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2022 ◽  
Vol 12 (1) ◽  
pp. 27
Author(s):  
Gökçe Kilinçalp ◽  
Anne-Christine Sjöström ◽  
Barbro Eriksson ◽  
Björn Holmberg ◽  
Radu Constantinescu ◽  
...  

Patients with Parkinson’s disease that may benefit from device-assisted therapy can be identified with guidelines like Navigate PD. The decision to offer advanced treatment and the choice of treatment modality are, however, not straightforward, and some patients respond less favorably to a chosen therapy. Measurements with the Parkinson Kinetigraph (PKG) can detect motor fluctuations and could therefore predict patients that respond better or worse to intestinal levodopa/carbidopa gel infusion (LCIG). In a retrospective analysis of 45 patients that had been selected to start LCIG between 2014 and 2020, the effects of baseline PKG and clinical characteristic on the outcome were determined with ordinal regression. Although all patients had been found to have handicapping medication-related symptom fluctuations, patients without clear objective off fluctuations in the baseline PKG had low odds ratio for success. Lower odds for success were also found with increasing age, whereas gender, medication intensity and baseline PKG summary scores (median bradykinesia and dyskinesia scores, fluctuation dyskinesia score and percent time with tremor) had no significant effect. Absence of easily identified off-periods in the PKG has a negative prognostic value for the effect of LCIG and could prompt noninvasive infusion evaluation before surgery.


2021 ◽  
Vol Volume 14 ◽  
pp. 5069-5078
Author(s):  
Cong Su ◽  
Ting Wu ◽  
Bao Meng ◽  
Chengcheng Yue ◽  
Yating Sun ◽  
...  

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Andrea Lalario ◽  
Eva Del Mestre ◽  
Michele Lo Casto ◽  
Vincenzo Nuzzi ◽  
Antonio Cannatà

Abstract Chemotherapy can lead to chemotherapy-induced dilated cardiomyopathy (CI-DCM), recognized as one of the Non-ischaemic Dilated Cardiomyopathy (DCM) phenotypes characterized by worse outcome. Evidences on a direct comparison between idiopathic-DCM (iDCM) and CI-DCM still lack. We included all the consecutive patients enrolled in the Trieste Muscle Heart Disease Registry. C-DCM was defined according to current recommendations. Uni- and multivariable analysis and Kaplan-Meier were performed. The primary outcome was all-cause death and the secondary outcomes were cardiac death and a composite of heart failure hospitalization, heart transplantation, ventricular assist-device implantation and major ventricular arrhythmias. The study included 511 patients (499 patients affected by iDCM and 52 patients affected by CI-DCM). Compared to iDCM, CI-DCM patients were older (51 ± 14 years vs. 58 ± 3 years respectively, P < 0.001) and had a higher LVEF (35%±10 vs. 32%±9, P = 0.03). CI-DCM patients had a higher incidence of all-cause of death compared to iDCM (36.5% vs. 8.4%, P < 0.001), while the incidence of cardiac death (7% in the CI-DCM group vs. 4% in the iDCM group, P = 0. 232) and of the composite secondary outcome was comparable amongst the two groups. At multivariable analysis, the diagnosis of CI-DCM was an independent predictor of primary outcome incidence (HR: 5.79, 95% CI: 1.83–18.27), P = 0.003, together atrial fibrillation. In a well-selected DCM cohort, patients with a chemotherapic etiology had a higher incidence of all-cause mortality compared to iDCM, while the incidence of cardiac adverse events was comparable among CI-DCM and iDCM.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jia Zhang ◽  
Tao Wang ◽  
Yi Fang ◽  
Mengzhou Wang ◽  
Wuming Liu ◽  
...  

Pyogenic liver abscess (PLA) remains a significant challenge for modern clinicians. Serum albumin/globulin ratio (AGR) can reflect the progress of many diseases. However, the clinical significance of AGR in PLA has not been evaluated. The aim of this study was to explore the effect of AGR on the clinical characteristic and prognosis in PLA patients. This retrospective study included 392 PLA patients who admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January, 2007 to December, 2016. The medical records on admission were collected. Compared with the healthy controls and the patients with extraperitoneal infection or non-infectious liver disease, PLA patients had lower levels of AGR. The mean level of AGR in PLA patients was 1.02 ± 0.25. There were 179 (45.4%) patients with AGR > 1.02 and 213 (54.6%) patients with AGR ≤ 1.02. The baseline data and treatment plans of PLA patients with high or low AGR were comparative. However, PLA patients with a low AGR had higher body temperature, leukocytes and neutrophils, lower hemoglobin, poorer liver and coagulation function, larger abscess diameter, higher positive rate of pus culture and proportion of Escherichia coli, and were more susceptible to multiple bacteria. Moreover, PLA patients with a low AGR had more complications, including systemic inflammatory response syndrome (SIRS), peritoneal effusion and pleural effusion. And it also needs longer time for temperature normalization and hospital stay. In conclusion, PLA patients have lower AGR and lower AGR is associated with worse clinical manifestations, more complications and poorer prognosis. Thus, monitoring of AGR is of great clinical significance for evaluating the progress of PLA patients.


2021 ◽  
Author(s):  
Maofeng Gong ◽  
Guanqi Fu ◽  
Zhengli Liu ◽  
Yangyi Zhou ◽  
Jie Kong ◽  
...  

Abstract Purpose The present study aimed to investigate the preliminary safety and efficacy of rheolytic thrombectomy (RT) using AngioJet ZelanteDVT catheter or Solent Omni catheter for acute proximal deep vein thrombosis (DVT).Material and Methods We conducted a retrospective review of 40 patients who treated by AngioJet RT divided into ZelanteDVT group (n=17) and Solent group (n=23) from January 2019 to January 2021. Data of demographics, clinical characteristic, technical success, clinical success, complications, and early follow-up were analysed.Results No significant differences regarding demographics were detected (all p >.05). The technical success rates were both 100%. ZelanteDVT group had a shorter duration time of RT and a higher primary RT success than those of Solent group (all p <.05), and percentage of adjunctive CDT was 29.4% in ZelanteDVT group, significantly lower than that was 79.3% in Solent group (p =.010). The successful outcome for ZelanteDVT group and Solent group were 100% (17/17) and 95.7% (22/23), both high in the two groups (p >.05). Except for transient macroscopic hemoglobinuria occurred in all patients at the first 24 hours post-RT, none suffered other procedure-related adverse events or major complications in both groups. Minor complications presented as bleeding events occurred in 21.7% (5/23) patients of Solent group, and one (5.9%) patient in Zelante DVT group (p >.05). At 6-month, the frequency of PTS was 5.9% (1/17) in ZelanteDVT group compared with 17.4% (4/ 23) in Solent group (p >.05).Conclusion Both catheters are safe and effective for the management of patients with proximal DVT, leading to improved clinical outcomes with low complication. Zelante-DVT catheter offered more powerful thrombectomy over Solent catheter, allowing for faster extraction of the DVT with shorter run time and lower adjunctive CDT.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Feng Lin ◽  
Jiarui Han ◽  
Teng Xue ◽  
Jilan Lin ◽  
Shenggen Chen ◽  
...  

AbstractMany studies report predictions for cognitive function but there are few predictions in epileptic patients; therefore, we established a workflow to efficiently predict outcomes of both the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in outpatients with epilepsy. Data from 441 outpatients with epilepsy were included; of these, 433 patients met the 12 clinical characteristic criteria and were divided into training (n = 304) and experimental (n = 129) groups. After descriptive statistics were analyzed, cross-validation was used to select the optimal model. The random forest (RF) algorithm was combined with the redundancy analysis (RDA) algorithm; then, optimal feature selection and resampling were carried out after removing linear redundancy information. The features that contributed more to multiple outcomes were selected. Finally, the external traceability of the model was evaluated using the follow-up data. The RF algorithm was the best prediction model for both MMSE and MoCA outcomes. Finally, seven markers were screened by overlapping the top ten important features for MMSE ranked by RF modeling, those ranked for MoCA ranked by RF modeling, and those for both assessments ranked by RDA. The optimal combination of features were namely, sex, age, age of onset, seizure frequency, brain MRI abnormalities, epileptiform discharge in EEG and usage of drugs. which was the most efficient in predicting outcomes of MMSE, MoCA, and both assessments.


2021 ◽  
Vol 11 (5) ◽  
pp. 146-153
Author(s):  
Ajay Menon ◽  
David Kelter ◽  
Gus J Slotman

Background: Today open Roux-en-Y gastric bypass (ORYGB) is reserved for abdomens too complex or obesity too severe for laparoscopic surgery. However, outcomes by age in ORYGB are unknown. Objective: Identify variation by age in ORYGB patients. Setting: Independent database. Methods: 5389 ORYGB BOLD patients was analyzed retrospectively by age: <30 (591), 30-40 (1252), 40-50 (1527), 50-60 (1388), 60-70 (592) and >70 (39). Statistics: ANOVA/general linear model. Results: Baseline female/male (p<0.01), weight, BMI, African-American, Hispanic, Medicaid, Private insurance, self-pay (p<0.0001), PCOS, PTC (n=10) varied inversely with age. Medicare, CHF, HTN, angina, LEE, PVD, IHD, dyslipidemia, OHS, diabetes, gout, IFS, and unemployment varied directly. Caucasian, Asian, Other race, DVT/PE, hernia, cholelithiasis, GERD, panniculitis, liver disease, SUI, MSP, fibromyalgia, alcohol and tobacco abuse, depression, PI, MHD (n=17) vary non-linearly. At 12 months, in spite of equal BMI by age, CHF, HTN, angina, PVD, dyslipidemia, cholelithiasis, SUI, diabetes, gout, IFS (n=10) varied directly. PCOS and PTC varied inversely, and LEE, OSA, hernia, MSP, tobacco abuse, depression, MHD varied non-linearly. 24 months CHF, HTN, angina, dyslipidemia, diabetes, IFS, and MSP vary directly. PTC and tobacco abuse varied inversely. LEE, OSA, PHTN, hernia, PCOS, and tobacco abuse varied non-linearly. Conclusions: ORYGB patients vary dramatically by decade of age. Pre-operatively 10 co-morbidities varied inversely, 13 directly, and 17 non-linearly by age. In spite of equal BMI by age at 24 months, important co-morbidities CHF, HTN, angina, dyslipidemia, diabetes varied directly, tobacco inversely, and OSA non-linearly. This advance clinical knowledge of age variation can aid ORYGB management


2021 ◽  
Vol 9 ◽  
Author(s):  
Piotr Kruczek ◽  
Paweł Krajewski ◽  
Roman Hożejowski ◽  
Tomasz Szczapa

Aim: To establish the impact of oxygen requirement before surfactant (SF) and time from birth to SF administration on treatment outcomes in neonatal respiratory distress syndrome (RDS).Methods: We conducted a post-hoc analysis of data from a prospective cohort study of 500 premature infants treated with less invasive surfactant administration (LISA). LISA failure was defined as the need for early (&lt;72 h of life) mechanical ventilation (MV). Baseline clinical characteristic parameters, time to SF, and fraction of inspired oxygen (FiO2) prior to SF were all included in the multifactorial logistic regression model that explained LISA failure.Results: LISA failed in 114 of 500 infants (22.8%). The median time to SF was 2.1 h (IQR: 0.8–6.7), and the median FiO2 prior to SF was 0.40 (IQR: 0.35–0.50). Factors significantly associated with LISA failure were FiO2 prior to SF (OR 1.03, 95% CI 1.01–1.04) and gestational age (OR 0.82, 95 CI 0.75–0.89); both p &lt;0.001. Time to SF was not an independent risk factor for therapy failure (p = 0.528) or the need for MV at any time during hospitalization (p = 0.933).Conclusions: The FiO2 before SF, but not time to SF, influences the need for MV in infants with RDS. While our findings support the relevance of FiO2 in SF prescription, better adherence to the recommended FiO2 threshold for SF (0.30) is required in daily practice.


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