scholarly journals Clinical factors predicting ureteral stent failure in patients with external ureteral compression

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1299-1305
Author(s):  
Kuan Ju Wu ◽  
Yi Zhong Chen ◽  
Marcelo Chen ◽  
Yu-Hsin Chen
Keyword(s):  
Risk Factors ◽  
Predictive Factors ◽  
Initial Treatment ◽  
Percutaneous Nephrostomy ◽  
Ureteral Stent ◽  
Important Predictor ◽  
Clinical Factors ◽  
External Compression ◽  
Ureter Obstruction ◽  
Double J Stent

Abstract Double-J stent (DJ) placement is usually the treatment of choice for relieving external compression of the ureter. However, in some cases DJ function may become impaired and a percutaneous nephrostomy (PCN) may be required. Previous studies have reported different predictive factors for choosing PCN or DJ insertion as the initial treatment. In this study, we analyzed the risk factors for DJ failure in patients with external ureteral compression. Our results showed that the patients with moderate and severe hydronephrosis (p-value = 0.0171 and 0.0249, respectively), preexisting pyuria (p-value = 0.0128), or lower ureter obstruction (p-value = 0.0305) were more prone to DJ laterality. Age was also an important predictor. Urologists should pay more attention to these patients and consider PCN as the initial treatment.

scholarly journals SPONTANEOUS RUPTURE OF DOUBLE J URETERAL STENT

2020 ◽  
Vol 7 (3) ◽  
pp. 114-116
Author(s):  
Abdi El Mostapha ◽  
Ghannam Youssef ◽  
Hissein Hagguir ◽  
Nedjim Abdelkerim Saleh ◽  
Dakir Mohamed ◽  
...  
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Stone Formation ◽  
Rare Complication ◽  
Percutaneous Nephrostomy ◽  
Ureteral Stent ◽  
Vaginal Examination ◽  
Ureteral Stenosis ◽  
Long Duration ◽  
Double J Stent ◽  
Obstructive Renal Failure

The double J stent is widely used in urological endoscopic surgery with different indications (ureteral stenosis, ureteropelvic junction obstruction, retroperitoneal tumor or fibrosis) and can be a subject to multiple complications including migration, encrustation, stone formation and fragmentation which is a rare complication. We are reporting a rare case of a 42-years-old, followed for cervical cancer since 2018 revealed by an acute obstructive renal failure drained by a left double J ureteral stent (of long duration) and right percutaneous nephrostomy. The patient maintained the double J stent for 2 years. On clinical examination there was a lumbar tenderness on the left side and a hardened vaginal cervix on bimanual vaginal examination. The patient underwent a renovesical ultrasound showing a minimal left ureterohydronephrosis. The uroscanner with reconstruction revealed a fragmented double J stent on the left side.

scholarly journals Study of risk factors for urinary colonization in patients with the double J catheter

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Amine Saouli ◽  
Tarik Karmouni ◽  
Khalid El Khader ◽  
Abdellatif Koutani ◽  
Ahmed Iben Attya Andaloussi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Predictive Factors ◽  
Univariate Analysis ◽  
Infectious Complications ◽  
Ureteral Stent ◽  
Continuous Variables ◽  
Qualitative Variables ◽  
Tract Infections ◽  
Jj Stent

Abstract Background The aim of this study is to evaluate the prevalence of urinary colonization in patients with the JJ stent and to define the predictive factors associated with this colonization. Methods This is a monocentric prospective study (between January 2013 and April 2017), conducted in the department of Urology B of Ibn Sina Hospital in Rabat. One hundred and forty-five double ureteral stents carried by 120 patients, 25 of which had bilateral double ureteral stent, were examined. The bacteriological profile of the urine of our patients was followed by the completion of an initial urine examination and another at the time of the removal of the JJ. The comparison of the means was made by the Student's test and the Mann–Whitney test for continuous variables and by the KHI-2 test and Fisher's test for qualitative variables. The threshold of significance is set at 0.05. Results The rate of colonization of JJ stent was 35.8% (43 out of 120). The urinary colonization rate was 31.7% (38 out of 120). Average time of indwelling of JJ stent was 90 days. On double ureteral stent culture, we identified Escherichia Coli as the most predominant colonizing pathogen (47.3% of probes) followed by Enterococcus faecalis and Klebsiella pneumoniae (18.4% and 15.8%, respectively). 11.5% of colonized patients developed infectious complications (5 out of 43) and have been treated successfully except a patient who died from septic shock. In univariate analysis, diabetes mellitus (p = 0.007, OR = 4.1, CI = 1.46–11.48), urgent establishment of JJ (p = 0.03, OR = 4.61; IC = 1.08–19.6) and time of indwelling of the JJ (p = 0.05, OR = 1.89, CI = 0.95–3.77) were the predictive factors for urinary colonization in patients with JJ. In multivariate analysis, these three factors were statistically associated with this risk: diabetes mellitus (p = 0.005, OR = 0.23, CI = 0.08–0.64), the urgent establishment of JJ (p = 0.05, OR = 0.26, CI = 0, 06–1.04) and time of indwelling of the JJ more than 30 days (p = 0.007, OR = 4.29, CI = 1.49–12.37). Conclusion The prevalence of urinary colonization in patients with the double J stent was 31.7%. Diabetes mellitus, time of indwelling of the JJ more than 30 days and urgent JJ ​​ establishment are associated with a higher risk of these urinary colonizations. Strict monitoring is therefore recommended in patients with these risk factors. These results should be confirmed by multicenter and randomized studies to analyze the development of urinary tract infections in colonized patients.

scholarly journals The Assessment of Early Complications and Risk Factors Affecting Their Occurrence in Breast Reconstructive Procedures

2021 ◽  
Author(s):  
Justyna Jończyk ◽  
Jerzy Jankau
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Complication Rate ◽  
Clinical Factors ◽  
Early Complications ◽  
Reconstructive Procedures ◽  
Factors Affecting ◽  
Rehospitalization Rate ◽  
Early Postoperative Complications

AbstractThe presence of postoperative complications may have a significant impact on the outcome of the breast reconstruction. The aim of this study was to investigate early postoperative complications and the risk factors for their occurrence. A prospective analysis was carried out to evaluate surgical outcomes after breast reconstructive surgeries performed over a 2-year period. Procedures included expander/implant (TE/IMP), pedicle transverse rectus abdominis musculocutaneous (pTRAM), and latissimus dorsi (LD) techniques. All adverse events which occurred within 6 weeks of surgery were ranked according to severity based on the contracted Accordion grading system. Outcomes were assessed for their association with surgical, demographic, and clinical variables. Sixty-one consecutive breast reconstruction procedures were analyzed. The overall complication rate was 60.7% (n = 37), and 8 patients (13.1%) required reoperation. The lowest complication rate was observed in implant-based reconstructions (TE/IMP, 18.8%; pTRAM, 72.7%; LD, 78.3%; p = 0.008). Mild complications occurred significantly more often after LD reconstructions (LD, 60.9%; pTRAM, 22.7%; TE/IMP, 12.5%; p = 0.031), while severe complications were significantly more frequent after the pTRAM procedures (pTRAM, 27.3%; TE/IMP, 6.2%; LD, 8.7%; p = 0.047). Severe complications were associated with higher rehospitalization rate (p = 0.010) and longer hospital stay. Study revealed a significant impact of the operative method on the incidence and severity of early complications after breast reconstruction procedures with little effect from other demographic and clinical factors.

scholarly journals Proportion and risk factors for death by euthanasia in dogs in the UK

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Camilla Pegram ◽  
Carol Gray ◽  
Rowena M. A. Packer ◽  
Ysabelle Richards ◽  
David B. Church ◽  
...  
Keyword(s):  
Risk Factors ◽  
Poor Quality ◽  
Clinical Factors ◽  
Sampling Frame ◽  
Additional Risk ◽  
Factors Associated ◽  
Regression Modelling ◽  
The Uk ◽  
Logistic Regression Modelling

AbstractThe loss of a pet can be particularly distressing for owners, whether the method of death is euthanasia or is unassisted. Using primary-care clinical data, this study aimed to report the demographic and clinical factors associated with euthanasia, relative to unassisted death, in dogs. Method of death (euthanasia or unassisted) and clinical cause of death were extracted from a random sample of 29,865 dogs within the VetCompass Programme from a sampling frame of 905,544 dogs under UK veterinary care in 2016. Multivariable logistic regression modelling was used to evaluate associations between risk factors and method of death. Of the confirmed deaths, 26,676 (89.3%) were euthanased and 2,487 (8.3%) died unassisted. After accounting for confounding factors, 6 grouped-level disorders had higher odds in euthanased dogs (than dogs that died unassisted), using neoplasia as the baseline. The disorders with greatest odds included: poor quality of life (OR 16.28), undesirable behaviour (OR 11.36) and spinal cord disorder (OR 6.00). Breed, larger bodyweight and increasing age were additional risk factors for euthanasia. The results highlight that a large majority of owners will face euthanasia decisions and these findings can support veterinarians and owners to better prepare for such an eventuality.

Features of Stroke in Chinese Diabetes Patients: A Hospital-based Study

2007 ◽  
Vol 35 (4) ◽  
pp. 540-546 ◽  
Author(s):  
X-D Zhang ◽  
Y-R Chen ◽  
L Ge ◽  
Z-M Ge ◽  
Y-H Zhang
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Ischaemic Stroke ◽  
Cerebral Haemorrhage ◽  
Mortality Rates ◽  
Demographic Characteristics ◽  
Major Influence ◽  
Diabetic Patients ◽  
Clinical Factors ◽  
Patients With Diabetes

In this study, demographic characteristics, risk factors, stroke subtypes and outcome were compared in 2532 patients with and without diabetes hospitalized for first-ever stroke. Diabetes was present in 471 (18.6%) of the patients. Patients with diabetes presented more frequently with ischaemic stroke (92.1% versus 71.3%), especially lacunar infarction (41.2% versus 35.2%), compared with non-diabetics. Cerebral haemorrhage was less frequent in diabetics than non-diabetics (4.2% versus 18.1%). In-hospital mortality rates from ischaemic stroke were similar in the two groups (18.2% in diabetics and 16.9% in non-diabetics). Predictors of in-hospital mortality in diabetic patients included decreased consciousness, congestive heart failure and atrial fibrillation. In conclusion, stroke in diabetic patients was different to stroke in non-diabetic patients: in diabetics the frequency of cerebral haemorrhage was lower and the rate of lacunar infarct syndrome was higher, but in-hospital mortality from ischaemic stroke was not increased. Clinical factors evident at the onset of stroke have a major influence on in-hospital mortality and may help clinicians provide a more accurate prognosis.

Predicting Persistent Developmental Stuttering Using a Cumulative Risk Approach

2021 ◽  
pp. 1-26
Author(s):  
Cara M. Singer ◽  
Sango Otieno ◽  
Soo-Eun Chang ◽  
Robin M. Jones
Keyword(s):  
Risk Factors ◽  
Predictive Validity ◽  
Predictive Factors ◽  
Language Skills ◽  
Speech Sound ◽  
Cumulative Risk ◽  
Standard Score ◽  
Persistent Developmental Stuttering ◽  
Risk Approach ◽  
Developmental Stuttering

Purpose: The purpose of this study was to explore how well a cumulative risk approach, based on empirically supported predictive factors, predicts whether a young child who stutters is likely to develop persistent developmental stuttering. In a cumulative risk approach, the number of predictive factors indicating a child is at risk to develop persistent stuttering is evaluated, and a greater number of indicators of risk are hypothesized to confer greater risk of persistent stuttering. Method: We combined extant data on 3- to 5-year-old children who stutter from two longitudinal studies to identify cutoff values for continuous predictive factors (e.g., speech and language skills, age at onset, time since onset, stuttering frequency) and, in combination with binary predictors (e.g., sex, family history of stuttering), used all-subsets regression and receiver operating characteristic curves to compare the predictive validity of different combinations of 10 risk factors. The optimal combination of predictive factors and the odds of a child developing persistent stuttering based on an increasing number of factors were calculated. Results: Based on 67 children who stutter (i.e., 44 persisting and 23 recovered) with relatively strong speech-language skills, the predictive factor model that yielded the best predictive validity was based on time since onset (≥ 19 months), speech sound skills (≤ 115 standard score), expressive language skills (≤ 106 standard score), and stuttering severity (≥ 17 Stuttering Severity Instrument total score). When the presence of at least two predictive factors was used to confer elevated risk to develop persistent stuttering, the model yielded 93% sensitivity and 65% specificity. As a child presented with a greater number of these four risk factors, the odds for persistent stuttering increased. Conclusions: Findings support the use of a cumulative risk approach and the predictive utility of assessing multiple domains when evaluating a child's risk of developing persistent stuttering. Clinical implications and future directions are discussed.

scholarly journals Development of Predictive Nomograms for Clinical Use to Quantify the Risk of Amputation in Patients with Diabetic Foot Ulcer

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Bocheng Peng ◽  
Rui Min ◽  
Yiqin Liao ◽  
Aixi Yu
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Prediction Model ◽  
Predictive Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Single Factor ◽  
Independent Risk Factors

Objective. To determine the novel proposed nomogram model accuracy in the prediction of the lower-extremity amputations (LEA) risk in diabetic foot ulcer (DFU). Methods and Materials. In this retrospective study, data of 125 patients with diabetic foot ulcer who met the research criteria in Zhongnan Hospital of Wuhan University from January 2015 to December 2019 were collected by filling in the clinical investigation case report form. Firstly, univariate analysis was used to find the primary predictive factors of amputation in patients with diabetic foot ulcer. Secondly, single factor and multiple factor logistic regression analysis were employed to screen the independent influencing factors of amputation introducing the primary predictive factors selected from the univariate analysis. Thirdly, the independent influencing factors were applied to build a prediction model of amputation risk in patients with diabetic foot ulcer by using R4.3; then, the nomogram was established according to the selected variables visually. Finally, the performance of the prediction model was evaluated and verified by receiver working characteristic (ROC) curve, corrected calibration curve, and clinical decision curve. Results. 7 primary predictive factors were selected by univariate analysis from 21 variables, including the course of diabetes, peripheral angiopathy of diabetic (PAD), glycosylated hemoglobin A1c (HbA1c), white blood cells (WBC), albumin (ALB), blood uric acid (BUA), and fibrinogen (FIB); single factor logistic regression analysis showed that albumin was a protective factor for amputation in patients with diabetic foot ulcer, and the other six factors were risk factors. Multivariate logical regression analysis illustrated that only five factors (the course of diabetes, PAD, HbA1c, WBC, and FIB) were independent risk factors for amputation in patients with diabetic foot ulcer. According to the area under curve (AUC) of ROC was 0.876 and corrected calibration curve of the nomogram displayed good fitting ability, the model established by these 5 independent risk factors exhibited good ability to predict the risk of amputation. The decision analysis curve (DCA) indicated that the nomogram model was more practical and accurate when the risk threshold was between 6% and 91%. Conclusion. Our novel proposed nomogram showed that the course of diabetes, PAD, HbA1c, WBC, and FIB are the independent risk factors of amputation in patients with DFU. This prediction model was well developed and behaved a great accurate value for LEA so as to provide a useful tool for screening LEA risk and preventing DFU from developing into amputation.

scholarly journals Analysis of factors influencing the complications of Solitaire AB stent mechanical thrombectomy in patients with acute intracranial artery occlusion

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Xin Zong ◽  
Jingmei Li ◽  
Shugai Liu ◽  
Qiuxia Liang ◽  
Xiaojun Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Hemorrhage ◽  
Mechanical Thrombectomy ◽  
Influence Factors ◽  
Artery Occlusion ◽  
Control Group ◽  
Intracranial Artery ◽  
Clinical Factors ◽  
Nihss Score ◽  
Factors Influencing

[Abstract] Objective: To investigate the influence factors of hemorrhage and stroke with retriever with Solitaire AB stent in patients with acute intracranial artery occlusion. Methods: A retrospective of 43 cases of patients with acute intracranial artery occlusion for endovascular treatment with Solitaire AB stent enrolled from March 2016 to June 2018 in our hospital, combining the characteristics of the patients of our city, through the clinical baseline data statistical analysis, complications screening of risk factors of complications. Results: There were 81.4% of patients who were dredged totally. The incidences of cerebral hemorrhage and infarction were 18.6% and 16.3%, cerebral hemorrhage group compared with control group, diabetes, blood pressure, revascularized time, NIHSS score, ASPECTS score had statistically significant differences, when infarction group compared with control group, age, opening time, ASITN_SIR score and grade of mTICI had statistically significant differences. Conclusion: Mechanical thrombectomy with Solitaire AB stent in patients with acute intracranial artery occlusion, the occurred of complications associated with various clinical factors, and the occurrence of complications seriously affect the prognosis of patients, therefore, selecting the indications strictly, and adopt individualized treatment to reduce complications.

scholarly journals Factors Associated with Prolonged Hospital Stay: a Retrospective Study for Imported Malaria Cases

2021 ◽  
Author(s):  
Liang Huang ◽  
Hong Jin ◽  
Hong Zhang ◽  
Yang Liu ◽  
Xinxing Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Infection ◽  
Hospital Stay ◽  
Predictive Factors ◽  
Imported Malaria ◽  
Health Concern ◽  
P Value ◽  
Prolonged Hospital Stay ◽  
Imported Cases ◽  
Prolonged Hospital

Abstract Background China had entered post-elimination era for malaria, however, the imported cases are continuously are a public health concern as the increasing number of cases. In this study we studied the potential predictive factors for prolonged hospital stay for imported malaria patients. Material and Methods We retrospectively collected patients of imported malaria cases data from 2017–2020 in our hospital. we analyzed the data from clinical, epidemiological, geographical, and seasonal points of view, and used cox proportional hazard model to find the predictive factors for prolonged hospital stay. Results We found most of imported cases were from Democratic Republic of the Congo(23%, 34/150) and most cases 74%(26/34) were infected by P. falciparum. Through Edwards Test, no significant seasonality of imported cases were found(χ2 = 2.51 p-value = 0.28). We found bacterial infection(HR = 0.58, p-value = 0.01) and thrombocytopenia(HR = 0.66, p-value = 0.02) were protective factors for discharge, that were, the risk factors for prolonged hospital stay. Conclusions The imported cases are the major risk of malaria in post-elimination era of China. The bacterial infection and thrombocytopenia were the risk factors for prolonged hospital stay.

Predictive Factors for Interstitial Lung Disease, Antitumor Response, and Survival in Non–Small-Cell Lung Cancer Patients Treated With Gefitinib

2006 ◽  
Vol 24 (16) ◽  
pp. 2549-2556 ◽  
Author(s):  
Masahiko Ando ◽  
Isamu Okamoto ◽  
Nobuyuki Yamamoto ◽  
Koji Takeda ◽  
Kenji Tamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Adverse Effect ◽  
Interstitial Lung Disease ◽  
Small Cell Lung Cancer ◽  
Predictive Factors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Antitumor Response ◽  
History Of

Purpose Interstitial lung disease (ILD) is a serious adverse effect of gefitinib, but its prevalence and risk factors remain largely unknown. We examined the prevalence of and risk factors for gefitinib-induced ILD associated with practical use of the drug in Japanese with non–small-cell lung cancer (NSCLC). Patients and Methods Clinical information was retrospectively assembled for NSCLC patients who started gefitinib treatment at affiliated institutions of the West Japan Thoracic Oncology Group between August 31 and December 31, 2002. Medical records of patients who developed pulmonary infiltrates were reviewed by a central committee of extramural experts for identification of patients with gefitinib-induced ILD. Multivariate logistic or Cox regression analysis was performed to identify independent predictive factors for ILD, antitumor response, and survival. Results Seventy cases of and 31 deaths from gefitinib-induced ILD were identified among 1,976 consecutively treated patients at 84 institutions, corresponding to a prevalence of 3.5% and mortality of 1.6%. Gefitinib-induced ILD was significantly associated with male sex, a history of smoking, and coincidence of interstitial pneumonia (odds ratios = 3.10, 4.79, and 2.89, respectively). Predictive factors for response were female sex, no history of smoking, adenocarcinoma histology, metastatic disease, and good performance status (PS), whereas predictive factors for survival were female sex, no history of smoking, adenocarcinoma histology, nonmetastatic disease, good PS, and previous chest surgery. Conclusion ILD is a serious adverse effect of gefitinib in the clinical setting that cannot be ignored. However, patient selection based on sex and smoking history can minimize ILD risk and maximize the clinical benefit of gefitinib.

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