scholarly journals Clinical features and influencing prognostic factors in patients with anti-NMDAR encephalitis: a cohort follow-up study in Chinese patients

2019 ◽  
Author(s):  
Yingxin Wang ◽  
Ailiang Miao ◽  
Yongwei Shi ◽  
Jianqing Ge ◽  
Lingling Wang ◽  
...  
Keyword(s):  
Clinical Features ◽  
East China ◽  
Factors Associated ◽  
Female Patients ◽  
Nmdar Encephalitis ◽  
Consciousness Disturbance ◽  
Initial Symptoms ◽  
Antibody Titers ◽  
Male Patients ◽  
Poor Outcomes

Abstract Objectives The clinical manifestations of patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis in East China and factors associated with prognosis were analyzed.Methods A retrospective study of 106 patients (58 females; 48 males) with anti-NMDAR encephalitis in East China was carried out from June 2015 to February 2019. Clinical features and factors influencing outcomes were reviewed.Results Behavioral changes were observed in 74.5% (79/106) of patients, and comprised the initial symptoms in 61.3% (65/106). Seizures were observed in 67% (71/106) of patients, and served as initial symptoms in 31.1% (33/106). A total of 54.9% (39/71) of seizures were focal seizures. More clinical symptoms were observed in female patients than in male patients ( P =0.000). Similarly, background activity (BA) with cerebrospinal fluid (CSF) antibody titers at the peak stage was more severe in female patients than in male patients ( P = 0.000). The Binary logistic regression and ROC curve analyses revealed the factors associated with poor outcomes included consciousness disturbance (OR: 4.907, 95% CI: 1.653-14.562, P =0.004; area: 65.4%, sensitivity: 44.2%, specificity: 86.5%, P =0.014 ), EEG BA (OR: 3.743, 95% CI: 1.766-7.932, P =0.001; area: 76.6%, sensitivity: 73%, specificity: 75%, P =0.000), number of symptoms (OR: 2.911, 95% CI: 1.811-4.679, P =0.000; area: 77.1%, sensitivity: 59.5%, specificity: 78.6%, P =0.000) and CSF antibody titer (OR: 31.778, 95% CI: 8.891-113.57, P =0.000; area: 83.9%, sensitivity: 89.2%, specificity: 78.6%, P =0.000).Conclusions EEG BA and number of symptoms were associated with CSF antibody titers. Consciousness disturbances, EEG BA, number of symptoms and CSF antibody titers served as predictors of poor outcomes.

Analysis of Relation Between Electroclinical Features and Cerebrospinal Fluid Antibody Titers in Patients With anti-NMDAR Encephalitis

2018 ◽  
Vol 50 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Ailiang Miao ◽  
Mingyang Du ◽  
Lingling Wang ◽  
Jianqing Ge ◽  
Hengdong Lu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Symptoms ◽  
Behavioral Changes ◽  
Female Patients ◽  
Nmdar Encephalitis ◽  
Initial Symptoms ◽  
Scale Scores ◽  
Antibody Titers ◽  
Male Patients ◽  
Eeg Recordings

Purpose. This study aimed to determine the relation between electroclinical features and cerebrospinal fluid (CSF) antibody titers in patients with anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. Method. Clinical symptoms and electroencephalography (EEG) at different stages were analyzed in 51 hospitalized patients with anti-NMDAR encephalitis. Results. Behavioral changes were the initial symptoms in 90.9% (20/22) of female patients with high (1:10 or 1:32) CSF antibody titers. A greater number of clinical symptoms were observed in the patients with high CSF antibody titers than in those with low (1:1 or 1:3.2) CSF antibody titers (mean 3.11 ± 1.06 vs 1.62 ± 0.65, P = .000). The number of clinical symptoms was greater in the female patients than in the male patients (mean 3.52 ± 0.98 vs 2.69 ± 1.09, P = .000). At the peak stage, worse background activity (BA) in EEG recordings was observed in patients with high CSF antibody titers than in those with low CSF antibody titers (Mann-Whitney U test, P = .001). The peak-stage BA in EEG was worse in female patients than in male patients (Mann-Whitney U test, P = .000). Modified Rankin scale scores were higher in patients with high CSF antibody titers than in those with low CSF antibody titers (mean 2.62 ± 1.42 vs 0.75 ± 0.97, P = .000). Brush patterns and constant chewing were observed primarily in female patients with high CSF antibody titers. Epileptic discharges were located predominately in the frontal regions and were noted to vary. Conclusion. The electroclinical features of patients with anti-NMDAR encephalitis were associated with gender and CSF antibody titers.

scholarly journals Comparison of Clinical Features Between Patients with Positive and Negative Appendectomy

2020 ◽  
Author(s):  
Guner Cakmak ◽  
Baris Mantoglu ◽  
Emre Gonullu ◽  
Kayhan Ozdemir ◽  
Burak Kamburoglu
Keyword(s):  
Acute Appendicitis ◽  
Clinical Features ◽  
Total Bilirubin ◽  
Negative Appendectomy ◽  
C Reactive Protein ◽  
Future Studies ◽  
Female Patients ◽  
Reactive Protein ◽  
Male Patients ◽  
The Mean

Abstract Background: The objective of this study was to retrospectively compare clinical features and prognostic values between the patients who were referred to the general surgery clinic of our hospital with the presumed diagnosis of acute appendicitis and underwent positive or negative appendectomy.Methods: Patients were divided into two groups as positive (PA) (n:362) and negative appendectomy (NA) (n:284) and the data obtained were compared between these two groups.Laboratory investigations were performed in all patients, and white blood cell (WBC), mean platelet volume (MPV), neutrophils count (NEU), neutrophils (%) (NEU%), C-reactive protein (CRP) and total bilirubin (TBIL) values were studied.Results: The mean MPV value was found as 7.88 fl in PA groups and 8.09 fl in NA group, and the mean MPV value was not statistically significantly difference in PA group, compared to NA groups (p=0.012). Laboratory parameters were also compared between genders. Accordingly, the mean MPV value was statistically significantly higher in female patients compared to male patients in PA group (p = 0.04). The mean TBIL value was 0.97 mg/dl in PA group and 0.69 mg/dl in NA group, and the mean TBIL value was statistically significantly higher in PA group (p< 0.001). Finally, TBIL value was statistically significantly lower in female patients compared to male patients in NA and PA group (p < 0.05).Conclusions: According to the results of our study, MPV and T. BIL values differ in PA and NA groups depending on gender. Therefore, these values may not be used as specific biomarkers in predicting positive acute appendicitis. We believe that these results will contribute to the literature and will be guiding for future studies.

Anorexia Nervosa in Males: A Report of 12 Cases

1993 ◽  
Vol 27 (3) ◽  
pp. 512-517 ◽  
Author(s):  
S. W. Touyz ◽  
E. M. Kopec-Schrader ◽  
P. J. V. Beumont
Keyword(s):  
Anorexia Nervosa ◽  
Retrospective Analysis ◽  
Clinical Features ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Female Patients ◽  
Male Patients

The demographic and clinical features of 12 male patients with anorexia nervosa were investigated by means of a retrospective analysis of their medical records. The clinical characteristics of the male patients were found to be remarkably similar to those reported for female patients and our findings concur with previously published literature. There appears however to be a greater tendency to exercise excessively. The importance of recognising anorexia nervosa in males is emphasized.

Incidences and risk factors for post--dural puncture headache after neuraxial anaesthesia: A national inpatient database study in Japan

2020 ◽  
Vol 48 (5) ◽  
pp. 381-388
Author(s):  
Kanako Makito ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi ◽  
Hideo Yasunaga
Keyword(s):  
Risk Factors ◽  
Spinal Anaesthesia ◽  
Epidural Anaesthesia ◽  
Dural Puncture ◽  
Academic Hospital ◽  
Post Dural Puncture Headache ◽  
Factors Associated ◽  
Female Patients ◽  
Neuraxial Anaesthesia ◽  
Male Patients

The reported incidence of post--dural puncture headache (PDPH) after neuraxial anaesthesia varies widely, depending on patient and procedural risk factors. Most previous studies have had small sample sizes and focused on obstetric patients. This study aimed to investigate the incidence of PDPH and factors associated with PDPH in non-obstetric and obstetric patients after neuraxial anaesthesia. We identified patients who underwent surgery with neuraxial anaesthesia between July 2010 and December 2017 from a Japanese nationwide inpatient administrative claims and discharge database. Factors associated with PDPH (body mass index (BMI), depression, spinal abnormalities, academic hospital and location of epidural anaesthesia) were examined using multivariable logistic analyses. The incidence of PDPH in non-obstetric patients after spinal anaesthesia, epidural anaesthesia and combined spinal epidural anaesthesia was 0.16%, 0.13% and 0.23% and in obstetric patients was 1.16%, 0.99% and 1.05%, respectively. Higher BMI was associated with decreased incidence of PDPH in non-obstetric patients receiving spinal anaesthesia and obstetric patients receiving epidural anaesthesia. In female patients receiving spinal anaesthesia, a history of depression was associated with increased incidence of PDPH. Being in an academic hospital was associated with decreased incidence of PDPH in male patients receiving spinal anaesthesia and female patients receiving spinal or epidural anaesthesia, but increased incidence of PDPH in male patients receiving epidural anaesthesia. Lumbar epidural anaesthesia was associated with increased incidence of PDPH in male patients, but decreased incidence of PDPH in obstetric patients compared with thoracic epidural anaesthesia. The present study identified several potential new risk factors for PDPH, and revealed that the incidence of PDPH in non-obstetric patients after neuraxial anaesthesia was lower than in obstetric patients.

Risk Factors of Carpal Tunnel Syndrome for Male Patient Undergoing Carpal Tunnel Release

2018 ◽  
Vol 50 (05) ◽  
pp. 335-340
Author(s):  
Jun-Ku Lee ◽  
Soo-Hyun Lee ◽  
Banghyun Kim ◽  
Kyunghun Jung ◽  
Inkeun Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Fluid Balance ◽  
Occupational Risk ◽  
Occupational Risk Factors ◽  
Factors Associated ◽  
Female Patients ◽  
Tunnel Syndrome ◽  
Male Patients

Abstract Introduction Although the major cause of carpal tunnel syndrome (CTS) remains idiopathic, many male CTS patients are clinically different from female patients and often have specific risk factors associated with their conditions. An accurate analysis of such propensity has yet to be established. The purpose of this study is to compare male and female patients by analyzing the risk factors associated with CTS patients who underwent surgical treatment, with focus on their occupation. Patients/Material and Methods retrospective chart review of 818 patients with CTS was performed to identify the associated risk factors. Patients were stratified by gender: female (n = 707, 86.4 %) and male (n = 111, 13.6 %). The mean patient age was 54.5 (range: 16–85 yr.) for all groups. The medical history and risk factors of each patient was thoroughly reviewed by medical charts and telephone survey. We categorized the risk factors of CTS into 7 categories: anatomic, neuropathic, inflammatory, alteration of fluid balance, distal radius fracture associated, occupational risk factor related, and idiopathic. Occupations of CTS patients were divided into high risk occupations (vibratory tools, assembly jobs, and food processing and packaging jobs, and other occupations of repetitive wrist motion and forceful gripping) and nonrisk occupations. All variables were analyzed with chi-square or Fisher’s exact test for differences between men and women. Results The number of individuals with known risk factors of CTS was greater in male, compared to that of female patients; 97 (87.4 %) male patients had the risk factors of CTS, while 361 (51.1 %) female patients (p < 0.001) did. In subgroup analysis of risk factors, male patients had frequent risk factors in neuropathic, inflammatory, and alteration of fluid balance (p < 0.001). Occupational risk was strongly associated with male gender (p < 0.001). Conclusion Male CTS patients who underwent surgery are more likely to have a reason and have many occupational risk factors than women.

scholarly journals Sex-related differences in smear-positive pulmonary tuberculosis patients in Kuala Lumpur, Malaysia: Prevalence and associated factors

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245304
Author(s):  
Norfazilah Ahmad ◽  
Mazni Baharom ◽  
Azimatun Noor Aizuddin ◽  
Rohaya Ramli
Keyword(s):  
Pulmonary Tuberculosis ◽  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Control Program ◽  
Kuala Lumpur ◽  
Cross Sectional ◽  
Factors Associated ◽  
Female Patients ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Male Patients

Smear-positive pulmonary tuberculosis (PTB) is more infectious compared to smear-negative PTB and have great significance for epidemiology and infection control. The prevalence of smear-positive PTB rarely affects males and females equally. Hence, we aimed to identify the sex-related differences in the prevalence of smear-positive PTB and its associated factors in Kuala Lumpur, Malaysia. A cross-sectional study was conducted using data from the National Tuberculosis Information System (TBIS) from 1 January, 2015, to 31 December, 2019. The study population was selected using simple random sampling from the list of registered PTB patients in TBIS. The criteria for inclusion were all Malaysian adults aged ≥18 years residing in Kuala Lumpur and registered as PTB in TBIS. Factors associated with smear-positive PTB in male and female patients were determined using multiple logistic regression analysis. Overall prevalence of smear-positive PTB was 68.6%, and male patients predominated (71%). The male:female prevalence ratio of smear-positive PTB was 2.4:1. Male patients who worked as machine operators and elementary workers (adjusted odds ratio (aOR) 2.23, 95% confidence interval (CI) 1.24–4.02, p = 0.007), were self-employed (aOR 2.58, 95% CI 1.46–4.56, p = 0.001), lived in a residence categorized as ‘other’ (aOR 2.49, 95% CI 1.28–4.86, p = 0.007) and were smokers (aOR 1.37, 95% CI 1.01–1.87, p = 0.045) had higher odds for smear-positive PTB. Meanwhile, female patients with diabetes mellitus had higher odds for smear-positive PTB (aOR 1.92, 95% CI 1.05–3.54, p = 0.035), while female patients who were healthcare workers had lower odds (aOR 0.33, 95% CI 0.12, 0.94, p = 0.039). The prevalence of smear-positive PTB is higher in males compared to females. The factors associated with smear-positive PTB differed based on sex. The current TB control program, especially on smear-positive PTB, should likely be strategized and stratified by sex.

Association of Handgrip Strength With Mortality in Hemodialysis Patients in Taiwan: A Prospective Cohort Study

2021 ◽  
Author(s):  
Yu-Ting Chu ◽  
Pai-Ching Hsu ◽  
Chih-Han Liu ◽  
Wen-Chin Lee ◽  
Chien-Hsing Wu ◽  
...  
Keyword(s):  
Predictive Value ◽  
Handgrip Strength ◽  
Muscle Quality ◽  
Factors Associated ◽  
Female Patients ◽  
Average Value ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Male Patients

Abstract Background:Poor muscle quality has been associated with mortality in patients undergoing hemodialysis (HD). Handgrip strength (HGS) has gained considerable attention as a marker of nutritional status and muscle function. The aim of this study was to verify the association between HGS and mortality in patients undergoing maintenance HD in Taiwan.Methods: A total of 188 stable HD patients from January to December 2009 were enrolled in the study. We used a standard handgrip dynamometer to measure the HGS. HGS was measured on enrolment at the beginning of the study. Each measurement was repeated three times for each patient, and the average value was recorded for analysis.Results: During a mean follow-up period of 47 ± 11 months, 34 of the 188 patients died. The all-cause mortality rate was 18%. Higher HGS (hazard ratio [HR] 0.891, 95% confidence interval [CI] 0.838–0.948; p < 0.001) and Kt/V (HR 0.086, 95% CI 0.018–0.421; p = 0.002) were independent factors associated with survival in HD patients. For female patients, an HGS < 17 kg had a positive predictive value (PPV) of 39% and a negative predictive value (NPV) of 96% for predicting mortality. For male patients, an HGS < 26 kg had a PPV of 29% and an NPV of 84% for predicting mortality.Conclusion: HGS provides a good marker for survival in HD patients. Our results indicate that HGS can identify male and female patients undergoing maintenance HD with an increased risk of all-cause mortality, with different cut-off values for each sex.

Clinical Features of Systemic Lupus Erythematosus in Tunisian Males

2020 ◽  
Vol 16 (2) ◽  
pp. 139-142
Author(s):  
Sameh Sayhi ◽  
Tayssir B. Achour ◽  
Sameh Mezri ◽  
Mohamed S. Hamdi ◽  
Gueddiche Nour ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
Biological Features ◽  
Male Group ◽  
Significant Difference ◽  
Male Patients

Purpose: Systemic Lupus Erythematosus (SLE) in males is rare. Clinical and biological features, as well as, the outcome may differ comparatively to female patients. The purpose of our study is to define these clinical and biological features in Tunisian male patients presenting SLE. Methods: A mono-centric, retrospective and descriptive study of 96 patients followed for SLE out of which 21 are males. A comparative study was then performed between male and female patients groups. Results: Sex-ratio female/male was 3.6/1, the average age at diagnosis of SLE was 37.8±14 years. The most frequently noted clinical manifestations were: skin involvement (81%), renal involvement (71.4%) and joint damage (66.7). We observed a significant difference in clinical features between male and female patients (21 males and 76 females): renal failure (52% vs. 71.4%), serositis (23.8% vs. 2.7%), peripheral neuropathy (19% vs. 4%) and lung interstitial disease (14.3% vs. 1.3%). No significant difference was found in the positivity of serum antibodies between the two groups. Fifteen male patients (71.4%) had a SLEDAI score greater than or equal to 11, referring to high/very high disease activity. Out of the 32 patients who developed infectious complications during the course of the disease, 11 were male (52.4% of males). Concerning the male group, complete remission was observed in 10 patients (47.6%), while 10 others presented persistent sequella. We observed one death in the male group secondary to infective acute respiratory failure. Conclusion: SLE in male patients is rare and associated with poor prognosis. Disparity was observed in clinical and biological features as well as outcome in the different studies. In our study, we concluded that male lupus is more severe.

scholarly journals Clinical and biochemical manifestations of systemic lupus erythematosus at first diagnosis within Chinese patients

2019 ◽  
Author(s):  
changhao xie ◽  
li li zhang ◽  
yuan yuan wang ◽  
zhi jun li ◽  
lin jie chen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Malar Rash ◽  
Female Patients ◽  
Initial Symptoms ◽  
Male Patients ◽  
First Diagnosis

Abstract Bankground: The objective of this paper was to describe the first symptoms associated with systemic lupus erythematosus (SLE), including clinical manifestations, laboratory findings, prognoses, differences between men and women at the time of first diagnosis of SLE. Methods : We enrolled 223 patients with initial diagnosis of SLE. Their initial symptoms, demographic, clinical and laboratory data，prognoses and causes of death were analyzed retrospectively. Clinical manifestations and laboratory profiles were compared between male and female patients. Results: Compared with female patients, male patients had an earlier age of onset, a higher incidence of neuropsychiatric involvements, a lower incidence of leukocytopenia , and a higher score of SLE Disease Activity Index (SLEDAI）at diagnosis. Fever and malar rash were most frequent presentations at onset of SLE. The most common clinical manifestation at first diagnosis was fever, followed by arthralgia, malar rash, Raynaud ’ s phenomenon, arthritis. The liver function abnormalities included increased ALT,AST,ALP and γ-GGT.ANA were found in 100% of patients, followed by anti-dsDNA(LIA) in 72.1%, anti-Ro60 in 67.8%, anti-Ro52 in 62.3%, anti-nucleosomes in 55.7%. Conclusions: We identified clinical and serological manifestations of Chinese SLE patients at first diagnosis. Male patients showed a distinctive manifestation including younger age of onset，a higher incidence of CNS manifestations, a higher score of SLEDAI compared to females.

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