scholarly journals Duration of Serum Phosphorus Control Associated with Overall Mortality in Patients Undergoing Peritoneal Dialysis

2020 ◽  
Vol 6 (6) ◽  
pp. 434-443
Author(s):  
Nirong Gong ◽  
Zhiwen Xiao ◽  
Fen Zhang ◽  
Xiaohong Zhong ◽  
Yanfang He ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Phosphorus ◽  
First Year ◽  
Mortality Hazard ◽  
Relationship Of ◽  
The Relationship ◽  
Mortality Hazard Ratio ◽  
Overall Mortality

<b><i>Background:</i></b> Serum phosphorus (SP) level is closely associated with overall mortality and cardiovascular events, while the role of SP controlled duration is not fully recognized. Here, we conducted a retrospective cohort study in our department to identify the relationship of SP controlled duration with clinical outcomes in patients undergoing peritoneal dialysis (PD). <b><i>Methods:</i></b> PD patients in our center from January 1, 2009, to June 30, 2019, were followed up at 2-month (the first year) or 5-month (the next follow-up period) intervals, and until death, until PD withdrawal, or until June 30, 2019. Data at each follow-up point were collected from their medical records. SP levels, changed degree of SP over baseline, and SP controlled duration were analyzed with overall mortality, PD withdrawal (including death, transferred to hemodialysis, and received renal transplantation), and combined endpoint (including death, acute heart failure, cardiovascular event, and stroke). <b><i>Results:</i></b> A total of 530 patients entered the analysis. Of them, 456 (86.0%) had hyperphosphatemia before dialysis, and the SP levels decreased soon after dialysis. The degree of SP change over baseline was the maximum at the 3rd month after dialysis (−31.0%), and lower degree was associated with higher overall mortality (hazard ratio [HR], 1.012; 95% CI, 1.004–1.020; <i>p</i> = 0.003). The median SP controlled duration was 13 (5–28) months, and longer duration was significantly associated with lower overall mortality (HR, 0.968; 95% CI, 0.956–0.981; <i>p</i> &#x3c; 0.001). After categorization, duration more than 12 months greatly improved overall mortality with a HR of 0.197 (0.082–0.458; <i>p</i> &#x3c; 0.001 vs. SP never controlled group) and 0.329 (0.150–0.724; <i>p</i> = 0.006 vs. duration &#x3c;12 months group). Longer SP controlled duration also improved PD withdrawal and combined endpoint. <b><i>Conclusions:</i></b> In summary, both degree and duration of SP control were tightly associated with overall mortality. We should control SP levels as early, as possible, and as long as we could.

Candida albicans Shunt Infection: Report of Two Cases

Neurosurgery ◽  
1986 ◽  
Vol 19 (1) ◽  
pp. 111-113 ◽  
Author(s):  
David J. Gower ◽  
Kerry Crone ◽  
Eben Alexander ◽  
David L. Kelly
Keyword(s):  
Candida Albicans ◽  
Blood Cells ◽  
White Blood Cells ◽  
Shunt Infection ◽  
Cerebrospinal Fluid Shunts ◽  
Previous Therapy ◽  
Relationship Of ◽  
The Relationship ◽  
Overall Mortality

Abstract Infection of cerebrospinal fluid shunts with Candida albicans is reported in two patients. Scanning electron microscopy in one case demonstrates the relationship of the Candida hyphae to the white blood cells and to silicone plastic. A review of 10 previously reported cases of Candida shunt infection indicates that the infection usually follows a major bacterial infection or direct contamination or occurs spontaneously, Previous therapy has usually involved removal of the shunt, and the role of parenteral antifungal therapy is still unclear. Overall mortality to date is 25%.

scholarly journals Lipidomic Signatures of Changes in Adiposity: A Large Prospective Study of 5849 Adults from the Australian Diabetes, Obesity and Lifestyle Study

Metabolites ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 646
Author(s):  
Habtamu Beyene ◽  
Gavriel Olshansky ◽  
Corey Giles ◽  
Kevin Huynh ◽  
Michelle Cinel ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
Weight Gain ◽  
Lipid Level ◽  
Baseline Survey ◽  
Linear Regression Models ◽  
Lipid Species ◽  
Relationship Of ◽  
The Relationship

Lipid metabolism is tightly linked to adiposity. Comprehensive lipidomic profiling offers new insights into the dysregulation of lipid metabolism in relation to weight gain. Here, we investigated the relationship of the human plasma lipidome and changes in waist circumference (WC) and body mass index (BMI). Adults (2653 men and 3196 women), 25–95 years old who attended the baseline survey of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) and the 5-year follow-up were enrolled. A targeted lipidomic approach was used to quantify 706 distinct molecular lipid species in the plasma samples. Multiple linear regression models were used to examine the relationship between the baseline lipidomic profile and changes in WC and BMI. Metabolic scores for change in WC were generated using a ridge regression model. Alkyl-diacylglycerol such as TG(O-50:2) [NL-18:1] displayed the strongest association with change in WC (β-coefficient = 0.125 cm increment per SD increment in baseline lipid level, p = 2.78 × 10-11. Many lipid species containing linoleate (18:2) fatty acids were negatively associated with both WC and BMI gain. Compared to traditional models, multivariate models containing lipid species identify individuals at a greater risk of gaining WC: top quintile relative to bottom quintile (odds ratio, 95% CI = 5.4, 3.8–6.6 for women and 2.3, 1.7–3.0 for men). Our findings define metabolic profiles that characterize individuals at risk of weight gain or WC increase and provide important insight into the biological role of lipids in obesity.

scholarly journals Serum YKL-40 as predictor of outcome in hypersensitivity pneumonitis

2016 ◽  
Vol 49 (2) ◽  
pp. 1501924 ◽  
Author(s):  
Xiaoping Long ◽  
Xuan He ◽  
Shinichiro Ohshimo ◽  
Matthias Griese ◽  
Rafael Sarria ◽  
...  
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Hazard Ratio ◽  
Healthy Controls ◽  
Baseline Serum ◽  
The Relationship ◽  
Mortality Hazard Ratio

YKL-40, a chitinase-like protein mainly secreted by macrophages, neutrophils and epithelial cells, is increased in patients with idiopathic interstitial pneumonia and sarcoidosis. We aimed to investigate the role of YKL-40 as a biomarker in hypersensitivity pneumonitis (HP).72 HP patients, 100 interstitial lung disease (ILD) controls and 60 healthy controls were studied. YKL-40 was measured by ELISA in serum and bronchoalveolar lavage fluid (BALF) at baseline and follow-up. The relationship between YKL-40 levels, clinical variables and disease outcome was evaluated.Baseline serum YKL-40 levels were significantly higher in HP patients than in healthy controls (p<0.001), but lower than in patients with other ILDs. Baseline BALF YKL-40 levels in HP patients were the highest among ILD patients. In HP patients, serum YKL-40 correlated with the diffusing capacity of the lung for carbon monoxide at baseline (p<0.01) and over time (p<0.001). HP patients whose disease progressed or who died had higher baseline YKL-40 levels than those who remained stable and survived (p<0.001). At a cut-off of 119 ng·mL−1, the baseline serum YKL-40 level predicted disease progression (hazard ratio 6.567; p<0.001), and at a cut-off of 150 ng·mL−1 was associated with mortality (hazard ratio 9.989; p<0.001).Serum YKL-40 may be a useful prognostic biomarker in HP patients.

scholarly journals Academic resilience as mediator of multidimensional perfectionism and academic performance among gen-Z undergraduate students

2019 ◽  
Vol 8 (4) ◽  
pp. 637
Author(s):  
Owen Ze Hua Choo ◽  
Kususanto Ditto Prihadi
Keyword(s):  
Academic Performance ◽  
Undergraduate Students ◽  
Protective Factor ◽  
Academic Resilience ◽  
First Year ◽  
Undergraduate Program ◽  
Age Range ◽  
Relationship Of ◽  
The Relationship

<span>This study focused on the relationship of </span><span lang="IN">two</span><span> dimensions of perfectionism (perfectionistic strivings, and perfectionistic concerns) and academic performance, with the role of academic resilience as mediator. Participants including 132 undergraduate students form age range 18 to 25, from first year to fifth year in their studies mainly from a Malaysian psychology undergraduate program were asked to fill questionnaires containing measures for perfectionism, academic resilience and academic performance. Although only partial mediations occurred, both hypotheses where academic resilience would mediate relationships between both dimensions of perfectionism and academic performance were supported. Findings suggested that other variables aside academic resilience could have played a role in predicting perfectionist’s academic performance. Findings also suggested interplay of academic performance acting as both protective factor and outcome of academic resilience.</span>

The Role of Ecological Variables in Residential Treatment

1988 ◽  
Vol 13 (2) ◽  
pp. 98-107 ◽  
Author(s):  
W. W. Lewis
Keyword(s):  
Residential Treatment ◽  
Personal Characteristics ◽  
Ecological Change ◽  
Ecological Data ◽  
Ecological Variables ◽  
Follow Up Studies ◽  
Relationship Of ◽  
The Relationship

The importance of a supportive ecology after a child returns from residential treatment has been documented in a number of follow-up studies. This study used ratings by liaison staff in a residential treatment program to measure both personal and ecological variables at admission and discharge and investigate the relationship of those ratings to adjustment status of students 6 months after discharge. It was found that some ecological data gathered at admission were predictive of follow-up status while most personal characteristics of the student were not. Unlike earlier follow-up studies, ratings of improvement, both of the student's behavior and his ecological support, were significantly related to follow-up ratings, possibly because liaison staff had worked directly with members of students' ecologies and were aware of support and problems to be faced on return to the community. These findings seem to support the proposition that personal change and ecological change must occur together for residential treatment to be successful.

AN APPROACH TO THE PROBLEM OF INTERSEX: THE ROLE OF THE GENERAL PEDIATRICIAN

PEDIATRICS ◽  
1966 ◽  
Vol 38 (3) ◽  
pp. 430-435
Author(s):  
Betty Suits Tibbs
Keyword(s):  
Medical Problem ◽  
Diagnosis And Treatment ◽  
Male Pseudohermaphroditism ◽  
General Pediatrician ◽  
The Family ◽  
Follow Up Care ◽  
Relationship Of ◽  
The Relationship

A case of intersex, male pseudohermaphroditism in an adolescent, is reported as an example of the complicated medical problem which lends itself in the diagnosis and treatment to the multi-discipline approach emphasizing the relationship of one physician, the pediatrician, to the patient. The pediatrician recognizes and evaluates the problem, informs the parents of the problem, organizes the multi-discipline approach, counsels and supports the family during diagnosis and treatment, and provides follow-up care for the patient and family.

scholarly journals Predictors and Outcomes of Transfers from Peritoneal Dialysis to Hemodialysis

2015 ◽  
Vol 35 (3) ◽  
pp. 306-315 ◽  
Author(s):  
Patrick G. Lan ◽  
Philip A. Clayton ◽  
John Saunders ◽  
Kevan R. Polkinghorne ◽  
Paul L. Snelling
Keyword(s):  
Peritoneal Dialysis ◽  
Regression Models ◽  
Logistic Models ◽  
Venous Catheter ◽  
Logistic Regression Models ◽  
Mortality Hazard ◽  
Risk Of Mortality ◽  
Cox Analysis ◽  
Mortality Hazard Ratio

IntroductionPeritoneal dialysis (PD) patients are commonly required to transfer to hemodialysis (HD), however the literature describing the outcomes of such transfers is limited. The aim of our study was to describe the predictors of these transfers and their outcomes according to vascular access at the time of transfer.MethodsA retrospective cohort study using registry data of all adult patients commencing PD as their initial renal replacement therapy in Australia or New Zealand between 2004 – 2010 was performed. Follow-up was until 31 December 2010. Logistic regression models were constructed to determine possible predictors of transfer within both 6 and 12 months of PD commencement. Cox analysis and competing risks regression were used to determine the predictors of survival and transplantation post-transfer.ResultsThe analysis included 4,781 incident PD patients, of whom 1,699 transferred to HD during the study period. Logistic models did not identify any clinically useful predictors of transfer within 6 or 12 months (c-statistics 0.54 and 0.55 respectively). 67% of patients commenced HD with a central venous catheter (CVC). CVC use at transfer was associated with increased mortality (hazard ratio 1.37, 95% confidence interval (CI) 1.11 – 1.68, p = 0.003) and a borderline significant reduction in the incidence of transplantation (subhazard ratio 0.76, 95% CI 0.58 – 1.00, p = 0.05).ConclusionsIt is difficult to predict the transfer to HD for incident PD patients. PD patients who commence HD with a CVC have a higher risk of mortality and a lower likelihood of undergoing renal transplantation.

scholarly journals Sexual Effect of Platelet-to-Lymphocyte Ratio in Predicting Cardiovascular Mortality of Peritoneal Dialysis Patients

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Hui Sheng ◽  
Yagui Qiu ◽  
Xi Xia ◽  
Chunyan Yi ◽  
Jianxiong Lin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Relationship Of ◽  
The Relationship ◽  
Cvd Mortality

Background. The study is aimed at exploring the relationship of platelet-to-lymphocyte (PLR), all-cause, and cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients based on gender. Methods. A total of 1438 PD patients from January 1,2007 to December 31, 2014 in PD center at The First Affiliated Hospital, Sun Yat-sen University, were included. Patients were followed up until December 31, 2019. The endpoint was all-cause mortality and CVD mortality. Cox proportional hazards regression models were used to evaluate the association of PLR with all-cause and CVD mortality to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results. After a median of 48.9 (interquartile range [IQR]: 23.4-79.3) months of follow-up, 406 (28.2%) patients died based on all-cause death, among which 200 (49.3%) patients died from CVD. In the multivariate Cox regression model, we found that PLR was independently related to an increased risk of CVD mortality only in female PD patients, with HR of 1.003 (95% CI: 1.001-1.006). Interaction test showed that the correlation between PLR level for all-cause and CVD mortality varied with gender ( p = 0.042 and p = 0.012 , respectively). Conclusion. Higher PLR was associated with a higher risk of CVD mortality in female PD patients.

scholarly journals PERAN EDUCATOR PERAWAT DENGAN PELAKSANAAN DISCHARGE PLANNING PADA PASIEN DI RUANG TULIP 1C RSUD ULIN BANJARMASIN

2017 ◽  
Vol 4 (2) ◽  
pp. 82 ◽  
Author(s):  
Endang Pertiwiwati ◽  
Ichsan Rizany
Keyword(s):  
Health Care Workers ◽  
Discharge Planning ◽  
Chi Square ◽  
Cross Sectional ◽  
Care Workers ◽  
Chi Square Test ◽  
Relationship Of ◽  
The Relationship

ABSTRAKDischarge planning merupakan interaksi dan kolaborasi antara petugas kesehatan, pasien, dan keluarga untuk memberikan dan mengatur kontinuitas perawatan yang diperlukan pasien.  Selama pelaksanaan discharge planning, perawat berperan melakukan pendidikan kepada pasien dan keluarga untuk mempersiapkan pemulangan dan kebutuhan untuk perawatan tindak lanjut di rumah. Penelitian ini bertujuan untuk mengetahui hubungan peran educator perawat dengan pelaksanaan discharge planning pada pasien  di Ruang Tulip 1C RSUD Ulin Banjarmasin. Rancangan penelitian ini adalah observasional analitik dengan cross sectional menggunakan sampling jenuh, dan subjek penelitian sebanyak 29 responden. Peran educator yang baik sebanyak 17 orang (59%) dan pelaksanaan discharge planning baik sebanyak 18 orang (62%). Analisis data menggunakan uji Chi Square dengan hasil didapatkan nilai p=0,002 yang berarti p<0,05, sehingga dapat disimpulkan bahwa ada hubungan bermakna antara peran educator perawat dengan pelaksanaan discharge planning pada pasien di Ruang Tulip 1C  RSUD Ulin Banjarmasin.Kata-kata kunci: perawat, discharge planning, peran educator.ABSTRACTDischarge planning is the interaction and collaboration among of health care workers, patients, and families together to provide and arrange the necessary continuity of patient care. During the implementation of discharge planning, nurses play a role in education to the patient and family for prepare the return and the possible need for follow-up care at home. This study aimed to determined the relationship of the educator nurse’s role with the implementation of discharge planning for patients in  Tulip 1C RSUD Ulin Banjarmasin. The study design was observational analytic cross sectional using saturated sampling and the subjects were 29 respondents. The role of a good educator were 17 people (59%) and the implementation of good discharge planning were 18 people (62%). Data analysis using Chi Square test with the results obtained p = 0.002, which means p <0.05, so it can be concluded that there was a significant relationship between the nurse educator role with the implementation of discharge planning for patients in Tulip 1C RSUD Ulin Banjarmasin.Keywords: nurse, discharge planning, educator role.

scholarly journals A Landscape Approach to Aspen Restoration: Understanding the Role of Biophysical Setting in Aspen Community Dynamics

2001 ◽  
Vol 25 ◽  
pp. 135-139
Author(s):  
Kathryn Brown ◽  
Andrew Hansen
Keyword(s):  
Community Dynamics ◽  
Fire Suppression ◽  
First Year ◽  
Landscape Approach ◽  
Greater Yellowstone ◽  
Northern Rockies ◽  
Abiotic Variables ◽  
Relationship Of ◽  
The Relationship

The aim of this study is to better understand the relationship of biotic and abiotic variables to the distribution, performance, and rates of loss of aspen in the Greater Yellowstone Ecosystem. Aspen commumtles, though critically important for maintaining biodiversity, soil quality, and nutrient cycling, are declining rapidly in the Northern Rockies. Fire suppression, elk browsing, and climatic change are the most widely advanced explanations for this widespread loss of aspen. The role of biophysical factors (e.g. topography, climate, soils, and competing vegetation) in determining aspen performance, however, is poorly understood. Knowledge of these relationships may provide a basis for tailoring aspen restoration efforts to specific landscape settings. To better understand the influence of biophysical variables on aspen dynamics, this study addresses three hypotheses: 1. The aerial distribution of aspen is not random across the landscape and varies as a function of biophysical setting. 2. Within its distribution, growth rates and productivity of aspen stands differ relative to biotic and abiotic variables. 3. Rates of aspen loss in the landscape differ relative to biophysical setting. Here we report progress on the first year of the two-year study.

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