scholarly journals Clinical Factors Associated With Successful Gastrostomy Tube Weaning in Patients With Prolonged Dysphagia After Stroke

2021 ◽  
Vol 45 (1) ◽  
pp. 33-41
Author(s):  
Bo Seong Jang ◽  
Jun Young Park ◽  
Jae Hyun Lee ◽  
Young Joo Sim ◽  
Ho Joong Jeong ◽  
...  
Keyword(s):  
Demographic Data ◽  
Characteristic Curve ◽  
Multiple Logistic Regression Analysis ◽  
Gastrostomy Tube ◽  
Screening Tools ◽  
Clinical Factors ◽  
Swallowing Function ◽  
Factors Associated ◽  
Korean Version ◽  
Tube Weaning

Objective To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke.Methods This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients’ demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated.Results There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634–0.987) and PAS scores (OR=0.205; 95% CI, 0.059–0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively.Conclusion In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.

scholarly journals T88. VALIDATION OF THE KOREAN VERSION OF THE 15-ITEM COMMUNITY ASSESSMENT OF PSYCHIC EXPERIENCES (CAPE-15) IN A COLLEGE POPULATION

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S265-S265
Author(s):  
Sung-Wan Kim ◽  
Jung Jin Kim ◽  
Yeonghyeok Kim ◽  
Anna Jo ◽  
Jae-Kyeong Kim ◽  
...  
Keyword(s):  
High Risk ◽  
Characteristic Curve ◽  
Mental States ◽  
Self Report ◽  
Screening Tools ◽  
Initial Screening ◽  
Community Assessment ◽  
Promising Alternative ◽  
Korean Version ◽  
Distress Score

Abstract Background The Community Assessment of Psychic Experiences-Positive 15-items scale (CAPE-15) is another brief, valid screening tool used to identify people at high risk of psychosis in the community. This study examined the reliability and validity of the Korean version of the CAPE-15 in university students. Methods This study had two stages: initial screening with self-report questionnaires including the CAPE-15, and semi-structured interviews to investigate the instrument’s diagnostic validity. The initial screening involved 1,749 college students. The modified Korean version of Prodromal Questionnaire-16 item (mKPQ-16) was also administered. The criteria for ultra-high risk (UHR) of psychosis in the Comprehensive Assessment of At-Risk Mental States (CAARMS) were the gold standard for diagnosis. Results Twelve of the interviewed subjects met the CAARMS criteria for UHR of psychosis. The area under the receiver operating characteristic curve was highest (0.936) for the CAPE-15 distress score (p<0.001). The use of 6 as the cutoff for the CAPE-15 distress score resulted in the best balance of sensitivity (91.7%) and specificity (85.2%), with a favorable positive predictive value of 32.4%. The coefficients of correlation between the CAPE-15 and mKPQ-16 were significant. Discussion This study showed that the CAPE-15 is a good screening instrument for use in community and school settings. In particular, the better validity of the CAPE-15 suggests that it is a promising alternative to other brief self-report screening tools that are currently used to detect UHR. This validation of a questionnaire with a small number of items may make it feasible to screen large numbers of young adults in the community and shorten the duration of untreated psychosis through prompt early intervention.

Weight Changes during Clozapine Treatment

1998 ◽  
Vol 32 (5) ◽  
pp. 718-721 ◽  
Author(s):  
Dianne Briffa ◽  
Thomas Meehan
Keyword(s):  
Weight Gain ◽  
Demographic Data ◽  
Activity Level ◽  
Clinical Factors ◽  
Weight Changes ◽  
Factors Associated ◽  
Clozapine Treatment ◽  
Marked Weight ◽  
Male Patients

Objective: The aim of this study was to assess the prevalence and magnitude of weight changes pre- and post-clozapine and to explore the ability of demographic and clinical factors to predict weight gain at 12 months post-clozapine. Method: Weight changes in a sample of 51 patients were assessed at 3 months pre-clozapine, at baseline, and at 3 and 12 months post-clozapine. In addition, demographic data and information concerning changes in appetite and activity level at 3 months was gathered and used to predict weight gain at 12 months. Results: Seventy percent of patients gained an average of 7.5 kg (10.6% increase in baseline body weight) over the 12-month period. Although post-clozapine weight gain for the total group was significant at 12 months, weight gain for the female sub-sample (n = 16) did not reach significance at either the 3 or 12 month assessments. The only factors associated with marked weight gain (> 15% increase) at 12 months were increased food intake early in treatment and having gained weight at 3 months. Conclusion: Clozapine treatment was found to be associated with significant weight gain in patients prescribed clozapine, especially male patients. Considering the long-term health risks associated with excess weight gain, health professionals can play an important role in educating clients about the potential for weight gain with clozapine treatment.

scholarly journals Case Analysis of Misdiagnosis in Emergency Internal Medicine

2015 ◽  
Vol 4 (4) ◽  
pp. 30
Author(s):  
Yuzhen Hu ◽  
Liguo Shi
Keyword(s):  
Young Adults ◽  
Demographic Data ◽  
Young Patients ◽  
Time Frame ◽  
Clinical Factors ◽  
Factors Associated ◽  
Stroke In Young Adults ◽  
Emergency Department Patients ◽  
Stroke Center ◽  
Stroke In Young

<p><strong>Objective: </strong>This paper attempts to determine the clinical factors associated with the diagnosis of stroke in young adults. <strong>Method: </strong>We registered and examined young patients from the hospital stroke center. Demographic data, past medical history, 3 hours diagnosis time within the time frame, and the outcomes were assessed. We compared the patients with misdiagnosis and those who were correctly diagnosed in order to identify the factors associated with acute stroke. <strong>Results: </strong>From 2005−2011, 57 patients (16−50 years) were enrolled in the registry. 8 patients (14%; 4 men and 4 women, mean age 38 years) were misdiagnosed. Of these 8 patients, seven were initially discharged from the emergency department. Patients aged less than 35 years old (<em>p</em> = 0.05) and posterior circulation stroke patients (<em>p</em> = 0.006) were more likely to be misdiagnosed. <strong>Conclusion: </strong>First aid department needs to popularize the awareness of stroke among young adults. Misdiagnosis may cause the patient to lose the best chance of thrombolysis.</p>

scholarly journals Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: comment

2021 ◽  
Author(s):  
Alessandra Bandera ◽  
Alessandro Nobili ◽  
Mauro Tettamanti ◽  
Sergio Harari ◽  
Silvano Bosari ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Clinical Factors ◽  
Factors Associated ◽  
Internal Medicine Wards

scholarly journals Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daiki Watanabe ◽  
Tsukasa Yoshida ◽  
Takashi Nakagata ◽  
Naomi Sawada ◽  
Yosuke Yamada ◽  
...  
Keyword(s):  
Older Adults ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Middle Aged ◽  
Cross Sectional ◽  
Factors Associated ◽  
Mail Surveys ◽  
Osaka Prefecture ◽  
Middle Aged Adults

AbstractBackgroundPrevious epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults.MethodsWe conducted face-to-face surveys of 525 adults, who were aged 40–91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40–97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia.ResultsSarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject’s calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8–9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants.ConclusionsSarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia.Trial registrationUMIN000036880, registered prospectively May 29, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027

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