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1.
Braz. j. otorhinolaryngol. (Impr.) ; 88(1): 36-45, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364585

ABSTRACT

Abstract Introduction The treatment of papillary thyroid microcarcinoma remains controversial. Central lymph node metastasis is common in papillary thyroid microcarcinoma and it is an important consideration in treatment strategy selection. Objective The aim of this study was to investigate clinicopathologic risk factors and thyroid nodule sonographic characteristics for central lymph node metastasis in papillary thyroid microcarcinoma. Methods We retrospectively reviewed the data of 599 papillary thyroid microcarcinoma patients who underwent surgery from 2005 to 2017 at a single institution. Univariate and multivariate analyses were used to identify the clinicopathologic factors and preoperative sonographic features of central lymph node metastasis. A receiver-operating characteristic, ROC curve analysis, was performed to identify the efficacy of ultrasonographic features in predicting central lymph node metastasis. A nomogram based on the risk factors was established to predict central lymph node metastasis. Results The incidence of central lymph node metastasis was 22.4%. The univariate and multivariate analyses suggested that gender, age, multifocality, extrathyroidal invasion, and lateral lymph node metastasis were independent risk factors for central lymph node metastasis. The univariate and multivariate analyses revealed that nodular shape, margin, and calcification were independently associated with central lymph node metastasis. The ROC curve analysis revealed that the combination of shape, margin and calcification had excellent accuracy in predicting central lymph node metastasis. The nomogram was developed based on the identified risk factors for predicting central lymph node metastasis, and the calibration plot analysis indicated the good performance and clinical utility of the nomogram. Conclusions Central lymph node metastasis is associated with male gender, younger age (<5 years), extrathyroidal invasion, multifocality and lateral lymph node metastasis in papillary thyroid microcarcinoma patients. The ultrasongraphic features, such as irregular shape, ill-defined margin and calcification, may improve the efficacy of predicting central lymph node metastasis. Surgeons and radiologists should pay close attention to the patients who have these risk factors. The nomogram may help guide surgical decision making in papillary thyroid microcarcinoma.


Resumo Introdução O tratamento do microcarcinoma papilífero de tireoide permanece controverso. A metástase em linfonodos centrais é comum e é uma consideração importante na seleção da estratégia de tratamento. Objetivo Investigar os fatores de risco clínico-patológicos e as características ultrassonográficas de nódulos tireoidianos para metástase em linfonodos centrais em microcarcinoma papilífero de tireoide. Método Foram analisados retrospectivamente os dados de 599 pacientes com microcarcinoma papilífero de tireoide submetidos à cirurgia de 2005 a 2017 em uma única instituição. Análises univariadas e multivariadas foram usadas para identificar os fatores clínico-patológicos e as características ultrassonográficas pré-operatórias das metástases em linfonodos centrais. Uma análise de curva ROC (receiver-operating characteristic) foi feita para identificar a eficácia das características ultrassonográficas na previsão dessas metástases. Um nomograma baseado nos fatores de risco foi estabelecido para prever a metástase em linfonodos centrais. Resultados A incidência de metástase em linfonodos centrais foi de 22,4%. As análises univariadas e multivariadas sugeriram que sexo, idade, multifocalidade, invasão extratireoidiana e metástase em linfonodos laterais eram fatores de risco independentes para a metástase em linfonodos centrais. As análises univariadas e multivariadas revelaram que o formato nodular, a margem e a calcificação estavam independentemente associadas à metástase em linfonodos centrais. A análise da curva ROC mostrou que a combinação do formato, margem e calcificação apresentou excelente precisão na previsão dessas metástases. O nomograma foi desenvolvido com base nos fatores de risco identificados para predizer a metástase em linfonodos centrais e a análise do gráfico de calibração indicou o bom desempenho e a utilidade clínica do nomograma. Conclusões Em pacientes com microcarcinoma papilífero de tireoide, metástase em linfonodos centrais está associado ao sexo masculino, menor idade ( < 45 anos), invasão extratireoidiana, multifocalidade e presença de metástase em linfonodos laterais. As características ultrassonográficas, como formato irregular, margem mal definida e calcificação, podem melhorar a eficácia da previsão de metástase em linfonodos centrais. Cirurgiões e radiologistas devem ficar mais atentos aos pacientes que apresentam esses fatores de risco. O nomograma pode ajudar a orientar a tomada de decisão cirúrgica para o microcarcinoma papilífero de tireoide.

2.
Multimed (Granma) ; 25(6): e1348, 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1356532

ABSTRACT

RESUMEN Introducción: la hemorragia digestiva alta constituye toda pérdida hemática de volumen suficiente como para producir hematemesis, melena o ambas, cuyo origen se encuentra entre el esfínter esofágico superior y el ángulo de Treitz. Objetivo: determinar los factores predictivos de mortalidad en pacientes con hemorragia digestiva alta. Métodos: se realizó un estudio observacional, analítico, de cohorte prospectiva. Se seleccionó una muestra de 456 pacientes mayores de 15 años con el diagnóstico clínico de hemorragia digestiva alta admitidos en el cuerpo de guardia de cirugía general y unidad de cuidados intensivos y emergentes del Hospital Celia Sánchez Manduley, Manzanillo, entre enero de 2020 a diciembre de 2021. Se identificó una cohorte de pacientes egresados vivos (n=415) y una cohorte de pacientes fallecidos (n=41). Se realizó un análisis bivariado y posteriormente un análisis multivariado. Resultados: el modelo más ajustado de los factores predictivos de mortalidad quedó constituido por las siguientes variables: edad mayor de 60 años, shock hipovolémico, insuficiencia cardíaca, insuficiencia hepática yhemorragia recidivante. Conclusiones: se obtuvo un modelo ajustado con los factores predictivos de mortalidad en pacientes con hemorragia digestiva alta. Por lo tanto, podremos egresar precozmente a un paciente con bajo riesgo de mortalidad, mientras que podemos considerar el ingreso de un paciente de alto riesgo en la unidad de cuidados intensivos.


ABSTRACT Introduction: upper gastrointestinal bleeding constitutes any blood loss of sufficient volume to produce hematemesis, melena or both, whose origin is between the upper esophageal sphincter and the angle of Treitz. Objective: to determine the predictive factors of mortality in patients with upper gastrointestinal bleeding. Methods: an observational, analytical, prospective cohort study was carried out. A sample of 456 patients older than 15 years with the clinical diagnosis of upper gastrointestinal bleeding admitted to the general surgery guardhouse and intensive and emergent care unit of the Celia Sánchez Manduley Hospital, Manzanillo, between January 2020 and December, was selected. 2021. A cohort of patients discharged alive (n = 415) and a cohort of deceased patients (n = 41) were identified. A bivariate analysis was performed and subsequently a multivariate analysis. Results: the most adjusted model of the predictive factors of mortality was made up of the following variables: age over 60 years, hypovolemic shock, heart failure, liver failure and recurrent bleeding. Conclusions: an adjusted model was obtained with the predictive factors of mortality in patients with upper gastrointestinal bleeding. Therefore, we can discharge a patient with low risk of mortality early, while we can consider the admission of a high-risk patient to the intensive care unit.


RESUMO Introdução: o sangramento gastrointestinal superior constitui qualquer perda de sangue de volume suficiente para produzir hematêmese, melena ou ambas, cuja origem se encontra entre o esfíncter esofágico superior e o ângulo de Treitz. Objetivo: determinar os fatores preditivos de mortalidade em pacientes com hemorragia digestiva alta. Métodos: foi realizado um estudo observacional, analítico e de coorte prospectivo. Foi selecionada uma amostra de 456 pacientes maiores de 15 anos com diagnóstico clínico de hemorragia digestiva alta internados na enfermaria de cirurgia geral e unidade de terapia intensiva e emergente do Hospital Celia Sánchez Manduley, Manzanillo, entre janeiro de 2020 e dezembro. coorte de pacientes que receberam alta com vida (n = 415) e uma coorte de pacientes falecidos (n = 41). Foi realizada uma análise bivariada e posteriormente uma análise multivariada. Resultados: o modelo mais ajustado dos fatores preditivos de mortalidade foi composto pelas seguintes variáveis: idade acima de 60 anos, choque hipovolêmico, insuficiência cardíaca, insuficiência hepática e sangramento recorrente. Conclusões: foi obtido um modelo ajustado com os fatores preditivos de mortalidade em pacientes com hemorragia digestiva alta. Por tanto, podemos dar alta precoce a um paciente com baixo risco de mortalidade, en quanto podemos considerar a admissão de um paciente de alto risco à unidade de terapia intensiva.

3.
Chinese Journal of Urology ; (12): 814-818, 2021.
Article in Chinese | WPRIM | ID: wpr-911125

ABSTRACT

Objective:To explore the efficacy of sacral neuromodulation (SNM) in the treatment of neurogenic bladder (NB), and to analyze the predictive factors.Methods:The clinical data of 91 patients underwent SNM testing therapy from January 2012 to January 2020 in China Rehabilitation Research Center were reviewed. There were 53 males and 48 females with the average age of 36.5(28.0-52.5)years. Urinary diary, residual urine, neurogenic bowel dysfunction score (NBDS), video-urodynamic and pelvic floor electrophysiological examination before treatment were recorded. Among the 91 patients, 60 patients had symptoms of urinary storage period, including urgency, frequency and / or incontinence.The average number of voids/24 h was 13 (11, 18), the average volume per void was (123.0±45.9) ml, the average degree of urgency was (3.5±1.0), and the average 24-hour urine leakage was 100.0(50.0, 231.5) ml. 78 patients had chronic urinary retention symptoms, and the average post-void residual volume (PVR) was 200.0 (132.3, 300.0) ml. The neurogenic bowel dysfunction score (NBDs) of 91 patients was 11 (6.25, 13). The mean maximum cystometric capacity (MCC), maximum detrusor pressure (P detmax) and bladder compliance were 250 (117, 369) ml, 33 (17, 72) cmH 2O and 8.275 (4.540, 20.307) ml / cmH 2O, respectively. Pelvic floor electrophysiological examination showed that somatosensory evoked potential (SEP) was normal in 39 cases, abnormal in 19 cases and undetected in 33 cases. Bulbocavernosus reflex (BCR) was normal in 39 patients, abnormal in 23 patients and undetected in 29 patients. At the end of the test phase, the patient was re-evaluated. If " effective" or the patient willing to implant, permanent implantation of pulse generator was done. " Effective" was defined as improvement of more than 50% in at least one of the following conditions, including the number of voids in 24 hours, volume per void, degree of urgency, leakage volume in 24 hours, PVR. Quantitative values were compared using the t-test or non-parametric test. The potential risk factors were considered by logistic regression analysis. Results:The average test time was (18.7±6.7) days. 43/60 patients (71.7%) had improvement of more than 50% in at least one symptom of the storage period, and 21/78 patients (26.9%) had more than 50% improvement in urination symptoms. NBDS decreased from 11(6.25, 13) to 3(0, 8)( P < 0.05). During the filling period, MCC increased from 173.0(98.0, 326.0) ml to 300.0(201.0, 386.0) ml ( P<0.05), P detmax decreased from 40.0(27.0, 84.0) cmH 2O to 22.0(15.0, 60.0) cmH 2O ( P < 0.05), and bladder compliance increased from 6.84(3.75, 11.79) ml/cm H 2O to 19.23(4.95, 32) ml/cm H 2O ( P < 0.05). At the end of the test phase, 54 (59.3%) patients underwent permanent implantation. The median follow-up was 25.5 (11.5, 60.5) months. Four patients lost their curative effect, two patients developed grade 2 vesicoureteral reflux, and one patient underwent cystoplasty. Risk factors analysis showed that chronic urinary retention was a statistically significant variable ( P<0.05). Conclusions:SNM can not only improve the lower urinary tract symptoms of patients with neurogenic bladder, but also improve the urodynamic parameters and bowel function. Patients with chronic urinary retention symptoms before treatment experienced low efficiency at the end of the test phase.

4.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(4): 367-371, July-Aug. 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1132100

ABSTRACT

Objective: Suicide risk (including attempted and completed suicide) should be measured over short periods of time after contacting health services. The objective of this study was to identify the patterns of attempted and completed suicides within 24-months of a psychiatric emergency department visit, as well as to investigate predictive risk factors, including sociodemographic and clinical variables, previous suicidal behavior, and service utilization. Method: A convenience sample (n=147), recruited at a general hospital's psychiatric emergency room, included patients with suicidal ideation, suicidal plans or previous suicide attempts. These patients were followed for 24 months, focusing on two main outcomes: attempted and completed suicides. Results: After six months there were no completed suicides and 36 suicide attempts, while after 24 months there were seven completed suicides and 69 suicide attempts. A final logistic regression model for suicide attempts at 24 months identified somatic pathology and the number of previous psychiatric hospitalizations as predictive factors, with a good area under the receiver operating characteristic curve. Conclusions: The findings showed distinct patterns of attempted and completed suicides over time, indicating the importance of a systematic multidisciplinary suicide risk evaluation in psychiatric emergency rooms.

5.
Article | IMSEAR | ID: sea-212101

ABSTRACT

Background: Organophosphorus poisoning is one of the most common poisonings often requiring ICU care and ventilatory support. The objective and aim of this study are to identify the factors which predict the need for ventilation in these patients.Methods: 50 patients who were diagnosed to have consumed organophosphorus compound poison admitted in Konaseema Institute of Medical Sciences and Research Foundation who presented within 24 hours of consumption are included in the study. Patients with double poisonings, concomitant illnesses, chronic lung diseases and those treated outside are excluded from the study.Results: A total number of 50 patients were studied. 18(36%) patients required ventilation. Generalized fasciculations was a discernible feature in 66% of cases in this study. 69.2% of patients with a fasciculation score of ≥4 required ventilation. Ventilation was needed by 55% of patients who had a Glasgow Coma Scale score of ≤10.Conclusions: Patients who presented with higher fasciculation scores and/or lower GCS scores were more likely to require ventilation. Using GCS scores as a predictor for the requirement of ventilatory support in organophosphate poisoning, a GCS score ten or less was significantly associated with an increased need for ventilatory support.

6.
Article | IMSEAR | ID: sea-209317

ABSTRACT

Background: Surgical site infection (SSI) is the most common complication occurring in 19–47% of patients undergoing surgery for head-and-neck cancers. This study aims to assess the predictive factors of SSIs and antibiotic resistance patterns in patients undergoing resection and reconstructive surgery for oral cancers. Materials and Methods: The clinicopathological data of all patients who underwent surgery for oral cancers at our oncological referral center in South India between October 2014 and May 2019 were reviewed. The differences between groups were compared using independent samples t-test or Mann–Whitney U-test and categorical data were analyzed by Pearson’s Chisquare test, Fisher’s exact, or continuity correction where appropriate. Receiver operating characteristic (ROC) curve analysis was performed to find the cutoff levels for the various predictors of SSI, using the Youden’s index method. A linear regression analysis was done to define the cause-effect relationship of the categorical response variable with explanatory variables. Results: Of the 135 patients who were studied in our cohort, 43 patients (31.2%) developed SSI. The most commonly isolated organism was Staphylococcus aureus (11%; n = 15) followed by Enterococcus species (4.4%; n = 6) followed by coagulasenegative S. aureus (3%; n = 4) and Escherichia coli (37%; n = 5). In this study, univariate and multivariate analyses have showed that diabetes mellitus, body mass index (BMI) >25 or <18, neutrophil-to-lymphocyte ratio (NLR) >3.75, platelet-tolymphocyte ratio (PLR) >137.5, neoadjuvant chemotherapy or radiotherapy, prolonged operative duration, and prolonged anesthesia exposure may render patients more vulnerable to SSI. Moreover, among these parameters, a PLR >137.5, NLR >3.75, and BMI >25 or <18 were found to be highly predictive of SSI. The highly resistant organisms isolated were S. aureus and Enterococcus species in our study. Conclusion: The identification of these risk factors in patients undergoing surgery for oral cancers can help in the identification of patients who may be at a higher risk of developing SSI and therefore help in improving the overall outcome, especially in an LMIC setting.

7.
Gac. méd. Méx ; 156(1): 40-46, ene.-feb. 2020. tab
Article in Spanish | LILACS | ID: biblio-1249868

ABSTRACT

Resumen Introducción: Estudiantes de medicina reportan mayor ansiedad que estudiantes de otras carreras. El conocimiento sobre su bienestar psicológico es escaso. Objetivo: Identificar factores sociodemográficos y académicos predictores del nivel de ansiedad y bienestar psicológico en estudiantes mexicanos de medicina. Método: Estudio transversal de estudiantes mexicanos de medicina de primer (n = 59), tercer (n = 43) y quinto semestre (n = 59), que contestaron un cuestionario sociodemográfico, la Escala de Ansiedad de Beck, la Escala de Bienestar Psicológico para Adultos y la Escala de Evaluación de la Cohesión y la Adaptabilidad Familiar. Resultados: Las mujeres presentaron mayor ansiedad (p < 0.01). La ansiedad en hombres fue similar en los distintos semestres (p > 0.05); las mujeres de tercer y quinto semestre fueron más ansiosas que las del primero (p < 0.01). Ansiedad y bienestar psicológico correlacionaron negativamente (p < 0.001). Se identificaron los subgrupos “Menor ansiedad, mayor bienestar” y “Mayor ansiedad, menor bienestar”, y una regresión logística identificó que ser mujer (OR = 4.70) y no profesar alguna religión (OR = 2.49) son factores predictores de mayor ansiedad. Conclusiones: Las estudiantes de medicina constituyen una población de riesgo para mayor ansiedad y menor bienestar psicológico, lo que compromete su aprendizaje, calidad de vida y futuro ejercicio profesional.


Abstract Introduction: Medical students report higher levels of anxiety than students from other majors. Knowledge about their psychological well-being is scarce. Objective: To identify sociodemographic and academic factors that predict the level of anxiety and psychological well-being in Mexican medical students. Method: Cross-sectional study of Mexican medical students of first (n = 59), third (n = 43) and fifth semester (n = 59), who answered a sociodemographic questionnaire, Beck Anxiety Inventory, the Psychological Well-being Scale for adults and the Family Adaptability and Cohesion Evaluation Scale. Results: Females showed higher levels of anxiety (p < 0.01). Anxiety in males was similar in the different semesters (p > 0.05); women of third and fifth semesters were more anxious than those at first semester (p < 0.01). Anxiety and psychological well-being were negatively correlated (p < 0.001). The “Less anxiety, higher level of well-being” and “More anxiety, lower level of well-being” subgroups were characterized, and a logistic regression identified that being a woman (OR = 4.70) and not practicing any religion (OR = 2.49) are predictive factors of higher levels of anxiety. Conclusions: Female medical students constitute a population at risk for higher levels of anxiety and less psychological well-being, which compromises their learning, quality of life and future professional practice.


Subject(s)
Humans , Male , Female , Young Adult , Anxiety/epidemiology , Students, Medical/psychology , Mental Health/statistics & numerical data , Psychological Tests , Religion and Psychology , Students, Medical/statistics & numerical data , Logistic Models , Sex Factors , Cross-Sectional Studies , Academic Performance , Mexico/epidemiology
8.
Article in English | WPRIM | ID: wpr-827420

ABSTRACT

Postpartum depression is a kind of mental disorder caused by the comprehensive effects of economics, psychosociology, biology, obstetrics and other characteristic factors in the process of female pregnancy. The pathogenesis of postpartum depression is complicated and has not been clarified. With the process pregnancy, the influence of psychosocial and biology factors are also in dynamic change. The postpartum depression predictor among psychosocial factors are antenatal depression, life events and social supports. Among biological factors, the predictors are hypothalamic-pituitary-thyroid axis and serum lipids. Timely and effective prediction can identify the high-risk population and risk factors for postpartum depression.


Subject(s)
Depression , Depression, Postpartum , Female , Humans , Postpartum Period , Pregnancy , Pregnancy Complications , Risk Factors
9.
J. Phys. Educ. (Maringá) ; 31: e3158, 2020. tab, graf
Article in English | LILACS | ID: biblio-1134705

ABSTRACT

ABSTRACT The study aimed to analyze the association between the position of the attacker, the place of the finish and the direction of the finalization with the effectiveness of the finalization, as well as the predictive factors of this. A total of 6146 attack actions of 66 matches were analyzed by the 24 teams participating in the 2015 Women's World Handball Championship. For the association between the variables studied, we used the Chi-Square test and for predictive analysis of the data, we used the multinomial regression. The significance level of p≤0.05 was adopted and the software SPSS version 20.0 for Windows was used. The results showed an association between the finalization effect and the attacker's position (χ2 = 107.39, p = 0.0001, ɸ = 0.13), association between the finishing effect and the finishing direction (χ2 = 715, (Χ2 = 587.25, p = 0.0001, ɸ = 0.34), and that the predictive factors of the finalization effect was statistically significant (χ2 = 854.666; p <0.0001). Thus, from the results, it is possible to concluded that the effect of the finalization and the direction of the finalization, suggesting that the position of the player does not influence in obtaining the goal.


RESUMO O estudo objetivou analisar a associação entre a posição da atacante, o local do lançamento e a direção do lançamento com o efeito do lançamento, bem como os fatores preditivos deste. Foram analisadas 6146 ações de ataque de 66 jogos realizados pelas 24 equipes participantes do Campeonato Mundial de Handebol Feminino de 2015. Para a associação entre as variáveis estudadas recorreu-se ao teste do Qui-Quadrado e para análise preditiva utilizou-se à regressão logística multinomial. Adotou-se o valor de significância de p≤0,05 e utilizou-se o software SPSS versão 20.0 para Windows. Os resultados apontaram associação entre o efeito do lançamento e a posição da atacante (��2= 107,39; p=0,0001; ɸ=0,13), entre o efeito do lançamento e o local do lançamento (��2= 715,01; p=0,0001; ɸ=0,34), entre o efeito do lançamento e a direção do lançamento (��2= 587,25; p=0,0001; ɸ=0,34) e que o local do lançamento e a direção do lançamento foram fatores preditivos do efeito do lançamento (��2=854,666; p<0,0001). Assim, a partir dos resultados, pode-se concluir que o efeito do lançamento é predito pelo local do lançamento e pela direção do lançamento, sugerindo que a posição da jogadora não influencia na obtenção do gol.


Subject(s)
Humans , Female , Play and Playthings , Efficacy , Predictive Value of Tests , Mediation Analysis , Sports , Women , Chi-Square Distribution , Athletic Performance
10.
Rev. urug. cardiol ; 35(1): 231-248, 2020. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1156860

ABSTRACT

Resumen: La ablación de la fibrilación auricular mediante el aislamiento de las venas pulmonares, es una estrategia ampliamente utilizada en la actualidad. La recurrencia posablación es un problema frecuente. Se han investigado varios predictores de recurrencia con el fin de optimizar la elección del paciente que más se beneficia del procedimiento. Actualmente la evidencia es controvertida, siendo necesarios más estudios al respecto.


Summary: The ablation of atrial fibrillation based on pulmonary veins isolation, is a widely used strategy nowadays. Post ablation recurrence is a frequent problem. Several recurrence predictors have been researched, with the purpose of choosing the patient that would benefit the most from this procedure. Current evidence is controversial and more research is needed.

11.
Braz. j. otorhinolaryngol. (Impr.) ; 85(5): 571-577, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1039292

ABSTRACT

Abstract Introduction: Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. Objectives: This investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant. Methods: Observational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1 + HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1 + CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1 + CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis. Results: Compared to the CI1 + HA, CI1 + CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio = 4.38, 95% confidence interval - 95% = 1.07-17.93, p = 0.04). Conclusions: The children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.


Resumo Introdução: Apesar dos avanços recentes na predição do resultado do implante coclear, ainda não está claro o benefício do procedimento bilateral em comparação com a estimulação bimodal e como podemos prever resultados de percepção da fala com implante coclear bilateral sequencial com base no desempenho auditivo bimodal em crianças. Objetivos: Este estudo foi realizado para: 1) Determinar o benefício do implante coclear bilateral sequencial e 2) Identificar os fatores associados com o resultado do implante bilateral sequencial. Método: Estudo observacional e retrospectivo. Analisamos retrospectivamente 29 pacientes com implantes sequenciais após a adaptação bimodal. Avaliações audiológicas foram realizadas; os escores das categorias de desempenho auditivo, a percepção da fala com palavras monossílabas e dissílabas e a versão coreana de Ling. As avaliações audiológicas foram realizadas antes do implante sequencial com o ajuste bimodal (IC1 + AH) e um ano após o implante coclear sequencial com implante bilateral (IC1 + IC2). O grupo com bom desempenho (BD) foi definido da seguinte forma: 90% ou mais em testes com monossílabos e dissílabos com condição apenas auditiva ou melhoria de 20% ou mais dos escores com IC1 + IC2. A idade no primeiro implante, o intervalo interimplante, o escore categorias de desempenho auditivo e as diversas comorbidades foram analisadas através de análise de regressão logística. Resultados: Em comparação com o IC1 + AA, IC1 + IC2 demonstraram benefícios significativos nos escores categorias de desempenho auditivo, percepção da fala e a versão coreana de Ling. Os escores de categorias de desempenho auditivo pré-operatórios foram o único fator associado para ser do grupo BD (odds ratio - OR = 4,38, intervalo de confiança de 95% - IC 95% = 1,07-17,93, p = 0,04). Conclusões: As crianças com desenvolvimento limitado de linguagem em condição bimodal devem ser consideradas, pois o implante coclear bilateral sequencial e o escore pré-operatório das categorias de desempenho auditivo poderiam ser usados como preditores na percepção da fala após implante sequencial.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Speech Perception/physiology , Cochlear Implants , Cochlear Implantation/methods , Hearing Loss, Bilateral/surgery , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Hearing/physiology
12.
Article | IMSEAR | ID: sea-189066

ABSTRACT

2-6 % of full term newborn children manifest symptoms of congenital nasolacrimal duct obstruction. The most frequent presentation is tearing associated with mattering of the eyelashes and recurrent infection. We designed a study to compare the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our western regional institute of ophthalmology. Probing under general anaesthesia was done in a cohort of children presenting with congenital nasolacrimal duct obstruction . The demography ,clinical presentation, management and outcome of the cases were documented. Factors associated with success of the procedure were documented. Aim: The aim of the study was to document the clinical outcome and factors predictive of success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our Western Regional Institute of Ophthalmology in India. Methods: The study was carried out at our Western Regional Institute of Ophthalmology. The study period was July 2018 to May 2019 . The study was a prospective interventional outcome study in an institutional cohort. Probing was reserved for patients with recurrent infection or acute dacryocystitis in children between 6 months to 9 months of age . Initial probing was the treatment of choice for children between one year and three years as well as older children above three years upto twelve years. Probing was performed under general anaesthesia. Patients were followed at 1 week, 3 weeks, 3 months and 6 months after the procedure. Outcome was defined as resolution of symptoms and signs of nasolacrimal duct obstruction as observed by the ophthalmologist as well as reported by the parents within 3 weeks of the procedure and continued remission for 6 months post procedure. Probing was done twice before the procedure was declared a failure. Statistical Analysis: Student t test and chi square test was used for statistical analysis . p<0.05 was taken as significant. The Fischer exact test was used to calculate the chi square value. Results: 25 eyes of 18 children with congenital nasolacrimal duct obstruction were subjected to probing during the time of the study. The age range was six months to eleven years. The overall success rate was 16/25(64%). The success rate for children less than or equal to three years was 8/9 (89%).The success rate in the age group three years to less than or equal to seven years was 7/12 (58.3%) . The success rate dropped to 25% (1/4) for children more than seven years of age. The success rate of nasolacrimal duct probing was observed to reduce with increasing age of the child. Persistent dacryocystitis, firm obstruction on nasolacrimal duct probing and repeat probing were statistically significantly associated with the outcome of probing. The children with any of the above factors had a lower success rate of nasolacrimal duct probing. Conclusion: The results of our study are comparable to other studies reporting outcome and predictive factors of nasolacrimal duct probing in younger and older children with congenital nasolacrimal duct obstruction. Children less than or equal to three years of age with congenital nasolacrimal duct obstruction could be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing. Conclusion: Children less than or equal to three years of age with congenital nasolacrimal duct obstruction can be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. Thus in the light of the fact that probing is a safe and effective procedure , it appears logical to give a trial of initial nasolacrimal duct probing even to children older than three years. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing.

13.
Rev. mex. trastor. aliment ; 10(1): 22-31, Jan.-Jun. 2019. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1004314

ABSTRACT

Resumen El objetivo principal de este estudio fue identificar variables sociodemográficas y psicosociales capaces de predecir las conductas alimentarias de riesgo (CAR) en estudiantes de bachillerato. Participaron 988 adolescentes (541 mujeres y 447 hombres) de entre 14 y 18 años de edad (M = 16.79, DE = 1.50). Además de las CAR (Atracón-purga, Medidas compensatorias y Restricción), examinadas a través del Cuestionario Breve de Conductas Alimentarias de Riesgo, fueron evaluadas las variables psicosociales siguientes: apoyo familiar y de amigos, ajuste escolar, victimización, ideación suicida, estrés académico, insatisfacción corporal y depresión; finalmente, las variables sociodemográficas incluidas fueron: sexo, edad, horas de sueño al día y horas dedicadas al Internet o las redes sociales. Mediante tres análisis de regresión lineal múltiple, uno para cada CAR (R2 = .36, .16 y .55, respectivamente; todas con p < .001), se pudieron identificar distintas variables predictivas, entre las que destacaron la insatisfacción corporal, la depresión y el sexo (mujeres). La identificación de estas variables puede contribuir a la mejora de las estrategias de prevención en materia de CAR y, por ende, de los trastornos alimentarios entre adolescentes.


Abstract The main objective of this study was to identify sociodemographic and psychosocial variables capable of predicting risk eating behaviors (REB) in high school students. Participants were 988 adolescents (541 women and 447 men) between 14 and 18 years of age (M = 16.79, SD = 1.50). In addition to the REB (Binge-purge, Compensatory behavior and Restriction), examined through the Brief Questionnaire on Risk Food Behaviors, the following psychosocial variables were also evaluated: family and friend support, school adjustment, victimization, suicidal ideation, academic stress, body dissatisfaction and depression; finally, the sociodemographic variables included were: sex, age, hours of sleep per day and hours dedicated to the Internet or social networks. Through three multiple linear regression analyzes, one for each REB (R2 = .36, .16 and .55, respectively; all with p < .001), different predictive variables could be identified, among which stood out the body dissatisfaction, the depression and sex (women). The identification of these variables can contribute to the improvement of prevention strategies in terms of REB and eating disorders among adolescents.

14.
Rev. mex. trastor. aliment ; 10(1): 85-94, Jan.-Jun. 2019. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1004320

ABSTRACT

Resumen La falta de adherencia al tratamiento (ADT) en personas con enfermedades crónicas puede fluctuar entre 40 y 75%. Dos tercios de los pacientes con obesidad bajo tratamiento recuperan el peso perdido tras un año, y casi todos a los cinco años, lo que se asocia con la falta de ADT. Esta refiere a un fenómeno multidimensional que supone la acción recíproca de diversos factores, y entre ellos los relativos al paciente. Supuesto que dio paso al surgimiento de los modelos socio-cognitivos de la ADT. El objetivo del presente trabajo fue identificar qué factores de tres diferentes modelos (Teoría de la conducta planeada [TCP], Creencias en salud y el de Wallston) pueden predecir la ADT de pacientes con sobrepeso u obesidad. Participaron 118 adultos, con edad promedio de 52.0 años (DE = 19.0), quienes estaban bajo tratamiento farmacológico y completaron tres cuestionarios, cada uno relativo a los modelos evaluados, y otro más referente a ADT. De los 13 factores, solo uno (Actitudes, del modelo de TCP) mostró capacidad para predecir la ADT (t = 2.75, ß = .26, p < .01). Por tanto, en el caso del sobrepeso u obesidad resulta necesario proponer modelos que reflejen mejor los aspectos que subyacen a la ADT.


Abstract The lack of adherence to treatment (ADT) in people with chronic diseases range from 40 to 75%. Two thirds of the patients with obesity under treatment recover the weight lost after one year, and almost all of them after five years, which is associated with the lack of ADT. Adherence refers to a multidimensional phenomenon that involves the reciprocal action of several factors, including those related to the patient. Assumption that triggered the first socio-cognitive models of ADT. The aim of the present work was to identify which factors of three different models (Theory of the planned behavior [TPB], Beliefs in health, and the one of Wallston) can predict the ADT of patients with overweight or obesity. A total of 118 adults participated, with an average age of 52.0 years (SD = 19.0), who were under pharmacological treatment and completed three questionnaires, each one related to the models evaluated, and another one related to ADT. Of the 13 factors, only one (attitudes, from the TPB model) showed ability to predict ADT (t = 2.75, ß = .26, p < .01). Therefore, for overweight and obesity it is necessary to propose models that can reflect better the differences that underlie the ADT.

15.
Article | IMSEAR | ID: sea-203671

ABSTRACT

Objective: We aimed to investigate the association between prediabetes risk factors, such as hemoglobin A1c(HbA1c) levels, age, body mass index, treatment regimen, and history of gestational diabetes mellitus (GDM) inwomen with GDM and impaired glucose tolerance postpartum. Methodology: We retrospectively reviewed themedical records of the women with GDM who were followed up at King Abdulaziz University Hospital, Jeddah,Saudi Arabia, between January 2014 and January 2018. A data collection form was designed to collectdemographic and clinical data. The likelihood of postpartum pre-diabetes was predicted using binomial logisticregression. Results: Medical charts of 267 women (240 with normal and 27 with abnormal oral glucose tolerancetest results) were reviewed. We found that age ≥ 45 years (p=0.001), obesity (p=0.041), oral hypoglycemic agentuse (p=0.006), and insulin use (p=0.016) were significantly associated with a higher risk for postpartum glucoseintolerance. Conclusion: The predictors of prediabetes among women visiting our clinics were age ≥45 years,obesity, oral hypoglycemic agent use, and insulin use. Identifying these factors antepartum is necessary to preventthe occurrence of prediabetes in GDM cases.

16.
Article | IMSEAR | ID: sea-198527

ABSTRACT

Background: The supratrochlear foramen (STF) is the most important anatomical variation of the humerus withgreat significance. However, in our environment, studies are rare and the FST remains almost unknown. Thisresearch aimed to study the prevalence of STF in a West African sample, its morphological characteristics andpredictive factors of its presence.Material and methods: We investigated the presence, shape, side, situation and dimensions of the STF in 142human adult humeri from West African cadavers. The morphometric measurements of the humeri were taken andwe analyzed the predictive factors of the presence of the STF by binary logistic regression.Results: The prevalence of the STF was 36.6%. In the depth of the olecranon fossa, the STF was closer to the medialepicondyle (24.9 ± 2.9 mm) than to the lateral epicondyle (26, 1 ± 2.8mm). The STF occurred in oval (50%), round(25%) triangular (23.1%) and irregular (1.9%) shapes. The mean transverse diameter of the STF was 6.5 ± 2.7 mmand 4.5 ± 1.5 mm for the vertical diameter. Humeri with STF had a significantly lower inter-epicondylar width;higher olecranon fossa width and height; and were significantly predominant on the left. The inter-epicondylarwidth (OR=1.10, P<0.001) and the width of the olecranon fossa (OR=0.81 P<0.001) were associated with theabsence of STF.Conclusion: A third of humeri in our population have STF. This implies that anatomists, anthropologists, orthopedistsand radiologists should be aware of this frequent anatomical variation with great implications.

17.
Article in Chinese | WPRIM | ID: wpr-802762

ABSTRACT

Objective@#To assess the symptom burden and its predictive factors in patients with prostate cancer.@*Methods@#A cross-sectional study of 370 men with prostate cancer were conducted in the department of urology, Fudan University Shanghai Cancer Center. The questionnaire included a general questionnaire, Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) and Hospital Anxiety and Depression Scale (HADS).@*Results@#The average score of EPIC-26 in patients with prostate cancer was 25.32±12.00. The sexual function (15.59±7.38) and endocrine disorder (4.09±3.70) scored higher in five domains. There were significant differences in symptom burden scores among different treatment methods (P < 0.01). Multiple linear regression showed that endocrine therapy, anxiety, prostate specific antigen (PSA) and income were the influencing factors of symptom burden in this population, which could explain 49.3% of symptom burden.@*Conclusions@#The symptom burden of patients with prostate cancer is heavy, especially during endocrine therapy. Health care provider should focus on assessing the psychology of them. What′s more, it is important to develop the symptom management and psychological support, especially for patients with lower income and advanced patients.

18.
Article in Chinese | WPRIM | ID: wpr-752605

ABSTRACT

Objective To assess the symptom burden and its predictive factors in patients with prostate cancer. Methods A cross-sectional study of 370 men with prostate cancer were conducted in the department of urology, Fudan University Shanghai Cancer Center. The questionnaire included a general questionnaire, Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) and Hospital Anxiety and Depression Scale (HADS). Results The average score of EPIC-26 in patients with prostate cancer was 25.32±12.00. The sexual function (15.59±7.38) and endocrine disorder (4.09±3.70) scored higher in five domains. There were significant differences in symptom burden scores among different treatment methods (P<0.01). Multiple linear regression showed that endocrine therapy, anxiety, prostate specific antigen (PSA) and income were the influencing factors of symptom burden in this population, which could explain 49.3% of symptom burden. Conclusions The symptom burden of patients with prostate cancer is heavy, especially during endocrine therapy. Health care provider should focus on assessing the psychology of them. What′s more, it is important to develop the symptom management and psychological support, especially for patients with lower income and advanced patients.

19.
Rev. Soc. Bras. Med. Trop ; 51(6): 753-760, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-977105

ABSTRACT

Abstract INTRODUCTION: Dengue is one of the most important mosquito-borne infections. Severe cases are more frequently observed in adults. However, in 2008, the State of Rio de Janeiro, Brazil, experienced a severe dengue epidemic that primarily affected children and caused many cases of dengue hemorrhagic fever (DHF) and death. METHODS: A cross-sectional analytical study was conducted to examine laboratory diagnosis and clinical epidemiologic factors for confirmed dengue cases in patients aged less than 16 years, from January to June 2008, at a municipal hospital in the City of Rio de Janeiro, Brazil. Variables associated with severe outcomes and P values less than .05 were evaluated by means of a logistic regression model. RESULTS: Of the 419 dengue cases studied, 296 were classified as DHF and 123 as classical dengue. Six patients who had DHF died. In multivariate analysis, some laboratory and clinical variables were independently associated with DHF: age 5 years or older (odds ratio [OR], 4.94; 95% confidence interval [CI], 1.30-18.71), abdominal pain (OR, 8.59; 95% CI, 3.17-23.27), hepatomegaly (OR, 15.87; 95% CI, 5.38-46.85), and positive tourniquet test (OR, 10.84; 95% CI, 3.96-29.71). Hypoalbuminemia occurred more frequently than hemoconcentration in DHF cases, and high aminotransferase levels were associated with severity. CONCLUSIONS: Age greater than 5 years, abdominal pain, painful hepatomegaly, and positive tourniquet test were predictors of DHF. The high frequency of hepatic impairment suggests that acetaminophen should be avoided in severe cases of dengue.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Severe Dengue/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors
20.
Rev. argent. mastología ; 37(135): 96-110, jul. 2018. graf, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1118024

ABSTRACT

Introducción En la evolución post-tratamiento conservador del cáncer de mama está la posibilidad de la recidiva local, por lo que el uso de factores predictivos permitiría delimitar el grupo de pacientes con mayor riesgo de presentarlas. Objetivo Determinar la importancia de los factores inmunohistoquímicos en la recidiva local del cáncer de mama tratado de manera conservadora. Material y método Se realizó un estudio observacional analítico retrospectivo de pacientes del Registro de Cáncer de Mama de la Sociedad Argentina de Mastología (rcm sam) que fueron intervenidas con técnicas conservadoras y presentaron una recidiva local. Resultados De un total de 4.268 pacientes que realizaron tratamiento conservador, un 5,6% presentó recidiva y, dentro de estas, el 71,7% fueron locales. Tanto en el grupo con recidivas como en el grupo que no las presentó las varia bles de tipo histológico y molecular se comportaron de igual forma, mientras que la cuantificación expresada por el Receptor de Estrógeno cercana o inferior al 70%, al igual que valores cercanos al 40% para el de Receptor de Progesterona, fueron predominantes en el grupo que tuvo recidivas. Conclusiones El tipo histológico y el tipo molecular no son pronósticos de las recidivas, pero si son válidos para definir a las verdaderas recidivas. En cambio, el análisis cuantitativo de los receptores puede brindar información pronóstica en cuanto a este evento.


Introduction In the evolution of conservative breast cancer post-treatment there is a possibility of local recidivation, so the use of predictive factors would allow the delimitation of the group of patients with a higher risk of presenting it. Objective To determine the importance of inmunohistochemistry factors in breast cancer local recidivation using a conservative treatment. Materials and method A retrospective analytical observational study was performed on patients from rcm sam who were operated using conservative techniques and presented local recidivation. Results From a total of 4,268 patients who underwent conservative treatment, 5,6% presented recidivation and among these, 71,1% were local. In both groups, with and without recidivation variables, the histological and molecular factors behaved in similar ways, while the quantification expressed by the Estrogen Receptor close to or below 70% and Progesterone values close to 40% prevailed in the recidivation group Conclusions The histological and molecular types are not prognosis of recidivation, but they are valid to define real recidivation. On the other hand, the receptors quantitative analysis can provide prognostic information as regards that event.


Subject(s)
Humans , Female , Prognosis , Breast Neoplasms , Immunohistochemistry , Neoplasm Recurrence, Local
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