Stone Localization Is Pivotal for the Success of Percutaneous Nephrolithotomy

2021 ◽  
pp. 1-7
Author(s):  
Tammo Lesch ◽  
Jens Uphoff ◽  
Wolfgang Mayer ◽  
Alexander Winter ◽  
Friedhelm Wawroschek ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Percutaneous Nephrolithotomy ◽  
Treatment Success ◽  
Regression Analyses ◽  
Multivariable Logistic Regression ◽  
Controlled Treatment ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Impact On Treatment ◽  
Free Status ◽  
Residual Stones

<b><i>Objective:</i></b> The objective of this study was to predict computed tomography (CT)-controlled treatment success after minimally invasive percutaneous nephrolithotomy (Mini-PCNL). <b><i>Patients and Methods:</i></b> We relied on retrospective single institutional data from 92 kidney stone patients treated with Mini-PCNL. Residual stones after treatment were evaluated by post-Mini-PCNL CT scans. Stone-free status was defined as clinically insignificant residual stones ≤3 mm after surgery. Multivariable logistic regression analyses predicted stone-free status after Mini-PCNL. <b><i>Results:</i></b> Overall, 53 (57.6%) patients achieved stone-free status after Mini-PCNL treatment. In multivariable logistic regression analyses, stone localization was the strongest predictor for stone-free status after Mini-PCNL. Specifically, patients with exclusively pelvic stones were 7.1-fold more likely to achieve stone-free status than those patients with stones at multiple localizations (OR: 7.1; <i>p</i> = 0.005). Additionally, stone size represented a barrier for stone-free status (OR: 0.9; <i>p</i> = 0.03). <b><i>Conclusions:</i></b> Stone localization revealed the highest impact on treatment success after Mini-PCNL. Especially, those patients with exclusively pelvic stones were most likely to achieve stone-free status. Conversely, patients with multiple stone localizations were less likely to achieve stone-free status and need to be informed about higher risk of additional interventions after initial Mini-PCNL.

scholarly journals Risk factors for symptomatic Avascular Necrosis (AVN) in a multi-ethnic Systemic Lupus Erythematosus (SLE) cohort

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248845
Author(s):  
Syahrul Sazliyana Shaharir ◽  
Siew Huoy Chua ◽  
Rozita Mohd ◽  
Ruslinda Mustafar ◽  
Malehah Mohd Noh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Avascular Necrosis ◽  
Lupus Erythematosus ◽  
Osteoporotic Fractures ◽  
Protective Effects ◽  
Regression Analyses ◽  
Mobility Limitations ◽  
Factors Associated ◽  
Multivariable Logistic Regression

Avascular necrosis of bone (AVN) is increasingly being recognized as a complication of SLE and causes significant disability due to pain and mobility limitations. We studied the prevalence and factors associated with avascular necrosis (AVN) in a multiethnic SLE cohort. SLE patients who visited the outpatient clinic from October 2017 to April 2019 were considered eligible. Their medical records were reviewed to identify patients who developed symptomatic AVN, as confirmed by either magnetic resonance imaging or plain radiography. Subsequently, their SLE disease characteristics and treatment were compared with the characteristics of patients who did not have AVN. Multivariable logistic regression analyses were performed to determine the independent factors associated with AVN among the multiethnic SLE cohort. A total of 390 patients were recruited, and the majority of them were females (92.6%); the patients were predominantly of Malay ethnicity (59.5%), followed by Chinese (35.9%) and Indian (4.6%). The prevalence of symptomatic AVN was 14.1%, and the mean age of AVN diagnosis was 37.6 ± 14.4 years. Both univariate and multivariable logistic regression analyses revealed that a longer disease duration, high LDL-C (low density lipoprotein cholesterol), positive anti-cardiolipin (aCL) IgG and anti-dsDNA results, a history of an oral prednisolone dose of more than 30 mg daily for at least 4 weeks and osteoporotic fractures were significantly associated with AVN. On the other hand, hydroxychloroquin (HCQ), mycophenolate mofetil (MMF) and bisphosphonate use were associated with a lower risk of AVN. No associations with ethnicity were found. In conclusion, several modifiable risk factors were found to be associated with AVN, and these factors may be used to identify patients who are at high risk of developing such complications. The potential protective effects of HCQ, MMF and bisphosphonates warrant additional studies.

scholarly journals Beliefs about the Harmfulness of Heated Tobacco Products Compared with Combustible Cigarettes and Their Effectiveness for Smoking Cessation among Korean Adults

2020 ◽  
Vol 17 (15) ◽  
pp. 5591
Author(s):  
Seung Hee Kim ◽  
Seo Young Kang ◽  
Hong-Jun Cho
Keyword(s):  
Higher Education ◽  
Smoking Cessation ◽  
Logistic Regression ◽  
Online Survey ◽  
Electronic Cigarettes ◽  
Regression Analyses ◽  
Tobacco Products ◽  
Korean Adults ◽  
Multivariable Logistic Regression ◽  
Negative Perceptions

Heated tobacco products (HTPs) have been widely used in Korea since their introduction in 2017. In this study, we investigated the perceptions of their relative harmfulness and smoking cessation effects. We performed an online survey in 7000 Koreans in 2018 (2300 males and 4700 females aged 20–69 years) by matching their age, sex, and provincial distribution. To investigate the factors causing HTPs to be perceived as less harmful than combustible cigarettes (CCs) and helpful for smoking cessation, we used multivariable logistic regression analyses. HTPs were less harmful than CCs in 16.8% of participants, particularly among HTP-only users and dual and triple users of HTPs, electronic cigarettes (ECs), or CCs than among CC-only users, those who were aged ≤ 34 years, males, and those with higher incomes. HTPs were reportedly helpful for smoking cessation in 11.2% of participants. Similar perceptions were more likely among HTP-only users, as well as dual and triple users than among CC-only users and adults with higher education/incomes. Although Korean adults generally had negative perceptions of the harmfulness and smoking cessation effects of HTPs compared with CCs, dual and triple users were more likely to have positive perceptions. Monitoring the use of multiple tobacco products and HTPs is a new challenge for Korean policymakers.

scholarly journals Predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding

2020 ◽  
Vol 302 (5) ◽  
pp. 1279-1296
Author(s):  
Anna Fernlund ◽  
Ligita Jokubkiene ◽  
Povilas Sladkevicius ◽  
Lil Valentin
Keyword(s):  
Logistic Regression ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Vaginal Bleeding ◽  
Treatment Success ◽  
Expectant Management ◽  
Crown Rump Length ◽  
Multivariable Logistic Regression ◽  
Vaginal Deliveries ◽  
Gestational Sac

Abstract Purpose To identify predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding. Methods This was a planned secondary analysis of data from a published randomized controlled trial comparing expectant management with vaginal single dose of 800 µg misoprostol treatment of women with embryonic or anembryonic miscarriage. Predefined variables—serum-progesterone, serum-β-human chorionic gonadotropin, parity, previous vaginal deliveries, gestational age, clinical symptoms (bleeding and pain), mean diameter and shape of the gestational sac, crown-rump-length, type of miscarriage, and presence of blood flow in the intervillous space—were tested as predictors of treatment success (no gestational sac in the uterine cavity and maximum anterior–posterior intracavitary diameter was ≤ 15 mm as measured with transvaginal ultrasound on a sagittal view) in univariable and multivariable logistic regression. Results Variables from 174 women (83 expectant management versus 91 misoprostol) were analyzed for prediction of complete miscarriage at ≤ 17 days. In patients managed expectantly, the rate of complete miscarriage was 62.7% (32/51) in embryonic miscarriages versus 37.5% (12/32) in anembryonic miscarriages (P = 0.02). In multivariable logistic regression, the likelihood of success increased with increasing gestational age, increasing crown-rump-length and decreasing gestational sac diameter. Misoprostol treatment was successful in 80.0% (73/91). No variable predicted success of misoprostol treatment. Conclusions Complete miscarriage after expectant management is significantly more likely in embryonic miscarriage than in anembryonic miscarriage. Gestational age, crown-rump-length, and gestational sac diameter are independent predictors of success of expectant management. Predictors of treatment success may help counselling women with early miscarriage.

scholarly journals Evaluation of the ability of the trypsin-like peptidase activity assay to detect severe periodontitis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256538
Author(s):  
Masanori Iwasaki ◽  
Michihiko Usui ◽  
Wataru Ariyoshi ◽  
Keisuke Nakashima ◽  
Yoshie Nagai-Yoshioka ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Characteristic Curve ◽  
Case Definition ◽  
Epidemiological Surveillance ◽  
Peptidase Activity ◽  
Regression Analyses ◽  
Activity Assay ◽  
A Value ◽  
Multivariable Logistic Regression ◽  
Severe Periodontitis

Objectives N-benzoyl-DL-arginine peptidase (trypsin-like peptidase) is specifically produced by certain strains of periodontitis-associated bacteria. We aimed to examine the effectiveness of an objectively quantified trypsin-like peptidase activity assay (TLP-AA) for detecting severe periodontitis. Methods The study population included 347 adults (108 men and 239 women; average age, 43.3 years) who underwent a full-mouth periodontal examination. Specimens for the TLP-AA were obtained using tongue swabs. Using a color reader, the TLP-AA results were obtained as a* values, with higher positive a* values indicating an increased intense enzymatic activity. The predictive validity of the TLP-AA results for severe periodontitis was assessed using receiver operating characteristic curve analysis and the periodontitis case definition provided by the Centers for Disease Control and Prevention/American Academy of Periodontology as the gold standard. Furthermore, multivariable logistic regression analyses were performed to predict severe periodontitis using the TLP-AA results and health characteristics, as the exposure variables. Results Severe periodontitis was observed in 5.2% of the participants. TLP-AA had high diagnostic accuracy for severe periodontitis, with an area under the curve of 0.83 (95% confidence interval [CI]: 0.75–0.92). The cut-off score for the a* value that best differentiated individuals with severe periodontitis was 0.09, with a sensitivity of 83% and specificity of 77%. Multivariable logistic regression analyses revealed that the TLP-AA results were significantly associated with severe periodontitis after adjusting for health characteristics (adjusted odds ratios: 1.90 [95% CI: 1.37–2.62] for the a* value). Conclusions Objectively quantified TLP-AA results are potentially useful for detecting severe periodontitis in epidemiological surveillance.

scholarly journals The relationship between ratio of serum triglyceride to high-density lipoprotein cholesterol and frequency of sarcopenia in Chinese community adults

2020 ◽  
Author(s):  
Na Wang ◽  
Mengjun Chen ◽  
Danhong Fang
Keyword(s):  
Logistic Regression ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Regression Analyses ◽  
Chinese Community ◽  
Multivariable Logistic Regression

Abstract Background In a previous study, the high ratio of serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) was relevant to a high risk of sarcopenia in Korean old males. In this study, the purpose was to discover the association in Chinese community adults.MethodsChinese adults who had physical examinations from May 2016 to August 2017 at the First Affiliated Hospital of Wenzhou Medical University were involved in this study. The univariable and multivariable logistic regression analyses were applied to evaluate possible effect.ResultsIn total, 2613 adults were involved in the study, with 13.85% presenting sarcopenia. Individuals with TG/HDL-C ratios <2.78 or ≥2.78 were categorized as TG/HDL-Clow or TG/HDL-Chigh, respectively. 1266 individuals were in high group and the remaining were in the low group. By univariate and multivariable logistic regression analyses, the ratio of TG/HDL-C remained independent association with sarcopenia status(OR: 0.63; 95%CI: 0.49-0.81). ConclusionsThe negative association between sarcopenia and TG/HDL-C ratio was discovered in Chinese community population.

scholarly journals Ten-year inhospital mortality trends for patients with trauma in Japan: a multicentre observational study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018635 ◽  
Author(s):  
Isao Nagata ◽  
Toshikazu Abe ◽  
Masatoshi Uchida ◽  
Daizoh Saitoh ◽  
Nanako Tamiya
Keyword(s):  
Logistic Regression ◽  
Observational Study ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Whole Body ◽  
Inhospital Mortality ◽  
Regression Analyses ◽  
Mortality Trends ◽  
Multivariable Logistic Regression

ObjectivesTrauma is one of the main causes of death in Japan, and treatments and prognoses of these injuries are constantly changing. We therefore aimed to investigate a 10-year trend (2004–2013) in inhospital mortality among patients with trauma in Japan.DesignMulticentre observational study.SettingJapanese nationwide trauma registry (the Japan Trauma Data Bank) data.ParticipantsAll patients with trauma whose Injury Severity Score (ISS) were 3 and above, who were aged 15 years or older, and whose mechanisms of injury (MOI) were blunt and penetrating between 2004 and 2013 (n=90 833).Outcome measuresA 10-year trend in inhospital mortality.ResultsInhospital mortality for all patients with trauma significantly decreased over the study decade in our Cochran-Armitage test (P<0.001). Similarly, inhospital mortality for patients with ISS 16 or more and patients who scored 50% or better on the Trauma and Injury Severity Score (TRISS) probability of survival scale significantly decreased (P<0.001). In addition, the OR for inhospital mortality of these three patient groups decreased yearly after adjusting for age, gender, MOI, ISS, Glasgow Coma Scale, systolic blood pressure and respiratory rate on hospital arrival in multivariable logistic regression analyses. Furthermore, inhospital mortality for patient with blunt trauma significantly decreased in injury mechanism-stratified Mantel-extension testing (P<0.001). Finally, multivariable logistic regression analyses showed that the OR for inhospital mortality of patients with ISS 16 and over decreased each year after adding and adjusting for means of transportation and usage of whole-body CT.ConclusionInhospitalmortality for patients with trauma in Japan significantly decreased during the study decade after adjusting for patient characteristics, injury severity and the response environment after injury.

scholarly journals The Influence of COVID-19 Information Sources on the Attitudes and Practices Toward COVID-19 Among the General Public of Saudi Arabia: Cross-sectional Online Survey Study (Preprint)

2021 ◽  
Author(s):  
Noor Alshareef ◽  
Ismaeel Yunusa ◽  
Mohammed Khaled Al-Hanawi
Keyword(s):  
Social Media ◽  
Logistic Regression ◽  
Saudi Arabia ◽  
General Public ◽  
Preventive Measures ◽  
Regression Analyses ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Multivariable Logistic Regression

BACKGROUND The COVID-19 pandemic has resulted in panic among the general public, leading many people to seek out information related to COVID-19 through various sources, including social media and traditional media. Identifying public preferences for obtaining such information may help health authorities to effectively plan successful health preventive and educational intervention strategies. OBJECTIVE The aim of this study was to examine the impact of the types of sources used for obtaining COVID-19 information on the attitudes and practices of the general public in Saudi Arabia during the pandemic, and to identify the socioeconomic and demographic factors associated with the use of different sources of information. METHODS This study used data from a cross-sectional online survey conducted on residents of Saudi Arabia from March 20 to 24, 2020. Data were analyzed using descriptive, bivariate, and multivariable logistic regression analyses. Bivariate analysis of categorical variables was performed to determine the associations between information sources and socioeconomic and demographic factors. Multivariable logistic regression analyses were employed to examine whether socioeconomic and demographic variables were associated with the source of information used to obtain information about COVID-19. Moreover, univariable and multivariable logistic regression analyses were conducted to examine how sources of information influence attitudes and practices of adhering to preventive measures. RESULTS In this analysis of cross-sectional survey data, 3358 participants were included. Most participants reported using social media, followed by the Ministry of Health (MOH) of the Kingdom of Saudi Arabia, as their primary source of information. Seeking information via social media was significantly associated with lower odds of having an optimistic attitude (adjusted odds ratio [aOR] 0.845, 95% CI 0.733-0.974; <i>P</i>=.02) and adhering to preventive measures (aOR 0.725, 95% CI 0.630-0.835; <i>P</i>&lt;.001) compared to other sources of information. Participants who obtained their COVID-19 information via the MOH had greater odds of having an optimistic attitude (aOR 1.437, 95% CI 1.234-1.673; <i>P</i>&lt;.001) and adhering to preventive measures (aOR 1.393, 95% CI 1.201-1.615; <i>P</i>&lt;.001) than those who obtained information via other sources. CONCLUSIONS This study provides evidence that different sources of information influence attitudes and preventive actions differently within a pandemic crisis context. Health authorities in Saudi Arabia should pay attention to the use of appropriate social media channels and sources to allow for more effective dissemination of critical information to the public.

scholarly journals The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Xiangjun Meng ◽  
Juan Bao ◽  
Qiwu Mi ◽  
Shaowei Fang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Minimally Invasive ◽  
Logistic Regression Analysis ◽  
Percutaneous Nephrolithotomy ◽  
Operation Time ◽  
Stone Size ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Staghorn Stone

Objective. This study investigated the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy, so as to prevent the occurrence of bleeding and improve the surgical effect. Patients and Methods. The data of 396 patients who underwent percutaneous nephrolithotomy by an experienced surgeon between May 2014 and December 2017 were retrospectively analyzed. To identify the risk factors for bleeding during percutaneous nephrolithotomy, each group was stratified according to the decrease in median hemoglobin. Age, gender, body mass index, stone size, operation time, stone type, degree of hydronephrosis, number of accesses, puncture guidance, underlying disease (diabetes; hypertension), and previous surgical history were evaluated. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of each factor, we finally selected stone size, staghorn stone, degree of hydronephrosis, and operation time. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Results. A total of 396 patients were successfully treated with percutaneous nephrolithotomy. The univariate analysis demonstrated that the potential risk factors for bleeding during percutaneous nephrolithotomy included stone size, type of stone, operative time, and degree of hydronephrosis. According to the previous studies, stone size, staghorn stone, degree of hydronephrosis, and operation time were ultimately selected. Multivariate logistic regression analysis was used to identify the risk factors for bleeding during percutaneous nephrolithotomy. According to the outcome of logistic regression analysis, stone size, staghorn stone, operation time, and degree of hydronephrosis were the risk factors for bleeding during minimally invasive percutaneous nephrolithotomy. Conclusions. Percutaneous nephrolithotomy is an effective method for the treatment of upper urinary calculi with few complications. According to the results achieved by an experienced surgeon, the size of stone, staghorn stone, operation time, and degree of hydronephrosis were associated with the bleeding during minimally invasive percutaneous nephrolithotomy.

Physical Violence Perpetration Among College Students: Prevalence and Associations With Substance Use and Mental Health Symptoms

2021 ◽  
pp. 088626052199188
Author(s):  
Kyle T. Ganson ◽  
Julia O’Connor ◽  
Jason M. Nagata
Keyword(s):  
Mental Health ◽  
College Students ◽  
Substance Use ◽  
Logistic Regression ◽  
Physical Violence ◽  
Regression Analyses ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Multivariable Logistic Regression ◽  
Violence Perpetration

The aims of this study were to, first, report the prevalence of physical violence perpetration among a sample of college students and, second, to identify associations between physical violence perpetration, substance use, and mental health symptoms. We analyzed survey data from the Healthy Minds Study. We examined the 12-month prevalence of physical violence perpetration by gender identity from 2014–2019 ( n = 181,056). We used multivariable logistic regression analyses to estimate associations between physical violence perpetration, substance use, and mental health symptoms from the 2018–2019 survey year ( n = 43,563). Results revealed that 12-month prevalence rates of physical violence perpetration increased from 2014–2019 among male, female, and transgender/gender nonconforming college students. Results from multivariable logistic regression analyses using the 2018–2019 survey year revealed higher odds of physical violence perpetration in the previous 12 months among students who reported substance use and mental health symptoms, including vaping or e-cigarette use, illicit drug use, and nonsuicidal self-injury, among others. Our findings highlight steadily rising prevalence of physical violence perpetration from 2014–2019 among college students, indicating a growing need for more research and prevention efforts to address this problem in higher education settings. Efforts to prevent violence on college campuses should consider how to reduce substance use and improve mental health to reduce this form of violence.

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