scholarly journals Αξιολόγηση του μετεγχειρητικού πόνου και άγχους σε παιδά με φίμωση

2014 ◽  
Author(s):  
Στυλιανή Τσαμουδάκη
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
T Test ◽  
Multivariate Logistic Regression ◽  
Univariate Logistic Regression Analysis

Σκοπός. Σκοπός της παρούσας μελέτης ήταν να εκτιμήσει το μετεγχειρητικό άγχoς και πόνο σε παιδιά που χειρουργήθηκαν για φίμωση και να συσχετίσει την παρουσία τους με διάφορους εκλυτικούς παράγοντες.Ασθενείς και Μέθοδος. Στην εργασία αυτή συμπεριελήφθησαν αγόρια, που προσήλθαν να χειρουργηθούν για φίμωση. Η αντιμετώπιση της φίμωσης έγινε με μια από τις παρακάτω τεχνικές: κλασσική περιτομή, πλαστική ακροποσθίας χωρίς συρραφή και πλαστική ακροποσθίας με συρραφή. Η αναλγησία κατά την επέμβαση έγινε με χορήγηση υπόθετου παρακεταμόλης ή/και περιοχική αναλγησία. Η εκτίμηση του μετεγχειρητικού πόνου έγινε με τη χρήση της συμπεριφορικής μέτρησης του πόνου FLACC, και την κλίμακα FACES σε συνδυασμό με οπτική αναλογική κλίμακα δέκα σημείων (VAS). Η παρουσία του μετεγχειρητικού άγχους εκτιμήθηκε από την παρουσία διαταραχών συμπεριφοράς του παιδιού στο σπίτι. Στην τελική αξιολόγηση του μετεγχειρητικού πόνου και άγχους λαμβάνονταν υπόψη οι εξής παράγοντες: η ηλικία του παιδιού, το κοινωνικό και μορφωτικό επίπεδο των γονέων, η προεγχειρητική ενημέρωση του παιδιού, η παρουσία άλλων αδερφών στην οικογένεια, η προηγούμενη εμπειρία του παιδιού από χειρουργική επέμβαση, η χειρουργική τεχνική, η παρουσία άμεσων μετεγχειρητικών επιπλοκών και η εθνικότητα. Για το σκοπό αυτό, χορηγήθηκε ειδικό ερωτηματολόγιο στους γονείς μετά τη χειρουργική επέμβαση.Η επεξεργασία των δεδομένων έγινε με τη βοήθεια του στατιστικού πακέτου SPSS 16.0 και την εφαρμογή της στατιστικής δοκιμασίας χ2-test, t-test και Anova. Για την αξιολόγηση του μετεγχειρητικού άγχους και τους παράγοντες που επιδρούν στην παρουσία του, χρησιμοποιήθηκε μονοπαραγοντική (Univariate Logistic Regression Analysis) και στη συνέχεια πολυπαραγοντική (Multivariate Logistic Regression Analysis) ανάλυση έχοντας ως βάση το μοντέλο των παραμέτρων ερωτηματολογίου που συμπληρώθηκε από τους γονείς των παιδιών. Με τη χρήση του ίδιου στατιστικού μοντέλου, εκτιμήθηκαν επίσης οι παράγοντες που επηρεάζουν την εμφάνιση πόνου μετεγχειρητικά. Το επίπεδο της στατιστικής σημαντικότητας τέθηκε στο p<0,05. ΑΠΟΤΕΛΕΣΜΑΤΑ. Τον πληθυσμό της μελέτης αποτέλεσαν 301 αγόρια ηλικίας δύο έως δεκατεσσάρων χρόνων. Όσον αφορά τα κλινικά χαρακτηριστικά των ασθενών, συγγενή φίμωση είχαν 285/301 (94.7%) και επίκτητη 16 (5.3%). Η αντιμετώπιση της φίμωσης έγινε με κλασσική περιτομή σε 109 (36.2%) αγόρια, πλαστική ακροποσθίας χωρίς συρραφή σε 93 (30.9%) και πλαστική ακροποσθίας με συρραφή σε 99 (32.9%) αγόρια αντίστοιχα.Η πολυπαραγοντική ανάλυση όσον αφορά την παρουσία πόνου μετεγχειρητικά, έδειξε ότι το αίσθημα του πόνου συσχετίζεται στατιστικά σημαντικά με τα παιδιά που υποβλήθησαν σε κλασσική περιτομή ή πλαστική ακροποσθίας με συρραφή σε σύγκριση με αυτά που εφαρμόσθηκε πλαστική ακροποσθίας χωρίς συρραφή, και στα παιδιά με επιπλοκές (p<0.001). Όσον αφορά το μετεγχειρητικό άγχος, η πολυπαραγοντική ανάλυση έδειξε ότι περισσότερες πιθανότητες εμφάνισης άγχους μετεγχειρητικά έχουν τα παιδιά που δεν έχουν αδέλφια, τα παιδιά άλλης εθνικότητας (εκτός της ελληνικής), καθώς και τα παιδιά με προηγούμενο ιστορικό ιατρικων χειρισμών. ΣΥΜΠΕΡΑΣΜΑΤΑ. Η μελέτη αυτή έδειξε ότι τα παιδιά που εμφανίζουν μετεγχειρητικό άγχος είναι παιδιά που δεν έχουν αδέλφια, τα παιδιά των ευαίσθητων κοινωνικά ομάδων όπως αυτά των μεταναστών και τα παιδιά που έχουν δυσάρεστες εμπειρίες από προηγούμενες επεμβάσεις. Όσον αφορά το μετεγχειρητικό αίσθημα πόνου, φαίνεται ότι σημαντικό ρόλο έχουν η εφαρμοζόμενη τεχνική και η παρουσία μετεγχειρητικών επιπλοκών.

scholarly journals Circulating miR-30d Predicts Survival in Patients with Acute Heart Failure

2017 ◽  
Vol 41 (3) ◽  
pp. 865-874 ◽  
Author(s):  
Junjie Xiao ◽  
Rongrong Gao ◽  
Yihua Bei ◽  
Qiulian Zhou ◽  
Yanli Zhou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Univariate Logistic Regression Analysis ◽  
Kaplan Meier ◽  
All Cause Mortality

Background/Aims: Identification of novel biomarkers to identify acute heart failure (AHF) patients at high risk of mortality is an area of unmet clinical need. Recently, we reported that the baseline level of circulating miR-30d was associated with left ventricular remodeling in response to cardiac resynchronization therapy in advanced chronic heart failure patients. However, the role of circulating miR-30d as a prognostic marker of survival in patients with AHF has not been explored. Methods: Patients clinically diagnosed with AHF were enrolled and followed up for 1 year. Quantitative reverse transcription polymerase chain reactions were used to determine serum miR-30d levels. The univariate logistic regression analysis and multivariate logistic regression analysis were used to determine the predictors for all-cause mortality in AHF patients. Kaplan–Meier survival analysis was used to analyze the role of miR-30d in prediction of survival. Results: A total of 96 AHF patients were enrolled and followed up for 1 year. Serum miR-30d was significantly lower in AHF patients who expired in the one year follow-up period compared to those who survived. Univariate logistic regression analysis yielded 18 variables that were associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 4 variables including heart rate, hemoglobin, serum sodium, and serum miR-30d level associated with mortality. ROC curve analysis showed that hemoglobin, heart rate and serum sodium displayed poor prognostic value for AHF (AUCs not higher than 0.700) compared to miR-30d level (AUC = 0.806). Kaplan–Meier survival analysis confirmed that patients with higher serum miR-30d levels had significantly lower mortality (P=0.001). Conclusion: In conclusion, this study shows evidence for the predictive value of circulating miR-30d as 1-year all-cause mortality in AHF patients. Large multicentre studies are further needed to validate our findings and accelerate the transition to clinical utilization.

scholarly journals Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Atsushi Kotera
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Postoperative Pain ◽  
Logistic Regression Analysis ◽  
Pain Control ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Postoperative Pain Control ◽  
Flurbiprofen Axetil ◽  
Postanesthetic Shivering

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.

scholarly journals Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Chen Dong ◽  
Minhui Zhu ◽  
Luguang Huang ◽  
Wei Liu ◽  
Hengxin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Failure ◽  
Logistic Regression Analysis ◽  
Disease Duration ◽  
Multivariate Logistic Regression Analysis ◽  
Tissue Expansion ◽  
Multivariate Logistic Regression ◽  
Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p &lt; 0.001), larger volume of expander (200–400 ml vs &lt;200 ml; OR, 1.74; p = 0.032; &gt;400 ml vs &lt;200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of &lt;1 year, expander volume of &gt;200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

Relationship Between Rotator Cuff Tears and Scapular Morphology

2021 ◽  
Author(s):  
Yoshihiro Nakamura ◽  
Shin Yokoya ◽  
Yuki Matsubara ◽  
Yohei Harada ◽  
Nobuo Adachi
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Rotator Cuff ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Lateral View ◽  
Multivariate Logistic Regression ◽  
Inferior Angle ◽  
Scapular Spine ◽  
Scapular Body

Abstract Background The purpose of this study was to identify differences in the morphology of the scapula according to the presence or absence of a rotator cuff tear (RCT). Methods One hundred and three shoulders with and 87 shoulders without RCTs were included in this study. The critical shoulder angle (CSA) and lateral acromion angle in the frontal view and the acromial coverage angle (ACA) and coracoid and scapular spine angle (CSSA) in the lateral view were evaluated using three-dimensional computed tomography. The glenoid anterior tilt, anterior acromial projection angle (AAPA), coracoid process angle, scapular spine angle (SSA) and inferior angle angle (IAA) with respect to the scapular plane were measured in the lateral view. The morphological parameters of the scapula associated with RCT were statistically analysed using a multivariate logistic regression analysis. Results In univariate logistic regression analysis, CSA, ACA, CSSA, AAPA, SSA and IAA were significantly different between shoulders with and without RCTs. In multivariate logistic regression analysis, CSA and IAA were greater in shoulders with RCT and were significantly associated with this condition. Conclusion To the best of our knowledge, this is the first study to focus on the relationship between RCT and the scapular body. RCT cases were characterised by a greater curvature of the scapular body in addition to CSA.

Confirmatory germline testing for presumed germline pathogenic variants using tumor-only testing.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e22524-e22524
Author(s):  
Tomohiro Kondo ◽  
Takahiro Yamada ◽  
Masahiro Yoshioka ◽  
Masakazu Nishigaki ◽  
Yoshihiro Yamamoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Tumor Board ◽  
Genomic Profiling ◽  
Multivariate Logistic Regression ◽  
Pathogenic Variants ◽  
Comprehensive Genomic Profiling ◽  
Germline Testing

e22524 Background: Presumed germline pathogenic variants (PGPVs) can be detected in tumor tissues using comprehensive genomic profiling. Clinicians and patients can decide whether to conduct confirmatory germline testing or not. However, the promoting and obstructive factors for confirmatory germline testing are unclear. Methods: This single institutional retrospective study aimed to identify factors related to confirmatory germline testing in patients with PGPVs. Between April 2015 and April 2019, 270 consecutive patients with cancers of unknown primary site, rare tumors, or solid tumors refractory to standard chemotherapy, who underwent tumor-only comprehensive genomic profiling were reviewed. PGPVs were proposed to be disclosed as variants to the patients by our institutional molecular tumor board. Univariate logistic regression analysis was conducted to investigate the relationship between each patient’s characteristics and confirmatory germline testing. Factors showing a statistical relationship (p < 0.10 in univariate analyses) were included in multivariate logistic regression analysis with a backward selection of variables. Statistical significance was set at p < 0.05. Results: Of the 270 patients who underwent tumor-only comprehensive genomic profiling, 77 possessed PGPVs. The most common PGPVs were TP53 (n = 56), APC (n = 9), PTEN (n = 7), RB1 (n = 6), and BRCA2 (n = 6). Among the 77 patients, only 11 (14.3%) chose to undergo confirmatory germline testing. Multivariate logistic regression analysis revealed that the person disclosing the results (experienced oncologists with knowledge of cancer genome medicine vs. others, odds ratio [OR]: 27.7, 95% confidence interval [CI]: 4.60–167) and study period (OR: 0.110, 95% CI: 0.015–0.787) were independently and significantly associated with confirmatory germline testing. Conclusions: These findings indicate that fostering genomic competency in oncologists and collaborating with genetic experts would facilitate cancer patients and their families to receive genetic medical services in the process of cancer genomic profiling.

scholarly journals Effect of Hypothermia in the Emergency Department on the Outcome of Trauma Patients: A Cross-Sectional Analysis

2018 ◽  
Vol 15 (8) ◽  
pp. 1769 ◽  
Author(s):  
Ting-Min Hsieh ◽  
Pao-Jen Kuo ◽  
Shiun-Yuan Hsu ◽  
Peng-Chen Chien ◽  
Hsiao-Yun Hsieh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Body Temperature ◽  
Propensity Score ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Trauma Patients ◽  
Body Temperatures ◽  
Multivariate Logistic Regression ◽  
Mortality Outcome

This study aimed to assess whether hypothermia is an independent predictor of mortality in trauma patients in the condition of defining hypothermia as body temperatures of <36 °C. Data of all hospitalized adult trauma patients recorded in the Trauma Registry System at a level I trauma center between 1 January 2009 and 12 December 2015 were retrospectively reviewed. A multivariate logistic regression analysis was performed in order to identify factors related to mortality. In addition, hypothermia and normothermia were defined as temperatures <36 °C and from 36 °C to 38 °C, respectively. Propensity score-matched study groups of hypothermia and normothermia patients in a 1:1 ratio were grouped for mortality assessment after adjusting for potential confounders such as age, sex, preexisting comorbidities, and injury severity score (ISS). Of 23,705 enrolled patients, a total of 401 hypothermic patients and 13,368 normothermic patients were included in this study. Only 3.0% of patients had hypothermia upon arrival at the emergency department (ED). Compared to normothermic patients, hypothermic patients had a significantly higher rate of abbreviated injury scale (AIS) scores of ≥3 in the head/neck, thorax, and abdomen and higher ISS. The mortality rate in hypothermic patients was significantly higher than that in normothermic patients (13.5% vs. 2.3%, odds ratio (OR): 6.6, 95% confidence interval (CI): 4.86–9.01, p < 0.001). Of the 399 well-balanced propensity score-matched pairs, there was no significant difference in mortality (13.0% vs. 9.3%, OR: 1.5, 95% CI: 0.94–2.29, p = 0.115). However, multivariate logistic regression analysis revealed that patients with low body temperature were significantly associated with the mortality outcome. This study revealed that low body temperature is associated with the mortality outcome in the multivariate logistic regression analysis but not in the propensity score matching (PSM) model that compared patients with hypothermia defined as body temperatures of <36 °C to those who had normothermia. These contradicting observations indicated the limitation of the traditional definition of body temperature for the diagnosis of hypothermia. Prospective randomized control trials are needed to determine the relationship between hypothermia following trauma and the clinical outcome.

scholarly journals Socioeconomic inequalities and non-communicable diseases in Serbia: National health survey

2018 ◽  
Vol 75 (9) ◽  
pp. 926-934
Author(s):  
Svetlana Radevic ◽  
Snezana Radovanovic ◽  
Nela Djonovic ◽  
Ivana Simic-Vukomanovic ◽  
Natasa Mihailovic ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
National Health ◽  
Multivariate Logistic Regression Analysis ◽  
Wealth Index ◽  
Communicable Diseases ◽  
Socioeconomic Inequalities ◽  
Multivariate Logistic Regression ◽  
Non Communicable Diseases

Background/Aim. Non-communicable diseases (NCDs) are a major public health challenge worldwide. Although they are preventable, NCDs are the major global causes of morbidity and mortality, absenteeism, disability and premature death. The aim of this study was to examine socioeconomic inequalities in the prevalence of non-communicable diseases in Serbia. Methods. Data from the 2013 National Health Survey of the population of Serbia was used in this study. There were 13,765 adults interviewed, aged ? 20 years. We used multivariate logistic regression analyses with demographic and socioeconomic determinants of health as independent variables and prevalence of non-communicable diseases as a dependent variable. The minimum level of significance was p < 0.05. Results. Hypertension was the most prevalent NCDs (36.1%). The prevalence of multimorbidity was 47.1%. Multivariate logistic regression analysis showed that gender, age, place of residence, employment status and education were associated with the presence of NCDs. The odds ratio (OR) for age was 1.074 [95% confidence interval (CI) : 1.070?1.077). Women were at a higher risk of NCDs by 58.9% when compared to men (OR = 1.589; 95% 95% CI : 1.467?1.726). Respondents who lived in the rural areas were at a higher risk for NCDs by 14.1% compared to those who lived in urban areas (OR = 1.141; 95% CI : 1.047? 1.244). Odds ratio for unemployment was 1.227 (95% CI: 1.118?1.346). Respondents with primary education were at a higher risk for chronic diseases by 47.1% (OR = 1.471; 95% CI : 1.281?1.687) while those with secondary school were at a higher risk by 27.7% (OR = 1.277; 95% CI : 1.142?1.428) compared to respondents who had higher education. When it comes to Wealth Index, univariate logistic regression analysis showed that respondents who belonged to the poor and middle classes were at a higher risk for NCDs (OR = 2.031; 95% CI : 1.819?2.267; OR = 1.473; 95% CI : 1.343? 1.615) compared to respondents who belonged to the rich class. Multivariate logistic regression analysis did not show statistically significant correlations between the Wealth index and NCDs. Conclusion. Socioeconomic inequalities in health status are the major challenge and should be a target of national health policy in Serbia, not only because they represent social injustice but also because solving the health problems of underprivileged groups of the population can influence improvement of health status of the population as a whole.

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