Abstract P341: Cerebral Microbleeds Load and Long-Term Outcomes in Minor Ischemic Stroke

Background and Purpose: The association between the cerebral microbleed (CMB) count and outcomes in ischemic stroke has not been fully clarified. The aim of this study was to investigate the relationship between the CMB count and functional outcomes in patients with a minor ischemic stroke treated with antiplatelet therapy. Methods: Non-cardiogenic minor ischemic stroke (NIHSS score <4 on admission) patients who were treated with antiplatelet therapy were enrolled. The patients were divided into four groups based on the number of CMBs (absent, 1, 2-4, and >4), and their clinical outcomes were compared. Deep white matter hyperintensities (DWMHs) were assessed using the Fazekas scale, and the relationship between DWMH burden and the CMB count was evaluated. A poor outcome was defined as a modified Rankin scale (mRS) score of 3-6 90 days after symptom onset. Logistic regression analysis was performed to evaluate whether the CMB count contributes to poor outcomes. Results: A total of 240 patients were enrolled, and their pre mRS scores were matched based on CMB presence. The median CMB count increased linearly with the Fazekas scale grade (P<0.001). A higher burden of CMBs was linearly correlated with the rate of poor outcomes (4% in the absent group, 8% in the 1 CMB group, 13% in the 2-4 CMB group, and 20% in the >4 CMB group, P=0.002). Multivariate logistic regression analysis performed with well-known risk factors including DWMH showed that CMB burden (subgroups) was the independent factor associated with poor outcomes (odds ratio 1.75, 95% confidence interval 1.13-2.72, P=0.012), whereas the DWMH burden was not. Conclusion: The CMB count contributes independently to poor outcomes in minor ischemic stroke patients treated with antiplatelet therapy.

Download Full-text

Decreased eGFR Is Associated With Ischemic Stroke in Patients With Dilated Cardiomyopathy

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619866909 ◽

2019 ◽

Vol 25 ◽

pp. 107602961986690 ◽

Cited By ~ 1

Author(s):

Yuqing Deng ◽

Zhiqing Chen ◽

Lili Hu ◽

Zhenyan Xu ◽

Jinzhu Hu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Dilated Cardiomyopathy ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Analysis Model ◽

Multivariate Logistic Regression ◽

Increased Risk

Dilated cardiomyopathy (DCM) is increasingly indicated as a cause of cardioembolic syndrome, in particular, cardioembolic ischemia stroke. However, the potential risk factors for stroke among DCM patients remain under investigated. DCM patients hospitalized from June 2011 to June 2016 were included. The cases were defined as the group of DCM patients with stroke compared with those without stroke. Clinical characteristic data were collected and compared between the two groups including demographic data, complicated diseases, echocardiography index, and laboratory parameters and estimated glomerular filtration rate (eGFR). A multivariate logistic regression analysis model adjusted by sex and age was used to explore the related risk factors for stroke in DCM patients. A total of 779 hospitalized patients with DCM were included. Of these, 55 (7.1%) had experienced a stroke. Significantly lower eGFR levels (68.03 ± 26.22 vs 79.88 ± 24.25 mL/min/1.73 m2, P = .001) and larger left atrial diameters (45.32 ± 7.79 vs 43.25 ± 7.11 mm, P = .04) were found in the group of patients having DCM with stroke compared to those without stroke. When the eGFR was categorized as eGFR >60, 30<eGFR≤ 60 and eGFR ≤ 30, there were more patients with 30<eGFR≤ 60 (30.9% vs 17.7%) and eGFR≤ 30 (9.1% vs 3.3%) in the ischemic stroke group ( P = 0.003). A multivariate logistic regression analysis model adjusted by sex and age showed that 30 <eGFR≤60 (odds ratio [OR]: 2.07, 95% confidence interval [CI]: [1.05-4.07], P = .035) and eGFR≤30 (OR: 4.04, 95% CI: [1.41-11.62], P = .009) were statistically associated with ischemic stroke in patients with DCM. It is concluded that decreased eGFR is significantly associated with an increased risk of ischemic stroke in patients with DCM.

Download Full-text

Association of Mannose Binding Lectin (MBL-2) Deficiency with Pulmonary Infection after Allogeneic Hematopoietic Stem Cell Transplantation (HSCT).

Blood ◽

10.1182/blood.v112.11.2209.2209 ◽

2008 ◽

Vol 112 (11) ◽

pp. 2209-2209

Author(s):

Dick Chung ◽

Lily Ding ◽

Isabelle Amigues ◽

Katuna Kadeishvili ◽

Theresa Lo ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Stem Cell ◽

Logistic Regression Analysis ◽

Pulmonary Infection ◽

Multivariate Logistic Regression Analysis ◽

Wild Type ◽

Multivariate Logistic Regression ◽

Increased Risk ◽

The Relationship

Abstract Background: Low MBL2 concentration and MBL2 genotype variants have been associated with an increased risk of infection in various clinical settings. Pulmonary infection is a major complication of HSCT. We examined the relationship of MBL genotypes with post-engraftment bacterial (B-PNA) and fungal (F-PNA) pneumonia Methods: Retrospective review of 236 non-consecutive, non-selected patients who underwent HSCT at MSKCC from 1/1/2000–4/30/2007. Microbiologically confirmed infections and pneumonias were recorded. Antifungal prophylaxis consisted of fluconazole 400 mg daily. Patients at high risk for mold infection received mold-active prophylaxis. After 1/1/2006 voriconazole was the first line anti-mold prophylaxis. Genotype was determined by PR-Melting Curve Analysis on blood or buccal swab specimens. MBL genotype was classified as wild-type: A/A (MBL-sufficient, MBL-S) or variant-type: A/O, O/O (MBL deficient, MBL-D). Patients were followed for up to 2 years. Statistical analysis: Fisher’s Exact test was used to compare the incidence rate between MBL-S and MBL-D patients. Multivariate logistical regression models were used to investigate the relationship between bacterial or fungal pneumonia and MBL genotype, matched related donor (MRD), myeloablative conditioning (MC) peripheral blood as stem cell source (PBSC), acute GVHD grade 2–4 (aGVHD). The results from Maximum Likelihood Estimates were summarized. Results: Transplant characteristics: 80% MC, 76% PBSC, 48.6% MRD. Incidence of aGVHD: 22.4%. MBL genotypes: One-hundred and forty-two (60%) patients were homozygous for wild-type MBL2 (AA), 85(36%) were heterozygous (A/0) and 9 (3.8%) were homozygous for variant genotypes (OO). Transplant characteristics, rates of GVHD, relapse-free and overall survival were similar between MBL-D and MBL-S. There was higher incidence of overall bacterial infections in MBL-D compared to MBL-S pts (47.87% vs 36.62%, p=0.1049). MBL-D had a higher incidence of B-PNA (12.7% vs 4.9%, p=0.048). In multivariate logistic regression analysis, MBL-D(p=0.04) and aGVHD(p=0.06) were likely associated with B-PNA. Rates of overall fungal infections and F-PNA were similar [among MBL-D and MBL-S pts (12.77% vs 9.86%, p=0.5277) and (8.51% vs 7.75%, p=0.1049) respectively]. In multivariate logistic regression analysis only aGVHD was statistically significantly associated with F-PNA p=0.0002. Conclusions: 1) MBL-D genotype was likely associated with increased risk of bacterial pneumonia. 2) MBL-D and aGVHD were risk factors for B-PNA. 3) Further analyses are in progress to evaluate the effect of MBL-D on fungal pneumonia in patients who received mold prophylaxis versus patients who did not receive mold prophylaxis. 4) Prospective studies are needed to assess the relative contribution of MBL-D genotype on the risk of pulmonary infection in HSCT.

Download Full-text

The Relationship Between Hemodialysis Modality and Insulin Resistance in Non-Diabetic Hemodialysis Patients

Blood Purification ◽

10.1159/000368882 ◽

2015 ◽

Vol 39 (1-3) ◽

pp. 224-229 ◽

Cited By ~ 3

Author(s):

Sung Jin Moon ◽

Jung Eun Lee ◽

Jwa-Kyung Kim ◽

Soo Young Yoon ◽

Shin Wook Kang ◽

...

Keyword(s):

Insulin Resistance ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Hemodialysis Patients ◽

Model Assessment ◽

Multivariate Logistic Regression ◽

Factors Associated ◽

The Relationship

Background: Although various modalities of hemodialysis (HD) are presumed to have different effects on insulin resistance (IR), the relationship between hemodiafiltration (HDF) and IR has not been fully evaluated. Methods: In a cross-sectional study, 82 non-diabetic HD patients were enrolled. The patients were divided into two groups according to the median homeostasis model assessment index (HOMA-IR) value of 1.685. Clinical and biochemical data were compared, and multivariate logistic regression analysis was performed to identify the independent factors associated with higher HOMA-IR. Results: The higher HOMA-IR group had increased body mass index (BMI), decreased HDL cholesterol, and lower beta-2 microglobulin reduction rate (β2-MG RR) compared to the lower HOMA-IR group. HOMA-IR was significantly correlated with β2-MG RR. In addition, HDF patients had lower HOMA-IR levels compared with low flux hemodialysis patients. On multivariate logistic regression analysis, BMI and HDF treatment were independent factors associated with higher and lower HOMA-IR, respectively. Conclusion: This study suggests that HDF treatment may reduce IR in non-diabetic HD patients.

Download Full-text

Delayed Stroke Treatment during COVID-19 Pandemic in China

10.1101/2020.11.17.20228122 ◽

2020 ◽

Author(s):

Shiyuan Gu ◽

Zhengze Dai ◽

Huachao Shen ◽

Yongjie Bai ◽

Xiaohao Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Acute Stroke ◽

Acute Ischemic Stroke ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Intravenous Thrombolysis ◽

Multivariate Logistic Regression ◽

Delayed Treatment

ABSTRACTBackgroundSocial distance, quarantine, pathogen testing and other preventive strategies implemented during COVID-19 pandemic may negatively influence the management of acute stroke.ObjectiveThe current study aimed to evaluate the impacts of COVID-19 pandemic on treatment delay of acute stroke in China.MethodsThis study included patients with acute stroke admitted in two hospitals in Jiangsu, China. Patients admitted before and after the COVID-19 epidemic outbreak (January 31, 2020, as officially announced by Chinese government) were compared for pre- (measured as onset-to-door time) and post-hospital delay (measured as door-to-needle time). The influence factors for delayed treatment (indicated as onset-to-needle time >4.5 hours) were analyzed with multivariate logistic regression analysis.ResultsOnset-to-door time increased from 202 min (IQR 65-492) before to 317 min (IQR 75-790) after the COVID-19 pandemic (P=0.001). Door-to-needle time increased from 50min (IQR 40-75) before to 65 min (IQR 48-84) after the COVID-19 pandemic (P=0.048). The proportion of patients with intravenous thrombolysis in those with acute ischemic stroke was decreased significantly after the pandemic (15.4% vs 20.1%; P=0.030). Multivariate logistic regression analysis indicated that patients after COVID-19 pandemic, lower educational level, rural residency, mild symptoms and transported by other means than ambulance were associated with delayed treatment.ConclusionsCOVID-19 pandemic has remarkable impacts on the management of acute ischemic stroke. Both pre- and post-hospital delays were prolonged significantly, and proportion of patient arrived within the 4.5-hour time window for intravenous thrombolysis treatment was decreased. Given that anti-COVID-19 measures are becoming medical routines, efforts are warranted to shorten the delay so that the outcomes of stroke could be improved.

Download Full-text

Serum Albumin Is Negatively Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients

Cerebrovascular Diseases ◽

10.1159/000498855 ◽

2019 ◽

Vol 47 (1-2) ◽

pp. 88-94 ◽

Cited By ~ 4

Author(s):

Changyi Wang ◽

Linghui Deng ◽

Shi Qiu ◽

Haiyang Bian ◽

Lu Wang ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Serum Albumin ◽

Acute Ischemic Stroke ◽

Logistic Regression Analysis ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

Hemorrhagic Transformation ◽

Dependent Manner

Background and Objective: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke (AIS). Serum albumin is known for its neuroprotective effects and is a marker of improved AIS patient outcomes. However, it is not known whether there is a relationship between serum albumin and HT. Methods: AIS patients admitted to the Department of Neurology of West China Hospital from 2012 to 2016 were prospectively and consecutively enrolled. Baseline characteristics were collected. HT during hospitalization was diagnosed by brain imaging. Multivariate logistic regression analysis was performed to determine the relationship between serum albumin and HT. Confounding factors were identified by univariate analysis. Stratified logistic regression analysis was performed to identify effect modifiers. Results: A total of 1996 AIS patients were recruited, of whom 135 (6.8%) developed HT. Serum albumin negatively correlated with HT. Patients in the upper serum albumin tertile (42.6–54.1 g/L) had a 46% lower risk of HT than patients in the lower tertile (19.3–39.1 g/L) after adjustment for potential confounders (OR 0.54, 95% CI 0.29–0.99, p = 0.04). Risk of HT decreased stepwise with higher serum albumin tertile (p for trend = 0.04). There was a significant interaction between serum albumin and age (p = 0.02), with no significant correlation between serum albumin and HT in patients over 60 years of age. Conclusions: Higher serum albumin is associated with lower HT risk in a dose-dependent manner in AIS patients younger than 60 years.

Download Full-text

Use of the angle of progression on ultrasonography to predict spontaneous onset of labor within 7 days

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0106 ◽

2014 ◽

Vol 0 (0) ◽

Author(s):

Geum Joon Cho ◽

Hye-Ri Hong ◽

Hyun-Joo Seol ◽

Bo Hae Koo ◽

Soon-Cheol Hong ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Cervical Length ◽

Nulliparous Women ◽

Intact Membrane ◽

The Relationship ◽

Angle Of Progression ◽

Spontaneous Onset

AbstractTo investigate the relationship between angle of progression (AoP) on ultrasonography at 37–40 weeks’ gestation and delivery within 7 days.This prospective study was conducted between January 2013 and May 2013 at Korea University Guro Hospital, Korea. Nulliparous women between 37/0 and 40/3 weeks’ gestation with a singleton fetus, intact membrane, and cephalic presentation from January 2013 to May 2013 were enrolled. To evaluate the cervical parameters of cervical length and AoP, transvaginal and transperineal ultrasonography were performed, respectively. We then assessed the relationship between cervical parameters and onset of labor within 7 days by multivariate logistic regression analysis.Women who underwent spontaneous onset of labor within 7 days had a significantly shorter cervical length and AoP than those who underwent labor after 7 days. Logistic regression analysis showed that a larger AoP was an independent predictor of spontaneous labor within 7 days.A larger AoP was significantly associated with spontaneous onset of labor within 7 days. These findings may be useful for counseling patients regarding the management of term pregnancies.

Download Full-text

Abstract TP176: Risk Factors and Clinical Significances of the Quantitative CTA Vascular Calcification in Ischemic Stroke Patients

Stroke ◽

10.1161/str.51.suppl_1.tp176 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Takashi Shimoyama ◽

Sibaji Gaj ◽

Kunio Nakamura ◽

Shivakrishna Kovi ◽

Ken Uchino

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Vascular Calcification ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Stroke Patients ◽

Age Category

Background and Purpose: Intracranial arterial calcification is a marker of atherosclerosis burden in the general population. The aim of the study is to investigate risk factor profiles of vascular calcification in ischemic stroke patients. Methods: We identified ischemic stroke patients who underwent complete CTA from a prospective single-hospital stroke registry in 2018. Automatic artery and calcification segmentation method measured calcification volumes in the intracranial, extracranial, and aortic arteries using deep-learning U-net model and region-grow algorithms. Severe vascular calcification was defined as patients in the upper quartile calcification volume. The prevalence of severe vascular calcification and mean calcification volume were investigated by age category (<60 years, 60-70 years, 70-80 years, 80 years ≥). The relation between each potential risk factors and severe vascular calcification was assessed using the multivariate logistic regression analysis adjusted for age, sex, NIHSS score, and TOAST stroke subtypes. Results: Of the 558 consecutive acute ischemic stroke patients, 388 patients (212 males; mean age 66.6±14.2 years) met inclusion and with quantitative CTA calcification. The prevalence of severe vascular calcification (CTA calcification volume> 812 mm 3 ) increased with increasing age category (<60 years: 6.8% (7/103), 60-70 years: 15.7% (18/115), 70-80 years: 39.6% (38/105), 80 years ≥: 45.9% (34/74), P<0.001 for χ 2 test). Over age 80 years subsets had significantly higher mean calcification volume with 1213 mm 3 than other age category (<60 years: 225 mm 3 , P<0.001; 60-70 years: 462 mm 3 , P<0.001; 70-79 years: 817 mm 3 , P=0.020 for t-test). In the multivariate logistic regression analysis, age (OR 1.096, 95% CI 1.066-1.128, P<0.001), smoking (OR 3.430, 95% CI 1.833-6.419, P<0.001), and large artery atherosclerosis (LAA) (OR 4.260, 95% CI 1.963-9.247, P<0.001) were independently associated with severe vascular calcification. Conclusion: In the quantitative CTA analysis of calcification volume, older age and smoking were high risk for severe atherosclerotic calcium burden in ischemic stroke patients. Moreover, severe vascular calcification may differentiate LAA from other stroke etiology.

Download Full-text

Association of Mycobacterium tuberculosis Beijing genotype with tuberculosis relapse in Singapore

Epidemiology and Infection ◽

10.1017/s095026880500525x ◽

2005 ◽

Vol 134 (2) ◽

pp. 329-332 ◽

Cited By ~ 21

Author(s):

Y.-J. SUN ◽

A. S. G. LEE ◽

S.-Y. WONG ◽

N. I. PATON

Keyword(s):

Logistic Regression ◽

Mycobacterium Tuberculosis ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Beijing Genotype ◽

Multivariate Logistic Regression ◽

Tuberculosis Relapse ◽

Relationship Of ◽

The Relationship

The relationship of Mycobacterium tuberculosis Beijing genotype with tuberculosis relapse was examined. Beijing strains were detected from 32 out of 45 (71%) relapsed cases and 148 out of 290 (51%) non-relapsed cases. Multivariate logistic regression analysis revealed that Beijing genotype was significantly associated with tuberculosis relapse (OR 2·64, 95% CI 1·30–5·34, P=0·005).

Download Full-text

ANALISIS HUBUNGAN SARANA, PENGETAHUAN, DAN SIKAP BIDAN PRAKTIK MANDIRI DENGAN KEPATUHAN MENJALANKAN STANDAR PELAYANAN ANTENATAL CARE DI KOTA PADANGSIDIMPUAN

Jurnal Penelitian Kebidanan & Kespro ◽

10.36656/jpk2r.v2i1.178 ◽

2019 ◽

Vol 2 (1) ◽

pp. 27-33

Author(s):

Megawati Sinambela ◽

Evi Erianty Hasibuan

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Antenatal Care ◽

Pregnant Women ◽

Logistic Regression Analysis ◽

Care Service ◽

Multivariate Logistic Regression Analysis ◽

Bivariate Analysis ◽

Cross Sectional ◽

The North

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).

Download Full-text

Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

JA Clinical Reports ◽

10.1186/s40981-020-00403-x ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Atsushi Kotera

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Postoperative Pain ◽

Logistic Regression Analysis ◽

Pain Control ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Postoperative Pain Control ◽

Flurbiprofen Axetil ◽

Postanesthetic Shivering

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.

Download Full-text