Prevalence and risk factors of depression and anxiety for inpatients with lung cancer in China: A hospital-based cross-sectional study

Background Lung cancer was often accompanied by depression and anxiety. Nowadays, most investigations for depression and anxiety were concentrated in western medical hospitals, while few related studies have been carried out in the tradition Chinese medicine (TCM) ward. It was necessary to understand the prevalence and risk factors of depression and anxiety in the inpatients with lung cancer in TCM hospital. Methods This study adopted cross-sectional research method, which enrolled a total of 222 inpatients with lung cancer in TCM hospital. PHQ-9 and GAD-7 scales were used to assess depression and anxiety for the inpatients, respectively. Demographic and clinical data were also collected. Statistical methods of the univariate analysis and the multivariate logistic regression model were used. Results The prevalence of depression and anxiety in the inpatients with lung cancer were 58.1% and 34.2%, respectively. Multivariate logistic regression analysis prompted that the common risk factor of depression and anxiety was the symptom of insomnia. Constipation and gender were the two anther risk factors of depression. Conclusion Depression and anxiety were common for the inpatients with lung cancer in TCM hospital. Gender, insomnia and constipation were risk factors for depression, and insomnia was risk factor for anxiety. Therefore, medical workers should pay close attention to the emotional changes of these high-risk patients and intervene the symptoms as early as possible.

The rs13347 Polymorphism of the CD44 Gene Is Associated with the Risk of Kidney Stones Disease in the Chinese Han Population of Northeast Sichuan, China

Objective. To investigate the association between the rs13347 polymorphism of the CD44 gene and the risk of kidney stone disease (KSD) in the Han population of northeast Sichuan, China, so as to provide a theoretical basis for the treatment of KSD. Methods. We used PCR-restriction fragment length polymorphism (RFLP) technique to perform genotyping at rs13347 locus of the CD44 gene in the KSD group and the gontrol group. SNP Hardy-Weinberg equilibrium (HWE) testing was used to confirm the balance of genetic inheritance. Multivariate logistic regression analysis was used for the assessment of rs13347 polymorphism and the risk of developing KSD and to compare the relationship between the polymorphism of rs13347 and clinical characteristics of patients with KSD. Results. Genotypic results of rs13347 locus of the CD44 gene in the two groups were consistent with the SNP-HWE test, indicating the genetic balance. At the same time, multivariate logistic regression analysis indicated that subjects with CT and TT genotypes at rs13347 in the CD44 gene were more likely to have KSD, and there was a higher prevalence rate in males. Furthermore, carrying allele T at rs13347 was also a risk factor for KSD. In addition, people carrying CT and TT genotypes at rs13347 also have a significantly increased risk of relapsing KSD. Conclusion. The rs13347 polymorphism of the CD44 gene may be associated with the risk of KSD in the Han population of northeast Sichuan in China, and the recurrence rate of KSD in the carriers of CT and TT genotypes is higher.

Automated Breast Volume Scanner (ABVS)-Based Radiomic Nomogram: A Potential Tool for Reducing Unnecessary Biopsies of BI-RADS 4 Lesions

Improving the assessment of breast imaging reporting and data system (BI-RADS) 4 lesions and reducing unnecessary biopsies are urgent clinical issues. In this prospective study, a radiomic nomogram based on the automated breast volume scanner (ABVS) was constructed to identify benign and malignant BI-RADS 4 lesions and evaluate its value in reducing unnecessary biopsies. A total of 223 histologically confirmed BI-RADS 4 lesions were enrolled and assigned to the training and validation cohorts. A radiomic score was generated from the axial, sagittal, and coronal ABVS images. Combining the radiomic score and clinical-ultrasound factors, a radiomic nomogram was developed by multivariate logistic regression analysis. The nomogram integrating the radiomic score, lesion size, and BI-RADS 4 subcategories showed good discrimination between malignant and benign BI-RADS 4 lesions in the training (AUC, 0.959) and validation (AUC, 0.925) cohorts. Moreover, 42.5% of unnecessary biopsies would be reduced by using the nomogram, but nine (4%) malignant BI-RADS 4 lesions were unfortunately missed, of which 4A (77.8%) and small-sized (<10 mm) lesions (66.7%) accounted for the majority. The ABVS radiomics nomogram may be a potential tool to reduce unnecessary biopsies of BI-RADS 4 lesions, but its ability to detect small BI-RADS 4A lesions needs to be improved.

Neutrophil-to-Lymphocyte Ratio Cut-Off Point for COVID-19 Mortality: A Retrospective Study

Several months have passed since the onset of the COVID-19 pandemic. Multiple characteristics have been proposed as prognostic factors so far. This study aims to provide evidence on the association of neutrophil-to-lymphocyte ratio (NLR) at the hospitalization time and three desired outcomes (mortality, prolonged hospitalization, and intensive care unit [ICU] admission). We designed a single-centre retrospective observational study in Baharloo Hospital (Tehran, Iran) from 20 February to 19 April 2020. Patients with confirmed COVID-19 diagnosis via rt-PCR or chest CT imaging were included. Demographic and clinical data were obtained. The sample was divided into three groups, using tertile boundaries of initial NLR. The differences in mortality, comorbidities, hospitalization duration, drug administration, and ICU admission between these three groups were investigated. The identified confounding factors were adjusted to calculate the odds ratio of death, ICU admission, and prolonged hospitalization. Nine hundred sixty-three patients were included. In total, 151 and 212 participants experienced mortality and ICU admission, respectively. In multivariate logistic regression models, the adjusted odds ratio for mortality event in the second and third tertile of initial NLR after full adjustment were 1.89 (95% CI:1.07-3.32) and 2.57 (95% CI:1.48-4.43) and for ICU admission were 1.85 (95% CI:1.14-3.01) and 2.88 (95% CI:1.79-4.61), respectively. The optimal cut-off value of the initial NLR for predicting mortality was 4.27. Initial NLR can predict mortality and ICU admission in COVID-19 patients. Further investigations for curating the calculated cut-off can propose initial NLR as an indicator of poor prognosis for COVID-19 patients.

Social Isolation and Associated Factors in Chinese Adults With Epilepsy: A Cross-Sectional Study

Objective: We aimed to determine the prevalence of social isolation and associated factors among adults with epilepsy in northeast China.Methods: A cohort of consecutive patients with epilepsy (PWE) from the First Hospital of Jilin University (Changchun, China) was recruited. Demographic and clinical data for each patient were collected during a face-to-face interview. Social isolation was measured using the Berkman-Syme Social Network Index (SNI), and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Quality of Life in Epilepsy Inventory (QOLIE-31) were also administered. Multivariate logistic regression analyses were used to determine the factors associated with social isolation in PWE.Results: A total of 165 patients were included in the final analysis. The mean SNI score was 2.56 (SD: 1.19), and 35 patients (21.2%) were socially isolated. In multivariate logistic regression analysis, higher depressive symptom levels (OR = 1.15, 95% CI: 1.003–1.318, P = 0.045) and poorer quality of life (OR = 0.967, 95% CI: 0.935–0.999, P = 0.047) emerged as independent factors associated with social isolation in PWE.Conclusion: Social isolation is common and occurs in approximately one-fifth of PWE. Social isolation is significantly associated with depressive symptoms and poor quality of life in PWE. Patients need to be encouraged to actively integrate with others and reduce social isolation, which may help improve their quality of life.

Prevalence and risk factors of overt postpartum urinary retention among primiparous women after vaginal delivery: a case-control study

Background Postpartum urinary retention (PUR) may lead to bladder neuromuscular damage and subsequently voiding dysfunction. However, the literature regarding the incidence of and risk factors for PUR remains unclear. Moreover, previously reported studies are limited to small sample sizes. Thus, this study aimed to assess the incidence of and risk factors for overt PUR after vaginal delivery. Methods This retrospective case-control study included all primiparas who delivered vaginally between July 1, 2017, and June 30, 2019, at our institution. The case group comprised 677 women diagnosed with overt PUR who required catheterisation after delivery. The control group comprised 677 women without overt PUR randomly selected in a 1:1 ratio matched for date of delivery and who delivered immediately after each woman with overt PUR to minimise the impact of variations over time in obstetric practice. Univariate and multivariate logistic regression analyses were performed to investigate the factors associated with overt PUR. Results Of the 12,609 women included in our study, 677 were diagnosed with overt PUR (incidence 5.37%). Univariate analysis identified epidural analgesia, episiotomy, perineal tears, instrument-assisted delivery, duration of labour stage, intrauterine operation, and vulvar oedema as risk factors for PUR. Multivariate logistic regression identified epidural analgesia (odds ratio [OR] = 1.41, 95% confidence interval [CI]: 1.11–1.79, P = 0.005), vulvar oedema (OR = 6.92, 95% CI: 4.65–10.31, P < 0.001), forceps delivery (OR = 8.42, 95% CI: 2.22–31.91, P = 0.002), episiotomy (OR = 1.37, 95% CI: 1.02–1.84, P = 0.035), and second-degree perineal tear (OR = 3.42, 95% CI: 2.37–4.94, P < 0.001) as significant independent risk factors for PUR. Conclusions PUR was highly associated with epidural analgesia, forceps delivery, vulvar oedema, episiotomy, and second-degree perineal tears. More attention should be paid to women at high risk to reduce the incidence of PUR.

Cognitive Ability as a Non-modifiable Risk Factor for Post-prostatectomy Urinary Incontinence: A Double-Blinded, Prospective, Single-Center Trial

Introduction: Urinary incontinence (UI) is a wide-spread and feared side-effect of conventional or even robot-assisted laparoscopic prostatectomy (RALP) due to its high impact on patients' quality of life (QoL). Non-modifiable risk factors for UI have already been identified – on surgical and patient side. Yet, to our knowledge, focus thus far has not been placed on functional aspects regarding general cognitive ability.Materials and Methods: This is an observational single-center, prospective, double-blinded evaluation of 109 RALPs performed between 07/2020 and 03/2021. All patients underwent a Mini Mental State Examination (MMSE) prior to surgery to evaluate their cognitive ability. Early post-prostatectomy incontinence (PPI) was evaluated using a standardized 1 h pad test performed 24 h after removal of the urinary catheter. The association between MMSE results and PPI were evaluated using univariate and multivariate logistic regression models.Results: Multivariate logistic regression analyses identified MMSE results and nerve sparing (NS) as independent predictors for PPI in patients with an intermediate MMSE result (25–27 points) having a 3.17 times higher risk of PPI when compared to patients with a good MMSE result (≥28) (95% Confidence Interval (CI): 1.22–9.06, p = 0.023), while patients without NS had a 3.53 times higher risk of PPI when compared to patients with NS (95% CI: 1.54–11.09, p = 0.006).Conclusion: A lower cognitive ability should be treated as a non-modifiable risk-factor for early PPI. In the future it could find its place as a clinical screening tool to identify patients who require more attention especially in the pre-, but also in the postoperative phase.

Kidney and Mortality Outcomes Associated with Ondansetron in Critically Ill Patients

Background: Ondansetron is a preferred anti-emetic in critical care to treat nausea and vomiting, and has historically been considered a largely safe option. A recent pharmacoepidemiology study reported that ondansetron may be associated with an increased risk for acute kidney injury (AKI). Methods: We interrogated the High-Density Intensive Care (HiDenIC-15) database containing intensive care data for 13 hospitals across Western Pennsylvania between Oct 2008-Dec 2014. AKI was defined using the Kidney Disease, Improving Global Outcomes 2012 guidelines. Ondansetron use was considered as receiving any form of ondansetron within 24 h of admission. The subsequent 48 h (hours 25-72 after admission) were analyzed for outcomes. Primary outcome was development of AKI; secondary outcomes included 90-day mortality and time to AKI. Propensity-matched, multivariate logistic regression was applied for both outcomes. Comparator groups were metoclopramide and prochlorperazine using the same exposure criteria. Results:AKI occurred in 965 (5.6%), 12 (3.0%), and 61 (6.5%) patients receiving ondansetron, prochlorperazine, and metoclopramide, respectively. In the adjusted analysis, no anti-emetic was associated with a significant change in the odds of developing AKI. Ondansetron was associated with a 5.48% decrease (CI −6.17–−4.79) in death within 90 days of ICU-admission, which was independent of AKI status; an effect not seen with other anti-emetics. Anti-emetic usage was not associated with a change in the time to first AKI. Conclusion:Anti-emetic usage did not alter AKI risk. Ondansetron was associated with a significant decrease in 90-day mortality that was not seen by other anti-emetics, which requires further exploration.

Association Between Breastfeeding and Nutritional Status In Children With Congenital Heart Disease At Dr. Soetomo General Hospital

Congenital heart disease (CHD) is a congenital condition caused by a lack of heart development during the fetal stage. There is a notion that children with CHD have low nutritional status due to their condition. Nutritional input, energy requirements, dietary components, and prenatal circumstances impact a person's nutritional status. An analytical observational design with a cross-sectional approach was used in this research. Data were obtained via medical records and questionnaires posed to the patients' guardians who had provided informed consent. The Chi-square test and multivariate logistic regression analysis were used to analyze the data. The study was conducted on 62 subjects. There were 74.19% of subjects with acyanotic CHD and 25.81% with cyanotic CHD. 61.29 % of the subjects were exclusively breastfed for the first six months. The Chi-Square test revealed a relationship between breastfeeding and the nutritional status of children with CHD, with p = 0.0001 (p<0.05). The multivariate logistic regression analysis showed the significance of the type of CHD suffered by the subjects was 0.003 (p<0.05). There is a significant association between breastfeeding for the first six months and the type of CHD suffered by children with their nutritional status at Dr. Soetomo General Hospital.

To Analyze the Influencing Factors of Senile Coronary Heart Disease Patients Complicated with Frailty Syndrome

To analyze the influencing factors of senile coronary heart disease patients complicated with frailty syndrome. A total of 80 elderly patients with coronary heart disease admitted to our hospital from March 2020 to March 2021 were selected as the research subjects. The Fried Frailty Symptom Scale was used to evaluate whether the 80 patients were complicated with frailty syndrome. According to the evaluation results, the patients were divided into a nonfrailty syndrome group (52 cases in total) and frailty syndrome group (28 cases in total). Clinical data of two groups of patients were collected, and multivariate logistic regression was used to analyze the influencing factors of senile coronary heart disease patients complicated with frailty syndrome. Among 80 patients, the incidence of frailty syndrome was 35.00% (28/80), including 18 cases in early frailty and 10 cases in frailty stage. Univariate analysis showed that age, body mass (BMI), diabetes mellitus, congestive heart failure, chronic renal insufficiency, chronic obstructive pulmonary disease (COPD), tumor, high uric acid hematic disease, arrhythmia, interleukin-6 (IL-6), c-reactive protein (CRP), fibrinogen (FIB), brain natriuretic peptide (BNP), uric acid (UA), serum creatinine (Scr), serum protein (ALB), white blood cell count (WBC), and neutrophil count were the possible risk factors for senile coronary heart disease complicated with frailty syndrome ( P < 0.05). Multivariate logistic regression analysis showed that combined COPD, combined tumor, IL-6, BNP, UA, SCR, ALB, and neutrophil count were independent risk factors for senile CHD complicated with frailty syndrome ( P < 0.05). Combined with COPD, combined with tumor, IL-6, BNP, UA, SCR, ALB, and neutron cell count are the influencing factors for senile coronary heart disease patients complicated with frailty syndrome. These factors can be used as the basis for the diagnosis of frailty syndrome and guide the clinical development of targeted diagnosis and treatment plan.