scholarly journals Factors associated with mechanical device-related complications in tube fed patients: A multicenter prospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241849
Author(s):  
Fernanda Raphael Escobar Gimenes ◽  
Flávia Fernanda Luchetti Rodrigues Baracioli ◽  
Adriane Pinto de Medeiros ◽  
Patricia Rezende do Prado ◽  
Janine Koepp ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Adverse Events ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Mechanical Device ◽  
Chi Square ◽  
Factors Associated ◽  
Level Of Consciousness ◽  
Chi Square Test

Aims To identify the types of nasogastric/nasoenteric tube (NGT/NET)-related adverse events and to analyze the degree of harm and the factors associated with mechanical device-related complications. Materials and methods A prospective cohort study was conducted from October 2017 to April 2019 in seven Brazilian hospitals. Data from 447 adult patients with NGT/NET were collected through electronic forms. Three methods were used to assess the NGT/NET-related adverse events: (1) encouraging spontaneous reports; (2) regular visits to the wards; and (3) review of medical records. The events were classified as mechanical device-related complications and other events. The degree of harm was classified according to the World Health Organization’s International Classification for Patient Safety. Data were analyzed using the R program, version 3.5.3. The following tests were applied to identify associations between the explanatory and response variables: Cochran-Armitage Chi-Square test, Fisher’s exact test, and Linear-by-linear Chi-Square test. Logistic regression analysis was performed to verify the predictors of mechanical device-related complications. All analyses were performed considering a 5% significance level. Results 191 NGT/NET-related adverse events were identified in 116 patients; the majority were mechanical device-related complications and resulted in mild harm to the patient. At the moment of the event, patients had a mean of 3.27 comorbidities, were highly dependent on nursing care, with high risk of death and altered level of consciousness. There was no association between the degree of harm and the care complexity, disease severity or level of consciousness. Intensive care was the strongest predictor for mechanical device-related complications and critical patients had a four times greater likelihood of presenting this type of event when compared to patients receiving minimal care. Conclusion Intensive care patients should receive special attention as the complexity of care is an important predictor for mechanical device-related complications in tube fed patients.

scholarly journals Neuropsychiatric Adverse Events During 12 Months of Treatment with Efavirenz in a Treatment-Naïve HIV-Infected Population in China: A Prospective Cohort Study

2020 ◽  
Author(s):  
Lili Dai ◽  
Sen Wang ◽  
Ying Shao ◽  
Yali Wang ◽  
Jiangzhu Ye ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Sleep Disturbances ◽  
Neuropsychiatric Disorders ◽  
Factors Associated ◽  
Anxiety Depression

Abstract Background: Efavirenz (EFV) is a widely used antiretroviral therapy (ART), but side effect risks of neuropsychiatric adverse events (NPAEs) have not been investigated in Chinese populations receiving rapid ART. Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4%, 22.7%, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months. Conclusions: These findings suggested EFV-based first-line antiretroviral therapy was well-tolerated and associated with improvements in HADS-A, HADS-D, and PSQI scores. Certain risk factors associated with neuropsychiatric disorders may be useful in identifying HIV-infected patients at higher NPAE risk.

scholarly journals Factors associated with self-efficacy for managing recovery in the trauma intensive care population: A prospective cohort study

Injury ◽  
2014 ◽  
Vol 45 (1) ◽  
pp. 272-278 ◽  
Author(s):  
Fiona R. Connolly ◽  
Leanne M. Aitken ◽  
Marion Tower ◽  
Bonnie Macfarlane
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Prospective Cohort Study ◽  
Self Efficacy ◽  
Prospective Cohort ◽  
Factors Associated

scholarly journals Effects of Dexmedetomidine and Fentanyl Premedication on Quality of Extubation in Children undergoing Tonsillectomy: A Prospective Cohort Study

2021 ◽  
Author(s):  
Chathoth Anjana ◽  
Suseela Indu ◽  
Prabhakaran Vineetha
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Sedation Score ◽  
Paediatric Anaesthesia ◽  
Chi Square ◽  
Exact Test ◽  
Chi Square Test ◽  
American Society

Introduction: Smooth extubation in children is a challenging task, especially those undergoing tonsillectomy. Dexmedetomidine, an alpha-2 receptor agonist has been found to be beneficial in paediatric anaesthesia due to its anxiolytic, sedative and analgesic properties. It also attenuates haemodynamic stress response and airway reflexes to intubation and extubation. Fentanyl, a synthetic opioid is also extensively used in paediatric anaesthesia. Aim: To compare the effects of dexmedetomidine and fentanyl premedication on quality of extubation and extubation haemodynamics. Materials and Methods: The prospective cohort study was conducted in 120 children divided into two groups of 60 each, aged 5-12 years, belonging to American Society of Anaesthesiologists’ (ASA) physical status I and II, posted for elective tonsillectomy under general anaesthesia. Group F received fentanyl 2 μg/kg intravenously and group D, dexmedetomidine 0.5 μg/kg as intravenous infusion over 10 minutes as premedication. The time from discontinuation of anaesthetics to extubation and to opening the eyes in response to verbal stimuli were noted. The quality of extubation was evaluated according to the 5 point extubation score and postoperative sedation assessed using Ramsay sedation score. The haemodynamic parameters were monitored immediately after discontinuation of anaesthetics and at 1, 3, 5 and 10 minutes postextubation. Any complications like airway obstruction, bradycardia, and hypotension were noted and treated appropriately. Statistical Package for Social Sciences (SPSS) software version 22 was used for statistical analysis and categorical outcomes compared with Chi-square test/Fisher’s-Exact test. Results: Extubation was smoother in group receiving dexmedetomidine. The median time from discontinuation of anaesthetics to extubation and eye opening was significantly shorter in dexmedetomidine group compared to fentanyl group (p<0.001). Postoperative sedation score was comparable between the two groups. Heart Rate (HR) and Mean Arterial Pressure (MAP) monitored showed significantly stable values in the dexmedetomidine group (p<0.001) when compared to fentanyl soon after discontinuation of anaesthetics and 1, 3, 5 and 10 minutes postextubation. Conclusion: Premedication with dexmedetomidine 0.5 μg/kg intravenously provides better quality and haemodynamics of extubation compared to fentanyl 2 μg/kg in children undergoing tonsillectomy, without causing significant sedation.

scholarly journals Neuropsychiatric Adverse Events During 12 Months of Treatment With Efavirenz in Treatment-Naïve HIV-Infected Patients in China: A Prospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Hua ◽  
Sen Wang ◽  
Xi Wang ◽  
Ying Shao ◽  
Yali Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Adverse Events ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Sleep Disturbances ◽  
Neuropsychiatric Disorders ◽  
Factors Associated ◽  
Anxiety Depression

Background: Efavirenz (EFV) is widely used in antiretroviral therapy (ART), but the incidence and risk factors of neuropsychiatric adverse events (NPAEs) after EFV treatment have rarely been studied in Chinese ART naïve patients.Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI).Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4, 22.7, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower income, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months.Conclusions: These findings suggested EFV discontinuation due to NAPEs was low, and the HADS-A, HADS-D, and PSQI scores after 12 months of EFV treatment were associated with several risk factors. The clinicians should keep in mind and routinely screen for the risk factors associated with neuropsychiatric disorders in HIV-infected patients.

scholarly journals POS0647 EFFICACY, SAFETY AND CHARACTERISTICS OF IGURATIMOD-BASED THERAPY IN THE TREATMENT OF UA, ERA AND RA PATIENTS FOR 24 WEEKS: A PROSPECTIVE COHORT STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 561.2-562
Author(s):  
X. Liu ◽  
Z. Sun ◽  
W. Guo ◽  
F. Wang ◽  
L. Song ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Adverse Events ◽  
Disease Activity ◽  
Prospective Cohort Study ◽  
Early Rheumatoid Arthritis ◽  
Prospective Cohort ◽  
Combined Treatment ◽  
Serious Adverse Events

Background:Experts emphasize early diagnosis and treatment in RA, but the widely used diagnostic criterias fail to meet the accurate judgment of early rheumatoid arthritis. In 2012, Professor Zhanguo Li took the lead in establishing ERA “Chinese standard”, and its sensitivity and accuracy have been recognized by peers. However, the optimal first-line treatment of patients (pts) with undifferentiated arthritis (UA), early rheumatoid arthritis (ERA), and rheumatoid arthritis (RA) are yet to be established.Objectives:To evaluate the efficacy and safety of Iguratimod-based (IGU-based) Strategy in the above three types of pts, and to explore the characteristics of the effects of IGU monotherapy and combined treatment.Methods:This prospective cohort study (ClinicalTrials.gov Identifier NCT01548001) was conducted in China. In this phase 4 study pts with RA (ACR 1987 criteria[1]), ERA (not match ACR 1987 criteria[1] but match ACR/EULAR 2010 criteria[2] or 2014 ERA criteria[3]), UA (not match classification criteria for ERA and RA but imaging suggests synovitis) were recruited. We applied different treatments according to the patient’s disease activity at baseline, including IGU monotherapy and combination therapies with methotrexate, hydroxychloroquine, and prednisone. Specifically, pts with LDA and fewer poor prognostic factors were entered the IGU monotherapy group (25 mg bid), and pts with high disease activity were assigned to combination groups. A Chi-square test was applied for comparison. The primary outcomes were the proportion of pts in remission (REM)or low disease activity (LDA) that is DAS28-ESR<2.6 or 3.2 at 24 weeks, as well as the proportion of pts, achieved ACR20, Boolean remission, and good or moderate EULAR response (G+M).Results:A total of 313 pts (26 pts with UA, 59 pts with ERA, and 228 pts with RA) were included in this study. Of these, 227/313 (72.5%) pts completed the 24-week follow-up. The results showed that 115/227 (50.7%), 174/227 (76.7%), 77/227 (33.9%), 179/227 (78.9%) pts achieved DAS28-ESR defined REM and LDA, ACR20, Boolean remission, G+M response, respectively. All parameters continued to decrease in all pts after treatment (Fig 1).Compared with baseline, the three highest decline indexes of disease activity at week 24 were SW28, CDAI, and T28, with an average decline rate of 73.8%, 61.4%, 58.7%, respectively. Results were similar in three cohorts.We performed a stratified analysis of which IGU treatment should be used in different cohorts. The study found that the proportion of pts with UA and ERA who used IGU monotherapy were significantly higher than those in the RA cohort. While the proportion of triple and quadruple combined use of IGU in RA pts was significantly higher than that of ERA and UA at baseline and whole-course (Fig 2).A total of 81/313 (25.8%) pts in this study had adverse events (AE) with no serious adverse events. The main adverse events were infection(25/313, 7.99%), gastrointestinal disorders(13/313, 4.15%), liver dysfunction(12/313, 3.83%) which were lower than 259/2666 (9.71%) in the previous Japanese phase IV study[4].The most common reasons of lost follow-up were: 1) discontinued after remission 25/86 (29.1%); 2) lost 22/86 (25.6%); 3) drug ineffective 19/86 (22.1%).Conclusion:Both IGU-based monotherapy and combined therapies are tolerant and effective for treating UA, ERA, and RA, while the decline in joint symptoms was most significant. Overall, IGU combination treatments were most used in RA pts, while monotherapy was predominant in ERA and UA pts.References:[1]Levin RW, et al. Scand J Rheumatol 1996, 25(5):277-281.[2]Kay J, et al. Rheumatology 2012, 51(Suppl 6):vi5-9.[3]Zhao J, et al. Clin Exp Rheumatol 2014, 32(5):667-673.[4]Mimori T, et al. Mod Rheumatol 2019, 29(2):314-323.Disclosure of Interests:None declared

scholarly journals Psychological Factors Associated With Development of TMD: The OPPERA Prospective Cohort Study

2013 ◽  
Vol 14 (12) ◽  
pp. T75-T90 ◽  
Author(s):  
Roger B. Fillingim ◽  
Richard Ohrbach ◽  
Joel D. Greenspan ◽  
Charles Knott ◽  
Luda Diatchenko ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Psychological Factors ◽  
Prospective Cohort ◽  
Factors Associated
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