scholarly journals Clinical manifestations, risk factors, and prognostic factors of cytomegalovirus enteritis

Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Pai-Jui Yeh ◽  
Cheng-Tang Chiu ◽  
Ming-Wei Lai ◽  
Ren-Chin Wu ◽  
Chien-Ming Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Clinical Manifestations ◽  
Mortality Rates ◽  
Protein Levels ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
Risk Patients ◽  
Hospital Stays ◽  
Overall Mortality

Abstract Background To comprehensively analyze the risk factors, clinical characteristics, outcomes, and prognostic factors of Cytomegalovirus (CMV) enteritis. Methods This retrospective cohort study enrolled patients who had undergone pathological examinations for CMV enteritis. They were divided into CMV and non-CMV groups according to immunohistochemistry staining results. The risk factors, clinical presentations, endoscopic features, treatments, outcomes, and prognostic factors of CMV enteritis were then analyzed. Results Forty-two patients (18 CMV, 24 non-CMV group) were included in the study. Major clinical presentations in the CMV group included gastrointestinal bleeding (72.2%), abdominal pain (55.6%), and fever (33.3%); ulcers (72.2%) were the most common endoscopic findings. In-hospital and overall mortality rates were 27.8% and 38.9%, respectively; and longer hospital stays and higher overall mortality rates were observed. Radiotherapy and C-reactive protein levels were prognostic factors for in-hospital mortality. The risk factors for CMV enteritis included immunocompromised status (p = 0.013), steroid use (p = 0.014), shock (p = 0.031), concurrent pneumonia (p = 0.01), antibiotic exposure (p < 0.001), radiotherapy (p = 0.027), chronic kidney disease (p = 0.041), and CMV colitis (p = 0.031). Conclusions Physicians should pay attention to the characteristics of CMV enteritis in high-risk patients to make an early diagnosis and potentially improve the clinical outcome.

Spinal Epidural Abscesses: Clinical Manifestations, Prognostic Factors, and Outcomes

Neurosurgery ◽  
2002 ◽  
Vol 51 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Martin Soehle ◽  
Thomas Wallenfang
Keyword(s):  
Prognostic Factors ◽  
Clinical Manifestations ◽  
Neurological Deficits ◽  
Motor Deficits ◽  
C Reactive Protein ◽  
Computed Tomographic ◽  
Protein Levels ◽  
Reactive Protein ◽  
Outcome Group ◽  
Spinal Epidural

Abstract OBJECTIVE This study was performed to evaluate the clinical manifestations and prognostic factors for outcomes among patients with nontuberculous spinal epidural abscesses. METHODS The records and magnetic resonance imaging/computed tomographic results for patients treated between 1994 and 2000 were retrospectively evaluated. Outcomes were assessed after 11 months, using scores ranging from 0 (dead) to 4 (no neurological deficits). RESULTS All 25 patients (mean age, 62 yr) underwent surgery and subsequently received antibiotics. Back/neck pain (72% of patients), leukocytosis (64%), fever (60%), and motor deficits (56%) were the most common symptoms at admission. Outcomes were assessed as poor for 40% of the patients and as good (no deficit or independently ambulatory) for 60%. Low leg muscle strength grades (r = 0.68, P &lt; 0.001) and high white blood cell (WBC) counts (r = −0.56, P = 0.006) at admission were significantly correlated with low outcome scores. From the time of admission until 14 days after surgery, the poor-outcome group exhibited significantly (P &lt; 0.005) higher WBC counts, compared with the good-outcome group. The same was true for C-reactive protein levels, with the exception that no differences between groups were observed until 8 days after surgery. Factors such as cervicothoracic abscess locations (P = 0.041), lower limb motor deficits (P = 0.005), complete paralysis (P = 0.005), and WBC counts of more than 14,000 cells/μl (P = 0.049) at admission were observed to be prognostic for poor outcomes. CONCLUSION Surgical decompression combined with antimicrobial therapy remains the recommended treatment. In addition to abscess locations and motor deficits, inflammatory markers such as WBC counts and C-reactive protein levels are prognostic for outcomes.

scholarly journals Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study

Diabetologia ◽  
2021 ◽  
Vol 64 (4) ◽  
pp. 778-794 ◽  
Author(s):  
Matthieu Wargny ◽  
◽  
Louis Potier ◽  
Pierre Gourdy ◽  
Matthieu Pichelin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Hospital Discharge ◽  
Microvascular Complications ◽  
White Cell Count ◽  
Symptom Duration ◽  
Protein Levels ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
History Of ◽  
Routine Therapy

Abstract Aims/hypothesis This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for coronavirus disease-2019 (COVID-19). Methods The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days. Results We included 2796 participants: 63.7% men, mean age 69.7 ± 13.2 years, median BMI (25th–75th percentile) 28.4 (25.0–32.4) kg/m2. Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5–14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors. Conclusions/interpretation In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period. Trial registration Clinicaltrials.gov identifier: NCT04324736 Graphical abstract

RISK FACTORS OF ADVERSE CLINICAL OUTCOMES IN THE ELDERLY AND SENILE PATIENTS WITH STROKE-ASSOCIATED PNEUMONIA

2021 ◽  
pp. 586-591
Author(s):  
В.А. Белобородов ◽  
И.А. Степанов ◽  
А.В. Щербатых ◽  
И.И. Томашов ◽  
З.С. Саакян ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Nosocomial Pneumonia ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Older Age ◽  
Binary Logistic Regression Model ◽  
Protein Levels ◽  
Reactive Protein ◽  
Degree Of Disability

В отечественной и зарубежной специализированной литературе отсутствуют исследования, посвященные изучению факторов риска развития неблагоприятного исхода у пациентов старшей возрастной группы с инсультассоциированной нозокомиальной пневмонией. Цель исследования - изучение факторов риска развития неблагоприятного клинического исхода у пациентов пожилого и старческого возраста с нозокомиальной пневмонией на фоне ОНМК. В исследование были включены 247 пациентов пожилого и старческого возраста (139 мужчин, 108 женщин, средний возраст - 74,1±6,3 года), госпитализированных с признаками ОНМК по ишемическому или геморрагическому типу. Согласно модели бинарной логистической регрессии, статистически значимо ассоциированы с развитием неблагоприятного исхода у изучаемой группы респондентов следующие параметры: возраст свыше 75 лет (p=0,011), степень инвалидизации по шкале mRS 3 (р=0,009), а также уровень С-РБ >100 мг/л (р=0,023) и мочевины >7 ммоль/л (р=0,044). Для снижения частоты встречаемости неблагоприятного клинического исхода у пациентов старшей возрастной группы с инсульт-ассоциированной нозокомиальной пневмонией необходимо верифицировать перечисленные выше клинико-лабораторные параметры на ранних этапах госпитализации. In the domestic and foreign specialized literature, there are no studies devoted to the study of risk factors of mortality in the older age patients with stroke-associated nosocomial pneumonia. The purpose of the study was to study the risk factors of adverse clinical outcomes in elderly and senile patients with stroke-associated nosocomial pneumonia. The study included 247 elderly and senile patients (139 men, 108 women, mean age - 74,1±6,3 years) who were hospitalized with signs of ischemic or hemorrhagic stroke. According to the binary logistic regression model, the following parameters are statistically significantly associated with adverse clinical outcomes in the studied group of respondents: age over 75 years (p=0.011), degree of disability according to mRS ≥3 (p=0,009), and C-reactive protein levels over 100 mg/l (p=0,023) and urea more than 7 mmol/l (p=0,044). In order to reduce the incidence of adverse clinical outcomes in patients of the older age group with stroke-associated nosocomial pneumonia, it is necessary to verify the above clinical and laboratory parameters at the early stages of hospitalization.

Association between diet, lifestyle, metabolic cardiovascular risk factors, and plasma C-reactive protein levels

Metabolism ◽  
2004 ◽  
Vol 53 (11) ◽  
pp. 1436-1442 ◽  
Author(s):  
Gunilla Nordin Fredrikson ◽  
Bo Hedblad ◽  
Jan-Åke Nilsson ◽  
Ragnar Alm ◽  
Göran Berglund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

scholarly journals Identification of RAGE and OSM as new prognosis biomarkers of severe pneumonia

2020 ◽  
Author(s):  
Li Wang ◽  
Yan Tan ◽  
Jiangnan Zhao ◽  
Lin Gao ◽  
Jing Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Oxygenation Index ◽  
Severe Pneumonia ◽  
Final Analysis ◽  
Apache Ii Score ◽  
Reactive Protein ◽  
Related Risk ◽  
Diabetes Mellitus Status ◽  
Jinling Hospital ◽  
Risk Patients

Abstract BackgroundPatients with severe pneumonia complicated with hypoxic respiratory failure often associated with increased morbidity and mortality rates. It is critical to discover more sensitive and specific markers for early identification of such high risk patients thus specific and timely treatment can be adjusted.MethodsThis retrospective study was performed in the respiratory intensive care unit (RICU) of Nanjing First Hospital and Jinling Hospital, Nanjing Medical University. Clinical data of patients admitted to the RICU and diagnosed with pneumonia from January 2017 to October 2019 was retrospectively reviewed. The eligible patients were classified into hypoxemia and non hypoxemia groups according to oxygenation index of 250 mmHg. In the meantime, the same cohort was separated into survival and deceased groups after 30 days post hospital admission. The related risk factors in these two classifications were examined separately.ResultsA total of 828 patients were screened for eligibility, and eventually 130 patients with pneumonia were included in our final analysis. Among the patients, 16 passed away despite exhausting standard treatments. The comparison between hypoxemia and non hypoxemia groups suggested that gender, diabetes mellitus status, count of white blood cell(WBC), neutrophils, neutrophils/Lymphocyte, lactic acid, creatinine, D-dimer, procalcitonin (PCT), C-reactive protein (CRP), PH, Lymphocyte, albumin and RAGE were significantly different.ConclusionsPrevious studies have suggested that the APACHE II score, LIS, SOFA, Nutric scores, WBC, neutrophils, lymphocyte counts and albumin levels were independent risk factors for severe pneumonia. Our study indicated that RAGE should be a new biomarker to predict poor prognosis in pneumonia. In addition, we also showed that LIS, SOFA, lactate, lymphocyte, platelet, BUN, total bilirubin, and PCT levels before treatment were independent factors that associated with 30 days survival rate. In addition, we proposed that OSM should be considered as a new prognosis marker for pneumonia patients.

scholarly journals Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China

2021 ◽  
Author(s):  
Judith Ju Ming Wong ◽  
Qalab Abbas ◽  
Soo Lin Chuah ◽  
Ririe Fachrina Malisie ◽  
Kah Min Pon ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Asia ◽  
Cultural Practices ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Logistic Regression Models ◽  
Clinical Presentations ◽  
The Common ◽  
Health Organization

There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.

Prognostic implication of hypocalcaemia in COVID-19: a systematic review

2021 ◽  
Vol 22 (2) ◽  
pp. 124-132
Author(s):  
T.A. Azeez ◽  
S. Lakoh ◽  
O.T. Bamidele ◽  
E. Ekhaiyeme ◽  
S.A. Nwosu
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Clinical Manifestations ◽  
Severe Illness ◽  
Prognostic Implication ◽  
Poor Prognostic Factor ◽  
Medical Databases ◽  
Reactive Protein ◽  
Prognostic Implications

Coronavirus disease-2019 (COVID-19) has been declared as a pandemic affecting several millions of people worldwide. It has varied clinical manifestations ranging from asymptomatic to critical illness. It has led to the mortality of several affected individuals. However, the prognosis seems to vary from one person to the other and efforts are being made to identify the prognostic factors. Hypocalcaemia has been identified as a poor prognostic factor with a high frequency among individuals affected with COVID-19. This review aims to estimate the prevalence of hypocalcaemia among COVID-19 patients and identify the poor prognostic factors associated with the presence of hypocalcaemia in COVID-19 patients. Electronic medical databases were searched for publications on the prognostic implications of hypocalcaemia in COVID-19 infection, and relevant articles were selected for systematic review following PRISMA algorithm. The prevalence of hypocalcaemia among patients with COVID-19 was 40.0-74.4%. There was a significant association between the rate of hospital admission, intensive care unit (ICU) admission as well as septic shock and hypocalcaemia in patients with COVID-19. Hypocalcaemia is also associated with a higher mortality rate in these patients. COVID-19 patients with hypocalcaemia tend to have elevated C-reactive protein, interleukin6, alanine transaminase, procalcitonin, serum creatinine and low albumin.   Hypocalcaemia is common in COVID-19 patients and is a poor prognostic factor in these patients. Presence of hypocalcaemia is  associated with a severe illness and even death. Keywords: COVID-19; hypocalcaemia; prognosis; systematic review

Outcomes and prognostic factors of patients with anti-melanoma differentiation-associated protein 5 and anti-aminoacyl-RNA synthetase antibodies positive idiopathic inflammatory myopathies in intensive care unit

2020 ◽  
Author(s):  
Shiyao Wang ◽  
Xinran Zhang ◽  
Yanhong Ren ◽  
Yi Zhang ◽  
Ye Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Serum Ferritin ◽  
Factors Associated ◽  
Overall Mortality

Abstract Background: This study aims to identify prognostic factors for mortality of patients with anti-melanoma differentiation-associated protein 5 (anti-MDA5) or anti-aminoacyl-RNA synthetase (anti-ARS) antibodies positive and acute respiratory failure in the intensive care unit.Methods: Clinical characteristics, laboratory test findings, imaging performance, and management were retrospectively collected in all cases with anti-MDA5 and anti-ARS antibodies positive, as well as follow-up survival data. Risk factors related to prognosis were identified by Cox regression analysis.Results: The 28-day mortality of all patients was 68.8% (n=44/64). The patients who died were more likely to have anti-MDA5 antibody(p<0.001), presented more Gottron papules(p=0.021) or heliotrope rash(p=0.008), had a relatively lower level of WBC(p=0.038), CRP(p=0.004), and had a higher level of LDH(p=0.029), serum ferritin(p=0.002). The main risk factors associated with 28-day mortality were anti-MDA5 antibody positive [HR 10.827 (95% CI: 4.261-27.514), p<0.001], presence of Gottron papules [2.299 (1.203-4.394), p=0.012], heliotrope rash [3.423 (1.773-6.606), p<0.001], and arthritis/arthralgia [2.365 (1.130-4.948), p=0.022). At a median of 14 (IQR 6.33-35.0) months of follow-up, the overall mortality of all patients was 75.0% (n=48/64). The non-survivors were more likely to own anti-MDA5 antibody(p<0.001), had a higher rate of Gottron papules(p=0.020) or heliotrope rash(p=0.014), had lower PFR(p=0.032) while ICU admission, and existed a higher level of serum ferritin(p=0.005). Main risk factors associated with overall mortality were consistent with risk factors for 28-day mortality. Conclusions: Anti-MDA5 antibody positive, presence of Gottron papules, heliotrope rash, or arthritis/arthralgia were the main independent risk factors of poor prognosis for IIM patients admitted to the ICU due to acute respiratory failure.

scholarly journals Joint evaluation of serum C-Reactive Protein levels and polygenic risk scores as risk factors for schizophrenia

2018 ◽  
Vol 261 ◽  
pp. 148-153 ◽  
Author(s):  
Vishwajit L. Nimgaonkar ◽  
Faith Dickerson ◽  
Jennie G. Pouget ◽  
Kodavali Chowdari ◽  
Colm O’Dushlaine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Scores ◽  
C Reactive Protein ◽  
Polygenic Risk ◽  
Protein Levels ◽  
Reactive Protein ◽  
Joint Evaluation

scholarly journals SERUM ZINC AND C-REACTIVE PROTEIN LEVELS AS RISK FACTORS FOR MORTALITY IN SYSTEMIC INFLAMMATORY RESPONSE SYNDROME

2018 ◽  
Vol 24 (1) ◽  
pp. 1
Author(s):  
Dwi Retnoningrum ◽  
Banundari Rachmawati ◽  
Dian Widyaningrum
Keyword(s):  
Risk Factors ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Serum Zinc ◽  
Latex Agglutination ◽  
Systemic Inflammatory Response ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Kondisi Systemic Inflammatory Response Syndrome (SIRS) berkebahyaan terjadinya sepsis dan kegagalan multi organ. Inflamasidapat menyebabkan terjadinya redistribusi zinc ke jaringan sehingga terjadi penurunan kadar zinc plasma. Kadar CRP pada SIRSmeningkat sebagai respons peningkatan protein tahap akut. Tujuan penelitian ini untuk mengetahui apakah kadar zinc dan CRP serummerupakan faktor kebahayaan kematian di pasien SIRS. Penelitian observasional analitik dengan pendekatan kohort prospektif di 30pasien SIRS berusia 27–64 tahun. Kadar zinc serum diperiksa dengan metode atomic absorbance spectrophotometer (AAS) dan CRPserum dengan metode latex agglutination immunoassay menggunakan alat autoanaliser. Kejadian kematian subjek dinilai setelah 28hari perawatan. Data dilakukan uji statistik Chi-Kwadrat, bila tidak memenuhi maka dilakukan uji alternatif Fisher. Besarnya nilaifaktor kebahyaan dilakukan perhitungan kebahayaan relatif. Rerata kadar zinc dan CRP berturut-turut 81,24 ± 8,72 μg/dL, dan 8,13± 8,12 mg/dL. Kematian dalam 28 hari adalah 33,3%. Penelitian ini menunjukkan bahwa kadar zinc plasma < 80 μg/dL bukanmerupakan faktor kebahayaan terjadinya kematian (p=0,114), sedangkan kadar CRP ≥ 10 mg/dL merupakan faktor kebahayaanterjadinya kematian di pasien SIRS (RR=3,28, 95% CI 1,33-8,13, p=0,015). Kadar zinc plasma bukan merupakan faktor kebahayaanterjadinya kematian pada SIRS, sedangkan kadar CRP merupakan faktor kebahayaan terjadinya kematian di pasien SIRS.

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