scholarly journals The relation between ACEI/ARB use and COVID-19 severity in RT-PCR–confirmed cases: A retrospective case-control study

2020 ◽  
Author(s):  
Sabrina Amaouche ◽  
Ziad Letaief ◽  
Nico Buls ◽  
Sabine Allard ◽  
Johan de Mey
Keyword(s):  
Odds Ratio ◽  
Clinical Presentation ◽  
Enzyme Inhibitor ◽  
Clinical Severity ◽  
Rt Pcr ◽  
Retrospective Case ◽  
Severe Clinical Presentation ◽  
Mortality Outcome ◽  
Polymerase Chain ◽  
Control Study

Abstract One hypothesis suggests that patients undergoing Angiotensin Converting Enzyme inhibitor (ACEI) or Angitensin Receptor Blocker (ARB) treatment might be at greater risk for severe COVID-19 disease. This retrospective study aims to elucidate whether patients with reverse transcription-polymerase chain reaction (RT-PCR)–confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection undergoing ACEI or ARB treatment present with a more severe clinical presentation or more severe lung injury than other patients, as evaluated by CT thorax scans. Comorbidities related to ACEI or ARB use, including arterial hypertension (AHT), heart disease (HD), and diabetes mellitus (DM), were found to be more frequent (p < 0.05 ) in the ACEI or ARB users’ group. The odds ratio of ACEI or ARB users for having a more severe clinical presentation was 1.12 (95% [CI] 0.59–2.13, p = 0.741). For having a severe CT severity score (with a cut-off of 12.5 on a total score of 25), the odds ratio was 1.46 (95% [CI] 0.73–2.94, p = 0.287). Furthermore, the odds ratio of the mortality outcome was 1.1 (95% [CI] 0.49–2.48, p = 0.824). Although the group of ACEI or ARB users had more comorbidities, we found no significant association between CT severity, clinical severity, or mortality and the use of these drugs. These findings bolster the argument against ACEI or ARB withdrawal in COVID-19 patients.

scholarly journals Adjacent-Level Ossification Development in Single-Level Standalone Anterior Cervical Discectomy and Fusion Versus Anterior Cervical Discectomy and Fusion With Plate

2020 ◽  
pp. 219256822090274
Author(s):  
Christopher Huang ◽  
Ralph Mobbs ◽  
Michael Selby ◽  
Kevin Phan ◽  
Prashanth Rao
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Case Control Study ◽  
Case Control ◽  
Anterior Cervical Discectomy ◽  
Adjacent Level ◽  
Retrospective Case ◽  
Cervical Discectomy ◽  
Surgical Data ◽  
Control Study

Study Design: Retrospective case control study. Objectives: Adjacent-level ossification development (ALOD) is a distinct form of adjacent segmental degeneration that has been recognized to occur after anterior cervical discectomy and fusion (ACDF). It is unclear whether ACDF with plate versus standalone has an effect on rates of ALOD. This retrospective case-control study aims to assess the rate of ALOD in a large series of patients undergoing ACDF with and without plate and factors causing ALOD. Methods: Data was collected for patients undergoing ACDF from January 2009 to July 2016. Data collected was from multiple centers and included demographic data, surgical data, radiological imaging at time of surgery, and serial follow-up imaging. The radiology for ALOD was independently reviewed. Cohorts were divided into ACDF with plate (Group P = plate) and ACDF without plate (Groups S = standalone) and outcomes were compared. Results: There were 260 patients with 138 (53%) in Group P and 122 (47%) in Group S. ALOD was observed in 15.3% of patients overall, 29% in group P and 2.8% in group S ( P < .001). Following multivariate adjustment, statistically significant association was found between use of plate and ALOD (odds ratio = 12.8, 95% confidence interval = 3.52-45.45, P < .001). Plate-to-disc distance <5 mm was significantly associated with ALOD (odds ratio = 13.5, 95% confidence interval = 3.83-47.62, P < .001). Conclusion: The use of anterior plate with ACDF was associated with ALOD. Plate-to-disc distance <5 mm was significantly associated with ALOD even after adjustment for confounding factors. We conclude utilization of standalone cages or cages with plate with more than 5 mm distance from adjacent disc to minimize ALOD.

scholarly journals Retrospective Case-Control Study of Apolipoprotein J/Clusterin Protein Expression in Early Liveborn Neonatal Deaths with and without Pontosubicular Necrosis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Kathreena M. Kurian ◽  
Declan McGuone
Keyword(s):  
Confidence Interval ◽  
Protein Expression ◽  
Odds Ratio ◽  
Control Group ◽  
Retrospective Case ◽  
Neonatal Deaths ◽  
Neuronal Protein ◽  
Apolipoprotein J ◽  
Clusterin Protein ◽  
Control Study

Aims. Our objective was to examine Apo J protein expression in a total of 27 early liveborn neonatal deaths (less than 7 days of age) selected from the Scottish Perinatal Study (gestation of 25–42 weeks) comparing a group with histological pontosubicular necrosis (PSN) () to a control group lacking PSN (). Methods. Using immunohistochemistry we evaluated postmortem pons and hippocampus from patients with PSN versus controls. Results. In the group with PSN, 11/12 (92%) cases showed positive Apo J neurones in the hippocampus/pons compared with 6/15 (40%) cases without PSN (, odds ratio 27.5, 95% confidence interval 2.881–262.48, using exact logistic regression)—independent of gestation, presence or absence of clinical asphyxia, duration of labour, or postnatal age. Clinical asphyxia was present in 10/15 (67%) without PSN compared with 11/12 (92%) with PSN. Neuronal Apo J positivity was present in 15/21 (71%) of clinically asphyxiated cases compared with 2/6 (33%) of the cases with no evidence of clinical asphyxia (, odds ratio 5, 95% confidence interval 0.71 to 34.94). Conclusions. Apo J neuronal protein expression is significantly increased in cases with PSN compared to cases without PSN—independent of gestation, presence of clinical asphyxia, duration of labour, or postnatal age.

scholarly journals Factores de riesgo asociados al embarazo en adolescentes

2021 ◽  
Vol 20 (2) ◽  
pp. 109-128
Author(s):  
Jennifer Castañeda Paredes ◽  
Henry Santa-Cruz-Espinoza
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Exposure To Violence ◽  
Retrospective Case ◽  
Small Magnitude ◽  
Factores De Riesgo ◽  
Family Functionality ◽  
Moderate Magnitude ◽  
Control Study

Objetivo: Evaluar los factores de riesgo para el embarazo en adolescentes.Método: Estudio retrospectivo de casos y controles con una muestra no probabilística por conveniencia de 180 adolescentes: 60 gestantes (casos) y 120 no gestantes (controles). La recolección de datos se realizó entre los meses de setiembre y octubre del 2019 en un centro de salud público de Trujillo, mediante el FACES-III y una ficha de identificación de datos sociodemográficos y familiares. Para el análisis de datos se determinó el Odds ratio, se calcularon los intervalos de confianza (IC) y se procedió a estimar la magnitud de efecto.Resultados: Tanto la exposición a la violencia (OR: 5.82), la funcionalidad familiar (OR: 3.87), la edad del primer embarazo de la madre (OR: 4.07) y la situación sentimental de los padres (OR: 4.24), actuaron como factores de riesgo con una magnitud de efecto moderada; en tanto que el grado de instrucción de la madre (OR: 2.03) se mostró como un factor de riesgo con magnitud de efecto pequeña y el grado de instrucción del padre (OR: 1.37) insignificante. Conclusiones: La exposición a la violencia, la funcionalidad familiar, la edad del primer embarazo de la madre, la situación sentimental y el grado de instrucción de los padres actuaron como factores de riesgo para el embarazo en adolescentes. Objective: To assess the risk factors for pregnancy in adolescents.Method: Retrospective case-control study with a non-probability sample for convenience of 180 adolescents: 60 pregnant women (cases) and 120 non pregnant women (controls) Data collection was carried out between September and October, 2019 in a public health center in Trujillo, using FACES-III and a card identifying sociodemographic and family data. For the data analysis the Odds ratio was determined, the confidence intervals (CI) were calculated and the magnitude of effect was estimated.Results: Exposure to violence (OR: 5.82), family functionality (OR: 3.87), age of mother's first pregnancy (OR: 4.07), and parents’ emotional situation (OR: 4.24) were risk factors with a moderate magnitude of effect, whereas mother's education (OR: 2.03) was a risk factor with a small magnitude of effect and father's education (OR: 1.37) was insignificant.Conclusions: Exposure to violence, family functionality, age of mother's first pregnancy, emotional situation and parents’ level of education all acted as risk factors for adolescent pregnancy.

Airway Hemangiomas in PHACE Syndrome: A Multicenter Experience

2020 ◽  
pp. 019459982096662
Author(s):  
Josephine A. Czechowicz ◽  
Tania Benjamin ◽  
Randall A. Bly ◽  
Sheila N. Ganti ◽  
Daniel M. Balkin ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Treatment Duration ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Case Series ◽  
Female Gender ◽  
Airway Disease ◽  
Retrospective Case ◽  
Crucial Component ◽  
High Prevalence

Objective To describe the prevalence and clinical characteristics of airway findings in a multi-institutional cohort of PHACE patients. Study Design Multicenter retrospective case series. Setting Multidisciplinary vascular anomalies clinics at 2 institutions. Methods Data were collected from the electronic medical record, including clinical presentation, airway findings, treatment, and outcomes. Results Of 55 PHACE patients, 22 (40%) had airway hemangiomas. Patients with airway involvement were more commonly female ( P = .034, odds ratio [OR] 23, 95% confidence interval [CI] 1.3-410) and of Caucasian ethnicity ( P = .020, OR 5.3, 95% CI 1.3-21). Anatomically, patients with bilateral S3 involvement had higher rates of airway disease ( P = .0012, OR 15, 95% CI 2.9-77). Most patients with airway hemangiomas had stridor (68%). Of the patients managed in the propranolol era (2008 or later, n = 35), 14 had airway involvement. All 14 were treated with propranolol, whereas 13 (62%) of 21 nonairway patients were treated with propranolol. The average treatment duration was longer in the airway patients (22.1 vs 16.7 months). All patients who underwent tracheostomy (n = 4) did so before 2008. Conclusion Risk factors for airway involvement in PHACE include female gender, Caucasian ethnicity, and stridor. Since the widespread use of propranolol, fewer patients have required surgical management of their airway disease. Given the high prevalence of airway involvement even in patients without stridor, assessment of the airway is a crucial component of a comprehensive PHACE workup.

Human Epidermal Growth Factor Receptor 2 Assessment in a Case-Control Study: Comparison of Fluorescence In Situ Hybridization and Quantitative Reverse Transcription Polymerase Chain Reaction Performed by Central Laboratories

2010 ◽  
Vol 28 (28) ◽  
pp. 4300-4306 ◽  
Author(s):  
Frederick L. Baehner ◽  
Ninah Achacoso ◽  
Tara Maddala ◽  
Steve Shak ◽  
Charles P. Quesenberry ◽  
...  
Keyword(s):  
Growth Factor Receptor ◽  
Oncotype Dx ◽  
Her2 Status ◽  
Rt Pcr ◽  
Her2 Positive ◽  
Polysomy 17 ◽  
Epidermal Growth ◽  
Polymerase Chain ◽  
Control Study

Purpose The optimal method to assess human epidermal growth factor receptor 2 (HER2) status remains highly controversial. Before reporting patient HER2 results, American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines mandate that laboratories demonstrate ≥ 95% concordance to another approved laboratory or methodology. Here, we compare central laboratory HER2 assessed by fluorescence in situ hybridization (FISH) and quantitative reverse transcriptase polymerase chain reaction (RT-PCR) using Oncotype DX in lymph node–negative, chemotherapy-untreated patients from a large Kaiser Permanente case-control study. Patients and Methods Breast cancer specimens from the Kaiser–Genomic Health study were examined. Central FISH assessment of HER2 amplification and polysomy 17 was conducted by PhenoPath Laboratories (ratios > 2.2, 1.8 to 2.2, and < 1.8 define HER2 positive, HER2 equivocal, and HER2 negative, respectively). HER2 expression by RT-PCR was conducted using Oncotype DX by Genomic Health (normalized expression units ≥ 11.5, 10.7 to < 11.5, and < 10.7 define HER2 positive, HER2 equivocal, and HER2 negative, respectively). Concordance analyses followed ASCO/CAP guidelines. Results HER2 concordance by central FISH and central RT-PCR was 97% (95% CI, 96% to 99%). Twelve percent (67 of 568 patients) and 11% (60 of 568 patients) of patients were HER2 positive by RT-PCR and FISH, respectively. HER2-positive patients had increased odds of dying from breast cancer compared with HER2-negative patients. Polysomy 17 was demonstrated in 12.5% of all patients and 33% of FISH-positive patients. Nineteen of 20 FISH-positive patients with polysomy 17 were also RT-PCR HER2 positive. Although not statistically significantly different, HER2-positive/polysomy 17 patients tended to have the worst prognosis, followed by HER2-positive/eusomic, HER2-negative/polysomy 17, and HER2-negative/eusomic patients. Conclusion There is a high degree of concordance between central FISH and quantitative RT-PCR using Oncotype DX for HER2 status, and the assay warrants additional study in a trastuzumab-treated population.

scholarly journals Assessment of Mixed Plasmodium falciparum sera5 Infection in Endemic Burkitt Lymphoma: A Case-Control Study in Malawi

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1692
Author(s):  
Nobuko Arisue ◽  
George Chagaluka ◽  
Nirianne Marie Q. Palacpac ◽  
W. Thomas Johnston ◽  
Nora Mutalima ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Plasmodium Falciparum ◽  
Burkitt Lymphoma ◽  
Odds Ratio ◽  
Childhood Infections ◽  
Molecular Barcode ◽  
Polymerase Chain ◽  
Measuring Diversity ◽  
Control Study

Background: Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in Africa and is linked to Plasmodium falciparum (Pf) malaria infection, one of the most common and deadly childhood infections in Africa; however, the role of Pf genetic diversity is unclear. A potential role of Pf genetic diversity in eBL has been suggested by a correlation of age-specific patterns of eBL with the complexity of Pf infection in Ghana, Uganda, and Tanzania, as well as a finding of significantly higher Pf genetic diversity, based on a sensitive molecular barcode assay, in eBL cases than matched controls in Malawi. We examined this hypothesis by measuring diversity in Pf-serine repeat antigen-5 (Pfsera5), an antigenic target of blood-stage immunity to malaria, among 200 eBL cases and 140 controls, all Pf polymerase chain reaction (PCR)-positive, in Malawi. Methods: We performed Pfsera5 PCR and sequencing (~3.3 kb over exons II–IV) to determine single or mixed PfSERA5 infection status. The patterns of Pfsera5 PCR positivity, mixed infection, sequence variants, and haplotypes among eBL cases, controls, and combined/pooled were analyzed using frequency tables. The association of mixed Pfsera5 infection with eBL was evaluated using logistic regression, controlling for age, sex, and previously measured Pf genetic diversity. Results: Pfsera5 PCR was positive in 108 eBL cases and 70 controls. Mixed Pf SERA5 infection was detected in 41.7% of eBL cases versus 24.3% of controls; the odds ratio (OR) was 2.18, and the 95% confidence interval (CI) was 1.12–4.26, which remained significant in adjusted results (adjusted odds ratio [aOR] of 2.40, 95% CI of 1.11–5.17). A total of 29 nucleotide variations and 96 haplotypes were identified, but these were unrelated to eBL. Conclusions: Our results increase the evidence supporting the hypothesis that infection with mixed Pf infection is increased with eBL and suggest that measuring Pf genetic diversity may provide new insights into the role of Pf infection in eBL.

scholarly journals Clinical severity and epidemiological spectrum of coronavirus disease 2019 in children – comparison with influenza

2020 ◽  
Author(s):  
Maria Pokorska-Śpiewak ◽  
Ewa Talarek ◽  
Jolanta Popielska ◽  
Karolina Nowicka ◽  
Agnieszka Ołdakowska ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Course ◽  
Household Contact ◽  
Clinical Severity ◽  
Nasopharyngeal Swab ◽  
Suspected Case ◽  
The Novel ◽  
Shortness Of Breath ◽  
Rt Pcr ◽  
Main Risk Factor

Abstract Data on the novel coronavirus disease 2019 (COVID-19) in children are limited, and studies from Europe are scarce. We analyzed the clinical severity and epidemiologic aspects of COVID-19 in consecutive children aged 0 – 18 years, referred with a suspicion of COVID-19 between February 1, and April 15, 2020. RT-PCR on a nasopharyngeal swab was used to confirm COVID-19. 319 children met the criteria of a suspected case. COVID-19 was diagnosed in 15/319 (4.7%) patients (8 male; mean age 10.5 years). All of them had household contact with an infected relative. Five (33.3%) patients were asymptomatic. In 9/15 (60.0%) children, the course of the disease was mild, and in 1/15 (6.7%), it was moderate, with the following symptoms: fever (46.7%), cough (40%), diarrhea (20%), vomiting (13.3%), rhinitis (6.7%), and shortness of breath (6.7%). In the COVID-19-negative patients, other infections were confirmed, including influenza in 32/319 (10%). The clinical course of COVID-19 and influenza differed significantly based on the clinical presentation. In conclusion, the clinical course of COVID-19 in children is usually mild or asymptomatic. In children suspected of having COVID-19, other infections should not be overlooked. The main risk factor for COVID-19 in children is household contact with an infected relative.

scholarly journals Patients with Initial Negative RT-PCR and Typical Imaging of COVID-19: Clinical Implications

2020 ◽  
Vol 9 (9) ◽  
pp. 3014 ◽  
Author(s):  
Florent Baicry ◽  
Pierrick Le Borgne ◽  
Thibaut Fabacher ◽  
Martin Behr ◽  
Elena Laura Lemaitre ◽  
...  
Keyword(s):  
Bayesian Methods ◽  
Clinical Presentation ◽  
Chronic Respiratory Disease ◽  
Clinical Implications ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Negative Results ◽  
Lower Oxygen ◽  
Baseline Characteristics ◽  
Polymerase Chain

The sensitivity of reverse transcriptase polymerase chain reaction (RT-PCR) has been questioned due to negative results in some patients who were strongly suspected of having coronavirus disease 2019 (COVID-19). The aim of our study was to analyze the prognosis of infected patients with initial negative RT-PCR in the emergency department (ED) during the COVID-19 outbreak. This study included two cohorts of adult inpatients admitted into the ED. All patients who were suspected to be infected with SARS-CoV-2 and who underwent a typical chest CT imaging were included. Thus, we studied two distinct cohorts: patients with positive RT-PCR (PCR+) and those with negative initial RT-PCR (PCR–). The data were analyzed using Bayesian methods. We included 66 patients in the PCR– group and 198 in the PCR+ group. The baseline characteristics did not differ except in terms of a proportion of lower chronic respiratory disease in the PCR– group. We noted a less severe clinical presentation in the PCR– group (lower respiratory rate, lower oxygen need and mechanical ventilation requirement). Hospital mortality (9.1% vs. 9.6%) did not differ between the two groups. Despite an initially less serious clinical presentation, the mortality of patients infected by SARS-CoV-2 with a negative RT-PCR did not differ from those with positive RT-PCR.

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