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1.
An. bras. dermatol ; 99(2): 189-195, Mar.-Apr. 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1556821

ABSTRACT

Abstract Background The development of rosacea is suggested to be closely associated with lipid metabolism, inflammation, and anxiety/depression. Gamma linolenic acid (GLA) is a key factor participating in lipid metabolism, which is also confirmed to regulate the inflammatory response. However, the associations of serum GLA levels with rosacea severity and psychological status still remain unclear. Objective and limitations of the study The present study aimed to investigate the associations of gamma linolenic acid (GLA), a key factor participating in lipid metabolism and the inflammatory response, with rosacea severity and psychological status. The present study still had some limitations. First, this study is a cross-sectional study and does not provide longitudinal evidence about the relationship between GLA and rosacea; Second, the cohort in this study is also relatively small, and a larger cohort is needed in further investigation to reveal the potential role of lipid metabolism in the pathogenesis of rosacea. Methods A total of 62 rosacea patients were consecutively recruited. Patient's Self-Assessment (PSA) scale and Clinician Erythema Assessment (CEA) as well as 7-item Generalized Anxiety Disorder (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9) were conducted to evaluate the degree of erythema severity and anxiety/depression, respectively. Serum GLA levels were determined by gas chromatography mass. Results Lower levels of serum GLA in rosacea patients were observed (p < 0.001), and subgroup analysis revealed that patients with higher-level GLA had lower scores of PSA, CEA, GAD-7 and PHQ-9. Moreover, Spearman correlation analysis uncovered that serum GLA levels were negatively associated with PSA, CEA, GAD-7 as well and PHQ-9 scores, respectively. Linear regression model found that serum GLA levels at baseline were a predictive factor for prognosis of clinical outcomes after 1-month conventional treatment. Conclusion The present study indicates that lower levels of serum GLA in rosacea patients are negatively associated with the degree of erythema and anxiety/depression status.

2.
Crit. Care Sci ; 36: e20240229en, 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1557663

ABSTRACT

ABSTRACT Objective To compare two methods for defining and classifying the severity of pediatric acute respiratory distress syndrome: the Berlin classification, which uses the relationship between the partial pressure of oxygen and the fraction of inspired oxygen, and the classification of the Pediatric Acute Lung Injury Consensus Conference, which uses the oxygenation index. Methods This was a prospective study of patients aged 0 - 18 years with a diagnosis of acute respiratory distress syndrome who were invasively mechanically ventilated and provided one to three arterial blood gas samples, totaling 140 valid measurements. These measures were evaluated for correlation using the Spearman test and agreement using the kappa coefficient between the two classifications, initially using the general population of the study and then subdividing it into patients with and without bronchospasm and those with and without the use of neuromuscular blockers. The effect of these two factors (bronchospasm and neuromuscular blocking agent) separately and together on both classifications was also assessed using two-way analysis of variance. Results In the general population, who were 54 patients aged 0 - 18 years a strong negative correlation was found by Spearman's test (ρ -0.91; p < 0.001), and strong agreement was found by the kappa coefficient (0.62; p < 0.001) in the comparison between Berlin and Pediatric Acute Lung Injury Consensus Conference. In the populations with and without bronchospasm and who did and did not use neuromuscular blockers, the correlation coefficients were similar to those of the general population, though among patients not using neuromuscular blockers, there was greater agreement between the classifications than for patients using neuromuscular blockers (kappa 0.67 versus 0.56, p < 0.001 for both). Neuromuscular blockers had a significant effect on the relationship between the partial pressure of oxygen and the fraction of inspired oxygen (analysis of variance; F: 12.9; p < 0.001) and the oxygenation index (analysis of variance; F: 8.3; p = 0.004). Conclusion There was a strong correlation and agreement between the two classifications in the general population and in the subgroups studied. Use of neuromuscular blockers had a significant effect on the severity of acute respiratory distress syndrome.


RESUMO Objetivo Comparar dois métodos para definição e classificação de gravidade na síndrome do desconforto respiratório agudo pediátrica: a classificação de Berlim, que utiliza a relação entre pressão parcial de oxigênio e fração inspirada de oxigênio e a classificação do Pediatric Acute Lung Injury Consensus Conference, que utiliza o índice de oxigenação. Métodos Estudo prospectivo com pacientes de 0 - 18 anos com diagnóstico de síndrome do desconforto respiratório agudo e ventilados mecanicamente de forma invasiva, que forneceram de uma a três amostras de gasometria arterial, totalizando 140 medidas válidas. Essas medidas foram avaliadas quanto à correlação pelo teste de Spearman e à concordância pelo coeficiente kappa entre as duas classificações, inicialmente usando a população geral do estudo e, depois, subdividindo-a em pacientes com e sem broncoespasmo e com e sem o uso do bloqueador neuromuscular. Também foi verificado o efeito desses dois fatores (broncoespasmo e bloqueador neuromuscular) de forma separada e conjunta sobre ambas as classificações por meio da análise de variância para dois fatores. Resultados Na população geral, composta de 54 pacientes com idades de 0 - 18 anos, foi encontrada forte correlação negativa pelo teste de Spearman (ρ -0,91; p < 0,001) e forte concordância pelo coeficiente kappa (0,62; p < 0,001) na comparação entre Berlim e Pediatric Acute Lung Injury Consensus Conference. Nas populações com e sem broncoespasmo e com e sem o uso do bloqueador neuromuscular, os coeficientes de correlação mantiveram valores semelhantes aos da população geral. Entretanto, para os pacientes sem uso do bloqueador neuromuscular, houve maior concordância entre as classificações em relação aos pacientes com uso do bloqueador neuromuscular (kappa 0,67 versus 0,56 com p < 0,001 em ambos). Acrescenta-se ainda o efeito significativo do uso do bloqueador neuromuscular sobre a relação entre pressão parcial de oxigênio e fração inspirada de oxigênio (análise de variância; F: 12,9; p < 0,001) e o índice de oxigenação (análise de variância; F: 8,3; p = 0,004). Conclusão Houve forte correlação e concordância entre as duas classificações na população geral e nos subgrupos estudados, entretanto, há efeito significativo do uso do bloqueador neuromuscular sobre as classificações de gravidade da síndrome do desconforto respiratório agudo.

3.
Arq. bras. oftalmol ; 87(3): e2022, 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1550036

ABSTRACT

ABSTRACT Purpose: This study aimed to investigate the effect of upper eyelid blepharoplasty with the removal of the skin and a strip of orbicularis oculi muscle on the ocular surface, tear film, and dry eye-related symptoms. Methods: Twenty-two eyes of 22 consecutive patients operated by a single surgeon (21 females; mean age, 61 years; age range, 41-75 years) were included. All subjects completed the Ocular Surface Disease Index questionnaire, underwent in vivo confocal microscopy, tear film breakup time measurements, the Schirmer test with anesthesia, and fluorescein and lissamine green staining measurements before, 1 month, and 6 months after upper blepharoplasty alone with preseptal orbicularis excision. Results: A significant increase in Ocular Surface Disease Index, and corneal fluorescein and lissamine green staining and a significant decrease in tear film breakup time were observed after 1 month (p=0.003, p=0.004, p=0.029, and p=0.024 respectively) and 6 months (p=0.001 for all findings). No significant difference in the Schirmer test score was observed during the follow-up. None of the in vivo confocal microscopy parameters showed significant changes during the study. Conclusions: An increase in dry eye symptoms and a decrease in tear film stability along with ocular surface staining were observed in patients undergoing upper eyelid blepharoplasty.

4.
Arq. gastroenterol ; 61: e23103, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1533823

ABSTRACT

ABSTRACT Background: To assess the efficacy of applying the endoscopic reference score for EoE (EREFS) in children with symptoms of esophageal dysfunction naïve to proton pump inhibitor (PPI) therapy. Methods: An observational cross-sectional study was conducted by reviewing reports and photographs of upper gastrointestinal endoscopies (UGE) and esophageal biopsies of patients with symptoms of esophageal dysfunction. Patients who were treated with PPI or had other conditions that may cause esophageal eosinophilia were excluded. Results: Of the 2,036 patients evaluated, endoscopic findings of EoE were identified in 248 (12.2%) and more than one abnormality was observed in 167 (8.2%). Among all patients, 154 (7.6%) presented esophageal eosinophilia (≥15 eosinophils per high power field) (P<0.01). In this group, 30 patients (19.5%) had normal endoscopy. In patients with EoE, edema (74% vs 6.5%, P<0.01) and furrows (66.2% vs 2.4%, P<0.01) were more prevalent than in the control group. Association of edema and furrows was more frequent in patients with EoE than in the control group (29.2% vs 1.6%, P<0.01, OR=24.7, CI=15.0-40.5). The presence of more than one endoscopic finding had sensitivity of 80.5%, specificity of 93.4%, positive predictive value (PPV) of 50%, negative predictive value (NPV) of 98.3%, and accuracy of 92.4%. Conclusion: In conclusion, this study showed that endoscopic features suggestive of EoE had high specificity and NPV for diagnosing EoE in children naïve to PPI therapy. These findings highlight the importance of the EREFS in contributing to early identification of inflammatory and fibrostenosing characteristics of EoE, making it possible to identify and to avoid progression of the disease.


RESUMO Contexto: Avaliar a eficácia da aplicação do escore de referência endoscópico para EoE (EREFS) em crianças com sintomas de disfunção esofágica sem tratamento prévio com inibidores da bomba de prótons (IBP). Métodos: Foi realizado um estudo transversal observacional por meio de revisão de laudos e fotos de endoscopia digestiva alta (EDA) e biópsias de esôfago de pacientes com sintomas de disfunção esofágica. Pacientes tratados com IBP ou com outras condições que podem causar eosinofilia esofágica foram excluídos. Resultados: Dos 2.036 pacientes avaliados, os achados endoscópicos de EoE foram identificados em 248 (12,2%) e mais de uma anormalidade foi observada em 167 (8,2%). Entre todos os pacientes, 154 (7,6%) apresentaram eosinofilia esofágica (≥15 eosinófilos por campo de grande aumento) (P<0,01). Nesse grupo, 30 pacientes (19,5%) apresentaram endoscopia normal. Em pacientes com EoE, edema (74% vs 6,5%, P<0,01) e linhas verticais (66,2% vs 2,4%, P<0,01) foram mais prevalentes quando comparados ao grupo controle. A associação de edema e linhas verticais foi mais frequente em pacientes com EoE do que no grupo controle (29,2% vs 1,6%, P<0,01, OR=24,7, IC=15,0-40,5). A presença de mais de um achado endoscópico teve sensibilidade de 80,5%, especificidade de 93,4%, valor preditivo positivo de 50%, valor preditivo negativo de 98,3% e acurácia de 92,4%. Conclusão: Em conclusão, esse estudo mostrou que as características endoscópicas sugestivas de EoE apresentam especificidade e VPN elevados para o diagnóstico da enfermidade em crianças sem tratamento prévio com IBP. Estes achados reforçam a importância do EREFS em contribuir para a identificação precoce de características inflamatórias e fibroestenosantes, possibilitando identificar e evitar a progressão da doença.

5.
Rev. bras. cir. cardiovasc ; 39(2): e20230104, 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1535539

ABSTRACT

ABSTRACT Introduction: Along with cardiopulmonary bypass time, aortic cross-clamping time is directly related to the risk of complications after heart surgery. The influence of the time difference between cardiopulmonary bypass and cross-clamping times (TDC-C) remains poorly understood. Objective: To assess the impact of cardiopulmonary bypass time in relation to cross-clamping time on immediate results after coronary artery bypass grafting in the Registro Paulista de Cirurgia Cardiovascular (REPLICCAR) II. Methods: Analysis of 3,090 patients included in REPLICCAR II database was performed. The Society of Thoracic Surgeons outcomes were evaluated (mortality, kidney failure, deep wound infection, reoperation, cerebrovascular accident, and prolonged ventilation time). A cutoff point was adopted, from which the increase of this difference would affect each outcome. Results: After a cutoff point determination, all patients were divided into Group 1 (cardiopulmonary bypass time < 140 min., TDC-C < 30 min.), Group 2 (cardiopulmonary bypass time < 140 min., TDC-C > 30 min.), Group 3 (cardiopulmonary bypass time > 140 min., TDC-C < 30 min.), and Group 4 (cardiopulmonary bypass time > 140 min., TDC-C > 30 min.). After univariate logistic regression, Group 2 showed significant association with reoperation (odds ratio: 1.64, 95% confidence interval: 1.01-2.66), stroke (odds ratio: 3.85, 95% confidence interval: 1.99-7.63), kidney failure (odds ratio: 1.90, 95% confidence interval: 1.32-2.74), and in-hospital mortality (odds ratio: 2.17, 95% confidence interval: 1.30-3.60). Conclusion: TDC-C serves as a predictive factor for complications following coronary artery bypass grafting. We strongly recommend that future studies incorporate this metric to improve the prediction of complications.

6.
Rev. Fac. Med. Hum ; 23(4): 129-141, oct.-dic. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1559082

ABSTRACT

RESUMEN La psoriasis es una enfermedad crónica de la piel mediada por el sistema inmunológico con una base genética y patogénica compleja, que frecuentemente conduce a comorbilidades significativas y una reducción en la calidad de vida. Su prevalencia varía a nivel global y muestra una tendencia creciente con el tiempo. Comorbilidades como la artritis psoriásica, enfermedades cardiovasculares y problemas de salud mental complican aún más la carga de la psoriasis. Las opciones de tratamiento van desde terapias tópicas hasta agentes sistémicos, siendo los agentes biológicos prominentes en los últimos años. Sin embargo, la seguridad y eficacia de estos tratamientos se evalúan continuamente a través de datos del mundo real. La vitamina D ha llamado la atención como un posible objetivo terapéutico debido a su papel en la regulación inmunológica y la función de barrera de la piel. Esta revisión tiene como objetivo evaluar la eficacia de la suplementación oral de vitamina D en mejorar la gravedad de la psoriasis. Después de una búsqueda bibliográfica, se encontró que la psoriasis es una condición multifacética con significativas implicaciones globales. Los agentes biológicos han transformado su manejo, y la suplementación oral de vitamina D es un camino prometedor para una mayor exploración. Un enfoque integral centrado en el paciente que tenga en cuenta las comorbilidades y los resultados a largo plazo es crucial para optimizar el cuidado de la psoriasis. Se necesita más investigación para comprender completamente el papel de la vitamina D en la psoriasis y su potencial como intervención terapéutica.


ABSTRACT Psoriasis is a chronic immune-mediated skin disease with a complex genetic and pathogenic basis, often leading to significant comorbidities and a reduced quality of life. Its prevalence varies globally and exhibits an increasing trend over time. Comorbidities such as psoriatic arthritis, cardiovascular diseases, and mental health issues further compound the burden of psoriasis. Treatment options range from topical therapies to systemic agents, with biologics playing a prominent role in recent years. However, the safety and efficacy of these treatments are continuously assessed through real-world data. Vitamin D has gained attention as a potential therapeutic target due to its role in immune regulation and skin barrier function. This review aims to evaluate the efficacy of oral vitamin D supplementation in ameliorating the severity of psoriasis. After bibliographic search, it was found that psoriasis is a multifaceted condition with significant global implications. Biologics have transformed its management, and oral vitamin D supplementation is a promising avenue for further exploration. A comprehensive, patient-centered approach that considers comorbidities and long-term outcomes is crucial for optimizing psoriasis care. Further research is needed to fully understand the role of vitamin D in psoriasis and its potential as a therapeutic intervention.

7.
Rev. peru. med. exp. salud publica ; 40(4): 432-440, oct.-dic. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1560389

ABSTRACT

RESUMEN Objetivos. Determinar la asociación entre el grado de severidad de la infección por COVID-19 durante el embarazo y la rotura prematura de membranas pretérmino (RPMP) en un hospital nivel III de Perú. Materiales y Métodos. Estudio transversal, analítico y observacional en mujeres mayores de 18 años con diagnóstico de infección por COVID-19 en el embarazo durante el 2020-2022. Se recogieron variables clínicas y obstétricas. Para el análisis descriptivo se realizaron las pruebas de Chi Cuadrado y exacta de Fisher, y para el análisis multivariado, se calculó la razón de prevalencia mediante regresión de Poisson en modelos crudos y ajustados. Todas las pruebas estadísticas se realizaron considerando un valor de p<0,05 como significativo y con un nivel de confianza de 95%. Resultados. Se analizaron los datos de 163 gestantes con COVID-19, de las cuales el 9,2% tuvieron RPMP, todas fueron casos sintomáticos. Los casos leves de COVID-19 tuvieron 1,10 veces la probabilidad de presentar RPMP (RPa=1,10; IC95%: 1,02−1,18) y los casos moderados/severos tuvieron 1,64 veces esta probabilidad (RPa=1,64; IC95%: 1,43−1,87), en comparación con los casos asintomáticos. Conclusiones. Se identificó que un mayor grado de severidad de la infección por COVID-19 durante el embarazo se asoció a una mayor probabilidad de tener RPMP.


ABSTRACT Objectives. To determine the association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of membranes (PPROM) in a level III hospital in Peru. Materials and Methods. Cross-sectional, analytical and observational study in women older than 18 years diagnosed with COVID-19 infection during pregnancy, between the years 2020 and 2022. Clinical and obstetric variables were collected. The chi-square and Fisher's exact tests were used for the descriptive analysis. For the multivariate analysis, we calculated the prevalence ratio by using Poisson regression in crude and adjusted models. All statistical tests were performed considering a value of p<0.05 as significant and with a confidence level of 95%. Results. We analyzed data from 163 pregnant women with COVID-19, of which 9.2% had PPROM; all were symptomatic cases. Mild COVID-19 cases were 1.10 times more likely to have PPROM (RPa=1.10; 95%CI: 1.02-1.18) and moderate/severe cases were 1.64 times more likely (RPa=1.64; 95%CI: 1.43-1.87), compared to asymptomatic cases. Conclusions. We identified that a higher degree of severity of COVID-19 infection during pregnancy was associated with a higher probability of having PPROM.

8.
Medisur ; 21(5)oct. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1521225

ABSTRACT

Fundamento el asma bronquial es una de las enfermedades crónicas de mayor prevalencia en la infancia. Las guías para el diagnóstico y tratamiento se rigen según severidad, nivel de control y calidad de vida, sin embargo, no existen evidencias que demuestren su asociación estadística. Objetivo medir el grado de asociación entre la severidad del asma bronquial, nivel de control y calidad de vida en niños. Métodos estudio de corte transversal, realizado en el periodo enero-diciembre de 2022, en una muestra de 189 pacientes con diagnóstico confirmado de asma bronquial. Se analizaron las variables: edad, sexo, severidad, nivel de control y calidad de vida. Se calcularon estadígrafos, frecuencia absoluta, porcentaje, media aritmética y desviación estándar. Para medir asociación se utilizó la prueba de Chi cuadrado (p<0,01) y para evaluar la fuerza de la asociación el coeficiente de V-Cramer. Resultados la edad media resultó 9,17 años (DE ± 0,67). Predominaron los varones, representativos del 53,54 %. Prevalecieron el asma intermitente (39,15 %), el nivel de control parcial (59,79 %) y la calidad de vida alta (50,26 %). Al relacionar severidad con nivel de control, el estadígrafo de asociación indicó X2=190,461 (VC= 0,662); en el caso de severidad y calidad de vida, X2=252,673 (VC=0,762); y entre nivel de control y calidad de vida, X2=66,733 (VC=0,401). Conclusiones existió asociación fuerte entre severidad del asma bronquial-nivel de control y entre la severidad del asma-calidad de vida; así como asociación moderada entre nivel de control-calidad de vida.


Foundation bronchial asthma is one of the most prevalent chronic diseases in childhood. The guidelines for diagnosis and treatment are governed by severity, level of control and quality of life, however, there is no evidence that demonstrates its statistical association. Objective to measure the association degree between the severity of bronchial asthma, control level and quality of life in children. Methods cross-sectional study, carried out from January to December 2022, in a sample of 189 patients with a bronchial asthma confirmed diagnosis. The analyzed variables were: age, sex, severity, level of control and quality of life. Statisticians, absolute frequency, percentage, arithmetic mean and standard deviation were calculated. The Chi-square test (p<0.01) was used to measure association and the V-Cramer coefficient was used to evaluate the strength of the association. Results the mean age was 9.17 years (SD ± 0.67). Males predominated, representing 53.54%. Intermittent asthma (39.15%), partial control level (59.79%) and high quality of life (50.26%) prevailed. When relating severity with level of control, the association statistician indicated X2=190.461 (VC= 0.662); in the case of severity and quality of life, X2=252.673 (VC=0.762); and between level of control and quality of life, X2=66.733 (VC=0.401). Conclusions there was a strong association between severity of bronchial asthma-level of control and between severity of asthma-quality of life; as well as a moderate association between level of control-quality of life.

9.
Medisur ; 21(1)feb. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1440621

ABSTRACT

Fundamento la COVID-19 es causada por el virus del SARS-Cov-2 y presenta una amplia sintomatología, tanto en su fase aguda como en su fase crónica. Entre los sistemas que afecta se encuentra el Nervioso, debido a su mecanismo neurotrópico. Objetivo determinar el riesgo de complicaciones neurológicas asociadas a la severidad de la COVID-19 en pacientes adultos. Métodos se realizó un estudio descriptivo y transversal, que incluyó a 143 pacientes positivos a COVID-19 atendidos en el Hospital San Vicente de Paúl, de Ibarra, Ecuador, durante el año de 2021. Se analizaron las complicaciones neurológicas y la severidad de la COVID-19. Como medida de asociación para dichas variables, se utilizó Test de Fisher (p = ≤ 0,05) y se realizó un análisis bivariado. Resultados el 54 % de los pacientes presentó complicaciones neurológicas del Sistema Nervioso Central, mientras que el 46 % fue del Sistema Nervioso Periférico; y fue la severidad leve-moderada la de mayor frecuencia (41 %), y la alteración auditiva la que mayor probabilidad estadística tuvo de presentarse (OR= 74,968; IC: 95 %). La tasa de letalidad en estos pacientes fue de 7,1 %; y en aquellos con complicaciones neurológicas, de 8,4 %. Conclusión las secuelas neurológicas con mayor probabilidad de presentarse fueron la alteración auditiva y la alteración del gusto, en pacientes con severidad leve y severidad grave, respectivamente; además de polineuropatía en pacientes con severidad crítica, la cual también se presentó en pacientes fallecidos.


Background COVID-19 is caused by the SARS-Cov-2 virus and presents a wide range of symptoms, both in its acute phase and in its chronic phase. Among the systems that it affects is the Nervous, due to its neurotropic mechanism. Objective to determine the risk of neurological complications associated with the COVID-19 severity in adult patients. Methods a descriptive and cross-sectional study was carried out, which included 143 positive patients for COVID-19 treated at the San Vicente de Paúl Hospital, in Ibarra, Ecuador, during 2021. Neurological complications and the severity of the COVID-19 disease were analyzed. As a measure of association for these variables, the Fisher Test was used (p = ≤ 0.05) and a bivariate analysis was performed. Results 54% of the patients presented neurological complications of the Central Nervous System, while 46% were of the Peripheral Nervous System; and mild-moderate severity was the most frequent (41%), and hearing impairment had the highest statistical probability of occurring (OR= 74.968; CI: 95%). The case fatality rate in these patients was 7.1%; and in those with neurological complications, 8.4%. Conclusion the neurological sequelae most likely to occur were hearing impairment and taste impairment, in patients with mild severity and serious severity, respectively; in addition to polyneuropathy in patients with critical severity, which also occurred in deceased patients.

10.
Rev. peru. med. exp. salud publica ; 40(1): 34-41, ene. 2023. tab
Article in Spanish | LILACS, INS-PERU | ID: biblio-1442117

ABSTRACT

Objetivos. Determinar la asociación entre los síntomas de la infección por la COVID-19 y los resultados materno-perinatales adversos en gestantes de un hospital de referencia. Materiales y métodos. Estudio transversal analítico en gestantes en el tercer trimestre, hospitalizadas por la COVID-19 en el área de ginecología y obstetricia de un hospital general de Lima, en el 2020. Se recogieron variables clínicas y obstétricas. Para el análisis descriptivo se empleó la prueba exacta de Fisher y Chi Cuadrado, y para hallar la asociación entre las variables de interés se usó la regresión de Poisson, con un intervalo de confianza al 95% (IC95%). Resultados. Se incluyeron a 272 gestantes, de ellas el 50,3% tuvieron síntomas de infección. El 35,7% de las gestantes y el 16,5% de los recién nacidos tuvieron un resultado adverso. Tener síntomas de la infección por la COVID-19 aumentó el riesgo de complicaciones maternas en su conjunto (RP= 2,32 IC95%: 1,61-3,34), de ruptura prematura de membranas (RP= 2,73 IC95%: 1,51-4,94) y de preeclampsia (RP= 2,73 IC95%: 1,51-4,94). De igual forma, aumentó el riesgo de complicaciones perinatales en su conjunto (RP= 2,51 IC95%: 1,34-4,68) y de sufrimiento fetal agudo (RP= 2,99 IC95%: 1,07-8,38). Conclusiones. Los síntomas de la infección por la COVID-19 aumentan el riesgo de resultados materno-perinatales adversos.


Objectives. To determine the association between symptoms of COVID-19 infection and adverse maternal-perinatal outcomes in pregnant women from a referral hospital. Materials and methods. Analytical cross-sectional study of women in the third trimester of pregnancy hospitalized due to COVID-19 in the gynecology and obstetrics area of a general hospital in Lima during 2020. Clinical and obstetric variables were collected. Fisher's exact test and Chi-square test were used during the descriptive analysis. Poisson regression was used to find the association between the variables of interest, with a 95% confidence interval (95%CI). Results. A total of 272 pregnant women were included, 50.3% of whom had symptoms of infection. Of these, 35.7% of the pregnant women and 16.5% of the newborns had an adverse outcome. Having symptoms of COVID-19 infection increased the risk of maternal complications as a whole (PR= 2.32 95%CI: 1.61-3.34), premature rupture of membranes (PR= 2.73 95%CI: 1.51-4.94) and preeclampsia (PR= 2.73 95%CI: 1.51-4.94). Similarly, symptoms of COVID-19 infection increased the risk of perinatal complications as a whole (PR= 2.51 95%CI: 1.34-4.68) and acute fetal distress (PR= 2.99 95%CI: 1.07-8.38). Conclusions. The presence of symptoms of COVID-19 infection increase the risk of adverse maternal-perinatal outcomes.


Subject(s)
Humans , Female , Pregnancy
11.
ABCD arq. bras. cir. dig ; 36: e1785, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1549970

ABSTRACT

ABSTRACT BACKGROUND: There is a lack of valid and specific tools to measure chronic constipation severity in Brazil. AIMS: To validate the Constipation Scoring System for Brazilian spoken Portuguese. METHODS: Translation, cultural adaptation, and validation itself (reliability and convergent and divergent validation). Translation: definitive version from the original version's translation and evaluation by specialists. Cultural adaptation: score content analysis of the definitive version, as an interview to patients. Interobserver reliability: application by two researchers on the same day. Intraobserver reliability: same researcher at different times, in a 7-day interval. Divergent validation: non-constipated volunteers. Convergent validation: two groups, good response to clinical treatment and refractory to treatment. RESULTS: Cultural adaptation: 81 patients, 89% female, with mean age of 55 and seven years of schooling, and overall content validity index was 96.5%. Inter and intraobserver reliability analysis: 60 patients, 86.7% female, mean age of 56 and six years of schooling, and the respective intraclass correlation coefficients were 0.991 and 0.987, p<0.001. Divergent validation: 40 volunteers, 25 male, mean age of 49 years, and the mean global score was 2. Convergent validation of patients with good response to clinical treatment: 47 patients, 39 female, mean age of 60 and six years of schooling, and the pre- and post-treatment scores were 19 and 8, respectively (p<0.001). Convergent validation of refractory to clinical treatment patients: 75 patients, 70 female, mean age of 53 and seven years of schooling, and the global average score was 22. CONCLUSIONS: The Constipation Scoring System (Índice de Gravidade da Constipação Intestinal) validated for the Brazilian population is a reliable instrument for measuring the severity of intestinal chronic constipation.


RESUMO RACIONAL: No Brasil há escassez de instrumentos específicos e validados para a avaliação da gravidade da constipação intestinal crônica. OBJETIVOS: Validar o instrumento Constipation Scoring System para pacientes com constipação crônica. MÉTODOS: Tradução, adaptação cultural e validação propriamente dita. Tradução: versão definitiva a partir de traduções do original avaliadas por especialistas. Adaptação cultural: avaliação do conteúdo por entrevista a pacientes. Confiabilidade interobservadores: entrevista por dois pesquisadores no mesmo dia. Confiabilidade intraobservador: duas entrevistas pelo mesmo pesquisador (intervalo de 7 dias). Validação divergente: voluntários não constipados. Validação convergente: dois grupos, boa resposta e refratários ao tratamento clínico. RESULTADOS: Adaptação cultural: 81 pacientes, sendo 89% do sexo feminino, com média de idade de 55 anos e 7 anos de escolaridade. O índice de validade de conteúdo global foi de 96,5%. Confiabilidade interobservadores e intraobservador: 60 pacientes, sendo 86,7% do sexo feminino, com média de idade de 56 anos e 6 anos de escolaridade. O coeficiente de correlação intraclasse foi de 0,991 e 0,987 (p<0,001), respectivamente. Validação divergente: 40 voluntários, sendo 62,5% do sexo masculino, com média de idade de 49 anos e pontuação média: 0. Validação convergente dos pacientes com boa resposta do tratamento clínico: 47 pacientes, sendo 83% do sexo feminino, com média de idade de 60 anos e 6 anos de escolaridade. Os índices pré e pós-tratamento foram 19 e 8 (p<0,001), respectivamente. Validação convergente dos pacientes refratários ao tratamento clínico: 75 pacientes sendo 93% do sexo feminino, com média de idade de 53 anos e 7 anos escolaridade. A pontuação média foi 22. CONCLUSÕES: O Constipation Scoring System validado para população brasileira (Índice de Gravidade da Constipação Intestinal), é instrumento confiável para a aferição da gravidade da constipação intestinal crônica.

12.
Chinese Journal of Obstetrics and Gynecology ; (12): 185-190, 2023.
Article in Chinese | WPRIM | ID: wpr-992886

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Objective:To explore the similarities and differences of China Society of Gynecology Endoscopy (CSGE) and American Fertility Society (AFS) intrauterine adhesion (IUA) scoring criteria on IUA grading and their predictive value of reproductive prognosis.Methods:From January 2016 to January 2019, a total of 1 249 patients were diagnosed with IUA by hysteroscopy at Beijing Obstetrics and Gynecology Hospital. Totally, 378 patients with complete clinical data were enrolled, and the results diagnosed by CSGT and AFS scoring criteria were compared and analyzed.And follow-up for 2 years, the pregnancy rate and live birth rate were statistical analysis.Results:(1) The grade of IUA according to AFS and CSGE scoring criteria was less consistent ( κ=0.295, P<0.001). Compared with AFS, the proportion of severe IUA cases diagnosed by CSGE was significantly lower [45.8% (173/378) vs 15.1% (57/378); RR=0.22, 95% CI: 0.15-0.30, P<0.01); the proportions of both mild and moderate IUA cases were significantly higher ( RR=4.16, 95% CI: 2.38-7.14; RR=2.38, 95% CI: 1.75-3.23; both P<0.01). (2) The pregnancy rates of mild, moderate and severe IUA diagnosed according to CSGE were 11/13, 64.5% (147/228), 31.8% (7/22), live birth rates were 11/13, 54.8% (125/228) and 22.7% (5/22), respectively; there were statistically significant differences between the groups (all P<0.01). The pregnancy rates of mild, moderate and severe IUA diagnosed based on AFS were 3/3, 66.9% (97/145) and 56.5% (65/115), respectively, with no statistically significant difference between the groups ( P>0.05). (3) IUA grades based on both CSGE and AFS criteria were significantly negatively correlated with pregnancy rates and live birth rates (CSGE: r=-0.210, r=-0.226; AFS: r=-0.130, r=-0.147; all P<0.05). Univariate logistic regression analysis showed that CSGE had higher OR for both pregnancy rates and live birth rates compared to AFS (3.889 vs 1.657, 3.983 vs 1.554, respectrvely). Conclusions:Compared with AFS, the IUA grade based on CSGE is better related with reproductive prognosis, suggesting that the CSGE standard might be more objective and comprehensive and has better predictive value for reproductive prognosis, thus avoiding overdiagnosis and overtreatment.

13.
Chinese Journal of Infectious Diseases ; (12): 128-136, 2023.
Article in Chinese | WPRIM | ID: wpr-992525

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Objective:To investigate the dynamic changes of routine laboratory parameters during the course of hemorrhagic fever with renal syndrome (HFRS) and estimate the predictive value for the severity of the disease.Methods:A retrospective cohort study was conducted, which enrolled 394 HFRS patients admitted to the Second Affiliated Hospital of Air Force Medical University (374 cases) and the Second Affiliated Hospital of Xi′an Jiaotong University (20 cases) from January 2019 to January 2022. The patients were divided into mild (mild and moderate) and severe (severe and critical) groups.The basic information, personal history, past history, treatment, complications and other clinical data of patients were collected and the results of the laboratory examinations in the morning at day 1, 2, 3, 4, 5, 7, 10, 15, 20 and 25 of hospitalization and before discharge were recorded. The dynamic changes of the patients′ routine laboratory indicators and the dynamic predictive values of each indicator for severe condition were analyzed. Mann-Whitney U test and chi-square test were used for comparison, and receiver operator characteristic (ROC) curve was used for predictive value evaluation. Results:The age of 212 patients in the mild group was 38(27, 61) years, and that of 182 patients in the severe group was 49(32, 64) years, the difference was statistically significant ( Z=-2.24, P=0.025). The incidences of acute pancreatitis, acute respiratory distress syndrome, multiple organ dysfunction syndrome, the utilization rates of blood purification and mechanical ventilation in the severe group were 6.0%(11/182), 12.6%(23/182), 19.8%(36/182), 89.6%(163/182) and 22.5%(41/182), respectively, and those in the mild group were 0(0/212), 0(0/212), 0(0/212), 15.6%(33/212) and 0.5%(1/212) respectively, and the differences were all statistically significant ( χ2=13.18, 28.45, 46.15, 214.48 and 50.02, respectively, all P<0.05). The levels of white blood cell count, lymphocyte count, monocyte count and neutrophil count were all increased rapidly after onset and peaked at days 4 to 6 of illness, with the counts of 14.2(9.7, 20.7)×10 9/L, 4.2(2.3, 6.2)×10 9/L, 1.5 (0.8, 3.3)×10 9/L and 8.3(4.3, 11.4)×10 9/L, respectively. Aspartate aminotransferase peaked (102(66, 178) U/L) within three days after onset and then decreased rapidly, returned to normal level by day 12. Blood urea nitrogen and creatinine both increased steadily after onset, peaked at day 9 to 10, with the levels of 13.2(7.7, 19.1) mmol/L and 255.4(122.9, 400.9) μmol/L, respectively. Prothrombin time, activated partial thromboplastin time, fibrinogen degradation products and D-dimer levels at day 3 after onset were 12.7(12.0, 13.2) s, 38.7(33.5, 51.9) s, 12.6(6.9, 32.0) mg/L and 4.9(2.2, 13.7) mg/L, respectively.Platelet count at day 4, neutrophil count at day 5, creatinine at day 11 and blood urea nitrogen at day 14 after onset had decent predictive values for estimating severity, of which the area under curve (AUC) values were 0.801(95% confidence interval (95% CI) 0.727 to 0.875), 0.824(95% CI 0.770 to 0.878), 0.862(95% CI 0.805 to 0.919) and 0.810(95% CI 0.722 to 0.897), respectively. Conclusions:Routine blood count, liver function and coagulation are important reference indicators for early warning of severe disease of HFRS, while with the progress of the disease, renal function indicators are effective in differentiating the severity of the disease. The platelet count at day 4, neutrophil count at day 5, creatinine at day 11 and blood urea nitrogen at day 14 after onset have predictive values for severe HFRS.

14.
Journal of Chinese Physician ; (12): 11-15, 2023.
Article in Chinese | WPRIM | ID: wpr-992253

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Objective:To analyze the clinical characteristics of nail involvement in patients with pemphigus and the correlation between nail damage and the severity of pemphigus.Methods:The clinical data of 23 patients with pemphigus combined with nail damage admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2011 to August 2019 were retrospectively analyzed, the manifestations of pemphigus combined with nail damage were summarized. The nail damage number of patients with pemphigus complicated with nail damage of different genders were analyzed, as well as the distribution of nail damage in nail and toenail. The titer of anti-desmocoglycoprotein(dsg) antibody was detected in all patients. The relationship between nail damage and disease severity and course in pemphigus patients was analyzed.Results:A total of 132 damage nails were found in 23 patients (14 males and 9 females) with pemphigus, including 66 nails in male, 66 nails in female, 82 nails and 50 toenails. There were 10 forms of nail damage, of which chronic paronychia was the most common. The number of damage nails between different genders in pemphigus patients was statistically significant (χ 2=9.183, P<0.001). The distribution of nail and toenail damage in pemphigus patients was statistically significant (χ 2=10.880, P<0.001). Of the 23 patients, only 3 were positive for dsg1 and 1 was positive for dsg3. There were 19 patients with both positive for dsg1 and dsg3. The titers of dsg1 and dsg3 were compared in 14 patients before and after nail damage. The results showed that the titers of anti-dsg antibody in pemphigus patients after nail damage were significantly higher than before. Thirteen of the 23 patients had nail damage at the time of the initial onset of pemphigus. The nail damage occurred from 6 weeks before the onset to 4 weeks after the onset. The nail damage occurred in 10 patients when the disease recurred. The nail damage occurred within 4 weeks before or at the same time with the blister. Conclusions:The number of damage nails per capita in female patients with pemphigus and nail damage was significantly higher than that in male patients, and nail damage was more common. The titers of anti-dsg antibody will be at a high level when pemphigus patients with nail damage, and the condition gets worse. Nail involvement is positive to the severity of the disease, and it can prolong the time of disease.

15.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1205-1210, 2023.
Article in Chinese | WPRIM | ID: wpr-991887

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Objective:To investigate the role of a simple Nomogram model in evaluating the severity of mycoplasma pneumoniae pneumonia (MPP) in adults.Methods:The clinical data of 162 patients with MPP who received treatment in Wenzhou Central Hospital from March 2015 to October 2022 were retrospectively analyzed. These patients were divided into a severe group ( n = 67) and a common group ( n = 95) according to whether they were diagnosed with severe MPP. The clinical data of patients were recorded. Fourteen clinical variables were screened, including age, sex, onset season, fever, heat peak, fever duration, cough duration, white blood cell count, percentage of neutrophils, percentage of lymphocytes, hemoglobin, platelet count, C-reactive protein, and procalcitonin. Multivariate logistic regression analysis of statistically significant variables in univariate analysis was performed. The Nomogram model was constructed with the R language software package (version 3.6.2). The model was verified with a calibration curve and receiver operating characteristic curve. Results:Univariate analysis results showed that in the severe group, the fever peak ( Z = 5.03, P < 0.001) was higher, fever duration ( χ2 = 27.55, P < 0.001), and cough duration ( χ2 = 28.72, P < 0.001) were longer, white cell count ( t = 2.93, P = 0.004), percentage of neutrophils ( t = 9.08, P < 0.001), C-reactive protein ( t = 35.05, P < 0.001), and procalcitonin level ( t = 15.09, P < 0.001) were greater compared with the common group. The percentage of lymphocytes ( t = 1.16, P < 0.001), hemoglobin level ( t = 1.22, P < 0.001), and platelet count ( t = 2.82, P < 0.001) in the severe group were significantly lower than those in the common group. Multivariate logistic regression analysis results showed that heat peak, cough duration, and C-reactive protein were positively correlated with the severity of MPP (all P < 0.05). The percentage of lymphocytes, hemoglobin concentration, and platelet count were negatively correlated with the severity of MPP (all P < 0.05). The establishment and validation results of the Nomogram model showed that the accuracy of the model was good, with a sensitivity of 88.73%, a specificity of 77.61%, and a C-index of 0.904. Conclusion:Heat peak, cough duration, percentage of lymphocytes, platelet count, and C-reactive protein are closely related to the severity of early MPP. A simple Nomogram model can be one of the tools for early assessment of the severity of MPP.

16.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 699-704, 2023.
Article in Chinese | WPRIM | ID: wpr-991809

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Objective:To correlate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and D-dimer (DD) with the severity of acute cholangitis.Methods:The clinical data of 96 patients with acute cholangitis who received treatment in Panjin Central Hospital from September 2019 to March 2021 were retrospectively analyzed. These patients were divided into three groups according to the severity of acute cholangitis: 36 patients with mild acute cholangitis (group A), 35 patients with moderate acute cholangitis (group B), and 25 patients with severe acute cholangitis (group C). The correlation between age, sex, NLR, PLR, DD, and the severity of acute cholangitis was compared among the three groups.Results:In groups A and B, the area under the receiver operating characteristic curve (AUC) showing the performance of DD, NLR, and PLR levels in predicting acute cholangitis was 0.800, 0.838, and 0.721, respectively, with the optimal cut-off value of 1.985 mg/L, 9.589, and 154.410, respectively. Among them, NLR had the largest AUC, and the highest sensitivity (82.9%), and had a high diagnostic value. In groups B and C, the AUC for DD, NLR, and PLR was 0.967, 0.915, and 0.543, respectively, with the optimal cut-off value of 6.000 mg/L, 22.390, and 264.220, respectively. DD and NLR had a diagnostic significance (both P < 0.05), but PLR had no diagnostic significance ( P > 0.05). The AUC for DD was the largest, and therefore DD had a great diagnostic significance. When NLR, PLR, and DD were jointly detected, the AUC was the highest and the diagnostic value was the highest. The AUC in groups A and B was 0.866, and that in groups B and C was 0.977. Conclusion:The levels of DD, NLR, and PLR increase in patients with acute cholangitis, which are related to the severity of the disease. DD, NLR, and PRL can be used as indicators to evaluate mild and moderate acute cholangitis, and NLR has the highest diagnostic value. DD and NLR can be used as indicators to evaluate moderate to severe acute cholangitis, and the effect of DD is superior to that of NLR. The combined detection of the three indicators can increase the value to evaluate the severity of acute cholangitis, and its effect is superior to that of a single detection. The combined detection of NLR, PLR, and DD is helpful for the clinical diagnosis and treatment of acute cholangitis.

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Chinese Journal of Primary Medicine and Pharmacy ; (12): 678-682, 2023.
Article in Chinese | WPRIM | ID: wpr-991805

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Objective:To investigate the relationship between serum interleukin-6 and interleukin-10 levels and clinical prognosis in patients with severe acute pancreatitis.Methods:Ninety-two patients with severe acute pancreatitis who received treatment in The Second People's Hospital of Liaocheng from August 2018 to July 2021 were included in this study. Serum interleukin (IL)-6 and IL-10 levels were detected. The Bedside Index of Severity in Acute Pancreatitis (BISAP) score was evaluated. Clinical interventions were performed. The relationship between serum IL-6 and IL-10 levels and the clinical prognosis of severe acute pancreatitis was investigated.Results:Serum IL-6 level [(103.75 ± 15.53) ng/L] was highest in patients who died. Serum IL-10 level [(97.33 ± 13.06) ng/L] was highest in patients with local complications. The highest number of patients with a prognostic outcome of death [26 (37.14%)] was found in patients with a BISAP score ≥ 3. Serum IL-6 level in patients with severe acute pancreatitis was positively correlated with the BISAP score ( r = 0.62, P < 0.05), and serum IL-6 level and BISAP score were negatively correlated with serum IL-10 level ( r = -0.57, -0.61, both P < 0.05). Conclusion:Increased or decreased serum IL-6 and IL-10 levels in patients with severe acute pancreatitis indicate that the patient's condition tends to worsen, and timely intervention according to serum IL-6 and IL-10 levels can improve the clinical prognosis of severe acute pancreatitis.

18.
International Journal of Cerebrovascular Diseases ; (12): 332-338, 2023.
Article in Chinese | WPRIM | ID: wpr-989234

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Objective:To investigate the correlation between serum uric acid to albumin ratio (UAR) and large-artery atherosclerosis (LAA), its severity and short-term outcome.Methods:Patients with acute ischemic stroke admitted to the Department of Neurology, the Affiliated Hospital of Qingdao University from September 2017 to August 2022 were retrospectively enrolled. They were classified into LAA and non-LAA according to the TOAST etiological criteria. Patients with LAA were further divided into mild stroke group (≤8) and moderate to severe stroke group (>8) according to the National Institutes of Health Stroke Scale score at admission, and good outcome group (≤2) and poor outcome group (>2) according to the modified Rankin Scale score at discharge. Multivariate logistic regression analysis was used to determine the correlation between UAR and LAA, its severity and short-term outcome. The predictive value of UAR for poor outcomes in patients with LAA was evaluated by receiver operating characteristic (ROC) curve. Results:A total of 4 178 patients with acute ischemic stroke were enrolled, including 2 751 males (65.8%), aged 61.95±10.73 years. There were 2 000 (47.9%) patients with LAA, including 1 112 (55.6%) mild stroke and 888 (44.4%) moderate to severe stroke; 813 (40.65%) had good short-term outcomes and 1 187 (59.35%) had poor outcomes. UAR in the LAA group was significantly higher than that in the non-LAA group ( P<0.05). In patients with LAA, the UAR of the moderate to severe stroke group and the short-term poor outcome group were significantly higher than that of the mild stroke group and the short-term good outcome group, respectively (all P<0.05). Multivariate logistic regression analysis showed that the UAR was an independent risk factor for LAA (odds ratio [ OR] 1.043, 95% confidence interval [ CI] 1.016-1.071; P=0.002), its severity ( OR 2.000, 95% CI 1.860-2.151; P<0.001), and short-term poor outcomes ( OR 1.456, 95% CI 1.379-1.537; P<0.001). ROC curve analysis showed that the area under the curve of UAR for predicting short-term poor outcomes in patients with LAA was 0.727 (95% CI 0.704-0.750; P<0.001). The optimal cutoff value was 6.62, and the sensitivity and specificity were 86.6% and 56.7%, respectively. The area under the curve of UAR for predicting short-term poor outcomes in patients with LAA was greater than that predicted solely by uric acid and albumin. Conclusions:UAR is associated with LAA, its severity and poor prognosis, and has higher predictive value for poor outcomes in patients with LAA.

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International Journal of Cerebrovascular Diseases ; (12): 321-326, 2023.
Article in Chinese | WPRIM | ID: wpr-989232

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Objective:To investigate the risk factors of early neurological deterioration (END) in patients with minor ischemic stroke caused by large vessel occlusion (LVO) and the impact of rescue endovascular thromboectomy (REVT) on clinical outcomes of patients with END at discharge.Methods:Consecutive patients with acute minor ischemic stroke caused by LVO within 24 h of onset in the Third Affiliated Hospital, Soochow University from January 2021 to March 2023 were retrospectively enrolled. Minor ischemic stroke was defined as baseline National Institute of Health Stroke Scale (NIHSS) score ≤5 at admission. END was defined as an increase of ≥4 in the NIHSS score within 24 h after the best medical management. The modified Rankin Scale was used to evaluate the clinical outcomes of patients with END at discharge. 0-2 was defined as a good outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for END and the impact of REVT on clinical outcomes in patients with END. Results:A total of 75 patients with minor ischemic stroke caused by LVO were included, of which 31 (41.3%) developed END and 13 (41.9%) underwent REVT after END. Multivariate logistic regression analysis showed that internal carotid artery occlusion was an independent risk factor for END (odds ratio 4.304, 95% confidence interval 1.213-15.270; P=0.024), and REVT was an independent protective factor for good outcomes in patients with END (odds ratio 0.068, 95% confidence interval 0.006-0.774; P=0.030). Conclusions:The incidence of END is higher in patients with minor ischemic stroke caused by LVO, and internal carotid artery occlusion is an independent risk factor for the occurrence of END. Providing REVT after END may improve the clinical outcomes of patients with END at discharge.

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International Journal of Cerebrovascular Diseases ; (12): 241-247, 2023.
Article in Chinese | WPRIM | ID: wpr-989218

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Objective:To investigate the predictive value of the National Institutes of Health Stroke Scale (NIHSS) score at 24 h after endovascular treatment on the outcomes in patients with acute basilar artery occlusion (ABAO).Methods:Consecutive patients with ABAO received endovascular treatment at the Department of Neurology, Shengli Oilfield Central Hospital from January 2019 to December 2020 were retrospectively included. According to the modified Rankin Scale scores at 90 days after onset, the patients were divided into a good outcome group (0-3) and a poor outcome group (4-6), as well as a survival group and a death group. The demographic and clinical data between the groups were compared respectively. Multivariate logistic regression analysis was use to identify independent influencing factors for clinical outcomes and mortality. The predictive value of postprocedural 24 h NIHSS score on the outcomes was evaluated using the receiver operating characteristic (ROC) curves. Results:A total of 35 patients with ABAO were included. Their age was 62 years (interquartile range, 56-66 years), and 28 patients were males (80%); 19 (54.3%) had a good outcome, 16 (45.7%) had a poor outcome, and 7 (20.0%) died. Univariate analysis showed that there were statistically significant differences in hypertension, low-density lipoprotein cholesterol, fasting blood glucose, collateral circulation grading, vascular recanalization, and postprocedural 24 h NIHSS scores between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that the postprocedural 24 h NIHSS score was independently correlated with the poor outcome (odds ratio 1.131, 95% confidence interval 1.017-1.258; P=0.023). Multivariate analysis did not find the independent influencing factors for death. ROC curve analysis showed that the area under the curve of the postprocedural 24 h NIHSS score for predicting poor outcome was 0.814 (95% confidence interval 0.668-0.960; P=0.011). The optimal cutoff value was 19 points, and the corresponding sensitivity and specificity were 85.7% and 71.4% respectively. Conclusions:In patients with ABAO receiving endovascular treatment, the postprocedural 24 h NIHSS score has good predictive value for poor outcomes at 90 d after procedure.

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