scholarly journals Antithrombin activity is a significant predictor of early mortality in pulmonary embolism patients

2022 ◽  
pp. 6-6
Author(s):  
Boris Dzudovic ◽  
Jelena Dzudovic ◽  
Bojana Subotic ◽  
Slobodan Obradovic
Keyword(s):  
Pulmonary Embolism ◽  
Multivariate Analysis ◽  
Predictive Value ◽  
Cox Regression ◽  
Early Stage ◽  
Venous Blood ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Early Mortality ◽  
Cross Sectional

Introduction and aim. The role of antithrombin (AT) activity in the prediction of early mortality in patients with pulmonary embolism (PE), measured at an early stage of the disease, has not yet been investigated. Therefore the aim is to examine the predictive value of AT activity for all-cause 30-day mortality, measured in consecutive PE patients on admission to the hospital. Methodology. This is a single-center, clinical retrospective cross-sectional study, which followed consecutive patients with acute PE in the period from 2014-2021. On admission to the hospital, venous blood was taken from patients for laboratory analyzes, from which, in addition to basic analyzes, the activity of AT was also measured. The basic parameters of the patients were recorded on admission and through univariate analysis, their connection with 30-day mortality was tested. The predictive significance of AT values for 30-day mortality was tested through quartile values by comparing the first quartile with all others together. Cox regression model analysis was used in the multivariate analysis where one parameter marked as significant in the univariate analysis was added to the basic model (AT, age and risk affiliation in two groups). Results. A total of 378 PE patients were included in the study. The total all-cause 30-day mortality was 30 patients (7.8%). Patients with AT activity in the first quartile had significantly higher early mortality compared with the other quartiles combined (log rank p = 0.001). AT retained a significant predictive value for early mortality in the multivariate analysis despite the comorbidity present, which also significantly affected mortality. Conclusion. Low AT activity measured at admission in PE patients is a significant and independent predictor of 30-day mortality.

scholarly journals Access to childbirth care by adolescents and young people in the Northeastern region of Brazil

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Érida Zoé Lustosa Furtado ◽  
Keila Rejane Oliveira Gomes ◽  
Silvana Granado Nogueira da Gama
Keyword(s):  
Multivariate Analysis ◽  
Health Insurance ◽  
Young People ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Cross Sectional ◽  
Northeast Region ◽  
Childbirth Care

ABSTRACT OBJECTIVE To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil. METHODS Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson’s Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed. RESULTS Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3%) had to travel in search of assisted birth, and the majority (66.7%) of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20) with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015), with no health insurance (p < 0.002) and from the countryside (p < 0.001) were more likely to have inadequate access to childbirth care. CONCLUSIONS Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this access and, consequently, minimize the maternal and fetal risks that arise from a lack of systematic hospitalization planning.

Plasma Irisin Levels in Subjects with Type 1 Diabetes: Comparison with Healthy Controls

2018 ◽  
Vol 50 (11) ◽  
pp. 803-810 ◽  
Author(s):  
Anastasios Tentolouris ◽  
Ioanna Eleftheriadou ◽  
Dimitrios Tsilingiris ◽  
Ioanna Anastasiou ◽  
Ourania Kosta ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 1 Diabetes ◽  
Multivariate Analysis ◽  
Waist Circumference ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Serum Triglycerides ◽  
Cross Sectional

AbstractIrisin is a myokine that increases energy expenditure. In this cross-sectional study, we examined for differences in plasma irisin concentrations between subjects with type 1 diabetes mellitus and healthy individuals and searched for associations between plasma irisin levels and clinical and biochemical characteristics as well as self-reported physical activity. A total of 79 subjects with type 1 diabetes [age 38.2±12.5 years, men/women (n): 27/52], were consecutively recruited. Moreover, 53 healthy controls, matched for age and body mass index with those with diabetes were recruited. Plasma irisin was measured with ELISA. Participants were asked about their physical activity during the last week. We also measured trunk and visceral fat. Circulating irisin levels were lower in subjects with diabetes than in controls [median value (interquartile range): 53.0 (35.2, 106.3) vs. 178.1 (42.6, 641.6) ng/ml, respectively, p<0.001]. In the group of diabetes, univariate analysis showed that irisin levels were associated with waist circumference (beta=–0.283, p=0.023), serum triglycerides (beta=–0.282, p=0.031), and trunk fat (beta=–0.324, p=0.012). In multivariate analysis after adjustment for potential confounders, irisin levels were associated independently only with waist circumference (beta=–0.403, p=0.005). Among controls, multivariate analysis demonstrated that irisin levels were associated with pack-years of smoking (beta=–0.563, p=0.012) and fasting triglycerides (beta=–0.338, p=0.041). Circulating irisin levels were lower in subjects with diabetes in comparison with healthy-matched controls. In conclusion, plasma irisin concentrations in subjects with diabetes were associated with waist circumference, while in controls with serum triglycerides and pack-years of smoking.

scholarly journals Schizophrenia among patients with systemic lupus erythematosus: population-based cross-sectional study

2016 ◽  
Vol 26 (4) ◽  
pp. 424-429 ◽  
Author(s):  
S. Tiosano ◽  
A. Farhi ◽  
A. Watad ◽  
N. Grysman ◽  
R. Stryjer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Multivariate Analysis ◽  
Lupus Erythematosus ◽  
Univariate Analysis ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Medical Database ◽  
Systemic Lupus ◽  
Cross Sectional

Aims.Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease involving multiple organs, including the central nervous system. Evidence of immune dysfunction exists also in schizophrenia, a psychiatric illness involving chronic or recurrent psychosis. The aim of our study was to investigate if there is an epidemiological association between SLE and schizophrenia.Method.A cross-sectional study was conducted comparing patients with SLE with age and gender-matched controls regarding the proportion of patients with comorbid schizophrenia. χ2- and t-tests were used for univariate analysis, and interaction of schizophrenia with SLE across strata of covariates was checked. A logistic regression model was used for multivariate analysis. The study was performed utilising the medical database of Clalit Health Services in Israel.Results.The study included 5018 patients with SLE and 25 090 controls. SLE patients had a female predominance, and a higher proportion of smoking compared with age and sex-matched controls. In multivariate analysis, SLE was found to be independently associated with schizophrenia while controlling for age, gender, socioeconomic status (SES) and smoking (OR 1.33, p = 0.042).Conclusions.We found a positive association between SLE and schizophrenia across patients of different age, gender and SES. This association can contribute to understanding the pathophysiology of the two disorders and may also have clinical implications for earlier as well as better diagnosis and treatment.

scholarly journals PLATELET COUNT SQUARED/SPLEEN DIAMETER-ASPARTATE AMINOTRANSFERASE RATIO: NON-INVASIVE METHOD TO PREDICT ESOPHAGEAL VARICES

2017 ◽  
Vol 54 (3) ◽  
pp. 222-224 ◽  
Author(s):  
Ângelo Zambam de MATTOS ◽  
Larissa Faraco DAROS ◽  
Angelo Alves de MATTOS
Keyword(s):  
Logistic Regression ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Aspartate Aminotransferase ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

ABSTRACT BACKGROUND - Variceal bleeding has a high mortality among cirrhotics, and screening with endoscopy is indicated at the diagnosis of cirrhosis. Screening with endoscopy implies discomfort, risks and considerable costs. OBJECTIVE - To evaluate platelet count squared/spleen diameter-aspartate aminotransferase ratio (PS/SA), as a non-invasive predictor of esophageal varices in cirrhotics. METHODS - This cross-sectional study evaluated cirrhotics for PS/SA and presence of esophageal varices. Outpatient records of cirrhotic patients were reviewed for the abovementioned data. Sensitivity, specificity, negative and positive predictive values of PS/SA were calculated. After the univariate analysis, variables with P<0.10 were submitted to a logistic regression. RESULTS - The study included 164 cirrhotics, 59.70% male, with a mean age of 56.7 years. Hepatitis C was the most frequent cause of cirrhosis, being present in 90 patients. Patients were classified as Child-Pugh A in 52.44% and as Child-Pugh B or C in 47.56%. Esophageal varices were present in 72.56% of the patients at endoscopy. PS/SA, with a cutoff of 3x108, had a sensitivity of 95.80% (confidence interval of 95% - 95%CI=0.92-0.99), a specificity of 22.70% (95%CI=0.10-0.35), a positive predictive value of 77.20% (95%CI=0.70-0.84) and a negative predictive value of 66.70% (95%CI=0.42-0.91). In the logistic regression, only platelet count and Child-Pugh score were associated to esophageal varices (P<0.05). CONCLUSION - PS/SA has an excellent sensitivity to predict esophageal varices, allowing almost one fourth of patients without esophageal varices to spare endoscopy. Nevertheless, PS/SA is not independently associated to esophageal varices.

scholarly journals P1361IS THE INFLAMMATORY STATE A DETERMINING FACTOR OF THE PRIMARY PERMEABILITY OF ARTERIOVENOUS FISTULES?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
LUIS GUILLERMO PICCONE SAPONARA ◽  
MARIA PAZ CASTRO FERNÁNDEZ ◽  
NANCY GIOVANNA URIBE HEREDIA ◽  
Agustin Carreno ◽  
SARA ANAYA FERNANDEZ ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Vascular Access ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Statin Treatment ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Low Grade ◽  
Cross Sectional ◽  
Inflammatory Parameters

Abstract Background and Aims Clinical practice guidelines recommend an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis and are associated with a lower incidence of morbidity and mortality. However, primary vascular access (AV) failure is not uncommon. Low-grade inflammation is present in ERCT. We identify the inflammatory parameters that influence the primary permeability of vascular access for hemodialysis. Method Cross-sectional study; We include all the AVs performed in the HGUCR. We evaluate the initial operation after the creation of the AV. Demographic variables (age, sex), aetiology of CKD and associated comorbidity were collected. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and are compared using the Chi2 Test. Quantitative variables are expressed as mean ± standard deviation and the t-student was used to compare them. We performed a multivariate analysis to determine those factors involved in the primary failure of the VA. Statistical significance for a value of p &lt;0.05. Results 600 VA performed on 466 patients were reviewed between October 2009 and December 2019. 492 autologous VA (86.8%) and 75 prosthetic VA (13.2%) were performed. The mean age of the patients was 65.3 ± 14.2 years and 66.2% were male. The most frequent etiology of CKD was diabetic nephropathy (29.9%), followed by non-affiliated (18%) and glomerulonephritis (16.5%). 90.8% of the patients had arterial hypertension (HT), diabetes mellitus (DM) 48%. 77.2% of AV presented primary permeability. In the univariate analysis using Chi2 and T student, statistical age (p = 0.017), HT (p = 0.002), statin treatment (p = 0.002), antiplatelet therapy (p = 0.001), low ferritin levels (p = 0.011) and PCR (p = 0.019). When performing a multivariate analysis, the high CRP figures (OR: 0.64 95% CI 0.42-0.98 p = 0.043) and ferritinemia (OR: 1.04 95% CI 1.01-1.06 p = 0.013) are predictive factors of primary AV failure. Conclusion In our study, high CRP decreases the probability of primary functioning of AVFs by 36% and elevated ferritin levels are predictors of primary failure after adjusting for age and sex in the multivariate model.

scholarly journals Association between schizophrenia and an autoimmune bullous skin disease-pemphigus: a population-based large-scale study

2017 ◽  
Vol 28 (2) ◽  
pp. 191-198 ◽  
Author(s):  
K. Kridin ◽  
S. Zelber-Sagi ◽  
D. Comaneshter ◽  
A. D. Cohen
Keyword(s):  
Multivariate Analysis ◽  
Large Scale ◽  
Matched Control ◽  
Univariate Analysis ◽  
Real Life ◽  
Population Based ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Wide Range

Aims.Immunological hypotheses have become increasingly prominent suggesting that autoimmunity may be involved in the pathogenesis of schizophrenia. Schizophrenia was found to be associated with a wide range of autoimmune diseases. However, the association between pemphigus and schizophrenia has not been established yet. We aimed to estimate the association between pemphigus and schizophrenia using a large-scale real-life computerised database.Methods.This study was conducted as a cross-sectional study utilising the database of Clalit Health Services. The proportion of schizophrenia was compared between patients diagnosed with pemphigus and age-, gender- and ethnicity-matched control subjects. Univariate analysis was performed usingχ2and Student'st-test and a multivariate analysis was performed using a logistic regression model.Results.A total of 1985 pemphigus patients and 9874 controls were included in the study. The prevalence of schizophrenia was greater in patients with pemphigus as compared to the control group (2.0%v. 1.3%, respectively;p= 0.019). In a multivariate analysis, pemphigus was significantly associated with schizophrenia (OR, 1.5; 95% CI, 1.1–2.2). The association was more prominent among females, patients older than 60 years, and Jews.Conclusions.Pemphigus is significantly associated with schizophrenia. Physicians treating patients with pemphigus should be aware of this possible association. Patients with pemphigus should be carefully assessed for comorbid schizophrenia and be treated appropriately.

scholarly journals Role of urinary podocalyxin in early diagnosis of diabetic nephropathy

2020 ◽  
Vol 58 (4) ◽  
pp. 233-241
Author(s):  
Irena Kostovska ◽  
Katerina Tosheska Trajkovska ◽  
Svetlana Cekovska ◽  
Sonja Topuzovska ◽  
Julijana Brezovska Kavrakova ◽  
...  
Keyword(s):  
Early Detection ◽  
Early Stage ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Control Group ◽  
Specific Marker ◽  
Cross Sectional ◽  
Podocyte Injury ◽  
Significant Difference ◽  
Biochemical Analyses

AbstractIntroduction. Podocyte injury has been reported as an early feature of DN therefore, the assessment of podocyte injury can be accomplished by estimation of podocalyxin in urine. This study aimed to estimate the urinary podocalyxin levels and to determine the sensitivity and specificity of this biomarker for early detection of DN.Materials and methods. A total of 90 patients with type 2 diabetes mellitus (T2DM) were included in this cross-sectional study. Sixty of them were without diagnosed DN, and 30 with diagnosed DN. A control group consisted of 30 healthy subjects. All patients with T2DM were divided into three subgroups according to urinary microalbumin/creatinine ratio (UM/CR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Urine samples, were used for measurement of podocalyxin by ELISA, creatinine and microalbumin. Fasting venous blood samples was collected for biochemical analyses.Results. The levels of urinary podocalyxin (u-PDX) were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied subgroups regarding u-PDX was found (p < 0.05). Levels of u-PDX are increasing gradually with the degree of DN (p < 0.029). u-PDX levels were positively correlated with UM/CR (r = 0.227, p = 0.002). A cut-off level of 43.8 ng/ml u-PDX showed 73.3% sensitivity and 93.3% specificity to detect DN in early stage. A cut-off level of 30 mg/g UM/CR showed 41.5% sensitivity and 90% specificity in predicting DN. u-PDX was elevated in 48,2% of normoalbuminuric patients.Conclusion. Urinary podocalyxin be useful and more sensitive and specific marker in early detection of DN than microalbuminuria.

scholarly journals Cord blood bilirubin level as a predictor of development of pathological hyperbilirubinemia in new-borns

2017 ◽  
Vol 4 (4) ◽  
pp. 1519 ◽  
Author(s):  
Ashish Pradhan ◽  
Rachna Lamichaney ◽  
Vibhu Sharma
Keyword(s):  
Cord Blood ◽  
Bilirubin Level ◽  
Predictive Value ◽  
Total Bilirubin ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
New Born ◽  
The Mean

Background: There may be a delay in recognition of pathological hyperbilirubinemia which may lead to serious consequences in the new born. The purpose of this study was to verify whether the cord bilirubin levels predicted the development of pathological hyperbilirubinemia.Methods: In this hospital based prospective cross-sectional study conducted at Central Referral Hospital, Gangtok from December 2014 to November 2015, 202 live new born meeting the inclusion criteria were enrolled. After birth, cord blood was collected for the estimation of cord blood bilirubin and the babies were followed up daily for the development of clinical jaundice. Peripheral venous blood was collected for the estimation of serum bilirubin levels in those who developed clinical jaundice.Results: The incidence of pathological hyperbilirubinemia in our study is 12.87%. The mean gestational age is 38.3 weeks. There is a significant association between cord blood total bilirubin levels and the development of pathological hyperbilirubinemia in newborns with a P-value of 0.000. A critical cord bilirubin level ≥ 2.50mg/dl has sensitivity of 84.1%, specificity of 88.5%, positive predictive value of 98% and negative predictive value of 45.1% for predicting the risk of developing pathological jaundice.Conclusions: This study concludes that cord blood total bilirubin levels reliably predict the occurrence of pathological hyperbilirubinemia as defined by current operational guidelines. 

scholarly journals Epidemiology of SARS-CoV-2 antibodies among firefighters/paramedics of a US fire department: a cross-sectional study

2020 ◽  
Vol 77 (12) ◽  
pp. 857-861 ◽  
Author(s):  
Alberto J Caban-Martinez ◽  
Natasha Schaefer-Solle ◽  
Katerina Santiago ◽  
Paola Louzado-Feliciano ◽  
Angel Brotons ◽  
...  
Keyword(s):  
Predictive Value ◽  
Early Stage ◽  
Serological Test ◽  
Fire Department ◽  
Cross Sectional Study ◽  
South Florida ◽  
Sectional Study ◽  
Antibody Testing ◽  
Cross Sectional ◽  
Fire Station

ObjectivesWe estimate the point seroprevalence of SARS-CoV-2 antibodies in the frontline firefighter/paramedic workforce of a South Florida fire department located in the epicentre of a State outbreak.MethodsA cross-sectional study design was used to estimate the point seroprevalence of SARS-CoV-2 antibodies using a rapid immunoglobulin (Ig)M-IgG combined point-of-care lateral flow immunoassay among frontline firefighters/paramedics collected over a 2-day period, 16–17 April 2020. Fire department personnel were emailed a survey link assessing COVID-19 symptoms and work exposures the day prior to the scheduled drive-through antibody testing at a designated fire station. Off-duty and on-duty firefighter/paramedic personnel drove through the fire station/training facility in their personal vehicles or on-duty engine/rescue trucks for SARS-CoV-2 antibody testing.ResultsAmong the 203 firefighters/paramedics that make up the fire department workforce, 18 firefighters/paramedics (8.9%) tested positive for SARS-CoV-2 antibodies, of which 8 firefighters/paramedics (3.9%) were IgG positive only, 8 (3.9%) were IgM positive only and 2 (0.1%) were IgG/IgM positive. The positive predictive value (PPV) of the serological test is estimated to be 33.2% and the negative predictive value is 99.3%. The average number of COVID-19 case contacts (ie, within 6 feet of an infected person (laboratory-confirmed or probable COVID-19 patient) for ≥15 min) experienced by firefighters/paramedics was higher for those with positive serology compared with those with negative (13.3 cases vs 7.31 cases; p=0.022). None of the antibody positive firefighters/paramedics reported receipt of the annual influenza vaccine compared with firefighters/paramedics who tested negative for SARS-CoV-2 antibodies (0.0% vs 21.0%; p=0.027).ConclusionRapid SARS-CoV-2 IgM-IgG antibody testing documented early-stage and late-stage infection in a firefighter workforce providing insight to a broader medical surveillance project on return to work for firefighters/paramedics. Given the relatively low PPV of the serological test used in this study back in April 2020, caution should be used in interpreting test results.

scholarly journals Clinical and echocardiographic predictors of silent cerebral infarctions in patients with persistent atrial fibrillation

2014 ◽  
Vol 20 (2) ◽  
pp. 10-17
Author(s):  
Oleg Sychov ◽  
Artem Borodai ◽  
Svetlana Fedkiv ◽  
Elina Borodai ◽  
Taisia Getman ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Multivariate Analysis ◽  
Creatinine Clearance ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Persistent Atrial Fibrillation ◽  
Cross Sectional Study ◽  
Neurological Dysfunction ◽  
Cross Sectional ◽  
History Of

Summary Aim. The aims of the study were to evaluate prevalence of silent cerebral infarctions (SCI) and determine their clinical and echocardiographic predictors in patients with atrial fibrillation (AF). Patients and methods. In prospective cross sectional study we examined 134 patients with non-valvular AF. Clinical examination, laboratory tests, transoesophageal, transthoracic echocardiography and multislice computed tomography of the brain were performed for all patients. According to current guidelines, SCI was defined as imaging (≥3 mm) or neuropathological evidence of central nervous system infarction, without a history of acute neurological dysfunction attributable to the lesion. Results. Silent cerebral infarctions were detected in 34.3% (n = 46) of patients, and infarctions ≥ 15 mm (mean diameter 31.3 mm) were detected in 11.2% (n = 15) of patients. Superficial SCIwere found in 12.7%and basal SCI in 21.6% of cases. In multivariate analysis low creatinine clearance < 90 ml/min was independently associated with small basal SCI (p = 0.04). In univariate analysis age ≥ 65 years was significantly associated with basal SCI, p = 0.004, but not with SCI ≥ 15 mm or superficial SCI. The results of multivariate analysis showed that CHA2DS2VASc score was an independent predictor of superficial SCI; low left atrial appendage velocity (LAAV) < 30 cm/s was independently associated both with SCI ≥ 15 mm (p = 0.03) and superficial SCI (p = 0.02). Conclusions. Large and superficial SCI were significantly and independently associated with low LAAV < 30 cm/s and other echocardiographic embolic risk factors and in case of absence of significant large arteries atherosclerosis may be considered as those of cardiac origin. Small basal SCI were associated with age and low creatinine clearance < 90 ml/min which was their independent predictor. CHA2DS2VASc score is useful for assessment of risk of cerebral infarctions even those without history of acute symptoms

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