scholarly journals Correlation of Urine Loss after Catheter Removal and Early Continence in Men Undergoing Radical Prostatectomy

2021 ◽  
Vol 28 (6) ◽  
pp. 4738-4747
Author(s):  
Benedikt Hoeh ◽  
Felix Preisser ◽  
Mike Wenzel ◽  
Clara Humke ◽  
Clarissa Wittler ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Models ◽  
Catheter Removal ◽  
Urinary Continence ◽  
Nerve Sparing ◽  
Logistic Regression Models ◽  
Pad Test ◽  
Multivariable Logistic Regression ◽  
Transurethral Catheter ◽  
Urine Loss

Background: To determine the correlation between urine loss in PAD-test after catheter removal, and early urinary continence (UC) in RP treated patients. Methods: Urine loss was measured by using a standardized, validated PAD-test within 24 h after removal of the transurethral catheter, and was grouped as a loss of <1, 1–10, 11–50, and >50 g of urine, respectively. Early UC (median: 3 months) was defined as the usage of no or one safety-pad. Uni- and multivariable logistic regression models tested the correlation between PAD-test results and early UC. Covariates consisted of age, BMI, nerve-sparing approach, prostate volume, and extraprostatic extension of tumor. Results: From 01/2018 to 03/2021, 100 patients undergoing RP with data available for a PAD-test and early UC were retrospectively identified. Ultimately, 24%, 47%, 15%, and 14% of patients had a loss of urine <1 g, 1–10 g, 11–50 g, and >50 g in PAD-test, respectively. Additionally, 59% of patients reported to be continent. In multivariable logistic regression models, urine loss in PAD-test predicted early UC (OR: 0.21 vs. 0.09 vs. 0.03; for urine loss 1–10 g vs. 11–50 g vs. >50 g, Ref: <1 g; all p < 0.05). Conclusions: Urine loss after catheter removal strongly correlated with early continence as well as a severity in urinary incontinence.

scholarly journals Effect of prostatic apex shape (Lee types) and urethral sphincter length in preoperative MRI on very early continence rates after radical prostatectomy

2021 ◽  
Author(s):  
Mike Wenzel ◽  
Felix Preisser ◽  
Matthias Mueller ◽  
Lena H. Theissen ◽  
Maria N. Welte ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Radical Prostatectomy ◽  
Regression Models ◽  
Urethral Sphincter ◽  
Anatomical Characteristics ◽  
Logistic Regression Models ◽  
Pad Test ◽  
Type D ◽  
Multivariable Logistic Regression ◽  
Type C

Abstract Purpose To test the effect of anatomic variants of the prostatic apex overlapping the membranous urethra (Lee type classification), as well as median urethral sphincter length (USL) in preoperative multiparametric magnetic resonance imaging (mpMRI) on the very early continence in open (ORP) and robotic-assisted radical prostatectomy (RARP) patients. Methods In 128 consecutive patients (01/2018–12/2019), USL and the prostatic apex classified according to Lee types A–D in mpMRI prior to ORP or RARP were retrospectively analyzed. Uni- and multivariable logistic regression models were used to identify anatomic characteristics for very early continence rates, defined as urine loss of ≤ 1 g in the PAD-test. Results Of 128 patients with mpMRI prior to surgery, 76 (59.4%) underwent RARP vs. 52 (40.6%) ORP. In total, median USL was 15, 15 and 10 mm in the sagittal, coronal and axial dimensions. After stratification according to very early continence in the PAD-test (≤ 1 g vs. > 1 g), continent patients had significantly more frequently Lee type D (71.4 vs. 54.4%) and C (14.3 vs. 7.6%, p = 0.03). In multivariable logistic regression models, the sagittal median USL (odds ratio [OR] 1.03) and Lee type C (OR: 7.0) and D (OR: 4.9) were independent predictors for achieving very early continence in the PAD-test. Conclusion Patients’ individual anatomical characteristics in mpMRI prior to radical prostatectomy can be used to predict very early continence. Lee type C and D suggest being the most favorable anatomical characteristics. Moreover, longer sagittal median USL in mpMRI seems to improve very early continence rates.

scholarly journals Youth Access to School Salad Bars in the United States—2011 to 2014

2016 ◽  
Vol 32 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Brenna K. VanFrank ◽  
Stephen Onufrak ◽  
Diane M. Harris
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Regression Models ◽  
The United States ◽  
Logistic Regression Models ◽  
Multivariable Logistic Regression ◽  
Let's Move ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Over Time

Purpose: To examine differences in students’ access to school salad bars across sociodemographic groups and changes in availability over time. Design: Nonexperimental. Setting: Nationally representative 2011 and 2014 YouthStyles surveys. Participants: A total of 833 (2011) and 994 (2014) US youth aged 12 to 17 years. Measures: Youth-reported availability of school salad bars. Analysis: Multivariable logistic regression models were used to assess differences in school salad bar availability by sociodemographics and changes in availability from 2011 to 2014. Results: Youth-reported salad bar availability differed by age in 2011 and race/ethnicity in 2014, but not by sex, income, metropolitan residence, or region in either year. Salad bars were reported by 62% of youth in 2011 and 67% in 2014; the increase was not statistically significant ( P = .07). Significant increases from 2011 to 2014 were noted among youth aged 12 to 14 years (56%-69%; P < .01), youth of non-Hispanic other races (60%-85%; P < .01), and youth in the Midwest (58%-72%; P = .01). Conclusion: These results suggest that youth-reported access to school salad bars does not differ significantly across most sociodemographic groups. Although overall salad bar availability did not increase significantly from 2011 to 2014, some increases were observed among subgroups. Continued efforts to promote school salad bars through initiatives such as Let’s Move Salad Bars to Schools could help increase access for the nearly one-third of US youth reporting no access.

scholarly journals Trends and Social Barriers for Inpatient Palliative Care in Patients With Metastatic Bladder Cancer Receiving Critical Care Therapies

2019 ◽  
Vol 17 (11) ◽  
pp. 1344-1352 ◽  
Author(s):  
Elio Mazzone ◽  
Sophie Knipper ◽  
Francesco A. Mistretta ◽  
Carlotta Palumbo ◽  
Zhe Tian ◽  
...  
Keyword(s):  
Palliative Care ◽  
Logistic Regression ◽  
Critical Care ◽  
Liver Metastases ◽  
Regression Models ◽  
Temporal Trends ◽  
Recent Analysis ◽  
Logistic Regression Models ◽  
Multivariable Logistic Regression ◽  
Nationwide Inpatient Sample Database

Background: Use of inpatient palliative care (IPC) in the treatment of advanced cancer represents a well-established guideline recommendation. A recent analysis showed that patients with genitourinary cancer benefit from IPC at the second lowest rate among 4 examined primary cancers, namely lung, breast, colorectal, and genitourinary. Based on this observation, temporal trends and predictors of IPC use were examined in patients with metastatic urothelial carcinoma of the bladder (mUCB) receiving critical care therapies (CCTs). Patients and Methods: Patients with mUCB receiving CCTs were identified within the Nationwide Inpatient Sample database (2004–2015). IPC use rates were evaluated in estimated annual percentage change (EAPC) analyses. Multivariable logistic regression models with adjustment for clustering at the hospital level were used. Results: Of 1,944 patients with mUCB receiving CCTs, 191 (9.8%) received IPC. From 2004 through 2015, IPC use increased from 0.7% to 25.0%, respectively (EAPC, +23.9%; P<.001). In analyses stratified according to regions, the highest increase in IPC use was recorded in the Northeast (EAPC, +44.0%), followed by the West (EAPC, +26.8%), South (EAPC, +22.9%), and Midwest (EAPC, +15.5%). Moreover, the lowest rate of IPC adoption in 2015 was recorded in the Midwest (14.3%). In multivariable logistic regression models, teaching status (odds ratio [OR], 1.97; P<.001), more recent diagnosis (2010–2015; OR, 3.89; P<.001), and presence of liver metastases (OR, 1.77; P=.02) were associated with higher IPC rates. Conversely, Hispanic race (OR, 0.42; P=.03) and being hospitalized in the Northeast (OR, 0.36; P=.01) were associated with lower rate of IPC adoption. Finally, patients with a primary admission diagnosis that consisted of infection (OR, 2.05; P=.002), cardiovascular disorders (OR, 2.10; P=.03), or pulmonary disorders (OR, 2.81; P=.005) were more likely to receive IPC. Conclusions: The rate of IPC use in patients with mUCB receiving CCTs sharply increased between 2004 and 2015. The presence of liver metastases, infections, or cardiopulmonary disorders as admission diagnoses represented independent predictors of higher IPC use. Conversely, Hispanic race, nonteaching hospital status, and hospitalization in the Midwest were identified as independent predictors of lower IPC use and represent targets for efforts to improve IPC delivery in patients with mUCB receiving CCT.

POLYSUBSTANCE USE IN INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S54-S55
Author(s):  
Kaleb Bogale ◽  
Kent Vrana ◽  
Wesley Raup-Konsavage ◽  
Vonn Walter ◽  
August Stuart ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Substance Use ◽  
Logistic Regression ◽  
Disease Activity ◽  
Bowel Disease ◽  
Regression Models ◽  
Logistic Regression Models ◽  
Polysubstance Use ◽  
Multivariable Logistic Regression ◽  
Inflammatory Bowel

Abstract Background Polysubstance Use (PSU), the use of two or more substances of abuse, has been associated with increased risk for development of psychiatric conditions and early death compared to both monosubstance use or no substance use. The vast majority of clinical research on prescription or recreational drug consumption in patients with inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and ulcerative colitis (UC), has focused on use of individual substances. We evaluated the incidence and impact of PSU in IBD and assessed potential predisposing factors in this setting. Methods We performed a retrospective analysis using a consented IBD natural history registry from a single tertiary care referral center between 1/1/2015–8/31/2019. Demographics, endoscopic severity (using Mayo endoscopy sub-score for UC and Simple Endoscopic Score for CD), totals and sub-scores of surveys (Harvey-Bradshaw Index, Simple Clinical Colitis Activity Index, Hospital Anxiety and Depression Scale, Short IBD Questionnaire) assessing for symptoms (abdominal pain, fatigue, anxiety/depression, gas, diarrhea, rectal bleeding, and fecal urgency), substance use (tobacco, alcohol, marijuana, cocaine, methamphetamine, heroin, opiates, or benzodiazepine), and antidepressant or anxiolytic medication were abstracted. PSU was defined as concurrent use of two or more non-prescription drugs or substances, and healthcare resource utilization was defined as any IBD-related imaging, emergency room visit, hospitalization, or surgery over the prior 12 months. We computed descriptive statistics and performed contingency table analyses in order to identify associations between PSU and a variety of demographic and clinical characteristics. Multivariable logistic regression models were fit incorporating the clinical factors described above. Results 315 consecutively enrolled IBD patients (166f:149m; 214 CD and 101 UC) were included. Sixty-six patients (21.0%) were polysubstance users. Of these patients, 40.9% had moderate to severe disease activity, 47.0% had extra-intestinal manifestations (EIM), and 36.4% demonstrated an anxious or depressed state. EIM and antidepressant or anxiolytic use were positively associated with PSU on bivariate analysis (Table 1) and multivariable analysis (Table 2). Conclusions PSU is common in IBD, including both CD and UC. Interestingly, disease activity, IBD therapy type, and IBD-related symptoms were not associated with PSU. EIM and antidepressant or anxiolytic use were the only statistically significant predictors of PSU among patients with IBD in the multivariable logistic regression models. Our study represents the first evaluation of PSU within IBD and reinforces the importance of appropriate substance use screening among IBD patients, particularly among those with EIM and antidepressant or anxiolytic use.

Residents’ educational attainment and preventive care utilization in China

2018 ◽  
Vol 31 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Yen-Han Lee ◽  
Timothy Chiang ◽  
Ching-Ti Liu
Keyword(s):  
Logistic Regression ◽  
Preventive Care ◽  
Health Reform ◽  
Regression Models ◽  
Education Level ◽  
Care Utilization ◽  
Content Type ◽  
Logistic Regression Models ◽  
Multivariable Logistic Regression ◽  
Before And After

Purpose China launched a comprehensive health reform in 2009 to improve healthcare quality. Because preventive care utilization in China has not been frequently discussed, the purpose of this paper is to focus on the association between education level and preventive care before and after the initiation of the reform. Education has been referred to as the best health outcome indicator and China’s educational reform has been progressive, such as the health reform. Design/methodology/approach The authors analyzed data from four China Health and Nutrition Surveys (CHNS): 2004 (n=9,617); 2006 (n=9,527); 2009 (n=9,873); and 2011 (n=9,430). Variables were selected based on Andersen’s healthcare utilization model (predisposing, enabling and need factors). Multivariable logistic regression models, odds ratios (ORs) and 95 percent confidence intervals (95 percent CI) were conducted and reported. Findings In the adjusted multivariable logistic regression models, the authors found that general education was associated (p<0.05) with access to preventive care in 2004, 2009 and 2011, but not in 2006. Individuals with higher education had higher ORs for utilizing preventive care, compared with lower education (primary school education or none). Practical implications Policy implications include providing educational protocols regarding preventive care’s significance to residents educated at lower level schools, especially younger individuals. Originality/value To the authors’ knowledge, this is the first comparative assessment on education level and preventive care utilization before and after the implementation of the Chinese health reform.

The impact of SPY angiography on intraoperative decision making and outcomes for post-mastectomy reconstruction

2019 ◽  
pp. 1-5
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Skin Necrosis ◽  
Regression Models ◽  
Multivariable Analysis ◽  
P Value ◽  
Flap Necrosis ◽  
Single Institution ◽  
Logistic Regression Models ◽  
The Impact

Objective: While the use of intraoperative laser angiography (SPY) is increasing in mastectomy patients, its impact in the operating room to change the type of reconstruction performed has not been well described. The purpose of this study is to investigate whether SPY angiography influences post-mastectomy reconstruction decisions and outcomes. Methods and materials: A retrospective analysis of mastectomy patients with reconstruction at a single institution was performed from 2015-2017.All patients underwent intraoperative SPY after mastectomy but prior to reconstruction. SPY results were defined as ‘good’, ‘questionable’, ‘bad’, or ‘had skin excised’. Complications within 60 days of surgery were compared between those whose SPY results did not change the type of reconstruction done versus those who did. Preoperative and intraoperative variables were entered into multivariable logistic regression models if significant at the univariate level. A p-value <0.05 was considered significant. Results: 267 mastectomies were identified, 42 underwent a change in the type of planned reconstruction due to intraoperative SPY results. Of the 42 breasts that underwent a change in reconstruction, 6 had a ‘good’ SPY result, 10 ‘questionable’, 25 ‘bad’, and 2 ‘had areas excised’ (p<0.01). After multivariable analysis, predictors of skin necrosis included patients with ‘questionable’ SPY results (p<0.01, OR: 8.1, 95%CI: 2.06 – 32.2) and smokers (p<0.01, OR:5.7, 95%CI: 1.5 – 21.2). Predictors of any complication included a change in reconstruction (p<0.05, OR:4.5, 95%CI: 1.4-14.9) and ‘questionable’ SPY result (p<0.01, OR: 4.4, 95%CI: 1.6-14.9). Conclusion: SPY angiography results strongly influence intraoperative surgical decisions regarding the type of reconstruction performed. Patients most at risk for flap necrosis and complication post-mastectomy are those with questionable SPY results.

785 Reported Restful Sleep Predicting Emotional Distress: Does Exercise (and its modalities) moderate?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A305-A306
Author(s):  
Jesse Moore ◽  
Ellita Williams ◽  
Collin Popp ◽  
Anthony Briggs ◽  
Judite Blanc ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Aerobic Exercise ◽  
Regression Models ◽  
Regression Analyses ◽  
Logistic Regression Models ◽  
The Past ◽  
Strengthening Exercise ◽  
Waking Up ◽  
The Relationship ◽  
Age And Sex

Abstract Introduction Literature shows that exercise moderates the relationship between sleep and emotional distress (ED.) However, it is unclear whether different types of exercise, such as aerobic and strengthening, affect this relationship differently. We investigated the moderating role of two types of exercise (aerobic and strengthening) regarding the relationship between ED and sleep. Methods Our analysis was based on data from 2018 National Health Interview Survey (NHIS), a nationally representative study in which 2,814 participants provided all data. Participants were asked 1) “how many days they woke up feeling rested over the past week”, 2) the Kessler 6 scale to determine ED (a score &gt;13 indicates ED), and 3) the average frequency of strengthening or aerobic exercise per week. Logistic regression analyses were performed to determine if the reported days of waking up rested predicted level of ED. We then investigated whether strengthening or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Logistic regression analyses were performed to determine if subjective reporting of restful sleep predicted level of ED. We investigated whether strengthening exercise or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Results On average, participants reported 4.41 restful nights of sleep (SD =2.41), 3.43 strengthening activities (SD = 3.19,) and 8.47 aerobic activities a week (SD=5.91.) We found a significant association between days over the past week reporting waking up feeling rested and ED outcome according to K6, Χ2(1) = -741, p= &lt;.001. The odds ratio signified a decrease of 52% in ED scores for each unit of restful sleep (OR = .48, (95% CI = .33, .65) p=&lt;.001.) In the logistic regression model with moderation, aerobic exercise had a significant moderation effect, Χ2(1) = .03, p=.04, but strengthening exercise did not. Conclusion We found that restful sleep predicted reduction in ED scores. Aerobic exercise moderated this relationship, while strengthening exercise did not. Further research should investigate the longitudinal effects of exercise type on the relationship between restful sleep and ED. Support (if any) NIH (K07AG052685, R01MD007716, K01HL135452, R01HL152453)

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