Delay in seeking medical care after the onset of symptoms in patients with sight-threatening diabetic retinopathy

Abstract Background Diabetic retinopathy (DR) is a common diabetes-associated complication and a primary cause of blindness. One of the critical factors affecting timely and effectual therapy for DR is the delay in treatment after the onset of symptoms. The present study aimed to investigate the reasons for the delay in the treatment of the condition and the risk factors associated with the delay. Methods We retrospectively reviewed data from 127 patients with sight-threatening diabetic retinopathy (STDR) treated at Qilu Hospital of Shandong University in China. Various forms of STDR were identified including severe non-proliferative DR, clinically significant macular edema (CSME) and proliferative DR(PDR). Information concerning demography, clinical, and socioeconomic status of the patients was gathered. Risk factors associated with the delay was evaluated using logistic regression analysis. Results Among 127 patients with STDR, 89.2% sought medical care one month after the onset of symptoms. Patients who sought for treatment 6 months post-symptom onset had significantly lower income and less knowledge about diabetic eye complications than those presenting within 6 months. Multivariate logistic regression analysis showed that never or infrequent routine examination for diabetic complications was associated with a long delay in seeking medical care (odds ratio 3.06, 95% CI 1.05-9.19, p <0.05; odds ratio 2.91, 95% CI 1.04-8.40, p <0.05). Conclusions Most STDR patients sought medical care one month after the onset of symptoms. Never or infrequent routine examination for diabetic complications was associated with a long delay. The results of the present study stress the necessity to implement educational programs on diabetic complications to encourage early medical care and prevent disastrous outcomes.

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Factors associated with depression in the patients with diabetes mellitus type 2

Vojnosanitetski pregled ◽

10.2298/vsp170328029s ◽

2019 ◽

Vol 76 (11) ◽

pp. 1178-1183 ◽

Cited By ~ 1

Author(s):

Admir Sabanovic ◽

Natasa Maksimovic ◽

Mirjana Stojanovic-Tasic ◽

Marijan Bakic ◽

Anita Grgurevic

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Diabetes Mellitus Type 2 ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Factors Associated

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ?9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (?2 = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (?2 = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (?2 = 10.74; p = 0.005). The presence of diabetic polyneuropathy (?2 = 6.04; p = 0.014) and cataract (?2 = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.

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Seroprevalence and Risk Factors ofChlamydia abortusInfection in Tibetan Sheep in Gansu Province, Northwest China

The Scientific World JOURNAL ◽

10.1155/2014/193464 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Si-Yuan Qin ◽

Ming-Yang Yin ◽

Wei Cong ◽

Dong-Hui Zhou ◽

Xiao-Xuan Zhang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Northwest China ◽

Gansu Province ◽

Factors Associated ◽

Tibetan Sheep ◽

Different Seasons

Chlamydia abortus, an important pathogen in a variety of animals, is associated with abortion in sheep. In the present study, 1732 blood samples, collected from Tibetan sheep between June 2013 and April 2014, were examined by the indirect hemagglutination (IHA) test, aiming to evaluate the seroprevalence and risk factors ofC. abortusinfection in Tibetan sheep. 323 of 1732 (18.65%) samples were seropositive forC. abortusantibodies at the cut-off of 1 : 16. A multivariate logistic regression analysis was used to evaluate the risk factors associated with seroprevalence, which could provide foundation to prevent and controlC. abortusinfection in Tibetan sheep. Gender of Tibetan sheep was left out of the final model because it is not significant in the logistic regression analysis (P>0.05). Region, season, and age were considered as major risk factors associated withC. abortusinfection in Tibetan sheep. Our study revealed a widespread and high prevalence ofC. abortusinfection in Tibetan sheep in Gansu province, northwest China, with higher exposure risk in different seasons and ages and distinct geographical distribution.

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Associations of Serum MicroRNA with Bone Mineral Density in Community-Dwelling Subjects: The Yakumo Study

BioMed Research International ◽

10.1155/2020/5047243 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Hiroaki Nakashima ◽

Kei Ando ◽

Kazuyoshi Kobayashi ◽

Taisuke Seki ◽

Shinya Ishizuka ◽

...

Keyword(s):

Risk Factors ◽

Bone Mineral Density ◽

Logistic Regression ◽

Regression Analysis ◽

Bone Mineral ◽

Logistic Regression Analysis ◽

Odds Ratio ◽

Significant Risk ◽

Mineral Density ◽

Confidential Interval

Osteoporosis is a disease characterized by deterioration of bone tissue and mass, with an increasing global prevalence. Therefore, the discovery of biomarkers for osteoporosis would help to guide appropriate treatment. Circulating microRNAs (miRNAs) have become increasingly recognized as biomarkers for detecting diseases. However, few studies have investigated the association of circulating miRNA with osteoporosis in the general population. The aim of this study was to identify miRNA associated with osteoporosis in a general resident health check-up for potential use as an osteoporosis biomarker. We conducted a cross-sectional study as part of a health check-up program and recruited 352 volunteers (139 men, 213 women, mean age 64.1±9.6 years). Osteoporosis was diagnosed according to the WHO classification. Twenty-two candidate microRNAs were screened through real-time quantitative PCR, and miRNAs associated with osteoporosis were analyzed using logistic regression analysis including other risk factors. In total, 95 females and 30 males were diagnosed with osteoporosis with bone mineral density tests (BMD: T‐score<−2.5). We found that miR195 was significantly lower in females, while miR150 and miR222 were significantly higher in males. The results of the logistic regression analysis indicated that in females, higher age and lower miR195 (odds ratio: 0.45, 95% confidential interval: 0.03–0.98) were significant risk factors for lower BMD, while the presence of a smoking habit and lower miR150 (odds ratio: 1.35, 95% confidential interval: 1.02–1.79) were significant risk factors for osteoporosis. Serum levels of miR195 and miR150 are independently associated with low bone mineral density in females and males, respectively.

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Delay in seeking medical care after the onset of symptoms in patients with sight-threatening diabetic retinopathy

Journal of International Medical Research ◽

10.1177/03000605211013224 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110132

Author(s):

Yan Wei ◽

Fenghua Mi ◽

Yan Cui ◽

Ying Li ◽

Xinyi Wu ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Medical Care ◽

Diabetic Complications ◽

Multivariate Logistic Regression Analysis ◽

Routine Examination ◽

Clinically Significant Macular Edema ◽

Clinically Significant ◽

Poor Outcomes ◽

Associated Risk Factors

Objective To investigate the reasons for delays in seeking medical care in patients with diabetic retinopathy and associated risk factors. Methods We retrospectively reviewed data for patients with sight-threatening diabetic retinopathy (STDR) who attended a hospital in China. Various forms of STDR were identified, including severe non-proliferative DR, clinically significant macular edema and proliferative DR. Demographic, clinical and socioeconomic information was collected and the associated risk factors were evaluated. Results Of the 127 patients with STDR, 89.2% sought medical care within 1 month of developing symptoms. Those who sought treatment ≥6 months after symptoms developed had significantly lower income and less knowledge of diabetic complications than those who attended earlier. Multivariate logistic regression analysis showed that no or infrequent routine examination for diabetic complications were associated with long delays in seeking medical care (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.05–9.19; and OR 2.91, 95% CI 1.04–8.40, respectively). Conclusions Most patients with STDR sought medical care within 1 month of symptoms developing, but no or infrequent routine examination for diabetic complications was associated with long delays. These results stress the importance of educational programs regarding diabetic complications to encourage timely medical care and prevent poor outcomes.

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447 - Risk factors associated with sleep disturbance in a general elderly Japanese population: The Arao Cohort Study

International Psychogeriatrics ◽

10.1017/s1041610220002999 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 167-167

Author(s):

Kazuki Honda ◽

Tomohisa Ishikawa ◽

Ryuji Fukuhara ◽

Seiji Yuki ◽

Yusuke Miyagawa ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Sleep Disturbance ◽

Logistic Regression Analysis ◽

Barthel Index ◽

Multiple Logistic Regression Analysis ◽

Multiple Logistic Regression ◽

Factors Associated

[Background]Sleep disturbance is a common symptom in elderly people. However, the associated risk factors have not been completely clarified. We examined possible risk factors associated with sleep disturbance in a community-based Japanese cohort study.[Methods]1521 community-dwelling individuals aged 65 years or older were selected from a consecutive series at a cohort study from 2016 to 2018 in Arao city, where located at south part of Japan. In this survey, the clinical valuables were collected as follows: age, sex, occupational status, education, lifestyle information, medical history, EuroQoL(EQ)-5D (a score of health-related quality of life [QOL]), Barthel index (a score of performance in activities of daily living), a score of Geriatric Depression Scale (GDS) and a score of Mini-Mental State Examination (MMSE). Sleep disturbance was assessed by the Pittsburgh Sleep Quality Index (when the global score was 6 or over, sleep disturbance was determined to be present). Multiple logistic regression analysis was used to examine the association between clinical valuables and sleep disturbance. This research was supported by AMED (Japan Agency for Medical Research and Development) under Grant Number JP18dk0207025h0003 and has been approved by the research ethics committee of Kumamoto University. Informed consent was obtained from all participants and their family members.[Results]Multiple logistic regression analysis revealed that Parkinson disease (Odds ratio[OR]=5.59), living alone (OR=1.93), liver disease (OR=1.89), hyperlipidemia (OR=1.36), higher score of GDS (OR=1.14), lower scores of both EQ-5D index (OR=1.11) and Barthel index (OR=1.03) were significantly associated as risk factors with sleep disturbance. Unexpectedly, lower score of MMSE was not a significant risk factor.[Conclusion]These results suggest that several physical illnesses, solitude, depressive symptoms and lower QOL, but not cognitive impairment, might be crucial risk factors associated with sleep disturbance in elderly population.

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Chronic pain after breast surgery: incidence, associated factors, and impact on quality of life, an observational prospective study

Perioperative Medicine ◽

10.1186/s13741-021-00176-6 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Gianluca Villa ◽

Raffaele Mandarano ◽

Caterina Scirè-Calabrisotto ◽

Valeria Rizzelli ◽

Martina Del Duca ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Chronic Pain ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Breast Surgery ◽

Factors Associated ◽

Axillary Surgery

Abstract Background Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods Women aged 18+ undergoing oncological or reconstructive breast surgery from Jan until Apr 2018 at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was measured at 0 h, 3 h, 6 h, 12 h, 24 h, 48 h, and 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results Among the 307 patients considered in this study, the incidence of CPBS was 28% [95% CI 23.1–33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95% CI], 2.99 [1.13–7.87], p = 0.03), preoperative use of pain medications (OR [95% CI], 2.04 [1.20–3.46], p = 0.01), and higher dynamic NRS values at 6 h postoperatively (OR [95% CI], 1.28 [1.05–1.55], p = 0.01) were all independent predictors for CPBS. Conclusions Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for pre-existing chronic pain, axillary surgery, and higher dynamic NRS values at 6 h postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation. Trial registration ClinicalTrials.gov registration NCT04309929.

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Chronic pain after breast surgery: incidence, associated factors and impact on quality of life, an observational prospective study

10.21203/rs.3.rs-53287/v3 ◽

2020 ◽

Author(s):

Gianluca Villa ◽

Raffaele Mandarano ◽

Caterina Scirè Calabrisotto ◽

Valeria Rizzelli ◽

Martina Del Duca ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Chronic Pain ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Breast Surgery ◽

Factors Associated ◽

Axillary Surgery

Abstract Background. Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods. Adult female patients scheduled for oncological or reconstructive breast surgery at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was evaluated at 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results. Among the 307 patients considered in this study, the incidence of CPBS was 28% [95%CI 23.1%-33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95%CI], 2.99 [1.13-7.87], p=0.03), preoperative use of pain medications (OR [95%CI], 2.04 [1.20-3.46], p=0.01), and higher dynamic NRS values at 6 hours postoperatively (OR [95%CI], 1.28 [1.05-1.55], p=0.01) were all independent predictors for CPBS. Conclusions. Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for preexisting chronic pain, axillary surgery, and higher dynamic NRS values at 6 hours postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation.Trial registration: clinicalTrials.gov registration NCT04309929

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Chronic pain after breast surgery: incidence, associated factors and impact on quality of life, an observational prospective study

10.21203/rs.3.rs-53287/v4 ◽

2021 ◽

Author(s):

Gianluca Villa ◽

Raffaele Mandarano ◽

Caterina Scirè Calabrisotto ◽

Valeria Rizzelli ◽

Martina Del Duca ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Chronic Pain ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Breast Surgery ◽

Factors Associated ◽

Axillary Surgery

Abstract Background. Chronic pain after breast surgery (CPBS) has a disabling impact on postoperative health status. Mainly because of the lack of a clear definition, inconsistency does exist in the literature concerning both the actual incidence and the risk factors associated to CPBS. The aim of this prospective, observational study is to describe the incidence of and risk factors for CPBS, according to the definition provided by the IASP taskforce. The impact of CPBS on patients’ function and quality of life is also described. Methods. Women aged 18+ undergoing oncological or reconstructive breast surgery from Jan until Apr 2018 at the Breast Unit of Careggi Hospital (Florence, Italy) were prospectively observed. Postoperative pain was measured at 0hrs, 3hrs, 6hrs, 12hrs, 24hrs, 48hrs, and 3 months (CPBS) after surgery. Preoperative, intraoperative, and postoperative factors were compared in CPBS and No-CPBS groups through multivariate logistic regression analysis. Results. Among the 307 patients considered in this study, the incidence of CPBS was 28% [95%CI 23.1%-33.4%]. Results from the logistic regression analysis suggest that axillary surgery (OR [95%CI], 2.99 [1.13-7.87], p=0.03), preoperative use of pain medications (OR [95%CI], 2.04 [1.20-3.46], p=0.01), and higher dynamic NRS values at 6 hours postoperatively (OR [95%CI], 1.28 [1.05-1.55], p=0.01) were all independent predictors for CPBS. Conclusions. Chronic pain after breast surgery is a frequent complication. In our cohort, long-term use of analgesics for pre-existing chronic pain, axillary surgery, and higher dynamic NRS values at 6 hours postoperatively were all factors associated with increased risk of developing CPBS. The possibility to early detect persistent pain, particularly in those patients at high risk for CPBS, might help physicians to more effectively prevent pain chronicisation.Trial registration: clinicalTrials.gov registration NCT04309929

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Safety and Feasibility Analysis of Laparoscopic Lymphadenectomy in Pelvic Gynecologic Malignancies: A Prospective Study

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000555 ◽

2015 ◽

Vol 25 (9) ◽

pp. 1704-1710 ◽

Cited By ~ 12

Author(s):

Virginia Benito ◽

Silvia Romeu ◽

Miriam Esparza ◽

Sonia Carballo ◽

Octavio Arencibia ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Adverse Events ◽

Confidence Interval ◽

Logistic Regression Analysis ◽

Odds Ratio ◽

Gynecologic Oncology ◽

Pelvic Lymphadenectomy ◽

Factors Associated ◽

Surgical Adverse Events

ObjectiveThe aims of this study were to evaluate prospectively the safety and feasibility of laparoscopic lymphadenectomy in gynecologic oncology and to analyze risk factors associated with surgical adverse events.Materials and MethodsThis study included 444 consecutive laparoscopic lymphadenectomy procedures conducted in 358 consecutive gynecologic oncology patients, between 2007 and 2014. Surgical adverse events were classified into intraoperative, early postoperative (≤6 weeks after surgery), and late postoperative (>6 weeks after surgery). Logistic regression analysis was used to assess the independent effects of different variables on the probability of complications. Differences were considered to be statistically significant for P values less than 0.05.ResultsTwo hundred forty-four pelvic lymphadenectomy and 200 aortic lymphadenectomy procedures were carried out during the studied period. All pelvic lymphadenectomy procedures were conducted with a transperitoneal approach, whereas 94.5% of aortic lymphadenectomy procedures were conducted with an extraperitoneal approach. A total of 52.2% of tumors were found to originate in the cervix, 38% in the endometrium, 6.4% in the ovary, 2.8% were sarcoma, and 0.6% were in a different region. The laparotomy conversion rate was 2.8%. The rate of intraoperative adverse events was 1.9%, the most frequent ones being vascular injuries followed by ureteral, bowel, or neurologic injuries. The rate of early-postoperative adverse events was 3.3%, the most frequent one being incisional hernia followed by hemoperitoneum, pelvic abscess, intestinal injury, and paralytic ileus. One patient with endometrial cancer died after surgery due to sepsis of unknown origin. The rate of late-postoperative adverse events was 3.6% and consisted mainly of symptomatic lymphocele or lymphedema. A logistic regression analysis showed that factors associated with increased risk of lymphadenectomy surgical complications were surgical bleeding and operative time (odds ratio, 2.6; 95% confidence interval, 1.1–6; P = 0.02 and odds ratio, 2.6; 95% confidence interval, 1–6.7; P = 0.04).ConclusionsLaparoscopic lymphadenectomy is a safe and feasible procedure in gynecologic oncology but not free of complications. We postulate that gynecologic oncologists should be properly trained in the management of such complications and be aware of the importance of adequate hemostasis and operating time during surgery.

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Enlarged subarachnoid space on cranial ultrasound in preterm infants: Neurodevelopmental implication

Scientific Reports ◽

10.1038/s41598-019-55604-x ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Sook Kyung Yum ◽

Soo Ah Im ◽

Yu Mi Seo ◽

In Kyung Sung

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Preterm Infants ◽

Logistic Regression Analysis ◽

Subarachnoid Space ◽

Multivariable Logistic Regression Analysis ◽

Cranial Ultrasound ◽

Factors Associated ◽

Equivalent Age

AbstractThe role of enlarged subarachnoid space (ESS) in preterm infants has not been described in concrete. We aimed to evaluate whether ESS should be considered a risk factor potentially associated with adverse neurodevelopmental outcomes in prematurity. Electronic medical records of 197 preterm infants (median 32.1 weeks' gestation) including cranial ultrasound (cUS) images, head circumferences, and Korean Developmental Screening Tests for Infants and Children (K-DST) results at 18–24 months corrected age were reviewed. The clinical characteristics and K-DST results were compared in infants with and without ESS (sinocortical width > 3.5 mm). A multivariable logistic regression analysis was performed to identify potential risk factors associated with positive K-DST results. At a median corrected age of 39.0 weeks, 81/197 (41.1%) infants presented ESS. A significantly greater percent of infants in the ESS group screened positive on the K-DST than in the no ESS group (27.2% vs 12.1%, p = 0.007). Within the ESS group, micro-/macrocephaly at term-equivalent age was not different with regard to the K-DST results. From the multivariable logistic regression analysis, gestational age (p = 0.016, OR = 0.855, 95% CI = 0.753–0.971) and ESS (p = 0.019, OR = 1.310, 95% CI = 1.046–1.641) were two significant risk factors associated with positive K-DST results. ESS identified on cUS at term-equivalent age in preterm infants is associated with possible developmental delays. Macrocephaly at term-equivalent age does not guarantee a benign prognosis. Future studies are required to verify ESS as a potential marker for neurodevelopmental delay in preterm infants.

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