scholarly journals Prediction of pancreatic fistula after distal pancreatectomy: Is it necessary to place prophylactic drain?

2020 ◽  
Author(s):  
Kazuhiro Suzumura ◽  
Kenjiro Iida ◽  
Hideaki Iwama ◽  
Yusuke Kawabata
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Confidence Interval ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Body Mass ◽  
Predictive Factors ◽  
Odds Ratio ◽  
Drain Placement ◽  
Pancreatic Thickness

The aim of this study was to determine the predictive factors for pancreatic fistula (PF) after distal pancreatectomy (DP) among preoperative and intraoperative parameters, and to clarify the patients who did not require drain placement. Between July 2009 and April 2017, 102 consecutive patients underwent DP at Hyogo College of Medicine. Preoperative and intraoperative data were collected, and the predictors of PF after DP were identified. PF was identified in 35 (34%) patients. In the multivariate analysis, 3 factors (body mass index [BMI] ≥22.4, contiguous organ resection, and pancreatic thickness ≥11 mm) were found to be independent predictors of PF (odds ratio, 5.7; 95% confidence interval, 1.9-17, p=0.002, odds ratio, 6.7; 95% confidence interval, 1.6-28, p=0.009, odds ratio, 11.6; 95% confidence interval, 3.7-36, p<0.001, respectively). A scoring scale for the prediction of PF was developed. BMI ≥22.4 (score: 1), contiguous organ resection (score: 1), and pancreatic thickness ≥11 mm (score: 2) were included in the scoring scale. Patients with a score of 0 never developed PF, while PF occurred in all patients with a score of 4. BMI ≥22.4, contiguous organ resection, and pancreatic thickness ≥11 mm were predictive factors for PF after DP. No patients with BMI <22.4, no contiguous organ resection, and a pancreatic thickness of <11 mm developed PF after DP, indicating that such patients may not require drain placement.

Central versus Distal Pancreatectomy for Benign or Low-Grade Malignant Lesions in the Pancreatic Neck and Proximal Body

2019 ◽  
Vol 85 (11) ◽  
pp. 1239-1245 ◽  
Author(s):  
Yangjun Li ◽  
Yujie Li
Keyword(s):  
Confidence Interval ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Low Grade ◽  
Exocrine Insufficiency ◽  
Fistula Rate ◽  
Pancreatic Fistula Rate

The purpose of this meta-analysis was to compare the clinical outcomes of central pancreatectomy (CP) with distal pancreatectomy (DP). PubMed, Web of Knowledge, and Ovid's database were searched for studies published in English language between January 1990 and December 2018. A meta-analysis was performed to compare the clinical outcomes of CP versus DP. Nineteen trials with 1440 patients were analyzed. Although there were no significant differences in the rate of intra-operative blood transfusion between two groups, CP costs more operative time as well as had more intraoperative blood loss than DP. Furthermore, the overall complication rate, pancreatic fistula rate, and the clinically significant pancreatic fistula rate were significantly higher in the CP group. On the other hand, CP had a lower risk of endocrine (odds ratio: 0.17; 95% confidence interval: 0.10, 0.29; P < 0.05) and exocrine insufficiency (odds ratio: 0.22; 95% confidence interval: 0.10, 0.48; P < 0.05). CP was associated with a higher pancreatic fistula rate, and it should be performed in selected patients who need preservation of the pancreas, which is of utmost importance.

scholarly journals FGF23 and Left Ventricular Hypertrophy in Children with CKD

2017 ◽  
Vol 13 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Mark M. Mitsnefes ◽  
Aisha Betoko ◽  
Michael F. Schneider ◽  
Isidro B. Salusky ◽  
Myles Selig Wolf ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Left Ventricular Hypertrophy ◽  
Confidence Interval ◽  
Body Mass ◽  
Odds Ratio ◽  
Ventricular Hypertrophy ◽  
Adjusted Odds Ratio ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
Interquartile Range

Background and ObjectivesHigh plasma concentration of fibroblast growth factor 23 (FGF23) is a risk factor for left ventricular hypertrophy (LVH) in adults with CKD, and induces myocardial hypertrophy in experimental CKD. We hypothesized that high FGF23 levels associate with a higher prevalence of LVH in children with CKD.Design, setting, participants, & measurementsWe performed echocardiograms and measured plasma C-terminal FGF23 concentrations in 587 children with mild-to-moderate CKD enrolled in the Chronic Kidney Disease in Children (CKiD) study. We used linear and logistic regression to analyze the association of plasma FGF23 with left ventricular mass index (LVMI) and LVH (LVMI ≥95th percentile), adjusted for demographics, body mass index, eGFR, and CKD-specific factors. We also examined the relationship between FGF23 and LVH by eGFR level.ResultsMedian age was 12 years (interquartile range, 8–15) and eGFR was 50 ml/min per 1.73 m2 (interquartile range, 38–64). Overall prevalence of LVH was 11%. After adjustment for demographics and body mass index, the odds of having LVH was higher by 2.53 (95% confidence interval, 1.28 to 4.97; P<0.01) in participants with FGF23 concentrations ≥170 RU/ml compared with those with FGF23<100 RU/ml, but this association was attenuated after full adjustment. Among participants with eGFR≥45 ml/min per 1.73 m2, the prevalence of LVH was 5.4%, 11.2%, and 15.3% for those with FGF23 <100 RU/ml, 100–169 RU/ml, and ≥170 RU/ml, respectively (Ptrend=0.01). When eGFR was ≥45 ml/min per 1.73 m2, higher FGF23 concentrations were independently associated with LVH (fully adjusted odds ratio, 3.08 in the highest versus lowest FGF23 category; 95% confidence interval, 1.02 to 9.24; P<0.05; fully adjusted odds ratio, 2.02 per doubling of FGF23; 95% confidence interval, 1.29 to 3.17; P<0.01). By contrast, in participants with eGFR<45 ml/min per 1.73 m2, FGF23 did not associate with LVH.ConclusionsPlasma FGF23 concentration ≥170 RU/ml is an independent predictor of LVH in children with eGFR≥45 ml/min per 1.73 m2.

Prediction of Difficult Mask Ventilation

2000 ◽  
Vol 92 (5) ◽  
pp. 1229-1236 ◽  
Author(s):  
Olivier Langeron ◽  
Eva Masso ◽  
Catherine Huraux ◽  
Michel Guggiari ◽  
André Bianchi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Confidence Interval ◽  
Body Mass ◽  
Univariate Analysis ◽  
Positive Pressure ◽  
Mask Ventilation ◽  
Airway Patency ◽  
Difficult Mask Ventilation ◽  
History Of

Background Maintenance of airway patency and oxygenation are the main objectives of face-mask ventilation. Because the incidence of difficult mask ventilation (DMV) and the factors associated with it are not well known, we undertook this prospective study. Methods Difficult mask ventilation was defined as the inability of an unassisted anesthesiologist to maintain the measured oxygen saturation as measured by pulse oximetry &gt; 92% or to prevent or reverse signs of inadequate ventilation during positive-pressure mask ventilation under general anesthesia. A univariate analysis was performed to identify potential factors predicting DMV, followed by a multivariate analysis, and odds ratio and 95% confidence interval were calculated. Results A total of 1,502 patients were prospectively included. DMV was reported in 75 patients (5%; 95% confidence interval, 3.9-6.1%), with one case of impossible ventilation. DMV was anticipated by the anesthesiologist in only 13 patients (17% of the DMV cases). Body mass index, age, macroglossia, beard, lack of teeth, history of snoring, increased Mallampati grade, and lower thyromental distance were identified in the univariate analysis as potential DMV risk factors. Using a multivariate analysis, five criteria were recognized as independent factors for a DMV (age older than 55 yr, body mass index &gt; 26 kg/m2, beard, lack of teeth, history of snoring), the presence of two indicating high likelihood of DMV (sensitivity, 0.72; specificity, 0.73). Conclusion In a general adult population, DMV was reported in 5% of the patients. A simple DMV risk score was established. Being able to more accurately predict DMV may improve the safety of airway management.

scholarly journals Blood Pressure Association with Sodium Intake from Snacks Among Undergraduates of Afe Babalola University, Nigeria

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 152-152
Author(s):  
Kayode Ajayi ◽  
Ibidayo Alebiosu
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Body Mass ◽  
Odds Ratio ◽  
Sodium Intake ◽  
Metabolic Equivalent ◽  
The Mean

Abstract Objectives The aim of the study was to assess the association between blood pressure (BP) values and sodium intake from snacks. Methods The mean weekly consumption of snacks was evaluated in 1500 randomly selected undergraduate aged 16–24 years by a food frequency questionnaire. Participants were divided into quartiles of systolic blood pressure and diastolic blood pressure. The mean weekly exercise level was calculated as the product of duration and frequency of each activity (in hours/week), weighted by an estimate of the metabolic equivalent of the activity (MET) and summed for the activities performed. The whole cohort was divided into tertiles of exercise and the individuals were classified as; sedentary, moderately active and active. The cut of points in the whole cohort were respectively; ≤10, 11–29, ≥30 MET h/week. Exercise levels were therefore expressed as MET h/week. Results The mean age, metabolic equivalent of activity (METs), body mass index (BMI) and mean sodium intake from snacks per day were; 20.10 ± 1.44 years, 25.51 ± 10.03 METs h/week, 24.86 ± 4.80 kg/m2 and 1.5 g/day respectively. Systolic blood pressure (SBP) ranges between 104.43 ± 4.89 mmHg and 137.27 ± 16.71 mmHg while the diastolic blood pressure (DBP) ranges from 71.24 ± 7.83–83.11 ± 12.03 mmHg. The SBP and DBP significantly increased from the lower to the higher tertile of sodium from snacks and with increasing frequency of salty snacks consumption (P &lt; 0.001). In the multiple logistic regression model, being in the highest SBP quartile (≥115 mmHg) was significantly associated with consumption of sodium from snacks (odds ratio (OR) = 1.46; 95% confidence interval (CI) 1.13–1.82; P = 0.001), age, gender and body mass index. Also, being in the highest DBP quartile (≥70 mmHg) was significantly associated with consumption of sodium from snacks (odds ratio (OR) = 2.84; 95% confidence interval (CI) 1.41–5.69; P = 0.003), age, body mass index, but not with gender. Conclusions The study has shown that a strong association exists between sodium intake from snack, daily frequency of consumption of salty snacks and blood pressure. Public education and social marketing are needed to motivate the undergraduate to choose healthier snacks with lower sodium content. Funding Sources The study did not receive any funding from any source.

scholarly journals Predictors of Clinical Outcomes After Hip Arthroscopy: 5 Year Follow- Up Analysis of 1038 Patients

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0038
Author(s):  
Benjamin Domb ◽  
Cammille Go ◽  
David Maldonado ◽  
Sarah Chen ◽  
Ajay Lall
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Clinical Outcomes ◽  
Body Mass ◽  
Predictive Factors ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Joint Space ◽  
Bivariate Analysis

Objectives: Identify predictive factors of midterm outcomes after hip arthroscopy in a cohort of 1038 patients, whose outcomes at minimum 2-year follow-up have previously been reported. In addition, to provide a comparison of short-term and midterm predictive factors in outcome measures following hip arthroscopy. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing hip arthroscopy between February 2008 and June 2012. Patients were included if they had minimum 5-year follow-up on 3 patient reported outcomes: Nonarthritic Hip Score (NAHS), modified Harris Hip Score (mHHS), and Hip Outcome Score-Sport Specific Subscale (HOS-SSS). Patients were excluded if they had any prior ipsilateral hip conditions. Using bivariate and multivariate analyses, we analyzed the effect of 36 preoperative and intraoperative variables on NAHS. Results: A total of 1038 patients met our listed inclusion and exclusion criteria, with a mean follow-up time of 62.0 months (range, 60.0 - 120.0 months). The bivariate analysis identified 11 variables (4 categorical and 7 continuous) that were predictive of 5-year postoperative NAHS. For the multivariate analysis, 7 variables were identified as being significant: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. These 7 variables were also predictive in the bivariate analysis. Conclusion: This study reports favorable midterm clinical outcomes in the largest cohort of hip arthroscopies with minimum 5-year follow up in the literature to date. Seven variables were identified as being significant predictors in both the bivariate and multivariate analysis: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. Of these, preoperative NAHS, BMI, age, and revision hip arthroscopy were predictive of both 2-year and 5-year postoperative NAHS. These predictive factors may prove useful to clinicians in determining indications for hip arthroscopy and counseling patients on its expected outcomes.

The association between body mass index and the risk of endometriosis: A meta-analysis

2019 ◽  
Vol 11 (2) ◽  
pp. 55-61 ◽  
Author(s):  
Ensiyeh Jenabi ◽  
Salman Khazaei ◽  
Yousef Veisani
Keyword(s):  
Body Mass Index ◽  
Confidence Interval ◽  
Body Mass ◽  
Odds Ratio ◽  
Web Of Science ◽  
Meta Analysis ◽  
Epidemiologic Studies ◽  
Overweight And Obesity ◽  
Bibliographic Databases ◽  
Q Statistic

Background: Many epidemiologic studies have been conducted to assess factors that were associated to endometriosis, but there is no consistency in results. Therefore, we conducted this meta-analysis to investigate the association between body mass index and the risk of endometriosis. Methods: In this meta-analysis, relevant studies that published in major international electronic bibliographic databases of PubMed, Scopus and Web of Science were systematically searched during November 2017. The Begg and Egger’s test was used to investigate publication bias in included studies. The Q-statistic and I2 tests were carried out for measuring heterogeneity. The random-effects model was conducted to obtain pooled odds ratio. Results: Our results showed a direct association between underweight and endometriosis in woman (odds ratio = 1.41, 95% confidence interval = 1.16–1.66), so underweight woman had 41% higher chance for endometriosis. However, we did not find linear association between overweight and endometriosis (odds ratio = 0.95; 95% confidence interval: 0.72–1.18) and obesity and endometriosis (odds ratio = 0.88; 95% confidence interval: 0.54–1.21), respectively. Conclusions: Our results suggested that underweight was a risk factor for the endometriosis, while overweight and obesity were not protective factors for endometriosis.

Combined Physical Activity and Sitting Time Association on Older Adults’ Body Mass Index: Cross-Sectional Findings From the Brazilian Longitudinal Study of Aging

2021 ◽  
pp. 1-7
Author(s):  
Juleimar S.C. Amorim ◽  
Juliana L. Torres ◽  
Sérgio V. Peixoto
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Mass Index ◽  
Longitudinal Study ◽  
Confidence Interval ◽  
Body Mass ◽  
Odds Ratio ◽  
Multinomial Logistic Regression ◽  
Sitting Time ◽  
Short Version

This study examined isolated and combined associations of physical activity (PA) and sitting time (ST) with body mass index (BMI) among older Brazilian adults. We have analyzed baseline data of 8,177 participants aged 50 years and older from the Brazilian Longitudinal Study of Aging. Respondents were categorized into sufficient PA/low ST, sufficient PA/high ST, insufficient PA/low ST, or insufficient PA/high ST using the Short Version of International Physical Activity Questionnaire. Multinomial logistic regression analysis examined the associations of being underweight (BMI, <18 kg/m2), overweight (BMI, 25–29.9 kg/m2), and obese (BMI, ≥30 kg/m2) with PA and ST categories. High ST (≥165 min/day) was associated with overweight (odds ratio, 1.26; 95% confidence interval [1.11, 1.44]) and obesity (odds ratio, 1.43; 95% confidence interval [1.21, 1.70]). However, no association was observed between PA and BMI. Participants in the insufficient and sufficient PA/high ST categories were more likely to be obese after adjusting for sociodemographic and health condition. Our findings call for public health initiatives that consider reducing ST in older adults.

scholarly journals Prognostic Factors for the Course of β Cell Function in Autoimmune Diabetes1

2000 ◽  
Vol 85 (12) ◽  
pp. 4619-4623 ◽  
Author(s):  
C. Törn ◽  
M. Landin-Olsson ◽  
Å. Lernmark ◽  
J. P. Palmer ◽  
H. J. Arnqvist ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Confidence Interval ◽  
Body Mass ◽  
Odds Ratio ◽  
Cell Function ◽  
Autoimmune Diabetes ◽  
Reference Level ◽  
Β Cell ◽  
C Peptide ◽  
Β Cell Function

This study presents a 2-yr follow-up of 281 patients, aged 15–34 yr, diagnosed with diabetes between 1992 and 1993. At diagnosis, 224 (80%) patients were positive for at least one of the following autoantibodies: islet cell antibodies (ICAs), glutamic acid decarboxylase antibodies (GADAs), or tyrosine phosphatase antibodies (IA-2As); the remaining 57 (20%) patients were negative for all three autoantibodies. At diagnosis, C-peptide levels were lower (0.27; 0.16–0.40 nmol/L) in autoantibody-positive patients compared with autoantibody-negative patients (0.51; 0.28–0.78 nmol/L; P &lt; 0.001). After 2 yr, C-peptide levels had decreased significantly in patients with autoimmune diabetes (0.20; 0.10–0.37 nmol/L; P = 0.0018), but not in autoantibody-negative patients. In patients with autoimmune diabetes, a low initial level of C-peptide (odds ratio, 2.6; 95% confidence interval, 1.7–4.0) and a high level of GADAs (odds ratio, 2.5; 95% confidence interval, 1.1–5.7) were risk factors for a C-peptide level below the reference level of 0.25 nmol/L 2 yr after diagnosis. Body mass index had a significant effect in the multivariate analysis only when initial C-peptide was not considered. Factors such as age, gender, levels of ICA or IA-2A or insulin autoantibodies (analyzed in a subset of 180 patients) had no effect on the decrease in β-cell function. It is concluded that the absence of pancreatic islet autoantibodies at diagnosis were highly predictive for a maintained β-cell function during the 2 yr after diagnosis, whereas high levels of GADA indicated a course of decreased β-cell function with low levels of C-peptide. In autoimmune diabetes, an initial low level of C-peptide was a strong risk factor for a decrease in β-cell function and conversely high C-peptide levels were protective. Other factors such as age, gender, body mass index, levels of ICA, IA-2A or IAA had no prognostic importance.

The D543N polymorphism of the SLC11A1/NRAMP1 gene is associated with treatment failure in male patients with pulmonary tuberculosis

2015 ◽  
Vol 30 (3) ◽  
Author(s):  
Yvain Salinas-Delgado ◽  
Carlos Galaviz-Hernández ◽  
René García Toral ◽  
Carmen A. Ávila Rejón ◽  
Miguel A. Reyes-Lopez ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Confidence Interval ◽  
Pulmonary Tuberculosis ◽  
Treatment Failure ◽  
Body Mass ◽  
Odds Ratio ◽  
Male Population ◽  
Nramp1 Gene ◽  
Male Patients

AbstractPolymorphisms inThirty-three subjects with treatment failure were paired by age and body mass index with 33 patients who successfully completed treatment and were considered cured. We assessed the polymorphisms ofWe found that D543N (G/A genotype) was associated with treatment failure in patients with pulmonary tuberculosis [odds ratio (OR) 11.61, 95% confidence interval (CI) 3.66–36.78]. When adjusted by gender, this association remained significant in males (OR 11.09, 95% CI 3.46–35.51).In our male population, the presence of the D543N polymorphism of

scholarly journals Body mass index is a risk factor for hemorrhagic transformation in older ischemic stroke patients after intravenous thrombolysis: a single center retrospective study

2019 ◽  
Author(s):  
Changqing Miao ◽  
Xiaoyan Yin ◽  
Chunying Mu ◽  
Yan Qu ◽  
Guogang Luo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Confidence Interval ◽  
Acute Ischemic Stroke ◽  
Body Mass ◽  
Odds Ratio ◽  
Intravenous Thrombolysis ◽  
Hemorrhagic Transformation ◽  
Stroke Patients ◽  
Tomography Scan

Abstract Background: The aim of our study was to determine whether body mass index is a predictor of hemorrhagic transformation in acute ischemic stroke patients after intravenous thrombolysis. Methods: A retrospective observational study was conducted to recruit 261 participants from a single center in China (67.0% males, median age 65 years). A head computed tomography scan was performed after 24 hours to evaluate hemorrhagic transformation occurrence, and a computed tomography scan was performed immediately in cases of clinical worsening. Multivariate logistic regression was used to estimate the association between risk factors and hemorrhagic transformation in acute ischemic stroke patients after intravenous administration of recombinant tissue plasminogen activator. Results: Of 261 patients, 40 (15.3%) developed hemorrhagic transformation (55% males, median age 70 years). Body mass index was higher in patients with hemorrhagic transformation than in patients without hemorrhagic transformation (25.7 vs 23.7; P value, 0.013). The multivariate logistic regression model showed that body mass index was an independent predictor of hemorrhagic transformation in patients aged ≥ 73 years (odds ratio, 1.74; 95% confidence interval, 1.22-2.49) but not in patients aged < 73 years (odds ratio, 1.01; 95% confidence interval, 0.87-1.18). In addition, the odds ratio was 5.16 (95% confidence interval, 2.21-12.04) when the body mass index was ≥ 25 kg/m2 compared to a body mass index < 25 kg/m2. Conclusions: The present study demonstrated that body mass index was an independent predictor of hemorrhagic transformation in older acute ischemic stroke patients after intravenous thrombolysis. Keywords: Body mass index, Hemorrhagic transformation, Intravenous thrombolysis, Ischemic stroke, Older patients.

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