scholarly journals High incidence of hypertension-mediated organ damage in a series of Chinese patients with 17α-hydroxylase deficiency

2021 ◽  
Author(s):  
Zhiyuan Zhao ◽  
Lin Lu ◽  
OU Wang ◽  
Xueyan Wu ◽  
Bang Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enzyme Activity ◽  
Functional Data ◽  
Logistic Regression Model ◽  
Organ Damage ◽  
Chinese Patients ◽  
Hydroxylase Deficiency ◽  
High Incidence ◽  
Independent Risk Factors ◽  
Grade Increase

Abstract Objective To analyze the prevalence of hypertension-mediated organ damage (HMOD) and its relationship with enzyme activity of mutant CYP17A1 and other risk factors in patients with 17α-hydroxylase/17,20-lyase deficiency (17-OHD). Methods A total of 68 patients with 17-OHD were recruited in the Peking Union Medical Hospital from 2003 to 2021.The incidence of hypertension and HMOD was analyzed. CYP17A1 sequencing was performed for all patients and the enzyme activity of CYP17A1 mutant was determined by analyzing the characteristics of mutation itself and the functional data reported previously. A logistic regression model was employed to analyze the factors related to HMOD and the specific damaged organs in patients with 17-OHD. Result(s): Sixty-five patients (95.6%) exhibited hypertension,32 of whom were diagnosed with HMOD in this 17-OHD cohort. c.985_987del TAC ins AA (p. Y329KfsX418) (53.8%) and c.1459_1467del (p. del D487_F489) (11.4%) were the top 2 mutations in this cohort, and no correlation was found between enzyme activity of mutant CYP17A1 and HMOD. Age, hypertension grade, and hypokalemia grade were independent risk factors for HMOD in 17-OHD patients. The risk of HMOD increased by 27% for each additional year of age, 7.7-fold for each one-grade increase in hypertension level, and 1.7-fold for each grade of exacerbation of hypokalemia. Conclusion Patients with 17-OHD experience high incidence of HMOD. There was no correlation between the HMOD occurrence and enzyme activity of mutant CYP17A1.Age, hypertension grade, and hypokalemia grade are independent risks for the occurrence of HMOD.

scholarly journals Differences in initial versus recurrent diabetic foot ulcers at a specialized tertiary diabetic foot care center in China

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098739
Author(s):  
Yuxia Cheng ◽  
Ping Zu ◽  
Jie Zhao ◽  
Lintao Shi ◽  
Hongyan Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Blood Glucose Control ◽  
Diabetes Duration ◽  
Chinese Patients ◽  
Foot Care ◽  
Vascular Intervention ◽  
History Of ◽  
Independent Risk Factors ◽  
Recurrence Group

Objective To investigate the characteristics of diabetic foot ulcer (DFU) recurrence. Methods A total of 573 patients with DFUs were recruited and divided into an initial group (395 patients) and a recurrence group (178 patients). The factors related to recurrence were analyzed using multivariate regression. Results The recurrence group had longer diabetes duration (odds ratio [OR] 192; 95% confidence interval 120, 252 vs. 156; 96, 240); lower glycated hemoglobin levels (OR 8.1; 95% CI 6.8, 9.6 vs. 9.1; 7.4, 10.5), and higher rates than the initial group of amputation (37.5% vs. 2.0%), history of vascular intervention (21.3% vs. 3.9%), retinopathy (77.7% vs. 64.7%), callus (44.4% vs. 20.8%), foot deformity (51.2% vs. 24.6%), and outdoor sports shoe wearing (34.0% vs. 21.2%). Multiple factor logistic regression analysis showed that diabetes duration (OR 1.004), callus (OR 2.769), vascular intervention (OR 2.824) and amputation (OR 22.256) were independent risk factors for DFU recurrence. Conclusion Diabetes duration, callus, history of vascular intervention, and amputation were independent risk factors for recurrent DFUs in a cohort of Chinese patients with active DFU. The prevention and treatment of DFUs, especially callus treatment, foot care, and blood glucose control, should be improved in China.

Bleeding, thrombosis and transfusion in patients on ECMO: A retrospective study in a tertiary center in Hong Kong

2020 ◽  
pp. 039139882096558
Author(s):  
Ka Man Fong ◽  
Shek Yin Au ◽  
George Wing Yiu Ng ◽  
Anne Kit Hung Leung
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Primary Outcome ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
Chinese Patients ◽  
Bleeding Complications ◽  
Bleeding Events ◽  
Tertiary Center ◽  
Independent Risk Factors

Purpose: Use of anticoagulation in patients on ECMO, especially in Chinese, has always been difficult. This study aimed to review the incidence of bleeding, thrombosis, and transfusion requirement in Chinese ECMO patients and to identify risk factors for bleeding complications. Materials and Methods: This was a retrospective observational study of a tertiary hospital from 2010 to 2018. Patients aged ⩾18 years who received ECMO were included. The primary outcome was incidence of bleeding. Secondary outcomes included ICU mortality, hospital mortality, and length of the ICU and hospital stay. Results: Of the 130 patients, 55(42.3%) had at least one bleeding events and thrombosis occurred in 37(28.5%). A lower fibrinogen level (adjusted OR 0.56 (0.36–0.86), p = 0.009), bloodstream infection (adjusted OR 2.76 (1.01–7.53), p = 0.047) and longer duration on ECMO (adjusted OR 1.14 (1.02–1.27), p = 0.018) were independently associated with occurrence of bleeding. APTT (adjusted OR 0.99 (0.97–1.01), p = 0.370) and platelet count (adjusted OR 1.00 (0.98–1.01), p = 0.632) were not statistically significant risk factors for bleeding events. Conclusions: Bleeding and thrombosis were common complications in Chinese patients receiving ECMO. Hypofibrinogenemia and bloodstream infection, but not APTT nor platelet counts, were independent risk factors for bleeding events.

scholarly journals Analysis of Motor Complication and Relative Factors in a Cohort of Chinese Patients with Parkinson’s Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Baihua Sun ◽  
Tao Wang ◽  
Nianying Li ◽  
Jin Qiao
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Duration ◽  
Motor Fluctuations ◽  
Levodopa Therapy ◽  
Chinese Patients ◽  
Motor Complications ◽  
Dominant Type ◽  
Independent Risk Factors

Objective. Motor complications are common in Parkinson’s disease (PD). The reported occurrence of motor complications varies across regions and races. The aim of our study was to describe the development of dyskinesias and motor fluctuations among Chinese PD patients and the relative risk factors. Methods. In the current cross-sectional survey study, PD patients with motor fluctuations and dyskinesia were enrolled from March to November 2018 in Shaanxi province, a northwest area of China. Data were collected by the movement disorder specialists. A self-designed questionnaire was utilized during face-to-face interviews. In addition, the relevant factors of motor complications were analyzed by univariable and multivariable analyses. Results. Of the166 PD patients recruited, 52 (31.33%) and 25 (15.06%) patients had motor fluctuations and dyskinesia, respectively, which occurred in 6.76 ± 3.77 and 8.61 ± 4.46 years after the onset of motor symptoms and 5.37 ± 3.33 and 6.80 ± 3.43 years after the treatment of levodopa therapy, respectively. Patients with motor fluctuations and dyskinesias had longer disease duration, younger onset age, higher Hoehn–Yahr stages and UPDRS III scores, higher daily levodopa dosage and levodopa equivalent daily dose (LEDD), and longer duration of levodopa treatment (P<0.05). Bradykinesia-rigidity dominant patients had higher incidences of motor fluctuations (61.54% vs 38.46%) and dyskinesias (68.00% vs 32.00%) than tremor-dominant patients (P<0.05). Results of the multivariate logistic regression analyses showed that the duration of levodopa therapy, age of the onset, and bradykinesia-rigidity dominant type were independent risk factors of motor fluctuations (P<0.05). In addition, duration of disease and bradykinesia-rigidity dominant type were independent risk factors of dyskinesia (P<0.05). Conclusions. The rate of motor fluctuations was higher than dyskinesias in Chinese patients with Parkinson’s disease. Patients with younger age onset, bradykinesia-rigidity dominant type, longer disease duration, and longer duration of levodopa therapy are more likely to develop motor complications.

scholarly journals Value of Routine Flexible Sigmoidoscopy and Potential Predictive Factors for Colonic Ischemia after Open Ruptured Abdominal Aortic Aneurysm Repair

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 229
Author(s):  
Sigitas Urbonavicius ◽  
Ingrid Luise Feuerhake ◽  
Reshaabi Srinanthalogen ◽  
Martinas Urbonavicius ◽  
Tomas Baltrunas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Logistic Regression Model ◽  
Flexible Sigmoidoscopy ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Colonic Ischemia ◽  
Abdominal Aortic ◽  
Independent Risk Factors

Background and Objectives: colonic ischemia (CI) after ruptured abdominal aortic aneurysm (rAAA) repair is associated with increased morbidity and mortality. CI may be detected by using flexible sigmoidoscopy, but routine use of flexible sigmoidoscopy after rAAA is not clearly proven. The objective of this study was to evaluate the efficacy of routine flexible sigmoidoscopy in detecting CI after rAAA repair, and to identify potential hemodynamic, biochemical, and clinical variables that can predict the development of CI in the patients who underwent rAAA surgery. Materials and Methods: we retrospectively included all rAAA cases treated in Viborg hospital from 1 April 2014 until 31 August 2017, recorded the findings on flexible sigmoidoscopy, and the incidence of CI. We collected specific hemodynamic, biochemical, and clinical variables, measured pre- and perioperatively, and the first three postoperative days. The association between CI and possible predictors was analyzed in a logistic regression model. Results: a total of 80 patients underwent open rAAA repair during the study period. Flexible sigmoidoscopy was performed in 58 of 80 patients (73.5%) who survived at least 24 h after open rAAA surgery. Perioperative variables lowest arterial pH (p = 0.02) and types of operations—aortobifemoral bypass vs. straight graft (p = 0.04) showed statistically significant differences between CI groups. The analysis of the postoperative variables showed statistically significant difference in highest lactate on postoperative day 1 (p = 0.01), and lowest hemoglobin on postoperative day 2 (p = 0.04) comparing CI groups. Logistic regression model revealed that postoperative hemoglobin and lactate turned out to be independent risk factors for the development of CI (respectively OR = 0.44 (95% CI = 0.29–0.67) and OR = 1.91 (95% CI = 1.2–3.05)). Conclusions: flexible sigmoidoscopy can identify patients being at higher risk of mortality after open rAAA repair. The postoperative lactate and hemoglobin were found to be independent risk factors for the development of CI after open rAAA repair. Further larger studies are warranted to demonstrate these findings.

Trends of changes in the specific contribution of selected risk factors for shoulder dystocia over a period of more than two decades

2020 ◽  
Vol 48 (6) ◽  
pp. 567-573
Author(s):  
Leah Grossman ◽  
Gali Pariente ◽  
Yael Baumfeld ◽  
David Yohay ◽  
Reut Rotem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Linear Increase ◽  
Shoulder Dystocia ◽  
Fetal Weight ◽  
Independent Risk Factors ◽  
Specific Contribution ◽  
Over Time

AbstractObjectivesShoulder dystocia (SD) is an obstetrical emergency with well-recognized risk factors. We aimed to identify trends of changes in the specific contribution of risk factors for SD over time.MethodsA nested case control study comparing all singleton deliveries with and without SD was undertaken. A multivariable logistic regression model was used in order to identify independent risk factors for SD and a comparison of the prevalence and the specific contribution (odds ratio (OR)) of the chosen risk factors in three consecutive eight-year intervals from 1988 to 2014 was performed.ResultsDuring the study period, there were 295,946 deliveries. Of them 514 (0.174%) were complicated with SD. Between 1988 and 2014 the incidence of SD has decreased from 0.3% in 1988 to 0.1% in 2014. Using a logistic regression model grandmultiparity, diabetes mellitus (DM), fetal weight, and large for gestational age (LGA) were found to be independent risk factors for SD (OR 1.25 95% CI 1.04–1.51, p=0.02; OR 1.53 95% CI 1.19–1.97, p=0.001; OR 1.002 95% CI 1.001–1.002, p < 0.001; OR 3.88 95% CI 3.09–4.87, p < 0.001; respectively). While the OR for grandmultiparity, fetal weight, and LGA has significantly changed during the study period with a mixed trend, the OR of DM has demonstrated a significant linear increase over time.ConclusionsThe individual contribution of selected risk factors for the occurrence of SD has significantly changed throughout the years. The contribution of DM has demonstrated a linear increase over time, emphasizing the great impact of DM on SD.

Risk factors for anxiety and depression in Chinese patients undergoing surgery for endometrial cancer

2020 ◽  
Vol 98 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Bin Wang ◽  
Baohua Li ◽  
Shuai Tan ◽  
Jinguo Zhai ◽  
Min Chen
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Liver Disease ◽  
Postoperative Pain ◽  
Protective Factors ◽  
Nk Cell ◽  
Clinical Stage ◽  
Chinese Patients ◽  
Anxiety And Depression ◽  
Independent Risk Factors

This study analyzed risk factors for anxiety and depression in 714 patients who received surgery for endometrial cancer. Our data indicate that the incidence of postoperative anxiety and depression in 714 patients with endometrial cancer was 15.55% and 32.77%, respectively. Univariate and logistic regression analysis showed postoperative pain (odds ratio (OR) = 3.166, P = 0.000) and combined liver disease (OR = 2.318, P = 0.001) were independent risk factors for postoperative anxiety. Additionally, CD4+/CD8+ (OR = 0.513, P = 0.042) and natural killer (NK) cell ratios (OR = 0.692, P = 0.021) were independent protective factors for postoperative anxiety. As for depression, low literacy (OR = 1.943, P = 0.042), postoperative pain (OR = 2.671, P = 0.001), high clinical stage (OR = 3.469, P = 0.009), and combined liver disease (OR = 4.865, P = 0.000) were independent risk factors for postoperative depression. CD4+/CD8+ (OR = 0.628, P = 0.002) and NK cell ratio (OR = 0.710, P = 0.013) were independent protective factors for postoperative depression. In conclusion, patients with endometrial cancer have a higher incidence of postoperative anxiety and depression where postoperative pain, liver disease, and decreased immune function are risk factors for both anxiety and depression in these patients.

scholarly journals Impact of acute kidney injury on in-hospital outcomes in Chinese patients with community acquired pneumonia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dawei Chen ◽  
Hongbo Yuan ◽  
Changchun Cao ◽  
Zhihe Liu ◽  
Linglin Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Invasive Mechanical Ventilation ◽  
Kidney Injury ◽  
Community Acquired Pneumonia ◽  
Chinese Patients ◽  
Vasoactive Drugs ◽  
Hospital Outcomes ◽  
Independent Risk Factors

Abstract Background Acute kidney injury (AKI) is a frequent complication of community acquired pneumonia (CAP). However, the impact of AKI on in-hospital outcomes of patients with CAP in the Chinese population remains unclear. Methods Patients diagnosed with CAP were evaluated in this retrospective observational study. Multiple Cox regression models were employed to identify the association between AKI and in-hospital mortality and 30-day mortality, respectively. Results A total of 4213 patients were recruited; 950 (22.5%) patients were diagnosed with AKI. Independent risk factors for AKI were age, male gender, hypertension, cardiac dysfunction, diabetes, chronic kidney disease, acute respiratory failure, use of diuretics, use of vasoactive drugs, and CURB-65. Cox proportional hazards regression revealed AKI, use of angiotensin receptor blocker, hypertension, CURB-65, acute respiratory failure, and use of vasoactive drugs to be independent risk factors for both in-hospital and 30-day mortality. Compared to patients without AKI, those suffering AKI were found to have 1.31-fold (HR 1.31, 95% CI, 1.04–1.66; P = 0.023) and 1.29-fold (HR 1.29, 95% CI, 1.02–1.62; P = 0.033) increased in-hospital and 30-day mortality risks, respectively. In addition, patients with AKI were likely to require admission to intensive care unit (ICU) (42.9% versus 11.4%; P < 0.001), mechanical ventilation (33.8% versus 9.3%; P < 0.001), invasive mechanical ventilation (25.9% versus 5.8%; P < 0.001), non-invasive mechanical ventilation (25.4% versus 7.1%; P < 0.001), and experienced a longer duration of hospital stay (14 days versus 10 days; P < 0.001) than those without AKI. However, no significant difference in ICU stay (11 days versus 10 days; P = 0.099) and duration of mechanical ventilation (8 days versus 8 days; P = 0.369) between AKI and non-AKI groups was found. Conclusion AKI was common in Chinese patients with CAP. Patients with CAP who developed AKI had worse in-hospital outcomes.

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