scholarly journals Association Between White Blood Cells at Baseline and Treatment Failure of MTX for Ectopic Pregnancy

2021 ◽  
Vol 8 ◽  
Author(s):  
Si Chen ◽  
Xiao-Feng Chen ◽  
Pin Qiu ◽  
Yan-Xi Huang ◽  
Gao-Pi Deng ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Ectopic Pregnancy ◽  
Subgroup Analysis ◽  
White Blood Cells ◽  
Multivariate Models ◽  
Logistics Regression ◽  
Exposure Variable ◽  
Wbc Count ◽  
Adjusted Model ◽  
Risk Of Treatment

Purpose: The aim of this study was to evaluate white blood cell (WBC) count as a risk factor related to methotrexate (MTX) treatment failure in patients with ectopic pregnancy (EP).Methods: A total of 236 women diagnosed with EP and treated with a single dose of MTX were included. The exposure variable was WBC count at baseline, and the outcome was MTX treatment outcome. Both a multivariate binary logistics regression model and subgroup analysis were performed to evaluate the association between WBC and MTX non-response.Results: WBC count was associated with the risk of treatment failure, and the odds ratio (OR) in different multivariate models was stable [minimally adjusted model: OR 1.2, 95% confidence interval (CI): 1.0–1.3, p = 0.008; fully adjusted model: OR 1.2, 95% CI: 1.0–1.4, p = 0.026]. For WBCs in group T3 (>8.9 × 109/L), the association between WBC count and treatment failure was significant (minimally adjusted model: OR: 2.0, 95% CI: 1.0–3.8, p = 0.050; fully adjusted model: OR: 2.2, 95% CI: 1.1–5.6, p = 0.034). Subgroup analysis showed that in participants with regular menstruation (OR 1.1, 95% CI: 1.0–1.3), WBC count was significantly different from irregular menstruation (OR 1.8, 95% CI: 1.2–2.8); p for interaction was 0.031.Conclusions: We found a reliable and non-linear relationship between WBC count and MTX treatment failure for EP.

scholarly journals Neutrophil-to-Lymphocyte Ratio and Treatment Failure in Peritoneal Dialysis-Associated Peritonitis

2021 ◽  
Vol 8 ◽  
Author(s):  
Peng He ◽  
Li-jie He ◽  
Chen Huang ◽  
Jin-ping Hu ◽  
Shi-ren Sun
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Failure ◽  
Estimating Equation ◽  
Neutrophil To Lymphocyte Ratio ◽  
Categorical Variable ◽  
Lymphocyte Ratio ◽  
Potential Risk Factors ◽  
Adjusted Model ◽  
The Relationship ◽  
Risk Of Treatment

Objective: We sought to explore if there is an association between neutrophil-to-lymphocyte ratio (NLR) and treatment failure in patients with peritoneal dialysis-associated peritonitis (PDAP).Methods: Our cohort involved 337 episodes of PDAP experienced by 202 patients who were undergoing continuous ambulatory peritoneal dialysis at a single center from 1 July 2013 to 30 June 2018. The exposures were log-transformed NLR and a categorical variable grouped by the tertiles of NLR levels (T1, <3.75; T2, 3.75–6.53; and T3, >6.53) at baseline. Generalized estimating equation (GEE) and restricted cubic spline (RCS) analyses were done to determine the association between NLR and treatment failure, defined as catheter removal or all-cause mortality during therapy.Results: After adjusting for other potential predictors, the log-transformed NLR exhibited an incremental relationship with the risk of treatment failure (odds ratio, 1.82; 95% confidence interval, 1.05–3.15). RCS analyses showed that the relationship was positively and linearly correlated (P for nonlinearity = 0.104). As a three-level categorical variable, in reference to T1, the T3 of NLR showed a 3.41-fold increased venture of treatment failure in fully adjusted model. Subgroup analyses suggested that the prognostic relevance of NLR in PDAP was particularly significant in gram-negative peritonitis.Conclusions: A greater level of NLR at baseline was remarkably associated with a higher incidence of treatment failure among PDAP episodes regardless of other potential risk factors.

scholarly journals Histologic Remission Is Associated With Lower Risk of Treatment Failure in Patients With Crohn Disease in Endoscopic Remission

2020 ◽  
Author(s):  
Hyuk Yoon ◽  
Sushrut Jangi ◽  
Parambir S Dulai ◽  
Brigid S Boland ◽  
Vipul Jairath ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Crohn Disease ◽  
Lower Risk ◽  
Hazard Analysis ◽  
Cumulative Risk ◽  
Treatment Optimization ◽  
Cox Proportional Hazard ◽  
Endoscopic Remission ◽  
Risk Of Treatment

Abstract Background Although achieving histologic remission in ulcerative colitis is established, the incremental benefit of achieving histologic remission in patients with Crohn disease (CD) treated to a target of endoscopic remission is unclear. We evaluated the risk of treatment failure in patients with CD in clinical and endoscopic remission by histologic activity status. Methods In a single-center retrospective cohort study, we identified adults with active CD who achieved clinical and endoscopic remission through treatment optimization. We evaluated the risk of treatment failure (composite of clinical flare requiring treatment modification, hospitalization, and/or surgery) in patients who achieved histologic remission vs persistent histologic activity through Cox proportional hazard analysis. Results Of 470 patients with active CD, 260 (55%) achieved clinical and endoscopic remission with treatment optimization; 215 patients with histology were included (median age, 33 years; 46% males). Overall, 132 patients (61%) achieved histologic remission. No baseline demographic, disease, or treatment factor was associated with achieving histologic remission. Over a 2-year follow-up, patients with CD in clinical and endoscopic remission who achieved histologic remission experienced a 43% lower risk of treatment failure (1-year cumulative risk: 12.9% vs 18.2%; adjusted hazard ratio, 0.57 [95% confidence interval, 0.35-0.94]) as compared with persistent histologic activity. Conclusions Approximately 61% of patients with active CD who achieved clinical and endoscopic remission with treatment optimization simultaneously achieved histologic remission, which was associated with a lower risk of treatment failure. Whether histologic remission should be a treatment target in CD requires evaluation in randomized trials.

scholarly journals Correlation between white blood cell count at admission and mortality in COVID-19 patients: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bin Zhu ◽  
Xiaokai Feng ◽  
Chunguo Jiang ◽  
Song Mi ◽  
Liya Yang ◽  
...  
Keyword(s):  
White Blood Cells ◽  
Vital Role ◽  
World Health ◽  
Kaplan Meier ◽  
Single Center Study ◽  
Union Hospital ◽  
Laboratory Examinations ◽  
The Difference ◽  
Wbc Count ◽  
Death Cases

Abstract Background Coronavirus disease-19 (COVID-19) has become a world health threaten. Its risk factors with death were still not known. White blood cells (WBC) count as a reflection of inflammation has played a vital role in COVID-19, however its level with death is not yet investigated. Methods In this retrospective, single-center study, all confirmed patients with COVID-19 at West Branch of Union Hospital from Jan 29 to Feb 28, 2020 were collected and analyzed. Demographic and clinical data including laboratory examinations were analyzed and compared between recovery and death patients. Results A total of 163 patients including 33 death cases were included in this study. Significant association was found between WBC count and death (HR = 1.14, 95%CI: 1.09–1.20, p < 0.001). The regression analysis results showed there was a significant association between WBC count and death (HR = 5.72, 95%CI: 2.21–14.82, p < 0.001) when use the second quartile as a cutoff value (> 6.16 × 10^9/L). The difference was still exist after adjusting for confounding factors (HR = 6.26, 95%CI: 1.72–22.77, p = 0.005). In addition, Kaplan-meier survival analysis showed that there was a significant decline of the cumulative survival rate (p < 0.001) in those with WBC count ≥6.16 × 10^9/L. Conclusion WBC count at admission is significantly corelated with death in COVID-19 patients. Higher level of WBC count should be given more attention in the treatment of COVID-19.

Factors associated to first line antiretroviral therapy (ART) failure among HIV/AIDS patients at Sanglah Hospital, Bali

2017 ◽  
pp. 4
Author(s):  
Cok Istri Sri Dharma Astiti ◽  
A.A Sagung Sawitri ◽  
Tuti Parwati
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Clinical Stage ◽  
Hiv And Aids ◽  
First Line ◽  
Aids Patients ◽  
Factors Associated ◽  
Art Initiation ◽  
Risk Of Treatment ◽  
Hiv Aids

Background and purpose: The incidence of first line ART failure is increasing in the South East Asia region. The main referral hospital in Bali has recorded an increased use of second line ART due to the first line ART failure. This study aims to explore risk factors associated to first line ART failure.Methods: A case control study was conducted among people living with HIV and AIDS at Sanglah Hospital Denpasar who started first line ART between 2004 and 2013. Cases were those who diagnosed as having clinical treatment failure and still on treatment in 2015. Controls were those with no treatment failure. Sex and year of ART initiation were matched between case and control. Data were obtained from medical records that include initial regiments, HIV mode of transmission, the WHO HIV clinical stage, CD4 count, opportunistic infections, body mass index, hemoglobin level, and drug substitution at the beginning and during treatment. Risk factors were analysed using logistic regression.Results: Out of 68 HIV/AIDS patients with clinical ART failure, 72.1% were confirmed with immunological and 36.8% were confirmed with virological failure. Median time before treatment failure was 3.5 years. Factors associated to ART failure were HIV clinical stage IV with (AOR=3.43; 95%CI=1.65-7.13) and being widow/widower (AOR=4.85; 95%CI=1.52-15.53). Patients with TB co-infection have a lower risk for treatment failure due to early diagnosis and treatment through TB-HIV program with (AOR=0.32; 95%CI=0.14-0.70).Conclusions: Higher HIV clinical stage at ART initiation increases the risk of treatment failure. HIV-TB co-infection indirectly reduces the risk of treatment failure.

scholarly journals Serum levels of CXCL-8, IL-10, and TNF-alpha in ankylosing spondylitis patients

Biomedicine ◽  
2021 ◽  
Vol 41 (3) ◽  
Author(s):  
Dhuha Karim
Keyword(s):  
Disease Severity ◽  
Functional Disability ◽  
White Blood Cells ◽  
Age Groups ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Hla B27 ◽  
Diagnostic Significance ◽  
Significant Difference ◽  
Wbc Count

The mean age of AS patients was (35.0 ± 9.8) years.When the patients and control subjects were divided into different age groups (>40, 30-40, <30 years), the differences were not significantin terms of disease prevalence. The results also showed that the percentage of male patients is higher than that of females. There was no significant difference (P?0.05) between patients and controls in the distribution of males and females.Most of the patients had the disease for a period of 5 years or higher, with a disease severity of ? 2.1 and functional disability degree of I, II. The resultsshoweddifferent patterns of distribution for the three tested cytokines. A significant increase in the level of TNF-?, anon-significantincrease in the level of CXCL-8, and a significant decrease in the level of IL-10 were observed in the sera of patients with AS compared with the control.The patients also demonstrated significant decreases in the serum ALT and AST enzyme levels, hemoglobin (Hb) level, white blood cells (WBC) count, and erythrocyte sedimentation rate (ESR) (P?0.05).The percentage of HLA-B27-positive Iraqi patients was lower than that of the HLA-B27-negative patients. Some of these patterns were also exposed to changes related to some determinants in patients, which included age, sex, disease duration, disease severity, functional disability, and HLA-B27 positivity,along with association with clinical subtypes of AS.The area under the curve was determined for the parameters of ESR, IL-10, TNF-? and CXCL-8.The most significant factor was found to beESR, followed by IL-10, and then TNF-?, with the presence of significant differences, while there was no diagnostic significance for CXCL-8 ,which showed no significant difference (p?0.05).  

scholarly journals Risk of Treatment Failure: Response to Czobor and Volavka

2018 ◽  
Vol 175 (9) ◽  
pp. 909-909
Author(s):  
Jari Tiihonen ◽  
Antti Tanskanen ◽  
Heidi Taipale
Keyword(s):  
Treatment Failure ◽  
Risk Of Treatment

scholarly journals Antibiotics for uncomplicated skin abscesses: systematic review and network meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e020991 ◽  
Author(s):  
Wen Wang ◽  
Wenwen Chen ◽  
Yanmei Liu ◽  
Reed Alexander C Siemieniuk ◽  
Ling Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Meta Analysis ◽  
Late Recurrence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
High Quality ◽  
Moderate Quality ◽  
The Impact ◽  
Risk Of Treatment

ObjectiveTo assess the impact of adjunctive antibiotic therapy on uncomplicated skin abscesses.DesignSystematic review and network meta-analysis.Data sourcesMedline, Embase, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov.Study selectionA BMJ Rapid Recommendation panel provided input on design, important outcomes and the interpretation of the results. Eligible randomised controlled trials (RCTs) included a comparison of antibiotics against no antibiotics or a comparison of different antibiotics in patients with uncomplicated skin abscesses, and reported outcomes prespecified by the linked guideline panel.Review methodsReviewers independently screened abstracts and full texts for eligibility, assessed risk of bias and extracted data. We performed random-effects meta-analyses that compared antibiotics with no antibiotics, along with a limited number of prespecified subgroup hypotheses. We also performed network meta-analysis with a Bayesian framework to compare effects of different antibiotics. Quality of evidence was assessed with The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsFourteen RCTs including 4198 patients proved eligible. Compared with no antibiotics, antibiotics probably lower the risk of treatment failure (OR 0.58, 95% CI 0.37 to 0.90; low quality), recurrence within 1 month (OR 0.48, 95% CI 0.30 to 0.77; moderate quality), hospitalisation (OR 0.55, 95% CI 0.32 to 0.94; moderate quality) and late recurrence (OR 0.64, 95% CI 0.48 to 0.85; moderate quality). However, relative to no use, antibiotics probably increase the risk of gastrointestinal side effects (trimethoprim and sulfamethoxazole (TMP-SMX): OR 1.28, 95% CI 1.04 to 1.58; moderate quality; clindamycin: OR 2.29, 95% CI 1.35 to 3.88; high quality) and diarrhoea (clindamycin: OR 2.71, 95% CI 1.50 to 4.89; high quality). Cephalosporins did not reduce the risk of treatment failure compared with placebo (moderate quality).ConclusionsIn patients with uncomplicated skin abscesses, moderate-to-high quality evidence suggests TMP-SMX or clindamycin confer a modest benefit for several important outcomes, but this is offset by a similar risk of adverse effects. Clindamycin has a substantially higher risk of diarrhoea than TMP-SMX. Cephalosporins are probably not effective.

PWE-065 Antibodies-to-infliximab post induction can help identify inflammatory bowel disease patients at risk of treatment failure

2018 ◽  
Author(s):  
Gloria Shwe Zin Tun ◽  
Sister Laura Marshall ◽  
Sister Kerry Robinson ◽  
Sister Alison Wright ◽  
Dr Alenka Brookes ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
At Risk ◽  
Treatment Failure ◽  
Bowel Disease ◽  
Post Induction ◽  
Patients At Risk ◽  
Inflammatory Bowel ◽  
Risk Of Treatment

scholarly journals Total Count of White Blood Cells in Adult Male Smokers

1970 ◽  
Vol 2 ◽  
pp. 49-53 ◽  
Author(s):  
Mohammed Montasir Islam ◽  
Md Ruhul Amin ◽  
Shameema Begum ◽  
Dilruba Akther ◽  
Abedur Rahman
Keyword(s):  
Cigarette Smoking ◽  
Adult Male ◽  
White Blood Cells ◽  
Total Count ◽  
Cigarette Smokers ◽  
History Of ◽  
Study Population ◽  
One Year ◽  
Wbc Count ◽  
Apparently Healthy

The present study was carried out to observe the changes in total count in WBC in cigarette smokers. The study population consisted of 105 adult male smokers and non-smokers, aged 20~40 years, from different socio-economic classes. Among them, 30 apparently healthy non-smokers were taken as control. 75 apparently healthy smokers, who had the history of smoking of one or more cigarette per day, regularly for at least last one year, were taken as the study group. Smokers were again subdivided into three categories according to the number of cigarettes they consumed per day. For statistical analysis unpaired ‘t' test was used for comparison. Mean ± SD of Total count of WBC in non smokers and smokers were 7501.66 ± 929.4 /mm3 and 9171.3 ± 1037.7/mm3 respectively. Smokers had significantly (P<0.001) higher WBC counts than non-smokers. In addition, WBC count was found increased with intensity of smoking. The smokers who were smoking e 20 cigarettes per day had the higher total WBC count than those who were smoking lesser. The findings of the present study suggest that cigarette smoking may cause increased the total count of WBC, which may predict high risk for some fatal diseases. Key words: Cigarette Smoking; White Blood Cell; Adult Male DOI:10.3329/jbsp.v2i0.985 J Bangladesh Soc Physiol. 2007 Dec;(2): 49-53

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