Factors associated with increased incidence of toxicities following administration of yttrium-90 resin microspheres.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 409-409
Author(s):  
John Roberson ◽  
Andrew M. McDonald ◽  
Craig Joseph Baden ◽  
Rojymon Jacob ◽  
Omer L. Burnett

409 Background: To further define factors associated with increased incidences of hepatic, constitutional, and gastrointestinal toxicities following administration of yttrium-90 (90Y) microspheres in a sequential cohort of heterogeneous patients. Methods: Fifty-seven patients who underwent 76 treatments were assessed for toxicity incidence following 90Y administration. Post-treatment clinical and liver function test (LFT) toxicities were assessed using Common Terminology Criteria for Adverse Events version 4.03. Binary logistic regression was used to evaluate the univariate effect of factors on toxicity incidences. A multivariate binary logistic regression model was performed for each toxicity using all factors with a p < 0.10 on univariate analysis. Results: Hepatic toxicities, including LFT toxicities, were present following 46.1% of treatments, while gastrointestinal and constitutional toxicities were present following 57.3% and 55.3%, respectively. Multivariate analyses revealed that colorectal adenocarcinoma, age at time of treatment, intraprocedural stasis, decreased Karnofsky Performance Status, increased body mass index (BMI), and decreased lung shunt were statistically significant (p < 0.05) predictors for increased incidence of toxicities most prevalent among our cohort. Increased pre-treatment laboratory values including albumin, alkaline phosphatase, total bilirubin, and white blood cells were also statistically significant predictors. Conclusions: Colorectal adenocarcinoma, declining functional status, decreased lung shunt, and increased pre-treatment laboratory values should be given more clinical attention when attempting to limit toxicities and improve the quality of life in patients following 90Y treatment. Specific constitutional, gastrointestinal, and hepatic toxicities including weakness, loss of appetite, and laboratory abnormalities are also associated with patients’ age, increased BMI, and intraprocedural stasis.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 941-941
Author(s):  
Rongfang Zhan ◽  
Cheng Yin ◽  
Liam O'Neill

Abstract Background Nursing home residents were impacted disproportionately by the coronavirus because of their vulnerabilities. Although many studies concentrated on risk factors associated with mortality of hospitalized patients, there were limited studies epitomizing them from skilled nursing facilities to hospitals. The study aims to identify inpatients’ characteristics on demographics, hospital admission types, insurance types, and chronic diseases associated with mortality among our cohort patients in Texas. Methods Individuals above 50 years, diagnosed with Covid-19, and admitted from skilled nursing facilities were included in the retrospective cohort study. Pearson’s Chi-Square and Mann-Whitney tests were applied to measure four major perspectives between survivors and non-survivors. Then, a binary logistic regression was employed to determine the association between independent variables and mortality. Results A total of 218 patients were included in the study, of which 54 (24.8%) died during hospitalization. According to the univariate analysis, expired patients were more likely to be emergency admission (p = 0.001), elective admission (p = 0.02), Medicaid as primary payment (p = 0.034), heart disease (p = 0.027), CKD (p = 0.03), and hypertension (p = 0.002). The binary logistic regression revealed that hypertension (OR = 3.176, 95% CI: 1.200-8.409, p = 0.02) and Medicaid (OR = 2.637, 95% CI: 1.287-5.405, p = 0.008) as primary payment had significantly high odds of mortality. Conclusion Hypertension and Medicaid as primary payment are the strongest predictive factors associated with mortality and suggest that hospitals in Texas distribute critical care and resources while prevent and treat them to increase survival rates.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reem M. Elsaid ◽  
Ashraqat S. Namrouti ◽  
Ahmad M. Samara ◽  
Wael Sadaqa ◽  
Sa’ed H. Zyoud

Abstract Background Postoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms. Methods This was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV. Results Of the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively). Conclusions PONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Philip Wilson ◽  
Fiona McQuaige ◽  
Lucy Thompson ◽  
Alex McConnachie

Aims. To investigate factors associated with language delay in a cohort of 30-month-old children and determine if identification of language delay requires active contact with families.Methods. Data were collected at a pilot universal 30-month health contact. Health visitors used a simple two-item language screen. Data were obtained for 315 children; language delay was found in 33. The predictive capacity of 13 variables which could realistically be known before the 30-month contact was analysed.Results. Seven variables were significantly associated with language delay in univariate analysis, but in logistic regression only five of these variables remained significant.Conclusion. The presence of one or more risk factors had a sensitivity of 89% and specificity of 45%, but a positive predictive value of only 15%. The presence of one or more of these risk factors thus can not reliably be used to identify language delayed children, nor is it possible to define an “at risk” population because male gender was the only significant demographic factor and it had an unacceptably low specificity (52.5%). It is not possible to predict which children will have language delay at 30 months. Identification of this important ESSENCE disorder requires direct clinical contact with all families.


2018 ◽  
Vol 7 (2) ◽  
pp. 205846011875757
Author(s):  
Tsuyoshi Morimoto ◽  
Takayuki Yamada ◽  
Kunihisa Miyakawa ◽  
Yasuo Nakajima

Background Pericolic fat stranding on computed tomography (CT) scans has been an important feature for staging colon cancer. However, the factors associated with pericolic fat stranding have not been elucidated to date. Purpose To determine factors associated with pericolic fat stranding of colon cancer on CT colonography (CTC). Material and Methods Overall, 150 patients with 155 colon cancer lesions were retrospectively assessed by two radiologists for pericolic fat stranding on CTC. Circumferential proportion of the tumor (CPtumor; <50%, 50–75%, and ≥75%), longitudinal length, depth of invasion (≤T2, T3, T4), lymph node and distant metastasis, and lymphovascular invasion were recorded. Univariate and multivariate logistic regression analyses were performed between pericolic fat stranding and each factor. Multi-group comparisons were performed for the CPtumor and depth of invasion. Results Pericolic fat stranding was identified in 57 lesions (36.8%). Univariate analysis revealed significant associations of pericolic fat stranding with all factors ( P < 0.027), except for lymph node metastasis ( P = 0.087). Multi-group comparisons revealed that pericolic fat stranding was more frequent with increasing CPtumor ( P < 0.001); however, no significant differences were observed beyond subserosal infiltration ( P = 0.225). Logistic regression analysis revealed the CPtumor (<75% vs. ≥75%; P = 0.008, <50% vs. 50–75%; P = 0.047) and longitudinal length ( P = 0.001) as explainable variables. Conclusion Pericolic fat stranding identified on CT images of colon cancer is demonstrated more frequently with increasing circumferential proportion of the tumor and longitudinal length.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jincong Yu ◽  
Ziyun Yang ◽  
Yuqin Wu ◽  
Ming Ge ◽  
Xuemei Tang ◽  
...  

Objectives: The 2019 coronavirus disease (COVID-19) epidemic has led to persistent negative psychological effects on the general public, especially on college students, who are highly susceptible to psychological difficulties, such as fear, anxiety, and depression. Little information is known about depressive symptoms among college students during the normalization stage of COVID-19 prevention and control in China. This study aimed to understand the prevalence of and factors associated with depressive symptoms after a long quarantine time and online learning at home among college students in Wuhan, China.Materials and Methods: A web-based survey was conducted from July to August 2020 during the Chinese summer holiday to collect data on sociodemographic variables, depressive symptoms, and their potential associated factors using an electronic questionnaire among college students in Wuhan, China. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Binary logistic regression was used to explore the factors associated with depressive symptoms.Results: A total of 9,383 college students were included in the analysis. The prevalence of depressive symptoms was 15.8% (1,486/9,383) among college students. The binary logistic regression showed that the experience of being quarantined for observation or treatment, family members or friends dying of COVID-19, rarely or never seeking help from others, fewer supportive relatives or friends, less support from family in the past month, a worse relationship with parents at home, a longer time spent daily on electronic devices except for online learning, and feeling anxious in the face of returning to school were independently associated with a higher risk of depressive symptoms. Academic stress and concern about the epidemic were the main reasons for their anxiety.Conclusions: Targeted psychological intervention measures are recommended for college students to improve their mental health during the normalization stage of COVID-19 prevention and control.


2021 ◽  
Author(s):  
Tomoharu Taga ◽  
Kayoko Ito ◽  
Kiyoshi Takamatsu ◽  
Mariko Ogawa ◽  
Saori Funayama ◽  
...  

Abstract Background: Perimenopausal women experience a wide variety of systemic symptoms: hot flashes, sweating, psychiatric symptoms and various oral sensory complaints (OSC). OSC in perimenopausal women include xerostomia, taste disturbance and burning mouth. However, the factors associated with these OSC have not been identified. The purpose of this investigation was to elucidate the factors associated with OSC in perimenopausal women.Methods: The study cohort comprised 43 perimenopausal women aged 45–55 years. Data on medical history, medications, menstrual status, menopausal symptoms, xerostomia, taste disturbance and burning mouth were collected. Volumes of unstimulated and stimulated saliva were measured. Tongue coating was evaluated according to a tongue coating index. Univariate analysis was performed to identify factors significantly associated with having xerostomia, taste disturbance, burning mouth and more than two OSC (2OSC). Next, the factors strongly associated with these symptoms were examined by logistic regression analysis.Results: The number of menopausal symptoms was significantly higher, and volume of unstimulated saliva significantly lower in participants with xerostomia, taste disturbance, burning mouth or 2OSC than in those without these characteristics. Agents targeting the central nervous system were more frequently taken by participants with burning mouth and 2OSC than by those without these characteristics. According to logistic regression analysis, the number of menopausal symptoms was an explanatory variable for xerostomia, taste disturbance, burning mouth and 2OSC. Conclusions: Our findings suggested that OSC associated with the number of menopausal symptoms. Management of menopausal symptoms may decrease OSC, leading to improved quality of life of perimenopausal women.


2021 ◽  
Author(s):  
Cuiping Zhou ◽  
Xiaohua Ban ◽  
Huijun Hu ◽  
Qiuxia Yang ◽  
Rong Zhang ◽  
...  

Abstract Background: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor in the liver. Partial hepatectomy is one of the most effective therapies for HCC but suffer from the high recurrence rate. At present, the studies of association between clinical outcomes and CT features of patients with HCCs undergoing partial hepatectomy are still limited. The purpose of this study is to determine the predictive CT features and establish a model for predicting relapse or metastasis in patients with primary hepatocellular carcinomas (HCCs) undergoing partial hepatectomy.Methods: The clinical data and CT features of 112 patients with histopathologically confirmed primary HCCs were retrospectively reviewed. The clinical outcomes were categorized into two groups according to whether relapse or metastasis occurred within 2 years after partial hepatectomy. The association between clinical outcomes and CT features including tumour size, margin, shape, vascular invasion (VI), arterial phase hyperenhancement, washout appearance, capsule appearance, satellite lesion, involvement segment, cirrhosis, peritumoral enhancement and necrosis was analyzed using univariate analysis and binary logistic regression. Then establish logistic regression model, followed by receiver operating characteristic (ROC) curve analysis.Results: CT features including tumor size, margin, shape, VI, washout appearance, satellite lesion, involvement segment, peritumoral enhancement and necrosis were associated with clinical outcomes, as determined by univariate analysis (P<0.05). Only tumor margin and VI remained independent risk factors in binary logistic regression analysis (OR=6.41 and 10.92 respectively). The logistic regression model was logit(p)=-1.55+1.86 margin +2.39 VI. ROC curve analysis showed that the area under curve of the obtained logistic regression model was 0.887(95% CI:0.827-0.947).Conclusion: Patients with ill-defined margin or VI of HCCs were independent risk predictors of poor clinical outcome after partial hepatectomy. The model as logit(p)= -1.55+1.86 margin +2.39 VI was a good predictor of the clinical outcomes.


2020 ◽  
Vol 11 (02) ◽  
pp. 291-298
Author(s):  
Karthick Subramanian ◽  
Vikas Menon ◽  
Siddharth Sarkar ◽  
Vigneshvar Chandrasekaran ◽  
Nivedhitha Selvakumar

Abstract Background Suicide is the leading contributor to mortality in bipolar disorder (BD). A history of suicidal attempt is a robust predictive marker for future suicide attempts. Personality profiles and coping strategies are the areas of contemporary research in bipolar suicides apart from clinical and demographic risk factors. However, similar research in developing countries is rarer. Objectives The present study aimed to identify the risk factors associated with suicidal attempts in BD type I (BD-I). Materials and Methods Patients with BD-I currently in clinical remission (N = 102) were recruited. Sociodemographic details and the clinical data were collected using a semistructured pro forma. The psychiatric diagnoses were confirmed using the Mini-International Neuropsychiatric Interview 5.0. The National Institute of Mental Health–Life Chart Methodology Clinician Retrospective Chart was used to chart the illness course. Presumptive Stressful Life Events Scale, Coping Strategies Inventory Short Form, Buss–Perry aggression questionnaire, Past Feelings and Acts of Violence, and Barratt Impulsivity scale were used to assess the patient’s stress scores, coping skills, aggression, violence, and impulsivity, respectively. Statistical Analysis Descriptive statistics were used for demographic details and characteristics of the illness course. Binary logistic regression analyses were performed to identify the predictors for lifetime suicide attempt in BD-I. Results A total of 102 patients (males = 49 and females = 53) with BD-I were included. Thirty-seven subjects (36.3%) had a history of suicide attempt. The illness course in suicide attempters more frequently had an index episode of depression, was encumbered with frequent mood episodes, especially in depression, and had a higher propensity for psychiatric comorbidities. On binary logistic regression analysis, the odds ratios (ORs) for predicting a suicide attempt were highest for positive family history of suicide (OR: 13.65, 95% confidence interval [CI]: 1.28–145.38, p = 0.030), followed by the presence of an index depressive episode (OR: 6.88, 95% CI: 1.70–27.91, p = 0.007), and lower scores on problem-focused disengagement (OR: 0.72, 95% CI: 0.56–0.92, p = 0.009). Conclusion BD-I patients with lifetime suicide attempt differ from non-attempters on various course-related and temperamental factors. However, an index episode depression, family history of suicide, and lower problem-focused engagement can predict lifetime suicide attempt in patients with BD-I.


2017 ◽  
Vol 156 (3) ◽  
pp. 484-488 ◽  
Author(s):  
Erdem Eren ◽  
Toygar Kalkan ◽  
Seçil Arslanoğlu ◽  
Mustafa Özmen ◽  
Kazım Önal ◽  
...  

Objective To determine the predictive value of nasal endoscopic findings and symptoms in the diagnosis of granulomatosis with polyangiitis (GPA). Study Design A cross-sectional study. Setting A tertiary university hospital. Subjects and Methods A total of 116 adults were enrolled in the study: 19 patients with GPA, 29 patients with other rheumatic diseases, and 68 healthy volunteers. All patients were examined with a flexible endoscope, and nasal endoscopic images were recorded and evaluated blindly. The medical history of each patient was taken by a physician blinded to the patient’s diagnosis. Results Univariate analysis indicated a statistically significant difference in rhinorrhea ( P = .002), postnasal drip ( P = .015), epistaxis ( P < .001), and saddle nose ( P = .017). However, binary logistic regression analysis demonstrated that only history of epistaxis ( P = .012; odds ratio, 5.6) was statistically significant in predicting GPA. Univariate analysis showed a statistically significant difference in nasal secretion ( P = .028), nasal septal perforation ( P < .017), nasal crusting ( P < .001), nasal adhesion ( P < .001), nasal granuloma ( P = .017), and hemorrhagic fragile nasal mucosa ( P < .001). A binary logistic regression analysis demonstrated that only hemorrhagic fragile nasal mucosa ( P < .001; odds ratio, 52.9) was a statistically significant predictor of GPA. Conclusions Given the results of this study, we believe that hemorrhagic fragile nasal mucosa and history of recurrent epistaxis may put patients at risk for GPA and should be investigated accordingly.


Open Medicine ◽  
2011 ◽  
Vol 6 (2) ◽  
pp. 220-226 ◽  
Author(s):  
Xiao Shi ◽  
Qinglong Jin ◽  
Yulin Hu ◽  
Xiumei Chi ◽  
Yanhang Gao ◽  
...  

AbstractDyslipidemia, is a major risk factor for premature coronary artery disease. Our aim was to estimate the prevalence of dyslipidemia (blood lipid abnormalities) and other risk factors associated with coronary artery diseases among an adult population in northeastern China. Throughout the months of September and October of 2007,a population-based cross-sectional study was conducted and a total of 3,815 individuals were included. Total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and triglycerides (TG) were measured. A binary logistic regression analysis was conducted to determine risk factors associated with dyslipidemia. The prevalence of hypercholesterolemia, high LDL-C, low HDL-C, and hypertriglyceridemia were 17.3%, 27.8%, 11.66% and 29.85%, respectively. The prevalence of hypertension, central obesity, alcoholic liver disease (ALD), non-ALD, diabetes and metabolic syndrome was higher in serum lipid abnormality groups than in the non-dyslipidemia group (p < 0.001). In a binary logistic regression, hyperlipidemia was positively correlated with age, male, hypertension, high body mass index, etc. There were negative correlations with being female and the level of education a subject had attained. Dyslipidemia is a major risk factor for premature coronary artery diseases and an important public health issue in the northeastern part of China. Dyslipidemia is more frequent than expected based on previous studies. To control dyslipidemia, routine evaluations in clinics and community centers are needed, as well as effective public health education.


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