scholarly journals Constipation, Diabetes, and Split-Dose Regimen Are Associated With Suboptimal Bowel Preparation in Young Patients

2021 ◽  
Author(s):  
Lexin Liu ◽  
Jingbin Wang ◽  
Yingzhe Lai ◽  
Li Liu ◽  
Guoxin Huang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Retrospective Study ◽  
Bowel Preparation ◽  
Dose Regimen ◽  
Clinical Characteristics ◽  
Young Patients ◽  
The Other ◽  
Split Dose ◽  
Factors Associated

Abstract Background An increase in the incidence of colorectal cancer in young patients has been observed. However, there is little research investigating the factors associated with suboptimal bowel preparation focusing on young patients compared to patients > 50 years. Aims We aimed to evaluate the factors associated with a suboptimal bowel preparation in young patients (age ≤ 50 years) using the Boston Bowel Preparation Scale (BBPS). Methods This retrospective study analyzed 1,980 patients who underwent complete colonoscopy from June 2017 to September 2020. Data regarding demographic and clinical characteristics and bowel preparation adequacy were collected. Furthermore, factors associated with suboptimal bowel preparation were analyzed. Results Among our participants, 17.8% demonstrated suboptimal bowel preparation. After adjusting for several factors, multivariate analysis showed that diabetes (OR:0.28; 95% CI, 0.14–0.56, P = .000), constipation (OR:0.20; 95% CI, 0.13–0.29, P = .000), and split-dose bowel preparation (OR:1.69; 95% CI, 1.28–2.23, P = .000) were independent predictors of suboptimal bowel preparation. Additionally, constipation was significantly associated with poor bowel preparation in all colonic segments; on the other hand, diabetes and split-dose bowel preparation were significant on right side of the colon. Conclusions Constipation, diabetes and split-dose bowel preparation were significantly associated with suboptimal bowel preparation in young patients.

scholarly journals Erythroderma caused by vancomycin in children: concentration and speed of infusion

2013 ◽  
Vol 1 (2) ◽  
Author(s):  
José F. Luna Álvarez ◽  
Mónica Gómez Vázquez ◽  
Ana L. Moreno González ◽  
Aldo Melchor Hernández ◽  
Marco A. Escamilla-Acosta ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Male Gender ◽  
The Other ◽  
Paediatric Hospital ◽  
Other Hand ◽  
Red Man Syndrome ◽  
Main Factors

Vancomycin is an antibiotic glycopeptide that was isolated of the Streptomyces orientalis. It was introduced in the clinical practice for treatment of infections caused by staphylococcus in which other antibiotics were proving to be ineffective. In this retrospective study, we determine its prescription, clinical characteristics as well as the factors that favor the apparition of the erythroderma or red-man syndrome in a paediatric hospital. Forty patients to which physicians administer vancomycin and presented erythroderma were evaluated. Male gender was more predominated, with a total of 25 cases (62.5 %). The average age was of 12 ± 6 years. We identified two main factors that are directly related to the appearance of erythroderma. On one hand, the "concentration of the drug", which is related to the dilution that it is realized when a dose of vancomycin is going to be administered to the patient and on the other hand the “time or speed of infusion”. In the present study, it was found a low incident of this adverse reaction and few cases of complications.

Classic or simplified LV5FU2 regimen: Multivariate analysis from a phase III study in metastatic colorectal cancer in elderly patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3550-3550
Author(s):  
Jean-Louis Legoux ◽  
Thomas Aparicio ◽  
Emilie Maillard ◽  
Jean Marc Phelip ◽  
Jean-Louis Jouve ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Elderly Patients ◽  
Metastatic Colorectal Cancer ◽  
Folinic Acid ◽  
Phase Iii ◽  
Second Line ◽  
Factors Associated ◽  
Third Line

3550 Background: In the early 2000s, classic LV5FU2 (C) (folinic acid, 5FU bolus, then 5FU infusion on D1 and D2) was replaced with simplified LV5FU2 (S) (folinic acid and 5FU bolus on D1 only), considered as effective and less toxic. No trial proved this assertion. The LV5FU2 companion in the FOLFIRI or FOLFOX regimen was C or S. The FFCD 2001-02 study compared in a 2 x 2 factorial design, in not-pretreated elderly patients (75+) with metastatic colorectal cancer, C or S, with or without irinotecan. No significant differences in PFS and OS were observed in the comparison with or without irinotecan. The median OS was 15.2 months in C versus 11.4 months in S, HR = 0.71 (0.55–0.92) and objective response rate was 37.1% in C vs S 25.6% in S, p = 0.004. The aim of this study was to present the factors associated with these differences. Methods: Prognostic factors associated with OS were studied using a Cox model. The multivariate analysis used the significantly different items from the univariate analysis and the differences observed at the inclusion. For each of these items, a subgroup analysis was performed. The second- and third-line treatments were analysed. Results: The 282 patients from the intent-to-treat study were included in the model. In OS, the prognostic factors were C versus S, number of metastatic sites, alkaline phosphatases (AP) and CEA. The interaction test in each subgroup for OS was not significant but C was significantly better in the following subgroup: age > 80 years, male, Karnofsky 100%, 1-2 Charlson index, AP ≤ 2N, leucocyte count > 11,000, CEA > 2N, CA 19-9 ≤2N. No differences were observed in the NCI toxicities but 130 serious adverse events in S versus 102 in C. A second-line was used for 55% patients in C, 46% in S, 81% of them with oxaliplatin or irinotecan in C, 76% after S. The third-line administration (20%) and targeted therapy (15%) were similar in C and S. Conclusions: C-LV5FU2 was superior both in subgroups with better and lower prognostics and this difference cannot be explained by an imbalance between the populations. The toxicity was not higher and a second-line was more often possible after C. The switch from C to S without scientific proof was perhaps a mistake in our practices. Clinical trial information: NCT00303771.

scholarly journals A Study in the Clinical Characteristics of Stenotrophomonas Maltophilia Bacteremia in Hematological Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4631-4631
Author(s):  
Haiyan Bao ◽  
Jia Chen ◽  
Xiaojin Wu ◽  
Xiao Ma ◽  
Chengcheng Fu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Respiratory Failure ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
P Value ◽  
Hematological Diseases ◽  
Factors Associated

Abstract Introduction: Stenotrophomonas maltophilia is an important nosocomial pathogen, particularly in immunocompromised patients, especially in patients with hematologic diseases. Methods: We reviewed the clinical characteristics and prognosis of patients with S. maltophilia bacteremia over a five-year period from January 2010 to December 2014. Species identification was performed using the automated Vitek 2 compact system (bioMe rieux). Results: The incidence of S. maltophilia bacteremia was 25.1 per 10 000 admissions in our study. Thirty-four patients (median age: 34 years; 64.7% males) with S. maltophilia bacteremia were analyzed. The S. maltophilia bacteremia related 30-day mortality was 44.1%. Risk factors associated with mortality in patients with S. maltophilia infection in the univariate and multivariate analysis were represented in Tables I and II. In the univariate analysis, risk factors included T>39.0¡æ, septic shock, respiratory failure and non-remission after treatment for primary hematological diseases (P <0.05). In the multivariate analysis, respiratory failure and non-remission status after treatment forhematological diseases were independent prognostic factors for mortality. In vitro susceptibility was higher to ciprofloxacin(82.4%), ceftazidime(70.6%), sulbactam and cefoperazone(58.8%), which was shown in Table III. Conclusion: Combination regimens with ciprofloxacin and ceftazidime, or sulbactam and cefoperazone could be alternative treatment. Novel antibiotics are required for treatment of S. maltophilia infection, as well as infection control practices of environmental reserves, rapid detection of pathogens, risk stratification strategy and appropriate treatment for primary hematologic malignancies, which might conjointly contribute to better survival outcome of S. maltophilia bacteremia. Univariate analysis of prognostic factors associated with mortality from S. maltophilia bacteremia Table 1. Factor Mortality HR 95%CI P-value Withfactor Withoutfactor T>39.0¡æ 75% 16.7% 2.490 1.318-4.704 0.005 Septic shock 90.0% 25.0% 2.544 1.473-4.393 0.001 Respiratory failure 100% 20.8% 4.672 2.366-9.225 0.000 Treatment outcome for hematological diseases Remission 10.0% 85.7% 0.247 0.116-0.526 0.000 HR, hazard ratio; CI, confidence interval; HSCT, Hematopoietic stem cell transplantation Table 2. Multivariate analysis of prognostic factors associated with mortality from S. maltophilia bacteremia Factor HR 95%CI P-value Respiratory failure 2.688 1.297-5.569 0.008 Remission after treatment for hematological diseases 0.367 0.153-0.879 0.025 HR, hazard ratio; CI, confidence interval Table 3. Susceptibility pattern of the 34 patients with Stenotrophomonas maltophilia bacteremia Antimicrobial agents S (%) I (%) Ceftazidime 24(70.6%) 1(2.9%) Cefoperazone 19(44.1%) 6(17.6%) Sulbactam and Cefoperazone 20(58.8%) 5(14.7%) Piperacillin 7(20.6%) 6(17.6%) Piperacillin-Tazobactam 11(32.3%) 7(20.6%) Amikacin 6(17.6%) 0(0%) Ciprofloxacin 28(82.4%) 1(2.9%) S, susceptible; I, intermediately susceptible. Disclosures No relevant conflicts of interest to declare.

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