scholarly journals Factors Associated with Failure of Pneumatic Reduction in Children with Ileocolic Intussusception

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 136
Author(s):  
Alaa Younes ◽  
Sanghoon Lee ◽  
Jong-In Lee ◽  
Jeong-Meen Seo ◽  
Soo-Min Jung
Keyword(s):  
Neutrophil Count ◽  
Univariate Analysis ◽  
Hemoglobin Level ◽  
Ileocolic Intussusception ◽  
First Line ◽  
Factors Associated ◽  
Pneumatic Reduction ◽  
Segmented Neutrophil ◽  
Common Causes ◽  
Weight Percentile

Intussusception is one of the most common causes of intestinal obstruction in children. Pneumatic reduction is the treatment of choice and has a high success rate. The most common cause of pneumatic reduction failure is the presence of a pathological leading point. We aimed to identify other factors that can lead to pneumatic reduction failure in children with ileocolic intussusception. This was a retrospective study conducted in two centers. Data were collected from January 2013 to December 2014. A total of 156 patients were diagnosed with intussusception and underwent pneumatic reduction, with the exception of one patient with peritonitis. We included patients with ileocolic-type intussusception without apparent pathological leading points. Logistic regression analysis of clinical parameters was performed to identify factors associated with pneumatic reduction failure. Of 156 patients diagnosed with intussusception in both hospitals, 145 were enrolled in the study. The overall efficacy of pneumatic reduction was 85.7%, and surgical reduction was performed in 21 patients. Univariate analysis showed that a high segmented neutrophil count, low hemoglobin level, high body temperature, and higher weight percentile were associated with pneumatic reduction failure. Multivariate analysis showed that a high segmented neutrophil count, low hemoglobin level, and higher weight percentile were significantly associated with pneumatic reduction failure. Pneumatic reduction is safe and effective as a first-line treatment for pediatric intussusception. However, a high segmented neutrophil count, low hemoglobin level, and higher weight percentile are associated with the failure of this treatment.

Prediction of hospitalizations in patients with cancer age 70 and older receiving chemotherapy.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 216-216
Author(s):  
Ioannis Voutsadakis ◽  
Melissa Reed ◽  
Caitlyn Patrick ◽  
Travis Quevillon ◽  
Natalie Walde
Keyword(s):  
Cancer Patients ◽  
Odds Ratio ◽  
Hospital Admissions ◽  
Univariate Analysis ◽  
Chemotherapy Treatment ◽  
First Line ◽  
Factors Associated ◽  
Metastatic Setting ◽  
Ecog Ps ◽  
Normal Albumin

216 Background: Chemotherapy is one of the main treatments for cancer and is associated in many cancers with significant benefits in overall and disease-free survival. Nevertheless, it is also associated with adverse effects that may lead to hospitalizations in older patients with comorbidities or decreased general status. We aimed to identify factors associated with hospital admissions in this population. Methods: Records of cancer patients 70 years-old or older who received adjuvant chemotherapy or first line chemotherapy for a cancer in a single center were retrospectively reviewed. Demographic, disease and treatment data were extracted. Factors associated with hospitalizations during chemotherapy treatment were evaluated in a univariate analysis with the x2 or the Fisher’s exact test. Factors identified were fitted in a multivariate regression model. Results: Among the 276 patients included in the study, 117 (42.4%) were male and 159 (57.6%) were female. Most patients (53.6%) were 70 to 75 years-old, but there were also significant proportions of patients that were 76 to 80 years-old and above age 80 (29.0% and 17.4% respectively). Chemotherapy was given in the adjuvant setting in 51.1% of patients and in the first line metastatic setting in 48.9% of patients. Treatment was with single chemotherapy drug in 22.8% of patients and poly-chemotherapy was given in 77.2% of patients. One hundred and six patients (38.4%) had a hospital admission during or up to a month after their chemotherapy treatment. Factors associated with admission in the multivariate analysis included ECOG PS > 1 (p = 0.04, odds ratio 1.4, 95% CI: 1.0-1.9) and hypoalbuminemia (p = 0.03, odds ratio 0.94, 95% CI: 0.88-0.99). Among the 174 patients that had a good PS (ECOG PS = 0 or 1) and normal albumin, only 28.7% had been hospitalized during treatment, while 62.3% of the 77 patients with PS of 2 or 3, hypoalbuminemia or both were hospitalized during or within the month after completion of treatment. Conclusions: Good ECOG PS in combination with a normal albumin is predictive of lower hospitalization rate in cancer patients 70 years-old and older receiving chemotherapy.

Predictive Factors of Severe Sepsis and Septic Shock in Patients with Hematological Malignancies and Pseudomonas Infections.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4552-4552
Author(s):  
Ramzi Jeddi ◽  
Hèla Ghédira ◽  
Ramzi ben Amor ◽  
Lamia Aissaoui ◽  
Karima Kacem ◽  
...  
Keyword(s):  
Septic Shock ◽  
Multivariate Analysis ◽  
Severe Sepsis ◽  
Neutrophil Count ◽  
Hematological Malignancies ◽  
Univariate Analysis ◽  
Skin Lesions ◽  
Hemoglobin Level ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract Abstract 4552 Background Pseudomonas aeruginosa is a leading cause of nosocomial infections usually associated with high mortality. The aim of this study was to determine the predictive factors of severe sepsis or septic shock in patients with hematological malignancies and pseudomonas infections. Methods This study was conducted in a teaching hospital (Aziza Othmana University Hospital, Tunis, Tunisia) to evaluate the clinical profile of infections due to Pseudomonas species and to determine risk factors for severe sepsis or septic shock defined according to the criteria of the ACCP/SCCM. Pearson test was used for univariate analysis, and logistic regression for multivariate analysis. Results Between 2004 and 2009,a total of 73 pseudomonas isolates (70 P, aeruginosa) was collected in 60 patients : 47 with acute leukemia (78%), 7 with lymphoma (12%), and 6 with others hematological disorders (10%).The median age was 29 yrs (range, 2-64). Most common sites of the isolates were from bloodstream (45%), and skin lesions (31.5%). At least 11 patients (18%) had 2 or more infections due to Pseudomonas. The most common clinical signs observed were isolated fever (18%), respiratory symptoms (15%), diarrhea (21%), and skin lesions (29%).Susceptibility to major anti-pseudomonas antibiotics revealed that isolates tested were resistant to:piperacillin/tazobactam (40%), cefatazidim (28%), ciprofloxacin (20.5%), imipenem (22%), and amikacin (22%).Severe sepsis or septic shock occurred in 49% of episodes. Crude mortality was (18%, 11 of the 60 patients) all caused by septic shock. In univariate analysis factors associated with severe sepsis or septic shock were: Isolates from more than one site (p=0.04), Absolute neutrophil count < 0.1 × 109/l (p=0.003), concomitant infection with other microorganism (p=0.019), fever lasting for more than 3 days in patients with antibiotherapy (p=0.003), C-reactive protein > 100 mg/l (p <0.0001), serum lactate >2.2 mmol/l (p< 0.0001), serum bicarbonate < 19 mmol/l (p=0.002), hemoglobin level < 70g/l (p<0.0001), renal failure (p=0.006), hypophosphatemia <0.8mmol/l (p=0.003), total bilirubin > 50 μmol/l (p=0.03), and hypoproteinemia <64g/l (p<0.0001). By multivariate analysis, antibiotherapy for more than 3 days (p=0.025,OR=0.217, 95%CI:0.05-0.82), absolute neutrophil count <0.1× 109/l (p=0.046,OR=170;95% CI:1-267), C-reactive protein >100 (p=0.04,OR=15,95%CI: 1,1-219,8), hemoglobin level <70g/l (p=0.037,OR=17,95%CI: 1,1- 243), and hypophosphatemia (p=0.02,OR=148,95%CI:2.2-942) remained as independent predictors of severe sepsis or septic shock. Conclusions This study revealed that several factors such as level of neutrophil count, C-reactive protein, hemoglobin level, severe hypophosphatemia, and antibiotherapy > 72 h before microbiological documentation may play a significant and independent role for the development of severe sepsis/septic shock and increase mortality of Pseudomonas infections in patients with hematological malignancies. Disclosures: No relevant conflicts of interest to declare.

scholarly journals High Toxicity and Poor Survival with Association CHOP Plus Etoposide Compared to CHOP Regimen in 124 Brazilian Patients with Nodal PTCL Lymphomas (nPTCL): A Real-Life Experience

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1398-1398
Author(s):  
Luis Alberto de Padua Covas Lage ◽  
Claudio Vinicius Brito ◽  
Guilherme Carneiro Barreto ◽  
Cadiele Oliana Reichert ◽  
Débora Levy ◽  
...  
Keyword(s):  
Latin American ◽  
Clinical Laboratory ◽  
Univariate Analysis ◽  
Real Life ◽  
Prognostic Impact ◽  
First Line ◽  
Chop Regimen ◽  
Factors Associated ◽  
Epidemiological Characteristics

Abstract Introduction: Nodal PTCL constitute a heterogeneous group of rare malignancies derived from CD4+ T-helper, CD8+ T-cytotoxic or follicular T-helper lymphocytes. It presents aggressive clinical-biological behavior and distinct outcomes [1]. These tumors have significant geographic variation, making important studies of clinical and epidemiological characteristics and outcomes of patients in specific areas of the word. Latin American data on nPTCL are scarce in the literature [2] and its first-line treatment is still controversial and ineffective, due to high rates of primary chemo-resistance. Therefore, this study aims to describe clinical, laboratory and epidemiological characteristics, identify prognostic factors and analyze the outcomes of patients with nPTCL treated with CHOP/CHOP-like regimens as first-line therapy in Brazil. Methods: This is a retrospective, observational and unicentric study involving 124-Brazilian patients with nPTCL treated at HC/FMUSP from January 2000 to December 2017. All cases were submitted to centralized histopathological review and classified according to WHO-2016 criteria on PTCL/NOS, AITL, ALK+/ALCL or ALK-/ALCL. Clinical-laboratory and outcomes data were obtained from digital medical records. Descriptive variables were arranged in absolute numbers and relative frequencies. OS and PFS curves were estimated by the Kaplan-Meier method. Univariate Cox analysis was used to determine factors with prognostic impact through the association between categorical variables and survival curves. Variables that were significant in the univariate analysis were tested in a multivariate analysis to establish independent variables. Statistical analysis was performed using SPSS V.22 software and p-values ≤ 0.05 were considered statistically significant. Results: The clinical-laboratory characteristics of 124 nPTCL patients were summarized in Table 1. With a median age of 48.5 years (18-87 years) and 57.3% of male, about 81.5% had B-symptoms, 88.7% with CS III/IV and 58.1% had IPI ≥ 3. ORR to first-line treatment was 58.9%, 37.9% (47/124) were treated with CHOP regimen and 35.5% (44/124) with CHOEP, 30.1% (37/124) were submitted to radiotherapy and 32.3% (40/124) were consolidated with ASCT. We observed a higher 2-year OS for patients treated with CHOP versus CHOEP (78.7% vs. 61.4%; p=0.05), as well as a better 2-year PFS for the same regimen (69.7% vs. 25.0%; p&lt;0.0001) - Figure 1. CHOEP treatment was associated with higher rates of G3-4 neutropenia, febrile neutropenia and G3-4 thrombocytopenia (57% x 88% p=0.001, 38% x 70% p=0.003 and 27% x 63% p=0.0007, respectively). Overall mortality was 55.6% (69/124) during all follow-up, with disease progression being the major cause of death (29/69 - 42.0%). With a median follow-up of 23.7 months (0.10-278.6 months), medians of OS and PFS were 48.0 months (95% CI: 9.0-86.9) and 8.8 months (95% CI: 3.9-13.7), respectively. Estimative of 2-year OS and PFS for the global cohort were 61.3% and 41.5%, respectively. In the univariate analysis, factors with a favorable prognostic impact on OS were: IPI &lt; 3 (HR: 0.30; 95% CI: 0.15-0.58; p&lt;0.0001), absence of bone marrow infiltration (HR: 0.39; 95% CI: 0.20-0.75; p=0.005), LDH &lt; 480 U/L (HR: 0.36; 95% CI: 0.19-0.68; p=0.002), radiotherapy (HR: 0.23; 95% CI: 0.10-0.55; p=0.001) and ASCT (HR: 0.28; 95% CI: 0.004-0.30; p&lt;0.0001). Factors associated with better 2-year PFS were: IPI &lt; 3 (HR: 0.36; 95% CI: 0.18-0.71, p=0.004), absence of bone marrow infiltration (HR: 0.30; 95% CI: 0.26-0.55; p=0.03 ), LDH &lt; 480 U/L (HR: 0.36; 95% CI: 0.19-0.67; p=0.001), radiotherapy (HR: 0.17; 95% CI: 0.06-0.44; p&lt;0.0001) and ASCT (HR: 0.03 ; 95% CI: 0.004-0.23); p=0.001). In the multivariate analysis, factors associated with better 2-year OS were: LDH &lt; 480 U/L (HR: 0.40; 95% CI: 0.21-0.76); p=0.005) and ASCT (HR: 0.47; 95% CI: 0.006-0.34; p=0.003). LDH &lt; 480 U/L (HR: 0.45; 95% CI: 0.23-0.87; p=0.01) and ASCT (HR: 0.07; 95% CI: 0.01-0.54; p=0.01) were also associated with higher 2-year PFS. Conclusion: This is the largest real-life Latin American nPTCL cohort published to date. Patients with nPTCL have poor survival and high rate of chemo-resistance. In our cohort, adding etoposide to the CHOP regimen showed no survival benefit and was associated with high toxicity. Normal values of LDH and consolidation with ASCT were independent factors associated with better outcomes in Brazilian patients with nPTCL. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Observational cohort study of first-line bevacizumab with oxaliplatin or irinotecan and fluoropyrimidines in metastatic colorectal cancer: HGCSG0802—Analysis of early tumor shrinkage (ETS).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 753-753 ◽  
Author(s):  
Satoshi Yuki ◽  
Hiroshi Nakatsumi ◽  
Kentaro Sawada ◽  
Takashi Kato ◽  
Takashi Meguro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Metastatic Colorectal Cancer ◽  
Univariate Analysis ◽  
First Line ◽  
Factors Associated ◽  
Early Tumor Shrinkage ◽  
Significant Difference ◽  
Early Tumor ◽  
Line Chemotherapy

753 Background: It was reported that early tumor shrinkage (ETS) was associated with better overall survival (OS) in patients (pts) with metastatic colorectal cancer (mCRC) receiving first line chemotherapy. We investigated association of ETS with progression-free survival (PFS) and OS in pts with mCRC treated with first-line bevacizumab (BV)-based chemotherapy (HGCSG0802). Methods: The objective of HGCSG0802 was to evaluate PFS, OS, response rate (RR), safety and so on. The key eligibility criteria were evaluable lesions, older than 20 years old, ECOG PS 0-2. This analysis evaluated the association of ETS at 8 weeks from the start of chemotherapy with pts characteristics, PFS and OS. To identify factors associated with ETS, if there were clinical variables with p < 0.2 in univariate analysis, we planned a multivariate analysis using the logistic regression model. To identify predictive and prognostic factors, a multivariate analysis was performed using Cox proportional hazard model with backward elimination for variables with p < 0.2 in univariate analysis. Results: Of 108 pts (the full analysis set), 99 pts were evaluable for ETS. Sixty-eight pts (68.7%) had ETS ≥20%. The pts characteristics between ETS ≥20% (ETS) and <20% (Non-ETS) were well balanced. In univariate analysis to identify factors associated with ETS, there were no clinical variables with p < 0.2. The median PFS and OS were 7.3/18.3 months in Non-ETS versus 10.0/25.2 months in ETS (HR 0.529; p=0.006 and HR 0.627; p=0.107). In multivariate analysis for PFS and OS, although there was no significant difference between ETS and Non-ETS for OS (HR 0.709; p=0.186), there was significant difference for PFS (HR 0.524; p=0.006). Conclusions: ETS was observed in 68.7% (68/99) and non-ETS in 31.3% (31/99) of patients with metastatic colorectal cancer received bevacizumab combined first line chemotherapy. In univariate analysis, it could not identify any factors associated with ETS. In the results of multivariate analysis, ETS showed an independent predictive impact, but not prognostic impact. Clinical trial information: UMIN000018935.

scholarly journals Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260233
Author(s):  
Chuthamas Sripongpunkul ◽  
Aisawan Petchlorlian ◽  
Tanchanok Chattaris ◽  
Saran Thanapluetiwong ◽  
Orapitchaya Sriwannopas ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Weight Loss ◽  
Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Hemoglobin Level ◽  
University Hospital ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Common Causes

Background Unintentional weight loss (UWL) is defined as unintentional reduction of more than 5% of baseline body weight over 6 to 12 months. UWL is a common problem in the older adults, resulting in increased rate of morbidity and mortality. With specific reference to Thailand, no information on factors associated with UWL in older adults could be traced. The aims of this research were to identify the factors associated with UWL and to assess the common causes of UWL among older adults in the geriatric outpatient clinic of university hospital. Methods A case-control study was conducted from June 1st, 2020 to December 31st, 2020. Eighty older adults aged 60 years or older were enrolled in the UWL group while the non-UWL group consisted of 160 participants. Data collection was performed by structural questionnaire including baseline characteristics, psychosocial factors, health information, lifestyle behaviors, and medications. The factors associated with UWL were analyzed by using univariate and multivariate logistic regression analysis. Causes of UWL were recorded from electronic medical records. Results The mean age of the 240 participants was 79.6 years (SD 7.4). Most patients were female (79.2%) and had fewer than 12 years of education (62.6%). The three common causes of UWL were reduced appetite (20.1%), dementia and behavioral and psychological symptoms of dementia (13.7%) and medications (11.0%). Multivariate logistic regression analysis showed that a Charlson Comorbidity Index (CCI) score of >1 (OR 2.55, 95% CI 1.37–4.73; P = 0.003), vitamin D deficiency (OR 4.01, 95% CI 1.62–9.97; P = 0.003), and hemoglobin level of <12 g/dL (OR 2.47, 95% CI 1.32–4.63; P = 0.005) were factors significantly associated with UWL. Conclusions Factors associated with UWL were CCI score >1, vitamin D deficiency, and hemoglobin level of <12 g/dl. The early detection of these associated factors, reduced appetite, dementia and polypharmacy may be important in UWL prevention in older adults.

scholarly journals Factors associated with mortality in newborn infants with meconium aspiration syndrome

2017 ◽  
Vol 41 (1) ◽  
pp. 6
Author(s):  
Asril Aminullah ◽  
Jonardi Sarmili ◽  
Sudigdo Sastroasmoro
Keyword(s):  
Mechanical Ventilation ◽  
Univariate Analysis ◽  
Mode Of Delivery ◽  
Newborn Infants ◽  
Meconium Aspiration Syndrome ◽  
Apgar Scores ◽  
Meconium Aspiration ◽  
Factors Associated ◽  
Common Causes ◽  
Tracheal Suctioning

Meconium aspiration syndrome (MAS) is still one of the common causes of morbidity and mortality in neonatal period. A retrospective study was conducted from January 1993 to December 1999, to identify factors associated with mortality in MAS. Univariate analysis disclosed that preeclampsia/eclampsia, sex, Apgar scores, consistency of meconium, and use of mechanical ventilation were significantly associated with mortality in MAS, while gestational age, mode of delivery, hypertension, birth weight, tracheal suctioning, blood cultures, and complications were not. Logistic regression analysis showed that mode of delivery, preeclampsia/eclampsia, Apgar scores, consistency of meconium, and use of mechanical ventilation were associated with mortality in MAS, while other variables were not.

Functional Decline in Older Patients With Cancer Receiving First-Line Chemotherapy

2013 ◽  
Vol 31 (31) ◽  
pp. 3877-3882 ◽  
Author(s):  
Stéphanie Hoppe ◽  
Muriel Rainfray ◽  
Marianne Fonck ◽  
Laurent Hoppenreys ◽  
Jean-Frédéric Blanc ◽  
...  
Keyword(s):  
Older Patients ◽  
Rating Scale ◽  
Univariate Analysis ◽  
Functional Decline ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
First Line ◽  
Factors Associated ◽  
Increased Risk ◽  
Line Chemotherapy

Purpose To determine factors associated with early functional decline during first-line chemotherapy in older patients. Patients and Methods Patients age ≥ 70 years receiving first-line chemotherapy for cancer were prospectively considered for inclusion across 12 centers in France. Functional decline was defined as a decrease of ≥ 0.5 points on the Activities of Daily Living (ADL) scale between the beginning of chemotherapy and the second cycle. Factors associated with functional decline were sought from pretreatment abbreviated comprehensive geriatric assessment, including ADL, Instrumental ADL (IADL), Mini-Nutritional Assessment (MNA), Mini–Mental State Examination (MMSE), Geriatric Depression Scale (GDS15), and Timed Get Up and Go (GUG) test, and from comorbidities (Cumulative Illness Rating Scale–Geriatrics), MAX2 index, and baseline biologic and clinical information. Results Of 364 included patients, 50 experienced functional decline (16.7%; median, 0.5 points). Abnormal preadmission performance status, IADL, GDS15, MMSE, GUG, and MNA were associated with increased likelihood of functional decline (univariate analysis). In the multivariate model adjusted for baseline ADL and MAX2 index, high baseline GDS (odds ratio [OR], 2.16; 95% CI, 1.09 to 4.30; P = .03) and low IADL scores (OR, 2.87; 95% CI, 1.06 to 7.79; P = .04) were independently associated with increased risk of functional decline. Conclusion Our results outline associations between baseline depression, instrumental dependencies, and early functional decline during chemotherapy for older patients. ADL should be sequentially evaluated early during treatment. Baseline evaluation of GDS15 and IADL may be proposed to anticipate this event.

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

scholarly journals Impella CP Implantation during Cardiopulmonary Resuscitation for Cardiac Arrest: A Multicenter Experience

2021 ◽  
Vol 10 (2) ◽  
pp. 339
Author(s):  
Vassili Panagides ◽  
Henrik Vase ◽  
Sachin P. Shah ◽  
Mir B. Basir ◽  
Julien Mancini ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Univariate Analysis ◽  
Cerebral Performance Category ◽  
Neurological Impairment ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Factors Associated ◽  
Analysis Survival

Background: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. Methods: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. Results: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (p = 0.035 and p = 0.008, respectively). Conclusions: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.

Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children

2020 ◽  
pp. 1-12
Author(s):  
P J Clamp ◽  
K De-Loyde ◽  
A R Maw ◽  
S Gregory ◽  
J Golding ◽  
...  
Keyword(s):  
Cohort Study ◽  
Otitis Media ◽  
Maternal Education ◽  
Univariate Analysis ◽  
Chronic Otitis Media ◽  
Birth Cohort Study ◽  
Control Group ◽  
Factors Associated ◽  
Prospective Longitudinal

Abstract Objective This study aimed to analyse social, health and environmental factors associated with the development of chronic otitis media by age nine. Method This was a prospective, longitudinal, birth cohort study of 6560 children, reviewed at age nine. Chronic otitis media defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma. Non-affected children were used as the control group. Results Univariate analysis demonstrated an association between chronic otitis media and otorrhoea, snoring, grommet insertion, adenoidectomy, tonsillectomy, hearing loss, abnormal tympanograms and preterm birth. Multivariate analysis suggests many of these factors may be interrelated. Conclusion The association between chronic otitis media and otorrhoea, abnormal tympanograms and grommets supports the role of the Eustachian tube and otitis media (with effusion or acute) in the pathogenesis of chronic otitis media. The role of snoring, adenoidectomy and tonsillectomy is unclear. Associations suggested by previous studies (sex, socioeconomic group, parental smoking, maternal education, childcare, crowding and siblings) were not found to be significant predictors in this analysis.

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