Are Fractures To The Bony Cage Protecting the Abdomen Associated with Splenectomy in Cases of Abdominal Trauma? A Cohort Study

Abstract Background The spleen is protected by the ribs anteriorly, the vertebral column posteriorly and the pelvis inferiorly. Fractures to this bony cage may indicate a high-grade splenic injury necessitating splenectomy. We aim to determine whether fractures to the bony cage protecting the abdomen are associated with splenectomy. Methods We performed a subgroup analysis of patients with splenic injury from a prospective trauma registry study named ‘Towards Improved Trauma Care Outcomes’ (TITCO) in India. Out of the 16047 patients enrolled in the TITCO study, 267 patients with splenic injury were included. Categorical variables were analyzed using the chi square test and logistic regression was used to assess the significance of continuous variables. A multivariate analysis was performed on the factors deemed clinically most significant. Results Patients with a higher grade of splenic injury were more likely to require splenectomy when adjusted for other variables (p value < 0.05). Patients with fractures to the vertebrae or pelvis had reduced odds of splenectomy on unadjusted analysis [Odds ratio 0.43 (0.19–0.94)], but this was not significant when adjusted for other variables. Conclusion In contradiction to our initial hypothesis, we found that fractures to the bony cage protecting the abdomen were not significantly associated with the splenectomy.

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350. Neurocysticercosis – Gender Differences in Clinical Presentations

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.545 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S244-S244

Author(s):

Bharath Pendyala ◽

Prasanth Lingamaneni ◽

Patricia DeMarais ◽

Lakshmi Warrior ◽

Gregory Huhn

Keyword(s):

Gender Differences ◽

Categorical Variables ◽

Public Health Issue ◽

Diagnostic Code ◽

Continuous Variables ◽

Chi Square ◽

Generalized Seizures ◽

Icd 10 ◽

Chi Square Test ◽

Reported Data

Abstract Background Neurocysticercosis is a Neglected Tropical Disease and an important public health issue. Our goal was to collect and analyze data regarding clinically significant gender differences among our Neurocysticercosis patients. Methods A retrospective chart search with ICD 9/ ICD 10 diagnostic code for Neurocysticercosis and neuroimaging suggestive of Neurocysticercosis was performed for clinical encounters in the hospital or affiliated clinics between years 2013–2018. After a careful chart review, patients who were clinically diagnosed with Neurocysticercosis were included in the study. T-test was used to compare means of continuous variables and chi-square test to compare proportions of categorical variables. Results Among 90 total patients included, male (49.4%) and female (50.6%) distribution were nearly identical. The mean age in females was found to be higher than males (52.5 vs 42.0, P < 0.0001). Almost an equal number of males and females presented with either seizures (63.6% vs 57.8%, P= 0.85), headaches (25.0% vs 28.9%, p= 0.85), or other symptoms (11.4% vs 13.3%, p= 0.85). Males had more generalized seizures compared to females (60% vs 38%, P= 0.37), although this result was not statistically significant. Females were more likely to present with > 1 lesion (82.2% vs 56.8%, P= 0.01). Males were more likely to have cystic lesions (64.7% vs 27.9%, P < 0.001) compared to females who had more calcified lesions on presentation (65.1% vs 20.6%, P < 0.001). Male patients were more likely to have contrast enhancement or edema surrounding the lesions (61.4% vs 33.3%, P= 0.01) and were more likely to require treatment with Albendazole/Praziquantel (75.8% vs 31.7%, P < 0.001). Conclusion Although previously reported data is limited, there is a suggestion that there are gender differences in host immune response and that inflammation surrounding parenchymal lesions is more intense in females. This study suggests that men either present early in the disease phase or have different immune responses than women and require anti-parasitic therapy more frequently. More research in this aspect is needed. Disclosures All Authors: No reported disclosures

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Non-Prescription Antibiotic Use For People Aged 15 Years Or Older For Cough In China: A Community-Based Survey

10.21203/rs.3.rs-539716/v1 ◽

2021 ◽

Author(s):

Yan Luo ◽

Xuewen Tang ◽

Lingling Ding ◽

Zhujun Shao ◽

Jianxing Yu ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Univariate Analysis ◽

Antibiotic Use ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Main Driver ◽

Antibiotics Use ◽

Chi Square Test ◽

Use Behavior

Abstract Background Non-prescription antibiotic use at community is a main driver of antimicrobial resistance. Cough is a common condition and prevalent in all communities, including China. This study aims to investigate the non-prescription antibiotic use for cough in China and explore to which extent antibiotic use knowledge was correctly instructed in communities.Methods A probability-proportionate-to-size (PPS) sampling method was adopted to survey from all 14 communities in Yiwu city, China. All participants were investigated by face-to-face interview on Portable Android Devices (PADs). The continuous variables were presented by mean and standard deviation (SD) or medium and inter-quartile range (IQR). The categorical variables were presented using percentage or constituent ratio. Chi-square test for univariate analysis and logistic regression for multivariate analysis were conducted to assess the odds ratios (ORs) and 95% confidence intervals (CIs), respectively.Results A total of 3034 respondents across the 14 communities and the 50 natural villages/streets completed all key items of the questionnaire. Of 2400 (79.10%) respondents stated that they experienced cough in the past 12 months with the medium age of 36.5 (IQR: 26-49) and 12.21% (293/2400) respondents had the non-prescription antibiotic use behavior. Among those 293 respondents, the proportion of non-prescription antibiotic use for cough peaked at around 16% among people aged 30-39 years old. The major sources of antibiotics were pharmacy (77.70%) and/or family storage (43.92%). As for antibiotic knowledge in 3034 participants, 61.8% participants had minimal knowledge on broad-spectrum antibiotic and 53.76% were not familiar about the effects of joint use.Conclusions Non-prescription antibiotics use for cough is prevalent in the community, especially among people in their thirties. Strengthened drug purchase regulation and well-trained professional pharmacists would be promising alternatives to ameliorate AMR. Moreover, penetrating antibiotics knowledge to common citizens and is an urgent task to alleviate antimicrobial resistance. Therefore, proactive policies and regulations should be made to improve current situations.

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Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

Advances in Virology ◽

10.1155/2021/6689669 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Víctor O. Costa ◽

Eveline M. Nicolini ◽

Bruna M. A. da Costa ◽

Fabrício M. Teixeira ◽

Júlia P. Ferreira ◽

...

Keyword(s):

Clinical Laboratory ◽

Lung Parenchyma ◽

Clinical Deterioration ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Exact Test ◽

Laboratory Confirmation ◽

Chi Square Test ◽

Imaging Markers

This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p = <0.001) and increases in serum creatinine ( p = 0.009), LDH ( p = 0.057), troponin ( p = 0.018), IL-6 ( p = 0.053), complement C4 ( p = 0.040), and CRP ( p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p = 0.001). Hypertension ( p = 0.064), heart disease ( p = 0.048), and COPD ( p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p = 0.027), as well as bilateral opacifications ( p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.

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Impact of Donor Inflow in COVID 19 Pandemic: A Tertiary Care Hospitals Blood Service Experience

Bangladesh Journal of Medicine ◽

10.3329/bjm.v33i1.56793 ◽

2021 ◽

Vol 33 (1) ◽

pp. 70-75

Author(s):

Md Abdul Quader ◽

Quazi Tarikul Islam

Keyword(s):

Tertiary Care ◽

Hospital Setting ◽

Police Department ◽

Distribution Patterns ◽

Categorical Variables ◽

Time Interval ◽

Continuous Variables ◽

Chi Square ◽

Travel Restrictions ◽

Chi Square Test

Background: The severe acute respiratory syndrome (SARS) causing the COVID 19 pandemic infection has affected one and all across the world and halting mosthuman activities. During the disease outbreak and country lockdown, Blood Transfusion Services faced numerous challenges to maintain the sustainability in service provision. We intend to identify the challenges faced during COVID-19 outbreak and the following imposed national lockdown. Methods: This retrospective study was done during the lockdown period from26/03/2020 to 30/05/2020 comprising 66 days to detect donor inflow declination and to compare the donor inflow with pre lockdown and post lockdown period of same duration. The periods were divided into six equal intervals to compare donor distribution patterns in lockdown, pre lockdown and post lockdown period. Mean and standard deviation was calculated for continuous variables and chi square test was done for categorical variables. Results: The donations collected during the lockdown period and post lockdown period were almost 71.37% and 62.82% less respectively when compared with the pre lockdown collection (211and 274 versus 737).While in interval periods, donor inflow was declined substantially in lockdown period and in post lockdown period, inflow was declined as of lockdown period initially but it increases as time passed. But the increment was not as such of pre lockdown period. Donor inflow in age group and time interval of donation frequency were statistically significant (p <0.00005 and p< 0.0037 respectively). Conclusion: Concerns of being infected through hospital contact, lack of public transport facilities, travel restrictions imposed by the police department, and no availability of medical student donors in the hospital setting were the main attributing factors for donor inflow. Bangladesh J Medicine July 2022; 33(1) : 70-75

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Predictors of 30-day readmission rate after total gastrectomy in patients with gastric malignancy.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16109 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e16109-e16109

Author(s):

Miguel Salazar ◽

Estefania Gauto ◽

Shristi Upadhyay Upadhyay Banskota ◽

Pedro Palacios ◽

Trilok Shrivastava ◽

...

Keyword(s):

Total Gastrectomy ◽

Economic Burden ◽

Readmission Rate ◽

Hospital Costs ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Prolonged Length ◽

Chi Square Test ◽

Gastric Malignancy

e16109 Background: Total gastrectomy with lymph node dissection is curative for early gastric malignancy which accounts for 1.5% of cancer cases in the U.S. Readmissions are common postoperatively, and are associated with increased morbidity, mortality, hospital costs and decreased quality of life. We hence aim to identify incidence, impact and independent predictors for readmission in patients who underwent total gastrectomy in gastric malignancy. Methods: We conducted a retrospective cohort study of the 2017 National Readmission Database (NRD) of adult patients readmitted within 30 days after an index admission for total gastrectomy with a concomitant diagnosis of gastric malignancy. T-test was used for continuous variables and chi square test was used for categorical variables. Multivariate regression was used to identify predictors for unplanned readmissions. ICD 10 codes were used to identify diagnoses and procedures. Results: A total of 1,779 patients with gastric malignancy underwent total gastrectomy. The 30-day readmission rate was 18.5%. Main causes for readmission were sepsis, ventricular fibrillation, recurrent STEMI. Readmitted patients were more likely to be on chemotherapy. (40.1% vs 27.2%; P<0.01) and more likely to be discharged to a skilled facility (13.5% vs 17.9%; P<0.01). The total health care in-hospital economic burden of readmission was $6.5 million in total charges and $25 million in total costs. Independent predictors of readmission were major bleeding, respiratory failure requiring mechanical ventilation, peripheral parenteral nutrition, history of non-alcoholic hepato-steatosis, and prolonged length of stay. Conclusions: Readmissions after gastrectomy in patients with gastric malignancies are associated with lower in-hospital mortality yet pose a substantial economic burden on healthcare. The lower mortality might be explained by the relatively stable course and lower comorbidities of patients who become eligible for discharge after surgery. Further studies are suggested. Modifiable risk factors like malnutrition and sepsis warrant special attention to decrease readmissions and improve overall outcomes.[Table: see text]

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Abstract P165: Comparing Grip Strength, Weakness, And Frailty Based On Comorbidity And Laboratory Data Among Patients With Cardiovascular Disease

Circulation ◽

10.1161/circ.141.suppl_1.p165 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Gloria Kim ◽

Arati A Gangadharan ◽

Matthew A Corriere

Keyword(s):

Grip Strength ◽

Frailty Index ◽

Laboratory Data ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Chi Square ◽

Mean Values ◽

Multivariable Models ◽

And Gender

Introduction: Some approaches to frailty screening use diagnostic or laboratory data that may be incomplete. Grip strength can identify weakness, a component of phenotype-based frailty assessment. We compared grip strength as a reductionist, phenotype-based approach to frailty screening with comorbidity and laboratory-based alternatives. Hypothesis: Grip strength and categorical weakness are correlated with the modified frailty index-5 (mFI-5) and lab values associated with frailty. Methods: Weakness based on grip, BMI, and gender was compared with mFI-5 comorbidities and lab values. Patients with at least 3/5 mFI-5 comorbidities were considered frail. Lab data collected within 6 months of grip measurement was assessed. Associations were evaluated using multivariable models and kappa. Methods: 2,597 patients had grip strength measured over 5 months. Mean age was 64.4±14.6, mean BMI was 29.5±6.9;46% were women, and 87% white. Prevalent comorbidities included hypertension (28%), CHF (22%), diabetes (29%), and COPD (26%); 9% were functionally dependent. 34% were weak, but only 13% were frail based on mFI-5. Hemoglobin, creatinine, and CRP differed significantly based on weakness ( Table ). Laboratory data were missing for 36%- 95% of patients. Multivariable models identified significant associations between weakness, hemoglobin, and all MFI-5 comorbidities. Categorical agreement between weakness and frailty was limited (kappa =0.09; 95% CL 0.0641-0.1232). Conclusion: Weakness based on grip strength provides a practical, inexpensive approach to risk assessment, especially when incomplete data excludes other approaches. Comorbidity-based assessment categorizes many weak patients as non-frail. Table. Demographic, laboratory values, and comorbidities by categorical weakness based on grip 20 th percentile. Mean values for continuous variables by weakness adjusted for gender and BMI, p-value for T-test; frequency and total percent for categorical variables, p-value represents chi-square test.

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VOMITING

The Professional Medical Journal ◽

10.29309/tpmj/18.4556 ◽

2018 ◽

Vol 25 (12) ◽

pp. 1887-1891

Author(s):

Malik Jamil Ahmed ◽

Muhammad Nasir ◽

Aamir Furqan

Keyword(s):

Computer Software ◽

Outcome Variable ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Postoperative Vomiting ◽

Hospital Data ◽

Chi Square ◽

Oral Ketamine ◽

The Difference

Objectives: To investigate whether the addition of dexamethasone and chloropheniramine to oral ketamine premedication affects the incidence of postoperative vomiting. Study Design: Randomized control trail. Setting: Department of Anesthesia and Intensive Care Nishtar Hospital, Multan. Period: March 2016 to March 2017. Methodology: After obtaining ethical approval ethical and review board of hospital. Data was entered in a computer software SPSS version 23.1 and analyzed for possible variables. Continuous variables were presented as mean and standard deviation like age, weight, sedation time, anesthesia time, admission time and PACU time. Categorical variables were presented as gender, ASA statusand postoperative vomiting. Student test and chi square test was applied to see association of outcome variable. P value of 0.05 was taken as significant. Results: Overall, 100% (n=80) patients were included in this study, both genders. The study group was further divided into twoequal groups, 50% (n=40) in each, i.e. Group K (Ketamine) group and group KD (Ketamine-Dexamethasone). The main outcome variable of this study was postoperative vomiting. In this study, Postoperative vomiting observed in 35% (n=10) and 10% (n=4) patients, for group K and group KD respectively. The difference was statistically significant (p=0.007). Conclusion: Addition of dexamethasone and chloropheniramine with ketamine as premedication reduce the incidence of postoperative vomiting.

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Tuberculum sellae meningiomas: A series of 41 cases; surgical and ophthalmological outcomes with proposal of a new prognostic scoring system

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.102608 ◽

2012 ◽

Vol 03 (03) ◽

pp. 286-293 ◽

Cited By ~ 10

Author(s):

Arun Palani ◽

Manas K Panigrahi ◽

Anirudh K Purohit

Keyword(s):

Prognostic Factors ◽

Scoring System ◽

Visual Outcome ◽

Categorical Variables ◽

P Value ◽

Visual Recovery ◽

Chi Square ◽

Factors Affecting ◽

Chi Square Test ◽

Tuberculum Sellae

ABSTRACT Context: Tuberculum sellae meningiomas have proved difficult to treat, partly because of their intimate association with the optic nerves and chiasma, hypothalamus, and internal carotid arteries. Aims: The aim of this study is to analyze the degree of influence of various prognostic factors affecting visual outcome; the pattern of visual recovery and develop a scoring system for prognostication. Settings and Design: This is a retrospective study carried out from January 2004 till June 2011. Materials and Methods: Patients were analyzed on the basis of clinical, radiological, and surgical factors that appeared to affect the outcome. A special scoring system (according to the guidelines of the German Ophthalmological Society) was adopted to quantify the extent of ophthalmological disturbances. Statistical Analysis Used: Comparison of categorical variables between the two was performed using chi-square test and a P value of ≤ 0.05 was considered significant. Logistic regression was used when multivariate analysis was required. Results: Vision improved in 27% and deteriorated in 7.3%. A prognostic scoring system (score 4–13) was developed depending on the degree of influence of significant prognostic factors. The patients with a score of ≤6 had improved vision postoperatively (44%), whereas none of those with a score > 6 improved. Completeness of visual recovery was perceived in 100% of patients within 3 months. Complete resectability was achieved in 73% of patients. Conclusions: The proposed scoring system is very useful in prognosticating the visual outcome of these patients. The patients with a score of ≤6 have the best visual outcome postoperatively. Complete resectability is better achieved with extended bifrontal and unilateral frontal approaches. Short-term postoperative visual outcome is a strong indicator of permanent visual outcome after surgery.

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Can racial and financial disparities be overcome in the surgical treatment of NSCLC?

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.208 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 208-208

Author(s):

Jordan R. Sasson ◽

Gary Schwartz ◽

Sadiq Rehmani ◽

Hassan S Moghaddas ◽

Sarah Almubarak ◽

...

Keyword(s):

Induction Therapy ◽

Categorical Variables ◽

Continuous Variables ◽

Urban Hospital ◽

Chi Square ◽

Black Patients ◽

Diverse Patient Population ◽

Chi Square Test ◽

Student’S T ◽

Nsclc Patients

208 Background: Considerable data exists examining disparities in the treatment of non-small cell lung cancer (NSCLC) patients. Black patients, in particular those of lower socioeconomic status (SES), are less likely to receive appropriate care, including induction therapy and resection of surgically treatable lesions. We analyzed the outcomes of resection of NSCLC among a racially and financially diverse patient population at a large urban hospital network with a comprehensive thoracic oncology program. In this system, a patient navigation support team helped overcome barriers to preoperative preparation and multidisciplinary referral. Methods: A retrospective review of 345 patients who underwent lobectomy at our institution from 2002 - 2011 was performed. Data was retrieved from the Society of Thoracic Surgeons (STS) database and patient charts. Patient demographics, payor information and preoperative characteristics were noted. Postoperative complications, 30-day survival and 3-year survival were compared. Statistical analysis was performed using SPSS 17.0 (SPSS Inc, Chicago, IL). Chi-square test was used to compare categorical variables and Student's t-test was used to compare continuous variables. Results: Demographics of black and non-black patients were similar. There were more black patients within the Medicaid group than non-Medicaid (48.9% and 25.3%, p=0.001). Physiologic characteristics, risk factors and use of pre-operative RT and chemotherapy were similar. Post-operative complications were comparable in Medicaid vs. non-Medicaid (11.1% and 14.7%, p=0.524), however black patients had a lower rate of complications vs. non-black (6.1% and 17.4%, p=0.007). 3-year survival was similar in the black vs. non-black (82.3% and 78.6%, p=0.879) and Medicaid vs. non-Medicaid (66.7% and 78.8%, p=0.342) groups. Conclusions: We demonstrated equivalent surgical outcomes for NSCLC in addition to the similar use of induction therapy. Surprisingly, complications were lower in the black cohort. Our results reveal that appropriate treatment is being provided regardless of race or SES, and postulate that our system of preoperative patient support eliminates potential barriers to care.

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Predictive Factors For Three Pronuclear Zygote In Ivf Cycle

KnE Medicine ◽

10.18502/kme.v1i1.531 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Budi Wiweko

Keyword(s):

Strong Predictor ◽

Multivariate Logistic Regression Analysis ◽

Controlled Ovarian Hyperstimulation ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Preimplantation Genetic Testing ◽

Vitro Fertilization ◽

Chi Square Test

Introduction: Preimplantation Genetic Testing is one of the methods to screen genetic defects in embryos created through In Vitro Fertilization. In developing country this technique is still new and expensive method. Thus, knowing several factors in predicting the occurrence of three-pronuclear zygote can help much.Method: 472 cycles in 449 subjects who underwent controlled ovarian hyperstimulation in IVF cycles between January 2013 and August 2014 were included in the study. Categorical variables were compared using Chi Square test and continuous variables were analyzed using Independent t-test, and statistically significant was considered when p < 0.05. Multivariate logistic regression analysis was performed in order to correlate clinical variables and the occurrence of three-pronuclear zygote (3pn). Results: There were 38 3pn was identified in this study (8.05%). No correlation was found between age of the women, number of mature follicles, which are less than six with the incidence of 3pn. However, level of Anti Mullerian Hormones (AMH) found to be the strongest predictor with the incidence of 3PN (p < 0,01, RR 2.5, CI95% 1,55; 4.16).Conclusion: level of AMH is known to be strong predictor of thee pronuclear zygote after IVF cycle.

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