scholarly journals Influence of Hyperglycemia Associated with Enteral Nutrition on Mortality in Patients with Stroke

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 996 ◽  
Author(s):  
López-Gómez ◽  
Delgado-García ◽  
Coto-García ◽  
Torres-Torres ◽  
Gómez-Hoyos ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Enteral Nutrition ◽  
Observational Study ◽  
Independent Risk Factor ◽  
Oral Feeding ◽  
Diabetic Patients ◽  
A Value ◽  
Longitudinal Observational Study ◽  
Lower Recovery

Objectives: To evaluate in patients admitted for stroke: (1) The frequency of hyperglycaemia associated with enteral nutrition (EN). (2) The risk of morbidity and mortality associated with the development of this type of hyperglycaemia. Methods: A longitudinal observational study was conducted in 115 non-diabetic patients admitted for stroke with EN. Age, functional capacity (Rankin scale), and blood plasma glucose (BPG) were recorded. Hyperglycaemia was considered as: a value higher than 126 mg/dL before the EN and/or a value higher than 150 mg/dL after a week of enteral nutrition. According to this, three groups were differentiated: HyperES: Those who had hyperglycemia before the beginning of the EN (33% patients); NoHyper: those who did not have hyperglycemia before or after (47.8% patients); and HyperEN: Those who did not have hyperglycemia before but suffered it after the beginning of the EN (19.1% patients). Results: The age was 72.72 (15.32) years. A higher rate of mortality was observed in the HyperEN group 45.50%, than HyperES 15.80% or NoHyper: 10.90%). A lower recovery of the oral feeding was observed in those patients of the HyperEN group 27.30%, than HyperES: 42.10% or NoHyper: 61.80%). In the multivariate analysis adjusting for age, sex, and Rankin scale the development of hyperglycemia in those who did not have it at the beginning (HyperEN) was an independent risk factor for non-recovery of the oral feeding (OR: 4.21 (1.20–14.79), p = 0.02); and mortality adjusted for age, sex and Rankin scale (OR: 6.83 (1.76–26.47), p < 0.01). Conclusions: In non-diabetic patients admitted for stroke with EN, the development of hyperglycaemia in relation to enteral nutrition supposes an independent risk factor for mortality and for the non-recovery of the oral feeding.

The impact of diabetes on HCC.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4029-4029
Author(s):  
Suzanne Graef ◽  
Sarah Berhane ◽  
Mabel Joey Teng ◽  
Anna Skowronska ◽  
Philip James Johnson
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Independent Risk Factor ◽  
Chronic Liver ◽  
Diabetic Patients ◽  
Alcoholic Fatty Liver ◽  
Treatment Of Diabetes ◽  
The Impact

4029 Background: The incidence of hepatocellular carcinoma (HCC) in the UK has increased by 40% over the last 20 years, with a corresponding increase in mortality rate. The rising incidence of obesity and type II diabetes are believed to be contributing factors due to the association with non-alcoholic fatty liver and steatohepatitis. We aimed to examine if diabetes was as an independent risk factor for the development of HCC and to assess the impact of diabetes on overall survival (OS). Methods: Data from 724 patients with HCC and a control group comprising 340 patients with chronic liver disease were collected prospectively between 2007 and 2012. The odds ratio (OR) for HCC in diabetic versus non-diabetic patients was calculated. Univariate and multivariate analysis was performed using logistic regression. Cox proportional hazards analysis was used to estimate hazard ratio (HR) for death for HCC patients, with and without diabetes and for the impact of variation in diabetic treatments. Results: The prevalence of diabetes was 39% within the HCC population and 10.3% within the chronic liver disease group. Univariate analysis demonstrated increased risk of HCC associated with age, sex, diabetes, haemochromatosis, cirrhosis, alcohol abuse and Child’s score. In patients with diabetes OR for HCC was 5.74 (CI 3.9-8.3; p<0.001). Age, sex, cirrhosis, Child’s score, diabetes and diabetes treatment with insulin, retained significance as independent risk factors in multivariate analysis. There was no survival difference for HCC patients with and without diabetes. In diabetic patients with HCC, treatment of diabetes with metformin, compared against other diabetic treatment options, was associated with a significantly longer OS (31 versus 24 months, p = 0.016; HR 0.74, p = 0.027). Conclusions: This study has demonstrated that diabetes is an independent risk factor for the development of HCC in a high risk population and that treatment with insulin appears to confer further independent risk. Diabetes has no effect on survival following the development of HCC but treatment of diabetes with metformin is associated with prolonged survival. In considering the optimal treatment for diabetes in chronic liver disease the beneficial effects of metformin on OS, if HCC develops, should be taken into account.

scholarly journals Serum High Lipoprotein(a) Levels in Patients with Type 2 Diabetes May Be an Independent Risk Factor for Hypertension

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Lingfen Zeng ◽  
Jieming Sun ◽  
Ming Cui
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Glycosylated Hemoglobin ◽  
Serum Triglyceride ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Lipoprotein A

Objective — To investigate whether serum lipoprotein(a) [Lp(a)] is an independent risk factor for abnormal blood pressure in patients with type 2 diabetes mellitus. Method — Analyzed data collected from diabetes patients and epidemiological survey from January 1,2020 to May 01,2021, with hypertension as a dependent variable, metabolic index such as glycosylated hemoglobin, serum total cholesterol, serum triglyceride and Lp(a) were independent variables, established logistic regression equation, analyze the influence of their variables on dependent variables. Results — The OR value of Lp(a) is 1.020, 95% confidence intervals (1.006, 1.035), p 0.006; The OR value of age is 1.073, 95% confidence interval (1.028, 1.119); and OR of the remaining parameters were tested no statistically different, p>0.05. Conclusions — The abnormal elevated Lp(a) level in the serum of type 2 diabetic patients may be related to the occurrence of hypertension. For patients with high Lp(a), Monitoring blood pressure may help to better detect and diagnose hypertension. At the same time, it is suggested that reducing serum Lp(a) level may reduce the risk of hypertension.

scholarly journals A Pilot Study Investigating the effect of Glycemic Control on Electrodiagnostic Parameters in Type II Diabetic Patients

2021 ◽  
pp. 146-153
Author(s):  
Parikshit Ashok Muley ◽  
Dalia A. Biswas ◽  
Avinash Taksande
Keyword(s):  
Risk Factor ◽  
Pilot Study ◽  
Glycemic Control ◽  
Glycaemic Control ◽  
Independent Risk Factor ◽  
Diabetic Patients ◽  
Type Ii ◽  
Duration Of Diabetes ◽  
Group Number

Background: Diabetes is a chronic metabolic abnormality due to either decreased secretion of insulin or decreased tissue sensitivity of insulin resulting in elevated blood glucose. Most common complication of diabetes is peripheral neuropathy. In this research project, we will be conducting a pilot study to observe the effect of glycaemic control on physiological functioning of nerve with the help of neurophysiological parameters, independent of duration of diabetes. Objectives: To investigate relationship of quality of glycemic control & severity of neurological changes. To find out whether glycemic control acts as an independent risk factor for progression of diabetic neuropathy despite the duration of diabetes. To validate the HBA1C at 10 for future longitudinal study to understand the association between glycemic control & progression of neuropathy. Methodology: 60 type II diabetic patients visiting diabetic OPD (Medicine) will participate in the study. The patients will be divided in to 2 groups of Group number 1 with (30 subjects) HBA1C < 10 and Group number 2 having (30 subjects) HBA1C >10. Electrodiagnostic study will be conducted on motor (tibial nerve) and sensory (sural nerve) will be performed in Neurophysiology lab. Neurophysiological parameters data of two groups will be analysed and compared. Expected Results: The pilot study will help to find out whether glycaemic control acts as a separate risk factor for progression of diabetic neuropathy despite duration of diabetes. Conclusion: This pilot study will help to establish the association between quality of glycaemic control and severity of neurological changes. Also, this will help to validate the HBA1C at 10 for further longitudinal study to know whether poor diabetes control is an independent risk factor associated to the severity of neuropathy in type II diabetes.

Risk factor of hyperglycemia with enteral nutrition in non diabetic patients in clinic universitary hospital

2021 ◽  
Vol 46 ◽  
pp. S629-S630
Author(s):  
E. Delgado Garcia ◽  
J.J. Lopez Gomez ◽  
B. Torres Torres ◽  
E. Gomez Hoyos ◽  
C. Serrna Valles ◽  
...  
Keyword(s):  
Risk Factor ◽  
Enteral Nutrition ◽  
Diabetic Patients

scholarly journals Risk factors for post-bronchoscopy pneumonia: a case–control study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yu Sato ◽  
Kengo Murata ◽  
Miake Yamamoto ◽  
Tsukasa Ishiwata ◽  
Miyako Kitazono-Saitoh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Tracheobronchial Stenosis ◽  
Control Study ◽  
Age And Sex

AbstractThe bronchoscopy, though usually safe, is occasionally associated with complications, such as pneumonia. However, the use of prophylactic antibiotics is not recommended by the guidelines of the British Thoracic Society. Thus far there are few reports of the risk factors for post-bronchoscopy pneumonia; the purpose of this study was to evaluate these risk factors. We retrospectively collected data on patients in whom post-bronchoscopy pneumonia developed from the medical records of 2,265 patients who received 2666 diagnostic bronchoscopies at our institution between April 2006 and November 2011. Twice as many patients were enrolled in the control group as in the pneumonia group. The patients were matched for age and sex. In total, 37 patients (1.4%) had post-bronchoscopy pneumonia. Univariate analysis showed that a significantly larger proportion of patients in the pneumonia group had tracheobronchial stenosis (75.7% vs 18.9%, p < 0.01) and a final diagnosis of primary lung cancer (75.7% vs 43.2%, p < 0.01) than in the control group. The pneumonia group tended to have more patients with a history of smoking (83.8% vs 67.1%, p = 0.06) or bronchoalveolar lavage (BAL) (4.3% vs 14.9%, p = 0.14) than the control group. In multivariate analysis, we found that tracheobronchial stenosis remained an independent risk factor for post-bronchoscopy pneumonia (odds ratio: 7.8, 95%CI: 2.5–24.2). In conclusion, tracheobronchial stenosis was identified as an independent risk factor for post-bronchoscopy pneumonia by multivariate analysis in this age- and sex- matched case control study.

Risk factors for peritoneal recurrence in serosa-negative gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 19-19 ◽  
Author(s):  
Hayato Omori ◽  
Yuichiro Miki ◽  
Wataru Takagi ◽  
Fumiko Hirata ◽  
Taichi Tatsubayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Independent Risk Factor ◽  
Peritoneal Recurrence ◽  
Node Metastasis ◽  
Gastric Cancer Patients

19 Background: Peritoneal recurrence is often observed in gastric cancer patients without serosal invasion. It is difficult for pathologists to evaluate whether tumor cells penetrate serosa or not, because the subserosa layer is very thin. We evaluated the incidence and risk factors of peritoneal recurrence in serosa -negative gastric cancer patients to clarify the mechanism of peritoneal recurrence in these patients. Methods: A total of 1,745 gastric cancer patients underwent R0 resection from 2002 to 2009 were enrolled. The incidence of peritoneal recurrence according to tumor depth was analyzed. In serosa-nagative patients, the univariate and multivariate analysis were performed to identify the risk factors for peritoneal recurrence. Results: Peritoneal recurrence was observed in 64 (3.7 %) out of 1,745 patients. The incidence of peritoneal recurrence according to depth of tumor invasion was in 0 / 466 in T1a, 5 / 567 (0.88 %) in T1b, 4 / 187 (2.1 %) in T2, 31 / 360 (7.9 %) in T3, 20 / 108 (15.9 %) in T4a, and 4 / 12 (25 %) in T4b, respectively (p<0.001). As for the risk factor for peritoneal recurrence in T3 patients, histologically undifferentiated type, negative lymphatic invasion, scirrhous type, invasive infiltrating growth pattern were the significant factors identified by univariate analysis. Only the invasive infiltrating growth pattern (OR3.44 p0.038) was selected as significant independent risk factor for peritoneal recurrence by multivariate analysis. In T1b / T2 patients, massive lymph node metastasis (N3a, 3b), scirrhous type were the significant factor for peritoneal recurrence by univariate analysis. Only massive lymph node metastasis (OR25.1 p<0.001) was selected as the significant independent risk factor by multivariate analysis. Conclusions: The incidence of peritoneal recurrence increases in proportion to the tumor depth. Invasive infiltrating growth pattern was selected as an independent risk factor for peritoneal recurrence in T3 patients, while it was massive lymph node metastasis in T1b / T2 patients. The results suggest the possibility that microscopic serosal invasion in T3 tumor and lymphatic progression in T1b / T2 tumor may contribute to peritoneal recurrence in gastric cancer.

scholarly journals Age is an independent risk factor for left atrial dysfunction: results from an observational study

2010 ◽  
Vol 18 (5) ◽  
pp. 243-247 ◽  
Author(s):  
M. A. M. Ploumen ◽  
L. H. B. Baur ◽  
M. J. Streppel ◽  
C. L. B. der Lodewijks-van Bolt ◽  
B. Winkens ◽  
...  
Keyword(s):  
Risk Factor ◽  
Observational Study ◽  
Left Atrial ◽  
Independent Risk Factor ◽  
Left Atrial Dysfunction

scholarly journals Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series.

2020 ◽  
Author(s):  
Jia-bin Wang ◽  
Zhen Xue ◽  
Jun Lu ◽  
Qing-liang He ◽  
Zhi-fang Zheng ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Independent Risk Factor ◽  
Neuroendocrine Neoplasms ◽  
Radical Gastrectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Systemic Complications

Abstract Background: The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy.Methods: This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS).Results: In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, incidences of serious postoperative complications were 0% and 3.7%, incidences of postoperative surgical complications were 13.6% and 15.2%, and incidences of postoperative systemic complications were 20.3% and 15.2%, respectively (all p>0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p=0.004; RFS: 52.54% vs 68.35%, p=0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p=0.007; RFS: 51.43% vs 74.36%, p=0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p<0.05).Conclusions: Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

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