Delta Neutrophil Index (DNI) as a Predictive and Prognostic factor for Candidemia patients: Matched Case-Control study

2020 ◽  
Author(s):  
So Yeon Park ◽  
JIN SEO LEE ◽  
Jihyu Oh ◽  
Ji-Young Park
Keyword(s):  
Prognostic Factor ◽  
Blood Culture ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study ◽  
Delta Neutrophil Index

Abstract Background: Delayed antifungal therapy for candidemia leads to increased mortality. Discriminating bacterial infection from candidemia in systemic inflammatory response syndrome (SIRS) patients is very complex and difficult. Delta Neutrophil Index (DNI) is recently considered as a new factor which can distinguish infections from non-infections and reflect the severity of sepsis. We aimed to assess whether DNI can predict and provide a prognosis for candidemia in SIRS patients.Methods: A matched case-control study was conducted from July 2016 to June 2017 at Kangdong Sacred Heart Hospital. Among patients with comorbidity of SIRS, those with candidemia were classified as the case group, while those with negative blood culture results were classified as the control group. The matching conditions included age, blood culture date, and SIRS onset location. To evaluate DNI as a predictive and prognostic factor for candidemia, multivariate logistic regression was performed.Results: The 140 included patients were assigned to each group in a 1:1 ratio. DNI-D1 values measured on the blood culture date were higher in the case group ( p <0.001). In the multivariate analyses, DNI_D1 (Odds ration〔ORs〕2.138, 95% confidential interval 〔CI〕1.421-3.217, P <0.001) and Candida colonization were confirmed as predictive factors for candidemia. The cutoff value of DNI for predicting candidemia was 2.75%. The area under the curve for DNI value was 0.804 (95% CI, 0.719-0.890, p<0.001), with a sensitivity and specificity of 72.9% and 78.6%, respectively. Analysis of 14-day mortality was conducted for patients with candidemia. DNI_D1 and DNI_48, measured 2 days after the onset of candidemia, were both significantly high in the non-survivor group.Conclusion: DNI was identified to be a predictive factor for candidemia in patients wit SIRS and a prognostic factor that predicts 14-day mortality in candidemia patients. DNI, along with clinical characteristics of patients, were useful in determining the occurrence of candidemia in patients with SIRS.

scholarly journals Delta Neutrophil Index as a Predictive and Prognostic Factor for Candidemia patients: A Matched Case-Control Study

2020 ◽  
Author(s):  
So Yeon Park ◽  
JIN SEO LEE ◽  
Jihyu Oh ◽  
Ji-Young Park
Keyword(s):  
Prognostic Factor ◽  
Blood Culture ◽  
Case Control Study ◽  
Control Group ◽  
Case Group ◽  
Survivor Group ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study ◽  
Delta Neutrophil Index

Abstract Background: Delayed antifungal therapy for candidemia leads to increased mortality. Differentiating bacterial infection from candidemia in systemic inflammatory response syndrome (SIRS) patients is complex and difficult. The Delta Neutrophil Index (DNI) has recently been considered a new factor to distinguish infections from non-infections and predict the severity of sepsis. We aimed to assess if the DNI can predict and provide a prognosis for candidemia in SIRS patients. Methods: A matched case-control study was conducted from July 2016 to June 2017 at Kangdong Sacred Heart Hospital. Among patients with a comorbidity of SIRS, those with candidemia were classified as the case group, whereas those with negative blood culture results were classified as the control group. The matching conditions included age, blood culture date, and SIRS onset location. Multivariate logistic regression was performed to evaluate DNI as a predictive and prognostic factor for candidemia.Results: The 140 included patients were assigned to each group in a 1:1 ratio. The DNI_D1 values measured on the blood culture date were higher in the case group than in the control group (p<0.001). The results of multivariate analyses confirmed DNI_D1 (odds ratio [ORs] 2.138, 95% confidential interval [CI] 1.421-3.217, p<0.001) and Candida colonization as predictive factors for candidemia. The cutoff value of DNI for predicting candidemia was 2.75%. The area under the curve for the DNI value was 0.804 (95% CI, 0.719-0.890, p<0.001), with a sensitivity and specificity of 72.9% and 78.6%, respectively. Analysis of 14-day mortality in patients with candidemia showed significantly higher DNI_D1 and DNI_48 in the non-survivor group than in the survivor group.Conclusions: DNI was identified as a predictive factor for candidemia in patients with SIRS and a prognostic factor in predicting 14-day mortality in candidemia patients. DNI, along with clinical patient characteristics, was useful in determining the occurrence of candidemia in patients with SIRS.

scholarly journals Sex-specific Difference in Phenotype of Kabuki Syndrome Type 2 Patients: A Matched Case-Control Study

2021 ◽  
Author(s):  
Yirou wang ◽  
Yufei Xu ◽  
Yao Chen ◽  
Yabin Hu ◽  
Qun Li ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Kabuki Syndrome ◽  
Specific Difference ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Abstract Background: Kabuki syndrome (KS) is a monogenic disorder leading to special facial features, mental retardation, and multiple system malformations. KDM6A (MIM*300128) is the pathogenic gene of Kabuki syndrome type 2 (KS2, MIM#300867), which accounts for only 5%–8% of KS. Previous studies suggested that female patients with KS2 may have a milder phenotype. Thus, we summarized the phenotype and genotype of KS2 patients who were diagnosed in Shanghai Children’s Medical Center since July 2017 and conducted a 1:3 matched case-control study according to age and sex to investigate sex-specific differences between patients with and without KS2. Results There were 12 KS2 cases in this study, and 8 of them matched with 24 controls. The intelligence quotient (IQ) score of the case group was significantly lower than that of the control group (P <0.001). In addition, both the incidence of intellectual disability (ID) (IQ <70) and moderate-to-severe ID (IQ <55) were significantly higher in the case group than those in the control group (P <0.05). No sex-specific difference was found in the incidence of ID or moderate-to-severe ID between the female cases and female controls (P>0.05), whereas there was a significant difference between male cases and male controls (P <0.01). Furthermore, the rate of moderate-to-severe ID and congenital heart disease (CHD) was significantly higher in the male group than that in the female group (P <0.05).Conclusions Our results showed that a sex-specific difference was exhibited in the clinical phenotypes of KS2 patients. The incidence of CHD was higher in male patients, and mental retardation was significantly impaired. However, the female patients’ phenotype was mild.

scholarly journals Association of Auricular Reflective Points and Status of Type 2 Diabetes Mellitus: A Matched Case-Control Study

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Lorna Kwai-Ping Suen ◽  
Chao Hsing Yeh ◽  
Jojo Yee Mei Kwan ◽  
Paul Hong Lee ◽  
Grace Sau Ping Yeung ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Case Control Study ◽  
Screening Method ◽  
Case Control ◽  
Case Group ◽  
Matched Case ◽  
Auricular Diagnosis ◽  
Matched Case Control Study ◽  
Control Study

The reflexive property of the ear can cause various physical attributes to appear on the auricle in the presence of bodily disorders. The association of auricular signals (presence or absence of discoloration, marks after pressing, tenderness, and electrical resistance) and diabetes mellitus (DM) should be further investigated because auricular diagnosis is an objective, painless, and noninvasive method that provides rapid access to information. A matched case-control study on 282 subjects was conducted. Cases (n=141) were defined as those diagnosed with type 2 DM (T2DM). Every subject in the case group was matched with the control by age and gender. Ear diagnosis was conducted in three aspects: inspection, electrical detection, and tenderness testing. Results suggest that the tenderness and electrical conductivity of some auricular points, including “pancreas and gallbladder,” “endocrine,” “kidney,” “lower tragus,” “heart,” and “eyes,” were associated with T2DM status in Chinese population. In the subgroup analyses, certain auricular signals were also associated with glycemic control, disease duration, and related complications. Auricular diagnosis could be considered as a screening method for vulnerable populations with T2DM risk. Thus, appropriate interventions can be implemented to prevent or delay the progression of T2DM.

scholarly journals Antibiotic Exposures and the Likelihood of Developing Pediatric Autoimmune Diseases: a Register-based Matched Case-control Study

2021 ◽  
Author(s):  
Laura Räisänen ◽  
Sohvi Kääriäinen ◽  
Reijo Sund ◽  
Elina Engberg ◽  
Heli Viljakainen ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Case Control Study ◽  
Case Control ◽  
Case Group ◽  
Delivery Mode ◽  
Frequent Use ◽  
Bowel Diseases ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Abstract Incidences of pediatric autoimmune diseases (ADs) have been increasing without clearly identified environmental risk factors. Using national registers (special reimbursement and drug purchase register), this matched case-control study aims to discover whether antibiotic exposures are related to development of ADs in general. From a cohort of 11,407 children (born 2000-2005, followed-up until December 2018), 242 children with ADs (type 1 diabetes (DM), autoimmune thyroiditis (AIT), juvenile idiopathic arthritis (JIA), and inflammatory bowel diseases (IBD)) generated the case group. Each case was matched with one to four child(ren) with similar age, sex, residential area, gestational age, and delivery mode, generating 708 matched controls. Number of antibiotic purchases throughout childhood was unrelated to the development of the studied ADs as one group, nor with DM, AIT, or IBD individually. While antibiotic exposures in infancy did not increase the likelihood of ADs, exposures to macrolides within two years before diagnosis showed minor association (OR 1.24, 95% CI 1.01-1.51). Exposures to cephalosporins, macrolides, and amoxicillin-clavulanic acid throughout childhood may increase the likelihood of JIA (OR 1.25, 95% CI 1.03-1.52; OR 1.21, 95% CI 1.06-1.38; OR 1.19, 95% CI 1.02-1.39, respectively). Regardless of frequent use in childhood (40% of all antibiotics), penicillins were not associated with the onset of any ADs.Conclusion: Occasional use of antibiotics are relatively safe regarding overall development of ADs. Penicillins are unlikely to be associated with any ADs, while broad-spectrum antibiotics (including macrolides) should be used considerately as they may associate with an increased likelihood of ADs, especially JIA.

Evaluation of the Adjuvant Efficacy of Natural Herbal Medicine on COVID-19: A Retrospective Matched Case-Control Study

2020 ◽  
Vol 48 (04) ◽  
pp. 779-792 ◽  
Author(s):  
Hai-Tao Zhang ◽  
Ming-Xing Huang ◽  
Xi Liu ◽  
Xin-Chun Zheng ◽  
Xing-Hua Li ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Western Medicine ◽  
Case Control Study ◽  
Clinical Symptoms ◽  
Case Control ◽  
Chest Ct ◽  
Control Group ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Since the outbreak of Corona Virus Disease 2019 (COVID-19) in Hubei province, the epidemic scale has increased rapidly, and no effective antiviral drug therapy has been identified yet. This study aimed to evaluate the adjuvant efficacy of Natural Herbal Medicine (NHM) combined with Western medicine in the treatment of COVID-19. We performed a retrospective, 1:1 matched, case-control study of the first cohort of hospitalized COVID-19-confirmed cases (January 17, 2020 to January 28, 2020). A total of 22 of the 36 confirmed patients were included in this study, split into two groups of 11: the NHM group (NHM combined standard Western medicine treatment) and control group (standard Western medicine treatment alone). All patients received appropriate supportive care and regular clinical and laboratory monitoring. Main evaluation indicators included improvement of clinical symptoms such as fever, cough and diarrhea after hospitalization; pathogen nucleic acid test result of respiratory tract and fecal specimens of the patient after hospitalization, and change of chest CT examination after hospitalization. The duration of fever in the NHM group ([Formula: see text] days) was significantly shorter than that in the control group ([Formula: see text] days) ([Formula: see text]). During the whole hospitalization period, the number of cases with diarrhea in the NHM group (two cases) was less than that in the control group (eight cases) ([Formula: see text]). Compared with the control group ([Formula: see text]), the duration for improvement (DI) of chest CT in the NHM group ([Formula: see text]) was significantly shorter ([Formula: see text]). Our results suggest that NHM could improve the clinical symptoms of COVID-19 patients and may be effective in treating COVID-19; thus, a larger, prospective, randomized, controlled clinical trial should be conducted to further evaluate the adjuvant efficacy of NHM in the treatment of COVID-19.

Prognosis of adenosquamous carcinoma of the pancreas: A matched case-control study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14540-e14540
Author(s):  
Hiroshi Imaoka ◽  
Kenji Yamao ◽  
Susumu Hijioka ◽  
Kazuo Hara ◽  
Nobumasa Mizuno ◽  
...  
Keyword(s):  
Case Control Study ◽  
Adenosquamous Carcinoma ◽  
Case Control ◽  
Control Group ◽  
Carcinoma Of The Pancreas ◽  
Study Results ◽  
Matched Case ◽  
Clinical Records ◽  
Matched Case Control Study ◽  
Control Study

e14540 Background: Adenosquamous carcinoma of the pancreas (ASC), which accounts for only 1-4% of exocrine pancreatic malignancies, is a variant of pancreatic ductal adenocarcinoma (PDAC). However, the prognosis of ASC is still unclear because these reports were based on only case studies and small surgical series with early stage cancers. The purpose of the present study was to clarify the prognosis of ASC using a matched case-control study. Methods: Pathological and clinical records of ASC cases between 2001 and 2011 in our institution were examined. All ASC cases were diagnosed pathologically by a surgical or endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimen. First, to examine the efficacy of EUS-FNA for the diagnosis of ASC, the pathological findings of EUS-FNA were compared with the surgical findings in the resected cases of ASC. Next, to clarify the prognosis of ASC, the clinical characteristics of ASC were evaluated. As a control group, PDAC cases matched with ASC cases by sex, age, pretreatment ECOG-PS, location, initial therapy, and the AJCC TNM staging for pancreatic cancer were also included in this study. Results: Of the 914 cases of pancreatic neoplasms, 28 cases of ASC were identified (3.06%), and 56 cases of PDAC were matched as controls. Of 28 cases of ASC, 6 cases underwent curative resection, and 22 cases were unresectable. Of the 6 resected cases of ASC, 5 cases were diagnosed preoperatively by EUS-FNA (κ, 0.83; positive predictive value [PPV], 100%). Overall survival (OS) was significantly worse for ASC than for PDAC, with a hazard ratio (HR) of 1.94 (95% CI, 1.07 to 3.51; p=0.026; median 8.38 months vs. 15.75 months). Of the 22 unresected cases, the OS of ASC was significantly worse than that of PDAC, with an HR of 2.39 (95% CI, 1.27 to 4.51; p=0.007; median 4.67 months vs. 12.36 months). Conclusions: In the present study, EUS-FNA had a high PPV for the diagnosis of ASC, and ASC was found to be more aggressive than PDAC.

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