scholarly journals Predictive Value of Ambulatory Objective Movement Measurement for Outcomes of Levodopa/Carbidopa Intestinal Gel Infusion

2022 ◽  
Vol 12 (1) ◽  
pp. 27
Author(s):  
Gökçe Kilinçalp ◽  
Anne-Christine Sjöström ◽  
Barbro Eriksson ◽  
Björn Holmberg ◽  
Radu Constantinescu ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Prognostic Value ◽  
Motor Fluctuations ◽  
Advanced Treatment ◽  
Lower Odds ◽  
Percent Time ◽  
Related Symptom ◽  
Choice Of Treatment ◽  
Clinical Characteristic ◽  
Clear Objective

Patients with Parkinson’s disease that may benefit from device-assisted therapy can be identified with guidelines like Navigate PD. The decision to offer advanced treatment and the choice of treatment modality are, however, not straightforward, and some patients respond less favorably to a chosen therapy. Measurements with the Parkinson Kinetigraph (PKG) can detect motor fluctuations and could therefore predict patients that respond better or worse to intestinal levodopa/carbidopa gel infusion (LCIG). In a retrospective analysis of 45 patients that had been selected to start LCIG between 2014 and 2020, the effects of baseline PKG and clinical characteristic on the outcome were determined with ordinal regression. Although all patients had been found to have handicapping medication-related symptom fluctuations, patients without clear objective off fluctuations in the baseline PKG had low odds ratio for success. Lower odds for success were also found with increasing age, whereas gender, medication intensity and baseline PKG summary scores (median bradykinesia and dyskinesia scores, fluctuation dyskinesia score and percent time with tremor) had no significant effect. Absence of easily identified off-periods in the PKG has a negative prognostic value for the effect of LCIG and could prompt noninvasive infusion evaluation before surgery.

scholarly journals Risk of Weight Loss in Adult Patients and the Effect of Staffing Registered Dietitians in Kaifukuki (Convalescent) Rehabilitation Wards: A Retrospective Analysis of a Nationwide Survey

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 753
Author(s):  
Shinta Nishioka ◽  
Yoji Kokura ◽  
Takatsugu Okamoto ◽  
Masako Takayama ◽  
Ichiro Miyai
Keyword(s):  
Weight Loss ◽  
Odds Ratio ◽  
Lower Risk ◽  
Nationwide Survey ◽  
Adult Patients ◽  
Weight Class ◽  
Registered Dietitians ◽  
Lower Odds ◽  
Nutrition Care ◽  
Class 1

There is scarce evidence regarding the risk of weight loss and the effect of having registered dietitians (RDs) on staff in rehabilitation wards on weight loss. We aimed to examine the effects of RDs in Kaifukuki (convalescent) rehabilitation wards (KRWs) on the prevention of weight loss in adult patients. Data from 2-year nationwide annual surveys on KRWs in Japan were retrospectively analysed. Weight loss was defined as loss of ≥5% weight during the KRW stay. Risk of weight loss in class 1 KRWs (obligated to provide nutrition care) was compared with that in class 2–6 KRWs (not obligated). Risk of weight loss in class 2–6 KRWs with RDs was compared to those without. Overall, 17.7% of 39,417 patients lost weight. Class 1 KRWs showed a lower risk of weight loss than class 2–6 KRWs (17.3% vs. 18.5%, p = 0.003). KRWs with RDs showed a significantly lower incidence of weight loss than those without RDs (16.1% vs. 18.8%, p = 0.015). Class 1 KRWs and exclusively staffed RDs were independently associated with lower odds of weight loss (odds ratio = 0.915 and 0.810, respectively). Approximately 18% of KRW patients lost weight, and having RDs on staff can lower the risk of weight loss.

scholarly journals Is maternal cigarette or water pipe use associated with stopping breastfeeding? Evidence from the Jordan population and family health surveys 2012 and 2017–18

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Esra Can Özalp ◽  
S. Songül Yalçın
Keyword(s):  
Odds Ratio ◽  
Maternal Smoking ◽  
Health Surveys ◽  
Family Health ◽  
Lactation Period ◽  
Water Pipe ◽  
Tobacco Products ◽  
Lower Odds ◽  
Lower Odds Ratio ◽  
Pipe Tobacco

Abstract Background Maternal smoking is suspected to have negative impacts on breastfeeding, such as decreasing the quantity of breast milk, and reducing vitamin and fat concentrations in the milk in the late lactation period. Cigarette and water pipe tobacco products are widely used in Jordan. We aimed to estimate the association between use of different tobacco products and the rates of current breastfeeding. Methods Data from Jordan’s Population and Family Health Surveys 2012 and 2017–18 were examined. Last-born, living children, aged < 25 months, from singleton births, ever breastfed, and living with their mother were included. The key outcome variables were the current breastfeeding (during last 24 h) and tobacco usage status [water pipe tobacco (hookah or narghile) and/or cigarette tobacco]. Complex sample multivariate logistic regression analysis was used to evaluate the association of the current breastfeeding with maternal smoking status. Results Overall, 6726 infants were included in the study. The current breastfeeding rate in infants aged 0–6 months was 87%, compared with 43.9% in infants aged 12–17 months and 19.4% in infants aged 18–24 months. Overall, 4.4% had mothers who smoked cigarettes, 5.4% smoked water pipe, and 1.6% both cigarettes and water pipe. The proportion of breastfed infants in non-smoking mothers was 57.7% and, those in smoke water pipe, cigarette and both tobacco products were 55.4, 44.9, and 51.0% respectively. Univariate analysis revealed that women cigarette smokers had a lower odds ratio (OR) for current breastfeeding (OR 0.60, 95% Confidence Interval [CI] 0.39, 0.92). Multivariate analysis revealed that maternal cigarette smoking was associated with a lower odds ratio for current breastfeeding compared with mothers who smoked neither water pipe nor cigarettes (AOR 0.51, 95% Cl 0.30, 0.87). Conclusions These results indicate that maternal smoking is associated with termination of breastfeeding, suggesting that structured training should be organized for healthcare professionals, expectant mothers and the general public about the association between maternal smoking and cessation of lactation.

Endovascular treatment with the Enterprise stent versus the Neuroform or Low-Profile Visualized Intraluminal Support stent for unruptured aneurysms

2021 ◽  
Vol 10 (4) ◽  
pp. 295-305
Author(s):  
Reade De Leacy ◽  
Emilie Kottenmeier ◽  
Stephanie HY Lee ◽  
Rahul Khanna ◽  
Alejandro M Spiotta
Keyword(s):  
Endovascular Treatment ◽  
Odds Ratio ◽  
Generalized Estimating Equations ◽  
Enterprise Group ◽  
Group Differences ◽  
Stent Group ◽  
Unruptured Intracranial Aneurysm ◽  
Lower Odds ◽  
Unruptured Aneurysms ◽  
Low Profile

Aim: To compare outcomes among patients undergoing endovascular treatment for unruptured intracranial aneurysm (UIA) with the Enterprise stent versus the Neuroform or Low-Profile Visualized Intraluminal Support (LVIS) stent. Patients & methods: Patients undergoing endovascular procedure for UIA were classified into Enterprise stent and Neuroform or LVIS stent group. Groups were propensity-score matched and generalized estimating equations were used for outcomes assessment. Results: There were no significant between-group differences in length of stay or mortality. The Enterprise group had significantly lower odds of UIA-related inpatient readmissions versus the Neuroform/LVIS group (odds ratio: 0.62; 95% CI: 0.42–0.91). Conclusion: Enterprise stent use was associated with significantly lower readmissions versus competitor stent, with no difference in other study outcomes.

Prognostic Value of Brain Magnetic Resonance Imaging in Neonatal Hypoxic-Ischemic Encephalopathy: A Meta-analysis

2017 ◽  
Vol 32 (13) ◽  
pp. 1065-1073 ◽  
Author(s):  
Iván Sánchez Fernández ◽  
J. Leon Morales-Quezada ◽  
Samuel Law ◽  
Paggie Kim
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Hypoxic Ischemic Encephalopathy ◽  
Resonance Imaging ◽  
Neonatal Brain ◽  
Ischemic Encephalopathy

Objective: To quantify the prognostic value of neonatal brain magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy. Methods: Meta-analysis of studies with ≥35-week neonates with hypoxic-ischemic encephalopathy who underwent brain MRI within age 4 weeks and had neurodevelopmental follow-up for at least 12 months. Results: An abnormal neonatal brain MRI was more frequent among patients with unfavorable neurodevelopmental outcome: odds ratio = 18.2 (95% confidence interval: 9.4-34.9), P <.0001. The prognostic value of neonatal brain MRI in moderate hypoxic-ischemic encephalopathy had an odds ratio of 17.7 (95% confidence interval: 5.3-59.3) and in severe hypoxic-ischemic encephalopathy, the odds ratio was 125.0 (95% confidence interval: 2.0-7917.1). Therapeutic hypothermia did not change the prognostic value of neonatal brain MRI (odds ratio for hypothermia, 14.0 [95% confidence interval: 3.1-63.6], vs no hypothermia, 18.1 [95% confidence interval: 10.0-33.1], P = .7525). Conclusion: Neonatal brain MRI provides prognostic information on outcome beyond early infancy in hypoxic-ischemic encephalopathy and therapeutic hypothermia does not change its prognostic value.

scholarly journals Effect of clinical mastitis on reproductive targets achievement in cows

2019 ◽  
Vol 26 ◽  
pp. 1-10
Author(s):  
Hector Nava-Trujillo
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Relative Frequency ◽  
Negative Impact ◽  
Clinical Mastitis ◽  
Lower Odds ◽  
Negative Effect

The aim of this study was to determine the effect of clinical mastitis occurring between calving and the first service on the percentage of cows that achieve two reproductive targets: be served before 70 days postpartum and be pregnant before 110 days postpartum (dpp). Relative frequency and odds ratio (OR) with the corresponding confidence interval (CI) were calculated. Fewer mastitic cows were served before 70 dpp than non-mastitic (24.86% vs 36.59% respectively P = 0.0137); mastitic cows had lower odds to be served than non-mastitic cows (OR: 0.57; 95% CI: 0.3679-0.8938, P = 0.0141). Fewer mastitic cows became pregnant before 110 dpp than non-mastitic cows (36.72% vs 50.73%, respectively, P = 0.006) and mastitic cows had lower odds to become pregnant than non-mastitic cows (OR: 0.56; 95% CI: 0.3739-0.8495, P = 0.0062).  Negative effect of clinical mastitis on percentage of cows served only was observed in primiparous cows, with 4.76% of mastitic cows being served in comparison with 30.19% of non-mastitic cows (P = 0.0017); primiparous mastitic cows had lower odds (0.11; 95% CI: 0.0249-0.5374, P = 0.0059) to be served than non-mastitic primiparous cows. Percentage of primiparous mastitic cows pregnant before 110 dpp was lower than non-mastitic cows (16.67% vs 37.74%, P = 0.0245) and mastitic cows had only 0.3300 odds (95% CI: 0.1234-0.8822, P = 0.0271) to become pregnant that primiparous non-mastitic. In multiparous, 42.96% of mastitic and 55.26% of non-mastitic cows (P = 0.0378) became pregnant before 110 dpp and mastitic cows had 0.6098 odd (95% CI: 0.3821-0.9730, P = 0.0380) to become pregnant than non-mastitic. In conclusion, clinical mastitis reduced the possibility of cows to be served and become pregnant during the first 70 and 110 dpp respectively, and the negative impact of clinical mastitis was more harmful in primiparous cows.

Blood albumin as a prognostic factor among unselected medically treated inpatients

2019 ◽  
Vol 13 (13) ◽  
pp. 1059-1069
Author(s):  
Krzysztof Tojek ◽  
Gabriel Kowalczyk ◽  
Beata Czerniak ◽  
Wioletta Banaś ◽  
Beata Szukay ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Lower Risk ◽  
Prognostic Value ◽  
Medical Documentation ◽  
Hospital Death ◽  
Prospective Analysis ◽  
Ideal Bodyweight ◽  
Unselected Population ◽  
Diagnostic Power ◽  
Blood Albumin

Aim: The aim of this study is to determine the prognostic value of blood albumin (BA) in an unselected population of inpatients. Materials & methods: We performed prospective analysis of the medical documentation of 7279 patients hospitalized between July 2014 and September 2017. Results: Individuals with BA ≥3.35 mg/dl had significantly lower risk of in-hospital death (odds ratio [OR]: 0.22; 95% CI: 0.19–0.27; p < 0.001) and 14-day readmission (OR: 0.64; 95% CI: 0.55–0.77; p < 0.0001). BA concentration was the strongest favorable factor predicting inpatient survival in a Cox hazard regression model (OR: 0.43; 95% CI: 0.36–0.50; p < 0.001), did not correlate with body mass index and actual-to-ideal bodyweight ratio and was strongly affected by numerous non-nutrient factors. Conclusion: BA concentration showed similar or better predictive and diagnostic power in relation to all-cause in-hospital mortality and 14-day readmission among inpatients than selected multifactorial scores.

scholarly journals Movement Behaviors and Perceived Loneliness and Sadness within Alaskan Adolescents

2020 ◽  
Vol 17 (18) ◽  
pp. 6866
Author(s):  
Ryan D. Burns ◽  
Yang Bai ◽  
Christopher D. Pfledderer ◽  
Timothy A. Brusseau ◽  
Wonwoo Byun
Keyword(s):  
Mental Health ◽  
Odds Ratio ◽  
Regression Models ◽  
Movement Behavior ◽  
Youth Risk Behavior Survey ◽  
Association Analyses ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Race Ethnicity ◽  
Screen Use

Physical activity, screen use, and sleep are behaviors that integrate across the whole day. However, the accumulative influence of meeting recommendations for these 24-h movement behaviors on the mental health of Alaskan adolescents has not been examined. The purpose of this study was to examine the associations between movement behaviors, loneliness, and sadness within Alaskan adolescents. Data were obtained from the 2019 Alaska Youth Risk Behavior Survey (YRBS). The number of adolescents participating in the 2019 Alaska YRBS was 1897. Associations between meeting recommendations for movement behaviors with loneliness and sadness were examined using weighted logistic regression models, adjusted for age, sex, race/ethnicity, and body mass index (BMI). Approximately 5.0% of the sample met recommendations for all three movement behaviors. Meeting 2 or 3 movement behavior recommendations was associated with lower odds of loneliness (odds ratio (OR) range = 0.23 to 0.44, p < 0.01). Additionally, meeting 1 to 3 movement behavior recommendations was associated with lower odds of sadness (OR range = 0.29 to 0.52, p < 0.05). Joint association analyses determined that these relationships were primarily driven by meeting the sleep recommendation for loneliness and meeting the screen use recommendation for sadness. The results support use of multiple movement-based behavior programming to attenuate feelings of loneliness and sadness within Alaskan adolescents.

scholarly journals Interdental Cleaning and Oral Health Status in an Adult Cohort, 2015 to 2018

2020 ◽  
Vol 99 (10) ◽  
pp. 1150-1156
Author(s):  
B.W. Chaffee ◽  
D. Persai ◽  
M.V. Vora
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Disease Risk ◽  
The United States ◽  
Oral Health Status ◽  
Oral Disease ◽  
Health Study ◽  
Lower Odds

Interdental cleaning is routinely recommended, despite limited evidence supporting efficacy to prevent advanced oral disease endpoints, such as caries and periodontal disease. We aimed to examine associations between interdental cleaning and oral health in a large, generalizable prospective cohort of adults in the United States. Data were drawn from wave 3 (2015 to 2016, n = 26,086 included in analysis) and wave 4 (2016 to 2018, n = 22,585) of the adult component (age ≥18 y) of the nationally representative Population Assessment of Tobacco and Health Study. Survey-weighted multivariable regression models estimated the associations between wave 3 weekly interdental cleaning frequency and 6 measures of self-reported oral health—overall rating, tooth extractions, gum bleeding, loose teeth, bone loss around teeth, and gum disease—cross-sectionally and prospectively, with adjustment for established periodontal disease risk factors. As compared with no interdental cleaning, interdental cleaning ≥7 times/wk was prospectively associated with greater odds of excellent self-rated oral health (adjusted odds ratio, 1.37; 95% CI, 1.17 to 1.62), lower odds of bleeding gums (adjusted odds ratio, 0.62; 95% CI, 0.54 to 0.70), but not statistically significantly lower odds of other oral health conditions in the following 12 mo. Older age, lower socioeconomic status, diabetes, and cigarette smoking were consistently associated with worse oral health across all outcome measures. Findings were largely robust to alternative model and variable specifications. Interdental cleaning is associated with better perceived oral health and less self-reported gingivitis. Prevention of more advanced disease states was not demonstrated. These findings should be interpreted cautiously given the self-reported nature of the measures and relatively short follow-up period.

scholarly journals Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability: An analysis of inpatient and institutional outpatient medical claims

Autism ◽  
2020 ◽  
pp. 136236132095510
Author(s):  
Daniel Gilmore ◽  
Lauren Harris ◽  
Anne Longo ◽  
Brittany N Hand
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Intellectual Disability ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Renal Dialysis ◽  
Health Centers ◽  
Outpatient Rehabilitation ◽  
Lower Odds ◽  
Healthcare Needs

Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. We conducted a cross-sectional retrospective cohort study of Medicare claims data from 2016 to 2017 to compare the prevalence of physical and mental health conditions among autistic older adults (age 65+ years) with intellectual disability ( N = 2054) to autistic older adults without intellectual disability ( N = 2631). Medicare claims data consisted of records from inpatient hospitalizations and institutional outpatient visits (i.e. visits to hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, Federally Qualified Health Centers, and community mental health centers). Examination of the largest between-group differences revealed that autistic older adults with intellectual disability had 350% greater odds of epilepsy (odds ratio = 4.5, 95% confidence interval = 3.9–5.2), 170% greater odds of osteoporosis (odds ratio = 2.7, 95% confidence interval = 2.3–3.2), and 100% greater odds of gastrointestinal conditions (odds ratio = 2.0, 95% confidence interval = 1.8–2.2) but 80% lower odds of attention deficit disorders (odds ratio = 0.2, 95% confidence interval = 0.1–0.3), 70% lower odds of substance use disorders (odds ratio = 0.3, 95% confidence interval = 0.2–0.4), and 60% lower odds of suicidal ideation or intentional self-injury (odds ratio = 0.4, 95% confidence interval = 0.3–0.6). These findings highlight the importance of developing tailored health management strategies for the autistic older adult population as a function of intellectual disability status. Lay abstract Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. Our study is the first, to our knowledge, to use US national data to compare physical and mental health conditions among autistic older adults with and without intellectual disability. The data analyzed in this study consisted of records from inpatient hospitalizations as well as “institutional outpatient” healthcare visits, which include visits to hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, Federally Qualified Health Centers, and community mental health centers. Autistic older adults with intellectual disability were significantly more likely to have thyroid disorders, epilepsy, respiratory infections, gastrointestinal conditions, osteoporosis, cognitive disorders, and schizophrenia/psychotic disorders. In contrast, autistic older adults without intellectual disability were significantly more likely to have obesity, diabetes, high blood pressure, cerebrovascular disease, chronic obstructive pulmonary disease, arthritis, back conditions, attention deficit disorders, substance use disorders, and suicidal ideation or intentional self-injury. These findings highlight the importance of developing distinct, tailored health management strategies for the autistic older adults with and without intellectual disability.

scholarly journals Influence of the COVID-19 Pandemic on Treatment Times for Acute Ischemic Stroke

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 40-47
Author(s):  
James E. Siegler ◽  
Alicia M. Zha ◽  
Alexandra L. Czap ◽  
Santiago Ortega-Gutierrez ◽  
Mudassir Farooqui ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Odds Ratio ◽  
Intravenous Thrombolysis ◽  
Interquartile Range ◽  
Continuous Variables ◽  
Significant Delay ◽  
Lower Odds ◽  
Collateral Effect ◽  
Novel Coronavirus

Background and Purpose: The pandemic caused by the novel coronavirus disease 2019 (COVID-19) has led to an unprecedented paradigm shift in medical care. We sought to evaluate whether the COVID-19 pandemic may have contributed to delays in acute stroke management at comprehensive stroke centers. Methods: Pooled clinical data of consecutive adult stroke patients from 14 US comprehensive stroke centers (January 1, 2019, to July 31, 2020) were queried. The rate of thrombolysis for nontransferred patients within the Target: Stroke goal of 60 minutes was compared between patients admitted from March 1, 2019, and July 31, 2019 (pre–COVID-19), and March 1, 2020, to July 31, 2020 (COVID-19). The time from arrival to imaging and treatment with thrombolysis or thrombectomy, as continuous variables, were also assessed. Results: Of the 2955 patients who met inclusion criteria, 1491 were admitted during the pre–COVID-19 period and 1464 were admitted during COVID-19, 15% of whom underwent intravenous thrombolysis. Patients treated during COVID-19 were at lower odds of receiving thrombolysis within 60 minutes of arrival (odds ratio, 0.61 [95% CI, 0.38–0.98]; P =0.04), with a median delay in door-to-needle time of 4 minutes ( P =0.03). The lower odds of achieving treatment in the Target: Stroke goal persisted after adjustment for all variables associated with earlier treatment (adjusted odds ratio, 0.55 [95% CI, 0.35–0.85]; P <0.01). The delay in thrombolysis appeared driven by the longer delay from imaging to bolus (median, 29 [interquartile range, 18–41] versus 22 [interquartile range, 13–37] minutes; P =0.02). There was no significant delay in door-to-groin puncture for patients who underwent thrombectomy (median, 83 [interquartile range, 63–133] versus 90 [interquartile range, 73–129] minutes; P =0.30). Delays in thrombolysis were observed in the months of June and July. Conclusions: Evaluation for acute ischemic stroke during the COVID-19 period was associated with a small but significant delay in intravenous thrombolysis but no significant delay in thrombectomy time metrics. Taking steps to reduce delays from imaging to bolus time has the potential to attenuate this collateral effect of the pandemic.

Sign in / Sign up

Export Citation Format

Share Document