High prevalence of neutralizing antibodies after long-term botulinum neurotoxin therapy

Neurology ◽  
2018 ◽  
Vol 92 (1) ◽  
pp. e48-e54 ◽  
Author(s):  
Philipp Albrecht ◽  
Alexander Jansen ◽  
John-Ih Lee ◽  
Marek Moll ◽  
Marius Ringelstein ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Botulinum Neurotoxin ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Binary Logistic Regression Analysis ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Kaplan Meier ◽  
The Individual

ObjectiveTo investigate the prevalence of neutralizing antibodies (NAbs) against botulinum neurotoxin type A (BoNT/A) during long-term BoNT/A treatment in different neurologic indications.MethodsIn this monocentric, observational cross-sectional study, 596 outpatients treated with BoNT/A for different indications were tested for BoNT/A binding antibodies by ELISA. Positive samples were investigated for NAbs with the mouse hemidiaphragm test. The prevalence of NAbs was analyzed for different indications: facial hemispasm, blepharospasm, cervical dystonia, other dystonia, and spasticity. Besides the rate of NAb-positive patients overall and per patient subgroup, a Kaplan-Meier analysis of the probability of remaining NAb negative with duration of treatment is provided, and a stepwise binary logistic regression analysis is performed to identify factors significantly contributing to the induction of NAbs.ResultsOverall, 83 of 596 patients (13.9%) had measurable NAbs. The probability of developing NAbs increased with the single and cumulative dose of treatment and was influenced by the BoNT/A formulation, while all other factors analyzed, including disease entity and treatment duration, had no additional influence.ConclusionsWe present the largest study to date of the prevalence of BoNT/A NAbs in a large unbiased cohort of patients including the relevant neurologic indications. Repeated injections of BoNT/A inevitably bear the risk of developing NAbs. However, in addition to avoiding booster injections and providing short intervals between injections, reducing the individual injected doses may diminish the risk of NAb induction independently of the indication for which BoNT/A is used.

MO376CLINICAL OUTCOMES OF ACUTE KIDNEY INJURY FOLLOWING SNAKE BITE INJURIES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Weerakit Naweera ◽  
Thapat Wannarong
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Kidney Injury ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Renal Recovery ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Hospital Arrival ◽  
Russell’S Viper

Abstract Background and Aims Snakebite is a common animal bite injury in tropical countries. Acute kidney injury (AKI) is an important complication in snakebite patients. This study aimed to comprehensively investigate the clinical profiles and outcomes of patients following hematotoxin-related snakebite associated with kidney impairment. Method We conducted a hospital-based, cross-sectional study of 238 patients with hematotoxin-related snakebite injuries. Data were retrieved from the King Narai Hospital Registry from October 2014 to August 2020. The prevalence of complications associated with snakebite injuries, including acute kidney injury (AKI) and its severity, was determined. Univariate and Multivariate predictors of AKI diagnosis were evaluated using binary logistic regression analysis Results A total of 238 patients, with 63.4% men, median (IQR) age 49.8 (39-61) years and median duration from injury to a hospital arrival of 1 hour (0.5-2) hours, were injured by Green pit viper (85.7%), Russell’s viper (12.6%) and Malayan pit viper (1.7%). AKI mostly occurred in Russell’s viper group 66.7%. An AKI was reported in thirty (12.6%, 95% CI: 8.7 % - 17.5%) patients, with the severity of 66.7% stage one, 6.7% stage two, 26.6% stage three by KDIGO classifications, and 13.3% requiring hemodialysis. Complete renal recovery was seen in twenty-two patients (73.3%), while partial renal recovery was 23.3%. Other complications included 84.4 % limb cellulitis, 4.6% significantly bleeding, 2.5% hypotension, 25.6% prolonged venous clotting time (VCT), 46.7% prolonged prothrombin time (PT), and 14.3% prolonged partial thromboplastin time (PTT). Of total patients, 60.1% were treated with anti-venom. Mortality was relatively low (0.4%). In multivariable logistic regression analyses, AKI was significantly associated with time to hospital arrival more than 3 hours (p = 0.04), Russell’s viper bitten (p = 0.01), clinical bleeding (p = 0.01), and prolonged PT (p < 0.01). Conclusion The prevalence of AKI in patients bitten by hematotoxin snakes was 12.6%, mostly from Russell’s viper. Factors associated with AKI outcomes were time to hospital arrival more than 3 hours, Russell’s viper bitten, clinical bleeding, and prolonged PT. Besides, one-fourth of AKI patients turned to chronic kidney disease.

scholarly journals The Uptake and Vaccination Willingness of COVID-19 Vaccine among Chinese Residents: Web-Based Online Cross-Sectional Study

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 90
Author(s):  
Yi Kong ◽  
Hao Jiang ◽  
Zhisheng Liu ◽  
Yi Guo ◽  
Dehua Hu
Keyword(s):  
Health Status ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Personal Health ◽  
Binary Logistic Regression Analysis ◽  
Snowball Sampling ◽  
Cross Sectional ◽  
Web Based ◽  
The Difference ◽  
High Level

Objective: To investigate the uptake and vaccination willingness of the COVID-19 vaccine among Chinese residents and analyze the difference and factors that impact vaccination. Methods: The snowball sampling method was used to distribute online questionnaires. Relevant sociodemographic data along with the circumstances of COVID-19 vaccination were collected from the respondents. The χ2 test, independent samples t test and binary logistic regression analysis were used to analyze the data. Results: Among 786 respondents, 84.22% had been vaccinated. Over 80% of the vaccinated population have completed all the injections because of supporting the national vaccination policies of China, while the unvaccinated population (23.91%) is mainly due to personal health status. Meanwhile, statistical analysis revealed that the main predictors of not being vaccinated were younger age (3 to 18 years old), personal health status, and lower vaccinated proportion of family members and close friends (p < 0.05). Conclusions: There was a high level of uptake of the COVID-19 vaccine in China, and people who have not been vaccinated generally had a low willingness to vaccinate in the future. Based on our results, it suggested the next work to expand the coverage of the COVID-19 vaccination should be concentrated on targeted publicity and education for people who have not been vaccinated.

Short-term residential care for dementia patients: predictors for utilization and expected quality from a family caregiver's point of view

2009 ◽  
Vol 21 (4) ◽  
pp. 703-710 ◽  
Author(s):  
Carolin Donath ◽  
Angelika Winkler ◽  
Elmar Gräßel
Keyword(s):  
Family Caregivers ◽  
Residential Care ◽  
Qualitative Content Analysis ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Point Of View ◽  
Binary Logistic Regression Analysis ◽  
Short Term ◽  
Cross Sectional ◽  
Dementia Patients

ABSTRACTBackground: Short-term residential care (SRC) has proved to be effective in reducing the burden on family caregivers of dementia patients. Nevertheless, little is known about the factors which influence its usage or the expectations of family caregivers regarding quality. In this paper we address the following questions: (i) which variables of the care situation, the caregivers and their attitudes act as predictors for the utilization of SRC facilities? (ii) What are the views of caregivers about the quality of SRC?Methods: The cross-sectional study was carried out as an anonymous written survey of family caregivers of dementia patients in four regions of Germany. With a 20% response it was possible to analyze the quantitative and qualitative data from 404 and 254 family caregivers respectively. Predictors for utilization were evaluated using binary logistic regression analysis. The answers to questions of quality were evaluated using qualitative content analysis.Results: Significant predictors for the utilization of SRC are the assessment of the helpfulness of SRC and the caregiver's knowledge of the accessibility of SRC facilities. Family caregivers who had already used SRC most frequently expressed the wish for “good care” in SRC facilities, followed by a program of suitable activities for dementia patients.Conclusions: In order to increase the rate of utilization, family caregivers must be convinced of the relevant advantages of using SRC facilities. The staff should be trained in caring for dementia patients and appropriate activities should be available.

scholarly journals Critical Incident Disclosing Behaviors and Associated Factors among Nurses Working in Amhara Region Referral Hospitals, Northwest Ethiopia: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yeshiambew Eshete ◽  
Bekele Tesfaye ◽  
Zewdu Dagnew ◽  
Demewoz Kefale ◽  
Demke Mesfin Belay ◽  
...  
Keyword(s):  
Patient Safety ◽  
Critical Incident ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Referral Hospitals ◽  
Administrative Sanctions ◽  
Significant Factors

Background. Though the goal of healthcare institutions is patient safety, errors have been committed by healthcare providers. Incident reporting behavior enhances patient safety by reducing the repeated occurrence of errors in the health facility. Therefore, this study aims to identify incident disclosing behaviors and associated factors among nurses working in referral hospitals, Northwest Ethiopia. Methods. Institution-based cross-sectional study design was conducted among randomly selected 319 nurses working in referral hospitals of Amhara region from March 1–30, 2019. Data were collected using a self-administered structured questionnaire. Data were coded and entered into EpiData 4.2 software and exported to Statistical Package for Social Sciences version 25 for analysis. All variables with p value <0.25 during bivariable binary logistic regression analysis were considered for multivariable binary logistic regression analysis. Odds ratio along with 95% CI was estimated to measure the strength of the association. Level of statistical significance was declared at p value ≤0.05. Results. The proportion of nurses who reported incidents was 31.9% (95% confidence interval (CI), 27, 3)). Fear of administrative sanctions (adjusted odd ratio (AOR) = 0.45; 95% CI, 0.22, 0.90), fear of legal penalty (AOR = 0.27; 95% CI, 0.14, 0.50), lack of feedback (AOR = 0.29; 95% CI, 0.13, 0.66), nonsupportive environment (AOR = 0.27; 95% CI, 0.14, 0.52), and feel that reporting to colleague is easier (AOR = 2.65; 95% CI, 1.35, 5.20) were all found to be significant factors. Conclusions. The proportion of nurses who reported incidents was low. Fear of administrative sanctions, fear of legal penalty, lack of feedback, nonsupportive environment, and felling that reporting to colleagues was easier are found to be significant factors. Developing a system that encourages critical incident reporting behavior and provide protection from penalties for nurses to report incidents for the enhancement of patient safety and quality of care at each health facility and regional level is crucial.

scholarly journals Spexin Levels are Associated with Painful Diabetic Peripheral Neuropathy

2021 ◽  
Author(s):  
Lu Zhu ◽  
Hangping Zheng ◽  
Yaojing Jiang ◽  
Qi Zhang ◽  
Bin Lu ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Antinociceptive Effect ◽  
Experimental Studies ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Control Group ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional

Abstract Background: Spexin is implicated in multiple functions of energy metabolism and glucose homeostasis regulation. Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes and approximately half of the patients with DPN suffer from neuropathic pain. Recent experimental studies in mice have shown that Spexin has an antinociceptive effect, but there are no relevant reports in clinical studies. This study aimed to evaluate Spexin levels in people with painful DPN and controls and assess the correlation between serum Spexin levels and painful DPN.Methods: This is a cross-sectional study including 20 patients with diabetes but without DPN (non-DPN) as a control group, 24 patients with painless DPN, and 16 patients with painful DPN. Questionnaires and laboratory surveys were conducted to collect demographic and clinical data. The existence and severity of DPN were assessed using neurological symptom score, neurological examination, and electromyography. Serum Spexin levels were measured by ELISA. Results: Serum Spexin levels of patients with painful DPN were significantly lower than those of non-DPN patients (p<0.001) and painless DPN patients (p=0.035). Serum Spexin levels were negatively correlated with neuropathic pain score. Compared with individuals with higher levels of Spexin, the prevalence rate of painful DPN in those with lower levels of Spexin was significantly higher. Binary logistic regression analysis showed that the odds ratios for painful DPN were significantly elevated along with decreasing Spexin levels even after adjusting for age, sex, BMI, diabetes duration, HbA1c, 2hPBG, hypertension and smoking or drinking status. serum Spexin levels have a sensitivity of 84.1% and a specificity of 56.2% for predicting painful DPN.Conclusions: Decreased serum Spexin levels were strongly associated with painful DPN, suggesting a possible role of this peptide in pain-related pathogenesis.

scholarly journals COVID-19-related stigma and its influencing factors: a nationwide cross-sectional study during the early stage of the pandemic in China

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048983
Author(s):  
Tianyu Jiang ◽  
Xudong Zhou ◽  
Leesa Lin ◽  
Yanzheng Pan ◽  
Yuyuan Zhong ◽  
...  
Keyword(s):  
Health Literacy ◽  
Online Survey ◽  
Early Stage ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Low Health Literacy ◽  
Related Stigma ◽  
The Individual ◽  
The City

ObjectivesTo describe the situation of COVID-19-related stigma towards patients with COVID-19 and people from the city of Wuhan in China and to assess the associations between COVID-19-related stigma, health literacy and sociodemographic characteristics during March 2020, the early stage of the pandemic.DesignA cross-sectional online survey.SettingThe study surveyed 31 provinces in China.ParticipantsThis study surveyed 5039 respondents in China.Outcome measuresPublic stigma towards both patients with COVID-19 and Wuhan residents was measured. Binary logistic regression was used to identify the factors associated with public COVID-19-related stigma.ResultsAmong the participants, 122 (2.4%) reported themselves and 254 (5.0%) reported the communities they lived in as holding a stigmatising attitude towards patients with COVID-19, respectively. Additionally, 114 (2.5%) and 475 (10.3%) reported that themselves and the communities they lived in, respectively, held a stigma against people from Wuhan, which was the most severely affected area in China. People aged over 40, lived in areas with severe epidemics (adjusted OR (aOR)=2.03, 95% CI (1.05 to 3.92)) and who felt it difficult to find and understand information about COVID-19 (aOR=1.91, 95% CI (1.08 to 3.37); aOR=1.88, 95% CI (1.08 to 3.29)) were more likely to stigmatise patients with COVID-19. People who were male, aged 41–50 and had difficulty understanding information (aOR=2.08, 95% CI (1.17 to 3.69)) were more likely to stigmatise people from Wuhan.ConclusionsPatients with COVID-19 and Wuhan residents suffered stigma at both the individual and the community levels. Those who had low health literacy, who lived in areas with a large number of COVID-19 cases and who were of ethnic minorities were more likely to stigmatise others. Tailored interventions are encouraged to improve health literacy and consequently to reduce public COVID-19-related stigma.

scholarly journals Inappropriate Use of Antibiotics and Their Predictors in Pediatric Patients Admitted at the Hospital Central De Nampula, Mozambique

2021 ◽  
Author(s):  
Sancho Pedro Xavier ◽  
Audêncio Victor ◽  
Graciano Cumaquela ◽  
Melsequisete Daniel Vasco ◽  
Osiyallê Rodrigues ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pediatric Patients ◽  
Treatment Time ◽  
Binary Logistic Regression ◽  
Antibiotic Use ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Inappropriate Use

Abstract Background Antibiotics are synthetic or natural substances used to treat diseases of infectious origin. When used incorrectly, they can be a factor in the development of antimicrobial resistance, increased treatment time, costs, and mortality. The present study aimed to assess the pattern inappropriate use of antibiotics and their predictors in pediatric patients admitted to the Hospital Central de Nampula, Mozambique Methods A cross-sectional, retrospective study with a quantitative approach was conducted between January and July 2019. The population consisted of children aged 0 to 10 years hospitalized in the pediatric ward I. Binary logistic regression was used to determine risk factors for inappropriate use of antibiotics with 95% CI. Results The prevalence of antibiotic use among pediatric patients was 97.5%. Of the 464 antibiotics prescribed, 39.9% were for patients suffering from gastroenteritis, 21.8% and 9.1% Affected with pneumonia and malaria. Most antibiotics were for systemic use (95.9%, 445/464). Most (36.5%) of prescriptions had errors. Duration of treatment (74.6%) and dosage (25.4%) were the most frequent errors. Binary logistic regression analysis revealed that patients were prescribed with ≥ 3 antibiotics (OR = 2.920, 95% CI = 1.283–6.646, p–value = 0.011) and with a short hospitalization time (OR = 1.726, 95% CI = 1.040–2.864, p–value = 0.035) were more likely to experience some inappropriate use of antibiotics. Conclusion The study showed a higher prevalence of antibiotic use, however, a greater number of prescriptions contained errors. Errors related to dose and duration of treatment were the most common among pediatric patients. These results reveal a concern, since inappropriate and excessive use of antibiotics is a major factor for the development of antibiotic resistant microorganisms. Therefore, strategies concerning the use of antibiotics in order to reduce their inappropriate and excessive use are necessary.

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.    

scholarly journals Work, Stress, and Diurnal Bruxism: A Pilot Study among Information Technology Professionals in Bangalore City, India

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
S. K. Rao ◽  
M. Bhat ◽  
J. David
Keyword(s):  
Information Technology ◽  
Work Stress ◽  
Work Experience ◽  
Strong Predictor ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Binary Logistic Regression Analysis ◽  
It Professionals ◽  
Cross Sectional ◽  
Bangalore City

The study assessed the prevalence of diurnal bruxism among information technology (IT) professionals and explored plausible predictors associated with the parafunctional habit. A cross-sectional study was designed and IT professionals were invited to participate. The inclusion criteria composed of participants in service for at least one year, having natural dentition, no history of cervical or facial injury and not undergoing orthodontic therapy. The participants () were interviewed by a trained interviewer to record information. A pre-tested questionnaire that included questions related to work, stress symptoms and diurnal bruxism was completed by each participant. The prevalence of self-reported diurnal bruxism was 59%. Bivariate analyses revealed that work () and work experience () were significantly associated with self-reported diurnal bruxism. In the binary logistic regression analysis stress (Odds Ratio [OR] , 95% Confidence Interval [CI] 2.6–13.3) was identified to be a strong predictor of diurnal bruxism. Professionals with 11 or more years of experience were less likely to report diurnal bruxism (, 95% CI 0.00–0.43) than those with 1 to 5 years of work experience. The study revealed that stress and less work experience were associated with diurnal bruxism among IT professionals in Bangalore city.

Social capital and health and job related outcomes: the case of a large municipality

2016 ◽  
Vol 9 (1) ◽  
pp. 17-31 ◽  
Author(s):  
Ann-Kristina Løkke
Keyword(s):  
Job Satisfaction ◽  
Social Capital ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Employee Survey ◽  
Content Type ◽  
The Relationship ◽  
Large Municipality

Purpose – The purpose of this paper is to investigate the relationship between workplace social capital and health and job related outcomes in a large Danish municipality. Design/methodology/approach – Data used in this cross-sectional study are based on an electronic employee survey conducted in 2012 in a large municipality. Of the total population of 5,672 individuals, the number of participants amounted to 4,162, leading to a response rate of 73.4 percent. Binary logistic regression analysis is used as a statistical method, and odds ratios and their corresponding 95 percent confidence intervals have been estimated. Findings – The level of social capital is fairly high in the municipality (3.75 on a five-point scale). Social capital is related to health (OR=0.420) and psychological distress (OR=0.282) but has an even stronger relationship to job satisfaction and commitment (OR is 9.889 and 7.800, respectively). The study contributes with the conclusion that different sub-dimensions of social capital are related to health and job related outcomes. Therefore, managers need to be specific about what exactly they want to achieve with the implementation of social capital in municipalities. Originality/value – Research of the relationship between social capital and health and job related outcomes based on a case study approach of a municipality are limited. This paper makes an original contribution in providing evidence of the importance of social capital for Danish municipal sector employees’ health, job satisfaction, and commitment in a work context.

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