Analysis of Multiple Factors Involved in Pertussis-Like Coughing

2020 ◽  
Vol 59 (7) ◽  
pp. 641-646
Author(s):  
Jiaying Cao ◽  
Lu Xu ◽  
Jiahua Pan
Keyword(s):  
Risk Factors ◽  
Bordetella Pertussis ◽  
Poor Prognosis ◽  
Clinical Symptoms ◽  
Lymphocyte Ratio ◽  
Study Results ◽  
Independent Risk Factors ◽  
Wbc Count ◽  
Case Data ◽  
Inhaled Glucocorticoids

Objectives. To identify risk factors associated with the prognosis of pertussis-like coughing. Methods. A retrospective study on children hospitalized with pertussis-like coughing from 2018 to 2019. We collected all the case data from medical records including age, gender, vaccination, clinical symptoms, complication, pathogens, white blood cell (WBC) count, lymphocyte ratio, application of macrolide antibiotics, usage of sulfamethoxazole, and usage of inhaled glucocorticoids. Logistic regression was used in this study. Results. A total of 213 hospitalized children with pertussis-like coughing were included in this study. About 70 children were cured within 2 weeks. One120 children were cured from 2 weeks to 3 months, including cases of initial attack and relapse. Symptoms lasting longer than 3 months accounts for 10.8%. Bordetella pertussis, WBC count >20 × 109/L and lymphocyte ratio >60% were associated with poor prognosis ( P < .05). Conclusions. Bordetella pertussis, WBC count, and lymphocyte ratio are independent risk factors for poor prognosis.

The Most Important Risk Factors for Carpal Tunnel Syndrome

2021 ◽  
Author(s):  
Ali Asghar Sharifi
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Normal Subjects ◽  
Shape Index ◽  
Mean Values ◽  
Tunnel Syndrome ◽  
Independent Risk Factors ◽  
Hand Length

Background: The aim of this study was to determine the risk factors for carpal tunnel syndrome and its relationship with the severity of the disease. Methods: A total of 131 patients with clinical symptoms of CTS and 131 normal subjects were enrolled, of whom 121 were female both in the CTS cases and the controls. All cases were electro diagnostically confirmed and assigned to three severity groups. BMI, wrist ratio, shape index, digit index and hand length/height ratio were measured in all participants. Mean values for each item were compared between cases and controls and severity subgroups. A logistic regression analysis was performed to determine independent CTS risk factors. Results: The mean values of BMI, wrist ratio and shape index were significantly higher in all CTS patients and females compared to controls, whereas in males only BMI and wrist ratio were higher. The patients in the mild severity subgroup had a significantly lower age and wrist ratio. BMI, wrist ratio and shape index were found to be independent risk factors of CTS development in all patients and females. Conclusion: Our study showed BMI, wrist ratio and shape index as independent risk factors for CTS. These findings are important anatomically and clinically and these are the risk factors of anatomical malfunction of the wrist in CTS.

Treatment of patients with locally advanced Merkel cell carcinoma: A multicenter study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21566-e21566
Author(s):  
Monika Dudzisz-Śledź ◽  
Pawel Sobczuk ◽  
Katarzyna Kozak ◽  
Tomasz Switaj ◽  
Hanna Kosela-Paterczyk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Poor Prognosis ◽  
Locally Advanced ◽  
Male Gender ◽  
Merkel Cell ◽  
Nodal Involvement ◽  
Free Survival ◽  
Independent Risk Factors ◽  
Clinical Metastases

e21566 Background: Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer with a high risk of recurrence and poor prognosis. The treatment of locally advanced disease includes surgery (SUR) and radiotherapy (RTH) to achieve high locoregional control rates. The sentinel lymph node biopsy (SLNB) is recommended procedure in cases without clinical nodal involvement. In selected cases, chemotherapy (CHT) may also be considered, but its role is not confirmed. This study aimed to analyze outcomes for locally advanced MCC pts treated in routine clinical practice. Methods: We conducted the retrospective analysis of data from 156 MCC pts treated with curative surgery in four oncological centers, diagnosed between 01/2010 and 12/2019, with data cut-off on 31/12/2020. The data collected included epidemiological and clinical information. Survival analyses were performed using the Kaplan-Meier method, log-rank test and multivariate Cox regression. Results: The median patient age at diagnosis was 72 years (30-94); 50.6% were male. The primary tumor (PT) locations were lower limbs (33.3%), upper limbs (30.1%), and head and neck (28.2%). MCC with no PT was diagnosed in 3.9%. In 62.0% the PT was located in the sun-exposed skin. The median tumor size was 25 mm (4-170). Lymph node (LN) involvement (clinical or positive SLNB or LND) at diagnosis was found in 26.9% (n = 42). The scar excision was done in 50.0% (positive in 16.6%), SLNB in 36.5% (positive in 10.5 %), 51.9% of pts received perioperative treatment, including RTH- 86.4%, CHT- 21%. The relapse rate was 38.3% (35.8% local-regional, 11.1% distant). With the median follow-up of 2.2-years, the median disease-free survival (DFS), local relapse-free survival (LRFS), and distant metastases-free survival (DMFS) were not reached. The 1-year DFS, LRFS and DMFS rates were 65%, 68%, and 90%. The negative independent risk factors for DFS were male gender (HR 1.42, 95%CI 1.06-3.01), metastases in LN at diagnosis (HR 5.41, 95%CI 2.39-12.26), no SLNB in pts with no clinical metastases in LN (HR 5.45, 95%CI 2.41-12.3), and no perioperative RTH (HR 2.19, 95%CI 1.29-3.76). The median overall survival (OS) was 6.9 years (95%CI 4.64-9.15). The negative independent risk factors for OS were male gender (HR 1.95, 95%CI 1.16-3.27), age above 70 (HR 2.0, 95%CI 1.15-3.48), metastases in LN at diagnosis (HR 3.15, 95%CI 1.49-6.68), and no SLNB in pts with no clinical metastases in LN (HR 2.30, 95%CI 1.10-4.82). PT location, UV-exposure, and perioperative CHT or RTH were not independent risk factors for OS. Conclusions: Our results confirm that the MCC treatment should be done in an experienced multidisciplinary team. Male gender, nodal involvement at diagnosis, and no SLNB in pts without clinical metastases in LN are associated with poor prognosis in DFS and OS. The perioperative RTH improves the treatment outcomes and reduces disease progression risk but does not impact OS. Perioperative CHT does not affect pts survival.

Bacterial meningitis caused by the use of ventricular or lumbar cerebrospinal fluid catheters

2005 ◽  
Vol 102 (2) ◽  
pp. 229-234 ◽  
Author(s):  
Rogier P. Schade ◽  
Janke Schinkel ◽  
Leo G. Visser ◽  
J. Marc C. van Dijk ◽  
Joan H. C. Voormolen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Clinical Symptoms ◽  
External Drainage ◽  
Content Type ◽  
Ventricular Catheters ◽  
Independent Risk Factors ◽  
Lumbar Cerebrospinal Fluid ◽  
Fine Print

Object. In the present study the authors compared the incidence and risk factors for external drainage—related bacterial meningitis (ED-BM) by using ventricular and lumbar catheters. Methods. A cohort of 230 consecutive patients with ED was evaluated. Cerebrospinal fluid samples were obtained daily for microbiological culture, and ED-BM was defined based on culture results in combination with clinical symptoms. The incidence of ED-BM was 7% in lumbar and 15% in ventricular drains. Independent risk factors included site leakage, drain blockage, and most importantly duration of ED. Despite a higher infection rate, ventricular catheters did not have a significant higher risk of infection after correcting for duration of drainage. Conclusions. Analysis of data in the present study showed that the incidence of ED-associated death is low (0.45%) in patients who do not receive continuous antibiotic prophylaxis during ED.

Association of De Ritis Ratio and Neutrophil Lymphocyte Ratio with renal functional decline and all-cause mortality in renal cell carcinoma.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 741-741
Author(s):  
Cathrine Keiner ◽  
Margaret Meagher ◽  
Dattatraya Patil ◽  
Kazutaka Saito ◽  
Devin Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Cell Carcinoma ◽  
Clear Cell ◽  
De Novo ◽  
Functional Decline ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Factors Associated ◽  
All Cause Mortality ◽  
Independent Risk Factors

741 Background: We sought to investigate utility of pre-operative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and De Ritis Ratio as predictors of all-cause mortality (ACM) and renal functional decline renal cell carcinoma (RCC). Methods: Multi-institutional retrospective analysis of patients undergoing surgery for RCC. Multivariable analysis (MVA) was conducted to elucidate independent risk factors for ACM, de novo estimated glomerular filtration rate (eGFR)<45 ml/min/1.73m2 and eGFR<30 ml/min/1.73m2. Kaplan-Meier analysis (KMA) was used to investigate ACM, and de novo CKD. Results: 2928 patients were analyzed [1850 Male/1078 Female, median follow up 30.5 months, median tumor size 4.5 cm, 1741 partial nephrectomy (PN)/1187 radical nephrectomy (RN)]. 690 patients had NLR ≥ 3, while 208 patients had NLR ≥ 6; 110 patients had PLR ≥ 3; and 474 patients had De Ritis Ratio ≥ 3. MVA for risk factors associated with worsened ACM showed male sex (OR 1.6, p=0.02), HTN (OR 2.1, p=0.001), increasing tumor size (OR 1.12, p<0.001), clear cell RCC (OR 2.0, p=0.001), RN (OR 1.6, p=0.048), NLR≥ 6 (OR=2.4, p=0.001), Di Ritis Ratio≥3 (OR 2.4, p<0.001), and de novo eGFR<45 (OR=1.6, p=0.015) to be independent risk factors. MVA for factors associated with development of eGFR<45 included increasing age (OR 1.03, p<0.001), male (OR 1.5, p=0.01), HTN (OR 2.3, p<0.001), clear cell RCC (OR 2.2, p<0.001), RN (OR 6.8, p=0.03), NLR≥6 (OR 2.0, p=0.002), and Di Ritis Ratio≥3 (OR 2.3, p<0.001) to be independently associated. Variables associated with development of eGFR<30 included age (OR 1.05, p<0.001), DM (OR=3.01, p<0.001), black race (OR 1.9, p=0.005), Di Ritis Ratio≥3 (OR 2.0, p=0.001), and NLR≥6 (OR 2.1, p=0.002). PLR was not associated with OS, de novo eGFR<45, or de novo eGFR<30. On KMA, NLR≥6 was associated with worse OS (p<0.001). Di Ritis ratio ≥1.5 was associated with worse OS p<0.001 and Di Ritis ratio (≥3) was associated decreased freedom from of de novo eGFR<45 (p=0.026). Conclusions: Elevated NLR and De Ritis Ratio were associated with functional decline and worsened OS, while PLR was not predictive. These markers may be helpful in identifying high-risk patients.

scholarly journals Neutrophil-to-lymphocyte Ratio as a Risk Determinant of Hemorrhage Transformation in Acute Ischemic Stroke

2020 ◽  
pp. 8-16
Author(s):  
Shuang Ma ◽  
Bilal Muhammad ◽  
Shu Kan ◽  
Zhen-Ying Shang ◽  
Li Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Hemorrhagic Transformation ◽  
Neutrophil To Lymphocyte Ratio ◽  
Optimal Cutoff ◽  
Ischemic Lesion ◽  
Lymphocyte Ratio ◽  
Independent Risk Factors

Objective: The purpose of this study was to investigate the clinical significance between neutrophil-to-lymphocyte ratio (NLR) and classification of non-thrombolytic hemorrhagic transformation (HT) in acute ischemic stroke (AIS), to unravel new diagnostic approach. Methods: We recruited and selected 636 patients who did not undergo thrombolytic therapy between May 2018 and April 2019 at the Affiliated Hospital of Xuzhou Medical University. The laboratory and clinical data were collected within 24 h after the onset of AIS. Based on the status of HT development during hospitalization, all participants were divided into three groups, namely, the non-HT (NHT) group, hemorrhagic infarction (HI) group, and parenchymal hematoma (PH) group. Results: Multivariate logistic regression analysis showed that NLR and the ischemic lesion diameter are independent risk factors of HI and PH, while the score of National Institutes of Health Stroke Scale (NIHSS) and cardioembolism are considered to be independent risk factors for PH only. Receiver operating characteristic (ROC) analysis determined that the optimal cutoff values of NLR in HI group and PH group were 3.75 and 3.97, respectively. The optimal cutoff value can be used as the critical value for the unfavorable outcome. Conclusion: NLR values were significantly increased and correlated with both HI and PH groups and NLR could be used as a predictor of both HI and PH.

scholarly journals High Platelet-Lymphocyte Ratio is a Risk Factor for 30-day Mortality In In-Hospital Cardiac Arrest Patients: A Case-Control Study

2021 ◽  
Author(s):  
Lihong Huang ◽  
Jingjing Peng ◽  
Xuefeng Wang ◽  
Feng Li
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Inflammatory Markers ◽  
Short Term ◽  
Dynamic Changes ◽  
Lymphocyte Ratio ◽  
Short Term Mortality ◽  
Independent Risk Factors ◽  
The Absolute ◽  
Hospital Cardiac Arrest

Abstract Background: Early identification of risk factors for short-term mortality in patients with in-hospital cardiac arrest (IHCA) is crucial for early prognostication. This study aimed to explore the association of early dynamic changes in inflammatory markers with 30-day mortality in IHCA patients.Methods: This study retrospectively collected demographic and clinical characteristics and relevant laboratory indicators within 72 h after recovery of spontaneous circulation (ROSC) of IHCA patients from December 2015 to December 2020 at the First Affiliated Hospital of Chongqing Medical University. The outcome was 30-day mortality. A linear mixed model was used to analyze the dynamic changes in laboratory indicators within 72 h after ROSC, and Cox regression was used to identify the independent risk factors for 30-day mortality.Results: Overall, 85 IHCA patients were included. The 0-72h and 0-30day cumulative mortality rates were 25.88% and 57.65%, respectively, and the median survival time was 13.79 days. There was no association of inflammatory markers before IHCA with mortality. Within 72 h after ROSC, inflammatory markers showed various changes: the absolute monocyte count (AMC) showed no significant change trend, and the absolute lymphocyte count (ALC) showed an overall upward trend, while the absolute neutral count (ANC), white blood cell (WBC) count, platelet (PLT) count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) showed an overall downward trend. Cox multivariate analysis showed that Charlson comorbidity index (CCI) (HR = 2.366, 95%CI (1.084, 5.168)), APACHE II score (HR = 2.550, 95% CI (1.001, 6.498)), abnormal Cr before IHCA (HR = 3.417, 95% CI (1.441, 8.104)) and PLR within 72 h after ROSC (HR = 2.993, 95% CI (1.442, 6.214)) were independent risk factors for 30-day mortality. When PLR ≥ 180, the risk of 30-day mortality increased by 199.3%.Conclusions: This study clarified the dynamic change trends of inflammatory markers within 72 h after ROSC. The PLR was an independent risk factor for 30-day mortality in IHCA patients; it can be used as a predictor of short-term mortality and provide a reference for early prognostication.Trial registration: ChiCTR1800014324

scholarly journals Clinical Characteristics and Risk Factors for Mortality in Very Old Patients Hospitalized With COVID-19 in Spain

2020 ◽  
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Verónica Buonaiuto ◽  
Michele Ricci ◽  
Jesica Martín-Carmona ◽  
Diana Paredes-Ruíz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Atherosclerotic Cardiovascular Disease ◽  
X Rays ◽  
Old Patients ◽  
Very Old ◽  
Independent Risk Factors ◽  
Male Sex

Abstract Background Advanced age is a well-known risk factor for poor prognosis in COVID-19. However, few studies have specifically focused on very old inpatients with COVID-19. This study aims to describe the clinical characteristics of very old inpatients with COVID-19 and identify risk factors for in-hospital mortality at admission. Methods We conducted a nationwide, multicenter, retrospective, observational study in patients ≥ 80 years hospitalized with COVID-19 in 150 Spanish hospitals (SEMI-COVID-19) Registry (March 1–May 29, 2020). The primary outcome was in-hospital mortality. A uni- and multivariate logistic regression was performed to assess predictors of mortality at admission. Results A total of 2772 consecutive patients (49.4% men, median age 86.3 years) were analyzed. Rates of atherosclerotic cardiovascular disease, diabetes mellitus, dementia, and Barthel Index &lt; 60 were 30.8%, 25.6%, 30.5%, and 21.0%, respectively. The overall case-fatality rate was 46.9% (n: 1301) and increased with age (80–84 years: 41.6%; 85–90 years: 47.3%; 90–94 years: 52.7%; ≥95 years: 54.2%). After analysis, male sex and moderate-to-severe dependence were independently associated with in-hospital mortality; comorbidities were not predictive. At admission, independent risk factors for death were: oxygen saturation &lt; 90%; temperature ≥ 37.8°C; quick sequential organ failure assessment (qSOFA) score ≥ 2; and unilateral–bilateral infiltrates on chest x-rays. Some analytical findings were independent risk factors for death, including estimated glomerular filtration rate &lt; 45 mL/min/1.73 m2; lactate dehydrogenase ≥ 500 U/L; C-reactive protein ≥ 80 mg/L; neutrophils ≥ 7.5 × 103/μL; lymphocytes &lt; 0.8 × 103/μL; and monocytes &lt; 0.5 × 103/μL. Conclusions This first large, multicenter cohort of very old inpatients with COVID-19 shows that age, male sex, and poor preadmission functional status—not comorbidities—are independently associated with in-hospital mortality. Severe COVID-19 at admission is related to poor prognosis.

Development of a prediction model for 1-year poor prognosis in patients with acute ischemic stroke

2019 ◽  
Vol 67 (6) ◽  
pp. 957-963 ◽  
Author(s):  
Xia Ling ◽  
Bo Shen ◽  
Kangzhi Li ◽  
Lihong Si ◽  
Xu Yang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Prediction Model ◽  
Acute Ischemic Stroke ◽  
Poor Prognosis ◽  
Multivariate Logistic Regression ◽  
Lemeshow Test ◽  
Independent Risk Factors ◽  
Auc Value

The goals of this study were to develop a new prediction model to predict 1-year poor prognosis (death or modified Rankin scale score of ≥3) in patients with acute ischemic stroke (AIS) and to compare the performance of the new prediction model with other prediction scales. Baseline data of 772 patients with AIS were collected, and univariate and multivariate logistic regression analyses were performed to identify independent risk factors for 1-year poor prognosis in patients with AIS. The area under the receiver operating characteristics curve (AUC) value of the new prediction model and the THRIVE, iScore and ASTRAL scores was compared. The Hosmer-Lemeshow test was used to assess the goodness of fit of the model. We identified 196 (25.4%) patients with poor prognosis at 1-year follow-up, and of these 68 (68/196, 34.7%) had died. Multivariate logistic regression and receiver operating characteristic curve analyses showed that age ≥70 years, consciousness (lethargy or coma), history of stroke or transient ischemic attack, cancer, abnormal fasting blood glucose levels ≥7.0 mmol/L, and National Institutes of Health Stroke Scale score were independent risk factors for 1-year poor prognosis in patients with AIS. Scores were assigned for each variable by rounding off β coefficient to the integer score, and a new prediction model with a maximum total score of 9 points was developed. The AUC value of the new prediction model was higher than the THRIVE score (p<0.05). The χ2 value for the Hosmer-Lemeshow test was 7.337 (p>0.05), suggesting that the prediction model had a good fit. The new prediction model can accurately predict 1-year poor prognosis in Chinese patients with AIS.

scholarly journals Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Shingo Hatakeyama ◽  
Masaaki Saito ◽  
Kumiko Ishigaki ◽  
Hayato Yamamoto ◽  
Akiko Okamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Lower Limb ◽  
Poor Prognosis ◽  
Perfusion Pressure ◽  
Hemodialysis Patients ◽  
Smoking History ◽  
Skin Perfusion ◽  
Skin Perfusion Pressure ◽  
Independent Risk Factors

Peripheral arterial disease (PAD) is common in hemodialysis patients and predicts a poor prognosis. We conducted a prospective cohort study to identify risk factors for PAD including skin perfusion pressure (SPP) in hemodialysis patients. The cohort included 373 hemodialysis patients among 548 patients who received hemodialysis at Oyokyo Kidney Research Institute, Hirosaki, Japan from August 2008 to December 2010. The endpoints were lower limb survival (peripheral angioplasty or amputation events) and overall survival of 2 years. Our results showed that <70 mmHg SPP was a poor prognosis for the lower limb survival and overall survival. We also identified age, history of cardiovascular disease, presence of diabetes mellitus, smoking history, and SPP < 70 mmHg as independent risk factors for lower limb survival and overall survival. Then, we constructed risk criteria using the significantly independent risk factors. We can clearly stratify lower limb survival and overall survival of the hemodialysis patients into 3 groups. Although the observation period is short, we conclude that SPP value has the potential to be a risk factor that predicts both lower limb survival and the prognosis of hemodialysis patients.

scholarly journals CHRONIC PROSTATITIS AND FIBROSIS OF PROSTATE. PREDISPOSING FACTORS FOR SURGICAL COMPLICATIONS

InterConf ◽  
2021 ◽  
pp. 254-263
Author(s):  
Ceslav Ciuhrii ◽  
Artur Colța ◽  
Alexei Pleșacov ◽  
Vitalii Ghicavîi
Keyword(s):  
Risk Factors ◽  
Endoscopic Surgery ◽  
Chronic Prostatitis ◽  
Inflammatory Process ◽  
Clinical Symptoms ◽  
Urethral Catheter ◽  
Predisposing Factors ◽  
Study Results ◽  
The Impact ◽  
Urological Diseases

Prostatitis is an inflammatory process of the prostate, which continues to be considered one of the most common urological diseases in men under 45. Predisposing factors as trophic, microcirculatory and congestive disorders, contributes to the onset and development of the inflammatory process in the prostate and risk factors as urethral catheter, urethrocystoscopy, endoscopic surgery for infection and deterioration of the integrity of the urethral epithelium. The purpose of this study was to determine the impact of chronic inflammation and fibrosis of prostate on urodynamics and local prostatic microcirculation and to evaluate the efficacy of medicamentous treatment. In the study were included 58 patients (with pronounced clinical symptoms as dysuria, stranguria, nocturnal pollakuria 2-4 times per night and residual urine about 50ml) that followed a course of treatment with Adenosprosin 250 mg. According to the study results, we can outline that the level of microcirculation and urodynamics impairment indicates the level of prostate fibrosis. This process in chronic prostatitis is reversible by using antifibrotic and anti-inflammatory treatment supplemented with Adenoprosin 250 mg.

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