scholarly journals Nutritional predictors of mortality in prevalent peritoneal dialysis patients.

2016 ◽  
Vol 63 (1) ◽  
Author(s):  
Sylwia Malgorzewicz ◽  
Michal Chmielewski ◽  
Malgorzata Kaczkan ◽  
Paulina Borek ◽  
Monika Lichodziejewska-Niemierko ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Total Cholesterol ◽  
Body Mass ◽  
Survival Curve ◽  
Skinfold Thickness ◽  
Predictors Of Mortality ◽  
Model Following ◽  
Kaplan Meier ◽  
Independent Association ◽  
Cox Analysis

Malnutrition remains one of the major predictors of mortality in peritoneal dialysis (PD) patients. The aim of the study was to evaluate the nutritional status of prevalent PD patients, and to determine the best predictors of outcome among anthropometric and laboratory indices of nutrition. The study included 106 prevalent PD patients from a single university-based unit. Anthropometric assessment at baseline included: body mass, body mass index (BMI), skinfold thickness, lean body mass (LBM), content of body fat (%F), mid-arm muscle circumference (MAMC). Laboratory analysis comprised of albumin and total cholesterol. Additionally, each patient underwent a subjective global assessment (SGA). The patients were followed for 36 months. Survival analyses were made with the Kaplan-Meier survival curve and the Cox proportional hazard model. Following SGA, malnutrition was diagnosed in 30 (28%) patients. Importantly, eight of the malnourished patients (27%) were nevertheless overweight or obese. Body weight and BMI showed complete lack of association with the outcome. In Kaplan-Meier analysis low: LBM, MAMC, albumin and cholesterol were significantly related to mortality. Cox analysis revealed that, following adjustment, LBM below median was independently associated with poor outcome (hazard ratio [HR] 3.15, 95% confidence interval [CI] 1.17-8.49, p=0.02). Moreover, the lowest quartile of total cholesterol showed independent association with mortality (HR 8.68, CI 2.14-35.21, p

scholarly journals Comparison of Mortality between Japanese Peritoneal Dialysis and Hemodialysis Patients: A 5-Year Multicenter Follow-Up Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Kazuko Suzuki ◽  
Tsuneo Konta ◽  
Kazunobu Ichikawa ◽  
Ami Ikeda ◽  
Hiroki Niino ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Japanese Patients ◽  
Diabetic Patients ◽  
Dialysis Modality ◽  
Multicenter Observational Study ◽  
Kaplan Meier ◽  
The Difference ◽  
Cox Analysis ◽  
The Relationship

To examine the relationship between dialysis modality and prognosis in Japanese patients, we conducted a prospective multicenter observational study. We recruited 83 background-matched peritoneal dialysis (PD) and 83 hemodialysis (HD) patients (average age, 64.9 years; men, 53.6%; diabetic patients, 22.9%; median duration of dialysis, 48 months in all patients) and followed them for 5 years. During the follow-up period, 27 PD patients (16 cardiovascular and 11 non-cardiovascular deaths) and 27 HD patients died (14 cardiovascular and 13 non-cardiovascular deaths). There were 8 PD patients switched to HD, and 6 PD patients received renal transplantation. Kaplan-Meier analysis revealed that the crude survival rate was not significantly different at the end of 5 years (PD 67.5% versus 67.5%, log-rankP=0.719). The difference in cardiovascular and non-cardiovascular mortalities between PD and HD was not statistically significant. Multivariate Cox analysis showed that the independent predictors for death were age and serum albumin levels, but not the dialysis modality. This study showed that the overall mortality was not significantly different between PD and HD patients, which suggests that dialysis modality might not be an independent factor for survival in Japanese patients.

Diminished Appetite Predicts Mortality of Chinese Peritoneal Dialysis Patients

2013 ◽  
Vol 16 (3) ◽  
pp. 241-249 ◽  
Author(s):  
Baoyan Huang ◽  
Zijuan Zhou ◽  
Hong Xu ◽  
Haiyun Wang ◽  
Bingyan Liu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Clinical Characteristics ◽  
Average Length ◽  
Inflammatory Marker ◽  
Survival Curve ◽  
Dialysis Patients ◽  
Treatment Information ◽  
Kaplan Meier

Background:Many maintenance dialysis patients experience a common cluster of symptoms, including diminished appetite (anorexia). This symptom has been associated with reduced quality of life and increased mortality in this population.Aim:The aim of this study was to determine whether diminished appetite is a significant predictor of negative clinical outcomes in patients on peritoneal dialysis (PD).Method:A longitudinal prospective study was conducted in 98 patients receiving PD in Beijing, China. Clinical characteristics, nutritional and inflammatory marker levels, and related peritoneal treatment information were collected. The appetite status and serum albumin levels were assessed initially and reevaluated monthly during the first year of follow-up. All patients were followed for nearly 5 years or until death. Data were collected about mortality, hospitalization, and peritonitis.Results:The mean age of participants was 60.3 ± 14.4, and 22.8% reported diminished appetite. At baseline, female sex, cardiovascular disease, and prealbumin level were the significant predictors of appetite. The average length of follow-up was 39 (range: 2–57) months. The Kaplan–Meier survival curve showed the survival rate was lower in patients reporting diminished appetite than for patients reporting normal appetite. Multivariate analysis indicated that diminished appetite, diabetes, ferritin, and serum albumin levels were independent predictors of mortality.Conclusion:Self-reported appetite was a predictor of clinical characteristics and outcome for patients receiving PD. Conducting appetite evaluation periodically is recommended as a nursing strategy to improve care for these patients.

Isolated oligohydramnios and long-term neurological morbidity of the offspring

2019 ◽  
Vol 11 (6) ◽  
pp. 648-652
Author(s):  
Avital Dorot ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Asnat Walfisch ◽  
Daniella Landau ◽  
...  
Keyword(s):  
Developmental Disorders ◽  
Medical Center ◽  
Survival Curve ◽  
Neurological Complications ◽  
Population Based ◽  
Exposed Group ◽  
Kaplan Meier ◽  
Neurological Morbidity ◽  
Independent Association

AbstractThis study aimed to assess the association between maternal-isolated oligohydramnios (IO) and offspring long-term neurological complications. A population-based retrospective cohort study was conducted, including all births at a single tertiary medical center in Israel between the years 1991 and 2014. Multiple pregnancies and potential pregnancy complications associated with oligohydramnios were excluded. The computerized obstetrical database was linked with the computerized dataset of all pediatric hospitalizations of the same medical center. Evaluation of cumulative neurological-associated hospitalizations rate over time was compared using a Kaplan–Meier survival curve. The Weibull survival parametric model was conducted to assess the neurological-associated hospitalization risk in the presence of IO, while accounting for potential confounders. A total of 190,259 pregnancies were included in the study, of which 4063 (2.13%) pregnancies were complicated with IO. Total neurological-related hospitalizations were significantly more common in the IO group (3.7% in the IO group and 3.0% in the comparison group, p = 0.005). Pervasive developmental disorder, movement disorders, developmental disorders, and degenerative and demyelization disorders were all specific neurological diagnoses significantly more common in the exposed group. The survival curve demonstrated a significantly higher cumulative hospitalization rate in the exposed group (log-rank p = 0.001). Using a multivariate model adjusting for gestational age, maternal age, and labor induction, an independent association between IO and long-term neurological morbidity of the offspring was observed (adjusted hazard ratio 1.203; 95% CI 1.02–1.42). In summary, a significant association was found between pregnancies complicated by IO and long-term neurological morbidity of the offspring.

scholarly journals The Significance of True Knot of the Umbilical Cord in Long-Term Offspring Neurological Health

2020 ◽  
Vol 10 (1) ◽  
pp. 123
Author(s):  
Yael Lichtman ◽  
Tamar Wainstock ◽  
Asnat Walfisch ◽  
Eyal Sheiner
Keyword(s):  
Umbilical Cord ◽  
Cox Regression ◽  
Survival Curve ◽  
Study Groups ◽  
Population Based ◽  
Kaplan Meier ◽  
Group A ◽  
Independent Association ◽  
Multivariable Regression Models

We aimed to study both the short- and long-term neurological implications in offspring born with confirmed knotting of the umbilical cord—“true knot of cord”. In this population based cohort study, a comparison of perinatal outcome and long-term neurological hospitalizations was performed on the basis of presence or absence of true knot of cord. A Kaplan–Meier survival curve was constructed to compare the cumulative incidence of neurological hospitalizations between the study groups. Multivariable regression models were used to assess the independent association between true knot of cord, perinatal mortality and long term neurological related hospitalizations, while controlling for potential confounders. The study included 243,639 newborns, of them 1.1% (n = 2606) were diagnosed with true knot of the umbilical cord. Higher rates of intrauterine fetal demise (IUFD) were noted in the exposed group, a finding which remained significant in the multivariable generalized estimation equation, while controlling for confounders. The cumulative incidences of neurological hospitalizations over time were comparable between the groups. The Cox regression confirmed a lack of association between true knot of cord and total long term neurological related hospitalizations. While presence of true knot of the umbilical cord is associated with higher IUFD rates, in our population, however, its presence does not appear to impact the long term neurological health of exposed offspring.

P987Dilated cardiomyopathy - a group that does not benefit from ICD?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Silverio Antonio ◽  
A Nunes-Ferreira ◽  
I Aguiar-Ricardo ◽  
J Rigueira ◽  
R Santos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Pharmacological Therapy ◽  
High Rate ◽  
Cardiac Resynchronization ◽  
Reduced Ejection Fraction ◽  
Predictors Of Mortality ◽  
Kaplan Meier ◽  
Cox Analysis ◽  
The Impact

Abstract Introduction The prevalence of sudden death in patients with heart failure with reduced ejection fraction has been declining in the last decade, not only due to better optimization of pharmacological therapy, but also due to the high rate of cardiac resynchronization responders. Overall, based on recent studies demonstrating a lack of improvement in mortality in some patients with dilated cardiomyopathy, the CRT-P/CRT-D implantation ratio has been increasing across Europe. Objective To evaluate the evolution of the CRT-P/CRT-D implantation ratio and to evaluate the impact on mortality of dilated cardiomyopathy (DCM) patients who underwent resynchronization therapy. Methods A single-center prospective study of non-randomized patients who underwent CRT implantation since 2015. Demographic and clinical data from patients with dilated cardiomyopathy were assessed. The mortality of these patients and the predictors of mortality by the Cox and Kaplan-Meier regression method were evaluated. Results 486 CRTs were implanted since 2015 (male 73.9%, age 72.06±9.9 years, median follow-up time of 487 days IIQ [175, 749].) During the last 3 years, occurred an increased in CRT-P/CRT-D ratio with the CRT-P implant rate increasing from 36% of the total devices in 2015 to 47% in 2018. Of the patients submitted to CRT implantation, 256 (55%) had dilated cardiomyopathy as the etiology of heart failure. In this population, by multivariate Cox analysis, age (HR 1.1, 95% CI 1.0–1.1, p=0.003) and GFR <60ml/min/1.73m2 (HR 1.8 IC 95% 1, 2–2.6, p=0.01) were independent predictors of mortality. In addition, CRT-D implantation in these patients was associated with a significant reduction in all-cause mortality (HR 0.33 95% CI 0.15–0.73, p<0.01) with a required number to treat only 10 patients. Similar results were obtained in the subgroup of patients aged ≥59 years. Mortality in DMC – CRT-P vs CRT-D Conclusion The CRT-P implant rate has been increasing at the expense of the CRT-D implant after some studies suggest no benefit in the population aged ≥59 years. However, in our population of patients with DCM, CRT-D implantation demonstrated a 67% mortality reduction. These results may demonstrate a good selection of patients for this therapy, but should also motivate further studies in the evaluation of mortality in this subgroup of patients.

scholarly journals Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 144
Author(s):  
Hee-Won Noh ◽  
Yena Jeon ◽  
Ji-Hye Kim ◽  
Ga-Young Lee ◽  
Soo-Jee Jeon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
High Density Lipoprotein ◽  
Total Cholesterol ◽  
Body Mass ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Cholesterol Ratio ◽  
All Cause Mortality

This study evaluated the association of the serum total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) with mortality in incident peritoneal dialysis (PD) patients. We performed a multi-center, prospective cohort study of 630 incident PD patients from 2008 to 2015 in Korea. Participants were stratified into quintiles according to baseline TC, HDL-C, LDL-C and TC/HDL-C. The association between mortality and each lipid profile was evaluated using multivariate Cox regression analysis. During a median follow-up period of 70.3 ± 25.2 months, 185 deaths were recorded. The highest TC/HDL-C group had the highest body mass index, percentage of diabetes and serum albumin level. Multivariate analysis demonstrated that the highest quintile of TC/HDL-C was associated with increased risk of all-cause mortality (hazard ratio 1.69, 95% confidence interval 1.04–2.76; p = 0.036), whereas TC, HDL-C and LDL-C were not associated with mortality. Linear regression analysis showed a positive correlation between TC/HDL-C and body mass index. Increased serum TC/HDL-C was an independent risk factor for mortality in the subgroup of old age, female, cardiovascular disease and low HDL-C. The single lipid marker of TC or HDL-C was not able to predict mortality in PD patients. However, increased serum TC/HDL-C was independently associated with all-cause mortality in PD patients.

scholarly journals Expression and clinical significance of miR-3615 in hepatocellular carcinoma

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098154
Author(s):  
Xin Yuan ◽  
Yize Zhang ◽  
Zujiang Yu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Curve ◽  
Clinicopathological Characteristics ◽  
The Cancer Genome Atlas ◽  
Prognostic Information ◽  
Ki 67 ◽  
Tissue Samples ◽  
Expression Levels ◽  
Kaplan Meier ◽  
Serum Alpha Fetoprotein

Objective To investigate the association between microRNA-3615 (miR-3615) expression and the prognosis and clinicopathological features in patients with hepatocellular carcinoma (HCC). Methods We obtained clinicopathological and genomic data and prognostic information on HCC patients from The Cancer Genome Atlas (TCGA) database. We then analyzed differences in miR-3615 expression levels between HCC and adjacent tissues using SPSS software, and examined the relationships between miR-3615 expression levels and clinicopathological characteristics. We also explored the influence of miR-3615 expression levels on the prognosis of HCC patients using Kaplan–Meier survival curve analysis. Results Based on data for 345 HCC and 50 adjacent normal tissue samples, expression levels of miR-3615 were significantly higher in HCC tissues compared with adjacent tissues. MiR-3615 expression levels in HCC patients were negatively correlated with overall survival time and positively correlated with high TNM stage, serum Ki-67 expression level, and serum alpha-fetoprotein level. There were no significant correlations between miR-3615 expression and age, sex, and pathological grade. Conclusion MiR-3615 may be a promising new biomarker and prognostic factor for HCC.

scholarly journals Overexpressed pseudogene MT1L associated with tumor immune infiltrates and indicates a worse prognosis in BLCA

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yanpeng Ding ◽  
Nuomin Liu ◽  
Mengge Chen ◽  
Yulian Xu ◽  
Sha Fang ◽  
...  
Keyword(s):  
Immune Cells ◽  
Biological Function ◽  
Prognostic Biomarker ◽  
Poor Survival ◽  
Common Cancer ◽  
Kaplan Meier ◽  
Cox Analysis ◽  
Kaplan Meier Plotter ◽  
Worse Prognosis

Abstract Background BLCA is a common cancer worldwide, and it is both aggressive and fatal. Immunotherapy (ICT) has achieved an excellent curative effect in BLCA; however, only some BLCA patients can benefit from ICT. MT1L is a pseudogene, and a previous study suggested that MT1L can be used as an indicator of prognosis in colorectal cancer. However, the role of MT1L in BLCA has not yet been determined. Methods Data were collected from TCGA, and logistic regression, Kaplan-Meier plotter, and multivariate Cox analysis were performed to demonstrate the correlation between the pseudogene MT1L and the prognosis of BLCA. To identify the association of MT1L with tumor-infiltrating immune cells, TIMER and TISIDB were utilized. Additionally, GSEA was performed to elucidate the potential biological function. Results The expression of MT1L was decreased in BLCA. Additionally, MT1L was positively correlated with immune cells, such as Tregs (ρ = 0.708) and MDSCs (ρ = 0.664). We also confirmed that MT1L is related to typical markers of immune cells, such as PD-1 and CTLA-4. In addition, a high MT1L expression level was associated with the advanced T and N and high grade in BLCA. Increased expression of MT1L was significantly associated with shorter OS times of BLCA patients (p < 0.05). Multivariate Cox analysis revealed that MT1L expression could be an independent prognostic factor in BLCA. Conclusion Collectively, our findings demonstrated that the pseudogene MT1L regulates the immune microenvironment, correlates with poor survival, and is an independent prognostic biomarker in BLCA.

scholarly journals Identification of ferroptosis genes in immune infiltration and prognosis in thyroid papillary carcinoma using network analysis

BMC Genomics ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ruoting Lin ◽  
Conor E. Fogarty ◽  
Bowei Ma ◽  
Hejie Li ◽  
Guoying Ni ◽  
...  
Keyword(s):  
Gene Expression ◽  
Thyroid Carcinoma ◽  
Risk Score ◽  
Immune Cells ◽  
Survival Curve ◽  
Enrichment Analysis ◽  
Papillary Thyroid ◽  
Hub Genes ◽  
Cox Analysis ◽  
Cluster 2

Abstract Background Papillary thyroid carcinoma (PTC) is the most common thyroid cancer. While many patients survive, a portion of PTC cases display high aggressiveness and even develop into refractory differentiated thyroid carcinoma. This may be alleviated by developing a novel model to predict the risk of recurrence. Ferroptosis is an iron-dependent form of regulated cell death (RCD) driven by lethal accumulation of lipid peroxides, is regulated by a set of genes and shows a variety of metabolic changes. To elucidate whether ferroptosis occurs in PTC, we analyse the gene expression profiles of the disease and established a new model for the correlation. Methods The thyroid carcinoma (THCA) datasets were downloaded from The Cancer Genome Atlas (TCGA), UCSC Xena and MisgDB, and included 502 tumour samples and 56 normal samples. A total of 60 ferroptosis related genes were summarised from MisgDB database. Gene set enrichment analysis (GSEA) and Gene set variation analysis (GSVA) were used to analyse pathways potentially involving PTC subtypes. Single sample GSEA (ssGSEA) algorithm was used to analyse the proportion of 28 types of immune cells in the tumour immune infiltration microenvironment in THCA and the hclust algorithm was used to conduct immune typing according to the proportion of immune cells. Spearman correlation analysis was performed on the ferroptosis gene expression and the correlation between immune infiltrating cells proportion. We established the WGCNA to identify genes modules that are highly correlated with the microenvironment of immune invasion. DEseq2 algorithm was further used for differential analysis of sequencing data to analyse the functions and pathways potentially involving hub genes. GO and KEGG enrichment analysis was performed using Clusterprofiler to explore the clinical efficacy of hub genes. Univariate Cox analysis was performed for hub genes combined with clinical prognostic data, and the results was included for lasso regression and constructed the risk regression model. ROC curve and survival curve were used for evaluating the model. Univariate Cox analysis and multivariate Cox analysis were performed in combination with the clinical data of THCA and the risk score value, the clinical efficacy of the model was further evaluated. Results We identify two subtypes in PTC based on the expression of ferroptosis related genes, with the proportion of cluster 1 significantly higher than cluster 2 in ferroptosis signature genes that are positively associated. The mutations of Braf and Nras are detected as the major mutations of cluster 1 and 2, respectively. Subsequent analyses of TME immune cells infiltration indicated cluster 1 is remarkably richer than cluster 2. The risk score of THCA is in good performance evaluated by ROC curve and survival curve, in conjunction with univariate Cox analysis and multivariate Cox analysis results based on the clinical data shows that the risk score of the proposed model could be used as an independent prognostic indicator to predict the prognosis of patients with papillary thyroid cancer. Conclusions Our study finds seven crucial genes, including Ac008063.2, Apoe, Bcl3, Acap3, Alox5ap, Atxn2l and B2m, and regulation of apoptosis by parathyroid hormone-related proteins significantly associated with ferroptosis and immune cells in PTC, and we construct the risk score model which can be used as an independent prognostic index to predict the prognosis of patients with PTC.

scholarly journals Prevalence of pre-diabetes/type 2 diabetes among adolescents (10–19 years) and its association with different measures of overweight/obesity in India: a gendered perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pradeep Kumar ◽  
Shobhit Srivastava ◽  
Prem Shankar Mishra ◽  
E. T. Krishnan Mooss
Keyword(s):  
Body Mass Index ◽  
Children And Adolescents ◽  
Body Mass ◽  
Adolescent Girls ◽  
National Level ◽  
Skinfold Thickness ◽  
Health Concern ◽  
Adolescent Boys ◽  
Nutrition Survey ◽  
Subscapular Skinfold Thickness

Abstract Background The International Diabetes Federation (IDF) estimated that 1.1 million children and adolescents aged 14–19 years are living with diabetes. Diabetes is a chronic, progressive disease characterized by elevated levels of blood glucose. It is also recognized as a complex disease that affects people of different ages due to different causes. The present study aims to estimate the prevalence of pre-diabetes/diabetes at the national level. Additionally, the respective study determines the factors associated with pre-diabetes/diabetes conditions among adolescents at the national level. Methods The data for this study was carried out from the Comprehensive National Nutrition Survey (CNNS), the first-ever nationally representative nutrition survey of children and adolescents in India. The study used a sample size of 17,865 adolescent boys and 17,965 adolescent girls for the analysis. Descriptive statistics, bivariate analysis, and logistic regression analysis were done to carve out the results. Results The prevalence of pre-diabetes/diabetes was 12.3% and 8.4% among adolescent boys and girls in India, respectively. Body mass index and Subscapular skinfold thickness were the two most important predictors of pre-diabetes/diabetes among adolescents. Further, physical activities show a negative association with pre-diabetes/diabetes. Moreover, interaction models in the present study clearly reveal the fact that adolescent girls were less likely to suffer from pre-diabetes/diabetes than adolescent boys. Additionally, it was found that the prevalence of pre-diabetes/diabetes was high among adolescent girls from lower socio-economic strata. Conclusion The high prevalence of pre-diabetes and diabetes among adolescents portrayed serious public health concern in India. As body mass index and Subscapular skinfold thickness were positively associated with pre-diabetes/diabetes conditions among adolescents. Therefore, effective approaches are needed to be taken to tackle these pre-diabetes/diabetes conditions among adolescents and especially among adolescent boys.

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