scholarly journals Decompression for Chiari malformation type II in individuals with myelomeningocele in the National Spina Bifida Patient Registry

2018 ◽  
Vol 22 (6) ◽  
pp. 652-658 ◽  
Author(s):  
Irene Kim ◽  
Betsy Hopson ◽  
Inmaculada Aban ◽  
Elias B. Rizk ◽  
Mark S. Dias ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Spina Bifida ◽  
Significant Relationship ◽  
Chiari Malformation ◽  
Patient Registry ◽  
Type Ii ◽  
History Of ◽  
Chiari Ii ◽  
Lesion Level ◽  
The Relationship

OBJECTIVEThe purpose of this study was to determine the rate of decompression for Chiari malformation type II in individuals with myelomeningocele in the National Spina Bifida Patient Registry (NSBPR). In addition, the authors explored the variation in rates of Chiari II decompression across NSBPR institutions, examined the relationship between Chiari II decompression and functional lesion level of the myelomeningocele, age, and need for tracheostomy, and they evaluated for temporal trends in rates of Chiari II decompression.METHODSThe authors queried the NSBPR to identify all individuals with myelomeningocele between 2009 and 2015. Among these patients, they identified individuals who had undergone at least 1 Chiari II decompression as well as those who had undergone tracheostomy. For each participating NSBPR institution, the authors calculated the proportion of patients enrolled at that site who underwent Chiari II decompression. Logistic regression was performed to analyze the relationship between Chiari II decompression, functional lesion level, age at decompression, and history of tracheostomy.RESULTSOf 4448 individuals with myelomeningocele identified from 26 institutions, 407 (9.15%) had undergone at least 1 Chiari II decompression. Fifty-one patients had undergone tracheostomy. Logistic regression demonstrated a statistically significant relationship between Chiari II decompression and functional lesion level of the myelomeningocele, with a more rostral lesion level associated with a higher likelihood of posterior fossa decompression. Similarly, children born before 2005 and those with history of tracheostomy had a significantly higher likelihood of Chiari II decompression. There was no association between functional lesion level and need for tracheostomy. However, among those children who underwent Chiari II decompression, the likelihood of also undergoing tracheostomy increased significantly with younger age at decompression.CONCLUSIONSThe rate of Chiari II decompression in patients with myelomeningocele in the NSBPR is consistent with that in previously published literature. There is a significant relationship between Chiari II decompression and functional lesion level of the myelomeningocele, which has not previously been reported. Younger children who undergo Chiari II decompression are more likely to have undergone tracheostomy. There appears to be a shift away from Chiari II decompression, as children born before 2005 were more likely to undergo Chiari II decompression than those born in 2005 or later.

scholarly journals Treated hydrocephalus in individuals with myelomeningocele in the National Spina Bifida Patient Registry

2018 ◽  
Vol 22 (6) ◽  
pp. 646-651 ◽  
Author(s):  
Irene Kim ◽  
Betsy Hopson ◽  
Inmaculada Aban ◽  
Elias B. Rizk ◽  
Mark S. Dias ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Spina Bifida ◽  
Temporal Trends ◽  
Patient Registry ◽  
Insufficient Data ◽  
Multivariate Logistic Regression ◽  
Significant Difference ◽  
Lesion Level ◽  
Hydrocephalus Treatment ◽  
The Relationship

OBJECTIVEAlthough the majority of patients with myelomeningocele have hydrocephalus, reported rates of hydrocephalus treatment vary widely. The purpose of this study was to determine the rate of surgical treatment for hydrocephalus in patients with myelomeningocele in the National Spina Bifida Patient Registry (NSBPR). In addition, the authors explored the variation in shunting rates across NSBPR institutions, examined the relationship between hydrocephalus, and the functional lesion level of the myelomeningocele, and evaluated for temporal trends in rates of treated hydrocephalus.METHODSThe authors queried the NSBPR to identify all patients with myelomeningoceles. Individuals were identified as having been treated for hydrocephalus if they had undergone at least 1 hydrocephalus-related operation. For each participating NSBPR institution, the authors calculated the proportion of patients with treated hydrocephalus who were enrolled at that site. Logistic regression was performed to analyze the relationship between hydrocephalus and the functional lesion level of the myelomeningocele and to compare the rate of treated hydrocephalus in children born before 2005 with those born in 2005 or later.RESULTSA total of 4448 patients with myelomeningocele were identified from 26 institutions, of whom 3558 patients (79.99%) had undergone at least 1 hydrocephalus-related operation. The rate of treated hydrocephalus ranged from 72% to 96% among institutions enrolling more than 10 patients. This difference in treatment rates between centers was statistically significant (p < 0.001). Insufficient data were available in the NSBPR to analyze reasons for the different rates of hydrocephalus treatment between sites. Multivariate logistic regression demonstrated that more rostral functional lesion levels were associated with higher rates of treated hydrocephalus (p < 0.001) but demonstrated no significant difference in hydrocephalus treatment rates between children born before versus after 2005.CONCLUSIONSThe rate of hydrocephalus treatment in patients with myelomeningocele in the NSBPR is 79.99%, which is consistent with the rates in previously published literature. The authors’ data demonstrate a clear association between functional lesion level of the myelomeningocele and the need for hydrocephalus treatment.

Tethered spinal cord among individuals with myelomeningocele: an analysis of the National Spina Bifida Patient Registry

2021 ◽  
Vol 28 (1) ◽  
pp. 21-27
Author(s):  
Mark S. Dias ◽  
Ming Wang ◽  
Elias B. Rizk ◽  
Robin Bowman ◽  
Michael D. Partington ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
Cox Proportional Hazards ◽  
Patient Registry ◽  
Tethered Spinal Cord ◽  
Significant Treatment ◽  
Data Set ◽  
Traditional Concept ◽  
Lesion Level ◽  
Males And Females

OBJECTIVE The aims of this study were to review the National Spina Bifida Patient Registry (NSBPR) data set to study the rates of tethered spinal cord release (TCR) among patients with myelomeningocele and variability between centers, to compare TCR rates between males and females, and to study the relationships between TCR rates and other condition-specific characteristics. METHODS The NSBPR registry was queried to identify all patients with myelomeningocele. TCR rates were calculated over time using survival analyses; rates between centers and between males and females were compared. Cox proportional hazards models were constructed to identify relationships between TCR rates and sex, functional lesion level, ambulation status, treated hydrocephalus, and prior Chiari decompression. RESULTS Of 6339 patients with information about their operations, 1366 (21.5%) underwent TCR, with significant variability between centers. The majority (75.8%) underwent a single TCR. The annual TCR rate was linear between birth and 13 years (1.8%/year) but declined sharply from 14 to 21 years (0.7%/year). There was no period of time at which the TCR rate accelerated. There were no significant differences in TCR rates between males and females. TCR rate was not related to functional lesion level but was lower among nonambulators compared with community ambulators (p = 0.005) and among those with treated hydrocephalus (HR 0.30, p < 0.001), and higher among those having prior Chiari decompression (HR 1.71, p < 0.001). CONCLUSIONS These results extend the results of prior single-institution studies, demonstrate significant treatment variability between institutions, and challenge the traditional concept that tethering is related to spinal cord stretching due to spinal growth.

scholarly journals Cigarette smoking and psychotic symptoms in bipolar affective disorder

2001 ◽  
Vol 179 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Aiden Corvin ◽  
Ed O'Mahony ◽  
Myra O'Regan ◽  
Claire Comerford ◽  
Robert O'Connell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Psychotic Symptoms ◽  
Heavy Smoking ◽  
Ordinal Logistic Regression Analysis ◽  
History Of ◽  
Categorical Diagnosis ◽  
The Relationship

BackgroundAn association exists between smoking and schizophrenia, independent of other factors and related to psychotic symptomatology.AimsTo determine whether smoking is associated with psychosis in bipolar affective disorder.MethodSmoking data were collected from 92 unrelated patients with bipolar affective disorder. An ordinal logistic regression analysis tested the relationship between smoking severity and psychotic symptomatology, allowing for potential confounders.ResultsA significant relationship was detected between smoking/heavy smoking and history of psychosis (68.7%, n=44). Smoking was less prevalent in patients who were less symptomatic (56.5%, n=13) than in patients with a more severe psychosis (75.7%, n=31). Prevalence and severity of smoking predicted severity of psychotic symptoms (P=0.001), a relationship independent of other variables (P=0.0272).ConclusionA link between smoking and psychosis exists in bipolar affective disorder and may be independent of categorical diagnosis.

Unrecognised myocardial infarction in patients with schizophrenia

2015 ◽  
Vol 27 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Jimmi Nielsen ◽  
Jacob Juel ◽  
Karam Sadoon Majeed Al Zuhairi ◽  
Rasmus Friis ◽  
Claus Graff ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Type Ii Diabetes ◽  
Psychiatric Hospitals ◽  
Patient Registry ◽  
Type Ii ◽  
Multiple Logistic Regression ◽  
National Patient Registry ◽  
National Patient ◽  
History Of ◽  
Silent Myocardial Infarction

ObjectiveSchizophrenia is associated with a reduction of the lifespan by 20 years, with type II diabetes and cardiovascular disease contributing the most to the increased mortality. Unrecognised or silent myocardial infarction (MI) occurs in ~30% of the population, but the rates of unrecognised MI in patients with schizophrenia have only been sparsely investigated.MethodElectrocardiograms (ECG) from three psychiatric hospitals in Denmark were manually interpreted for signs of previous MI. Subsequently, ECGs were linked to the National Patient Registry in order to determine whether patients had a diagnosis consistent with previous MI.ResultsA total of 937 ECGs were interpreted, 538 men (57.4%) and 399 women (42.6%). Mean age at the time of ECG acquisition was 40.6 years (95% CI: 39.7–41.5, range: 15.9–94.6). We identified 32 patients with positive ECG signs of MIs. Only two of these patients had a diagnosis of MI in the National Patient Registry. An additional number of eight patients had a diagnosis of MI in the Danish National Patient Registry, but with no ECG signs of previous MI. This means that 30 out of 40 (75%) MIs were unrecognised. Only increasing age was associated with unrecognised MI in a stepwise multiple logistic regression model compared with patients with no history of MI, OR: 1.03 per year of age, 95% CI: 1.00–1.06, p=0.021.ConclusionUnrecognised MI is common among patients with schizophrenia and may contribute to the increased mortality found in this patient group.

scholarly journals The relationship between Fear of Hypoglycemia and Sleep Quality among type II Diabetic Patients

2019 ◽  
Author(s):  
Leili Yekefallah ◽  
Farzaneh Talebi ◽  
Ali Razaghpoor ◽  
Mohammmad Hossein Mafi
Keyword(s):  
Sleep Quality ◽  
Significant Relationship ◽  
Diabetic Patients ◽  
Poor Sleep ◽  
Type Ii ◽  
Poor Sleep Quality ◽  
Fear Of Hypoglycemia ◽  
The Mean ◽  
The Relationship

Abstract Introduction and Objective Fear of hypoglycemia can result in anxiety, stress, anger, depression and severe avoidance behaviors that it affects the sleep quality of diabetic patients. Therefore, the present study was conducted with the aim of investigating the relationship between fear of hypoglycemia and sleep quality among type II diabetic patients. Methods The present cross-sectional study was conducted on 400 type II diabetic patients referred to endocrinology clinic of Velayat Hospital and Boali Hospital in Qazvin, in 2018. Data were collected using a checklist for demographic variables, the Fear of Hypoglycemia Survey (FHS-W), and the Pittsburgh sleep quality index (PSQI). Descriptive statistics and Spearman correlation test were performed for data analysis using SPSS v24. Results In this study, the mean age of diabetic patients was 55.75±10.31. The majority of the participants were female (n=299, 74.8%) and were treated with oral anti-diabetic drugs (n=174, 43.5%). The mean score of sleep quality in patients was 8.98±3.64 and the fear of hypoglycemia was 21.27±11.92. The results of this study showed that there was a significant relationship between the fear of hypoglycemia and the poor sleep quality among patients (p<0.001, r=0.305). Conclusion The fear of hypoglycemia has a direct and significant relationship with poor sleep quality in diabetic patients; so that this fear reduces the quality of sleep in diabetic patients. Therefore, in order to provide adequate sleep to prevent inappropriate sleep complications, great attention should be paid to the issue of fear of hypoglycemia, and consider some actions to reduce this fear.

Cigarette Smoking Is An Independent Predictor of Chronic Pain In Sickle Cell Patients: Results From the Walk-PHaSST Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4804-4804
Author(s):  
Ruchika Goel ◽  
Kathryn Hassell ◽  
Oswaldo Castro ◽  
Robyn J. Barst ◽  
Erika Berman Rosenzweig ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Logistic Regression ◽  
Effect Size ◽  
Research Funding ◽  
Smoking History ◽  
Cigarette Smoker ◽  
Hydroxyurea Treatment ◽  
History Of ◽  
The Relationship ◽  
A Current

Abstract Abstract 4804 Introduction: Smoking is known to promote vascular inflammation, in-vitro platelet aggregation and expression of endothelial adhesion molecules, processes that contribute to vasculopathy. Inflammation, abnormal platelet activation with thrombus formation and endothelial cell activation also play a role in vaso-occlusion in sickle cell disease (SCD). These overlapping pathobiological mechanisms suggest the possibility of a relationship between smoking and SCD vaso-occlusive pain. While small single center studies have suggested a link between environmental smoke exposure and hospitalization rate for acute chest syndrome and SCD pain (West et al 2003, Cohen et al 2010) there is a paucity of data derived from large multicenter studies about the interplay between smoking and pain phenotype in SCD. Aims: To determine the relationship between patient self reported chronic pain and history of current or former cigarette smoking in the SCD subjects screened in the walk-PHaSST study. Methods: Walk-PHaSST was a multi-center, placebo-controlled, double-blind 16-week trial designed to evaluate the safety and efficacy of sildenafil in patients with tricuspid regurgitant velocity [TRV] ≥2.7m/s and decreased exercise capacity as assessed by the six-minute walk distance (6MWD). We analyzed the data from all subjects screened for the walk-PHaSST trial. In the screening trial, subjects were evaluated by medical history, physical examination, laboratory screening, echocardiography and 6MWD testing. Univariate and stepwise multivariable logistic regression was used for this analysis. P value of <0.05 was considered statistically significant. Results: Of the 720 patients screened, medical history on pain and smoking was obtained in a total of 673 subjects. Of these, 483/673 subjects (72%) had HbSS disease and 137 (20.4%) had HbSC disease. Mean age was 36.6 years (median 36.1 years). A total of 104 (15.5%) were current smokers and 114 (17.4%) reported having smoked in the past and 451 (67.1%) subjects reported no history of any life-time or current smoking. Subjects had smoked for a mean of 11.5 years (median 9 years, range 1–42 years). The mean pack years of smoking were 8.8 (median 5 years, range <1- 60 pack years). In a multivariable logistic regression model, being a ‘current’ cigarette smoker was associated with an increased odds ratio (OR 3.0, 95% CI 1.8–4.9) (See Table 1) of reporting chronic SCD pain as compared to no smoking history when adjusted for 1) self reported acute pain, 2) age, 3) gender, 4) hematocrit 4) marijuana use, 5) SCD genotype and 6) current hydroxyurea treatment. Additionally, in the multivariable model, being a ‘former’ cigarette smoker was associated with a smaller effect size (OR 2.2, 95% CI 1.4–3.5) of reporting chronic SCD pain as compared with no smoking history when adjusted for the above listed variables. On examining by SCD genotypes, the effect size was similar for HbSS genotype (OR 2.79, 95% CI: 1.54–5.0) while the effect size was significantly higher for HbSC genotype (OR 5.6, 95% CI: 1.7–19.0). The increase in self reported pain with number of pack years adjusted for age was not statistically significant although an increase in reported pain was observed with increase in the number of pack years (See Figure 1). Conclusions: These data suggest that being a current or former smoker is independently associated with ‘self reported chronic SCD pain’ after adjusting for potential confounding variables including age of the patient, gender, hematocrit, marijuana use and being on hydroxyurea treatment. However, it is unclear whether smoking might worsen pain, represent a stress relieving behavior by patients to chronic pain or even provide a beneficial adaptation to chronic pain mediated by nicotine, carbon monoxide, nitric oxide, or other substances known to be present in tobacco smoke. These data provide a rationale for further mechanistic studies of the relationship between smoking and chronic pain in patients with SCD. Disclosures: Hassell: Novartis: Research Funding. Barst: Pfizer: Consultancy, Research Funding. Rosenzweig: Pfizer: Research Funding. Badesch: Pfizer: Honoraria, Research Funding.

scholarly journals The Relationship between AAS (Addiction Admission Scale) and APS (Addiction Potential Scale) with Timely Graduation of UPH Medical Faculty Students

Medicinus ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 170
Author(s):  
Engelberta Pardamean ◽  
Veli Sungono
Keyword(s):  
Logistic Regression ◽  
Significant Relationship ◽  
T Test ◽  
Behavioral Changes ◽  
P Value ◽  
Test Results ◽  
Cross Sectional ◽  
Potential Scale ◽  
Spearman Correlation Test ◽  
The Relationship

<p><strong>Background:</strong> Addiction influential to neurotransmitter damage in the brain, resulting in physical fatigue and behavioral changes that will affect the length of studies of students. The MMPI-2 questionnaire is an instrument used to assess the Addiction Admission Scale / AAS and Addiction Potential Scale / APS.</p><p><strong> </strong></p><p><strong>Objective: </strong>This study looks at the relationship between AAS and APS with the timely graduation of students.</p><p> </p><p><strong>Methods:</strong> The study design of this research was cross-sectional for students of the Faculty of Medicine who were running a co-ass program at the Dharmawangsa Mental Hospital and had carried out the MMPI-2 test. Data analysis was done using Stata IC version 16 using t-test, spearman correlation test, and logistic regression.</p><p> </p><p><strong>Results: </strong>Of the 81 respondents, 67% of women and 33% of men and students who graduated on time amounted to 79%. T-test results obtained an AAS score in the group that was not on time (mean 2.53 ± 1.37) significantly higher than the group that was on time / study period of 5.5 years (mean 1.27 ± 1.56) with a p value of 0.0035. APS has a significant correlation to AAS with a coefficient value of r of 0.2595 and p value of 0.0201. AAS logistic regression test for the accuracy of graduation has a p value of 0.0067 with an OR value of 1.559 (95% CI 1.09-2.21).</p><p> </p><p><strong>Conclusion:</strong> There is a significant relationship between AAS on time graduation and there is no significant relationship between APS with on timely graduation.</p>

scholarly journals The Relationship Between Obesity and Smoking to Hypertension Incidence

2014 ◽  
Vol 2 (3) ◽  
pp. 286
Author(s):  
Tifani Lasianjayani ◽  
Santi Martini
Keyword(s):  
Significant Relationship ◽  
Random Sampling ◽  
Smoking Behavior ◽  
Simple Random Sampling ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
History Of ◽  
Cross Sectional Design ◽  
The Relationship

ABSTRACTHypertension is a disease that causes morbidity and mortality about 20–50% of all deaths. In the worldwide, about 927 people suffer hypertension and that number will be increase to 29,2 in 2025. Obesity and smoking are one of risk factors to hypertension incidence. The purpose of this research was to analayze the relationship between obesity and smoking to hypertension incidence. The cross sectional design is used in this research and involved 75 samples who ware selected from cardiology’s patients at Haji Hospital Surabaya by simple random sampling on May 2014. The variables are sex, obesity, and smoking behavior. In the smoking behavior data, the history of smoking, filters used, smoking periode, total cigarette, and types of cigarette are used. In this research, crosstabulation with Chi Square test is used on data analysis. There are 45 people (60%) had hypertension and 64,4% from sample with hypertension was women. The result of this research showed that there was a significant relationship between obesity and hypertension (p = 0,014) with coeffisient contingension about 0,299. Otherwise, there was no a significant relationship between history of smoking (p = 0,211), filters used (p = 0,378), smoking periode (p = 1,000), smoker criteria (p = 0,848), and types of cigarette (p = 0,673) to hypertension incidence. The conclution of this research was only obesity which had a relationship with hypertension incidence.Keywords: hypertension, sex, obesity, smoking behavior

scholarly journals Faktor-faktor yang mempengaruhi kemampuan kognitif pada lansia obesitas di Indonesia

2018 ◽  
Vol 14 (4) ◽  
pp. 154
Author(s):  
Yoseph Leonardo Samodra ◽  
Neni Trilusiana Rahmawati ◽  
Sumarni Sumarni
Keyword(s):  
Logistic Regression ◽  
Body Weight ◽  
Significant Relationship ◽  
Body Height ◽  
Cognitive Capacity ◽  
Upper Arm ◽  
Knee Height ◽  
History Of ◽  
Anthropometric Status ◽  
Upper Arm Length

Background: Elderly (>60 years old) population is growing in Indonesia. It is important to prevent degradation of cognitive capacity by risk factor identification and treatment.Objective: To identify the relationship between anthropometric status and cognitive capacity on elderly population.Method: This is an analysis of The Fifth Wave of the Indonesia Family Life Survey (IFLS5) data with cross-sectional design. Anthropometric status is consisted of: body weight, body height, body mass index (BMI), knee height, upper arm length, waist circumference, hip circumference, and waist-hip ratio (WHR). Cognitive capacity is measured by modified telephone survey of cognitive status (TICS). Chi-Square and Mann-Whitney test are used for bivariate analysis, logistic regression is used for multivariate analysis.Results: Variables with significant relationship to cognitive capacity are body weight (p=0.0002), body height (p=0.0001), knee height (p=0.0387), upper arm length (p=0.0114), age (p=0.011), sex (p=0.014), and history of hypercholesterolemia (p=0.003). Logistic regression shows that body height, age, and history of hypercholesterolemia are simultaneously affecting cognitive capacity.Conclusion: There is significant relationship between body height, body weight, upper arm length, knee height, and cognitive capacity on elderly population with obesity.

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