scholarly journals Risk Factors for Therapeutic Intervention of Remdesivir in Mild to Moderate COVID-19—A Single-Center Retrospective Study of the COVID-19 Fourth Pandemic Period in Wakayama, Japan

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 118
Author(s):  
Shinobu Tamura ◽  
Takahiro Kaki ◽  
Mayako Niwa ◽  
Yukiko Yamano ◽  
Shintaro Kawai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Therapeutic Intervention ◽  
Odds Ratio ◽  
Previous History ◽  
Single Center ◽  
Medical Systems ◽  
History Of ◽  
Independent Risk Factors ◽  
Length Of Hospitalization

Background and Objectives: The incidence of coronavirus disease 2019 (COVID-19) has increased in Wakayama, Japan, due to the spread of the highly infectious B.1.1.7 variant. Before this event, the medical systems were almost unaffected. We aimed to assess the clinical characteristics of patients hospitalized with COVID-19 and the risk factors for therapeutic intervention of remdesivir during the fourth pandemic period in Wakayama, Japan. Materials and Methods: This single-center retrospective study enrolled 185 patients with mild to moderate COVID-19 hospitalized in our hospital without intensive care between 14 March and 31 May 2021. Results: In this period, 125 (67.6%) of the 185 patients had the B.1.1.7 variant. Sixty-three patients (34.1%) required remdesivir treatment. Age upon admission and length of hospitalization were significantly different between remdesivir treatment and careful observation groups (mean (standard deviation); 59.6 (14.7) versus 45.3 (20.6) years; p < 0.001 and median (interquartile range); 10 (9–12) versus 9 (8–10) years; p < 0.001). One patient was transferred to another hospital because of disease progression. At hospital admission, age ≥60 years (odds ratio (OR) 6.90, p < 0.001), a previous history of diabetes mellitus (OR 20.9, p = 0.002), B.1.1.7 variant (OR 5.30; p = 0.005), lower respiratory symptoms (OR 3.13, p = 0.011), headache (OR 3.82, p = 0.011), and fever ≥37.5 °C (OR 4.55, p = 0.001) were independent risk factors to require remdesivir treatment during the admission. Conclusions: Many patients with mild to moderate COVID-19 required the therapeutic intervention of remdesivir during the fourth pandemic period in Wakayama, Japan. From the clinical data obtained at admission, these risk factors could contribute to a prediction regarding the requirement of remdesivir treatment in cases of mild to moderate COVID-19.

The Effect of Seromuscular-Dermal and All Layer-Dermal Suturing on the Rate of Early Stomal Mucocutaneous Separation: A Retrospective Study

2021 ◽  
Vol 67 (3) ◽  
pp. 21-28
Author(s):  
Yusuke Ohara ◽  
Tsuyoshi Enomoto ◽  
Yohei Owada ◽  
Daichi Kitaguchi ◽  
Katsuji Hisakura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Odds Ratio ◽  
Suture Technique ◽  
Short Term ◽  
Steroid Use ◽  
Surgical History ◽  
History Of ◽  
Independent Risk Factors

BACKGROUND: Stomal mucocutaneous separation (SMS) is a serious and common short-term and long-term complication of ostomy surgery, but optimal methods to help prevent it have not been established. The authors hypothesized that seromuscular-dermal (SM-D) suturing may be better than all layer-dermal (AL-D) suturing to help prevent SMS. METHODS: This retrospective study evaluated the short-term SMS rate of patients who underwent colostomy or ileostomy surgery between 2015 and 2019. Patient demographics, medical and surgical history variables, as well as SMS outcomes were abstracted. Postoperative SMS severity was categorized by extent as follows: grade A (mild), grade B (moderate), and grade C (severe). RESULTS: In total, 105 patients (AL-D group, 45 patients; SM-D group, 60 patients) were enrolled in the study. SMS occurred in 24 patients (23%). The overall SMS rate was 18% (n = 11) in the SM-D group and 29% (n = 13) in the AL-D group (P = .202). The occurrence of severe (grade C) or moderate and severe SMS (grades B + C) in the SM-D compared with the AL-D group was significantly different (2% vs 16% [P = .011] and 10% vs 24% [P = .047], respectively). A history of steroid use was a risk factor for moderate and severe SMS (P = .016, odds ratio 5.694). Stomal height ≤1 cm was a a risk factor for all cases of SMS (P = .037, odds ratio 2.650). AL-D suture technique and a history of steroid use were independent risk factors for severe and moderate plus severe SMS (P = .021, odds ratio 12.844 and P = .027, odds ratio 4.808, respectively). CONCLUSION: In this study, use of the AL-D suturing technique and a history of steroid use were independent risk factors for the short-term development of moderate or severe SMS. Patients whose stoma was secured using the SM-D technique had a significantly lower rate of moderate or severe SMS.

scholarly journals Perioperative risk factors for occurrence of myasthenia gravis after thymectomy in patients with thymoma

2020 ◽  
Vol 31 (4) ◽  
pp. 519-526
Author(s):  
Xin Zhang ◽  
Bin Li ◽  
Jianyong Zou ◽  
Chunhua Su ◽  
Haoshuai Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myasthenia Gravis ◽  
Odds Ratio ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Previous History ◽  
Tumour Resection ◽  
History Of ◽  
Independent Risk Factors ◽  
The Relationship

Abstract OBJECTIVES The goal of this study was to identify the relationship between clinical characteristics and the occurrence of postoperative myasthenia gravis (PMG) in patients with thymomas and to further identify the relationship between PMG and prognosis. METHODS Thymoma patients who had surgery at the First Affiliated Hospital of Sun Yat-sen University between July 2004 and July 2016 were reviewed and those who had no previous symptoms of myasthenia gravis were selected for further investigation. In total, 229 patients were included in the study; their clinical characteristics were gathered and analysed. RESULTS Among the 229 patients, 19 (8.3%) had PMG. The time between the operation and the onset of myasthenia gravis was 134 days on average (range 2–730 days). Patients experiencing PMG showed a lower rate of complete thymoma resection (73.7% vs 91.4%; P = 0.014) and total thymectomy (63.2% vs 82.9%; P = 0.035) compared with those who did not. Univariable and multivariable logistic regression revealed that thymomectomy [odds ratio (OR) 2.81, 95% confidence interval (CI) 1.02–7.77; P = 0.047] and incomplete tumour resection (OR 3.79, 95% CI 1.20–11.98; P = 0.023) were associated with the occurrence of PMG. Multivariable Cox regression showed that the PMG was not related to overall survival (P = 0.087). CONCLUSIONS This study revealed that incomplete tumour resection and thymomectomy were independent risk factors for PMG in thymoma patients with no previous history of myasthenia gravis.

scholarly journals Prediction of Length of Hospital Stay and Immediate Outcome of Children Suffering From Bronchiolitis on the Bases of Associated Risk Factors

2021 ◽  
Vol 7 (2) ◽  
pp. 67-71
Author(s):  
Bithi Debnath ◽  
Sajani Islam ◽  
Nazmul Haque
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Hospital Stay ◽  
Previous History ◽  
Length Of Hospital Stay ◽  
Wood Burning ◽  
History Of ◽  
Male Sex ◽  
Associated Risk Factors ◽  
Length Of Hospitalization

Background: Bronchiolitis is the most common reason for hospitalization among children younger than 2 years. Objective: The aim of the study was to assess the possibility that the associated risk factors in children suffering from bronchiolitis could predict the length of hospital stay and also to observe the immediate outcome. Methodology: This prospective study was conducted in a district hospital of Bangladesh in a period of two years from January 2011 to December 2012. Patients aged 2 years or less fulfilling inclusion criteria for bronchiolitis and required admission were enrolled in this study. Patients having comorbidities and who were discharged before fulfilling the study criteria for discharge were excluded from the study. Treatment was given according to National Guidelines for the Management of Bronchiolitis. All demographic, clinical and laboratory data were recorded in a prefixed questionnaire and analyzed. Results: Among 100 patients, 60% cases were hospitalized for 4 days or more. Mean duration of hospital stay was 4.37±1.93 days. Patients of male sex (67%), younger than 6 months of age (71%), preterm birth (21%), weight-for-age was either ≥2SD (60%) or ≤3SD (23%) were hospitalized for longer duration. Length of hospitalization was also increased in patients with family history of asthma (37%), smoking (75%), using wood-burning stoves for cooking (89%) and no previous history of respiratory distress (81%). Exclusively breastfed infants (41%) stayed hospital for shorter duration than those who fed partially (53%) or not at all (6%). All patients were improved in this case series (100%). Conclusion: Bronchiolitis patients having male sex, age less than 6 months, preterm born, partially breast fed , family history of asthma, exposure to smoking and wood-burning stoves were deduced to be significant risk factors for prolongation of length of hospitalization. Further research is needed to determine how these risk factors contribute to the development of the disease and prolong the length of hospital stay. Bangladesh Journal of Infectious Diseases 2020;7(2):67-71

scholarly journals Risk Factors for Ectopic Pregnancy: A Case-Control Study in Tertiary Care Hospitals of Jammu and Kashmir

2021 ◽  
Vol 3 (4) ◽  
pp. 293-299
Author(s):  
Neha Mahajan ◽  
◽  
Rohit Raina ◽  
Pooja Sharma ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Ectopic Pregnancy ◽  
Odds Ratio ◽  
Tertiary Care ◽  
Previous History ◽  
Tubal Ligation ◽  
Increased Risk ◽  
Study Results ◽  
History Of

Introduction: An ectopic pregnancy occurs when a fertilized egg attaches somewhere outside the uterus.There are many risk factors for ectopic pregnancy. This study will help us to prepare a list of risk factors associated with ectopic pregnancy in our state. In addition, it will help implement a risk-reduction counseling program before conception, which will help us screen high-risk patients and reduce and manage ectopic pregnancy. Materials and methods: The present study was conducted in our department for two years, from August 2018 to July 2019. Cases included all patients with ectopic pregnancy admitted in labor. A total of 192 cases were taken, out of which 8 cases refused to participate in the study, so 184 patients were included in the study. Results: Patients with previous ectopic pregnancy have 6.34 times increased risk of a repeat ectopic pregnancy (odds ratio 6.34, confidence interval 1.40-28.77), and this association was highly significant (p = 0.006). The risk of ectopic pregnancy is 3.02 times increased (odds ratio 3.10; 95% confidence interval, 1.16-7.84) if the patient once had the pelvic inflammatory disease and is statistically significant (p = 0.01). The study also revealed that 17 (10.3%) patients with ectopic pregnancy had a history of tubal ligation or some other tubal surgery done in the past compared to 3 (2.2%) patients among controls, and this finding is statistically highly significant (p = 0.001). Conclusions: In the present study, we found that the main risk factors for incidence of ectopic pregnancy are prior ectopic pregnancy, prior tubal ligation, and prior pelvic/abdominal surgery. In addition, ectopic pregnancy was positively related to the previous history of ectopic pregnancy, abortion, cesarean section, and infertility. These findings can be helpful for early diagnosis of ectopic pregnancy to pursue proper medical therapy instead of unnecessarily surgical treatment.

Prevalence, risk factors and molecular epidemiology of methicillin-resistantStaphylococcus aureus(MRSA) colonization in residents of long-term care facilities in Luxembourg, 2010

2012 ◽  
Vol 141 (6) ◽  
pp. 1199-1206 ◽  
Author(s):  
J. MOSSONG ◽  
E. GELHAUSEN ◽  
F. DECRUYENAERE ◽  
A. DEVAUX ◽  
M. PERRIN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Previous History ◽  
Prevalence Survey ◽  
Term Care ◽  
Care Facilities ◽  
History Of ◽  
Independent Risk Factors ◽  
Mrsa Colonization

SUMMARYA prevalence survey of methicillin-resistantStaphylococcus aureus(MRSA) was performed in 2010 in 19 long-term care facilities in Luxembourg. Of the 954 participating residents, 69 (7·2%) were colonized by MRSA. Previous history of MRSA [odds ratio (OR) 7·20, 95% confidence interval (CI) 3·19–16·27], quinolone therapy in the previous year (OR 2·27, 95% CI 1·17–4·41) and ⩾24 h care administered per week (OR 4·29, 95% CI 1·18–15·56) were independent risk factors for MRSA colonization. More than 75% of strains were of clonal complex (CC)5, mainlyspa-type t003 or sequence type (ST)225 and ST710, which is a rapidly emerging lineage prevalent in central Europe. Five residents were colonized by livestock-associated genotypes belonging to CC398. Previously dominant CC8 strains have recently been replaced by more resistant CC5 strains in Luxembourg.

scholarly journals Obstetrical outcome in gestational diabetes mellitus: a retrospective study

2019 ◽  
Vol 8 (2) ◽  
pp. 552
Author(s):  
Anitha Aldur Manjappa ◽  
Maya Menon ◽  
Aruna Bholenath Patil
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Retrospective Study ◽  
Family History ◽  
Gestational Diabetes ◽  
Caesarean Delivery ◽  
Previous History ◽  
Family History Of Diabetes ◽  
History Of ◽  
Obstetrical Outcome

Background: Gestational diabetes mellitus (GDM) is associated with adverse maternal and fetal outcomes. Majority of the maternal complications associated with GDM have been decreasing nowadays, however the relative risk of development of perinatal complications remain higher in women with hyper glycaemia.Methods: This retrospective study was conducted among 286 delivered pregnant women. The pregnant women were diagnosed as GDM by DIPSI diagnostic criterion. The study was performed to find the association of various risk factors with GDM occurrence and to assess the obstetrical outcome in the GDM and normoglycaemic women.Results: Out of the 286 women, the proportion of women affected with GDM was 20.6%. The onset of GDM was more common among women between 25-30year (62.7%). GDM onset is increased when they had previous history of GDM and family history of diabetes.  The obstetric complications were less common among GDM women (23.72%). GDM women had increased rate of caesarean delivery (69.5%) and induction of labour (42.4%). The neonatal complications were more common among GDM neonates (57.62%). The proportion of occurrence of congenital anomalies and macrosomia (>3.5kg) was similar among both groups.Conclusions: Risk factors associated with GDM onset such as previous history of GDM and family history of diabetes are significant risk factors. Advanced age, increasing parity and occurrence of abortions were not associated with GDM onset.  With good glycaemic control the obstetrical complications and macrosomia are preventable. Rate of Induction of labour, caesarean delivery and neonatal morbidity remains higher among GDM women.

Enteric Carriage of Vancomycin-ResistantEnterococcus faeciumin Patients Tested forClostridium difficile

1999 ◽  
Vol 20 (10) ◽  
pp. 664-670 ◽  
Author(s):  
Jane M. Garbutt ◽  
Benjamin Littenberg ◽  
Bradley A. Evanoff ◽  
Daniel Sahm ◽  
Linda M. Mundy
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Retrospective Case ◽  
Convenience Sample ◽  
History Of ◽  
Independent Risk Factors ◽  
Vancomycin Resistant ◽  
Gram Negative Organisms

AbstractObjective:To identify independent risk factors for enteric carriage of vancomycin-resistantEnterococcus faecium(VREF) in hospitalized patients tested forClostridium difficiletoxin.Design:Retrospective case-cohort study.Setting:Tertiary-care teaching hospital.Patients:Convenience sample of 215 adult inpatients who had stool tested forC difficilebetween January 29 and February 25,1996.Results:41 (19%) of 215 patients had enteric carriage of VREF. Five independent risk factors for enteric VREF were identified: history of priorC difficile(odds ratio [OR], 15.21; 95% confidence interval [CI95], 3.30-70.10;P<.001), parenteral treatment with vancomycin for ≥5 days (OR, 4.06; CI95, 1.54-10.73;P=.005), treatment with antimicrobials effective against gram-negative organisms (OR, 3.44; CI95, 1.20-9.87;P=.021), admission from another institution (OR, 2.95; CI95, 1.21-7.18;P=.017), and age >60 years (OR 2.57; CI95, 1.13-5.82;P=.024). These risk factors for enteric VREF were independent of the patient's currentC difficilestatus.Conclusions:Antimicrobial exposures are the most important modifiable independent risk factors for enteric carriage of VREF in hospitalized patients tested forC difficile.

scholarly journals Prognosis and Prognostic Factors of Patients with Emergent Cerclage: A Japanese Single-Center Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ami Kobayashi ◽  
Hironori Takahashi ◽  
Shigeki Matsubara ◽  
Yosuke Baba ◽  
Shiho Nagayama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Odds Ratio ◽  
Cervical Length ◽  
Single Center ◽  
Spontaneous Preterm Birth ◽  
Single Center Study ◽  
History Of ◽  
Prolonged Pregnancy ◽  
Center Study

Objectives. The aims of this study were to clarify the following: (1) how often does prolonged pregnancy ≥34 weeks occur in patients with emergent cerclage without progesterone and (2) the risk factors preventing such pregnancy continuation. Materials and Methods. This retrospective observational study was performed using medical records of patients for whom emergent cerclage had been performed between April 2006 and December 2018 in our institute. Results. Emergent cerclage was performed in 123 patients (median age: 34, interquartile range: 31–36). Primiparous patients numbered 44 (36%). A history of spontaneous preterm birth (SPTB) was present in 30 (24%). The median presurgical cervical length (CL) was 16 (8–21) mm at surgery. Of the 123, 20 (16%) were delivered at 33 + 6 weeks or less (<34 weeks). We conducted logistic regression analysis of the risk factors of SPTBs <34 weeks after cerclage. Three risk factors were identified that increased the risk of SPTB <34 weeks: presurgical CL 0 mm (odds ratio (OR): 5.30; 95% confidence interval (CI): 1.58–17.7), a history of SPTB (OR: 4.65; 95% CI: 1.38–15.7), and the presence of sludge (OR: 4.14; 95% CI: 1.20–14.3). Conclusion. Three risk factors predicted SPTB <34 weeks after emergency cerclage without progesterone administration: unmeasurable CL (CL 0 mm), a history of SPTB, and the presence of sludge on ultrasound. SPTB <34 weeks occurred after emergency cerclage in 16% of patients, being comparable with the recent data with progesterone.

scholarly journals A retrospective study to assess prevalence of gestational diabetes mellitus among those who delivered in Saveetha Medical College and Hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 3475
Author(s):  
Sharmila Kumar Gopalan ◽  
Kohila Kalimuthu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Retrospective Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Previous History ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
Medical College ◽  
History Of

Background: Gestational diabetes mellitus (GDM) defined as any degree of carbohydrate intolerance with onset or first recognition during pregnancy contributes to about 90% of diabetes complicating pregnancy. GDM imposes risks for both mother and fetus, some of which continues throughout the life of mother and child. The objective of the present study was to determine the prevalence of gestational diabetes mellitus and the associated risk factors among those who delivered in Saveetha medical college and hospital.Methods: A retrospective study was conducted by analysing the medical records of the patients who were admitted in the Department of Obstetrics and Gynaecology over a period of 1 year at Saveetha medical college and hospital, Chennai, Tamil Nadu, India. The diagnosis of GDM was made mainly by 75gm one step oral glucose tolerance test (OGTT). The guideline endorses 2-hours 75-gm OGTT, irrespective of last meal timings with a cut off value of ≥140 mg/dl. All data was analysed by simple descriptive statistics and percentage method.Results: In the present study, the total number of deliveries for 1 year from April 2018 - March 2019 were 511 and among those the total number of antenatal mothers with GDM who delivered were 46. Therefore the prevalence of GDM was calculated to be 9% or 90 per thousand deliveries. In the present study, 37 (65.1%) pregnant women of GDM group were seen in the age group of above 25 years, 27 (58.59%) were multiparous, 25(54.25%) pregnant females with GDM were found to have overweight and obese out of 46 cases.Conclusions: Our current study concludes the Prevalence of GDM in Saveetha Medical College Hospital is 9% between April 2018-March 2019. We have identified the following risk factors for developing GDM: multiparity≥2; previous history of diabetes mellitus; age ≥ 25; BMI ≥25; and family history of diabetes.

scholarly journals Prevalence and risk factors of anaemia in hospitalised HIV-infected patients in southeast China: a retrospective study

2019 ◽  
Vol 147 ◽  
Author(s):  
J. L. Lai ◽  
Y. H. Chen ◽  
Y. M. Liu ◽  
J. J. Yuan ◽  
J. Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Odds Ratio ◽  
Severe Anaemia ◽  
Hiv Positive ◽  
Cd4 Counts ◽  
Total Prevalence ◽  
Hospitalised Patients ◽  
Independent Risk Factors ◽  
Medical University

AbstractThe association between opportunistic infection (OI) and anaemia among HIV-infected patients remains to be studied. We investigated the prevalence and risk factors of anaemia in hospitalised HIV-infected patients to reveal the association between OI and anaemia. We conducted a retrospective study of HIV-positive hospitalised patients from June 2016 to December 2017 in Mengchao Hepatobiliary Hospital of Fujian Medical University. Patients’ information on socio-demographic and clinical characteristics were carefully collected. The comparison of anaemia prevalence between groups was conducted withχ2test. A logistic regression model was carried out to analyse the predictors of anaemia. The total prevalence of anaemia in hospitalised HIV-infected patients was 55.15%. The prevalence of mild, moderate and severe anaemia was 41.42%, 11.08% and 2.64%, respectively. Predictors independently associated with anaemia were: CD4 counts <50 cells/μl (odds ratio (OR): 6.376, 95% confidence interval (CI) = 1.916–21.215,P= 0.003), CD4 counts 50–199 cells/μl (OR: 6.303, 95% CI = 1.874–21.203,P= 0.003), co-infection with tuberculosis (TB) (OR: 2.703, 95% CI = 1.349–5.414,P= 0.005) or Penicillium marneffei (PM) (OR: 7.162, 95% CI = 3.147–15.299,P< 0.001). In Fujian, China, more than half inpatients with HIV were anaemic, but severe anaemia is infrequent. Lower CD4 counts, co-infection with TB or PM were independent risk factors for anaemia. Chinese HIV patients especially with TB, PM infection and low CD4 level should be routinely detected for anaemia to improve therapy.

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