Impact of the COVID-19 pandemic on migraine in Japan: a multicentre cross-sectional study

Abstract Objectives To assess the impacts of social situation changes due to the coronavirus disease 2019 (COVID-19) pandemic on headache-related disability and other symptoms in patients with migraine in Japan. Methods We conducted a multicentre, cross-sectional study including 659 outpatients with migraine diagnosed by headache specialists. The participants were asked about the impacts of the first wave of the COVID-19 pandemic on headache-related disability, headache days, headache intensity, stress, physical activity, hospital access and their work and home lives. For headache-related disability, the total Migraine Disability Assessment (MIDAS) score and part A and B scores were analysed. Multivariate stepwise linear regression analysis was performed to identify the clinical predictors of changes in the total MIDAS score before and during the COVID-19 pandemic. Logistic regression analysis was performed to determine the factors related to new-onset headache during the COVID-19 pandemic. Results Finally, 606 migraine patients (73 M/533 F; age, 45.2 ± 12.0 years) were included in the study, excluding those with incomplete data. Increased stress, substantial concern about COVID-19 and negative impacts of the first wave of the COVID-19 pandemic on daily life were reported in 56.8 %, 55.1 and 45.0 % of the participants, respectively. The total MIDAS and A and B scores did not significantly change after the first wave of the COVID-19 pandemic. New-onset headache, which was observed in 95 patients (15.7 %), was associated with younger age and worsened mood and sleep in the logistic regression analysis. The multivariate stepwise linear regression analysis of changes in the total MIDAS score before and during the first wave of COVID-19 pandemic identified worsened sleep, increased acute medication use, increased stress, medication shortages, comorbidities, the absence of an aura and new-onset headache were determinants of an increased total MIDAS score during the first wave of the COVID-19 pandemic. Conclusions In this multicentre study, clinical factors relevant to headache-related disability, such as new-onset headache, stress and sleep disturbances, were identified, highlighting the importance of symptom management in migraine patients during the first wave of the COVID-19 pandemic.

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Nutritional status and quality of life in diabetic patients on hemodialysis: a cross-sectional study from Palestine

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00255-w ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Eba’a Hafi ◽

Ro’ya Soradi ◽

Sarah Diab ◽

Ahmad M. Samara ◽

Marah Shakhshir ◽

...

Keyword(s):

Quality Of Life ◽

Regression Analysis ◽

Linear Regression ◽

Nutritional Status ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional

Abstract Background End-stage renal disease (ESRD) is a leading cause of death and morbidity worldwide. Malnutrition is a common problem among hemodialysis (HD) patients that negatively impacts their prognosis and is linked to an increase in morbidity and mortality in these patients, as well as a decrease in their quality of life (QOL). In this study, we aimed to evaluate the QOL and to investigate factors that can influence it, including nutritional status, as well as socio-demographic factors, among Palestinian diabetic patients on HD therapy. Methods This was a cross-sectional study that occurred at a large hemodialysis center in Palestine. Malnutrition was assessed by the malnutrition-inflammation scale (MIS), and the quality of life was evaluated by using the EuroQoL five-dimensional instrument (EQ-5D). Multivariable linear regression analysis was carried out to look at the effect of multiple variables on QOL. Results A total of 118 diabetic patients on HD were included. Of these, 66.9% were male, and 60.2% were aged 60 years or higher. Having multiple comorbid diseases (p=0.004) and having been on HD for >4 years (p=0.003) were significantly associated with a higher MIS score, whereas living alone (p=0.037) and having been on HD for >4 years (p=0.002) was significantly associated with lower EQ-5D score. We also observed a significant association between the MIS score and the EQ-5D score(r=−0.616, p<0.001). Multiple linear regression analysis demonstrated that diabetic hemodialysis patients who lived within a family household were positively correlated with the QOL score (standardized coefficient, 0.178; 95% confidence interval (CI), 0.042 to 0.372; p = 0.015), and MIS score was significantly and negatively correlated with QOL scores (standardized coefficient, −0.587; 95% CI, −0.047 to −0.028; p < 0.001). Conclusions We found that malnutrition was associated with a lower QOL score among diabetic patients on HD. We recommend general practitioners, dietitians, nephrologists, and nurses to make plans that pay more attention to this group of patients who show evidence of malnutrition. Patients on dialysis for ≥ 4 years, patients who live alone, and those suffering from multiple co-morbid diseases should receive special care due to their higher risk of being impacted by this problem.

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Association between Visceral or Subcutaneous Fat Accumulation and B-Type Natriuretic Peptide among Japanese Subjects: A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm10061315 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1315

Author(s):

Yoshinori Hayashi ◽

Hirohide Yokokawa ◽

Hiroshi Fukuda ◽

Mizue Saita ◽

Taiju Miyagami ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Multiple Linear Regression ◽

Natriuretic Peptide ◽

Linear Regression Analysis ◽

Subcutaneous Fat ◽

Multiple Linear Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

Background: Some previous studies have shown reduced levels of plasma B-type natriuretic peptide (BNP) in individuals with obesity. We aimed to estimate the relationship between BNP and abdominal fat distribution, adjusted for confounding factors. Methods: This cross-sectional study included 1806 Japanese individuals (981 men and 825 women) who underwent a medical health check-up. Analyzed data included age, sex, visceral fat area (VFA), and subcutaneous fat area (SFA) as obtained from computed tomography, blood pressure, and blood test results including BNP. Multiple linear regression analysis was used to examine the association between BNP, VFA, and SFA after adjusting for age, sex, comorbidities, and body mass index. Results: In the models analyzed separately for VFA and SFA, BNP correlated independently with VFA in multiple linear regression analysis among all subjects and in both men and women, while SFA correlated inversely with BNP in all subjects and women but not in men. In the model that included both VFA and SFA, BNP correlated independently with VFA, but SFA and BNP were not correlated in any models. Conclusion: Higher VFA showed an independent, significant association with lower BNP. In addition, the inverse correlation with BNP was stronger for VFA than for SFA.

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Bone responsiveness to parathyroid hormone is negatively associated with parathyroid hormone-lowering drug use in patients undergoing hemodialysis: a cross-sectional study

BMC Nephrology ◽

10.1186/s12882-021-02482-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Naoto Tominaga ◽

Tomoki Yonaha ◽

Masayuki Yamanouchi ◽

Hirofumi Sumi ◽

Yasuhiro Taki ◽

...

Keyword(s):

Regression Analysis ◽

Parathyroid Hormone ◽

Bone Resorption ◽

Linear Regression ◽

Linear Regression Analysis ◽

Significant Negative Correlation ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Tracp 5B

Abstract Background Parathyroid hormone (PTH) acts on bone to indirectly increase the number and activity of osteoclasts. Thus, PTH has a stimulatory effect on bone resorption and upregulates bone turnover. However, the responsiveness of bone to PTH varies widely among patients receiving dialysis. In fact, relative to the serum PTH level, the level of serum tartrate-resistant acid phosphatase-5b (TRACP-5b), a bone resorption marker derived from osteoclasts, varies as well. This study aimed to examine factors related to bone responsiveness to PTH in patients undergoing chronic hemodialysis (HD). Methods This study included patients receiving chronic HD in Kawasaki Municipal Tama Hospital (Kanagawa, Japan) and Yonaha Medical Clinic (Okinawa, Japan) and excluded patients who received HD for less than 6 months, those who received a combination of HD and peritoneal dialysis, and those who had cancer bone metastases or myeloma. The TRACP-5b/intact PTH (iPTH) ratio was created as an index of bone responsiveness to PTH, categorized into tertiles (low, medium, and high), and a cross-sectional study was conducted. P < 0.05 indicated statistically significant differences. Results One hundred and six patients were analyzed. Age (P = 0.010), body mass index (BMI) (P = 0.003), use of calcium-sensing receptor (CaSR) agonists (P = 0.008), use of vitamin D receptor activators (VDRAs) (P = 0.012), plasma iPTH level (P < 0.001), serum 1,25(OH)2D level (P = 0.003), and serum TRACP-5b level (P < 0.001) were significantly different among the three categories. In the single linear regression analysis, age (P = 0.016), corrected serum calcium level (P = 0.007), and ln [1,25(OH)2D] (P = 0.044) showed a significant positive correlation with ln [TRACP-5b/iPTH], whereas BMI (P = 0.026), use of CaSR agonists (P = 0.001), use of VDRAs (P = 0.009), and serum phosphorus level (P = 0.018) showed a significant negative correlation. Upon conducting multiple linear regression analysis incorporating significant variables in the single linear regression analysis, a significant negative correlation was observed between the TRACP-5b/iPTH ratio and intravenous administration of a CaSR agonist (etelcalcetide) and/or a VDRA (calcitriol or maxacalcitol) in all the adjusted models. Conclusions Bone responsiveness to PTH is negatively correlated with the intravenous administration of a CaSR agonist and/or a VDRA in patients undergoing chronic HD.

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Association of burnout with doctor–patient relationship and common stressors among postgraduate trainees and house officers in Lahore—a cross-sectional study

PeerJ ◽

10.7717/peerj.5519 ◽

2018 ◽

Vol 6 ◽

pp. e5519 ◽

Cited By ~ 1

Author(s):

Waqas Ahmad ◽

Huma Ashraf ◽

Afnan Talat ◽

Aleena Ahmad Khan ◽

Ammad Anwar Baig ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Power Sharing ◽

Patient Relationship ◽

Sectional Study ◽

Doctor Patient Relationship ◽

Cross Sectional ◽

Graduate Trainees

Introduction Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor–patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor–patient relationship. Methods A descriptive, cross-sectional study design with convenience (non-probability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or “HOs” (recent graduates doing their 1 year long internship) and post-graduate trainees or “PGRs” (residents for 4–5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor–patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P > 0.05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson’s burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor–patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced.

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Analysis of diagnostic delay and its influencing factors in patients with chronic obstructive pulmonary disease: a cross-sectional study

Scientific Reports ◽

10.1038/s41598-021-93499-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zhongshang Dai ◽

Yiming Ma ◽

Zijie Zhan ◽

Ping Chen ◽

Yan Chen

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Diagnostic Delay ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

Sectional Study ◽

Cross Sectional ◽

Obstructive Pulmonary Disease

AbstractTo explore the status of diagnostic delay and to clarify its potentially influencing factors in patients with chronic obstructive pulmonary disease (COPD). A cross-sectional study was conducted in a Chinese tertiary hospital between July 2019 and February 2020. A total of 408 eligible outpatients with COPD were recruited, and relevant data were collected in the form of questionnaires. Diagnostic delay was compared among different characteristics using the Wilcoxon test and Kruskal–Wallis H test. Multivariable linear regression analysis was performed to determine the factors related to diagnostic delay. The median (interquartile range [IQR]) duration of diagnostic delay was 230 (50–720) days. The proportions of COPD patients who chose tertiary, secondary, and first-level hospitals for the first visit were 53.7%, 29.9%, and 16.4%, respectively. Additionally, the proportions of patients who underwent pulmonary function tests for the first visit in tertiary, secondary, and first-level hospitals were 74.0%, 24.6%, and 1.5% (p < 0.001), respectively. In terms of characteristics related to diagnostic delay, there was a significant difference in residence, resident manner, COPD assessment test (CAT) score, modified Medical British Research Council (mMRC) dyspnea scale, age, forced expiratory volume in one second (FEV1) % predicted, and years of education (all p < 0.01). Linear regression analysis showed that significant predictors of diagnostic delay included FEV1% predicted (p < 0.05), resident manner (p < 0.001), and years of education (p < 0.01). Our study indicates that varying degrees of diagnostic delay may exist in patients with COPD. Measures are needed to intervene in the potential factors associated with diagnostic delay.

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The status of medication literacy and associated factors of hypertensive patients in China: a cross-sectional study

Internal and Emergency Medicine ◽

10.1007/s11739-019-02187-0 ◽

2019 ◽

Vol 15 (3) ◽

pp. 409-419 ◽

Cited By ~ 1

Author(s):

Guiyue Ma ◽

Aijing Luo ◽

Zhiying Shen ◽

Yinglong Duan ◽

Shuangjiao Shi ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Multiple Linear Regression ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Hypertensive Patients ◽

Literacy Level

Abstract The adverse consequence of low medication literacy is a major problem that threatens patients' health. The number of people with hypertension is increasing in China. We described the current situation of medication literacy of patients with hypertension in China and its related influencing factor. We conducted a cross-sectional study, which contains 590 hypertensive patients. Stratified sampling was adopted according to the hospital level in China. To determine the factors related to medication literacy, multiple linear regression analysis was used to determine associations between medication literacy of hypertensive patients and other factors. Among 590 respondents, results showed that they have poor medication literacy. Multiple linear regression analysis showed that level of education, annual income, occupation status, and type of medical insurance were significantly associated with medication literacy level of hypertensive patients. In addition, our study also demonstrates that we can identify the medication literacy level of hypertensive patients using the Chinese version Medication Literacy Scale for Hypertensive Patients. High medication literacy is an important factor for hypertensive patients to improve medication adherence, so as to better control blood pressure. We should pay attention to the improvement of medication literacy and take corresponding measures.

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Association of glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS): a cross-sectional study

Arthritis Research & Therapy ◽

10.1186/s13075-021-02466-2 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Yoshia Miyawaki ◽

Sayaka Shimizu ◽

Yusuke Ogawa ◽

Ken-ei Sada ◽

Yu Katayama ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Emotional Health ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Low Disease Activity ◽

Activity State

Abstract Background While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS). Methods This cross-sectional study drew on data from SLE patients in 10 Japanese institutions. The participants were adult patients with SLE duration of ≥ 1 year who met LLDAS criteria at the study visit from April 2018 through September 2019. The exposure was the daily glucocorticoid dose (mg oral prednisolone). The outcome was the emotional health score of the lupus patient-reported outcome scale (range: 0 to 100). Multiple linear regression analysis was performed with adjustment for confounders including disease-related damage, activity, and psychotropic drug use. Results Of 192 patients enrolled, 175 were included in the analysis. Their characteristics were as follows: female, 89.7%; median age, 47 years (interquartile range (IQR): 37.0, 61.0). Median glucocorticoid dose was 4.0 mg (IQR 2.0, 5.0), and median emotional health score 79.2 (IQR 58.3, 91.7). Multiple linear regression analysis showed daily glucocorticoid doses to be associated with worse emotional health (β coefficient = − 2.54 [95% confidence interval − 4.48 to − 0.60], P = 0.01). Conclusions Daily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS. Further studies are needed to determine whether glucocorticoid tapering leads to clinically significant improvements in emotional health.

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Comparison of COVID-19 outcomes with alpha-1-antitrypsin deficiency prevalence: A cross-sectional study.

10.22541/au.162408270.08290884/v1 ◽

2021 ◽

Author(s):

Yılmaz Sezgin ◽

Sinan Becel

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Significant Relationship ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin

Background: We hypothesized that the geographic distributions of COVID-19 prevalence and risky alpha-1-antitrypsin allele prevalence are similar. We aimed to investigate whether there is a relationship between the geographical density of the COVID-19 pandemic and the distributions of risky alpha-1-antitrypsin alleles. Methods: This research is a cross-sectional study. Alpha-1-antitrypsin PI*SZ and PI*ZZ genotypes frequencies of European and American countries were compared with the case and death data related to the COVID-19 pandemic as of March 30, 2021. The relationship between the data was evaluated using Linear regression analysis. Results: According to the linear regression analysis results, a significant relationship was found between the number of COVID-19 cases in both European and American countries and the sum of PI*SZ and PI*ZZ genotypes. Similarly, according to the linear regression analysis results, a significant relationship was found between the COVID-19 death numbers in both European and American countries and the sum of PI*SZ and PI*ZZ genotypes. Conclusions: The findings showed that the prevalence distribution of the risky alleles of the gene defect that causes alpha-1-antitrypsin insufficiency is related to the prevalence of COVID-19 pandemic data.

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The current status and associated factors of fatigue in Chinese patients with gout: A cross-sectional study

10.21203/rs.2.23942/v1 ◽

2020 ◽

Author(s):

Jiaxin Guo ◽

Wei Zhou ◽

Mei He ◽

Jianlin Gao ◽

Yilin Wang ◽

...

Keyword(s):

Logistic Regression ◽

Linear Regression ◽

Sleep Quality ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Sectional Study ◽

Cross Sectional ◽

Stepwise Linear Regression ◽

Chi Square Analysis

Abstract BackgroundFatigue is a common symptom in patients with rheumatism that is easy to ignore. In the absence of previous studies, our study aims to investigate the fatigue status, explore the potential predictors of fatigue and the effects of fatigue on health-related quality of life (HRQoL) among Chinese gout patients.MethodThis cross-sectional study was conducted from the Affiliated Hospital of Nantong University. A series of questionnaires were applied: Fatigue Scale-14 (FS-14), the 10 cm visual analog scale (VAS), the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder questionnaire (GAD-7), the Pittsburgh Sleep Quality Index (PSQI), Health Assessment Questionnaire(HAQ), the Short Form 36 health survey (SF-36). Laboratory examinations were taken to obtain some biochemical indicators. Independent samples t-test, Mann–Whitney U-test, Chi-square analysis, Pearson /Spearman correlation, Stepwise linear regression and binary logistic regression were used to analyze the data.Results410 gout patients were included in this study. Among them, more than 50% patients reported physical fatigue in FS-14, severe disease, poor psychological status and reduced HRQoL were associated with fatigue. Multiple stepwise linear regression and binary logistic regression were applied and showed that pain, sleep quality, anxiety and depression were the potential predictors of fatigue. In addition, we found that the more severe the fatigue, the lower the patient’s HRQoL.ConclusionsFatigue among gout patients is exceedingly common. The results of this study suggested that rheumatologists should pay closely attention to gout patients who suffer from serious fatigue, especially those with pain, poorer sleep quality, anxiety and depression.

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Cross-Sectional Examination of Homocysteine Levels with Sarcopenia and Its Components in Memory Clinic Outpatients

Journal of Alzheimer s Disease ◽

10.3233/jad-210083 ◽

2021 ◽

pp. 1-10

Author(s):

Yosuke Yamada ◽

Hiroyuki Umegaki ◽

Fumie Kinoshita ◽

Chi Hsien Huang ◽

Taiki Sugimoto ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Linear Regression ◽

Logistic Regression Analysis ◽

Linear Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Memory Clinic ◽

Cross Sectional

Background: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p < 0.001) or clinical diagnosis of dementia (β= –3.145, p < 0.001). These results were similar for men and women. Conclusion: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.

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