scholarly journals Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing

2019 ◽  
Vol 13 ◽  
pp. 175346661987152 ◽  
Author(s):  
Hongwu Wang ◽  
Meimei Tao ◽  
Nan Zhang ◽  
Hang Zou ◽  
Dongmei Li ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Previous History ◽  
Metallic Stents ◽  
Interventional Bronchoscopy ◽  
Related Factors ◽  
Airway Stenting ◽  
History Of ◽  
Airway Stents ◽  
Covered Metallic Stents

Background: Thoracogastric-airway fistula (TGAF) post-thoracic surgery is a rare and challenging complication for esophagectomy. The aim of this study was to explore the effectiveness of airway stenting for TGAF patients and find related factors coupled with healing of fistula. Methods: This is a retrospective study involving patients with TGAF who were treated with airway stentings. Based on different TGAF locations and sizes on chest computed tomography, covered metallic or silicon airway stents were implanted to cover orifices under interventional bronchoscopy. TGAF healing was defined as the primary outcome, and complete sealing of TGAF as the second outcome. The predictors for TGAF healing were analyzed in univariate and multivariate analysis. Results: A total of 58 TGAF patients were included, of whom 7 received straight covered metallic stents, 5 straight silicon stents, 3 L-shaped covered metallic stents, 21 large Y-shaped covered metallic stents, 17 large Y-shaped silicon stents, and 5 with Y-shaped covered metallic stents. Healing was achieved in 20 (34.5%) patients, and complete sealing in 45 (77.6%) patients. There were no significant differences in healing rate and complete sealing rate between patients receiving metallic stents and those with silicon stents. In univariate analysis, lacking a previous history of radiotherapy or chemotherapy, nonmalignant fistulas, small fistulas, and shorter postesophagectomy duration were found associated with a higher rate of TGAF healing. Only shorter postesophagectomy duration was associated with TGAF healing in multivariate analysis. Conclusions: Both silicon and covered metallic airway stenting are effective methods to close TGAF. A shorter postesophagectomy period may predict better TGAF healing. The reviews of this paper are available via the supplemental material section.

scholarly journals Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)—Two-Year Follow-Up Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Leila Yazdanpanah ◽  
Hajieh Shahbazian ◽  
Iraj Nazari ◽  
Hamid Reza Arti ◽  
Fatemeh Ahmadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Previous History ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Population Based ◽  
University Hospital ◽  
Foot Deformity ◽  
History Of

Aim/Introduction. This study was carried out to assess the incidence and risk factors of diabetic foot ulcer (DFU). Materials and Methods. In this prospective cohort study in a university hospital, all the participants were examined and followed up for new DFU as final outcome for two years. To analyze the data, the variables were first evaluated with a univariate analysis. Then variables with P value < 0.2 were tested with a multivariate analysis, using backward-elimination multiple logistic regression. Results. Among 605 patients, 39 cases had DFU, so we followed up the remaining 566 patients without any present or history of DFU. A two-year cumulative incidence of diabetic foot ulcer was 5.62% (95% CI 3.89–8.02). After analysis, previous history of DFU or amputation [OR = 9.65, 95% CI (2.13–43.78), P value = 0.003], insulin usage [OR = 5.78, 95% CI (2.37–14.07), P value < 0.01], gender [OR = 3.23, 95% CI (1.33–7.83), P value = 0.01], distal neuropathy [OR = 3.37, 95% CI (1.40–8.09), P value = 0.007], and foot deformity [OR = 3.02, 95% CI (1.10–8.29), P value = 0.032] had a statistically significant relationship with DFU incidence. Conclusion. Our data showed that the average annual DFU incidence is about 2.8%. Independent risk factors of DFU development were previous history of DFU or amputation, insulin consumption, gender, distal neuropathy, and foot deformity. These findings provide support for a multifactorial etiology for DFU.

Pleural Effusions Associated with Use of Dasatinib in Chronic Myeloid Leukemia May Have an Auto-Immune Pathogenesis.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2945-2945 ◽  
Author(s):  
Sinthiya Punnialingam ◽  
Hugues de Lavallade ◽  
Dragana Milojkovic ◽  
Bua Marco ◽  
Jamshid S. Khorashad ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Autoimmune Disease ◽  
Skin Rash ◽  
Previous History ◽  
Fluid Retention ◽  
Pleural Effusions ◽  
Imatinib Resistance ◽  
Immune Pathogenesis ◽  
History Of

Abstract Pleural effusions (PE) are a relatively common side effect of dasatinib (an oral multi-targeted kinase inhibitor) and have been reported in 20–30% of CML patients. The underlying mechanism is unclear but may be related to inhibition of the PDGFR gene. We report a series of 43 patients, who received dasatinib while in first chronic phase, after imatinib resistance (n=31) or intolerance (n=12). Twenty two patients had previously received interferon. Patients were treated with dasatinib 70 mg twice daily. The median follow-up was 149 days (range 21–730). Of the 43 patients, 14 developed PE at a median of 150 days (range 21–698) after starting dasatinib. The dasatinib was interrupted in all cases and not resumed until the PE had resolved completely, which occurred in all cases. Diuretics were administered in some cases. The median duration of discontinuation was 14 days (range 7–65). In 8 of the 14 patients the drug was re-started at reduced dose following the first episode of PE. PE recurred in 4 patients (3 patients had two and 1 patient 5 episodes). The dose was further reduced in these cases and eventually abandoned in 2 patients. We performed univariate and multivariate analysis to identify prognostic factors for the development of PE. Significant variables were: prior skin rash on imatinib therapy, [21% non PE vs 57% PE (p=0.035)], skin rash on dasatinib [(before the development of PE vs any time during the follow up) 4% non PE vs 47% PE (p=0.002)], and previous history of autoimmune disease, [non PE 7% vs 50% PE (p=0.006)]. The documented autoimmune diseases were: hyperthyroidism (n=1), hypothyroidism (n=3), systemic lupus erythematosus (n=1), Sweets syndrome (n=1) and auto-immune hepatitis (n=1). We did not find correlation between the previous history of autoimmune disorders and having been treated with interferon. The dose of dasatinib prior to the onset of PE was compared with the dose in patients who did not develop PE at 6 months; patients still receiving 70 mg twice a day were more likely to develop PE than those for whom the dose had been reduced, with a relative risk (RR) for the development of PE of 4.7 (95CI 1.2–18.4, p=0.02). The only variables that were predictive in the multivariate analysis were a history of autoimmune disease and the dose of dasatinib [RR 13 (95CI 1.6–103) and RR 7.4 (95CI 1.2–44.3) respectively]. Interestingly the presence of generalised fluid retention was not found to be significant (p=0.54) nor the previous therapy with interferon (p=1.0). Our results are in agreement with recent reports which suggest that dasatinib-induced PE does not correlate with generalised fluid retention and may be mediated by an immune mechanism. Moreover dasatinib-induced PE are usually exudates and are believed to respond to steroids. In summary in this series PE occurred more frequently in patients with a previous history of autoimmunity and imatinib-related dermatological side effects; both observations support the notion that PE secondary to dasatinib therapy may have an auto-immune pathogenesis.

Evaluation of Exercise Capacity In Children with SCD by Six Minute Walk Test

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2664-2664
Author(s):  
Caterina Minniti ◽  
Shoaib Alam ◽  
Gregory J. Kato ◽  
Mehdi Nouraie ◽  
Craig Sable ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Exercise Capacity ◽  
Conflicts Of Interest ◽  
Strong Predictor ◽  
Univariate Analysis ◽  
History Of ◽  
Rate Of Decline ◽  
Changes Over Time ◽  
Minute Walk

Abstract Abstract 2664 Background: The six-minute walk (6MW) test is used in pediatrics in clinical practice and research to determine cardiopulmonary functional status. A change in 6MW may be affected by factors not strictly related to cardiopulmonary function, which may be different in different patient populations. In children and adolescents, age and height has been found to be a strong predictor of 6MW distance. We set out to study the effects of hematological and echocardiographic variables on 6MW distance in children with sickle cell disease (SCD) and its changes over time. Methods: We reviewed prospectively collected hematological, 6MW distance, and echocardiographic data from four hundred children with SCD (including 311 Hb SS or β0) and 69 controls (including 21 Hb AS) enrolled in PUSH (Pulmonary Hypertension and the Hypoxic Response in SCD). Subjects were evaluated at baseline and after 18–24 months, as per protocol. An un-encouraged 6MW was performed in children 5 years or older by trained personnel as per the guidelines of the American Thoracic Society. Subjects were studied at steady state, at least three weeks after any acute exacerbation of SCD. We used ANOVA for univariate analysis and stepwise linear regression for multivariate analysis. Results: Median (interquartile range) 6MW in severe SCD genotype (SS and S-β0) was 444 (399-508) and in controls was 495 meters (435-539) (P = 0.0002), while it was 461 meters (408-518) in milder SCD genotypes (P=0.2 for comparison with severe genotypes) (Table 1). In multivariate analysis, Hb, WBC and history of frequent pain episodes were significantly associated to distance of 6MW. Follow up 6MW obtained in 174 SCD subjects revealed a decline of 10% or more in distance in 22% of subjects with severe genotypes and 33% of other genotypes. The decline was more frequent in the subset of SS subjects with TRV>2.59 (40% vs 19%). CONCLUSION: Six minute walk distance is significantly shorter in children with SCD, even as young as 5 years of age, when compared to age and race appropriate controls, indicating early compromise of exercise capacity. SS and S-β-0 genotype subjects have more impairment of exercise capacity compared to milder genotypes. Predictors of 6MW distance are similar in SCD and non SCD subjects, which validates the use of this test in this patient population. Longitudinal changes in subjects with SCD are similar, with declines in about a quarter of the subjects. Patients with SS who have an elevated TRV have the highest rate of decline in 6MW. These results validate the use of 6MW as a tool for assessing exercise capacity in children with SCD. Disclosures: No relevant conflicts of interest to declare.

Prognostic analysis of Chinese patients with metastasic renal cell cancer (mRCC) receiving sorafenib: A multicenter retrospective study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15582-e15582 ◽  
Author(s):  
Fang Guo ◽  
Xiaodong Xie ◽  
Zhaozhe Liu ◽  
Xishuang Song ◽  
Qifu Zhang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lung Metastasis ◽  
Univariate Analysis ◽  
Chinese Patients ◽  
Related Factors ◽  
Metastatic Lesions ◽  
Long Term Study ◽  
Previous Therapy ◽  
Ecog Ps

e15582 Background: This study was to investigate long-term efficacy of sorafenib and survival-related factors in Chinese patients with mRCC. Methods: 406 consecutive patients enrolled in this study between Oct. 2006 and Oct. 2009 from 6 comprehensive cancer centres in China. All cases were diagnosed as mRCC histopathologically without exception. 400mg sorafenib was orally taken twice daily until PD, death or intolerable toxic reaction. The primary endpoint was OS. The secondary endpoints were PFS and survival-related factors such as gender, age, ECOG PS, previous therapy and primary metastatic lesions. Data was analyzed using the SPSS statistical software. OS and PFS curves were output using the Kaplan-Meier method. Clinical parameters were included on univariate and multivariate analysis to evaluate associations with OS and PFS by the log-rank test and Cox proportional hazard models, P<0.05 (two-sided) was considered statistically significant. Results: 131 patients were available for survival analysis, including 96 males and 35 females. The median age was 60 years old. The median follow-up periods were 16.9 months. The median OS was 16.1 months. 1-year, 2-year and 3-year survival rates were 64.9%, 35.9% and 5.3%, respectively. The median PFS was 10.5 months. Univariate analysis demonstrated that OS was significantly associated with ECOG PS, metastatic lesions and previous therapy, whereas PFS was merely associated with ECOG PS and previous therapy. Multivariate analysis suggested that ECOG PS and previous therapy were independent prognostic factors for OS(P=0.004, P=0.019) and PFS (P=0.000, P=0.003), metastatic lesions was merely independent prognostic factor for OS (P=0.003). In the subgroup of patients with visceral metastasis, patients with lung metastasis alone had better prognosis than those with liver metastasis or dimerous metastasis. Conclusions: This long-term study demonstrated that sorafenib had good effects on Chinese patients with mRCC, especially for patients with lung metastasis alone. ECOG PS, metastatic lesions and previous therapy could be important parameters for survival and need attention in future.

Prediction of Difficult Mask Ventilation

2000 ◽  
Vol 92 (5) ◽  
pp. 1229-1236 ◽  
Author(s):  
Olivier Langeron ◽  
Eva Masso ◽  
Catherine Huraux ◽  
Michel Guggiari ◽  
André Bianchi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Confidence Interval ◽  
Body Mass ◽  
Univariate Analysis ◽  
Positive Pressure ◽  
Mask Ventilation ◽  
Airway Patency ◽  
Difficult Mask Ventilation ◽  
History Of

Background Maintenance of airway patency and oxygenation are the main objectives of face-mask ventilation. Because the incidence of difficult mask ventilation (DMV) and the factors associated with it are not well known, we undertook this prospective study. Methods Difficult mask ventilation was defined as the inability of an unassisted anesthesiologist to maintain the measured oxygen saturation as measured by pulse oximetry &gt; 92% or to prevent or reverse signs of inadequate ventilation during positive-pressure mask ventilation under general anesthesia. A univariate analysis was performed to identify potential factors predicting DMV, followed by a multivariate analysis, and odds ratio and 95% confidence interval were calculated. Results A total of 1,502 patients were prospectively included. DMV was reported in 75 patients (5%; 95% confidence interval, 3.9-6.1%), with one case of impossible ventilation. DMV was anticipated by the anesthesiologist in only 13 patients (17% of the DMV cases). Body mass index, age, macroglossia, beard, lack of teeth, history of snoring, increased Mallampati grade, and lower thyromental distance were identified in the univariate analysis as potential DMV risk factors. Using a multivariate analysis, five criteria were recognized as independent factors for a DMV (age older than 55 yr, body mass index &gt; 26 kg/m2, beard, lack of teeth, history of snoring), the presence of two indicating high likelihood of DMV (sensitivity, 0.72; specificity, 0.73). Conclusion In a general adult population, DMV was reported in 5% of the patients. A simple DMV risk score was established. Being able to more accurately predict DMV may improve the safety of airway management.

The associations between risk behaviour and reported history of sexually transmitted diseases, among young women: a population-based study

1997 ◽  
Vol 8 (8) ◽  
pp. 501-505 ◽  
Author(s):  
Monica Jonsson ◽  
Roger Karlsson ◽  
Ewa Rylander ◽  
Ake Gustavsson ◽  
Goran Wadell
Keyword(s):  
Alcohol Consumption ◽  
Sexually Transmitted Diseases ◽  
Univariate Analysis ◽  
Previous History ◽  
Multivariate Logistic Regression Analysis ◽  
Risk Behaviour ◽  
Population Based ◽  
Sexual Partners ◽  
Sexually Transmitted ◽  
History Of

The aim of this study was to determine the associations between risk behaviour and women's reported sexually transmitted diseases (STDs). All the women aged 19, 21, 23 and 25, residing in a specified housing area, were invited to answer a questionnaire regarding their sexual behaviour, smoking and alcohol consumption and previous history of STD. Of the 611 women participating, one out of 4 women had a history of at least one STD. In an univariate analysis, self-reported STD was found to be related to age, having more than 4 lifetime sexual partners, having practised intercourse at first date, inconsistent use of condoms, alcohol consumption of more than 3 bottles of wine per month and smoking. These factors were, however, not independent of each other and when subjected to a multivariate logistic regression analysis 2 factors, i.e. the lifetime number of sexual partners (more than 4 partners vs one; OR 7.94, (3.41-18.50)) and coitus on first date (practised more than once vs never, OR 2.99 (1.55-5.78)) emerged as independently associated with a previous STD.

scholarly journals Incidence and Risk Factors for Bilateral Nephrolithiasis: A Large Case-retrospective Study

2021 ◽  
Author(s):  
Xiong Yang ◽  
Zhi Li ◽  
Shiyong Qi ◽  
Linguo Xie ◽  
Qiduo Shi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
Kidney Stones ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Renal Stones ◽  
Urinary Stones ◽  
Preoperative Imaging ◽  
History Of

Abstract To determine the incidence and risk factors of bilateral kidney stones. Utilized the retrospective analysis method on demographic characteristics and clinical data of patients with renal stones in the Second Hospital of Tianjin Medical University. Grouped patients into unilateral and bilateral renal stones according to preoperative imaging and ultrasound examination. Univariate and multivariate analysis methods were used to evaluate the factors that may cause bilateral stones. The study included 7587 patients with kidney stones in total, of whom 4983 had unilateral kidney stones (including 2719 left stones and 2264 right stones), and 2604 had bilateral kidney stones (34.3%). By comparing the unilateral stones group with the bilateral stones group, the univariate analysis demonstrated that weight, body mass index (BMI), history of nephrolithiasis, diabetes mellitus (DM), hypertension, gout, and the maximal stone diameter had statistical significance. Binary logistic regression multivariate analysis demonstrated that BMI, history of nephrolithiasis, diabetes mellitus, hypertension, gout, and the maximal stone diameter were independent risk factors for bilateral urinary stones. This study shows that 34.3% of patients with kidney stones were diagnosed as having bilateral kidney stones; BMI and the maximal stone diameter are positively correlated with the incidence of bilateral kidney stones; Patients with a history of nephrolithiasis, diabetes, hypertension, and gout have a significantly higher risk of having bilateral kidney stones.

scholarly journals Perioperative outcomes following surgery for brain tumors: Objective assessment and risk factor evaluation

2012 ◽  
Vol 03 (01) ◽  
pp. 28-35 ◽  
Author(s):  
Aliasgar V Moiyadi ◽  
Prakash M Shetty
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Brain Tumors ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Perioperative Outcomes ◽  
Related Factors ◽  
Important Indicator ◽  
Systemic Complications

ABSTRACT Background: Perioperative outcomes following surgery for brain tumors are an important indicator of the safety as well as efficacy of surgical intervention. Perioperative morbidity not only has implications on direct patient care, but also serves as an indicator of the quality of care provided, and enables objective documentation, for comparision in various clinical trials. We document our experience at a tertiary care referral, a dedicated neuro-oncology center in India. Materials and Methods: One hundred and ninety-six patients undergoing various surgeries for intra-axial brain tumors were analyzed. Routine microsurgical techniques and uniform antibiotic policy were used. Navigation/ intraoperative electrophysiological monitoring was not available. The endpoints assessed included immediate postoperative neurological status, neurological outcome at discharge, regional complications, systemic complications, overall morbidity, and mortality. Various risk factors assessed included clinico-epidemiological factors, tumor-related factors, and surgery-related factors. Univariate and multivariate analysis were performed. Results: Median age was 38 years. 72% had tumors larger than 4 cm. Neurological morbidity, and regional and systemic complications occurred in 16.8, 17.3, and 10.7%, respectively. Overall, major morbidity occurred in 18% and perioperative mortality rate was 3.6%. Although a few of the known risk factors were found to be significant on univariate analysis, none achieved significance on multivariate analysis. Conclusions: Our patients were younger and had larger tumors than are generally reported. Despite the unavailability of advanced intraoperative aids we could achieve acceptable levels of morbidity and mortality. Objective recording of perioperative events is crucial to document outcomes after surgery for brain tumors.

scholarly journals Can negative ureteroscopy be predicted in ureteral stone treatment?

2019 ◽  
Vol 14 (5) ◽  
Author(s):  
Mehmet Oguz Sahin ◽  
Volkan Sen ◽  
Bora Irer ◽  
Guner Yildiz
Keyword(s):  
Multivariate Analysis ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Ureteral Stones ◽  
Imaging Procedure ◽  
Significant Difference ◽  
Small Stone ◽  
Stone Treatment ◽  
History Of ◽  
Distal Localization

Introduction: We aimed to evaluate factors predictive of negative ureteroscopy (URS) in ureteral stones. Methods: Patients who underwent URS between January 2007 and June 2018 were included in the study. Patients were divided into two groups; group 1: positive URS (841 patients) and group 2: negative URS (75 patients). These two groups were compared in terms of demographic data, stone characteristics, and postoperative outcomes. Results: The mean age of the study patients was 44.5±15.1 years. The absence of collecting system dilatation due to the present stone was found to be a significant predictive factor for negative URS in univariate analysis, but there was no significant difference in multivariate analysis. In the multivariate analysis, low body mass index (BMI), no history of stone surgery, stone located in the distal ureter, small stone area, longer time between the last imaging procedure and URS, and medical expulsive therapy (MET) application were statistically significant in predicting negative URS. Conclusions: In this study, the parameters that significantly predicted negative URS were found to be low BMI, no history of stone surgery, distal localization of the stone, small stone area, longer time between the last imaging procedure and URS, and MET applied for the current stone. These parameters should be considered to avoid negative URS and patients should be informed of the possibility of negative URS prior to operation.

Conjunctival melanoma: Risk factors for recurrent or new tumor in 540 patients at a single ocular oncology center

2020 ◽  
pp. 112067212097039
Author(s):  
Sarangdev Vaidya ◽  
Lauren A Dalvin ◽  
Antonio Yaghy ◽  
Richard Pacheco ◽  
Jerry A Shields ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Tumor Formation ◽  
Older Age ◽  
Conjunctival Melanoma ◽  
Secondary Tumor ◽  
Unit Increase ◽  
History Of

Purpose: To investigate risk factors for recurrent or new tumor in patients with conjunctival melanoma. Methods: Retrospective review of patients with conjunctival melanoma managed on the Ocular Oncology Service, Wills Eye Hospital from 1974 to 2019. Results: There were 540 patients with mean follow-up of 57.6 months, of whom 176 (33%) had recurrent or new tumor formation. Risk factors for recurrent or new tumor on univariate analysis included presentation at older age (OR: 1.02 [1.01–1.03] per 1-year increase in age, p = 0.002), history of prior conjunctival surgery (OR: 1.62 [1.05–2.49], p = 0.03), worse visual acuity at presentation (OR: 1.76 [1.04–2.98] per 1 log-unit increase, p = 0.04), more advanced AJCC clinical T-subcategory (OR: 1.08 [1.02–1.14] per 1 subcategory increase, p = 0.01), tumor primary location in tarsal conjunctiva (OR: 1.80 [1.09–2.98], p = 0.02), and secondary tumor involvement of the fornix (OR: 1.68 [1.06–2.65], p = 0.03), and eyelid (OR: 1.92 [1.07–3.43], p = 0.03). Risk factors on multivariate analysis using all demographics, clinical features, and tumor location included presentation at older age (OR: 1.02 [1.00–1.03], p = 0.01), history of prior conjunctival surgery (OR: 1.84 [1.16–2.94], p = 0.01), and more advanced AJCC clinical T-subcategory (OR: 1.07 [1.01–1.13] per one subcategory increase, p = 0.03). Conclusion: On multivariate analysis, the strongest predictors of recurrent or new tumor formation following treatment of conjunctival melanoma included older age, history of prior conjunctival surgery, and advanced AJCC T-subcategory. These results suggest that earlier detection and the first surgery in conjunctival melanoma management are critical for prevention of recurrent or new tumor, and we recommend prompt referral to an experienced surgeon.

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