Predictors of disability in a childhood-onset systemic lupus erythematosus cohort: results from the CARRA Legacy Registry

Objective Few descriptions of physical disability in childhood-onset SLE (cSLE) exist. We sought to describe disability in a large North American cohort of patients with cSLE and identify predictors of disability. Methods Sociodemographic and clinical data were obtained from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry for patients with cSLE enrolled between May 2010 and October 2014. The Childhood Health Assessment Questionnaire (CHAQ) was used to assess disability and physical functioning. Chi-square tests were used for univariate analyses, and multivariate logistic regression was used to assess predictors of disability. Results We analyzed data for 939 patients with cSLE. The median and mean CHAQ scores were 0 and 0.25, respectively, and 41% of the cohort had at least mild disability. Arthritis and higher pain scores were significantly associated with disability as compared to those without disability ( p < 0.001). In multivariate logistic regression analysis, low annual income, arthritis, and higher pain scores were associated with disability at baseline. Conclusions Disability as measured by baseline CHAQ was fairly common in cSLE patients in the CARRA Legacy Registry, and was associated with low household income, arthritis, and higher pain scores. In addition to optimal disease control, ensuring psychosocial supports and addressing pain may reduce disability in cSLE. Further study is needed of disability in cSLE.

Download Full-text

Prevalence, involved domains, and predictor of cognitive dysfunction in systemic lupus erythematosus

Lupus ◽

10.1177/0961203320958061 ◽

2020 ◽

Vol 29 (13) ◽

pp. 1743-1751

Author(s):

Rui Yue ◽

Ishwor Gurung ◽

Xin-Xin Long ◽

Jia-Yi Xian ◽

Xue-Biao Peng

Keyword(s):

Systemic Lupus Erythematosus ◽

Logistic Regression ◽

Disease Activity ◽

Cognitive Dysfunction ◽

Lupus Erythematosus ◽

Activity Index ◽

Multivariate Logistic Regression Analysis ◽

Enzyme Linked Immunosorbent Assay ◽

Multivariate Logistic Regression ◽

Systemic Lupus

Background Cognitive Dysfunction (CD) can occur in Systemic Lupus Erythematosus (SLE) before the occurrence of Neuropsychiatric Lupus Erythematosus (NPSLE). Given the reversibility and fluctuation of SLE-related CD, the research for possible predictors is of great significance for early detection and intervention. Objective We sought to determine the prevalence, involved domains, and possible predictors of CD in SLE patients. Methods We conducted a retrospective cross-sectional study at Nanfang Hospital from 2018 to 2019. A total of 78 SLE patients were recruited. The Montreal Cognitive Assessment (MoCA) scale was used to screen cognitive function. Demographic, clinical, and laboratory characteristics were collected. The serum anti-methyl-d-aspartate receptor (anti-NMDAR) antibody and S100β were measured by enzyme-linked immunosorbent assay (ELISA). Multivariate logistic regression analysis and ROC curve were used to assess the predictor of SLE-related CD. Results Of 78 recruited patients,53 (67.9%) had CD. It mainly involved delayed recall, abstract generalization, verbal repetition, and fluency. The disease activity index (SLEDAI) was not associated with SLE-related CD ( p > 0.05). Multivariate logistic regression showed that an increase in each year of education there was a decrease in the likelihood of CD (OR 0.261, CI 0.080-0.857, p = 0.027) whereas with each unit increase in serum anti-NMDAR antibody there was an increased likelihood of SLE-related CD (OR 1.568, CI 1.073–2.292, p = 0.020). Conclusion The prevalence of SLE-related CD was 67.9% in our study and SLE-related CD was not associated with disease activity. Serum anti-NMDAR antibody can be used as a predictor for SLE-related CD.

Download Full-text

Association Between Breastfeeding and Nutritional Status In Children With Congenital Heart Disease At Dr. Soetomo General Hospital

Syntax Literate ; Jurnal Ilmiah Indonesia ◽

10.36418/syntax-literate.v7i1.5741 ◽

2022 ◽

Vol 7 (1) ◽

pp. 345

Author(s):

Safina Fairuz Salwaa ◽

Taufiq Hidayat ◽

I Gde Rurus Suryawan

Keyword(s):

Congenital Heart Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Heart Disease ◽

Nutritional Status ◽

Congenital Heart ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Chi Square ◽

Chi Square Test

Congenital heart disease (CHD) is a congenital condition caused by a lack of heart development during the fetal stage. There is a notion that children with CHD have low nutritional status due to their condition. Nutritional input, energy requirements, dietary components, and prenatal circumstances impact a person's nutritional status. An analytical observational design with a cross-sectional approach was used in this research. Data were obtained via medical records and questionnaires posed to the patients' guardians who had provided informed consent. The Chi-square test and multivariate logistic regression analysis were used to analyze the data. The study was conducted on 62 subjects. There were 74.19% of subjects with acyanotic CHD and 25.81% with cyanotic CHD. 61.29 % of the subjects were exclusively breastfed for the first six months. The Chi-Square test revealed a relationship between breastfeeding and the nutritional status of children with CHD, with p = 0.0001 (p<0.05). The multivariate logistic regression analysis showed the significance of the type of CHD suffered by the subjects was 0.003 (p<0.05). There is a significant association between breastfeeding for the first six months and the type of CHD suffered by children with their nutritional status at Dr. Soetomo General Hospital.

Download Full-text

FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP KEJADIAN PENYAKIT SKABIES PADA SANTRI DI PONDOK PESANTREN QOTRUN NADA CIPAYUNG DEPOK FEBRUARI TAHUN 2016

Jurnal Profesi Medika Jurnal Kedokteran dan Kesehatan ◽

10.33533/jpm.v10i1.12 ◽

2017 ◽

Vol 10 (1) ◽

Author(s):

Hasna Ibadurrahmi ◽

Silvia Veronica ◽

Nunuk Nugrohowati

Keyword(s):

Logistic Regression ◽

Student Behavior ◽

Multivariate Logistic Regression Analysis ◽

Boarding School ◽

Sarcoptes Scabiei ◽

Multivariate Logistic Regression ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

Academic Year

Scabies is a skin disease caused by mite infestation and sensitization Sarcoptes scabiei variety hominis. Every student who live in dormitories boarding school has the same opportunities for the occurrence of scabies. Students and environmental characteristics of the rooms thought to contribute to the incidence of scabies. Tis study aims to determine what factors most inﬂuence on the incidence of scabies disease at boarding Qotrun Nada Cipayung Depok academic year 2015/2016. Tis research was observational analytic with cross sectional design. The subjects were 258 students of MTs and MA Boarding school of Qotrun Nada academic year 2015/2016. Data analysis was based on the incidence of disease scabies using Chi-square test (p < 0,05) and followed by multivariate logistic regression. Chi-Square test results showed that there was inﬂuence among knowledge, attitudes, student behavior, density of occupant, humidity, lighting, temperature, and room ventilation students with the incidence of scabies disease at boarding Qotrun Nada Cipayung, Depok. Results of multivariate logistic regression analysis showed the most inﬂuences characteristics were student attitude and density of occupant.

Download Full-text

7. Clinical outcomes and epidemiological characteristics of bacteremia in the older population of Japan

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.007 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S6-S6

Author(s):

Keiji Nakamura ◽

Kayoko Hayakawa ◽

Shinya Tsuzuki ◽

Satoshi Ide ◽

Hidetoshi Nomoto ◽

...

Keyword(s):

Logistic Regression ◽

Age Groups ◽

Multivariate Logistic Regression Analysis ◽

Central Line ◽

Multivariate Logistic Regression ◽

Chi Square ◽

Old Patients ◽

Exact Test ◽

Clinical Consequences ◽

Epidemiological Characteristics

Abstract Background Japan is one of the most aging societies worldwide. Because older people are highly susceptible to infectious diseases, the characteristics and clinical consequences of bacteremia in this population need clarification. Methods Patients aged ≥ 65 years with positive blood cultures were included in this study conducted between April 1, 2015 and March 31, 2018, and divided into three groups: pre-old (65–74 years), old (75–89 years), and super-old (≥90 years) according to the criteria of the Japanese Society of Geriatrics. They were also classified based on medical exposure: community-acquired (CA), healthcare-associated (HCA), and hospital-onset (HO). Parameters retrieved from medical records were used to compare each group using the chi-square test or Fisher’s exact test; factors related to mortality were identified using multivariate logistic regression analysis after controlling for the confounding effect of baseline characteristics and underlying diseases. The Bonferroni corrected P < 0.05 was deemed to be statistically significant. Results Overall, 1716 cases of bacteremia were identified in 1415 patients. Of these, 505 cases (29.4%) were found to be due to contamination. Of the 1211 cases without contamination, 397 (32.8%) included pre-old, 658 (54.3%) included old, and 156 (12.9%) included super-old patients. HCA bacteremia increased with age, while HO bacteremia was most common in pre-old patients. Escherichia coli bacteremia was most common in super-old patients. While a central line-associated bloodstream infection was more common in pre-old patients, a urinary tract infection was more common in old and super-old patients. The 7-day mortality was 7.4%, 5.8%, and 14.2% in the pre-old, old, and super-old groups, respectively (P = 0.002). The 7-day mortality for CA, HCA, and HO bacteremia was 5.4%, 6.6%, and 9.5%, respectively (P > 0.05). Multivariate logistic regression showed that HO bacteremia (aOR: 1.76 [1.05–2.94], P = 0.028) and increasing age (aOR: 1.03 [1–1.06], P=0.038) are independent risk factors for 7-day mortality. Table Comparison of characteristics of bacteremia among the pre-old, old, super-old groups, n (%) Conclusion The epidemiology of bacteremia differs among different older age groups; thus, these populations should not be treated as a single entity. A careful approach is needed for the optimal management of bacteremia in them. Disclosures All Authors: No reported disclosures

Download Full-text

Epidemiology of pediatric hydrocephalus in Haiti: analysis of a surgical case series

Journal of Neurosurgery Pediatrics ◽

10.3171/2018.12.peds18568 ◽

2019 ◽

Vol 23 (5) ◽

pp. 568-576

Author(s):

Michael Ragheb ◽

Ashish H. Shah ◽

Sarah Jernigan ◽

Tulay Koru-Sengul ◽

John Ragheb

Keyword(s):

Public Health ◽

Logistic Regression ◽

Head Circumference ◽

Rainy Season ◽

Statistical Tests ◽

Multivariate Logistic Regression Analysis ◽

Case Series ◽

Multivariate Logistic Regression ◽

Surgical Case ◽

Operative Notes

OBJECTIVEHydrocephalus is recognized as a common disabling pediatric disease afflicting infants and children disproportionately in the developing world, where access to neurosurgical care is limited and risk of perinatal infection is high. This surgical case series describes the Project Medishare Hydrocephalus Specialty Surgery (PMHSS) program experience treating hydrocephalus in Haiti between 2008 and 2015.METHODSThe authors conducted a retrospective review of all cases involving children treated for hydrocephalus within the PMHSS program in Port-au-Prince, Haiti, from 2008 through 2015. All relevant epidemiological information of children treated were prospectively collected including relevant demographics, birth history, hydrocephalus etiology, head circumference, and operative notes. All appropriate associations and statistical tests were performed using univariate and multivariate logistic regression analyses.RESULTSAmong the 401 children treated within PMHSS, postinfectious hydrocephalus (PIH) accounted for 39.4% (n = 158) of cases based on clinical, radiographic, and endoscopic findings. The majority of children with hydrocephalus in Haiti were male (54.8%, n = 197), born in the rainy season (59.7%, n = 233), and born in a coastal/inland location (43.3%, n = 61). The most common surgical intervention was endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) (45.7%, n = 175). Multivariate logistic regression analysis yielded coastal birth location (OR 3.76, 95% CI 1.16–12.18) as a statistically significant predictor of PIH. Increasing head circumference (adjusted OR 1.06, 95% CI 0.99–1.13) demonstrated a slight trend toward significance with the incidence of PIH.CONCLUSIONSThis information will provide the foundation for future clinical and public health studies to better understand hydrocephalus in Haiti. The 39.4% prevalence of PIH falls within observed rates in Africa as does the apparently higher prevalence for those born during the rainy season. Although PIH was the most frequent etiology seen in almost all birth locations, the potential relationship with geography noted in this series will be the focus of further research in an effort to understand the link between climate and PIH in Haiti. The ultimate goal will be to develop an appropriate public health strategy to reduce the burden of PIH on the children of Haiti.

Download Full-text

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

Current Neurovascular Research ◽

10.2174/1567202616666190618164528 ◽

2019 ◽

Vol 16 (3) ◽

pp. 250-257 ◽

Cited By ~ 1

Author(s):

Jiann-Der Lee ◽

Ya-Han Hu ◽

Meng Lee ◽

Yen-Chu Huang ◽

Ya-Wen Kuo ◽

...

Keyword(s):

Logistic Regression ◽

Ischemic Stroke ◽

Multivariate Logistic Regression Analysis ◽

Stroke Recurrence ◽

Prior History ◽

Multivariate Logistic Regression ◽

Cart Analysis ◽

Younger Age ◽

History Of ◽

One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

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

The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00656-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Takahisa Handa ◽

Akinobu Nakamura ◽

Aika Miya ◽

Hiroshi Nomoto ◽

Hiraku Kameda ◽

...

Keyword(s):

Type 2 Diabetes ◽

Logistic Regression ◽

Regression Analysis ◽

Observational Study ◽

Elderly Patients ◽

Prospective Observational Study ◽

Multivariate Logistic Regression Analysis ◽

Glycemic Variability ◽

Multivariate Logistic Regression

Abstract Background This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes. Methods We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Results In the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses. Conclusions Among elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined. Trial registration UMIN-CTR: UMIN000029993. Registered 16 November 2017

Download Full-text

Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

Burns & Trauma ◽

10.1093/burnst/tkaa037 ◽

2020 ◽

Vol 8 ◽

Author(s):

Chen Dong ◽

Minhui Zhu ◽

Luguang Huang ◽

Wei Liu ◽

Hengxin Liu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Treatment Failure ◽

Logistic Regression Analysis ◽

Disease Duration ◽

Multivariate Logistic Regression Analysis ◽

Tissue Expansion ◽

Multivariate Logistic Regression ◽

Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p < 0.001), larger volume of expander (200–400 ml vs <200 ml; OR, 1.74; p = 0.032; >400 ml vs <200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of <1 year, expander volume of >200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

Download Full-text

Donepezil Combined with DL-3-n-Butylphthalide Delays Cognitive Decline in Patients with Mild to Moderate Alzheimer’s Disease: A Multicenter, Prospective Cohort Study

Journal of Alzheimer s Disease ◽

10.3233/jad-201381 ◽

2021 ◽

Vol 80 (2) ◽

pp. 673-681

Author(s):

Jin Wang ◽

Xiaojuan Guo ◽

Wenhui Lu ◽

Jie Liu ◽

Hong Zhang ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Prospective Cohort ◽

Daily Living ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Significant Difference

Background: Vascular factors and mitochondria dysfunction contribute to the pathogenesis of Alzheimer’s disease (AD). DL-3-n-butylphthalide (NBP) has an effect in protecting mitochondria and improving microcirculation. Objective: The aim was to investigate the effect of donepezil combined NBP therapy in patients with mild-moderate AD. Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n = 43) or the donepezil combined NBP group (n = 49) for 48 weeks. All patients were evaluated with Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog), Clinician’s Interview-Based Impression of Change plus caregiver input (CIBIC-plus), Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), and Neuropsychiatric Inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using multivariate logistic regression analysis. Results: The multivariate logistic regression analysis showed that the changes of ADAS-cog score (OR = 2.778, 95% CI: [1.087, 7. 100], p = 0.033) and ADCS-ADL score (OR = 2.733, 95% CI: [1.002, 7.459], p = 0.049) had significant difference between donepezil alone group and donepezil combined NBP group, while the changes of NPI (OR = 1.145, 95% CI: [0.463, 2.829], p = 0.769), MMSE (OR = 1.563, 95% CI: [0.615, 3.971], p = 0.348) and CIBIC-plus (OR = 2.593, 95% CI: [0.696, 9.685], p = 0.156) had no significant difference. The occurrence of AEs was similar in the two groups. Conclusion: Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.

Download Full-text