scholarly journals Predictors of Treatment Requirements in Women with Gestational Diabetes: A Retrospective Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4421
Author(s):  
Friederike Weschenfelder ◽  
Karolin Lohse ◽  
Thomas Lehmann ◽  
Ekkehard Schleußner ◽  
Tanja Groten
Keyword(s):  
Risk Factors ◽  
Gestational Diabetes ◽  
Insulin Treatment ◽  
Treatment Options ◽  
Patient Characteristics ◽  
Multivariate Regression Analysis ◽  
Fetal Ultrasound ◽  
Potential Risk Factors ◽  
Glucose Test ◽  
Bolus Insulin

The diagnosis of gestational diabetes is usually very stressful for pregnant women, especially because they fear that insulin treatment may become necessary. Knowledge about personal risk factors predicting the probability of insulin treatment could therefore help to improve acceptance of the diagnosis and therapy adherence. The aim of this study was to find potential risk factors for insulin dependency and treatment requirements using information available at the time of diagnosis of gestational diabetes during pregnancy. We included 454 singleton pregnancies diagnosed ≥24 weeks of gestation. Multivariate regression analysis was used to evaluate independent associations of metabolic, anthropometric and fetal ultrasound parameters with the general need for insulin treatment and further stratified treatment options: diet (n = 275), bolus insulin only (n = 45), basal insulin only (n = 73) and multiple daily injections (n = 61). Receiver operator characteristics and cut-off values for independent variables were generated. Treatment groups differed significantly concerning pre-pregnancy weight and BMI as well as fasting glucose and 1 h glucose test values. Significant cut-offs for insulin dependency were HbA1c level of 5.4%, FPG of 5.5 mmol/L and 1 h glucose of 10.6 mmol/L. At time of diagnosis, certain patient characteristics and measurements can help to predict treatment necessities and therefore improve individualized counselling.

scholarly journals Non-Smoking-Associated Lung Cancer: A distinct Entity in Terms of Tumor Biology, Patient Characteristics and Impact of Hereditary Cancer Predisposition

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 204 ◽  
Author(s):  
Elisabeth Smolle ◽  
Martin Pichler
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Tobacco Smoke ◽  
Treatment Options ◽  
Tumor Biology ◽  
Patient Characteristics ◽  
Driver Genes ◽  
Unique Type ◽  
Personalized Cancer Therapy ◽  
Personalized Cancer

Non-small cell lung cancer (NSCLC) in non-, and especially in never-smoking patients is considered a biologically unique type of lung cancer, since risk factors and tumorigenic conditions, other than tobacco smoke, come into play. In this review article, we comprehensively searched and summarized the current literature with the aim to outline what exactly triggers lung cancer in non-smokers. Changes in the tumor microenvironment, distinct driver genes and genetic pathway alterations that are specific for non-smoking patients, as well as lifestyle-related risk factors apart from tobacco smoke are critically discussed. The data we have reviewed highlights once again the importance of personalized cancer therapy, i.e., careful molecular and genetic assessment of the tumor to provide tailored treatment options with optimum chances of good response—especially for the subgroups of never-smokers.

scholarly journals Risk Factors for the Requirement of Antenatal Insulin Treatment in Gestational Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mayu Watanabe ◽  
Akihiro Katayama ◽  
Hidetoshi Kagawa ◽  
Daisuke Ogawa ◽  
Jun Wada
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Therapy ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Insulin Treatment ◽  
Diet Group ◽  
Glucose Levels

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n=10) and without insulin therapy (Diet group;n=27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.

Sternal Anomalies in Asymptomatic Patients after Median Sternotomy and Potential Influencing Factors

2017 ◽  
Vol 66 (06) ◽  
pp. 517-522
Author(s):  
Simon Sündermann ◽  
Hatem Alkadhi ◽  
Michele Genoni ◽  
Francesco Maisano ◽  
Maximilian Emmert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Surgery ◽  
Plate Fixation ◽  
Treatment Options ◽  
Open Heart Surgery ◽  
Median Sternotomy ◽  
Patient Specific ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Potential Risk Factors

Background We aimed to assess asymptomatic patients who had open-heart surgery with median sternotomy for potential sternal anomalies (SA), their related patient-specific risk factors, and treatment options for the prevention of SA. Methods Multiplanar CT scans (CTs) from 131 asymptomatic consecutive patients were analyzed retrospectively. Of these, 83 underwent CABG (63.4%), and 48 had aortic valve (AV) procedures via median sternotomy. Sternal bone healing was analyzed for SA and their exact location. Results In total, 49 SA were identified in 42 (32.1%) patients; 65% SA were found in the manubrium (n = 32). Five hundred thirty-two wires were implanted (4.2 ± 0.5 wires/patient), out of which 96.1% (n = 511) were figure 8 wires. There was no difference between normal and abnormal sterna with regard to the number of wires used for sternal closure (4.2 ± 0.5 vs. 4.3 ± 0.6, p = ns). The distance between wire placement to the proximal edge of the manubrium in normal and abnormal sterna was comparable (11.2 ± 4.2 vs. 10.9 ± 4.8 mm, p = ns). Patients who underwent CABG had a significantly higher risk for SA (OR = 2.4, p ≤ 0.05, 95% CI [1.2–4.9]). The use of BIMA (OR = 4.4, p ≤ 0.05, 95% CI [1.1–17.9]) and body mass index (BMI) > 31 kg/m2 (OR = 3.4, p ≤ 0.01, 95% CI [1.4–8.3]) significantly increased the risk of SA. Conclusion At least 30% of patients were at an increased risk for SA after receiving a median sternotomy. CABG, use of BIMA, and a BMI > 30 kg/m2 were potential risk factors for the development of SA and warrant close clinical follow-up. Sternal plate fixation, particularly in the manubrium, could be beneficial in such patients.

scholarly journals Patient Characteristics Can Influence the Incidence of Perioperative Microemboli during Carotid Artery Interventions

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Mohamed A. Zayed ◽  
Elizabeth Hitchner ◽  
Simin Gholibeikian ◽  
Allyson Rosen ◽  
Barton Lane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Patient Characteristics ◽  
Diffusion Weighted Mri ◽  
Specific Patient ◽  
Patient Cohort ◽  
Large Patient ◽  
Potential Risk Factors ◽  
History Of ◽  
Artery Disease

Purpose. Perioperative cerebral microembolization demonstrated on diffusion-weighted MRI (DWI) can occur following carotid endarterectomy (CEA) and carotid artery stenting (CAS). We sought to explore potential risk factors for this in the large patient cohort. Methods. We reviewed a 6-year consecutive patient cohort that received either CEA or CAS, and perioperative DWI evaluations. Results. 303 patients were reviewed, and 56 (19.4%) patients were found to have perioperative microemboli. The incidence was higher among patients who received CAS (P < 0.001). Hypertension (P = 0.03), smoking (P = 0.001), and a history of transient ischemic attacks (P = 0.04) were risk factors for microembolization. The risk was higher among CEA patients with obesity (P = 0.05), and among CAS patients with coronary artery disease (P = 0.03). Conclusion. Specific patient populations are likely more prone to develop perioperative cerebral microemboli following carotid intervention. Continued risk stratification may help decrease future perioperative cerebral microembolization rates.

Risk Factors for the Development of an Incisional Hernia after Sigmoid Resection for Diverticulitis: An Analysis of 33 Patient, Operative and Disease-associated Factors

2015 ◽  
Vol 81 (5) ◽  
pp. 492-497 ◽  
Author(s):  
Tara M. Connelly ◽  
Rafel Tappouni ◽  
Paul Mathew ◽  
Javier Salgado ◽  
Evangelos Messaris
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Incisional Hernia ◽  
Multivariate Regression Analysis ◽  
Sigmoid Resection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
History Of

Incisional hernia (IH) is a relatively common sequelae of sigmoidectomy for diverticulitis. The aim of this study was to investigate factors that may predict IH in diverticulitis patients. Two hundred and one diverticulitis patients undergoing sigmoidectomy between January 2002 and December 2012 were identified (mean follow-up 5.15 ± 2.33 years). Patients with wound infections were excluded. Thirteen patient-associated, three diverticular disease-related, and 17 operative variables were evaluated in patients with and without IH. Volumetric fat was measured on pre-operative CTs. Fischer's exact, χ2, and Mann–Whitney tests and multivariate regression analysis were used for statistics. Thirty-four (17%) patients had an IH. On multivariate analysis, wound packing (OR 3.4, P = 0.017), postoperative nonwound infection (OR 7.4, P = 0.014), and previous hernia (OR 3.6, P = 0.005) were as independent predictors of IH. Fifteen of 34 (44%) patients who developed a hernia had a history of prior hernia. Of 33 potential risk factors analyzed, including smoking, chronic obstructive pulmonary disease, and obesity, the only patient factor present preoperatively associated with increased risk of a postsigmoidectomy hernia after multivariate analysis was a history of a previous hernia. Preoperative identification of patients with a history of hernia offers the opportunity to employ measures to decrease the likelihood of IH.

Prevalence and Risk Factors of Anxiety and Depression in Patients with Postherpetic Neuralgia: A Retrospective Study

Dermatology ◽  
2020 ◽  
pp. 1-5
Author(s):  
Jingyi Du ◽  
Guoliang Sun ◽  
Han Ma ◽  
Ping Xiang ◽  
Yue Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pain Intensity ◽  
Postherpetic Neuralgia ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Patient Characteristics ◽  
Anxiety And Depression ◽  
Female Sex ◽  
Potential Risk Factors ◽  
Clinic Medical

Objectives: Pain and psychological disorders are the 2 most commonly occurring symptom clusters in patients with postherpetic neuralgia (PHN). This study aimed to investigate the risk factors for anxiety and depressive disorders in patients with PHN. Methods: Retrospectively, we examined the potential risk factors of anxiety and depression among patients with PHN from the clinic medical records of the Third Affiliated Hospital of Sun Yat-Sen University from 2017 to 2019. The Chinese version of the Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Patients were retrospectively allocated to 2 groups – PHN with and without anxiety/depression – and compared to identify the differential patient characteristics. Results: Cases of 661 patients who were diagnosed with PHN were included. Anxiety and depression developed in 69.0% (456/661) and 65.8% (435/661) of the enrolled patients with PHN, respectively. Results of univariate regression analyses showed that female sex, magnitude of pain intensity, time from onset of rash and extent of spread of rashes were significantly associated with anxiety and depression in patients with PHN. Multivariate analysis revealed that both anxiety and depression states significantly correlated with female sex, magnitude of pain intensity, and extent of spread of rashes. Conclusions: Anxiety and depression were not uncommon in patients with PHN. Women with PHN who experience severe pain and develop extensive rashes have a high risk of developing anxiety and depressive disorders.

scholarly journals Patient Characteristics Associated With Readmission to 3 Neurology Services at an Urban Academic Center

2020 ◽  
Vol 11 (1) ◽  
pp. 25-32
Author(s):  
Steven Bondi ◽  
Dixon Yang ◽  
Leah Croll ◽  
Jose Torres
Keyword(s):  
Risk Factors ◽  
New York ◽  
Patient Characteristics ◽  
Prior History ◽  
New York University ◽  
General Neurology ◽  
Academic Center ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Discharge Location

Background and Purpose: Hospital 30-day readmissions in patients with primary neurological problems are not well characterized. We sought to determine patient characteristics associated with readmission across 3 different inpatient neurology services at New York University Langone Hospital. Methods: We retrospectively reviewed all 30-day readmissions from the General Neurology, Epilepsy, and Stroke services at NYULH Brooklyn and Manhattan campuses from 2016-2017 and compared them to a random sample of non-readmitted neurology patients. We used univariate analyses to compare demographics, clinical characteristics, disease specific metrics, and discharge factors of non-readmitted and readmitted groups and binomial logistic regression to examine specific variables with adjustment for confounders. Results: We included 284 patients with 30-day readmissions and 306 control patients without readmissions matched by discharge location and service. After adjusting for confounders, we found that the following factors were associated with increased readmission risk: a recent hospital encounter increased risk for all services, increased number of medications at discharge, intensive care unit stay, higher length of stay, and prior history of seizure for the General Neurology Service, increased number of medications at discharge for the Epilepsy Service, and active malignancy and higher discharge modified Rankin Scale score for the Stroke Service. Conclusion: This study identifies potential risk factors for readmission in patients across multiple neurology services. Further research is needed to establish whether these risk factors hold across multiple institutions.

scholarly journals Risk Factors for Psychotic Relapse After Dose Reduction or Discontinuation of Antipsychotics in Patients With Chronic Schizophrenia: A Systematic Review and Meta-analysis

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Jan P A M Bogers ◽  
George Hambarian ◽  
Maykel Michiels ◽  
Jentien Vermeulen ◽  
Lieuwe de Haan
Keyword(s):  
Risk Factors ◽  
Dose Reduction ◽  
Clinical Judgment ◽  
Rating Scales ◽  
Meta Analysis ◽  
Chronic Schizophrenia ◽  
Patient Characteristics ◽  
Study Characteristics ◽  
Potential Risk Factors ◽  
High Doses

Abstract High doses of antipsychotics in patients with chronic schizophrenia might lead to more severe side effects and possibly hamper recovery, but dose reduction carries the risk of psychotic relapse. It would be helpful to establish risk factors for relapse during dose reduction. We systematically searched MEDLINE, EMBASE, and PsycINFO from January 1950 through June 2019 and reviewed studies that reported on relapse rates (event rates [ERs]) after dose reduction or discontinuation of antipsychotics in cohorts of patients with chronic schizophrenia. We calculated ERs (with 95% CIs) per person-year and sought to identify potential risk factors, such as patient characteristics, dose reduction/discontinuation characteristics, and study characteristics. Of 165 publications, 40 describing dose reduction or discontinuation in 46 cohorts (1677 patients) were included. The pooled ER for psychotic relapse was 0.55 (95% CI 0.46–0.65) per person-year. The ER was significantly higher in inpatients, patients with a shorter duration of illness, patients in whom antipsychotics were discontinued or in whom the dose was reduced to less than 5 mg haloperidol equivalent, studies with a short follow-up or published before 1990, and studies in which relapse was based on clinical judgment (ie, rating scales were not used). Clinicians should consider several robust risk factors for psychotic relapse in case of dose reduction in chronic schizophrenia.

Sign in / Sign up

Export Citation Format

Share Document