scholarly journals Prevalence, risk factors, and complications associated with hyponatraemia following elective primary hip and knee arthroplasty

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Emma Cunningham ◽  
Nicola Gallagher ◽  
Paul Hamilton ◽  
Leeann Bryce ◽  
David Beverland
Keyword(s):  
Risk Factors ◽  
Knee Arthroplasty ◽  
Emergency Departments ◽  
Fasting Glucose ◽  
Rank Test ◽  
Chi Square ◽  
Exact Test ◽  
Retrospective Audit ◽  
Hip And Knee Arthroplasty ◽  
Chi Square Analysis

Abstract Background Hyponatraemia, defined as a serum sodium [Na] concentration below 135 mmol/L, is common following surgery. As inpatient peri-operative stays shorten, there is a need to recognise pre-operative risk factors for post-operative hyponatraemia and complications associated with a peri-operative drop in Na. This audit aimed to investigate the prevalence of, risk factors for, and complications associated with hyponatraemia following elective primary hip and knee arthroplasty. Methods Data were collected within a retrospective audit of inpatient complications and unplanned reattendance or readmission at hospital in consecutive elective primary hip and knee arthroplasty patients in a single high throughput elective primary joint unit. The hospital’s electronic database identified 1000 patients who were admitted electively between February 2012 and June 2013 under the care of a single consultant orthopaedic surgeon for either total hip arthroplasty, total knee arthroplasty, or uni-compartmental knee arthroplasty. Groups were compared using appropriate tests, including chi-square analysis (or Fisher’s exact test), Mann-Whitney U test, Kruskal-Wallis test, and Wilcoxin signed-rank test. Logistic regression analysis was used to determine factors associated with hyponatraemia. Results Of the total 1000 patients, 217 (21.7%) developed post-operative hyponatraemia. Of these, 177 (81.6%) had mild (Na 130–134 mmol/L), 37 (17.1%) had moderate (Na 125–129 mmol/L), and 3 (1.4%) had severe (Na < 125 mmol/L) hyponatraemia. In multivariate analysis, age, pre-operative Na, and fasting glucose on day 1 remained significantly associated with having hyponatraemia post-operatively. There were no significant differences in reattendance at emergency departments and/or readmission within 90 days between those who had post-operative hyponatraemia whilst in hospital (39/217 = 18.0%) and those who did not (103/783 = 13.2%), or between those who were discharged with hyponatraemia (18/108 = 16.7%) and those discharged with normal Na (124/880 = 14.1%). Conclusion Approximately one fifth of elective joint arthroplasty patients had post-operative hyponatraemia. In these patients, older age, lower pre-operative Na and higher fasting glucose predicted post-operative hyponatraemia. We found no evidence that those discharged with hyponatraemia had more reattendance at emergency departments or readmission to hospital. We suggest that otherwise well patients with mild hyponatraemia can safely be discharged and followed up in the community.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

scholarly journals Elimination of Intravenous Di-2-Ethylhexyl Phthalate Exposure Abrogates Most Neonatal Hypertension in Premature Infants with Bronchopulmonary Dysplasia

Toxics ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 75
Author(s):  
Randall Jenkins ◽  
Katia Farnbach ◽  
Sandra Iragorri
Keyword(s):  
Risk Factors ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Chi Square ◽  
Neonatal Hypertension ◽  
Vlbw Infants ◽  
Chi Square Analysis ◽  
Ethylhexyl Phthalate ◽  
Current Report

(1) Background: The incidence of hypertension in very low birthweight (VLBW) infants in a single neonatal intensive care unit (NICU) dropped markedly during a 2-year period when the IV fluid (IVF) in both the antenatal unit and the NICU temporarily changed to a di-2-ethylhexyl phthalate (DEHP)-free formulation. The objective of the current report is to document this observation and demonstrate the changes in incidence of hypertension were not associated with the variation in risk factors for hypertension; (2) Methods: The charts of all VLBW infants born in a single NICU during a 7-year span were reviewed. This time includes 32 months of baseline, 20 months of DEHP-free IVF, 20 months of IVF DEHP re-exposure, and two 4-month washout intervals. The group of interest was limited to VLBW infants with bronchopulmonary dysplasia (BPD). Chi-square analysis was used to compare incidence of hypertension among periods. Vermont Oxford NICU Registry data were examined for variation in maternal and neonatal risk factors for hypertension; Results: Incidence of hypertension in VLBW infants with BPD decreased from 7.7% (baseline) to 1.4% when IVF was DEHP-free, rising back to 10.1% when DEHP-containing IVF returned to use. Risk factors for neonatal hypertension were stable across the 3 study periods in the NICU’s group of VLBW infants; (3) Conclusions: Serendipitous removal of IVF containing DEHP resulted in near elimination of hypertension in one NICU—an effect entirely reversed after the same brand of DEHP-containing IVF returned to clinical use. These results suggest that DEHP exposure from IVF plays a major role in neonatal hypertension.

scholarly journals Phenotypic Characterization of Juvenile Idiopathic Arthritis in African American Children

2016 ◽  
Vol 43 (4) ◽  
pp. 799-803 ◽  
Author(s):  
Lauren Fitzpatrick ◽  
K. Alaine Broadaway ◽  
Lori Ponder ◽  
Sheila T. Angeles-Han ◽  
Kirsten Jenkins ◽  
...  
Keyword(s):  
African American ◽  
Juvenile Idiopathic Arthritis ◽  
Early Onset ◽  
Disease Onset ◽  
Phenotypic Characterization ◽  
Rank Test ◽  
Chi Square ◽  
Phenotypic Data ◽  
Exact Test ◽  
American Children

Objective.Juvenile idiopathic arthritis (JIA) affects children of all races. Prior studies suggest that phenotypic features of JIA in African American (AA) children differ from those of non-Hispanic white (NHW) children. We evaluated the phenotypic differences at presentation between AA and NHW children enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry, and replicated the findings in a JIA cohort from a large center in the southeastern United States.Methods.Children with JIA enrolled in the multicenter CARRA Registry and from Emory University formed the study and replication cohorts. Phenotypic data on non-Hispanic AA children were compared with NHW children with JIA using the chi-square test, Fisher’s exact test, and the Wilcoxon signed-rank test.Results.In all, 4177 NHW and 292 AA JIA cases from the CARRA Registry and 212 NHW and 71 AA cases from Emory were analyzed. AA subjects more often had rheumatoid factor (RF)-positive polyarthritis in both the CARRA (13.4% vs 4.7%, p = 5.3 × 10−7) and the Emory (26.8% vs 6.1%, p = 1.1 × 10−5) cohorts. AA children had positive tests for RF and cyclic citrullinated peptide antibodies (CCP) more frequently, but oligoarticular or early onset antinuclear antibody (ANA)-positive JIA less frequently in both cohorts. AA children were older at onset in both cohorts and this difference persisted after excluding RF-positive polyarthritis in the CARRA Registry (median age 8.5 vs 5.0 yrs, p = 1.4 × 10−8).Conclusion.Compared with NHW children, AA children with JIA are more likely to have RF/CCP-positive polyarthritis, are older at disease onset, and less likely to have oligoarticular or ANA-positive, early-onset JIA, suggesting that the JIA phenotype is different in AA children.

scholarly journals Seroprevalence of Brucellosis and Associated Risk Factors among Indigenous Breeds of Goats in Wukari, Taraba State, Nigeria

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Olaolu T. Olufemi ◽  
Danjuma B. Dantala ◽  
Paul A. Shinggu ◽  
Umesi A. Dike ◽  
Gbeminiyi R. Otolorin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
The Public ◽  
Factors Associated ◽  
Males And Females ◽  
Associated Risk Factors ◽  
La Jolla

A cross-sectional study was conducted in Wukari, Taraba state, Nigeria, to determine the prevalence of Brucella antibodies and the risk factors associated with brucellosis in indigenous breeds of goats. A total of 386 goats were sampled from three political wards: Puje, Avyi, and Hospital: harvested sera samples were subjected to Rose Bengal Plate Test (RBPT). GraphPad Prism version 7.03 for Windows (GraphPad Software, La Jolla California, USA) was used to analyse the association between seroprevalence of brucellosis and age, sex, breed, location, and management system by using Chi square and Fisher’s exact test as appropriate. Brucellosis was detected in all three wards: Puje; 15%, Avyi; 6.6%, and Hospital; 7.6%. A prevalence rate of 2.8%, 8%, 18.7%, and 1% was recorded for <20-month, 22-35-month, 36-45-month, and ≥46-55-month age categories, respectively (P < 0.05). Only 9.5% was observed for male animals while 9.8% was observed for female animals with no statistical difference between the males and females. Breed-specific seroprevalence yielded 7.4%, 5.4% 12%, 12.8%, and 11.6%, for Cross, West Africa Dwarf, Red Sokoto, Kano Brown, and Sahel breeds of goat, respectively. There is an evidence of brucellosis (9.6%) in Wukari L.G.A, Taraba State, and age is a risk factor for the disease in the study area. There is a need to enlighten the public on the zoonotic potentials and economic impacts of brucellosis.

scholarly journals CORRELATION OF EXCLUSIVE BREASTFEEDING AND CIGARETTE SMOKE EXPOSURE WITH PNEUMONIA IN CHILDREN UNDER TWO YEARS

2020 ◽  
Vol 8 (3) ◽  
pp. 228
Author(s):  
Denisca Vanya Almeida ◽  
Fariani Syahrul
Keyword(s):  
Risk Factors ◽  
Cigarette Smoke ◽  
Exclusive Breastfeeding ◽  
Simple Random Sampling ◽  
Observational Research ◽  
Cigarette Smoke Exposure ◽  
Chi Square ◽  
Prevention Education ◽  
Control Research ◽  
Chi Square Analysis

Background: Pneumonia is one of the leading causes of death for children and is caused by pneumococcus, staphylococcus, and streptococcus bacteria. Exclusive breastfeeding and exposure to cigarette smoke are risk factors for pneumonia in children less than two years old. Purpose: The aim of this research was to analyze the relationship between exclusive breastfeeding or exposure to cigarette smoke and pneumonia in children aged less than two years at Public Health Center (PHC) of Wates, Kediri District. Methods: This research employed analytic observational research using a case–control research design. The number of research samples used was 60, consisting of 30 case respondents and 30 control respondents. The samples were taken in the PHC of Wates, Kediri District’s working area in July 2019. The determination of the samples was carried out through simple random sampling. The data were analyzed using chi-square analysis. Results: The research variables related to pneumonia in children less than two years old at PHC of Wates, Kediri District were exclusive breastfeeding with Odds Ratio (OR) = 3.50 (95% Confidence Interval (CI) = 1.20–10.19), the age of the mothers of the two-year-old infants with OR = 0.19 (95% CI = 0.04–0.78), and the education of the mothers of children less than two years old with OR = 3.14 (95% CI = 1.07–9.27). Conclusion: Exclusive breastfeeding, maternal age, and mothers’ level of education are some of the risk factors for pneumonia. The suggestion from this research is to hold socialization in the form of pneumonia prevention, education on exclusive breastfeeding for mothers who have children under two years of age, and the dangers of smoking for children's health.

scholarly journals Deep brain stimulation hardware–related infections: 10-year experience at a single institution

2019 ◽  
Vol 130 (2) ◽  
pp. 629-638 ◽  
Author(s):  
Kingsley O. Abode-Iyamah ◽  
Hsiu-Yin Chiang ◽  
Royce W. Woodroffe ◽  
Brian Park ◽  
Francis J. Jareczek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Single Institution ◽  
Chi Square ◽  
Related Factors ◽  
Exact Test ◽  
Vancomycin Powder ◽  
The Impact ◽  
Deep Brain

OBJECTIVEDeep brain stimulation is an effective surgical treatment for managing some neurological and psychiatric disorders. Infection related to the deep brain stimulator (DBS) hardware causes significant morbidity: hardware explantation may be required; initial disease symptoms such as tremor, rigidity, and bradykinesia may recur; and the medication requirements for adequate disease management may increase. These morbidities are of particular concern given that published DBS-related infection rates have been as high as 23%. To date, however, the key risk factors for and the potential preventive measures against these infections remain largely uncharacterized. In this study, the authors endeavored to identify possible risk factors for DBS-related infection and analyze the efficacy of prophylactic intrawound vancomycin powder (VP).METHODSThe authors performed a retrospective cohort study of patients who had undergone primary DBS implantation at a single institution in the period from December 2005 through September 2015 to identify possible risk factors for surgical site infection (SSI) and to assess the impact of perioperative (before, during, and after surgery) prophylactic antibiotics on the SSI rate. They also evaluated the effect of a change in the National Healthcare Safety Network’s definition of SSI on the number of infections detected. Statistical analyses were performed using the 2-sample t-test, the Wilcoxon rank-sum test, the chi-square test, Fisher’s exact test, or logistic regression, as appropriate for the variables examined.RESULTSFour hundred sixty-four electrodes were placed in 242 adults during 245 primary procedures over approximately 10.5 years; most patients underwent bilateral electrode implantation. Among the 245 procedures, 9 SSIs (3.7%) occurred within 90 days and 16 (6.5%) occurred within 1 year of DBS placement. Gram-positive bacteria were the most common etiological agents. Most patient- and procedure-related characteristics did not differ between those who had acquired an SSI and those who had not. The rate of SSIs among patients who had received intrawound VP was only 3.3% compared with 9.7% among those who had not received topical VP (OR 0.32, 95% CI 0.10–1.02, p = 0.04). After controlling for patient sex, the association between VP and decreased SSI risk did not reach the predetermined level of significance (adjusted OR 0.32, 95% CI 0.10–1.03, p = 0.06). The SSI rates were similar after staged and unstaged implantations.CONCLUSIONSWhile most patient-related and procedure-related factors assessed in this study were not associated with the risk for an SSI, the data did suggest that intrawound VP may help to reduce the SSI risk after DBS implantation. Furthermore, given the implications of SSI after DBS surgery and the frequency of infections occurring more than 90 days after implantation, continued follow-up for at least 1 year after such a procedure is prudent to establish the true burden of these infections and to properly treat them when they do occur.

scholarly journals Risk factors for intradomiciliary infestation by the Chagas disease vector Triatoma dimidiatain Jutiapa, Guatemala

2009 ◽  
Vol 25 (suppl 1) ◽  
pp. S83-S92 ◽  
Author(s):  
Dulce Maria Bustamante ◽  
Carlota Monroy ◽  
Sandy Pineda ◽  
Antonieta Rodas ◽  
Xochitl Castro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Chagas Disease ◽  
Linear Models ◽  
Control Strategies ◽  
Chi Square ◽  
Disease Vector ◽  
Log Linear ◽  
Chi Square Analysis

Seventeen variables were evaluated as possible risk factors for the intradomiciliary infestation with Triatoma dimidiata in 644 houses in Jutiapa, Guatemala. During 2004 the houses were assessed for vector presence and evaluated for hygiene, cluttering, material comfort, construction conditions and number of inhabitants, among other factors. Chi-square analysis detected significant associations between vector presence and eight variables related to domestic sanitary and construction conditions. Log-linear models showed that regardless of the age of the house, the odds of vector presence were 4.3 and 10 times lower in houses with a good socioeconomic status compared with poor and very poor houses respectively. Log-linear models also pointed to a greater chance of vector presence when walls lacked plastering (3.85 times) or walls had low quality-incomplete plastering (4.56 times), compared with walls that were completely plastered. Control strategies against T. dimidiata should include the introduction of better-quality but inexpensive plastering formulations and better sanitation practices should also be promoted among the population. Such control strategies should not only reduce or eliminate infestation, but also prevent vector reinfestation.

Risk factors for biopsy complications in initial versus subsequent biopsies in native and transplant kidneys

2020 ◽  
pp. 028418512096668
Author(s):  
Björn Peters ◽  
Henri Afghahi ◽  
Salar Maitlo ◽  
Henrik Hadimeri
Keyword(s):  
Risk Factors ◽  
Binary Logistic Regression ◽  
Chi Square ◽  
Exact Test ◽  
Major Complications ◽  
Native Kidney ◽  
Transplant Kidney ◽  
Student’S T ◽  
Biopsy Complications ◽  
Student’S T Test

Background Few studies exist about risk factors for complications in subsequent biopsies. Purpose To explore risk factors for complications in initial versus subsequent biopsies in native and transplant kidneys, which may predict biopsy complications. Material and Methods In a multicenter study, 2830 native kidney biopsies (4.3% subsequent) were analyzed for major complications (1251 of these were also analyzed for minor) and 667 transplant kidney biopsies (29% subsequent) were analyzed for major and minor complications. No death or nephrectomy were described. Fisher’s exact test, Student’s t-test, chi-square analyses, and univariate and multiple binary logistic regression analyses were employed; P < 0.05 was considered significant. Results In initial native kidney biopsies, the frequency of major complications was higher in women compared to men (odds ratio 1.6, 95% confidence interval 1.1–2.2), in younger patients (50 vs. 54 years, P = 0.007), and in patients with lower weight (78 vs. 82 kg, P = 0.005). In subsequent native kidney biopsies, patients with major complications had a higher systolic blood pressure (145 vs. 132 mmHg, P = 0.03). In initial transplant kidney biopsies, biopsies with major complications had less glomeruli in the biopsy (17 vs. 24, P = 0.046). In subsequent transplant kidney biopsies, patients with major complications had a higher mean arterial pressure (112 vs. 98 mmHg, P = 0.002). In subsequent native kidney biopsies, there was a higher number of SLE-nephritis (12% vs. 4.6%, P = 0.001) compared to initial biopsies. Conclusion The different types of risk factors for complications in initial versus subsequent renal biopsies could be important for the clinicians to improve patients’ safety.

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