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1.
J. bras. psiquiatr ; 71(2): 149-160, abr.-jun. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1386071

ABSTRACT

ABSTRACT Objective Posttraumatic stress disorder (PTSD) is a highly prevalent and disabling disorder. Even when treated with the first-line intervention, cognitive-behavioral therapy (CBT), 45% of the patients continue suffering from this disorder. Therefore, knowing the factors that could foresee who will respond to CBT would be of great value to the treatment of these patients. Thus, we have systematically reviewed the literature to identify the variables that could predict response to CBT in patients suffering from PTSD. Methods Following the PRISMA 2020 guidelines, we searched the electronic databases ISI Web of Science, Scopus, PsycINFO, MEDLINE, and PTSDpubs until November 2021. Two authors have independently conducted study selection and data extraction. Studies that examined possible predictors of response to therapy on a sample of adults (18-65 years), both genders, with and without comorbidities were considered eligible. The characteristics of the studies were synthesized in a table. The risk of bias was assessed by the Cochrane risk of bias quality assessment tool. Results Twenty-eight studies comprising 15 variables were selected. Among those, eight showed a low risk of bias, 19 showed some concerns, and one showed a high potential risk of bias. The therapeutic relationship was the only variable considered to be a predictor of a good response to therapy. All other variables showed conflicting results. Conclusions The most promising variable, although scientifically weak, is the therapeutic relationship. Additional randomized clinical trials should be conducted to clarify the role of this variable as a predictor of response to CBT in patients with PTSD.


RESUMO Objetivo O transtorno de estresse pós-traumático (TEPT) é um transtorno altamente prevalente e incapacitante. Mesmo quando tratado com uma intervenção de primeira linha, terapia cognitivo-comportamental (TCC), 45% dos pacientes continuam sofrendo desse transtorno. Portanto, conhecer os fatores que podem prever quem responderá à TCC seria de grande valor no tratamento desses pacientes. Por esse motivo, revisamos sistematicamente a literatura para identificar as variáveis que poderiam predizer a resposta à TCC em pacientes que sofrem de TEPT. Métodos Seguindo as diretrizes do PRISMA 2020, pesquisamos em banco de dados eletrônico como ISI Web of Science, Scopus, PsycINFO, MEDLINE e PTSDpubs até novembro de 2021. Dois autores conduziram independentemente a seleção do estudo e a extração de dados. Estudos que examinaram possíveis preditores de resposta à terapia, com amostra de adultos (18-65 anos) de ambos os sexos, com e sem comorbidades, foram considerados elegíveis. As características dos estudos foram sintetizadas em uma tabela. O risco de viés foi avaliado pela ferramenta de avaliação de qualidade de risco de viés da Cochrane. Resultados Vinte e oito estudos envolvendo 15 variáveis foram selecionados. Desses, oito mostraram baixo risco de viés, 19 mostraram algumas preocupações e um mostrou alto risco potencial de viés. A relação terapêutica foi a única variável considerada um preditor de boa resposta à terapia. Todas as outras variáveis apresentaram resultados conflitantes. Conclusões A variável mais promissora, embora muito fraca cientificamente, é a relação terapêutica. Ensaios clínicos randomizados adicionais devem ser conduzidos para esclarecer o papel dessa variável como um preditor de resposta da TCC em pacientes com TEPT.

2.
Cienc. Salud (St. Domingo) ; 6(1): [45-53], ene.-abr. 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1366754

ABSTRACT

Introducción: la utilización de la escala NEWS podría construir una herramienta en el diagnóstico, pronóstico y estratificación precoz ante la sospecha de sepsis. El propósito de esta investigación fue determinar la eficacia de la escala NEWS como predictor de sepsis en pacientes ingresados por síndrome febril en el Hospital Salvador Bienvenido Gautier, en el período de octubre-diciembre 2019. Material y método: se realizó un estudio descriptivo, prospectivo y de corte transversal donde la técnica utilizada para la recolección de la información fue la evaluación directa de los 43 pacientes admitidos aplicando la escala NEWS y revisión de expedientes clínicos. Resultados: se determinó que el punto de corte ≥6 en la escala NEWS obtuvo valores de sensibilidad (91 %), especificidad (70 %), índice de Youden de 0.61, valor predictivo positivo de 78 %, valor predictivo negativo de 88 %, razón de verosimilitud positiva de 3 y negativa de 0.1. La aplicación de la escala NEWS en el sexo masculino presentó una sensibilidad de 92.9 % y especificidad de 87.5 %. En los grupos de 18-30 y 71-80 años, esta escala presentó una sensibilidad y especificidad de 100 %. Los pacientes clasificados como riesgo bajo, moderado y alto fueron diagnosticados con sepsis el 16.67 %, 63.64 % y un 70 %, respectivamente. Conclusiones: una puntuación mayor o igual a 6 en la escala NEWS se presenta como un predictor estadísticamente significativo que ayudaría en el diagnóstico temprano de sepsis, siendo más sensible que especifica. Fue mejor predictor en el sexo masculino y en los grupos etarios de 18-30 y 71-80 años


Introduction: The use of the NEWS could build a tool in the diagnosis, prognosis and early stratification in case of suspected sepsis. The purpose of this research was to determine the efficacy of the NEWS as a predictor of sepsis in patients admitted for febrile syndrome at the Salvador Bienvenido Gautier Hospital, October-December 2019. Materials and methods: A descriptive, prospective and crosssectional study was conducted where the technique used for the collection of the information was the direct evaluation of the 43 admitted patients applying the NEWS and the review of clinical records. Results: It was determined that the cutoff point ≥6 on the NEWS obtained sensitivity value (91%), specificity (70%), Youden index of 0.61, positive predictive value of 78%, negative predictive value of 88%, ratio of positive likelihood of 3 and negative of 0.1. The application of the NEWS scale in males presented a sensitivity of 92.9% and specificity of 87.5%. In the groups of 18-30 and 71-80 years, this scale presented a sensitivity and specificity of 100%. Patients classified as low, moderate and high risk were diagnosed with sepsis 16.67%, 63.64% and 70% respectively. Conclusions: A score greater than or equal to 6 on the NEWS is presented as a statistically significant predictor that would help in the early diagnosis of sepsis being more sensitive than specific. It was a better predictor in the male sex and in the age groups of 18-30 and 71-80 years


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Sepsis , Cross-Sectional Studies , Fever
3.
J. pediatr. (Rio J.) ; 97(4): 409-413, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287037

ABSTRACT

Abstract Objective This study aimed to identify the predictors and threshold of failure in neonatal acute respiratory distress syndrome. Methods Newborns with severe acute respiratory distress syndrome aged 0-28 days and gestational age ≥36 weeks were included in the study if their cases were managed with non-extra corporal membrane oxygenation treatments. Patients were divided into two groups according to whether they died before discharge. Predictors of non-extra corporal membrane oxygenation treatment failure were sought, and the threshold of predictors was calculated. Results A total of 103 patients were included in the study. A total of 77 (74.8%) survived hospitalization and were discharged, whereas 26 (25.2%) died. Receiver operating characteristic analysis of oxygen index, pH, base excess, and combinations of these indicators demonstrated the advantage of the combination of oxygen index and base excess over the others variables regarding their predictive ability. The area under the curve for the combination of oxygen index and base excess was 0.865. When the cut-off values of oxygen index and base excess were 30.0 and −7.4, respectively, the sensitivity and specificity for predicting death were 77.0% and 84.0%, respectively. The model with base excess added a net reclassification improvement of 0.090 to the model without base excess. Conclusion The combination of oxygen index and base excess can be used as a predictor of outcomes in neonates receiving non-extra corporal membrane oxygenation treatment for acute respiratory distress syndrome. In neonates with acute respiratory distress syndrome, if oxygen index >30 and base excess <−7.4, non-extra corporal membrane oxygenation therapy is likely to lead to death.


Subject(s)
Humans , Infant, Newborn , Infant , Respiratory Distress Syndrome, Newborn/therapy , Respiratory Distress Syndrome, Newborn , Respiratory Insufficiency , Oxygen , Oxygen Inhalation Therapy
5.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 101-108, 20210000.
Article in Spanish | LILACS | ID: biblio-1178954

ABSTRACT

La litiasis vesicular sintomática puede presentarse asociada a litiasis de la vía biliar principal, siendo necesaria la utilización de medios diagnósticos adecuados para su posterior tratamiento. En este trabajo, se sugiere la evaluación mediante las guías de la Sociedad Americana para Endoscopia Gastrointestinal (American Society for Gastrointestinal Endoscopy ASGE), usando factores como la edad, pruebas hepáticas y hallazgos ecográficos, categorizando a los pacientes en baja, intermedia y alta probabilidad de coledocolitiasis. Estudio de diseño retrospectivo, observacional, descriptivo, de corte transversal, con un muestreo no probabilístico de casos consecutivos, sobre pacientes con diagnóstico de litiasis vesicular sintomática y sospecha de litiasis de la via biliar principal internados en la II Cátedra de Clínica Quirúrgica, del Hospital de Clínicas de San Lorenzo, entre los años 2017 a 2019. Con los siguientes resultados, de un total de 339 pacientes con diagnóstico de litiasis vesicular sintomática, el 6,64% tuvo el diagnóstico de coledocolitiasis asociada. En cuanto a los predictores muy fuertes de coledocolitiasis el más frecuentemente (68,6%,) encontrado fue el nivel de la bilirrubina total ≥ 4mg/dl; de los predictores fuertes el 70,6% presentaba la vía biliar principal dilatada; de los predictores moderados, el 84,3% presentó las enzimas hepáticas alteradas. En conclusión, se pudo identificar que la mayoría de los pacientes presentó alta probabilidad de coledocolitiasis y la conducta tomada fue realizar en primer lugar una colangiografía retrógrada endoscópica, con fines terapéuticos y luego colecistectomía, correspondiente al manejo correcto establecido por las guías actuales internacionales.


Symptomatic gallstones can occur associated with lithiasis of the main bile duct, requiring the use of adequate diagnostic tools for subsequent treatment. In this paper, we suggest using the guidelines of the American Society for Gastrointestinal Endoscopy (ASGE), that uses factors such as age, liver tests, and ultrasound findings, categorizing patients as those with low, intermediate, and high probability. of choledocholithiasis. A Retrospective, observational, descriptive, cross-sectional design study, with a non-probabilistic sampling of consecutive cases, on patients with a diagnosis of symptomatic gallstones and suspected stones of the main bile duct admitted to the the 2nd Surgical Department and Service of Clinica´s Hospital of San Lorenzo, between the years 2017 to 2019. With the following results; of a total of 339 patients with the diagnosis of symptomatic gallstones, 6.64% had associated choledocholithiasis. Regarding the very strong predictors of choledocholithiasis, the most frequent (68.6%) was the total bilirubin level ≥ 4mg / dl; 70.6% had a dilated main bile duct as a strong predictor; as a moderate predictor, 84.3% had altered liver enzymes. In conclusion, it was possible to identify that most of the patients presented a high probability of choledocholithiasis and the action taken was to first perform an endoscopic retrograde cholangiography, for therapeutic purposes, and then cholecystectomy, corresponding to the correct management established by current international guidelines.


Subject(s)
Bile Ducts , Bilirubin , Cholangiography , Cholecystectomy , Gallstones , Lithiasis , Liver , Sampling Studies , Endoscopy, Gastrointestinal , Endoscopy
6.
Rev. inf. cient ; 100(2): e3339, mar.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1251823

ABSTRACT

RESUMEN Introducción: Las enfermedades cardiovasculares representan la principal causa de muerte de la población mundial. Objetivo: Identificar los factores predictores de mortalidad hospitalaria en pacientes con infarto agudo del miocardio en el Hospital General Docente "Dr. Agostinho Neto", durante el año 2017. Método: Se realizó un estudio retrospectivo analítico de tipo caso y control, en una población conformada por 90 pacientes con infarto. En el grupo caso se encontraron todos los pacientes fallecidos durante el ingreso (n=30) que cumplieron los criterios de inclusión y exclusión, mientras que el grupo control estuvo constituido por 60 pacientes que egresaron vivos, seleccionados al azar mediante un muestreo aleatorio simple. Resultados: La media de la edad fue mayor en el grupo de los casos 74,06 respecto a los controles, (p=0,021). El 86,6 % de los casos no recibió trombolisis y el 6,6 % tuvo algún criterio de reperfusión pos-estreptoquinasa (p=0,00). El 36,6 % de los casos presentó choque cardiogénico (p=0,003), ruptura cardíaca (30 %) (p=0,03), y taponamiento (23,3 %) (p=0,01). Conclusiones: Los factores predictores de mortalidad hospitalaria en pacientes con infarto agudo del miocardio son: la edad avanzada, el tiempo prolongado entre el inicio de los síntomas y la asistencia médica, la existencia de las complicaciones, tales como el choque cardiogénico, el taponamiento cardíaco y la ruptura cardíaca, así como la no administración de tratamiento trombolítico y la ausencia de reperfusión.


ABSTRACT Introduction: Cardiovascular disease is the main cause of death worldwide. Objective: To identify the predictor factors of hospital mortality in patients with acute myocardial infarction at the Hospital General Docente "Dr. Agostinho Neto" in 2017. Method: A retrospective analytical case-control study was performed in a population of 90 patients with myocardial infarction. The case-cohort study included all patients who died during admission (n=30) and met the inclusion and exclusion criteria, while the case-control study included 60 patients who were discharged alive, randomly selected by simple random sampling. Results: The mean age was higher in the case-cohort studied (74.06 years) than the case-control (p=0.021). The 86,6% of cases did not receive thrombolysis and 6.6% had some reperfusion criteria after the streptokinase (p=0.00). Cardiogenic shock (p=0.003), cardiac rupture (30%) (p=0.03), and cardiac tamponade (23.3%) (p=0.01) were present in 36.6% of cases. Conclusions: The predictor factors of hospital mortality in patients with acute myocardial infarction are as follows: age, the prolonged time between the onset of symptoms and medical attention, presence of complications such as cardiogenic shock, cardiac tamponade and cardiac rupture, as well as the non-administration of thrombolytic treatment and the absence of reperfusion.


RESUMO Introdução: As doenças cardiovasculares representam a principal causa de morte da população mundial. Objetivo: Identificar os fatores preditivos de mortalidade hospitalar em pacientes com infarto agudo do miocárdio no Hospital Geral Universitário "Dr. Agostinho Neto", durante 2017. Método: Foi realizado um estudo retrospectivo analítico caso-controle em uma população de 90 pacientes com infarto. No grupo caso, foram encontrados todos os pacientes que morreram na admissão (n=30) que atenderam aos critérios de inclusão e exclusão, enquanto o grupo controle foi composto por 60 pacientes que receberam alta com vida, selecionados aleatoriamente por amostragem aleatória simples. Resultados: A média de idade foi maior no grupo de casos 74,06 em relação aos controles (p=0,021). 86,6% dos casos não receberam trombólise e 6,6% tinham algum critério para reperfusão pós-estreptoquinase (p=0,00). 36,6% dos casos apresentaram choque cardiogênico (p=0,003), ruptura cardíaca (30%) (p=0,03) e tamponamento (23,3%) (p=0,01). Conclusões: Os fatores preditivos de mortalidade hospitalar em pacientes com infarto agudo do miocárdio são: idade avançada, longo tempo entre o início dos sintomas e o atendimento médico, a existência de complicações, como choque cardiogênico, tamponamento cardíaco e ruptura cardíaca, bem como a não administração de tratamento trombolítico e a ausência de reperfusão.


Subject(s)
Humans , Middle Aged , Hospital Mortality , Myocardial Infarction/mortality , Case-Control Studies , Retrospective Studies
7.
Rev. Fac. Med. Hum ; 21(1): 12-18, Ene.-Mar. 2021.
Article in English, Spanish | LILACS-Express | LILACS | ID: biblio-1147093

ABSTRACT

Se realizó una investigación de tipo correlacional evaluando a 145 pacientes con sepsis por covid-19. Objetivos: Determinar si la hipoalbuminemia es predictor de mortalidad e identificar el valor sérico de albumina más frecuentemente relacionado con la letalidad. Métodos: Se incluyeron a pacientes mayores o igual de 18 años atendidos en el Hospital II Chocope durante mayo a agosto del 2020. Se excluyeron a pacientes con patologías oncológicas, e historias clínicas incompletas. La técnica empleada es la de análisis documental, mediante la revisión de historias clínicas. Resultados: Hubo asociación estadísticamente significativa entre la hipoalbuminemia y mortalidad (p = 0.00), los pacientes con hipoalbuminemia tuvieron 3 veces más riesgo de fallecer. (OR=3.97 IC al 95%). Así mismo, la sensibilidad y especificidad más alta de la prueba fue cuando el punto de corte de la hipoalbuminemia estuvo en 1.38 g/dl. Finalmente, la hipertensión arterial es la enfermedad asociada más frecuente. Conclusiones: la hipoalbuminemia es predictor de mortalidad y a menor valor de albumina mayor mortalidad.


A correlational type investigation was carried out evaluating 145 patients with covid-19 sepsis. Objectives: To determine whether hypoalbuminemia is a predictor of mortality and to identify the serum albumin value most frequently related to lethality. Method: Patients older than or equal to 18 years seen at Hospital II Chocope during May to August 2020 were included. Patients with oncological pathologies and incomplete medical records were excluded. The documentary analysis technique was used, by reviewing medical records. Results: There was a statistically significant association between hypoalbuminemia and mortality (p = 0.00), patients with hypoalbuminemia had 3 times the risk of dying. (OR = 3.97 95% CI). Likewise, the highest sensitivity and specificity of the test was when the cut-off point for hypoalbuminemia was 1.38 g / dl. Finally, the most frequent comorbidity was arterial hypertension. Conclusions: hypoalbuminemia is a predictor of mortality and the lower the albumin value, the higher the mortality.

8.
Article in Chinese | WPRIM | ID: wpr-907938

ABSTRACT

Mycoplasma pneumoniae is one of the common causes of community-acquired pneumonia in preschool and school-age children.Although it is self-limited in some children, there are still some cases of refractory Mycoplasma pneumoniae pneumonia(RMPP), which are characterized by various intrapulmonary and extrapulmonary complications, such as the formation of bronchial mucus plugs, necrotizing pneumonia and so on, and even endanger the lives of children.In recent years, with the increase of morbidity of RMPP, some studies have shown that early use of corticosteroids can significantly relieve its clinical symptoms and improve prognosis.Therefore, it is essential to understand the pathogenesis of Mycoplasma pneumoniae pneumonia, identify the high risk factors for predicting RMPP and its associated complications, and then formulate relevant prediction scales.

9.
Article in English | WPRIM | ID: wpr-882047

ABSTRACT

@#BACKGROUND: Neuroendocrine dysfunction after traumatic brain injury (TBI) has received increased attention due to its impact on the recovery of neural function. The purpose of this study is to investigate the incidence and risk factors of adrenocortical insufficiency (AI) after TBI to reveal independent predictors and build a prediction model of AI after TBI. METHODS: Enrolled patients were grouped into the AI and non-AI groups. Fourteen preset impact factors were recorded. Patients were regrouped according to each impact factor as a categorical variable. Univariate and multiple logistic regression analyses were performed to screen the related independent risk factors of AI after TBI and develop the predictive model. RESULTS: A total of 108 patients were recruited, of whom 34 (31.5%) patients had AI. Nine factors (age, Glasgow Coma Scale [GCS] score on admission, mean arterial pressure [MAP], urinary volume, serum sodium level, cerebral hernia, frontal lobe contusion, diffuse axonal injury [DAI], and skull base fracture) were probably related to AI after TBI. Three factors (urinary volume [X4], serum sodium level [X5], and DAI [X8]) were independent variables, based on which a prediction model was developed (logit P= -3.552+2.583X4+2.235X5+2.269X8). CONCLUSIONS: The incidence of AI after TBI is high. Factors such as age, GCS score, MAP, urinary volume, serum sodium level, cerebral hernia, frontal lobe contusion, DAI, and skull base fracture are probably related to AI after TBI. Urinary volume, serum sodium level, and DAI are the independent predictors of AI after TBI.

10.
Chinese Journal of Lung Cancer ; (12): 188-195, 2021.
Article in Chinese | WPRIM | ID: wpr-880257

ABSTRACT

With the development of precise medicine, targeted therapy has greatly improved the survival and prognosis of patients in advanced non-small cell lung cancer (NSCLC) with oncogenic drivers. However, no matter which kinds of targeted therapy are inevitable to develop therapeutic resistance, treatment options upon exhaustion of targeted therapies are limited. Immune checkpoint inhibitors (ICIs) can bring long-term survival to some patients with advanced NSCLC because of its unique long tailing effect. More and more studies have shown that ICIs can also benefit NSCLC patients with oncogenic drivers. However, the timing of ICIs intervention, the therapeutic regimen and the predictive biomarkers are actually debated, underscoring the need to explore the potential interest of ICIs in these populations.
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11.
Article in Chinese | WPRIM | ID: wpr-908806

ABSTRACT

Objective:To explore the clinical characteristics and predictors of severe acute pancreatitis complicated with acute respiratory distress syndrome (SAP-ARDS).Methods:Clinical data of consecutive 313 SAP patients hospitalized from January 2000 to January 2020 in Peking Union Medical College Hospital, were retrospectively analyzed, including 258 cases with ARDS (ARDS group) and 55 cases without ARDS (non-ARDS group). According to the severity of ARDS, ARDS group were further divided into mild ARDS group (165 cases) and moderate to severe ARDS group (93 cases). Clinical symptoms, laboratory examination and imaging results, ICU admission time and clinical outcome, as well as the local and systemic complications, acute physiology and chronic health evaluation (APACHEⅡ) within 24 h after admission, bedside index for severity in acute pancreatitis (BISAP), CT severity index (CTSI), sequential organ failure assessment (SOFA) and quick sequenctial organ failure assessment(qSOFA) score were recorded. Univariate and multivariate logistic regression were performed to analyze independent risk factors of SAP complicated with moderate to severe ARDS. Receiver operating characteristics curves (ROC) was drawn to calculate area under the ROC curve (area under curve, AUC) and evaluate the performance of WBC and hsCRP in predicting SAP complicated with moderate to severe ARDS, and assess the performance of APACHEⅡ, BISAP, CTSI, SOFA and qSOFA scores in predicting SAP-ARDS endotracheal intubation.Results:The ICU length of stay and mortality rate of SAP-ARDS patients were significantly higher than those without ARDS [(8.3±11.6 day vs 5.7±7.7 day, 12.4% vs 3.6%, all P value <0.05)]. Univariate analysis showed that elevated WBC ( OR 4.52, 95% CI 1.64-12.4) and hsCRP ( OR 3.69, 95% CI 1.29-10.48) on admission were independent risk factors for moderate to severe ARDS with SAP. The AUC of WBC and hsCRP for predicting SAP with moderate to severe ARDS at admission were 0.651(95% CI 0.532-0.770) and 0.615 (95% CI 0.500-0.730), respectively. The predicted cut-off values (Cut-off values) were 17.5×10 9/L and 159 mg/L, respectively, and the sensitivity was 53.1% and 78.1%, the specificity was 78.1% and 48.4% respectively. The area under the ROC curve for APACHEⅡ, BISAP, CTSI, SOFA, and qSOFA score 24 h after admission in the early prediction of endotracheal intubation were 0.739 (95% CI 0.626-0.840), 0.705 (95% CI 0.602-0.809), 0.753 (95% CI 0.650-0.849 ), 0.737 (95% CI 0.615-0.836) and 0.663 (95% CI 0.570-0.794), and the optimum Cut-off values were 14 points, 3 points, 5 points, 7 points, 2 points, and the sensitivity and specificity for these predictors were 58.8% and 81.4%, 79.4% and 60.0%, 73.5% and 67.1%, 38.2% and 98.6%, 45.5% and 83.3%, respectively. Conclusions::Elevated blood WBC and hsCRP on admission were independent risk factors for moderate to severe ARDS in SAP. APACHEⅡ≥14, BISAP≥3, CTSI≥5, SOFA≥7, or qSOFA≥2 within the 24 h admission indictaed that the risk of SAP patients to receive endotracheal intubation was high.

12.
Article | IMSEAR | ID: sea-208001

ABSTRACT

Background: The World Health Organization (WHO) factsheet revealed that 15 million babies are born too early every year and almost 1 million children die each year due to complications of preterm birth. The objective of this study was to determine whether cervicovaginal β-hCG level can be used as predictor of preterm delivery in asymptomatic high-risk pregnant women at 24-34 weeks gestation age.Methods: This was prospective observational study. Total 134 asymptomatic pregnant women were taken for study who had at least one risk factor for preterm delivery at 24-34 weeks gestation age. Cervicovaginal secretion was collected and β-hCG level was measured by chemiluminescent immunoassay.Results: Out of 134 cases, 42.5% had preterm delivery and 57.5% had term delivery. Mean cervicovaginal β-hCG level (mIU/ml) in preterm delivery group was 39.38±19.66 and term delivery group was 21.86±11.18. Cervicovaginal β-hCG level was significantly higher in preterm group compare to term group demonstrating significant association of raised β-hCG with preterm group (p value <0.001). ROC curve analysis was done to find out best cut off value of cervicovaginal β-hCG for prediction of preterm delivery and optimal cut off value was 36.45 mIU/ml. The optimal cut off value for cervicovaginal β-hCG (36.45 mIU/ml) gave sensitivity 71.9%, specificity 81.8%, positive predictive value 74.5%, negative predictive value 79.7% and diagnostic accuracy of 77.6% for prediction of preterm delivery.Conclusions: Cervicovaginal β-hCG can be used as sensitive and specific biomarker of prediction of preterm delivery in asymptomatic high-risk women.

13.
Article | IMSEAR | ID: sea-215042

ABSTRACT

Early diagnosis and treatment of acute appendicitis prevents development of markers that have been used to improve the diagnostic accuracy in appendicitis. The objective of this study was to assess the role of procalcitonin in the prediction of complications of appendicitis. METHODSA cross sectional study involving 110 patients diagnosed with acute appendicitis was conducted. After obtaining ethical clearance, informed written consent was obtained from the patients. Blood investigations such as total leucocyte counts, C reactive proteins and procalcitonin levels were done. Cases were categorized into uncomplicated appendicitis (n=67) and complicated appendicitis (n=43). Descriptive analysis, ROC analysis of predictive validity, and Shapiro Wilk test comparing all the three parameters in both the groups was done using IBM SPSS version 22. RESULTSThe mean age was 29.59 ± 9.17 years. 67 (60.91%) had uncomplicated appendicitis and 43 (39.09%) had complicated appendicitis. The WBC, hsCRP, serum procalcitonin percentile had good predictive validity in predicting score as indicated by the area under the curve (0.822). Serum procalcitonin value had a sensitivity of 97.67% in predicting the type of appendicitis and specificity of 94.03%. CONCLUSIONSSerum procalcitonin is a better biomarker than total leucocyte count and hs-C reactive protein in predicting complications of appendicitis and differentiating it from uncomplicated appendicitis.

14.
Rev. MVZ Córdoba ; 25(1): 51-58, ene.-abr. 2020. tab
Article in Spanish | LILACS | ID: biblio-1279654

ABSTRACT

RESUMEN Objetivo. Estimar parámetros genéticos para peso a los ocho meses de edad (W8M), edad al primer parto (AFC) y primer intervalo entre partos (FCI) usando parentesco genómico y por pedigrí. Materiales y métodos. Se utilizaron 481, 3063 y 1098 registros fenotípicos para W8M, AFC y FCI, respectivamente. La información genómica estuvo compuesta por una población de 718 animales genotipados con un chip que incluyó 30106 marcadores genéticos tipo polimorfismo de nucleótido simple (SNP). Modelos univariado y bivariado fueron construidos bajo la metodología del mejor predictor lineal insesgado convencional (BLUP) y genómico en una etapa (ssGBLUP). Resultados. Las heredabilidades para W8M, AFC y FCI variaron desde 0.25 a 0.26, 0.20 a 0.22 y 0.04 a 0.08, respectivamente. Los modelos de AFC y FCI con la metodología ssGBLUP disminuyeron ligeramente el error y aumentaron la varianza genética aditiva, respectivamente. Conclusiones. La inclusión de información genómica mejora levemente la precisión de las estimaciones genéticas en esta población. Sin embargo, una población de animales genotipados más grande y con mayor conectividad genética por parentesco permitiría aumentar para los criadores el potencial de la metodología ssGBLUP en ganado Simmental de Colombia.


ABSTRACT Objective. To estimate genetic parameters for weight at eight months of age (W8M), age at first calving (AFC) and first calving interval (FCI) using pedigree and genomic relationship. Materials and methods. Phenotypic data on 481, 3063 and 1098 animals for W8M, AFC and FCI were used, respectively. The genomic information came from a population of 718 genotyped animals with a density chip of 30,106 single nucleotide polymorphism markers (SNP). Univariate and bivariate models were used under the conventional (BLUP) and single step genomic best linear unbiased predictor (ssGBLUP) methodologies. Results. The heritabilities for W8M, AFC and FCI ranged from 0.25 to 0.26, from 0.20 to 0.22 and from 0.04 to 0.08, respectively. The AFC and FCI models under ssGBLUP slightly decreased the error and increased the additive genetic variance, respectively. Conclusions. The inclusion of genomic information slightly increases the accuracy of the genetic estimates in this population. However, a larger amount of genotyped animals and with a higher genetic relationship connectivity would allow breeders to increase the potential of the ssGBLUP methodology in Colombian Simmental cattle.


Subject(s)
Animals , Livestock , Reproduction , Genomics
15.
Article | IMSEAR | ID: sea-207566

ABSTRACT

Background: Hypertensive disorders of pregnancy (HDP) is a major cause of maternal, fetal morbidity and mortality complicating 10% of all gestations. As effective treatments are very limited, prediction of HDP occurrence is most importance. Though many biomarkers have shown relationship with HDP, serum magnesium (Mg) has shown better predictor as involved in maintaining vascular contractility, tone. This study is intended to analyse incidence of GHT and fetomaternal outcome in pregnant women with normal and low serum magnesium level measured at mid trimester (18-20 weeks).Methods: A total of 105 consecutive singleton pregnant women in between 18-20 weeks of gestation attending OBG outpatient department were enrolled. After obtaining the informed consent, structured proforma was used to collect demographic, clinical details. Serum magnesium was measured by the colorimetric method and study participants were divided into two groups based on Mg cut off 1.5 mg/dl and followed up throughout pregnancy for fetomaternal outcome.Results: This study results revealed that 35.2% (37/105) pregnant women had serum Mg level < 1.5 mg/dl and mean value of Mg of all participant is 1.7 mg/dl, just above the lower limit. During follow-up of these two groups, statistically significant correlation between serum Mg levels (< 1.5 mg/dl) with GHT (8/12) occurrence and pre term birth was found. Other fetomaternal outcome not had significant correlation.Conclusions: As per the findings, serum Mg concentration measurement in between 18-20 weeks can be considered as a one of the predictors for subsequent occurrence of maternal outcome of GHT and fetal outcome of pre-term birth.

16.
Article | IMSEAR | ID: sea-204563

ABSTRACT

Background: Most unconjugated bilirubin formed by the fetus is cleared by the placenta into the maternal circulation. Albumin constitutes 70 - 75% of Plasma oncotic pressure. Another important function of albumin is its antioxidant property. Bilirubin binds to albumin in an equimolar ratio. Free bilirubin is anticipated when the molar bilirubin- to- albumin (B: A) ratio is >0.8 Objective of the study was to predict the proportion of newborn requiring intervention for NH (phototherapy or exchange transfusion) based on cord serum albumin level at birth.Methods: The present prospective study was conducted at Navodaya Medical College, Raichur from October 2018 to November 2019. A total of 180 babies which were born during the study period were included in the study. INCLUSION CRITERIA' Term babies both genders' Mode of delivery (normal and C-section)' Birth weight ?2.5kg.' APGAR ?7/10 at 1 min. Cord Serum Albumin level was estimated at birth. Total Serum Bilirubin (TSB) estimation was done at 72-96 hours of age. All the babies were followed up daily for first 4 postnatal days and babies were daily assessed for NH and its severity.Results: In our study nearly 54.4% of them had Cord Serum Albumin levels of less than 2.8 gm/dl, 27.3% of them had albumin levels of 2.9 to 3.3 gm/dl, 18.3% of them had Serum Albumin of 3.4 gm/dl. Out of 180 study subjects, 13.9% of them required phototherapy to treat neonatal hyper bilirubinemia and 2.8% of the study subjects required exchange transfusion.Conclusions: From the present study, cord serum albumin level of ?2.8g/dl has a correlation with incidence of significant hyperbilirubinemia in term newborns. So, this ?2.8g/dl of cord serum albumin level can be used as risk indicator to predict the development of significant hyperbilirubinemia.

17.
Article | IMSEAR | ID: sea-204497

ABSTRACT

Background: The aims of the study were to estimate the incidence of reactive thrombocytosis(RT) among febrile children aged 2 months to 12 years and to identify any differences in age group and gender in mounting thrombocytosis as a response to infection, to identify if thrombocytosis occurred preferentially in any particular group of serious bacterial infections(SBI), to compare thrombocytosis with other parameters like total white cell count, C-reactive protein(CRP), cultures etc. and to assess the utility of platelet count as a potential predictor of serious bacterial infection.Methods: This was a prospective study done in Institute of Child Health and Hospital for children, Madras Medical College from September 2015 to July 2016. Inclusion criteria: Children aged 2 months to 12 years with symptoms of fever less than 6 days admitted in the paediatric wards and those seen at the outpatient department. Exclusion criteria: Children having received parenteral antibiotics.Results: Of the 500 children, 142 (28.4%) had reactive thrombocytosis. RT was mild in 120 children (24%), moderate in 16 children (3.2%), severe in 4(0.8%) and extreme in two children (0.4%). This study showed that 36.48% (85 / 233) of children under 1 year had RT (p = 0.0002).There was no significant sex related difference in mounting RT. Out of 500 children included in the study, serious bacterial infection was diagnosed among 171 children (34.2%).Pneumonia (n=100) was the most common SBI followed by urinary tract infections (n=33), meningitis (n=23), sepsis (n=15). This study showed that RT has a moderate ability to predict serious bacterial infections (AUC=0.78; PPV-75.35%).Conclusions: Incidence of reactive thrombocytosis in febrile children aged 2 months to 12 years is 28.4%. It occurs more frequently in infants and without any sex predilection. RT is associated with leucocytosis, positive CRP, positive Chest X ray findings, positive urine culture and positive CSF findings. This shows that RT has a moderate ability in predicting SBI in children.

18.
Article | IMSEAR | ID: sea-214670

ABSTRACT

Hypertensive disorders complicate 2% to 8% of pregnancies globally. They are one of the leading causes of maternal mortality responsible for 16% of maternal deaths. Preeclampsia is a pregnancy specific syndrome whose pathophysiologic features have not been clearly established, but research during past two decades has suggested that maternal endothelial damage and improper placental development are involved in the genesis of preeclampsia. Fibronectin is known to be a marker of endothelial dysfunction, which occurs in early gestation in women who develop preeclampsia in later gestation and hence levels of fibronectin may vary in first trimester itself in such women. We wanted to examine the usefulness of single biomarker ‘plasma fibronectin’ in screening of pregnant women for gestational hypertension/preeclampsia, study the difference in fibronectin levels in early versus late onset gestational hypertension/preeclampsia and evaluate its levels in preeclampsia with severe features.METHODS200 antenatal women with singleton pregnancy, who were normotensive were enrolled in the study and plasma fibronectin levels were measured at 10-12 weeks of gestation. Women were followed throughout pregnancy and 12 weeks postpartum. Plasma fibronectin levels were compared between normotensive women and women who developed gestational hypertension/preeclampsia.RESULTSThe mean values of plasma fibronectin are significantly higher in group who developed gestational hypertension/preeclampsia compared to group who remained normotensive (167+/-81 vs 114+/-58; p<0.05). The mean value in group with early onset disease as well as preeclampsia with severe features is higher than that of group with late onset disease and preeclampsia without severe features respectively. But the difference is not statistically significant.CONCLUSIONSStudy showed that plasma fibronectin could be used as a marker for early prediction of gestational hypertension/ preeclampsia.

19.
Braz. j. med. biol. res ; 53(8): e9469, 2020. tab, graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1132537

ABSTRACT

This is a retrospective, single-center observational study to explore the predictors of chest drainage for neonatal pneumothorax. A total of 183 neonates (age ≤28 days) who presented to the Children's Hospital of Soochow University between January 1, 2015 and December 31, 2018 for pneumothorax or developed pneumothorax during a hospital stay were included. Demographic data, clinical presentation, and imaging characteristics of neonatal pneumothorax were collected and analyzed. We used univariate and multivariate logistic regression analyses to determine significant predictors of chest drainage of pneumothorax in neonates. Pneumothorax occurred within 24 h after birth in 131 (71.6%) cases, between 24 and 48 h after birth in 41 (22.4%) cases, and 48 h after birth in 11 (6.0%) cases. Univariate and multivariate logistic regression analyses revealed that lung collapse ≥1/3 on initial chest X-ray (OR 4.99, 95%CI 2.25-11.07), chest retractions (OR 8.12, 95%CI 2.88-22.89), cyanosis (OR 2.25, 95%CI 1.08-4.66), and frothing from mouth (OR 2.49, 95%CI 1.12-5.49) (P<0.05 for all) were significant predictors of the need for chest drainage due to pneumothorax. In conclusion, the thorough evaluation of the above predictive factors can guide treatment and improve patient outcome.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Pneumothorax , Meconium Aspiration Syndrome , Retrospective Studies , Dyspnea , Length of Stay
20.
Article in Chinese | WPRIM | ID: wpr-828106

ABSTRACT

OBJECTIVE@#Loss of response (LOR) has become an important clinical problem in patients with Crohn's disease receiving infliximab (IFX) treatment. Neutrophil-lymphocyte ratio (NLR) has been shown to correlate with the activity of inflammatory bowel disease (IBD), and NLR at the 14th week of IFX therapy potentially allows the prediction of sustained response to IFX in Crohn's patients. The aim of this study was to explore whether NLR at the 14th week of IFX therapy could predict the occurrence of LOR to IFX in Crohn's patients.@*METHODS@#Between January, 2012 and December, 2016, 54 patients with Crohn's disease underwent a 52-week treatment with IFX and successfully achieved response to the induction treatment in Zhongnan Hospital. We retrospectively examined their medical records and assessed the association between NLR at 14 weeks and LOR during IFX therapy.@*RESULTS@#Of the 54 patients, 15 (27.8%) showed LOR to IFX during the follow-up. We noted a significant increase in NLR at 14 weeks in the patients with LOR as compared with the patients with sustained response to IFX[3.51 (2.9-6.25) 1.77 (1.23-2.56), =0.00]. Receiver-operating characteristic analysis showed that at the cut-off value of 2.75, NLR at 14 weeks was predictive of LOR within 52 weeks of IFX therapy with a sensitivity of 93.33% and a specificity of 84.62%, and the area under curve (AUC) of NLR was 0.903 (0.731-0.959). Univariate analysis revealed a significant correlation between relapse-free survival and the NLR at 14 weeks (=0.00). Multivariate analysis identified NLR at 14 weeks as an independent prognostic factor for LOR with a hazard ratio of 1.851 (95% :1.096-3.026, =0.021).@*CONCLUSIONS@#NLR at the 14th week during IFX therapy is a useful predictor for LOR in patients with Crohn's disease.


Subject(s)
Crohn Disease , Gastrointestinal Agents , Humans , Infliximab , Lymphocytes , Neutrophils , Retrospective Studies , Treatment Outcome
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