scholarly journals High levels of unbound bilirubin are associated with acute bilirubin encephalopathy in post-exchange transfusion neonates

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Yiyi Ding ◽  
Shuo Wang ◽  
Rui Guo ◽  
Aizhen Zhang ◽  
Yufang Zhu
Keyword(s):  
Exchange Transfusion ◽  
Binary Logistic Regression ◽  
Positive Association ◽  
Binary Logistic Regression Analysis ◽  
Bilirubin Encephalopathy ◽  
Red Blood Cell Count ◽  
Unbound Bilirubin ◽  
Independent Variable ◽  
The Mean ◽  
The Brain

Abstract Background Although it is known that unbound bilirubin can enter the brain, there is little evidence of its association with the development of acute bilirubin encephalopathy. Here, we investigated this potential relationship in neonates who had undergone exchange transfusion. Methods Data from 46 newborns who underwent exchange transfusion between 2016 and 1-1 to 2018-12-31 at the First People’s Hospital of Changde City in China were analyzed. The unbound bilirubin level was taken as the independent variable and the development of the acute bilirubin encephalopathy as the dependent variable. The covariates were age, birth weight, sex, red blood cell count, blood glucose, hemolytic disease, and whether the infant had received phototherapy. Results The mean age and gestational age of the neonates were 146.5 ± 86.9 h and 38.6 ± 1.3 weeks [38.7(34.6–41.1) weeks] old, respectively; 52.17% were male. Binary logistic regression analysis after adjustment for covariates showed a positive association between the levels of unbound bilirubin and the development of acute bilirubin encephalopathy (odds ratio = 1.41, 95% confidence intervals 1.05–1.91, P = < 0.05). Conclusion There is a significant association between unbound bilirubin levels and the development of acute bilirubin encephalopathy in neonates. Further investigations are required to explore the mechanisms.

scholarly journals Relationship Between Unbound Bilirubin Levels and Acute Bilirubin Encephalopathy in Exchange Transfusion Neonates

2021 ◽  
Author(s):  
Yiyi Ding ◽  
Shuo Wang ◽  
Rui Guo ◽  
Aizhen Zhang ◽  
Yufang Zhu
Keyword(s):  
Logistic Regression ◽  
Blood Glucose ◽  
Odds Ratio ◽  
Exchange Transfusion ◽  
Binary Logistic Regression ◽  
P Value ◽  
Bilirubin Encephalopathy ◽  
Unbound Bilirubin ◽  
Independent Variable ◽  
The Relationship

Abstract BACKGROUND: Evidence regarding the relationship between unbound bilirubin levels and acute bilirubin encephalopathy was limited. Therefore, this study set out to investigate whether the unbound bilirubin level was independently related to acute bilirubin encephalopathy in children who underwent exchange transfusion after adjusting for other covariates. METHODS: A total of 46 neonates who underwent exchange transfusion were involved in The First People's Hospital Of Changde City in China from 2016-1-1 to 2018-12-31. The target independent variable and the dependent variable were unbound bilirubin levels measured at baseline and acute bilirubin encephalopathy respectively. Covariates involved in this study included sex, age, birth weight, blood glucose, red blood cell, hemolysis, receive phototherapy before exchange transfusion. RESULTS: The average gestational age of 46 selected participants was 38.6 ± 1.3 weeks old, the average age was 146.5 ± 86.9 hours old, 52.17% of them were male. Result of fully-adjusted binary logistic regression showed unbound bilirubin levels were positively associated with risk of acute bilirubin encephalopathy after adjusting confounders (Odds ratio = 1.41, 95% confidence intervals 1.05-1.91, P value <0.05). CONCLUSION: Unbound bilirubin levels are associated with neonatal acute bilirubin encephalopathy. The mechanism of unbound bilirubin levels leading to neonatal acute bilirubin encephalopathy needs to be further explored.

Risk Factors for Nephrolithiasis in Adults with Short Bowel Syndrome

2019 ◽  
Vol 75 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Jianbo Yang ◽  
Haifeng Sun ◽  
Songlin Wan ◽  
Gulsudum Mamtawla ◽  
Xuejin Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Short Bowel Syndrome ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Creatinine Concentration ◽  
Short Bowel ◽  
Tertiary Referral Center ◽  
Prolonged Duration ◽  
Clinical Consequences ◽  
The Mean

Introduction: Patients with short bowel syndrome (SBS) commonly develop nephrolithiasis. However, the risk factors for nephrolithiasis in patients with SBS remain unclarified. The present study aimed to identify the risk factors for nephrolithiasis in adults with SBS. Methods: All eligible adults diagnosed with SBS and admitted to a tertiary referral center from December 2008 to 2018 were retrospectively identified from a prospectively maintained database. Patients’ demographic and clinical characteristics were analyzed using univariate and multivariate analyses to identify the risk factors for nephrolithiasis. Results: Of 231 adults with SBS, 42 (18.2%) developed nephrolithiasis. The mean age was 46.4 ± 17.8 years, the mean body mass index was 18.2 ± 3.8 kg/m2, and median duration of SBS was 11 months (range 2–324 months). Multivariate binary logistic regression analysis revealed that the independent risk factors for nephrolithiasis in adults with SBS were jejuno-ileal anastomosis and colon-in-continuity (OR 4.335; 95% CI 1.175–16.002; p = 0.028), prolonged duration of SBS (OR 1.008; 95% CI 1.002–1.014; p = 0.010), and increased serum creatinine concentration (OR 1.005; 95% CI 1.001–1.009; p = 0.012). Conclusions: Nephrolithiasis is common in adults with SBS. As nephrolithiasis can have adverse clinical consequences, patients with SBS should be closely monitored, and prophylactic interventions should be considered.

scholarly journals Treatment Outcomes of Extensively Drug-Resistant Tuberculosis in Pakistan: A Countrywide Retrospective Record Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Muhammad Abubakar ◽  
Nafees Ahmad ◽  
Abdul Ghafoor ◽  
Abdullah Latif ◽  
Izaz Ahmad ◽  
...  
Keyword(s):  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Binary Logistic Regression ◽  
Positive Association ◽  
Treatment Success Rate ◽  
Binary Logistic Regression Analysis ◽  
High Dose ◽  
Significant Positive Association ◽  
Resistant Tuberculosis

Background: The current study is conducted with the aim to the fill the gap of information regarding treatment outcomes and variables associated with unsuccessful outcome among XDR-TB patients from Pakistan.Methods: A total of 404 culture confirmed XDR-TB patients who received treatment between 1st May 2010 and June 30, 2017 at 27 treatment centers all over Pakistan were retrospectively followed until their treatment outcomes were reported. A p-value &lt;0.05 reflected a statistical significant association.Results: The patients had a mean age 32.9 ± 14.1 years. The overall treatment success rate was 40.6% (95% confidence interval [CI]:35.80–45.60%). A total of 155 (38.4%) patients were declared cured, 9 (2.2%) completed treatment, 149 (36.9%) died, 60 (14.9%) failed treatment and 31 (7.7%) were lost to follow up (LTFU). The results of the multivariate binary logistic regression analysis revealed that the patients’ age of &gt;60 years (OR = 4.69, 95%CI:1.57–15.57) and receiving high dose isoniazid (OR = 2.36, 95%CI:1.14–4.85) had statistically significant positive association with death, whereas baseline body weight &gt;40 kg (OR = 0.43, 95%CI:0.25–0.73) and sputum culture conversion in the initial two months of treatment (OR = 0.33, 95%CI:0.19–0.58) had statistically significant negative association with death. Moreover, male gender had statistically significant positive association (OR = 1.92, 95%CI:1.04–3.54) with LTFU.Conclusion: The treatment success rate (40.6%) of XDR-TB patients in Pakistan was poor. Providing special attention and enhanced clinical management to patients with identified risk factors for death and LTFU in the current cohort may improve the treatment outcomes.

scholarly journals Prevalence and determinants of malnutrition among under-five children in Lusaka urban, Zambia

2020 ◽  
Vol 21 (1) ◽  
pp. 1-13
Author(s):  
Emmanuel M. Musenge ◽  
Sophia Tembo ◽  
Mutinta Hankwebe ◽  
Ndonia Kahinga ◽  
Ovy Mushibwe ◽  
...  
Keyword(s):  
Binary Logistic Regression ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Simple Random Sample ◽  
Binary Logistic Regression Analysis ◽  
Interview Schedule ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
The Mean

Background: Malnutrition is a severe and persisting cause of morbidity and mortality among under-five children in Zambia. We assessed malnutrition and its determinants among under-five children in Lusaka urban, Zambia.  Methods: This cross-sectional study was conducted at Chawama, Kabwata, Chilenje and Mtendere urban clinics in Lusaka. A simple random sample of 384 under-five children were selected between February and March 2015. A structured interview schedule was used to collect data on demographic characteristics, determinants of malnutrition and anthropometric measurements. Multivariate binary logistic regression analysis was carried out using IBM® SPSS® Statistics for Windows Version 20.0 to identify determinants of malnutrition while adjusting for confounders.  Results: Of the 384 under-five children, most (51.8%) of them were male and the mean (SD) age was 13.83±10.17 months. The zH/A; zW/H; and zW/A was 68.5% and 31.5%; 95.6% and 4.4%; and 86.2% and 13.8% for normal and stunted; normal and wasted; and normal and underweight respectively. Majority (77.1%) of the children had MUAC > 12.5 cm, 16.9% had 11.5 – 12.5 cm and 6.0% had < 11.5 cm. Mother’s good nutritional practices (OR 0.50, 95% CI: 0.27 – 0.95) and MUAC > 12.5 cm (OR 0.10, 95% CI: 0.01 – 0.94; OR 0.01, 0.00 – 0.10; and OR 0.4, 0.01 – 0.19) were statistically significantly associated with stunting, wasting and underweight respectively.  Conclusion: We established varied levels of stunting, wasting and underweight and mother’s nutritional practices and MUAC predicted these levels. More information, education and communication messages to the mothers and caretakers with regard to nutritional practices are needed so that under-nutrition can be improved, to ensure healthy living for mothers, care takers and under-five children.    

Methodology for prediction of clinical outcomes using logistic regression analysis in IBM SPSS Statistics 20.0 (part 1)

2020 ◽  
Author(s):  
Rustam R. MANYAKOV ◽  
Valeriya V. DEMENKOVA ◽  
Yuliya V. AGAFONOVA ◽  
Denis N. PETRYAKHIN
Keyword(s):  
Mathematical Model ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Outcome ◽  
Logistic Regression Analysis ◽  
Social Factors ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Independent Variables ◽  
The Brain

We presented a description of the organization of the method of constructing a mathematical model of clinical outcome risk prediction on the identified medical and social factors. Purpose: description of binary logistic regression analysis methodology in medical research. Research methods. Logistics regression is a form of multiple regression whose general purpose is to analyze the relationship between several independent variables and a dependent variable. For binary logistic regression analysis application, the following conditions must be met: the resulting variable must assume two values (favorable clinical outcome/adverse clinical outcome), the independent variables can be both categorical and interval, and must be independent of each other. Results of a research. On the basis of the studied medical and social factors, a mathematical model of the prediction of the probability of developing primary disability among persons who have suffered brain injuries has been developed. The obtained regression equation contains four variables: the patient's age, the nature of the brain injury, the level of formation, the severity of the brain injury. The mathematical model predicts the onset of an adverse clinical outcome with a probability of 87.6 %. The obtained results allow calculating the predicted probability of the studied clinical outcome with the permissible proportion of sensitivity and specificity. Conclusion. The presented technique is of practical importance in terms of improving the knowledge of the beginner researcher in the field of building mathematical models for predicting the probability of the event being studied.

scholarly journals A2DS2 Score to Predict the Risk of Stroke-Associated Pneumonia in Acute Stroke: An Indian Perspective

2019 ◽  
Vol 10 (03) ◽  
pp. 465-471
Author(s):  
Limesh Vyas ◽  
Dinkar Kulshreshtha ◽  
Pradeep Maurya ◽  
Ajai Singh ◽  
Abdul Qavi ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Odds Ratio ◽  
Binary Logistic Regression ◽  
High Sensitivity ◽  
Risk Scores ◽  
Binary Logistic Regression Analysis ◽  
Stroke Severity ◽  
The Mean ◽  
Strength Of Association ◽  
Indian Perspective

Abstract Background Stroke-associated pneumonia (SAP) is an important cause of poststroke morbidity and mortality. Several clinical risk scores predict the risk of SAP. In this study, we used the A2DS2 score (age, atrial fibrillation, dysphagia, sex, and stroke severity) to assess the risk of SAP in patients admitted with acute stroke. Methods A high (5–10) and a low (0–4) A2DS2 score was assigned to patients with acute stroke admitted to the neurology ward. Univariate binary logistic regression analysis was performed to find the strength of association of SAP and A2DS2 score. Results There were 250 patients with acute stroke of which 46 developed SAP. Forty-four patients developed SAP in high score as against 2 in low-score group (odds ratio [OR] = 0.03, 95% confidence interval [CI] = 0.01–0.15, p = 0.0001). A2DS2 score >5 had sensitivity of 82.6% and specificity of 65.1% to predict SAP. The mean A2DS2 score in patients with pneumonia was 7.02 ± 1.40 compared to 4.75 ± 1.92 in patients without pneumonia (p = 0.0001). Conclusions A2DS2 score has a high sensitivity of 82% in predicting the risk of SAP and is a useful tool to monitor patients after acute stroke. A2DS2 score can help in timely detection and prevention of SAP and reduction in caregiver’s burden.

scholarly journals Factors affecting retrieval of 12 or more lymph nodes in pT1 colorectal cancers

2019 ◽  
Vol 47 (10) ◽  
pp. 4827-4840
Author(s):  
Seung-Myoung Son ◽  
Chang Gok Woo ◽  
Ok-Jun Lee ◽  
Sang-Jeon Lee ◽  
Taek-Gu Lee ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Binary Logistic Regression ◽  
Tumor Location ◽  
Colorectal Cancers ◽  
Binary Logistic Regression Analysis ◽  
Tumor Diameter ◽  
Clinicopathological Factors ◽  
Factors Affecting ◽  
Maximum Tumor Diameter ◽  
The Mean

Objective The aim of this study was to identify clinicopathological factors that affect the number of lymph nodes (LNs) (12 or more) retrieved from patients with colorectal cancer (CRC), particularly those with pathologic T1 (pT1) disease. Methods From 429 CRC patients, 75 pT1 cancers were identified and digitally scanned. Binary logistic regression analysis was performed to identify the clinicopathological factors affecting the number of LNs retrieved from all 429 patients and from the subset of patients with pT1 CRC. Results For the 429 patients, the mean number of harvested LNs per specimen was 20 (median, 19). The number of retrieved LNs was independently associated with maximum tumor diameter > 2.3 cm and right-sided tumor location. The mean number of LNs retrieved from the 75 patients with pT1 CRC was 14 (median, 15); retrieval of 12 or more LNs from this group was independently associated with maximum tumor diameter > 14.1 mm. Conclusion The number of LNs retrieved from patients with CRC was associated with maximum tumor diameter and right-sided tumor location. For patients with pT1 CRC, maximum tumor diameter was independently associated with the harvesting of 12 or more LNs.

scholarly journals Compliance with aspirin in paediatric CHD post-percutaneous transcatheter occlusion: a cross-sectional study

2020 ◽  
Vol 30 (10) ◽  
pp. 1462-1468
Author(s):  
Qing-Qing Song ◽  
Li-Hui Zhu ◽  
Ou-Ying Chen ◽  
Zhi-Rong Xiao ◽  
Zhi Chen ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Transcatheter Occlusion ◽  
Effective Strategies ◽  
Adherence Scale ◽  
Level Of Knowledge ◽  
The Mean

AbstractBackground:Predictors of compliance with aspirin in children following cardiac catheterisation have not been identified. The aim of this study is to identify the caregivers’ knowledge, compliance with aspirin medication, and predictors of compliance with aspirin in children with Congenital Heart Disease (CHD) post-percutaneous transcatheter occlusion.Methods:A cross-sectional explorative design was adopted using a self-administered questionnaire and conducted between May 2017 and May 2018. Recruited were 220 caregivers of children with CHD post-percutaneous transcatheter occlusion. Questionnaires included child and caregivers’ characteristics, a self-designed and tested knowledge about aspirin scale (scoring scale 0–2), and the 8-item Morisky Medication Adherence Scale (scoring scale 0–8). Data were analysed using multivariate binary logistic regression analysis to identify predictors of compliance with aspirin.Results:Of the 220 eligible children and caregivers, 210 (95.5%) responded and 209 surveys were included in the analysis. The mean score of knowledge was 7.25 (standard deviation 2.27). The mean score of compliance was 5.65 (standard deviation 1.36). Child’s age, length of aspirin use, health insurance policies, relationship to child, monthly income, and knowledge about aspirin of caregivers were independent predictors of compliance with aspirin (p < 0.05).Conclusion:Caregivers of children with CHD had an adequate level of knowledge about aspirin. Compliance to aspirin medication reported by caregivers was low. Predictors of medium to high compliance with aspirin were related to the child’s age and socio-economic reasons. Further studies are needed to identify effective strategies to improve knowledge, compliance with medication, and long-term outcomes of children with CHD.

scholarly journals Nordic population-based study on internet use and perceived meaningfulness in later life: How they are linked and why it matters

2021 ◽  
pp. 140349482098745
Author(s):  
Emilia W.E. Viklund ◽  
Ingeborg Nilsson ◽  
Anna K. Forsman
Keyword(s):  
Health Status ◽  
Internet Use ◽  
Demographic Factors ◽  
Binary Logistic Regression ◽  
Positive Association ◽  
Later Life ◽  
Population Based ◽  
Binary Logistic Regression Analysis ◽  
Significant Positive Association ◽  
Socio Demographic Factors

Aim: The aim was to explore the association between internet use, the use of specific internet-based activities and perceiving life as meaningful, among older adults in two regions in Finland and Sweden. Methods: The data was collected through a population-based survey ( N = 9386) as part of the GERDA project conducted in 2016. In order to analyse the associations between perceiving life as meaningful and internet use and related activities, odds ratios with a 95% confidence interval were calculated using binary logistic regression analysis, where socio-demographic factors and health status were controlled for. Results: Statistically significant associations were found between perceiving life as meaningful and internet use in later life. When looking further at the specific internet-based activities under study, activities related to leisure and entertainment showed a statistically significant connection to perceived meaningfulness in later life, after controlling for socio-demographic factors and health status. Conclusions: The results indicated that there was a statistically significant positive association between internet use and perceiving life as meaningful in later life. Online activities related to leisure and entertainment seem to be especially associated with perceived meaningfulness. Although causal direction could not be determined, the results suggest that internet use may support the experience of wellbeing in everyday life among older persons, through the unlimited access to interest-driven activities that it provides.

Comparison of Fluorine(18)-fluorodeoxyglucose and Gallium(68)-citrate PET/CT in patients with tuberculosis

2019 ◽  
Vol 58 (05) ◽  
pp. 371-378
Author(s):  
Alfred O. Ankrah ◽  
Ismaheel O. Lawal ◽  
Tebatso M.G. Boshomane ◽  
Hans C. Klein ◽  
Thomas Ebenhan ◽  
...  
Keyword(s):  
Tracer Uptake ◽  
Pet Ct ◽  
The Mean ◽  
18F Fdg ◽  
Definition Of ◽  
Gallium 68 ◽  
Attending Physician ◽  
Pet Scans ◽  
The Brain

Abstract 18F-FDG and 68Ga-citrate PET/CT have both been shown to be useful in the management of tuberculosis (TB). We compared the abnormal PET findings of 18F-FDG- and 68Ga-citrate-PET/CT in patients with TB. Methods Patients with TB on anti-TB therapy were included. Patients had a set of PET scans consisting of both 18F-FDG and 68Ga-citrate. Abnormal lesions were identified, and the two sets of scans were compared. The scan findings were correlated to the clinical data as provided by the attending physician. Results 46 PET/CT scans were performed in 18 patients, 11 (61 %) were female, and the mean age was 35.7 ± 13.5 years. Five patients also had both studies for follow-up reasons during the use of anti-TB therapy. Thirteen patients were co-infected with HIV. 18F-FDG detected more lesions than 68Ga-citrate (261 vs. 166, p < 0.0001). 68Ga-citrate showed a better definition of intracerebral lesions due to the absence of tracer uptake in the brain. The mean SUVmax was higher for 18F-FDG compared to 68Ga-citrate (5.73 vs. 3.01, p < 0.0001). We found a significant correlation between the SUVmax of lesions that were determined by both tracers (r = 0.4968, p < 0.0001). Conclusion Preliminary data shows 18F-FDG-PET detects more abnormal lesions in TB compared to 68Ga-citrate. However, 68Ga-citrate has better lesion definition in the brain and is therefore especially useful when intracranial TB is suspected.

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