The Use of Total Contact Orthoses in Patients with Foot Problems in Foot Clinic, Siriraj Hospital

2020 ◽  
Vol 103 (12) ◽  
pp. 1292-1299
Keyword(s):  
Odds Ratio ◽  
Univariate Analysis ◽  
Stepwise Logistic Regression ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial Tendon Dysfunction ◽  
Stepwise Logistic Regression Analysis ◽  
Cross Sectional ◽  
Siriraj Hospital ◽  
Foot Problems ◽  
Foot Clinic

Objective: To study the use rate, outcome, and concomitant factors of the use of the total contact orthoses (TCO) in the Foot Clinic, Siriraj Hospital Materials and Methods: The present study was a cross-sectional descriptive study collecting data from patient medical records and questionnaires. Patients who had foot problems without impairment of foot sensation and received the TCO from the Foot Clinic between July 2015 and April 2016 were interviewed before and after using the latest TCO for one month. Results: One hundred seven participants were recruited. Most were female (84.1%) with a median age of 59.3 years. The majority had chronic plantar fasciitis (26.2%), posterior tibial tendon dysfunction (PTTD) (25.2%), hallux valgus (21.5%), or metatarsalgia (21.5%). The TCO user was defined as a participant who had to use the TCO for more than three days per week and for more or equal to 50% of daily walking and standing duration. The use rate was 67.3%. The TCO provides standing and walking stability (p=0.008). For patients with metatarsalgia, using the TCO could significantly reduce pain (p=0.002). Using univariate analysis, many factors were found to be associated with the use of the TCO including having level of convenience of putting on or taking off shoes with TCO at 9 or more (odds ratio 2.66, 95% CI 1.16 to 6.12), having difficulty to find proper shoes that fit with the TCO (odds ratio 0.36, 95% CI 0.15 to 0.89), receiving more than one pair of TCO (odds ratio 4.09, 95% CI 1.51 to 11.05), and having level of comfort satisfaction during the TCO use at 9 or more (odds ratio 3.61, 95% CI 1.55 to 8.40). The latter two factors were found to be associated with the use of the TCO from stepwise logistic regression analysis (adjusted odds ratio 3.39, 95% CI 1.18 to 9.71 and 3.02, 95% CI 1.07 to 8.47, respectively). Conclusion: The use of the TCO in the Foot Clinic, Siriraj Hospital was 67.3%. Using the TCO could promote walking stability. Factors affecting the use of the TCO included receiving more than the first pair of TCO and having comfort satisfaction level of 9 or more. Keywords: Use, Total contact orthoses, Total contact insole, Foot problems

scholarly journals Hemoglobin A1c as A Potential Indicator for Intraplaque Hemorrhage of Carotid Artery Atherosclerosis in Asymptomatic Adults

2021 ◽  
Author(s):  
Yu Wang ◽  
Runhua Zhang ◽  
Yong Jiang ◽  
Miaoxin Yu ◽  
Huiyu Qiao ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Plaque ◽  
Hemoglobin A1c ◽  
Univariate Analysis ◽  
Intraplaque Hemorrhage ◽  
Stepwise Logistic Regression ◽  
Community Based ◽  
Stepwise Logistic Regression Analysis ◽  
Cross Sectional ◽  
High Hba1c

Abstract BackgroundTo investigate the association between hemoglobin A1c (HbA1c) and intraplaque hemorrhage (IPH) in carotid atherosclerotic plaque detected by high-resolution magnetic resonance imaging (HR-MRI) in a community-based population. MethodsIn this cross-sectional, community-based study, a total of 598 participants were recruited from May 2015 to September 2019. All participants underwent carotid artery HR-MRI. Data on demographics, medical history, and physical examinations were obtained through face-to-face interview, and fasting blood sample were collected. HbA1c was determined using high-performance liquid chromatographic analysis. Presence or absence of carotid plaque IPH was determined by HR-MRI. Multiple stepwise logistic regression analysis was performed to investigate the association between HbA1c levels and carotid plaque IPH. ResultsOf the 598 participants, 317 (53.0%) had atherosclerotic plaques, and 25 (4.2%) had IPH in carotid arteries. HbA1c was associated with the presence of IPH (OR, 1.94; 95% CI, 1.38-2.73) in the univariate analysis, and the association remained significant after adjustment for age, sex, traditional vascular factors, high-sensitivity C-reactive protein, and other potential confounders (OR, 1.70; 95% CI, 1.14-2.52).ConclusionsThis study showed that high HbA1c was associated with carotid plaque IPH detected by HR-MRI, which suggests that individuals with high HbA1c may have a higher risk of developing vulnerable carotid plaques.

Characterization of high- and low-grade cervical intraepithelial neoplasia

1993 ◽  
Vol 3 (4) ◽  
pp. 203-207 ◽  
Author(s):  
M. I. Shafi ◽  
J. A. Dunn ◽  
C. B. Finn ◽  
S. Kehoe ◽  
E. J. Buxton ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Surface Area ◽  
Univariate Analysis ◽  
Intraepithelial Neoplasia ◽  
Stepwise Logistic Regression ◽  
Low Grade ◽  
Abnormal Cytology ◽  
Stepwise Logistic Regression Analysis ◽  
Cytologic Smear ◽  
Cancer Precursors

A need exists to characterize the various grades of cervical intrapithelial neoplasia (CIN), and attempt to differentiate between high- and low-grade lesions, that may have different behavioral and progressive potentials. The identification of patients with high- or low-grade CIN is useful, as it may allow identification of those patients that have true cancer precursors. Fifty patients referred for colposcopy with abnormal cytology were studied. Univariate analysis identified three factors as important predictors of histologic grade; the colposcopic opinion, lesion surface area and the index cytology (P< 0.005). Colposcopic opinion was associated with the index cytology (P< 0.01) and the lesion surface area (P< 0.005). Only the colposcopic opinion and the index cytologic smear appeared in the final model using a stepwise logistic regression analysis, indicating their independent prognostic importance in prediction of grade of abnormality in cervical intraepithelial neoplasia. The study demonstrates the value of colposcopic training and experience being necessary prior to utilizing excisional treatment methods if overtreatment is to be avoided.

scholarly journals Prevalence of vulvovaginitis and bacterial vaginosis in patients with koilocytosis

2008 ◽  
Vol 126 (6) ◽  
pp. 333-336 ◽  
Author(s):  
Ana Claudia Camargo Campos ◽  
Ruffo Freitas-Junior ◽  
Luiz Fernando Jubé Ribeiro ◽  
Régis Resende Paulinelli ◽  
Cleomenes Reis
Keyword(s):  
Confidence Interval ◽  
Bacterial Vaginosis ◽  
Odds Ratio ◽  
Bacterial Colonization ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
P Values ◽  
The City

CONTEXT AND OBJECTIVE: Empirical discussion regarding an association between koilocytosis and vulvovaginitis often occurs. Thus, the objective of this study was to assess the prevalence of microorganisms associated with bacterial vaginosis and vulvovaginitis in women with and without koilocytosis. DESIGN AND SETTING: Analytical cross-sectional study including two cohorts of women (with and without koilocytosis) who attended a cancer hospital in the city of Goiânia, state of Goiás. METHODS: A total of 102 patients entered the study. The whiff test, Gram and Papanicolaou staining and bacterial and fungal culturing were performed. The results were observed using univariate analysis. The odds ratio and confidence interval (CI) of the variables were calculated; P-values < 0.05 were considered significant. RESULTS: The prevalence of bacterial colonization was similar in patients with and without koilocytosis. The odds ratio for candidiasis was 1.43 (CI 1.05-1.95) and the odds ratio for trichomoniasis was 1.78 (CI 1.49-2.12), in patients with koilocytosis. CONCLUSIONS: The prevalence of candidiasis and trichomoniasis seems to be higher in patients with koilocytosis.

scholarly journals Percutaneous endoscopic discectomy might be effective in selected cases of pyogenic spondylitis

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901988544
Author(s):  
Mamoru Kono ◽  
Masao Koda ◽  
Tetsuya Abe ◽  
Kousei Miura ◽  
Katsuya Nagashima ◽  
...  
Keyword(s):  
Renal Failure ◽  
Univariate Analysis ◽  
Acute Onset ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Reactive Protein ◽  
Pyogenic Spondylitis ◽  
Minimally Invasive Surgical ◽  
Additional Surgery ◽  
Endoscopic Discectomy

Background: Percutaneous endoscopic discectomy (PED) has been reported to be an effective procedure and minimally invasive surgical therapy for various spinal pathologies. Objective: To evaluate the clinical outcome of patients with pyogenic spondylitis who were treated with PED. Methods: Twenty-four patients with pyogenic spondylitis who underwent PED were evaluated for medical history, level of the affected intervertebral space, mode of onset, plain radiographs, epidural or psoas abscesses on MRI, results of blood and intraoperative sample cultures, preoperative C-reactive protein (CRP) level, time until postoperative CRP normalization (CRP < 0.3), and any additional surgery. Patients who underwent additional surgery and showed uncontrollable inflammation were considered to have “failed” PED for pyogenic spondylitis. To elucidate the factors that were significantly associated with a failure of PED for pyogenic spondylitis, statistical analyses were conducted by univariate analysis. Results: Control of inflammation was achieved in 19 of 24 patients (76%) after PED for pyogenic spondylitis. The remaining five patients failed to achieve infection control by PED. One such patient was not able to control the infection after PED, and another patient developed an epidural abscess 2 weeks after PED. Remaining three “failed” patients had exacerbations of their infections during the postoperative course and required additional surgery. Univariate analyses demonstrated that diabetes mellitus (DM; p = 0.05), hemodialysis due to DM-induced renal failure ( p = 0.02), concomitant malignant disease ( p = 0.09), and acute onset ( p = 0.05) were possibly correlated with PED failure. Stepwise logistic regression analysis revealed that hemodialysis due to DM-induced renal failure was an independent factor associated with PED failure ( p = 0.03). Conclusions: PED might be considered as one of the alternative therapeutic options before invasive radical surgeries for pyogenic spondylitis after failure of standard conservative therapy. Even by less invasive PED, pyogenic spondylitis patients with DM-hemodialysis showed poor outcome.

Factors Influencing Anatomic and Visual Results in Primary Scleral Buckling

2000 ◽  
Vol 10 (2) ◽  
pp. 153-159 ◽  
Author(s):  
H. Ahmadieh ◽  
M. Entezari ◽  
M. Soheilian ◽  
M. Azarmina ◽  
M.H. Dehghan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Logistic Regression ◽  
Retinal Detachment ◽  
Univariate Analysis ◽  
Scleral Buckling ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Factors Influencing ◽  
Preoperative Visual Acuity ◽  
Visual Results

Purpose To identify the factors influencing anatomical and visual results in cases of rhegmatogenous retinal detachment undergoing primary scleral buckling. Methods A retrospective study of 233 eyes of 226 patients was done. The data were evaluated by univariate analysis and stepwise logistic regression analysis. Results Retinal reattachment was achieved with primary scleral buckling in 197 eyes (84.5%). The extent of retinal detachment, preoperative proliferative vitreoretinopathy (PVR), preoperative visual acuity and relative afferent pupillary defects were identified as influencing anatomical results, by univariate analysis. The predictive roles of extent of retinal detachment (p<0.0001) and preoperative PVR (P=0.0085) were shown to be significant by stepwise logistic regression. As well as the above factors, the patient's age, the duration of symptoms and the status of the macula were predictors of visual results, by univariate analysis. Stepwise logistic regression analysis confirmed the predictive roles of preoperative visual acuity (P < 0.0001) and the extent of retinal detachment (P=0.0089). Conclusions Cases with a larger extent of retinal detachment, more advanced preoperative PVR and poorer preoperative visual acuity have less favorable anatomical and functional results.

scholarly journals Epidemiology and risk factors for ESBL-producing Klebsiella pneumoniae: a case control study

2010 ◽  
Vol 4 (11) ◽  
pp. 717-722 ◽  
Author(s):  
Kutbettin Demirdag ◽  
Salih Hosoglu
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Surgical Intervention ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Case Control ◽  
University Hospital ◽  
Stepwise Logistic Regression ◽  
Invasive Infection ◽  
Stepwise Logistic Regression Analysis

Introduction: Increased production of extended-spectrum β-lactamases (ESBLs) has become an important issue for treatment of severe Klebsiella pneumoniae (K. pneumoniae) infections. This study aimed to evaluate risk factors of infection from ESBL-producing K. pneumoniae (ESBL-KP). Methodology: Risk factors were evaluated using a retrospective case control design. Fifty-two patients admitted to Firat University Hospital (FUH) with invasive infections from ESBL-KP were employed as cases. Patients admitted to FUH with non-ESBL-producing K. pneumoniae invasive infection were chosen as controls. Potential risk factors of the cases and controls were evaluated using hospital charts. Pulsed-field Gel Electrophoresis (PFGE) was used to show the relatedness of ESBL-KP strains. Results: In univariate analysis, the following factors were found significant for ESBL-KP: pre-infection hospital stay, nosocomial origin, central venous catheterization, surgical intervention, antibiotic use longer than one week, and previous hospitalization. In contrast, stepwise logistic regression analysis showed that two variables, previous antibiotic use (p = 0.000) and surgical intervention (p = 0.006), remained significantly associated with risk for infection with an ESBL-KP. Molecular epidemiology identified several clusters among the ESBL-producing isolates. Conclusions: Antibiotic use and surgical intervention were significant associated factors for infections with ESBL-KP.

scholarly journals Stress, Anxiety and Depression among Pregnant Women during the first wave of the COVID-19 Pandemic in Israel

2021 ◽  
pp. 1-15
Author(s):  
Jimmy E. Jadaon ◽  
Ola Ali-Saleh ◽  
Ofra Halperin ◽  
Jawad Karram ◽  
Izhar Ben Shlomo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Emotional State ◽  
Post Partum ◽  
Univariate Analysis ◽  
High Stress ◽  
Income Level ◽  
Anxiety And Depression ◽  
Stepwise Logistic Regression ◽  
Postpartum Women ◽  
Cross Sectional

Background: The new COVID-19 pandemic resulted in tremendous challenges to mankind in health, emotions and economy. A specifically vulnerable group are pregnant and postpartum women. We conducted a study that aimed to shed light on the effects of this pandemic on emotional state of pregnant and postpartum women. Objective and Study Design: A cross-sectional study in northern Israel based on web questionnaire for the assessment of general stress, anxiety and depression during the quarantine period of COVID-19 pandemics from April 20 until May 7, 2020. Participants were pregnant women and women up to a year after childbirth. Overall, 356 women of whom 251 pregnant and 101 post-partum filled the questionnaire. Results: Among 251 pregnant women, 199 (79.3 %) reported moderate-high stress, 145 (57.8 %) high anxiety. A hundred and three (41.0%) reported high level of depression (PH2>3). Among pregnant women, the following were the most prevalent stressors: fear that someone in their family will acquire the virus (80.1%), concern for the health of the baby (77.7%), fear that someone close will die from COVID-19 (72.9%) and worry of being infected within the hospital (71.7%). A univariate analysis of stress revealed that age (χ2=10.93, p<0.004) and income level (χ2=13.35, p<0.001) were associated with the level of stress. Stepwise logistic regression revealed that both age and income level below the mean were predictors of stress. Among the 165 multiparous pregnant women, age (25-34 vs. 35-44) was a predictor of stress (p<0.04). Conclusion: Our study clearly showed an enormous negative effect of the COVID-19 pandemic on emotional condition including stress, anxiety and depression on both pregnant and postpartum women. This provides an insight on the relation between economy and emotional state during uncertainty period. This effect adds a huge challenge to healthcare system and social support providers as well as the governments in providing means and solutions during pandemics and worldwide disaster. Keywords: COVID-19, Pregnant, Postpartum, Depression, Anxiety, Stress

scholarly journals Posterior Tibial Tendon Dysfunction

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Jason Bariteau ◽  
Douglas Robertson ◽  
William Carpenter
Keyword(s):  
Clinical Diagnosis ◽  
Fluid Volume ◽  
Posterior Tibial Tendon ◽  
Ankle Pain ◽  
Posterior Tibial Tendon Dysfunction ◽  
Cross Sectional ◽  
Posterior Tibial ◽  
Sheath Fluid ◽  
Stage 1 ◽  
Tendon Pathology

Category: Hindfoot Introduction/Purpose: Stage 1 posterior tibial tendon dysfunction (PTTD) may be present without intra-substance tendon pathology. We hypothesize that in individuals with the clinical diagnosis of Stage 1 PTTD, with no MRI-detectable intra-substance tendon pathology, that sheath fluid amount is a confirmatory finding of PTTD. This purpose of this study was to quantify the amount of PTT sheath fluid in 1) individuals with the clinical diagnosis of Stage 1 PTTD and no MRI-detectable intra-substance tendon pathology and compare to controls with medial ankle pain (causes other) also without MRI-detectable intra-substance PTT pathology, and 2) test if there was a sheath fluid measurement predictive of the clinical diagnosis of PTTD. Methods: 326 individuals with medial ankle pain, no intra-substance PTT pathology, were studied, 48 with the clinical diagnosis of Stage 1 PTT dysfunction and 278 with medial ankle pain, causes other. Geometric methods defined MRI-based sheath fluid volume, maximum cross-sectional fluid area, and maximum fluid width. Fluid measurements were compared between groups and a predictive measurement calculated to identify individuals with PTTD. Measurement reliability was tested. Results: Individuals with PTT dysfunction had larger PTT sheath fluid volume, area, and width than controls (p’s < 0.001). An 9 mm threshold maximum fluid width was associated with PTTD (sensitivity 84%, specificity 85%). Measurements were reliable (p’s <0.03). Conclusion: The amount of PTT sheath fluid, in individuals with medial ankle pain and no intra-substance PTT pathology, was associated with Stage 1 PTTD and a maximum PTT sheath fluid width of > 9 mm predicted PTTD. This is clinically significance as MRI-detected sheath fluid can now be used as a confirmatory finding in individuals with the clinical diagnosis of Stage 1 PTTD who do not have MRI-detectable intra-substance pathology

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