scholarly journals The Association Between Age and Prognosis in Patients Under 45 Years of Age With Anti-NMDA Receptor Encephalitis

2020 ◽  
Vol 11 ◽  
Author(s):  
Yueqian Sun ◽  
Guoping Ren ◽  
Jiechuan Ren ◽  
Wei Shan ◽  
Xiong Han ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Nmda Receptor ◽  
Confidence Interval ◽  
Modified Rankin Scale ◽  
Odds Ratios ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Multivariable Logistic Regression ◽  
Neurological Prognosis

This study aims to evaluate the association between age and prognosis in patients with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) under the age of 45 years. A retrospective study was conducted in patients younger than 45 years diagnosed as anti-NMDARE in four hospitals in China. Age at admission was divided into four categories: <15, 15–24, 25–34, 35–45 years. Neurological prognosis was evaluated using modified Rankin Scale. Adjusted multivariable logistic regression was used to analyze the association. The multivariable-adjusted odds ratios (95% confidence interval) of prognosis in anti-NMDARE across the categories of age were as follows: in males, 1.00 (reference), 4.76 (0.39–58.76), 13.50 (0.79–230.40), and 8.81 (0.36–218.39) (P for trend = 0.171); in females, 1.00 (reference), 7.27 (0.36–146.19), 20.08 (1.09–370.39), and 54.41 (1.60–1,849.10) (P for trend = 0.01). We concluded that the increasing age was associated with a poorer prognosis of anti-NMDARE in females but not males.

scholarly journals Interictal high frequency background activity as a biomarker of epileptogenic tissue

2021 ◽  
Author(s):  
Truman Stovall ◽  
Brian Hunt ◽  
Simon Glynn ◽  
William C Stacey ◽  
Stephen V Gliske
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
High Frequency ◽  
High Frequency Oscillation ◽  
Epileptogenic Zone ◽  
Odds Ratios ◽  
Seizure Onset ◽  
High Frequency Oscillations ◽  
Seizure Onset Zone ◽  
Background Data

Abstract High Frequency Oscillations are very brief events that are a well-established biomarker of the epileptogenic zone, but are rare and comprise only a tiny fraction of the total recorded EEG. We hypothesize that the interictal high frequency “background” data, which has received little attention but represents the majority of the EEG record, also may contain additional, novel information for identifying the epileptogenic zone. We analyzed intracranial EEG (30–500 Hz frequency range) acquired from 24 patients who underwent resective surgery. We computed 38 quantitative features based on all usable, interictal data (63–307 hours per subject), excluding all detected high frequency oscillations. We assessed association between each feature and the seizure onset zone and resected volume using logistic regression. A pathology score per channel was also created via principle component analysis and logistic regression, using hold-out-one-patient cross validation to avoid in-sample training. Association of the pathology score with the seizure onset zone and resected volume was quantified using an asymmetry measure. Many features were associated with the seizure onset zone: 23/38 features had odds ratios >1.3 or < 0.7 and 17/38 had odds ratios different than zero with high significance (p < 0.001/39, logistic regression with Bonferroni Correction). The pathology score, the rate of high frequency oscillations, and their channel-wise product were each strongly associated with the seizure onset zone (median asymmetry > =0.44, good surgery outcome patients; median asymmetry > =0.40, patients with other outcomes; 95% confidence interval > 0.27 in both cases). The pathology score and the channel-wise product also had higher asymmetry with respect to the seizure onset zone than the high frequency oscillation rate alone (median difference in asymmetry > =0.18, 95% confidence interval >0.05). These results support that the high frequency background data contains useful information for determining the epileptogenic zone, distinct and complementary to information from detected high frequency oscillations. The concordance between the high frequency activity pathology score and the rate of high frequency oscillations appears to be a better biomarker of epileptic tissue than either measure alone.

scholarly journals Sugar-Containing Beverages Consumption and Obesity in Children Aged 4–5 Years in Spain: the INMA Study

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1772 ◽  
Author(s):  
Sandra Gonzalez-Palacios ◽  
Eva-María Navarrete-Muñoz ◽  
Manoli García-de-la-Hera ◽  
Laura Torres-Collado ◽  
Loreto Santa-Marina ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preschool Children ◽  
Confidence Interval ◽  
Soft Drinks ◽  
Multiple Logistic Regression ◽  
Obese Children ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Obesity In Children

The consumption of sugar-containing beverages (SCB) has been associated with obesity although the evidence in preschool children is scarce. Cross-sectional analyses were performed to assess the association between obesity and SCB consumption (packaged juices and sugar-sweetened soft drinks) in 1823 children at the age of 4–5 years from the INfancia y Medio Ambiente (INMA) Project. One drink was defined as a glass of 175 mL, and the consumption of SCB was categorized in <1, 1–7 drinks/week and > 1 drink/day. We used multiple logistic regression to estimate odds ratios (OR). The average SCB consumption was 79.1 mL/day, mainly from packaged juices (80.9%). The SCB consumption was lower in non-obese children than in children with obesity, 76.6 vs 118.4 mL/day (p = 0.02). After adjusting for covariates, children who consumed >1 drink/day showed elevated odds of obesity, OR = 3.23 (95% confidence interval (CI): 1.48–6.98) compared to children who consumed <1 SCB drink a week. Each additional SCB drink per day was associated with higher odds of obesity, OR = 1.55 (1.14–2.09). Higher consumption of packaged juices, but not sugar-sweetened soft drinks, was significantly associated with higher odds of obesity, OR = 1.55 (1.09–2.15) and OR = 1.59 (0.76–3.39), respectively. A higher SCB consumption is associated with obesity in preschool children, mainly due to the consumption of packaged juices.

scholarly journals Antibody titres at diagnosis and during follow-up of anti-NMDA receptor encephalitis: a retrospective study

2014 ◽  
Vol 13 (2) ◽  
pp. 167-177 ◽  
Author(s):  
Nuria Gresa-Arribas ◽  
Maarten J Titulaer ◽  
Abiguei Torrents ◽  
Esther Aguilar ◽  
Lindsey McCracken ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Nmda Receptor ◽  
Nmda Receptor Encephalitis ◽  
Antibody Titres

scholarly journals Risk Factors in Patients with Diabetes Hospitalized for COVID-19: Findings from a Multicenter Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yili Zhang ◽  
Juan Wang ◽  
Nannan Tan ◽  
KangJia Du ◽  
Kuo Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Retrospective Study ◽  
Age Factors ◽  
Laboratory Data ◽  
The Elderly ◽  
Electrolyte Disorders ◽  
Multivariable Logistic Regression Model ◽  
Multivariable Logistic Regression ◽  
Patients With Diabetes

Background and Purpose. Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and identify the risk factors for COVID-19 patients complicated with diabetes. Methods. In this multicenter retrospective study, patients with COVID-19 in China were included and classified into two groups according to whether they were complicated with diabetes or not. Demographic symptoms and laboratory data were extracted from medical records. Univariable and multivariable logistic regression methods were used to explore the risk factors. Results. 538 COVID-19 patients were finally included in this study, of whom 492 were nondiabetes and 46 were diabetes. The median age was 47 years (IQR 35.0-56.0). And the elderly patients with diabetes were more likely to have dry cough, and the alanine aminotransferase, lactate dehydrogenase, Ca, and mean hemoglobin recovery rate were higher than the other groups. Furthermore, we also found the liver and kidney function of male patients was worse than that of female patients, while female cases should be paid more attention to the occurrence of bleeding and electrolyte disorders. Moreover, advance age, blood glucose, gender, prothrombin time, and total cholesterol could be considered as risk factors for COVID-19 patients with diabetes through the multivariable logistic regression model in our study. Conclusion. The potential risk factors found in our study showed a major piece of the complex puzzle linking diabetes and COVID-19 infection. Meanwhile, focusing on gender and age factors in COVID-19 patients with or without diabetes, specific clinical characteristics, and risk factors should be paid more attention by clinicians to figure out a targeted intervention to improve clinical efficacy worldwide.

scholarly journals NATURAL PRODUCTS IN TREATMENT OF ENCEPHALITIS: A REVIEW

2021 ◽  
Vol 21 (no 1) ◽  
Author(s):  
Danishpreet Kaur Takhar ◽  
Mukta Gupta
Keyword(s):  
Natural Products ◽  
Nmda Receptor ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Psychotic Disorders ◽  
Treatment Options ◽  
Therapeutic Approaches ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor

Brain on fire, an unusual phrase used for the deadliest autoimmune ailment, called anti-NMDA (N-methyl-D-aspartate) receptor encephalitis, characterizing extreme psychiatric and neurotic signs. Though being the deadliest one, still it can be treated with the help of various therapeutic approaches such as Corticosteroids, Intravenous immunoglobulin (IVIG) and plasmapheresis or plasma exchange. Although the prevalence of encephalitis can be observed in both the sexes, however the majority of ailment (95%) is seen in women with teratoma ovaries or different neoplasms. Recognition of nti-NMDA receptor encephalitis could be very essential to avoid any misconception regarding incorrect interpretation of various psychotic disorders. However, various treatment options are available still further investigation should be required to carried out to find out other clinically beneficial drugs.

BOTTLENECK FACTOR AND HEIGHT-WIDTH RATIO

Neurosurgery ◽  
2007 ◽  
Vol 61 (4) ◽  
pp. 716-723 ◽  
Author(s):  
Brian L. Hoh ◽  
Christopher L. Sistrom ◽  
Christopher S. Firment ◽  
Gregory L. Fautheree ◽  
Gregory J. Velat ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Cerebral Aneurysms ◽  
Maximum Diameter ◽  
Width Ratio ◽  
Parent Artery ◽  
Computed Tomographic ◽  
Multivariable Logistic Regression ◽  
Risk Of Rupture

Abstract OBJECTIVE Determining factors predictive of the natural risk of rupture of cerebral aneurysms is difficult because of the need to control for confounding variables. We studied factors associated with rupture in a study model of patients with multiple cerebral aneurysms, one aneurysm that had ruptured and one or more that had not, in which each patient served as their own internal control. METHODS We collected aneurysm location, one-dimensional measurements, and two-dimensional indices from the computed tomographic angiograms of patients in the proposed study model and compared ruptured versus unruptured aneurysms. Bivariate statistics were supplemented with multivariable logistic regression analysis to model ruptured status. A total of 40 candidate models were evaluated for predictive power and fit with Wald scoring, Cox and Snell R2, Hosmer and Lemeshow tests, case classification counting, and residual analysis to determine which of the computed tomographic angiographic measurements or indices were jointly associated with and predictive of aneurysm rupture. RESULTS Thirty patients with 67 aneurysms (30 ruptured, 37 unruptured) were studied. Maximum diameter, height, maximum width, bulge height, parent artery diameter, aspect ratio, bottleneck factor, and aneurysm/parent artery ratio were significantly (P &lt; 0.05) associated with ruptured aneurysms on bivariate analysis. When best subsets and stepwise multivariable logistic regression was performed, bottleneck factor (odds ratio = 1.25, confidence interval = 1.11–1.41 for every 0.1 increase) and height-width ratio (odds ratio = 1.23, confidence interval = 1.03–1.47 for every 0.1 increase) were the only measures that were significantly predictive of rupture. CONCLUSION In a case-control study of patients with multiple cerebral aneurysms, increased bottleneck factor and height-width ratio were consistently associated with rupture.

scholarly journals Anti-N-methyl-d-aspartate receptor encephalitis: review of clinical presentation, diagnosis and treatment

2015 ◽  
Vol 39 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Helen Barry ◽  
Susan Byrne ◽  
Elizabeth Barrett ◽  
Kieran C. Murphy ◽  
David R. Cotter
Keyword(s):  
Nmda Receptor ◽  
Clinical Presentation ◽  
Behavioural Change ◽  
Review Of The Literature ◽  
Impaired Consciousness ◽  
Motor Disturbance ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Nr2 Subunits ◽  
Symptoms And Signs

SummaryAnti-N-methyl-d-aspartate (NMDA) receptor encephalitis is a form of encephalitis occurring primarily in women and associated with antibodies against NR1 or NR2 subunits of the NMDA receptor. As a potentially treatable differential for symptoms and signs seen in neurology and psychiatric clinics, clinicians practising across the lifespan should be aware of this form of encephalitis. Common clinical features include auditory and visual hallucinations, delusions, behavioural change (frequently with agitation), impaired consciousness, motor disturbance (ranging from dyskinesia to catatonia), seizures, and autonomic dysfunction. We present a review of the literature on the disorder, including its clinical presentation, differential diagnosis, epidemiology, treatment and prognosis.

Group B streptococcal colonization and the risk of pre-eclampsia

2012 ◽  
Vol 141 (5) ◽  
pp. 1089-1098 ◽  
Author(s):  
Z. D. MULLA ◽  
V. ANNAVAJJHALA ◽  
J. L. GONZALEZ-SANCHEZ ◽  
M. R. SIMON ◽  
B. S. NUWAYHID
Keyword(s):  
Sensitivity Analysis ◽  
Logistic Regression ◽  
Confidence Interval ◽  
Group B Streptococcus ◽  
The State ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
Group B

SUMMARYTo determine if there was an association between recto-vaginal group B streptococcus (GBS) colonization and pre-eclampsia, two cross-sectional studies were conducted using statewide hospital databases. The first study analysed data from the state of Florida, USA, and included 190 645 women who were discharged in 2001. This dataset was used to generate the hypothesis that GBS colonization is associated with pre-eclampsia. The second study tested the GBS hypothesis using the records of 577 153 women who delivered in 2004 or 2005 in Texas, USA. Adjusted odds ratios (aOR) for the outcome of pre-eclampsia comparing GBS-positive to GBS-negative women were calculated using logistic regression. The aOR for the association between GBS carriage and pre-eclampsia was 0·71 [95% confidence interval (CI) 0·65–0·77] in the Florida dataset. In the Texas dataset, the overall prevalence of GBS carriage was 14·1% while the overall prevalence of pre-eclampsia was 4·0%. GBS carriers were 31% less likely than non-carriers to have pre-eclampsia (aOR 0·69, 95% CI 0·66–0·72) in Texas. In two large statewide analyses, GBS carriage was inversely associated with pre-eclampsia. A sensitivity analysis revealed that misclassification of GBS status is not a likely explanation of our findings.

EEG Findings May Serve as a Potential Biomarker for Anti–NMDA Receptor Encephalitis

2016 ◽  
Vol 48 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Erin Pennock Foff ◽  
David Taplinger ◽  
Joanna Suski ◽  
M. Beatriz S. Lopes ◽  
Mark Quigg
Keyword(s):  
Early Identification ◽  
Clinical Characteristics ◽  
Power Ratio ◽  
Modified Rankin Scale ◽  
Single Center ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Retrospective Comparison ◽  
Potential Biomarker ◽  
Risk Patients

Objective. To determine if an electroencephalographic (EEG) characteristic, beta:delta power ratio (BDPR), is significantly higher for N-methyl-d-aspartate receptor encephalitis (NMDARE) patients than for non-NMDARE patients on presenting EEG. Identification of an additional EEG biomarker with significant specificity for NMDARE (in the absence of frank delta brush) could potentially allow for early identification of at-risk patients. Methods. Single center retrospective comparison of NMDARE and non-NMDARE consecutive cases of encephalitis, collated over a 6-year period (from 2008 to 2014). Results. None of the 10 NMDARE patients displayed the extreme delta brush pattern on EEG previously described, but the ratio of BDPR was significantly higher for NMDARE patients ( P < .005). There was no significant relationship between BDPR and the time of recording from symptom onset. Additional analysis of clinical characteristics also indicated that the patients with NMDARE (median age 19.5 years) were younger than the 5 patients with non-NMDARE (median age 36 years). Encephalopathy, seizure, and psychiatric complaints were the most common diagnoses at time of first health care presentation and did not favor a single etiology, though the latter was present only in the NMDARE population (50% at T0). Prodromal illness featuring headache was more common in the non-NMDARE population. Outcomes, as measured by the Modified Rankin Scale, were globally better in the NMDARE group. Conclusions. Patients with NMDARE had a significantly higher BDPR on EEG when compared with non-NMDARE patients even in the absence of extreme delta brush. This suggests that early EEG characteristics may be helpful in distinguishing NMDARE from non-NMDARE.

scholarly journals Risk analysis of pulmonary metastasis of chondrosarcoma by establishing and validating a new clinical prediction model: a clinical study based on SEER database

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wenle Li ◽  
Shengtao Dong ◽  
Haosheng Wang ◽  
Rilige Wu ◽  
Huitao Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Confidence Interval ◽  
Predictive Ability ◽  
Receiver Operating Characteristics ◽  
Seer Database ◽  
Operating Characteristics ◽  
Multivariable Logistic Regression ◽  
Receiver Operating ◽  
Training Sets

Abstract Background The prognosis of lung metastasis (LM) in patients with chondrosarcoma was poor. The aim of this study was to construct a prognostic nomogram to predict the risk of LM, which was imperative and helpful for clinical diagnosis and treatment. Methods Data of all chondrosarcoma patients diagnosed between 2010 and 2016 was queried from the Surveillance, Epidemiology, and End Results (SEER) database. In this retrospective study, a total of 944 patients were enrolled and randomly splitting into training sets (n = 644) and validation cohorts(n = 280) at a ratio of 7:3. Univariate and multivariable logistic regression analyses were performed to identify the prognostic nomogram. The predictive ability of the nomogram model was assessed by calibration plots and receiver operating characteristics (ROCs) curve, while decision curve analysis (DCA) and clinical impact curve (CIC) were applied to measure predictive accuracy and clinical practice. Moreover, the nomogram was validated by the internal cohort. Results Five independent risk factors including age, sex, marital, tumor size, and lymph node involvement were identified by univariate and multivariable logistic regression. Calibration plots indicated great discrimination power of nomogram, while DCA and CIC presented that the nomogram had great clinical utility. In addition, receiver operating characteristics (ROCs) curve provided a predictive ability in the training sets (AUC = 0.789, 95% confidence interval [CI] 0.789–0.808) and the validation cohorts (AUC = 0.796, 95% confidence interval [CI] 0.744–0.841). Conclusion In our study, the nomogram accurately predicted risk factors of LM in patients with chondrosarcoma, which may guide surgeons and oncologists to optimize individual treatment and make a better clinical decisions. Trial registration JOSR-D-20-02045, 29 Dec 2020.

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