after prenatal MMC repair regarding those who may require surgery for MMC-associated hydrocephalus. The predictive value for the need and timing of CSF diversion surgery is highly clinically relevant for improving and optimizing decision-making for the treatment of hydrocephalus in this patient population.


2016 ◽  
Vol 24 (4) ◽  
pp. 527-534 ◽  
Author(s):  
Bong Ju Moon ◽  
Justin S. Smith ◽  
Christopher P. Ames ◽  
Christopher I. Shaffrey ◽  
Virginie Lafage ◽  
...  

OBJECT To identify the characteristics of cervical deformities in Parkinson's disease (PD) and the role of severity of PD in the development of cervical spine deformities, the authors investigated the prevalence of the cervical deformities, cervical kyphosis (CK), and cervical positive sagittal malalignment (CPSM) in patients with PD. They also analyzed the association of severity of cervical deformities with the stage of PD in the context of global sagittal spinopelvic alignment. METHODS This study was a prospective assessment of consecutively treated patients (n = 89) with PD. A control group of the age- and sex-matched patients was selected from patients with degenerative cervical spine disease but without PD. Clinical and demographic parameters including age, sex, duration of PD, and Hoehn and Yahr (H&Y) stage were collected. Full-length standing radiographs were used to assess spinopelvic parameters. CK was defined as a C2–7 Cobb angle < 0°. CPSM was defined as C2–7 sagittal vertical axis (SVA) > 4 cm. RESULTS A significantly higher prevalence of CPSM (28% vs 1.1%, p < 0.001), but not CK (12% vs 10.1%, p = 0.635), was found in PD patients compared with control patients. Among patients with PD, those with CK were younger (62.1 vs 69.0 years, p = 0.013) and had longer duration of PD (56.4 vs 36.2 months, p = 0.034), but the severity of PD was not significantly different. Logistic regression analysis revealed that the presence of CK was associated with younger age, higher mismatch between pelvic incidence and lumbar lordosis, and lower C7–S1 SVA. The patients with CPSM had significantly greater thoracic kyphosis (TK) (p < 0.001) and a trend toward more advanced H&Y stage (p = 0.05). Logistic regression analysis revealed that CPSM was associated with male sex, greater TK, and more advanced H&Y stage. CONCLUSIONS Patients with PD have a significantly higher prevalence of CPSM compared with age- and sex-matched control patients with cervical degenerative disease but without PD. Among patients with PD, CK is not associated with the severity of PD but is associated with overall global sagittal malalignment. In contrast, the presence of CPSM is associated more with the severity of PD than it is with the presence of global sagittal malalignment. Collectively, these data suggest that the neuromuscular pathogenesis of PD may affect the development of CPSM more than of CK.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Shuran Shao ◽  
Chunyan Luo ◽  
Kaiyu Zhou ◽  
Yimin Hua ◽  
Mei Wu ◽  
...  

Abstract Background Intravenous immunoglobulin (IVIG) resistance prediction is one pivotal topic of interests in Kawasaki disease (KD) since those patients with KD resistant to IVIG might improve of an early-intensified therapy. Data regarding predictive value of procalcitonin (PCT) for IVIG resistance, particularly for repeated IVIG resistance in KD was limited. This study aimed to testify the predictive validity of PCT for both initial and repeated IVIG resistance in KD. Methods A total of 530 KD patients were prospectively recruited between January 2015 and March 2019. The clinical and laboratory data were compared between IVIG-responsive and IVIG-resistant groups. Multivariate logistic regression analysis was applied to determine the association between PCT and IVIG resistance. Receiver operating characteristic (ROC) curves analysis was further performed to assess the validity of PCT in predicting both initial and repeated IVIG resistance. Results The serum PCT level was significantly higher in initial IVIG-resistance group compared with IVIG-response group (p = 0.009), as well as between repeated IVIG responders and nonresponders (p = 0.017). The best PCT cutoff value for initial and repeated IVIG resistance prediction was 1.48 ng/ml and 2.88 ng/ml, respectively. The corresponding sensitivity was 53.9 and 51.4%, while the specificity were 71.8 and 73.2%, respectively. Multivariate logistic regression analysis failed to identify serum PCT level as an independent predictive factor for both initial and repeated IVIG resistance in KD. Conclusions Serum PCT levels were significantly higher in IVIG nonresponders, but PCT may not be suitable as a single marker to accurately predict both initial and repeated IVIG resistance in KD.


2017 ◽  
Vol 41 (3) ◽  
pp. 865-874 ◽  
Author(s):  
Junjie Xiao ◽  
Rongrong Gao ◽  
Yihua Bei ◽  
Qiulian Zhou ◽  
Yanli Zhou ◽  
...  

Background/Aims: Identification of novel biomarkers to identify acute heart failure (AHF) patients at high risk of mortality is an area of unmet clinical need. Recently, we reported that the baseline level of circulating miR-30d was associated with left ventricular remodeling in response to cardiac resynchronization therapy in advanced chronic heart failure patients. However, the role of circulating miR-30d as a prognostic marker of survival in patients with AHF has not been explored. Methods: Patients clinically diagnosed with AHF were enrolled and followed up for 1 year. Quantitative reverse transcription polymerase chain reactions were used to determine serum miR-30d levels. The univariate logistic regression analysis and multivariate logistic regression analysis were used to determine the predictors for all-cause mortality in AHF patients. Kaplan–Meier survival analysis was used to analyze the role of miR-30d in prediction of survival. Results: A total of 96 AHF patients were enrolled and followed up for 1 year. Serum miR-30d was significantly lower in AHF patients who expired in the one year follow-up period compared to those who survived. Univariate logistic regression analysis yielded 18 variables that were associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 4 variables including heart rate, hemoglobin, serum sodium, and serum miR-30d level associated with mortality. ROC curve analysis showed that hemoglobin, heart rate and serum sodium displayed poor prognostic value for AHF (AUCs not higher than 0.700) compared to miR-30d level (AUC = 0.806). Kaplan–Meier survival analysis confirmed that patients with higher serum miR-30d levels had significantly lower mortality (P=0.001). Conclusion: In conclusion, this study shows evidence for the predictive value of circulating miR-30d as 1-year all-cause mortality in AHF patients. Large multicentre studies are further needed to validate our findings and accelerate the transition to clinical utilization.


2021 ◽  
Author(s):  
Yulan Cai ◽  
Shili Zhang ◽  
Ying Cao ◽  
Fang Gao ◽  
Mengchen Zou

Abstract Background: Bullosis diabeticorum (BD) is a spontaneous, non-inflammatory vesicular disease of diabetes, with the observed risk of infection, including diabetic skin ulcers, osteomyelitis and even leading to amputation. However, the exact cause of BD is not well understood. So the aim of this study is to explore the high-risk factors of BD for preventing its occurrence.Methods: A retrospective study was conducted, including baseline characteristics, laboratory data, and bullosis diabeticorum outcomes of 602 patients with bullosis diabeticorum. Besides, 904 diabetic patients without bullosis diabeticorum in the same period were randomly selected as the control group. The indicators of the two groups were compared. Multivariable logistic regression analysis was performed to investigate which indicator was most associated with bullosis diabeticorum outcomes.Results: SCr[145.00(69.00-195.00) μmol/L, n = 602 vs. 81.00(27.40-35.60) μmol/L, n= 904, p=0.032], BUA [674.00(372.50-758.50) µmol/L, n = 602 vs. 318.50(241.75-415.25) µmol/L, n= 904, p = 0.003] and Cys-C[1.96(1.10-2.95) mg/L, n = 602 vs. 1.49(1.10-1.62) mg/L, n = 904, p=0.004] was significantly higher in BD-positive patients than that in BD-negative patients, whereas eGFR [67.38(45.33-87.53) ml/min, n = 602 vs. 75.86(56.80-95.69) ml/min, n = 904, p=0.038] of patients with BD was significantly lower than that of patients without BD. Multiple logistic regression analysis showed that BUA, but not SCr, Cys-C and eGFR, was independently and significantly associated in a positive manner with BD (odds ratio: 8.569, 95% confidence interval: 1.136-55.250, p=0.004).Conclusion: We found a positive and independent association of BUA with BD, which provides a great clinical predictive factor for BD and helps to prevent the appearance of diabetic foot.


2020 ◽  
Author(s):  
Kai-Yang Lin ◽  
Han-Chuan Chen ◽  
Hui Jiang ◽  
Sun-Ying Wang ◽  
Hong-mei Chen ◽  
...  

Abstract Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.


2020 ◽  
Author(s):  
Xinguang Liu ◽  
Ran Ding ◽  
Chen Liu ◽  
Bin Yang ◽  
Weiguo Wang

Abstract Background Previous studies have indicated that medial meniscal subluxation (MMS) is associated with special types of medial meniscus tears (MMT) and chondral lesions. However, most of these studies lacked arthroscopic findings and did not adjust for possible confounders. The purpose of this study was to explore factors associated with MMS in patients with MMT using multivariate logistic regression analysis. Methods A retrospective analysis of 115 patients who underwent arthroscopic surgery for MMT was conducted. The medial meniscal extrusion (MME) distance was measured on a single mid-coronal magnetic resonance (MR) image, and the MMS group included patients with MME distance ≥3 mm (55 patients with 55 knees). Other patients were included as the control group (60 patients with 60 knees). Demographic and clinical data were collected as variates. A multivariate logistic regression analysis was performed to identify factors associated with MMS. Results In a univariate analysis, the Outerbridge classification (P=0.002) and the type of MMT (P<0.001) were significantly different between the MMS group and the control group. According to unadjusted and age- and body mass index (BMI)-adjusted multivariate logistic regression analysis, the type of MMT was an independent factor associated with MMS. Compared with horizontal tears, radial tears, posterior medial meniscus root tears (PMMRT) and complex tears had approximately 6-fold (adjusted OR 6.468, 95% CI 1.509–27.718, P=0.012), 10-fold (adjusted OR 10.324, 95% CI 1.719–61.989, P=0.011) and 4-fold (adjusted OR 4.458, 95% CI 1.602–12.408, P=0.004) higher associations with MMS, respectively. Conclusion The type of MMT was an independent factor associated with MMS in knees with MMT. Radial tears, PMMRT and complex tears were more likely than horizontal tears to result in MMS. The results suggest that MMT combined with MMS should be noted when managing MMT, especially radial tears, PMMRT and complex tears. Moreover, the results indicate that we must not only preserve the meniscus as much as possible but also restore its position to as close to normal as possible.


2021 ◽  
Author(s):  
Ziqiang Xia ◽  
Juzeng Zheng ◽  
Liang Zheng ◽  
Endian Zheng ◽  
Zhuolin Zou ◽  
...  

Abstract BackgroundThe prevalence of dyslipidemia in China is increasing annually. Current studies suggest that dyslipidemia affects the antiviral efficacy of hepatitis C virus (HCV) therapies. Recent studies have shown that serum lipids influence the response rates of chronic hepatitis B patients receiving PEGylated interferon-alpha (Peg IFN-a) treatment. However, the role of dyslipidemia in the efficacy of nucleoside (acid) analogues in chronic hepatitis B patients has not been determined. Methods From January 2010 to December 2013, data from 179 treatment-naive patients with chronic hepatitis B (CHB) who were hepatitis B e antigen (HBeAg)-positive and visited the first affiliated hospital of Wenzhou Medical University were collected. Amongst them, 68 patients were diagnosed with CHB complicated with dyslipidemia (dyslipidemia group) whilst 111 patients comprised the lipid control group. Three treatment strategies were performed amongst the 179 CHB patients over a 5 year period. Treatments included combination therapy of lamivudine (LAM) plus adefovir dipivoxil (ADV), telbivudine (LdT) monotherapy or entecavir (ETV) monotherapy. Serum assessments, blood biochemistry, HBV serological markers, HBV DNA before treatment and HBeAg serological conversion and virological responses at different time points after treatment were compared between the two groups. Measurement data were compared using τ tests, whilst enumeration data were compared using c2 tests. Correlation analysis was performed using binary Logistic regression analysis. Results The rates of HBeAg seroconversion in the dyslipidemia group at years 1, 2, 3 and 4 were 10.3%, 13.2%, 17.6% and 22.1%, respectively, which were not significantly lower than those of the lipid control group 11.7%, 16.2%, 18.0% and 33.3%, (c2 = 0.085, 0.293, 0.004 and 2.601, respectively; R > 0.05). However, the rates of HBeAg seroconversion in the dyslipidemia group were significantly lower than those of the lipid control group at year 5 (27.9% vs 43.2%, c2 =4.216, R<0.05). Univariate logistic regression analysis showed significant differences in sex PTA, ALT, AST, CR and LDL-C. Multivariate regression analysis demonstrated that dyslipidemia (OR=1.993, R=0.038), and male gender (OR=2.317, R=0.029) were risk factors associated with HBeAg seroconversion.Conclusions During antiviral therapy, dyslipidemia affects HBeAg seroconversion in CHB patients treated with nucleoside (acid) analogues but does not affect the virological response.


Sign in / Sign up

Export Citation Format

Share Document