scholarly journals Risk Factors of Postoperative Shivering at Post Anesthesia Care Unit in Normothermic Patients Underwent General Anesthesia

2021 ◽  
Author(s):  
Laortip Rattanapittayaporn ◽  
Maliwan Oofuvong
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Core Temperature ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Emergency Case ◽  
Increased Risk ◽  
Duration Of Surgery

Objective: The aim of study was to identify risk factors that can be modified to reduce incidence of postoperative shivering in normothermic patient who underwent general anesthesia.Material and Methods: A retrospective case control study was conducted between January 2017 and August 2018 by assessing the anesthetic records of normothermic patients at a post anesthesia care unit who underwent general anesthesia. A control group of 201 patients was randomly matched with 201 cases by age (±5 years) and site of surgery. Medical records were reviewed for data including patient demographics, operative time, anesthetic medication, type of fluid, core temperature at the end of surgery and occurrence of postoperative shivering. Conditional logistic regression analysis was performed to assess the association between potential risk factors and postoperative shivering.Results: Higher body mass index (BMI) [odds ratio (OR) 0.91, 95% confidence interval (CI) 0.87-0.96] and higher core temperature at end of surgery (OR 0.33 95% CI 0.18-0.63) are associated with reduced risk of postoperative shivering. Whereas emergency case compared with elective case (OR 3.06 95% CI 1.63-5.72) and longer duration every 10 minutes (OR 1.05 95% CI 1.03-1.08) are associated with an increased risk of postoperative shivering.Conclusion: Emergency case, longer duration of surgery, lower BMI and lower core temperature at end of surgery were significantly associated with postoperative shivering.

scholarly journals The effects of antibiotic exposure on asthma in children with atopic dermatitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
I-Lun Chen ◽  
Ming-Kai Tsai ◽  
Hao-Wei Chung ◽  
Hui-Min Hsieh ◽  
Yu-Ting Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atopic Dermatitis ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Case Group ◽  
Antibiotic Exposure ◽  
Defined Daily Doses ◽  
Increased Risk ◽  
Asthma In Children ◽  
New Onset

AbstractEarly-life antibiotic use is associated with allergic diseases. The risk factors for the progression from atopic dermatitis (AD) to asthma or allergic rhinitis are still unknown. We aimed to investigate the association between exposure to different antibiotics and the risk of new-onset asthma in children with AD. By using the Longitudinal Health Insurance Database 2005, we selected AD patients less than 6 years old identified by ICD-9-CM code 691.8. The case group was defined as those having new-onset asthma, and the control group was defined as those without an asthma history. Information on antibiotic exposure in the 5 years prior to the index date was collected from drug prescription records. We estimated the adjusted odds ratio by using conditional logistic regression, adjusted for age, sex, index year, other potential risk factors and antibiotics. Antibiotic exposure was associated with the development of asthma in patients with AD (aOR = 3.68, 95% CI 2.13–6.36), particularly for patients less than 5 years old (aOR = 4.14, 95% CI 2.24–7.64) (p for trend < 0.001), even though lower cumulative antibiotic defined daily doses (DDDs) were associated with new-onset asthma occurrence. Antibiotic exposure, especially macrolide exposure, is associated with an increased risk of asthma in patients with AD.

scholarly journals Risk Factors for Intraoperative Pressure Injury in Aortic Surgery: A Nested Case-Control Study

2020 ◽  
Author(s):  
Yao Dong
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Conditional Logistic Regression ◽  
Aortic Surgery ◽  
Case Control ◽  
Control Group ◽  
Single Factor ◽  
Increased Risk ◽  
Pressure Injury ◽  
Nested Case Control

Aims and Objectives: The aim of this study was to identify risk factors associated with an increased risk of intraoperativepressure injury in patients undergoing aortic surgery.Background: Intraoperative pressure injuries are some of the most significant health problems in clinical practice.According to previous studies, patients undergoing aortic surgery are at high risk of developing an intraoperative pressure injury, with an incidence much higher than that associated with other types of cardiac surgery.Design: This was a nested case-control study.Methods: Following the STROBE checklist, a nested case-control approach was adopted in this study. A patient cohort was selected on the basis of inclusion and exclusion criteria from patients undergoing aortic surgery. Data were collected from these patients by means of a tailored questionnaire designed in-house. Patients with intraoperative pressure injury at the end of surgery were identified as the case group, while the control group consisted of patients without intraoperative pressure injury. Patients in the groups underwent 1:1 matching based on age and sex. Initially,a single-factor analysis was conducted between the two groups. Subsequently, risk factors for intraoperative pressureinjury were identified through conditional logistic regression analysis with use of the variables that exhibited statisticallysignificant differences in the single-factor analysis.Results: A total of 400 patients were selected. Among these, 167 patients experienced intraoperative pressure injury at an incidence rate of 41.8%. Strict preoperative bed confinement, deep hypothermic circulatory arrest during surgery,application of norepinephrine or dopamine during surgery, and intraoperative skin wetting were associated with theoccurrence of intraoperative pressure injury in patients undergoing aortic surgery.Conclusions: Nurses should thoroughly assess the risk of intraoperative pressure injury and implement appropriatepreventative interventions, particularly in high-risk patients undergoing aortic surgery.

scholarly journals Relationship of Hydroxychloroquine and Ophthalmic Complications in Patients with Type 2 Diabetes in Taiwan

2021 ◽  
Vol 18 (15) ◽  
pp. 8154
Author(s):  
Hung-Chih Chen ◽  
Hung-Yu Lin ◽  
Michael Chia-Yen Chou ◽  
Yu-Hsun Wang ◽  
Pui-Ying Leong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Conditional Logistic Regression ◽  
Categorical Variables ◽  
Control Group ◽  
Case Group ◽  
Research Database ◽  
Continuous Variables ◽  
Chi Square ◽  
Increased Risk

The purpose of this study is to evaluate the relationship between hydroxychloroquine (HCQ) and diabetic retinopathy (DR) via the national health insurance research database (NHIRD) of Taiwan. All patients with newly diagnosed type 2 diabetes (n = 47,353) in the NHIRD (2000–2012) were enrolled in the study. The case group consists of participants with diabetic ophthalmic complications; 1:1 matching by age (±1 year old), sex, and diagnosis year of diabetes was used to provide an index date for the control group that corresponded to the case group (n = 5550). Chi-square test for categorical variables and Student’s t-test for continuous variables were used. Conditional logistic regression was performed to estimate the adjusted odds ratio (aOR) of DR. The total number of HCQ user was 99 patients (1.8%) in the case group and 93 patients (1.7%) in the control group. Patients with hypertension (aOR = 1.21, 95% CI = 1.11–1.31) and hyperlipidemia (aOR = 1.65, 95% CI = 1.52–1.79) significantly increased the risk of diabetic ophthalmic complications (p < 0.001). Conversely, the use of HCQ and the presence of rheumatoid diseases did not show any significance in increased risk of DR. HCQ prescription can improve systemic glycemic profile, but it does not decrease the risk of diabetic ophthalmic complications.

scholarly journals Role of CASP7 polymorphisms in noise-induced hearing loss risk in Han Chinese population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanmei Ruan ◽  
Jinwei Zhang ◽  
Shiqi Mai ◽  
Wenfeng Zeng ◽  
Lili Huang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Chinese Population ◽  
Conditional Logistic Regression ◽  
Han Chinese ◽  
Control Group ◽  
Environment Interaction ◽  
Noise Induced Hearing Loss ◽  
Han Chinese Population ◽  
Hearing Thresholds ◽  
Increased Risk

AbstractGenetic factors and gene-environment interaction may play an important role in the development of noise induced hearing loss (NIHL). 191 cases and 191 controls were selected by case–control study. Among them, case groups were screened from workers exposed to noise in binaural high-frequency hearing thresholds greater than 25 dB (A). Workers with hearing thresholds ≤ 25 dB (A) in any binaural frequency band were selected to the control group, based on matching factors such as age, exposure time to noise, and operating position. The blood samples from two groups of workers were subjected to DNA extraction and SNP sequencing of CASP3 and CASP7 genes using the polymerase chain reaction ligase detection reaction method. Conditional logistic regression correction was used to analyze the genetic variation associated with susceptibility to NIHL. There was an association between rs2227310 and rs4353229 of the CASP7 gene and the risk of NIHL. Compared with the GG genotype, the CC genotype of rs2227310 reduced the risk of NIHL. Compared with CC genotype, the TT genotype of rs4353229 reduced the risk of NIHL. Workers carrying the rs2227310GG and rs4353229CC genotype had an increased risk of NIHL compared to workers without any high-risk genotype. There were additive interaction and multiplication interaction between CASP7rs2227310 and CNE, and the same interaction between CASP7rs4353229 and CNE. The interaction between the CASP7 gene and CNE significantly increased the risk of NIHL. The genetic polymorphisms of CASP7rs2227310GG and CASP7rs4353229CC were associated with an increased risk of NIHL in Han Chinese population and have the potential to act as biomarkers for noise-exposed workers.

scholarly journals Obesity is positively related and tobacco smoking and alcohol consumption are negatively related to an increased risk of thyroid cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Soo-Youn An ◽  
So Young Kim ◽  
Dong Jun Oh ◽  
Chanyang Min ◽  
Songyoung Sim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Alcohol Consumption ◽  
Smoking Status ◽  
Conditional Logistic Regression ◽  
Overweight And Obesity ◽  
Control Group ◽  
Increased Risk ◽  
Region Of Residence ◽  
Korean National Health Insurance ◽  
Comorbidity Index

Abstract The purpose of this study was to evaluate the relationships of smoking, alcohol consumption, and obesity with thyroid cancer in Korean residents. The Korean National Health Insurance Service-Health Screening Cohort includes individuals ≥ 40 years who were assessed from 2002 to 2013. In total, 4977 thyroid cancer participants were matched with respect to age, sex, income, and region of residence with 19,908 controls at a ratio of 1:4. Crude and adjusted (for the Charlson comorbidity index, smoking status, frequency of alcohol consumption, and obesity) odds ratios (ORs) were analyzed using conditional logistic regression analyses. Additionally, 95% confidence intervals (CIs) were calculated. The adjusted OR of smoking for thyroid cancer was 0.62 (95% CI 0.54–0.72, P < 0.001), and that of alcohol consumption was 0.83 (95% CI 0.75–0.92, P < 0.001). The adjusted ORs of the BMI categories were 1.13 (95% CI 1.05–1.22, P = 0.002) for obese I, and 1.24 (95% CI 1.04–1.47, P = 0.014) for obese II. The ORs of smoking and alcohol consumption were lower, and those of overweight and obesity were higher in thyroid cancer patients than in individuals in the control group.

scholarly journals Malnutrition Was Not Related With Emergence Delirium in Elderly Patients After Noncardiac Surgery

2021 ◽  
Author(s):  
Fang Zhang ◽  
Shu-Ting He ◽  
Yan Zhang ◽  
Dong-Liang Mu ◽  
Dong-Xin Wang
Keyword(s):  
Elderly Patients ◽  
Multivariable Analysis ◽  
Noncardiac Surgery ◽  
Nutritional Risk ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Emergence Delirium ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
The Relationship

Abstract Background: Delirium is one of the most common complications in elderly surgical patients. Although previous studies reported that preoperative malnutrition was related with postoperative delirium (POD), there was lack of evidence to illustrate the relationship between malnutrition and emergency delirium (ED). The objective of this study was to investigate the relationship between preoperative malnutrition and ED in elderly patients undergoing noncardiac surgery.Methods: The study was carried out in accordance with STROBE guidelines. This was a secondary analysis of a prospective cohort study. Elderly patients (65-90 years) who underwent noncardiac surgery under general anesthesia were enrolled in Peking University First Hospital.Preoperative malnutrition was defined as nutritional risk screening 2002 (NRS 2002) ≥3. Emergence delirium was assessed by Confusion Assessment Method for intensive care unit at 10 and 30 min after Post-anesthesia care unit (PACU) admission, and before PACU discharge. Multivariable analysis was employed to analyze the relationship between malnutrition and emergence delirium.Results: 915 patients were enrolled. The incidence of malnutrition was 53.6% (490/915). The incidence of emergency delirium was 41.8% (205/490) in malnutrition group and 31.5% (134/425) in control group, P<0.001. After adjusting confounding factors (i.e., age, mild cognitive impairment, American Society of Anesthesiologists classification (ASA), duration of surgery, pain score, low body temperature and allogeneic blood transfusion), malnutrition was not associated with increased risk of emergency delirium (OR=1.055, 95% CI 0.767-1.452, P=0.742).Conclusions: Malnutrition was common in elderly patients undergoing non-cardiac surgery, but it’s not related with emergence delirium after adjusted for confounders.Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn) (Number: ChiCTR-OOC-17012734).

Association between statin use and the risks of glaucoma in Australia: a 10-year cohort study

2021 ◽  
pp. bjophthalmol-2021-318789
Author(s):  
Yixiong Yuan ◽  
Wei Wang ◽  
Xianwen Shang ◽  
Ruilin Xiong ◽  
Jason Ha ◽  
...  
Keyword(s):  
Large Scale ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Case Group ◽  
Conditional Logistic Regression Model ◽  
The People ◽  
Increased Risk ◽  
Nested Case Control ◽  
Statin Use

SynopsisIn a cohort of middle-aged and elderly Australians, we found that long-term statin use was associated with a higher risk of glaucoma onset. As to subtypes of statins, the increased risk was only found in rosuvastatin users.PurposeTo investigate the relationship between statin use and glaucoma onset in a 10-year longitudinal study.MethodsThis nested case–control study was based on data from a large-scale cohort of Australians aged over 45 years old. Medication exposure was identified by claims records from the Pharmaceutical Benefits Scheme during the follow-up period (2009–2016). The onset of glaucoma was defined as the people with at least three claims of antiglaucoma medications. Controls matched by age, gender and cardiovascular diseases were selected from participants without prescription of antiglaucoma medications. A conditional logistic regression model was used to assess the association between statin use and glaucoma onset.ResultsThe proportion of statin users was higher in the case group (40.5%) than that in the control group (38.4%). After adjusting for baseline characteristics and longitudinal claims records, statin use was not associated with glaucoma onset (OR 1.04, 95% CI 0.97 to 1.11). However, an increased risk of glaucoma onset was observed in participants with a longer duration of statin use (>3 years vs <1 year: OR 1.12, 95% CI 1.04 to 1.21). With respect to specific types of statins, participants taking rosuvastatin were more likely to suffer from glaucoma (OR 1.11, 95%CI 1.01 to 1.22). The use of other statins was not significantly associated with glaucoma onset.ConclusionsLong-term statin use was found to be associated with a higher risk of glaucoma onset in this study. Regarding specific types of statins, the increased risk of glaucoma onset was only observed in users of rosuvastatin.

Intraoperative Awareness

2018 ◽  
pp. 443-446
Author(s):  
Jennifer Knuth ◽  
Lindsay Gennari ◽  
John Cagino
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Trauma Surgery ◽  
Rare Event ◽  
General Anesthetic ◽  
Intraoperative Awareness ◽  
Patient Reports ◽  
Increased Risk ◽  
Patient’S Outcome

Awareness following general anesthesia is a rare event; however, it may have significant impact on patient satisfaction and long-term morbidity. Detecting intraoperative awareness during a general anesthetic is difficult due to the fact that the signs and symptoms are often absent in documented cases of awareness. Often, intraoperative awareness goes unnoticed until a patient reports the experience. Anesthesiologists should be cognizant of the risk factors associated with an increased risk of intraoperative awareness. Cesarean section performed under general anesthesia, cardiac surgery, and trauma surgery all carry an increased risk. Anesthesiologists should consider patient specific risk factors involving a higher than expected anesthetic requirement in developing their anesthetic plan. In the event of intraoperative awareness, the anesthesiologist’s actions and interactions with the patient are critical in improving the patient’s’ outcome and minimizing long-term psychological stress. Anesthesiologists should acknowledge the event and create a supportive relationship with the patient.

scholarly journals Peripartum Predictors of the Risk of Postpartum Depressive Disorder: Results of a Case-Control Study

2020 ◽  
Vol 17 (23) ◽  
pp. 8726 ◽  
Author(s):  
Kornelia Zaręba ◽  
Jolanta Banasiewicz ◽  
Hanna Rozenek ◽  
Stanisław Wójtowicz ◽  
Grzegorz Jakiel
Keyword(s):  
Risk Factors ◽  
Mood Disorders ◽  
Medical Records ◽  
Case Control Study ◽  
Uterine Cavity ◽  
Control Group ◽  
Gynecology And Obstetrics ◽  
Increased Risk ◽  
Retrospective Comparative Study ◽  
Control Study

Background: The study aimed at the identification of the risk factors present during delivery, which might be present in prophylactic programs concerning postpartum mood disorders. Material and Method: This was a retrospective comparative study. The study material included data retrieved from the medical records of patients hospitalized in the Teaching Department of Gynecology and Obstetrics of Professor Orłowski Hospital in Warsaw, in the years 2010–2017. The EPDS data of 604 patients were analyzed. The study group included 75 women who obtained at least 12 points in the EPDS and the control group was made up of 75 women who obtained no more than 5 points in the EPDS. Results: The women in whom we noted an increased risk of developing mood disorders had blood loss >1000 mL and had a significantly longer stage II and III of labor than the control group. Other risk factors were cesarean section, vaginal delivery with the curettage of the uterine cavity, slightly lower APGAR scores (0.4 pts), and lower birth weight (approximately 350 g) of the child. Women at a low risk of postpartum mood disorders more commonly underwent episiotomy during delivery (76%). Conclusions: Increased supervision and support should be offered to women who experienced the above-mentioned risk factors.

scholarly journals P0897RISK FACTORS FOR AVASCULAR BONE NECROSIS IN PATIENTS WITH LUPUS NEPHRITIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Daniela Monova ◽  
Simeon Monov ◽  
Assen Kamenov ◽  
Vladislava Milenova
Keyword(s):  
Risk Factors ◽  
Lupus Nephritis ◽  
Avascular Necrosis ◽  
Immunosuppressive Agents ◽  
Individual Risk ◽  
Control Group ◽  
High Dose ◽  
Increased Risk ◽  
Avascular Necrosis Of Bone ◽  
Class Iv

Abstract Background and Aims Avascular necrosis of bone (AVN) is an important complication of systemic lupus erythematosus (SLE) and often causes serious physical disability. The aim of this study was to investigate the risk factors for symptomatic avascular necrosis of bone (AVN) in lupus nephritis (LN) patients. Method The records of 374 patients (43 males, 331 females) with kidney biopsy-proven LN were reviewed retrospectively. Symptomatic AVN cases were defined as those with at least one diagnosis of AVN. The patients with LN who did not have AVN were evaluated as a control group. To determine risk factors for AVN, clinical, laboratory and therapeutic variables were analyzed by logistic regression. Results Symptomatic AVN was present in 17 patients (4 males, 13 females, mean age of 27,4±6,7 years). Among the 17 patients, 28 joints presented AVN. 12 occurred in hips (2 bilateral), 6-in ankles, 4-in knees, 3-in shoulders and 1- in lumbar spine. In 9 patients AVN involved 2 or more joints. 14 patients were on steroids at the time of presentation of AVN. 2 patients were not on CS and 1 patient did not has documentation of steroid use. Meta-analysis demonstrates a significant increased risk of AVN in patients with high disease activity and class IV LN (p&lt;0,005). LN patients with AVN showed an earlier onset age (p&lt;0,05) and received significantly higher total cumulative corticosteroid dose. AVN was not significantly associated with use of immunosuppressive agents. Serositis, coagulation disorders, vasculitis, cigarette smoking were higher incidence in male with LN and AVN. Raynaud‘s phenomenon, autoimmune thyroiditis, arthritis, Sjögren’s syndrome, IgM anticardiolipin antibodies, antiphospholipid syndrome, Cushingoid body habitus were higher incidence in female with LN and AVN. Conclusion Many risk factors have been involved in the development of AVN in LN patients. AVN is prevalent in class IV LN and in younger patients. Since asymptomatic osteonecrosis may remain undetected, its true prevalence could be much higher than we reported. Multifocal lesions involving more than three anatomical sites are unusual. Corticosteroids are the principal risk factor, although some cases of AVN occur in relatively steroid naïve patients. Early detection of AVN is important because the prognosis depends of the stage and location of the lesion. An individual risk assessment for AVN development should be made prior to and during treatment for LN, especially in patients high dose corticosteroids.

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