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1.
Braz. j. biol ; 83: e249104, 2023. tab
Article in English | LILACS, VETINDEX | ID: biblio-1339389

ABSTRACT

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.


Resumo O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis ​​pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados ​​usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p ˂ 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui que níveis elevados de homocisteína plasmática são fator de risco independente para doença cardíaca coronária, independentemente dos fatores de risco convencionais, e pode ser usado como um indicador para prever a possibilidade futura de aparecimento de DCV.


Subject(s)
Humans , Adult , Middle Aged , Coronary Disease/embryology , Hyperhomocysteinemia/diagnosis , Hyperhomocysteinemia/epidemiology , Case-Control Studies , Risk Factors , Fasting
2.
Rev. med. (Säo Paulo) ; 101(4): e-177013, jul.-ago. 2022.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1391671

ABSTRACT

Objetivo: Avaliar o risco de suicídio e a existência de comportamento suicida entre acadêmicos nos estágios inicial, intermediário e final do curso de Medicina de uma universidade particular e analisar os fatores de risco possivelmente associados à ideação suicida nessa população. Materiais e métodos: Foram analisados, em estudo transversal, 376 estudantes. Todos os participantes responderam questionário autopreenchível, por meio da plataforma eletrônica Google Forms, composto por 3 seções: perguntas sobre questões pessoais, perguntas do Questionário de Comportamento Suicida Revisado (Suicide Behavior Questionnaire Revised: SBQ-R) e do Inventário de Ideação Suicida Positiva e Negativa (Positive and Negative Suicide Ideation: PANSI). Resultados: 34% dos alunos eram do 1º ano, outros 34% do 3º ano e 32%, do 6º ano. 71,8% da população do estudo é composta pelo sexo feminino e 39,6% possui idade entre 21 e 24 anos. Na classificação de risco de suicídio segundo o PANSI, 31,7% dos estudantes apresentaram médio risco e 5,3%, alto risco. Na análise por etapa do curso, o 3º ano apresentou-se com maior porcentagem em alto risco (70,0%). De acordo com o SBQ-R, 37,2% dos estudantes da população total apresentaram comportamento suicida. Dentre as variáveis analisadas, orientação sexual, história de bullying na infância, conflito com responsáveis, história familiar de transtorno mental, uso de drogas ilícitas, história de violência sexual e ansiedade autorreferida foram consideradas como fatores de risco para suicídio na população total e na subanálise feita por ano de faculdade. Conclusão: A população do estudo apresenta aumento das taxas de ideação e comportamento suicida em relação a população geral. Assim, é necessária a implantação de medidas dentro das universidades para promover a saúde mental e diminuir aspectos estressantes sobre os acadêmicos. [au]


Objective : The purpose of this study is to assess the risk of suicide and the existence of suicidal behavior among academics in the early, intermediate and final stages of a private medical school, and also to analyze risk factors possibly associated with suicidal ideation in this population. Methods: This is a cross-sectional study with 376 medical students. All the participants answered a self-fillable questionnaire through the electronic platform Google Forms composed of 3 sections: questions about personal issues; questions of the Suicide Behavior Questionnaire Revised (SBQ-R); and of the Positive and Negative Suicide Ideation (PANSI) Inventory. Results: 34% of the students were in the 1st year of graduation, 34% in the 3rd year, and 32%, in the 6thyear. 71.8% of the population is female and 39.6% are between 21 and 24 years old. In the suicide risk classification according to PANSI, 31.7% of the students were in the medium risk group and 5.3% in high risk group. In the analysis per year, the 3rd year showed a greater percentage of high risk (70.0%). According to the SBQ-R classification of suicide risk, 37.2% of students out of the total population revealed suicidal behavior. Among the analyzed variables, sexual orientation, history of childhood bullying, domestic conflict, presence of mental disorders in family, use of illicit drugs, history of sexual violence and self-reported anxiety were considered as risk factors for suicide. The highlighted results revealed the same pattern when analyzed per year of college. Conclusion: The survey population has increased rates of suicidal negative ideation and behavior compared to the general population. Therefore, it is necessary to implement programs in colleges to promote a greater state of well-being and reduce stressful aspects in academics. [au]

3.
Infectio ; 26(2): 161-167, Jan.-June 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1356263

ABSTRACT

Resumen Objetivo: Determinar los factores asociados, las características clínicas, microbiológicas y perfiles de resistencia en las infecciones sintomáticas de tracto urinario asociado a catéter (ISTU-AC) en los dos Instituciones de alto nivel de complejidad. Materiales y métodos: Se llevó a cabo un estudio de casos y controles. Se incluyeron todos los pacientes con más de 48 horas de hospitalización con inserción de catéter urinario y se recolectaron todas las variables clínicas y microbiológicas de cada paciente. Se incluyeron 446 pacientes, 223 con infección sintomática del tracto urinario asociado a catéter. El análisis multivariado se realizó por medio de regresión logística. Resultados: Se evidenció una mayor proporción de hombres en los controles (60,5%) en comparación con los casos (51,1%), la mediana de la edad fue muy similar para los dos grupos de estudio. Se evidenció por el análisis de regresión logística multivariado que la estancia en UCI (OR 2,176; IC de 95% 1,332 - 3,555), más de 10 días de catéter urinario (OR 2,907; IC de 95% 1,744 - 4,846) y la terapia antibiótica previa (OR 0,060; IC de 95% 0,037 - 0,103) fueron los principales factores asociados con la ocurrencia de ISTU-AC. No se encontró asociación entre presentar el evento de interés y la edad, esta variable no está relacionada con la pre sencia de infecciones intrahospitalarias. Es probable que las comorbilidades, presentes con más frecuencia en el adulto mayor, hayan sobrepasado el efecto de la edad en esos estudios. La asociación con género no fue identificada como un factor de riesgo, lo cual podría esperarse, dado que el uso de la sonda vesical hace equiparable el riesgo entre los hombres y las mujeres. Conclusiones: Este estudio mostró que la infecciones sintomáticas de tracto urinario asociado a catéter sigue siendo la entidad más frecuente) en el ámbito hospi talario, poniendo en riesgo la seguridad de los pacientes y aumentando tanto las tasas de morbi-mortalidad


Summary Objective: To determine the associated factors, clinical and microbiological characteristics, and resistance profiles in symptomatic urinary tract infections associated with catheters in the two institutions with a high level of complexity. Materials and methods: A case-control study was carried out. All patients with more than 48 hours of hospitalization with urinary catheter insertion were included and all the clinical and microbiological variables of each patient were collected. 446 patients were included, 223 with symptomatic urinary tract infection associated with a catheter. The multivariate analysis was carried out by means of logistic regression. Results: A greater proportion of men was evidenced in the controls (60.5%) compared to the cases (51.1%), the median age was very similar for the two study groups. It was evidenced by the multivariate logistic regression analysis that the stay in the ICU (OR 2.176; 95% CI 1.322 - 3.555), more than 10 days of urinary catheter (OR 2.907; 95% CI 1.744 - 4.846) and antibiotic therapy previous (OR 0.060; 95% CI 0.037 - 0.103) were the main factors associated with the occurrence of CA-UTI. No association was found between presenting the event of interest and age, this variable is not related to the presence of intrahospital infections. Co morbidities, which are more frequently present in the elderly, are likely to have outweighed the effect of age in these studies. The association with gender was not identified as a risk factor, which could be expected, since the use of the urinary catheter makes the risk comparable between men and women. Conclusions: This study showed that symptomatic urinary tract infections associated with catheters are still a frequent entity in the hospital setting, putting the safety of patients at risk and increasing both morbidity and mortality rates

4.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1398249

ABSTRACT

Señor editor: Actualmente, los estudios publicados sobre factores de riesgo para el desarrollo de preeclampsia no incluyen la altura sobre el nivel del mar del lugar de residencia. La incidencia de preeclampsia a nivel del mar tiene un riesgo de presentación 17 al 21%, mientras que en zonas de mayor altitud esta cifra se triplica, probablemente por los cambios fisiopatológicos que produce la elevada altitud (>2500 m.s.n.m.) sobre el cuerpo humano y por ende en mujeres gestantes.


Dear Editor: Currently, published studies on risk factors for the development of preeclampsia do not include the height above sea level of the place of residence. The incidence of preeclampsia at sea level has a risk of presentation 17 to 21%, while in higher altitude areas this figure triples, probably due to the fisiopathological changes that high altitude (>2500 m.a.s.l.) produces on the human body and therefore in pregnant women.

5.
Organ Transplantation ; (6): 240-2022.
Article in Chinese | WPRIM | ID: wpr-920855

ABSTRACT

Objective To investigate the risk factors of central airway stenosis after lung transplantation. Methods Clinical data of 155 recipients undergoing lung transplantation in Wuxi People's Hospital Affiliated to Nanjing Medical University from July 2016 to December 2017 were retrospectively analyzed. According to the incidence of central airway stenosis following lung transplantation, all recipients were divided into the stenosis group (n=36) and control group (n=119). The incidence of central airway stenosis after lung transplantation was summarized. The risk factors of central airway stenosis after lung transplantation were assessed by univariate and multivariate logistic regression analyses. Results Among 155 lung transplant recipients, 36 cases (23.2%) developed central airway stenosis. The average incidence time was (53±13) d after lung transplantation. Univariate analysis demonstrated that bilateral lung transplantation, grade 3 primary graft dysfunction (PGD), airway fungal infection, long cold ischemia time, long mechanical ventilation time and long intensive care unit (ICU) stay were the risk factors for central airway stenosis after lung transplantation (all P < 0.05). Multivariate analysis showed that airway fungal infection, long cold ischemia time and long mechanical ventilation time were the independent risk factors for central airway stenosis after lung transplantation (all P < 0.05). Conclusions Airway fungal infection after lung transplantation, long cold ischemia time and long mechanical ventilation time probably lead to central airway stenosis after lung transplantation. Active preventive measures and intimate monitoring should be taken to improve the quality of life of the recipients after lung transplantation.

6.
Article in Chinese | WPRIM | ID: wpr-936071

ABSTRACT

Objective: To explore the incidence and risk factors of postoperative surgical site infection (SSI) after colon cancer surgery. Methods: A retrospective case-control study was performed. Patients diagnosed with colon cancer who underwent radical surgery between January 2016 and May 2021 were included, and demographic characteristics, comorbidities, laboratory tests, surgical data and postoperative complications were extracted from the specialized prospective database at Department of General Surgery, Peking Union Medical College Hospital. Case exclusion criteria: (1) simultaneously multiple primary colon cancer; (2) segmental resection, subtotal colectomy, or total colectomy; (3) patients undergoing colostomy/ileostomy during the operation or in the state of colostomy/ileostomy before the operation; (4) patients receiving natural orifice specimen extraction surgery or transvaginal colon surgery; (5) patients with the history of colectomy; (6) emergency operation due to intestinal obstruction, perforation and acute bleeding; (7) intestinal diversion operation; (8) benign lesions confirmed by postoperative pathology; (9) patients not following the colorectal clinical pathway of our department for intestinal preparation and antibiotic application. Univariate analysis and multivariate analysis were used to determine the risk factors of SSI after colon cancer surgery. Results: A total of 1291 patients were enrolled in the study. 94.3% (1217/1291) of cases received laparoscopic surgery. The incidence of overall SSI was 5.3% (69/1291). According to tumor location, the incidence of SSI in the right colon, transverse colon, left colon and sigmoid colon was 8.6% (40/465), 5.2% (11/213), 7.1% (7/98) and 2.1% (11/515) respectively. According to resection range, the incidence of SSI after right hemicolectomy, transverse colectomy, left hemicolectomy and sigmoid colectomy was 8.2% (48/588), 4.5% (2/44), 4.8% (8 /167) and 2.2% (11/492) respectively. Univariate analysis showed that preoperative BUN≥7.14 mmol/L, tumor site, resection range, intestinal anastomotic approach, postoperative diarrhea, anastomotic leakage, postoperative pneumonia, and anastomotic technique were related to SSI (all P<0.05). Multivariate analysis revealed that anastomotic leakage (OR=22.074, 95%CI: 6.172-78.953, P<0.001), pneumonia (OR=4.100, 95%CI: 1.546-10.869, P=0.005), intracorporeal anastomosis (OR=5.288, 95%CI: 2.919-9.577,P<0.001) were independent risk factors of SSI. Subgroup analysis showed that in right hemicolectomy, the incidence of SSI in intracorporeal anastomosis was 19.8% (32/162), which was significantly higher than that in extracorporeal anastomosis (3.8%, 16/426, χ(2)=40.064, P<0.001). In transverse colectomy [5.0% (2/40) vs. 0, χ(2)=0.210, P=1.000], left hemicolectomy [5.4% (8/148) vs. 0, χ(2)=1.079, P=0.599] and sigmoid colectomy [2.1% (10/482) vs. 10.0% (1/10), χ(2)=2.815, P=0.204], no significant differences of SSI incidence were found between intracorporeal anastomosis and extracorporeal anastomosis (all P>0.05). Conclusions: The incidence of SSI increases with the resection range from sigmoid colectomy to right hemicolectomy. Intracorporeal anastomosis and postoperative anastomotic leakage are independent risk factors of SSI. Attentions should be paid to the possibility of postoperative pneumonia and actively effective treatment measures should be carried out.


Subject(s)
Case-Control Studies , Colonic Neoplasms/surgery , Humans , Retrospective Studies , Risk Factors , Surgical Wound Infection/etiology
7.
Article in Chinese | WPRIM | ID: wpr-936055

ABSTRACT

Adenocarcinoma of esophagogastric junction (AEG) is at a special anatomic site with obviously higher morbidity of postoperative complication than gastric cancers at other sites. Postoperative quality of life and survival rate are influenced by the occurrence of complications. Moreover, the perioperative complications are associated with multiple factors such as patient factors (advanced age, obesity and preoperative nutritional status), surgical factors (surgical route, surgical procedure, resection range and prophylactic multivisceral resection), tumor factors (size, stage) etc. Optimizing perioperative management and formulating standardized surgical methods are the key points to prevent postoperative complications of AEG. In conclusion, we should strive to ensure the radical resection and reduce the occurrence of postoperative complications in order to truly benefit patients.


Subject(s)
Adenocarcinoma/pathology , Esophageal Neoplasms/pathology , Esophagogastric Junction/surgery , Gastrectomy , Humans , Neoplasm Staging , Postoperative Complications/surgery , Quality of Life , Retrospective Studies , Stomach Neoplasms/pathology
8.
Article in Chinese | WPRIM | ID: wpr-936044

ABSTRACT

Objective: To explore the independent risk factors of lymph node metastasis (LNM) in early gastric cancer, and to use nomogram to construct a prediction model for above LNM. Methods: A retrospective cohort study was conducted. Inclusion criteria: (1) primary early gastric cancer as stage pT1 confirmed by postoperative pathology; (2) complete clinicopathological data. Exclusion criteria: (1) patients with advanced gastric cancer, stump gastric cancer or history of gastrectomy; (2) early gastric cancer patients confirmed by pathology after neoadjuvant chemotherapy; (3) other types of gastric tumors, such as lymphoma, neuroendocrine tumor, stromal tumor, etc.; (4) primary tumors of other organs with gastric metastasis. According to the above criteria, 1633 patients with early gastric cancer who underwent radical gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital First Medical Center from December 2005 to December 2020 were enrolled as training set, meanwhile 239 patients with early gastric cancer who underwent gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital Fourth Medical Center from December 2015 to December 2020 were enrolled as external validation set. Risk factors of LNM in early gastric cancer were identified by using univariate and multivariate logistic regression analyses. A nomogram prediction model was established with significant factors screened by multivariate analysis. Area under the receiver operating characteristic curve (AUC) was used for assessing the predictive value of the model. Calibration curve was drawn for external validation. Results: Among 1633 patients in training set, the mean number of retrieved lymph nodes was 20 (13-28), and 209 patients (12.8%) had lymph node metastasis. Univariate analysis showed that gender, resection range, tumor location, tumor morphology, lymph node clearance, vascular invasion, lymphatic cancer thrombus, tumor length, tumor differentiation, microscopic presence of signet ring cells and depth of tumor invasion were associated with LNM (all P<0.05). Multivariate analysis revealed that females, tumor morphology as ulcer type, vascular invasion, lymphatic cancer thrombus, tumor length≥3 cm, deeper invasion of mucosa, and poor differentiation were independent risk factors for LNM in early gastric cancers (all P<0.05). Receiver operating characteristic curve indicated that AUC of training set was 0.818 (95%CI: 0.790-0.847) and AUC of external validation set was 0.765 (95%CI: 0.688-0.843). The calibration curve showed that the LNM probability predicted by nomogram was consistent with the actual situation (C-index: 0.818 in training set and 0.765 in external validation set). Conclusions: Females, tumor morphology as ulcer type, vascular invasion, lymphatic cancer thrombus, tumor length≥3 cm, deeper invasion of mucosa and poor differentiation are independent risk factors for LNM of early gastric cancer. The establishment of a nomogram prediction model for LNM in early gastric cancer has great diagnostic value and can provide reference for treatment selection.


Subject(s)
Female , Gastrectomy , Humans , Lymph Node Excision , Lymph Nodes , Lymphatic Metastasis , Nomograms , Retrospective Studies , Risk Factors , Stomach Neoplasms/surgery
9.
Article in Chinese | WPRIM | ID: wpr-935755

ABSTRACT

Objective: To understand the relationship between female breast cancer and occupational risk factors in Beijing, and provide scientific basis for the formulation of prevention strategies and measures. Methods: From June to December 2019, A 1: 1 case-control study was adopted, eight medical institutions in Beijing were selected as the research objects. Patients with breast cancer diagnosed by medical institutions were selected as case group and non breast cancer patients in the same medical institution as control group. A total of 973 subjects were included, including 495 in the case group and 478 in the control group. A one-to-one survey was conducted using a questionnaire uniformly compiled by the Beijing Centers for Disease Control and Prevention. The survey content mainly includes basic demographic characteristics and occupational risk factors. The Trait Coping Style Questionnaire (TCSQ) was used to investigate the corresponding methods, including two aspects: positive coping and negative coping. First, chi square test or Wilcoxon rank sum test were used for univariate analysis. Then Lasso regression was used to screen the risk factors of breast cancer. Finally, the risk factors were screened by multivariate logistic regression analysis. Results: Education lovel was 49.64%, body mass index (BMI) was 18.4~23.9 kg/m(2), accounting for 48.82%, marital status ws 84.48%. Compared with no night shift history, there was a significant increase in risk of breast cancer at night shift history (OR=1.70, 95% CI: 1.25~2.30, P<0.05) . Compared with most of the sitting posture and sometimes standing, the risk of breast cancer was increased, and the difference was statistically significant (OR=2.01, 95%CI: 1.40~2.90, P<0.05) . Conclusion: In the occupation risk factors, night shift work and working posture are related to the incidence of breast cancer in women, establishing a good schedule and avoiding long standing can effectively prevent and reduce the occurrence of breast cancer.


Subject(s)
Beijing , Breast Neoplasms/epidemiology , Case-Control Studies , Female , Humans , Logistic Models , Risk Factors
10.
Article in Chinese | WPRIM | ID: wpr-933739

ABSTRACT

Objective:To investigate the prevalence of hyperuricemia (HUA), patients′ awareness of HUA, and related factors among elderly in community.Methods:The health check-up data of 6 897 residents aged over 65 years in Gumei Community of Shanghai were collected from January 2019 to January 2020. There were 1 156 subject with increased serum uric acid levels (HUA group) and 5 741 with normal uric acid levels (non-HUA group). The differences of clinical indicators between HUA group and non-HUA group were analyzed and the risk factors of HUA was determined by multivariate logistic stepwise regression. A questionnaire survey on the knowledge of HUA and the adoption of relevant health behaviors was conducted among HUA patients.Results:The overall prevalence was 16.8% (1 156/6 897) in this population. The prevalence in males was significantly higher than that in females[26.4%(842/3 195) vs. 8.5%(314/3 702), P<0.001); and the prevalence in females increased with age (χ 2=7.56, P=0.023). Body mass index(BMI), waist circumference(WC), total cholesterol(TC), triglyceride(TG), serum creatinine, alanine aminotransferase(ALT) and albumin/urine creatinine ratio(UACR) in the HUA group were significantly higher than those in the non-HUA group, while estimated glomerular filtration rate(eGFR) and high-density lipoprotein(HDL) were lower than those in the non-HUA group (all P<0.01). The prevalence of hypertension, decreased renal function, overweight or obesity, abdominal obesity, fatty liver and renal cyst in HUA group was significantly higher than that in non-HUA group (all P<0.01). High values of TG, low-density lipoprotein(LDL), WC, hypertension and fatty liver were risk factors for HUA( OR=1.14, 1.20, 1.03, 1.43, 2.19; P<0.01); while female gender, eGFR, HDL and glycosylated hemoglobin A1c(HbA1c) were protective factors for HUA( OR=0.32, 0.94, 0.65, 0.78; P<0.01). The questionnaire survey was conducted among 1 090 HUA patients, and the results showed that 73.2% (798 cases) were aware of the disease after the health check-up results released; only 30.9% (337 cases) knew the diagnostic criteria of HUA, 21.1% (230 cases) knew that HUA needed life-long follow-up care, 56.3% (614 cases), 49.2% (536 cases) and 47.9% (522 cases) thought that HUA should eat less seafood, broth and soya bean products, 17.0%(185 cases) were atcohol drinker and the awareness rates of above questions in patients with gout were higher than those in patients without gout ( P<0.05). Conclusion:The study shows that the prevalence of HUA among the elderly in Gumei community of Shanghai is high, and the HUA related knowledge levels and health behavior performance are not ideal, especially for HUA patients without gout, therefore health education should be strengthened for elderly residents in the community.

11.
Article in Chinese | WPRIM | ID: wpr-933631

ABSTRACT

Objective:To explore the risk factors of lymph node metastasis (LNM) in early gastric cancer (ECG), and establish a risk-prediction model based on LNM.Method:Four hundred and twenty-seven EGC patients undergoing curative radical gastrectomy were enrolled in this study. The risk factors for LNM of ECG were analyzed with Logistic regression. LNM risk was stratified and risk-predicting model was established. The risk-predicting model was measured by area under ROC curve. According to the same standard, clinical data of 133 patients with EGC who underwent radical surgery were selected for external verification of the model.Results:The frequency of LNM was 13.3% (32/427) in EGC patients. The LNM ratio of intramucosal carcinoma and submucosal carcinoma was 1.3% (3/237), 15.3% (29/190) respectively. Ulcer presence, tumor size >2 cm, undifferentiated tumor, submucosal invasion, neural invasion, and vascular tumor thrombus were significantly associated with LNM in EGC patients ( χ2=3.408, 16.379, 4.808, 29.804, 25.305, 47.120, respectively P<0.05). Multivariate analysis suggested that ulcer presence, tumor size >2 cm, depth of invasion, neural invasion, and vascular tumor thrombus were independent predictors of LNM in EGC patients, ( OR=0.326, 2.924, 11.824, 13.047, 7.756, respectively P<0.05). LNM predicting model is established, P=e

12.
Chinese Journal of Dermatology ; (12): 123-128, 2022.
Article in Chinese | WPRIM | ID: wpr-933522

ABSTRACT

Objective:To investigate clinical features of and risk factors for scleroderma-like cutaneous graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation.Methods:Clinical data were collected from 24 patients with scleroderma-like cutaneous GVHD in Department of Dermatology, Peking University People′s Hospital from 2014 to 2019. Clinical features, treatment, prognosis, and possible factors influencing the development of scleroderma-like cutaneous GVHD were analyzed retrospectively.Results:Among the 24 patients, 11 were males, and 13 were females, aged 33 ± 12 years; 20 were human leukocyte antigen (HLA) -identical recipients, 4 were HLA-haploidentical recipients; GVHD occurred 18.5 (8.0, 30.9) months after transplantation. Nineteen patients had discontinued anti-rejection therapy or received low-dose anti-rejection drugs before the onset of GVHD. Fifteen patients presented with generalized scleroderma-like lesions, 1 with linear scleroderma-like lesions, 5 with morphea-like lesions, and 3 with fasciitis-like lesions. None of the 15 patients with generalized scleroderma-like GVHD had Raynaud syndrome. Thirteen patients were accompanied by graft rejection in other systems, 8 had joint mobility limitations, and 1 developed cutaneous squamous cell carcinoma secondary to chronic skin ulcers. All patients were treated with systemic glucocorticoids and immunosuppressive agents, and 11 also with topical glucocorticoids. An intensive follow-up was carried out in 11 patients, of whom 3 achieved marked improvement, 4 achieved improvement, 2 experienced exacerbation, and 2 died. A total of 223 patients with non-sclerodermatous cutaneous GVHD admitting during the same period served as controls, and the proportion of HLA-identical patients was significantly higher in the scleroderma-like cutaneous GVHD group (20/24, 83.3%) than in the non-sclerodermatous cutaneous GVHD group (47/223, 21.1%; P < 0.001) . Conclusions:Scleroderma-like cutaneous GVHD commonly occurs late, and can mimic clinical manifestations of all 4 types of spontaneous scleroderma. HLA-identical transplants, premature discontinuation or excessive dose reduction of anti-rejection drugs may be risk factors for scleroderma-like cutaneous GVHD.

13.
Article in Chinese | WPRIM | ID: wpr-932981

ABSTRACT

Objective:To investigate the correlation between fasting plasma glucose (FPG) and new-onset carotid plaque through latent class trajectory models.Methods:A total of 953 observation objects came from the first affiliated hospital of Zhengzhou University in accordance with the inclusion criteria. According to the FPG values of the observed subjects during the annual physical examination from January 2017 to December 2019, the following four different FPG trajectories groups were determined by latent class trajectory modelling tools: the low-stable group, the medium stable group, the medium-high stable group, and the high stable group. Carotid plaque incidence in each group was followed up in 2020 to compare the differences of the cumulative incidences of the four groups. The Cox proportional risk regression model was used to analyze the correlation between different FPG trajectories and new-onset carotid plaque.Results:The incidence of carotid plaque increased with the increase of FPG trajectories by 11.13%, 19.70%, 23.44%, 23.81%, respectively, with significance ( P<0.001). After adjusting gender, age, BMI and other confounding factors with the cox proportional risk regression model, the risk of carotid plaque in the FPG medium stable group, medium and high stable group, high-stable group was still 1.895 (95% CI: 1.296-2.769), 2.273 (95% CI: 1.241-4.161), 2.527 (95% CI: 1.219-5.241) times of the low stable group (all P<0.05). Conclusion:The long-term high FPG levels are independent risk factors for the incidence of carotid plaque, and controlling FPG at a low level steadily can reduce the risk of carotid plaque.

14.
Article in Chinese | WPRIM | ID: wpr-932971

ABSTRACT

Objectives:To investigate the risk factors associated with carotid atherosclerosis based on a retrospective longitudinal monitoring cohort study of healthy subjects during physical examinations.Methods:From 2005 to 2019, a total of 3 344 healthy adults who received at least five routine physical examinations at the Beijing Physical Examination Center and had no carotid atherosclerosis for the first time were selected as the research objects, including 1 714 males (51.25%).The average age of the male and female participants was 47.14 and 47.56 years old, respectively. A retrospective longitudinal monitoring cohort was established and the incidence of carotid atherosclerosis was documented during the follow-up. A Cox regression model was used to analyze the risk factors related to carotid atherosclerosis.Results:At the follow-up of 5.17 years, 2 038 patients had developed carotid atherosclerosis (60.94%, 66.69% in males and 54.91% in females). Multivariate Cox regression analysis showed that advanced age (>60 years old, HR=18.973, 95% CI: 12.353-29.139), female ( HR=0.639, 95% CI: 0.582-0.701), hypertension ( HR=1.166, 95% CI: 1.047-1.298), and low estimated glomerular filtration rate ( HR=1.011, 95% CI: 1.009-1.013) were associated with the onset of carotid atherosclerosis. Conclusions:The main factors influencing the development of carotid atherosclerosis included age, sex, blood pressure, and estimated glomerular filtration rate.

15.
Article in Chinese | WPRIM | ID: wpr-932945

ABSTRACT

Objective:To analyze the screening status of high-risk population of chronic obstructive pulmonary disease (COPD) in areas where “Happy Breathing” project was carried out.Method:There were 1 008 518 COPD screening questionnaires (COPD-SQ) filled out in 18 pilot areas of “Happy Breathing” program from November 2017 to October 2019. Within subjects who scored 16 points or more with COPD-SQ, 63 523 of them underwent pulmonary function tests before bronchodilator inhalation. Stratified analysis, chi-square test and other statistical methods were performed to analyze the distribution of COPD high-risk groups, the prevalence of COPD among high-risk groups and risk factors of COPD.Results:Results in this study suggested that the high-risk population of COPD accounted for 18.99% (191 498/1 008 518) of the population who received the questionnaire screening. Among the high-risk population who received lung function test, 31.59% (20 070/63 523) were screened and diagnosed as COPD patients. As for risk factors of COPD, the proportion of high-risk population was higher in people with a smoking index ≥600 compared with never-smokers (54.20% vs 12.60%), and the prevalence of COPD was also higher in people with a smoking index ≥600 (35.62% vs 25.22%); people who were exposed to second-hand smoke almost every day also showed an increased proportion of high-risk groups (27.39% vs 10.97%) and a high prevalence of COPD (31.36% vs 27.93%) than those without second-hand smoke exposure; the presence or absence of biofuel exposure also caused the difference in the proportion of high-risk groups (33.92% vs 13.11%); compared with people without a family history of respiratory diseases, the proportion of high-risk groups (56.38% vs 16.42%) and the prevalence of COPD in high-risk groups (32.40% vs 29.19%) were both higher in those with family history of respiratory diseases.Conclusion:The high-risk group of COPD accounts for a high proportion of the screened population, suggesting that the “Happy Breathing” project is feasible and necessary in COPD screening, which is helpful for the development of COPD diagnosis and treatment.

16.
Article in Chinese | WPRIM | ID: wpr-932699

ABSTRACT

Objective:To analyze the failure patterns and influencing factors of stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer (ES-NSCLC).Methods:113 cases of ES-NSCLC treated with SABR from 2012 to 2020 in our hospital were retrospectively analyzed. The failure patterns, recurrence time, recurrence site and influencing factors were analyzed. Kaplan-Meier method was used to calculate the local recurrence rate, regional lymph node recurrence rate and distant metastasis rate. Univariate analysis was performed by Log-rank test, and multivariate analysis was performed by Cox model.Results:The median follow-up time was 58 months (range: 6-108 months), and a total of 45 patients (39.8%) recurred. The median recurrence time was 36 months. Distant metastasis (DM) occurred in 31 patients (27.4%) and DM alone in 24 patients (21.2%). Local recurrence (LR) was developed in 12 patients (10.6%) and LR alone in 7(6.2%). Regional lymph node recurrence (RR) occurred in 11 patients (9.7%) and RR alone in 6 patients (5.3%). LR combined with RR was observed in 1 case (0.9%), LR combined with DM in 3(2.7%), LR combined with RR and DM in 1(0.9%), and RR combined with DM in 3(2.7%). The 1-, 2-, 3-, 4-and 5-year recurrence rates were 5.4%, 16.6%, 27.5%, 44% and 51.2%, respectively. Univariate and multivariate analyses suggested that EGFR mutation was an influencing factor of high recurrence rate.Conclusion:ES-NSCLC patients treated with SABR alone have a high recurrence rate, and DM is the most common mode of failure. Follow-up consolidation therapy is recommended, especially for EGFR mutation-positive NSCLC patients.

17.
Article in Chinese | WPRIM | ID: wpr-932682

ABSTRACT

Small cell lung cancer (SCLC) has the biological characteristics of high recurrence and metastasis. The brain is the common site of SCLC extrapulmonary metastasis. Prophylactic cranial irradiation (PCI) can effectively reduce the incidence of brain metastasis and prolong the overall survival of patients with limited SCLC. Nevertheless, nearly one third of patients develop brain metastases after PCI. This article reviews the risk factors of brain metastasis after PCI, aiming to determine which subgroup of patients with limited SCLC can benefit from PCI and provide reference for the clinical application of PCI.

18.
Chinese Critical Care Medicine ; (12): 250-254, 2022.
Article in Chinese | WPRIM | ID: wpr-931858

ABSTRACT

Objective:To investigate the effect of intensive care unit (ICU) admission model on acute kidney injury (AKI) development and the prognosis in patients with sepsis.Methods:Patients with sepsis admitted to the ICU of Xinjiang Uygur Autonomous Region People's Hospital from January 2019 to July 2020 were retrospectively analyzed. According to the ICU admission model, the patients were divided into emergency group (first admission or emergency transfer from relevant surgical departments) and delayed group (transferred from the general ward due to disease evolution). Patients were divided into AKI group and non-AKI group according to whether AKI was accompanied. The gender, age, underlying diseases, surgical history, heart rate, laboratory test indicators, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), organ failure and acute complications were collected. The incidence of AKI, 28-day mortality and length of ICU stay were recorded. Univariate and multivariate Logistic regression was used to analyze the risk factors of AKI in patients with sepsis.Results:A total of 185 patients with sepsis were enrolled, including 96 cases in the emergency group and 89 cases in the delayed group. 119 cases of AKI occurred while 66 cases without AKI development. The incidence of AKI within 7 days and the 28-day mortality of patients in the delayed group were significantly higher than those in the emergency group [AKI incidence rate: 77.53% (69/89) vs. 52.08% (50/96), 28-day mortality: 24.72% (22/89) vs. 10.42% (10/96), both P < 0.05], and the length of ICU stay was significantly longer than that of the emergency group (days: 18.70±7.29 vs. 14.56±4.75, P < 0.05). Univariate Logistic analysis showed that there were significant differences in age, diabetes, hypertension, organ failure, heart failure, APACHEⅡscore, SOFA score, white blood cell count (WBC), absolute neutrophil value, platelet count (PLT), blood lactate, total bilirubin, and ICU transferred from general wards between AKI group and non-AKI group. Multivariate Logistic regression analysis showed that transfer from general ward to ICU due to disease evolution was an independent risk factor for AKI in ICU sepsis patients [odds ratio ( OR) = 5.165, 95% confidence interval (95% CI) was 3.911-6.823, P < 0.001]. Conclusion:Septic patients transferred from general ward to ICU due to disease evolution are more likely to develop AKI, and also had a higher mortality and longer ICU stay. It may be an independent risk factor for AKI complicated by patients with sepsis in ICU.

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Chinese Critical Care Medicine ; (12): 161-166, 2022.
Article in Chinese | WPRIM | ID: wpr-931842

ABSTRACT

Objective:To investigate the risk factors of postoperative hypoxemia in patients admitted to intensive care unit (ICU) for resuscitation.Methods:Clinical data of 220 postoperative patients admitted to the ICU for resuscitation in Shandong Provincial Hospital Affiliated to Shandong University from June to August 2020 were collected and retrospectively analyzed. According to their oxygenation index within 30 minutes after admission to ICU, they were divided into hypoxemia group (oxygenation index≤ 300 mmHg, 1 mmHg≈0.133 kPa) and non-hypoxemia group (oxygenation index > 300 mmHg). Baseline data and perioperative indicators were compared between the two groups, and risk factors for early postoperative hypoxemia were analyzed. The improvement of oxygenation index of patients with hypoxemia in next morning after admission to ICU was observed, and the factors related to the improvement of hypoxemia were analyzed.Results:The incidence of hypoxemia was 36.8% (81/220) in the cohort. The majority cases of hypoxemia were from general surgery department, accounting for 42.0% (34/81). The incidence rate of hypoxemia from orthopaedic was the highest at 53.3% (16/30). Univariate analysis showed that body mass index (BMI), intraoperative hypoxemia, minimally invasive surgery were all risk factors of postoperative hypoxemia (test values were -2.566, 12.352 and 0.033; P values were 0.010, 0.000 and 0.019, respectively). Multivariate analysis showed that intraoperative hypoxemia and BMI were independent risk factors for postoperative hypoxemia [intraoperative hypoxemia: odds ratio ( OR) = 3.602, 95% confidence interval (95% CI) was 1.143-3.817, P = 0.001; BMI: OR = 1.119, 95% CI was 1.026-1.208, P = 0.036]. The improvement rate of hypoxemia next morning after admission to ICU was 63.0% (51/81). Pulmonary dysfunction was the independent risk factor for the improvement of hypoxemia ( OR = 0.200, 95% CI was 0.052-0.763, P = 0.019). Conclusions:Hypoxemia might occur early after surgery. Intraoperative hypoxemia and BMI were independent risk factors for postoperative hypoxemia.

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Article in Chinese | WPRIM | ID: wpr-931159

ABSTRACT

Objective:To explore the long-term prognosis evaluation value and risk factors of normal coronary computed tomography angiography (CCTA) in patients with suspected coronary heart disease (CHD).Methods:The clinical data of 332 patients with suspected CAD from June 2006 to July 2017 in the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed. All patients received more than 2 times of CCTA examination, and the baseline CCTA was normal. Patients were followed up for at least 4 years, and the endpoints were coronary neo-plaque on CCTA or cardiovascular events.Results:Among 332 patients, the interval time between baseline and follow-up CCTA and clinical follow-up time were (5.6 ± 0.5) and (9.8 ± 0.6) years, 304 patients had normal baseline and follow-up CCTA (group Ⅰ); 28 patients had normal baseline CCTA while abnormal follow-up (group Ⅱ), the patient found coronary neo-plaque, and the incidence of coronary neo-plaque was 8.4% (28/332). Two patients (0.6%, 2/332) suffered from cardiovascular events, all of whom were in group Ⅱ. In group Ⅱ, a total of 34 coronary neo-plaques were found on follow-up CCTA. Multivariate Logistic regression analysis results showed that smoking, hypertension and hyperlipidemia were the independent risk factors of normal baseline while follow-up CCTA with neo-plaque in patients with suspected CAD ( β = 0.84, 0.83 and 0.84; OR = 2.37, 2.32 and 2.33; P<0.01). Conclusions:The suspected CAD patients with normal baseline CCTA have a good long-term prognosis. However, the patients who have risk factors such as smoking, hypertension and hyperlipidemia should be taken seriously, especially the patients who have normal baseline while follow-up CCTA with neo-plaque.

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