Percutaneous endoscopic discectomy might be effective in selected cases of pyogenic spondylitis

Background: Percutaneous endoscopic discectomy (PED) has been reported to be an effective procedure and minimally invasive surgical therapy for various spinal pathologies. Objective: To evaluate the clinical outcome of patients with pyogenic spondylitis who were treated with PED. Methods: Twenty-four patients with pyogenic spondylitis who underwent PED were evaluated for medical history, level of the affected intervertebral space, mode of onset, plain radiographs, epidural or psoas abscesses on MRI, results of blood and intraoperative sample cultures, preoperative C-reactive protein (CRP) level, time until postoperative CRP normalization (CRP < 0.3), and any additional surgery. Patients who underwent additional surgery and showed uncontrollable inflammation were considered to have “failed” PED for pyogenic spondylitis. To elucidate the factors that were significantly associated with a failure of PED for pyogenic spondylitis, statistical analyses were conducted by univariate analysis. Results: Control of inflammation was achieved in 19 of 24 patients (76%) after PED for pyogenic spondylitis. The remaining five patients failed to achieve infection control by PED. One such patient was not able to control the infection after PED, and another patient developed an epidural abscess 2 weeks after PED. Remaining three “failed” patients had exacerbations of their infections during the postoperative course and required additional surgery. Univariate analyses demonstrated that diabetes mellitus (DM; p = 0.05), hemodialysis due to DM-induced renal failure ( p = 0.02), concomitant malignant disease ( p = 0.09), and acute onset ( p = 0.05) were possibly correlated with PED failure. Stepwise logistic regression analysis revealed that hemodialysis due to DM-induced renal failure was an independent factor associated with PED failure ( p = 0.03). Conclusions: PED might be considered as one of the alternative therapeutic options before invasive radical surgeries for pyogenic spondylitis after failure of standard conservative therapy. Even by less invasive PED, pyogenic spondylitis patients with DM-hemodialysis showed poor outcome.

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The Use of Total Contact Orthoses in Patients with Foot Problems in Foot Clinic, Siriraj Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.12.11044 ◽

2020 ◽

Vol 103 (12) ◽

pp. 1292-1299

Keyword(s):

Odds Ratio ◽

Univariate Analysis ◽

Stepwise Logistic Regression ◽

Posterior Tibial Tendon ◽

Posterior Tibial Tendon Dysfunction ◽

Stepwise Logistic Regression Analysis ◽

Cross Sectional ◽

Siriraj Hospital ◽

Foot Problems ◽

Foot Clinic

Objective: To study the use rate, outcome, and concomitant factors of the use of the total contact orthoses (TCO) in the Foot Clinic, Siriraj Hospital Materials and Methods: The present study was a cross-sectional descriptive study collecting data from patient medical records and questionnaires. Patients who had foot problems without impairment of foot sensation and received the TCO from the Foot Clinic between July 2015 and April 2016 were interviewed before and after using the latest TCO for one month. Results: One hundred seven participants were recruited. Most were female (84.1%) with a median age of 59.3 years. The majority had chronic plantar fasciitis (26.2%), posterior tibial tendon dysfunction (PTTD) (25.2%), hallux valgus (21.5%), or metatarsalgia (21.5%). The TCO user was defined as a participant who had to use the TCO for more than three days per week and for more or equal to 50% of daily walking and standing duration. The use rate was 67.3%. The TCO provides standing and walking stability (p=0.008). For patients with metatarsalgia, using the TCO could significantly reduce pain (p=0.002). Using univariate analysis, many factors were found to be associated with the use of the TCO including having level of convenience of putting on or taking off shoes with TCO at 9 or more (odds ratio 2.66, 95% CI 1.16 to 6.12), having difficulty to find proper shoes that fit with the TCO (odds ratio 0.36, 95% CI 0.15 to 0.89), receiving more than one pair of TCO (odds ratio 4.09, 95% CI 1.51 to 11.05), and having level of comfort satisfaction during the TCO use at 9 or more (odds ratio 3.61, 95% CI 1.55 to 8.40). The latter two factors were found to be associated with the use of the TCO from stepwise logistic regression analysis (adjusted odds ratio 3.39, 95% CI 1.18 to 9.71 and 3.02, 95% CI 1.07 to 8.47, respectively). Conclusion: The use of the TCO in the Foot Clinic, Siriraj Hospital was 67.3%. Using the TCO could promote walking stability. Factors affecting the use of the TCO included receiving more than the first pair of TCO and having comfort satisfaction level of 9 or more. Keywords: Use, Total contact orthoses, Total contact insole, Foot problems

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Characterization of high- and low-grade cervical intraepithelial neoplasia

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1993.03040203.x ◽

1993 ◽

Vol 3 (4) ◽

pp. 203-207 ◽

Cited By ~ 5

Author(s):

M. I. Shafi ◽

J. A. Dunn ◽

C. B. Finn ◽

S. Kehoe ◽

E. J. Buxton ◽

...

Keyword(s):

Cervical Intraepithelial Neoplasia ◽

Surface Area ◽

Univariate Analysis ◽

Intraepithelial Neoplasia ◽

Stepwise Logistic Regression ◽

Low Grade ◽

Abnormal Cytology ◽

Stepwise Logistic Regression Analysis ◽

Cytologic Smear ◽

Cancer Precursors

A need exists to characterize the various grades of cervical intrapithelial neoplasia (CIN), and attempt to differentiate between high- and low-grade lesions, that may have different behavioral and progressive potentials. The identification of patients with high- or low-grade CIN is useful, as it may allow identification of those patients that have true cancer precursors. Fifty patients referred for colposcopy with abnormal cytology were studied. Univariate analysis identified three factors as important predictors of histologic grade; the colposcopic opinion, lesion surface area and the index cytology (P< 0.005). Colposcopic opinion was associated with the index cytology (P< 0.01) and the lesion surface area (P< 0.005). Only the colposcopic opinion and the index cytologic smear appeared in the final model using a stepwise logistic regression analysis, indicating their independent prognostic importance in prediction of grade of abnormality in cervical intraepithelial neoplasia. The study demonstrates the value of colposcopic training and experience being necessary prior to utilizing excisional treatment methods if overtreatment is to be avoided.

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Hemoglobin A1c as A Potential Indicator for Intraplaque Hemorrhage of Carotid Artery Atherosclerosis in Asymptomatic Adults

10.21203/rs.3.rs-370709/v1 ◽

2021 ◽

Author(s):

Yu Wang ◽

Runhua Zhang ◽

Yong Jiang ◽

Miaoxin Yu ◽

Huiyu Qiao ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Plaque ◽

Hemoglobin A1c ◽

Univariate Analysis ◽

Intraplaque Hemorrhage ◽

Stepwise Logistic Regression ◽

Community Based ◽

Stepwise Logistic Regression Analysis ◽

Cross Sectional ◽

High Hba1c

Abstract BackgroundTo investigate the association between hemoglobin A1c (HbA1c) and intraplaque hemorrhage (IPH) in carotid atherosclerotic plaque detected by high-resolution magnetic resonance imaging (HR-MRI) in a community-based population. MethodsIn this cross-sectional, community-based study, a total of 598 participants were recruited from May 2015 to September 2019. All participants underwent carotid artery HR-MRI. Data on demographics, medical history, and physical examinations were obtained through face-to-face interview, and fasting blood sample were collected. HbA1c was determined using high-performance liquid chromatographic analysis. Presence or absence of carotid plaque IPH was determined by HR-MRI. Multiple stepwise logistic regression analysis was performed to investigate the association between HbA1c levels and carotid plaque IPH. ResultsOf the 598 participants, 317 (53.0%) had atherosclerotic plaques, and 25 (4.2%) had IPH in carotid arteries. HbA1c was associated with the presence of IPH (OR, 1.94; 95% CI, 1.38-2.73) in the univariate analysis, and the association remained significant after adjustment for age, sex, traditional vascular factors, high-sensitivity C-reactive protein, and other potential confounders (OR, 1.70; 95% CI, 1.14-2.52).ConclusionsThis study showed that high HbA1c was associated with carotid plaque IPH detected by HR-MRI, which suggests that individuals with high HbA1c may have a higher risk of developing vulnerable carotid plaques.

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Factors Influencing Anatomic and Visual Results in Primary Scleral Buckling

European Journal of Ophthalmology ◽

10.1177/112067210001000211 ◽

2000 ◽

Vol 10 (2) ◽

pp. 153-159 ◽

Cited By ~ 27

Author(s):

H. Ahmadieh ◽

M. Entezari ◽

M. Soheilian ◽

M. Azarmina ◽

M.H. Dehghan ◽

...

Keyword(s):

Visual Acuity ◽

Logistic Regression ◽

Retinal Detachment ◽

Univariate Analysis ◽

Scleral Buckling ◽

Stepwise Logistic Regression ◽

Stepwise Logistic Regression Analysis ◽

Factors Influencing ◽

Preoperative Visual Acuity ◽

Visual Results

Purpose To identify the factors influencing anatomical and visual results in cases of rhegmatogenous retinal detachment undergoing primary scleral buckling. Methods A retrospective study of 233 eyes of 226 patients was done. The data were evaluated by univariate analysis and stepwise logistic regression analysis. Results Retinal reattachment was achieved with primary scleral buckling in 197 eyes (84.5%). The extent of retinal detachment, preoperative proliferative vitreoretinopathy (PVR), preoperative visual acuity and relative afferent pupillary defects were identified as influencing anatomical results, by univariate analysis. The predictive roles of extent of retinal detachment (p<0.0001) and preoperative PVR (P=0.0085) were shown to be significant by stepwise logistic regression. As well as the above factors, the patient's age, the duration of symptoms and the status of the macula were predictors of visual results, by univariate analysis. Stepwise logistic regression analysis confirmed the predictive roles of preoperative visual acuity (P < 0.0001) and the extent of retinal detachment (P=0.0089). Conclusions Cases with a larger extent of retinal detachment, more advanced preoperative PVR and poorer preoperative visual acuity have less favorable anatomical and functional results.

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Epidemiology and risk factors for ESBL-producing Klebsiella pneumoniae: a case control study

The Journal of Infection in Developing Countries ◽

10.3855/jidc.778 ◽

2010 ◽

Vol 4 (11) ◽

pp. 717-722 ◽

Cited By ~ 16

Author(s):

Kutbettin Demirdag ◽

Salih Hosoglu

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Surgical Intervention ◽

Univariate Analysis ◽

Antibiotic Use ◽

Case Control ◽

University Hospital ◽

Stepwise Logistic Regression ◽

Invasive Infection ◽

Stepwise Logistic Regression Analysis

Introduction: Increased production of extended-spectrum β-lactamases (ESBLs) has become an important issue for treatment of severe Klebsiella pneumoniae (K. pneumoniae) infections. This study aimed to evaluate risk factors of infection from ESBL-producing K. pneumoniae (ESBL-KP). Methodology: Risk factors were evaluated using a retrospective case control design. Fifty-two patients admitted to Firat University Hospital (FUH) with invasive infections from ESBL-KP were employed as cases. Patients admitted to FUH with non-ESBL-producing K. pneumoniae invasive infection were chosen as controls. Potential risk factors of the cases and controls were evaluated using hospital charts. Pulsed-field Gel Electrophoresis (PFGE) was used to show the relatedness of ESBL-KP strains. Results: In univariate analysis, the following factors were found significant for ESBL-KP: pre-infection hospital stay, nosocomial origin, central venous catheterization, surgical intervention, antibiotic use longer than one week, and previous hospitalization. In contrast, stepwise logistic regression analysis showed that two variables, previous antibiotic use (p = 0.000) and surgical intervention (p = 0.006), remained significantly associated with risk for infection with an ESBL-KP. Molecular epidemiology identified several clusters among the ESBL-producing isolates. Conclusions: Antibiotic use and surgical intervention were significant associated factors for infections with ESBL-KP.

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Platelet Function and the Bleeding Time in Progressive Renal Failure

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647640 ◽

1988 ◽

Vol 60 (01) ◽

pp. 083-087 ◽

Cited By ~ 30

Author(s):

M P Gordge ◽

R W Faint ◽

P B Rylance ◽

G H Neild

Keyword(s):

Renal Failure ◽

Platelet Aggregation ◽

Platelet Function ◽

Bleeding Time ◽

C Reactive Protein ◽

Severe Renal Failure ◽

Reactive Protein ◽

Thromboxane Production ◽

Von Willebrand ◽

Willebrand Factor

SummaryBleeding time and platelet function tests were performed on 31 patients with progressive chronic renal failure (CRF) due to non-immunological (urological) causes, and compared with 22 healthy controls. Patients were classified as mild (plasma creatinine <300 μmol/l), moderate (300-600 μmol/l) or severe renal failure (>600 μmol/l). Bleeding time was rarely prolonged in mild and moderate CRF and mean bleeding time significantly elevated only in severe CRF (p <0.005). Haematocrit was the only index which correlated with bleeding time (r = -0.40). Platelet counts, collagen stimulated thromboxane generation, and platelet aggregation responses to ADP, collagen and ristocetin were all either normal or increased in all three CRF groups, but thromboxane production in clotting blood was reduced. Plasma fibrinogen, C reactive protein and von Willebrand factor (vWF) were elevated in proportion to CRF. We found no evidence that defects in platelet aggregation or platelet interaction with vWF prolong the bleeding time in patients with progressive CRF.

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Patterns of care in Italian psychiatric services and psychosocial outcome of schizophrenic patients. A three-year prospective study

Psychiatry and Psychobiology ◽

10.1017/s0767399x00004090 ◽

1989 ◽

Vol 4 (1) ◽

pp. 23-31 ◽

Cited By ~ 1

Author(s):

D. Kemali ◽

M. Maj ◽

B. Carpiniello ◽

R.D. Giurazza ◽

M. Impagnatiello ◽

...

Keyword(s):

Psychosocial Adjustment ◽

Ad Hoc ◽

Social Withdrawal ◽

Skills Training ◽

Favourable Outcome ◽

Stepwise Logistic Regression ◽

Psychosocial Outcome ◽

Stepwise Logistic Regression Analysis ◽

Schizophrenic Patients ◽

The Difference

Summary141 patients with an ICD-9 diagnosis of schizophrenic psychosis were followed up prospectively for 3 years in 7 Italian centres, representative of the different degrees of application of the psychiatric reform law (Law 180) passed in 1978. It was agreed that each centre would treat the patients according to its routine, and that all contacts with the patients and each intervention performed would be carefully recorded in an ad hoc schedule. The baseline evaluation of psychosocial adjustment was performed by the Disability Assessment Schedule (DAS), and this assessment was then repeated every 6 months during the follow-up period. At the end of this period, the rating on the DAS section 5 was taken as a global measure of patients’ psychosocial outcome. On a stepwise logistic regression analysis, 2 variables were found to be significantly predictive of psychosocial outcome, that is the use of social and/or vocational skills training (associated with a favourable outcome) and the number of days/year of full hospitalization (associated with a poor outcome). Trieste and Arezzo were the only centres in which a significant improvement of the score on some DAS subscales (namely, “occupational role, interest” and “social withdrawal”) was detected. In the whole patient sample, the difference between the final and the baseline score on these subscales correlated significantly with the number/year of outpatient contacts and of home visits. These findings confirm the favourable impact of the community-oriented care provided in some Italian centres on the Psychosocial outcome of schizophrenic patients.

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A rapid screening model for early predicting novel coronavirus pneumonia in Zhejiang Province of China: a multicenter study

Scientific Reports ◽

10.1038/s41598-021-83054-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yi-Ning Dai ◽

Wei Zheng ◽

Qing-Qing Wu ◽

Tian-Chen Hui ◽

Nan-Nan Sun ◽

...

Keyword(s):

Operating Characteristic ◽

Clinical Manifestations ◽

Cost Effective ◽

Rapid Screening ◽

Stepwise Logistic Regression ◽

Stepwise Logistic Regression Analysis ◽

Screening Model ◽

Epidemiological Features ◽

Geographical Regions ◽

Novel Coronavirus

AbstractNovel coronavirus pneumonia (NCP) has been widely spread in China and several other countries. Early finding of this pneumonia from huge numbers of suspects gives clinicians a big challenge. The aim of the study was to develop a rapid screening model for early predicting NCP in a Zhejiang population, as well as its utility in other areas. A total of 880 participants who were initially suspected of NCP from January 17 to February 19 were included. Potential predictors were selected via stepwise logistic regression analysis. The model was established based on epidemiological features, clinical manifestations, white blood cell count, and pulmonary imaging changes, with the area under receiver operating characteristic (AUROC) curve of 0.920. At a cut-off value of 1.0, the model could determine NCP with a sensitivity of 85% and a specificity of 82.3%. We further developed a simplified model by combining the geographical regions and rounding the coefficients, with the AUROC of 0.909, as well as a model without epidemiological factors with the AUROC of 0.859. The study demonstrated that the screening model was a helpful and cost-effective tool for early predicting NCP and had great clinical significance given the high activity of NCP.

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Direct Versus Calculated LDL Cholesterol and C-Reactive Protein in Cardiovascular Disease Risk Assessment in the Framingham Offspring Study

Clinical Chemistry ◽

10.1373/clinchem.2019.304600 ◽

2019 ◽

Vol 65 (9) ◽

pp. 1102-1114 ◽

Cited By ~ 3

Author(s):

Hiroaki Ikezaki ◽

Virginia A Fisher ◽

Elise Lim ◽

Masumi Ai ◽

Ching-Ti Liu ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Ldl Cholesterol ◽

Disease Risk ◽

Univariate Analysis ◽

Significant Risk ◽

C Reactive Protein ◽

Cox Regression Analysis ◽

Reactive Protein ◽

Standard Risk

AbstractBACKGROUNDIncreases in circulating LDL cholesterol (LDL-C) and high-sensitivity C-reactive protein (hsCRP) concentrations are significant risk factors for cardiovascular disease (CVD). We assessed direct LDL-C and hsCRP concentrations compared to standard risk factors in the Framingham Offspring Study.METHODSWe used stored frozen plasma samples (−80 °C) obtained after an overnight fast from 3147 male and female participants (mean age, 58 years) free of CVD at cycle 6 of the Framingham Offspring Study. Overall, 677 participants (21.5%) had a CVD end point over a median of 16.0 years of follow-up. Total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C), direct LDL-C (Denka Seiken and Kyowa Medex methods), and hsCRP (Dade Behring method) concentrations were measured by automated analysis. LDL-C was also calculated by both the Friedewald and Martin methods.RESULTSConsidering all CVD outcomes on univariate analysis, significant factors included standard risk factors (age, hypertension, HDL-C, hypertension treatment, sex, diabetes, smoking, and TC concentration) and nonstandard risk factors (non-HDL-C, direct LDL-C and calculated LDL-C, TG, and hsCRP concentrations). On multivariate analysis, only the Denka Seiken direct LDL-C and the Dade Behring hsCRP were still significant on Cox regression analysis and improved the net risk reclassification index, but with modest effects. Discordance analysis confirmed the benefit of the Denka Seiken direct LDL-C method for prospective hard CVD endpoints (new-onset myocardial infarction, stroke, and/or CVD death).CONCLUSIONSOur data indicate that the Denka Seiken direct LDL-C and Dade Behring hsCRP measurements add significant, but modest, information about CVD risk, compared to standard risk factors and/or calculated LDL-C.

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Early predictors of two month response with mianserin and selective serotonin reuptake inhibitors and influence of definition of outcome on prediction

European Psychiatry ◽

10.1016/s0924-9338(98)80137-5 ◽

1998 ◽

Vol 13 (3) ◽

pp. 138-142 ◽

Cited By ~ 6

Author(s):

I Berlin ◽

F Lavergne

Keyword(s):

Complete Remission ◽

Selective Serotonin Reuptake Inhibitors ◽

Stepwise Logistic Regression ◽

Stepwise Logistic Regression Analysis ◽

Double Blind ◽

Significant Treatment ◽

Early Improvement ◽

Time Interaction ◽

Early Predictors ◽

Definition Of

SummaryIn order to identify clinical and demographic variables that predict response to antidepressants and to analyse prediction of outcome as a function of definition of outcome we analysed pooled data of two independent, multicentre, double blind parallel group studies. Study I compared the efficacy of mianserin with that of fluoxetine in 65, and study II compared mianserin with fluvoxamine in 60 patients with depression. Improvement was defined as at least 20% decrease in MADRS by day 14. Patients were considered as responders if they had greater than 50% decrease and non-responders if they had ≤ 50% decrease from baseline in the MADRS at day 56. Complete remission was defined as MADRS score ≤ 6 at day 56. Patients' characteristics did not differ between mianserin and SSRI groups. Early improvement predicted response in 92% and complete remission in 55% of the patients improved at day 14. Multivariate forward stepwise logistic regression analysis showed that response to treatments at day 56 was significantly (P = 0.0003) associated with early improvement, age (responders had higher age than non-responders) and weight (responders weighted more than non-responders). Complete remission was only predicted by early improvement. Treatments could not be differentiated when data were analysed according to responder/nonresponder status or complete remission/no complete remission. However, when the same data were analysed by analysis of variance a significant treatment effect (P = 0.02, mianserin > SSRIs) and a quadratic type treatment by time interaction (P = 0.023) were found. The robustness of the analysis was further improved by inclusion of covariates (age, weight). Early clinical improvement seems to be the best predictor of 2 month response to antidepressants (mianserin, SSRIs). Younger age and lower weight may predict non-response. Quantitative analysis differentiates treatments better than analysis of responder status. As obtenation of complete remission is a realistic objective with current antidepressants, studies longer than 2 months are needed to assess effectiveness of these drugs in the obtenation of complete remission.

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