Abstract P220: Hemorrhagic Stroke Patients Admitted to Inpatient Rehabilitation Facilities Improve Differently Based on Their Involvement of Corticospinal Tract

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Shayandokht Taleb ◽  
Dorothea Parker ◽  
Lamya Ibrahim ◽  
Billie Hsieh ◽  
Muhammad E Haque ◽  
...  
Keyword(s):  
Corticospinal Tract ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Inpatient Rehabilitation ◽  
Functional Improvement ◽  
Volume Estimate ◽  
Factors Affecting ◽  
Rehabilitation Facilities ◽  
And Gender ◽  
Time Of Admission

Introduction: We asked whether intracerebral hemorrhage (ICH) patients admitted to inpatient rehabilitation facilities(IRF) improve differently based on their involvement of the corticospinal tract(CST). Aim: To predict associating radiological factors affecting discharge FIM score. Methods: We reviewed the patients’ characteristics and their respective imaging findings presenting with ICH between 4/17 to 8/19. The ICH volume and edema around the ICH were measured using analyze software. The main outcome measure was FIM score at time of discharge. Statistical significance was set at 0.05. Results: Among the 53 patients included, 49% were female. The median age of the patients was 62 years (IQR 25,89). The median length of stay at IRF was 22days (IQR 14,26). In univariate analysis, FIM score at the time of discharge FIM score at the time of discharge admission were significantly associated with NIHSS (estimate -1.26, p<0.001), and ICH volume (estimate -3.45, p=0.01). However, the univariate analysis did not reveal an association of age (estimate -0.15, p=0.4) and gender (estimate 0.207, p=0.97) with FIM score at the time of discharge.Multiple regression analysis reflected that the CST involvement had a decrement in functional improvement on FIM in comparison with patients with intact CST when adjusting for age ( p = 0.008), gender ( p <0.01), NIHSS at the time of admission ( p <0.01), and the ICH volume ( p =0.02). Conclusion: This preliminary study suggests that functional improvement declines in ICH patients with CST involvement.

scholarly journals Prognostic Factors for Tumor Recurrence after a 12-Year, Single-Center Experience of Liver Transplantations in Patients with Hepatocellular Carcinoma

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Matteo Cescon ◽  
Matteo Ravaioli ◽  
Gian Luca Grazi ◽  
Giorgio Ercolani ◽  
Alessandro Cucchetti ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Microvascular Invasion ◽  
Proportional Hazard ◽  
Single Center ◽  
Tumor Treatment ◽  
Factors Affecting ◽  
Single Center Experience ◽  
Liver Transplantations

Background. Factors affecting outcomes after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) have been extensively studied, but some of them have only recently been discovered or reassessed.Methods. We analyzed classical and more recently emerging variables with a hypothetical impact on recurrence-free survival (RFS) in a single-center series of 283 patients transplanted for HCC between 1997 and 2009.Results. Five-year patient survival and RFS were 75% and 86%, respectively. Thirty-four (12%) patients had HCC recurrence. Elevated preoperative alpha-fetoprotein (AFP) levels, preoperative treatments of HCC, unfulfilled Milan and up-to-seven criteria at final histology, poor tumor differentiation, and tumor microvascular invasion negatively affected RFS by univariate analysis. Milan and up-to-seven criteria applied preoperatively, and the use of m-TOR inhibitors did not reach statistical significance. Cox's proportional hazard model showed that only elevated AFP levels (Odds ; 95% –5.80; ), preoperative tumor treatments (Odds ; 95% –16.42; ), and microvascular invasion (Odds ; 95% –12.41; ) were predictors of lower RFS.Conclusions. Biological aggressiveness and preoperative tumor treatment, rather than traditional and expanded dimensional criteria, conditioned the outcomes in patients transplanted for HCC.

Factors Affecting Outcome of Patients with Refractory/Relapsed Hodgkin’s Disease (HD) Treated with IGEV Chemotherapy (CT) and High Dose Consolidation Therapy (HDT) with Stem Cell Rescue.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2091-2091
Author(s):  
Monica Balzarotti ◽  
Michele Spina ◽  
Massimo Magagnoli ◽  
Teodoro Chisesi ◽  
Antonello Pinto ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
High Dose ◽  
Refractory Disease ◽  
Chi Square ◽  
Factors Affecting ◽  
Stem Cell Rescue ◽  
Logistic Analysis ◽  
Intent To Treat

Abstract Purpose: to identify prognostic factors in pts with relapsing/refractory HD treated with IGEV CT and HDT Methods: From 01/98 to 01/05 104 patients (pts) from our institutions with relapsed/refractory HD received 4 induction cycles of IGEV (ifosfamide 2000 mg/mq d 1–4; gemcitabine 800 mg/mq d 1& 4; vinorelbine 20 mg/mq d 1; prednisolone 100 mg/mq d 1–4, and G-CSF) and HDT consolidation. Prognostic factors for freedom for progression (FFP) were analyzed by means of the chi-square and Fisher’s exact tests. Multivariate regression logistic analysis was then applied for variable associated with outcome. Results: Main pt characteristics at accrual: M/F 56/48, median age 31 (range 17–65), refractory/relapsed following last CT course 40/64, median previous CT regimens: 1 (range 1–2), simptoms A/B 32/71, Hasenclever (IPS) score <3/≥ 4: 72/24 (8 pts not evaluable), LDH ratio ≤ 1/> 1: 68/35, previous radiotherapy (RT) yes/no: 62/42. After induction, 45 pts (43%) obtained complete remission (CR), 41(40%) partial remission (PR) and18 (17)% di not response (NR). Overall 89 pts received HDT and at the end of the treatment program 76 out of 104 pts were in CR. On an intent-to treat analysis, two-year freedom from progression (FFP) and overall survival (OS) for the whole series were 47% and 74,6%, respectively. In univariate analysis FFP was negatively influenced by B symptoms, IPS score ≥ 4, LDH ratio > 1, refractory disease, and by response to IGEV (see table). Multivariate analysis revealed that factors retaining statistical significance were refractory disease, B symptoms, high IPS score and chemoresistance (see table). Conclusions: based on this analysis, a prognostic model for IGEV-treated patients with refractory/relapsed HD can be constructed. Factors influencing FFP Factor ≥ FFP p (univariate) p(multivariate) Symptoms B/A 16/57% 0.003 0.007 IPS > 4/< 3 32/51% 0.0035 0.051 LDH >1/<1− 19/61% 0.003 n.s. refrac/relaps 22.5/62% < 0.001 0.012 < CR/CR to IGEV 32/68% 0.002 n.s. NR/CR + PR 23.5/52% 0.001 0.005

Abstract P191: A Large Cohort Study Predicting the Temporal Course and Rate of Improvement in Stroke Patients Admitted to Inpatient Rehabilitation Facilities

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Shayandokht Taleb ◽  
Dorothea Parker ◽  
Billie Hsieh ◽  
Mohammad H Rahbar ◽  
Joseph Wozny ◽  
...  
Keyword(s):  
Goodness Of Fit ◽  
Statistical Significance ◽  
Age At Onset ◽  
Inpatient Rehabilitation ◽  
Change Score ◽  
Large Cohort ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Rehabilitation Facilities ◽  
Stroke Type

Introduction: We sought to predict the course and rate of functional improvement and length of stay (LOS) in patients with ischemic and hemorrhagic strokes admitted to inpatient rehabilitation facilities(IRF). Aim: To study the course and associating factors affecting functional outcomes among a large cohort of stroke patients admitted to IRFs. Methods: The cohort consists of stroke patients admitted to 5 IRFs in Houston, between 4/17-8/19. Higher order polynomial (quartic, cubic, quadratic) regressions were fitted to predict the temporal relationship between FIM score improvement and LOS, and based on goodness of fit statistics, cubic polynomial fit was selected. Effects of interactions were tested and later dropped from the final model because of non-statistical significance. Models were adjusted for age, gender, stroke type (hemorrhagic vs ischemic), and stroke severity based on NIHSS. Results: The demographics of patients are presented in table 1. Among 679 patients, the univariate analyses reflected that age (F=24.2, p <0.001), admission NIHSS score (F=67, p<0.001), stroke type (F=25.2, p <0.001), and admission FIM (F=283, P<0.001) were significant factors predicting IRF LOS. History of previous stroke, diabetes, hypertension, and hyperlipidemia did not have any significant effects on LOS. In multiple regression model, age at onset (β=-0.18, p<0.001), hemorrhagic vs ischemic stroke (β=3.02, p <0.01) were significant predictors of total FIM change score when adjusting for stroke severity and gender. Total FIM change score was positively correlated with LOS at IRF with a steep improvement in the first 15 days of IRF stay which plateaued afterwards in patients with 1-30 days of IRF stay (Fig. 2). Conclusion: Patient’s age, ischemic vs hemorrhagic stroke were the most significant predictors when deriving the relationship between total FIM score and LOS while adjusting for stroke severity and patient’s gender, which plateaued after 2 weeks of IRF stay.

Abstract TP146: Rate of Functional Improvement for Stroke Patients Plateaus During Inpatient Rehabilitation

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shayandokht Taleb ◽  
Amy Durand ◽  
Melissa Huynh ◽  
Kaushik Parsha ◽  
Dorothea Parker ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcomes ◽  
Hemorrhagic Stroke ◽  
Polynomial Regression ◽  
Inpatient Rehabilitation ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Improvement Rate ◽  
Score Improvement ◽  
Rehabilitation Facilities

Introduction: Functional outcomes and length of stay (LOS) are common outcome measures in stroke patients at Inpatient Rehabilitation Facilities (IRF). Aim: To examine trends in functional outcomes among patients with hemorrhagic versus ischemic stroke in IRF. Methods: Using a prospectively collected database of stroke patients admitted in our health system of 5 IRFs in Houston, we reviewed patients with either ischemic or hemorrhagic stroke between 1/18 to 6/19. The main outcome measure was the FIM scores. The relationship between LOS and FIM score improvement were analyzed using a third order polynomial regression model. Results: Among 88 patients, 43% were female and 60% had an ischemic stroke. The median LOS was 21 days (IQR14, 26) for all patients; 22 (IQR16, 30) in patients with hemorrhagic stroke; 20.5 (IQR14, 25) in patients with ischemic stroke (P: 0.24). Based on change in FIM, stroke patients benefited the most from IRF in the first 17 days (P<.0001) while the improvement rate declined significantly afterwards with the highest FIM score change of 32. The FIM score changes were not significantly different when adjusting for CMI. There were no significant differences in FIM changes and extent of temporal benefit between ischemic and hemorrhagic strokes. Moreover, bathing, dressing, tub transfer and walking were the areas of greatest improvement (Median change: 2 for all variables). Conclusion: Stroke patients in our IRF network benefit the most on FIM in the first 17 days. Further studies are needed to identify factors that could maximize functional gains in IRF.

The integrated interventional radiology match: a bibliometric analysis of matched first-year residents

2019 ◽  
Vol 3 ◽  
pp. 13 ◽  
Author(s):  
Vishnu Chandra ◽  
Neil Jain ◽  
Pratik Shukla ◽  
Ethan Wajswol ◽  
Sohail Contractor ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Bibliometric Analysis ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Impact Factors ◽  
Index Number ◽  
Research Information ◽  
H Index ◽  
Scopus Database ◽  
Journal Impact

Objectives: The integrated interventional radiology (IR) residency has only been established relatively recently as compared to other specialties. Although some preliminary information is available based on survey data five, no comprehensive bibliometric analysis documenting the importance of the quantity and quality of research in applying to an integrated-IR program currently exists. As the first bibliometric analysis of matched IR residents, the data obtained from this study fills a gap in the literature. Materials and Methods: A list of matched residents from the 2018 integrated-IR match were identified by contacting program directors. The Scopus database was used to search for resident research information, including total publications, first-author publications, radiology-related publications, and h-indices. Each matriculating program was categorized into one of five tiers based on the average faculty Hirsch index (h-index). Results: Sixty-three programs and 117 matched residents were identified and reviewed on the Scopus database. For the 2018 cycle, 274 total publications were produced by matched applicants, with a mean of 2.34 ± 0.41 publication per matched applicant. The average h-index for matched applicants was 0.96 ± 0.13. On univariate analysis, the number of radiology-related publications, highest journal impact factor, and h-index were all associated with an increased likelihood of matching into a higher tier program (P < 0.05). Other research variables displayed no statistical significance. All applicants with PhDs matched into tier one programs. Conclusions: Research serves as an important element in successfully matching into an integrated-IR residency. h-index, number of radiology-related manuscripts, and highest journal impact factors are all positively associated with matching into a higher tier program.

Subjective factors affecting gun shooting accuracy among employees of internal affairs agencies in process of learning

2020 ◽  
Vol 2020 (4) ◽  
pp. 198-206
Author(s):  
Anton Rozhkov ◽  
Anton Popov ◽  
Vitaliy Balahonskiy
Keyword(s):  
Subjective Experience ◽  
Statistical Significance ◽  
Self Regulation ◽  
Sensorimotor Coordination ◽  
Factors Affecting ◽  
Intelligent Behavior ◽  
Experience Of Stress ◽  
Firing Line ◽  
High Level ◽  
In Fire

The article is devoted to the study of subjective factors affecting shooting accuracy of law enforcement officers. The empirical study identified some subjective factors reducing gun shooting accuracy and effectiveness among law enforcers. These characteristics include sensorimotor coordination and subjective experience of stress during the shooting process. Scientific analysis made it possible to determine statistical significance of the influence of these factors on the accuracy of shooting. To increase the effectiveness of shooting among officers with a low index of sensorimotor coordination, the authors suggest using exercises aimed at cultivating sensorimotor coordination in fire training classes. While working with employees being under a high level of subjectively experienced stress, more attention should be paid to training techniques to overcome stress and form intelligent behavior in extreme situations. The authors also draw readers’ attention to factors increasing the effectiveness of shooting: officers’ ability to determine the subjective level of stress, their knowledge of emotional self-regulation techniques, knowledge of the sequence of their actions in the firing line.

scholarly journals SURG-22. CUSHING’S DISEASE: A DIFFICULT TO TREAT NEURO-ONCOLOGICAL CONDITION

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi244-vi244
Author(s):  
Santanu Bora ◽  
Ashish Suri
Keyword(s):  
Cortisol Level ◽  
Remission Rate ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Plasma Cortisol Level ◽  
Cushing Disease ◽  
Factors Affecting ◽  
Microscopic Surgery ◽  
Acth Secreting ◽  
Better Than

Abstract BACKGROUND Cushing disease (CD) comprises a spectrum of clinical manifestations secondary to hypercortisolism due to ACTH-secreting pituitary adenoma. Transsphenoidal adenomectomy remains the standard treatment. Because of the significant rate of recurrence or persistence of CD, it is of interest to determine factors that may correlate with long-term outcomes following surgical intervention. OBJECTIVE The objective of our study is to determine the remission rate after surgery with special emphasis on factors affecting remission. METHODS Data of all patients undergoing surgery for CD from 2009 to 2017 was analyzed retrospectively. Transphenoidal resection was the preferred treatment with a recent trend in favor of endonasal endoscopic skull base approach. Post-operative cortisol level of < 2 μg/dL was taken as remission and value between 2 and 5 μg/dL as possible remission. RESULTS 104 patients operated primarily for CD were included for analysis. 47 patients underwent microscopic surgery, 55 endoscopic surgery and two were operated trans-cranially. Remission was achieved in 76.47% of patients. In univariate analysis, factors significantly associated with remission were (1) type of surgery (p=0.01); endoscopy (88.23% remission) better than microscopy (56.6% remission) (2) postoperative day-1 morning cortisol (p=0.004) and; (3) postoperative day-1 morning ACTH (p=0.015). In multivariate analysis, however only postoperative day-1 cortisol was found to be significant as predictor of remission (p=0.02). CONCLUSION Postoperative plasma cortisol level is a strong independent predictor of remission and value less than 10.7µgm/dl can be taken as cut off for predicting remission. Remission provided by endoscopy appears to be significantly better than microscopic approach.

Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 191-195 ◽  
Author(s):  
Chia-Te Liao ◽  
Chih-Chung Shiao ◽  
Jenq-Wen Huang ◽  
Kuan-Yu Hung ◽  
Hsueh-Fang Chuang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Clinical Laboratory ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Residual Renal Function ◽  
Measure Data ◽  
Chi Square ◽  
Artery Disease

⋄ Objective Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan. ⋄ Methods The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR. ⋄ Results All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis. ⋄ Conclusions Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.

Capture Rates of Comorbidity Measures at Inpatient Rehabilitation Facilities After a Stroke or Brain Injury

PM&R ◽  
2021 ◽  
Author(s):  
Gregory T. Robbins ◽  
Richard Goldstein ◽  
Sameer Siddiqui ◽  
Donna S. Huang ◽  
Ross Zafonte ◽  
...  
Keyword(s):  
Brain Injury ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Facilities ◽  
Capture Rates

scholarly journals Vitamin D Deficiency as a Risk Factor for Myocardial Ischemia

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 774
Author(s):  
Christina Batsi ◽  
Evangelia Gkika ◽  
Loukas Astrakas ◽  
Athanassios Papadopoulos ◽  
Ioannis Iakovou ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Myocardial Ischemia ◽  
Single Photon ◽  
Statistical Significance ◽  
Photon Emission ◽  
Serum Levels ◽  
Emission Computed Tomography ◽  
And Gender ◽  
D Values

Background and Objectives: Vitamin D (Vit D) deficiency has been implicated in various conditions, including cardiovascular disease. The purpose of this retrospective study was to investigate the incidence of patients with myocardial ischemia in relation to their serum levels of vitamin D. Materials and Methods: A 64-month search (January 2016 to April 2021) in our database of the Nuclear Medicine Laboratory revealed 113 patients who had both myocardial perfusion imaging with single photon emission computed tomography (MPI SPECT) and Vit D measurements. MPI SPECT obtained myocardial images during both stress (summed stress score, SSS) and rest (summed rest score, SRS). Abnormal MPI SPECT was when the SSS was ≥4. Vit D was determined by radioimmunoassay (RIA). Patients with Vit D values <10 ng/mL, 10–29 ng/mL and ≥30 ng/mL were defined as having a deficiency, insufficiency and sufficiency, respectively. Results: Among patients, 46/113 (40.7%) were male and 67/113 (59.3%) were female. Abnormal MPI was found in 58/113 (51.3%) patients. Vit D deficiency was noted in 20/113 (17.7%) patients, insufficiency in 86/113 (76.1%) patients, and normal Vit D was noted in only 7/113 (6.2%) patients. Sixteen of the 20 patients (80%) with Vit D deficiency, and 38/86 (44.2%) with insufficiency had an abnormal MPI SPECT. In contrast, only 1/7 (14.3%) patients with sufficient Vit D levels had an abnormal MPI SPECT. The Mann-Whitney U-test showed that ischemia reduced the values of Vit D. Correlation analysis showed a negative association of Vit D levels with SSS (rho = −0.232, p = 0.014) and SRS (rho = −0.250, p = 0.008). Further evaluation with a Vit D cut off 20 ng/mL retrieved no statistical significance. Finally, Vit D and gender were independently associated with myocardial ischemia. Conclusions: Low Vit D levels may represent a risk factor for myocardial ischemia.

Sign in / Sign up

Export Citation Format

Share Document