Clinical profile and predictors of severity in paediatric scrub typhus with pulmonary involvement

2021 ◽  
pp. 004947552110125
Author(s):  
Dinesh Kumar Narayanasamy ◽  
Thirunavukkarasu Arun Babu ◽  
Prakash Mathiyalagen
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Interstitial Pneumonitis ◽  
Clinical Characteristics ◽  
Scrub Typhus ◽  
Radiographic Finding ◽  
Maculopapular Rash ◽  
Pulmonary Involvement ◽  
Clearance Time ◽  
Fever Clearance Time

Pulmonary involvement is common in children with scrub typhus. Our paper outlines the clinical characteristics of pulmonary involvement and analyses the predictors of its severity. All scrub typhus serology-positive (optical density >0.5) children with pulmonary symptoms were included. Of 506 serology-positive scrub typhus cases, 256 (50.5%) had pulmonary symptoms, of whom 50 (9.8%) were severe. These severe cases were compared with non-severe cases. Interstitial pneumonitis was the commonest chest radiographic finding. Logistic regression analysis identified ‘fever clearance time’ >48 h, facial puffiness, maculopapular rash and anaemia to be significantly associated with severe pulmonary involvement.

scholarly journals Sex-Disaggregated Data on Clinical Characteristics and Outcomes of Hospitalized Patients With COVID-19: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengdie Wang ◽  
Nan Jiang ◽  
Changjun Li ◽  
Jing Wang ◽  
Heping Yang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Clinical Characteristics ◽  
Random Effect ◽  
Hospitalized Patients ◽  
Male And Female ◽  
Female Patients ◽  
Disease Outcomes ◽  
Male Patients

BackgroundSex and gender are crucial variables in coronavirus disease 2019 (COVID-19). We sought to provide information on differences in clinical characteristics and outcomes between male and female patients and to explore the effect of estrogen in disease outcomes in patients with COVID-19.MethodIn this retrospective, multi-center study, we included all confirmed cases of COVID-19 admitted to four hospitals in Hubei province, China from Dec 31, 2019 to Mar 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for demographic, clinical, laboratory and radiographic parameters. Random-effect logistic regression analysis was used to assess the association between sex and disease outcomes.ResultsA total of 2501 hospitalized patients with COVID-19 were included in the present study. The clinical manifestations of male and female patients with COVID-19 were similar, while male patients have more comorbidities than female patients. In terms of laboratory findings, compared with female patients, male patients were more likely to have lymphopenia, thrombocytopenia, inflammatory response, hypoproteinemia, and extrapulmonary organ damage. Random-effect logistic regression analysis indicated that male patients were more likely to progress into severe type, and prone to ARDS, secondary bacterial infection, and death than females. However, there was no significant difference in disease outcomes between postmenopausal and premenopausal females after propensity score matching (PSM) by age.ConclusionsMale patients, especially those age-matched with postmenopausal females, are more likely to have poor outcomes. Sex-specific differences in clinical characteristics and outcomes do exist in patients with COVID-19, but estrogen may not be the primary cause. Further studies are needed to explore the causes of the differences in disease outcomes between the sexes.

scholarly journals The clinical characteristics of patients with pulmonary hypertension combined with obstructive sleep apnoea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lu Yan ◽  
Zhihui Zhao ◽  
Qing Zhao ◽  
Qi Jin ◽  
Yi Zhang ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Obstructive Sleep Apnoea ◽  
Logistic Regression Analysis ◽  
Oxygen Pressure ◽  
Clinical Characteristics ◽  
Sleep Apnoea ◽  
Arterial Oxygen ◽  
Obstructive Sleep

Abstract Objective Obstructive sleep apnoea (OSA) is one cause of pulmonary hypertension (PH) and can also emerge along with PH. The clinical diagnosis and treatment of OSA in patients with PH are still controversial. The purpose of this clinical observation study was to observe and summarize the incidence and clinical characteristics of OSA in patients with PH and to explore possible predictors of PH combined with OSA. Methods Patients with PH diagnosed by right heart catheterization who underwent overnight cardiorespiratory monitoring from December 2018 to December 2020 were enrolled. OSA was defined as an apnoea–hypopnoea index of ≥ 5/h with ≥ 50% of apnoeic events being obstructive. Baseline clinical characteristics and parameters were collected to compare PH patients with and without OSA. Logistic regression analysis was run to determine the risk factors for OSA in PH patients. Results A total of 35 (25%) of 140 patients had OSA. OSA is relatively frequent in patients with PH, especially in patients with chronic thromboembolic pulmonary hypertension and patients with lung disease– or hypoxia-associated PH. The patients who had OSA were mostly male and had a higher age and a lower daytime arterial oxygen pressure. Logistic regression analysis found that older age, male sex, and lower daytime arterial blood oxygen pressure correlated with OSA in PH patients. Conclusion OSA is common in patients with PH. Lower daytime arterial oxygen pressure is a risk factor for OSA in older male patients with PH.

scholarly journals The prevalence and clinical characteristics of diabetes mellitus in Chinese inpatients with chronic schizophrenia: a multicenter cross-sectional study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12553
Author(s):  
Yanni Wang ◽  
Lingyun Zeng ◽  
Lijuan Chen ◽  
Xin Zhou ◽  
Lijuan Huo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Clinical Characteristics ◽  
Chronic Schizophrenia ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional

Background Diabetes mellitus (DM) is common among patients with schizophrenia. However, information on patients comorbid DM and schizophrenia is limited in China. The present study investigated the prevalence of DM and its clinical characteristics in Chinese inpatients with chronic schizophrenia. Methods A cross-sectional study was performed in Chinese inpatients with chronic schizophrenia. Diagnosis of Diabetes was established using World Health Organization diagnostic criteria for diabetes mellitus (persistent fasting glucose levels ≥ 126 mg/dl or 2-h plasma glucose ≥ 200 mg/dL after a 75-g Oral Glucose Tolerance Test). Patients were also measured height, weight, waist circumference, hip circumference, triglyceride level, and cholesterol level. Patients’ psychiatric symptoms were measured by the Positive and Negative Syndrome Scale (PANSS). Binary logistic regression analysis was performed to examine the associated demographic and clinical variables in chronic schizophrenia. Results A total of 988 inpatients (64.6% male, average age of 47.19 ± 12.55) was recruited. The prevalence of DM in Chinese patients with chronic schizophrenia was 13.8% (95% CI [11.6–15.9]%). Logistic regression analysis showed that overweight (OR = 1.90, 95% CI [1.20–3.03], p = 0.006), obesity (OR = 1.85, 95% CI [1.07–3.21], p = 0.028), comorbid hypertension (OR = 2.14, 95% CI [1.34–3.42], p = 0.002), and course of schizophrenia (OR = 1.03, 95% CI [1.01–1.06], p = 0.040) were significantly associated with the DM risk in patients with schizophrenia. Conclusion The findings indicated that diabetes mellitus was non-negligible in patients with chronic schizophrenia. Patients with schizophrenia should be regularly monitored for DM. Overweight/obesity, long duration of schizophrenia, and comorbid hypertension possibly were risk factors for diabetes.

Association of PIK3CA mutations and age with the occurence of second primary lung cancer (SPLC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1589-1589
Author(s):  
Marc Christiaan Allardt Bos ◽  
Masyar Gardizi ◽  
Matthias Scheffler ◽  
Lucia Nogova ◽  
Thomas Zander ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Clinical Characteristics ◽  
Pik3ca Mutation ◽  
Primary Lung Cancer ◽  
Driver Mutations ◽  
Second Primary ◽  
Pik3ca Mutations

1589 Background: The incidence of SPLC in Germany was reported to be 1.2 per 100,000 inhabitants in 2007 and the prevalence of second primary cancers reported by the US International Cancer Institute's Surveillance, Epidemiology and End Results Program has more than doubled over the last 25 years. Recently there has been tremendous progress in the ability to detect driver mutations in lung cancer and large studies presented the frequencies of driver mutations in unselected patient populations. We conducted an association study of known genetic driver events and clinical characteristics with the occurence of SPLC. Methods: Within the Network Genomic Medicine Lung Cancer, a local molecular screening network encompassing hospitals and office-based oncologists in the catchment area of the Center for Integrated Oncology Köln Bonn, we retrospectively reviewed the medical records of 375 molecularly annotated NSCLC patients for their SPLC status and clinical characteristics (age at diagnosis, histology, sex, smoking status). Molecular analysis for lung adenocarcinoma included the EGFR, ALK, BRAF, KRAS and PIK3CA status and for squamous cell lung cancer the FGFR1 and PIK3CA status. Results: 84 of 375 (22,4%) patients were SPLCs. The median age of SPLC diagnosis was 70 yrs. (Range 53 - 85 yrs.) and differed significantly from the rest of the population with a median age of 65 yrs. (Range 28 - 86 yrs.). The frequency of SPLCs was not significantly different between males and females (p = 0,259). In univariate logistic regression analysis active and former smoking, positive PIK3CA mutation and FGFR1 amplification status as well as age were significantly associated with the occurrence of SPLC. In a multivariate logistic regression analysis including the variables mentioned above only PIK3CA mutations (OR 9,48 95% CI 1,83 - 49,1) (p = 0,007) and age (OR 1,06 95% CI 1,03 - 1,1) (p = 0,015) could be confirmed to be independent prognosticators for the occurrence of SPLCs. Conclusions: The occurrence of SPLC was associated with age and PIK3CA mutations in our study population. Further comprehensive investigations on this topic are needed to confirm our findings and to further understand the association between mutation status and SPLCs.

scholarly journals Relationship between socio-demographics, body composition, emotional state, and social support on metabolic syndrome risk among adults in rural Mongolia

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0254141
Author(s):  
Jin Hee Kim ◽  
Hyun Lye Kim ◽  
Bolorchimeg Battushig ◽  
Jae Yong Yoo
Keyword(s):  
Social Support ◽  
Metabolic Syndrome ◽  
Body Composition ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Score ◽  
Clinical Characteristics ◽  
Emotional State ◽  
Risk Level ◽  
Ordinal Logistic Regression Analysis

Background In Mongolia, where there is a large regional gap in the quality of healthcare services, metabolic syndrome (MetS) is steadily increasing. However, there are few studies on the risk level of MetS and affecting factors among adults living in rural Mongolia. This study aims to explore the relationship between socio-demographics, clinical characteristics, emotional state, and social support on the risk level of MetS prevalence among adults living in rural Mongolia. Methods In this cross-sectional study, 143 adults living in the soum area of Dondgovi aimag in Mongolia were recruited. Data collection was conducted from July 2 to 3, 2019. The self-reported questionnaires including socio-demographic, clinical characteristics and emotional status, anthropometric tests using the InBody, and blood sampling tests were conducted. The number of individual diagnostic criteria met was scored as a MetS risk score and classified into 6 groups, from the lowest score of 0 to the highest score of 5. The ordinal logistic regression analysis was used to identify the factors affecting the risk of MetS. Results The prevalence of MetS among adults living in rural Mongolia was 58.0%, and the mean MetS risk score was 2.70±1.34 points. In the ordinal logistic regression analysis, age, regular exercise of moderate intensity or higher, InBody score reflecting obesity or sarcopenia, and depression level were statistically significantly associated with the risk score for MetS. Conclusions Our study demonstrated that MetS risk levels among adults living in rural Mongolia with limited medical resources were strongly associated with demographic characteristics, body composition and emotional health condition, particularly depression.

scholarly journals Incidence Trends and Risk Prediction Nomogram for Suicidal Attempts in Patients With Major Depressive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Sixiang Liang ◽  
Jinhe Zhang ◽  
Qian Zhao ◽  
Amanda Wilson ◽  
Juan Huang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Major Depressive Disorder ◽  
Regression Analysis ◽  
Depressive Disorder ◽  
Logistic Regression Analysis ◽  
Clinical Characteristics ◽  
Information Criteria ◽  
Demographic Information ◽  
Major Depressive ◽  
Incidence Trends

Background: Major depressive disorder (MDD) is often associated with suicidal attempt (SA). Therefore, predicting the risk factors of SA would improve clinical interventions, research, and treatment for MDD patients. This study aimed to create a nomogram model which predicted correlates of SA in patients with MDD within the Chinese population.Method: A cross-sectional survey among 474 patients was analyzed. All subjects met the diagnostic criteria of MDD according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). Multi-factor logistic regression analysis was used to explore demographic information and clinical characteristics associated with SA. A nomogram was further used to predict the risk of SA. Bootstrap re-sampling was used to internally validate the final model. Integrated Discrimination Improvement (IDI) and Akaike Information Criteria (AIC) were used to evaluate the capability of discrimination and calibration, respectively. Decision Curve Analysis (DCA) and the Receiver Operating Characteristic (ROC) curve was also used to evaluate the accuracy of the prediction model.Result: Multivariable logistic regression analysis showed that being married (OR = 0.473, 95% CI: 0.240 and 0.930) and a higher level of education (OR = 0.603, 95% CI: 0.464 and 0.784) decreased the risk of the SA. The higher number of episodes of depression (OR = 1.854, 95% CI: 1.040 and 3.303) increased the risk of SA in the model. The C-index of the nomogram was 0.715, with the internal (bootstrap) validation sets was 0.703. The Hosmer–Lemeshow test yielded a P-value of 0.33, suggesting a good fit of the prediction nomogram in the validation set.Conclusion: Our findings indicate that the demographic information and clinical characteristics of SA can be used in a nomogram to predict the risk of SA in Chinese MDD patients.

scholarly journals Tuberculosis-Related Hospitalizations in a Low-Incidence Country: A Retrospective Analysis in Two Italian Infectious Diseases Wards

2019 ◽  
Vol 17 (1) ◽  
pp. 124
Author(s):  
Laura Campogiani ◽  
Mirko Compagno ◽  
Luigi Coppola ◽  
Vincenzo Malagnino ◽  
Gaetano Maffongelli ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Retrospective Study ◽  
South America ◽  
Infectious Diseases ◽  
Clinical Characteristics ◽  
Western Region ◽  
Time Period ◽  
The World ◽  
Low Incidence

In recent years, a decrease in the incidence of tuberculosis (TB) has been recorded worldwide. However, an increase in TB cases has been reported in foreign people living in low-incidence countries, with an increase in extrapulmonary TB (EPTB) in the western region of the world. In the present work, a retrospective study was conducted in two Italian infectious diseases wards to evaluate the clinical characteristics of TB admission in the time period 2013–2017. A significant increase in TB was shown in the study period: 166 (71% males) patients with TB were enrolled, with ~70% coming from outside Italy (30% from Africa, 25% from Europe, and 13% from Asia and South America). Compared to foreign people, Italians were significantly older (71.5 (interquartile range, IQR: 44.5–80.0) vs. 30 (IQR: 24–40) years; p < 0.0001) more immunocompromised (48% vs. 17%; p < 0.0001), and affected by comorbidities (44% vs. 14%; p < 0.0001). EPTB represented 37% of all forms of the disease, and it was more incident in subjects coming from Africa than in those coming from Europe (39.3% vs. 20%, respectively). In logistic regression analysis, being European was protective (odd ratio, OR (95% CI): 0.2 (0.1–0.6); p = 0.004) against the development of EPTB forms. In conclusion, an increase in the rate of TB diagnosis was documented in two Italian reference centers in the period 2013–2017, with 39% of EPTB diagnosed in patients from outside Europe.

Incomplete stent apposition of low-profile visualized intraluminal support stents in the treatment of cerebral aneurysms

2019 ◽  
Vol 12 (6) ◽  
pp. 591-597
Author(s):  
Huan Zhang ◽  
Xiaoping Gao ◽  
Hui Liang ◽  
Yi Ren
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Characteristics ◽  
Management Strategies ◽  
Cerebral Aneurysms ◽  
Thromboembolic Events ◽  
Incomplete Stent Apposition ◽  
Low Profile ◽  
Independent Risk Factors

ObjectiveThis study retrospectively analyzed the risk factors, management strategies, and complications of incomplete stent apposition (ISA) of low-profile visualized intraluminal support (LVIS) stents after initial deployment in the treatment of cerebral aneurysms.MethodsThe clinical characteristics of ISA or wall apposition (WA) of LVIS stent after initial deployment were analyzed. The risk factors of ISA were identified using univariate logistic regression analysis and multivariate logistic regression analysis. The clinical characteristics of ISA following different management strategies were also shown.ResultsThe retrospective study enrolled 303 patients with 315 LVIS stent-assisted aneurysms. Fifty-nine patients with 59 stents showed ISA after initial deployment. At the end of the study, the presence of ISA was only observed in eight patients (2.5%). The stent-subtended arc angle (>90) and the aneurysm of the internal carotid artery (ICA) were associated with ISA. The stent-subtended arc angle (>90) and stent size (4.5*20 mm) were independent risk factors of ISA. The incidence of thromboembolic events in the ISA group was significantly higher than that in the WA group. After the treatment of ISA, there was no significant difference in good outcomes between patients with ISA and those with WA after initial deployment.ConclusionsISA is more likely to occur at tortuous vessels. The stent-subtended arc angle (>90) and LVIS size (4.5*20 mm) were independent risk factors of ISA. ISA led to significantly increased incidence of thromboembolic events. However, ISA after initial deployment did not affect the patient's prognosis.

scholarly journals Central Hypoventilation Is a Key Risk Factor for Mechanical Ventilation During the Acute Phase of Anti-N-Methyl-D-Aspartate Receptor Encephalitis

2021 ◽  
Vol 12 ◽  
Author(s):  
Qianhui Xu ◽  
Qian Wang ◽  
Jing Han ◽  
Fengju Mao ◽  
Silin Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Clinical Characteristics ◽  
Test Results ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Central Hypoventilation

Objective: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an acute form of encephalitis of autoimmune etiology. We aimed to evaluate the risk factors that predicted the need for mechanical ventilation during the acute phase of anti-NMDAR encephalitis through an analysis of the clinical characteristics and biochemical test results of the patients with anti-NMDAR encephalitis.Methods: In this retrospective study, patients who primarily presented with anti-NMDAR encephalitis and exhibited anti-NMDAR antibody positivity in the cerebrospinal fluid (CSF) between November 2015 and February 2020 were included. Data on the clinical characteristics, biochemical test results, and treatment methods selected for the patients were collected for the analysis of factors predicting the need for mechanical ventilation.Results: Thirty-one patients with a median age of onset of 31 years (inter-quartile range: 21–48 years) were included in this study, of which 15 were male (48.4%). Psychosis (23, 74.2%), seizures (20, 64.5%), and memory deficit (20, 64.5%) were the most common clinical manifestations. At admission, 17 patients (54.8%) presented with pyrexia, of which 12 (38.7%) had a body temperature ≥38°C, and six patients (19.4%) presented with central hypoventilation. All patients received first-line therapy (glucocorticoids, intravenous immunoglobulin, or plasmapheresis alone or combined), whereas two patients (6.5%) received rituximab, a second-line agent, as well. Seven patents required mechanical ventilation. Results of univariate logistic regression analysis revealed that body temperature ≥38°C [odds ratio (OR) = 18, 95% confidence interval (CI): 1.79–181.31, P &lt; 0.05] and central hypoventilation at admission (OR = 57.50, 95% CI: 4.32–764.89, P &lt; 0.05) were the risk factors for mechanical ventilation. Multivariate logistic regression analysis showed that central hypoventilation at admission was the only risk factor predicting the need for mechanical ventilation.Conclusion: Central hypoventilation at admission is a key risk factor for mechanical ventilation during hospitalization in patients with anti-NMDAR encephalitis.

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