scholarly journals Clinical Characteristics of Patients Infected With the Novel 2019 Coronavirus (SARS-Cov-2) in Guangzhou, China

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Yaping Wang ◽  
Baolin Liao ◽  
Yan Guo ◽  
Feng Li ◽  
Chunliang Lei ◽  
...  

Abstract Background The clinical manifestations and factors associated with the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections outside of Wuhan are not clearly understood. Methods All laboratory-confirmed cases with SARS-Cov-2 infection who were hospitalized and monitored in Guangzhou Eighth People’s Hospital were recruited from January 20 to February 10. Results A total of 275 patients were included in this study. The median patient age was 49 years, and 63.6% had exposure to Wuhan. The median virus incubation period was 6 days. Fever (70.5%) and dry cough (56.0%) were the most common symptoms. A decreased albumin level was found in 51.3% of patients, lymphopenia in 33.5%, and pneumonia based on chest computed tomography in 86%. Approximately 16% of patients (n = 45) had severe disease, and there were no deaths. Compared with patients with nonsevere disease, those with severe disease were older, had a higher frequency of coexisting conditions and pneumonia, and had a shorter incubation period (all P < .05). There were no differences between patients who likely contacted the virus in Wuhan and those who had no exposure to Wuhan. Multivariate logistic regression analysis indicated that older age, male sex, and decreased albumin level were independently associated with disease severity. Conclusions Most of the patients infected with SARS-CoV-2 in Guangzhou, China are not severe cases and patients with older age, male, and decreased albumin level were more likely to develop into severe ones.

Hand ◽  
2021 ◽  
pp. 155894472110068
Author(s):  
Joanne Y. Zhang ◽  
Aneesh V. Samineni ◽  
David C. Sing ◽  
Alyssa Rothman ◽  
Andrew B. Stein

Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs <50) (OR = 2.73, P = .05), and American Society of Anesthesiologists (ASA) ≥3 (OR = 2.45, P = .047). Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.


Sports ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 71
Author(s):  
Yasufumi Gon ◽  
Daijiro Kabata ◽  
Sadahito Kawamura ◽  
Masahito Mihara ◽  
Ayumi Shintani ◽  
...  

The yips are a set of conditions associated with intermittent motor disturbances that affect precision movement, especially in sports. Specifically, skilled golfers suffer from the yips, although its clinical characteristics and pathophysiology have not been well-studied. We surveyed skilled golfers to characterize their yips-related symptoms, to explore potential confounding factors associated with the yips. Golfers’ demographic information, golfing-career-related history, musculoskeletal status and manifestations of the yips are surveyed. Among the 1576 questionnaires distributed, 1457 (92%) responses were received, of which 39% of golfers had experienced the yips. The median age and golfing careers were 48 and 28 years, respectively. Golfers who had experienced the yips were older and had longer golfing careers and more frequent musculoskeletal problems than those without experience of the yips. The multivariate logistic regression analysis revealed that a longer golfing career and musculoskeletal problems were independent factors associated with yips experience. More severe musculoskeletal problems were associated with higher odds of experiencing the yips. A positive association between the yips and musculoskeletal problems was also observed. The yips have similar characteristics to task-specific movement disorders, with a detrimental effect caused by excessive repetition of a routine task. These findings support the notion that the yips are a type of task-specific dystonia.


2021 ◽  
Author(s):  
Kyle Melin ◽  
Cheyu Zhang ◽  
Juan Pablo Zapata ◽  
Yonaira M. Rivera ◽  
Katie Fernandez ◽  
...  

UNSTRUCTURED COVID-19 has been particularly devastating to Black and Latinx communities in the U.S. However, data on acceptability of the COVID-19 vaccines among minority populations are limited. We conducted an online survey among adults in Puerto Rico to identify factors associated with intention to vaccinate against COVID-19. Sociodemographic variables were analyzed independently for association with intention to vaccinate. Significant associations were included in the multivariate logistic regression analysis. A total of 1016 responses were available for analysis. In the bivariate analysis, younger age, higher education, pre-covid employment, male sex, gay/bisexual identity, and single marital status were associated with increased intention to vaccinate. In the multivariate logistic regression, younger, male respondents who had higher educational attainment reported higher intention to vaccinate. Lower-income and living outside the San Juan metro region were associated with lower intention to vaccinate. National and international health organizations were identified as the most reliable sources of information, followed by healthcare professionals. These findings highlight the importance of considering sociodemographic characteristics identified with low intention to vaccinate as well as using trusted sources of information when designing public messaging related to increasing COVID-19 vaccinations.


Author(s):  
Elisabetta Schiaroli ◽  
Anna Gidari ◽  
Giovanni Brachelente ◽  
Sabrina Bastianelli ◽  
Alfredo Villa ◽  
...  

IntroductionCOVID-19 is characterized by a wide range of clinical expression and by possible progression to critical illness and death. Therefore it is essential to identify risk factors predicting progression towards serious and fatal diseases. The aim of our study was to identify laboratory predictive markers of clinical progression in patients with moderate/severe disease and in those with acute respiratory distress syndrome (ARDS).Material and methodsUsing electronic medical records for all demographic, clinical and laboratory data, a retrospective study on all consecutive patients with COVID-19 admitted to the Infectious Disease Clinic of Perugia was performed. The PaO2/FiO2 ratio (P/F) assessment cut‑off of 200 mm Hg was used at baseline to categorize the patients into two clinical groups. The progression towards invasive ventilation and/or death was used to identify critical outcome. Statistical analysis was performed. Multivariate logistic regression analysis was adopted to identify risk factors of critical illness and mortality.ResultsIn multivariate logistic regression analysis neutrophil/lymphocyte ratio (NLR) was the only significant predictive factor of progression to a critical outcome (p = 0.03) and of in-hospital mortality (p = 0.03). In ARDS patients no factors were associated with critical progression. Serum ferritin > 1006 ng/ml was the only predictive value of critical outcome in COVID-19 subjects with moderate/severe disease (p = 0.02).ConclusionsNeutrophil/lymphocyte ratio and serum ferritin are the only biomarkers that can help to stratify the risk of severity and mortality in patients with COVID-19.


Author(s):  
Chandrashekar Udyavara Kudru ◽  
Vandana Kalwaje Eshwara ◽  
Shivashankara Kaniyoor Nagiri ◽  
Vasudeva Guddattu

Introduction. Bacterial infections are more frequent in patients with decompensated cirrhosis than those with compensated liver disease and account for significant morbidity and mortality in them. Once an infection develops, it induces excessive production of pro-inflammatory cytokines leading to organ failure and death. Aims. This study aims to identify the clinical characteristics and outcome of bacterial infections affecting various organ systems in patients with liver cirrhosis and to determine factors associated with mortality. Materials and methods. A cross sectional study was performed on subjects with cirrhosis having microbiologically proven bacterial infection involving various organ systems, admitted to a tertiary care hospital in southern India. Demographic, clinical data, laboratory parameters and outcome details were noted. Univariate associations and subsequent multivariate logistic regression analysis was performed to determine factors associated with mortality. Results. The study included 158 patients. Chronic alcohol intake was the most common etiology of cirrhosis (66.4%). Community acquired infections occurred more frequently than hospital acquired infections (85.5% vs 14.5%). The common site of isolation of etiological agent was ascitic fluid (38.3%) followed by blood (24.3%), respiratory tract (15.5%) and urinary tract (14.5%). Gram negative bacterial infections were more common (74.3%), Escherichia coli being the most frequent pathogen (38.5%). Mortality was noted in 38 (24%) patients. The factors associated with mortality were the type of infection, Child Pugh category, acute kidney injury, hepatic encephalopathy, urinary tract infection, and creatinine and bilirubin levels. Multivariate logistic regression analysis revealed that type of infection (OR: 0.33, 95% CI: 0.11-1.01), ascitic fluid infection (OR: 2.81, 95% CI: 1.11-7.12), hepatic encephalopathy (OR: 0.17, 95% CI: 0.070-0.422) and acute kidney injury (OR: 0.19, 95% CI: 0.077-0.502) were significantly associated with in-hospital mortality. Conclusion. This study indicates that the type of infection, hepatic encephalopathy, ascitic fluid infection and acute kidney injury are associated with mortality in cirrhotic patients. Early effective treatment and prevention of these complications may help modify the outcome.


2019 ◽  
Vol 76 (11) ◽  
pp. 1178-1183 ◽  
Author(s):  
Admir Sabanovic ◽  
Natasa Maksimovic ◽  
Mirjana Stojanovic-Tasic ◽  
Marijan Bakic ◽  
Anita Grgurevic

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ?9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (?2 = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (?2 = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (?2 = 10.74; p = 0.005). The presence of diabetic polyneuropathy (?2 = 6.04; p = 0.014) and cataract (?2 = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.


2017 ◽  
Vol 87 (4) ◽  
pp. 583-589 ◽  
Author(s):  
Soonshin Hwang ◽  
Yoon Jeong Choi ◽  
Ji Yeon Lee ◽  
Chooryung Chung ◽  
Kyung-Ho Kim

ABSTRACT Objective: The purpose of this study was to investigate the diagnostic aspects, contributing conditions, and predictive key factors associated with ectopic eruption of maxillary second molars. Material and Methods: This retrospective study evaluated the study models, lateral cephalographs, and panoramic radiographs of 40 adult subjects (20 men, 20 women) with bilateral ectopic eruption and 40 subjects (20 men, 20 women) with normal eruption of the maxillary second molars. Studied variables were analyzed statistically by independent t-tests, univariate and multivariate logistic regression analysis, followed by receiver-operating characteristic analysis. Results: Tooth widths of bilateral lateral incisors, canines, and premolars were wider in the ectopic group, which resulted in greater arch lengths. The ANB angle and maxillary tuberosity distance (PTV-M1, PTV-M2) were smaller in the ectopic group. The long axes of the maxillary molars showed significant distal inclination in the ectopic group. The multivariate logistic regression analysis showed that three key factors—arch length, ANB angle, and PTV-M1 distance—were significantly associated with ectopic eruption of the second molars. The area under the curve (AUC) was the largest for the combination of the three key factors with an AUC greater than 0.75. PTV-M1 alone was the single factor that showed the strongest association with ectopic eruption (AUC = 0.7363). Conclusions: An increase in arch length, decrease in ANB angle, and decrease in maxillary tuberosity distance to the distal aspect of the maxillary first molar (PTV-M1) were the most predictive factors associated with ectopic eruption of maxillary second molars.


Neurology ◽  
2020 ◽  
Vol 95 (19) ◽  
pp. e2683-e2696 ◽  
Author(s):  
Alejandra Vasquez ◽  
Marina Gaínza-Lein ◽  
Nicholas S. Abend ◽  
Marta Amengual-Gual ◽  
Anne Anderson ◽  
...  

ObjectiveTo identify factors associated with low benzodiazepine (BZD) dosing in patients with refractory status epilepticus (RSE) and to assess the impact of BZD treatment variability on seizure cessation.MethodsThis was a retrospective study with prospectively collected data of children with convulsive RSE admitted between June 2011 and January 2019. We analyzed the initial and total BZD dose within 10 minutes of treatment initiation. We used logistic regression modeling to evaluate predictors of low BZD dosing and multivariate Cox regression analysis to assess the impact of low BZD dosing on time to seizure cessation.ResultsWe included 289 patients (55.7% male) with a median age of 4.3 (1.3–9.5) years. BZDs were the initial medication in 278 (96.2%). Of those, 161 patients (57.9%) received a low initial dose. Low initial BZD doses occurred in both out-of-hospital (57 of 106; 53.8%) and in-hospital (104 of 172; 60.5%) settings. One hundred three patients (37.1%) received low total BZD dose. Male sex (odds ratio [OR] 2, 95% confidence interval [CI] 1.18–3.49; p = 0.012), older age (OR 1.1, 95% CI 1.05–1.17; p < 0.001), no prior diagnosis of epilepsy (OR 2.1, 95% CI 1.23–3.69; p = 0.008), and delayed BZD treatment (OR 2.2, 95% CI 1.24–3.94; p = 0.007) were associated with low total BZD dose. Patients who received low total BZD dosing were less likely to achieve seizure cessation (hazard ratio 0.7, 95% CI 0.57–0.95).ConclusionBZD doses were lower than recommended in both out-of-hospital and in-hospital settings. Factors associated with low total BZD dose included male sex, older age, no prior epilepsy diagnosis, and delayed BZD treatment. Low total BZD dosing was associated with decreased likelihood of Seizure cessation.Classification of evidenceThis study provides Class III evidence that patients with RSE who present with male sex, older age, no prior diagnosis of epilepsy, and delayed BZD treatment are more likely to receive low total BZD doses. This study provides Class III evidence that in pediatric RSE low total BZD dose decreases the likelihood of seizure cessation.


2015 ◽  
Vol 39 (1-3) ◽  
pp. 224-229 ◽  
Author(s):  
Sung Jin Moon ◽  
Jung Eun Lee ◽  
Jwa-Kyung Kim ◽  
Soo Young Yoon ◽  
Shin Wook Kang ◽  
...  

Background: Although various modalities of hemodialysis (HD) are presumed to have different effects on insulin resistance (IR), the relationship between hemodiafiltration (HDF) and IR has not been fully evaluated. Methods: In a cross-sectional study, 82 non-diabetic HD patients were enrolled. The patients were divided into two groups according to the median homeostasis model assessment index (HOMA-IR) value of 1.685. Clinical and biochemical data were compared, and multivariate logistic regression analysis was performed to identify the independent factors associated with higher HOMA-IR. Results: The higher HOMA-IR group had increased body mass index (BMI), decreased HDL cholesterol, and lower beta-2 microglobulin reduction rate (β2-MG RR) compared to the lower HOMA-IR group. HOMA-IR was significantly correlated with β2-MG RR. In addition, HDF patients had lower HOMA-IR levels compared with low flux hemodialysis patients. On multivariate logistic regression analysis, BMI and HDF treatment were independent factors associated with higher and lower HOMA-IR, respectively. Conclusion: This study suggests that HDF treatment may reduce IR in non-diabetic HD patients.


2021 ◽  
Author(s):  
Necla Benlier ◽  
Nevhiz Gundogdu ◽  
Mehtap Ozkur

Clinicians and researchers observing the natural history of endemic and epidemic infections have always been fascinated by the vagaries of these diseases, in terms of both the changing nature of the disease severity and phenotype over time and the variable susceptibility of hosts within exposed populations. SARS-CoV-2, the virus that causes COVID-19 and is believed to originate from bats, quickly transformed into a global pandemic. The pandemic of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been posing great threats to the global health in many aspects. Currently, there are no proven effective vaccines or therapeutic agents against the virus. Comprehensive understanding of the biology of SARS-CoV-2 and its interaction with hosts is fundamentally important in the fight against SARS-CoV-2. Advanced age, male sex, and comorbidities such as hypertension and cardiovascular disease as well as diabetes and obesity have been identified as risk factors for more severe COVID-19. However, which and to what extent specific genetic factors may account for the predisposition of individuals to develop severe disease or to contract the infection remains elusive. The increasing availability of data from COVID-19 patient populations is allowing for potential associations to be established between specific gene loci and disease severity, susceptibility to infection, and response to current/future drugs.


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