scholarly journals Use of HBA1c and potentiality of gender, missed medication and fasting glucose in the prediction of poor glycemic control in resource-limited setting; a clinic-based case-control study

2020 ◽  
Vol 2 ◽  
Author(s):  
Daniel Wilfred Gunda ◽  
Hussein Abbas Bandali ◽  
Evangelista Kenan Malindisa ◽  
Benson Richard Kidenya
Keyword(s):  
Glycemic Control ◽  
Case Control Study ◽  
Fasting Glucose ◽  
Case Control ◽  
Resource Limited Setting ◽  
Poor Glycemic Control ◽  
Resource Limited ◽  
Control Study ◽  
Limited Setting

scholarly journals Schistosoma mansoni-related periportal fibrosis; can we use APRI and PSDR levels in the real-time selection of patients for targeted endoscopy in a resource-limited setting? A case–control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel W. Gunda ◽  
Elizabeth F. Mtui ◽  
Paulina M. Manyiri ◽  
David C. Majinge ◽  
Semvua B. Kilonzo ◽  
...  
Keyword(s):  
Schistosoma Mansoni ◽  
Case Control Study ◽  
Validation Cohort ◽  
Case Control ◽  
Derivation Cohort ◽  
Non Invasive ◽  
Periportal Fibrosis ◽  
Resource Limited ◽  
Control Study ◽  
Limited Setting

Abstract Background Schistosoma mansoni related hepatic fibrosis is usually associated with hemodynamic alteration with increased mortality due to bleeding varices. The diagnosis of varices before bleeding imposes a big challenge in resource-limited countries using endoscopy. Published evidence on the utility of non-invasive clinical tools in predicting the presence of varices among patients with S. mansoni related periportal fibrosis is still inadequate including Aspartate to platelet ratio index (APRI) and Platelet to splenic diameter ratio (PSDR) levels. This study describes the determinants of portal varices and assesses the potential utility of the APRI and PSDR level in the discrimination of portal varices among patients with S. mansoni related periportal fibrosis (PPF). Methods A case–control study using cross-sectional data was done among patients with Schistosoma mansoni related periportal fibrosis at Bugando Medical Centre, in Mwanza Tanzania. The derivation cohort included patients enrolled between 2015 and 2019 and the validation cohort included patients enrolled from 2019 till March 2021. Socio-demographic, laboratory, ultrasound, and upper digestive endoscopic information were analyzed using STATA 13. The prevalence and determinants of varices were determined by logistic regression. The sensitivity and specificity of independent factors were determined to assess their utility in discriminating the presence of portal varices in patients with PPF. Results In total, 250 patients were included in the derivation cohort, 109 (43.6%; 95% CI 37.3–49.9) of them had varices. The odds of having varices were independently increased among patients with higher APRI levels than 1.51, (AOR: 5.8; 95% CI 3.1–11.1; p < 0.001) and PSDR levels that were lower than 5700 (AOR: 5.9; 95% CI 3.2–11.2; p < 0.001). Both APRI and PSDR levels had significantly high sensitivity and specificity in predicting the presence of esophageal varices. However, the combined values of APRI and PSDR had higher specificity than any of the two markers. Of the 200 patients in the validation cohort 94 (47.0%; 95% CI 40.0–54.2) had varices, the discriminative power of the final model and the predictive ability of both APRI, PSDR, and APRI-PSDR combined levels were highly maintained. Conclusions This study indicates that varices are a common encounter among patients with S. mansoni related periportal fibrosis and it is independently associated with higher APRI and lower PSDR levels suggesting that these tools are potential discriminators of varices in this subgroup of patients. The reproducibility of these results should further be assessed longitudinally as potential non-invasive tools in selecting patients at high risk of having esophageal varices who could benefit from the targeted endoscopic intervention in a resource-limited setting like ours.

scholarly journals Risk factors for hospital-acquired ‘poor glycemic control’: a case–control study

2010 ◽  
Vol 23 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Matthew D. Mchugh ◽  
Jingjing Shang ◽  
Douglas M. Sloane ◽  
Linda H. Aiken
Keyword(s):  
Risk Factors ◽  
Glycemic Control ◽  
Case Control Study ◽  
Case Control ◽  
Poor Glycemic Control ◽  
Hospital Acquired ◽  
Control Study

Abnormalities in the Exocrine Pancreas May Explain Poor Glycemic Control in Type 2 Diabetes: A Pilot Case-Control Study

2011 ◽  
Vol 140 (5) ◽  
pp. S-70
Author(s):  
Beatriz Cigarran-Vicente ◽  
Enrique Dominguez-Munoz ◽  
Ana Alvarez-Castro ◽  
Julio Iglesias-Garcia
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Exocrine Pancreas ◽  
Case Control Study ◽  
Case Control ◽  
Poor Glycemic Control ◽  
Control Study

scholarly journals Schistosoma mansoni-related periportal fibrosis; can we use APRI and PSDR levels in the real-time selection of patients for targeted endoscopy in a resource-limited setting? A case-control study

2020 ◽  
Author(s):  
Daniel W. Gunda ◽  
Elizabeth F. Mtui ◽  
Paulina M. Manyiri ◽  
David C. Majinge ◽  
Semvua B. Kilonzo ◽  
...  
Keyword(s):  
Schistosoma Mansoni ◽  
Esophageal Varices ◽  
Case Control Study ◽  
Case Control ◽  
Potential Utility ◽  
Non Invasive ◽  
Periportal Fibrosis ◽  
Resource Limited ◽  
Control Study ◽  
Limited Setting

Abstract Background Schistosoma mansoni related hepatic fibrosis is usually associated with hemodynamic alteration with increased mortality due to bleeding varices. The diagnosis of varices before bleeding imposes a big challenge in resource-limited countries using endoscopy. Published evidence on the utility of non-invasive clinical tools in predicting the presence of varices among patients with S. mansoni related periportal fibrosis is still inadequate including Aspartate to platelet ratio index (APRI) and Platelet to splenic diameter ratio (PSDR) levels. This study describes the determinants of portal varices and assesses the potential utility of the APRI and PSDR level in the discrimination of portal varices among patients with S. mansoni related periportal fibrosis (PPF). Methods A case-control study using cross-sectional data was done among patients with Schistosoma mansoni related periportal fibrosis at Bugando Medical Centre, in Mwanza Tanzania. Socio-demographic, laboratory, ultrasound, and upper digestive endoscopic information were collected for analysis using STATA 13. The prevalence of varices was calculated and its associated factors were determined by logistic regression. The sensitivity and specificity of independent factors were determined to assess their potential utility in discriminating the presence of portal varices in patients with PPF.Results In total, 250 patients were included in this study, 109 (43.6%; 95%CI: 37.3-.49.9) of them had varices. On multivariate analysis the odds of having varices were independently increased among patients with higher APRI levels than 1.51, (AOR: 5.8; 95%CI: 3.1-11.1; p<0.001) and PSDR levels that were lower than 5700 (AOR: 5.9; 95%CI: 3.2-11.2; p<0.001). Both APRI and PSDR levels had significantly high sensitivity and specificity in predicting the presence of esophageal varices. However, the combined values of APRI and PSDR had higher specificity than any of the two markersConclusions This study indicates that varices are a common encounter among patients with S. mansoni related periportal fibrosis and it is independently associated with higher APRI and lower PSDR levels suggesting that these tools are potential discriminators of varices in this subgroup of patients. The reproducibility of these results should further be assessed longitudinally as potential non-invasive tools in selecting patients at high risk of having esophageal varices who could benefit from the targeted endoscopic intervention in a resource-limited setting like ours.

scholarly journals Schistosoma mansoni-related periportal fibrosis; can we use APRI and PSDR levels in the real-time selection of patients for targeted endoscopy in a resource-limited setting? A case-control study

2020 ◽  
Author(s):  
Daniel W. Gunda ◽  
Elizabeth F. Mtui ◽  
Paulina M. Manyiri ◽  
David C. Majinge ◽  
Semvua B. Kilonzo ◽  
...  
Keyword(s):  
Schistosoma Mansoni ◽  
Esophageal Varices ◽  
Case Control Study ◽  
Case Control ◽  
Potential Utility ◽  
Non Invasive ◽  
Periportal Fibrosis ◽  
Resource Limited ◽  
Control Study ◽  
Limited Setting

Abstract Background Schistosoma mansoni related hepatic fibrosis is usually associated with hemodynamic alteration with increased mortality due to bleeding varices. The diagnosis of varices before bleeding imposes a big challenge in resource-limited countries using endoscopy. Published evidence on the utility of non-invasive clinical tools in predicting the presence of varices among patients with S. mansoni related periportal fibrosis is still inadequate including Aspartate to platelet ratio index (APRI) and Platelet to splenic diameter ratio (PSDR) levels. This study describes the determinants of portal varices and assesses the potential utility of the APRI and PSDR level in the discrimination of portal varices among patients with S. mansoni related periportal fibrosis (PPF). Methods A case-control study using cross-sectional data was done among patients with Schistosoma mansoni related periportal fibrosis at Bugando Medical Centre, in Mwanza Tanzania. Socio-demographic, laboratory, ultrasound, and upper digestive endoscopic information were collected for analysis using STATA 13. The prevalence of varices was calculated and its associated factors were determined by logistic regression. The sensitivity and specificity of independent factors were determined to assess their potential utility in discriminating the presence of portal varices in patients with PPF.Results In total, 250 patients were included in this study, 109 (43.6%; 95%CI: 37.3-.49.9) of them had varices. On multivariate analysis the odds of having varices were independently increased among patients with higher APRI levels than 1.51, (AOR: 5.8; 95%CI: 3.1-11.1; p<0.001) and PSDR levels that were lower than 5700 (AOR: 5.9; 95%CI: 3.2-11.2; p<0.001). Both APRI and PSDR levels had significantly high sensitivity and specificity in predicting the presence of esophageal varices. However, the combined values of APRI and PSDR had higher specificity than any of the two markersConclusions This study indicates that varices are a common encounter among patients with S. mansoni related periportal fibrosis and it is independently associated with higher APRI and lower PSDR levels suggesting that these tools are potential discriminators of varices in this subgroup of patients. The reproducibility of these results should further be assessed longitudinally as potential non-invasive tools in selecting patients at high risk of having esophageal varices who could benefit from the targeted endoscopic intervention in a resource-limited setting like ours.

scholarly journals Diabetes, Glycemic Control, and Risk of Tuberculosis: A population-based case-control study

Diabetes Care ◽  
2011 ◽  
Vol 34 (12) ◽  
pp. 2530-2535 ◽  
Author(s):  
A. Leegaard ◽  
A. Riis ◽  
J. B. Kornum ◽  
J. B. Prahl ◽  
V. O. Thomsen ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Control Study

Implications of pancreatic cancer with diabetes mellitus on patient outcomes and care: A matched case-control study.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 239-239
Author(s):  
Nina J. Karlin ◽  
Shailja Amin ◽  
Matthew Buras ◽  
Heidi E. Kosiorek ◽  
Patricia M. Verona ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Glycemic Control ◽  
Cancer Diagnosis ◽  
Case Control Study ◽  
Case Control ◽  
Kaplan Meier ◽  
The Impact ◽  
Control Study ◽  
Over Time

239 Background: The aim of this case-control study was to determine the impact of DM on survival in pancreatic cancer patients, and to examine the impact of pancreatic cancer on glycemic control in DM. Methods: Ninety-two patients with newly diagnosed pancreatic cancer from 2007 to 2015 with DM were identified from the institutional Cancer Registry and matched to ninety-two pancreatic cancer patients without DM according to age, gender, and year of pancreatic cancer diagnosis. The file was linked to the electronic medical record to obtain information on DM and pancreatic cancer therapies, and laboratory results. Overall survival (OS) was estimated with the Kaplan-Meier method and compared by Cox regression analysis. Mixed models were used to compare hemoglobin A1c (HbA1c) and glucose over time. Results: Mean age of the entire pancreatic cancer cohort was 70 years, most (92%) were white, most common (88%) histology was adenocarcinoma, and majority (41%) were stage IV. No differences in age, race/ethnicity, histology, or tumor stage were detected between patients with and without DM, although DM patients had higher body mass index (P = 0.014). Mean ca 19-9 (U/ml) was 804 for diabetics, and 395 for non-diabetics. Among those with DM the mean HbA1c during the year following cancer diagnosis was 7.3%. Time (days since diagnosis) was significant in DM patients (p = 0.014) as HbA1c decreased over time. Mean glucose during the year following diagnosis among DM patients was significantly higher compared to non-DM patients [160.6 (SD = 38.0) versus 117.2 (SD = 19.0); p < 0.001]. Both groups had a decline in glucose over time (p = 0.008). In Kaplan-Meier survival analysis (median follow-up time of 11.9 months), 2 year overall survival was estimated at 15% [95% CI: 8-24%] for DM patients versus 26% [95% CI: 17-36%] in non-DM patients. Hazard ratio (for matched pairs) was 1.15 (95% CI: 0.75-1.77; p = 0.51). Conclusions: DM did not adversely impact survival in patients with pancreatic cancer. Pancreatic cancer did not affect glycemic control. Elevated ca 19-9 in diabetic patients may be an unreliable marker for gauging disease progression.

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