scholarly journals C-MAC Video Laryngoscope versus Conventional Direct Laryngoscopy for Endotracheal Intubation During Cardiopulmonary Resuscitation

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 225 ◽  
Author(s):  
Byeong Chul Min ◽  
Jong Eun Park ◽  
Gun Tak Lee ◽  
Tae Rim Kim ◽  
Hee Yoon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Cardiopulmonary Resuscitation ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Multiple Logistic Regression Analysis ◽  
Video Laryngoscope ◽  
Multiple Logistic Regression ◽  
Total N ◽  
Significant Difference

Background and objectives: To compare the first pass success (FPS) rate of the C-MAC video laryngoscope (C-MAC) and conventional Macintosh-type direct laryngoscopy (DL) during cardiopulmonary resuscitation (CPR) in the emergency department (ED). Materials and Methods: This study was a single-center, retrospective study conducted from April 2014 to July 2018. Patients were categorized into either the C-MAC or DL group, according to the device used on the first endotracheal intubation (ETI) attempt. The primary outcome was the FPS rate. A multiple logistic regression model was developed to identify factors related to the FPS. Results: A total of 573 ETIs were performed. Of the eligible cases, 263 and 310 patients were assigned to the C-MAC and DL group, respectively. The overall FPS rate was 75% (n = 431/573). The FPS rate was higher in the C-MAC group than in the DL group, but there was no statistically significant difference (total n = 431, 79% compared to 72%, p = 0.075). In the multiple logistic regression analysis, the C-MAC use had higher FPS rate (adjusted odds ratio: 1.80; 95% CI, 1.17–2.77; p = 0.007) than that of the DL use. Conclusions: The C-MAC use on the first ETI attempt during cardiopulmonary resuscitation in the emergency department had a higher FPS rate than that of the DL use.

scholarly journals Comparison of videolaryngoscopy and direct laryngoscopy by less experienced paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.

2019 ◽  
Author(s):  
Joachim Risse ◽  
Christian Volberg ◽  
Thomas Kratz ◽  
Birgit Plöger ◽  
Andreas Jerrentrup ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Direct Laryngoscopy ◽  
Successful Intubation ◽  
Limited Data ◽  
Total N ◽  
Popular Method ◽  
Observational Prospective Study ◽  
Significant Difference ◽  
Good Visibility

Abstract Introduction: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to show the benefit of VL during CPR performed by non-physicians in a single emergency department in Germany. We investigated in an observational prospective study the superiority of VL for less-experienced paramedics during CPR compared with direct laryngoscopy (DL).Methods: We instructed and equipped paramedics from four ambulances in endotracheal intubation (ETI) with GlideScope® (GVL). The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation.Results: In total n = 97 patients were included, n = 69 using DL (with n = 85 intubation attempts) and n = 28 using VL (with n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63).Conclusions: When used by paramedics during CPR, GVL led to better visibility of the glottis but did not increase the number of successful initial intubation attempts. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.

scholarly journals Contribution of rs1799998 polymorphism in CYP11B2 gene in susceptibility to preeclampsia

2020 ◽  
Vol 20 (2) ◽  
pp. 467-471
Author(s):  
Kaio Raffael Valotta Bezerra ◽  
Sarah Cristina Sato Vaz Tanaka ◽  
Vanessa Resende Souza Silva ◽  
Marina Carvalho Paschoinni ◽  
Roseane Lopes da Silva Grecco ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Recessive Model ◽  
Control Group ◽  
Study Group ◽  
Genotypic Frequency ◽  
Multiple Logistic Regression ◽  
Significant Difference

Abstract Objectives: the present study aimed to evaluate the association between the rs1799998 polymorphism of the CYP11B2 gene and the susceptibility to preeclampsia (PE) in a Brazilian population. Methods: the study group comprised 61 women who were diagnosed with PE. The control group included 116 women who did not show changes in their blood pressure levels during their pregnancies. The rs1799998 polymorphism of the CYP11B2 gene was amplified by allele-specific polymerase chain reaction (PCR). A multiple logistic regression analysis was performed using the SNPStat program to evaluate the risk of the CYP11B2 gene rs1799998 polymorphism contributing to PE. Results: the PE group had the following genotypes: 1.64% CC, 91.80% CT, and 6.56% TT. In the control group, the observed genotypic frequencies were: 11% CC, 73% CT, and 16% TT. The genotypic frequency distribution did not fit the Hardy Weinberg Equilibrium (HWE) in either study group. The multiple logistic regression analysis showed a statistically significant difference for the rs1799998 polymorphism in the recessive model. Conclusion: the results suggest an association between the recessive model of C/C genotype of the rs1799998 polymorphism of the CYP11B2 gene and susceptibility to PE.

scholarly journals Risk Factors for Revisiting After Emergency Department Discharge: a Longitudinal Retrospective Chart Review

2020 ◽  
Author(s):  
Chie Teramoto ◽  
Satoko Nagata ◽  
Takashi Naruse ◽  
Susumu Nakajima ◽  
Shinichiroh Yokota ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Logistic Regression ◽  
Chart Review ◽  
Multiple Logistic Regression Analysis ◽  
Retrospective Chart Review ◽  
Multiple Logistic Regression ◽  
Enabling Factors ◽  
History Of ◽  
Hospital Use

Abstract Background: Emergency department (ED) patients are often discharged after treatment for minor illnesses. However, many of these patients revisit the ED. This study aimed to describe ED revisit rate and investigate the risk factors for 3-day/30-day ED revisit. Methods: A longitudinal retrospective chart review was used to extract data regarding predisposing factors (e.g. gender, age), enabling factors (e.g. economic status, ambulance use) and need factors (e.g. diagnosis at ED discharge, history of diseases), from the medical charts of patients discharged from an ED in Tokyo, Japan, from February to December 2013. Multiple logistic regression analyses were used to predict 3-day/30-day ED revisit based on initial visit information. Results: During the studied period, 8,754 patients were discharged from the ED, of whom 48.8% were men, and the mean age was 39.7 years. Of these, 338 (3.9%) revisited the ED within three days and 682 (7.8%) revisited the ED within 30 days of discharge. In the multiple logistic regression analysis, risk factors for 3-day ED revisits were: having a history of same hospital use, arriving by ambulance, having a common problem (e.g. fever), and history of asthma. Risk factors for 30-day ED revisits were using health care services and having a history of same hospital use. Conclusions: In this study, the rate of ED revisit was less than that reported by other studies, which might be because most patients included in this study usually visited the hospital. Our results show that the predictive factors for 3-day/30-day ED revisit in Japan were similar to those in other countries. Patients with the abovementioned factors should be carefully screened on their initial ED visit, and some follow-up care in clinical and community settings should be arranged.

Polymorphisms 677C > T and 1298A > C in the MTHFR gene and homocysteine levels in patients with non-alcoholic fatty liver disease as a component of the ontological model

2021 ◽  
Author(s):  
N. A. Nosko ◽  
O. M. Rud
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Mthfr Gene ◽  
Scientific Data ◽  
Multiple Logistic Regression ◽  
Alcoholic Fatty Liver ◽  
Significant Difference ◽  
Alcoholic Fatty Liver Disease

Objective — to systematize literature data on the presence of 677C > T and 1298A > C polymorphisms in the MTHFR gene and homocysteine levels in patients with non‑alcoholic fatty liver disease (NAFLD); to calculate the frequencies 677C > T and 1298A > C polymorphisms combinations in the MTHFR gene and their impact on NAFLD development; to compare homocysteine levels in patients with and without NAFLD. Materials and methods. The analysis has been performed for the results of investigation of 49 patients, from them 17 subjects with NAFLD and 32 without it. Clinical, laboratory, statistical and ontological methods were used in the study. The MTHFR 677C > T and MTHFR 1298A > C polymorphisms in the MTHFR gene were investigated with the use of real time polymerase chain reaction (RT‑PCR) technique. Homocysteine levels were determined with chemiluminescent immunoassay with reference values 3.7 — 13.9 µmol/L. Multiple logistic regression method was used to evaluate the effects 677C > T and 1298A > C polymorphisms in the MTHFR gene on NAFLD development. Results. The variant of combination of 667С/С/1298А/А polymorphisms in the MTHFR gene (absence of mutation) was reveled in 6 (12 %) persons, that showed a widespread prevalence of variants with the presence of mutations. The correlation between variants of 677C > T and 1298A > C polymorphism in the MTHFR gene has been established (r = 0.429; p < 0.05). The results of multiple logistic regression demonstrated absence of the significant effects of 677C > T and 1298A > C polymorphisms in the MTHFR gen on NAFLD development (p > 0.05). Comparison of the homocysteine levels in patients with and without NAFLD didn’t reveal significant difference (р > 0.05), as well as comparison in the groups with combinations of 677C > T and 1298А > С polymorphisms in the MTHFR gen (р > 0.05). This can be explained by the fact that NAFLD group consisted of manly young patients without hypertension, type 2 diabetes mellitus and severe liver fibrosis. Conclusions. Ontological systematization of the scientific data on NAFLD revealed that 677C > T and 1298A > C polymorphisms in the MTHFR gen are pathogenetically associated with the significant increase in homocysteine levels as a marker of cardiovascular pathology. Giving the multifactorial nature of hyperhomocysteinemia and wide spread of 677C > T and 1298A > C polymorphisms in the MTHFR gen in population, it seems to be impractical to use genetic investigations for MTHFR gen polymorphism in NAFLD patients routinely, but only for the purpose of differential diagnosis of hyperhomocysteinemia.  

scholarly journals MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

2021 ◽  
Vol 11 ◽  
Author(s):  
Guang-xian Wang ◽  
Xiao-dong Ge ◽  
Dong Zhang ◽  
Hai-ling Chen ◽  
Qi-chuan Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Diagnostic Accuracy ◽  
Multiple Logistic Regression Analysis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Threshold Value ◽  
Arterial Phase ◽  
Multiple Logistic Regression ◽  
Scoring Model ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

ObjectiveTo determine whether contrast-enhanced computed tomography (CT) can promote the identification of malignant and benign distal biliary strictures (DBSs) compared to the use of magnetic resonance cholangiopancreatography (MRCP) alone and to identify imaging findings of malignant DBSs.Materials and MethodsA total of 168 consecutive patients with confirmed DBSs were reviewed. MRCP alone and MRCP combined with CT images were blindly analyzed by two radiologists (e.g., stricture pattern, margins), and malignant or benign DBSs were identified based on surgical findings, endoscopy findings, or follow-up. The diagnostic accuracy of the two reviewers using MRCP alone and MRCP combined with CT were evaluated. MRCP and CT features of malignant and benign DBSs were compared using multiple logistic regression analysis to identify independent malignant risk factors.ResultsMRCP combined with CT examination could improve the diagnostic accuracy, which increased from 70.2% to 81.5% in Doctor A and from 85.1% to 89.3% in Doctor B. The multiple logistic regression model revealed that stricture length [odds ratio (OR) 1.070, P=0.016], angle of the DBS (OR 1.061, P&lt;0.001), double duct sign (OR 4.312, P=0.003) and low density in the arterial phase (OR 0.319, P=0.018) were associated with malignant DBS. A scoring model incorporating these four factors was established; at a threshold value of 1.75, and the sensitivity and specificity for the detection of malignant DBSs were 73.5 and 85.9%, respectively.ConclusionsCompared to the use of MRCP alone, MRCP combined with contrast-enhanced CT can improve the accuracy of DBS diagnosis. The scoring model accurately predicts malignant DBSs and helps make treatment decisions.

scholarly journals Analysis and Factors Associated with Measles in Larut, Matang and Selama Districts, Perak, Malaysia

2020 ◽  
Vol 27 (5) ◽  
pp. 130-140
Author(s):  
Asraf Ahmad Qamruddin ◽  
Reza Qamruddin ◽  
Ayu Malik
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Incidence Rate ◽  
Logistic Regression Analysis ◽  
Protective Factor ◽  
Multiple Logistic Regression Analysis ◽  
Prior History ◽  
Multiple Logistic Regression ◽  
Case Definitions ◽  
Factors Associated

Objectives: To determine the incidence rate of measles and the factors associated with confirmed measles cases in Larut, Matang and Selama districts. Methods: Cross-sectional analysis was carried out looking at all suspected and laboratoryconfirmed measles cases in Larut, Matang and Selama districts between 2015 and 2019. Multiple logistic regression analysis was used to determine the associated factors for laboratory-confirmed measles cases. Results: The incidence rate for suspected measles showed an increasing trend from 2015–2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. From multiple logistic regression analysis, cases that fulfilled the case definition of measles were more likely to be laboratory-confirmed measles. On the other hand, a prior history of measles immunisation was a protective factor. Conclusion: Measles incidence is increasing in trend. Any suspected measles cases that fulfilled the clinical case definitions need to be further investigated. Immunisation should be promoted as they are effective in preventing and eliminating measles.

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